REVISED RULES AND REGULATIONS GOVERNING ACCREDITATION OF MEDICAL CLINICS AND HOSPITALS AND CONDUCT OF MEDICAL EXAMINATION FOR OVERSEAS WORKERS AND SEAFARERS

SECTION 1.       Title — These rules shall be known
as the “Revised Rules and Regulations Governing Accreditation of
Medical Clinics and Hospitals and the Conduct of Medical Examination for
Overseas Workers and Seafarers”.

SECTION 2.       Authority — These rules and
regulations are issued to implement the functions of the Bureau of
Licensing and Regulation under Section 13-C of Executive Order 119 and
the Memorandum of Agreement between the Department of Health (DOH) and
the Department of Labor and Employment (DOLE); and the DOH and the
MARITIME INDUSTRY AUTHORITY ( MARINA).

SECTION 3.       Purpose — The rules and
regulations are promulgated in order to establish, regulate, and upgrade
the standards of medical service and/or examination of overseas
landbased workers and seafarers for interisland/overseas employment and
to ensure that only occupationally qualified and physically and
medically fit workers/seafarers participate in the overseas/ interisland
employment program.

SECTION 4.       Scope — These regulations shall
apply to duly licensed and registered medical clinics, hospitals and
laboratories desirous of participating and offering their services to
private recruitment entities and manning agencies, and shipping
companies in the medical examination of overseas workers and seafarers
for overseas or interisland employment.

SECTION 5.       Regulatory Authority — The
Department of Health through the Bureau of Licensing and Regulation in
the Office of Standards and Regulation shall exercise licensing,
accreditation and regulatory functions under these rules and
regulations.

SECTION 6.       Classification of Clinics —

6.1     Regular land-based overseas workers clinic — a clinic that
conducts examination on land-based workers for overseas employment.
 These clinics are required to post a bond of P30 ,000.00 with the
Bureau of Licensing and Regulation, Department of Health.

6.2     Seafarers clinic — a clinic that conducts examination of
seafarers to local and foreign employment. These clinics are required to
post a bond of P30 ,000.00 with the Bureau of Licensing and Regulation,
Department of Health.

6.3     Seafarers and land-based overseas workers clinic — is one
that conducts examination of overseas and land-based workers. These
clinics are required to post a bond of P30 ,000.00 with the Bureau of
Licensing and Regulation, Department of Health.

6.4     In-house (land-based/seafarers) clinic — is a clinic that
conducts examination on land-based workers or seafarers for one
particular agency/company.  These clinics except for those owned by the
company, are required to post a bond of P30 ,000.00 with the Bureau of
Licensing and Regulation, Department of Health.

SECTION 7.       Accreditation Requirements (Technical Standards)

7.1     The following requirements shall be complied with by a
medical clinic or hospital applying for accreditation as land-based
clinic.

7.1.1.      Adequate clinic facilities such as examining table,
stethoscope, Mercury sphygmomanometer, clinical scale, examining light,
Snellens and Jaeger Charts, otoscope, fundoscope, pair of gloves.

7.1.2       X-ray facilities duly licensed by the Bureau of
Licensing and Regulation, certificate of which shall be attached to the
application for accreditation.

7.1.3       In case the clinic maintains a laboratory, it should
have a license to operate from the Bureau of Research and Laboratories.
It shall have adequate facilities to perform the following examinations:
CBC, Blood Typing, Hemoglobin determination, Pregnancy test,
Filariasis, Laboratories performing HIV testing should be accredited by
the BRL-DOH.

7.1.4       Physical Plant of the Clinic shall include:

a.         Reception room spacious enough to accommodate at least ten (10) applicants comfortably at a time.

b.         Consultation room

c.         Treatment/examination room

d.         Laboratory room

e.         Dental room with dental unit

f.          Psycho room

g.         Comfort rooms separate for male and female but for
those with twenty (20) applicants or less per day one (1) comfort room
is sufficient.

7.1.5       Clinic staff should include the following:

1.         Two (2) full time examining registered physicians,
one (1) male and one (1) female with a minimum of two (2) years active
practice and of good moral standing. In case the clinic has less than 40
clients per day one female physician may be sufficient.

2.         One cardiologist – may be part-time (consultant)

3.         One pathologist – for those with laboratories

4.         Radiologist – full time or part-time (consultant)

5.         Two (2) registered nurses. For in-house clinics, one nurse will do.

6.         Psychologist

7.         Medical Radiation Technician

8.         Medical Technologist (for those with laboratories)

9.         Dentist

10.       Medical Aide

11.       Messenger

7.2     For a clinic that will conduct examination of seafarers the following are the additional requirements:   aDSIHc

7.2.1       Space and facilities for examination of visual
acuity, color perception using Ishihara test, hearing and speech test.

7.2.2       EENT Consultant

7.2.3       Facilities for audiometry or contract of affiliation with a DOH-Accredited Clinic with such facilities.

SECTION 8.       Guidelines on the Conduct of Medical Examination — The following guidelines shall govern the conduct of medical examinations for land-based workers and seafarers.

8.1     Who shall conduct medical Examination for land-based workers or seafarers?

Medical examination of land-based workers and seafarers both for
interisland and overseas employment shall be conducted only by
hospitals, medical clinics and laboratories duly accredited for the
purpose.  Agencies/companies shall have their recruits medically
examined only by accredited hospitals or medical clinic.

Agency refers to a private recruitment entity, private employment
agency or manning agency duly authorized/licensed by the Philippine
Overseas Employment Administration, DOLE, to recruit and deploy workers
overseas.

A shipping company refers to any Philippine Registered Shipping Company engaged in local/foreign trade.

8.2     When to conduct Medical Examination?

Medical examination of overseas workers and seafarers both for
interisland and overseas employment shall be conducted only after the
Agency or its principal/company has interviewed and trade tested or has
decided to accept the worker/seafarer for employment. The Agency/Company
Medical Examination Referral Slip issued to the worker/seafarer shall
state this information.

This referral slip refers to a form duly accomplished and issued by
an agency/company addressed to an accredited medical clinic or hospital
to conduct medical examination on the worker named therein.

8.3.    Scope of Pre-employment Medical Examination.

Unless otherwise stated in the Medical Examination Referral Slip,
the pre-employment medical examination shall include the following:

8.3.1    Complete physical examination

8.3.2    Chest X-ray using plates not smaller than 11″ x 14″

8.3.3    Complete blood count (CBC) including hemoglobin determination

8.3.4    Blood typing (ABO)

8.3.5    Urinalysis

8.3.6    Stool examination

8.3.7    Dental examination

8.3.8    Psychometric evaluation

8.4     For Seafarers:

8.4.1    All the above examination, plus visual acuity and with emphasis on color perception specifically for Ishihara Test.

8.4.2    Hearing and audiometry required for all officers, engine watchkeeper and radio officers;

8.4.3    Speech test for radio officers.

8.5     Test for HIV Antibodies, Hepatitis-B Antigen, or VDRL when required by country of destination.

8.6     In case the applicant is 40 years and above, the
pre-employment medical examination shall include an electrocardiographic
examination.  For applicant below 40 years such examination shall be
done when required by the employer.

8.7     Other medical tests not included in the scope of the
pre-employment medical examination as defined above may be conducted on
land-based workers and seafarers upon request by the Agency or its
Principal/Company.

8.8     Submission of medical examination results.  In order to
hasten the deployment process, medical findings on land-based
workers/seafarers officially referred to hospital/clinic for
pre-employment medical examination shall be submitted to the referring
agency/company within 48 hours after referral.  In the event that
medical findings indicate the need for certain minor ailments to be
treated, the clinic or hospital shall advise the agency/company of the
estimated period of time that said treatment shall be undertaken so that
the same may be referred to the principal/company for his acquiescence.

8.9     Medical rating system. In order to standardize the medical
examination of workers/seafarers the hospital or medical clinic shall
use the prescribed Medical Rating Form and Medical Examination Records
Form.

SECTION 9.       Integrity of Medical Examination Results
— The hospital or medical clinic shall guarantee the integrity of its
medical examination results for a period of three months.  As part of
this guarantee, the clinic/hospital shall file with its clients Agency
or Company and the Department of Health and affidavit of undertaking. 
The cost of repatriation and other expenses shall be shouldered by the
clinic in the event the employer rejects the accepted applicant or
terminates the employment of the workers/seafarers within a period of
three (3) months from the date of examination due to medical reasons. 
This includes major cardiac and/or pulmonary conditions like advanced
pulmonary tuberculosis, pulmonary tumor, bronchiectasis, cardiomegaly,
congestive heart failure and such other illness the progress or state of
which could have been detected during the pre-employment medical
examination under Section 8.

SECTION 10.    Whenever the result of medical examination is
contested by an applicant, recruitment agencies, companies or other
interested parties, the Bureau of Licensing and Regulation (BLR) may be
assisted by experts in medical specialties or psychologists as needed to
review the results. Recommendations will be referred to the Bureau of
Licensing and Regulation, Department of Health.

SECTION 11.    Standard Medical Examination Fees —
In order to standardize and upgrade the quality of pre-employment
medical examination of overseas workers and seafarers, accredited
hospitals and medical clinics shall follow strictly the schedule of fees
which shall be prescribed by the Bureau of Licensing and Regulation in
charging the workers/seafarers or agency/company.

SECTION 12.    Responsibilities of Medical Clinics or Hospitals
— In addition to complying with all the above requirements, it shall be
the responsibility of an accredited medical clinic and hospital to:

12.1   Ensure compliance by its staff with the Code of Ethics of their respective professions in the Philippines.

12.2   Submit to the Bureau of Licensing and Regulation, Department
of Health a monthly report of the workers/seafarers it has medically
examined per agency/company.

12.3   Continually upgrade its facilities and the competencies of its medical staff.

12.4   Ensure that medical examination of workers/seafarers are
done only at its premises and are conducted by its practitioners-staff
duly identified in the application for accreditation.

12.5   Make sure that workers/seafarers are not subjected to
unnecessary and prolonged medication for nonexistent ailments or
sickness.

SECTION 13.    Basic Accreditation Requirements —
Any licensed hospitals registered medical clinics desirous of getting
accredited to service overseas workers/seafarers including seafarers on
domestic trade shall submit the following requirements:

13.1   Letter of application on the prescribed form of the Bureau of Licensing and Regulation.

13.2   Bureau of Domestic Trade Registration for single
proprietorship or Securities and Exchange Commission Registration for
partnership or corporation.

13.3   License to operate and maintain a laboratory from the Bureau
of Research and Laboratories for clinics that have their own
laboratories.  In case the clinic has no laboratory of its own a copy of
affiliation agreement with and a copy of license to operate from the
Bureau of Research and Laboratories of the laboratory to which the
clinic is affiliated shall be submitted.

13.4   License to operate from the Bureau of Licensing and Regulation for hospitals, or Mayor’s permit to operate a clinic.

13.5   Certificate of accreditation from the Bureau of Research and Laboratories for HIV testing laboratories.

13.6   License to operate an X-ray facility from the Bureau of Licensing and Regulation.

13.7   Professional Tax Receipts (PTR) of practitioner staff of the
clinic or hospital who will involved in the examination of
workers/seafarers for overseas employment.

13.8   NBI clearances of officers/practitioners staff identified above.

13.9   Valid Professional Regulation Commission (PRC) Identification Card of the medical staff and paramedical staff.

13.10 Location map or sketch of the location of the clinic should be attached to the application.

13.11 For regular land-based or seafarers clinic, a cash bond of
Thirty thousand pesos (P30 ,000.00) shall be deposited with the
Department of Health and the xerox copy of the official receipt shall be
submitted together with the application.

SECTION 14.    Application for Accreditation —
Application for accreditation shall be filed with the Bureau of
Licensing and Regulation in the form prescribed by the Bureau.

14.1   Each application shall be signed under oath or affirmation
by the applicant or the person duly authorized to act for and on his
behalf.

14.2   Any material false statement in this application or failure
to comply with the requirements may serve as basis for refusal to issue a
certification of accreditation.

14.3   Application fee of One thousand pesos (P1 ,000.00) shall
accompany the application together with the supporting papers enumerated
in Section 13.

14.4   Any accredited clinic or hospital which desires to perform
medical examination on seafarers for inter-island and overseas
employment may apply for accreditation in the appropriate category.

SECTION 15.    Accreditation Fee —

15.1   A non-refundable fee of One thousand pesos (P1 ,000.00)
shall be paid upon approval of the application for accreditation. A
clinic shall pay an accreditation fee of P1 ,000.00 regardless of
category.

15.2   All fees shall be payable to the Bureau of Licensing and
Regulation to be paid to the Cashier of the Department of Health.

15.3   A penalty of Five hundred pesos (P500.00) for late renewal
shall be charged in addition to the renewal fee of hospital/clinic if
the application is filed during the next three (3) months after
anniversary date.

15.4   The certificate of accreditation shall be considered lapsed
if not renewed within three months after expiration. Subsequently any
application shall be subject to an application fee.

SECTION 16.    Separate Accreditation — Separate
accreditation shall be required for clinics/hospitals or branches
thereof, maintained in separate premises even though they are operated
under the same management.

SECTION 17.    Inspection — Accredited hospitals
and clinics shall be inspected regularly and records shall be made
available to determine compliance with the rules and regulations.

17.1   Each accredited hospital or clinic shall give the Director,
Bureau of Licensing and Regulation (BLR) or his authorized
representative(s) at any reasonable time the opportunity to inspect the
hospital or clinic.

17.2   Each accredited hospital or clinic shall make available to
the Director, Bureau of Licensing and Regulation or his duly authorized
representative(s) records kept by them for inspection pursuant to these
regulations.

17.3   The Director of the Bureau of Bureau of Licensing and
Regulation or his representatives may be assisted by duly designated
experts from professional associations in such inspection.

17.4   Director of Regional Health Offices, Provincial, City and
Municipal Health Officers are hereby empowered to report the existence
of medical clinics examining overseas workers or seafarers without
proper accreditation and any violation of these rules of the Bureau of
Licensing and Regulation.

SECTION 18.    Issuance of Certificate of Accreditation

18.1   After the clinic is found to have met all the requirements
including payment of the accreditation fees, the application shall be
approved by the Undersecretary of Health for Standards and Regulation
upon recommendation by the Director, Bureau of Licensing and Regulation,
and a certificate of accreditation shall be issued.

18.2   A provisional accreditation shall be granted to hospitals or
clinics for a duration of one (1) to three (3) months in the meantime
that all necessary requirements and standards governing their operation
are not fully complied with.

18.3   Upon written appeal duly verified by the applicant or
accredited hospital/clinic, the Undersecretary of Health for Standards
and Regulation or his duly authorized representative shall conduct an
inquiry to determine the justifiability of the recommendation of the
Director, Bureau of Licensing and Regulation in denying issuance of
certificate of accreditation enclosing therewith a certified copy of the
recommendation sought to be reviewed.

SECTION 19.    Terms and Conditions of the Accreditation Certificate —

19.1   The certificate of accreditation and any right granted under the accreditation shall not be assigned or transferred.

19.2   Accreditation shall be automatically terminated upon change
of ownership or change in location, therefore in either case a
reaccreditation has to be applied for and approved by the Undersecretary
of Health for Standards and Regulation upon recommendation by the
Director, BLR.

19.3   Change of ownership or location shall be reported in writing
to, and acknowledged by the Bureau of Licensing and Regulation fifteen
days from the effectivity of such change.

SECTION 20.    Exhibition of Certificate — The
certificate of accreditation of the clinic/hospital must be posted in a
conspicuous place readily seen by the public. A copy of the Rules and
Regulations shall be readily available for guidance of all the staff and
personnel of the hospital or clinic. The certificate of accreditation
shall expire one year after issuance.

SECTION 21.    Renewal —

21.1   Application for renewal of certificate of accreditation
shall be filed within sixty (60) days prior to the date of expiration. A
penalty shall be paid if the renewal is filed after the anniversary
date in accordance with Section 15.

21.2   The Bureau of Licensing and Regulation shall process
application for renewal immediately upon receipt thereof subject to
ocular inspection by the inspection team. The accredited clinic/hospital
shall continue operation during the final action of its application
unless otherwise advised or ordered by the Director of the Bureau of
Licensing and Regulation.

21.3   An accreditation that has not been renewed for a period of
three (3) months after expiration shall be considered lapsed and the
registration of the clinic shall be cancelled.  Applicants for
reaccreditation shall be required before such hospital/clinic can be
allowed to operate for purpose of overseas employment. No authentication
shall be done on documents submitted by these clinics or hospitals
until they are accredited.

SECTION 22.    Publication of List of Accredited Hospitals/Clinics —

22.1         A list of accredited clinics/hospitals shall be
published periodically and shall be made available to any person, agency
or company for legitimate purpose.

SECTION 23.    Modification and Revocation of Accreditation
— The terms and conditions of each Certificate of Accreditation shall
be subject to amendments to these regulations as the Secretary of Health
may deem necessary. Except in cases of willful or repeated violations
hereof, or where public health interest or safety requires otherwise, no
accreditation shall be modified, suspended or revoked unless prior
notice has been made and the corresponding investigation has been
conducted.

SECTION 24.    Authentication of Medical and Aids Clearance Certificates —

24.1   Medical and AIDS Clearance certificates issued by duly
accredited medical clinics or hospitals only shall be authenticated by
the Department of Health.

24.2   An authentication fee of Ten pesos (P10.00) shall be charged per medical certificate.

24.3   Authentication shall be done by the Bureau of Licensing and Regulation, Accreditation and Authentication Section.

SECTION 25.    Violation and Penalties —

25.1   Violation of the rules and regulations governing
accreditation of medical clinics and hospitals and the conduct of
medical examination for overseas workers and seafarers and/or commission
of the following acts by persons operating the hospital or clinic or
persons under their authority shall be penalyzeable.

25.1.1     Clinics/hospitals issuing medical and/or laboratory examination reports without actually performing them.

First Offense — one month suspension of accreditation.

Second Offense — three months suspension of accreditation.

Third Offense — revocation of accreditation.

25.1.2     In-house clinics performing examination on applicants
or agencies or companies other than the one specified in their
application for accreditation.

First Offense — 6 months suspension of accreditation.

Second Offense — revocation of accreditation.

25.1.3     Clinics performing laboratory examination in its own
unlicensed laboratory instead of collecting specimens from applicants
and sending them to the laboratories to which they are affiliated.

First Offense — one month suspension of accreditation.

Second Offense — three months suspension of accreditation.

Third Offense — revocation of accreditation.

25.1.4     Change of ownership or location of the clinic/hospital without notifying the Bureau of Licensing and Regulation.

—    Denial of accreditation

25.1.5     Operating unauthorized branches for examination of overseas workers/seafarers

—    Suspension/revocation of accreditation

25.1.6     Allowing other medical clinics to use their official forms of medical examination.

First Offense — three months suspension of accreditation.

25.1.7     Refusal to allow inspection of the clinic/hospital by persons authorized by the Director, BLR during working hours.

First Offense — Reprimand

Second Offense — three months suspension

Third Offense — six months suspension

Fourth Offense — revocation of accreditation.

25.1.8     Failure to correct deficiencies within a reasonable
time after due notice from the Bureau of Licensing and Regulation.

First Notice — Reprimand

Second Notice — three months suspension of accreditation

Third Notice — non-renewal or revocation of accreditation.

25.1.9     Clinics found guilty of misinterpretation of
pre-employment medical/laboratory examination done on applicant/overseas
workers/seafarers, causing non-deployment or repatriation.

First Offense — three months suspension of accreditation.

Second Offense — six (6) months suspension of accreditation.

Third Offense — revocation of accreditation.

Suspension shall be for a minimum of one month and in no case shall exceed 6 months.

In repatration cases, garnishment of the cash bond shall be done in addition to the administrative sanctions.

SECTION 26.    Investigation of Charges or Complaints
— Upon receipt of duly sworn complaints or charges against an
accredited clinic or hospital by any person, interested party or
corporation, the Undersecretary of Health for Standards and Regulation
or the Director of the Bureau of Licensing and Regulation, through their
duly authorized representative shall investigate complaints or charges
to verify whether the clinic or hospital is guilty of the charges.

If upon investigation, a clinic or hospital is found violating the
provisions of these rules and regulation, or have committed any of the
acts enumerated in the preceding section the Undersecretary of Health
for Standards and Regulation shall impose the corresponding sanctions
enumerated therein without prejudice to referring the case to judicial
authorities for criminal action.

SECTION 27.    Effectivity — These rules and
regulations shall take effect fifteen (15) days after its publication in
the official gazette or in a newspaper of general circulation and shall
supercede all issuances inconsistent thereof including the Joint
DOH-DOLE Rules and Regulations for the Accreditation of Medical Clinics
and the Conduct of Medical Examination for Overseas Employment.

Adopted: 22 Feb. 1990

(SGD.) ALFREDO R.A. BENGZON, M.D.
Secretary