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