Implementing Rules and Regulations of Republic Act No. 7937

June 28, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0026

 

I. Rationale/background

The Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital (MHARSRTTH) was established as Ozamiz City Emergency Hospital with 75 beds in 1971. The hospital was upgraded to 100 bed capacity and operated as a secondary hospital and the name was later changed to Mayor Hilarion A. Ramiro, Sr. General Hospital. With the implementation of R.A. No. 7160 otherwise known as of the Local Government Code of 1991, the hospital was devolved to the Local Government of the Province of Misamis Occidental in 1992. By virtue of R.A. No. 7937 approved on March 1, 1995, the hospital was renationalized and converted into a regional training and teaching hospital of Region X, changing its name to Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital (MHARSRTTH). Subsequently, MHARSRTTH was upgraded to 150 bed capacity tertiary hospital with significant increase in health human resource complement.

In 1997, the four (4) major departments were fully functional together with the subspecialties in Orthopedics, Neurology, Nephrology, Cardiology, Family Medicine, Psychiatry and Diabetology.

Considering the accessibility of MHARSRTTH to the neighboring municipalities and cities of the provinces of Region X such as Misamis Occidental and Lanao del Norte, the provinces of Region IX, i.e., Zamboanga del Sur and Zamboanga del Norte and the ARMM province of Lanao del Sur, the hospital serves as the referral health care facility of patients needing tertiary care. The Bed Occupancy Rate (BOR) for the years 2013, 2014 and 2015 were 180.68%, 238.13% and 293.88% respectively yielding an average of 237.56% in the last three (3) years which is beyond the ideal 85% thereby depleting the hospital resources and compromising the quality of health services. Hence, RA No. 7937 must be fully implemented.

II. Objectives

This Administrative Order sets the Implementing Rules and Regulations of RA No. 7937, "An Act Converting the Mayor Hilarion A. Ramiro, Sr. General Hospital in Ozamis City, Misamis Occidental into a Regional Training and Teaching Hospital to be known as the Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital, and Appropriating Funds Therefor."

III. Scope

The Rules and Regulations discussed in this Administrative Order pertains only to R.A. No. 7937. HTcADC

IV. Definition of Terms Acronym

1. Act — refers to Republic Act No. 7937, "An Act Converting the Mayor Hilarion A. Ramiro, Sr. General Hospital in Ozamis City, Misamis Occidental into a Regional Training and Teaching Hospital to be known as the Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital, and Appropriating Funds Therefor";

2. AO 2012-0012-A — refers to the Amendment of Administrative Order No. 2012-0012 entitled "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" dated 3 September 2015;

3. Bed Occupancy Rate — is the ratio of the actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period;

4. Level 3 Hospital — as classified in Administrative Order No. 2012-0012-A;

5. MHARSRTTH — refers to Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital;

6. Referral Hospital — refers to a health care institution capable of accepting referrals, from lower level hospitals and render general and special health care services.

V. Policies and Guidelines

A. General Policies

Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital shall provide a promotive, curative, preventive, rehabilitative health care services and research. It shall be fully equipped with state of the art equipment and facilities, complemented by adequately trained and competent health human resources as appropriate for a licensed Level 3 health care facility.

Furthermore, the MHARSRTTH shall strengthen its existing services and aim for the improvement of its service capability while continually serving as a tertiary referral hospital, complementing the services of local government health care facilities in the province and the region. The increase in bed capacity shall be consistent with the Development Plan of MHARSRTTH.

B. Implementing Mechanisms

In support of the implementation of RA. 7937, the following guidelines shall be implemented.

1. Expansion Services

The Mayor Hilarion A. Ramiro, Sr. Regional Training and Teaching Hospital shall operate as a 150 bed, Level 3 hospital with additional services such as Mother and Child Health Care Services; New Born Screening Services, TB-DOTS Facility, Basic Emergency Obstetric and Newborn Care (BEmONC) training facility, Blood Bank, Animal Bite Center, Sub specialty clinics at the OPD Department such as Diabetology, ENT, Ophthalmology, Mental Health, Urology, Gastroenterology and high end diagnostic and imaging services. The MHARSRTTH shall be continuously upgraded of the requisite expanded bed capacity of a regional teaching and training hospital as provided in the Act.

2. Health Human Resource

In case of detailed employees and/or deployment of staff as a result of the Department of Health (DOH) Rationalization Plan, the MHARSRTTH shall continue to honor the positions, security of tenure and other rights of its human resource complement. The hospital shall evaluate the existing health human resource complement, re-classify and/or propose upgrading positions, promote professional development and shall hire additional staff to comply and conform to the DOH standards pursuant to the purpose and intent of R.A. No. 7937.

The MHARSRTTH shall implement the staffing standard of a 150 bed capacity hospital or the requisite expanded bed capacity as provided for in the Act following the DBM-DOH Joint Circular No. 2013-01, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals CY 2013 Edition" dated 23 September 2013.

3. Assets and Liabilities

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

4. Equipment

The MHARSRTTH shall make an inventory of the existing hospital equipment and undertake upgrading to conform to DOH minimum standards of a Level 3 hospital provided under DOH AO No. 2012-0012-A and other regulatory agencies. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of the DOH until the hospital attains its mandated status.

5. Infrastructure

The MHARSRTTH shall implement and seek the support of DOH for the construction/repair/renovation of physical infrastructure to conform to all existing laws and licensing standards and current international standards for hospital buildings in line with Hospital Safe from Disasters Program, among others.

6. Systems Development

The MHARSRTTH shall develop and sustain the standards of hospital operations to provide quality patient care and safety for patients, health workers and clientele of the hospital. It shall implement an electronic information system conforming to the basic requirement of the Integrated Hospital Operations and Management Program (IHOMP).

7. Quality Management

The MHARSRTTH shall enhance and implement Continuing Quality Improvement Program (CQIP),Patient Safety, DOH Policies and regulations, standards of hospital operations prescribed in the DOH-Health Facility Development Bureau (HFDB) manuals, Health Facilities and Services Regulatory Bureau (HFSRB),Philippine Health Insurance Corporation (Philhealth) and other health organization standards provided by international health organizations which are supportive of existing local and national standards.

VI. Implementing Structure

1. Administrative Control

The Medical Center Chief of MHARSRTTH shall be accountable and responsible for the operations and management relative to the increase in bed capacity, upgrading of service capability and the implementation of all other provisions of RA 7937.

The DOH Regional Office X shall have oversight jurisdiction over the hospital operations. It shall monitor and may recommend necessary upgrading guided by this Administrative Order.

Further, the Health Facility Development Bureau (HFDB) shall provide the needed technical assistance in line with hospital upgrading, development and capacity building.

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of R.A. No. 7937 shall be sourced out accordingly:

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

2.2 The additional Maintenance and Other Operating Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital income, PhilHealth payments, public-private partnership and/or other financing schemes. aScITE

2.3 Personnel Services (PS) shall be appropriated to carry out the full implementation of the staffing pattern of 150 beds or the requisite expanded bed capacity as provided for in the Act; and shall be implemented in compliance with DOH-DBM Joint Circular 2013-01 dated September 23, 2013 and other related issuances.

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

VII. Repealing/Separability Clause

Provisions from previous issuances that are inconsistent or contrary to the provisions of this Order are hereby rescinded and modified accordingly.

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.

VIII. Effectivity

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

(SGD.) JANETTE P. LORETO-GARIN, MD, MBA-HSecretary of Health