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Law No. 270 Hospitals Of 18 June 2003

Original Language Title:  LEGE nr. 270 din 18 iunie 2003 spitalelor

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LEGE no. 270 270 of 18 June 2003 (* updated *) hospitals ((updated until 27 December 2005 *)
ISSUER PARLIAMENT




--------------- *) The initial text was published in the OFFICIAL GAZETTE no. 438 438 of 20 June 2003. This is the updated form of S.C. "Territorial Center of Electronic Computing" S.A. Piatra Neamt until December 27, 2005, with the amendments and additions made by: ORDINANCE no. 40 40 of 29 January 2004 ; LAW no. 151 151 of 14 May 2004 ; ORDINANCE no. 68 68 of 13 August 2004 ; LAW no. 523 523 of 24 November 2004 ; EMERGENCY ORDINANCE no. 206 206 of 22 December 2005 . The Romanian Parliament adopts this law + Chapter I General provisions + Article 1 (1) The hospital is the health unit with beds, public or private, of public utility, with legal personality, which provides medical services. (2) The medical services provided by the hospital are: preventive, curative, recovery and palliative, care in case of pregnancy and maternity, as well as of the newborn. (3) The hospital participates in ensuring the health of the population. The powers, by types of hospitals, are established by rules approved by order of the Minister of Health. ------------- Alin. ((3) art. 1 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((1) art. 1 was amended by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((1) art. 1 1 has been amended by section 1 1 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. + Article 2 (1) The hospital must meet the conditions of sanitary authorization of operation and, as the case may be, accreditation provided by law. Hospitals are required to own or obtain the operating health authorization. (2) Hospitals that do not obtain the sanitary authorization to operate within the period provided by norms developed by the Ministry of Health shall be suspended their activity partially or totally. (3) The accreditation fee shall be borne by the hospital. The level of the tax is approved by order of the Minister of Health, on the proposal of the National Commission for Accreditation + Article 3 (1) In hospitals, medical-pharmaceutical, post-secondary, university and postgraduate education activities can also be carried out, as well as medical scientific research. (2) The criteria for carrying out medical scientific research activities shall be proposed by the Academy of Medical Sciences and approved by order of the Minister of Health, with the opinion of the Ministry of Education, Research and Youth, and the criteria for the conduct of educational activities are developed and approved by the Ministry of Health, with the opinion of the Ministry of Education, Research and Youth (3) The collaboration between hospitals and medical higher education institutions, namely the medical education units, is based on a contract concluded according to the methodology approved by joint order of the Minister of Health and the Minister education, research and youth. (4) Medical scientific research is carried out on the basis of research contract, concluded between the hospital and the research financier, endorsed by the Academy of Medical Sciences. (5) The educational and research activities will be organized so as to strengthen the quality of the medical act, in compliance with patients ' rights, ethics and medical deontology. ((6) Hospitals have the obligation to carry out continuous medical education activities for their own staff, borne by their own income. + Article 4 (1) The hospital provides accommodation, hygiene, food and prevention of nosocomial infections, according to the norms approved by order of the Minister of Health. (2) The hospital responds, according to the law, for the quality of the medical act, for compliance with the conditions of accommodation, hygiene, nutrition and prevention of nosocomial infections, according to the norms approved by order of the Minister of Health, damage caused to patients, established by the competent bodies. For damage caused to medical fault patients, liability is individual. + Article 5 (1) Any hospital has the obligation to provide first aid and emergency medical assistance to any person who presents himself to the hospital, if the state of the person's health is critical. After stabilizing the vital functions, the hospital will ensure, as the case may be, the mandatory transport medicalized to another profile medical-health unit. (2) The hospital will be constantly prepared to provide medical assistance in case of war, disasters, terrorist attacks, social conflicts and other crisis situations and is obliged to participate with all resources to eliminate the effects. (3) The expenses incurred by the hospital units, in the cases referred to in par. (2), shall be reimbursed by the state, by decision of the Government, within a maximum of 30 days from the date of termination of the case that generated them, in order to preserve the internal financial economic balance. + Chapter II Organisation and operation of hospitals + Article 6 (. Depending on the territory, hospitals shall be classified as: a) county hospitals; b) municipal and city hospitals; c) communal hospitals. (2) Depending on the specifics of the pathology, hospitals are classified in: a) general hospitals; b) emergency hospitals; c) specialized hospitals; d) hospitals for patients with chronic conditions. (3) Depending on the way of establishment and organization, as well as the legal regime of property, hospitals are classified in: a) public hospitals, which are hospitals organized as public institutions; b) private hospitals, which are hospitals organized as legal entities under private law; c) repealed. (. Depending on the way of financing, hospitals shall be classified as: a) hospitals with funding from public funds; b) hospitals with funding from private funds; c) hospitals with mixed funding. (5) In terms of education and medical scientific research, hospitals shall be classified as: a) clinical hospitals; b) university hospitals. ------------- Alin. ((3) art. 6 was amended by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Letter c) a par. ((3) art. 6 6 has been repealed by section 6.6. 2 2 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. + Article 7 (1) Other health facilities with beds are: institutes and medical centers, sanatoriums, calories, diagnostic and treatment centers with beds, health centers and medical-social assistance units. (2) For the purposes of this law, the category of hospitals shall include the health facilities provided in par. ((1). ------------ Article 7 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 8 For the purposes of this Law, the following notions shall be defined as follows: a) the general hospital is the hospital that has organized in the structure, as a rule, 3 of the 4 basic specialties, namely internal medicine, pediatrics, obstetrics-gynecology and surgery; b) the specialized hospital is the hospital that provides medical assistance in a specialty in connection with other complementary specialties; c) the emergency hospital is the hospital that has a complex structure of specialties, equipped with appropriate medical equipment, specialized personnel, with site and accessibility for extended territories. In the structure of the emergency hospital it is mandatory the emergency department that, depending on the needs, can also have an emergency mobile service-reanimation and medical transport; d) the hospital for patients with chronic conditions is the hospital where the duration of hospitalization is extended due to the specificity of the pathology. Patients with chronic conditions and social problems will be taken over by the medical-social assistance units, as well as by the social assistance settlements provided by the law; e) the county hospital is the general hospital providing medical assistance to the county; f) the municipal hospital and the city hospital are general hospitals that have at least the basic specialties, except for municipal hospitals organized in the county seat; g) the communal hospital is the health unit with beds, which provide specialized medical assistance for the population of several close rural localities, having in the composition of wards or compartments of internal medicine, pediatrics and obstetrics; h) the clinical hospital is the hospital that has at least two university clinics that provide medical assistance, carry out educational activity, medical scientific research and continuing education. Institutes, medical centers and specialized hospitals that have a university clinic are clinical hospitals; i) the university hospital is the hospital organized in medical university centers, in the structure of which all the specialized departments are clinical wards and are included in the structure of the university clinics; j) clinical wards are the hospital wards where university education activities are carried out. The university clinic has one or more clinical wards in its structure; k) sanatorium is the health unit with beds that provide medical assistance using natural curative factors associated with other processes, techniques and therapeutic means; l) The cure is the health unit with beds that ensure the prevention and control of tuberculosis in children and young people, as well as in tuberculosis patients stabilized clinically and unmistakably; m) health centers are health facilities with beds that provide specialized medical assistance for the population of several close localities, in at least two specialties; n) institutes and clinical medical centers are specialized medical assistance units in which educational and medical scientific research, guidance and methodological coordination are carried out on their fields of activity, as well as continuous medical education; for specialized medical care can be organized medical centers where medical education and medical scientific research are not carried out; o) the medical-social assistance units are specialized public institutions, subordinated to the local public administration authorities, which provide care services, medical services, as well as social services to people with medical-social needs; p) diagnostic and treatment centers with beds are health facilities that provide specialized outpatient medical care and may have in the medical structure beds for hospital care. ------------- Article 8 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Points a), b), f), g), h) and n) of art. 8 were amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 9 (1) Clinical and university hospitals, institutes, university clinics and clinical wards may receive status of centres of excellence for medical activities of particular complexity, which prove professional overqualification and produce results. at the level of international standards, at the proposal of the Ministry of Health, with the opinion of the Academy of Medical Sciences, by (2) The centers of excellence benefit from a special program of financing and endowment with high performance medical equipment, a program provided distinctly in the budget of the Ministry of Health or in the budget of ministries with their own health network. (3) The centres of excellence benefit from additional amounts allocated through the national health programmes, highlighted distinctly in the income and expenditure budget of the health unit. + Article 10 (1) The organizational structure of the hospital includes, as the case may be: wards, departments, laboratories, diagnostic and treatment services, compartments, services or technical, economic and administrative offices, pre-hospital assistance service and urgent transport, emergency structures and other structures approved by the Ministry of Health. ((2) Abrogat. (3) The county hospital shall be organized, as appropriate, with the following structures: a) emergency department, a pre-hospital nursing structure and medicalized transport; b) sections or specialized compartments with a minimum number of beds, approved by order of the Minister of Health for: internal medicine, anesthesia and intensive care, general surgery, traumatology and orthopedics, pediatrics, obstetrics-gynecology and neonatology, infectious diseases, neurology, O.R.L. and ophthalmology, except in situations where specialized hospitals operate in that locality. Optionally you can organize wards or compartments in other specialties; c) laboratories with on-call service; d) central sterilization service; e) laboratory of pathological anatomy and prosecture; f) services or compartments of prevention and control of nosocomial infections, depending on the number of beds in the hospital; g) computer science department; h) pharmacy; i) technical-economic-administrative department; j) station for harvesting and preserving blood and blood products; k) service or compartment of public relations and other services. ((4) Hospitals may have in their composition structures that provide specialist outpatient services. The provision of these services is negotiated and contracts distinctly with health insurance companies. (5) The medical services provided by the hospital outpatient include: consultations, investigations, diagnosis, medical and/or surgical treatment, care, recovery, medicines and sanitary materials, orthotics and prosthetics. (6) The organizational and functional activities of medical-health in hospitals are regulated and subject to the control of the Ministry of Health, the central authority in the field of public health assistance. Professional activity, as well as compliance with manworks and medical procedures are subject to the regulations in force. The problems of ethics and professional deontology are competent, as the case may be, of the Romanian College of Physicians, the Romanian College of Pharmacists or the Order of Nurses in Romania. ------------- Alin. ((2) art. 10 was repealed by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Letters b), f) and k) of par. ((3) art. 10 were amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 11 The forms of hospitalization are: a) continuous hospitalization; b) day hospitalization; c) one day hospitalization. + Article 12 Clinical and university hospitals can organize clinical and/or fundamental research activity, in the form of collective, laboratories, centers and/or institutes without legal personality, within the hospital. Medical institutes can be organized with legal personality and can be assimilated to clinical and university hospitals, in compliance with the provisions of art. 8 lit. j), if it offers predominantly curative medical services in internment with beds. + Article 13 (1) After granting the operating health authorization, hospitals enter the accreditation process, which is carried out at the request of hospitals. (2) Accreditation guarantees that hospitals operate to the standards established under this law, on the provision of medical services and related to the medical act, certifying the quality of health services in accordance with the classification hospitals, by category of accreditation. (3) The accreditation is granted by the National Commission for the Accreditation of Hospitals, an autonomous public law institution, with legal personality, under the control of the Parliament, and gives the hospital the right to enter into contractual relations with the houses of health insurance. (4) The Commission has 7 members, appointed as follows: 2 representatives of the Parliament, one per Chamber, 1 representative from the Ministry of Health, 1 representative from the Romanian College of Physicians, 1 representative from Part of the National Health Insurance House, 1 representative of the Romanian Hospital Association and 1 representative of the Order of Nurses in Romania. The members of the National Hospital Accreditation Commission are appointed by the Parliament, with the opinion of the health committees of the two Chambers, after the individual hearing, for a period of 4 years. (5) The President of the Commission shall be elected by vote from among the members of the Commission, (6) The financing of the National Commission for the Accreditation of Hospitals is made from the reserve fund of the National Health Insurance House in the first year and, subsequently, from its own sources. (7) The Regulation on organization and functioning of the National Commission for the Accreditation of Hospitals shall be established by law. (8) The members of the National Commission for the Accreditation of Hospitals receive a monthly allowance in the amount of 48% of the salary of a secretary of state, provided that they participate in all the meetings of that month. (9) The establishment, training and organization of the body of experts-accredited, which consists of specialists working in the health system, shall be established by the National Commission for the Accreditation of Hospitals, within 60 days of publication of the regulation on its organisation and functioning. ------------- Alin. ((8) art. 13 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((7) art. 13 13 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. Alin. ((8) art. 13 13 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 14 The hospital asks the National Hospital Accreditation Commission to change the classification when the conditions on the basis of which it was accredited have changed. + Article 15 (1) The procedures, the conditions of accreditation, the medical quality standards and the corresponding indicators, as well as the categories of accreditation of hospitals are approved by the National Commission for the Accreditation of Hospitals. (2) The list of accredited hospital units is approved by order of the President of the National Commission for Accreditation of Hospitals, which is published in the Official Gazette of Romania, Part I. (3) The members of the National Hospital Accreditation Commission are incompatible with the membership in the management bodies of hospitals and cannot hold private offices or clinics. ------------- Article 15 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((3) art. 15 15 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 16 Every 5 years hospitals are subject to reaccreditation. + Article 17 If the hospital is withdrawn the operating health authorization, the National Hospital Accreditation Commission shall withdraw its accreditation certificate. + Article 18 (1) At the request of the Ministry of Health and the National Health Insurance House, the National Hospital Accreditation Commission, through its structures, can carry out the reassessment of the respective health unit. Fees related to revaluation shall be borne by the applicant. (2) If the reassessment is found that the conditions at the time of accreditation are no longer met, the National Hospital Accreditation Commission shall proceed, as the case may be, as follows: a) give a deadline to remedy the situation; b) change the category of accreditation, when it finds that the deficiencies have not been remedied within the established deadline or there have been repeated deviations from the norms and conditions envisaged at the time of accreditation; c) proposes to the Ministry of Health the withdrawal of the operating health authorization when serious deviations from the sanitary norms are found in the hospital units, together with the withdrawal of accreditation. + Article 19 (1) The establishment or abolition of public hospitals shall be made by Government decision, initiated by the Ministry of Health, with the opinion of the local and county council, or by the ministries and institutions with their own health network, with the opinion Health Ministry. (2) Private hospitals shall be established or abolished with the assent of the Ministry of Health, under the law. (3) Reorganization, change of headquarters and names for public hospitals shall be approved by order of the Minister of Health, at the proposal of the management of the hospitals, with the opinion of the county council or of the local council, as the case may be sanitary subordinated to ministries and institutions with their own health network, by order or decision of the minister or director of the institution, with the opinion of the Ministry of Health. The organizational structure of health facilities subordinated to ministries and institutions with their own health network is established with the opinion of the Ministry of Health. (4) Reorganization and change of headquarters and names for private hospitals shall be made with the assent of the Ministry of Health, under the law. (5) If the public or private property of the state or the administrative-territorial units in use and/or in the administration of a public hospital, as well as the public services carried out by the public hospital are concession or enter into a public-private partnership relationship, fully or more than 50%, the legal person of private law who will exploit them will organize and operate as a private hospital, for the duration of the concession, with compliance with the relevant legal provisions. -------------- Alin. ((1) and (3) of art. 19 were amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. Alin. ((2) art. 19 was amended by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((4) art. 19 was amended by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((5) art. 19 was introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. + Article 20 (1) In the act of establishment of the public hospital, at least the following elements are established: the name, the type of hospital, the type of financing, the number of beds and the category of hospital medical services granted. (2) The content of the act of establishment for the private hospital will be established by a special law. + Article 20 ^ 1 Private hospitals will be established, will be organized and will operate according to the legal provisions applicable to legal persons of private law, with patrimonial or non-patrimonial purpose, who are in the object of activity providing medical services. ------------- Art. 20 ^ 1 was introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Article 20 ^ 1 has been amended by section 1. 3 3 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. + Article 21 In order to ensure the right to health protection, the Ministry of Health proposes annually the National Plan of Beds, which is approved by Government decision. + Article 22 The governing bodies of public hospitals are: a) the Management Board; b) the steering committee; c) the general manager. + Article 23 (1) The executive management of public hospitals is provided by the steering committee. (. The Steering Committee shall include: a) the general manager; b) the medical deputy director-general, for hospitals with more than 200 beds, except for clinical hospitals, institutes and clinical medical centers; c) the chief accountant; d) the administrative director, for hospitals with over 200 beds, except for clinical hospitals, institutes and clinical medical centers; e) the director of care, a nurse by profession, for hospitals with over 400 beds. (3) Persons who hold private clinics or are shareholders or associates in companies that are in the object of activity the provision of medical services are incompatible with the membership in the director committee of the hospital. (4) The members of the steering committee shall be appointed for a period of 4 years by the board of directors, by competition organized under the law. (. The Steering Committee shall conduct the entire activity of the hospital between the meetings of the Management Board, in accordance with its decisions. (. The Director-General shall conduct the work of the (7) The executive management of public hospitals with a smaller number of 200 beds is provided by the Director-General and the Chief Accountant. (8) Within the hospital the medical board is organized, consisting of heads of department, heads of departments, laboratories or compartments. (9) The duties and powers of the medical board are approved by order of the Minister of Health, with the opinion of the Romanian College of Phys (10) Institutes, clinical medical centers and clinical hospitals carrying out medical scientific research activities may still have a medical assistant general manager, with scientific research coordination tasks that will be part of the Steering committee The tasks of coordinating the scientific work will be determined by the board of directors. (11) The units provided in par. (10) will be nominated by order of the Minister of Health, with the opinion of the Academy of Medical Sciences. ------------- Article 23 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Article 23 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. Alin. ((10) and (11) art. 23 were introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((10) art. 23 23 has been amended by section 4 4 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. + Article 24 The Public Hospitals Steering Committee shall have the following main tasks: a) elaborates the draft revenue and expenditure budget of the hospital; b) analyze and recommend measures for the development of the hospital activity in accordance with the medical services needs of the population; c) substantiates and submits for approval to the board of directors the public procurement plan, as well as the list of investment works, current repairs or capitals that are carried out in a financial year, under the law; d) responds to the way of fulfilling the obligations assumed by contracts and orders measures to improve the activity of the hospital; e) presents to the board of directors quarterly and annual information on the assets under management, as well as to the execution of the revenue and expenditure budget. ------------- Letters c) and e) of art. 24 were amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 25 (1) The Board of Directors consists of 7-9 members, depending on the size of the hospital and the complexity of the medical services awarded. The chairman of the board is elected from among its members, with a simple majority of the total number. (. The members of the Management Board shall be: a) two representatives of the Ministry of Health or of the public health department, as appropriate; b) two representatives appointed by the county or local council, one of which is a specialist in local public finances, or by ministries or institutions with their own health network, as the case may be; c) a representative of the Romanian College of Physicians; d) a representative of the Order of Nurses in Romania; e) the general manager; f) two representatives of the university or faculty of medicine, for clinical, university hospitals, institutes and clinical medical centers. (3) For hospitals in the defense system, public order, national security and judicial authority, the members of the hospital's board of directors are designated according to their own regulations. (4) The validation of the nominal composition of the board of directors shall be made by the National Commission for the Accreditation of Hospitals. Until the establishment of the National Hospital Accreditation Commission, the validation of the nominal composition of the boards is made, as the case may be, by the public health department, the Ministry of Health, respectively the specialized directions in the framework of ministries and institutions with their own health network. ((4 ^ 1) The delegation expenses for participation in the meetings of the board of directors for the members referred to in par. (2), which reside in a locality other than the one in which the hospital is based, shall be borne from the budget of the institution it represents. (5) At the meetings of the board of directors participate, without the right to vote, a representative of trade union organizations and employers signatories of the collective agreement at the level of health branch. (6) The Board of Directors shall be headed by the President. (7) The main tasks of the Management Board are as follows: a) approve the hospital's revenue and expenditure budget, as well as the annual financial statements, under the law; b) organizes a competition for the position of general manager, deputy director-general, of the other positions of director and chief accounting officer, on the basis of the regulation approved for this purpose by order of the Minister of Health; the Chairman of the Management Board shall appoint the persons who have promoted the contest c) approve the measures for the development of the hospital's activity, in accordance with the needs of medical services d) approve the public procurement plan, as well as the list of investments and current repair works or capitals that are to be carried out in a financial year, under the law; e) analyze the fulfilment of the obligations of the steering committee and the activity of the Managing Director, having measures to improve the activity; f) negotiates, through the president and the general manager, the contracts for the supply of medical services with the health insurance companies. (8) The Board of Directors shall meet monthly or whenever necessary, at the request of the majority of its members, the President or the Director-General, and shall take decisions with the simple majority of the total number of members. ------------- Paragraphs 2, 3 and 5 of the art. 25 were amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((7) art. 25 was repealed by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004 *). Article 25 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. Alin. ((4 ^ 1) art. 25 was introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((4 ^ 1) art. 25 25 has been amended by section 5 5 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. ------------- * *) Pct. 10 of ORDINANCE no. 40 40 of 29 January 2004 by which paragraph is repealed. ((7) art. 25 25 of Law no. 270/2003 has been repealed by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 26 (1) For clinical and university hospitals, as well as for institutes and clinical medical centers, candidates for the position of general manager must be university teaching staff and meet the conditions provided in par. ((2) and (3). For institutes and clinical medical centers, scientific researchers may participate. (2) The general manager must have a mandatory health management competence and conclude an administration contract, for a term of 4 years, with the board of directors, based on the criteria established by the Ministry of Health, with the possibility to be renewed. (3) The position of general manager may be occupied by competition and by a person who has not acquired competence in health management according to the requirements provided in par. (2), which is required by 31 December 2005 *) to acquire this competence. In case of non-compliance with this obligation, the person concerned will be relieved of the position of Director General. (4) For military hospitals in the defense system, public order, national security and judicial authority, the position of commander/general manager shall be handled by a person appointed by the head of the ministry or institution having the structure the hospital, according to its own regulations, in compliance with the ((1), (2) and (3). (5) The Managing Director is authorising officer and represents the hospital in relations with third parties. ------------- Article 26 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((1) art. 26 26 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. * *) According to section 1 1 of the single article of EMERGENCY ORDINANCE no. 206 206 of 22 December 2005 , published in MONITORUL OFFICIAL no. 1.175 of 27 December 2005, the period referred to in Article 26 (3) shall be extended until 30 June 2006. + Article 27 Repealed. ------------- Article 27 was repealed by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 28 The model of the management contract, in which the activity performance indicators are also provided, is approved by order of the Minister of Health, with the consultation of ministries with their own health network. The level of activity performance indicators is established annually by the territorial public health department or by the Ministry of Health, respectively the relevant ministry, depending on the subordination of the hospital. + Article 29 (1) The management of public hospitals shall respond to the public health department and/or the Ministry of Health, respectively to the relevant ministry, for the performance of their duties. ((1 ^ 1) In the case of committing particularly serious deviations from the norms of professional conduct, as well as from the discipline of work by the general director of the hospital, the minister of health or, as the case may be, the competent minister, for health facilities subordinated to the ministries with their own health network, may propose to the hospital board the suspension from office of the hospital for the duration of the prior administrative research. ((2) Revocation of the members of the Steering Committee, namely the Director-General, the Deputy Director-General, the Administrative Director, the Chief Accountant or the Director of Care, in case of non-realisation of performance indicators the activity established in the management contract or in the case of committing abuses or misconduct, shall be done by the board of directors. The Ministry of Health, the public health department and/or the relevant ministry may propose the revocation of the members of the ((3) In the process of analysis and evaluation of the performance of public health facilities with beds, which are in contractual relations with health insurance companies, regardless of their subordination or the holder of the right of administration on to them, the boards and the principal committees may be revoked by order of the Minister of Health. For public health facilities with beds in the network of the Ministry of National Defence, Ministry of Justice, Ministry of Administration and Interior, Ministry of Transport, Construction and Tourism, Romanian Intelligence Service, the leaders of these institutions will issue the revocation orders, with the opinion of the Minister The chairmen of the boards, the boards and the interim directories shall be appointed for a maximum period of 6 months, by order of the Minister of Health, without the provisions of art. 25 25 para. ((1)-(4). (4) The restructuring of the health facilities with beds, carried out as a result of the analysis and evaluation of their activity, under the conditions of 20 20 para. (5) of Government Emergency Ordinance no. 154/2005 on the rectification of the 2005 state budget, maintains its validity. ------------- Alin. ((2) art. 29 29 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. Alin. ((1 ^ 1) art. 29 was introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((1 ^ 1) art. 29 29 has been amended by section 6 6 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. Alin. ((3) and (4) of art. 29 29 have been introduced by section 2 2 of the single article of EMERGENCY ORDINANCE no. 206 206 of 22 December 2005 , published in MONITORUL OFFICIAL no. 1.175 1.175 of 27 December 2005. + Article 30 (1) The hospital's departments, laboratories, departments and medical services are run by a section chief, head of laboratory, department head or head of service. These functions are handled by competition organized under the law. ((2) Upon appointment, they shall conclude with the Director-General a subcontract of administration, for a term of 4 years, as an addendum to the employment contract, in which specific performance indicators that are established are provided. annually by the Management Board. ------------ Article 30 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 31 (1) The hospital has the obligation to register, store, process and transmit the information related to its activity, according to the norms approved by order of the Minister of Health. ((2) The reports shall be made to the territorial public health department and shall constitute the database, at national level, for major health policy decisions and for the reports necessary for the bodies of the European Union and the World Organisation of Health. (3) The hospital has the obligation to provide health insurance companies with the medical information that was the basis of the contracts for the supply of medical services. (4) The primary documentation, as a source of these data, will be preserved, secured and secured in the form of a written and electronic document, constituting the hospital archive, according to the legal regulations in force. + Article 32 The organization and functioning regulations, as well as internal hospital regulations and job descriptions of the staff employed will be developed by the hospital management and approved by the board of directors, respectively by the management the minister/institution with its own health network, according to its own regulations. ------------ Article 32 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 33 In public hospitals the positions of department head, section chief, head of compartment, head of laboratory or chief pharmacist will only be able to be occupied by doctors, pharmacists, biologists, chemists and biochemists, at least 5 years old in That specialty. + Article 34 (1) In clinical and university hospitals the activity of education and research is led by the head of the clinic. This is, by law, the teacher with the highest university title, teacher or lecturer in that clinic. The head of the clinic cannot be a consultant teacher. (2) If several teachers meet the condition provided in par. (1) in the same university clinic, the appointment of the head of the clinic shall be made by the faculty council, confirmed by the senate of the university and approved by order of the Minister of Health or of the relevant ministers, for the university clinics of clinical hospitals subordinated to ministries with their own health network. The wards in the same university clinic are run by the heads of the wards, university staff appointed with the same procedure and subordinate to the head of the clinic. ----------- Alin. ((2) art. 34 34 has been amended by section 7 7 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. + Chapter III Hospital financing + Article 35 (1) Public hospitals are public institutions financed by their own income and operate on the principle of financial autonomy. The own revenues of public hospitals come from the amounts collected for medical services provided on the basis of contracts concluded with health insurance companies and other sources, according to the law. (2) Public hospitals shall monitor the implementation of the budget on a monthly basis, following the implementation of the revenues and the expenditure ------------ Article 35 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((1) art. 35 35 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 36 (1) Public hospitals receive amounts from the state budget or local budgets, which will be used only for the destinations for which they have been allocated, as follows: a) from the state budget through the budget of the Ministry of Health or ministries or central institutions with their own health network; b) from the budget of the county council, for county hospitals; c) from the budget of the local council and the county council, for local hospitals. (2) From the state budget shall be ensured: a) carrying out the activities contained in the national health programmes; b) equipping with high performance medical equipment, under the law; c) investments related to the construction of new hospitals, including for the completion of those in execution; d) expertise, transformation and consolidation of constructions severely affected by earthquakes and other cases of force majeure; e) modernization, transformation and extension of existing constructions, as well as carrying out capital repairs; f) activities specific to units and institutions with their own health network. (3) Local budgets participate in the financing of maintenance and management expenses, repairs, consolidation, extension, modernization and completion of construction of public health facilities, of county or local interest, within the limits of credits budget approved with this destination in local budgets. (4) Public hospitals may make additional own income from: a) donations and sponsorships; b) related; c) investment associations in medical and pharmaceutical research; d) temporary rental, without total loss of use, of medical facilities, equipment or medical equipment to other healthcare providers; e) contracts for the provision of medical services concluded with private insurance companies or economic agents; f) editing and dissemination of medical publications; g) medical, hotel or other services, provided at the request of patients or employers; h) home health care services provided at the request of the patients; i) other sources. ------------- Alin. ((1) and (3) of art. 36 were amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Letter e) a par. ((2) art. 36 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Alin. ((3) art. 36 36 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 37 (1) The contract for the provision of medical services of the public hospital with the health insurance house is the main source of income within the revenue and expenditure budget and is negotiated by the board of directors with management of the health insurance house, depending on the indicators set out in the framework contract for the provision of medical services. (2) In the case of refusal of one of the parties to sign the contract for the provision of medical services with the health insurance company, a mediation commission made up of representatives of the Ministry of Health, respectively of the ministry of resort, as well as of the National Health Insurance House, which, within a maximum of 10 days, resolves divergences. (3) Hospitals may conclude contracts for the supply of medical services and private health insurance companies. (4) Clinical and university hospitals are financed as a differentiated priority, taking into account the complexity of medical services and educational activities, based on the norms developed jointly by the Ministry of Health, the Ministry of Education, Research and Youth and National Health Insurance House. + Article 38 (1) The draft revenue and expenditure budget of public hospitals shall be drawn up by the management of the hospital on the basis of the methodological norms approved by order of the Minister of Health, in consultation with ministries and institutions with networks own sanitary. (2) The budget of revenue and expenditure of public hospitals is approved, under the law, no later than 10 days from the date of contracting of medical services with health insurance companies. ((3) The execution of the revenue and expenditure budget shall be reported monthly and quarterly to the public health departments, the Ministry of Health and the relevant ministry, depending on the subordination. ((4) The execution of the revenue and expenditure budget is reported monthly and quarterly and to the local and/or county council, as the case may be, if it benefits from financing from local budgets. (5) The public health departments shall analyze the execution of the monthly and quarterly revenue and expenditure budgets and submit them to the Ministry of Health and the relevant ministry, as the case may be. If deviations are found towards the indicators in the administration contract, the public health department notifies them and makes proposals that it submits for approval to the management of the Ministry of Health. ------------ Alin. ((2) art. 38 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 39 (1) In case of debts at the date of appointment of the hospital management, they will be highlighted separately in the management contract establishing the possibilities and the range in which these debts will be liquidated, under the law. (2) In special situations affecting the health of the population, declared by order of the Minister of Health, the debts that require the supplementation of the approved income and expenditure budget shall be borne from the Reserve Fund of the Fund Unique national health insurance. ------------ Article 39 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. Article 39 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 40 (1) The internal public audit shall be exercised by a specialized structure, organized under the law at the level of the hospital. If such a specialized structure is not organized, the internal public audit shall be exercised by the specialized structure within the public health department or within the Ministry of Health, respectively by the relevant ministry, where appropriate. (2) The control over the financial activity of the public hospital is made, under the law, by the Court of Accounts, the Ministry of Health, the ministries and institutions with their own health network or other bodies empowered by law. ------------- Alin. ((1) art. 40 40 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 40 ^ 1 (1) The hospital development fund shall be established from the following sources: a) the share of the depreciation calculated monthly and included in the hospital's revenue and expenditure budget, with the preservation of the financial balance; b) amounts resulting from the valorization of the available goods, as well as from those scrapped in compliance with the legal provisions c) sponsorships with the destination "development"; d) a 20% share of the surplus of the revenue and expenditure budget recorded at the end of the financial year; e) amounts resulting from rentals or leases. (2) The development fund shall be used for the procurement of medical and laboratory equipment and equipment necessary to carry out the activity of the hospital, and shall be approved with the revenue and expenditure budget. (3) The balance of the development fund remaining at the end of the year shall be carried over to the following year, being used with the same ------------- Art. 40 ^ 1 was introduced by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. + Article 41 Repealed. ------------- Article 41 was repealed by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 42 The settlement of the contracted medical services is made according to the contract for the supply of medical services, based on supporting documents, depending on their realization, in compliance with the provisions of the framework contract on the conditions for the provision of health care in the health insurance system. + Article 43 In the case of medical activities for which the hospital unit has no competent specialists in such medical activities or workings, a contract may be concluded on the provision of such medical services with a medical office specialized or with another accredited public or private medical facility. Hospital units can conclude contracts on the provision of auxiliary services necessary for the operation of the hospital ------------ Art. 43 was amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 44 Health insurance companies are required to conclude contracts for the provision of medical services with hospitals for the following year, until December 31 of the current year. + Article 45 (1) The salary of the management staff in public hospitals, as well as the other categories of personnel, shall be established according to the law. ((1 ^ 1) Abrogat. (2) Teachers who operate in the health facilities provided in art. 6 and 7, as well as in the units assimilated to them benefit from an allowance of 50% of the salary rights due to the position and professional degree. ------------- Alin. ((2) art. 45 45 was amended by LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004. Alin. ((1 ^ 1) art. 45 was introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((2) art. 45 was amended by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. Alin. ((1 ^ 1) art. 45 45 has been repealed by section 6.6. 8 8 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. Alin. ((2) art. 45 45 has been amended by section 9 9 of the single article of LAW no. 523 523 of 24 November 2004 , published in MONITORUL OFFICIAL no. 1.123 1.123 of 29 November 2004. + Chapter IV Transitional and final provisions + Article 46 The Ministry of Health and ministries and institutions with their own health network will take measures to reorganize existing public hospitals, in accordance with the provisions of this law, within 6 months from the date of its entry into force. + Article 47 (1) Imobiles in the public domain of the state or some administrative-territorial units, under the administration of public hospitals, which are reorganized and become available, as well as medical equipment may be, under the law, rented or concession, as the case may be, to natural or legal persons, for the purpose of organizing and operating private hospitals or for other forms of medical or social assistance, under the law. (2) I take exception to the provisions of par. (1) spaces designed to carry out the activity of medical and human pharmaceutical higher education. ((3) The amounts obtained from the rental or concession of the goods constitute the hospital's own income and are used for current and capital expenditures, in accordance with the approved revenue and expenditure budget. ------------ Alin. ((1) and (3) of art. 47 were amended by ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 92 of 31 January 2004. + Article 47 ^ 1 Until the entry into force of the special law provided for in art. 20 20 para. (2), the act establishing the private hospital will have the content provided by the legislation applicable to companies or, as the case may be, associations and foundations, and the organizational structure will be established with the opinion of the Ministry of Health. ------------- Art. 47 ^ 1 was introduced by ORDINANCE no. 68 68 of 13 August 2004 published in MONITORUL OFFICIAL no. 773 773 of 24 August 2004. + Article 48 The provisions of this law also apply to hospitals belonging to ministries with their own health networks. + Article 49 Annually, the Minister of Health will present the situation to Parliament a) number of hospitals, in different categories; b) the number of hospital beds relative to the number of inhabitants; c) the degree of endowment of hospitals; d) the main indicators of morbidity and mortality; e) the state of public hospital accreditation; f) the areas and counties of the country where the need for hospital medical services is not covered. + Article 50 Non-compliance with the provisions of this law attracts disciplinary, contravention, civil or criminal liability, as the case may be, under the law, of the guilty + Article 51 The provisions of this law shall enter into force within 90 days from the date of publication in the Official Gazette of Romania, Part I. + Article 52 The date of entry into force of this Law shall be repealed art. 25 25-30 of Law no. 3/1978 on the health insurance of the population, published in the Official Bulletin, Part I, no. 54 54 of 10 July 1978, and Law no. 146/1999 on the organization, operation and financing of hospitals, published in the Official Gazette of Romania, Part I, no. 370 of August 3, 1999, with subsequent amendments and completions, as well as any other provisions to the contrary. ------------- See also EMERGENCY ORDINANCE no. 64 64 of 28 June 2003 published in MONITORUL OFFICIAL no. 464 464 of 29 June 2003. ORDINANCE no. 40 40 of 29 January 2004 published in MONITORUL OFFICIAL no. 92 of 31 January 2004 entered into force 3 days after the publication in the Official Gazette. ------------- NOTE: See: ORDINANCE no. 57 57 of 22 August 2003 published in MONITORUL OFFICIAL no. 607 607 of 27 August 2003 providing, at art. unique: " The deadline for entry into force of the Hospital Law no. 270/2003 , published in the Official Gazette of Romania, Part I, no. 438 of 20 June 2003, shall be extended until 1 January 2004. '; ORDINANCE no. 94 94 of 24 December 2003 published in MONITORUL OFFICIAL no. 935 935 of 24 December 2003 providing, at art. unique: " The deadline for entry into force of the Hospital Law no. 270/2003 , published in the Official Gazette of Romania, Part I, no. 438 438 of 20 June 2003, as prorogated by Government Ordinance no. 57/2003 , approved by Law no. 470/2003 ,, shall be extended until 1 March 2004. ' -------------- See also art. II and III of LAW no. 151 151 of 14 May 2004 published in MONITORUL OFFICIAL no. 460 460 of 21 May 2004 stating: "" Art. II: Within 60 days from the publication of the present law in the Official Gazette of Romania, Part I, the law on the organization and functioning of the National Commission for the Accreditation of Hospitals is adopted. Art. III: Within 90 days from the date of entry into force of this law, the contest for filling positions for the position of general manager shall be held, as well as for the other positions belonging to the steering committee, to hospitals in which the posts are not filled by contest. ". This law was adopted by the Senate at the meeting of May 12, 2003, in compliance with the provisions of art 74 74 para. (2) of the Romanian Constitution. p. SENATE PRESIDENT, ALEXANDRU ATHANASIU This law was adopted by the Chamber of Deputies at the meeting of May 20, 2003, in compliance with the provisions of 74 74 para. (2) of the Romanian Constitution. p. CHAMBER OF DEPUTIES PRESIDENT, VIOREL HREBENCIUC Bucharest, June 18, 2003. No. 270. ---------------