Implementing Rules and Regulations of Republic Act No. 8255

June 7, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0018

 

I. Rationale/Background

The Caraga Regional Hospital (CRH), originally known as the Surigao Provincial Hospital was established on October 6, 1946 with an authorized capacity of 25 beds. The bed capacity of the hospital was increased to 50 beds on July 1, 1958, and then to 75 beds in 1962 and to 100 beds in 1970. Finally, it was increased to 150 beds in 1975, which is being implemented up to the present. On April 1, 1993 by virtue of Republic Act No. 7160, otherwise known as the Local Government Code of 1991, the Surigao Provincial Hospital was devolved to the Local Government of Surigao del Norte and remained with the provincial government until Republic Act 8255 was signed into law on February 11, 1997, converting the Surigao Provincial Hospital into Caraga Regional Hospital, under the Department of Health (DOH). Section 1 of the Act states, "The existing Surigao del Norte Provincial Hospital in Surigao City is hereby converted into a regional training hospital to be known as Caraga Regional Hospital."

The CRH is currently a level 2 hospital. Based on its 150 authorized bed capacity, the utilization rate of CRH in the last three years (2013-2015) was 170%, being the referral hospital of the island province of Dinagat, other neighboring municipalities of Surigao del Sur, Surigao del Norte, Agusan del Norte, Agusan del Sur and other island municipalities of Southern Leyte, Region 8. To address the increasing health needs of its catchment population, CRH needs an increase in bed capacity with human resource complement, advancement in infrastructure, medical supplies, and medical and information technology (IT) equipment.

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for Republic Act No. 8255, "An Act Converting the Surigao del Norte Provincial Hospital in Surigao City into a Regional Training Hospital to be known as the Caraga Regional Hospital, and Appropriating Funds Therefor."

III. Scope

The Implementing Rules and Regulations discussed in this Administrative Order shall pertain only to the provisions of Republic Act No. 8255. EcTCAD

IV. Definition of Terms/Acronyms

1. Act — refers to Republic Act No. 8255," An Act Converting the Surigao del Norte Provincial Hospital in Surigao City into a Regional Training Hospital to be known as the Caraga Regional Hospital and Appropriating Funds Therefor."

2. AO No. 2012-0012 — refers to the "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" dated July 18, 2012.

3. Bed Capacity — refers to the number of beds offered by the hospital for in-patient care.

4. DBM-DOH Joint Circular No. 2013-01 — refers to the "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals, CY 2013 Edition" dated 23 September 2013 by the Department of Budget and Management and the Department of Health.

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

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

7. Regional Hospital — a higher level tertiary referral hospital with teaching, training and research functions. It shall have specialty and sub-specialty services in the four (4) major departments and provides basic diagnostic and ancillary procedures. The catchment population is at least 500,000.

V. Policies and Guidelines

A. General Policies

The CRH as a training health facility shall be fully equipped with updated medical equipment and upgraded facilities, complemented by adequately trained and competent health human resources appropriate for a licensed and accredited Level 3 hospital.

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

B. Implementing Mechanisms

In support to the implementation of Republic Act No. 8255, the following guidelines shall be implemented:

1. Expansion of Services

The CRH shall comply with the licensing standards as specified in AO 2012-0012 as amended to fully operate as level 3 hospital with Psychiatric Unit. The CRH shall increase its bed capacity to 250 upon recommendation of the DOH Regional Office XIII.

2. Health Human Resource

In case of deployment of staff as a result of the DOH Rationalization, the CRH shall continue to honor the positions, security of tenure and other rights of its human resource. The hospital shall evaluate the existing health human resource complement, re-classify and/or upgrade positions, promote professional development and hire additional staff to comply and conform to the DOH standards pursuant to the purpose and intent of Republic Act No. 8255.

The CRH shall immediately implement the staffing standard of a 150 bed capacity hospital following the DBM-DOH Joint Circular No. 2013-01, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals CY 2013 Edition."

3. Assets and Liabilities

All movable and immovable assets, liabilities and obligations as well as records of the CRH shall be properly updated and shall be accounted for in accordance with existing policies and guidelines, laws, as well as the issuance of orders by duly constituted authorities.

4. Equipment

The CRH shall make an inventory of the existing hospital equipment and undertake upgrading thereof to conform to DOH minimum standards of a Level 3 hospital provided for under DOH AO No. 2012-0012, as amended. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of the DOH.

5. Infrastructure

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

6. Systems Development

The CRH 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 that conforms to the basic requirements of the Integrated Hospital Operations and Management Program (IHOMP) of the DOH.

7. Quality Management

The CRH shall enhance and implement Continuing Quality Improvement Program (CQIP), Patient Safety, DOH policies and regulations, standards on 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 international health organization standards which are supportive of existing local and national standards. HSAcaE

VI. Implementing Structure

A. Administrative Control

The Medical Center Chief of CRH shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit their development plans, financial and statistical reports to the DOH-Central Office through the DOH Regional Office No. XIII.

The DOH, through the Regional Office No. XIII shall have oversight jurisdiction over the hospital operations. It shall monitor the implementation of the Act and may recommend further necessary upgrading guided by this Administrative Order. Further, the Health Facility Development Bureau (HFDB) shall provide the needed technical assistance in line with the hospital upgrading, development and capacity building.

B. Sourcing and Use of Funds

The amount necessary to carry out the provisions of the Act shall be sourced accordingly:

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital revenues, Philippine Health Insurance Corporation (PhilHealth) reimbursements and other financing schemes subject to the prevailing government rules and regulations.

2. The additional Maintenance, Operating and Other Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital income, which includes Philhealth payments, public-private partnership and/or other financing schemes subject to the prevailing government rules and regulations.

3. Personnel Services (PS) which shall be appropriated to carry out the full implementation of the staffing pattern of a 150-bed capacity hospital in compliance with DOH-DBM Joint Circular 2013-01 and other related services shall be sourced from the GAA.

4. Release of funds shall be approved by the designated 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 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