Revised IRR of Republic Act No. 8536

May 10, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0012

 

I. Background/Rationale

The Far North Luzon General Hospital and Training Center (FNLGHTC) is a national hospital created by virtue of RA No. 8536, "An Act Establishing the Far North Luzon General Hospital in Quirino, Municipality of Luna, Province of Apayao, and Appropriating Funds Therefor". Section 1 of the said Act states that "There is hereby to be established in Quirino, Municipality of Luna, Province of Apayao, a general hospital under the direct supervision of the Department of Health which shall be known as the Far North Luzon General Hospital and Training Center which shall be financed by the Department of Health and the Provincial Government."

On August 24, 1998, the Implementing Rules and Regulations of RA No. 8536 was issued, and on the following year, the hospital started its operations as an infirmary in a four-room public elementary school building in Tumog, Luna, Apayao. Subsequently, on September 15, 2001 the hospital was transferred to its leased vacant buildings of the Catholic Mission School in Poblacion Luna, Apayao. On February 17, 2004, the FNLGHTC was licensed as a Level 2 hospital and in 2005, was accredited by the Philippine Health Insurance Corporation (Philhealth). The FNLGHTC moved to its permanent site in Quirino, Luna, Apayao upon the completion of the construction of the hospital building in 2010.

At present, the FNLGHTC is categorized as a Level 1 hospital catering to the health needs of the geographically isolated depressed areas (GIDA) of Apayao and Kalinga provinces of Cordillera Administrative Region (CAR) and its neighboring municipalities in Regions 1 and 2. It has available services such as Surgery, Dialysis, CT-scan, Endoscopy, Ultrasound, Laparoscopy, ENT, Nephrology, Opthalmology, Gastroenterology, Urology and Orthopedics in addition to its four basic services, i.e., Medicine, Pediatrics, Surgery, Obstetrics and Gynecology.

However, patients needing higher level of care are referred to the Cagayan Valley Medical Center in Region 2 (125 kilometers from FNLGHTC) or to Mariano Marcos Memorial Hospital and Medical Center, Batac City, Ilocos Norte in Region 1 (200 kilometers away from FNLGHTC). Furthermore, the bed occupancy rate (BOR) of FNLGHTC for the years 2013, 2014, 2015 are 119%, 109.25% and 127.50%, respectively. With the continuous increase in BOR, there is a need to increase the hospital's authorized bed capacity to accommodate the influx of patients. TCAScE

It is in the above light, that this revised Implementing Rules and Regulations is issued to fully implement RA No. 8536, thereby upgrading the FNLGHTC to a training/teaching institution and referral tertiary hospital.

II. Objective

This Administrative Order sets the revised Implementing Rules and Regulations of RA No. 8536, "An Act Establishing the Far North Luzon General Hospital in Quirino, Municipality of Luna, Province of Apayao, and Appropriating Funds Therefor."

III. Scope

The revised Implementing Rules and Regulations discussed in this Administrative Order shall pertain only to RA No. 8536.

IV. Definition of Terms and Acronyms

1. AO 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;

2. 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;

3. DBM-DOH Joint Circular No. 2013-01 — refers to the "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals, CY 2013 Edition" dated 23 September 2013;

4. FNLGHTC — stands for Far North Luzon General Hospital and Training Center;

5. Level 1 Hospital — as classified in Administrative Order No. 2012-0012-A;

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

V. Policies and Guidelines

A. General Policies

The FNLGHTC, currently a Level 1 hospital shall fully operate as a 200 bed Level 3 hospital within 3 years. It shall have a departmentalized medical and nursing service geared towards the development of a training health care facility with subspecialty services. The hospital shall be equipped with state-of-the-art infrastructure, facilities and equipment complemented with an adequate number of highly trained health human resources.

It shall continue to improve its service capability and capacity while serving as a tertiary end-referral hospital of district hospitals, other government and private health care facilities. The increase in bed capacity shall be consistent with the three-year Hospital Development Plan of FNLGHTC commencing FY 2017.

B. Implementing Guidelines

1. Expansion of Services

By the end of year 2017, the FNLGHTC shall operate as a 150-bed capacity, Level 2 hospital.

By the end of year 2019, the FNLGHTC shall operate as a 200-bed capacity, Level 3 hospital.

2. Health Human Resource

The FNLGHTC shall respect the positions, security of tenure and other rights of its human resources. It shall propose the upgrading of positions, training and development of staff and may hire additional staff in conformity with the DOH standards as per DBM-DOH Joint Circular No. 2013-01.

3. Assets and Liabilities

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

4. Equipment

The FNLGHTC shall make an inventory of its existing equipment and undertake upgrading to conform with the DOH minimum standards of a Level 3 hospital as provided for under DOH AO No. 2012-0012, as amended. Additional equipment and facilities to complement the expansion of services shall be procured with the support of the DOH until the hospital attains its mandated status.

5. Infrastructure and Facilities

The FNLGHTC shall implement and seek for the continuing support of DOH for the construction/repair/renovation of physical infrastructures from Level 1 to Level 3 hospital to conform with 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 cTDaEH

The FNLGHTC 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 requirement of the Integrated Hospital Operations and Management Program (IHOMP).

7. Quality Management

The FNLGHTC hospital management shall enhance and implement Continuing Quality Improvement Program, Patient Safety, standards prescribed in the Manuals of Hospital Operations and Management issued by the Health Facility Development Bureau (HFDB), other policies and standards provided by the DOH Health Facilities and Services and 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.

VI. Implementing Structure

A. Administrative Control

The Medical Center Chief of FNLGHTC 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 other provisions of RA No. 8536.

The DOH, through the CAR Regional Office 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.

B. Sourcing and Use of Funds

The amount necessary to carry out the provisions of RA No. 8536 shall be sourced 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 financing schemes subject to prevailing government rules and regulations.

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

3. Personnel Services (PS) to carry out the full implementation of the staffing pattern for 150 beds and 200 beds in compliance with DOH-DBM Joint Circular 2013-01 and other related issuances shall be sourced from the GAA.

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

VII. Repealing/Separability Clause

AO No. FAE 12 s. 1998 and other provisions of 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 a newspaper of general circulation.

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

Published in The Philippine Daily Inquirer on May 25, 2016.