Republic of the Philippines m
HOUSE OF REPRESENTATIVES {|= DATE November 16, 2022 oy

Quezon City

NINETEENTH CONGRESS
First Regular Session

HOUSE BILL No, _6163

Introduced by Representative Joseph Gilbert F. Violago

EXPLANATORY NOTE

‘The 1987 Constitution provides that the State shall protect and promote the
right to health of the people and instill health consciousness among them. (Art. Il, Sec.
15) 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. Finally, the
State shall endeavor to provide free medical care to paupers. (Art. XIII, Sec. 11)

Geriatric medicine is a specialty of medicine concerned with physical, mental,
functional and social conditions in acute, chronic, rehabilitative, preventive, and end
of life care in older patients.' Due to their frailty, older patients need a specialized and
holistic healthcare.

‘The Philippine Statistics Authority's 2020 Census reported that there are about
9,222,672 Filipinos aged 60 years old or older, comprising 8.5 percent of the total
population of the Philippines. This is comparatively higher to the 7,534,306 Filipinos
of the same age group or about 7.5 percent of the population in 2015.2 Needless to
say, there is an increase in the number of elderly people in the Philippines and it is
expected to grow in the coming decades.

‘The proposed measure seeks to establish a world-class Philippine center for
geriatric health and a research institute which shall serve as an apex hospital or end-
referral facility for senior citizens in the country. The center shall be a teaching,
research, and training hospital that shall specialize in geriatric care, providing
hospital-based, community-based services as well as technical assistance and capacity
building in the establishment and maintenance of nursing homes and residential care
facilities and senior citizens’ wards in government hospitals and the establishment of
geriatric specialty centers. Lastly, education programs and scholarships will be

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likewise provided.

This commendable bill had been filed in the 14" Congress by Rep. Bienvenido
Abante Jr. and Rep, Godofredo Arquiza, Thereafter, similar legislative measures had
been filed in succeeding Congresses. This bill was approved on 3"! Reading in the 18
Congress and the present proponent is acknowledging the wisdom and hard work of
his predecessors.

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

JOS! ERT F. VIOLAGO


Republic of the Philippines
HOUSE OF REPRESENTATIVES
‘Quezon City

NINETEENTH CONGRESS
First Regular Session

HOUSE BILL NO. _ 6163

~ Introduced by Representative Joseph Gilbert F. Violago

AN ACT
ESTABLISHING THE NATIONAL CENTER FOR GERIATRIC HEALTH AND
RESEARCH INSTITUTE, DEFINING ITS POWERS AND FUNCTIONS,
CREATING REGIONAL GERIATRIC SPECIALTY CENTERS IN THE
DEPARTMENT OF HEALTH-RETAINED HOSPITALS, AND
APPROPRIATING FUNDS THEREFOR

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 “Philippine Geriatric
Health Act of 2022”.

SECTION 2. Declaration of Policy. — Itis the policy of the State to protect and promote
the right to health of senior citizens all over the country by ensuring that holistic health
services are available and accessible to them through the establishment of a
specialized hospital and research institute as well as geriatric specialty centers in the
Department of Health (DOH)-retained hospitals in every region.

SECTION 3. Definition of Terms. — As used in this Act:
a) “Acute care” refers to a specialized program that addresses the needs of

hospitalized older adults in a multidisciplinary team approach to prevent
functional and cognitive decline and improve outcomes;

b) “Apex or end-referral hospital” refers to a hospital offering specialized
services as determined by DOH, which is contracted as a stand-alone facility by
the Philippine Health Insurance Corporation (PhilHealth):

©) “Geriatric health services” refer to the medical services or interventions
provided by a multidisciplinary team to older adult patients;

d) “Geriatric medicine or Geriatrics” refers to the sub-specialty of internal and


family medicine that diagnoses and treats a wide range of conditions and
diseases that affect people as they age and aims to promote health and treat
disabilities of older adults;

©) “Geriatric palliative care” refers to a specialized medical care that focuses on
providing elderly patients relief from pain and other symptoms of a serious
illness, regardless of diagnosis or stage of disease, and provided alongside
curative and other forms of treatment. It is a field of inter-specialty
collaboration to respond to the socio-demographic changes and challenges of
older adults with severe and life-limiting conditions;

£) “Geriatric specialty center” refers to a unit or department in a DOH-retained
hospital that offers socialized care to the aging population, particularly to frail
older persons, addressing their particular conditions and providing specific
procedures and management of cases, requiring specialized training and/or
‘equipment;

g) “Geriatrician” refers to a medical doctor who has passed the necessary training
and specialty licensure examination for the practice of Geriatric Medicine;

h) “Gerontology” refers to the study of the biological, psychological, spiritual,
social, economic, and the demographic aspects of the aging process;

i) “Home-based healtheare and reablement program” refers to a community-
based service which primarily caters to the frail older persons who have lost or
are experiencing problems with mobility;

j) “Integrated delivery of geriatric health services” refers to hospital and
community-based medical and psycho-social services provided to senior
citizens by a multidisciplinary team;

k) “Multi-disciplinary team” refers to a team composed of health professionals
headed by a geriatrician and includes surgeons, organ-system specialists,
nurses, clinical pharmacists, rehabilitation therapists, nutritionists, dentists,
social workers, caregivers, family members and patients themselves;

1) “People-centered service” refers to an approach to geriatric care that
consciously adopts the perspectives of individuals, families, and communities,
and sees them as participants as well as beneficiaries of trusted health systems
that respond to their needs and preferences in holistic and humane ways;

m) “Senior citizen” refers to an elderly Filipino who is at least sixty (60) years old;
n) “Sub-acute care” refers to care for patients who no longer require

hospitalization, but still need skilled medical care through rehabilitative
medicine, Sub-acute rehabilitation is recommended when a patient is not


functionally able to return home; and,

0) “Transitional care” refers to a form of health care in geriatric medicine designed
to ensure coordination and continuity of care as patients transfer between
different locations or different levels of care, and the safe and effective
management of both chronic and acute illness in older adults.

SECTION 4. National Center for Geriatric Health and Research Institute. ~The
National Center for Geriatric Health (NCGH) is hereby classified as a teaching,
research, and training hospital that shall specialize in geriatric care and serve as an
apex hospital or end-referral facility for senior citizens in the country. The NCGH shall
be renamed as the National Center for Geriatric Health and Research Institute
(NCGHRI) and shall be under the direct control and supervision of the DOH.

‘The bed capacity, service capabilities, healthcare facilities, expansion, organizational
structure, and human resource requirements of the NCGHRI shall be based on the
hospital and human resource development plan to be prepared by the NCGHRI and
approved by the DOH.

SECTION 5. Powers and Functions. - To carry out the provisions of this Act, the
NCGHRI shall have the following powers and functions:

a) Serve as an apex hospital or end-referral facility which shall specialize in
geriatric health services;

b) Formulate a hospital development plan which shall be regularly updated to
reflect the expansion and future development of the NCGHRI;

©) Provide and maintain affordable, quality, and timely people-centered hospital
care through an efficient health service delivery system for senior citizens;

d) Provide higher and up-to-date geriatric training for _ professionals,
postgraduates, academics, and allied healthcare providers especially from the
geriatric specialty centers in the regions and LGUs, and other government
hospitals;

€) Develop and implement cutting edge research studies on diseases related to old
age with a view to translating research outcomes into policy and specialized
health care solutions, and publish research studies that shall serve as critical
information resource for the medical and research community, in coordination
with the Philippine Council on Health Research and Development (PCHRD)
and the Institute on Aging of the National Institutes of Health (IA-NTH);

f) Conduct and participate in international and local gerontological research
activities;


g) Provide consultancy service and technical assistance in the setting of standards
for geriatric wards in every tertiary level hospital, nursing home and residential
center catering to the health and functioning needs of senior citizens, in
coordination with the PCHRD and the [A-NIH;

hh) Develop and maintain a core information hub on geriatrics and gerontological
studies in coordination with the LA-NIH and concemed offices in the DOH and
its attached agencies, such as the Disease Prevention and Control Bureau and
the Knowledge Management and Information Technology Service;

i) Extend medical services to senior citizens pursuant to the goals, objectives, and
rules of the National Health Insurance Program and in accordance with
Republic Act No. 11223, otherwise known as the "Universal Health Care Act":

j) Provide an integrated and effective approach in the delivery of geriatric health
services in collaboration with other government agencies, local government
units (LGUs) and other stakeholders:

k) Conduct specialty training and technical assistance in collaboration with
concerned DOH offices and other relevant professional organizations;

1) Finance, sponsor, hold or participate in congresses, conventions, conferences,
seminars, workshops, and training programs on geriatric health services or
related fields in the Philippines and abroad; and

m) Establish a standardized referral system for psychosocial services.

SECTION 6. Scope of Services. ~The NCGHRI shall provide the following services:

a) Hospital-based services to ensure the availability of medical facilities and
equipment for senior citizens needing acute and sub-acute care, geriatric
palliative care, transitional and outpatient care services, and such other
necessary services;

b) Community-based services utilizing multidisciplinary team approaches such as
home- based healthcare and reablement programs, research and external
resource outsourcing for community-based integrated geriatric health services
and trainings necessary for the psycho-social/functioning of senior citizens and
their families, in coordination with LGUs;

©) Technical assistance and capacity building in the establishment and
maintenance of nursing homes and residential care facilities and senior citizens’
wards in government hospitals pursuant to Republic Act No. 9994, otherwise
known as the "Expanded Senior Citizens Act of 2010";


4) Technical assistance and capacity building in the establishment of geriatric
specialty centers and services to strengthen the network of geriatric care service
providers across the country and ensure the delivery of quality health services
for senior citizens;

) Education programs and scholarships to pursue excellence and the highest level
of quality in the practice of the specialized field of geriatrics and other related
fields, including postgraduate training and short-term courses for medical
doctors and other allied medical health professions, in coordination with the
IA-NIH; and

f) Education programs in geriatrics and gerontology subjects in undergraduate
health and allied professions, including training of students, as well as
postgraduate medical education of physicians, nurses, allied professionals,
pharmacists, dentists, and social workers.

‘The Geriatric Specialty Fellowship Training Program of the NCGHRI shall seek and
maintain full accreditation status in the Philippine College of Geriatric Medicine.

‘The NCGHRI shall ensure the accessibility of all its programs and services and take
into consideration the special needs of senior citizens with disabilities.

SECTION 7. Organizational Structure and Staffing Pattern, — The Secretary of the
DOH shall determine the organizational structure and staffing pattern of the NCGHRI in
accordance with the revised compensation and position classification system subject
to the evaluation and approval of the Department of Budget and Management (DBM)
and in compliance with the civil service laws, rules and regulations.

SECTION 8. Establishment of Geriatric Specialty Centers. — Geriatric specialty
centers are hereby established in DOH regional hospitals, which shall serve as apex or
end-referral hospitals of the health care provider networks and training and research
facilities on geriatric specialty care services. Geriatric health services shall be available
in all government primary health facilities.

‘The level of geriatric services and corresponding facilities in specialty centers and
their respective health human resource requirements shall be determined by the DOH,
in coordination with NCGHRI and other stakeholders: Provided, That the standards to
be adopted thereon shall be consistent with the Philippine Health Facility Development
Plan and Section 6 of this Act.

SECTION 9. Categorization of Patients. — The DOH shall ensure that the NCGHRI
shall adopt and enforce a categorization of paying and non-paying patients. The
allocation of beds for non-paying patients shall be not less than seventy percent (70%)
of the total number of hospital beds.

SECTION 10. Income Retention. ~ All income generated from the operations of the


NCGHRI shall be deposited in an authorized government depository bank and shall be
used to augment the funds allocated for its maintenance, other operating expenses and
capital outlay requirements, subject to the guidelines set by the DOH and the DBM.

SECTION 11. Privilege. - The NCGHRI may request and receive assistance from the
different agencies, bureaus, offices or instrumentalities of the government, including
the Philippine Charity Sweepstakes Office and Philippine Amusement and Gaming
Corporation, in pursuit of its purposes and objectives.

SECTION 12. Tax Exemptions. — All donations, endowments, contributions, grants
and requests used actually, directly and exclusively for and in accordance with the
purposes and functions of the NCGHRI shall be exempt from donor's tax, and the
same shall be considered as allowable deductions from gross income for purposes of
computing the taxable income of the donor, in accordance with the provisions of the
National Internal Revenue Code of 1997, as amended.

The NCGHRI shall be exempt from income tax and customs duty levied by the
government and its political subdivisions, agencies and instrumentalities subject to the
provisions of the National Internal Revenue Code of 1997, as amended and Republic
‘Act No. 10863, otherwise known as the "Customs Modernization and Tariff Act.

‘The NCGHRI shall avail of the tax expenditure subsidy administered by the Fiscal
Incentives Review Board (FIRB), subject to the provisions of Title XI (Tax
Incentives) of the National Internal Revenue Code of 1997. as amended, Executive
Order No. 93, as amended, and the General Appropriations Act.

SECTION 13. Coordination with and Assistance from Other Government Agencies.
— The NCGHRI shall collaborate with the National Commission of Senior Citizens
(NCSC) in the development of its programs and services. It may likewise call upon
any department, bureau, office, agency, or instrumentality of the government for
assistance, in the pursuit of the purposes and objectives of this Act.

SECTION 14. Appropriations. — The amount necessary for the implementation of this
Act shall be charged against the current year’s appropriation of the DOH. Thereafter,
the funding of which shall be included in the annual General Appropriations Act.

SECTION 15, Annual Report. — The NCGHRI shall submit an annual report to the
President of the Philippines, the Senate Committee on Health and Demography, the
House of Representatives Committee on Health, and the NCSC, on its activities,
accomplishments and recommendations to further improve the delivery of geriatric
health services.

SECTION 16. Transitory Provisions. — In accomplishing organizational changes and
improvements that have to be implemented, the following transitory provisions shall
be complied with:


a) The National Center for Geriatric Health (NCGH) currently under the Jose R.
Reyes Memorial Medical Center (IRRMMC) shall be absorbed by NCGHRI
including its existing personnel regardless of status, and all buildings and
equipment, fixtures and furnishings, other assets and liabilities, and current
appropriations;

b) The independence of the NCGHRI from the JRRMMC shall be fully realized
within a period of two (2) years. The DOH shall ensure that no disruption of
service will occur during this transitory period;

©) The existing officials and employees of NCGH shall continue to assume the
duties of their positions until new appointments are issued. They shall be
placed in the new staffing pattern of the NCGHRI in accordance with R.A. No.
6656, entitled "An Act to Protect the Security of Tenure of Civil Service
Officers and Employees in the Implementation of Government Reorganization”
and the rules and regulations governing reorganization. Officials and
employees, including casual and temporary employees, who shall not be
absorbed in the new staffing pattern due to redundancy shall avail of the
applicable retirement benefits and separation incentives as provided under
existing laws: Provided, That officials and employees holding permanent
appointment shall also be given the option to be transferred to other units or
offices within the DOH without reduction in rank, status, pay and benefits;

d) Research grants acquired by the NCGHRI during the transition shall be utilized
solely for their intended purposes and of the affected units or offices; and

©) Existing contracts and agreements entered into with third parties prior to the
enactment of this Act shall remain valid.

SECTION 17. Implementing Rules and Regulations. — The Secretary of Health shall, in
consultation with the Secretary of Budget and Management, Secretary of Social
Welfare and Development, the Chairperson of the NSC, promulgate rules and
regulations for the effective implementation of this Act within ninety (90) days after
its effectivity.

SECTION 18. Separability Clause. — Ifany portion or provision of this Act is declared
invalid or unconstitutional, other provisions hereof shall remain in full force and effect.

SECTION 19. Repealing Clause. — All laws, decrees, executive orders, rules and
regulations, issuances or part thereof inconsistent with the provision of this Act are
hereby repealed, amended, or modified accordingly.

SECTION 20. Effectivity. - This Act shall take effect fifteen (15) days after the
completion of its publication in the Official Gazette or in a newspaper of general
circulation


Approved,