How to Navigate ethical dilemmas without a gps Lynda Frost, J.D., Ph.D. Lynda@lynfro.com

Disclosure to Participants Successful Completion of This Continuing Education Event Requires You to: • Complete registration and sign in sheet • Attend entire event • Participate in education activities • Complete participant evaluation Commercial Support: This educational activity received no commercial support. Disclosure of Conflict of Interest: The speakers and planning committee for this event have disclosed no financial interests. Non-Endorsement Statement: Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, CE Service; Texas Medical Association; or American Nurse Credentialing Center. Off-Label Use: The speakers did not disclose the use of products for a purpose other than what it had been approved for by the Food and Drug Administration. Expiration Date for Awarding Contact Hours: Complete the attendance sheet and evaluation by the end of the session. Other Credits Offered: Professional Development (PD) for Licensed Psychologists Continuing Education for Licensed Chemical Dependency Counselors (LCDC) Social Work/LPC/LMFT Continuing Legal Education (CLE) Continuing Professional Education for Accounting (CPE) CEUs for Certified Peer Specialists (CPS) and Certified Family Partners (CFP)

Disclosure to Participants Continuing Medical Education: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Texas Medical Association (TMA) through the joint providership of The Texas Department of State Health Services, Continuing Education Service and Texas Council of Community Centers. The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. The Texas Department of State Health Services, Continuing Education Service designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This course has been designated by The Texas Department of State Health Services, Continuing Education Service for 4.5 credit(s) of education in medical ethics and/or professional responsibility. Continuing Nursing Education: The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 7.5 contact hour(s) of Continuing Nursing Education.

Continuing Legal Education This session qualifies for 1.5 hours of CLE credit, including 1.5 hours of ethics. Course Title: 34th Annual Texas Council Conference Course Number: 174051119 Date: June 21-23, 2019

With Ethics, there usually is no GPS

Sources of ethical guidance State & Federal Law Professional Codes of Ethics Employer Codes of Conduct Morals

Sources of ethical guidance State and Federal Law Texas Occupations Code (e.g. Nurses, Psychologists, Marriage & Family Therapists, LPCs, CDCs, Social Workers) Texas Administrative Code (e.g. Nurses, Marriage & Family Therapists, LPCs, CDCs, Social Workers) Professional Codes of Conduct Mandatory (part of licensure) Texas HHS/DSHS Professional Licensing and Certification: https://www.dshs.texas.gov/plc/ Aspirational Employer Codes of Conduct e.g. Texas HHS Code of Conduct (https://hhs.texas.gov/sites/default/files/documents/about-hhs/hhs-ethics-policy.pdf)

Lawyers Model Rules of Professional Conduct: https://www.americanbar.org/groups/professional_responsibility/pu blications/model_rules_of_professional_conduct/model_rules_of_pro fessional_conduct_table_of_contents.html Texas Disciplinary Rules of Professional Conduct: https://www.texasbar.com/AM/Template.cfm?Section=Home&Templa te=/CM/ContentDisplay.cfm&ContentID=27271

Psychiatrists APA’s Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry: https://www.psychiatry.org/psychiatrists/practice/ethics Texas Society of Psychiatric Physicians Four Principles [competency, advocacy, leadership, collaboration]: http://www.txpsych.org/practice-guidelines/

Nurses ANA’s Code of Ethics for Nurses: https://www.nursingworld.org/practice- policy/nursing-excellence/ethics/code-of-ethics-for-nurses/ Texas Standards of Nursing Practice and Unprofessional Conduct (22 TAC Ch. 217 Rules 217.11 & 217.12): http://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=T&app=9&p_dir=P&p_rloc=1 87878&p_tloc=&p_ploc=1&pg=4&p_tac=&ti=22&pt=11&ch=217&rl=12 http://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=T&app=9&p_dir=N&p_rloc=1 33132&p_tloc=&p_ploc=1&pg=5&p_tac=&ti=22&pt=11&ch=217&rl=12

Psychologists APA’s Ethical Principles of Psychologists and Code of Conduct: https://www.apa.org/ethics/code/ethics-code-2017.pdf

Licensed Professional Counselors ACA’s Code of Ethics: https://www.counseling.org/resources/aca-code-of-ethics.pdf AMHCA Code of Ethics: http://connections.amhca.org/HigherLogic/System/DownloadDocumentFile.ashx?Docum entFileKey=d4e10fcb-2f3c-c701-aa1d-5d0f53b8bc14 Texas Code of Ethics (22 TAC Ch. 681 Subch. C): http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=22&pt=30&ch= 681&sch=C&rl=Y

Licensed Marriage and Family Therapists ACA’s Code of Ethics: https://www.counseling.org/resources/aca-code-of-ethics.pdf AMHCA Code of Ethics: http://connections.amhca.org/HigherLogic/System/DownloadDocumentFile.ashx?Docum entFileKey=d4e10fcb-2f3c-c701-aa1d-5d0f53b8bc14 Texas Guidelines for Professional Therapeutic Services and Code of Ethics (22 TAC Ch. 801 Subch. C): http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=22&pt=35&ch= 801&sch=C&rl=Y

Social Workers NASW Code of Ethics: https://www.socialworkers.org/About/Ethics/Code-of- Ethics/Code-of-Ethics-English Texas Code of Conduct and Professional Standards of Practice (22 TAC Ch. 781 Subch. B): http://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=22&pt=34 &ch=781&sch=B&rl=Y

Certified Peer Support Specialists iNAPS National Practice Guidelines for Peer Supporters: https://na4ps.files.wordpress.com/2012/09/nationalguidelines1.pdf NAADAC’s National Certified Peer Recovery Support Specialist Code of Ethics: https://www.naadac.org/ncprss-code-of-ethics Via Hope Texas Mental Health Peer Specialist Code of Ethics: https://www.viahope.org/programs/peer-specialist-training-and- certification/cps-code-ethics/ Texas Certification Board of Addiction Professionals Ethical Standards for Peer Recovery Support Specialists: https://www.tcbap.org/page/PRSEthics Via Hope Texas Certified Family Partner Code of Ethics: https://www.viahope.org/programs/family-partner-training-and- certification/cfp-code-ethics/

how to navigate ethical challenges: Identify Identify issues that raise ethical challenges Analyze Analyze the rules and other guidance for your specific role Consult Consult peers and supervisors

Boundaries: Reflect on this… Providing treatment to the family member of a fellow employee What ethical issues or tensions do you identify? Are there principles, rules or guidance to help you think through this situation?

Boundaries: Reflect on this… Peer providers working where they receive services What ethical issues or tensions do you identify? Are there principles, rules or guidance to help you think through this situation?

Workplace issues: Reflect on this… Treating all staff the same regarding pay increases when some have not performed adequately What ethical issues or tensions do you identify? Are there principles, rules or guidance to help you think through this situation?

Workplace issues: Reflect on this… Co-worker falsely documenting time What ethical issues or tensions do you identify? Are there principles, rules or guidance to help you think through this situation?

how to navigate ethical challenges: Identify Identify issues that raise ethical challenges Analyze Analyze the rules and other guidance for your specific role Consult Consult peers and supervisors

What is a challenging situation you experience in your work that raises complex ethical questions?

Troika Consulting Form groups of three, preferably with people you don’t know Individual reflection on question Nine minutes per person Spend 2 minutes sharing your ethical challenge Spend 2 minutes responding to clarifying questions Spend 4 minutes receiving feedback and advice from your consultants For 1 minute, thank your consultants and share what was most valuable Switch to next person

What questions should be asked? What resources might be helpful? Consultant: What questions should be asked? What resources might be helpful?

Key resources National and state-based ethical codes by profession Federal and state law Employer code of conduct Professional board ethics hotlines, advisory opinions Consultation with professional peers and your supervisor

Navigating ethical challenges: Identify Identify issues that raise ethical challenges Analyze Analyze the rules and other guidance for your specific role Consult Consult peers and supervisors

Thank you for your engagement! Lynda Frost, J.D., Ph.D. Lynda@lynfro.com