Bill 265.

Summary.

The bill declares the legal establishment of Health Committees to be in the public interest so they can participate in the direction, planning, and implementation of programs of the Ministry of Health (Ministerio de Salud). It allows committees to be established in communities throughout the country and, where there is more than one Health Center, one for each center. Each Health Committee would be established at a community General Assembly convened by the local health authority, adopt bylaws, and have a General Assembly, Board of Directors, and working committees. Registration in the Ministry of Health’s records would grant it legal personality, recognized by a resolution of the ministry or the designated authority.

The National Council of Health Committees (Consejo Nacional de Comités de Salud) is created to coordinate, supervise, and direct the committees, issue technical guidelines, resolve jurisdictional disputes, and integrate public health programs. It would include representatives of the Ministry of Health’s legal advisory office, general secretariat, and Health Promotion Directorate (Dirección de Promoción de la Salud). In each region, the Regional Council of Health Committees (Consejo Regional de Comités de Salud) would oversee local programs and committees, approve their bylaws, decide requests for reconsideration in electoral and disciplinary matters, impose sanctions, and resolve technical disagreements with binding effect. For each recognized committee, a Technical Health Commission (Comisión Técnica de Salud), composed of Health Center staff, would advise on the planning, implementation, evaluation, and budgeting of community programs.

The committees would participate in health programs, preventive education, risk identification, coordination with authorities, and lawful activities to sustain their operations. Their members would have the right to speak and vote, access information and training, propose initiatives, and hold office. They would be required to attend, carry out assigned tasks and comply with the bylaws, manage resources transparently, and report irregularities. The bill requires confidentiality of health data, nondiscriminatory treatment, accountability, mandatory ethics training at least once a year, and disclosure of conflicts of interest; it prohibits participation in decisions affected by those conflicts and use of office to advance personal, family, or political interests.

The bylaws would govern meetings, quorum, funds, reports, audits, allowances, sanctions, and voluntary dissolution. The General Assembly would consist of registered adult members, elect the Board of Directors every 2 years, approve bylaws, plans, and budgets, and oversee the accounts. Membership would require the patient visits, good moral standing, and absence of the convictions specified in the text. The Board of Directors would maintain a registration book containing identity and contact details. People who hold party positions or engage in political campaigning would be barred from registering and holding the specified offices. The Board of Directors would have a President, Vice President, Secretary, Treasurer, Auditor, and 2 Members; the bill assigns them responsibilities for representation, coordination, records, treasury, and oversight. Board members would receive no salaries, although they could receive authorized and documented allowances. The bill also regulates their attendance and the approval of working committees.

When the board’s term expires, public elections would be called at least 10 working days in advance. An Elections Committee (Comité de Elecciones) would organize and document the vote, which could be held by slate or for individual offices. The bill sets attendance rules for the first call, a second date with those voters present, a new vote in the event of a tie, and reconsideration of electoral disputes by the Regional Council of Health Committees. Documents concerning legal personality and updates to the board’s composition would pass through the Health Center authority, the Regional Department of the Health Promotion Directorate (Departamento Regional de la Dirección de Promoción de la Salud), and the Health Region’s Legal Advisory Office (Oficina de Asesoría Legal de la Región de Salud). It also regulates authorization to change signatories, calls for coordination meetings, and compliance with decisions adopted by a simple majority.

The committees’ assets would include voluntary contributions, proceeds from activities, and donations. Funds would be used according to the approved budget, with the involvement of the President, Treasurer, and technical staff. Resources would be deposited in the National Bank of Panama (Banco Nacional de Panamá), and their disbursement would require joint signatures from the Health Center and the Board of Directors, supported by documentation. The bill requires records, audits, internal controls, an annual budget, and administrative training; it allows funding for supplies, medicines, equipment, and other needs of the center that the Ministry of Health does not provide. It proposes an exemption from the Tax on the Transfer of Movable Goods and Provision of Services (ITBMS) for committees and goods, income tax deductibility for donations, and audits by the Office of the Comptroller General of the Republic (Contraloría General de la República). It prohibits using meetings or funds for political purposes. It allows personnel to be hired with committee resources, subject to the Labor Code, the Ministry of Health’s internal regulations, and the directives of the Health Center Directorate (Dirección del Centro de Salud).

In the event of a collective resignation or lack of cooperation by the board, the local authority could request an Interim Board (Junta Interventora); the bill regulates its composition, the opportunity to present a defense, and the calling of elections within 60 days. Violations could result in suspension or expulsion following an investigation and recommendation by an ethics committee, with reconsideration before the regional council. The bill repeals Cabinet Decree 401 of December 29, 1970, and provides that it would take effect upon promulgation. Given its content, it relates to the Ministry of Health, community health centers, the Office of the Comptroller General of the Republic, and the National Bank of Panama; it may be of interest to patients, community organizations, health personnel, suppliers, and donors.