i.
Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY
MAY 11-2015
ADMINI: ATIVE ORDER
No. 2015- 90M
SUBJECT: Guidelines _on_the Deployment_of Physicians Graduating from
Residency Training Programs in Department of Health (DOH) -
Retained Teaching and T) 2 Hospitals
RATIONALE
In compliance with the provisions of Republic Act No. 10351 entitled “_An Act
Restructuring the Excise Tax on Alcohol and Tobacco Products by Amending Sections
141, 142, 143, 144, 145, 8, 131 and 288 of Republic Act No, 8424, otherwise known as
the National Internal Revenue Code of 1997, as amended by Republic Act No. 9334, and
for Other Purposes”; and Joint Circular No. 001.2014 or Implementing Rules and
Regulations for Section 288, Subsections (B) and (C) of the National Intemal Revenue
Code, as amended by RA 10351 of the Department of Finance, Bureau of Internal
Revenue, Department of Health, Department of Budget and Management, the DOH shall
ensure the availability of skilled health professionals who can deliver quality health care
services in health facilities.
As such the Department is exerting efforts to create responsive human resources for
health. With the growing inequitable distribution of medical professionals in urban-rural
areas, the Department is expanding its Residency Training Program in DOH-Retained
Teaching and Training Hospitals and Medical Pool Placement and Utilization Program,
including the deployment of resident physicians, as HRH complement in government
hospitals in priority poor and underserved areas.
This Order establishes the Guidelines for the deployment of physicians undergoing
residency training in DOH-Retained Teaching and Training Hospitals to LGU hospitals in
priority poor and underserved areas under the Medical Pool Placement and Utilization
Program (MPPUP). It revises AO 29 s.1994, which aimed to provide medical officers and
medical specialists in government hospitals
OBJECTIVES
A. To prescribe guidelines for the deployment of physicians under residency training in
DOH-Retained Teaching and Training Hospitals under the Medical Pool Placement
ai to identified LGU hospitals in priority poor and underserved
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1B. To provide an opportunity to assimilate graduates of residency training programs in
DOH-Retained Teaching and Training Hospitals in LGU Hospitals where they are
needed
C. To establish coordination mechanisms between DOH Health Human Resource and
Development Bureau (HHRDB), DOH Regional Offices, DOH-Retained Teaching
and Training Hospitals and Local Government Unit (LGU) Hospitals in providing for
the adequate and appropriate physician complement in priority poor and underserved
areas
I. SCOPE
WV.
This Order shall apply to the DOH Medical Poo! Placement and Utilization Program and
Level II DOH-Retained Teaching and Training Hospitals with accredited residency training
programs in the four major specialties namely: Internal Medicine, Pediatrics, Obstetrics and
Gynecology, and Surgery (refer to AO No. 2012-0012: Rules and Regulations Governing the
‘New Classification of Hospitals and Other Health Facilities in the Philippines).
Recipient hospitals shall include LGU-owned provincial/city/muni
priority poor and underserved areas.
al hospitals in identified
OPERATIONAL DEFINITION
‘A. Deployment — means by which select health professionals are physically transferred
to areas of need to complement existing health care providers
B. Development Management Officer - a representative of DOH Regional Office in
Local Health Boards in provinces, cities and municipalities; serves as the direct link
of the DOH to the local stakeholders especially the LGU:
C. DOH-Retained Teaching and Training Hospital — hospitals that are solely funded
and managed by the Department of Health following the enactment of Local
Government Code of 1991
D. Geographically Isolated and Disadvantaged Areas (GIDA) - communities with
marginalized populations, physically and socio-economically separated from
mainstream society such as island municipalities, up-land communities, hard-to reach
areas, and conflict areas or zones
E, Health Facilities Enhancement Program (HFEP) ~ refers to the financial assistance
provided to government-owned health facilities to satisfy licensing and accreditation
standards required by the DOH or its attached agencies
F. Hospital - a place devoted primarily to the maintenance and operation of health
facilities for the diagnosis, treatment and care of individuals suffering from illness,
disease, injury or deformity or in need of obstetrical or other surgical, medical and
nursing care. It shall also be construed as any institution, building or place where
there are installed beds, cribs or bassinets for 24-hour use or longer by patients in the
treatment of diseases. It is classified according to ownership, scope of services and
ripeness 2
Yfunctional capacity (refer to AO No. 2012-0012: Rules and Regulations Governing
the New Classification of Hospitals and Other Health Facilities in the Philippines).
Local Health Board (RA 7160) Composition: Local Chief Executive
(Mayor/Governor) as Chairman; Municipal/City/Provincial Health Officer as Vice-
Chairman; Sangunniang Bayanon Health, DOH Representative and non-government
organization representative. The local health board serves primarily as:
+ A policy recommending body on the planning and implementation of local health
programs;
+ A body that crafts budgetary allocation for the operation and maintenance of
health facilities and services and;
+ Adviser to the Sanggunian and other local government agencies
Local Government Unit (LGU) - (NSCB definition) Local Government refers to the
political subdivisions established by or in accordance with the Constitution. The five
political subdivisions of the LGU are: 1) Regional, 2) Provincial, 3) City, 4)
Municipal and 5) Barangay.
Medical Officer — based on Quality Standards of the Civil Service Commission, a
physician who has passed the physician licensure examination, with or without
previous clinical work experience
Medical Pool Placement Utilization and Program (MPPUP) — a DOH program
that deploys competent Medical Human Resource by providing medical officers
replacement in provincial and district hospitals who are sending their service residents
for training, augmenting medical specialist needed in government hospitals and
providing items for residency training to identified physicians who have rendered
government service.
Medical Residency — a clinical training leading to specialization in a particular
medical field
. National Household Targeting System (NHTS) - a data bank and information
management system managed by the Department of Social Welfare and Development
(DSWD) that identifies who and where the poor are. The system generates and
‘maintains the socioeconomic classification of poor households.
Organizational Structure and Staffing Pattern — a hierarchical arrangement that
defines how roles and responsibilities are assigned and coordinated; and the required
number, types and mix of personnel to fulfill those roles and responsibilities
|. Team of physicians — a group of specialist physicians from various clinical
specialties who can complement one another functionally (i.e. Obstetrician-
Gynecologist-Pediatrician, Surgeon-Anesthesiologist)
|. Underserved areas - communities with documented low levels of health system
performance as reflected in official government documents such as the LGU
Scorecard, NHTS data or NSCB reports hence, considered priority areas for health
service delivery
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GENERAL GUIDELINES
A
The deployment of physicians to LGU hospitals in priority poor and underserved
areas shall fall within the scope of the residency training program in DOH-Retained
Teaching and Training Hospitals and MPPUP.
Residents in DOH-Retained Teaching and Training Hospitals shall be deployed to
LGU hospitals in identified priority poor and underserved areas for a minimum
prescribed period of one year or as stipulated in their contract of service.
. Salaries, allowances, per diems and benefits of deployed physicians holding a
Medical Officer III position under DOH shall be drawn from the funds of DOH Rural
Health Practice Program subject to financial resources allocated by RA 10351
SPECIFIC GUIDELINES
A
Selecting underserved areas for deployment
Recipient LGU hospitals in underserved areas shall be identified by Provincial Health
Officers (PHO) based on, but not limited to, the following factors:
1. Geographic location and socio-economic classification of the area (GIDA,
Indigenous Cultural Community/Indigenous People Area, and National Priority
Area for Poverty Reduction (NAPR)) based on the National Household Targeting
System (NHTS) and other similar targeting systems or programs.
2. Need for additional medical staff to cover the outpatient department, emergency
room and inpatient areas in the four major specialties, but not limited to: Internal
Medicine, Pediatrics, Obstetrics and Gynecology, and Surgery according to the
prescribed Organizational Structure and Staffing Pattern for a given hospital level
3. Need for additional staff in the following positions, but not limited to: chief of the
medical service, head of a clinical department, medical officer of the pathology
department, medical officer of the radiology department
4, Ability to meet minimum DOH licensing requirements and PhilHealth
Accreditation requirements
5. Evidence of inclusion in the Province-wide Investment Plan for Health, and a
fully or partially functional Human Resources for Health Management and
Development System (HRHMDS) that include a HRH Planning System;
Recruitment, Selection and Placement; Retention and Succession Planning to meet
and finance the Organizational Structure and Staffing Pattern requirements of the
hospital. When a HRHMDS is partially functional or absent, the Chief of
Hospital, together with the Local Chief Executive, must provide evidence of
efforts to fully install a HRHMDS or a justification on why they cannot finance
the needed medical specialist/s
otpscnbr4.85 4B. Deployment of residents from Residency Training Programs in DOH-Retained
Teaching and Training Hospitals to LGU Hospitals in identified priority poor
and underserved areas
1. Prior to acceptance in the residency training program, the applicant shall sign a
contract of service, which stipulates that the deployment and rendering of services
to a rural and underserved LGU hospital is part of the residency training program,
the roles and responsibilities of a deployed physician, duration of deployment and
compensation. A contract shall be forged among the following: resident physician,
Chief of the DOH-Retained Teaching and Training Hospital, DOH Regional
Office ctor, and DOH HHRDB Director.
2. Deployment to form/complement a team of physicians rendering services in the
following clinical departments: Intemal/Family Medicine, Pediatrics, Obstetrics
and Gynecology Surgery, and Anesthesiology, at the minimum, shall be preferred
but may include their sub-specialties and ancillary services depending on need.
3. Upon deployment, the physician shall occupy a full-time Medical Officer III
position under the DOH serving a minimum of 40 hours per week.
C. Functions and Entitlements of Deployed Physician
The deployed physician shall:
1. Fulfil the requirements needed to enter into the Medical Pool Placement and
Utilization Program
2. Perform duties and functions of a deployed physician in a designated LGU
hospital for a minimum of one (1) year, or as stipulated in the contract.
3. Receive salaries, allowances and other benefits of a Medical Officer III or its
equivalent which shall be drawn from DOH Rural Health Practice Program funds
subject to financial resources allocated by RA 10351.
4, Receive a Certificate of Completion of Residency Training Program from the
DOH and its corresponding Teaching and Training Hospital after a satisfactory
completion of the residency training and one-year deployment service
5. Receive a Certification for services rendered from the recipient LGU hospital
VII. ROLES AND RESPONSIBILITIES
‘A. DOH-Retained Teaching and Training Hospitals shall:
1. Select applicants for residency who meet the minimum eligibility requirements
with a preference to those who intend to practice in a rural and underserved area.
oupsaniaess 5
»2. Implement and monitor the accredited residency training programs based on the
standards set by the Specialty Boards and the Professional Regulatory Board of
Medicine
3. Coordinate with the DOH Regional Office for the matching of resident physician
to a recipient LGU hospital.
4. Coordinate with the Development Management Officer of the DOH Regional
Office for the performance evaluation of the deployed physician.
5. Sign a Certificate of Completion of Residency Training Program upon satisfactory
‘completion of the residency training program and deployment services, and
clearance from hospital accountabilities.
B. Recipient LGU hospital shall:
1. Submit a request for needed physician complement according to the prescribed
Organizational Structure and Staffing Pattern of the hospital including an up-to-
date HRHMDS report to the DOH Regional Office (Human Resource
Development Unit) signed by the Chief of Hospital and Local Chief Executive.
This request must be accompanied by a justification on why the needed physician
complement could not be secured or financed by the hospital or local government.
2. Sign a contract or agreement with DOH Regional Office and DOH HHRDB
which stipulates their duties and responsibilities with respect to the deployment of
physician or team of physicians,
3. Support the Health Facilities Enhancement Program of the DOH to upgrade
physical conditions and services as necessary.
4, Evaluate the performance of the deployed physician.
5, Issue a certificate of services rendered to the deployed physician/s upon
satisfactory completion of the deployment service and clearance from hospital
accountabilities. This certificate shall be signed by the Chief of Hospital, Local
Chief Executive, and DOH Regional Director.
6. Endeavour to retain the deployed physician/s by providing employment and other
incentive mechanisms,
The Local Health Board shall:
1. Nominate or endorse qualified physicians residing in their respective LGUs to the
Development Management Officer of the DOH Regional Office for entry into the
DOH Residency Training Program.
2. In coordination with LGU Hospital, endeavor to retain the physician/s by
providing employment and incentive mechanisms.
etch 85 6 ODD. The DOH Regional Offices shall:
1
E. DOI
1
Evaluate LGU requests based on the following criteria:
a. No available or vacant Medical Officer III items in the requesting LGU
hospital
b. LGU hospital has an average of more than 100% occupancy rate per approved
bed capacity
c. LGU qualifies as an underserved area according to this AO (A. Underserved
areas for deployment)
Submit to DOH-HHRDB the list of recipient LGU hospitals and request for
needed physician complement.
Coordinate with the LGU Hospital for the placement of residents to occupy
Medical Officer Positions based on the allocated MPPUP items provided by DOH
HHRDB.
In coordination with the recipient LGU Hospital, conduct social preparation and a
pre-deployment orientation seminar for the deployed physician/s for the proper
discharge of his/her functions according to the service needs of the area.
Conduct administrative procedures including processing of contracts and
evaluation of recipient LGU hospitals.
Health Human Resource Development Bureau shall:
Develop policies and standards for the implementation of the various deployment
and placement programs for physicians.
Provide overall supervision and proper alignment of residency training programs
in DOH-Retained Teaching and Training hospitals to MPPUP and deployment of
physicians in LGU Hospitals in priority poor and underserved areas.
Provide distribution list and budget allocation to respective DOH Regional Offices
for the implementation of this Order allocated through the RA 10351 funds
Regularly evaluate the impact of the deployment programs for the continuous
improvement of its policies and guidelines.
Issue a Certificate of Completion of Residency Training Program to resident
physicians upon satisfactory completion of the residency training program and
deployment service and clearance from hospital accountabilities. This certificate
shall be signed jointly by the Department Chair, Training Officer, and Chief of
Hospital of the DOH Teaching and Training Hospital, DOH HHRDB Director and
Sceretary of Health.
a) (
sand 7Vill. FUNDING SOURCE
Funds for the salaries, allowances and other benefits of deployed physicians shall be
lodged under DOH-HHRDB’s Rural Health Practice Program subject to financial
resources allocated by RA 10351
Vi TRANSITORY CLAUSE
XI.
Current resident physicians in training are not covered by this AO, but only incoming
applicants to the MPPUP and residents who sign a contract of service.
REPEALING CLAUSE
Provisions of Administrative Order No. 29 s. 1994: “Medical Human Resource
Development and Placement Program (MHRDPP) of the Department of Health”, and all
other issuances inconsistent with the provisions of this Order are hereby rescinded and
modified accordingly.
#%, SEPARABILITY CLAUSE
xu.
If for any reason, any part or provision of this Order be declared invalid or
unconstitutional, such shall not affect the other provisions which shall remain in full force
and effect.
“ EFFECTIVITY
This Administrative Order shall take effect fifteen (15) days after publication in an
official online or print media of general circulation.
JANETTE, doudthttdan, MD, MBA-H
ee
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