Joint Circular No. 08/2005/TTLT/BYT-BQP guiding the implementation of Directive No. 25/2004/CT-TTg dated June 29, 2004 of the Prime Minister on strengthening the integration of military and civilian healthcare to care for and protect the health of the people and soldiers in the new period.

JOINT CIRCULAR

Guidelines for Implementing Directive 25/2004/CT-TTg dated June 29, 2004 of the Prime Minister on Strengthening the Work of Military-Civilian Medical Cooperation to Care for and Protect the Health of the People and Troops in the New Period

of the Prime Minister on strengthening the work of military-civilian medical cooperation to care for and protect the health of the people and troops in the new period

in the new period

To implement Directive 25/2004/CT-TTg dated June 29, 2004 of the Prime Minister on "Strengthening the Work of Military-Civilian Medical Cooperation to Care for and Protect the Health of the People and Troops in the New Situation," the Ministry of Health and the Ministry of National Defense hereby provide guidelines for implementing specific contents as follows:

1. Organization and Tasks of Military-Civilian Medical Committees at All Levels

1.1. Military-Civilian Medical Committees at All Levels

The Military-Civilian Medical Committee (Committee) is a joint sector organization established from the level of the Ministry of Health and the Ministry of National Defense down to local levels.

Members participating in the Committee include leaders of the Ministry of Health, Commanders of Military Regions; People's Committees at the district and commune levels; heads of military and civilian medical agencies at all levels, and some related agencies.

1.2. Organization and Tasks of the Committee at the Ministry Level

1.2.1. The Committee at the Ministry level is an organization of the Ministry of Health and the Ministry of National Defense, established upon the proposal of the Director of the Department of Planning and Finance of the Ministry of Health and the Director of the General Logistics Department's Military Medicine Bureau; appointed by the Minister of Health after reaching a written agreement with the Ministry of National Defense.

1.2.2. The Committee at the Ministry level has the following tasks:

a) Based on directives and resolutions of the Party and State regarding the tasks of caring for and protecting the health of the people and national defense-security tasks; propose and advise the leadership of the Ministry of Health and the Ministry of National Defense and the Prime Minister to develop plans, programs, and strategic orientations for military-civilian medical cooperation (MCMM);

b) Based on annual work orientation and plans of the two Ministries; develop MCMM plans for the entire sector to be submitted to the leadership of the Ministry of Health and the Ministry of National Defense for approval; directly direct, monitor, and evaluate the implementation results of the plans of the Military Region MCMM Committees and the provincial MCMM Committees (hereinafter referred to as provinces);

c) Advise the leadership of the two Ministries to gradually institutionalize MCMM activities to improve the quality of healthcare for the people and troops; build and consolidate medical-national defense potential;

d) Regularly report to the leadership of the Ministry of Health and the Ministry of National Defense on the situation and propose organizing a nationwide MCMM conference to assess the results of each phase and draw lessons, build MCMM programs for the next phase.

1.2.3. Composition of the Committee at the Ministry level includes:

a) Chair: One Deputy Minister of Health.

b) Vice Chairs:

- Director of the General Logistics Department's Military Medicine Bureau.

- Director of the Department of Planning and Finance of the Ministry of Health.

- Director of the Office of the Ministry of Health.

c) Members: Leaders and Commanders of some relevant functional agencies of the Ministry of Health and the Ministry of National Defense.

1.2.4. Operating funds for the Committee at the Ministry level are allocated from the health service budget.

1.3. Military-Civilian Medical Committee of Military Regions

1.3.1. The Military-Civilian Medical Committee of Military Regions is established in all Military Regions; decided by the Commander of the Military Region based on the proposal of the Chief of Military Medicine of the Military Region, after reaching a written agreement with the People's Committees of the provinces within the Military Region.

1.3.2. The Military-Civilian Medical Committee of Military Regions has the following tasks:

a) On the basis of the MCMM program and plan approved by the leadership of the two Ministries; study and apply to the specific conditions of each Military Region to develop the MCMM program of the Military Region and disseminate it to the provincial MCMM Committees (after being approved by the Commander of the Military Region).

b) Direct, manage, and inspect and supervise MCMM activities within the Military Region;

c) Guide and assist provincial MCMM Committees in fulfilling their tasks of building local military medical potential, enhancing the ability to ensure medical care for combat situations in the province's defensive area;

d) Direct provincial MCMM Committees to coordinate with medical forces of other Ministries and sectors stationed in the region, focusing on comprehensive efforts to implement medical work in the region, effectively meeting the requirements of examination, treatment, and medical intervention in emergency situations such as epidemics, typhoons, floods, mass casualties, etc.;

e) Regularly report the results of MCMM activities of the Military Region to the Committee at the Ministry level and organize mid-term and final reviews according to schedule.

1.3.3. Composition of the Military-Civilian Medical Committee of Military Regions includes:

a) Chair: One Deputy Commander of the Military Region.

b) Vice Chairs:

- Chief of Military Medicine of the Military Region: Acting Vice Chair.

- Director of the Health Department of the province where the Military Region headquarters is located.

- Members: Directors of Health Departments, Chiefs of Military Medicine of Military Corps and Services stationed in the region, and Directors of Central Military Hospitals and Regional Institutes and Hospitals (if any).

1.3.4. Operating funds for the Military-Civilian Medical Committee of Military Regions will be supported from the health service budget through the Committee at the Ministry level.

1.4. Military-Civilian Medical Committee of Provinces

1.4.1. The Military-Civilian Medical Committee of Provinces is established in all provinces; decided by the Chairman of the Provincial People's Committee based on the proposal of the Director of the Health Department, the Commander of the Provincial Military Command, and the Commander of the Provincial Border Guard Command (if any).

1.4.2. The Military-Civilian Medical Committee of Provinces has the following tasks:

a) Based on the MCMM plan of the Military Region and the actual situation of the locality; develop MCMM plans for each phase and year and propose a budget plan to ensure MCMM activities to be approved by the Chairman of the Provincial People's Committee.

b) Direct and organize the coordination to fulfill regular tasks of local military medical work.

c) Organize coordination, unified direction, and management of military and civilian medical forces in the province to implement the following contents:

- Mobilizing military and civilian medical forces to participate in providing health care for the people in the areas where they are stationed;

- Combining MCMM in disease prevention and organizing unified forces to combat diseases when there are epidemic situations or biological terrorism;

- Supporting each other between military hospitals and civilian hospitals in disease prevention and treatment;
- Military medical lines (in border areas, islands...) where medical organizations are weak in expertise and lack personnel, participate in emergency rescue and treatment for the people as a regional medical line.
- Medical facilities participate in emergency rescue and treatment for military personnel;

- Develop effective plans to respond to emergencies;

- Combine military and civilian medical forces in training, supplementing medical staff, and developing medical science and technology;

- Organize the implementation of wartime medical mobilization according to orders from the Military Region Commander and the Chairman of the Provincial People's Committee;

- Establish a network for transporting and treating wounded and sick persons during wartime within the defensive area;

- Regularly report the results of the Medical Mobilization Board's activities to the Provincial People's Committee, the Military Region Medical Mobilization Board, and the Medical Mobilization Board at the Ministry level;

1.4.3. The members of the Provincial Medical Mobilization Board include:

a) Chairperson: Director of the Department of Health.

b) Deputy Chairpersons:

- One Deputy Director of the Department of Health.

- Chief of Military Medicine of the Provincial Military Command.

- Director of the Provincial Preventive Health Center.

c) Members:

- Head of the Planning and Finance Division of the Department of Health.

- Head of the Business Division of the Department of Health.

- Chief of Military Medicine of the Provincial Border Guard Command (if applicable).

- Chiefs of Military Medicine of divisions stationed in the province (if applicable).

- Directors of military hospitals, hospitals of ministries and sectors stationed in the province (if applicable).

1.4.4. The regular operating funds for the Provincial Medical Mobilization Board are allocated annually from the state budget for provincial health services.

1.5. Medical Mobilization Boards at the district, town, city under provincial jurisdiction (hereinafter referred to collectively as district)

1.5.1. Medical Mobilization Boards at the district level are established in all districts; the decision to establish them is made by the District People's Committee Chairman upon the proposal of the District Health Office Director and the District Military Command Chief.

1.5.2. The tasks of the Medical Mobilization Board at the district level include:

a) Implementing the plans and programs of the Provincial Medical Mobilization Board and proactively proposing contents and budgets to ensure the work of medical mobilization and health care for the district, to be approved by the District People's Committee;

b) Carrying out regular tasks of local military health work: conducting conscription medical examinations, directly managing the health of reservists and discharged soldiers; organizing training on five basic first aid techniques for local self-defense forces;

c) Coordinating with military and civilian medical forces on the territory to carry out health care activities for the people and military personnel during peacetime; organizing military medical forces, civilian medical forces, Red Cross... to receive wounded and sick persons during wartime or in epidemic, natural disaster, and catastrophic situations;

d) In key areas where civilian medical facilities and military medical units are close to each other, the Medical Mobilization Board will study and organize integration into a combined military-civilian medical facility (functional unit of the Medical Mobilization Board) suitable for the type of operation to jointly perform the task of examining, rescuing, and treating patients in the area.

1.5.3. The members of the Medical Mobilization Board at the district level include:

a) Chairperson: Deputy Chairman of the District People's Committee.

b) Deputy Chairpersons:

- Deputy commander of the District Military Command.

- Director of the District Health Office.

c) Members:

- Military Medical Officer of the District Military Command (secretary member).

- Chiefs of Military Medicine of military units stationed in the district.

- Director of the District Hospital and Head of the Preventive Health Team.

1.5.4. The regular operating funds for the Medical Mobilization Board at the district level are allocated annually from the state budget for district health services.

1.6. Medical Mobilization Boards at the commune, ward, town (hereinafter referred to collectively as commune)

1.6.1. Medical Mobilization Boards at the commune level are established in communes located in key areas, remote and mountainous regions, and places where military medical units are stationed; the decision to establish them is made by the Commune People's Committee Chairman upon the proposal of the Commune Health Station Director, the unit commander (with military medical forces) stationed in the commune, and with the written consent of the District Health Office Director.

1.6.2. The tasks of the Medical Mobilization Board at the commune level include:

a) Cooperating with commune health forces and military medical units stationed in the area to organize medical mobilization and health care work to protect the health of military personnel and civilians, implementing the contents of the national health program such as: strengthening primary health care, expanded immunization, disease prevention, population education, family and child health, malaria prevention, and prevention of disorders due to iodine deficiency...

b) In communes with weak and insufficient health networks, under the guidance of the District Health Office Director and the Commune People's Committee, the Medical Mobilization Board at the commune level organizes the integration of the commune health station with military medical units into a combined health station (functional unit of the commune Medical Mobilization Board) to jointly perform the task of examining, treating, and caring for the health of the people in the commune.

1.6.3. The members of the Medical Mobilization Board at the commune level include:

a) Chairperson: Deputy Chairman of the Commune People's Committee (responsible for civil affairs).

b) Deputy Chairperson:

- Director of the Commune Health Station.

- Deputy Commander or Chief of Logistics of the military unit stationed in the commune (main force unit, border guard post).

c) Members:

- Military Medical Officer of the main force unit stationed in the commune.

- Military Medical Officer of the Border Guard Post.

- Director of the Commune Health Station.

- Head of the Mass Mobilization Team of the Border Guard Post.

- A commune health officer.

1.6.4. The regular operating funds for the Medical Mobilization Board at the commune level are allocated annually from the state budget for commune health services.

2. Regulations on the relationship of guidance, management, and operation of the Medical Mobilization Boards at various levels

2.1. The relationship of guidance, management, and operation of the Medical Mobilization Board at the Ministry level

2.1.1. The Medical Mobilization Board at the Ministry level is directly guided by the leadership of the Ministry of Health and the Ministry of Defense and is responsible to the Minister of Health and the Minister of Defense for the entire content of its activities in medical mobilization and health care.

2.1.2. The Military Medicine Department of the General Logistics Department (Military Medicine Department) directly manages, guides, and comprehensively directs the implementation of medical mobilization and health care work throughout the military, specifically: military medicine of military regions, corps, branches, and services, and coordinates with military medicine of military regions to guide the Military Medicine Department of the Provincial Military Command.

2.1.3. Functional Departments and Bureaus of the Ministry of Health have the responsibility to guide the Departments of Health and Sectoral Health Services in implementing tasks within their functional scope.

2.1.4. The Medical Mobilization Board at the Ministry level directly guides the Medical Mobilization Board of the Military Region in implementing medical mobilization work according to the approved activity plan by the Ministry of Health and the Ministry of Defense. The Medical Mobilization Board at the Ministry level collaborates with the Medical Mobilization Board of the Military Region to directly guide the Provincial Medical Mobilization Boards in key areas on specific contents of medical mobilization work, meeting defense and security requirements and community health care in the region.

2.1.5. In case of emergency situations, with the authorization of the leaders of the Ministry of Health and the Ministry of National Defense, the Central Military-Civilian Medical Coordination Board at the ministry level shall directly direct the Provincial Military-Civilian Medical Coordination Board to utilize military and civilian medical forces and supplies on-site and mobile forces to meet the requirements for medical intervention in such situations. After completing the mission, the Central Military-Civilian Medical Coordination Board at the ministry level shall be responsible for reporting the results, mobilizing forces, and using medical supplies to the Ministry of Health and the Ministry of National Defense.

2.1.6. The working methods and reporting system of the Central Military-Civilian Medical Coordination Board at the ministry level are as follows:

a) The organization that directs the implementation of the health work plan of the Central Military-Civilian Medical Coordination Board at the ministry level is the Ministry of Health and the General Department of Military Medicine. All military and civilian medical units within the country's territory are subject to management, direction, and inspection by the Central Military-Civilian Medical Coordination Board at the ministry level.

b) Directly monitor and inspect the implementation of activities under the program; guide units to implement reporting systems; collect, synthesize, and report to the leadership of the Ministry of Health and the Ministry of National Defense about the results of activities on a regular basis.

c) The Central Military-Civilian Medical Coordination Board at the ministry level convenes meetings every three months to review the directive work and evaluate the implementation of the health work plan, while determining the content of activities for the subsequent period. Organize extraordinary meetings when there are urgent tasks.

2.2. Directive, management, and operational relationships of the Military-Civilian Medical Coordination Board at the military region level

2.2.1. The Military-Civilian Medical Coordination Board at the military region level is directly directed by the Commander of the Military Region, and professionally guided by the Central Military-Civilian Medical Coordination Board at the ministry level; it is responsible before the Commander of the Military Region and the Central Military-Civilian Medical Coordination Board at the ministry level for the results of health work in the Military Region.

2.2.2. The relationship between the Military-Civilian Medical Coordination Board at the military region level and the Provincial Military-Civilian Medical Coordination Boards is a directive and organizational implementation relationship.

2.2.3. In case of emergency situations occurring in the Military Region, under the direction of the Commander of the Military Region, the Chief of Military Medicine of the Military Region, authorized, coordinates with the Provincial Military-Civilian Medical Coordination Boards to utilize forces and medical supplies to meet the requirements for disease prevention and control, participate in mitigating consequences, and directly organize treatment for injured and affected individuals.

2.2.4. The working methods and reporting system of the Military-Civilian Medical Coordination Board at the military region level are as follows:

a) The organization implementing the health work plan of the Military-Civilian Medical Coordination Board at the military region level is the Provincial Military Medicine Boards. The Directors of the Departments of Health mobilize civilian medical forces; with the authorization of the Chief of Logistics of the Military Region, the Chief of Military Medicine of the Military Region mobilizes military medical forces throughout the Military Region.

b) The Military-Civilian Medical Coordination Board at the military region level convenes meetings every six months to review directive work and evaluate the implementation of health work plans within the Military Region, determine work for the subsequent period, and organize extraordinary meetings when there are urgent tasks.

c) The Military-Civilian Medical Coordination Board at the military region level reports regularly every six months and annually to the Commander of the Military Region, the Ministry of Health, and the Ministry of National Defense (General Department of Military Medicine) about the results of health work in the Military Region.

2.3. Directive, management, and operational relationships of the Provincial Military-Civilian Medical Coordination Board

2.3.1. The Provincial Military-Civilian Medical Coordination Board is directly led and commanded by the People's Committee of the Province; it is directed and guided in implementing health work by the Military-Civilian Medical Coordination Board at the military region level within the province; it is responsible before the Chairman of the People's Committee of the Province for all health work in the locality.

2.3.2. The Provincial Military-Civilian Medical Coordination Board has the responsibility to direct and guide professional health work for the County and Commune Military-Civilian Medical Coordination Boards within the province.

2.3.3. The relationship between the Provincial Military-Civilian Medical Coordination Board and medical facilities under the Ministry of Health, medical facilities of various sectors, as well as military medical organizations of the military region, corps, and military branches... stationed in the province is a cooperative and coordinated relationship in ensuring medical care. In case of emergency situations causing significant casualties, the Head of the Provincial Military-Civilian Medical Coordination Board has the right to request support from these organizations in resolving consequences, and these organizations have the duty to respond to such requests.

2.3.4. The working methods and reporting system of the Provincial Military-Civilian Medical Coordination Board are as follows:

a) The organization implementing decisions of the Provincial Military-Civilian Medical Coordination Board is the Department of Health and the Military Medicine Board of the Provincial Military Command, the Military Medicine Board of the Border Guard Provincial Command (if applicable). The Director of the Department of Health mobilizes the forces of the civil health sector; with the authorization of the Chief of Logistics, the Chief of Military Medicine of the Provincial Military Command mobilizes military medical forces to implement decisions of the Provincial Military-Civilian Medical Coordination Board.

b) When support from other sectors such as transportation, commerce... or the military is needed. The Director of the Department of Health reports to the Chairman of the People's Committee of the Province, the Chief of Military Medicine reports to the Commander of the Provincial Military Command and the Border Guard Provincial Command (if applicable) to seek guidance and organize implementation.

c) The Provincial Military-Civilian Medical Coordination Board convenes meetings every six months to review directive work and evaluate the implementation of health work plans within the province, determine the content of activities for the subsequent period; hold extraordinary meetings when there are urgent tasks.

d) The Director of the Department of Health reports the results of health work to the People's Committee of the Province and the Ministry of Health in regular reports. The Chief of Military Medicine of the Province reports the results of health work to the Provincial Military Command and the Military Medicine Department of the Military Region in regular reports. The Provincial Military-Civilian Medical Coordination Board reports every six months and annually to the People's Committee of the Province, the Military-Civilian Medical Coordination Board at the military region level, and the Central Military-Civilian Medical Coordination Board at the ministry level.

2.4. Directive, management, and operational relationships of the County and Commune Military-Civilian Medical Coordination Boards

2.4.1. The County Military-Civilian Medical Coordination Board is directly led and commanded by the People's Committee of the County, directed and guided in implementing health work by the Provincial Military-Civilian Medical Coordination Board, and is responsible before the Chairman of the People's Committee of the County and the Provincial Military-Civilian Medical Coordination Board for all health work in the locality.

2.4.2. In case of emergency situations causing significant casualties; under the direct leadership and command of the Chairman of the People's Committee of the County, the County Military-Civilian Medical Coordination Board mobilizes all military and civilian medical forces available in the area to implement measures to promptly meet the needs of medical intervention in encirclement, containment, extinguishing of epidemics, emergency transport of injured and affected individuals... At the same time, report to higher authorities to request reinforcements of forces and medical supplies to quickly mitigate consequences.

2.4.3. The working methods and reporting system of the County Military-Civilian Medical Coordination Board are as follows:

a) The organization implementing the health work plan of the County Military-Civilian Medical Coordination Board is the Health Office and Military Medicine Office of the County Military Command; military medicine units of military units and civil medical facilities stationed in the county have the responsibility to cooperate and participate.

b) The Head of the Health Department of the district reports on the results of the health care work to the People's Committee of the district and the Provincial Health Department according to regular reports. The Health Care Board of the district reports every six months and annually on the results of the health care work to the Health Care Board of the province.

c) The Director of Military Medical Services of units stationed in the district participates in the health care work within the area in accordance with the reporting system prescribed for military medical units at higher levels.

d) The Health Care Board of the district convenes a meeting once every six months to review and evaluate the results of implementing tasks as determined in the duties section, and simultaneously propose contents for activities in the subsequent period.

2.4.4. The relationship and working methods of the Health Care Board of the commune shall be implemented similarly to that of the Health Care Board of the district within the scope of the commune level.

3. Provisions on organization, duties, relationships, and mechanisms to ensure for medical teams and military-civilian medical facilities in examination, treatment, disease prevention, and disaster relief

3.1. Organization, duties, relationships, and mechanisms to ensure for medical teams and medical facilities in examination and treatment

3.1.1. Types of organization for medical teams and medical facilities in examination and treatment include: Military Health Stations, Military Clinics, Military Polyclinics, Military Health Centers, and Military Hospitals. Based on natural conditions, socio-economic factors, military-medical forces available in the area, and community health care needs, the appropriate type should be determined, with particular emphasis on organizing in remote, border, island, and key defense and security areas.

3.1.2. Duties of medical teams and medical facilities in examination and treatment: Implement according to the specific functions and responsibilities defined for each level of medical examination and treatment by the Ministry of Health and the General Department of Military Medicine.

3.1.3. Organizing medical teams and medical facilities in examination and treatment through two methods:

a) Comprehensive integration method: Concentrating all human resources, materials, equipment, and infrastructure from both military and civilian medical services to form medical teams or facilities; operating under regulations established and issued by the competent authority.

b) Collaborative operation method: Collaborating between military and civilian medical services in periodic, phased, or ad hoc operations based on ongoing or urgent tasks; operating under regulations decided by the competent authority.

3.1.4. Authority to decide on establishment and issuance of operational regulations:

a) Military Hospitals:

- Central-level hospitals are established by the Prime Minister's decision upon the proposal of the Minister of Health and the Minister of National Defense. Operational regulations are jointly issued by the Ministry of Health and the Ministry of National Defense.

- Regional and provincial hospitals are established by the Minister of Health's decision (with written agreement from the Ministry of National Defense) upon the proposal of the Regional Military Commander after obtaining the consensus of the Chairman of the People's Committee of the province where the hospital is located. Operational regulations are issued by the Regional Military Commander upon the proposal of the Regional Health Care Board.

b) Military Health Centers, Military Polyclinics, Military Health Stations: Established by the Chairman of the People's Committee of the province's decision upon the proposal of the Provincial Health Director after reaching an agreement with the leadership of the military unit operating in these facilities. Operational regulations are jointly issued by the Provincial Health Director and the military unit's commander (directly operating military medical personnel).

c) Military Clinics: Established by the Ministry of National Defense's decision, formed based on the signing of operational regulations among the Head of the District Health Department, the District People's Committee, and the leadership of the military unit directly managing the clinic.

3.1.5. Management and Command:

a) Medical teams and facilities organized through comprehensive integration fall under the management of the military unit's head and the superior health administration.

b) Medical teams and facilities organized through collaborative operation methods:

- Military Hospitals: Direct management follows the establishment decision.

- Military Clinics are managed directly by the unit's command.

- Military Health Centers, Military Polyclinics, and Military Health Stations are managed directly by the superior civil health administration.

3.1.6. Mechanism to ensure funding sources:

a) Ensuring funding for medical teams and facilities in examination and treatment is one of the main contents determined in the operational regulations issued by the competent authority. These regulations serve as a legal basis ensuring the feasibility, sustainability, and effectiveness of medical teams and facilities.

b) Principles for ensuring funding:

- Using budget funds correctly according to current regulations;

- Funding for military medical examinations and treatments is ensured by the military, while funding for civilian medical examinations and treatments is ensured by civilian medical services.

- Depending on the capabilities of participating parties, mutual financial support may be provided such as upgrading infrastructure, initial drug funds, medical equipment, and emergency activities based on task requirements.

3.2. Organization, duties, relationships, and mechanisms to ensure for mobile military medical teams in disease prevention and disaster relief

3.2.1. Organization of mobile military medical teams in disease prevention and disaster relief:

a) Mobile military medical teams are medical teams (military and civilian) organized from the staffing of military and civilian medical examination and treatment facilities and preventive health care facilities, independently organized but operate under the military-civilian health care relationship to implement tasks under the direction of the Health Care Boards at various levels.

b) Composition of mobile military medical teams includes:

- Emergency transport team.

- Mobile surgical team.

- Mobile disease control team.

- Mobile disease control group.

- Specialized reinforcement team.

c) Tasks for building mobile military medical organizations for disease prevention and disaster relief are carried out according to Section 6 - Part I (General Provisions) of Circular 03/TT-LB dated March 4, 1994, of the Joint Ministry of Health and National Defense regarding the combination of military and civilian medical rescue and care for victims caused by disasters.

3.2.2. Duties of mobile military medical teams in disease prevention and disaster relief:

a) Always ready with manpower, equipment, and means to ensure mobility within the shortest time when mobilization orders are received;

b) Organize comprehensive training for all necessary contents regarding professional skills and organizational levels of the team's work; ensure that when mobilization orders are issued, they have the capability to effectively implement assigned tasks.

c) In situations where teams are mobilized and deployed to perform tasks according to the assignment of the person responsible for health management in areas affected by epidemics, natural disasters, or catastrophes.

3.2.3. The relationship and operational methods of mobile medical teams in disease prevention and control activities, as well as disaster aftermath mitigation:

a) Teams are adequately staffed with sufficient material and specialized equipment to ensure their independent operational capacity according to assigned tasks.

b) Under normal circumstances: Organizations are formed from bases directly managed and maintained by unit leaders to ensure readiness for mobilization upon orders.

c) Upon mobilization: All activities are organized and carried out according to the assignment of the person responsible for health management in areas affected by catastrophes.

3.2.4. Mechanism for ensuring medical supplies and financial support for the activities of mobile medical teams in disease prevention and control, as well as disaster aftermath mitigation, shall be implemented according to Section 5 - Part II (Specific Provisions) of Circular 03 dated March 4, 1994, jointly issued by the Ministry of Health and the Ministry of National Defense on the integration of military-medical rescue and care for victims caused by catastrophes.

4. Regulations on the responsibilities of Military-Civilian Medical Boards at various levels in organizing local military medical work.

4.1. Contents and tasks of local military medical work.

4.1.1. Contents of local military medical work:

a) Local military medical work is one of the main components of the task of building provinces and cities into solid defense zones. The Department of Health is the leading agency, coordinating with the Provincial Military Command to organize implementation and is responsible before the People's Committee of the province for the results achieved.

b) Local military medical work includes all civil and military medical work ensuring the execution of local military tasks. Depending on geographical location and military tasks of each province, the content of local military medical work may differ. However, generally, the basic content of local military medical work is to ensure medical care for the locality's combat readiness and combat tasks.

4.1.2. Specific tasks of local military medical work:

a) Ensuring medical care for recruitment and managing the health of newly discharged soldiers.

b) Medical work in the task of mobilizing the army and national defense mobilization.

c) Training emergency medical care during wartime for the entire population, training military medicine according to classification for reserve medical personnel, organizing medical exercises according to the defense area's tasks.

d) Building military medical geography of the locality.

đ) Building a network for transporting and treating casualties in war.

e) Cooperating between military and civilian medical services in disease prevention (especially dangerous diseases), participating in resolving disaster aftermaths, natural disasters, and other military situations (terrorism, biological and chemical terrorism threats).

g) Stockpiling medical supplies for wartime.

4.2. Responsibilities of Military-Civilian Medical Boards at various levels for local military medical work.

4.2.1. The Central Military-Civilian Medical Board has the responsibility:

a) To develop contents, submit to the leadership of the Ministries of Health and National Defense and the Government for the institutionalization of contents related to local military medical work through legal documents for localities to organize implementation.

b) To guide local military medical work within the annual plans of the Military-Civilian Medical Service throughout the sector.

c) To coordinate with the Military Region's Military-Civilian Medical Board to direct, inspect, and guide the organization and implementation of local military medical work by provincial boards.

4.2.2. The Military Region's Military-Civilian Medical Board has the responsibility:

a) Annually, to establish and submit to the Military Region's Command for approval the plan for local medical work in the region.

b) To directly monitor, direct, inspect, and guide the implementation of plans and results by provincial boards within the region.

4.2.3. The Provincial Military-Civilian Medical Board has the responsibility:

a) Annually, based on the regional medical work plan approved by the Provincial People's Committee and the practical needs of the locality, to establish and submit for approval the provincial medical work plan.

b) To assign specific responsibilities to officers under the Department of Health and the Military Medical Board of the Provincial Military Command, the Military Medical Board of the Border Guard Command, who will be directly responsible for the contents of local military medical work.

c) To directly inspect and guide the implementation and results of the plan.

5. Financial assurance for combined military-civilian medical activities.

5.1. The Central Military-Civilian Medical Board is responsible for developing annual activity plans submitted for approval by the Ministry of Health's leadership. Annual budgets are allocated from the state budget for health services and other sources as prescribed by law. Military units are guaranteed funding for regular and urgent tasks according to the requirements of combined military-civilian medical activities.

5.2. Based on the annual combined military-civilian medical activity plan approved by the Provincial People's Committee, the Department of Health is responsible for preparing a budget estimate with the Department of Planning and Investment and the Department of Finance to allocate funds from the local budget for activities according to the approved plan.

5.3. Assurance mechanism: Depending on the requirements of tasks and types of activities, partial or full funding can be provided through contracts of responsibility with implementing units for each task.

5.4. Settlement and final accounting shall be conducted according to Circular 48/2003/TT-BTC dated May 15, 2003, issued by the Ministry of Finance, guiding the content and level of expenditure for the Combined Military-Civilian Medical Protection Project for the health of the people and national defense security for the period 2001-2010 and current regulations.

6. Effective date

6.1. This Circular takes effect fifteen days after its publication in the Official Gazette.

6.2. Chapter I - Provisions on the organization and tasks of the Military-Civilian Health Bureaus at all levels in this Circular replaces Chapter I - Provisions on the organization of the Military-Civilian Health Bureaus at provincial, district, and commune levels in Circular 09/TT-LB dated July 21, 1992, issued by the Ministry of Health and Ministry of National Defense regarding the organization of the Military-Civilian Health Bureau, the integration of military-civilian health in disease prevention and treatment, and the reception of wounded and sick persons.

6.3. In the course of implementation, if there are any difficulties, localities and units shall report to both the Ministry of Health and the Ministry of National Defense for consideration and resolution./.