Keywords Social Affairs, health, social security, CSS, AGENCE RÉGIONALE DE Santé, ARS, establishment of health, CODE course of health, PATIENT, care, quality of care, practice of care, INFECTION, risk infectious, risk drug, risk of RUPTURE of course, safety of care, contract of improvement of practices in health establishments, implementation JORF n ° 0270 November 21, 2015 page 21674 text no. 29 Decree No. 2015-1511 19 November 2015 concerning contract for improvement practices in health NOR facilities: AFSH1520666D ELI: https://www.legifrance.gouv.fr/eli/decret/2015/11/19/AFSH1520666D/jo/texte Alias: https://www.legifrance.gouv.fr/eli/decret/2015/11/19/2015-1511/jo/texte interested Publics: health institutions, regional health agencies.
Subject: procedures for implementation of the contract to improve practices in health facilities.
Entry into force: the text comes into force the day following its publication.
Notice: the contract of improved practices in health facilities is designed to accompany the underperforming facilities in terms of quality and safety of certain practices.
This order specifies the modalities of implementation of this agreement. It defines such three risks (risk of infection, drug risk and risk of rupture of course) serving as basis for the definition of the objectives of the contract and the rules under which penalties may be applied when the targets are not met or when the establishment refuses to sign the contract.
References: this order is taken for the purposes of article 51 of Act No. 2014-1554 of December 22, 2014, of financing social security for 2015. The provisions of the social security code amended by this Decree may be consulted in their drafting resulting from this change, the site of Légifrance (http://www.legifrance.gouv.fr).
The Prime Minister, on the report of the Minister of Social Affairs, health and women's rights, having regard to the code of public health;
Having regard to the code of social security, notably its article L. 162-30-3;
Having regard to the opinion of the Council of the National Fund insurance illness of employees dated September 8, 2015;
Having regard to the opinion of the Council of the National Union of sickness insurance funds as of September 17, 2015;
Having regard to the opinion of the central Board of Directors of social mutuality agricultural dated October 21, 2015;
The Council of State (social section) heard, enacts as follows: Article 1 more on this article...
Section 5 of chapter II of title VI of book I of the code of social security, after article R. 162-44-5, it is inserted a subsection 6 as follows: "subsection 6 ' contract to improve practices in health facilities «Art»» R. 162 - 45.-L' regional health agency appreciates at least every two years the level of quality and safety of care by health institutions mentioned in article L. 162-22-6 to the following risks: '1 ° infectious risk measured by indicators relating to infections associated with care;
2 ° the drug risk measured by indicators related to the therapy of patients;
«3 ° the risk of rupture of course of patient care measured by indicators relating to the Organization and continuity of its support.
"An order of the Ministers of health and fixed social security, after the opinion of the high authority of health, the national indicators of quality and safety of care taken into account to assess the risks mentioned, as well as the values limits that must reach settlements.
«Art.» R. 162-45 - 1.-I.-where the regional health agency finds that an establishment referred to in 1 ° of article L. 162 - 22 does not reach one or more of the values set by the order referred to in article L. 162-30-3, it shall notify the establishment risks identified by any means of proving its date of receipt.
"The establishment has a period of 30 days on receipt of the notification of the regional agency, to propose a draft contract for improvement of practices which involve the commitments referred to in article R. 162-45-2.
"When the health care facility has not proposed a draft contract, latter is proposed by the Director general of the regional health agency within a period of thirty days after expiry of the period indicated in paragraph 2.
"Within a period of thirty days after receipt by the Agency of the draft contract proposed by the health care facility or after receipt by the establishment of the draft proposed contract health or, if necessary, amended by the Agency, Executive Director of the regional health agency and the legal representative of the health institution sign the contract of improved practices in health facility for a maximum period of four years After the opinion of the medical conference of establishment or of the medical commission.
"II.-in case of refusal of the institution to sign the contract, the Director general of the regional health agency can, after having put the institution able to submit its comments, decide a financial penalty commensurate with the extent and the seriousness of breaches the objectives of quality and safety of care referred to in article R. 162 - 45 and set within the limit of 1% of products received by the establishment of health on the part of the compulsory health insurance schemes to the title. for the last year ended. Successful penalty shall be notified to the institution by reasoned order of the Director general of the regional health agency.
"The Director of the regional health agency made its decision as soon as deadlines to the Fund referred to in articles L. 174 - 2, L. 174 - 18 or L. 752 - 1 responsible for the recovery of the sums due. ''
«Art.» R. 162-45 - 2.-I.-the contract of improved practices in health facility, complies with contract type mentioned in the I of article L. 162-30-3, fixed his schedule, qualitative and quantitative objectives of improving the quality and safety of care, the plan of action to achieve.
"Each year, the health facility informs the regional health agency of the objectives with regard to the implementation timetable. In the event of breach of commitments by the hotel, Executive Director of the regional health agency highlights remains the establishment to reduce discrepancies in a maximum period of one year.
'II.-A the end of the deadline, of failure to respect its commitments by the institution, the Director-general of the regional agency of health may take action against a penalty corresponding to a fraction of the amount of revenue paid by health insurance in the last year of the contract, proportionate to the magnitude and the gravity of the deficiencies and in the limit of 1% of these products.
"III. - the penalty is calculated according to the number of completely untreated risks contained in the contract of improved practices and the degree of implementation of improvement actions by the establishment.
«The maximum penalties which may be retained shall be fixed in the following table: CAPES sign on 1 risk CAPES signed on 2 risk CAPES sign on 3 risk improvement Actions not at all implemented 0.33% 0.66% 1% partially implemented 0.16% 0.33% 0.50% completely implemented 0% 0% 0% ' the amount of the proposed penalty shall be communicated to the establishment by any means of proving its date of receipt.» The establishment transmits his written submissions, in the same forms, to the regional health agency within thirty days of the receipt. The withheld penalty is fixed by reasoned order of the Director general of the regional health agency. This order is notified to the institution.
"Executive Director of the regional health agency made its decision as soon as deadlines to the Fund referred to in articles L. 174 - 2, L. 174 - 18 or L. 752 - 1 responsible for the recovery of the sums due. ''
Article 2 more on this article...
Is added after 5 ° of article R. 161 - 73 of the code of social security, a 6 ° as follows: «6 ° Emet's opinions on national indicators of quality and safety of care taken into account in assessing the risks mentioned in article R. 162 - 45 of the code of social security and the limits that must reach health facilities. ''
Article 3 read more on this article...
The Minister of finance and public accounts, the Minister of Social Affairs, health and rights of women and the Secretary of State for the budget are responsible, each in relation to the implementation of this Decree, which shall be published in the Official Journal of the French Republic.
Is November 19, 2015.
Manuel Valls by the Prime Minister: the Minister of Social Affairs, health and rights of women, Marisol Touraine the Minister of finance and public accounts, Michel Sapin Secretary of State in charge of the budget, Christian Eckert