Responses to: Volunteering in For-Profit Settings: Exploitation or Value Added?

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Posted by 2/29/00
Submitted by Lucas Meijs, Meijs Consultancy, The Netherlands
What a great (USA) discussion this is. In the Netherlands at this moment there are no real for-profit organizations in health care but I do observe some other trends in volunteers being used in for profit settings and also some discussion around it. Just without any pretention some examples:

1. The use of volunteer first aid people and volunteer stewards at large profit-making games and events such as soccergames and marathons;

2. The use of gifts in time by all kinds of self service organizations such as McDonalds

3. The change from nonprofit to for-profit in training for recreational activities such as sailing or wind surfing. In these organizations the volunteers also stay for a longer time, usually because the (commercial) school offers them a great opportunity to do their hobby (e.g. sailing is all kind of boats) without having to pay for it.

4. A bit different is the misuse for-profits make of the Dutch volunteer reimbursement policies. Organizations are allowed to cover expenses of a volunteer to about $800 a year without any proof at all of the expenses

Posted 2/29/00
Submitted by Brian Fidler, Volunteering NT, Darwin, Northern Territory, Australia
I know the discussion is about volunteers working in a for-profit hospital environment, but isn't the issue a little wider than that? We regularly get requests for volunteers from non-profit organisations for what are clearly paid positions."We would like a volunteer, computer literate, with good office skills and a pleasant telephone manner.Hours: 9 to 5, Monday to Friday." When we told the agency (large and international) that this sounded like a paid position, the suggestion was that two volunteers, each about 18 hours per week would do instead. I'm reminded of one of the best ways I ever found to decide if you need volunteers (got it from S.Ellis)..."If you had the money to pay for all the staff you wanted, would you use volunteers?"

Posted 2/28/00
Submitted by Sue Henderson, USA
I work as an activity director and volunteer coordinator in a for profit long term care facility. Volunteers are mostly (90 percent) used in the activity department. They are the ones doing the the visitation and all the things that wouldn't be provided by a paid staff person. Some of the volunteers do participate in clerical type jobs to develop skills so that they can seek paid employment--I see that we are providing a service here for actual on the job training. We also use students from the university in a program called community-based service. In this program I meet with the students and we determine what kind of skills or learning experience they wish to obtain. I get some good volunteers this way but the facility is also giving the students something that is very valuable that they can't get from books. The basis of this is that it is a fair and clearly understood exchange of value both ways. That is the way I look at all of my volunteer positons--both the volunteer and the facility are getting something they want in exchange.

Posted 2/28/00
Mary Kay Hood posted the following to CyberVPM and has given permission for Energize to repost it here as it is very pertinent to this Hot Topic--thank you!

Reprint from CyberVPM
I came across an article published in the Miami Herald about a hospital
volunteer demanding pay in a class action lawsuit against hospital chain
Columbia-HCA Healthcare Corp. The suit, which requests class action status and seeks back pay and damages, challenges the long-held practice of in-hospital volunteers. The lawsuit alleges that "volunteers were placed wherever there was a shortage of labor."

New York resident Alexander Eltman, a retiree who winters in Florida, said he signed on as a volunteer because he wanted to help patients, by reading them books or talking with them to lift their spirits. Instead, during his three-month stint as a volunteer in the hospital's admitting room, Eltman was put to work greeting patients and performing other tasks like photocopying insurance and prescription cards and pushing people in wheelchairs to various hospital departments for tests.

Apparently, when Eltman realized the hospital was owned by a profit-making corporation and part of an investor-owned chain, his perception of carrying out his volunteer duties changed. Attorney's for Eltman said "We're talking about people who volunteered to be helpful to patients and essentially ended up doing an orderly's work. The hospital saved a great deal of money using volunteer labor. You're talking about a company that's making profits, not about a mom-and-pop community hospital."

The lawsuit seeks to represent others who volunteered without pay at any of Columbia's hospitals after Jan 26, 1997.

Posted 2/22/00
Submitted by Kathy Gabel, Volunteer Coordinator, HealthSouth Rehabilitation Hospital, Toms River, NJ, USA
I have been paying special attention to this month's hot topic because I am one of the people who emailed Susan for guidelines on volunteer programs in "for-profit" organizations. I run a volunteer program in a for-profit physical rehabilitation hospital where the volunteer emphasis is "patient visitation". Whether for-profit or non-profit, clearly volunteers add value to the organization and assist with it's "cause" or "mission". In the healthcare field, the primary focus has to be the patient ... whose mental, physical and spiritual needs can be well met by volunteers. Right up there with the patient is the mental, physical and spiritual needs of the volunteer, not to mention educational. As long as these two groups of people are the primary benefactors of a volunteer program in a for-profit, then I do not find it to be "wrong."

We learned in "Volunteerism 101" that the organization cannot help but benefit from the talents of volunteers, but I do not believe that should be the primary motivation for a volunteer program. If the benefit to the organization's bottom line is the primary reason for volunteers, then I believe this to be the exploitation of people, thus making it wrong. I am very fortunate to work for someone who agrees with me. My concern is that without guidelines, this leaves volunteers wide open to being exploited. I'd rather organizations like JCAHO focus their attentions on protecting volunteers from being exploited than emphasizing some of the "paperwork" requirements such as competencies. Just a thought ... based upon the feedback I get from our volunteers, I believe their presence in our facility has actually spurred patients and staff to consider volunteering their time. So for the woman from the U.S.S. Constitution Museum, maybe the visibility of volunteers in for-profits can actually play a role in increasing the volunteer pool.

Posted: 2/15/00
Submitted by Vickie A. Morgan, DVS, Holy Spirit Hospital, PA/USA
To the best of my knowledge, ASDVS has always indicated that health screenings, such as TB tests or Rubella screenings, should be determined by individual institutions. I was surprised to hear that you were attributing TB screenings as mandated by ASDVS! We have many community-based volunteers associated with our hospital and we do not require TB tests for them. I suspect that my hospital-based volunteer program is not alone in recognizing that TB screenings may be appropriate for patient care volunteers, but not necessary for outreach volunteers!

From Susan: Sorry, I didn't mean to imply that it was ASDVS that required the t.b. screening. The mandates were spoken about at the ASDVS Conference, but the source is the American Hospital Association and the Joint Council of Accreditation of Hospitals.

Posted: 2/10/00
Submitted byBetty Tibbits, Volunteer Manager, Oklahoma Blood Institute, Oklahoma City, USA
As a member of as task force on volunteerism in Oklahoma City, I can tell you that we deliberately invited a volunteer director of a large local for-profit hospital because of her unique position in the volunteer field. Our decision for her inclusion was that the needs of hospital patients haven't changed. However, managing the hospital gift shop in a for-profit setting and utilizing non-paid staff to make money for the hospital conglomerate owners does propose problems.

By incorporating the hospital auxiliary, hospital generated revenue may be donated to the hospital by the auxiliary but not towards equipment or materials that would generate patient revenue; eg., landscaping, redecorating, neonatal parent rooms, TV sets, cable, art, etc. Volunteer management just keeps getting more complicated doesn't it? Another interesting twist is that as a volunteer mgr. in a major community owned blood center in Oklahoma City, I am required to give safety training and Good Mfg. training to all 700 plus volunteers statewide. I feel like I am employed by the FDA since one third of my time is spent in training and documentation!

Posted: 2/10/00
Submitted by Mary Kay Hood, Director of Volunteer Services, Hendricks Community Hospital, Danville, IN, USA
Couple of thoughts -- Susan makes a valid point of "exploitation" when it comes to volunteers. However, the article doesn't even touch on the "exploitation" of employees. We all know of people who work in for-profits as well as non-profits who end up working 50, 60 even 80 hours each week and get paid for only 40. Isn't that true "exploitation?" I remember working in a large corporation some time ago when my boss asked me to work late and when I told him I had plans, his reply was: "Unless your mother died, you better cancel them." Yes, it's a hot button with me. Seems to me that if there was a little more respect for people as individual people, the entire business world would be much better off -- both for-profits and non-profits as well.

As far a JCAHO goes, the Indiana Society of Directors of Volunteer Services (ISDVS) sent a proposal to Indiana Health & Hospital Association (IHHA) for IHHA to help champion the cause of streamlining some of the processes and rules of JCAHO to make it easier for those of us in volunteer management to do our jobs. That was last fall and ISDVS is still working with IHHA in that regard. Stay tuned for news!

Posted 2/7/00
Submitted by Cheryl Morehouse, Manager, Volunteer Services, St. Joseph Hospital, Nebraska, USA
Recruiting volunteers for a for-profit hospital has been a challenge. Years ago we were a not-for-profit. Many volunteers chose not to continue volunteering, because they morally struggled with the issue of contributing their time and talents to a "for-profit". Also, with repeated downsizing, many office/clerical/service type positions have been and continue to be eliminated. Instead of volunteer opportunities to visit with patients & family members, I am increasingly requested by our departments for someone to "answer the phones", "file", stuff envelopes, etc. I do have some volunteers that love to do that sort of thing, but it just seems we're really swinging away from what most people think of when "hospital volunteering" is mentioned. Also, I have to agree with your views on the TB test. I personally think it's a lot of expense to the hospital and unnecessary hassle to the prospective volunteer. Especially when the numbers of "long term" volunteers are becoming a rarity, and we are seeing increasing numbers of "short term" or episodic volunteers.

Posted 2/7/00
Submitted by Marsha Riddle, Western Carolina Center, North Carolina, USA
The members of the for-profit world are expected to be good corporate citizens and good citizens. This does not close them to involvement in the community and its citizens, especially if the business is human services. The human services industry whether for profit or non-profit should care about the Quality of Life of the persons they serve. This must include the involvement of the families of the persons being served, the churches of the persons, and friends and volunteers. If we care about service and the quality of service to persons and the community, we must begin to bring to bear all the support we can to meet the needs of people. There are literally thousands of people who need the emotional caring support of thousands of people who want and need to make a difference in peoples' lives. Are we to deny that because of who is getting paid, the overpaid executives of non-profits or the stock holders of for-profits. What difference does it make to the person in need? None!!!!

Posted 2/7/00
Submitted by Bonnie Jennings Steele, DVS, The Stamford Hospital, CT, USA
Many of us in healthcare volunteer administration DO make the distinction between those who work with patients and those who do not come into our facilities. We do not, nor do many of our peers, require TB tests of volunteers working off campus at special events. There are liability and risk management issues for the healthcare environment, however, that lead us to require all staff (full time, part-time, unpaid - volunteer, per diem, subcontractors) to have the annual TB test. Some of this is driven by regulatory agencies; some by rising insurance costs.

Posted 2/7/00
Submitted by Sandra Porterfield, USA
Three years ago I had the privilege to spend two weeks at an educational/training course sponsored by the National Institute of Health. Several of my classmates represented the "for-profit sector". We discussed the issue over many sessions. I was very against the idea of volunteers working with a business until I really explored the other side. For-profit businesses do "give" to their communities in substantial monetary amounts, as well as with in-kind services. They provide educational opportunities and back-to-work experience just as non-profits do. How many times have we asked a business to sponsor a fund raiser or give a substantial gift for an auction? I have Assisted Living Facilities and Retirement Communities on the top of my list when I need something. In return they have helped me with fundraising mailing projects,etc. I think we need to be careful of how we comment about the for-profit business using volunteers until we have the opportunity to observe what they give in return and how they use the volunteers - For fundraising: NO. For patient or client comfort: YES. Thanks for the opportunity to speak out on this issue

Posted 2/4/00
Submitted by Tammy Herron, Director of Volunteers, American Red Cross, TN, USA
My opinion is that for profit settings such as hospitals or nursing homes could use volunteers, but volunteers would give services to the patients or their families only. They shouldn't be helping sort mail or stuff envelopes or anything clerical. A volunteer who goes in to play a card game with a patient/resident or read the paper to someone who can't see well is not volunteering for the "for profit" organization, but for the people.

Posted 2/4/00
Submitted by Nancy Gedraitis, Manger, Volunteer and Group Services at USS Constitution Museum, Boston, MA, USA
I have some strong concerns. Volunteers are so essential to many non-profits and there is already a lot of competition for the existing pool of able volunteers who have time and are able to make a commitment. If for-profits begin recruiting volunteers, it means an even smaller pool for those of us who cannot operate without them.

I question that for-profits have the proper structure to offer volunteers the support, gratitude and recognition that they deserve. I anticipate conflicts between paid staff (especially unionized) and volunteers. That said, I certainly agree in nursing homes the quality of care is lacking. But is that because of the all important "bottom line" and cost-cutting of for-profits?

Posted 2/4/00
Submitted by Ellen Didimamoff, CVA, Dir. of Vols., Morris View Nursing Home, NJ USA
Let's keep volunteers where I believe they belong; with the non-profits. Utilizing the services of volunteers for business is a "no-no". At that point, they should just be considered non-paid staff working for a business, not a philanthropic setting.

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