Law No. 263 Of 16 June 2004 On The Continuity Of Primary Health Care Through The Centers Of All Times

Original Language Title:  LEGE nr. 263 din 16 iunie 2004 privind asigurarea continuităţii asistenţei medicale primare prin centrele de permanenţă

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Law No. 263 of 16 June 2004 (* updated *) to ensure continuity of primary health care through the centres of all times (updated until 11 February 2014 *)-PARLIAMENT ISSUING — — — — — — — — — — — —-*) form of this updated regulatory action until 11 February 2014 is carried out by the legal department within the S.C. "territorial Center of Electronic Computing" Piatra Neamt by including all changes and additions made to the : Order No. 32 of 14 July 2005; Law No. 14 of 11 January 2006; ORDINANCE No. 11 of 30 January 2008; EMERGENCY ORDINANCE No. 32 as of April 1, 2009; Law No. 244 of 23 June 2009; ORDINANCE No. 7 of 26 January 2011; Law No. 124 of 12 July 2012; EMERGENCY ORDINANCE No. 91 of 12 December 2012 *); EMERGENCY ORDINANCE No. 2 of 29 January 2014.
The contents of this act is not an official document, being intended for the information of users *) NOTE C.T.C.E. S.A. Piatra Neamt: according to paragraph 2. (1) of article 1. The EMERGENCY ORDINANCE nr. 7 of 19 February 2013, published in MONITORUL OFICIAL nr. 111 of 26 February 2013, within the period prescribed in article VI of the Government Emergency Ordinance nr. 91/2012 for the modification and completion of some legal acts in the field of health, published in the Official Gazette of Romania, part I, no. 886 of 27 December 2012, shall extend until 1 April 2013.
Romanian Parliament adopts this law.


Chapter I General provisions Article 1 this law shall regulate insuring through primary health care centers in local communities permanently subordinated level.
— — — — — — — —- 1 was amended by section 1 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.


Article 2 (1) permanently centres are forms of organisation of medical activity in the health system, fixed or mobile, without legal personality, which operates outside of the family medicine cabinet established in the contract for the provision of medical services in primary health care concluded with health insurance, which are organized under the conditions provided for by law and ensuring continuity of primary health care.
  

— — — — — — — —-. (1) of article 1. 2 was amended by section 2 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(2) in order to ensure the continuity of primary health care, according to this law, family medicine cabinets can engage medical doctors and nurses who had authorized the pursuit of the profession in accordance with the legal provisions in force, within the limits of funds contracted with health insurance with this destination.
  

— — — — — — — —-. (2) of article 9. 2 was amended by section 2 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.
(2 ^ 1) Nurses needed for activity centers can be assigned permanently for family physicians associates a graph determined by mutual agreement between doctors that provide continuity of care and nurses employed in compliance with the legal provisions in force.
— — — — — — — —-. (2 ^ 1), art. 2 was introduced by point 3 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.
(2 ^ 2) The work of nurses referred to in paragraph 1. (2 ^ 1) shall be paid by the family doctor, with fixed hourly rate depending on salary negotiated for hours actually rendered outside working hours set, and shall be borne by the amounts reimbursed by the health insurance medical cabinets which have concluded separate agreement for continuity through the primary health care centres.
— — — — — — — —-. (2 ^ 2) of art. 2 was introduced by point 3 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(3) permanently fixed centres are established with sanitary units, without legal personality, which can have the armored vehicles for carrying out consultations to patients. Activity within the fixed centers continually unfolds under a guard, on its premises, as well as in part of the area of the Centre, where the Centre has autospecială for carrying out consultations to patients.
  

(4) mobile centres permanently represent forms of organisation of medical activity that ensures continuity of primary health care under guard of the ambulance services, family medicine cabinets or, where appropriate, the physician, and who use the vehicles for consultations at home.
  

(5) permanently centres referred to in paragraph (1) shall be established on the basis of the provision issued by the Executive Director of the County Department of public health and of Bucharest, where appropriate, with the prior agreement of the institutions referred to in article 1. 4.---------. (5) article. 2 was introduced by section 4 of the article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(6) the Association of physicians to participate in ensuring the continuity of primary health care through continually centres shall be carried out on the basis of association conventions, in terms of the methodological norms regarding the continuity of primary health care through the centres.
  

— — — — — — — —-. (6) article. 2 was introduced by section 4 of the article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.
— — — — — — — —- 2 was amended by section 1 of article. 1 of ORDINANCE No. 11 of 30 January 2008, published in MONITORUL OFICIAL nr. 79 of 1 February 2008.


Article 3 are held continually centers in isolated areas or accessible times from urban areas or rural areas where public health directorates, namely medical departments and ministries of health institutions with his own network, believes that it is necessary to ensure continuity of primary health care.
— — — — — — —- 3 was amended by section 1 of article. 1 of ORDINANCE No. 32 of 14 July 2005, published in Official Gazette No. 641 of 20 July 2005.


Article 4 (1) shall be established in Areas that continually centers are established by the public health departments, with the prior consent of local councils.
  

— — — — — — — —-. (1) of article 1. 4 was amended by section 1 of article. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which amends section 5 of art. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(2) exception from paragraph 1. (1) permanently organized centres in ministries and institutions with his own health network, which is set up in the areas determined by the structure of the medical departments of the ministries and institutions concerned with the prior consent of the House of health insurance defence, public order, national security and Judicial Authority, namely the health insurance of the Ministry of transport, constructions and tourism.
  

— — — — — — — —- 4 was amended by section 5 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.


Chapter II establishment, organisation and functioning of centres permanently Article 5 Powers of public health concerning the operation of all times are as follows: the arondarea of localities) territorial centres of all times;
  

(b) Organization and control) activities;
  

c) advising doctors monthly programming involved in insuring primary health care within the centres, established by the Coordinator of the Centre, the doctor until the 25th day of the month for the following month.
  

— — — — — — — —- 5 was modified by art. IV of the EMERGENCY ORDINANCE nr. 91 of 12 December 2012, published in MONITORUL OFICIAL nr. 886 of 27 December 2012.


Article 6 (1) the functions of local councils on the functioning of the centres of all times: the spaces required) ensuring activity centres for perpetuity;
  

b) ensuring staff;
  

(c) ensuring the minimum necessary) to equip the centres functioning permanently fixed by order of the Minister of health;
  

(d) securing the necessary utilities) operation centers.
  

e) securing of all times.
  

— — — — — — — —-Lit. s) para. (1) of article 1. 6 was introduced by point 3 of article 1. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which amended point 7 of article. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.


(2) the local councils can participate in ensuring emergency kits to equip it with the necessary medicines and sanitary materials to grant medical assistance at the level of all times, in accordance with the scale fixed by minimal order of the Minister of health.
  

(3) exception from paragraph 1. (1) and (2) permanently organized centres in ministries and central institutions with his own health network, for which the conditions of functioning, including equipping with medicines and sanitary materials for emergency kits, ensure that ministries and central institutions in the structure to which they are organized.
  

— — — — — — — —- 6th amended point 7 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.


Article 7 (1) continuity of primary health care is met by continually centres of family doctors, medical doctors and nurses exercising their profession in accordance with the law.
  

(2) referred to in paragraph 1. Doctors (1), which operates in the territorial settlements subordinated to the centers, which are in a contractual relationship with health insurance, ensure continuity of primary health care through the centres, under the present law.
  

— — — — — — — —-. (2) of article 9. 7 was amended by paragraph 4 of art. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which amends section 8 of art. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(3) the doctor is taking place, as a rule, at the Centre of all times.
  

(4) Notwithstanding the provisions of paragraphs 1 and 2 of the. (3), the doctor can travel to major emergencies within the locality where the located Center.
  

(5) by continually centres are organised in accordance with the law shall be paid to the medical services provided for in the methodological norms regarding the continuity of primary health care through the centres.
  

(6) medical services referred to in paragraph 1. (5) shall be granted to all persons requesting them, regardless of the quality of insured or uninsured.
  

(7) in the event that I can't participate in the continuity of primary health care through the centres, under the present law, or cannot comply with the schedule approved by the public health departments of the times medical departments of ministries and institutions structure with its own health network, if applicable, the doctors provide their replacement by another physician, notification in writing , public health directorates or divisions in the structure of ministries and medical institutions with his own health network, where appropriate.
  

— — — — — — — —-. (7) article. 7 was amended by section 5 of art. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which amends point 9 of article. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.
— — — — — — — —- 7 was changed by subpct. 1 of item 2 of article in law No. 244 of 23 June 2009 published in Official Gazette No. 445 from June 29, 2009, which amends article in EMERGENCY ORDINANCE No. 32 as of April 1, 2009, published in MONITORUL OFICIAL nr. 214 of 2 April 2009.


Article 8 (1) permanently centres works with a number of minimum 7 posts of physician and, where appropriate, with a minimum of 7 medical Assistant positions. Criteria for organizing the work of the centres, as well as other aspects of their operation shall establish detailed rules for the application of the provisions of this law, in consultation with the ministries and institutions with his own health network, to be published in the Official Gazette of Romania, part I.
  

— — — — — — — —-. (1) of article 1. 8 has been modified by subpct. 2 of item 2 of article in law No. 244 of 23 June 2009 published in Official Gazette No. 445 from June 29, 2009, which amends article in EMERGENCY ORDINANCE No. 32 as of April 1, 2009, published in MONITORUL OFICIAL nr. 214 of 2 April 2009.

(2) in the event that family doctors may not be make from administrative-territorial units concerned or of sanitary units belonging to ministries and institutions with own sanitary network can participate in the Association in the territorial-administrative units, other than those allotted to the Centre.
  

(3) public health Directorates, namely medical departments and ministries of health institutions with his own network, called permanency for each centre a physician Coordinator of family physicians associates.
  

— — — — — — —- 8 was amended by section 5 of art. 1 of ORDINANCE No. 32 of 14 July 2005, published in Official Gazette No. 641 of 20 July 2005.


Article 9 (1) Funding to ensure continuity of services in the primary health care is made from the State budget through the budget of the Ministry of health, through the National Fund budget transfers unique health insurance, within the limit of the amounts approved annually with this destination.
  

— — — — — — — —-. (1) of article 1. 9 was amended by paragraph 10 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.
(1 ^ 1) Funding to ensure the continuity of services in primary health care, i.e. payment of medical personnel working permanently within the centres and equipping emergency description here can be made and from the local budgets.
— — — — — — — —-. (1 ^ 1), art. 9 was introduced by art. The EMERGENCY ORDINANCE nr. 2 of 29 January 2014, published in MONITORUL OFICIAL nr. 104 of 11 February 2014.

(2) payment of physicians that operate within the centres of all times is made on the basis of a separate agreement between the physician and the health insurance House, under the detailed rules for the application of this law.
  

(3) payment of nurses is made in accordance with the legal regulations in force or, where appropriate, in accordance with the specific regulations of ministries and institutions with own sanitary network for nurses you permanently organized centres within them.
  

— — — — — — —- 9 was amended by paragraph 4 of art. 1 of ORDINANCE No. 11 of 30 January 2008, published in MONITORUL OFICIAL nr. 79 of 1 February 2008.


Article 10 (1) in cases of emergency of all times is provided, as appropriate, to the nearest ambulances Service substations County ambulance or ambulance service of the municipality of Bucharest-Ilfov Bucharest and Ilfov County, ambulance services organized by ministries and institutions with own sanitary network which have established centres.
  

— — — — — — — —-. (1) of article 1. 10 was amended by section 6 of article. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which changes the point 11 of article 1. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(2) in addition to the centers of all times which provides medical care for at least ten villages, set up an ambulance substation or the atomic bomb.
  

— — — — — — — —-. (2) of article 9. 10 was amended by section 6 of article. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which changes the point 11 of article 1. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(3) the work outside the center of all times is controlled by dispatcher medical ambulance public service or, where appropriate, integrated emergency dispatcher.
  

— — — — — — — —-. (3) art. 10 has been changed from point 11 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(4) co-ordinators continually centres organized within the network health of the Ministry of Interior and Administrative reform are appointed in accordance with the provisions of art. 8 para. 3. For activities outside the Centre, coordination will be assured of medical diagnostic centres and outpatient treatment of the Ministry of Interior and Administrative reform, namely medical centers and of the municipality of Bucharest.
  

— — — — — — —-. (4) article. 10 was introduced by section 5 of art. 1 of ORDINANCE No. 11 of 30 January 2008, published in MONITORUL OFICIAL nr. 79 of 1 February 2008.

(5) in the case of centres within the network permanently organized health of the Ministry of Interior and Administrative reform, the Ministry of transport, specially equipped vehicle for trips to emergency physicians ' consultations will be provided by units of the Ministry of Interior and Administrative reform, the Ministry of transportation of the units awarded permanently Centre respectively.
  

— — — — — — —-. (5) article. 10 was introduced by section 5 of art. 1 of ORDINANCE No. 11 of 30 January 2008, published in MONITORUL OFICIAL nr. 79 of 1 February 2008.
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Art. 10 [originally single-paragraph] was amended by point 7 of article. 1 of ORDINANCE No. 32 of 14 July 2005, published in Official Gazette No. 641 of 20 July 2005.


Article 11 the working permanently centres shall be established between 15.00-8.00 on weekdays and permanent, non-working days.


Chapter III transitional and final Provisions Article 12 family doctors associates in perpetuity are required to show medical in which operates during working hours the following data: the times Center) which provide for the resolution of emergency situations outside work;
  

b) telephone number of all times;
  

c) program of doctors Associates;
  

d) number of unique call 112 for emergency calls.
  

— — — — — — — —- 12 has been modified by item 12 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.


Article 13 (1) in a situation where there is space available, up to the insurance of the premises by the local authorities to organize a permanently independent, resolving emergency situations outside of the task can be ensured by rotation by family physicians Associates for this purpose, at the base of each clinic.
  

— — — — — — — —-. (1) of article 1. 13 has been amended point 7 of article. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, which amends point 13 of article. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(2) in the cases referred to in paragraph 1. (1) each family physician is required to show medical schedule and shall ensure the resolution of emergency situations, the doctor's name, phone number, medical cabinet, as well as the phone number which can be called ambulance service substation.
  

— — — — — — — —- 13 has been amended item 13 of article in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.


Article 14 centres permanently set up until the date of entry into force of the present law would reorganize the work under it.


Article 14 ^ 1 (1) where family physicians do not comply with the provisions of art. 7 para. (2) and (7), with health insurance who are in contractual relationship diminishes every month, 10% minimum guaranteed amount of per capita income, respectively, of physicians new arrivals in a locality, as determined in accordance with the provisions of the framework contract concerning conditions of granting medical assistance within the system of health insurance.
  

— — — — — — — —-. (1) of article 1. 14 ^ 1 was amended by section 8 of article. in accordance with law No. 124 of 12 July 2012, published in MONITORUL OFICIAL nr. 484 of 16 July 2012, point 14 amending art. in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

(2) the provisions of paragraphs 1 and 2. (1) shall apply until the date of conclusion by the family doctor and the House health insurance contract to be distinct in order to ensure the continuity of primary health care through the centres, under the present law.
  

— — — — — — — —- 14 ^ 1 was introduced by the pct article 14, in ORDER No. 7 of 26 January 2011, published in MONITORUL OFICIAL nr. 78 of 31 January 2011.

— — — — — — —- 15 was abrogated by point 7 of article. 1 of ORDINANCE No. 11 of 30 January 2008, published in MONITORUL OFICIAL nr. 79 of 1 February 2008.


Article 16 the provisions relating to the functioning of the centres permanently within the ministries and institutions with own sanitary network shall apply with effect from 1 January 2006.
— — — — — — — —- 16 was amended by point 9 of article. 1 of ORDINANCE No. 32 of 14 July 2005, published in Official Gazette No. 641 of 20 July 2005.

This law was adopted in the Romanian Parliament, in compliance with the provisions of art. 76 para. (2) of the Constitution of Romania, republished.
PRESIDENT of the CHAMBER of DEPUTIES VALER DANNER SENATE CHAIRMAN NICOLAE VĂCĂROIU Bucharest, June 16, 2004.
No. 263.
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