One minute, your nonprofit’s activities were going off without a hitch. The next? Screams, sirens, and a young child whisked away in an ambulance.
Suddenly, the community you serve isn’t asking “How can I help support your mission?” anymore. Instead, they’re demanding to know “How could you let this happen?”
You never want someone getting hurt or sick on your watch, but when it happens because your trained/certified staff failed to do their duties, that’s a problem that no nonprofit can afford.
Let’s explore a scenario involving a nonprofit whose failure to follow its procedures led to the inadvertent harm of a child — and discuss some steps and practices your nonprofit might consider adopting to help protect yourself in a similar situation.
The Nonprofit:
A nonprofit operated a summer day camp for children in third through sixth grades. Activities included field trips, nature hikes, and interactive science lessons. The camp also provided children with lunch and two snacks per day.
When children were enrolled in the program, their parents/guardians were required to both notify the nonprofit of any allergies, medical conditions, or special needs so that proper accommodations could be arranged, and to sign consent forms for staff to administer any necessary medications or treatments.
The Incident:
One summer afternoon, a group of about 25 campers were on a nature walk, accompanied by four counselors. When the group stopped, the campers were given a snack.
One camper, who was known to have a severe peanut allergy, suddenly began exhibiting signs of anaphylaxis: Swollen tongue, trouble breathing, and dizziness.
While the counselors called 9-1-1 immediately, they had not been given the child’s epinephrine auto-injector, which was kept in the camp’s infirmary. As a result, they could do little more than help the child remain calm and monitor their breathing while awaiting the ambulance, which quickly arrived.
The camper was taken to the hospital, where they made a full recovery.
The Coverage:
Once the nonprofit was certain that the camper was safe and being cared for, they alerted their insurance broker, who began the process of making a claim on the organization’s Social Service Professional (SSP) policy with Nonprofits Insurance Alliance (NIA).
The Legal Action:
Once it became clear that the counselors hadn’t administered epinephrine because the child’s auto-injector hadn’t been included with the portable first aid kit, the child’s guardians were extremely upset and made that very clear when they met with the camp director.
While the family did not immediately file a lawsuit against the nonprofit, the organization’s in-house attorney believed there was potential for eventual legal action claiming negligence and improper supervision on the part of the camp’s director and on-site nurse.
This opinion was shared with NIA’s assigned claims examiner, along with the rest of the nonprofit’s information around the incident.
The Result:
NIA’s claims examiner reviewed the events and circumstances surrounding the incident, along with witness statements and the nonprofit’s policies and procedures around allergies, medications, and off-site activities.
After the review, it was concluded that the failure of the camp’s director and on-site nurse to ensure that the child’s epinephrine auto-injector was readily accessible at all times could be considered negligent and that the camp director had failed to supervise the nurse — which could potentially have left the organization vulnerable if the camper’s family had chosen to pursue legal action.
With this conclusion in-hand, NIA was able to work with the camper’s family to reach an appropriate settlement, preventing legal action from being filed against the nonprofit.
What Did the Nonprofit Do Right?
The nonprofit took the following positive steps, which helped prevent a bad situation from turning into a worse one.
Procedures Around Medications and Special Needs
Although they failed to follow them properly, the nonprofit did have the right procedures in place around medications and clients with medical conditions or other special needs.
- Parents/guardians were required to declare any allergies, ailments, or other conditions that may require medication, accommodation, or other considerations at registration.
- The nonprofit required permission slips for medications to be administered by staff.
- The medications themselves were to be under the supervision of either the camp director or the on-site nurse.
- All staffers that worked directly with the campers were required to have first aid and CPR training, which included using defibrillators, auto-injectors, and other emergency-response situations.
In this scenario, although the camp director and on-site nurse failed to ensure the auto-injector was available, the counselors’ training helped them keep the child remain calm until help arrived.
Multiple Staff Present
By having an appropriate staff-to-camper ratio, it meant that, when the incident occurred, there were enough trained adults present to simultaneously:
- Provide first aid to the child having the allergic reaction.
- Call 9-1-1 and alert the camp director.
- Supervise the remaining campers.
This helped to keep everyone calm, reassured, and not in the way of the medical responders.
Incident Reports & Documentation
The nonprofit had procedures in place around incident reports and recordkeeping. Staff members were trained on these procedures and the nonprofit regularly held refresher sessions.
Once they were aware something was wrong, the nonprofit’s staff knew to document the relevant times, dates, locations, witnesses, steps taken, and other details surrounding the incident.
This helped the nonprofit’s legal defense team get a clear timeline of events, identify potential witnesses, and to review the nonprofit’s actions and processes to spot potential liabilities.
Quick Activation of the Claims Process
As soon as the incident happened, the nonprofit notified their insurance broker, who then activated the process of making a claim on their SSP policy with NIA.
Doing this quickly was important because it enabled NIA to be involved in the defense process from the start, review the situation, determine the potential for liability, and respond appropriately.
In this scenario, NIA was able to assess the incident, use those facts to determine the likelihood of legal action being taken against the nonprofit, and work to settle the matter quickly — instead of simply waiting around for legal action to be filed.
How Can Your Nonprofit Protect Itself?
Whatever your nonprofit does, safety must be your top priority, both for the people you serve and the people that serve your mission.
Any activity comes with the risk that people might get hurt. Your job is to prevent it where you can and respond appropriately when you can’t.
Some steps you might consider include:
Safety Protocols & Procedures
The last thing you want is for a problem to catch you off-guard and unprepared — especially when you’re off-site — so what can help you keep everyone (and your mission) safe?
Here are some questions you might consider asking yourself as part of your overall risk management plan — wherever your mission might take you.
- Are There Any Special Needs to Consider? Be sure to have parent/guardian disclose all known allergies, any and all medications required, and any accommodation required.
Once you have that information, make your plans and train your staff accordingly.
- Is the First Aid Kit Ready? A fully stocked first aid kit is crucial. Be sure to confirm what items can and cannot legally be included in a kit in your area, but the basics can include:
- Bandages
- Single-use ice packs
- Gauze
- Gloves
- Antiseptic wipes
- Prescribed emergency medications:
- Asthma inhalers
- EpiPens
Having your first aid kits present, fully stocked, and ready whenever there are clients around can help you be sure that you’re ready to protect them in case of emergencies.
- Is There Enough Staff? When you’re planning an activity or event, consider the number of people you can realistically expect to have available, and plan your activities around that.
Ideally, you want to be sure you have enough people to safely run all your activities, with several additional people on hand to provide breaks and extra help as needed.
- Proper Supervision: You never want something bad to happen because no one was watching. That means that, not only do you need to make sure your team members are following your practices and procedure, but that your supervisors are following them, too.
Some questions to consider ahead of time:- Does everyone understand their roles?
- How will your people communicate?
- Is everyone appropriately certified? (For example: If you’re hosting a swimming event, are the supervisors trained lifeguards?)
- Where should supervisors be positioned?
- Are there any blind spots?
- Are shifts properly covered, and does everyone know how and when to safely rotate?
- Who is in charge in an emergency?
- Do all staff members know the emergency procedures, and how to activate them?
- Is everyone aware of known, reported allergies?
- If someone with an allergy has a reaction, does everyone know where the medication is?
- Incident Reports: Keeping detailed incident reports can help protect you in a variety of ways. Even for minor bumps and scrapes, be sure your team knows to record:
- What happened
- Who was involved
- Any and all care given
- Who was notified
- Any other relevant details
Review the incident report with the client’s parent, caregiver, or guardian, have them sign and acknowledge it, and give them a copy.
NIA Resources:
- All nonprofits insured by NIA get free access to My Risk Management Plan — online tools to help you create a risk management plan that reflects your organization’s unique needs, priorities, and culture.
- NIA offers members free access to a library of e-books to help them navigate specific types of risks. For your special events, consider checking out “Sound Advice for Functions and Events: Tips for Staging Safer Special Events E-Book,” available online and in PDF.
The Right Training
It’s essential that you train your nonprofit’s staff and volunteers, especially those in supervisory roles, to lead effectively and respond appropriately to crisis situations.
Especially when it comes to allergies, administering medications, and other special needs/accommodations, you want to be sure that everyone knows what to do, and doesn’t panic, in an emergency.
Training you might consider include:
- First Aid/CPR training
- Conflict resolution/crisis prevention training
- Leadership training
- Risk management training
- Harassment prevention training
- Abuse prevention training
- Mandated reporter training
Note: Training requirements vary from state to state. Be sure to check and see what your state’s requirements are for training, and what your nonprofit’s responsibilities for providing training include.
Documentation & Recordkeeping
It’s relevant for all risks: If someone accuses your nonprofit of wrongdoing, and it’s your word against theirs, you’re going to have a hard time defending yourself.
That’s why it’s smart to document everything — your processes, your procedures, times, dates, decisions, attendance, every incident report, all security footage, and more.
Keeping good records not only helps your team stay more organized, but if your nonprofit ever needs to defend itself in court, your records can serve as proof that:
- You operated responsibly and in good faith
- Your policies, training, and procedures complied with the law
- Rules, policies, and procedures were consistently and equitably applied
- Everyone understood their responsibilities and duties
- Staff acted and responded appropriately
Strong recordkeeping practices can provide you with evidence to present in court, which can help put you in a much stronger position to defend your mission and your good name.
Conclusion
When your nonprofit works with children, the last thing you want is for the community to think of your organization as dangerous or poorly supervised.
When you supervise trained, certified people on your team — like nurses, teachers, etc. — you want to be able to trust that they are doing the duties they are supposed to be doing. But, as a supervisor, you can’t afford to leave it to chance.
Your job as a supervisor is to make sure your team is doing their duties, following procedures, and complying with the law.
Running a nonprofit is hard — especially with working with children, the elderly, or other vulnerable people. And making sure you have the supervision you need is part of that challenge.
Keeping a close eye on your team and making sure they’re doing their duties correctly is one of the best things you can do to protect both your nonprofit and the people you serve.
From the Claims Files stories like the one above are intended to be informational in nature. Coverage will vary depending on language specific to your policy and your specific facts and circumstances.
Please contact your insurance broker and/or agent for your specific coverage implications based on your specific situation and follow any claims reporting procedures from your policy with your broker if there might be a claim.
Nothing in this story should be considered as legal advice or opinion and you should seek independent advice or legal counsel.
