ESTABLISHING AN OFWS MEDICAL REHABILITATION PROGRAM AT THE SECRETARIAT FOR MENTALLY ILL AND PHYSICALLY DISABLED WORKERS AND PRESCRIBING ITS IMPLEMENTING MECHANICS

In view of the Board of Trustee’s directive to come-up with a
responsive health program for medically challenged OWWA members,
particularly those afflicted with mental illness and/or suffering from
physical impairment, requiring appropriate medical intervention, a
special medical program shall be established within the Secretariat to
be known as the OFWs Medical Rehabilitation Program and prescribing its
implementing mechanics.

1.0 NATURE OF THE PROGRAM

The OFWs Medical Rehabilitation Program is designed to extend limited
but sustainable medical rehabilitation services for returning/repatriated OFWs who manifested either symptom of mental illness or
are suffering from any form of physical disability, resulting from
injury or illness contracted at jobsites, to facilitate gradual but
resolute medical progress for regained functional capacity.

2.0 GENERAL OBJECTIVE

The program aims to provide medically challenged OFWs with a support
system of clinical programs to enable them to regain at the very least
minimal functional capacity if not maximum level of functional
independence.

2.1 Other Objectives

2.1.1 To provide free access to rehabilitation services and benefit after the PhilHealth benefits have been exhausted;

2.1.2 To enable families of concerned OFWs cope with costly rehabilitation expenses;

2.1.3 To facilitate personal and social reintegration of the OFWs.

3.0 PROGRAM COMPONENT

The Program has four (4) program components:

3.1 Pre-Evaluation Examination – to be undertaken
by a competent medical practitioner specialized in his field of
discipline to determine client’s eligibility for rehabilitation and
similar services. The OFW has either to proceed to the next stages of
the program or be declared ineligible to the program because he can not
be rehabilitated anymore.

3.2 Rehabilitation Services – this includes
necessary confinement (for cases of mental illness) in identified
PhilHealth-accredited medical center/hospital/clinic with the end
purpose of undergoing physical and/or mental therapy as required. It
shall also cover corrective surgery and giving away appropriate medical
appliances/braces/splints/orthopedic shoes/supplies and counseling
services as a follow through therapy of his/ her rehabilitation.

3.3 OFW Family Value Reorientation – the focus of
intervention shall be on enhancing the OFW family acceptance and coping
to sustain the gains of the rehabililation component. The earning
potential of the family shall also be harnessed to replace the income
loss of the OFW.

3.4 Referral Services – this shall be utilized in
case the client manifested intention to be referred to other
institutions for further assistance or is seeking local or overseas
employment.

4.0 MEDICAL COVERAGE

The following mental disorder/illness, disabilities, paralysis, etc. are covered under the program:

4.1 All forms of mental disorder/illness (e.g. acute reactive
psychosis and others), regardless of degree of severity requiring
medical attention and/or rehabilitation;

4.2 Physical disability – temporary or permanent – requiring therapy/braces, under the following categories:

4.2.1 Back pain, all forms of fractures
4.2.2 Slip disc and other spinal disorder
4.2.3 Other forms of dislocation of the bones

4.3 All cases of paralysis, numbness, speech disorder and the like,
whether as a result of heart attack or stroke, accidents, and other
illnesses and injuries causing temporary physical incapacity.

4.4 Corrective surgery (with implants) for OFWs with physical disability

5.0 ELIGIBILITY REQUIREMENTS

To be qualified under the program, the OFW applicant:

5.1 must be an active OWWA member at the time of application to the program;

5.2 must be medically repatriated OFW whose mental illness or physical disability was sustained at the post:

5.3 For those already in the country, OFW must have sustained
his/her illness/disability within six (6) months upon arrival from
overseas employment;

5.4 must be medically diagnosed to be needing rehabilitation
services and/or has clear prospect of regaining, at the very least,
minimum functional capacity, if not entire recovery, through regular
therapy and rehabilitation as may be determined by competent medical
practitioners (program component 3.1);

5.5 If currently undergoing therapy, must be personally defraying
all attendant rehabilitation expenses, and is not a recipient of free
medical/financial assistance benefit from his company, Philippine Health
Insurance Corporation (PHIC), any medical insurance or from other
sources.

6.0 DOCUMENTARY REQUIREMENTS

6.1 Proof of at least one (1) OWWA contribution;

6.2 Proof that OFW was medically repatriated;

6.3 Copy of Doctor’s medical conclusion/findings with recommendation
that OFW need to undergo rehabilitation and/or therapy program;

6.4 Copy of passport with stamped arrival date in the country;

6.5 Notarized Affidavit certifying that the OFW has been defraying
personal rehab/therapy expenses (for those currently undergoing
medications at own expenses) and not a recipient of free medical
insurance from any sources; and

6.6 Copy of medical/police report from the post (with English translation, in case report is written in local language).

7.0 IMPLEMENTING STRATEGIES

7.1 Establish tie-up with PhilHealth-accredited medical
centers/hospitals/clinics or specialized medical/rehabilitation
institutions with, at least, basic rehabilitation facilities and a
conducive environment for fast recuperation.

7.2 Forge MOUs with identified institutions/centers for clear delineation of responsibilities and other areas of cooperation.

7.3 Forge MOUs with NGOs, government and private institutions, to
include industries, dealing within capacitated persons for possible
local employment or capacity/skills training.

7.4 Provision of special medicines and supplies shall only be
sustained while the client is confined or an in-patient such as in the
case OFWs with mental illness or those undergoing corrective surgery. No
maintenance drugs shall be covered by this program.

7.5 The client shall shoulder medical expenses in excess of maximum allowable amount under this program.

7.6 The program shall be implemented nationwide after six (6) months
of initial implementation in the National Capital Region (NCR).

8.0 ENTITLEMENT

Each beneficiary of the program is entitled to avail of any of the
following medical expenses (with minimum and maximum allowable
expenses):

8.1 Physical Disability/Paralysis Cases
	Min. Cost	Max. Cost
8.1.1 Check-up Fee		Php 500.00
8.1.2 X-ray Fee		Php 600.00
8.1.3 MRI examination		Php 8,000.00
8.1.4 Rehab Service (@Php400.00/session x 3 sessions x 2-6 months therapy)	Php9,600.00	Php 28,800.00
8.1.5 Corrective Surgery		Php 40,000.00
8.1.6 Cost of special braces/splints/Orthopedic shoes	Php1,500.00	Php 17,000.00
8.1.7 Provision of wheel chair		Php   4,000.00
8.1.8 Provision of crutches		Php     700.00
8.2 Mental Illness Cases
8.2.1 Institutional Care (to include professional fees, rehab and other services, drugs and board and lodging)	Php10,000.00	Php 40,000.00
8.2.2 Special medicines/supplies (confinement cases only)		Php 10,000.00
8.3 Other Special Diagnostic Procedures – Any qualified worker (under 8.1 and 8.2) can avail of this special benefit over and above the above stated medical expenses.
8.3.1 CT Scan guided thoracentesis, angiography, etc.		Php 65,000.00

9.0 PROCEDURAL STEPS

9.1 RWO-NCR receives and interviews OFW applicant or next-of-kin
(NOK) of client if the latter is medically incapable for an interview.

9.2 RWO-NCR evaluate eligibility of applicant to the program. If
found qualified, requests applicant/NOK to fill-out application form and
submit all documentary requirements under 6.0.

9.3 RWO-NCR registers and refers client to OWWA Medical Retainer (MR) for pre-medical evaluation.

9.4 MR conducts pre-evaluation of the client’s condition. Determines
if client need to undergo basic medical exam/testing such as x-ray, MRI,
etc. or not to qualify for rehabilitation, etc.

9.5 MR recommends whether client is qualified/not qualified for rehabilitation, etc.

– If not qualified, He endorses back to NCR the client with a disapproved application. If qualified, proceed to 9.6.
– NCR reviews MR recommendation and relay the same to the client.
Disapproved application for rehabilitation and sends client home.
– If client seek reconsideration, NCR may refer client to partner medical institution (PMI). Proceed to next step.

9.6 RWO-NCR prepares Letter of Authorization (LOA) to be sent to partner institution. Client brings and submit LOA to PMI.

9.7 Partner medical institution (PMI) conducts basic exam/testing and evaluates results.

– Initially informs client of result of medical examination.
– If result is non-conclusive and there is further need for
comprehensive testing, PMI may recommend special diagnostic testing.
Otherwise, advise client of his/her eligibility to the program whether
qualified or not to undergo rehabilitation.
– If not qualified, refer back client to NCR with disapproved application. Proceed to 9.12.
– Sends bill to NCR.
– If qualified, seek approval from NCR for rehabilitation. Proceed to 9.13.
– If needing special diagnostic testing, proceed to the next step.

9.8 PMI seeks approval from NCR for special diagnostic examination.

9.9 RWO-NCR evaluates request; confer with MR. Either seek reconsideration to PMI or sends its approval via phone call.

-If disapproved, relay message to PMI seeking reconsideration. PMI may proceed to rehabilitation process 9.13
-If approved, proceed to next step

9.10 PMI conducts special diagnostic examination and based on result,
advise client whether qualified or not to undergo rehabilitation, etc.

9.11 PMI submit findings/recommendation to RWO-NCR.

– If client do not need rehab, PMI refer back client to NCR. Proceed to 9.12.
– PMI sends bill to NCR.
– If client need rehabilitation, proceed to 9.13.

9.12 RWO-NCR informs client-applicant of PMI conclusion. Disapprove
application for rehabilitation and inform client he/she can not be
rehabilitated anymore.

9.13 PMI admits client and conducts necessary rehabilitation services/program as required.

9.14 PMI, after rehabilitation services, discharges client. Sends
bill to RWO-NCR for payment together with “Medical Certificate” citing
final state of client/patient upon discharge.

9.15 RWO-NCR, upon completing all documentary requirements, pays partner medical institution.

9.16 RWO-NCR makes house visitation and conducts family value orientation as may be needed.

9.17 RWO-NCR provides other services such as referral letter to concerned partner institution per need of the client.

10.0 BUDGETARY REQUIREMENTS

Initial program fund requirement of Ten Million Pesos (Php10,000,000) to defray the following expenses/services:

10.1 Check-up
10-2 X-ray fees
10.3 MRI examination
10.4 Rehab services
10.5 Corrective surgery
10.6 Cost of special braces, etc.
10.7 Provision of appliances (wheel chair, crutches, etc.)
10.8 Institutional care
10.9 Special medicines and supplies
10.10 Special diagnostic procedures

Subsequent budgetary appropriations of the program to be determined by the Board of Trustees.

11.0 EFFECTIVITY

This MOI takes effect immediately.

Adopted: 02 June 2009

(SGD.) CARMELITA S. DIMZON, DPA
Administrator