Joint Circular No. 8-TTLB amending the average annual bed cost standards applicable to hospitals under the management of provinces, cities, and sectors.

JOINT CIRCULAR

OF THE MINISTRY OF HEALTH AND FINANCE NUMBER 8 - TTLB DATE 14 - 4 - 1986 AMENDING THE STANDARDS FOR ANNUAL AVERAGE EXPENSES PER BED APPLICABLE TO PROVINCE AND CITY HOSPITALS AND OTHER SECTORS

IN ORDER TO BE CONSISTENT WITH NEW PRICES AND SALARIES, THE JOINT MINISTRY OF HEALTH AND FINANCE REISSUES THE STANDARDS FOR ANNUAL AVERAGE EXPENSES PER BED FOR COUNTY, PROVINCIAL HOSPITALS AND CENTRALLY-GOVERNED CITIES AS PREVIOUSLY DEFINED IN CIRCULAR NO. 21-TT/LB OF JULY 22, 1985 BY THE JOINT MINISTRY AS FOLLOWS:

I. REGULAR EXPENSE STANDARDS.

1. THE STANDARDS FOR ANNUAL AVERAGE EXPENSES PER BED (INCLUDING THREE GROUPS: GROUP I: EXPENSES FOR ADMINISTRATIVE STRUCTURE; GROUP II: EXPENSES FOR ADMINISTRATIVE MANAGEMENT; GROUP III: EXPENSES FOR MEDICAL SERVICES) APPLY TO VARIOUS TYPES OF HOSPITALS AND SANATORIUMS AS FOLLOWS:

2. EXPENSES FOR SALARIES AND ALLOWANCES ARE BASED ON LABOR STANDARDS ACCORDING TO DECISION NO. 253-UBKH OF MAY 29, 1978 ISSUED BY THE HEAD OF THE STATE PLANNING COMMISSION AND MUST BE CAREFULLY CHECKED AND DISTRIBUTED IN ACCORDANCE WITH CIRCULAR NO. 19-TTLB OF OCTOBER 10, 1964 ISSUED BY THE JOINT MINISTRY OF FINANCE AND BANKING. EXPENSES FOR SALARIES AND ALLOWANCES, ALTHOUGH INCLUDED IN THE BUDGET, ARE AN INDEPENDENT CATEGORY AND ANY CHANGES WILL BE CONSIDERED FOR ADDITIONAL FUNDS TO ENSURE THAT THEY DO NOT IMPACT THE BUDGET OF GROUPS II AND III.

3. REGULAR EXPENSE STANDARDS ARE ISSUED BASED ON ACTUAL BED USE (TOTAL TREATMENT DAYS DIVIDED BY 340 DAYS). IF A HOSPITAL EXCEEDS ITS BED PLAN, IT WILL RECEIVE ADDITIONAL FUNDS RANGING FROM 40 TO 50% OF THE REGULAR EXPENSE STANDARDS ACCORDING TO THE CORRESPONDING INCREASE, BUT NOT MORE THAN 10% OF THE HOSPITAL'S BED PLAN.

4. THE JOINT MINISTRY WILL REVIEW THE ANNUAL AVERAGE EXPENSE STANDARDS EACH YEAR TO ADJUST THEM TO THE CURRENT PRICE LEVELS.

II. EXPENSES OUTSIDE THE STANDARDS.

1. EXPENSES FOR OUTPATIENT TREATMENT FOR STATE EMPLOYEES (INCLUDING RETIREES, DISABLED PERSONS RECEIVING PENSION BENEFITS) SUFFERING FROM CHRONIC DISEASES, SOCIAL DISEASES, OCCUPATIONAL DISEASES, AND EPIDEMIC DISEASES.

2. EXPENSES FOR DRUG DISTRIBUTION TO POLICY BENEFICIARIES.

THE JOINT MINISTRY WILL ISSUE GUIDELINES ON THE AMOUNTS OF EXPENSES AND THE LIST OF DISEASES ELIGIBLE FOR OUTPATIENT DRUG DISTRIBUTION AS DESCRIBED IN SECTION II POINT 1 AND THE AMOUNTS AND METHODS OF DRUG DISTRIBUTION FOR POLICY BENEFICIARIES AS DESCRIBED IN SECTION II POINT 2 ABOVE.

3. EXPENSES FOR PURCHASING LARGE EQUIPMENT, UTENSILS, AND FIXTURES, MAJOR REPAIRS (BUILDINGS, MACHINERY), AND SMALL CONSTRUCTION PROJECTS. THESE EXPENSES MUST BE SPECIFICALLY BUDGETED AND SUBMITTED TO THE APPROPRIATE FINANCIAL AUTHORITIES FOR APPROVAL. EXPENSES CAN ONLY BE INCURRED ACCORDING TO THE APPROVED BUDGET AND CANNOT BE USED FOR OTHER PURPOSES.

III. IMPLEMENTATION PROVISIONS

1. HEALTH AUTHORITIES AND FINANCIAL AUTHORITIES AT ALL LEVELS SHALL CALCULATE THE SPECIFIC EXPENSES FOR EACH HOSPITAL AND SANATORIUM BASED ON THE REGULAR EXPENSE STANDARDS IN SECTION I AND THE EXPENSES OUTSIDE THE STANDARDS IN SECTION II AND SUBMIT THEM TO THE PEOPLE'S COMMITTEE AT THE RESPECTIVE LEVEL FOR APPROVAL.

2. HEALTH AUTHORITIES UNDER MINISTRIES AND OTHER CENTRAL TOTALITY BUREAUS SHALL CALCULATE THE SPECIFIC EXPENSES FOR EACH HOSPITAL AND SANATORIUM UNDER THEIR MANAGEMENT BASED ON THE STANDARDS SET HERE AND SUBMIT THEM TO THE MINISTRY OF FINANCE FOR BUDGET APPROVAL.

3. HOSPITALS THAT HAVE BEEN FULLY ASSISTED WITH EQUIPMENT OR ARE CURRENTLY BEING ASSISTED THROUGH PROGRAMS, AND PROVINCIAL AND CITY HOSPITALS WITH OVER 500 BEDS, IF APPROVED BY THE JOINT DEPARTMENT OF HEALTH AND FINANCE, MAY BE AUTHORIZED BY THE PROVINCIAL OR CITY PEOPLE'S COMMITTEE TO HAVE HIGHER REGULAR EXPENSE STANDARDS THAN THE MAXIMUM STANDARDS ABOVE AFTER AGREEMENT WITH THE JOINT MINISTRY OF HEALTH AND FINANCE.

4. FOR ANY SURPLUS GENERATED AFTER DEDUCTING EXPENSES (INCLUDING INCOME FROM PRODUCTION, DRUG MANUFACTURING, AND OTHER HEALTH SERVICES), HOSPITALS WITH INCOME MUST PREPARE A SPECIFIC BUDGET TO BE APPROVED BY THE SUPERVISORY AUTHORITY AND THE FINANCIAL AUTHORITY TO BE USED TO IMPROVE WORKING CONDITIONS AND PATIENT SERVICES.

IN CASES WHERE INTERNATIONAL ORGANIZATIONS PROVIDE MEDICATION, EQUIPMENT, AND COMMON SUPPLIES TO HOSPITALS, SUCH ITEMS MUST BE INVENTORIED AND VALUED FOR MANAGEMENT UNDER CURRENT REGULATIONS AND USED TO REDUCE ANNUAL BUDGET DISTRIBUTIONS.

THIS CIRCULAR REPLACES CIRCULAR NO. 21-TT/LB OF JULY 22, 1985 ISSUED BY THE JOINT MINISTRY AND SHALL TAKE EFFECT UPON ISSUANCE.