Implementing Rules and Regulations of Republic Act No. 11208

July 25, 2019

DOH ADMINISTRATIVE ORDER NO. 2019-0025

 

I. RATIONALE AND BACKGROUND

Rizal Medical Center (RMC), formerly known as Rizal Provincial Hospital, was first established as an emergency hospital in the Commonwealth Era in the 1940s. It was a 25-bed capacity hospital in 1947, which expanded to 100 beds in 1955, and then further to 200 beds in 1960. In 1980, the hospital was categorized as a provincial hospital under the direct control and supervision of Regional Health Office No. 4. By virtue of Executive Order No. 851, series of 1984, the hospital was then placed under the direct supervision and control of the Office of the Secretary, Department of Health. As of 2017, the RMC is a licensed Level 3 general hospital with 300 authorized bed capacity. CHTAIc

Together with its medical care mission, the RMC was designated a medical training hospital in the 1950s. It already had nine fully accredited major services then. In the 1960s, the hospital expanded its outpatient department, emergency department, and extension services for mental hygiene, cancer detection and treatment. In the 1970s, the tumor clinic and cancer registry launched, the family clinic established, and the radiology department expanded. The RMC has since embarked on other innovative services: minimally invasive surgery and endoscopy, pediatric intensive care unit, animal bite center, poison control center, TB-DOTS, hemodialysis, brachytherapy, and disaster preparedness.

On February 14, 2019, the President signed Republic Act No. 11208, "An Act Increasing the Bed Capacity of Rizal Medical Center in Pasig City from Three Hundred (300) to Five Hundred (500) Beds and Appropriating Funds Therefor." Section 3 of this Act provides that the DOH to implement the RMC's bed capacity in three (3) years.

II. OBJECTIVE

The Administrative Order sets the Implementing Rules and Regulations of Republic Act (R.A.) No. 11208, "An Act Increasing the Bed Capacity of Rizal Medical Center in Pasig City from Three Hundred (300) to Five Hundred (500) Beds 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. 11208, "An Act Increasing the Bed Capacity of Rizal Medical Center in Pasig City from Three Hundred (300) to Five Hundred (500) Beds and Appropriating Funds Therefor."

3. IRR — refers to the Implementing Rules and Regulations of R.A. No. 11208.

4. Referral Hospital — refers to a hospital capable of accepting patients referred by other health care facilities, and of rendering specialized health care services.

5. RMC — refers to the Rizal Medical Center.

IV. POLICIES AND GUIDELINES

A. General Policies

The RMC shall be a teaching and training hospital that delivers tertiary-level curative, promotive, preventive and rehabilitative care, performs research, and provides professional training programs 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 500-bed general hospital and medical center. cHDAIS

The RMC shall strengthen its existing services, and aim for the improvement of its service capability and capacity while continually serving as referral hospital primarily in the east of the National Capital Region and Region IV-A (or CALABARZON, or the provinces of Cavite, Laguna, Batangas, Rizal and Quezon). The increase in bed capacity shall be consistent with the RMC'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 RMC shall develop and submit its HDP to the HFDB. The HDP shall be consistent with the Philippine Health Facility Development Plan (PHFDP) leading towards a 500-bed general teaching and training hospital. The incremental annual increases in bed capacity and commensurate services shall be achieved within three (3) years of implementation of this Act.

2. Health Human Resources

Based on the approved HDP, the RMC 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 RMC 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 RMC, 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 RMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform to the DOH standards of a Level 3 General 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. EATCcI

5. Infrastructure

The RMC shall implement and seek the support of 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 Hospital Safe from Disaster Program, the Green Healthcare Facilities Guidelines, among others.

6. System Development

The RMC 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 RMC'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 STRUCTURES

A. Administrative Control

The highest DOH-designated official for Metro Manila hospitals and medical centers shall have oversight jurisdiction and control over the RMC's operations. The official shall monitor the implementation of R.A. No. 11208, and may recommend the necessary further upgrading as guided by this Order.

The Medical Center Chief (MCC) of the RMC 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. ISHCcT

B. Sourcing and Use of Funds

The amounts necessary to carry out the provisions of R.A. No. 11208 shall be sourced out accordingly:

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

b. The additional Maintenance and Other Operating Expenses (MOOE) resulting from 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 hospital staffing pattern following the DOH-DBM Joint Circular 2013-01, and other related issuances shall be sources 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. DHITCc

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