FAQ's on drop in clinic charges
- Why are you charging for services at JMS
The UN has had its budgets cut globally. Management has to find ways to save and chose to introduce payment by the staff on primary health care services (offered at drop in clinic). The rationale being that these services are covered by your insurance. The insurance is subsidized by the employer; hence the employer pays twice if offering free services
- How was this decided
The common services management system decided this. All agencies are represented and the decision was endorsed at country director level.
- What are you charging for
The time taken by the nurse or doctor as well as cost of drugs and disposables
- Is everything charged for
No, most of JMS services are free to the user. . All occupational heath and emergency services are free to staff members. For more please click here for a paper on definitions
Each agency pays for services used according to a menu from which they select the desired services.
- How is it done in other UN clinics
This is a global policy but each country is free to implement it as local circumstances see fit. ECA clinic in Addis Abeba has charged staff for years. The UN dispensaries in Zimbabwe and Laos have already implemented cost recovery from staff. New York is closing its drop in clinic totally because there are many primary health care service providers elsewhere in town.
- Why such high fees
The fees are calculated based on UN salaries which are substantially higher than local hospital salaries. The common services management team could not find a way to cross subsidize it from other sources
- Why do we have to claim from our insurance? Why no direct billing?
Direct billing is desirable from JMS point of view. Each agency has to initiate this with heir insurance company and we will gladly sign an agreement with the insurance company. Once such an agreement is in place, staff will only pay their 20% co-payment and the rest goes directly to the insurance company
- Will this lead to higher insurance premiums?
Insurance premiums are calculated on usage.
- What about emergencies?
All emergency services in acute life threatening cases are free to the user. His/her agency will pay
- If JMS is not seeing staff when they are sick, what are you there for?
JMS is an occupational health unit. The primary function is to attend to work related issues of health and safety, not primary treatment of acute or chronic disease. We do have responsibility to adjust the work place to cater for staff with chronic illness or disabilities, and to ensure that the workplace does not bring about acute illness. We do have standby emergency services on Gigiri compound. In addition we have medical administrative responsibilities
- How do I get a Travel Medical Kit
First aid Kit is supplied to staff members on official assignments in places with limited or no Medical facilities.
It is issued free to staff of agencies who have subscribed to SLA 4 ( Travel Medicine) and who bring authorization letter from the administering office. Contents in the First aid Kit is standard but may be varied depending on type of assignment to to be done. If there are items required for travel and are not available in the kit, UN doctor will give a prescription to the staff member to procure and claim reimbursement from employer, This is only if the UN doctor recommends that missing item is necessary for the trip and should be procured.
How to get the Kit.
Staff member must visit the clinic personally and consult with the nurse/doctor on duty, no prior appointment is required. Staff member will be required to present his/ her Vaccination certificate to the clinician to check and advise as appropriate on what vaccines are due. Staff members are advised to visit the clinic two weeks to the travel date. This is important because some vaccinations and chemoprophylaxis require to be commenced well ahead of travel.
Yellow fever vaccine is required to be administered at least 10 days before travel, and is mandatory for entry into some countries. At the clinic, you may be requested to fill in a questionnaire form regarding drug allergies and previous medical history. This is to enable the clinician determine whether it is safe to administer the vaccination or chemoprophylaxis during the visit, and to be sure that the medications included in your kit are safe for you. Clinicians will be available to explain the use of items in the Kit.
FAQ's on Medical Clearance
(1). Why are UN- staff members required to do medical examination for clearance?
Medical examination for medical clearance for the UN staff members is required to ensure as far as possible that candidates are physically and mentally fit to perform the functions for which they have been selected without risk to their own health and safety or the health and safety of others.
In this respect pre-employment entry medical clearance is conducted for new recruits while periodic clearance is to ensure staff members remain healthy during their employment by the organization
(2). How do I book for medical clearance examination with the JMS?
Candidates who require pre- employment medical clearance are advised by their HR office upon receipt of their letter of appointment to contact the Joint Medical Service at email@example.com Tel: (254 – 20) 7622267 in order to book appointment for the medical examination.
Periodic medical examinations are conducted every two years. In the case of drivers, manual workers and security officers, periodic examinations are conducted every one year. Human resource officers book for their respective offices. JMS will automatically book staff from UNEP, UNON and Habitat whenever their periodic examination is due and communicate directly to the staff member. JMS will rely on individual agency HR officers in other agencies to book staff when the periodic checkup is due.
(3). Who pays for the medical examination at UNON JMS?
If your agency has subscribed to the service, you will not be asked to pay for the medical clearance.
For those agencies who have not subscribed for this service( generally Peacekeeping and those outside Kenya or Somalia), their staff members are required to pay $250 to the UN Cooperative bank and bring the receipt to the JMS clinic. It is important to confirm your agencies subscription status before coming for the medical clearance. This amount will usually be fully reimbursed to you by your agency on an F10 claim.
(4) What does the examination entail?
The examination entails the candidate answering a questionnaire about pasta and present health.
Then there are diagnostic test and finally a physical examination the doctor.
The following diagnostic tests are conducted during the medical examination:
Blood or serum analysis for: - hemogram, hematocrit, erythrocyte count, ESR, leucocyte count and differential count; fasting blood sugar and cholesterol, uric acid and either urea or creatinine (ii) urine testing for glucose, protein, and microscopic examination ( iii)resting electrocardiogram (ECG ( iv) full size chest X- ray
Appointment to see the examining doctor is assigned once the above tests are done. The candidate fills the MS.2 form on the part which indicates his/her personal profile and the medical history as well as the family medical history. The MS.2 form and the diagnostic test results are placed in the candidate’s file.
The doctor conducts a physical and mental examination in a systematic manner and documents his findings. He/she then discusses the results of the diagnostic tests mentioned above and their health implications with the candidate. If the doctor makes a significant observation with relation to the candidate’s medical/family history as well as his examination findings, this is communicated to the candidate at the same sitting and he/she is free to ask questions
The duty station hardship status, travel requirements of the role, specific job demands, geographic and climatic conditions of the duty location, availability of appropriate medical facilities, presence of infectious or contagious diseases or uncontrolled chronic illness in the candidate are some of the key factors which determine the candidate’s medical fitness clearance for the role.
The doctor is charged with the responsibility to make professional clinical conclusions and advise the candidate and the employer on any special clearance conditions e.g. not fit to fly.
(5). Are the details of my examination findings disclosed to my employer /HR officer?
All staff members working at the JMS clinic have the ethical responsibility to observe medical confidentiality. Medical information is therefore not communicated to unauthorized persons. In communicating with the HR officers / employer, only the terms ‘fit’ or ‘not fit’ are used. No other details are disclosed be it in the form of clinical details or diagnosis or laboratory test results.
(6). How long does it take to get the results of my examination?
Medical clearance may be approved immediately if no health limitation is detected. It takes a maximum period of 5 days between the time a candidate attends the clinic for examination to the time results indicating fit/not fit are communicated to the respective HR office.
The results may take longer to communicate in certain situations. Depending on individual circumstances, the candidate may be advised to undertake additional investigations in order to assist the JMS doctor get a clearer assessment of his/ her fitness status. This may happen where the baseline assessments do not return a definitive answer or where initial documentation reveals the need for additional assessments. In some cases additional reports may be required from specialists’ and external physicians in respect of the candidate’s medical condition. Candidates are informed of the doctor’s findings and recommendations.
(7) What am I expected to do if the doctor detects any abnormalities with my test/ examination results?
If the doctor detects a condition which requires urgent medical attention, he/ she will advise the candidate to go for treatment while the medical clearance remains pending till the disease condition is controlled. The HR office will thus be informed about the pending clearance without disclosing the medical details. If the medical tests delays staff member’s return to duty station, the days taken will be charged to sick leave.
(8) Can I appeal a decision of the examining doctor?
Any appeal on the medical clearance decisions of a candidate should be addressed to the Chief Medical Officer, UNON Joint Medical Service. The Chief Medical Officer will review the details of the case and make any further observations and decisions.
(9) Is HIV test part of the examination?
In accordance with the Organization’s policy on HIV/ AIDS in the workplace, candidates will not be screened for HIV for purposes of medical clearance. HIV status is not a reason to decline medical clearance.
The WHO guidelines recommend that all clinicians discuss the benefits of HIV testing with their clients. In this respect the UNON JMS implements a policy on voluntary Provider Initiated HIV Testing and Counseling whereby staff are offered an HIV test during periodic medical. The staff member is free to accept or decline.
(10) What if I am not medically cleared?
Where a candidate or staff member is considered medically fit to perform functions for which they have been selected, the final employment decision lies with the recruiting office. Where the JMS doctor has specified restrictions or disabilities which need to be reasonably accommodated, the final employment or deployment decisions will be made by Office of Human Resource Management and the recruiting office. In the event that a candidate or staff member is considered not medically fit, such individuals shall be considered as not having fulfilled the medical clearance requirements as set out in the Organization policy.
Staff members are encouraged to access ST/AI/2011/3 for detailed administrative information on UN Medical clearances and examinations.