Thông tư liên tịch 10/2014/TTLT-BYT-BNV-BTC-BLDTBXH

JOINT CIRCULAR

GUIDING THE IMPLEMENTATION OF A NUMBER OF ARTICLES OF DECISION No. 73/2011/QD-TTG DATED DECEMBER 28^th 2011 BY THE PRIME MINISTER ON DETAILING A NUMBER OF POLICIES ON PECULIAR ALLOWANCES FOR OFFICIALS, CIVIL SERVANTS AND EMPLOYEES OF PUBLIC MEDICAL FACILITIES AND POLICIES ON EPIDEMIC CONTROL ALLOWANCES

Pursuant to the Decree No. 63/2012/ND-CP dated August 31^st 2012 by the Government defining the functions, tasks, entitlements and organizational structure of the Ministry of Health;

Pursuant to the Decree No. 61/2012/ND-CP dated August 10^th 2012 by the Government defining the functions, tasks, entitlements and organizational structure of the Ministry of Home Affairs;

Pursuant to the Decree No. 215/2013/ND-CP dated December 23^rd 2013 by the Government defining the functions, tasks, entitlements and organizational structure of the Ministry of Finance;

Pursuant to the Decree No. 106/2012/ND-CP dated December 20^th 2012 by the Government defining the functions, tasks, powers and organizational structure of the Ministry of Labor, War Invalids and Social Affairs;

Pursuant to the Decree No. 85/2012/ND-CP dated October 15^th 2012 by the Government on operational structure and financial structure of public medical service providers and prices of healthcare services at public medical facilities;

Pursuant to the Decision No. 73/2011/QD-TTg dated December 28^th 2011 by the Prime Minister detailing a number of policies on peculiar allowances for officials, civil servants and employees of public medical service providers and policies on epidemic control allowances;

After getting opinions of the Ministry of National Defense in Official Dispatch No. 1795/BQP-BUILDING WORK dated June 22^nd 2012 and Official Dispatch No. 2841/BQP-CT dated April 22^nd 2013;

The Minister of Health, the Minister of Home Affairs, the Minister of Finance and the Minister of Labor, War Invalids and Social Affairs promulgate the Joint Circular guiding the implementation of a number of Decision No. 73/2011/QD-TTg dated December 28^th 2011 by the Prime Minister detailing a number of policies on peculiar allowances for officials, civil servants and employees of public medical service providers and policies on epidemic control allowances.

Article 1. Limit of employees on each shift

Limit of employees on a shift specified in Clause 2 Article 2 Decision No. 73/2011/QD-TTg dated December 28^th 2011 by the Prime Minister on detailing a number of policies on peculiar allowances for officials, civil servants and employees in public medical service providers and policies on epidemic control allowances (hereinafter referred to as Decision No. 73/2011/QD-TTg) is guided as follows:

1. Regarding medical facilities being hospitals (including military hospitals), medical centers of districts, towns, provincial-affiliated cities that are providing both medical examination and treatment and prophylaxis (hereinafter referred to as medical centers of districts): the limit of employees on a shift shall comply with regulations in Point a Clause 2 Article 2 of Decision No. 73/2011/QD-TTg.

2. Regarding local polyclinics, maternity wards:

a) Regarding local polyclinics/maternity wards affiliated to the Department of Health: the limit of employee on each shift shall comply with regulations in clause 5 of this Article;

b) Regarding local polyclinics/maternity wards affiliated to a hospital or a medical center of district: the limit of employee on a shift shall be calculated generally for the number of hospital beds of both the hospital/medical center of district and its affiliated polyclinics/maternity wards.

Director of the hospital/medical center shall decide the number of employee on each shift of each affiliated polyclinic/maternity ward supposed that the human resources for professional activities are ensured according to financial sources of the unit.

3. Regarding medical treatment facilities established according to the legislation on penalties for administrative violations and  healthcare service facilities for wound soldiers, sick soldier and disabled people:

a) Grade I facilities: not more than 24 persons per shift;

b) Grade II facilities: not more than 16 persons per shift;

c) Grade III facilities: not more than 10 persons per shift.

4. Regarding medical stations of communes/wards and military medical stations (hereinafter referred to as medicals stations of communes): the limit of employees on each shift shall comply with regulations in Point b Clause 2 Article 2 of Decision No. 73/2011/QD-TTg.

The Department of Health shall specify the number of employees on a shift for each affiliated medical station of commune according to the criteria on professional capacity, number of examination/treatment visits per day of each medical station of commune; distance from medical stations of communes to the superior facilities; geographical and natural conditions and local budgets.

If during a shift, there is an emergency case subject to being sent to a superior facility or in case the number of employees on the shift is not sufficient, the Leader of the medical station shall appoint human resources to work overtime and pay the extra wages according to the law.

5. Regarding polyclinics/military clinics, limit of employees on a shift is specified as follows:

a) Regarding clinics with less than 10 hospital beds: 02 persons per shift;

b) Regarding clinics with 10 hospital beds to under 20 hospital beds: 03 persons per shift;

c) Regarding clinics with 20 hospital beds ore more: 05 persons per shift.

6. Regarding medical facilities other than those specified in clauses 1, 2, 3, 4 and 5 of this Article, the limit of employees on a shift shall comply with regulations on limit of employees on a shift applicable to grade IV hospital and unclassified hospitals specified in Point a Clause 2 Article 2 of Decision No. 73/2011/QD-TTg.

Article 2. Allowance levels applicable to medical treatment facilities established according to the legislation on penalties for administrative violations and healthcare service facilities for wound soldiers, sick soldier and disabled people

1. Regular allowances:

a) Regular allowances in normal areas:

- VND 90,000 per person per shift, applicable to grade I facilities;

- VND 65,000 per person per shift, applicable to grade II and grade III facilities;

b) Regular allowances for medical staff working for detoxification and recovery areas or infectious disease isolation area are 1.5 times of the allowances specified in Point a of this Clause.

2. Regular allowances for weekly days-off, holidays and allowances for meals in 24/7 shifts shall comply with regulations in Clause 3 Article 3 of Decision No. 73/2011/QD-TTg.

Article 3. Epidemic control allowances for people directly participating examination, diagnosis and treatment at infectious disease examination and treatment facilities

1. Any people directly participating examination, diagnosis and treatment at an infectious disease examination and treatment facilitity is eligible for epidemic control allowances according to regulations in Clause 1 Article 3 of Decision No. 73/2011/QD-TTg.

2. List of group B infectious diseases of which people directly participating examination, diagnosis and treatment at infectious disease examination and treatment facilities are eligible for allowances is provided in Appendix 1 of this Circular.

Depending on the actual conditions, and the dangerous level of the disease, the Minister of Health shall consider deciding the list of group B infectious diseases other than those specified in Appendix 1 of this Circular and the list of group C infectious diseases according to regulations in Article 3 of the Law on prevention and control of infectious diseases of which people directly participating examination, diagnosis and treatment at infectious disease examination and treatment facilities are eligible for allowances according to regulations in this Circular.

3. Infectious disease examination and treatment facilities include infectious disease specialized hospitals; department of infectious diseases of polyclinics of districts, towns, provincial-affiliated cities and higher and other medical facilities in charge of providing infectious disease examination and treatment that are mobilized by epidemic control steering committees of all levels in case of epidemic.

4. Time for calculating epidemic control allowances of a medical employees is the actual days he/she participating in providing examination, diagnosis and treatment for people having infectious diseases specified in Appendix 1 of this Circular at infectious disease examination and treatment facilities within the period from the time the outbreak declaration is issued by a competent agency until the declaration about the end of the disease is issued.

Article 4. Including of peculiar allowances in medical service prices

1. Spending on regular allowances (excluding regular allowances applicable to medical stations of communes) is included in daily price of a hospital bed as follows:

a) Special grade and grade I hospitals: not exceeding VND 20,000;

b) Grade II hospitals: not exceeding VND 15,000;

c) Grade III hospitals: not exceeding VND 11,000;

d) Grade IV hospitals and unclassified medical facilities (excluding medical stations of communes): not exceeding VND 10,000;

Example 1: A hospital is a grade I hospital, daily price of a hospital bed decided by the competent authority excluding regular allowances is VND 55,000. If the competent authority decide that the regular allowances for a hospital bed of grade I hospital (VND 18,000) is added to the price, the hospital may collect from the patient or the social insurance agency an amount applicable to hospital beds of internal medicine is VND 55,000 + VND 18,000 = VND 73,000.

2. The allowances for surgeries and procedures are included in the price of each case and added to the price of each type of surgeries/procedures as follows:

a) Special surgery: not exceeding VND 1,520,000 per case;

b) Type I surgery: not exceeding VND 660,000 per case;

c) Type II surgery: not exceeding VND 340,000 per case;

d) Type III surgery: not exceeding VND 190,000 per case;

dd) Special procedure: not exceeding VND 300,000 per case;

e) Grade I procedure: not exceeding VND 140,000 per case;

g) Grade II procedure: not exceeding VND 63,000 per case;

h) Grade III procedure: not exceeding VND 28,500 per case;

Example 2: A surgical case is classified as grade I case by the Ministry of Health. Price for this case decided by a competent authority that is exclusive of allowances for surgeries/procedures is VND 3,500,000.

If the competent authority decide that the regular allowances for a type I surgery (VND 600,000) is added to the price, the hospital may collect from the patient or the social insurance agency an amount equal to VND 3,500,000 + VND 600,000 = VND 4,100,000.

3. Competence in deciding the regular allowances and allowances for surgeries/procedures to be included in the price of medical service:

a) Allowances applicable to medical facilities under the management of the Ministry of Health shall be decided by the Minister of Health;

b) Allowances applicable to medical facilities under the management of Ministries, ministerial-level agencies or Governmental agencies shall comply with the regulations in Circular No. 04/2013/TT-BYT dated January 21^st 2013 by the Ministry of Health;

c) Regarding allowances applicable to medical facilities under the management of local governments: Departments of Health shall preside over and cooperate with the Service of Finance requesting People’s Committees of provinces to consider and decide according to regulations in Point i Clause 4 Article 8 of Decree No. 177/2013/ND-CP dated November 14^th 2013 by the Government.

Article 5. Sources of funding

1. Funding for the implementation of policies on disease control allowances specified in Article 3 of Decision No. 73/2011/QD-TTg regulations in Article 3 of this Circular and funding for the implementation of policies on regular allowances applicable to medical stations of communes specified in Article 1 of Decision No. 73/2011/QD-TTg shall be provided by the state budget and  estimated, allocated, and included in the annual budget estimates according to the regulations in the Law on the State budget and its guiding documents.

2. Funding for peculiar allowances applicable to establishments specified in Clause 3 Article 1 of this Circular shall be covered by the state budget according to the current decentralization in budget management and other legal revenues (if any).

3. Funding for regular allowances, allowances for surgeries/procedures applicable to healthcare services on request, and services of public sector-involved services shall be paid by the medical facilities from their revenues.

4. A medical facility may initiatively used the revenues and the allocated budget estimates to pay the regular allowances and allowances for surgeries/procedures according to regulations in Clause 1 Article 6 of Decision No. 73/2011/QD-TTg If a medical facility does not receive any decision on regular allowances, allowances for surgeries/procedures in healthcare service price according to regulations in Article 4 of this Circular and its revenues and the allocated budget are not sufficient to provide allowances according to regulations in Articles 2 and 4 of Decision No. 73/2011/QD-TTg then the remaining amount shall be subsidized from the state budget according to the current budget decentralization.

Article 6. Transitional clauses

1. When the regular allowances and allowances for surgeries/procedures are not included in the healthcare price, funding for payment for the difference of allowances for surgeries/procedures specified in Decision No. 73/2011/QD-TTg in comparison with those specified in Decision No. 155/2003/QD-TTg dated July 30^th 2003 by the Prime Minister amending a number of policies on peculiar allowances for medical officials/civil servants (hereinafter referred to as Decision No. 155/2003/QD-TTg) shall be handled as follows:

a) Medical facilities directly paying wages to employees shall make a report on demand for additional funding according to Appendix 2 of this Circular and send it to the management office;

b) The management office shall conduct appraisal and collect information according to Appendixes 3, 4 and 5 of this Circular and send to the financial office of the same level for appraisal;

c) People’s Committees of provinces, Ministries, ministerial-level agencies and Governmental agencies shall collect information and make reports according to Appendix 3, 4 and 5 of this Circular and send them to the Ministry of Finance for consideration and solution according to regulations.

2. Time limit for paying additional regular allowances and additional allowances for surgeries/procedures (the difference between the amount prescribed in Decision No. 73/2011/QD-TTg and the one prescribed in Decision No. 155/2003/QD-TTg) shall be calculated as follows:

a) In 2012: Additional regular allowances and additional allowances for surgeries/procedures shall be calculated from February 15^th 2012 to December 31^st 2012;

b) In 2013: Additional regular allowances and additional allowances for surgeries/procedures shall be calculated from January 01^st 2013 to December 31^st 2013;

c) In 2014: Additional regular allowances and additional allowances for surgeries/procedures shall be calculated from January 01^st 2014 to the time when the competent authorities specified in Clause 3 Article 4 of this Circular decide to calculate the allowances.

Article 7. Effect

1. This Joint Circular comes into effect from May 05^th 2014.

Joint Circular No. 09/2003/TTLT-BYT-BNV-BTC dated September 29^th 2003 by the Ministry of Health, Ministry of Home Affairs and the Ministry of Finance and Joint Circular No. 18/2004/TTLT-BLDTBXH-BYT-BTC dated November 22^nd 2004 by the Ministry of Labor, War Invalids and Social Affairs, the Ministry of Health and the Ministry of Finance are annulled by the effect of this Joint Circular.

2. Policies on peculiar allowances specified in this Joint Circular are calculated from February 15^th 2012.

Difficulties that arise during the implementation of this Circular should be reported to the Ministry of Health, the Ministry of Home Affairs, the Ministry of Finance and the Ministry of Labor, War Invalids and Social Affairs for consideration and solution./.