KUMC POLICY ON VOLUNTEERS IN THE WORKPLACE

POLICY STATEMENT The University of Kansas Medical Center recognizes and appreciates the contributions of volunteers to its mission of education, research and service. This policy enables departments to set forth requirements pertaining to volunteers and to engage their services. This policy does not govern minors who volunteer in a research laboratory; such activities are governed by the KUMC Policy for Minors Working, Volunteering or Shadowing in Research Laboratories.

Volunteers are individuals who perform services for KUMC for civic, charitable or humanitarian reasons without promise, expectation or receipt of compensation for their services. A volunteer offers services freely and without pressure or coercion and is not otherwise employed by the University to perform the same type of services as those for which the individual proposes to volunteer. All of the following criteria must be satisfied in order for an individual to be approved as a volunteer:

 The services are intended to be voluntary and to be rendered without promise or expectation of compensation.  The services must constitute a bona fide effort of the individual to volunteer for a civic, charitable or humanitarian purpose.  The fact that the individual is an employee elsewhere in the University (including other KUMC campus locations and KU Lawrence) does not mean he/she cannot volunteer provided the volunteer activity differs, substantially and distinctly, from his/her employment.  However, an employee of KUMC cannot volunteer to perform activities that are the same or similar to ones he/she performs in his/her KUMC job.  Volunteers must not be utilized in ways that displace or replace regular employees in the performance of their normal duties. If volunteer services jeopardize employment of an individual to perform the same services, the volunteer activity should not be approved.  Volunteer service, other than research volunteers, should be limited to 6 months. Volunteer service beyond 6 months requires approval of Human Resources. If volunteer service will continue beyond a one-year period, the volunteer application must be re-submitted and re-approved on an annual basis.  Research volunteers are involved in direct interaction with KUMC personnel in the conduct of research or training or other sponsored projects for a defined and short-term duration of less than 4 months, consistent with project objectives. Research volunteers must be authorized by the vice chancellor for research or designee. Research volunteer roles may be renewable for an additional 4-month period. Approval for the renewal is required by the vice chancellor for research or designee.

Exclusions

Temporary, intermittent or occasional employees, contractors, and student employees are not eligible for volunteer {L0036187.2 } status.

Requirements and responsibilities pertaining to volunteers

Volunteers must be 16 years of age

University volunteers are subject to and must abide by all applicable University and departmental policies, procedures and rules including but not limited to those relating to health and safety, confidentiality, protected health information, non-discrimination, computer use, ethics, conflict of interest, background check, financial responsibility, drug use and anti-violence.

Foreign nationals must have the appropriate visa and authorization to engage in volunteer activities, as certified by the KUMC International Programs office.

Volunteers who work with human subjects research must meet the requirements of this policy as well as being approved by the Human Subjects Committee (HSC). Volunteers who work with animal subjects must meet the requirements of this policy as well as being approved by the Institutional Animal Care and Use Committee.

Prohibited activities for volunteers University volunteers cannot replace employee positions or impede the employment of a University position.

University volunteers are also prohibited from performing the following activities:

 Operating heavy equipment including university owned heavy equipment and state vehicles

 Working with stored energy (e.g. steam, electricity, hydraulics)

 Working in machine shops

 Activity considered inappropriate for any employee

 Entering into any contract on behalf of the University

 Working with viruses, infectious or potentially infectious agents, including human blood.

Research volunteers are prohibited in the following labs:

 Entering or working in any laboratory or facility designated as: a) BSL-2 with BSL-3 practices b) BSL-3, or c)ABSL-3 or higher.

{L0036187.2 }  Entering or working in any laboratory were select agents or explosives are used or stored.

 Entering or working in any nonhuman primate holding room.

 Entering or working in areas where procedures with awake nonhuman primates are conducted.

 Working with human and/or non-human primate: blood, body fluids and tissues unless are known to be free of pathogens or have been rendered non-infections by chemical means.

 Handling of biological substance classified about Risk Group 1.

 Handling any carcinogens, reproductive toxins or other acutely toxic chemicals (i.e. mammalian LD 50 of <100 ug/kg body weight).

 Entering any animal housing area, unless approved by the manager or director of the animal housing area to be entered.

An international volunteer (an individual who is not a permanent resident or U.S. citizen) may not receive any kind of compensation or gift for volunteer service, including but not limited to, gift cards, tickets to events, food, etc. Any type of gift is considered payment for services and could violate the individual’s immigration status.

Procedure for placing a volunteer (see volunteer procedure checklist at end of policy)

Any department that engages a volunteer must develop a description of the volunteer assignment. Following this, the department must establish a screening and selection process that best meets its needs. The department informs their HR Business Partner the volunteer’s name and email address for the completion of a background check. A Volunteer Engagement Form (Attachment 1) must be completed by the department and be signed by the department director or chair. A copy of the Engagement Form must be sent to Human Resources for institutional approval. The Human Resources office is located at 1044 Delp. The Volunteer Engagement Form must be maintained in Human Resources for a minimum of 3 years after the volunteer’s activity at KUMC is completed.

A volunteer must complete a Volunteer Application Form (Attachment 2), which includes providing of proof of health insurance, signing a liability release and signing a confidentiality agreement.

Volunteers who interact with animals or patients are required to provide proof of current immunizations for Tetanus- Diphtheria, MMR, Hepatitis B, Varicella, and annual TB screening. Any immunizations that are not current can be obtained from KUH Occupational Health at the department’s expense. Immunizations, if needed, are recorded on the Immunization Checklist (Attachment 3).

Once all forms are completed, validated and returned to Human Resources, Human Resources issues an ID badge form and authorizes the applicant for the KUMC Volunteer Program.

{L0036187.2 } Any department that engages a volunteer must ensure that the volunteer has the necessary training and/or supervision to safely carry out the volunteer activity; and, depending on the particular function performed, must meet appropriate licensure requirements. An individual who volunteers services in a field which requires a license or certificate must satisfy that requirement prior to volunteering.

A volunteer may provide services in the same department as a family member, but a volunteer cannot be directly supervised by a family member.

Termination of Volunteer Service Volunteer service may be terminated at any time without prior notice.

Procedure in Case of Volunteer Injury If a volunteer is injured while on KUMC premises and providing service to the University, the department should complete and submit the Workers Compensation Employers Report of Accident Form to Employee Health immediately following the accident occurring. Eligibility for coverage by workers’ compensation is determined by the State Self Insurance Fund Office on a case-by-case basis.

{L0036187.2 } VOLUNTEER PROCEDURE CHECK LIST

(Note – Volunteers who interact with animals or patients are required to provide proof of current immunizations.)

Department identifies a volunteer per Volunteer Policy

Department has candidate complete the volunteer paperwork

If the volunteer is not a Permanent Resident or US Citizen, the department has the candidate make an appointment with the Office of International Programs (OIP) by emailing [email protected] or by calling 913-588-1480. The international volunteer must submit the following to OIP: o A color copy of his/her passport o A color copy of his/her VISA o A copy of his/her I-94 o His/her current address and contact information o Immunization records (requested by OIP) o Deemed Export (if applicable and completed by the department)

*** note to department supervisor: an international volunteer may not receive any kind of gift for their volunteering including but not limited to gift cards, tickets to events, food etc. as this is considered payment for services by the Department of Homeland Security and could violate the person’s status. ***

Department emails the HR Business Partner the completed volunteer paperwork, which includes the volunteer name, email and speed type for background checks.

The HR Business Partner informs the department of the results of the background check and asks the Department to complete the Volunteer Engagement Form; Department also asks the volunteer to complete the Volunteer Application Form.

*** If the volunteer does not require immunizations, the volunteer will bring the Volunteer Engagement Form and Volunteer Application Form to the HR Business Partner in Human Resources. The HR Business Partner will review the forms to insure appropriate authorizations, the volunteer receives an ID badge and the process is complete. If the Volunteer requires immunizations, the Volunteer follows the additional steps below.

Once the HR Business Partner receives the Volunteer Engagement and Volunteer Application Forms, she forwards the applicable information to Occupational Health.

The HR Business Partner then contacts the Volunteer to schedule their immunization appointment with Occupational Health.

The Volunteer will take a copy of the Volunteer Engagement Form and the Immunization Form to Occupational Health for immunizations.

Once immunizations are complete the Volunteer brings the Immunization Form to the HR Business Partner in Human Resources. The HR Business Partner will review the forms to insure appropriate authorizations,

{L0036187.2 } the volunteer receives an ID badge and the process is complete.

Approval by HSC for volunteers working with human subjects research

Approval by IACUC for volunteers working with animal subjects research

Approved by EHS (See attached Hazard Evaluation Form)

Approval by Vice Chancellor for Research or designee – applicable only to research volunteers applications

{L0036187.2 } ATTACHMENT 1 KUMC VOLUNTEER ENGAGEMENT FORM

Identification Information

Name:

Address:

City: State: ZIP:

Date of Birth: Age:______

Phone: Email:

Country of Citizenship: If other than US, current VISA status:

Profile Information

□ Undergraduate Student □ Graduate Student □ Post-Doctoral Student □ Community Member □ Other:

Volunteer Duties

KUMC department:

Volunteer’s supervisor:

Volunteer Name / Date Chair/Director Name / Date Supervisor Name /Date

Volunteer Signature Chair/Director Signature Supervisor Signature

______Department Administrator Office of International Programs Vice Chancellor for Research

______Department Administrator OIP Signature / Date Vice Chancellor for Research Signature/Date Signature / Date

{L0036187.2 } ATTACHMENT 2 KUMC VOLUNTEER PLAN

Responsibilities for the Volunteer ( in detail)

How will this volunteer benefit your department?

Expected dates of volunteer service (beginning and end dates):

Days and Hours of expected volunteer service:

{L0036187.2 } ATTACHMENT 3 KUMC VOLUNTEER APPLICATION FORM

Applicant Information

Name:

Address:

City: State: ZIP:

Date of Birth:

Phone: Email:

Have you previously been employed by The University of Kansas Medical Center? □ Yes □ No If you answered “yes”, describe below the date(s) of employment, the responsibilities of the position, and any other relevant information you wish to provide about the employment:

______

Do you have any criminal convictions? □ Yes □ No If you answered “yes”, describe below the date(s) of conviction, the charge(s) involved, and any other relevant information you wish to provide about each conviction:

______

Profile Information

□ Undergraduate Student □ Graduate Student □ Post-Doctoral Student □ Community Member □ Other:

{L0036187.2 } Interests and Skills

Please tell us what interests you in volunteering at KUMC.

______

Please tell us about any skills or interests that may be relevant to volunteering at KUMC.

______

{L0036187.2 } Confidentiality Agreement

Patients at KU Medical Center are entitled to confidentiality with regard to their medical and personal information. The right to confidentiality of medical information is protected by state law and by federal privacy regulations known as the Health Insurance Portability and Accountability Act (“HIPAA”). Those regulations specify substantial penalties for breach of patient confidentiality. 1. All patient medical and personal information is confidential information regardless of the educational or clini cal setting(s) and must be held in strict confidence. This confidential information must not become casual co nversation anywhere in or out of a hospital, clinic or any other venue. Information may only be shared with health care providers, supervising faculty, hospital or clinic employees, and students involved in the care of o r services to the patient or involved in approved research projects, who have a valid need to know the inform ation. 2. Under strict circumstances, upon receipt of a properly executed medical authorization by the patient or a HIP AA-compliant subpoena, medical information may be released to the requesting party. Inquiries regarding th e appropriateness of the authorization or subpoena should be directed to the medical records department or th e University’s Office of Legal Counsel at 913-588-7281, depending upon the situation.

3. Computer user codes/passwords are confidential. Only the individual to whom the code/password is issued s hould know the code. No one may attempt to obtain access through the computer system to information to w hich he/she is not authorized to view or receive. 4. If a violation of this policy occurs or is suspected, immediately report this information to your supervising fa culty. 5. Violations of this policy will result in disciplinary action up to and including termination from the program. Intentional misuse of protected health information could also subject an individual to civil and criminal penal ties.

{L0036187.2 } Liability Release

In consideration of the fact that KUMC has agreed to allow me to be on its premises in the capacity of a volunteer, I agree to the following terms and conditions required for the experience.

I agree that I am covered by a privately purchased and effective health insurance policy and will continue to be covered by such a policy during the time in which I am volunteering at KUMC. My health insurance carrier is:______Policy No:______

I shall complete KUMC’s required training prior to beginning any volunteer activities. The department in which I am volunteering will inform me about training relevant to my volunteer activities.

I agree that, if KUMC determines that I may have any contact with patients or animals, I will be required to provide proof that the following immunizations are current: Tetanus-Diphtheria, MMR, Hepatitis B, Varicella, and annual TB screening.

I understand that volunteering may involve risks of injuries or health exposures, and I agree that my volunteering and any risks are being voluntarily assumed.

I agree that KUMC, its employees and agents are hereby released from any and all liability related, directly or indirectly, to my volunteering, and I agree to hold KUMC and its employees and agents harmless from any and all liability, causes of action, or other claims related to my volunteering.

Declaration

I confirm that the information that I have provided in support of this application is complete and true. I agree to the terms and conditions stated in this application. I authorize KUMC to conduct a criminal history background investigation on me. I understand that this position is truly a volunteer position and that I am volunteering my time and effort without cost to KUMC and understand that I will receive no compensation or benefits for this work.

Volunteer Name / Date Signature of Parent or Guardian /Date (If student is under 18 years of age)

Volunteer Signature

{L0036187.2 } ATTACHMENT 4 IMMUNIZATION CHECKLIST FOR KUMC VOLUNTEERS

(This form is applicable when the volunteer will interact with animal subjects or patient populations)

Name: ______Date of Birth: ______

Social Security Number: ______(SSN is required only if immunizations are provided by KUH Occupational Health)

Immunization Requirement Current Date Provided by Initials KUH Occ. Health Tdap (Tetanus, Diphtheria, Pertussis) Within 10 years Yes No MMR Two doses Yes No Hepatitis B Three doses Yes No Varicella Two doses Yes No Annual for TB Surveillance* Yes No Animal labs; Every other year from human research

*For convenience to the volunteer and the department, Occupational Health recommends a one-time blood draw for TB surveillance rather than four visits needed for skin testing. Additional information is available from the Occupational Health office at 588-6512.

Volunteer may provide current immunization records. If records are not available, or if all immunizations are not current, Occupational Health can provide the necessary vaccines at the Department’s expense. Please complete the lines below if immunizations are needed. ______KUMC Department

Department SpeedType ______

Department Mail Stop ______

______Department Administrator Name Department Administrator Signature/Date

Appendix C: MINOR POLICY HAZARD EVALUATION FORM Please type requested information into yellow boxes prior to printing and submitting. Submit a copy of this

{L0036187.2 } evaluation form to the Environment, Health and Safety Office (email to [email protected], mail to Mailstop 3032 or fax to 913-588-5093). Principle Investigator / Responsible Department Representative: Locations (Building and Room #) that the minor will be occupying: Minor’s Full Name: Minor’s Age: Description of activities to be performed by the minor (please be specific in regards to potential hazards the minor could be exposed to) Estimated number of hours per week when minor will be on campus: Days of the week when minor will be on Monday Tuesday Wednesday Thursday campus (check all that apply): Friday Saturday Sunday

Times of the day when minor will be on Normal Hours (7am – 5pm) Very Late/Early (10pm – 7am) campus (check all that apply): Evenings (5pm – 10pm) Radiation hazards present in the lab None P-32 S-35 C-14 (check at least one box): H-3 X-Rays Other (list): Biological Hazards present in the lab None Recombinant DNA Infectious Agents (check at least one box): Blood Human Cell Lines Other (list): Hazardous Chemicals in the lab (check at None Flammables Acids/Bases Reactives least one box): Toxic Organic Other (list): Other Hazards present in the lab (check at None UV Lights Lasers least one box): Other (list): Precautions that will be taken to minimize the Constant Supervision if hazards are present minor’s exposure to hazards: Hazards kept in storage while minor is in the area Other (list): Proposed training that the minor will be General Safety Training required to complete and precautions that will Radiation Safety Training be taken to mitigate hazards/exposure: Bloodborne Pathogens General Biosafety Personal Protective Equipment Hazard Communication & RCRA Chemical Safety Training Other (list):

Request Approved Date: Requestby: Denied by: Date:

{L0036187.2 }

ToRequest be filled Approved out by w the ith the Office follow of ing Modifications: Compliance: