Managing the Unique Risks of Hospice Care
Volunteers are a necessity in a successful hospice program. With this realization, Federal regulations actually require a specific level of volunteer activity at each hospice receiving Medicare and Medicaid funding. Although these dedicated and caring volunteers are important assets to a successful hospice program, they provide a unique area of risk management.
In addition to the liability for the acts and omissions of employees, hospices are also liable for acts and omissions of its volunteers. Not only does this liability affect the willingness of hospices to use volunteers, but also volunteers might be reluctant to assume liability. Fortunately, the Federal Volunteer Protection Act of 1997 promoted the idea of volunteer participation by attempting to immunize volunteers at charitable and nonprofit organizations from liability for their acts and omissions if performed within their volunteer duties. The requirements of the act are:
- If appropriate or required, the volunteer must have been properly licensed, certified, or authorized by the appropriate authorities in the state in which the harm occurred.
- The harm was not caused by the volunteer operating a motor vehicle for which the state requires the operator to possess an operator's license or maintain insurance.
- The harm was not caused by willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious, flagrant indifference to the rights or safety of the individual harmed by the volunteer.
- The volunteer must have been acting within the scope of his or her responsibilities when the act or omission occurred.
However, the statute does not apply to misconduct which:
- Constitutes an act of international terrorism or crime of violence.
- Constitutes a hate crime.
- Involves a sexual offense.
- Involves misconduct for which the defendant has been found to have violated a civil rights law.
- Involves the volunteer's use of any drug or alcohol at the time of the misconduct.
Note: If state law provides more protection to volunteers than the federal act does, the state law preempts the federal act.
As with any other medical provider, the goal is to reduce incidents that give rise to any legal liability. Additionally, hospices depend heavily on the support of the public for monetary donations as well as volunteers. Therefore, any incidents that bring unwanted publicity could prove damaging in the long run.
When implementing a risk management program for a hospice volunteer program, consider the following:
- Be sure that liability insurance extends to actions or omissions of volunteers. If it does not, a separate policy should be available to cover volunteers.
Volunteer Licensing and Insurance
- Require volunteers to have a valid driver's license and automobile insurance if part of the volunteer's duties will involve driving.
- Be certain volunteer assignments requiring a professional license or certification has a volunteer with an active license or certification.
- Have a detailed written job description for each volunteer, because liability often hinges upon whether the volunteer was acting within the scope of his or her responsibilities.
- Provide assignments and supervision for volunteers, just as you do for paid staff.
- Perform and record background checks on all potential volunteers.
- Document all aspects of the volunteer program, as required by Medicare as a condition of participation.
- Provide opportunities for initial and continual volunteer training.
- Encourage volunteers to ask questions.
- Make sure you closely supervise all volunteer activities.
- The Volunteer Protection Act does not apply if the volunteer is paid more than $500 annually, so review any compensation arrangements you might have with volunteers. Remember: State protections may have similar provisions.
At Highland Risk Services, we are familiar with the unique risks faced by providers of hospice care. We are ready to help you assess the needs of your clients while insuring the ongoing participation of the volunteers whose service is so vital to hospice service. Please let us serve you by calling one of our two offices in Chicago at 847-832-9100 or Lansing at 517-676-7100.