of a Medical Referral Board that now screens and approves all referrals. But the point of major, eurrent importance is that the Marshall Islands Government has funds for outside referral costs. If emergency situations result and the fund ie exhausted, additional finds could be made available to this aceount by reprogramming or by special appropriations of the Marshall Islands Legislature, the Nitijela. The Majfuro Hospital now ig run by a medical care contractor. Part of the contract calls for up-grading of medical staff at the Majuro Hospital, and specialized staff is being made available. Conditions are improving at the Majuro Hospital. Obviously, a Rongelapese who requires emergency open-heart surgery would have to be referred to Honolulu, but this also would be the case for any Marshallese individual in a similer condition regardless of residence. The Bikini situation you cite is unique in thet the agreement to provide special medical care was connected with the emergency evacuation of the group of 144 Bikinians from Bikini Island in August of 1978, These individuals believed that they had received contamination by living on Bikint Island, and the agreement was made under these very special circumstances. It did not provide for special medical coverage for Bikinians who were living on Kili Island or elsewhere in the Marshall Islands. Until a special comprehensive health care program is in effect pursuant to P.L. 96-205, non-radiation related medical cases that require treatment should be referred to the appropriate medical authorities in Majuro. The Medical Review Board there has the authority to refer cases thet cannot be treated locally to Honolulu. Sincerely yours, (Signed) Billy Lee Hart Acting Deputy Assistant Secretary - Operations Territorial and International Affairs