Ombudsman Compendium - Recruitment Appendices

Appendix A - Ombudsman Program Needs and Management Capacity

• Long-Term Care Ombudsman Volunteer Program Procedure Flow Chart (HI SLTCOP)
• Recruitment and Selection Process Outline (Pierce County, WA LTCOP)
• Volunteer Recruitment Steps (OK SLTCOP)
• Recruitment Planning (TX SLTCOP)

Appendix B - Position Descriptions

• NASOP Mission Statement
• Regional Long-Term Care Ombudsman (WA SLTCOP)
• State LTCO Volunteer Coordinator (HI SLTCOP)
• Lead Ombudsman (Salt Lake County, UT LTCOP)
• Certified Volunteer LTCO (Suffolk County, NY LTCOP)
• Volunteer Pharmacist Consultant (Salt Lake County, UT LTCOP)
• Volunteer Ombudsman, Foreign Language Specialist (Northern VA LTCOP)
• Volunteer Ombudsman Mentor (Northern VA LTCOP)

Appendix C Formal - Program Commitments

• Volunteer Commitment Form (LAFMC of Metro Chicago, IL LTCOP)
• Confidentiality Agreement (Salt Lake County, UT LTCOP)
• Conflict of Interest Statement and Ethical Guidelines (OK SLTCOP)
• Statement of Agreement Between Ombudsman Volunteer Representative and LTCOP (HI SLTCOP)

Appendix D - Application Forms

• Volunteer Application (short form) (GA SLTCOP)
• Volunteer Application (long form) (GA SLTCOP)

Appendix E - Recruitment Messages

• The Importance of Key Messages (TX LTCOP)
• Recruitment Ad (OK SLTCOP) - full page; half page
• Recruitment Ad (Salt Lake County, UT LTCOP)
• News Release (MO SLTCOP)
• Recruitment Flyer (Suffolk County, NY LTCOP)
• Volunteer Advocates Needed (Suffolk County, NY LTCOP)
• Volunteer Recruitment Brochure (Snohomish County WA LTCOP)
• Volunteer Recruitment Flyer (Northern VA LTCOP)
• Volunteer Recruitment Flyer for Foreign Language Specialists (Northern VA LTCOP)

Appendix F - Response to Applicant Interest

• Code of Ethics for Long-Term Care Ombudsmen (developed by NASOP)
• Follow-Up Letter (KIPDA District, KY LTCOP)
• Follow-Up Letter (Oklahoma City, OK LTCOP)

Appendix G - Conflict of Interest

• GA LTCOP Policies and Procedures - Section on Conflict of Interest (GA SLTCOP)
• Conflict of Interest Screen (OH SLTCOP)

Appendix H - Interview Questions

• Sample Interview Tool for Ombudsman Volunteer Supervisor (OK SLTCOP)
• Ombudsman Volunteer Interview Form (Northern VA LTCOP)

Appendix I -  Reference and Criminal Background Checks

• Reference Request Letter (Salt Lake County, UT LTCOP)
• Volunteer Reference Form (Snohomish County WA LTCOP)
• Questions for Volunteer Reference (Snohomish County WA LTCOP)
• Criminal Background Check Overview (MN SLTCOP)

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