14 June 2018

ADMINISTRATIVE ORDER No. 87 s. 1980



ADMINISTRATIVE ORDER
No. 87 series 1980


POLICIES, PROCEDURES AND GUIDELINES GOVERNING AFFILIATION AND TRAINING OF STUDENTS IN THE MINISTRY OF HEALTH HOSPITALS, RURAL HEALTH UNITS AND OTHER HEALTH AGENCIES


The Ministry of Health cognizant of its responsibility of improving and maintaining the quality 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 Medical, Nursing, Midwifery, Medical Technology, Pharmacy, Public Health Nutrition and Hospital Dietetics, Radiologic Technology, Social Work and Occupational Therapy, hereby promulgates the following policies, procedures and guidelines to be observe by schools, colleges and universities affiliated to agencies under the Ministry of Health

1. Decentralization

All affiliation and training of students in the Ministry of Health Hospitals, Rural Health Units and other agencies shall be maintained by the Committee on Affiliation and Training of Students, Administration and management of affiliation activities shall be decentralized to the Regional Health Offices

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

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

Assistant Regional Health Director in his absence

Chief, Medical Service

Chief, Regional Hospital

Chief, Regional Training Center

Chief, Regional Health Laboratory

Regional Training Center

A Provincial Health Officer

The Regional Health Director is hereby authorized to appoint a Chairman and Executive Secretary from among the members

c. Signing of the contracts shall be delegated to the Regional Health Directors

2. Functions of the Committee on Affiliation and Training of Students (CATS)

a. National Committee on Affiliation and Training of Students (NCATS)

(1) Responsible to the Minister of Health Planning/Programing and implementing of policies, standards and guidelines pertaining to Affiliation and Training of Students (ATS) in the Ministry of Health

(2) Supervision and control of ATS programs/activities in Metro Manila and other health agencies/offices directly under the Office of the Minister in Metro Manila and other health agencies/offices directly under the Office of the Minister

(3) Plan, formulate, amend and recommend to the Minister of Health, policies, standards and guidelines on ATS

(4) Process affiliation contracts and not on communications and other matters relative to the activities/programs on ATS

(5) Keep records and reports



b. Regional Committee on Affiliation and Training of Students (RCATS)

(1) Responsible to the Regional Health Director for the implementation of policies, standards, guidelines on Affiliation and training of students

(2) Supervision and control of programs/activities on affiliation and training of students at the regional level

(3) Evaluation of programs/activities on affiliation and training of students  at regional level

(4) Plan, formulate and recommend to the Minister of Health policies, standards and guidelines on affiliation and training of students

(5) Process affiliation contracts and act on communications relative to affiliation and training of students at the regional level.

(6) Keep records and reports

(7) Submit  to the National Committee quarterly reports on:

(a) Number and category of student affiliating

(b) Length of stay of students

(c) Amount collected during the period

(d) Copy of the payroll on apportionment and distribution of honorarium

(e) List of purchases of supplies and equipment and other miscellaneous expenses

(f) Expenditures on funds for operational expenses of the committee which shall be reimbursed from funds allocated for Health Manpower Programs (HMP)

3. Procedures for filing affiliation in hospitals/rural health units and/or other training field

a. Application forms/contracts maybe available at the Office of the National Committee on Affiliation and Training of Students at the Ministry of Health, and at the Regional Committee on Affiliation and Training of Students, Regional Health Officers.

b. Accomplish four (4) copies of affiliation contract.

c. Affiliation contracts on hospitals/rural health units shall be recommended by the Chief of Hospital and/or Provincial Health Officers or Head of agency where affiliation takes place.

d. Affiliation contracts properly accomplished and recommend by the chief of office concerned shall be forwarded to the Executive Secretary of the National Committee on Affiliation and Training of Students for Metro Manila and to the Executive Secretary of the Regional Committee on Affiliation and Training of Students at the regional level. All contracts shall be screened and evaluated by the Committee on ATS and shall be forwarded to the Minister of Health for approval for Metro Manila. Signing of affiliation contracts form the Regional Health Offices shall be delegated to the Regional Health Directors.

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

f.  Committee section shall be within the two (2) months after the date of filing. Final approval shall be made one (1) month after the committee action.

g. All affiliation contracts shall be renewed every two (2) years after the first six (6) years and once every five (5) years thereafter. The Minister of Health reserves the right to adjust affiliation fees, cancel contracts, institute measures deems necessary

4.  Apportionment and distribution of honorarium

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

a. For Medicine, Nursing, Midwifery, Public Health, Nutrition and Hospital Dietetics, Pharmacy, Social Work, Radiologic Technology and Occupational Therapy:

60% for Honorarium

30% for Supplies and Materials

10% for Health Manpower Programs of the Minister of Health (HMP)

(1) In Hospitals

30% for supplies and materials: 15% for supplies and materials as requisitioned by the service concerned; 15% for needs as determined by the Chief of Hospitals.

60% for honorarium shall be distributed to hospital staff and personnel who are directly participating in affiliation and training activities. It shall be distributed as follows:

            1.8% Chief of Hospital

            1.2% Administrative Staff

            1.2% Training Officer and Staff

55.8% will be distributed to the service involved with the affiliation of students and shall be apportioned according to the degree of actual participation in the teaching, supervision and such other activities related to student learning. The chief of hospital shall create a committee to decide on the manner of distribution and shall report the same to the NCAT

In hospitals where there is no training officer or training staff, the 1.2% shall be distributed to the service concerned

(2) In the case of Regional Training Centers and Rural Health Units, the 60% for honorarium shall be distributed to the staff and personnel according to their degree of participation in the training of students. They shall likewise create a committee in their respective offices to decide the manner of distribution. The Regional Training Officer shall recommend to the Regional Health Director the names of the personnel who shall receive the honorarium

b. For Medical Technology

(1) Hospital Laboratory

50% for Honorarium distributed similarly as in 4.1

40% for supplies and materials: 30% as requisitioned by the laboratory and 10% as determined by the Chief of Hospital

10% for Health Manpower Programs (HMP) of the Minster of Health

(2) Regional Training Laboratory

50% for Honorarium

                                    1% Director, Regional Health Office

                                    1% Administrative Staff

                                    1% Training Officer

                                    0.5% Assistant Director

                                    6.5% For Consultants/Bacteriologist/Chemist

                                    3% Senior Medical Technologist

                                    27% to be apportioned among technical staff

                        40% for Laboratory Supplies

                        10% for Health Manpower Programs of the Minister of Health

5. Specific provisions

a. Medicine

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b. Medical Technology

(1) 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

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

(b) 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.

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

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

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

(f)  The laboratory should have a training program for medical technology interns:

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

·  The training program should be prepared in coordination with the training officer of the hospital or health region and submit to the Committee on affiliation with the contract of affiliation.

·  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 from patients.

·  The program should include the (1) objective of training, (2) methods or procedures to be taught, (3) principles that go with the method, (4) 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.

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

·  Clinical Chemistry – 3000 exam/annum

·  Clinical Microscopy

Urinalysis – 1500 samples/annum

Parasitology – 1500 samples/annum

·   Microbiology

Gram–staining, acid fast staining – 800 samples/annum

Isolation and identification of organisms – 1000 samples/annum

·  Hematology

Peripheral blood study to include hemoglobin, white cell count, Schilling, hematocrit and red cell morphology or CBC – 1200 samples/annum

Sedimentation rate, platelet count, bleeding and clotting time, malarial smears and other tests – 800 samples/annum

·  Blood Banking and Serology

Typing – 900 tests/annum

Complete cross matching – 600 tests/annum

Serology:

            VDRL – 300 tests/annum

            Widal test – 300 tests/annum

·  Histopathology – 500 tissues/annum

Cytology – 500 tissues/annum
                                

For each additional intern, another half of the requirement shall be added

(h) 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.

(i) The staff and personnel of the laboratory will be assisted by a laboratory instructor 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.

(j) No more than 10 medical technology interns should 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.

(k) 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.

(l) 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 the Administrative Order are not complied with.

(m) Priority should be given to interns residing within the area or region of the hospital

Quarterly reports on the affiliation fees received showing the percentage of each category of 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 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.

(2)  All universities, schools and colleges of Medical Technology must have the following requirements before applying for affiliation to any clinical laboratory of the Ministry of Health:

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

(b) Compliance with the provisions of R.A. 5527 and Presidential Decree No. 498

These universities, schools and colleges shall:

(a) Provide laboratory instructor experienced in actual laboratory work to monitor individual attendance, behavior and performance of the students including guidance in reading 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 interns.

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

(c) 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.

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

(e) 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.

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

(3) Joint responsibilities of affiliating universities, schools and Colleges of Medical Technology and the Laboratories

(a) The training program should be prepared by the Pathologist–in–charge of the laboratory in coordination with the training officer of the hospital. Its implementation shall that 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.

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

Clinical Chemistry – 2.5 months

Clinical Microscopy – 3 months

Microbiology – 2.5 months

Hematology – 2 months

Blood Banking and Serology – 1 month

Histopathology – 1 month

(c) 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

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

c. Pharmacy

d. Public Health Nutrition and Hospital Dietetics

e. Radiologic Technology

f. Social Work

g. Occupational Therapy

6. Collection and Disbursement of Affiliation Fees

a. Affiliation fees paid by students for their training in government hospital/rural health units intended for the compensation or allowance of staff members for the compensation or allowance of staff members who participate in such training shall be deposited in an authorized government depository bank as a trust liability and the hospital/rural health unit concerned is authorized to withdraw the amount deposited on the joint signatures of the authorized representatives 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 accrue to the general fund. Provided, further, that the quarterly reports of income and payments of such funds shall be submitted to the Ministry of Budget in such format and following such procedures as the Ministry of the Budget may prescribe.

b. Each Chief of Hospital/Rural Health Unit or Chief of Agency/Chief of Laboratory Health Unit or Chief of Agency/Chief of Laboratory concerned shall be authorized to purchase supplies and materials out of the 30 – 40% of the affiliation fees intended for the purpose, and shall be made in accordance with existing accounting and auditing rules and regulations. It is therefore, understood among other things, that all collections shall be acknowledged by official receipts and all disbursements shall be evidenced by the necessary documents.

(1) Collection from RHU shall be thru the Regional Health Office. A separate books of account shall be maintained by the Regional Accounting Unit.

(2) Disbursement for RHU shall be thru the Regional Health Office support staff subject to the following condition:

(a) Payroll for honorarium – certificate No.1 signed by Rural Health Physician and approved by Regional Health Directors

(b) Vouchers – Certificate No. 2 by Rural Health Physician and Certificate No. 3 by Regional Health Director

(c) For supplies – Certificate No. 1 by the Public Health Nurse

Certificate No. 2 – Rural Health Physician

Certificate No. 3 – Regional Health Director

(3) The 10% affiliation fee intended for Health Manpower Progress of the Minister of Health shall be remitted immediately after collection to the Ministry of Health which shall be considered as a trust fund and shall be deposited in a government depository bank. Disbursement shall be subjected to special budget pursuant to section 48 of PD 1177. Operational expenses of the National Committee on Affiliation and Training of Students in connection with their function shall likewise be taken from the Health Manpower Program funds and shall follow existing accounting and auditing rules and regulations.

7.  Repealing Clause

Administrative orders No. 162 s. 1971 and No. 6 s. 1978 and all other orders inconsistent with the provision of this Administrative Order, are hereby repealed.

8. Effectivity

This Administrative Order is made effective as of June 1, 1980




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