B Y T -------S: 14/2013/TT-BYT

CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc --------------H Ni, ngy 06 thng 5 nm 2013

THNG T
HNG DN KHM SC KHE Cn c Lut khm bnh, cha bnh ngy 23 thng 11 nm 2009; Cn c B lut lao ng ngy 18 thng 6 nm 2012; Cn c Lut ngi lao ng Vit Nam i lm vic nc ngoi theo hp ng ngy 29 thng 11 nm 2006 ; Cn c Ngh nh s 06/CP ngy 20 thng 01 nm 1995 ca Chnh ph quy nh chi tit mt s iu ca B lut lao ng v an ton lao ng, v sinh lao ng v Ngh nh s 110/2002/N-CP ngy 27 thng 12 nm 2002 ca Chnh ph v vic sa i, b sung mt s iu ca Ngh nh s 06/CP ngy 20 thng 01 nm 1995 ca Chnh ph quy nh chi tit mt s iu ca B lut lao ng v an ton lao ng, v sinh lao ng; Cn c Ngh nh s 126/2007/N-CP ngy 01 thng 08 nm 2007 ca Chnh ph quy nh chi tit v hng dn thi hnh mt s iu ca Lut ngi lao ng Vit Nam i lm vic nc ngoi theo hp ng; Cn c Ngh nh s 34/2008/N-CP ngy 25 thng 3 nm 2008 ca Chnh ph quy nh v tuyn dng v qun l ngi nc ngoi lm vic ti Vit Nam v Ngh nh s 46/2011/N-CP ngy 17 thng 6 nm 2011 sa i, b sung mt s iu ca Ngh nh s 34/2008/N-CP ngy 25 thng 3 nm 2008 ca Chnh ph quy nh v tuyn dng v qun l ngi nc ngoi lm vic ti Vit Nam; Cn c Ngh nh s 63/2012/N-CP ngy 31 thng 8 nm 2012 ca Chnh ph quy nh chc nng, nhim v, quyn hn v c cu t chc ca B Y t; Xt ngh ca Cc trng Cc Qun l khm, cha bnh v V trng V Php ch; B trng B Y t ban hnh Thng t hng dn khm sc khe. Chng I

QUY NH CHUNG
iu 1. Phm vi iu chnh v i tng p dng 1. Thng t ny hng dn h s, th tc, ni dung khm sc khe (KSK), phn loi sc khe v iu kin ca c s khm bnh, cha bnh (KBCB) c php thc hin KSK. 2. Thng t ny p dng i vi cc i tng sau y: a) Ngi Vit Nam, ngi nc ngoi ang sng, lm vic ti Vit Nam KSK khi tuyn dng, KSK nh k, KSK khi vo hc ti cc trng i hc, cao ng, trung hc chuyn nghip, trng dy ngh v cc i tng khc; b) KSK cho ngi lao ng Vit Nam khi i lm vic nc ngoi theo hp ng. 3. Thng t ny khng p dng i vi cc trng hp sau y: a) Khm bnh ngoi tr, ni tr trong cc c s KBCB; b) Khm gim nh y khoa, khm gim nh php y, khm gim nh php y tm thn; c) Khm cp giy chng thng; d) Khm bnh ngh nghip; ) KSK khi tuyn vo lc lng v trang v KSK trong lc lng v trang. 4. Vic KSK ch c thc hin ti c s KBCB c cp giy php hot ng theo quy nh ca Lut KBCB v c iu kin theo quy nh ti Thng t ny. 5. i vi ngi c giy KSK do c s y t c thm quyn ca nc ngoi cp th giy KSK c s dng trong trng hp Vit Nam v quc gia hoc vng lnh th cp giy KSK c iu c hoc tha

thun tha nhn ln nhau v thi hn s dng ca giy KSK khng qu 6 thng k t ngy c cp. Giy KSK phi c dch sang ting Vit c chng thc bn dch. iu 2. S dng tiu chun sc kho phn loi sc khe 1. Vic phn loi sc khe ca ngi c KSK thc hin theo quy nh ti Quyt nh s 1613/BYTQ ngy 15 thng 8 nm 1997 ca B trng B Y t v vic ban hnh tiu chun phn loi sc khe khm tuyn, khm nh k cho ngi lao ng (sau y gi tt l Quyt nh s 1613/BYT Q). 2. i vi nhng trng hp KSK theo b tiu chun sc khe chuyn ngnh do c quan qun l nh nc c thm quyn ca Vit Nam ban hnh hoc tha nhn th vic phn loi sc khe cn c vo quy nh ca b tiu chun sc khe chuyn ngnh . 3. i vi nhng trng hp khm sc khe theo yu cu nhng khng khm y cc chuyn khoa theo mu Giy KSK quy nh ti Thng t ny, th c s KBCB ni thc hin vic KSK (sau y gi tt l c s KSK) ch khm, kt lun i vi tng chuyn khoa theo yu cu ca i tng KSK v khng phn loi sc khe. iu 3. Chi ph khm sc khe 1. T chc, c nhn ngh KSK phi tr chi ph KSK cho c s KSK theo mc gi dch v KBCB c c quan nh nc c thm quyn ph duyt hoc theo tha thun gia hai n v, tr cc trng hp c min hoc gim theo quy nh ca php lut. 2. Trng hp ngi c KSK c yu cu cp t hai Giy KSK tr ln th phi np thm ph cp Giy KSK theo quy nh ca php lut. 3. Vic thu, np, qun l v s dng ngun kinh ph t hot ng KSK c thc hin theo quy nh ca php lut. Chng II

TH TC, NI DUNG KHM SC KHE

iu 4. H s khm sc khe 1. H s KSK ca ngi t 18 (mi tm) tui tr ln l Giy KSK theo mu quy nh ti Ph lc 1 ban hnh km theo Thng t ny, c dn nh chn dung c 04cm x 06cm, c chp trn nn trng trong thi gian khng qu 06 (su) thng tnh n ngy np h s KSK. 2. H s KSK ca ngi cha 18 (mi tm) tui l Giy KSK theo mu quy nh ti Ph lc 2 ban hnh km theo Thng t ny, c dn nh chn dung c 04cm x 06cm, c chp trn nn trng trong thi gian khng qu 06 (su) thng tnh n ngy np h s KSK. 3. i vi ngi mt nng lc hnh vi dn s hoc khng c nng lc hnh vi dn s hoc hn ch nng lc hnh vi dn s ngh KSK nhng khng thuc trng hp KSK nh k, h s KSK bao gm: Giy KSK theo quy nh ti Khon 1 hoc Khon 2 iu ny v vn bn ng ca cha hoc m hoc ngi gim h hp php ca ngi . 4. i vi ngi c KSK nh k, h s KSK bao gm: a) S KSK nh k theo mu quy nh ti Ph lc 3 ban hnh km theo Thng t ny; b) Giy gii thiu ca c quan, t chc ni ngi ang lm vic i vi trng hp KSK nh k n l hoc c tn trong danh sch KSK nh k do c quan, t chc ni ngi ang lm vic xc nhn thc hin KSK nh k theo hp ng. iu 5. Th tc khm sc khe 1. H s khm sc khe np ti c s KSK. 2. Sau khi nhn c h s KSK, c s KSK thc hin cc cng vic: a) i chiu nh trong h s KSK vi ngi n KSK; b) ng du gip lai vo nh sau khi thc hin vic i chiu theo quy nh ti im a Khon ny i vi cc trng hp quy nh ti Khon 1, Khon 2, Khon 3 iu 4 Thng t ny; c) Kim tra, i chiu giy chng minh nhn dn hoc h chiu i vi ngi gim h ca ngi c KSK i vi trng hp quy nh ti Khon 3 iu 4 Thng t ny; d) Hng dn quy trnh KSK cho ngi c KSK, ngi gim h ca ngi c KSK (nu c); ) C s KSK thc hin vic KSK theo quy trnh. iu 6. Ni dung khm sc khe

1. i vi KSK cho ngi t 18 (mi tm) tui tr ln nhng khng thuc trng hp KSK nh k: khm theo ni dung ghi trong Giy KSK quy nh ti Ph lc 1 ban hnh km theo Thng t ny. 2. i vi KSK cho ngi cha 18 (mi tm) tui nhng khng thuc trng hp KSK nh k: khm theo ni dung ghi trong Giy KSK quy nh ti Ph lc 2 ban hnh km theo Thng t ny. 3. i vi trng hp KSK nh k: khm theo ni dung ghi trong S KSK nh k quy nh ti Ph lc 3 ban hnh km theo Thng t ny. 4. i vi trng hp KSK theo b tiu chun sc khe chuyn ngnh: khm theo ni dung ghi trong Giy KSK quy nh ti mu giy KSK ca chuyn ngnh . 5. i vi nhng trng hp khm sc khe theo yu cu: khm theo ni dung m i tng KSK yu cu. iu 7. Phn loi sc khe 1. Ngi thc hin khm lm sng, cn lm sng cho i tng KSK phi ghi r kt qu khm, phn loi sc khe ca chuyn khoa, k tn v chu trch nhim trc php lut v vic khm v kt qu khm ca mnh. 2. Cn c vo kt qu khm ca tng chuyn khoa, ngi c c s KSK phn cng thc hin vic kt lun phn loi sc khe v k Giy KSK, S KSK nh k (sau y gi tt l ngi kt lun) thc hin vic kt lun phn loi sc khe nh sau: a) Phn loi sc khe ca ngi c KSK theo quy nh ti Quyt nh s 1613/BYT- Q hoc phn loi sc khe theo quy nh ca b tiu chun sc khe chuyn ngnh i vi trng hp KSK chuyn ngnh; b) Ghi r cc bnh, tt ca ngi c KSK (nu c). Trng hp ngi c KSK c bnh, tt th ngi kt lun phi t vn phng n iu tr, phc hi chc nng hoc gii thiu khm chuyn khoa khm bnh, cha bnh. 3. Sau khi phn loi sc khe, ngi kt lun phi k, ghi r h tn v ng du ca c s KSK vo Giy KSK hoc S KSK nh k (du s dng trong giao dch chnh thc ca c s KSK theo quy nh ca php lut v qun l v s dng con du). Trng hp ngi c KSK c yu cu cp nhiu Giy KSK th vic ng du c thc hin sau khi tin hnh nhn bn Giy KSK theo quy nh ti iu 8 Thng t ny. iu 8. Cp Giy khm sc khe 1. Giy KSK c cp 01 (mt) bn cho ngi c KSK. Trng hp ngi c KSK c yu cu cp nhiu Giy KSK th c s KSK thc hin nh sau: a) Tin hnh vic nhn bn (photocopy) Giy KSK c ch k ca ngi kt lun trc khi ng du. S lng Giy KSK c nhn bn theo yu cu ca ngi c KSK; b) Sau khi tin hnh vic nhn bn, thc hin vic dn nh, ng du gip lai vo Giy KSK bn photocopy v ng du theo quy nh ti Khon 3 iu 7 Thng t ny. 2. Thi hn tr Giy KSK, S KSK nh k: a) i vi trng hp KSK n l: c s KSK tr Giy KSK, S KSK nh k cho ngi c KSK trong vng 24 (hai mi t) gi k t khi kt thc vic KSK, tr nhng trng hp phi khm hoc xt nghim b sung theo yu cu ca ngi thc hin KSK; b) i vi trng hp KSK tp th theo hp ng: c s KSK tr Giy KSK, S KSK nh k cho ngi c KSK theo tha thun ghi trong hp ng. 3. Gi tr s dng ca Giy KSK, kt qu KSK nh k: a) Giy KSK c gi tr trong thi hn 12 (mi hai) thng k t ngy k kt lun sc khe; i vi KSK cho ngi Vit Nam i lm vic nc ngoi theo hp ng th gi tr ca Giy KSK theo quy nh ca quc gia hoc vng lnh th m ngi lao ng Vit Nam n lm vic; b) Kt qu KSK nh k c gi tr s dng theo quy nh ca php lut. 4. Trng hp ngi c KSK c xt nghim HIV dng tnh th vic thng bo kt qu xt nghim ny phi theo quy nh ca php lut v phng, chng HIV/AIDS. Chng III

IU KIN CA C S KHM BNH, CHA BNH C PHP THC HIN KHM SC KHE
iu 9. iu kin v nhn s

1. Ngi thc hin khm lm sng, cn lm sng phi c chng ch hnh ngh KBCB theo quy nh ca Lut KBCB ph hp vi chuyn khoa m ngi c giao trch nhim khm. Trng hp ngi thc hin k thut cn lm sng m php lut khng quy nh phi c chng ch hnh ngh KBCB th phi c bng cp chuyn mn ph hp vi cng vic c phn cng. 2. Ngi kt lun phi p ng cc iu kin sau: a) L bc s c chng ch hnh ngh KBCB v c thi gian KBCB t nht l 54 (nm mi t) thng; b) c ngi c thm quyn ca c s KSK phn cng thc hin vic kt lun sc khe, k Giy KSK, S KSK nh k. Vic phn cng phi c thc hin bng vn bn v ng du hp php ca c s KBCB. 3. i vi c s KSK cho ngi nc ngoi, ngi Vit Nam nh c nc ngoi v ngi Vit Nam i lao ng theo hp ng nc ngoi, hc tp nc ngoi (sau y gi tt l c s KSK c yu t nc ngoi), ngoi vic p ng cc quy nh ti Khon 1, Khon 2 iu ny, phi p ng thm cc iu kin sau: a) Ngi thc hin khm lm sng, ngi kt lun phi l bc s chuyn khoa cp I hoc thc s y khoa tr ln; b) Khi ngi c KSK v ngi KSK khng cng thnh tho mt th ting th phi c ngi phin dch. Ngi phin dch phi c giy chng nhn trnh phin dch trong KBCB theo quy nh ca Lut KBCB. iu 10. iu kin v c s vt cht, trang thit b 1. C phng khm lm sng, cn lm sng tng chuyn khoa theo quy nh ca B Y t ph hp vi ni dung KSK. 2. C c s vt cht v thit b y t thit yu theo quy nh ti Ph lc 4 ban hnh km theo Thng t ny. iu 11. iu kin v phm vi hot ng chuyn mn 1. iu kin i vi c s KSK khng c yu t nc ngoi: Thc hin c cc k thut chuyn mn ph hp vi ni dung ghi trong Giy KSK quy nh ti cc Ph lc 1, 2, 3 ban hnh km theo Thng t ny. 2. iu kin i vi c s KSK c yu t nc ngoi, ngoi vic p ng quy nh ti Khon 1 iu ny, phi thc hin c cc k thut cn lm sng sau: a) Xt nghim mu: Cng thc mu, nhm mu ABO, nhm mu Rh, tc mu lng, t l huyt sc t, u r mu; b) Tm k sinh trng st rt trong mu; c) Xt nghim vim gan A, B, C, E; d) Xt nghim huyt thanh giang mai; ) Xt nghim khng nh tnh trng nhim HIV (HIV dng tnh); e) Th phn ng Mantoux; g) Th thai; h) Xt nghim ma tu; i) Xt nghim phn tm k sinh trng; k) in tm ; l) in no ; m) Siu m; n) Xt nghim chn on bnh phong. Trng hp c s KSK c yu t nc ngoi cha iu kin thc hin cc k thut quy nh ti im v im n Khon 2 iu ny th phi k hp ng h tr chuyn mn vi c s KBCB c giy php hot ng v c php thc hin cc k thut . 3. Phm vi chuyn mn: a) C s KBCB iu kin quy nh ti Khon 1, Khon 2 iu 9, iu 10 v Khon 1 iu 11 ca Thng t ny c t chc KSK nhng khng c KSK c yu t nc ngoi.

b) C s KBCB iu kin quy nh ti Khon 3 iu 9, iu 10 v Khon 2 iu 11 Thng t ny c t chc KSK bao gm c vic KSK c yu t nc ngoi. iu 12. H s, th tc cng b thc hin vic khm sc khe 1. H s cng b iu kin thc hin KSK: a) Vn bn cng b iu kin thc hin KSK theo mu quy nh ti Ph lc 5 ban hnh km theo Thng t ny; b) Bn sao c chng thc Giy php hot ng khm bnh, cha bnh ca c s; c) Danh sch ngi tham gia KSK theo mu quy nh ti Ph lc 6 ban hnh km theo Thng t ny (c ng du trn tng trang hoc ng du gip lai tt c cc trang); d) Bn danh mc c s vt cht v thit b y t quy nh ti Ph lc 4 ban hnh km theo Thng t ny; ) Bo co v phm vi hot ng chuyn mn ca c s KSK; e) Bn sao c chng thc hp ng h tr chuyn mn i vi trng hp quy nh ti Khon 3 iu 11 Thng t ny (nu c). 2. Th tc cng b thc hin vic khm sc khe: Trc khi t chc KSK ln u, c s KBCB phi gi h s cng b KSK theo quy nh ti Khon 1 iu ny n c quan qun l nh nc v y t, c th nh sau: a) i vi c s KBCB trc thuc B Y t: H s gi v Cc Qun l khm, cha bnh - B Y t; b) i vi c s KBCB thuc thm quyn qun l ca B Quc phng th h s gi v Cc Qun Y B Quc phng; c s KBCB thuc thm quyn qun l ca B Cng an th h s gi v Cc Y t B Cng an; c s KBCB thuc thm quyn qun l ca B Giao thng vn ti h s gi v Cc Y t Giao thng vn ti - B Giao thng vn ti; c) i vi c s KBCB thuc thm quyn qun l ca S Y t tnh, thnh ph trc thuc Trung ng (sau y gi tt l S Y t); c s KBCB c tr s ti tnh, thnh ph trc thuc Trung ng (tr cc c s KBCB quy nh ti im a, im b Khon 2 iu ny): H s gi v S Y t ni c s KBCB t tr s. iu 13. Thi gian, trnh t gii quyt h s cng b iu kin khm sc khe 1. Trong thi hn 02 ngy lm vic k t ngy nhn c h s cng b iu kin KSK, c quan qun l nh nc v y t quy nh ti Khon 2 iu 12 Thng t ny (sau y gi tt l c quan tip nhn h s) gi cho c s KBCB cng b iu kin KSK (sau y gi tt l c s cng b iu kin) Phiu tip nhn h s theo quy nh ti Ph lc 7 ban hnh km theo Thng t ny. 2. Trong thi hn 10 ngy lm vic k t ngy nhn c h s, c quan tip nhn h s phi tin hnh thm nh h s. Trng hp h s cha hp l th c quan tip nhn h s phi c vn bn thng bo cho c s cng b iu kin hon chnh h s. Vn bn thng bo phi nu c th ti liu phi b sung v cc ni dung phi sa i. C s cng b iu kin ch phi b sung, sa i theo ni dung ca vn bn thng bo. Khi nhn c vn bn thng bo h s cha hp l, c s cng b iu kin phi hon thin v gi h s b sung v c quan tip nhn h s. Trong thi hn 02 ngy lm vic k t ngy nhn c h s b sung, c quan tip nhn h s phi gi cho c s cng b iu kin Phiu tip nhn h s b sung. Trng hp c s cng b iu kin b sung h s nhng khng ng vi yu cu th phi tip tc hon chnh h s theo th tc quy nh ti Khon ny cho n khi h s t yu cu. 3. Trong thi hn 20 ngy lm vic k t ngy ghi trn Phiu tip nhn h s i vi h s hp l hoc k t ngy ghi trn phn tip nhn h s b sung i vi h s cha hp l, nu c quan tip nhn h s khng c vn bn tr li th c s cng b iu kin KSK c trin khai hot ng KSK theo ng phm vi chuyn mn cng b. Chng IV

TRCH NHIM THC HIN

iu 14. Trch nhim ca ngi c khm sc khe 1. Cung cp thng tin trung thc v tin s bn thn, bnh tt v chu trch nhim v thng tin cung cp. 2. Tun th cc hng dn, ch nh ca ngi KSK trong qu trnh thc hin KSK.

3. Xut trnh H s KSK theo quy nh ti iu 4 Thng t ny cho ngi KSK kim tra trong mi ln thc hin mt hot ng khm lm sng hoc khm cn lm sng. iu 15. Trch nhim ca c s s dng lao ng, trng i hc, cao ng, trung hc chuyn nghip v trng dy ngh 1. Chu trch nhim t chc vic KSK cho i tng thuc thm quyn qun l theo quy nh ca php lut. 2. Qun l S KSK nh k ca i tng thuc thm quyn qun l. iu 16. Trch nhim ca c s khm sc khe 1. Chu trch nhim trc php lut v kt qu KSK do c s mnh thc hin. 2. Tng hp kt qu thc hin hot ng KSK do c s mnh thc hin vo bo co hot ng chung ca c s v bo co theo quy nh v thng k, bo co. iu 17. Trch nhim ca S Y t v c quan qun l nh nc v y t ca cc B, ngnh 1. Ch o, hng dn hot ng KSK ti cc c s KBCB thuc thm quyn qun l. 2. Kim tra, thanh tra hot ng ca cc c s KSK theo quy nh; nh ch hoc kin ngh nh ch hot ng KSK hoc x l vi phm theo thm quyn i vi cc c s KSK khng iu kin theo quy nh ti Thng t ny. iu 18. Trch nhim ca Cc Qun l khm, cha bnh - B Y t 1. Ch o, hng dn hot ng KSK ti cc c s khm bnh, cha bnh trong phm vi c nc. 2. Kim tra, thanh tra hot ng ca cc c s KSK theo quy nh ca php lut; nh ch hoc kin ngh nh ch hot ng KSK hoc x l vi phm theo thm quyn i vi cc c s KSK khng iu kin theo quy nh ti Thng t ny. Chng V

IU KHON THI HNH

iu 19. Hiu lc thi hnh Thng t ny c hiu lc k t ngy 01 thng 7 nm 2013. Thng t s 13/2007/TT-BYT ngy 21 thng 11 nm 2007 ca B Y t hng dn KSK v Thng t lin tch s 10/2004/TTLT - BYT - BLTBXH - BTC ngy 16 thng 12 nm 2004 ca: B Y t B Lao ng - Thng binh v X hi - B Ti chnh hng dn thc hin khm v chng nhn sc kho cho ngi lao ng Vit Nam i lm vic nc ngoi ht hiu lc thi hnh k t ngy Thng t ny c hiu lc thi hnh. iu 20. iu khon tham chiu Trng hp cc vn bn dn chiu trong Thng t ny c thay th hoc sa i, b sung th thc hin theo vn bn thay th hoc sa i, b sung . iu 21. Quy nh chuyn tip Cc c s KBCB ang thc hin hot ng KSK trc ngy Thng t ny c hiu lc c tip tc thc hin hot ng KSK n ht ngy 31 thng 12 nm 2013. Sau , nu mun tip tc thc hin hot ng KSK th phi p ng cc iu kin v thc hin quy trnh, h s cng b iu kin KSK c quy nh ti Thng t ny. Trong qu trnh thc hin, nu c kh khn, vng mc, ngh c nhn, t chc phn nh v B Y t (Cc Qun l khm, cha bnh) xem xt, gii quyt./. KT. B TRNG TH TRNG

Ni nhn:
- Vn phng Chnh ph (V Khoa gio vn x, Cng bo, Cng TTT Chnh ph); - Cc B, c quan ngang B, c quan thuc Chnh ph; - UBND cc tnh, thnh ph trc thuc TW; - C quan Trung ng ca cc on th; - Cc Kim tra VBQPPL-B T php; - S Y t cc tnh, thnh ph trc thuc TW; - Cc n v trc thuc B Y t; - Y t cc B, ngnh; - Cng TTT B Y t;

Nguyn Th Xuyn

- Lu: VT, KCB (03b), PC (02b).

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