Southern California CERT Regional Workshop
March 6, 2014
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 Describe the benefits and components of
the Program
 Explain the revised Regulations and their
application
 Identify the ‘anatomy’ of a worker’s
compensation claim
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•
Nation at war
•
Pacific situation
– Fear of mass attack on CA Coast
•
Volunteer workforce
– Recruited and trained
– No expectation of compensation
•
Legislative action
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
Certified War Councils (renamed Disaster
Councils) as “accredited”
• Allowed registration of volunteers as DSWs

Provided worker’s compensation to registered
volunteers

Offered limited liability protection

Required Loyalty Oath
• For proper enrollment as a DSW volunteer
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California Governor’s Office of Emergency Services
 Approves disaster council accreditation, regulations,
classifications
 Delegates registration/oath authority to state agencies
 Manages DSW appropriation
- Works with State Fund and Cal OES Divisions
 Reviews claims, authorize settlements, issue checks
 Ensures compliance: Centers for Medicare & Medicaid
Services
- Federal reporting mandate: Medicare beneficiaries
Ref: ESA, GC 8585.5, 8585.7
State Legislature
 Approves DSW appropriation in state budget (annually)
 Source of funding: General Fund
Fiscal Year (s)
Amount
1988 - 2004
$ 663,000
2004 - 2008
$1,125,000
2008 - present
$1,012,000
 Funds pay approved workers’ compensation claims
State Compensation Insurance Fund (SCIF)
 Processes claims
 Calculates benefits
 Communicates with Cal OES from start of claim to closure
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Accredited Disaster Councils or Authorized Designees*
 Registration (Group or Individual):
⇨ Complete DSW registration form: applicant & government entity.
⇨ Administer Oath at meeting or event/activity by authorized official.
⇨ File and maintain DSW records.
 Supervision:
√ Decide who acts in supervisory capacity and how supervision performed
√ Determine criteria, i.e. experience, training
√ Provide Program education, worker’s compensation claim instruction
*Government/public entities delegated Program authority by the ADC.
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Accredited Disaster Councils or Authorized Designees*
 Training:
Determine
 Minimum emergency management experience
 Curriculum, number of exercises, hours
 License/certification for a given classification
 Background Checks: Required?
Considerations
1. Classification – Duties performed? Volunteer contact?
2. Cost - $$$ Who pays?
3. How to interpret findings? What to do with
information?
*Government/public entities delegated Program authority by the ADC.
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•
DSW Volunteer
•
Disaster Service: Eligible & Excluded Activities
•
DSW Registration
•
Volunteer Classifications
•
Oath Authority
•
File Retention & Recordkeeping
•
Worker’s Compensation Claims
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KEY REVISIONS:

Statutory Inclusion
(i.e. Agency name change, amended filing language)






Supervision: Clarification/Definition [CCR §2570.2(b)(1)]
Background Check (CCR §2572.1)
Eligible & Excluded Activities: Definition [CCR §2570.2(b)(1)]
Classifications: Description updates/Addition (CCR §2572.1)
Registration and Training (CCR §2573.1)
Claim Submissions: Training document addition (CCR §2573.3)
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
Registered with:
• Accredited Disaster Council (ADC) or
Authorized Designee
(i.e. ADC designates County Animal Control)
• Cal OES or authorized state agency

Receives no pay

Activated by registering agency

Impressed into service (rare)

Auxiliary Firefighter
EXCLUDES:
Volunteer Firefighters
Spontaneous Unaffiliated volunteers
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


Adults physically and mentally capable of
performing disaster related activities
Employed, unemployed, or retired persons
Volunteers under 18 with parental or legal
guardian consent
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Activities authorized in:
California Emergency Services Act (ESA)
► Resulting from:
-
State of War emergency
State & Local proclaimed emergencies
Search and rescue missions
Official out-of-state deployments
Activities performed to mitigate imminent threat of extreme peril to
life, property
- Official mutual aid assistance
► Described in DSW classifications
scope of duties
► Travel to and from the incident site
REF: GC Sections 8558 & 8585.5
CCR §2570.2(b)(1)
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► Training
May be required by:
- ADC, authorized designee, supervising agency
May include:
√ Basic/Advanced/Refresher courses
√ Exercises
(Person in ‘victim’ role must be registered as DSW volunteer)
√ Out-of-state: only under very specific criteria
Must be:
1. Approved in advance by the ADC or authorized agency
2. Documented to verify participation
3. Supervised
► Offsite, onsite
►Paid staff, volunteers
4. Commensurate with classification
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
Day-to-day operations
◦ Activities typically associated with emergency response
agencies
(i.e., assisting with single structure fires, traffic collisions; crowd
control for concerts & sporting events)

Preparedness/Planned Activities
◦ Educational fairs, first aid booths
◦ Parades, festivals, fundraisers, smoke detector installations,
website development, etc.

Self Activation

Travel to and from the training site
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
Accredited Disaster Councils (ADC)
• All 58 counties in CA
• Most cities in CA

Authorized Designees of ADC
• Government/public agencies

Cal OES
o Law Enforcement Branch
o Recovery Branch
o Telecommunications Division

County OES

Authorized state agencies
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Required:
1. Name & address of registrant
2. Classification
 More than one may be identified depending
on scope of duties
3. Date enrolled (date Loyalty Oath signed)
4. Loyalty Oath
√ Taken & signed by applicant before authorized official
√ Signed by authorized official
√ Signed prior to date of injury
5. Name of registering govt agency w/signature &
title of authorized person CCR 2573.1(a)(4)
Optional: Specialty, ID #, Emergency Contact, License #, Phone #
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Animal Rescue, Care & Shelter
Communications
Community Emergency Response Team Member
Emergency Operations Center/Incident Command
Human Services
Fire
Laborer
Law Enforcement
Logistics
Medical & Environmental Health
Safety Assessment Program Evaluator
Search & Rescue
Utilities
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
Authorized Persons
(GC §3104)
 Elected officials
 Designated public officials
 County and city clerks
 Notary public
 Cal OES Director
*NO FEE
MAY BE CHARGED FOR THE OATH ADMINISTRATION
NOTE: Volunteers CANNOT administer the Loyalty Oath
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Registration Form
Completed by ADC
or authorized
designee.
Completed by
applicant.
Applicant:
subscribe,
date & sign.
Official:
administer
oath & sign.
•
Loyalty Oath – Registration Form
 State Agency – filed within 30 days
 County – Clerk or Official Department personnel file
 City – Clerk
 Other authorized Public Agency
- designated Officer/Employee of the agency
•
Available for inspection by SCIF/Cal OES
•
Registrations to be kept current
•
Storage: hardcopy or electronic format
• If electronic format, requires written statement on file verifying that
original used to scan, e-mail, attach in database, etc.
•
Destruction of records: 5 years after DSW’s service ends
Ref: GC §3105
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Required Documents:
SCIF Form 3301 – Claim Form
SCIF Form 3267 – Employer’s Report
DSW Volunteer Registration



•

Including Loyalty Oath
Written Incident Report
If injury due to training:


Training Documentation
Pre-authorization of Training Activity
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 Injured
DSW Volunteer
• Completes Employee section
 ADC/Supervising
Agency
• Completes Employer section
• Provides copy of completed form to volunteer
• Mails original to SCIF within 5 calendar days
after receipt from DSW volunteer
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Employee/Injured DSW Volunteer


Lines 1- 7
Line 8 (Signature)
Employer/ADC or Supervising
Agency






Lines 9-13
Line 14
Line 15
Line 16
Line 17
Line 18
Supervisor
Pre-filled
N/A
Supervisor’s
signature
Supervisor’s title
Phone number
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 ADC/Supervising
Agency
• Completes within 5 days of injury notification
• Mails original to SCIF
OR
• Calls 24 hr. Claims Reporting Center at:
(888) 222-3211
• Faxes or emails copy to Cal OES
Do not wait for completed SCIF Form 3301
Do not have volunteer complete
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



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Lines 1-3
Lines 4-5
Line 6
Lines 7-10
Lines 11-16
Lines 17-26
Lines 27-29
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Lines 30-34
Line 35

Lines 36-39
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Lines 40-43

Line 1a pre-filled
4 pre-filled, 5 N/A
Pre-filled
If unknown, leave blank
May have partial
information
Regular job– not
DSW duties
If unknown, leave blank
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If injury is due to training:

Training log sheet or similar document verifying
participation showing:
•
•
•
•
•

Volunteer’s name
Time in/time out
Supervisor’s name/signature
Date
Name of event
Pre-authorization of training activity must be:
• Approved in advance
• Commensurate with DSW classification
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DSW Volunteers & Mutual Aid Assistance Claims Submission
Requesting Agency
needs
DSW volunteers
Sending Agency
deploys
DSW volunteers
DSW volunteer
injured under
Requesting Agency’s
supervision
Both Agencies provide copies
of all documents to each other.
Requesting Agency
1. Mail original 3267, 3301 to SCIF & fax/e-mail copies
to Cal OES.
2. Fax/e-mail copies: incident report to SCIF & Cal OES;
3. Fax/e-mail training docs, if applicable, to SCIF &
Cal OES
Sending Agency
Fax/e-mail Registration & Oath to SCIF & Cal OES
Who
submits
paperwork?
Who is
responsible for
paperwork?
Both Agencies
coordinate efforts
to complete & submit
required forms
Requesting Agency
1. SCIF 3267 – Completes Form
2. SCIF 3301 – Provides Form to injured DSW volunteer
3. Incident Report – Completes brief narrative
Sending Agency
1. DSW Registration & Oath
DOCUMENT
SCIF
SCIF 3267
CAL OES
Fax Copy
&
Mail Orig
SCIF 3301
DSW Registration & Oath
Incident Report
Training Pre-Authorization*
Fax Copy
COMMENTS
SCIF Fax:
707-646-0562
Fax
or
Scan
Copy
Training Verification*
CAL OES Fax:
916-845-8736
*Required for
training related
injuries
Step-by-step claim information located at:
www.calema.ca.gov/PlanningandPreparedness/Pages/Disaster-ServiceWorker-Volunteer-Program.aspx
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
Government Code
◦
◦
◦
◦
◦
◦
◦


3100-3109
8555-8561
8567
8585.5, 8585.7
8610-8614
8655-8660
8668
Vehicle Code
◦ 25259.1
Labor Code
◦
◦
◦
◦
◦

3211-3211.93a
3350-3371
3600-3605
4351-4354
5400 et. Seg
Civil Code
◦ 1714.5
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Anita Chant
Program Lead
(916) 845-8763
anita.chant@caloes.ca.gov
Kathryn Chin
Claims Analyst
(916) 845-8787
kathryn.chin@caloesma.ca.gov
DSWVP Regulations, Guidance & Related Documents:
http://www.calema.ca.gov/PlanningandPreparedness/Pages/Disaster-Service-WorkerVolunteer-Program.aspx
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