FIFTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES —)
FIRST REGULAR SESSION

HOUSE OF REPRESENTATIVES

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

House Bill No. 2729

EXPLANATORY NOTE

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 newborns and
children who are deaf or hard-of-hearing have unique language, leaming and
communication needs, and should be the result of consultation with the sectors
concerned.

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.

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

RUFUS B. RIGUEZ

<i

MAXIMO B. RODRIGUEZ, JR.


FIFTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES )
FIRST REGULAR SESSION )
HOUSE OF REPRESENTATIVES

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

2729

House Bill No.

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 2010".

SEC. 2. Declaration of Policy. -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 newboms and children who are deaf or hard-of-hearing have unique
language, leaming and communication needs, and should be the result of
consultation with the sectors concerned,

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 newbom 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 newboms and their families;

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

e. To establish and maintain a newbom hearing screening database.

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

a. "Universal Newbom 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;

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

d. “Newbom*” 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 newbom with possible
hearing loss for purpose of ensuring that the newborn patient receives
additional diagnostic services and intervention or treatment,

f. “Recall” shall refer to a procedure for locating a newborn with a
Possible hearing loss 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 follow-up
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
Newbom Hearing Screening Program;

h. "Newborn Hearing Screening Center” shall refer to a facility equipped
with a newbom 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;

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

1. “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;

m. “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

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

SEC. 5. 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 newborns 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 availability, 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 bom in hospitals in the Philippines shall be made to
undergo newborn 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 newbom hearing loss screening result, the
newbom 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 newbom to ensure that hearing
screening is performed. An appropriate informational brochure for parents to
assist in fulfiling 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 newbom'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-I, with the assistance of the National Institute for Health
and other concemed goverment 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

b. 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 newboms, 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 shal

1. Establish an Advisory Committee on Newbom 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 NIIH Newborn
Screening Reference Center for the certification of Newborn 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;

c. 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 Govemment;

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 newbom 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;

¢. 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

@. To periodically review and recommend the newborn hearing loss screening
fees to be charged by Newborn Screening Centers and to review the report of
the Newbom 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. -Newborn
Hearing Screening Centers shall be established to provide newbom 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, shall 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
Newborn 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

@ 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.

A plan 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 jin consultation with the Advisory Committee.
Implementation of this plan shall become a responsibility of the Advisory
Committee.

SEC, 15. Newbom 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 Newborn Hearing Loss Screening, Diagnosis and Intervention
Networks. -For the purpose of camying 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 (P5,000,000) 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,