B Y T

S TAY

HNG DN THC HIN

D N H TR X L CHT THI BNH VIN

VAY VN NGN HNG TH GII

(Ban hnh km theo Quyt nh s 3078/Q-BYT ngy 26 /8/2011 ca B trng B Y t)

H nI, thng 8 nm 2011

MC LC

1PHN I. T CHC, QUN L THC HIN D N

CHNG 1 tHNG TIN C BN V D N21.1C S PHP L CA D N21.2THNG TIN C BN V D N2CHNG 2: T CHC THC HIN D N112.1. T CHC QUN L D N112.2PHN CP C TH TRCH NHIM THC HIN D N132.3CHC NNG NHIM V CA CC T NGHIP V TRONG CPMU162.4MT S QUY NH V CHC NNG NHIM V CA CH U T:202.5HNG DN V PH CP QUN L D N V CH LNG CHO CN B TUYN CHN THEO HP NG21CHNG 3: CH BO CO, GIM ST NH GI233.1 CH BO CO233.2 KIM TRA, GIM ST243.3 HOT NG NH GI25PHN II. HNG DN CNG TC TI CHNH-K TON26CHNG 1: LP K HOCH TI CHNH D N271.1NGUYN TC LP K HOCH TI CHNH271.2 CC CN C V NI DUNG LP K HOCH TI CHNH271.3 CC BC LP V PH DUYT K HOCH TI CHNH28CHNG 2: NGN HNG PHC V V CC VN M TI KHON302.1 NGN HNG PHC V302.2 NG K CH K CA CH D N, K TON TRNG C Y QUYN K N RT VN ( CH P DNG CPMU)312.3 M TI KHON CHO D N313.1TH TC THANH TON VN VAY WB333.1. 1 CHU TRNH CHUYN VN I VI HP PHN 1333.1. 2 CHU TRNH CHUYN VN I VI HP PHN 235CHNG 4. CNG TC K TON D N424.1 QUY NH CHUNG K TON CA D N H TR X L CHT THI BNH VIN424.2 T CHC CNG TC K TON, T CHC B MY K TON424.3 NI DUNG CNG TC K TON434.4CHNG T K TON434.5H THNG TI KHON K TON444.6 HINH THC S K TON444.7 QUN L TI SN D N45CHNG 5: CH BO CO, KIM TRA, KIM TON, QUYT TON D N465.1 CH BO CO465.2 KIM TRA, KIM SOT NI B465.3 KIM TON495.4QUYT TON49CHNG 6: CC NI DUNG CN THC HIN KHI KT THC D N516.1 KIM K TON B VT T, TI SN, TIN VN CA D N TT C CC CP CC N V TRIN KHAI THC HIN D N51PHN III. HNG DN QUY TRNH U THU MUA SM53CHNG 1: GII THIU CHUNG541.1THM QUYN V TRCH NHIM CA BAN QLDA CC CP TRONG CNG TC U THU, MUA SM541.2 NHNG VN CHUNG QUAN TRNG551.3 I TNG P DNG V I TNG S DNG56CHNG 2: HNG DN CCH THC NGHIN CU TI LIU V U THU MUA SM57T CHC QUN L CNG TC U THU CA D N57CHNG 3: K HOCH U THU593.1.CHUN B K HOCH U THU593.2CC BC TRIN KHAI LP, PH DUYT K HOCH U THU59CHNG 4: U THU TUYN CHN T VN624.1TUYN CHN DA TRN CHT LNG V CHI PH (QCBS)624.2TUYN CHN DA TRN CHI PH THP NHT (LCS)734.3TUYN CHN DA TRN NNG LC CA T VN (CQS)744.4 TUYN CHN T VN C NHN764.5TUYN CHN T VN T MT NGUN DUY NHT (SSS)774.6.SAO K CHI PH (SOE)77CHNG 5: U THU MUA SM HNG HA V XY LP785.1U THU CNH TRANH QUC T (ICB)785.2U THU CNH TRANH TRONG NC (NCB)845.3 CHO HNG CNH TRANH (Shopping)915.4 CH NH THU (DC):94CHNG 6: KIM TRA CA NGN HNG TH GII956.1TH TC KIM TRA TRC956.2TH TC KIM TRA SAU96Phn IV. HNG DN THC HIN THNH PHN 1..............................97Phn V. HNG DN THC HIN THNH PHN 2...............................99CHNG 1: KHI QUT100CHNG 2: CC NGUYN TC CHUNG TRONG VIC TRIN KHAI THC HIN THNH PHN 2108CHNG 3 CC VN BN LIN QUAN109PHN VI: QUN L NGUY C MI TRNG.

113PH LC131PH LC 1: M T THC N CNG NGH V NH MC H TR131PH LC 2 : HNG DN LA CHN CNG NGH QUN L CHT THI Y T131PH LC 1. M T THC N CNG NGH V NH MC H TR1321.7 KHI TON khON TI TR CHO BNH VIN THAM GIA VNG 1162PH LC 2 :HNG DN LA CHN CNG NGH1832.1.2Cc phng n cng ngh1832.1.2.2Cc cng ngh khng t 1842.2.1 Cc cng ngh x l nc thi hin ang p dng trong cc bnh vin Vit Nam:2Hnh 1: S cng ngh ca phng n 13Hnh 2: S cng ngh ca phng n 23Hnh 3: S cng ngh ca phng n 34Hnh 4: S cng ngh ca h thng x l nc thi4s dng cng ngh x l gin on theo m42.2.2 Hng dn la chn cng ngh5PH LC 3: MU K HOCH QUN L CHT THI Y T CA TNH3PH LC 4: MU K HOCH QUN L CHT THI CA BNH VIN5PH LC5:8IU KHON THAM CHIU CHO C QUAN KIM NH C LP8PH LC6:16

DANH MC CC CH VIT TT

ATVSTP

An ton v sinh thc phm

BTC

B Ti chnh

BKHT

B K hoch v u t

CT

Ch u t

CQLN&TCNCc Qun l n v Ti chnh i ngoi (BTC)

KCB

Khm cha bnh

BS

Bc s

BV

Bnh vin

BVK

Bnh vin a khoa

BYT

B Y t

CT

Ch u t

CSSK

Chm sc sc khe

CSSKB

Chm sc sc khe ban u

CSYT

C s y t

BSCL

ng bng Sng Cu long

HCSN

Hnh chnh s nghip

HMIS

H thng thng tin qun l y t

KTV

K thut vin

KT-XH

Kinh t - X hi

LTBXH

Lao ng thng binh x hi

NHTG

Ngn hng Th gii

NVYT

Nhn vin y t

CPMU

Ban Qun l d n Trung ng

PPMU

Ban Qun l d n tnh

QLDA

Qun l d n

SYT

S Y t

TTB

Trang thit b

TTGDSK

Truyn thng gio dc sc khe

TTYTDP

Trung tm y t d phng

TYTX

Trm y t x

UBND

y ban nhn dn

VSDT

V sinh dch t

VSMT

V sinh mi trng

XDCB

Xy dng c bn

XLCT

X l cht thi

XN

Xt nghim

WB

Ngn hng th gii

WHO

T chc Y t th gii

VIHEMA

Cc Qun l Mi trng Y t

PHN I. T CHC, QUN LTHC HIN D N

CHNG 1 tHNG TIN C BN V D N

1.1C S PHP L CA D N

Ngh nh s 188/2007/N-CP ngy 27/12/2007 ca Chnh ph qui nh chc nng, nhim v, quyn hn v c cu t chc ca B Y t;

Ngh nh s 22/2010 ngy 09/3/2010 ca Chnh ph sa i, b sung iu 3 ca Ngh nh s 188/2007/N-CP ngy 27/12/2007 ca Chnh ph quy nh chc nng, nhim v, quyn hn v c cu t chc ca B Y t;

Ngh nh s 131/2006/N-CP ngy 9/11/2006 ca Chnh ph v vic ban hnh Quy ch qun l v s dng ngun vn h tr pht trin chnh thc (ODA);

Thng t s 108/2007/TT-BTC ngy 7/9/2007 ca B Ti chnh hng dn qun l ti chnh p dng i vi cc chng trnh, d n h tr pht trin chnh thc (ODA). Thng t s 40/2011/TT-BTC ngy 22/3/2011 cu B Ti Chnh hng dn sa i, b sung thng t 108/2007/TT-BTC ngy 7/9/2007 ca B Ti chnh v hng dn c ch qun l ti chnh i vi cc chng trnh, d n ODA. Thng t s 107/2011/TT-BTC ngy 20/7/2011 cu B Ti Chnh sa i im sa i im c, khon 2 iu 1 thng t s 40/2007/TT-BTC ngy 22 thng 3 nm 2011 ca B Ti chnh. Vn bn s 1367/TTg-QHQT ngy 9/8/2010 ca Th tng Chnh ph ph duyt danh mc D n H tr x l cht thi bnh vin, vay vn ca Ngn hng th gii

Kt qu m phn Hip nh tn dng pht trin ca D n H tr x l cht thi bnh vin vay vn ngn hng th gii;

Quyt nh s 147/Q-BYT ngy 21/01/2011 ca B trng B Y t v vic ph duyt ni dung vn kin D n H tr x l cht thi bnh vin s dng vn vay Ngn hng Th gii;

Hip nh Tn dng Pht trin s 4899-VN k ngy 31/5/2011 gia i din nc Cng ho x hi Ch ngha Vit Nam v Ngn hng Th gii.

Quyt nh s 4708/Q-BYT ngy 6/12/2010 v vic thnh lp Ban Qun l D n H tr x l cht thi bnh vin vay vn Ngn hng Th gii (WB).

Quyt nh s 5408/Q-BYT ngy 28/12/2007 ca B trng B Y t ph duyt k hoch qun l cht thi y t.

1.2THNG TIN C BN V D N

1.2.1Tn D n: H tr x l cht thi bnh vin

(Tn ting Anh: Hospital Waste Management Support Project)

1.2.2 C quan ch qun D n: B Y t

1.2.3 C quan ch d n: B Y t v cc S y t c h tr u t t D n, trong chc nng ch u t cc tiu d n x l cht thi c D n ti tr thc hin nh sau:

Ch u t: Ban Qun l d n Trung ng (Thc hin hp phn 1 v 3).

Cc bnh vin tuyn Trung ng (Thc hin hp phn 2 tuyn

trung ng).

Cc S Y t theo quyt nh ca cp c thm quyn (Thc hin hp phn 2 tuyn a phng).1.2.4 a bn thc hin D n: C nc (cc bnh vin tuyn Trung ng, tuyn tnh v a khoa khu vc lin huyn) v B Y t.

1.2.5 Thi gian thc hin: 6 nm, k t ngy D n c hiu lc (D kin 1/9/2011 n 31/8/2017).

1.2.6 Mc tiu ca D n:

a) Mc tiu chung

D n H tr x l cht thi bnh vin nhm gim tnh trng nhim mi trng do cht thi y t pht sinh t cc bnh vin ti Vit Nam, gp phn nng cao sc kho ca nhn dn.

b) Mc tiu c th

Vi mc tiu chung nu trn, D n s u t, h tr cho h thng x l cht thi ca cc bnh vin c hng li, ng thi h tr nng cao nng lc v kinh ph vn hnh, lp chnh sch vi 3 mc tiu trc mt nh sau:

i. Ci thin h thng chnh sch lin quan n qun l cht thi y t Vit Nam

ii. H tr u t xy lp, trang b h thng x l cht thi rn v cht thi lng cho khang 200 250 cc bnh vin ti Vit Nam (t nht 150 bnh vin), u tin cho cc bnh vin cng c nhu cu cp thit v x l cht thi thuc tuyn trung ng, tuyn tnh, bnh vin a khoa khu vc lin huyn, mt s bnh vin huyn quy m ln thuc cc tnh kh khn thuc min ni pha Bc, vng ng bng sng Cu Long, Ty Nguyn v mt s a phng khc.

iii. Nng cao nng lc qun l, vn hnh, quan trc, kim nh h thng x l cht thi rn v nc thi y t.

1.2.7 Ni dung u t ca D n

Ni dung u t ca D n bao gm 3 Hp phn

Hp phn 1: Tng cng c s chnh sch v nng lc th ch cho qun l cht thi y t (9 triu USD)K hoch tng th quc gia thng nht v cc ti liu k thut c xy dng khc ch ra nhu cu o to, h tr nng cng nng lc th ch v vic tip tc xy dng cc vn bn chnh sch. Hp phn ny s ti tr cho cc dng hot ng sau:

(i) o to/tp hun, bao gm tng cng c cu o to/tp hun, o to ging vin, xy dng ti liu o to: D n s phi hp vi cc tnh, huyn, bnh vin ni trin khai d n xc nh cc nhu cu v tp hun/o to, ni dung v i tng o to cho ph hp;

(ii) cc ti liu thng tin cho qu trnh hoch nh chnh sch ca ban gim c v cc nh qun l bnh vin, trong bao gm xy dng, ban hnh mt danh mc cc phng tin, dng c mua sm phc v cng tc phn loi, thu gom v vn chuyn cht thi y t;

(iii) nng cao nhn thc cho cng chng;

(iv) gim st v nh gi vic tun th chnh sch v cc tiu chun mi trng.

Hp phn 2: Khon ti tr da trn kt qu ci thin x l cht thi y t (134 triu USD)

D n xy dng mt hng dn la chn cng ngh v chi ph gi tt l thc n cc khon ti tr da trn kt qu cho tng loi hnh, quy m bnh vin, phn loi bnh vin theo nguy c (mc nh hng ti sc kho, mi trng ca cht thi m c s thi ra mi trng) cng nh cho cc cng ngh hin c. Thc n ny s bao gm cc la chn cho nng cp qun l cht thi rn, nng cp qun l cht thi lng, h tr qun l cp c s y t, v h tr kinh ph vn hnh trong mt khong thi gian nht nh sau khi vic nng cp hon tt. D n s t chc nghin cu, xem xt v p dng cc gii php xy dng v cng ngh x l nc thi bnh vin ph hp vi thc t ca Vit Nam v c chi ph ph hp. Cc hng dn la chn cng ngh v chi ph c trnh by trong ph lc ti phn VI.

Cc khon ti tr cng c th c cp tr cho ton b hoc mt phn chi ph vn hnh sau khi h thng x l c nng cp v u t. u ra/kt qu mong i ca nhng khon ti tr l c s y t p ng c cc tiu chun v qun l cht thi y t (nu trong phn VI). Cc tiu ch la chn c s y t xy dng trn 2 nguyn tc chnh bao gm:

Tnh cp bch v nguy c nhim mi trng, c bit cc c s thuc danh sch cc c s gy nhim mi trng nghim trng nu ti ph lc s 2 Quyt nh s 64/2003/Q-TTg ngy 22/4/2003 ca Th tng Chnh ph v vic ph duyt k hoch x l trit cc c s gy nhim mi trng nghim trng v cc thay i hin hnh ca Chnh ph v cc vn bn sa i, iu chnh hin hnh;

Tnh sn sng p ng cc yu cu ca d n, bao gm k hoch qun l cht thi y t ca tnh v bnh vin v nng lc thc hin d n.

Cc tiu ch la chn c th nh sau:

a) i vi la chn tnh u t

- Phi c K hach qun l cht thi y t ca tnh chun b theo hng dn c duyt ca D n v c D n xem xt, chp thun.

- u tin cc a phng vng kh khn v a phng c cc bnh vin nm trong danh sch cc c s gy nhim hin hnh (Quyt nh 64/2003/Q-TTg ca Th tng Chnh ph).

b) i vi bnh vin

- L bnh vin cng;

- Bnh vin tuyn tnh, a khoa khu vc lin huyn hoc bnh vin huyn quy m ti thiu c B Y t v Ngn hng th gii thng nht (ti thi im thm nh d n l 200 ging bnh); l ngun c nguy c gy nhim t ti cc khu vc ng dn c. Quy m ging bnh ti thiu c th c u t c th s c xem xt trong qu trnh trin khai d n.

- C xy dng K hach qun l cht thi ca bnh vin theo mu c duyt (c nh gi cht lng).

- Khng c cc h tr khc hoc u t ca cc ngun khc khng so vi tng mc u t c duyt;

- D n s tp trung vo cc bnh vin hin c v tt c vic lp t, xy dng cc h thng x l nc thi cn phi c b tr trong khun vin hin c ca bnh vin (khng chim t mi);

- Yu cu v cng ngh: Trong iu kin cc l t sn sinh cc cht nhim hu c bn vng c hi cho mi trng (bao gm c Furan v Dioxin), d n s ch trng u t cho cc cng ngh x l cht thi khng t p dng cho cc cht thi rn (v d hp, vi sng) p dng cho tng bnh vin c u t. Mc d vn tha nhn ti cc khu vc th ln, cc l t tp trung (v d cc m hnh cng ty mi trng th hoc cc m hnh hp tc cng t) vn tip tc l cng ngh x l cht thi y t nguy hi c thit k quy m ln v c p dng cc l t hiu nng cao, nng sut ln v c p thit b an tan mi trng.

Cc khon ti tr s c cung cp cp quc gia/tnh, theo tng vng cp vn, c th l hai t/nm.

Theo tnh ton ban u v nh mc ti tr cho mi khon ti tr (da trn cc quy nh hin hnh ca Chnh ph v cc d n trin khai) nh sau:

(i) Bnh vin huyn quy m 200 ging s vo khong 300.000 la M.

(ii) Bnh vin tuyn tnh 500 ging s vo khong 800.000 la.

(iii) Bnh vin tnh hoc Trung ng ln s vo khong 2 triu USD.

nh mc ti tnh s c hiu chnh ty theo s thay i cng ngh, tnh hnh kinh t x hi v ch s lm pht (c bit l ch s gi xy dng v t gi) cng nh s thay i quy m ca c s y t theo quyt nh ca cp c thm quyn.

Trong trng hp nu n v la chn cng ngh v quy m u t c tng mc u t u t cao hn nh mc ti tr do D n v Ngn hng th gii quyt nh, phn chnh lch s cho a phng/n v t thu xp.

Cc bnh vin nhn c khon ti tr phi t c cc tiu chun quc gia v qun l cht thi y t (c v cc tiu chun pht thi v x thi cng nh quy nh v thc hnh qun l cht thi ni b, bao hm t chc, trch nhim, gim thiu, phn loi, thu gom v lu gi cht thi nguy hi). S tun th ny s c xc nhn (thm nh) ca mt C quan kim nh c lp trong s 4 Vin c chn Vin y hc lao ng v v sinh mi trng, Vin v sinh y t cng cng TP HCM, Vin Pasteur Nha Trang, Vin V sinh dch t Ty Nguyn. Mt cn b ca c quan qun l nh nc v mi trng s tham gia cc on thm nh ca cc C quan kim nh c lp

Hp phn 2 gm cc tiu thnh phn sau:

B1. H tr trang thit b v u t cho h thng x l cht thi cc bnh vin tuyn a phng (tnh v huyn):Cc khon ti tr s c s dng cho cc hng mc u t theo hng dn v cng ngh v hng dn chi tit ti phn VI.

V c ch thc hin, D n khng h tr vic thnh lp Ban qun l d n tuyn tnh (PPMU). Cc chi ph qun l trong qu trnh trin khai c kt cu vo chi ph qun l ca tng khon ti tr.

B2. H tr trang thit b v u t cho h thng x l cht thi cc bnh vin tuyn trung ng:

D n s h tr u t xy dng cc h thng x l cht thi ca cc bnh vin ph hp vi cng sut x thi v t tiu chun x thi cng nh cc tiu chun mi trng hin hnh vi mc h tr c Ngn hng th gii v B Y t ph duyt cho vng cp vn ban u (trung bnh 1200USD (tng ng) trn 1 ging bnh cho h thng XLNT).

V c ch qun l, s p dng h thng qun l hin hnh ca Chnh ph Vit Nam v qun l u t xy dng. Khon ti tr t d n cho cc Ch u t s s dng :

(i) Nng cp c s h tng phc v cho qun l, x l cht thi rng v cht thi lng;(ii) Nng cao nng lc ni b i vi qun l cht thi trong bnh vin (bao gm c Hi ng kim sot nhim khun v h thng cc nhn vin khoa phng c lin quan, ci thin cc quy ch/hng dn ca bnh vin i vi vic gim pht thi, phn loi, thu gom v lu gi cht thi c hi;(iii) Xy dng nng lc v o to nhn vin v thc hnh an ton ngh nghip;(iv) Cung cp cc vt t, vt liu tiu hao phc v h thng hu cn ni b.

Hp phn 3: iu phi v h tr trin khai d n (7 triu USD)

D n c t chc nhm gim c cu t chc cng knh cho vic qun l d n. D n s khng thnh lp mi cc Ban qun l d n ring tuyn tnh. Cc Ch u t a phng v bnh vin tuyn trung ng c th s dng cc Ban qun l d n hin c ti cc a phng v bnh vin ca mnh qun l cc khon vin tr (hoc cng c th thnh lp Ban qun l d n ring s dng ngun vn i ng theo quy nh hin hnh v qun l u t xy dng). Sau khi c la chn, mi t, cc n v tham gia s c tp hun v quy trnh xin ti tr v ch bo co s dng khon vin tr.

Ti tuyn Trung ng, mt Ban qun l d n Trung ng c B trng B Y t thnh lp c nhim v iu phi ton b hot ng ca D n t lp k hoch, trin khai cc hot ng, gim st, nh gi v cc hot ng ca D n. C cu c th s c m t trong Hng dn v m hnh qun l d n.

Ban qun l d n hot ng di s ch o ca mt Ban ch o do B trng Y t thnh lp bao gm B trng, mt th trng v i din lnh o, chuyn gia cc c quan lin quan. Bn cnh , mt Nhm t vn k thut bao gm cc chuyn gia c c v B Y t ph chun s tham gia nh gi trong cc vng xt danh mc v mc cp vn. Chi ph chuyn gia s tnh trn s ngy thc t c huy ng.

Hp phn 3 c xy dng h tr cng tc iu phi, qun l, trin khai thc hin hot ng ca cc hp phn 1, 2, nhm t c cc mc tiu ca D n, thng qua t chc hot ng ca cc c cu Qun l d n trung ng v a phng. Chi tit v t chc v cc hot ng ca Hp phn 3 c nu c th trong phn T chc thc hin D n. 1.2.8Vn u t v c cu s dng vn

a) Tng vn u t: 155 triu la M, tng ng 3.022,5 t VN, t cc ngun vn sau:

Vn ODA: 150 triu la M, tng ng 2.925 t ng; trong :

Ngn sch cp pht XDCB: 100 % tng vn ODA. Trong :

+ C ch cp pht trc tip cho cc B, c quan Trung ng: p dng i vi cc bnh vin do trung ng qun l.

+ Ngn sch Trung ng b sung c mc tiu cho a phng: p dng i vi cc bnh vin do a phng qun l.

Cho vay li: 0% tng vn ODA

Vn i ng: 5 triu la M, tng ng 97,5 t ng Vit Nam1

b) Vn u t phn theo cc nm v ngun vnBng 3. C cu ti chnh ca D n t IDA (triu USD)

Hp phnKinh phIDA Ti chnh% Ti chnh

1. Ci thin mi trng chnh sch v th ch i vi qun l cht thi y t9.0

9.0

100

1.1 Ci thin chnh sch v khung php l lin quan n qun l cht thi y t0.650.65

1.2 Tng cng nng lc trin khai cng tc qun l cht thi y t1.051.05

1.3 Xy dng h thng quan trc, gim st qun l cht thi y t7.237.23

2. H tr ci thin x l cht thi bnh vin134.0134.0100

2.A Bnh vin Trung ng40.040.0

2.B Bnh vin thuc tnh94.094.0

3. Qun l, iu phi d n7.07.0100

Tng s chi ph ban u

D phng vt cht

D phng trt gi

Tng kinh ph d n

Li sut trong qu trnh thc hin

Tng cc lai ph

Tng s kinh ph yu cu ti chnh150.0150.0150.0

Bng 4: Phn k k hoch gii ngn ca D n (triu USD)

Nm trin khai DANm 1Nm 2Nm 3Nm 4Nm 5Nm 6

Hng nm3,010,030,040,050,017,0

Ly tch3,013,043,083,0133,0150,0

c) C cu phn b vn i ng- Vn i ng: (97,5 t ng Vit Nam) cp di hnh thc hin vt hoc tin mt. Chi tit v vn i ng:

+ Lng, ph cp kim nhim cho cc b d n tuyn TW v a phng, cn b hp ng lm vic do d n.

+ Cc chi ph, l ph khng thuc din c s dng vn nc ngoi (IDA) chi tr.

Ngun vn i ng c huy ng theo mt hoc mt s hnh thc sau:

Vn ngn sch trung ng cp pht 19,5 t ng Vit Nam (20%) tng vn i ng: nm trong d ton chi u t pht trin hng nm ca cc B, c quan Trung ng ( y l B Y t).

Cc a phng (80%): ngn sch a phng t m bo; tr cc a phng ngn sch kh khn c Ngn sch Trung ng h tr theo quy nh ti Quyt nh s 210/2006/Q-TTg ngy 12/9/2006 ca Th tng Chnh ph. Cc a phng c trch nhim b tr vn b sung trong trng hp tng mc u t ca tng d n cao hn mc h tr ca D n c B Y t v Ngn hng th gii ph duyt.

1.2.9. C ch qun l ngun vn

a) D n H tr x l cht thi bnh vin c qun l v thc hin theo cc quy nh hin hnh ca Chnh ph v qun l d n ODA, ng thi ph hp vi cc iu khon trong Hip nh vay vn k vi WB.

b) Vn vay ca WB c qun l qua mt ti khon c bit do CPMU chu trch nhim. Cc khon ti tr c cp pht cho CMPU (i vi cc hot ng do CPMU thc hin) v cp pht cc Ch u t thc hin D n (theo m t c th ti Phn hng dn qun l ti chnh). V qun l ngun vn ti tr ti a phng, D n s u tin la chn S Y t l cc Ch u t ti tuyn tnh v cc bnh vin Trung ng l ch u t ti tuyn trung ng (theo quy nh c th ti Tha thun ti tr k gia B Y t v a phng/bnh vin (xem ph lc 7).

c) Vn i ng do ngn sch trung ng (vn u t) v ngn sch a phng b tr trong k hoch ngn sch hng nm m bo ph hp vi tin ca D n.

d) Vn ca D n u t thc hin hng mc u t xy dng, nng cp h thng x l cht thi bnh vin c qun l, s dng theo quy nh i vi ngun vn u t xy dng c bn.

e) Vn ca D n thc hin cc hng mc h tr pht trin chnh sch, o to, chi ph hot ng gia tng c qun l, s dng theo quy nh hin hnh i vi ngun vn hnh chnh s nghip.

1.2.10 K hoch thc hin v quy trnh c bn la chn a bn, a ch u t

D n s c thc hin trong vng 06 nm k t ngy D n c hiu lc v kt thc vo ngy 31/8/2017. D n s xt cp vn mi nm 2 ln, vi s lng ban u l 16 bnh vin khu vc BSCL v 5 bnh vin Trung ng (theo danh mc v mc cp vn ti bng 5). Vic la chn a bn cho cc vng cp vn s do Ban ch o thc hin D n (do B trng y t thnh lp) quyt nh.

Chu trnh xem xt v quyt nh khon ti tr c thc hin nh sau:

(1) Thng tin, truyn thng v khon ti tr cho a phng v bnh vin (CPMU thc hin)

(2) Cc bnh vin xy dng v gi CPMU xut u t km k hoch qun l cht thi ca a phng v bnh vin

(3) Nhm t vn k thut s xem xt, nh gi k thut v khuyn co CPMU i vi cc xut u t (bao gm c K hoch Qun l cht thi)

(4) Thng bo d kin mc ti tr cho tng a phng, bnh vin Trung ng(B Y t)

(5) Cc a phng, bnh vin xy dng, trnh cp thm quyn ph duyt cc bo co kh thi (tiu d n) v gi CPMU xem xp tnh ph hp vi cc xut u t ban u; i vi cc bnh vin trung ng, trn c s K hoch qun l cht thi c chp thun, CPMU s thng bo Bnh vin xy dng bo co kh thi trnh CPMU. CPMU s trnh V K hoch-Ti chnh lm u mi thm nh vi s tham gia ca Cc QLMTYT, V TTB-CTYT, Cc QLKCB trnh B Y t ph duyt

(6) B Y t quyt nh mc ti tr chnh thc

(7) K tha thun ti tr gia B Y t v a phng/ bnh vin theo mu quy nh

(8) o to, tp hun cho i tng th hng

(9) Cc Ch u t trin khai u t theo quy nh hin hnh

(10) CPMU s tin hnh gim st v cung cp h tr k thut cho cc Ch u t

(11) C quan kim nh c lp tin hnh kim nh (theo iu khon tham chiu v cng c kim nh do D n xy dng) v khuyn co cho CPMU v s tun th cc tiu chun nh

(12) Ch u t (a phng/bnh vin TW) hon tr vn nu khng t tiu chun kim nh

(13) Nghim thu, hon thnh v quyt ton khon ti tr theo quy nh (bao gm c vic kim ton v np bo co quyt ton theo quy nh cho CPMU)

Bng 1: Danh mc u t cc bnh vin trung ng v d kin mc cp vn vng 1 (USD)

TTa imTn Bnh vinS ging bnhHu cn ni b*Phng tin vn chuynX l cht thi rnX l nc thiNng cao nng lc qun l h thng XLNTQun l d nD phngTng mc ngh h tr u t

1H NiBnh vin Tai Mi Hng TW3006,90000300,0006,6002,10033,600349,200

2H NiBnh vin Mt Trung ng4007,70000400,0007,60026,80044,500486,600

3H NiBnh vin Phi TW5008,60000500,0008,30032,80055,400605,100

4H NiBnh vin Y hc c truyn TW5008,60000500,0008,00032,80055,400604,800

5ng NaiBnh vin Tm thn T 21,30014,900001,053,00011,40038,600116,4001,234,300

Tng s cho bnh vin Trung ng3,00046,700002,753,00041,900133,100305,3003,280,000

*Hu cn ni b gm cc dng c gip lu gi, vn chuyn rc thi bnh vin (nh ti nilon, thng ng vt sc nhn, thng rc, xe vn chuyn ch ni b, khu cha

Bng 2: Danh mc bnh vin tuyn tnh v d kin mc h tr cho cp vn 1 (USD)

TTa imTn Bnh vinS ging bnhHu cn ni bPhng tin vn chuynXLCT rnX l nc thiNng cao nng lc qun l h thng XLNTQun l d nD phngTng mc ngh h tr u t

1Long AnBVK tnh Long An80021,1800371,400424,63011,50045,88088,307962,897

2Tin GiangBnh vin a khoa tnh TG1,00024,43024,0000530,98011,40045,53063,270699,610

3Tin GiangBVK khu vc Cai Ly5009,14024,000199,900265,0909,50035,39054,430597,450

4Tin GiangBV khu vc G Cng, TG40012,68024,000199,900212,3108,80031,81049,060538,560

5Tin GiangBV huyn Ci B, TG2007,43000107,3906,60010,13012,970144,520

6ng ThpBV khu vc Sa c, T50014,39024,000199,900265,0909,50035,87054,970603,720

7ng ThpBV khu vc Hng Ng, T2508,3900199,70007,50014,32023,080252,990

8ng ThpBV khu vc Thp Mi2508,3900199,70007,50014,32023,080252,990

9ng ThpBVK tnh ng Thp90022,89024,000371,400476,77012,20046,92096,5201,050,700

10ng ThpBV YHCT ng Thp4006,22000107,3906,0009,99012,790142,390

11Bn TreBVK tnh Bn Tre90022,89024,000371,400476,77012,20046,92096,5201,050,700

12Bn TreBV khu vc C Lao Minh40012,68024,000199,900212,3108,20031,80049,000537,890

13Bn TreBnh vin huyn Ba Tri2508,40024,000199,700134,2407,50025,63040,080439,550

14Bn TreBnh vin YHCT Bn Tre5008,55000265,0908,90022,86030,280335,680

15Kin GiangBVK Kin Giang1,30033,5700370,800668,62014,90051,660115,4201,254,970

16Kin GiangBV YHCT Kin Giang4007,71000212,3107,60018,82024,370270,810

Tng s cho cc bnh vin tnh8,950228,940192,0002,883,7004,358,990149,800487,850834,1479,135,427

cHNG 2: T CHC THC HIN D N

2.1. T CHC QUN L D N

2.1.1 Cc vn chung:

T chc qun l D n c m t theo s sau:

SHAPE \* MERGEFORMAT

a) Ban ch o D n do B Y t thnh lp do 1 B trng lm Trng Ban v 1 Lnh o B ph trch h Bnh vin lm Ph trng Ban. Ban ch o c trch nhim hng dn v ch o cc hot ng ca D n v vn chnh sch, phi kt hp vi cc c quan, B, ngnh khc nh B Ti chnh, K hoch v u t, Ti nguyn v Mi trng cng nh iu ha s phi hp cc V, Cc lin quan ca B Y t.

b) Ban Qun l D n Trung ng (vit tt l CPMU) do B Y t thnh lp chu trch nhim lp k hoch, qun l, iu hnh cc hot ng ca D n. CPMU chu s hng dn v gim st v qun l nh nc ca B Y t v cc B, ngnh chc nng lin quan v l u mi lm vic vi Ngn hng th gii.

c) Nhm t vn k thut (Technical Advisory Group) do B Y t thnh lp bao gm cc chuyn gia v x l cht thi rn v lng. Cc chuyn gia ny c cc Trng i hc, cc bnh vin, cc Vin chuyn ngnh c. V KH-TC s phi hp vi Cc QLMT y t, V TTB-CTYT, Cc QLKCB thng nht trnh B trng ph duyt. Mi t xt chn cc bnh vin, 3-4 chuyn gia thch hp s c Gim c d n mi tham d thm nh cng vi cc thnh vin i din cc t thuc CPMU. T XDCB v cng ngh s lm u mi trin khai vic thm nh.

d) i vi cc n v th hng (a phng v Bnh vin): B Y t s k tha thun ti tr vi cc tnh v bnh vin c la chn (ph lc 7).

i vi tuyn tnh, S Y t c chn lm u mi, v/hoc lm ch u t cc d n h tr u t h thng qun l cht thi cc bnh vin c ti tr. ng thi, UBND tuyn tnh s ch o cc S Y t/Ch u t thc hin cc mc tiu ca d n.

Ti cc tnh tham gia D n, vic la chn Ch u t do UBND tnh quyt nh (u tin giao cho S Y t l Ch u t). S Y t c th s dng Ban qun l D n u t xy dng cc cng trnh y t ca tnh trc thuc S Y t (Ban QLDA SYT tnh) qun l, thc hin cc hot ng ca D n c trin khai ti cc tnh.

i vi tuyn trung ng, cc bnh vin Trung ng l Ch u t d n h tr u t h thng x l cht thi bnh vin c ti tr. B Y t s ch o cc Ch u t thc hin cc mc tiu ca d n.

Cc Ch u t/S Y t chu s hng dn, gim st ca CPMU v qun l thc hin D n v ca cc c quan chc nng ti a phng v qun l nh nc trong trin khai thc hin D n.

e) C quan kim nh c lpbao gm 4 Vin (V sinh y t cng cng TP HCM, Y hc lao ng v VSMT, Pasteur Nha Trang v Vin VSDT Ty Nguyn) s kim nh kt qu theo iu khon tham chiu v cng c kim nh km theo (ph lc). Kt qu kim nh s c s dng lm cn c xc nh s tun th cc tiu chun mi trng v/hoc hon tr vn.

2.1.2Ban Qun l d n Trung ng (CPMU)

CPMU c thnh lp theo Quyt nh s 4708/Q-BYT ngy 6/12/2010 ca B trng B Y t. C 5 v tr ch cht: Gim c, 2 Ph Gim c, K ton trng, Cn b ph trch u thu mua sm. Cc chc danh iu phi vin d n v cc cn b khc c B Y t giao cho Gim c Ban Qun l d n Trung ng xut tuyn chn.

CPMU s c 5 T nghip v (chi tit v chc nng nhim v nu ti phn 2.3) gm:

- T Chnh sch;

- T K hoch, gim st, o to, iu phi v Hnh chnh;

- T Mua sm, u thu;

- T Xy dng c bn v cng ngh;

- T Ti chnh k ton v Gii ngn;

Cc chuyn gia t vn trong nc v nc ngoi, s tuyn chn tu theo tng thi im, theo yu cu v nhu cu ca d n.

S lng cn b, t vn ca cc T nghip v s do Gim c d n tuyn chn theo quy nh chung v k hp ng lm vic cho D n.

CPMU c t cch php nhn, c ng k s dng con du ring theo quy nh ca php lut phc v cho vic thc hin d n. CPMU c m ti khon ti Kho bc Nh nc v ngn hng thng mi ph hp vi cc quy nh ca php lut v iu c quc t v ODA k kt vi nh ti tr.

2.1.3Qun l d n ti a phng v bnh vin TW:

Ti cc tnh trin khai D n, s u tin la chn S Y t s thc hin chc nng ch u t. Ch u t l i din cho c quan qun l thc hin hin k hoch hot ng ca D n ti a phng c cc cp c thm quyn ph duyt v lm u mi ti tnh v cc vic lin quan ti D n, chu trch nhim v vic thc hin cc cng vic c giao;

Ti cc bnh vin trung ng, giao gim c bnh vin trung ng s l ch u t d n, thc hin k hoch hot ng ca d n ti bnh vin.

Kinh ph hot ng ca Ch u t nm trong kinh ph qun l ca tng d n XLCT c cp c thm quyn ph duyt theo quy nh hin hnh.

h tr trin khai cc hot ng, Ch u t s c thu cn b hp ng v tuyn chn t vn chuyn trch cho cc thnh phn. Thi gian v s lng t vn s do Ch u t tuyn chn v k hp ng m bo ng quy nh tuyn chn t vn ca WB (nu s dng ngun vn ti tr ca WB) v Vit Nam. Lng cho cc cn b hp ng s chi t ngun vn i ng ca ca d n.

2.2PHN CP C TH TRCH NHIM THC HIN D N

2.2.1 B Y t

B Y t l c quan Ch qun d n, chu trch nhim iu phi chung v phi hp vi UBND cc tnh, thnh ph th hng D n, cc B, Ngnh lin quan t chc thc hin nhim v qun l nh nc i vi D n theo quy nh. B trng B Y t chu trch nhim ph duyt Vn kin D n, ph duyt k hoch ti chnh nm, k hoch u thu ca D n v chu trch nhim ch o ton din v qun l thc hin D n, m bo t mc tiu v hiu qu u t.

B Y t s k vi Lnh o UBND cc tnh v Lnh o cc bnh vin Trung ng bn Tha thun trin khai D n, trong nu r trch nhim v quyn hn ca mi bn (B Y t, UBND cc tnh, cc bnh vin Trung ng). Cc ni dung c bn ca Tha thun c nu trong ph lc.

2.2.2Ban Qun l D n trung ng (CPMU)

L i din cho Ch qun u t tham gia cc quan h php lut v trong quan h vi cc c quan qun l nh nc, nh ti tr, cc t chc, c nhn trong v ngoi nc v cc cng vic lin quan ti D n theo u quyn ca Ch qun d n; chu trch nhim trc B Y t v cc cng vic c giao;

L Ch u t cho cc cng vic, hng mc thuc hp phn 1 v hp phn 3 ca D n.

Chu trch nhim phi hp vi cc S Y t, Bnh vin Trung ng xy dng k hoch tng th hng nm gm k hoch hot ng, k hoch u thu, k hoch ti chnh trnh cp thm quyn ph duyt;

Hng dn, h tr, gim st cc Ch u t (S Y t, Bnh vin TW) xy dng v trin khai chng trnh hot ng ca Tiu d n ti a phng, n v, theo hng tng cng phn cp trch nhim qun l thc hin cho cc Ch u t (S Y t, Bnh vin TW);

Qun l ti khon c bit ca D n v thc hin vic rt vn ODA trn c s thm nh v tng hp bo co thanh, quyt ton ca cc Ch u t (S Y t, Bnh vin TW) theo quy nh;

Thc hin u thu mua sm quc t, u thu mua sm rng ri trong nc cc gi thu hng ho, trang thit b thuc hp phn 1 v hp phn 3 ca D n;

Ch tr phi hp vi cc n v chc nng t chc thc hin k hoch o to di hn c bng cp, cc nghin cu h tr trin khai xy dng khung chnh sch lin quan ti lnh vc x l cht thi y t;

Ch tr t chc cc cuc nh gi khi bt u trin khai thc hin d n, nh gi gia k, cui k, cc cuc hp s kt, tng kt; chun b cc bo co tng hp v D n v xut iu chnh cn thit trong qu trnh thc hin m bo mc tiu v hiu qu u ra ca D n;

Thc hin bn giao kt qu ca D n v kt ton tr gi vn u t cho cc n v th hng lm c s quyt ton khi kt thc D n vi B Ti chnh.

C cu c bn ca BQLDATW nh sau:

2.2.3U ban Nhn dn cc tnh thc hin D n

UBND tnh chu trch nhim qun l thc hin cc hot ng ca D n c thc hin ti a phng, bao gm cc ni dung c bn: (i) cc hot ng xy dng c bn (nng cp cc h thng x l cht thi bao gm t vic ph duyt cc bo co kh thi ca cc tiu d n, ph duyt k hoc v thm tra kt qu u thu theo quy nh ca Nh nc Vit Nam v Ngn hng th gii ; (ii) cc hot ng o to ngn hn cho cn b y t ti a phng; (iii) u thu, mua sm trang thit b x l cht thi rn v mt s trang thit b khc c mua theo hnh thc u thu rng ri trong nc khi c u quyn; (iv) Ph duyt quyt ton cc khon ti tr ng hn; v (v) Hon tr vn cho QLDATW trong trng hp khng p ng cc tiu chun t ra sau khi C quan kim nh c lp xc nhn.

Quyn hn v trch nhim ca UBND tnh c nu c th ti vn bn Tho thun ti tr k gia B Y t v UBND tnh v vic qun l v t chc thc hin d n (Xem ph lc).

UBND tnh m bo vn i ng, trong :

- Kinh ph t vn lp K hach qun l cht thi ca tnh, bnh vin;

- T vn lp bo co kh thi tiu d n; thit k k thut, thi cng, lp v thm tra d ton;

- Cc t vn lin quan n u thu (lp h s mi thu, chm thu);

- T vn gim st;

- T vn thm nh, thm tra s tun th tiu chun;

- Kinh ph cho Ban qun l d n ca Ch u t m khon ti tr t D n khng chi tr.

- Cung cp hoc ch o cc n v th hng bo m kinh ph vn hnh, bo dng cc h thng c u t.

2.2.4Ch u t (S Y t v cc bnh vin Trung ng)

i vi cc Ch u t l S Y t c th la chn m hnh qun l theo quy nh hin hnh v qun l u t xy dng (v d, c th s dng l cc Ban qun l d n hin c ca mnh qun l cc d n u t x l cht thi ti tuyn a phng hoc thnh lp Ban qun l cc d n cht thi y t ring (song D n khng h tr kinh ph hot ng ring cho cc BQL ny).

i vi cc Bnh vin tuyn Trung ng s dng b my ca mnh hoc Ban qun l d n hin c qun l d n. Quyn hn v trch nhim ca Bnh vin Trung ng c nu c th ti vn bn Tho thun ti tr k gia B Y t v Bnh vin Trung ng v vic qun l v t chc thc hin d n (Xem ph lc 7). V m hnh qun l tiu d ca Ch u t: Tu theo c th ring ca tng a phng v cc bnh vin tuyn Trung ng m Ch u t c th thnh lp Ban qun l d n (gm cc t nghip v ph hp) hoc Ch u t s dng b my chuyn mn ca mnh qun l thc hin d n. C cu qun l d n hoc ca Ban qun l d n ca ch u t p dng theo iu 11 Thng t s 03/2009/TT-BXD ngy 26/3/2009 ca B Xy dng quy nh chi tit mt s ni dung ca Ngh nh s 12/2009/N-CP ngy 12/02/2009 ca Chnh ph v qun l d n u t xy dng cng trnh v thng t s 03/2007/TT-BKH ngy 12/3/2007 ca B K hoch v u t hng dn chc nng, nhim v v c cu t chc ca Ban qun l chng trnh d n ODA. Cc b phn ca Ban qun l d n ca Ch u t c th gm: 1 Gim c PPMU (s l 01 lnh o S Y t hoc l 1 lnh o bnh vin i vi bnh vin Trung ng), 1 Ph Gim c PPMU, 1 K ton trng v mt s cn b chuyn mn chia thnh cc b phn: K hoch; XDCB, mua sm - u thu; Ti chnh gii ngn, Hnh chnh.

Phi hp vi CPMU t chc thc hin cc hot ng gim st, nh gi v ch tr chun b cc bo co v thc hin D n thnh phn v ton d n ti tnh;

Chu trch nhim xy dng k hoch hot ng chi tit, k hoch u thu, k hoch ti chnh hng nm ca d n ti tnh, lp d ton v bo co quyt ton hng nm trnh cp c thm quyn ph duyt;

Ch tr trin khai thc hin k hoch hot ng ca d n. T chc thc hin cc gi thu mua sm; chu trch nhim thanh ton, quyt ton d n theo ng quy nh v qun l u t xy dng v u thu mua sm.

Ph duyt h s mi thu, kt qu u thu.

Kinh ph qun l d n c tnh trong chi ph qun l nm trong d n u t c duyt.

Cc Ch u t c t cch php nhn, con du ring, ti khon ring v hch ton c lp hot ng giao dch theo cc quy nh ring thuc phm vi d n, nhm m bo s ph hp gia cc iu khon ca Hip nh k v quy nh ca Chnh ph v qun l, s dng ngun vn ODA.

2.3CHC NNG NHIM V CA CC T NGHIP V TRONG CPMU

2.3.1 T chnh sch:

- T Chnh sch ca Ban qun l D n Trung ng chu trch nhim thc hin cc hot ng thuc Hp phn 1 v bo co Ph Gim c CPMU (Lnh o Cc Qun l mi trng y t) cc hot ng c lin quan ca Hp phn 1. Ph Gim c ny chu trch nhim bo co vi Gim c CPMU.

- T Chnh sch xut cho Gim c CPMU tuyn chn cn b theo yu cu trin khai cc hot ng thuc Hp phn 1. Cc v tr chnh bao gm: iu phi vin, cn b theo di v nh gi, cc t vn, chuyn gia k thut. Cc cn b ny c th c ly t VIHEMA hoc c hp ng lm vic (t vn) thng qua hnh thc la chn cnh tranh. Nu cc cn b ny l cng chc, th h c hng nhng li ch t B Y t tng t nh cn b c tuyn vo lm cho Ban Qun l d n. Nu cc cn b ny c tuyn vo lm hp ng th h c tr lng theo hp ng t kinh ph ca Hp phn 3. Mt khon kinh ph c duyt s c ly t Hp phn 3 chi tr cho cc hot ng pht sinh trong qu trnh thc hin Hp phn 1, bao gm: cc in thoi, fax, e-mail, cc bu chnh, photocopy, vn phng phm v cc trang thit b vn phng cn thit cho nhu cu qun l, thc hin Hp phn 1.

- K hoch hot ng hng nm ca Hp phn 1 s do T chnh sch (VIHEMA) xy dng cng vi s t vn ca cc T chuyn mn khc trong BQLDA v c ph duyt bi Gim c Ban Qun l D n nh mt phn ca k hoch hot ng hng nm ca D n.

2.3.2T K hoch, Theo di, gim st, Hnh chnh, iu phi

Do 01 iu phi vin d n (c TOR ring) lm t trng nhm gip Gim c, cc Ph Gim c d n iu hnh d n. T c cc chc nng sau:a) Xy dng k hoch

Hng dn, gip cc n v tham gia d n xy dng k hoch hot ng ngn hn v di hn.

Xy dng v tng hp k hoch chung ca ton d n, cc phng n iu chnh k hoch v iu chnh cc ngun lc ca d n.

Chun b cc bo co bo v k hoch.

b) Hng dn, t chc thc hin v theo di, gim st vic thc hin d n.

Hng dn, n c, theo di, gim st cc n v tham gia d n thc hin cc hot ng theo k hoch.

T chc thc hin cc hot ng ca d n tuyn trung ng v cc hot ng lin tnh.

c) Phi hp v h tr

Phi hp vi cc ban k thut trong vic t chc thc hin nhng hot ng c tnh cht chuyn mn ca d n.

H tr cc n v tham gia thc hin d n gii quyt, tho g nhng kh khn, vng mc trong qu trnh thc hin d n trn c s cc iu khon ca Hip nh vay v cc quy nh hin hnh ca Nh nc.

Phi hp vi cc nh ti tr v cc c quan hu quan trong vic ch o, qun l, t chc v thc hin D n.

d) Thng tin, bo co

Thit lp h thng thng tin qun l ca D n v t chc, hng dn, theo di, gim st vic thc hin ca cc n v tham gia D n.

Cung cp nhng thng tin cn thit cho cc n v tham gia D n, cc nh ti tr v cc c quan cp trn, theo quy nh.

e) Hnh chnh, iu phi d n

T chc chuyn giao chnh xc, kp thi cc loi cng vn, giy t lin quan n d n.

Thc hin chc nng th k cho cc cuc hp ca CPMU.

Cung cp v thc hin chc nng phin dch cho CPMU.

Theo di v m bo lu tr cng vn, giy t lin quan ca D n.

m bo nhim v c tnh cht l tn ca D n, cung cp cc phng tin lm vic, phng tin thng tin lin lc, phng tin i li cho cn b ca CPMU v cc chuyn gia (Trong trng hp i cng tc).

m bo b mt ca D n v b mt quc gia.

iu phi vin d n gip Gim c, Ph gim c d n iu hnh d n. iu phi vin c tuyn chn di hnh thc t vn qun l d n c nng lc v kinh nghim theo iu khon tham chiu c duyt.2.3.2 T ti chnh k ton, gii ngn

a) Chu trch nhim qun l ti chnh D n bao gm cc ngun vn vay, vn i ng, trn c s cc k hoch c ph duyt hng nm theo cc quy nh ca Lut Ngn sch v ph hp vi cc iu khon ca Hip nh tn dng.

b) Thc hin nhim v k ton ti chnh ca D n bao gm cc cng vic:

Lp d ton kinh ph hng nm (k hoch ti chnh) trn c s k hoch thc hin v k hoch u thu c ph duyt trnh cp c thm quyn ph duyt.

Thit lp v duy tr h thng k ton bao gm h thng s sch, chng t k ton, h thng ti khon k ton, phn mm k ton kp thi ghi nhn v qun l cc nghip v ti chnh, k ton pht sinh.

Tng hp cc bo co ti chnh t cc Ch u t lp bo co hp nht cho ton D n theo yu cu ca Chnh ph v nh ti tr.

Thit lp v duy tr h thng kim sot ni b cho D n bao gm c chc nng kim sot ni b ti CPMU v cc ch u t.

c) Tp hp chng t ca cc ch u t v CPMU, thc hin vic rt vn, thanh ton, quyt ton m bo kinh ph hot ng v tin ca D n.

d) Hng nm, t chc kim ton ni b bao gm: duyt quyt ton, thng bo, hng dn, theo di, gim st n v thuc quyn thc hin cng tc ti chnh k ton i vi cc ngun vn ca D n, theo cc iu khon trong Hip nh tn dng v cc quy nh hin hnh ca Nh nc.

e) Phi hp, h tr cc n v thuc quyn gii quyt v xut gii quyt i vi nhng kh khn vng mc lin quan v cng tc ti chnh k ton ca d n, bao gm c cng vic lin quan ti iu chnh d ton, k hoch vn.

f) L u mi t chc cng tc kim ton c lp cho ton b D n bao gm c vic kim ton c lp ti cc tnh ca D n.

g) L u mi tng hp v cung cp thng tin bo co ti chnh nh k, t xut v tnh hnh rt vn, gii ngn, thanh ton, quyt ton ca D n theo yu cu ca c quan qun l theo quy nh hin hnh ca Nh nc v theo yu cu ca nh ti tr, iu khon ca Hip nh tn dng, qun l phn mm qun l ti chnh, biu mu thng k bo co v ti chnh k ton ca D n, lu gi cc ti liu lin quan n cng tc ti chnh k ton ca D n ti n v.

2.3.3 T Xy dng c bn v cng ngh

a) Xy dng k hoch

Hng dn, gip cc n v tham gia d n xy dng k hoch hng nm v k hoch nhiu nm thuc lnh vc u t xy dng, k c cc phng n iu chnh k hoch v tng hp k hoch chung ca D n.

b) Hng dn thc hin cc hot ng XDCB ti cc tnh, bnh vin tuyn TW

Hng dn, theo di, gim st cc hot ng xy dng c bn do Ch u t thc hin, bao gm gim st chuyn mn k thut.

c) Phi hp v h tr

Phi hp vi cc ban k thut trong vic t chc thc hin nhng hot ng c tnh cht chuyn mn, k thut ca D n.

H tr cc n v tham gia thc hin D n gii quyt, tho g nhng kh khn vng mc trong qu trnh thc hin d n trn c s cc iu khon ca Hip nh vay v cc quy nh hin hnh ca Nh nc.

d) Bo co, thng tin

Hng dn, h tr v n c cc n v tham gia D n bo co tnh hnh xy dng c bn.

Chun b cc bo co v XDCB theo ch quy nh.

2.3.4 T Mua sm, u thu

a) Xy dng k hoch

Hng dn, gip cc Ch u t v n v tham gia d n xy dng k hoch hng nm v k hoch nhiu nm thuc lnh vc u t xy dng, dch v t vn v cc dch v khc k c cc phng n iu chnh k hoch v tng hp k hoch chung ca D n.

Xy dng v trnh duyt k hoch u thu ca D n.

b) T chc thc hin cc hot ng mua sm.

T chc thc hin cc hot ng mua sm cho hp phn 1 v 2 ca D n.

Hng dn, theo di, gim st cc hot ng xy dng c bn, mua sm hng ho v dch v t vn do cc n v tham gia D n thc hin.

c) Phi hp v h tr

Phi hp vi cc ban k thut trong vic t chc thc hin nhng hot ng c tnh cht chuyn mn, k thut ca D n.

H tr cc n v tham gia cc n v thc hin D n gii quyt, tho g nhng kh khn vng mc trong qu trnh thc hin d n trn c s cc iu khon ca Hip nh vay v cc quy nh hin hnh ca Nh nc.

d) Bo co, thng tin

Hng dn, h tr v n c cc n v tham gia D n bo co tnh hnh u thu mua sm hng ho.

Chun b cc bo co v mua sm theo ch quy nh.

m bo b mt ca d n v b mt quc gia.

2.3.5 Chuyn gia t vn

Cn c vo nhim v chuyn mn ca tng giai on thc hin d n, D n s tuyn chn cc chuyn gia, t vn ngn hn v di hn h tr cho Ban qun l theo tng lnh vc chuyn mn c tuyn chn.

S lng v thi gian lm vic ca chuyn gia s thc hin trn c s s cn thit ca nhu cu cng vic. Chc nng, nhim v ca tng t vn c th hin r trong iu khon tham chiu (TOR) v trong hp ng c k vi CPMU.

2.4MT S QUY NH V CHC NNG NHIM V CA CH U T:

2.4.1. Chc nng, nhim chung:

a) Chu trch nhim qun l ti chnh ca D n thnh phn t cc ngun vn vay, vn i ng, trn c s cc k hoch c ph duyt hng nm theo cc quy nh ca Lut Ngn sch v ph hp vi cc iu khon ca Hip nh tn dng.

b) Thc hin nhim v k ton ti chnh ca D n bao gm cc cng vic: lp d ton kinh ph hng nm (k hoch ti chnh) trn c s k hoch thc hin v k hoch u thu c ph duyt trnh cp c thm quyn ph duyt.

Thit lp v duy tr h thng k ton bao gm h thng s sch v chng t k ton, h thng ti khon k ton, phn mm k ton kp thi ghi nhn v qun l cc nghip v ti chnh, k ton pht sinh.

Lp cc bo co ti chnh cho cc hot ng d n ti tnh theo yu cu ca Chnh ph v nh ti tr.

Thit lp v duy tr h thng kim sot ni b cho D n ti cp tnh.

c) Thc hin vic rt vn, thanh ton, quyt ton vi CPMU m bo kinh ph hot ng v tin ca D n.

d) Hng nm, t chc kim ton ni b bao gm: thng bo, hng dn, theo di, gim st n v thuc quyn thc hin cng tc ti chnh k ton i vi cc ngun vn ca D n, theo cc iu khon trong Hip nh tn dng v cc quy nh hin hnh ca Nh nc.

e) Phi hp, h tr cc n v thuc quyn gii quyt v xut gii quyt i vi nhng kh khn vng mc lin quan v cng tc ti chnh k ton ca d n, bao gm c cng vic lin quan ti iu chnh d ton, k hoch vn.

f) Phi hp vi CPMU trong vic t chc cng tc kim ton c lp cho cc hot ng ca D n ti tnh.

g) L u mi cung cp thng tin, bo co ti chnh nh k, t xut v tnh hnh rt vn, gii ngn, thanh ton, quyt ton ca D n theo yu cu ca c quan qun l theo quy nh hin hnh ca Nh nc v theo yu cu ca nh ti tr iu khon ca Hip nh tn dng, qun l phn mm qun l ti chnh, biu mu thng k bo co v ti chnh k ton ca D n, lu gi cc ti liu lin quan n cng tc ti chnh k ton ca D n ti n v.

h) Trin khai cng tc u thu theo hng dn ca D n

2.4.2Kinh ph hot ng

Kinh ph cho hot ng ca ch u t c ly t hai ngun:

Vn i ng tr lng, ph cp cho cn b nhn vin, cc loi ph khng nm trong din dng vn vay chi tr nh chi ph t vn lp bo co kh thi, t vn lp h s mi thu, ph thm nh, chi ph qung co mi thu, ... Phn chi ph qun l trong cc d n u t h thng x l cht thi c cp thm quyn ph duyt theo quy nh hin hnh v hng dn ca d n (theo hng dn lp d n ca D n). Cc chi ph qun l khng c vn IDA chi tr s c chi bng vn i ng nh chi ph thm nh, lp h s mi thu, chm thu.

Vn vay chi tr chi ph hot ng gia tng - l nhng chi ph khng pht sinh nu khng c D n, bao gm: chi ph thu mn, mua sm phng tin lm vic, phng tin i li, thng tin lin lc, chi ph kim tra, gim st v chi p h khc... (ph hp vi vn kin v hng dn ca d n).

2.5HNG DN V PH CP QUN L D N V CH LNG CHO CN B TUYN CHN THEO HP NG

1) Ph cp qun l D n

Cn b, nhn vin CPMU v Ch u t lm vic ton b thi gian hoc lm vic theo ch kim nhim ti cc Ban QLDA c hng ph cp qun l D n theo quy nh hin hnh i vi cc D n ODA vay n. Hin ti l thng t s 219/2009/TT-BTC ngy 19/11/2009 ca B Ti chnh Quy nh mt s nh mc chi tiu p dng cho cc d n/chng trnh s dng ngun vn H tr pht trin chnh thc (ODA). Theo :

a. Cn b ca CPMU, S Y t l cng chc, vin chc thuc bin ch cc c quan hnh chnh, n v s nghip ca Nh nc c iu chuyn sang lm vic ton b (100%) thi gian ti CPMU, cc Ch u t c hng nguyn lng theo ngch bc nh khi cha chuyn sang d n v hng thm mt khon ph cp bng 100% lng ca cng chc .

b. i vi cc cng chc thuc bin ch cc c quan hnh chnh s nghip Nh nc c phn cng lm kim nhim cho CPMU, S Y t th vn hng lng c bn ti c quan ng chc v c hng thm ph cp qun l d n. Khon ph cp qun l d n c hng bng ng % thi gian lm vic cho D n. Trng hp cng chc c phn cng kim nhim nhiu d n th ch c hng ph cp mt ln mt BQLDA c thi gian lm vic kim nhim nhiu nht.

c. Trong c hai trng hp trn, lng c bn do c quan iu ng chi tr v khon ph cp do D n chi tr t ngun vn i ng cho qun l d n. Nu c quan iu ng chm dt vic tr lng cho cng chc c iu ng th Ban Qun l d n c trch nhim tr ton b (100%) lng v ph cp cho cn b. Kinh ph cho vic tr tr lng v ph cp ph cp ny c CPMU, PPMU xy dng trong k hoch vn i ng hng nm ca D n.

2) Tin cng, tin lng ca cn b CPMU, PPMU c tuyn dng theo hp ng

a. Ngi lao ng c tuyn dng theo ch hp ng lm vic 100% thi gian cho d n, c tr mc lng bng vi lng ca ngi lao ng trong bin ch c quan hnh chnh s nghip c trnh o to v trnh nghip v cng vic tng ng, (mc lng chi tr cho cc cn b hp ng phi cn c vo nng lc, hiu qu cng vic ca cn b ) cng thm khon ph cp qun l d n nh quy nh ti mc 2.5.2 nu trn, tc bng 100% mc lng ang c hng.

b. Ch bo him x hi v bo him y t cho ngi lao ng tuyn dng theo ch hp ng c p dng theo quy nh hin hnh ca nh nc.

cHNG 3: CH BO CO, GIM ST NH GI

3.1

CH BO CO

3.1.1Bo co phc v cng tc xy dng k hoch hng nm s c thc hin theo nh k nh sau:

a. Vo u thng 12 v thng 6 mi nm, CPMU xy dng k hoch hot ng cho chu k cp vn trn c s mc tiu v tin ca giai on theo phn k u t, d kin vng c u t v phn b kinh ph cho cc hot ng theo thnh phn ni dung, n v thc hin v theo cc ngun vn.

b. Trn c s thng bo k hoch d kin ca CPMU, cc tnh xy dng k hoch v ng k xin cp vn ca cc bnh vin km theo d ton chi tit kinh ph (vn ODA v vn i ng) theo nh mc quy nh v gi cho CPMU chm nht 31/12 hoc 30 thng 6.

c. CPMU tng hp, xy dng k hoch hot ng c th ca D n, thng qua Nhm t vn k thut ca d n bo v k hoch nm v ng k vn u t vi c quan ch qun l V KHTC B Y t tng hp vo k hoch ngn sch nm ca B Y t trnh Th tng Chnh ph ph duyt, ng thi gi cho NHTG, chm nht 31/10 hng nm.

d. Sau khi c kt qu ph duyt k hoch hot ng ca D n t cp c thm quyn, CPMU thng bo k hoch hot ng v kinh ph cho cc S Y t v Bnh vin TW (Ch u t).

e. Trn c s thng bo ca CPMU, cc S Y t gi phn k hoch hot ng ca Tiu D n v S K hoch u t hoc V K hoch Ti chnh B Y t v ng k vn i ng t ngun ngn sch a phng cho cc hot ng.

Trong qu trnh thc hin, thng qua cc hot ng gim st, nh gi v bo co nh k, cc c quan qun l s theo di c tnh hnh thc hin k hoch v s c iu chnh cn thit.

3.1.2Bo co tnh hnh thc hinD n H tr x l cht thi bnh vin phi thc hin ch bo co cho B Y t v cc c quan qun l ODA ca Chnh ph theo quy nh ti Quyt nh 803/2007/Q-BKH ngy 30/7/2007 ca B K hoch v u t v vic ban hnh ch bo co tnh hnh thc hin cc chng trnh, d n ODA.

Trong qu trnh thc hin CPMU phi tng hp v gi bo co tnh hnh thc hin D n cho c quan ch qun (B Y t) theo mu quy nh thng nht cho tng loi, vi cc thi im bo co nh sau:

- Bo co qu, chm nht 15 ngy lm vic sau khi ht qu;

- Bo co nm, chm nht vo ngy 31 thng 01 nm sau;

- Bo co kt thc, chm nht 6 thng sau khi kt thc thc hin D n

Cc ch u t c cp vn ti tr cn gi bo co tnh hnh thc hin, gii ngn theo quy nh ca Chnh ph v qun l vn u t v qun l ODA. V qun l ti chnh, CPMU v Ch u t cn tun th cc bo co theo quy nh ti phn Qun l ti chnh (Phn 2 cun s tay ny). c s liu bo co nh k, cc Ch u t cn phi gi bo co qu trc 5 ngy v bo co nm trc 10 ngy so vi thi hn quy nh gi bo co ca CPMU. C th :

Cc loi bo co Qu, Nm phi nu c th tnh hnh trin khai k hoch hot ng, s liu gii ngn cc ngun vn ODA v i ng, trong thi gian ca k bo co v lu k t u, ng thi phi c kin nh gi v mc thc hin so vi k hoch ca tiu D n, a ra cc kin ngh cn thit. Bo co Qu gi ngy 10 ca thng u Qy sau v bo co Nm gi vo ngy 20/1 ca nm tip sau, bng ng th in t v bn chnh bng ng bu in. ng thi bn bo co Nm nh vy cng s c gi cho NHTG vo trc 31/3 hng nm k t nm 2011.

Cc bo co phi nu y cc ni dung yu cu trong mu quy nh, chnh xc v trung thc, m bo thi hn quy nh. Gim c CPMU, gim c S y t v Ch u t l Bnh vin trung ng l ngi k v chu trch nhim v cc ni dung thng tin ca bo co.

Cc ch u t np bo co kt qu thc hin, gii ngn khon cp vn theo quy nh ca D n lm cn c cp vn cho t tip theo.

3.2 KIM TRA, GIM ST

D n m bo ng mc tiu, tin v vn hnh ng vi quy nh ca Chnh ph v ca WB, cn c s gim st, theo di lin tc cng vi cc cuc nh gi nh k CPMU, S Y t c th cp nht tnh hnh v c can thip kp thi khi cn thit.

Hot ng kim tra, gim st ca D n s thc hin thng xuyn trong nm theo nh k ca nm k hoch hoc c t chc ph hp vi tin trin khai ca mt hot ng c th. Mi hot ng kim tra gim st s c tiu ch, ni dung, mc tiu tu theo cc hot ng c th, s xem xt ti ch tnh hnh trin khai thc hin v gim st hot ng trin khai theo ng phng php, mc ch, tin t ra. ng thi qua kim tra, gim st, s pht hin nhng im vng mc, khng ph hp gia k hoch v thc t c bin php h tr n v thc hin tm ra nguyn nhn v khc phc, hoc kin ngh vi cc cp c thm quyn iu chnh, tho g.

Sau khi thng nht v k hoch ca t gim st, CPMU c cn b chuyn trch ti cc S Y t v cng cn b gim st ca S Y t ti kim tra, gim st cc n v trin khai hot ng c th. V vy, hot ng kim tra, gim st t c hiu qu mong mun, cn c s phi hp cht ch v tham gia y gia CPMU, S Y t v cc n v trc tip thc hin. D n s b tr kinh ph cho cc chuyn i gim st cng nh vic kt ni mng li thng tin cp nht thng tin kp thi tnh hnh trin khai cc hot ng.

Ngn hng Th gii s t chc cc chuyn kim tra, gim st 6 thng mt ln vi s tham gia ca CPMU. nh k v t xut, cc c quan qun l d n ODA ca Chnh ph: B K hoch v u t, B Ti Chnh, B Y t... s t chc cc t kim tra tnh hnh thc hin, vic s dng vn ca d n. Nu pht hin D n c vn bt cp v xc nh mc tiu, c ch qun l thc hin, phn b s dng vn, tin gii ngn hoc cc trng hp thc hin khng ng vi quy nh, s c kin cc c quan c thm quyn x l.

3.3 HOT NG NH GI

Trong chu k thc hin, D n s tin hnh nhng cuc nh gi sau:

3.3.1nh gi ban u

nh gi ban u s tin hnh trong thi gian khi ng D n nhm thu thp cc thng tin c bn v cc ch s ca D n. Cc ch s ny s c s dng trong qu trnh theo di nh gi thc hin d n, nh gi kt thc d n.

3.3.2nh gi gia k

nh gi gia k s tin hnh vo gia chu k D n i vi tt c cc thnh phn ca D n. nh gi gia k s tin hnh kt hp i kim tra ti ch v thu thp s liu qua bo co ca cc tnh xem xt cc cam kt php l ca D n, kt qu thc hin cc mc tiu ca D n v xut cc iu chnh cn thit ca d n m bo cho D n tip tc tin hnh hiu qu, t c mc tiu u t xc nh.

3.3.3nh gi cui k

nh gi cui k s c thc hin trc ngy chm dt cc hot ng ca D n. t nh gi ny, ch yu xem xt tin thc hin, tc ng ca nhng ni dung u t i vi cc mc tiu thnh phn v s b lng gi ch s u ra t c c nhng iu chnh ph hp vi thi hn kt thc D n v k hoch s dng s vn cam kt cn li (nu cha s dng ht).

3.3.4nh gi kt thc

nh gi kt thc D n thc hin trong khong thi gian 6 thng sau khi chm dt cc hot ng do B Y t v cc c quan qun l u t ca Chnh ph tin hnh trc ngy ng ti khon c bit. nh gi kt thc xem xt mc thnh cng ca D n, kt qu t c cc mc tiu t ra v tc ng ca D n i vi cc mt kinh t x hi ca tnh v c vng, trn c s so snh cc ch s u ra t c vi bng ch s kt qu u ra d kin ng thi so snh vi cc ch s u vo.

nh gi kt thc D n nhm xc nhn s liu quyt ton vn u t ca D n cho cc thnh phn D n ti a phng, n v, lm c s thanh quyt ton vo ngn sch v ghi vn u t cho cc a phng, n v. ng thi qua vic tng kt ton b qu trnh thc hin D n, cc nh qun l s rt ra cc kinh nghim cn thit lm c s xy dng cc chng trnh, d n u t mi trong giai on tip theo.

PHN II. HNG DN CNG TC TI CHNH-K TON

CHNG 1: LP K HOCH TI CHNH D N

1.1NGUYN TC LP K HOCH TI CHNH

D n H tr x l cht thi bnh vin s dng vn vay WB v vn i ng ca Chnh ph Vit nam. Vic lp k hoch ti chnh cho D n phi tun th cc quy nh hin hnh ca Lut php Vit Nam, cc cam kt gia Chnh ph Vit Nam v WB trong qu trnh thc hin.

Vn a vo k hoch ti chnh phi c phn b theo ni dung cng vic v theo mc lc Ngn sch Nh nc, ph hp vi tin v kh nng thc t trin khai D n. Lp k hoch vn phi y , st thc vi nhu cu ca d n cho nm ti.

B Y t, U ban nhn dn cc tnh, thnh ph u tin b tr vn i ng trong d ton ngn sch hng nm nhm thc hin cam kt trong cc iu c quc t v ODA k v ph hp vi kh nng gii ngn thc t hng nm ca D n.

1.2 CC CN C V NI DUNG LP K HOCH TI CHNH

a/ Cn c Hip nh Tn dng s 4899-VN ngy 31 thng 5 nm 2011 k gia Vit Nam v WB, Quyt nh s 147 /Q-BYT ngy 21 thng 1 nm 2011 ph duyt ni dung vn kin D n, c th nh sau:

D n H tr x l cht thi bnh vin l d n hn hp. Ni dung chi ca D n bao gm:

- Chi u t XDCB thng qua hnh thc cp pht trc tip qua ngn sch v h tr u t c mc tiu: u t ci to, sa cha v nng cp h thng x l cht thi (rn, lng) ca cc bnh, mua sm TTB quan trc cho 4 Vin.

- Chi c tnh cht hnh chnh s nghip: Cc hng mc cn li nh o to cn b, dch v t vn, qun l d n, xy dng chnh sch ...

- Vn vay ca WB c cp pht cho B Y t v cc tnh thc hin D n chi tr cho cc chi ph hp l ca 03 thnh phn ca D n. C cu phn b vn vay c th nh sau:

Hng mcLng tn dng c phn b (tnh theo SDR)% chi ph oc ti tr (bao gm c thu)

(1) Chi ph hp l theo hp phn 1 ca d n[9 triu USD]100%

(2) Cc khon ti tr theo hp phn 2 ca d n[134 triu USD]100%

(3) Chi ph hp l theo hp phn 3 ca d n[7 triu USD]100%

Tng s[150.000.000 USD]

K hoch ti chnh l k hoch vn u t (i vi d n XDCB), hoc k hoch vn HCSN (i vi d n HCSN).

Chi ph hp l: khon thanh ton hp l cho hng ha, xy lp, dch v, o to, Chi ph hot ng gia tng cn thit cho d n, c ti tr bng ngun ca d n v c mua sm theo ng quy nh ca Hip nh Ti tr

Chi ph hot ng gia tng c ngha l cc khon chi ph gia tng hp l v cn thit pht sinh trong qu trnh thc hin D n (nu khng c D n th nhng chi ph ny khng pht sinh) v c bao gm trong k hoch chi tiu hng nm do Ngn hng Th gii ph duyt, bao gm chi ph thu vn phng, trang thit b v vn phng phm, chi ph thng tin lin lc, chi ph i li v cng tc ph cho cn b D n, nhng khng bao gm lng v tr cp ca cn b cng chc nh nc.

o to c ngha l cc chi ph hp l pht sinh trong qu trnh thc hin cc hot ng hi tho trong khun kh d n, bao gm chi ph ti liu, thu a im v thit b, chi n , cng tc ph v i li cho cc thnh vin tham gia hi tho o to, tt c nhng chi ph ny phi c bao gm trong k hoch chi tiu hng nm do Ngn hng Th gii ph duyt.

Khon ti tr c ngha l mt khon ti tr c thc hin hoc c xut thc hin trong khun kh hip nh ny theo ng on 2 trong Phn I.C ca Chng 2 ca Hip nh, v theo Phn IV ca S tay Hng dn thc hin ny.

b/ Cc quy nh v xy dng k hoch v d ton NSNN; Thng t s 108/2007/TT-BTC ngy 07/9/2007 hng dn c ch qun l ti chnh i vi cc chng trnh D n h tr pht trin chnh thc; Thng t 40/2011/TT-BTC ngy 22/3/2011 sa i, b sung Thng t 108/2007/TT-BTC ngy 07/9/2007; Thng t s 219/2009/TT-BTC ngy 19/11/2009 ca B Ti chnh quy nh mt s nh mc chi tiu p dng cho cc d n/chng trnh s dng ngun vn H tr pht trin chnh thc (ODA); Thng t 97/2010/TT-BTC ngy 6/7/2010 ca B Ti Chnh quy nh ch cng tc ph, ch chi t chc cc cuc hi ngh vi cc c quan nh nc v n v s nghip cng lp v cc vn bn hng dn c thng nht gia B Y t v B Ti Chnh; Thng t s 139/2010/TT-BTC ngy 21 thng 9 nm 2010 ca B Ti chnh quy nh vic lp D ton, qun l v s dng kinh ph t ngn sch Nh nc dnh cho cng tc o to, bi dng cn b, cng chc v cc vn bn sa i, b sung.

c/ D kin v tin v kh nng thc t trin khai D n theo k hoch.

1.3 CC BC LP V PH DUYT K HOCH TI CHNH

(1) CPMU hng dn ch u t lp, ng k k hoch xin ti tr

Thng 7 hng nm, CPMU c cng vn hng dn cc Ch u t (S Y t, BV tuyn TW) lp, ng k k hoch xin ti tr (k hoch vn) ca D n cho nm ti, bao gm ngun vn vay v vn i ng theo quy nh

(2) Ch u t lp k hoch vn d n

Cn c vo tin thc hin D n, S Y t, Ch u t lp k hoch vn ca d n thc hin a phng mnh hoc bnh vin (i vi bnh vin trung ng) theo cc ni dung chi v kt cu cc ngun vn ca d n gm vn vay WB, vn i ng t ngun NSP theo Quyt nh s 147/Q-BYT ngy 21 thng 1 nm 2011 ca B Y t v vic ph duyt ni dung vn kin d n trong chi tit theo hng mc cng vic, theo tnh cht ngun vn s dng (vn u t XDCB, vn HCSN) v Bn thuyt minh chi tit nhu cu vn cho tng hng mc cng vic

(3) Ch u t np k hoch vn cho c quan thm quyn

Ch u t (S Y t) gi bn k hoch vn cho S K hoch v u t, S Ti chnh tng hp trnh c quan c thm quyn ph duyt k hoch vn i ng cho d n trong ngn sch a phng; Cc ch u t l Bnh vin Trung ng gi bn k hoch vn cho V K hoch-Ti chnh, B Y t; ng thi gi CPMU (trc ngy 30/7) tng hp k hoch vn chung ca ton d n

(4) Tng hp k hoch vn ton d n

CPMU tng hp k hoch vn chung cho ton d n bao gm: K hoch vn WB, vn i ng thuc Ngn sch Trung ng giao, vn i ng a phng v cc ngun vn khc (nu c), trong chi tit theo hng mc cng vic, theo tnh cht ngun vn s dng (vn HCSN,vn u t XDCB) v Bn thuyt minh chi tit nhu cu vn cho cc hng mc cng vic. K hoch vn ny c tng hp chung vo k hoch vn ca B Y t (V K hoch Ti chnh), trc khi gi B K hoch v u t, B Ti chnh trnh Chnh ph v Quc hi ph duyt

(5) Giao d ton ngn sch

Sau khi d ton Ngn sch nh nc c cp c thm quyn quyt nh, B K hoch v u t v B Ti chnh giao d ton Ngn sch nh nc cho B Y t theo ng quy nh hin hnh, trong ghi r d ton vn ca D n. B Y t giao k hoch phn b vn (bao gm vn vin tr ca cc Ban Qun l D n Trung ng v a phng v vn i ng ca CPMU) cho D n, ng thi thng bo cho c quan ti chnh v c quan kho bc ng cp. Vn i ng cho cc hot ng ti a phng do a phng chu trch nhim phn b v thng bo cho c quan ti chnh v c quan kho bc ng cp lm cn c kim sot v thanh ton vn trong nm k hoch

CHNG 2: NGN HNG PHC V V CC VN M TI KHON

2.1 NGN HNG PHC V

Ngn hng phc v l mt ngn hng thng mi c la chn trong danh sch cc ngn hng thng mi tiu chun u quyn thc hin vic giao dch i ngoi, thanh ton, cung cp dch v ngn hng cho d n ODA. Danh sch ngn hng thng mi tiu chun do Ngn hng Nh nc phi hp vi B Ti chnh xc nh v cng b hoc theo tho thun gia Chnh ph v nh ti tr trong iu c quc t k kt.Vic la chn Ngn hng phc v phi tun th Thng t s 40/2011/TT-BTC ngy 22 thng 3 nm 2011 ca B Ti chnh v thng t s 107/2011/TT-BTC ngy 20 thng 7 nm 2011 ca B Ti chnh.

i vi Ti khon c bit dng ngun vn WB, Ngn hng Nh nc Vit nam ch tr phi hp vi B Ti chnh c kin tham kho ca B Y t la chn mt Ngn hng thng mi lm Ngn hng phc v cho D n. CPMU cn ch ng c cng vn xut vic la chn Ngn hng phc v gi Ngn hng Nh nc Vit nam ngay sau khi Hip nh ti tr c hiu lc.

Ngn hng phc v c xut phi p ng cc yu cu sau:

(1) p ng y cc quy nh ca Ngn hng nh nc Vit Nam v t l m bo an ton ti chnh p dng i vi cc t chc tn dng;

(2) C a bn hot ng trn ton quc;

(2) c php duy tr Ti khon c bit bng ng tin c tha thun gia WB v Chnh ph;

(3) c kim ton mt cch u n, v nhn cc bo co kim ton tt;

(4) C kh nng thc hin nhanh chng mt lng ln cc giao dch;

(5) C kh nng thc hin tt cc dch v ngn hng trn phm vi rng;

(6) C kh nng cung cp cc sao k chi tit cho Ti khon chuyn dng;

(7) L thnh vin ca mt h thng ngn hng i l tt;

(8) Cam kt tun th cc quy nh ca Chnh ph, B ti chinh v quy nh ca Ngn hng th gii v qun l ngun vn ODA; v

(8) Ph dch v hp l.

Ngn hng phc v m cc ti khon lin quan ca d n v thc hin cc giao dch thanh ton, rt vn cn c theo quy nh hin hnh.

Ngn hng phc v c trch nhim hng dn v cung cp cho d n y cc thng tin thc hin cc giao dch thanh ton trong v ngoi nc qua h thng ngn hng.

nh k hng thng hoc khi c yu cu, ngn hng phc v c trch nhim gi bo co sao k ti khon tm ng cho ch ti khon; thng bo cho ch ti khon s li pht sinh trn cc ti khon tm ng ca cc d n; s ph phc v do ngn hng phc v thu; s chnh lch gia li v ph; s d u k, cui k.

Trong vng 2 ngy lm vic k t khi nhn c bo c s tin rt t ngn hng nc ngoi, ngn hng phc v thc hin ghi c vo ti khon ca d n v thng bo cho ch d n bit.

Ngn hng phc v c hng ph theo quy nh hin hnh v thu ph dch v i vi cc dch v cung cp cho d n. Ph dch v ngn hng c hch ton vo tng chi ph ca d n.

Cc giao dch chuyn i ngoi t trn ti khon c bit sang VND hoc sang ngoi t khc thanh ton c thc hin vi ngn hng phc v. Mi trng hp ngn hng phc v mua ngoi t ca d n u phi p dng t gi nim yt ca ngn hng phc v ti thi im mua ngoi t.

2.2 NG K CH K CA CH D N, K TON TRNG C Y QUYN K N RT VN ( CH P DNG CPMU)

Ch Ti khon ca D n l CPMU i vi cc ti khon d n tuyn trung ng, l Ch u t (S Y t) i vi cc ti khon d n tuyn tnh v l Gim c bnh vin trung ng i vi cc bnh tuyn trung ng. Gim c d n, K ton trng c trch nhim ng k kt i vi cc giao dch t ti khon d n.

D n phi ng k ch k ca Ch ti khon v K ton trng d n c y quyn k n rt vn vay WB v ngh thanh ton bng ngun vn ny. B Y t c cng vn gi NHNN gii thiu nhng ngi c y quyn k n rt vn nu trn.

2.3 M TI KHON CHO D N

Thi im m ti khon: Ti khon c bit c m ngay khi Hip nh vay c WB tuyn b c hiu lc.i vi CPMU:

a) Ti Ngn hng phc v, CPMU m 01 ti khon c bit v 03 ti khon tin gi:

+ 01 Ti khon c bit (USD) tip nhn ngun vn vay u i ca WB.

+ 01 Ti khon tin gi (ngoi t) gi vo tin bn h s mi thu, bo lnh d thu (trng hp u thu rng ri quc t (ICB)),...

+ 01 Ti khon tin gi (ng Vit Nam) gi vo tin bn h s mi thu, bo lnh d thu, bo lnh thc hin hp ng (trng hp u thu rng ri trong nc(NCB)),...

+ 01 Ti khon (USD) theo di li, ph ca ti khon c bit;

Ti khon c bit (USD) tip nhn ngun WB chi tiu cc hng mc hp l c WB chp thun. b) Ti Kho bc Nh nc:

CPMU m mt ti khon d ton ti Kho bc Nh nc tip nhn vn i ng do NSTW cp cho cc hot ng ca d n.

i vi cc Ch u t:

a) Ti chi nhnh Ngn hng phc v d n Ch u t c m 01 ti khon tm ng (VND) tip nhn ngun vn WB c CPMU chuyn n theo k hoch ti chnh c duyt. 01 ti khon (VND) theo di li, ph ngun tm ng.

b) Ti Ngn hng Thng mi, Ch u t c m mt ti khon tin gi (VND) gi vo nhng khon thu ti d n nh: Tin bn h s thu, tin bo lnh thu, bo lnh thc hin hp ng, tin ng gp ca ngi c hng li (nu c)...

c) Ti kho bc Nh nc tnh, Ch u t c m 01 ti khon d ton vn ngn sch thc hin vic thanh ton vn i ng u t.

CPMU v cc Ch u t c s dng s li pht sinh trn Ti khon tm ng thuc cp mnh thanh ton cc khon dch v ngn hng, phn li cn li sau khi kt thc d n phi np NSNN. Trng hp s li khng chi ph dch v ngn hng, CPMU v cc Ch u t tng hp phn thiu ht vo k hoch vn i ng v s dng vn i ng thanh ton ph dch v ngn hng.

CHNG 3: MT S TH TC GII NGN, THANH TON

Th gii ngn ca WB: WB s gi cho Gim c CPMU mt Th gii ngn vi mc ch ch dn th tc rt tin t ti khon vay ca WB khi khon vay ny c tuyn b c hiu lc. Th gii ngn c gi km theo S tay gii ngn. Th gii ngn lu D n mt s vn c th hn trong qu trnh rt vn nh:

Thi im gi ng k cc ch k ca i din c y quyn k n rt vn;

Mc xin rt vn ti thiu cho tng ln rt vn, hn mc rt vn ln u;

Ngng ca cc hp ng c th p dng hnh thc sao k chi tiu;

a ch gi h s rt vn;

Mt s vn khc cn cha cp n hoc cp cha r trong Hip nh vay.

Theo thit k ca D n, CPMU mi c thc hin rt vn nc ngoi.

3.1TH TC THANH TON VN VAY WB

Mi th tc, hnh thc rt vn thanh ton t nc ngoi v t ti khon c bit c thc hin theo quy nh ti Thng t s 108/2007/TT-BTC ngy 09/7/2007 ca B trng B Ti Chnh ban hnh Hng dn c ch qun l ti chnh i vi cc chng trnh, d n h tr pht trin chnh thc (ODA), Thng t 40/2011/TT-BTC ngy 22/3/2011 ca B trng B Ti Chnh sa i, b sung Thng t 108/2007/TT-BTC ngy 09/7/2007 v tun th cc nguyn tc gii ngn ca WB.

H s v th tc kim sot chi i vi D n thc hin theo quy nh ti Thng t s 79/2003/TT-BTC ngy 13/08/2003 ca B Ti chnh hng dn ch qun l, cp pht, thanh ton cc khon chi ngn sch nh nc qua Kho bc Nh nc v cc vn bn sa i, b sung, thay th (nu c) cc quy nh ti Thng t ny; Thng t s 86/2011/TT-BTC ngy 13 thng 6 nm 2011 v hng dn qun l v thanh ton vn u t v vn s nghip c tnh cht u t thuc ngun vn Ngn sch Nh nc.

Sau khi kim sot chi, Kho bc Nh nc xc nhn vo Giy ngh xc nhn tm ng/thanh ton vn d n ODA (gi chung l Giy ngh thanh ton).

Giy ngh thanh ton c xc nhn (bn gc) ca Kho bc Nh nc l c s rt vn ODA. Mi Giy ngh thanh ton ch c s dng mt ln rt vn ODA.

3.1. 1 CHU TRNH CHUYN VN I VI HP PHN 1

1. Ti khon: VIHEMA s thng bo cho CPMU thng tin v ti khon ca mnh tip nhn kinh ph tm ng t CPMU thc hin cc hot ng nu trong k hoch c duyt.

2. Cc khon chi tiu hp l trong K hoch ca Hp phn 1 s c CPMU gii ngn theo cc hnh thc: Hon ngn, tm ng v thanh ton trc tip, c th:

2.1. Cc hnh thc thanh ton

- Hnh thc hon ng: l hnh thc thanh ton hi t cc khon chi ph m VIHEMA ng trc chun b d n, hon thin cc iu kin k kt Hip nh. Th tc rt vn nh sau:

Sau khi dng ngun vn ngn sch hoc tm ng cc khon khc thanh ton cho nh cung cp, VIHEMA gi h s ngh thanh ton hon vn n CPMU

- Hnh thc tm ng: Trn c s K hoch hot ng v K hoch Ti chnh hng nm ca Hp phn 1 c ph duyt, CPMU s tm ng cc chi ph hot ng ca Hp phn 1. Hng thng hoc sau khi chi tiu ht 50% kinh ph c CPMU tm ng, VIHEMA tin hnh cc th tc thanh ton tm ng vi CPMU v ngh CPMU tm ng kinh ph cho cc hot ng tip theo.

- Hnh thc thanh ton trc tip: L hnh thc thanh ton theo ngh ca VIHEMA, CPMU s thanh ton trc tip cho nh thu, nh cung cp hng ha dch v cho cc Hp ng ca Hp phn 1.

2.2. H s, chng t thanh ton :

- Giy ngh thanh ton; Giy ngh tm ng

- Hp ng, ha n ti chnh, bng k k nhn .. cc chng t khc theo quy nh hin hnh.

Khi nhn c y h s hp l ca VIHEMA, trong vng 5 ngy lm vic, CPMU s tin hnh cc th tc thanh ton cho VIHEMA. CPMU s tin hnh th tc kim sot chi kho bc v rt vn vi nh ti tr.

3.1. 2 CHU TRNH CHUYN VN I VI HP PHN 2

3.1.2.1 Tam ng v thanh ton

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(2)

(1)

(4)

(6)

(8) (7) (10)

(9)

Bc 1 3: chuyn tin t NHTG n CPMU

1) CPMU chun b n rt vn (WA) gi B Ti chnh (Cc qun l n v Ti chnh i ngoi) ng k n.

2) CPMU np n rt vn c ch k ca Cc QLN v TCN BTC cho NHTG.

3) NHTG gii ngn vo Ti khon c bit ca CPMU ti Ngn hng phc v.

Bc 4 n 10: chuyn tin t CPMU n ch u t

4) Ch u t np H s ngh chuyn tin ti tr cho CPMU cng cc ti liu lin quan;

t chuyn tin u tin (50% gi tr ti tr c duyt): Tha thun ti tr k vi CPMU; chi tit K hoch ci thin QLCT bnh vin; D ton kinh ph c CPMU ph duyt.

t chuyn tin th 2 (40%): bo co tin c CPMU ph duyt.

t chuyn tin th 3 (10%): Bo co kim nh ca C quan kim nh c lp t cc tiu chun quy nh.

5) CPMU yu cu Ngn hng phc v chuyn tin cho ch u t

6) Ngn hng phc v chuyn tin cho ch u t

7) Nh thu np h s gii ngn, ha n, chng t, h s khi lng hp l cho Ch u t.

8) Ch u t thm tra, xc nhn v np cho Kho bc Nh nc tnh kim sot chi. KBNN tnh, thnh ph r sot, kim sot chi v chuyn li Ch u t.

9) Ch u t thanh ton cho Nh thu theo ng h s c kim sot chi

3.1.2.2. Kim sot chi

1) H s v th tc kim sot chi vn u t xy dng c bn ph hp vi quy nh ti Thng t s 86/2011/TT-BTC ngy17/6/2011 ca B Ti chnh v cc vn bn sa i b sung (nu c). H s (01 b) c th nh sau:

a) H s gi ln u

Hip nh ti tr k (dch ting Vit, c ch k ca ch d n)

D n u t xy dng cng trnh (Hoc bo co KTKT) km Q ph duyt d n ca cp c thm quyn.

Vn bn la chn nh thu theo Lut u thu

Hp ng k kt gia Ch u t v Nh thu cng cc ti liu km theo lin quan n iu kin thanh ton. i vi Hp ng bng ting nc ngoi th gi km bn dch ting Vit phn cc quy nh v iu kin thanh ton, c ch k v ng du ca Ch d n; Th khng phn i ca Nh ti tr (nu p dng).

D ton v quyt nh ph duyt d ton ca cp c thm quyn i vi tng cng vic, hng mc cng trnh, cng trnh i vi trng hp ch nh thu hoc t thc hin v cc cng vic thc hin khng thng qua hp ng (tr d n ch lp bo co kinh t-k thut).

H s ti liu xc nhn vn tm ng (bo lnh tm ng vi tr gi bng gi tr ngh tm ng, bo lnh tm ng phi c thi hn m bo thu hi ht tm ng theo quy nh ca hp ng, giy ngh thanh ton vn u t)

b) Thanh ton tm ng: thc hin theo quy nh ca TT 86/2011/TT-BTC

Vic tm ng vn ca ch u t cho nh thu ch cho cc cng vic cn thit phi tm ng trc v phi c quy nh r i tng, ni dung v cng vic c th trong hp ng. Mc vn tm ng, thi im tm ng v vic thu hi tm ng phi theo quy nh ca Nh nc i vi tng loi hp ng. Ch u t c trch nhim cng vi nh thu tnh ton mc tm ng hp l, qun l vic s dng vn tm ng ng mc ch, ng i tng, c hiu qu v c trch nhim hon tr s vn tm ng theo quy nh.

Trng hp vn tm ng cha thu hi nhng khng s dng, nu qu thi hn 6 thng quy nh trong hp ng phi thc hin khi lng m nh thu cha thc hin do nguyn nhn khch quan hay ch quan hoc sau khi ng vn m nh thu s dng sai mc ch ch u t c trch nhim cng Kho bc nh nc thu hi hon tr vn tm ng cho ngn sch nh nc. Trng hp n ht nm k hoch m vn tm ng cha thu hi ht do hp ng cha c thanh ton t n t l quy nh th tip tc thu hi trong k hoch nm sau v khng tr vo k hoch thanh ton vn u t nm sau.

H s thanh ton tm ng: c thanh ton tm ng, ch u t gi n Kho bc nh nc cc ti liu sau:

- Giy ngh thanh ton vn u t;

- Chng t chuyn tin;

- Bo lnh khon tin tm ng ca nh thu (nu trong hp ng ch u t v nh thu tho thun c bo lnh tin tm ng), ch u t gi Kho bc nh nc bn sao c ng du sao y bn chnh ca ch u t.

c) H s xc nhn khi lng hon thnh:

Khi c khi lng hon thnh c nghim thu theo giai on thanh ton v iu kin thanh ton trong hp ng, ch u t lp h s ngh thanh ton gi Kho bc nh nc, bao gm:

- Bng xc nh gi tr khi lng cng vic hon thnh theo hp ng ngh thanh ton c xc nhn ca i din bn giao thu v i din t vn (nu c) v i din bn nhn thu (ph lc s 03.a TT86/2011/TT-BTC).

- Khi c khi lng pht sinh ngoi hp ng, ch u t gi Bng tnh gi tr khi lng pht sinh (nu c) ngoi phm vi hp ng k kt ngh thanh ton c xc nhn ca i din bn giao thu v i din t vn (nu c) v i din bn nhn thu (ph lc s 04 TT 86/2011/TT-BTC).

- Giy ngh thanh ton vn u t hoc thanh ton tm ng - ph lc s 05 TT 86/2011/TT-BTC.

- Chng t chuyn tin ban hnh theo quy nh h thng chng t k ton ca B Ti chnh.

2. i vi cc cng vic ca d n c thc hin khng thng qua hp ng xy dng (nh mt s cng vic qun l d n do ch u t trc tip thc hin, trng hp t lm,...), vic thanh ton trn c s bng k khi lng cng vic hon thnh v d ton c duyt ph hp vi tnh cht tng loi cng vic. H s thanh thanh ton bao gm: bng k khi lng cng vic hon thnh v d ton c duyt cho tng cng vic; giy ngh thanh ton vn u t hoc tm ng (nu c) v chng t chuyn tin.

2) H s v th tc kim sot chi i vi ni dung hot ng c tnh cht HCSN hay thnh phn chi HCSN trong D n: thc hin theo quy nh ti Thng t s 79/2003/TT-BTC ngy 13/8/2003 ca B Ti chnh hng dn ch qun l, cp pht, thanh ton cc khon chi NSNN qua Kho bc nh nc v cc vn bn sa i, b sung, thay th (nu c) v cc quy nh ti Thng t ny.

3.1.2.2. Hon tr vn ti tr

Trong trng hp C quan kim nh c lp thc hin kim nh chng nhn cc h thng x l cht thi v quy trnh qun l cht thi ca Bnh vin khng t tiu chun (sau 2 ln Ch u t t t chc khc phc), Ch u t c trch nhim hon tr vn ti tr cho CPMU. Quy trnh hon tr vn thc hin theo hng dn ring ca D n do cp c thm quyn ban hnh.

3.1.2 Chu trnh chuyn vn cho CPMU cho Hp phn 1 v 3

3.1.2.1. Chu trnh gii ngn p dng cho CPMU vi thnh phn 1 v 3

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(2)

(1) (7)

(5) (4) (6)

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1. CPMU chun b n xin rt vn v gi cho Cc Qun l n v Ti chnh i ngoi ng k n;2. CPMU np n xin rt vn k cho IDA;

3. Ngn hng th gii chuyn tin cho Ti khon c bit ca D n ti Ngn hng thng mi;

4. Nh cung cp, chuyn gia t vn np ngh thanh ton cho CPMU;

5. CPMU r sot, xc nhn v np cho Kho bc Nh nc kim sot chi;

6. KBNN kim sot, chp thun v chuyn li CPMU;

7. CPMU chuyn ngh chi cho Ngn hng thng mi;

8. Ngn hng thng mi tr tin cho nh cung cp/chuyn gia t vn.

3.1.2.2 Thanh ton trc tip

L hnh thc thanh ton theo ngh ca CPMU, WB s thanh ton trc tip cho nh thu, nh cung cp hng ha dch v cho d n. Tr gi ti thiu ca mi n rt vn ngh thanh ton trc tip bng 20% mc trn (theo quy nh c th ca tng d n) ca Ti khon c bit.

thc hin thanh ton trc tip, CPMU thc hin nh sau:

Khi c yu cu thanh ton, cn c vo tin thc hin hp ng CPMU k vi nh cung cp, CPMU gi h s ngh thanh ton n B Ti chnh gm:

Cng vn ngh rt vn nu r cc cn c php l xin rt vn;

n rt vn theo mu v cc sao k gi km nh mu quy nh;

Hp ng, hoc n t hng v ha n, Cng vn yu cu thanh ton ca nh thu/nh cung cp;

Bn gc giy ngh thanh ton c c quan kim sot chi xc nhn (k c tm ng);

Mt s ti liu gii trnh b sung khc (nu B Ti chnh yu cu)

Sau khi nhn y h s hp l ngh thanh ton ca CPMU, B Ti chnh xem xt k hoc ng k n rt vn gi WB (khong 5 ngy lm vic).

WB xem xt v chp thun, chuyn tin thanh ton trc tip vo ti khon ca nh cung cp. Hnh thc Thanh ton trc tip c m t theo s sau:

THANH TON TRC TIP

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(2)

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(1) CPMU hoc Ch u t k hp ng vi nh thu. Nh thu thc hin hp ng v ngh thanh ton.

(2) CPMU kim tra, chp nhn thanh ton cho nh thu v chun b cc n rt vn km b chng t chuyn B Ti chnh xem xt. B chng t bao gm:

Cng vn ngh rt vn v n xin rt vn

Ha n, yu cu thanh ton ca nh thu

Bin bn xc nhn khi lng hon thnh i vi trng hp thanh ton theo tin thc hin cng trnh xy dng.

Phiu gi thanh ton ( c KBNN xc nhn)

Cc ti liu gii trnh hp l v hp l khc khi c yu cu

(3) B Ti chnh (Cc Qun l n v Ti chnh i ngoi) sot xt k / hoc ng k n rt vn gi cho WB.

(4) WB sot xt n rt vn v thc hin thanh ton cho nh thu, nh cung cp

3.1.2.3Th tc thanh ton bng Th cam kt

L hnh thc thanh ton m theo ngh ca D n, WB pht hnh mt th cam kt khng hy ngang m bo tr tin cho Ngn hng thng mi phc v nh thu/nh cung cp i vi khon thanh ton c thc hin hoc s thc hin cho mt nh thu/nh cung cp theo mt Th tn dng (L/C). Tr gi ti thiu ca mi n rt vn ngh thanh ton theo hnh thc thanh ton bng th cam kt l 20% mc trn ca Ti khon c bit c p dng.

thc hin hnh thc thanh ton bng Th cam kt, CPMU thc hin nh sau:

CPMU gi h s ngh thanh ton bng Th cam kt n B Ti chnh:

Cng vn ngh B Ti Chnh ng k n xin cp th cam kt( Nhng nm gn y b th tc xin phep BTC m L/C ri ah, d n t m LC);

n xin pht hnh Th cam kt (n rt vn) cng cc sao k theo mu;

Hp ng k hoc n t hng c xc nhn.

Trong vng 5 ngy lm vic k t khi nhn h s hp l, B Ti Chnh xem xt ng k n rt vn ngh nh ti tr pht hnh th cam kt v c thng bo gi ngn hng phc v

WB xem xt chp thun, pht hnh Th cam kt thanh ton cho NHPV nh thu/nh cung cp v thc hin thanh ton cho NHPV nh thu/nh cung cp khi Ngn hng ny thanh ton, hoc cam kt s thanh ton cho L/C .

Hnh thc Thanh ton bng Th cam kt c m t theo s sau:

THANH TON BNG TH CAM KT

(1)

(1) CPMU k hp ng vi nh thu

(2) CPMU ngh Ngn hng phc v m L/C

(3) CPMU gi B Ti chnh (Cc Qun l n v Ti chnh i ngoi) bn sao L/C v h s rt vn theo hnh thc Cam kt c bit.

(4) B Ti Chnh xem xt ng k n rt vn gi WB.

(5) WB pht hnh Th cam kt c bit cho Ngn hng phc v nh thu thc hin thanh ton theo L/C.

(6) Ngn hng phc v ca nh thu chuyn tin thanh ton cho nh thu v ngh WB hon vn.

(7) Ngn hng phc v, nh thu c trch nhim tp hp v chuyn b chng t nhp hang theo yu cu trn hp ng v L/C cho ngn hng phc v d n.

(8) in u quyn ca ngn hng phc v d n yu cu WB thanh ton cho L/C ni trn khi b chng t c chp nhn.

3.1.2.4Thanh ton theo hnh thc ti tr hi t

L hnh thc thanh ton hi t cho cc khon m CPMU chi chun b d n, hon thin cc iu kin K kt Hip nh. Theo Hip nh, D n c chi hi t khng qu 500.000 USD cho thanh ton cc chi ph hp l theo hng mc (3) thc hin trc ngy k kt Hip nh nhng phi sau ngy 1 thng 5 nm 2010 D n s gi n rt vn cho cc khon chi hi t ngay sau khi Hip nh tn dng pht trin c hiu lc.

thc hin hnh thc thanh ton hi t, CPMU sau khi dng ngun vn ngn sch hoc tm ng cc khon khc thanh ton cho nh thu, CPMU gi h s ngh thanh ton hon vn n B Ti Chnh (Cc qun l n v TCN), h s gm c:

Cng vn ngh rt vn;

n xin rt vn (theo mu) v cc sao k km theo. n rt vn phi ghi r tn, ti khon, Ngn hng/Kho bc ca n v th hng l n v chi ng trc cho khon xin hon vn. i vi cc khon do NSNN ng trc thanh ton, cn nu r tn v s ti khon ca cp NSNN ni ng vn. Tn v ti khon ca cp ng vn phi c c quan kim sot chi (Kho bc nh nc) xc nhn;

Phiu gi c xc nhn (bn gc) ca c quan kim sot chi (Kho bc nh nc) theo quy nh hin hnh v cc chng t khc chng minh s tin v ngun vn thanh ton cho ngi th hng.

Trong mt s trng hp, c th phi km theo mt s ti liu gii trnh b sung khc khi B Ti Chnh yu cu.

Khi nhn c y h s hp l ca d n, B Ti Chnh xem xt v ng k n rt vn gi WB.

WB xem xt chp thun, thanh ton hon vn theo ch dn trong n rt vn ca CPMU v chuyn s kinh ph, ng s ti khon v tn n v th hng ghi trong n rt vn.

Hnh thc Thanh ton hi t c m t theo s sau:

THANH TON THEO HNH THC HI T

(1)

(3)

(4)

(2)

(5)

B Ti chnh chuyn tin theo k hoch ca Kho bc Nh nc

(1) CPMU k hp ng vi nh thu, nh cung cp. Nh thu, nh cung cp ngh thanh ton.

(2) CPMU kim tra, duyt v ngh Kho bc Nh nc thanh ton cho nh thu.

(3) Kho bc Nh nc thc hin thanh ton theo yu cu ca CPMU.

(4) CPMU tp hp chng t thanh ton v gi B Ti chnh.

(5) B Ti chnh sot xt, k hoc ng k n rt vn gi cho Ngn hng Th gii.

(6) Ngn hng Th gii hon vn vo ti khon ca Ngn sch nh nc.

CHNG 4. CNG TC K TON D N

4.1 QUY NH CHUNG K TON CA D N H TR X L CHT THI BNH VIN

Thu thp, ghi chp, tnh ton v phn nh y , chnh xc, kp thi tnh hnh lun chuyn, s dng ti sn v cc ngun vn ca d n ng mc ch, ng c cu vn v t hiu qu cao.

Kt hp cht ch vi b phn lp k hoch, k thut v cc cn b d n khc xy dng k hoch vn hng nm, kim tra, gim st vic thc hin cc mc tiu ca d n. Kim tra kt qu hot ng v cc khon chi ph ca d n, tham gia phn tch v nh gi hiu qu d n.

Lp v np bo co ti chnh theo yu cu ca nh ti tr v chnh ph trong thi gian d n hot ng v khi kt thc d n.

4.2 T CHC CNG TC K TON, T CHC B MY K TON

4.2.1 i vi CPMU:

T chc cng tc k ton gm: Lp v x l chng t k ton; La chn v vn dng ti khon k ton; M v ghi s k ton; Lp v np bo co ti chnh theo cc quy nh, chun mc k ton ca Vit Nam v c iu chnh theo cc nguyn tc k ton c chp nhn chung, m bo vic cung cp thng tin, s liu, p ng yu cu ca Chnh ph Vit Nam v qun l ngun vn vay, vn i ng v yu cu ca WB.

CPMU p dng ch k ton cho D n theo Ch k ton hn hp (ch k ton HCSN ban hnh theo Quyt nh s 19/2006/Q-BTC ngy 30/3/2006 ca B Ti Chnh v cc Thng t b sung, hng dn v ch k ton ch u t ban hnh theo Quyt nh s 214 /2000/Q - BTC ngy 28 thng 12 nm 2000 ca B Ti chnh.

i vi Ch u t:

Cc S Y t tham gia d n sn c Ban qun l d n, Phng Ti chnh K ton, nn k ton d n c th gn vi phng TCKT ca n v v cng c t chc theo hnh thc va tp trung va phn tn. Trng phng TCKT kim K ton trng d n hoc c ngi tiu chun lm k ton trng cho d n, cc k ton vin do k ton trng phn cng nhim v. Nu Phng TCKT khng p ng k ton vin cho Ban QLDA, Ban QLDA xin thu b sung k ton. B phn TCKT cc Ch u t nn c t nht 3 ngi.

4.3 NI DUNG CNG TC K TON

Ch k ton p dng: D n H tr X l cht thi bnh vin l d n hn hp, c hot ng chi u t XDCB (Sa cha, xy mi v Trang thit b), c hot ng chi HCSN (Cc ni dung cn li: o to, mua sm thit b...). Do vy ch k ton p dng cho D n ti Trung ng p dng Ch k ton HCSN ban hnh theo Quyt nh s 19/2006/Q-BTC ngy 30/3/2006 ca B Ti chnh v cc Thng t b sung, hng dn kt hp vi ch k ton ch u t ban hnh theo Quyt nh s 214 /2000/Q - BTC ngy 28 thng 12 nm 2000 ca B Ti chnh.

i vi cc Ch u t (bao gm c cc hot ng u t, mua sm cho BQLDA Trung ng thc hin), p dng ch k ton ca ch u t ban hnh theo Quyt nh s 214 /2000/Q - BTC ngy 28 thng 12 nm 2000 ca B Ti chnh.

h tr cng tc k ton, D n cn la chn mua phn mm k ton ph hp p ng c cc yu cu cho cng tc k ton d n v c ci t mt cch h thng tt c cc cp trung ng v ch u t

Phn mm k ton phi m bo in c y s k ton v bo co ti chnh theo quy nh. Hnh thc k ton trn my vi tnh p dng ti n v phi m bo cc yu cu sau:

- C cc s k ton tng hp v s k ton chi tit cn thit p ng yu cu k ton theo quy nh. Cc s k ton tng hp phi c y cc yu t theo quy nh ca ch s k ton.

- Thc hin ng cc quy nh v m s, ghi s, kha s v sa cha s k ton theo quy nh ca Lut K ton, cc vn bn hng dn thi hnh Lut K ton v ca Ch k ton ny.

- D n phi cn c vo cc tiu chun, iu kin ca phn mm k ton do B Ti chnh quy nh ti Thng t s 103/2005/TT-BTC ngy 24/11/2005 la chn phn mm k ton ph hp vi yu cu qun l v iu kin ca n v.

4.4CHNG T K TON

Tt c cc nghip v kinh t, ti chnh pht sinh lin quan n hot ng ca CPMU v cc Ch u t D n H tr x l cht thi bnh vin u phi lp chng t k ton. Chng t k ton ch lp mt ln cho mi nghip v kinh t, ti chnh pht sinh, theo ng mu.

Mu chng t k ton bao gm mu chng t k ton bt buc v mu chng t k ton hng dn. Chng t k ton phi lp r rng, y , kp thi chnh xc ni dung quy nh trn mu. i vi chng t k ton hng dn, CPMU v cc Ch u t lp chng t phi th hin y cc ni dung nh quy nh (tn chng t, ngy thng lp, ni dung pht sinh, s tin v cc ch k...). Chng t k ton c lp giao dch vi t chc, c nhn bn ngoi d n phi c ng du d n.

Ni dung nghip v kinh t, ti chnh trn chng t k ton khng c vit tt, khng c ty xa, sa cha, khi vit phi dng mc khng phai, s v ch phi vit lin tc, khng ngt qung, ch trng phi gch cho. Khi vit sai vo mu chng t k ton phi hy b bng cch gch cho vo chng t vit sai v lu li cung chng t, khng x ri.

Trong iu kin hot ng kinh t ti chnh ca D n H tr x l cht thi bnh vin, c th s pht sinh mt loi chng t k ton mi Chng t in t c Lut K ton cng nhn.

4.5H THNG TI KHON K TON

Trn c s h thng ti khon k ton quy nh trong ch k ton p dng cho d n, D n nghin cu, la chn cc ti khon k ton p dng cho d n ph hp vi c im hot ng v yu cu qun l ca d n, ng thi p ng cc yu cu, hoc quy nh trong iu c quc t v ODA k gia Chnh ph Vit Nam v WB.

Khi cn b sung thm cc ti khon cp I phc v cho yu cu qun l c th ca d n, CPMU ngh vi B Y t (V K hoch Ti chnh) bo co B Ti chnh (V Ch K ton) cho php b sung.

4.6 HNH THC S K TON

thng nht Hnh thc s k ton trong ton d n (CPMU v cc Ch u t) ng thi thun tin cho vic xy dng phn mm k ton ca d n, d n la chn Hnh thc s k ton Nht k chung.

S nht k chung: Nhn vin k ton m s nht k chung ghi chp cc nghip v kinh t pht sinh theo trnh t thi gian v thc hin nh khon k ton phc v cho vic ghi chp vo s ci. S liu ca s nht k chung c dng lm cn c ghi vo s ci trn nguyn tc mi nghip v kinh t ti chnh pht sinh trong qu trnh thc hin d n u phi ghi vo s nht k chung.

S ci: Nhn vin k ton dng s ci ghi chp cc nghip v kinh t, ti chnh pht sinh trong nm ti chnh theo ti khon k ton quy nh ti h thng ti khon d n. Mi ti khon s dng c m trn mt trang ring, ghi chp trong mt nin k ton. Cui nm ti chnh, k ton cn kha s, cng tng cc s pht sinh n, pht sinh c, lp bng cn i s pht sinh v bo co ti chnh.

S k ton chi tit: S k ton chi tit dng ghi chp cc i tng k ton cn theo di, phc v yu cu tng hp, phn tch v qun l d n. Mt s loi s chi tit nh s theo di ngun kinh ph d n, s chi tit chi d n, s chi tit tin mt, s chi tin theo di tin gi, s theo di tm ng, s theo di ti sn c nh.

Cc s k ton c thit k v lm trn my tnh, k ton vin s in s mt ln vo cui qu v trnh K ton trng v Gim c Ban qun l ph duyt.

4.7 QUN L TI SN D N

Ti sn ca d n c qun l s dng theo ng ch qun l ti sn cng. CPMU v cc Ch u t t chc m s sch theo di v tnh hao mn TSC, c quy nh ch s dng ti sn ng mc ch, c hiu qu. i vi phng tin vn chuyn, d n khng c thay i cng dng ca ti sn. Hng nm, CPMU v Ch u t t chc kim k ti sn, xc nh tnh trng ca ti sn v chp hnh ch bo dng ti sn nh k.

CPMU c trch nhim hng dn cc Ch u t v quy ch qun l v s dng nhng ti sn giao cho c nhn (my tnh c nhn, my nh, in thoi di ng)

Trong qu trnh s dng cc ti sn ca d n b h hng khng sa cha c hoc sa cha khng c hiu qu v kinh t v hiu qu s dng. Ch u t thnh lp Hi ng v lp bin bn kin ngh xin thanh l ti sn. Khi c cp c thm quyn ph duyt cho php thanh l ti sn bng vn bn, Ch u t ghi gim ti sn trn s sch k ton.

CHNG 5: CH BO CO, KIM TRA, KIM TON, QUYT TON D N

5.1 CH BO CO

Hng thng, CPMU bo co B Y t (V KHTC), B Ti chnh (Cc qun l n v TCN, V HCSN, V u t), B K hoch v u t, WB tnh hnh thc hin d n, tnh hnh s dng vn vay v vn i ng ca Chnh ph.

nh k hng qu, vo ngy 10 ca thng u qu, CPMU c trch nhim lp bo co sao k cc khon c WB gii ngn trong qu trc chi tit theo tng n rt vn v chi tit theo tnh cht s dng vn (XDCB, HCSN), chi tit theo i tng s dng vn v c quan kim sot chi, gi B Ti chnh (Cc qun l n v Ti chnh i ngoi) phc v mc ch hch ton ngn sch.

Bo co ti chnh d n s dng mu biu quy nh trong Ch k ton hnh chnh s nghip ban hnh km theo Quyt nh s 19/2006/Q-BTC ngy 30/03/2006 ca B trng B Ti chnh, cc Thng t hng dn sa i, b sung v mu bo co AMT theo Quyt nh s 803/2007/Q -BKHT ca B K hoch u t.

Cc bo co ti chnh theo quy nh ca WB

Bo co ti chnh gia k cha kim ton theo qu: Ch u t np cho CPMU chm nht l 25 ngy k t ngy kt thc qu, CPMU np cho WB chm nht l 45 ngy k t ngy kt thc qu.

Bo co ti chnh hp nht nm c kim ton: CPMU chu trch nhim lp bo co ti chnh hp nht nm phc v cng tc kim ton. Bo co ti chnh hp nht nm bao gm hot ng d n ti tt c cc tnh tham gia d n v ti CPMU. CPMU chu trch nhim np bo co ti chnh hp nht nm c kim ton cho WB chm nht l 6 thng k t ngy kt thc nm ti chnh.

Cc bo co ti chnh theo quy nh ca Vit Nam

Bo co qu: Ch u t/S Y t np cho CPMU, cc c quan ti chnh v kho bc ti chnh ng cp chm nht l 15 ngy k t ngy kt thc qu.

Bo co nm: Ch u t/S Y t np cho CPMU chm nht l 60 ngy k t ngy kt thc nm (c km theo bo co kim ton ca c quan kim ton c lp) tng hp. Chm nht 90 ngy, CPMU gi bo co ti chnh v B Y t tng hp gi B Ti chnh.

5.2 KIM TRA, KIM SOT NI B

- Kim tra: Cc c quan chc nng ca B Y t phi hp vi CPMU kim tra t xut ti cc tnh tham gia d n v cc ni dung v nhim v d n, tin thc hin d n, nhng kh khn trong vic iu hnh d n, tm nguyn nhn v kin ngh vi cc cp bin php tho g.- H thng kim sot ni b: Hot ng kim sot ni b mang tnh khch quan v c tin hnh vi mc ch ci thin hiu qu hot ng v m bo vic s dng vn ng mc ch v quy trnh ca cc tnh.

nh k 6 thng, cn b ca CPMU s c on kim tra lm vic ti cc S Y t v Ch u t. Cc S y t/Ch u t c trch nhim lu gi cc ti liu chng t gc v sn sng cung cp, gii trnh theo yu cu ca on kim tra.

Nhim v ca qu trnh kim sot ni b bao gm:

Kim tra tnh ph hp, hiu lc v hiu qu ca h thng kim sot ni b.

Kim tra xc nhn cht lng, tin cy ca thng tin kinh t, ti chnh trnh by trn bo co ti chnh.

Kim tra tnh tun th cc quy nh ca WB, ch qun l Nh nc, c bit cc quy nh ti cun Hng dn qun l thc hin d n.

Pht hin nhng s h yu km trong qun l.

Khi kt thc qu trnh kim sot, nhm kim sot s tin hnh vit bo co v trnh Gim c CPMU. Bo co kim sot s cp ti kt qu kim sot, cc vn tn ti v cc khuyn ngh phng php gii quyt.

Cng tc kim sot ni b ca D n tun theo cc quy nh ca Chnh ph v h thng kim sot ni b thng nht ca WB. Cc yu cu ti thiu ca kim sot ni b bao gm: (i) xc nh r cc trch nhim qun l ti chnh v cu trc bo co (trong S tay hng dn v qun l ti chnh); (ii) phn tch nhim v; (iii) cc i chiu c thc hin u n, kp thi (i chiu ti khon ngn hng hng thng); (iv) m bo an ton cho tin mt v ti sn (tin mt v ti sn c kim k nh k); (v) theo di v kim tra c lp (kim sot ni b ca d n); (vi) theo di v c cc bin php khc phc, sa cha kp thi; v (vii) chng t hp l v lu gi chng t, s sch ti chnh d n.

tng cng kim sot, d n cn m bo:

Ti khon, ngn hng v gii ngn

Mc tin mt trong qu c mc hp l v kim k tin mt mt cch khch quan v u n;

i chiu ngn hng hng thng c thc hin, th hin bng vn bn v kim tra li mt cch khch quan cho c ti khon chuyn dng v cc ti khon d n;

Thanh ton cho chuyn gia/nh cung cp/nh thu nn c thc hin bng chuyn khon hoc sc, thanh ton bng tin mt ch s dng cho cc mua sm nh c gi tr tng ng di 1000 USD;

Thanh ton bng tin mt c lm chng bi ngi tr tin, ngi nhn tin v nhn chng c lp;

Cc tm ng cn c thanh quyt ton trong vng 5 ngy k t khi hon thnh hot ng c tm ng.

Cc yu cu v chng t v kim sot thanh ton cho o to, hi tho, hi ngh

tng cng kim sot i vi cc thanh ton cho o to, hi ngh, hi tho, cc hot ng kim sot cn c thc hin bao gm:

Cc yu cu v chng t thanh ton:

Bo co hot ng;

Cc bng chng chng minh hot ng c thc hin: Ho n, hp ng, phiu thu, chi (v d: nh, bi bo, chng nhn khch quan);

Danh sch ch k ca ngi tham d ghi r tn, chc v, c quan, s in thoi lin h.

Chn ngu nhin hot ng kim tra v xc minh qua ngi tham d.

Cc yu cu v chng t v kim sot thanh ton cho chi ph i li

tng cng kim sot i vi cc thanh ton cho chi ph i li, cc hot ng kim sot cn c thc hin bao gm:

K hoch hot ng c ph duyt lin quan n chi ph i li;

Ph duyt d ton, k hoch cho chuyn cng tc trc khi i cng tc;

Cc chng t thanh ton:

Ha n/bin nhn thanh ton khch sn;

i li bng tu thy, xe t cng cng: v s dng, ha n/bin nhn thanh ton v;

i li bng my bay: v s dng, th ln my bay, bin nhn/ha n thu;

i li bng taxi: Ha n/bin nhn cc taxi.

Cng lnh (giy i ng).

Bo co/bng chng hot ng, v d: xc nhn khch quan v chuyn cng tc;

Thanh ton c xt duyt bi ngi khc (khng phi l ngi i cng tc);

Thanh ton theo nh mc quy nh.

Ti sn c nh:

Ti sn c nh c ghi chp trong s ti sn c nh chi tit v m hiu ti sn, m t, ngy mua sm, nm sn xut, nm a vo s dng, tr gi, ti liu tham kho, ni , tnh trng, ngi c trch nhim gi ti sn. Cc ti sn c xc nh thng qua nh s v c th ring;

Quy trnh qun l ti sn bao gm c vic theo di vic s dng ti sn, tnh trng v cc ti sn b loi ra do mt hay chuyn nhng;

Giy php/bn quyn my tnh cng c coi l ti sn c nh;

S sch ghi chp v bo dng i vi cc ti sn cn c lu gi;

Kim tra hin trng ti sn cn c tin hnh v thng nht ca c nhm kim tra bao gm cn b u thu mua sm/ti chnh v cc cn b c trch nhim khc.

H thng qun l v k ton ti chnh vi tnh ha

H thng cn c nh dng m bo cc ghi chp ti chnh khng th thay i hoc xa b (cc thay i i vi ghi chp k ton phi c thc hin bi bt ton ghi s);

Cn phi c mt khu bo v;

Quy trnh sao lu thch hp v y .

Lu tr ti liu, h s, s sch

H thng lu tr d n cn c thit lp m bo ton b cc h s ti chnh c nhn bit v lu gi ng cch;

H thng lu tr phi m bo cc ti liu, h s c th tm c v ly ra mt cch d dng.

5.3 KIM TON

Hng nm ton b hot ng ti chnh ca d n phi c c quan kim ton c lp thc hin kim ton theo cc quy nh ca php lut, ca Hip nh vay. CPMU thc hin thu tuyn cng ty kim ton theo quy nh hin hnh ca nh nc v ca nh ti tr .

Khi thc hin kim ton, CPMU phi thc hin y cc quy nh ti Ngh nh s 105/2004/N-CP ngy 30/3/2004 ca Chnh ph v Kim ton c lp v Thng t s 64/2004/TT-BTC ngy 29/6/2004 ca B Ti chnh Hng dn thc hin mt s iu ca Ngh nh s 105/2004/N-CP nu trn.

Mc ch ca kim ton bo co ti chnh l n v kim ton a ra cc kin, nhn xt v tnh hnh ti chnh ca D n ti thi im kt thc nm ti chnh v v kinh ph nhn c, kinh ph s dng tch ly n cui k k ton da trn cc bo co ti chnh, cng nh nhn xt v bo co ti khon chuyn dng v cc sao k chi tiu.

Kim ton c lp c ti tr t ngun IDA ca d n, c CPMU tuyn chn theo ng quy trnh tuyn chn t vn ca Ngn hng Th gii. Cng ty kim ton v iu khon tham chiu cho cng vic kim ton c lp cn c Ngn hng Th gii ph duyt.

5.4QUYT TON

Kt thc nm ti chnh, CPMU v cc Ch u t phi lp bo co quyt ton nm cc hot ng ca d n trong nm theo quy nh hin hnh v phn cng thc hin v thm quyn thm nh, ph duyt bo co quyt ton. Quy trnh lp bo co, xt duyt v tng hp quyt ton c thc hin theo tng ngun vn