Republic of the philippines                         r` `j :;
HoUSE OF REPRESENTATIVES                      .g.\ae
Quezon City
|9th CONGRESS
Second Regular Session
HoUSEBILLNo.     99£9
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Introduced by HONORABLE IvllLAGROS 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.
V\/hile 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
it is 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  incurable and  is a  major cause of disability
and dependency affecting individuals, families and 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 200/o
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


people  in  their  30s,  40s,  or  50s  with  early  onset  of  dementia.   Sadly,  dementia  is
considered the 5th leading cause of death globally.
Meanwhile,  Dr.  Veeda  Michelle  Anlacan,  President  of the  A[zheimer's  Disease
Association  of  the  Philippines,  shares  that  the  local  prevalence  of  dementia  in  the
Philippines  is  10.6°/o,  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.


Republic of the Philippines
House of Representatives
Quezon City, Metro Manila
Nineteenth Congress
Second Regular Session
HOUSEBILLNo.99.'i9
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  1.  SECTION  1.  Short  Title  -This  Act  shall  be  known  as  the  "PAr-/i.ppr'ne
Dementia Care Policy' .
SECTION 2. Declaration of Policy -lt 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 11,  Section IX,  mandates: "The State sha// promote a/.usf and
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,  a  rising  standard  of living,  and  an  improved quality of life for all."  ln addifiior\,
Ariiale 11, Secfron X dectaiTes.. "The State shall promote social justice in all phases of national
development." Moreover, Artiicle Xlll , Section Xl comwiits-. " 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 lmpor+arrty , A\Ttiicle Sectiion lv prov.ides.. " 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  (\/Vllo)  Global Action  plan on  Public Health  Response to  Dementia 2017-
2025 and the Philippine Mental Health Strategic Plan 2019-2023.
SECTloN  4.  Dementia  as  a  National  Public  Health  Priority  -  Even  with  the  passage  of
Republic Act No.11036,  othelwise 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 - lt 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 (lEC) materials shall be
developed and circulated through various modes of media.  In addition,  es fab/i.shments
and communities must be capacitated to become dementia-friendly and supportive
envi.ronments. 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.
8.   Dementia Risk Reduction or Prevention - \/Vhile there is no cure for dementia, there
are effective means Of preventing or delaying its onset, including reducing chances
Of developing dementia through lifestyle changes and healthy ageing 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 actjvjties 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  activities
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
promotion on dementia.


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 ad`rocacy 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.   Vvhile   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 Alzhejmer's, speci.a/i-zed Ira/-Ping on demenf/-a 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.   InformationlGathering 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
r\ecesis,ary to .ihitiiate 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  Hearth.  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.
SECTION 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 21st.
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.
c)   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  PVVDs to  be conscious  of dementia  symptoms  and  assist dementia
patients in their daily living.
SECTION 9. World Alzheimer's Day of September 21St -As part of World Alzheimer's Month
celebrations,  every  September 21st shall  be  recognized  and  celebrated  nationwide to  promote
dementia awareness.
SECTION  10.  Funding.  -  ln  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 (PhilHea[th),  UP  Manila National  Institute of Health-Institute of Ageing (NIH-IA),
Philippine General Hospital Center for Memory and Cognition, St.Luke's Medical Center Institute
of  Neurosciences,  Philippine  College  of  Geriatric  Medicine  (PCGM),  Philippine  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.
SECTloN 12. Separability Clause - lf any portion or provision of this Act is declared invalid
or unconstitutional, other provisions not affected thereby shall continue to be in full force and
effect.
SECTloN 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. Effectivify -This Act shall take effect fifteen (15) days after publication in the
Official Gazette or in newspaper of general circulation.
Approved