Implementing Rules and Regulations of Republic Act No. 11108

June 18, 2019

DOH ADMINISTRATIVE ORDER NO. 2019-0011

 

I. RATIONALE AND BACKGROUND

On September 19, 1929, Act 1711 of the Philippine Commission established Bicol Treatment Station at the Reagan Barracks in Legazpi City, Province of Albay for the treatment of patients afflicted with leprosy. The facility was relocated to its present site in San Pedro, Cabusao, Camarines Sur and renamed Bicol Sanitarium in 1949, following rapid urbanization of past location. cSaATC

Eventually, through the effective implementation of the National Leprosy Control Program (NLCP) of the Department of Health, in partnership with the Local Government Units (LGUs) and Non-Governmental Organizations (NGOs), the prevalence of leprosy cases in the country commendably declined. Accordingly, DOH went on to reassess the roles of the country's eight sanitaria.

In 1994, through the issuance of Department Order No. 72, Bicol Sanitarium's roles were redirected towards providing training, technical supervision and monitoring of NLCP, emergency and out-patient treatment, and care to the general population in its immediate catchment area. Further, DOH Administrative Order No. 2005-0013 expanded its functions to provide emergency, out-patient, and in-patient care services in five major service departments.

With its increasing roles, Republic Act No. 11108, was passed to upgrade Bicol Sanitarium's mandate and services, and to be henceforth named as Bicol Region General Hospital and Geriatric Medical Center (BRGHGMC) that shall provide expanded health care services including Sanitaria, General Hospital Services, and Specialized Healthcare Services for adult and ageing population, as well as a center for research and development in the field of Geriatric Medicine.

II. OBJECTIVE

This Administrative Order sets the Implementing Rules and Regulations of Republic Act (R.A.) No. 11108, "An Act Expanding the Mandate and Service Capability of the Bicol Sanitarium in the Municipality of Cabusao, Province of Camarines Sur, to be known as the Bicol Region General Hospital and Geriatric Medical Center, upgrading its Service Facilities, Authorizing the Increase of Its Medical Personnel and Appropriating Funds Therefor." CHTAIc

III. DEFINITION OF TERMS AND ACRONYMS

1. A.O. No. 2012-0012 — refers to the "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" issued by the DOH on July 18, 2012, as amended.

2. Act — refers to Republic Act (R.A.) No. 11108, "An Act Expanding the Mandate and Service Capability of the Bicol Sanitarium in the Municipality of Cabusao, Province of Camarines Sur, to be known as the Bicol Region General Hospital and Geriatric Medical Center, Upgrading its Service Facilities, Authorizing the Increase of Its Medical Personnel and Appropriating Funds Therefor."

3. BRGHGMC — refers to Bicol Region General Hospital and Geriatric Medical Center.

4. Geriatric Medical Center — refers to a facility or institution that focuses on health care of elderly people to promote health by preventing and treating diseases and disabilities.

5. IRR — refers to the Implementing Rules and Regulations of R.A. No. 11108. cHDAIS

6. Level 3 Hospital — refers to the type of general hospital according to functional capacity as provided in A.O. No. 2012-0012, as amended.

7. Medical Center — refers to a hospital staffed and equipped to care for many patients and for a large number of kinds of diseases and dysfunctions using modern technology.

8. Sanitarium — refers to an institution for the care and treatment of people who are recovering from illness or who have a disease that will last a long time.

IV. POLICIES AND GUIDELINES

A. General Policies

The BRGHGMC shall provide tertiary-level of promotive, preventive, diagnostic, curative, rehabilitative and palliative health care services, as well as teaching, training and research services, also in accordance to provisions of and related issuances to R.A. No. 11223, or the "Universal Health Care Act." The Medical Center shall be fully equipped with state-of-the-art equipment and facilities, complemented by adequately trained and competent human resources for health as appropriate for a licensed and accredited Level III General Hospital. EATCcI

The BRGHGMC shall strengthen its existing basic and specialty services, and aim for the improvement of its service capability and capacity while continually serving as referral hospital in the Province of Camarines Sur and the adjacent areas of the surrounding municipalities of Camarines Norte Province, complementing local health systems and providers in these areas. The increase in bed capacity and expansion of services and capability shall be consistent with the BRGHGMC's Hospital Development Plan (HDP) as approved by the Health Facility Development Bureau (HFDB).

The BRGHGMC shall prioritize its expansion to a Geriatric Medical Center serving as end-referral facility of the Bicol Region and nearby provinces of Southern Tagalog and Eastern Visayas Regions. The Medical Center shall gear towards being a center for research and development in the field of geriatric medicine.

The BRGHGMC shall maintain its mandate as Sanitarium for Hansen's Disease until the disease is fully controlled and existing patients are discharged.

B. Implementing Mechanisms

The implementation of the Act shall be supported by the following guidelines: ISHCcT

1. Change in Name

The Bicol Sanitarium shall be renamed as Bicol Region General Hospital and Geriatric Medical Center. The acronym shall be known as "BRGHGMC." The official address shall be at the Brgy. San Pedro, Cabusao, Camarines Sur.

The Medical Center Chief shall ensure that directory and future official documents adhere to the new hospital name and be reflected in the DOH-National Health Facility Registry and other official databases.

2. Expansion of Services

The BRGHGMC shall develop and submit its Hospital Development Plan (HDP) to the HFDB through the Center for Health Development (CHD)-Bicol. The HDP shall be consistent with the Philippine Health Facility Development Plan (PHFDP) leading towards a 500-bed Level 3 General Hospital and Medical Center with specialty and sub-specialty services focuses on geriatric medicine. The BRGHGMC shall start its operation as mandated in this Act not more than three (3) years upon approval of this Act. DHITCc

The incremental annual increases in bed capacity and commensurate services shall be achieved within five (5) years of implementation of this Act. Allocation of beds as general, sanitaria and geriatric specialty services shall be reviewed at least every two (2) years. The determination of the bed allocation per service areas shall consider the burden of disease, catchment population, existing and developmental goals of other health facilities and healthcare service providers in the area, readiness of the facility, and available competent human resources for health, among others.

3. Health Human Resources

Based on the approved HDP, the BRGHGMC shall request for an increase in its health human resources based on 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.

The BRGHGMC shall honor the positions, security of tenure, and other rights of its human resource complement including the transfer of all personnel from Bicol Skin Clinic, Legazpi City to BRGHGMC. The Medical Center shall evaluate the existing human resource complement, re-classify and/or propose upgrading of positions, promote professional development and hire additional staff to comply and conform to the Civil Service Commission and DOH standards and intent of the Act. CAacTH

An organizational structure detailing the operations and management of the hospital mandated in this Act shall be developed by the BRGHGMC and submit to Health Facility Development Bureau for review and recommendation for the approval of the Department of Budget and Management.

4. Assets and Liabilities

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

5. Equipment

The BRGHGMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform to the DOH standards of a Level 3 General Hospital and Medical Center as provided for under A.O. No. 2012-0012. Additional equipment and facilities shall be provided to complement the expansion of services consistent with the approved HDP. cEaSHC

6. Infrastructure

The BRGHGMC shall implement and seek the support of the DOH for the construction, repair and/or renovation of its physical infrastructure, consistent to the approved HDP, and conforms to all existing laws, regulations, national and international standards for hospital buildings, also in line with the Hospitals Safe from Disasters Program, the Green Healthcare Facilities Guidelines, among others.

7. Systems Development

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

8. Quality Management

The SIMC's Quality Management System shall conform to ISO 9001:2015 standards. It shall enhance operations with the implementation of the Continuing Quality Improvement Program, Patient Safety Program, and Manuals of Standards of Hospital Operations and Management by HFDB, policies and standards by Health Facilities and Services Regulatory Bureau (HFSRB), Food and Drug Administration (FDA), Philippine Health Insurance Corporation (PhilHealth) and other standards by international organizations that support national or local standards. Its management shall comply with the gender and development (GAD) mainstreaming policies for government bureaucracies. IAETDc

The Medical Center shall complete all stages and become certified with the Performance Governance System towards its organizational development and performance improvement, as guided by DOH performance accountability measures such as the Hospital Scorecard.

V. IMPLEMENTING STRUCTURE

1. Administrative Control

The highest DOH-designated official of the Center for Health Development-Bicol (CHD-Bicol) shall have oversight jurisdiction and control over the SIMC's operations. The CHD-Bicol shall monitor the implementation of R.A. No. 11108, and may recommend the necessary further upgrading as guided by this Order.

The Medical Center Chief (MCC) of the BRGHGMC shall be accountable and responsible for the implementation of quality standard hospital operations and management. The MCC shall establish responsibility accounting as means of management control and determine respective contributions and performances of the Medical Center's division and units. The MCC shall also submit developmental plans, financial and statistical reports to the DOH Central Office. CTIEac

2. Sourcing and Use of Funds

The amounts necessary to carry out the provisions of R.A. No. 11108 shall be sourced out accordingly:

a. Capital investments for infrastructure and equipment shall be sourced from DOH appropriations under the General Appropriations Act (GAA), hospital income including PhilHealth payments, public-private partnership, and/or other financing modes or schemes subject to prevailing government rules and regulations;

b. The additional Miscellaneous and Other Operating Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital income including PhilHealth payments, public-private partnerships, and/or other financing modes or schemes;

c. Personal Services (PS) to carry out the full implementation of the staffing pattern following the DOH-DBM Joint Circular 2013-01, and other related issuances shall be sourced out from the GAA and other sources; and DcHSEa

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

VI. SEPARABILITY CLAUSE

If any of the provisions under 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 a newspaper of general circulation. SaCIDT

(SGD.) FRANCISCO T. DUQUE, III, MD, MScSecretary of Health