PROSES PENYUSUNAN RBA (Rencana Bisnis Anggaran) BLUD Rumah Sakit

Hubungan RBA dengan Laporan Keuangan BLUD

Tulisan ini berusaha untuk memvisualkan dan memaparkan kembali proses penyusunan RBA, terkait dengan pertanyaan pembaca yang menanyakan tentang bagaimana metode/proses untuk melakukan revisi RBA.  Pertanyaan ini sering saya temui ketika sedang mendampingi rumah sakit dalam penyusunan RBA mereka, baik dari kalangan internal rumah sakit sendiri maupun mitra kerja mereka dari DPPKA (bagian keuangan) pemda setempat.  Besar kemungkinan pertanyaan ini muncul karena memang secara eksplisit Permendagri 61/2007 tidak mengatur masalah revisi RBA.  Meskipun sebenarnya proses penyusunan RBA sudah diatur sedemikian jelasnya dalam Permendagri 61/2007 mulai dari pasal 71 sampai dengan 79.  Proses penyusunan RBA sampai dengan terbitnya DPA definitif terbagi dalam dua proses besar.  Yaitu proses yang berjalan di internal rumah sakit dan proses penetapan RBA yang berlangsung di wilayah eksternal rumah sakit.  Dengan asumsi bahwa rumah sakit memiliki struktur organisasi sub bagian anggaran dan verifikasi, maka proses internal penyusunan RBA rumah sakit dapat digambarkan sebagai berikut:

Proses penyusunan RBA di internal BLUD RS

Proses penyusunan RBA di internal BLUD RS

Dari bagan terlihat bahwa koordinator penyusunan RBA terletak pada sub bagian anggaran.  Koordinator ini dapat disesuaikan dengan nomenklatur organisasi yang berlaku di setiap rumah sakit.  Substansinya adalah koordinator penyusunan RBA merupakan tanggungjawab pejabat keuangan BLUD.  Form Pendapatan yang didistribusikan harus mencakup seluruh jenis pendapatan yang disepakati internal rumah sakit, yang nantinya akan menjadi objek pendapatan dalam RBA.  Sedangkan form belanja harus dapat menjelaskan secara detail input,output dan outcome dari setiap program dan kegiatan yang diusulkan.  Meskipun untuk kepentingan anggaran belanja RBA BLUD rumah sakit hanya sampai pada jenis belanja, namun form belanja yang didistribusikan harus mampu menampung belanja hingga rincian belanja.  Hal ini dilakukan sebagai antisipasi terhadap permintaan DPPKA pemda setempat sekaligus sebagai pengendalian internal BLUD RS.

Pada saat pembahasan internal seluruh pendapatan dan belanja dari semua bagian/instalasi dikonsolidasikan.  Jika terdapat keterbatasan sumber daya (semisal pendapatan yang kurang untuk menutup usulan belanja) maka disinilah tempat untuk menetapkan skala prioritas program dan kegiatan.  Pembahasan internal harus melibatkan semua bagian yang menjadi subjek pengusul.  Prinsip transparansi menjadi pilar utama, sehingga ketika suatu usulan program dan kegiatan dengan terpaksa harus ditunda/dibatalkan tidak terjadi keresahan, prasangka negatif dan kekecewaan yang berdampak pada motivasi kerja bagian/instalasi yang bersangkutan.

Draft pendapatan dan belanja yang telah dibahas akan menjadi dokumen penganggaran untuk tahun anggaran yang direncanakan.  Itulah substansi RBA, yang akan digunakan sebagai dasar untuk membuat laporan keuangan prognosa tahun anggaran yang direncanakan.  Terdiri dari laporan operasional, laporan arus kas , neraca serta catatan atas laporan keuangan.  Betapa pentingnya RBA (draft pendapatan dan belanja) ini dalam penyusunan laporan keuangan tergambar sebagai berikut:

Hubungan RBA dengan Laporan Keuangan BLUD

Hubungan RBA dengan Laporan Keuangan BLUD

Komponen pendapatan dan belanja dalam RBA merupakan bahan utama pembuatan laporan prognosa operasional dan arus kas.  Laporan operasional menggambarkan kinerja BLUD RS dalam mengelola sumber daya untuk menghasilkan pendapatan, sedangkan laporan arus kas menggambarkan aliran kas masuk dan keluar dari setiap aktivitas pendapatan dan belanja.  Dari laporan arus kas,orang akan melihat seberapa cerdas suatu rumah sakit mengelola utang dan piutangnya sehingga tetap menampilkan perbandingan yang optimal antara pendapatan yang belum diterima dengan kecukupan kas untuk memutar roda pelayanan.  Dari keduanya (laporan operasional dan arus kas) neraca -yang menggambarkan seberapa kaya rumah sakit tersebut- BLUD RS disusun.

Usai penyusunan dokumen RBA, dimulailah tahap kedua,yaitu penetapan RBA hingga menjadi DPA definitif sebagai dasar penerimaan pendapatan dan pengeluaran belanja.  Proses penetapan ini tergambar sebagai berikut:

Bagan Alir Penetapan RBA Menjadi DPA

Bagan Alir Penetapan RBA Menjadi DPA

RBA yang telah selesai disusun, diusulkan oleh pemimpin BLUD ke DPPKA (dulu PPKD, dalam permendagri 61/2007).  Usulan RBA dibahas secara internal DPPKA untuk dicocokkan dengan ketersediaan dana dan prioritas anggaran tahun yang direncanakan.  Setelah disetujui, DPPKA menyerahkan RBA tersebut ke Tim anggaran pemda setempat untuk dibahas dan dikaji bersama dengan RKA SKPD lainnya.  Dokumen RKA seluruh SKPD (termasuk RBA) kemudian disampaikan ke tim anggaran DPRD untuk dibahas dan disahkan menjadi Perda APBD.

Dengan mengacu pada APBD definitif yang diperolehnya, pemimpin BLUD melakukan penyesuaian/revisi RBA.  RBA yang telah disesuaikan dengan APBD kemudian menjadi dasar penyusunan DPA yang akan diusulkan ke DPPKA.  Begitu disetujui DPPKA, DPA tersebut telah menjadi dokumen penganggaran yang menjadi dasar pelaksanaan anggaran BLUD yang bersangkutan.

Pada intinya revisi DPA BLUD dapat dilakukan melalui dua kategori perubahan anggaran.  Yang pertama , melalui penetapan oleh DPPKA mengenai kebijakan perubahan anggaran yang menjadi wewenang SKPD tanpa melalui PAK, yang kedua melalui mekanisme PAK.

Bila melalui PAK, proses yang mesti dilalui tidak jauh berbeda kala pertama kala menyusun RBA hingga menjadi DPA definitif.  Bila berupa kebijakan, maka harus ada kesepakatan dengan DPPKA mengenai prosedur dan batasan kewenangan untuk merubah pendapatan dan belanja.  Dan kebijakan ini harus dituangkan dalam peraturan kepala daerah tentang pengelolaan anggaran tahun berjalan.

175 Responses to PROSES PENYUSUNAN RBA (Rencana Bisnis Anggaran) BLUD Rumah Sakit

  1. trismi says:

    terimakasih atas info ttg BLUD. Bisakah kami meminta juga petunjuk ttg BLUD Puskesmas dimana sbg Unit kerja dr Dinas Kesehatan.

    • Julianto Supangat says:

      Sama dengan BLUD yang berstatus SKPD, perbedaannya mungkin hanya arus penganggaran dan pertanggungjawaban keuangan saja.

      Terima kasih telah berkunjung dan…
      Tetap Semangat..!

    • dadan dhaniswara,dr says:

      postingan blud nya sangat menarik dan memberikan inspirasi bagi kami yang memulai implementasi blud di puskesmas..mohon bantuannya untuk selalu posting hal terbaru mengenai penyusunan RBA

      • dadan dhaniswara,dr says:

        salam kenal dari saya dr.H .Dadan Dhaniswara (kepala pukesmas Kadungora Garut)

  2. Amren Rahim says:

    Saya bertugas di rumah sakit blud, kami membutuhkan materi-materi ini sebagai rujukan. Mohon kiranya kami bisa mendapatkan materi tsb.
    Terimakasih . . .

  3. Syifa says:

    Bapak tinggal copy paste naskah di atas sebagaimana saya. Kalau ingin lebih mendalam tinggal hubungi pada kolom kontak di menu atas halaman.

  4. agus purnomo hady says:

    salam kenal saya dr rsu ra kartini jepara, mau menanyakan untuk revisi dpa kami harus menggunakan dasar hukum apa karena setiap bulannya ada revisi kendala kami dalam memberikan pertanggung jawaban kami kepada BPKP terima kasih

    • Salam kenal juga Mas Agus…,
      Revisi DPA tiap bulan? Wow saya harus koprol dulu kayaknya. Mas Agus bisa jelaskan lebih detail gitu, apa yang direvisi, jumlahnya, kode belanjanya, kegiatannya, de el el. Karena BLUD dibuat bukan untuk nambahin kerjaan, tapi untuk alasan efektivitas.
      Lalu mengenai pertanggungjawaban kepada BPKP, maksudnya apa ya? Ada hubungan apa RSUD RA Kartini dengan BPKP?

      Itu dulu saja mas, maaf ya, telah mengecewakan…

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