. Iv. TIL, Translation ‘Restatement of refined objectives '4n consideration of restraints. As in Opcion A - The increased . . terms of: patient care demanded by Gption B What: matipower and logistics (funding) since the increase is directly fand is, therefore, not DOE's responsibility, perhaps some inter- } agency agreement with DOI could be reached to provide this supple- ment. In addition, if, under the “free association" agreement the DOD- Kwajalein taxes are to paid directly : to.the Marshall Islands, some fixed F portion might be diverted to pri- mary medical care under a DOD/KwajMarshall Islend Government agreement. a V. ——Po Performance or results As in Option A - However, the section on radiatiofirelated ‘diseases will neec to be expanded to include those age and sex specific general medical problens Ag in Option A - plus * screening, care and fol-ow-up. ‘who: As-in Option A - BNL is4 not currently associated with radiation. ° st Be " Where: Screening, care and Bee, 5 follow-up of exposed and cogrrol’ groups wherever we can locate’ them. f _When: As in Option A — plus regular intermittent visits { (every 24 months) for foliow-* up of non-radiationrelated ‘problems (already being done) How: to cut back on our present commitments to> comply with atherosclerosis in young females, evidence for alcoholism will ber sought in gd hag Bb The methodology of Robbins and bali will be used to determine what specific historical, physical, and laboratory findings would be most sensitive and specific to detect the most prevalent diseases (age and sex-determined, e.g., we will notlook for coronary ) - currently exceeding Option Bin its j active commitment. Selection Criteria Set forth tha criteria for the selection of an approach: - ‘selected "risk hazard appraisal" will require a slight increase in frelated to primary patient care Analysis Develop possible approaches tof attaining the objectives, witht each approach being stated inf young and old males, etc.). . . Total Cost Sl woeTEL As in Option A -but we can cancel out the specific education " pragvan {explaining the cut in services). The various cost trade-offs have been discussed in the previous sections of this option. We must keepin mind, that this option is still below our present commitment, - ft. : sf i There is increased flexibility with this option. We feel the ‘BNL tean stationed at Ebeye cculd handle this additional load without problems -~ in fact, it would enrich their ‘Practice and provide some welconé{variety, Avoidance of untoward consequences # .The added flexibility and commit:.entof the DOE/BNL team should?enhance our ~ shaky credibility and generate trie gratitude among some. of theMarshallese. The critical point is never to promise more than you can delivers. The ' credibility gap may be partially patched by saying "I don’t know™ more frequently and by forwarding all pertinent data onto interested!Marshallese elie: costs screening care and? stgpifics cilities Fo: “a ES ove: > ‘complLar . i Be " The risks to DOE/ENL are less than with Option A - Rouever,thia level of effort is below the current program and will cause some adverse”Feaction ” ee me a ee ag,*rekuras tical Mags" Risk (publicity, cooperation, etc.),. ms The risks to the Marshallese are that a great deal of potengiiy eveatable disease will be excluded from our attention by this option. Cost/effecriveness As in Option A As in Option A - The increased population would not opprsciauly«cha ange our existing schedule. wea pe Serer ne as soon as it is available. « oe See i oia te gen nage :