Implementing Rules and Regulations of Republic Act No. 11498

February 11, 2021

DOH ADMINISTRATIVE ORDER NO. 2021-0013

 

I. BACKGROUND AND RATIONALE

The beginnings of the Cagayan Valley Medical Center trace back at the end of the Second World War, when a field hospital was put up in Tuguegarao, Cagayan to service American and Filipino soldiers, and later civilians suffering from diseases due to exposure, injuries, malnutrition, among others. From this facility was established the 25-bed Tuguegarao Hospital on June 25, 1945, which was later converted by the province to Cagayan Provincial Hospital with a capacity of 200 beds. HTcADC

In 1963, the hospital was designated as regional training and teaching hospital, and in 1980, as tertiary regional hospital for Region II. Through Executive Order No. 851, series of 1985, the hospital integrated with the regional health laboratory and mental health facility to become the Integrated Cagayan Regional Hospital (ICRH). Republic Act (R.A.) No. 6782 renamed ICRH to Cagayan Valley Regional Hospital, then R.A. No. 8599 converted it to Cagayan Valley Medical Center (CVMC) with a 500-bed capacity. Between 2015 and 2019, the CVMC's bed occupancy rate had averaged 103.16 percent while in-patient admissions averaged 35,945, emergency room patients 47,693, and outpatient visits 95,270.

On November 13, 2020, the President signed into law R.A. No. 11498, "An Act Increasing the Bed Capacity of the Cagayan Valley Medical Center (CVMC) in Tuguegarao City, Province of Cagayan, from Five Hundred (500) to One Thousand (1,000) Beds and Appropriating Funds Therefor." Section 4 of the Act provides for its implementation through the programs of the Department of Health.

II. OBJECTIVE

This Administrative Order sets the Implementing Rules and Regulations of Republic Act No. 11498, "An Act Increasing the Bed Capacity of the Cagayan Valley Medical Center (CVMC) in Tuguegarao City, Province of Cagayan, from Five Hundred (500) to One Thousand (1,000) Beds 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 Cagayan Valley Medical Center and the implementation of Republic Act No. 11498.

IV. DEFINITION OF TERMS AND ACRONYMS

1. A.O. No. 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 Philippine" dated July 18, 2012 as amended.

2. Act — refers to Republic Act (R.A.) No. 11498, "An Act Increasing the Bed Capacity of the Cagayan Valley Medical Center (CVMC) in Tuguegarao City, Province of Cagayan, from Five Hundred (500) to One Thousand (1,000) Beds and Appropriating Funds Therefor."

3. CVMC — refers to Cagayan Valley Medical Center.

4. IRR — refers to the Implementing Rules and Regulations of this Act.

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

V. GENERAL GUIDELINES

Cagayan Valley Medical Center (CVMC) 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), Department Circular No. 2020-0410, where CVMC is listed as an eligible apex or end-referral facility, and Department Order No. 2021-0001, where specialty centers are designated for establishment to CVMC.

CVMC shall strengthen and improve its service capability and capacity while continually serving as end-referral and apex hospital in Tuguegarao City, provinces of Batanes, Cagayan, Isabela, Nueva Vizcaya and Quirino in Cagayan Valley region, and neighboring provinces of Apayao, Kalinga and Ifugao in the Cordillera Administrative 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 No. 2020-0268, CVMC shall make certain that its plans, policies, protocols and norms ensure the continued health service delivery while maintaining the public health standards for COVID-19 disease.

VI. IMPLEMENTING MECHANISMS

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

A. Expansion of Services

CVMC shall formulate and submit its Hospital Development Plan (HDP) to the HFDB through the Cagayan Valley Center for Health Development (CHD). CVMC's health facility development unit shall make the proper internal and external coordination for the complete, timely submission of its updated HDP. The HDP shall provide the capacity increase and capability expansion, and shall be consistent with the Philippine Health Facility Development Plan (PHFDP) leading towards a 1,000-bed Level 3 General Hospital with specialty and sub-specialty services.

CVMC shall comply with the operations of the Malasakit Center as mandated by the R.A. No. 11463 to enable eligible patients to access medical and financial assistance services.

B. Health Human Resources

Based on the approved HDP, CVMC 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.

CVMC shall honor the positions, security of tenure, and other rights of its 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, the DOH standards, and the intent of this IRR.

C. Assets and Liabilities

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

D. Equipment

CVMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform to the DOH standards of a tertiary teaching and training 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

CVMC shall implement and seek the support of 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

CVMC 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 and 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, CVMC'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 and 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 the 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 CVMC's operations. The designated DOH official, with the aid of the Cagayan Valley CHD, shall monitor the implementation of R.A. No. 11498, and may recommend further the necessary upgrading as guided by this Order.

The Medical Center Chief (MCC) of CVMC 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 submit developmental plans, financial and statistical reports to DOH Central Office.

B. Sourcing and Use of Funds

The amount necessary to carry out the provisions of R.A. No. 11498 shall be sourced out accordingly:

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

2. 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 partnership and/or other financing modes or scheme.

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 provision of 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 the Official Gazette or in a newspaper of general circulation.

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