Joint Circular No. 13 TT/LB guiding the implementation of Decision No. 72/CT dated March 25, 1986, of the Chairman of the Council of Ministers on the allowance for medicine and food for patients at state healthcare facilities.

JOINT CIRCULAR

GUIDELINES FOR IMPLEMENTING RESOLUTION NO. 72/CT OF MARCH 25, 1986 ISSUED BY THE CHAIRMAN OF THE COUNCIL OF MINISTERS ON THE SUBSIDY SYSTEM FOR MEDICINE AND FOOD FOR PATIENTS AT STATE HEALTH FACILITIES.

PART I -
SUBSIDY FOR MEDICINE IN REGULAR CLINICAL CARE

1.-The level of expenditure on medicine for regular clinical care for those eligible for medicine subsidies.

a) The beneficiaries of the regular medicine subsidy: 60đ/person, including:

- State employees and those working under long-term contracts

- Retired state employees and military personnel who have ceased work due to loss of labor capacity; war invalids and disabled veterans receiving monthly pension or disability allowance

- Cadres engaged in revolutionary activities before August 1945 receiving monthly living expenses;

- Labor heroes and incumbent members of the National Assembly not receiving monthly salary or living expenses;

- State employees studying at universities, colleges, secondary schools, vocational schools, and technical training centers

The above-mentioned expenditure on medicine includes: common medicines, gynecological medicines, chronic disease medicines, and occupational disease medicines divided as follows:

+) For purchase of emergency and regular medical supplies at health stations within enterprises, factories, and schools: 24đ/person/year

+) The remaining amount of 44đ/person/year is transferred to outpatient clinics (both within and outside central and local hospitals, and hospital sectors) to cover the cost of medicine for the aforementioned beneficiaries.

- Organizations without their own health facilities and with fewer than 68đ worth of staff can transfer this amount to outpatient departments of hospitals for medicine distribution.

b) For students at universities, colleges, secondary schools, vocational schools, and technical training centers, 18đ/student/year is reserved by school health stations for medicine management and distribution.

c) Ethnic minorities in mountainous areas and people involved in land reclamation and economic development in the first three years receive 12đ/person/year from the village budget for common and emergency medicine provided by village health stations.

d) Beneficiaries of a 3đ/subsidy per visit for medicine include:

- Village-level cadres and mass organizations' staff receiving monthly living expenses

- Those contributing to the revolution and receiving monthly allowances

- Elderly parents and children under 18 years old of state employees, officers, and professional soldiers who are retired or deceased.

- Parents, spouses, and children under 18 years old of martyrs receiving monthly allowances.

- People affected by epidemics, natural disasters, and calamities;

- Disabled individuals, orphaned children without support, and those facing special difficulties in life recognized by local authorities.

- Beneficiaries mentioned in points b and c above, when sick and referred to regional outpatient clinics and hospital outpatient clinics, also receive regular medicine according to a 3đ/subsidy per visit.

e) Special outpatient clinics of central hospitals and specialized institutes, responsible for treating patients beyond the capacity of lower levels, are allocated a budget of 5đ/subsidy per visit for medicine for those eligible for state medicine subsidies.

h) For those suffering from social diseases and implementing planned births, if referred to outpatient clinics of provincial, municipal, and central specialized hospitals, they receive medicine according to the treatment regimen specified by the Ministry of Health, averaging 1đ/day; specifically, tuberculosis medicine averages 2đ - 3đ/day.

2.-Allocation and use of medicine funds:

a) Enterprises, schools, etc., based on the number of employees and students annually, prepare budgets for regular medicine expenses according to the rates stipulated in point a and b of item 1 above, and submit them to higher financial authorities if they are administrative or public service units, or incorporate them into production costs or circulation fees if they are business units.

- Quarterly, enterprises, schools transfer 11đ or 17đ/quarter (if there is no health organization) to hospital outpatient clinics.

b) Veterans and social welfare agencies, based on the number of beneficiaries of the 68đ/year regular medicine subsidy, transfer 17đ/quarter to outpatient clinics for medicine distribution to those seeking treatment.

c) Outpatient clinics must settle accounts quarterly with units that have paid the money. If a unit fails to pay, it will not be supplied with medicine but only allowed to receive treatment.

d) The health sector prepares quarterly budgets for medicine for the groups specified in point d, e, h of item 1 part I above and sends them to the finance department for review, consideration, and allocation outside the annual average bed cost standard.

e) Those specified in item 1 part I above, if hospitalized due to illness, are exempt from paying for medicine and other medical services: only the daily food cost as stipulated in part II below.

3.-Patients not included in the group specified in item 1 part I, when seeking medical care at state health facilities, are exempt from payment for medical services but must pay for food and medicine; specifically:

- They are allowed to seek medical advice and obtain prescriptions for medicine to purchase and use

- For inpatient treatment: pay for daily food and medicine, including: oral medication, injections, blood, intravenous fluids, and X-ray films

The revenue collected here is retained by the hospital to supplement the unit's budget to serve patients.

PART II-
AMOUNT OF FOOD MONEY AND CONTRIBUTION LEVELS OF PATIENTS

1.- For current employees, retired employees, and those who have ceased working and lost their ability to work:

The following cases shall apply the food money and contribution levels as follows:

a) Apply the first food level in the table for:

- Village and ward officials and village and ward health workers receiving monthly living expenses: pay 30% of the hospital food cost.

- War invalids and disabled veterans ranked: pay 20% of the hospital food cost

b) Apply the second food level in the table for:

- Officials who participated in the revolution before August 1945 and receive monthly allowances: pay 30% of the hospital food cost

- Current labor heroes and National Assembly deputies not receiving salaries or living expenses: pay 20% of the hospital food cost

c) For patients requiring special dietary treatment:

- For seriously ill patients and post-operative patients (major surgery), higher food levels than the normal food level according to salary in the above table shall be applied, decided by the department head (for central hospitals) and the hospital director (for local hospitals and sector hospitals).

- In cases where patients need to be fed under special conditions, higher food levels may be applied, decided by the hospital director.

Patients applying special dietary treatment only need to pay the food cost as specified in the table above.

2.- For civilians and children:

Civilians and children treated at hospitals shall apply a food level of 8 - 10đ/day; if patients request food above this level and pay the additional cost themselves, hospitals will provide service based on their capacity, and patients will pay the full food cost according to the service provided.

The following patients only need to pay 30% of the 8 - 10đ/day food cost:

+) Elderly parents and those under 18 years old (first and second child) of civil servants, officers, and professional soldiers currently employed, retired, or deceased

+) Students of universities, colleges, high schools, vocational schools, and technical training schools.

The following patients only need to pay 20% of the 8 - 10đ/day food cost:

+) Those who have contributed to the revolution and receive monthly allowances

+) Parents, spouses, and children under 18 years old of martyrs receiving monthly allowances

+) Ethnic minorities in mountainous and border regions as decided by Decision No. 156/CP dated October 7, 1960 of the Council of Ministers

+) People clearing land and building new economic zones for the first three years as decided by Decision No. 95/CP dated March 27, 1980 and Decision No. 254/CP dated June 16, 1981 of the Council of Ministers

The following patients, if confirmed by the commune or ward authorities, can eat at a level of 8 - 10đ/day and are exempt from paying the food cost:

+) Those injured by natural disasters or epidemics

+) Disabled individuals and orphaned children without support

+) Individuals facing exceptional difficulties in life

+) Patients with social diseases such as tuberculosis, mental illness, leprosy, if hospitalized from the second month onwards, do not need to pay the food cost.

3.- Food money regulations:

a) To align with the cost of living in each region, based on the food levels for officials and civilians as stipulated above, the People's Committees of each locality will decide specifically on a unified food level for officials according to their salary grade and a food level for civilians hospitalized at hospitals, maternity houses, and primary health care centers with beds. For medical facilities under the Ministry of Health and other General Departments, specific regulations will be made by the Ministry of Health and relevant Ministries and General Departments.

The unified food level decided by the People's Committee and Ministries and General Departments serves as the basis for paying or being exempt from paying food costs according to the ratios already stipulated.

b) The food money and contribution levels stipulated above will be supplemented by the increase in the price subsidy difference according to the region issued by the Chairman of the Council of Ministers (if applicable) compared to the levels prescribed in Decision No. 86/CT dated April 4, 1980 of the Chairman of the Council of Ministers.

4.- Patients staying at hospitals, convalescent homes, maternity houses, and primary health care centers with beds must submit rice according to the prescribed standard, and the hospital will refund the amount of rice submitted according to the stable price directive of the State at each location to the patient.

If patients do not eat at these treatment and convalescence facilities, they will not be reimbursed for food subsidies.

PART III-
IMPLEMENTING PROVISIONS

This Circular shall take effect from July 1, 1986. All previous provisions that conflict with Decision No. 72/CT dated March 13, 1986 of the Chairman of the Council of Ministers and the provisions set forth in this Circular shall be abolished.

Place of Receipt:

- Ministry of Finance (2b)

- Ministry of Health (2b)

- Archive 2 copies (2b)

- Central Office: 1 copy (2b)

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