An emergency bill to be presented today for a vote by the D.C. City Council would prevent four private clinics in the District from closing by adding them to the city's insurance plan for citizen volunteers in District-run facilities.
Under a bill to be introduced by council member Frank Smith (D-Ward 1), only the four free clinics facing imminent closure would be eligible for protection, even though day care centers and other local health and social service providers also are seeking help in obtaining hard-to-find malpractice insurance.
"We have a crisis here in the District," Smith said, noting that thousands of low-income District residents depend on the clinics for health care. "We have to deal with the clinics first."
Three of the clinics face closure within two months because their malpractice liability insurer has refused to renew their policies. They are the Whitman-Walker Clinic, the Washington Free Clinic and Clinica del Pueblo. A fourth clinic, the Zacchaeus Clinic, expects to lose its insurance coverage in December. All the clinics are nonprofit clinics that give treatments and medicines at no cost if a patient has no money.
Under the bill, the 89 doctors, 55 nurses and 610 clinic volunteers who work at the four clinics would be included in a self-insurance program run by the city that provides liability insurance to volunteers who work in District health clinics, nursing homes and other facilities. The coverage would be extended for nine months, giving the clinics time to find a private insurer willing to cover them.
If no insurer could be found, the situation could become permanent, Smith said. "This is a healthy and well-run set of clinics," he said. "We are not taking in high risks."
In a report to the D.C. Insurance Department Integrity Inc., the Paramus, N.J., firm that has canceled the clinics' coverage, said it collected about $40,000 in premiums from D.C. clients, but paid $60,000 in claims.
"They're losing money, but it's not on our clinics," said Dr. Peter Shields, medical director of Clinica del Pueblo. Shields, like administrators of the other clinics, says his clinic has not been sued.
Smith said there would be little or no charge to the clinics for the coverage, as the city's program can absorb new individuals with little extra expense.
"We are very pleased," said Shields, whose clinic serves the Central American refugee community. "We've gone across the country looking for insurance coverage at any price. For our patients to have to use District clinics would be a large new cost to the city."
Smith said several council members support the bill and said Mayor Marion Barry has agreed to sign it immediately to prevent the closing of Washington Free Clinic, whose coverage expires Saturday.