administrator did not know about.)
oo
There are no “management reports" dealing
with the relationships between costs and services provided to assist in the
effective administration of the health delivery systems.
While much of the
information is "known", there is no system for recording,
accumulating,
analyzing, and presenting the information for effective management.
This
must be a high priority item in the implementation of the health care program
under 96-205.
For details with respect to the financial considerations for
the proposed health plan, refer to the budget sections.
D.
Five-year Plan/Trust Territory Relationship
Until recently most decision-making over finances, manpower, health
planning, etc. for the various health districts in TTPI were directly under
the control of the Director of the Bureau of Health Services, Office of the
High Commissioner, TTPI Saipan.
With the decision of the Marshalls to go to
a Freely Associated State path (separate from Federated States of Micronesia
or Guam) a period of uncertain transition has set in.
In the area of health planning, all the districts until recently came
under the jurisdiction of the TT State Health Planning and Development
Agency.
is
Like all Health Service Agencies in the U.S., on which this agency
modeled,
the
development
of
a
five-year
health
plan
and
annual
implementation plan is to be drafted and submitted to a consumer-provider
board, here called the Micronesian Health Coordinating Council.
On March 29, 1980 the Five-Year Plan covering 1981-1986 was approved by
this Council and submitted to the Regional Health Administrator, Public
Health Services, Health and Human Services, Region IX, San Francisco.
The
plan is presently being deliberated by the Nitijela (Marshallese Congress)
and is to be approved before funds under the control of various Federal
programs can be released.
Actual
implementation
of
the
plan
as
drafted
is
somewhat tenuous
because within a year (August 1981) the Marshalls will probably no longer be
under the State Health Planning Agency's jurisdiction.
The Marshall Islands
Government (MIG) may yet opt as part of the current U.S. - MIG negotiations
to remain within it.
has
in
essence
activities
But the latter is unlikely, particularly since the MIG
expressed
its
desire
to
turn
over
all
health
service
to the Seventh-day Adventist Church on a contractual basis.
Thus, the most likely result is that the Marshallese Health Services wil]
need
to
very
quickly
set
up
their
own
independent
health