of a Medical Referral Board that now screens and approves all referrals. But the point of major, eurrent importance is that the Marshall Islands Govermaent has funds for outside referral costs. If emergency situations result and the fund is exhausted, additional funds could be made available to this account by reprogramming or by special appropriations of the Marshall Islands Legislature, the Nitijela. The Majuro Hospital now is 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 eondition regardless of residence. The Bikini situation you cite is wnique in thet the agreement to provide special medical care was connected with the emergency evacuation of the group of 144 Bikinfans from Bikini Island in August of 1978. These individuals believed that they had received contamination by living on Bikini Island, and the agreement was made wnder 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 ia 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 that cannot be treated locally to Honolulu. Sincerely yours, (Signéd Billy Lee Hart Acting Deputy Assistant Secretary - Operations Territorial and International Affairs