DONOR AGREEMENT on the voluntary contribution of the Republic of Slovenia (RS) to the
World Health Organization (WHO), number C2711-15-951319
Between
WHO Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark, represented by Zsuzsanna Jakab, Regional Director
And
THE GOVERNMENT OF SLOVENIA (herein after referred to as the "Donor"), represented by
Milojka Kolar Celarc, Minister of Health
I. Introductory remarks
I. The parties acknowledge to enter into this agreement on the basis of Biennial Collaborative
Agreement (BCA) between the Ministry of Health of Slovenia and the Regional Office for Europe of the World Health Organization for the period of 2014-2015.
II. This Agreement relates to a financial contribution to be made by the Donor to WHO towards the implementation of the Activity [Analysis of the health system in Slovenia], which is outlined in
Annex I hereto, and which is hereinafter referred to as the “Project”. The budget for the activities financed by the contribution is set out in Annex I, which is an integral part of this Agreement.
Prior to effecting major changes between categories of expenditure that may be found necessary in the course of implementing the activities, WHO shall consult the Donor.
III. Responsibility
1. WHO shall be responsible for the monitoring and implementation of the Project.
2. The Donor shall be responsible for the provision of funds to WHO for the Project, in accordance with the terms of this Agreement and its Annex I.
IV. Financial arrangements
1. Budget heading
The funds shall be provided under budget heading of Ministry of Health, number 9513 -
Systemic regulation of health care, and action number 2711-11-0030 - regulation and development of health system.
2. Schedule of payments
The total amount of the contribution is EUR € 260,000.
The contribution shall be paid in one instalment on signature of this Agreement by both parties, and therefore:
EUR € 260,000.
3. Payment of contribution
The EUR € contribution shall be deposited according to the above schedule of payments in the WHO’s Geneva bank account:
EUR € World Health Organization
IBAN CH8500240240C01699201
UBS AG
SWIFT - UBSWCHZH 80A

1211 Genève 2, Switzerland and the details of the contribution clearly identified using [HS Analysis Slovenia] and
EURO/337/SVN/SVN/OBS codes.
4. Utilization of funds and accounting
(i) The contribution shall be used for the purposes indicated in Annex I hereto and shall be administered in accordance with the Financial Regulations and Rules, and financial and administrative rules and practices of WHO.
(ii) Under this Agreement 13% of expenditure will be deducted by WHO to cover the costs of administrative support, in accordance with World Health Assembly resolution
WHA34.17.
(iii) Any interest earned on the cash balance of the contribution shall be used in accordance with WHO Financial Regulations and Rules, and financial and administrative rules and practices of WHO.
(iv) Income and expenditure recorded in respect of the contribution shall be identified and kept separately by WHO in relevant accounts.
(v) Any balance of the contribution that is outstanding at the time of completion of the
Project, or of termination of this Agreement, and after all encumbrances (financial liabilities) incurred by WHO prior to completion or termination have been fully liquidated, shall be treated in the following manner:
If the remaining balance is EUR € 1,000 or less, WHO shall be entitled to use this balance for any activities concerning Slovenia;
If the remaining balance is more than EUR € 1,000, this remaining balance shall be used in the development of activities on health system reform in Slovenia which are consistent with the priorities of the Biennial Collaborating Agreements in place at the time.
V. Implementation
1. Period of implementation
The start date of the Project shall be 15 April 2015, regardless of the date the Agreement is signed.
The end date of the Project shall be 20 December 2015.
WHO shall have no obligation to implement the Project unless all necessary and sufficient funds for the implementation have been received by WHO. If the start date is postponed for that reason, the end date shall be extended accordingly.
The Donor shall allow WHO a period of up to twelve months after completion of the
Project, or any termination of this Agreement (close date), to liquidate all encumbrances for activities completed by WHO prior to completion or termination.
VI. Reporting
1. Technical
WHO shall transmit to the Donor at regular intervals of three months a technical report of no more than one page on the progress in the activities financed by the contribution.
2. Financial

(i) The income and expenditure recorded in respect of the contribution shall be included in the WHO Financial Reports submitted to the World Health Assembly on an annual basis. Certified financial statements of income and expenditure shall be provided to the
Donor on a yearly basis, upon request.
(ii) A Final Certified Financial Statement (FCFS) of income and expenditure will be provided by WHO, by the close date of the Agreement (namely, after settlement of all encumbrances for activities started by WHO prior to completion or early termination of the
Agreement).
VII. Audit
It is understood that all contributions to WHO are subject exclusively to its internal and external auditing procedures. The External Auditors’ certification of accounts and audit report is made available to the World Health Assembly on an annual basis. The Donor may request a copy.
VIII. Acknowledgement
WHO will make an appropriate acknowledgement of the contribution in all of its publications emanating from the Project, or in reports that are habitually made available to its Member States.
In the absence of the consent of the other party, neither party may otherwise refer to the contribution or to the relationship between the parties in any material of a promotional nature.
Donors are always entitled to make reference to their donations in their internal documents and in their annual reports.
IX. Termination
Either party may give the other notice of termination of this Agreement. Such termination shall enter into effect six months after notice has been received, subject to the settlement of any outstanding encumbrances.
X. Notices
Any notices required under this Agreement shall be in writing and shall be delivered personally or sent by registered or certified mail or facsimile to the following addresses:
To WHO :
World Health Organization
Josep Figueras and Suszy Lessof
Eurostation (Office 07C020)
Place Victor Horta, 40/10
B - 1060 Brussels
Tel. +32 2 524 9240
Email: jfi@obs.euro.who.int; szy@obs.euro.who.int
With copies to:
Hans Kluge
WHO Regional Office for Europe
UN City
Marmorvej 51
DK2100 Copenhagen Ø
Denmark
Tel nr: +45 45 33 67 44
Email: HKL@euro.who.int
To the Donor :
Ministry of Health of the Republic of Slovenia
Tomaž Glažar and
Vesna Kerstin Petrič

Stefanova 5
SI – 1000 Ljubljana
Slovenia
Tel nr: + 386 1 478 69 76; +386 1 478 60 98
Fax nr: + + 386 1 478 69 58; +386 1 478 6058
Email: tomaz.glazar@gov.si; vesna-kerstin.petric@gov.si, liza.zorman@gov.si
With copies to:
Metka Logar
Stefanova 5
SI – 1000 Ljubljana
Tel nr: + 386 1 478 60 66
Fax nr: + 386 1 478 60 49
Email: metka.logar@gov.si or such other addresses as either party shall have notified the other party.
Any such communication shall be deemed to have been given or made on the date such letter was hand-delivered, registered or transmitted from the sender's facsimile operator, but any assumption of actual notice shall be subject to rebuttal to show that it has not actually been received.
XI. Settlement of disputes
Any dispute relating to the interpretation or application of this Agreement shall, unless amicably settled, be subject to conciliation. In the event of failure of the latter, the dispute shall be settled by arbitration. The arbitration shall be conducted in accordance with the modalities to be agreed upon by the parties or, in the absence of agreement, with the rules of arbitration of the
International Chamber of Commerce. The parties shall accept the arbitral award as final.
XII. Privileges and immunities of WHO
Nothing contained in this Agreement shall be construed as a waiver of any of the privileges and immunities enjoyed by WHO under national and international law, and/or as submitting WHO to any national court jurisdiction.
XIII. The validity of the agreement
This Agreement shall enter into force from the date of the signature and shall be applicable from
15 April 2015 (from the start date of the Project) onwards.
Accepted on behalf of the
Donor:
Accepted on behalf of the
World Health Organization:
………………………………………………..
Milojka Kolar Celarc
Minister of Health
Pl ace:…………………………………………
Date: ………………………………………….
…………………………………………………..
Zsuzsanna Jakab
Regional Director
WHO Regional Office for Europe
Place:…………………………………………
Date:…………………………………………..

ANNEX 1
1. Project outline
Objectives: The Ministry of Health has commissioned a review and analysis of the health system from
WHO Regional Office for Europe specifically to

Address European Commission concerns about sustainability raised in its CSRs

Inform the Minister on the performance of the health system

Assist the Government in identifying their reform priorities and

Generate some initial consensus around reform options to be pursued with policy advisers in
2016.
The analysis will inform government policy on health expenditure and financing reform measures (as an intermediate outcome) as well as on the optimization of health services network. The government is expected to develop, approve and implement reform measures to improve service delivery and efficiency in the health sector and to enhance the fiscal sustainability of the health system given growing costs and aging demographics, while preserving and continuing to improve health outcomes
(the ‘final’ outcome).
The analysis will draw on cross-country comparisons and move beyond them to use detailed administrative and facility-level datasets to examine within-country expenditure, including across spending units and geographical areas. The technical work will identify key issues, and provide evidence on reform options and priority actions to improve the functions and structure of general public sector efficiency and performance. The analysis will also use these administrative and facility-level datasets to examine patterns and trends in service delivery and identify opportunities for optimizing service delivery, so contributing to improving system efficiency and performance. The focus throughout will not be just on diagnostics, but on drilling down to the issues that the reform must tackle to achieve sustainability providing evidence to design and stage reforms and to support implementation.
Approach: There are to be five teams one for each of the evidence generation activities. Each team will be guided by WHO and will include technical experts external to WHO with knowledge of and access to the data sources needed to support the analysis. The teams will be headed by a Slovenian focal point working in tandem with an international (WHO - Observatory) focal point. The Slovenian focal point will ensure work is clearly defined, assigned and delivered and will identify resource needs.
The role of the WHO - Observatory focal point is to facilitate and support the team; to provide international comparative evidence and to ensure appropriate analytic and strategic inputs. S/he will also identify any external expertise that the team needs to complete the work.
There will be two further activities to address the link between policy and evidence (through consultation with the Minster and a wider group of experts and stakeholder) in which WHO will play a central role supported by WHO and the Observatory.
A project manager based in the Ministry of Health will ensure that all five teams are working to plan and that there is appropriate coordination between them and effective links with the WHO -
Observatory.
Timing: The five teams will deliver their analysis by the end of July. There will be consultation with the
Minister in September involving the Ministry staff, the Institute of Public Health and WHO which will identify the themes she wishes to take forward. WHO – the Observatory will organize a set of policy dialogues in October with WHO taking a key policy role. These will validate the analysis and build consensus around the options. The final report will be written up in November and submitted by the beginning of December.
2. Activities and outputs
Activity
Activity 1: Fast Track
Health Systems
Performance Review
Objectives

To provide an analytic overview of the health system

To evaluate the performance of organization, financing, resources, and services in terms of social
Output
1. HiT profile

Activity 2: Health system expenditure review
Activity 3: Assessment of health system funding
Activity 4: Purchasing and payment review
Activity 5: Optimizing service delivery: coordinated delivery at the primary-secondary and health and long-term care interfaces
Activity 6: Ministerial consultation
Activity 7: Policy dialogues protection, equity, health outcomes, efficiency and accountability

To set the work of the other activities in context

To analyze health expenditure levels,





 allocations and trends
To assess health system performance at macro, meso and micro levels
To compare Slovene health expenditure and performance to other
European countries
To explore options for improving revenue generation and collection

To map alternative roles for voluntary health insurance

To review levels of coverage and the benefits package

To explore sustainable funding for long term care services and benefits
To analyze key areas of purchasing and payments systems
To synthesize relevant international evidence
To draft options for reform in Slovenia

To analyze the referral patterns by identifying facilitators and barriers for coordination at the primary-secondary care interface

To assess the management of patients with multiple health care needs including the collaboration between different specialists

To analyze the interface between health and long-term care

To present the evidence to the
Minster and her team

To support the selection of an initial round of priorities for Slovenia to address

To present the evidence and initial options on the priority areas selected by the Minister

To validate the evidence and analysis

To test the acceptability of the options identified with key stakeholders
2. Comprehensive health expenditure review and performance assessment
(5 analytic chapters including also revenue, labour and capital inputs)
3. Two instructional seminars on:
(i) patient-level data analysis
(ii) financial protection measures
4. Workshop to review and validate the final health expenditure review report
5. 4 report chapters reflecting the international experience on the benefits and challenges of funding reforms options
6. A workshop to
(i) Review and validate draft findings
(ii) Map the issues for LTC
(iii) Map tentative policy options for
Slovenia
7. 5 report chapters with each a national situation analysis, key international evidence and options for reform in Slovenia
8. A workshop to
(i) Review and validate draft findings
(ii) Map tentative policy options for
Slovenia
9. Review of opportunities and challenges to optimizing coordinated delivery at the primary-secondary and health and long-term care interfaces (a summary & 3 analytic chapters)
10. A workshop to
(i) Review and validate draft findings
(ii) Map tentative policy options for
Slovenia

Set of priorities for initial policy focus

Consolidated evidence and options

Activity 8: Reporting

To pull together the conclusions of the report such that they can inform
Ministry and EC work from 2016

To ensure the different strands of evidence are organized and signposted such that they can be reused in subsequent rounds of policy making 2016-18.
11. Final report
12. Dossier of evidence
3. Objectives by activity
Activity 1: Fast track health system performance review: The Health System in Transition profile will allow all the individual activities to be related to a single comprehensive overview of Slovenia. It will systematically review and analyze the health system providing a comprehensive understanding of the way the system works, is governed and financed. It will cover the services provided, resources involved and recent reforms. It will also assess how far the system meets its objectives and in terms of financial protection, access, equity, responsiveness, quality; efficiency; and accountability. The HiT will ensure the findings of individual activities are set in context and understood in relation to the other dimensions of the system.
Activity 2: Expenditure review: The health expenditure review will provide actionable evidence on how resources for health are generated and spent to allow the Slovenian government to identify and implement reforms so that the health system achieves better value for money and can secure longterm sustainability. The review will provide a detailed assessment of current funding levels, resource allocations and trends and capture new performance data on efficiency, quality and financial protection to support an evaluation of health system performance at the macro, meso, and micro levels. It will feed into each of the other activities including the HiT profile, creating a strong evidence base to underpin the analysis.
Activity 3: Assessment of health systems funding: To assessment of health systems funding will draw on the expenditure review data to explore options for improving revenue generation and collection. It will also explore the impact of the current voluntary insurance model on efficiency and equity of the health financing system and the map alternative roles for voluntary health insurance that the government might consider. It will also review levels of coverage and the benefits package with a view to informing work in activity 4.
Activity 4: Purchasing and payment systems review: The purchasing and payment review will bring together national and relevant international evidence in five main areas: (1) establishing a benefits package and use of HTA; (2) the care purchasing process and its governance; (3) payment methods for health services, (4) payment of professionals in hospitals; and (5) opportunities to introduce pay for performance. It will provide analysis of each national issue in context and map links between them; outline relevant international evidence and experience; and formulate evidence supported options such that the government can select priorities and move towards policy choices.
Activity 5: Integrated health care delivery report: This activity seeks to provide insights into current practices and identify key facilitators and barriers towards optimizing the interfaces between primary and secondary care, and between different healthcare settings and long-term care. It will seek to draw on existing successes of good p ractice but also ‘failures’ in order to derive lessons that can inform key bottlenecks as well as opportunities to advance service delivery. Using a combination of quantitative and qualitative analysis as well as international evidence, this activity will develop policy options for the further development of service delivery towards enhanced coordination of providers within and across sectors and integrated provision of services.
Activity 6: Ministerial consultation: This activity recognizes the extent of the analysis, the scope of the review and the ‘longevity’ of the evidence to be generated. It aims therefore to present the evidence to the Minster and her team to allow her to review the range of issues and to select an initial round of priorities for Slovenia to address. It is expected that the Minister will consult in detail with the
Ministry team and will draw on the support of the WHO Regional Office for Europe.
Activity 7: Policy dialogues: This activity seeks to take forward the priority areas selected by the
Minister. It will present the evidence and initial options to a group of national stakeholders and international experts with a view to validating the findings and insights generated and strengthening

the final report. It will also test the acceptability of the range of options identified with the Slovenian experts most likely to be involved in future choices, policy development and implementation.
Activity 8: Reporting: This activity will write up the findings of all previous stages to ensure the
Ministry and Commission can readily access the evidence and options generated. It will also organize the dossier of supporting evidence so that it will support future rounds of discussion in 2016-18.
4. Project management
The project is to support the Ministry of Health and will have national project and strategic leadership within the Ministry and related agencies.
The international project aspects will be led by the WHO Regional Office for Europe, specifically by Dr
Josep Figueras, Director of the European Observatory on Health Systems and Policies and Dr Hans
Kluge, Director of the Department of Health Systems and Public Health . It will be supported by their respective teams and by the Head of the WHO Country Office Dr Marijan Ivanusa.
Dr Figueras and Dr Ivanusa will contribute to any Project Board established by the Slovenian Project
Manager. Administrative support will be provided both from the Observatory and through the Country
Office.
5. Dissemination: Audience and outreach strategy
Focus and ‘shelf life’: The report will provide relevant data and analysis on core health system issues to inform the political and policy choices of the Slovenian government and to support its efforts to address EC CSRs. It will therefore assemble a comprehensive range of complex evidence which is deliberately technical and that will continue to be of relevance to successive rounds of reform over a 3-
5 year time horizon supporting both an immediate round of decision making and a second and third wave of policy choices in the follow up period 2016-8.
Reaching key audiences: In line with the above the reports is primarily intended for the Minister and
Government colleagues and the technical Ministry staff that support them. It will also target the EC, and EC FIN in particular.
Public dissemination: All the findings and policy options will also be available to health professionals, the general public and other stakeholders.
6. Budget
Activity
Activity 1
Activity 2
Activity 3
Activity 4
Activity 5
Activity 6
Activity 7
Activity 8
Euro
46,000
39,088
43,000
24,000
35,000
8,000
24,000
11,000
PSC at 13% 29,912
Total
260,000
The funds will be held by WHO and in line with detailed project plans agreed with the Slovenian
Project Manager.

Please note that the amounts allowed per activity are provisional and WHO may vire funds between budget lines without prior agreement provided that the project manager is notified and the outputs continue to meet expectations.