26 October 2017

Administrative Order No. 26-C s. 1982

May 23, 1982


ADMINISTRATIVE ORDER
No. 26–C series 1982


AMENDING ADMINISTRATIVE ORDER No. 87 AND 93, s. 1980 ON POLICIES, PROCEDURES AND GUIDELINES GOVERNING AFFILIATION AND TRAINING OF STUDENTS IN THE MINISTRY OF HEALTH HOSPITALS, RURAL HEALTH AND OTHER HEALTH AGENCIES


The Ministry of Health cognizant of its responsibility of improving and maintaining the quality of life of the people and aware of its role in the development of manpower that is responsive to health needs, has committed to offer its hospitals and community health resources for learning and training experiences of students in Medicine, Nursing, Midwifery, Medical Technology, Pharmacy, Public Health Nutrition and Hospital Dietetics, Radiologic Technology, Social Work, Occupational and Physical Therapy, Psychology and Dentistry hereby formulates the following guideline to be observed by schools, colleges and universities affiliated to agencies under the Ministry of Health.

1. All affiliation and training of students in the Ministry of Health Hospitals, Rural Health Units and such other agencies, shall be maintained and supervised by the committee on affiliation and training of students.

2. A National Committee on Affiliation and Training of Students (NCATS) is hereby composed of the following:
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a. Functions of National Committee on Affiliation and Training of Students (NCATS):

(1)   Formulates policies, guidelines, rules and regulations on affiliation and training of students
(2)   Plans programs and activities pertaining to affiliation and training of students.
(3)   Implements, supervises, monitors and evaluates the implementation of all programs and activities on affiliation and training of students.
(4)   Processes affiliation contracts for medical centers and special hospitals designated directly under the Office of the Minister of Health.
(5)   Keep records and reports.

3. A Regional Committee on Affiliation and Training of Students (RCATS) shall be created by the Regional Health Director to be composed of the following:

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The Regional Director Health Director is hereby authorized to sign contracts of affiliation within the region.

            Functions of RCATS:

a. Supervises programs and activities on affiliation and training of students at the regional level.
b. Evaluates programs and activities on affiliation and training of students in the region.
c. Processes affiliation contracts at the regional level.
d. Keeps records and reports.
e. Submits quarterly report to National Committee on Affiliation and Training of Students (NCATS) on:

(1)   Number and category of students of each affiliating schools.
(2)   Length of stay
(3)   Amount collected during the period and manner of distribution (payroll).

4. Filing of contracts of affiliation shall be done in hospitals/Rural Health Units and such other agencies where affiliation and training activities takes place. Hospitals and Rural Health Units shall make available copies of the affiliation contact to the schools/colleges/universities.

a. Schools/ Colleges/Universities shall accomplish four (4) copies of the contract.

b. Contracts shall be recommended by the Chief of Hospitals/Provincial Health Officers/City Health Officers or Heads of agency where affiliation takes place.

c. Duly accomplished affiliation contract for hospitals directly under the Office of the Minister shall be forwarded to the NCATS for processing and shall be forwarded to the Minister of Health or his representative for approval.

d. Duly accomplished affiliation contract at the regional level shall be forwarded to the RCATS for processing and shall be forwarded to the Regional Health Director for approval.

e. All affiliation contracts shall be filed two (2) months before the end of every school year.

f.  Committee action shall be within two (2) months after the date of filing. Final approval shall be made once month after the committee action.

g. All affiliation contracts shall be renewed every two (2) years for the first six (6) years and one every three (3) years thereafter. The Minister of Health reserved the right to cancel contracts, adjust affiliation fees, institute measures as deemed necessary.

5. Honorarium form Affiliation Fees:

The affiliation fees collected from hospitals, rural health units, regional training centers, regional training laboratories and other offices/agencies of the Ministry of Health shall be distributed as follows:

a. 50% for Honorarium

These shall be divided into:

40% for honorarium
5% for supplies and materials for student’s use
5% for supplies and operational expenses of the committee on affiliation and training

The 40% for honorarium shall be distributed to the staff that participate in the training of students and shall be apportioned according to the degree of participation. It is suggested that the following guide on the distribution shall be followed:

                        Chief of Hospital – 1.8
                        Administrative Staff – 2.0
                        Training Officer and Staff – 1.4
                        Chief of Service concerned for such training – 4.8
                        Assistance, if any – 7.0
                        Training staff and supervisors of the particular service
concerned for such training – 23.0

In case where there are no training officers or no assistants to the Chief of the Service, the remaining amount allotted for these staff mentioned above shall be distributed to the staff concerned for such training, upon recommendation of the Chief of Service, taking into consideration the degree of participation.

The 5% for supplies and materials shall be used for such purpose as determined by the Chief of the Service concerned, subject to the approval of the Chief of the Hospital/RHUs and such other agencies concerned.

The 5% for supplies and operational expenses of the committee shall be remitted immediately after collection to the National Committee on Affiliation and Training of Students for hospitals and agencies in Metro Manila, and to the Regional Committee for hospitals and agencies in their respective regional offices. The amount shall be considered as a trust fund and shall be deposited in government depository bank.

Disbursement shall be subject to special budget pursuant to Section 40 of P.D. 1177. Operational expenses for affiliation with their functions shall be taken from the funds for supplies and operational expenses and shall follow existing accounting and auditing rules and regulations.

b. 50% for Incentive

The 50% for incentive shall be distributed in equal shares to Nurses, Medical Social workers, Therapist, Medical Technicians, Nursing Attendants and other hospital personnel directly engaged in patient care; Provided that the share of any employees may not in aggregate, exceed fifty percent of the employee salary for the corresponding period for which the honorarium is received.

c. The Chief of the service concerned for such training (ex. Chief Nurse for Nursing Students) shall form a committee who shall determine the manner of distribution of honorarium and shall submit to the Chief of hospital/rural health units (PHO) or head of the agency for approval. No employees shall be allowed to receive a double share, meaning getting a share from the honorarium as well as from the incentive.

6.     Medicine

7.     Nursing/Midwifery

8. Medical Technology

a. Ministry of Health Laboratories designated for training of Medical Technology interns in order to obtain the necessary skills and knowledge in clinical laboratory practice must meet the following requirements:

(1)   The laboratory should be duly licensed as specified by the law on clinical laboratories, R.A. 4688.

(2)   The position of medical technologist should be provided for each of the sections of clinical chemistry, clinical microscopy (urinalysis and parasitology), microbiology (bacteriology), hematology, blood banking and serology and histopathology.

(3)   There should be an adequate laboratory space to accommodate both the staff and the medical technology interns.

(4)   There should be sufficient equipment and supplies necessary depending on the volume and type of examinations as well as the number of interns to be trained by the laboratory.

(5)   Each section of the laboratory can be utilized for training only if it can accommodate at least two (2) interns at any one time.

(6)   The laboratory should have a training program for medical technology interns.

(a)   The person responsible for this program should be a member of the specialty in laboratory medicine.

(b)   The training program should be prepared in coordination with the training officer of the hospital or health region and submitted to the Committee on Affiliation with the contract of affiliation.

(c)    The program should provide for an objective measure or evaluation of the baseline skills and knowledge prior to allowing or utilizing interns to handle actual specimens form patients.

(d)   The program should include the (1) objective of training, (2) method or procedures to be taught, (3) principles that go with the methods, (4) right work attitudes and ethical values, (5) precision, (6) objective evaluation of performance in each section, (7) time schedule and (8) lectures, seminars and conferences and (9) methodology of training.

(7)   The minimum number of examination or samples of each section to accommodate interns are as follows:

(a)   Clinical chemistry – 3,000 exam/annum

(b)   Clinical Microscopy

Urinalysis – 1,500 samples /annum
Parasitology – 1,500 samples / annum

(c)    Microbiology

Gram staining – 800 samples /annum
Isolation and identification of organism – 1,000 samples/annum

(d)   Hematology

Peripheral blood study to include hemoglobin, white cell count, schilling hematocrit and red cell morphology or CBC – 1,200 samples /annum
Sedimentation rate, platelet count, bleeding and clotting time, malarial smears and other tests – 800 samples

(e)   Blood Banking and Serology

Typing – 900 tests/annum
Cross matching – 600 tests /annum
Serology
      VDRL – 300 tests/annum
      Widal Test – 300 tests/annum

(f)    Histopathology – 500 tissues/annum
Cytology – 500 tissues/annum

(8)   At least one member of the professional staff of the laboratory to every group of interns not exceeding 10 in each section should be provided.

(9)   The staff and personnel of the laboratory will be assisted by a laboratory instructors experienced in actual laboratory work from the sending University or College to assist especially to monitor individual attendance, behavior, performance of the students including guidance in readings and application of the theoretical knowledge taken up in school to actual practice.

(10) No more than 10 medical technology interns shall be allowed to train during the night shift in understaffed hospitals and so certified by the director of the same, such interns is to be assigned without the regular professional staff of the laboratory on duty at the same time.

(11)  The allotment derived from the intern’s affiliation fee for the laboratory must be spent for the laboratory needs utilized exclusively for training and not for payment of furniture or appliances of the laboratory.

(12)  The Director of the Hospital is responsible for the admission of the number of interns approved by the Committee. He should not enter into any contract of affiliation with any college, university or school for medical technology if any of the conditions set forth in this Administrative Order are not complied with.

(13)  Priority should be given to interns residing within the area or region of the hospital
Quarterly reports on the affiliation fees received showing the performance of each category or personnel and the budgetary outlay showing the proposed amount for each personnel participating in the affiliation program must be submitted to the Minister of Health or Regional Health Director thru the Committee on Affiliation and Training of Students together with the narrative report on the status and/or problems of the affiliation program.

b. All universities, schools, colleges of Medical Technology must have met the following requirements before applying for affiliation to any clinical laboratory of the Ministry of Health:

(1)   Approval from the Ministry of Education and Culture and the Board of Medical Technology.

(2)   Compliance with the provision of R.A. 5527 and Presidential Decree No. 498.

These universities, schools and colleges shall:

(3)   Provide laboratory instructor experienced in actual laboratory work to monitor individual attendance, behavior and performance of the students including guidance in readings and application of theoretical knowledge obtained from school to actual practice and to assist the Pathologist and professional staff in implementing the approved training program for the duration of the training of the interns.

(4)   Pay or replace damage, breakages or losses by the medical technology interns of laboratory property, equipment and supplies.

(5)   See to it that all medical technology interns before beginning the internship in any section must have completed the theoretical aspect of that particular section.

(6)   Pay to the hospital thirty five (P35.00) pesos for each intern each month. Payment is done within the first five days of the month.

(7)   See to it that the laboratory instructor and students observe and abide with the policies, rules and regulations of the hospital and that discipline is maintained at all times.

(8)   See to it that the student and instructor are in their proper uniforms and provided with a laboratory gown.

c. Joint responsibilities of affiliating universities, schools and colleges of medical technology and the laboratories.  

(1)   The training program shall be prepared by the Pathologist–in–charge of the laboratory in coordination with the training officer of the hospital. Its implementation shall be the joint responsibility of the Pathologist, staff and personnel of the laboratory and the laboratory instructor of each university, school or colleges assigned to the laboratory for the duration of the internship of their respective students.

(2)   The internship schedule shall be properly apportioned to the different sections of the laboratory services as follows:

(a)   Clinical Chemistry – 2 ½ months
(b)   Clinical Microscopy – 3 months
(c)    Microbiology – 2 ½ months
(d)   Hematology – 2 months
(e)   Blood Banking & Serology – 1 month
(f)    Histopathology – 1 month

(3)   A monthly conference should be held to evaluate the implementation of the program and institution of changes by the Pathologist, laboratory instructor and staff of the laboratory and for problems that might arise during the implementation.

(4)   Maintenance of cooperation and harmonious working relations at all times among the students and the staff of the hospital.

9.     Pharmacy
10.  Public Health Nutrition and Hospital Dietetics
11.  Radiologic Technology
12.  Social Work
13.  Psychology
14.  Occupational and Physical Therapy
15.  Dentistry

16.  Collection and Disbursement of Affiliation Fees

a. Affiliation fees paid by the students for their training in government hospitals/rural health units intended for honorarium or incentive pay for staff members who participated in such training or other personnel directly engaged in patient care shall be deposited in an authorized government depository bank as a trust liability, and the hospitals, rural health units concerned is authorized to withdraw the amount deposited on the joint signatures of the authorized representative of the hospital/rural health unit and the Commission on Audit without the need for Cash Disbursement Ceiling. Provided that, if the amount is deposited in a savings account, the interest shall to the general fund. Provided, further, that the quarterly reports of income and payments of such fund shall be submitted to the Ministry of Budget in such format and following such procedures as the Ministry of Budget may prescribe.

17.  Special Provision

Other government owned or controlled schools or colleges shall be required to pay the affiliation fee to the Ministry of Health hospitals and rural health units, except the University of the Philippines. However, the University of the Philippine shall be required to accomplish the necessary contract of affiliation.

18.  Repealing Clause

Administrative Order Nos. 97 and 93 series 1980, and all other orders inconsistent with the Provision of this Administrative Order are hereby repealed.

19.  Effectivity

This Administrative Order shall take effect immediately.



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