LEY NÚM. 21.621

STRENGTHEN THE VÍNCULO BETWEEN THE CLINESE HOSPITAL OF CHILE UNIVERSITY "DR. THE NATIONAL SYSTEM OF HEALTH SERVICES

Bearing in mind that the H. National Congress has approved the following

Bill:

"Article 1.- Introduce the following modifications to the decree by force of law No. 1, of 2005, of the Ministry of Health, which establishes the consolidated, coordinated and systematized text of Decree Law No. 2.763, of 1979, and of Laws No. 18.933 and No. 18.469:

1. Please refer to the following articles 17 bis, 17 ter and 17 quater:

"Article 17 bis.- The Clinical Hospital of the University of Chile is an establishment that forms part of the National Health Services System for the purpose of granting health care to the beneficiaries of the Health Benefits Scheme contained in Book II, in the care modality established in Article 141, paragraph 1, and will form part of the Health Care Network of one or more Health Services, under the or the agreements to be signed by the University of Chile, the National Health Fund.

The above, without prejudice to the authority of the Assistant Secretary of Assistance Networks to subscribe to or those referred to in representation of two or more Health Services for the purpose of integrating the Clinical Hospital of the University of Chile into the care networks of those services, in accordance with article 8 (c).

The Conventions that integrate the Clinical Hospital of the University of Chile to the Assistance Network shall, in order that the establishment take its responsibility, on behalf of the respective Health Service, according to the same payment and tariff mechanisms, a part of the beneficiary population of its territory, especially the inhabitants of the communes of Recoleta, Independencia, Conchalí, Huechuraba, Quilicura, Lampa, Til. Also, the high complexity benefits assigned to it for the implementation of actions to promote, protect and recover the health or rehabilitation of the sick.

The National Health Fund, the University of Chile, the respective Health Service, or the Assistant Secretary of Assistance Networks when signing the agreement, may apply for temporary suspension in the event of a serious breach of the obligations set out in the same instrument.

However, the agreements signed by the Ministry of Health with the Clinical Hospital of the University of Chile should aim to expand, among others, the training quotas for the specialty of geriatrics for the regions with the highest proportion of adults in the country.

Article 17 ter.- Persons who are not beneficiaries of the agreement referred to in the previous article may require and obtain from the Clinical Hospital of the University of Chile the granting of health benefits, as authorized by article 99 of Act No. 18,681 and article 39 (a) of Act No. 21.094.

However, the attention of the persons referred to in the preceding paragraph may not mean deferral or impairment of the attention that the Clinical Hospital of the University of Chile should give to the beneficiaries of the agreement referred to in the previous article. Accordingly, with the sole exception of duly qualified emergencies, such beneficiaries shall be preferred by persons referred to in the preceding subparagraph.

Article 17 quater.- The conventions that integrate the Clinical Hospital of the University of Chile to the Assistance Network shall, at least, include the following minimum content, as appropriate:

1. Health goals and targets.

2. The allocated budget framework, which should be paid in twelfth grades, provided that the or conventions ensure proper accountability, efficiency in the use of resources and methods of reliquidation. This budget framework may not exceed that authorized by the Public Sector Budget Act of each year. However, it should have as an average reference to the benefits granted by the hospital to the beneficiaries of the National Health Services System for at least three years.

3. Levels of activity and monitoring by egress, by major outpatient surgery or by any type of work.

4. Control, evaluation and accountability procedures.

5. The beneficiary population of the North Metropolitan Health Service that will be in charge of the Clinical Hospital of the University of Chile, which should include, in particular, the inhabitants of the communes of Recoleta, Independencia, Conchalí, Huechuraba, Quilicura, Lampa, Til Til, Colina and Renca, as well as the guidelines for solving the health needs of that population according to the service portfolio, which should be included.

6. The primary care establishments of the North Metropolitan Health Service network whose users will be treated by the Clinical Hospital of the University of Chile in all types of health benefits, following the referral of their professionals, are discharged in the hospital to provide the corresponding health benefits.

7. The high complexity benefits that the Hospital Clínico de la Universidad de Chile will provide to the beneficiaries of the National Health Services System that are derived by the respective professionals in the framework of the institutional care modality, and the functions for granting such benefits are delegated to the premises.

8. The guidelines for performing high complexity benefits as a benchmark for the National Health Services System Network.

9. The payment mechanisms of the National Health Fund shall correspond to the same mechanisms used for payment to the other establishments of the Health Services Assistance Network, according to the type of benefits and conditions under which they are granted. Without prejudice to the above, the benefits values will be set with the National Health Fund in common agreement, in view of the university and state nature of the clinical hospital recognized in the following numeral.

10. An annual contribution for being "Public University Hospital", in consideration of the university and state nature of the clinical hospital, when the actions carried out for the benefit of the health system, according to the guidelines and definitions of the Ministry of Health. This contribution will be determined annually by the application of the criteria and indicators set out in a decree issued under the formula "By order of the President of the Republic", signed by the Minister of Health and also signed by the Minister of Finance. Such criteria and indicators should consider, at least, professionals in the training of specialists and sub-specialists, academic publications, research projects, linking with the environment and impact of the activities of the clinical hospital in regions. The contribution will be determined by the Rectory of the University of Chile to the Ministry of Health during the budget formulation process.

11. The obligation of the Hospital Clínico de la Universidad de Chile to maintain information systems that are compatible and interoperable with those of the corresponding Assistance Network, which will be determined by the Undersecretariat for Assistance Networks and the National Health Fund. Both the Fund and the above-mentioned Undersecretariat shall collaborate with the clinical hospital in the fulfilment of this obligation.

12. The obligation of the clinical hospital to provide the statistical and patient care information requested, in accordance with its legal competences, by the Ministry of Health, the National Health Fund, the respective Health Service, the Superintendency of Health, the establishments of the corresponding Healthcare Network or other institution with powers to require it.

13. The contribution that the State will provide annually to the University of Chile for the acquisition of equipment, medical equipment and infrastructure renovation of the clinical hospital, through budget programs and/or its incorporation into the public health network investment plan.

14. The grounds for serious breach of the convention, as well as the procedure for temporarily suspending it through a resolution based on the occurrence of any of these cases.

The determination of the benefits to be granted by the Clinical Hospital of the University of Chile should consider all its available capacity and the needs of the National Health Services System, in addition to the educational requirements of the establishment in the framework of its training role and academic project, which will be agreed at least once a year in the respective conventions or in an annex to those instruments.

In all matters not regulated by this article, the provisions contained in the Decree No. 36 of 1980 of the Ministry of Public Health shall be supplemented. ".

2. After article 68, insert the following article 68 bis:

"Article 68 bis.- The National Health Services Service Supply Centre will provide the Clinical Hospital of the University of Chile, according to the prices that are agreed, with medicines, instruments and other elements or inputs that may require, in the same terms, conditions and availability as the other organs and establishments that form part of the National Health Services System, for which purposes only the corresponding budgetary support will be required.

The above-mentioned will not preclude the University of Chile to conclude additional agreements with the National Health Services Supply Centre, or the authority of that higher education institution to acquire the aforementioned elements of other providers in accordance with the law. ".

3. Incorporate in the first paragraph of Article 102, following the expression "of 1974," the following: "and the one noted in Article 17 bis,".

Article 2.- A regulation issued by the University of Chile will contain the rules of organization and operation of its Clinical Hospital, considering the presence of an Advisory Council of the Director General of the Recinto, with representatives of the community and users.

Transitional arrangements

And for I have had it good to approve and punish it; therefore, promute and take it into effect as the Law of the Republic.

Santiago, November 9, 2023.- GABRIEL BORIC FONT, President of the Republic.- Ximena Aguilera Sanhueza, Minister of Health.

Transcribing for your knowledge Law No. 21.621 - 9 November 2023.- By order of the Undersecretary of Public Health.- He presents his compliments to you, Yasmina Viera Bernal, Chief of the Legal Division, Ministry of Health.