Republie of the Philippines Department of Health OFFICE OF THE SECRETARY MAY 08 2013 ADMINISTRATIVE ORDER No. AMENDED ty AL Postod onby: dala 13, 40> Min, No. w 2013-017 SUBJECT : Revised Roles, Functions, and Responsibilities of the DOH Representatives (DOH Reps) in Support of National Health Thrusts I. Rationale The Centers for Health Development (CHDs) as described in Department Order 2011-0188 or the Kalusugan Pangkalahatan (KP) Execution Plan and Implementation Arrangements are the frontline managers of KP implementation. ‘Under the present organizational set-up, the DOH through the CHDs influences the manner by which LGUs govern local health systems. The DOH Representatives (DOH Reps) play an important part in the CHDs’ role of facilitating and coordinating the strengthening of local health systems to provinces and cities in implementing the national health thrusts and directions. The roles and functions of DOH Reps in support of national health thrusts and directions are found in Administrative Order 135 5.2004. However, despite issuance of said AO, many DOH Reps are still confused on their roles and functions, and they have not been fully able to perform their main role as facilitator and advisor on local health reforms. In the Final Report “Support to the Strengthening of Capacity Development Systems for DOH CO and CHDs” submitted by Bretemitz, et al in September 2010, it was found that DOH Reps often seem to face fundamental capacity problems, such as unclear and overlapping roles and functions, and limited decision power. DOH Reps often have limited authority to decide on both downstream and upstream processes. Such ambiguities in role delineations often result in ineffective performance of their expected functions. Results of past consultations with selected staff from the CHDs and Provincial Health Officers (PHOs) also showed the need to update and revise the existing roles and functions of DOH Reps, based on Section 47 of the DOH Implementing Rules and Regulations of the Local Government Code, roles and functions of CHDs from DO No. 2009-0153, and DO No. 2011-0188. In the light of existing studies, past consultations and new policy developments, a new issuance on the definition of roles, functions and responsibilities of DOH Reps nationwide is necessary. This policy envisions the DOH Reps to become more focused, responsive and effective CHD staff and LGU partner through the Local Health Boards. . Objective This Administrative Order provides guidelines for the revised functions, roles and responsibilities of the DOH Representatives in support of national health thrusts. Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila e Trunk Line 651-7800 Direct Line: 711-9501 Fax: 7431829; 743-1786 © URL: hitp:/nww.dohsov.ph; e-mail: oeca-doh.zov.pbIILScope This Order shall cover DOH Representatives at all levels ~ provinees, cities and municipalities. Definition of Terms 1, Inter-Local Health Zone (ILHZ) ~ refers to any form of organized arrangement for coordinating the operations of an array and hierarchy of health providers and facilities serving a common population with a local geographic area under the jurisdictions of more than one local government.(A.O.No.2006-0017 dated August 3, 2006) . Local Government Unit (LGU) ~ refers to an autonomous unit (province, city and municipality) which has clear and legally recognized geographical boundaries within which they exercise authority and perform public functions. 3. Local Health Board (LHB) — refers to the health advisory committee of the Sangguniang Panlalawigan, Panglungsod or Pambayan concemed on health matters. The provincial/city or municipal health board shall be headed by the govemnoricity or municipal mayor as chairman, the provincial/city or municipal health officer as vice chair, and the chairman of the Committee on Health of the Sangguniang Panlalawigan, Panlungsod, or Pambayan, a representative from the private sector and a representative of the DOH in the province/city/municipality as members. Its primary function is to approve the investment plans for health (IPH) and the required annual budget for its implementation, 4, Local Health Systems (LHS) — localities in the Philippines are served by “local health systems”, which following the WHO conceptual framework on health systems (World Health Report 2000), are defined as “all organizations, institutions, and resources devoted to undertaking local health actions”. The Philippine health system may be regarded as a collection of different local health systems serving their respective localities supported by national policies, programs and activities. (Administrative Order No.2008-0020 dated May 2, 2008) V. Implementing Mechanisms A. Structure DOH Central Office ~ The Department of Health holds the overall technical authority on health as it is a national health policy maker and regulatory institution. 2. Center for Health Development (CHD) — The CHD is the sub-national level health organization of the DOH administratively in-charge of the field operations and the retained hospitals of DOH. It is mandated to implement and monitor health and health-related laws, regulations, policies and programs; and to coordinate with regional offices of other departments, offices and national government agencies as well as local government units within the region.DOH Team in the Province Team - DOH Team in the province is composed of DOH retained personnel of vertical health programs, city and municipal DOH Representatives, Food and Drug Regulation Officer and other detailed staff from the CHD. The CHD oversees the functions of the DOH Representatives. Provincial Health Team Leader (PHTL) - the DOH Representative in the province designated as the team leader and whose function is to oversee the day to day operations of the Provincial Health Team Office. DOH Representative (DOH Rep) -DOH permanent personnel designated and delegated to perform DOH functions with the LGU at the municipal, city, Inter- Local Health Zone and provincial level. ‘The CHD — Metro Manila (CHD-MM), due to its unique set-up has designated City DOH Representatives in all cities. A Team Leader is designated to lead the DOH Reps in every sector of Metro Manila (CAMANAVA, MAMAMANSAN, PAPAMATAQUE, MUNTIPARLASPA). B. Specific Roles and Functions of DOH Reps (TA) - Health Planning - Health Program/ Project Mgt - Health Facilities Improvement - Health Emergency ‘Management - Reporting ‘AREA of Specific Roles of DOH Representative RESPONSIBILITY _ : 1. Technical Assistance Participate in the LGU planning for health. . Develop a Technical Assistance Plan for the realization of the LGU plan. ‘Assist the LGU in the preparation of project proposals for health. |. Assist the LGU in the documentation of best practices and other innovations on health. Assist the LGU in resource mapping and resource mobilization. Act as Resource Person/facilitators for trainings and other human resources for health-related activities of the LGU. Assist the LGU in the conduct of health facility self- assessment and preparation of Quality Improvement Plan (QIP) and develop a TA Plan for the continual improvement of the health facility. |. Assist the LGU in the implementation and operationalization of emergency/disaster plan including contingency plan especially on information management, needs and gaps assessment, resource mobilization, and cluster-approach adoption. Assist the LGU in complying with submission of required quality health data. 2. Policy formulation, ‘Adoption and Dissemination Participate in the development/passage of local health policies in support of priority health programs/projects through the Local Health Board. Present and discuss national health policies and thrusts durin; weProv/HUC/ ILHZ City/ Municipal Health Board meetings and other | fora Disseminate and explain national/Regional Orders and policies among LGUs and other stakeholders 3. Advocacy Represent the DOH and participate in the deliberations of LHB‘provincial/ILHZ/city/municipal health programs. Advocate to local officials, local health personnel and key stakeholders to support the implementation of national health thrusts, laws, policies and standards. Propose to LGUs to replicate good practices, initiatives and innovations of health programs/projects being implemented by other LGUs. 4, Monitoring and Evaluation Conduct monitoring, evaluation and analysis of local health data and implementation of health services, programs and projects of LGUs and other stakeholders, and provide feedback at all levels. . Propose solutions/recommendations based on the M&E findings and follow up implementation of such solutions. Recommend to LGUs mechanisms to ensure sustainability of health programs’projects in coordination with provincial/city/municipal and concerned program coordinators. |. Monitor/facilitate the submission of LGU required reports and validate prior to submission to the CHD. 3. Inter-agency and Inter-sectoral Collaboration! Networking Coordinate/Pariner with local officials, NGOs and other stakeholders concerned in the implementation of health programs and other health- related activities . Facilitate the formation/strengthening of alliances & networks/work groups on health or health related activities with other gov't agencies and civil society organizations (¢.g.PPP). Follow-up updates and provide feedback on agreements, negotiations and discussions made by DOH officials with LCEs and partners (c.g. primary health care and other community-based health activities). B. _ Specific Functions of PHTL In addition to performing the above tasks, the PHTL shall: 1. Serve as the representative of the CHD Director in the province. 2. Supervise, monitor and assist the city/municipal DOH Representatives and other DOH retained personnel and detailed staff in the PHTO in the performance of their duties and responsibilities. 3. Manage and oversee the day-to-day operations of the PHTO.c 4. Work in partnership with PHOs and other stakeholders in the performance of his/her duties. 5. Perform other duties and responsibilities as assigned by the CHD Director. Minimum Performance Standards for DOH Reps The following are the minimum performance standards for a DOH Rep with corresponding performance indicator and means of verification: Performance Indicator Specific Role Means of Verification (Mov) Participate in the LGU planning —_| No.of LGU planning process Drafi/final plans, DOH process and develop TA Plan in support of the LGU plan participated in No. of TA Plans formulated Rep’s Monitoring Logbook TA Plan Assist in the preparation of project proposals for health No. of TA provided in packaging of proposals Drafi/final proj. proposals, activity report signed by LGU official/health officer Act as resource person/ facilitators for training and other HR-related activities Facilitate the provision of identified TA needs of the LGU. No. of seminars/ training and other HR-related activities participated as Resource Person No. of training/ workshops facilitated Invitation/ Certificates! modules/ window schedule/ Program of Activity/ documentation/pictures | No. of identified TA needs facilitated Activity Report(indicating recommended sustainable mechanisms), DOH Rep’s TA Plan Assist LGU in the conduct of health facility assessment and preparation of QI plan and develop TA Plan for continual improvement of health facility No. of Facility Self-Assessment assisted No. of TA plans formulated in response to QIP Completed Assessment Tool, QIP, TA Plan Assist the LGU in the implementation and operationalization of emergency/disaster plan including contingency plan especially on information management, needs No.of LGUs assisted in the mplementation and operationalization of emergency/disaster plan Activity Report Copy of Emergency/Disaster Plan quSpecific Role Performance Indicator Means of Verification (Mov) and gaps assessment, resource mobilization, and cluster-approach adoption. Assist LGU in the complying with | No. of assistance provided to Copy of report required quality health data LGU in complying with required data Represent DOH and participate in the deliberation of Prov'l/ ILHZ/HUC/ City/Municipal Health Boards No. of LHB meetings participated in/attended Minutes of meeting, invitations with agenda, Activity Report Advocate to local officials, health personnel and key stakeholders to support the implementation of national health thrusts, laws, policies and standards No. of advocacy activities conducted Activity Report, Minutes of meeting/programme, advocacy materials/references used, Attendance, EOs, Ordinances, Resolutions and other issuances Propose to LGU to replicate good practices, initiatives and innovations of health programs/projects being implemented by other LGUs No. of advocacy activities conducted Activity Report, Minutes of meeting/ programme, materials/references used Participate/ assist in the development/ passage of local policies in support of priority local health programs and projects No. of policies developed with DOH Rep assistance Invitation for committee hearings’ Minutes of meeting/ draft policy Present and discuss national health policies and thrusts in different for a Disseminate national/regional orders and policies among LGUs and other stakeholders No. of health policies presented at fora No. of national/ regional orders! policies disseminated % of stakeholders provided with issuances Minutes of meeting/ Attendance sheet Distribution list! Acknowledgment receipt wwSpecific Role Means of Verification Performance Indicator (mov) Conduct monitoring, evaluation _ | No. of monitoring visits Monitoring! and analysis of the implementation | conducted Narrative/Feedback of health services, programs and —_ | No.of analysis reports prepared | Reports acknowledged by projects in the LGUs and other stakeholders, and provide feedback atall levels No.of feedback activities conducted LGU/ Monitoring checklist Propose solutions! ‘No.of proposed Monitoring reports! recommendations based on the solutions/recommendations Logbook MGE findings and follow-up No. of follow-ups done implementation Facilitate the submission of all _| No. of reports validated prior to | Acknowledgment Receipt LGU routine reports and validate prior to submission to the next reporting level submission of file copy of Reports submitted Coordinate/Partner with local officials, NGOs and other stakeholders concerned in the implementation of health programs and other health related activities No. of partners/stakeholders coordinated with Attendance sheet/ Minutes of meeting /Centficate of appearance/ Locator slip/ logbook Facilitate the formation/ strengthening of alliances and networks! work groups on health related activities with other gov't agencies and CSO No. of alliances and networks working groups organized/strengthened MOA/ Joint Memorandum/ Documentation of activities! Minutes of meetings Participate/lead in the installation and strengthening of local health systems No. of local health systems installation activities participated in (e.g.ILHZ, GIDA, UHS, Telehealth) Minutes of meeting / Attendance sheet Follow-up updates and provide feedback on agreements, negotiations and discussions made by DOH officials with LCEs and Rertners No. of follow-up visits on agreements and negotiations ‘Minutes of meetings! Attendance sheet QAJ*D. _ Roles and Responsibilities of other DOH Units To carry out the functions, roles and responsibilities of the DOH Representatives, the following are expected from the different DOH units: 1. Bureau of Local Health Development (BLHD) 1.1, Initiate development of policies and guidelines including plans and programs to ensure an effective and efficient performance of DOH Reps in carrying out their functions; 1.2. Provide venue for technical sharing and information inputs through conventions/consultative meetings and consolidation of best practices/initiatives; 1.3. Create opportunities for DOH Reps by networking and collaborating with both public and private sectors in providing the necessary training programs for their career advancement. 1.4. Review and recommend minimum performance standards for DOH Reps. 1.5. Monitor and report the compliance of this policy to respective Area Cluster Office. 2. Health Human Resources Development Bureau (HHRDB) 2.1, Assist in the development of a national framework for the career path of DOH Reps. 3. Center for Health Development (CHD) 3.1. Conduct meetings/sessions to update the knowledge of DOH Reps on national health thrusts/directions, newly signed laws, new DOH policy issuances, and other policies with local health implications and provide copies thereof. 3.2. Act appropriately and promptly on requests for technical, financial and logistic, and other assistance made by DOH Reps on behalf of their concerned LGUs and PHTO; 3.3. Provide regular budget for the operation of the Provincial Health Team Office including supplies, equipment and other MOOE (see Section VI); 3.4. Conduct training and development needs analysis (TDNA) to DOH Reps based on their areas of responsibilities (See Sec. V.B) as basis for their retooling; 3.5. Ensure the performance of DOH Reps’ functions through regular performance assessment/evaluation, and provision of coaching and mentoring; 3.6. Ensure proper coordination of program managers with the PHTO; 3.7, RD/ARD to assist the DOH Reps in providing high level advocacy to LGUs/LCEs; 3.8. Provide PHTOs with communication, relevant documents released, agreements and negotiations made with the LGUs; 3.9. Submit reports on issuesiconcems relative to DOH Representatives to their respective operations cluster office, furnishing copies to the BLHD to ensure that appropriate actions are taken. 4. DOH Provincial Health Team Office/CHD-MM DOH Rep Team Leader 4.1. Serve as conduit of the CHD in providing technical and financial assistance to ) LGUs;4.2. Develop plans that will strengthen local health systems in their respective provinces in coordination with LGU; 4.3. Work in partnership with PHOs, CHOs, MHOs and other stakeholders. 4.4, Perform administrative functions as delegated by CHD. 4.5. Facilitate the submission of reports and other pertinent documents by the PHO/CHO to CHD. 5. Operations Cluster Office 5.1. Ensure that CHDs provide technical and financial support to DOH Reps in the performance of their functions; 5.2. Act on requests by CHDs for support related to local health systems implementation from other DOH units. VI Resource Requirements for the PHTO Operations Aside from an office for the Provincial Health Team that will be designated by their respective CHD, the following minimum requirements are expected to be provided and funded from the CHD budget: OFFICE FIXTURES AND EQUIPME! chairs/tables conference room pantry with refrigerator and microwave airconditioning unit sleeping quarters/dorm TV with cable filing cabinets desktops with printer and intemet access laptop LCD projector copier fax machine landline phone scanner camera service vehicle BP Apparatus | MANPOWER admin.asst /clerk liaison officer records officer driver utility worker security guard The budget for PHTO shall be included in the Annual CHD budget submitted to the DOH Central Office for consideration and inclusion in the Annual General Appropriations Act.VII. Repealing Clause The provisions of the previous Administrative Order 135 s.2004 which are not contrary to the provisions of this Administrative Order shall remain in effect. VILL. Separability Clause In the event that any section, paragraph, sentence, clause or word of this Administrative Order is declared invalid, other provisions not affected thereby shall remain in effect. Any provisions of existing and other related issuances which are inconsistent or contrary with the provisions of this Administrative Order are hereby revised, modified or rescinded accordingly. IX. Effectivity This Order shall take effect immediately. ENRIQU}-TLONA, MD Seerpy/of Heath