Week 8-10 Flashcards
3 Primary Entities of Policy Process
1) US Congress (House of Reps, Senate)
2) President
3) Special Interest Groups
Legislative Process
Speaker of the House and Majority leader of Senate hear bills (proposed laws), schedule hearings, join committees to listen to bills, resolve differences between House and Senate
President roles in policy making
- sets the agenda
- lets congress know what he/she would have passed into law
*puts pressure on congress via constituents to accomplish items on agenda
3 Branches of Government
Executive - President
Legislative - Congress
Judicial - Supreme Court
Executive Branch
The executive branch has appointees who have large impact on policy development. They are responsible for taking the law passed and establishing the rules and regulations to realize them in programs that work
-Dept of Education
-Dept of Health & Human Services
-US Dept of Justice
IDEA
-requires public schools to develop appropriate individualized education plans for each child
-each students IEP must be developed by a team of knowledgable persons and must be reviewed at least annually
-team must be child’s teacher, child, special educator, and other at parent’s discretion
PACs
-Political Action Committees are formed to raise and contribute to the campaigns of candidates likely to advance a particular groups and interests
Examples of Legislature that Influenced OT
1) Education for all Handicapped Children Act of 1975 and IDEA
-all public schools must provide equal access to children with physical and mental disabilities
2) Medicare Part B 1987
-provision to cover OT as a free standing service under Medicare Part B
3) ADA 1990
-cicil rights law for people with disabilities
4) HIPPA 1996
-protects health insurance coverage for workers and families when they change or lose their jobs and identifies who are the health care providers, insurance plans, and addresses security and privacy of health data
5) Balanced Budget Act 1997
-medicare adopted a new approach for payment of services
regulations
rules that implement laws on a state or national basis (provide foundation for public policy)
policy
rules that regulate behaviors in an organization or an a larger scale like public policy, regulates behavior in the public area
Hiring and Firing Practices
Hiring: a match between the candidates skills and abilities to do the job requirements (can’t consider race, sex, age, disability, religion, etc)
Firing: cannot use discriminatory or other illegal reasons to terminate
FMLA (Family Medical Leave Act of 1993)
allows employees to take 12 weeks off work (pay is not mandatory) for health/family related issues: birth or adoption of child, taking care of sick child, spouse, parent
ADA (Americans with Disabilities Act 1990)
ensures that disabled individuals are treated fairly and this includes at their place of work
privacy
right of patients to be left alone, free from intrusion and to choose whether or not to share one’s self
confidentiality
implies a trust in private communications
liability
OTs are responsible for performing accurate assessments, developing sound plans of care, delivering proper clinical interventions, doing no harm
Legal claims are civil, criminal, tort law
Tort Law
Battery & Assault: intentional harm
-battery: person intentionally comes in physical contact with another person without their permission (must prove touch occured, that it was intentional, that is caused harm)
-assault: must appear the threat is imminent, person feels threatened
Intentional Infliction of Emotional Distress
* Through extreme and outrageous conduct, someone intentionally causes severe emotional or mental distress
Negligence
* Failure to exercise the standard of care a reasonable person would
* Not intentional or reckless, it is careless
Malpractice
* “Improper or unethical conduct or unreasonable lack of skill by a holder
of a professional or official position”
Medicare Fraud and Abuse
- Fraud: “intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes knowing that the deception could result in some unauthorized benefit to himself or some other person”
- Abuse: incidents or provider practices that are inconsistent with accepted sound
medical practice
Antikickback Statute
this law makes it a criminal offense to knowingly and willfully pay for or
receive ay remunerations for referrals for items or services that are paid for by a federal health program
Stark Law
This is the Physician Self-Referral Prohibition Statute. Doctors are not supposed to
refer patients for certain designated health services (OT is one of those services), in an entity where that doctor has a financial relationship
False Claims Act
makes a person who knowingly submits a false claim to the federal government liable for that behavior.
Anyone found liable for this will owe the government damages up to 3x the original erroneous payment + mandatory penalties
Requisite Managerial Authority
The level of control and discretion that a
manager must have to be fairly held
responsible for the outcomes of work groups
* Hire and fire employees
* Determine rewards
* Determine promotions
* Determine assignment of work
* planning, organizing and staffing, directing, controlling
fiscal year
A fiscal year is a period consisting of one
budget cycle that coincides with a calendar
year (January 1 to December 31) or with
another cyclical calendar (e.g., many
organizations operate on a fiscal year that
runs from July 1 to June 30)
Training, Education, and Development
Training activities are related to improving
an employee’s capacity to perform his or her
current job, such as learning a new
treatment technique related to a patient
population that he or she currently treats.
Education activities are related to improving
an employee’s capacity for a specific but
future job, such as a staff therapist taking an
introductory course on supervising others.
Development activities are related to overall
capacities that may be used in any job, such
as time management or communication
skills.
Types of Controls
Physical: Standards related to tangible
elements of a product or outcome of a
process, such as smoothness, texture, or size
Quantity: Amounts or counts that provide a
measure of conformance and efficiency,
such as the number of units of care
provided, or hours billed
Quality: Quantitative measures of quality,
such as outcome measures or patient or
customer satisfaction
Cost: The cost of a process, such as the cost
per unit of service provided, or the cost of
materials associated with a process, such as
fabricating a splint
Leadership
Leadership is a process of creating structural
change where the values, vision, and ethics
of individuals are integrated into the culture
of a community as a means of achieving
sustainable change.
Management
Management is the process of guiding an
organization by planning for future work
obligations, organizing employees into
functional units, directing employees in the
process of completing daily work tasks, and
controlling work processes and systems to
assure adequate quality of work output.
Three Categories of Supervisory Functions
- Management related to monitoring and
evaluating the work of others - Education related to the development and
evaluation of competencies of staff - Support-related professional development,
including promotion of self-awareness and
emotional growth
Span of control
The number of immediate subordinates who
report to any one supervisor
Too large a span of control may result in
inability to attend to needs of individual
employees
Too small a span of control may result in
unnecessary labor costs
-Factors affecting span of control: type of work, degree of training, & organizational stability
Four Strategies for Increasing Personal
Power
- Increase your centrality in the organization by
looking for opportunities to include new
functions central to the flow of work in your
job. Volunteer for committees where you can
build networks with other department
leaders. - Increase the personal discretion and flexibility
of your position by replacing routine activities
with involvement in new projects in the early
stages of decision making. - Increase the visibility of your job
performance by developing and nurturing
relationships with organizational leadership.
Volunteer to make presentations from task
groups, offer suggestions and examples
when a presenter asks for input from a large
group, or volunteer to become a trainer. - Increase the relevance of your job tasks to
the organization by finding ways to develop
programs that align with the organization’s
top priorities.
Models of Supervision
Psychotherapy-based models
-Make the same assumptions about the
nature of what constitutes an effective
supervisor–trainee relationship as they do
about what constitutes an effective
therapist–client relationship
Developmental models
-It is assumed that close supervision is
needed for a new therapist, but as the
therapist gains experience, his or her need
for supervision is lessened and the
relationship with the supervisor changes
also
Social roles models
-Basic tenets are that as the needs of the
supervisee change, the role of the
supervisor should change to better meet
those needs
Eclectic/integrationist models
-Blend of a number of different supervision theories (e.g., a social roles model as well as a developmental approach). The main components of these models include:
* A customized approach
* Needs assessment
* Consideration of the supervisee’s developmental
level and cognitive style
* Assessment and evaluation of the supervisee’s skills
Direct Supervision
Direct observation can be defined as
observing performance without making real-
time changes to the actions being observed
and is a requirement of some state laws.
Indirect Supervision
Indirect supervision is a method of
supervision in which face-to-face interaction
is not a component; may include phone
conversations, written correspondence,
electronic exchanges, and other methods
using secure telecommunication technology
Authoritative style of supervision
Authoritative style of supervision is one in
which the supervisor (in this case the OT)
has absolute say, and the supervisee (the
OTA) is expected to comply without question
or contribution.
OTR vs. OTA
OTR: Masters Degree, Certification, Evaluates and sets the treatment plan, Research scientist
OTA: Associates Degree, Certification, can contribute to the evaluation and do specific standardized assessments if competent, data gathers for research
TRANSFORMATIONAL THEORY
This theory proves to be the greatest for
follower effectiveness and satisfaction.
Leaders articulates the vision and shares with the
subordinates to increase passion.
Focus on vision, and individual differences among
workers.
Tries to change team effectiveness
Seek new ways to work
Take risks.
Inspirational, motivational
Charismatic
Inspire, Energize, Intellectually Stimulate
TRANSACTIONAL THEORY
Leaders promise rewards and benefits to
subordinates for meeting work goals.
Together managers and subordinates
agree on rewards and punishments.
Working with individuals and groups to
achieve work objectives, setting up a
compensation and reward system
SITUATIONAL THEORY
Managers adopt a style that best fits the level of
the subordinates.
They change according to situation
Delegation responsibilities so that subordinates
come to managers for assistance.
Flexibility
Coaching
Use directing by refining roles and tasks
Supportive, let the subordinates make daily
decisions to change tasks.
Managers vs. Leaders
Leader
- motivates people to perform to full potential
-Focus on effectiveness
Manager
-Supervise employees
-Focus on efficiency
“Managers are people who do things right and leaders are people who do the right things”
Managers are transistors and leaders are
transformers
Corporation
- Most complex type of business structure
- Legally acts as a completely separate entity from the owner
- Can have 1 ore more owners or stockholders
- Stockholders are not personally responsible for any losses
- 3 common types of corporations
- C corporation (general corporation): is taxed separately from its owners, must pay income tax on their net income (double taxation)
- Subchapter S corporation: shareholders do not pay federal income tax on company profits, profit or loss directly to owner’s personal income tax
- Professional corporation or professional service corporation (PSC): can only be owned and operated by licensed professionals
ETHICAL APPROACHES
DESCRIPTIVE ETHICS
* FACT BASED EXAMINATION OF DIFFERENT SOCIETIES OR CULTURES USING SCIENTIFIC INQUIRY TO IDENTIFY HOW PEOPLE REASON AND ACT
* EXAMINE THE SOCIETY’S PERCEPTION OF RIGHT AND WRONG WITHOUT
JUDGING WHETHER THE SOCIETY IS “CORRECT”
METAETHICS
* MEANING OF MORAL JUDGMENTS AND PRINCIPLES
* HOW MORAL KNOWLEDGE MIGHT BE POSSIBLE, REASONS FOR CULTURAL
BELIEFS
NORMATIVE ETHICS
* PRACTICE OF PUTTING FORWARD THE CORRECT MORAL PRINCIPLES AND
RULES
* DEBATE ABOUT WHAT IS THE “CORRECT” MORAL VIEW
* LACK OF CONSENSUS RESULTED IN SEVERAL NORMATIVE THEORIES
VIRTUE ETHICS
* FOCUS ON HUMAN CHARACTER
* WHAT ARE THE CORRECT VIRTUES THAT STRONG MORAL CHARACTER
SHOULD HAVE?
Ethics of Care
* EMPHASIZES INTIMACY, CARING AND RELATIONSHIP BUILDING
* FOCUSES ON RELATIONSHIPS OF ACTORS IN THE CASE
TELEOLOGICAL THEORY
- THE RIGHTNESS OF AN ACTION DEPENDS EXCLUSIVELY ON IT
PRODUCING CERTAIN KINDS OF GOOD CONSEQUENCES - TELOS = “END”, “GOAL”
- FOCUS ON OUTCOMES OF A PROPOSED ACTION
- “THE ENDS JUSTIFY THE MEANS”
DEONTOLOGICAL THEORY
- EMPHASIZES THE ACTION ITSELF
- “THE ENDS NEVER JUSTIFY THE MEANS”
- DEON = DUTY
- EMPHASIZES MORAL DUTY, OBLIGATION, PRINCIPLE, NOT CONSEQUENCES
- RIGHT OR WRONG OF AN ACT MAY DEPEND ON OTHER SITUATIONS
- PATH TO THE CONSEQUENCE MATTERS
PRINCIPLES OF BIOMEDICAL ETHICS
- AUTONOMY: right to self determination
-RESPECT A PERSON’S FREEDOM TO MAKE DECISIONS THAT CONTROL HIS OR HER LIFE - NON MALEFISCENCE: do no harm
- BENEFICENCE: do good for one another
-PROTECTING AND DEFENDING THE RIGHTS OF OTHERS
-REMOVING CONDITIONS THAT WILL CAUSE HARM TO OTHERS - JUSTICE: fair, equitable and appropriate treatment
- VERACITY: truthfulness, honesty
- FIDELITY: being faithful/loyal, keeping promises & commitments, respect
