1. Andrea Standley PhD

2.  Values ◦ Beliefs and attitudes that provide direction to everyday living  Internal  Ethics ◦ Beliefs we hold about what constitutes right conduct. Ethics are moral principles adopted by an individual or group to provide rules for right conduct  External

3.  Cory, Cory & Calanan (2011)  Autonomy: to promote self-determination  Beneficence: to do good for others and promote the well-being of participants  Non-maleficence: to avoid doing harm

4.  Justice: to be fair by giving equally to others and to treat others justly  Fidelity: to make realistic commitments and keep these promises  Veracity: to be truthful and deal honestly with participants

5.  The National Organization for Human Services promotes the following ethical standards: ◦ Respect the integrity and welfare of the participant at all times ◦ Protect the participant’s right to privacy and confidentiality except when such confidentiality would cause harm to the participant or others

6. ◦ Protect the integrity, safety and security of participant records ◦ Protect the participant’s right to self-determination  Recognize the participant’s right to receive or refuse services  Self-Neglect  Hoarders ◦ Recognize and build on participant strengths ◦ Keep informed about current social issues as they affect the participant and the community.

7. ◦ Act as advocates in addressing unmet participant and community needs ◦ Provide services without discrimination or preference based on age, ethnicity, culture, race, disability, gender, religion, sexual orientation or socioeconomic status ◦ Be knowledgeable about the cultures and communities within which you practice ◦ Be aware of your own cultural backgrounds, beliefs, and values

8.  The Health Insurance Portability and Accountability Act of 1996 (HIPAA)  Passed by congress to promote standardization and efficiency in the health care industry and to give patients more rights and control over their health information.

9.  The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities  It provides patients an array of rights and respect with respect to that information  The Privacy rule is balanced so that it permits the disclosure of personal health information needed for patient care

10.  Establishes administrative, technical and physical standards for the security of electronic health information  Requires that we maintain the availability, integrity, and confidentiality of electronic health information

11.  Protected Health Information (PHI) under HIPAA means any information that identifies an individual and relates to at least one of the following: ◦ The individual’s past, present or future physical or mental health ◦ The provision of health care to the individual ◦ The past, present or future payment for health care

12.  Name  Address  Birth Date  Social Security number  E-mail address  Health plan beneficiary number  Account number  Photographic image  Any other characteristic that could uniquely identify the individual

13.  Make sure participants know that information is confidential  Power of Attorney  Release of information form  Provide Notice of Privacy Practices  Privacy in Hospitals

14.  When clerical assistants handle information  When an in-home service worker or care coordinator is being supervised  When a participant has given consent  When a participant poses a danger to self or others

15.  When a participant discloses intention to commit a crime  Suspected abuse or neglect of a child or vulnerable adult  Court orders  Public health purposes to control disease

16.  Assisting the government in overseeing health care programs  Law enforcement purposes  National security purposes

17.  Mandatory Reporting ◦ Designed to encourage reporting of any suspected cases of child, elder, or dependent abuse ◦ If children, the elderly, or other dependent adults disclose that they are being abused or neglected, the professional is required to report ◦ We have an obligation to protect those who cannot advocate for themselves

18.  Child Abuse 1-800-252-2873  Elder Abuse 1-866-800-1409

19.  Balancing participant confidentiality and protecting the public is a major ethical challenge ◦ We must exercise the skill and care of a reasonable professional to:  Identify participants who are likely to do physical harm to third parties  Protect third parties from participants judged potentially to be dangerous

20.  Most ethics codes address diversity, however, reliance on ethics codes alone does not guarantee multicultural competence  Ethical practice requires that professionals be trained to address diversity factors  We need to reflect on our own assumptions and challenge stereotypical beliefs and cultural bias

21.  A temporary dependence is not necessarily problematic  A ethical issue occurs when workers/professionals encourage and promote dependence

22.  Supervising is a process that involves a supervisor overseeing the professional work of a trainee with five major goals: ◦ To promote employee growth and development ◦ To protect the welfare of the participant ◦ To not participate in dual relationships

23. ◦ To monitor supervisee performance and to serve as a gatekeeper for the profession ◦ To empower the employee  Can you think of other goals of a supervisor?

24.  Ladany and Colleagues(1999) conducted a study and found: ◦ 51% of employees sampled (151) reported ethical violations by their supervisors. ◦ Ethical violations included:  Performance evaluations  Confidentiality issues  Ability to work with alternate perspectives

25.  It is beneficial to discuss the rights of employees from the beginning of the supervisory relationship  When employees learn what they can expect and what they need to do to achieve success, they are empowered to do a good job

26.  Supervisors should be upfront with employees by providing: ◦ Methods to be used in supervising ◦ Responsibilities and requirements  For supervisor and employee ◦ Policies pertaining to confidentiality and privacy ◦ Documentation of supervision

27.  Risks and benefits  Evaluation of job performance  Complaint procedures and due process  Professional development goals

28.  Supervisory sessions should be in private  To be fully informed of supervisor’s approach  Confidentiality with regard to employee’s disclosure  Confidentiality with regard to participants except as mandated by law

29.  Supervisors are ultimately responsible, both ethically and legally for the actions of their employees  Supervisors have responsibilities to current participants and future participants as well

30.  Supervisors must have a clearly developed framework for supervision and a rationale for the methods they employ  Good supervisors demonstrate the four A’s: ◦ Available ◦ Accessible ◦ Affable ◦ Able

31.  Don’t supervise beyond your competence  Evaluate and monitor employee’s competence  Be available for supervision consistently  Maintain written policies  Document all supervisory activities

32.  Maintain a working knowledge of ethics codes, legal statutes, and certification regulations  Use multiple methods of supervision  Have a feedback and evaluation plan  Establish a policy for ensuring confidentiality  Manage boundaries

33.  Human services can be a stressful profession which can lead to empathy fatigue.  Some sources for stress are: ◦ Feeling of not helping their participants enough ◦ The tendency to accept full responsibility for participant’s progress ◦ Feeling a pressure to quickly solve participant’s problems ◦ Having extremely high personal goals and perfectionist strivings.

34.  An absence of boundaries with participants or employees  Preoccupation with work  Inability to say no  Poor health habits in the areas of nutrition and exercise

35.  Low productivity  Depression  Negativity  Frustration  Agitation  Feeling of futility

36.  As supervisors, what can you do to minimize the possibility of burnout in your employees?  As supervisors, what can you do to minimize the possibility of burnout in yourself?

37.  Paid Family Caregivers  Gift Giving  Can you think of any other ethical issues?

38.  Any effort to defraud the Medicaid system by billing for services not delivered, or under delivered.  It can also manifest itself in cases where physical abuse or neglect has occurred.  In order for there to be Medicaid Fraud, Medicaid money must be involved.  Medicaid fraud can also occur when participants knowingly falsify Medicaid/CCP applications.

39.  Two Ways to report Medicaid Fraud  Illinois State Police ◦ 1-888-557-9503  Healthcare and Family Services ◦ Office of Inspector General

41. “Never let your sense or morals get in the way of doing what’s right.” Isaac Asimov

42.  Corey, Cory & Callanan (2011). Issues and ethics in the helping professions. Brooks/ Cole – Cengage Learning  Hall, J. (2012) Staff retention and minimizing burnout. Retrieved on 2/11/2013 fromhttp://humanservices.ucdavis.edu/resource/library/pdf/D14%20Staff%2 0Retention%20and%20Minimizing%20Burnout.pdf  Ladany and colleagues (1999). Psychotherapy supervisor ethical practice: Adherence to guidelines, the supervisory working alliance, and supervisee satisfaction. The Counseling Psychologist, 27(3), 443-475.  National Organization for Human Services (2013). Ethical standards for human service professionals. Retrieved on 1/29/13 from www.nationalhumanservices.org/index.php?option=com_conte nt&view==article&id= www.nationalhumanservices.org/index.php?option=com_conte  U.S. Department of Health and Human Services (2013). Health Information Privacy. Retrieved on 1/29/2013 from www.hhs.gov/ocr/privacy/hipaa/understanding/index.html