Republic of the Philippines

Department of Health
Regional Office II
Carig Norte, Tuguegarao City
Telephone Number: 304-6585, 304-8737, 846-7261 & 8467230
e-mail address: chdcvdoh@yahoo.com/dohregionaloffice2@gmail.com
TeleFax no. 304-6523

Ref: RO2-2017-01-001 For : Violation of Administrative

Order No. 2008-0001 in
In re : Complaint against the owner and
relation to R.A. 9439
personnel of Timbuktu Institute of
Behavioral Medicine, Inday Norte,
Laude City
x----------------------------------------------------------x

RESOLUTION
This resolves the complaint filed against Dr. Rowel S. Matila, Dr. Jerry
Sagabaen and Ms. Ivory L. Callueng of Timbuktu Institute of Behavioral Medicine
for the alleged illegal detention committed against the person of Ms. Damsel Katrina
A. Jose for failure to fully settle the hospital bills for her confinement at the
aforementioned facility.

Mr. Genaro L. Jose in his letter complaint dated 5 January 2017 informed this
Office that the Cagayan Institute of Behavioral Medicine (CIBM) refused to
discharge his daughter, who was diagnosed with Bipolar Affective Disorder. His
daughter was brought to Cagayan Valley Medical Center (CVMC) for check-up on
November 17, 2016. Dr. Jerry Sagabaen, the attending physician, advised them to
confine their daughter at CIBM and agreed that his daughter will stay there for one
to two weeks and was further informed among others of the charges to be imposed
by the facility particularly: Php 800 for food and accommodation, Php 300.00 for
medicine and Php 170.00 for his professional fee. Not until 29 December 2017 when
one of the personnel of the facility sent a text message, nobody informed him that his
daughter is already for discharge when in fact they visited his daughter on 22
December 2016.

Surprisingly, the statement of account reached up to P57, 632.00 as they

automatically computed the medicine given to his daughter and charged it to their
P8,000.00 initial down payment despite the fact that the medicines are supposed to
be 100% covered by the PCSO. As a result, the facility did not allow his daughter to
go home notwithstanding the fact that they are already tendering the amount of P20,
000.00 as partial payment.

Upon receipt and initial evaluation of the complaint, a letter dated 5 January
2017 was sent to Dr. Rowel S. Matila, owner of Cagayan Institute of Behavioral
Medicine, requesting for a written explanation or comment on the allegations made
against the said health facility. On the same date, the complaint was also endorsed
by this Office to Mr. Rodrigo F. Balaqui Jr., Regional Director of the Professional
Regulation Commission, Regional Office II, for his information and appropriate
action on the said complaint.

On the other hand, Dr. Rowel Matila in his letter dated 16 January 2017,
contends that Damsel Katrina Jose was admitted at CIBM on 17 November 2016, a
decision which came from the father after she had her check-up at CVMC psychiatry
ward and contrary to the complainant’s claim that he was advised to be admitted
directly to the CIBM.

As regards the claim of the complainant that he and his daughter’s attending
physician agreed that the patient will be admitted in the facility for a period of one
to two weeks only, Dr. Matila asserts that the complainant did not visit or call the
facility to ask for the condition of their daughter and had not updated their bill. In
fact, on the first month of stay of the patient in the facility without any visit or call
from the father, the staff of the facility called up the former to inquire on his plan. He
said that he is in Tagaytay and will visit his daughter soon. On 22 December 2016,
the complainant visited his daughter and asked for a medical certificate and
statement of account which they used to seek financial assistance from PCSO.

Furthermore, he emphasized that the father had signed a contract of

admission stating their financial responsibility and obligation to the facility, hence,
they should not be blamed that the cost of medicine given to his daughter was
automatically deducted to their down payment on the basis that the PCSO will cover
the full cost of medicines of his daughter. Dr. Matila stresses that the total bill of the
patient amounted to Php 60, 432.00 for the 48 days that his daughter was confined
including medicine, professional fee, board and loading and additional snacks of the
patient. The complainant would like to pay only the amount of Php 20,000.00 plus
the down payment of Php 8,000.00 and the PCSO support of Php 5,999.00, he insists
that it was the fault of the personnel of the facility why the PCSO did not grant the
full payment of the expenses on medicine. He was not even willing to pay the
remaining bill and had not expressed his intention to execute a promissory note with
collateral in order to bring home his daughter.

A perusal of the facts presented in this case as well as the result of the
investigation conducted, it was ascertained that the primordial issue at hand is the
failure of the facility to discharge the patient due to the failure of his father, who is
the complainant in this case to pay medical expenses incurred while the former was
confined at the facility for about two months.

Notably, Administrative Order No. 2008-0001 which provides for the

implementing rules and regulations in order to carry out the provisions of R.A. No.
9439 otherwise known as “An Act Prohibiting the Detention of Patients in Hospitals
and Medical Clinics on Grounds of Nonpayment of Hospital Bills or Medical
Expenses” specifically lays down what constitutes detention to wit:

V. Policies and Guidelines

 A. General Policies

4. Any hospital or medical clinic detaining or causing to detain,

directly or indirectly, the detention of patient for reason of
nonpayment, in part or full, of hospital bills or medical expenses/
hospitalization expenses shall be held accountable for such
unlawful act. Detention occurs when all of the following are
present:

a. The patient who is partially or fully recovered has

expressed his/her intention to leave the hospital
or medical clinic, or the attending physician has
issued a discharge order;

b. The patient is not confined in a private room and

is financially incapable to settle in part or in full
the corresponding hospital bills or medical
expenses/ hospitalization expenses;

c. Patient has executed a promissory note covering

the unpaid hospital bills or medical
expenses/hospitalization expenses; and

d. The officer and employee of the hospital or

medical clinic responsible for releasing the patient
has restrained him from leaving the hospital
premises.

Remarkably, the complainant does not want to execute a promissory note in

favor of CIBM covering the unpaid medical expenses incurred by her daughter at
the onset instead he refused to acknowledge the statement of account and maintains
that the facility personnel should be faulted why the Philippine Charity Sweepstakes
Office did not cover all his daughter’s medicine expenses and the former should bear
the same.

While this administrative order aims to address the problem involving

hospitals and medical clinics that refuse to discharge patients due to the latter’s
inability to pay their bills, we must also keep in mind that the patient or anyone in
his stead, the complainant in this case, should also recognize and honor his
obligation that they incurred during the confinement of his daughter in the facility
and propose a payment scheme in order to settle the same. Thus, the facility has the
right not to release the patient as the complainant refused to execute a promissory
note as regards their unsettled bill.

On the other note, while this case is pending investigation, the complainant
informed this Office in his letter dated 6 January 2017 that an amicable settlement
had been reached between him and the Medical Director of Cagayan Institute of
Behavioral Medicine, Dr. Jenalyn T. Matilla.

After the evaluation of the facts and circumstances present in this case, the
complaint against Dr. Rowel S. Matila, Dr. Jerry Sagabaen and Ms. Ivory L. Callueng
of Cagayan Institute of Behavioral Medicine is hereby dismissed for utter lack of
merit. It is respectfully recommended that the personnel as well as the physicians in
the said facility should observe the guidelines set forth by Administrative Order No.
2008-0001, to wit:

1. Classify the patients in terms of their capacity to pay

according to the guidelines set by DOH in Administrative
Order No. 51-A s. 2000;

2. Written policies and procedures to classify patients in

terms of their capacity to pay;

3. As far as practicable, assist patients in looking for financial

assistance from government and non-government sources
to settle the unpaid hospital bills or medical expenses.

Respectfully submitted.

DOH Regional Office No. II, Tuguegarao City, Cagayan.

VALERIANO JESUS V. LOPEZ, MD, MPH, MHA, CESO IV

Director IV