About The Order Of Carrying Out The Reform Of The Health Care System In Vinnytsia, Dnipropetrovsk, Donetsk Oblasts And The City Of Kyiv

Original Language Title: Про порядок проведення реформування системи охорони здоров'я у Вінницькій, Дніпропетровській, Донецькій областях та місті Києві

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Read the untranslated law here: http://zakon3.rada.gov.ua/laws/show/3612-17

                                                          
With a k o n u r as th h s About order of reforming the health care system in Vinnytsia, Dnipropetrovsk, Donetsk oblasts and the city of Kyiv (Supreme Council of Ukraine (BD), 2012, N 12-13, 81) {amended in accordance with the laws of 5081 N-VI (5081-17) from 05.07.2012, VVR, 2013, N 30, 340 N 1197-VII (1197-18) from 10.04.2014, VVR, 2014 , N 24, item 883} establishes the organizational and legal framework for reforming the health care system in Vinnytsia, Dnipropetrovsk, Donetsk oblasts and in Kiev.
Article 1. Reforming the health care system 1. To implement in Vinnytsia, Dnipropetrovsk, Donetsk oblasts and Kyiv City pilot project to reform the health care system (hereinafter the pilot project) is the introduction and development of new organizational and economic mechanisms aimed at enhancing the efficiency and accessibility of health care and are necessary for the development of the system of health protection of Ukraine.
2. A pilot project to reform the health care system provides for during the 2011-2014 structurally-organizational and functional reorganization of the system of medical care in pilot regions that will: increase the level of health care of the population, to expand the opportunities for its availability and quality;
implement new approaches to the Organization of health care establishments in pilot regions and their financial security;
increase the efficiency of use of budget funds provided for the financial security of the health care system in pilot regions.
3. Implementation of the pilot project involves: creating on the basis of the existing institutions in pilot regions for health network structured by type of health care system of medical service by way of separating (or Union) health care establishments that meet the needs of the population in the primary, secondary, tretinnìj, and ekstrenìj medical care;
Organization and functioning in pilot regions of primary medical centers (health) care to meet the needs of the population in such medical care;
diversifying health care establishments of pilot regions that provide secondary (specialized) medical assistance, taking into account the intensity of its provision;
the Organization of activities in pilot regions hospital districts must ensure that the conditions for granting public secondary (specialized) medical assistance;
in pilot regions the centres of emergency medical care to meet the needs of the population in the following medical care;
the redistribution of resources between institutions of health pilot regions, providing primary, secondary (specialized), tretinnu (highly specialized) and emergency medical care on the territory of these regions;
Division of expenditure between local health budgets according to the kind of medical care;
implementation starting in 2012, the financial security of health care establishments in pilot regions for the types of medical assistance in accordance with agreements on medical care of the population in accordance with the requirements of this law;
Introduction starting in 2012, the system of indicators of the quality of primary, secondary (specialized), tertiary (tertiary care) and emergency medical care, which are taken into account during the evaluation of the quality of care of the corresponding type;
application of elements of program-target method in the budget process at the level of local budgets in expenditure on health for the relevant types of medical care.
Participants in the pilot project are health regardless of the type and the type that carry medical service on the territory of the pilot regions in accordance with the requirements of this law, as well as the central body of the Executive power in the sphere of health, local State administration and local self-government bodies in pilot regions.
4. for the purposes of this law, municipal health institutions in pilot regions according to law can be reorganized in a communal non-profit company or municipal non-profit institution whose main purpose is to implement the health care of the population without the goal of profit.
Such health care institutions are non-profit organizations.
Article 2. The network of health establishments of pilot regions 1. The network of health establishments in pilot regions-a set of health care establishments that meet in pilot regions in need of medical service, based on professional medical (pharmaceutical) employees.
The functioning of the network of health establishments in pilot regions carried out taking into account the needs of the population in the medical service, the need to create conditions to ensure proper quality of such service, its timeliness and accessibility for citizens, the effective use of material, labour and financial resources.
2. Planning and forecasting the development of a network of municipal health care establishments in pilot regions carried out within

the powers defined by law, the Executive power and bodies of local self-government.
3. Planning and forecasting the development of a network of municipal health care establishments in pilot regions carried out taking into account: profile, specialization and intensity of medical aid;
standards of medical care to population by types of medical care.
The procedure of planning and forecasting the development of a network of municipal health care establishments in pilot regions, as well as regulations concerning the medical care of the population by health care defines the central body of the Executive power in the sphere of public health.
4. List of types of health care establishments by type of care, provided their functions according to the profile and specialization are determined by the central body of the Executive power in the sphere of public health.
Article 3. Organization providing primary care in pilot regions 1. Primary health care-the kind of medical care that is provided in an outpatient environment, or the place of residence (stay) the patient's physician general practitioner-family physician and envisages consultations, Diagnostics and treatment of the most common diseases, injuries, poisoning, pathological, physiological (during pregnancy), the implementation of preventive measures; direction according to the patient's medical condition, which does not require emergency medical care, to provide him secondary (specialized) or tertiary (tertiary care) health care; emergency medical care in case of an acute disorder of the physical or mental health of a patient, which requires no emergency, the secondary (specialized) or tertiary (tertiary care) care.
2. Primary medical care centers provide primary medical (health) care that are health institutions, as well as doctors general practice-family doctors who conduct economic activity of medical practice as individuals-entrepreneurs and can stay with these health care institutions in civil legal relations. The composition of primary medical centers (health) care can include structural or separated units health obstetric, outpatient clinics, medical offices, medical offices.
For the period of implementation of the pilot project of the outpatients ' clinic of general practice – family medicine can be supplied doctors therapists registers and doctors by pediatricians grudnichka registers. During this period the design schedule for primary medical centers (health) care can be included the posts of doctors obstetricians-gynecologists, surgeons, ophthalmologists, otolaringologìv, nevropatologìv, psychiatrists who provide primary medical care in certain diseases, taking into account the Division of functions between the primary and secondary (specialized) medical help.
Primary medical care, including conducting medical examination for temporary disability in accordance with the central body of the Executive power in the sphere of health, may provide doctors general practice-family physicians that conduct business with medical practices as physical persons-entrepreneurs.
3. primary medical Centers (health) care are institutions of health and can be created as a municipal non-profit company or municipal non-profit institutions, the main objective of which is to provide primary medical care without the goal of profit.
Primary medical centers (health) care are non-profit organizations.
The regulation on primary medical center (health) care is approved by the central body of the Executive power in the sphere of public health.
Electing and changing patient doctor general practitioner-family doctor and medical care to the citizens of primary medical centers (health) care shall be determined by the central body of the Executive power in the sphere of public health.
Article 4. The Organization of the provision of secondary (specialized) medical care and functioning of hospital districts in pilot regions 1. Secondary (specialized) medical assistance-the kind of medical care that is provided in an outpatient or in-patient conditions routinely or emergency cases and provide advice, Diagnostics, treatment, rehabilitation and prevention of diseases, injuries, poisoning, pathological and physiological (pregnancy and childbirth), which can be provided by doctors of the respective specialisation (except doctors general practice-family doctors); referral of the patient to provide secondary (specialized) medical assistance from another specialization or for the provision of tertiary (tertiary care) care.
2. provision of secondary (specialized) medical assistance is provided in the fixed conditions of bagatoprofìl′nimi hospitals, rehabilitation hospitals, intensive treatment (rehabilitation), the planned treatment, hospìsami, specialized medical centers; in outpatient-consultative-diagnostic

departments of hospitals, centres for medical consultation and Diagnostics (consultative-diagnostic centres).
3. The criteria for the definition of health care institutions that can meet the needs of the population in the pilot regions in the secondary (specialized) medical care, their types and kinds determined by the central body of the Executive power in the sphere of public health.
4. the Organization of medical care citizens in health care establishments of secondary (specialized) medical assistance is carried out in the manner prescribed by the central body of the Executive power in the sphere of public health.
The procedure for referral of patients to the health care establishments that provide secondary (specialized) medical assistance, the central body of the Executive power in the sphere of public health.
5. To ensure effective provision of secondary (specialized) medical assistance on the territory of the pilot regions in order (1113-2012-p), established by the Cabinet of Ministers of Ukraine, hospital districts, which include health care institutions of the respective profile and specialization.
Gospìtal′nij district-organizational and functional Association of healthcare pilot region, which satisfy the needs of the population of one or more administrative-territorial units of this region in the secondary (specialized) medical care.
Within one administrative-territorial units of the pilot region established by the Cabinet of Ministers of Ukraine of the procedure can be created more than one gospìtal′nij district.
Health care facilities may be included in the composition of the hospital districts in consultation with agencies, authorized under the Act to administer the property of these institutions.
The Organization and functioning of the hospital districts are carried out with observance of the constitutional rights of citizens to health care and medical assistance.
Standards and requirements for organization of activity of the hospital districts of pilot regions established by the central body of the Executive power in the sphere of health given the density and distribution of the population, the State of transport communications and other regional features.
6. Coordination of the activities of health care institutions that are part of the hospital district, is within the powers of the management body of the health region (Kyiv city) State administration, the corresponding pilot region.
Article 5. Organization providing tertiary (tertiary care) health care in pilot regions 1. Tertiary (visokospecìalìzovana) medical assistance-the kind of medical care that is provided in an outpatient or in-patient conditions routinely or emergency cases and provide advice, Diagnostics, treatment of diseases, injuries, poisoning, pathological conditions, physiological and pathological conditions (pregnancy and childbirth) with the use of high-tech equipment and/or highly specialised medical procedures of high complexity; referral of the patient to provide secondary (specialized) or tertiary (tertiary care) health care from another specialization.
2. provision of tertiary (tertiary care) health care is provided by the visokospecìalìzovanimi bagatoprofìl′nimi or odnoprofìl′nimi institutions of health care.
3. The criteria for the definition of health care institutions that can meet the needs of the population in tretinnìj (a highly specialised) medical care, their types and kinds determined by the central body of the Executive power in the sphere of public health.
4. the procedure for referral of patients to the health care establishments providing tretinnu (highly specialized) medical assistance, the central body of the Executive power in the sphere of public health.
Organization of health services in the tertiary health care establishments (tertiary care) health care is carried out in the manner prescribed by the central body of the Executive power in the sphere of public health.
Article 6. Organization providing emergency medical care in pilot regions 1. Emergency medical care-medical assistance, which consists in the implementation of medical workers under the law urgent organizational, diagnostic and therapeutic measures, aimed at saving and preserving human life in an urgent condition and minimize the impact of this condition on her health.
2. Organization for emergency medical care in pilot regions carried out by establishing in every region of the system of emergency medical care, which consists of emergency and disaster medicine, emergency (emergency) medical assistance teams of emergency (emergency) medical care and emergency departments (emergency) medical care.
3. the system of emergency medical care is created taking into account the need to ensure the implementation of teams of emergency (emergency) medical care standard arrival on the scene, which is determined by the Cabinet of Ministers, and their interaction with health care institutions {Text of article 6 as amended by law N 5081-VI (5081-17) from 05.07.2012}


Article 7. Organization of financial security functioning health systems in pilot regions during implementation of the pilot project 1. The Organization of the financial implementation of the pilot project includes: formation of indicators projects budgets for 2012-2014 given the concentration of budget funds for the provision of primary health care at the level of district budgets and the budgets of cities of regional value funds for the provision of secondary (specialized), tertiary (tertiary care) and emergency medical care at the level of regional budgets pilot regions (except the city of Kiev) and budget funds for the provision of primary, secondary (specialized) , tertiary (tertiary care) and emergency medical care at the level of the budget of the city of Kyiv;
the definition in the pilot regions of the volume of expenditure by levels of local budgets on health care: primary, secondary (specialized), tretinnu (highly specialized) and emergency medical assistance for the development of indicators of project budgets for 2012-2014;
the introduction of the mechanism of financial security of health care establishments in pilot regions for the types of medical care on the basis of agreements on health care of the population, who are placed in accordance with the requirements of this law.
2. Distribution of the volume of expenditure between the health establishments in pilot regions according to the kind of medical care that is provided to them, in accordance with the methodology (z1044-13), which is approved by the central body of the Executive power in the sphere of public health.
Article 8. Agreements on health care of the population of 1. The agreement on medical care of the population fit in order to ensure the provision of public health care institutions health in pilot regions.
Model agreements on medical care of the population shall be approved by the central body of the Executive power in the sphere of public health.
2. The parties to the Treaty on the medical care of the population are: regarding primary care centers of primary (health) care and appropriate the main stewards of budget funds of the district, urban (cities of regional value) budgets, the budget of the city of Kyiv;
on the secondary (specialized) medical care-health care institutions that ensure the provision of such assistance, and appropriate the main stewards of budget funds of regional budgets and the budget of the city of Kyiv;
on the tertiary (tertiary care) health care-health care institutions that ensure the provision of such assistance, and appropriate the main stewards of budget funds of regional budgets and the budget of the city of Kyiv;
for emergency medical care centers emergency medical care and appropriate the main stewards of budget funds of regional budgets and budget of the city of Kiev.
3. In the agreement on the health care of the population required shall include: the volume of medical assistance, the provision of which shall ensure the establishment of health;
indicators of quality of care;
expenditures on the provision of medical care;
the rights and obligations of the parties of their responsibility.
4. Information concerning the agreements on medical care of the population within a week from the date of their conclusion is hosted on the official Web site of the main Trustees of budget funds and available for the public places in health care establishments.
Article 9. Staff list health care establishments of pilot regions 1. Staff list health care institution in the pilot region is defined by the head of this institution and approved by its submission of the Chief Administrator of budget funds. List of the painting is formed depending on the volume of care provided by this institution.
2. for health care institutions that are participants in the pilot project, the existing staff regulations established by the central body of the Executive power in the sphere of health, does not apply.
Article 10. Pay health workers health care establishments of pilot regions 1. The conditions of remuneration of employees of health care institutions that are participants in the pilot project on reforming the health care system under this Act, including the procedure for establishing merit medical workers based on the volume and quality of the work performed (209-2012-p), are determined by the Cabinet of Ministers of Ukraine.
Article 11. Monitoring of the reform of the health care system 1. Monitoring of the reform of the health care system in Vinnytsia, Dnipropetrovsk, Donetsk oblasts and in Kiev held a central executive authority in the health sector using a system of indicators.
2. Indicators to assess the results of the pilot project, as well as indicators of the quality of medical care approved by the central body of the Executive power in the sphere of public health.
3. The results of the monitoring of the reform of the health care system are used exclusively for making decisions on further development of the system of medical service of population and health care system reform in Ukraine and may not be used for other purposes.
4. Local State administration and local authorities

Government pilot regions have the right to make to the central body of the Executive power in the sphere of health care proposals on the implementation of the pilot project on the territory of such regions.
5. Local State administrations of the pilot regions to ensure the involvement of the public, in particular associations of patients, to the monitoring and implementation of quality control of medical assistance and health services in pilot regions.
Article 12. Final and transitional provisions 1. This Act shall take effect from the day following the day of its publication, and is valid until December 31, 2014.
2. During implementation of the pilot project: action of licenses and other permits issued by establishments of health protection of the pilot regions to the enactment of this Act, apply to establishments of health protection of such regions that are created on their basis in the process of reorganization;
the doctors-specialists of the reorganized health care establishments of pilot regions that are employed as doctors general practice-family medicine, pass the appropriate specialization donated and utmost priority. Before issuing a certificate, which confirms the passing of this specialization, such doctors kept qualification category by prior profession.
3. If as a result of the reorganization of health care establishments in pilot regions employees of such institutions are transferred with their consent to the other nižčeoplačuvanu work in the same or another establishment, the remuneration of such employees is carried out according to the provisions of this law or at the request of such workers, their average earnings over the previous place of work on all the time nižčeoplačuvanoï work, but no more than six months from the date of such transfer.
4. Make changes to the following legislative acts of Ukraine: 1) to the budget code (2456-17) (Supreme Council of Ukraine, 2010, N 50-51, 572): item "and" paragraph 3 of article 89, after the words "fel′dšers′kì points" add the words "primary medical centers (health) care;
section VI "final and transitional provisions" to supplement paragraphs 12 and 13 of this "12. For the period of realization of the law of Ukraine "on the procedure for carrying out the reform of the health care system in Vinnytsia, Dnipropetrovsk, Donetsk oblasts and the city of Kyiv" (3612): 1) the Cabinet of Ministers of Ukraine has the right to change the Division of spending on health care between the local budgets of the pilot regions established in articles 89 and 90 of this code, and determine the features of the financial providing of health care institutions that are participants in the pilot project;
2) determine the General Fund spending of local budgets pilot regions for health protected;
3) to expenditures made from regional budgets, the budget of the city of Kiev and taken into account when determining the scope of intergovernmental transfers include expenditures on secondary (specialized), tretinnu (highly specialized) and emergency medical care (health care institutions in pilot regions that provide respectively the secondary (specialized), tertiary (tertiary care) and emergency medical care).
13. The expenditures made from the district budgets, budgets of cities of regional importance, the city budget and taken into account when determining the scope of intergovernmental transfers include expenditures for primary medical care (primary medical centers (health) care). "

{Sub 2 part four article 12 repealed by law N 1197-VII (1197-18) from 10.04.2014}

5. The Cabinet of Ministers within three months from the date of enactment of this Act: to adopt regulations relating to this Act;
ensure acceptance of the ministries, other Central and local bodies of executive power of regulations stemming from this law.

President of Ukraine Viktor Yanukovych Kiev, 7 July 2011 3612 N-VI