planning/statistical unit. As to the handling of Federal categorical grants i.e. Cervical Cancer Screening, Meals-on-Wheels, etc., this is even more unsure. depends on negotiations between the U.S. and the MIG. The outcome It seems to be the desire of the Marshallese to still be eligible for some of the categorical grants, but they don't want the funds to be tied to a lengthy Health Systems Agency certificate-of-need process. It would seem more efficient and politically palatable to the Marshallese if funds were allocated "globally" in block grants (directly from government to government) agreed-upon health service needs. to cover all Administration and accounting of the funds would be done by the Ministry of Health or its contractor directly with the funding federal agency, without an intermediary “outside” Health Planning agency dictating requirements. Continuing relationships with TTPI for manpower training, consultation on specialized medical problems, special grants, etc., would probably be continued but preferably on a low-key “voluntary” basis. A function which is as yet unclarified is the whole licensing/credentialing process of both institutions (hospitals, technicians). lab, etc.) and manpower (nurses, physicians, Some officials in the MIG would like to assume that role themselves, while others would like to keep this process tied to the U.S. systems. The outcome of this decision could determine a lot on how closely the MIG will be tied to TTPI Bureau of Health Services and all the federal categorial grants they control. E. Categorical U.S. Funded Programs The present Ministry of Health Services has a Public Health Division (under the hospital administrator) which performs most health promotion and prevention services. It includes among others: environmental health, maternal and child health, health education, crippled children's services, special clinics (i.e. diabetes, leprosy, hypertension), continuing education for health assistants, etc. immunizations, All of these administered by the Majuro Hospital and funded partially by the MIG and partially by U.S. categorical grants. other ministries Many other health related services are administered by of the government. This unfortunately has caused considerable inefficiency and duplication of effort, not to mention fiscal accounting problems.