Best Practices for Efficient Hospital Volunteer Management

1. Hospital Volunteer Coordinators Matthew Roberts, Esq.Hamilton Barber, Esq. MRoberts@nexsenpruet.comHbarber@nexsenpruet.com Best practices May 17, 2019

2. Overview • Volunteers play a key role in running organizations, handling day-to-day tasks, and raising funds • The boards and committees of some of the largest hospital organizations are made up entirely of volunteers • Many hospitals rely on the help of volunteers and their coordination • The use of volunteers is another form of community outreach • It is critical that a hospital put resources behind its volunteer program to create volunteer loyalty and improve the hospital’s brand

3. Overview Topics covered • Policy and Procedure Requirement • Screening and Interviewing Volunteers • Risk Management and Liability Reduction • What is an Employee? What is a Volunteer? • The South Carolina Workers’ Compensation Law • Use of Volunteers and Fundraising • Orientation and Training for Volunteers • Effective Supervision of Volunteers • Best Policies for Volunteers • Legal Protections for Volunteers & Volunteer Coordinators

4. Policy and Procedure Requirement • Harassment • Infection Control • Disaster Plan • Record Retention • Relationship between Volunteers and Employees/Patients • Competency of volunteers/Recruitment • Screening and selection process • Orientation/Training/Ongoing Education • Developing and Updating Volunteer Guidelines • Discipline and Termination • Volunteer On-Duty Injury • First, it is essential to have a policy governing the Volunteer Management program in your hospital and procedures that support this policy. Volunteer coordinators and supervisors should have easy access to the policies and procedures. • At a minimum, the policies should include:

5. Screening and Interviewing Volunteers • Standard volunteer application form • Commitment and appropriateness for service • Background check, sex offender search, drug testing, etc. • Health screening • Interview as an additional layer of screening • Other requirements, e.g., minimum age, training modules/quizzes

6. Risk Management and Liability Reduction • Review hospital’s insurance coverage re: volunteers • Directors and officers liability insurance (D&O) • Liability waivers and volunteer agreements • Mandatory orientation and general training • Ensure volunteers receive proper training for specific role • Ensure volunteers do not become inadvertent employees

7. What is an employee? What is a Volunteer? • Employee • Very broad legal definition; one whom an employer “suffers” or “permits” to work; employer exercises control over actions • An employee cannot be both a “paid” employee and a “nonpaid” volunteer while performing the same type of work for the same employer • Volunteer • An individual who, without pressure or coercion, works for a public agency or charitable, civic, humanitarian, or religious nonprofit enterprise without the expectation of compensation

8. The South Carolina Workers’ Compensation LAW S.C. Code Ann. §§ 42-1-10 et seq. • To be covered by the Workers’ Compensation Law, the worker must both come within the statutory definition of “employee” and be excluded from any of the relevant statutory exemptions. • Under the Law, an employee is defined as a “person engaged in an employment under any appointment, contract of hire, or apprenticeship, expressed or implied, oral or written....” (S.C. Code Ann. § 42–1–130) • A person providing a service who has no right to or expectation of payment does not fall under the Law. See Shuler v. Tri-Cty. Elec. Co-op, Inc., 385 S.C. 470, 473, 684 S.E.2d 765, 767 (2009).

9. Use of Volunteers and Fundraising • For nonprofit and public hospitals, the use of volunteers can help and hurt fundraising for the hospital or foundation • Use same oversight for volunteers as employees • Privacy concerns of donors • Follow laws on solicitation of donations • Are volunteers used for fundraising in your hospital?

10. Orientation and Training for Volunteers Orientation • Time to acclimate and assess willingness to participate • Ensure volunteers understand they are not covered by the Workers' Compensation Act • Review handbook with volunteers • Annual attendance in order to maintain active status. • Alternatively, have the volunteer re-sign the most current volunteer handbook each year.

11. Orientation and Training for Volunteers Training • Volunteer training should be conducted by experienced staff. • General training and training for specific roles • Could include volunteers in employee training (could wear volunteer vests, shirts, or nametags to differentiate during training) • Active Shooter Training • April 10-11, 2019 • One employee of the Regional Medical Center in Orangeburg was shot. • Officer and suspect wounded in an exchange of gunfire at Prisma Health Laurens County Hospital in Greenville. • Disaster Preparedness Training

12. Effective Supervision of Volunteers • Designate a “supervisor” for each volunteer role • Volunteers are required to check in with supervisors, sign-in and sign-out • Maintain evaluation procedure at least annually • Maintain disciplinary policies, including re-training, reassignment, time off, and termination

13. Best Policies for Volunteers Safety • Volunteers should submit the same health-related documentation and submit to the same vaccinations (i.e., flu vaccines and TB screenings) as employees, faculty, staff, and physicians • Volunteers should understand emergency policies and procedures • Volunteers should know best practices for safety near hazardous/toxic substances. • Volunteers should be instructed how to avoid workplace injury.

14. Best Policies for Volunteers Confidentiality • Volunteers should sign a HIPAA Confidentiality agreement • Hospitals may incur HIPAA-related penalties for actions of volunteers (71 FR 8390, 8402 (Feb. 16, 2006); 45 C.F.R. § 160.103) • Make clear what information is confidential and instruct how to dispose of confidential documents • Make clear what type of conduct is not allowed: • Gossip with patients, staff, or other volunteers • Asking a patient why he or she is in the hospital • Direct involvement with bedside care

15. Best Policies for Volunteers Professional Conduct & Ethics • Volunteer Do’s • Maintain professional relationships • Professional dress • Visible identification as volunteer • Volunteer Don’ts • Ask or accept money from patients • Solicit medical staff for professional advice • Discuss patient medical needs outside scope of duties

16. Best policies for volunteers Cautionary tales • Doe by Doe v. Greenville Hospital System (SC case) • Minor volunteer sued hospital for negligent hiring of employee who sexually assaulted her • Jury awarded $545,000 against hospital; judge reduced to $250,000 • Marcus v. Frankford Hospital (PA case) • Volunteer sued hospital after she fainted and struck her face against oxygen tank in course of her shift • Jury awarded $11,000 against hospital

17. Legal Protections for Volunteers Federal Protection • The Federal Volunteer Protection Act (42 U.S.C. § 14503) • Protects almost all volunteers acting within the scope of their responsibilities on behalf of a nonprofit or governmental entity from many third party claims of injury due to volunteer’s negligence • Volunteer must not receive compensation or any other thing of value in excess of $500 per year (42 U.S.C. § 14505) • Does not protect the organization, but the organization may in some instances sue its own volunteers • Applies to claims against officers and directors as well as day-to-day hospital volunteers • Applies to all types of liability, not just tort liability

18. Legal Protections for Volunteers State Protections • Volunteers for charitable organizations likely protected in same way as “employees” under S.C. Code Ann. § 33-56-180 • “Employee” means an agent, servant, employee, or officer of a charitable organization” (S.C. Code 33-56-170(2)) • One who volunteers services without agreement for or expectation of reward may be a servant of the one accepting such services (Restatement (Second) of Agency § 225 (1958)) • If sued, volunteers should have protection under South Carolina nonprofit law. • Complete bar to recovery against an “employee” of charitable organization (a tax-exempt organization) unless employee acted in a “reckless, willful, or grossly negligent manner.”

19. Legal Protections for Volunteers State Protections • Good Samaritan Law (S.C. Code Ann. § 15-1-310) • Individual who provides emergency care at the scene of an accident or emergency not liable for damages for personal injury arising out of his or her negligence, except for damages resulting from gross negligence or willful misconduct • Indemnification • Volunteers may be entitled to indemnification by the hospital when sued in their capacity as volunteers (S.C. Code Ann. §§ 33-31-852, 33-31-856)

20. Questions?