Republic of the Philippines.
HOUSE OF REPRESENTATIVES:
Quezon City, Metro Manila -7

NINETEENTH CONGRESS: ~~
Is Regular Session

450

House Bill No.

Introduced by Representatives JEFFREY SORIANO, ERIC G. YAP, PAOLO Z.
DUTERTE, EDVIC G. YAP, JOCELYN P. TULFO, and RALPH TULFO

EXPLANATORY NOTE

The 1987 Constitution guarantees the protection and promotion of the right to health
of the people and availability of health services to its citizens at an affordable cost. The
pursuit towards this constitutional mandate primarily includes the role of health

workers in our country in order to swiftly and effectively deliver health services.

Owing to the 1991 Local Government Code, the devolution of health in the local
government units paved the critical role of healthcare workers in the localities,
particularly barangay health workers (BHWs). The rationale of the said devolution is
to improve the efficiency and effectiveness of health services management, which
target starts from the basic political unit in our country. In addition, the main goal of

util

1g healthcare workers in the localities is to bring health services to rural areas,

most especially the far-flung one.

However, despite the crucial and heroic role of our barangay health workers (BHWs)
especially during the proliferation of the COVID-19 pandemic, they still remain to be
the sectors to suffer unreasonable compensation and lack of benefits. As a result, most
of them and the rest of the Filipino healthcare workers opt to contribute their
knowledge and talent abroad, in search of better pay and humane working conditions.
This put our healthcare system in turmoil as there is a significant decline in the patient
to healthcare worker ratio. Evidently, in 2019, the doctor to patient ratio in our country

is 1:33,000—significantly higher than the global average of 1:6,600.


This bill aims to provide free education and training programs for our barangay health

workers, in addition to their entitlement to additional compensation and incentives.

Apart from granting due recognition to the incomparable services rendered by the
BHWs, this proposed measure also seeks to encourage more healthcare workers to
render their service in their own country, which would positively effectuate to at par

healthcare programs of our government.

In view of the foregoing, approval of this bill is earnestly sought.

JEFFREY Lest ano PAOLO Z| DUTERTE
JOCELYN P. TULFO

RALPH TULFO



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

NINETEENTH CONGRESS
1s Regular Session

House Bill No. 490

Introduced by Representatives JEFFREY SORIANO, ERIC G. YAP, PAOLO Z.
DUTERTE, EDVIC G. YAP, JOCELYN P. TULFO, and RALPH TULFO

AN ACT
PROVIDING FOR THE MAGNA CARTA OF BARANGAY HEALTH WORKERS

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 "Magna Carta of Barangay
Health Workers,

SEC. 2. Declaration of Policy. - Itis hereby declared. the policy of the State to
protect and promote the right to health of people and adopt an integrated and
comprehensive approach to health development. Pursuant thereto, it shall endeavor
to make essential goods, healthcare, and other social services available to all the
people. in line with the country’s commitment to accomplish health indicator targets
under United Nations’ Millennium Development Goals (MDGs), the State shall adopt
policies that promote the welfare and well-being of barangay health workers who are
the forefront of the delivery of healthcare at the grassroots level, and which shall
effectively harness their potential as partners in development.

SEC. 3. Definition. ~ As used in this Act, the term “barangay health worker”
refers to a person who has undergone training under any accredited government and
nongovernment organization and who voluntarily renders primary healthcare
services in the community after having been accredited to function as such by the local
health board in accordance with the guidelines promulgated by the Department of
Health (DOH) pursuant to Section 3 of Republic Act No. 7883 otherwise known as the

“Barangay Health Workers’ Benefits and Incentives Act of 1995.

SEC. 4, Registration. - Barangay health workers (BHWs) shall be registered
with the local health board in the city or municipality in which they render service.
‘The registered health workers shall be given appropriate proof of said registration.



The municipal and city health offices shall regularly maintain and update the
BHW Registry with the assistance of the BHW Federation and shall submit the same
to the municipal or city health board. The local health offices shall submit a copy of
their respective updated BHW registry to the Provincial Health Office which shall
consolidate all registries. Upon the validation of the Provincial BHW Federation, the
consolidated Provincial Registry shall be submitted to the Provincial Health Board,
and the same shall be posted in the municipal or city bulletin boards and barangay
health centers.

The Provincial BHW Registry shall be submitted on or before April 30 of every
year to the DOH at the regional and national levels for consolidation. The DOH is
hereby mandated to maintain a national register of BHWs.

In order to qualify for registration, a barangay health worker must:

a. Have rendered basic community health care services continuously and
satisfactorily for at least six (6) months immediately preceding the date of
the filing of application for registration in the barangay as certified by the
Rural Health Midwife (RHM) or public health nurse assigned to the
barangay and by the head of the barangay health workers association;

b. Have completed the basic orientation and training for BHWs as prescribed
by the DOH and conducted by an accredited government agency, or DOH-
recognized academic institution, or nongovernmental organization (NGO);

c. Be at least eighteen (18) years of age at the date of the filing of the
application for registration; and,

d. Be physically and mentally fit

It shall be the duty of the municipal and city health offices, in cooperation with
the Provincial Health Office and DOH, to provide the BHW applicants with basic
orientation and training within six (6) months from the date of approval of their
application.

SEC. 5. Accreditation. - To further professionalize the health care services
rendered by the BHWs and ensure the health and welfare of the community, a duly
registered BHW must be accredited by the municipal or city health board.

The municipal or city health board shall issue the certificate of accreditation to
qualified BHWs. In order to qualify for accreditation, the applicant BHW must:

a. Be registered in accordance with Section 4 hereof;



b. Have completed in the locality at least two (2) vears of continuous and
satisfactory service immediately prior to the filing of application for
accreditation;

c. Have completed a regular training program on health care service and
community-based health program, that would upgrade and develop the
skills and competency of BHWs to perform their roles. The training
program shall be institutionalize by the DOH, in cooperation with local
government units (LGUs).

It shall be the duty of the municipal and city LGUs, in cooperation with the
provincial government and the DOH, to provide the applicant BHWs the necessary
support and opportunities for accreditation.

A BHW must complete the regular training program on health care service and
community-based health program within five (5) years from registration.

The municipal and city health boards or through their registration and
accreditation committee shall act on the applications for accreditation of BHWs not
later than thirty (30) days from the date of application.

The DOH shall also maintain an updated roster of accredited BHWs that is
accessible to the general public.

SEC. 6. Number and Role of Barangay Health Workers. - Notwithstanding the
limitations prescribed under Section 325(a) of Republic Act No. 7160, as amended,
otherwise known as “The Local Government Code of 1991”, each barangay shall at
least have one (1) BHW for every twenty (20) households.

As one of the key partners in a reformed healthcare delivery system, the DOH
and LGUs shall support the roles of BHWs as:

a. Advocate - to support, promote and champion current health programs,
projects, and activities to improve access to quality health services towards
the improved health status of the community

b. Educator - to guide and advise the community on the current DOH and
health priorities of LGUs such as importance of birth plan and facility-based
delivery in reducing maternal and infant deaths; newborn screening for the
early detection of congenital metabolic disorders which may lead to mental
retardation and even death, among others;

¢. Disseminator - to maintain regular communication with local professional
health workers on health events and updates and concerns relevant to the
community and inform the same to the community for appropriate action,
if necessary;

d. Coordinator - to facilitate access to any group or association of the
community with a relevant network of or specific health and non-health



service providers; Record Keeper - to maintain updated records of health
data, heaith activities and events in the community;
c. Health Care Service Provider - to assist and provide basic healthcare
1s may be needed in the community in any health event.

services

A BHW shall not be required to engage in any partisan political activity.

SEC. 7. Mandatory Appointment of Barangay Health Worker (BHW). - There
shall be appointed at least one (1) BHW in every barangay for every twenty (20)
households who shall be under the supervision and control of the DOH. The BHW so
appointed shall coordinate closely with the local government health officer in the
implementation of health programs in the locality. As far as practicable, the BHW to
be employed must be a resident of the barangay

The DOH shall determine the ratio of barangay health workers according to
the number of households: Provided, That there shall be at least one (1) BHW for every
twenty (20) houscholds: Provided, further, That the total number of barangay health
workers nationwide shall not be less than one percent (1%) of the total population.

SEC. 8. Incentives and Benefits. - All BHWs who are actively and regularly
performing their duties shall be entitled to monthly honoraria in the amount of not
less than Three thousand pesos (P3,000.00) subject to adjustment based on the
prevailing market value, in addition to the following incentives and benefits:

a. Privileges for the BHWs, ~ All accredited BHWs shall be entitled to twenty
percent (20%) discount on all the items enumerated under Section 4(a) of
Republic Act No. 9994 otherwise known as the “Expanded Senior Citizens
‘Act of 2010”: Provided, That the privileges shall not be claimed if the BHW
is eligible for a higher discount that may be granted by the commercial
establishment or other existing laws.

‘The commercial establishment may claim the discount granted under this,
Section as tax deduction based on the cost of goods sold or services
rendered; Provided, that the discount shall be allowed as deduction from the
gross income for the same taxable year that the discount is granted:
Provided, further, that the total amount of the claimed tax deduction net of
value-added tax, if applicable, shall be included in their gross sales receipt
for tax purposes and shall be subject to proper documentation and to the
provisions of the National Internal Revenue Code of 1997, as amended.

b. Hazard Allowance. - All accredited BHWs shall be entitled to hazard
allowance in an amount to be determined by the local health board of the
LGU concemed, which in no case shall be less than One thousand pesos
(P1,000.00) per month, subject to existing laws, rules, and regulations;


Subsistence Allowance. - All accredited BHWs who render service within the
premises of isolated barangay health stations shall be entitled to subsistence
allowance equivalent to the meals they take in the course of their duty,
which shall be computed in accordance with prevailing circumstances as
determined by the LGU concerned. such allowance shall, in no case, be less
than One hundred pesos (P100.00) per day;

.. Transportation Allowance. ~ All accredited BHWs, in the performance of their
official duties, shall be entitled to a transportation allowance of not less than
‘One thousand pesos (P1,000.00) per month, subject to auditing rules and
regulations;

One-time Retirement Cash Incentive. - An accredited BHW who has
continuously and satisfactorily served for at least fifteen (15) years shall be
entitled to a one-time retirement cash incentive of not less than Ten
thousand pesos (P10,000.00) in recognition of their loyalty and dedication,
which shall be borne by the municipality or city concerned. The provincial
government may provide assistance for this purpose, in the case of
component cities;

Training, Education and Career Enrichment Programs. - The DOH shall, in
coordination with the Department of Education (DepEd), Commission on
Higher Education (CHED), Technical Education and Skills Development
Authority (TESDA), DOH-recognized academic institutions, other
concerned agencies and nongovernment organizations, provide
information on and opportunities for education and career enrichment for
accredited BHWs, such as in the following programs

1. Educational programs which credit the years of primary healthcare
service of the BHW towards higher education completion in institutions
with stepladder curricula thus allowing them to upgrade their skills and
knowledge for community work or to pursue further training as
midwives, pharmacists, nurses or doctors;

2. Continuing education, study and exposure tours, grants, field
immersion, and scholarships, among others;

»

Scholarship benefits in the form of tuition fees in state colleges, to be
granted to one (1) child of every barangay health worker who will not
be able to take advantage of the programs described in paragraphs (1),
(2), and (3) hereof; and

4. Special training programs such as traditional medicine, disaster
preparedness and other programs that address emergent community
health problems and issues.



h,

Health Benefits. - All accredited BHWs shall be entitled to the following
health benefits during their incumbency:

1, Free medical care, including surgery and surgical expenses medicines,
x-ray and other laboratory fees, when confined in any public hospital or
health institution;

i)

Emergency assistance not exceeding the amount of Five thousand pesos
(P3,000.00) chargeable against the fund of the barangay concerned, for
expenses incurred in the nearest private hospital or clinic in case of
extreme emergency where there is no available public hospital;

3. Mandatory and immediate membership in the PhilHealth as indirect
contributors,

4. The LGUs concerned shall also endeavor to provide other health
benefits to accredited BHWs not otherwise provided by law;

Insurance Coverage. ~ Accredited BHWs shall be granted insurance coverage
and benefits by the Government Service Insurance System (GSIS) which
shall be borne by the LGU concerned. For this purpose, the GSIS shall
design an insurance benefit package suited to the needs and unique
circumstances of the BHWs;

Sick, Vacation aud Maternity Leaves. ~ All accredited BHWs shall be entitied
to sick, vacation and maternity leaves as may be prescribed in the
implementing rules and regulations of this Act: Provided, That, the BHWs
shall continue to receive their monthly honoraria while on leave, for such
period in accordance with existing laws and practices.

Cash Gift. - All accredited BHWs are entitled to a cash gift not less than the
minimum monthly honoraria to be given every December from the general
fund of the barangay or from such other funds appropriated by the national
government for the purpose;

Disability Benefit. - An accredited BHW who sustains an injury or falls ill in
the course of the performance of their duties shall be entitled to Two
thousand pesos (P2,000.00) for every year of service.

Civil Service Eligibility. - A first grade eligibility shall be granted to
accredited BHWs who have rendered three (3) years continuous service as
such: Provided, That should a BHW become a regular employee of the
government, the total numbers of years served as such shalll be credited to
the BHW’s service in the computation of retirement benefits.


No person duly accredited as a BHW shall be removed except for a valid
cause to be determined by the Local Health Board (LHB): Provided, That if
found to be unjustly removed from service, a BHW shall be entitled to
reinstatement without loss of benefits and incentives from the time of
termination up to the time of his reinstatement. The LHB shall resolve
termination cases against a BHW judiciously not later than ninety (90) days
from the receipt of a complaint.

m. Free Legal Services. ~ Legal representation and consultation services shall be
immediately provided by the Public Attorney's Office to a BHW in cases of
coercion, interference, and in other civil and criminal cases filed by or
against the BHW arising out of or in connection with the performance of
their duties as such.

n. Preferential Access to Loan Facilities. - The DOH in coordination with other
concerned government agencies shall provide, within one hundred eighty
(180) days after the effectivity of this Act, a mechanism that shall provide
organized BHWs access to loan services. The agencies providing loan
services will set aside one percent (1%) of their loanable funds for organized
BHW groups that have community-based income generating projects in
support of health programs or activities.

SEC. 9. Review by the Local Health Board. - Every incentive or benefit for
BHWs requiring expenditure of local funds shall be reviewed and approved by the
LHB. Such benefits and incentives may be increased, upon review of the LHB, after
considering, among others, the present Consumer Price Index (CPI) as published by
the Philippine Statistics Authority (PSA).”

SEC. 10. Discrimination Prohibited. - Discrimination against any BHW by
reason of gender, civil status, creed, religious or political beliefs and ethnic groupings
in the exercise of their functions and responsibilities is hereby prohibited.

SEC. 11. Protection of BHWs. - The municipal, city, provincial governments
and the Department of the Interior and Local Government (DILG) shall establish a
grievance mechanism as a means of processing complaints of BHWs against alleged
acts of discrimination and unjust removal from the service. A BHW may appeal their
grievances to the DILG.

SEC. 12. Right to Self-organization. - A BHW shall have the right to freely
form, join or assist organizations to obtain redress of their grievances through peaceful
concerted activities, ina manner not contrary to law, and with utmost regard to service
to patients and the continuous operation of barangay health services in the interest of
public health, safety, or survival of patients.

SEC. 13. Representation in the Local Health Board and Primary Health Care
Provider Network. - The president of the municipal or city association of BHWs shall


be a member of the municipal or city local health board. The presidents of the
association of BHWs of each component city and municipality associations of a
province shall clect from among themselves their representative to the provincial
health board: Provided, That, the BHW representatives to the health boards shall not
be allowed to vote on the registration, accreditation and disciplinary or removal
complaints of BHWs.

The BHWs shall also form part of the healthcare provider network and shall
participate in the implementation of healthcare services and programs.

SEC 14. Continuous Capacity Building for BHWs. - The DOH shall conduct
continuous capacity building for BHWs to enhance and upgrade their knowledge and
skills, including training programs conducted online and in major Philippine dialects.

The DOH shall, in coordination with TESDA and other concerned agencies
shall also assist the LGUs in the development of education modules or materials that
highlight the collective experiences and learnings of BHWs and the use of traditional
and complementary medicine.

‘The LGUs shall endeavor to establish their own training centers for their BHWs.
and other health workers in coordination with TESDA, NGOs, and other agencies
concerned.

The LGUs shall also implement a development program for BHWs that will
allow them to benefit from ladderized training as provided under Republic Act No.
10968, otherwise known as the “PQF Act,” and Republic Act No. 10647, otherwise
known as the “Ladderized Education Act of 2014," including academic credits for
health-related courses,

SEC. 15. Penalty Clause. - Any local government official who violates any
provision of this Act may be administratively and criminally charged in accordance
with law.

SEC. 16. Appropriations. - The amount necessary for the implementation of
this Act shall be charged against the National Tax Allotment (NTA) of the LGUs, other
local funds and the special health fund under Republic Act No. 11223 otherwise
known as the “Universal Health Care Act”.

SEC. 17. Implementing Rules and Regulation. - The DOH and the DILG shall,
in consultation with the DepEd, the CSC, the GSIS, and other concerned government
agencies and nongovernmental entities, promulgate the rules and regulations to
implement this Act not later than one hundred eighty (180) days from the effectivity
of this Act.



SEC. 18. Separability Clause. - If any portion or provision of this Act is
declared invalid or unconstitutional, other provisions hereof shall remain in full force
and effect.

SEC. 19. Repealing Clause. - Republic Act No. 7883 otherwise known as the
“Barangay Health Workers’ Benefits and Incentives Act of 1995” is hereby repealed.
Alllaws, decrees, executive orders, rules and regulations, which are inconsistent with
this Act are hereby repealed, or modified accordingly’

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

Approved,