Volunteering & Managing Your Risk
A Comprehensive Guide for Arizona Physicians, Presented by MICA & ArMA
The MICA Risk Team frequently receives calls about physicians planning to donate their time and services within the borders of Arizona. These calls range from physicians planning to hold a free health fair, to physicians volunteering to help with their child's sports team, to physicians planning to work in a free clinic. Physicians are often surprised to learn that although Arizona has Good Samaritan and other volunteer immunity laws, these laws might not provide liability protection in all volunteer situations.
In this article, the Risk Team discusses two calls to the MICA Risk Consultation Line. During the calls, the risk management consultant and the physician considered Arizona's Good Samaritan and volunteer immunity laws to manage the physician's liability risk while volunteering.
Although Arizona has Good Samaritan and other volunteer immunity laws, these laws might not provide liability protection in all volunteer situations.
Scenario 1: Free Community Hypertension Screening Event
A physician in rural Arizona called the MICA Risk Consultation Line about organizing and hosting a free hypertension screening event at a local church. The risk management consultant explained some of the laws that might limit the physician's liability for medical services the physician planned to provide during the event.
Arizona's Good Samaritan Law
Arizona's Good Samaritan law is intended to protect people who help someone during an emergency. The Good Samaritan law states that a "health care provider . . . who renders emergency care at a public gathering or at the scene of an emergency occurrence" without compensation and in good faith, is not liable for damages resulting from the emergency care unless they acted with gross negligence.
- Requires an Emergency
The Good Samaritan law does not define "emergency occurrence" or "emergency care," and Arizona's courts have not seen many lawsuits involving the law. However, an Arizona Supreme Court case describes the purpose of the law, stating that it allows an individual to help someone in a crisis without being penalized for a bad outcome. Other sources of the definition of "emergency" generally state that an emergency is unforeseen and unexpected.
The hypertension screening event will be planned and advertised throughout the community. A court probably would not consider the screening event an emergency and probably would not apply the Good Samaritan law.
Arizona's Volunteer Immunity Law
Physicians might be aware of an Arizona law that offers immunity to health professionals who provide free medical care in nonprofit clinics. The law protects health professionals who provide uncompensated medical care within the scope of their license at nonprofit clinics, unless the care is grossly negligent.
- Requires a Nonprofit Clinic
Arizona's volunteer immunity law only provides protection to health professionals who provide care in a "nonprofit clinic". The law states that a "nonprofit clinic" includes: a clinic, office, homeless or other shelter, health or screening fair, or any other setting where care, treatment, or screening is provided at no cost.
The physician's planned free screening event likely meets this definition of "nonprofit clinic." If it meets this definition, then it might provide the physician with immunity from liability in a medical malpractice lawsuit. However, Arizona courts have not yet interpreted this law's definition of "nonprofit clinic," so whether a free screening event meets this definition remains uncertain.
- Requires Uncompensated, Reasonable, and Prudent Care
Arizona's volunteer immunity law only protects physicians who provide care without receiving compensation. So long as the physician does not receive anything of value in exchange for providing care at the free screening event, he likely meets this requirement.
The law does not protect physicians who provide grossly negligent care. Courts consider the specific facts in a lawsuit to determine whether someone acted with gross negligence, but gross negligence usually involves a reckless disregard for others' safety. To meet this requirement, the physician should ensure he provides reasonable and prudent care.
Last, this law only protects physicians who provide care within the scope of their license. The physician should therefore make sure he has the education, training, and experience to screen and educate the people he sees during the event.
Federal Tort Claims Act (FTCA) and the FTCA Free Clinic Program
If the physician planned to volunteer in a federally funded free clinic, then the FTCA Free Clinic Program might provide additional protection in a medical malpractice lawsuit. Through the FTCA Free Clinic Program, health care professionals volunteering at federally funded free clinics can receive medical malpractice liability coverage.
- Requires Program Approval of the Free Clinic
Before the FTCA's protections can apply, the FTCA Free Clinic Program must approve the clinic and the clinic's "sponsored" health care professionals. The sponsored health care professionals cannot receive any compensation for their services. Additionally, clinics must notify patients in writing of the sponsored health care professionals' limited liability.
Physicians interested in learning more about the FTCA Free Clinic Program can visit the Health Resources & Services Administration's FTCA website.
Scenario 2: Treating Children's Recreational League Soccer Team Injuries
Another physician who called the MICA Risk Consultation Line planned to volunteer to treat injuries at her child's recreational league soccer games. The risk management consultant walked the physician through the Arizona Good Samaritan and volunteer immunity laws.
Arizona's Good Samaritan Law
As discussed in the previous example, Arizona's Good Samaritan law applies to physicians and other health care providers who provide free emergency care in good faith at a public gathering, or at or near the scene of an emergency in Arizona. The law does not protect grossly negligent care.
Arizona's Good Samaritan law applies to physicians and other health care providers who provide free emergency care in good faith at a public gathering, or at or near the scene of an emergency in Arizona.
- Requires Emergency Care Provided at or Near the Scene of an Emergency or at a Public Gathering
To receive protection under the Good Samaritan law, the physician must first determine that the care she provides qualifies as "emergency care," and that the care was provided at a "public gathering" or "at or near the scene of an emergency."
As discussed in the free screening event example, the Good Samaritan law does not define "emergency." Instead, the Arizona Supreme Court has explained that the law is intended to allow individuals to help someone in a crisis without being penalized for a bad outcome. Although planned soccer games might not be considered emergencies, an emergency might occur during or around the soccer games. Additionally, the soccer games might be considered a public gathering.
- Requires Gratuitous, Good Faith Care
To meet the gratuitous, good faith care requirement, the physician must confirm that she will not be compensated for any care she provides. She must also ensure that she does not intentionally, knowingly, illegally, willfully, or recklessly cause an injury.
- Requires Care Provided in Arizona
Arizona's Good Samaritan law applies to individuals providing emergency care in Arizona.
If the physician plans to travel with the team to any games outside of Arizona, she should consult with her business or health law attorney to determine what other states' laws say about volunteers and their liability. She should also discuss with her attorney whether she must be licensed in any other states in which she might provide care.
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Arizona's Volunteer Immunity Law
As discussed in the free screening event example, Arizona's volunteer immunity law states that licensed or certified health care professionals who provide uncompensated medical treatment, care, or screening within the scope of their license or certification in a nonprofit clinic are not liable in a medical malpractice action, unless they acted with gross negligence.
- Requires a Nonprofit Clinic
To receive protection under Arizona's volunteer immunity law, the care must be provided at a "nonprofit clinic." The law defines "nonprofit clinic" as a clinic, office, homeless shelter, other shelter, health or screening fair, or "any other setting where treatment, care or screening is provided at no cost."
The physician planned to provide treatment or care during the games at no cost. Although the physician plans to provide care at no cost, it is unclear whether the soccer games meet the law's definition of "nonprofit clinic." The physician should talk with her business or health care attorney for a legal opinion on whether the soccer games might meet this definition.
- Requires Uncompensated, Reasonable, and Prudent Care
Arizona's volunteer immunity law only protects health professionals who provide uncompensated care. The physician did not sign a contract with the soccer league, and treating children at the game was outside her responsibilities as an employee of her medical group. The league would not pay her, and she would not receive anything of value for her services. The physician likely meets this requirement.
The physician also must ensure she provides reasonable and prudent care, because the law does not protect physicians who provide grossly negligent care. She must also ensure that she has the education, training, and experience to treat the injured players, because the law only protects physicians who provide care within the scope of their license.
- Requires Care, Treatment, or Screening in Arizona
Arizona's volunteer immunity law only applies to care, treatment, or screenings provided in Arizona. If the physician will travel with the team to other states, she should discuss with her attorney whether to rely on this law to protect her.
Important Reminder: Recipients of Free Care May Still Sue
Physicians should remember that these laws do not prevent an individual who received emergency or free care from filing a lawsuit alleging professional medical negligence. Instead, these laws ensure that the physicians and other health care professionals who meet the laws' requirements are not liable for damages resulting from their care.
Insurance Coverage Considerations
Before volunteering, it is important to understand how these activities may affect your insurance coverage. Contact your employer, insurance company, or broker to review policy options and confirm whether your volunteer work is covered. Key considerations include:
- Policy Territory
Consider your policy coverage territory. If you plan to volunteer outside your state of domicile, contact your employer, insurance company, or broker to discuss potential coverage implications.
- Scope of Practice
Many policies require that volunteer activities must remain within your training and licensure.
- Group Policies
If you are a scheduled physician under an insurance company's group policy, you usually must coordinate with your authorized group administrator before engaging in volunteer work. Under a group policy through MICA, for example, the entity is the Named Insured and holds the associated rights and responsibilities. The group policy may have an exclusion or endorsement to the policy that could directly affect your coverage for volunteer work.
There may be other policy coverage options available to MICA insureds, such as MICA's Retired Volunteer policy. A MICA insured who has retired from active medical practice, maintains a valid medical license, and provides volunteer health care services without financial compensation may be eligible for coverage under a MICA Retired Volunteer Policy.
Physicians are encouraged to review their insurance policy to confirm whether volunteer work is covered.
For more information, MICA-insured physicians may contact their broker or MICA Customer Service at help@mica-insurance.com or 877-215-6422.
MICA's Risk Team
The Mutual Insurance Company of Arizona (MICA) Risk Team provides expert risk management consultation for Arizona physicians. With decades of combined experience in medical malpractice insurance and risk management, the team helps physicians navigate complex liability issues and maintain the highest standards of patient care.
MICA has been the leading medical malpractice insurance carrier for Arizona physicians for 50 years, partnering with the Arizona Medical Association to protect physicians and advance patient care across the state.
To learn more about MICA's risk management services and insurance options, visit www.mica-insurance.com or contact MICA Customer Service at help@mica-insurance.com or 877-215-6422.
