Questions and answers

No. A healthcare facility is a municipal non-profit enterprise, so, unlike a budget-funded institution, it does not draw up a budget estimate. Instead, the enterprise must agree on a financial plan with its owner — the main planning document that reflects all of the facility's income and expenses and sets out the amount and allocation of funds for performing its functions during the year in accordance with its founding documents. The local authorities approve the procedure for drawing up, approving and monitoring the implementation of the financial plan, as well as its form. The form and procedure of the financial plan differ between regions and in some cases follow the requirements set by Order of the Ministry of Economic Development of Ukraine No. 205 of 2 March 2015. The financial plan must be approved by 1 September of the year preceding the plan year. The plan is drawn up for a calendar year with a quarterly breakdown. Learn more about drawing up a financial plan in the webinar: ttps://goo.gl/AtW1d8. If such an enterprise receives budget funds (that is, funds other than payments from the National Health Service of Ukraine (NHSU) under its contract), it must have an approved plan for using budget funds

No. The regulations describing the healthcare transformation contain no provisions that set the staffing table of a primary care provider. This matter falls within the competence of the facility's management, and when deciding on it, they should be guided by the need to provide quality primary care to the population of the facility's service area.

Staff of feldsher-midwife posts are part of the staff of the primary care facility. Therefore, their salaries are part of the facility's payroll. The facility must also provide the equipment, devices and supplies needed to deliver primary care. Utilities must be paid by the local authorities — just as for the facility as a whole.

Since an extensive network of FAPs sometimes becomes an economic burden for primary health care centers, management should make the best decision together with the local authorities in each case. One option may be additional funding for FAPs from the local budget. In some cases, it may make more sense to arrange transport for patients to outpatient clinics in neighboring communities that are better equipped and staffed. Another option, already used by some primary health care centers, is for a primary care doctor to visit remote communities on an optimal schedule.

Under the law, municipal non-profit enterprises are not budget fund managers. That is why local self-government bodies must, within a month, adopt decisions designating regional, district and city state administrations and amalgamated territorial communities as budget fund managers. This must be done without delay in regions where the final managers of budget funds are autonomized healthcare facilities that provide primary care. The new budget fund managers must re-sign contracts with the pharmacies taking part in the “Affordable Medicines” program. Particular attention should be paid to paying off current debts to pharmacies. All private healthcare facilities that have signed a contract with the NHSU already have the right to start writing prescriptions for medicines under the program. To do this, they need to contact the designated fund manager and obtain the necessary approval. Individual entrepreneurs will also soon be legally granted this opportunity. The Ministry has already prepared draft amendments to the Cabinet of Ministers of Ukraine resolution and will soon submit them to the Government for consideration.