Revised Implementing Rules and Regulations of Republic Act No. 7850

June 29, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0028

 

I. Rationale

Republic Act No. 7850, "An Act Providing for the Establishment of a District Hospital in the Municipality of Conner, Province of Kalinga-Apayao, and Appropriating Funds Therefor" was approved on December 24, 1994, paving the way for the establishment of Conner District Hospital (CDH). The Implementing Rules and Regulations (IRR) of the said Act was issued through Administrative Order No. FAE 11, dated August 24, 1998. Subsequently, CDH started its operation as an eight (8) bed capacity primary hospital in a dilapidated building of the main health center at Barangay Calafug, Conner. The CDH's bed capacity was later increased to 25 and was issued a License to Operate (LTO) as Level 1 hospital. Despite an increase in bed capacity, its human resource complement remained as that of an eight (8) bed capacity hospital.

The Conner District Hospital is located in a geographically isolated and disadvantaged area (GIDA). It serves patients from the municipalities of Calanasan, and Kabugao, (the capital town) and the upper part of the Province of Apayao, the neighboring municipalities of the Province of Kalinga such as Pinukpuk and Rizal, and the municipality of Tuao, Province of Cagayan Valley in Region II. The total catchment area has a bed population of 1:2,466 which is far beyond the ideal 1:1,000 bed population ratio. Hence, to comply with the ideal bed to population ratio, the area need 173 beds. By excluding the existing beds available from other local hospitals in the area, CDH should have at least a total of 128 beds. Due to the shortage in beds, human resource complement and equipment, the CDH has an average of three (3) patient referrals every week to Cagayan Valley Medical Center in Tuguegarao City which is more than 3 hours travel time by land. Hence, the average bed occupancy rate of the CDH in the last 3 years (2013-2015) is 56.47% which falls below the ideal 80%.

On January 2, 2006, the hospital was transferred to its new and permanent site in Barangay Ripang, Municipality of Conner upon completion of the main building that was constructed and funded through the assistance of the Department of Health (DOH). For the hospital to be classified as a Level 1 hospital (based on the AO No. 2012-0012 as amended), the DOH through the Health Facility Enhancement Program (HFEP) provided funds for the construction of the OPD Building, OR/DR Complex, Administrative and Dietary Buildings which were completed in 2015. At present, upgrading of the main building, constriction of morgue and upgrading of powerhouse and lines are ongoing.

It is in the above light, that these implementing Rules and Regulations are issued to further implement RA No. 7850 and upgrade CDH to a Level 2 hospital. ATICcS

II. General Objective

This Administrative Order sets to revise Administrative Order No. FAE 11 s. 1998 titled, "Implementing Rules and Regulations of Republic Act No. 7850, An Act Providing for the Establishment of a District Hospital in the Municipality of Corner, Province of Kalinga-Apayao, and Appropriating Funds Therefor", to upgrade the hospital service capability from Level 1 to Level 2 hospital with a corresponding upgrading of infrastructure, equipment, health human resource complement. The CDH shall increase its bed capacity by phases from 25 to 100 and or upon recommendation of the DOH-Cordillera Administrative Regional (CAR) Office.

III. Scope

The revised rules and regulations discussed in this Administrative Order shall only pertain to Republic Act No. 7850.

IV. Definition of Terms/Acronyms

1. Act — refers to Republic Act No. 7850 also known as an "Act Providing for the Establishment of a District Hospital in the Municipality of Conner, Province of Kalinga-Apayao, and Appropriating Funds Therefor".

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

3. AO 2012-0012-A — refers to AO No. 2012-0012 as amended dated September 3, 2015.

4. Bed Capacity — refers to the number of bed made available for in-patient care.

5. Bed Population Ratio — the ratio of hospital beds to catchment population that is usually expressed as the number of available hospital beds for every 1,000 population.

6. CDH — refers to the Conner District Hospital.

7. Level 1 Hospital — as classified in DOH Administrative Order No. 2012-0012-A.

8. Level 2 Hospital — as classified in DOH Administrative Order No. 2012-0012-A.

V. Policies and Guidelines

A. General Policies

The Conner District Hospital shall be fully equipped with state of the art equipment, upgraded facilities, complemented by adequately trained and competent health human resources appropriate for a licensed Level 2 hospital.

Furthermore, Conner District Hospital shall strengthen and improve its existing services and capabilities while continually serving as a referral hospital, complementing the services of local government health care facilities in the province and the region. The upgrading of hospital services shall be consistent with the Hospital Development Plan of CDH.

B. Implementing Mechanisms

In support of the implementation of RA No. 7850, the following guidelines shall be implemented:

1. Expansion of Services

The CDH shall operate as a Level 1 hospital with functional OR/DR/ICU (Operating Room, Delivery Room, and Intensive Can Unit) Complex and Pay Wards. It shall upgrade its capability to Level 2 hospital with corresponding increase in beds by phases in a period of three (3) years from CY 2017 with well-trained health human resource complement.

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

2. Health Human Resource

In case of staff deployment as a result of the DOH Rationalization Plan, the CDH shall continue to honor the positions, security of tenure, and other rights of its human resource complement, reclassify 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 the Act.

The CDH shall implement the staffing standard of a hospital following the DBM DOH Joint Circular No. 2013-01, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals, CY 2013 Edition" dated 23 September 2013.

3. Assets and Liabilities

All movable and immovable assets, liabilities and obligations and records of the CDH shall be properly updated and accounted for in accordance with existing policies and guidelines.

4. Equipment

The CDH shall make an inventory of its existing hospital equipment and undertake upgrading to conform to DOH minimum standards for a Level 2 hospital. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of DOH.

5. Infrastructure

The CDH 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 CDH 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 CDH shall enhance and implement Continuing Quality Improvement Program, Patient Safety, standards on the Manuals of Hospital Operations issued by the DOH-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 CDH shall implement the quality management system in conformance with ISO 9001:2008 certification standards.

VI. Implementing Structure

1. Administrative Control

The Chief of Hospital of CDH 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 the DOH-CAR Office.

The DOH through the CAR Office shall have oversight jurisdiction and control over the hospital operations. It shall monitor the implementation of this Order. TIADCc

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 further carry out the provisions of R.A. No. 7850 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 the 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;

2.3. Personnel Services (PS) to carry out the full implementation of the staffing pattern of 50 beds in compliance with DOH-DBM Joint Circular 2013-01 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

The Administrative Order No. FAE 11 s. 1998 providing the Implementing Rules and Regulations of RA No. 7850 and other provisions of previous issuances that are inconsistent or contrary to the provisions of this Order are hereby repealed, revised 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