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Ask Deborah: Private Pay
July 2, 2012

Deborah Patterson knows health ministry. As the executive director of Northwest Parish Nurse Ministries and author of Health Ministries: A Primer for Clergy and Congregations, she works daily with parish nurses, pastors, and health professionals. In this feature, she answers your most pressing or perplexing questions on health ministry. Are you hitting a roadblock with a program in your church? Are you wondering where to start with health ministry? Do you feel like you need a new idea on a specific topic? Ask Deborah!

QUESTION: I am a parish nurse, and I am wondering if I can receive pay for the work I am doing.

ANSWER: Certainly, as a professional member of the church staff, you can negotiate an hourly, monthly, or annual salary for yourself with the congregation. Generally, the hourly salary for parish nursing ministry is in the range of $15-25 per hour, and it is based primarily on what the congregation is able to offer. In some cases grants are available through local foundations for start-ups for parish nursing programs. The best place to start looking for grant funding is through your local library, where research librarians can help you locate foundations in your area.

Most faith community nurses are highly experienced in the nursing profession, and the typical salary they receive is significantly less than they would earn elsewhere. However, salaries for all professionals in the church—including clergy—are significantly lower than those earned by professionals in health care organizations that receive payment from public and private insurers.

On the other hand, if you are asking whether you can receive payment for services rendered to an individual congregational member or family, the answer is no. A clergyperson receives a salary for services and would not ethically provide services, such as counseling, on a fee-for-service basis—unless the person was working only on a one-to-one basis as a licensed pastoral counselor for a counseling center and not as the pastor of the church where the center was located. Similarly, a parish nurse’s “client” is the congregation itself, and therefore it would be unethical to receive payment from individuals for services rendered.

I suggest that you work with your health committee (and you have a health committee, right?) to set up a special fund at the church for donations to the faith community ministry. The church can use this fund to pay your salary. Then if an individual or family would like to thank you or the congregation for the services you provided, they could donate to the parish nursing ministry (or even make regular contributions), and those funds would contribute to your continued salary. This contribution would be a tax-deductible donation for the person or family giving the funds to the church.

You would not want it to appear that you are giving preferential treatment to those who can afford to pay for your help over those who have fewer financial resources. In addition, under the Scope and Standards of Practice for Faith Community Nursing developed by the Health Ministries Association and approved by the American Nurses Association, you cannot offer hands-on nursing care (such as private duty nursing or home health care), since no medical director is available for this service. To do so would be put at risk your nursing license, and both your own professional liability insurance and the church’s liability insurance.

Finally, you want to be sure that you are fulfilling your role as a faith community nurse in assisting people to access needed services by helping them find affordable, ongoing services that will meet their long-term needs. If you were working as a private duty nurse for someone in the church, you would not be helping to arrange the ongoing services the person needs. What happens if you want to go on vacation or are sick? If you don’t arrange for appropriate coverage for the care you agreed to provide on an ongoing basis, you could be found liable for professional negligence.

The key is to remember that this is a ministry to the congregation. Any payment needs to go to the congregation, and any salaries or stipends you receive should come through the congregation.

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Deborah Patterson is here for you and your church. To send in a question to Deborah, send an email and write "Ask Deborah" in the subject line. Please include your first name and location.