Republic of the Philippines
House of Representatives
Quezon City, Metro Manila

Twentieth Congress
First Regular Session

No.2594

Introduced by

HON. REPRESENTATIVE LAARNI LAVIN ROQUE
4™ DISTRICT, BUKIDNON

EXPLANATORY NOTE

It is hereby declared the policy of the State to protect and promote the
right to health of people and adopt an integrated and comprehensive
approach to health development. Pursuant thereto, it shall endeavor to make
essential goods, healthcare, and other social services available to all the
people. In line with the country’s commitment to accomplish health indicator
targets under United Nations’ Millennium Development Goals (MDGs), the
State shall adopt policies that promote the welfare and well-being of
barangay health workers who are the forefront of the delivery of healthcare
at the grassroots level, and which shall effectively harness their potential as
partners in development.

This bill emulates the spirit of Section 12, Article XIII (Social Justice
and Human Rights) of the 1987 Constitution, which compels the State to
“undertake appropriate health manpower development and research,
responsive to the country's health needs and problems.” To this end,
Republic Act No. 7610 or the Local Government Code of 1991 specifies the
Local Government Units' responsibility to provide for health services and
facilities for each barangay, including the implementation of programs and
projects on primary health care, maternal and child care, and communicable
and non-communicable disease control services, access to secondary and
tertiary health services


To further address the State's role on undertaking health manpower
development, Republic Act No. 7883 or the Barangay Health Workers '
Benefits and Incentives Act of 1995 was enacted to provide support for
barangay health workers in terms of health education and trainings, and in
incentives and benefits. The State recognizes that it is ultimately the
barangay health workers that secure the effectiveness of the most basic of
the country's healthcare programs and projects.

However, despite the barangay health workers' critical role as front-
liners of our country's community-based health interventions, many cities
and municipalities still lack health workers. ! While there are those that are
equipped with functional barangay health services and workers, the many
challenges hampering efficient healthcare service delivery remain a glaring
reality the Government cannot keep disregarding. Some barangay health
workers need to slog through the fields just to conduct house-to-house visits
in some areas; some need to shell out of their own pockets for food and
travel; some are exposed to many health and hazard risks while on the job;
and some lack up to date awareness on emerging health issues. Their heroic
services, whether to the most far-flung of barangays or to the most
populated ones, need not be at the expense of the depreciation of their labor
for the country's indigent communities.

This bill provides the process of registration and accreditation of
barangay health workers as well as providing that each barangay shall at
least have one (1) BHW for every twenty (20) households. It also prohibits
the discri ion of a BHW by reason of gender, civil status, creed, religious
or political beliefs and ethnic groupings in the exercise of their functions and
responsibilities.

Most importantly, this legislative measure provides for the incentives
and benefits that the BHWs deserve to receive such as entitlement of twenty
percent (20%) discount on all the items enumerated under Section 4(a) of
Republic Act No, 9994 otherwise known as the “Expanded Senior Citizens Act
of 2010", hazard allowance, subsistence allowance, transportation
allowance, retirement cash incentive, training, education and career
enrichment programs, health benefits, insurance coverage, sick, vacation
and maternity leaves, cash gift, disability benefit, civil service eligibility, free
legal services and preferential access to loan facilities.

This bill was previously filed by this representation in the 19%
Congress and was approved by the House of Representative on Third
Reading and was transmitted to the Senate for its concurrence. However,
due to lack of material time it was not passed into law.


Given the above premises, the urgent passage of this bill is earnestly
sought.

HON. LAVIN ROQUE
4™ DI , BUKIDNON


sans

Pipes
Republic of the Philippines
Bouse of Representatives
Queson City, Metro Manila
Twentieth Congress
First Regular Session
House Bil! No. 229%

Introduced by

HON. REPRESENTATIVE LAARNI LAVIN ROQUE
FOURTH DISTRICT, BUKIDNON

AN ACT
PROVIDING FOR THE MAGNA CARTA OF BARANGAY HEALTH
WORKERS

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

SECTION 1. Short Title.
Barangay Health Workers".

This Act shall be known as the "Magna Carta of

Section 2. Declaration of Policy - It is hereby declared the policy of the
State to protect and promote the right to health of people and adopt an
integrated and comprehensive approach to health development, and
pursuant thereto, it shall endeavor to make essential goods, healthcare and
other social services available to all the people. In line with the country’s
commitment to accomplish health indicator targets under United Nations
sustainable development goals, the State shall adopt policies that promote


the welfare and well-being of barangay health workers who are the forefront
of the delivery of health care at the grassroots level, and effectively harness
their potential as partners in development.

SEC. 3. Definition. - As used in this Act, the term “barangay health worker”
refers to a person who has undergone training under any accredited
government or non-government organization (NGO), and who voluntarily
renders primary healthcare services in the community after having been
accredited to function as such by the local health board.

SEC. 4. Coverage. - This Act shall apply to all barangay health workers
(BHWs) as defined under Section 3 of this Act: Provided, That all incentives
and benefits granted under this Act shail extend only to duly accredited
BHWs, who have undergone at least two (2) years of training: Provided,
however, That duly registered barangay health workers shall be entitled to a
monthly honoraria and hazard allowance as provided in Sec. 9 herein:
Provided, further, That when the BHW receives a fixed salary under a
permanent appointment in any government office, by election to another
public office or by employment in the private sector, coverage under this
Act shall automatically cease and the BHW shall be covered under applicable
laws.

SEC. 5. Registration. - All BHWs shall be registered with the local health
board in the city or municipality in which they render service. Registered
BHWs shall be given appropriate proof of said registration.

The municipal and city health offices shall regularly update and
maintain the BHW Registry with the assistance of the BHW Federation. The
BHW Registry shall be subject to the approval of the municipal or city health
board. The local health offices shall submit a copy of the updated and duly
approved registry to the Provincial Health Office for consolidation and
validation with the assistance of the Provincial BHW Federation, which shall
also be subject to the approval of the Provincial Health Board. The Provincial
BHW Registry shall be posted in the municipal or city bulletin board and
barangay health centers.


The Provincial BHW Registry shall be submitted on or before April 30 of
every year to the Department of Health (DOH) at the regional and national
levels for consolidation. The DOH is hereby mandated to maintain a national
registry of BHWs.

In order to qualify for registration, a Barangay Health Worker must:

(a) Have rendered basic community health care services continuously
and satisfactorily for at least six (6) months immediately preceding the date
of the filing of application for registration in the barangay as recommended
by the Rural Health Midwife (RHM) or public health nurse assigned to the
barangay and by the head of the barangay health workers association and
certified by the Sangguniang Barangay;

(b) Have completed the basic orientation and training for BHWs as
prescribed by the DOH and conducted by an accredited government agency,
or DOH-recognized academic institution, or (NGO);

(©) Be at least eighteen (18) years of age at the date of the filing of
the application for registration; and,

(d) Be physically and mentally fit. It shall be the duty of the municipal
and city health offices, in cooperation with the Provincial Health Office and
the DOH, to provide BHW applicants basic orientation and training within six
(6) months from the date of approval of their application.

SEC. 6. Accreditation. - To further professionalize the health care services
rendered by the BHWs and ensure the health and welfare of the community,
a duly registered BHW must be accredited by the municipal or city health
board.

The municipal or city health board shall issue a certificate of
accreditation to qualified 19 BHWs. In order to qualify for accreditation, the
applicant BHW must:

(a) Be registered in accordance with Section 5 hereof;

(b) Have satisfactorily undertaken the role of a BHW in the locality as
provided for in Section 7 hereof, for at least two (2) years of continuous and
satisfactory service immediately prior to the filing of application for
accreditation;


(c) Have completed a regular training program on health care service
and community-based health program in order to upgrade and develop the
skills and competency required of a BHW. The training program shall be
institutionalized by the DOH, in cooperation with local government units
(LGUs).

It shall be the duty of the municipal or city government, as the case
maybe, in cooperation with the provincial government and DOH, to provide
the applicant BHWs the necessary support and opportunities for
accreditation.

A BHW must complete the regular training program on health care
service and community-based health program within five (5) years from
registration.

The municipal and city health boards or through their registration and
accreditation committee shall act on the applications for accreditation of
BHWs not than later thirty (30) days from the date of application.

The DOH shall also maintain an updated roster of accredited BHWs
that is accessible to 4 the general public.

SEC. 7. Roles, and Duties and Responsibilities of Barangay Health Workers.
- As one of the key partners in a reformed health care delivery system, the
DOH and LGUs shall support BHWs as they perform the following roles:

(a) Advocate - to support, promote and champion current health programs,
projects, and activities to improve access to quality health services towards
the 10 improved health status of the community;

(b) Educator - to guide and advise the community on the current DOH and
health priorities of LGUs such as the importance of a birth plan and facility-
based delivery in reducing maternal and infant deaths; newborn screening
for the early detection of congenital metabolic disorders which may leads to
mental retardation and even death, among others;

(c) Disseminator - to maintain regular communication with local professional
health workers on health events and updates and concerns relevant to the
community and inform the same to the community for appropriate action, if
necessary;

(d) Linker - to facilitate access to any group or association of the commu
with a relevant network of or specific health and non-health service
providers;



(e) Record Keeper - to maintain updated records of health data, health
activities and events in the community;

(f) Health Care Service Provider - to assist and provide basic health care
services as may be needed in the community in any health event.

The BHW shall perform the following duties and responsibilities:

(a) Height and weight monitoring, and reporting the same to the
barangay;

(b) Monitoring and following up of defaulted cases of immunization,
family planning, tuberculosis compliance to treatment and others, and
reporting the same to the barangay;

(c) Reporting to the barangay any incidence of disease or any health
cases in the 33 community;

(d) Communicating and coordinating with the community to participate
in barangay 35 health center activities;

(e) Gathering of data about overall status of health of the community;

(f) Administering first aid;

(g) Conducting health visits;

(h) Conducting birth planning for pregnant women;

(i) Conducting health education;

(j) Strengthening referral systems;

(k) Collecting sputum;

(1) Identifying people with disease and sickness;

(m) Community health profiling;

(n) Psychosocial debriefing for stress and post-calamity initiatives;

(0) Responding in natural calamities and disasters; and

(p) Coordinating closely with the local government health officer in the
implementation 12 of health programs in the locality.

SEC. 8. Number of Barangay Health Workers (BHWs). - Subject to relevant
laws, and in coordination with relevant government agencies and respective
local government units, the number of BHWs in every barangay shall be
guided by and based on the particular need of the barangay for BHW
services. The DOH shall determine the ideal ratio of barangay health workers
to the number of households: Provided, That the total number of barangay
health workers nationwide shall not be less than one percent (1%) of the
total population. The residents of the barangay must be given preference in
the employment of BHWs.


SEC. 9. Incentives and Benefits. - All accredited BHWs who are actively and
regularly performing their duties and responsibilities shall be entitled to the
following incentives and benefits:

(a) Monthly Honoraria in the amount of not less than Three thousand pesos
(P3,000.00), subject to adjustment based on the prevailing market value;
(b) Hazard Allowance in an amount to be determined by the local health
board of LGU concerned, which in no case shall be less than One thousand
pesos (P1,000.00) per 29 month, subject to existing laws, rules, and
regulations;

(c) Subsistence Allowance equivalent to the meals they take in the course of
their duty, which shall be computed in accordance with prevailing conditions
as determined by the LGU concerned, which in no case shall be less than
One hundred pesos (P100.00) per day: Provided, That the accredited BHW
shall render service within the premises of isolated barangay health stations
in order to make it available at any and all times;

(d) Transportation Allowance of not less than One thousand pesos
(P1,000.00) per month, subject to auditing rules and regulations, on the
condition that the availment of transportation services are in line with the
performance of the BHW’s official duties and responsibilities;

(e) One-time Gratuity Cash Incentive of not less than Ten thousand pesos
(P10,000.00) in recognition of the BHW’s loyalty and dedication and for
having continuously and satisfactorily served for at least fifteen (15) years;
(f) Discount Privileges for BHWs. - All BHWs shall be entitled to twenty
percent (20%) discount on all the items enumerated under Section 4(a) of
Republic Act No. 9994, otherwise known as the Expanded Senior Citizens Act
of 2010: Provided, That the privileges shall not be claimed if the BHW is
eligible for a higher discount as may be granted by the commercial
establishment and/or other existing laws.

The commercial establishment may claim the discount granted under this
section as tax deduction based on the cost of goods sold or services
rendered: Provided, That the discount shall be allowed as deduction from the
gross income for the same taxable year that the discount is granted:
Provided further, That the total amount of the claimed tax deduction net of
VAT, if applicable, shall be included in their gross sales receipt for tax
purposes and shall be subject to proper documentation and to the
provisions of the National Internal Revenue Code of 1997, as amended.


(g) Training, Education, and Career Enrichment Programs. - The DOH shall,
in coordination with the Department of Education (DepEd), Commission on
Higher Education (CHED), Technical Education and Skills Development
Authority (TESDA), DOH-recognized academic institutions, other concerned
agencies and non-government organizations, provide information on and
opportunities for education and career enrichment for accredited BHWs, such
as the following:

1) Educational programs which credit the years of primary health care
service of the 2BHW towards higher education completion in institutions with
stepladder curricula, thus allowing them to upgrade their skills and
knowledge for community work or to pursue further training as midwives,
pharmacists, nurses or doctors;

2) Continuing education, study and exposure tours, grants, field immersion,
scholarships; and

3) Special training programs such as traditional medicine, disaster
preparedness and other programs that address emergent community health
problems and issues.

(h) Health Benefits. - During their incumbency, all BHWs are entitled to the
following health benefits:

1) Free medical care, including surgery and surgical expenses, medicines, x-
ray and other laboratory fees, when confined in any public hospital or health
institution;

2) Emergency assistance not exceeding the amount of five thousand pesos 5
(P5,000.00) chargeable against the fund of the barangay concerned, for
expenses incurred in the nearest private hospital or clinic in case of extreme
emergency where there is no available public hospital;

3) Mandatory and immediate membership in the Philippine Health Insurance
Corporation (Philhealth) as indirect contributors.

(i) Insurance Coverage. - All BHWs shall be granted insurance coverage and
benefits from the Government Service Insurance System (GSIS) which shall
be borne by the LGU concerned. For this purpose, the GSIS shall design an
insurance benefit package suited to the needs and status of BHWs;

(j) Sick and Maternity Leaves. - All BHWs shall be entitled to sick and
maternity leaves as prescribed by the Local Health Board: Provided, That,
the BHWs shall continue to receive their monthly honoraria while on leave,
for such period in accordance with existing laws and practices;


(k) Cash Gift - All accredited BHWs are entitled to cash gift of not less than
the minimum monthly honoraria to be given every December from the
general fund of the barangay or from such other funds appropriated by the
national government for the purpose;

(1) Disability Benefit - An accredited BHW who sustains injury or sickness in
the course of the performance of their duties shall be entitled to Two
thousand pesos (P2,000.00) for every year of service;

(m) Civil Service Eligibility. - A second-grade eligibility shall be granted to
accredited BHWs who have rendered five (5) years continuous service as
such: Provided, That, should a BHW become a regular employee of the
government, the total numbers of years served as such shall be credited to
the BHWs service in computing the retirement benefits;

(n) Free Legal Services. - Legal representation and consultation services
shall be immediately provided by the Public Attorney's Office to an
accredited BHW in cases of coercion, interference, and in other civil and
criminal cases filed by or against BHWs arising out of or in connection with
the performance of their duties as such;

(0) Preferential Access to Loan. - The DOH in coordination with other
concerned government agencies shall provide, within One hundred eighty
(180) days after the effectivity of this Act, a mechanism that shall provide
BHWs organized access to loan services. The agencies providing loan
services will set aside one percent (1%) of their loanable funds for organized
BHW groups that have community-based income generating projects in
support of health programs or activities.

Notwithstanding the limitations under this section, all registered BHWs shall
be entitled to monthly honoraria and hazard allowance.

The LGUs concerned shall also endeavor to provide other health benefits to
BHWs not otherwise provided by law.

SEC. 10. Annual Review. - The local health boards shall conduct an annual
review of the BHW program, performance, as well as the benefits, incentives
and allowances enumerated in the immediately preceding Section taking into
consideration the current consumer price index as published by the
Philippine Statistics Authority.

SEC. 11. Discrimination Prohibited. - Discrimination against any BHW by
reason of gender, civil status, creed, religious, or political beliefs and ethnic
groupings in the exercise of their functions and responsibilities is hereby
prohibited.


SEC. 12. Protection of BHWs. - No accredited BHW shall be removed except
for a valid cause as determined by the Local Health Board (LHB). The LHB
shall resolve termination cases against BHWs judiciously and not later than
ninety (90) days from the receipt of a complaint: Provided, That if a BHW is
found to be unjustly removed from service, the BHW shall be entitled to
reinstatement without loss of benefits and incentives from the time of
termination up to the time of reinstatement.

SEC. 13. Grievance Mechanism. - The LHB shall establish a grievance
mechanism as a means of processing complaints of BHWs against alleged
acts of discrimination and unjust removal from the service. The decisions
rendered by the LHB shall be final and executory.

SEC. 14. Municipal, City, Provincial, and National Federation of BHWs. -
There shall be an organization of accredited BHWs for the purpose of
electing the municipal, city, provincial, and national-level federation in order
to ventilate, articulate, and crystalize issues affecting health care delivery
system and with utmost regard to service to patients and the continuous
operation of barangay health services in the interest of public health, safety,
or survival of patients.

The BHW federation for municipalities, cities, and provinces shall elect their
respective local federation boards of directors, and a set of national officers
to comprise the national board of directors to be headed by a president. A
Secretary-General shall be chosen from among the national federation
members to manage the day-to-day operation and activities of the
federation. The respective boards of directors may create such other
positions as may be necessary for the management of the affairs of the local
and national federation.

SEC. 15. Representation in the Local Health Board and Primary Health Care
Provider Network. - The President of the municipal or city federation of
BHWs shall be a member of the municipal or city local health board. The
respective presidents of the federation of BHWs of each city and municipali

federation of a province shall elect from among themselves their
representative to the provincial health board: Provided, That the BHW
representatives to the local health boards shall not be allowed to vote on the
registration, accreditation, and disciplinary or removal complaints of BHWs.



The BHWs shall also be part of the health care provider network, in the
implementation of health care services and programs.

SEC. 16. Prohibition from Engaging in Partisan Political Activity. - No BHW
shall engage in any partisan political activity.

SEC. 17. Continuous Capacity Building for BHWs. - The DOH shall conduct
continuous capacity building for BHWs that will enhance and upgrade their
knowledge and skills through various forms including online learning and
multimedia in major Philippine dialects.

The DOH shall, in coordination with TESDA and other concerned agencies,
assist the LGUs in the development of education modules or materials to
promote the collective experiences and learnings of BHWs as well as to
promote traditional and complementary medicine.

The LGUs shall endeavor to establish their own training centers for their
BHWs and other health workers in coordination with the TESDA, NGOs, and
other agencies concerned.

The LGUs shail also implement a development program for BHWs that will
allow them to benefit from the ladderized training as provided under
Republic Act No. 10968, otherwise known as the Philippine Qualification
Framework Act, and Republic Act No. 10647, otherwise known as the
Ladderized Education Act of 2014, including academic credits for health-
related courses.

SEC. 18. Observance of BHW Day. - Every barangay shall commemorate
BHW Day during April 7 of every year in recognition of the service of
Barangay Health Workers, their heroic services in times of crises, and their
indispensable role in promoting health and wellness among the citizenry.

The DOH, in cooperation with the Department of the Interior and Local
Government (DILG) and all local government units shall hold simple
ceremonies or activities to highlight the indispensable role of BHWs in
nation-building.

SEC. 19. Penalty Clause. - Any local government official who violates any
provision of this Act may be administratively and criminally charged in
accordance with law.


SEC. 20. Appropriations. - The amount necessary for the implementation of
this Act shall be charged against the National Tax Allotment of the LGUs,
other local funds, the special health fund under Republic Act No. 11223,
otherwise known as the “Universal Health Care 12 Act”.

SEC. 21. Implementing Rules and Regulation. - The DOH and the DILG
shall, in consultation with the DepEd, CSC, GSIS, and other concerned
government agencies and non-governmental entities, promulgate the rules
and regulations to implement this Act not later than One hundred eighty
(180) days from the effectivity of this Act.

SEC. 22. Separability Clause. - If any portion or provision of this Act is
declared invalid or unconstitutional, the other provisions hereof shall remain
in full force and effect.

SEC. 23. Repealing Clause. - Republic Act No. 7883, otherwise known as
the “Barangay Health Workers’ Benefits and Incentives Act of 1995” is
hereby repealed. All laws, decrees, executive orders, rules and regulations,
which are inconsistent with this Act are hereby repealed or amended or
accordingly.

SEC. 24, Effectivity. - This Act shall take effect fifteen days (15) after its
publication in the Official Gazette or in a national newspaper of general
circulation.

Approved.