JOINT CIRCULAR No. 28-TT-LB ON THE MANAGEMENT OF MEDICINE AND NUTRITION EXPENSES FOR STATE WORKERS DURING ILLNESS

JOINT CIRCULAR

Regarding the management of medical expenses for workers and officials of state agencies when sick

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Based on the social insurance regulations for workers and officials of state agencies when sick, they are entitled to be examined and treated at state health facilities, with all costs for medicines and supplementary expenses being covered by the state.

Up until now, medical expenses and supplementary expenses for workers and officials when sick have been managed by their agencies and enterprises. In cases where workers and officials are hospitalized at hospitals or clinics, their agencies and enterprises settle hospitalization fees with the hospitals or clinics.

This does not create favorable conditions for the healthcare sector to effectively utilize these funds to enhance the health protection of workers and officials and prevent waste. Moreover, settling accounts between agencies, enterprises, and hospitals or clinics also causes many unnecessary paperwork inconveniences.

Therefore, the Council of Ministers has decided to entrust the healthcare sector with managing medical expenses and supplementary expenses for workers and officials of state agencies.

To implement this resolution, after a trial period in Nam Dinh and drawing lessons learned, the Ministry of Health and the Ministry of Finance stipulate as follows:

2. Individuals who have registered as the principal investigator of a Research Project or Pilot Production Project and those participating in its implementation shall not participate in the Evaluation and Selection Council for that Research Project or Pilot Production Project (hereinafter referred to as the Council). In necessary cases, members of the Council may be staff members of the organization registering as the principal investigator of the Research Project or Pilot Production Project, but not more than one person and they cannot serve as Chairperson, Vice-Chairperson, or reviewing member.

A. FOR NON-PRODUCTION AREAS (ADMINISTRATIVE AND PUBLIC SERVICE ORGANIZATIONS):

1. Workers and officials of state agencies who are eligible for social insurance benefits, when sick, may go to examine and treat at healthcare facilities directly managed by the healthcare sector. All costs for medicines and supplementary expenses will be covered by the healthcare sector, and the agency will not need to budget for or settle these expenses with the healthcare facility.

Medical expenses for common medicines in the agency will also be managed by the healthcare sector. The healthcare sector will reasonably organize the agency's healthcare system and reorganize the examination and dispensing of medicines for workers and officials.

2. In cases where central agency workers and officials are hospitalized at local hospitals or clinics, or local agency workers and officials are hospitalized at central hospitals, or these workers and officials are hospitalized at other local hospitals or clinics, the costs for medicines and supplementary expenses will still be covered by the receiving facility, and the agency will not need to settle these expenses with the hospital.

Central agencies located in local areas, whose health care for workers and officials is managed by the local healthcare sector, will contribute to the local budget for medical expenses and supplementary expenses according to a ratio of 3.5% of the total salary fund.

3. Medical expenses and supplementary expenses for workers and officials of Party and mass organizations, kindergartens, and collective dining halls will also be covered by healthcare facilities. Financial departments will no longer subsidize these expenses to Party and mass organizations and kindergartens, but will directly allocate them to the healthcare sector. Only trade unions at various levels and collective dining halls must contribute from their union and dining hall funds to the state budget according to a ratio of 3.5% of the total salary fund.

B. FOR PRODUCTION AND BUSINESS AREAS (STATE ENTERPRISES, INDUSTRIAL, AGRICULTURAL, FORESTRY, AND FISHERY ENTERPRISES):

1. At enterprises with their own hospitals or clinics, the enterprise will continue to manage medical expenses and supplementary expenses and record them according to the provisions in Point 8 of Circular No. 115-TTg dated December 12, 1963 issued by the Prime Minister.

2. At enterprises without their own hospitals or clinics, workers and officials who are sick can go to examine and treat at healthcare facilities directly managed by the healthcare sector, with all costs for medicines and supplementary expenses being covered by the healthcare sector, except for the cost of common medicines which the enterprise will cover and record in its production costs according to the spirit of Circular No. 115-TTg dated December 12, 1963.

These funds will be allocated by the financial department to the healthcare sector for management and deducted from the enterprise's profit according to the provisions in Point C, Part II of Circular No. 191-UB-TT-TC dated December 12, 1963.

C. MANAGEMENT PRINCIPLES:

1. The aforementioned medical expenses and supplementary expenses will be allocated by the financial department to the healthcare sector for management and recorded in the state budget under Category II, Item 38, Sub-item 2, Section 4.

The amount contributed to the state budget will be recorded under Category III, Item 90 (revenue from other public services).

2. Medical expenses and supplementary expenses at local healthcare facilities will be covered by the local budget. Medical expenses and supplementary expenses at central healthcare facilities will be covered by the central budget.

II. MANAGEMENT MEASURES

Departments of Health will prepare budgets based on the number of workers and officials eligible for social insurance, at a rate of 19.20 dong per person per year. This standard is for budget planning and includes the following expenditures:

- Expenditure on common medicines in agencies;

- Expenditure on medicines and supplementary expenses at outpatient clinics;

- Expenditure on medicines and supplementary expenses at hospitals and clinics;

1. Expenditure on common medicines in agencies:

Agencies will prepare budgets for common medicines based on the following criteria:

- The number of workers and officials eligible for social insurance benefits;

- Average expenditure per person per year: 3.60 dong.

The Departments of Health will base their budget planning on this and will allocate monthly funds to agencies for purchasing medicines and provide guidance and supervision on usage.

Agencies need to maintain records of purchased and used medicines, and report monthly to the Departments of Health.

Quarterly, the Departments of Health will report to the financial department on expenditure status; final settlement must be based on actual expenditure for purchased medicines, with purchase invoices serving as proof of expenditure.

2. Expenditure on medicines and supplementary expenses at outpatient clinics:

Outpatient clinics within and outside hospitals and clinics will prepare budgets based on the following criteria:

- The number of times patients are examined and prescribed medicine;

- Average expenditure per examination and prescription. The Departments of Health will prepare budgets based on:

- The number of workers and officials eligible for social insurance benefits;

- An average expenditure of 12.00 dong per person per year.

Afterward, the Departments of Health will distribute funds to outpatient clinics according to specific needs.

Outpatient clinics need to maintain records according to the provided model and report monthly to the Departments of Health on the following:

- Medicine expenditure situation;

- Supplementary expense expenditure situation;

- The number of examinations and prescriptions given;

- Average expenditure per examination and prescription.

Each quarter, the Health Department compiles the situation of outpatient clinics and reports to the corresponding financial authority.

3. Expenses for medicines and supplementary care at hospitals and dispensaries:

Hospitals and dispensaries prepare budgets based on the following criteria:

- The number of beds used for workers and officials;

- Total treatment days; Average expenditure on medicines and supplementary care per person per day according to the following standards:

- Dispensaries in counties from 1đ00 to 1đ10 per bed per day;

- Provincial hospitals from 1đ40 to 1đt50 per bed per day;

- Regional hospitals from 1đ50 to 1đ60 per bed per day;

The expenditure standard for central hospitals will be stipulated by the Ministry of Health and the Ministry of Finance subsequently.

The Health Departments may prepare estimates based on the number of workers and officials entitled to social insurance benefits at a rate of 3đ60 per person per year, requesting the financial authorities to allocate funds and then distributing them to healthcare facilities according to specific needs.

Hospitals and dispensaries need to maintain records tracking the amount of medicine used, expenses for medicines and supplementary care, and report the situation monthly with attached settlements to the Health Departments. Each quarter, the Health Departments compile the situation and report it to the Financial Departments.

4. For the three aforementioned expenses, the Health Departments may adjust funds from one category to another as appropriate to the specific circumstances. If expenditures fall below the average guidance provided, the excess funds may be utilized for the development of health protection services for workers and officials under their management. within the scope under their management.

III. IMPLEMENTATION PROVISIONS

1. This Circular takes effect from January 1, 1965.

2. The Joint Ministries request the Administrative Committees of regions, cities, provinces, Health Departments, and Financial Departments to pay attention and properly prepare the following matters:

a) Ensuring that all sectors and levels understand the significance and purpose of entrusting the health sector with managing medical expenses and supplementary care for state workers and officials.

b) Studying and reasonably organizing the health service structure within agencies and outpatient examination and medication distribution systems.

c) Mastering staffing and salary funds to serve as the basis for preparing budgets for medical expenses and supplementary care.

d) Preparing necessary accounting books.

3. The Joint Ministries request the Administrative Committees of regions, cities, and provinces to arrange necessary staffing for the health sector to implement this task, particularly focusing on the Health Departments which must specifically manage the medical fund and supplementary care. During implementation, if there are any difficulties, they should be reported to the Administrative Committees for the Joint Ministries to study and resolve.

During implementation, if there are any difficulties, they should be reported to the Administrative Committees for the Joint Ministries to study and resolve.