Joint Circular No. 09/2003/TTLT-BYT-BTC-BNV guiding the implementation of Decision No. 155/2003/QĐ-TTg dated July 30, 2003, amending and supplementing certain special allowances for civil servants and employees in the health sector.

JOINT CIRCULAR

Guidelines for Implementing Decision No. 155/2003/QĐ-TTg dated July 30, 2003 of the Prime Minister on Amending and Supplementing Certain Special Allowance Regimes for Civil Servants and Employees in the Health Sector

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In accordance with Decision No. 155/2003/QĐ-TTg dated July 30, 2003 of the Prime Minister on Amending and Supplementing Certain Special Allowance Regimes for Civil Servants and Employees in the Health Sector; Jointly issued by the Ministry of Health, the Ministry of Finance, and the Ministry of Interior to provide guidance as follows:

A. APPLICABLE OBJECTS:

1. Civil servants and employees in the health sector and military forces performing 24/24 hours continuous professional medical duty at healthcare facilities include:

- Hospitals and institutes with beds (collectively referred to as hospitals);

- District and county health centers (including regional multi-specialty clinics and maternity homes), health centers under ministries and sectors with beds;

- Healthcare facilities established according to Decree No. 14/2002/L-CTN dated July 16, 2002 of the President;

- Commune, ward, and town health stations (collectively referred to as commune health stations).

2. Civil servants and employees in the health sector and military forces directly participating in extinguishing outbreaks and standing by to combat outbreaks 24/24 hours at state-managed healthcare facilities within epidemic areas.

3. Civil servants and employees in the health sector and military forces directly performing surgeries and procedures.

B. SPECIAL ALLOWANCE REGIMES:

I. REGIME FOR CONTINUOUS 24/24 HOUR DUTY ALLOWANCE:

Civil servants and employees in the health sector and military forces performing continuous 24/24 hours professional medical duty at healthcare facilities as stipulated in point 1 of Section A of this Circular shall be entitled to the following allowance regimes:

1. Continuous duty allowance rate:

1.1. The continuous duty allowance rate per person per shift on regular working days includes the following rates:

a. Continuous duty allowance rate in ordinary areas:

- Rate of 45,000 VND/person/shift: applicable to continuous duty at Class I hospitals;

- Rate of 35,000 VND/person/shift: applicable to continuous duty at Class II hospitals; Class I Traditional Medicine hospitals;

- Rate of 25,000 VND/person/shift: applicable to continuous duty at Class III hospitals; Class II Traditional Medicine hospitals and district and county health centers, regional multi-specialty clinics, maternity homes, and healthcare facilities established according to Decree No. 14/2002/L-CTN dated July 16, 2002 of the President;

- Rate of 10,000 VND/person/shift: applicable to continuous duty at commune health stations.

b. Continuous duty allowance rate in intensive care and special care areas is 1.5 times the continuous duty allowance rate in ordinary areas of the same class hospital:

- Intensive care areas include: Emergency Care Department, Anesthesia and Intensive Care Surgery Department, Neonatal Intensive Care Unit, Intensive Treatment Department, Emergency Department, Poison Control Department;

- Special care areas include: Neonatal Intensive Care, Acute Mental Health Care in hospitals and specialized mental health centers;

1.2. Continuous duty allowance rate on standard weekly rest days (Saturday, Sunday) is 1.3 times the continuous duty allowance rate on regular working days;

1.3. Continuous duty allowance rate on public holidays and Tet is 1.8 times the continuous duty allowance rate on regular working days;

On regular days: VND 45,000.

Example 1: Dr. Nguyen Van A works at the Emergency Care Department of a Class II general hospital and is assigned to perform continuous 24/24 hours duty. Dr. A's continuous duty allowance is as follows:

- On regular working days: 35,000 VND x 1.5 = 52,500 VND;

- On Saturday or Sunday: 52,500 VND x 1.3 = 67,860 VND;

- On public holidays and Tet: 52,500 VND x 1.8 = 94,500 VND;

Example 2: Dr. Tran Thi B works at a district health center and is assigned to perform continuous 24/24 hours duty. Dr. B's continuous duty allowance is as follows:

- On regular working days: 25,000 VND;

- On Saturday or Sunday: 25,000 VND x 1.3 = 32,500 VND;

- On public holidays and Tet: 25,000 VND x 1.8 = 45,000 VND;

2. Compensatory leave after duty shifts:

- Civil servants and employees in the health sector and military forces performing continuous 24/24 hours professional medical duty on regular working days or weekly rest days are entitled to one day off and full pay;

- Civil servants and employees in the health sector and military forces performing continuous 24/24 hours professional medical duty on public holidays and Tet are entitled to two days off and full pay;

3. Staffing standards during 24/24 hours duty shifts at healthcare facilities and commune health stations are specified as follows:

- For Class I hospitals: 14 people/shift/100 beds;

- For Class II and III hospitals, Class I Traditional Medicine hospitals, district and county health centers (including regional multi-specialty clinics and maternity homes), health centers of ministries and sectors: 12 people/shift/100 beds;

- For commune health stations: 1 person/shift/station for communes in plains with over 8,000 inhabitants and mountainous, border, and island communes with up to 3,000 inhabitants; 2 people/shift/station for communes in plains with more than 8,000 inhabitants and mountainous, border, and island communes with more than 3,000 inhabitants.

- For healthcare facilities established according to Decree No. 14/2002/L-CTN dated July 16, 2002 of the President: the Ministry of Health will coordinate with the Ministry of Labor, Invalids, and Social Affairs to provide specific guidance on staffing standards during duty shifts.

II. OUTBREAK CONTROL ALLOWANCE REGIME:

1. Direct outbreak control allowance: civil servants and employees in the health sector and military forces directly participating in extinguishing outbreaks as stipulated in point 2 of Section A of this Circular shall be entitled to outbreak control allowances calculated based on actual participation days as follows:

a. Rate of 60,000 VND/day/person applicable to the most dangerous outbreaks: Cholera, Plague, Yellow Fever, Severe Acute Respiratory Syndrome (SARS), Malaria, Ebola, Dengue Fever, and other infectious diseases causing epidemics with unknown causes as announced by the Ministry of Health;

b. Rate of 30,000 VND/day/person applicable to other types of outbreaks.

2. Continuous 24/24 hours duty allowance for outbreak control.

a. Rate of allowance: Civil servants and medical staff participating in 24/7 anti-epidemic duty at healthcare facilities under state management at all levels responsible for professional and technical matters in epidemic areas determined by competent health authorities shall also receive a duty allowance rate of VND 40,000/person/session. The allowance rate for duty on standard weekly rest days (Saturday, Sunday) is 1.3 times the regular duty allowance rate; if on statutory holidays or Tet, the allowance rate is 1.8 times the regular duty allowance rate.

b. Compensatory leave: Civil servants, medical staff, and armed forces personnel performing 24/7 anti-epidemic duty on regular workdays or weekly rest days shall be granted one day of compensatory leave; if on statutory holidays or Tet, they shall be granted two days of compensatory leave and shall receive full pay.

III. ALLOWANCE REGIME FOR SURGERY AND PROCEDURES:

Civil servants and medical staff directly performing surgery and procedures as stipulated in Point 3, Section A of this Circular shall receive allowances as follows:

1. Surgery Subsidy Level:

The list of surgical classifications is implemented according to Decision No. 1904/1998/QĐ-BYT dated August 10, 1998, issued by the Minister of Health (when this document is supplemented or amended, it will be implemented according to the amended document).

- For the list of IA, IB, and IC surgeries, the surgery type I allowance rate as specified above shall be received;

- For the list of IIA, IIB, and IIC surgeries, the surgery type II allowance rate as specified above shall be received.

In cases where surgeries were previously required but have now been converted to procedures, a subsidy equal to 1/3 of the surgery subsidy of the same type shall be enjoyed.

a. In cases where surgery was previously required but has now been converted to a procedure, the allowance shall be equal to one-third of the surgery allowance rate of the same type;

b. The Ministry of Health shall specify the list of procedures that shall receive an allowance equal to one-third of the surgery allowance rate of the same type.

C. SOURCE OF FUNDS FOR PAYING ALLOWANCES:

1. The funds for implementing special allowance regimes of the health sector are allocated in the annual state budget estimates assigned to ministries, central agencies, localities, and the income of units.

2. For the year 2003, the principle for funding the allowance regime is as follows:

2.1. Ministries and central agencies allocate within their assigned state budget estimates to implement special allowance regimes.

2.2. Provinces and centrally-administered cities allocate funds within their assigned budget estimates to implement the anti-epidemic allowance and surgery/procedure allowance regimes.

2.3. Regarding the 24/7 duty allowance for localities:

- For provinces with central budget transfers, they shall arrange within their local budget scope to implement the allowance regime.

- For provinces in extremely difficult mountainous regions according to Decision No. 186/2001/QĐ-TTg dated December 7, 2001, and the four Central Highlands provinces according to Decision No. 168/2001/QĐ-TTg dated October 30, 2001, issued by the Prime Minister, the central budget shall provide 100% support.

- For other provinces, the central budget shall provide support as follows:

+ 100% of the funds for implementing the allowance regime for communes under Program 135.

+ 80% of the funds for implementing the allowance regime for healthcare facilities in mountainous provinces and healthcare facilities in mountainous districts and communes recognized as mountainous areas.

+ 60% of the funds for implementing the allowance regime for healthcare facilities in provinces, districts, and communes not covered by the aforementioned regulations.

The central budget funding provided at the aforementioned ratio shall be determined based on the difference between the total amount of funds for implementing the regime stipulated in Decision No. 155/2003/QĐ-TTg dated July 30, 2003 of the Government Prime Minister and the sources already allocated for supplementation in the local budget when implementing Circular Joint No. 150/LB-TT dated April 16, 1996 of the Civil Service Organization Board of the Government - Ministry of Health - Ministry of Finance guiding Decision No. 794/TTg dated December 5, 1994 of the Government Prime Minister.

D. IMPLEMENTATION ORGANIZATION

This Circular takes effect from July 1, 2003 and replaces Circular No. 150/LB-TT dated April 16, 1996 of the Joint Ministries: Civil Service Organization Board of the Government (now the Ministry of Home Affairs) - Ministry of Finance - Ministry of Health, Circular No. 07/2003/TT-LT dated January 15, 2003 of the Joint Ministries: Ministry of Home Affairs - Ministry of Finance - Ministry of Health, and Point 1, Part 1 regarding epidemic prevention allowances in Circular No. 80/2001/TTLT-BTCCBCP-BTC-BYT dated December 5, 2002 of the Joint Ministries: Civil Service Organization Board of the Government - Ministry of Finance - Ministry of Health guiding the implementation of certain special allowances for civil servants and public officials in the health sector. All previous regulations contrary to this Circular are hereby abolished.

The Departments of Health, Finance and Prices, and the Civil Service Boards of the provinces and centrally governed cities shall guide, inspect the implementation of this Circular and report the results annually to the Joint Ministries.

Any difficulties encountered during implementation should be reported to the Joint Ministries for study and resolution.