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| HOUSE OF REPRESENTATIVES

Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

pare: 10 AUG 201
tive Lp

| RECEIVED

SEVENTEENTH CONGRESS
First Regular Session

2816

House Bill No.

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

EXPLANATORY NOTE

As of the 2011 data of the Bureau of Local Health Development, Department of
Health, there are 219,433 active Barangay Health Workers (BHWs) in the entire archipelago.
Given the enormous number of BHWS, it is but a cogent proof that BHWs are indispensible
in the delivery and promotion of primary health care programs of our government. It is also
rightful to say that BHWs are the ones working on the grassroot level for community profiling
thus, directly dealing with the smallest unit of our society, which is the family.

These 219,433 BHWs are working full time in our communities, and yet, they are
regarded and treated as mere volunteers under Republic Act No. 7883, entitled “The
Barangay Health Workers’ Benefits and Incentives Act of 1995", Although R.A. No. 7883
provides for an opportunity for BHWs to obtain second grade eligibility, the process of
arriving thereat seems unattainable, if not impossible. Consequently, numerous factors
placed BHWs to economic oppression and human exploitation.

Economic oppression: While the government is mindful that BHWs are volunteers, it
is unmindful that being a BHW is their bread and butter. Perforce, the nature of their work is.
fulltime. BHWs are receiving an allowance ranging from P1,000.00 to 6,000.00. This
allowance is their only source of living, sans fixed income, benefits and incentives.

Human exploitation: It is an uncontroverted fact that BHWs are at the mercy of local
government officials, due to the absence of security of tenure. Their continuous work is
dependent 0 the political support they rendered to the incumbent official. BHWs are being
terminated whimsically and capriciously by the local officials when their political pledge
belongs to another. Thus, in the case of Albana, et. al. vs. Belo, et. al., G.R. No. 158734, it
was held:

“XXX = Xxx x x x Exhibit J details how the
armed Civilian Volunteer Organization (CVO) and
Barangay Health Workers (BHW) were effectively
used by respondents to enhance their chances of
winning.”

All the foregoing predicaments facing BHWs are defeating the very mandate
enunciated in Section 1, Article Ill of our Constitution on right to life or right to a good life and
right to property or right to a decent work with corresponding decent pay, to wit: "No person



shall be deprived of life, liberty or property without due process of law, nor shall any person
be denied the equal protection of the law."

After 23 years of being caged in the shadows of volunteerism, it is now high time to
revisit, revise and repeal R.A. No. 7883 of 1995 in order to make the BHW a key player
towards the attainment of inclusive economic growth through sustainable human
development.

In view of the foregoing, the passage of this bill is earnestly sought.

ELLITA B. SUAN!
1* District, Nueva Ecij

IG HORACI UANSING, JR.
2 Distrit, Sultan Kudarat

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
First Regular Session

2816

House Bill No.

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

AN ACT
INSTITUTING REFORMS TO PROMOTE AND PROTECT THE SOCIO-ECONOMIC, AND
POLITICAL RIGHTS AND WELL-BEING OF COMMUNITY HEALTH WORKERS
TOWARDS EFFICIENT HEALTH SERVICES DELIVERY, REPEALING FOR THE
PURPOSE REPUBLIC ACT NO. 7883, OTHERWISE KNOWN AS THE BARANGAY
HEALTH WORKERS’ BENEFITS AND INCENTIVES ACT OF 1995, AND
APPROPRIATING FUNDS THEREFOR

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 “Community Health
Workers and Services Reform Act.”

SECTION 2. Declaration of Policy. ~ It is hereby declared the policy of the State
to promote a just and dynamic social order that will ensure prosperity and independence of
the nation and free the people from poverty through policies that provide adequate social
services, promote full employment, a rising standard of living, and an improved quality of life
for all. The State recognizes that quality health care services promote social justice in all
phase of national development.

The State further protects and promotes the right to health of the people and
provides conditions of health empowerment, where each individual has access to
information and services that will bring about health and well being. Primary Health Care
(PHC) is recognized as the major strategy towards health empowerment emphasizing the
need to provide accessible, available and affordable quality health services through
community-based participatory strategies.

Towards this end, the government and all its instrumentalities recognize the
economic and social rights of community health workers to just compensation, consistent
with the principle of equal pay

SECTION 3. Definition of Terms. — As used in this Act, the following terms shall
mean:

(a) Community Health Worker (CHW) refers to a support public health worker as
defined and covered by Republic Act No. 7305 entitled "Magna Carta of Public

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1 Health Workers”. It includes, but is not limited to, those who render primary health

2 care (PHC) services, nutrition services, population services an environmental
3 health services;

4 (b) Primary Health Care (PHC) is an essential health care made universally
5 accessible to individuals and families in the community through their full
6 Participation and at a cost that the community and country can afford to maintain
7 at every stage of their development in the spirit of self-reliance and self-
8 determination. It forms an integral part both of the country’s health system, of
9 which it is the central function and main focus, and of the overall social and
10 economic development of the community, characterized by partnership and
u empowerment of the people by means acceptable to them. It is the first level of
2 contact of individuals, the family and community with the national health system
3 bringing health care as close as possible to where people live and work, and
14 constitutes the first element of a continuing health care process;

15 (c) Public Health Workers (PHW) refer to persons who are engaged in health and
16 health-related work, and all persons employed in all hospitals, sanitaria, health
v7 infirmaries, health centers, rural health units, barangay health stations, clinics and
18 other health-related establishments owned and operated by the government or its
19 political subdivisions with original charters and shall include medical, allied health
20 professionals, administrative and support personnel employed regardless of their
21 employment status, as pursuant to Section 3 of Republic Act No. 7305, otherwise
2 known as the Magna Carta of Public Health Workers;
23 SECTION 4. Barangay Health Center (BHC). - There shall be one (1) Barangay

24 Health Center (BHC) in every barangay unit: Provided, That additional BHCs may be
25 constituted on the basis of population, terrain, demographic, geography or need of the
26 community. Each BHC shall have the following basic and essential facilities and provisions:

7 (a) Adequate lighting and ventilation;
28 (b) Adequate supply of potable water and electricity;

29 (0) Floor area of at least twenty-five (25) square meters;

30 (d) Equipments including, but not limited to, blood pressure apparatus, dressing kit,
31 over-the-counter medicines, weighing scale for infants and adults, thermometers,
32 standard operating procedure manual from the Department of Health (DOH),
33 glucometer and delivery kit;

34 (e) Examining area which must be enclosed, with bed, cabinet, foot stool and stool;
35 (f) Consultation area with table, cabinet and two (2) chairs;

36 (g) Toilet with sink and running water; and

37 (h) Birthing area with delivery equipment, as may be required and determined by the
38 community.

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SECTION 5. Functions of the Barangay Health Center. - The BHC shall be
primarily responsible for the delivery of public health services in the community level. Each
BHC shall have the following functions, in both regular/normal and emergency situations:

(2) Delivers basic and primary health care services for the community such as, but
not limited to the following: immunization, pre- and post-natal check-up,
assessment and monitoring of well and ill infants;

(b) Provides services for uncomplicated deliveries, as may be determined and
required by the community;

(c) Provides nutrition services that include growth monitoring and promotion, infant
and young child feeding, counseling, micronutrient supplementation, and
supplementary feeding;

(4) Coordinates efforts and actions of the different members of the health team;
(e) Keeps records of health indices, community profile and other data;

(f) Surveys and updates a family health profile through a comprehensive population
database;

(g) Provides support to the population management program of the government
specifically family planning, such as modern methods including natural and
artificial methods;

(h) Monitors and maintains the standards of water safety, air pollution, sewerage,
solid waste management, ensures environmental health in the community and
coordinates, reports and alerts the Rural Sanitary Inspector (RSI) of the same;

(i) Serves an area of congregation for meetings of the health team;
(Serves as a training ground of future and present members of the health team;

(k) Assists and coordinates with the respective local government units (LGUs) and
appropriate offices on first aid and procedures in disaster risk reduction;

() Advocates for community well-being, in terms of health, nutrition, population and
environmental, among others;

(mm)Monitors and reports on community mental health; and

(n) Performs such functions and duties as may be necessary to carry out the
provisions of this Act.

SECTION 6. Referral System. - The BHC shall observe and follow the two-tiered
referral system framework of Primary Health Care as determined by the DOH.

SECTION 7. Community Health Team (CHT). - The BHC shall be composed of
Nurse, Midwife, and CHWs. The operation and functioning of the BHC shall be headed and
supervised by a Nurse

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Each BHC shall be manned by a CHT duly supervised by the DOH and the local
health board proportionate with the existing population in the barangay:

(a) Nurse — There shall be at least one (1) nurse for every barangay with a
population not exceeding five thousand (5,000);

(b) Midwife - There shall be at least one (1) midwife for every barangay with a
population not exceeding two thousand five hundred (2,500);

(c) CHW — There shall be at least one (1) CHW for every barangay with a population
not exceeding five hundred (500): Provided, That the CHWs in the barangay shall
be composed of at least one (1) worker in each field, to wit: primary health care
services, nutrition services, population services, and environmental services.

SECTION 8. Qualifications of CHW. — All CHWs must be a resident of the
community where they are assigned: Provided, That any of the following requirements, as
the case may be, has been complied with:

(a) Any person who has completed the Technical Education and Skills Development
Authority (TESDA) CHW program or have undergone training specific for CHW
by a TESDA-accredited institution: Provided, That he or she has passed the
training assessment and obtained the equivalent national certification; or

(b) All existing CHW, regardless of accreditation or registration status, who have
served for at least two (2) years upon the effectivity of this Act must undergo
CHW assessment by TESDA-accredited assessors and pass the equivalent
national certification.

Only those who have obtained the equivalent national certification shall be eligible for
‘employment.

SECTION 9. Hiring of CHW. - The Local Government Selection and Promotion
Board, jointly with the Civil Service Commission Regional Office (CSCRO), shall process the
hiring of the Community Health Team personnel, pursuant to existing Civil Service rules,
regulations, issuances and orders on placement and hiring: Provided, That, all existing
CHWs, upon the effectivity of this Act, who have met the qualifications under Section 8 (b) of
this Act shall be given preference in hiring and priority in placement.

The Civil Service Commission (CSC), Department of Interior and Local Government
(DILG), LGUs, DOH, NNC, and other concerned government agencies, as the case may be,
with the participation of various health union representatives, shall formulate and provide
effective mechanism for the selection and hiring of CHWs.

SECTION 10. Duties and Responsibilities of the CHW. — The Community Health
Workers shall, independent of each other, perform the following duties and responsibilities:

(a) Primary Health Care Services Worker:
(1) Height and weight monitoring and reporting the same to the BHC;

(2) Monitoring and following-up on defaulters, and reporting the same to the
BHC;

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(3) Reporting to the BHC any incidence of disease or any health cases in the
‘community;

(4) Communicating and coordinating with the community to participate in
BHC activities;

(5) Gathering data about the health of the community, filing, encoding and
reporting the same to the BHC;

(6) Administering first aid;
(7) Conducting health visits; and

(8) Responding in natural calamities and disasters.

(b) Community Nutrition Worker:

(1) Growth monitoring and promotion;

(2) Infant and young child feeding program;
(3) Nutrition counseling;

(4) Micronutrient supplementation; and

(5) Supplementary feeding.

(c) Community Population Worker:

(1) Family health profiling through a comprehensive population database; and

(2) Support the population management program of the government
specifically family planning, such as modern methods including natural
and artificial methods.

(d) Environmental Health Worker:

(1) Standards of water safety monitoring and maintenance;
(2) Air pollution monitoring;

(3) Sewerage preservation;

(4) Solid waste management;

(6) Ensure environmental health in the community; and

(6) Coordination with the Rural Sanitary Inspector (RSI).

The CHW shall perform the following duties and responsibilities assistive to the
Community Health Team:

(a) Sputum collection;

(b) Identifying people with disease and sickness;

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(0) Health community profiling;
(d) Psychosocial debriefing for stress and post-calamity initiatives; and
(e) Strengthening the health programs of the government.

SECTION 11. Compensation of the CHW. — The entry pay level of a CHW shall be
equivalent to Salary Grade One (SG 1) under Republic Act No. 6758, otherwise known as
the Compensation and Positions Classification Act.

SECTION 12. Incentives and Benefits for CHW. — All members of the Community
Health Team shall be entitled to the same incentives and benefits provided under the Magna
Carta for Public Health Workers. They shall also be covered by other benefits granted to
government employees under existing laws, such as GSIS, PhilHealth, Pag-IBIG, 13" Month
Pay, and other allowances

SECTION 13. Right to Self-Organization. - The right of a CHW to self-organization
shall not be abridged.

SECTION 14. Penalty. - Any person who violates any provision of this Act, either
through malfeasance, misfeasance, and nonfeasance, shall be liable to a fine of not less
than Three hundred thousand pesos (P300,000.00) nor more than Five hundred thousand
pesos (P500.000.00) and/or imprisonment of not less than one (1) year nor more than six (6)
years upon discretion of the court and without prejudice to any administrative liability.

SECTION 15. Training Programs. — Within one (1) year from the effectivity of this
Act, the DOH, National Nutrition Council (NNC), and other concerned government agencies,
in coordination with TESDA and LGU representatives, with the participation of various health
union representatives, shall formulate, finalize, and launch the CHW training program,
assessment, and national certification program.

SECTION 16. Transitory Provisions. — Within one (1) year from the effectivity of
this Act, the TESDA, DOH, NNC, DILG, and LGUs shall allocate funds from their annual
appropriations to immediately implement Sections 8 (b) and 9 of this Act.

SECTION 17. Appropriations. — The Department of Budget and Management
(DBM), LGUs, DOH, NNC, and other concerned government agencies, as the case may be,
and other appropriate government agencies, shall allocate necessary funds for
compensation, incentives and benefits of the community health team from the national and
local funds, as the case may be: Provided, That the PhilHealth income and Sin Tax revenue
must be taken into account.

SECTION 18. Implementing Rules and Regulations. - Within ninety (90) days
from the effectivity of this Act, the CSC, TESDA, DOH, NNC, DILG, LGUs, and other
concerned government agencies, in coordination with various health union representatives,
shall promulgate the necessary rules and regulations to implement the provisions of this Act.

SECTION 19. Separability Clause. — If, for any reason, any part or provision of this
Act is declared unconstitutional or invalid, other parts or provisions not affected thereby shall
continue to be in full force and effect.

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SECTION 20. Repealing Clause. ~ Republic Act No. 7883, otherwise known as the
Barangay Health Workers Benefits and Incentives Act of 1995, and Presidential Decree No.
1569, entitled “Strengthening the Barangay Nutrition Program by Providing for a Barangay
Nutrition Scholar in Every Barangay, Providing Funds Therefor, and for Other Purposes” are
hereby repealed.

All other laws, decrees, orders, circulars, issuances, rules and regulations and parts
thereof which are inconsistent with this Act are hereby repealed, amended or modified
accordingly.

SECTION 21. Effectivity. - This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in a newspaper of general circulation.

Approved,

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