-8- 5. Definition of Comprehensive Health Care The Interior Department proposes to provide to the contractor the following definition of comprehensive health care: Primarv Care Primary care is the care received when the patient first seeks assistance from the medical care system. The care at that point would include the care and treatment of the simpler and/or more common illnesses, or determine the need for consultation with or referral to medical specialists. In addition to immediate care, primary care may also include ongoing responsibility for the patient in both health maintenance and therapy.Secondzrv Care Secondary care is the care provided by medical specialists who generally do not have first contact with the patient, for example, neurologists, This care generally cannot be provided internists, and dermatologists. at the primary care level and is obtained upon consultation or referral through the primary health care system. Tertiary Care Tertiary care consists of se?mices provided by highly specialized medical and neurosurgeons. such services personnel, for example, #@ologists generally require highly sophisticated technological and support facilities, such as intensive care units and specialized surgical facilities. These specialized services and facilities generally are not available at the secondary care level. 6. Responsibilities of the Contractor The Department of the Interior proposes to require the contractor to offer advice, by mid-November, on at least the following issues: (a) A plan to provide for comprehensive health care for the inhabitants of Bikini, Enewetak, Rongelap, and Utirik, and for the <fitiitan=> of additional atolls if they have been affected by radiation As noted in point 2 above, in from the nuclear weapons testing program. deciding whether the inhabitants of additional atolls have been so affected, the Secretary would consider information obtained from on-site health evaluations of the people of those atolls, and other relevant information presented to him. It would be anticipated that the health evaluations would focus initially on atolls of the Northern Marshall Islands, beyond the four specified. The sequence in which atolls would be investigated would be developed following consultation with the representatives of the people of each of the affected atolls and the Government of the Marshall Islands.