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

NINETEENTH CONGRESS
| First Regular Session

HOUSE BILLNo.__ 600

| Introduced by HON. EDGAR M. CHATTO.
First District, Bohol

| EXPLANATORY NOTE

idamental under the 1987 Constitution, specifically under Article II, Section
15 that, “The State shall protect and promote the right to health of the people and instill
health consciousness among them”.

Equally important are relevant provisions under Article XIII on Social Justice and
Human Rights which enumerates the declared responsibility of the State on health, to wit:

1,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 the people at affordable cost. There shall be priority for the
needs of the under-privileged, sick, elderly, disabled, women, and children. The State
shall endeavor to provide free medical care to paupers” (Section12);

2,To “establish and maintain an effective food and drug regulatory system
and undertake appropriate health, manpower development, and research, responsive
to the country’s health needs and problems” (Section 12); and

3,To “establish a special agency for disabled person for their rehabilitation,
self-development, and self-reliance, and their integration into the mainstream of
society”(Section 13).

The onslaught of the Coronavirus or Covid 19 pandemic provided the litmus test on
the readiness of the country’s health system in all regions. Among the various challenges
highlighted in the past three years are the disparity on the capacity of hospitals as well as
well as access of the most vulnerable to quality health care system.

The improvement of our health facilities, services and system is now an imperative to
only to address the ongoing global pandemic but to prepare for future health related
emergencies and crisis.

The establishment and designation of apex hospitals in strategic areas in all regions
in the country is a step towards the right direction in implementing the declared policy
enshrined in the 1987 Constitution. These specialized hospitals will ensure accessible,
available and quality health care services to our vulnerable constituents especially in the far-
flung areas.

When |, all qualified DOH regional hospitals shall be upgraded or established,
to have minimum functional capacities of apex hospitals that are at par with international
health care institutions that provide quality medical services. To achieve this goal, there
i tion Program for the establishment, development, and
enhancement of the physical facilities, equipment and instruments, and service delivery of
all the apex hospitals.

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This will also be complementary to the recent passage of the Republic Act No. 11223
or the Universal Health Care Act as well as Republic Act No. 11463 or the Malasakit Center
Act.

For the foregoing reasons, passage of the instant bill is earnestly sought.

ha

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

NINETEENTH CONGRESS
First Regular Session

HOUSE BILLNo. _ 600

Introduced by HON, EDGAR M. CHATTO
First District, Bohol

AN ACT

ESTABLISHING APEX HOSPITALS IN EVERY REGION OF THE COUNTRY

AND PROVIDING FUNDS THEREFOR

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

assembled:
SECTION 1. Short title. - This Act shall be known as the “Apex Hospitals Act.”
SEC. 2, Declaration of Policy. - It is the policy of the State to adopt an

integrated and

comprehensive approach to health development which shall make health

services available, accessible and affordable for all. To this end, reforms shall be introduced
to the Philippine health delivery system to achieve universal health care for Filipinos
through the upgrading of facilities that shall transform regional hospitals into functioning

apex hospitals

ind the establishment of new apex hospitals in strategic areas of the country.

SEC. 3. Definition of Terms. - As used in this Act:

(a) Anatomic and clinical pathology laboratory system — refers to a facility for
the diagnosis of diseases through laboratory testing of blood and other body fluids,
tissues, and the microscopic evaluation of individual cells. The laboratory testing
shall cover the following areas:

1) Anatomic pathology, which includes histopathology, cytopathology, and
electron microscopy; and,

2) Clinical pathology, which includes clinical microbiology, clinical chemistry,
hematology, blood bank, and molecular diagnostics or DNA testing.

(b)Angiogram — refers to a diagnostic procedure that outlines blood vessels, usually
arteries, in various areas in the body to identify narrowing of or blockages in the
arteries in the body.

(©) Apex hospital — refers to an end-referral hospital offering specialized services in
accordance with this Act, and is contracted as a stand-alone facility by the
Philippine Health Insurance Corporation (PhilHealth)

(d)Basi¢ emergency care — refers to the response to a situation where there is
urgently required medical care and attention, and shall include procedures
required for initial diagnosis, use of equipment and supplies in sufficiently
addressing the emergency situation, considering the welfare of the patient. It also
includes the necessary medical procedures and treatment administered to a
woman in active labor to ensure the safe delivery of the newborn.

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() Computed tomography (CT) scan — refers to an X-ray image which is produced by
applying tomography, a technique wherein a computer controls the motion of the
X-ray source and detectors, and processes the data to produce the image. The

images of internal organs obtained by this type of sophisticated X-ray

device can reveal anatomic details of internal organs that cannot be seen in
conventional X-rays

is — refers to the process of removing waste products and excess fluid from
ly. Dialysis is necessary when the kidneys are not able to adequately filter

the bl
(g) Dialysis facility system — refers to a facility that provides treatment for chronic
kidney disease.

(h) High risk pregnancy unit (HRPU) - refers to a unit in the hospital where women
with complications arising from pregnancy are confined, and whose treatment
requites constant supervision or further investigation and assessment. The unit is
operated by experts such as perinatologists, obstetricians and pediatricians, with
the assistance of other specialists. It is a fully equipped obstetric intensive care
unit (ICU) that can handle high risk cases including high risk neonates.

(i) Intensive care unit (ICU) ~ refers to a hospital unit where patients requiring close
monitoring, continuous attention, and intensive or critical care are confined. An
ICU contains highly technical monitoring devices and equipment with specially
trained personnel on critical care.

(Magnetic resonance imaging (MRI) ~ refers to a procedure that uses a strong
ic field and radio waves to capture detailed images of the organs and
tissues within the body.

(kK) Mammogram — refers to an X-ray test to visualize normal and abnormal
structures within the breasts.

() Medical specialist — refers to a doctor of medicine that practices and has expertise
on a specific branch of medicine.

(m) Neonatal intensive care unit (NICU) - refers to a hospital unit containing a
variety of mechanical devices and special equipment for the care and management
of premature or preterm and seriously ill newborn babies. The unit is comprised of
neonatologists, pediatric subspecialists, and nurses who are highly trained in the
management of medical and surgical conditions of the newborn,

(n) Regional government hospital — refers to a hospital operated and maintained,
either partially or wholly, by the national government or by any department,
division, board or other agency thereof.

(0) Rehabilitation care facility system — refers to a hospital facility that provides a
specialized medical care and/or rehabilitation services to injured, sick or
disabled patients, which includes speech therapy and physical rehabilitation.

SEC. 4, Coverage. - This Act shall apply to regional hospitals whose service

capacities are as general hospitals with at least five hundred (500) beds, and which have
been identified by the Department of Health (DOH) to have full potential to operate as apex
hospitals based on the Philippine Health Facility Development Plan (PHFDP).

The DOH may establish new apex hospitals in strategic areas in the country in

accordance with the PHFDP, and subject to the requirements of Sections 5 and 6 hereof.

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SEC. 5, Apex Hospital Modernization Program. - Within five (5) years from
the effectivity of this Act, all the DOH regional hospitals described in Section 4 shall be
upgraded or established, to have minimum functional capacities of apex hospitals that are
at par with international health care institutions that provide quality medical services. To
achieve this goal, there shall be an Apex Hospital Modernization Program for the
establishment, development, and enhancement of the physical facilities, equipment and
instruments, and service delivery of all the apex hospitals, including the following:

a) Physical Facilities, Equipment and Instruments. - At the minimum, all apex
hospitals shall operate and maintain the following physical facilities, complete
with the necessary equipment and instruments including:

. Ambulatory Surgical Clinic;
. Anatomic and Clinical Laboratory;
Blood Station;

Dialysis Facility;

General Intensive Care Unit;

leonatal Intensive Care Unit;

luclear Medicine Facility;

sical Medicine and Rehabilitation Facility;
iatry Facilit
diologic Facilities such as X-Ray, CT Scan, Mammogram, MRI, ECG,
giogram, Ultrasound and others;

Peranaepe

the facilities enumerated herein shall have competent and trained nurses,
therapists, medical technicians and other ancillary and support staff.

b) Service Delivery. - All apex hospitals shall offer the services for all kinds of
illnesses, diseases, injuries or deformities. It shall have certified and eligible
medical specialists to facilitate timely, efficient, affordable, and accessible
diagnosis and treatment for the following areas:

L Clinical Services

Family Medicine;
Internal Medicine;

c| Obstetrics and Gynecology;
d| Pediatrics; and,

e, Surgery.

b,

2. Basie Emergency Care Services

3. At least one medical specialist on any of the following areas, to be determined
by the DOH based on the burden of disease in the region:

epoe

|, Pathology;

Pulmonology;

Psychiatry;

g, Rehabilitation Medicine;

Urology; and

Other specialists as determined by the DOH.

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¢) Teaching and training hospital. Within three (3) years from the effectivity of this
Act, all apex hospitals shall be expanded as teaching and training hospitals with
accredited residency training programs for physicians in the four (4) major
specialties namely, Medicine, Pediatrics, Obstetrics and Gynecology, and Surgery.

The sectetary of the DOH shall determine the additional positions required for the
purpose in accordance with the revised compensation and position classification system
subject to the evaluation and approval of the Department of Budget and Management and
in compliance with the civil service laws, rules and regulations.

SEC. 6, Inventory and Audit of Hospitals. - An inventory and audit of the
physical facilities, equipment and instruments, as well as the personnel of the regional
hospitals, shall be conducted within one hundred eighty (180) days from the effectivity of
this Act, to determine the present classification of the respective regional hospitals based on
their functional capacity. The result of the inventory and audit shall be the basis of the
modernization plan for each apex hospital. The establishment of apex hospitals shall be
prioritized in io where they are most needed.

The DOH shall conduct an annual inventory and audit of apex hospitals for their
continuous development and to determine the need to establish new ones, in line with the
Apex Hospital Modernization Program.

SEC. 7. Annual Report. — Two (2) years from the effectivity of this Act and every
year thereafter, the DOH shall submit an annual report on the Apex Hospital Modernization
Program to the Congress of the Philippines, through the Committee on Health of the House
of Representatives and the Committee on Health and Demography of the Philippine Senate.

]

SEC. 8, Appropriations. - The initial amount 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.

shall issue the necessary rules and regulations within ninety (90) days after the effectivity of

SEC. tone Rules and Regulations. — The Secretary of the DOH
this Act.

SEC. 16. Separability Clause. - If any provision of this Act shall be held
unconstitutional or invalid, the remaining provisions which are not affected thereby shall
continue to be in full force and effect.

SEC. 11. Repealing Clause. - All laws, decrees, executive orders, rules and
regulations, and other issuances, or parts thereof, contrary to or inconsistent with this Act
are hereby modified, amended or repealed accordingly.

SEC. 12. 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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