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Health schemes for poor ..By Dr.N J Rathod


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Health schemes for poor ..By Dr.N J Rathod

  1. 1. Schemes for Patients below Poverty line <ul><ul><li>Jeevan dai Yojna </li></ul></ul><ul><ul><li>Bombay Public Trust Act Section 41 AA </li></ul></ul><ul><ul><li>Janani Suraksha Yojna </li></ul></ul><ul><ul><li>Free treatment in Government Hospitals </li></ul></ul><ul><ul><li>Matrutwa Anudan Yojna </li></ul></ul><ul><ul><li>Below Poverty line patient is defined as one whose annual income is 2000 in rural areas and 25000 in urban areas which is approved by Tahsildar. </li></ul></ul>
  2. 2. JEEVANDAI AROGYA YOJANA Public Health Department, Government of Maharashtra
  3. 3. OBJECTIVES <ul><li>Provision of financial assistance to below poverty line patients for surgical facilities which are not available at District and Municipal Hospitals was under consideration of Govt. </li></ul><ul><li>Vide GR dated 6-11-1997, decision was taken to provide financial assistance to BPL patients for brain, kidney, heart and spinal cord surgeries upto Rs. 50,000/-. </li></ul><ul><li>This expenditure is allowed for medicine and consumables. </li></ul>
  4. 4. Criteria for sanction <ul><li>Certificate of resident of Maharashtra (Domicile Certificate) </li></ul><ul><li>Yellow Ration Card / certificate issued by Tahasildar </li></ul><ul><li>Detailed estimate of expenditure of approved hospital required to perform the proposed surgery. </li></ul>
  5. 5. Enhancement of Financial Assistance <ul><li>Scheme started in 1997 </li></ul><ul><li>Due to hike in rates of medicines and consumables, the financial provision was raised from Rs.50,000/- to Rs.70,000/- vide G. R. dated 26 July 2001. </li></ul><ul><li>Vide G.R. Dated 10.07.06 The illness cancer is added and financial limit for assistance is increased upto 100,000 at DHS level & 150000 at Government level </li></ul><ul><li>Civil surgeons have powers to sanction cases upto 100000, while Deputy Director from 100000 to 150000 </li></ul><ul><li>Brain and spinal cord surgeries, Cardiovascular surgeries, Kidney transplant surgeries and cancer treatment are included under the scheme </li></ul>
  6. 6. Sustainability <ul><li>Society registered vide G. R. dated 3 February 1998 under Societies Registration Act, 1860, with a view to raise corpus fund of 250 crores </li></ul><ul><li>Initially 14.00 crores were invested by the State Government </li></ul><ul><li>For management and control of society, Governing Council was formed under the Chairmanship of the Hon. Governor. </li></ul>
  7. 7. Approved hospitals under the Scheme Government – 10 Private - 39 <ul><li>KEM Hospital Mumbai </li></ul><ul><li>Sion Hospital Mumbai </li></ul><ul><li>Nair Hospital, Mumbai </li></ul><ul><li>JJ Hospital Mumbai </li></ul><ul><li>Wanless Hospital Miraj </li></ul><ul><li>Superspeciality Hospital Nagpur </li></ul><ul><li>Military Hospital Pune </li></ul><ul><li>CPR Hospital Kolhapur </li></ul><ul><li>Sasoon Hospital Pune </li></ul><ul><li>GMC Aurangabad </li></ul>
  8. 8. <ul><li>Bombay Hospital Mumbai </li></ul><ul><li>Hinduja Hospital Mumbai </li></ul><ul><li>Jaslok Hospital Mumbai </li></ul><ul><li>Harkisandas Hospital Mumbai </li></ul><ul><li>Leelawati Hospital Mumbai </li></ul><ul><li>Cumballa Hill Hospital Mumbai </li></ul><ul><li>Nanawati Hospital Mumbai </li></ul><ul><li>Breech Candy Hospital Mumbai </li></ul><ul><li>Tata Hospital, Mumbai. </li></ul><ul><li>Dindayal Hospital Pune </li></ul><ul><li>Inamdar Hospital Pune </li></ul><ul><li>Rubi Hall Pune </li></ul><ul><li>Kalbande Hosp Aurangabad </li></ul><ul><li>Ashwini Hosp Solapur </li></ul><ul><li>Institute of Urology Pune </li></ul><ul><li>Hardikar Hosp Pune </li></ul><ul><li>Bhoite Hosp Baramati, Pune </li></ul><ul><li>Giriraj Hospital,Satara </li></ul><ul><li>Anand Krushiji Hospital,Ahamadnagar </li></ul><ul><li>Shri Sai Baba Hospital, Shirdi. </li></ul><ul><li>Shusrut Hospital, Latur. </li></ul><ul><li>Shri Markendey Hospital Solapur </li></ul><ul><li>Dr.Shinde Hospital Sangli </li></ul><ul><li>Sanjivani Hospital, Jalgaon </li></ul><ul><li>Gajanan Hospital, Jalgaon </li></ul><ul><li>Sant Tukaram Hospital Akola </li></ul><ul><li>Shraya Hospital Latur </li></ul><ul><li>Dr.D.Y.Patil Hospital New Mumbai </li></ul><ul><li>Suraj Hospital Sanpada New Mumbai </li></ul><ul><li>Shidheshwar Hospital Solapur </li></ul><ul><li>Arneja Hospital Nagpur </li></ul><ul><li>Care Hospital Nagpur </li></ul><ul><li>Wockhardt Hospital Nagpur </li></ul><ul><li>Kamalnayan Bajaj Hosp Aurangabad </li></ul><ul><li>Dhut Hosp Aurangabad </li></ul><ul><li>Dr Deshpande Memorial Hospital Nagpur. </li></ul><ul><li>Chimote Hospital,Amravati </li></ul><ul><li>Acchut Maharaj Hospital Amravati. </li></ul><ul><li>Lifeline Hospital Panvel . </li></ul>
  9. 9. SPECIALITY-WISE SURGERIES 12290 142 10164 88 TOTAL 2600 2007-2008 636 07 627 02 2006-2007 1587 71 1509 07 2005-2006 1316 26 1278 12 2004-2005 1230 20 1206 4 2003-2004 1052 2 1045 5 2002-2003 1128 3 1114 11 2001-2002 976 5 954 17 2000-2001 1147 4 1128 15 1999-2000 1186 2 1170 14 1998-1999 136 2 133 1 1997-1998 TOTAL BRAIN & SPINAL CORD HEART KIDNEY TRANS PLANT YEAR
  10. 10. YEAR-WISE EXPENDITURE 6385.65 12290 TOTAL 1100.00 2600 2007-2008 362.00 636 2006-2007 700.00 1587 2005-2006 850.00 1316 2004-2005 635.00 1230 2003-2004 690.00 1052 2002-2003 360.00 1128 2001-2002 430.00 976 2000-2001 195.50 1147 1999-2000 654.40 1186 1998-1999 48.75 136 1997-1998 Expendtiure Incured (In Lacks) Operated Cases YEAR
  11. 11. High Court Guidelines Scheme for treatment of Indigent and economically weaker section patients
  12. 12. Definitions <ul><li>Indigent Patient – Income less than Rs 25000 per annum </li></ul><ul><li>Economically weaker section patients – Income between Rs 25000 to Rs 50000 per annum </li></ul>
  13. 13. Emergency Treatment <ul><li>All emergency patients should be admitted irrespective of financial status </li></ul><ul><li>Emergency treatment given till patient is stabilized </li></ul><ul><li>Emergency patients should not be asked for deposit </li></ul><ul><li>Transportation to public hospital after stabilization should be arranged by charitable hospital if necessary. </li></ul>
  14. 14. Free Services to both Indigent and weaker section patients <ul><li>Bed </li></ul><ul><li>RMO Charges </li></ul><ul><li>Nursing Care </li></ul><ul><li>Routine diagnostics required for treatment of general specialities </li></ul><ul><li>Food if provided by hospital </li></ul><ul><li>Linen </li></ul><ul><li>Water </li></ul><ul><li>Electricity </li></ul><ul><li>Housekeeping services </li></ul>
  15. 15. Facilities for indigent Patients <ul><li>Examination and treatment - Total free of cost </li></ul><ul><li>No deposit should be taken </li></ul><ul><li>Bill of billable services – at rates applicable to lowest class </li></ul><ul><li>Bill of medicines, consumables are to be charged at purchase prize. </li></ul><ul><li>If doctors fore go the charges it should not be included in bill. </li></ul><ul><li>Bill so prepared – debited to IPF account . </li></ul>
  16. 16. Facilities for weaker Patients <ul><li>Examination and treatment – Concessional rates </li></ul><ul><li>Bill of billable services – at rates applicable to lowest class </li></ul><ul><li>Bill of medicines, consumables are to be charged at purchase prize. </li></ul><ul><li>If doctors fore go the charges it should not be included in bill. </li></ul><ul><li>Weaker section patients should pay at least 50% of bills for medicines, consumables and implants </li></ul><ul><li>Bill so prepared – 50% debited to IPF account. </li></ul>
  17. 17. Provision for IPF <ul><li>Hospitals shall transfer 2% of patients' billing ( excluding bill of indigent and weaker patients) in each month to IPF account. </li></ul><ul><li>Amount from IPF shall be spent to indigent and weaker patients. </li></ul><ul><li>Surplus amount shall be carried forward for next month. </li></ul><ul><li>In case there is imbalance in IPF account and expenditure for more than six months, it should be brought to notice monitoring committee, so that it can issue directives to concerned hospital. </li></ul>
  18. 18. Information to be given to Charity Commissioner under Rule 25 of BPT ACT 1951 <ul><li>Amount collected in IPF account </li></ul><ul><li>Amount spent on Indigent and Weaker patients </li></ul><ul><li>Treatment profile of respective patients </li></ul>
  19. 19. General Guidelines <ul><li>Relatives of trustees, employees of trust, their dependents shall not be included in category of indigent and weaker section patients </li></ul><ul><li>Indigent and weaker section patients coming from public hospitals should be admitted </li></ul><ul><li>Indigent and weaker section patients should be admitted to the extent of 10% each. </li></ul><ul><li>Economic status should be varified from 1) Ration card 2) Certificate from Tahsildar. </li></ul>
  20. 20. Members of Monitoring committee at Mumbai Member Secretary Joint Director of Health Services ( Medical ) Mumbai Member Health Officer Municipal Corporation of Greater Mumbai Member Secretary/Nominee of Association of Hospitals in Mumbai Chairman Joint Charity Commissioner
  21. 21. Members of Monitoring Committee at District Level Member Secretary Civil Surgeon Member Representative of Charitable Hospitals in District Member District Health Officer Zilla Parishad Chairman Joint Charity Commissioner ( Regional level ) or his nominee.
  22. 22. Working of Monitoring Committee <ul><li>Hold meeting once in a month and monitor implementation of scheme by Charitable hospitals. </li></ul><ul><li>Consider grievances of the patients, if any, and submit its report to Charity Commissioner. </li></ul><ul><li>In case of breech of the scheme, besides the penal action as is provided under section 66 of BPT Act, Charity Commissioner shall make report to State Government recommending withdrawal of exemption granted to the concerned hospitals in payment of PTA. Charity Commissioner may also request Government to withdraw any other concessions given to hospital. </li></ul><ul><li>Each Charitable hospital governed by this scheme shall publish the scheme on its notice board displayed at conspicuous place of the hospital . </li></ul>
  23. 23. Janani Suraksha Yojna <ul><li>Applicable to BPL, SC and ST beneficiaries </li></ul><ul><li>Under this scheme Rs 600 are paid to pregnant mothers attending for institutional delivery in urban area whereas Rs 700 in rural area </li></ul><ul><li>The age of mother should be above 19 years and payment is made for first two deliveries only, provided she is registered with PHC or Government hospital. </li></ul><ul><li>All payments are made by cheque </li></ul><ul><li>Objective is to promote institutional deliveries. </li></ul><ul><li>Rs 1500 are given to private accredited hospitals if they operate for caesarian section on above beneficiaries . </li></ul>
  24. 24. Matrutwa Anudan Yojna <ul><li>Scheme applicable to 15 Tribal Districts </li></ul><ul><li>Tribal Beneficiaries are paid 800 rupees after institutional delivery, out of which 400 is paid in cash whereas 400 is paid in the form of Medicines. </li></ul>
  25. 25. Free treatment in Government hospitals <ul><li>With reference to GR Dated 7 July 2001 all patients below poverty line are given free treatment in Government hospitals. </li></ul>