Bill 419.

Summary.

The bill creates the Board of Trustees of the Anita Moreno Azuero Regional Hospital, based at that hospital in Los Santos Province, as a nonprofit entity serving the public and social interest, with legal personality, its own assets, and administrative, economic, financial, and operational autonomy. It defines the concepts guiding its management and subjects it, among other things, to the principles of equity, efficiency, quality, integrity, transparency, solidarity, and universality. It charges the Board with managing, maintaining, and protecting the facilities and property under its responsibility, and providing preventive and curative health care, rehabilitation, teaching, and research services appropriate to a tertiary regional hospital.

Its assets would include state funds, contributions, donations, bequests, revenue from services and activities, and movable property. The hospital complex’s land and improvements would be placed in its custody and under its management but would remain state property. The Board would treat the maintenance, replacement, and improvement of buildings, equipment, and instruments as operating expenses. Its funding would include budget appropriations, payments every four months for patients covered by the Social Security Fund (Caja de Seguro Social), paid services, and insurer payments. Its budget would be no lower than the previous year’s. The bill provides for deductions for private contributions under Article 697 of the Tax Code (Código Fiscal), exemption from national taxes, municipal exemptions granted by municipal agreement, and the same judicial privileges as the state.

The Board would be chaired by the head of the Ministry of Health (Ministerio de Salud) or their delegate. Participants would include the Social Security Fund’s Los Santos office and representatives of retirees and pensioners, a public or semipublic university in the area, Anagan’s Los Santos chapter, the Los Santos Lions Club, cooperatives, the Los Santos Chamber of Commerce, Industry and Agriculture (Cámara de Comercio, Industrias y Agricultura de Los Santos), and hospital users. Hospital management personnel and the Office of the Comptroller General of the Republic (Contraloría General de la República) could attend and speak. Decisions would require an absolute majority, with the chair casting the deciding vote in the event of a tie. The text governs members’ election, alternates, terms, unpaid service, incompatibilities, and grounds for removal, as well as the offices they would elect annually. The general medical directorate would be the hospital’s highest authority, subject to the Board’s directives.

Among its powers, the Board would define the administrative and operational structure with equal participation by workers; manage property, the budget, purchases, and contracting; and authorize medical directorate expenditures of up to 50,000 balboas (B/. 50,000.00). For additional unbudgeted expenses, it sets a limit of 20,000 balboas (B/. 20,000.00) each, with an immediate report, and requires Board approval for larger urgent expenditures. It would also establish charges, internal auditing, information systems, financial reports, and a public annual report. It would submit information to the Ministry of Health and the Office of the Comptroller General of the Republic. It would issue staff, competitive selection, and evaluation rules in accordance with the Administrative Career Law (Ley de Carrera Administrativa); submit the human resources regulations to the Executive Branch (Órgano Ejecutivo) together with professional associations; and oversee occupational health, biosafety, hospital waste, teaching, research, training, and cooperation agreements.

The text creates a council of directors to advise the medical directorate and an association of Anita Moreno Hospital users. It requires merit-based selection and competitive examinations for staff and managers, preserves their labor rights, and allows those assigned to another institution to return to or remain at that institution after giving written notice within 30 calendar days of the law’s entry into force. Internal audit would conduct preliminary audits; the Office of the Comptroller General of the Republic would conduct subsequent audits and fiscal oversight; and an external auditor could be engaged. Administrative decisions of the medical directorate could be challenged through reconsideration and appeal. The general regulations would complete the organizational rules. The bill repeals conflicting provisions and sets its commencement at 30 (60) business days after promulgation. Its provisions concern the Ministry of Health, the Social Security Fund, the Office of the Comptroller General of the Republic, hospital staff and users, insurers, educational institutions, and the civic, cooperative, commercial, industrial, and agricultural sectors of Los Santos Province.