Obtaining SES (Sanitary and Epidemiologic Service) conclusion in Ukraine: problem projects from our practice

The premises-related issue is one of the most complicated when opening a healthcare business, since they require not only significant capital investments (rent, repairs, etc.), but also approval of regulatory authorities.

The issue of obtaining an SES certificates is directly relevant for:

• Private entrepreneurs and company owners who are just planning to start a healthcare business or are making changes to their licenses due to a change of place of business;
• Entrepreneurs who have an open space planning or who intend to make major repair of the premises;
• Entrepreneurs who have some discrepancies in the square of the premises;
• Those who want to have a premise that do not comply with the design and structure requirements of the State Building Standards.

In this publication, we will elaborate on the most frequent issues related to choosing and adjustment of the areas of the premises used for medical centers, clinics and private practitioners, using the example of successful cases of our law firm.

We have singled out groups of challenging issues that our team most often faces in the process of obtaining an SES Certificate for entrepreneurs.

Related article: Our Lawyers Obtained A Sanitary and Epidemiologic Certificate For An Individual Entrepreneur

Approval of premises by state authorities

Today, there is a large number of inspections and other authorities that you may need to contact when opening a healthcare facility. The specific list of authorities that you need to deal with depends on the following factors:

• Whether the building has been built and is already in operation or it is only under the construction;
• Whether the room is located in a residential or non-residential building;
• Whether primary, secondary or other healthcare will be provided there, and which doctors will provide the services, etc.

There is currently no premises compliance control authority, which you need to deal with, in order to become eligible to practice medicine. It is more appropriate to talk about the most common permits, the authorities that issue them, and situations that require/ do not require you to obtain such permits.

• The State Service of Ukraine on Food Safety and Consumer Protection. It issues the most popular document from this list: the Sanitary and Epidemiologic Service Certificate. Only institutions and doctors providing primary health care (in practice, this should be interpreted as health care provided by family doctors exclusively) are not required to obtain this document;
• The State Emergency Service of Ukraine. In everyday life, the document issued by this authority is known as “firefighter’s permit”, “fire safety permit”, “permit of the State Emergency Service”. But its legally correct name is the declaration. This document concerns the compliance of the technical and material base (in this case, the premises of the healthcare facility) with fire safety requirements. Only tenants whose landlords have already obtained the declaration, as well as buildings that were properly put into operation after the construction, major repairs, etc., are not required to obtain this document;
• The Department of Urban Development and Architecture, local authorities. One of the most popular documents to be obtained by healthcare business owners is a permit to transfer the premises to a non-residential fund. Since no one can practice medicine in residential premises, all premises shall be withdrawn from the housing fund.

This list of authorities is not exhaustive or even obvious sometimes and depends on the specific situation.

Working with open space planning of premises

We quite often work with this category of projects. It involves entrepreneurs who have an open space planning of the premises or intend to carry out a major repair. In this case, our main services concern:

• Preliminary conformity assessment of the building used for carrying out medical practice;
• Proposals for possible design of doctors rooms, with due consideration of the list of medical specialties, the total area available, and relevant building standards;
• Assessment of the need for obtaining permits for redesign, development of project documentation, etc;
• Obtainment of a positive Sanitary and Epidemiologic Certificate (also known as the conclusion of the Sanitary and Epidemiologic Service).

Related article: Our Lawyers Supported Signing Of Lease On A Dental Clinic 

Approval of the premises that do not comply with the building standards

In this category of projects, we usually provide legal support and assistance to Clients whose premises:

• are already owned or leased and they cannot be brought in line with all building standards;
• may be brought into compliance, but due to outdated legal requirements and the Client’s desire to follow international best practice, there is a request to circumvent the requirements. 

The work on such projects is rather complicated, as it is necessary to take into account not only the regulatory side of the issue, but also the practice of the relevant authorities, which are usually the State Service of Ukraine on Food Safety and Consumer Protection and the Ministry of Health of Ukraine.

The success of your desired space project depends on:

• Involvement of relevant project, expert organizations;
• Compliance with the requirements that will help to balance the shortcomings of the premises;
• Reasonable delivery of your standpoint to the regulatory authorities.

Regardless of the challenges that may arise in this case, if you like the premise and you want to get it this way - we will take care of all the bureaucratic problems. You will get the desired result.

Conclusion

The selection and approval of the premises for providing healthcare services plays a key role in the opening of healthcare facilities and offices.

Today, there is a large number of regulatory authorities, which you potentially need to contact when setting up a business. However, their number may finally be reduced to 1-2. It is only important to choose the right authorities and to know their requirements.

When choosing a premise, you can stop at an open space planning, or take the premise that is already divided into rooms.

In the first case, it is necessary to correctly place doctors rooms, auxiliary rooms and, if necessary, to obtain proper permits. When choosing a premise divided into rooms, it is necessary to assess whether the areas, ceiling heights, etc. meet the established requirements. In case of non-conformity, it is necessary to correctly approach its adjustment/approval in the current form.