Setting up of Grievance/Advisory Committee At Dispensary Level — Modification: CGHS

 Setting up of Grievance/Advisory Committee At Dispensary Level — Modification: CGHS

F. No. S.11030/19/2023-EHS
Government of India
Ministry of Health and Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated the March 17th , 2023.

OFFICE MEMORANDUM

Subject: Setting up of Grievance/Advisory Committee At Dispensary Level — Modification Reg.

Local Advisory Committees were set up for all CGHS dispensaries with specific composition and specific mandate in 2005 with some modifications notified in 2010. It has been seen that the functioning of these Advisory Committees has been less than satisfactory. Hence, this mechanism needs to be refined to ensure optimal functionality to facilitate seamless delivery of health care services and prompt redressal of grievances within the CGHS System. In this context the following guidelines are being issued.

2. Constitution of Local Advisory Committee (LAC) at the Health and Wellness Centre (HWC), CGHS level:

• The LAC for all Health and Wellness Centres (HWCs) across the country to have the following composition:

1. C.M.O In-Charge
2. Area Welfare Officer(s)
3. Representative from Resident Welfare Associations.
4. Representative of Pensioners
5. Representative of Local Chemist.

• This Committee shall be duly notified by the Additional Director, CGHS of the Zone. The meetings of the Committee shall be held at least once in a month and the mandate of the Committee shall be the following:

1. Disposal of the pending claims of individuals and HCOs,
2. Assessment/Evaluation of performance of Local Chemists, including Jan Aaushadhi Kendra and other systems of medicines;
3. Provision of amenities to beneficiaries (infrastructure) at the HWC,
4. Staff punctuality and behaviour towards beneficiaries,
5. Cleanliness and maintenance of the HWC,
6. Grievance Redressal of any grievance received in the grievance box of the dispensary or otherwise (on line)

• The term of the Members of LAC at Health and Wellness (HWC) level shall be as follows:

1. The term of the Members of the Committee except CMO in-charge will be for two years only and will come into effect on 1st January every alternate year.
2. No Member shall be nominated for the 2nd term.
3. Except Area Welfare Officer, who is nominated by DOPT, two Members each from Resident Welfare Association and Pensioners’ Welfare Association shall be nominated by respective Association and CMO I/C shall approach these Associations for this purpose.

• Based on the mandate above, LAC shall be responsible for taking up such tasks and adhere to such norms as prescribed here under:

1. The Committee will meet every 2nd Saturday of the month,
2. Study the grievances/suggestions received in the complaint box and record in the register in the presence of all the LAC members,
3. Should a need arise, call the complainant on phone or in the next meeting to sort out the grievances,
4. To suggest ways and means to improve the functioning of the dispensaries within the available resources,
5. To liaise with different agencies involved in the supportive services for the maintenances of the CGHS dispensaries,
6. To inform the CMO I/C about any serious patient (CGHS beneficiary) and help to organise for his/her treatment,
7. To monitor the functioning of Authorised Local Chemist/ Jan Aushadhi Pariyojana,
8. To study the stock availability in the Wellness Centre store,
9. To study the status/pendency of the claims,
10. To monitor the performance of staff and will identify the best worker on quarterly basis. His/ Her photograph will be displayed prominently in the Wellness Centre and will also be awarded certificate of appreciation by the Committee,
11. In the meetings, only local issues of the concerned dispensary shall be discussed, and the Committee shall not interfere in any policy matter, and shall not correspond directly with the authorities but through proper channel that is, Zonal Additional Director / City Additional Director / Joint Director for the same,
12. The names, addresses and telephone numbers of the Committee members to be prominently displayed in the Health and Wellness Centre,
13. Area Welfare Officer, who is also a member of the committee, will also inform the beneficiaries about the functioning of the Advisory Committee in the Area Welfare Meetings. He will also guide the beneficiaries that any complaint regarding functioning of the Wellness Centre is to be made to the Committee instead of approaching the higher authorities directly,
14. Establishment of a dedicated helpline (TOLL FREE No. 1800-208-8900) and a call log shall be maintained,
15. Record of Discussions to be maintained and pasted on the NOTICE BOARD of Wellness Centre for perusal of beneficiaries.

3. Similarly, there shall be a Zonal Advisory Committee (ZAC) at the level of Additional Director of the concerned Zone. The composition of the committee at the zonal level shall comprise of:

1. Additional Director (Zone), CGHS
2. Chief Medical Officer dealing with Reimbursement / Hospital Bills,
3. Nodal Officer for Gnevances,
4. Administrative Officer/Office Superintendent- Member Secretary,
5. Two representative of CGHS beneficiaries,
6. Representative of CGHS empanelled Hospitals/Distributor of Jan Aushadhi Pariyojana may be co-opted as needed’ and
7. Area Welfare Officer to be included on rotation basis (quarterly).

• The Zonal Advisory Committee shall be notified by the Joint Secretary (MoHFW), looking after affairs of CGHS. The ZAC meeting shall be held once in a month, preferably on the fourth Saturday.

4. The mandate of Zonal Advisory Committee shall be:

1. To examine the issues /grievances escalated post- LAC Meetings;
2. To examine and take action based on the recommendations of the local advisory committee;
3. To monitor the issue of CGHS cards;
4. To Monitor the settlement of individual medical claims and Hospital bills;
5. To monitor issues related to shifting of Wellness Centre / Major repairs of Wellness Centres in progress/ proposed;
6. To study the grievances/suggestions received in the complaint box of Zonal office / AD office and record in the register;
7. Monitoring of timely issue of Pension pay order / Family Pension and timely settlement of Gratuity and other matters related to retirement benefits;
8. To examine the complaints against the empanelled private hospitals and sort out the grievances;
9. To look into the complaints against CMOs In- charge;
10. To ensure complete adherence to the budgetary allocation and monitor expenditure on a monthly basis;
11. To invite HCOs and Labs for addressing their issues and ensure that the contents of the MoU is honoured by them in letter and spirit; and
12. To hold CGHS panchayat at Zonal level; once in 2 months where all the executive orders, office memoranda shall be shared with the beneficiaries.

5. CGHS beneficiaries are urged to make optimal usage of the LAC and ZAC for redressal of their issues and grievances.

This issues with the approval of the Competent Authority.

                                                                                                                                   (Dr. Manashvi Kumar)

Joint Secretary (CGHS)
Tel. 2306 1887