fo." administrator did not know about.) There are no "management repprts" dealing with the relationships between costs and services provided to effective administration of the health delivery systems. information is “known", &ssist in the Whil@ there is no system for recording, much of the &ccumulating, analyzing, and presenting the information for effective management. This must be a high priority item in the implementation of the health} care program under 96-205. For details with respect to the financial considerations for the proposed health plan, refer to the budget sections. D. Five-year Plan/Trust Territory Relationship Until recently most decision-making over finances, mangower, health planning, etc. for the various health districts in TTPI were directly under the control of the Director of the Bureau of Health Services, High Commissioner, TTPI Saipan. Dffice of the With the decision of the Marshalls to go to a Freely Associated State path (separate from Federated States Pf Micronesia or Guam) a period of uncertain transition has set in. In the area of health planning, all the districts until fecently came under the jurisdiction of the TT State Health Planning and Agency. is Development Like all Health Service Agencies in the U.S., on which this agency modeled, the development of a five-year health plan and annual implementation plan is to be drafted and submitted to a conshmer-provider board, here called the Micronesian Health Coordinating Councif. On March 29, 1980 the Five-Year Plan covering 1981-1986 was this Council and submitted to the Regional approved by Health Administ¥ator, Public Health Services, Health and Human Services, Region IX, San Frfncisco. The plan is presently being deliberated by the Nitijela (MarshallPse Congress) and is to be approved before funds under the control of vafious Federal programs can be released. Actual implementation of the plan as drafted is som@what tenuous because within a year (August 1981) the Marshalls will probably no longer be under the State Health Planning Agency's jurisdiction. The Marshall Istands Government (MIG) may yet opt as part of the current U.S. - MI@ to remain within it. has in essence activities But the latter is unlikely, particularlyJsince the MIG expressed its desire to turn over all ha@alth to the Seventh-day Adventist Church on a contrfctual Thus, the most likely result is that the Marshallese Health need to negotiations very quickly set up their own service basis. Bervices will independent health