EIGHTEENTH CONGRESS OF THE ) [> > RECEIVED
REPUBLIC OF THE PHILIPPINES ) -. AUG_0 6 2018
First Regular Session )

HOUSE OF REPRESENTATIVES
1.B. No, 3488

INTRODUCED BY REPRESENTATIVE FERDINAND L. HERNANDEZ,

AN ACT
INSTITUTIONALIZING AN EMERGENCY MEDICAL SERVICES SYSTEM,
CREATING FOR THE PURPOSE THE NATIONAL EMSS COUNCIL,
APPROPRIATING FUNDS THEREFOR, AND FOR OTHER PURPOSES

EXPLANATORY NOTE

It is necessary for our government to implement a well-coordinated and effective
response system, especially in cases emergencies, to prevent any injury or loss of life that
may be suffered by our fellow Filipinos. On 25 May 2018, President Rodrigo Duterte issued
Executive Order (E.O.) No. 56, which created a nationwide 911 emergency hotline to better
connect Filipinos to the emergency response resources of the government. This proposed
legislation seeks to enhance the effectiveness of E.O. No. 56 by institutionalizing an
Emergency Medical Service System (EMSS) that will ensure the effective, coordinated, and
timely delivery of health, medical, and safety services to victims of any sudden illness
and/or injury in the pre-hospital setting.

Under this bill, which is a counterpart of the one filed by Senator Christopher “Bong”
Go in the Senate, the government shall implement a comprehensive EMSS that will organize
its personnel, facilities, and equipment in the national level, through the creation of the
Emergency Medical Service System Council (EMSSC) under the Departmentment of Interior
and Loccal Government. Meanwhile, this bill shall task the various Local Government Units
with the creation of dedicated dispatch centers, that will be connected with the EMSSC's


National Command Center, in their respective jurisdictions that will link all Filipinos to the
necessary EMSS Services they require.

Furthermore, the bill also proposes the creation of additional plantilla positions as
well as the purchase and designation of additional government resources, specifically
designated for the delivery of EMSS Services, to ensure that quality emergency medical
assitance is provided to our fellow Filipinos.

In light of the foregoing, the immediate enactment of this proposed legislation is
sought.


Seocwmvsavneun

u

13
14
1s
16

EIGHTEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES,

H.B. No. 3488

INTRODUCED BY REPRESENTATIVE FERDINAND L. HERNANDEZ

AN ACT
INSTITUTIONALIZING AN EMERGENCY MEDICAL SERVICES SYSTEM,
CREATING FOR THE PURPOSE THE NATIONAL EMSS COUNCIL,
APPROPRIATING FUNDS THEREFOR, AND FOR OTHER PURPOSES

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

CHAPTER I
GENERAL PROVISIONS

Section 1. Short Title. - This Act shall be known as the “Emergency Medical Services
‘System (EMSS) Act of 2019”.

Sec. 2. Declaration of Policy. It is hereby declared the policy of the State to protect
and promote the right to health of the people. Pursuant to this national policy, the
government shall institutionalize a comprehensive, accessible, integrated and standardized
system of emergency medical services and provide an environment that will maximize the
capability and potential of emergency medical services (EMS) personnel.

Sec. 3. Objectives. — This Act has the following objectives:
a) To create a national Emergency Medical Services System Council (EMSSC);
b) To develop and institutionalize an emergency medical services system at the

national and local government;


u
12

13
14
1s
16
17
18
19
20
21

23
24
25
26
27

©) To encourage and promote the active participation of the private sector in the
provision of emergency medical services;

d) To establish a national standard for an emergency medical services such as
training of EMS institutions and personnel, and establishing standards for
design, accreditation and regulation of emergency medical vehicles;

‘e) To institutionalize the use of a Nationwide Emergency Hotline Number;
f) Toestablish and provide support services to emergency medical services;

g) To promote public safety and accessible emergency medical services to the
people especially those in need of emergency medical services and give priority
for the under-served and unserved communities; and

h) To adopt an emergency medical service protocol in times of natural and man-

made disasters.

Sec 4. Definition of Terms. — For purposes of this Act, the following terms are hereby

defined:

a) Accredited training and assessment institutions refer to organizations, in good
standing with the Emergency Medical Service System Council (EMSC), accredited
to offer training programs, courses, continuing education and competency-based
assessment in Emergency Medical Services for EMS personnel that meet the
standards established by the Philippine Public Safety College (PPSC) for uniformed
personnel and the EMSSC, hereinafter referred to as the Council created under this
Act;

b) Advanced Cardiac Life Support (ACLS) refers to a group of interventions used to
treat and stabil

adult victims of life-threatening cardiorespiratory emergencies
and to resuscitate victims of cardiac arrest. These interventions include Cardio
Pulmonary Resuscitation (CPR), basic and advanced airway management such as
endotracheal intubation, emergency medications, electrical therapy, automated
external defibrillation and intravenous (IV) access;


ween

Care

"W
12
13
14

15
16
7
18

19
20
21
2
23

25
26
7
28

©) Advanced Trauma Life Support (ATLS) refers to a group protocol for managing
trauma victims and designed to maximize management in the first hour after trauma
and ensure an optimal long-term outcome. These interventions include BLS, ACLS,
immobilization, venous cannula insertion and Pediatric Advanced Life Support
(PALS) for children;

4) Ambulance/Emergency medical vehicle refers to a vehicle designed and equipped
for transporting sick or injured patients to, from, and between places of treatment by
land, water or air, affording safety and comfort to the patients and avoiding illness or
injury;

€) Basic Life Support (BLS) refers to a group of actions and interventions used to
resuscitate and stabilize victims of cardiac and respiratory arrest. These BLS actions
and interventions includes the recognition of a Cardiac or a Respiratory emergency
or Stroke, activation of the emergency response system, CPR and relief of foreign-
body airway obstruction;

£) Competency-based assessment refers to the confirmation of an EMS personnel’s
capability and capacity to perform one’s duties and responsibilities, through the
process of collective evidence and judgment, in accordance with the standards and
guidelines established by the Council;

g) Emergency Medical Dispatch refers to the immediate identification and prioritization
of emergency situations, the timely dispatch of appropriate resources, providing
essential pre-arrival medical instructions and full endorsement to the receiving
hospital. Dispatch encompasses all aspects of communication including request
processing, coordination and support, documentation and monitoring.;

hh) Emergency medical services (EMS) refer to:

(1) Emergency care which refers to the independent delivery of pre-hospital emergency
medical services by appropriately trained and certified EMS personnel, usually in a
mobile or community setting, in full accordance with the Emergency Medical
Services Treatment Protocols established by the EMSSC;


1 2) Advanced Life Support which refers to a set of life saving protocols and skills that
2 extend beyond BLS (Basic Life Support) to further support the circulation and
3 provide an advanced airway and adequate ventilation. Advanced Life Support may
4 refer to Advanced Cardiac Life Support (ACLS) and Advanced Trauma Life Support
3 (ATLS);

6) Emergency Medical Services Personnel refers to a trained and certified personnel engaged in
7 the provision of emergency medical services during emergencies. Responders may either be
8 health professionals or non-health professionals;

9 Emergency Medical Services (EMS) System refers to the arrangement and coordination of
10 personnel, facilities, and equipment for the effective delivery of emergency medical services
11 required in the management of emergencies; for the management and prevention of further
12 incidents or accidents and the broad range of emergency care from emergency care to
13. transport in an intensive care setting;

14) Emergency Response and Care refers to the arrival of resources at the scene and the timely

15 initiation and provision of appropriate medical interventions.

16) Emergency Transport refers to the transporting of a patient to the most appropriate and

17 _ definitive health facility with continued provision of care and appropriate interventions en

18 route to the appropriate health facility.

19n) Inter-Agency Referral and Transport refers to the transport of patient with EMS personnel, if

20 necessary, from one referring facility or agency to another receiving facility or agency for

21 definitive care, as the patient requires, in an event that the services are not available in the

22. referring facility;

2h) Medical Direction refers to the communication between an EMS personnel and a physician

24 from the field via radio or other means to obtain instruction on further care of a patient.

2%) Medical Emergency refers to any acute or life-threatening condition that requires immediate

26 _ intervention by competent medical personnel.

2) Medical Oversight refers to the broad understanding of the emergency medical system as a

28 whole and ensuring proper policies and procedures exist to ensure safe transitions of care

29 and utilization of appropriate resources in the field, it is typically performed by a medical

30 director at the local, regional, and national levels, in collaboration with regulatories, regional

31 and local medical directors and advisory committees.

6


1) National Emergency Medical Services Treatment Protocols refer to emergency medical
2 procedures outlining approved clinical practices and therapies to be observed by EMS
3. personnel, as established by the Council; and

4) Patient Transport refers to the transport of patients to and from medical facilities whose
5 condition is of a non-fe-threatening nature in emergency situations, patients are
6 transported by the emergency medical services.

7

8 CHAPTER II

9 EMERGENCY MEDICAL SERVICES SYSTEMS COUNCIL

0

u Sec. 5. Creation of the Emergency Medical Services Systems Council. - There shall be
12 a council to be known as the "Emergency Medical Services Systems Council (EMSSC)"
13 created under the Department of Interior and Local Government (DILG).

1s Sec. 6. Powers and Functions of the EMSSC. - The Council shall perform the
16 following functions:

7 (a) To formulate policies governing the field of emergency medical services and
18 related institutions;

19 (b) To develop national standards for the provision of emergency medical services
20 to include, among others, the skills and competencies required for EMS
2 personnel and the development of mandatory national emergency medical
2 services treatment protocols to be observed by EMS personne! and such other
23 entities as it may consider appropriate;

24 (©) To promulgate a Code of Ethics for EMS personnel;

25 (d) To develop high standards of operation for EMS personnel;

26 (e) To develop standards and protocols for the design, construction, outfitting and

27 operations of emergency medical vehicles


13
14

15
16
17

18
19

20

21
2

23
24
25

26

(© To integrate the training and study of Standard Basic Life Support and First Aid
in different kinds of situations and emergencies in the curriculum of all public
and private tertiary educational institutions.

(g) To ensure the establishment of a system of networking and coordination among
all existing government health agencies, LGUs, and private and non-government
medical institutions for the effective implementation of this Act;

(h) To monitor compliance by all LGUs and government and private health
fa

sof the standards and requirements set out in this Act;

(i) To establish a Secretariat under an Executive Director for the administrative and
day-to-day operations of the Council;

() To create committees and other mechanisms to help expedite the
implementation of plans and strategies;

(k) To generate resources from local, national and_ international

organizations/agencies, whether government or private sector, for its operation;

() To receive and accept donations and other conveyances including funds,
materials and services by gratuitous title: Provided, that not more than thirty
percent (30%) of said funds shall be used for administrative expenses;

(m) To prepare an annual budget of the Council and submit the same to the
President for inclusion in the annual General Appropriations Act;

(n) To advise the President on matters pertaining to EMS;

(0) To investigate complaints against violators of this Act, its rules and regulations
and policies of the Council;

(p) To request any department, instrumentality, office, bureau or agency of the
government, including LGUs, to render such assistance as it may require in
order to carry out, enforce or implement the provisions of this Act;

(q) To regulate activities inimical to the delivery of emergency medical services;


w

wane

7
18
19
20
21
2
23

25
26

(8) To meet at least once every quarter; and

(8) To promulgate rules and regulations and policies of the Council and enforce the
provisions of this Act.

Sec. 7. Membership of the Council. - The members of the Council shall be composed

of the following:
(a) The Secretary of the Department of Interior and Local Government (DILG) as
Chairperson of the Council;

(b) The Secretary of the Department of Health (DOH) as Co-Chairperson;

(©) The Secretary of the Department of Transport (DOT®);

(a) The Secretary of the Department of Information, Communication and
Technology (DICT);

(e) The Head of the Office of Civil Defense (OCD);

(f) The Director General of the TESDA;

(g) The Chairperson of the CHED;

(h) The Chairman of the Philippine Red Cross (PRC); and

(i) The President of the Philippine Health Insurance Corporation (PhilHealth).

Relevant stakeholders from the different government offices, private entities and civil
society organizations (CSOs) who are involved in the practice and implementation of
emergency medical services can be invited as resource persons or representatives in the
Council's meetings.

Sec. 8. Compensation and Remuneration. — The Secretaries of the DILG and DOH
shall perform their duties as such without compensation or remuneration, subject to
reasonable per diem allowances as approved by the Council and subject to existing rules
and regulations of the Department of Budget and Management (DBM). Members who are
not government officials or employees shall be entitled to necessary traveling expenses, per


Seocwmnaueun

B
14
15
16
7
18
19
20
21
2
23
24
25
26
27
28

29
30

diem and representation allowances chargeable against funds of the DOH, as approved by
the Council, subject to existing rules and regulations of the DBM.

Sec. 9. The Secretariat. - The Council shall organize a Secretariat headed by a person
of probity and shall have at least five (5) years experience in emergency medical services or a
related field.

Sec. 10. Program Plans. - The Council shall within six (6) months after having been
officially constituted and finally staffed, adopt and immediately cause to be implemented, in
coordination with medical and related agencies, a short-term program in support of relevant
existing projects and activities and, within one (1) year, a long-term five (5)-year
development program. This development program shall be developed and subjected to
annual review and revision by the Council, in coordination with relevant public and private
‘medical agencies and organizations.

Sec. 11. Accreditation. - The Council shall issue certifications and licenses for the
accreditation of training institutions for EMS personnel and emergency medical vehicle
providers.

CHAPTER IIT
EMERGENCY MEDICAL SERVICES PERSONNEL

Sec. 12. Creation of Plantilla Positions for Emergency Medical Services Personnel-
There shall be created a minimum number of plantilla positions for EMS personnel in the
within the next five (5) years upon approval

(a) Level 2 and 3 Hospitals ~ Ten (10) EMS personnel and at least one (1) Ambulance
Assistant;

(b) Level 1 Hospitals ~ Six (6) EMS personnel and at least one (1) Ambulance
Assistant;

10


cw raue

10
W

12
13
14
15
16
7
18
19
20
21

2
23
24
25
26
27
28
29
30

(©) Local Government Units ~ Six (6) EMS personnel; and
(d) Other Health Facilities - as may be deemed necessary by the Council.

Upon the approval of the necessary plantilla positions for EMS personnel, the
Council shall submit a proposed standard of qualification for positions to the Civil Service
Commission (CSC) for its approval, pursuant to Executive Order No. 292, entitled “The
Revised Administrative Code of 1987 on the Civil Service Commission”. The annual
financial requirements needed to pay for the salaries of EMS personnel shall be included in
the annual general appropriations of the respective hospitals, health facilities and LGUs.

Sec. 13. Authorized Training Institution. - Training programs, courses and
continuing education for an EMS personnel shall be conducted by an institution that has
been granted a Certificate of Program Registration (COPR) by the TESDA, in case of
technical non-degree courses falling under the TESDA jurisdiction, or a Certificate of
Accreditation as a Higher Education Institution (HEI) as well as Program Accreditation by
the CHED, in the case of degree programs falling under the CHED jurisdiction, and the
Philippine Public Safety College (PPSC) for uniformed personnel.

‘The requirements prescribed by the Council shall serve as the minimum requirement

for program registration. The DOH can provide training programs for EMS personnel:
Provided, That these shall be in accordance with the standards set by the Council.

Sec. 14. Code of Ethics of EMS Personnel. - The Council, in coordination with the
appropriate agencies, shall adopt and promulgate the Code of Ethics and the Code of
Technical Standards for EMS personnel to include, among others, duties of EMS personnel
to emergency medical patients, to the community, and to their colleagues.

CHAPTER IV
EMERGENCY MEDICAL SERVICES SYSTEM

Sec. 15. Emergency Medical Vehicles. - The Council shall develop minimum
requirements for the design, construction, performance, equipment, testing and appearance

nu


Cm uaneon

10
WW
2
13
14

15
16
7

18
19

20

21

22
23

25
26
27
28
29

of emergency medical vehicles. As such, only emergency medical vehicles shall be allowed
to display the word "Ambulance" and the universally-accepted "Star of Life” symbol. It shall
also provide for the operation protocols of said vehicles.

The DILG in coordination with the DOH shall design a specification and an
accreditation systems and procedures, which shall follow Administrative Order (AO) No.
2016-0029 or the Department's A.O. governing licensure of ambulance and ambulance
service provider, to provide the public with ambulances and other emergency medical
vehicles that are easily identifiable, nationally recognizable, properly constructed, easily
maintained and, when appropriately equipped, will enable EMS personnel to safely and
reliably perform their functions as basic and advanced life support providers.

‘The ambulance shall be designed to provide the following features at the minimum:
(a) A driver's compartment;

(b) A patient compartment with sufficient space to safely and comfortably
accommodate an EMS personnel and a patient who can be given intensive life
support during transit;

(©). Equipment and supplies for emergency care at the scene as well as during
transport;

(d)_A two-way radio, telephone or electronic communication; and
(e) When necessary, equipment for light rescue or extrication procedures.

The emergency medical vehicle shall be so designed and constructed to provide the
patient with safety and comfort, and to prevent aggravation of the patient's injury or illness.
The designated vehicle marking of “ambulance” is hereby restricted for use by emergency
medical vehicles only. While failure of an emergency medical vehicle to conform to the
‘Council standards may be a ground for the removal of its certification, such failure shall not,
bar EMS personnel from:

(@) Responding and providing appropriate basic or advanced life support on-site to

persons reported experiencing acute injury or illness in an emergency care

2


10

12

13
4
15
16
7
18
19
20
21

23
24
25
26
27
28
29

setting, and transporting them, while continuing such life support care, to an
appropriate medical facility for definitive care;

(b) Providing inter-hospital critical transport care;

(©) Transporting essential personnel and equipment to and from the site of a
multiple medical emergency or a triage site and transporting appropriately
triaged patients to designated medical facilities;

(d) Emergency medical vehicles will be strictly be used for emergency cases only
and not for patient OPD/ambulatory consults, non-emergent cases, and elective
laboratory procedures; and

(e) BFP emergency medical vehicles will not be used for transporting non-emergent
cases, LGU emergency medical vehicles can be used for transporting elective or
non-emergent cases.

Sec 16. Emergency Dispatch. — All local government units are mandated to establish
their dispatch centers where constituents can call for all cases of emergencies, with adequate
and qualified personnel. The dispatch centers shall follow the prescribed guidelines on
dispatch protocol as determined by the DILG and the Council.

Sec. 17. Emergency Response, Care and Transport. ~ All LGUs shall ensure the
lability of adequate emergency transport vehicles or ambulances with qualified EMS

personnel. All emergency transport vehicles and the procedures to be undertaken in
responding and caring for patients shall follow the prescribed guidelines of the Department
of Health (DOH) and the Council on ambulance services and on emergency response and

care.

Sec. 18. Inter-Agency Referral and Transport. - This Council shall establish the
prescribed protocols / guidelines on inter-agency referral and transport.

(CHAPTER V
EMERGENCY COMMUNICATIONS,

13


cC@mwauneun

10
i
12
13
14
15
16
7
18
19
20
21
2
23
24
25
26
27
28
29
30
31

Sec. 19. Adoption of a Nationwide Emergency Hotline Number. - There shall only be
‘one (1) nationwide emergency hotline number to enable the public to access emergency
medical services. Towards this end, the National Telecommunications Commission (NTC)
and the Council shall develop a program for the adoption of a nationwide emergency
hotline number. It shall consult and cooperate with national and local agencies and
institutions; LGUs and officials responsible for emergency service and public safety; the
telecommunications industry (specifically including the cellular and other wireless
telecommunications service providers); the motor vehicle manufacturing industry;
emergency medical service providers; emergency dispatch providers; transportation
officials; public safety, fire service and law enforcement officials; consumer groups; and
hospital emergency and trauma care personnel, including emergency physicians, trauma
surgeons and nurses.

Sec. 20. Compliance. - It shall be the duty of every voice service provider to provide
its subscribers with access to the national universal emergency number in accordance with
the implementing rules and regulations to be adopted pursuant to this Act.

Sec. 21. Prohibited Acts and Penalties on Emergency Communications. ~

(a) Any person who makes a telephone call to an emergency hotline number with
intent to annoy, abuse, threaten or harass any person who answers the telephone
call shall be guilty with the first offense and, subject to subsection (c) of this
section, shall be compelled to attend a seminar on the proper use of the
nationwide emergency hotline number. Upon commission of the offense for the
second time, the offender shall, upon conviction, be imposed with a fine of not
less than Five hundred pesos (P500.00) but not more than One thousand pesos
(P1,000.00). Upon commission of the offense for the third and succeeding times,
the offender shall, upon conviction, be imposed with a penalty of imprisonment
of not less than one (1) month but not more than six (6) months or a fine of not
less than Two thousand pesos 16 (P2,000.00) but not more than Five thousand
pesos (P5,000.00), or both, at the discretion of the court.

4


Socwmiviauneun

i

13
4
15
16
7
18
19
20
21
22
23
24
25
26

27
28
29

(b) Any person who makes a telephone call to an emergency hotline number and,
upon the call being answered, makes or solicits any comment, request,
suggestion, proposal or sound which is obscene, lewd, lascivious, filthy or
indecent, shall be mandated to attend a seminar on the proper use of the
nationwide emergency hotline number for the first offense. Upon commission of
the offense for the second time, the offender shall, upon conviction, be imposed
with a fine of not less than Five hundred pesos (P500.00) but not more than One
thousand pesos (P1,000.00). Upon commission of the offense for the third and
succeeding times, the offender shall, upon conviction, be imposed with a penalty
of imprisonment of not less than one (1) month but not more than six (6) months
or a fine of not less than Two thousand pesos (P2,000.00) but not more than Five
thousand pesos (P5,000.00), or both, at the discretion of the court.

(0 A person who gives a false report of a medical emergency or gives false
information in connection with a medical emergency, or makes a false alarm of a
medical emergency, knowing the report or information or alarm to be false; or
makes a false request for ambulance service to an ambulance service provider,
knowing the request to be false, shall be mandated to attend a seminar on the
proper use of the nationwide emergency hotline number for the first offense.
Upon commission of the offense for the second time, the offender shall, upon
conviction, be imposed with a fine of not less than Two thousand pesos
(P2,000.00) but not more than Five thousand pesos (P5,000.00) and payment of
damages. Upon commission of the offense for the third and succeeding times,
the offender shall, upon conviction, be imposed with a penalty of imprisonment
of not less than one (1) year but not more than three (3) years or a fine of not less
than Five thousand pesos (P5,000.00) but not more than Ten thousand pesos
(P10,000.00) and payment of damages, or both, at the discretion of the court.

CHAPTER VI
OTHER PROVISIONS

15


SowmiyxrdsaHweun

i

13
14
15
16
7
18
19
20
21

2
23
24
25
26
27
28
29

Sec. 22. Role of the LGUs. - The LGUs are hereby mandated to develop and
institutionalize an emergency medical service system within their area of jurisdiction. The
Council shall include in its programs, activities that will support and enable the LGUs to
accomplish such task.

Sec. 23. Enforcement of the Emergency Medical Services System. - The DILG,
including all relevant agencies, instrumentalities, offices or bureaus of the government that
are involved in the enforcement of emergency medical services, are hereby mandated to
render its utmost support for the implementation of this Act.

Sec. 24. Appropriations. - The amounts necessary for the implementation of this
Order shall be sourced from the appropriations of all concemed agencies and local
government units. Additional funds and possible fund sources as may be necessary for the
implementation of this Order shall be identified and provided by the Department of Budget
and Management.

Sec. 25. Implementing Rules and Regulations. - Except as otherwise provided, the
Council, in coordination with the NTC, the TESDA, the CHED, and the DOH, shall issue
and promulgate the rules and regulations to implement the provisions of this Act within one
hundred twenty (120) days upon constitution of the Council.

Sec 26. Separability Clause. - If any clause, sentence, paragraph or part of this Act
shall be declared unconstitutional or invalid, such judgment shall not affect, invalidate or
impact any other part of this Act.

Sec. 27. Repealing Clause. - Any provision of laws, orders, agreements, rules or
regulations contrary to and inconsistent with this Act is hereby repealed, amended or
modified accordingly.

Sec. 28. Effectivity. - This Act shall take effect fifteen (15) days after its publication in
the Official Gazette or in a newspaper of general circulation.
Approved,

16