Republic of the Philippines
‘House of Representatives
Quezon City

EIGHTEENTH CONGRESS
First Regular Session

0532

HOUSE BILL NO.

Introduced by Rep. JOSEPH STEPHEN S. PADUANO

EXPLANATORY NOTE

The Philippines is one of the countries with a high risk population
when itcomes to renal disease because of numerous cases of diabetes,
high blood pressure and other hereditary diseases, all of which can
lead to kidney malfunction. According to the National Kidney Transplant
Institute (NKTI), kidney diseases are already the 7th leading cause of
death among Filipinos with one Filipino developing chronic renal failure
every hour or about 120 Filipinos per million population per year. In
2013, Dr. Antonio Paraiso of the Department of Health's (DOH) Philippine
Network for Organ Sharing reported that close to 23,000 patients were
undergoing dialysis treatment compared to the 4,000 patients in 2004.
He also noted that glomerulonephritis used to be the primary cause of
kidney failure until it was overtaken by diabetes and hypertension.

The cost of medical treatment for kidney disease is really very
expensive, beyond the reach of ordinary patients. It was reported that in
2007, only 73% of Filipino patients with kidney failure were able to afford
necessary treatment. A 2013 research by Dr. Romina Danguilan placed the
average monthly income of chronic kidney disease (CKD) patients at
P4,838.16 compared to the cost of treatment of P2,250 to be paid to
the health care institution and P350 for the professional fee which has
risen to P350 for the professional fee and to P700 in January 2016. A
study by the Philippine Society of Nephrology (PSN) showed that 60
percent of CKD patients are the so-called service patients who badly
needed state subsidy to get the life-saving treatment. And most of them
usually reach out to politicians, foundations, state agencies, the
Philippine Charity Sweepstakes Office (PCSO), among others.

Article XIII, Section 11 of the 1987 Philippine Constitution provides that:

"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. The State shall endeavor to provide free
medical care to paupers."


Despite the efforts of the government — through the DOH, together with
its specialty and regional hospitals and accredited dialysis clinics, PCSO
and Philhealth — in addressing the problem, still the occurrence of renal
diseases in the country is on the rise. More and more CKD patients
facing economic difficulties who cannot afford the cost of the necessary
treatment available as well as the cost of transportation to the available
hospital/clinic tend to forego the treatment.

Hence, providing a dialysis machine to national, regional and
provincial government hospitals will help CKD patients, especially from rural
areas, to get the necessary treatment near their places of abode. A dialysis
machine costs around P400,000.00 and this will not burden the government
if the provision of the machine to DOH hospitals is done on a staggered basis.
What is important is CKD patients from the rural areas can avail of the treatment
near their homes.

In consonance with the constitutional mandate to make health
services available to all the people at affordable cost, this bill requires
all national, regional and provincial government hospitals to establish, operate
and maintain a dialysis service facility in their respective hospital in
order that dialysis treatment will be available and accessible to the people
especially those in the rural areas in a cost effective manner. This bill
further requires that dialysis treatment should be provided to indigent patients,
free of charge. Moreover, the bill also requires that the dialysis service
facility to disseminate the necessary information to prevent the occurrence of
kidney malfunction and CKD.

For more efficient delivery of health care services to the Filipino
people, the immediate approval of this proposed measure is earnestly sought.

nat

JOS RHEN S. PADUANO


Republic of the Philippines
House of Representatives
Quezon City

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL NO.” 0532

Introduced by Rep. JOSEPH STEPHEN S. PADUANO

AN ACT
REQUIRING ALL NATIONAL, REGIONAL, AND PROVINCIAL GOVERNMENT
HOSPITALS TO ESTABLISH, OPERATE AND MAINTAIN A _ DIALYSIS
SERVICE FACILITY IN THEIR RESPECTIVE HOSPITAL AND PROVIDING
FREE DIALYSIS TREATMENT TO INDIGENT PATIENTS

Be 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 "Dialysis Service
Facility for Indigents Act of 2019".

SEC 2. Declaration of Policy. \t is the declared policy of the State to
improve the delivery of health care services to the people and to ensure hospital
facilities are available, affordable and accessible to the people.

SEC. 3. Definition of Terms. For purposes of this Act, the following terms shall
mean:

a) "Dialysis Service Facility" shall refer to a facility that provides treatment for
chronic kidney disease to indigent patients and disseminate information on its
prevention,

b) "National Government Hospital" shall refer to a hospital operated and
maintained either partially or wholly by the national government or by any
department, division, board or other agency thereof.

©) "Regional Government Hospital" shall refer to a hospital operated and
maintained either partially or wholly by the national government or by any
department division, board or other agency thereof.

d) "Provincial Government Hospital" shall refer to a hospital operated and
maintained either partially or wholly by the provincial government or other
political subdivision, or by any department division, board or other agency
thereof.

€) "Indigent Patient" shall refer to a patient whose combined annual family


income does not exceed Fifty Thousand (P50,000.00) annually,

SEC. 4. Establishment, Operation and Maintenance of a Dialysis
Service Facility. Within two (2) years from the effectivity of this Act, all national,
provincial, and regional government hospitals are hereby required to establish,
operate and maintain a dialysis service facility in their hospital. It shall have a
dialysis service area compliant with the Licensing Requirements imposed by the
Department of Health (DOH) for private dialysis clinics. It shall further be
provided with the necessary personnel and equipped with complete dialysis
machine, equipment and supplies as provided for in the same DOH-issued
Licensing Requirements for private dialysis clinics.

The Dialysis Service Facility shall further have a as well as a
nontreatment area which shall serve as a waiting area for CKD patients
and a business area for information service that shall give importance on
information dissemination on the prevention of CKD.

SEC. 5. Free Dialysis Service Treatment to Indigent Patients. Indigent
patients, as defined in Section 3 (e) hereof, shall be provided dialysis treatment
in all national, provincial and regional hospitals.

SEC. 6 Penalty. Any hospital chief, administrator or officer-in-
charge who fails to comply with this Act shall be meted with a fine of Fifty
Thousand Pesos (P50,000.00) but not more than One Hundred Thousand Pesos
(P100,000.00).

SEC. 7. Implementing Rules and Regulations. The DOH Secretary shall
promulgate the necessary rules and regulations to implement the provisions of
this Act.

SEC. 8 Appropriations. Such amount as may be necessary to
implement the provisions of this Act is hereby authorized to be appropriated from
the National Treasury. Thereafter, the amount necessary for the continuous
implementation of this Act shall be included in the government hospital's annual
appropriations.

SEC. 9. Separability Clause. If any provision or part hereof is held
invalid or unconstitutional, the remainder of the law or the provision not otherwise
affected shall remain valid and subsisting.

SEC. 10. Repealing Clause. Any law, presidential decree or issuance,
executive order, letter of instruction, administrative order, rule or regulation
contrary to or inconsistent with the provisions of this Act are hereby repealed,
modified or amended accordingly.

SEC. 11. Effectivity. This Act shall take effect fifteen (15) days after its
publication in at least two (2) newspapers of general circulation.

Approved,