LITERATURE WAS REVIEWED, QUESTIONNAIRES WERE DISTRIBUTED, AND EACH INSTITUTION IN WASHINGTON STATE WAS VISITED. THE TWO MAJOR AREAS UNDER STUDY WERE ADMINISTRATION AND CLINICAL SERVICES. THE FORMER INCLUDES STRUCTURAL ORGANIZATION, BUDGET AND FINANCE, PERSONNEL, AND INTRA-AGENCY RELATIONSHIPS. CLINICAL SERVICES INCLUDES THE FOLLOWING: STRUCTURE OF SERVICE DELIVERY; MEDICAL SERVICES; PHYSICIAN SERVICES; NURSING SERVICES; DENTAL SERVICES; MENTAL HEALTH SERVICES; AND ANCILLARY SERVICES, INCLUDING LABORATORY AND X-RAY, PHARMACY, MEDICAL RECORDS, AND HEALTH EDUCATION.