Two ministries: health and families are preparing a draft to amend the law on social assistance and the law on medical activity. It was envisioned that the DPS could contract with the National Health Fund and, as a medical entity, provide outpatient health services at its expense. The provisions should also “indirectly” regulate the legal position of nurses working at the DPS.
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The list of legislative and program works of the Council of Ministers contains the principles for the draft law amending the law on social assistance and the law on medical activity (project number: UD409). The planned date for government approval of the project is the fourth quarter of 2022.
As we read in the project description, due to the advancing demographic changes, including: on the increasing number of older people (with a simultaneous decrease in the number of young people) and cultural and social activities where, among other things, an increasing number of single-person households are concerned with the systems of social assistance and health protection to increasing challenges. One of the solutions to these challenges is greater integration of the above systems, allowing for the optimal resources available and the optimization and maximization of benefits for recipients and the wider society as a whole.
The proposed provisions are intended to enable the DPS to provide ambulatory health services to the residents of the homes who need these services. Currently, health services, including publicly funded health services (guaranteed services), may only be provided to residents of SCH by “external” entities, i.e. by medical entities and persons practicing a medical profession as part of their profession (mainly nurses ).
The proposed solutions are aimed at a more complete integration of the welfare function with the care functions. Thanks to this solution, the Public Prosecution Service can provide care directly to its residents.
Changes to DPS. What does the bill provide?
The draft scheme stipulates that DPS, as a medical entity, will provide ambulatory health services. These services would be performed in an outpatient clinic which is a DPS treatment facility.
The costs of setting up a health center and performing medical work in a care home are not included in the average monthly cost of living in a care home.
After implementation of the changes, the DPS will be able to be a healthcare provider within the meaning of the provisions of the law of 27 August 2004 on publicly funded health services (Official Gazette 2021, item 1285, as amended), conclude agreements with the National Health Fund on basis on which it will provide healthcare to its residents. In addition, the proposed regulation “indirectly” (DPS as a medical entity) regulates the legal position of the nurses currently working at the DPS.
DPS as a healthcare institution: conditions
The proposed regulation provides for the possibility to carry out health activities by the DPS (regardless of the organizational form in which it operates) according to the conditions stipulated in the law of 15 April 2011 on medical activities (Official Gazette of 2022, item 633 , as amended) d .). DPS will be able to apply to the voivode, as the body that keeps the register of entities performing medical activities, for registration in the register.
Nursing home can start medical work after the conditions for performing medical work have been met, namely:
- Having suitable rooms and appliances.
- Employment of medical professionals, for example nurses.
- Use of medical devices.
- Taking out a third-party liability insurance contract in connection with running a medical entity.
In addition, the rules on the principles of management of the DPS (acting in the form of a budget unit) and the method of selection and employment of a manager are regulated in the Act of 12 April 2004 on social assistance ( Journal of Laws of 2021 , item 2268, as amended), it was proposed to exclude the application of certain provisions of the Act of 15 April 2011 on Medical Activity (Articles 46 (2) – (4), 47 and 49 of the Qualification Requirements Act for the head of a medical entity that is not an entrepreneur, grounds for hiring a manager and assuming another employment by him). In addition, it was proposed that the provision of art. 48 of the law of 15 April 2011 on medical activity, which concerns the social council.
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