Joint Circular No. 10/2014/TTLT-BYT-BNV-BTC-BLDTBXH guiding the implementation of certain provisions of Decision No. 73/2011/QD-TTg dated December 28, 2011 of the Prime Minister on special allowances for civil servants, public officials, and workers in public health facilities and anti-epidemic allowances.

JOINT CIRCULAR

Guidelines for Implementing Certain Provisions of Article 24Decision number 73/2011/QD-No.g

 December 28, 2011 of Tthe Prime Minister CGovernment on the regulation

 of certain special allowances for civil servants, public officials, and workers

 in public health facilities and anti-epidemic allowances

________________________________________

This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

Pursuant to Decree No. 61/2012/NĐ-CP dated August 10, 2012, promulgated by the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Home Affairs;

Pursuant to Decree No. 215/2013/NĐ-CP dated December 23, 2013, promulgated by the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Finance;

Pursuant to Decree No. 106/2012/NĐ-CP dated December 20, 2012, of the Government, stipulating the functions, tasks, powers, and organizational structure of the Ministry of Labor, Invalids, and Social Affairs;

Pursuant to Decree No. 85/2012/NĐ-CP dated October 15, 2012 of the Government on the operational mechanism and financial mechanism for public health service units and prices of medical examination and treatment services at public medical examination and treatment facilities;

Pursuant to Decision No. 73/2011/QĐ-TTg dated December 28, 2011 of the Prime Minister on the regulation of certain special allowances for civil servants, public officials, and workers in public health facilities and anti-epidemic allowances;

After receiving the agreement of the Ministry of National Defense through Circular No. 1795/BQP-CT dated June 22, 2012 and Circular No. 2841/BQP-TC dated April 22, 2013;

The Ministers of Health, Home Affairs, Finance, and Labour - Invalids and Social Affairs hereby issue this Joint Circular guiding the implementation of certain provisions of Decision No. 73/2011/QĐ-TTg dated December 28, 2011 of the Prime Minister on the regulation of certain special allowances for civil servants, public officials, and workers in public health facilities and anti-epidemic allowances.

Article 1. Staffing levels during shifts

The staffing levels during shifts stipulated in Clause 2, Article 2 of Decision No. 73/2011/QĐ-TTg dated December 28, 2011 of the Prime Minister on the regulation of certain special allowances for civil servants, public officials, and workers in public health facilities and anti-epidemic allowances (hereinafter referred to as Decision No. 73/2011/QĐ-TTg) shall be guided as follows:

1. For medical examination and treatment facilities that are hospitals (including military-civilian hospitals), district health centers, and township health centers that perform both medical examination and treatment and preventive health functions (hereinafter referred to as district health centers): apply the staffing levels during shifts stipulated in Point a, Clause 2, Article 2 of Decision No. 73/2011/QĐ-TTg.

2. For multi-disciplinary clinics in regions and maternity homes:

a) In cases where multi-disciplinary clinics or maternity homes are under the Department of Health: apply the staffing levels during shifts stipulated in Clause 5 of this Article;

b) In cases where multi-disciplinary clinics in regions or maternity homes are under hospitals or district health centers: the staffing levels during shifts shall be calculated jointly for the total number of hospital beds in the hospital or district health center and the number of beds in the multi-disciplinary clinics in regions or maternity homes under their jurisdiction.

The Director of the hospital or the Director of the district health center shall decide the staffing levels during shifts for each multi-disciplinary clinic in regions or maternity homes under their management based on the principle of ensuring sufficient staff for professional activities and being consistent with the financial resources of the unit.

3. For medical facilities established according to the regulations on administrative violations and rehabilitation centers for war invalids, disabled veterans, and persons with disabilities:

a) Class I facility: maximum not exceeding 24 people per shift;

b) Class II facility: maximum not exceeding 16 people per shift;

c) Class III facility: maximum not exceeding 10 people per shift.

4. For commune health stations, town health stations, urban health stations, and military-civilian health stations (hereinafter referred to as commune health stations): apply the staffing levels during shifts stipulated in Point b, Clause 2, Article 2 of Decision No. 73/2011/QĐ-TTg.

 The Department of Health shall specify the staffing levels during shifts for each commune health station managed by the locality based on criteria such as professional capacity, average number of medical examinations and treatments per day for each commune health station; distance from the commune health station to higher-level medical examination and treatment facilities; geographical and natural conditions; and local budgetary capacity.

In cases where there are patients requiring emergency care during shifts, it is necessary to have medical personnel accompany them to higher-level facilities or in cases where incidents occur leading to insufficient staffing levels to meet professional requirements, the Head of the Commune Health Station may decide to assign additional personnel to work overtime and pay night and overtime wages in accordance with the law.

5. For infirmaries and military-civilian clinics, the staffing levels during shifts shall be applied as follows:

a) Scale below 10 beds: 2 people per shift;

b) Scale from 10 beds to less than 20 beds: 3 people per shift;

c) Scale 20 beds and above: 5 people per shift.

6. For medical examination and treatment facilities not falling within any of the cases stipulated in Clauses 1, 2, 3, 4, and 5 of this Article: apply the staffing levels during shifts for Class IV hospitals and unranked hospitals stipulated in Point a, Clause 2, Article 2 of Decision No. 73/2011/QĐ-TTg.

Article 2. The level of allowances for medical establishments established in accordance with the laws on administrative violations and rehabilitation centers for war invalids, disabled veterans, and persons with disabilities.

1. The daily allowance levels during regular working days include the following rates:

a) The allowance rate for regular duty at ordinary areas:

- 90,000 VND per person per shift for facilities ranked Class I;

- 65,000 VND per person per shift for facilities ranked Class II and Class III.

b) The allowance rate for regular duty at areas treating acute conditions, detoxification, and recovery or isolation areas for infectious diseases is 1.5 times the rate specified in Point a of this Clause.

2. The allowance rate for regular duty on standard weekly rest days, holidays, and the meal support rate during 24-hour shifts shall be implemented according to the provisions of Clause 3, Article 3 of Decision No. 73/2011/QĐ-TTg.

Article 3. Allowance system for epidemic prevention for those directly involved in diagnosis and treatment at infectious disease medical establishments.

1. Those directly involved in diagnosing and treating infectious disease patients at infectious disease medical establishments shall receive epidemic prevention allowances at the rates stipulated in Clause 1, Article 3 of Decision No. 73/2011/QĐ-TTg.

2. The list of Group B infectious diseases for which those directly involved in diagnosing and treating at infectious disease medical establishments are entitled to epidemic prevention allowances is set out in Appendix 1 attached to this Circular.

Based on actual circumstances, the severity and complexity of the epidemic, the Minister of Health shall consider and decide specifically on the list of additional Group B infectious diseases outside the list provided in Appendix 1 attached to this Circular and the list of Group C infectious diseases as prescribed in Article 3 of the Law on Prevention and Control of Infectious Diseases, for which those directly involved in diagnosing and treating at infectious disease medical establishments are entitled to epidemic prevention allowances under this Circular.

3. Infectious disease medical establishments include specialized infectious disease hospitals; infectious disease departments within district, county, town, provincial city general hospitals and other healthcare facilities tasked with diagnosing and treating infectious diseases, decided by the Anti-Epidemic Command at all levels to mobilize in case of an epidemic.

4. The duration of entitlement to epidemic prevention allowances is the actual number of days spent diagnosing and treating infectious disease patients as specified in Appendix 1 attached to this Circular at infectious disease medical establishments, from the date the competent authority announces the epidemic until it declares the end of the epidemic.

Article 4. Structure of costs for special allowances included in the price of medical services.

1. Costs for regular duty allowances (excluding regular duty allowances for commune health stations) are included in bed day costs, with the cost added to the bed day price according to each hospital category as follows:

a) Special class and Class I hospitals: maximum 20,000 VND;

b) Class II hospitals: maximum 15,000 VND;

c) Class III hospitals: maximum 11,000 VND;

d) Class IV hospitals and unranked medical establishments (excluding commune health stations): maximum 10,000 VND;

Example 1: Hospital A is a Class I hospital, the bed day price determined by the competent authority before incorporating the cost of regular duty allowances was 55,000 VND. If the competent authority decides that the cost of regular duty allowances for Class I beds is added to the price at 18,000 VND, then the hospital can charge patients or settle with the Social Insurance Agency at a bed day price of 55,000 VND + 18,000 VND = 73,000 VND.

2. Costs for surgical and procedural allowances are included in the costs of individual surgeries and procedures, with the cost added to the price of each surgery and procedure as follows:

a) Special category surgeries: maximum 1,520,000 VND per case;

b) Category I surgeries: maximum 660,000 VND per case;

c) Category II surgeries: maximum 340,000 VND per case;

d) Category III surgeries: maximum 190,000 VND per case;

đ) Special category procedures: maximum 300,000 VND per case;

e) Category I procedures: maximum 144,000 VND per case;

g) Category II procedures: maximum 63,000 VND per case;

h) Category III procedures: maximum 28,500 VND per case;

Example 2: Surgery A, according to the Ministry of Health's classification, is Category I. The price of this surgery determined by the competent authority before incorporating the cost of surgical and procedural allowances was 3,500,000 VND.

If the competent authority decides that the cost of surgical allowances for Category I surgeries is added to the price at 600,000 VND, then the hospital can charge patients or settle with the Social Insurance Agency at a price of 3,500,000 VND + 600,000 VND = 4,100,000 VND.

3. Authority to decide on the inclusion of regular duty allowances, surgical and procedural allowances into the price of medical services:

a) For medical establishments under the Ministry of Health's management: decided by the Minister of Health;

b) For medical establishments under the management of other Ministries, agencies equivalent to Ministries, and government agencies: implemented according to Circular No. 04/2013/TT-BYT dated January 21, 2013, of the Ministry of Health guiding the approval and application of service prices managed by other ministries and sectors;

c) For medical establishments under local management: the Department of Health shall take the lead and coordinate with the Department of Finance to submit to the People's Committee of the province for consideration and decision in accordance with Point i, Clause 4, Article 8 of Decree No. 177/2013/NĐ-CP dated November 14, 2013, of the Government detailing and guiding the implementation of certain articles of the Law on Prices.

Article 5. Source of funds for implementation

1. The funding for the epidemic prevention allowance system stipulated in Article 3 of Decision No. 73/2011/QĐ-TTg, Article 3 of this Circular, and the funding for the regular duty allowance system at commune health stations stipulated in Article 1 of Decision No. 73/2011/QĐ-TTg shall be guaranteed by the state budget, incorporated, compiled, allocated, and assigned in the annual budget estimate for units in accordance with the State Budget Law and guiding documents thereof.

2. The funds for paying the special allowance regime specified in Clause 3, Article 1 of this Circular shall be guaranteed by the state budget according to the current budget management hierarchy and other lawful sources of revenue (if any).

3. The funds for paying the regular allowance regime, surgical allowance regime, and procedural allowance regime for medical examination and treatment services provided on demand and socialized services shall be ensured by the medical examination and treatment facilities from the revenue generated by these services and techniques.

4. Medical examination and treatment facilities may proactively utilize their revenue and self-managed budget estimates to pay the regular allowance regime, surgical allowance regime, and procedural allowance regime as stipulated in Clause 1, Article 6 of Decision No. 73/2011/QĐ-TTg. In cases where medical examination and treatment facilities have not been authorized by competent authorities to include the regular allowance regime, surgical allowance regime, and procedural allowance regime in the price of medical examination and treatment services (or have not been fully included) as prescribed in Article 4 of this Circular, after utilizing their revenue and self-managed budget estimates but still failing to ensure sufficient resources to implement the allowance regimes as prescribed in Article 2 and Article 4 of Decision No. 73/2011/QĐ-TTg, additional funding shall be supplemented from the state budget according to the current budget hierarchy.

Article 6. Transitional Provisions

1. During the period when the regular allowance and surgical/procedural allowance have not been included in the price of healthcare services: the source of funds for paying the increased regular allowance and surgical/procedural allowance between Decision No. 73/2011/QĐ-TTg and Decision No. 155/2003/QĐ-TTg dated July 30, 2003 of the Prime Minister regarding amendments and supplements to certain special allowances for civil servants and employees in the health sector (hereinafter referred to as Decision No. 155/2003/QĐ-TTg) shall be handled as follows: The Prime Minister's Decision No. 155/2003/QĐ-TTg concerning amendments and supplements to certain special allowances for civil servants and employees in the health sector (hereinafter referred to as Decision No. 155/2003/QĐ-TTg) is hereby regulated as follows:

a) Medical examination and treatment facilities directly responsible for paying salaries to workers shall prepare reports on additional funding requirements according to Appendix 2 attached to this Circular and submit them to higher-level management agencies;

b) Higher-level management agencies shall review and consolidate the information according to Appendices 3, 4, and 5 attached to this Circular submitted by subordinate units and send it to the financial agency at the same level for verification;

c) People's Committees of provinces, Ministries, agencies equivalent to Ministries, and government agencies shall consolidate and prepare reports according to Appendices 3, 4, and 5 attached to this Circular and submit them to the Ministry of Finance for consideration and resolution in accordance with regulations.

2. The period for implementing the payment of the increased regular allowance and surgical/procedural allowance between Decision No. 73/2011/QĐ-TTg and Decision No. 155/2003/QĐ-TTg shall be calculated as follows:

a) In 2012: The increased regular allowance and surgical/procedural allowance shall be calculated from February 15, 2012 to December 31, 2012;

b) In 2013: The increased regular allowance and surgical/procedural allowance shall be calculated from January 1, 2013 to December 31, 2013;

c) In 2014: The increased regular allowance and surgical/procedural allowance shall be calculated from January 1, 2014 until the date when the competent authority stipulated in Clause 3, Article 4 of this Circular decides to include the regular allowance and surgical/procedural allowance in the price of medical examination and treatment services.

Article 7. Effective Date

1. This Circular takes effect from May 5, 2014.

Joint Circular No. 09/2003/TTLT-BYT-BNV-BTC dated September 29, 2003 of the Joint Circular of the Ministry of Health, the Ministry of Home Affairs, and the Ministry of Finance guiding the implementation of Prime Minister's Decision No. 155/2003/QĐ-TTg dated July 30, 2003 concerning special preferential allowances for staff working in state-owned healthcare facilities and Joint Circular No. 18/2004/TTLT-BLĐTBXH-BYT-BTC dated November 22, 2004 of the Ministry of Labor, Invalids and Social Affairs, the Ministry of Health, and the Ministry of Finance guiding the implementation of certain special regimes for staff working in medical treatment facilities established under the Administrative Violation Handling Ordinance shall cease to be effective from the date this Joint Circular takes effect.

2. The special allowances prescribed in this Joint Circular shall be calculated from February 15, 2012.

Any issues arising during implementation should be reported to the relevant ministries for study and resolution.