1. 1
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
INDICATOR MEANS OF
VERIFICATION AND
DATA SOURCE
POINT ALLOCATION AND
PERFORMANCE LEVEL
SCHEME
CONDITION REMARKS
Component 1: Agriculture and Fisheries- 20 pts City/
Municipality
Province
1. Presence of allocation
for agriculture and
fisheries program in the
LGU budget(P/C/M)
1.1. Percentage of
allocation for agriculture
and fisheries
program/projects
against LGU total
budget
• 2022 LGU Annual
Budget/20% LGU
Development
Fund/2022
AIP
• Appropriation
Ordinance and page
from the annual
budget containing the
support to agriculture
and fisheries
3 4 • At least one (1) MOV showing the presence
of allocation, then the indicator is considered
complied.
Allocation for agriculture and fisheries programs,
which includes but not limited to the following:
• Provision of farming or fishing inputs
(dispersal of livestock, poultry, and
fingerlings)
• Provision of the administrative support to
farmer cooperatives and fisher folk
associations
• Establishment of seed nurseries; demo
farms; irrigation systems; facilities for water
and soil conservation; markets
The percentage of
allocation is for data
purposes only.
• Amount allocated to
agriculture and fisheries
programs / Estimated
reverse from regular
resources x 100 =
Percentage allocation for
agriculture and fisheries
• Please indicate the
agriculture and fisheries
program being provided by
the LGU
2. Presence of LGU
policies in support to
sustainable agriculture
and fisheries (P/C/M)
• Ordinances
supporting
sustainable
agriculture and
fisheries
2 3 At least one (1) MOV (any ordinance
supporting sustainable agriculture and
fisheries)
• Please indicate ordinance
number, date and title
3. Presence of legislation
on land use
classification (C/M)
• PDF or JPEG format
of Comprehensive
Land Use Plan
(CLUP) Cover page
and 1st
page
3 - Must provide all 3 MOVs for the indicator to be
considered complied

2. 2
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
• zoning ordinance
cover page and
1st
page
• Sanggunian
Panlalawigan
resolution
approving the
CLUP
4. Functional Local
Agriculture and
Fisheries Council
(LAFC) (P/C/M)
• Executive Order with
complied composition
of members
• 4 Meetings (once
every quarter)
• Plans and budget
• Annual
accomplishment
report
1
1st
Q meeting-
2
2nd
Q meeting-
2
3rd
Q meeting-
2
4th
Q meeting-
2
0.5
0.5
1
1st
Q meeting-
2
2nd
Q meeting-
2
3rd
Q meeting-
2
4th
Q meeting-
2
1
1
For the meetings, must provide MOVs with the
following point allocations per quarter
meetings:
MOVs Point
Allocation
minutes per meeting 0.50 pts
Attendance per
meeting
0.50 pts
Agenda per meeting 0.50 pts
Notice per meeting 0.50 pts
Total Score for one
quarter meeting 2 pts
• Executive Order
• No. 116, s. 1987 mandates the
replication of NAFC in the
regions, provinces, cities,
municipalities and barangays
• Composition:
o 60% private sector
representation
(farmers and fisheries
organizations; CSOs)
o 40% from the
government (DA; NFA;
NIA; DAR; PCA; DBM;
DOH, DOST; DILG;
DTI)

3. 3
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
5. Presence of LGU hired
veterinarian (P/C)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
-Office order/memo
• For database purposes only
• Indicated whether locally hired
or the regional ministry
• Also indicate whether
permanent, temporary or
designated
6. Presence of Local
Agriculture Office
(P/C/M)
• Photo of the actual
Local Agriculture
Office with space and
equipment
• For database purposes only,
please indicate the presence
or none presence of actual
P/C/MAO office space and
equipment
7. Presence of farmers or
fisherfolks who are
members of
cooperatives/collective
organizations (P/C/M)
• Certification from
Local Agricultural,
Fisheries and Reform
officer
1 1 • At least one (1)
cooperative/collective
organizations with member
farmer/fisherfolks, the
indicator is considered
complied.
• No. of farmers/fisherfolks
who are members of
cooperatives/collective
organizations /Total No. of
farmers/fisherfolks in the
LGU x 100
• Please indicate the number of
cooperatives/collective
organizations with
farmer/fisherfolks members

4. 4
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
8. Presence of farmers
benefiting from
agricultural extension
and on-site research
services/facilities
(P/C/M)
• Certification form
Local Agricultural,
Fisheries, and
Reform Officer
1 1 • No. of farmers availing
agricultural services/ total
number of farmers in the LGU
x 100
• Please indicate the number of
farmers/fisherfolks
beneficiaries
9. Presence of Local
Agriculture Officer hired
by LGU
(P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
-Office order/memo
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated
10. Presence of Staff
complement for
Agriculture Officer
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
• -Office
order/memo
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated
Component 2: Health- 20 pts C/M P
1. Presence of allocation
for health services in the
LGU total budget
• PDF format of the
Appropriation
Ordinance for 2022
LGU Annual Budget
2 3
At least one (1) MOV showing the presence of
allocation, then the indicator is considered
complied.
• The percentage of allocation
is for database purposes only.

5. 5
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
1.1. Percentage of
allocation for health
services against LGU
total budget (P/C/M)
containing the
allocation for health
services or PDF
format of the 20%
LGU Development
Fund for 2022 or PDF
format of the 2022
AIP highlighted
therein the allocation
for health services
Health services include the implementation of
programs and projects on primary health care,
maternal and child care, and communicable and
non-communicable disease control services;
access to secondary and tertiary health
services; purchase of medicines, medical
supplies, and equipment needed to carry out the
services herein enumerated, and adequate
communication and transportation facilities in
the case of Cities.
• Amount allocated to health
services/Total regular
resources x 100
= Percentage allocation for
health services
• Please indicate the health and
nutrition program being
provided by the LGU
2. Presence of legislation
on the enforcement of
public health (P/C/M)
• Ordinance or other
similar issuance on
the enforcement of
public health
2 3 Minimum of one legislation, indicator is
considered complied
3. Presence of Local
Investment Plan for
Health (LIPH) (C/M)
• Approved Local
Investment Plan for
Health
2 3
4. Presence of PhilHealth
accredited Rural Health
Unit (C/M)`
• Copy(ies) of
2021/2022 Philhealth
accredication
certificates of LGU
run Rural Health
Units`
4 - Accreditations to:
- Konsultasyong Sulit at Tama (KONSULTA)
Package- 1pt
Maternity Care Package (MCP)-1pt
Anti-TB Treatment or Directly Observed
Treatment Short-Course TB-DOTS) – 1pt
Animal Bites Treatment Center (ABTC)
Package – 1pt
5. Presence of Provincial-
managed hospital (P)
• Certification from
LHO
- 4
6. Support to Rural Health
Unit (C/M)
• Certification from
LHO and Accountant
indicating the amount
allocated for RHU
2 -
With logistical support provided
such as personnel augmentation,
medicine, facilities, supplies for
the year being assessed

6. 6
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
7. Percentage of
barangays with
functional Barangay
Health Stations (C/M)
• Certification from
LHO with the % of
functional barangay
health station
- - # of barangays with functional brgy health
stations / Total No. of barangays in the LGU x
100
For data purposes only
8. Presence of functional
Epidemiologic
Surveillance Unit (either
organized by MHO-RHU
or LGU Health Services)
(P/C/M)
• Established through
an
ordinance/executive
order;
For each staff:
• Designated
through local
ordinance or
executive order
On complete ESU Staff
complement:
• Team Leader,
Disease
Surveillance
Officer,
Registered
Medical
Technologist,
Encoder
• Certificate of
attendance for
each training and
staff
On staff competency:
• All ESU staff
trained on Basic
Epidemiology,
Disease
Surveillance, and
If 6 MOVs are
present = 3pts
If 5 MOVs are
present = 2pts
If 3 to 4 MOVs
are present =
1pt
If 1 to 2 MOVs
are present =
0.5pts
If 6 MOVs are
present = 4pts
If 5 MOVs are
present = 2pts
If 3 to 4 MOVs
are present –
1.5pts
If 1 to 2 MOVs
are present =
1pt
Please indicate the number of
MOVs present out of the 6 ESU
Components

7. 7
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
Event-Based
Surveillance;
• Approve Planning
Documents
(AIP/AOP/WFP) with
budgetary allotment
from the local budget
• Certification from
partner health
service provider on
the Coordination/link
with Provincial
Hospital and other
Health Facilities
within the locality
• Certification from
local Health Board
on the Disease and
Event Surveillance
Report submitted in
the prescribed
timeline and
released at least on
a monthly basis to
the Local Health
Board
9. Presence of nutrition
services (P/C/M)
• Approved nutrition
action plan
• Annual budget of the
year being assessed
containing the
nutrition services
1
1
2.5
1
All MOVs must be present for the indicator to
be considered complied
10. Presence of barangays
with declared Zero-
• Certifications from
the Ministry of
71% TO 100%
of the total
• No. of barangays with
declared ZOD / Total No. of
brgys in the LGU x 100

8. 8
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
Open Defecation (ZOD)
(C/M)
Health (MOH)
declaring ZOD
barangays =
3pts
49% to 70% of
the total
barangays =
2pts
1% to 40% of
the total
barangays =
1pt
11. Presence of LGU-hired
Health Officer (P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
-Office order/memo
on notice of
designation
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated
12. Presence of LGU-hired
Nutrition Action Officer
(P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
• -Office
order/memo on
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated

9. 9
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
notice of
designation
13. Presence of LGU-hired
nurses (P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
• -Office
order/memo on
notice of
designation
No. of LGU-hired nurses / projected population
as of CY 2022 = Ratio of nurses to population
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated
14. Presence of LGU-hired
Midwives (P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
• -Office
order/memo on
notice of
designation
No. of LGU-hired midwives / projected
population as of CY 2022 = Ratio of midwives
to population
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated
15. Presence of LGU-hired
Disease Surveillance
Officer (DSO) (P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry

10. 10
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
-CSC Appointment
-List of plantilla
positions
• Designated:
• -Office
order/memo on
notice of
designation
• Also indicate whether
permanent, temporary or
designated
Component 3:Education- 20 pts C/M P
1. Presence of allocation
for education services in
the LGU total budget
1.1. Utilization rate of
Special
Education
Fund(P/C/M)
• AIP showing the part
allocating for the
support services
• Certification from the
Accountant on the
utilization of allocated
funds
• SEF utilization report
(utilization from the
preceding year)
1
1
3
1
1
3
2. Local School Board Plan
aligned with Local
School Improvement
Plans(P/C/M)
• Certification from
MPDC and School
District Supervisor/
Division
Superintendent
showing the % of
alignment of LSBP
and LSIP
80-100%
aligned=3
points
50-79%
aligned= 2
point
1% to 49%
aligned= 1
points
80-100%
aligned=3
points
50-79%
aligned= 2
point
1% to 49%
aligned= 1
points
3. Implemented programs
funded out of Special
Education Fund (P/C/M)
• SEF utilization report 1
1
1
1

11. 11
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
• Accomplishment
report of Local School
Board
4. Completion rate of Local
School Board Plan
(P/C/M)
• Certification from
Local Accountant and
School District
Supervisor/Division
Superintendent
2 2
For the meetings, must provide MOVs with the
following point allocations per quarter
meetings:
MOVs Point
Allocation
minutes per meeting 0.25 pts
Attendance per meeting 0.25 pts
Agenda per meeting 0.25 pts
Notice per meeting 0.25 pts
Total Score for one quarter
meeting 1 pt
Component 4: Social Welfare and Development -20
pts
C/M P
1. Presence of allocation
for children’s welfare in
the LGU
• AIP showing the part
allocating for the
services
• Annual Budget of the
year being assessed
showing the support
for children’s
development
program
2 2 All MOVs must be present for the
indicator to be considered complied.
Allocation for children’s development
programs, includes but not limited to
the following:
Children in Need of Special Protection
(CNSP), Program for Children in
Conflict with Law (CICL), Violence
Against Women and their Children
(VAWC), Early Childhood Care and
Development (ECCD), Children
Welfare Program, Supplemental
Feeding Program, Recovery and
Reintegration Program for Trafficked
Persons
Please indicate the children’s
development program being provided by
the LGU
2. Utilization rate of budget
allocation for
children(P/C/M)
• AIP showing the part
allocating for the
support services
• Certification from the
Accountant on the
91% to 100%
utilized= 2
points
91% to 100%
utilized= 2
points
Amount utilized / Amount
allocated for children x100%

12. 12
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
utilization of allocated
funds
90-50%
utilized= 1
point
1%-49%= 0.5
points
90-50%
utilized= 1
point
1%-49%= 0.5
points
3. Presence of allocation
for senior citizen in the
LGU (P/C/M)
• AIP showing the part
allocating for the
support services
• Annual budget of the
year being assessed
showing the support
for senior citizens
2 2
All MOVs must be present for the
indicator to be considered complied.
Program for Older persons include but
not limited to the following:
Establishment of Office of the Senior
Citizens Affairs, Registration of Senior
Citizens and issuance of Senior
Citizens ID, Issuance of purchase
booklet, generate public awareness of
the rights and privileges of senior
citizens, Enrolment of all indigent
senior citizens in national insurance
program or PhilHealth, Establishment
of a Senior Citizens, Elderly Filipino
Week Celebration, Counterpart on
Social Pension Implementation,
Assistance in the identification of
potential Social Pension beneficiaries,
maintenance of list/profile of all senior
citizen (Medical, burial, and food),
referral and documentation of clients
to different agencies
4. Functionality of Persons
with Disabilities Affairs
Office (PDAO) (P/C/M)
• PDAO Functionality
Assessment Form
(Annex C from MILG
MC 2021-041)
Ideal = 3
Mature = 2
Progressive =
1
Basic = 0.5
Ideal = 2
Mature = 1.5
Progressive =
1
Basic = 0.5
To ensure that PPAs for persons with
disabilities are given due priority,
Sec.1 of RA 10070, or the law
amending the Magna Carta for
Disabled Persons, mandates the
creation of PDAO in provinces, cities,
and 1st
-3rd
class municipalities and

13. 13
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
designation of a Focal Person for 4th
–
6th
Class municipalities.
DILG Memorandum Circular No. 2021-
041 ensures and strengthens the
PDAOs’ functionality in LGUs in order
to properly cater to the needs of their
respective local persons with
disabilities population.
5. Utilization rate of budget
allocation for persons
with disabilities (PWDs)
and senior citizens
(P/C/M)
• Certification from the
accountant on the
utilization allocated
funds
91% to 100%
utilized = 2pts
90%-50%
utilized = 1pt
1%-49%
utilized =
0.5pts
91% to 100%
utilized = 2pts
90%-50%
utilized = 1pt
1%-49%
utilized =
0.5pts
Amount utilized / amount allocated for
PWDs and SCs x 100
6. Utilization rate of GAD
fund
• AIP showing the part
allocating for the
support services
• Certification from the
Accountant on the
utilization of allocated
funds
100%
utilized= 3 pts
90-50%
utilized= 1
point
1% to 49%
utilized= 0.5
points
100% utilized=
2 points
90-50%
utilized= 1
point
1% to 49%
utilized=
0.5 points
All MOVs must be present for the
indicator to be considered complied
Amount utilized / Amount
allocated for gender and development x
100%
7. Implemented programs
for each vulnerable
sector
• Accomplishment
Report for each
program for the
vulnerable sector
Implemented
Aside from programs stated in Nos. 1,
3, and 4, programs for social welfare
include but not limited to the following:
Please indicate the programs being
provided by the LGU.

14. 14
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
-Children and Youth
-Women
-Persons with
Disabilities
-Senior Citizens
-Family and
Community
1
1
1
1
1
1.5
1.5
1.5
1.5
1.5
Promotion of Social Justice,
Assistance to individual in crisis
situation, family and community
welfare, case management,
emergency/disaster assistance
programs/services, women’s welfare,
and solo parent.
These implemented social welfare
programs for sectoral concerns must
also be reflected in the AIP of the year
being assessed.
8. Existence of LGU-
managed functional
water system
• Photos of actual
water system
• Certification from
Local Engineer and
P/C/MPDC on the
existence of
functional water
system
Identify the level of water system • For database purposes only
• Indicate the number of households
served
2Presence of LGU hired
registered local Social
Worker in the local
Social Welfare and
Development
Office(P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
-Office order/memo
on notice of
designation
• With PRC license
• For database purposes only, indicated
whether locally hired or hired by the
regional ministry
• Also indicate whether permanent,
temporary or designated
Component 5: Environment and Natural Resources – 20 pts

15. 15
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
1. Provision for the
maintenance of a sound
ecology.
• AIP containing the
allocation for the
maintenance/implem
entation of sound
ecology
2 4 As provided in the Local Government Code of 1991, Section 17-
Basic Services and Facilities (2) for municipalities (ii)
“ Pursuant to national policies and subject to supervision, control
and review of the DENR, implementation of community-based
forestry projects which include integrated social forestry programs
and similar projects; management and control of communal forests
with an area not exceeding fifty (50) square kilometers;
establishment of tree parks, greenbelts, and similar forest
development projects;”
and for provinces, (3)(iii), “Pursuant to national policies and
subject to supervision, control and review of the DENR,
enforcement of forestry laws limited to communitybased forestry
projects, pollution control law, smallscale mining law, and other
laws on the protection of the environment; and mini-hydro electric
projects for local purposes;
Please indicate the environmental
management program being
provided by the LGU
2. Presence of Solid Waste
Management Plan
(P/C/M)
• Issuance from
NSWMC approving
the LGU’s SWM Plan
• Approved SWM Plan
Conditions:
• In case Plan is still
under review of
NSWMC: Copy of
the letter duly
received by the
NSWMC
requesting
agency to review
SWM Plan of LGU
• List of SWM Plans still
under NSWMC
review
2
3
1
1
5
4
2
1
3. Presence of legislation
or policy guidelines on
• Policies implemented
on waste collection
and disposal
2 4 One policy, the indicator is considered complied Please indicate the policies
implemented on waste collection
and disposal by the LGUs

16. 16
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
the waste collection and
disposal (P/C/M)
4. Presence of Sanitary
Land Fill and/or other
legal alternative mode of
waste disposal (C/M)
• Actual Sanitary Land
Fill and/or other legal
alternative mode of
waste disposal
• MOA if facility is in
partnership with a
private entity or other
LGUs
5
2
- One MOV, the indicator is considered complied Please indicate the legal
alternative mode of waste
disposal, If there is any
5. Presence of policies on
environmental
protection/conservation
and natural resources
(P/C/M)
• Ordinance
implemented on
environmental
protection/conservati
on and natural
resources
2 3
One policy, the indicator is considered complied
6. Presence of Local
Environment and
Natural Resources
Officer (P/C/M)
• Permanent:
-CSC Appointment
- List of plantilla
positions
• Temporary:
-CSC Appointment
-List of plantilla
positions
• Designated:
-Office order/memo
on notice of
designation
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry
• Also indicate whether
permanent, temporary or
designated
7. Presence of Staff
Complement
Permanent:
-CSC Appointment
- List of plantilla
positions
Temporary:
-CSC Appointment
• For database purposes only,
indicated whether locally hired
or hired by the regional
ministry

17. 17
MINISTRY OF THE INTERIOR AND LOCAL GOVERNMENT
Performance Assessment Scorecard System (PASS)
CY 2023
Indicator and Rating Reference
-List of plantilla
positions
Designated:
-Office order/memo
on notice of
designation
• Also indicate whether
permanent, temporary or
designated and the number of
Staff Support(s)
*All files for uploading shall be in PDF Format
* AIP as basis for allotted/appropriated funds
* Documents for uploading should be clear and readable