Disaster Volunteer Utilization Plan: Guidance Document
Version 1: February 2013
Acknowledgements
The Community Clinic Association of Los Angeles County would like to thank the following Disaster
Volunteer Toolkit planning group members for their efforts in compiling this draft Disaster Volunteer
Utilization Plan:
Sandra Shields, LMFT, CTS
Senior Disaster Services Analyst, EMS Agency
Jacqueline Rifenburg, RN, MICN
Disaster Resource Center Program Manager, EMS Agency
Brian Budds, RN, MS, JD
Ciraolo Consulting, LLC
Michael Ciraolo, RN, MS
Ciraolo Consulting, LLC
Jee Kim, MPH
Emergency Preparedness and Response Program
County of Los Angeles Department of Public Health
Terry Stone, Safety/Emergency Management Manager EMS
Henry Mayo Newhall Memorial Hospital
Christopher Riccardi
Emergency Management, Security and Environmental Safety
Providence Little Company of Mary Medical Center San Pedro
Carole Snyder
Emergency Preparedness Coordinator,
Presbyterian Intercommunity Hospital
Trevor Rhodes, MEM
Emergency Preparedness Coordinator, CCALAC
Madeline Kiefer
Community HealthCorps Navigator, CCALAC
NOTE: This is a draft document. Comments and suggestions can be directed to Trevor Rhodes at (213)
201-6507 or [email protected].
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Disaster Volunteer Utilization Plan: Guidance Document
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Table of Contents
Acknowledgements................................................................................................................................... 1
INTRODUCTION ............................................................................................................................................. 4
I. Executive Summary ................................................................................................................................ 4
II. Purpose ................................................................................................................................................. 5
III. Definitions and Acronyms .................................................................................................................... 5
BACKGROUND ............................................................................................................................................... 6
IV. Healthcare Sector: Clinics .................................................................................................................... 6
V. Triggers and Surge Strategies ............................................................................................................... 7
Indicators and Triggers.......................................................................................................................... 7
Clinic Tiers ............................................................................................................................................. 7
Clinic Facility Sizes: ................................................................................................................................ 7
Clinic Incident Command Team ............................................................................................................ 8
VI. Surge Strategies ................................................................................................................................. 10
Core Medical Surge Clinic Services ..................................................................................................... 10
Surge Strategies to Increase Patient Care........................................................................................... 11
Clinic Surge Staff Strategies Based on Facility Impact ........................................................................ 12
CONCEPT OF OPERATIONS.......................................................................................................................... 14
VII. Volunteer Use ................................................................................................................................... 14
Volunteer Use During Non-Emergency Events ................................................................................... 14
Role of Volunteers in an Emergency ................................................................................................... 14
VIII. General Volunteer Management ..................................................................................................... 14
Initial Issues to Consider ..................................................................................................................... 14
Requesting of Volunteers.................................................................................................................... 14
Supervision of Volunteers ................................................................................................................... 16
Tracking of Volunteers ........................................................................................................................ 16
Orientation and Training of Volunteers .............................................................................................. 16
Utilization Strategies ........................................................................................................................... 16
Demobilization of Volunteers ............................................................................................................. 17
IX. Credentialed (DHV) Volunteers.......................................................................................................... 18
Requesting of Credentialed Volunteers .............................................................................................. 18
Qualifications and Credentialing ......................................................................................................... 18
Legal Responsibilities and Liabilities ................................................................................................... 19
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Orientation and Training ..................................................................................................................... 19
Utilization Strategies ........................................................................................................................... 19
Demobilization .................................................................................................................................... 19
X. Affiliated Volunteers ........................................................................................................................... 19
Requesting of Affiliated Volunteers .................................................................................................... 19
Qualifications and Credentialing ......................................................................................................... 20
Legal Responsibilities and Liabilities ................................................................................................... 20
Utilization Strategies ........................................................................................................................... 20
Demobilization .................................................................................................................................... 20
XI. Spontaneous Volunteer Management............................................................................................... 20
Qualifications and Credentialing ......................................................................................................... 21
Legal Responsibilities and Liabilities ................................................................................................... 21
Utilization Strategies ........................................................................................................................... 21
XII. References ........................................................................................................................................ 22
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Disaster Volunteer Utilization Plan: Guidance Document
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INTRODUCTION
I.
Executive Summary
As surely as disasters will happen, volunteers will show up asking to help. The use of volunteers in the
medical community often raises concern because there are so many unknowns. How many volunteers
will come, and when? Will any of the volunteers have the skills we really need? What happens if
somebody gets hurt? Where will the volunteers stay? Who will feed them, and how? How will they
know where to go and what to do? Who will manage them? Who will provide liability insurance? The list
goes on.
While these concerns are all important, the value that volunteers can provide in the critical recovery
phase of a disaster cannot be denied. Volunteers offer skills necessary to help meet a clinic’s
commitments to the community. However, without an effective screening and referral process in place,
the convergence of volunteers without needed skills, organization, or training will hamper the clinic’s
response. Specialized planning, information sharing, and management structures are necessary to
coordinate efforts and maximize the benefits of volunteers during any disaster, therefore volunteers
must be anticipated, planned for, and managed through public, private, and non-profit coordinated
efforts.
Volunteers are successful participants in emergency management systems when they are flexible, selfsufficient, aware of risks, and willing to be coordinated. Volunteers want their time to be valued, and
they want to feel like they are making a difference in support of the disaster. The ultimate goal of
volunteers is to provide assistance to others. An effective volunteer management system positively
affects the volunteers themselves and thus contributes to the healing process of both individuals and
the larger community. To ensure that community clinic facilities are equally benefited by the efforts of
volunteers, policies, processes, documentation, training, and reporting structures must be in place prior
to the arrival of any volunteers at the clinic site.
This Disaster Volunteer Utilization Toolkit establishes recommended guidelines, procedures, and policies
for the effective utilization of volunteers across the whole disaster lifecycle at community clinics. Due to
the unique nature of various types of volunteers, the requesting, receiving, utilization, and
demobilization process is categorized into specific sections for credentialed, affiliated, and spontaneous
volunteers.
The toolkit does not address day to day use of volunteers in the clinic setting. Instead, the operational
concepts reflected in the plan focus on potential large-scale disasters that can generate unique
situations requiring novel responses when day-to-day resources are overwhelmed. The surge strategies
and volunteer utilization examples are designed to facilitate response to extraordinary emergencies or
disaster situations associated with natural disasters, human caused events, and technological incidents.
However, these concepts may be employed and practiced with preplanned special events conducted by
the clinic on a seasonal or annual basis. Normal clinic use of volunteers should be considered and
incorporated into the Disaster Volunteer Utilization Plan as deemed appropriate for your facility.
The toolkit is meant to function as just that: a toolkit. Take out the ‘tools,’ or pieces of information that
are relevant to your clinic, to fill existing gaps and provide a comprehensive approach to credentialed,
affiliated, and spontaneous volunteer management.
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II.
Purpose
The purpose of the Los Angeles County Community Clinic Disaster Volunteer Utilization Plan is to
provide a framework that strengthens the ability of Los Angeles County community clinics to rapidly and
effectively respond to emergencies through the coordination and utilization of credentialed, affiliated,
and spontaneous volunteers.
Recent natural and man-made catastrophic events have demonstrated the need for volunteer
healthcare professionals and lay volunteers to supplement and enhance response and recovery
capabilities during and after such events. Public health preparedness initiatives that include precredentialed volunteers have been developed to address local, regional, multi-state and federal
collaboration.
This Plan aims to provide community clinics with resources regarding the use of volunteers, including
information outlining the process of requesting, receiving, training, credentialing, utilizing, and
demobilizing volunteers.
III.
Definitions and Acronyms
Volunteer
Credentialed Volunteer
Affiliated Volunteer
Spontaneous Volunteer
DSW (Disaster Service
Worker)
DHV (Disaster Healthcare
Volunteer)
Someone who willingly provides his/her services without receiving financial
compensation.
An individual with some sort of medical or clinical qualification that is
registered within the Disaster Healthcare Volunteer (DHV) system. These
volunteers have had their credentials verified. They are requested through
the Medical Alert Center and are then deployed to hospitals and clinics that
need their services during an emergency. DHVs are not first responders;
these resources are not to be considered a rapid-reaction force.
Credentialed Volunteers might be physicians, medical assistants, registered
nurses, mental health professionals, emergency medical technicians, etc.
An individual that is attached to a recognized voluntary or nonprofit
organization and is trained for specific disaster response activities. Their
relationship with the organization precedes the immediate disaster.
Examples of affiliated volunteer groups include CERT, Search and Rescue
teams, the Disaster Medical Reserve Corps, and American Red Cross
Disaster Action Teams (DAT).
An individual who comes forward following a disaster to assist in response
efforts, without pay or other consideration. Spontaneous volunteers, also
called unaffiliated volunteers, are not initially affiliated with a response or
relief agency or pre-registered with an accredited disaster council.
However, they may possess training, skills and experience that can be useful
in the relief effort.
Any person registered with a disaster council or the Governor’s Office of
Emergency Services for the purpose of engaging in disaster service pursuant
to the California Emergency Services Act without pay or other
consideration.
Any individual with medical, health, mental health, and other specialties
that has been pre-registered in the DHV system. They have had their
qualifications verified and are registered as DSWs. During emergencies, they
are requested by and deployed to clinics and hospitals that need additional
medical staff.
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MHOAC (Medical and
Health Operational Area
Coordinator)
SEMS (Standard
Emergency Management
System)
NIMS (National Incident
Management System)
CERT:
EOC:
FEMA:
ICS:
NVOAD:
VOAD:
VRC:
Each Operational Area has a MHOAC who serves as a 24-hour, seven days a
week, single point of contact for disaster medical and health operations.
They assist the Operational Area Coordinator with the coordination of
medical and health resources within the Operational Area. This includes
evaluating the availability of resources within the Operational Area,
identifying medical health resource requirements as the status of an
incident changes, and assisting with the requesting, prioritization and
assignment of incoming resources.
The fundamental structure for the response phase of emergency
management in California. SEMS is required by the California Emergency
Services Act (ESA) for managing multiagency and multijurisdictional
responses to emergencies in California. The system unifies all elements of
California’s emergency management community into a single integrated
system and standardizes key elements.
A structured framework, similar in concept to SEMS, used nationwide to
coordinate emergency preparedness and incident management among
various federal, state, and local agencies.
Community Emergency Response Teams
Emergency Operations Center
Federal Emergency Management Agency
Incident Command System
National Voluntary Organizations Active in Disaster
Voluntary Organizations Active in Disaster
Volunteer Reception Center
BACKGROUND
IV.
Healthcare Sector: Clinics
The clinic sector is composed of health centers, including Federally Qualified Health Centers,
Department of Public Health clinics, and Los Angeles County clinics. These clinics represent a mix of
public and private entities that provide a number of services and face specific challenges in a surge
event. Due to regulations, clinics are unable to provide 24 hour patient care and satellite clinic sites are
limited to 20 hours of operations per week. They serve the uninsured and medically underserved
populations, and address cultural differences and economic disparities that can impact the health of
their patients.
Community Health Centers and Free Clinics are referred to collectively as “Community Clinics.” These
include federally funded and federally designated clinics, large and small clinic corporations. Community
clinics provide an assortment of primary non-acute medical and dental care services, and some have lab
and radiology. Most have a pharmacy or dispensary. Many also offer mental health and social services.
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V.
Triggers and Surge Strategies
Indicators and Triggers
When any of the triggers listed below are reached the clinic, the Incident Management Team should be
activated and the surge strategies outlined in the following section should be utilized, based on the
severity of the emergency.
□ 20% above average daily census
□ Staff loss/unavailability of 15-30%
□ Inability to transfer patients to hospitals
□ EMS/MAC notification of a system wide surge
□ Mayoral declaration of an emergency, or a federally declared disaster
Additional Triggers to Consider:
□ The incident significantly impacts or is anticipated to impact public health or safety
□ The incident disrupts or is anticipated to disrupt the Public Health and Medical System
□ Resources are needed or anticipated to be needed beyond the capabilities of the
Operational Area, including those resources available through existing agreements (day-today agreements, memoranda of understanding, or other emergency assistance agreements)
□ The incident produces media attention or is politically sensitive
Clinic Tiers
Clinic tier and size information can assist in the planning process of requesting volunteers and
recognizing various surge levels. This information should be used to determine how many volunteers are
needed, and how to reassign existing staff.
Tier III:
 About 30% of clinics fall in this category
 Facilities with annual census < 10,000
Tier II:
 About 65% of clinics fall in this category
 Facilities with annual census 10,000 – 100,000
Tier I:
 About 5% of clinics fall in this category
 Extremely high annual census
 Facilities that have the following:
o Urgent care and/or ambulatory surgery
o Pharmacy, Radiology and Laboratory
 On a daily basis, they provide a “higher level of care”
 They employ a high concentration of providers, MDs & RNs, with
Emergency Medicine experience and background
Clinic Facility Sizes:
Small:
Medium:
Large:
Corp. Office:
Facility offering patient services with 1-3 exam rooms and/or 1-20 total staff
members
Facility with 3-10 exam rooms and 20-50 total staff
10+ exam rooms and 50+ total staff on site
Facility supports clinical activities in an administrative capacity.
(May or may not be co-located with a patient services site)
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Clinic Incident Command Team
The Incident Command System (ICS) is designed to enable effective and efficient incident management
by integrating a combination of facilities, equipment, personnel, procedures, and communications
operating within a common organizational structure. Clinics should use the ICS to plan, organize, staff,
direct, and control emergency situations. The specific ICS organizational structure used will depend on
the scope and type of the emergency.
In most emergencies, core objectives should be prioritized as follows:
 Ensure life safety – protect life and provide care for injured patients, staff, and visitors
 Contain hazards to facilitate the protection of life
 Protect critical infrastructure, facilities, vital records, and other data
 Resume the delivery of services
 Support the overall community response
 Restore essential services/utilities
 Provide crisis public information
ICS staffing starts with the Incident Commander, and expands based on the positions needed to manage
the size and complexity of the incident. ICS employs four functional sections (Operations, Planning,
Logistics, and Finance and Administration) in its organizational structure. The Incident Management
Team is responsible for external notifications and ongoing communications with other responding
agencies, including DHV resource requests.
Sample Small Clinic Team Structure:
Sample Medium Clinic Team Structure:
Incident Commander
Operations Section Chief
(General Staff)
Medical Care
Branch Director
Labor Pool
Unit Leader
Incident Commander
Medical/Technical Specialist
(Command Staff)
Operations Section Chief
(General Staff)
Medical Care
Branch Director
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Planning Section Chief
(General Staff)
Finance/Administration
Section Chief
(General Staff)
Labor Pool
Unit Leader
Disaster Volunteer Utilization Plan: Guidance Document
Version 1: February 2013
Sample Large Clinic Team Structure:
Incident Commander
Operations Section Chief
(General Staff)
Public Information Officer
(Command Staff)
Safety Officer
(Command Staff)
Liaison Officer
(Command Staff)
Medical/Technical Specialist
(Command Staff)
Planning Section Chief
(General Staff)
Logistics Section Chief
(General Staff)
Finance/Administration
Section Chief
(General Staff)
Medical Care
Branch Director
Resources
Unit Leader
Service
Branch Director
Patient Tracking Unit Leader
Triage Unit Leader
Situation Unit Leader
Support
Branch Director
Labor Pool
Unit Leader
Security
Branch Director
Volunteer Coordinator
Sample Corporate Office Clinic Team Structure:
Incident Commander
Operations Section Chief
(General Staff)
Public Information Officer
(Command Staff)
Safety Officer
(Command Staff)
Liaison Officer
(Command Staff)
Medical/Technical Specialist
(Command Staff)
Planning Section Chief
(General Staff)
Logistics Section Chief
(General Staff)
Finance/Administration
Section Chief
(General Staff)
Medical Care
Branch Director
Resources
Unit Leader
Service
Branch Director
Patient Tracking Unit Leader
Labor Pool
Branch Director
Situation Unit Leader
Support
Branch Director
Labor Pool
Unit Leader
Volunteer Coordinator
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Credentialing Specialist
Disaster Volunteer Utilization Plan: Guidance Document
Version 1: February 2013
VI.
Surge Strategies
Core Medical Surge Clinic Services
The clinic services mentioned below are services likely to be required in the case of a medical
emergency. Included is a description of the service, and the tasks associated with it.
Mass Casualty Care
Description: Clinics should be prepared to
respond to a mass casualty event.
Tasks:
 Sufficient staff to manage patient surge
 Triage capability
 ALS Capability
 Holding
 Agreements with receiving hospitals
 Integration of clinic into operational area
medical response system
Reception and Triage
Description: During disasters, clinics may become
points of convergence for injured, infected,
worried, or dislocated community members.
Depending on the emergency and availability of
other medical resources, clinics may not be able
to handle all of the presenting conditions.
Minimum clinic role will likely be triage, reporting,
stabilization, and holding until transport can be
arranged.
Tasks:
 Reception area
 Response plan
 Staff recall procedure
 Crowd Management
 Location of Shelters
 Triage tags
 Triage training
 Medical supplies
Reception of Hospital Overflow
Description: In disasters, hospitals may be
Tasks:
overwhelmed with ill and injured patients requiring  Requirements above for mass casualty care
high levels of care, while at the same time facing
 Prior agreement that defines: circumstances
convergence from patients with minor injuries or
for implementation, types of patients that will
the worried well. Clinics may be requested to
be accepted, resource/staff support provided
handle people with minor injuries of patients to
by hospital, patient information/medical
relieve the pressure on the hospital.
records, liability releases
Mental Health Services
Description: Clinics can expect the convergence of Tasks:
the “worried well” following a disaster.
 Disaster mental health training for
clinicians/licensed mental health staff
 Internal or external mental health team
 External source of trained personnel to
augment response
Mass Prophylaxis
Description: Clinics may be requested to
participate in mass prophylaxis managed by the
local health department.
Tasks:
 Availability of staff who can volunteer
 Procedures for determining when clinic staff
can volunteer
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Surge Strategies to Increase Patient Care
The diagram below illustrates possible surge strategies that can be implemented in clinic surge
situations. When there is an increase in the number of patients at the clinic and a loss in normal staff
availability, consider the suggestions below to increase the clinic’s patient care capabilities. Begin with
the box on the left, and move to the middle and right boxes as more patients come to the clinic.






Cancel elective
appointments
Process to extend normal
outpatient clinic hours
Rapid patient discharge
Reassign staff
Recall staff
Utilize staff from other clinic
sites
 Standing orders for licensed
nursing staff
 Standing orders for medical
assistants
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
Increase staff via requesting
and assigning credentialed
volunteers (DHV, DMAT,
Disaster Service Workers),
affiliated volunteers, and
spontaneous volunteers

Establish unlicensed
treatment areas (ex.
Outpatient surgery rooms,
parking lots, waiting rooms)

Establish temporary
treatment areas (ex. Tents)
Disaster Volunteer Utilization Plan: Guidance Document
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Clinic Surge Staff Strategies Based on Facility Impact
On the following page, you will see a table that outlines the five different levels of facility surge.
Depending on the current level of surge at the clinic, different services can be prioritized and staff can
be reassigned to meet the needs of certain services. If the clinic facility continues to experience surge
and moves to more extreme surge levels (ie. Red or Black), volunteers from affiliate agencies and the
DHV system should be requested.
A blank Clinic Surge Staff Planning Matrix is provided in Appendix 7, and should be filled out by the clinic
prior to an emergency. In this matrix, every row should represent a different clinic service (ie. General
Medicine, Pediatrics, Laboratory, Radiology, Mental Health, OB/GYN, Triage). The columns should be
filled out, outlining the staff used for a given service depending on surge level. As surge increases, staff
should be reassigned, assigned, or have volunteers requested, depending on whether that service is
necessary in an emergency. (For example, triage will most likely need more staff assigned to its service,
or have volunteers requested, while OB/GYN and radiology can most likely reassign their staff to other
services). Clinics should fill out two versions of this matrix: one for sudden onset events, such as
earthquakes, and one version for slow onset events, like a pandemic.
Use the following Service Surge Strategies Staff Category Legend, and list of possible services offered at
the clinic site to fill out your blank Matrix.
Service Surge Strategies
NO
EH
IS
RS
RV
CS
Normal Operations
Extend Hours
Increase Staff
Reassign Staff
Request Volunteers
Close Service
Possible services offered at clinic site:
 General Medicine
 Pediatrics
 OB/GYN
 Urgent Care
 Mental Health
 Dental
 Laboratory
 Radiology
Staff Categories
MH
Mental Health Worker
NP
Nurse Practitioner
OB/GYN
Obstetrician
PA
Physician’s Assistant
PED
Pediatrician
RN
Registered Nurse
REG
Intake Worker (Billing Office, Receptionist,
and Registration)
WIC
Women, Infants, and Children
DDS
Dentist
DA
Dental Assistant
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IN
NIN
CCN
NCN
PHM
RTH
MD
Intensivists
Non-Intensivists
Critical Care Nurses
Non-Critical Care Nurses
Pharmacists
Respiratory Therapists
Physician
MA
DN
HE
Medical Assistant
Dental Hygienist
Health Educator
Disaster Volunteer Utilization Plan: Guidance Document
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Service Surge Strategies Based on Facility Impact
Surge Monitoring Diagram Color Descriptions
The designations of the surge monitoring colors will be made by the authorized designee from the clinic operations/command center to the local
jurisdiction. Below is a description of each of the five facility levels of surge.
 Green (Normal Operations): Facility is operational and in usual day-today status. No assistance from the jurisdiction required
 Yellow (Under Control): Facility is experiencing a surge and is able to manage the situation within their organization. No assistance from
the jurisdiction required.
 Orange (Modified Services): Facility is experiencing a surge and has begun to modify their services. Some assistance from the jurisdiction
required.
 Red (Limited Services): Facility is not capable of meeting the demand for care, are able to offer limited services and requires assistance from
the jurisdiction.
 Black (Essential Services): Facility is not capable of meeting the demand for care.
*Surge Diagram colors and descriptions were adapted from the CDPH Standards and Guidelines…Foundational Knowledge
CLINICS
MODE OF
OPERATIONS
STAFF
Normal Operations
- Continue Operations,
i.e. Do not close doors;
all regular clinic patients
self-refer to the hospital
& emergency dept for
regular, ongoing, chronic
care needs
- Triage by phone
Under Control
Modified Services
Limited Services
Essential Services
- Reassign staff with a
clinical background
according to their skillset
- Standing orders for
licensed nursing staff
- Standing orders for
medical assistants
- Standing orders for licensed
nursing staff
- Standing orders for medical
assistants
- Increase staffing via accepting
and assigning healthcare
volunteers (DHV, DMAT, etc.)
- Increase staffing via
accepting and assigning
healthcare volunteers and
displaced county workers
(DHV, DMAT, Disaster Service
Workers, etc.)
- Cancel non-urgent
appointments
- Provide medication by
phone, or fast-track, e.g.
medication refill, ‘known’
clinic patients, etc.
- Extend operating hours
- Accept Minor, Stable,
ambulatory patients
from the hospital via
referral
- Tier 1 Urgent Care and
MACCs to accept minor,
stable patients via BLS
transport
- Implement Continuity
of Operations Plan
- Tier 1 Urgent Care and MACCs
to accept minor, stable patients
via BLS Ambulance transport
- Continue to provide care to
clinic patients (stable and noncritical) beyond the 23 hour limit.
- Implement Continuity of
Operations Plan
- Implement Continuity of
Operations Plan
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CONCEPT OF OPERATIONS
The concept of operations describes a strategy behind organizing the multiple volunteer management
functions into a system.
VII. Volunteer Use
Volunteer Use During Non-Emergency Events
Volunteers may be used to support disaster and community events, public health events such as health
fairs, exercises, and immunization clinics. Clinics should consider training volunteers that are already
registered as volunteers at their clinic in emergency response, and contact them if an emergency should
occur and their assistance is needed.
Role of Volunteers in an Emergency
Volunteers can be a significant resource of timely manpower, skills, and abilities, while providing
valuable insight on a community’s needs. Often, volunteer assistance is important because it can be
quickly provided by people living or working close to damaged areas. Volunteers can also augment
emergency staff with basic skills and support activities, allowing responders to focus their efforts on
specialized work. In addition to helping others, some believe that participating in volunteer service is
helpful to disaster victims. Volunteerism has been suggested as an avenue to reduce stress, as an outlet
for rage, as part of the healing process, and as a means of empowering victims.
VIII. General Volunteer Management
Initial Issues to Consider
Before requesting volunteers, clinics need to consider whether or not they can provide certain services
for their volunteers. If you cannot provide your volunteers with food, transportation, and lodging, you
need to make sure that the volunteers that you request are able to bring their own food, have
somewhere to stay, and have transportation to the clinic.
If the clinic is experiencing an austere condition (ie. Exposure to hazardous materials or contagious
pathogens), volunteers must be informed so they can bring the required personal protective equipment.
Similarly, volunteers should be informed of any other special conditions that might influence their ability
to volunteer, or might influence what they bring to the clinic. For example, volunteers with asthma
would need to know if there were large amounts of debris and dust so they know to bring their inhaler.
Requesting of Volunteers
The requesting process varies depending on what type of volunteer is being requested (credentialed or
affiliated). Below is a flowchart that outlines the process.
 This flowchart can also be found in Appendix 2a.
 See the “Requesting of Volunteers” section under both “Credentialed Volunteers” and
“Affiliated Volunteers” for more specifics.
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Supervision of Volunteers
An appropriate level of supervision must be provided to volunteers at all times. The supervisor’s job is to
ensure that volunteers understand their responsibilities, know how to carry out their work, and are
meeting performance standards, especially in regard to safety. Supervision ensures volunteers are
correctly utilizing necessary supplies and equipment and not creating a situation which may cause harm
to others. Additionally, Volunteer Coordinators and other clinic employees working with volunteers
should be trained to recognize signs of critical incident stress among volunteers.
Tracking of Volunteers
Volunteers who are deployed must be accounted for from the initiation of assignments through
demobilization. This involves:
□ Signing volunteers in and out
□ Noting the role they were assigned to and the tasks they completed
□ Rating their performance
 Use the Disaster Volunteer Registration Form (Appendix 3f) and HICS 253 and 252 forms
(Appendix 4a and 4b) to properly and efficiently register and track your volunteers.
Orientation and Training of Volunteers
Developing a plan for orienting, training, and supervising volunteers is essential to the successful
involvement of volunteers in disaster response and recovery efforts. Training helps ensure safe
volunteer operations, tells volunteers they are being taken seriously, helps maintain consistency and
quality of services to clients, and helps protect the interest and assets of the organization.
The amount and type of training that volunteers receive should be based on:
 The level of the volunteers’ experience
 The risk of the activity they will be engaging in
 The complexity of the task
 The equipment required
 Any policies or regulations related to the task
Volunteers should be oriented to the organization and the disaster situation. Orientation should cover:
□ The agency’s disaster mission, key policies and procedures
□ Safety instructions, what to do in case of accident or injury, and relevant environmental factors
□ A tour of necessary facility sites
□ A written description of their role, to include known skills, knowledge, or abilities to support
each role
 Read Appendix 3g: Disaster Volunteer Orientation Checklist for more instructions on how to
orient volunteers.
 See the “Orientation and Training” section under “Credentialed Volunteers” for more
information on training DHVs.
Utilization Strategies
Fill out the Clinic Surge Staff Matrix in Appendix 7 to determine how you will utilize volunteers during an
emergency.
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Demobilization of Volunteers
All volunteer activities will, at some point, come to an end. This may occur as a whole for all volunteers
involved in a mission or for individual volunteers as they reach the limits of their ability to volunteer or
at the end of their assignment. In all cases, there are steps that need to be taken to ensure that assigned
duties are addressed, volunteers’ concerns are taken into consideration, logistical concerns are attended
to, and the volunteer’s experience is appreciated and documented. The following should be addressed:
Release from Duty
Before a disaster volunteer can be demobilized, they must be released from duty by their immediate
supervisor. The Volunteer Coordinator should confirm their release from duty through pre-identified
documentation protocols.
Volunteer Brief of Replacement
Volunteers should brief any replacement staff, be they volunteer or otherwise, if appropriate, on all
pertinent information needed to perform the job and ensure smooth operations.
Out-processing and Exit Interview
An exit interview should be conducted to educate the volunteer about the typical physical and mental
health reactions to disasters, and to inform them of the follow up resources available if the typical
mental health reactions last longer than the volunteer is comfortable with and/or it interferes with their
functioning. At small facilities, the Volunteer Coordinator may assume this role. Ideal candidates for this
role may come from Human Resources staff or Mental/Behavioral Health staff.
 Use the “PsyStart Staff Self Triage System” form (Appendix 3e) to assess the physical and mental
health of each volunteer
Notification of Home/Sponsoring Organization
The receiving clinic is responsible for ensuring that the sending organization is informed of the
demobilization of the disaster volunteer.
Completion of Tracking Data
Confirm that Appendix 3f: Disaster Volunteer Registration Form is completed for each volunteer (this
form should be filled out for each volunteer when they are received). In addition, the number of hours
worked should be noted using Appendix 4a: HICS 253 or Appendix 4b: HICS 252. All post-deployment
records must be properly collected and stored according to local guidance.
Debriefing and Assessment
It is important to understand what the volunteer experience was like and what lessons can be learned
for future volunteer use. The receiving clinic may ask volunteers to participate in debriefing and may use
their own volunteer feedback form if they have one.
 Use Appendix 4c: ICS 226 Individual Performance Rating form to assess the performance of each
volunteer
Transportation Back to Point of Departure/Embarkation
Depending on arrangements made at the time of the deployment, the receiving clinic is responsible for
arranging disaster volunteer transportation back to the point of departure/embarkation or initiating the
process to request transportation from the sending organization.
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IX.
Credentialed (DHV) Volunteers
Disaster Healthcare Volunteers (DHV) is a statewide “database” of volunteers that have some type of
medical expertise, such as physicians, nurses, EMTs, and medical assistants. All of the volunteers in the
database have signed up to help in the case of a disaster. Clinics utilizing this resource will need to
establish a just-in-time on-boarding process to ensure volunteers have all the information and resources
they need to adequately respond to an emergency and maintain existing clinic controls and standards of
care.
Requesting of Credentialed Volunteers
Fill out the “Resource Request Medical and Health” form (Appendix 2b) and the supplementary
“Disaster Healthcare Volunteer Personnel Request Form” (Appendix 2c) to request DHVs. These forms
should be submitted to one of the following contacts (listed in order of preference):
1. ReddiNet (for clinics with access)
2. Los Angeles Emergency Medical Services Agency:
a. Email: [email protected]
b. Fax: Medical Alert Center (562) 906-4300; DOC (562) 944-5248
c. Phone: Medical Alert Center (866)-940-4401
3. The Community Clinic Association of Los Angeles County (CCALAC)
a. Email: [email protected]
b. Fax: (213) 250-2525
c. Phone: (213) 201-6500
4. Everbridge
5. CWIRS Radio: for County Comprehensive Centers
6. HAM Radio (Frequency List available by request)
The Disaster Healthcare Volunteer Request Form requires clinics to denote the desired Emergency
Credential Level (ECL) of the DHVs deployed to their clinic site. The legend below should be used to
determine which ECL is required for the tasks of DHVs at the clinic:
ECL I: Hospital Ready
ECL II: Clinically Ready
ECL III: Active License
ECL IV: Training/Experience
Qualifications and Credentialing
Volunteers who are deployed through the DHV program will have had their licenses verified
electronically within the 24 hours prior to deployment. Thus, you can be assured that a licensed
volunteer had a valid, unencumbered license at the time of deployment. Any board certifications or
DEA numbers will also be verified prior to deployment. In addition, volunteers’ work is verified within six
months of deployment. Thus, you will be informed if a volunteer has recent hospital or clinical
experience. All DHVs will be sworn in as Disaster Service Workers prior to deployment.
Joint Commission Standards dictate that healthcare facilities should verify the qualifications of each
credentialed volunteer within 72 hours of the demobilization of the volunteer.
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Legal Responsibilities and Liabilities
Volunteers processed and delivered through county agencies are sworn Disaster Service Workers with
workers’ compensation liability coverage. In addition to this coverage, many federal and state laws exist
to protect disaster volunteers. It is important for each clinic to carefully consider their own liability
protection needs, and enact policies, procedures, and waivers as they see fit. For more information on
existing legislation, see Appendix 6c: Disaster Volunteer Legal Summary.
Orientation and Training
The onboarding process for DHVs should include shadowing and/or mentoring for 1-2 hours, a tour
showing volunteers storage and resource locations, reporting structures, and other important places.
Utilization Strategies
Fill out the matrix provided in Appendix 7, and described on page 12 of this Guidance Document, to
determine how you will utilize your requested DHVs during an emergency.
Demobilization
See the “Demobilization Section” under General Volunteer Management for the steps involved in
volunteer demobilization.
In addition to those steps, clinic staff should inform the Department of Health Services Department
Operations Center (DHS DOC) of the demobilization of each DHV, and ensure that the following forms
are sent to the DHS DOC:
 PsySTART Staff Self-Triage System form (Found in Appendix 3e)
 ICS 226 Form (Individual Performance Rating) (Found in Appendix 4c)
X.
Affiliated Volunteers
An affiliated volunteer is an individual who is affiliated with either a governmental agency or NGO and
who has been trained for a specific role or function in disaster relief or response during the
preparedness phase.
Requesting of Affiliated Volunteers
To request affiliated volunteers from an outside agency, fill out the “Affiliated Volunteer Personnel
Request Form” in Appendix 2d and send the form to the Community Clinic Association of Los Angeles
County (CCALAC):
 Email: [email protected]
 Fax: (213) 250-2525
 Phone: (213) 201-6500
Prior to emergency personnel being deployed to an incident, the requestor and provider should agree
upon who will provide logistical support, including transportation, lodging, feeding, and specialized
equipment and materials.
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Qualifications and Credentialing
The credentialing of affiliated volunteers may vary depending on the affiliate organization in question,
so specific qualifications desired or required for certain tasks should be denoted on the Volunteer
Request Form.
Legal Responsibilities and Liabilities
Affiliate volunteers might not be sworn in as DSWs and therefore may or may not be covered by the
county for liability purposes. Clinics receiving non-DSW volunteers should include the signing of a
Liability Release Form in their onboarding process.
Utilization Strategies
Your clinic should develop an internal policy addressing the use of affiliated volunteers during
emergencies. You should use your judgment in determining how you will use these volunteers. Below
we have provided some utilization strategies:
 Crowd control
 Non-medical service control
 Clean-up
 Safety and building inspections
 Data entry and clerical support
 Animal care
 Interpreting
 Construction
Demobilization
See the “Demobilization Section” under General Volunteer Management for the steps involved in
volunteer demobilization.
In addition to these steps, clinics should also notify the home (i.e., sending) organization of the
demobilization of the affiliated volunteer. All volunteer forms, including Disaster Volunteer Registration
Form, ICS 226 (Individual Performance Review) and HICS 252 or 253 forms, should be sent to the
sending organization.
XI.
Spontaneous Volunteer Management
Ideally, all volunteers should be affiliated with an established organization and trained for specific
disaster response activities. However, the spontaneous nature of individual volunteering is inevitable;
therefore it must be anticipated, planned for, and managed. Specialized planning, information sharing,
and a management structure are necessary to coordinate efforts and maximize the benefits of volunteer
involvement. Clear, consistent, and timely communication is essential to successful management of
spontaneous volunteers. A variety of opportunities and messages should be utilized in order to educate
the public, minimize confusion, and clarify expectations.
Although the media often present volunteer efforts as exclusively positive, serious issues and risks are
commonly associated with massive convergence. Volunteer efforts can be ineffective because
organizations and management system have not prepared for nor considered how to integrate the
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volunteer resources. As a result, response personnel are diverted from their primary duties to consider
how spontaneous volunteers will be used, to create and assign tasks, to manage logistics related to
volunteers, and to supervise actions.
With efficient management, however, spontaneous volunteers are a valuable resource to the
community and contribute to positive public perception of local government response and recovery
efforts.
Qualifications and Credentialing
Clinics should assume that spontaneous volunteers have no formal qualifications. The Volunteer
Coordinator should have each volunteer fill out a Volunteer Application (Appendix 3c) upon arrival,
which includes their contact information, availability, occupation and skills, and more. Volunteer
Coordinators should also interview all potential volunteers (see Appendix 3b: Disaster Volunteer
Interview Record). This will give Volunteer Coordinators an idea of what task to assign each spontaneous
volunteer to.
Legal Responsibilities and Liabilities
It should be assumed that spontaneous volunteers come with no liability coverage, and should go
through the clinic’s standard volunteer onboarding process.
Utilization Strategies
Develop a system coordinated by the ‘formal’ responders and pre-trained volunteers that can integrate
a large number of spontaneous volunteers. This strategy essentially transforms spontaneous volunteers
(individuals with or without specialized skills) into an assigned resource.
Your clinic should develop an internal policy addressing the use of spontaneous volunteers during
emergencies. You should use your judgment in determining how you will use these volunteers, and use
forms provided in Appendix 3 to interview volunteers and determine which skills they possess that could
help the clinic’s emergency response efforts. Below are some utilization strategies:










Managing traffic flow
Acquiring goods and services from the community
Coordinate and process other spontaneous volunteers
Sandbagging in the case of a flood
Debris removal
Resource management (coordinate pick-up and distribution of supplies, clear out spaces,
restock medical supplies in triage stations)
Answer phones
Distribute food and water
Clean up
Interface with CERT
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XII. References
A Community Clinic Guide to Disaster Response: Incident Management Team Development,
The Community Clinic Association of Los Angeles County
California Public Health and Medical Emergency Operations Manual, California Department
of Public Health
Emergency Volunteer Center Activation Guide, Voluntary Organizations Active in Disaster,
Santa Barbara County
Los Angeles County Disaster Healthcare Volunteers Deployment Operations Manual, Los
Angeles County Department of Public Health and Emergency Medical Services Agency
Managing Spontaneous Volunteers in Times of Disaster: Participant Materials, Points of
Light Foundation and the Corporation for National and Community Service
Managing Spontaneous Volunteers in times of Disaster: The Synergy of Structure and Good
Intentions, Points of Light Foundation and Volunteer Center National Network
Monterey County Volunteer Management Plan, Bay Area Urban Area Security Initiative
Spontaneous Volunteer Management Annex: Marin County Operational Area Emergency
Operations Plan, Marin County Office of Emergency Services
“Strategies for Managing Volunteers during Incident Response: A Systems Approach,”
Lauren S. Fernandez, Joseph A. Barbera, Johan R. van Dorp
University of Toledo Disaster Volunteer Deployment Management Plan, Emergency
Preparedness Task Force
Volunteer Policies and Procedures Handbook, National Association of County and City Health
Officials and Mesa County Advanced Practice Center
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