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Volunteers a great asset until they cost you
Volunteers are a key component to the success of many health care organizations, but how often do you consider the risks they bring? No one wants to turn away people offering their time for free, but at the same time, risk managers must consider the potential downside.
Many organizations rely on volunteers to enhance services provided by staff, improve the quality of life for clients, or simply to meet the goals of their mission. Based on a recent study by the Bureau of Labor and Statistics, almost 65 million people volunteer their time each year, and that number continues to grow.
However, without a good risk management plan, volunteer programs can expose your organization to additional risks of a loss, damage to your reputation, or even imperil operations, says Tim Folk, a producer at The Graham Company, an insurance broker and consulting firm in Philadelphia. Folk works with the Health and Human Services Industry Practice Group, a group established to address the risk management challenges specific to behavioral health, senior services, home health, addictive services, and mental health businesses.
"This is something that slides under the radar a little bit," Folk says. "Most nonprofit providers are operating on a shoestring budget, which is the very reason they value their volunteers. And then everyone in administration is wearing multiple hats and working very hard, so the volunteers are just appreciated, but forgotten about in terms of any potential downside."
Folk says the risks associated with volunteer programs can be summarized in three categories:
injury or loss to a volunteer while performing services for the organization;
claims filed against the organization resulting from harm or loss caused by a volunteer while performing services for the organization;
claims filed against the volunteer that resulted from harm or loss caused by a volunteer while performing services for the organization.
An important issue is who is expected to pay for a volunteer's medical expenses for injuries sustained while volunteering, Folk says.
Your employees are provided workers compensation for their medical expenses and lost wages arising from injuries sustained while working for the organization. Volunteers are not typically included on a workers compensation policy, and you are not typically required by law to provide any benefits to volunteers. Some organizations choose to protect their volunteers with an accidental death and dismemberment Policy as a way of attracting and communicating their commitment to their volunteers, Folk says.
This type of policy provides a benefit amount (such as $25,000) if a volunteer is injured in an accident and it results in the death or dismemberment of the volunteer. It also pays a medical expense benefit for medical services incurred due to injury to a volunteer from an accident. Note that this medical expense coverage is typically in excess of the volunteer's own medical health insurance, Folk says.
Some organizations choose not to carry any insurance to protect volunteers for their medical expenses for injuries sustained while volunteering, Folk says. In this situation, it is critical to make sure your volunteers understand what to expect if they get injured.
In considering whether to provide coverage to volunteers, Folk suggests asking these questions:
What is the cultural message we send to our volunteers if we don't provide some level of benefit?
What are the costs as weighed against the potentially negative cultural impact?
Will an AD&D policy help prevent significantly greater exposure (i.e., a lawsuit by a disgruntled volunteer)?
Will volunteers sue you?
Another important issue is whether a volunteer can sue your organization if he or she gets hurt while volunteering, Folk says.
Employees are prevented from suing for their injuries, because workers compensation benefits are their sole remedy for their injuries. Since volunteers are not employees, they are entitled to sue you for their injuries just like any other third party, Folk says. (You would typically be covered for this lawsuit by your general liability policy, he notes.)
Some organizations minimize their exposure to these types of lawsuits by requiring their volunteers to sign a waiver and release. These types of agreements explain to the volunteer that because of the hazards and risks associated with volunteering, the organization requires every volunteer to be alert for his/her own safety and to sign a written agreement releasing the organization of any and all responsibility in connection with all risks encountered while volunteering, Folk explains. This helps protect the general liability loss experience, which then helps control the cost of purchasing insurance.
Some organizations are not comfortable with this approach and do not request their volunteers to restrict their right to sue.
Folk advises risk managers to ask these questions regarding exposure to lawsuits by volunteers:
Do we currently use waiver and release forms?
How will existing and new volunteers react to the request to sign one?
What are the leadership methodologies we can employ to create a balance between the need to manage risk and maintain volunteer relations?
Need to screen, evaluate volunteers
For claims filed against the provider and resulting from harm or loss caused by a volunteer while performing services for the organization, you would typically be covered by your general liability policy, Folk says.
"However, the last thing an organization wants is a volunteer who turns out to be a bad apple," Folk says. "Your organization's loss experience, reputation, and ultimately, bottom line are all at risk. In order to protect your organization, good risk management practices should be followed and documented, including volunteer screening, training, and evaluations.
Screening practices may include criminal background checks, DMV records, sexual predator histories, and even credit reports, says Martin Irons, CPCU, CIC, ARM, vice president, Technical Development Department, with The Graham Company. Even a claim with little to no merit can become cause for serious concern if a third party is able to substantiate a lack of diligence in your selection and screening processes, especially for those individuals in direct contact with patients, he says.
"The training can be a real challenge for some organizations, because they already are stretched thin just trying to keep their employees trained and up to date, and plus they don't have the same kind of control over volunteers in terms of scheduling and requiring them to do certain things," Irons says.
Training is important to minimize both the physical risks to volunteers and clients, as well as non-physical risks, he says. Safe lifting, patient handling, restraints, and similar safety issues are all important. But so is training in regard to patient interaction, dispute resolution, and harassment, he says.
Note, however, that performing evaluations and reviews of volunteers may place a burden on the time of management and supervisors.
"But it also allows for a continuous screening process and helps ensure you have the best of the best helping you complete your mission," Folk says.
Volunteers can hurt each other
With claims filed against the volunteer, resulting from harm or loss caused by another volunteer, the volunteer who caused the injury would typically also be covered by your organization's general liability policy for these types of claims, since volunteers are included as "Insureds" in the standard ISO policy form, Folk says. This means the volunteer would also receive defense coverage from your policy. In most cases, this is beneficial to your organization, because your insurance carrier can coordinate the defense of your volunteer and your organization, since you would also typically be named in a lawsuit if the volunteer is alleged to be liable, he notes. In addition, it is another way for your organization to protect and value your volunteers.
"However, many insurance carriers use non-standard general liability forms for Health and Human Services clients," Folk says. "The definition of who is insured should be carefully scrutinized, as you may not have the coverage you assumed you had."
Don't forget automobile coverage
Another area that is a difficult exposure to manage is when a volunteer is using their own automobile while performing services for the organization. In this situation, only the volunteer's personal auto policy would protect the volunteer, Folk says. The organization's business auto policy only protects the organization.
An option some organizations consider is adding volunteers as "Insureds Endorsement" to provide excess auto liability coverage to the volunteer under the organization's auto policy, Folk notes. Since your organization would also typically be named in a lawsuit, this could again be beneficial to your organization for coordination of defense, he says.
In addition to making these internal decisions, Folk says you should work with your insurance broker to ensure that your insurance program is properly tailored to respond to volunteers. Irons and Folk note that management of volunteers and the risks they bring can be a "hot potato" that administrators try to avoid, but they say the risk manager should take responsibility for controlling the risks.
"Volunteers bring numerous benefits to organizations. However, they also bring additional risks," Folk says. "Having a good risk management plan for your volunteer program is key to coming out on the winning side."
Tim Folk, Producer, The Graham Company, Philadelphia. Telephone: (215) 701-5231. E-mail: firstname.lastname@example.org.
Martin Irons, CPCU, CIC, ARM, Vice President, Technical Development Department, The Graham Company, Philadelphia. Telephone: (215) 701-5266. E-mail: email@example.com.