Liability Law Blocks Federally Insured Doctors from Helping in Disasters

Dozens of federally insured medical providers have been blocked from helping the Gulf Coast recover from Hurricane Katrina because their medical liability protection doesn’t apply outside their own states.

Doctors and nurses from community health centers across the country, who encountered the insurance problem after Sept. 11, 2001, and found it most devastating after Katrina, hope a change can be made before another major medical emergency.

Unlike the 2001 terrorist attacks in New York and Washington, the hurricanes raised the medical liability issue by hitting health clinics as hard as the victims they had to treat. Fourteen Texas centers asked sister clinics to send doctors, nurses, equipment and medication. Dozens of other centers in the massive state were among those prevented by the law from helping.

“If we are hit by another natural disaster, we’ll have the same problems all over again,” said Jose Camacho, executive director of the Texas Association of Community Health Centers.
One physician who was thwarted was U.S. Rep. Joe Schwarz, R-Mich.

“This is a little quirk in the tort laws, but it’s a big piece of a big puzzle,” said Schwarz, an ear, nose and throat doctor in Battle Creek, Mich. “We have all these centers with superbly trained individuals who do these things locally all the time, and to deny people access to their physicians if there’s a disaster is senseless.”

His proposed legislation to allow federally insured medical employees to be covered for work in a declared disaster area drew attention last week when Rep. Paul Gillmor, R-Ohio, got involved.

Gillmor, a member of a House health subcommittee that will review the bill, co-sponsored the bill Thursday because a health center in his district, from Fremont, Ohio, tried unsuccessfully to send medical volunteers to a center in Biloxi, Miss., as recently as last month.
The Health Resources and Services Administration, which runs the federal insurance program, worked last fall with the Fremont center and several others to get around the law’s restrictions, using its power to treat the workers as temporary federal employees, after a credential review.

But a Jan. 20 e-mail from the agency said Fremont volunteers could not help in Mississippi again because “there would not be a federal employee on site to swear-in and supervise the volunteer providers.”

Similarly, it took so long for a federal review of a team of Iowa volunteers that they had to return from New Orleans after a week, said Michelle Stephan, chief executive at Siouxland Community Health Center in Sioux City.

“They just sat around. They went and viewed the damage, but they were almost in the way of relief efforts,” said Stephan, who sent three volunteers to New Orleans in a mobile health van to help a local center that lost four of its clinics to flooding.

“If we could have helped out in those shelters, that would have been a huge relief off of their staff, who had also been displaced,” she said.

The Texas health centers tried another way to get around the law: buying private liability coverage for health care providers coming in from out of state. It didn’t work, Camacho said, because the insurance market wouldn’t support new coverage for the high-risk hurricane relief effort.

A change in the law wouldn’t affect the private insurance market; the federal malpractice insurance is funded entirely by taxpayers through federal aid to the nonprofit health centers. In 2006, Congress gave $1.8 billion to the centers, and $45 million was set aside for the federal medical liability coverage.