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

EIGHTEENTH CONGRESS
First Regular Session
269

House Bill No.

Introduced by DIWA Party-list Representative Hon. Michael Edgar Y. Aglipay

EXPLANATORY NOTE

It is the policy of the State to provide quality health services and facilities that is
available, affordable, and accessible to everyone. Section 11, Article XIII of the 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. xxx.”

The present condition of health care provision in the Philippines remains unimproved
and as reported by the World Health Organization in 2012, itis still true to this date, that- “in
general, quality of health services as measured by outcomes, population coverage,
effectiveness, and safety and other indicators is highly variable depending on geographic
location and social and economic factors. Highly urbanized metropolitan areas with higher
income levels tend to and are perceived to have better quality health service than the mainly
tural impoverished and often isolated communities where licensing standards are absent, and
accreditation rates are very low.”!

Various programs of the department of Health and the National government are still
inadequate to address the large disparities in health outcomes between the rich and poor,
resulting from economic and geographic barriers to health services. Hence, this representation
perceives the need to undertake critical reforms in improving the efficiency, effectiveness and
equity of the Philippine health care delivery such that every Filipinos across the country can
avail a comprehensive universal health care for all

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' Health Service Delivery Profile, Philippines 2012 compiled by the World Health Ll {_ of
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This Bill aims to address the persistent inequality and inequity in health care delivery
and access across the country. Specifically, the objective of this legislative measure is to close
the capacity gaps among of Regional Hospitals in terms of providing quality, efficient and
extensive medical diagnostic, treatment, :ehabilitation as well as prevention by providing an
upgrade of the physical and management infrastructure to create and institutionalize a Regional
Center of Excellence for Health Care thai provides world class quality medical services and
international standards accreditations across regions

With the foregoing considerations, this representation eamestly seek the approval of
this measure.

MICHAEL. EI Y/AGLIPAY
Represegtative, Party-list

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

SEVENTEENTH CONGRESS
Third Regular Session
269

House Bill No.

Introduced by DIWA Party-list Representative Michael Edgar Y. Aglipay

AN ACT

TO INSTITUTIONALIZE A STANDARD UPGRADE AND MODERNIZATION OF
REGIONAL HOSPITALS TO CREATE AND ESTABLISH REGIONAL CENTER
OF EXCELLENCE FOR HEALTH CARE

Be it enacted by the Senate and House of Representatives of the Republic of the Philippines in
Congress assembled:

SECTION 1. Short Title. This Act shall be known as “Institution of Regional Center of
Excellence for Health Care Act.”

SEC. 2. Declaration of Policy. It is the policy of the state shall to adopt an integrated
and comprehensive approach to health dev ‘elopment, which shall be available and accessible to
all the people at affordable cost. Towards this end, reforms shall be introduced and
implemented within the Philippine health delivery system that must be available, accessible
and affordable in order to achieve the common objective of universal health care for Filipinos

SEC. 3. Definition of Terms. As used in this Act, the terms enumerated below shall
have the following meaning’

(a) Anatomic and Clinical Pathology Laboratory System — shall refer to a laboratory
facility that provides the diagnosis of disease using laboratory testing of blood and
other bodily fluids, tissues, and microscopic evaluation of individual cells. The
laboratory testing shall cover the following areas:

1) Anatomic pathology, which includes histopathology, cytopathology,
and electron microscopy: and

2) Clinical pathology, which typically includes — Clinical Microbiology,

Clinical Chemistry, Hematology, Blood Bank, and Molecular
diagnostics or DNA testing

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(b) Angiogram — refers to a diagnostic procedure that outlines blood vessels, usually
arteries, in various areas in the body that is used to identify narrowing or blockages
in the arteries in the body

(©) Computed Tomography (CT) Scan ~ refers to an X-ray image made using a form of
tomography in which a computer controls the motion of the X-ray source and
detectors, processes the data, and produces the image. The detailed images of
internal organs are obtained by this type of sophisticated X-ray device can reveal
anatomic details of internal organs that cannot be seen in conventional X-rays.

(d) Dialysis ~ refers to the process of removing waste products and excess fluid from
the body. Dialysis is necessary when the kidneys are not able to adequately filter
the blood.

(©) Dialysis Facility System — refers to a facility that provides treatment for chronic
kidney disease.

( High Risk Pregnancy Unit (HRPU) ~ a unit in the hospital where women are
confined, with complications arising from pregnancy, whose treatment requires
constant supervision or further investigation and assessment. The unit is operated
by a staff of experts such as. but not limited to, perinatologists, obstetricians,
pediatricians, with the assistance, as needed, of other specialists. It is a fully
equipped obstetric ICU that can handle high risk cases and with a corresponding
high risk neonatal ICU (NICU) to handle high risk neonates

(g) Intensive Care unit (ICU) — a hospital unit in which patients requiring close
monitoring, continuous attention and intensive/critical care are kept. An ICU
contains highly technical monitoring devices and equipment and is staffed by
personnel trained to deliver critical care.

(h) Mammogram — refers to an X-ray test that produces an image of breast tissue on
film. This technique, called mammography, is used to visualize normal and
abnormal structures within the breasts

(i) Magnetic Resonance Imaging (MRI) ~ refers to a procedure that uses a strong
magnetic field and radio waves to create detailed images of the organs and tissues
within the body

(Medical Specialist — refers to a doctor of medicine that practices a specific branch
of medicine.

(k) Neonatal Intensive Care Unit (NICU) ~ a hospital unit containing a variety of
mechanical devices and special equipment for management and care of
premature/preterm and seriously ill newborns, The unit is staffed by a team of
neonatologists, other pediatric subspecialists, and nurses who are highly trained in
the management of medical and surgical conditions of the newbom.

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© Rehabilitation Care Facility System — refers to hospital facility that provides a
specialized medical care and/or rehabilitation services to injured, sick or disabled
Patients, which includes speecii therapy and physical rehabilitation

(m)Regional Government Hospital — refers to a hospital operated and maintained either
partially or wholly by the national government or by any department, division,
board or other agency thereof.

SEC. 4. Coverage. The provisions of this Act shall apply specifically and exclusively
to Regional Hospitals with service mandate of a general hospital and at least five hundred (500)
authorized bed capacity and identified by the Department of Health to have full operational
Potential to maintain and operate as a Center for Excellence on Health Care Facility that
provides affordable, quality, accessible and efficient hospital services and health care to the
general population throughout their respective regions

SEC. 5. Regional Hospital Modernization Program. Within five (5) years from the
effectivity of this Act, all the DOH identified Regional Hospitals under Section 4 of this Act
shall be upgraded to have a minimum functional capacity of a Regional Center of Excellence
for Health Care that is comparable to health care institution with a world class quality medical
services and international standards accreditations, such as but not limited to, Joint
Commission International, and the likes. In order to achieve this goal there shall be a Regional
Hospital Modernization Program to facilitate improvement and enhancement of the physical
facilities, equipment and instruments, and service delivery of all the DOH identified Regional
Hospitals, specifically —

a) Physical Facilities and Equipment and Instruments. At the minimum, all DOH
identified Regional Hospitals shall establish, operate and maintain the following
physical facilities, complete with the necessary equipment and instruments,
including but not limited to:

1. Isolation facilities;

2. General Intensive Care Unit

3. Neonatal Intensive Care Unit;

4. Surgical Facility/Maternal Facility

5. High Risk Pregnancy Unit;

6. Ambulatory Surgical Clinic

7. Anatomic and Clinical Laboratory:

8. Blood Station;

9. Dialysis Facility;

10. Physical Medicine and Rehabilitation Facility;

11. Radiologic Facilities, such as, X-Ray, CT Scan, Mammogram, MRI, ECG,
Angiogram, Ultrasound and others;

12. Psychiatry Facility
13, Nuclear Medicine Facility; and

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14, Other necessary medical facilities as may be identified by the Department of
Health.

b) Support Staff. All the facilities enumerated in Section 5 (a) must have competent
and trained staff, nurses, therapists, medical technicians and/or other ancillary and
support staff that can perform the highly specialized procedures required in the
above mentioned facilities. Required plantilla positions for the said professional
health care services for the respective regional hospitals are hereby created to
conform and to be commensurate to the requirements of the facilities and services
offered of the Regional Hospital

©) Service Delivery. All DOH identified Regional Hospitals shall offer the services
for all kind of illnesses, diseases, injuries or deformities. It shall have
certified/eligible medical specialists, to facilitate timely, efficient, affordable and
accessible, diagnosis and treatment. Plantilla positions for the required medical
specialists are hereby created for the following areas:
1. Clinical Services
a Family Medicine
b. Pediatrics:
©. Internal Medicine
d. Obstetrics and Gynecology: and
e. Surgery;
2. Emergency Services;
3. Atleast one Medical specialist on the following areas:
Pulmonology:
Cardiology;
Urology;
Pulmonology;
Neurology
Pathology
Oncology
Psychiatry
Rehabilitation Medicine; and
j. Other specialists as recommended by the Department of Health.

d) Teaching and/or training hospital. Within three (3) years from the effectivity of
this Act all the DOH identified Regional Hospitals must be expanded to be
Teaching and/or training hospital a with accredited residency training program
for physicians in the four (4) major specialties namely: Medicine, Pediatrics,
Obstetrics and Gynecology, and Surgery.

ze me ees ep

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SEC. 6. Creation of Regional Hospital Modernization Commission. There is hereby
created a Regional Hospital Modernization Commission, hereinafter referred to as the
Commission, which shall be attached to the Department of health (DOH), which shall function
as the implementing body for the proper execution and for policy and coordination of the
Regional Hospital Modernization Program.

‘The Commission shall be composed of (7) members, to wit: the Secretary of the
Department of Health as ex officio chairman, a vice-chairman to be appointed by the President
of the Philippines, a representative from the Philippine Medical Association (PMA); two (2)
representatives from other health professionals; a representative from the Private Hospitals
Association of the Philippines (PHAP) and the Executive Director of the Commission
Secretariat, all to be appointed by the President of the Philippines upon recommendation
Secretary of the Department of Health to be made on the basis of the list of nominees submitted
of their respective organizations and who shall serve for a term of five [5] years. The Executive
Director of the Commission Secretariat shall also be a member of the Commission.

‘The Commission shall be assisted by a Secretariat to be headed by an Executive
Director and two [2] Deputy Directors, who shall be appointed by the President of the
Philippines, upon recommendation of the Secretary of the Department of Health

‘The Executive Director shall have the same rank, salary, benefits and other emoluments
as that of a Department Assistant Secretary, while the Deputy Directors shall have the same
rank, salary, benefits and other emoluments as that of a Bureau Director. The members of the
Commission representing the PMA, other health professionals and PHAP shall have the same
rank, emoluments, allowances and other benefits as those of a Regional Hospital Director."

SEC. 7. Powers and Functions of the Commission. - The Commission shall have the
following powers and functions

(a) To act as the national consultative and advisory body to the Department of Health
‘on matters relating to the Regional Hospital Modernization Program;

(c) To prescribe rules and criterion for the determination of the regional hospitals that
will be included in the program:

(b) To formulate policies and guidelines on the required upgrade and modernization of
the physical facilities, procurement of equipment and instruments, hiring and training
medical specialists, nurses, therapist, technicians and other ancillary and support staff:

(A) To study the upgrading and modemization plan and to determine if these are in
accordance with the objective to create a health care facility with a world class quality
medical services and international standards accreditations;

(e) To undertake studies, researches and surveys necessary for the attainment of its
functions and objectives, and to collect and compile data on the latest developments in
the health care industry;

(g) To exercise technical and administrative supervision over the DOH identified
Regional Hospital during the upgrade and modemization program and until the
Regional Hospital becomes self-sulficient and self-sustaining;

(i) To exercise such powers and functions as may be necessary to implement this Act.

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SEC. 8. Inventory/Audit of Regional Hospitals. An inventory/audit of the physical
facilities, equipment and instruments as well as the personnel of the Regional Hospitals shall
be conducted within Six (6) months from the promulgation of the implementing rules and
regulations of this Act, to determine the present classification of the respective regional
hospitals based on their functional capacity. The result of the audit and inventory shall be the
basis of the respective upgrade and modemization plan for each DOH identified Regional
Hospitals. Priority shall be given to the regional hospital that requires the most upgrade.

SEC. 8. Appropriations. ‘The Secretary of Health shall immediately include in the
Department of Health's priority the Regional Hospital Modernization Program, the funding of
which shall be included in the annual General Appropriations Act

SEC. 9. Jmplementing Rules and Regulations. The Department of Health (DOH) shall
promulgate the implementing rules and regulations as may be necessary to carry out the
provisions of this Act.

SEC. 10. Separability Clause. If any provision of this Act shall be held unconstitutional
or invalid, the remaining provisions which are not affected thereby shall continue to be full
force and effect.

SEC. 11. Repealing Clause. All laws, decrees, executive orders, rules and regulations,
and other issuances, or parts thereof, contrary to or inconsistent with this Act are hereby
modified, amended or repealed accordingly

SEC. 12. Effectivity. This Act shall take effect fifteen (15) days after its publication in
the Official Gazette or in at least two (2) newspapers of general circulation.

Approved,

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