CLAIM VOLUNTEER RISK AND PROGRAM MANAGEMENT … · training and qualification procedures, volunteer performance management, and volunteer program management activities are also completed

CLAIM VOLUNTEER RISK AND PROGRAM MANAGEMENT POLICY HANDBOOK

CLAIM is the Missouri State Health Insurance Assistance Program (SHIP). Trained CLAIM counselors provide

free, unbiased advocacy, education, and enrollment assistance to people with Medicare and those who help

them to make informed decisions about Medicare and related health insurance needs.

Contents

INTRODUCTION ....................................................................................................................................................................... 2

SECTION 1 – Introductory Volunteer Engagement Policies .................................................................................................... 4

SECTION 2 – Risk Management and Health and Safety .......................................................................................................... 6

SECTION 3 – Volunteer Program Management .................................................................................................................... 10

SECTION 4 – Information Technology ................................................................................................................................... 30

CLOSING ................................................................................................................................................................................ 31


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INTRODUCTION

CLAIM is part of a national network of 54 entities known as the State Health Insurance Assistance Programs

(SHIPs). The Administration for Community Living (ACL) funds SHIP programs, which offer volunteer counseling

and enrollment assistance to people on Medicare. SHIP grants are awarded to state agencies with

responsibility for administering insurance or senior services. In Missouri, this agency is the Department of

Insurance, Financial Institutions and Professional Registration (DIFP). DIFP has awarded the grant to operate

Missouri’s SHIP to Primaris Foundation, which has administered CLAIM since 1993.

CLAIM provides information about financial aid programs to people with limited income and resources and

helps with Medicare claims, billing, and appeals. Medicare beneficiaries and their families or those assisting

them can call CLAIM’s toll-free helpline, 1-800-390-3330. Call center representatives gather information from

callers and refer them to counselors in their area of for further assistance. Call center team members are not

trained counselors.

CLAIM serves Medicare beneficiaries through a statewide network of

Volunteers,

Local Community Partners such as hospitals, faith-based organizations, area agencies on aging,

community action agencies, independent living centers, senior programs, and others, and

Individual volunteer counselors affiliated with other organizations.

Community Partners support CLAIM counselors by providing them with space to provide face-to-face

counseling and access to equipment such as printers, copiers, and computers. Some provide additional

support.

CLAIM’s organizational office is in Columbia, with field staff in St. Louis, Kansas City, Springfield, and other

regions. There are approximately 300 year-round and seasonal volunteers who provide Medicare counseling

at approximately 170 community partner locations. Some of these volunteers are members of CLAIM

AmeriCorps.



CLAIM, as Missouri’s State Health Insurance Assistance Program (SHIP), relies on volunteers, AmeriCorps

Members, and collaboration with local Community Partners to serve the Medicare beneficiaries across the

state. These policies describe CLAIM’s governing principles and values that shape and guide our programs

volunteer involvement.

The purpose of establishing these volunteer policies is to support the mission of CLAIM and to foster

adherence to ethical values and to provide a safe, productive, and rewarding experience for CLAIM volunteers

who support Missourians with Medicare.



SECTION 1 – INTRODUCTORY VOLUNTEER ENGAGEMENT POLICIES

Related ACL SHIP/SMP policies – 1. 1, 1. 2, 1. 3, 1. 4

These policies apply to all volunteers who provide CLAIM services. Some policies may not apply to paid or in-

kind volunteer staff whose employers may have policies which supersede them. Every effort will be made to

inform volunteers of these policies, through orientation, during in-person meetings, webinar training, and by

providing the manual in print format and on the CLAIM website. In addition, local guidance and support are

available from the local coordinator and Regional Liaison.

The policies are written in the best interest of the overall program to ensure integrity and safeguard the long-

term reputation and sustainability of the CLAIM Program. These policies provide guidance to ensure

confidence among CLAIM volunteers. Volunteers are expected to follow the policies; failure to do so may

result in coaching and can lead to dismissal from the program.

Alterations of or exceptions to ACL-required polices requires advance, written approval from ACL and must be

requested by the CLAIM Program director. All other policies are reviewed by the director, management, and

appropriate staff.

These policies are created with true volunteers in mind, meaning those volunteers that do not receive regular

compensation for their time and effort. Those policies that do not apply to in-kind staff are noted within the

policy. CLAIM has defined different roles for volunteers. Many volunteers have more than one role within the

CLAIM Program. This flexibility provides an opportunity for volunteers to use their unique talents, time and

knowledge. See Appendix A for a description of responsibilities.

CLAIM Counselors help Missouri Medicare beneficiaries by offering one-on-one counseling, including in-

person contacts at the CLAIM office, outreach sites, by telephone, or at the home of a homebound client. See

guidelines for Home Visits.

Volunteers may also become Leaders in Outreach and attend events hosted by other organizations or those

sponsored by CLAIM. A Leader in Outreach receives specialized training.



An Administrative Support volunteer may assist with duties related to counselor training, SHIP Tracking and

Reporting System (STARS) data entry, receptionist, or other tasks that support the counselors and the CLAIM

program activities.

After becoming certified, a counselor may choose an area of expertise, as an Interest Specialist, such as Part D

prescription drug plans, Medicare Advantage Plans, or public assistance programs. Choosing to specialize may

involve additional training in the specific area.

Some experienced counselors work as Mentors. Mentors model counseling and advise new counselors on

counseling, reporting, and research techniques.



SECTION 2 – RISK MANAGEMENT AND HEALTH AND SAFETY

Related ACL SHIP/SMP policies – 2. 1, 2. 2, 2. 3, 2. 4, 2. 5, 2. 6, 2. 7, 2. 8, 2. 9, 2. 10

RISK ASSESSMENTS

The safety of CLAIM staff, volunteers, and beneficiaries is paramount. The program strives to operate a health-

and-safety-conscious work environment; delivering safe and reliable services to its beneficiaries. Risk

management is tailored to the CLAIM volunteer program as a whole. It is a dimension of effective and safe

role development, appropriate volunteer screening and placement, comprehensive volunteer orientation,

training, certification, and ongoing volunteer supervision and support.

A risk assessment of the roles, work, and activities of SHIP volunteers is conducted every three years. Regular

training and qualification procedures, volunteer performance management, and volunteer program

management activities are also completed. Risk management strategies are implemented as needed,

including local-level procedures that identify, prevent, and reduce the incidence and impact of risk.

INSURANCE

CLAIM volunteers are covered by the Federal Volunteer Protection Act of 1997 and Missouri Volunteer

Protection Act Chapter 537. 118. See Appendix B. These laws provide certain protections to volunteers,

nonprofit organizations, and governmental entities from lawsuits based on the activities of volunteers. In

addition, CLAIM volunteers injured in the course of their duties are covered by workers’ compensation

insurance. CLAIM ensures that volunteers are explicitly identified in the relevant policies as named insureds.

Volunteers are advised to notify their own automobile insurance provider about their CLAIM driving activities

(i.e. to partner site, training, outreach events) and ensure coverage is in place and provides adequate protection.

CLAIM volunteers who drive their own vehicle for CLAIM purposes are required to carry liability coverage on any

vehicle so used and have a valid driver’s license. The cost of this insurance and driver’s license is borne by the

volunteer.

A visual review of Certificate of Insurance Coverage and current driver’s license will be completed, and a

verification form signed annually by the Regional Liaison, Trainer or local partner coordinator and by the volunteer

and submitted to the central office. (Note this is a visual review of the documents and does not require copies of the

insurance card or driver’s license. This verification can be done at training, annual certification, and/or site visits.

Volunteers must immediately notify their Regional Liaison in case of vehicle insurance lapse or loss of a driver

license.



SAFETY TRAINING

Volunteers are informed of foreseeable hazardous activities, materials, equipment, or processes they may

encounter while performing volunteer work and are trained and equipped in methods to deal with all

identified risks during orientation at the community partner sites. Training for volunteers includes discussion

of safe work practices and methods for responding to potentially hazardous situations. Volunteers will

exercise caution in all work activities. Volunteers who violate safety standards, who cause hazardous or

dangerous situations, or who fail to report such situations are subject to coaching, and may include dismissal.

REPORTING ABUSE

CLAIM volunteers who witness instances of physical, psychological, financial, or verbal abuse of consumers

while performing their assigned duties should report this to their local community partner coordinator and

Regional Liaison to ensure appropriate follow-up action occurs. In concert with the director, a hotline report

will be made. In-kind volunteers will follow their agency’s protocol for reporting abuse. An Abuse Report will

be completed by the director in concert with the volunteer. See Appendix C.

PRIVACY AND LOCATION OF COUNSELING

Face-to-face work with individual beneficiaries primarily takes place at a local community partner site or at the

CLAIM office. When beneficiaries are unable to travel to the local community partner site, volunteers discuss

alternate meeting arrangements that will maintain beneficiary privacy with their Regional Liaison. Off-site

counseling work is not undertaken by volunteers without prior approval.

When one-on-one assistance is requested by an audience member at a public event, the CLAIM volunteer will

provide only general information and not gather any personal, financial or other confidential information from

the beneficiary. The beneficiary can provide a name and telephone number for a follow-up appointment to be

made.

HOME VISITS

CLAIM understands that travel may be difficult for some beneficiaries and/or their families. Where cost or

travel logistics are a legitimate hardship, the volunteer will attempt to locate a community transportation

service for the beneficiary at the expense of the consumer, and when necessary, make arrangements to meet



the beneficiary in a safe and secure public place that also provides an environment suitable for the exchange

of confidential information, such as a neighborhood library, or by arrangement with a partner agency located

more conveniently to the beneficiary.

In-kind volunteers are required to follow their agency policies regarding home visits. When home visits by a

CLAIM volunteer are determined to be necessary, the following procedures are required:

1) Visits are made in pairs (two volunteers or a volunteer and staff member).

2) Notice of the visit is provided to at least one other CLAIM staff or local coordinator. The staff needs to

know the time of the appointment, anticipated return time, and the beneficiary’s name, address and

phone number.

3) At least one of the two volunteers must have a functional, charged cell phone.

4) The availability of cell phone or and network coverage must be checked before entering the home;

where phone coverage does not exist, the visit must be cancelled.

5) Volunteers who do not feel comfortable as they approach the home, or feel uncomfortable or

threatened during a visit, must terminate visit in a non-confrontational manner and report the event to

their local coordinator and Regional Liaison.

6) Visiting volunteers notify the on-alert staff immediately upon return from the visit.

7) If the returned of the volunteers is overdue by more than 15 minutes, the on-alert staff attempts to

contact the visiting staff by cell phone as prearranged; two attempts to reach visiting staff are made at

five-minute intervals.

8) Failure to reach the visiting volunteers after two attempts triggers an immediate notification to the

coordinator of the volunteer or Regional Liaison who implements further actions as required, including,

for example, calling the beneficiary home, notification of authorities, and 9-1-1 report.

INCIDENT REPORT

Any accident or injury to or by a volunteer must be reported immediately to the local coordinator and

Regional Liaison. An incident may include, but is not limited to, an error in judgment, other misstep, or

substandard performance (particularly in relations to provisions of services given to one or more

beneficiaries), lost possession, boundary breach, offensive remark, or sense of risks or peril while on duty.



In response to a reported incident, the volunteer, coordinator, Regional Liaison and/or director will

ensure/oversee the notification of relevant authorities (management, police, public health, insurance, ACL,

etc.) as appropriate and undertake the steps necessary to respond to and resolve and document the incident.

See policy on complaints and grievances for additional information.

EMERGENCY CONTACT PROCEDURES AND DISASTER PLANNING

CLAIM volunteers are assigned to a volunteer community partner, therefore the community partner is

responsible for those volunteers at the site. Volunteers will have contact information for the community partner

coordinator and CLAIM staff directory in case of an incident, dangerous environment, or substantive

programming questions while on duty. In addition, it is important for the community partner coordinator to be

able to contact the volunteer in the event of a change of schedule or other event that requires off-hours contact.

Contact information must be exchanged at orientation training and at the site. Volunteer contact information

is also maintained at the CLAIM office. Volunteers will provide emergency contact information at initial training

and update annually for the CLAIM Program. Note: In-Kind volunteers will be asked for emergency contact

information.

CLAIM does not share volunteer information with Community Partners. Volunteers must share their own

information.


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SECTION 3 – VOLUNTEER PROGRAM MANAGEMENT

Related ACL SHIP/SMP policies – 3. 1-3. 38; 3. 41-3. 46, 3. 50-3. 108

INFRASTRUCTURE

CLAIM policies guiding volunteer program management will be applied equally to all volunteers, including

AmeriCorps Members, and compliance with these policies is a condition of continued volunteer and

AmeriCorps Member involvement in the program.

CLAIM strives to develop a volunteer team that mirrors the diversity of the community in which it operates.

CLAIM values the rich diversity of Missouri.

CLAIM accepts the service of volunteers with the understanding that such service is at the sole discretion of

CLAIM. Volunteers abide by the terms of the commitment form signed by them during the initial and annual

commitments. CLAIM may at any time decide to terminate the volunteer’s relationship with the program or

to make changes in the nature of their volunteer assignment. Similarly, a volunteer may at any time, for any

reason, decide to withdraw from CLAIM. In such cases, CLAIM requests that the volunteer provide 30 days’

advance notice.

CLAIM volunteers are a valuable resource to the program, staff, local community partners, and the

beneficiaries they serve. All volunteers are assigned to a community partner agency with a coordinator, and

they are given meaningful assignments, treatment as equal co-workers, effective supervision, and are

informed about significant matters affecting their roles. In return, volunteers agree to actively perform their

duties to the best of their abilities, comply with polices and other work-related direction and provisions, and

remain loyal to the CLAIM values, goals, and policies and procedures.

CLAIM Program staff engages and supports volunteers to create an effective, productive, safe, and rewarding

experience for volunteers. The following activities are completed:

a) Volunteers are assigned to a Regional Liaison and a community partner coordinator who has

designated responsibility for scheduling and managing the work of volunteers.


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b) An annual budget for the volunteer management unit is developed and includes staffing, volunteer

recruitment and screening, staff and volunteer training, volunteer supervision and recognition, and

other appropriate volunteer operations.

c) A database record is maintained pertaining to each volunteer and community partner, including but

not necessarily limited to application and related information gathered in the screening process, dates

of service, positions held, training and orientation received, duties performed, achievements attained,

including performance records including appropriate documentation of any performance issues,

awards received, record of exit and current contact information. All records are retained for five years

and stored securely. All background checks are maintained in the Primaris Foundation’s Human

Resources department. Volunteers are entitled to examine the contents of their personnel file, just as

paid staff may.

d) An annual certification process is completed by the volunteer coordinator and director. This includes a

review of training hours, commitment of time, reporting, and successful completion of a certification

test. Regional Liaisons, trainers, and local community partners have regular contact with volunteers.

ROLE DESIGN

CLAIM volunteers enhance the capacity of the program, and they work collaboratively with the Community

Partner site to achieve the program goals. They do not replace the paid staff. Volunteers supplement but do

not supplant the work of paid staff.

Volunteers may fill a wide range of standard roles at CLAIM. All roles must conform to the primary goals

CLAIM. The CLAIM team of volunteers has a role classification of Counselor, Leader in outreach,

Administrative Support, Interest Specialist, and Mentor. All role descriptions include the purpose of the role,

role duties, qualifications, and benefits of the role to volunteers. Standards of performance are established

for each volunteer role. A copy of the relevant standards of performance is provided to all volunteers at initial

certification and annually, in the form of certificates.

The Regional Liaison recruits and places volunteers only in settings where staff are clearly supportive of

volunteer involvement and willing to work together with, and provide support for the volunteer’s


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participation. Community partners sign a Memorandum of Understanding with CLAIM to host volunteers and

may assist with recruitment of volunteers.

Volunteers are expected to refuse work assignments whenever an assignment exceeds the parameters of the

volunteer role description, requires the volunteer to perform a function for which they have not been trained

or are not qualified, or exceeds the limits of their individual capacity. Volunteers may ask their Regional

Liaison to be assigned to a different community partner at any time.

Every volunteer will work in a safe and appropriate worksite that provides facilities, equipment, and space

necessary for the volunteer to safely, effectively, and comfortably perform their duties.

CLAIM regards volunteers as a key part of the team and accordingly requests a 12-month commitment and an

annual certification, which is granted to all volunteers who successfully complete a year of service. The

average length a time a volunteer serves is three years.

At the discretion of the Regional Liaison or the volunteer coordinator, leaves of absence are granted to

volunteers. Leaves of absence may be granted up to three months, for but not limited to needs such as

vacations, health issues, and family commitments. The Regional Liaison will keep in contact with the

volunteer throughout the leave of absence. If the volunteer does not choose to return after three months,

they will be retired from the program but may reapply at a later date.

RECRUITMENT

CLAIM’s recruitment messages include the need for volunteers in the community, the good they will do, and

the benefit, skills, and knowledge they will gain by being a CLAIM volunteer. These points are communicated

through outreach, targeted recruitment, and word-of-mouth. It is the responsibility of the Regional Liaison to

coordinate the activities with appropriate staff, partners, and volunteers.

Volunteers are recruited by CLAIM on a proactive basis, with the intent of broadening and extending

services to Missouri beneficiaries. Volunteers fulfill all screening, orientation, and training

requirements for the role in which they are interested before being accepted into service.

Volunteer roles are open to community members aged 18 years and above regardless of race, religion,

color, national origin, gender, gender identity, sexual orientation, ancestry, mental or physical

disability, medical condition, disability, political activity, marital status, or age.


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Opportunities to volunteer are publicized broadly and through a variety of methods to ensure that no

group of people is excluded because of limited distribution of information. CLAIM shares the

recruitment message through social media, statewide outreach (at presentations and exhibits, with

poster and brochure distribution and through approved notices in local media), targeted recruitment

(current partners and counselors identify potential volunteers, organizations and agencies the CLAIM

program collaborates with who assist with promotion, and use of VolunteerMatch. com and other

community volunteer websites) and lastly, through word-of-mouth (volunteers asking friends and

family, clients realizing the good we do and deciding to become a volunteer).

The Volunteer Coordinator in most cases will be the potential volunteer’s first contact with CLAIM.

The Coordinator will confirm receipt of the prospective volunteer’s application and/or their interest

and inform them the appropriate Regional Liaison will be contacting them within two weeks. In

addition, a wait list of potential volunteers is maintained and prospective volunteers will receive up to

three invitations to training before they are removed from the potential candidate list.

SCREENING

All prospective volunteers for CLAIM go through a standardized screening process for all positions to ensure the

relationship is a good fit for both the volunteer and the CLAIM Program. All prospective applicants will complete a

standardized application form and all prospective volunteers are interviewed to ascertain their suitability for, and

interest in, various roles at CLAIM. A prospective volunteer may inquire to learn more information about the program

before completing an application.

Prospective volunteers are notified early in the application process about the range of screening inquiries used

by CLAIM for its various volunteer roles. No screening inquiry is undertaken without the prior knowledge and

permission of the applicant.

The decision to accept or deny each volunteer applicant is based on careful consideration of all pertinent

information gathered in the screening process. Acceptance as a volunteer is not automatic. CLAIM reserves

the right reject applicants based on an objective and equitable assessment of their suitability.

Screening and acceptance decisions are made by authorized persons only, typically the Regional Liaison.

While screening processes vary by role, applicants for any given role are screened in the same way as all other

applicants for that same role.


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No person who has a conflict of interest in connection with the work they will do at CLAIM, whether personal,

philosophical, or financial may serve as a volunteer. Volunteers may not be employed with an insurance

company within the previous 12 months or have a license to sell insurance. Volunteers may not promote any

personal or business interest while undertaking their CLAIM assignment.

All prospective volunteers applying for any position of trust at CLAIM are subjected to a national-level criminal

record and sex offender check. At least two personal and/or professional references are checked for

prospective volunteers who may be placed in a position of trust at CLAIM. Prospective volunteers have the

right to refuse permission for any line of screening inquiry, in which case CLAIM reserves the right to

terminate the application process and refuse acceptance as a volunteer.

The confidentiality of information collected during volunteer screening is carefully protected and kept by

Primaris Foundation’s Human Resources. The documentation is retained for a minimum of five years after the

volunteer involvement with the program ends. For applicants who do not complete initial training or are not

accepted into the program, the documentation is kept for six months after notification.

Falsification of information, including material omission or misrepresentation, at any point during screening is

grounds for immediate disqualification from the application process, or even immediate dismissal if the

falsehood is discovered after acceptance.

All CLAIM volunteers, regardless of length of tenure, are subject to the provisions of all volunteer policies,

including new policies coming into effect during an existing volunteer's tenure. Existing volunteers must meet

all new screening standards relevant to the role(s) they hold, with the exception of interviews and reference

checks which do not need to be initiated or repeated with the existing volunteers.

The first three months of a new volunteer’s service is considered an introductory period. This allows the

volunteer, Community Partner local coordinator, and Regional Liaisons time to determine if the program is a

good fit for the volunteer.


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Re-acceptance of previous CLAIM volunteers is not automatic. Re-acceptance decisions are based on past

performance and the results of any updated or additional screening inquires undertaken in connection with

the role for which the person is applying.

PLACEMENT

All new volunteers have an introductory period of three months after their initial training is complete and they

have been placed into a role. During that time, a mentor may be assigned, orientation at the partner site will

be scheduled, and the volunteer may determine if additional training is required, if the assigned community

partner is a good fit, and if the program as a whole is a good fit.

Adjustments are made wherever appropriate, including the possibility of placement into a different volunteer

role or different community partner that better suits the volunteer. If it is determined by either party during

the introductory period that involvement in the work of CLAIM is not appropriate, the counselor commitment

can be declared null and void and without prior notice or reason provided by either party. Between 30 and 60

days after a volunteer’s placement, a second interview with the volunteer will be conducted, providing an

opportunity for mutual assessment of the initial placement. Introductory status also applies to volunteers

who have been reassigned to new roles with the organization. CLAIM staff keep the following in

consideration:

When placing a volunteer in a role, attention is paid to the interests and capabilities of the volunteer

and to the requirements of the volunteer role. Placements are not made unless the requirements of

the volunteer, the role requirements, and the supervising staff can be met. Volunteers are not placed

in roles where paid staff are unsupportive. Wherever possible, paid staff who will be working with the

volunteer participate in the interview and placement process.

Service as a volunteer with CLAIM begins only with an official, written notice of acceptance or

appointment to a volunteer role.

Volunteers who are at any time re-assigned to a new role receive all appropriate orientation, training, and

updated screening (if applicable) before they begin work.


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ORIENTATION AND TRAINING

Becoming a Volunteer for the CLAIM program requires a serious commitment. To qualify as a CLAIM

volunteer, applicants must first complete the Volunteer Application. See Appendix D. Prospective volunteers

must not

Have a current license to sell insurance,

Have been active in selling insurance, or worked for an insurance company for at least one year

prior to application,

Have any potential financial gain from being a CLAIM volunteer.

Applicants must be able to find information on the Internet after training on the use of specific Web sites.

Prospective counselors must sign the Counselor Commitment and Confidentiality/Conflict of Interest Form

and a Media Release in addition to the forms allowing screening.

Volunteer counselors are initially certified after attending a three-day CLAIM Initial Medicare Training and

national online training including the successful completion of a post-course online examination. CLAIM, like

SHIP agencies in other states and territories, was created as an organization of volunteers helping Medicare

beneficiaries. CLAIM counselors assist with

Medicare enrollment and billing,

Medicare prescription drug plans,

Medigap and other supplemental insurance,

Long-term care planning and insurance,

Medicare Advantage plans,

Public benefits,

Medicare appeals and grievances,

Suspected waste, fraud, and abuse, and

Programs that help with Medicare costs.

See Appendix E for a description of appropriate methods and prohibitions for volunteers when providing

counseling services.

Counselors must be certified every year by completing a minimum of 12 hours of training through continuing

education courses, conference calls, webinars, and other opportunities provided. The CLAIM Lead Trainer

tracks volunteer training hours throughout the year. When volunteers participate in training through a

conference call and/or webinar they must report participation to the CLAIM staff via email at

claimcallcenter@primaris. org

mailto:[email protected]


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Volunteers must register and successfully complete a quiz (when one is given) on the material presented at

any training session they attend to earn credit. Additionally, counselors are required to pass an annual

certification examination.

A counselor who specializes in a specific area such as Part D, Fraud and Abuse, etc., must have at least four

hours of additional training in that area. See Appendix B for Interest Specialist responsibilities.

A volunteer must commit to an agreed-upon minimum level of activities each month in counseling, outreach

services, or administrative service. Additional and/or modified training may be provided for volunteers in

Leaders in Outreach, Administrative Support, or Mentorship roles. Job descriptions define requirements.

Commitment forms specify the minimum levels required.

An orientation to the mission, values, and responsibilities of the CLAIM program during orientation is

completed by the trainer, Regional Liaison, and volunteers when possible. Local community partners will also

provide an orientation to their organization’s facilities, security, and office protocol. CLAIM has paid trainers

who provide training to volunteers. Trainers may invite other experts on the subject to participate in training,

when appropriate.

Volunteers may participate in more than one role and may be invited to be part of another team. In some

cases, the Regional Liaison may choose a volunteer to accept or assist with another role that may be a better

fit.

PERFORMANCE MANAGEMENT

CLAIM’s goal is to provide the structure to provide a wide range of support and a variety of techniques for

staff to encourage and enable volunteers to have a productive and satisfying volunteer experience.


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Volunteers will be advised about the volunteer performance requirements during their initial orientation with

CLAIM and on an ongoing basis by the Regional Liaison, trainer, or the local coordinators, who follow these

policies and procedures in their day-to-day work with volunteers. In instances where more support,

understanding, or direction is needed; they will help the volunteer to achieve necessary modifications.

Upon acceptance into service with CLAIM, volunteers agree to accept supervision and support from

designated leaders. Each volunteer who is accepted has an identified coordinator or Regional Liaison who is

responsible for direct supervision and support of that volunteer.

CLAIM has both the right and the obligation to provide supervision and support to manage the work done by

volunteers and to determine the nature and extent of guidance provided. Supervision and support of the

volunteers reflects the principles of positive, constructive, and success-oriented guidance that underpins

CLAIM’s volunteer performance management system.

Experienced and qualified volunteers may be assigned volunteer leadership and support responsibilities,

provided that they are connected to a local coordinator/or leader.

Volunteers receive all information pertinent to the performance of their work assignments. Accordingly,

volunteers are included in and have access to all appropriate information, memos, materials, meetings, and

consumer records relevant to work assignments.

Regional Liaisons maintain regular communication with the volunteer and the Volunteer Coordinator on the

status of the volunteers they are supervising, and are responsible for the timely submission of all necessary

paperwork. The Volunteer Coordinator is informed immediately of any substantial change in the work or

status of a volunteer and is consulted in advance before any proposed corrective action is taken. Issues

requiring corrective action may include lack of reporting, not reporting to site when scheduled, sharing

personal bias versus being unbiased in counseling, misrepresentation of themselves, not following community

partner’s guidelines, etc. Volunteers will receive periodic feedback about their work and the outcome of their

activities, including annual certification.


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CLAIM corrective action begins with the informal development of a coaching process, additional training, and

adjustment in duties, to the more formal written warning, suspension, or, absent of success through other

methods, dismissal of volunteers from the program.

CLAIM has a corrective action review and appeals procedure in place. Volunteers are made aware of the

appeals procedure upon acceptance into volunteer service. Actions will be taken against volunteers who fail

to represent company’s mission, vision and values.

The following are examples of possible issues or behaviors that may constitute grounds for dismissal. This is

not intended to be a comprehensive list.

Sexual harassment

Harm, abuse or mistreatment of beneficiaries, co-workers, or other persons

Gross misconduct

Serious misjudgment that may undermine trust in the volunteer, cause harm to others, or

diminish public trust in the program

Insubordination including failure or unwillingness to perform essential role responsibilities

and/or accept direction from local coordinator or Regional Liaison

Unauthorized use or misuse of CLAIM equipment or materials

Serious and repeated failure to abide by CLAIM policies and procedures

Failure to meet physical, cognitive, or emotional standards of performance

Repeated failure to satisfactorily perform assigned duties

Irresolvable conflict of interest

Serious breach of boundaries

Immediate dismissal will be required for the following issues. This is not intended to be a comprehensive list.

Stealing, fraud, or other illegal acts

Gross negligence causing bodily harm in connection with CLAIM services

Intentional or repeated breach of confidentiality agreement

Use of drugs or alcohol while on volunteer duty

Violence in the workplace

Volunteers may be released for the following reasons, though regular communications will happen prior to

being released. An example of a volunteer being released may include actions such as not meeting

commitment (i.e. reporting, not keeping hours of service, not attending training).


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The following are other issues that may be discussed with a volunteer and may result in being released as a

volunteer. Every effort will be made to resolve the issues.

Moved to new partner for a better fit

Inability to work compatibly with staff

Fitness to complete required tasks

Issues with tardiness and keeping appointments; not keeping the local coordinator/Regional

Liaison informed when not available

Lack of professionalism

Leave of absence longer than four months

All volunteers will receive a letter when they are retired as a volunteer or released from the program. The

community partner coordinator and Regional Liaison will be copied on the correspondence. Any current

clients or referrals will be reassigned. All correspondence will recognize and respect the rights, dignity and

confidentiality of the volunteer when released. Volunteers may resign from their service CLAIM at any time

for any reason. Thirty days’ notice is appreciated when resigning.

Filing Complaints or Grievances

Volunteers with complaints or grievances with staff, other volunteers, beneficiaries, or partner organizations

should communicate these to their coordinator. If the complaint involves the volunteer's own coordinator,

the volunteer conveys the complaint to the Regional Liaison. All complaints will be considered confidential.

The following outlines the process for volunteers to resolve a complaint or grievance. Every effort will be

made by the coordinator, Regional Liaison, and director as appropriate to achieve a speedy and effective

resolution of the situation, and the volunteer will be kept informed of the progress of this effort.

1) Volunteer and staff will try to resolve the issues by meeting together.

2) If unable to resolve the issues, the volunteer will put the issue in writing, and submit it to the director.

3) The director will acknowledge the receipt of the complaint and will discuss the issue with all parties

involved and provide a written response to the volunteer and, as appropriate, to the other parties

involved. The director has 10 business days to respond.

4) If the volunteer is not satisfied with the director’s decision, he or she may request in writing for the

complaint/grievance to be escalated to Primaris Foundation’s Human Resources department. The


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Human Resource Director will discuss the issue with all parties involved and provide a written response

to the volunteer and as appropriate to the parties involved. The director has 10 business days to

respond.

5) If the volunteer is not satisfied with the Human Resource director’s decision, he or she may request in

writing for the complaint/grievance to be escalated to the Missouri Department of Insurance’s SHIP

Liaison. The DIFP SHIP Liaison will discuss the issue with all parties involved and provide a written

response to the volunteer and, as appropriate, to the parties involved. The SHIP Liaison has 10

business days to respond, and this decision is final.

6) All notes and information will be forwarded through each step in the escalation process.

Outside Complaints

At times, accusations or complaints may be lodged by beneficiaries or outside organizations against

volunteers. Each complaint is investigated and a resolution found. Examples may include:

Follow up by trainer or Regional Liaison on the complaint and provide a resolution. If needed, provide

coaching to the volunteer.

Explain program responsibilities, funding, and purpose to the organization. Provide coaching to the

volunteer if needed, and/or provide resolution.

Volunteers Aging in Place

CLAIM values the commitment of volunteers and recognizes that at times, volunteers may want to continue

service although it is not a wise choice for the volunteer, the program, or the beneficiaries they serve.

CLAIM honors all volunteers. Attempts by volunteers to continue to provide services will be respected,

since the diminishing of one’s ability is through no fault of their own.

Coordinators and the Regional Liaison will find alternate methods for volunteers to provide services,

which may include changes in volunteer role, partnering with other volunteers, or enabling techniques.

Coordinator and the Regional Liaisons will encourage the volunteer to undertake their own self-

assessment of capacity. The volunteer will be encouraged to seek counsel from their own support

network, such as family member and others who might provide objective information regarding the

feasibility of continuing volunteer efforts.

Coordinator and the Regional Liaison will support the decision, if the volunteer choses to resign, and

reinforce to the volunteer that by resigning, they are not letting the program down or failing

commitments.


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In situations where the volunteer has exhibited diminishing capacity that significantly affects their

ability to perform their duties and the volunteer does not choose to resign, the director will initiate

retirement of the volunteer and honor the service they have provided.

Exit Interviews

Exit interviews provide the CLAIM Program with insights on program strengths and weakness. Exit surveys are

included in all retirement letters when a volunteer leaves the program. Responses are collected and reviewed

by staff. Program adjustments are made based on this feedback.

VOLUNTEER BEHAVIOR, PERFORMANCE AND ROLES

CLAIM Volunteers provide service in a responsible and objective fashion, without regard to the background or

characteristics of beneficiaries. They are representatives of both the CLAIM Program and their local

community partner while functioning in their assigned roles. Volunteers must wear their name tags when

volunteering.

The following provides additional guidance on expectation, performance and roles as volunteer. It is the

volunteer’s responsibility to seek clarification about policies as needed. Not understanding a policy is not

acceptable grounds for failure to comply. Questions about these policies may be asked of the local

coordinator, Regional Liaison, or trainer.

CLAIM volunteers perform their duties in an objective, timely and conscientious manner. They at all times act

in a knowledgeable manner, consistent with their training and these policies. The goal is for volunteers to feel

safe, prepared, supported, and competent in the fulfillment of their responsibilities.

CLAIM will clearly communicate role boundaries to volunteers through role descriptions, performance

standards, orientation, initial training, on-the-job training, and on-going training. Volunteers recognize and

respect the limits of their skills and abilities, and the boundaries and limitations of their role. If a volunteer is

in doubt regarding the limitations of their role, no action is taken until direction on the matter is received from

the Regional Liaison or the coordinator.


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Volunteers may not say anything or act in any way that might obligate or be construed as a formal CLAIM

statement or act in the following situations. This is not a comprehensive list.

Partisan politics,

Religious matters,

Business dealings or community issues,

Public statements that might in any way be construed as originating from or representing CLAIM,

Statements to the press regarding anything pertaining to the CLAIM Program, except if coordinated

by the CLAIM office,

Collaborations or joint initiatives not clearly authorized in advance by the CLAIM Program,

Any agreements, undertakings or contractual obligations on behalf of the CLAIM Program,

Representing themselves as a CLAIM volunteer at an insurance meeting, (i.e. Medicare Advantage

or any meeting they attend on a personal matter either in person or in social media interactions).

Volunteers may not use their affiliation with CLAIM in connection with partisan politics, religious matters,

business dealings, or community issues. Volunteers do not sell, recommend, or endorse any specific insurance

or medical product, agent or company, or provide religious or political perspectives or practices as part of

their service to CLAIM.


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Confidentiality and CLAIM’s Security Plan

Volunteers must sign a Counselor Commitment and Confidentiality/Conflict of Interest form annually. See

Appendix F.

The Protection of Confidentiality sets out confidentiality guidelines for CLAIM volunteers and staff.

Confidentiality is crucial to CLAIM services. CLAIM has confidentiality guidelines and a detailed plan for data

security. Emails shall not include personal information (i.e. list of medication, health information, Social

Security and/or Medicare number, date of birth). Volunteers should protect clients’ information as if it were

their own. Confidential documents containing beneficiary information, including client referral sheets, should

be maintained in a locked file cabinet and appropriately destroyed when no longer needed. In-kind volunteers

will follow their agency’s procedures regarding the protection of confidential information.

CLAIM uses a Client Authorization for Release of Information form for special circumstances. See Appendix G.

Insurance companies, doctors, and institutions may require Medicare clients to sign a special release form

before providing information about the client to CLAIM volunteers. Counselors must access only what

information necessary to solve the problem presented.

The uploading of Medicare Part D comparison and enrollment documents to STARS must follow the guidelines

provided by CLAIM and the local community partner site for saving these temporary documents on their

computers, if allowed. Documents must be destroyed after uploading. No documents may be saved and/or

maintained on a volunteer’s personal computer, laptop, tablet, or any other electronic device. An encrypted

thumb drive may be provided at enrollment events, which will be promptly returned to the Regional

Liaison/Trainer at the end of the event. AmeriCorps members will be issued an encrypted thumb drive.

Counselors must sign a Confidentiality Agreement for Receipt of Unique ID before the ID will be issued by

CMS. See Appendix H. This unique ID number, along with other information identifying the beneficiary, allows

a Medicare Customer Service Representative, as well as some Medicare Advantage and prescription drug plan

companies, to disclose certain information about beneficiary eligibility and claims for the purpose of assisting

them.


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Recording of time and activity and absenteeism

Volunteers must accurately complete and submit required information about their volunteer activity on a

timely basis. This may include timesheets required by the local agency, client or outreach contacts, and/or

other reports. Though they are expected to be reliable and punctual, when expecting to be absent from a

scheduled duty, volunteers should inform their staff coordinator as far in advance as possible so that alternate

arrangements may be made. Frequent absenteeism may be addressed by the local coordinator or Regional

Liaison.

Dress Code

Volunteers are responsible to present a good image to the beneficiaries and the community. Volunteers

should dress appropriately for the conditions and the nature of their volunteer duties, presenting a clean and

neat appearance.

Work Environment – Harassment and Alcohol and Drug Free Workplace

CLAIM is committed to providing a safe and respectful work environment for all personnel and beneficiaries.

No one has to put up with harassment for any reason at any time. No one has the right to harass anyone else,

in the workplace or in any situation related to CLAIM programs and services. We treat all complaints of

harassment seriously, whether they are made informally or formally. Action is taken on all complaints to

ensure that they are resolved quickly, confidentially, and fairly. Corrective action will be taken with anyone

who has harassed a person or group of people. Volunteers should report harassment to their local

coordinator and/or Regional Liaison.

CLAIM operates a work environment that is free of alcohol and drug use/abuse. This is a zero tolerance policy.

Non-compliance is grounds for immediate dismissal. If a volunteer is reported to be impaired as a result of

legal medication, the coordinator will determine whether the volunteer remains at work or work restrictions

are required.

Acceptance of Gifts and Honoraria

CLAIM volunteers do not accept gifts from beneficiaries, their families, caregivers, or other representatives.

Any such offerings are respectfully and tactfully declined, citing, as needed, this policy as the basis for their


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action. Honoraria offered to CLAIM volunteers are respectfully and tactfully declined, citing, as needed, this

policy as the basis for their action. Honoraria which are given to the CLAIM Program may be accepted by the

volunteer on behalf of the program. Exempted from this policy are one-time speakers’ gifts that can

reasonably be regarded as small or token and nominal value under $15.

Reimbursement of Expenses

CLAIM recognizes and supports the contribution of counselor activities by providing reimbursement to

counselors or their organizations for expenses incurred during approved activities including, but not limited to,

training, outreach activities, and special committee assignments. To receive reimbursement, volunteers must

complete the following, as applicable.

Submit a completed and signed expense voucher,

Complete and submit event form for outreach events (including material distribution, informational

table and/or exhibits),

Obtain prior approval for non-CLAIM training from the Lead Trainer, and provide documentation of

attendance and an agenda,

Complete a contact form for any home visits and/or mailings,

Obtain prior approval for supply purchases, and submit receipts, and

Submit postage receipts and a completed “Postage Log Sheet” for stamps provided by CLAIM along

with name of client contact(s) on the expense form. Staff will verify in STARS. Postage receipt(s)

are required along with expense form if requesting reimbursement for stamps purchased by the

volunteer.

Counselors will be reimbursed for mileage to outreach event(s) and closest training sites. In the event a

counselor wishes to attend training at a different location, prior approval for reimbursement is required.

Counselors are not reimbursed for mileage to their assigned counseling site and/or travel associated with

providing Medicare counseling to family members. Counselors are eligible for mileage reimbursement when

the monthly total exceeds 15 miles or more. Counselors must complete and sign the expense voucher to

receive reimbursement. Hotel arrangements and reimbursement for meals require prior approval of the

director for overnight travel.


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The CLAIM mileage rate is set as a matter of policy and determined by the IRS. Effective July 1, 2016, mileage

will be reimbursed at the IRS standard mileage rate. Standard mileage rate is 14 cents per mile for use of an

automobile in rendering gratuitous services to a charitable organization under § 170. See section 5 of Rev.

Proc. 2010-51. A form is available to help track travel for any volunteers who choose to use their volunteer

travel as a tax deduction. This rate is not necessarily adjusted annually.

In-kind counselors will not be reimbursed for activities if the employer makes reimbursement, however,

reimbursement may be requested by the employer or employee for the activities outlined in this policy.

Expense vouchers may be obtained from CLAIM staff at events, through the www. missouriclaim.org website,

or requested from the Regional Liaison or the CLAIM Call Center by e-mail or phone. Expense vouchers must

be submitted monthly in a timely fashion (within 30 days of the end of the month) to receive reimbursement.

Completed expense vouchers or appropriate receipts may be faxed to 573-817-8341 or mailed to the CLAIM

office. Reimbursement can be expected within two to three weeks from receipt of the expense voucher.

Access to CLAIM Property and Labor Disputes

As appropriate, volunteers have access to property of CLAIM and those materials and equipment necessary to

fulfill their duties, in addition to a local community partner site. Volunteers receive training in the operation

of any work-related equipment and have the same responsibilities as paid staff regarding the safe use and

maintenance of the equipment and materials.

When a worksite is affected by a labor dispute, the Regional Liaison, in consultation with CLAIM management,

determines whether it is appropriate for volunteers to continue their duties at the worksite and/or in

alternate settings.

Relationships with Beneficiaries

Volunteer relationships with beneficiaries have the same boundaries as those between paid staff and

beneficiaries. It is appropriate to be friendly, courteous, and caring, but it is not appropriate to become

friends with beneficiaries, their family members or others connected to the delivery of service while also

serving as their counselor. Friendships with beneficiaries can lead to unclear boundaries, inappropriate

https://www.irs.gov/Credits-&-Deductions/Individuals/Standard-Mileage-Rates-Glance

https://www.irs.gov/pub/irs-drop/rp-10-51.pdf

https://www.irs.gov/pub/irs-drop/rp-10-51.pdf

http://www.missouriclaim.org/


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expectations, the appearance of favoritism or exploitation, and conflicts of interest. Beneficiaries can be

referred to another counselor if there is a conflict of interest.

Volunteers do not enter into financial transactions with beneficiaries, their family members or caregivers,

either lending or borrowing in either direction. They do not engage in political activities, campaigning, or

lobbying during volunteer hours.

Volunteers are offered training opportunities regarding the norms of identified consumer groups/cultures and

they show respect towards the people they work with and are sensitive to consumers’ beliefs, traditions, and

lifestyles.

RETENTION AND RECOGNITION

CLAIM has a system for recognizing and rewarding the work done by volunteers, both individually and

collectively. Paid staff and volunteers responsible for volunteer supervision provide recognition of volunteer

service on a regular and day-to-day basis. The program wants to encourage and to develop the skills of

volunteers while they serve with the program. Whenever possible, a volunteer can request and expect

feedback on the results of their work, including data on volunteer contributions that allow CLAIM to meet its

service goals.

CLAIM believes recognition of volunteers is key to CLAIM’s success. Recognition is important for motivation

and to reward volunteers for the contributions they make to the success of the program. These are just some

of the ways CLAIM recognizes volunteers.

Believing one can never say “thank you” too much,

Giving respect and equal status to volunteers,

Involving volunteers in meetings, as appropriate,

Spending time and effort with volunteers to provide support, guidance, and show genuine

interest,

Writing thank you notes,

Sending notes of caring (i.e. , sympathy cards, get well cards),

Providing personalized certification cards and training certificates,

Providing a CLAIM briefcase, name tag, and volunteer pin,

Providing special recognitions given by DIFP,

Providing small gifts, such as annual calendars or other item during the holidays,


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Providing birthday and anniversary recognition,

Offering platinum and gold standard certifications,

Providing National Community Service Presidential Awards,

Publicizing volunteers’ service, contributions, awards, recognitions, and special services in

their local media,

Hosting annual recognition events, regionally and/or statewide.

VOLUNTEER/PAID STAFF RELATIONSHIP

Volunteers and paid staff are partners in implementing the mission and programs of CLAIM, with each having

an equal but complementary role to play. Each partner understands and respects the needs and abilities of

the other. An orientation to working with volunteers is provided to all paid staff at CLAIM and previous

experience in working with volunteers is a key consideration in hiring staff into that role. Paid staff will not

make unreasonable demands on volunteers or request that volunteers exceed the boundaries of the role

description or the limits of their individual capacity.

Lastly, Regional Liaisons and the coordinators who supervise volunteers provide oversight similar to that

provided to paid employees and individuals are evaluated on their own performance as well as on their ability

to develop effective working relationships with other team members. Staff receive routine training on

effective volunteer management to ensure the program exhibits the practices of a high quality volunteer

program.


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SECTION 4 – INFORMATION TECHNOLOGY

Related ACL SHIP/SMP policies – 4. 1, 4. 2, 4. 3, 4. 4, 4. 5

CLAIM has adopted an information management protocol that outlines procedures to control volunteer access

to and use of beneficiary information and the safe operation of computers used to collect and store program

and beneficiary information. Volunteers will follow each community partner’s guidelines for logging in,

protection of passwords, saving documents, etc.

The program has a protocol for use of the Internet, covering email use and appropriate access to web sites. In

addition, there is a protocol and appropriate training for volunteers who use wireless devices or their personal

computers while performing volunteer work.

If data is misplaced or stolen, volunteers immediately notify their Regional Liaison or coordinator so that

appropriate notification can be made to affected beneficiaries and to the Department of Insurance, and future

safeguards are instituted as appropriate.

All of the information security policies related to general computer and Internet use also apply to CLAIM

national data reporting software use.

Lastly, social media should be used responsibly by volunteers. The same principles and policies that apply to

volunteer behavior in any volunteer role also apply to all activities online.

A record of client contacts is maintained in the SHIP Tracking and Reporting System (STARS), an ACL website

that tracks contacts, and by CLAIM. Each counselor may request a CMS Unique ID, issued after they sign a

Confidentiality Agreement for Receipt of Unique ID. Counselors must complete STARS counseling reports for

each contact with a beneficiary or other person who is assisting the beneficiary.

Reporting CLAIM’s efforts on STARS keeps CLAIM accountable and measures performance nationally. It also

shows partners CLAIM’s impact on their communities. CLAIM values the accomplishments of its counselors.

STARS entries demonstrate how CLAIM compares with other SHIP programs.


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CLOSING

The CLAIM staff wants your experience with CLAIM to be rewarding and positive. Our goal is to provide a

program with the leadership and staffing to complete the mission of the SHIP program. CLAIM is a trusted

resource for helping individuals and communities navigate the Medicare system and has been since 1993. As

a CLAIM Volunteer, YOU MAKE A DIFFERENCE.

Welcome aboard, and know that your questions, concerns, and compliments are always encouraged and

welcomed.

Questions regarding the content of this handbook may be directed to a Regional Liaison/Trainer or to the

Director.