8/31/2011

1

Health Programs for

CWDs/YWDs/PWDs:

The Legal Basis, atbp. Fe Abarcar- delos Reyes, MD.

Executive Director, HELP Learning Center Foundation Inc.

Problem 1: Models of Care: A Paradigm ChangeProblem 1: Models of Care: A Paradigm Change

Problem 2: Accessing Children’s Rights: The UN Problem 2: Accessing Children’s Rights: The UN Declaration of Children’s RightsDeclaration of Children’s Rights

Problem 3: Accessing Rights of PWDs thru UNProblem 3: Accessing Rights of PWDs thru UN--Convention on the Rights of Persons with Disabilities Convention on the Rights of Persons with Disabilities (UN(UN--CRPD)CRPD)

Solution 1: Magna Carta for PWDS:Solution 1: Magna Carta for PWDS:RA 7277, RA 9442RA 7277, RA 9442Provisions on healthProvisions on health

Solution 2: Community Based RehabilitationSolution 2: Community Based Rehabilitation

Solution 3: Examples of Best Practices Solution 3: Examples of Best Practices

Problem Oriented Situational Analysis

Models of CareModels of Care

CharityCharityCharityCharityCharityCharityCharityCharity Social

MedicalRights-based

Development

Impairment is

the problem

Child

Develop-

mental

teamSpecialist

Doctors

Guardian/

Parents

Speech

Therapist

Occupational

Therapist

Benefits

agency

Social

Worker

Surgeon

Special

transport

Educational

Psychologist

Special

schools

Training

centerSheltered

workshop

MEDICAL MODEL

8/31/2011

2

Filipino Income Quintiles

Monthly income Families per quintileQ1 3,460 5,218,267

Q2 6,073 4,094,164

Q3 9,309 3,912,443

Q4 15,064 3,707,494

Q5 38,065 3,485,067

Source: National Health and Demographic Survey, 2008

The

system

is the

problem

Inaccessible

environment

Devaluing

Inaccessible

transportInaccessible

information

Discrimination

in employment

Belief in the

Medical

model

Segregated

services

Poverty

Prejudice

SOCIAL MODEL

ADULT42.2 M

23, 125,600

17,808,400CWD

1.26 M (Gifted & Talented)

UNIVERSAL ESTIMATE OF CHILDREN WITHSPECIAL NEEDS 13 %

PHILIPPINE POPULATION 84.4 M AS OF 2005

Source: Dep.Ed.newsletter

Below 24 y.o.42.2 M

Lack of data of Persons with Disability (ADB, 2004)Lack of data of Persons with Disability (ADB, 2004)

8/31/2011

3

97% of

CWDs (7-12

yrs. old) no

SPED

services

despite of

100 years in

existence (DepEd, 2009)

UN Convention on the Rights of ChildrenUN Convention on the Rights of Children

The UNCR has 41 articles that stipulate the rights of The UNCR has 41 articles that stipulate the rights of all children. These can be grouped into 4 broad all children. These can be grouped into 4 broad categories:categories:

SURVIVAL basic needs food, clothing, shelter, healthSURVIVAL basic needs food, clothing, shelter, health

DEVELOPMENT to the fullest, early stimulation, free DEVELOPMENT to the fullest, early stimulation, free public educationpublic education

PROTECTION from harmful influences, abuse, PROTECTION from harmful influences, abuse, exploitationexploitation

PARTICIPATE fully in family, cultural, social lifePARTICIPATE fully in family, cultural, social life

4 CORE PRINCIPLES4 CORE PRINCIPLESNon discriminationNon discrimination

Devotion to the best interest of the childDevotion to the best interest of the child

Respect for the views of the childRespect for the views of the child

Right to life, survival, and development Right to life, survival, and development

The convention protects children’s rights by setting The convention protects children’s rights by setting The convention protects children’s rights by setting The convention protects children’s rights by setting The convention protects children’s rights by setting The convention protects children’s rights by setting The convention protects children’s rights by setting The convention protects children’s rights by setting standards in health care, education legal, civil and standards in health care, education legal, civil and standards in health care, education legal, civil and standards in health care, education legal, civil and standards in health care, education legal, civil and standards in health care, education legal, civil and standards in health care, education legal, civil and standards in health care, education legal, civil and social servicessocial servicessocial servicessocial servicessocial servicessocial servicessocial servicessocial services

UN-Convention on the RIGHTS OF

PERSONS WITH DISABILITIES

Purpose of UNPurpose of UN--CRPDCRPD

-- To promote, protect and ensure the full and To promote, protect and ensure the full and

equal enjoyment of all human rights by persons equal enjoyment of all human rights by persons

with disabilities.with disabilities.

-- It covers key areas: Accessibility, Personal It covers key areas: Accessibility, Personal

Mobility, Health, Education, Employment, Mobility, Health, Education, Employment,

Habilitation & Rehabilitation, Participation in Habilitation & Rehabilitation, Participation in

political life, Equality and Nonpolitical life, Equality and Non--Discrimination Discrimination

8/31/2011

4

How was the Convention negotiated?

When will the new Convention take effect?

2006 2006 -------- The General Assembly adopted the The General Assembly adopted the The General Assembly adopted the The General Assembly adopted the The General Assembly adopted the The General Assembly adopted the The General Assembly adopted the The General Assembly adopted the

Convention Convention Convention Convention Convention Convention Convention Convention

Sep.2007 Sep.2007 –– Sec. Alberto Romulo of DFA signed Sec. Alberto Romulo of DFA signed

the Convention in behalf of PGMAthe Convention in behalf of PGMA

Dec.2007 Dec.2007 –– The President ratified the The President ratified the

Convention. We were the 23Convention. We were the 23rdrd

country that ratified the Convention country that ratified the Convention

UN Convention on the Rights

of Persons with Disabilities

By ratifying the Convention, and after the treaty By ratifying the Convention, and after the treaty

comes into force, a country accepts legal comes into force, a country accepts legal

obligations and will adopt implementing legislation.obligations and will adopt implementing legislation.

States (like the Philippines) will be States (like the Philippines) will be obligated to obligated to

introduce measures that promote human rights of introduce measures that promote human rights of

persons with disabilities without discriminationpersons with disabilities without discrimination. .

Will the Convention create

obligations for states?

Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes.

It will enact It will enact antianti--discrimination legislationdiscrimination legislation, eliminate , eliminate laws and practices that discriminate against laws and practices that discriminate against persons with disabilities, and consider persons with persons with disabilities, and consider persons with disabilities in adopting new policies and disabilities in adopting new policies and programs…and where resources are scarce, it is programs…and where resources are scarce, it is hoped that international assistance will helphoped that international assistance will help

Disability Laws and EOs

I.I. Executive Order 709Executive Order 709

II.II. Republic Act 7277Republic Act 7277

III.III. Republic Act 9442Republic Act 9442

IV.IV. NCDA AO No. 001NCDA AO No. 001

V.V. Executive Order 437Executive Order 437

VI.VI. Accessibility LawAccessibility Law

8/31/2011

5

EO 709 – February 26, 2008

Redefining the functions and organizational Redefining the functions and organizational

structure of NCWDP which is renamed to NCDA structure of NCWDP which is renamed to NCDA

and attached to the DSWD. and attached to the DSWD.

RA 7277: Magna Carta for Disabled

Persons

“An Act providing for the Rehabilitation, Self “An Act providing for the Rehabilitation, Self

Development, and Self Reliance of Persons with Development, and Self Reliance of Persons with

Disability, their Integration into the Mainstream Disability, their Integration into the Mainstream

of Society and other purposes.of Society and other purposes.

Passed into law on March 24, 1992 under Pres. Passed into law on March 24, 1992 under Pres.

Corazon AquinoCorazon Aquino

NATIONAL COUNCIL FOR THE NATIONAL COUNCIL FOR THE

WELFARE OF DISABLED PERSONSWELFARE OF DISABLED PERSONS

MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED MAGNA CARTA FOR DISABLED

PERSONS (RA 7277)PERSONS (RA 7277)PERSONS (RA 7277)PERSONS (RA 7277)PERSONS (RA 7277)PERSONS (RA 7277)PERSONS (RA 7277)PERSONS (RA 7277)

Chapter 3; Rule 4 Chapter 3; Rule 4 Chapter 3; Rule 4 Chapter 3; Rule 4 Chapter 3; Rule 4 Chapter 3; Rule 4 Chapter 3; Rule 4 Chapter 3; Rule 4

Section 18Section 18Section 18Section 18Section 18Section 18Section 18Section 18--------20 20 20 20 20 20 20 20 -------- Health ProvisionsHealth ProvisionsHealth ProvisionsHealth ProvisionsHealth ProvisionsHealth ProvisionsHealth ProvisionsHealth Provisions

BASIC POLICIES & PRINCIPLESBASIC POLICIES & PRINCIPLES

(IRR(IRR--RA 7277 Rule IV, Section 1)RA 7277 Rule IV, Section 1)

Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society, Disabled Persons are part of Philippine Society,

thus the thus the thus the thus the thus the thus the thus the thus the State shall give full support for the State shall give full support for the State shall give full support for the State shall give full support for the State shall give full support for the State shall give full support for the State shall give full support for the State shall give full support for the provision of health services to themprovision of health services to themprovision of health services to themprovision of health services to themprovision of health services to themprovision of health services to themprovision of health services to themprovision of health services to them and it shall and it shall and it shall and it shall and it shall and it shall and it shall and it shall

be the be the be the be the be the be the be the be the responsibility of the government and responsibility of the government and responsibility of the government and responsibility of the government and responsibility of the government and responsibility of the government and responsibility of the government and responsibility of the government and

private sector and the members of the private sector and the members of the private sector and the members of the private sector and the members of the private sector and the members of the private sector and the members of the private sector and the members of the private sector and the members of the

community at large.community at large.community at large.community at large.community at large.community at large.community at large.community at large.

8/31/2011

6

RA 7277: Magna Carta for Disabled Persons

Required the DOH to :Required the DOH to :

1. Institute a national health program for PWDs1. Institute a national health program for PWDs

2. Establish medical rehabilitation centers in 2. Establish medical rehabilitation centers in

provincial hospitals provincial hospitals

3. Adopt an 3. Adopt an integrated and comprehensive integrated and comprehensive

approach to health development of PWD approach to health development of PWD which which

shall make essential health services available to shall make essential health services available to

them at affordable costthem at affordable cost

Functions and Areas of Functions and Areas of

Responsibility Responsibility (IRR(IRR--RA 7277 Rule IV, Section 3)RA 7277 Rule IV, Section 3)

The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:

1.2 Create a Division under non communicable 1.2 Create a Division under non communicable 1.2 Create a Division under non communicable 1.2 Create a Division under non communicable 1.2 Create a Division under non communicable 1.2 Create a Division under non communicable 1.2 Create a Division under non communicable 1.2 Create a Division under non communicable

disease control service that shall administer and disease control service that shall administer and disease control service that shall administer and disease control service that shall administer and disease control service that shall administer and disease control service that shall administer and disease control service that shall administer and disease control service that shall administer and

lead in the implementation of the programlead in the implementation of the programlead in the implementation of the programlead in the implementation of the programlead in the implementation of the programlead in the implementation of the programlead in the implementation of the programlead in the implementation of the program

1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system 1.3 set up a national registration/reporting system

for specific types of disabilities and shall for specific types of disabilities and shall for specific types of disabilities and shall for specific types of disabilities and shall for specific types of disabilities and shall for specific types of disabilities and shall for specific types of disabilities and shall for specific types of disabilities and shall

generate and assess data base…generate and assess data base…generate and assess data base…generate and assess data base…generate and assess data base…generate and assess data base…generate and assess data base…generate and assess data base…

Functions and Areas of Functions and Areas of

Responsibility Responsibility (IRR(IRR--RA 7277 Rule IV, Section 3)RA 7277 Rule IV, Section 3)

The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:The Department of Health shall:

1.4 Strengthen its programs on immunization, breast 1.4 Strengthen its programs on immunization, breast

feeding, child care, safe motherhood…in support feeding, child care, safe motherhood…in support

of the National Health Program for PWDof the National Health Program for PWD

4. Set the standard requirements and capabilities 4. Set the standard requirements and capabilities

for care of disabled persons appropriate for for care of disabled persons appropriate for

each level of health care facilityeach level of health care facility

RA 7277: Magna Carta for Disabled

Persons

Rule IV, Section 4, Part B of Implementing rules Rule IV, Section 4, Part B of Implementing rules

and regulations required the DOH to address the and regulations required the DOH to address the

concerns of 7 categories of disability:concerns of 7 categories of disability:

1. Psychosocial and behavioral disabilities1. Psychosocial and behavioral disabilities

2. Chronic illnesses with disabilities2. Chronic illnesses with disabilities

3. Learning disabilities3. Learning disabilities

8/31/2011

7

RA 7277: Magna Carta for Disabled

Persons

44. Mental disabilities. Mental disabilities

55. Visual/ seeing disabilities. Visual/ seeing disabilities

66. Orthopedic/moving disabilities. Orthopedic/moving disabilities

77. Communication deficits. Communication deficits

RA 9442 “An Act Amending RA 7277”

A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 A new chapter to be denominated as Chapter 8 with new sections 32,33.with new sections 32,33.with new sections 32,33.with new sections 32,33.with new sections 32,33.with new sections 32,33.with new sections 32,33.with new sections 32,33. Signed into law last Signed into law last April 30, 2007April 30, 2007

An Act Amending RA No. 7277 Otherwise known as An Act Amending RA No. 7277 Otherwise known as the “Magna Carta for Disabled Persons and for the “Magna Carta for Disabled Persons and for other Purposes”, Granting Additional Privileges other Purposes”, Granting Additional Privileges and Incentives and Prohibitions on Verbal, Nonand Incentives and Prohibitions on Verbal, Non--Verbal Ridicule and Vilification against Persons Verbal Ridicule and Vilification against Persons with Disabilities.with Disabilities.

DOH-AO No.2009-0011 IRR (RA 9442)

Chapter 8: Other privileges and IncentivesChapter 8: Other privileges and Incentives

Sec 32: Persons with disability shall be entitled to the Sec 32: Persons with disability shall be entitled to the following:following:

aa. At least 20% discount for the purchase of medicines in . At least 20% discount for the purchase of medicines in all drugstores all drugstores for the exclusive use or enjoyment or for the exclusive use or enjoyment or persons with disabilitiespersons with disabilities

B. B. At least 20% discount on medical and dental services At least 20% discount on medical and dental services including diagnostic and laboratory fees such as but not including diagnostic and laboratory fees such as but not limited to xlimited to x--rays, computerized tomography, scans and rays, computerized tomography, scans and blood tests in all government facilitiesblood tests in all government facilities subject to guidelines subject to guidelines issued by DOH and PhilHealthissued by DOH and PhilHealth

DOH A.O. 2009-0011

All PWDs confined in the pay section of All PWDs confined in the pay section of government facilities are granted 20% discount government facilities are granted 20% discount for medical and dental services, and diagnostic for medical and dental services, and diagnostic and laboratory feesand laboratory fees provided that these are in provided that these are in accordance with available clinical practice accordance with available clinical practice guidelines of Hospital Treatment Protocolsguidelines of Hospital Treatment Protocols

For outpatient, the same rule shall be followedFor outpatient, the same rule shall be followed

8/31/2011

8

DOH A.O. 2009-0011

All pwds are granted 20% discount in all private All pwds are granted 20% discount in all private

hospitals and medical facilities hospitals and medical facilities for the costs of for the costs of

medical, dental, rehabilitation, occupational and medical, dental, rehabilitation, occupational and

physical and speech therapies or services and physical and speech therapies or services and

diagnostic and laboratory fees such as but not diagnostic and laboratory fees such as but not

limited to xlimited to x--rays, CT scans, blood tests and rays, CT scans, blood tests and

others including professional fees for attending others including professional fees for attending

doctorsdoctors

20% discount in Professional Fees

Professional fees for inpatient and outpatient Professional fees for inpatient and outpatient

medical, dental, and other health care medical, dental, and other health care

professional services shall be provided 20% professional services shall be provided 20%

discount. discount. The concerned physician or dentist The concerned physician or dentist

must issue corresponding official receiptmust issue corresponding official receipt

DOH-AO No.2009-0011 IRR (RA 9442)

Rule IV, Section Rule IV, Section 66, par , par 1010::

“Express lanes for persons with disabilities shall be “Express lanes for persons with disabilities shall be provided in all private, commercial, and government provided in all private, commercial, and government establishments, in the absence thereof, priority shall be establishments, in the absence thereof, priority shall be given them in all transactions of the establishments”given them in all transactions of the establishments”

LGUs shall ensure that this provision is implemented LGUs shall ensure that this provision is implemented within their area of jurisdictionwithin their area of jurisdiction

There should be assigned person or desk manned by There should be assigned person or desk manned by trained personnel to assist PWDs which shall be part of trained personnel to assist PWDs which shall be part of existing human resource in all other government existing human resource in all other government agencies/offices and private establishmentsagencies/offices and private establishments

Guidelines on 20% discount in the purchase of

medicines exclusive for PWD use

Discounts shall be granted to pwds on the purchase Discounts shall be granted to pwds on the purchase of all medicines provided that it is supported by the of all medicines provided that it is supported by the following:following:

PWD identification card PWD identification card

Doctors’ prescription with complete information: pwd Doctors’ prescription with complete information: pwd name, age, address, date, generic name of meds, dosage name, age, address, date, generic name of meds, dosage form, strength, quantity, signature over printed name, form, strength, quantity, signature over printed name, name of physician, contact number, PRC number, PTR, S2 name of physician, contact number, PRC number, PTR, S2 if applicable. Prescription is required in the purchase of if applicable. Prescription is required in the purchase of over the counter medicinesover the counter medicines

8/31/2011

9

Guidelines on 20% discount in the purchase of

medicines exclusive for PWD use

Purchase booklet issued by local social/health Purchase booklet issued by local social/health office to PWDs for free containing basic office to PWDs for free containing basic informationinformation

Authorization letter of pwd in case bought by Authorization letter of pwd in case bought by representativerepresentative

Any single dispensing of medicines should not Any single dispensing of medicines should not exceed one month supplyexceed one month supply

Non transferableNon transferable

Require PWD to present a PWD ID CardRequire PWD to present a PWD ID Card

(Sec. 5) Prohibition on availment of

double discounts:

PWD claiming higher discount as may be PWD claiming higher discount as may be

granted by the commercial establishment and/or granted by the commercial establishment and/or

existing laws or in combination with other existing laws or in combination with other

discount programs. The PWD who is at the same discount programs. The PWD who is at the same

a senior citizen can only claim one 20% discount a senior citizen can only claim one 20% discount

on a particular sales transaction.on a particular sales transaction.