Committing Full Support to the Rationalization Program of

Committing Full Support to the Rationalization Program of the Department of Health Per Executive Order 366, s. 2004 NSM Resolution No. 2005 -01 -02 Alexander A. Padilla Undersecretary Chair, Change Management Team National Staff Meeting April 19 – 21, 2006 1

NSM Resolution No. 2005 -01 -02 Commit all efforts and resources in implementing the DOH Rationalization Program § Review and evaluate proposals and suggestions on personnel movement § Create a Speaker’s Bureau that will be responsible in the dissemination of vital information relative to the guidelines and processes of the Rationalization Plan § Implement the moratorium of post residency dispersal program § National Staff Meeting April 19 – 21, 2006

NSM Resolution No. 2005 -01 -02 updates Rationalization Plan for CHDs, Hospitals, and attached agencies completed § Central DOH Rationalization Plan for further study § Information relative to the guidelines and processes of the Rationalization Plan disseminated through the CMT and CMT sub-committees § Moratorium of post residency dispersal program through Department Memorandum No. 2005 -0180 dated 28 December 2005 § National Staff Meeting April 19 – 21, 2006

NSM Resolution No. 2005 -01 -02 critical issues Employees opting for retirement under EO 366 whose positions cannot be declared redundant. § Employees requesting for transfer to other offices § Excess in the PS requirement especially in hospitals § Upgrading of entry level positions at CHDs and Hospitals from Salary Grade 1 - 5 to SG 6 § National Staff Meeting April 19 – 21, 2006

Rationalization Plan for Centers for Health Development National Staff Meeting April 19 – 21, 2006 5

Basis for Staffing Requirements based on Phil. Health index for small, medium, and large regions but excluding staffing for special concerns e. g. BFAD satellite laboratories, HMS, etc… § 200 personnel for small regions § 225 personnel for medium regions § 250 personnel for large regions § Staffing proposal not to exceed current PS budget § Some CHD services shall be outsourced e. g. janitorial, security, etc… § National Staff Meeting April 19 – 21, 2006

Proposed Changes in the Centers for Health Development § There shall only be one (1) Office of the Director composed of § § CHD Director Deputy Director Respective Support Staff There shall only be two (2) Divisions in the CHD CURRENT PROPOSED Administrative Technical Services Budget and Finance Health Manpower Development and Training Local Health Support Regulations National Staff Meeting April 19 – 21, 2006

Proposed Changes in the Centers for Health Development § Medical Specialist positions in the CHDs shall be renamed as Medical Officer positions (MO V, VII). § Nurse positions shall also be progressed § § i. e. provide Nurse III, IV, V positions DOH representatives shall be renamed as Development Management Officers (DMO). § DMO IV for provinces and chartered cities § DMO III for municipalities and chartered cities § § Each Provincial Health Team shall have one Administrative Officer I and one Administrative Aide One (1) Sanitary Inspector Supervisor and one (1) Midwife Supervisor to provide technical assistance to and address concerns of local sanitary inspectors and midwives National Staff Meeting April 19 – 21, 2006

Proposed Changes in the Centers for Health Development § § One (1) Consumer arbitration Officer , SG 18 Legal Researcher positions, SG 18 Legal Officer/Attorney incumbents on permanent status shall be converted to Co-terminus with the Incumbent (CTI) status. § Legal Officer/Attorney incumbents on temporary status shall be offered Legal Researcher position with reduced salary § § All positions under the BFAD satellite and reference laboratories shall be part of CHD plantilla § All positions in the quarantine stations at the CHDs shall be transferred back to the BQHIS National Staff Meeting April 19 – 21, 2006

Proposed Changes in the Centers for Health Development § There will be no filling up of vacant Malaria / Schistosomiasis / Filaria and traveling skin clinic items. Such services shall be slowly devolved to the LGUs Positions under the Malaria / Schistosomiasis / Filaria shall be declared redundant. § Incumbents who do not wish to retire shall be declared their positions CTI or be given priority to be absorbed in the vacant CHD positions. § Incumbents of traveling skin clinic shall be absorbed by the nearest sanitarium to the CHD, except when there is none, in which case it will remain with that CHD. § National Staff Meeting April 19 – 21, 2006

Proposed Changes in the Centers for Health Development § § § Positions under the Hospital Maintenance Services (HMS) shall be transferred to the nearest retained hospital within the region. Employees under Special Concern who will be absorbed in the vacant positions shall be re-tooled. Blood Center items shall be transferred to the proposed Philippine Blood Center Maximum number of driver-courier items shall be ten (10) Entry level positions will be Salary Grade 6. Incumbents of positions with SG 1 -5 will automatically be upgraded. However incumbents who do not meet the qualification standards for SG 6, shall be declared Co-Terminus with the Incumbent (CTI). National Staff Meeting April 19 – 21, 2006

DOH REGIONAL OFFICE OF THE DIRECTOR IV & DIRECTOR III Medical Centers Regional Hospitals Retained Hospitals Sanitaria Management Support Staff Special Concerns LOCAL HEALTH SUPPORT RESU/HEMS REGULATIONS DOH (name) Field Extension Office (province) (formerly PHTO) National Staff Meeting April 19 – 21, 2006

LOCAL HEALTH SUPPORT/RESU/HEMS OFFICE OF THE DIRECTOR IV & DIRECTOR III OFFICE OF THE DIVISION CHIEF HEALTH SYSTEMS & FACILITY DEVELOPMENT PROGRAM SERVICE DEVELOPMENT RESU/HEMS HUMAN RESOURCE DEVELOPMENT UNIT National Staff Meeting April 19 – 21, 2006

REGULATIONS OFFICE OF THE DIRECTOR IV & DIRECTOR III OFFICE OF THE DIVISION CHIEF HEALTH FACILITY, SERVICES & TECHNOLOGY FOOD & DRUGS National Staff Meeting April 19 – 21, 2006

MANAGEMENT SUPPORT STAFF OFFICE OF THE DIRECTOR IV & DIRECTOR III OFFICE OF THE CHIEF ADMINISTRATIVE OFFICER* FINANCE PERSONNEL SUPPLY LEGAL UNIT INFO. MGNT. PLANNING & STATISTICS TRANSPORT & FACILITY MAINTENANCE INTERNAL AUDIT** *with RATA **for decision National Staff Meeting April 19 – 21, 2006

SPECIAL CONCERN OFFICE OF THE DIRECTOR IV & DIRECTOR III SPECIAL CONCERNS* • Hospital Maintenance Service • Collaboration Center • Malaria/Filaria/Schistosomiasis • BFAD Satellite Laboratory • Travelling Skin Clinic • Blood Center * only for selected regions National Staff Meeting April 19 – 21, 2006

Rationalization Plan for DOH Hospitals National Staff Meeting April 19 – 21, 2006 17

Strategic Shifts in Hospitals Implementing strategy § General health services § § § Highly capable services Upgraded facilities Specialized health services leading to corporate restructuring § Comprehensive provision of services § Devolution of primary and secondary services § High emphasis on medical services § Strengthening of public health services in hospitals National Staff Meeting April 19 – 21, 2006

Basis for Staffing Requirements Approved staffing Requirements for General Hospitals Classification of Hospitals i. e Teaching and Training, Research etc… § Needed positions based on authorized bed capacity per Republic Act § Percentage of Primary and Secondary Cases § Hospital Conversion Plan § § National Staff Meeting April 19 – 21, 2006

Staff Requirements Tertiary Hospital Bed Capacity No. of Positions 200 225 250 300 325 665 696 728 1, 091 1, 122 350 400 425 450 1, 154 1, 212 1, 243 1, 275 500 525 550 1, 385 1, 416 1, 448 National Staff Meeting April 19 – 21, 2006 20

Staff Requirements Bed Capacity No. of Positions Second Level Hospital 100 150 200 367 416 Primary Hospital 25 50 75 65 100 149 National Staff Meeting April 19 – 21, 2006 21

Proposed Changes for entry level positions in the Hospitals Entry level positions shall be Salary Grade 6. Incumbents of positions with SG 1 -5 will automatically be upgraded. However incumbents who do not meet the qualification standards for SG 6, shall be declared Co-Terminus with the I Incumbent (CTI). § Entry level for nurses shall be based on the provision of the Nurses Act which is SG 15 § National Staff Meeting April 19 – 21, 2006

Proposed Changes in the Position Title of Chief of Hospitals CURRENT PROPOSED Med. Center Chief II Med. Center Chief I 27 27 Chief of Hospital IV 27 27 Chief of Hospital III Chief of Sanitarium III District Health Officer II 26 26 Chief of Hospital IV Chief of Hospital III 27 26 26 Chief of Hospital II Chief of Sanitarium II 25 25 Chief of Hospital II 25 25 Chief of Sanitarium I Chief of Hospital I 24 24 National Staff Meeting April 19 – 21, 2006

Proposed Changes cont… § District Health Officer I in the Public Health of CHD Metro Manila will be abolished. If with incumbent, it will be declared Co-Terminus with Incumbent (CTI) § DHO I position in the hospital will be converted to Chief, Medical Professional Staff position National Staff Meeting April 19 – 21, 2006

Proposed Changes in the entry level for Medical Specialists and Resident Physicians CURRENT PROPOSED Medical Specialist II Medical Specialist I 22 21 Medical Specialist III 23 23 Medical Officer III Medical Officer IV 18 20 Medical Officer IV Medical Officer V 20 22 § There will be no Medical Specialist positions in the Central Office and the Centers for Health Development National Staff Meeting April 19 – 21, 2006

ORGANOGRAM FOR SPECIALTY HOSPITAL BOARD OF TRUSTEES EXECUTIVE DIRECTOR (Chief Executive Officer) Continuous Quality Improvement ((CQI) Program Integrated Hospital Operations & Mgt. Program (IHOMP Unit) Legal Affairs Internal Audit Professional Education & Training Medical Office of the Deputy Director for Nursing Services Nursing Non-Medical Office of the Deputy Director for Medical Services Dept. of Laboratory - All Nursing Depts. ** - Will vary per specialty hospital Research Dept. of Radiology - All Clinical Depts. ** - Will vary per specialty hospital Medical Records Division Bids & Awards Committee (BAC) Office of the Deputy Director for Finance Accounting Division Budget & Planning Division Cash Mgt Division Patient Business Division Office of the Deputy Director for Hospital Operations & Mgt Support Admin. Department Personnel Division Purchasing Division Building Admin. Division Nutrition & Dietetics Division Corp. /Business Services Social Service Material Mgt. Division Pharmacy Div. Engineering & Mgt. Div National Staff Meeting April 19 – 21, 2006

Tertiary Teaching and Training Non-Corporate Hospital 200 -500 bed Office of the Chief of Hospital Integrated Hospital Operations & Mgt. Program (IHOMP Unit) Continuous Quality Improvement ((CQI) Program Legal Affairs Internal Audit Professional Education & Training Medical Surgery Medicine OB-GYN Pediatrics Ear, Nose & Throat. Head Neck Surgery Dept. of Laboratory Medicine Blood Bank Public Health Unit OB-GYN Dept. of Radiology Operating Room Pediatrics Medical Records Delivery Room Emergency Room Specialized Care Area Anesthesiology Ear, Nose & Throat Head, Neck Surgery SICU *Others SICU Others Special Services Burn Unit Rehab. Med. Respiratory Med. Dialysis Specialized Care Area Hospital Operations & Mgt Support Accounting Budget & Planning Administrative Service Cash Management Personnel Corporate/Business Services Social Services Procurement Patient Business Material Management Property & Supply Admitting Billing Pharmacy Dental NICU Medical Records Committee Out Patient Department MICU PICU Finance Nutrition & Dietetics Ophthalmology *Others: Ortho/Urology/Neuro/Other Sub-Specialty Trng Therapeutics Committee Surgery Out Patient Department Bids & Awards Committee (BAC) Non-Medical Service Nursing Service Clinical Areas Nursing Research Engineering & Maint. PICU NICU Special Services Burn Unit Rehab. Med. Equipt. /Bldg. Maint Waste Mgt. Transport Services General Services Linen/Laundry Housekeeping Solid Waste Mgt. Waste water Mgt. Security Respiratory Med. Dialysis National Staff Meeting April 19 – 21, 2006

Office of the Chief of Hospital with National Reference Laboratory Integrated Hospital Operations & Mgt. Program (IHOMP Unit) Continuous Quality Improvement ((CQI) Program Legal Affairs Internal Audit Professional Education & Training Medical Surgery Medicine OB-GYN Pediatrics Ear, Nose & Throat. Head Neck Surgery Out Patient Department Therapeutics Committee Surgery Dept. of Laboratory Medicine Blood Bank Public Health Unit OB-GYN National Reference Laboratory Operating Room Pediatrics Dept. of Radiology Delivery Room Emergency Room Specialized Care Area Anesthesiology Ear, Nose & Throat Head, Neck Surgery Specialized Care Area MICU *Others SICU *Others: Ortho/Urology/Neuro/Other Sub-Specialty Trng Accounting Budget & Planning Administrative Service Cash Management Personnel Corporate/Business Services Social Services Procurement Patient Business Material Management Admitting Billing Pharmacy Ophthalmology Dental PICU NICU Special Services Burn Unit Rehab. Med. Dialysis Medical Records Committee Hospital Operations & Mgt Support Property & Supply Out Patient Department MICU Respiratory Med. Finance Medical Records Ophthalmology Special Services Bids & Awards Committee (BAC) Non-Medical Service Nursing Service Clinical Areas Nursing Research Nutrition & Dietetics Engineering & Maint. Equipt. /Bldg. Maint Waste Mgt. Transport Services General Services Linen/Laundry Housekeeping Solid Waste Mgt. Waste water Mgt. Security Respiratory Med. Dialysis National Staff Meeting April 19 – 21, 2006

Organogram of Hospital with National Reference Laboratory Office of the Medical Center Chief Integrated Hospital Operations & Mgt. Program (IHOMP Unit) Continuous Quality Improvement ((CQI) Program Legal Affairs Internal Audit Professional Education & Training Medical Surgery Medicine OB-GYN Pediatrics Ear, Nose & Throat. Head Neck Surgery Dept. of Laboratory Medicine Blood Bank Public Health Unit OB-GYN Dept. of Radiology Operating Room Pediatrics Medical Records Delivery Room Emergency Room Specialized Care Area Anesthesiology Ear, Nose & Throat Head, Neck Surgery SICU *Others SICU Others Special Services Burn Unit Rehab. Med. Respiratory Med. Dialysis Specialized Care Area Hospital Operations & Mgt Support Accounting Budget & Planning Administrative Service Cash Management Personnel Corporate/Business Services Social Services Procurement Patient Business Material Management Property & Supply Admitting Billing Pharmacy Dental NICU Medical Records Committee Out Patient Department MICU PICU Finance Nutrition & Dietetics Ophthalmology *Others: Ortho/Urology/Neuro/Other Sub-Specialty Trng Therapeutics Committee Surgery Out Patient Department Bids & Awards Committee (BAC) Non-Medical Service Nursing Service Clinical Areas Nursing Research Engineering & Maint. PICU NICU Special Services Burn Unit Rehab. Med. Equipt. /Bldg. Maint Waste Mgt. Transport Services General Services Linen/Laundry Housekeeping Solid Waste Mgt. Waste water Mgt. Security Respiratory Med. Dialysis National Staff Meeting April 19 – 21, 2006

THANK YOU National Staff Meeting April 19 – 21, 2006 30