Ash Salient Features Stakeholders

AGRARIAN REFORM COMMUNITY SAVINGS FOR HEALTH MICRO-INSURANCE ARC Saves for HMI

OBJECTIVES

To develop and install a community-based social health insurance scheme that will transform the ARBs into self-reliant communities that are able to sustain the continuous access to health care services through partnership PhilHealth, LGUs and other relevant private organizations.

SPECIFIC OBJECTIVES 1. Increase the awareness and appreciation of ARB households on the benefits of SHI and ensure their sustained enrollment beyond the project duration; 1. Implement the graduated enrollment scheme for ARB households in PhilHealth’s Sponsored Program to Individually Paying Program and/or communitymanaged social health insurance; 3. Install and strengthen a system for savings mobilization as a mechanism for generating funds from the cooperatives’ members for their premium counterpart

SPECIFIC OBJECTIVES 1. Maximize the utilization of the capitation fund by the participating LGUs for the improvement of the health facilities in the project areas; 5. Enhance the partnership intiatives on health at the local level with the involvement of the LGUs, PHILHEALTH and ARC cooperatives 6. Document the processes undertaken under the project for possible expansion and replication in other ARCs

PROJECT OUTPUTS

• ARBs enrolled in Philhealth’s SP and/or in IPP • Graduated enrollment SHI scheme pilot tested • ARC Coop-managed Social Health Insurance Scheme • Local level initiatives in the delivery of health services strengthened

Area Coverage

Pilot Area: 4 ARC Organizations in Pangasinan Expansion Area: Visayas and or Mindanao

SELECTION CRITERIA

For the ARCs • presence of organization/s with profitable enterprises being managed and patronized by its members; • with PhilHealth-accredited rural health unit (RHU) in the municipality; • with presence of support LGU; and • project areas covered both by DLR and GSKF. For the Cooperatives • within an organizational maturity (OM) rating from levels 3 to 5; • with a minimum of 100 ARB members; • with existing savings mobilization program; • managing viable economic enterprises; and • willing and interested to undergo the processes under the project.

PARTNERSHIP ARRANGEMENTS DAR • Capacity Building for ARBs •Systems Installation on Savings Mobilization •Partnership building •Health education on SHI • Identification of Qualified ARBs • Process Documentation GlaxoSmithKline • 50% of annual premium for ARB enrollees for year 1 (1st – 3rd class municipality; ) • Preventive health care education program • Assist in the facilitation/promotion of partnership building with LGU

PARTNERSHIP ARRANGEMENTS PhilHealth • 50% of annual premium of ARB enrollees from Y1-Y3 • Facilitate/Promotion of Partnership Building with LGUs • Assist in Health Education on SHI LGU • 25% annual premium of ARB enrollees in Y2 (1st – 3rd Class Municipality) • Confirm qualified ARBs • Manage capitation fund • Provision of Out-Patient Benefit (OPB)

PARTNERSHIP ARRANGEMENTS Cooperative •

Identify qualified agrarian reform beneficiaries •Members in good standing •Willing to participate in the project •Members with livelihood activities •With income of below poverty line •Residence of ARCs

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Implement the savings mobilization scheme to generate • health funds • premium counterpart

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Manage the social health insurance scheme

ARC Save for HMI

OPERATIONAL FRAMEWORK

Year 3

MOA with the LGU Year 1

C oop

LG U

Save 50% of LGU counterpart premium for Y2 and health funds for year 4 health cares services Manage capitation fund/ confirm qualified ARBs

GS K

Pay the 100% of LGU counterpart premium Y1 & provide Health Education

P HIC

Pay the 50% counterpart premium

DA R

Year 2 Pay the 50% LGU counterpart premium and save the 100% LGU counterpart premium Y3 premium and health funds for year 4 health cares services. Pay the 50% LGU counterpart premium/ confirm qualified ARBs

Pay 100% LGU Pay the 100% IPP counterpart premium & premium and save for save 100% of IPP the succeeding years premium on Yr. 4. enrollment premium Manage profitable Or enterprise using the Manage the Health Health Fund (Option to Fund through a engage in CBSHI or IPP Community-Base using their savings from Social Health Y1 to Y3) Insurance or POGI of Philhealth Manage capitation fund/ confirm qualified ARBs

Provide Health Education

Phase-out

Pay the 50% counterpart premium

Pay the 50% counterpart premium

Year 4

Managing Investment/ Enterprise Activities Using Portion of Health Funds Generated

Provide technical guidance & mentoring activities on the installation/strengthening of policies, systems & procedures on enterprise & savings mobilization for SHI; continuous capability building & enhancement for the pilot cooperatives

Give a man fish and he will live for a day Teach a man how to fish ….and he will live for a lifetime.