Implementing Rules and Regulations of Republic Act No. 11331

October 23, 2019

DOH ADMINISTRATIVE ORDER NO. 2019-0045

 

I. RATIONALE AND BACKGROUND

Tondo Medical Center (TMC) started in 1971 as an annex of the Jose R. Reyes Memorial Medical Center. In the same year, Republic Act (R.A.) No. 6375 created the Tondo General Hospital and Medical Center as a non-profit public institution for free inpatient and outpatient medical care to the residents of the Tondo district of the City of Manila. In 1987, the hospital came under the Department of Health (DOH).

The trend in the number of patients seen by TMC shows a 20 percent annual increase between 2014 and 2018. Similarly, the bed occupancy rate jumped from 80 percent in 2015 to over 115 percent in the first quarter of 2019. With its 200-bed authorized capacity, TMC caters to the health needs in residential, commercial and industrial areas of Manila, Caloocan, Malabon, Navotas and Valenzuela cities, and nearby areas of the Bulacan province.

On April 17, 2019, the President signed R.A. No. 11331, "An Act Increasing the Bed Capacity of Tondo Medical Center in the City of Manila from Two Hundred (200) to Three Hundred (300) Beds, Upgrading its Professional Health Care Services and Facilities, Authorizing the Increase of its Medical Personnel, and Appropriating Funds Therefor." Section 4 provides for immediate implementation of this Act through the DOH's programs and appropriations.

II. OBJECTIVE AND SCOPE

This Administrative Order sets the Implementing Rules and Regulations of Republic Act No. 11331, "An Act Increasing the Bed Capacity of Tondo Medical Center in the City of Manila from Two Hundred (200) to Three Hundred (300) Beds, Upgrading its Professional Health Care Services and Facilities, Authorizing the Increase of its Medical Personnel, and Appropriating Funds Therefor," and pertains only to the provisions of this Act.

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. 11331, "An Act Increasing the Bed Capacity of Tondo Medical Center in the City of Manila from Two Hundred (200) to Three Hundred (300) Beds, Upgrading its Professional Health Care Services and Facilities, Authorizing the Increase of its Medical Personnel, and Appropriating Funds Therefor."

3. IRR — refers to the Implementing Rules and Regulations of R.A. No. 11331.

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

5. Referral Hospital — refers to a health care institution capable of accepting referrals from other health facilities and renders specialized health care.

6. TMC — refers to the Tondo Medical Center.

IV. POLICIES AND GUIDELINES

A. General Policies

Tondo Medical Center (TMC) shall be a teaching and training hospital that delivers tertiary-level promotive, preventive, curative 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 state-of-the-art equipment and facilities, complemented by adequately trained and competent human resources for health as appropriate for a licensed and accredited 300-bed general hospital and medical center.

The TMC shall strengthen its existing services, and aim for the improvement of its service capability and capacity while continually serving as referral hospital in Manila, Caloocan, Malabon, Navotas and Valenzuela cities, and nearby areas of the Bulacan province. The increase in bed capacity and expansion of services and capability shall be consistent with the TMC'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 TMC 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 300-bed general, teaching and training hospital. The incremental annual increases in bed capacity and commensurate services shall be achieved in accordance with the hospital's HDP.

2. Health Human Resources

Based on the approved HDP, the TMC 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 September 23, 2013.

The TMC shall honor the positions, security of tenure, and other rights of its human resource complement. The hospital shall evaluate its existing human resource complement, re-classify and/or propose upgrade positions, promote professional development, and/or hire additional staff to comply with and conform to the Civil Service Commission and DOH Standards and intent of the Act. The management shall also adhere to CSC's Program to Institutionalize Meritocracy and Excellence in Human Resource Management (PRIME-HRM).

3. Assets and Liabilities

All movable and immovable assets and records of the TMC, 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 TMC shall make an inventory of its existing hospital equipment and undertake upgrading to conform to DOH standards appropriate for a Level 3 General Hospital under A.O. 2012-0012 as amended. Additional equipment and facilities shall be provided to complement the expansion of services consistent with the approved HDP.

5. Infrastructure

The TMC shall implement and seek the support of the DOH for the construction, repair and/or renovation of its physical infrastructure, consistent with 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, Integrated People-Centered Health Services, among others.

6. Systems Development

The TMC 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 TMC'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, 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.

The TMC shall complete all stages and become certified with the Performance Governance System towards its organization 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 TMC's operations. The official shall monitor the implementation of R.A. No. 11331, and may recommend the necessary further upgrading as guided by this Order.

The Medical Center Chief (MCC) of the TMC 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.

B. Sourcing and Use of Funds

The amounts necessary to carry out the implementation of R.A. 11331 shall be sourced out accordingly:

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

2. 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;

3. Personal Services (PS) to carry out the full implementation of the staffing pattern following the DBM-DOH Joint Circular 2013-1, and other related issuances shall be sourced out from the GAA and other sources; and

4. 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.

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