Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasang Pambansa, Quezon City

FIFTEENTH CONGRESS
Second Regular Session

HOUSE BILL NO. 5250

Authored by HON. LINABELLE RUTH R. VILLARICA

EXPLANATORY NOTE

When a life threatening illness, like cancer, no longer responds to
treatment and reaches its terminality, patients and family are often told,
“I'm sorry, there is nothing more we can do.” This causes a
profound suffering and emotional impact to the patient and his or her
family. But a study of medicine called Palliative Care, and a
compassionate caring philosophy embodied in Hospice Care, asserts
that from the time the patient has been diagnosed to the end-of-life-—
something can and still should be done so that the patient can still have
quality of life in his or her remaining days free from pain and
suffering.

Cancer is the third cause of death among men and women, one third
(1/3) of the disease can be curable once detected early but two thirds
(2/3) of those afflicted are in an advanced stage and incurable and can
only have palliative care that may result in an acceptable quality of
life. There is also a rising incidence of HIV/AIDS. From January 1984 to
July 2007, there were 2,916 reported HIV Abseropositive cases of which
2,146 (74%) were asymptomatic and 770 (26%) were AIDS cases.

As of this time, the Philippine Health Care Delivery System covers the
scope of preventive and curative services. It fails to address palliative or
end-of-life care. Yet there are many benefits to be derived from the
integration of Palliative and Hospice Care into our current way of
delivering health care, such as:

(a) Improved quality of life for the terminally-ill patient while
minimizing the financial burden of their families.


(b)

()

(d)

)

Declogging of government hospitals from emergency
admissions of terminally-ill patients and preventing the
draining of public hospital resources for indigent patients.

An easing of the burden of local government units to support
the medical and financial expenses of terminally-ill indigent
patients, which will result in better channeling of resources
to benefit a greater number of beneficiaries.

The development of a home-based Palliative and Hospice
Care program at the grassroots level will increase access of
quality health service, especially by the poor.

Creation of more jobs and opportunities for nurses and other
allied medical health workers for the demands of the local
and global Palliative and Hospice Care industry.

In keeping with the spirit of the Health Sector Reform Agenda,
which improved the way health services are being provided and financed
in our country, this Act integrates Palliative and Hospice Care into our
health care delivery system thus pooling together the efforts and
resources of all the major stakeholders such as the DOH, PhilHealth, the
local government, civil society groups, and the beneficiaries. Budget
appropriation for the implementation of this Act shall be sourced from
existing fund sources of the present health care delivery system.

Ah Marner’
LINABELLE RUTH R. VILLARICA


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasang Parmbansa, Quezon City

FIFTEENTH CONGRESS
Second Regular Session

HOUSE BILL NO. 5250

Authored by HON. LINABELLE RUTH R. VILLARICA

AN ACT TO INTEGRATE PALLIATIVE AND HOSPICE CARE INTO
THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM

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

SECTION 1. Short Title. This Act shall be known as "The Palliative and
Hospice Care Act of 2010".

SECTION 2. Deciaration of Policy. The State guarantees the right of the
People to quality health care;ensuring that the health status of the
people is to be made as good as possible over the entire life cycle. As
the Constitution mandates, an integrated and comprehensive approach
to health development shall endeavor to make essential goods, health
and other social services available to all people at affordable cost even
to patients suffering from life threatening illnesses.

SECTION 3. Definition of Terms.

Palliative and Hospice Care. As per the World Health Organization
definition, is an approach that improves the quality of life of patients and
their families facing the problems associated with life-threatening illness,
through the prevention and relief of suffering by means of early
identification and, impeccable assessment and management of pain and
other problems, physical, psychosocial and spiritual.


Terminally-Ti. Patients who are certified by primary physician and
Palliative care specialist physicians as terminally-ill have active,
progressive, far-advanced disease with six (6) months or less to live.

SECTION 4. Services And Site of Care. They can avail of Palliative and
Hospice Care services either in hospitals, hospice institutions, or in the
Privacy of their homes.

Palliative and Hospice Care services include, but are not limited to the
following:

{a) Palliative Physician care.

(b) Palliative Nursing care

(c) Medications for pain and symptom control

(d) Medical supplies (bandages, catheters, etc.)

(e) Medical equipment (oxygen machine, wheelchair, hospital
bed, etc.)

(f) Counseling (spiritual, emotional) to help patients live as
actively as possible until death and to help the family cope
during the patient's illness and in their own bereavement

(g) Palliative surgery, palliative chemotherapy, and palliative
radiation to better manage distressing clinical complications

SECTION 5. Compassionate Care Leave Benefits. Notwithstanding any
law, rules and regulations to the contrary, immediate family members or
relatives who actually look after or take care of a critically-ill patient,
shall be entitled to a compassionate care leave benefit of sixty (60) days
a year with full pay, whether in public or private employment sector.

SECTION 6. Mandatory Palliative Care And Hospice Services. All
government and private hospitals shall provide Palliative and Hospice
Care services to all patients with life-threatening illness. Provinces, cities
and municipalities shall include Palliative and Hospice Care into their
Rural Health Unit services as a home-based care program.

SECTION 7. Accreditation. Private hospice institutions, medical
practitioners, health workers, and social workers for Palliative and
Hospice Care shall be accredited by the Department of Health in
partnership with the National Palliative and Hospice Care Council of the
Philippines (Hospice Philippines, Inc.) shall promote the rules and
guidelines for accreditation to ensure standard quality services.


SECTION 8. Education And Training Health Care Professionals and
Volunteers. Physicians especially Provincial Health Officer (PHO) and
Municipal Health Officers (MHOs), nurses, darangay health workers
(BHWs), social workers, occupational therapists, _ nutritionists,
volunteers, caregivers, or members of religious community shal! undergo
multi-disciplinary education and specialized training, under the
Department of Health through partnerships with accredited palliative
and hospice Care institutions, with respect to an integrated and
coordinated approach towards palliative and hospice care support
services.

SECTION 9. Continuing Research. There shall be a continuing research
and collection of data on palliative and hospice care. The public shall
have access to good health data, including, socioeconomic issues of
palliative and hospice care, including the physical, mental and economic
impact on the patients, their families and informal caregivers.

SECTION 10. Designation Of The National Palliative And Hospice Care
Council Of The Philippines (HOSPICE Phils., Inc.). As the attached
agency of the Department of Health it shall perform the following
functions;
(a) To promote palliative care in the Philippines through
advocacy.
{b) To provide policy formulation, standard development and
monitor implementation of its programs.
(c) To mobilize and generate resources or sustainability of
operation.
(d) To network with the intemational hospice association.
(e) To plan and carry out or coordinate research with other
institutions and agencies.
(f) To provide the database for policy formulation that will
stimulate and sustain palliative care registry
(g) To organize and develop continuing training programs for
physicians, nurses, physical therapists, and other
professional health workers and volunteers workers in the
field of palliative care.
{h) To serve as the coordinating center of a national palliative
care network located in the different regions of the country.


(i) To formulate a code of ethics and standards for the practice
of palliative care modalities.

SECTION 11. Grants And Donations. All non-profit Palliative and Hospice
Care institutionsthat are serving indigent patients are to be included as
beneficiaries of PAGCOR and PCSO funding to support programs and
services.

{a) All government-owned and/or controlled corporations are
authorized to give grants to accredited Palliative and Hospice Care
providers at their discretion;

(b) Private donations and other conveyances including funds,
materials, property and services, by gratuitous title are also
allowed and encouraged under this Act;

(c) Contributions shall be exempt from the donor's tax and the
same shall be considered as allowable deductions from the gross
income of the donor, in accordance with the provisions of the
National Internal Revenue Code of 1997, as amended.

SECTION 12. Appropriations. Congress shall allocate funds for training,
education, promotion, and mobilizationfor the implementation of this Act
throughout the provinces, cities and municipalities. Thereafter, such sum
as may be necessary for its continued implementation shall be incuded
in the annual General Appropriations Act. The local government units
shall also appropriate ten percent (10%) of their health budget for
Palliative and Hospice Care.

SECTION 13. Implementing Rules And Regulations. Within ninety (90)
days from the effectivity of this Act, the rules and regulations necessary
to effectively implement its provisions shall be promulgated by the
Department of Health with the assistance of the National Palliative and
Hospice Care Council of the Philippines (Hospice Philippines).

SECTION 14. Repealing Clause. All laws, executive orders, rules and
regulations or any part thereof inconsistent herewith are deemed
repealed, modified or amended accordingly.


SECTION 15. Separability Clause. In case any provision of this Act is
dedared unconstitutional or invalid, the other provisions hereof which
are not affected thereby shall continue in full force and effect.

SECTION 16. Effectivity. This Act shall take effect fifteen (15) days after
its publication in two (2) national newspapers of general circulation.

Approved,