Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasang Pambansa, Quezon City

FIFTEENTH CONGRESS
First Regular Session
‘ 3842
HOUSE BILL NO.

Authored by HON. JOSEPH VICTOR G. EJERCITO

EXPLANATORY NOTE

The cases of cancer, cardio vascular diseases and other life
threatening illnesses are steadily increasing every year. This brings
not only financial concerns but more importantly, emotional sufferings
to the patients and their families.

This bill proposes that all government and private hospitals and health
centers provide palliative care and end-of-life services to all patients
with life-threatening illness. Provinces, cities, municipalities and
barangays shall establish community-based hospice units and
palliative care centers in every barangay in their respective
jurisdiction.

Further, this measure proposes that there shall be continuing research
and collection of data on palliative and end-of-life care. The public
shall have an access to good health data, including socio-economic
issues on palliative and end-of-life care, and the physical, mental and
economic impact on the patients, their families and informal
caregivers.

In addition, immediate family members or relatives who actually 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 in public or private employment sector.

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

This bill was inspired by the innovative initiative of Canadian Senator
Sharon Carstairs who pioneered on this work to help make life
somehow pleasant for the people of her country up to the very last
hours of their existence.

In view thereof, the immediate approval of this bill is requested.

— Cr =
JOSEPH VICTOR G. EJERCITO


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasang Pambansa, Quezon City

FIFTEENTH CONGRESS
First Regular Session

2542
HOUSE BILL NO.

Authored by HON. JOSEPH VICTOR G. EJERCITO

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

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

SECTION 1. Short Title. - This Act shall be known as “The Palliative
and End-of-Life Care Act of 2010”.

SEC 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, emotion, psychosocial and spiritual diseases.

Palliative care and end-of-life services include, but not limited to the
following:
1. Pain management;
2. Support to terminally-ill patients to live as best as possible a
comfortable life;
3. Prolong as far as practicable, the life span of critically-ill patients
through therapies, such as chemotherapy, radiation, and other
* natural or alternative methods of healing;
4. Provide support and counseling to the families,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.

SEC 3. Mandatory Palliative Care and End-of-Life Services. - All
government and private hospitals and health 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.

SEC 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 shall undergo multi-
disciplinary education and specialized training with respect to an
integrated and coordinated approach towards palliative and end-of-life
care support services.

SEC 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 socio-economic issues
of palliative and end-of-life care, including the physical, mental and
economic impact on the patients, their families and informal
caregivers.

SEC 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-relative;

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

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

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

1. Those 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.

SEC 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 shall be subject to the following:

(a) The contribution to the Fund shall 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 Fifty million pesos (P50,000,000.00) shall be
taken from the Philippine Charity Sweepstakes Office
(PCSO) at Five million 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;

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

(d) Government-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.

SEC 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 government concerned.


The other four (4) members of the Board shall be composed of: (1) a
representative from the Department of Health; (2) the Chair of the
Committee of Health of the Sanggunian concerned; (3) a
representative of the opposition party or parties in the Sanggunian
concerned; and (4) a representative of the families or family
organization 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 two (2)
consecutive terms.

The members of the Board shall serve and continue to hold office until
their successors shall have been appointed and qualified. Should the
private representative 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 appointed to the Board unless 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.

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 earnings
thereof, shall be used to underwrite overhead expenses
for the administration.

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

SEC 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.

SEC 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 shall be promulgated
by the Department of Health with the assistance of the duly authorized


representative of the families or family associations mentioned in the
Constitution.

SEC 12. Appropriations. - For the initial implementation of this Act,
the amount of One hundred million pesos (P100,000,000.00), 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.

SEC 13. Repealing Clause. - All laws, executive orders, rules and
regulations or any part thereof inconsistent herewith are deemed
repealed, modified or amended accordingly.

SEC 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.

SEC 15. Fffectivity. - This Act shall take effect fifteen (15) days after
its publication in two (2) national newspapers of general circulation.

Approved,