Volunteers and FTCA

Community health centers will often consider utilizing volunteers in providing their required and additional services. But many have questions about what is required and how this impacts their FTCA coverage.

Here are a few things to consider:

Credentialing & Privileging

Volunteer licensed independent practitioners (LIPs), other licensed or certified practitioners (OLCPs), or other clinical staff (OCS) must be credentialed and privileged just as all of your employed (W-2) and individual contractors are (HRSA Site Visit Protocol, Chapter 5). This documentation must be maintained by the health center (HRSA PAL 2021-02). At the time service is provided, the Volunteer Health Professional (VHP) must also be “licensed or certified in accordance with applicable Federal and state laws regarding the provision of the service” (HRSA Compliance Manual).

Signed Agreement

The health center must execute and maintain, “a written, signed agreement that clearly states that the health professional is a volunteer of the health center and outlines the terms and conditions of the services that the volunteer will provide (which reflects the requirements of section 224(q))” (HRSA PAL 2021-02). HRSA provides a sample “Volunteer Agreement” here.

FTCA-Deeming Application

“Volunteer health professionals may receive deemed employment status based on individual applications by the sponsoring, deemed health center. Whether a specific activity is covered by the FTCA will also require a determination or certification that the activities at issue occurred within the scope of deemed PHS employment” (HRSA Compliance Manual).

Compensation

In order for the volunteer health care practitioner to be covered under FTCA, they cannot, “receive any compensation for the service from the patient, the sponsoring health center, or any third-party payer (including reimbursement under any insurance policy, health plan, or Federal or state health benefits program). However, the health care practitioner may receive repayment from the health center for reasonable expenses incurred in providing the service to the patient” (HRSA Compliance Manual).

Notification

Before the volunteer provides their services, the health center should ensure that a “clear and conspicuous notice” is posted at the site where the service is provided regarding FTCA deeming (HRSA Compliance Manual).

Scope

If a volunteer clinical “staff” member is providing clinical services, their services should be documented as a Column I service on the health center’s Form 5A. Though the individual is not being paid by the health center or a W-2 employee of the health center, HRSA advises that these services provided by the volunteer should be documented as directly-provided services on Form 5A (HRSA Form 5A Self-Assessment Document, HRSA SVP, Chapter 4).

If you’re interested in expert assistance from our RegLantern team, contact us today.