Implementing Rules and Regulations of Republic Act No. 8634

April 22, 2015

DOH ADMINISTRATIVE ORDER NO. 2015-0013

 

I. Rationale/Background

The Baguio General Hospital and Medical Center (BGHMC) started as the Baguio Sanitarium in 1902, pioneered by Dr. H. Eugene Stafford, then a captain of the staff of General Douglas MacArthur and Head of the bureau of civil hospitals and sanitarium. It began as a convalescent sanitarium in a small grass-roofed building at the former site of Pines Hotel or the present exact location of Shoe Mart (SM) Baguio. The construction of a larger hospital building that would accommodate at least 60 patients was completed by the end of 1902. It was renamed Baguio Hospital in 1907 and expansion programs were undertaken. By 1937, Baguio Hospital's name was changed to Baguio General Hospital but its first concrete hospital building, which inaugurated in 1941, was destroyed during WWII. The main hospital building was reconstructed much later in 1948.

By 1958, BGH had recovered and progressed further such that it was designated as one of the eleven training and teaching hospitals in the Philippines. The hospital received accreditation from the Philippine Medical Association, Philippine College Surgeons and from other professional accreditation societies for all the services and residency training programs it deemed necessary to provide.

The BGH was renamed Dr. Efrain C. Montemayor Medical Center (DECMMC) by virtue of Batas Pambansa BLG. 175 passed on December 14, 1981. On July 24, 1989, Republic Act 6789, was passed changing its name to "Baguio General Hospital and Medical Center" or BGHMC. Republic Act No. 7185 approved on January 30, 1992, increased its bed rapacity from 350 to 400 beds.

Since BGHMC was the only Level IV government training hospital in CAR, it was designated as the end referral center north of Manila. The BGHMC serves its primary catchment areas such as Baguio City, Benguet and the rest of Cordillera Administrative Region (CAR). The secondary catchment areas are towns located in eastern part of Pangasinan and La Union, Nueva Ecija, other towns of Pangasinan, Ilocos Province, Cagayan, Isabela, Nueva Vizcaya and some provinces in Region III.

Due to the increase in bed occupancy rate to 97.07% in 1997, the hospital's bed capacity could no longer accommodate the increasing health needs of its catchment areas. Thus, Republic Act 8634 was approved on May 7, 1998 upgrading and increasing the bed capacity of the Baguio General Hospital and Medical Center from 400 beds to 500 beds. It is likewise noted that between 1998 and 2014 the population of the primary catchment areas served by BGHMC has more than doubled, from 746,168 to 1.74 million. caITAC

II. Objective

This Administrative Order sets the Implementing Rules and Regulations to fast track the institutional development of BGHMC in compliance with policy implementation requirements of R.A. No. 8634 "An Act increasing the Bed Capacity of the Baguio General Hospital and Medical Center, located in Baguio City, from Four Hundred (400) to Five Hundred (500) Beds and Appropriating Funds Therefor."

III. Definition of Terms/Acronyms

1. AO No. 2012-0012 — refers to "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines", dated July 18, 2011

2. Bed capacity — refers to the number of beds offered by the hospital for inpatient care

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

4. BGHMC — refers to Baguio General Hospital and Medical Center

5. IHOMP — refers to Integrated Hospital Operations and Management Program

6. IRR — refers to Implementing Rules and Regulations of Republic Act No. 8634

7. Republic Act No. 8634 — refers to "An Act increasing the Bed Capacity of the Baguio General Hospital and Medical Center, Located in Baguio City, from Four (400) Hundred to Five (500) Hundred Beds and Appropriating Funds Therefor."

8. Referral hospital — refers to health care institution capable of accepting referrals from lower level hospitals and render and specialized health care services

IV. Policies and Guidelines

A. General Policies

The BGHMC, as a general, teaching and training hospital with a five hundred (500) bed capacity, shall provide tertiary level of curative, promotive, preventive and rehabilitative care and likewise do research and provide professional training programs. It shall be fully equipped with state-of-the-art facilities, equipment and adequate and competent human resource complement.

Furthermore, the BGHMC shall strengthen its existing services. It shall aim for the improvement of its service capability and capacity while continually serving as a Level 3 referral hospital in the region. The increase in bed capacity shall be consistent with the updated Development Plan of the Baguio General Hospital and Medical Center, which shall cover for at least a 500-bed capacity hospital.

With Department Order 2011-0188, "Kalusugang Pangkalahatan Execution Plan and Implementing Arrangements", the BGHMC is mandated to provide universal health care. Thus, implementation of Republic Act 8634 shall be responsive to the provision of Section 15, Article II of the Philippine Constitution, which is to protect and promote the right health of the people and instill health consciousness among them."

B. Implementing Mechanisms

In support of Republic Act No. 8634, the following shall be implemented:

1. Expansion of Services

By the end of 2016, BGHMC shall fully operate 500-bed level III teaching and training medical center with additional services and training programs. New training programs include, among others: neuroscience, family medicine, and emergency medicine. The BGHMC shall also add the development of the following services: cancer center, nuclear medicine, pulmonary, and high-end diagnostic services. Structural reorganization with the above additional services and programs shall be established and incorporated in its updated Hospital Development Plan.

2. Health Human Resource

The BGHMC shall continue to honor the positions, security of tenure and other rights of its human resource complement. The BGHMC shall evaluate existing health human resource requirement, reclassify and/or upgrade positions, promote professional development and/or hire additional staff to comply with DOH Standards for a Level 3 end-referral hospital in Northern Luzon. ICHDca

Increase in the number of health human resources shall be based on RA 8634, on the need to have additional services and programs recognized by accrediting institutions, and shall follow DBM-DOH Joint Circular No. 2013-1, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals CY 2013 Edition" dated September 23, 2013.

3. Assets and Liabilities

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

4. Equipment

The BGHMC shall make an inventory of all existing hospital equipment and undertake upgrading to conform to DOH standards appropriate for a Level 3 hospital under DOH AO 2012-0012. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of DOH.

5. Infrastructure

The BGHMC shall implement and seek the support of DOH for the construction, repair and 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. System Development

The BGHMC shall develop and sustain 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 requirements of the IHOMP.

7. Quality Management

The BGHMC shall strive to be ISO 9001:2008 certified by 2015. It shall implement and maintain continuing quality improvement standards recommend by the DOH, the Philippine Health Insurance Corporation (PhilHealth) and other health standards of international health organizations which are supportive of existing local and national standards.

V. Implementing Structure

1. Administrative Control

The highest DOH designated official for Office of Technical Services shall have oversight jurisdiction over the hospital operations of BGHMC, following Department Order No. 2011-0188. The DOH Cordillera Administrative Regional Office shall monitor the implementation of RA 8634 and may recommend further upgrading guided by this Administrative Order.

The Medical Center Chief of BGHMC shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit developmental plans, financial and statistical reports to the DOH Central Office through DOH Cordillera Regional Office. TCAScE

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of Republic Act No. 8634 shall be sourced out accordingly.

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/or other mode of financing scheme subject to 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, and/or other sources.

3. Personal Services to carry out the full implementation of the hospital staffing pattern of 500 bed capacity shall be implemented in compliance with DOH-DBM Joint Circular 2013-01 dated September 23, 2013 and other related issuances.

4. Release of funds from DOH shall be approved by the designated appropriate authority upon the recommendation of the highest designated authority of the Office of Technical Services.

VI. Repealing/Separability Clause

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

If any provisions of this order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected hereby shall remain valid and effective.

VII. Effectivity

This order shall take effect fifteen (15) days after publication in a newspaper of general circulation.

(SGD.) JANETTE LORETO-GARIN, MD, MBA-HActing SecretaryDepartment of Health