NAIIONa)^ CO!

flNUL FOR,
law RfPORTIhhls
library
SPECIAL ISSUE

Kenya Gazette Supplement No l(Kiambu County Bills No 1)

REPUBLIC OF KENYA

KENYA GAZETTE SUPPLEMENT

I

KIAMBU COUNTY BILLS, 2019

I

NAIROBI,18th January,2019

CONTENT

Bill for Introduction into the County Assembly of Kiambu—

Page
I

The'Klambu County Health Services Bill, 2019 1

PRINTED AND PUBLISHED BY THE GOVERNMENT PRINTER NAIROBI

 THE KIAMBU COUNTY HEALTH SERVICES BILL,2019
ARRANGMENT OF CLAUSES

Clause

PART I-PRELIMINARIES

1 —Short title and commencement

2— Interpretation
3 — Purpose ofthe Act
4— Application
5—Guiding principles
6—Annual and other reports
PART H - RIGHTS AND DUTIES OF PATIENTS

7 — Rights of patients
8 — Emergency treatment
9—Coordination of emergency health care services
10— Requirements for consent
11— Confidentiality
12 — Obligations of patients
PART HI -ADMINISTRATION
13—Responsibility of the County Government
14—County Director of Health
15— Establishment of Directorates

16— Hospital superintendent or officer in charge of a health unit

17—Other staff

18— Deployment & designation of staff

19—Appointment of Hospital Boards
20—Appointment ofHealth Facility Management Committees
21 — Establishment of County Health Management Team
22—Appointment of Hospital Management Team
 The Kiambu County Health Services Bill, 2019
PART IV - ESTABLISHMENT,CLASSIFICATION AND
STRUCTURES OF PUBLIC HEALTH FACILITIES
23 — Establishment of public health facilities
24—Classification of public health facilities
25— Establisliment of a County teaching and referral hospital
" 26 — Other specialized units & centers
PART V-QUALITY ASSURANCE
27—Maintenance of quality standards
28 — Appointment of County Health Advisory Board
PART VI- THE HEALTH SERVICES MANAGEMENT FUND
29— Establishment of the Fund

30— Sources of the Fund

31 — Utilization of the Fund

32— Fund's bank account

33— Appointment of an officer to admimstei the Fund

34— Responsibilities of the officer administering the Fund
35— Administration of the Fund

36—Administration of momes realized by a public health facilities

37— Public institution's bank account

38 - Health Fund Committee

39— Functions ofthe Health Fund Committee

40 — Conduct of Business ofthe Health Fund Committee

41 — Audits of accounts

42—Investment of surplus
43— Winding up
44—Transition prior to enactment of this Act
PART VHI- GENERAL PROVISIONS

45—Regulations
46 — Appeals
47— Savings
 The Kiambu County Health Services Bill, 2019
THE KIAMBU COUNTY HEALTH SERVICES BILL,2019
A BiU for

AN ACT of the County Assembly of Kiambu to provide

for implementation of section 2 of part 2 of the
Fourth Schedule to the Constitution on county
health services and for connected purposes
ENACTED by the County Assembly of Kiarabu as follows-
PARTI - PRELIMINARIES
1 This Act may be cited as the Kiambu County Health short title
Services Act, 2019

2 In this Act unless the context otherwise requires — interpretation

"Act" means the Kiambu County Health Semces Act,
^ 2019,
"Board" means the hospital Board established under
section 16 of this Act,
"Chief Officer" means Chief Officer responsible for
the Department on Health Services,
"County" means Kiambu County
1

, "Emergency medical condition" means an acute

1 situation of injury or illness that pauses an immediate risk
to life or health of person or has potential for deterioration
in the health of a person or if not managed timely would
lead to adverse consequences in the person's wellbemg
"Emergency treatment" refers to necessary immediate
health care that must be administered to prevent death or
worsening of a medical condition,
"Executive Membei" means the County Executive
Committee Member in charge of Health Services,
"Health" refers to a state of complete physical, mental
and social wellbemg of a peison and not merely i the
absence of disease or infmmty,
"Health care professional" mcludes any person who
has obtained health professional qualifications and licence
from the relevant regulatory body,
"Health caie provider" means a person who provides
health care services and includes a health care professional,
4 The Kiambu County Health Services Bill 2019

"Health care services" means the prevention

promotion, management or alleviation of disease, illness,
injury and other physical and mental impairment in
individuals delivered by the health care providers through
the health care system's routine health services, or its
emergency health care services,
"Health facility" means the whole or parts of a public
or private institution, building or place, whether for profit
or not, that is operated or designed to provide mpatient or
outpatient treatment, diagnostic or therapeutic
interventions, nursing, rehabilitative, palliative,
convalescent, preventive or other health services,
"Health system" means an organization of people,
institutions and resources, that deliver health care services
to meet the health needs of the population in accordance
with the established policies,
"Fund" means the Fund established under section 33
of this Act,
"Private health care services" provisions of health care
services offered by a health facility that is not owned by the
Government and includes health care services provided by
individuals, faith based organization and private health
institutions,

"Public health" means the health of the population as a

whole, especially as monitored, regulated and promoted by
the Government,
"Public health care services" means health care
services by a health facility owned by the Government
3 The purpose of the Act IS to— Purpose ofthe Act
(a) promote access to health services,
(b) facilitate the progressive realization of the right to
health within the County to the highest attainable
!i standard of health, including public health,
reproductive health care and the right to
emergency medical treatment,
(c) promote public health, and
(d) establish a framework for cooperation with the
health regulatory bodies established under any
 The Kiambu County Health Services Bill 2019

Other written law for purposes of assuring

standard health care services

4 (1) This Act applies to any person offering health Application

care services within the County

(2) A person who offers any health eare service within the
County in contravention of this Act commits an offence and on
conviction is be liable to a fine of a sum not exceeding one
million Kenya shillings or to imprisonment for a term not
exceeding twelve months or to both
Guiding Principles
5 The implementation of this Act is guided by the
following principles—
(a) the individual nght to health shall be upheld,
observed, promoted and protected,
(b) provision of health care services shall focus on
promotion of health,
(c) health care services shall be available, accessible
and of highest attainable standards, and
(d) provision of health care services shall be withm the
established health care system and in accordance
with the standards prescribed in national and
county policies and legislations
6 (1) The Executive Committee Member shall submit an Annual and other

annual report to the Assembly outlining — Reports

(a) the measures taken to implement the piovisions of this

Act

(b) the quality status of health care services within the

County,
(c) the county preparedness to offer emergency health care
serviees,

(d) the measures taken to control and mitigate the impact

of health risk factors,
(e) the level of disease burden disaggregated in terms of
age, gender, social status, communicable and injuries
among others,
(f) measures taken to implement health policies, including
the national health policies.
 The Kiambu County Health Services Bill 2019

(g) the status of compliance with quality standard for the

health care services within the County, and
(h) any other matter as the Executive Member may deem
relevant

(2) Notwithstanding the provisions of subsection (1),

the Executive Membei may be called upon to make such
other reports to the Assembly from time to time as may be
deemed necessary
PART II - RIGHTS AND DUTIES OF PATIENTS

7 (1) A patient has the right to — Rights of patients

(a) access to the highest attainable standard health
care services,

(b) be treated with dignity, respect and their privacy

respected m accordance with the Constitution,
(c) emergency medical treatment by the health care
provider of the first contact,
(d) be informed about his or her health, including the
health care services, procedures or products that
may be administered and the identity of the
health care provider attending to hrm or her, and
(e) to file a complaint where aggrieved with the health
care services rendered
(2) To ensure the implementation of sub-sections (1),
the Chief Officer shall—
(a) co-ordinate the provision of health care services,
(b) co-ordinate the implementation of national and
County health care policies and laws,
(c) co-ordinate provision of emergency health care
services,

(d) establish a structure for implementation of

outreach health care services,
(e) recommend to the Executive Member policies,
regulations, guidelines, standards and strategies on
health care services,
(f) supervise of the health care system within the
county.
 The Kmmbu County Health Services Bill 2019

(g) ensure continued maintenance of quality health

care standards within the County, and
(h) monitor and evaluate the implementation of this
Act

^ (1) Every person has the right to emergency Emergency

treatment treatment
(2) Foi the purposes of this section, emergency
treatment shall include—

(a) pre-hospital care,

(b) stabilizing the health status of the individual, or
(c) arranging for referral in cases where the health provider
of first call does not have facilities or capability to
stabilize the health status of the victim
(3) Any health care provider who fails to provide
emergency treatment while having ability to do so
commits an offence and is liable upon conviction to a fine
not exceeding three million shillings or to imprisonment for
a term not exceeding twelve months or to both
9 (1) There shall be the emergency health care ordmation of
services unit within the County headed by the County emergency healtli
care services
emergency health care services coordinator
(2) In addition to other requirements under this Act,
the Executive Member shall progressively ensure that there
IS at least one casualty unit in every sub-county
(3) The Chief Officer shall designate a health caie
provider to be the County emeigency health care services
coordinator

(4) The County Emergency health care services

coordmatoi shall be responsible to the Chief Officer foi
supervising and coordinating—
(a) casualty services,
(b) ambulance services and pre-hospital care,
(c) health evacuations,
(d) other services deemed or declared to be a health
emergency or disaster within the County,
(e) collaborations, linkages and co-operations with
 The Kiambu County Health Services Bill 2019

Other entities for purposes of providing emergency

services,

(f) advising the Chief Officer on matters relating to

provisions of emergency health care services, and
(g) undertaking such other function as may be
assigned by the Director from time to time
(5) The Chief Officer shall deploy such number of
staff to the emergency health unit as shall be necessary for
delivery of better emergency services
(6) The Executive Member may prescribe regulations
for better implementation of this section
10 (1) A patient shall not receive health care services
unless the patient gives informed consent
(2) Notwithstanding the provisions of sub-section (1)
if a patient is unable to give informed consent, the consent
may be given on behalf of the patient by either —
(a) the patient's parent or guardian in the case of a ,
mmor,

(b) a person mandated by the patient m'writing to

grant the consent on his or her behalf, or
(c)the patients next of kin
(3) Notwithstandmg sub-sections (1) and (2), health
care services may be provided to a patient without a
consent if—

(a) the provision of the health care service is

authorized by a law or a court order,
(b) the patient is receiving emergency health care
services,

(c) failure to treat the patient may result m serious risk

to public health, or
(d) any delay m the provision of the health care
service to the patient might result to death or
irreveisible damage to their health and the patient
has not expressly or by implications or conduct
refused to receive the service
 The Kiambu County Health Services Bill 2019

(4) for purposes of this section "informed consent"

means the consent given by a person with legal and mental
capacity to give such consent, which is given on the basis
of the information given to that person by a health care
provider on the specified health care service to be provided
11 A person shall not disclose any information contidentiaiity
coneemmg a patient, ineludmg information relating to his
or her health status, treatment or stay in a health facility
unless —

(a) the patient has given written informed consent,

(b) a court order or any applicable law requires such
disclosure, or
(e) non-disclosure of the information represents a
serious threat to public health
12 A patient IS required to— obligations of
patients
(a) adhere to the rules of a health facility when
receiving treating or accessing any other services
from a health facility,
(b) adhere to the medical or health advice and
treatment provided,
(c) give accurate information pertaining to his or her
health when receiving treatment,
(d) cooperate with the health care providers,
(e) treat health care providers with dignity and respect,
and

(f) sign a discharge certificate or release of liability if

he or she refuses to accept or to implement
recommended treatment

PART m - ADMINISTRATION

13 (1) The County Government shall be responsible Responsibility of

for— the County
Government
(a) promotion of public health,
(b) management ofpublic health facilities, and
(c) quality assurance of health care services within the
County
10 The Kiambu County Health Semces Bill 2019

(2) The County Govemraent shall establish

appropriate governance, administrative structures and
personnel structures as shall be necessaiy for better
implementation of its mandate
(3) The County Government may prescribe fees and
charges for services rendered by the Department or any of its
agents charged with the responsibility of implementing the
County Government's mandate under this Act
(4) The fees and charges pi escribed under the First
Schedule to this Act shall be the fees payable for services
rendered under this Act

(5) iNotv ithstandmg the provisions of subsection (4), no

fees shall be charged to public health facility of level three and
below except on publication of an order in the gazette made by
the Executive Member responsible foi Finance specifying—
(a) the level of the public health facility m which such
charge shall be made,
(b) the amount payable, and
(c) date of commencement of such payment
(d) the Executive Member responsible foi Finance may,
under the Finance Act, amend the first schedule
14 The Chief Officer shall perform the fimctions of County Director of
the County Director of Health as provided foi under section Health

19 of the Health Act 2017

15 (1) The Executive Member may establish such Establishment of

Directoiates as may be necessary for better implementation Directorates
of this Act

(2) The Directorates shall be headed by a Director

appointed by the County Public Service Board through a
competitive process
(3) The County Public Service Board may, on the
recommendation of the Chief Officer, appoint a person to
deputize a Director on such terms and conditions as shall be
appropriate

(4) A Director shall be responsible to the Chief

Officer for the day to day operations and implementation of
the Directorate's functions
 The Kiambu County Health Services Bill 2019 11

(5)A person shall not be appointed as a Director under

this Act unless that person—
(a) IS a Kenyan citizen,
(b) possess a Masters Degree in Medical Sciences from
a university recognized in Kenya,
(c) has at least five years' relevant experience, and
(d) meets the requirements of chapter six of the
Constitution

16 (1) The Chief Officer may designate a staff to be a Hospital oi

superintendent of a hospital or the officer m charge of a officerlroh™^^^ of
health unit a health unit

(2) A person shall not be designated under this section

unless the person has a degree m health sciences
(3) A Superintendent of a hospital or the officer in charge
of a health unit shall be responsible for day to day
administration of the hospital or health unit
17 (1) The County Public Service Board may appoint other staff
such other members of staff as shall be necessary for the
better implementation ofthis Act
(2) Notwithstanding subsection (1), a hospital
Superintendent or an officer in charge of a hospital may
recruit such other staff on a short term or temporary basis
for purposes of providing essential services
18 The Chief Officer may - Deployment and
designation of staff
(a) designate a staff member to be a head of a
department or programme, or
(b) deploy a member staff to any duty station within
the County
19 (1) The Executive Member shall appoint a Board Appointment
r- 1 1 /. j 1 1 i 1 o Hospital Boards
for a level four and above hospital, compnsmg of—
I

(a) a chairperson who shall not be a staff of the

County Government with a minimum of a
diploma,
(b) the hospital superintendent who shall be the
secretary.
^2 The Kiambu County Health Services Bill 2019

(c) A representative of the Chief Officei,

(d) four residents of the sub-county in which the
hospital IS located who has attained basic level
education taking into account gender parity and
special interest groups
(2) The Board may coopt any person with relevant
expertise necessary to assist the Board determine with a
matter before it
(3) A person shall not be appointed as a Chairperson
of a Board unless that person—
(a) IS a Kenyan,
(b) possesses at least a diploma from an institution
recognized m Kenya,
(c) has experience in management, leadership or
administration, and
(d) meets the requirements Chapter six ofthe
Constitution

(4) The Members of the Board, other than an ex-

officio Member, shall serve for a term of three years which
term may be renewed
(5)The Board shall—
(a) provide oversight over the general administration
of the hospital,
(b) promote the development of the hospital,
(c) recommend to the Executive Member plans and
programs for implementing the county health
strategies in the hospital,
(d) recommend to the Executive Member budget
estimates,

(e) establishing a hospital-community participation

and feedback platform,
(f)assessing the delivery of services at the hospital and
advice the Executive Member,
(g) monitoring the hospitals performance against set
targets and advice the Executive Member, and
 The Kiambu County Health Services Bill 2019 13

(h) carrying out any other function that may assigned

hy the Executive Member
(6)The term of office of a member appointed under
sub seetion (1)(a) and (c) shall be three years which term
may he renewed
(7) The Executive Member may hy Regulations
prescribe the conduct of business ofthe Board
(8) The Executive Member may remove from office
any member ofthe Board who—
(a) has been absent for three consecutive meetings of
the Board without the permission of the
Chairperson,
(h) IS adjudged bankrupt,
(c) IS unable to discharge his or her duties due to
physical or mental incapacity,
(d) violates or is suspected of violating the provisions
of Chapter six of the Constitution, or
(e) IS charged with a criminal offence in court oflaw
or a traffic offence attracting an imprisonment
term of a mmimum of six months

20 (1) The Executive Member shall appoint a Health

_ , f 1 ^ 1 Health Facility
Facility Management committee for every hospital every Management
level two and three hospital, comprising of— committees
(a) a chairperson who shall not he a staff of the County
Government,
(b) not more than foui persons from the ward in which
the health facility is located with at least five years
experience in health related matters, and
(c) the officer m charge of the health facility, who shall
be the secretary
(2) A person shall not he appointed as a Chairperson
under this section unless that person—
(a) IS a Kenyan,
(h) has attained at least a diploma from an institution
recognized m Kenya,
14 The Kiambu County Health Services Bill 2019

(c) resident of the area,

(d) meets the requirements of Chapter six of the
Constitution

(3) The provisions of sub-section 19(7) shall apply

with the necessary modifications
(4)The Health Facility Management committees shall
be responsible for—
(a) identifying the health needs of the community and
advice the Chief officer,
(b) providing oversight on the general the
administration ofthe health facility,
(c) promoting the development of the health facility,
(d) recommending to the Executive Member plans and
programs for implementing county health
strategies in the health facility,
(e) recommending to the Executive Member budget
estimates,
(f)establishmg a health facility-community
participation and feedback platform,
(g) assessing the delivery of services at the health
facility and advice the Executive Member,
(h) monitoring the health facility performance against
set targets and advice the Executive Member, and
(i)carrying out any other function that may assigned
by the Executive Member
(5) The term of office of a member appointed under
sub section (1)(a) and (c) shall be three years which term
may be renewed
(6) The Executive Member may remove from office
any member ofthe Board who—
(a) has been absent for three consecutive meetings of
the Board without the permission of the
Chairperson,
(b) is adjudged bankrupt,
(c) IS unable to discharge his or her duties due to
physical or mental mcapaeity.
 The Kiambu County Health Services Bill 2019 15

(d) Violates or is suspected of violating Article 6 and

10 ofthe Constitution, or
(e) is charged with a criminal offence in court oflaw
or a traffic offense attracting an imprisonment
term of a minimum of six months
21 (1) There shall be a County Health Management Appointment of
Team appointed by the Executive Member comprising of-— County Health
(a) the Chief Officer, Management Team
(b) directors within the Department, and
(c) heads of umts or sections within the Department
(2) The Executive Member shall designate a Chairperson
and a Secretary from amongst members of the County Health
Management Team
(3) The County Hospital Management Team shall be
responsible for—
(a) reviewing and monitoring the implementation of this Act
and advising the Department on appropriate measures to
be adopted for effective implementation of this Act,
(b) supervising and supporting the management of the
hospitals and county health facilities,
(c) exercising disciplinary measures over health personnel
working within the Department,
(d) assessing the delivery and impact of the health care
services within the County and advising the Executive
Membei,
(e) monitoring drugs and commodities availability and
diagnostic standards,
(f) recommending policies, strategies, regulations and
standards to the Executive Member, and
(g) undertake such other matters as the Executive Member
may from time to time assign
(4) The County Health Management Team shall meet
at least once m every quarter
(5)The County Health Management Team shall
prepare and submit quarterly report of its operations to the
Department, which may inform the preparation of the
reports under section 6
16 The Kiambu County Health Services Bill, 2019

(6) The Executive Member may prescribe guidelines

for conduct of business of the County Health Management
Team
!

22 (1) Each public hospital or public health facility Establishment of

shall establish a hospital management team comprising of Hospital
all the heads of the hospital departments to assist m the day Management Team
to day management ofthe hospital
(2) A hospital management team shall meet at least
once every quarter
(3) The hospital management team sha^l submit a
quarterly report to the Chief Officer on its operations and
status of health care services at the health facility
PART IV -ESTABLISHMENT,CLASSIFICATION
AND STRUCTURES OF PUBLIC HEALTH
FACILITIES

23 (1) The Executive Membei may, with the

approval of the County Executive Committee, establish a facilities '
public health facility
(2) A public health facility established before the
enactment of this Act shall be deemed to have been
established under this Act
(3) A health facility established under this section
shall be a planning unit within the Department responsible
for health care services unless otherwise provided under
any other written law
Classification of
24 (1) The public health facilities may be classified m public health
level one, two, three, four, five or County referral hospital facilities

(2) The Executive Member may, m accordance with '

the laws and standards applicable nationally for
classification of health facilities and with the approval of
the County Executive Committee, classify or upgrade a
health facility in any classification level as shall be
necessary for better implementation ofthis Act
(3) The Executive Member shall ensure the
establishment and implementation of a health services
referral structure within the various levels of health
facilities m accordance with the national regulations and
standards
 The Kiambu County Health Services Bill 2019 17

25 (1) The Executive Member may, with approval of Establishment of a

County referral
the County Executive Committee, upgrade a level five hospital
hospital to be a County referral hospital
(2) The Executive Member shall prescribe regulations
for management and administration of a County referral
hospital
26 The Executive Member may, establish such other Other specialized
units and centers
specialized healthcare units including—
(a)reproductive units,
(b)child health units,
(c) mental health,
(d)oncology, and
(e)any other specialized centers
PART V- QUALITY ASSURANCE
27 (1) A health facility shall have a quality Maintenance of
quality standards
management system applicable to health care services
(2) The Executive Member may by Regulations
prescribe the quality management standards and a
framework for cooperation with the health care services
legulatory bodies established under any other written law
for purposes of ensuring maintenance of quality health care
standards within the County
28 (1) The Executive member shall appoint a County Appointment of a
County Health
Health Advisory Board comprising of— Advisory Board

(a) a Chairperson,
(b) the Directors m the Department of Health Services,
(c) the officer in charge of public of Health
(d) a representative of universities within the County
teaching medical subjects,
(e) two representatives of private health care providers,
, and
j

(f) the head of quality health standards who shall be the

secretary
(2) The County Health Advisory Board shall have
powers to enter and inspect a health facility within the
County at any time for purposes of—
18 The Kiambu County Health Services Bill 2019

(a) preparing a report on compliance with the quality

assurance standards in any policy or written law and
making recommendations to the relevant regulatory
body on compliance thereof,
(b) advising the Executive Member on compliance with the
provisions of this Act by a health caie provider,
(c) advising the licensing officer before issuance of a
business permit or licence where applicable
(3) A person who obstructs a member of the County
Health Advisory Board to conduct an inspection commits and
offence and on conviction, is liable to a fine of a sum not
exceeding five hundred thousand or to imprisonment for a term
not exceeding one year or to both
(4) The County Health Advisory Board shall prepare and
submit an annual report to the Executive Member on its
operations and compliance with the prescribed health care
standards within the County
PART VI - KIAMBU COUNTY HEALTH
SERVICES FACILITY IMPROVEMENT FUND
29 (1) There IS established a Fund to be known as the Establishment of
Kiambu County Health Services Facility Improvement the fond
Fund

30 The Fund shall consist of— Sources ofthe fond

(a) monies appropiiated for this purpose by the County
Assembly,
(b) monies earned by oi arising from investment made m
respect of the Fund,
(c) monies collected as charges by the health service
institutions for services rendered or goods sold,
(d) other sums of money that may in any manner become
payable to or vested in the Fund including gifts, grants,
bequeaths and donations,
(e) charges and fees levied in relating to promotion of
public health, and
(f)any other sums of money earned by the institutions in
execution of their mandate
 The Kiambu County Health Services Bill 2019 19

31 The Fund shall be utilized for— Utilization of the

fund
(a) purchase of drugs and commodities,
(b) health facilities administrative functions,
(c) acquisition and maintenance of health care equipment,
apparatus and accessories, and
(d) purchase or acquisition of such other items or
services as may be approved by the Executive
Member
32 (1) The monies of the Fund shall be deposited m Funds bank
account
a bank accoimt approved by the Executive Member for
finance under the name "Kiambu County Health Services
Facility Improvement Fund"
(2) The signatories of the account shall be the officer
administering the Fund and other officers of the County
Government designated by the Executive Member for
finance
33 The Executive Member for finance shall designate Appointment ofan
a staff ofthe County Government to administer the Fund atomster the
Fund
34 The officer administering the Fund shall— Responsibilities of
the officer
(a) ensure that money held in the Fund including any admmistermg the
Fund
earnings or accruals are retained in the Fund unless the
Executive Member for finance otherwise directs,
(b) ensure that the money held m the Fund is spent only for
the purposes for which the Fund is established,
(c) submit the Fund's budget to the Executive Member for
approval,
(d) ensure efficient management of the Fund,
(e) authorize disbursement of funds to the institutions in
accordance with the approved budget,
(f)continuously review, monitor and evaluate utilization of
the Fund,
(g) ensure that the accounts of the Fund and the annual
financial statements relating to the Fund's accounts
comply with the accounting standards prescribed by the
Accounting Standards Board,
(h) prepare the financial accounts for the Fund in each
financial year,
20 The Kiambu County Health Services Bill 2019

(1)submit financial statements for the Fund to the Auditor-

General not later than three months after the end of
each financial year,
(j)present the financial statements to the County Assembly,
and

(k) undertake such other functions as the Executive

Member may from time to time assign
Administration of
35 (1) The Fund shall be administered m accordance with the Fund
the Public Finance Management Act
(2) The officer administering the Fund shall at the
beginning of every quarter issue an authority to incur
expenditure to the institutions' accounting officers
(3) The Executive Member for finance may from time
to time issue guidelines for better administration of the
Fund
36 (1) All monies realized by an institution shall be ^^^"dby
deposited in an account for the institution operated m a public hospital
accordance with section 37 of the Act
(2) An institution shall only utilize the funds—
(a) in accordance with the approved budget,
(b) on the basis of the authority to incur expenditure,
and

(c) m accordance with the laws governing public

procurement and disposal
(3) All payments to the institution shall be recorded and
banked in the instiUition's bank account within twenty four
hours

(4) Not later than the fifth day after the close of the
financial year, all monies held in an institution s bank account
shall be transferred to the Fund's account
Institutions bank
37 (1) Every institution shall operate a bank account under accounts

its name which name shall include the words "facility

improvement fund"
(2) All the monies realized by an institution for
services rendered or for goods sold or other sources shall
be deposited m that institutions' bank account
(3) The signatories of the account shall be the
institution's accounting officer together with either —
 The Kiambu County Health Services Bill 2019 21

(a) the officer administering the Fimd, or

(b) a member of staff designated by the Executive Member
for finance

38 (1) There
« 1
is established
^ n
the Health Fund Committee
j 1 .1
J""''
Committee
comprising of the following persons appointed by the
Executive Member—

(a) Chief Officer who shall be the Chairperson,

(b) A secretary,
(c) not more than three accounting officers of any of the
institutions, and
(d) not more than two Directors m the department for the
time being responsible for Health services or their
appointees

(2) In making the appointments, the Executive

Member shall endeavor to attain gender parity and
inclusion of special interest groups
39 The Health Fund Committee shall- SSuiS''"'
Committee
(a) recommend to the Executive Member policies and
strategies for better implementation ofthe Fund,
(b) recommend the respective institutions' budget to
the Executive Member,
V

(c) evaluate an institution's performance including its

capacity to generate and utilize funds,
(d) recommend to the Executive Member Fund's
investments,

(e) advice the Executive Member on matters relating

to the Fund, and
(f)perform any other functions as may be assigned from
time to time by the Executive Member
40 (1) The Department of Health Services shall Conduct of
business of the
provide a secretariat for the Health Fimd Committee Health Fund
Committee

(2) The quorum for the meeting shall be half of the

members

(3) The Committee shall not exceed four meetings m a

year unless authorized by the Executive Member
22 The Kiambu County Health Services Bill 2019

(4) The Executive Member may from time to time

direct the procedure for the conduct of meetings of the
Health'Fund Committee

41 (1) The Fund account and each institution's banlc Audits ofaccounts
account shall be audited in accordance with laws governing
management of public funds
(2) Notwithstanding subsection (1), an internal auditor
may be designated to the Fund m accordance with the
County deployment guidelines
Investment of
42 (1) The surplus realized in any financial year from surplus funds
the operations of the Fund shall be retained m a reserve
account of the Fund and any deficiency realized in any
financial year shall, subject to prior approval of the County
Treasury, be offset against the realized surplus held in the
reserve account ofthe Fund

(2) The Executive Member for Finance may from

time to time give guidelines on investment of the fund
surplus
43 (1) The Executive Member for Finance may, with wmdmgup
the approval ofthe County Assembly wind up the Fund
(2) Upon winding up of the Fund, the officer
administering the Fund shall—
(a) pay any outstanding debt or liability of the Fund
from the money held in the Fund's account, and
(b) pay any amount remaining in the Fund to the
County Treasury
(3) The Executive Member for finance shall, with the
approval of the County Assembly, pay any debt or liability
ofthe Fund from the County Treasury
(4) Any money held in the institution's bank account
at the time of winding up of the Fund shall be paid to the
County Treasury
44 Any money held by a public health facility from Transition
Its eamings prior to enactment of this Act shall be deemed
to be money administered m accordance with this part
 The Kiambu County Health Services Bill 2019 23

PART VIII -GENERAL PROVISIONS

45 (1)The Executive Member may make Regulations Regulations
generally for the better carrying out ofthe objects ofthis
Act
(2) Without prejudice to the generality of sub-section
(1), the Regulations may prescribe —
(a)(a) proeedure for conducting inspections and audits
of health facilities,
(b) for the eonduct of business of Committees and
Boards established under this Act,
(c) procedure for diselosmg a patient's confidential
information,
(d) coordination of emergency health care services,
(e) guiding the eooperation between the County
Govemment and the Regulatory bodies m the health
care system,
(f) management and administration of County referral
hospital and other speeiahzed units and centers,
46 Any person aggrieved by the decision of Director or Appeals
of a Committee or a Board established under this Act, or by
a health eare provider may appeal to the Executive Member
within sixty days from the date of communication ofthat
decision
47 Any contract entered into or any loan granted or any Savmg s
liability, right or interest arising or accrued in the
implementation of the Kiambu County Health Services
Act, 2014 shall be deemed to be a contract, loan, liability,
right or interest accrued under this Aet
24 The Kiambu County Health Services Bill 2019
FIRST SCHEDULE

Fees and Charges for Public Health (S 13 &30)

PART I—Public Health Services

A Foods. Drues and Non-food Hygiene Permit Fee

Fee Code Fee Description Food &
Drugs
Permit
Fee
1 100 Distributors, traders, wholesalers, hypermarkets,
department stores, supermarkets,show rooms,
boutiques, retail shops & stores, chemists,take-away
butcheries, personal service providers, kiosks
(a) 102 Hyper supermarket premises ,construction
over an area of 625 m2 12,500
(b) 103 Mega Store ,Large multi-department store,
premises area from 100 m2 to 624 m2 5,000
re) 104 medium supennarket 3,500
(d) 105 Large Trader, Shop, Retail Store or Personal
Service From 50m2 to 99m2 5,odo
(e) 110 Medium Trader, Shop or Retail Service From
25ni2 to 49m2 2,000
(f) 114 General retail shop between 17m2 and 24m2 1,000
(g) 115 Small Trader, Shop or Retail Service Up to16
m2 ' 1,000
(h) 120 Kiosk Light or Temporary Construction Less
than 5 m2 1,000
196 market hawkers -

0) 195 Other -Retail Traders, Stores, Shops and

Services 1,000
2 200 Small vendors & small traders and service providers
(a) 290 Commercial housing and breeding of annuals 2,000
(b) 295 Small Informal Sector services providers 1,000
3 300 Transport operators- taxis- matatus-buses-lorries-
planes-boats, tour / safari operators petrol stations,
storage facihties, cold storage facilities, publishing co,
newspapers

(a) 305 Large Tiansportation Company Over 30

vehicles 3,000
(b) 310 Medium Transport Company From 6 to 30
vehicles 3,000
(c) 315 Small Transport Company From 2 to 5
vehicles 3,000
 The Kiambii County Health Services Bill 2019 25

(d) 320 Independent Transport Operator 1 vehicle 1,000

(e) 325 Large Petrol Filling Station Over 6 pumps or
with garage-workshop & retail shop 5,000
(f) 330 Medium Petrol Filling Station From 4 to 6
pumps or with garage-workshop or retail
shop 5,000
(g) 335 Small Petrol Filling Station Up to 3 pumps
and without garage-workshop or retail shop 5,000
(h) 340 Large Cold Storage Facility Over 1,000 m2,
insulated walls, cold production equipment 5,000
(0 345 Medium Cold Storage Facility Between 100-
1,000 m2 5,000
(1) 350 Small Cold Storage Facility Up to 100 m2 5,000
(k) 355 Large Storage Facility Over 5,000 m2 Go
down. Warehouse Liquid Storage Tanks
Complex 5,000
(1) 360 Medium Storage Facility From 1,000 to
5,000 m2 5,000
(m) 365 Small Storage Facility Up to 1,000 m2 5,000
(n) 370 Large Communications Co Premises over
2500 m2 3,000
(o) 375 Medium Communications Co Premises from
1000 to 2499 m2 3,000
(P) 380 Small Communications Co Premises less
than 1000m2 3,000
(q) 395 Other Transport, Storage, and
Commumcations 3,000
4 400 Production of coffee, tea, fruits, flowers, cereals,
vegetables and horticultural products gram storage
and processing, mills & Posho mills, bakeries, forestry
and timber production, sawmills, coal production,
animal breeding, dairy products processing
(a) 405 Large Agricultural
Producer/Processor/Dealer/Exporter Over
100 acres 10,000
(b) 410 Medium Agricultural
Producer/Processor/Dealer/Exporter From
50 acres to 99 acres 5,000
(c) 415 Small Agricultural Producer/Processor/Dealer
less than 49 acres 1,000
(d) 420 Large Mining or Natural Resources Extraction
Operation Over 7 acres 3,000
26 The Kiambu County Health Services Bill 2019

(e) 425 Medium Mining or Natural Resources

Extraction Operation From 5 to Tacres 3,000
(f) 430 Small Mining or Natural Resources Extraction
Operation Less than 5 acres 1,000
(g) 495 Other Agricultural, Forestry, and Natural
Resources 1,000
5 500 Hotels, tourist camps,lodging houses, restaurants,
bars, eating houses, tea & coffee houses Butcheries
with meat roasting &/or soup kitchen facilities
Membership clubs, night clubs & casinos
(a) 503 Large-High Standard Lodging House/Hotel D
Class Over 100 rooms 5,000
(b) 506 Medium-High Standard Lodging House /
Hotel D Class From 41 to 100 rooms 3,500
(c) 509 Small-High Standard Lodging House/Hotel D
Class Up to 40 rooms 3,000
(d) 512 Large Lodging House with Restaurant and/ or
Bar B / C Class Basic standard over 15
rooms 2,000
(e) 515 Medium Lodging House with Restaurant and/
or Bar B / C Class Basic standard from 6 to
15 rooms 2,000
(f) 518 Small Lodging House with Restaurant and/ or
Bar B / C Class Basic standard up to 5
rooms 1,000
(g) 521 Large Lodging House B / C Class Basic
standard over 15 rooms 2,000
(h) 524 Medium Lodging House B / C Class Basic
standard from 6 to 15 rooms 2,000
(i) 527 Small Lodging House B/C Class Basic
standard up to 5 rooms 1,000
(0 530 large hostels with more than 100 rooms 5,000
(k) 531 medium hostels with between 50 to 99 rooms 3,000
(1) 532 small hostels with up to 49 rooms 2,000
(m) 540 Large Restaurant with Bar/Membership Club
Capacity over 30 customers/members 3,500
(n) 543 Medium Restaurant with Bar/Membership
Club Capacity from 11 to 30
customers/members 3,500
(0) 544 soup kitchen(e g mutura,kichwa and soup)
and other eating places 1,000
(P) 546 Small Restaurant with Bar Up to 10 1,000
 The Kiambu County Health Services Bill 2019 27

customers

(q) 549 Large Eating House, Snack Bar, Tea House

"Hotel" No lodging and no alcohol served
with capacity over 20 customers 1,500
(r) 552 Medium Eating House, Snack Bar, Tea House
"Hotel" No lodging and no alcohol served
with capacity from 6 to 20 customers 1,500
(s) 555 Small Eating House, Snack Bar, Tea House
"Hotel" No lodging and no alcohol served
with capacity up to 5 customers 1,500
(t) 556 other eating house ,catering with no
accommodation and sale of alcohol 1,000
(u) 557 Places that sell meat, milk, hides and skin,
honey 1,000
(V) 558 Butchery with Roasted Meat and / or Soup
Kitchen Any size 2,500
(w) 561 Large Bar/Traditional Beer Seller Capacity
over 50 customers 3,000
(X) 564 Medium Bar/Traditional Beer Seller
Capacity from 16 to 50 customers 3,000
(y) 567 Small Bar/Traditional Beer Seller Capacity
up to 15 customers 3,000
(z) 571 Large Night Club / Casino Over 500 m2 5,000
(aa) 574 Medium Night Club/Casmo From 101 to 500
m2 5,000
(bb 577 Small Night Club/Casino Up to 100 m2 5,000
(cc) 567 Small Bar/Traditional Beer Seller Capacity
up to 15 customers 3,000
6 600 Private education institutions, including universities,
museums, nurseries, primary and secondary schools,
professional training Centre's / polytechnic institutes
private health chnics and doctor's surgeries,
consulting offices of doctors, dentists
(a) 602 Universities (over 1000 students) 5,000
(b) 603 Universities(500 - 999 students) 5,000
(c) 604 Universities(below 500 students) 5,000
(d) 605 Private Higher Education Institution Any
type of private college or higher education
institution With Over 500 students 5,000
(e) 606 Private Higher Education Institution Any
type of private college or higher education
institution With between 300 to500 students 3,000
28 The Kiambu County Health Services Bill 2019

(f) 607 Private Higher Education Institution Any

type of private college or higher education
institution Up to 100 students 1,000
(g) 610 Large Private Education Institution Over 100
pupils 5,000
(

(h) 615 Medium Private Education Institution From

31 to 100 pupils 5,000
(1) 620 Small Private Educational Facility Up to 30
pupils including Day care and Nursery schools 5,000
621 Driving schools 2,000
(0
(k) 625 Large Private Health Facility Hospital,
Clinic, Nursing Home(providmg overnight
accommodation with capacity over 30 beds).
Funeral Home 5,000
(1) 630 Medium Private Health Facility Providing
overnight accommodation with capacity from
11 to 30 beds 5,000
(m) 635 Small Private Health Facility Providmg
overnight accommodation with capacity up to
10 beds 5,000
(n) 640 Health Clinic/Doetor's Surgery Doctor-
Dentist-Physiotherapist-Psychologist-etc
Consult Office with no overnight
accommodation available 3,000
(0) 645 Traditional Health Services, Herbalist,
Traditional Healer, etc 3,000
(P) 650 Large Entertainment Facility Cinema-
Theatre-Video Show (over 100 seats),
Amusement-Juke Box-Games Machines
Arcades (over 10 machines). Sports Club-
Gym (Over 50 members) 3,000
(q) 655 Medium Entertainment Facility From 50 to
100 seats, from 4 to 10 machines,from 16 to
50 members 3,000
(r) 660 Small Entertainment Facility Up to 50 seats,
up to 3 machines, up to 15 members 3,000
(s) 695 Other Education, Health, and Entertainment
Services 3,000
7 700 Manufacture, process and assembly of products,
vehicles, machinery and equipment, and workshops
servicing and repairing products, vehicles, machinery
and equipment, contractors of new building
 The Kiambu County Health Services Bill 2019 29

construction and old buildingSj restoration, and

iervice-

(a) 705 Large Industnal Plant premises over 2,500

ti2 10,000
(b) 710 Medium Industrial Plant premises from 100
m2 to 2,500 m2 10,000

(c) 715 Small Industrial Plant premises up to 100

m2 5,000
(d) 720 Large workshop/Service-Repair Contractor
premises over 500 m2 3,000
(e) 725 Medium workshop/Service-Repair Contractor
premises from 25 m2 to 500 m2 3,000

(f) 730 Small workshop/Service-Repair Contractoi

premises up to 25 m2 2,000

(g) 795 Other Manufacturer, workshop. Factory,

Contractor 1,000

(h) Penalty on late payment(After 31st 25% of t le

March) applicab e fee
Student attacliment 2,000
(1) 1,000
CO Food Export Public Health Certificate
1) PHA711 Student attachment 2,000
B Vector. Vermin And Rodent Control
Unit of Charges
Fee Code Item Description Measure (KSh)
Per instance 1,000
(f\) PHB 100 All tvpes of inspection
(b) Treatment of termites (public
PHB 101 institution) Per sq m 100

(c) Treatment of termites (private

Per sq m 200
PHB 102 residence)
Per lob 1,500
((\) PHB 103 Control of Bees
Per lob 2,000
(e) PHB 104 Eradication of snakes
Per sq m 50
(0 PHB 105 Stagnant water treatment
Per sq m 200
(g) PHB 106 Space fogging
Per sq m 50
fb) PHB 107 Larvicidmg
Per sq m 300
0) PHB 108 Spraying of Domestic premises
Per sq m 350
0) PHB 109 Spraying of Hotels & restaurants
Per sq m 500
(k) PHB 110 Spraying of All others
(1) Spraying of Fence infested with
crawling ants Per sq m 500
PHB 111
fm)PHB 112 Baiting m Private premises Per visit 1,500
Per visit 500
M PHB 113 Baiting in institutions
Per visit 2,000
(0) PHB 114 Baiting m Factories
30 The Kiambu County Health Services Bill 2019

(p) PHB 115 Baiting in Go downs Per visit 10,000

(q) Derating(Removal ofrats) from
PHB 116 premises Per Visit 600
c Inoculation Centre Services
Unit of Charges
Fee Code Item Description Measure (Kshs)
(a) PHC 101 Yellow Fever vaccination Per dose 2,000
(b) PHC 102 Typhoid TAB Per dose 1,000
(c) PHC 103 Polio vaccination Per dose 1,000
(d) PHC 104 Other vaccinations Per dose 1,000
International vaccination
(e) PHC 105 certificate booklet Per booklet 1,000
(i) PHC 106 Duplicate vaccination certificate Per cert 1,000
General Vaccination record
(g) PHC 107 book Per booklet 1,000
(h) PHC 108 Exemption letter Per letter 1,000
(1) PHC 109 Anti-Rabies Vaccine Per dose 500
(]) PHC 110 Anti-Snake Venom Per dose 500
D Vetting And Approval Of Buildings
1 PHD 100 Public Health Occupation Permit
Unit of Charges
Fee Code Item Description Measure (Kshs)
(a) PHD 101 Residential houses Per Instance 3,000
(b) PHD 102 Commercial enterprises Per Instance 6,000
(c) PHD 103 Industrial enterpnses Per Instance 25,000
(d) PHD 104 Institutions Per Instance 10.000
2 PHD 200 Pubhc Health Approval Of Bui
Idmg Plans
e) PHD 201 Residential houses Per Instance 3,500
f) PHD 202 Commercial enterprises Per Instance 7,000
g) PHD 203 Industrial enterprises Per Instance 25,000
ii) PHD 204Institutions Per Instance 10,000
1) PHD 205 Site visit Per visit 2.000
3 PHD 300 Health Inspection of Premises
1) PHD 301 Private school for registration Per Instance 5,000
Private medical clinic for
,1) PHD 302 registration Per Instance 3,000
k) PHD 303 Registered hotel Per Instance 3,500
1) PHD 304 Busmess premises re-mspection Per Instance 1,500
m) PHD 305 ^ny other special inspection Per Instance 3,500
n) f*HD306 Inspection of Laboratories Per Instance 3,000
0) J™307 ]inspection of a Nursing Home Per Instance 3,000
q) iTO 309 ]nspection ofa chemist Per Instance 3,000
 The Kiambu County Health Services Bill 2019 31

4 PHD 400 Inspection, sampling and analysis Charges

Inspection of Sites for Toilets/
septic tanks on constructions
a) PHD 401 sites Per visit 7,000
b) PHD 402 Food Biological test Per test 2,500
c) PHD 403 Food Chemical analysis per test Per test 5,000
Per
d) PHD 404 Export health certificate certificate 6,000
e) PHD 405 Drainage System inspection card Per instance 3,000
f) PHD 406 Incineration of health care waste Per kg 50
PART 11 -PUBLIC HEALTH CARE SERVICES CHARGES (S 13)
Hospital Charges
S/No Description Charges
(Kshs)
27 Absconders
a) ABSOOl Absconders 0
Attachment
28 Fee
b) ATC 006 Action Aid Attachment 7,000
c) ATC002 Bachelors of Nursing Students 2,000
d) ATC 007 Diploma In Clinical Medicine 5,000
e) ATC003 Laboratory Attachment 2,000
f) ATCOOl MbChb Students 5,000
s) ATC005 Others 2,000
h) ATC004 Records Attendants Attachment 2,000
0 ATC 008 Research KMTC 1,000
1) ATC 009 Research Other Institution / Degree 3,000
29 Casualty
a) CAS 006 Adrenaline Iniection 100
b) CAS 007 Aminophylline Iniection 100
c) CAS 030 Antiseptic Disinfectant 50
d) CAS 008 Atropine Iniection 100
e) CAS009 Bed Fee 250
f) CAS 010 Bianular 50
g) CAS Oil Buscopan Iniection 100
h) CAS 012 Change Of Catheter 150
1) CAS 027 Chest Tube Insertion 1,000
1) CAS 013 Circumcision 1,000
k) CAS 014 Crystalline Iniection 100
1) CAS 015 Diclofenac Iniection 100
ra) 1001 Doctors Fee 0
32 The Kiambu County Health Semces Bill 2019

n) CAS 016 Dressing 100

o) CAS 009 Excision Biopsies 1000
P) CAS 024 Excision OfLipoma Keloids/Biopsy 1,000
q) CAS 025 Exploration OfForeign Body 1,000
r) CAS 017 Gastric Lavage ' 200
s) CAS 018 Gloves 40
t) 1002 Intravenous Fluid 50
u) CAS 019 Largactil Iniection 100
V) CAS 020 Lasix Iniection 100
w) CAS029 Reduction of fracture 1,000
X) CAS 021 Removal Of Stitches 300
V) CAS005 Stitching under local anesthesia 500
z) CAS 028 Suprapubic Catheter 1,000
aa) CAS 026 Surgical Toileti 1,000
bb) CAS 022 Tetanus Iniection 100
cc) CAS 023 Vellum Iniection 100
30 Casualty Pharmacy
PH 001 Casualty(Emergency) drugs 0
31 Casualty Ward
a) CW21 Antiseptic Disinfectant 50
b) CWOl Bed Fee 250
c) CW02 Branulla 50
d) CW03 Catheterization 150
e) CW19 Consumable Products 200
f) CW04 Dressing 100
g) CW05 Givmg Set 25
h) CW06 Gloyes 40
0 CW07 Iniection , 100
1) CW08 Laundry 30
k) CW17 Mua 1000
1) CW 09 Orthopedic Sciew 1,500
m) CWIO Stitching 500
n) CW12 Stitching under local Anaesthesia 300
o) CW13 Sanction offluid GI 1000
P) CW14 Surgical Toilet 300
q) CW18 Under water seal Bottle 2500
r) CWll Urine Bag 30
s) CW20 Ward Consultation 50
t) CW16 Wound Dressing 50
DENTAL
1 D045 Acrylic Crown/Unit ' 1000
 The Kiambu County Health Services BUI 2019 33

2 D046 Acrylic Veneers/Tooth 1000

3 D063 Amalgam Filling ' 1000
4 D078 Amalgam Filling Under 5 years 1000
5 D041 Apicectomy 1000
6 D043 Bleaching single tooth 500
Bleaching Upper/Lower Labial
7 D042 Segment 10,000
8 D035 Closed Disimpaction 600
9 D008 Complete Denture 6000
10 D083 Complete Lower Denture 3000
11 D070 Complete/Partial Denture Repair 500
12 D082 Complete Upper Denture 3000
13 D064 Composite Filling 2000
14 D048 Cyst Enocleation 500
15 DOll Dental Consultation 100
16 D072 Dental Extractions Under 5 years 0
17 DOB Dental Suturing 500
18 D029 Difficult Tooth Extraction 400
19 D049 Dry Socket Management 200
Excision Biopsies Dental not under
20 D005 Anaesthesia 500
Excision Biopsies Dental under
21 D005 Anaesthesia 2000
22 D047 Fixed Ortho Appliances 30000
23 D084 Fixed Orthodontics 40000
24 D055 Full Mouth Scaling 2000
25 DOB Full Mouth Scaling 2000
26 D050 Glass Lonomei Cement Filling 1000
Glass Lonomer Cement Filling
27 D077 Under 5 yrs 1000
28 D038 Incision and Draining 500
29 D073 Minor Oral Surgery Under 5 Years 0
MMF (Maxillary Mandibular
30 D002 Fixation) 3000
31 D051 Mucocele Excision 500
32 D036 Open Disimpaction 2000
33 D052 Operculectomy 500
Oral Prophylaxis and Tropical
34 D076 Fluoride Application Under 5 years 500
35 D068 Ortho Adiustment 200
36 D081 Partial Denture (Four Teeth) 2500

'37 D009 Partial Denture(One Tooth) 1000

34 The Kiambu County Health Services Bill 2019

38 D080 Partial Denture (Three Teeth) 2000

39 D071 Partial Denture(Two Teeth) 1500
40 D075 Pulpectomy 2000
41 D074 Pulpectomy Under 5 years 1500
42 DOlO Removable Orthodontic Appliance 4500
43 D054 Removal of Splint/Mmf 500
44 D057 Root Canal Anteroir 2500
45 D065 Root Canal Molar 4500
46 D060 Root Canal Premolar 3000
47 D053 Space Mamtamer 1500
48 D003 Splinting 2000
49 D079 Splinting Under 5 years 1500
50 D040 Temporary Filling 500
51 DOOl Tooth Extraction 200
52 D044 Tooth Implantation 1000
DEPOSIT
DOOl Deposit 0
32 ENT
a) ENT014 Anterior Nasal Packing 500
b) ENT035 Chemical Cautery Under L A 1000
c) ENT005 Consultation Climc < 5 Yrs 0
d) ENTOll Ear Syringing 300
e) ENT006 Emergency Surgery 5,000
f) ENTOOl Ent Change of dressing n 100
9t) ENT033 Ent Clinic Visit 100
h) ENT 004 Ent Consultation Clinic > 5 Yrs 100
ENT Suturing Under Local
1) ENT034 Anaesthesia 2000
Exammation Under Operating
1) ENT037 Microscopy 500
k) ENT038 Excision Biopsy La 2000
Excision Head and Neck Mass
1) ENT016 under L A 2,000
m) ENT018 Excision/Biopsy 1,000
Filter Clinic Registration Fee < 5
n) ENT003 Yrs 0
Filter Clinic Registration Fee > 5
o) ENT002 Yrs 50
P) ENTOlO Foreign Body Removal 500
q) ENT029 Foreign Body Removal Under L A 500
Foreign Body Removal Under G A
r) ENT030 Mam Theatre 5,000
 The Kiambu County Health Services Bill 2019 35

s) ENT012 I/D-Incision and Drainage 2000

t) ENT031 Indirect Lanngoscopy 1000
U) ENT032 Maior Theatre Cases Under G A 5000
V) ENT020 Mentylcellulose 100
w) ENT036 Nasal Packing Under LA 1000
X) ENT007 Non-Emergency Surgery 5000
V) ENT021 Removal Foreign Body(Ent) 500
z) ENT022 Removal of Nasal Packing 250
EXEA/rPTIONS
EXEOl Exemptions 0
33 EYE
a) EY008 A/C Washout 1500
b) EY014 Antiseptic/Disinfectant 50
c) ET 050 Application Of Firm Bandage 100
d) E004 Bed Fee 250
e) E005 . Bed Fee(Under 5 years) 150
f) F050 Bed & Medication 250
g) E020 Branulla 50
h) EY006 BTPR 2000
1) E007 Cataract Operations 500
.1) EYOll Cataract Surgery 3,000
k) E014 Chalazion 1000
1) E018 Children < 5yrs Old Surgery 0
m) E013 Coniunctival Growth Excision 1,000
n) E025 Consumable Products 200
o) EY013 Comeal Repair 2,000
P) EYOlO Dressing with Firm Bandage 200
q) E006 Drugs 500
r) ET012 Econazole 1% 150
s) ET013 Emergency Surgery 500
t) EY003 Epilation ' 100
U) EY007 Eyisceration 4,500
V) E030 Eye Consultation 100
w) EYOOl Eye Irrigation 500
X) EY004 Eye Padding 100
y) E021 Eye Syrmging 300
z) E016 Fb Remoyal 200
aa) EY002 Foreign Body Removal 1000
bb) E022 Gloves 40
cc) ET018 Hydrocortisone eye drops 100
dd) E017 Irrigation 200
36 The Kiambu County Health Services Bill 2019

ee) EOOl Ivf 50

ff) E023 Laundry 30

gR) E015 Lid Repair 2000
hh) ET039 Nepucrom 150
11) ET 033 Nepuphecol 100

ll) ET 035 Nepupine 100

kk) ET 047 Nepusolne Forte 150
11) ET 038 Nepusolone G 150
mm) E008 Nursing Care 0
Operation Undei General
nn) E002 Anaesthesia 5,000
oo) ET049 Padding / Dressing 50

PP) ET023 Povidone Iodine 0 5 % 100

qq) EY012 Probing and Syringing 1000
rr) E009 Review / Consultation 100
ss) EY005 Stitching 1000.
tt) E003 Tarsorrhapy 1,000
uu) EY009 Tet 2000
w) EOll Trabeculectomy 1,000
ww) E024 Treatment 150
xx) E029 Ward Consultation 50
34 EYE
a) ETOOl Atropine 1% 100
b) ET002 Bilamalla 1,000
c) ET003 Cetaroxime 5% 110
d) ET004 Chalazion Incision &Drainage 500
e) ET005 Chloramphanicol 55 100
f) ET006 Conjuctival Growth Excision 1,000
g) ET007 Consultation Clinic< 5yrs 0
h) ET008 Consultation Clmic>5yrs 100

1) ET009 Dexagenta 100

l) ETOlO Dexamethasone 0 1% 100
k) ETOl 1 Ear Syimgmg 300
1) ET048 Epilation 50
m) ETOl5 Evisrection/Minor Operation 1,000
n) ETOl6 Excision Ula 1,000
o) ETOl7 Gentamycin 100
P) ENT020 Mentylcellulose 100
q) ENT021 Miconazole 1% 200
r) ET042 Nepucellulose 100

s) ET 044 Nepueortisone 100

 The Kiambu County Health Set vices Bill 2019 37

ET 037 MepuDexa 100

t)
ET040 Hepugenta 50
u)
ET 036 Nepumiconazole 200
v)
ET 046 Nepuntolate 150
w)
ET 034 Nepusolone 150
x)
ET 043 Nepuutolol 0 5 % 100
v)
ET045 Nepuvidone 100
z)
ET 041 Nepuzinc 100
aa)
Pilocarpme 2% 200
bb) ET 022
ET 030 Pimoiol 100
cc)
Porsorrhraphy 200
dd) ET 031
ET025 PredGanta 100
ee)
ET 026 Predmsolone 1% 100
ff)
ET024 Pred Porte 150
ET027 R 0 Scoinaa(L A) 200
hh)
ET 028 Sodiumchromogylacate 100
11)
ET 029 Sty Chalazion I&D 200
ii)
ET 052 Theatre Fee 1,500
kk)
ENT019 Top/Rbs/Dilation 100
11)
ET032 Zinc Sulphate 100
mm)
fJT^OUND FLOOR WARD
012 Bed Fee and Medication 250
a")
ICU
ICU08 Endotracheal Intubation 1000
a)
ICU05 Icu Antiseptic 50
b)
ICU02 Icu Bed 1000
c)
ICU07 Icu Feeding 900
d)
Icu Laundry 30
e") ICU06
ICU03 Icu Mechanical Ventilation 4000
f)
ICU04 Icu Monitoring 1000
g)
ICUOl Nursing Care-ICU 1000
h)
ICU09 Rescusitation 1000
i)
35 Incinerator Fee
NCOOl Incinerator Fee 50
a)
NC003 Incinerator fee per Kg 198
b)
NC004 Incinerator Per Safety Box 50
c)
NC002 Load(per Kg) 198
d)
36 Inpatient Ward
AF002X Admission Fee 0
a)
AFR005X Bill Carried Forward 0
bl
IP PHARMACY
38 The Kiambu County Health Services Bill 2019

a) AF004X Bill Canied Forward 0

37 Laboratory General
a) L037 Acid Fast Bacilli Sputum 0
b) LOOl Albumin SOO
c) L002 Alkaline Phosphate SOO
d) ANCOl Anc Profile 400
e) LOOS Antenatal Profile(Anc) 400
f) LOSS Ascitic Fluid Biochem SOO
s) L0S9 Anti strepolyzm 0 titres 200
h) L052 Base Line 0
L0066 Bihrubm 200
l) LB070 Bleeding Time 200
k) LB072 Blood Culture ISOO
1) LOOS Blood Grouping ISO
m) L006 Blood Sugar 100
n) L050 Bone Chemistry 700
o) L007 Brucella Test 200
P) L0S4 B/S ForMPS ISO
q) L0S6 Calcium 200
r) L044 CD4 0
s) LOSS Clotting Time 200
t) L006I Crag SOO
u) LOOS Creatinme 200
V) L009 CerebrospmalFluid Biochemistry 400
w) LOlO Culture &Sensitivity 400
x) L042 Direct Coomb Test SOO
y) L04S DU Test SOO
z) LOll Erythrocyte Sedimentation Rate 100
aa) LOOSS Fine Needle Aspirate 400
bb) ME007 Food Handlers Certificate SOO
cc) LOOSl Full Haemogram SSO
dd) LOOSO Full Haemogram and ESR SSO
ee) LB069 Grouping And Cross Match CGxm) SOO
ff) L00S7 Haemoglobin ISO
Glycohemoglbin-Variant of HBA
gg) L0060 fHBAIC) 1,400
hh) LOOSS Hepatitis A 200
11) LOIS Hepatitis B 200
11) L00S9 Hepatitis C 200
kk) ]L016 ]HIV TesttBlisa) 100
11) ]^079 ]Hormonal Profile 4000
 The Kiambu County Health Services Bill 2019 39

mm) L041 Helicobacter pvlori) H Pvlori 350

im) L062 High Vaginal Swab 150
oo) L0064 Indirect Coombs Test 300
Inr/ Pti (International Narmalised
PP) LAB 072 Ratio) 300
qq) L026 (Liver Function Tests) LFTS 800
rr) L018 Lipids Profile 800
ss) L020 Medical Examination 500
tt) L072 Ostt 900
uu) L0056 Pap Smear 400
vv) L021 Pregnancv Test(P) 200
ww) L048 Prostatic Surface Antigen 1500
xx) L065 Pus Culture And Sensitivitv 400
vv) L022 Rheumatoid Factor 200
zz) LB071 Salmonella Antigen 450
aaa) L049 Semen analvsis 300
Alanine Aminotransferase/
bbb) L023 AspertateAmmotran Sgpt/Sgot 300
ccc) L0062 Sicklmg Test 200
ddd) L080 Sputum Genexpert 0
eee) L0052 Stool Culture and Sensitivitv 400
fff) L024 Stool Ova and Cvst 150
ass) L0068 Stool Occult Blood 300
hhh) L025 Surfactant Test 200
111) L040 Thvroid Function Test 2,000
111) L014 Total Cholesterol 200
kkk) L027 Total Protein 300
111) L028 Urea And Electrolvtes 600
mmm) L029 Urethral Smears 200
nnn) L046 Uric Acid 200
ooo) L030 Urmalvsis 150
PPP) URC009 Urine Culture and Sensitivity 400

qqq) LB073 Urine for Drug Analvsis 1500

rrr) L0067 Urine For Microalbmian 300
sss) L031 VDRL 200
WidalTest(NB TEST
ttt) L032 ABOLISHED ,STOOL CULTURE 100
uuu) L033 X-Matching 300
MAIN PHARMACY
a) PH004 Insulin 360
b) PHOOl Pharmacy Drug Casualty Ward 0
40 The Kiambu County Health Services Bill 2019

c) PH008 Phamacy Drug Maternity 0

d) PH006 Pharmacy Drug Nbu 0
e) PH060 Pharmacy Drug Ward 4 0
f) PH002 Pharmacy Drug Ward 1 0
g) PHOOl Pharmacy Drug Ward 2 0
h) PH004 Pharmacy Drug Ward 5 0
1) PH005 Pharmacy Drug Ward 6 0
1) PH007 Pharmacy Drug Paeds 0
k) PH003 Theatre Diiags 1500
38 Main Theatre
a) APA 06 Aps 1,800
b) AP022 Endoscopy 6000
c) AP014 Extremities 400
d) AP013 Nasal Bone Coned View Of Sella 400
e) AP019 Occlusal 300
f) AP016 Skull, Sinuses, Facial Bone 600
r) AP021 Surgical Toilet 3,000
h) APOOl Theatre Maior Operation 5,000
0 AP002 Theatre Minor Operation 3,000
MATEjElNITY WARD
a) MAT002 Antiseptic/Disinfectant 30
b) MATOOl Daily Bed Charges 250
c) MAT004 Ward Consultation 50
d) MAT005 Ward Consumables 200
MATERNITY
a) MAT029 Antiseptic/Disinfectant 50
b) MAT005 Bed Day Fee 250
c) MAT012 Blood Transfusion 200
d) MAT013 Branullai 50
e) MAID14 Btl 500
f) MAT007 Caesarian Secection 4000
8) MAT40 Caesarian Drugs 1850
h) MAT015 Catheterization 150
1) MAT008 Consumable Products 200
.1) MAT006 CTZ 100
k) MAT002 Dehyery Seryices 5200
1) MAT016 Delivery Svd 1500
m) MAT017 Delivery(Twui) 2000
n) MAT006 Disposal of infant bodies 1000
0) MAT018 Dressing 100
P) MAT019 Episiotomy 200
 The Kiambu County Health Set vicei Bill 2019 41

q) MAT007 File 200

r) MAT020 Giving Set 20

s) MAT021 Gloves 40
t) MAT022 Laundry 30
u) MAT023 Manual Removal ofPlacenta 1500
V) MATOll Maternity Package 600
w) MAT024 Pelvic Assessment 100

x) MAT025 Removal of Macdonald Stitch 300

V) MATOlO Returned Placenta 1500
z) MAT009 Sutuie 200
aa) MAT41 Svd Drugs 50
bb) MATOOl Svd (Normal Deliverv) 1500
cc) MAT026 Tear Repair 2000
dd) MAT027 Urine Bag 20
ee) MAT028 Ward Consultation 50
MCH/FP SERVICES
a) MCH03 Bit 500
b) MCH04 Chemical Cautery 250

c) MCH05 Coil 150

d) MCH06 Coilscopy 150
e) MCH07 Consultant 100
f) MCH08 Cryscurgery 2000

g) MCH09 Dopplar Test 200

h) MCH013 Family Planning Pills 20

0 MCHOl Fp Card 50

i) MCH02 Fp Commodities 50
k) MCH014 Gloves 40

n MCHOl5 Imienom (Insertion and Removal) 100

m) MCHOl6 Incision and Drainage 500
n) MCHOl7 Jaddel (Insertion or Removal) 500
o) MCHOlO Removal of Coil 500

P) MCHOl 1 Vascular Dopplar 200

q) MCHOl2 Viavilli 100

39 Medical Examination
a) MDOl Students 500
b) MD02 Medical Employment 1,000
c) MD03 Medical Exam For Employment 1,000
Medical Examination (Foreign
d) MD04 Travels) 2500
Medical Examination for food
e) MD05 handlers 500
42 The Kiambu County Health Services Bill 2019

MD06 Medical Examination Report 500

MEDICAL LEGAL
a) M009 Age Assessment 500
b) ME008 Births and Death Verification 200
c) MEOll Marriage Med Exam 1000
d) ME014 Medical Board 1000
e) ME015 Medical Board Special 3000
f) ME004 Medical Certificates 500
g) MEOOl Medical Reports 1000
h) M007 Medical Report(Lawyers) 5000
1) ME009 P3 1500
.1) ME003 Verification of Medical Records 1000
40 Mortuary
a) RF012 Beard Shaving 250
b) RF002 Body after 5 Days 700
Bodies(Per Day For The First 5
c) MOOOl Days) 500
d) RF004 Body on Transit(0-24his) 3500
e) RF014 Disposal(3000) 3000
f) RF015 Disposal (Private) 3000
g) M0006 Embalming(Preseivation) 1,500
h) RF008 Post-mortem 4,000
1) RFOll Reconstruction 0
l) RFOlO Removal ofImplants 0
k) RF013 Unbraiding 1000
1) RFOOl Viewing of body 500
NBU
a) NBU04 Antiseptic/Disinfectant 50
b) NBUOl Bed Fee 150
c) NBU02 Consumable Products 200
d) NBU05 Disposal ofInfant Bodies 1000
e) NBU03 Laundry 30
41 NHIF Payment
a) NHIF002 Caesaiean Section 18,000
b) NHIF 006 NHIF Outpatient 5,000
c) NHIF 004 NHIF Payment 800
d) NHIFOOl NHIF Payment(Rebate) 1,500
e) NOOl NHIF Payments 800
f) NHIF003 SVD 6,000
 The Kiambu County Health Services Bill 2019 43

42 Occupational Therapy
Finger Splint(Orplast)(Orthplast) 5-
a) OTD008 12yrs 500
b) OTD013 Finger Splint(Orthoplast) 200
c) OTD006 Neck Collarr(Orthoplast(5-12yrs)) 500
Neck Collar Orthoplast(Above
d) OTD007 12yrs) 200
e) OTDOOl Occupational Therapy 100
f) OTD016 Occupation Therapy Child(Under5) 0
g) OTD014 Pressure Garments 1,500
h) OTD017 Splint Education -Adult 0
1) OTD003 Splinting(Orthoplast) 1,500
.1) OTD005 Splinting(Plaster ofParis>5yrs 200
k) OTD018 Ward Service 100
43 Orthopaedic
a) ORT60 Above Knee Prosthesis(Adult) 130,000
b) ORT59 Above Knee Prosthesis (Child) 80,000
c) ORT78 Afo /Kafo REPAIRS 200
AlluminumAnxillary Crutches
d) ORT20 Bilateral Adult 2,500
AlluminumAnxillary Crutches
e) 0RT21 Unilateral Adult 1,500
Allummum Elbow Cruches
f) ORT23 Unilateral Adult 1,500
g) ORT46 Ankle Foot(Adult) 3,000
h) ORT45 Ankle Foot(Child) 2,500
1) 0RT13 Ankle Foot Orthosis 2,500
.1) ORT22 Ankle Foot OrthosisAfo(Children) 1,000
k) ORT24 Apo Bilateral 1,000
1) ORT25 Apo Unilateral 500
m) ORT27 Arch Support Adult 2,000
n) ORT26 Arch Support Children 1,500
o) ORT62 Below Knee Prosthesis(Adult) 70,000
P) 0RT61 Below Knee Prosthesis (Child) 50,000
q) ORT04 Calcaneal Pads 2,000
r) ORTIO Calhner Above Knee AdultsO 8,500
s) ORT09 Calliner Above Knee Children 6,500
t) ORT08 Calhner Below Knee Adults 6,000
u) ORT07 Calhner Below BCnee Children 4,500
44 The Kmmbu County Health Services Bill 2019

V) ORT57 Cervical Collar(Adult) 3,000

w) 0RT12 Cervical Collar (child) 2,500
X) ORT28 Ciuches Levi 150
y) ORT02 Crutches(Elbow)Pair 2,000
z) ORT76 Crutch Repair 200
aa) 0RT17 Elbovvf crutches (pair) 2,000
bb) 0RT16 Elbow Crutches (single) 1,000
cc) ORT29 Heel Pad 800
dd) 0RT14 Knee Brace 2,000
ee) ORT77 Knee Cap 200
ff) ORT74 Knee Cap Pair(Adult) 1,000
gg) ORT73 Knee Cap Pair(Child) 800
hh) ORT72 BCnee Cap Single (Adult) 500
11) 0RT71 Knee Cap Single (Child) 400
ll) 0RT31 Ma-ior Repair Orthosis 200
Ick) ORT30 Major Repair Prosthesis 1,000
11) ORT32 Marmaid Night Sphnt(Adult) 4,500
mm) ORT33 Marmaid Night Splmt(Children) 2,000
nn) ORT34 Matataisal Pads 500
oo) ORT35 Minor Repaii Of OrthosisAldult 400
PP) ORT36 Minor Repair OfProsthesis 500

qq) 0RT18 Orthopaedic Any Repair 200

rr) ORT37 Ortho Reharb Registration Adult 100
ss) ORT48 Orthosis (Afo)Single (Adult) 3,000
tt) ORT47 Orthosis(Afo) Single (Child) 2,500
uu) ORT50 Pair Of Kafos(Adult) 6,500
vv) ORT49 Pair Of Kafos(Child) 4,500
ww) ORT38 Repair Valorostraps Adult 100
xx) ORT70 Resting SpImt(Adult) 3,500
yy) ORT69 Resting Splint(Child) 2,500
zz) ORT39 Sachfoot 8,000
aaa) ORT64 Sach Foot Replacement(Adult) 12,000
bbb) ORT63 Sach Foot Replacement(Child) 5,000
ccc) ORTOl shoe raise(WOOD) 800
ddd) ORT06 Shoe Raising(RUBBER)Per Inch 200
eee) ORT54 Single Above Knee calliper(Adult) 4,000
fff) ORT53 Single Above Knee calliper(Child) 3,000
ggg) ORT56 Single Below Knee calliper(Adult) 3,000
hhh) ORT55 Single Below Knee calliper(Child) 2,000
 The Kiambu County Health Services Bill 2019 45

DRT 52 single Kafos(Adult) 3,000

111)
3RT51 single Kafos(Child) 2,000
111)
DRT 66 5oft Insert(Adult) 2,000
kkk)
DRT 65 Soft Insert(Child) 1,000
111)
3RT68 Spinal Jacket(Adult) 12,000
mmm)
ORT67 Spinal Jacket(Child) 8,000
nnn)
ORTl 1 Splint Back Slab 2,000
ooo)
ORT40 Splint Back Slap 2,000
PPP)
0RT41 Stump Insert 400
pqq)
ORT42 Vecro Repair(child) 200
rrr)
ORT75 Velcro Repair replacement(Adult) 300
sss)
Velcro Straps replacement 100
ttt) ORT43
ORTl5 Walking Flame (child) 3,000
uuu)
CRT 58 Walking Frame (Adult) 4,500
wv)
Wedges Arc Support(mcr) 200
www) ORT03
Wooden Crutches
CRT 44 (Adults) 1,000
xxx)
44 Other Debtors
Attachment 2,000
a) 1
Fines 100
b 2
OTHERS
ODROOl Cmches 2000
a)
45 Out Patient
OP07 Biospy 1,000
a)
Catheterization 100
b) OP022
Catheterization 150
c) 0P12
Consultation And Review(Above
5yrs) 50
d) OPOl
Consultation And Review(Below
5Yrs) 0
e) OP23
Consultation In Consultation Clinics 100
f) OP02
Counsellmg 200
g) OP25
Counselling 1000
h) OPIO
Counselling 200
i) 0P19
Depo Provera 20
l) OP14
Dressing Per Day 50
'k) OPOl8
Ear Syringing 200
1) OPll
Family Plannmg Pills 20
m) 0P13
Imlenomdnsertion And Removal) 100
n) 0P17
46 The Kiantbu County Health Services Bill 2019

o) OP06 Incision & Drainage 500

p) OP04 Iniection For ChildrenfBelow 5vrs) 5
q) OP021 Injection For Adults 50
r) OP03 Iniection For Adults 20
s) 0P15 JADDEL(Insertion Or Removal) 100
t) OP020 Norplant 100
U) 0P16 Norplant(Insertion And Removal) 100
V) OP24 Pep Consultation 1000
w) OP 18 Psychotherapy 50
X) OP09 Removal of Stitches 100
y) OP05 Stitching 500
2) OP08 VCT 0
46 Paediatric Ward
a) 026 Antiseptic/Disinfectant 50
b) 024 Bed Fee 150
c) 003 Catheterization 20
d) 022 Consumable product 200
e) 025 Daily Bed Fee 250
f) 005 Dressing 100
g) 006 Gloves 40
h) 007 Injection 100
016 Laundry 30
.1) 009 Orthopedic Screw 1,500
k) 012 Steam Inhalation 100
1) 010 Stitching 500
m) 013 Stitching Under Local Anesthesia 300
n) 020 Suction ofFluid 100
o) 017 Urine Bag 20
P) 021 Ward Consultation 50
q) 023 Wound Dressing 100
47 Physiotherapy
a) 0O3 Physiotherapy under 5 50
b) 304 Physiotherapy 200
48 Plaster Department
a) ]^L02 \bove Llbow 600
\bove Llbow Pop Fracture Mid-
j.

b) I^H013 s haft
700
c) I'HOI9 1kbove ICnee
500
d) I'H016 iVbove Knee Pop Fracture Mid-shaft
1,000
 The Kiambti County Health Sei vices Bill 2019 47

Tibia
e) PL 020 Arrow Comp Plate 900

f) PL 021 Application OfPlaster 200

g) PL 037 Arm Sling(Above Syrs) SO

h) PL 036 Arm Sling(Under Syrs) 0

1) PH006 Below Elbow 500

Below Elbow POP E G Eractual
1) PH012 Colles 600

k) PHOlO Below Knee 600

1) PH015 Below Knee POP 800

m) OCA008 Boot POP 600
n) PL 022 Cotton Wool 400 130
o) PL 023 Crepe Bandages 8 250

p) PL 024 Ciepe Bandages Size 6 250

q) PL 026 Cock/Screw 700

r) PHOOl Femur Skin Tiaction(Adult Size) 1,500
Finger Splinting(Orthoplast)(5-
s) OCT007 12yrs) 400
Fingei Splinting (Orthoplast)(Above
t) OCT008 12 Yrs) 600
u) PH020 Full Length Plaster of Plaster 700
Full Length POP E G Fracture
V) PH018 Femur Distal 50
w) PL 027 Gauze Roll Standard Size 600
X) PHOll Hip Spica 700
V) OPTO18 I&D 250
z) OCA005 Neck-Color-Orthoplast(5-12yrs) 1,000
Neck-Color-Orthoplast(Above
aa) OCA006 12yrs) 2,000
bb) PL 028 Plaster OfPans Size 6 200
cc) PL 040 Plaster of Plaster(POP) 200
dd) POP0918 Pop 1000 1000
ee) PH017 Pop Boot E G Fracture Tarsal Bone 700
Pop U-slap e g Humerus+Crepe
ff) PH014 Bandages 700

gg) OCT009 Pressure Gannent(5-12 Yrs) 3,000

hh) OCTOlO Pressure Garment(Above 12yis) 4,000
u) PL 025 Removal of Crepe Bandage 100
11) PLOl Removal OfPOP (above Syrs) 200
48 The Ktambu County Health Serx'ica Bill 2019

kk) PH002 Removal POP 500

11) OCA009 Removal POP (under 5yrs) 100
Review After POP Application
mm) PL 035 (Above 5yis) 100
Review After POP Application
nn) PL 034 (Undei 5yrs) 50
oo) OCAOOl Sessions(Assessment & Treatment) 200
PP) PL 030 Skin Traction Kits Adult 1,500
qq) PL 029 Skin Traction Kits Children 900
n) PH003 Skin Traction(Small Size) 500
ss) OCA002 Splmting(Orthoplast)(5-l 2yrs) 3,000
tt) OCA003 Splinting(Orthplast)(Above 12yrs) 4,000
uu) OCA004 Splintmg(Pop)(Above 12yrs) 200
vv) PL 031 Stemmanspm 150 Mm 1,500
ww) PL 032 Stamsmans Pins 300mm 1,500
xx) PH005 Stamina Pin Insertion 1,500
yy) PL.033 Strapping 3 1,500
zz) PH008 Upper Slab 500
PUBLIC HEALTH
a) HP008 Auti-Rabies Vaccine 0
b) HP009 Anti-Snake Vanon 0
c) HPOOl Building Plans 1000
d) HPOll Food Cert 0
e) HPOlO Food Handlers 0
f) HP002 Health Licenses 500
g) HP009 Incinerator 0
h) HP004 Inspection Chemistry 2000
1) HP007 Inspection Clinic 1000
.1) HP006 Inspection Laboratories 1000
k) HP005 Inspection Nursing Home 3000
1) PH004 Inspection School 2000
m) HP003 Liquor Licences 1000
IDF PHARMACY
a) RDFOOl Rdf Pharmacy 0
49 Records Department
a) RD04 Ante Natal Clinic Cards 20
b) RD06 Ante Natal Clinic Registration 100
c) RD07 Clinic File 200
d) RD015 Consultation Files 200
 The Kiambu County Health Services Bill 2019 49

EODOS CWC Cards 0

e)
RDOlO Family Planning Card 100
f)
RD09 General Inpatient p File 200
g)
RD02 Outpatient Card(Above 5yrs) 100
h)
RDOl Outpatient Card (Under 5 yrs) 50
i)
RD013 Paediatric/Nbu File 200
1)
RD014 Registration Fee 100
k)
Search For Lost Document(Birth
RDOll Certificate. Death Records) 200
1)
ra) RD012 Verification Of Hospital Records 1,000
50 Referrals
Requests Referral To Other Hospitals
RF003 e e Nairobi 3,000
RENAL UNIT
RU06 Catheter Insertion 5000
a)
RU04 Insertion 3000
b)
RU02 NhifPatient 3500
c)
RU03 Nhif Renal Rebates 2500
d)
RU04 Renal Nhif 9500
e)
RUOl Renal Service 6100
f)
RU05 Subclavm Catheter 7000
r)
51 Rental Income
R00091 Rent 1500
a)
b) REN 001 Rental Charges Per Month 5,000
52 Reseai eh
a) res 001 Diploma 1,000
b) res 006 International Body 50,000
res 003 Masters Degree 4,000
c)
Non -Governmental Orgamzation
d) res 005 /Universities 20,000
e) res 004 Post Doctoral Degiee 10,000
f) res 002 Undergraduates Bachelors Degree 2,000
53 Tender
TEOl Tender Document 3,000
TOP FLGOR WARD
Bed Fee and Medication 250
a) Oil
54 Vehicle Transport
AMBTl 1
0 Ambulance Around Thika 1,500
a)
50 The Kiambu County Health Service Bill 2019

b) VT017 Ambulance Fee to Nairobi 3,000

c) VT005 Ambulance Fee to Nairobi (private) 4,000
Local hue within the District(Fiom
d) VT007 100km to Above) 7,800
Referral in (Juja Farm, Runu,Ithanga,
e) VT018 Kirwara) 1,500
55 Waivers
a) 001 Bed Fee 250
WARD 1
a) WD021 Antiseptic/Disinfectant 50
b) WDOOl Bed Fee and Medication 250
c) WD004 Branulla 50
d) WD005 Gatheterization 150
e) WD002 Consumable Products 200
f) WD003 Dressing 100
g) WD007 Giving Set 30
h) WD008 Gloves 40
1) WD009 Injection 100
.1) WDOlO Laundry 30
k) WDOll Orthopedic Screw 1500
1) WD014 Steam Inhalation 100
m) WD012 Stitching 500
n) WD015 Stitching Under Local Anaesthesia 300
0) WD016 Sunction of fluid 100
P) WD017 Treatment 150
q) WD013 Urine Bag 30
r) WD020 Ward Consultation 50
s) WD018 Wound Dressing 100
WARD 2
a 024 Antiseptic/Djsinfectant 50
b) 001 Bed Fee 250
c) 019 Catheterization 150
d) 023 Consumable Products 200
e) 021 Daily Bed Fee 150
f) 004 Dressing 100
g) 006 Givmg Set 30
h) 007 Gloves 40
1) 0O8 Injection 100
.1) 309 Laundrv 30
 The Kiambu County Health Services Bill 2019 51

k) on Stitchmg 500
1) 013 Stitching Under Local Anaesthesis 300
m) 015 Surgical Toilet 3000
n) 012 Urine Bag 30
o) 020 Ward Consultation 50
WARD 4
a) 020 Antiseptic/Disinfectant 50
b) 001 Bed Fee 250
c) 019 Catheterization 150
d) 004a Consumable Products 200
e) 005 Dressing 100
f) 016 Laundry 30
g) 013 Stitching Under Local Anaesthesis 300
h) 015 Surgical Toilet 3000
1) 017 Urine Bag 20
J) 018 Ward Consultation 50
WARDS
a) 027 Antiseptic/Disinfectant 50
b) 003 Bed Fee 250
c) 019 Catheterization 150
d) 022 Consumable Products 200
e) 005 Dressing 100
Q 026 ECG 500
g) 021 Laundry 30
h) Oil Steam Inhalation 100
1) 012 Stitching Under Local Anaesthesis 300
.1) 014 Surgical Toilet 3000
k) 025 Ward Consultation 50
WARD 6
a) 029 Antiseptic/Disinfectant 50
b) 024 Bed Fee 150
c) 006 Bed Fee 250
d) Oil Branulla 50
e) 012 Catheterization 150
f) 008 Consumable Products 200
g) 020 Disposal 1000
h) 014 Dressing 100
1) 009 Induction 1000
.]) 016 Laundry 30
52 The Kiambii County Health Services Bill 2019

k) 019 Manual Removal ofPlacenta 1000

1) 007 Mva 1000

m) 010 Retained Placenta 1500

n) 020 Stitching
o) 023 Stitching Under Local Anaesthesis 300
p) 015 Smgical Toilet 3000

q) 021 Urine Bag 30

r) 017 Urine Bag 20

s) 018 Ward Consultation 50

t) 026 Wound Dressing 100

56 XRAY
a) X049 Abdominal Ultrasound 1000
b) X481 Ankle 400
c) X065 Barium Enema 2,500
d) xlOl Baiium meal 2,000
e) X064 Barium Swallow 2,000
f) ' X081 Bilateral Foreaim 800
g) X085 Bilateral Ankle 800
h) X082 Bilateral Elbow 800

1) POP0919 Bilateral Foot 800

.1) X086 Bilateral Knee 800
k) X080 Bilateral Shoulder 800

1) X084 Bilateral Tibia/FibuIa 800

o
o
m) X483 Bitewmg 400
n) xl02 Both Clavicles 800

o) xl03 Both Foie Aral 800

P) X077 Breast Ultrasound 1,000
q) X024 Calcanium 400
Carotid Doppler Ultra-sound
r) X062 (Bilateral) 3,500
Carotid Doppler Ultra-sound
s) x32 (Unilateral) 2,000
t) X039 Cervical Spine 600
u) XOll Chest AP and Lateral 500
V) XOOl Chest PA Or AP 400
w) X020 Clavicle 400
X) xl07 Clavicle X-iay 400
y) X046 Coccyx 600
z) X013 Coned View of SellaTusca 400
 The Kiambu County Health Services Bill 2019 53

aa) xl20 Conyentional Athrography 2,500

bb) xl04 Conyentional Genitography 2,500
cc) xl23 Conventional Myelography 2,500
dd) X052 Cranial Ultrasound 1,000
ee) X136 Ct Abdominal Pelyic 7000
ff) X135 Ct Angiogram 8000
rr) X130 Ct Scan Abdomen 6000
hh) X129 Ct Scan Brain 5000
ii) X133 Ct Scan Chest 6000

1]) X134 Ct Scan Extremities 6000

kk) X132 Ct Scan Neck 6000
U) X131 Ct Scan Pelyis 6000
mm) X017 Elbow 400
nn) X063 Endoscopy 6000
oo) xl08 Erect Lateral Pelvis 500

PP) xl09 Extremities 400

qq) X032 Facial Bones 600

rr) X087 Feet 800
ss) X028 Femur 400
tt) X014 Finger 400
uu) X092 Foot 400

vv) X016 Forearm 400

ww) X091 Hand 400
xx) X025 Heel 400

yy) X029 Hip Joint 400

zz) X018 Humerus 400
aaa) X1250 Hvstrosalphmography(Hsg) 2500

bbb) X053 INGUINAL SCROTAL Ultrasound 1,000

ccc) X055 Inguinal Ultrasound 1,000
ddd) X066 Intravenous/Excretion Urogiaphy
flvu) 2500
eee) X008 lOPA 300
fff) X096 Knee (Unilateral) 400

rrr) X079 Kub Ultrasound 1,000

hhh) RD124 Lateral Neck X ray 400

111) X31 Lower Limb Artenal Doppler

(Bilateral) 3500

JJJ) X30 Lower LimbArtenal Doppler

(Unilateral) 2,000
54 The Kiambu Coimt\ Health Set vices Bill 2019

m) X059 Lower Limb Venous Doppler

(bilateral) 3500
111) xl21 Lower Standard Occlusal 400
mmm) X043 Lumbei Spine 600
nnn) X044' Lumbo- Sacral Spine 600
ooo) x0200 Manimogram (Unilateral) 1,500
PPP) x0201 Mapimogram (Bilateial) 2,000
qqq) X036 Mandible 600
rrr) X034 Mastoids 600
sss) xl22 MicturatingCystourethrography MCU 2,500
ttt) MRI002 MRI Biain 12000
uuu) RD129 MRI Cerical Spine 12000
vw) RD133 MRI Knee Bilateral 24000
www) RD130 MRI Knee Joint 12000
xxx) MRI003 MRI Lumbar 12000
yyy) RD127 MRI Lumbar Spine 12000
zzz) RD131 MRI Pelvic 12000
aaaa) RD132 MRI Shoulder Bilateral 24000
bbbb) RD128 MRI Thoracic Spine 12000
cccc) X076 Nasal Bone 400
dddd) X484 Neck 1000
eeee) X047 Obstetric Ultra-sound(2nd & 3rd
Tnmester) 1,000
ffff) X058 Obstretic Ultrasound (1st Tnmester) 1,000
gggg) X009 Occlusal 400
hhhh) XOlO Orthopathogiam(OPG) 600
nil) X037 Optic Foramina 600
JJJJ) X033 Orbits 600
kkkk) X068 Other (Specify) 0
1111) xl24 Paranasal Smuses 600
mnimm) X0480 Pelvic Abdominal Ultrasound 2000
minn) X048 Pelvic Ultrasound 1,000
oooo) X030 Pelvis 500
PPPP) X088 Pelvis/Lateral Hip 600
qqqq) X129 Peripheral lower limb Venography
(Unilateral) 2,500
mT) X067 Peripheral Venography (bilateial) 4,000
ssss) X002 Plain Abdomen 400
tttt) X075 Post Nasal Space xray 400
 The Kiambu County Health Seiyices Bill 2019 55

uuuu) xl26 Post -operattonT-Tube Cholagrogiam 2,500

vvvv) xl06 Pre-opeiative Cholangiograpy In
Theatre 2,500
wwww) X056 Prostrate Ultrasound 1,000
xxxx) X125 RetrogadePyeloreterography Bilateral 2,500
yyyy) X078 RegionalU Itrasound 1,000
zzzz) X071 Renal ultrasound 1,000
aaaaa) RD123 Reporting 200
bbbbb) X045 Sacial Spine 600
ccccc) X054 Scrotal Ultrasound 1,000
ddddd) X019 Shoulder Joint 400
eeeee) X031 Sinuses 600
fffff) X006 Skull AP AND LATERAL 600
RD080 Temporo-Mandubular Joint 600
hhhhh) X074 Testiculai ultra-sound 1,000
iiin) X042 Thoraco Lumbar Spine 600

.mil) X041 ' Thoracic Spme 600

kkkkk) X051 Thyroid Ultrasound 1,000
11111) X026 Tibia/Fibula 400
mmramm) X035 Temporal Mandibulai Joint 600
nnnnn) X021 Toe 400
ooooo) RD125 Tvs 1500
PPPPP) xl27 Ultra Sohnd Guided Biopsy 1500

qqqqq) X061 Upper Limb Ailerial Doppler

(unilateral) 2,000
rrrrr) X057 Upper Limb Venous Doppler
(bilateral) 3,500
sssss) XI28 Upper Standaid Occlusal( unilateral) 400
ttttt) X015 Wrist 400
uuuuu) X34 X-ray Optic Foramina 600
56 The Kiambu County Health Setvices Bill 2019
MEMORANDUM OF OB,IECTS AND REASONS

The Kiambu County Health Services Bill, 2019 seeks to establish a

framework of management of public health facilities while assuring
quality health standards in both piivate and public health facilities The
definition of health care facilities in the Act is wide and ensures that all
practitioners in the medical field, such as clinics, laboratories, hospitals
and drugs dispensation services are catered foi puiposes of quality
assurance The Bill also seeks to establish a framework within which the
County Government can cooperate with other regulatory bodies within
this sector

PART I of the Bill addresses preliimnary issues It introduces the

purpose of the Bill and guiding principles It also ensures that there is a
reporting structure between the Executive arm and the County Assembly
through the office ofthe Executive Member
PART IT provides for the rights of patients to receive health care
services, mcluding emergency treatment and right to pnvacy It also
introduces the patient's light to informed consent, which requires that a
patient be informed of the health caie services being delivered In the
same part, the obligations of a patient, especially to adhere to medical
advice are provided for
PART in introduces the administration structuie It prescribes the
County Govemmenfs role in promotion of public health The part created
Directorates, Boards of Hospitals, Committee and other officers in charge
of management of public health facilities
PART IV provides for classification of public health facilities m
levels one to five It also provides a procedure for establishing a County
Referral hospital and other specialized units and centers
PART V provides for quality assurance It creates the County Health
Advisory Board which has power to mspect both public and private health
facilities for purposes of advising a Regulatory Body, advising a licensing
officer or for quality assurance purposes which relates to the mandate of
promoting public health
PART VI IS the general provisions section It gives the Executive
Member the power to make regulations It also creates the appeals
procedure, which lies in the office ofthe Executive Member The part also
creates a transition clause for all rights and liabilities accruing under the
Kiambu County Health Services Act, 2014 which was invalidated by a
decision of the Court
Dated the 10th January, 2019
NGUGI EDWARD KINYANJUI,
Chairperson, Health Services Committee