Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Philippines

EIGHTEENTH CONGRESS
First Regular Session

2080
HOUSE BILL NO.

Introduced by: HON, “KUYA” JOSE ANTONIO R. SY-ALVARADO.

AN ACT
ESTABLISHING A UNIVERSAL NEWBORN HEARING SCREENING PROGRAM FOR THE
, PREVENTION, EARLY DIAGNOSIS AND INTERVENTION OF HEARING LOSS AMONG
CHILDREN

EXPLANATORY NOTE

The 1987 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 at an affordable cost. There shall be priority for the needs of the
children.

‘The preventive measures and health related procedures is crucial for the development of the
health of the child. The purpose of this bill is to establish a universal newborn hearing screening
program to integrate measures for the early detection and prevention of this condition among every
new born infant and orient their respective families on how to productively deal with such condition.

In view thereof, the early passage of this proposed measure is highly recommended.

ee

“KUYA" JOSE ANTONIO R. SY-ALVARADOK-
/ Representative
J First District Bulacan

/

/


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Philippines

EIGHTEENTH CONGRESS
First Regular Session
2080
__HOUSE BILL NO.
“KUYA” JOSE ANTONIO R. SY-ALVARADO

© Introduci

AN ACT.
G A UNIVERSAL NEWBORN HEARING SCREENING PROGRAM FOR THE
N, EARLY DIAGNOSIS AND INTERVENTION OF HEARING LOSS AMONG
CHILDREN

+ PREVI

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

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
newborn and children who are deaf or hard-of-hearing have unique language, learning 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 Newborn and the provision of referral, early intervention, counseling and other
support services for Newborn 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 newborn have access to hearing loss screening;

b. To institute a system of newborn hearing loss screening, follow-up, referral and
recall for purpose of providing access to information and services on prevention of hearing
Joss, early diagnosis and intervention, including consultations, to new born and their families;

c. To establish a network among pertinent government and private sector stakeholders
for the implementation, monitoring, evaluation and policy development to further universal
‘Newborn 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


¢. To establish and maintain a new born hearing screening database.

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

a, "Universal Newborn Hearing Screening Program" or "UNHSP" shall refer to the
program developed for carrying out hearing screening for all babies born 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. "Newborn" 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 newborn 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;

2. "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 proficieney 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
Newborn Hearing Screening Program;

h. "Newborn Hearing ‘Screening Center" shall refer to a facility equipped with a
newborn 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 newborns 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. "Newborn hearing loss screening" shall refer to an objective, physiological
procedure completed in a child thirty (30) days old or below to determine the likelihood of
hearing loss: f

| L\"Audiologie 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;


if m, "Advisory Committee" shall refer to the Advisory Committee on Newborn Hearing
Screening established under Section 11 of this Act;

i 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

Four 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 newborn 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
i 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 newborn object to the screening subject to Section 7 of this Act. Babies who are not
bor in hospitals should be screened within the first three (3) months of life

In the event of a positive newborn hearing loss screening result, the newborn shall undergo
audiologie 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.

| [shall be the joint responsibility of the parents or legal guardian, and the practitioner or other
person delivering the newborn to ensure that hearing screening is performed. An appropriate
informational brochure for parents to assist in fulfilling 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

iC. 7, Refusal to be Test.“ 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 newborn’s medical record and refusal shall be indicated in the national newborn hearing
sereening database.

SEC. 8. Continuing Education, Re-education and Training Health Personnel. - The DOH-1,
with the as ce of the National Institute for Health and other concerned government 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, disseminates 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 newborns,
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 shall
1, Establish an Advisory Committee on Newborn 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 interagency
coordination and ' the’ cooperation of private sector’ and. professional associations in policy
development, technology development, enforcement monitoring, data banking 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:

Philippine Medical Association;

Philippine Pediatric Society,

Philippine Society of Otorhinolaryngologist - Head and Neck Surgery;
Philippines Obstetrics Gynecologic Society;

Philippine Hospitals Association;

Department of Education;

s. Department of Interior and Local Government;

h. Association of Municipal Health Officers of the Philippines;

i, A duly organized association of audiologists in the Philippines;

mesegs

e


|. 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 newborn 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 Newborn 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 newborn hearing loss screening, audiologie 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 NTH 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 Newbom 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 Newbom Screening
Reference Center for consolidation of patient databases. The NIH Newborn Screening Reference
Center shall maintain a national database of children tested and a 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 in consultation with the Advisory Committee.
Implementation of this plan shall become a responsibility of the Advisory Committee


SEC. 15. Newborn 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
oss screening, audiologic diagnostic evaluation, and intervention services subject to actuarial and
feasibility studies

SEC. 16, Authorization of Appropriations. —

i a Nationwide Newborn Hearing Loss Screening, Diagnosis and Intervention Networks. - For
the purpose of carrying 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 (7,000,000) 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. Rn
| SEC: 18: Repealing ‘Clause. = “All' Jaws,’ decrees, ‘executive’ orders,’ proclamations and
‘administrative regulations, or any parts thereof, contrary to or inconsistent with this Act are hereby
repealed or modified accordingly.

Hab

SEC. 19. Separability. Ifany 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, EffecyGity. This’ Act shall take effect fifteen (15) days after its publication in at least
pegs ff general circulation