[Congressional Record Volume 154, Number 127 (Tuesday, July 29, 2008)]
[Senate]
[Pages S7631-S7633]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ENZI:
  S. 3354. A bill to award grants for the establishment of 
demonstration programs to enable States to develop volunteer health 
care programs; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. ENZI. Mr. President, I rise to discuss the importance of ensuring 
the people of our Nation have access to health care and what the Senate 
can do today to help the neediest people get the kind of care they need 
and are entitled to.
  There are currently 61 million Americans who are either uninsured or 
underinsured. These people, many of whom are working and have families 
to care for, may have limited access to the kind of routine health care 
and nonemergency services so many of us take for granted.
  Fortunately, at the present time, there is a large, vital network of 
health care providers in this country who are doing their best to 
address this need and provide care to this underserved population. We 
don't talk about this network much, as the Federal Government does not 
pay for it.
  It is made up of volunteers, hundreds of thousands of health care 
providers, working across America, in almost every community, 
volunteering their expertise and donating their time to help those in 
need. These people are physicians, dentists, nurses, optometrists and 
chiropractors, to name a few of the professions that are represented in 
this group. Hospitals and outpatient surgical centers are also 
contributing to the effort.
  Caring for our neighbor has always been a basic value for us as 
Americans. My mother always told me that the service we provide to 
others is the rent we pay for the space we take up on God's green 
earth. The people who are participating in this network of care have 
taken that philosophy to heart and we are all the beneficiaries of 
their efforts. They are making a difference in more lives than we will 
ever know.
  We have all heard the saying that charity begins at home, and while 
it is an important part of any effort to address a need in our towns 
and cities, I am not suggesting that it is the final answer to correct 
the social injustices that exist in the world. We all realize that too 
many Americans lack health insurance, and that health care reform is a 
top priority for Congress. America needs health care reform, and I have 
a

[[Page S7632]]

plan to put that into action in my 10 Steps bill.

  As we work on health care reform and all it entails, we can also do 
something to help provide some support and encouragement to the 
volunteer effort I have just described. Government has a role to play 
and it is to facilitate the care that is provided to those who need it 
so badly by those who are willing to freely offer it to them.
  As with so many things, there is a catch, and that is why I am 
introducing my Volunteer Health Care Act of 2008. My bill will remove a 
legal barrier that currently prevents physicians and health care 
professionals from volunteering their services to individuals who 
either can't afford or can't access even the most basic of care. There 
is an overwhelming need for medical volunteers to work with the poor in 
the United States, but medical liability concerns discourage many 
doctors from providing voluntary services. This bill will help provide 
access for the disadvantaged and provide them with the care they so 
desperately need. In return, it will help to alleviate the concerns of 
health care providers who want to share their talents with the people 
of their community and give something back to make their part of the 
world a better place to live.
  This legislation addresses the situation in a way that is fair to the 
patient. It provides an avenue to recover damages if, by chance, some 
harm is done. It makes use of a formula that has been tried before and 
been proven to be effective.
  I have said before that States are the laboratories for the Federal 
Government. We know the positive effects that this program can provide 
because a few States have been using it for more than 10 years. Since 
the State of Florida started such a program 16 years ago, more than 
20,000 health care volunteers have provided more than $1 billion worth 
of charity care at free clinics, community health and migrant worker 
clinics, and with other indigent clinics to provide health care that 
would otherwise not be available. This program calls for minimal 
expense, but it has the potential for a huge return. Eight other States 
have enacted this program and have had excellent results. But that is 
only 8 other States. The legislation that I am proposing today 
encourages the remaining 41 States to consider it.
  Some people would say that the Federal Government has already made 
provisions for volunteer care with the federal Volunteer Protection Act 
of 1997. This act raises the standard of care from simple negligence to 
gross negligence. This law has two drawbacks however. It makes it more 
difficult for an injured party to prove substandard care and it leaves 
volunteer providers responsible for paying the cost of their defense.
  The bill that I am introducing, the Volunteer Health Care Program Act 
of 2008, would provide grants to States that would accept medical 
liability for volunteer medical providers. These programs would protect 
providers from liability claims, while also ensuring that injured 
patients could recover damages. This bill addresses both drawbacks of 
the current Federal volunteer law, it does so at a minimal cost to 
Federal and state governments, and it has a proven record of working. 
The passage of this bill will take us one step closer to ensuring 
access to quality health care for all Americans.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3354

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Volunteer Health Care 
     Program Act of 2008''.

     SEC. 2. PURPOSES.

       It is the purpose of this Act to provide grants to States 
     to--
       (1) promote access to quality health and dental care for 
     the medically underserved and uninsured through the 
     commitment of volunteers; and
       (2) encourage and enable healthcare providers to provide 
     health services to eligible individuals by providing 
     sovereign immunity protection for the provision of 
     uncompensated services.

     SEC. 3. GRANTS TO STATES TO ESTABLISH AND EVALUATE HEALTHCARE 
                   VOLUNTEER INDEMNITY PROGRAMS.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399R. GRANTS TO STATES TO ESTABLISH AND EVALUATE 
                   HEALTHCARE VOLUNTEER INDEMNITY PROGRAMS.

       ``(a) In General.--The Secretary shall award a grant to an 
     eligible State to enable such State to establish a 
     demonstration program to--
       ``(1) promote access to quality health and dental care for 
     the medically underserved and uninsured through the 
     commitment of volunteer healthcare providers; and
       ``(2) encourage and enable healthcare providers to provide 
     health services to eligible individuals, and ensure that 
     eligible individuals have the right to recover damages for 
     medical malpractice (in accordance with State law) by 
     providing sovereign immunity protection for the provision of 
     uncompensated services.
       ``(b) Eligibility.--To be eligible to receive a grant under 
     subsection (a), a State shall--
       ``(1) submit to the Secretary an application at such time, 
     in such manner, and containing such information as the 
     Secretary may require;
       ``(2) provide assurances that the State will not permit 
     hospitals to enroll individuals seeking care in emergency 
     departments into the State program; and
       ``(3) provide assurances that the State will provide 
     matching funds in accordance with subsection (e).
       ``(c) Use of Funds.--
       ``(1) In general.--A State shall use amounts received under 
     a grant under this section to establish a demonstration 
     program under which--
       ``(A) the State will arrange for the provision of health 
     and dental care to eligible individuals (as determined under 
     subsection (d)) participating in the State program;
       ``(B) ensure that the health and dental care under 
     paragraph (1) is provided by qualified healthcare providers 
     that do not receive any form of compensation or reimbursement 
     for the provision of such care;
       ``(C) sovereign immunity is extended to qualified 
     healthcare providers (as defined in paragraph (2)) for the 
     provision of care to eligible individuals under the State 
     program under this section;
       ``(D) the State will agree not to impose any additional 
     limitations or restrictions on the recovery of damages for 
     negligent acts, other than those in effect on date of the 
     establishment of the demonstration program;
       ``(E) the State will use more than 5 percent of amounts 
     received under the grant to conduct an annual evaluation, and 
     submit to the Secretary a report concerning such evaluation, 
     of the State program and the activities carried out under the 
     State program.
       ``(2) Qualified healthcare providers.--
       ``(A) In general.--The term `qualified healthcare provider' 
     means a healthcare provider described in subparagraph (B) 
     that--
       ``(i) is licensed by the State to provide the care involved 
     and is providing such care in good faith while acting within 
     the scope of the provider's training and practice;
       ``(ii) is in good standing with respect to such license and 
     not on probation;
       ``(iii) is not, or has not been, subject to Medicare or 
     Medicaid sanctions under title XVIII or XIX of the Social 
     Security Act; and
       ``(iv) is authorized by the State to provide health or 
     dental care services under the State program under this 
     section.
       ``(B) Provider described.--A healthcare provider described 
     in this subparagraph includes--
       ``(i) an ambulatory surgical center;
       ``(ii) a hospital or nursing home;
       ``(iii) a physician or physician of osteopathic medicine;
       ``(iv) a physician assistant;
       ``(v) a chiropractic practitioner;
       ``(vi) a physical therapist;
       ``(vii) a registered nurse, nurse midwife, licensed 
     practical nurse, or advanced registered nurse practitioner;
       ``(viii) a dentist or dental hygienist;
       ``(ix) a professional association, professional 
     corporation, limited liability company, limited liability 
     partnership, or other entity that provides, or has members 
     that provide, health or dental care services;
       ``(x) a non-profit corporation qualified as exempt from 
     Federal income taxation under section 501(c) of the Internal 
     Revenue Code of 1986; and
       ``(xi) a federally funded community health center, 
     volunteer corporation, or volunteer health care provider that 
     provides health or dental care services.
       ``(d) Priority.--Priority in awarding grants under this 
     section shall be given the States that will provide health or 
     dental care under the State program under this section, to 
     individuals that--
       ``(1) have a family income that does not exceed 200 percent 
     of the Federal poverty line (as defined in section 673(2) of 
     the Community Health Services Block Grant Act) for a family 
     of the size involved;
       ``(2) are not be covered under any health or dental 
     insurance policy or program (as determined under applicable 
     State law); and
       ``(3) are determined to be eligible for care, and referred 
     for such care, by the State department of health or other 
     entity authorized by the State for purposes of administering 
     the State program under this section.
       ``(e) Provision of Information.--A State shall ensure that 
     prior to the enrollment under a State program under this 
     section,

[[Page S7633]]

     the individual involved shall be fully informed of the 
     limitation on liability provided for under subsection 
     (c)(1)(C) with respect to the provider involved and shall 
     sign a waiver consenting to such care.
       ``(f) Matching Requirement.--
       ``(1) In general.--The Secretary may not award a grant to a 
     State under this section unless the State agrees, with 
     respect to the costs to be incurred by the State in carrying 
     out activities under the grant, to make available non-Federal 
     contributions (in cash or in kind under paragraph (2)) toward 
     such costs in an amount equal to not less than $1 for each $3 
     of Federal funds provided in the grant. Such contributions 
     may be made directly or through donations from public or 
     private entities.
       ``(2) Determination of amount of non-federal 
     contribution.--
       ``(A) In general.--Non-Federal contributions required in 
     paragraph (1) may be in cash or in kind, fairly evaluated, 
     including equipment or services (and excluding indirect or 
     overhead costs). Amounts provided by the Federal Government, 
     or services assisted or subsidized to any significant extent 
     by the Federal Government, may not be included in determining 
     the amount of such non-Federal contributions.
       ``(B) Maintenance of effort.--In making a determination of 
     the amount of non-Federal contributions for purposes of 
     paragraph (1), the Secretary may include only non-Federal 
     contributions in excess of the average amount of non-Federal 
     contributions made by the State involved toward the purpose 
     for which the grant was made for the 2-year period preceding 
     the first fiscal year for which the State is applying to 
     receive a grant under this section.
       ``(g) Administrative Provisions.--
       ``(1) Amount of grant.--The amount of a grant under this 
     section shall not exceed $600,000 per year for not more than 
     5 fiscal years.
       ``(2) Number of grants.--The Secretary shall not award more 
     than 15 grants under this section.
       ``(h) Evaluation.--Not later than [__] years after the date 
     of enactment of this section, and annually thereafter, the 
     Secretary shall conduct an evaluation of the activities 
     carried out by States under this section, and submit to the 
     appropriate committees of Congress a report concerning the 
     results of such evaluation.
       ``(i) Authorization of Appropriations.--
       ``(1) In general.--There is authorized to be appropriated 
     such sums as may be necessary to carry out this section.
       ``(2) Evaluations.--The Secretary shall use 5 percent of 
     the amount appropriated under paragraph (1) for each fiscal 
     year to carry out evaluations under subsection (h).''.
                                 ______