Republic of the Philippines Si

HOUSE OF REPRESENTATIVES //Y pecE|\VED
Quezon City 2
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NINETEENTH CONGRESS *
First Regular Session a
House Bill No. 87

Introduced by REP. MARJORIE ANN A. TEODORO

EXPLANATORY NOTE

Aging is said to be a result of development, Based on World Bank data, life
expectancy in the country follows an increasing trend. People live longer due to
advances in health care, better nutrition and sanitation, development in education and
economic progress. Meanwhile, fertility rates remain low. According to the
Commission on Population and Development, the country recorded its lowest birth
rate for the past 34 years in 2020.

With these trends, it is already anticipated that the percentage of elderly
population in the country will increase. World Bank noted that population aged 65
and above comprised 6 percent of the total population in the country in 2020.
Commission on Population Development recently projected that people 60 years old
and above would comprise 14 percent of the total population in 2035.

This growth in the elderly population inevitably affects the capacity of our
health care system to accommodate their needs, especially that this population group
tend to have high prevalence of chronic and noncommunicable diseases and physical
disabilities. In fact, we have already seen in our local hospitals that most patients
seeking health services are senior citizens.

The State is constitutionally mandated to protect and promote the right to
health of the people. It shall also adopt a comprehensive approach to health
development which shall endeavor to make essential goods, health, and other social
services available to the public at an affordable cost. There shall be priority for the
needs of the underprivileged sick, elderly, disabled, women, and children.

Hence, in anticipation and response to these needs, this bill is filed to ensure
the accessibility and availability of health care services to the elderly through the
establishment of a specialized hospital and research institute as well as geriatric


Hence, in anticipation and response to these needs, this bill is filed to ensure
the accessibility and availability of health care services to the elderly through the
establishment of a specialized hospital and research institute as well as geriatric
specialty centers in the Department of Health (DOH) - retained hospitals in every
region.

There shall be a functional National Center for Geriatric Health and Research
Institute that will serve as a teaching, training and research hospital specializing in
geriatric care. Geriatric specialty centers will be established in DOH regional hospitals
which shall serve as apex or end-referral hospitals. The bill also ensures that geriatric
health services will be available in all government primary health facilities.

This is a re-filing of House Bill No. 10697 which was passed on Third Reading
during the 18" Congress.

Through this bill, it is hoped that health care facilities will be able to better cater
and attend to the health needs of our elderly population.

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

MARJQRIE Al ORO
Représentati
First District, Marikina City


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

NINETEENTH CONGRESS,
First Regular Session

_ 87

House Bill No.

Introduced by REP. MARJORIE ANN A. TEODORO.

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 accessible to them through the establishment of a
specialized hospital and research institute as well 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;

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 Insurance 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. Geriatric 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. It is a 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;

9g. Geriatrician refers to a medical doctor who has passed the necessary
training and specialty licensure examination for the practice of Geriatric
Medicine;

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

i. Home-based healthcare and reablement program refers to a
community-based service which primarily caters to the frail older persons who
have lost or are experiencing problems —_ with mobility;

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

k.  Multi-disciplinary team refers to a team composed of health
professionals headed by a geriatrician and includes surgeons, organ-system
specialists, nurses, clinical pharmacists, rehabilitation therapists, nutritionists,
dentists, social workers, caregivers, family | members and patients
themselves;

|. 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
old;

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

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,

0. 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. National Center for Geriatric Health and Research institute. - The National
Center for Geriatric Health (NCGH) is hereby classified as a teaching, research, and
training hospital that shall specialize in geriatric care and serve as an apex hospital or
end-referral 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 under the direct control and supervision of the DOH.

The bed capacity, service capabilities, healthcare facilities, expansion, organizational
structure and human resource requirements of the NCGHRI shall be based on the
hospital and human resource development plan to be prepared by the NCGHRI and
approved by the DOH.

Sec. 5, Powers 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;

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

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

d. 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;

e. 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);

f. Conduct and participate in international and local gerontological
research activities;

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

h. Develop and maintain a core information hub on geriatrics and
gerontological studies in coordination with the IA-NIH and concerned offices
in the DOH and its attached agencies, such as the Disease Prevention and
Control Bureau and the Knowledge Management and information Technology
Service;

i 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”;

j. 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;

k. Conduct specialty training and technical assistance in collaboration with
concerned DOH offices and other relevant professional organizations,

lL 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

m. __ Establish a standardized referral system for psychosocial services.


Sec. 6. Scope of Services. - The NCGHRI shall provide the following services:

a 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;

b. Community-based services utilizing multidisciplinary team approaches
such as home-based healthcare and reablement 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 their 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";

d. 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;

e. 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.

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 of the 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 enforce a categorization of paying and non-paying patients. The allocation of beds
for non-paying 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.

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.”


The NCGHRI shall avail of the tax expenditure subsidy administered by the Fiscal
Incentives Review Board (FIRB), subject to the provisions of Title XIll (Tax Incentives) of
the National Internal Revenue Code of 1997, as amended, Executive Order No. 93, as
amended, and the General Appropriations Act.

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.

Sec. 16. Transitory Provisions. - In accomplishing organizational changes and
improvements that have to be implemented, the following transitory provisions shall
be complied with:

a. The 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;

The existing officials and employees of NCGH shall continue to assume
the duties of their positions until new appointments are issued. They shalll 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 to 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 transferred to other units or offices within the DOH
without reduction in rank, status, pay and benefits;

d. Research 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 effective implementation of this Act within ninety (90) days after its
effectivity.

Sec. 18. Separability Clause. - If any part or provision of this Act is held invalid or
unconstitutional, the remaining parts or provisions not affected shall remain in full
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,