Law & Ethics - Iii Final

Front 1

What kinds of matters does Criminal Law cover? What is the standard of proof?

Back 1

-things that ppl do wrong that require moral action by society; moral blame

- "Beyond a reasonable doubt" or a standard of 99% certainty

Front 2

What kinds of matters does Civil Law cover?

What is the standard of proof?

Back 2

-assigns responsibility for harm & determining proper amends; liability

-"by clear & convincing evidence" 70% certainty

Front 3

Who has the burden of proof?

Back 3

1. Criminal – prosecutor (govt or state) to show the defendant is guilty beyond a reasonable doubt

2. Malpractice – complaining party and their attorney

Front 4

– “a preponderance of the evidence”

Back 4

- Lowest standard of proof
- only about 51% so jury has to be a little more sure that something happened than it didn’t (this is where malpractice is)

Front 5

Standard of proof

Back 5

amount of proof needed to support one’s case in the legal system

-Criminal "beyond a reasonable doubt"
-Civil "by clear & convincing evidence"

Front 6

What is "Discovery" ??

Back 6

a process by which one party in a lawsuit discovers facts from another party in the law suit

Front 7

What are the 3 important purposes of Discovery?

Back 7

-helps focus the issues to be addressed in trial
-helps save facts that might otherwise have been forgotten or misplaced
-might lead to a settlement outside of court

Front 8

Depositions

Back 8

used to discover facts that are unknown; consist of oral questions & responses and attorneys can ask questions from a wide range of topics; most will occur at an attorney’s office

Front 9

Interrogatory

Back 9

written portion of discovery

Front 10

i. Writ of habeas corpus:

Back 10

originally used for a judge to review the legality of putting someone in jail; in CA used in mental health laws to review an individual’s involuntary hospitalization. Allows someone to go in front of judge and make case that they were hospitalized illegaly

Front 11

Statute of Limitations

Back 11

law limits amount of time that can pass before a person brings a law suit

BECAUSE
-Even if a person has harmed someone, they have right after a certain amount of time to know they can continue with life

-Evidence can get old; stale

Front 12

Subpoena

Back 12

legal process granted to lawyers in order to conduct discovery (part of fishing expedition) & to have a witness appear at legal proceeding

Front 13

Subpoena duces tecum

Back 13

requires you to bring docu with you to legal proceedings

Front 14

What are the steps you should take after receiving a subpoena for client records?

Back 14

1. Contact client & ask to waive or invoke privilege

2. If unsure – ask to be released from subpoena but if not, have to comply. Once there say client has invoked privilege and can’t release info (or documents if that is the case); if judge says you still need to comply, follow rules to a “T”

Front 15

If you received a subpoena what must you do regardless of a client's decision to invoke privilege?

Back 15

APPEAR; this is mandatory & you don't need the client's release in order to do this. Privilege is a different matter & must be determined by judge & your client

Front 16

Who grants a subpoena?

Back 16

The judge

Front 17

Who issues a court order? What does it contain?

Back 17

Issued by the judge

Specifies what material is to be released

Front 18

After receiving a subpoena, how many days do you have to respond?

Back 18

30 days to notify insurance & file a response in court or else the court will file a default judgment in favor of the opposition

Front 19

What are you supposed to do after receiving a subpoena? What are the steps?

Back 19

1. Contact insurance– will provide counsel
2. Start gathering docus, reports, journals you have on patient’s case (client record)
3. Provide everything to attorney
4. Meet w/attorney appointed to case & be truthful & omit nothing
5. Duty of Confidentiality COMPLETE – give everything to lawyer (they can't breach confidentiality)
6. Do not contact patient/patient’s family

Front 20

What are some examples of false, misleading, or deceptive statements that are prohibited by the ad/marketing rule?

Back 20

-misrep of fact
-failure to disclose material facts
-false/unproven expectations of + results
-unclear fee statements
-anything misleading to an ord prudent person

Front 21

What should be included in ads/marketing?

Back 21

-the purpose
-degrees, license #, school
-statements of fact
-intern status, licensure status, ID-ing info

Front 22

Are there specific standards written in the Ethical Principles... regarding website content?

Back 22

NO

Front 23

What do consumers look for on psychologists' websites?

Back 23

-office address, insurance, hrs, experience, work #, kind of therapy, area of specialty, fees, etc

Front 24

What do you have to do before offering services to someone who is already receiving services from another therapist?

Back 24

-confer w/other therapist & get approval

or

-wait until they terminate other therapy

Front 25

What does the Health Insurance Portability & Accountability Act cover?

Back 25

-rules regarding security of records
-privacy policies that must be dvlpd & notice given to clients
-assures consumer access to records
-uniform electronic records
-"scale-able" compliance

Front 26

What are the 3 major rules under HIPAA?

Who enforces them?

Back 26

1. Privacy Rule
2. Transaction Rule
3. Security Rule

Enforced by DHHS by relying on complaints & imposing fines; currently emphasize voluntary compliance

Front 27

What are the requirements covered in HIPAA's Privacy Rule?

Back 27

-written acknowledgment obtained of privacy practices notice
-obtain authorization to release things such as therapy notes
-have privacy policies/procedures
-disclose info about client's privacy & access rights to them
-adopt & be able to demonstrate safeguards
-train employees
-in place procedures for if records/confidentiality gets broken
-in place complaint procedures

Front 28

Duty to Mitigate

Back 28

covered in HIPAA Privacy rule

example: if records are mistakenly disclosed, retrieve & notify client

Front 29

Who does the HIPAA Privacy Rule pertain to?

Back 29

-hospitals, clinics
-managed care orgs
-group practices
- solo practitioners who use electronic transactions

Front 30

Issue: Necessity of License

Back 30

Rule: In order to provide psychotherapy services for $, one needs a valid license

Front 31

Issue: Scope of Practice

Back 31

A psych may provide individuals, gps, orgs, or the public any psychological service, including, but not restricted to: Dx, prevention, treatment, & amelioration of psychological problems & emotional & mental disorders of individuals & gps

Front 32

Issue: Competence

Back 32

A psych must demonstrate appropriate edu, training, & (supervised) experience to provide services. If not, the edu, training, & (supervised) experience must be gained as quickly as possible or a thoughtful & appropriate referral must be made.

Front 33

Issue: Informed Consent

Back 33

Rule: A client must be informed of anything that would affect his/her decision to enter/continue treatment, including but not limited to, fees, cancellation policy, intern or trainee status, & limits of confidentiality

Front 34

Issue: Client Welfare

Back 34

Rule: A psych must do what is in the best interest of the client &, if the client fails to benefit from treatment, the psych should get consultation or make a thoughtful & appropriate referral

Front 35

Issue: Confidentiality

Back 35

Rule: A psych has a legal & ethical responsibility to safeguard his/her clients from unauthorized disclosure of info revealed during treatment, except when there is a danger to self/others, child abuse, dependent adult abuse, or elder abuse

Front 36

Issue: Treatment of Minors

Back 36

Rule: In order to treat a minor (<18yrs old), the consent of a parent w/legal custody or a guardian is req'd unless:
-the minor is emancipated or
-12 yrs old & mature enough to consent to treatment &
-----in danger of severe phys/mental harm or
-----the victim of incest or child abuse

Front 37

Issue: Advertising & Marketing

Back 37

Rule: Psychologists should not use any false, misleading, or deceptive statements in their advertising/marketing materials/claims

Front 38

Issue: Inter-professional Relations

Back 38

Rule: A psychologist may NOT receive commissions/rebates for referrals & should not offer services to a person already receiving services from another therapist *EXCEPT*
-by agreement w/other therapist
OR
-after the person terminates other therapy

Front 39

Issue: Psychotherapist Conduct

Back 39

Rule: A psychotherapist should do nothing that negatively impacts the client's welfare

Front 40

HIPAA: Privacy Rule

Electronic Transactions - definition

Back 40

The transmission of info between 2 parties to carry out financial or admin activities related to healthcare via electronic technology

Front 41

What are the types of electronic transactions that HIPAA's Privacy Rule covers?

Back 41

-the internet
-the extranet (internet tech linking a biz w/collaborating parties only)
-leased lines
-dial-up lines
-private networks
-using magnetic tape, disk, or cd media
-computer faxes

Front 42

HIPAA: Transaction Rule

What kind of format must you submit claims for services in?
Who must comply?

Back 42

-requires that you use the standard format

-any one who submits claims electronically
-who provides MediCal or MediCare services

Front 43

HIPAA: Security Rule

Back 43

Assures secure & private communication maintenance of confidential info
-Covers how you put together your systems (physical infrastructure, access to offices, files, computers, hard drives, software)

Front 44

HIPAA: Health Care Record

includes...

Back 44

-dates & times of services provided
-meds
- test results
- Dx
- Treatment Plan
- Prognosis & progress notes

Front 45

HIPAA: Psychotherapy Notes

include...

Back 45

-Contents of sessions
-Impressions regarding client
-details of conversations
-process note entries

Front 46

What is the difference between a Health Care Record and Psychotherapy Notes

Back 46

- HIPAA mandates you maintain a health care record (objective data) but the psychotherapist has a choice as to whether or not to keep psychotherapy notes (subjective/"soft" data, such as impressions, conversations, session content)

Front 47

What would SOAP notes fall under? Psychotherapy Notes or the Health Care Record?

Back 47

The health care record

Front 48

Do you have to inform your client that you may keep psychotherapy notes?

Back 48

YES

Front 49

What is the Client Record?

Back 49

-All paperwork associated w/treatment, including
- Intake forms
-Informed Consent
-Treatment Plan
-Assessments, test results, measures
-Progress notes (NOT PROCESS NOTES!)
-Financial records
-Correspondence

Front 50

What should you take caution to do when adding to your Client Record?

Back 50

-Avoid being emotional, judgmental, etc b/c it can be used against you

-write & store as though a lawyer were looking over your shoulder

Front 51

Who owns the client records?

Back 51

The content is owned by the client but the therapist owns the physical documents

Front 52

Who has the right to access the client record?

Back 52

-The client (complete access)
-authorized client reps

Either way, records are reviewed together in your office; originals can't be changed so don't leave your client alone w/them!

- Summaries can be written instead, but the client then has the option of going to court & having entire record reviewed

Front 53

Before you can allow access to the client record, what must be done?

Back 53

- a written request specifying which documents they want to be reviewed

Front 54

What is the time line for responding to written requests to see the client record?

Back 54

-w/in 5 WORKING days, records must be made available during REGULAR biz hours

-w/in 15 DAYS after request is received, copies must be transmitted to requester

Front 55

What happens if you deny the client access to their client record?

Back 55

(only do if you believe that sharing would be set back their progress in therapy or otherwise hurt them)

-provides grounds for a lawsuit
-you MUST have a very sound rationale

Front 56

In order to deny the client access to their client record, what must the therapist do?

Back 56

-Note date, reason for referral, description of adverse consequences
-inform client of the decision & of their right to have another therapist review the records
-permit another clinician (chosen by client) to access records
- note whether or not another therapist was directed to do so by the client

Front 57

For how long does HIPAA require us to retain a client's records?

Back 57

-at least 7 yrs post discharge (hospitals) though 10 years is best

- Minors: at least 1 yr after minor turns 18 yrs old

Front 58

What shouldn't you keep in the client record?

Back 58

-personal opinions
-discussions about a 3rd party
-sensitive info
-past criminal behavior (only important for your record if pertains to current activity)

Front 59

What are the minimal requirements of Record-keeping?

Back 59

-ID-ing data
-Background/historical data
-Dx/prognosis
-Treatment plan
-Informed consent
-Progress notes
-Termination summary

Front 60

In addition to the minimum reqs of info to be included in your record-keeping, what might be helpful to include?

Back 60

-current psychological/psychiatric evaluations
-risk management/incident notes
-consultations/supervisions
-correspondence & phone calls
-suggestions/directives ("failure to comply" documentation)
-failed/ canceled appointment data
-releases of info

Front 61

Which principle applies to the issue of psychotherapist conduct?

What are some examples of conduct rules?

Back 61

Principle - Nonmaleficence

Examples of conduct rules:
-Do not breach confidentiality
-Do not have sexual relations w/clients

Front 62

What is Malpractice?

Back 62

The failure to render professional services/to exercise the degree of skill ordinarily expect of other professionals in a similar situation AND which involves negligence that results in injury/loss to the client

Front 63

Who has the burden of proof in regards to claims of malpractice?

What must they prove?

Back 63

-Plaintiff has the burden of proof

-4 Ds (Duty, breach of duty, damage, direct causation)

Front 64

What are the 2 major sources of malpractice suits?

Back 64

1. Sexual misconduct (Client Welfare - Dual Relationships)

2. Breaches of confidentiality outside the legitimate exceptions (confidentiality)

Front 65

What is an assessment?

Back 65

An opinion based upon information and techniques sufficient to support findings

Front 66

If the case review doesn't support need for an assessment, what must you do?

Back 66

-Provide an explanation & sources of info that influenced your conclusion

Front 67

What does informed consent look like in regards to performing an assessment?

Back 67

-nature/purpose of the assessment
-related fees
-3rd parties
-opportunity for Q & A
-time involved
-confidentiality issues
- given using reasonable language

Front 68

What are the components of an assessment?

Back 68

Test data
--scores (raw & scaled)
--test taker's responses
--notes/recordings of statements & Bx
Release of test data (very confidential)
Obsolete tests/outdated test results
Security of test materials (manuals, forms, test data, etc)

Front 69

What does Sect 8 of the Ethics Code, Research & Publication, contain?

Back 69

-informed consent to participants
-deception in research
-debriefing participants
-reporting results (be specific; no generalizations)
-Plagiarism
-Publication