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This page is devoted to the management of volunteer programs in health care settings.

~September 2011~

Points of View


letter H


Healthcare is a unique business. While people will still get sick and require medical attention, today’s current economic condition often forces people to delay until it is truly serious resulting in exorbitant charges.  And once treated, some of the patients cannot afford to pay for their care.  The new “Value-based Purchasing” aspect of Healthcare reform is  on the horizon and  could result in reduced reimbursements.  It is no wonder that healthcare organizations are looking at ways to trim budgets.  But replacing paid staff with volunteers is very short-sighted.  Add in the union variable and it can be a nightmare.

Fortunately, the healthcare organization where I am employed is a non-union organization.  As the county hospital, the organization wrote off $16M in bad debt last year alone, illustrating the severity of the economic situation.  Judy Lieberman with Taylor Hospital in Ridpley Park, PA and Marsha Shanker from BJC Hospice in St Louis, MO offer the following comments on the issue of supplanting. Mary Kay Hood

1) Is there pressure to use volunteers to do things paid staff did?

Judy Lieberman

I am not sure if you'd say pressure as opposed to more requests for help and expectations that I will get things done for them.

Marsha Shanker

Yes, volunteers in our hospice are expected to pick up more of the office work and responsibilities with patients.  Since we only have 2 chaplains, we are now training "Spiritual Volunteers" so the chaplains are not spread so thin.  (So we do not have to add another one.)  We are also in the midst of asking more volunteers to take on more supervisory role, like being in charge of certain programs when workers are off on weekends and trying to get them to manage other volunteers in their area.


2)  How do you explain supplementing versus supplanting to administrators?

Judy Lieberman

Because many of our jobs here in the hospital are union, I explain that they are opening themselves up for a law suit.  I also decide what is appropriate and what is not.

Marsha Shanker

I am not usually in on those conversations.

3) How are volunteers responding to replacing staff?

Judy Lieberman

Many think some jobs are for staff and will not assist.

Marsha Shanker

We used to be able to offer housekeeping services to patients and their families from paid individuals.  Most of our volunteers will NOT do that.  They said they do not want to be maids.  Many come in to help in the office more because they see their two volunteer coordinators “blown away.”

4) How are other paid staff responding to volunteers doing what paid staff did?


Judy Lieberman

Grateful for the help.

Marsha Shanker

I really do not see that most of the staff get it yet since the organization has been calling it downsizing.

5) How has it impacted your ability to carry out the duties of administrator of volunteers?

Judy Lieberman

I am in a constant state of organized chaos.
My secretary was let go in a reduction of staff.  The unsaid expectation is that I don't need anyone….I can just get volunteers to help me.

Marsha Shanker

I know that since we have to rely on volunteers more, things do not get done in a timely fashion or with the correctness that they should.  Volunteers do not want to be pushed on time lines, which I can understand: they are not paid employees.  They also tend to call in a lot and say they are not coming at the last minute.  It is unfortunate for us because we have to count on them so much that we then have to take up that slack with our additional responsibilities.

It’s easy to see from this response that the expectation is that volunteer resources will “fill the gaps” as staff reductions happen.  And for some, you see the disparity of providing solid advice to not being in the conversation at all.  The final answer to the question of the impact on duties really hits home illustrating that those in positions of authority and decision making do not really understand what we as volunteer administrators do in this profession.

See Who Made This Issue Possible

Thank You Page


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The author of the Heath Care Volunteer Programs column is Mary Kay Hood MS, Hendricks Regional Health, Danville, IN (317) 745-3556. With a BS degree in biology from Marian College and a Master of Science in Management from Indiana Wesleyan University, Mary Kay has been involved in volunteer management over twenty years with a zoo and in the health care field. During that time, she completed the Management of Volunteer Programs course offered at University of Indianapolis, several supervisory training programs as well as the Indiana Hospital and Health Association’s Management Institute offered by the Executive Education Program, School of Public and Environmental Affairs at Indiana University. Mary Kay served on the Nonprofit Training Center of United Way from 1993 to 2006. During that time, she taught many workshops also facilitating speaker arrangements for the Basic Volunteer Management series. Additionally, she has presented at various national and international conferences. Mary Kay served as president of the Central Indiana Association for Volunteer Administration (CIAVA) from 1993-1997 and the Indiana Society of Directors of Volunteer Services (ISDVS) from 2006-2008. She was also the recipient of the 1995 Outstanding Director of Volunteer Services Award and the 2002 United Way of Central Indiana Volunteer of the Year Award. Most recently she served on the Steering Committee for COVAA resulting in the formation of a new national membership organization for those in volunteer management, the Association of Leaders in Volunteer Engagement (AL!VE). With several published articles, she is also author to two books: The One Minute Answer to Volunteer Management Questions and The Volunteer Leader as Change Agent.

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