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