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Dinas Kesehatan Lampung Utara dalam penjabaran tujuan pembangunan kesehatan telah menerapkan suatu kebijakan unit swadana di Puskesmas Bukit Kemuning dengan tujuan memberikan keleluasan Puskesmas dalam mengelola pendapatan fungsionalnya untuk meningkatkan mutu pelayanannya. Selanjutnya untuk menentukan kebijakan lebih lanjut Puskesmas unit swadana yang sudah di uji cobakan di Puskesmas Bukit Kemuning selama 3 tahun ini perlu dievaluasi. Berkaitan itu dilakukan penelitian yang bertujuan mendapatkan informasi mengenai pengelolaan sumber daya manusia dan sumber daya keuangan sebelum dan sesudah diterapkannya kebijakan unit swadana di Puskesmas Bukit Kemuning Kabupaten Lampung Utara tahun 2002 dengan pendekatan input ,proses dan out put. Penelitian ini adalah studi kasus dengan disain potong lintang di Puskesmas Bukit Kemuning Kabupaten Lampung Utara. Data diperoleh dari wawancara, dan observasi, dan penelusuran data sekunder. Wawancara mendalam dilakukan pada 12 informan yang terlibat dan memahami proses keswadanaan, tidak melibatkan pengguna Puskesmas. Hasil Penelitian menunjukkan dalam hal pengelolaan sumber daya manusia sesudah swadana dengan adanya kebijakan untuk dapat menggunakan pendapatan fungsional untuk menunjang pengelolaan sumber daya manusia menyebabkan telah diberikannya insentif sebagai sistem reward, dilakukannya kegiatan pendidikan dan ketrampilan secara mandiri serta dilakukannya kegiatan peningkatan kedisiplinan. Hasil kegiatan ini adalah terjadinya peningkatan pendapatan karyawan dari Rp 8.974.523 (tahun 1999) sampai Rp 35.580.745 (tahun 2001), adanya kegiatan peningkatan pengetahuan karyawan yang dilaksanakan secara mandiri sebanyak 6 kali dan adanya peningkatan jumlah hari kerja dari 93,72 % ke 96,05 % dibandingkan sebelum swadana. Permasalahan yang ada adalah masa depan tenaga honorer, belum adanya konsep perhitungan insentif dan standar pelaksanaan pelatihan. Dalam hal pengelolaan keuangan menunjukkan bahwa sesudah swadana dengan adanya sumber dana dari seluruh pendapatan fungsional Puskesmas dan kebijakan mengelola semua pendapatan fungsionalnya sehingga menyebabkan penganggaran keuangan dilakukan terpadu dengan botom up system, penerimaan dari semua pelayanan dengan sistem satu pintu, penggunaan keuangan berdasarkan pedoman yang telah disahkan dan pelaporan keuangan yang dilaksanakan tiap bulan dan akhir tahun yang terdokumentasi lengkap dibandingkan sebelum swadana. Permasalahan yang ada sesudah swadana adalah administrasi yang rinci dengan tidak didukungnya penyelenggara keuangan dengan pendidikan dan pelatihan yang sesuai. Puskesmas swadana membawa manfaat terutama dalam bidang pengelolaan sumber daya manusia dan pengelolaan keuangan untuk meningkatkan pelayanan, sehingga dapat diterapkan pada Puskesmas lain yang telah memenuhi kriteria. Puskesmas swadana juga merupakan salah satu solusi mengurangi beban pemerintah daerah dalam rangka menyediakan kebutuhan dana untuk operasional Puskesmas namun harus disesuaikan dengan kondisi daerah dimana Puskesmas berada.
Financial and Human Resources Management before and after Implementation of Swadana Policy (A Case Study in Bukit Kemuning Health Center, North Lampung District, 2002)To achieve the goal of health development, the District Health Office of North Lampung has decided Bukit Kemuning Health Center to be transformed as an Swadana Health Center. The Health Center has a more flexibility in managing its revenue and uses it to improve the quality of care. Bukit Kemuning Swadana Health Center has been set up as a trial Health Center three years ago and need to be evaluated as lesson learned and further policy making. A study is conducted to obtain the information on the management of financial and human resources before and after implementation swadana policy the input, process and out-put approach. This study is a cross-sectional study. The data were obtained from in-depth interview, observation, and analysis of the secondary data. In-depth interview is conducted, 12 informants that related and understand to the process of swadana policy were interview. The result of study showed that there was improvement on management of human resources after implementation of the policy where they could use their revenue for incentive as part of the reward system. Education and training activities were also undertaken to improve staff skills. There was also improvement in discipline on staff. The employees? income has increased from Rp. 8.974.523 in 1999 to Rp. 35.580.745 in 2001, as well as the knowledge of employee and productive working days increase from 93.72% to 96.05%. However, sustainability for providing honoraria of the staff remains questionable. The employment status has not cleared yet, since there is no concept of incentive formula and standard of training for the employee. After implementation of the policy swadana unit, Bukit Kemuning Health Center managed its revenue from all source of funds. The budget is allocation process is conducted integrated leg using bottom up approach, one door policy. Monthly and annual income statements were documented regularly. However, the financial administration in detail remain a problem, it is not supported by training on financial management. After implementation of swadana Health Center, the management of financial and human resources at Bukit Kemuning Health Center has been improving. The policy might be applied to other Health Centers, as long as is the criteria could be met. District Health office could consider this policy to reduce financial burden without scarifying the community.
Sesuai dengan UU No. 19 tahun 2003 tentang Perbendaharaan Negara, misi rumah sakit adalah urituk menjamin tersedianya pelayanan kesehatan bagi seluruh masyarakat. Pasal 68 dan 69 mengamanatkan- untuk membentuk suatu Badan Layanan Umum (BLU) yang bersifat nirlaba, yang dikelola secara profesional dan independen serta dibentuk untuk meningkatkan pelayanan kepada masyarakat dalam rangka memajukan kesejahteraan umum dan mencerdaskan kehidupan bangsa, dan juga untuk menghasilkan pelayanan yang berkualitas dan terjangkau yang sumber pembiayaannya berasal dari tarif yang dikenakan kepada pengguna jasa dan dari subsidi Pemerintah. BLU adalah instansi di lingkungan pemerintah yang dibentuk untuk memberikan pelayanan kepada masyarakat berupa penyediaan barang dan 1 atau jasa yang dijual tanpa meroari keuntungan dan dalarn melakukan kegiatannya didasarkan pada prinsip efisiensi dan produktivitas (PP No. 23 tahun 2005 tentang Pcngelolaan Keuangan Badan Layanan Umum ( BLU ) ). Untuk mengetahui persepsi stakeholder, kelebihan dari BLU dan faktorfaktor yang menghambat serta solusinya di Rumah Sakit Dr. Hasan Sadikin (RSHS ) Bandung - Sawa Barat tahun 2006. Penelitian dengan menggunakan pendekatan kualitatif melalui wawancara mendalam dan telaah dokumen pada Rumeh Sakit Dr. Hasan Sadikin ( RSHS ) Bandung - Sawa Barat pads bulan Juni sampai dengan Juli 2006. Hasil Penelitian : Menunjukkan bahwa Rumah Sakit Dr. Hasan Sadikin ( RSHS ) Bandung sudah melakukan persiapan untuk menjadi rumah sakit dengan Pala Pengelolaan Keuangan Badan Layanan Umum ( PPK -- BLU ). Hal ini dapat dilihat dari rencana kerja yang dibuat, perubahan-perubahan yang ada serta kebijakan I keputu'san yang dibuat pimpinan di RSHS Bandung dan dipatuhi oleh angotaanggotanya, antara lain : Perubahan budaya kerja rrelalui pelatihan, Secara keuangan lebih. balk karena berpikir secara akrual basis sehingga bisa lebih efektif dan efisien, Sumber daya 1 asset dapat dikelola oleh nimah sakit sendiri, Perubahan perilaku 1 mindset dari birokrat ke enterpreuner, Perubahan performa ( lebih rapi ), Peningkatan pendapatan karyawan, Manajemen operasional berjalan balk, Membangun sistem manajemen di tiap level RSHS Bandung secara terintegrasi yang berfokus pada customer oriented, Menyusun Rencana Kerja Anggaran Kementerian Lembaga (RICA - KL) dan Rencana Bisnis Anggaran ( RBA) sejak tahun 2006. SDM yang sangat beragam, sehingga sosialisasi dan perubahan yang dilakukan rumah sakit sehubungan dengan perubahan PPK - BLU jadi agak lambat, Peraturan MenKeu belum lengkap sehingga Standar Operasional Prosedur ( SOP ) pun belum lengkap. ]ika rumah sakit berubah menjadi rumah sakit dengan PPK - BLU tidak masalah asalkan tetap survive dan berkembang lebih baik serta tetap dapat menjalankan fungsi sosial sesuai Pancasila dan UUD 45 dan fungsi usaha tetap berjalan baik tanpa melepas tanggung jawab sosial, memberikan aspek manfaat bagi sernua pihak serta memberikan pelayanan bagi masyarakat dengan memperhatikan aspek-aspek efisiensi, efektifitas, bermutu dan terjangkau.
As according to UU No. 19 in year 2003 about Exchequer of Nation, hospital mission is to guarantee available of health service for all society. Section 68 and 69 commending to form Public Service ( BLU ) having the character of nirlaba, managed professionally and independent and also foul-led to increase service to society in order to moving forward public prosperity and educate life of nation, as well as to yield service which with quality and reached by which source of its defrayal come from imposed tariff to service user and from governmental subsidy. BLU is institution in governmental environment which formed to give service to society in the form of goods supply and 1 or sold service without searching advantage and in conducting its activity is relied on efficiency and productivity principle (PP No. 23 year 2005 about Finance Management of Public Service ( BLU ). To find stakeholder perception, excess from BLU and factors pursuing and also solution its in Dr. Hasan Sadikin Hospital Bandung - West lava in year 2006. Research by using approach qualitative through in depth interview and document study in Dr. Hasan Sadikin Hospital Bandung - West Java in June to July 2006 Result Indicating that Dr. Hasan Sadikin Hospital Bandung have conducted preparation to become hospital with Finance Pattern Management of Public Service (PPK - BLU ). This Matter can be seen from made activity plan, existing change and also policy / decision made by director in Dr. Hasan Sadikin Hospital Bandung and obeyed by officer, for example : Cultural change of activity through training, monetaryly better because thinking by acrual bases so that can more effective and is efficient, Resource 1 asset can be managed by hospital, Behavioral change 1 mindset from bureaucrat to enterpreuner, change of Performa, Make-Up of earnings of employees, Operational management work well, Develop Build management system in every level integrated which focusing at oriented customer, Compiling Plan Work Budget Ministry (RKA - KL) and Plan Business Budget ( RBA) since year 2006. Immeasurable Human Resource which is very, so that conducted by change and socialization is hospital referring to change of Finance Pattern Management of Public Service ( PPK - BLU )-become rather tardy, Regulation of Minister for Finance not yet complete so that Standard Operational Procedure ( SOP ) even also not yet is complete. If hospital turn into hospital with Finance Pattern Management of Public Service ( PPK - BLU) do not the problem of so long as remain to survive and expand better and also remain to earn to run social function according to Pancasila and UUD.
Cakupan Peran Serta Masyarakat di Kabupaten Subang masih rendah, salah satu penyebab dari permasalahan tersebut berhubungan dengan kemampuan manajerial kepala Puskesmas. Berkaitan dengan hal tersebut maka dilakukan penelitian yang bertujuan untuk mendapatkan gambaran mengenai faktor-faktor yang berhubungan dengan kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat di Kabupaten Subang pada Tahun 2006. Dengan mempelajari hubungan antara kemampuan manajerial kepala Puskesmas tersebut dengan faktor internal yang terdiri dari Umur, Pendidikan dan Lama kerja serta faktor eksternal yang terdiri dari Supervisi, Pelatihan, Umpan balik dan Sarana kerja. Dalarn penelitian ini pendekatan yang digunakan adalah pendekatan kualitatif, dimana data yang dikumpulkan berupa data primer yang didapat melalui kegiatan wawancara mend alam dan Focus Group Discussion dengan informan dari Dinas Kesehatan, Kepala Puskesmas dan Tokoh Masyarakat, sedangkan data sekunder diperoleh melalui kegiatan penelusuran dokumen baik di tingkat Dinas Kesehatan maupun Puskesmas yang menjadi lokasi penelitian. Dari wawancara mendalam dapat diketahui bahwa rendahnya cakupan peran serta masyarakat dipicu oleh beberapa permasalahan mendasar, selain karena kualitas dan kuantitas tenaga kesehatan yang ada masih sangat terbatas, kemampuan manajerial kepala Puskesmas sebagai pimpinan tertinggi di wilayah kerjanya juga rata-rata masih kurang, mereka belum mampu memaksimalkan potensi yang ada untuk membantu pelaksanaan program Puskesmas. Hasil penelitian menunjukan bahwa dari ketiga faktor internal yang diteliti ternyata faktor yang tampak cenderung berhubungan dengan kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat adalah faktor lama kerja. Sedangkan dari keempat faktor eksternal temyata tidak ada satupun yang mempengaruhi kemampuan manajerial kepala Puskesmas dalam penggerakan masyarakat. Saran yang dapat disampaikan berdasarkan hasil penelitian ini ditujukan kepada pihak Dinas Kesehatan sebaiknya mempertimbangkan faktor-faktor tersebut diatas terutama lama kerja pegawai dalam pengangkatan Kepala Puskesmas di wilayah kerjanya. Disamping itu sebaiknya pihak Dinas lebih menyeimbangkan porsi pelatihan antara pelatihan teknis medis dengan pelatihan manajemen, khususnya mengenai manajemen dalam peningkatan peran serta masyarakat.
Public Cooperation in health sector in Subang distric still far from adequate, one of the causes from those problems related with Puskesmas chief managerial ability. Related with those cases then done research that aim to get the view about related factors related with Puskesmas chief managerial ability in moving society Subang distric in year 2006. By learn the relation between Puskesmas chief managerial ability along with internal factor that consist of Age, Education, and Working Length and also external factor that consist of Supervision, Training, Feedback and Working tools. In this research, approach that used is qualitative approach, where collected data is primary data that got from deep interview activity and Focus Group Discussion with informant from Health Agency, Puskesmas Chief and Public Figure, while secondary data got from document study activity whether in Health Agency or Puskesmas that become research location. From deep interview also known that public cooperation in health sector still far from adequate those cases triggered by some basic problems, besides quality and quantity of health source that still limited, Puskesmas chief managerial ability as highest leader in his working area even still low, they not yet can maximize available potency to help in conduct Puskesmas program. Research result be known that from three researched internal factor obviously factor that affect Puskesmas chief managerial ability in moving society is working length. While from four external factors obviously no one that affect Puskesmas chief managerial ability in moving society. Suggestion that can be submitted based on this research result showed to Public Health office is better considering those factors especially employee working length in giving position of Puskesmas Chief in his working area. Besides, Agency should balance training portion between medical techniques with management training, especially about management in improving public role.
In the incentive policy for health workers in regions dealing with COVID-19 (Innakesda) it is part of the health budget for handling COVID-19 which must be budgeted by local governments sourced from the Refocusing 8% DAU/DBH fund in 2021. It becomes interesting to further study the differences in the results of the implementation of the Innakesda policy carried out by the Regional Government where there are local governments that have succeeded in implementing this policy and there are also regional governments that have not succeeded in doing so. The success in this implementation can be seen from the availability of the budget and the realization of the incentive budget for health workers in the area. Therefore, it is interesting to know the factors that influence a region's success in implementing this policy. This research was conducted with a qualitative approach using in-depth interviews with several key informants and literature review. The analysis was conducted to see the success of Innakesda policy implementation from the dimensions of actors, content, context and processes in regional financial management. The location of the research was conducted in one of the areas that have successfully implemented the implementation of incentive policies for health workers in the regions, namely South Tangerang City. The conclusion of the study illustrates that there are situational context factors for handling the pandemic that rely on the role of health workers as the frontline as well as structural factors on the principle of decentralization of local government administration and humanitarian factors, this context also influences Political Will of the South Tangerang City government in implementing the Innakesda policy. Innakesda policy content in the harmonization of regulations in principle is in harmony with higher regulations to underpin the law on Innakesda policies and various efforts to evaluate policy implementation are also carried out by the central government and the results are used as input in making improvements to policy content in an effort to accelerate the realization of Innakesda in the Government South Tangerang City Area. Political Will of the Mayor of South Tangerang is a key role in the policy implementation process in regional financial management from the planning and budgeting stages in the integration and coordination of refocusing and budget reallocation while maintaining conformity/alignment of achieving RPJMD targets and staying focused on the COVID-19 handling program and Innakesda by looking at budgeting ability. For the implementation and administration stages, the principles of order and compliance in regional financial management are supported by a realization reporting system by utilizing technology in the Planning, Budgeting and Reporting Management Information System (SIMRAL). The research recommends that the South Tangerang City Government make improvements to the Regional Regulation on Disaster Management. Local governments in Indonesia make local regulations on non-natural disaster management with details related to budgeting, recording and reporting as well as maximizing the role of APIP. In determining the provision of incentives for Health Workers, the Ministry of Finance continues to pay attention to regional financial capabilities and the Ministry of Home Affairs continues to encourage Regional Governments to implement the Regional Government Information System (SIPD) properly. Keywords: Health Worker Incentives, Regional Financial Management, COVID-19
Berdasarkan Surat Keputusan Bupati Kepala Daerah Tingkat II Solok, Nomor 05 Tahun 1995, telah ditetapkan bahwa tugas dan wewenang sebagai pelaksana pengelolaan sampah di Kabupaten Solok di limpahkan kepada Badan Pengelola Kebersihan Dan Keindahan (BPKK) Kabupaten Solok. Sejak mulai berdiri sampai saat ini BPKK Kabupaten Solok belum mempunyai rencana strategis dalam menjalankan tugas dan fungsinya. Untuk mengantisipasi kecenderungan dimasa yang akan datang, permasalahan sampah dimasa yang akan datang di Kabupaten Solok, maka organisasi BPKK Kabupaten Solok ini dipandang sangat perlu mempunyai perencanaan strategis. Untuk dapat menyusun rencana strategis BPKK Kabupaten Solok, dilakukan penelitian operasional dengan analisis kualitatif dan kuantitatif. Penyusunan strategi ini dilaksanakan melalui tiga tahap. Tahap I (input stage) terdiri dari analisis lingkungan eksternal dan internal dari BPKK yang dilakukan oleh Decision Making Consensus Group (DMCG), yang terdiri dari Kepala dan seorang staf Badan Pengelola Keuangan Daerah (BPKD), Kepala BPKK serta seorang pejabat dari Dinas Kesehatan dan Dinas Kependudukan/KB & Tenaga Kerja Kabupaten Solok. Kemudian pada Tahap II (matching stage), DMCG melakukan identifikasi alternatif strategi dengan analisis Matriks Internal-Ekstemal (1E) dan Matriks SWOT. Setelah itu dilanjutkan dengan Tahap III (decision stage) untuk menentukan prioritas strategis terpilih dengan menggunakan metode Quantitative Strategic Planning Matrix (QSPM). Berdasarkan hasil analisis Matriks SWOT memperlihatkan BPKK berada dalam kuadran Weaknesses-Opportunities (WO), dimana pada kondisi yang demikian BPKK dapat meminimalkan kelemahan internalnya dengan memanfaatkan peluang yang ada. Sedangkan pada analisisis dengan Matriks IC, inemperlihatkan posisi BPKK pada Sel V ( Hold and Maintain ), yang berarti BPKK masih punya peluang untuk melakukan pertumbuhan atau pengembangan organisasinya. Melalui analisa kedua matriks tersebut, maka strategi prioritas yang tepat untuk digunakan oleh BPKK Kabupaten Solok di dalam pengembangan organisasi sesuai dengan tugas dan fungsi yang diembannya adalah sebagai berikut ; 1). Strategi Penetrasi Pasar, 2). Strategi Perluasan Pasar dan, 3). Strategi Diversifikasi Terkait. Secara umum ada tiga komponen kegiatan yang dapat dijalankan didalam penerapan strategi tersebut yaitu ; a). Melakukan peningkatan penjualan dan pemasaran, b). Melakukan peningkatan kemampuan operasi dan c). Melakukan pembenahan/peningkatan infrastruktur pendukung. Sebagai saran, agar perencanaan strategis BPKK yang telah dibuat ini dapat dioperasionalkan maka perlu adanya rekomendasi dan dukungan dari Kepala Daerah dan DPRD Kabupaten Solok, setelah itu baru dilakukan sosialisasi kepada pihak terkait untuk menjalin koordinasi didalam pelaksanaannya.
Chief Executive's (Bupati's) of Solok District Decree No.: 05, 1995, had given the responsibility and authority of waste management at Solok District to the Cleanliness and Beauty Management Board (BPKK). Since it was founded, the Board has not had Strategic Planning to conduct its tasks and functions yet. To anticipate the future environmental cleanliness, especially in waste problems at Solok District, this Strategic Plan would be a necessity for Solok District organization of BPKK. In order to build a Strategic Planning of this Board, this operational research had been conducted using qualitative and quantitative analyses. These strategies were built in three steps. First (input stage), consists of external and internal environmental analyses of BPKK through Decision Making Consensus Group (DMCG). People in this group include Head and one staff of District Financial Management Board (BPKD), head of BPKK and Head of District Health Office and Head of District Demographic/ Family Planning and Manpower Office. On the second stage (matching stage), DMCG identified alternative strategies by Internal-External Matrix and SWOT Matrix analyses. Finally, the third step (decision stage) was selecting the strategic priority, using Quantitative Strategic Planning Matrix (QSPM) method. Based on the result of SWOT Matrix Analysis, BPKK is positioned at Weaknesses-Opportunities (WO) quadrant, which means BPKK could minimize its internal weaknesses using the opportunities. Meanwhile, the result of IE Matrix shown a position of BPKK was at Cell five (Hold and maintain), it means that the Board still the opportunity to grow and develop its organization. Both matrix analyses resulted in the priority strategies for organization development of BPKK, related to the tasks and functions, are as follows : 1). Market Penetration Strategy 2). Market Development Strategy and 3). Related Diversification Strategy. In general, there are three of actions that can be done to apply the strategies: a). Increasing sales and marketing efforts b). Enhancing operational abilities, and c). Improving supporting infrastructures. In order to operational this BPKK strategic planning, there is a need of recommendation and support from Bupati and District Parliament (DPRD). After ward socialization to the related sectors should be done to build coordination of the delivery of the programs.