planning/statistical unit. As to the handling of Federal categorical grants i.e. C rvical Cancer Screening, Meals-on-Wheels, etc., this is even more unsure. depends on negotiations between the U.S. and the MIG. The outcome It s ems to be the desire of the Marshallese to still be eligible for some of t e categorical grants, but they don't want the funds to be tied to a lengthy ealth Systems Agency certificate-of-need process. fficient It would seem more and politically palatable to the Marshallese if funds were alloca ed “globally” in block grants (directly from government to government) to cover all agreed-upon health service needs. nting of the Administration and acc funds would be done by the Ministry of Health or its contr ctor directly with the funding federal agency, without an intermediary “ogtside" Health Planning agency dictating requirements. Continuing relationships with TTP] for manpower training, consultation on specialized medical problems, special grants, etc., wou probably be continued but preferably on a low-key “voluntary” basis. A Function which is as yet unclarified is the whole licensing/credentialing pfocess of both institutions (hospitals, technicians). lab, etc.) and manpower (nurseg, physicians, Some officials in the MIG would like to asqume that role themselves, while others would like to keep this process tid to the U.S. systems. The outcome of this decision could determine a lot the MIG will be tied to TTPI Bureau of Health Services and fon how closely al the federal categorial grants they control. E. Categorical U.S. Funded Programs The present Ministry of Health Services has a Public (under the hospital administrator) which performs most healt prevention services. It includes among others: alth Division promotion and environfhental health, maternal and child health, health education, crippled children's services, special clinics (i.e. diabetes, leprosy, hypertension), continuing education for health assistants, etc. immunizations, All of the e administered by the Majuro Hospital and funded partially by the MIG and paftially by U.S. categorical grants. other ministries Many other health related services are administered by of the government. This unfortunately has caused considerable inefficiency and duplication of effort, not to[mention fiscal accounting problems. af