death, resulting from the performance of medical, surgical, 
dental, or related functions, including the conduct of clin-
ical studies or investigations, by any employee of the Serv-
ice while acting within the scope of the employee’s employ-
ment, shall be exclusive of any other civil action or pro-
ceeding by reason of the same subject matter against the 
employee (or the employee’s estate) whose act or omission 
gave rise to the claim. 
(b) DEFENSE.—The Attorney General shall defend 
any civil action or proceeding brought in any court against 
any person referred to in subsection (a) (or the person’s 
estate) for any such damage or injury. Any such person 
against whom such civil action or proceeding is brought 
shall deliver within such time after date of service or 
knowledge of service as determined by the Attorney Gen-
eral, all process served upon the person or an attested true 
copy thereof to the person’s immediate superior or to 
whomever was designated by the appropriate National 
Health Board to receive such papers and such person shall 
promptly furnish copies of the pleading and process there-
in to the United States attorney for the district embracing 
the place wherein the proceeding is brought, to the Attor-
ney General, and to the National Health Board. 
(c) PROCEDURE.— 
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(1) REMOVAL FROM STATE COURTS.—Upon a 
certification by the Attorney General that the de-
fendant was acting in the scope of employment at 
the time of the incident out of which the suit arose, 
any such civil action or proceeding commenced in a 
State court shall be removed without bond at any 
time before trial by the Attorney General to the dis-
trict court of the United States of the district and 
division embracing the place wherein it is pending 
and the proceeding deemed a tort action brought 
against the United States under the provision of 
title 28, United States Code, and all references 
thereto. 
(2) MOTIONS TO REMAND.—If a United States 
district court determines on a hearing on a motion 
to remand held before a trial on the merits that the 
case so removed is one in which a remedy by suit 
within the meaning of subsection (a) is not available 
against the United States, the case shall be re-
manded to the State court. 
(3) EFFECT
OF
ALTERNATIVE
REMEDIES.— 
Where a remedy by suit within the meaning of sub-
section (a) is not available because of the availability 
of a remedy through proceedings for compensation 
or other benefits from the United States as provided 
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by any other law, the case shall be dismissed, but in 
the event the running of any limitation of time for 
commencing, or filing an application or claim in, 
such proceedings for compensation or other benefits 
shall be deemed to have been suspended during the 
pendency of the civil action or proceeding under this 
section. 
(d) SETTLEMENT.—The Attorney General may com-
promise or settle any claim asserted in such civil action 
or proceeding in the manner provided in section 2677 of 
title 28, United States Code, and with the same effect. 
(e) LIMITATION.—For purposes of this section, the 
provisions of section 2680(h) of title 28, United States 
Code, shall not apply to assault or battery arising out of 
negligence in the performance of medical, surgical, dental, 
or related functions, including the conduct of clinical stud-
ies or investigations. 
(f) LIABILITY INSURANCE.—The appropriate Na-
tional Health Board may, to the extent it deems appro-
priate, hold harmless or provide liability insurance for any 
employee of the Service for damage for personal injury, 
including death, negligently caused by such employee while 
acting within the scope of employment and as a result of 
the performance of medical, surgical, dental, or related 
functions, including the conduct of clinical studies or in-
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vestigations, if the employee is assigned to a foreign coun-
try or detailed to a State or political subdivision thereof 
or to a nonprofit institution, and if the circumstances are 
such as are likely to preclude the remedies of third persons 
against the United States described in section 2679(b) of 
title 28, United States Code, for such damage or injury. 
TITLE IV—OTHER FUNCTIONS 
OF HEALTH BOARDS 
Subtitle A—Advocacy, Grievance 
Procedures, and Trusteeships 
SEC. 401. ADVOCACY AND LEGAL SERVICES PROGRAM. 
(a) ESTABLISHMENT OF PROGRAM.—The National 
Health Board shall establish a program of health advocacy 
to ensure the full realization of the patient rights enumer-
ated in subtitle A of title II. Such a program shall in-
clude— 
(1) the employment of individuals having basic 
legal knowledge and skills as health advocates; 
(2) the presence of health advocates— 
(A) in inpatient health care facilities at all 
times; and 
(B) in other health care facilities during 
the provision of health care services; 
(3) provision for health advocates to (A) in-
form, on an ongoing basis, users and health workers 
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of such patient rights and (B) report to the National 
Health Board any infraction of such rights which is 
not promptly corrected; 
(4) provision for regular meetings between 
health workers and health advocates, users, and any 
user representatives to discuss ways of ensuring the 
fulfillment of such rights through affirmative action 
of such workers and the National Health Board; and 
(5) appropriate action by the National Health 
Board to ensure that infractions of such rights are 
promptly and sufficiently corrected. 
(b) HEALTH RIGHTS LEGAL SERVICES.— 
(1) ESTABLISHMENT OF PROGRAM.—The Na-
tional Health Board shall establish a health rights 
legal services program and shall provide such pro-
gram with sufficient legal and administrative per-
sonnel, funding, and facilities (A) to ensure that 
users and health workers receive, free of charge, 
high quality legal services (including representation 
in grievance proceedings commenced under section 
402) for legal problems related to health rights and 
health care services, and (B) to improve, through 
litigation and other activities, the health care system 
and expand the rights of users and health workers. 
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(2) SERVICES.—The health rights legal services 
program shall provide directly, by contract with the 
Legal Services Corporation, or by contract with 
members of the private bar, for— 
(A) establishment of a legal services office 
in each region to provide representation (other 
than representation provided under subpara-
graph (B)) of users, health workers, and vol-
untary associations having a demonstrated in-
terest in health care in proceedings and hear-
ings under sections 324 and 402; and 
(B) establishment of legal services offices 
in such communities and districts as are deter-
mined, in accordance with guidelines established 
by the National Health Board, to have inad-
equate legal services to provide the legal serv-
ices described in paragraph (1)(A). 
(3) USE OF CONTRACTS.—The National Health 
Board may carry out the functions described in 
paragraph (1)(B) directly, by contract, or otherwise. 
SEC. 402. GRIEVANCE PROCEDURES. 
(a) GRIEVANCE PROCEEDINGS.— 
(1) IN GENERAL.—The National Health Board 
shall provide, in accordance with this section, that 
any user, health worker, or any user association hav-
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ing a demonstrated interest in health care may com-
mence a grievance proceeding before the Board (or 
a person or committee designated by such Board) 
with respect to an alleged violation of this Act. The 
National Health Board may commence a grievance 
proceeding before itself (or a person or committee 
designated by such Board) with respect to an alleged 
violation of this Act. 
(2) GRIEVANCES AGAINST NATIONAL HEALTH 
BOARD.—Grievances against the National Health 
Board may be presented to and adjudicated by the 
Inspector General for Health Services or the Inspec-
tor’s General local designees. Grievants shall also 
have access to review in the courts. 
(b) REVIEW.— 
(1) BY NATIONAL HEALTH BOARD.—The Na-
tional Health Board shall provide, subject to para-
graphs (2) and (3), for its review (or a review by a 
person or committee designated by the Board), by 
appeal to the Board by any party to a proceeding 
described in subsection (a)(1) or on its own initia-
tive, of an adverse decision. 
(2) LIMITATION ONCE SUIT COMMENCED.—On 
and after the date a suit with respect to an adverse 
determination in a grievance proceeding or review 
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proceeding is filed under subsection (e), no review 
proceeding respecting such proceeding may be com-
menced by appeal to the Board under paragraph (1), 
and any such review proceeding which was com-
menced by appeal to the Board under such para-
graph before the date of filing of such suit and is 
pending on such date shall promptly be discon-
tinued. 
(3) TIME LIMIT.—No review of an adverse ad-
ministrative decision may be made by appeal or by 
initiative under this subsection unless the appeal is 
filed or notice of the initiative is published (as the 
case may be) not later than 30 days after the publi-
cation of the decision. 
(c) INVESTIGATION.—Whenever a grievance pro-
ceeding is commenced under subsection (a), the entity be-
fore which the proceeding is held shall investigate the 
grievance. 
(d) RIGHT TO SUE.—Any party to a grievance pro-
ceeding or review proceeding commenced under this sec-
tion may bring suit in the United States district court for 
the judicial district in which such proceeding, or review 
proceeding, was brought, for the review of an adverse de-
termination in such proceeding or review proceeding. Such 
court shall affirm such determination unless it finds that 
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such determination is not supported by substantial evi-
dence or is arbitrary and capricious. 
Subtitle B—Occupational Safety 
and Health Programs 
SEC. 411. FUNCTIONS OF THE NATIONAL HEALTH BOARD. 
(a) OVERSIGHT AUTHORITY.—On and after the effec-
tive date of health services, the National Health Board 
shall oversee occupational safety and health programs con-
ducted at the regional level, and shall participate in the 
establishment and administration of occupational safety 
and health standards under the Occupational Safety and 
Health Act of 1970. 
(b) CONFORMING AMENDMENTS.— 
(1) IN GENERAL.—To provide for participation 
of the National Health Board in the establishment 
and administration of occupational safety and health 
standards, the Occupational Safety and Health Act 
of 1970 (29 U.S.C. 651 et seq.) is amended— 
(A) in section 3, by adding at the end the 
following new paragraph: 
‘‘(15) The term ‘National Health Board’ means 
the National Health Board of the United States 
Health Services.’’; 
(B) by striking ‘‘Secretary of Health and 
Human Services’’ each place it appears (other 
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than in section 22(b)) and inserting ‘‘National 
Health Board’’; 
(C) in the first sentence of section 6(b)(1), 
by inserting ‘‘shall request the National Health 
Board and’’ before ‘‘may request’’; 
(D) in the second sentence of section 
6(b)(1), by inserting ‘‘the Board and’’ after 
‘‘The Secretary shall provide’’; 
(E) in the third sentence of section 
6(b)(1), by striking ‘‘An’’ and inserting ‘‘The 
Board and an’’; 
(F) in the third sentence of section 
6(b)(1), by striking ‘‘its’’ each place it appears 
and inserting ‘‘their’’; 
(G) in the fourth sentence of section 
6(b)(6)(A), by inserting ‘‘after consultation 
with the National Health Board and’’ after 
‘‘may be granted only’’; 
(H) in the third sentence of section 6(d), 
by inserting ‘‘after consultation with the Na-
tional Health Board and’’ before ‘‘after oppor-
tunity for’’; 
(I) in section 8(g)(2), by striking ‘‘The 
Secretary’’ and all that follows through ‘‘shall 
each’’ and inserting ‘‘The Secretary shall’’; 
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(J) in section 8(g)(2), by striking ‘‘their’’ 
and inserting ‘‘his’’; 
(K) in section 16, by inserting ‘‘after con-
sultation with the National Health Board and’’ 
before ‘‘after notice and opportunity’’; 
(L) in section 18(c), by inserting ‘‘(after 
consultation with the National Health Board)’’ 
after ‘‘in his judgment’’; 
(M) in section 19(d), by inserting ‘‘and the 
National Health Board’’ after ‘‘Secretary’’ each 
place it appears; and 
(N) in section 20(a), by striking the first 
sentence of paragraph (5). 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall take effect on the effective 
date of health services. 
(c) GUIDELINES.—The National Health Board shall 
establish guidelines— 
(1) for its participation in the establishment 
and administration of occupational safety and health 
standards under the Occupational Safety and Health 
Act of 1970; and 
(2) for the establishment and operation of 
workplace health facilities under section 413. 
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SEC. 
412. 
COMMUNITY 
OCCUPATIONAL 
SAFETY 
AND 
HEALTH ACTIVITIES. 
The Occupational Safety and Health Administration, 
under the direction of the National Health Board, shall 
develop and provide staff support for local and regional 
occupational safety and health programs, to include com-
munity-based occupational safety and health councils that 
represent community workers and residents. Such pro-
grams shall— 
(1) promote and assist in the establishment of 
workplace occupational safety and health committees 
in workplaces in the community, and advise and fa-
cilitate such committees’ actions relating to safety 
and health hazards in workplaces in the community; 
(2) assist employees in determining methods of, 
and requirements for, inspections of workplaces in 
the community for safety and health hazards; 
(3) implement training programs to enhance 
the ability of employees in the region to monitor 
safety and health conditions in their workplaces and 
to assist safety and health inspectors in the conduct 
of workplace inspections; 
(4) facilitate communication among workers 
employed in similar industries in the region and the 
Nation with respect to occupational health and safe-
ty hazards they face in common; 
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(5) conduct baseline and periodic biologic 
screening of employees in the region; 
(6) develop and maintain environmental moni-
toring programs to identify and isolate hazardous 
workplaces and work areas in the region; and 
(7) analyze employment-related injuries and ill-
nesses occurring in the region. 
SEC. 413. WORKPLACE HEALTH FACILITIES. 
(a) ESTABLISHMENT.—The Occupational Safety and 
Health Administration, under the direction of the Na-
tional Health Board, shall develop a program to establish 
worksite health facilities, distributed to make available oc-
cupational and emergency health care services to individ-
uals employed in the workplace in accordance with this 
section and guidelines and standards for such facilities es-
tablished by the National Health Board. Such facilities 
may be maintained by each employer where the facility 
is located, or by the group of employers covered by a facil-
ity. 
(b) APPLICATION OF GUIDELINES.—Each workplace 
health facility established pursuant to subsection (a) shall, 
taking into account guidelines established by the National 
Health Board— 
(1) be organized in a manner so as to provide 
an appropriate number of appropriately skilled 
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