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Health Care Waste Management (HCWM) Financing of the Future HCWM System

Health Care Waste Management (HCWM) Financing of the Future HCWM System. Ohrid, Ana Petrovska. Present Tariffs. Tariff paid for collection of HCW in the Skopje area is: MKD 56 (0,9 Euro) per kg excl. VAT (18%).

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Health Care Waste Management (HCWM) Financing of the Future HCWM System

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  1. Health Care Waste Management (HCWM)Financing of the Future HCWM System Ohrid, Ana Petrovska STRATEGY ON THE MANAGEMENT OF THE BIOMEDICAL WASTE

  2. Present Tariffs • Tariff paid for collection of HCW in the Skopje area is: MKD 56 (0,9 Euro) per kg excl. VAT (18%). • Tariff paid for delivery of HCW at the gate at Drisla Landfill is: MKD 45 (0,75 Euro) per kg excl. VAT (18%). • Tariff paid for collection of yellow HCW boxes (25 litres) from private General Practitioners and ambulatories, etc. in the Skopje area, is: MKD 385 (6,4 Euro) per box (3 kg), or 128 MKD per kg. (2,0 Euro) excl. VAT (18%). • Tariff paid for collection of yellow HCW boxes (25 litres) from private General Practitioners and ambulatories in Kumanovo MKD 130 (2,1 Euro) per kg excl. VAT (18%), to be paid to the Kumanovo Health Centre, which is organizing collection and transport to the "Drisla" landfill • Transparency of setting the tariffs is not sufficient STRATEGY ON THE MANAGEMENT OF THE BIOMEDICAL WASTE

  3. Sources of Financing • Major investments in a new HCWM system can not be made based on funds from the Health Insurance Fund, due to its accumulated debts. • Financing directly from the state budget via MoH is considered, in combination with: • Contributions from MEPP on specific environmental programmes, • Soft loans based on Government guarantees, • International grants, etc STRATEGY ON THE MANAGEMENT OF THE BIOMEDICAL WASTE

  4. Future Tariffs • Future tariff for HCWM should incorporate the following costs: • The costs of establishing and maintaining proper storage facilities at general hospitals and health centres, • Costs for purchase, maintenance and operation of a sufficient number of small vans or trucks to be used in the primary collection service, • Other internal costs such as investments in small plastic containers on wheels, receptacles, etc. and use of consumables in the form of plastic bags, sharps boxes, etc. • Costs for the investments in the establishment of the final treatment facilities (e.g. three regionally based autoclaves) and associated operation & maintenance costs STRATEGY ON THE MANAGEMENT OF THE BIOMEDICAL WASTE

  5. Responsibilities for Setting of Tariffs • According to the Law on Waste the Operator of the disposal facility is in charge of setting the tariff • The MEPP shall approve the tariff, taking care for the inclusion of all costs • Tariff paid by the generator shall cover the full costs for the operation of the (regional) HCWM Systems • Small generators shall pay to the regional centers also a margin for the “internal” collection STRATEGY ON THE MANAGEMENT OF THE BIOMEDICAL WASTE

  6. Financing of the Regional HCWM Systems • Preparation of annual budgets on all costs related to the operation and maintenance of the regional system; • Determination of corresponding tariffs to be paid by medical waste generators being serviced by the system, and assuring approval of such tariffs; • Daily accounting/bookkeeping, and based hereon issuing of invoices at regular intervals to the medical waste generators being serviced by the system and assure that invoices are being paid; • Financing of regional offices and staff management; • Reporting of all relevant financial, technical and environmental aspects to the owners of the medical waste management system and to the responsible authorities (MoH and MoEPP). STRATEGY ON THE MANAGEMENT OF THE BIOMEDICAL WASTE

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