Implementing Rules and Regulations of R.A. No. 7445 and R.A. No. 8314

June 9, 2014

DOH ADMINISTRATIVE ORDER NO. 2014-0022

 

I. Rationale/Background

The Mountain Province General Hospital came into existence by virtue of Republic Act (RA) 1806 on June 22, 1957. It operated as a 50-bed capacity general hospital from February 12, 1964 until 1977. Due to the increasing number of patients, the hospital's bed capacity was increased from 50 to 75. The enactment of Batas Pambansa Blg. 836 on April 27, 1984 renamed the hospital as Luis Hora Memorial Hospital.

On April 27, 1992, RA 7445 was signed into law increasing the bed capacity of the hospital from seventy-five (75) to one hundred (100). The passage of RA 7160, otherwise known as the Local Government Code of 1991 that took effect in 1993 devolved the Luis Hora Memorial Hospitals to the Local Government of Mountain Province. Thus RA 7445 was not implemented. Due to its strategic location, RA 8314 was approved in 1998 re-nationalizing and designating the hospital as the Regional Hospital of the Cordillera Administrative Region (CAR). Hence, the hospital was renamed, Luis Hora Memorial Regional Hospital (LHMRH).

Although, LHMRH is the designated Regional Hospital in the Cordillera Administrative Region, a good all-weather road access and availability of reliable and regular transportation services to and from the surrounding areas had not been fully realized. This explains the average utilization rate of 75.04% in the last three (3) years (2011-2013) based on the Implementing Bed Capacity of 75. The opening of the Cervantes Bridge connecting Mountain Province to Ilocos Sur in 2013 has made LHMRH accessible to patients coming from the Municipality of Cervantes, Ilocos Sur and other neighboring municipalities in Abra.

The good collaboration with the Local Government Units (LGUs) resulted in full support by local government officials and that of the national Government. The LHMRH is equipped with essential competencies. The nearby population of various ethnic affiliations can now avail of quality health care services.

Aside from its primary catchment area, Mountain Province, LHMRH and the neighboring municipalities of CAR provinces such as the northern part of Benguet, the southern part of Ifugao, the eastern part of Kalinga, and the northern part of Abra and other neighboring municipalities of Ilocos Sur as secondary catchment areas.

Currently, the LHMRH receives referrals from Rural Health Units and other health care facilities with lower and higher capacities of the province. Patients requiring intensive tertiary care, invasive and non-invasive diagnostic and medical procedures, are often referred to Baguio General Hospital and Medical Center which is 124 kilometers away from the Mountain Province.

Therefore, through the implementation of RA 7445 and RA 8314, it is assured that the much needed hospital services will be provided to the primary and secondary catchment areas and other neighboring communities of other provinces outside the CAR.

II. Objective

This Administrative Order sets the Implementing Rules and Regulations of RA 7445 (An Act Increasing the Bed Capacity of the Congressman Luis Hora Memorial Hospital in Mountain Province and Appropriating Funds Therefor), and RA 8413 (An Act Designating the Luis Hora Memorial Hospital in Bauko, Mountain Province, as the Regional Hospital of the Cordillera Administrative Region, and Appropriating Funds Therefor) to facilitate compliance therewith and to achieve the objectives thereof. ASaTHc

III. Definition of Terms/Acronyms

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

2. CAR — refers to Cordillera Administrative Region.

3. General Hospital — refers to a hospital that provides services for all kinds of illnesses, diseases, injuries or deformities. A general hospital shall provide medical and surgical care to the sick and injured, maternity, newborn and child care. It shall be equipped with the service capabilities needed to support board certified/eligible medical specialist and other licensed physicians rendering services in, but not limited to, the following:

a. Clinical Services

1. Family medicine;

2. Pediatrics;

3. Internal Medicine;

4. Obstetrics and Gynecology;

5. Surgery;

b. Emergency Services;

c. Outpatient Services;

d. Ancillary and Support Services such as, clinical laboratory, imaging facility and pharmacy.

4. Level II — refers to the DOH Classification of LHMRH as defined by AO 2012-012.

5. LHMRH — refers to Luis Hora Memorial Regional Hospital, the designated Regional Hospital of CAR.

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

7. Regional Hospital — refers to the health facility designated as Regional Hospital to serve as referral hospital of the catchment areas within the Region.

8. RO — refers to DOH Regional Office.

IV. General Policies

The LHMRH 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. It shall provide secondary 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 II health care facility to comply with DOH Administrative Order (AO) No. 2012-0012, Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines.

Furthermore, the increase in bed capacity of LHMRH shall be consistent with the hospital Development Plan.

V. Implementing Guidelines

In support of the implementation of RA 7445 and RA 8413, the following guidelines shall be implemented:

1. Expansion of Services

The LHMRH shall fully operate as Level 2 general hospital with mother and child health care services, toxicology and high end diagnostic services from the current implementing bed capacity of 75 and be continuously upgraded to be a fully operational 100-bed Level 2 general hospital by the year 2015 upon recommendation of the Regional Office for CAR.

2. Health Human Resource

The LHMRH 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 requirement, re-classify and/or upgrade positions, promote professional development and or hire additional staff to comply and conform to the DOH standards of a Level 2 general hospital.

The increase its health human resource complement shall be based on recommended staffing pattern for a 100 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. AEITDH

3. Assets and Liabilities

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

4. Equipment

The LHMRH shall make an inventory of its existing hospital equipment and undertake upgrading to conform to DOH standards of a general hospital as provided for under DOH AO 2012-0012.

5. Infrastructure

The LHMRH shall implement construction/repair/renovations of existing infrastructures to conform to DOH standards, Fire Code, and the National Building Code of the Philippines, among others.

6. Systems Development

The LMHRH 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) to be able to submit reportable cases of chronic non-communicable diseases, injuries, violence, disabilities and other data in compliance to the national DOH data reporting requirements.

7. Quality Management

The LHMRH shall implement quality management system in conformity with ISO 9001 2008 certification which the hospital aims to acquire in 2015. Furthermore, the LHMRH shall enhance and improve Continuing Quality Improvement (CQI) programs, 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 not contrary to existing local and national standards. Furthermore, it will develop and further strengthen its hospital resource management capability.

VI. Implementing Structure

1. Administrative Control

The highest DOH-designated official for Region CAR shall have oversight jurisdiction over the hospital operations of LHMRH. However, DOH Region CAR shall monitor the implementation of the Republic Act Nos. 7445 and 8413 guided by this Administrative Order. aTCAcI

The Chief of Hospital of LHMRH shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit developmental and financial reports to the DOH Central Office through the RO-CAR.

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of Republic Act Nos. 7445 and 8413 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 (if any) and other mode of financing scheme.

2. The additional Maintenance, Operating and Other Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital revenue, PhilHealth reimbursements and other sources.

3. Personal Services to carry out the full implementation of the hospital staffing pattern of 100 beds which shall be implemented by phases as shall be sourced from the GAA 2014 and onward as provided by DOH-DBM Joint Circular 2013-01 dated September 23, 2013.

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.

VIII. Effectivity

This order shall take effect fifteen (15) days after publication in a newspaper of general circulation.

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