a REPRESENTATIVES

Republic of the Philippines! LLECEIVED
HOUSE OF REPRESENTATIVES
Quezon City 10 AUG 2016

SEVENTEENTH CONGRES!
First Regular Session

House BillNo._ 2826 PESISTRATION UNT
BiLLS AND INDEX SERVICE

__Introduced by Representatives Estrellita B. Suansing and Horacio P. Suansing, Jr.

EXPLANATORY NOTE

Palliative and Hospice Care is a multidisciplinary care that improves the quality of life
of patients and their families who are facing problems associated with life-threatening
illnesses. It is an approach that provides terminally ill patients relief from suffering and upholds
the quality of life.

Palliative care, when first introduce in the country, mainly focused on cancer patients.
Through the years, other components of palliative care were gradually practiced, leading to its
recognition as a public health service. National and international government health care
policy documents identified palliative care as an integral component of care and support for
all patients who have the following conditions: cancer, end-stage renal disease (ESRD),
advanced heartlliver/respiratory diseases, dementia and AIDS.

Acknowledging the call of the World Health Assembly which recognized palliative care
as a core component of integrated, people-centered health services, and not an optional extra,
this bill aims to integrate hospice and palliative care into the structure and financing of the
Philippine health care system by:

(A) Strengthening and expanding human resources, including training of existing
health professionals, embedding palliative care into the core curricula of all new health
professionals, as well as educating volunteers and the public.

(B) Encouraging the development of home-based palliative and hospice care
programs at the grassroots level, which would increase the poor's access to quality health
service.

(C) Directing the PhilHealth to increase its present benefit package to include
inpatient palliative services, outpatient hospice care and home-based palliative care.

Moreover, the integration of palliative and hospice care into the Philippine health care
system would greatly reduce the burden on the family because they can somehow continue
with their daily lives with the knowledge that their loved one is being cared for by trained
professionals, with an assurance that said loved one is being given the most appropriate and
best care possible for pain and symptom management.

This bill has been filed during the 16" Congress and was approved on Third Reading
and is being re-filed for consideration in the 17" Congress. The passage of this measure is
earnestly sought.

ELLITA B. SUANSI

nomcigt UANSING, JR.
1" District, Nueva Ecija 2 Disffict, Sultan Kudarat

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
First Regular Session
2826

House Bill No.

“Introduced by Representatives Estrellita B. Suansing and Horacio P. Suansing, Jr.

AN ACT
INTEGRATING PALLIATIVE AND HOSPICE CARE INTO THE PHILIPPINE HEALTH CARE
SYSTEM

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

SECTION 1. Short Title. - This Act shall be known as the “Palliative and Hospice
Care Act.”

SECTION 2. Declaration of Policy. - The State guarantees the right of the people to
quality health care; ensuring that the health status of the people is to be made as good as
possible over the entire life cycle. As the Constitution mandates, an integrated and
comprehensive approach to health development 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 illnesses.

SECTION 3. Definition of Terms. — As used in this Act:

Palliative and hospice care refers to an approach that improves the quality of life of
patients with life threatening, complex and chronic illnesses or those experiencing
progressively debilitating diseases beyond any benefit from curative or definitive treatment,
regardless of life expectancy. The approach covers the prevention and relief of suffering by
means of early identification, assessment and management of pain and symptoms.

SECTION 4. Accreditation. - Hospitals, private hospice institutions, medical
practitioners, health workers, and social workers for palliative and hospice care shall be
accredited by the Department of Health (DOH). The DOH, in partnership with the National
Palliative and Hospice Care Council of the Philippines (Hospice Philippines, Inc.) shall
formulate the rules and guidelines for accreditation to ensure a standard quality of palliative
care services.

SECTION 5. Quality Assurance. - Key elements necessary to ensure quality
palliative care services in accredited hospitals and hospices include the following:

a. Adequate number of multi-specialty personnel;
b. Assured financing from health and custodial services;

c. Clear and practical standards for facilities and services;



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d. Appropriately designed and equipped facilities; and
e. Regular and systematic supervision and reporting to the DOH

SECTION 6. Mandatory Palliative Care and Hospice Services. — All government and
private hospitals shall provide palliative and hospice care services to patients with life-
threatening illnesses.

Hospitals are required to link with a referral and aftercare network that is organized
and made functional by all provincial, city and municipal governments under the guidance and
monitoring of the DOH.

Rural health units, health centers and health offices are required to develop a home-
based or near home palliative care program in coordination with government-owned and
privately-owned hospices in the local government units.

SECTION7. Leave Benefits. - Immediate family members or relatives who are
employed, whether in the public or private sectors, and are assigned by the family to provide
palliative and hospice care to a critically-il relative shall be allowed to use all existing leave
benefits granted by their employers subject to the guidelines on the use of said leave benefits,

SECTION 8. Education and Training of Health Care Professionals and Volunteers. -
The DOH, in partnership with the National Hospice and Palliative Care Council of the
Philippines and other accredited members, shall develop the education and training modules
for health care professionals and workers.

The Commission on Higher Education shall integrate courses on the principles and
practice of Palliative Care and Hospice Care into the curriculum of Medicine and Nursing, as
well as in all paramedical and allied health courses.0

SECTION 9. Continuing Research. - The DOH, in coordination with the Philippine
Council for Health Research and Development of the Department of Science and Technology,
shall ensure a continuing research and collection of data on palliative and hospice care and
availabilty of funds for this purpose.

SECTION 10. Program Implementor. - The DOH-Office for Technical Services, in
coordination with other offices of the Department, is hereby mandated to perform the following
functions:

a. Promote palliative care in the Philippines through advocacy and social
marketing;

b. Formulate policies and develop standards on quality palliative and hospice
care;

¢. Monitor the enforcement of standards and implementation of the program on
palliative and hospice care;

d. Mobilize and generate resources for sustainability of operation;
e. Network with international hospice associations;

f. Coordinate research undertakings with other institutions and agencies;


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g. Serve as repository of database for policy-making and maintenance of
palliative care registry;

h. Organize and develop continuing training programs for physicians, nurses,
physical therapists, and other professional health workers and volunteer
workers in the field of palliative care;

i. Serve as the coordinating center of a national palliative care network located in
the different regions of the country; and

j. Establish a Code of Ethics and standards in the practice of palliative care.

SECTION 11. PhilHealth Benefit Package. — Pursuant to this Act, the PhilHealth shall
increase its present benefit package to include inpatient palliative services, outpatient hospice
care and home-based palliative care.

SECTION 12. Funding Support. - All non-profit, DOH-accredited palliative and
hospice care institutions which are serving indigent patients shall qualify as institutional
beneficiaries under the Philippine Charity Sweepstakes Office (PCSO) Institutional Financial
Assistance Program; Provided, That the hospice care institutions comply with the
documentary and other requirements of the said Program.

SECTION 13. Tax Exemptions. - Any donation or bequest made to the DOH that is
intended for palliative and hospice care program shall be exempt from the donor's tax and the
same shall be considered as allowable deduction from the gross income of the donor, in
accordance with the provision of the National Internal Revenue Code of 1997, as amended:
Provided, That such donations shall not be disposed of, transferred or sold

SECTION 14. Appropriations. — The initial amount necessary to implement the
provisions of this Act shall be charged against the current year’s appropriation of the
Department of Health. Thereafter, such sums as may be necessary for the continued
implementation of this Act shall be included in the annual General Appropriations Act.

SECTION 15. Rules and Regulations. — Within sixty (60) days from the approval of
this Act, the Secretary of Health, after consultation with the National Palliative and Hospice
Care Council of the Philippines (Hospice Philippines, Inc.) shall promulgate the rules and
regulations implementing the provisions of this Act

SECTION 16. Separability Clause. - If any provision of this Act is held invalid or
unconstitutional, the other provisions not so declared shall remain in full force and effect.

SECTION 17. Repealing Clause. — All laws, executive orders, decrees, instructions,
issuances, rules and regulations contrary or inconsistent with the provisions of this Act are
hereby repealed or modified accordingly.

SECTION 18. Effectivity. — This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in a newspaper of general circulation.

Approved,