Implementing Rules and Regulations of Republic Act No. 9792

June 7, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0015

 

I. Rationale/Background

The Southern Philippines Medical Center (SPMC), formerly Davao Public Hospital then became Davao General Hospital, before it became Davao Medical Center (DMC), was originally established in 1917. Through Republic Act No. 1859, dated June 22, 1957, the Davao General Hospital was converted into Davao Regional Medical and Training Center (DRMTC). In 1986, DRMTC was changed to Davao Medical Center (DMC) with a 200-bed capacity general hospital. It was also in this year that the Nervous Disease Pavilion at DMC was transferred to the Mental Hospital as Department of Psychiatry of DMC through Ministry of Health's Administrative Order No. 12. In 1992, DMC was upgraded to 400-bed capacity general hospital through R.A. 7210. The psychiatry department which is part of DMC is situated three (3) kilometers away from the main hospital. It is the largest government tertiary health care facility in Mindanao.

Despite of its 600-bed capacity, the DMC remains inadequate to fully serve the public. The DMC serves the patients from the provinces of Region XI such as Compostela Valley, Davao del Norte, Davao Oriental, Davao del Sur, Davao Occidental, and Davao City as the primary catchment population. Being strategically situated, the DMC serves as end referral of patients from other provinces in Mindanao and other neighboring islands of the Visayas.

On November 19, 2009, R.A. No. 9792 "An Act Changing the Name of the Davao Medical Center in Davao City to the Southern Philippines Medical Center, Increasing its Bed Capacity from Six Hundred (600) to One Thousand Two Hundred (1,200), Upgrading its Service Facilities and Professional Health Care, Authorizing the Increase of its Medical Personnel and Appropriating Funds Therefor" was approved. Subsequently, the SPMC was licensed as a 1,200 bed Level 3 hospital. Aside from the four (4) major services, SPMC has other services licensed by DOH. These are Clinical Laboratory (Tertiary), Blood Bank, HIV Testing Laboratory, Pharmacy, Dialysis Clinic, Ambulatory Surgical Clinic, Diagnostic X-ray Services (Level 3), Specialized Diagnostic X-ray Services: Computed Tomography (CT-Scan) and Magnetic Resonance Imaging (MRI), Burn Unit, Rehabilitation Medicine, Respiratory Therapy Unit, Endoscopy, Laparoscopy, Interventional Radiology, Emergency and Trauma Medicine, Heart Institute, Kidney Transplantation, and Mental Health.

Due to its accessibility to other provinces in Mindanao, the bed occupancy rates (BOR) of SPMC in the last three (3) years (2013-2015), were 181% for general hospital (SPMC) and 84% for mental hospital, respectively.

The SPMC encountered the same perennial problem of any government institutions, such as the insufficient budgetary support, specifically for the Maintenance and Other Operating Expenses (MOOE) and inadequate health human resource complement. Consequently, this has further compromised the quality of the delivery of service.

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for Republic Act No. 9792, "An Act Changing the Name of the Davao Medical Center in Davao City to the Southern Philippines Medical Center, Increasing its Bed Capacity from Six Hundred (600) to One Thousand Two Hundred (1,200), Upgrading its Service Facilities and Professional Health Care, Authorizing the Increase of its Medical Personnel and Appropriating Funds Therefor."

III. Scope

These Rules and Regulations discussed in this Administrative Order shall only pertain to Republic Act No. 9792 to facilitate compliance therewith and achieve the objectives thereof.

IV. Definition of Terms/Acronyms:

1. Act — refers here to Republic Act No. 9792 entitled "An Act Changing the Name of the Davao Medical Center to the Southern Philippines Medical Center in Davao City, Increasing its Bed Capacity from Six Hundred (600) to One Thousand Two Hundred (1,200), Upgrading its Service Facilities and Professional Health Care, Authorizing the Increase of its Medical Personnel 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 as amended

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

4. 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

5. Level 3 Hospital — as classified in Administrative Order No. 2012-0012-A dated September 3, 2015

6. Medical Center — refers to a hospital staffed and equipped to care for many patients and a large number of kinds of diseases and dysfunctions using modern technology

7. PhilHealth — refers to Philippine Health Insurance Corporation

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

9. SPMC — refers to Southern Philippines Medical Center

V. Policies and Guidelines

A. General Policies

The SPMC shall provide a tertiary level of 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 and accredited Level 3 health care facility.

Further, the SPMC 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 SPMC.

B. Implementing Mechanisms

In support of the implementation of R.A. 9792, the following general guidelines shall be implemented:

1. Expansion of Services

The Southern Philippines Medical Center shall operate as a 1,200 bed — Level 3 hospital with the following services such as Clinical Laboratory (Tertiary), Blood Bank, HIV Testing Laboratory, Pharmacy, Dialysis Clinic, Ambulatory Surgical Clinic, Diagnostic X-ray Services (Level 3), Specialized Diagnostic X-ray Services: Computed Tomography (CT-Scan) and Magnetic Resonance Imaging (MRI), Burn Unit, Rehabilitation Medicine, Respiratory Therapy Unit, Endoscopy, Laparoscopy, Interventional Radiology, Emergency and Trauma Medicine, Heart Institute, Kidney Transplantation, and Mental Health, and be continuously upgraded to be a fully operational 1200-bed Level 3 hospital.

Structural reorganization with additional services shall be established based on the Hospital Development Plan.

Further, the SPMC shall maintain and expand its present accredited thirteen (13) residency training programs for physicians.

2. Health Human Resource

In case of detailed employees, the SPMC shall continue to honor the positions, security of tenure and other rights of its human resource complement. The SPMC 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 RA No. 9792.

The SPMC shall implement the maximum staffing standards following the DBM-DOH Joint Circular No. 2013-01 including provisions in its future amendments/revisions on standard for hospital with bed capacity beyond 500.

3. Assets and Liabilities

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

4. Equipment

The SPMC 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, and other regulatory agencies. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of DOH until the hospital attains its mandated status.

5. Infrastructure

The SPMC 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 SPMC 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 requirements of the Integrated Hospital Operations and Management Program (IHOMP).

7. Quality Management

The SPMC shall continually enhance and implement the quality standard policy being an accredited institution by TUV-SUD in conformance with ISO 9001:2008, as well as to improve and execute 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), 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 SPMC 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 Regional and Central Office.

The DOH Regional Office XI shall have oversight jurisdiction and control over the hospital operations of SPMC and shall monitor the implementation of R.A. 9792. Likewise, it 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 hospital upgrading, development and capacity building.

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of R.A. 9792 shall be sourced 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 modes of financing scheme 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 modes of financing scheme subject to prevailing government rules and regulations.

2.3. Personnel Services (PS) shall be appropriated and sourced from the GAA to carry out the full implementation of the standard staffing pattern appropriate to 1,200 beds.

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