The Mandanas-Garcia Ruling and the DOH Initial Devolution

Transition Plan CY 2022-2024

As Presented in the Inception Workshop with LGUs on May 24, 2021

Dr. Mario C. Villaverde, MPH, MPM, CESO I

Undersecretary, Health Policy and Systems Development Team
Chair, DOH Steering Committee on Full Devolution
 Internal Revenue Allotment of LGUs and SC
Ruling on the Mandanas-Garcia Case

❏ The petition filed in court questioned the IRA computation as the practice
espoused from the Local Government Code, which was said to be against the
1987 Constitution.
❏ The Supreme Court ruled in favor of the petitioners, stating that “just share” of
LGUs include ALL national taxes and not just the national internal revenue
taxes, but also custom duties and others.
❏ The ruling shall have a prospective application.

Republic of the Philippines

DEPARTMENT OF HEALTH
 Expected Increase in the IRA (NTA) of LGUs in 2022
Source: DBM Budget Fora FY 2022

PhP 234.39 B (27.61% more, 1.03% of GDP) *

Projected IRA (NTA) in 2022 % to GDP (2022)**
Before SC decision PhP 848.44 B 3.72%
After SC decision PhP 1.083 T 4.75%
*Based on the 07 March 2020 computation of DOF
**Based on DBCC AdRef Meeting on July 28, 2020

Sample LGU Computation

Income 2022 IRA Share 2022 IRA Share Nominal
LGU % Increase
Class (w/o Mandanas) (w/ Mandanas) Increase
Province A 1st 3.59 B 4.401 B 27.61% 814 M
CIty B 1st (HUC) 1.74 B 2.134 B 27.61% 394 M
Municipality C 1st 826 M 1.014 B 27.61% 187.62 M

Republic of the Philippines

DEPARTMENT OF HEALTH
 Fiscal Impact of the Mandanas-Garcia Ruling
DBM’s proposed measure to mitigate its FISCAL IMPACT is to
gradually “REDEVOLVE SERVICES” to LGUs

LGUs to fully provide Develop Transition Release an Executive

delivery of devolved Plans with NGAs Order on Full
services not later than Devolution
end of FY 2024

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Features of Executive Order No. 138
Full Devolution of Certain Functions of Executive Branch to Local Government

Delineation Preparation of Creation of Development of

of NG and Devolution Committee on Communication
LGU Roles Transition Plans Devolution Plan and Strategy

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Features of Executive Order No. 138
Full Devolution of Certain Functions of Executive Branch to Local Government

Capacity Strengthening of Establishment of Options for

Building Planning, Investment Growth Equalization Affected NGA
for LGUs Programming & Fund Personnel
Budgeting Linkage and
M&E Systems
Republic of the Philippines
DEPARTMENT OF HEALTH
 The functions that DOH will re-
devolve to LGUs on HFEP, HRH
Deployment, Hiring of DSOs, and
Commodities all fall under the red
boxes which is consistent with the
Local Gov’t Code in providing
basic health services to its
constituents.

Republic of the Philippines

DEPARTMENT OF HEALTH
 VISION STRATEGY MAP 2022
Impact Filipinos are among the healthiest people in Southeast Asia by 2022 and in Asia by 2040 Department of Health

More Responsive Health Systems

Catalyze the transformation of Local Health Systems to Province-

Strategic
Focus

wide and City-wide Health Systems

DOH’s support to LGUs in the
DOH’s Inherent Functions in the DOH’s Inherent Functions in the
Devolution Transition
Process

Devolution Transition Devolution Transition

Core

Capacity Building and

Policy, Standards, and Sectoral and Local
Technical Assistance
Regulation Engagements
Support

Infrastructure,
Process

Human Resources Procurement and Performance

Equipment, and Budget Planning and
Management and Supply Chain Management and
Information Technology Execution
Development Management Management Accountability

DOH’s Support for Equity/Augmentation DOH’s Inherent Functions

MISSION CORE VALUES
To lead the country
Republic in the development of a Productive, Resilient, Equitable and People-
of the Philippines Professionalism | Responsiveness Integrity
Centered DEPARTMENT
health system forOF HEALTH
Universal Health care | Compassion | Excellence
 Overview of the Initial DOH Devolution
Transition Plan CY 2022-2024
Considerations:
● Income Class
● Poverty Incidence
Health System has a
● Local Capacity
Devolved Set-up
● Availability of Services & Commodities
in the Local Market
● UHC Act & Pertinent Laws

Not Affected by Re-devolution:

Re-devolution of ● DOH Hospitals & Other National
functions, not necessarily Health Facilities
downloading of funds ● Attached Agencies &
Corporations

Republic of the Philippines

DEPARTMENT OF HEALTH
 Principles for Retention of Functions with DOH
Mandate based on EO 102 s. 1999 & UHC Act

Enabler and Capacity

Leader in Health
Builder

Administrator of National
Financier of
Health Facilities,
Population-based
Attached Agencies &
Corporations Health Services

Republic of the Philippines

DEPARTMENT OF HEALTH
 Expenditure Assignment on Health
Based on the Local Government Code

Province Municipality Cities Barangays

Health ● Health services which include the implementation of All the services Health
services programs and projects on: and facilities of services which
which ○ Primary Health Care, the include the
include ○ Maternal and Child Care, and municipality maintenance
hospitals ○ Communicable and Non-communicable Disease and province, of barangay
and other Control Services and in addition health facilities
tertiary ● Access to secondary and tertiary health services; thereto,
health ● Purchase of medicines, medical supplies, and adequate
services equipment needed to carry out the services herein communication
enumerated and
● Rehabilitation programs for victims of drug abuse; transportation
● Nutrition services and family planning services facilities
● Clinics, health centers, and other health facilities
necessary to carry out health services

Republic of the Philippines

DEPARTMENT OF HEALTH
 Definition of Terms

Retained with DOH Maintain DOH-retained functions in the GAA

Partially Devolved Shared responsibility between NG and LGUs

(e.g. NG to retain buffer / augmentation for GIDA, etc.)

Gradually Devolved Re-devolution of functions in phases (CY 2022-2024)

Fully Devolved Entire function / responsibility re-devolved to LGUs

Republic of the Philippines

DEPARTMENT OF HEALTH
 Summary of DOH P/A/Ps for Re-Devolution CY 2022-2024
DOH Budget Line Items (P/A/Ps) DOH Recommendation LGU Role
1. Health Facilities Enhancement Gradually and Partially Devolved Procurement of
Program (HFEP) Capital Outlay
2. Epidemiology and Surveillance - Partially Devolved by CY 2023 Hiring of DSOs
Disease Surveillance Officers (DSOs)*
3. Human Resources for Health (HRH) Gradually and Partially Devolved Hiring of nurses and
Deployment midwives
4. Public Health Commodities:
❏ Family Health, Immunization, Gradually and Partially Devolved Procurement,
Nutrition and Responsible warehousing,
Parenting storage, and
❏ Prevention & Control of Partially Devolved distribution of
Communicable Diseases Commodities to
target recipients
❏ Prevention & Control of Non- Gradually and Partially Devolved
Communicable Diseases
Republic of the Philippines
Note: DSOs are fully devolved to LGUs by CY 2023 but DSOs in DOH are retained
DEPARTMENT OF HEALTH
 Summary of Retained & Re-devolved Functions

RETAINED PARTIALLY DEVOLVED FULLY DEVOLVED

■ Environmental & Occupational Health ■ HRH Deployment ■ Hypertension

■ National Immunization ■ Health Facilities Enhancement ■ Hypercholesterolemia
■ Rabies Control Program ■ Leprosy
■ Tuberculosis Control ■ Disease Surveillance Officers ■ Integrated Management of
■ Soil-Transmitted Helminthiasis ■ Family Health, Nutrition & Childhood Illness (IMCI)
■ Mental Health Responsible Parenting ■ Diabetes (beginning CY
■ Cancer ■ Sexually Transmitted Diseases 2023)
■ Oral Health ■ Food & Water-Borne Diseases
■ HIV ■ Filariasis
■ Vector Control (Malaria, Dengue) ■ Dengue Rapid Test
■ Mass Drug Administration
■ Medical Assistance for Indigent Patients Note: These are some examples of key programs and not an exhaustive list.
Subject for further discussion and may be subject to changes.

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (1)

Issues Recommendations

Capacity and lower share from ● Comprehensive capacity

national taxes of poorer LGUs assessment and profiling
● Effective capacity
development

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (2)

Issues Recommendations

● Legislate the relaxation of PS cap

through amendments to Local
Difficulty in hiring HRH
Government Code
● DOH to continue support of hiring
DSOs in LGUs needing the support
during the initial transition years

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (3)

Issues Recommendations

Difficult and challenging for ● DOH to study all provincial hospitals

lower rank LGUs to manage being managed by 3rd to 6th class
LGU hospitals LGUs
● DOH to support the renationalization of
provincial hospitals

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (4)

Issues Recommendations

Late timelines of implementation Start the consultations and other

strategies and activities for activities as early as this year
further devolution

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (5)

Issues Recommendations

Lack of technical skills for Recruitment from local or regional

supply chain management colleges/universities and Expansion
of scholarship for public health
pharmacists with Return Service
Agreement

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (6)

Issues Recommendations

Improving health outcomes ● Identify core indicators that cut

of LGUs across all levels of government
units
● Provision of incentives / grants /
recognition for performance

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (7)

Issues Recommendations

● DOH to provide guidance on the local

Health financing; management of
operationalization of the SHF vis-a-vis
increased share of LGUs from the increased local funding from the
national taxes national tax
● DOH to help LGUs determine priority
P/A/Ps in their local health plans to
simultaneously address COVID-19 and
primary health care needs

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (8)

Issues Recommendations

Dissemination of NGA’s Immediate cascading so that LGUs

devolution transition plan may align its own local devolution
transition plan

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (9)

Issues Recommendations

Devolution of HFEP DOH to provide more information on the

gradual devolution of HFEP

Republic of the Philippines

DEPARTMENT OF HEALTH
 Key Issues and Recommendations (10)
Issues
Basis / Criteria for LGUs to
be assisted
Republic of the Philippines
DEPARTMENT OF HEALTH
Recommendations
● Prioritize updating of the LGU income class
● Conduct consultation with the LGUs on the
possible updating of the Poverty Incidence*
due to COVID-19
*Poverty Incidence is updated every 3 years.
*Data for provinces are from the 2018 1st semester poverty estimates
*Data for cities and municipalities are taken from the 2015 Small Area Poverty Estimates.
 DOH Permanent Positions Affected

❖ None will be affected since the existing permanent positions in

DOH will still execute the retained functions and services
❖ The DOH will propose to DBM a recommended organizational
structure and counterpart staffing complement for LGUs in light
of the re-devolved functions

Republic of the Philippines

DEPARTMENT OF HEALTH
 Service Delivery Standards for
Re-devolved Health Functions
Download the compilation from this link:
https://www.tinyurl.com/DOHDevolutionStandards

Republic of the Philippines

DEPARTMENT OF HEALTH
 Maraming salamat po!

Republic of the Philippines

DEPARTMENT OF HEALTH