[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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