Implementing Rules and Regulations of R.A. No. 8200 (Converting the Rizal Memorial District Hospital in Dapitan City into a Tertiary Hospital)

September 15, 2015

DOH ADMINISTRATIVE ORDER NO. 2015-0041

 

I. Rationale/Background

The Rizal Memorial Hospital (RMH) was established on December 30, 1916 in the town of Dapitan, Province of Zamboanga del Norte. The first hospital building was constructed at the Casa Commandancia as provided by Legislative Act No. 2662 of the Philippine Service Commission approved by the Governor General at that time. In 1927, through the Philippine Legislation Act No. 3427, the Provincial Government of Zamboanga del Norte provided funds for the construction of a 25-bed hospital building. In 1928, the bed capacity of RMH was further increased from 25 beds to 50 beds, and since March 1958 RMH began operating as a 75-bed capacity hospital.

Executive Order No. 851 s. 1985 mandated the integration of the Field Health Services of the municipalities of Rizal, Sibutad and La Libertad with the RMH and established the Rizal Memorial District Hospital (RMDH). In February 1991, RMDH was transferred to a 3-hectare lot in Brgy. Lawaan, Dapitan City, its current location. With the implementation of the Local Government Code of 1991, the RMDH was devolved to the provincial local government of Zamboanga del Norte on April 1, 1993.

On July 30, 1996, RA No. 8200 "An Act Converting the Rizal Memorial District Hospital in Dapitan City into a Tertiary Hospital under the Full Administrative and Technical Supervision of the Department of Health, which shall be Known as the Dr. Jose Rizal Memorial Hospital, and Appropriating Funds Therefor" was approved. The law mandated the increase of its bed capacity from 75 to 200 beds and renaming the hospital to be known as Dr. Jose Rizal Memorial Hospital (DJRMH).

Considering the increasing health needs of the population of Zamboanga del Norte, Zamboanga Sibugay, Zamboanga del Sur and the neighboring municipalities of Misamis Occidental that seek hospitalization at DJRMH, full implementation of its authorized 200-bed capacity is necessary.

At present, DJRMH has an annual average bed occupancy rate of 111% based on an implementing capacity of 75 beds, which is beyond the ideal of 80-85%. The DJRMH receives referral from lower level health facilities from the neighboring Zamboanga provinces. Likewise it refers patients needing higher level of care that are not available in the hospital to other higher health facilities.

The improvements in the physical structure as well as the additional health human resources of DJRMH will allow the hospital to develop and implement the departmentalization of services, achieve its vision and fulfill its mission based on its legal mandate as a 200 bed-capacity Level II hospital.

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for the implementation of RA No. 8200, "An Act Converting the Rizal Memorial District Hospital in Dapitan City into a Tertiary Hospital, under the Full Administrative and Technical Supervision of the Department of Health, which shall be known as the Dr. Jose Rizal Memorial Hospital and Appropriating Funds Therefor".

III. Definition of Terms/Acronyms

1. Act — refers to RA No. 8200 "An Act Converting the Rizal Memorial District Hospital in Dapitan City into a Tertiary Hospital, under the full administrative and technical supervision of the Department of Health, which shall to be known as the Dr. Jose Rizal Memorial Hospital and appropriating funds therefor". EcTCAD

2. Bed Capacity — refers to the number of beds offered by the hospital to inpatient care.

3. BOR or Bed Occupancy Rate — refers to the ratio of actual inpatient service days for a given period to the declared bed capacity of the hospital of the same period.

4. Departmentalization — refers to the re-organization of the present medical and nursing staffing into different specialized and functional components of departments for Level-II hospital.

5. DJRMH — refers to Dr. Jose Rizal Memorial Hospital.

6. IHOMP — refers to the program implementing the standard systems and procedures in hospitals, the Integrated Hospital Operations and Management Program.

7. IRR — refers to Implementing Rules and Regulations of RA No. 8200.

IV. Policies and Guidelines

A. General Policies

DJRMH shall fully operate as a 200-bed Level II hospital. It shall provide tertiary level curative, promotive and preventive care. It shall be equipped with state-of-the-art equipment complemented with adequate and competent health human resources. Its bed capacity, licensing and accreditation shall be based on its Development Plan.

B. Implementing Mechanisms

1. Redirection and Expansion of Services

DJRMH shall operate as a 200-bed, Level II hospital with additional services for dialysis, multi-drug resistant tuberculosis (MDR-TB) and mental health by the end of year 2016. Structural reorganization with additional services shall be established based on a Hospital Development Plan that has been approved by the DOH cluster head in charge of hospital operations.

DJRMH shall serve as a referral hospital for the Rizal Shrine Inter Local Health Zone and the other municipalities of the province of Zamboanga del Norte and other nearby provinces.

2. Health Human Resource

DJRMH shall continue to honor the positions, security of tenure and other rights of its human resource complement, upgrade their positions and hire additional staff to comply and conform to the DOH standards for a 200-bed capacity hospital following DBM-DOH Joint Circular No. 2013-01 "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals" CY 2013 Edition dated September 13, 2013.

3. Assets and Liabilities

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

4. Equipment

DJRMH shall make an inventory of the existing hospital equipment and undertake upgrading to conform to DOH standards appropriate for a Level II hospital under DOH AO No. 2012-0012. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of DOH.

5. Infrastructure

DJRMH shall implement and seek the support of DOH for the 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 the Hospital Safe from Disasters Program, among others.

6. Systems Development

DJRMH 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 the Integrated Hospital Operations and Management Program (IHOMP) aimed at attaining operational efficiency.

7. Quality Management

DJRMH shall implement the quality management system in conformance with ISO 9001:2008 standards. DJRMH shall enhance and implement 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. HSAcaE

V. Implementing Structure

A. Administrative Control

The highest ranking designated DOH official or Head of Office for Health Operations shall have oversight jurisdiction and control over hospital operations of DJRMH, DOH Regional Office NO. 9 shall monitor the implementation of RA No. 8200 guided by this Administrative Order.

The Chief of Hospital of DJRMH 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.

B. Sourcing and Use of Funds

The amount necessary to carry out the provisions of Republic Act No. 8200 shall be sourced out accordingly.

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital revenues, PhilHealth payments, Public Private Partnership and other financing scheme subject to prevailing government rules and regulations;

2. The additional Maintenance and Other Operating Expenses (MOOE) resulting from hospital expansion shall be sourced from the GAA, hospital income, PhilHealth payments, Public Private Partnership and/or other modes of financing scheme;

3. Personal Services (PS) to carry out the full implementation of the approved hospital staffing pattern of 200 beds shall be implemented in compliance to DOH-DBM Joint Circular 2013-01 dated September 23, 2013 and other related issuances.

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

VI. Repealing/Separability Clause

Provisions of 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.

VII. Effectivity

This Order shall take effect fifteen (15) days after publication in the official gazette or in a newspaper of general circulation.

(SGD.) JANETTE LORETO-GARIN, MD, MBA-HSecretary of Health