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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
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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)
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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
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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
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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.
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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
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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
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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
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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.