Person & Family Centered Care Volunteer Program Agreement & Acknowledgement

We are delighted that you have made the choice to lend your voice as a Person & Family

Centered Care (PFCC) Volunteer. Thank you for taking this step in giving back to your

community and choosing Kaiser Permanente for your volunteer experience. Our key goal at

Kaiser Permanente is to provide high quality care and service to our members and the

communities we serve. Kaiser Permanente PFCC Volunteers are a valuable part of a dynamic

team and we rely on your skills, experience, and commitment to meet our goal.

This PFCC Volunteer Agreement will cover the following expectations you will need as you begin

your volunteer services at Kaiser Permanente:

PFCC Volunteer Program Requirements

Service Standards and Expectations

Professional Conduct and Appearance

Safety and Infection Control

Confidentiality

Discontinuing PFCC Volunteer Service

Before you begin your PFCC volunteer experience, you are required to read through this

agreement, in addition to fulfilling the below application requirements:

Complete a Background Check

Complete a Health Screening

Final acceptance into the Kaiser Permanente Person and Family Centered Care Volunteer

Program is determined by the PFCC Manager/Coordinator at your selected Kaiser

Permanente location.

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Table of Contents

Table of Contents ........................................................................................................................................................... 2

PFCC Volunteer Program Requirements ................................................................................................................ 3

Annual Requirements ..................................................................................................................................... 3

Service Standards and Expectations ........................................................................................................................ 4

Professional Conduct and Appearance .................................................................................................................. 5

Safety and Infection Control ....................................................................................................................................... 6

Handwashing ..................................................................................................................................................... 6

Confidentiality .................................................................................................................................................................. 7

Discontinuing Volunteer Service ............................................................................................................................... 8

National Human Resources Volunteer Policy ...................................................................................................... 9

PFCC Volunteer Program Acknowledgement ................................................................................................... 18

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PFCC Volunteer Program Requirements

A positive attitude about Kaiser Permanente

A commitment to improving the care for all patients, families, and caregivers

An ability to share experience and insight in a balanced and objective manner

The desire and ability to work with persons of differing beliefs, opinions, and experiences

An ability to listen to, and reflect on, differing points of view

An ability to engage in direct, honest, and respectful communication

A personality that demonstrates noticeable compassion for others

A respect for the collaborative process

An ability to keep information confidential

A good sense of humor

Annual Requirements**

To maintain active PFCC Volunteer status, each PFCC Volunteer will be required to complete the

following annual requirements:

Health Screenings – as health screening requirements vary from market to market, you

will receive instructions specific to your market and location

Annual Education/Compliance Training – Onboarding education and compliance training

is administered during your initial orientation and annually thereafter. The training

reviews important topics, such as infection prevention, safety, confidentiality, and much

more to promote a safe, collaborative environment.

**PFCC Volunteers who fail to comply with annual requirements, may be terminated from the

program.

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Service Standards and Expectations PFCC Volunteers serve as the “voice of the member” in collaborative settings across Kaiser

Permanente. Making a positive impression while providing critical, timely feedback is an

important part of the member experience. Kaiser Permanente PFCC Volunteers are expected to

meet the following service expectations.

Share all information relevant to the topic at hand.

Be curious. Ask questions to understand others’ perspectives.

Assume others have good intentions, even when you think you disagree with them.

Have compassion for each other; try to understand what it is like to walk in their path.

Be solution focused. Our goal is to improve the way Kaiser Permanente provides health

care, not just to criticize.

Be open to new ideas in an accommodating and supportive manner regardless of

position, background, race, religion, gender, etc.

Place the needs of Kaiser Permanente members as your priority.

Act with integrity, competence, and respect.

Maintain discussions relevant to Kaiser Permanente member’s needs (not personal).

Take care of yourself. You can’t be a good partner if you are stressed or tired.

If things don’t feel right, ask for and participate in a conversation about what is

happening and how to improve how we are working together.

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Professional Conduct and Appearance

Professional Conduct

Interactions are courteous, and tactful.

Treatment of others is respectful, accommodating, and supportive, regardless of their

position, background, race, religion, gender, etc.

Name Badges/Clothing Attachments

Name badges, provided by Kaiser Permanente, will be worn at all times during

participation in collaborative in-person meetings, or events. The goal is identification,

and name badges must be easily visible, worn at or above the waist, consistent with the

name badge policy (Policy Number HR>HR.004).

Name badges, including photographs, must not be altered or covered and kept current

and in good repair. Attaching Kaiser Permanente award, healthcare related stickers or

pins is permissible, if they do not interfere with your photo or identification information.

No other attachments are acceptable on a name badge.

Clipping of the name badge to the outer clothing is preferred. If a necklace lanyard is

required to secure the badge, the lanyard must be professional or consistent with Kaiser

Permanente’s brand and must not include professional sport team logos, local

public/private schools, theme parks, political messages, or other related souvenir items.

Any clothing attachment or pin unrelated to Kaiser Permanente, such as political

pins/buttons, professional, college, high school sport teams’ logos, and other similar

products are not permitted.

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Safety and Infection Control

PFCC Volunteers are an integral part of hospital and clinic operations. PFCC Volunteers are

involved with staff, patients, families, and caregivers and provide on-going insights, information,

and assistance. It is essential that PFCC Volunteers understand hospital policies and procedures

related to Safety and Infection Control.

Safety is a responsibility shared by all at Kaiser Permanente. We must make every effort to

prevent injury to patients, visitors, volunteers, employees, and ourselves. Be on alert for unsafe

conditions, such as:

Wet or slippery floors

Equipment in halls

Defective equipment

Careless handling of equipment

Operating electrical equipment with wet hands

Use of combustible materials near open flame

All observed unsafe conditions should be reported immediately to your PFCC Volunteer

coordinator.

Hand Washing

Hand washing is the single most important and effective way of preventing the spread of

infection. Hand washing is required:

Before and after your on-site PFCC Volunteer activities

Between contact with other patients

Before eating, drinking, or handling food

After using the restroom

After removing any personal protective equipment (e.g. face mask)

Standard/Universal Precautions

Standard/Universal Precautions are guidelines mandated by Kaiser Permanente to protect

volunteers and employees from the transmission of infections, including the HIV virus. More

information on this will be provided during your orientation and annual training.

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Confidentiality

Kaiser Permanente has a legal and ethical responsibility to protect the privacy and security of

patients, members, employees, and physicians. Kaiser Permanente also has a responsibility to

ensure the security of its proprietary business information.

Employees, consultants, contractors, agency personnel, volunteers, students and other

associates of Kaiser Permanente must follow all applicable laws, regulations, rules, guidelines,

policies and procedures. They must not misuse Kaiser Permanente information. Kaiser

Permanente information includes medical and employee information. It also includes the

confidential and privileged business information that belongs to Kaiser Permanente. PFCC

Volunteers must not use, remove, or disclose Kaiser Permanente information without

permission.

PFCC Volunteers must follow all communications regarding policies and procedures. This

includes current and future policies and procedures. PFCC Volunteers must follow these policies

and procedures as long as they are associated with Kaiser Permanente. Employees, consultants,

contractors, agency personnel, volunteers, students, and other associates of Kaiser Permanente

are permanently bound by the law and regulations even after their employment or association

with Kaiser Permanente ends.

PFCC Volunteers must not violate federal and state confidentiality requirements, including

Health Insurance Portability and Accountability Act (HIPAA); 42 CHR, Part 2; Kaiser Permanente

policies and procedures and other standards that may be implemented during my associating

with Kaiser Permanente. These requirements do not cease at the time I terminate my

relationship with Kaiser Permanente.

Violation of confidential information is a violation of hospital ethics. Overt release of confidential

information will be grounds for termination of your PFCC volunteer services at Kaiser

Permanente. Kaiser Permanente is required to provide all volunteers with training concerning

the HIPAA Privacy Rule. You will receive separate materials about this.

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Discontinuing Volunteer Service

Kaiser Permanente, or the PFCC Volunteer, may discontinue service as a volunteer at any time,

with or without cause and without prior notice.

Reasons for dismissal may include, but are not limited to the following:

Non-compliance with the PFCC Volunteer Program’s annual requirements.

Non-compliance with Kaiser Permanente policies and procedures.

Breach of patient, member, staff, physician, or volunteer confidentiality.

Should the PFCC Volunteer be dismissed from service due to any of the above stated reasons as

determined by the PFCC Volunteer coordinator, they will not be permitted to return as a Kaiser

Permanente PFCC Volunteer in the future.

Should the PFCC Volunteer elect to end their volunteer service, a courtesy notification to their

PFCC Volunteer Coordinator of two weeks would be appreciated before final day of service.

To continue to application process, PFCC Volunteer applicants are required to read and

understand the National Human Resources (HR) Volunteer Policy and sign the PFCC

Volunteer Program Agreement Acknowledgement

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Kaiser Permanente National Human

Resources (HR) Volunteer Policy

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PFCC Volunteer Program Agreement &

Acknowledgment

PFCC Volunteer Program Agreement Acknowledgment – Non-Employee Volunteer

I acknowledge that I have read the Kaiser Permanente National Human Resources (HR)

Volunteer Policy and confirm that as a PFCC Volunteer:

1. My services to Kaiser Permanente are entirely voluntary;

2. I have not been promised, nor do I expect, compensation from Kaiser Permanente for my

services;

3. My services are for charitable or humanitarian objectives as well as for my personal

purpose or pleasure;

4. I am not economically dependent on Kaiser Permanente for food, shelter, clothing, or

pharmacy supplement benefits/services;

5. I am not currently an employee of Kaiser Permanente; and

6. Kaiser Permanente or I may discontinue my service as a PFCC Volunteer at any time, with

or without cause and without prior notice.

PFCC Volunteer Program Agreement and Acknowledgement – Employee Volunteer

I acknowledge that I have read the Kaiser Permanente National Human Resources (HR)

Volunteer Policy and confirm that as a volunteer:

1. My services to Kaiser Permanente are entirely voluntary with no coercion by Kaiser

Permanente, no promise of advancement, and no penalty for not volunteering;

2. I have not been promised, nor do I expect, compensation from Kaiser Permanente for my

services;

3. My services are for charitable or humanitarian objectives as well as for my personal

purpose or pleasure;

4. My volunteer services are different from my regular Kaiser Permanente work duties and

outside my normal work hours;

5. Kaiser Permanente or I may discontinue my service as a volunteer at any time, with or

without cause and without prior notice; and

6. I recognize that my volunteer services are not within the course and scope of my

employment with Kaiser Permanente

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Kaiser Permanente takes great pride in providing excellent service with care and

compassion in a safe and secure environment for our members, patients, visitors, guests,

staff, and you. Thank you for reviewing the Kaiser Permanente PFCC Volunteer Program

Agreement and Acknowledgement. If you have any questions regarding the information

contained in this document, please contact your PFCC Volunteer Program Coordinator

before moving forward with the application process.

To continue through this application process, please close this window and select one of

the following options from the PFCC Volunteer Program Dashboard:

☐ I have read, understood, and agree to the Kaiser Permanente PFCC Volunteer Program

Agreement and Acknowledgement (Employee or Non-Employee, as applicable). **By

selecting this option, you will be required to enter in your social security number below to

initiate the background authorization.

☐ I do not agree and request to withdraw my application.