Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
First Regular Session

House Bill No. 4627

introduced by Representatives
DIOSDADO MACAPAGAL ARROYO and GLORIA MACAPAGAL ARROYO

AN ACT
PROVIDING PALLIATIVE AND END-OF-LIFE CARE, APPRORIATING FUNDS
THEREFOR AND FOR OTHER PURPOSES

EXPLANATORY NOTE

Cases of cancer, cardio vascular diseases and other life threatening
illnesses are steadily increasing every year which leave many families
emotionally, spiritually and physically drained. Pain and anguish shatter the lives
of families upon news of loved ones afflicted with an acute disease that can no
longer be cured medically. Most families hope for a miracle as their loved ones
hold on tightly to the precious thread of life.

Patients with such critical illnesses suffer unbearable pain and sorrows
and often rely on the sympathy and indefatigable assistance of their families,
relatives, doctors, nurses and others in allied health sciences, to make the
Temaining days of their lives bearable.

This proposed bill was inspired by the innovative initiative of Canadian
Senator Sharon Carstairs who pioneered on this work to help make life more
pleasant for the peopte of her country up to the very last hours of their existence.
It is our hope that we can replicate her nobie intentions in our country even if we
have to start from modest beginnings and on tentative steps.

This bill proposes that ail govemment and private hospitals and health
centers shail provide palliative care and end-of-life services to all Patients with


life-threatening illnesses. Provinces, cities, municipalities and barangays shall
establish community-based hospice units and palliative care centers in every
barangay in their respective jurisdiction.

Likewise, this legislative measure provides that there shall be continuing
research and collection of data on palliative and end-of-life care. The public shall
have access to good health data, including, socioeconomic issues of Palliative
and end-of-life care, and the physica, mental and economic impact on patients,
their families and informal caregivers.

Furthermore, immediate family members or relatives who actuatly look
after or take care of a critically-ill patient, shall be entitled to an appropriate care
leave benefit of sixty (60) days a year with full pay, whether employed in the
public or private sectors.

A Palliative Care Trust Fund is hereby established exclusively for the
financial support and assistance for the medical needs of indigent patients.

Itis the fervent goal of this bill to provide legislated support and assistance
to critically-ill patients and their families, in order to alleviate their agony, and face
life with hopeful equanimity even in the midst of pain.

Given the importance of the reasons cited above, prompt approval of this
bill is eamestly requested

DIOSDADO. GAL ARROYO cord uacanan. ARROYO
Second District, Camarines Sur Second District, Pampanga


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
First Regutar Session

House BillNo.. _ 4627

SSS

Introduced by Representatives
DIOSDADO MACAPAGAL ARROYO and GLORIA MACAPAGAL ARROYO

AN ACT
PROVIDING PALLIATIVE AND END-OF-LIFE CARE, APPRORIATING FUNDS
THEREFOR AND FOR OTHER PURPOSES

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

SECTION 1. Title. — This Act shall be known as 'The Palliative and End-
of-Life Care Act of 2011".

SECTION 2. Declaration of Policy. — The State guarantees the right of the
people to quality health care. It is likewise mandated by the Constitution to adopt
an integrated and comprehensive approach to health development which 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 and
degenerative diseases. The services aim to improve the quality of life of the
patients and their families, and as far as practicable, alleviate their physical,
emotional, psychosocial, and spiritual distress.

Palliative care and end-of-life services inctude, but not limited to the
following:

1) Pain management:

2) Support to terminally-il patients to live as best as possible a
comfortable life;


3) Prolong as far as practicable, the life span of criticalty-ill patients
through therapies, such as chemotherapy, radiation, and other natural or
alternative methods of healing;

4) Provide support and counseling to the famities of terminally-ill patients,
especially in times of distress and bereavement

5) Integrate physiological, emotional and spiritual assistance to patients
and their families

6) Enhance the quality of life of the patients and their families.

SECTION 3. Mandatory Patiiative Care and End-of-Life Services. ~ All
government and private hospitals and heath centers shall provide palliative care
and end-of-life services to all patients with life-threatening illness. Provinces,
cities and municipalities shall jointly establish community-based hospice units
and palliative care centers in their respective jurisdiction.

SECTION 4. Education and Training of Health Care Professionals and
Volunteers. - Physicians, nurses, midwives, social workers, pharmacists,
occupational therapists, nutritionists, private volunteers, caregivers, or members
of religious community shail undergo multi-disciplinary education and specialized
training with respect to an integrated and coordinated approach towards palliative
and end-of-life care support services.

SECTION 5. Continuing Research. — There shall be a continuing research
and collection of data on palliative and end-of-life care. The public shall have
access to good health data, including, socioeconomic issues of palliative and
end-of-life care, including the physical, mental and economic impact on the
patients, their families and informal caregivers.

SECTION 6. 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,

Employees availing of this leave privilege shall submit to their employers
the following:

1. Name of patient - relative undergoing palliative treatment;
2. Copy of Medical Abstract of the patient-reiative:

3. A Certification from the hospital or hospice providing palliative services
to a caiticaily-ill patient, and


4. The nature of the care that is required of them under the circumstances.

SECTION 7. Disqualification from Leave Benefits. - The following
employees shall not be allowed to avail of this leave:

1. Thase who are absent from work without official leave;
2. Those who are on vacation, sick, forced or study leave:

3. In times of emergency, those whose services are necessary to prevent
loss of life or damage to property, brought about by serious accidents,
fires, floods, typhoons, earthquake, epidemic or other disasters.

SECTION 8. Establishment of Palliative Care Trust Fund. — A Palliative
Care Trust Fund, hereafter referred to as the Fund, is hereby established
exclusively for the financial support and assistance for the medical needs of
indigent patients. Indigent patient who needs palliative and end-of-life care who
has no money or property sufficient and available for food, shelter and basic
necessities for him and his family, shall be eligible for assistance in payment for
the palliative care treatment.

The Fund shalt be subject to the following;
(a) The contribution to the Fund shalt be sourced from the following:

(1) The amount of Fifty million pesos (P50,000,000.00) shall be
allotted in the annual General Appropriations Act (GAA) for the next
five (5) years starting from the enactment of this law;

(2) The amount of Fifty million pesos (P50,000,000.00) shall be
taken from the Philippine Amusement and Gaming Corporation
(PAGCOR) fund at Five million pesos (P5,000,000.00) per month
for ten (10) months;

(3) Another amount of Fifty million pesos (P50,000,000.00) shall be
taken from the Philippine Charity Sweepstakes Cifice (PCSO) at
Five mitlion pesos (P5,000,000.00) per month for ten (10) months:

(4) Ten percent (10%) of the health budget of all local government
units shall be contributed annually to such fund.

(b) Only the interest drawn from the Fund from sources cited in Section 9
(a1), (a2) and (a3) shall be awarded as grants to qualified patients,

w


{c} The grants can be awarded only after one (1) year from the
organization of the Fund.

{d) Govermment-owned and/or controlled corporations are authorized to
give grants to the Fund at their discretion;

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

(f) Contributions to the Fund 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 9. The Palliative Care Assistance Board. - There is hereby
created for every province, city or municipality a Palliative Care Assistance Board
hereinafter referred to as the Board. The Board shall be composed of five (5)
members who shall be Chaired by the Governor or the Mayor of the local
goverment concerned,

The other four (4) members of the Board shail be composed of. (1) a
representative from the Department of Health; (2) the Chair of the Committee of
Health of the Sangguniang concemed; (3) a representative of the opposition
party or parties in the Sangguniang concemed; and (4) a representative of the
families or family organizations mentioned in Article XV (3 [4]) of the Constitution.

The members of the Board shall serve for a term of three (3) years:
Provided, That no member shall serve for more than (2) consecutive terms.

The members of the Board shail serve and continue to hold office until
their successors shall have been appointed and qualified. Should the private
fepresentative member of the Board fail to complete his or her term, the
successor shall be replaced by the families or family associations mentioned
above only for the unexpired portion of the term.

No person shall be appainted to the Board untess he or she is a citizen of
the Philippines, at least thirty (30) years of age, and of good reputation and
probity.

The members of the Board shall receive such per diems and allowances
as may be authorized for every meeting actually attended and subject to
pertinent laws, rules and regulations.

For the ‘sound and judicious management of the Fund, the PCAB shall
appoint a government financial institution, with a sound track record on fund


Management, as portfolio manager of the Fund, subject to guidelines
promulgated by the PCAB; and

‘The PCAB shall prepare the implementing guidelines and decision-making
mechanisms, subject to the following:

(1) No part of the seed capital of the Fund, including eamings
thereof, shalt be used to underwrite overhead expenses for the
administration; and

(2) There shall be an extemal auditor to perform an annual audit of
the Fund's performance.

SECTION 10. Accreditation of Private Hospices. — The Department of
Health with the participation of the duly authorized member of families or family
associations mentioned in Article XV (3 [4}) of the Constitution shall promote the
rules and guidelines for the accreditation of private hospices providing palliative
and end-of-life care to patients to ensure standard quality services.

SECTION 11. Implementing Rules and Regulations. — Within ninety (90)
days from the effectivity of this Act, the rules and regulations necessary to
effectively implement its provisions shail be promulgated by the Department of
Heaith with the assistance of the duly authorized representative of the families or
family associations mentioned in the Constitution.

SECTION 12. Appropriations. — For the initial implementation of this Act,
the amount of One Hundred Million pesos (Php100,000,000,.00), in addition to
the budget of the Department of Health, is hereby allotted. The amount shall be
equitably allotted to the provinces, cities and municipalities to start the
implementation of this Act. Thereafter, such sum as may be necessary for its
continued implementation shall be included in the annual General Appropriations
Act and shall be apportioned accordingly.

SECTION 13. Repeating Clause. ~ All laws, executive orders, rules and
regulations or any part thereof inconsistent herewith are deemed repealed,
modified or amended accordingly.

SECTION 14. 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.

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

Approved,

vw