Code of Ethics, Role & CMS Flashcards
4 Main Purposes of Code of Ethics
- ID/describe principles supported by OT profession. 2. Edu gen public/members regarding est principles to which OT personnel are accountable. 3. Socialize OT personnel to expected standards of conduct. 4. Assist OTs in recognition/resolution of ethical dilemmas.
7 Principles - AOTA Code of Ethics
- Beneficence, 2. Non-maleficence 3. Autonomy/Confidentiality 4. Social Justice 5. Procedural Justice 6. Veracity 7. Fidelity
- Beneficence
Demo concern for safety/well-being of service recipients: EBR, competence, timely, scope, avoid outdated info, proper termination, referals, OT edu, ensure research is done properly, report & take responsibility for profession. Mandated reporters- min reporting is to ones immed supervisor
- Non-maleficence
Shall intentionally refrain from actions that cause harm: avoid harm, efforts for continuity of services, avoid exploitation, maintain professionalism/objectivity, avoid sexual relations w any service recipient, take appropriate action to remedy personal probs that could interfere, avoid influences, maintain/adhere to Code in volunteer roles, avoid bartering & determine proportion of risk w research
- Autonomy & Confidentiality
Shall respect right of individual to self-determination: Collab relations w full disclosure - benefits/risks/progress, obtain consent, respect pt right to refuse services, provide students w accurate OT edu info, informed consent/disclosure w research ppl & respect right to w/d, maintain privacy - only except w immediate harm, confidentiality & HIPPA & facilitate meaningful communication
- Social Justice
Provide services in fair & equitable manner: uphold OT altruistic responsibilities to ensure common good, edu ppl about wealth of OT, make effort to promo acts that benefit health of community, advocate for fair/just tx & access to services for all, consider pro-bono for ppl that need it & provide/teach generalization services
- Procedural Justice
Shall comply w institutional rules, local, state, fed, international laws & AOTA docs applicable to profession. must be familiar w Code & share/edu, be familiar w all laws/AOTA and implement, hold credentials as required, take responsibility for maintaining high standards/continue competence, ensure all duties match qualifications, provide appropriate supervision, necessary approval for research, report all gifts, use funds for intended for purposes, prevent discrimination/unfair labor, advocate for workers w disabilities, form policies/procedures to ensure all legal compliance, collect fees legally, maintain ethical principles in all areas of professional work
- Veracity
Shall provide comprehensive, accurate & objective info when rep’in profession: rep credentials/qual/experience/edu accurately, refrain from using/participating in any form of comm w false info, record/report in timely manner, doc is in accordance w laws/guides, ensure truthful marketing, accept responsibility for act that reduce public trust in OT, outline services accurately, honest/fair/respectful & timely & no plagiarizing
- Fidelity
Shall tx colleagues/other professionals w respect, fairness, discretion & integrity: respect traditions, practices, competencies & responsibilities of own/others, preserve privacy of all other workers, discourage/prevent/report breaches of Code - use internal resources first, avoid conflicts of interest/commitment, do not use position to create conflicts, use conflict resolution, “be diligent humans of human/financial/material resources & no not exploit
Ethical distress vs dilemma
Distress- when OT knows correct actions but a barrier prevents them from taking course. Dilemma- 2(+) potentially morally correct ways to solve prob but solutions are exclusive.
AOTA & Vol membership
As a vol membership org, AOTA has no direct authority over practitioners who are not members and no direct legal mechanisms for preventing non-mems who are incomp, unethical or unqual-ed from practicing
Ethics Commission
Comp of AOTA resp for Code/Standards of practice of profession - responsible for inform/edu mems about current ethical issues, upholding practice & edu standards. monitoring behaviors & reviewing allegations
State Reg Boards
Created by state legislature to assure health/safety of the citizens of the state. Responsibility to protect pub from harm - licensure that describes scope of practice & qualifications. Intervene when OT involved legally.
Actions for Violations
Reprimand: private convo. Censure: pub statement of agency stating disapproval. Ineligibility: removal of eligibility for membership/license renewal. Probation: req to meet certain conditions. Suspension or Revocation. (All expect reprimand are made public by respected agency)
OTA
Grad from ACOTE accredited tech edu program w A degree/cert. Can expand role w service comp-specialty; but does not make I. Prim role=tx implementation; can contrib to eval but not I & cant begin tx prior to OT eval; can be activity directors at SNFs and supervise OT aids. AOTA supports I practice of OTAs w advanced level skills who work for I living centers although SRBs may supersede this. Must be supervised by OT for any/all aspects of OT serive delivery.
OT Aids
*Not considered OT practitioners. Can be trained by OTA or OT to perform specific non-skilled tasks (routine maintenance/clerical tasks/CG-trans). OT is responsible for determination/delegation of client & non-client tasks and aid performs. Client tasks: OT must know anticipated outcome, that pt can perform, that Aid is competent & that no adaptation will be needed. S by OTA/OT must be doc-ed. *Cont S for patient tasks
Indirect vs Direct Supervision
D- Face-to-face: co-tx, observation, instruction, modeling, discussion. I- electronic, written, tele comm
Supervision Continuum
Close: direct/daily at site of work. Routine: direct at least every 2wks at work site w interim in-direct S. General: at least monthly direct contact w S as needed by other methods. Min: provided only as needed & may be less than monthly.
Fx’al S
Info/feedback from co-workers
FW S
Entry Level OT/OTA can S Level I FW. OT w 1yr experience can S Level II. OTA’s w 1yr experience can supervise Level II OTAs. 3yrs of experience recommended for individuals w multiple students & supervisors.
Intradisciplinary Teams
One(+) mems of 1 discipline eval, plan & implement tx - at risk d/t lim perspective
Multidisciplinary Teams
of professionals from diff disciplines conduct assessments/tx I from one another. Members prim allegiance is to own discipline & lim comm may result in lack of understanding.
Interdisciplinary Teams*
All disciples relevant to tx agree to collab on decision making, eval/tx still conducted I-ly but there is greater understanding of each discipline’s perspective. Directed toward common goal & not bound by discipline line-specific roles/fxs. Tend to use group process skills effectively.
Transdisciplinary Teams*
Characteristics of interdis are maintained & expanded on. mems committed to ongoing comm/collab. Eval/tx planned cooperative, role blurring is accepted. ongoing training/support/consultation is important.
ACA
The Pt Protection & Affordable Care Act: Signed into law 2010 cont to 2016. Seeks to expand access to Health Insurance for all Americans & improve quality of HC services in US.
Key Components of ACA
Accountable Care Orgs (ACOs ): provide financial incentives for HC providers who develop an integrated network to collab when tx pts across care settings-aim is to lower costs while meeting quality standards. & Pt-Centered Medical Homes (PCMHs): places designed to meet pts complete needs for mental/phys health via preventative, acute care & disability/chronic illness mngt services
CMS
Center for Medicare/Medicaid Services; a division of US dept of Health & Human Services (HHS) = fed agency which develops rules/regs pertaining to fed laws governing Medicare/caid programs. Programs must comply/meet guidelines
SNFs & CMS
LT settings are strongly influenced by CMS since Medicare/caid pay for all/most of expenses
5 CMS Centers
1.Center for Beneficiary Choices: focus on Medicare Choice & Medigap. 2.Center for Medicare Mngt: focus on traditional fee-4-service Medicare. 3.Center for Medicaid & State Operations: focus on state admin programs like Medicaid & State Children’s Health Insurance Program (SCHIP). 4.Center for Program Integrity: provides oversight of Medicare/caid Programs to ensure integrity/best practice. 5. Center for Medicare/caid Innovation: est by ACA; develops/tests new service delivery & payment models for maintaing/improving qual of care - while controlling costs
OSHA
Occ Safety & Health Admin; division of US dept of labor. Structural standards/building codes; safety of employees/consumers regulated.
State Accreditation to obtain licensure for HC facility
MANDATORY. States develop own requirements & local/county entities also develop regs pertaining HC institutions (ex: fire/elevator safety)
Accreditation Means
Compliance w est standards; ensures orgs are adequate;y equipped & meets high standards for pt care & employs qual-ed professionals.
Accreditation thru accreditation agency is vol but
mandatory to receive 3rd party reimbursement & to be eligible for gov’t grants/contacts; Vol agencies include: JACHO, CARF & Accred. Council for Services for MR & Other DD Persons (AC-MRDD)
Accreditation Process
Initiated by org w application, self-study/assessment conducted, on-site review by surveyor team, involves staff-doc prep, hosting the site team & interviews > once accredited, periodic review (%3yrs)
