Republic of the Philippines
HOUSE OF
REPRESENTATIVES
Quezon City

TWENTIETH CONGRESS
Second Regular Session

HOUSE BILL no 185

INTRODUCED BY REPRESENTATIVE MILAGROS AQUINO-MAGSAYSAY

AN ACT INSTITUTIONALIZING DEMENTIA AND ALZHEIMER'S DISEASE
CARE IN THE PHILIPPINES BY ADOPTING A NATIONAL DEMENTIA CARE
POLICY, AND RECOGNIZING DEMENTIA AS A PUBLIC HEALTH PRIORITY

EXPLANATORY NOTE

This bill seeks to institutionalize Alzheimer's disease and Dementia care in the
Philippines through the adoption of a national dementia care policy, as well as the
introduction of some basic programs, which will hopefully transform into relevant standards
and procedures in addressing dementia and the handling of Alzheimer's disease patients.

While previously dismissed as simple senility in ageing persons, dementia together with
‘Alzheimer's disease, is now better understood. Dementia is characterized by the loss of cognitive
functioning in terms of thinking, remembering, and reasoning, to such an extent that it interferes
with a person's daily life and activities. Some people with dementia cannot control their
emotions, and their personalities may change, making them extremely difficult to live with.
Dementia ranges in severity from the mildest stage, when itis just beginning to affect a person's
functioning, to the most severe stage, when the person must depend completely on others for
basic activities of daily living, such as feeding and cleaning one's self. Sadly, it is incuratile
and is a major cause of disability and dependency affecti

communities.

In her July 2021 paper, Dr. Shelley Dela Vega, Director of the Institute on Ageing, UP
Manila College of Medicine, presented that in the Western Pacific region, over 200 million are
affected by mental health disorders and substance abuse problems. Over 20% of adults 60 years
old and over suffer from mental or neurological disorder, with dementia being the most common
affecting approximately 5% of the world's older population. It is believed that dementia affects
hundreds of people because it is more common in older persons, although it is not really a

normal part of ageing. There are actually younger
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people in their 30s, 40s, or 50s with early onset of dementia, Sadly, dementia is
considered the St! Jeading cause of death globally.

Meanwhile, Dr. Veeda Michelle Anlacan, President of the Alzheimer's Disease
Association of the Philippines, shares that the local prevalence of dementia in the Philippines is
10.6%, equating to 726,864 people living with dementia in 2015. This is almost twice the crude
estimated prevalence of 5.8% in Southeast Asia,

Philippine cultural values such as close-family ties and the tradition of Filipino
households taking care of their elderlies highlights the value of family-care practices. In addition,
Filipino families being predominantly Catholic, religion and faith have become an invaluable
coping mechanism for family member-caregivers. As such, both Dr. Precy
S. Cruz and Dr. Jacqueline C. Dominguez of the St. Luke's Medical Center-Institute of
Neurosciences, recommend the consistent and sustained involvement of family in the
provision of care for dementia patients, as well as the development and refinement of
healthcare policies to strengthen and support home-based dementia care.

While there are existing pre-planned strategies on dementia prevention and
treatment, long-term and sustained home-based care for patients is still quite limited
considering the Philippines is a developing country challenged by inadequate government
funding and resources. The National Dementia Plan of the Philippines is relatively new and
would greatly benefit by being institutionalized as a national policy or program through
legislation. In effect, the 5Cs that have to be addressed to overcome dementia policy barriers
are the need for a) Champions, b) Collaboration, c) Communication and Coordination. d)
Consistency, and e) Community-Empowerment.

This bill, if enacted into law, will serve as the enabling law for the informal policies
and current practices governing dementia and Alzheimer's care in the country at present. An
enacted law shall formalize and institutionalize policies and practices, and even spur relevant
training and education on dementia.

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

H ILAGROS SAYSAY


Republic of the Philippines
HOUSE OF
REPRESENTATIVES

Quezon City

TWENTIETH CONGRESS
Second Regular Session

HOUSE BILL nol

INTRODUCED BY REPRESENTATIVE MILAGROS AQUINO-MAGSAYSAY

AN ACT INSTITUTIONALIZING DEMENTIA AND ALZHEIMER'S DISEASE CARE
IN THE PHILIPPINES BY ADOPTING A NATIONAL DEMENTIA CARE POLICY,
AND RECOGNIZING DEMENTIA AS A PUBLIC HEALTH PRIORITY

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

SECTION I. SECTION 1. Short Title - This Act shall be known as the "Philippine Dementia
and Alzheimer Care Policy’.

SECTION 2. Declaration of Policy - It shall be the declared policy of the State to protect and
promote the health and well-being of Filipino senior citizens, and ensure a decent and dignified
standard of living and quality of life by providing a comprehensive and holistic healthcare and
welfare system, with accessible programs and affordable services.

The 1987 Constitution, Article II, Section IX, mandates: "The State shall promote ajust und

dynamic social order that will ensure the prosperity and independence of the nation and free
the people from poverty through policies that provide adequate social services, promote full
employment, arising standard of living, and an improved quality of life for all.""In addition,
Article 11, Section X declares: "The State shall promote social justice in all phases of national
development." Moreover, Article XIII, Section XI commits: "The State shall adopt an integrated
and comprehensive approach to health development which shall endeavor to make essential
goods, health and other social services available to all the people at affordable cost. There
shall be priority for the needs of the underprivileged sick, elderly, disabled, women and
children, More importantly, Article Section IV provides: "The family has the duty to care for its
elderly members, but the State may also do so through just programs of social security.”



SECTION 3. Scope and Coverage - For purposes of this Act, the proposed policies,
programs, standards and practices on Alzheimer's disease and dementia care that affect a
substantive number of Filipino older persons shall be based on and comply with the plans
under the World Health Organization (WHO) Global Action Plan on Public Health Response
to Dementia 2017- 2025 and the Philippine Mental Health Strategic Plan 2019-2023.

SECTION 4. Dementia as a National Public Health Priority - [ven with the passage of
Republic Act No. 11036, otherwise known as the "Mental Health Act of 2018" and Republic
Act No. 11223 or the” Universal Health Care Act of 2018", where mental health care gained
much attention, there was only limited focus given to dementia and Alzheimer's disease.
Given the number of people that are affected, especially older persons, it is time to consider
Dementia as a National Public Health Priority

SECTION 5. National Dementia Care Policy - The Philippines’ National Dementia Plan
is hereby adopted and institutionalized as the "National Dementia Care Policy", entitled to
proper funding requirements to consolidate, coordinate and implement the following
programs and practices.

SECTION 6. Dementia Care Programs - The following interventions shall comprise the
five (5) basic areas of dementia care policy for implementation by various stakeholders and
duty-bearers:

A Advocacy and Awareness Promotion - It is essential to create more awareness about
dementia and Alzheimer's disease to understand the type of care and interventions
required. A variety of information, education, and communication (IEC) materials shail
be developed and circulated through various modes of media. In addition.
establishments and communities must be capacitated to become dementia-friendly and
supportive environments, These include enjoining schools or educational institutions
to emphasize family values and elderly care in the curriculum

Since there are efforts currently being undertaken by the private sector on this, particularly
the Alzheimer’s Disease Association of the Philippines (ADA), dementia advocacy
and awareness promotion may build on ADA's earlier practices.

B. Dementia Risk Reduction or Prevention - While there is no cure for dementia.
there are effective means of preventing or delaying its onxet, including reducing
chances of developing dementia through lifestyle changes and healthy agei
practices. For this purpose, the Department of Health (DOH) Healthy and Productive
Ageing Program (HPAP) for Filipino elderly shall be the basis to encourage older
persons to continue engaging in productive activities and maintain healthy and active
lifestyles.

Senior Citizens Centers established in local government units under Republic Act No.
7876 shall be reactivated and maximized as venues for socialization and act
promoting active and productive ageing. The Office of Senior Citizens Affairs (OSCA)
shall ensure that its plans, projects, and activities will include advocacy and awareness



C. Dementia Early Diagnosis, Treatment, and Care - Besides prevention, early detection
or screening has become an effective tool in managing health issues and treatment of
disease. Some hospitals with neurosciences departments and mental health practitioners
belonging to professional associations like the Dementia Council of the Philippine
Neurological Association and Alzheimer’s Disease Association of the Philippines have
developed an early detection or dementia screening tool which should be popularized
and rolled-out along with the advocacy efforts on dementia awareness. This service,
consisting of initial screening and referral system, shall be made available and accessible
through elderly facilities like Senior Citizens Centers, in coordination with hospital
neurosciences departments or professional associations of neurology specialists. Moving
forward, stakeholders and duty-bearers shall also endeavor to develop an online- based
support and monitoring system for dementia care by various service providers.

D. Support for Caregivers - ‘The current state of elderly care in the Philippines is still
predominantly on the shoulders of family members. While some financially-able
households are able to find suitable elderly facilities for their relatives, dementia patients
have specific requirements for care and support. Hence, in addition to awareness
promotion on dementia and Alzheimer's, specialized training on dementia care must be
made available to both family members and caregivers. Given the demands of caring
for dementia patients, support for caregivers should include respite care and if possible,
some standard monetary consideration. As such, networking between and among
stakeholders and service providers as well as strengthening of community resources shall
be undertaken.

E. Information-Gathering and Data Management on Dementia - In an effort to develop
more responsive interventions and further improve on existing programs, there is a need
for more information on the state of dementia care in the Philippines. Hence, it is
necessary to initiate a national register of dementia patients for proper data-banking.
Hospitals, clinics, and other medical facilities, including residential establishments or
group homes for the elderly, shall be enjoined to keep a record of their dementia patients
and forward to a central database which can be maintained by a proper government
agency like the DOH through the Philippine Council for Mental Health. Research and
innovation on dementia care shall also be encouraged through the academe, neurology
practitioners in hospitals and medical facilities, and health profession associations,

Other relevant interventions may be developed, as the above-mentioned programs may be
enhanced accordingly to further efforts in dementia care in the Philippines. These may include
the formulation of appropriate standards and the adoption of Best Practices in dementia care.

ECTION 7. Institutional Arrangements-To help develop relevant policies and implement
the above-mentioned programs, the Philippine Council for Mental Health under the DOH shall
constitute a special Dementia Care Consultative Committee composed of representatives from
the Dementia Society of the Philippines, Alzheimer's Disease Association of the Philippines, the
Dementia Council of the Philippine Neurological Association, UP Manila National Institutes of
Health - Institute on Ageing, National Center for Mental Health, Philippine General Hospital -
Center for Memory and Cognition, St.Luke's Medical Center - Institute of Neurosciences,



Philippine College of Geriatric Medicine (PCGM), and Philippine Society of Geriatrics and
Gerontology (PSGG).

SECTION 8. Responsibility of Local Government Units (LGUs) - Local Government Units
(LGUs), from the provincial to the city/municipal and barangay levels, are hereby enjoined to
utilize a portion of the legally mandated budget allocation reserved for the senior citizens and
Persons with Disabilities (PWDs) of not less than 1% to promote awareness on dementia and
Alzheimer's disease, and to create a friendly and supportive environment within their
communities.

a) The LGUs, through the Office of Senior Citizens Affairs (OSCA) and Persons with
Disability Affairs Office (PDAO), shall conduct regular advocacy activities such as
orientations and seminars amongst their sectoral constituents to promote awareness
and educate the community about dementia and Alzheimer's disease. This includes
taking the initiative and active participation in celebrating the annual World Alzheimer’s
Day every September 21°"

b) The LGU, through the Barangay Health Centers and Senior Citizens Centers, with the
support and assistance of the Department of Health (DOH) and/or private
organizations such as the Alzheimer's Disease Association of the Philippines (ADAP),
may conduct basic initial screenings and early detection tests for community residents.
‘These venues shall also be utilized for activities that encourage socialization, active
ageing and healthy lifestyle that prevent the early onset of dementia.

©) The LGUs, through their respective barangays, shall endeavor to make their
communities friendly and supportive of dementia patients and their families by
encouraging business establishments and public service facilities frequented by senior
citizens and/or PWDs to be conscious of dementia symptoms and assist dementia
patients in their daily living.

SECTION 9. World Alzheimer's Day of September 21*-As part of World Alzheimer’s
Month celebrations, every September 21 shall be recognized and celebrated nationwide to
promote dementia awareness.

SECTION 10. Funding. - In order to carry out the provisions of this Act, the amount of Two
Hundred Fifty Million Pesos (P 250,000,000.00) shall immediately be released and made
available to the DOH for the Philippine Council for Mental Health upon the approval of this Act.

SECTION 11. Implementing Rules and Regulations - The Secretary of Health through
the Philippine Council for Mental Health, shall in consultation with the Secretary of the
Department of Social Welfare and Development (DSWD), the Chairperson of the National
Commission for Senior Citizens (NCSC), and representatives from the Philippine Council for
Mental Health, the National Center for Mental Health, the Philippine Health Insurance
Corporation (PhilHealth), UP Manila National Institute of Health-Institute of Ageing (NIH-
1A), Philippine General Hospital Center for Memory and Cognition, St.Luke's Medical Center
Institute of Neurosciences, Philippine College of Geriatric Medicine (PCGM), Phil
Society of Geriatrics and Gerontology (PSGG), the Dementia Council of the Philippine
Neurological Association, Dementia Society of the Philippines and Alzheimer's Disease
Association of the



Philippines (ADAP}. shall craft and promulgate relevant rules and regulations for effective
implementation of this Act within ninety (90) days of its effectivity.

SECTION 12. Separability Clause - If any portion or provision of this Act is declared invalid
oF unconstitutional, other provisions not affected thereby shall continue to be in full force and
effect.

SECTION 13. Repealing Clause - All laws, decrees, executive orders, rules or regulations
contrary to or inconsistent with the provisions of this Act are hereby repealed or modified
accordingly.

SECTION 14. Effectivity- This Act shall take effect fifteen (15) days after publication in
the Official Gazette or in newspaper of general circulation.

Approved