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

IVED \
JAN 2014
HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriguez a
Representative Maximo B. Rodriquez, Jr.

House BillNo. 3694

EXPLANATORY NOTE

It is the policy of the State to protect and promote the right to health of the people,
including the rights of children to survival, full and healthy development as individuals and a
better quality of life. The prevention, early detection and diagnosis of congenital hearing loss
and interventions thereto should be based on applied research and the recognition that
newborns and children who are deaf or hard-of-hearing have unique language, learning and
communication needs, and should be the resutt of consultation with the sectors concerned.

The purpose of this Act is to establish a Universal Newbom Hearing Screening
Program (UNHSP) to institutionalize measures for the prevention and early diagnosis of
congenital hearing loss among newborns and the provision of referral, early intervention,
counseling and other support services for newborns with hearing loss, and their families to
afford them all the opportunities to be productive members of the community

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

RUFYS B. ROI UEZ

M 0 B. RODRIGUEZ, JR.


‘SIXTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriguez and
Representative Maximo B. Rodriguez, Jr.

House Bill No, __ 3694

AN ACT
ESTABLISHING A UNIVERSAL NEWBORN HEARING SCREENING PROGRAM FOR
THE PREVENTION, EARLY DIAGNOSIS AND INTERVENTION OF HEARING LOSS
AMONG CHILDREN

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 "Universal Newborn Hearing
Screening and Intervention Act of 2013".

SEC. 2. Declaration of Policy. -Itis the policy of the State to protect and promote the right
to health of the people, including the rights of children to survival, full and healthy
development as individuals, and a better quality of life. The prevention, early detection and
diagnosis of congenital hearing loss and interventions thereto should be based on applied
research and the recognition that newboms and children who are deaf or hard-of-hearing
have unique language, learning and communication needs, and should be the result of
consultation with the sectors concemed

SEC. 3. Purpose. -The purpose of this Act is to establish a Universal Newborn Hearing
Screening Program (UNHSP) to institutionalize measures for the prevention and early
diagnosis of congenital hearing loss among newborns and the provision of referral, early
intervention, counseling and other support services for newborns with hearing loss, and their
families, to afford them all the opportunities to be productive members of the community.
The objectives of the UNHSP are:

‘a. To ensure that all newborns have access to hearing loss screening;

b. To institute a system of newborn hearing loss screening, follow-up, referral and
recall for purpose of providing access to information and services on prevention of hearing
loss, early diagnosis and intervention, including consultations, to newborns and their
families;

¢. To establish a network among pertinent government and private sector
stakeholders for the implementation, monitoring, evaluation and policy development to
further universal newborn hearing screening program in the country;

d. To provide continuing capacity building of stakeholders including training to
practitioners, conduct of applied research, and other such activities to aid in the effective
implementation of a universal newbom hearing screening program; and
e. To establish and maintain a newborn hearing screening database.

SEC. 4. Definition of Terms. -Under this Act, the following terms shall mean the following

‘a. "Universal Newborn Hearing Screening Program” or “UNHSP" shall refer to the
program developed for carrying out hearing screening for all babies bom in the Philippines
and for providing adequate interventions for babies with congenital hearing loss;

b. “Congenital hearing loss” shall refer to hearing loss present at birth,


¢. "Newbom hearing screening database” shall refer to an organized body of
information related to newborn hearing screening;

d. “Newborn” shall refer to a child from the time of complete delivery to thirty (30)
days old;

e. "Follow-up" shall refer to the monitoring of a newborn with possible hearing loss for
purpose of ensuring that the newborn patient receives additional diagnostic services and
intervention or treatment;

1. 'Recall” shall refer to a procedure for locating a newborn with a possible hearing
Joss for purposes of providing diagnostic services to confirm hearing condition and, as
appropriate, provide intervention or treatment;

g. "Newborn Screening Reference Center” shall refer to the central facility at the
National Institutes of Health that defines testing and followup protocols, maintains an
‘external laboratory proficiency testing program, oversees the national testing database and
case registries, assists in training activities in all aspects of the program, oversees content of
educational materials and acts as the Secretariat of the Advisory Committee on Universal
Newborn Hearing Screening Program;

fh. "Newbom Hearing Screening Center’ shall refer to a facility equipped with a
newborn hearing loss screening and audiologic diagnostic evaluation laboratory that
Complies with the standards established by the NIH and provides all required laboratory tests
and recall and follow-up programs for newboms with hearing loss;

i. NIH’ shall refer to the, National Institutes of Health;

|, “Health Institutions" shall refer to hospitals, health infirmaries, health centers, lying
in centers or puericulture centers with obstetrical and pediatric services, whether public or
private;

k. "Newborn hearing loss screening” shall refer to an objective, physiological
procedure completed in a child thirty (30) days old or below to determine the likelihood of
hearing loss;

|. “Audiologic diagnostic evaluation” shall refer to a service related to diagnosis of
hearing loss as provided by professionals or centers certified by the NIH, through the DOH;

im. "Advisory Committee” shall refer to the Advisory Committee on Newborn Hearing
Screening established under Section 11 of this Act;

n."DOH shall refer to the Department of Health;

©. “Intervention” shall refer, to any act to render service for a child diagnosed with
hearing loss ranging from counseling, diagnosis, hearing aid or any medical procedure for
correction of hearing loss; and

. “Referral” shall refer to an act of sending a patient to another service provider
within the network for continuation of care.

SEC. § Obligation to Inform. -Any health practitioner who delivers, or assists in the
delivery, of a newborn in the Philippines shall, prior to delivery, inform the parents or legal
guardian of the newborn of the availability, nature and benefits of hearing loss screening
among newboms or children three months old and below.

Parents or legal guardians of newborns who, after undergoing newbom hearing loss
screening, have been found to have congenital hearing loss shall be informed of the
availablity, nature and benefits of diagnostic audiologic evaluation, intervention and
treatment options, and counseling regarding hearing loss.

The DOH’ shall coordinate with the Advisory Committee to ensure the preparation
and production of informational and educational materials for these purposes and ensure the
distribution of the same in coordination with public and private health facilities, hospitals and
local government units.

SEC. 6. Obligation to perform Newborn Hearing Loss Screening and Audiologic
Diagnostic Evaluation. - Upon consent of parents or legal guardians, all babies born in
hospitals in the Philippines shall be made to undergo newbom hearing loss screening before
discharge, unless the parents or legal guardians of the newbom object to the screening


subject to Section 7 of this Act. Babies who are not bom in hospitals should he screened
within the first three (3) months of life.

In the event of a positive newborn hearing loss screening result, the newborn shall
undergo audiologic diagnostic evaluation in a timely manner to allow appropriate follow-up,
recall and referral for intervention before the age of six (6) months; Provided That, audiologic
diagnostic evaluation shall be performed by Newborn Hearing Screening Centers duly
certified by the NIH.

It shall be the joint responsibility of the parents or legal guardian, and the practitioner
or other person delivering the newborn to ensure that hearing screening is performed, An
appropriate informational brochure for parents to assist in fulfilling this responsibility shall be
made available by the DOIH, through the Advisory Committee, and shall be distributed to all
health institutions and made available to any health practitioner requesting it for appropriate
distribution.

SEC. 7. Refusal to be Tested. -A parent or legal guardian may refuse hearing loss
screening on the grounds of religious beliefs but shall acknowledge in writing that they have
been informed of their responsibility to perform said screening and their understanding that
refusal for testing places their newborn at risk for undiagnosed congenital hearing loss. A
copy of this waiver shall be made part of the newborn's medical record and refusal shall be
indicated in the national newborn hearing screening database.

SEC. 8. Continuing Education, Re-education and Training Health Personnel. - The DOI-
|, with the assistance of the National Institute for Health and other concemed government
agencies, professional associations and civil society organizations, shall:

‘a. conduct continuing information, education, re-education and training programs for
health personnel on the rationale, benefits, and procedures of hearing loss screening; and

. disseminate information materials on newborn screening at least annually to all
health personnel involved in material and pediatric care.

SEC. 9. Licensing. -To ensure the timely provision of hearing loss screening to newborns,
the DOH shall require health institutions to provide hearing loss screening services as a
condition for licensure. The Advisory Committee shall recommend to the DOH Secretary the
acceptable standards and technologies of such services.

SEC. 10. Lead Agency. - The DOH shall be the lead agency in implementing this Act. It
shall coordinate with all stakeholders from every stage of human development and at all
levels of society in order to achieve the objectives of this Act.
For purposes of achieving the objectives of this Act, the DOH shall
1. Establish an Advisory Committee on Newborn Hearing Screening in the
Department of Health;
2. Coordinate with the Department of the Interior and Local Government (DILG) and
the local government units for implementation of the provisions of this Act; and
3. Coordinate with the Advisory Committee and the NIH Newbom Screening
Reference Center for the certification of Newbom Hearing Screening Centers and
preparation of defined testing protocols and quality assurance programs.

SEC. 11. The Advisory Committee. - To ensure the effective implementation of this Act,
the Advisory Committee on Newborn Hearing Screening is hereby created to facilitate inter-
agency coordination and the cooperation of private sector and professional associations in
policy development, technology development, enforcement monitoring, databanking and
training. The Advisory Committee shall be made an integral part of the Office of the
Secretary of the DOH. It shall be composed of the Secretary of the DOH as Chairperson;
Director of the Philippine National Ear Institute as Vice-Chairperson and the following as
members:


a. Philippine Medical Association;

b. Philippine Pediatric Society;

¢. Philippine Society of Otorhinolaryngologist - Head and Neck Surgery;
d. Philippines Obstetrics Gynecologic Society;

e. Philippine Hospitals Association;

f. Department of Education;

g. Department of Interior and Local Government;

h. Association of Municipal Health Officers of the Philippines;

i. A duly organized association of audiologists in the Philippines;

j A duly organized association of midwives in the Philippines; and
k. Two representatives from civil society organizations.

Sec. 12. Responsibilities of the Advisory Committee, -The Advisory Committee shall provide
technical assistance in the formulation of operational policies, plans and programs:

a. To develop the State's capacity to support newborn hearing loss screening, early
diagnosis and intervention;

b. To monitor the extent to which hearing loss screening and audiologic diagnostic
evaluation are conducted in health institutions, and assist in the development of universal
newborn hearing loss screening programs for hospitals and non-hospital sites;

c. To collect data on early detection, diagnosis and intervention that can be used for applied
research and policy development;

d. To develop models which ensure effective screening, referral and linkage with appropriate
diagnostic, medical and qualified early intervention services providers and programs within
the community; and

e. To periodically review and recommend the newborn hearing loss screening fees to be
charged by Newbom Screening Centers and to review the report of the Newborn Screening
Reference Center on the quality assurance of the hearing loss screening and recommend
corrective measures as deemed necessary.

SEC. 13. Establishment of Newborn Hearing Screening Center. -Newbom Hearing
Screening Centers shall be established to provide newborn hearing loss. screening,
audiologic diagnostic evaluation and recall, follow-up and referral programs to babies with
hearing loss; Provided, That, such centers shall be established through a certification by the
NIH based on standards formulated in collaboration with the
‘Advisory Committee and the DOH

Newborn Screening Centers (NSC) established pursuant to Section 12, of Republic
Act No. 9288, shail adopt and implement a program to develop its capacity to become
Newborn Hearing Screening Centers. The DOH and the Advisory Committee shall develop
incentives to encourage the establishment of Newbom Hearing Screening Centers other
than those under the Newborn Screening Centers.

SEC. 14. Data Management and Applied Research. - All hospitals and Newborn Screening
Centers shall periodically submit copies of the, results of the screening tests to the NIH
Newborn Screening Reference’ Center for consolidation of patient databases. The NIH
Newborn Screening Reference Center shall maintain a national database of children tested
and a separate registry for those found positive for hearing loss. It shall submit reports
annually to the Advisory Committee and to the DOH on the status of and relevant health
information derived from the database

‘Aplan for long-term outcome evaluation of hearing loss screening utilizing the case
registries shall be developed within one (1) year of passage of this Act by the NIH in
consultation with the Advisory Committee. Implementation of this plan shall become a
responsibility of the Advisory Committee.

SEC. 15. Newborn Screening Fees. -The Philippine Health Insurance Corporation (PHIC)
shall include the cost of hearing loss screening in its newborn package. The screening fee


shall be applied to, among others, testing costs, education, registry, follow-up and
reasonable overhead expenses. For this purpose, the PHIC shall develop a program for the
gradual coverage of hearing loss screening, audiologic diagnostic evaluation, and
intervention services subject to actuarial and feasibility studies.

SEC. 16. Authorization of Appropriations. -

a. Nationwide Newbom Hearing Loss Screening, Diagnosis and Intervention Networks, -For
the purpose of carrying out this Act, there are hereby authorized to be appropriated to the
DOH Fifteen Million Pesos (P15,000,000) for the current fiscal year, Thirty Million Pesos
(P30,000,000) for the next fiscal year, and such sums as may be necessary for each of the
succeeding fiscal years

b. Technical Assistance, Data Management and Applied Research. -For the purpose of
carrying our this Act, there are hereby authorized to be appropriated to the National
Institutes of Health-Philippine National Ear Institute Five Million Pesos (5,000,000) for the
current fiscal year and Seven Million Pesos (P7,000,000) for the next fiscal year.

SEC. 17. Implementing Rules. - Within thirty (30) days from the effectivity of this Act, the
DOH, in collaboration with relevant government agencies and professional associations,
shall develop the implementing rules and regulations necessary to effectively implement the
provisions of this Act.

SEC. 18. Repealing Clause. -All laws, decrees, executive orders, proclamations and
administrative regulations, or any parts thereof, contrary to or inconsistent with this Act are
hereby repealed or modified accordingly.

SEC. 19. Separability. -If any provision of this Act shall be held unconstitutional or invalid,
the other provisions hereof shall remain valid and continue to be in full force and effect.

SEC. 20. Effectivity. -This Act shall take effect fifteen (15) days after its publication in at least
two (2) newspapers of general circulation

Approved,