Implementing Rules and Regulations of Republic Act No. 11478

September 30, 2020

DOH ADMINISTRATIVE ORDER NO. 2020-0046

 

I. BACKGROUND AND RATIONALE

The beginnings of the Camarines Sur Provincial Hospital in Naga City trace back to 1933 when it was established as a 25-bed facility. It struggled in its early years, and was wrecked in the Second World War. With postwar reparations from the United States, the facility was rebuilt, then its capacity gradually increased in the ensuing years. In the 1970s, the capacity had grown to 200 beds. By virtue of Executive Order No. 851, series of 1982, it became a regional hospital, it absorbed a psychiatric facility in Pili, Camarines Sur, and it increased to 450 beds. HTcADC

Republic Act (R.A.) No. 7454 in 1992 converted the hospital to the Bicol Regional Training and Teaching Hospital. Then, R.A. No. 8053 in 1995 renamed the hospital to Bicol Medical Center and increased its capacity to 500 beds. At present, the BMC is composed of the main hospital in Naga City and a psychiatric ward in Pili. From 2015 to 2019, the average occupancy rate of the main hospital was 212.32 percent, and the average outpatient consultations were 122,783, indicating increases of 22 percent and 32 percent respectively in five years.

On July 1, 2020, the President approved and signed R.A. No. 11478, "An Act Increasing the Bed Capacity of the Bicol Medical Center from Five Hundred (500) Beds to One Thousand (1,000) Beds, Upgrading its Service Facilities and Professional Health Care Services, Authorizing the Increase of its Medical Workforce Complement, Amending for the Purpose Republic Act No. 8053, and Appropriating Funds Therefor." Ensuring that all Filipinos have equitable access to quality health care goods and services, in accordance to RA No. 11223, also known as the "Universal Health Care Act," Section 5 provides for the implementation of this Act through the Department of Health's programs and appropriations.

II. OBJECTIVE

This Administrative Order sets the Implementing Rules and Regulations of Republic Act No. 11478, "An Act Increasing the Bed Capacity of the Bicol Medical Center from Five Hundred (500) Beds to One Thousand (1,000) Beds, Upgrading its Service Facilities and Professional Health Care Services, Authorizing the Increase of its Medical Workforce Complement, Amending for the Purpose Republic Act No. 8053, and Appropriating Funds Therefor," and pertains only to the provisions of this Act.

III. SCOPE

The extent of coverage of this Order shall include the operations and management of Bicol Medical Center and the implementation of Republic Act No. 11478.

IV. DEFINITION OF TERMS AND ACRONYMS

1. A.O. 2012-0012 — refers to the DOH Administrative Order (A.O.) on "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" dated July 18, 2012 as amended

2. Act — refers to Republic Act (R.A.) No. 11478, "An Act Increasing the Bed Capacity of the Bicol Medical Center from Five Hundred (500) Beds to One Thousand (1,000) Beds, Upgrading its Service Facilities and Professional Health Care Services, Authorizing the Increase of its Medical Workforce Complement, Amending for the Purpose Republic Act No. 8053, and Appropriating Funds Therefor"

3. BMC — refers to the Bicol Medical Center

4. IRR — refers to the Implementing Rules and Regulations of R.A. No. 11478

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

V. GENERAL GUIDELINES

The Bicol Medical Center (BMC) shall provide promotive, preventive, diagnostic, curative, rehabilitative and palliative health care, research and training services in accordance with the provisions of R.A. No. 11223, the "Universal Health Care Act," and related issuances such as A.O. No. 2020-0019, where roles and responsibilities are defined for DOH hospitals in the service delivery design of health care provider networks (HCPN).

The BMC shall strengthen and improve its service capability and capacity while continually serving as end-referral hospital in the Province of Camarines Sur, the City of Naga, and the rest of the provinces of the Bicol region, complementing the local health systems and providers therein, consistent with its Hospital Development Plan as approved by the Health Facility Development Bureau (HFDB). It 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 3 General Hospital.

It shall comply with standards and meet requirements in preparedness and response strategies in public health emergencies as in A.O. No. 2020-0016, which include but are not limited to allocation of beds, dedication of select services or units, and performance of enhanced protocols in infection prevention and control, patient and health worker safety, and patient navigation in the HCPN. Likewise, concordant to the country's transitioning towards the New Normal, as guided by Department Memorandum (DM) No. 2020-0268, the BMC shall ensure its plans, policies, protocols and norms ensure continued health service delivery while maintaining the public health standards for COVID-19 disease. aScITE

VI. IMPLEMENTING MECHANISMS

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

A. Expansion of Services

The BMC shall formulate and submit its Hospital Development Plan (HDP) to the HFDB through the Bicol Center for Health Development. The HDP shall be consistent with the Philippine Health Facility Development Plan (PHFDP) leading towards a 1,000-bed Level 3 General Hospital with specialty and subspecialty services. The increase in bed capacity and expansion of service capabilities shall be achieved in accordance with the HDP.

The BMC shall establish and operate its Malasakit Center as mandated by R.A. No. 11463 to enable eligible patients to access medical and financial assistance services.

B. Health Human Resources

Based on the approved HDP, the BMC shall request for the required 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, and its succeeding amendments.

The BMC 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 this IRR.

C. Assets and Liabilities

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

D. Equipment

The BMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform to the DOH standards of a tertiary care hospital as provided for under A.O. No. 2012-0012 as amended. Additional equipment and facilities shall be provided to complement the expansion of services consistent with the approved HDP.

E. Infrastructure

The BMC 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 conforming to all existing laws, regulations, national and international standards for hospital buildings, also in line with Hospitals Safe from Disasters Program, Green Healthcare Facilities Guidelines, among others.

F. Systems Development

The BMC 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).

G. Quality Management

Through the term of its HDP implementation, the BMC'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, Integrated People-Centered Health Services, 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 in government.

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.

VII. IMPLEMENTING STRUCTURE

A. Administrative Control

A DOH official designated by the Secretary of Health shall have oversight jurisdiction and control over the BMC's operations. The designated DOH official shall monitor the implementation of R.A. No. 11478, and may recommend the necessary further upgrading as guided by this Order.

The Medical Center Chief (MCC) of the BMC 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. HEITAD

B. Sourcing and Use of Funds

The amounts necessary to carry out the provisions of R.A. No. 11478 shall be sourced out accordingly:

1. 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;

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. Personnel Services (PS) to carry out the full implementation of the hospital staffing pattern following the DBM-DOH Joint Circular No. 2013-01 and related issuances shall be sourced from the GAA; and

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

VIII. 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.

IX. EFFECTIVITY

This Order shall take effect fifteen (15) days after publication in a newspaper of general circulation.

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