CJPEE
Terms
undefined, object
copy deck
- Parent authorizes treatment of a minor. When does s/he have access to treatment records
-
Always
Unless
- therapist anticipates detrimental effect on therapy
- therapist anticipates detrimental effect on child's physical or emotional well being - What did the Tarasoft Statute add to previous Tarasoft practice?
- It restricted Tarasoft duties to threats made directly by the patient.
- CA record retention
- 7 years after termination
- APA record retention
-
3 years after termination
a record summary for 12 addtional years - Process when ethics and law conflict
-
Make known commitment to Ethics
Try to resolve conflict
If that doesn't work, obey the law - Psychologist reporting responsibility for spousal abuse
- Neither mandated nor permitted
- Relationshp between supervisor and Psych Assistant
- Employer and employee
- Response to 3rd party phone calls
-
May listen
May acknowledge that patient is in therapy only in extenuating circumstances
May breach confidentiality only in extenuating circumstances - Timing of child abuse reports (phone, written)
-
By phone immediately
Written within 36 hrs - Examples of breach of duty
-
Patient sues for malpractice
Therapist sues for non-payment - What is the status of privilege in breach of duty suits?
- There is no privilege
- Process when a multiple relationship is discovered
- Try to resolve the conflict in the patient's best interest and maximal compliance with the Ethics Code
- When is sex permisible with former patients?
-
After 2 years and
Only in most unusual circumstances - Def: grave disability
- Inability to provide one's own food, shelter and clothing
- HIPAA requirement for privacy notice document
- It must be separate from other signed forms, such as a general consent form
- Meaning of availability of supervisor to supervisee
- Can be contacted by any means
- Conditions for elder abuse reporting
-
Any reasonable suspicion of abuse including, but not limited to:
Direct evidence of abuse
Elder reports abuse - Types of elder abuse
-
Physical abuse
Abandonment
Isolation
Financial abuse
Neglect - When can a psychologist do a custody review of a family s/he is treating?
-
Almost never
It would be an insurmountable threat to objectivity - When do you get assent instead of consent?
-
When the patient does not have legal capacity (eg a minor or dependent adult)
Consent is procured from his/her guardian
Note: informed consent is required for court mandated treatment - When would a temporary suspension of a licence be issued?
- When you are possibly a danger to the public (eg for an untreated addiction) and before the problem has been resolved with the Board
- What happens when a license revocation is stayed?
- Therapist is put on probation
- Def: multiple role
-
Being in more than one role with the same person
or in a role with someone close or related, now or in the future - Requirements for documentation of treatment
-
Ethically mandated
And includes progress notes - In a legal proceeding when is privilege inapplicable to a minor?
-
Patient is <16 and victim of a crime
Therapist believes that disclosure is in the best interest of the child - Who is responsible for posting the notice to consumers about how to make complaints to the Board?
- All licensees and registrants
- What is the disciplinary action for incarceration for a felony?
- License suspension
- What is the best defense for breaching confidentiality to prevent a suicide?
- A safety emergency occured
- What are the general conditions for an exception to privilege?
- When a judge has legal authority to order disclosure in the course of a legal proceeding (eg court, deposition, administrative hearing)
- What is the appropriate course of action when you learn that goods received in barter were stolen?
- Maintain confidentiality
- Who is authorized to provide consent for HIV testing to an 11 year old living in a county facility? *
- The responsible county official
- Who are emancipated minors?
-
Legally married
Enlisted in the military
By court declaration - What are the enabling conditions for the Court to declare a minor emancipated? *
-
Minor >= 14 yo
Living apart from parents with consent
Management of finances with legal income
In the best interest of the minor - Obligation to provide records to a patient with an outstanding bill
-
Respond within 15 days
Records may not be withheld for non-payment - If a patient requests a copy of his / her records and you believe there may be adverse consequences if you do, you must:
-
1. Make a note in the record as to why
2. Permit inspection of records and note by another licensed health care professional
Summary optional - Conditions of Tarasoft duty
-
Direct communication by patient
Threat of violence against an identifiable victim - Tarasoft duty
-
Notify victim
Notify police
(But not attempt to prevent potential violence) - Detention schedule for a gravely disabled person
-
03 days - 72 hours
14 days
30 days
47 days max - Detention schedule for someone who is a threat to self
-
03 days - 72 hours
14 days
14 days
31 days max - Detention schedule for some who is a threat to others
-
03 days - 72 hours
14 days
180 days, renewable
197 days max - Criteria to be met for a 14 day hold
-
Completion of 72 hour hold
Still a danger to self or others, or gravely disabled
Refuses voluntary treatment - When is a report of sexual assault required for lewd or lascivious contact?
-
Child is under 14
Child is 14 or 15 and perp is 10 years older - When is a report of sexual assault required for intercourse, even if voluntary
- Child is under 16 and perp is 21 or older
- When is a report of sexual assault required for rape, incest or sodomy?
- Child is under 18
- When is a report of sexual assault not required?
- When both participants are 16 or older and it is voluntary
- Types of child abuse
-
Physical
Sexual assault or exploitation
Neglect
Willful cruelty or unjustifiable punishment
Unlawful corporal punishment or injury - To whom are child abuse reports made?
-
Police department
Sheriff's department
County welfare department - Recommendations for informed consent
-
Written informed consent to treatment (written standard of care, but oral legal)
Written privacy policy
2 separate documents - Who are the third parties to whom confidential information may not be released?
- Anyone outside the professional relationship
- Retention period for HIPAA documentation
- 6 yrs
- Ethical obligation in face of a colleague's ethical violation *
-
Depending on severity:
Attempt informal resolution
Report to Ethics committee or Board - How long may someone with an out-of-state license practice in CA without applying for a CA license?
- 180 da
- How long may someone with a foreign license (eg Canadian) practice in CA
- Up to 30 days in the calendar year
- Continuing Ed requirements in first renewal cycle
-
Spousal abuse
Aging and long term care
Courses prior to licensing may count at the descretion of the Board - After license expiration, for how long may the license be renewed?
- 3 years
- When may a license be surrendered?
- Before the hearing
- What happens to your license if you are incarcerated
- It is suspended (at min)
- What is covered by the evidence code
- Exceptions to privilege
- Under what condition may you not assert privilege?
- If it has been waived by the patient
- Who holds privilege?
-
Patient
Patient's guardian
Patient's representative - Who can claim privildege?
-
Holder of privilege
Person authorized by the holder
The therapist - Who can authorize a waiver of privilege?
-
Holder of privilege
If more than 1 then all holders
Anytime confidential communication is disclosed by the patient to a third party - Constraints on self-sufficient minors *
-
15 or older
Living apart from parents
Managing own finances
May consent to medical and dental treatment
Provider may contact parents with or without consent - Under what circumstances may a minor get outpatient or residential shelter treatment?
-
12 or older
Mature enough to participate
Cannot get ECT, psychosurgery or meds without parental consent - What are the parental contact requirements for outpatient or residential shelter treatment?
-
Outpatient: should attempt to contact unless inappropriate; document
Residential: MUST attempt to contact - Rule of thumb age constraints on treating a minor *
-
Generally must be 12 or older
Except for:
pregnancy
sexual assault (except rape) - Time frames for inspecting and copying records
-
Inspection - 5 working days
Copying - 15 days from receipt of written request
Treatment summary - 10 working days or 30 days with extenuating circustances - Time frames for abuse reporting
-
Child abuse
immediately by phone
written follow up in 36 hrs
Elder abuse
asap by phone
written follow up in 2 working days - Consequences of not filing an abuse report
-
Guilty of a misdemeanor
Possible jail up to 6 mo
Possible fine up to $1000
Both - Elder abuse report recipients
-
In general: to adult protective services or police
In a long term care facility: ombudsman or police - Non-disciplinary actions by the Board
-
Mediation
Education letter or review
Letter of warning
Citation and fine - Disciplinary actions by the Board
-
Letter of reprimand
Two-step agreement
Probation
Suspension
Interim suspension order
License surrender
License revocation - Tarasoft with respect to confidentiality
- Confidentiality must be considered even though it may be breached to provide the requisite information
- Def in HIPAA: patient authorization
- Written release of information beyond consent agreement
- Hours of SPE a trainee may accrue under a single primary supervisor
- Unlimited
- When must you get a new license instead of a renewal?
- 3 years after expiration
- Conditions under which graduate students must expose personal information
-
If requirement is clearly stated in admissions and program materials
If necessary to evaluate students for competence or threat to self or others - Def: sexual contact
- Touching an intimate part, including intercourse
- Ethics code on bartering
-
Permitted, as long as not clinically contraindicated or exploitive
Not encouraged or discouraged - Ethics on collection agency
-
Acceptable if:
Patient first given opportunity to settle accounts
Patient given advance notice - Contents of child abuse report
-
Reporter name and contact
Type of abuse
Narrative descripton
(But not risk of future abuse) - Requirements on professional initiating a 5150
- Provide confining facility with a statement of probable cause
- Responsibility to report to patients disciplinary actions by the Board
- No requirement unless asked
- Who may inspect patient records?
-
The patient or his/her representative and
One other person only - Requirements to reactivate inactive license
-
Application to the Board
Payment of fees
Completion of continuing ed prorated for time in active status - What is relevant to a patient threat against property?
-
Evidence Code 1024, stating
No privelege exists if the patient's mental state poses a risk to self, others or property and disclosure is necessary to prevent the threat - Ethics: handling of confidential information for didactic purposes
- Must be disguised unless the person has consented in writing
- Continuing education requirements
-
36 hours / renewal cycle
18 hours may be via distance learning
4 hour course in Law and Ethics
1 time course in spousal abuse - From whom must consent to treatment be secured?
-
Patient or legal guardian
Consent is not implicit in institutional consent - When is parental consent required for services to prevent or treat a pregnancy?
-
Contraception - no
Abortion - no
Sterilization - yes - What should be done in the event of the discovery of a harmful multiple relationship (APA)?
- Take reasonable steps to resolve it with due regard for the best interests of the client and maximal compliance with the Ethical Code
-
Referral payments are
illegal
unethical
both - Both
- Examples of insurmountable conflicts of interest
-
Doing a custody evaluation for a family you have been treating
Using the wife as the translator for the husband in an assessment - What should you do if the police demand to see client records on the strength of a warrent for his/her arrest *
- Inform them that any and all information regarding treatment is priviledged and confidential
- When can a physician disclose HIV status to a partner w/o the patient's consent
- Only after trying to secure consent
- State law vs HIPAA
- State law supersedes HIPAA unless HIPAA is more stringent or state and federal law are contradictory