University Teaching Hospital for Universal Health Care Act

Senate Office of the secretary TWENTIETH CONGRESS OF THE REPUBLIC OF THE PHILIPPINES MAY -5 P3:43 First Regular Session SENATE RECEIVED BY: S. No. _ 2103 Introduced by Senator Loren Legarda AN ACT ESTABLISHING A NATIONAL FRAMEWORK FOR UNIVERSITY TEACHING HOSPITALS AND INTEGRATED ACADEMIC HEALTH SYSTEMS TO STRENGTHEN MEDICAL EDUCATION AND SUPPORT THE IMPLEMENTATION OF UNIVERSAL HEALTH CARE, AND FOR OTHER PURPOSES EXPLANATORY NOTE The effective implementation of Republic Act No. 11223, or the Universal Health Care Act, requires a health workforce that is sufficient in number, appropriately trained, and responsive to community health needs. Despite recent reforms, the country continues to face persistent gaps in the production, distribution, and training quality of physicians and other health professionals. These gaps are not solely due to limited supply, but also to the lack of alignment between medical education and the health system in which professionals are expected to serve. Medical education in the Philippines remains largely hospital-centered and uneven in the availability and quality of clinical training opportunities. In many areas, especially outside major urban centers, training platforms are often limited or fragmented and not consistently integrated with primary care and community health services. At the same time, the expansion of medical schools under Republic Act No. 11509, or the Doktor Para sa Bayan Act, has heightened the need for strong, accredited, and properly integrated clinical training environments to ensure educational quality, patient safety, and health system responsiveness. This measure addresses these structural challenges by institutionalizing a

national typology of University Teaching Hospitals and strengthening the integration of medical schools into Academic Health Systems. The measure defines the levels and functions of teaching hospitals, promotes partnerships among State Universities and Colleges, the Department of Health, local government units, and primary care networks, and embeds medical education within Health Care Provider Networks established under the Universal Health Care Act. Through these reforms, the measure ensures that future physicians and health professionals are trained in settings that reflect the realities of health service delivery, including primary care, referral systems, community health, and population health management. It supports equitable access to quality training platforms, strengthens rural health service capacity, and promotes the production and retention of health professionals prepared to serve in underserved communities. By establishing a coherent national framework for university teaching hospitals and integrated academic health systems, this measure safeguards patient safety, strengthens health workforce development, and enhances health system performance. It advances the constitutional mandate to protect and promote the right to health and supports the effective implementation of Universal Health Care. In view of the foregoing, the immediate passage of this measure is earnestly sought. LOREN LEGARDA

Senate Office of the gecretary TWENTIETH CONGRESS OF THE REPUBLIC OF THE PHILIPPINES MAY -5 P3:43 First Regular Session SENATE RECEIVED BY: S. No. — 2103 Introduced by Senator Loren Legarda AN ACT ESTABLISHING A NATIONAL FRAMEWORK FOR UNIVERSITY TEACHING HOSPITALS AND INTEGRATED ACADEMIC HEALTH SYSTEMS TO STRENGTHEN MEDICAL EDUCATION AND SUPPORT THE IMPLEMENTATION OF UNIVERSAL HEALTH CARE, AND FOR OTHER PURPOSES Be it enacted by the Senate and the House of Representatives of the Philippines in Congress assembled:

Section 1. Short Title. - This Act shall be known as the "University Teaching

2 Hospitals for Universal Health Care Act".

Sec. 2. Declaration of Policy. - It is hereby declared the policy of the State to:

(a) Ensure that medical and health professions education is high-quality, socially accountable, community-responsive, and aligned with the objectives of Republic Act No. 11223, otherwise known as the Universal Health Care Act; (b) Foster an integrated academic-service ecosystem linking universities, hospitals, primary care facilities, and communities; (c) Ensure that the expansion of medical education programs under Republic Act No. 11509, otherwise known as the Doktor Para sa Bayan Act, is supported by adequate, accredited, and properly integrated clinical training platforms; (d) Strengthen the production, equitable geographic distribution, and retention of physicians and health professionals trained in primary care, population health, systems-based practice, and community service;

(e) Establish a coherent national framework for University Teaching Hospitals that safeguards patient safety, promotes health equity, and strengthens health system performance; and 4 (f) Support evidence-based national health workforce planning and the effective implementation of Universal Health Care. Toward these ends, the State shall institutionalize a national framework for 7 University Teaching Hospitals and Academic Health Systems to support health professions education, strengthen health workforce development, and improve health 9 system performance.

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

(a) Academic Health System (AHS) refers to an integrated system composed of a university or state university or college (SUC), affiliated teaching hospitals, research units, and community-based training platforms operating within a Health Care Provider Network; (b) Health Care Provider Network (HCPN) refers to a province- or city-wide network of primary, secondary, and tertiary care providers delivering coordinated and continuous care pursuant to RA 11223; (c) University Teaching Hospital (UTH) refers to a hospital or network of health facilities that is formally affiliated with a university or SUC for clinical education, training, research, and health services as part of an academic health system. (d) Universal Health Care (UHC) refers to the health coverage framework, programs, and systems established under Republic Act No. 11223, the Universal Health Care Act; (e) UHC-Ready Physician refers to a physician with demonstrated competencies in primary care, systems-based practice, population health, continuity of care, interprofessional collaboration, community-oriented service, and public health advocacy, in alignment with the health workforce requirements of the Universal Health Care Act.

Sec. 4. National Typology of University Teaching Hospitals. - There is hereby

established a National Typology of University Teaching Hospitals, comprising the following types:

(a) Apex University Hospital (AUH). A Level 3 or specialty hospital designated as a national referral center for quaternary and subspecialty care, advanced simulation, health systems research, and clinical innovation; (b) Regional University Teaching Hospital (RUTH). A Level 2 or Level 3 hospital serving as a regional referral center with responsibility for specialty training, clinical education at the regional level, and support for regional health workforce development; (c) Provincial University-Affiliated Training Hospital (PUTH). A Level 1 or Level 2 hospital serving as the principal training site for generalist and primary-care- oriented clinical programs, including clerkships, internships, and residency training in general medicine, general surgery, pediatrics, and obstetrics and gynecology; (d) Community Teaching and Learning Network (CTLN). A structured network of primary care and community health facilities, providing longitudinal, community-based, and population-health training. The CTLN functions as an essential component of the Academic Health System. (e) Specialized University Institute (SUI). A center of excellence operating within an AUH or RUTH, focused on priority areas including, but not limited to, cancer care, trauma, infectious diseases, mental health, public health emergency preparedness, and health security. The DOH, in coordination with CHED, shall issue the criteria, standards, and procedures for the accreditation, designation, and upgrading of UTHs under the National Typology established in this Section.

Sec. 5. Mandates of University Teaching Hospitals. - All UTHs, in accordance

with their respective type and level under the National Typology, shall: (a) Provide UHC-aligned clinical training across primary, secondary, and tertiary levels of care; (b) Support the health professions education programs of affiliated SUCs and partner institutions; (c) Integrate academic, research, and service functions to promote learning health systems and continuous quality improvement;

(d) Conduct research that addresses public health priorities, health equity, and the evidence needs of the National Health System; (e) Function as operational components of the HCPN in which they are geographically situated, participating in referral networks, clinical pathways, and coordinated care arrangements; (f) Uphold patient safety, ethical standards, and quality improvement systems in accordance with applicable DOH standards and international best practices; and (g) Promote interprofessional education and team-based care across health disciplines.

Sec. 6. Special Mandates of Apex University Hospitals. - In addition to the

11. general mandates in Section 5, Apex University Hospitals shall: (a) Serve as national centers for subspecialty care, advanced clinical simulation training, biomedical and health systems research, and health technology assessment; Lead national faculty development, curriculum innovation, and the development of simulation-based and competency-based education programs for medical and health professions; (c) Provide mentoring, technical assistance, and capacity-building support to RUTHS, PUTHs, CTLNs, and SUC-affiliated medical schools; (d) Host national centers aligned with strategic health priorities, including pandemic preparedness, precision medicine, global health security, and health systems science; (e) Serve as national institutional hubs for DOH, CHED, PhilHealth, and LGU capacity-building programs related to health workforce development; (f) Lead in the development of national clinical guidelines and health systems quality improvement frameworks in collaboration with DOH and CHED; and (g) Receive priority funding support consistent with their national mandates, as provided under Section 11.

Sec. 7. Status of Existing Government Hospitals. - The following classification

shall apply to existing government-operated hospitals: (a) DOH-retained hospitals at Level 2 and Level 3 may be designated as Apex or

Regional University Teaching Hospitals upon compliance with the standards prescribed under this Act; (b) Provincial and district hospitals at Level 1 or Level 2 may be designated as Provincial University-Affiliated Training Hospitals upon compliance with applicable standards; (c) RHUs, BHS, and Konsulta providers enrolled under the UHC system shall be eligible for integration into CTLNs, subject to the affiliation agreements required under this Act; and (d) SUCs shall prioritize integration of medical education programs within existing government hospitals and health networks. New SUC-operated hospitals may be authorized only upon a determination by DOH and CHED that appropriate clinical training platforms are not available within the geographic area, or where national health policy requires the establishment of a training facility.

Sec. 8. Integration of SUC-Affiliated Medical Schools. - The following

requirements shall govern the integration of SUC-affiliated medical schools into the Academic Health System: (a) No SUC-affiliated medical school shall be granted an initial permit to operate, or continue operating, without a DOH- and CHED-approved Academic Health System Integration Plan demonstrating adequate and verifiable clinical exposure through formally affiliated UTHs and CTLNs: Provided, That nothing in this Act shall be construed to diminish the academic autonomy of SUCs as provided under existing laws; (b) DOH and CHED shall jointly develop the standards and evaluation methodology for assessing the service-training alignment of SUC-affiliated medical schools on a regular basis, which shall not be less than once every three (3) years; (c) Distributed and community-based clinical training models shall be prioritized to strengthen rural health service delivery, community-based practice, and the retention of physicians in underserved areas; and (d) All SUC-affiliated medical schools shall enter into formal Academic Affiliation Agreements with appropriate UTHs for clerkships, internships, residency training, and collaborative research, which agreements shall be subject to DOH

and CHED guidelines.

Sec. 9. Integration with Health Care Provider Networks and Local Health

3 Systems. - The following requirements shall govern the integration of UTHs within the 4 broader health system: 5 (a) Every UTH shall be embedded within the HCPN of the province or city in which it is located, and shall enter into service agreements with the relevant HCPN consistent with the provisions of the Universal Health Care Act; (b) UTHs shall actively participate in HCPN referral systems, capitation and PhilHealth financing arrangements, telehealth platforms, clinical pathways, and multidisciplinary care teams as mandated under Republic Act No. 11223; and (c) UTHs shall provide technical assistance and capacity support to LGUs, upon request or through agreed partnership arrangements, in quality assurance, clinical governance, health facility operations, and UHC program implementation.

Sec. 10. Governance of University Teaching Hospitals. - Each UTH shall be

governed by a Governing Board with the following composition: (a) Secretary of Health, or a duly authorized representative, who shall serve as Chairperson; (b) Chairperson of the Commission on Higher Education, or a duly authorized representative, who shall serve as Co-Chairperson; (c) President of the affiliated university or SUC; (d) Medical Center Chief or Hospital Director of the UTH; (e) Representative from the relevant Provincial or City Health Board; (f) Representative of patient and community stakeholders; and (g) Dean or highest academic official of the SUC-Affiliated Medical School. Apex University Hospitals may include such additional members as are necessary to reflect their national mandate, as prescribed in the Implementing Rules and Regulations. The Governing Board, which shall meet not less that once every quarter, shall be responsible for policy direction, strategic oversight, approval of institutional plans and budgets, and accountability reporting for the UTH: Provided, That the Governing

1 Board shall exercise policy and oversight functions consistent with existing DOH 2 hospital governance structures and applicable laws.

Sec. 11. Financing. - UTHs shall be financed through the following sources:

4 (a) Annual appropriations under the General Appropriations Act, in amounts sufficient to carry out the mandates of this Act; (b) Other financing mechanisms established under the Universal Health Care Act; (c) Research grants, innovation funds, and special-purpose funding from government and international sources; (d) Public-private partnerships consistent with the public service mandate of UTHS and applicable laws; and (e) Donations, endowments, and other lawful sources of funding. Apex University Hospitals shall receive priority consideration in national budget allocations in accordance with existing budgeting processes to support the discharge of their national mandates under this Act.

Sec. 12. Capacity-Building and Faculty Development. - The DOH, CHED, and

SUCs shall jointly establish and implement programs for: (a) Faculty recruitment, deployment, and academic service partnerships between UTHs and SUC-affiliated medical schools; (b) Distributed and ladderized residency and specialty training programs aligned with national health workforce needs; (c) Visiting faculty and clinical exchange programs among AUHs, RUTHs, and PUTHs to build institutional capacity; and (d) Continuing professional development programs for UTH clinical faculty and health workforce, aligned with UHC competency frameworks.

Sec. 13. Monitoring, Evaluation, and Quality Assurance. - The following

monitoring, evaluation, and quality assurance mechanisms are hereby established: (a) DOH and CHED shall jointly conduct annual performance evaluations of all UTHs. Evaluation results shall be publicly disclosed and transmitted to the Office of the President, Congress, and relevant oversight bodies; (b) The performance evaluation framework shall include, at a minimum, the following indicators:

(i) Graduate competency outcomes and licensure examination performance; (ii) UHC readiness and primary care integration metrics; (iii) Degree of operational integration within the HCPN; (iv) Patient safety and clinical quality indicators; (v) Research productivity and knowledge generation; and (vi) Community health impact and equity outcomes; (c) CHED, upon recommendation of the DOH and after due notice and hearing, may suspend or revoke the authority of a SUC-affiliated medical school to operate where the school fails to demonstrate adequate clinical training platforms meeting the standards established under this Act; and (d) DOH and CHED shall submit a consolidated annual report to Congress on the status of UTH implementation, Academic Health System integration, and health workforce outcomes under this Act.

Sec. 14. Implementing Rules and Regulations. - DOH and CHED, in consultation

with SUCs, LGUs, health professional organizations, and other relevant stakeholders, shall jointly promulgate the Implementing Rules and Regulations of this Act within six (6) months from its effectivity.

Sec. 15. Appropriations. - The amount necessary for the initial implementation

20 of this Act shall be drawn from the current appropriations of concerned agencies. Thereafter, annual funding requirements shall be included in the General 22 Appropriations Act.

Sec. 16. Separability Clause. - If any provision of this Act shall be held

unconstitutional or invalid, the other provisions not otherwise affected shall remain in full force and effect.

Sec. 17. Repealing Clause. - All laws, executive orders, issuances, or any part

27 thereof, which are inconsistent herewith, are hereby repealed or amended 28 accordingly.

Sec. 18. Effectivity. - This Act shall take effect fifteen (15) days after its

30 publication in the Official Gazette or in a newspaper of general circulation. Approved,