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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

TWENTIETH CONGRESS
First Regular Session

House Bill No.27599

Introduced by Representative Julius Cesar “Jay” V. Vergara

EXPLANATORY NOTE

Republic Act No. 11223 or the "Universal Health Care Act" is a landmark law
which launched comprehensive reforms in the country's health system such as the
automatic enrolment of all Filipinos in PhilHealth’s National Health Insurance
Program, among others. While this law has indeed benefited many of our countrymen
by guaranteeing equal access to quality and affordable health services to every citizen,
one of its major features has been subject to mishandling, hindering equitable access
to funding and resources for some local governments.

The Universal Health Care Act created the Special Health Fund (SHF) which
aims to consolidate funding pools in a local government, to finance public health
services and expenditures. This law introduced the integration of local health systems
into Province-wide and City-wide Health Systems. A Province-wide health system is
composed of the municipal and component city health systems within the province,
whereas a City-wide health system is either a highly urbanized city (HUC) or an
independent component city.

For a province under this structure, the SHF is managed by the Provincial
Health Board (PHB) which is also mandated to exercise administrative and technical
jurisdiction of the province. The PHB is headed by the governor as chairperson, and
composed of the chief health officer, the chairman of the committee on health of the
Sangguniang Panlalawigan, a DOH representative, representatives of component
municipalities or cities, and representatives of the indigenous community and other
organizational stakeholders. This composition gives excessive power to the elective
head of the province in the management of the fund, opening the fund to abuse and
misuse.

For instance, there have been cases where the SHF management has been used
by elected provincial officials to advance their personal political propaganda agenda
within their provinces. Some provincial government leaders unreasonably use its
management powers in such a way that they can decide to allocate less funds to
component cities or municipalities whose leaders are not their political allies.

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Consequently, the innocent people living in these component cities or municipalities
are unjustly deprived of their much-needed health services and infrastructures, just
because of political differences between their leaders.

In practice, political differences between the Nueva Ecija provincial
government: and the LGU of Cabanatuan have led to disparities in the delivery of
health services. These differences have resulted in Cabanatuan City being left out of
the Local Investment Plan for Health (LIPH), leading to unequal access to health
services for its residents compared to other cities/ municipalities in Nueva Ecija. This
situation is not unique to Cabanatuan but is a common theme among other cities like
San Jose del Monte in Bulacan, where similar political dynamics have resulted in these
cities being marginalized in provincial health planning and budgeting.

When a city is left behind in the delivery and enhancement of health services
and facilities, it will negatively impact more than just the well-being of its residents.
This will also cause the city to struggle and fail in attracting businesses, investments
and economic activities, thereby impeding its economic growth and creation of job
opportunities for its people.

This proposed amendment to Universal Health Care Act will help resolve the
abovementioned problem by giving autonomy to cities in the management of their
SHF. This will ensure that cities will receive fair and reasonable share in the funding
and resources that will be allocated to them, free from any political interference, so
they can focus on what matters most, the delivery of proper health care to their people.
In view of the foregoing, the approval of this bill is earnestly sought.

Se

JULIUS CESAR “JAY” V. VERGARA
Third District of Nueva Ecija


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

TWENTIETH CONGRESS
First Regular Session

House Bill No. 2755

Introduced by Representative Julius Cesar “Jay” V. Vergara

AN ACT AMENDING REPUBLIC ACT NO. 11223, OTHERWISE KNOWN AS
THE "UNIVERSAL HEALTH CARE ACT", FOR THE PURPOSE OF GRANTING
AUTONOMY TO CITIES IN THE MANAGEMENT OF THEIR SPECIAL
HEALTH FUND (SHF)

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

Section 1. Section 19 of Republic Act No. 11223, otherwise known as the "Universal
Health Care Act," is hereby amended to read as follow:

Section 19. Integration of Local Health Systems into Province-wide and City-
wide Health System.- The DOH, Department of the Interior and Local
Government (DILG), PhilHealth and the LGUs shall endeavor to integrate
health systems into province-wide and city-wide health systems. The
Provincial and—City Health Boards shall oversee and coordinate the
integration of health services for province-wide and-eity-wide health
systems, to be composed of municipal and-component city health systems
ONLY,

component cities, respectively-and FOR CITIES, REGARDLESS OF THEIR
STATUS AS COMPONENT, INDEPENDENT OR HIGHLY URBANIZED,
THE CITY HEALTH BOARDS SHALL OVERSEE AND COORDINATE
THE INTEGRATION OF HEALTH SERVICES FOR THEIR RESPECTIVE
CITY-WIDE HEALTH SYSTEMS. The Provincial and City Health Boards
shall manage the Special Health Fund referred to in Section 20 of this Act
and shall exercise administrative and technical supervision over health
facilities and health human resources within their respective territorial
jurisdiction: Provided, That municipalities and—eities included in the
province-wide and—city-wide health systems shall be entitled to a
representative in the Provincial er-City Health Board, as-the-case-may-be.

Section 2. Section 20 of Republic Act No. 11223, otherwise known as the "Universal
Health Care Act," is hereby amended to read as follows:



"Section 20. Special Health Fund (SHF). — The province-wide or city-
wide health system shall pool and manage, through a special health fund,
all resources intended for health services to finance population-based and
individual-based health services, health system operating costs, capital
investments, and remuneration of additional health workers and incentives
for all health workers: Provided, That the DOH, in consultation with the
DBM and the LGUs, shall develop guidelines for the use of the Special
Health Fund.

EACH CITY, REGARDLESS OF ITS STATUS AS A COMPONENT,
INDEPENDENT OR HIGHLY URBANIZED CITY, SHALL HAVE FULL
AUTONOMY OVER ITS SPECIAL HEALTH FUND (SHF). THE SHF
SHALL BE MANAGED BY THE CITY HEALTH BOARD AND UTILIZED
BY THE LOCAL GOVERNMENT UNIT (LGU) OF THE CITY,
INDEPENDENTLY, WITH NO OVERSIGHT OR CONTROL FROM THE
PROVINCIAL GOVERNMENT. THIS AUTONOMY IS GRANTED TO
ENSURE THE EQUITABLE DISTRIBUTION OF HEALTH RESOURCES
AND SERVICES, FREE FROM POLITICAL INFLUENCE, AND TO
EMPOWER CITIES TO ADDRESS THEIR UNIQUE HEALTH NEEDS
EFFECTIVELY.

COMPONENT CITIES SHALL NO LONGER BE SUBJECT TO THE
ADMINISTRATIVE SUPERVISION OF THE PROVINCIAL,
GOVERNMENT CONCERNING THE MANAGEMENT AND
ALLOCATION OF THE SHF. THE CITY HEALTH BOARD AND THE
CITY GOVERNMENT SHALL BE RESPONSIBLE FOR THE PLANNING,
BUDGETING, AND IMPLEMENTATION OF HEALTH PROGRAMS
FUNDED BY THE SHF, IN ALIGNMENT WITH THE LOCAL
INVESTMENT PLAN FOR HEALTH (LIPH) AND THE OBJECTIVES OF
THE UNIVERSAL HEALTH CARE ACT.

TO ENSURE TRANSPARENCY AND ACCOUNTABILITY, EACH CITY
AND PROVINCE SHALL SUBMIT AN ANNUAL REPORT ON THE
UTILIZATION OF THE SHF TO THE DEPARTMENT OF HEALTH (DOH)
AND PHILHEALTH. THE REPORT SHALL INCLUDE A DETAILED
ACCOUNT OF EXPENDITURES, OUTCOMES OF HEALTH
PROGRAMS, AND ANY OTHER RELEVANT DATA AS REQUIRED BY
THE DOH."

Section 2. Repealing Clause — All laws, decrees, orders, rules, and regulations or parts
thereof inconsistent with this Act are hereby repealed or modified accordingly.

Section 3. Effectivity — This Act shall take effect fifteen (15) days after its publication
in the Official Gazette or in a newspaper of general circulation.

Approved,