MUNICIPAL HEALTH OFFICECALASIAO, PANGASINAN

LOCAL HEALTH BOARD

Meeting August 2011

Previous LOCAL HEALTH BOARD meeting Dec.17, 2010

AGENDA:LOCAL RESOLUTIONS/ORDINANCESAMENDMENT OF THE LOCAL TAX CODEBUDGET FOR HEALTH (2011)HEALTH ACTIVITIES / PROJECTSBHW CONCERNS MCP PROJECT (new agendum)

LOCAL RESOLUTIONS/ORDINANCES:Existing local ordinances/resolutions pertaining to health:

ASIN LAW - Ordinance No.2, S. 2002 Municipal Fitness Day - Resolution No. 53 S. 2002 STAC Creation - Ordinance No. 12 S. 2004 Advocacy on Healthy Life style - Executive Order No. 11 S.

2005 Ordinance Regulating Videoke Bars, Etc. - Ordinance No. 3 S.

2005 Ordinance on Use of Fortified Foods - Ordinance No. 5 S. 2007 Creation of Philhealth Capitation Trust Fund Ordinance No. 7

S. 2008

Proposed local ordinances/resolutions pertaining to health:

Voluntary Blood Bank (Republic Act 7719 - National Blood Services Act of 1994)

Anti-Dengue Fever Clean-up Day (4 O’clock Habit) Ordinance – Ordinance No. __Series of 2011

Garantisadong Pambata - Resolution of Support to the Program

EPI Program - Resolution of Support to the Program Ordinance on NTP-DOTS Program Ordinance No. 4 Series of

2011 Ordinance Adopting TB Control Program - deferred TB for Children - Resolution of Support to the Program Republic Act 7183: An Act Regulating the Sale, Manufacture,

Distribution and Use of Firecrackers and Other Pyrotechnic Devices

LOCAL RESOLUTIONS/ORDINANCES:

Proposed local ordinances/resolutions pertaining to health: – Micronutrient Supplementation - A Resolution requesting

the Municipal Mayor to include in his priority projects the procurement and distribution of Vitamin A capsules for supplementation to sick children and lactating mothers - Resolution No. 42, series of 2011

– Regulation of Smoking (Republic Act 9211 - Tobacco Regulation Act of 2003)

– Ordinance Banning Smoking in Public Places and Public Utility Vehicles

– Ordinance Prohibiting Use, Sale and Distribution of Cigarettes and other Tobacco Products in Certain Places

LOCAL RESOLUTIONS/ORDINANCES:

Proposed local ordinances/resolutions pertaining to health: Republic Act 8504 - Aids Prevention and Control Act of

1988 - deferred Republic Act No. 10028 An Act Expanding The

Promotion Of Breastfeeding Resolution Promoting Advocacy for Breastfeeding to

Protect the Health of Infants and Children Resolution No. 44, series of 2011

Ordinance Prohibiting Counterfeit Drugs - deferred Resolution supporting Healthy Lifestyle Program as a

Major Health Policy in the Municipality of Calasiao Resolution No. 43, series of 2011

Ordinance on Avian Influenza (AI) Prevention and Preparedness Program in the Municipality of Calasiao

Rabies Control Ordinance - deferred

LOCAL RESOLUTIONS/ORDINANCES:

AMENDMENT OF THE LOCAL TAX CODE: CALASIAO REVISED REVENUE CODE OF 2005 ORDINANCE NO.10, SERIES OF 2005ARTICLE V- PHYSICAL EXAMINATION & MEDICAL CERTIFICATION FEES

Service / Laboratory Examinations: Present Proposed New Rate Rate

a. Medical Certification 50.00b. Transfer Permit of Food Product 50.00c. Health Certificate for Employment 50.00d. Health Certificate for Employment (renewal) 20.00e. Complete Blood Count (CBC) 90.00f. Urinalysis 40.00g. Fecalysis 35.00h. Sputum Exam 30.00i. Hemoglobin 45.00j. Hematocrit 45.00k. Platelet Count 70.00l. Fasting Blood Sugar 90.00m. Blood Typing 45.00

Laboratory services discount rates; • Philhealth enrollees – free• BHWs - 10 % discount• Senior Citizens - 20 % discount• PWDs - 20 % discount• LGU employees - 10 % discount

Requirements for Water Refilling businesses:– 1. Certificate of Potability

Proposed Fee: P 50.00 per quarter– 2. Drinking Water Site Clearance Certificate

Proposed Fee: P 50.00 per year

AMENDMENT OF THE LOCAL TAX CODE:

BUDGET FOR HEALTH (2011):A. PERSONNEL SERVICES:

Full implementation of SSL III and Magna Carta for 2012 Personnel requirement:

1. Public Health Dentist

Rationale: Calasiao Health Office can not offer dental services for the people. No accomplishment reports for dental services for pregnant women and children.

2. Rural Sanitary Inspector

Rationale: Poor Environmental Sanitation Report compliance resulting to Zero Accomplishment Reports of Calasiao to the PHO, CHD and the DOH

Prioritization of Personnel Requirement

Rural Sanitary Inspector

BUDGET FOR HEALTH (2011):A. PERSONNEL SERVICES:

SANITARY INSPECTOR’S ACTIVITIES1. For business permit applications

If restaurants, canteens, food vendors, food manufacturers, - require medical certification (sputum microscopy/fecalysis)

Inspections of establishment before issuing sanitary permitEnter name and other details of establishments in

database

2. Survey household water supply and sanitary toilets and maintain/update records and reports

3. Monitor safe water supplyConduct water sampling If warranted, decontaminate water source (chlorination)

BUDGET FOR HEALTH (2011):A. PERSONNEL SERVICES:

SANITARY INSPECTOR’S ACTIVITIES4. Monitor Water refillers

For new water refilling stations Issue drinking water site clearance Issue application for drinking water site clearance Refer owner to Engr. Ashley Antonio of CHD

For old water refilling stations Personally obtain water samples for bacteriological

examination once a month Coordinate or personally bring water samples to testing

centers with payment ( secure O.R. to be endorsed to owner)

Physicochemical test- twice a year

BUDGET FOR HEALTH (2011):A. PERSONNEL SERVICES:

SANITARY INSPECTOR’S ACTIVITIES5. Monitor commercial sex workers

Check documents of CSWs ( police clearance, Mayor’s Permit, NSO birth certificate, etc)

Take pictures, issue pink cards after presentation of smear results from the Social Hygiene Clinic-Dagupan City

Make master list of CSWs, date of pink card issuanceAssist in inspection of videoke bars, night clubs, etc.

6. Inspection of complaints with Mission OrdersAct on complaints/petition on environmental sanitation

concerns Issue and deliver Sanitary Order, Sanitary Permit

7. Others as maybe determined by the MHO

BUDGET FOR HEALTH (2011):B. MOEE: The full implementation of SSL III for the Calasiao public health workers for

FY 2011 resulted in cuts in the MOOE which affected the following:

Regular Activities: drugs and medicines, from P 870,000.00 to 750,000.00 medical and laboratory supplies, from P 60,000.00 to P 0.00 gasoline, oil & lubricants, from P 145,000.00 to 120,000.00 maintenance of health centers, from P 25,000.00 to P 0.00 ambulance maintenance, from P 120,000.00 to 100,000.00 office supplies, from P 60,000.00 to P 50,000.00 maintenance of I.T. equipments, from P 10,000.00 to P 0.00 Amount deducted for SSL III from regular MOEE items = Php 270,000.00

(-120,000.00) (-60,000.00) (-25,000.00) (-25,000.00) (-20,000.00) (-10,000.00) (-10,000.00)

BUDGET FOR HEALTH (2011):B. MOEE:Special Projects: 2010 Budget

Stimulation Therapeutic Activity Center (STAC) P 200,000.00 Rehabilitation Treatment for the Masses (RTM) P 30,000.00 Botica ng Barangay (BnB) P 0.00 Environmental Sanitation Program (ESP) P 240,000.00

Php 470,000.00But since all the Special Projects require contractual/consultants for their

operations, for 2011, they have been allocated the following:

Contractual/Consultants Per month Per yearPT for STAC Project 7,000.00 84,000.00

SPED Coordinator for STAC 6,000.00 72,000.00

PT for RTM Project 6,000.00 72,000.00Pharmacist for BnB 7,000.00 84,000.00Sanitation Adviser 7,000.00 84,000.00

Php 396,000.00

BUDGET FOR HEALTH (2011):B. MOEE:Special Projects: Thus, for 2011, all special projects are lumped together ( P 40,000.00)

for expenses such as rehab equipments, teaching materials for both STAC and SPED, rehab equipments for both STAC and RTM Project and sanitation and environmental IEC materials, cleaning gears and chemicals for the Environmental Sanitation Program (ESP).2011 Budget for Special Projects

Php 396,000.00

40,000.00

Php 436,000.00

Amount for SSL III from regular MOEE items -TOTAL AMOUNT DEDUCTED FROM MOEE FOR SSL III =

+

+

Php 470,000.00 (2010 allocation)

436,000.00 (2011 allocation)

Php 34,000.00 added to SSL III

-

270,000.00

Php 304,000.00

BUDGET FOR HEALTH (2011):B. MOEE:TOTAL AMOUNT DEDUCTED FROM MOEE FOR SSL III = Php 304,000.00The Health Office is pleading for the return of the Php

270,000.00 to the Regular Activities MOEE allocations in order to reinstitute the proper operations of the health services affected by the deductions in 2011, without prejudice to the 3rd trance of the SSL II implementation. Also proposed are the following:

-The services and allocations for the contractuals/ consultants of Special Projects be retained

- Allocation for overtime pay of our 6 personnel (2 PHNs, 4 JOWs) who will be in charge of the treatment and management (Tutok Gamutan) of our Multi-Drug Resistant-Tuberculosis (MDR-TB) patients every Saturday. (If a Sanitary Inspector is appointed, the annual allocation for a Sanitation Adviser (P 84,000.00) can instead be used for this purpose) Letter request August 18, 2011

HEALTH ACTIVITIES/PROJECTS: Philhealth coverage of Calasiao for OBP: 250

Families/Year – Basis for identification (MSWD) Enrolment of poor pregnant women New Pnoy program using NHTS – no capitation Fund?

Anti-Dengue Activities Municipal resolution/ordinance – Done Year-round info dissemination – reproduction of

tarpaulins, IEC materials Barangay resolution/ordinance; budget for Anti-

Dengue Activities – Cleaning, misting chemicals/fuel, IECM

Volunteer Blood Donation and Barangay Pool- Done

HEALTH ACTIVITIES/PROJECTS: Lectures/Seminars to improve health staff

knowledge and capabilities including BHWs Request LIGA for appropriation for weighing

scales (Nutrition) and syringes (EPI) and STAC contribution

LGU Scorecard: Contraceptive Prevalence Rate (FP) Case Detection Rate (NTP) Safe Water and Sanitary Toilets – hiring of RSI

PLANS FOR BHWS FOR 2011:(Taken up during the Local Health Board Meeting held last December 17,

2010)

Clarification of Provisions of Republic Act No. 7883: Barangay Health Workers' Benefits and Incentives Act of 1995

Request LIGA for appropriation for BHW training

Set guidelines and lectures, specific assignments /tasks of BHWs in Calasiao

BHW CONCERNS

Republic Act No. 7883: AN ACT GRANTING BENEFITS AND INCENTIVES TO ACCREDITED

BARANGAY HEALTH WORKERS AND FOR OTHER PURPOSES

Section 1. Short Title. – This Act shall be known as the “Barangay Health Workers’ Benefits and Incentives Act of 1995.”

Section 2. Statement of Policy. – The state shall protect and promote the right to health of the people and to provide …

Section 3. Definition. – The term “barangay health workers” refers to a person who has undergone training programs under any accredited government and non-government organization and who voluntarily renders primarily health care services in the community after having been accredited to function as such by the Local Health Board in accordance with the guidelines promulgated by the Department of Health (DOH).

Section 4. Registration. – In order of barangay health workers to be entitled to benefits and incentives provided under this Act, they shall register with the Local Health Board…

Section 5. Number of Barangay Health Workers. – The DOH shall determine the ideal ratio of barangay health workers…

Section 7. Review by the Local Health Board. – Every incentive or benefit for barangay health worker requiring expenditure of local funds shall be reviewed and approved by the Local Health Board to ensure that only the deserving barangay health workers get the same.

Section 11. Effectivity. – This Act take effect fifteen days (15) after its publication in at least two (2) national newspapers of general circulation.

Approved: February 20, 1995

Sgd. Jose de Venecia, Jr Sgd. Edgardo Angara Speaker of the House Senate President

of RepresentativesSgd. Fidel V. Ramos

President of the Philippines

BHW BASIC TRAINING SEMINAR RURAL HEALTH UNIT - I

Ambonao 8

Bued 5

Cabilocaan 4

Gabon 2

Lasip 3

Mancup 3

Nalsian 5

Poblacion East 2

Poblacion West 2

Quesban 4

San Miguel 6

Talibaew 2

46

BHW BASIC TRAINING SEMINAR RURAL HEALTH UNIT - II

Ambuetel 7

Banaoang 5

Buenlag 1

Dinalaoan 4

Doyong 6

Longos 3

Lumbang 6

Macabito 3

Malabago 12

Nagsaing 9

San Vicente 4

Songkoy 10

70

BASIC TRAINING FOR NEW BARANGAY HEALTH WORKERS

IDENTIFYING INFORMATION:Project Title: Basic Training for BHWs

Program Component: Primary Health Care and other Department of Health Programs

Sector: Barangay Health Workers

Coverage: Municipality of Calasiao

Implementing Agency: Calasiao Municipal Health Office/Center for Health Development for Ilocos (CHD-!)/Pangasinan Provincial Health Office

Funding Source: Calasiao LIGA ng Mga Barangay (24 Barangays of Calasiao, Pangasinan)

LEGITIMIZATION A certificate of training will be issued to all who

successfully comply with training requirements and their names will be submitted for accreditation to the Local Health Board which will, in turn, endorse the names of the accredited BHWs to the Office of the Municipal Mayor, Municipal Budget Office, Municipal Accounting Office and the Municipal Treasurer’s Office.

FIRST BATCH August 3-4, 2011

Ambonao 8 Ambuetel 7 Bued 5 Cabilocaan 4 Dinalaoan 4 Doyong 6 Malabago 12 Poblacion West 2 Quesban 4 San Miguel 6

58

SECOND BATCH August 10-11, 2011

Banaoang 5 Buenlag 1 Gabon 2 Lasip 3 Longos 3 Lumbang 6 Macabito 3 Mancup 3 Nagsaing 9 Nalsian 5 Poblacion East 2 San Vicente 4 Talibaew 2 Songkoy 10

58

CONSTITUTION AND BY-LAWSof the

BARANGAY HEALTH WORKERS FEDERATION OF CALASIAO, PANGASINAN

ARTICLE IV – COMPOSITION AND MEMBERSHIP• Section 1. Composition- This Federation shall be composed of

registered and accredited Barangay Health Workers of all the twenty-four (24) barangays within the territorial jurisdiction of the Municipality of Calasiao;

• Section 2. Membership- It is open primarily to men and women who subscribe to the objectives of the Federation, its goal and purpose, abide by this laws, are willing to accept responsibility and are duly qualified having undergone the Basic Training Course for BHWs conducted by and accredited government agency and NGOs and are at least 18 years of age, and are physically and mentally fit.

This Constitution and By-Laws was signed and approved by all the members of the Federation on August 17, 2007.

ARTICLE IV – COMPOSITION AND MEMBERSHIP;

• Section 3. Grounds for Suspension and Removal – Any member or officer of the Federation may be suspended or dropped from the roster upon commission of acts inimical or prejudicial to the affairs of the Federation which includes, but not limited to the following:

1. Neglect of duty;Excessive absence from the duties of rendering

health services in their respective barangays exceeding 30 cumulative service days with no letter of explanation prior to or during the said duration 0f absence submitted to and approved by the Board of Directors.

Any negligence of duty which the Board of Directors may consider to be a serious ground for removal or suspension.

2. Gross misconduct;

ARTICLE IV – COMPOSITION AND MEMBERSHIP;

3. Non-payment of annual membership dues and non-payment of financial obligations related to the affairs and projects of the Federation;

4. Culpable violations of the Constitution and By-Laws;

5. Any medical, physical or mental disability that renders any member or officer unfit to perform expected tasks and assignments. The assigned Rural Health Midwife in each of the barangay, being the direct supervisor, will submit the names of barangay health workers who have failed to perform expected tasks and assignments due to any disability to the Municipal Health Officer for medical, physical or mental evaluation. The Municipal Health Officer may refer the case to a higher level of medical examination if warranted. The Municipal Health Officer, based on the results of the evaluation and the provision stated in Article IV, Section 2, will recommend to the Board of Directors through the Committee on Membership, the removal of the barangay health worker

ARTICLE IV – COMPOSITION AND MEMBERSHIP;

6. And other grounds for suspension or removal as determined by the Board of Directors through the Committee on Membership, with the recommendation of the supervising Rural Health Midwife, the Public Health Nurse, the Municipal Health Officer, and other agencies under the Department of Health

RECOMMENDED FOR REMOVAL AS BHWs RURAL HEALTH UNIT - I

Ambonao 3

Bued 5

Gabon 1

Lasip 1

Mancup 2

Nalsian 1

Quesban 2

15

RECOMMENDED FOR REMOVAL AS BHWs RURAL HEALTH UNIT - Ii

Banaoang 1

Dinalaoan 2

Lumbang 3

Malabago 8

Nagsaing 1

San Vicente 5

Songkoy 2

22

• The health workers recommended for removal will be properly informed and be given due process during the suspension/removal evaluation by the Local Health Board;

• After the Local Health Board evaluation, if the grounds for suspension/removal is/are deemed sufficient and with cause, the concerned BHWs will be not be reinstated to the Calasiao BHW roster of members. A master list of the registered and accredited Calasiao BHW members will then be submitted by the Local Health Board to the Office of the Municipal Mayor, Municipal Budget Office, Municipal Accounting Office and the Municipal Treasurer’s Office, as their guide pursuant to Section 7 of R.A. 7883:

Section 7. Review by the Local Health Board. – Every incentive or benefit for barangay health worker requiring expenditure of local funds shall be reviewed and approved by the Local Health Board to ensure that only the deserving barangay health workers get the same.

BHW CONCERNS

PLAN OF ACTION FOR THE ESTABLISHMENT OF A MATERNITY CARE FACILITY FOR THE MUNICIPALITY OF CALASIAO

UNDER THE MATERNITY CARE PACKAGE (MCP) PROGRAM OF PHILHEALTH

A. IDENTIFICATION OF MATERNAL CARE HEALTH SPECIALISTS– The MCP Program of PhilHealth requires the LGU to enter into an

agreement (Memorandum of Agreement) with two private and accredited medical professionals, an Obstetrician who is an active member of the Philippine Obstetrical and Gynecological Society (POGS) and a Pediatrician who is an active member of the Philippine Pediatric Society (PPS), and both doctors should be Philhealth accredited as well.

– It is preferable that both doctors are residents of Calasiao although assurance of their immediate accessibility in times when their services are needed will be adequate enough (must be stipulated in the MOA).

– Philhealth will provide the guidelines on the sharing scheme of Philhealth-enrolled mothers who avails of the Calasiao MCP services while services rendered by the two medical professionals on mothers with no Philhealth coverage will be shouldered by the LGU (must be stipulated in the MOA).

– The two medical professionals will be on-call status. UPDATE STATUS (as of August 22, 2011): The PHO, Dr. Anna de Guzman,

will facilitate the approval of this Philhealth requirement.

MATERNAL CARE PACKAGE

B. THE LOCAL MCP STAFF– Another requirement of the MCP Program of PhilHealth is the skills

training on birth delivery and newborn care for the local health staff who will take charge of the MCP operations. However, this training will have to be coordinated first with either the Region1 Medical Center (R1MC) in Dagupan City or with the Pangasinan Provincial Hospital (PPH) in San Carlos City since this type of training is not routinely being given. The Health Office will coordinate with Dr. Roland Mejia. Hospital Director, for the R1MC and Dr. Anna de Guzman, Provincial Health Officer, for PPH

– Other required personnel are midwives, at least 6 to 9 in number, who will be hired under JOW/contractual basis. They will go on 24 hour duty rotation.

UPDATE STATUS (as of August 22, 2011): The CHD was gracious enough to provide free trainings on Basic Life Saving Skills (BLS) training, sponsored by POGS, to two (2) of our Health Office staff last August 15 to 21, 2011:

1. Brigida de Vera – RHM III2. Jacqueline Salazar – RHM II

MATERNAL CARE PACKAGE

C. BIRTHING FACILITY– The MCP Program of PhilHealth has set minimum requirements for the

structure, equipments, furniture and fixtures of the birthing facility. – The compliance of such requirements can be achieved by either of two

ways: Use the present facility of the Health Office- Identified as a possible

area is the radiology room which is being presently used as a stock room. For this room to be used as a viable place for the birthing facility, the following are recommended:

Construct an alternative storage room Renovations to be done on the radiology room

Renovations to be done on the radiology room Construct a new building in an adjacent area near the health center.

The birthing facility can be constructed in front of the health center where an extensive area has been recently earth-filled although the structure itself will only use a small part of the said area. The birthing facility can be designed and planned already based on the MCP Program requirements

UPDATE STATUS (as of August 22, 2011): None

MATERNAL CARE PACKAGE

THANK YOU VERY MUCH!!