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174 Cards in this Set
- Front
- Back
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What is the purpose of the Board of Psychology (BOP, "Board")? |
to regulate providers of psychological services with the goal of PROTECTING THE PUBLIC. |
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Who is regulated by the Board? |
Licensed psychologist |
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Board of Psychology investigates... |
* Allegations of unprofessional conduct, fraud, illegal behavior * Institutes disciplinary action *Periodically checks to see whether providers are in compliance with the code |
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Requirements for a psych assistant (2) |
Master's degree |
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Requirements for a registered psychologist (3) |
Doctoral degree |
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Notice to Consumers must be... |
posted where patients can see it. |
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Board members consist of... |
9 MEMBERS: |
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Requrements for licensed psychologist (4) |
Doctorate Degree |
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Coursework for psychologists |
Substance Abuse- semester/quarter class |
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An SPE "year" (i.e., 1500 hours) must be completed in how many months? |
30 months |
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Ways to earn SPE (5) |
Formal internship (pre-doc) |
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Primary supervisors must have completed... |
a minimum of 6 hours of supervision coursework every two years. |
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When is the supervisor-supervisee agreement to be signed? |
BEFORE any SPE.
(primary supervisor must maintain the agreement until the SPE hrs are completed, and must then submit both the agreement and VOE to board) |
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Supervision requirements for SPE |
10% of total time worked each week |
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How many hours of SPE can be counted per week |
Up to 44 |
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What needs to go on the SPE log? |
Info re: work setting |
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Who can be primary supervisor? |
Generally only licensed psycholgists |
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Supervisor's employment |
Must be employed in the same work setting (no minimum % of time) |
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Supervisor's availability |
Must be available 100% of the time supervisee is working |
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Can you pay for supervision? |
no |
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Can you work under another license while earning SPE? |
no |
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Who monitors delegated supervisors? |
Primary supervisors |
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Who can be delegated (i.e., secondary) supervisors? |
LPs, LMFT, LICSW, psychiatrists |
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Who is responsible for notifying patients of supervisee's unlicensed status? |
Supervisor |
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Supervisor- supervisee relationship is a _________________ relationship. |
employer-employee |
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How many psych assistants can each have? |
Psychologist- 3 |
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Can a psych assistant rent office space from supervisor? |
no |
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Do delegated supervisors have to be employeed in same organization? |
Yes for psych assistants. Also, can only be LP or psychiatrist. |
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What does a psych assistant need to put on advertisements? |
That they are supervised |
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Who renews they psych assistant registration? |
supervisor |
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How often is psych assistant registration?
When psych assistantship is terminated employer must notify BOF within... |
yearly
30 days |
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How long can you be registered as psych assistant? |
6 years cummulative (72 mths) |
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When does a psychology license expire? |
every 2 years on midnight on last day of birth month |
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A license that has expired may be renewed in ____ years. |
Three |
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When license has expired for over 3 years, what do you have to do? |
take CPSE again (if licensed for < 5 years) |
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How may CE hours are required? |
36 every licensing cycle (1.5/mth) |
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How much CE can you do over internet (or other independent method)? |
75% (27 hours) |
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The Board encourages psychologists to take CEs in... |
geriatric psychopharmacology assessment and tx of AIDS issues of human diversity |
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What is the requirement for training in law and ethics? |
once each renewal cycle no minimum number of hours can be CEs, workshop, grandrounds, professional presentation, etc. should cover changes and updates |
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For those who graduated before 2004 there are 2 required one time CE requirements. They are... |
1 hour spousal/partner abuse 3 hours aging and long term care |
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What types of CE accreditations are allowed? |
APA/APA sponsorship CPA/CPA sponsorship CME by CMA or ACCME |
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What proof is needed that you've attended CEs? |
None needs to be sent into the board but you have to have documentation in case of audit. Must keep documentation for 4 years after renewal period. |
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If you are licensed in another state or Canada, how many days per year can you practice in CA? |
30
This is IN PERSON, not telecare |
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If you are licensed in another state and you have applied for a CA license, how long can you practice? |
180
Starts the date you apply OR the date you are a resident, whichever is sooner |
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What do you have to include in any advertisement, directory or solicitation of business?
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Your license number |
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What are the penalites for false advertisement? |
6 months jail
$2500 fine
disciplinary action |
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What are the causes of disciplinary action (14)? |
-conviction of a crime related to psych duties -use of substance that affects work or is dangerous to the public -misrepresenting license -impersonating another with a license -fraud or deception to obtain license -pay/receiving fees for referrals -willful breaking of confidentiality -gross negligence -license from another state suspended/revoked -dishnesty, corruption, fraud -sexual abuse or relations with patient -practice outside competency -failure to provide stuff to board for supervisee -repeated negligence |
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What non-disciplinary action is public? |
Citation and fine |
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What are possible non-disciplanary actions (5)? |
mediation- no clear violation but rather a misunderstanding
education letter- minor departure in care, but no real harm
letter of warning- minor infraction, no harm
educational review- voluntary, when there are serious conerns or significant violation, meet wtih BOP to discuss issues of concern
citation and fine- less serious violations (i.e., false advertising) - considered non disciplinary yet becomes public record. |
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What are possible disciplinary actions (6)? |
letter of reprimand- not severe violation, no patient harm
two-step agreement- not severe violation, no patient harm, will include conditions such as coursework, when completed accusation is withdrawn
probation- license is revoked but the revocation is stayed, for gross neglignece, dishonesty, corruption, fradulence
suspension- may not practice or refer to self as psychologist, automatic when incarcerated for felony, interim suspension means immediately suspend- happens when have been BOTH in violation of the code or convicted of crime related to practice AND continuing would represent danger |
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Informed consent for telehealth... |
* provider must obtain verbal consent * document in the medical record
* psychologist must be license in the state in which the consumer is a resident. |
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What are some of the important legal exceptions to privilege based on evidence codes? (10) |
1) Patient raises issue of their emotional condition (i.e., emotional suffering)
2) Therapist is appointed by the court to examine patient
3) Evaluation for sanity at time of act
4) Evaluation for competence to stand trial
- DOES NOT APPLY when it is solely an evaluation to determine case strategy by patient's lawyer
5) If therapy relationship is used to hide a crime
6) Regarding deed, will or other property document of dead patient (and validity thereof)
7) When therapist or patient alleges breach of duty (e.g., patient non-payment, therapist negligence)
8) danger to self or others requires hospitalization or extension of hold
9) mandated reporting
10) A patient under 16 has been a victim of a crime and disclosure is in their best interest |
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What should a therapist do when subpoenaed? |
1) see if patient wants to waive privilege
2) if not: - ask to be released - comply by presenting with records - assert privilege - if ordered, provide records |
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When parents are divorced, who consents to minor's treatment? |
a parent with legal custody |
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What rights to parents have to treatment information? |
Usually it is based on minor's best interests, but when it comes to drug and alcohol counseling law is very clear that the provider should disclose information. |
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When can a minor consent to treatment? |
Emancipated minors (married, military, court ordered)
Self-sufficient minors for MEDICAL AND DENTAL treament (at least 15, living on own, own finances)
Minor at risk/consent will discourage treament
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What conditions are required for a minor to consent to their own MH treatment? |
1) 12 or older
2) Mature enough to "participate intelligently"
Used to also have to present danger or been victim of abuse (per Family Code but Health and Safety Code has overriden that) |
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When a minor consent to own treament what must be documented? |
Whether or not parents were contactd
If not, why? |
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Can minors get psych meds without parent consent? |
Nope; can't get psychosurgery or ECT either |
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What must be done when a minor consent for residential shelter services? |
Parents must be contacted (so they don't think child has gone missing) |
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What are the laws relating to MEDICAL care for pregnancy, contraception or abortion? |
Any age can get treatment
Providers are NOT permitted to tell parents
Sterilization NOT permitted |
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What are the laws relating to MEDICAL care for STDs? |
Anyone 12 or older can consent to treatment
Providers are NOT permitted to tell parents |
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What are the laws relating to MEDICAL care for sexual assault? |
An age can consent to treatment
Providers MUST try to contact parents (unless patient is over 12 and parent comitted assault) |
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What are the laws relating to MEDICAL care for rape? |
Anyone 12 or older can consent to treatment
Providers are NOT permitted to tell parents |
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What are the laws relating to MEDICAL and COUNSELING care for chemical dependency? |
Anyone 12 or older can consent to treatment
Therapy services can only be provided by someone under contract with state or county
Providers should contact parents if appropriate, document why or why not and any attempts to contact
NO methadone or similar without parent consent |
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How long do you need to keep adult treatment records? |
7 years after treatment is completed |
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How long do you need to keep minor treatment records? |
7 years after they turn 18 (i.e., age 25)
Note: APA says only 3 after 18 |
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What needs to be included in records? |
Patient's identifying info
Dates of service
Type of service
Time spent with patient
Fee
Brief notation of mental status
General assessment
Plan for intervention
Also: consultations, summary/testing reports, and ROIs |
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What is needed for electronic records? |
Ensure safety and integrity:
- Offsite backup
- Image mechanism that can copy signature documents
- Record unalterable |
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Can you withold records for non-payment? |
According to CA law, NO
(APA says yes except in emergency) |
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Which parent(s) can access minor's records? |
Any parent with LEGAL custody (even if not physical custody) |
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When can records be denied to parents or minors (2)? |
Minor consented to treatment
There could be detrimental effect on therapy relationship or minor's well-being |
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When can records be denied to patients? |
CA Law: detrimental consequences to patient
HIPAA: endanger life or physical safety of individual or another person HIPAA supersedes CA law |
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When can records be denied to another provider? |
Never |
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How long does the therapist have to allow for inspection of records? |
5 working days after a written request is received |
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How long does the therapist have to give copies of treatment records? |
15 days after receiving a writting request |
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How much can you charge for copies of records? |
Up to 25 cents per page |
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How long does a therapist have to provide a treatment summary? |
10 working days (30 days if extensive records) |
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How long does a therapist have to provide records to the Board? |
15 days |
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What are the penalties if you don't provide records to the Board? |
$1000/ day that they are late (over 15 days)
Considered unprofessional conduct and may result in suspension or revocation of license |
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What are the three parts of a Tarasoff threat? |
1) The patient (or a family member per Ewing decision) has communicated to the therapist
2) A serious threat of physical violence
3) Against a reasonably identifiable victim |
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Who does a therapist contact in a Tarasoff situation? |
1) the victim(s)
2) law enforcement |
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What are the holds for danger to self as a result of a mental disorder? |
5150/5585- 72 hours
5250- 14 days
5260- 14 days (NOT renewable)
Total: 31 days |
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Who can put someone on a 5150? |
1) peace officer
2) crisis team member
3) professional designated by county |
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What are the holds for danger to others as a result of a mental disorder? |
5150/5585- 72 hours
5250- 14 days
5300- 180 days (renewable)
Total: unlimited |
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What are the holds for grave disability as a result of a mental disorder? |
5150/5585- 72 hours
5250- 14 days
5270.15- 30 days (NOT renewable unless conservatorship is filed)
Total: 47 days |
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What is grave disability? |
Unable to adequately provide good, clothing, or shelter |
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When does a certification (i.e., 5250) hearing need to take place? |
Within 4 days of the hold |
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Does a therapist have a duty to mandated reoprting when outside of their professional capacity (e.g., at home, on vacation)? |
No, but like any citizen they may report abuse |
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If one of your adult patients was abused as a child, do you have to report it? |
No,
but you need to determine if there may be other children currently at risk, if so make a reportIf one of your minor patients |
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If one of your minor patients was abused many years ago, do you have to report it? |
Yes, even if it was just one incident! |
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Is a "mutual affray" between minors a mandated report? |
Nah |
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What is included in the definition of child abuse? (4) |
1) physical injury (not accidental)
2) sexual abuse
3) act of omission (willful cruelty, unjustifiable punishment, unlawful corporal punishment/injury)
4) neglect |
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When can you petition for reinstatement of a revoked/suspended/surrendered license? |
2 years for revocation of 3 or more years |
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When an application for licensure has been denied (e.g., for MI or CD issues), how long do you have to wait to reapply? |
1 year |
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If you are a registered sex offender, can you get a license? |
Nope |
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3 years from discovery of act or 7 years since act, whichever first |
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What is minimum needed for consent in telehealth care? |
Verbal consent that is documented |
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What are the licensure requirements for telehealth? |
Licensed in client's state of residence |
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Confidentiality is both a _______ and _________ imperative. |
legal; ethical |
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What are the two basic principles that apply to ok disclosure of confidential info? |
1) It should never come as a surprise. |
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Exceptions to confidentiality include (9): |
-Patient consent |
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True or False? Consent to release info must be in writing. |
True |
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Who can sign (and date) consent? |
Patient |
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Who HOLDS privilege? |
Patient |
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Who can CLAIM privilege? |
Holder |
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When more than one person is holder of privilege (e.g. couple's therapy) who can waive? |
Both have to waive |
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When is privilege automatically waived? |
When you disclose something to a unauthorized third party |
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When can a therapist NOT claim privilege? |
There is no holder in existence |
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Is a positive tox screen at time of delivering a baby considered abuse? |
No, but a further assessment for substance abuse should be completed. If other factors indicate risk, then report. |
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What are the two categories of sexual abuse of a child? |
sexual assault
sexual exploitation |
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What is the general guideline for what constitutes physical abuse of a child? |
Bruises/marks
Using an object on bare skin (i.e., belt, whip)
Hitting with closed fist |
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What is considered statutory rape? |
Any sexual intercourse between and adult and a minor (under 18) |
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What are the criminal and civil penalties for statutory rape? |
Criminal- Jail for 1 year, or prison for 2, 3, or 4
Civil- up to $25,000 |
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What are the age paramaters for a mandated report for sex? |
If person is 16 or older, consentual sex ok.
If person under 16 (i.e. 14-15), no intercourse with those over 21. No "lewd and lascivious" with someone 10 years older.
If person is under 14 (i.e., 13, 12, 11, etc), can only do "lewd and lascivious" with others under 14.
Rape, incest, or sodomy is ALWAYS mandated report for those under 18. |
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What is the difference between general neglect and severe neglect? |
General- inadequate food, clothing, shelter, medical care, or supervision, NO injury
Severe- severe malnutrition, WILLFULLY causing or permitting the health of a child to be endangered |
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Is a child witnessing domestic violence a mandated report of child abuse? |
Often it is. Has to cause unjustifiable emotional suffering. |
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What is "willful cruelty or unjustifiable punishment?" |
WILLFULLY causes or permits child to suffer, inflicts unjustifiable pain or mental suffering, or endangers health of child |
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What is "unlawful corporal punishment or injury?" |
Cruel or inhuman punishment or injury resulting in a traumatic condition |
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Is emotional abuse a mandated report? |
No, but one has the OPTION to report when there is "serious emotional damage." |
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How long do you have to file a child abuse report by phone? In writing? |
Immediately (or as soon as is practically possible); 36 hours |
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What needs to be included in a child abuse report? |
-Reporting party and mandated reporter capacity -Victim info AND ANY SIBLINGS -Parent info -Date/time/place of incident -Type of abuse -Narrative of event |
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What is the penalty for not reporting child abuse? |
Misdemeanor
6 months jail
$1000 |
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What is the penalty for WILLFULLY not reporting child abuse and then it ends in death or serious injury? |
Misdemeanor 1 year jail
$5000 |
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Elder abuse is (5): |
Physical abuse Abandonment Isolation Financial abuse Neglect |
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What is a "dependent adult?" |
Ages 18-64, limitations (physical or mental) that restrict ablity to carry out normal activities or protect rights |
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Is emotional abuse in an elder a mandated report? |
No, but law permits you to do so |
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When do you NOT have to report elder abuse in a long-term care facility? |
When there is a proper plan of care that is properly executed and the reporter believes it wasn't actually abuse. |
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What is considered elder PHYSICAL abuse? |
assault, batter, unreasonable physical restraint, deprivation of food/water, sexual assault, chemical restraint |
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What is considered elder NEGLECT? |
Hygiene, food, shelter, medical care.
There can be "self-neglect" |
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What is considered elder ISOLATION? |
Preventing contact (calls, mail), false imprisonment, physically restrainting so can't see others |
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What is considered elser FINANCIAL abuse? |
Wrongfully taking or using financies of elder that results in physical harm or mental suffering
Not allowing elder access to their own funds |
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How long do you have to make an elder abuse report on the phone? in writing? |
immediately as is possible, 2 working days |
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Who do you report elder abuse to? |
generally- APS, law enforcement
long-term care facility- ombudsman, law enforcement
state hospital- hospital investigator or law enforcement |
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What are the penalties for not reporting elder abuse? |
Misdemeanor 6 months jail
$1000 |
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What is the penalty for WILLFULLY not reporting elder abuse and then it ends in death or serious injury? |
Misdemeanor
1 year jail
$5000 |
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Who is mandated to report domestic violence? |
Providers of MEDICAL services for wounds
Therapist MAY NOT report or it is considered a breach of confidentiality |
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Who is mandated to report HIV status? |
Providers of MEDICAL services are PERMITTED TO report if they have tried to get consent from client; they may report to those who have come in contact with blood during job and to known sexual or needle-sharing partners
Therapist MAY NOT report or it is considered a breach of confidentiality |
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What is the penalty for sexual exploitation of a patient? |
single act or victim- 6 month jail, $1000
two or more victims OR two acts with single victim with prior conviction - 1 year jail, $1000 OR 16 mth, 2 year, 3 year prison, $10,000 |
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What happens to your license if you have sex with a patient (or w/in two years of termination)? |
it is revoked, revocation cannot be stayed |
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What do you do if you find out a patient had sexual contact with a previous therapist? |
give them pamphlet "Professional Therapy Never Includes Sex" and discuss pamphlet |
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What does the "Professional Therapy Never Includes Sex" pamplet include? (6) |
1) Definition of sexual contact
2) Common reactions to sexual contact
3) Bill of rights
4) Reporting options
5) Administrative, civil and professional association complaint procedures
6) Support services |
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Is psychologist-patient sexual contact a mandated report? |
No, reporting without consent is a breach of confidentiality |
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What are the three HIPAA rules? |
Privacy rule
Transaction rule
Security rule
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Which to follow: CA law or HIPAA? |
Whichever is stricter
If they are contradictory, you must follow HIPAA |
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When can you deny adults access to their treatment records? |
Follow stricter HIPAA guideline
HIPAA- When access is reasonably likely to endanger the life or physical safety of the individual or another person
CA law- adverse or detrimental consequences are anticipated (including emotional) |
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What are the penalties for failure to comply with HIPAA? (3) |
1) sanctions from the Office for Civil Rights of Health and Human Services
2) civil penalty of $100 per violation (up to $25,000 a year)
3) fines of up to $250,000 and 10 years in prison for knowing and deliberate violations |
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What is "generalized consent" according to HIPAA? |
the privacy policy which allows for disclosures for treament, payment and health care operations; written consent is NOT needed |
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What are the HIPAA patient rights (6)? |
1) Right of notice (written copy of privacy notice)
2) Right to request restrictions
3) Right to receive confidential communications by alternative means and at alternative locations (i.e., not at home address)
4) Access to records
5) Right of amendment (to increase accuracy, but the record may never be expunged)
6) Right of accounting of PHI disclosures (for 6 years) |
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What is required of the privacy policy in HIPAA? |
Given to all patients
Physically and visually distinct from regular consent form |
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Recourse - Person who has been subject to disciplinary action may petition reinstatement or modification. For a revoked, suspended, or surrendered ___ years; _____ years for early termination of probation of 3 years or more or modification of a condition of probation. At least __ years for early termination of probation of less than 3 years. |
3 years; 2 years; 1 year |
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Time Frame for filing accusations against a licensee |
3 years from the date BOP discovers or within 7 years from the date the alleged act occurred. |
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Telehealth is defined as |
delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a patient's health care while the patient is at the originating site and the health care provider is at a distant site. |
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Evidence code 1016 |
no privilege exists in proceeding in which the patient raises the issue of his/her own mental or emotional condition. |
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Evidence code 1017, 1023 and 1025 |
1017 - no privilege exists when there therapist is APPOINTED by the court of by the Board of Prison Terms to examine the patient.
1023 - proceeding initiated at the request of a defendant in a criminal action suit to determine his/her sanity
1025 - in proceedings brought by the patient to establish his or her competence. |
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Evidence 1018 |
no privilede if the services of a therapist were sought or obtained to aid anyone to commit a crime or to escape detection or apprehension. |
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Evidence codes 1019, 1021, and 1022. |
1019 - no privilege as to communication that is specifically relevant to an issue between parties all of whom claim through a deceased patient
1021 - concerning a deceased patient's intent with regard to a deed, will, or other document executed by the patient, affecting an interest in property
1022 - concerning the validity of a deceased patient's feel, will or other |
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Evidence code 1020 |
* no privilege when the therapist or the patient alleges a breach of duty (malpractice initiated by patient or collection agency for non payment by psychologist) |
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Evidence code 1024 |
* most commonly when a patient who is put on a 5250 challenges the hold and requests a certification hearing * therapist believes that patient's mental or emotional condition causes him to be a danger to himself, person or property of others and disclosure is NECESSARY to prevent danger (may report) |
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Evidence code 1026 |
no privilege when therapist or patient is required to make a reports and such report is open to public inspection |
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Evidence code 1027 |
* if the patient is under 16 and the therapist has reason to believe the child has been the victim of a crime, and the disclose is in the best interest of the child. |
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Reminders... |
1) notice what entity is highlighted in the questions (APA, BOP or HiPPA) before choosing the answer. 2) Attention for legal/key words (mandated, appointment, consensual, ethical, legal, best course, may vs. must) 3) on vignettes, notice patients ages and other demographics |
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Reminders... |
5) when symptoms are described, especially on vignettes, pay attention to duration 6) notice when questions asks NOT, LEAST, EXCEPT 7) on vignettes, notice the language used by patient, notice if it is vague "feel like dying". 8) pay particular attention to mandated vs. non mandated situation if one of the answers says "assess further" 9) pay attention to "who is the patient?" on vignettes |
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Sexual Assault Reporting
Child - under 14 Other party - any age |
A report is mandated if there has been LEWD AND LASCIVIOUS CONTACT |
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Sexual Assault Reporting
Child - 14 or 15 Other party - 10 years older than the child |
A reported is mandated if there has been LEWD AND LASCIVIOUS CONTACT |
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Sexual Assault Reporting
Child - under 16 Other party - 21 and older |
A reported is mandated if there has been sexual intercourse, even if voluntary |
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Sexual Assault Reporting
Child - 16 or older Other party - 16 or older |
Not reportable if voluntary sexual intercourse |
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Sexual Assault Reporting
Child - under 18 Other party - any age |
mandated report if rape, incest, or sodomy |
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Involuntary hold
Adult... Child... |
5150
5585 (only implemented if the parent or guardian is not available to authorize voluntary tx). |
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Involuntary Confinement (Adult) |
5250 - after 72 hr hold, certification for up to 14 days of tx. (entitled to review within 4 days)
5260 - additional 14 days, not renewable
5300 - up to 180 day hold, can be renewed.
5270.15 - after 5250, gravely disabled pt., additional 30 days. after 30 days, conservatorship filed. |
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Tarasoff details: |
* duty to WARN, PROTECT and PREDICT * FORESEEABLE victim * SERIOUS threat * on Tarasoff excludes hearing from 3rd party * threat to property only if there are human lives potentially in danger * Ewing (if close family members disclose, consider pt. communication) |
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Treatment of Minors:
1) Emancipated minors have rights to... |
confidentiality, privilege and consent to tx. |
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Tx of Minors:
1) outpatient mental health tx 2) residential shelter 3) pregnancy 4) communicable disease 5) sexual assault 6) rape victims 7) drug and alcohol tx. |
1) 12 or older - able participate intelligently and presents danger or physical (and/or mental harm to self or others, victim of incest/child abuse) 2) make an effort to notify the parent 3) minor of any age (except sterilization) 4) 12 or older (don't report to parents) 5) any age (attempt to contact parent unless.. 6) 12+ - don't report to parents 7) 12 or older w/o parent (no methadone, narc)
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Subpoenas |
* requires that the person appear and testify, bring documents or both. * must not be ignored * first step is to contact pat. and ascertain whether he wishes to waive or invoke privilege * if invoked, therapist asks to be released from the subpoena, if not released, must comply with it and appear hat the specified time and place, bringing any documents required. At the proceeding, may assert prilivege and judge will determine. |
