Revised Implementing Rules and Regulations of Republic Act No. 7799

June 21, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0021

 

I. Rationale/Background

The Talisay District Hospital (TDH), was established in 1998 under Republic Act No. 7799 of 1994. An Administrative Order (A.O.) No. 16, dated April 24, 1998 was issued which provided the Implementing Rules and Regulations of the Act. The construction of the hospital was funded by the National Government and upon completion, the TDH was inaugurated on August 3, 1999 and became operational on August 5, 1999. The hospital was licensed by DOH as a Level 1 health facility with an authorized capacity of 10 beds. On October 10, 2013, Administrative Order No. 2013-0029 was issued which amended A.O. No 16 s. 1998 in order to implement and increase its bed capacity to 50 and operate as a level 2 hospital.

Initially, the TDH was envisioned to provide health services to the 22 densely populated barangays of Talisay City with a total population of 280,000 in addition to the population of the neighboring municipalities of the 1st and 3rd Districts of the Province of Cebu. In the Central Visayas Health Referral System (CVHRS) established by the DOH Regional Office 7, TDH was designated as the first referral hospital of all infirmary, Level 1 hospitals, and other health facilities in the southern part of Cebu Province before patients are referred to Vicente Sotto Memorial Medical Center which is located in Cebu City. The strategic location of TDH in Talisay City, made it the favored destination of various sports enthusiasts and serves as the immediate health facility for trauma, sports injuries, vehicular accidents, and the like.

The average annual admissions in the last 5 years (2011-2015) were 3,660 with 1,516 trauma cases and in the 1st quarter of 2016, there were 2,026 admissions. The TDH has had an average annual bed occupancy rate of 180.0% based on authorized bed capacity of 50 beds in the last 3 years (2013-2015). Due to lack of space, the excess 80% or 40 hospital beds were placed along the corridors to accommodate more in-patients who preferred to be confined at TDH. An average of 400 patients per year was referred to other hospitals for further management. Hence, TDH, a DOH Level 1 hospital is now implementing 100 beds despite the funding allocation which is appropriate only for a 50-bed capacity hospital. IAETDc

With the implementation of Department of Budget and Management-DOH Joint Circular No. 2013-01, dated September 23, 2013, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals, CY 2013 Edition" and the DOH-Health Facility Enhancement Program (HFEP), TDH was able to provide departmentalized clinical services in General Surgery, Obstetrics and Gynecology, Pediatrics, Internal Medicine, and Anesthesia that started in November of 2014. Since the establishment of the Major Operating Room in November 2014, there has been eleven (11), 139 and a total of 92 major surgeries performed in 2014, 2015, and 1st quarter of 2016 respectively.

In the DOH Philippine Hospital Development Plan, the TDH is envisioned to become a Trauma, Rehabilitation, and Sports Medicine Center in the Visayas. It is in the above light, that these revised Implementing Rules and Regulations are issued to further implement the Act.

II. Objectives

This Administrative Order sets the revised Implementing Rules and Regulations of the Act in order to implement a 250-bed capacity Level 2 hospital.

III. Scope of Application

These Implementing Rules and Regulations of R.A. No. 7799 supersede A.O. No. 2013-0029, dated October 10, 2013 and are adopted to prescribe new guidelines and procedures for the implementation of the Act in order to facilitate compliance therewith and achieve the objectives thereof.

IV. Definition of Terms/Acronyms

1. Act — refers to Republic Act No. 7799, "An Act Establishing a District Hospital in the Municipality of Talisay, Province of Cebu, to be Known as the Talisay District Hospital, and Appropriating Funds Therefor"

2. Administrative Order No. 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. 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 2 hospital — as classified in DOH Administrative Order No. 2012-0012

6. Level 3 hospital — as classified in DOH Administrative Order No. 2012-0012-A

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

8. Trauma-Capable Facility — A DOH licensed hospital designated as a Trauma Center

9. TDH — refers to Talisay District Hospital

V. Policies and Guidelines

A. General Policies

The TDH shall provide a secondary to tertiary level of promotive, curative, preventive, rehabilitative health care services with fully departmentalized medical and nursing services. It shall be equipped with state of the art equipment and facilities, complemented by adequately trained and competent health human resource.

Further, the TDH shall strengthen its existing services and shall aim for the improvement of its capability and capacity while continually serving as a referral hospital for trauma, rehabilitation and sports medicine complementing the services of local health care facilities in the province and the region. The increase in bed capacity shall be consistent with the Hospital Development Plan of TDH.

B. Specific/Implementing Guidelines

In support of the upgrading of the hospital, the following guidelines shall be implemented:

1. Expansion of Services

Being the favored destination of sports enthusiasts in Central Visayas, TDH shall operate as 100 bed capacity Level 2 hospital fully departmentalized clinical and services with additional capability and services in trauma, rehabilitation and sports medicine with health human resource complement.

In consideration of TDH's approved Master Development Plan wherein a 250-bed capacity four (4) storey Building 2 is being constructed (through HFEP 2015 and 2016 funding), the TDH shall increase its bed capacity from 100 to 250 and upgrade its capability to Level 3 upon recommendation of the DOH Regional Office VII.

2. Health Human Resource

In case of staff deployment resulting from the DOH Rationalization, the TDH 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 shall hire additional staff to comply and conform to the DOH standards pursuant to the purpose and intent of RA No. 7799. DcHSEa

The staffing standard of the hospital shall be based on 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 TDH as well as its liabilities and obligations shall be properly documented and be accounted for, following existing policies and guidelines.

4. Equipment

The TDH shall make an inventory of the existing hospital equipment and undertake upgrading to conform to DOH standards of a Level 2 hospital as provided for under DOH AO No. 2012-0012, as amended. Additional equipment and facilities that will complement with the expansion of services such as trauma, rehabilitation, and sports medicine shall be procured with the support of the DOH until the hospital attains its mandated status.

5. Infrastructure

The TDH shall implement and seek the support of the 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 TDH shall develop and implement 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 TDH shall enhance and implement Continuing Quality Improvement Program (CQIP), Patient Safety, DOH policies and regulations, standards of hospital operations prescribed in the manuals of hospital operations prescribed by the DOH-Health Facility Development Bureau (HFDB), Health Facilities and Services Regulatory Bureau (HFSRB), Philippine Health Insurance Corporation (Philhealth) and other health organization standards provided by international health organizations which are supportive of existing local and national standards.

VI. Implementing Structure

A. Administrative Control

The Chief of Hospital of TDH shall be accountable and responsible for the operations and management relative to the increase in bed capacity, upgrading of service capability and the implementation of the Act.

The DOH through the Regional Office VII shall have oversight jurisdiction over the hospital operations, and monitor the implementation of the Act and shall recommend 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.

B. Source of Financing

The amount necessary to carry out the implementation of Republic Act No. 7799 shall be sourced out accordingly.

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital income, PhilHealth payments, Public-Private Partnership and/or, other financial schemes subject to prevailing government rules and regulations.

2. The Maintenance, Operating and Other Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital revenue, PhilHealth payments, Public-Private Partnership and/or other financial schemes subject to prevailing government rules and regulations.

3. The budget for Personnel Services to carry out the full implementation of the approved hospital staffing pattern of a 250-bed capacity hospital shall be sourced from the GAA, hospital revenue, Philhealth payments, public-private partnership and/or other financial schemes subject to the prevailing government rules and regulations.

4. Release of funds from the DOH shall be approved by the appropriate authority.

VII. Repealing/Separability Clause

DOH Administrative Order No. 16 s. 1998, DOH A.O. No. 2013-0029, and other provisions from previous issuances that are inconsistent or contrary to the provisions of this Order is hereby rescinded and modified/revised accordingly. SCaITA

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 a newspaper of general circulation.

(SGD.) JANETTE P. LORETO-GARIN, MD, MBA-HSecretary of Health