Republicof the Philippines

Department of Health
OFFICE OF THE SECRETARY
December 15, 2023

DEPARTMENT CIRCULAR

OF
No. 2023 -_0570
FOR: ALL UNDERSECRETARIES; ASSISTANT SECRETARIES;
MINISTER OF HEALTH - BANGSAMORO AUTONOMOUS
REGION MUSLIM MINDANAO (MOH-BARMM):

EXECUTIVE
__IN_

DIRECTORS OF BUREAUS AND CENTERS FOR HEALTH

PITALS; Ik ICA. R PITAL

SANITARIA, AND INSTITUTES: HEADS OF OTHER HEALTH
FACILITIES; AND OTHERS CONCERNED

SUBJECT:

SPECIALTY
DIRECTORS
DEVELOPMENT;
To assist Project Proponents, HIA Preparers, and the general public in conducting
Health Impact Assessment (HIA) and navigating the Health Impact Assessment (HIA)
Review Process for Development Projects, the Process Guide and Methods Guide on HIA for
development projects are hereby disseminated all
relevant stakeholders, for reference and
to

compliance.

The Process Guide entitled, “The Health Impact Assessment Review Process for
Development Projects: A Process Guide for the Filipino People,” provides the abridged steps,
processes, and requirements in undergoing the HIA Review Process for the issuance of the HIA
certificates, for consumption of project proponents and the general public. A soft copy of this
document may also be accessed through this link:
https://bit.ly/HIA ReviewProcessGuide2023.

On the other hand, the Methods Guide entitled, “Methods Guide for Conducting
Health Impact Assessment for Development Projects: Institutionalizing Health Impact
Assessment in the Philippines,” provides the comprehensive and step-by-step process in
conducting an HIA anchored on the social determinants of health, for reference of HIA
preparers and practitioners and interested professionals. A soft copy of this document may
also be accessed through this link: https://bit.ly/HIAReviewMethodsGuide2023.

For dissemination and compliance.

By Authority of the Secretary of Health:

MARIA ROSARIO SINGH-WVERGEIRE, MD, MPH,

Undersecr¢tary of Health
CESO
II
Public Health Services Team

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila e Trunk Line 651-7800 local 1108, 1111, 1112, 1113
Direct Line: 711-9502; 711-9503 Fax: 743-1829 e URL: http://www.doh.gov.ph; e-mail: [email protected]
oli elgtslMstey:] ae
Maria Rosario Clarissa Singh-Vergeire, MD, MPH, CESO
II
Beverly Lorraine C. Ho, MD, MPH
Rodley Desmond Daniel Carza, RN, MPH
Armund DM. Arguelles

eer
Frances Claire
RS Ci
C. Onagan, MPH
Alyzza Vienn M. Eclavea

Design and Layout

Julius Sabile
T.
Kristina Marie A. Balazuela
 PREFACE

This Process Guide supplements DOH-DILG Joint Administrative

Order 2021-0001, which operationalizes the HIA Review Process for
development projects inthe country. It outlines the procedural
framework and guidelines for compliance of Project Proponents to
secure a Health Impact Clearance Certification or a Certificate of
Exemption from the DOH, which shall be a requirement for the
issuance of local government permits for infrastructure
developments to commence operations. This reference document
intended to provide an easy guide for Project Proponents and HIA
is
Preparers in navigating the HIA Review Process in orderto facilitate
submissions for ease of compliance, and efficient turnaround times.

Suggested citation:
Department of Health Philippines. 2023.
HIA Review Process for Development Projects:

for
A Process Guide the Filipino People
TABLE OF CONTENTS
Health Impact Assessment

Legal Basis fen} —

Delineating HIA with EIA and EHIA Mandates

The HIA Review Process

Screening Review

Exemption

Ad Referendum Review for Clearance to

Proceedto the Scoping Stage

Identifying Level of HIA

Scoping Review

Ad Referendum Review for Exempt Projects

Convening the HIA Review Committee

oO
|
Issuing Certifications

Signatory for HICC

Signatory for COE

Monitoring and Evaluation

Grievance Redress Mechanism

For Projects with an HICC or COE

already issued
i
For Projects undergoing review a Sl

Annexes pa ite)
PUNei tg
Health Impact Assessment
Health Impact Assessment (HIA) is operationally defined by existing legal instruments in
the Philippines as a means of assessing the health impacts of policies, programs, and
projects in diverse economic sectors before, during, and after implementation. HIA is
intended toprovide practical and alternative recommendations to increase positive health
effects and minimize negative health effects of projects, while still attaining the
development objective of the policy, program, and project. The Department of Health
(DOH) underscores that HIA is not meant to impede the country’s envisioned
development agenda for economic and social transformation, but shall instead function
as a support mechanism for health promoting and equitable developments in aid of the
country’s Universal Health Care reforms.

Legal Basis

The mandate forrequiring HIA is provided by the Universal Health Care Act (Republic Act
No. 11223, §33) and its Implementing Rules and Regulations (IRR), which covers all
policies, programs, and projects that may be crucial for attaining better health outcomes
or those that may have an impact on the health sector.

The scope of this reference guide however shall only include the procedural review of
HIA Reports conducted for development projects. This was set under §33.2 of the IRR,
and further operationalized in the DOH-DILG Joint Administrative Order No. 2021-0001
(Guidelines for the Operationalization of the Health Impact Assessment Review Process
for Development Projects). This joint order encompasses the standards and guidelines on
the review of development projects for the issuance of a Health Impact Clearance
Certification (HICC) or a Certificate of Exemption (COE); and with additional oversight
from the DILG - mandating LGUs to include the HICC or COE as part of the required
submission before local-level permits are issued.

Delineating HIA with EIA and EHIA Mandates

The institutionalization ofthrough the UHC Act hereby supersedes the Environmental
HIA
Health Impact Assessment (EHIA) mandate provided by the IRR of Presidential Decree
No. 856 or the Sanitation Code of the Philippines. All other issuances, processes, and
standards on EHIA that are inconsistent with the HIA mandate under the UHC Act and its
subsequent implementing guidelines are thus considered null and void.

01
Further to this, as an independent and autonomous process with its own governing
mandate, HIA shall not be associated interchangeably with Environmental Impact
Assessment (EIA), which is under the purview of the Department of Environment and
Natural Resources (DENR). As such, the ‘People Module’ in the EIA Report shall not serve
as a substitute submission to the DOH inlieu of an HIA Report, nor shall the ‘People
Module’ be cited or referred to by Project Proponents and other stakeholders justify its to
non-compliance with or exemption from the HIA mandates under the UHC Act.

HIA Review Process

The HIA Review Process is a review mechanism institutionalized in the DOH to evaluate
HIA Reports or Public Health Management and Mitigation Plans (PHMMP) submitted for
development projects that are applying for a Health Impact Clearance Certificate (HICC)
or a Certificate of Exemption (COE), respectively - in compliance with the provision under
§33 of the Universal Health Care Act and its Implementing Rules and Regulations, and the
DOH-DILG Joint Administrative Order No. 2021-000.

Table 1. Interface of the HIA Process and HIA Review Process

Operation of the HIA Review

Conduct of HIA fet rele(-t-t-4

Project Proponent / HIA Preparer HIA Review Committee

Review application packages and

Develop the project profile and
identify whether the project will be
Screening submit application package for
issuance of HICC / COE exempted or required to conduct
an HIA.

Review the scoping report and

Conduct scoping activities and
Scoping develop the scoping report and approve the HIA Terms of
Reference with the Preparers and
HIA TOR
Proponents
Gather, analyze, and triangulate
Appraisal data based on the approved HIA
Convene the HIA Review
Committee and review the HIA
TOR
Reports and the Public Health
Evidence synthesis, development Management Plans (PHMMP)
Reporting of the HIA Report & PHMMP. and
presentation to stakeholders Issue the HICC or COE

Conduct self-monitoring activities Validate the self-monitoring

Monitoring and
and identify operation compliance conducted by the Preparers and
Evaluation
to the PHMMP Proponents

02
screening Review

What is expected from Project Proponents:

L Submit Screening Form (Form 1)
CL) Submit a copy of the Project Proposal

Upon submission of the Screening Form, the Secretariat determines whether the
development project will be exempted from the conduct of an HIA or will be required to
submit an HIA Report. Only the Secretariat can determine and decide on the exemption
status for projects. Project Proponents and/or HIA Preparers shall not self-exempt based
on their interpretation and understanding of the exemption criteria.
Pursuant to the DOH-DILG JAO 2021-0001, Development Projects shall be required to
conduct HIAif itis:

Located in a Health Sensitive Area A Health Sensitive Project

Disease-endemic areas or emerging For this purpose, the determination

hotspots for vector-borne diseases of projects as health sensitive shall
Areas with limited local health care be based on the Department of
system Environment and Natural Resources’
Areas vulnerable to natural (or (DENR) Categories of
climate occurrences) ‘Environmentally Critical Projects’
disasters/calamities or effects of pursuant to the applicable provisions
climate change of EMB Memorandum Circular No.
Areas designedas tourism sites or 005 s. 2014. The catchment of
areas whose natural resources are projects classified as
used for tourism purposes ‘Environmentally Critical Projects’
Areas of indigenous and ancestral shall be identified without prejudice
domains, or areas traditionally to the subsequent updates to the
occupied by cultural communities guidelines that will be issued by the
Areas where local communities DENR.
derive their livelihood and basic A list of health-sensitive projects is
needs provided in Annex B.
Areas designated as industrial towns,
zones, sites or areas with multiple
development projects in operation
Areas whose land is converted for
housing and resettlement purposes.

HIA Preparers and Project Proponents are expected to carry out their best effort to
assess their project sites’ characteristics and determine if their chosen site falls under
the categories of Health Sensitive Areas listed above.

03
Exemption
Development projects may be exempt from conducting an HIA provided that (1) the
project does not fall under any of the categories stated above, and (2) the total project
cost shall not exceed the cost threshold of Php 2.5 billion that was jointly set and agreed
upon by the DOH and the National Economic and Development Authority.

Projects exempted from conducting HIA however does not imply absolute exemption
from the HIA Review Process. Development projects identified as “Exempt from the
Conduct of HIA" shall submit their project's Public Health Management and Mitigation
Plan (PHMMP) to the DOH for review and issuance of
COE. Failure to submit the PHMMP
shall result in the non-issuance of the COE to
the Project Proponents.
Screening Review Decisions (to be provided by the Secretariat)
Decision 1: Apply for HICC Decision 2: Apply for COE
(Conduct HIA) (Exempt from Conducting HIA)

[CL]
Next steps: Submit Scoping Guide [] Next steps: Submit Scoping Guide
(Form 1.2) (in aid of developing (Form 1.2) (in aid of developing
Scoping Report) PHMMP)

Regardless if the project is tasked to conduct HIA or exempt from conducting HIA,
Project Proponents and HIA Preparers are required to submit a Scoping Guide before
they can proceed with the conduct of the scoping activities for their project. The purpose
of the Scoping Guide isto serve as a reference document for the HIA Preparers to ensure
the objective and well-planned conduct of the scoping activities. The approved scoping
guide shall serve as the basis by the HIA Review Committee in evaluating the outputs
that will be produced from the scoping activities.

Ad Referendum Review Decisions for Clearance to Proceed to the Scoping Stage

What isSubmit
expected from Project Proponents:
Guide
CL]
Scoping (Form 1.2)

The submitted Scoping Guide will then undergo a rapid review by Primary Reviewers from
the HIA Review Committee. The review for this submission will primarily focus on
evaluating the proposed methodologies that will be employed for the scoping activities -
such as the appropriate use of participatory methodologies with local communities. An
essential pillar of the HIA mandate as envisioned by the UHC Act are the local
communities that stand to be affected by the proposed development. As such, the DOH
endeavors that community inputs and needs are taken into account, and shall
substantially inform the content development of the HIA Report and the PHMMP.

04
 Decision 1: Cleared to Proceed to the Decision 2: Cleared to Proceed to
the
Scoping Stage of the HIA Process Scoping Stage of the HIA Process
(for projects required to conduct HIA) (for projects exempt to conduct HIA)

Ll] Level of HIA identified: Intermediate (1 Next steps: Conduct data gathering
HIA or Comprehensive HIA to be activities based on the agreed key
conducted |
areas of assessment and data
L] Next steps: Conduct Scoping |
gathering methodologies and
Activities based on identified level of develop the PHMMP
HIA and agreed data gathering L] Next steps: Submit PHMMP to the
methodologies and develop the DOH
for the next round of Ad
scoping report and HIA TOR Referendum Review (to be
L} Next steps: Submit scoping report conductedin parallel with the
and HIA TOR
Review
to the DOH for Scoping Scoping Review Stage)

Identifying Level of HIA

The level of HIA is identified based on the scope of data and data sources needed to
supplement scoping details, resource requirements, and level of assessment as
categorized below:
1. Intermediate HIA - conducted for a shorter period of time (~12 weeks to 6 months)
with the aim to provide a basic systematic analysis of prioritized health
determinants through the use of best available evidence, and collection of
pertinent data and insights from key informants such as content experts and local
communities.
2. Comprehensive HIA - aims to provide a comprehensive assessment of all potential
health impacts and health determinants as part of the analysis. Involves data
gathering from multiple sources (qualitative and quantitative), and entails
significant time and resources for assessment.

Scoping Review
What is expected from Project Proponents:
(1 Submit Scoping Form (Form 2.1)
L] Submit approved Scoping Guide (Form 1.2)
CL]
Submit Draft HIA Terms of Reference

Upon submission of the scoping report, the HIA Review Committee shall review the draft
HIA Terms of Reference (HIA TOR) and Scoping Report orderin to
finalize and concur on
the scope, extent, level of HIA, and requirements of the HIA TOR
conduct of an HIA. The HIA TOR shall serve as the basis for the
in
preparation for the
HIA that will be
conducted for a development project.

05
As such, an approved HIA TOR
isforathenecessary prerequisite before Project Proponents can
proceed in conducting the HIA development ofthe HIA Report.

Decision 1; Cleared to Proceed with the

Decision 2: Revise TOR
Appraisal Stage of the HIA Process

Next steps: Proceed with the data _

(1) Next steps: Secretariat to inform

gathering and evidence synthesis Preparers of the comments and
based on the agreed scope and recommendations from the Ad
methodologies in the approved HIA_ Referendum Review
TOR L} Next steps: Preparers to submit the
Next steps: Submit HIA Report response / revised TOR
Secretariat
to the

[] Next steps: Secretariat to endorse

response / revised TOR for Ad
Referendum Review

Upon approval of the HIA Terms of Reference, the HIA Preparer proceeds to conduct data
collection, evidence synthesis and other proposed methodologies as reflected on the
agreed scope and coverage provided in the HIA TOR. In the course of developing the HIA
Report, it is important to ensure that the Appraisal Stage will follow a structured and
transparent process that considers inputs from both experts and community members,
including the use of best available evidence. The aforementioned is being emphasized
since
it
Report.
will be a consideration of the HIA Review Committee in their evaluation of the HIA

To further guide the development of

the HIA Report, the following should be accounted
for by HIA Preparers before finalizing and submitting to the Secretariat:

1. Complied with and addressed all terms and conditions as agreed upon in the HIA
TOR;
Proof of participation of communities through systematic and participatory
methods;
Balanced narrative of the assessment, without suspected underreporting of
negative impacts or overstating positive impacts;
All sources of evidence are reviewed and validated to inform the assessment; and,
Distribution of impacts and equity consideration have been identified and
disaggregated by key socioeconomic indicators, and cross-tabulated by gender.

06
 Project Description/Information
ve)
Methodology
Evidence Generation
4. Appraisal of Evidence to
Identify/Characterize Health Impacts
The members of the HIA Review Committee, will decide using the following ratings to
arrive at a consensus:
1. Satisfactory (when no further modification is required)
2. For revision (for modification or revision of project details, impacts and mitigation

oT
measures)
3. Unsatisfactory (due
to irreconcilable equity or legal concerns)
”
els Cla yxc wea ala Teel) Decision 3: Weert ™
Be

[] Next steps: [|] Next steps: HIA [| Next steps: Project

Secretariat to issue Preparers revise and Proponents to file an
HICC signed by the resubmit the HIA appeal to the HIA
Secretary of Health Report to the HIA Review Committee
[J Next step: HIA Review Committee L] Incase of unsuccessful
Preparers prepare the [] Next Steps: appeals, submit a new
social acceptability Secretariat to deck application reflecting
endorsement and resubmitted HIA the changes made in
notarized sworn Report to the next consideration of the
statement of earliest Ad recommendations
compliance and Referendum Review raised by the HIA
Review Committee

Issuing Certifications

What is expected from Project Proponents:

(1 Submit notarized affidavit of Compliance
L} Submit social acceptability endorsement issued by the Local Government Unit

Once approved by the HIA Review Committee, the Secretariat shall draft and endorse a
sworn statement of compliance to the Project Proponents for their appropriate action,
prior to the release of the HICC or COE. Project Proponents shall submit a notarized
sworn statement of compliance to the agreements and conditionalities of the HICC or
COE, and the social acceptability endorsement issued by the local government unit with
administrative jurisdiction over the project - pursuant to DILG Memorandum Circular
2002-200. The HICC will only be released upon receipt of the notarized sworn statement
of compliance.

08
Ad Referendum Review for Exempt Projects

What is expected from Project Proponents:

CL}
Submit approved Scoping Guide (Form 1.2)
C1 Submit PHMMP (for projects applying for a COE)

On the other hand, PHMMPs submitted for exempt projects will undergo an Ad
Referendum Review by the HIA Review Committee. This review will focus on evaluating
the PHMMP vis-a-vis the approved Scoping Guide. In particular, they will assess how the
use of best available evidence informs the routine mitigation measures that will be
employed during the course of the Project's operational life span; including the
appropriateness of the identified and prioritized mitigation measures. Further to this, they
will also be evaluating the balanced use
of
insights and inputs from local communities on
the recommended measures that are best fit for their context and lived experiences.

Decision 1: PHMMP Approved Decision 2: Revise PHMMP

[] Next steps: Secretariat to endorse the LJ Next steps: Secretariat to inform

PHMMP and COE
to the HIA Review
Committee for ratification and
Preparers of the comments and
recommendations from the Ad
signature of the Chair Referendum Review
CL]
Next steps: Secretariat to issue the CL}
Next steps: Preparers to submit the
signed COE, upon receipt of the
notarized sworn statement of
response / revised PHMMP
Secretariat
to the

compliance. Please refer to the section| [1 Next steps: Secretariat to endorse

on ‘Issuing Certifications’ for further response / revised PHMMP for Ad
guidance Referendum Review

Convening the HIA Review Committee

What is expected from Project Proponents:

L] Submit HIA Report and its required attachments (Form 3.1, Form 4)
L] Submit the approved HIA Terms of Reference
[| Representatives of Project Proponents and/or HIA Preparers on standby for
a video
conference call in case of clarifications or inquiries from the HIA Review Committee
members during the deliberation and evaluation of their HIA Report

Upon submission of the HIA Report the Secretariat convenes the HIA Review Committee
to review, assess, and provide recommendations, if any, to the aforementioned
documents. Core members, invited experts, and other representatives attending the
RevCom meeting will review and comment on the following:

07
Signatory for HICC
The HICC shall only be signed by the Secretary of Health, with the recommending
approval of the HIA Review Committee. The Secretary of Health shall not sign off on any
HICC without the recommending approval of the HIA Review Committee. The HICC may
be revoked at any time after undergoing the necessary due processes,
as a result of the
Project Proponents’ non-compliance to the conditions and agreements specified in the
HICC.

Signatory for COE

The COE shall only be signed by the Chair of the HIA Review Committee after the
advisory body’s ratification of the PHMMP’s approval during the Ad Referendum Review.
The Chair shall not sign off on any COE without this ratification. The COE may be revoked
at any time after undergoing the necessary due processes, as a result of the Project
Proponents’ non-compliance to the conditions and agreements specified in the COE.

Monitoring and Evaluation

What is expected from Project Proponents:

C1 Submit Monitoring and Evaluation Report

The governing CHDs/MOH-BARMM, in partnership with the Provincial, City and/or

Municipal Health Offices and Local Government Units, creates a Multi-Sectoral Monitoring
Team (MMT) based on the needed expertise and membership of the development project
to be assessed. Monitoring and evaluation on compliance of the implemented
development project is conducted every six (6) months after the issuance of the HICC.

Upon submission of the Monitoring and Evaluation Report of the Project Proponents, the
MMT validates the information provided in the report through routine monitoring
methods. The MMT shall then identify whether the project is compliant or non-compliant
to the agreements and conditionalities stated in the HICC. If deemed compliant, HICC
shall remain effective.

Based on the findings

of the MMT and emerging evidence on health impacts, the PHMMP
- as part of the HIA Report or as a standalone submission in the case of exempted

projects, may be revised to accommodate additional and/or updated mitigating measures

for the operation of the development projects, for consideration of the Project
Proponents.

09
In the event that the operation of the development project is identified as non-compliant
to the conditions and agreements provided in the HICC, the governing CHD requires the
submission of a catch-up plan from the Project Proponent. The development and
implementation of the catch-up plan must address all non-compliant monitoring
components as identified by the MMT and shall be validated by the MMT 30 days upon
submission of the plan. If, after the implementation of the catch-up plan, the project is
still identified as non-compliant, the HICC shall be revoked.

The MMT drafts and submits the decision on the project to the concerned CHD. The CHD
communicates the decision to the Project Proponent for their action and copy furnishes
the concerned LGU and the HIA RevCom. The CHDs shall issue a public advisory based
on the decision of the MMT. The HICC may be revoked should the project exhibit
non-compliance with the PHMMP and the conditionalities in the HICC.

Decision 1: Project is Compliant Decision 2: Project is Non-Compliant

L} HlICC remains effective L] Proponents develop and implement

L] Proponents may revise the PHMMP a catch-up plan to address all
to accommodate additional/ non-compliant components
updated mitigating measures
Next step: MMT disseminates the
MMT
to conduct validation activities
on implementation of the catch-up
findings of the M&Eto all concerned plan and ensure compliance
stakeholders. L] If found to be compliant after

implementation to catch-up plan,

refer to Decision 1 of this section.
L) If found
to still be non-compliant,

LC}
HICC
is revoked.
Next step: MMT disseminates the
findings of the M&E to all concerned
stakeholders.

10
Grievance Redress Mechanism

What is expected from Complainant or Concerned Groups and Individuals:

C1 Submit the Grievance Redress Form (Form 12)

A Grievance Redress Mechanism (GRM) is a formal system embedded in the HIA Review
Process in
order to be responsive to arising issues voiced out by affected communities,
or concerned groups and individuals. To formally initiate the grievance redress process,
the complainant must accomplish and submit the Grievance Redress Form to the GRM
Focal Office, who will then endorse the complaint to the appropriate responding authority.
It must be underscored that the DOH and DILG do not have inherent authority to order a
“stop operation” for projects. The GRM's intent in this matter is to facilitate meaningful
dialogues to induce changes atthe project proposal level such as updating proposed
routine project operations or mitigation measures; or revoking the issued HICC or COE in
cases of non-compliant projects and endorsing recommendations to the LGUs for their
appropriate action, accordance
in
to their established guidelines and procedures.

The grievance redress process promulgated by the joint order of the DOH and DILG
(DOH-DILG Joint Administrative Order No. 2021 - 0001) shall only cover projects that have
undergone or is currently undergoing the HIA Review Process. The GRM procedures that
will be outlined in the succeeding sections cannot be applied retroactively for existing
projects already in operation prior to the enactment of the Universal Health Care Act (RA
No. 11223, §33). However,
the
if the existing project is in pipeline for expansion or major
upgrades during effectivity of the HIA mandates, then that project shall thus be
covered by the said aforementioned mandates, which will also include the benefit of a
Grievance Redress Mechanism co-instituted by the DOH and DILG in coordination with
their local-level counterparts.

Further to this, the GRM procedure adopted for development projects shall strictly follow
the process specified in the succeeding sections. As such, complainants must abide by
the said procedures outlined to ensure efficient turnaround times and prompt response
on the matter. Furthemore, the HIA Review Process’ GRM shall not be misconstrued as a
substitute judicial process to legally settle complaints and conflicts due to project
operations. In cases in which a resolution has not been attained despite best effort of all
GRM Focal Offices due
to irreconcilable circumstances of the complaint, referrals to
other judicial and administrative processes shall be carried out.

11
For Projects with an HICC or COE already issued

Single Site, Region-Specific Projects

In instances wherein the project already has an HICC or COE issued and
region, the complaint shall be filed with the CHD
is located in one
with the administrative jurisdiction over
the project site as the designated GRM Focal Office. The CHD shall then endorse
it to the
-
appropriate responding authority. The CHDs in their capacity as the GRM Focal Office
shall ensure that the complaint endorsement process is transparent and -
well-documented.

Given that the project in this circumstance has already commenced operations by
securing the necessary permits and clearances to operate, the resolution for such
matters is intended to be an LGU-led resolution, pursuant to the provisions under Title V.
Local Health Boards Section 102 (b) (3) of the Local Government Code of the Philippines.
As such, the CHDs shall endorse the complaint to the Local Health Office (LHO) to initiate
the investigation and mobilize their counterparts from the Local Health Board (LHB) and
LGUs to engage their best efforts to resolve the complaint at their level, and implement
localized problem solving measures with the concerned community in a collaborative
manner. Assuming that a resolution has been attained with the affected communities, the
resolution and key recommendations to be carried out shall be endorsed to the Project
Proponents for their appropriate action - such as but not limited to revising the PHMMP
for a well-documented and binding agreement to recalibrate its mitigation measures.

If no resolution has been attained despite best effort by the LHO, LHB, and LGU - the LHO
will elevate the unresolved matter to the CHDs, which the CHD shall then investigate and
resolve with their MMT. At their level, the CHD and MMT shall engage their best effort to
resolve the matter, and implement localized problem solving measures with the
concerned community in a collaborative manner. Assuming that a resolution has been
attained with the affected communities, the resolution and key recommendations to be
carried out shall be endorsed to the LGU, and Project Proponents for their appropriate
action - such as but not limited to revising the PHMMP for a well-documented and
binding agreement to recalibrate its mitigation measures.

If no resolution has been attained despite best effort by the CHD and MMTs, the CHDs
will elevate the unresolved matter to the DOH-HPB and DILG-BLGD. The
joint review body
co-led by the DOH and DILG shall convene the HIA Review Committee members, other
experts relevant to the development project, representatives from the CHDs and LHBs,
and other appropriate National Government Agencies to engage their best effort to
resolve the matter and/or arrive at a Best Alternative to a Negotiated Agreement between
the Project Proponent and the Complainant. Assuming that a resolution has been
attained with the affected communities, the resolution and key recommendations to be
carried out shall be endorsed to the LGU, and Project Proponents for their appropriate
action - such as but not limited to revising the PHMMP for a well-documented and
binding agreement to recalibrate its mitigation measures.

However, if no resolution has been attained despite this concerted effort, the DOH and
DILG shall refer the complaint to the relevant judicial and/or administrative governing
body.

12
 Community/group/
individuals file a
report to the CHD

to endorse the '

}

CHD

complaint to the
concerned LHO

i
Leu to implement
appropriate action
—

LHO
to
investigate
the issue/complain

DOH and DILG to

investigate,
resolve, and
feedback *
LHB & LGU to
resolve and provide
CHD
to investigate,
feedback to the
filling entity *
resolve, and
feedback *

Labels:
* Proceed to % if resolved. If not resolved, proceed to the next procedure
in the process flow

Figure 1. Accountability Flowchart of GRM Focal Offices for Development Projects with
an HICC or COE Issued (Single Site, Region-Specific Projects)

Table 2. Summary Process Flow of the Complaint Endorsement and Resolution Process
for Development Projects with an HICC or COE Issued for Single Site, Region-Specific
Projects
What is expected from Complainant? Action to be carried out by GRM Focal Office
CL]
Complainant officially files a CL} CHDs endorse to LHO for appropriate
complaint to the CHDs action
[] LHOs
to
and LGU
investigate and mobilize LHB
Counterparts for a resolution

13
VL

Ss
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asJOpUua 0} SGHO O
d918-9 11d Pue adH-HOd
0} JO}EW BY} 8}eA9/9 0} SGHO O
Osa 1S9aq ayidsap
‘uonnjosas ou si aay} Jey) Bulmnssy =
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0} pasjopua aq ||IM uoINjosaL
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Nd
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j/eys uol}e}USWa|dWWI! 8}e!pauUI
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uaaq sey uoljnjosad }ey}) Bulunssy
e ee
Ja} ay}aAjosaJ pue ayebisaaul
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asiopus0}SOH]
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94} JO sjuataeiBe Ady pue
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N/A L} DOH-HPB and DILG-BLGDto convene
its reviewing body to investigate and
resolve the matter
(] Assuming that a resolution has been
attained:
[] Recommended actions for
immediate implementation shall
be endorsed to the Project
Proponents and the concerned
LGU
L] Assuming that there is no resolution
despite best effort:
CL) DOH and to
DILG refer the
complaint to the relevantjudicial
and/or administrative governing
body

Multi-Site, Multiple Region Projects

In instances which the project with an issued HICC or COE

in
isoperating concurrently in
multiple regions - as part of the nationwide scope of project implementation, the
complaint shall be filed with the DOH-HPB or DILG-BLGD as the GRM Focal Office. To
ensure a streamlined resolution process given the multi-site nature of the project under
complaint, the CHDs with administrative jurisdiction over each component site of the
project operations shall lead the investigation and propose resolutions for the complaint.
With oversight from the DOH-HPB and DILG-BLGD - the concerned CHDs shall be
reconvened with the HIA RevCom to resolve the complaint, and implement localized
problem solving measures that is deemed appropriate for each site and will sufficiently
address the complaint.

Assuming that a resolution has been attained, the resolution and key recommendations
to be carried out shall be endorsed to the LGUs to implement appropriate actions. The
same findings and recommendations shall also be endorsed to Project Proponents for
their appropriate action - such as but not limited to revising the PHMMP for a
well-documented and binding agreement torecalibrate its mitigation measures.

However, if no resolution has been attained despite this concerted effort, the DOH and
DILG shall refer the complaint to the relevant judicial and/or administrative governing
body.

15
 Community/group/
individuals file a
report to the DOH
or DILG
Lin
dink a aes

|
DOH to endorse
|

the complaint to
the concerned
LGU to implement CHDs
appropriate action

Ee
aor
the CHDs and the
HIA RevCom to
venient iis
paar p
resolve, and
feedback

Figure 2. Accountability Flowchart of GRM Focal Offices for Development Projects with
an HICC or COE Issued (Multi-Site, Multiple Region Projects)

Table 3. Summary Process Flow of the Complaint Endorsement and Resolution Process
for Development Projects with an HICC or COE Issued for Multi-Site, Multiple Region
Projects

What is expected from Complainant Action to be carried out by GRM Focal Office
L} Complainant officially files a L} DOH to endorse to concerned CHDs for
complaint to the DOH or DILG investigation
[] LHOs
to investigate and mobilize MMT
and relevant stakeholders

16
 L] DOH to convene the HIA RevCom and
concerned CHDs to discuss findings of
the investigation and arrive at a
resolution
L} Assuming that a resolution has been
attained:
CL]
Recommended actions for
immediate implementation shall
|
be endorsedto the Project
Proponents and concerned LGU
CL)
Expand the PHMMP toinclude
other recommended mitigation
measures
L] Documentation of proceedings
and key agreements of the
resolution will be endorsed to
the CHDs, and DILG.
L} Assuming that there is no resolution,
despite best effort:
LC] DOH and DILG to endorse
complaint to judicial or
administrative processes

For Projects Undergoing Review

In instances wherein the complaint involves a project that is currently undergoing review,
it must be filed at the national level through the DOH-HPB and the DILG-BLGD
capacity as the GRM Focal Offices. The GRM
in their
Focal Office - through the Secretariat - shall
then endorse the complaint to the HIA Review Committee. However, while the project is
still in its early stages of pre-implementation, Project Proponents are highly endeavored
to secure broad community support during project design development and consultation
in order to prevent any delays and setbacks due to complaints that may be raised.

Furthermore, given that the Development Project isstill in the early stages of the HIA
Review Process, this is also the ideal timeframe to address complaints. Such matters can
be easily resolved at a project proposal level, and with a more streamlined resolution
process compared to complaints raised for projects that have already been approved.
In convening the identified reviewing body, the GRM Focal Office must ensure that a
representative from the DILG-BLGD
body shall commence the
is also present during the proceedings. The reviewing
investigation process to gather data, understanding the root
cause of complaint, and engaging their best effort in order to arrive at a resolution. Such
resolutions in this circumstance may consist of revising project components and routine
activities of the proposal, and requiring a more robust lineup of routine health-protecting
measures in the PHMMP.

7
The recommendations resulting from this investigation shall then be endorsed to project
proponents
-for their appropriate action, and to the affected communities - for feedback.
The HIA Review Committee - in coordination with the Secretariat, shall then ensure that
the recommendations shall be incorporated in the approved HIA Report and/or the
PHMMP; including the conditionalities stated in the HICC and COE.

Community/group/
individuals file a
report to the
DOH-HPB and/or
DILG-BLGD

DOH-HPB endorses
the complaint to
the appropriate
reviewing body

Concerned project
proceed to the
standard HIA
Review Process

Reviewing body
investigates the
complaint

Reviewing body
resolves the
complaint and
finalizes the
documents Secretariat endorses
the findings and
Proponent and recommendations
the Proponent and
to
complainant
provides response complainant
to the findings and
recommendations

Figure 3. Accountability Process Flowchart for Development Projects Undergoing the

Review (ie., no HICC or COE Issued yet)

17
Table 4. Summary Process Flow of the Complaint Endorsement and Resolution Process
for Development Projects Undergoing the Review (ie., no HICC or COE Issued yet)

What is expected from Complainant Action to be carried out by GRM Focal Office

CL}
Complainant officially files a CL]
Secretariat will endorse the complaint
complaint to the DOH-HPB and to the HIA Review Committee
DILG-BLGD |
L] HIA Review Committee to investigate
and mobilize other key experts relevant
to the project
L]
in
Resolution options light of findings
from the investigation:
L} Revise project components and
routine activities
CL]
Expand the PHMMP toinclude
other recommended mitigation
measures
(1 Secretariat to ensure that the agreed
upon recommendations and
resolutions are reflected in the
conditionalities stated in the HICC and
COE

18
AN das
Annex A. Table of Activities for HIA of Development Projects

is Process for the Issuance of the HICC

PROCESS METHOD
Review
HIA Review Process Conduct of HIA

Screening
Screening of projects based on
inclusion and exclusion criteria sie wide Submission of the Screening
Form (Fonn 1) Pic eo Buruses0g

~ Refer
to Figure 7
for Exemption
Process

Review of the Scoping Guide

’ Burdoos

Conduct of Scoping Activities

Review

Scoping Ad Referendum Review

Development of HIA Terms of

Reference (Form 3)

| Synthesis
impa ik
of Potential jesieiddy

Conduct of HIA

Review

(lal\helMalfametsialaint
Review of the HIA RevComm
HIA pand PAMMP {Form 5)
the 1
Committee

Bumodey

Revisions on the HIA Report

Convening
and/or PHMMP (if
any)

Development of HICC Conditions

HICC

Sworn to by Proponent
the
1

Issuing

Issuance of the HICC

Creation of the Multisectoral

Evaluation

Monitoring Team Buuoyu0yy

!
and
Conduct of Monitoring and pue

Evaluation Activities
1
Monitoring
uoyenjeag

Development of M&E Report

(Form 6)
 Process for the Issuance of the COE
PROCESS METHOD
HIA Review Process Conduct of HIA
af

Screening of projects submission of Screening for

-——t based inclusion and
on

_
{Form 4)
Review exclusion criteria

Er
Screening

NO
_- Development
Project?

“Y ey a Community
aS a ts ae

Profiliag
allie
or
sik

the
Development of the Draft TOR
of |
PHMMP
: Data Gathering for PHMMP
Development

Ad Referendum Review of
PHMMP.
ELEM (clteloleutclee) plete linn
| eigen iol

|
ised: PHMMP,
Revision of PHMMP (if any)
i

PHMMP

the
Ratification of the HIARevComm =|. —
of

Review
|
Revision of PHMMP (if any)
submission obRevised PHMMP tf
any

Issuance of COE

Creation of the Multisectoral ki

Co
ie leliicoiney
Monitoring Team
Evaluation

\
for non
and
Conduct of Monitoring and
Evaluation Activities
“End
eenin
projects

|
Monitoring

Development of M&E Report Developmen d

PHMMP
(Form 6) iy
Annex B.
List of Health Sensitive Projects

Pursuant to the DENR-EMB Memorandum Circular No. 005 s. 2014, the following are
considered as ‘Environmentally Critical Projects; hence, shall be categorized as ‘Health
Sensitive Projects’:

Project/ Description Threshold

1. Heavy and Other Processing/ Manufacturing Industries
1.1. Non-Ferrous Metal Industries 2 30,000 MT
1.2. Iron and Steel Mills

1.3. Petrochemical or petroleum-based

projects
1.4. Refineries > 30,000 barrels
1.5. Recycling of oil and other 210 MT
petroleum-based chemicals
1.6. Smelting Plants 2 15,000 MT
1.7. Pulp and Paper Industries 2 50,000 MT
2. Resource Extractive Industries
2.1. Coal mining > 70,000 MT
2.2. Extraction of metallic ores/minerals > 100,000 MT OR
Area = 25 ha (regardless
(on shore) of capacity)
2.3. Extraction of Non-metallic Minerals
such as
= 75,000 OR Area
capacity)
= 20 ha (regardless of
- Limestone/shale/silica/clay/
placer and other non-metal
minerals/ores
- Aggregates (sand, stone, gravel
including dredging with/intended
for recovery/use of materials
2.4. Land-based Commercial Extraction = 4,000 barrels (or equivalent)
of Oil

2.5. Land-based Commercial Extraction > 250,000 m3

of Gas

2.6. Extraction of metallic and Regardless of commercial capacity or area

non-metallic minerals including
extraction of oil and gas, deuterium
(off-shore)
2.7. Metallic Mineral or Ore Processing > 70,000 MT
2.8. Non-metallic mineral processing > 50,000 MT
plants like cement, other cement
products, clinker, limestone, ceramic
industries, manufacture of glass and
glass products, manufacture and
processing of calcium
2.9. Forestry Projects (involving = 10,000 m3
development/construction of
infrastructures and/or facilities)
2.10. Wood Processing Projects (involving 210,000 m3
development/construction of
infrastructures and/or facilities)
2.11. Grazing Projects (involving 2 500 Animal Unit (AU)
development/construction of
infrastructures and/or facilities)
2.12. Fishery/Aquaculture Projects using >25ha
fresh or brackish water including
pearl farm and similar activities
3. Infrastructure Projects
3.1. Dams (including those for irrigation, > 25 ha OR 2 20 million m3
flood control, water source and
hydropower projects) including
run-of-river type

3.2. Gas-fired thermal power plants > 50 MV

3.3. Geothermal facilities 250 MV

3.4. Hydropower facilities 250 MV

3.5. Other Thermal Power Plants (eg. coal, = 30 MV

diesel, bunker, etc.)
3.6. Power Barges > 50 MV

3.7. Fuel cell 2100 MV

3.8. Reclamation and other land > 25 ha

restoration projects
3.9. Roads, new construction NATIONAL ROAD: = 20.0 km (length with no
critical slope) OR = 10.0 km (length with
critical slope)
3.10. Bridges and viaducts (including 210.0 km
elevated roads), new construction
3.11. Tunnels and sub-grade roads and 2=1.0km
railways
3.12. On-grade railway system, new Regardless of length and width
4. Golf Course and Other Tourism Projects

4.1. Golf course projects/ complex Regardless of number of holes

Form No. Form Title
1.1 Screening Form
1.2 Scoping Guide
2.1 Scoping Report
2.3 HIA Terms of Reference
3.1 HIA Report
4 Public Health Management and Mitigation Plan

5 Resubmission Form
6 Monitoring and Evaluation Form
12 Grievance Redress Form
 REPUBLIC OF THE PHILIPPINES

Aa)J DEPARTMENT
HEALTH IMPACT ASSESSMENT
OF HEALTH
FORM 1.1
SCREENING FORM
To be filled up by Proponent/ Preparer

Date of
HIA Code eos
(To be provided by HPB) Submission (To be provided by HPB)

Section I. General Information

Name of Project
Project Proponent

Project Site Barangay/s:

(If projecthas multiple
project sites, kindly attach a City/Municipality/ies:
separate sheet providing
pertinent details on the Province/s:
other project sites)
Region/s:

Project Operation Status oO New proposed O For expansion/

(check the appropriate box) modification

Project Objectives Enumerate project objective/s

Area Classification CL] Health Sensitive Area

(check the appropriate box) C] Non-Health Sensitive Area

If Health Sensitive Area, please specify corresponding HSA category/ies:

If Non-Health Sensitive Area, please justify:

Project Rationale Provide details on the background and rationale of proposed development
project
Project Phase QO +Pre-construction O Operation
(check the project phase/s {J Construction [1 Decommissioning
covered in
this proposal)
Duration of Project Provide estimated duration of project (per project phase) in year or months

Project Category
(check the appropriate
[
OO)
Heavy Industry
Chemical Industry
CL)

C1
Resource-Extractive Industry
Waste Management Project
category) [Industrial Estate C1)
Agricultural, Food and
OO Public and Economic Related Industry
Infrastructure (e.g., roads C1 Social and Recreational
and highways, overpasses, Establishment
bridges, etc.) CL]
Power and Petroleum
1 Others, please specify Industries

Resource Requirements Provide details on the resources (e.g., natural, human, financial, etc.)

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT
HEALTH IMPACT ASSESSMENT
OF HEALTH
Project Cost Provide the total project cost. Attach breakdown of project cost, if any

Land Area in hectares:

Section II. Declaration of Conflict of Interest

Are you an employee

Project Proponent?
of the LI) Yes Ol No

Did you do consultancy or part Ol Yes CL}

No
time work for the Project
Proponent?

In the past year, did you Ol Yes LI No

receive P500,000 or more
from the sponsor/s?

Other ties with the Project

Proponent:

hi ibility an | men

|hereby pledge to
address all
forms of COI that | may have and perform my tasks objectively, protect the
integrity of the health impact assessment, prioritize the health and well-being of the potentially-affected
community, ensure genuine stakeholder consultation, and comply with my ethical responsibilities as HIA
Preparers.

Section Ill. Contact Information

Contact Person

Designation

Address

Landline

Mobile No.

Email Address

Signature

Section IV.A Document Submission Checklist (To be

filled up by the Secretariat)

Upon assessment, applicant must submit:

Public Health Management and Mitigation Plan
Form 2: Scoping Form
Oe:
Form 3: HIA Terms of
Reference
Signed Project Proposal
CV of the HIA Preparer/s

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT
HEALTH IMPACT ASSESSMENT
OF HEALTH
Section IV.B Assessment of Document (To filled up by the
be
Secretariat)

C1 Complete Received by:

Name & Signature

Date & Time:
(1 Incomplete List any missing or incomplete documents.
Provide brief explanation(s) for omissions.

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1003, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 FORM 1.2
SCOPING GUIDE
To be
filled up by Proponent/ Preparer
Name
of Project HIA Code:
(To be provided by HPB)

Section I. Scope of Work

Level of HIA to be 0 Intermediate L) Comprehensive
conducted
the Secretariat)
(to
be filled
up by

Dimension of Assessment Describe the geographic scope of assessment

Section II. Proposed Methodology

Methodologies 1, List of data collection activities
2. Objective of each activity

Public Participation Provide information on:

Strategy 1, Stakeholder Analysis
2. Design of public participation mechanisms or activities
3. Plan for sharing, disclosure, and/or presentation of HIA
findings

Scope of Evidence Key Area of Research Type of Data Data Sources

Assessment Question Needed
Specify the key State the Identify the List down
area of specific type of data potential data
assessment research needed to sources of the
question in answer identified data
relation to the the identified needs
KAA research
question

Timeline Provide project timeline and Gantt chart/s

Budget Provide details on budgetary needs and line-item budget for the
conduct of
the HIA

Section Ill. Summary of Deliverables

Documentation of co nsultations
OOOO
Data Sets collected
Other deliverables:
Annexes, if any
Section IV. List HIA Preparer/s

Name/s Qualification/s

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1003, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 -
70 REPUBLIC OF THE PHILIPPINES
Cy
DEPARTMENT OF HEALTH
HEALTH IMPACT ASSESSMENT

Section V. Contact Information

Contact Person

Signature

Date & Time

Section IV.A. Receipt of Submission

Name
of Recipient
Signature

Date & Time

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 FORM 2.1
SCOPING REPORT
To be filled up by Proponent/ Preparer

Name of Project HIA Code:

(To be provided by HPB)

Section I. Community Profiling

Demography Describe the population demographics of the potentially-affected

community such as, but not limited to:
Population Size/ Density
Gender diversity
Socioeconomic structure
Poverty rate
Unemployment rate
Average household income
Percentage of households on public assistance (e.g., 4Ps)
OOOROOO]Jn~arswonna

Special Populations Children under 18 years (significant part of population)

(Vulnerable groups present within Elderly (significant part of population)
proximity to the area) Persons with disability (significant part of population)
Refugees or displaced persons
Indigenous peoples and ethnic minority groups
Others:
None

List of Stakeholders (attach Beneficiaries: List down all potential beneficiaries of the project
additional pages, if necessary)
Negatively Affected: List down all potential stakeholders to be
negatively affected by the project

Other stakeholders: List down all other stakeholders present in the

community

Social Issues and Risks Discuss here existing social issues and risks in the
potentially-affected community such as, but not limited to:
Poverty and Homelessness
Unemployment
Discrimination (e.g. gender, race, religion, culture, age, etc.)
AanKRWNHS

Violence Against Women and Children

Social Disorganization
Literacy

Social Safeguards Describe existing and available social safeguard and safety nets
for communities (e.g. financial assistance, housing and/or
resettlement plan, alternative work opportunities, etc.)

Community Map Enumerate and describe the following:

1. Concentration/ Location of Other Development Projects in
Progress or in Operation
2. Institutions or Common Spaces Present the community in
3. Project location relative to components of the community
(e.g., residential areas, public spaces, coast, farmlands,
etc.)

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 Sy
i)
REPUBLIC OF THE PHILIPPINES

x ZZ~]
DEPARTMENT OF HEALTH
WEALTH IMPACT ASSESSMENT

Section Il. Methodology (Please provide information on scoping activities done)

Methodology Provide information on activities done for:
7. Community Scoping
2. Technical Scoping
3. Literature Review

Section Ill. Scoping Activity Findings

Baseline Health Condition Describe the current health conditions and other health
and Other Health determinants in the community
Determinants
Example:
a. Health conditions - data on health conditions, description of
the local health system, morbidity, and mortality data
b. Social conditions - data on the social and cultural aspects
of the community i.e. demographics, housing and/or
schooling conditions, crime rate and violence, groups
present and nature of interaction, political dynamics,
cultural practices, community values, etc.
c. Economic conditions - data on the socio-economic
characteristics of the community i.e. employment data,
common trade or livelihood, major sources of income, etc.
d. Environmental conditions
-
data on air quality, concentration
of relevant particulate matters, access and availability of
drinking water, noise and vibration
e. Built environment
land use
-
public infrastructure, public services,

Section IV. Health Impact Pathway Diagrams

Accomplish the Health Impact Pathway Diagram and describe exposure pathways.

Section V. Contact Information

Contact Person

Signature
Date & Time

Section Ill.A. Receipt of Submission (To be

filled up by the Secretariat)

Name
of Recipient
Signature
Date & Time

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
 ene REPUBLIG OF THE PHILIPPINES
fi eee) DEPARTMENT OF HEALTH
un
HEALTH IMPACT ASSESSMENT

FORM 2.3
HIA TERMS FOR REFERENCE
To be
filled up by Proponent/ Preparer
Name of Project HIA Code:
(To be provided by HPB)

Section I. Scope of Work

Level of HIA to be [] Intermediate CL}
Comprehensive
conducted (to be
filled up by
the Secretariat)

Dimension of Assessment Describe the geographic scope of assessment

Key Areas of Assessment Based on the health impact pathway diagram, enumerate the key areas of
assessment

Section Il. Proposed Methodology

Methodologies 1. List of data collection activities

2. Objective of each activity

Public Participation Provide information on:

Strategy 1. Stakeholder Analysis
2. Design of public participation mechanisms or activities
3. Plan for sharing, disclosure, and/or presentation of HIA findings

Scope of Evidence
Key Area of Research Type of Data Data Sources
Assessment Question Needed
Specify the key State the Identify the type List down
area of specific of data needed potential data
assessment as_ research fo answer the sources of the
identified in the question in identified identified data
Health Impact relation to the research needs
Pathway KAA question
Diagram

Data Analysis Plan Provide information and work plan for data analysis

Timeline Provide project timeline and Gantt chart/s

Budget
Provide details on budgetary needs and line-item budget for the conduct of
the HIA

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
Section Ill. Summary of Deliverables
HIA Report, including plain-language and executive summaries
Cross reference matrix for the HIA TOR and HIA Report
Ef Data Sets collected
Other deliverables:
Annexes

Section IV. List HIA Preparer/s

Name/s Qualification/s

Section V. Contact Information

Contact Person

Signature
Date & Time

Section IV.A. Receipt of Submission

Name of Recipient
Signature
Date & Time

Department ofHealth - Health Promotion Bureau

38rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT
HEALTH IMPACT ASSESSMENT
OF HEALTH
FORM 3.1
HIA REPORT
To be
filled up by Proponent/ Preparer
Name
of Project HIA Code:
(To be provided by HPB)
Section I. Methodology
Data Gathering Describe the data collection methods and activities conducted by the
Methodologies HIA Preparers during the appraisal phase.
7. List of Data Collection Activities
a. Objective of each activity
b. Data or information needed
C. Intended source of data
2. Public Participation Strategy
a. Stakeholder identification and analysis
b. Identification and design of activities for
sharing/disclosure/
presentation of findings
c. Date and duration of engagement
d. Mode
of engagement/communication
e. Summary of engagement - Concerns and issues
raised, commitments and agreements
1. Documentation (e.g., pictures, videos, data gathering sheets,
records, etc.)
Section Il. Findings and Analysis
Evidence Synthesis of Present all relevant empirical evidence on the predicted impacts
Potential Impacts of the development project to health and its determinants.
Discussion of evidence may include:

- Use of primary data from combination of methods

- Use of secondary data from published reports and
literature
- Provide complete references where historical data is used
- Impact pathways to individual and public health
- Description of techniques used in
predicting impacts (i.e.
models, etc.)

Specifically, this section includes:

1. Description and synthesis of evidence on potential direct

effects on health
a. Prevalence and/or incidence of pertinent diseases
b. Change in the capacity and/or operations of the
local health system
c. Accessto and availability of local health services

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
i“@re)
Sunil REPUBLIC OF THE PHILIPPINES
DEPARTMENT
HEALTH IMPACT ASSESSMENT
OF HEALTH

__
—
Section Il. Findings and Analysis
Evidence Synthesis of 2. Description and synthesis of evidence on potential
Potential Impacts physical and environmental impacts on health
a. Air quality
b. Water quality
c. Land use orsoil quality
d. Noise and vibration
3. Description and synthesis of evidence on potential
social and cultural impacts on health
a. Housing and settlement conditions
b. Local education system
C. Local transportor mobility
d. Social cohesion/capital
4. Description and synthesis of evidence on potential
economic impacts on health
a. Local livelihood
b. Household employment
c. Sources of income
5. Description and synthesis of evidence on potential
impacts on other determinants of health
6.
if
Limitations and data gaps, any

Characterization of Describe potential impacts using empirical primary and/or

Potential Impacts secondary evidence. Presentation of evidence must include
discussion on the direction of change, likelihood and/or certainty of
impact, latency of impact, and magnitude of potential health
consequence.
Section Ill. Conclusion
Based on
the analysis all gathered
of evidence, provide a conclusion on the HIA conducted.

Section IV. Recommendation

Based on the analysis all gathered

of evidence, provide a project and implementation
recommendation as well as mitigating measures for consideration in the PHMMP.

Identified Health Impact Management and/or Mitigation Measure

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
Section V. Attachment/s
O Public Health Management and Mitigation Plan
O References
O Curriculum Vitae of HIA Preparers
(1 —HIA Terms
of Reference
Section VI. Contact Information
Contact Person

Signature
Date & Time

Section IV.A. Receipt of Submission

Name
of Recipient
Signature
Date & Time

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
 FORM 4
EVALUATION FORM FOR THE HIA REPORT
To be filled up by the HIA RevCom

Name of Project HIA Code:

(To be provided by HPB)

Section I. Impact Management and Mitigation Plan

Project Phase SDH Affected Potential Impact

s,
ore)
Mitiaati
itigation
Operational
Provision/ Means
see
of Verification
gs

Measure
Identify the project Identify the Enumerate the Describe the Identify the means
phase (i.e., Social Potential Impact prevention and of verification to
preconstruction,co Determinant of mitigating ensure that the
nstruction, Health measure to be measure/s to
operation, affected/ likely
decommissioning) to be affected
employed in prevent, mitigate
response to the and/or increase
and the specific identified potential health gains is/
project impact are being/ was
component implemented (e.g.
regular
monitoring, site
visit,
self-monitoring)

Section tl. Community Assistance Plan

Based on the identified potential health impacts, describe the following components of the
Community Assistance Plan
1. Compensation Plan
and its implementation strategy:

2. Employment Plan
3. Community Development Assistance
4, Housing and Resettlement
5. Alternative Livelihood
6. Other Community Welfare Project/s
Section Ill. Monitoring and Evaluation Plan

Key Area of Impact to be Method Frequency Lead Person/ Focal

Assessment (SDH) Monitored Office

Identify KRA of Identify Identify the Identify Identify specific project

concern as identified specific health method of frequency of member responsible
in the HIA Report impact to be monitoring the monitoring for the monitoring of
monitored identified the identified health
impact impact

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1003, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
Section IV.A Contact Information
Contact Person

Signature
Date & Time

Section IV.B Receipt of Submission

Name
of Recipient
Signature
Date & Time

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1003, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 FORM 5
Resubmission Form
To be filled up by Proponent/Preparer

Name
of Project HIA Code:
(To be provided by HPB)

Section I. Revision/s
Document/s revised O HIA Report O HIA TOR
1) =PHMMP O Other:

HIA RevCom Reviewer Comments (to be

Revision Made filled up by primary
Recommendation
reviewers)

Section Il. Contact Information

Contact Person

Signature
Date & Time

Section VI.A. Receipt of Submission

Name
of Recipient
Signature
Date & Time

Section Ill.A. Assessment of Revision (to be

filled up by primary reviewer/s)
Summary of Comments

Recommendation O Satisfactory O Unsatisfactory

O For revision CL}
Other:
Name
of Reviewer
Signature

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
Section IIl.B Assessment of Revision (to be filled up by HIA RevCom Chairperson)
Final Decision

Name
of Chairperson
Date & Signature

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 Scebtios %>
REPUBLIC OF THE PHILIPPINES

FORM 6
Monitoring and Evaluation Report
To be completed by MMT (and Proponent)

Name
of Project HIA Code:
(To be provided by HPB)
Section |. Summary of Self-Monitoring (to be completed by Proponents/ Preparers)

Based on the approved Public Health Management and Mitigation Plan, the following monitoring
was undertaken:

Key Area of Person!

to be
impact
Method Frequency Complied?
MeSH) Monitored Focal
Office
Yes or No?

Identify the Identify the Identify the Identify the Identify the Specify if
KRA of specific health method of frequency of | specific management or
concern as impact to be monitoring monitoring project mitigation
identified in monitored the identified member measure was
the HIA impact responsible implemented for
Report for the the specified
monitoring impact
of the
identified If ‘no’, kindly
health explain the
impact reason for
non-compliance

Section II. Monitoring Activities Conducted (to be completed by MMT)

Describe the monitoring activities conducted for the period indicated:
1. Key assessment areas monitored
WL
Data sources and methods used for
data collection
Timeline, locations, and duration of monitoring activities
AR
Composition of monitoring team
Oa
Documentation (e.g., pictures, videos, etc.)
Budget and expenses
Section Ill.A. Evaluation Results (to be completed by MMT)
Health Impact Complied? Proof of Compliance Remarks
As
identified in State or attach the If any
the monitoring means of verification
and evaluation as proof that the
monitoring and
plan, state the Yes No evaluation plan has
health impact been complied with
being
monitored

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1003, Philippines
Tel. Nos. (682) 8651-7800 locals 2834
Email Address: [email protected]
Section IIIl.B. Discussion of Evaluation Results (to be completed by MMT)
Discuss the project proponent’s
compliance to conditions set by the governing body and its
implementation of the PHMMP., and discussion of impacts to health and other determinants or
changes in
baseline data previously reported.

1. Implementation Monitoring - Discussion includes:

a. Compliance with regulatory conditions, and agreements with governing body
b Implementation fidelity of PHMMP
C. Factors and barriers for successful compliance/implementation
d. Explanation from project proponents, for cases of non-compliance of
unsuccessful implementation of PHMMP. and suggested alternative courses of
action
e. Description of the project proponent’s historical compliance/ implementation of
PHMMP
for
continuous monitoring and evaluation
2. Impacts Monitoring - Discussion includes:
a. Changes in
baseline health conditions of workers and potentially- affected
communities, and other pertinent determinants
b. Changes in usual operations, and service delivery patterns of the local health
system
3. Summary of previous M&E report, for continuous monitoring and evaluation, and simple
trend or cumulative analysis of the changes monitored

Section IV. Conclusion and Recommendation (to be completed by MMT)

Based on
the result of the evaluation conducted, present the conclusion and recommendations
on project implementation and monitoring.

Include details on:

1. Key conclusions and recommendations for
implementation monitoring
2. Key conclusions and recommendations for impact monitoring
3. Technical and practical recommendations for the next M&E period
4. Any requirements for revision of PHMMP

Section V. Contact Information (to be completed by MMT)

Contact Person

Signature
Date & Time

Section VI.A. Receipt of Submission

Name
of Recipient
Signature
Date & Time

Department of
Health - Health Promotion Bureau
8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834.
Email Address: [email protected]
 REPUBLIC OF THE PHILIPPINES
G

EN
a) DEPARTMENT OF HEALTH
HEALTH IMPACT ASSESSMENT

FORM 12
GRIEVANCE REDRESS FORM
To be
filled up by Complainant
Date:
are
Name of Project
GRM Code:
Project
oject P Froponen t
(To be provided by HPB)

Section |. Complainant Information

Name

Address

Contact Number

Email Address

Section II.A. Complaint Details

Location of the problem/

issue

Description of the problem

Description of the factors

causing the problem

Person/agency responsible (] Project Implementing C1 Local political authority

for causing the problem Agency O Civil organizations
LC]
Affected parties [] Funding agencies
1 Service delivery agencies [ Others:

Past action/s taken by

the complainant
(if any)

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 REPUBLIC OF THE PHILIPPINES

{e\) 5
DEPARTMENT OF HEALTH
HEALTH IMPACT ASSESSMENT

Section II.B. Receipt of Submission

Name

Position

Name
Office
of Receiving
Date and Time

Section III. Actions Taken (To filled up by the GRM Focal Ofice)
be

Action 1 Action 2 Action 3 Action 4

Short Description Short Description Short Description Short Description

Name of Focal Person Name

of Focal Person Name
of Focal Person Name
of Focal Person
Office Office Office Office

Date Date Date Date

Final Resolution

Department of Health - Health Promotion Bureau

8rd Floor, Building 14C, San Lazaro Compound, Tayuman, Santa Cruz, Manila, Metro Manila, 1008, Philippines
Tel. Nos. (632) 8651-7800 locals 2834
Email Address: [email protected]
 Para sa Healthy Pilipinas

Department of Health Health Promotion Bureau

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® [email protected] [email protected]
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