Implementing Rules and Regulations of R.A. No. 8411 (Converting Ilocos Regional Hospital to Ilocos Training and Regional Medical Center)

March 9, 2015

DOH ADMINISTRATIVE ORDER NO. 2015-0010

 

I. Rationale/Background

Ilocos Training and Regional Medical Center (ITRMC) is located in the capital city of San Fernando, La Union. It came to existence as a 40-bed first aid center in 1945 just before the end of World War II under the auspices of the 6th Infantry Division of USAFFE. Through the years, it evolved into what it is today, a 200-bed sprawling complex made up of 26 different but interconnected buildings, housing the clinical and support services through which the highest quality services are provided for patients coming from La Union, Pangasinan, Ilocos Sur and Ilocos Norte, Abra and Benguet.

It is the policy of the hospital to ensure the highest standards of health care, in compliance with statutory and regulatory requirements, and to continually improve quality management systems. Currently the hospital is a Level 3 training institution with preventive and promotive care, comprehensive curative care, an array of basic and specialized diagnostic and ancillary procedures, rehabilitative medicine and specialized services. ITRMC is one of the lead hospitals for NVBSP, public health laboratory services and eye instruments center, the only HIV/AIDS treatment hub in the region with adequate readiness in dealing with outbreaks from emerging/re-emerging diseases (e.g., SARS, meningococcemia, AH1N1, leptospirosis). The hospital is also dubbed as training center of the North with 11 accredited residency training programs as well as training programs for nurses, undergraduates and other health care professionals.

In 1997, RA No. 8411 was enacted into law converting the Ilocos Regional Hospital to the Ilocos Training and Regional Medical Center, and authorizing the increase in its bed capacity from 200 to 300 beds.

The upgrading of ITRMC which designated as one of the DOH regional medical centers in Region 1, into a teaching/training hospital shall fulfill its goal to serve as a responsive and referral center in Northern Luzon. The increase in bed capacity to accommodate the influx of patient referrals and render additional specialized health services, training and research activities is truly a valid and urgent undertaking. SCEHaD

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for the Implementation of Republic Act No. 8411, "An Act Amending Republic Act No. 7364 by Converting the Ilocos Regional Hospital to Ilocos Training and Regional Medical Center Further Increasing its Bed Capacity to Three Hundred (300) Beds and Appropriating Funds Therefor."

III. Scope

The Rules and Regulations discussed in this Administrative Order shall pertain only to the provisions of RA No. 8411.

IV. Definition of Terms/Acronyms

1. Act — Republic Act No. 8411, "An Act Amending Republic Act No. 7364 by Converting the Ilocos Regional Hospital to Ilocos Training and Regional Medical Center, Further Increasing its Bed Capacity to Three Hundred (300) Beds and Appropriating Funds Therefor"

2. AO No. 2012-0012 — refers to the Rules and Regulations Governing the New Classification of Hospitals and other Health Facilities in the Philippines, dated July 18, 2012

3. AREX — Association of Regional Executives in Region 1

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

5. DOH-CO — Department of Health-Central Office

6. DOH Retained Hospital — refers to all other hospitals under the management and operation of the DOH which are not classified as Specialty Hospitals and Special Hospitals

7. Health Facility — refers to DOH retained hospitals, LGU hospital and SUC Hospitals

8. IRH — Ilocos Regional Hospital

9. ITRMC — Ilocos Training and Regional Medical Center

10. NVBSP — National Voluntary Blood Services Program

V. Policies and Guidelines

A. General Policies

The Ilocos Training and Regional Medical Center shall provide tertiary care with promotive, preventive, curative, rehabilitative health care services; training and research. It shall be fully equipped with state-of-the-art equipment and facilities, complemented by adequately trained and competent health human resources appropriate for a licensed and accredited Level 3 hospital.

Furthermore, the ITRMC shall strengthen its existing services and aim to improve its service capabilities as it continually serves 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 ITRMC.

B. Implementing Guidelines

In support of the implementation of RA No. 8411, the following guidelines shall be implemented:

1. Expansion of Services

The ITRMC shall operate as a 300-bed capacity, Level 3 medical center with additional services e.g., on mother and child health care services, toxicology and high end diagnostic services, AIDS/HIV treatment hub, emerging diseases, medical wastes management and be continuously upgraded to be a fully operational 300-bed Level 3 medical center by year 2015. Additional services shall be established based on the Hospital Development Plan. This will be achieved through training needs analysis, staff training and development, capability building and organizational development. The increase in bed capacity and commensurate services provided by the Act shall be achieved by the end of year 2016. CAScIH

2. Health Human Resource

The ITRMC shall continue to honor the positions, security of tenure and other rights of its human resources. The hospital shall evaluate the existing health human resource complement, re-classify or and/or upgrade positions, promote professional development and shall hire additional staff to comply and conform with DOH standards and the intent of RA No. 8411.

The ITRMC shall increase its health human resource complement based on recommended staffing pattern for a 300-bed capacity hospital following the DBM-DOH Joint Circular No. 2013-01, "Revised Standards and Organizational Structure and Staffing Pattern of Government Hospitals," CY 2013 Edition dated 23 September 2013.

3. Assets and Liabilities

An inventory of all assets, movable and immovable, and records of the ITRMC 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 ITRMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform with DOH minimum standards of a Level 3 tertiary hospital as provided for 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

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

In addition, ITRMC shall endeavor in partnership with socio-civic organizations in addressing gaps needed in the overall expansion and modernization of the hospital.

6. Systems Development

The ITRMC shall develop and sustain the 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 with the basic requirements of the Integrated Hospital Operations and Management Program (IHOMP) aimed at attaining operational efficiency.

7. Quality Management

The ITRMC shall implement quality management system in conformance with ISO 9001:2008 standards. The ITRMC 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.

VI. Implementing Structure

A. Administrative Control

The highest DOH-designated official or Head of the Office for Health Operations shall have oversight jurisdiction and control over the hospital operations of ITRMC. DOH Regional Office No. 1 shall monitor the implementation of Republic Act No. 8411 and may recommend further necessary upgrading guided by this Administrative Order.

The Medical Center Chief of ITRMC 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. Source of Funds

The amount necessary to carry out the provisions of Republic Act No. 8411 shall be sourced out accordingly:

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital income which includes PhilHealth payments, Public-Private Partnership and other modes of 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. Personnel Services (PS) to carry out the full implementation of the staffing pattern of 300 beds shall be implemented in compliance with DOH-DBM Joint Circular 2013-01, dated September 23, 2013 and other related issuances.

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. cCAIES

VIII. 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-HActing Secretary of Health