Local Health Facility

Development Plan
2022-2025
[NAME OF PROVINCE/CITY]
[Name of Province/City]
Local Health Facility Development Plan
2022-2025

Prepared by: XXXX

Position

Approved by: XXXX

PHB
 TABLE OF CONTENTS

PAGE
I. GOALS AND GAP ANALYSIS x
A. Vision of UHC x

B. Legal basis/Mandate x
(If there are relevant/enabling law other than PHFDP)

C. Supply, Needs, and Gaps (per facility type and equipment) x

D. National Allocation Framework x

1. Capacity vs. Gap of Health Facilities x

2. Estimated Cost of Health Facilities x

E. Health Care Provider Network x

1. Status of Provinces based on required facilities x

2. LGU Profile and Provincial Access Map x

3. Issues, Gaps and Recommendations in establishing x

individual HCPN

4. Tourist & GIDA areas (if applicable) x

F. Linkage of HCPNs to Apex Hospitals x

G. Linkage to Special Facilities x

II. PLANS AND TIMELINES x

III. IDENTIFICATION OF FINANCING SOURCES x

IV. ANNEXES x

A. List of Infirmaries and Hospitals x

CHAPTER I: Goals and Gap Analysis
A. The Vision of Universal Health Care for the Province

(Introduce your Province. Link with Chapter II of PHFDP. Preferably 2-4 paragraphs.)
● Geography and Demographics
● Socio-Economic Profile
● Existing Provincial Health Systems

Universal Health Care in the Province

Figure 1. Patient Flow Under The Universal Health Care

The Republic Act 11223 or Universal Health Care Act of 2019 envisions an
equitable, primary care-oriented, and integrated healthcare system through the creation
of province or city-wide Health Care Provider Networks (HCPN) where both public and
private health facilities are integrated to provide coordinated and comprehensive
healthcare.

As shown in Figure 1, the province of [insert name of province/city] aims to

create an HCPN consisting of the following:
● Primary care provider network (PCPN) composed of Barangay Health Station
(BHS) and Primary Care Facility (PCF);
● Levels 1 and 2 hospitals (and Level 3 hospitals owned by LGUs); and
● Ancillary facilities such as standalone birthing homes, standalone laboratories,
and dental clinics.

The HCPN will be linked to an apex hospital, a Level 3 single-specialty or a multi-

specialty general hospital, which serves as the end-referral center.

These facilities have different roles under UHC (see Figure 2). The Primary Care
Provider Network will provide individual and population-based primary care while
hospitals will provide inpatient general care. Apex hospitals, which are outside the
HCPN, will provide highly specialized care that is not available in the HCPN.
 Figure 2. Role of Health Facilities Under Universal Health Care

Associated with the goal of forming HCPN is to ensure that health facilities in the
province are climate-resilient and environmentally sustainable. Projects in the province
will include interventions for the four major areas namely (see Figure 3), 1. health
infrastructure, 2. energy, 3. water, sanitation, hygiene and healthcare waste, and 4.
health workforce.

Figure 3. Conceptual Framework: Building Climate-Resilient And Environmentally

Sustainable Health Care Facilities

B. Legal basis/Mandate
 ● List down and describe any relevant/enabling law other than PHFDP.
● May include local ordinances with specific mandates on health.
● Please include the implications of the mentioned policies in the Local
Health Facility Development Plan

C. Supply, Needs, and Gaps

Describe the current supply, in view of the standards. Preferably 1-2 paragraphs)

The supply of Primary Care Facilities, Level 1, 2 and 3 Hospitals, and priority
medical equipment are described in Tables 1-4.

The province has a total of [xx] Primary Care Facilities (Rural Health Units).
Private Primary Care Facilities will be added to the supply once with complete data.

Table 1. Supply and Gap in Primary Care Facilities

PCF (RHU)
Province/City No. of PCF:Pop Gap for 2020-
Population*
PCF (1:20,000) 2025
[Province/City Name]

(Indicate source of provided data (e.g Supply from validated data of the Provincial
Health Office, Projected 2021 population from DOH DC 2021-0053, etc)

The province has [xx] Level 1 beds, [xx] Level 2 beds, and [xx] Level 3 beds.

Table 2. Supply and Gap in Hospital Beds per Province/HUC

In-Patient Beds

Supply Gap
Province/
City Level 3
Populatio No. of No. of No. of Level 1 Level 2
Beds
n Level 1 Level 2 Level 3 Beds Gap Beds Gap
Gap for
Beds Beds Beds for 2025 for 2025
2025

[Province/
City
Name]

(Indicate source of provided data (e.g Supply from validated data of the Provincial
Health Office, Projected 2021 population from DOH DC 2021-0053, etc)

The province has [xx] Xray machines, [xx] CT Scan machines, [xx] MRI
machines, and [xx] LINAC machines

Table 3. Supply in Medical Equipment per Province/HUC

Province/City Supply Medical Equipment
 Xray CT Scan MRI LINAC

[Province/City Name]

Table 4. Gap in Medical Equipment per Province/HUC

Medical Equipment Gaps
Province/City
Xray CT Scan MRI LINAC

[Province/City Name]

D. National Allocation Framework

1. Capacity vs. Gap of Health Facilities

Figure 4. National Allocation Framework of the PHFDP 2020-2040

To promote equity, this regional and provincial plan follows the National
Allocation Framework in the PHFDP 2020-2040 (see Figure 4). This framework
categorizes LGU based on capacity parameters such as resources of the local
government, presence of Geographically Isolated and Disadvantaged Areas (GIDA) as
classified by the DOH, and the level of household income. The four (4) categories are
the following:
a. Category 1: Low Capacity and High Gap;
b. Category 2: Low Capacity and Low Gap;
c. Category 3: High Capacity and High Gap; and
d. Category 4: High Capacity and Low Gap.

The categories of the province/HUC/ICC based on the framework is shown in

Table 5. Moreover, the priority infrastructure per LGU as recommended by the PHFDP
2020-2040 based on the gaps are identified. The red color means high priority, blue
means medium priority, and green means low priority/no priority.

Table 5. Gaps and Priority Facility of the Province

 National Gap until 2025
Poverty
Province/City Priority
Incidence PCF L1 Beds L2 Beds
(Category)

[Province/City
Name]

High priority Medium priority Low Priority

Based on the category of the provinces/city what is the implication of the category
relative to funding support they can have. (2-3 paragraphs)

This is also relative to the DOH Devolution Transition Plan where services would be
partially and gradually re-devolved to LGUs. This will guide LGUs in exploring
possible sources other than financial support from the national government

2. Estimated Cost of Health Facilities

(Please indicate here the standard costing used for the plan. You may use your
provincial costing estimates.)

NOTE: Local proxy costs are preferred over the national level estimates to more
accurately reflect estimated investment needs of the province/city

SAMPLE: THIS IS BASED ON THE REGIONAL PLAN STANDARD COSTING

This regional plan has computed the investments needed in the region using
the standard cost estimates presented in Table 19.

Table A. Cost Estimates per Type of Facility in the Region (based on PHFDP 2020-
2040)

Table B. Estimated Cost of Health Facilities (in 2020 Prices) (based on PHFDP 2020-
2040)
 E. Health Care Provider Network

a. Status of Provinces based on required facilities

(Provide a narrative with 2-4 paragraphs)

Guide questions/statements:
● Situational Analysis of of current referral system
● Identify issues and gaps to comply with the provisions of AO 2020-0019.

b. LGU Profile and Provincial Access Map

● Refer to bit.ly/LGUprofiles for LGU Profile.

○ NOTE: LGU Profile is based on available data during the crafting
of the document, thus numbers/data should be validated from
your part

● Refer to bit.ly/PHFDP_AccessMaps for the Access Maps

○ NOTE: You may utilize your own access maps if available

Table 6. Profile of Province of [Name of Province/City]

Indicator Value

No. of Barangays

No. of BHS

BHS:Barangay Ratio

Population

No. of PCF

PCF per 20,000 people

No. of Infirmaries (government)

No. of Infirmaries (Private)

Level 1 beds (government)

Level 1 beds (private)

Level 2 beds (government)

Level 2 beds (private)

Level 3 beds (government)

Level 3 beds (private)

c. Issues, Gaps and recommendations in establishing HCPN

Guide questions/statements:
● Identify the gaps and issues in establishing the HCPN including the
proposed interventions to address the issues and gaps. (The target
setting section in Chapter 2 should reflect these interventions to
establish their HCPN and sustain its operations in the future)

d. Tourist & GIDA areas (if applicable)

Guide questions/statements:
● List the major tourist destinations in your province. Describe issues and
highlight planned interventions
● List the GIDA areas in your province. Describe issues and highlight
planned interventions

STANDARDS:
Standards for Emergency Response
● Local 911 Call Center Hotline ideally with a Geographic Information
System
● Rescue teams respond to the scene and facilitate transfer to the
appropriate health facility within one hour.
● At least one member per household in tourist destinations trained in
BLS.
● All boat men, travel guides, travel drivers, staff of commercial
establishments who engage with clients, and other people as authorized
by the LGU trained as first responders.
● Barangay Health Workers trained in First Aid.
● RHU nurses trained in First Aid and BLS and physicians trained in Basic
Emergency Care.
● Level 1 and 2 hospital physicians trained in Advanced Cardiac Life
Support (ACLS) and Advanced Emergency Care. Hospital nurses
trained in ACLS and Basic Life Support (BLS).
 Standards for Health Facilities
● Compliance to DOH Administrative Order 2020-0016 or the Minimum
Health Capacity Standards for COVID-19 Preparedness and Response
Strategies, and Infection, Prevention and Control Standards in DOH
Department Memorandum 2020-0268 or the Interim Guidelines on
Health Facilities in the New Normal.
● Established HCPN with a functional referral network in the locality.
● First aid kits available at all times in hospitals, RHUs, and Barangay
Health Stations (BHS).
● Availability of health emergency personnel and transport vehicles in all
accommodation establishments to cater to the emergency needs of their
client
● Hospitals and RHUs with adequate supply of drugs, medicines, and
supplies appropriate to the tourist destination’s health concerns (e.g.
specific antibiotics for destinations with certain infections, anti-venom for
destinations with high cases of snake bites, etc).

F. Linkage of HCPN to Apex Hospitals

1. Eligibility and Designation

Table 7. Apex Hospitals in Region II

Apex Hospitals Government Private

Cagayan Valley Medical Center ● ●

Southern Isabela Medical Center ● ●

Region 2 Trauma and Medical Center ● ●

There are 3 apex hospitals in the region which are all DOH Retained hospitals.

2. Linkage of HCPNs to Apex Hospitals

The province is matched based on geographic proximity. The apex hospitals for
the region are Cagayan Valley Medical Center, Southern Isabela Medical Center and
Region 2 Trauma and Medical Center. The identified apex hospital for the province of
[insert name of province] is [insert name Apex hospital].

Table 8. Matching of Provinces/HUC with Apex Hospitals

Province/City Matched Apex Hospitals
[insert name of
[insert name Apex hospital matched to the HCPN]
province/city]
 The specialty services provided by the apex hospitals including the proposed
specialty centers for the region are described in Table 9.

Table 9. Specialty Services Provided by Apex Hospitals

G. Linkage to Special Facilities

While core facilities such as health stations, primary care facilities, and hospitals
in health care provider networks (HCPNs) are meant to provide care for the majority of
patients, particular services require specialized care from facilities with capability to
cater to specific patient populations for particular procedures and overall care. These
Special Facilities are meant to complement HCPNs.

Table 10. List of Existing and Proposed Special Facilities linked to the HCPN

Matching of Special Facility Existing Proposed

Blood Centers [insert name special facility] ● ●

Specialized [insert name special facility] ● ●
Laboratory
DATRC [insert name special facility] ● ●
Military Health [insert name special facility] ● ●
Facilities

Table 11. Gaps in the linkage of Special Facilities to the HCPN

Remarks
Blood Centers [Identify issues and gaps]
Specialized [Identify issues and gaps]
Laboratory
DATRC [Identify issues and gaps]

Military Health [Identify issues and gaps]

Facilities
CHAPTER II: Plans and Timelines
A. Target Setting for Closing the Gaps in Health Facilities

From validated total gaps of your province/city, kindly include a narrative of the
following:
● Identify the annual targets for the medium term
● Parameters / Prioritization framework used by the LGU in setting the targets
● Proposed strategies to accomplish targets

After gaps per health facility are identified through validation of data and in
consideration of the establishment of HCPNs, targets should be set on how these gaps
are to be addressed. The engagement of other sectors are also an essential
consideration in the crafting of the plans. In PHFDP, existing private market penetration
was used to determine private-public share. The province can also adapt that or
indicate the public-private share that the province would want to pursue.

Table 12. Targets to close the gap per medium-term, disaggregated into public and
private share
Gap in 2022 Gap in 2023 Gap in 2024 Gap in 2025

Primary care
BHS 100% No gap No gap No gap
Primary care facilities 100% 100% 100% 100%
Public 100% 100% 100% 100%

Level 1 Hospitals 100% 100% 100% 100%

Public X% X% X% X%
Private X% X% X% X%

Level 2 Hospitals 100% 100% 100% 100%

Public X% X% X% X%
Private X% X% X% X%

Level 3 Hospitals 100% 100% 100% 100%

Public X% X% X% X%
Private X% X% X% X%

(Each province can make their own schemes as to the annual targets. These
schemes can be based on the fiscal space and capacity of the LGU to implement the
said projects.)

Table 13. Annual targets per facility type in the medium term
2022 2023 2024 2025
Qty & HR Qty & HR Qty & HR Qty & HR
FACILITIES Descri comple Descri comple Descri compl Descri compl
ption ment ption ment ption ement ption ement
Barangay 1 New
Health constru 1 Nurse
Station ction
Primary Care
Facilities
Level 1 Beds
Level 2 Beds
Level 3 Beds
(regional)
CHAPTER III: Identification of Financing Sources

Discuss in details your financial strategies to achieve the identified targets)

Table 14. Total cost of annual investments and respective sources of funds
2022 2023 2024 2025
Sources Source Source Source
FACILITIES Total Total Total Total
of s of s of s of
Cost Cost Cost Cost
Funds Funds Funds Funds
Barangay
Health 2.5 M LGU
Station
Primary Care
Facilities
Level 1 Beds
Level 2 Beds
Level 3 Beds
(If regional)

SOURCES OF FINANCING

LGU ● The province and municipalities should broaden tax and non-
revenue tax base revenues to finance health infrastructures.
(tax and ● Re-allocate less efficient expenditures to health infrastructure
non-tax expenditures. This could be explored especially among
provinces with relatively low health spending to total public
expenditures (less than 5%).

IRA and ● Allocate higher IRA to finance health and health

national infrastructures. In the medium to long-term, higher IRA share is
share expected because of the Mandanas ruling.

PhilHealth ● Provinces and HUCs need to maximize PhilHealth income to

finance health expenditures. Explore the possibility of using
PhilHealth income to finance MOOE and capital outlay. In
theory, provinces are not precluded to use PhilHealth income
to finance capital outlay.

Loans ● The local government should explore loans from financial

institutions.

HFEP ● Based on national allocation framework

PPP ● Private-public partnerships based on existing guidelines (LGU

P4, etc)
 ANNEXES
List of Infirmaries and Hospitals in the Province

6.
Name of Facility Type Authorized Bed
Capacity

7.
[Insert other stakeholders who contributed to make the P/CWHS HFDP
HFDU, HFDB, UHCC, CHD, SPECIFIC PROVINCIAL LOGO/SEAL and others]