Cpse

Front 1

HIPAA - Health Insurance Portability and Accountability Act - PRIVACY RULE

Back 1

Regulations for using and disclosing protected health information (PHI)

Front 2

HIPAA - SECURITY RULE

Back 2

security safeguards for electronic PHI

Front 3

HIPAA - TRANSACTION RULE

Back 3

requires providers who transmit certain transactions electronically to use the same electronic format, code sets, and identifiers

Front 4

HIPAA or State Law?

Back 4

You compare HIPAA regulations and state law to determine which one preempts, or supersedes, the other. State law preempts HIPAA only when it is "stricter." Which means it provides greater privacy, access, or control.

Front 5

Who are covered entities that must comply with HIPAA?

Back 5

Health care providers, health plans, and health care cleringhouses. Psyhcotherapists are linked as health care providers, which refers to a person who bills for, is paid for, or provides health care services as a normal part of services

Front 6

PHI - Protected Health Information

Back 6

Individually "identifiable" information that provides information about:
1 - an individuals past present or future physical and mental health condition
2 - the provision of health care to the individual
3 - past present or future payment for health care provided to the individual

Front 7

Individually identifiable health information in educational records is covered by

Back 7

FERPA - Family and Educational Rights and Privacy Act

Front 8

HIPAA's privacy rule

Back 8

is designed to provide clients with increased protection ot their PHI and requires providers to:
1. inform clients of their privacy policies
2. grant clients access to their health information
3. obtain client authorization before sharing health information for nonroutine purposes
4. secure client records
5. inform business associates of privacy practices
6. train employees so that they understand privacy procedures.

Front 9

HIPAA's privacy rule is triggered when

Back 9

A provider transmits PHI electonically. Once triggered it applies to all of the transactions, even those not electronic.

Front 10

HIPAA regulations for denying access to health records

Back 10

preempts CA law, provides more stringent standards

Front 11

HIPAA - Right review denial of access to PHI

Back 11

The client has right to review a denial in the following:
1. Health care provider has decided that disclosure of PHI is reasonably likely to endanger the life or phsycial safety of the client or other person
2. The PHI contains information about another person and releasing it will endanger that other person
3. the request was made by the client's personal representative and the professional believes that disclosure is likly ot cause harm to either party (representative or client)

Front 12

HIPAA - NO right to review denial to access PHI

Back 12

Client does not have the right to review the denial when:
1. The information is exempt bec it was compiled of use in criminal, civil or adminsitrative hearing.
2. The CE is a correctional institution, is acting under the direction of a correctional institution, and the requester is an inmate, and the CE believes that the disclosure will likely harm inmate, requester, employees at the institution, or other inmates
3. The information was compiled in a research study and the denial was discussed in the consent
4. The PHI was obtained from someone other than a HCP unde a promise of confidentiality

Front 13

HIPAA PERMITS psychologists to maintain ___ sets of records; which are ___________; _____________

Back 13

2
a general set of records: these are more readily accessable to the clients

psychotherapy notes: notes recorded in any medium by a mental health provider that documents and analyze the contents of conversations during therapy.

Front 14

Psychotherapy Records

Back 14

Under HIPAA - Clients do not have the right to review them

CA law preempts HIPAA - Psychologists MAY provide the client with a copy of the notes OR a summary of them when they request BUT if there is a substantial risk of sig adverse or detrimental consequences to the client in viewing or receiving a copy oth the notes they MAY decline.

Front 15

What should be contained in the general record?

Back 15

info related to medication prescription and monitoring, start and stop times of sessions, modality and frequency of treatment, results of clinical tests, dx, functional status, treatment plan, symptoms, prognosis, and progress

Front 16

Amendment of Health Information

Back 16

Under HIPAA - clients have the right to request an amendment of their PHI if they believe it is incorrect

Front 17

Provider can deny a clients request to amend their PHI when:

Back 17

1. the information was not created by the provider, unless the person who created it is not available to make the amendment
2. the information is not part of the designated record set or is not available for inspection
3. the provider believes the information is accurate and complete

Front 18

Request for account of disclosures

Back 18

client can request an accounting of disclosures to third parties mad during the past six years (does not include routine disclosures for operation) does applly to disclosures made to public health authorities, health oversight agencies, and researchers

Front 19

August 2002 change to consent and authorization to disclose health information

Back 19

eliminated need for a health care provider to obtain consent from a patient prior to using or disclosing PHI for the purposes of TPO (Treatment, Payment, Operations)

Front 20

Notice of Privacy Practices

Back 20

HIPPAA requires psychologists to provide clients with a written NOTICE OF PRIVACY PRACTICES (NPP) on or before the onset of treatment that indicates how health information may be used and disclosed and that informs clients to their rights with regard to health information. The NPP must also be posted in a prominant location in the psychologists office. The psychologist must make a "good faith effort" to obtain the clients written acknowledgement of receipt of the notice.

Front 21

Business Associates

Back 21

A Business Associate (BA) is a person or organization who receives PHI in order to provide services to the psychologist. Psychologists must have a HIPAA contract with all BAs and when psychologists learn that a BA is violating the terms, they take reasonable steps to correct the violation, terminate the contract, or report the violation to DHHS.

Front 22

Minimum Necessary Standard

Back 22

the psycologist limit disclosure of PHI to the minimum necessary to accomplish the purpose of the disclosure.

Front 23

Scope of competence

Back 23

psychologists are legally and ethically bound to practice within their scope of competence

Front 24

Boundaries of Competencies: working with special populations that require special knowledge

Back 24

psychologists have or obtain the training, experience, consulation, or supervision necesary to ensure their competence

Front 25

Psychologists providing services for those who do not have other services available

Back 25

Psychologists with closely related prior training or experience may provide such services and make a resonable effort to obtain the competence through research, training, consultation, or study.

Front 26

Emergency situations

Back 26

may provide services until emergency passes

Front 27

Personal problems

Back 27

legally and ethically bound to take appropriate actions when factors might interfere with their ability to provide effective services

Front 28

when a condition affects ones ability to safely practice

Back 28

licensing agency may order the licentiate to be examined by one or more physicians and surgeons or psychologists designated by the agency
Failure to comply is grounds for suspension or revocation

Front 29

Confidential information may be reveales when________.

Back 29

there is a medical emergency, the client is a danger to self or others, to report child or elder abuse, the client communicates a reasonable threat of physical violence to a reasonably identifiable victim, there is a reasonable suspicion that an elder or dependent adult is being abused, or there is a court order

Front 30

California laws that protect confidentiality are:
1.______
2.______

Back 30

Lanterman-Petris-Short Act (LPSA)
The Confidentiality of Medical Information Act (CMIA)

When there is a conflict LPSA applies.

Front 31

You see abuse occuring in a supermarket on your weekend. Do you have to report it.

Back 31

No, because it did not occur when you are in your professional role.

Front 32

You are in the waiting room area of your group practice. You see a child being physically abused by your colleagues patient. Do you have to report?

Back 32

Yes. You are in a professional role.

Front 33

When seeking consultation

Back 33

only relevant information is shared and must not share confidential information that could lead to the identification of the client unless he has obtained consent or disclosure cannot be avoided

Front 34

Privilege

Back 34

aka testimonial privilege
A legal term that refers to a person's right not to have confidential information revealed in a legal proceeding.

Front 35

Evidence Code (EC) Section 1014 and B&PC Section 2918

Back 35

States that the confidential relations and communications between psychologist and client shall be privileged

Front 36

Privilege vs Confidentiality

Back 36

Privilege is narrower in scope, only pertaining to confidentiality of client inf in the context of a court proceeding, deposition, or administrative hearing

Front 37

HOLDER of privilege

Back 37

1. The patient when he has no guardian or conservator
2. The guardian or conservator
3. The personal representative of the client when he is dead

Front 38

When can a psychologist release confidential information in a legal proceeding?

Back 38

When the client or other holder of privilege (guardian, conservator, or representative) waives the privilege or the court has determined that an exception to privilege applies

Front 39

Minors and Privilege

Back 39

Guardians and conservators hold privilege not parents. Case law considers minors to be the holders, but they rely on adults to claim or waive on their behalf.

Front 40

Minors who are Dependents of the court (wards of the court)

Back 40

Either the child, or the cousel for the child with the informed consent of the child, if the child is found to be of sufficient age and maturity to consent (12 yrs) may invoke the psychotherapist client privilege. If child invokes privilege, counsel may not waive it. Counsel shall be the holder of privilege if the child is found by the court not to be sufficient in age or maturity to consent.

Front 41

Joint Holders of Privilege

Back 41

waiver of the privilege by one client does not affect another client's right to claim the privilege