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

EIGHTEENTH CONGRESS
First Regular Session

5788

HOUSE BILL NO.

Introduced by Rep. CAMILLE A. VILLAR

AN ACT
INSTITUTIONALIZING AN EMERGENCY MEDICAL SERVICES SYSTEM,
PROVIDING FOR THE ESTABLISHMENT, SUPERVISION AND REGULATION
OF EMERGENCY MEDICAL SERVICES PROFESSION, AND APPROPRIATING
FUNDS THEREFOR

EXPLANATORY NOTE

The goal of this measure is to establish, institutionalize and strengthen an
emergency medical services system (EMSS) throughout the country. This is in view
‘of the Constitutional mandate for the state to adopt “an integrated and
comprehensive approach to health development...to make essential goods, health
‘and other social services available to all the people at affordable cost,” aligned with
the recently enacted law on universal healthcare.

EMSS would constitute the overarching policy framework governing the
provision of emergency medicine (EM) in each of the country’s Local Government
Units (LGUs). Emergency medicine is a specialized discipline in the medical field
focused on giving timely and coordinated health and safety services to victims of
sudden iliness or injury, prior to them reaching hospitals, health centers or other
brick-and-mortar healthcare facilities.

As a brief background, the Philippines was one of the earliest among
participating countries who officially recognized pre-hospital EM as a separate
discipline (1988) and instituted post-graduate EM exams (1990)! to recognize and
certify EM physicians and nurses. However, despite these early developments, EM in
the country has fallen behind, as a national society for EM was established only in

Pek, Jen Heng et al. 2016. “Emergency medicine as a specialty in Asia.” Acute Medicine & Surgery, 3: 65-73.
‘Accessible via http://onlinelibrary.wiley,com/doV/10,1002/ams2.154/abstract. [Accessed on June 20, 2017).


2011. According to data cited at the 2013 Asian Conference on Emergency Medicine,
the Philippines only has 3,300 recognized Emergency Medical Service (EMS)
personnel. And out of a reported 1,795 hospitals in the country, only 200 (or 11
Percent) can be considered “emergency hospitals"—that is, facilities that are capable
of providing quality EM care. This is especially alarming as, according to a World
Heaith Organization 2017 data, about 7,000 Filipinos die each year due to road
‘waffic accidents.

By mandating LGUs to establish emergency dispatch centers with adequate
and qualified personnel equipped with emergency transport vehicles like
ambulances, the country will take a big step forward and be able to save more lives.

The bill creates a National EMSS Advisory Committee, co-chaired by the
Department of Health (DOH) and the Department of Interior and Local Government
(DILG), shall be created to ensure the establishment of a nationwide EMS network.
The National Telecommunications Commission (NTC) is also called on to develop a
working system for a national emergency number, such as the 911 emergency
hotline rolled out under the Duterte Administration. The measure also stipulates that
each LGU, hospital and healthcare facility should have a minimum number of
positions for Emergency Medical Technicians (EMTs), the salaries of which should be
included in the annual financial requirements of their respective institutions.

The nation’s health care system remains a work in progress. The undersigned
believes that this measure will significantly contribute to the delivery of efficient
medical services to the people, and thus, earnestly seeks its swift passage.

UMA
‘CAMILLE A. VILLAR


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

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL No. _ 5738

Introduced by Rep. CAMILLE A. VILLAR

AN ACT
INSTITUTIONALIZING AN EMERGENCY MEDICAL SERVICES SYSTEM,
PROVIDING FOR THE ESTABLISHMENT, SUPERVISION AND REGULATION
OF EMERGENCY MEDICAL SERVICES PROFESSION, AND APPROPRIATING
FUNDS THEREFOR

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

CHAPTER I
GENERAL PROVISIONS

Section 1. Title. - This Act shall be known as the “Emergency Medical Services
System (EMSS) Act.”

Sec. 2, Declaration of Policy. - It is hereby declared the policy of the State to
protect and promote the right to health of the people and instill health
consciousness among them. Pursuant to this national policy, the government shall
institutionalize a comprehensive, accessible and integrated system of emergency
medical services.

Sec. 3. Objectives. — In support of State policy, this Act:

a) Mandates the development and institutionalization of EMSS at the national
and local levels;

b) Creates a national EMSS Advisory Committee;

©) Establishes the national standards for the provision of Emergency Medical
Services (EMS);

d) Ensures the provision of qualified EMS personnel;


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e)

f)

Mandates the adoption and use of a National Universal Emergency Number;
and

Establishes support services to emergency medical services.
Sec. 4. Definition of Terms. — For purposes of this Act, the following terms are

hereby defined:

a)

b)

°)

4)

e)

Accredited Training Institution refers to a training institution offering training
programs, courses and continuing education for EMS personnel that meet the
standards established by the EMS Advisory Committee in coordination with
physicians, Emergency Medical Technicians, nurses, and other health care
professionals, TESDA, and CHED, among others, and are duly registered in
good standing with the EMS Advisory Committee;

Automated External Defibrillator (AED) refers to a portable device that checks
the heart rhythm and can send an electric shock to the heart to try to restore
a normal rhythm. AEDs are used to treat sudden cardiac arrest (SCA);
Command and Control refers to the multi-faceted supervision or medical
oversight by the EMS medical director in handling the processes of EMS
operations that may affect patient care directly through provision of orders to
an EMS personnel over the radio, by phone, or on-scene; or indirectly through
the development and promulgation of protocols, the education and
credentialing of EMS personnel, the conduction of quality improvement
activities, and the increased advocacy of appropriate EMS for the patients;
Emergency Medical Dispatch refers to the immediate identification and
Prioritization of emergency situations, the timely dispatch of appropriate
resources, providing essential pre-arrival medical instructions and full
endorsement to the receiving hospital. Dispatch encompasses all aspects of
communication including request processing, coordination and support,
documentation and monitoring;

Emergency Medical Service Personnel refers to unique health care personnel
involved in the practice of pre-hospital care, which includes provision of
medical care, systematic coordination and transportation of patients with
medical direction. They may include Medical First Responder (MFR),


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Ambulance Care Assistants (ACA), Emergency Medical Technicians (EMT),
Paramedics, Emergency Medical Dispatcher (EMD) and EMS Medical Director;
Emergency Medical Services (EMS) refer to the network of services
coordinated to provide aid and medical assistance from the scene to the most
appropriate and definitive health facilities, involving personnel trained in
stabilization, transportation, and treatment of trauma or medical cases in the
pre-hospital setting;

Emergency Medical Services System (EMSS) refers to a comprehensive
system which provides the arrangement of personnel, facilities, and
equipment for effective, coordinated, and timely delivery of health and safety
services to victims of sudden illness or injury in the pre-hospital setting. The
conceptual framework of the system revolves around five components and
core services of pre-hospital management namely: Emergency Medical
Dispatch, Emergency Response and Care, Emergency Transport, Inter-agency
referral and Transport, and Command and Control;

Emergency Response and Care refers to the arrival of resources at the scene
and the timely initiation and provision of appropriate interventions;
Emergency Transport refers to transporting the patient to the most
appropriate and definitive health facility with continued provision of care and
appropriate interventions en route,

Emergency Medical Vehicles refer to an ambulance or other vehicles for
‘emergency medical care which provides, a minimum, (a) a driver's
compartment; (b) a patient compartment to accommodate an emergency
medical technician (EMT) and a patient so positioned that said patient can be
given intensive life-support during transit; (c) equipment and supplies for
‘emergency care at the scene as well as during transport; (d) two-way radio,
telephone or electronic communication with the primary medical services
provider, and when necessary, equipment for light rescue/extrication
procedures. The emergency medical vehicle shall be so designed and
constructed to provide the patient with safety and comfort, and avoid
aggravation of the patient's injury or illness; and


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k) Inter-Agency Referral and Transport refers to the transport of patient with
EMS personnel, if necessary, from one referring facility or agency to another
receiving facility or agency for definitive care, as the patient requires, in an
event that the services are not available in the referring facility.

CHAPTER IT
EMERGENCY MEDICAL SERVICES SYSTEM

Sec. 5. Emergency Dispatch. — This Act mandates local government units to
create their Dispatch Centers with adequate and qualified personnel. The Dispatch
Centers shall follow the prescribed guidelines on dispatch protocol.

Sec. 6. Emergency Response and Care. — This Act ensures the availability of
‘emergency transport vehicle or ambulance with qualified EMS personnel. Responders
shall follow the prescribed guidelines on emergency response and care.

Sec. 7. Emergency Transport. ~ This Act shall follow the prescribed guidelines
of the Department of Health on Ambulance Services. The Philippine Health Insurance
Corporation (PHIC) shall provide coverage for EMS subject to their policies and
guidelines.

Sec. 8. Inter-agency Referral and Transport. — This Act shall establish the
prescribed protocols / guidelines on inter-agency referral and transport.

‘Sec. 9. Command and Control. - This Act mandates the establishment of a
National Command Center with a functional Universal Emergency Number. All Local
Government Units shall establish their respective Command Centers with designated
qualified EMS medical director. Command Centers shall govern the EMS systems
based on the prescribed operational guidelines. The Command Center can be co-
located with the Dispatch Center.

CHAPTER III
NATIONAL EMSS ADVISORY COMMITTEE

Sec. 10. Creation of the National EMSS Advisory Committee. — The National
EMSS Advisory Committee is hereby created under the leadership of the Department
of Health (DOH) and the Department of Interior and Local Government (DILG).

Sec. 11. Membership of the EMSS Advisory Committee. - The members of the
EMSS Advisory Committee shall be composed of the Secretary of the DOH as


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Chairperson, and the Secretary of the Department of the Interior and Local
Government (DILG) as Co-Chairperson with the following:
a) Permanent Members —

i.
ii,
iii.
iv.

v.

‘The Chair of the Professional Regulation Commission (PRC);

The Secretary of the Department of Justice (DOJ);

The Secretary of the Department of Education (DEPED);

The Secretary of the Department of Transport (DOT);

The Secretary of the Department of Information, Communication and
Technology (DICT);

The Director of the National Telecommunication Commission (NTC);

The Secretary of the Department of National Defense (DND);

The Commissioner of the Commission on Higher Education (CHED);

The Director General of Technical Education and Skills Development
Authority (TESDA).

b) Members to be appointed by the Secretary of the DOH upon nomination by their
respective associations —

Two (2) nominees of a national organization representing the EMT
profession duly registered with the Securities and Exchange Commission
(SEC) and recognized by the DOH;
Four (4) nominees of HEMB, one (1) each from the National Capital
Region, Luzon, Visayas and Mindanao;
Two (2) registered emergency medical practitioners representing
Philippine College of Emergency Medicine (PCEM);
One (1) representative from the Philippine Red Cross.

‘Sec. 12. Term of Office. - Each member of the EMSS Advisory Committee

shall not serve for more than three (3) consecutive terms. A term shall be for a

period

of two (2) years.
Sec. 13. Functions, - To carry out its mandate, the EMSS Advisory Committee

shall exercise the following functions:

a)

Ensure the establishment of a system of networking & coordination among all
existing government health agencies, local government units (LGUs), private


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and non-government medical institutions for the effective implementation of

the bill;

b) Ensure the development of national standards for the provision of Emergency

Medical Services; and

c) Determine staffing, duties, qualifications, responsibilities, and functions of the

Secretariat.

Sec. 14. The Secretariat. - The EMSS Advisory Committee shall organize a
Secretariat headed by a person of probity and shall have at least five (5) years
experience in emergency medical services or a related field.

Sec. 15. Meetings. - The EMSS Advisory Committee shall meet at least once
every quarter and as needed.

CHAPTER IV
EMERGENCY MEDICAL SERVICES (EMS) PERSONNEL

Sec. 16. Creation of Positions for Emergency Medical Services (EMS)
Personnel. - This Act shall create a minimum number of positions for EMS personnel
especially Emergency Medical Technicians (EMTs) in the all local government units
and healthcare facilities, according to their context and needs. The annual financial
requirements needed to pay for the salaries and benefits of EMS personnel shall be
included in the annual general appropriations of the respective hospitals, agencies
and local government units.

Sec. 17. Authorized Training Institution. - Training programs, course, and
continuing education for Emergency Medical Technician may only be conducted in an
institution ha has been granted a Certificate of Program Registration (COPR) by
TESDA, in the case of technical non-degree courses falling under TESDA jurisdiction,
or a Certificate of Accreditation as a Higher Education Institution (HEI) as well as
Program Accreditation by CHED, in the case of degree programs falling under CHED
jurisdiction. The requirements prescribed by the EMSS Advisory Committee shall
serve as the minimum requirement for program registration. The DOH can provide
training programs for EMTs following the standards set by the EMSS Advisory
Committee.


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CHAPTER V
EQUIPMENTS AND SUPPORT SERVICES FOR EMS

Sec. 18. Emergency Medical Vehicles. - This Act shall follow the prescribed
guidelines of the Department of Health on the specification and equipage of an
Ambulance Service.

Sec. 19. Adoption of a National Universal Emergency Telephone Number. —
There shall only be one national emergency number to enable the public to access
emergency medical services (911). Towards this end, the National
Telecommunications Commission (NTC) shall develop a program for the adoption of
a national emergency number with the LGUs and officials responsible for emergency
service and public safety; the telecommunications industry (specifically including the
cellular and other wireless telecommunications service providers); the motor vehicle
manufacturing industry; emergency medical service providers; emergency dispatch
providers; transportation officials; public safety, fire service and law enforcement
officials; consumer groups; and hospital emergency and trauma care personnel
(including emergency physicians, trauma surgeons and nurses).

Sec. 20. Access to Automated External Defibrillators (AED). — This Act shall
mandate all government/public and private institutions, including malls, parks and
transport stations, to place at least one (1) automated defibrillator in their respective
areas of responsibility.

(CHAPTER VI
OTHER PROVISIONS

Sec. 21. Appropriations. ~ The Secretaries of the Departments concerned
shall include in their programs the implementation of this Act, the funding of which
‘shall be included in the annual General Appropriations Act.

Sec. 22. Separability Clause. - If any portion or provision of this Act is
subsequently declared invalid or unconstitutional, other provisions hereof which are
not affected thereby shall remain in full force and effect.

Sec. 23. Repealing Clause. - All other laws, acts, presidential decrees,
executive orders, presidential proclamations, issuances, rules and regulations, or
parts thereof which are contrary to or inconsistent with any of the provisions of this
‘Act are hereby repealed, amended, or modified accordingly.


1 Sec. 24. Effectivity. — This Act shall take effect fifteen (15) days after its
2. publication in the Official Gazette or in a newspaper of general circulation.
Approved,