JOINT CIRCULAR No. 22/TT-LB ON AMENDING THE EXPENSE REGIME FOR MEDICAL EXPERTISE WORK

JOINT CIRCULAR

On Amending the Indicators for Medical Examination and Appraisal Work

To be in line with the current price situation, the Ministry of Health and the Ministry of Finance amend the expenditure indicators for medical examination and appraisal work and the remuneration for part-time staff involved in such work as follows:

I. DETERMINATION OF EXPENSES FOR ONE MEDICAL EXAMINATION AND APPRAISAL SESSION

1. The subjects to be examined:

- State employees who have lost their ability to work due to occupational accidents, occupational diseases, war injuries, or war-related illnesses shall be examined and have their disability rate assessed by the Medical Examination and Appraisal Board.

- Members of cooperatives in small-scale industries who have lost their ability to work or suffer from occupational diseases and need to be examined shall be referred to the Medical Examination and Appraisal Board by their cooperatives.

2. The average expenditure for one medical examination and appraisal session for the aforementioned subjects is set at 25 dong per person per session, covering expenses related to the examination process such as:

a) Expenses for X-ray photography, including film costs; chemical processing and testing chemicals will be included in the bed cost standard.

b) Office supplies, postal fees, examination record books, printing of examination documents such as medical records, examination reports, test results, etc.

c) Drinking water, newspapers for the examinees, soap for the examiners.

d) Remuneration for part-time examiners and policy committee members (specifically detailed in Part III below).

II. OTHER EXPENSES

(Not included in the medical examination and appraisal expense standard) include:

1. Salaries, allowances, and subsidies for full-time staff working in medical examination and appraisal units under district health departments, county health departments, provincial health departments, or hospitals at the district, county, regional, provincial, and central special zone levels. These expenses are determined based on approved staffing levels and are provided outside the average bed cost standard.

2. Travel expenses, training fees for medical examination and appraisal work, procurement and maintenance costs for equipment and facilities serving the medical examination and appraisal process, which must be budgeted annually and provided outside the average bed cost standard.

III. MONTHLY REMUNERATION FOR PART-TIME STAFF INVOLVED IN MEDICAL EXAMINATION AND APPRAISAL WORK

A. ELIGIBLE PERSONNEL INCLUDE:

1. Medical professionals:

a) Medical professionals within the staffing of district health departments, provincial health departments, district, county, provincial, and central special zone hospitals, and regional clinics, who, in addition to their regular duties, also perform part-time medical examination and appraisal tasks such as chairing and vice-chairing examination boards directly examining patients in internal medicine, surgery, otolaryngology, ophthalmology, radiology, psychiatry, neurology, occupational diseases, etc., as well as radiographers and laboratory technicians.

b) Regarding the remuneration standards: There are three levels:

- Level 5 standard applies to examination boards conducting less than 1,000 examinations per year, including 3 standards for mid-to-senior level medical professionals and 2 standards for technicians.

- Level 8 standard applies to examination boards conducting between 1,000 and 3,000 examinations per year, including 5 standards for mid-to-senior level medical professionals and 3 standards for technicians.

- Level 11 standard applies to examination boards conducting between 3,000 and 5,000 examinations per year, including 1 standard for mid-to-senior level medical professionals and 4 standards for technicians.

In cases where the number of examinations exceeds 5,000 per year, an additional standard will be added for every 1,000 examinations, but not exceeding 14 standards.

2. Personnel from other sectors serving as policy committee members:

Staff from the Veterans Affairs, Trade Union, and Labor sectors who regularly participate in meetings and examinations of the Provincial and Municipal Medical Examination and Appraisal Boards.

B. REMUNERATION LEVELS

1. For senior doctors and pharmacists performing part-time duties: 40 dong per person per month.

2. For the Chair, Vice-Chair of the Board, and policy committee members: 40 dong per person per month.

3. For mid-level medical assistants, pharmacists, nurses, and technicians performing part-time duties: 25 dong per person per month.

4. For junior nurses and technicians performing part-time duties: 20 dong per person per month.

This remuneration includes an additional percentage allowance for living cost differences according to the region as stipulated in Decision No. 86-CT dated April 4, 1986, issued by the Council of Ministers, and is paid monthly to eligible personnel.

IV. FEES FOR MEDICAL EXAMINATION AND APPRAISAL

To create additional funding for medical examination and appraisal work, the Ministries temporarily set the fee for medical examination and appraisal as follows:

1. State employees who have lost their ability to work due to occupational accidents or diseases, when referred by their agencies or enterprises for initial examination and assessment by the Medical Examination and Appraisal Board, must pay a fee of 25 dong per person per session. This fee is deducted from pre-distribution profits before allocation to enterprise funds (for production and business units) or settled in the social welfare budget item (for administrative and public service units).

2. Cooperative members in small-scale industries who have lost their ability to work or suffered occupational accidents or diseases, when referred by their cooperatives for examination and assessment by the Medical Examination and Appraisal Board, must pay a fee of 25 dong per person per session. This fee is covered by the cooperative.

V. DISTRIBUTION AND MANAGEMENT OF EXPENSES FOR MEDICAL EXAMINATION AND APPRAISAL WORK

1. For Medical Examination and Appraisal Boards attached to hospitals, all examination fees are collected by the hospital, and all expenses for the examination process as outlined in Parts I and II are managed, budgeted, and settled separately by the hospital, subject to supervision by the provincial health department.

For Medical Examination and Appraisal Boards under the district health department or provincial health department, examination fees are collected by the district health department or provincial health department, and the entire income and expenditure of these fees are budgeted and settled separately.

2. Based on the appraisal plan, budget allocation, and fee collection rates..., the Medical Appraisal Board at the district, county, or region level (where such boards have been established) in provinces, cities, and centrally-administered special economic zones must prepare quarterly and annual revenue and expenditure forecasts to be submitted to hospitals for consolidation with hospital budgets, which will then be sent to the Department of Health and the Department of Finance for approval of funding.

3. The financial authority shall allocate funds quarterly to hospitals or to the Medical Appraisal Boards based on approved revenue and expenditure budgets for medical appraisals to ensure sufficient funding for appraisal activities.

4. Revenue from medical appraisal fees collected by district and county hospitals (where district and county Medical Appraisal Boards have been established) and provincial, city, and centrally-administered special economic zone hospitals (linked to these hospitals) or by Medical Appraisal Boards under the Health Office and the Department of Health shall be retained and deducted from the annual allocated budget (the state budget only covers the difference) to supplement the expenditure for this work. Hospitals and Medical Appraisal Boards must maintain accounts and records strictly according to current regulations and policies and within approved expenditure limits.

VI. IMPLEMENTATION PROVISIONS

This Circular takes effect from October 1, 1986, and all previous documents that conflict with this Circular are hereby abolished.