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who have been exposed to radioactive hazards resulting from nuclear

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testing at Enewetak and Bikini receive proper medica! follow-up and,

where appropriate, medical care.
Vhe amendment contained in section 103 would change the present
procedure where the Department of Energy performs and pays for the
services rendered under the current medical surveillance, care and
monitoring program, to one where the Secretary of the Interior would
fund the program, but could request the Department of Energy to

administer it,

The Department of Energy is presently conducting a program under
a general authorization for (1) radiological monitoring of people
and the environment of Rongclap, Utirik, Bikini, and Enewetak, and
(2) providing medical care to those people who mayhavesufferedillness or injury as a result of our nuclear weapons testing program. The
medical part of the prograia primarily consists of quarterly exarainations of the exposed people and the stationing of a resident physician
in the Marshall Islands. In addition, general sick-calls are periodically
held forall persons on the affected atolls. Those who have non-radiation related aliments are referred to appropriate Trust Territory

medical personnel. Specialized examinations ure also conducted on a
periodic basis. Individuals who are diagnosed as suffering from ill-

nesses or injuries which are likely related to radiation exposure receive
comprehensive treatment under the Energy program. Program costs

in fiscal year 1979 were about $3 million, with 590 persons underdirect
medical surveillance.

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The Administration agrees that the present. program should be
specifically authorized, but recommends that the Department of
Energycontinue to administer both the medical surveillance and radivlogical monitoring. The Department of Energy has both the medical
and scientific expertise necessary for proper program management and
continuity, without the administrative complexity and cost of one
department contracting with another to perform the program, We also
believe that the program should be funded through Energy (in consultation with Interior and others) so that program costs are clearly

reflected as arising from this country’s nuclear testing program, not

from our administration of the territories..
We, therefore, propose a substitute to section 103 that contains the

Administration’s recommended changes. Our proposed substitute
would not only fully extend the Department of Energy’s present program to Enewetak, but it would also give the Secretary of Energydis--

eretion to designate as eligible for assistance any other atoll in the

Marshalls, the people of which are determined to be in need of medical
survelllance and care. We believe this flexibility is necessary in order
to provide assistance to any other Marshallese who may be subsequently found to have been exposed to radiation as a reslt of the
nuclear weaponstesting program.
The Administration’s substitute would also clarify the fact that the
program would pro:ide medical care for illnesses or injuries which
mayhave resulted from nucleartesting, and is not intended to provide
comprehensive health care for general medical or phychiatric problems
that are unrelated to the testing program.
Oursubstitute for section 103 1s as follows:
Sec. 108. The Act entitled “An Act to authorize certain apprepriations for the territories of the United States, to amend certain Acts

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