', Irganizaticnal Issues
A.
Organizational Chart
The present structure of the Marshall
Islands health care system is
typical down to the level of Secretary of Health.
several views as to what exists.
recent
contract
with
Adventist Church.
the
Below that 1
el there are
This problem has been magnified by the
Guam/Micronesia
Mission
of
the
Seventh-day
The best concensus appears to be that the Gu
Mission has
contracted to administer the two hospitals, and traditionally al
health care
activity is under the direction of the hospitals.
section IV.
(See followi
B. and the contract in appendix F for additional information).
Another factor which
complicates
the
administration
and] delivery of
health care is that other departments outside the Ministry o
Health are
responsible for providing support services to the hospitals and clinics.
For
example, the Department of Public Works is responsible for prov ding ground,
equipment, and facility maintenance.
When Public Works doesn't have the time
or money, things do not get done regardless
delivery of health care.
of need and
in pact on the
The proposed organizational structur] anticipates
all support services to be budgeted items and under the control
f the health
delivery system.
In designing the proposed organizational structure, the fo lowing items
were of concern:
l.
Effective and accessible health care
2.
Interests of the two governments
3.
A functional health care organization
The organizational chart which follows reflects an orga ization that
deals with these concerns.
To facilitate an understanding of
[the proposed
structure, a short description of the function/responsibilitieq
for certain
areas will be provided.
Financial
Intermediary/Program Implementator (FIPI) :
It
that this will be an entity mutually agreed to by the U.S. andj
Islands.
This would be a university, a private firm, or somP
agency.
Its primary function would be to provide fiscal
implement
the
approved
program.
participation
in
the
health
envisioned
the Marshal]
appropriate
ntegrity and
Under this proposed organization,
Guam/Micronesia Mission would not be the FIPI.
their
s
care
the
We are recommending that
delivery
system
ocus
on
the
management of the two hospitals (division of secondary and te ‘tiary care).
1&2