The World Bank Improving Financial Protection and Quality of Care (P163532) REPORT NO.: RES33490 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF IMPROVING FINANCIAL PROTECTION AND QUALITY OF CARE APPROVED ON OCTOBER 4, 2017 TO REPUBLIC OF KOSOVO HEALTH, NUTRITION & POPULATION EUROPE AND CENTRAL ASIA Regional Vice President: Cyril E Muller Country Director: Linda Van Gelder Senior Global Practice Director: Timothy Grant Evans Practice Manager/Manager: Enis Baris Task Team Leader: Dorothee Chen The World Bank Improving Financial Protection and Quality of Care (P163532) BASIC DATA Product Information Project ID Financing Instrument P163532 Investment Project Financing Original EA Category Current EA Category Not Required (C) Not Required (C) Approval Date Current Closing Date 04-Oct-2017 30-Nov-2018 Organizations Borrower Responsible Agency Republic of Kosovo Ministry of Health,Ministry of Labor and Social Welfare Financing (in USD Million) FIN_SUMM_PUB_TBL SUMMARY Total Project Cost 0.29 Total Financing 0.00 Financing Gap 0.00 DETAILS -NewFin3 Project Development Objective (PDO) Original PDO The proposed Project Development Objective (PDO) is to contribute to the design and implementation of the health sector reforms that aim to improve financial protection and quality of care in the Republic of Kosovo. OPS_TABLE_PDO_CURRENTPDO The World Bank Improving Financial Protection and Quality of Care (P163532) Summary Status of Financing Net TF Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed TF-A5865 16-Oct-2017 12-Dec-2017 12-Dec-2017 30-Nov-2018 .29 0 .29 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING 1. The Improving Financial Protection and Quality of Care Project is a Small Recipient-Executed Grant, which is a part of the Trustee Trust Fund (TF) for Improving Financial Protection and Quality of Care in the Republic of Kosovo received from the Swiss Agency for Development and Cooperation (SDC). The Grant supports the improvement of financial protection of the population and quality of care in the Republic of Kosovo by contributing to the design and implementation of the health sector reforms. It has two components: (i) support to the implementation of an improved poverty targeting mechanism for exemptions from health insurance contributions; and (ii) study tours and workshops. 2. The current closing date of the Grant is November 30, 2018. The Grant became effective on December 12, 2017, and project activities only started in February 2018. Since then, the implementation of the activities has been delayed because of expected changes in the Law on Health Insurance that determines the population categories that are exempt from health insurance contributions. In addition, the initial timeline was ambitious, and the Ministry of Labor and Social Welfare (MoLSW), one of the Implementing Agencies of the Grant, needed to get familiar with the Bank procedures. Consequently, the Government requested for the extension of the Grant closing date until June 30, 2020 to allow the resources to be fully disbursed as initially planned. The request was approved by the Donor (SDC), and the Amendment to the Administration Agreement for the Trustee TF was countersigned on August 12, 2018, extending the End of Disbursement Date until December 31, 2020. 3. Procurement under the Grant is proceeding as agreed in the STEP system. Terms of Reference (TORs) for key activities are now ready, and counterparts’ needs regarding knowledge exchanges are clarified. 4. There are no outstanding audits for the Grant. II. DESCRIPTION OF PROPOSED CHANGES 1. Government has requested a 19-months extension of the Grant to complete the design and the implementation of a targeting mechanism for health insurance subsidies including a poverty targeting system; and conduct further study tours and workshops to ensure that international best practices are incorporated by the client into policy design and implementation of reforms. 2. No other changes are proposed. The World Bank Improving Financial Protection and Quality of Care (P163532) 3. The list of activities as defined in the initial procurement plan remains relevant. The deadlines will be revised to take into account the extension of the closing date. III. SUMMARY OF CHANGES Changed Not Changed Loan Closing Date(s) ✔ Implementation Schedule ✔ Implementing Agency ✔ Project's Development Objectives ✔ Results Framework ✔ Components and Cost ✔ Cancellations Proposed ✔ Additional Financing Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Change in Overall Risk Rating ✔ Safeguard Policies Triggered ✔ EA category ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Other Change(s) ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_LOANCLOSING_TABLE The World Bank Improving Financial Protection and Quality of Care (P163532) LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline TF Status Closing Closing(s) Closing for Withdrawal Applications TF-A5865 Effective 30-Nov-2018 30-Jun-2020 30-Oct-2020