The Semnani Foundation, which established the clinic, believes an adjustment to state malpractice laws will help it and other clinics recruit more volunteer physicians and nurses.

Sen. Peter Knudson, R-Brigham City, is developing legislation based on the clinic's idea: a clarification that volunteer doctors and nurses providing charity care retain a certain immunity to lawsuits even if they receive a salary or payment for travel or other expenses.

Volunteer health care providers and facilities already are protected under Utah's state code, which limits their liability in charity care cases. They cannot be sued for negligence; they face liability only if their care is "grossly negligent" or "willful and wanton."

But that immunity only covers volunteers if they are uncompensated.

Knudson believes both working and retired physicians and nurses would be more willing to volunteer if they were clearly granted such immunity even when receiving payment or reimbursement.

Patients at the Maliheh Clinic are required to sign a waiver saying they will not sue, and volunteers are able to provide care without carrying malpractice insurance. But Knudson and the board wanted to close what they perceive is a loophole in the law.

Volunteers "are not being paid for their service from the patients, but they might get a token reimbursement from the clinic," Knudson said. "It presents a hurdle."

"What we're trying to do is provide competent health care for low-income people," Knudson said. "We have good, wonderful, retired people who would love to offer their expertise, but it costs so much for them to buy malpractice insurance.

"We live in a litigious society, but if a person is choosing to have access to free health care, I think it's incumbent upon them to understand there is no liability insurance."

Douglas White, a lawyer who is on the clinic's board, said one impetus for changing the law is a desire to be able to pay an administrator.

"It is very difficult, if not impossible, to get a doctor to come in and run a free clinic," White said.

The foundation eventually wants to expand its free clinics into Utah and Weber counties and would likely pay someone to run them.

Jonathan Horne, a retired orthopedic surgeon who volunteers at the Maliheh Clinic, said he thinks doctors would feel more comfortable volunteering if the law were passed. He dropped his insurance in November after its premiums increased to $90,000 from $18,000 four years ago.

The cost of insurance, on top of the overhead of running his office, was one of the reasons he closed his practice.

"The main reason malpractice insurance cases are filed is there is a pot of gold at the end of the rainbow," he said. "I think [the legislation] would be a very good start down the road of trying to temper or eliminate the requirement that doctors carry malpractice insurance for any reason."

Before cancelling his insurance, Horne was able to perform free surgeries at area hospitals.

Now, "we have to find other doctors to perform the surgeries, which is difficult," he said. "They are busy doctors and they have to have money to run their offices, which is very expensive."

Some critics don't agree with relaxing requirements for health professionals, even at facilities that provide free care.

LaRee Miller, the executive director of the Utah Citizens Alliance, said she will be closely watching the bill during the upcoming legislative session, which begins on Jan. 16. She worries about the vulnerability of the needy.

"They'll be left with no recourse," Miller said. "I can see their point, but if they're going to be in there treating patients, they should have liability insurance. I think we are granting too much immunity."

Mansoor Emam, medical director of the Maliheh Clinic, said the issue boils down to helping more people.

"We have a lot of physicians with a lot of experience, but they don't have malpractice insurance," he said. "It's important they have the assurance that the law is on their side."

chamilton@sltrib.com

The Maliheh Free Clinic

* Located in South Salt Lake, opened by the Semnani Foundation, treats chiefly the working poor and unemployed.

* In Salt Lake County alone, 9.9 percent - about 85,000 people - are without health coverage. Of that group, 72 percent are under 34 years of age, about 43 percent work full time and 20 percent work part time.

Source: Maliheh Free Clinic