Implementing Rules and Regulations of Republic Act No. 11561 (East Avenue Medical Center)

December 23, 2021

DOH ADMINISTRATIVE ORDER NO. 2021-0067

 

I. BACKGROUND AND RATIONALE

In 1969, the GSIS General Hospital was established under the Government Service Insurance System in line with the policy on extending health services to GSIS members. Presidential Decree No. 1411 dissolved the GSIS Hospital and from it the Ospital ng Bagong Lipunan was created under the supervision and control of the Ministry of Health. In 1986, Memorandum Order No. 48 renamed the hospital as East Avenue Medical Center. HTcADC

In 1997, Republic Act (R.A.) No. 8345 increased the hospital's capacity from 350 to 600 beds. In the years 2018 and 2019, the average bed occupancy rate was 160.9 percent, far above the recommended national rate of 80 to 85 percent. Its outpatient visits totaled almost 300,000 in the same period. Legislation proposed to increase the hospital's capacity passed the 18th Congress as House Bill No. 6728.

On June 24, 2021, the President approved and signed the R.A. No. 11561, "An Act Increasing the Bed Capacity of the East Avenue Medical Center in Barangay Diliman, Quezon City from Six Hundred (600) to One Thousand (1,000) Beds, and Appropriating Funds Therefor." Section 4 provided for the implementation of this Act through the Department of Health's programs and appropriations. The implementing rules and regulations shall also be in accordance with R.A. No. 11223, Universal Health Care Act, which ensures that all Filipinos have equitable access to quality health care goods and services.

II. OBJECTIVE

This Administrative Order (A.O.) sets the Implementing Rules and Regulations of Republic Act (R.A.) No. 11561, "An Act Increasing the Bed Capacity of the East Avenue Medical Center in Barangay Diliman, Quezon City from Six Hundred (600) 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 East Avenue Medical Center and the implementation of Republic Act No. 11561.

IV. DEFINITION OF TERMS AND ACRONYMS

A. EAMC — refers to East Avenue Medical Center.

B. HDP — refers to the Hospital Development Plan, which serves as a guide for the development of the health facility towards its contribution to the achievement of Universal Health Care as well as in ensuring allocation of government's investments in the delivery of quality, people-centered health services.

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

D. Level 3 General Hospital — refers to the type of general hospital according to functional capacity as provided in A.O. No. 2012-0012, "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" as amended.

V. GENERAL GUIDELINES

A. The East Avenue Medical Center (EAMC) 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), and Department Circular No. 2020-0410, where EAMC is listed as an eligible apex or end-referral facility as of 2020.

B. The EAMC shall strengthen and improve its service capability and capacity while continually serving as end-referral and apex hospital in Quezon City, the rest of Metro Manila and neighboring provinces, complementing the local health systems and providers therein, consistent with its Hospital Development Plan as approved by the Health Facility Development Bureau (HFDB).

The EAMC 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 1,000-bed Level 3 General Hospital with specialty and sub-specialty services in accordance with Department Order (D.O.) No. 2021-0001, which designated the EAMC as National Specialty Centers for burn care, eye care, and toxicology. Accordingly, the hospital shall establish its basic comprehensive specialty centers on orthopedic care, mental health, neonatal care, and geriatric care, and advanced comprehensive specialty centers on trauma care, cancer care, and dermatology care.

Pursuant to D.O. No. 2020-0820 and the direction of the Philippine Health Laboratory System, the EAMC shall institutionalize and strengthen the National Reference Laboratories designated to it, and which shall independently operate from the main/general clinical laboratory.

C. The EAMC shall comply with standards and meet requirements in preparedness and response strategies in public health emergencies as in A.O. No. 2020-0016, as amended, 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, the EAMC 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. aScITE

VI. IMPLEMENTING MECHANISMS

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

A. Expansion of Hospital Services

The EAMC shall formulate and submit its Hospital Development Plan (HDP) to the HFDB. The EAMC'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.

The EAMC shall comply with the requirements for 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, the EAMC 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. It shall likewise request for the organizational structure and staffing to institutionalize and strengthen the operations and management of its NRLs.

The EAMC shall faithfully observe and promote the security of tenure, professionalization, equal opportunity principles and other fundamental rights of its human resources by complying with all relevant rules and regulations of the Civil Service Commission (CSC) under the 2017 Omnibus Rules on Appointments and Other Human Resource Actions (ORA-OHRA), as Amended, promote professional growth, and pursue continued learning and development program for its entire workforce.

C. Assets and Liabilities

All movable and immovable assets and records of the EAMC, 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 EAMC 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

The EAMC 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 and Safe Health Facilities Guidelines, among others.

F. Systems Development

The EAMC 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 a hospital information system conforming to the basic requirements of the Integrated Hospital Operations and Management Program (IHOMP).

The EAMC shall support, participate and adhere to the implementation of the HCPN policies and guidelines for health systems integration and complementation of health services of local and national government facilities.

G. Quality Management

Through the term of its HDP implementation, the EAMC's Quality Management System shall conform with A.O. No. 2020-0034 for Continuous Quality Improvement, and ISO 9001:2015 standards. It shall enhance operations with the implementation of the 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.

At the same time, the EAMC shall endeavor to pursue higher maturity levels for all its human resource management systems and processes by undergoing further accreditation assessment under the CSC Program to Institutionalize Meritocracy and Excellence in Human Resource Management (PRIME-HRM). HEITAD

VII. IMPLEMENTING STRUCTURE

A. Administrative Control

A DOH official designated by the Secretary of Health shall have oversight jurisdiction and control over the EAMC's operations. The designated DOH official shall monitor the implementation of R.A. No. 11561, and may recommend further the necessary upgrading as guided by this Order.

The Medical Center Chief (MCC) of the EAMC 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 amount necessary to carry out the provisions of R.A. No. 11561 shall be sourced out accordingly:

1. Capital investments for infrastructure, equipment, motor vehicles and land outlays 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, and upon filing of three (3) certified copies with the Office of the National Administrative Register, University of the Philippines Law Center.

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