State may cut malpractice insurance for volunteer providers

Among budget cuts Washington state lawmakers are considering is eliminating a program that pays for the malpractice insurance of health care providers who volunteer to treat the poor at free and low-cost clinics.

Though the state is struggling to close a $1.4 billion revenue shortfall, it is hard to imagine a more penny-wise and pound-foolish cut than eliminating Volunteer/Retired Provider Malpractice Insurance, say officials acquainted with the program.

“For less than $300,000, the state receives $82 million worth of care for the most impoverished citizens across Washington,” said Jodi Palmer, CEO and director of the Western Washington Area Health Education Center, which administers the program statewide.

“We would lose many volunteers across the state,” Palmer said. “Clinics would be forced to close, and their patients would end up in the emergency rooms of hospitals.”

On Wednesday, Dr. Charles Wolfe, a retired physician and former legislator, volunteered at the Union Gospel Mission clinic, which is open not just to shelter residents but to poor and uninsured patients from throughout the city.

Among his patients was a 50-year-old homeless man who showed up at the clinic when he could no longer bear the pain of an incarcerated hernia.

Wolfe, 80, who has volunteered at the mission for 16 years, said without state coverage of his malpractice insurance he could not treat any of the dozen or so men seated in the mission’s cramped waiting room.

“I can’t afford $10,000 a year,” said Wolfe, one of four retired physicians who volunteer at the clinic.

He estimated that the clinic receives about 2,400 patient visits a year. If just half of these patients ended up in hospital emergency rooms instead, Wolfe said, their care would cost more than $1 million. The cost would be passed on to taxpayers or insured patients in their premiums.

According to Palmer, the Union Gospel Mission, which also runs a clinic at Anna Ogden Hall, its long-term shelter for women and children, has nine volunteer providers covered by state malpractice insurance.

The House of Charity’s outreach clinic, run by Providence Sacred Heart Medical Center, has 18 volunteers covered under the program and has had more than 2,000 patient visits so far this year.

Christ Clinic has 10; Community Health Association of Spokane has two ; Camp STIX diabetes program has two; and the Spokane Guild School has one. These include physicians, physician assistants, nurse practitioners, nurses, dentists, hygienists, pharmacists and a chiropractor, among others, Palmer said.

Many of these providers, like Wolfe, are retired. In some cases, providers who volunteer at free or low-cost clinics are covered by their own insurance, but in many cases their carriers won’t cover volunteer work.

Among cuts proposed under Gov. Chris Gregoire’s budget proposal is a $297,000 reduction in Area Health Education Centers/Rural Health Capacity, most of which would be realized by elimination of the malpractice program.

Enacted by the Legislature in 1992, the program covers the malpractice insurance for 662 providers.

Palmer, whose Seattle-based agency administers the program under contract with the Department of Health, estimates these providers treat 67,500 clients who might otherwise seek treatment in emergency rooms.

Dr. Allen Seely, a physician with Rockwood Clinic in Liberty Lake, also volunteers at the Union Gospel Mission, though he is covered by his own group insurance.

“We could not have this clinic without Dr. Wolfe and our other (retired) partners,” Seely said.