Republic of the Philippines Ky RECEIVED
HOUSE OF REPRESENTATIVES |/O
Batasan Hills, Quezon City ZX DATE August 5, 2022
* TIME 2:05pm
NINETEENTH CONGRESS % BY Revi
First Regular Session Ks. ry
</
House Bill No. 3240 _ Wo inper?

Introduced by

HON. YEDDA MARIE K. ROMUALDEZ
HON. JUDE A. ACIDRE
and
HON. BAI DIMPLE MASTURA

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

EXPLANATORY NOTE

According to latest data from the Philippine Statistics Authority, there were
12,336,355 Filipinos aged 60 years old and above as of May 2020. The total number
of senior citizens was 11.31 percent of the country's estimated total population at
109,035,343, based on the 2020 Census of Population and Housing.

This bill seeks to implement the policy of the State to protect and promote the
right to health of senior citizens all over the country by ensuring that a comprehensive
set of health services are available and accessible to them through the establishment
of a specialized hospital and research facility.

To fulfill this mandate and address the specialized health care needs and
requirements of the elderly, the National Center for Geriatric Health and Research
Institute (NCGHRI) shall be established. The NCGHRI shall be 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. Itis hoped that through
the establishment of the NCGHRI, hospital-based services, medical facilities and
equipment specialized for senior citizens needing acute and sub-acute care, geriatric
palliative care, transitional and outpatient care services, are made accessible to the
public.

Through this proposed legislation, technical assistance and capacity building
may also be made 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.”

Finally, this bill aims to enrich 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.

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

Rep. YEDDA MARIE K. ROMUALDEZ
Representative,“Tingog Sinirangan

Rep. JUDE/A. ACIDRE
Representative, Tingog Sinirangan

LEE

Rep. BAI DWMPLE MASTURA
Representative, First District of Maguindanao



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasan Hills, Quezon City

NINETEENTH CONGRESS
First Regular Session

House Bill No. 3240
ee
Introduced by

HON. YEDDA MARIE K. ROMUALDEZ
HON. JUDE A. ACIDRE
and
HON. BAI DIMPLE MASTURA

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.”

Section 2. Dec/aration of Policy. \t 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.

Section 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);

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

|. 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;

. 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 state 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
‘sever and life-limiting conditions;
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;

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

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;
Integrated delivery of geriatric health services refer 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. 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,

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.

Section 4. National Center for Geriatric Health and Research Institute
(NCGHR)). 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.


Section 5. Powers and Functions of NCGHRI. 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;

. Develop and implement cutting edge research studies on diseases

related to old age with a view to translating research outcomes into
policy and specialized healthcare 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);
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 center catering to the health and functioning
needs of senior citizens, in coordination with the PCHRD and the IA-
NIH;

1. 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;

|. 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.

Section 6. Scope of Services of NCGHRI. 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;

c. Technical assistance and capacity bull

gin 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-NH; 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.

Section 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.

Section 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 healthcare 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.

Section 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.

Section 10. /ncome Retention. Ail 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.

Section 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.

Section 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 XIII (Tax
Incentives) of the National Internal Revenue Code of 1997, as amended, Executive
Order No. 93, as amended, and the General Appropriations Act.

Section 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.

Section 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.

Section 15. Annual Report. The NCGHAI 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.

Section 16. Transitory Provisions. \n 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;

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 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 benefit

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.

Section 17. /mplementing 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.

Section 18. Separability Clause. \f 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.


Section 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.

Section 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,