andrea standley phd. values ◦ beliefs and attitudes that provide direction to everyday living ...
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Ethics and Supervising
Andrea Standley PhD
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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
Ethics
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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
Basic Principles to Guide Ethical Decision Making
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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
Basic Principles to Guide Ethical Decision Making
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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
Ethical Standards
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◦ 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.
Ethical Standards
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◦ 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
Ethical Standards
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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.
HIPAA
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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
HIPAA Privacy Rule
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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
HIPAA Security Rule
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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
Protected Health Information
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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
Identifiers Under HIPAA
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Make sure participants know that information is confidential
Power of Attorney
Release of information form
Provide Notice of Privacy Practices
Privacy in Hospitals
Confidentiality
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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
Limits to Confidentiality
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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
Limits to Confidentiality
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Assisting the government in overseeing health care programs
Law enforcement purposes
National security purposes
Limits to Confidentiality
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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
Protecting Children, the Elderly, and Dependent Adults From Harm
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Child Abuse 1-800-252-2873
Elder Abuse 1-866-800-1409
Contact information for Reporting Abuse
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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
Duty to Protect Potential Victims
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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
Multicultural Competence
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A temporary dependence is not necessarily problematic
A ethical issue occurs when workers/professionals encourage and promote dependence
Ethics and Participant Dependence
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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
Ethical Issues in Supervising
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◦ 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?
Ethical Issues in Supervising
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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
Ethical Violations by Supervisors
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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
Rights of Employees
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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
Information Provided to Employees
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Risks and benefits
Evaluation of job performance
Complaint procedures and due process
Professional development goals
Information Provided to Employees
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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
Rights of Employees
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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
The Supervisor’s Roles and Responsibilities
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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
The Supervisor’s Roles and Responsibilities
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Don’t supervise beyond your competence
Evaluate and monitor employee’s competence
Be available for supervision consistently
Maintain written policies
Document all supervisory activities
Risk Management Practices for Supervisors
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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
Risk Management Practices for Supervisors
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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.
Stress in the Human Service Profession
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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
Signs which lead to Potential Burnout
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Low productivity
Depression
Negativity
Frustration
Agitation
Feeling of futility
Signs of Burnout
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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?
Question
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Paid Family Caregivers
Gift Giving
Can you think of any other ethical issues?
Potential Ethical Participant Issues
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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.
What is Medicaid Fraud?
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Two Ways to report Medicaid Fraud
Illinois State Police◦ 1-888-557-9503
Healthcare and Family Services◦ Office of Inspector General
Reporting Medicaid Fraud
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Reporting Medicaid Fraud
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“Never let your sense or morals get in the way of doing what’s right.”
Isaac Asimov
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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_content&view==article&id=
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
References