9. pants

Noslēguma nosacījumi

1. Šī Vienošanās ir noslēgta uz neterminētu laika periodu un

tā stājas spēkā 30 (trīsdesmit) dienas pēc pēdējā paziņojuma

saņemšanas, kurā Puses informē viena otru par pilnīgu iekšējo

juridisko procedūru pabeigšanu, kas nepieciešamas, lai šī

Vienošanās stātos spēkā.

2. Katra Puse var pārtraukt šīs Vienošanās darbību, informējot

par to rakstiski. Tādos gadījumos līguma darbības izbeigšanās

iestājas sešus (6) mēnešus pēc datuma, kad otra Puse ir saņēmusi

paziņojumu par šīs Vienošanās darbības pārtraukšanu.

3. Šo Vienošanos var grozīt un papildināt Pusēm savstarpēji

rakstiski vienojoties. Jebkādi grozījumi un papildinājumi stājas

spēkā šī panta 1. punktā noteiktajā kārtībā.

4. Pušu atbildīgās iestādes var slēgt papildus vienošanās, kas

nosaka konkrētu Vienošanās nosacījumu izpildes kārtību.

Vienošanās ir sastādīta 3 (trijos) eksemplāros - latviešu,

igauņu un angļu valodās. Visiem eksemplāriem ir vienāds

juridiskais spēks. Atšķirīgas interpretācijas gadījumā, par

pamatu ņemama angļu valodas versija.

Latvijas Republikas Veselības

ministrija

Igaunijas Republikas Sociālo

lietu ministrija

Igaunijas Republikas

Iekšlietu ministrija

.....................................

.....................................

....................................

Veselības ministrs

Didzis Gavars

Sociālo lietu ministrs

Hanno Pevkurs

Iekšlietu ministrs

Marko Pomerants

Agreement

between the Ministry of Health of the Republic of Latvia, the

Ministry of Social Affairs of the Republic of Estonia and the

Ministry of Interior of the Republic of Estonia on Mutual Aid for

Providing Ambulance Services in Border Areas

The Ministry of Health of the Republic of Latvia, the Ministry

of Social Affairs of the Republic of Estonia and the Ministry of

the Interior of the Republic of Estonia (hereinafter referred to

as "the Parties"),

recognising that collaboration between the competent

authorities and the providers of ambulance services is

necessary,

considering this agreement as a framework agreement on

providing the mutual aid of ambulance services and

being determined for further collaboration in this field,

have agreed on the following:

Article 1

Definitions

The terms used in this Agreement shall mean the following:

"ambulance service" - out-patient health care services

carried out by an ambulance crew concerning the initial diagnosis

and treatment of life-threatening diseases, injuries and

intoxication and, if necessary, for the transportation of a

person requiring care to the nearest hospital capable of

providing the necessary in-patient health care as well as the

dispatch of ambulance crews and processing emergency calls;

"border" - the Latvian - Estonian state border, in

accordance with the Agreement between the Republic of Latvia and

the Republic of Estonia on the Renewal of the State Border of 20

March 1992 and its additional protocol;

"border area" - municipal (territorial) administrative

areas of the Republic of Latvia and the Republic of Estonia

adjacent to the border and located within 40 km from it; if a

part of such an administrative area is located within a range of

40 to 60 km of the border, then such an administrative area is

also considered to be part of the border area. The Parties shall

agree on the list of border areas as soon as possible but not

later than within 2 (two) months after this Agreement comes into

force. The agreed list will become an integral part of this

Agreement.

Article 2

Scope

This Agreement covers the collaboration among the competent

authorities and the providers of ambulance services of the

Parties with the intent of improving ambulance service

accessibility within the border area.

Article 3

Competent authorities

The competent authorities, having the right to make direct

contacts and conclude additional agreements under the terms of

this Agreement, are following:

1. in the Republic of Estonia:

1.1. The Health Board of the Republic of Estonia (hereinafter

- "The Health Board") responsible for drawing up contracts with

the owners of ambulance crews, executing payment for provided

services and executing supervision over compliance with the

requirements provided for health care providers;

1.2. Emergency Response Centre of the Republic of Estonia

(hereinafter - "The Emergency Response Centre") responsible for

emergency call processing and the dispatch of ambulance

crews;

2. in the Republic of Latvia:

2.1. The State Emergency Medical Service of the Republic of

Latvia (hereinafter - "The State Emergency Medical Service")

responsible for providing ambulance services, emergency call

processing, dispatching ambulance crews and payments for provided

services;

2.2. The Health Payment Centre of the Republic of Latvia

(hereinafter - "The Health Payment Centre") responsible for

executing supervision over compliance with the requirements

provided by the health care providers under the respective

agreements and for executing international payments for health

care services provided.

Article 4

Provision of ambulance service

1. For the purposes of this Agreement, in both the Republic of

Estonia and the Republic of Latvia, the ambulance service

commences with the dispatch of an ambulance crew by the competent

authority of the respective country and terminates when an

ambulance crew reaches the base of its permanent location or

receives a new dispatching order from the competent authority of

its country of origin. When providing the required health care

service to a patient, the ambulance crew decides whether the

patient can be released for further out-patient treatment at

home, transported to the nearest adequate hospital or handing the

patient over to the ambulance crew of the country where the event

takes place.

2. The competent authority responsible for the dispatch of an

ambulance crew (as stated in Article 3) in all of the dispatching

stages, has the right to make a direct call to the dispatching

authority of an ambulance crew of the other Party and ask for

dispatching of the ambulance crew to the place of destination in

the territory of the requesting country.

3. When called, the respective competent authority is obliged

to organize the provision of help in the same manner as in the

case of the national requirement. If the prioritization of an

ambulance dispatch is required, all cases have to be treated

according to the same national rules.

4. The competent authorities responsible for dispatching

ambulance crews permanently exchange information during the

respective service provision. Each competent authority ensures

that the relevant information is delivered to the ambulance crew

of its country.

5. Cases when the emergency call from a person from country A,

being in country A, but whose location is close to the border

with country B, is received by the competent authority

responsible for the dispatch of an ambulance crew in country B,

the call is to be transferred to the competent authority

responsible for the dispatch of an ambulance crew in country

A.

6. The exact procedure of requesting and providing aid shall

be governed by agreement between The Health Board, The Emergency

Response Centre and The State Emergency Medical Service.

7. In cases where the ambulance service event is related to

the rescue event, cooperative action at the scene of an accident

is conducted within the "Framework Agreement between the

Government of the Republic of Estonia and the Government of the

Republic of Latvia on Mutual Assistance in the Event of

Disasters".

8. When being present in the country of the other Party:

8.1. the ambulance crew ensures that the quality of service is

in accordance with the requirements and the rules of its state of

origin. The ambulance crew is held liable for the service

provided, in a manner that is consistent with the national laws

and regulations of its state of origin.

8.2. the ambulance crew ensures that the service provided is

documented as is the case when the respective service is

provided in its country of origin. At the end of the provision of

the service (i.e. the transportation of the patient to the

hospital, handing the patient over to the ambulance crew of the

patient's country of origin, leaving the patient's home for

out-patient treatment, or any other outcome of the service) the

ambulance crew is also required to hand over a copy of the

document either to the hospital or the ambulance crew of the

other Party or to the person in need. Ambulance crews prepare all

the documentation using the template of the referral specially

designed for the enforcement of this Agreement. Each Party is to

make a translation of their national templates into English and

ensures that they are at the disposal of the ambulance crews that

could be involved in the provision of cross-border emergency

health care with regard to this Agreement.

9. In cases where the ambulance event requires additional

resources, it is to be organized by the competent authority of

the country in which the ambulance event occurs.

10. The competent authority which asks for help may withdraw

its request at any time regarding the specific event, by

informing the competent authority of the other country.

11. The competent authorities ensure that ambulance crews are

equipped according to the requirements and rules of their

countries. This requirement also has to apply to the provision of

an ambulance service in the territory of another country in

accordance with this Agreement.

Article 5

Expenses

1. Expenses of ambulance service cases, if there is not a

fixed price per service set in the national legislation of the

country of which the ambulance service provider is providing

service, are calculated according to following principle: the

total budget of the ambulance service provider in the present

year divided by the number of service provision cases in the

preceding year.

2. In cases where the average price, calculated in the way

mentioned above does not cover real expenses, the authority

responsible for ambulance service payment of that country

provides the evidence needed to the corresponding authority of

another country. Expenses will be counted on the basis of the

actual expenses of the country that is providing aid. The exact

procedure and practical arrangements needed for account setting

shall be governed using the agreement between The Health Board

and The Health Payment Centre.

3. The setting of accounts takes place between The Health

Board and The Health Payment Centre. The accounting currency is

Euros. The demanding Party compensates the offering Party for all

direct expenses related to the ambulance service cost. Depending

on the nature and the scope of a specific ambulance event, the

Parties may come to a different agreement if such a necessity

arises.

4. The demanding Party that has withdrawn the request for aid

without any legally, economically or technically-based reasons

concerning a specific event at that time compensates the offering

Party the price of the service. The detailed procedure shall be

described in the Agreement of the competent authorities of the

Parties.

5. In cases where The Health Board and The Health Payment

Centre have not agreed otherwise, expenses shall be compensated

after submitting a reasoned invoice within sixty (60) days.

Article 6

Compensation for damages or injuries

1. Each Party shall renounce any claim of compensation on the

other Party in cases of death, bodily injury or any other damage

to the health and personal effects of the member of the ambulance

crew, provided that such damage has occurred in the course of

fulfilling duties deriving from this Agreement.

2. If a member of the ambulance crew of the Party rendering

assistance causes damage to a third party in the territory of the

Party requesting assistance by fulfilling duties deriving from

this Agreement, the Party requesting assistance shall compensate

the damage according to the same legal acts as would be the case

if the damage had been caused by an employee or ambulance crew

member of the Party requesting assistance.

Article 7

Settlement of disputes

1. Any disputes that may occur in the process of the

interpretation or execution of this Agreement which cannot be

resolved by negotiation between the competent authorities shall

be resolved between the Parties.

2. Any complaints of a medical nature or directly related to

the provision of ambulance service submitted by the patient to

the responsible surveillance authority of its country of origin,

shall be dealt in collaboration with its respective authority in

the country of the other Party in accordance with the provisions

of its national laws and regulations and provisions of this

Agreement. The detailed procedure shall be described in the

agreement of the competent authorities of the Parties.

Article 8

Information exchange

1. The competent authorities of both Parties will regularly

exchange the relevant information that is necessary for executing

this Agreement. The competent authorities may agree on separate

agreements which would prescribe the exact procedure of the

information exchange.

2. The Parties and the competent authorities may meet in order

to discuss or review this Agreement as often as they find

necessary.

Article 9

Final provisions

1. This Agreement is concluded for an indefinite period of

time and shall enter into force thirty (30) days after receipt of

the last notification whereby the Parties have notified each

other of the fulfilment of the internal legal procedures

necessary for the entry into force of this Agreement.

2. Either Party may terminate this Agreement by a written

notification. In such case, the termination shall take effect six

(6) months after the date of receipt by the other Party of the

notification on the termination of this Agreement.

3. This Agreement may be amended and supplemented by mutual

written agreement of the Parties. The amendments and supplements

shall enter into force in accordance with paragraph 1 of this

Article.

4. The competent authorities of the Parties may conclude

separate agreements to specify the circumstances of the

implementation of this Agreement.

Signed ………………………………… in three original copies each in Latvian,

Estonian and English languages, all texts being equally

authentic. In case of any divergence of interpretation, the

English text shall prevail.

Ministry of Health

The Republic of Latvia

Ministry of Social Affairs

The Republic of Estonia

Ministry of the Interior

The Republic of Estonia

………………………………………

…………………………………..

…………………………………….

Didzis Gavars

Minister of Health

Hanno Pevkur

Minister of Social Affairs

Marko Pomerants

Minister of the Interior