Joint Circular No. 30/1999/TTLT/BTC-BYT guiding the contents and budget allocation for the National Program on Payment for Certain Social Diseases and Dangerous Epidemics

JOINT CIRCULAR

Guidelines on the content and budget allocation for the National Program

to settle certain social diseases and dangerous epidemics

___________________________

 

Pursuant to Decision No. 05/1998/QD-TTg dated January 14, 1998 of the Government on managing national target programs;

Pursuant to Decision No. 05/1998/QĐ-TTg dated January 14, 1998 of the Prime Minister on managing national target programs;

Pursuant to Decisions No. 84/1998/QĐ-TTg dated April 16, 1998; No. 196/1998/QĐ-TTg dated October 10, 1998 and No. 224/1998/QĐ-TTg dated November 17, 1998 of the Prime Minister approving the national target program to settle certain social diseases and dangerous epidemics; supplementing the goal of protecting community mental health; the goal of preventing dengue fever; the goal of preventing malnutrition in children into the national program to settle certain social diseases and dangerous epidemics;

I. GENERAL PROVISIONS:

1. The National Target Program to Settle Social Diseases and Dangerous Epidemics (TTMSBXH&BDNH) includes several Objectives specified by the Government for each period of operation. The funding for the TTMSBXH&BDNH Program is formed from the State Budget (SB) and other sources of funds raised according to state regulations. These sources of funding are managed under the Law on SB and guiding documents implementing the Law on SB.

2. The entities subject to this Circular are units using the funds of the TTMSBXH&BDNH Program.

II. FINANCIAL MANAGEMENT OF THE TTMSBXH&BDNH PROGRAM

A. CONTENT AND ALLOCATION OF EXPENSES FOR THE TTMSBXH&BDNH PROGRAM

1. Common expenses of the TTMSBXH&BDNH Program

- Administrative expenses at the central level include expenses for office supplies, office equipment, telephone and postal fees, inspection, evaluation, interim review, final summary, hiring of office staff for the Program and its Objectives. Administrative expenses for the Program and its Objectives are budgeted annually but shall not exceed 0.3% of the total domestic budget investment in the TTMSBXH&BDNH Program.

- Purchase of transportation means for professional activities: purchase of specialized cars for the health sector, motorcycles, bicycles suitable for mountainous areas, boats and junks for provinces in the Mekong Delta after approval by competent authorities.

- Expenses for writing, compiling, translating, and printing professional materials and forms.

- Expenses for training and professional courses for each Objective. Expenses for overseas training (if applicable).

- Information, education, and communication.

- Repair of professional equipment and maintenance of drug warehouses and vaccines.

- Organizing periodic evaluations of the implementation of professional objectives for each Objective.

- Hiring of domestic and foreign experts and expert offices (if applicable). - Rewards according to the Decision of the Minister of Health.

- Scientific research linked to the content of the Objectives as approved by the Ministry of Health.

- Counterpart capital for domestic projects financed by loans and foreign aid agreements signed by the Government within the TTMSBXH&BDNH Program.

- Other expenses;

2. Direct expenses for each Objective of the TTMSBXH&BDNH Program. In addition to the common expenses mentioned above, each Objective also receives specific expenses as follows:

2.1 Content of expenses for the Objective of Preventing Malaria (PCSR)

- Purchase of antimalarial drugs; supporting drugs (including common antibiotics, anti-diarrheal drugs, pain relievers, antipyretics, vitamins).

- Purchase of mosquito control chemicals, testing chemicals...

- Purchase of spraying equipment, insect investigation tools, microscopes, and testing equipment.

- Purchase of bed nets for poor people in malaria endemic areas.

- Expenses for malaria epidemiological surveillance.

- Training allowances for malaria prevention personnel at commune health stations, villages, and key malaria areas, mobile malaria prevention teams, personnel catching mosquitoes at night, examining malaria parasites, and those directly involved in mosquito control spraying.

- Expenses for supporting malaria epidemic prevention in areas affected by natural disasters.

2.2 Content of expenses for the Objective of Preventing Iodine Deficiency Disorders

- Purchase of treatment and preventive chemicals for iodine deficiency disorders.

- Subsidies for mixing and transporting iodized salt according to the current regime of the State to ensure that the price of iodized salt does not exceed the price of white salt on the same market in localities.

- Purchase of packaging for iodized salt.

- Payment for testing iodine levels in salt and urine, and thyroid-stimulating hormone (TSH) levels.

- Training allowances for personnel collecting salt and blood samples from households.

- Payment for interviewers, epidemiological surveillance officers, data entry into computers, analysis, and processing of data from surveys and investigations.

- Purchase of ultrasound machines for thyroid glands, iodine urine quantification machines, TSH quantification machines, and accessories to equip iodine deficiency disorder prevention centers in provinces and cities.

2.3 Content of expenses for the Objective of Expanded Immunization (TCMR)

- Purchase, receipt, storage, and transport of vaccines to district and commune levels for expanded immunization. - Purchase of equipment and tools for vaccine storage and transport, injection tools, and sterilization tools for immunization activities.

- Investigation, assessment, and epidemiological surveillance of diseases, quality and safety assessment of immunizations, and promotion of service quality.

- Training allowances for vaccination, disease control, investigation, verification of cases, sample collection, storage, and transport of specimens.

- Hiring of labor for expanded immunization activities during campaigns.

2.4 Content of expenses for the Objective of Tuberculosis Prevention

- Purchase, receipt, storage, and transport of tuberculosis medications and tuberculin to commune and district levels.

- Purchase, receipt, storage, mixing, and transport of testing chemicals to provincial and district levels.

- Purchase, receipt, storage, and transport of microscopes, safety slides, laminae, sputum cups, X-ray machines, films, gloves, masks, protective clothing, and testing equipment for provincial, district, and commune levels.

- Training allowances for personnel engaged in tuberculosis screening, regular medication distribution, and patient follow-up at district, town, commune, village, and hamlet levels.

- Epidemiological investigation, surveillance, and assessment of tuberculosis status.

2.5 Content of expenses for the Objective of Leprosy Prevention

- Purchase of drugs and chemicals for leprosy detection and treatment activities.

- Purchase specialized medical equipment and drug storage facilities to serve the work of detecting and restoring functions for leprosy patients.

- Investigate, assess, and monitor the epidemiology of leprosy.

- Treat and restore function for deformed leprosy patients through surgery and provide essential items such as corrective shoes, sandals, crutches, splints, and prosthetic limbs for treatment and functional restoration.

- Provide allowances to healthcare staff and volunteers directly involved in the detection of cases, distribution of medication, treatment of leprosy patients, and home care for deformed patients.

- Provide allowances to staff who have achieved results in early detection of leprosy reactions and timely treatment to prevent disability.

- Hire personnel and transportation means to transport patients from their homes to commune health centers, leprosy treatment areas, or regional general hospitals for extremely poor patients in mountainous provinces, remote, and far-flung areas.

- Provide allowances to laboratory technicians performing two smear samples to find leprosy bacilli in suspected leprosy patients or those currently undergoing treatment and under surveillance (one sample from the earlobe, two samples from skin lesions).

2.6/ Objective of Dengue Fever Prevention and Control:

- Purchase chemicals for mosquito eradication, reagents, serological diagnostic chemicals, viral isolation materials. - Purchase spraying machines and replacement parts, entomological investigation tools, microscopes, testing equipment, and diagnostic devices for grassroots levels.

- Purchase stockpiles of medicines for patients eligible for reduced or waived hospital fees and without health insurance in key communes and wards according to the guidelines of the Ministry of Health.

- Allocate funds for epidemiological surveillance of dengue fever (case surveillance, vector surveillance, serological surveillance).

- Provide allowances to dedicated dengue prevention and control staff at commune health centers and networks of volunteers including healthcare workers in key communes and wards, individuals directly applying chemical sprays for mosquito eradication, and those implementing biological and chemical methods to eliminate mosquito larvae.

- Allocate funds for hiring labor for dengue prevention and control campaigns.

- Allocate support for dengue prevention and control activities in heavily affected areas based on the allocation by the Ministry of Health after coordination with the Ministry of Finance.

2.7/ Objective of Mental Health Protection:

- Purchase specialty drugs for the treatment of patients in key communes and wards (list of key communes and wards approved by the Ministry of Health).

- Provide allowances to healthcare staff assigned to distribute medications regularly to patients, volunteers participating in the rehabilitation of schizophrenia patients in communes and wards, and healthcare staff documenting new schizophrenia cases in key communes and wards.

- Allocate funds for model projects on community mental health care in communes.

- Conduct epidemiological investigations, identify, and establish patient records for schizophrenia patients.

2.8/ Objective of Child Malnutrition Prevention:

- Purchase children's health scales.

- Pay allowances to dedicated staff (commune/ward health workers) and nutrition volunteers who are healthcare workers in key communes, wards, villages, and hamlets.

- Provide allowances for under-two-year-old children with slow weight gain, pregnant women not gaining sufficient weight, and iron-deficient pregnant women in key communes and poor communes according to the standards set by the Ministry of Health.

- Allocate funds for practical nutrition activities and food preparation techniques for pregnant women and under-two-year-old children.

- Support breastfeeding and appropriate complementary feeding activities. - Allocate funds for food safety and quality control activities in malnutrition prevention programs.

- Support regular weighing of children under five years old twice a year. - Support some models of child health care.

- Purchase deworming medicine for children under five years old in poor communes and demonstration sites.

B- Budget Preparation, Disbursement, Accounting, and Settlement:

The financial resources of the TTMSBXH&BDNH program are managed, budgeted, disbursed, and settled according to the provisions of Circular Joint No. 06/LBKH-TC dated April 29, 1997, issued by the Ministry of Planning and Investment and the Ministry of Finance guiding the implementation of Decision No. 531/TTg of the Prime Minister on managing national programs, Circular No. 103/1998/TT-BTC dated July 18, 1998, issued by the Ministry of Finance guiding the delegation, preparation, execution, and settlement of state budget revenues and expenditures, Decision No. 999-TC/QD/CĐKT dated November 2, 1996, issued by the Minister of Finance promulgating accounting regulations for public institutions, Decision No. 144 BYT/QĐ dated January 31, 1997, issued by the Minister of Health promulgating accounting regulations for public health institutions applicable in health public institutions. Circular No. 184/1998/TT-BTC dated December 28, 1998, issued by the Ministry of Finance guiding inventory accounting, valuation of finished construction works, and project completion at the end of the year for public institutions.

1/ Budget Preparation: Annually, based on the total budget estimate of the TTMSBXH&BDNH program approved by the National Assembly, the Ministry of Health, in collaboration with the Ministry of Finance and the Ministry of Planning and Investment, allocates the budget for each objective and distributes the budget estimates for each objective to relevant ministries, sectors, and localities for approval by the Government and notification to the relevant ministries, sectors, and localities using the program's funds. The Ministry of Health is responsible for guiding the regulations on tasks and professional indicators for health-related ministries, sectors, and localities to implement in accordance with the approved budget estimates for each objective.

2/ Capital disbursement:

2. 1/ For funds delegated to localities:

Based on the annual budget allocated, localities (led by the Department of Health in collaboration with related units) prepare and consolidate quarterly expenditure budgets (classified according to the budget classification) and submit them to the Ministry of Finance and the Ministry of Health; the Ministry of Finance delegates funds to the Department of Finance-Price Control. The Department of Finance-Price Control disburses funds to direct users of the TTMSBXH&BDNH program according to the budget and notifies the Department of Health.

For the subsidy and transportation cost reimbursement for iodized salt produced by localities, the Department of Finance-Price Control provides it to the Department of Health, which then enters into contracts with salt production and transportation entities (the Department of Health is responsible for settling this expense with the Department of Finance-Price Control according to regulations).

2.2/ For the funds implemented by central ministries, sectors, and mass organizations to achieve the objectives under the National Target Program for Health Care and Population Control: Quarterly, based on the annual budget notification approved by the Government, the Ministry of Finance shall directly allocate funds to those ministries, sectors, and mass organizations for implementation.

2.3/ For funds allocated in kind to localities, ministries, and sectors:

The principal agency responsible for distribution must notify the Department of Health and the supervising agency of the quantity and unit price of each type of goods distributed each time so that the Department of Health and the supervising agency can monitor and participate in the recording and accounting entries. At the time of settlement, there must be signatures from the representative of the distributing agency, the recipient's representative, and the Department of Health (or the supervising agency). The Department of Health is responsible for guiding units within the department receiving goods from the Program to monitor, manage, and use them according to their intended purpose effectively.

3/ Settlement of funds:

Units at provincial level cities directly under the Central Government and ministries, sectors receiving funds (both in kind and through delegation) of the National Target Program for Health Care and Population Control have the responsibility to:

- Maintain accounting books to record, account for, and settle accounts for all sources of funds provided by the program to the unit in accordance with current regulations of the state budget accounting system.

- Quarterly and annually, units using funds must submit final reports (including both goods and delegated funds) to the head of each objective program in accordance with the prescribed reporting forms and deadlines set by the State.

- For annual final reports of agencies and units receiving delegated funds in localities, after the audit verification and review report of the Provincial Finance Department

- Local price levels, the Department of Health will consolidate and send to the head of the objective program for consolidation and reporting to the Ministry of Health and the Ministry of Finance for formal approval. If the audit report of the locality contains recommendations requiring central-level action, such recommendations will only be addressed after receiving a written response from the Joint Ministries of Health and Finance.

- and Finance, the relevant expenditure item will only be officially settled.

III. IMPLEMENTATION PROVISIONS:

This Circular takes effect fifteen days from the date of signature and replaces Circular No. 72/TTLT-FINANCE-MINISTRY OF HEALTH dated October 17, 1997, guiding the content and expenditure standards of the National Program on Health Care. Any previous provisions contrary to the contents stipulated in this Circular are hereby abolished. The funds required to implement this Circular will be arranged within the annual budget of the Program assigned by the State. In case of difficulties during implementation, they should be reported to the Joint Ministries for consideration and resolution.