Creation of NHPC and ILHZs for Health Delivery

Legal policy and purpose

Section 1 establishes the State policy that full and integrated delivery and development of health care services throughout the country must be promoted, encouraged, and ensured, especially for the poor and marginalized sectors of society.
Section 1 directs that achieving an integrated health care delivery system at the national and local levels is an objective for by the year 2000 and thereafter.
Section 1 mandates participation and active involvement and collaboration of all local government units (LGUs) together with major stakeholders, particularly DOH and DILG, to pursue integrated health care delivery.

NHPC creation and role

Section 2 creates the National Health Planning Committee (NHPC) as the overall coordinating body.
Section 2 requires the NHPC to oversee and ensure adherence by all LGUs and concerned stakeholders to guiding principles and to coordinated planning and implementation of comprehensive and integrated National and Local Health Plans and priority programs and projects by LGUs through local health boards (LHBs).
Section 3 requires convening the NHPC within one (1) month after approval of the Executive Order.

NHPC composition and secretariat

Section 3 states that the NHPC shall be composed of:
- Secretary of the DOH as Chairman.
- Secretary of DILG as Co-Chairman.
- National President of the League of Provinces as Vice-Chairman.
- Executive Secretary as Ex-Officio Member.
- Chairman of Senate Committee on Health as Ex-Officio Member.
- Chairman of House Committee on Health as Ex-Officio Member.
- Secretary of the DBM as Member.
- Two (2) representatives from the private sector as Members.
Section 3 requires that an NHPC Secretariat be organized to provide support to the NHPC.
Section 3 mandates the DOH Secretary to designate his Undersecretary to act as head of the NHPC Secretariat.
Section 3 specifies Secretariat membership as official representatives from DOH, DILG, Union of Local Authorities of the Philippines (ULAP), League of Cities, League of Municipalities, and Liga ng mga Barangay.

NHPC functions and reporting

Section 4 requires the NHPC to ensure and sustain agreements from the “Governors’ Workshop for Health” held last March 9-10, 1999, including the recommendations in “Health Covenant '99”, and the workshop outputs, treated as integral to the Executive Order.
Section 4 directs the NHPC to promote policies, programs and projects on health to enhance local autonomy in planning and implementing an integrated health care delivery system and an integral health plan at national and local levels.
Section 4 requires the NHPC to formulate a partnership mechanism among all LGUs, concerned National Government Agencies (NGAs) through DOH and DILG, and the private sector, NGOs and civic groups to support local health service delivery systems.
Section 4 mandates the NHPC to ensure LGUs prioritize the reactivation and strengthening of the LHBs as an initial move to make decentralized health services work.
Section 4 directs the NHPC to recommend specific and adequate resources in cash and in kind to be allotted by concerned NGAs (DOH and DILG) to enhance local government capability, responsibility, and accountability for basic health services.
Section 4 requires NHPC recommendations to be guided by guidelines and criteria formulated by the NHPC in consultation with LGUs through LPP and ULAP, and requires ensuring inclusion in the Annual General Appropriations Act (GAA) budget of DOH and DILG beginning CY 2000 and every succeeding fiscal year for proper implementation of consolidated plans.
Section 4 requires the NHPC to act as the over-all coordinating body for all LHBs, and to ensure organization and/or reactivation of all LHBs at every local government level and their active involvement in health policy formulation and program planning and implementation.
Section 4 requires the NHPC to formulate annual planning guides, standards and format to serve as integrating principles for functional merger of national and local priority health programs/projects carried out at provinces with component cities and municipalities and highly urbanized cities (HUCs).
Section 4 requires that Provincial/HUC Health Plans be submitted to the NHPC, copy furnished the Office of the President not later than forty-five (45) days after the signing of this Order.
Section 4 directs the NHPC to recommend to the President an initiative scheme package for outstanding LGUs with the best local health plan implemented, including a health insurance scheme particularly to the 100 poorest families in every province and city.
Section 4 requires NHPC to submit a semi-annual and year-end report to the Office of the President.
Section 4 authorizes the NHPC to perform other functions designated by the President or deemed necessary by the NHPC Chairman.

Establishment of inter-local health zones (ILHZs)

Section 5 establishes Inter-Local Health Zones (ILHZs) through DOH and DILG for effective delivery of integrated health care and smooth coordination among cities, municipalities and barangays, pursuant to Section 33 of R.A. 7160.
Section 5 defines ILHZs as comprising a well-defined population (by level of governance) in a rural or urban area, and all institutions and sectors whose activities contribute to improved health care delivery in that zone.
Section 5 requires the composition, functions, and required resources of ILHZs to be approved by the NHPC upon endorsement by the Provincial Governor or City Mayor.

Integrated local health planning system

Section 6 requires that, in accordance with NHPC guidelines, every municipality, component city, and highly urbanized city through its local health board must develop its own health plan.
Section 6 requires each local health plan to be integrated into an Inter-Zonal Health Plan incorporating two (2) levels of health care:
- referral (district) hospital; and
- an identified set of main health centers/barangay health stations with catchment populations.
Section 6 requires that Inter-Zonal Health Plans be aggregated into a Provincial/City Health Plan taking into account actual needs and available resources of LGUs in relation to national health objectives.
Section 6 requires all Provincial/City Health Plans to be submitted to the NHPC on the date prescribed by the committee.

Funding and operational resources

Section 7 requires Governors, City and Municipal Mayors, through their respective Sanggunians, to provide specific budgetary appropriations under their approved local development plan for proper implementation of their health plans.
Section 7 directs that, as counterpart support, the DOH and other concerned NGAs shall allocate and devolve funds to augment local funds intended for this purpose, consistent with Article 31 of the IRR of R.A. 7160, subject to NHPC guidelines and criteria.
Section 7 mandates that the DOH shall set aside a separate fund for the technical and administrative operations of the NHPC Secretariat beginning CY 1999 and thereafter.

Inter-agency cooperation duties

Section 8 directs all concerned Departments and other attached agencies, LGUs, GOCCs, and other government instrumentalities to cooperate and give full support to NHPC, ILHZS and LHBs.
Section 8 requires the cooperation and support to ensure the effective performance of the NHPC, ILHZs, and LHBs functions.

Legal basis and operational ties

Executive Order No. 205 anchors ILHZs establishment on Section 33 of R.A. 7160 (Local Government Code), which authorizes LGUs to group, consolidate efforts and services for commonly beneficial purposes.
Section 1 ties health service devolution to the mandate of R.A. 7160 for devolution of delivery of health services and facilities as a basic function of LGUs.
Section 7 links counterpart national funding and devolution mechanics to Article 31 of the IRR of R.A. 7160.

Issuance continuity and implementation timetable

Section 3 requires the NHPC to be convened within one (1) month after approval of the Executive Order.
Section 4 requires Provincial/HUC Health Plans to be submitted to the NHPC and copy furnished the Office of the President not later than forty-five (45) days after the signing of this Order.
Section 4 requires NHPC to recommend and coordinate support to ensure inclusion in the GAA for DOH and DILG beginning CY 2000 and every succeeding fiscal year.
Section 7 requires the DOH to set aside separate secretariat operations funding beginning CY 1999 and thereafter.