Are Outsourced Health Workers Entitled to the Health Emergency Allowance? An Analysis of DOH Rules in the Philippine Context

Introduction

In the wake of the COVID-19 pandemic, the Philippine government introduced various measures to support frontline health workers, recognizing their critical role in managing the public health crisis. One such initiative is the Health Emergency Allowance (HEA), a financial benefit designed to compensate health workers for the risks and hardships they faced during the emergency. Administered primarily by the Department of Health (DOH), the HEA has been governed by a series of laws, executive orders, and departmental guidelines. A key question that has arisen, particularly in legal and administrative discussions, is whether outsourced health workers—those employed through third-party agencies, contracts of service (COS), or job orders (JO)—are entitled to this allowance. This article examines the legal framework, DOH rules, eligibility criteria, and practical implications for outsourced health workers in the Philippines, drawing on relevant statutes, circulars, and policy interpretations.

Legal Basis for the Health Emergency Allowance

The HEA traces its origins to Republic Act (RA) No. 11469, known as the Bayanihan to Heal as One Act, enacted on March 24, 2020. This law empowered the President to provide emergency subsidies and allowances to health workers in both public and private sectors involved in the COVID-19 response. Section 4(o) of RA 11469 specifically authorized the grant of a "special risk allowance" to public health workers, in addition to hazard pay, during the state of public health emergency.

This was extended and formalized through subsequent legislation, including RA No. 11494 (Bayanihan to Recover as One Act) in September 2020, which continued the emergency measures. RA 11494 expanded the scope to include compensation for health workers who contracted COVID-19 or died in the line of duty. Further, RA No. 11712, the Public Health Emergency Benefits and Allowances for Health Care Workers Act, signed into law on April 27, 2022, institutionalized these benefits, mandating the provision of HEA to eligible health workers during any declared public health emergency.

The HEA is distinct from regular hazard pay under RA No. 7305 (Magna Carta of Public Health Workers), as it is a temporary, emergency-specific allowance. The amount varies based on risk levels: high-risk areas receive up to PHP 9,000 per month, medium-risk up to PHP 6,000, and low-risk up to PHP 3,000, as outlined in joint circulars from the Department of Budget and Management (DBM) and DOH.

DOH Rules and Guidelines on Eligibility

The DOH, in coordination with the DBM, has issued several joint circulars and memoranda to implement the HEA. Key documents include:

DBM-DOH Joint Circular No. 1, s. 2020: This established the initial guidelines for the grant of COVID-19 Special Risk Allowance (SRA), the precursor to HEA, covering the period from February 1, 2020, to June 30, 2020. It defined eligible health workers as those directly catering to or in contact with COVID-19 patients in public health facilities.
DBM-DOH Joint Circular No. 1, s. 2021: Extending the allowance from July 1, 2021, onward, this circular rebranded it as the One COVID-19 Allowance (OCA) before it evolved into HEA. It broadened eligibility to include health workers in quarantine facilities, laboratories, and other related settings.
DOH Department Memorandum No. 2022-0195: This provided clarifications on the implementation of RA 11712, emphasizing that the HEA applies to all health workers, both public and private, involved in the response to public health emergencies declared by the President or DOH.

Eligibility under DOH rules generally requires that the individual be a "health worker" as defined in RA 11712, which includes doctors, nurses, medical technologists, allied health professionals, and support staff (e.g., administrative, maintenance, and utility personnel) in health facilities. Crucially, the worker must have rendered services during the emergency period and been exposed to health risks.

DOH guidelines also stipulate that claims must be validated by the head of the health facility or agency, with documentation such as duty rosters, payroll records, and certifications of exposure. Retroactive claims are allowed for periods covered by the emergency declaration, subject to fund availability from the national budget.

Entitlement of Outsourced Health Workers

The status of outsourced health workers—often referred to as contractual, COS, or JO personnel—has been a point of contention. These workers are not regular government employees but are engaged through service contracts with government agencies or third-party providers. In the Philippine civil service system, governed by Civil Service Commission (CSC) rules, COS and JO workers are considered non-permanent and are typically excluded from certain benefits reserved for regular employees, such as retirement pensions or full leave credits.

However, for the HEA, DOH rules adopt an inclusive approach. Under RA 11712, Section 2 defines "health care workers" broadly to include "all personnel, whether employed by the public or private sector, who are involved in the delivery of health services during a public health emergency." This definition does not explicitly exclude outsourced workers. In fact, DOH Memorandum Circular No. 2022-0018 clarifies that COS and JO personnel in DOH-attached agencies, hospitals, and local health units are eligible for HEA, provided they meet the exposure and service criteria.

Key points from DOH interpretations:

Public Sector Outsourced Workers: Those under COS or JO in government health facilities (e.g., DOH regional offices, public hospitals like the Philippine General Hospital) are entitled if their contracts specify involvement in health emergency response. The allowance is funded from the agency's budget or special allocations from the DBM.
Private Sector and Third-Party Outsourced Workers: Health workers outsourced to private hospitals or clinics may also qualify if the facility is accredited by DOH for COVID-19 response and receives government subsidies. However, claims are processed through the private entity, which must apply for reimbursement from DOH.
Validation Process: Outsourced workers must submit proof of service, such as contracts, time logs, and endorsements from the contracting agency. DOH requires that the worker's role directly supports the emergency response, excluding purely administrative roles without risk exposure.

In practice, DOH has released funds for outsourced workers in batches, as seen in various allotment orders from 2020 to 2023. For instance, in 2022, DOH allocated over PHP 19 billion for HEA payments, including arrears for contractual staff.

Challenges and Legal Issues

Despite the inclusive language in DOH rules, outsourced health workers have faced several hurdles in claiming HEA:

Delayed Payments: Bureaucratic delays in validation and fund releases have been common, leading to backlogs. Outsourced workers, lacking permanent status, often experience longer processing times as their claims require additional inter-agency coordination.
Disputes Over Eligibility: Some local government units (LGUs) have interpreted rules narrowly, excluding JO workers on the grounds that they are not "regular" employees. This has prompted petitions to the CSC and DOH for clarification.
Court Interventions: Legal challenges have emerged, such as petitions filed with the Supreme Court or Commission on Audit (COA) questioning the exclusion of certain outsourced groups. For example, in 2021, health worker unions argued before the COA that denying HEA to COS personnel violates equal protection under the Constitution (Article III, Section 1). While no landmark ruling has definitively resolved this, DOH has issued advisory opinions affirming inclusion.
Fund Availability: The HEA is contingent on national budget allocations. With the end of the COVID-19 state of emergency in July 2023 (per Proclamation No. 297), new claims are limited, but retroactive payments continue under RA 11712.

Additionally, outsourced workers in devolved health services (under LGUs per RA 7160, the Local Government Code) may face varying interpretations, as LGUs have discretion in implementation, subject to DOH oversight.

Implications and Recommendations

The entitlement of outsourced health workers to HEA underscores the Philippine government's recognition of their contributions during crises, aligning with international labor standards under the International Labour Organization (ILO) conventions ratified by the Philippines. It promotes equity in compensation, ensuring that risk exposure, rather than employment status, determines benefits.

For health workers seeking HEA, it is advisable to:

Gather comprehensive documentation, including service contracts and exposure certifications.
Coordinate with facility heads for endorsement to DOH regional offices.
Monitor DOH issuances for updates on claim periods and procedures.

Policymakers may consider amending RA 11712 to explicitly address outsourced workers in future emergencies, reducing ambiguity. In the broader context, this issue highlights the need for reforms in the contractualization of health services, as critiqued in CSC Memorandum Circular No. 6, s. 2012, which limits COS/JO engagements.

In conclusion, under DOH rules and prevailing laws, outsourced health workers are generally entitled to the Health Emergency Allowance if they meet the criteria of service during a public health emergency and risk exposure. This inclusive policy reflects the extraordinary demands placed on all health personnel, regardless of employment modality, during times of crisis. As the Philippines prepares for potential future emergencies, clear and consistent implementation will be essential to uphold fairness and morale in the health sector.