Malasakit Centers Act Establishing Health Aid Centers

Policy, purpose, and guiding framework

The State policy is to improve the delivery of health care services to the people and to ensure access to and efficiency in the process of availing medical and financial to fund health services (Section 2).
The Malasakit Program must adopt a multi-sectoral and streamlined approach in addressing health issues, recognizing the integrated and indivisible linkage between health and social services consistent with the whole-of-government, whole-of-society and whole-of-system framework under Republic Act No. 11223 (Section 2(a)).
The program must ensure patients experience compassion and empathy (“Malasakit”) and receive respect and dignity when availing health services (Section 2(b)).
The program must provide medical and financial assistance through a one-stop shop (Section 2(c)).

Key definitions under the Act

A DOH Hospital is a hospital under the management and administration of the Department of Health (DOH), including the four (4) corporate hospitals under the Secretary of Health: the Philippine Heart Center, Lung Center of the Philippines, National Kidney and Transplant Institute, and Philippine Children's Medical Center (Section 3(a)).
Financial Assistance means monetary aid in the form of guaranty letter, cash or check, covering burial, transportation, and other allied assistance or physical aid (such as food, clothing, general assistive devices), given by agencies and mandated by existing laws, rules and regulations (Section 3(b)).
A Financially incapacitated patient is one who is not classified as indigent but shows clear inability to pay for necessary medical treatment, such as catastrophic illness or any life or limb-threatening illness requiring prolonged hospitalization, extremely expensive therapies, or other special but essential care, assessed and certified by the medical social worker (Section 3(c)).
An Indigent Patient is one with no visible means of income or income insufficient for family subsistence, assessed by DSWD, local government social worker, or the medical social worker of the health facility (Section 3(d)).
Medical Assistance is assistance for out-of-pocket expense in the form of coupon, stub, guaranty letter, promissory note or voucher with monetary value, given to be used to purchase drugs, medicines, goods or other services prescribed by the physician for in-and-out patients (Section 3(e)).
A One-Stop Shop is a common site/location to receive and process requests for medical and financial assistance for indigent and financially incapacitated patients (Section 3(f)).
Out-of-pocket expense means medical and surgical services arising from hospitalization not currently paid for or sufficiently covered by PhilHealth benefits, insurance coverage, discounts, or similar sources (Section 3(g)).
Patient navigation is directing and assisting an individual to obtain health care services and overcome barriers for timely, cost-effective, and appropriate medical care (Section 3(h)).
PGH refers to the state-owned tertiary hospital administered and operated by the University of the Philippines-Manila (Section 3(i)).

Coverage and authorized Malasakit Centers

The DOH shall establish a Malasakit Program that all DOH hospitals and the PGH shall adopt and implement (Section 4).
A Malasakit Center shall be established in all DOH hospitals and the PGH (Section 6).
Malasakit Centers must function as one-stop shops for medical and financial assistance in the hospital setting (Section 6(a)).
Malasakit Centers must include a special space exclusively for senior citizens and persons with disabilities (PWDs) in each Malasakit Center (Section 6).
Non-DOH entities may establish Malasakit Centers—LGUs, state universities and colleges (SUCs), Department of National Defense (DND), Department of the Interior and Local Government (DILG) including the Philippine National Police (PNP), Department of Justice (DOJ) and other public hospitals—provided they meet standards set out in the Act and requirements prescribed by the DOH (Section 6).
Public hospitals with existing Malasakit Centers must comply with the standards and criteria stated in the Act (Section 6).
The DOH may augment Malasakit Centers personnel in other public hospitals subject to standards and criteria set by the DOH (Section 6).

Malasakit Program and program office

The DOH must establish a Malasakit Program with objectives that include a policy framework for integrated people-centered health services geared toward responsiveness, appropriate infrastructure and processes, and client engagement and empowerment (Section 4(a)).
The Malasakit Program must ensure financial risk protection and alleviate the financial burden of indigent and financially incapacitated patients and families through medical and financial assistance provided by national government agencies, local government, nongovernment organizations, private corporations, and individuals (Section 4(b)).
Financially incapacitated patients seeking services in other public hospitals and private facilities remain eligible for financial and medical assistance, subject to assessment and recommendation of the medical social worker (Section 4).
The DOH must provide policy direction and guidelines, in consultation with DSWD, PCSO, and PhilHealth, to promote responsive and effective social service engagement in Malasakit Centers (Section 4).
The DOH must establish a Malasakit Program Office by augmenting, reclassifying, and strengthening the existing Public Assistance Unit (PAU) of the DOH (Section 5).
The Malasakit Program Office oversees Malasakit Center operations (Section 5).
The DOH, in coordination with DBM, must ensure creation of adequate plantilla positions and staffing pattern for the Malasakit Program Office (Section 5).

Malasakit Center functions and physical requirements

Each Malasakit Center must serve as a one-stop shop for medical and financial assistance (Section 6(a)).
Each Malasakit Center must provide patient navigation and referral health care provider networks (Section 6(b)).
Each Malasakit Center must provide information regarding membership, coverage and benefit packages in the National Health Insurance Program (Section 6(c)).
Each Malasakit Center must document, process, and utilize patient experience data through a standardized form to shape institutional changes (Section 6(d)).
Each Malasakit Center must provide capacity-building and performance evaluation to ensure good client interaction (Section 6(e)).
Each Malasakit Center must provide critical information on healthy behaviors and conduct health promotion activities in the hospital (Section 6(f)).
Each Malasakit Center must have a special space exclusive for senior citizens and PWDs (Section 6).
Malasakit Centers must be non-partisan, convenient, free of charge, accessible, and must have a standard system of availment of assistance (Section 6).

Administration, operations, and staffing

The incumbent Medical Director, Chief of Hospital, or Medical Center Chief shall be designated as the Malasakit Centers Director (Section 7).
The Malasakit Centers Director must oversee proper management and efficient operation of the Malasakit Center (Section 7).
The Malasakit Centers Director must ensure provision of appropriate space, furniture, equipment, and fixtures based on the DOH-provided standard schematic plan (Section 7(a)).
The Malasakit Centers Director must promote harmony, coordination, and cooperation among participating agencies and strengthen service delivery through highest performance of duties and responsibilities (Section 7(b)).
The Malasakit Centers Director must perform other necessary functions to accomplish Malasakit Program objectives (Section 7(c)).
The Malasakit Centers Director must assign the Head of the Medical Social Work Office as the Malasakit Center Operations Manager to handle day-to-day management and operations (Section 7).
The Malasakit Centers Director and Malasakit Center Operations Manager receive no extra compensation (Section 7).
Each Malasakit Center must be adequately staffed by medical social workers and support staff (Section 8).
The Medical Director, Chief of Hospital, or Medical Center Chief appoints and assigns other personnel needed for effective operation (Section 8).
Each Malasakit Center consists of duly designated representatives from DOH, DSWD, PCSO, and PhilHealth (Section 8).
The DOH, DSWD, and PCSO representatives must process and approve requests for medical and financial assistance (Section 8).
The PhilHealth representative must assist in availment of benefits and address PhilHealth-related concerns of patients (Section 8).
DOH, DSWD, PCSO, and PhilHealth are authorized to create required plantilla and staffing patterns to implement the Act in coordination with DBM, Civil Service Commission (CSC), and the Governance Commission for Government Owned or Controlled Corporations (GCG), as applicable (Section 8).
DOH and DSWD must include in their budgetary submission to DBM the required budget for personnel services requirements of each Malasakit Center, and the budget requirement must be included in their respective budgets in the General Appropriations Act (Section 8).

Medical and financial assistance process

Malasakit Centers must facilitate access to: (a) DOH medical assistance to indigent patients, (b) DSWD financial assistance based on existing Assistance to Individuals in Crisis Situation (AICS) guidelines, (c) PCSO medical assistance under its existing programs chargeable against its funds, and (d) medical and financial assistance programs provided by other government agencies, LGUs, nongovernment organizations, and private institutions and individuals (Section 9).
DOH medical assistance for indigent and financially incapacitated patients must be based on need recommended by the medical social worker and the attending physician (Section 9(a)).
Eligibility assessment must be performed by the medical social worker, who must provide complete information to the patient on the type, form, character, and degree or extent of welfare assistance the patient may receive from various funding sources in Malasakit Centers (Section 9).
Patients admitted in LGU and other public hospitals who are eligible may be extended medical and financial assistance through Malasakit Centers or through the concerned government agencies (Section 9).
If clinically indicated drugs, medicines, tests, services, or procedures are not available in a DOH hospital, the DOH hospital may contract with a DOH-accredited private health facility to provide the needed items charged against the hospital, subject to DOH guidelines (Section 9).
Efficient and streamlined delivery of assistance to all beneficiaries is the primary consideration, and rules and practices must be formulated and implemented to achieve this purpose (Section 9).
No provision limits access to medical and financial assistance only to indigent and financially incapacitated patients referred through Malasakit Centers (Section 9).
Patients or their representative may directly access and request medical and financial assistance from the agencies involved in Malasakit Centers (Section 9).

Monitoring, annual reporting, and implementation rules

The DOH shall conduct monitoring and evaluation of Malasakit Centers responsiveness, including a client satisfaction survey, using indicators such as reduced waiting time, percentage of indigent and financially incapacitated patients served, and percentage of complaints endorsed for action, among others (Section 10).
The DOH, DSWD, PCSO, and PhilHealth must jointly submit a report to the Office of the President of the Philippines, the Senate Committee on Health and Demography, and the House of Representatives Committee on Health on or before the end of December of every year, or upon request of any of those offices (Section 12).
The report must give a detailed account of the status of implementation of the Act (Section 12).
Within ninety (90) days from approval, DOH, PhilHealth, DSWD, and PCSO must jointly issue the implementing rules and regulations of the Act (Section 14).

Appropriations and funding provisions

The amount necessary for the establishment and operation of Malasakit Centers must be included in the General Appropriations Act (Section 13).
Amounts earmarked under Section 288-A of the National Internal Revenue Code, as amended, for medical assistance must be appropriated under DOH, specifically for medical assistance to indigent patients, with a portion allotted for DOH hospitals and the PGH (Section 13).
Other public hospitals without Malasakit Centers must continue to receive medical assistance from the DOH (Section 13).

Penal provisions for misuse and fraud

A public official or employee who commits the following acts must be penalized after due notice and hearing: (1) committing an unethical and fraudulent act or abusing authority results in suspension for three (3) months without pay for the first offense and dismissal from service for the succeeding offense (Section 11(a)(1)); and (2) appropriating Malasakit Program funds for personal use, or willingly or negligently consenting to misappropriation without objecting and properly reporting the matter, results in liability for misappropriation and punishment with a fine equivalent to triple the amount misappropriated per count and suspension of three (3) months without pay (Section 11(a)(2)).
Administrative penalties under Section 11(a) must not prevent the filing of criminal charges under Republic Act No. 3019, the Anti-Graft and Corrupt Practice Act, and existing penal laws (Section 11(a)).
Any person who commits fraud or misrepresentation as to indigency or financial incapacity must render the assistance void, must be liable for twice the amount of assistance provided, and must suffer imprisonment from six (6) months to not more than two (2) years (Section 11(b)).
Any person who aids or abets the offense under Section 11(b) must suffer imprisonment for one (1) day to not more than six (6) months (Section 11(c)).

Separability, repealing, and effect

Section 15 provides that any unconstitutional portion or provision does not nullify other portions if the remaining parts can still subsist and be given effect in their entirety.
Section 16 repeals or modifies all laws, ordinances, rules, regulations, other issuances, or parts thereof that are inconsistent with Republic Act No. 11463.