Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SIXTEENTH CONGRESS
First Regular Session

House Bill No. 2649

Introduced by Representatives
DIOSDADO MACAPAGAL ARROYO and GLORIA MACAPAGAL ARROYO

AN ACT
PROVIDING PALLIATIVE AND END-OF-LIFE CARE, APPRORIATING FUNDS
THEREFOR AND FOR OTHER PURPOSES

EXPLANATORY NOTE

Cases of cancer, cardio vascular diseases and other life threatening illnesses are
steadily increasing every year which leave many families emotionally, spiritually and
physically drained. Pain and anguish shatter the lives of families upon news of loved
ones afflicted with an acute disease that can no longer be cured medically. Most
families hope for a miracle as their loved ones hold on tightly to the precious thread of
life.

Patients with such critical illnesses suffer unbearable pain and sorrows and often
rely on the sympathy and indefatigable assistance of their families, relatives, doctors,
nurses and others in allied health sciences, to make the remaining days of their lives
bearable

This proposed bill was inspired by the innovative initiative of Canadian Senator
Sharon Carstairs who pioneered on this work to help make life more pleasant for the
people of her country up to the very last hours of their existence. It is our hope that we
can replicate her noble intentions in our country even if we have to start from modest
beginnings and on tentative steps.

This bill proposes that all government and private hospitals and health centers
shall provide palliative care and end-of-life services to all patients with life-threatening


illnesses. Provinces, cities, municipalities and barangays shall establish community-
based hospice units and palliative care centers in every barangay in their respective
jurisdiction.

Likewise, this legislative measure provides that there shall be continuing
research and collection of data on palliative and end-of-life care. The public shall have
access to good health data, including, socioeconomic issues of palliative and end-of-life
care, and the physical, mental and economic impact on patients, their families and
informal caregivers.

Furthermore, immediate family members or relatives who actually look after or
take care of a critically-ll patient, shall be entitled to an appropriate care leave benefit of
sixty (60) days a year with full pay, whether employed in the public or private sectors.

A Palliative Care Trust Fund is hereby established exclusively for the financial
support and assistance for the medical needs of indigent patients.

It is the fervent goal of this bill to provide legislated support and assistance to
ctitically-ill patients and their families, in order to alleviate their agony, and face life with
hopeful equanimity even in the midst of pain.

Given the importance of the reasons cited above, prompt approval of this bill is
earnestly requested.

nosourdlt Non ARROYO ee ARROYO.

Second District, Camarines Sur Second District, Pampanga


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SIXTEENTH CONGRESS
First Regular Session

House Bill No,_ 2549

Introduced by Representatives
DIOSDADO MACAPAGAL ARROYO and GLORIA MACAPAGAL ARROYO

AN ACT
PROVIDING PALLIATIVE AND END-OF-LIFE CARE, APPRORIATING FUNDS
THEREFOR AND FOR OTHER PURPOSES

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

SECTION 1. Title. - This Act shall be known as "The Palliative and End-of-Life
Care Act of 2013."

SECTION 2. Declaration of Policy. ~ The State guarantees the right of the people
to quality health care. It is likewise mandated by the Constitution to adopt an integrated
and comprehensive approach to health development which shall endeavor to make
essential goods, health and other social services available to all people at affordable
cost even to patients suffering from life threatening and degenerative diseases. The
services aim to improve the quality of life of the patients and their families, and as far as
practicable, alleviate their physical, emotional, psychosocial, and spiritual distress

Palliative care and end-of-life services include, but not limited to the following:
1) Pain management;

2) Support to terminally-ill patients to live as best as possible a comfortable life;


3) Prolong as far as practicable, the life span of critically-ill patients through
therapies, such as chemotherapy, radiation, and other natural or alternative
methods of healing;

4) Provide support and counseling to the families of terminally-ill patients,
especially in times of distress and bereavement

5) Integrate physiological, emotional and spiritual assistance to patients and their
families

8) Enhance the quality of life of the patients and their families.

SECTION 3. Mandatory Palliative Care and End-of-Life Services. ~ All
government and private hospitals and health centers shall provide palliative care and
end-of-life services to all patients with life-threatening illness. Provinces, cities and
municipalities shall jointly establish community-based hospice units and palliative care
centers in their respective jurisdiction

SECTION 4. Education and Training of Health Care Professionals and
Volunteers. — Physicians, nurses, midwives, social workers, pharmacists, occupational
therapists, nutritionists, private volunteers, caregivers, or members of religious
community shall undergo multi-disciplinary education and specialized training with
respect to an integrated and coordinated approach towards palliative and end-of-life
care support services.

SECTION 5. Continuing Research. - There shall be a continuing research and
collection of data on palliative and end-of-life care. The public shall have access to
good health data, including, socioeconomic issues of palliative and end-of-life care,
including the physical, mental and economic impact on the patients, their families and
informal caregivers.

SECTION 6. Compassionate Care Leave Benefits. - Notwithstanding any law,
rules and regulations to the contrary, immediate family members or relatives who
actually look after or take care of a critically-ill patient, shall be entitled to a
compassionate care leave benefit of sixty (60) days a year with full pay, whether in
public or private employment sector.

Employees availing of this leave privilege shall submit to their employers the
following:

4, Name of patient - relative undergoing palliative treatment;
2. Copy of Medical Abstract of the patient-relative:

3. A Certification from the hospital or hospice providing palliative services to a
critically-ill patient, and


4. The nature of the care that is required of them under the circumstances.

SECTION 7. Disqualification from Leave Benefits. - The following employees
shall not be allowed to avail of this leave:

1. Those who are absent from work without official leave;
2. Those who are on vacation, sick, forced or study leave:

3, In times of emergency, those whose services are necessary to prevent loss of
life or damage to property, brought about by serious accidents, fires, floods,
typhoons, earthquake, epidemic or other disasters.

SECTION 8. Establishment of Palliative Care Trust Fund. - A Palliative Care
Trust Fund, hereafter referred to as the Fund, is hereby established exclusively for the
financial support and assistance for the medical needs of indigent patients. Indigent
patient who needs palliative and end-of-life care who has no money or property
sufficient and available for food, shelter and basic necessities for him and his family,
shall be eligible for assistance in payment for the palliative care treatment

The Fund shall be subject to the following;
(a) The contribution to the Fund shall be sourced from the following:

(1) The amount of Fifty million pesos (P50,000,000.00) shalll be allotted in
the annual General Appropriations Act (GAA) for the next five (6) years
starting from the enactment of this law;

(2) The amount of Fifty million pesos (P50,000,000.00) shalll be taken from
the Philippine Amusement and Gaming Corporation (PAGCOR) fund at
Five million pesos (P5,000,000.00) per month for ten (10) months;

(3) Another amount of Fifty million pesos (P50,000,000.00) shall be taken
from the Philippine Charity Sweepstakes Office (PCSO) at Five million
pesos (P5,000,000.00) per month for ten (10) months;

(4) Ten percent (10%) of the health budget of all local government units
shall be contributed annually to such fund.

(b) Only the interest drawn from the Fund from sources cited in Section 9 (a1),
(a2) and (a3) shall be awarded as grants to qualified patients;

(c) The grants can be awarded only after one (1) year from the organization of
the Fund


(4) Government-owned and/or controlled corporations are authorized to give
grants to the Fund at their discretion;

(e) Private donations and other conveyances including funds, materials, property
and services, by gratuitous title are also allowed and encouraged under this Act;

(f) Contributions to the Fund shall be exempt from the donor's tax and the same
shall be considered as allowable deductions from the gross income of the donor,
in accordance with the provisions of the National Internal Revenue Code of 1997,
as amended.

SECTION 9. The Palliative Care Assistance Board. — There is hereby created for
every province, city or municipality a Palliative Care Assistance Board hereinafter
referred to as the Board. The Board shall be composed of five (5) members who shall
be Chaired by the Governor or the Mayor of the local government concemed.

The other four (4) members of the Board shall be composed of: (1) a
representative from the Department of Health; (2) the Chair of the Committee of Health
of the Sangguniang concerned; (3) a representative of the opposition party or parties in
the Sangguniang concerned; and (4) a representative of the families or family
organizations mentioned in Article XV (3 [4]) of the Constitution

The members of the Board shall serve for a term of three (3) years: Provided,
That no member shall serve for more than (2) consecutive terms

The members of the Board shall serve and continue to hold office until their
successors shall have been appointed and qualified. Should the private representative
member of the Board fail to complete his or her term, the successor shall be replaced
by the families or family associations mentioned above only for the unexpired portion of
the term.

No person shall be appointed to the Board unless he or she is a citizen of the
Philippines, at least thirty (30) years of age, and of good reputation and probity.

The members of the Board shall receive such per diems and allowances as may
be authorized for every meeting actually attended and subject to pertinent laws, rules
and regulations.

For the sound and judicious management of the Fund, the PCAB shall appoint a
government financial institution, with a sound track record on fund management, as
portfolio manager of the Fund, subject to guidelines promulgated by the PCAB; and

The PCAB shall prepare the implementing guidelines and decision-making
mechanisms, subject to the following


(1) No part of the seed capital of the Fund, including earnings thereof,
shall be used to underwrite overhead expenses for the administration; and

(2) There shall be an external auditor to perform an annual audit of the
Fund's performance

SECTION 10. Accreditation of Private Hospices. - The Department of Health
with the participation of the duly authorized member of families or family associations
mentioned in Article XV (3 [4]) of the Constitution shall promote the rules and guidelines
for the accreditation of private hospices providing palliative and end-of-life care to
patients to ensure standard quality services.

SECTION 11. Implementing Rules and Regulations. — Within ninety (90) days
from the effectivity of this Act, the rules and regulations necessary to effectively
implement its provisions shall be promulgated by the Department of Health with the
assistance of the duly authorized representative of the families or family associations
mentioned in the Constitution.

SECTION 12. Appropriations. — For the initial implementation of this Act, the
amount of One Hundred Million pesos (Php100,000,000,.00), in addition to the budget
of the Department of Health, is hereby allotted. The amount shall be equitably allotted
to the provinces, cities and municipalities to start the implementation of this Act.
Thereafter, such sum as may be necessary for its continued implementation shall be
included in the annual General Appropriations Act and shall be apportioned accordingly

SECTION 13. Repealing Clause. - All laws, executive orders, rules and
regulations or any part thereof inconsistent herewith are deemed repealed, modified or
amended accordingly.

SECTION 14, Separability Clause. — In case any provision of this Act is declared
unconstitutional or invalid, the other provisions hereof which are not affected thereby
shall continue in full force and effect.

SECTION 15. Effectivity. - This Act shall take effect fifteen (15) days after its
publication in two (2) national newspapers of general circulation:

Approved,