Legal Issues in Healthcare Health Care Core Curriculum.

Legal Issues in Healthcare Health Care Core Curriculum

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Legal Issues in Healthcare Module Description O This module explores legal issues involving clients and healthcare workers including: O Health care laws O Clients’ rights and responsibilities O Confidentiality O Liability O Documentation O Regulation. O The relationship between ethics and legal issues O Impact of healthcare systems’ laws and regulations.

Module Outline and Instructor Resources This module consists of 9 competencies. O Each competency is divided into unit competencies with learning activities to help students master the competency. O Each learning activity is explained on the Module Outline and the resources described. O Choose the learning activities that best meet your classroom needs.

Module Outline and Instructor Resources O Find these learning activities and resources on the website or create your own. O The Course Outline also has documents the instructor can use in teaching the lesson. O These competencies are listed on the following slide and will then be addressed throughout the remainder of the power point. O On D2L website review O Course Outline O Competency Modules and Instructor Notes

Module Competencies 1. Explain the laws related to healthcare and their influence on the delivery system. 2. Describe one’s legal responsibility related to abuse, neglect, exploitation, and the Vulnerable Adults Law. 3. Explain clients rights and responsibilities and how healthcare providers can ensure those rights. 4. Describe the components of healthcare employee and healthcare facility liability when delivering client care. (see next slide)

Module Competencies 5. Discuss how confidentiality must be maintained in healthcare facilities with clients and their medical records. 6. Explore legal issues such as sexual harassment, wrongful discharge, negligence, malpractice and violence in the workplace. 7. Identify the legal issues for accurate documentation, informed consent and advanced directives. (see next slide)

Module Competencies 8. Describe the consequences of inappropriate use of health data (including use of social media and email) in terms of disciplinary action. 9. Using a problem solving process applied to healthcare situations, describe how laws influence health care facilities and the care of clients.

Module Competency #1 Explain the laws related to healthcare and their influence on the delivery system.

Competency #1-Explain the laws related to healthcare and their influence on the delivery system. Five units and learning activities round out the learning for this first competency. 1. Discuss common legal terms. 2. Name the federal laws relating to healthcare. 3. Discuss Minnesota state laws that relate to healthcare. 4. Explain why everyone should have a healthcare directive whether ill or not. 5. Define differences between certification, registration, and licensure. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1A: Terms Recommended Content O Many of our students may have some understanding of the law and yet may not know the legal terms in relation to healthcare. O At the beginning of this module it is beneficial to have a discussion about the definitions of common legal terms. O Review the Vocabulary List on D2L

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Recommended Content O Healthcare facilities operate under federal, state and local laws. O All healthcare workers must function within these laws. O The six laws are addressed in the following slides. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Equal Employment Opportunity Commission (EEOC) O The U.S. Equal Employment Opportunity Commission (EEOC) is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information.

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws O The EEOC is a governmental agency that handles sexual harassment complaints that cannot be settled in the workplace. O The EEOC defines sexual harassment as “unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature”.

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws American with Disabilities Act (ADA) The Americans with Disabilities Act (ADA), passed by U.S. Congress in 1990 and fully implemented in 1994, prohibits discrimination on the basis of disability in employment, public services, and public accommodations. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Purposes of ADA O Provide a clear and comprehensive national mandate for eliminating discrimination among individuals with disabilities. O Provide clear, strong, consistent, enforceable standards addressing discrimination against individuals with disabilities. O Ensure the federal government plays a central role in enforcing standards established under the act.

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Equal Pay Act O The Equal Pay Act requires that men and women in the same workplace be given equal pay for equal work. The jobs need not be identical, but they must be substantially equal. O All forms of pay are covered by this law, including salary, overtime pay, bonuses, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. O If there is an inequality in wages between men and women, employers may not reduce the wages of either sex to equalize their pay. (U.S. EEOC, n.d.) What year?

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Patient Self-Determination Act O Congress passed the Patient Self- Determination Act (PSDA) in 1990. The regulations were implemented in December 1991. O This act gives patients the right to make choices and decisions about the types and extent of medical care they wish for themselves.

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws O Patients can specify if they want to accept or refuse specific medical care. O They can also identify a legal representative for urgent healthcare decision purposes. If they become unable to make decisions due to illness, the patient’s wishes have been clearly documented at an earlier point. (Northern Virginia Community College, n.d.)

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Omnibus Budget Reconciliation Act The Federal Nursing Home Reform Act or OBRA 1987 creates a set of national minimum set of standards of care and rights for people living in certified nursing facilities. O These minimum federal health and care requirements for nursing homes are to be delivered through variety of established protocols within nursing homes and regulatory agencies. O OBRA set in motion forces that changed the way state inspectors approached all their visits to nursing homes. (Turnham, n.d.)

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Health Insurance Portability and Accountability Act (HIPAA) In 1996, a law was passed by Congress to: O Improve portability and continuity of health insurance coverage in the group and individual markets. O Combat waste, fraud, and abuse in health insurance and health care delivery.

Module Competency #1: Laws related to healthcare Unit #1B: Federal Laws Health Insurance Portability and Accountability Act (HIPAA) O Reduce costs and administrative burdens of health care by improving efficiency and effectiveness of the health care system by standardizing the interchange of electronic data for specified administrative and financial transactions. O Ensure protecting the privacy of Americans’ personal health records by protecting the security and confidentiality of health care information. ( Maryland Department of Health and Mental Hygiene)

Module Competency #1: Laws related to healthcare Unit #1C: MN State Laws Recommended Content Three Minnesota state laws to be discuss with the students are: 1. Criminal Background Checks 2. Minnesota Good Samaritan Law 3. Vulnerable Adult Law Details of each are discussed on the following slides.

Module Competency #1: Laws related to healthcare Unit #1C: MN State Laws O A background check or background investigation is the process of looking up and compiling criminal records, commercial records and financial records (in certain instances such as employment screening) of an individual. O Background checks are often requested by employers for job candidates and interns. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1C: MN State Laws O Good Samaritan acts are laws designed to protect healthcare providers against the claims of malpractice when they provide assistance at the scene of an emergency. O A person who renders help in an emergency, at a level that would be provided by any reasonable prudent person under similar circumstances, cannot be held liable for his/her actions.

Module Competency #1: Laws related to healthcare Unit #1C: MN State Laws O The Minnesota Vulnerable Adult Act outlines the types of abuse and the role of Adult Protective Services. O There are three basic kinds of maltreatment: O Abuse - physical, emotional or sexual O Neglect - caregiver neglect or self neglect O Financial exploitation

Module Competency #1: Laws related to healthcare Unit #1D: Advanced Directives Tips on teaching the material O Teaching advanced directives often provides students with information that they have never heard before and may not think that it pertains to them. O Having this conversation with students can be quite intense and bring up a variety of emotions -- especially when students come from different cultures and religions. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1D: Advanced Directives Recommended Content The Advance Directive unit addresses terms and concepts such as: O Life-prolonging treatments O Terminal condition O Persistent vegetative state O Do not resuscitate (DNR) (Minnesota Department of Health)

Module Competency #1: Laws related to healthcare Unit #1D: Advanced Directives An advanced directive is a document that states what the patient wishes to happen to his/her body while alive but is unable to speak for him/herself. The three parts of an advanced directive addressed in the curriculum are: 1. Living will 2. Healthcare proxy 3. Durable power of attorney (see next slide)

Module Competency #1: Laws related to healthcare Unit #1D: Advanced Directives Living wills are written documents that direct treatment in accordance with a patient’s wishes in the event of terminal illness or condition. The living will takes effect only when the patient is incapacitated and can no longer express his or her wishes. The living will states which medical treatments may be used and which may not be used to die naturally and without the patient’s life being artificially prolonged by various medical procedures. The purpose of a living will is to allow you to make decisions about life support and direct others to implement your desires in that regard. (Kockrow and Christensen, 2pp. 203)

Module Competency #1: Laws related to healthcare Unit #1D: Advanced Directives Healthcare proxy is a person who has been designated to make medical decisions for the patient when he/she is unable to speak for him/herself. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1D: Advanced Directives O A durable power of attorney for health care is a document that designates an agent, surrogate, or proxy to make health care decisions on his/her own behalf. O This agent is appointed to make health care treatment decisions based on the patient’s wishes. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1E: Certification, Registration, Licensure Recommended Content The curriculum address three credentials required for the healthcare profession to maintain its standard of practice. They are: 1. Certification 2. Registration 3. Licensure (see next slide)

Module Competency #1: Laws related to healthcare Unit #1E: Certification, Registration, Licensure O Professional certification ensures that health professionals meet established levels of competency. O Professional certification is granted by national organizations and NOT by individual states and carries national recognition. O In health professions with no state licensure, professional certification may be required. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1E: Certification, Registration, Licensure O Registration is a written record of an individual practicing within a field. O Professional registration means the listing of certified health professionals on an official roster kept by the state agency or health professional organization. (see next slide)

Module Competency #1: Laws related to healthcare Unit #1E: Certification, Registration, Licensure O Before a person can begin work in many health professions, a state license is required. An individual must complete certain steps, such as training, acquiring an academic degree in a particular area of study, and/or passing an exam before becoming eligible to receive a license. O Licensure is usually granted on the basis of education and examination rather than performance. O Licensure has been set in place to protect the public from unqualified practitioners. (Ramont and Niedringhaus, p. 31) (see next slide)

Module Competency # 1: Laws Related to Healthcare Recommended Learning Activities AssignmentResourcesNotes LIH Competency 1: Team Assignment Organizations/Laws Online websites This is a team based assignment in which the team researches an organization or law, and presents it to the group. LIH Competency 1: Medical Grid MN Healthcare Directive Toolkit This assignment involves studying advanced directives, then having the student discuss with family members four different case scenarios and deciding upon an advanced directive in these situations for themselves.

Module Competency #2 Describe one’s legal responsibility related to abuse, neglect, exploitation, and the Vulnerable Adults Law.

Competency #2: Describe one’s legal responsibility related to abuse, neglect, exploitation, and Vulnerable Adults Law For this competency, you will be introduced to nine units with learning activities. 1. Define abuse 2. Explain why abuse may occur. 3. Identify types of abuse. 4. Define neglect 5. Define exploitation. 6. Identify populations at risk for abuse, neglect, and exploitation. (see next slide)

Competency #2: Describe one’s legal responsibility related to abuse, neglect, exploitation, and Vulnerable Adults Law 7. Identify federal and state laws protecting vulnerable persons. 8. Explain an individual’s legal responsibility if abuse or neglect is suspected. 9. Explain a facilities legal responsibility if abuse or neglect is suspected.

Module Competency #2 O The first three units are easily presented together. They are: O Unit #2A: Define Abuse O Unit #2B: Explain why abuse may occur O Unit #2C: Identify types of abuse \ (see next slide)

Module Competency #2: Legal Responsibilities Units #2A-1C: Abuse Tips on presenting the material O This part of the module can be difficult to present and discuss, as many people have either witnessed or experienced abuse. O Consider ways to be sensitive to students’ personal disclosure of abuse, their experiences and stories.

Module Competency #2: Legal Responsibilities Units #2A-2C: Abuse Abuse is defined as: O any action that intentionally harms or injures another person. O the willful infliction of injury, unreasonable confinement, intimidation, or punishment that results in physical harm, pain, or mental anguish. Abuse also encompasses inappropriate use of any substance, especially those that alter consciousness (e.g., alcohol, cocaine, methamphetamines). (Medical-Dictionary, n.d.)

Module Competency #2: Legal Responsibilities Units #2A-2C: Abuse O Abuse may occur when a person feels stressed, tired, overwhelmed, dealing with personal problems or loss of control. O There are several types of abuse. The curriculum addresses the following: O Physical abuse O Verbal abuse O Psychological abuse O Sexual abuse

Module Competency #2: Legal Responsibilities Units #2A-2C: Abuse Physical abuse can be defined as abuse that consists of anything one person does to another that causes physical pain. (see next slide)

Module Competency #2: Legal Responsibilities Units #2A-2C: Abuse Verbal abuse is: O Manipulative and controlling. O Unpredictable. O Threatening. O Ordering. O Is a lie told to you or about you. (see next slide)

Module Competency #2: Legal Responsibilities Units #2A-2C: Abuse Psychological abuse includes: O Making the patient fearful of you, such as threatening not to respond when the patient calls. O Threatening the patient/resident with harm. O Threatening to tell something to others that the patient does not want to be known. O Threatening to withhold care. (Hegner, Acello, and Caldwell, pp. 40-4) (see next slide)

Module Competency #2: Legal Responsibilities Units #2A-2C: Abuse Sexual abuse is the use of physical means or verbal threats to force the patient/resident to perform sexual acts. O In many states, sexual abuse is any behavior that is seductive, demeaning, harassing, or reasonably interpreted as sexual by the patient. (Hegner, Acello, and Caldwell, pp. 40-41)

Module Competency #2: Legal Responsibilities Unit #2D: Neglect Neglect can be defined as: O A lack of care and attention O Lacking concern O To leave undone or leave out O Failure to act responsibly O Failure to act with the caution that a reasonable person would exercise under the same circumstances (Robinson, Benedictis, and Segal, 2011)

Module Competency #2: Legal Responsibilities Unit #2E: Exploitation This involves illegal use of a vulnerable adult’s funds or property, either by a caregiver or an outside scam artist. An unscrupulous caregiver might: O misuse an elder’s personal checks, credit cards, or accounts O steal cash, income checks, or household goods O forge the elder’s signature O engage in identity theft

Module Competency #2: Legal Responsibilities Unit #2F: Populations at Risk Recommended Content The curriculum identifies four populations at risk for abuse, neglect, or exploitation. Those populations are: 1. The aging population 2. Adults with a disability 3. People who cannot help themselves (see next slide)

Module Competency #2: Legal Responsibilities Unit #2F: Populations at Risk 4. Persons 18 years of age or older who: A. Live in licensed facilities B. Receive services from licensed agencies C. Are in family settings but cannot report abuse or neglect themselves (see next slide)

Module Competency #2: Legal Responsibilities Unit #2G: Federal and State Laws Recommended Content There is a federal and state law that addresses the issue of the populations at risk. O Federal Child Abuse Prevention and Treatment Act O Vulnerable Adult Law in Minnesota These are addressed on the following slides.

Module Competency #2: Legal Responsibilities Unit #2G: Federal and State Laws Federal Child Abuse Prevention and Treatment Act (CAPTA) O The Child Abuse Prevention and Treatment Act (CAPTA) is the main piece of federal legislation addressing child abuse. O Puts forth a framework for defining types of child abuse and enables federal assistance for preventing, identifying and treating child abuse nationwide. O CAPTA provides a minimum definition of child abuse and neglect. (AVVO Staff) (see next slide)

Module Competency #2: Legal Responsibilities Unit #2G: Federal and State Laws Federal Child Abuse Prevention and Treatment Act (CAPTA) O Requires the reporting of physical and mental abuse of a child O Protects those who do the reporting O Patient confidentiality does not exist in cases of suspected abuse

Module Competency #2: Legal Responsibilities Unit #2G: Federal and State Laws Vulnerable Adult Law in Minnesota The act declares that it is the public policy of Minnesota to: O protect adults who, because of physical or mental disability or dependency on institutional services, are particularly vulnerable to maltreatment; O to assist in providing safe environments for vulnerable adults; and to provide safe institutional or residential services, community-based services, or living environments for vulnerable adults who have been maltreated. (Stearns County)

Module Competency #2: Legal Responsibilities Unit #2H: Individual’s Responsibility Recommended Content O The healthcare worker is responsible for reporting abuse immediately to the supervisor and should know the workplace’s reporting policy. O Laws protect workers who do the reporting. Confidentiality of the reporter is protected.

Module Competency #2: Legal Responsibilities Unit #2I: Facilities Responsibility Recommended Content O It is critical to present a broad brushstroke of the legal responsibilities of a facility if abuse or neglect is suspected. O The four areas to be presented for this module are listed on the following slide. (see next slide)

Module Competency #2: Legal Responsibilities Unit #2I: Facilities Responsibility 1. Develop an abuse protection plan 2. Develop an individual abuse prevention plan for clients in the facility. 3. Establish a written policy to ensure all cases of abuse or neglect are reported promptly. 4. Keep records of incidents to monitor for the trends or repeated incidents.

Module Competency #2: Legal Responsibilities Recommended Learning Activities AssignmentsResourcesNotes LIH Competency 2: Scenarios – Abuses in Healthcare Scenarios This learning activity provides three short scenarios for discussion on the type of abuse portrayed in each scenario. LIH Competency 2: Scenario – Vulnerable Adults ScenariosThis scenario portrays elder abuse and offers questions for thoughtful discussion or assignment.

Module Competency #3 Explain clients rights and responsibilities and how healthcare providers can ensure those rights.

Competency #3: Explain client rights and responsibilities and how healthcare providers can ensure those rights. Four units and learning activities round out the learning for this third competency: 1. Identify the purpose of the Patient’s Bill of Rights. 2. Identify the purpose of the Resident’s Bill of Rights. 3. Explain how to help clients/individuals keep their rights. 4. Discuss how to report and document a violation of patient rights.

Module Competency #3: Client Rights and Responsibilities Unit #1: Patient’s Bill of Rights Recommended Content O In 1973, the American Hospital Association (AHA) published “A Patient’s Bill of Rights” to promote the rights of hospitalized clients. O The Patient’s Bill of Rights, by federal law, must be explained verbally and signed by the client before care can be provided. O Verification of compliance is an important function at the time of admission of the patient. O A copy of the Patient’s Bill of Rights must be posted on the wall in every facility. (Ramont and Niedringhaus, pp. 113-114)

Module Competency #3: Client Rights and Responsibilities Unit #3A: Patient’s Bill of Rights Included in the Patient’s Bill of Rights are: O Considerate and respectful care O Consideration of privacy for clients O Confidentiality of all records and communications regarding care O The right to refuse a treatment or plan of care O Patient involvement in decisions about care O Patient will be informed of the costs of care (Ramont and Niedringhaus, p. 113)

Module Competency #3: Client Rights and Responsibilities Unit #3B: Resident’s Bill of Rights Recommended Content O OBRA (Omnibus Budget Reconciliation Act) guarantees the rights of residents in nursing homes. O The rights of a resident are: O To be informed O To examine federal and state surveys regarding the facility O Be treated with dignity O Receive care regardless of race, color, ethnic origin, age, etc.

Module Competency #3: Client Rights and Responsibilities Unit #3C: Maintaining Rights Recommended Content O Explain the ways a client/individual can keep their rights are through education. O Educational pieces include: O A copy of the Patient’s or Resident’s Bill of rights must be given on admission O A copy must be posted where it can be easily seen O The patient/individual must be given as much control over his/her care as possible O Tasks/care must be explained O The patient’s/resident’s privacy must be maintained

Module Competency #3: Client Rights and Responsibilities Unit #3D: Reporting and Documenting Recommended Content O Reporting and documentation are critical when a violation of a patient/client has occurred or is suspected. O Basic steps to follow are: O Report violations to the supervisor O Document only the facts and not opinions O Follow facility policy

Module Competency #3: Client Rights and Responsibilities Recommended Learning Activities AssignmentResourcesNotes LIH Competency 3: Scenario -Health Care Bill of Rights Health Care Bill of Rights This learning activity has students looking up the bill of rights and applying what they learn to questions in a scenario.

Module Competency #4 Describe the components of healthcare employee and healthcare facility liability when delivering client care.

Module Competency #4: Describe the components of healthcare employee and healthcare facility liability when delivering client care. Three units are embedded in this competency and their learning activities. 1. Define liability, negligence, malpractice and scope of practice. 2. Discuss what policy and procedure is. 3. Describe how policy and procedures protect the worker and client from harm.

Module Competency #4: Employee and Facility Liability Unit #4A: Define Terms Recommended Content O At this point there are 4 helpful terms to define and discuss with the students: O Liability O Negligence O Malpractice O Scope of Practice (see next slide)

Module Competency #4: Employee and Facility Liability Unit #4A: Terms Liability O One of the most significant words in the field of law, liability means legal responsibility for one's acts or omissions. (thefreedictionary.com) O Liability can result if the healthcare worker breaches confidentiality by passing along confidential client information to others or by intruding into the client’s private domain. (Ramont and Niedringhaus, p. 30)

Module Competency #4: Employee and Facility Liability Unit #4A: Define Terms Negligence O Negligence is when a person does NOT act the way they should. O For example, a nursing assistant is negligent when s/he does NOT take vital signs when s/he should have.

Module Competency #4: Employee and Facility Liability Unit #4A: Terms Malpractice O A person who does NOT give care with same level of skill learned in school can be found guilty of malpractice when this leads to an injury or damage to the person. O For example, when a nursing assistant does NOT wash his/her hands between patients and some patients get a serious infection, this nursing assistant can be found guilty of malpractice.

Module Competency #4: Employee and Facility Liability Unit #4A: Define Terms Scope of Practice O To practice within the guidelines of training, the profession, and organization’s job description. O What a person is legally allowed to do

Module Competency #4: Employee and Facility Liability Units #4b & 4C: Policy and Procedures At this point, both Unit #4B (Discuss what a policy and procedure is) and Unit #4C: (Describe how policy and procedures protect the worker and client from harm) can easily be discussed as one unit.

Module Competency #4: Employee and Facility Liability Units #4B & 4C: Policy and Procedures Recommended Content Policy – A course of action that should be taken every time a certain situation occurs O Example: Most agencies have a policy that the patient’s/resident’s /client’s plan of care should be followed. So every time you care for a patient or make a home visit, what you will do is determined by that client’s care plan. (Fuzy) (see next slide)

Module Competency #4: Employee and Facility Liability Units #4B & 4C: Policy and Procedures Some Common Policies O All information in a business relationship must remain confidential. O The patient’s/client’s/resident’s plan of care must always be followed-determines the care to be provided. O Employees should only do tasks within their Scope of Practice and generally are stated in their job description. O Employee must report on time for work and be dependable. (Fuzy)

Module Competency #4: Employee and Facility Liability Units #4B & 4C: Policy and Procedures Procedures O Particular method or way of doing something O Step-by-step method in performing a task O May be lengthy, but each step of process is important O Example: An agency will have a “procedure” for reporting about your patient/resident that would include: O What form to fill out O When and how often to report/complete form O To whom the report is given (Fuzy)

Module Competency #5 Discuss how confidentiality must be maintained in healthcare facilities with clients and their medical records.

Module Competency #5: Discuss how confidentiality must be maintained in healthcare facilities with clients and their medical records. This competency consists of four units and learning activities. 1. Define confidentiality. 2. Discuss examples of confidential information. 3. Discuss with whom confidential information can be shared. 4. Define libel and slander.

Module Competency #5: Confidentiality Units #5A & 5B: Define and Examples At this point, both Unit #5A (Define Confidentiality) and Unit #5B: (Discuss examples of confidential information) will be discussed as one unit.

Module Competency #5: Confidentiality Units #5A & 5B: Define and Examples Recommended Content O The curriculum defines confidentiality as a client’s legal right to privacy concerning their medical/personal affairs. O Those areas in which confidentiality must be maintained are: O Patient’s personal history O Patient’s medical history O Patient’s diagnosis O Patient’s treatment plan O Patient’s prognosis

Module Competency #5: Confidentiality Units #5A & 5B: Define and Examples O Here are examples of confidentiality that students may not be aware of: O Discuss client information only in appropriate places O Never discuss patients with family or friends O Discuss patients and their personal concerns only with a supervisor.

Module Competency #5: Confidentiality Unit #5C: Shared Information Recommended Content Here are some guidelines to follow regarding confidential information and what can be shared. O Discuss client information only in appropriate places not in elevators, cafeteria, etc. O Information can be shared only with those directly involved in the patient’s care O Patients must give consent (permission) to transfer information to other healthcare providers.

Module Competency #5: Confidentiality Unit #5D: Libel and Slander Recommended Content O To address libel and/or slander, defamation is defined as communication that is false, or made with a careless disregard for the truth, and that results in injury to the reputation of a person. O Libel: Defamation by means of print, writing, or pictures. For example, writing in a patient’s chart that the physician is incompetent because he doesn’t respond immediately to a call is an example of libel. (see next slide)

Module Competency #5: Confidentiality Unit #5D: Libel and Slander O Slander: Defamation by the spoken word, stating information or false words that can cause damage to a person’s reputation. O An example of slander would be for the healthcare worker to tell the client that another healthcare worker is incompetent.

Module Competency #5:Confidentiality Recommended Learning Activities AssignmentResourcesNotes LIH Competency 5 9 Scenario HIPAA Discussion HIPAAThis learning activity has a scenario with discussion questions on HIPAA.

Module Competency #6 Explore legal issues such as sexual harassment, wrongful discharge, negligence, malpractice and violence in the workplace.

Module Competency #6: Explore legal issues such as sexual harassment, wrongful discharge, negligence, malpractice and violence in the workplace. One unit makes up this competency. 1. Define terms: sexual harassment, wrongful discharge and malpractice.

Module Competency #6: Legal Issues in the Workplace Unit #6A: Define Terms Recommended Content O At this point in the module, sexual harassment, wrongful discharge and malpractice will be discussed. Sexual Harassment - unwelcomed actions that are sexual in nature. O The EEOC is a governmental agency that handles sexual harassment complaints that cannot be settled in the workplace. (see next slide)

Module Competency #6: Legal Issues in the Workplace Unit #6A: Define Terms Equal Employment Opportunity Commission (EEOC) O It is unlawful to harass a person because of that person’s gender. Harassment can include “sexual harassment” or unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature. O Harassment does not have to be of a sexual nature, however, and can include offensive remarks about a person’s gender. For example, it is illegal to harass a woman by making offensive comments about women in general. (U.S. EEOC)

Module Competency #6: Legal Issues in the Workplace Unit #6A: Define Terms O Wrongful Discharge occurs when some is fired who should not have been. O Due process is one of the most important rights that employees have in the workplace because it affects all of their other rights. O It refers to the right of an impartial and fair hearing regarding employers decisions and procedures. O This may also take place when the employer decides to get rid of someone and get them fired.

Module Competency #6: Legal Issues in the Workplace Unit #6A: Define Terms O Malpractice is negligence that results in harm to the patient. O To prevent from being sued: O Stay within your scope of practice and do not overstep your authority. O Do only things that you have been taught to do and that are within your scope of training. O Carry out procedures carefully as you were taught. (Hegner, Acello, and Caldwell, p. 41)

Module Competency #6: Legal Issues in the Workplace Recommended Learning Activities AssignmentResourcesNotes LIH Competency 2 3 4 5 6 9 Scenarios – Abuse, Sexual Harassment, Confidentiality, and Neglect Assignment on website This learning activity has 4 scenarios with questions to reflect on and answer

Module Competency #7 Identify the legal issues for accurate documentation, informed consent and advanced directives.

Module Competency #7: Identify the legal issues for accurate documentation, informed consent and advance directives. For this competency, you will be introduced to three units and learning activities. 1. Discuss accurate documentation 2. Define informed consent 3. Discuss advanced directives

Module Competency #7: Accurate documentation Unit #7A: Discuss Accurate Documentation Recommended Content O Accurate Documentation O Objective and completed at time of contact O Record is complete O Information is factual O Implications of inaccurate documentation O Legal Document O Communication between health care professionals to assure quality care

Module Competency #7: Informed Consent Unit #7B: Define Informed Consent O Informed Consent O Healthcare Provider must tell a patient all the potential benefits, risks, and alternatives involved in any surgical procedures, medical procedure, and specific treatments. O Patient must provide written consent O When Informed Consent is needed O Surgical Procedures O Medical Procedures O Some Treatments

Module Competency #7: Accurate documentation Unit #7C: Discuss Advanced Directives O Consequences when no Advanced Directives O If you are unable to make decisions about your health care (unconscious, etc) O Your closest relative will decide how to proceed with your care.

Module Competency #8 Describe the consequences of inappropriate use of health data (including use of social media and email) in terms of disciplinary action.

Module Competency #8: Describe the consequences of inappropriate use of health data (including use of social media and email) in terms of disciplinary action. Three units and learning activities round out the learning for this third competency: 1. Define social media. 2. Discuss inappropriate use of social media. 3. Describe consequences when social media is inappropriately used.

Module Competency #8: Social Media Unit #8A: Define Social Media Recommended Content Forms of electronic communication include: O Web sites for social networking and microblogging through which users create online communities to share information, ideas, personal messages, and other content (as videos) (Merriam/Webster)

Module Competency #8: Social Media Unit #8B: Discuss Inappropriate use of Social Media O While providing care O When talking to a client, patient, resident or customer O Private emails when working O Taking pictures of individuals being cared for O Personal calls when working O Sharing individuals personal information

Module Competency #8: Social Media Unit #8C: Consequences of Misusing Social Media When an employee misuses social media, the following may occur. O Loss of job O Criminal investigation O Loss of license, certification O Removal from state registry

Module Competency # 8: Inappropriate use of health care data Recommended Learning Activities AssignmentResourcesNotes LIH Competency 8 Consequence of Misusing Social Media YouTube VideoThis assignment has the students review a social media white paper, watch a You Tube on examples of misuse of social media and then answer questions pertaining to the You Tube video.

Module Competency #9 Using a problem solving process applied to healthcare situations, describe how laws influence healthcare facilities and the care of clients.

Module Competency #9: Using a problem solving process applied to healthcare situations, describe how laws influence healthcare facilities and the care of clients. This competency consists of one unit. 1. Discuss the problem solving process as applied to legal issues in health care utilizing a team approach.

Module Competency #9: Problem Solving Unit #9A: Problem Solving Process Recommended Content Review and utilize a five step problem solving process applied to legal issues in healthcare. 1. Identify the problem 2. Gather information 3. Create alternative solutions 4. Select and act/implement solutions 5. Evaluate and revise, as needed.

Module Competency # 9: Problem Solving Recommended Learning Activities AssignmentResourcesNotes LIH Competency 9 Health Care in the New Online health care newsStudents on a weekly basis, find a healthcare article in the news and write and report on it.

This completes the curriculum for Legal Issues in Healthcare. (see next slide)

What to do now You have now been introduced to Legal Issues in Healthcare. O Key Points Review the key points found on the instructor resource outline and the possible learning activities to use. O Teaching Tips Review the tips on teaching the material, along with areas to be sensitive with students. O Complete Assessment Click on the “Assessments” tab and complete the Legal Issues in Healthcare Quiz. O Check the Website You are invited to go to the website to preview additional learning activities, PowerPoints, assessments, etc. O Make Your Notes Use the instructor learning resource module outline to make notes on the online resources that would benefit you and your teaching style.

Accessing HealthForce Minnesota To access the HCCC curriculum go to: 1. www.healthforceminnesota.org/Curriculum.ht m www.healthforceminnesota.org/Curriculum.ht m 2. Click on Health Care Core Curriculum 3. Click on Curriculum (Password Required) A. Password: HCCC 4. Select desired module to view

Health Care Core Curriculum “This workforce solution was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.” This work by the Health Professions Pathways (H2P) Consortium, a Department of Labor, TAACCCT funded project is licensed under a Creative Commons Attribution 3.0 Unported License.Creative Commons Attribution 3.0 Unported License This power point created by: Dede Carr, BS, CDA, LDA Pat Reinhart, RN

References Center for Psychiatric Rehabilitation. (n.d.). The Americans with Disabilities Act (ADA). Retrieved from http://www.bu.edu/cpr/reasaccom/whatlaws-adaact.html http://www.bu.edu/cpr/reasaccom/whatlaws-adaact.html City of Minneapolis. (1997-2011). Vulnerable adults. Retrieved from http://www.ci.minneapolis.mn.us/police/crime- reporting/vulnerableadults.asp http://www.ci.minneapolis.mn.us/police/crime- reporting/vulnerableadults.asp Department of Justice, (2011). ADA Regulations and Technical Assistance Materials. Retrieved from http://www.ada.gov/publicat.htm#Anchor-ADA-44867 http://www.ada.gov/publicat.htm#Anchor-ADA-44867 Fighel, T. (2011). Due process law in the workplace. Retrieved from http://ezinearticles.com/?Due-Process-Law-in-the- Workplaceandid=4003032 http://ezinearticles.com/?Due-Process-Law-in-the- Workplaceandid=4003032 Kockrow, O.E. and Christensen, B.L. (2006).Loss, grieving, dying, and death. In B.L. Christensen and E. O. Kockrow (Eds.). Foundations and adult health nursing (5 th ed.) (pp. 188-216). St. Louis, MO: Elsevier, Mosby

References Maryland Department of Health and Mental Hygiene. (2002). Health Insurance Portability and Accountability Act. Retrieved from http://www.dhmh.state.md.us/hipaa/whatishipaa.html http://www.dhmh.state.md.us/hipaa/whatishipaa.html Minnesota Board on Aging. (2010). Adult Protective Services Unit. Retrieved from http://www.mnaging.org/advisor/vulnerable.htmhttp://www.mnaging.org/advisor/vulnerable.htm Minnesota Department of Health. (2011). Questions and answers about health care directives. Retrieved from http://www.health.state.mn.us/divs/fpc/profinfo/advdir.htm http://www.health.state.mn.us/divs/fpc/profinfo/advdir.htm Minnesota Department of Health. (1991, October). Recommended menu pattern and small portion guidelines: Developed in accordance with OBRA Regulations for Nursing Facilities. Information Bulletin 91-3: NH-3. Retrieved from http://www.health.state.mn.us/divs/fpc/profinfo/ib91_3.htmhttp://www.health.state.mn.us/divs/fpc/profinfo/ib91_3.htm Northern Virginia Community College. (n.d.). Patient Self-Determination Act: 1990. Retrieved from http://www.nvcc.edu/home/bhays/dogwood/selfdeterminationact.htm http://www.nvcc.edu/home/bhays/dogwood/selfdeterminationact.htm

References Office of Reviser of Statutes, State of Minnesota. (2006). 604A.01, Minnesota Statutes 2006 : 604A.01 Good Samaritan Law. Retrieved from https://www.revisor.mn.gov/bin/getpub.php?type=sandnum=6 04A.01andyear=2006 https://www.revisor.mn.gov/bin/getpub.php?type=sandnum=6 04A.01andyear=2006 Standfield, P.S., Cross, N., and Hui, U.H. (2008). Introduction to Health Professions (5 th ed.). Sudbury, MA: Jones and Bartlett Publishers Turnham, H. (n.d.). OBRA ‘87 Summary. National Long Term Care Ombudsman Resource Center. Retrieved from http://www.allhealth.org/briefingmaterials/OBRA87Summary -984.pdf http://www.allhealth.org/briefingmaterials/OBRA87Summary -984.pdf

References Fuzy, J. (2003). The nursing assistant’s handbook. Albuquerque, NM: Hartman Publishing Inc Fuzy, J. and Leahy, W. (2005). The home health aide handbook. Albuquerque, NM: Hartman Publishing Inc.

You have completed Heath Care Core Curriculum Legal Issues in Healthcare Congratulations!!! Complete the “Quiz” found under “Assessments”.

Legal Issues in Healthcare Health Care Core Curriculum.

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