POINT ARENA CITY COUNCIL
AGENDA ITEM SUMMARY
AGENDA ITEM: IX D
MEETING DATE: 4/23/2024
TITLE
Resolution of the Point Arena City Council Providing for Workers’ Compensation Coverage for Certain Volunteers
RECOMMENDED ACTION
Adopt Resolution providing Workers Compensation coverage for City volunteers.
ANALYSIS
Volunteers are a key resource for Point Arena, often bringing a wealth of skills and knowledge to City operations in a variety of areas. Not only can volunteers expand and improve community services and events, but they can also enable Point Arena to stretch its tax dollars to improve our community.
Volunteers can also pose a risk to the City, and potentially to themselves, if they are injured while volunteering. However, when managed properly, the liability and Workers Compensation exposure can be significantly minimized, which protects both the City’s financial resources as well as the safety of community volunteers.
Staff contacted California Intergovernmental Risk Authority (CIRA), the City’s risk management agency to determine how we can protect the safety of volunteers while they serve the City. CIRA recommended the City Council adopt the CIRA Resolution Attachment 1) that would provide Worker’s Compensation coverage for City volunteers. Once the Resolution is approved, volunteers would be required to complete a Volunteer Application (Attachment 2), as well as a Release of Liability (Attachment 3) which states that under Workers Compensation laws, Workers Compensation benefits will be the only remedy in the event of an injury. These two forms work together to formally identify an individual as an authorized volunteer.
FISCAL IMPACT
Undetermined but potentially significant savings to City operations.
ATTACHMENTS
Attachment 1: Resolution
Attachment 2: Volunteer Application
Attachment 3: Release of Liability
CITY MANAGER SIGNATURE
_________________________________
Peggy Ducey, Interim City Manager
RESOLUTION NO. 2024-08
RESOLUTION OF THE POINT ARENA CITY COUNCIL PROVIDING FOR WORKERS’ COMPENSATION COVERAGE FOR CERTAIN VOLUNTEERS PURSUANT TO 3363.5 OF
THE LABOR CODE
WHEREAS, the City of Point Arena desires to provide Workers’ Compensation coverage for persons authorized to perform volunteer services for the City.
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Point Arena, California hereby adopts the policy that an unsalaried person as designated and authorized by the City to perform volunteer service for the City shall be deemed to be an employee of the City for the purpose of Workers’ Compensation benefits provided by law for any injury or illness sustained by him or her while acting in the course and scope of the authorized services of the City and under the direction and control of the City.
PASSED AND ADOPTED The foregoing Resolution No. 2024-08 was passed and adopted at a Regular meeting of the Point Arena City Council on the 23rd day of April, 2024 by the following vote. Motion by _______, Seconded by ________.
Ayes:
Noes:
Absent:
Abstain:
Barbara Burkey
Mayor
ATTEST:
Peggy Ducey
Interim City Manager
ATTACHMENT 2
VOLUNTEER APPLICATION
City of Point Arena
Date:
CONTACT INFORMATION
Full Name: Address:
Phone:
Cell Home Work
Best time to call:
Date of Birth:
SKILLS AND BACKGROUND
Current Occupation: Place of Employment:
Previous Volunteer Experience: Special Training/Skills/Certifications:
Drivers License Number:
Do you own a vehicle? No Yes, Insurance Co.:
Languages Spoken:
If attending school, please provide name of school: Highest Grade Completed: Degree/Major:
VOLUNTEER INTERESTS
What types of volunteer projects interest you? How long are you available to volunteer? Special Projects Only 3 months 6 months 1 year Ongoing Other:
Please indicate days/times you are available:
Sunday Monday Tuesday Wednesday Thursday Friday Saturday Hours:
Do you have any friends or family members who work for the City? If so, please provide their name and position:
Friend
Name: Position: Family
Friend
Name: Position: Family
Friend
Name: Position: Family
REFERENCES
Please provide two references (not related to you):
Name: Phone: Years Known:
Name: Phone: Years Known:
EMERGENCY CONTACTS
(Minors must list at least one parent or guardian)
Full Name:
Relationship to you:
Address:
Phone:
Cell Home Work
Full Name:
Relationship to you:
Address:
Phone:
Cell Home Work
Have you ever been convicted of any misdemeanor or felony? No Yes, please explain:
REVIEW AND ACKNOWLEDGE
Initials
I understand all volunteers are subject to a screening process that may include but is not limited to: fingerprinting, background check, credit check, driving record review, interview, and contacting references. I understand I have the right to refuse any of these screening processes, but in doing so may become ineligible for volunteer opportunities.
I understand that as a volunteer I will not be paid for my services beyond reimbursement for incidental expenses related to the assignment (i.e. mileage reimbursement).
I understand that my selection as a volunteer is dependent on my review of the job description and ability to perform the essential functions, duties, and responsibilities of the assignment.
I understand that I may not begin an assignment until orientation has been completed and all requested paperwork has been submitted including but not limited to: Release of Liability, Acknowledgement of Workers’ Compensation Benefits, Consent to Background/Credit Check and Information Release, Affidavit of Criminal History, and Proof of Insurance.
I understand that if using my personal vehicle, the City is not liable for any damage unless caused by the City’s sole negligence. In the event of an accident, it is my responsibility to immediately notify my volunteer supervisor, Department of Motor Vehicles, and my insurance company.
I understand as a volunteer I am subject to the rules, policies, and regulations of the City. I further understand that as a volunteer, I may be dismissed at any time, with or without notice or cause.
Applicant Signature: Parent/Guardian Signature (if applicant is a minor):
Print Name:
ATTACHMENT 3
City of Point Arena
Volunteer Services Agreement
Release of Liability and Assumption of Risk
16535.00000\5741434.3
I, _________________________, hereby acknowledge that I have voluntarily applied to participate in performing _____________________services for the City of Point Arena (“Services”). I am voluntarily participating in the Services with the knowledge that there is a risk that I may be injured while I do so and I freely and voluntarily expressly assume all the risks of participating in the Services. I understand that the City’s policy is to cover volunteers as employees of the City for purposes of Worker’ Compensation benefits. I also understand that under Workers’ Compensation laws, Workers’ Compensation benefits will be my sole and exclusive remedy in the event I am injured while participating in the Services.
In consideration of my participation in the Services, with the exception of Workers’ Compensation benefits, I hereby waive and release on my behalf and on behalf of my heirs, guardians, legal representatives and assigns, the City of Point Arena, its officials, officers, employees, agents volunteers and representatives (collectively “City”) from any and all liability of any kind or nature for injuries to persons or property, including death, arising from or in connection with my participation in the Services, that this waiver and release is applicable even though the actively or passively negligent activities of City may have caused or contributed to the injuries suffered.
I also certify that I am physically fit and in proper physical condition to participate in the Services and have not been advised otherwise by a qualified medical person. Lastly, I agree to accept and abide by the rules and regulations of the City of Point Arena while participating in the Services.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT. I FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT I HAVE
GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Date: ______________________ _______________________________ Signature
_______________________________
Print Name
Date:______________________ ________________________________ Parent or Guardian*
________________________________
Print Name
*Signature of parent or guardian is required if volunteer is under age 18.