Reforming the Community Health Center Law

In the 102nd Congress, then-Representative Wyden wrote H.R. 6183, the Federally Supported Health Centers Assistance Act of 1992. This legislation, signed into law in October 1992, ensured health care for to millions of Americans dependent on community health centers, by protecting health care professionals serving at those centers from unnecessary legal liability. (see New York Times article below.)

In 2001, Sen. Wyden co-sponsored S.CON.RES.59, a resolution expressing the sense of Congress that there should be established a National Community Health Center Week to raise awareness of health services provided by community, migrant, public housing, and homeless health centers.

January 19, 2001. The National Association of Community Health Centers recognized Wyden as one of their "2001 Community Health Superheroes” award for his efforts to help community health centers.

The New York Times
October 18, 1992
Congress Passes Bill to Widen Health-Care Access
By Robert Pear

WASHINGTON, Oct. 15 -- A half-million people will get new access to health care under a bill passed by Congress to protect community health centers against lawsuits alleging medical malpractice.

The bill represents the most significant action by the 102d Congress to help people without health insurance. More ambitious bills died amid partisan wrangling in this Presidential election year.

The Bush Administration opposed an earlier version of the bill on the ground that it would shift liability for medical malpractice from the clinics to the United States Treasury. But Administration officials said Tuesday that President Bush plans to sign the latest measure, worked out by the Administration and members of Congress from both parties. The final version still includes such a shift in liability.

Under the bill, doctors and nurses who work at community health centers will be treated as if they were employees of the United States Public Health Service. The Justice Department will defend them in court, and the Federal Government will pay claims arising from the death or injury of patients.
Representatives Ron Wyden of Oregon, a Democrat, and Nancy L. Johnson of Connecticut, a Republican, were the chief sponsors of the measure.

In an interview, Stuart M. Gerson, Assistant Attorney General in charge of the civil division of the Justice Department, said, "It's our expectation that the President will sign it."

Insurance Forces Cutbacks
The 1,500 community health centers serve six million low-income people. The clinics are a major source of prenatal care, deliver thousands of babies each year and primarily serve areas with high rates of infant mortality. But rising malpractice insurance costs have forced many of the clinics to cut back or eliminate services.

Insurance costs for some clinics have risen 30 percent to 40 percent in the last year and have increased more than fourfold in the last decade, even though many of the clinics have paid nothing in malpractice claims. In New York, for example, the insurance premium for the Peekskill Area Health Center rose last year to $218,000 from $168,000, even though it has not paid any malpractice claims in 15 years. The center serves Westchester and four nearby counties.

Under the bill, doctors and nurses who work at such nonprofit clinics will be treated as if they were employees of the United States Public Health Service. The Justice Department will defend them in court, and the Federal Government will pay claims arising from the death or injury of patients.

The clinics will no longer have to buy private insurance to protect them against malpractice claims. The money saved on insurance premiums, $60 million a year, can be used for the care of patients.

"That money will be sufficient to provide services to a half-million additional people," said Daniel R. Hawkins Jr., director of policy analysis at the National Association of Community Health Centers. "We are very happy with this legislation. It is something we have sought for more than five years. It's far more productive to use the money providing direct services to people than to spend it on premiums for insurance coverage."

Low Malpractice Claims
Mr. Hawkins said that the clinics had been spending $60 million a year for insurance, or 10 percent of the money they get from the Federal Government, while paying only $4 million to $8 million a year in malpractice claims.

The bill brings community health centers under the protection of a 1946 law, the Federal Tort Claims Act. Under that law, the Justice Department normally defends Government employees sued for actions taken within the scope of their official duties.

The measure applies to health-care services provided at clinics after Jan. 1, 1993. The clinics will be protected as long as they have "policies and procedures to reduce the risk of malpractice and the risk of lawsuits." In addition, they must verify the professional credentials of clinic employees to make sure they do not have a history of malpractice.

The Justice Department may refuse to provide protection for a particular doctor or nurse if it concludes, after a hearing, that covering that person will "expose the Government to an unreasonably high degree of risk." Thus, for example, the Government may refuse to cover doctors who have lost several malpractice suits or who have been disciplined by medical licensing authorities.

Consumer Group Unhappy
Mr. Wyden said the bill showed that "when you have a bipartisan coalition, you can be creative and stretch existing money to meet the needs of our citizens." Mrs. Johnson hailed the measure as "the only real health-care reform bill" passed this year.

But Pamela Gilbert, acting director of Congress Watch, a consumer group founded by Ralph Nader, said: "We are very unhappy with this bill. Not because it will help community health centers; that's a wonderful, laudable goal. We are opposed to the method.

"The bill relegates patients and consumers at community health centers to second-class justice because it takes away their right to a jury trial and their right to collect punitive damages if they are victims of medical malpractice at those clinics."

There are no punitive damages and no jury trials in lawsuits brought under the Federal Tort Claims Act. Congress Watch has opposed many of the restrictions on lawsuits proposed by the Bush Administration.

Senators Edward M. Kennedy, Democrat of Massachusetts, and Orrin G. Hatch, Republican of Utah, strongly supported the bill to help community health centers.