., 
SIXTEENTH CONGRESS OF THE REPUBLIC 
OF THE PHILIPPINES 
Second Regular Session 
SENATE 
S.No. 
2284 
) 
) 
) 
Introduced by Senator Miriam Defensor Santiago 
AN ACT 
'14 
JUNIB P2:37 
CREATING A PATIENT-CENTERED QUALITY OF CARE INITIATIVE FOR 
SERIOUSLY ILL PATIENTS THROUGH THE ESTABLISHMENT OF A 
STAKEHOLDER STRATEGIC SUMMIT, QUALITY OF LIFE EDUCATION, AND 
AWARENESS INITIATIVE, HEALTH CARE WORKFORCE TRAINING, AN 
ADVISORY COMMITTEE, AND PALLIATIVE CARE FOCUSED RESEARCH 
EXPLANATORY NOTE 
The Constitution, Article 2, Section 15 provides: 
SEC. 15. The State shall protect and promote the right to health of 
the people and instill health consciousness among them. 
People living with a serious illness experience inadequately treated symptoms, 
fragmented care, poor communication with their doctors and enormous strains on their 
family caregivers. I 
Studies in the United States show that, despite soaring health expenditures, 
seriously ill patients are supposedly not satisfied with the quality of their medical care 
because of untreated symptoms, unmet psychosocial and personal care needs, high 
caregiver burden, and low patient and family satisfaction. 
In order to improve the quality of life of the patients and even their families, there 
should be public outreach and education on pain and symptom management of chronic 
diseases. Palliative care is (ocused on the relief of the pain, stress, and other debilitating 
symptoms of serious illness, such as cancer; heart, renal, and liver failure; lung disease; 
and Alzheimer's disease and related dementias. 
I Morrison, R. Sean and Meier, Diane E. America's Care of Serious Illness. Center to Advance 
Palliative Care. New York, NY. 2011. 
1 


.. 
. 
. 
, 
This bill seeks to address the symptoms and needs of patients with chronic disease 
by providing the patients as well as their caregivers and families with greater access to 
palliative care? 
2 This bill was originally filed by Mr. Emannel Cleaver and Mr. Spencer Bachus in the U.S. 
House of Representatives (H.R. 1666; l13lh Congress, First Session). 
2 


SIXTEENTH CONGRESS OF THE REPUBLIC 
OF THE PHILIPPINES 
Second Regular Session 
SENATE 
S.No. 
2284 
) 
) 
) 
Introduced by Senator Miriam Defensor Santiago 
'14 
JUN 18 P2 :37 
Be it enacted by the Senate and the House of Representatives of the Philippines in 
Congress assembled: 
1 
AN ACT 
2 
CREATING A PATIENT-CENTERED QUALITY OF CARE INITIATIVE FOR 
3 
SERIOUSLY ILL PATIENTS THROUGH THE ESTABLISHMENT OF A 
4 
STAKEHOLDER STRATEGIC SUMMIT, QUALITY OF LIFE EDUCATION, AND 
5 
AWARENESS INITIATIVE, HEALTH CARE WORKFORCE TRAINING, AN 
6 
ADVISORY COMMITTEE, AND PALLIATIVE CARE FOCUSED RESEARCH 
7 
SECTION 1. Short Title. - This Act shall be known as "Patient-Centered Quality 
8 
Care for Life Act". 
9 
SECTION 2. National Patient-Centered Health Care and Quality of Life 
10 
Stakeholder Strategic Summit. -
11 
(a) Summit. - Not later than one year after the date of the effectivity of this Act, 
12 
the Secretary of Health (here referred to as the "Secretary") shall convene a Patient-
13 
Centered Health Care and Quality of Life Stakeholder Strategic Summit (here referred to 
14 
as the "Summit") to be composed of individuals with appropriate expertise to: 
15 
(1) analyze key health system barriers to providing patient-centered health 
16 
care that integrates symptom management and other aspects of coordinated or 
17 
palliative care; and 
18 
(2) id.entify strategic solutions for collectively addressing quality of life 
19 
concerns for the rapidly expanding population of patients and survivors facing 
20 
serious, complex, and chronic illness in the Philippines and for the families of 
21 
such patients and survivors. 
1 


1 
(b) Participants. - The Summit shall include representatives from at least the 
2 
following: 
3 
(I) Government agencies, including the Department of Health; 
4 
(2) Private organizations, including: 
5 
(A) health professional organizations that represent physicians, 
6 
nurses, pharmacists, and social workers; 
7 
(B) patient non-profit organizations; 
8 
(C) private health insurance organizations; 
9 
(D) faith community representatives; and 
10 
(E) other professionals as deemed appropriate by the Secretary. 
11 
(c) Steering Committee. -
12 
(I) In General. -
The Secretary shall establish a Summit Steering 
13 
Committee to plan the Summit, coordinate participants of the Summit, develop an 
14 
agenda for the Summit that is in accordance with paragraph (d), and draft a 
15 
summary report detailing recommendations made by the participants of the 
16 
Summit for a national strategic action agenda to improve patient-centered care and 
17 
quality of life (here referred to as the "National Action Agenda") in accordance 
18 
with paragraph (d)(4). The Secretary shall appoint the representatives described in 
19 
paragraph (2)(A) and shall seek nominations from relevant stakeholders, and from 
20 
such nominations, appoint representatives described in paragraph (2)(B). 
21 
(2) Composition. - The Summit Steering Committee shall consist of at least 
22 
the following members: 
23 
(A) Membersfrom Government Agencies.-
24 
(i) The Secretary, who will serve as chair of the Committee. 
2 


1 
(ii) r our representatives from government agencies described 
2 
III subsection (b) (or any other government agency deemed 
3 
appropriate by the Secretary), to be appointed by the Secretary. 
4 
(B) Members Representing Stakeholder Entities. -
5 
(i) Six representatives of health professionals (with each of 
6 
such six representatives having research, clinical, and teaching or 
7 
mentoring expertise); 
8 
(ii) Three representatives of patient advocacy organizations. 
9 
(iii) One representative of a private health insurance 
10 
organization. 
11 
(iv) One representative of faith communities. 
12 
(v) Two physicians. 
13 
(vi) Two nurses. 
14 
(vii) One social worker. 
15 
(d) Agenda. - The agenda for the Summit shall focus on specific areas that include 
16 
. at least the following: 
17 
(1) Improving communication and coordination of health care among 
18 
primary care providers, medical specialists, and other health professionals and 
19 
seriously ill patients and families of such patients to ensure that symptoms are 
20 
managed and other quality of life needs are met to support the continued 
21 
functioning and well-being of such patients. 
22 
(2) Examining the appropriate roles of both physician and non-physician 
23 
professionals (such as nurse practitioners, clinical social workers, physician 
24 
assistants, and other patient or survivor navigators or case coordinators) in 
25 
strengthening access to integrated, coordinated, or palliative care across care 
26 
settings for all seriously ill patients and families of such patients. 
3 


1 
(3) Examining the role of health information technology III promoting 
2 
delivery of integrated care to such patients. 
3 
(4) Developing recommendations for a National Action Agenda, which 
4 
shall specify research, surveillance, health information technology, workforce 
5 
training, delivery of care, and communication activities required to collectively 
6 
address barriers to achieving integrated palliative care for seriously ill patients in 
7 
all care settings. Such agenda shall include strategies for reducing disparities 
8 
among medically underserved populations. 
9 
(e) Report. - Not later than one year after the last day of the Summit, the Secretary 
10 
shall submit to the Committee on Health of the House of Representatives and the 
11 
Committee on Health and Demography of the Senate a report on the recommendations 
12 
made by the participants of the Summit and shall make such recommendations available 
13 
to the public. 
14 
(£) Seriously III Patient Defined. - For purposes of this Act, the term "seriously ill 
15 
patient" means an individual who has a serious health condition. 
16 
(g) Authorization of Appropriations. - There is authorized to be appropriated to 
17 
carry out this Section such sums as are necessary for each of the fiscal years 2014 
18 
through 2018. 
19 
SECTION 3. Quality of Life Patient and Professional Awareness Grants Program 
20 
Initiative. -
21 
(a) In General. - Not later than six months after the date of the submission of the 
22 
report by the Patient-Centered Health Care and Quality of Life Stakeholder Strategic 
23 
Summit, the Secretary shall establish a national quality of life education and awareness 
24 
grants program initiative for seriously ill patients, families of such patients, and health 
25 
professionals who treat such patients for the purposes of encouraging an increased 
26 
demand for and delivery of integrated and patient-centered care for managing pain and 
4 


1 
symptoms of such patients and improving the quality of life of such patients. Under the 
2 
initiative, the Secretary shall, subject to paragraph (h), award competitive grants to 
3 
eligible entities described in paragraph (b) to develop new and expand existing 
4 
information, resources, and communication materials about symptom management and 
5 
other aspects of patient-centered care as an integral part of quality for serious illnesses 
6 
such as cancer; heart, renal, and liver failure; lung disease; and Alzheimer's disease and 
7 
related dementias. Such materials shall be presented in a variety of formats (such as 
8 
online, print, and public service announcement). 
9 
(b) Eligible Entities. - For purposes of this Section, an eligible entity includes 
10 
only a community health center, health profession school, chronic disease or cancer 
11 
center, academic medical center, physician practice, home health care agency, palliative 
12 
care or psychosocial care team (as defined in paragraph (g», hospice program, patient 
13 
non-profit organization (as defined in paragraph (g», clinical pastoral education program, 
14 
long-term care facility, faith community organization, or other public or private entity or 
15 
organization addressing patient-centered care and quality of life concerns of seriously ill 
16 
patients. 
17 
(c) Application. - To be eligible to receive a grant under this Section, an entity 
18 
sh,all submit to the Secretary an application at such time, in such manner, and containing 
19 
such information as the Secretary may require, including assurances that the entity will: 
20 
(1) evaluate programs carried out by the entity through a grant provided 
21 
under this section; 
22 
(2) submit to the Secretary a report on the findings of such evaluations; and 
23 
(3) coordinate the dissemination of such findings with the Secretary, 
24 
(d) Use of Funds. -- An entity awarded a grant under this Section shall use such 
25 
grant to carry out programs described in paragraph (e), for patients and families of such 
26 
patients that further the purposes described in paragraph (a). 
5 


1 
(e) Programs. - Programs described in this paragraph, for which a grant awarded 
2 
under this Section may be used, include programs to: 
3 
(1) navigate the health system, including assistance to patients with finding 
4 
health professionals to support quality of life needs, care decision-making and 
5 
coordination, and transitions across care settings; 
6 
(2) provide general advocacy on behalf of patients and survivors to provide 
7 
patients information to help them effectively communicate with health care 
8 
providers about pain, physical and psychosocial symptoms, and barriers they are 
9 
facing in adhering to curative or disease-directed treatments; 
10 
(3) encourage health professionals to request coordinated patient-centered 
11 
care consults for patients that are integrated alongside disease directed treatment in 
12 
various care settings; and 
13 
(4) collect and analyze data related to the effectiveness of the initiative 
14 
under paragraph (a). 
15 
(f) Priority. - In carrying out the grant program under this Section, the Secretary 
16 
shall give priority to applications that include an emphasis on addressing outreach efforts 
17 
for seriously ill patients who are among me'dically underserved popUlations and families 
18 
of such patients or health professionals serving medically underserved populations. Such 
19 
populations would include pediatric patients, young adult and adolescent patients, racial 
20 
and ethnic minority populations, and other priority populations specified by the 
21 
Secretary. 
22 
(g) Definitions. - For purposes ofthis Section: 
23 
(1) Psychosocial Care Team. - The term "psychosocial care team" means 
24 
health professionals focused on addressing social and emotional concerns of 
25 
serious illness, and may include professionals such as social workers, 
26 
psychiatrists, psychologists, nurses, child life specialists, teachers, chaplains, 
6 


· 
" 
I 
1 
spiritual counselors, physical and occupational therapists, nutritionists, integrative 
2 
medicine specialists, patient service coordinators, patient navigators, and patient 
3 
representatives. 
4 
(2) Patient Non-Profit Organization. -
The term "patient non-profit 
5 
organization" means a non-profit entity primarily engaged in raising funds for 
6 
health-related research, such as disease prevention, health education, and patient 
7 
services. 
8 
(h) Authorization of Appropriations. -
There is authorized to be 
9 
appropriated to carry out this Section such sums as are necessary. 
10 
SECTION 4. Professional Workforce Training Grants Program Initiative. -
11 
(a) Initiative. -
12 
(1) In General. - Not later than six months after the date of the submission 
13 
of the report by the Patient-Centered Health Care and Quality of Life Stakeholder 
14 
Strategic Summit, the Secretary shall establish a health care professional 
15 
workforce training grants program initiative for the purposes of promoting and 
16 
enhancing symptom assessment and management, communications skills, 
17 
coordinated patient-centered care, and other quality of life focused clinical core 
18 
competencies (as described in paragraph (2)) across all clinical specialties that 
19 
serve seriously ill patients and patients with multiple or complex chronic diseases, 
20 
such as patients with cancer; heart, renal, and liver failure; lung disease; and 
21 
Alzheimer's disease and related dementias. Under such initiative, the Secretary 
22 
shall, subject to paragraph (i), award competitive grants to eligible entities to 
23 
provide evidence-based training and develop new training for health professionals, 
24 
including physicians, nurses, social workers, and professional chaplains for the 
25 
purposes described in the previous sentence. 
7 


, 
I 
1 
(2) Quality of Life Focused Clinical Core Competencies Described. - For 
2 
purposes of paragraph (l), quality of life focused clinical core competencies 
3 
include, at a minimum, the assessment and management of physical, 
4 
psychological, and spiritual symptoms; establishment of patient-centered goals of 
5 
care; support to patient and family caregivers; and management of transitions 
6 
across care sites. 
7 
(b) Application. - To be eligible to receive a grant under this Section, an entity 
8 
shall submit to the Secretary an application at such time, in such manner, and containing 
9 
such information as the Secretary may require, including assurances that the entity will -
10 
(I) evaluate programs carried out by the entity through the grant provided 
11 
under this section; 
12 
(2) submit to the Secretary a report on the findings of such evaluations; and 
13 
(3) coordinate the dissemination of such findings with the Secretary. 
14 
(c) Use of Funds. -- An entity awarded a grant under this section shall use such 
15 
grant to carry out programs described in paragraph (d) to train health care professionals 
16 
described in paragraph (a)(1) for the purposes described in such subsection. 
17 
(d) Programs. - Programs described in this subsection, for which a grant awarded 
18 
under this section may be used, include programs to: 
19 
(I) enhance health professional communication skills in caring for seriously 
20 
ill patients and survivors, establishing goals of care, and tailoring treatments; 
21 
(2) improve health profession identification of patient populations that 
22 
benefit from coordinated palliative care and appropriate referral of patients for 
23 
consultations with specialized interdisciplinary palliative care teams; 
24 
(3) improve health professional skills in symptoms assessment and 
25 
management, developing comprehensive care coordination and discharge plans to 
8 


1 
support transitions across care settings, managmg patients with complex or 
2 
multiple chronic conditions, and preparing survivorship care plans; 
3 
(4) promote quality of life focused clinical core competencies (as described 
4 
in paragraph (a)(2)) across all clinical specialties serving seriously ill patients; 
5 
(5) provide technical assistance to hospitals and other care settings to 
6 
establish coordinated palliative care teams; 
7 
(6) create and expand coordinated palliative care leadership centers (as 
8 
defined in paragraph (f)); 
9 
(7) provide mentoring and training to health professionals; 
10 
(8) improve cultural sensitivity communication and patient care for 
11 
minority and medically underserved populations, including by addressing the 
12 
particular needs of children, adolescents, and families of such children and 
13 
adolescents; racial and ethnic groups; and other medically underserved patient and 
14 
survivor popUlations; and 
15 
(9) collect and analyze data related to the effectiveness of health 
16 
professional education and training efforts carried out pursuant to this section. 
17 
(e) Priority. - In carrying out the grant program under this section, the Secretary 
18 
shall give priority to applications that include an emphasis on addressing outreach efforts 
19 
for seriously ill patients who are among medically underserved populations and families . 
20 
of such patients or health professionals serving medically underserved popUlations. Such 
21 
populations would include pediatric patients, young adult and adolescent patients, racial 
22 
and ethnic minority populations, and other priority populations specified by the 
23 
Secretary. 
24 
(f) Palliative Care Leadership Center Defined. - For purposes of this section, the 
25 
term "palliative care leadership center" means a center: 
26 
(1) that trains hospital palliative care programs; 
9 


· 
I 
1 
(2) that provides intensive operational training and mentoring for palliative 
2 
care programs at every stage of development and growth; and 
3 
(3) that provides training oriented to teams rather than individuals, and 
4 
involves participation by teams of hospital and hospice health care professionals 
5 
involved in starting or running a palliative care program, including physicians, 
6 
nurses, social workers, administrators and financial managers. 
7 
(g) Authorization of Appropriations. - There is authorized to be appropriated to 
8 
carry out this Section such sums as are necessary for each of the fiscal years 2014 
9 
through 2019.' 
10 
11 
SECTION 5. Quality of Life Cross-Agency Advisory Committee. -
12 
(a) Establishment. -- Not later than 90 days after the date of the effectivity of this 
13 
Act and subject to paragraph (e), the Secretary shall establish a Quality of Life Cross-
14 
Agency Advisory Committee (here referred to as the "Advisory Committee") to advise, 
15 
coordinate, and assist the Department of Health in creating and conducting the national 
16 
quality of life education and awareness initiative and the health care professional 
17 
workforce training initiative and disseminate findings that have been identified from such 
18 
initiatives for cross agency implementation of best practices. 
19 
(b) Membership. - The Advisory Committee shall be composed of members who 
20 
shall be appointed by the Secretary and shall include representatives of: 
21 
(1) the Department of Health; 
22 
(2) public and private organizations with expertise in patient-centered care, 
23 
palliative care, psychosocial care, and symptom management and survivorship; 
24 
and 
25 
(3) such other representatives as the Secretary deems necessary. 
26 
(c) Duties. - The Advisory Committee shall: 
10 


, 
( • 
1 
(1) evaluate the results of the programs funded by the grants awarded under 
2 
this Act; 
3 
(2) coordinate and implement it cross-agency strategic plan, with respect to 
4 
the agencies specified in subsection (b), to disseminate findings from such 
5 
programs; 
6 
(3) advise the Secretary of Health on strategies for disseminating across 
7 
agencies specified in paragraph (b) recommendations from the National Action 
8 
Agenda; 
9 
(4) consider and summarize recent advances achieved in symptom 
10 
management and survivorship research relevant to the goals of this part and make 
11 
recommendations to the Secretary on gaps in basic, clinical, behavioral, or other 
12 
research required to achieve further improvements in care to support quality of life 
13 
and survivorship; 
14 
(5) develop a strategy for developing new and enhancing health 
15 
surveillance tools used to track symptoms, late effects, and quality care trends over 
16 
time, including national surveys of the overall population of the Philippines; and 
17 
(6) make appropriate updates and addendums annually to the National 
18 
Action Agenda. 
19 
(d) Meetings. - The Advisory Committee shall meet at least once a year. 
20 
(e) Authorization of Appropriations.-There are authorized to be appropriated to 
21 
carry out this Section such sums as are necessary for each of the fiscal years 2014 
22 
through 2019. 
23 
SECTIO,N 6. Enhancing Research in Support of Patient Quality of Life. -
24 
(a) In General. - The Secretary shall develop and implement a strategy to be 
25 
applied nationwide that is in accordance with recommendations of the Advisory 
11 


, , 
1 
Committee to expand national research programs in symptom management, palliative, 
2 
psychosocial, and survivorship care. 
3 
(b) Research Programs. - The Secretary shall expand and intensifY research 
4 
programs in symptom management and palliative, psychosocial, and survivorship care 
5 
and research programs that address the quality of life needs for the rapidly growing 
6 
population in the Philippines of seriously ill patient (with illnesses such as cancer; heart, 
7 
renal, and liver failure; lung disease; and Alzheimer's disease and related dementias). 
8 
9 
SECTION 7. Separability Clause. - If any provision or part hereof, is held invalid 
10 
or unconstitutional, the remainder of the law or the provision not otherwise affected shall 
11 
remain valid and subsisting. 
12 
SECTION 8. Repealing Clause. - Any law, presidential decree or issuance, 
13 
executive order, letter of instruction, administrative order, rule or regulation contrary to 
14 
or is inconsistent with the provision ofthis Act is hereby repealed, modified, or amended 
15 
accordingly. 
16 
SECTION 9. Effectivity Clause. - This Act shall take effect fifteen (15) days after 
17 
its publication in at least two (2) newspapers of general circulation. 
Approved, 
IfJdp22may2014 
12