Implementing Rules and Regulations of Republic Act No. 8343

June 7, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0017

 

I. Rationale/Background

The Adela Serra Ty Memorial Medical Center (ASTMMC) today, started as an emergency hospital on April 16, 1961 with 25 bed capacity. This was established when Surigao was divided into two provinces, namely: Surigao del Norte and Surigao del Sur. In 1967, the hospital bed capacity was increased to 50 and became Surigao del Sur Provincial Hospital. It moved up to a 75-bed capacity in 1970 with the construction of the left wing of the building and new plantilla were created and filled up. In 1983, it was increased to 100 beds and issued a License to Operate as Level 1.

The hospital caters patients from (17) municipalities and two (2) cities of Surigao del Sur as its primary catchment areas in addition to patients coming from Surigao del Norte, Agusan del Sur and neighboring municipalities of Agusan del Norte; Some patients from neighboring islands of the Visayas are referred to ASTMMC for further treatment. Aside from the above, it also serves as referral hospital of the nine (9) district hospitals and nineteen (19) birthing homes of the neighboring municipalities.

The implementation of R.A. No. 7160, known as the Local Government Code of 1991 devolved the Surigao del Sur Provincial Hospital to the provincial government of Surigao del Sur. On April 23, 1992, the Surigao del Sur Provincial Hospital was renamed Adela Serra Ty Memorial Hospital by virtue of RA No. 7433.

On August 12, 1997, R.A. 8343, "An Act Converting the Adela Serra Ty Memorial Hospital in Tandag, Surigao Del Sur, into a Tertiary Level Medical Center, under the Full Administrative and Technical Supervision of the Department of Health (DOH), to be known as the Adela Serra Ty Memorial Medical Center, and Appropriating Funds Therefor" was approved. The Act re-nationalized and converted the hospital into Adela Serra Ty Memorial Medical Center, a tertiary level medical center with 200 bed capacity. It was only in April 2000 that the hospital was completely renationalized with a national funding under General Appropriations Act (GAA) as Level 1 hospital. AIDSTE

Based on the authorized bed capacity of 200 beds, the current hospital's occupancy rate is 73%. Of the 73% bed occupancy rate, 98% were service patients provided with tertiary hospital services. Like any other government health facilities, ASTMMC shared the same perennial problem, the lack of space/beds for inpatients, facilities and other high-end medical equipment. Thus, other patients are referred to Tagum City, Davao del Norte and Davao City with more or less eight (8) hours of travel time, and six (6) hours to Butuan City.

II. Objectives

This Administrative Order sets the Implementing Rules and Regulations for Republic Act No. 8343, "An Act Converting the Adela Serra Ty Memorial Hospital in Tandag, Surigao Del Sur, into a Tertiary Level Medical Center, under the Full Administrative and Technical Supervision of the Department of Health (DOH), to be known as the Adela Serra Ty Memorial Medical Center, and Appropriating Funds Therefor."

III. Scope

These Rules and Regulations discussed in this administrative order shall only pertain to Republic Act No. 8343 to facilitate compliance therewith and achieve the objectives thereof.

IV. Definition of Terms/Acronym

1. Act — refers here to Republic Act No. 8343 known as "An Act converting the Adela Serra Ty Memorial Hospital in Tandag, Surigao del Sur, into a Tertiary Level Medical Center, under the full administrative and technical supervision of the Department of Health (DOH), to be known as the Adela Serra Ty Memorial Medical Center, and Appropriating Funds Therefor."

2. AO 2012-0012 — refers to the "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" dated 18 July 2012.

3. ASTMMC — refers to Adela Serra Ty Memorial Medical Center.

4. Bed Capacity — refers to the number of beds made available for inpatient care.

5. Bed Occupancy Rate (BOR) — is the ratio of actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period.

6. Level 2 hospital — as classified in Administrative Order 2012-0012, dated July 18, 2012.

7. Level 3 hospital — as classified in Administrative Order 2012-0012-A dated September 5, 2015.

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

V. Policies and Guidelines

A. General Policies

The ASTMMC shall provide tertiary level of care with promotive, preventive, curative and rehabilitative services, with fully departmentalized medical and nursing services, fully equipped with state of the art equipment and facilities complemented by adequately trained and competent health human resources as appropriate for a licensed and accredited Level 3 health care facility.

Furthermore, the ASTMMC 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 whole region. The increase in bed capacity shall be consistent with the Development Plan of ASTMMC to be a Level 3 hospital.

B. Implementing Mechanism

In support to the implementation of the Act, the following guidelines shall be implemented:

1. Expansion of Services

The ASTMMC shall operate as a 200 bed Level 2 hospital with additional services in eye care services, rehabilitation center, dialysis units, toxicology, high end diagnostic services, and be continuously upgraded to be a fully operational 200 bed Level 3 hospital. Structural reorganization with additional services shall be established based on the Hospital Development Plan.

2. Health Human Resource

In case of deployment of a staff, the ASTMMC 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 of positions, promote professional development and hire additional staff to comply and conform to the DOH standards, purpose and intent of Republic Act No. 8343. The ASTMMC shall implement the staffing standard of a 200 bed capacity hospital to conform to the DBM-DOH Joint Circular No. 2013-01 dated September 23, 2013.

3. Assets and Liabilities

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

4. Equipment

The ASTMMC shall make an inventory of the existing hospital equipment and undertake upgrading to conform to DOH minimum standards of a Level 3 hospital as 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 DOH. AaCTcI

5. Infrastructure

The ASTMMC 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 ASTMMC 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 ASTMMC hospital management shall enhance and implement Continuing Quality Improvement Program, Patient Safety, standards prescribed on the Manuals of Hospital Operations and Management of the Health Facility Development Bureau (HFDB), other policies and standards provided by the DOH, Health Facilities and Services Regulatory Bureau (HFSRB), Food and Drug Administration (FDA), the Philippine Health Insurance Corporation (PhilHealth) and other standards provided by international health organizations which are supportive of existing local and national standards.

The ASTMMC shall pursue the ISO 9001:2008 certification standards.

VI. Implementing Structure

1. Administrative Control

The Medical Center Chief of ASTMMC shall be accountable and responsible for the operation and management relative to the increase of bed capacity, upgrading of service capability and implementation of all other provisions of Republic Act No. 8343. It shall submit developmental plans, financial and statistical reports to the DOH Central Office through the Regional Office XIII.

The DOH Region XIII shall have oversight jurisdiction over the hospital operations of ASTMMC. It shall monitor the implementation of Republic Act No. 8343 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.

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of Republic Act No. 8343 shall be sourced out accordingly:

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

2.3. Personnel Services (PS) to carry out the full implementation of the staffing standards of 200 beds in compliance with DOH-DBM Joint Circular 2013-01 dated September 23, 2013 and other related issuances shall be sourced out from GAA and other sources; and

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