Implementing Rules and Regulations of Republic Act No. 9793, Otherwise Known as "An Act Increasing the Bed Capacity of Eastern Visayas Regional Medical Center (EVRMC) in Tacloban City from Two Hundred Fifty (250) to Five Hundred (500), Upgrading its Services and Facilities and Professional Health Care, Authorizing the Increase of its Medical Personnel and Appropriating Funds Therefor

April 11, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0011

 

I. Rationale

The Eastern Visayas Regional Medical Center today had humble beginnings as a 10 bed hospital under the provincial government of Leyte. It opened its doors to the public initially in July 16, 1916 as the Leyte Provincial Hospital. With increasing demand for healthcare facilities, the hospital's absorptive capacity was gradually increased until it became a 40 bed hospital prior to the onset of World War II. The war wrought devastation and laid waste to much infrastructure and the hospital was one of the buildings that was rehabilitated under the Government Rehabilitation Program. The rehabilitation resulted to an increase in bed capacity to 100 beds.

In July 22, 1972, RA 6527 — An Act Amending RA 4764 by Merging Hospitals in Tacloban City and constituting them into a General Hospital to be known as the Speaker Daniel Z. Romualdez Memorial Hospital (SDZRMH) was enacted. A salient provision of this legislation was the merging of the three hospitals (the Tacloban City Hospital, the Leyte Provincial Hospital and the Speaker Daniel Z. Romualdez Memorial City Hospital (created by RA 4764) into one with a total bed capacity of two hundred fifty (250) Beds.

After the EDSA revolution, SDZRMH was renamed Tacloban City Medical Center (TCMC) per Memorandum Order No. 48 (dated November 12, 1986) by the Office of the President. Being a tertiary medical facility at the time of the passage of the Local Government Code, TCMC was identified as one of the DOH-retained hospitals in the region and remained a national government agency.

During the presidency of Fidel V. Ramos, by virtue of Republic Act No. 7289 (enacted March 24, 1992), TCMC was renamed as the Eastern Visayas Regional Medical Center (EVRMC) and was designated as the regional teaching-training hospital with the three-pronged mandate of SERVICE, TEACHING-TRAINING, and RESEARCH.

Being the regional teaching-training hospital and the apex hospital of the DOH Health Referral System in Region VIII, EVRMC has been burdened by issues common to all government hospitals such as but not limited to lack of space, skewed manpower to workload ratio and inadequate budget for maintenance, operations and other expenditures. SICDAa

Realizing the difficulties being encountered by the hospital, several bills were filed in Congress to increase its bed capacity and service capability by the region's representatives but their efforts were not met with success. It took years before House Bill 5927, a harmonized version of HB 2737 and HB 1651 filed by Congressman Ferdinand Martin "FM" Romualdez (1st District of Leyte) and Congressman Florencio "Bem" Noel (An Waray Party List) respectively was approved by both Houses of Congress. This bill was enacted and passed as Republic Act 9793 by President Gloria Macapagal-Arroyo in November 19, 2009.

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for the implementation of the provisions of R.A. 9793 — "An Act Increasing the Bed Capacity of Eastern Visayas Regional Medical Center in Tacloban City from Two Hundred Fifty (250) to Five Hundred (500), Upgrading its Service and Facilities and Professional Health Care, Authorizing the Increase of Its Medical Personnel and Appropriating Funds Therefor".

III. Definition of Terms/Acronyms

1. Act — refers here to Republic Act 9793 or R.A. 9793 otherwise known as An Act Increasing the Bed Capacity of Eastern Visayas Regional Medical Center in Tacloban City from Two Hundred Fifty (250) to Five Hundred (500), Upgrading its Service and Facilities and Professional Health Care, Authorizing the Increase of Its Medical Personnel and Appropriating Funds Therefor.

2. RO 8-EV — Regional Office 8-Eastern Visayas

3. EVRMC — Eastern Visayas Regional Medical Center

4. Level III — Refers to a health facility that shall have as minimum of Level II capacity including but not as limited to the following:

• Teaching or training hospital with at least two (2) accredited residency training program for physicians in any medical/surgical specialty and/or subspecialty;

• Provision for Physical Medicine and Rehabilitation Unit;

• Provision for ambulatory surgical clinic (ASC) — ASC in the Out-Patient Department or designate one of its major operating rooms in the OR complex solely for elective day surgeries;

• Provision for dialysis facility — hemodialysis or peritoneal dialysis or both.

IV. Policies and Guidelines

A. General Policies

The EASTERN VISAYAS REGIONAL MEDICAL CENTER shall be a provider of general, specialized, and sub-specialized health care and be fully equipped with all the updated equipment and facilities, complimented by adequately trained health human resource which is appropriate for a Level III health care facility.

Furthermore, it shall serve as the apex referral hospital of the Eastern Visayas Region and provide technical oversight over lower level health care facilities within the catchment area.

B. Implementing Guidelines

In support of Republic Act 9793, the following guidelines shall be implemented:

1. Redirection of Roles

A fully operational 500 Bed Multi-Specialty Tertiary, Teaching-Training Health Care Facility shall be implemented.

An increase of 50 beds annually shall be implemented from 2012-2016, until the full implementation of 500 bed capacity hospital compliant to the safety and other Department of Health (DOH) regulations and standards for a level III health facility, as stipulated under DOH AO 2012-0012 and its revisions.

2. Structural Re-organization

There shall be creation/re-organization of departments in all Divisions/Services as necessary for the organizational structure of a 500 Bed Level III Health Facility.

3. Health Human Resource Complement

EVRMC shall make an evaluation of its existing health human resource. It shall reclassify and upgrade positions and hire additional manpower to comply and conform to DOH standards as indicated in the Licensing Requirement Form for Level III hospitals. It shall include staff trainings and development seminars to further build up competency and skill enhancement among its employees.

Furthermore, it shall continue to honor the positions, seniority, security, and other rights of tenure of medical and non-medical personnel of the hospital. DHIcET

The upgrading and increase in manpower complement shall be done in phases and shall be reflected in the Implementation Plan.

4. Infrastructure, Facilities and Services

EVRMC shall evaluate its existing physical structure and upgrade if necessary to conform to safety and other DOH regulations and standards. It shall also upgrade its health service facilities to provide general and specialized healthcare services, conforming to the DOH standards for a Level III hospital.

The EVRMC shall implement its Hospital Infrastructure Development Plan.

5. Equipment

EVRMC shall make an inventory of its existing hospital equipment and undertake upgrading and procurement of additional general, medical and diagnostic equipment in order to conform to DOH standards for a Level III hospital, Philippine Health Insurance Corporation (PHIC) and specialty society accreditation requirements among others.

This shall be done in phases as defined in the Implementation Plan.

6. Systems Development

EVRMC shall continue to strengthen its existing health referral system, hospital operations and financial management systems. Moreover, it shall endeavor to pursue the implementation of standard hospital information and management systems through ICT development for the purpose of easy data accessibility, connectivity, and efficient knowledge management and storage.

7. Quality Management

EVRMC shall continue to pursue the implementation of Continuous Quality Improvement (CQI) programs, patient safety, policies and standards stated in the Philhealth Benchbook, DOH Hospital Score Card and the different Manuals of Standards for hospital operations and management among others. Furthermore, it shall develop or further strengthen its hospital resource management capability.

C. Implementing Structure

1. Administrative Control

The Medical Center Chief II of the Eastern Visayas Regional Medical Center shall be accountable and responsible for the operation and management relative to the increase in bed capacity, upgrading of service capability and the implementation of all the other provisions of RA 9793.

The DOH, through the Office for Health Operations (OHO) and Regional Office 8-Eastern Visayas shall have oversight jurisdiction over the hospital operations. It shall monitor the implementation of 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 Republic Act No. 9793 shall be included in the DOH Annual Budget Proposal subject to the approval of the DBM and the same shall be included in the annual General Appropriations Act (GAA).

EVRMC shall also tap other financing sources available like the proceeds from income retention mechanisms of the hospital, cost recovery, revenue enhancement, and implementation of user's fee in addition to Philhealth (PHIC) reimbursement and other health insurances to finance the upgrading of the facility.

The recurrent costs (MOOE, PS) shall be subsidized by government funds and augmented by other extra budgetary sources if needed.

V. Repealing/Separability Clause

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.

VI. 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