Implementing Rules and Regulations of R.A. No. 10355

June 9, 2014

DOH ADMINISTRATIVE ORDER NO. 2014-0019

 

I. Rationale/Background

The Jose B. Lingad Memorial Regional Hospital (JBLMRH) is a tertiary teaching and training hospital with 250 authorized beds as mandated by Republic Act 4098, "An Act Converting Pampanga Provincial Hospital into Central Luzon General Hospital and Authorizing the Appropriation of Funds Therefor" dated 19 June 1964 and Republic Act 6780, "An Act Changing the Name of Central Luzon General Hospital located in the Municipality of San Fernando, Province of Pampanga, to Jose B. Lingad Memorial Regional Hospital" dated 25 November 1989. The hospital caters to the people of Region III with Pampanga as its primary catchment area and the nearby provinces of Bataan, Nueva Ecija, Bulacan, Tarlac, Zambales and Aurora as its secondary catchment area.

The current bed capacity of JBLMRH is 250 with a bed population ratio of 1 bed for every 400 population in the primary catchment area and 1:1000 population for its secondary catchment area. The bed population ratio prescribed in the 1990s by the Department of Health is 1:1000 and the World Health Organization standard is 1:500. Furthermore, the current number of government hospital beds per 10,000 population in Region III is 4 as compared to the national average of 6.

From 2008 to 2012, the 5-year average bed occupancy rate (BOR) of JBLMRH is 171.85%, while the standard BOR is 65%-85%. Furthermore, more than 90% of our patients have been classified as Class C and D (AO 51-A Series of 2001). And as the only Level III DOH hospital in the area with accredited teaching and training residency programs, JBLMRH also provides various service specialties.

With Department Order 2011-0188 "Kalusugang Pangkahalatan Execution Plan and Implementation Arrangements", the JBLMRH is mandated to provide universal health coverage through its hospital services. JBLMRH needs to address the growing demands of its clientele by increasing the number of its medical and paramedical human resources, improve its infrastructures in order to accommodate more patients, and upgrade its capabilities in terms of expertise, instruments and equipment.

Therefore, the implementation of Republic Act 10355 will effectively provide quality health care to its patients, in consonance with the policy of the state "to protect and promote the right to health of the people and instill health consciousness among them. (Philippine Constitution, Article II Section 15).

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for Republic Act No. 10355, "An Act Increasing the Bed Capacity of Jose B. Lingad Memorial Regional Hospital in the City of San Fernando, Pampanga from Two Hundred Fifty (250) to Five Hundred (500), Upgrading its Services and Facilities and Professional Health Care, Authorizing the Increase of its Medical Personnel and Appropriating Funds Therefor."

III. Definition of Terms/Acronyms

1. Act — refers to Republic Act 10355, "An Act Increasing the Bed Capacity of Jose B. Lingad Memorial Regional Hospital in the City of San Fernando, Pampanga from Two Hundred Fifty (250) to Five Hundred (500), Upgrading its Services and Facilities and Professional Health Care, Authorizing the Increase of its Medical Personnel and Appropriating Funds Therefor."

2. AO 2012-0012 — refers to the Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines dated 18 July 2012.

3. Bed Capacity — refers to the number of beds offered by the hospital for tertiary patient care.

4. Bed Occupancy Rate (BOR) — refers to the ratio of actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period; the ideal or recommended BOR is from 65% to 85%.

5. COH — refers to the Chief of Hospital III of JBLMRH.

6. IRR — refers to Implementing Rules and Regulations of RA 10355.

7. JBLMRH — refers to Jose B. Lingad Memorial Regional Hospital.

8. Level III Hospital — refers to the DOH Classification of JBLMRH as defined by AO 2012-0012.

9. Referral Hospital — refers to a health care institution capable of accepting referrals from lower level hospitals and render general and specialized health care services.

10. Region III — refers to Central Luzon or the region covering the Provinces of Pampanga, Bulacan, Nueva Ecija, Bataan, Zambales, Tarlac and Aurora.

IV. General Policies

The JBLMRH shall provide a tertiary level of promotive, curative, preventive, rehabilitative health care services and research. It shall be fully equipped with state of the art equipment and facilities, complemented by adequately trained and competent health human resources as appropriate for a licensed and accredited Level III health care facility. EcTaSC

Furthermore, JBLMRH shall strengthen its existing services and aim for the improvement of its service capability and capacity while continually serving as a referral hospital, complementing the services of local government health care facilities in the province and the region. The increase in bed capacity shall be consistent with the Development Plan of JBLMRH.

V. Implementing Guidelines

In support of the implementation of R.A. 10355, the following guidelines shall be implemented:

1. Expansion of Services

The JBLMRH shall fully operate as a 500-bed level III tertiary teaching and training medical center with additional services on oncology, family medicine and emergency medicine. Structural reorganization with additional services shall be established based on the Hospital Development Plan. The incremental annual increase in bed capacity and commensurate services provided by the Act shall be achieved by the end of year 2017.

2. Health Human Resource

The JBLMRH shall continue to honor the positions, security of tenure and other rights of its human resource complement. The hospital shall evaluate its existing health human resource complement, re-classify and/or upgrade positions, promote professional development and hire additional staff to comply and conform to the DOH standards.

The JBLMRH shall increase its health personnel based on recommended staffing pattern for a 500 bed capacity hospital following the DBM-DOH Joint Circular No. 2013-1, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals, CY 2013 Edition" dated 23 September 2013.

3. Assets and Liabilities

All moveable and immovable assets, and records of the JBLMRH as well as its liabilities and obligations shall be properly updated and shall be accounted for in accordance with existing policies and guidelines.

4. Equipment

The JBLMRH shall make an inventory of its existing hospital equipment and undertake upgrading to conform with the DOH minimum standards of a general hospital as provided for under DOH AO 2012-0012. Additional equipment and facilities that will complement the expansion of services shall be implemented.

5. Infrastructure

The JBLMRH shall implement construction, repair and renovation of physical infrastructure to conform to all existing laws and licensing standards, and current international standards for hospital buildings in line with Hospital Safe from Disasters Program, among others.

6. Systems Development

The JBLMRH shall develop and sustain standards of hospital operations to provide quality patient care and safety for patients, health workers and clientele of the hospital. It shall implement an electronic information system conforming to the basic requirements of Integrated Hospital Operations and Management Program (IHOMP).

7. Quality Management

The JBLMRH shall implement the quality management system in conformance with ISO 9001:2008 standards. The JBLMRH shall enhance and improve Continuing Quality Improvement Program, Patient Safety, policies and standards provided by the DOH, the Philippine Health Insurance Corporation (PhilHealth) and other health standards provided by international health organizations which are supportive of existing local and national standards.

VI. Implementing Structure

1. Administrative Control

The highest DOH-designated official for Region 3 shall have oversight jurisdiction over the hospital operations of JBLMRH. However, DOH Regional Office 3 shall monitor the implementation of the Act guided by this Administrative Order.

The Chief of Hospital of JBLMRH shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit developmental plans, financial and statistical reports to the DOH Central Office. ICTaEH

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of Republic Act No. 10355 shall be sourced out accordingly.

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), public-private partnership and other modes of financing scheme.

2. The additional Maintenance, Operating and Other Expenses (MOOE) resulting from the hospital expansion shall be sourced from the hospital income, PhilHealth reimbursements, public-private partnership and other modes of financing scheme.

3. Personal Services to carry out the full implementation of the Act shall be sourced from the GAA and other sources.

4. Release of funds shall be approved by the designated appropriate authority.

VII. Repealing/Separability Clause

Provisions from previous issuances that are inconsistent or contrary to the provisions of this Order are hereby rescinded and modified accordingly.

If any provision of this order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected thereby shall remain valid and effective. aHTCIc 

VIII. Effectivity

This order shall take effect fifteen (15) days after publication in the Official Gazette or in at least two (2) newspapers of general circulation.

(SGD.) ENRIQUE T. ONA, MDSecretaryDepartment of Health