Circular No. 46/2013/TT-BYT stipulates the functions, tasks, and organizational structure of rehabilitation facilities.

 CIRCULAR

Regulations on functions, tasks, and organizational structure of rehabilitation facilities

Decree No. 1. The List of Biddable Medicines at Appendix I.

At the proposal of the Director of the Department of Medical Examination and Treatment and the Director of the Personnel Department;

The Minister of Health issues this Circular to regulate the functions, tasks, and organizational structure of rehabilitation facilities.

PART I
GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular stipulates the functions, tasks, and organizational structure of rehabilitation facilities.

1. Rehabilitation Departments, Rehabilitation Centers within medical examination and treatment facilities.

2. Outpatient Rehabilitation Clinics.

3. Rehabilitation Hospitals.

In this Circular, the following terms are understood as follows:

2. Community-based rehabilitation is the process of rehabilitation carried out in the community with the participation and collaboration of people with disabilities, their families, local authorities, primary healthcare services, and other relevant organizations and individuals.

4. Convalescence is a form of health recovery and enhancement through rest, nutrition, exercise, and other measures prescribed by physicians.

1. Specialist physician in rehabilitation is a physician who has been trained in the specialty of rehabilitation at the specialist level or higher and obtained a practice certificate for medical examination and treatment in rehabilitation according to the laws on medical examination and treatment.

The specialist physician in rehabilitation is responsible for examining patients, diagnosing diseases, prescribing treatments, and rehabilitation for patients.

2. Specialist technician in rehabilitation is a technician who has been trained in the specialty of rehabilitation and obtained a practice certificate for medical examination and treatment in rehabilitation according to the laws on medical examination and treatment.

The specialist technician in rehabilitation assists the physician in diagnosing diseases, prescribing rehabilitation, maintaining patient records, developing plans, and implementing rehabilitation for patients. In areas lacking specialist physicians in rehabilitation, the director of the provincial health department may stipulate that a specialist technician in rehabilitation with at least 24 months of experience practicing medical examination and treatment in rehabilitation can diagnose diseases and prescribe rehabilitation. Such regulations must be documented in writing (decision) by the director of the provincial health department.

3. Bachelor of Medical Technology is a person trained in physical therapy or occupational therapy at the bachelor's degree level.

The Bachelor of Medical Technology assists the specialist physician in rehabilitation in diagnosing diseases, developing plans, and implementing rehabilitation for patients.

4. Bachelor of Speech-Language Therapy is a person trained in speech-language therapy at the bachelor's degree level.

The Bachelor of Speech-Language Therapy assists the specialist physician in rehabilitation in diagnosing diseases, developing plans, and implementing speech-language therapy for patients.

5. Physical Therapy Technician is a person trained in physical therapy at the intermediate level or a person trained in nursing at the intermediate level or higher, who has received at least three months of training in physical therapy at training institutions specified by the Ministry of Health, and obtained a practice certificate for medical examination and treatment in rehabilitation according to the laws on medical examination and treatment.

The Physical Therapy Technician implements physical therapy and occupational therapy techniques for patients.

6. Occupational Therapy Technician is a person trained in occupational therapy at the intermediate level or a person trained in nursing at the intermediate level or higher, who has received at least three months of training in occupational therapy at training institutions specified by the Ministry of Health, and obtained a practice certificate for medical examination and treatment in rehabilitation according to the laws on medical examination and treatment.

The Occupational Therapy Technician trains patients in daily self-care activities and helps them reintegrate into their home and community environments.

7. Speech-Language Therapy Technician is a person trained in speech-language therapy at the intermediate level or a person trained in nursing at the intermediate level or higher, who has received at least three months of training in speech-language therapy at training institutions specified by the Ministry of Health, and obtained a practice certificate for medical examination and treatment in rehabilitation according to the laws on medical examination and treatment.

The Speech-Language Therapy Technician trains patients with language and communication disorders.

8. Orthotic Technician is a person trained in orthotics at the intermediate level and obtained a practice certificate for medical examination and treatment in rehabilitation according to the laws on medical examination and treatment.

The Orthotic Technician manufactures, produces, repairs assistive devices, replacement devices, and guides patients, their families, and communities in making appropriate assistive devices.

9. In addition to the specialized positions specified from Clause 1 to Clause 8 of this Article, the designation and participation in implementing rehabilitation also include specialized positions in orthopedic surgery, sports medicine, general practitioners, specialists, nurses, and other specialized positions knowledgeable and skilled in rehabilitation.

10. Patients and their families are responsible for cooperating with the rehabilitation team during the examination, treatment, and rehabilitation of patients. Patients and their families are indispensable members of the rehabilitation team.

11. In addition to the main tasks of the specialized positions specified from Clause 1 to Clause 9 of this Article, the specialized positions in rehabilitation perform other tasks as prescribed by the laws on medical examination and treatment.

1. The issuance of a practice certificate for medical examination and treatment in Rehabilitation shall be carried out in accordance with the provisions of Articles 5, 6, and 7 of Circular No. 41/2011/TT-BYT dated November 14, 2011, of the Ministry of Health on guiding the issuance of practice certificates for practitioners and permits to operate for healthcare facilities (hereinafter referred to as Circular No. 41/2011/TT-BYT).

2. Conditions for granting a permit to operate for Rehabilitation Hospitals shall be implemented in accordance with the provisions of Article 23 of Circular No. 41/2011/TT-BYT.

3. Conditions for granting a permit to operate for Rehabilitation Outpatient Clinics shall be implemented in accordance with the provisions of Article 25 of Circular No. 41/2011/TT-BYT. Specifically, the area of the movement therapy room of Rehabilitation Outpatient Clinics must ensure a minimum of 20 square meters.².

Chapter II
FUNCTIONS, DUTIES AND ORGANIZATIONAL STRUCTURE OF REHABILITATION FACILITIES

OF THE REHABILITATION FACILITY

Section 1

REHABILITATION DEPARTMENT

Article 6. Functions of the Rehabilitation Department

The Rehabilitation Department is a clinical unit within a medical examination and treatment facility, having the function of examining patients, treating diseases, and providing rehabilitation services to patients.

Article 7. Duties of the Rehabilitation Department

1. Conducting medical examinations, treating diseases, and providing rehabilitation services at the Rehabilitation Department and other departments within the medical examination and treatment facility according to inpatient, outpatient, and day rehabilitation forms.

2. Providing and instructing patients on the use of assistive devices.

3. Advising patients and their families on rehabilitation, psychological, educational, and vocational guidance.

4. Implementing preventive measures against disabilities and diseases.

5. Serving as the focal point for the medical examination and treatment facility to carry out supervisory work on rehabilitation and community-based rehabilitation.

6. Performing other tasks related to medical examination and treatment when having the necessary conditions and being approved by the competent authority.

Article 8. Organizational Structure of the Rehabilitation Department

1. The Rehabilitation Department of a medical examination and treatment facility must have the following units at a minimum:

a) Administrative;

b) Physical Therapy;

c) Inpatient Treatment.

2. In addition to the provisions of Clause 1 of this Article, the medical examination and treatment facility will organize the Rehabilitation Department to include additional units based on the number of beds and the requirements for rehabilitation activities of the facility:

a) Therapy Activities;

b) Psychological Therapy;

c) Speech Therapy.

Section 2

REHABILITATION CENTER

Article 9. Functions of the Rehabilitation Center

1. The Rehabilitation Center is a clinical unit within a medical examination and treatment facility, having the function of examining patients, treating diseases, and providing rehabilitation services to patients.

2. The Rehabilitation Center may have its own seal and separate account.

Article 10. Duties of the Rehabilitation Center

1. Conducting medical examinations, treating diseases, and providing rehabilitation services at the center and other departments within the medical examination and treatment facility according to inpatient, outpatient, and day rehabilitation forms.

2. Organizing production, provision, and instruction on the use of assistive devices for patients.

3. Advising patients and their families on rehabilitation, psychological, educational, and vocational guidance.

4. Implementing preventive measures against disabilities and diseases.

5. Serving as the focal point for the medical examination and treatment facility to carry out supervisory work on rehabilitation and community-based rehabilitation.

6. Performing other tasks related to medical examination and treatment when having the necessary conditions and being approved by the competent authority.

Article 11. Organizational Structure of the Rehabilitation Center

1. The Rehabilitation Center of a medical examination and treatment facility must have the following departments and rooms at a minimum:

a) Departments and rooms specified in Clause 1 of Article 8 of this Circular;

b) Workshop for producing assistive devices (rehabilitation).

2. In addition to the provisions of Clause 1 of this Article, the medical examination and treatment facility will organize the Rehabilitation Center to include additional units based on the number of beds and the requirements for rehabilitation activities of the facility as specified in Clause 2 of Article 8 of this Circular.

Article 12. Human Resources of the Department of Functional Recovery and the Center for Functional Recovery

1. The Department of Functional Recovery (PHCN) or the Center for Functional Recovery must have the specialized positions prescribed in Article 4 of this Circular, which are appropriate to the functions, tasks, organizational structure, and scope of professional activities of the unit.

2. Based on the demand for medical examination, treatment, and functional recovery services of the people in the locality, the current status of the facilities and equipment of the unit, the head of the medical examination and treatment facility shall develop a job position proposal, determine the number of staff and human resource structure of the Department of Functional Recovery or the Center for Functional Recovery, submit it to the competent authority for approval, serving as the basis for recruiting human resources in accordance with the Labor Code, the Law on Public Officials, and other guiding documents implementing the Law.

Section 3

 FUNCTIONAL RECOVERY CLINIC

Article 13. Functions and Legal Status of the Functional Recovery Clinic

1. The Functional Recovery Clinic has the function of providing specialized medical examination and treatment services in the field of functional recovery for patients and people in need.

2. The Functional Recovery Clinic is an independent specialized clinic, having its own seal and separate account.

Article 14. Tasks of the Functional Recovery Clinic

1. Conduct specialized medical examinations and treatments in the field of functional recovery through inpatient, outpatient, and daytime functional recovery forms.

2. Advise patients and their families about functional recovery, psychology, education, and vocational guidance.

3. Carry out preventive campaigns against disabilities and diseases.

4. Implement statistical and reporting systems according to regulations related to medical examinations and treatments when meeting the required conditions and obtaining approval from the competent authority.

Article 15. Organizational Structure and Human Resources of the Functional Recovery Clinic

1. The Functional Recovery Clinic must have at least one specialist doctor in functional recovery and one nurse or one technical assistant in functional recovery.

2. In addition to the provisions of Clause 1 of this Article, the Functional Recovery Clinic may have other specialized positions as prescribed in Article 4 of this Circular, which are appropriate to the scope of professional activities.

3. The minimum organizational structure of the Functional Recovery Clinic must include the following functional departments:

Point a) Medical examinations;

b) Physical Therapy.

4. Depending on the facilities, equipment, human resources, and scope of professional activities, the Functional Recovery Clinic may have additional specialized departments as appropriate.

Section 4

FUNCTIONAL RECOVERY HOSPITAL

Article 16. Functions and Legal Status of the Functional Recovery Hospital

1. The Functional Recovery Hospital is a medical examination and treatment facility with the function of conducting medical examinations, treatments, functional recovery, and organizing convalescence for patients and other individuals in need.

2. The Functional Recovery Hospital is a specialized hospital, having its own seal and separate account.

Article 17. Tasks of the Functional Recovery Hospital

1. Conduct medical examinations, treatments, and functional recovery through inpatient, outpatient, daytime functional recovery, and convalescence organization:

a) Specialized medical examinations and treatments in the field of functional recovery;

b) General medical examinations and treatments;

c) Resuscitation and emergency care;

d) Convalescence;

đ) Medical examination and certification of health status as prescribed;

e) Participate in medical examination and determination of disability when requested.

2. Training of human resources:

a) Serve as a practical training base for specialized medical schools and other legitimate educational institutions;

b) Implement continuous training and knowledge enhancement programs in the field of functional recovery and issue certificates according to the training program.

3. Scientific Research:

a) Conduct scientific research and apply new techniques and methods in medical examinations, treatments, and functional recovery;

b) Provide advice to higher-level management agencies on scientific research work in medical examinations, treatments, and functional recovery.

4. Directing lower levels in functional recovery and community-based functional recovery:

a) Guide lower levels in developing techniques and improving the quality of functional recovery;

b) Take the lead and coordinate with relevant units to implement community-based functional recovery according to the guidelines of the Ministry of Health;

c) Provide advice to higher-level management agencies on building and developing the network and activities of functional recovery.

5. Disease prevention:

a) Carry out campaigns to prevent disabilities and diseases;

b) Participate in disease control work as prescribed.

6. Health Education Communication:

a) Organize propaganda on the policies and legal documents of the Party and State regarding health protection, care, and improvement;

b) Communicate and educate the public on health issues to enhance awareness among all sectors and the general public about the role and importance of functional recovery and community-based functional recovery.

7. Advise patients and their families about functional recovery, psychology, education, vocational guidance, and create opportunities for patients to be self-reliant in life and reintegrate into society.

8. Implement hospital drug regulations as currently prescribed.

9. Economic Management:

a) Manage and use state budget funds and other legitimate sources of funding effectively;

b) Implement socialization in hospital operations in accordance with the law;

c) Receive and utilize aid funds.

10. International Cooperation:

a) Implement international cooperation programs in the fields of functional recovery and community-based functional recovery;

b) Provide advice to higher-level management agencies on international cooperation in the field of functional recovery and community-based functional recovery.

11. Organize production, supply, and guide the effective use of assistive devices for patients. Guide the community in producing and using simple assistive devices for patients.

12. Implement statistical and reporting systems according to regulations and other tasks related to medical examinations and treatments when meeting the required conditions and obtaining approval from the competent authority.

Article 18. Organizational Structure of the Rehabilitation Hospital

1. Leadership of the hospital and persons responsible for technical and professional matters of the hospital:

a) Director and Deputy Directors;

b) Persons responsible for technical and professional matters of the hospital: Appointed in writing by the head of the hospital.

2. Functional Departments:

a) Human Resources Organization;

b) Comprehensive Planning;

c) Finance and Accounting;

d) Administrative Management;

đ) Medical Supplies and Equipment;

e) Training and Line Guidance (including scientific research and international cooperation);

g) Nursing.

3. Specialized Departments:

a) Specialty Outpatient Clinic for Rehabilitation;

b) General Outpatient Clinic;

c) Emergency and Intensive Care;

d) Physical Therapy;

đ) Therapeutic Activities;

e) Speech Therapy;

g) Psychological Therapy;

h) Internal Medicine;

i) Surgery and Orthopedics;

k) Pediatrics;

l) Ophthalmology - ENT - Rhinology;

m) Traditional Medicine;

n) Nutrition;

o) Infection Control;

p) Palliative Care;

q) Diagnostic Imaging and Functional Testing;

r) Laboratory Testing;

s) Pharmacy;

t) Workshop for Production of Assistive Devices;

u) Other Departments.

4. Based on the needs for medical examination and treatment, rehabilitation services of the population in the locality, the current status of infrastructure, medical equipment, human resources, and the scope of specialized services of the hospital, the head of the hospital approves the organizational structure of the hospital in accordance with the provisions of Clause 1, Clause 2, and Clause 3 of this Article or submits it to the competent authority for approval in accordance with regulations.

Chapter III
IMPLEMENTATION

Article 19. Line Guidance and Referral

1. Professional line guidance in rehabilitation is carried out in accordance with Decision No. 4026/QD-BYT dated October 20, 2010 of the Ministry of Health promulgating the division of responsibilities for line guidance in the field of medical examination and treatment.

2. The Department of Health of provinces and centrally governed cities assigns line guidance on rehabilitation as follows:

a) If there is a rehabilitation hospital in the locality, the rehabilitation hospital acts as the main entity to implement line guidance on rehabilitation and community-based rehabilitation at the local level;

b) If a rehabilitation hospital has not been established, the rehabilitation department or center of the provincial general hospital will act as the main entity to implement line guidance on rehabilitation and community-based rehabilitation at the local level.

3. Healthcare facilities under the management of Ministries and sectors shall carry out line guidance on rehabilitation according to the division of responsibilities by the health administrative agencies of those Ministries and sectors.

4. The referral process for medical examination and treatment at rehabilitation facilities shall be carried out in accordance with the regulations on technical and professional referrals issued by the Ministry of Health.

Article 20. Medical Examination and Treatment under Health Insurance at Rehabilitation Facilities

Rehabilitation facilities may accept patients holding health insurance cards registered for initial medical examination and treatment if they meet the conditions stipulated by laws on health insurance.

Article 21. Coordination of Professional Work Between the Rehabilitation Department or Center and Other Departments in the Hospital

1. Responsibilities of the Rehabilitation Department or Center:

a) Dispatching doctors and technicians specializing in rehabilitation to clinical departments to examine patients and assess their rehabilitation needs upon notification from the clinical departments;

b) Cooperating with clinical departments to develop plans, guide, and support nurses and technicians in clinical departments to provide rehabilitation services to patients in clinical departments;

c) Accepting and providing rehabilitation services to patients transferred from other departments.

2. Responsibilities of Clinical Departments:

a) Notifying the rehabilitation department about patients in their department who have rehabilitation needs;

b) Cooperating and creating conditions for doctors and technicians specializing in rehabilitation to examine patients, provide guidance, and support nurses and technicians in clinical departments to provide rehabilitation services to patients;

c) Providing rehabilitation services to patients in clinical departments with the assistance of doctors and technicians specializing in rehabilitation;

d) Depending on professional requirements, clinical doctors and specialists in rehabilitation must organize consultations in accordance with regulations.

Article 22. Ensuring Human Resources for Rehabilitation

1. The Science, Technology and Training Department shall take the lead and coordinate with the Department of Medical Examination and Treatment and related units to develop plans for specialized rehabilitation training, submit them to the competent authority for approval, and direct universities, colleges, intermediate-level medical schools, and other institutions with the function of specialized medical and pharmaceutical training to organize various types and levels of specialized rehabilitation training.

2. The Cadres and Civil Servants Department shall take the lead and coordinate with the Department of Medical Examination and Treatment and related units to develop regulations and policies to ensure recruitment, utilization, and maintenance of human resources for rehabilitation at medical examination and treatment facilities according to regulations, submit them to the competent authority for approval.

Article 23. Coordination with the Vietnam Association of Rehabilitation

1. The Department of Medical Examination and Treatment, the Science, Technology and Training Department shall take the lead and coordinate with departments, bureaus, and general directorates under the Ministry of Health based on their assigned functions and responsibilities to collaborate with the Vietnam Association of Rehabilitation in advising the Minister of Health on regulations, policies, normative legal documents, professional materials, and development plans for the specialized field of rehabilitation.

2. Medical examination and treatment facilities shall coordinate with the Vietnam Association of Rehabilitation and provincial and central city rehabilitation associations during their medical examination and treatment activities and rehabilitation work.

Article 24. Implementation Responsibilities

2. Provincial Departments of Health, heads of health sectors under ministries and agencies have the responsibility to direct, organize, and inspect the implementation of this Circular for medical examination and treatment facilities under their management.

Chapter IV
IMPLEMENTING PROVISIONS

Article 25. Cross-referenced Provisions

In cases where referenced documents in this Circular are replaced or amended, they shall be implemented according to the replacing or amending documents.

Specialized rehabilitation medical examination and treatment facilities operating before the effective date of this Circular are permitted to continue operations but must comply with the organizational form of rehabilitation facilities as prescribed in Article 2 of this Circular before January 1, 2015.

Article 27. Effective Date

1. This Circular takes effect from February 27, 2014.

2. Decision No. 963/1999/QĐ-BYT dated April 2, 1999 of the Minister of Health on issuing the "Regulations on Functions, Tasks, and Organizational Structure of Rehabilitation Hospitals under Provincial and Central City Health Departments"; Clause 10, Part V of the Regulations on Work of Certain Departments issued pursuant to Decision No. 1895/1997/QĐ-BYT dated September 19, 1997 of the Minister of Health on issuing Hospital Regulations and Section 5, Point c, Clause 1, Article 25 of Circular No. 41/2011/TT-BYT cease to be effective from the date this Circular takes effect.

During implementation, if there are difficulties or obstacles, agencies, organizations, and individuals are advised to report to the Department of Medical Examination and Treatment, Ministry of Health for timely guidance and resolution.