Circular No. 26/2005/TT-BTC guiding the management, use, and settlement of funds for medical examination and treatment for children under six years old without payment at public health facilities

 CIRCULAR

Guidelines for managing, using, and settling accounts for medical examination and treatment expenses for children under six years old without payment providing medical treatment for children under six years of age without charge at public health facilities

Pursuant to Decree No. 60/2003/NĐ-CP dated June 6, 2003 of the Government detailing and guiding the implementation of the Law on State Budget;

Pursuant to Article 18 of Decree No. 36/2005/NĐ-CP dated March 17, 2005 of the Government detailing implementation of certain provisions of the Law on Protection, Care, and Education of Children,

The Ministry of Finance issues guidelines for managing, using, and settling accounts for medical examination and treatment expenses for children under six years old without payment at public health facilities as follows:

This technical regulation sets out technical requirements, testing methods, sampling procedures; management requirements; responsibilities of organizations and individuals producing, trading, and importing cigarettes.

1. Units directly responsible for managing, using, and settling accounts for medical examination and treatment expenses for children under six years old without payment as stipulated in this Circular include public health facilities under the Ministry of Health, central ministries, agencies, and units, and localities.

2. Medical examination and treatment expenses for children under six years old without payment are allocated from the central government budget to implement medical examinations and treatments for children under six years old at public health facilities under central ministries, agencies, and units; from the provincial budget to implement medical examinations and treatments for children under six years old at local public health facilities. For provinces with difficulties, the central government will provide support according to the State Budget Law to ensure medical examination and treatment expenses for children under six years old.

3. Public health facilities shall record and settle accounts for medical examination and treatment expenses for children under six years old in the following categories, subcategories, and sub-subcategories:

- Category 15: Healthcare and social activities.

- Subcategory 60: Activities for medical examinations and treatments for children under six years old pursuant to the Law on Protection, Care, and Education of Children.

- Corresponding sub-subcategories according to the current State Budget Classification.

4. Public health facilities may open accounts at the State Treasury for transactions related to state budget funds allocated for medical examinations and treatments for children under six years old, and open accounts at banks for transactions related to fundraising from domestic and foreign organizations and individuals supporting medical examinations and treatments for children under six years old. At year-end, any unspent funds from these sources shall be carried forward for continued use and serve as a basis for balancing the budget for medical examinations and treatments for children under six years old in the following year; such funds shall not be used for other purposes.

5. In addition to state budget funds, public health facilities may mobilize financial support from domestic and foreign organizations and individuals for medical treatments of seriously ill children under six years old.

II. SPECIFIC PROVISIONS

1. Preparation and allocation of the budget for medical examinations and treatments for children under six years old

1.1. For central ministries, agencies, and units:

a) Annually, during the time specified for preparing the state budget, the Ministry of Health shall take the lead and coordinate with central ministries, agencies, and units with public health facilities under their management to prepare the budget for medical examinations and treatments for children under six years old to submit to the Ministry of Finance for consolidation and submission to the competent authority for decision-making. The bases for preparing the budget include:

- Expenses for medical examinations and treatments for children under six years old in the previous year at public health facilities under the management of central ministries, agencies, and units.

- Remaining funds from the previous year's budget for medical examinations and treatments for children under six years old (if any).

The Ministry of Finance shall discuss with central ministries, agencies, and units to agree on the budget for medical examinations and treatments for children under six years old and consolidate it into the state budget, and the plan for allocating the central budget shall be reported to the Prime Minister for submission to the National Assembly for decision-making.

b) Based on the allocated state budget for medical examinations and treatments for children under six years old, the Ministers and Heads of central ministries, agencies, and units shall be responsible for allocating the budget to subordinate public health facilities according to the specific categories and subcategories stipulated in Point 3, Part I of this Circular, and consolidate it into the overall budget allocation plan of the central ministry, agency, or unit to submit to the Ministry of Finance for review in accordance with the State Budget Law.

c) During the year of implementation, the Ministers of central ministries and Heads of central agencies and units may adjust medical examination and treatment expenses for children under six years old between surplus and deficit units within their management scope to ensure timely funding for medical examinations and treatments for children under six years old. The results of the adjustment shall be sent to the Ministry of Finance and the State Treasury where transactions are conducted as a basis for controlling expenditures in accordance with the State Budget Law and guiding documents.

If there is still a shortage after adjusting the budget, central ministries, agencies, and units shall issue a document to the Ministry of Finance requesting consideration and decision to supplement from the central budget reserve to ensure sufficient and timely funding for medical examinations and treatments for children under six years old.

Based on the supplementary budget decision, central ministries, agencies, and units shall allocate and notify the supplementary budget to public health facilities that lack medical examination and treatment expenses for children under six years old, and send it to the Ministry of Finance and the State Treasury where transactions are conducted as a basis for controlling expenditures in accordance with regulations.

1.2. For localities:

a) Annually, during the time specified for preparing the state budget, the Department of Health shall take the lead and coordinate with relevant agencies to prepare the budget for medical examinations and treatments for children under six years old in the locality to submit to the Department of Finance for consolidation and reporting to the People's Committee of the province for decision-making in accordance with the State Budget Law and guiding documents. The bases for preparing the budget include:

- The number of children under six years old in the locality provided by the Provincial Population, Family, and Child Commission.

- Expenses for medical examinations and treatments for children under six years old in the previous year at public health facilities under the management of the locality.

- Remaining funds from the previous year's budget for medical examinations and treatments for children under six years old (if any).

b) Based on the budget estimate for medical examination and treatment for children under six years old allocated to it, the Department of Health shall be responsible for allocating to public health facilities within the locality according to the types and items specified in point 3, Section I of this Circular, and send it to the Department of Finance for review of the purpose of use and accuracy of data compared with the budget estimate decided by the Provincial People's Council. After receiving the review opinion from the Department of Finance, the Department of Health shall notify the budget estimate for expenses to public health facilities within the locality.

As for Health Stations at the commune level, based on the budget notification from the Department of Health for the District Health Office; the District Health Office shall prepare a notification of the budget for medical examination and treatment for children under six years old to be sent to the Commune People's Committee, and also sent to the Commune Health Station and the State Treasury where the Commune People's Committee conducts transactions.

c) Monthly, the Commune People's Committee shall report to the District Health Office on the situation of using the budget for medical examination and treatment for children under six years old; the District Health Office and public health facilities at the provincial and district levels shall report to the Department of Health on the implementation situation (in case of necessity, the Department of Health and the District Health Office may request health facilities and Commune People's Committees to submit ad hoc reports to serve the work of balancing funds between surplus and deficit areas). The authority to adjust is as follows:

- The District Health Office is authorized to adjust the budget between surplus and deficit areas for commune-level Health Stations in the district; in case of shortage, the District Health Office must compile and report to the Department of Health for consideration and handling.

- The Department of Health is authorized to adjust the budget between surplus and deficit areas for public health facilities at the provincial and district levels and the District Health Office to ensure timely funding for medical examination and treatment for children under six years old.

The results of adjustments to the budget estimate for medical examination and treatment for children under six years old between units shall be submitted to the Department of Finance and the State Treasury where transactions take place (in the case where the Department of Health implements the adjustment) or submitted to the State Treasury where transactions take place (in the case where the District Health Office implements the adjustment) as the basis for controlling expenditures in accordance with the provisions of the State Budget Law and guiding documents of the Law. In cases of necessity, the District Health Office and the Department of Health shall coordinate with the Treasury to verify the accuracy of the reports.

d) In case there is still a shortage after adjusting the budget, the health facility shall issue a document to the Department of Health for consideration and consolidation to be submitted to the Department of Finance for the Provincial People's Committee to decide on the use of local government reserve funds and other legitimate financial sources in accordance with regulations to ensure sufficient and timely funding for medical examination and treatment for children under six years old in the locality.

Based on the decision to supplement the budget estimate, the Department of Health shall allocate and notify the supplementary budget estimate to public health facilities that are short of funds for medical examination and treatment for children under six years old, and also send it to the Department of Finance and the State Treasury where transactions take place as the basis for controlling expenditures in accordance with regulations.

The procedure for allocating supplementary funds for medical examination and treatment for children under six years old to public health facilities that are short of funds shall be carried out in accordance with the provisions of paragraph b of this point.

2. Management and use of the budget for medical examination and treatment for children under six years old

2.1. The management, use, and settlement of the budget for medical examination and treatment for children under six years old shall be implemented in accordance with the provisions of the State Budget Law, guiding documents of the Law, and specific provisions in this Circular.

Public health facilities allocated the budget estimate for medical examination and treatment for children under six years old shall be responsible for preparing the budget estimate for medical examination and treatment for children under six years old and withdrawing the budget estimate at the State Treasury where transactions take place in accordance with Circular No. 79/2003/TT-BTC dated August 13, 2003, issued by the Ministry of Finance, guiding the management, issuance, and settlement of state budget expenditures through the State Treasury.

Public health facilities at the district level and Commune People's Committees are allowed to open accounts for withdrawing budget estimates at the State Treasury where transactions take place, using books, forms, and vouchers in accordance with regulations for units using the provincial budget (primary budget unit is the Department of Health) to receive funds, record accounting, and settle accounts separately for the budget for medical examination and treatment for children under six years old.

On the basis of the request of the Commune Health Station, the Commune Financial Board shall handle the withdrawal of the budget estimate for medical examination and treatment for children under six years old, which is approved by the Chairman of the Commune People's Committee or the person authorized to sign and sent to the State Treasury where transactions take place in accordance with regulations for units using the provincial budget (primary budget unit is the Department of Health) to transfer to the Commune Health Station to implement medical examination and treatment for children under six years old. The Commune People's Committee shall not use this fund for other purposes.

The state budget funds allocated to public health facilities to perform the task of medical examination and treatment for children under six years old are regular expenditures from the state budget. Public health facilities shall not distribute and use this fund like hospital fees.

In case public health facilities organize medical examination and treatment using high-end services and techniques upon the family's request, the public health facility may collect from the patient's family the difference between the cost of high-end services and techniques and the current hospital fee reimbursement rate. This difference can be distributed and used by public health facilities like hospital fees.

2.3. The State Treasury shall be responsible for supervising the documents and vouchers for expenditures and promptly making payments and settlements for expenditures related to medical examination and treatment for children under six years old that meet the conditions for payment according to current regulations on controlling state budget expenditures.

Relevant functional agencies in the fields of Health, Finance, Population, Family, and Children, and local People's Committees have the responsibility to regularly inspect and audit the implementation of policies and the use of the budget for medical examination and treatment for children under six years old in accordance with their assigned functions and tasks.

3. Accounting and settlement of the budget for medical examination and treatment for children under six years old

3.1. Units using funds for medical examination and treatment of children under six years old must account and settle accounts according to the current state and public institution accounting regulations and the guidance provided in this Circular.

3.2. Documents related to the expenditure of funds for medical examination and treatment of children under six years old at public health facilities shall be kept separately to serve the work of compiling and evaluating the implementation of medical examination and treatment services for children under six years old. Units are responsible for managing, using, and settling accounts for these funds in accordance with their intended purpose, correct beneficiaries, and ensuring the accuracy and legality of settlement documents.

3.3. The process of compiling and settling accounts for funds for medical examination and treatment of children under six years old:

- Public health facilities subordinate to Ministries, agencies, and units at the central level shall prepare and submit reports on the settlement of funds for medical examination and treatment of children under six years old to their supervising authorities; the supervising authorities shall be responsible for reviewing, approving, and consolidating these reports into a general report to be sent to the Ministry of Finance for review in accordance with current regulations.

- Public health facilities at the local level shall prepare and submit reports on the settlement of funds for medical examination and treatment of children under six years old to the Department of Health. For commune health stations, the People's Committee of the commune shall prepare and submit settlement reports to the District Health Office for review and consolidation, which will then be submitted to the Department of Health. The Department of Health shall be responsible for reviewing, approving, and consolidating these reports into its general settlement report to be sent to the Department of Finance for review and consolidation into the provincial budget settlement report for approval by the competent authority. Public health facilities at the district level and commune health stations shall not include funds for medical examination and treatment of children under six years old in the settlement of district and commune budgets.

Annually, Ministries, agencies, and units at the central level and localities, in addition to submitting budget settlement reports that already include funds for medical examination and treatment of children under six years old, must also submit separate reports on the implementation of medical examination and treatment services for children under six years old to the Ministry of Finance for consolidation.

- The Ministry of Finance shall be responsible for consolidating the settlement of funds for medical examination and treatment of children under six years old from Ministries, agencies, and units at the central level and localities into the national budget settlement report to be reported to the Prime Minister in accordance with current regulations.

III. IMPLEMENTATION

1. This Circular takes effect fifteen days after its publication in the Official Gazette. Previous provisions contrary to this Circular are abolished.

2. For revenues and expenditures for medical examination and treatment of children under six years old arising from January 1, 2005, which have not been recorded under Item 15, Subitem 60, they shall be adjusted according to the guidance provided in this Circular.

In 2005, Ministries, agencies, and units at the central level shall use the state budget allocation assigned to them to implement medical examination and treatment services for children under six years old. For localities that have delegated the task of funding medical examination and treatment of children under six years old to various levels of the budget, they shall retain the source of funds for implementation according to the delegation of the locality in 2005, but must ensure the source of funds for implementing the policy of medical examination and treatment for children under six years old.

3. During the implementation period, if there are any difficulties, they should promptly reflect them to the Ministry of Finance for consideration and appropriate amendments and supplements./.