FOURTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular bession 
S E N A T E  
Introduced by Senator Loren Legarda 
EXPLANATORY NOTE 
This bill seeks to provide for mandatory hearing loss screening to infants born in 
public hospitals to promote the early diagnosis and intervention of congenital hearing 
loss and prevent the morbidity caused by the late detection and rehabilitation of the 
same. 
Republic Act No. 9288 otherwise known as An Act Promulgating a 
Comprehensive Policy and a National System for Ensuring Newborn Screening was 
enacted in 2004 to oblige 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 newborn screening. 
Newborn screening as defined in this law means the process of collecting a few drops of 
blood from the newborn onto an appropriate collection card and performing 
biochemical testing for determining if the newborn has a heritable condition. A 
heritable condition, under this law, is any condition that can result in mental 
retardation, physical deformity or death if left undetected and which is usually 
inherited from the genes of either or both biological parents of the newborn. 
However, congenital hearing loss is not a heritable condition that can be detected 
as a heritable condition. 
The prevalence of significant hearing impairment at birth has been determined in 
United States, Europe and Australia to be 1 to 4 per 1000 when performing this 
procedure on the majority of babies born before discharge from the hospital (universal 
newborn hearing screening. In the Philippines, The Report of the Task Force On 
Hearing Disorders (2003) 12, a study by Chiong et a18 and Quintos et a19 showed that the 
local prevalence may also be much higher than the United States or Europe, but because 
of poor follow-up of patients for confirmatory tests, the exact prevalence could not be 
determined. There are, however, anecdotal reports of many children with congenital 
hearing loss who are still diagnosed at a later age, at 2 to 8 years old, due to speech and 
language delays with no other abnormalities or obvious medical problems. 
In the February 2007 Position Paper of the Committee on Newborn Hearing 
Screening of the Philippine Society of Otolaryngology, Head and Neck Surgery on the 
National Ear Institute, newborn hearing screening tools are available in the major 


hospitals in Metro Manila. The use of these devices for newborn hearing screening 
(otoacoustic emissions and automated auditory brainstem response) are easy to learn. 
The procedure itself takes usually less than 5 minutes to perform. And the cost for a 
newborn hearing screening test in a universal newborn hearing screening program 
ranges from PlOO to P5OO. A cost analysis study by Dr. Villarta15 from the Quirino 
Medical Center in 2005 showed that it will cost approximately P4,OOO (if testing only 
selected or high-risk newborns) to P5,OOO (if testing all newborns or universal screening) 
to detect one child with significant congenital hearing loss. 
When undiagnosed before h months, children with significant congenital hearing 
loss develop speech and language delays, do poorly in school and may suffer 
psychosocially due to feelings of isolation and low self-esteem. Also, when diagnosed 
after 6 months, there is need for longer intervention and special education for these 
children before they can be mainstreamed into regular schools as compared to those 
diagnosed and habilitated before 6 months of age. 
There is therefore a need for legislation that would impose a universal newborn 
hearing screening program on all public hospitals given that early diagnosis and 
intervention will effectively address detected hearing loss. 
Among the barriers identified by medical practitioners on the difficulty of 
implementing a universal newborn hearing screening program are: hospitals do not 
want to invest on the technology, the procedure is "expensive", parents and doctors are 
skeptical about the procedure. 
Compared to the benefits of a healthy and productive citinzenry as a result of 
early detection, diagnosis and intervention of congenital hearing loss, these setbacks are 
negligible. 
In view of the foregoing, immediate passage of this bill is earnestly requested. 
Senator 


FOURTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session 
S E N A T E  
Introduced by Senator Loren Legarda 
AN ACT PROVIDING FOR THE EARLY DETECTION, DIAGNOSIS AND 
INTERVENTION FOR CONGENITAL HEARING LOSS AMONG CHILDREN IN 
THE PHILIPPINES AND FOR OTHER PURPOSES 
Be it enacted by fhe Senate and House of Representatives of the Philippines in Congress 
nssembled: 
SECTION 1. Short Title. - This Act shall be known as the "Hearing Loss Screening 
Act of 2007." 
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 and full and 
healthy development as normal ir,dividuals. 
In pursuit of such policy, the State shall institutionalize the early detection, 
diagnosis, referral and intervention of hearing loss among children one year old and 
below to ensure that every baby born in the Philippines is afforded all the opportunities 
to be productive members of the family and the community. 
SEC. 3. 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 oId and below. Appropriate 
notification and education regarding this obligation shall be the responsibility of the 
Department of Health (DOH). 
SEC. 4. Obligation to Perform Newborn Hearing Loss Screening. - A11 babies 
born in public hospitals in the Philippines shall be screened for hearing loss before 
leaving the hospital, Prouided, that a parent or legal guardian of the newborn submits a 
written consent to the hospital prior to the performance of the procedure. 
For purposes of this section, hearing loss screening is a procedure that can be 
performed after twenty-four (24) hours of life but not later than six (6) months from 
complete delivery of the newborn. 
A newborn that must be placed in intensive care in order to ensure survival may 
be exempted from the 3-day requirement but must be tested by seven (7) days of age. 


It shall be the joint responsibility of the parent@) and the practitioner or otlxer 
person delivering the newborn to ensure that hearing screening is performed. A11 
appropriate informational brochure for parents to assist in fulfilling this responsibility 
shall be made available by the Department of Health and shall be distributed to all 
health institutions and made available to any health practitioner requesting it for 
appropriate distribution. 
SEC. 5. Refusal to be Tested. - a parent or legal guardian may refuse testing on 
the grounds i: ieligious beliefs, but shall acknowledge in writing their understanding 
that refusal for testing places their newborn at risk for undiagnosed congenital hearing 
loss. A copy of this refusal documentation shall be made part of the newborn's medical 
record and refusal shall be indicated in the national newborn hearing screening 
database likewise created under this Act. 
SEC. 6. - Continuing Education, Re-education and Training Health Personnel. - 
The DOH, with the assistance of the National Institute for Health and other government 
agencies, professional societies and non-government organizations, shall: (i) conduct 
continuing information, education, re-education and training programs for health 
personnel on the rationale, benefits, procedures of hearing loss screening; and (ii) 
disseminate information materials on newborn screening at least annually to all health 
personnel involved in material and pediatric care. 
SEC. 7. Licensing and Accreditation. - The DOH and the Philippine Health 
Insurance Corporation (PHIC) shall require health institutions to provide hearing loss 
screening services as a condition for licensure or accreditation. 
SEC. 8. k a d  Agency. - The DOH shall be the lead agency in implementing this 
Act. For purposes of achieving the objectives of this Act, the DOH shall: 
1. 
Establish an Advisory Committee on Hearing Loss Screening in the 
Department of Health; 
Coordinate with the Department of the Interior and Local GoLernrnent 
(DILG) for implementation of the hearing loss screening in the local 
hospitals; and 
2. 
3. 
Coordinate with the Advisory Committee and the NIH Newborn 
Screening Reference Centel for the accreditation of Hearing Loss 
Screening Centers and preparation of defined testing protocols and 
quality assurance programs. 
Sec. 9. The Advisory Committee. - The Advisory Committee shall perform the 
following functions: 
a. Devchp State capacity to support newborn hearing loss detection, diagnosis 
and intervention; 
b. To monitor the extent to which hearing detection is conducted 'in health 
institutions, and assist in the development of universal newborn hearing loss 
screening programs for hospitals and non-hospital sites; 
c. To collect data on early detection, diagnosis and intervention that can be used 
for applied research and policy development 


d. Review annually and recommend the newborn screening fee to be charged by 
Newborn Screening Centers; review the report of the Newborn Screening 
Reference Center on the quality assurance of the Universal Hearing Loss 
Screening and recommend corrective measures as deemed necessary. 
SEC. 10. Accreditation of Newborn Screening Centers. -No Hearing Loss 
Screening Center shall be allowed to operate unless it has been duly accredited by the 
Department of Health based on the standards set forth by the Committee. At a 
minimum, every Hearing Loss Screening Center shall: (i) have a certified laboratory 
performing all tests included in the hearing loss screening program, (ii) have a 
recall/follow up programs for infants found positive for hearing loss; (iii) be supervised 
and staffed by trained personnel who have been duly qualified by the NIH; and (iv) 
submit to periodic announced or unannounced inspections by the Reference Center in 
order to evaluate and ensure quality performance. 
SEC. 11. Database. - All public hospitals and Hearing Loss Screening Centers 
shall coordinate with 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 a separate registry for those found positive for 
hearing loss.. It shall submit reports annually to the 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 cases registries shall be 
developed within one (1) year of passage of this Act by the NIH Newborn Screening 
Reference Center in consultation with the Advisory Committee. Implementation of this 
plan shall become a responsibility of the Advisory Committee. 
SEC. 12. Newborn Screening Fees -The Philippine Health Insurance Corporation 
shall include the cost of hearing loss screening in its benefits package. The screening fee 
shall be applied to, among 'others, testing costs, education, sample transport, foollow-up 
and reasonable overhead expenses. 
SEC. 13. Penalties. - Any person who violates any provision of this Act shall 
suffer the penalty of a fine of not less than fifty thousand pesos (P50,OOO.OO) nor more 
than one hundred thousand pesos (PlO0,OOO.OO) and suspension or revocation of license 
to operate Hearing Loss Screening Center at the discretion of the Court: Puouzded, Tllnt, 
its officers directly responsible for the violation shall suffer the penalty of fine and 
suspension or revocation of license to practice profession, if applicable; and by 
imprisonment of not less than six (6) months nor more than one (1) year or both fine 
and imprisonment at the discretion of the Court: and Provided, further, That if the 
guilty party is an alien, he shall be ipsofacto deported after service of sentence without 
need of further proceedings. 
The Secretary of Health shall have the authority to impose administrative 
sanctions such as suspension or cancellation of license to operate or recommend 
suspension of license to practice profession to the Professional Regulation Commission 
as the case may be for the violation of this Act. 
SEC. 14. Repealing ,Clause. - All general and special laws, decrees, ,executive 
orders, proclamations and administrative regulations, or any parts thereof, which are 
inconsistent with this Act are hereby repealed or modified accordingly. 


SEC. 15. Separability. - If, for any reason or reasons, any party of provisions of 
this Act shall be declared or held to be unconstitutional or invalid, other provision or 
provisions hereof which are not affected thereby shall continue to be in full force and 
effect. 
SEC. 16. Effectivity. - This Act shall take effect fifteen (15) days after its 
publication in at least two (2) newspapers of general circulation. 
Approved,