The second year of the Kentucky, Ohio, Michigan Regional Medical Library (KOMRL) might be characterized as one in which there was operational stability, but continuous confusion of purpose and direction. Although the administrative structure remained unaltered and the number of papers produced and the meetings held were considerable, the program was handicapped by a lack of funding in meeting its proposed objectives. The objectives, procedures and quality of service may not continue to be a satisfactory base from which to operate in providing the optimum service to meet the needs of the biomedical community. An attempt is made to bring out facts, opinions and assessments on the possible functions and directions for a regional medical library which is to consider health resources as a national problem and to meet its user needs. (AB)