Republic of the Philippines

HOUSE OF REPRESENTATIVES & W REC EIVED aA
Quezon City 2 .DATEFEB 08 2 ma
EIGHTEENTH CONGRESS * 2:
Second Regular Session %

HOUSE BILL NO. 8635

Introduced by HON. JOY MYRA S. TAMBUNTING

EXPLANATORY NOTE

The World Health Organization defines Health as a “state of complete physical, mental, and social
well-being and not merely the absence of disease or infirmity.” Over the years, numerous
measures have been proposed to make our health care system more responsive to the health
needs of the public. Bulk of the efforts in improving the healthcare system however is geared
towards the cure and prevention of sickness. While these are undoubtedly essential components
of healthcare systems, the promotion of people's overall well-being and quality of life is equally
important. This is particularly true for individuals afflicted with cancer, diabetes, end-stage renal
disease, respiratory disease, cardiovascular diseases, dementia, Alzheimer’s disease, and similar
degenerative illnesses. As the number of individuals afflicted with these degenerative increases
each year, there is an increasing need for the integration of palliative and hospice care to country’s
healthcare system.

This proposed measure seeks to strengthen and expand the availability of palliative care for all
patients through mandatory palliative and hospice services in all government and private hospitals
and include in-patient palliative services, outpatient hospice care, and home-based palliative care
to PhilHealth’s benefit packages. This measure also provides for the development of education
and training modules for health care professionals, workers and volunteers.

On behalf of the people of Parafiaque City’s Second District, and for the common good of the
Filipino people, the approval of the said measure is earnestly sought.

\,

S. TAMBUNTIN'
istrict, Parafiaque City


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
Second Regular Session

HOUSE BILL NO, 8635

Introduced by HON. JOY MYRA S. TAMBUNTING

AN ACT
INTEGRATING HOSPICE AND PALLIATIVE CARE INTO THE PHILIPPINE HEALTH
(CARE SYSTEM 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 “Hospice and Palliative Care Act.”

SEC. 2. Declaration of Policy. - The State guarantees the right of the people to quality health
care and ensures that the health status of the people is protected over the entire life cycle.
Pursuant to the 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, including patients suffering from life-
threatening illnesses.

SEC. 3. Definition of Term. — As used in this Act:

Hospice and Palliative care refers to an approach that improves the quality of life of patients with
life-threatening, complex and chronic illnesses or those experiencing progressively debilitating
diseases beyond any benefit from curative or definitive treatment, regardless of life expectancy.
‘The approach ALSO covers the prevention .arid relief of suffering by means of early identification,
assessment, and management of pain and symptoms.

Tt should not be limited to the terminally ill, or those who have been deemed as having six (6)
months to live.

SEC. 4. Accreditation. — Hospitals, private hospice institutions, medical practitioners, health
workers, and social workers for hospice and palliative care shall be accredited by the Department
of Health (DOH). The DOH, in partnership with the National Hospice and Palliative Care Council
of the Philippines, Inc. (NHPCCP) shall formulate the rules and guidelines for accreditation to
ensure a standard quality of palliative care services.


SEC. 5. Quality Assurance. — Key elements necessary to ensure quality hospice and palliative
care services in accredited hospitals and hospices include the following:

a) Adequate number of multi-specialty personnel;
b) Assured financing for health and custodial services;

©) Clear and practical standards for facilities and services;

d) Appropriately designed and equipped facilities; and

e) Regular and systematic supervision and reporting to the DOH.

SEC. 6. Mandatory Hospice and Palliative Care Services. - All government and private
hospitals shall provide hospice and palliative care services to patients with life-threatening
illnesses. The purpose is to support the patients’ emotional, social and spiritual needs as well as
minimize the medical symptoms in seriously ill or terminally il patients.

Hospitals are required to link with a referral and aftercare network that is organized and made
functional by all provincial, city and municipal governments under the guidance and monitoring
of the DOH.

Rural health units, health centers and health offices are required to develop home-based or near
home palliative care program in coordination with government-owned and privately-owned
hospices in the local government units (LGUs).

SEC. 7. Leave Benefits. — Immediate family members or relatives who are employed, whether
in the public or private sectors, and are assigned by the family to provide hospice and palliative
care to a critically-ill relative shall be allowed to use all existing leave benefits granted by their
employers subject to the guidelines on the use of said leave benefits.

The DOH, in coordination with the Civil Service Commission (CSC), the Social Security System
(SSS), the Government Service Insurance System (GSIS), and the Department of Labor and
Employment (DOLE), shall be tasked to formulate the necessary guidelines in the availment of
leave benefits.

SEC. 8. Education and Training of Health Care Professionals and Volunteers. - The
DOH, in partnership with the NHPCCP and other accredited members, shall develop the education
and training modules for health care professionals, workers and volunteers.

The Commission on Higher Education (CHED) shall integrate courses on the principles and
practice of hospice and palliative care into the curriculum of Medicine and Nursing, as well as in
all paramedical and allied health courses.

SEC. 9. Continuing Research. — The DOH, in coordination with the Philippine Council for Health
Research and Development of the Department (PCHRD) of the Department of Science and
Technology (DOST), shall ensure a continuing research and collection of data on palliative and
hospice care and availability of funds for this purpose.

SEC.10. Program Implementor. - The DOH-Office for Technical Services, in coordination with
other offices of the Department, is hereby mandated to perform the following functions:


a) Promote hospice and palliative care in the Philippines through advocacy and social
marketing;

b) Formulate policies and develop standards on quality hospice and palliative care;

©) Monitor the enforcement of standards and implementation of the program on hospice
and palliative care;

d) Mobilize and generate resources for sustainability of operation;

e) Network with international hospice associations;

f) Coordinate research undertakings with other institutions and agencies;

9) Serve as repository of database for policy-making and maintenance of hospice and
palliative care registry;

h) Organize and develop continuing training programs for physicians, nurses, physical
therapists, and other professional health workers and volunteer workers in the field of
hospice and palliative care;

i) Serve as the coordinating center of a national hospice and palliative care network
located in the different regions of the country; and

j) __ Establish a Code of Ethics and Standards in the practice of hospice and palliative health
care,

SEC. 11. Philippine Health Insurance Corporation (PhilHealth) Benefit Package. —
Pursuant to this Act, the PhilHealth shall increase its present benefit package to include inpatient
palliative services, outpatient hospice care, and home-based palliative care.

SEC. 12. Funding Support. - All non-profit, DOH accredited hospice and palliative care
institutions which are serving indigent patients shall qualify as institutional beneficiaries under the
Philippine Charity Sweepstakes Office (PCSO) Institutional Financial Assistance Program:
Provided, That the hospice and palliative care institutions shall ensure funding for health and
custodial services and shall comply with the documentary and other requirements of the Program.
Provided, further, that, clear and practical standards for facilities and services are in place.

SEC. 13. Reporting. - One (1) year after the implementation of this Act and every year
thereafter, the DOH shall submit a written assessment to Congress on the implementation of the
hospice and palliative care program.

SEC. 14. Tax Exemptions. — All grants, bequests, endowments, donations and contributions
made to the DOH to be used actually, directly, and exclusively for hospice and palliative care
program shall be exempt from donor's tax and the same shall be allowed as deduction from the
gross income of the donor 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.

SEC. 15. Appropriations. — The initial amount necessary to implement the provisions of this
Act shall be charged against the current year's appropriation of the DOH. Thereafter, such sums
as maybe necessary for the continued implementation of this Act shall be included in the Annual
General Appropriations Act.


SEC. 16. Rules and Regulations. — Within sixty (60) days from the approval of this Act, the
Secretary of Health, after consultation with the NHPCCP shall promulgate the rules and
regulations to implement the provisions of this Act.

SEC. 17. Separability Clause. In case any provision of this Act is declared unconstitutional
or invalid, the other provisions hereof which are not affected thereby shall continue in full force
and effect.

SEC. 18. Repealing Clause. — All laws, executive orders, rules and regulations or any part
thereof inconsistent herewith are deemed repealed, modified or amended accordingly.

SEC. 19. Effectivity. - This Act shall take effect fifteen (15) days after its publication in the
Official Gazette or in any newspaper of general circulation.

Approved,