Quyết định 4039/QD-BYT

DECISION

APPROVING THE NATIONAL PLAN FOR REHABILITATION SERVICE DEVELOPMENT FOR THE 2014 – 2020 PERIOD

MINISTER OF HEALTH

Pursuant to the Government’s Decree No. 63/2012/ND-CP dated August 31, 2012 defining Functions, Tasks, Powers and Organizational Structure of Ministry of Health;

Pursuant to Decision No. 1019/QD-TTg dated August 05, 2012 by the Prime Minister on giving approval for the Assistance Scheme for people with disabilities for the 2012 – 2020 period;

Pursuant to Decision No. 651/QD-TTg dated June 01, 2012 by the Prime Minister on giving approval for the “National action plan for mitigation of effects of toxic chemicals used by the U.S Military during the Vietnam War by 2015 and the orientations towards 2020”;

At the request of the Director of the Administration of Medical Examination and Treatment,

HEREBY DECIDES:

Article 1. The “National plan for rehabilitation service development for the 2014 – 2020 period”, including the following key contents, is given approval herein.

I. OBJECTIVES

1. General objectives

Consolidate and expand rehabilitation facilities as well as improve the quality rehabilitation services; intensify prevention of disabilities, early detection and intervention as well as improve the quality of life of people with disabilities in all areas so that they can participate in and be treated on equal terms in social activities, and thus can promote their ability in the best way.

2. Specific objectives

2.1. Consolidate and expand rehabilitation facilities nationwide, gradually modernize facilities and equipment so as to improve the quality of rehabilitation services and achieve the following objectives by 2020:

a) At communal level: 90% of medical stations of communes will have medical officials who have completed training courses in basic rehabilitation skills to take charges of rehabilitation services;

b) At district level: 90% of district hospitals will establish and maintain rehabilitation divisions that must be comprised of doctors (or medical assistants) and technicians who have completed training courses in rehabilitation major;

c) At provincial level: 100% of provincial general hospitals will establish and maintain rehabilitation wards; 75% of provinces is expected to establish rehabilitation hospitals and more than 50% of specialty hospitals is expected to establish rehabilitation wards;

d) At central level: Vietnam Rehabilitation Hospital will adopt and develop professional and advanced rehabilitation techniques, assign qualified officials to hold required professional titles and develop corresponding rehabilitation techniques in accordance with the Circular No. 46/2013/TT-BYT dated December 31, 2013 by the Ministry of Health providing for functions, duties and organizational structure of rehabilitation facilities (hereinafter referred to as the "Circular No. 46/2013/TT-BYT”); 100% of rehabilitation wards of general hospitals affiliated to the Ministry of Health and other ministries will have enough inpatient beds and develop early rehabilitation at clinical wards in the window period so as to help patients to recover as soon as possible; 70% of specialty hospitals affiliated to the Ministry of Health and other ministries will establish rehabilitation wards.

2.2. Develop community-based rehabilitation, attach special importance to the prevention of disabilities, early detection and intervention for children with disabilities so as to improve the quality of life of people with disabilities in all areas, and achieve the following objectives by 2020:

a) 100% of rehabilitation facilities will disseminate information about the prevention of disabilities, rehabilitation and community-based rehabilitation so as to increase the awareness of leaders at all levels and people of these contents;

b) 100% of provinces and central-affiliated cities will implement and develop community-based rehabilitation programs in at least 40% of communes, wards and provincial- or city-affiliated towns;

c) 70% of children from 0 to 6 years old will undergo screening tests for early detecting congenital anomalies or developmental disorders, and provide early intervention for the ones with disabilities;

d) 80% of people with disabilities are able to use appropriate rehabilitation services for achieving the purpose of social inclusion.

2.3. Increase capacity of rehabilitation officials so as to achieve the following objectives by 2020:

a) 100% of universities of medicine and 50% of public medical colleges and secondary schools will organize training courses in rehabilitation and establish rehabilitation departments;

b) 100% of rehabilitation departments will organize training programs related to professional titles specified in Article 4 of the Circular No. 46/2013/TT-BYT comprising of rehabilitation doctors, rehabilitation medical assistants, bachelor of science in medical technology, bachelor of language (or speech) therapy, physical therapy technicians, occupational therapy technicians, speech-language pathologists and orthopedic device technicians;
c) 100% of central general hospitals and specialty hospitals, provincial general hospitals and specialty hospitals, and the ones affiliated to Ministries will organize continuous training courses in rehabilitation major;

d) 85% of rehabilitation hospitals have officials assigned to hold professional titles as prescribed in Article 4 of the Circular No. 46/2013/TT-BYT;

dd) 100% of directors of rehabilitation hospitals have completed training courses in hospital management.

II. DUTIES AND SOLUTIONS

1. Revising policies, legislative documents and specialized guidelines on rehabilitation

a) Do research, formulate and revise legislative documents on rehabilitation works.

- Formulate allowance policies and incentive policies for officials and employees performing rehabilitation jobs;

- Ministry of Health shall cooperate with the Ministry of Labour, War Invalids and Social Affairs, the Ministry of Education and Training, and the Ministry of Finance to formulate the Joint Circular providing guidelines on development of community-based rehabilitation programs;

- Do research, amend and supplement the list and price bracket of rehabilitation technologies and services, including regulations on payments for these technologies and services by the health insurance fund.

b) Formulate and promulgate specialized documents on rehabilitation and community-based rehabilitation (operational procedures, guidelines for diagnosis, treatment and rehabilitation, etc.) for application nationwide;

c) Formulate regulations on inclusion of rehabilitation activities in national target programs in healthcare sector and relevant programs and schemes for the purpose of saving personnel and material resources.

2. Developing community-based rehabilitation activities

a) Disseminate information about and increase awareness of leaders at all levels of the roles of community-based rehabilitation, and hence attach special importance to investments in the community-based rehabilitation by means of organizing seminars, training courses, visiting and learning from domestic and overseas community-based rehabilitation models;

b) Disseminate information and increase people’s awareness of prevention of disabilities, rehabilitation and community-based rehabilitation so that people are able to actively detect and prevent disabilities, and people with disabilities may properly use healthcare services and rehabilitation services as well as other community services;

- Disseminate, via means of mass media, rehabilitation and preventive measures for people with disabilities, especially prevention, early detection and intervention for disabilities.

- Organize talks and provide advices about the prevention of disabilities, ways to early detect disabilities at authorities, social organizations and communities with the cooperation of social organizations such as the Vietnam Association of the Elderly, Vietnam Veterans Association, Vietnam Women’s Union, Communist Youth Union of Ho Chi Minh City, Vietnam Farmer’s Union, Vietnam Red Cross Society and schools;

- Cooperate with other propagation programs.

c) Implement inter-sector cooperation mechanism between the Ministry of Health, the Ministry of Labour, War Invalids and Social Affairs, and the Ministry of Education & Training in development of community-based rehabilitation programs.

- Organize the implementation of the Joint Circular providing guidelines for community-based rehabilitation with the participation of local governments, local health agencies, departments of labour, war invalids and social affairs, departments of education and training, and other relevant authorities, organizations and individuals;

- Establish systems for supervision of prevention of disabilities and management of people with disabilities at central, provincial, district and communal levels;

- Do surveys and screening tests for early detection of people with disabilities at communities, especially in hamlets and communes. Establish and develop management software for the disabled;

- Inspect, evaluate and report community-based rehabilitation results.

d) Improve and multiply the community-based rehabilitation model.

- Establish and strengthen the management boards of the community-based rehabilitation programs at all levels or assign the community-based rehabilitation duties to the local healthcare committees;

- Provide training for officials, collaborators, social workers, people with disabilities and their families about the community-based rehabilitation;

- Do surveys and examinations for early detection of disabilities, classification of disabilities and make plan for early intervention at local areas, refer the patients to higher level facilities and provide rehabilitation services for people with disabilities in accordance with regulations;

- Provide rehabilitation services at home for disabled persons, periodically monitor and provide instructions on rehabilitation for them, evaluate their development, provide advices and facilitate them in using medical, educational and occupational services and participating in other social activities;

- Give assistance in establishing and operating the Clubs for parents of disabled children, Associations of people with disabilities or Clubs for people with disabilities in local areas;

- Combine community-based rehabilitation activities with other healthcare programs;

- Inspect, evaluate and improve the community-based rehabilitation model;

- Compile documents giving instructions, disseminating and multiplying the community-based rehabilitation model nationwide.

3. Establishing and developing rehabilitation facilities

a) Establish and supplement job positions and the number of persons working in rehabilitation field, put the community-based rehabilitation model into the national criteria for communal medical services, and organize the application of approved one;

b) Provincial Departments of Health shall instruct local hospitals within their competence to establish rehabilitation wards or divisions that must be comprised of professional and competent rehabilitation officials;

c) Improve specialized rehabilitation hospitals nationwide in conformity with actual social and economic conditions of each local area. Provinces and cities are encouraged to establish rehabilitation hospitals to effectively provide rehabilitation services for the disabled, persons suffering from occupational diseases and other subjects;

d) Provincial Departments of Health shall instruct provincial general hospitals and specialty hospitals to provide training courses for rehabilitation officials and make investments in facilities and equipment for establishing rehabilitation wards;

dd) Hospitals affiliated to the Ministry of Health, or other Ministries or other central agencies are responsible for training officials, doing preparations for providing treatment and rehabilitation services for inpatients and develop early rehabilitation at clinical wards in the window period; Intensify, improve and expand Sam Son and Thanh Hoa National Rehabilitation Hospitals; establish the rehabilitation institute affiliated to Bach Mai Hospital for developing scientific research and training for professional officials and directing rehabilitation activities.

e) Ministry of Health encourages and provides professional assistance for health agencies of ministries and private healthcare providers in establishing rehabilitation hospitals to serve employees and other subjects.

4. Training officials and doing scientific researches on rehabilitation

a) Intensify training for human resources in rehabilitation field for hospitals, including officials holding professional titles as prescribed in Article 4 of the Circular No. 46/2013/TT-BYT; adopt incentive and allowance policies for doctors who want to attend training courses for improving their professional competence to Specialty-I or Specialty-II Doctor, Master or Doctor of Philosophy in Rehabilitation;

b) Medical universities, medical colleges and medical secondary schools shall strengthen and intensify rehabilitation-related operations with attaching special importance to training for high-skilled and high-level teachers and lecturers; increase the number of enrolment targets in rehabilitation major;

c) Formulate and revise training programs and materials in rehabilitation and community-based rehabilitation majors at different levels; amend and supplement contents of training programs and continuous training programs in rehabilitation to meet actual demands;

d) Intensify different training models at various levels in rehabilitation and community-based rehabilitation majors to meet social needs;

dd) Rehabilitation hospitals, rehabilitation wards and rehabilitation centers shall provide continuous training programs, training and drilling courses for lower-level divisions according to the training programs approved by competent authorities;

e) Organize training in rehabilitation for each type of diseases for doctors, technicians and nurses at provincial hospital and district general hospitals with the aims of increasing the capacity of rehabilitation officials;

g) Provide training courses in basic rehabilitation skills for healthcare officials in charge of rehabilitation works at medical stations of communes or wards;

h) Provide training for healthcare officials of hamlets/villages, collaborators, social workers, school medical staff, and teachers of kindergartens and nursery schools so as to early detect and intervene in children with disabilities;

k) Intensify scientific research activities for the purposes of developing rehabilitation and community-based rehabilitation fields, pay attention to technological transfer between levels and learning, receiving transfer of advanced rehabilitation technologies from foreign countries to Vietnam; cooperate with Vietnam Rehabilitation Association to organize at least 02 scientific seminars in rehabilitation for sharing and learning experience.

5. Investing in equipment and facilities

a) Establish and improve rehabilitation wards, rehabilitation centers and rehabilitation hospitals, gradually modernize rehabilitation hospital and improve the application and development of high technology, science and techniques in rehabilitation sector. Develop highly-specialized rehabilitation wards and majors with the orientation of rehabilitation for each type of diseases;

b) Equip enough rehabilitation equipment and facilities according to technical levels, gradually modernize rehabilitation equipment and facilities in hospitals so as to enhance the quality of medical services and rehabilitation services.

6. Developing early rehabilitation for patients

Rehabilitation hospitals, rehabilitation wards and rehabilitation centers shall closely cooperate with clinical wards to provide rehabilitation services for patients in the post-emergency phase and during treatment at the hospital; apply high technologies in rehabilitation and combine them with traditional medicine so as to meet increasing demands of patients and people with disabilities.

7. Directing healthcare activities at different levels

a) Higher-level hospitals shall intensify healthcare activities direction, transfer of high rehabilitation technologies and training for lower-level officials so as to facilitate people in accessing and using high quality medical services and making contribution to obtain justice in healthcare activities and mitigate higher-level hospital overload;

b) Provincial rehabilitation hospitals or rehabilitation wards of provincial general hospitals shall take charge of local community-based rehabilitation activities.

8. Managing hospitals

a) Innovate the hospital management mechanism in conformity with special features of rehabilitation specialty;

b) Intensify private sector involvement in providing rehabilitation services, diversify sources of investments and court the investments made by domestic and overseas organizations and individuals in addition to funding from state budget in accordance with law regulations.

9. International cooperation

Intensify international cooperation in rehabilitation sector court the assistance from foreign countries and international organizations to mobilize material and human resources, learn experience, improve professional competence and step by step promote the international integration in rehabilitation activities. Arrange officials of rehabilitation facilities to visit and learn experience from rehabilitation facilities overseas.

10. Inspection, emulation and commendation

a) Ministry of Health shall conduct inspections of performance of rehabilitation activities by local authorities; Provincial Departments of Health and health agencies affiliated to Ministries shall conduct inspections of performance of rehabilitation activities by units within their competence;

b) Ministry of Health and Provincial Departments of Health shall annually make preliminary and final summing-up of emulation and commendation activities so as to timely encourage communities and individuals that have achieved excellent performance in rehabilitation.

III. FUNDING

This Plan shall be implemented with the following funding sources:

1. Funding from state budget included in estimates of recurrent expenditures of ministries, central agencies and local governments;

2. Budgets for target healthcare programs and other relevant programs as allocated under the regulations of the Law on state budget, comprising of: Decision No. 651/QD-TTg dated June 01, 2012 by the Prime Minister on giving approval for the “National action plan for mitigation of effects of toxic chemicals used by the U.S Military during the Vietnam War by 2015 and the orientations towards 2020”; Decision No. 1019/QD-TTg dated August 05, 2012 by the Prime Minister on giving approval for the Assistance Scheme for people with disabilities for the 2012 – 2020 period;

3. ODA grants; contributions made by domestic and overseas organizations and individuals;

4. Funds for professional career development established by health facilities;

5. Other legal sources of funding.

IV. IMPLEMENTION ORGANIZATION

1. The Administration of Medical Examination and Treatment shall:

a) Assist the Minister of Health to instruct and organize the implementation of the Plan for performing rehabilitation activities in the 2014 – 2020 period;

b) Lead and cooperate with relevant authorities and units to formulate detailed action plans and annual cost estimates for implementing this Plan, submit them to the Minister of Health for consideration and organize the implementation of the approved ones within the ambit of its assigned functions and duties; conduct annual or unexpected inspections to evaluate the performance of the Plan, and submit reports thereof to the Minister of Health for promptly dealing with difficulties that arise during the implementation of the Plan;

c) Formulate legislative documents and specialized regulations on rehabilitation and community-based rehabilitation, and submit them to competent authorities for promulgation;

d) Instruct Provincial Departments of Health and health agencies affiliated to Ministries to formulate plans for performance of rehabilitation activities in the 2014 – 2020 period;

dd) Instruct and supervise the implementation of the Plan and legislative documents and/or specialized regulations on rehabilitation and community-based rehabilitation nationwide.

2. Department of Planning and Finance shall take charge and cooperate with the Administration of Medical Examination and Treatment and relevant agencies to formulate and amend regulations on prices of medical services regarding rehabilitation activities; consolidate and propose the allocation of funding to the Minister of Health for consideration; provide guidance on financial policies for implementing this Plan.

3. Department of Health Insurance shall take charge and cooperate with relevant agencies to do researches and propose regulations on medical services covered by health insurance fund and payment for covered rehabilitation-related services.

4. The Administration of Science Technology and Training shall take charge and cooperate with the Administration of Medical Examination and Treatment and relevant agencies to formulate and appraise training programs and materials, and instruct the organization of continuous and regular training programs in rehabilitation major at different levels; take charge of directing training activities and scientific research on rehabilitation field nationwide.

5. The Organization and Personnel Department shall take charge and cooperate with relevant agencies to consider formulating policies on allowances and incentives for officials and employees performing rehabilitation jobs.

6. The Department of Health Equipment and Works shall take charge and cooperate with relevant agencies to formulate regulations on infrastructure facilities (buildings and structures) and list of rehabilitation equipment required in rehabilitation facilities.

7. The Department of Communications, Emulation and Commendation shall take charge of communications, emulation and commendation activities during the implementation of the Plan; instruct communications agencies in medical sector or other relevant communications agencies to develop propagation and education activities to increase people's awareness of prevention of disabilities as well as benefits of early detection and early intervention for disabilities.

8. The Department of International Cooperation shall mobilize grants from international organizations so as to increase funding for implementing the Plan.

9. Public medical training institutions shall:

a) Establish, maintain and improve capacity of rehabilitation wards;

b) Proactively intensify training programs for rehabilitation officials in different modes and levels according to social needs.

10. The National Center for Health Communication and Education, Sức khỏe và Đời sống (”Health & Life”) Newspapers, and Gia Đình và Xã hội (“Family & Society”) Newspapers shall cooperate with communications agencies to disseminate information about prevention of disabilities, benefits of early detection and early intervention for disabilities, and necessity of the community-based community.

11. Provincial Departments of Health, and health agencies affiliated to Ministries shall:

a) Based on actual conditions of each local area or Ministry, actively propose specific action plans or programs as well as cost estimates for implementing the Plan for rehabilitation service development in the 2014 - 2020 period within the scope of local or ministry areas;

b) Based on the plans given approval by Chairpersons of People’s Committees of provinces or central-affiliated cities, or Ministers or competent authorities, Provincial Departments of Health, and health agencies affiliated to Ministries shall annually formulate local or ministry's estimates for operating expenditures, submit them to financial agencies for consideration and submission to Chairpersons of People’s Committees of provinces or central-affiliated cities for consideration.

c) Instruct and organize the implementation of activities of the approved Plan; conduct inspections to evaluate the implementation of the Plan;

d) Submit annual and unexpected reports on the implementation of the Plan to the Ministry of Health.

12. Health facilities and rehabilitation facilities shall:

a) Plan and formulate cost estimates for rehabilitation activities based on the Ministry of Health’s Plan and specific action plans of Provincial Departments of Health, or health agencies affiliated to Ministries;

b) Implement action plans for rehabilitation; gradually improve their organizational structure, appoint enough officials to hold required professional titles and adopt rehabilitation techniques as prescribed in the Circular No. 46/2013/TT-BYT.

c) Submit annual and unexpected reports to on rehabilitation and community-based rehabilitation results to the Ministry of Health or Provincial Departments of Health.

d) Vietnam Rehabilitation Hospital shall in addition to the said duties formulate the master plan for development by 2020, and submit it to the Minister of Health for consideration. The master plan must attach special importance to the development of professional and advanced rehabilitation technologies and improvement of early rehabilitation in clinical wards; intensify training programs for professional rehabilitation officials so as to ensure that they are fully capable of holding professional titles specified in Article 4 of the Circular No. 46/2013/TT-BYT; promote the management roles of authorities at all levels and the community-based rehabilitation as assigned by the Ministry of Health; provide advice about policies for development of rehabilitation activities to the Ministry of Health.

Article 2. This Decision shall come into force as from the date on which it is signed.

Article 3. Chief of Ministry's Office, Director of the Administration of Medical Examination and Treatment, Chief Inspector of the Ministry of Health, Directors and Directors General of Departments, Bureaus and General Departments directly under the Ministry of Health, Directors of medical facilities directly under the Ministry of Health, Directors of Departments of Health of central-affiliated cities or provinces, Rectors of Medical Universities, Heads of health agencies affiliated to Ministries, and Heads of relevant units shall implement this Decision./.