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

CIRCULAR

Guidelines for Implementing Decision No. 155/2003/QĐ-TTg

dated July 30, 2003 of the Prime Minister amending and supplementing certain special allowances for civil servants and public officials in the health sector

Implementing Decision No. 155/2003/QĐ-TTg dated July 30, 2003 of the Prime Minister amending and supplementing certain special allowances for civil servants and public officials in the health sector; Joint Circular: Ministry of Health, Ministry of Finance, Ministry of Home Affairs provide guidelines for implementation as follows:

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

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

A. APPLICABLE OBJECTS:

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

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

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

2. Civil servants and public officials in the health sector and military forces directly participating in extinguishing disease outbreaks and standing by against epidemics 24/24 hours at state-managed healthcare facilities in epidemic areas.

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

B. SPECIAL ALLOWANCES REGIME:

I. REGIME OF 24/24 HOURS STANDING BY ALLOWANCE

Civil servants and public officials in the health sector and military forces performing 24/24 hours continuous professional medical duty at healthcare facilities as stipulated in Point 1, Section A of this Circular shall enjoy the following allowance regime:

1. Standing by allowance rate:

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

- Rate of 45,000 VND/person/shift: applicable for standing by at Class I hospitals;

- Rate of 35,000 VND/person/shift: applicable for standing by at Class II hospitals; Traditional Medicine Class I hospitals;

Level VND 35,000/person/shift: applicable to on-call duty at the Military Traditional Medicine Institute; other hospitals and the Center for Nuclear Medicine and Radiation Protection;

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

- Rate of 10,000 VND/person/shift: applicable for standing by at commune health stations.

b) The standing by allowance rate in the emergency resuscitation and intensive care area is 1.5 times the standing by allowance rate in the general area of the same class hospital mentioned above;

- Emergency resuscitation area includes: Emergency Resuscitation Department, Anesthesia and Resuscitation Surgery Department, Neonatal Intensive Care Unit, Intensive Treatment Department, Emergency Department, Poison Control Department;

- Intensive care area includes: neonatal intensive care, acute mental patient care in hospitals and specialized mental health centers;

1.2. The standing by allowance rate on standard weekly rest days (Saturday, Sunday) is 1.3 times the standing by allowance rate on regular working days;

1.3. The standing by allowance rate on holidays and Tet is 1.8 times the standing by allowance rate on regular working days;

Example 1: Dr. Nguyen Van A works at the Emergency Resuscitation Department of a Class II multi-disciplinary hospital and is assigned to stand by 24/24 hours. Dr. A's standing by allowance is as follows:

- Stand by on regular working days: 35,000 VND x 1.5 = 52,500 VND;

On regular days: VND 45,000.

- Stand by on Saturday or Sunday: 52,500 VND x 1.3 = 67,860 VND;

- Stand by on 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 stand by 24/24 hours. Dr. B's standing by allowance is as follows:

- Stand by on regular working days: 25,000 VND;

- Stand by on Saturday or Sunday: 25,000 VND x 1.3 = 32,500 VND;

- Stand by on holidays and Tet: 25,000 VND x 1.8 = 45,000 VND;

2. Compensatory leave after a shift:

- Civil servants and public officials in the health sector and military forces performing 24/24 hours standing by medical duty on regular working days or weekly rest days are entitled to one day compensatory leave and full pay;

- Civil servants and public officials in the health sector and military forces performing 24/24 hours standing by medical duty on holidays and Tet are entitled to two days compensatory leave and full pay;

3. Manpower quota during 24/24 hours standing by shifts at healthcare facilities and commune health stations is specified as follows:

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

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

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

- For healthcare facilities established pursuant 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 manpower quotas during 24/24 hours standing by shifts.

1. Direct participation in disease outbreak control allowance rate: civil servants and public officials in the health sector and military forces directly participating in disease outbreak control as stipulated in Point 2, Section A of this Circular shall be entitled to an epidemic control allowance, calculated based on actual days of participation as follows:

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

Military personnel, civil servants, and professional medical staff specializing in military medicine directly participating in epidemic control according to point 2 of Section A of this Circular shall be entitled to epidemic control allowance, calculated based on actual participation days as follows:

b) Rate of 30,000 VND/day/person applicable for other types of diseases.

2. Regime of 24/24 hours standing by allowance for epidemic control.

b) The rate of 30,000 VND per day per person applies to other types of services.

2. The 24/7 epidemic control duty allowance system;

a) Allowance level: Civil servants and public officials participating in continuous anti-epidemic duty 24/7 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 enjoy a duty allowance of VND 40,000/person/session. The allowance for continuous duty on standard weekly rest days (Saturday, Sunday) is 1.3 times the regular duty allowance; if on holidays or Tet, the allowance is 1.8 times the regular duty allowance.

b) Compensatory leave: Civil servants, public officials in the medical sector, and military forces performing continuous anti-epidemic duty 24/7 on regular working days or weekly rest days shall be granted one day off; if on holidays or Tet, they shall be granted two days off and shall receive full pay.

III. SUBSIDY REGIME FOR SURGERIES AND PROCEDURES

Civil servants and public officials in the medical sector directly performing surgeries and procedures as stipulated in point 3, Section A of this Circular shall enjoy allowances as follows:

1. Surgery Subsidy Level:

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

- For surgery categories IA, IB, and IC, the surgery type I allowance as prescribed above shall be enjoyed;

- For surgery categories IIA, IIB, and IIC, the surgery type II allowance as prescribed above shall be enjoyed.

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, a third of the surgery allowance of the same category shall be enjoyed.

b) The Ministry of Health shall specify the list of procedures that shall enjoy a third of the surgery allowance of the same category.

C. SOURCE OF FUNDS FOR PAYING ALLOWANCES

1. The funds for implementing special allowances of the healthcare sector shall be allocated from the annual state budget estimates assigned to ministries, central agencies, localities, and the operating revenue of units.

2. For the year 2003, the principle for funding the payment of allowances shall be as follows:

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

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

2.3. As for the 24/7 duty allowance of localities:

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

- For provinces in extremely difficult mountainous regions according to Decision No. 186/2001/QD-TTg dated December 7, 2001, and the four Central Highlands provinces according to Decision No. 168/2001/QD-TTg dated October 30, 2001, of 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 system for communes under Program 135.

+ 80% of the funds for implementing the allowance system 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 system for healthcare facilities in provinces, districts, and communes not covered by the aforementioned provisions.

The central budget support funds at the aforementioned ratio shall be determined based on the difference between the total actual expenditure under the regime stipulated in Decision No. 155/2003/QĐ-TTg dated July 30, 2003 of the Government Prime Minister compared to the additional sources allocated in the local budget when implementing Circular Joint No. 150/LB-TT dated April 16, 1996 of the Government Cadres and Civil Servants Organizing Board - Ministry of Health - Ministry of Finance guiding Decision No. 794/TTg dated December 5, 1994 of the Government Prime Minister.

D. IMPLEMENTATION ORGANIZATION

This joint circular takes effect fifteen days after its publication in the Official Gazette and replaces Circular No. 150/LB-TT dated April 16, 1996 of the Joint Ministries: Government Cadres and Civil Servants Organizing Board (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 the epidemic prevention allowance at Circular No. 80/2001/TTLT-BTCCBCP-BTC-BYT dated December 5, 2002 of the Joint Ministries: Government Cadres and Civil Servants Organizing Board - Ministry of Finance - Ministry of Health guiding the implementation of certain special allowances for civil servants and employees in the health sector. All previous provisions contrary to this Circular are hereby abolished.

The Health Departments, Finance and Price Departments, and the Organization Boards of the provincial and centrally-administered city governments 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./.