f4'h Congress of the 
) 
3rd Regular Session 
) 
Republic of the Philippines ) 
SENATE 
Introduced by Senator Aquilino Q. Pimentel, Jr. 
EXPLANATORY NOTE 
Every year, cases of cancer, cardio vascular diseases and other life threatening 
illnesses are steadily increasing, leaving many families emotionally, spiritually and 
physically bruised and broken. Pain and anguish shatter the lives of families upon 
learning that their loved ones are afflicted with acute disease that can no longer be 
cured medically. Families can only hope for a miracle, as their loved ones hold on 
tightly to the precious thread of life. 
Patients with critical illnesses who suffer unbearable pain and sorrows, can only 
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 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 
illness. 
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 
an access to good health data, including, socioeconomic issues of palliative and end-of- 
life care, and the physical, mental and economic impact on the patients, their families 
and informal caregivers 
Furthermore, immediate family members or relatives who actually look after or 
take care of a critically-ill patient, shall be entitled to an appropriate care leave benefit of 
sixty (60) days a year with full pay, whether in public or private employment sector. 
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 
critically ill patients and their families, in order to alleviate their agony, and face life with 
hopeful equanimity even in the midst of pain. 


For the record, this bill was inspired by the innovative initiative of Canadian 
Senator Sharon Carstairs who pioneered on this work to help make life somehow 
pleasant for the people of her country up to the very last hours of their existence. It is 
my hope that we can replicate her noble intentions here in our country even if we have 
to start from modest beginnings and on tentative steps. 
Owing to its importance, prompt approval of this bill is earnestly recommended, 
u 4  
c 
. 
AQUlLlNO Q. PIMENTEL, JR. 


14'h Congress of the 
) 
3rd Regular Session 
) 
Republic of the Philippines ) 
Introduced by Senator Aquilino Q. Pimentel, Jr. 
AN ACT PROVIDING PALLIATIVE AND END OF LIFE CARE, 
APPRORIATING FUNDS THEREFOR AND FOR OTHER PURPOSES 
Be it enacfed by the Senafe 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 2009". 
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. 
2. 
3. 
4. 
5. 
6. 
Pain management; 
Support to terminally-ill patients to live as best as possible a comfortable life; 
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; 
Provide support and counseling to the families of terminally-ill patients, 
especially in times of distress and bereavement ; 
Integrate physiological, emotional and spiritual assistance to patients and 
their families 
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: 
1, 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 are 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) shall be allotted in 
the annual General Appropriations Act (GAA) for the next five (5) years 
starting from the enactment of this law; 
(2) The amount of Fifty million pesos (P50,000,000.00) shall be taken from 
the Philippine Amusement and Gaming Corporation (PAGCOR) fund at 
Five million pesos (P5,000,000.00) per month for ten ( I O )  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 (IO) 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 (al), 
(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. 
(d) Government-owned andlor 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; 
(9 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 concerned. 
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 I O .  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 Regulation. 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,