Filenews 12 November 2024 - by Marilena Panayi
Rehabilitation and recovery centers of two categories, criteria and conditions of operation, building facilities, required equipment and nine years deadline in existing structures to comply with the legislation.
The bill providing for the operation of rehabilitation and recovery centres in Cyprus was submitted last week to Parliament and its discussion in the parliamentary health committee should be expected in December since, at the moment, the bill concerning the establishment of the institution of the Patient Ombudsman is pending, the article-by-article discussion of which is expected to begin on November 21.
The new bill on the operation of rehabilitation centers (relevant bills had been prepared in the past, which, however, got bogged down in disagreements between the parties involved), is clearly improved (compared to a previous bill), in terms of transitional provisions and requirements and relaxations to and from existing providers.
However, reactions are still to be expected since for years, two stakeholder groups have been created whose disagreements delay or even prevent the passage of any law related to recovery and rehabilitation services. Besides, for this reason, the General Health System continues to provide a limited number of services of this kind. The Ministry of Health and the Parliamentary Committee on Health express, however, behind the scenes, readiness to pass the bill into law, regardless of any business interests, although inevitably all positions will be discussed in Parliament.
In essence, the bill aims to "regulate the establishment, operation and control of recovery and rehabilitation centers" and aims to "achieve a better quality of life and maximum independence of people who suffer injuries, temporarily or long-term due to congenital and/or due to illness and/or injury and/or for any other reason."
The bill provides for the operation of an Advisory and Scientific Committee, the appointment of a Superintendent of Rehabilitation and Recovery Centers, the criteria, building and other that the centers must meet, the terms and conditions of licensing. It also includes transitional provisions concerning centres that still offer rehabilitation and recovery services inside or outside the GHS. It is reported that a number of centers that currently offer services have not been included in the General Health System due to the absence of a law, a gap that is attempted to be filled by this bill.
Regarding the categories of rehabilitation and recovery service centers, the bill provides for the existence of:
>> Independent center: That is, independent building infrastructure.
>> Segmented center which is part of another structure that is licensed but operates autonomously and independently
The first category is expected to include rehabilitation centers that currently, due to the absence of law, operate under the law governing the operation of nursing homes and in the second category centers that currently operate within licensed hospitals.
For the first category (which concerns not only the new centers that will be created, but also existing independent centers), the bill provides that in order to exempt existing centers from the provisions of the new legislation, they must:
– Provide such services for a period of at least 18 months prior to the entry into force of the law.
– Have a valid license for the operation of homes for the elderly.
– Building permit valid as housing for the elderly.
– Present "evidence that they provide recovery and rehabilitation services on a systematic basis, on a specific topic or topics, throughout the last eighteen months with the presentation, where applicable, of documents confirming the provision of recovery and rehabilitation services to patients and persons with disabilities".
– Have approved therapeutic areas based on an existing planning permit.
– That they have an adequately staffed "basic" recovery and rehabilitation team and/or other "professionals, depending on the subject or themes they are active in.
For the second category, i.e. autonomous units operating within other structures (hospitals), it is provided that
– "A natural or legal person may apply to the Superintendent within six months from the entry into force of this Law and apply for the licensing of a private hospital as a recovery and rehabilitation center, provided that the hospital at the time of entry into force of the law is licensed, in terms of its operation, under the provisions of the Private Hospitals Law and provides recovery and rehabilitation services in the thematic and/or thematic areas set out therein. are included in the contract for the provision of medical rehabilitation services to the General Health System and/or in the Memorandum of Understanding between the HIO and the private hospital maintained for a period of at least 18 months before the entry into force of this law".
– The centre must present a contract for the provision of services within the GHS, a memorandum of understanding with the HIO and a license to operate as a hospital.
For both categories, the bill provides that
– "For a period of nine years from the entry into force of the law, the private hospital/center for which an application is submitted is exempted from compliance with the building requirements, provided that the building requirements concerning the accessibility of persons with disabilities are met, based on the relevant laws in force of the Republic".
– "For a period of nine years, the private hospital/centre is exempted from the equipment requirements required to maintain centres not licensed under the transitional provisions, when, due to its size, the equipment cannot be placed in the already existing countries of the private hospital".
Both the differentiation between the centres, in terms of the requirements for the certification of the services they provide, as well as the nine-year period given to the centres to comply with the provisions of the legislation must be considered certain to concern both the Parliament and the public debate.
Required specialties of professionals and managers
Each center must have a core team of professionals since the goal is multidisciplinary patient management. An adequately staffed "core" group is defined in the bill as a group that "includes at least a doctor, physiotherapist, occupational therapist and nurse with experience in rehabilitation and a speech-language pathologist in the case of acquired brain injuries, neurological and neurodegenerative disorders or conditions affecting swallowing, speech and communication".
For both categories, the scientific director must be "a physiatrist or a doctor of another specialty or a health professional whose services are consistent with the orientation of the center and the topics in which it provides rehabilitation and recovery services".
In its other provisions, the bill provides for the establishment of an Advisory Committee, the terms of reference and the bodies to be represented in it, as well as the corresponding terms for the Scientific Committee. Both committees will report to the Superintendent of Rehabilitation and Recovery Centers, whose appointment is also included in the bill and will be, among other things, responsible for licensing the centers.
