2011 PCCYFS Annual Spring Conference Making A Difference for 35 Years… One Child at a Time April 13-14

2011 PCCYFS Annual Spring Conference2011 PCCYFS Annual Spring Conference

Making A Difference for 35 Years…Making A Difference for 35 Years…One Child at a TimeOne Child at a Time

April 13-14April 13-14

Exposure and Risk Managementin the Social Services

April 13, 2011

Brian M. Block, ARM, ARM-P Managing Director

“We’re Aggressive About Your Safety”

AGENDAAGENDA

Introduction and WelcomeIntroduction and Welcome

Overview of GoalsOverview of Goals

Definition Ethics in Social ServicesDefinition Ethics in Social Services

Definition and Principles of An Ethical AuditDefinition and Principles of An Ethical Audit

Defining NegligenceDefining Negligence

Defining the Duty of Care Standard Defining the Duty of Care Standard

Discussion: What’s Wrong With This PictureDiscussion: What’s Wrong With This Picture

Q&AQ&A

GOALSGOALSLearn a Functional Definition of Ethics for Learn a Functional Definition of Ethics for Social ServicesSocial Services

Understand the Principles and Techniques of Understand the Principles and Techniques of A Personal Ethical AuditA Personal Ethical Audit

Learn to Use the Principles of An Learn to Use the Principles of An Organizational Ethical AuditOrganizational Ethical Audit

Understand the Expectations of the Duty of Understand the Expectations of the Duty of CareCare

Avoid Practicing NegligentlyAvoid Practicing Negligently

Learn to Differentiate and Solve Ethical Learn to Differentiate and Solve Ethical Dilemmas Dilemmas

ETHICSETHICS

A SET OF PRINCIPLES, PROTOCOLS, A SET OF PRINCIPLES, PROTOCOLS, PROFESSIONAL RESPONSIBILITIES PROFESSIONAL RESPONSIBILITIES AND ACCOUNTABILITIES DEFINING AND ACCOUNTABILITIES DEFINING THE PARAMETERS OF HIGH QUALITY THE PARAMETERS OF HIGH QUALITY CARECARE..

THE RULES OF RECOGNIZED THE RULES OF RECOGNIZED CONDUCTCONDUCT

ETHICSETHICS

INVOLVES CHOOSING RIGHT FROM INVOLVES CHOOSING RIGHT FROM WRONG OR MAKING THE “MORAL” WRONG OR MAKING THE “MORAL” CHOICECHOICEIS DRIVEN BY “DO NO HARM”IS DRIVEN BY “DO NO HARM”AND IS ASSOCIATED WITH THE AND IS ASSOCIATED WITH THE TENANTS OF PERFORMANCE TENANTS OF PERFORMANCE IMPROVEMENT: “DO THE RIGHT IMPROVEMENT: “DO THE RIGHT THING AND DO THE RIGHT THING THING AND DO THE RIGHT THING WELLWELL””

ETHICAL PRINCIPLESETHICAL PRINCIPLES

Recognize that we serve in a position of Recognize that we serve in a position of public trustpublic trustDo not use a public position to obtain Do not use a public position to obtain advantages or favorsadvantages or favorsUse information gained from our positions Use information gained from our positions only for the benefit of those we are only for the benefit of those we are entrusted to serveentrusted to serveConduct our personal affairs in such a Conduct our personal affairs in such a manner that we cannot be improperly manner that we cannot be improperly influenced in the performance of our duties influenced in the performance of our duties

ETHICAL PRINCIPLESETHICAL PRINCIPLES

Seek no favor and accept no form of Seek no favor and accept no form of personal reward from our clients personal reward from our clients Engage in no outside employment or Engage in no outside employment or professional activities that may impair professional activities that may impair or appear to impair our primary or appear to impair our primary responsibilities responsibilities Carry out policies established by the Carry out policies established by the organization’s policy makers to the organization’s policy makers to the best of our ability. best of our ability.

ETHICAL PRINCIPLESETHICAL PRINCIPLESAcknowledge that job descriptions are Acknowledge that job descriptions are meant to produce behaviors in accordance meant to produce behaviors in accordance with recognized definitions of the field and with recognized definitions of the field and the organization’s needsthe organization’s needsOrient new employees to the organization's Orient new employees to the organization's ethics program during new employee ethics program during new employee orientationorientationReview the ethics management program in Review the ethics management program in management training experiences and management training experiences and have systems in place to resolve ethical have systems in place to resolve ethical issuesissuesDeliver accurate and timely information to Deliver accurate and timely information to the public the public

WHY ETHICS?WHY ETHICS?

• To build and comply to a common set of To build and comply to a common set of values upon which we fashion our values upon which we fashion our professional work activities.professional work activities.

• To assure the welfare and protection of the To assure the welfare and protection of the individuals and groups with whom we work.individuals and groups with whom we work.

• To assist ourselves and other professionals To assist ourselves and other professionals to recognize the boundaries related to their to recognize the boundaries related to their competence and the limitations of their competence and the limitations of their expertise.expertise.

• To provide the general public a set of To provide the general public a set of standards upon which to build expectations standards upon which to build expectations and accountability regarding our profession.and accountability regarding our profession.

AN ETHICAL AUDIT - AN ETHICAL AUDIT - PROCESSESPROCESSES

Gather and Analyze Empirical Trend Data Gather and Analyze Empirical Trend Data That Summarizes Actual Ethics, Complaints That Summarizes Actual Ethics, Complaints and Lawsuitsand Lawsuits

Review Organizational Policy & Procedures Review Organizational Policy & Procedures for Handling Ethical Issues, Dilemmas and for Handling Ethical Issues, Dilemmas and DecisionsDecisions

Identify Ethical Hazards Within Organization, Identify Ethical Hazards Within Organization, Within Divisions, Within Departments and Within Divisions, Within Departments and Within ProgramsWithin Programs

AN ETHICAL AUDIT - AN ETHICAL AUDIT - PROCESSESPROCESSES

Develop a Risk Grid Rating Identified Ethical Develop a Risk Grid Rating Identified Ethical Hazards Using a 4-point Scale of No Risk, Hazards Using a 4-point Scale of No Risk, Minimal Risk, Moderate Risk and High RiskMinimal Risk, Moderate Risk and High Risk

Develop and Implement an Action Plan for All Develop and Implement an Action Plan for All Ethical HazardsEthical Hazards

Monitor Action Plan(s)Monitor Action Plan(s)

CLINICAL MIDDLE MANAGER CLINICAL MIDDLE MANAGER ROLE AND FUNCTIONROLE AND FUNCTION

CARE, CUSTODY, AND CONTROLCARE, CUSTODY, AND CONTROL

OVERSIGHT – Ethics on a Global ScaleOVERSIGHT – Ethics on a Global Scale

SUPERIVSION – Ethics of the SUPERIVSION – Ethics of the OrganizationOrganization

EMPLOYEE COMPETENCYEMPLOYEE COMPETENCY

SERVICE PROVIDERSERVICE PROVIDER

NEGLIGENCE NEGLIGENCE

A SECOND 5-PART TESTA SECOND 5-PART TEST

1.1. Scope of Service?Scope of Service?

2.2. Performance of An Ability or Skill?Performance of An Ability or Skill?

3.3. Does the Public Believe You’re The Does the Public Believe You’re The Expert?Expert?

4.4. Did Harm Come To Another Person In Did Harm Come To Another Person In Care?Care?

5.5. Could Anything Have Been Done To Could Anything Have Been Done To Prevent The Harm From Occurring?Prevent The Harm From Occurring?

……and…and…


……and…and…

To What Standard of Care Is Your To What Standard of Care Is Your

Organization Being Held?Organization Being Held?


NegligenceNegligence is is coduct or lack of conduct coduct or lack of conduct for which the professional or for which the professional or organization can be held legally liable, organization can be held legally liable, and that because the conduct or lack of and that because the conduct or lack of conduct is below the standard of duty conduct is below the standard of duty required harm comes to the consumer.required harm comes to the consumer.Professional NegligenceProfessional Negligence is a specific is a specific form of negligence based on an form of negligence based on an organization or professional who is organization or professional who is represented as having some kind of represented as having some kind of abilities and skills, but who fails to abilities and skills, but who fails to follow the duty of care owed to the follow the duty of care owed to the consumer because of the common consumer because of the common knowledge of what it means to possess knowledge of what it means to possess those skills and abilities.those skills and abilities.


Obligation OwedObligation Owed Practice standards Practice standards assume that the organization and each assume that the organization and each direct care worker, whether licensed or direct care worker, whether licensed or not, has a degree of skill and learning not, has a degree of skill and learning that can be “ordinarily” possessed and that can be “ordinarily” possessed and exercised by members of their exercised by members of their profession in order to provide proper profession in order to provide proper care; i.e., they are competent to do their care; i.e., they are competent to do their jobjob

TYPES OF LIABILITY TYPES OF LIABILITY

STRICT LIABILITYSTRICT LIABILITY – It’s All Your Fault – It’s All Your Fault

VICARIOUS LIABILITYVICARIOUS LIABILITY – You Should – You Should Have Known What They (S/He) Were Have Known What They (S/He) Were DoingDoing

CONTRIBUATORY LIABILITYCONTRIBUATORY LIABILITY – We Both – We Both Should Have Known BetterShould Have Known Better

DUTY OF CARE STANDARDDUTY OF CARE STANDARD

The The average practitioneraverage practitioner or customary or customary practice standard examines negligence practice standard examines negligence strictly from the perspective of employee or strictly from the perspective of employee or organizational competence. organizational competence. – Sometimes referred to as a niche standard, it Sometimes referred to as a niche standard, it

assumes that the organization or professional’s assumes that the organization or professional’s practice is limited in its scope of service to those practice is limited in its scope of service to those things recognized as being done well or things recognized as being done well or competently by the professional or organization. competently by the professional or organization.

DUTY OF CARE OWEDDUTY OF CARE OWED

The The reasonably prudent practice standardreasonably prudent practice standard uses a perspective of accepted practices by uses a perspective of accepted practices by the field in the most general terms. the field in the most general terms. – Current organizational licensure and Current organizational licensure and

accreditation, primary source verification and accreditation, primary source verification and employee licensure, supervision and training employee licensure, supervision and training would be factors considered average practitioner would be factors considered average practitioner and/or customary practice standards. and/or customary practice standards.

– Peers, “trade associations”, licensing and Peers, “trade associations”, licensing and accrediting bodies related to the various types of accrediting bodies related to the various types of Health and Human Service organizations or Health and Human Service organizations or businesses promulgate these standards.businesses promulgate these standards.

DUTY OF CARE OWEDDUTY OF CARE OWED

The The standard of excellencestandard of excellence is the most is the most subjective practice standard and is given to the subjective practice standard and is given to the whims of the general public.whims of the general public. – ““Do No Harm” or “Do The Right Thing and Do The Do No Harm” or “Do The Right Thing and Do The

Right Thing Well?” Right Thing Well?” – Zero tolerance for going outside the strict Zero tolerance for going outside the strict

definition of the obligation or duty owed no matter definition of the obligation or duty owed no matter how that agreement is reached.how that agreement is reached.

– If not written agreements that are unspoken, If not written agreements that are unspoken, implicit, inferred, implied, or unstated remain implicit, inferred, implied, or unstated remain open to interpretation.open to interpretation.

DUTY OF CARE: SUMMARYDUTY OF CARE: SUMMARY

An organization must understand their duty orAn organization must understand their duty or““obligation owed” from the perspective of whatobligation owed” from the perspective of whathazards need to be monitored. From that point a hazards need to be monitored. From that point a determination can be made about what normative determination can be made about what normative risk management protocols are needed, whether risk management protocols are needed, whether or not special techniques may be required, and or not special techniques may be required, and what it means to be defensible when allegations what it means to be defensible when allegations and/or the actual occurrence of serious adverse and/or the actual occurrence of serious adverse incidences may be normal aspects of doing incidences may be normal aspects of doing business. business.


1.1. Scope of Service?Scope of Service?– customary practice standardcustomary practice standard

2.2. Performance of An Ability or Skill?Performance of An Ability or Skill?– mandate to follow a standard of caremandate to follow a standard of care– reasonably prudent practice standardreasonably prudent practice standard

3.3. Does the Public Believe You’re The Expert?Does the Public Believe You’re The Expert?– standard of excellencestandard of excellence

4.4. Did Harm Come To Another Person In Care?Did Harm Come To Another Person In Care?– reasonably prudent person practice standardreasonably prudent person practice standard

5.5. Could Anything Have Been Done To Prevent Could Anything Have Been Done To Prevent The Harm From Occurring?The Harm From Occurring?

– standard of excellencestandard of excellence

……therefore…therefore…To What Standard of Care Is Your To What Standard of Care Is Your

Organization Being Held?Organization Being Held?

WHAT’S WRONG WITH THIS WHAT’S WRONG WITH THIS PICTURE?PICTURE?

So How Did The Paper Find Out?So How Did The Paper Find Out?I’m Sorry I’ll Have To ResignI’m Sorry I’ll Have To ResignI Reserve The Right To Not Serve YouI Reserve The Right To Not Serve YouI Reserve The Right To No Longer Get I Reserve The Right To No Longer Get Service From YouService From YouWe Have Someone Here That’s YoursWe Have Someone Here That’s YoursTeletherapy?Teletherapy?Crisis Worker Is Whom?Crisis Worker Is Whom?And Our Client Demographic Is? And And Our Client Demographic Is? And Our Direct Care Demographic Is? Our Direct Care Demographic Is?


But S/He Didn’t Have Anywhere To Go But S/He Didn’t Have Anywhere To Go For The HolidaysFor The Holidays

What’s A Middle Seat?What’s A Middle Seat?

Foster Mom’s New BoyfriendFoster Mom’s New Boyfriend

Wait Right There or Sure, Go Ahead Wait Right There or Sure, Go Ahead Outside and Have A SmokeOutside and Have A Smoke

You Knew She Was A Runaway RiskYou Knew She Was A Runaway Risk

Sorry We Forgot To Pick You UpSorry We Forgot To Pick You Up

So How Far Can S/He Get In 8 Hours?So How Far Can S/He Get In 8 Hours?


He Only Fell Off Playground Equipment He Only Fell Off Playground Equipment

So, What’s One Visit I Forgot? So, What’s One Visit I Forgot?

Can’t I Hire Him Part Time?Can’t I Hire Him Part Time?

The Program Needs Your Cash The Program Needs Your Cash DonationDonation

It’s 4:55 p.m. on a Friday AfternoonIt’s 4:55 p.m. on a Friday Afternoon

QUESTIONSQUESTIONS

ANDAND

ANSWERSANSWERS

Documents

2011 PCCYFS Annual Spring Conference Making A Difference for 35 Years… One Child at a Time April 13-14