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PHILIPPINE HEALTH INSURANCE CORPORATION C 1ryst;HL· <:cn trL, 7DlJ ~ l tl\\ - Kouk·\-;lrd, J>nstg Ctty

I k.dLh ill lL -1-11-7-1-12 J/'ll'IICf'hi!h.-,i/t!t .. ~lll . /'h

December 5, :2()1.)

PHILHEALTH CIRCULAR No. 00 =1- , s-2014

dllfl•) TO ALL PHILHEAL TH MEMBERS, ACCREDITED HEALTH

CARE PROVIDERS, PHILHEALTH REGIONAL OFFICES AND ALL OTHERS CONCERNED

SUBJECT Guidelines for the OKs ang Bakuna ko Laban sa Pulmonya: a Program on Pneumococcal Vaccine for PhiiHealth Members and Dependents Aged 50 years old and Above

I. BACKGROUND

Th e Dep;.utment of Health issued .Administrative Order (.-\ .0.) 2010-0036 that enunciate ~

th e implementation framework for achievmg Uni,·ersal H ealth Care (Ul-IC) also kn own as "Kalusugan Pangkalahatan" (KP) Program of th e .Aquino Administration and Largets achi eHmenr of UHC in three (3) \'Cars. The _r\ .0. al so defin es public-pri\'ate partnership (PPP) as a cooperative venture between the public and pri\·ate sectors, built o n the experti se of each partner tha t best meet defined public needs through the appropria te­alloca tion of resources , ri sks and rewards. Thi s partnership may range from health care prm·ision w logistics management, from information and communication technolog,- to capacnv building of health providers

Pursuan t to th1s A.O., PhilHealth intends to pro,·ide irs members witb quality health care benefit s which includes among others, vaccina tion again st pneumococcal diseases .

II. COVERAGE

The spee1al price of pneumococcal ,-accines shall apply ro all PhilHealth m embers an d th eir qualitl.ed dependents aged 50 years old and above. The vaccines shall be made m·aiL:tblc to identi fi ed n ccin e access points (\ '_c\ P s) whi ch are composed o f public and pri,rate health care insntutions nati omcv:ide .

III. ROLES AND RESPONSIBILITIES

A. PhilHealth

1. Ivionitor regularlr the implementation of the program 1ncluding the anilabilitr and compliance to the agreed price o f th e ' ' accine, performance of 'lc-\P~ and industry partners;

2. 1\ssist in the promotion o f the program by prm·iding necessary logistic and administrative support;

3. Review and approve materials for publication thar are related to the program; 4. Organize orientations - for identified health care providers in the VAPs, as

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B. Industry Partner

c.

1. Identify the V.r\Ps for the program in coordination wi th and approval of Phill-Iealth;

2. Provide the V[\Ps with unbranded custonuzed \'accination cards to be distributed to eligible Philf-lealth members and dependenrs who will recci\T the \'accJne for record / tn1cking purposes;

3. Provide qualitY, safe and efficacious \'accines ar the agreed special pncc to identified VAPs on a consignment bas1s;

4. J\Jonitor and ensure safe and cimely delivery of vaccines ru V .:-\Ps; ::;,. E nsure availability of the vaccines at V1-\Ps at all times; 6. Provide Phill-lealth with necessarv and relevanr public 1nformation and

educational materials for the promotion of the program; 7. Implement a multi-medi3 public informmion c3mpaign. [\11 information matenals

8.

VAPs

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6.

related to the program should be pre-approved bv PhilJ-Iealth 3nd ph;um.aceutic3l partner before publication ro mcrease public awareness on the progr3m; Conduct, as needed and in coordination with Phill-lealth, patient education and awareness campaigns on the benefits of preventing pneumococcal disea:;es .

Identified V,-\Ps shall determme which departm.ent of the health care institution will serve as the vaccination unit for the program; Ensure the presence of health care providers who will screen the parienr prior to prescnption of Yaccines when needed; Ensure th e a\' ailability of health care providers who will wnre a prescripti on for the \' accine if patient does not vet have a written prescription; Ensure the anilabilitr of health care providers who \vill adm111ister the ,·accinc ro the PhilHealth members or dependents in the assigned Vaccination U nit; Develop a system to determine how and where the vaccines will be mnde aYaihblc to eligible PhilHealth !Tlembers and dependents; Ensure aYaihbility of all supplies and equipment needed for the implementation of the program (i.e. sterile cotton, adhesiYe, alcohol, cold chain, sharps disposal container, etc.);

7. Require the PhilHealth member or dependen t to presen t the original co1w of the prescription for the \'acone before filling it;

8. Issue an official receipt upon receinng payment for the \'accines; 9. Report any adverse reaction to the Food and Drug }~.dminisrration, cop)- furnish

the mdustlT partner/ sand PhilJ-Jealth ; 10. Keep a record of all PhilHealth members and their dependents that a\' ailed of the

pneumococcal \'accine. Th1s record shall contain pertinent pntienr information, lo t number of the vaccine, person adminis tering the Yaccine and remarks for any ndversc events. The record shall be a\'aihble at all times for monitnnng _of PhilHealth.

D. PhilHealth member/ dependent(s)

1. Consul t \Vith and secure a prescnption from a doctor ei ther \vitllin or outside the health care insti tution where the vaccine will be administered pri or to anilment of the Yaccines; Have at hand their Phili -Tealth number cards or iden tification cards or proof of dependency 111 case the patienr is no t· the member (e.g. membership data record, birtb certificate) for presentati_qn to the \'APs.

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IV. Patient Vaccination Procedure

:1 . Philf lcal th nwmbcr / dqwndctlt (s) m nl· go to the· tll":lrL·st \' .\Ps. b. Phi!J ·lc:-~lth m cmber/ dcpendent(s) shall proceed tu the \ '_ \P-:-~ssigned \"accit1:Jttotl L' ll1t

witlun the health can· tn srir urion . c. Phil! lealth tllc·mhcr/ dcpencknt (s) shall ptTsc·nt an\ pwol· o( mc· mhcrshtp such :1' Jl) m

f\ fDR for dependents. d. ll e:1 lth care prm·tclct·s in the \ ·:1ccin ;nion L:nit wirhtn \ ' .\Ps sh:-~ 11 screen th e patlL'IH for

conditi ons / contraindication that \\'il l pn:H'tlt :1 mcmlxT from :lCLJlliring the Y:tccim·. c. l ( th e pattetH has !Hl prcscripuotl \"CI :H h:tmL :1 docrm from the f:-~cilm sh:tll \ITitc· :1

prescriprion for rh c· \":lCC tlll" f. ln c:-~scs when :1 p:1ticnt :1irt:'::Jlil' h:1s :1 prescrip tion from a dc>ctor. th e: p:-~r i et l t Cll l proceed

to the \'accinatiutl L.i ntl instck the\ ' \Ps. g. The -sraff from the \ 'acCJn:uion Uni t 11·ill direc t the panenr to the :1rc:1 11·hcrc the

prescription will be filled. h . . \fter \':lccination. the Phil! kalth membcr / dependent(s) sha ll p:l\ the prnlcrcrmitH:d

:-~ mount :1 nd :1greed up c>tl b_~ · Phi l! k:1lth and th e indus rrr pmrncr of ll<>t - t<> -c·;;ccnl st;; hundred pesos (Php600) at the ca sllH:r or ;ul\ \ '. \P-assigncd p:tyt11ent ccntn. Thi s sha ll cover for :1ll th e sctTiccs needed for the :-tdmimstr:lrion of the ,·accinc.

1. Phii!Tc;tlrh membcr/dcpencknt ( ~) I"C'CcJves "\':Jccin:-ttion c:1rcl (JP/Jid; Jl!i///;1' jll"lll'it!,·rl /;)' !IIi'

jl!Jttrllliln'llliral flt11111l'!" !o I · J P.1) :mel () fficial Rcceipr from the c:1shicr or \' . \ P- :-t s~ Jgned

pm·men t center. I· The Phil! le:-~1th mem ber or dependent shall retum ro the \ ':-tccJn:-ttion Center l-o r

\'::J!iclarion of the \'accinc card.

V. Monitoring and Evaluation

:1 . \".\Ps ~hall ensure the :wailabilin· of their \·acctue~ :1nd ~ h:1ll inform the i mlu~rrr j):l rttHT or the ::Juthorl/:cd disrribmor of the need for :1dditional stocks.

b. Quarterh· reports as to numbcr of :1"\"::J ilment, compli:-tncc and outcome:; shall b e proYidcd br the :1uthorized disrriburor tu indusrn· p:-trm er :1ncl shall sh:1re rhc rcporr to Phil! k:-tlrh for monitoring purposes.

c. Schedule for j1:1 \' ll1ents to the distributor by \' .-\ Ps and replenishmem of \"::JCcJm· stocks shall be ;~greed upon b\ both \ '_-\P ;~nd the distributor .

d. PhilHe::Jlrh , 111 collabor:-t tion \Vith the industrY p:-trtner, s h;~ll develop :1nd implement :1 monitoring :-~nd cv:1luation \vork pbn and :1 cl!cn t s::Jtisf::~ct i on or fecclb:1ck m cch:mism r·or th c progr;~m.

VI. EFFECTIVITY

This Circul ar sldl Utkc effect imm ccli:1tck This shall be published in all\' nc\\·spapcr of gcm·r:1l circuLJtion and clep{)sttnl tl1cn:oi' with th e N:1rional _-\dministr:ltin· Rc!!btcr ;11 the LlniYCrsit\" of tbe Philippine~ LmY Center.

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