Republicof the Philippines

Department of Health
OFFICE OF THE SECRETARY

January 11, 2024

DEPARTMENT MEMORANDUM
No. 2024-_0Q20

FOR: ALL UNDERSECRETARIES OF THE UHC HEALTH

SERVICES CLUSTER; MINISTER OF
BANGSAMORO AUTONOMOUS REGION IN MUSLIM
HEALTH -
MINDANAO; DIRECTORS OF CENTERS FOR HEALTH
DEVELOPMENT; EXECUTIVE DIRECTORS OF SPECIALTY
HOSPITALS; CHIEFS OF MEDICAL CENTERS, HOSPITALS,
AND SANITARIA; AND OTHERS CONCERNED

SUBJECT: Delineation of Functions of the Health Facility Development Unit,

Health Emergency Management Staff - Operation Center, and the
Regional Patient Navigation and Referral Unit in the Centers for
Health Development _and the Public Health Unit and Health
Emergency_and Disaster Management Unit in DOH Hospitals
Relative to their Roles in the Referral System

In order to enhance coordination, streamline processes, and ensure optimal health care
delivery, the Health Regulation and Facility Development Cluster reiterates the delineation of -

functions of the Health Facility Development Unit (HFDU), Health Emergency Management
Staff - Operation Center (HEMS-OPCEN), and the Regional Patient Navigation and Referral
Unit (RPNRU) in the Centers for Health Development (CHDs) and the Public Health Unit
(PHU) and Health Emergency and Disaster Management Unit HEDMU)
relative to their roles in the referral system.
DOH
hospitals in
I. Delineation of Referral Functions of HFDU, HEMS-OPCEN, and RPNRU in
CHDs

A. HFDU
Administrative Order (AO) No. 2019-0031 or the “Establishment and
Strengthening of the Health Facility Development Unit in All Centers for Health
Development and Ministry of Health - Bangsamoro Autonomous Region in
Muslim Mindanao” stipulates that the HFDU shall provide technical assistance
(TA) on health facility development, planning, operation, and maintenance of
health facilities. These include TA on the establishment of PHU and referral
system, as well as TA and validation of the Local Health Systems Maturity
~

Level (LHS ML) monitoring tool for the Service Delivery (SD) 1 (Referral
System) characteristics.

B. HEMS-OPCEN
AO No. 2010-0029 or the “Policies and Guidelines on the Establishment of
Operation Center for Emergencies and Disasters” outlines the following
functions of the HEMS-OPCEN
in
the CHDs:
1. Serves as the center of command, control, and coordination the health of
sector response in the region.

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila @ Trunk Line 651-7800 local 1108, 1111, 1112, 1113
Direct Line: 711-9502; 711-9503 Fax: 743-1829 e URL: http://www.doh.gov.ph; e-mail: dchosec@doh.gov.ph
 Coordinates with the Regional Office of Civil Defense and Local
Government Units in their area of responsibility.
Coordinates with all hospitals within the region to prepare for the influx
of patients and alerts additional teams that may be needed.
Cc. RPNRU
Department Order No. 2022-0210 or the “Guidelines for the Strengthening of
the National Patient Navigation and Referral System (NPNRS)” specifies that
_

the RPNRU shall operate as a section lodged in the regional Disaster Risk
Reduction and Management in Health (DRRM-H) Units with adequate human
resources, and other relevant resources necessary to support its operations. The
functions of the RPNRU are:
1. Adopt the NPNRS policies, plans, guidelines, and Information and
Communications Technology (ICT) system.
2. Operate 24 hours a day, seven (7) days a week to provide navigation and
referral services and data on the coordination of patients, transport,
telemedicine, and other health-related services including financial
assistance through the Field Implementation and Coordination Team
(FICT).
Initiate, update, and maintain healthcare service delivery resource
mapping within its scope of jurisdiction and report to the National
Patient Navigation and Referral Center (NPNRC).
Initiate, update, and maintain referral pathways and networks within its
scope of jurisdiction considering existing health care provider networks
(HCPNs) and referral pathways, and its geographical limitations.
Provide guidance, support and technical assistance to all the members
of the HCPN through the establishment of linkages and partnerships for
ease in health service navigation and referral.
Maintain interoperability among HCPNs through an organized line of
communication and established referral networks.
Coordinate with its Health Promotion Units (HPUs) for the publication
and posting in conspicuous areas and/or on the official social media
pages of the CHD and the regional referral hotlines. Updates shall be
communicated to all members of the NPNRS.
Maximize the referral to the appropriate health facilities that can cater
to the patient’s needs taking into consideration the geographical location
of the patient.
Escalate inter-regional, specialized inter-facility, and other needs-based
referrals to the NPNRC.
10. Ensure equitable health service delivery to its partners and stakeholders.
11. Report to the NPNRC the key performance indicators (KPIs), issues,
concerns, and recommendations on a regular basis.

IJ. Delineation of Referral Functions of PHU and HEDMU in DOH Hospitals

A. PHU
Section 17 of the Implementing Rules and Regulations of the Universal Health
Care Act states that “to facilitate the provision of population-based health
services, a public health unit shall be established in all hospitals to support the
implementation of national public health programs, institutionalize a
~
 mechanism with primary care provider networks, and provide one-stop-shop
patient navigation support mechanism within the hospital.”

AO No. 2020-0019 or the “Guidelines on the Service Delivery Design of Health

Care Provider Networks” reiterates that all hospitals should have a PHU to
facilitate the implementation of population-based health services and seamless
patient navigation with the HCPN. The functions of the PHU are:
1. Ensure that hospital policies are aligned with national public health
programs.
2. Assist the hospital management in ensuring surveillance and reporting
of notifiable diseases through the disease surveillance officer or disease

surveillance coordinator.
3. Ensure proper referral and navigation of patients within the hospital and
from the hospital to primary care facilities and other necessary facilities
in the network.
4. Implementation of health education programs.

The PHU is responsible for establishing and institutionalizing the patient

navigation and referral system of the hospital. However, it is crucial to
emphasize that the PHU will not be solely responsible for executing the actual
patient navigation and referral tasks. The delegation of these responsibilities to
other units (i.e. ED, HEDMU) may occur based on the hospital management's
discretion and as deemed appropriate.

In accordance with the Revised Standards on Organizational Structure and

Staffing Pattern (RSOSSP) for Level III Government Hospitals, the PHU shall
operate under the Office of the Medical Center Chief. The unit is expected to
comprise of 5-6 staff members, with the exact number contingent upon the
authorized bed capacity of the hospital. Furthermore, functions of the Hospital
Epidemiology and Surveillance Unit and HPU are subsumed under the PHU.

. HEDMU

AO No. 2010-0029 states that the HEDMU, otherwise known as the DRRM-H
Unit, shall act as an Operation Center for emergencies and disasters, including
transfer and referral of patients with the following specific functions:
1. Serves as the center of command, control, and coordination of the
hospital.
2. Coordinates with their respective CHD, local government units (LGUs),
and other partners in their community.
3. Coordinates with other hospitals regarding transfer and referral of
patients.
4. Prepares and submits reports to their respective CHD and LGUs.

In accordance with the RSOSSP for Level III government hospitals, the
HEDMU shall operate under the Office of the Medical Center Chief with 8 staff
members.
 C. Other Referral Functions of Hospitals

Furthermore, DO 2022-0210 delegates patient navigation and referral functions

to hospitals with the following specific tasks:
1. Designate the Emergency Departments (EDs) as the receiver of
emergency referrals while the PHUs as the coordinating office for
referral of non-emergency cases as well as providing reportorial
—

requirements to the NPNRC.

Provide a service hotline accessible 24/7 using available PNRS ICT
system with an identified focal person, and interoperable with the ICT
system of the NPNRC.
Allocate and communicate the number of all
dedicated beds for patients
especially those with emerging/re-emerging infectious diseases in terms
of isolation beds based on approved bed capacity.
Coordinate with the HCPN for transferring and receiving patients and
logistics.
Ensure proper and standardized endorsement of patients between health
facilities.
Standardize regularly and update case definitions.
Update regularly the list of services and schedule, available beds, and
other pertinent data in the PNRS health facilities database to the NPNRC
via the existing ICT system.
Report to the NPNRC the KPIs, issues, concerns, and recommendations
on a regular basis.

Should you have any queries or clarification, please contact the Health Facility
Development Bureau at 8651-7800 local 1401/1403 or via email at hfdb@doh.gov.ph.

For your information and guidance.

By Authority of the Secretary of Health:

anrer(f.Watencta, MD, MPH, CESO III

OIC - Assistant Secretary for Health
Health Regulation and Facility Development Cluster