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

SEVENTEENTH CONGRES;
First Regular Session

484

HOUSE BILL NO.

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BILLS AND ini x SERVICE

Introduced by Honorable MARK A. VILLAR

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

EXPLANATORY NOTE

It is heartbreaking and devastating for any family to hear doctors say there is
nothing more they can do for the patient.

Under the 1987 Constitution, Congress shall give highest priority to the
enactment of measures that protect and enhance the right of all the people to human
dignity. (Sections 1, Article Xil!)

But with palliative care, patients and their families can face the prospect of
death more courageously. More importantly, the patient is given the opportunity to
die with dignity and comfort

The World Health Organization defines Palliative care as an approach that
improves the quality of life of patients and their families facing the problem
associated with life-threatening illness, through the prevention and relief of suffering
by means of early identification and impeccable assessment and treatment of pain
and other problems, physical, psychosocial and spiritual. Palliative care:

+ provides relief from pain and other distressing symptoms;

+ affirms life and regards dying as a normal process;

+ intends neither to hasten or postpone death;

+ integrates the psychological and spiritual aspects of patient care;


offers a support system to help patients live as actively as possible until
death;

offers a support system to help the family cope during the patients iliness
and in their own bereavement;

uses a team approach to address the needs of patients and their families,
including bereavement counselling, if indicated;

will enhance quality of life, and may also positively influence the course of
illness;

Is applicable early in the course of illness, in conjunction with other
therapies that are intended to prolong life, such as chemotherapy or
radiation therapy, and includes those investigations needed to better
understand and manage distressing clinical complications.

This legislative measure features the following:

1) The government and private hospitals and health centers shalll 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.

2) 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;

3) Immediate family members or relatives who actually look after or take
care of a critically-il 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.

4) A Palliative Care Trust Fund shall be established exclusively for the
financial & support and assistance for the medical needs of indigent
patients.

This bill was previously filed by Senator Aquilino Pimentel in the Fourteenth

(14) Congress who was inspired by the 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

Considering that terminal ilinesses have been increasing in the country, and

‘owing to its importance, | have filed this measure.

In light of the foregoing reasons, the enactment of this bill is eamestly sought.

youre

MARK A. VILLAR


7 &

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

SEVENTEENTH CONGRESS
First Regular Session

484

HOUSE BILL NO.

Introduced by Honorable MARK A. VILLAR

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 2015",

SEC. 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 altemative
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;
6. Enhance the quality of life of the patients and their families.

SEC. 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

SEC. 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.

SEC. 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.

SEC. 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:

Name of patient - relative undergoing palliative treatment;

Copy of Medical Abstract of the patient-relative:

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

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

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SEC. 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

SEC. 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 (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;

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

d) 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.

SEC. 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 eamings 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.

SEC. 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.

SEC. 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,

SEC. 12. Appropriations. For the initial implementation of this Act, the
amount of One Hundred Million pesos (P100,000,000.00), 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.

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

SEC. 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.


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

Approved,