meets or exceeds whatever threshold and credibility limits Congress or other bodies may recommend. As explained earlier, the committee does not intend to imply that all persons, in all counties, are automatically eligible for RECA compensation; rather, the committee’s recommendations regarding screening turn in part on proof of administrative eligibility (including calculation of an individual PC/AS for a RECA-compensable disease). Insofar as earlier recommendations have direct ramifications for HRSA and its RESEP program, we make suggestions here for their implementation.

Finally, we outline a planning framework that may help HRSA to strengthen its education and outreach programs. Our recommendations and examples for implementation of proven educational intervention strategies are aimed at overcoming barriers to effective outcomes-based education programs that could be adapted for future RECA and RESEP programs.

Education is one of nine core activities expected of RESEP grantees. Grantees have told HRSA that they need guidance in public education and outreach mechanisms to those at risk or experiencing symptoms as a result of exposure to radiation (letter from HRSA to committee via Dr. Isaf Al-Nabulsi dated May 6, 2004). In developing its Request for Applications (RFA), HRSA asked potential grantees to develop strategies to expand and enhance public outreach and education in the following six categories:

• The possibility of disease.

• Symptoms.

• The potential need for diagnostic evaluation.

• The availability of screening for disease through RESEP.

• The possibility of compensation through RECA.

• The need for documentation of medical and occupational history if RECA claim is filed.

Although the RFA speaks to symptoms, as explained in Chapter 9 screening is a term that usually applies to asymptomatic individuals. If patients are symptomatic, the perspective is one of diagnosis and treatment, if indicated.

The main elements of RECA were reviewed in the several earlier chapters that dealt with the history of the program, compensation under the current program, and new information and science that will influence future developments. Chapters 9 and 10 examined the screening aspects of the RESEP program. We comment briefly here on the audiences, responsibilities, activities, and funding of the HRSA’s RESEP effort.