Implementing Rules and Regulations of Republic Act No. 11189

June 25, 2019

DOH ADMINISTRATIVE ORDER NO. 2019-0018

 

I. RATIONALE AND BACKGROUND

Saint Anthony Mother and Child Hospital (SAMCH) began as an extension of the Vicente Sotto Memorial Medical Center, which was then named Southern Islands Medical Center. SAMCH primarily catered to outpatients, but it briefly admitted patients between 1992 and 1994. On December 8, 1994, Republic Act (R.A.) No. 7830 established SAMCH as a specialty hospital for obstetrics, gynaecology and paediatrics. EATCcI

The Hospital has a 25-bed authorized capacity to serve a high catchment population of 600,000. Between 2011 and 2017, its bed occupancy rate (BOR) ranged between 110 and almost 150 percent. In 2018, the BOR was at 205.86 percent. The Hospital's very limited capacity has deprived its patients of the necessary medical attention and accommodation, especially among the indigent patients, who make up a large majority of SAMCH's patients.

On January 10, 2019, the President approved R.A. No. 11189, "An Act Increasing the Bed Capacity of St. Anthony Mother and Child Hospital in Cebu City from Twenty-Five (25) to Two Hundred (200), and Appropriating Funds Therefor." The Department of Health shall issue the necessary implementing rules and regulations as directed by this Act, including the incremental increase of the Hospital's bed capacity, in line with the DOH's strategy to boost Universal Health Care, FOURmula One Plus for Health.

II. OBJECTIVE

This Administrative Order sets the Implementing Rules and Regulations of Republic Act (R.A.) No. 11189, "An Act Increasing the Bed Capacity of St. Anthony Mother and Child Hospital in Cebu City from Twenty-Five (25) to Two Hundred (200), and Appropriating Funds Therefor."

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. 11189, "An Act Increasing the Bed Capacity of St. Anthony Mother and Child Hospital in Cebu City from Twenty-Five (25) to Two Hundred (200), and Appropriating Funds Therefor."

3. IRR — refers to the Implementing Rules and Regulations of R.A. No. 11189.

4. Specialty Hospital — refers to hospital that specialized in a particular disease or condition or in one type of patient as provided in A.O. No. 2012-0012, as amended.

5. SAMCH — refers to the St. Anthony Mother and Child Hospital.

IV. POLICIES AND GUIDELINES

A. General Policies

The SAMCH shall primarily provide specialty services on maternal and child care, and with promotive, preventive, diagnostic, curative, rehabilitative and palliative health care services in accordance to provisions of and related issuances to R.A. No. 11223, or the "Universal Health Care Act." The Hospital shall be fully equipped with appropriate equipment and facilities, complemented by adequately trained and competent human resources for health as appropriate for a licensed and accredited 200-bed Specialty Hospital. CAacTH

The SAMCH shall strengthen its existing services, and aim for the improvement of its service capability and capacity while continually serving as referral hospital in Cebu City, the Province of Cebu, and other nearby provinces. The increase in bed capacity and expansion of services and capability shall be consistent with the SAMCH's Hospital Development Plan (HDP) as approved by the Health Facility Development Bureau (HFDB).

B. Implementing Mechanisms

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

1. Expansion of Services

The SAMCH shall develop and submit its HDP to the HFDB through the Center for Health Development (CHD) in Central Visayas. The HDP shall be consistent with the Philippine Health Facility Development Plan (PHFDP) leading towards a 200-bed Specialty Hospital. The incremental annual increases in bed capacity and commensurate services shall be achieved within four (4) years of implementation of this Act.

2. Health Human Resources

Based on the approved HDP, the SAMCH shall request for an increase of 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 and other related issuances.

The SAMCH shall honor the positions, security of tenure, and other rights of its human resource complement. The Hospital 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.

3. Assets and Liabilities

All movable and immovable assets and records of the SAMCH, 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 SAMCH shall make an inventory of the existing hospital equipment and undertake upgrading to conform to the DOH standards of a Specialty Hospital 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

5. Infrastructure

The SAMCH 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 shall conform 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.

6. Systems Development

The SAMCH 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 Hospital. It shall implement an electronic information system conforming to the basic requirements of the Integrated Hospital Operations and Management Program (IHOMP).

7. Quality Management

The SAMCH's Quality Management System shall conform to ISO 9001:2015 standards. It shall enhance operations with the implementation of the Continuous 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.

The Hospital 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 CHD in Central Visayas shall have oversight jurisdiction and control over the SAMCH's operations. The CHD shall monitor the implementation of R.A. No. 11189, and may recommend the necessary further upgrading as guided by this Order.

The Medical Center Chief (MCC) of the SAMCH 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 determination of respective contributions and performances of the Hospital's divisions or units. The MCC shall also submit developmental plans, financial and statistical reports to the DOH Central Office. IAETDc

2. Sourcing and Use of Funds

The amounts necessary to carry out the provisions of R.A. No. 11189 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 Maintenance 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

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. CTIEac

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

Published in the Philippine Daily Inquirer on July 24, 2019.