Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
First Regular Session

4828

HOUSE BILL NO.

Introduced by Hon. John Marvin “Yul Servo” C. Nieto

EXPLANATORY NOTE

This bill seeks to institutionalize an emergency medical service system (EMSS),
which will provide for a well-coordinated and effective response system in cases of
emergencies that will ultimately prevent any injury or loss of life that may be suffered
by the Filipinos.

As complement to the initiative of President Rodrigo Duterte for his creation of
‘a central hotline designed to receive and respond to emergency calls, this proposed
legislation will push for the organization of personnel, facilities, and equipment in the
national level through the creation of the Emergency Medical Services System Council
(EMSSC), under the Department of the Interior and Local Government (DILG).

Moreover, this measure will mandate the Local Government Units (LGUs) to
create their respective dedicated dispatch centers, to be connected with the EMSSC’s
National Command Center, in order to promote centralization and coordination of
efforts.

‘As a manifestation of support to the main proponent of this measure, Senator
Bong Go, as well as our colleagues in the Lower House, this representation

respectfully refiles this bill.

JOHN IN 7WUL SERVO” C. NIETO


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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
First Regular Session
4828

HOUSE BILL NO.

Introduced by Hon. John Marvin “Yul Servo” C. Nieto

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;

c) 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;


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f) To establish 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 (EMSSC),
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 stabilize 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;

Advanced Trauma Life Support (ATLS) refers to a group protocol for managing
trauma victims and designed to maximize management in the first hour after

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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;

d) 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;

e) 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;

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f) 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.;

h) 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;

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

Emergency Medical Services Personnel refers to a trained and certified personnel
engaged in the provision of emergency medical services during emergencies.
Responders may either be health professionals or non-health professionals;
Emergency Medical Services (EMS) System refers to the arrangement and
coordination of personnel, facilities, and equipment for the effective delivery of
emergency medical services required in the management of emergencies; for the
management and prevention of further incidents or accidents and the broad range of
emergency care from emergency care to transport in an intensive care setting;
Emergency Response and Care refers to the arrival of resources at the scene and the
timely initiation and provision of appropriate medical interventions.

Emergency Transport refers to the transporting of a patient to the most appropriate
and definitive health facility with continued provision of care and appropriate
interventions en route to the appropriate health facility.

107m) Inter-Agency Referral and Transport refers to the transport of patient with EMS

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personnel, if necessary, from one referring facility or agency to another receiving


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facility or agency for definitive care, as the patient requires, in an event that the
services are not available in the referring facility;

Medical Direction refers to the communication between an EMS personnel and a
physician from the field via radio or other means to obtain instruction on further care
of a patient.

Medical Emergency refers to any acute or life-threatening condition that requires
immediate intervention by competent medical personnel.

Medical Oversight refers to the broad understanding of the emergency medical
system as a whole and ensuring proper policies and procedures exist to ensure safe
transitions of care and utilization of appropriate resources in the field, it is typically
performed by a medical director at the local, regional, and national levels, in
collaboration with regulatories, regional and local medical directors and advisory
committees.

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

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

CHAPTER II
EMERGENCY MEDICAL SERVICES SYSTEMS COUNCIL

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

(DILG).

Sec. 6. Powers and Functions of the EMSSC. - The Council shall perform

the following functions:
(a) To formulate policies governing the field of emergency medical services

and related institutions;

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

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


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

(e) To develop standards and protocols for the design, construction, outfitting
and operations of emergency medical vehicles

(f) 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 alll
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
facilities, of 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;

(j) 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;

(1) 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;


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

services;
(r) To meet at least once every quarter; and

(s) 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;
(c) The Secretary of the Department of Transport (DOTr);

(d) 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;

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


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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 following government hospitals/health facilities within the next five

(5) years upon approval of this Act:
(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;

(c) 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.


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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 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.


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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;

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

(4) 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:

(a) Responding and providing appropriate basic or advanced life support on-
site to persons reported experiencing acute injury or illness in an
emergency care 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

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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 availability 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

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

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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.

(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.

(c) 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

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thousand pesos (P10,000.00) and payment of damages, or both, at the
discretion of the court.

CHAPTER VI
OTHER PROVISIONS

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 concerned 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,

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