1. CONTRACTS PRIVILEGED COMMUNICATION PRIVACY ACT
LEGAL AND ETHICAL
CONTRACTS
PRIVILEGED COMMUNICATION
PRIVACY ACT

2. Contracts An agreement between two or more parties
Most contracts have 3 parts:
Offer: a competent individual enters into a relationship with a health care provider and offers to be a new patient
Acceptance: the health care provider gives an appointment or examines or treats the patient
Consideration: the payment made by the patient for services provided

3. Contracts
Implied: those obligations that are understood without verbally expressed terms. Example, when a qualified health worker prepares a medication and a patient takes a medication, it is implied that the patient accepts this treatment
Expressed: stated in distinct and clear language, either orally or in writing. Example, a surgery permit. Promises of care must be kept. Therefore, all risks associated with treatment must be explained completely by the patient

4. Legal Disability
All parties entering into a contract must be free of it
Person does not have the legal capacity to form a contract
Examples are minors, mentally incompetent persons, individuals under the influence of drugs that alter the mental state, and semiconscious or unconscious people.
Parents, guardians, or others permitted by law must form the contract for the individual

5. Breach of Contract
If a contract is not performed according to the agreement, the contract is breached
Failure to provide care and giving improper care are breaches of contract
If the patient refuses to pay for care, this can be considered breach of contract and lead to legal action

6. Translator
Law required that a translator must be used when a contract is explained to a non-English speaking person
Many states require the use of translator services for those that are deaf or hard of hearing
At times, an English-speaking relative or friend of the patient can also serve as a translator

7. Agent
When a person works under the direction of another person, the employer is called the principal and the employee is called the agent.
The principal is responsible for the actions of the agent
He or she can be required to pay or otherwise compensate people who have been injured by the agent
Health care workers must be aware of their role as agents and work to protect the interests of their employees

8. Privileged Communications
Include all information given to health care personnel by a patient
By law, this information must be kept confidential and shared only with other members of the patient’s health care team
It cannot be told to anyone else without the WRITTEN consent of the patient

9. Consent The written consent must state:
What information is to be released
To whom the information should be given
Any time limits
Certain information is exempt by law and must be reported. Here are some examples:
Births and deaths
Injuries caused by violence (assault and battery, abuse, stabbings) that may require police involvement
Drug abuse
Communicable diseases
STDs

10. Health Care Records Also privileged communications
The record belongs to the health care provider, but the patient has the right to obtain a copy of any info in the record
Can be used as legal records in a court of law
For this reason the following principles must be followed…..

11. Health Care records continued…
Erasures are NOT allowed
Errors should be crossed out with a single line so material is still readable
Correct information should then be inserted, initialed, and dated
If necessary, an explanation for the correction should also be provided

12. More Principles to Follow
Health care records must be properly maintained, stored in a locked or secure area, kept confidential, and retained for the amount of time required by stated law
If records are destroyed after the legal time for retention, they should be burned or shredded to maintain confidentiality

13. Computerized Records
The growing use of computerized records has created a dilemma in maintaining confidentiality
Many health care providers are creating safeguards to maintain confidentiality, such as:
Limiting personnel who access to such records
Using codes to prevent access to certain info
Requiring passwords in order to access specific information on records
Constantly monitoring and evaluating computer use

14. Privacy Act
The Health Insurance Portability and Accountability Act (HIPAA)
Created by Congress in 1996
Required the U.S. Department of Health and Human Services (USDHHS) to establish standards to protect health info
USDHHS published the Standards for Privacy of Individually Identifiable Health Information (aka Privacy Rule)
Went into effect in 2003

15. Privacy Rule
Standards provide federal protection for privacy of health information in all states
Patients must be:
Able to see and obtain copies of their medical records
Given information by health care providers about how they use medical information
Allowed to set limits on how personal health information is used
Permitted to request that health care providers take reasonable care to keep communications confidential
Given the right to state who has access to their information and even to limit providing information to their family
Provided with information on how to file a complaint against a health care provider who violates the privacy act

16. “Last Thought”
Most health care agencies have specific rules, regulations, and standards that determine activities performed by individuals holding different positions of employment
IT IS YOUR RESPONSIBILITY TO LEARN EXACTLY WHAT YOU ARE LEGALLY PERMITTED TO DO AND TO FAMILIARIZE YOURSELF WITH YOUR EXACT RESPONSIBILITIES