Adult Care Ministry: Planning Helps Avert Liability Risks

Adult care ministries present opportunities to provide care and support to elderly or disabled individuals, but they also pose potential liability risks to you and your ministry. Whether you serve adults through hospital visitation, visiting shut-ins, or a sponsored adult day care facility, careful planning and forethought are two of the most important elements of a successful adult care ministry.

Take special care when evaluating individuals who are candidates for participation in an adult care ministry. Such a ministry can be mentally taxing, so workers with patient and positive dispositions are usually the best ministry workers.

Select Qualified and Trustworthy Staff

Regardless of the specific adult care ministry you intend to operate, the selection of staff and volunteers is critical to the safety and success of your ministry. As you select staff members, keep in mind several basic steps to ensuring that the individuals you choose to represent your ministry are trustworthy and qualified to work in an adult care ministry.

Conduct Background Screening on All Staff and Volunteer Candidates
Some states require criminal background checks for those who participate in specific types of adult care ministries. This requirement may apply even if the participant is a volunteer. Check with a local attorney to determine if your state requires your ministry to conduct background screening.

Even if the state does not require it, you should strongly consider conducting criminal background checks on all potential staff members and volunteers. Whenever a ministry involves children or those who are elderly and/or disabled, there exists a heightened opportunity for wrongdoing. Take special care when evaluating individuals who are candidates for participation in such a ministry. Adult care can be mentally taxing, so workers with patient and positive dispositions are usually the best ministry workers.
Know Who You Appoint as Drivers
If your adult care ministry involves transporting individuals from one location to another (doctor’s appointments, grocery store trips, etc.), careful driver screening is essential. You need to be confident that you are retaining good, qualified drivers to transport people on behalf of your ministry. Ask these four important questions as part of the screening process:
1. What is the candidate’s driving record?
  A candidate’s driving record will expose any suspensions, citations, or other violations.
2. Does the candidate have the proper license?
  This is especially important if your ministry worker will potentially be driving any buses or large vans. Most states require the driver to have a commercial drivers’ license (CDL) when driving such vehicles.
3. Should you consider the candidate’s age?
  According to the National Safety Council, drivers under the age of 21 or over 65 are the two groups with the highest crash rates. Before implementing age restrictions, check with a local attorney to ensure that such restrictions won’t create age discrimination issues with respect to older drivers.
4. Can the candidate safely operate the type of vehicle required for your ministry?
  Some adult care ministries will require drivers to operate handicap or wheelchair accessible vans. This may involve operating wheelchair lifts, using wheelchair straps, etc. Make sure that your driving candidate has the proper training and experience to operate the appropriate vehicles for your ministry.
Appropriately Train and License Staff and Volunteers
After selecting your ministry staff and volunteers, make sure they have the necessary training to carry out the jobs they will be doing for your adult care ministry. Training may involve the operation of a handicap accessible van, use of wheelchair restraints, undertaking CPR training, and more.

If you plan to offer ministry-sponsored adult day care or any other extended care program, more detailed training may be necessary. Depending on the type of ministry and the state in which your ministry is located, state-approved training or licensing may be required. Consult with a locally licensed attorney to ensure that you know and understand your state’s adult day care regulations and requirements.

Address Safety and Security Liability Risks

If your adult care ministry involves the transportation of individuals or if you plan to operate the ministry out of your church or other parts of the property you own or maintain, you’ll need to address several liability exposures. If a staff or volunteer worker operates a vehicle that’s deemed unsafe, a court may hold your ministry responsible for accident-related injuries. The same situation also could occur if you’re operating your adult care ministry out of church building or other facility that isn’t up to the safety code.

Check Auto Insurance Coverage
Auto insurance coverage is one aspect of an adult care ministry that is often overlooked when a staff member or volunteer use their own vehicle to transport passengers on behalf of a church or ministry. Too frequently, staff members and volunteers incorrectly assume that their personal auto liability insurance policy will cover them. This can be a potentially costly mistake.

If staff members or volunteers plan to use their personal vehicles to transport ministry passengers, require them to contact their personal insurance agent to determine whether their personal policy will provide coverage. Personal auto liability policies often exclude coverage when the policyholder uses the insured vehicle for any “for hire” purposes. For this reason, ministries would be wise to avoid charging any fee in exchange for transporting adult care clients. Even if you charge no fee, staff members who drive their own autos should still check with their personal auto insurance agent to ensure that liability coverage will apply.
Use the Right Vehicle to Get the Job Done
Any time your ministry is involved in the transportation of people, it’s important to use the correct vehicle. This is especially true when your ministry transports elderly or handicapped individuals. If your ministry plans to provide the vehicles to use in transporting elderly or special needs individuals, consider investing in vehicles designed for this purpose. This may involve purchasing a wheelchair-accessible van or modifying the vehicles that your ministry currently owns to accommodate those who you will be transporting.

The same considerations apply if your staff or volunteers plan to use their personal vehicles to transport passengers. Ministry passengers may find some vehicles difficult and dangerous to enter or exit, even if they are not confined to wheelchairs. Before your staff or ministry worker transports anyone, consider the physical limitations of passengers and make sure the vehicle is easily accessible and will safely accommodate them.

For safety reasons, avoid using 15-passenger vans to transport groups of people for any ministry-related activity. A small "people mover" bus is a much safer option. If you plan to use 15-passenger vans as part of your adult care ministry, Brotherhood Mutual recommends that you enhance the suspension of the vehicle and remove the back seat. Accident records show that 15-passenger vans pose a higher risk of rollover than smaller vehicles or people movers.
Equip Adult Care Facilities for Convenient Access and Use
The ministry facilities you use to adult care should be designed to be as accessible as possible to those who will be using them. Facilities for elder care ministries should be handicap accessible. Buildings that you make available for these ministries should be equipped with wheelchair ramps, handicap accessible restrooms, wheelchair lifts, and other handicap-related safety features.

Carefully Consider Supervision Exposures to Protect Participants and Workers

If your ministry provides care or supervision of Alzheimer’s patients, mentally challenged individuals, or other physically healthy but mentally compromised individuals, carefully consider their personal safety, as well as that of other ministry participants, workers, and bystanders. Address the specifics of the situation, giving special consideration to the following safeguards.

Assign Multiple Workers
Assign at least two workers per room in any adult day care setting. This practice provides backup assistance whenever an unexpected situation arises and one of the workers steps in to help. It also provides a witness in the event of an injury or accident.
Leave Diagnosis to Medical Professionals
Leave any medical diagnosis, treatment, or administration of medication exclusively to medical professionals. Your ministry can be instrumental in other forms of assistance, however, especially in providing help and support to those who suffer from mental disabilities. You ministry also can benefit primary caregivers by referring them to a support group or agency, particularly if ministry participants are suffering early stage Alzheimer’s or other forms of dementia.
Educate and Support Your Staff and Volunteers
Be sure to not only provide education and support for your ministry’s clients, but also for your workers and volunteers. Studies show that those who provide care to mentally disabled individuals often experience increased stress, anxiety, depression, and other forms of mental health issues themselves.
Refer Patients to an Attorney for Legal Decisions
Many of those who suffer from mental disability or forms of dementia often need legal or financial assistance and are not in a position to make independent decisions. Your ministry should not attempt to provide this type of advice, but you should refer those in your care or their family members to a trusted attorney or financial professional.
Monitor and Assess Changes in Participants Constantly
Monitoring and assessing changes in conditions and daily activities is constant when caring for mentally challenged individuals. Assess a participant’s mental status, living arrangements, and long-term care plans with special concern. Once a participant's condition exceeds the ministry's capacity to safely care for the individual, promptly notify the participant's caregiver, and then establish a plan to transition the individual out of the ministry's adult care program.

Miscellaneous Issues

Confirm Worker Access to Facilities
When developing a visitation program, ministries should contact and work with local hospitals and nursing homes to identify and address privacy concerns. For example, make certain that your approved ministry workers are on visitation lists, have proper access credentials, and are prepared meet any other requirements that a hospital or nursing home expect.
Establish Appropriate Communication Channels
Establish a way to double-check information you receive from elderly or mentally challenged adults. Those with Alzheimer’s or other mental disabilities may not recall events, details, or conversations correctly, so it’s necessary to verify information with family and other caregivers.

Complete this communication task in a way that maintains your ministry participants’ feelings of being trustworthy. Be discreet while verifying statements with a relative or caregiver. By doing so, you will help to maintain the dignity of your ministry client and potentially save your ministry from relying on inaccurate or incomplete information at the same time.

Related Resources

Updated August 14, 2019