EPRES,
Republic of the Philippines Ze" “ON
HOUSE OF REPRESENTATIVES
Quezon City M RECEIVE ie
2 LATE Pie
The
NINETEENTH CONGRESS o TIMES, om ae &y
First Regular Session Aa fei SS

79
House BitNo,__1720
Introduced by HON. RUTH MARIANO- HERNANDEZ

AN ACT
LISHING THE NATIONAL CENTER FOR GERIATRIC HEALTH AND
RESEARCH INSTITUTE, DEFINING ITS POWERS AND FUNCTIONS, CREATING
REGIONAL GERIATRIC SPECIALTY CENTERS IN THE DEPARTMENT OF
HEALTH-RETAINED HOSPITALS, AND APPROPRIATING FUNDS THEREFOR

EXPLANATORY NOTE

In the 18th Congress, House Bill 10697 primarily authored by Reps. Bienvenido Abante,
Jr. and Cheryl Deloso-Montalla, was passed on third reading by the House of
Representatives on January 31, 2022 and was transmitted to the Senate for appropriate
action on February 2, 2022. The Senate did not take action on the said measure.

This bill needs to be enacted in pursuit of the national mandate to make health services
affordable to all Filipinos, as stated in Article XIII, Section 11 of the 1987 Philippine
Constitution:

“The State shall adopt an integrated and comprehensive approach to health
development which shall endeavor to make essential goods, health and other social
services available to all the people at affordable cost. There shall be priority for the
of the underprivileged, sick, elderly, disabled, women, and children. The State
Shi endeavor to provide free medica caret papers .
Currently, senior citizens are provided health care by the general health care delivery
system in the country that is yet to reach the fullest potential. However, at the primary
care level, the infrastructure is still grossly deficient, to say the least. The health system
machinery is ostensibly geared up to deal with maternal and child health, and
communicable diseases.

But senior citizens contend with multiple and chronic diseases. They need long term,
constant care and their multiple and specific health problems call for specialist care

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from various disciplines such as ophthalmology, orthopedics, psychiatry, cardiology and
urology, among many others.

Itis imperative that comprehensive health services for senior citizens at every level of
the health care delivery system is put into State policy and practice with the evolving
needs of the times.

‘The Department of Health is entrusted with the following agenda to attend to the health
care oeran citizens:

+ Establishing geriatric wards for elderly patients at all district level hospitals;

- Expansion of treatment facilities for chronic, terminal and degenerative diseases;

: Profi for improved medical facilities to those unable to access medical
centers;

- Strengthening Community Health Centers (CHCs) / Primary Hospitals
(PHs)/Mobile Clinics (MCs);

= Inclusion of geriatric care in the syllabus of medical and nursing courses;

= Reservation of senior citizens beds in public hospitals;

= Training of geriatric care givers; and,
= Setting up of research institutes for chronic diseases such as dementia and

Alzheimer's disease.

Generally, pur health care system is not yet adequate to the health needs of senior
citizens. As they suffer from multiple chronic and disabling diseases, it becomes difficult
for them to access appropriate health care.

There is also huge shortage of human resources in geriatrics in the country. The
undergraduate medical curriculum does not fully cover all aspects of geriatric care
while post-graduate geriatric courses in the country are still deficient.

To innovatively expand the health care delivery system of the country, establishing the
National Center for Geriatric Health and Research Institute and creating Regional
Geriatric Specialty Centers in Department of Health-retained hospitals will be a major
step in the right direction.

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In view ofthe foregoing, the immediate approval of this bill is earnestly sought.

Approved,



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

NINETEENTH CONGRESS
First Regular Session

| vousepuino,_1720

Introduced by HON. RUTH MARIANO-HERNANDEZ

AN ACT

ESTABLISHING THE NATIONAL CENTER FOR GERIATRIC HEALTH AND

RESEARCH INSTITUTE, DEFINING ITS POWERS AND FUNCTIONS, CREATING
REGIONAL GERIATRIC SPECIALTY CENTERS IN THE DEPARTMENT OF

HEALTH-RETAINED HOSPITALS, AND APPROPRIATING FUNDS THEREFOR

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:

Section 1, Short Title. - This Act shall be known as the “Geriatric Health Act.”

Sec. 2. Declaration of Policy. - It is the policy of the State to protect and promote the
right to health of senior citizens all over the country by ensuring that holistic health
services are available and 3 accessible to them through the establishment of a
specialized hospital and research institute as well 4 as geriatric specialty centers in the
Department of Health (DOH) - retained hospitals in every region.

Sec. 3. Definition of Terms. - As used in this Act:
a. Acute care refers to a specialized program that addresses the needs of hospitalized
older adults in a multidisciplinary team approach to prevent functional and cognitive
decline and to improve outcomes;

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b. Apex or end-referral hospital refers to a hospital offering specialized services as
determined by DOH, which is contracted as a stand-alone facility by the Philippine
Health Ingurance Corporation (PhilHealth);

c. Geriatric health services refer to the medical services or interventions provided by
a multidisciplinary team to older adult patients;

d. Geriatric medicine or Geriatrics refers to the sub-specialty of internal and family
medicine that diagnoses and treats a wide range of conditions and diseases that affect
people as they age and aims to promote health and treat disabilities of older adults;



e. coriete palliative care refers to a specialized medical care that focuses on
providing elderly patients relief from pain and other symptoms of a serious illness,
regardless of diagnosis or stage of disease, and provided alongside curative and other
forms of treatment.

Itisa field of inter-specialty collaboration to respond to the socio-demographic changes
and challenges of older adults with severe and life-limiting conditions;

f. Geriatric specialty center refers to a unit or department in a DOH-retained hospital
that offers specialized care to the aging population, particularly to frail older persons,
addressing their particular conditions and providing specific procedures and
management of cases, requiring specialized training and/or equipment;

&- Geriatrician refers to a medical doctor who has passed the necessary training and
specialty licensure examination for the practice of Geriatric Medicine;

h. Gerontology refers to the study of the biological, psychological, spiritual, social,
economic, and the demographic aspects of the aging process;

service which primarily caters to the frail older persons who have lost or are

i. once healthcare and re-ablement program refers to a community-based
experiencing problems with mobility;

j. Integrated delivery of geriatric health services refers to hospital and community-
based medical and psycho-social services provided to senior citizens by a
multsepinary team;

by a geriatrician and includes surgeons, organ-system specialists, nurses, clinical
pharmacists, rehabilitation therapists, nutritionists, dentists, social workers, caregivers,
family members and patients themselves;

k. seer team refers to a team composed of health professionals headed

1. People-centered service refers to an approach to geriatric care that consciously
adopts the perspectives of individuals, families, and communities, and sees them as
participants as well as beneficiaries of trusted health systems that respond to their
needs and preferences in holistic and humane ways;

m, Senior citizen refers to an elderly Filipino who is at least sixty (60) years old;

n. Sub-acute care refers to care for patients who no longer require hospitalization, but
still need skilled medical care through rehabilitative medicine. Sub-acute rehabilitation
is recommended when a patient is not functionally able to return home; and,

o. Transitional care refers to a form of health care in geriatric medicine designed to
ensure coordination and continuity of care as patients transfer between different
locations or different levels of care, and the safe and effective management of both
chronic and acute illness in older adults.



Sec. 4. Natiboal Center for Geriatric Health and Research Institute. - The National

Center for

end-referré

jeriatric Health (NCGH) is hereby classified as a teaching, research, and

facility for senior citizens in the country. The NCGH shall be renamed as the

National Center for Geriatric Health and Research Institute (NCGHRI) and shall be

training va that shall specialize in geriatric care and serve as an apex hospital or

under the direct control and supervision of the DOH.

structure al

1d human resource requirements of the NCGHRI shall be based on the

The bed or service capabilities, healthcare facilities, expansion, organizational

hospital ani

human resource development plan to be prepared by the NCGHRI and

approved id the DOH.

Sec. 5. Pot

ers and Functions. - To carry out the provisions of this Act, the NCGHRI

shall have the following powers and functions:

a.

=

Serve as an apex hospital or end-referral facility which shall specialize in
geriatric health services;

Formulate a hospital development plan which shall be regularly updated to
reflect the expansion and future development of the NCGHRI;

Provide and maintain affordable, quality, and timely people-centered hospital
care through an efficient health service delivery system for senior citizens;

Provide higher and up-to-date geriatric training for professionals, postgraduates,
academics and allied healthcare providers especially from the geriatric specialty
centers in the regions and LGUs, and other government hospitals;

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. Develop and implement cutting edge research studies on diseases related to old

age with a view to translating research outcomes into policy and specialized
health care solutions, and publish research studies that shall serve as a critical
information resource for the medical and research community, in coordination
with the Philippine Council on Health Research and Development (PCHRD) and
the Institute on Aging of the National Institutes of Health (IA-NIH);

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Conduct and participate in international and local gerontological research

activities;

Provide consultancy service and technical assistance in the setting of standards
for geriatric wards in every tertiary level hospital, nursing home and residential
enter catering to the health and functioning needs of senior citizens, in
coordination with the PCHRD and the IA-NIH;

3

Develop and maintain a core information hub on geriatrics and gerontological
studies in coordination with the [A-NIH and concerned offices in the DOH and

is attached agencies, such as the Disease Prevention and Control Bureau and
the Knowledge Management and Information Technology Service;



Sec. 6.

Extend medical services to senior citizens pursuant to the goals, objectives, and
rules of the National Health Insurance Program and in accordance with Republic
Act No. 11223, otherwise known as the “Universal Health Care Act”;

Provide an integrated and effective approach in the delivery of geriatric health
services in collaboration with other government agencies, local government
units (LGUs) and other stakeholders;

Conduct specialty training and technical assistance in collaboration with
— DOH offices and other relevant professional organizations;

Finance, sponsor, hold or participate in congresses, conventions, conferences,
seminars, workshops, and training programs on geriatric health services or
related fields in the Philippines and abroad; and

Establish a standardized referral system for psychosocial services.
Scope of Services. ~ The NCGHRI shall provide the following services:

Hospital-based services to ensure the availability of medical facilities and
equipment for senior citizens needing acute and sub-acute care, geriatric

palliative care, transitional and outpatient care services, and such other
necessary services;

Community-based services utilizing multidisciplinary team approaches such as
homebased healthcare and re-ablement programs, research and external
resource outsourcing for community-based integrated geriatric health services
and trainings necessary for the psycho-social functioning of senior citizens and
a families, in coordination with LGUs;

. Technical assistance and capacity building in the establishment and maintenance

of nursing homes and residential care facilities and senior citizens’ wards in
government hospitals pursuant to Republic Act No. 9994, otherwise known as
the "Expanded Senior Citizens Act of 2010";

|. Technical assistance and capacity building in the establishment of geriatric

specialty centers and services to strengthen the network of geriatric care service
providers across the country and ensure the delivery of quality health services
for senior citizens;

.. Education programs and scholarships to pursue excellence and the highest level

of quality in the practice of the specialized field of geriatrics and other related
fields, including postgraduate training and short-term courses for medical
doctors and other allied medical health professions, in coordination with the IA-
NIH; and



f, Education programs in geriatrics and gerontology subjects in undergraduate
health and allied professions, including training of students, as well as
postgraduate medical education of physicians, nurses, allied professionals,
pharmacists, dentists, and social workers.

The Geriatric Specialty Fellowship Training Program of the NCGHRI shall seek and
maintain full accreditation status in the Philippine College of Geriatric Medicine.
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The NCGHRI shall ensure the accessibility of all its programs and services and take into
consideration the special needs of senior citizens with disabilities.

Sec. 7. Organizational Structure and Staffing Pattern. - The Secretary of the DOH
shall determine the organizational structure and staffing pattern of the NCGHRI in
accordance with the revised compensation and position classification system subject to
the evaluation and approval of the Department of Budget and Management (DBM) and
in compliance with the civil service laws, rules and regulations.

Sec. 8, Establishment of Geriatric Specialty Centers. - Geriatric specialty centers are
hereby established in DOH regional hospitals, which shall serve as apex or end-referral
hospitals oie health care provider networks and training and research facilities on
geriatric specialty care services. Geriatric health services shall be available in all
government primary health facilities.

The level of geriatric services and corresponding facilities in specialty centers and their
respective health human resource requirements shall be determined by the DOH, in
coordination with NCGHRI and other stakeholders: Provided, That the standards to be
adopted thereon shall be consistent with the Philippine Health Facility Development
Plan and Section 6 of this Act.

Sec. 9. Categorization of Patients. - The DOH shall ensure that the NCGHRI shall adopt
and enforge a categorization of paying and non-paying patients. The allocation of beds
for non pain patients shall be not less than seventy percent (70%) of the total
number of hospital beds.

Sec. 10. Income Retention. - All income generated from the operations of the NCGHRI
shall be deposited in an authorized government depository bank and shall be used to
augment the funds allocated for its maintenance, other operating expenses and capital
outlay requirements, subject to the guidelines set by the DOH and the DBM.

Sec. 11. Privilege. - The NCGHRI may request and receive assistance from the different
agencies, bureaus, offices or instrumentalities of the government, including the
Philippine Charity Sweepstakes Office and Philippine Amusement and Gaming
Corporation, in pursuit of its purposes and objectives.

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Sec. 12. Tax Exemptions. - All donations, endowments, contributions, grants and
bequests used actually, directly and exclusively for and in accordance with the purposes
and functions of the NCGHRI shall be exempt from donor's tax, and the same shall be
considered as allowable deductions from gross income for purposes of computing the



taxable income of the donor, in accordance with the provisions of the National Internal
Revenue Code of 1997, as amended.

The NCGHRI shall be exempt from income tax and customs duty levied by the
government and its political subdivisions, agencies and instrumentalities subject to the
provisions of the National Internal Revenue Code of 1997, as amended and Republic Act
No. 10863, otherwise known as the “Customs Modernization and Tariff Act.”

Incentives Review Board (FIRB), subject to the provisions of Title XIII (Tax Incentives)
of the National Internal Revenue Code of 1997, as amended, Executive Order No. 93, as
amended, and the General Appropriations Act.

The mies shall avail of the tax expenditure subsidy administered by the Fiscal

Sec. 13. Coordination with and Assistance from Other Government Agencies. - The
NCGHRI shall collaborate with the National Commission of Senior Citizens (NCSC) in the
development of its programs and services. It may likewise call upon any department,
bureau, office, agency, or instrumentality of the government for assistance, in the
pursuit of the purposes and objectives of this Act.

Sec. 14. Appropriations. - The amount necessary for the implementation of this Act
shall be charged against the current year’s appropriation of the DOH. Thereafter, the
funding of which shall be included in the annual General Appropriations Act.

Sec. 15. Annual Report. - The NCGHRI shall submit an annual report to the President
of the Philippines, the Senate Committee on Health and Demography, the House of
Representatives Committee on Health, and the NCSC, on its activities, accomplishments
and recommendations to further improve the delivery of geriatric health services.

improvements that have to be implemented, the following transitory provisions shall be

Sec. 16. Transitory Provisions. - In accomplishing organizational changes and
iments

a. kas National Center for Geriatric Health (NCGH) currently under the Jose R.
Reyes Memorial Medical Center (JRRMMC) shall be absorbed by NCGHRI
including its existing personnel regardless of status, and all buildings and
equipment, fixtures and furnishings, other assets and liabilities, and current
appropriations;

b. The independence of the NCGHRI from the JRRMMC shall be fully realized within
a period of two (2) years. The DOH shall ensure that no disruption of service will
occur during this transitory period;

c. The existing officials and employees of NCGH shall continue to assume the duties
of] their positions until new appointments are issued. They shall be placed in the
new staffing pattern of the NCGHRI in accordance with R.A. No. 6656, entitled
“An Act to Protect the Security of Tenure of Civil Service Officers and Employees
in the Implementation of Government Reorganization” and the rules and
regulations governing reorganization. Officials and employees, including casual



and temporary employees, who shall not be absorbed in the new staffing pattern
due ia redundancy shall avail of the applicable retirement benefits and
separation incentives as provided under existing laws: Provided, That officials
and employees holding permanent appointment shall also be given the option to
be pects to other units or offices within the DOH without reduction in

rank, status, pay and benefits;

a. senha grants acquired by the NCGHRI during the transition shall be utilized
solely for their intended purposes and of the affected units or offices; and
e. Existing contracts and agreements entered into with third parties prior to the
enactment of this Act shall remain valid.
Sec. 17. Implementing Rules and Regulations. - The Secretary of Health shall, in
consultation with the Secretary of Budget and Management, Secretary of Social Welfare

and Development, and the Chairperson of the NCSC, promulgate rules and regulations
for the see implementation of this Act within ninety (90) days after its effectivity.

unconstitutional, the remaining parts or provisions not affected shall remain in full

Sec. 18. ona he Clause. - If any part or provision of this Act is held invalid or
force and effect.

Sec. 19. Repealing Clause. - All laws, decrees, orders, rules, and regulations, and other
issuances or parts thereof, which are contrary to or inconsistent with this Act are
hereby repealed, amended, or modified accordingly.

Sec. 20. Effectivity. - This Act shall take effect fifteen (15) days after its publication in
the Official Gazette or in a newspaper of general circulation.

Approved,