OPTLON C
ALE gadivtion rebated diseases in the exposed and control groups on Rungelap and
Uticth plus all iow level radiation exposed pattents who have already yone
through full screening - irrespective of
1,
findings of disease
Establish che broad objectives
As in Options A and & bue adding
all patients, exposed to low level
Il.
Existing Potlcy
As in Options A and B,
Thia option refleces exis¢ ing
sereening will be modifted as derailed
de facto fleld policy.
Hobbins and tall.
Existing needs and demands
As in Option A and B.
Adding a
for the "Wirected data base - risk
hazard appraisal" approach of
portion of the Bikint populetion wl)l
probably not fulfith the Marshallese
demands or needs.
Projected needs and demands
As in Option A and &
It scems
probable that we will be unable co
separate, for medical purpases,
the Bikini people who returned to
Bikini from the remainder on Kilé.
The Eniwetok people will probably
alse demand equal treatmenc.
Planning ar ather levels
43 in Option A and 8.
U.S.
Powerful
congressional groups (Yates
Committee - on appropriations,
etc.) are interested in and investigating the well-being of
the Marshallese.
Existing facilities
As in Option A and 8.
A redesign and construction of o flexible,
mobile screening and treatment support
facility - would in che long run
increase efficiency and reduce
cost/patient.
Flnanciat
As in option A and B.
The signifi-
cant variable will be the (7) addition of the people of
Bikint and Enlwecok.
Manpower
As in Option A and 8B.
Aguin the additLon of Bikini and
Enivetok would more than double the outpatient load.
However, the staif could
probably handle the increased load wich che addition of a Physician Assistant
ead a nurse praccitioner.
Timing
DemographicPopulut lon
As in Uption ASB.
sere
nd.
As
[6 Oprion A and &,
oractyriatics
No further constraines (optimum timing).
Plus 41! patients (exposed ta lew lovel cuddatio) previously
Adding Bikans
(450) 4 Poiwetuk
(450).
I¥.
ILI, Tranalations
As in Gptions A and B.
rudiation, who have already yone
through the BNL screening procedures.
This represencgs the current level of
uperation. In the future, the
Constraince
Present levels of care
Restatement: of
reflned objectives
in constderacton
of restraints.
As in Options A and
B - Since this {3 our
present level of
operation with existing
funds - no significant
Cranskation of
objectives fs necded.
Analysis
V.
Develop possible approaches tu
attaining the objectives, with
each approach being stated in
terma of:
What:
AS in Options A and Bb.
Whe:
As in Options A and B, -
Selection Criteria
Set forth che criteria for
the selection of an approach:
_ Performance or results
As in Options A and B.
Totalcost
As in Options A and B.
Ser
- low: for discussion of costs.
ay TW,
plus all patlents, exposed
to low level radiation who huve
already gone through BNL
Flexibility
sctatuy of Blkinl and Eniwetok
will change requirements.
and manpower} + permits betrer acheduling,
screening procedure - again
Where:
As in Options A and B plus Kili, Jaluic, 7?
Enivetok ? Ujelang.
Whea:
As in Optiona A and B.
How: Tf the patient loud Ls
doubled and increased,
primary care la expected.
There will need to be upproxi-
mately a doubling of the operat
ing budgec with a 66% Increase
in personnel and a ship
assigned specifically to the
medical program.
Ic would de
prudent ta separate the
idencify of rhe BikiniEniwetok group from BNL We could retain administrative concrei and
function as advisors, but
a subconmtractor might
alleviate some of the
unxtety of the new study
group that would arise from
the “radiation” oriented
BNL group. We would suggest
the University of Hauwali as
the most suitable and interested party.
Funding for
this increase in primary care
might be obtained hy pass~
through funding from DOI.
As in Options A and & - Increasing EFlexibllicy due ro
larger responsibility for care and betcer support (logistic
Avofdance of untoward congcquences
As in Opetons A and B - plus added credit tor more
comprehensive care,
Risk
As in Options A and & - With increasing volume of
patient care che pussibility of ut.
-loor poor
performance may increase - 7?)
Gverc.
vente - thls
cun be offsec by adequate planning audi iugistie
supporr - Expanded operations withour these elements
should not be attempted.
Lost/effectéivenusas
As in Oprions A and B.
Timtag
As in Options A and B.
This Ls the optimum rime, in Lighe
of the political and soctologle situation in the Marshalls
to enlarge the progrum and to make a positive effurt to
change the image of the study.