LEGE no. 263 263 of 16 June 2004 (* updated *) on ensuring the continuity of primary care through permanent centres ((updated until 11 February 2014 *)
ISSUER
PARLIAMENT
---------------- *) The updated form of this normative act until February 11, 2014 is carried out by the legal department of S.C. "Territorial Center of Electronic Computing" S.A. Piatra-Neamt by including all the changes and additions made by: ORDINANCE no. 32 32 of 14 July 2005 ; LAW no. 14 14 of 11 January 2006 ; ORDINANCE no. 11 11 of 30 January 2008 ; EMERGENCY ORDINANCE no. 32 32 of 1 April 2009 ; LAW no. 244 244 of 23 June 2009 ; ORDINANCE no. 7 7 of 26 January 2011 ; LAW no. 124 124 of 12 July 2012 ; EMERGENCY ORDINANCE no. 91 91 of 12 December 2012 ** **); EMERGENCY ORDINANCE no. 2 2 of 29 January 2014 . The content of this act is not an official document, being intended to inform users **) NOTE C.T.C.E. S.A. Piatra-Neamt: According to para. ((1) art. II of EMERGENCY ORDINANCE no. 7 7 of 19 February 2013 , published in MONITORUL OFFICIAL no. 111 111 of 26 February 2013, the period laid down in Article VI of Government Emergency Ordinance no. 91/2012 for amending and supplementing certain normative acts in the field of health, published in the Official Gazette of Romania, Part I, no. 886 of 27 December 2012, shall be extended until 1 April 2013. The Romanian Parliament adopts this law + Chapter I General provisions + Article 1 This law regulates the provision of continuity of primary care through permanent centers at the level of local authorities arondate. --------- Article 1 has been amended by section 1. 1 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. + Article 2 (1) The permanent centers are forms of organization of medical activity in the health system, fixed or mobile, without legal personality, which operates outside the program of activity of the family medicine cabinet established and provided in the contract for the provision of medical services in primary health care concluded with the health insurance house, which are organized under the conditions provided by law and which ensure the continuity of primary health care. ... --------- Alin. ((1) art. 2 2 has been amended by section 2 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2) In order to ensure the continuity of primary care, according to this law, family medicine offices may employ general medical practitioners and nurses who have authorized the exercise of the profession in accordance with the legal provisions in force, within the limits of the funds contracted with the health insurance companies with this destination. ... --------- Alin. ((2) art. 2 2 has been amended by section 2 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2 ^ 1) Nurses necessary for the work of permanent centers can be assigned by family doctors associated according to a schedule established by common agreement between doctors who ensure continuity of health care and nurses employees, in compliance with legal provisions in force. --------- Alin. ((2 ^ 1) art. 2 2 has been introduced by section 3 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2 ^ 2) The activity of nurses provided in par. (2 ^ 1) is paid by the family doctor, with the hourly rate set according to the salary negotiated for the hours actually provided outside the established working hours, and shall be borne from the amounts settled by the health insurance companies medical offices with which they have concluded a separate contract to ensure the continuity of primary care through permanent centers. --------- Alin. ((2 ^ 2) art. 2 2 has been introduced by section 3 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (3) Fixed permanent centers are health facilities with stable headquarters, without legal personality, which can have special trucks to carry out consultations at the patients ' home. The activity within the fixed permanent centers is carried out as a guard, at their headquarters, as well as in the area aronded to the center, if the center has the autospecial for conducting consultations at the patients ' home. ... (4) Mobile permanence centres are forms of organisation of medical activity which ensure the continuity of primary care in on-call mode, from the level of ambulance services, family medicine offices or, where appropriate, at the doctor's home, and who use autospecials for home consultations. ... (5) The permanent centers referred to in par. (1) shall be established on the basis of the provision issued by the executive director of the county public health department and of the city of Bucharest, as the case may be, with the prior agreement of the institutions provided in 4. ... --------- Alin. ((5) art. 2 2 has been introduced by section 4 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (6) The association of physicians in order to participate in ensuring the continuity of primary care through permanent centers is carried out on the basis of an association agreement, under the conditions laid down in the methodological norms regarding the insurance continuity of primary care through permanent centres. ... --------- Alin. ((6) art. 2 2 has been introduced by section 4 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. --------- Article 2 has been amended by section 2. 1 1 of art. I of ORDINANCE no. 11 11 of 30 January 2008 , published in MONITORUL OFFICIAL no. 79 79 of 1 February 2008. + Article 3 Permanent centers are organized in isolated or difficult accessible areas or in urban or rural localities where the public health departments, namely the medical directions in ministries and institutions with their own health network, believes that the continuity of primary care is necessary. -------- Article 3 has been amended by section 3. 1 1 of art. I of ORDINANCE no. 32 32 of 14 July 2005 , published in MONITORUL OFFICIAL no. 641 641 of 20 July 2005. + Article 4 (1) The areas in which permanent centres are established are established by the public health directorates, with the prior consent of the local councils. ... --------- Alin. ((1) of art. 4 4 has been amended by section 1 1 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 5 5 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2) I take exception to the provisions of par. (1) the permanent centers organized within the ministries and institutions with their own health network, which are established in the areas established by the medical directions in the structure of the respective ministries and institutions, with the prior consent of the House by Health Insurance, Public Order, National Safety and Judicial Authority, respectively of the House of Health Insurance of the Ministry of Transport, Construction and Tourism. ... --------- Article 4 has been amended by section 4. 5 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. + Chapter II Establishment, organisation and operation of permanent centres + Article 5 The tasks of the public health departments on the functioning of the permanent centres are as follows a) territorial arondation of localities at permanent centers; ... b) control of organization and activity; ... c) the approval of the monthly appointment of doctors participating in ensuring the continuity of primary care within the permanent centers, established by the coordinating physician of the center, until the 25th of the current month for the month next. ... --------- Article 5 has been amended by art. IV of EMERGENCY ORDINANCE no. 91 91 of 12 December 2012 , published in MONITORUL OFFICIAL no. 886 886 of 27 December 2012. + Article 6 (1) The tasks of the local councils on the functioning of the permanent centres consist of ... a) ensuring the necessary spaces for the activity of permanent centers; ... b) providing support to ... c) ensuring the minimum endowment necessary for the functioning of the permanent centers, established by order of the Minister of Health; ... d) providing utilities necessary for the operation of permanent centers. ... e) ensuring the security of the permanent centers. ... --------- Lit. e) a par. ((1) of art. 6 6 was introduced by section 4.2. 3 3 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 7 7 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2) Local councils may participate in providing emergency kits with medicinal products and sanitary materials necessary to provide medical assistance at the level of permanent centers, in accordance with the minimum scale established by order of Health Minister ... (3) I am an exception to the provisions of para. (1) and (2) the permanent centres organized within the ministries and central institutions with their own health network, for which the conditions necessary for operation, including the provision of medicines and sanitary materials for emergency kits, shall be ensure the ministries and central institutions in which they are organised. ... --------- Article 6 has been amended by section 6. 7 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. + Article 7 (1) The continuity of primary care is ensured through the permanent centers of family doctors, general medicine doctors and nurses who exercise their profession under the law. ... (2) Doctors referred to in par. (1), which operates in territorial arondate localities at the permanent centers, in contractual relationship with health insurance companies, ensures the continuity of primary health care through permanent centers, in conditions of this law ... --------- Alin. ((2) of art. 7 7 has been amended by section 4 4 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 8 8 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (3) The activity of the doctor is usually carried out at the headquarters of the permanent center. ... (4) By exception to the provisions of par. (3), the doctor can travel to major emergencies within the locality where the permanent center is located. ... (5) Through the permanent centers organized under the law, the medical services provided in the methodological norms on ensuring the continuity of primary health care through the permanent centers are granted. ... (6) Medical services provided in par. ((5) shall be granted to all persons who require them, regardless of the quality of their insured or uninsured. ... (7) If they cannot participate in ensuring the continuity of primary care through permanent centers, under the conditions of this law, or they cannot comply with the programming approved by the public health directorates or the directions medical from the structure of ministries and institutions with their own health network, as the case may be, doctors ensure their replacement by another doctor, with the information, in writing, of public health departments or medical departments in the structure ministries and institutions with their own health network, as appropriate. ... --------- Alin. ((7) of art. 7 7 has been amended by section 5 5 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 9 9 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. --------- Article 7 has been amended by the subsection. 1 1 of section 2 2 of the single article of LAW no. 244 244 of 23 June 2009 , published in MONITORUL OFFICIAL no. 445 445 of 29 June 2009, amending the single article of EMERGENCY ORDINANCE no. 32 32 of 1 April 2009 , published in MONITORUL OFFICIAL no. 214 214 of 2 April 2009. + Article 8 (1) The permanent centers operate with a minimum of 7 doctor posts and, as the case may be, with a minimum of 7 medical assistant positions. The criteria for organizing the activity of the centers, as well as other aspects regarding their functioning are established by the methodological norms for the application of the provisions of this law, in consultation with ministries and institutions with sanitary network own, which is published in the Official Gazette of Romania, Part I. ... --------- Alin. ((1) of art. 8 8 has been modified by the subsection. 2 2 of section 2 2 of the single article of LAW no. 244 244 of 23 June 2009 , published in MONITORUL OFFICIAL no. 445 445 of 29 June 2009, amending the single article of EMERGENCY ORDINANCE no. 32 32 of 1 April 2009 , published in MONITORUL OFFICIAL no. 214 214 of 2 April 2009. (2) If the family doctors cannot be insured from the respective administrative-territorial units or from the health facilities belonging to the ministries and institutions with their own health network, doctors from the units administrative-territorial, other than those arondate to the center. ... (3) The public health departments, namely the medical directorates of the ministries and institutions with their own health network, call for each permanent center a coordinating physician between the associated family doctors. ... -------- Article 8 has been amended by section 6.6. 5 5 of art. I of ORDINANCE no. 32 32 of 14 July 2005 , published in MONITORUL OFFICIAL no. 641 641 of 20 July 2005. + Article 9 (1) The financing of the continuity of services in primary care shall be made from the state budget, through the budget of the Ministry of Health, through transfers to the budget of the National Single Health Insurance Fund, within the limits of the amounts approved annually with this destination. ... --------- Alin. ((1) art. 9 9 has been amended by section 10 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. ((1 ^ 1) Financing the continuity of services in primary care, namely the payment of medical personnel operating within the permanent centers and the endowment of the emergency kit can also be done from local budgets. --------- Alin. ((1 ^ 1) of art. 9 9 was introduced by art. XI of EMERGENCY ORDINANCE no. 2 2 of 29 January 2014 , published in MONITORUL OFFICIAL no. 104 104 of 11 February 2014. (2) The payment of doctors operating within the permanent centers is based on a distinct contract concluded between the doctor and the health insurance company, under the conditions provided by the methodological norms for the application of this laws. ... (3) The payment of nurses shall be made in accordance with the legal regulations in force or, as the case may be, in accordance with the specific regulations of ministries and institutions with their own health network, for the nurses of the centres of permanent organised within them. ... -------- Article 9 has been amended by section 6.6. 4 4 of art. I of ORDINANCE no. 11 11 of 30 January 2008 , published in MONITORUL OFFICIAL no. 79 79 of 1 February 2008. + Article 10 (1) The transport of emergency cases of the permanent centers is provided, as the case may be, by the ambulances of the nearest substation of the county ambulance service or the Bucharest-Ilfov Ambulance Service of Bucharest and Ilfov County, respectively by ambulance services organized by ministries and institutions with their own health network that have established permanent centers. ... --------- Alin. ((1) of art. 10 10 has been amended by section 6 6 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 11 11 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2) In addition to the permanent centers providing medical assistance for at least 10 localities, an ambulance or SMURD substation is established. ... --------- Alin. ((2) of art. 10 10 has been amended by section 6 6 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 11 11 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (3) The activity outside the permanent center is coordinated by the medical dispatch of the public ambulance service or, as the case may be, by the integrated emergency dispatch. ... --------- Alin. ((3) art. 10 10 has been amended by section 11 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (4) The coordinators of the permanent centers organized within the health network of the Ministry of Interior and Administrative Reform are appointed according to the provisions of art. 8 8 para. ((3). For the activities carried out outside the permanent center, the coordination will be provided by the heads of the medical centers for diagnosis and outpatient treatment of the Ministry of Interior and Administrative Reform, respectively of the centers county medical and the city of Bucharest. ... -------- Alin. ((4) of art. 10 10 has been introduced by section 5 5 of art. I of ORDINANCE no. 11 11 of 30 January 2008 , published in MONITORUL OFFICIAL no. 79 79 of 1 February 2008. (5) In the case of permanent centers organized within the health network of the Ministry of Interior and Administrative Reform, respectively of the Ministry of Transport, the special vehicle equipped for the trips of doctors to emergency consultations will be provided by the units of the Ministry of Interior and Administrative Reform, respectively by the units of the Ministry of Transport in the territory of the permanent center. ... -------- Alin. ((5) of art. 10 10 has been introduced by section 5 5 of art. I of ORDINANCE no. 11 11 of 30 January 2008 , published in MONITORUL OFFICIAL no. 79 79 of 1 February 2008. -------- Article 10 [initially with a single paragraph] has been amended by point (a). 7 7 of art. I of ORDINANCE no. 32 32 of 14 July 2005 , published in MONITORUL OFFICIAL no. 641 641 of 20 July 2005. + Article 11 The opening hours of the permanent centers shall be established between 15,00-8,00 on working days and permanently, on non-working days. + Chapter III Transitional and final provisions + Article 12 Family doctors associated in permanent centers have the obligation to display at the medical office in which they operate during the working hours the following data: a) the permanent center that ensures the resolution of emergency situations outside the activity program; ... b) the telephone number of the permanent centre; ... c) the program of each of the associated ... d) 112 single telephone call number for emergency calls. ... --------- Article 12 has been amended by section 4.2. 12 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. + Article 13 (1) If there is no space available, until the premises are provided by the local authorities for the organization of an independent permanent center, the resolution of emergency situations outside the activity program may be provided by rotation, by the family doctors associated with this purpose, at the headquarters of each medical office. ... --------- Alin. ((1) of art. 13 13 has been amended by section 7 7 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 13 13 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2) In the situations provided in par. (1) each family doctor has the obligation to display at the medical office the appointment and the place where emergency situations are ensured, the name of the doctor, the telephone number of the scheduled medical office, as well as the telephone number to which The substation of the corresponding ambulance service can be called. ... --------- Article 13 has been amended by section 1. 13 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. + Article 14 The permanent centers established until the date of entry into force of this Law will reorganize their activity according to its provisions. + Article 14 ^ 1 (1) If family doctors do not comply with the provisions of art. 7 7 para. (2) and (7), the health insurance companies with which they are in contractual relationship diminish monthly, by 10%, the guaranteed minimum value of the point per capita, respectively the monthly income of the newly arrived doctors in a locality, established in accordance with the provisions of the Framework Contract on the conditions for the provision of health care in the health insurance system. ... --------- Alin. ((1) of art. 14 ^ 1 has been amended by section 4.2 8 8 of art. unique from LAW no. 124 124 of 12 July 2012 , published in MONITORUL OFFICIAL no. 484 484 of 16 July 2012, amending section 14 14 of art. unique of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. (2) Provisions of para. (1) shall apply until the date of conclusion by the family doctor and the health insurance company of the distinct contract for ensuring the continuity of primary medical care through the permanent centers, under the conditions of this law. ... --------- Article 14 ^ 1 has been introduced by item 1. 14 of the single article of ORDINANCE no. 7 7 of 26 January 2011 , published in MONITORUL OFFICIAL no. 78 78 of 31 January 2011. -------- Article 15 has been repealed by point (a). 7 7 of art. I of ORDINANCE no. 11 11 of 30 January 2008 , published in MONITORUL OFFICIAL no. 79 79 of 1 February 2008. + Article 16 The provisions relating to the operation of centres of permanence within ministries and institutions with their own health network shall apply from 1 January 2006. --------- Article 16 has been amended by section 4. 9 9 of art. I of ORDINANCE no. 32 32 of 14 July 2005 , published in MONITORUL OFFICIAL no. 641 641 of 20 July 2005. This law was adopted by the Romanian Parliament, in compliance with the provisions of art. 76 76 para. (2) of the Romanian Constitution, republished. CHAMBER OF DEPUTIES PRESIDENT VALER DORNEANU SENATE PRESIDENT NICOLAE VACAROIU Bucharest, June 16, 2004. No. 263. -----------
