Chapter I: Tasks of healthcare institutions.

I.- In order to facilitate the cooperation they organise within the framework of the agreement referred to in article L. 6111-3-2 with primary care providers in the areas they serve, local hospitals may adapt their operating and governance conditions in accordance with the procedures set out in II and III.

II.-A local public hospital on the regional list referred to in IV of article L. 6111-3-1 may be authorised by the Director General of the Regional Health Agency to adapt its governance arrangements by providing that, by way of derogation from articles L. 6144-2 and L. 6143-7-5, external persons or healthcare professionals, in particular representatives of territorial professional healthcare communities, may take part as members with voting rights in meetings of the hospital medical committee and the management board of the local hospital or of the public establishment to which it belongs, if it does not have legal personality.

The number of members with voting rights on the hospital medical committee resulting from the previous paragraph may not exceed a proportion of the total number of its members set by decree in the Conseil d'Etat.

The adaptations mentioned in this II are the subject of a request to the regional health agency, made by the director of the local hospital or the public establishment to which it belongs, after a favourable opinion from the bodies concerned and, in addition, when the adaptation concerns the management board, after an opinion from the establishment's supervisory board. These adaptations may be terminated following the opinion of the bodies concerned in the event of difficulties in their implementation.

A decree in the Conseil d'Etat specifies the terms and conditions for the application of this II. This decree shall specify in particular the procedure by which the Director General of the Regional Health Agency authorises these adaptations, the status and number of external persons or competent health professionals authorised to join the relevant bodies of the local hospital, the way in which they are appointed and, where applicable, the duration of their term of office, the way in which these adaptations are monitored and evaluated, and the conditions under which they may be terminated.

III. -When the local hospital does not have legal personality or shares management with another establishment, the establishment to which it belongs guarantees that the local hospital has implemented operating and organisational procedures for the site that enable it to fulfil its local missions as mentioned in article L. 6111-3-1 and adapted to the cooperation with its partners established in application of article L. 6111-3-2.

To this end, a sub-committee of the hospital's medical committee or a medical and nursing committee, made up of medical and non-medical staff, may be set up, dedicated to the performance of its local tasks.

The organisational methods implemented in this way are notified to the relevant regional health agency within one year of the local hospital being included on the regional list referred to in article L. 6111-3-1.