[Congressional Record Volume 156, Number 128 (Wednesday, September 22, 2010)]
[House]
[Pages H6848-H6850]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              FAMILY HEALTH CARE ACCESSIBILITY ACT OF 2010

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1745) to amend the Public Health Service Act to provide 
liability protections for volunteer practitioners at health centers 
under section 330 of such Act, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1745

       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 ``Family Health Care 
     Accessibility Act of 2010''.

     SEC. 2. LIABILITY PROTECTIONS FOR HEALTH PROFESSIONAL 
                   VOLUNTEERS AT COMMUNITY HEALTH CENTERS.

        Section 224 of the Public Health Service Act (42 U.S.C. 
     233) is amended by adding at the end the following:
       ``(q)(1) For purposes of this section, a health 
     professional volunteer at an entity described in subsection 
     (g)(4) shall, in providing a health professional service 
     eligible for funding under section 330 to an individual, be 
     deemed to be an employee of the Public Health Service for a 
     calendar year that begins during a fiscal year for which a 
     transfer was made under paragraph (4)(C). The preceding 
     sentence is subject to the provisions of this subsection.
       ``(2) In providing a health service to an individual, a 
     health care practitioner shall for purposes of this 
     subsection be considered to be a health professional 
     volunteer at an entity described in subsection (g)(4) if the 
     following conditions are met:
       ``(A) The service is provided to the individual at the 
     facilities of an entity described in subsection (g)(4), or 
     through offsite programs or events carried out by the entity.
       ``(B) The entity is sponsoring the health care practitioner 
     pursuant to paragraph (3)(B).
       ``(C) The health care practitioner does not receive any 
     compensation for the service from the individual or from any 
     third-party payer (including reimbursement under any 
     insurance policy or health plan, or under any Federal or 
     State health benefits program), except that the health care 
     practitioner may receive repayment from the entity described 
     in subsection (g)(4) for reasonable expenses incurred by the 
     health care practitioner in the provision of the service to 
     the individual.
       ``(D) Before the service is provided, the health care 
     practitioner or the entity described in subsection (g)(4) 
     posts a clear and conspicuous notice at the site where the 
     service is provided of the extent to which the legal 
     liability of the health care practitioner is limited pursuant 
     to this subsection.
       ``(E) At the time the service is provided, the health care 
     practitioner is licensed or certified in accordance with 
     applicable law regarding the provision of the service.
       ``(3) Subsection (g) (other than paragraphs (3) and (5)) 
     and subsections (h), (i), and (l) apply to a health care 
     practitioner for purposes of this subsection to the same 
     extent and in the same manner as such subsections apply to an 
     officer, governing board member, employee, or contractor of 
     an entity described in subsection (g)(4), subject to 
     paragraph (4) and subject to the following:
       ``(A) The first sentence of paragraph (1) applies in lieu 
     of the first sentence of subsection (g)(1)(A).
       ``(B) With respect to an entity described in subsection 
     (g)(4), a health care practitioner is not a health 
     professional volunteer at such entity unless the entity 
     sponsors the health care practitioner. For purposes of this 
     subsection, the entity shall be considered to be sponsoring 
     the health care practitioner if--
       ``(i) with respect to the health care practitioner, the 
     entity submits to the Secretary an application meeting the 
     requirements of subsection (g)(1)(D); and
       ``(ii) the Secretary, pursuant to subsection (g)(1)(E), 
     determines that the health care practitioner is deemed to be 
     an employee of the Public Health Service.
       ``(C) In the case of a health care practitioner who is 
     determined by the Secretary pursuant to subsection (g)(1)(E) 
     to be a health professional volunteer at such entity, this 
     subsection applies to the health care practitioner (with 
     respect to services performed on behalf of the entity 
     sponsoring the health care practitioner pursuant to 
     subparagraph (B)) for any cause of action arising from an act 
     or omission of the health care practitioner occurring on or 
     after the date on which the Secretary makes such 
     determination.
       ``(D) Subsection (g)(1)(F) applies to a health care 
     practitioner for purposes of this subsection only to the 
     extent that, in providing health services to an individual, 
     each of the conditions specified in paragraph (2) is met.
       ``(4)(A) Amounts in the fund established under subsection 
     (k)(2) shall be available for transfer under subparagraph (C) 
     for purposes of carrying out this subsection.
       ``(B) Not later May 1 of each fiscal year, the Attorney 
     General, in consultation with the Secretary, shall submit to 
     the Congress a report providing an estimate of the amount of 
     claims (together with related fees and expenses of witnesses) 
     that, by reason of the acts or omissions of health 
     professional volunteers, will be paid pursuant to this 
     section during the calendar year that begins in the following 
     fiscal year. Subsection (k)(1)(B) applies to the estimate 
     under the preceding sentence regarding health

[[Page H6849]]

     professional volunteers to the same extent and in the same 
     manner as such subsection applies to the estimate under such 
     subsection regarding officers, governing board members, 
     employees, and contractors of entities described in 
     subsection (g)(4).
       ``(C) Not later than December 31 of each fiscal year, the 
     Secretary shall transfer from the fund under subsection 
     (k)(2) to the appropriate accounts in the Treasury an amount 
     equal to the estimate made under subparagraph (B) for the 
     calendar year beginning in such fiscal year, subject to the 
     extent of amounts in the fund.
       ``(5)(A) This subsection takes effect on October 1, 2011, 
     except as provided in subparagraph (B).
       ``(B) Effective on the date of the enactment of this 
     subsection--
       ``(i) the Secretary may issue regulations for carrying out 
     this subsection, and the Secretary may accept and consider 
     applications submitted pursuant to paragraph (3)(B); and
       ``(ii) reports under paragraph (4)(B) may be submitted to 
     the Congress.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Kentucky (Mr. Whitfield) 
each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in strong support of H.R. 1745, the Family 
Health Care Accessibility Act. The bill is authored by my colleagues on 
the Energy and Commerce Committee, Mr. Murphy of Pennsylvania and Mr. 
Green of Texas, and obviously it enjoys strong bipartisan support.
  The bill would provide liability protections for health care workers 
who volunteer to work at community health centers. Very similar 
protections are already provided for the employees and contractors of 
such centers. The bill, as introduced, would have provided such 
protection only to physicians and psychologists, but the committee 
adopted an amendment that expanded coverage to all health care workers 
who are volunteers at CHCs so long as they are working within their 
appropriate scope of practice and licensure and are performing work 
that is appropriate to the center.
  CBO has estimated that the bill will not affect mandatory spending or 
revenue and is not subject to the PAYGO rules. Versions of this 
legislation have passed in the House in previous years, so I hope this 
bill will become law.
  Again, I want to thank Mr. Murphy and Mr. Green for all their hard 
work on this legislation. As well, I want to express my appreciation to 
our minority leaders on health legislation in the committee, Mr. 
Shimkus and Mr. Barton, for their support and commitment in getting 
this bill to the floor.
  I urge my colleagues to support the bill.
  I reserve the balance of my time.
  Mr. WHITFIELD. I also want to thank Mr. Green of Texas and Mr. Murphy 
for their leadership on this issue.
  All of us recognize the importance of community health centers. They 
are spreading throughout the country and they are playing an important 
role in providing primary health care for the American people.
  At this time I would like to yield 5 minutes to one of the real 
leaders in this area, Mr. Murphy of Pennsylvania.
  Mr. TIM MURPHY of Pennsylvania. Mr. Speaker, community health centers 
provide a neighborhood medical home that is both high quality and lower 
cost. They are more than just a doctor's office; they are a place where 
a child can see a pediatrician and an adult can see an internist. You 
can get dental care, mental health services, or prenatal care. You can 
go there when you are getting a cold instead of running up big costs at 
an emergency room.
  The doctors, dentists, nurse practitioners, and other medical 
professionals are under one roof; and they coordinate your care, 
working as a team for your family's health in a one-stop wellness 
center, and the costs per patient are far, far below the costs one 
would pay if you went to a hospital or private practice. That 
coordinated effort saves a lot of money through preventative care, 
keeping you up with immunizations and providing quality medical 
intervention when you need it at one of these 1,250 nonprofit community 
health centers.
  In our Nation's $2.4 trillion health care system, the community 
health centers are credited with saving nearly $25 billion each year. 
Families save money and Medicaid saves money. On average, a person 
using a community health center saves $1,100 per year on health care 
costs, according to a recent study by George Washington University. 
That's the good news. The sad news is that there is a serious shortage 
of health care providers at these centers, and no matter now great the 
center, if there are long delays because of the shortage, then health 
care delayed is health care denied.
  Health centers located in medically underserved urban or rural areas 
report a 27 percent shortage of dentists, a 26 percent shortage of OB/
GYNs that could be providing prenatal care, and a 13 percent shortage 
of family physicians. The centers simply do not have enough money to 
hire the additional staff required to cover the growing patient needs, 
but there is an answer.
  Many health professionals, especially part-time workers or highly 
qualified, semi-retired medical providers are willing and able, but not 
allowed to do so. That's right. They want to volunteer their time, but 
they cannot. They cannot because the centers are not able to cover the 
costs of medical liability insurance for the doctors and nurses.
  Medical liability insurance can cost tens of thousands of dollars, 
and, in some cases, well over $100,000 per year per doctor, and the 
clinics simply cannot cover that expense. Here's why: Practitioners 
employed by the community health centers are covered by the Federal 
Torts Claim Act, which extends Federal liability protection to those 
volunteer doctors. Oddly enough, the opposite applies at free clinics, 
where volunteers are covered by the FTCA, while those who are employed 
at free clinics are not covered.
  The Congressional Budget Office said that medical liability insurance 
costs pose a ``significant barrier'' for many providers who otherwise 
would be eager to volunteer at health centers. This bill, H.R. 1745, 
fixes this disparity and opens the door for volunteer providers at 
clinics all over America. This bill, which I introduced with 
Representative Gene Green, will eliminate the barriers for millions of 
patients seeking care in these neighborhood health care homes and will 
allow thousands of practitioners to volunteer their expertise for high-
quality, low-cost patient care.
  The Congressional Budget Office estimated that the cost of this bill 
could be as little as $5 million a year for 5 years, and, in return, 
the clinics receive hundreds of millions of dollars worth of free 
health care services for those living in underserved communities. And 
because this funding is part of the health centers program's annual 
appropriations, this funding is not a scored cost. The dedicated health 
center fund means that the slight additional cost to the FTCA program 
will require no new appropriations. I repeat: The slight additional 
cost will require no new annual appropriations.
  I am grateful for the support of my colleagues--Representative Gene 
Green, Frank Pallone, John Shimkus, Phil Gingrey, Ranking Member Joe 
Barton, and Chairman Henry Waxman--for working with me on this 
legislation, and also my staff--Brad Grantz and Susan Mosychuk.
  Mr. Speaker, we in Congress have a chance to do something to expand 
care to millions of Americans with this act without raising the health 
care bills for families. This is an example of real bipartisan reform 
that helps people get the health care they need when they need it close 
to home at an affordable cost. Isn't that what we all want with health 
care?
  So let's say ``yes'' to community health centers, ``yes'' to 
families, ``yes'' to doctors who want to volunteer their care, ``yes'' 
to affordable and accessible care to millions of families, and please 
say ``yes'' to H.R. 1745, the Family Health Care Accessibility Act.
  Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to my 
colleague from Texas, Representative Green. But before I do that, let 
me just

[[Page H6850]]

say that he has been an outstanding leader on community health centers. 
He sponsored the bill that reauthorized the community health centers, 
and he is always looking out for ways to improve what goes on there.

                              {time}  1720

  Mr. GENE GREEN of Texas. I thank the chairman of the Health 
Subcommittee for those kind words but also for this legislation. I 
would also like to thank the full committee chair, Henry Waxman; and 
our ranking member, Joe Barton; along with our ranking member on our 
subcommittee, Congressman Shimkus from Illinois, for the support of 
this bill; and all of the Members on the Energy and Commerce Committee.
  I rise in strong support of H.R. 1745, the Family Health Care 
Accessibility Act. H.R. 1745 will extend Federal Tort Claim coverage 
for licensed volunteer practitioners for section 330 services provided 
under the Public Health Service Act in community health centers.
  This legislation will allow licensed practitioners to volunteer and 
provide them adequate tort claims protection equal to employees of the 
community health centers.
  A March 2006 study in the Journal of the American Medical Association 
found community health centers had a 13 percent vacancy rate for family 
physicians, 9 percent for internists, a 20 percent vacancy rate for OB-
GYNs, an 8 percent vacancy rate for podiatrists, a 22 percent vacancy 
rate for psychiatrists, and an 18 percent vacancy rate for dentists. If 
we rely on community health centers as medical homes, we need to 
increase the number of health care providers--including volunteer 
practitioners. So many qualified individuals want to volunteer their 
time but are afraid to do so because they do not have Federal Tort 
Claim protection and the Government Accountability Office has found 
that doctors and nurses choose not to volunteer their skills at 
community health centers because medical liability insurance is too 
costly for individuals to purchase on their own.
  We can address the workforce shortage in health centers by clarifying 
that medical malpractice coverage is provided to clinicians who wish to 
volunteer their time working at the community health center.
  I want to thank Congressman Murphy from Pennsylvania for sponsoring 
the legislation. Again, this will mark the third time we've worked 
together to pass this legislation in the House. It was in the health 
care reform bill, but the Senate did not include it in their version.
  Again, Mr. Speaker, I want to thank the House, and hopefully we'll 
pass this bill today again and give the Senate another opportunity.
  Mr. WHITFIELD. Mr. Speaker, I think all of our speakers have 
explained very clearly why we need to support this legislation. I urge 
all of our Members to support it.
  I yield back the balance of my time.
  Mr. PALLONE. Mr. Speaker, I also urge passage of the bill.
  I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 1745, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. TIM MURPHY of Pennsylvania. Mr. Speaker, on that I demand the 
yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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