. 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
: