Implementing Rules and Regulations of Republic Act No. 10865

October 10, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0037

 

I. Rational/Background

On June 19, 1965, Republic Act (R.A.) No. 4225 was approved mandating the creation of Ozamiz City National Emergency Hospital. The hospital became operational in 1971. On April 13, 1984, the hospital was renamed as Mayor Hilarion A. Ramiro Sr. General Hospital by virtue of Batas Pambansa Blg. 777. The bed capacity was increased from 100 to 150 beds through the approval of R.A. No. 7197 on February 25, 1992. With the implementation of R.A. No. 7160, otherwise known as the Local Government Code of 1991, the hospital was devolved to the local government of the province of Misamis Occidental in 1992.

The hospital was renationalized and converted into a regional training and teaching hospital of Region X, changing its name to Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital (MHARSRTTH) by virtue of R.A. No. 7937 that was approved on March 1, 1995. Consequently, MHARSRTTH was upgraded to a 150 bed capacity tertiary hospital with significant increase in health human resource complement.

With the implementation of the five (5) major departments of the hospital which are the Medicine, Pediatrics, Obstetrics and Gynecology, Family Medicine and Surgery, departments together with Radiology, Pathology, and sub-specialties in Orthopedics, Neurology, Nephrology, Neurosurgery, Urology, Anesthesiology, Ophthalmology, Otorhinolaryngology, Gastroenterology and Psychiatry, the existing one hundred fifty bed (150) capacity is inadequate for the hospitalization needs of the catchment population. The accessibility of MHARSRTTH to the neighboring municipalities and cities of the provinces of Region X such as Misamis Occidental, Lanao del Norte, the neighboring municipalities of the provinces of Zamboanga del Sur, Zamboanga Sibugay and Zamboanga del Norte of Region IX and Lanao del Sur of the Autonomous Region of Muslim Mindanao (ARMM) makes the hospital as the referral health care facility of patients needing tertiary care. Thus, adding to the influx of patients. HTcADC

The average bed occupancy rate of 237.33% in the last three (3) years (2013-2015) is beyond the DOH ideal rate of 80%-85%. Hence, MHARSRTTH could not satisfy the hospitalization needs of the catchment population. On June 23, 2016, R.A. No. 10865, "An Act Converting the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in the Province of Misamis Occidental into a Medical Center to be Known as Mayor Hilarion A. Ramiro Sr. Medical Center" was approved. In this light, these Implementing Rules and Regulations are being promulgated in consultation with the Department of Budget and Management as provided for under Section 13 of the Act.

II. Objectives

This Administrative Order sets the Implementing Rules and Regulations of R.A. No. 10865, "An Act Converting the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in the Province of Misamis Occidental into a Medical Corner to be Known as Mayor Hilarion A. Ramiro Sr. Medical Center".

A. Objectives ofMHARSMC

a. To provide the Filipino people, particularly in the province of Misamis Occidental, and in the provinces of Region X and neighboring municipalities of the adjacent Region IX and the Autonomous Region of Muslim Mindanao (ARMM) with more affordable, quality and timely hospital care through a more efficient health service delivery system that prioritizes the needs of the underprivileged, sick, elderly, physically and mentally disabled, women and children, and when resources are available provide free medical care to indigent citizens;

b. To develop the MHARSMC into a world class tertiary health care provider that utilizes modern and advanced medical technologies that caters to specialized cases;

c. To promote, encourage and engage in scientific research in the prevention of diseases and the care and treatment of patients and related activities, including scholarship and conduct of relevant congresses, conventions, seminars, and conferences;

d. To encourage and undertake the training of physicians, nurses, medical technicians, health officers, social workers, and other health professionals on the practical and scientific conduct and implementation of health and medical services, and related activities; and

e. To extend other medical services pursuant the goals, objectives and rules of the National Health Insurance Program (NHIP)

III. Scope

The rules and regulations discussed in this Administrative Order shall pertain only to R.A. No. 10865.

IV. Definition of Terms/Acronyms

1. Act — refers here to R.A. No. 10865, "An Act Converting the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in the Province of Misamis Occidental into a Medical Center to be Known as Mayor Hilarion A. Ramiro Sr. Medical Center".

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. AO 2012-0012-A — refers to "Amendment to Administrative Order (A.O.) No. 2012-0012 entitled Rules and Regulations Governing the New Classification of Hospitals and other Health Facilities in the Philippines" dated 3 September 2015.

4. Bed Occupancy Rate — is the ratio of the actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period.

5. Level 3 Hospital — a classified in Administrative Order No. 2012-0012-A dated September 3, 2015. aScITE

6. Medical Center — a hospital, one especially staffed and equipped to care for many patients and for a large number of kinds of diseases and dysfunctions, including specialized cases, using sophisticated technology as defined in AO 2016-0027.

7. MHARSMC — refers to Mayor Hilarion A. Ramiro Sr. Medical Center, the new name of Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital.

8. Regional Hospital — refers to a higher level tertiary referral hospital with teaching, training and research functions. It shall have specialty and sub-specialty services in the four (4) major departments and provide basic diagnostic and ancillary procedures as defined in AO 2016-0027.

V. Policies and Guidelines

A. General Policies

The Mayor Hilarion A. Ramiro Sr. Medical Center (MHARSMC) shall provide a promotive, curative, preventive, rehabilitative health care services, training and research. It shall enhance the knowledge and skills of its health human resources through adequate and relevant trainings and shall be fully equipped with state of the art equipment and facilities appropriate for a licensed Level 3 medical center. It shall provide a more efficient health service delivery system prioritizing the needs of the underprivileged, sick, elderly, persons with disability, women and children.

Furthermore, the MHARSMC shall strengthen its existing services and aim for the improvement of its service capability while continually serving as a tertiary referral hospital, complementing the services of local government health care facilities in the province and the region. It shall operate to attend special cases such as but not limited to cardiology, kidney, and cancer cases. Pursuant to the Local Government Code of 1991, providing for one (1) medical center and one (1) regional hospital per region under the Department of Health (DOH), MHARSMC shall remain as the designated regional hospital for Region X. The hospital development plan of MHARSMC shall be in accordance with the 500-bed capacity as provided for by R.A. 10865. Effective FY 2017, the hospital shall operate with a 300-bed capacity, and the 500-bed capacity shall be fully implemented by FY 2018.

B. Implementing Mechanisms

In support of the implementation of R.A. No. 10865, the following guidelines shall be implemented:

1. Expansion Services

The MHARSMC shall be an operational 500-bed capacity medical center within a period of not more then three (3) years from the approval of the Act, effective under the following timetable: a) 300 beds by FY 2017; b) 500 beds by FY 2018. It shall continue to improve its capability to satisfy the licensing requirement for a Level 3 hospital as defined in AO 2012-0012-A such as expansion of Intensive Care Unit, Physical Medicine and Rehabilitation Unit, Tertiary Laboratory with Histopathology and Third Level X-Ray Services, among others.

The MHARSMC shall submit to the DOH its hospital development plan which includes the future expansion of its services and development of the medical center into a world class tertiary health care provider that utilizes modern and advanced medical technologies pursuant to the goals and objectives of the National Health Insurance Program (NHIP) within six (6) months from the effectivity of this IRR The MHARSMC hospital development plan shall include provisions for future expansion of its scope of services as a specialty hospital.

2. Change in Name

By virtue of R.A. No. 10865, the name of the hospital, Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital (MHARSRTTH) shall be changed to Mayor Hilarion A. Ramiro Sr. Medical Center (MHARSMC). Despite the change in name, the MHARSMC shall remain as the designated regional training and teaching hospital with residency training programs for physicians, nurses, other disciplines, and serves as referral health care facility of Region X.

3. Health Human Resource

In case of detailed employees of deployment of staff as a result of the Department of Health (DOH) rationalization plan, and/or the conversion of MHARSRTTH into a Medical Center, the MHARSMC shall continue to honor the positions, security of tenure and other rights of its existing health human resource complement. HEITAD

The MHARSMC shall evaluate the existing health human resources including key management positions, re-classify and/or propose upgrading of positions, promote professional development such as training of physicians and staff in the medical, nursing, ancillary and support services. Furthermore, it shall hire additional staff to comply and conform to the DOH standards pursuant to the purpose and intent of the Act.

The MHARSMC shall implement the staffing standard of a 500 bed capacity hospital following the DBM-DOH Joint Circular No. 2013-01, "Revised Organizational Structure and Staffing Standards for Government Hospitals, CY 2013 Edition" dated 23 September 2013 within three (3) years from the approval of this IRR. The MHARSMC shall coordinate with the DOH, DBM and Civil Service Commission (CSC) for the implementation of the appropriate staffing in hospital services especially in critical or special areas.

4. Asset and Liabilities

All movable and immovable assets, liabilities and obligations as well as records of the MHARSMC shall be properly updated and accounted for in accordance with the existing policies and guidelines, laws, as well as the issuance of Orders by any duly constituted authorities.

5. Reports

The Medical Center Chief of the MHARSMC through Regional Office X shall, within three (3) months after the end of every fiscal year, submit periodic reports such as hospital statistical report, financial and physical accomplishment report to the DOH as may be required. Other reports shall be submitted to DOH Central Office as needed.

6. Equipment

The MHARSMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform to DOH minimum standards of a Level 3 hospital as provided under DOH AO No. 2012-0012 and its amendment, and other regulatory agencies. Additional State of the art equipment and facilities that complement the expansion of services and its upgrading shall be procured by DOH using the Health Facilities Enhancement Program (HFEP) Funds, Philippine Amusement and Gaming Corporation (PAGCOR) funds, and other sources, until the hospital attains its mandated status, but not later than the third (3rd) year of its operation as medical center.

7. Infrastructure

The MHARSMC shall implement and seek the support of DOH for the construction/repair/renovation of physical infrastructure and upgrading of facilities to conform with and be commensurate to the increase in bed capacity as provided for in Section 2 of the Act, in compliance with the DOH licensing standards of a Level 3 medical center, and to all existing laws and standards, and current international standards for hospital buildings in line with Hospital Safe from Disasters Program, among others, not later than 2018; and provided that an amount in accordance to the Hospital Development Plan submitted by MHARSMC shall be allocated every year from the HFEP Funds and other sources.

8. Systems Development

The MHARSMC shall develop and implement the standards of hospital operations for assurance of hospital quality services and provide quality patient care and safety for patients, health workers and clientele. It shall implement an electronic information system conforming to the basic requirement of the Integrated Hospital Operations and Management Program (IHOMP) in gathering of hospital data and information.

9. Quality Management

The MHARSMC shall enhance and implement Continuing Quality Improvement Program (CQIP), Patient Safety Program, Infection Prevention and Control Program, Health Care Waste Management Program, and other DOH policies and regulations, standards of hospital operations prescribed in the DOH-Health Facility Development Bureau (HFDB) Manuals, Health Facilities and Services Regulatory Bureau (HFSRB), Philippine Health Insurance Corporation (PhilHealth) and other standards provided by international health organizations which are supportive of existing local and national standards.

10. Assistance from other Government Offices

Pursuant to Section 8 of the Act, the MHARSMC may call upon any department, bureau, office, agency, or instrumentality of the government, including government-owned or -controlled corporations for such assistance as it may need in the pursuit of its objectives.

All individuals, entities and institutions are hereby enjoined to render full assistance and cooperation to the MHARSMC in the accomplishment of its objectives and activities. ATICcS

VI. Implementing Structure

1. Administrative Control

The MHARSMC shall be headed by a Medical Center Chief (MCC) appointed by the Secretary of Health. The MCC shall be responsible for the following: (a) Overall management and administration of the MHARSMC including hospital operations, increase in bed capacity and upgrading of service capability pursuant to the implementation of the Act; and (b) Formulation of policies, plans, programs and strategies and its implementation to ensure the provision of high quality health care and high standards of clinical training for medical and allied medical personnel in conformance to the clinical practice guidelines and standards of hospital operations.

The Secretary of Health or his/her authorized representative in coordination with the Office for Field Implementation Management (OFIM) shall have oversight jurisdiction over the hospital operations and ensure its alignment to the DOH thrusts and objectives. It shall monitor and may recommend necessary upgrading guided by this Administrative Order.

Further, the Health Facility Development Bureau (HFDB) shall provide the needed technical assistance in line with hospital upgrading, development and capacity building.

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of R.A. No. 10865 shall be sourced out accordingly:

2.1 Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA) and hospital income which includes PhilHealth payments, public-private partnership and other financing schemes subject to the prevailing government rules and regulations effective FY 2017 and every year thereafter as provided under this Administrative Order.

2.2 The additional Maintenance and Other Operating Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital income, PhilHealth payments, public-private partnership and other financing schemes subject to the prevailing government rules and regulations effective FY 2017.

2.3 Personnel Services (PS) shall be appropriated to carry out the full implementation of the staffing pattern of 500 beds; and shall be implemented in compliance with DOH-DBM Joint Circular 2013-01 dated September 23, 2013 and other related issuances effective FY 2017.

2.4 Release of funds from the DOH shall be approved by the appropriate authority.

3. Tax Exemption

Pursuant to Section 9 of the Act, any donation or bequest made to the MHARSMC shall be exempt from imposition of donor's tax and the same shall be considered as allowable deduction from the gross income of the donor in accordance with the provisions of the National Internal Revenue Code of 1997, as amended, provided, that such donation shall not be disposed of, transferred or sold.

4. Audit

Pursuant to Section 10 of the Act, the Commission on Audit (COA) shall appoint a representative who shall be the auditor of the MHARSMC and such personnel as may be necessary to assist said representatives in the performance of his/her duty.

VII. Repealing Clause

The Administrative Order No. 2016-0026, "Implementing Rules and Regulations of Republic Act No. 7937, An Act Converting the Mayor Hilarion A. Ramiro, Sr. General Hospital in Ozamiz City, Misamis Occidental, into a Regional Training and Teaching Hospital to be known as the Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital, and Appropriating Funds Therefor", as well as other issuances that are inconsistent or contrary to the provisions of this order are hereby repealed, amended or modified accordingly.

VIII. Effectivity

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

 

(SGD.) PAULYN JEAN B. ROSELL-UBIAL, MD, MPH, CESO IISecretary of Health

Published in The Philippine Star on October 26, 2016.