be VED
is nay ul 18 2022

rime: Gem

Republic of the Philippines

HOUSE OF REPRESENTATIVES

Quezon City, Metro Manila

NINETEENTH CONGRESS
First Regular Session

2933 _

HOUSE BILL NO. ___-

Introduced by HON. CHRISTOPHERSON “COCO” M. YAP

EXPLANATORY NOTE

In the 18th Congress, House Bill 10697 primarily authored by Rep. Cheryl Deloso-
Montalla, was passed on third reading by the House of Representatives on January 31,
2022.

Senior citizens are afflicted with multiple chronic diseases. Our elderly need long term
and constant medical care that should primarily be addressed by the State.

But our health care system is yet to reach the appropriateness and adequacy needed by
our senior citizens who find it difficult to access the health care facilities,

This bill aims to establish the National Center for Geriatric Health and Research
Institute and create Regional Geriatric Specialty Centers in Department of Health—
retained hospitals across the country in the long term.

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

CHRISTOPHERSON *COCO” YAP

Representative, Second District of Southern Leyte


eaVausun

Republic of the Philippines
HOUSE OF REPRESENTATIVES

Quezon City, Metro Manila

NINETEENTH CONGRESS
First Regular Session

2033

HOUSE BILL NO.

Introduced by HON. CHRISTOPHERSON “COCO” M. YAP

AN ACT

ESTABLISHING THE NATIONAL CENTER FOR GERIATRIC HEALTH AND
RESEARCH INSTITUTE, DEFINING ITS POWERS AND FUNCTIONS,
CREATING REGIONAL GERIATRIC SPECIALTY CENTERS IN THE
DEPARTMENT OF HEALTH-RETAINED HOSPITALS, AND APPROPRIATING

FUNDS THEREFOR

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

assembled:
SECTION 1.

SECTION 2.

SECTION 3.

Short Title. This Act shall be known as the “Geriatric Health Act.”
Declaration of Policy. It is the policy of the State to protect and
promote the right to health of senior citizens all over the country
by ensuring that holistic health se are available and 3
accessible to them through the establishment of a specialized
hospital and research institute as well 4 as geriatric specialty centers
in the Department of Health (DOH) - retained hospitals in every
region.

Definition of Terms. As used in this Act:

a. Acute care refers to a specialized program that addresses the
needs of hospitalized older adults in a multidisciplinary team
approach to prevent functional and cognitive decline and to
improve outcom



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b. Apex or end-referral hospital refers to a hospital offering
specialized services as determined by DOH, which is contracted
as a stand-alone facility by the Philippine Health Insurance
Corporation (PhilHealth);

Geriatric health services refer to the medical services or
interventions provided by a multidisciplinary ream to older
adult patients;

d. Geriatric medicine or Geriatrics refers to the sub-specialty of
internal and family medicine that diagnoses and treats a wide
range of conditions and diseases that affect people as they age
and aims to promote health and treat disabilities of older adults;

¢. Geriatric palliative care refers to a specialized medical care that
focuses on providing elderly patients relief from pain and other
symptoms of a serious illness, regardless of diagnosis or stage
of disease, and provided alongside curative and other forms of
treatment.

It is a field of inter-specialty collaboration to respond to the
socio-demographic changes and challenges of older adults with
severe and life-limiting conditions;

f. Geriatric specialty center refers to a unit or department in a
DOH-retained hospital that offers specialized care to the aging
population, particularly to frail older persons, addressing their
particular conditions and providing specific procedures and
management of cases, requiring specialized training and/or
equipment;

g. Geriatrician refers to a medical doctor who has passed the
necessary training and specialty licensure examination for the
practice of Geriatric Medicine;

h. Gerontology refers to the study of the biological, psychological,
spiritual, social, economic, and the demographic aspects of the
aging process;

i. Home-based healthcare and re-ablement program refer to a
community-based service which primarily caters to the frail
older persons who have lost or are experiencing problems with



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SECTION 4.

j. Integrated delivery of geriatric health services refers to hospital
and community-based medical and psycho-social services
provided to senior citizens by a multidisciplinary teams

k. Multi-disciplinary team refers to a team composed of health
professionals headed by a geriatrician and includes surgeons,
organ-system specialists, nurses, clinical __ pharmacists,
rehabilitation therapists, nutritionists, dentists, social workers,
caregivers, family members and patients themselves;

|. People-centered service refers to an approach to geriatric care

that consciously adopts the perspectives of individuals, fam:
nd communities, and sees them as participants as well as
beneficiaries of trusted health systems that respond to their
needs and preferences in holistic and humane ways;

Ss

m. Senior citizen refers to an elderly Filipino who is at least sixty
(60) years old;

n. Sub-acute care refers to care for patients who no longer require
hospitalization, but still need skilled medical care through
rehabilitative medicine. Sub-acure rehabilitation is
recommended when a patient is not functionally able to return
home; and,

©. Transitional care refers to a form of health care in geriatric
medicine designed to ensure coordination and continuity of
care as patients transfer between different locations or different
levels of care, and the safe and effective management of both
chroni¢ and acute illness in older adults.

National Center for Geriatric Health and Research Institute. The
National Center for Geriatric Health (NCGH) is hereby classified
asa teaching, research, and training hospital that shall specialize in
geriatric care and serve as an apex hospital or end-referral facility
for senior citizens in the country. The NCGH shall be renamed as
the National Center for Geriatric Health and Research Institute
(NCGHRI) and shall be under the direct control and supervision
of the DOH.

The bed capacity, service capabilities, healthcare facilities,
expansion, organizational structure and human resource
requirements of the NCGHRI shall be based on the hospital and
human resource development plan to be prepared by the NCGHRI
and approved by the DOH.



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SECTION 5. Powers and Functions. To carry out the provisions of this Act, the
NCGHRI shall have the following powers and functions:

Serve as an apex hospital or end-referral facility which shall
specialize in geriatric health services;

Formulate a hospital development plan which shall be
regularly updated to reflect the expansion and future
development of the NCGHRI;

Provide and maintain affordable, quality, and timely
people-centered hospital care through an efficient health
service delivery system for senior citizens;

Provide higher and up-to-date geriatric training for
professionals, postgraduates, academics and allied
healthcare providers especially from the geriatric specialty
centers in the regions and LGUs, and other government
hospitals

Develop and implement cutting edge research studies on
diseases related to old age with a view to translating
research outcomes into policy and specialized health care
solutions, and publish research studies that shall serve as a
critical information resource for the medical and research
community, in coordination with the Philippine Council on
Health Research and Development (PCHRD) and the
Instieute on Aging of the National Institutes of Health (IA-
NIH);

Conduct and participate in international and_ local
gerontological research activiti

Provide consultancy service and technical assistance in the
setting of standards for geriatric wards in every tertiary level
hospital, nursing home and residential center catering to the
health and functioning needs of senior citizens, in
coordination with the PCHRD and the [A-NIH;

Develop and maintain a core information hub on geriatrics
and gerontological studies in coordination with the A-NIH
and concerned offices in the DOH and its attached agencies,
such as the Disease Prevention and Control Bureau and the
Knowledge Management and Information Technology
Services


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SECTION 6.

i.

f

Extend medical services to senior citizens pursuant to the
goals, objectives, and rules of the National Health Insurance
Program and in accordance with Republic Act No. 11223,
otherwise known as the “Universal Health Care Act”;

Provide an integrated and effective approach in the delivery
of geriatric health services in collaboration with other
government agencies, local government units (LGUs) and
other stakeholders;

k. Conduct specialty training and technical assistance in

lL

collaboration with concerned DOH offices and other
relevant professional organizations;

Finance, sponsor, hold or participate in congresses,
conventions, conferences, seminars, workshops, and
training programs on geriatric health services or related
fields in the Philippines and abroad; and

m. Establish a standardized referral system for psychosocial

services.

Scope of Services. The NCGHRI shall provide the following
services:

Hospital-based services to ensure the availability of medical
facilities and equipment for senior citizens needing acute
and sub-acute care, geriatric palliative care, transitional and
outpatient care services, and such other necessary services;

b. Community-based services utilizing multidisciplinary team

c

approaches such as homebased healthcare and re-ablement
programs, research and external resource outsourcing for
community-based integrated geriatric health services and
trainings necessary for the psycho-social functioning of
senior citizens and their families, in coordination with
LGUs;

Technical assistance and capacity building in the
establishment and maintenance of nursing homes and
residential care facilities and senior citizens’ wards in
government hospitals pursuant to Republic Act No. 9994,
otherwise known as the "Expanded Senior Citizens Act of
2010";



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SECTION 7.

SECTION 8.

d. Technical assistance and capacity building in the
establishment of geriatric specialty centers and services to
strengthen the network of geriatric care service providers
across the country and ensure the delivery of quality health
services for senior citizens;

Education programs and scholarships to pursue excellence
nd the highest level of quality in the practice of the
specialized field of geriatrics and other related fields,
including postgraduate training and short-term courses for
medical doctors and other allied medical health professions,
in coordination with the IA-NIH; and,

f, Education programs in geriatrics and gerontology subjects
in undergraduate health and allied professions, including
training of students, as well as postgraduate medical
education of physicians, nurses, allied professionals,
pharmacists, dentists, and social workers.

The Geriatric Specialty Fellowship Training Program of the
NCGHRI shall seek and maintain full accreditation status in the
Philippine College of Geriatric Medicine.

The NCGHRI shall ensure the accessibility of all its programs and
services and take into consideration the special needs of senior
citizens with disabilities.

Organizational Structure and Staffing Pattern, The Secretary of the
DOH shall determine the organizational structure and staffing
pattern. of the NCGHRI in accordance with the revised
compensation and position classification system subject to the
evaluation and approval of the Department of Budget and
Management (DBM) and in compliance with the civil service laws,
nd regulations.

rules

Establishment of Geriatric Specialty Centers. Geriatric specialty
centers are hereby established in DOH regional hospitals, which
shall serve as apex or end-referral hospitals of the health care
provider networks and training and research facilities on geriatric
specialty care services. Geriatric health services shall be available in
all government primary health facilities.

The level of geriatric services and corresponding facilities in
specialty centers and their respective health human resource
requirements shall be determined by the DOH, in coordination

with NCGHRI and other stakeholders: Provided, That the


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SECTION 9.

SECTION 10.

SECTION 11.

SECTION 12.

standards to be adopted thereon shall be consistent with the
Philippine Health Facility Development Plan and Section 6 of this
Act.

Categorization of Patients. The DOH shall ensure that the
NCGHRI shall adopt and enforce a categorization of paying and
non-paying patients. The allocation of beds for non-paying patients
shall be not less than seventy percent (70%) of the total number of
hospital beds.

Income Retention. All income generated from the operations of the
NCGHRI shall be deposited in an authorized government
depository bank and shall be used to augment the funds allocated
for its maintenance, other operating expenses and capital outlay
requirements, subject to the guidelines set by the DOH and the
DBM.

Privilege. The NCGHRI may request and receive assistance from
the different agencies, bureaus, offices or instrumentalities of the
government, including the Philippine Charity Sweepstakes Office
and Philippine Amusement and Gaming Corporation, in pursuit of
its purposes and objectives.

Tax Exemptions. All donations, endowments, contributions,
grants and bequests used actually, directly and exclusively for and
in accordance with the purposes and functions of the NCGHRI
shall be exempt from donor's tax, and the same shall be considered
as allowable deductions from gross income for purposes of
computing the taxable income of the donor, in accordance with the
provisions of the National Internal Revenue Code of 1997, as
amended.

The NCGHRI shall be exempt from income tax and customs duty
levied by the government and its political subdivisions, agencies
and instrumentalities subject to the provisions of the National
Internal Revenue Code of 1997, as amended and Republic Act No.
10863, otherwise known as the “Customs Modernization and
Tariff Act.”

The NCGHRI shall avail of the tax expenditure subsidy
administered by the Fiscal Incentives Review Board (FIRB), subject
to the provisions of Title XIIL (Tax Incentives) of the National
Internal Revenue Code of 1997, as amended, Executive Order No.
93, as amended, and the General Appropriations Act.


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SECTION 13.

SECTION 14.

SECTION 15.

SECTION 16.

Coordination with and Assistance from Other Government
Agencies. The NCGHRI shall collaborate with the National
Commission of Senior Citizens (NCSC) in the development of its
programs and services. It may likewise call upon any department,
burcau, office, agency, or instrumentality of the government for
assistance, in the pursuit of the purposes and objectives of this Act.

Appropriations. The amount necessary for the implementation of
this Act shall be charged against the current year’s appropriation
of the DOH. Thereafter, the funding of which shall be included in
the annual General Appropriations Act.

Annual Report. The NCGHRI shall submit an annual report to the
President of the Philippines, the Senate Committee on Health and
Demography, the House of Representatives Committee on Health,
and the NCSC, on its activities, accomplishments and
recommendations to further improve the delivery of geriatric health
services.

Transitory Provisions. In accomplishing organizational changes
and improvements that have to be implemented, the following
transitory provisions shall be complied with:

a. The National Center for Geriatric Health (NCGH)
currently under the Jose R. Reyes Memorial Medical Center
(JRRMMC) shall be absorbed by NCGHRI including its
existing personnel regardless of status, and all buildings and
equipment, fixtures and furnishings, other assets and
liabilities, and current appropriations;

b. The independence of the NCGHRI from the JRRMMC shall
be fully realized within a period of two (2) years. The DOH
shall ensure that no disruption of service will occur during
this transitory period;

c. The existing officials and employees of NCGH shall
continue to assume the duties of | their positions until new
appointments are issued. They shall be placed in the new
staffing pattern of the NCGHRI in accordance with R.A.
No. 6656, entitled “An Act to Protect the Security of Tenure
of Civil Service Officers and Employees in the
Implementation of Government Reorganization” and the

Is

rules and regulations governing, reorganization. Offi
and employees, including casual and temporary employees,
who shall not be absorbed in the new staffing pattern due
to redundancy shall avail of the applicable retirement



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SECTION 17.

SECTION 18.

SECTION 19.

SECTION 20.

Approved,

benefits and separation incentives as provided under
existing laws: Provided, that officials and employees
holding permanent appointment shall also be given the
option to be transferred to other units or offices within the
DOH without reduction in rank, status, pay and benefits;

d. Research grants acquired by the NCGHRI during the
transition shall be utilized solely for their intended purposes
and of the affected units or offices; and

¢. Existing contracts and agreements entered into with third
parties prior ro the enactment of this Act shall remain valid.

Implementing Rules and Regulations. The Secretary of Health
shall, in consultation with the Secretary of Budget and
Management, Secretary of Social Welfare and Development, and
the Chairperson of the NCSC, promulgate rules and regulations for
the effective implementation of this Act within ninety (90) days
after its effectivity.

Separability Clause. ~ If any part or provision of this Act is held
invalid or unconstitutional, the remaining parts or provisions not
affected shall remain in full force and effect.

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

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