1. ETHICAL AND LEGAL ISSUES

2. ETHICAL AND LEGAL
ISSUES
LEGAL TERMS AND DEFINITIONS
• Abandonment:
– Is when a family or agency leaves an Consumer without care or
support.
• Assault:
– Takes place when an Consumer intentionally attempts or
threatens to touch another Consumer in a harmful or offensive
manner without their consent.
• Battery:
– Takes place when an Consumer harmfully or offensively touches
another Consumer without their consent.

3. ETHICAL AND LEGAL
ISSUES
LEGAL TERMS AND DEFINITIONS
• False imprisonment:
– Takes place when you intentionally restrict an Consumer’s
freedom to leave a space.
• Fraud:
– Means that a person intentionally gives false information in order
to make money or gain an advantage.
• Invasion of privacy:
– Is revealing personal or private information without an
Consumer’s consent.

4. ETHICAL AND LEGAL
ISSUES
LEGAL TERMS AND DEFINITIONS
• Liability
– Refers to the degree to which you or your employer will be held
financially responsible for damages resulting from your
negligence.
• Malpractice
– Is a failure to use reasonable judgment when applying your
professional knowledge.
• Negligence
– Is when a personal injury or property damage is caused by your
act or your failure to act when you have a duty to act.

5. ETHICAL AND LEGAL
ISSUES
MANDATORY REPORTING
• Mandatory reporting:
– All persons responsible for the care of an incapacitated or
vulnerable adult or child have a duty to report suspected abuse
and neglect.
– Reports must be made immediately (by phone or in person) to
Adult Protective Services or Child Protective Services
(depending on the person’s age) or to the police.
– Failure to report is a misdemeanor.

6. ETHICAL AND LEGAL
ISSUES
MANDATORY REPORTING
– If the Consumer is in immediate danger, call 911.
– If the abuse is not life-threatening, report it to your Supervisor
who will assist you in making the report to either of the 24-hour
statewide reporting lines:
– Adult Protective Services: 1-877-SOS-ADULT (1-877-767-2385)
– Child Protective Services: 1-888-SOS-CHILD (1-888-767-2445)
• Immunity:
– All persons reporting are immune from any civil or criminal
liability if the report does not involve any malicious
misrepresentation, according to Arizona statutes (ARS § 46-
453).

7. ETHICAL AND LEGAL
ISSUES
PURPOSE OF A SERVICE PLAN
• A care plan or support plan:
– Is a written plan created to meet the needs of the person.
– The plan is usually created during an in-home assessment of the
Consumer’s situation, the strengths and care being provided by
family and friends.
– The plan defines the needs and objectives/goals for care.

8. ETHICAL AND LEGAL
ISSUES
PURPOSE OF A SERVICE PLAN
• The plan:
– Lists the actions to be provided by the DCW.
– You must follow the plan as written.
– Any deviations from a care or support plan may put the DCW at
risk for disciplinary action.
– Therefore, any changes need to be approved by the
supervisor.
– Care/support plans are reviewed by the care team.
– The DCW may be asked for input as to how the plan is working.
– Reporting and documenting are very critical in evaluating
whether the plan is working or if it needs revision.

9. ETHICAL AND LEGAL
ISSUES
FOLLOW THE SERVICE PLAN
• Only perform work assigned:
– If you perform a task that was not assigned by your supervisor,
you become liable for those actions.
– A plan is developed for each Consumer that describes exactly
what services should be provided.
– This is called a care plan or support plan.
– It lists the tasks you should do for this Consumer.

10. ETHICAL AND LEGAL
ISSUES
FOLLOW THE SERVICE PLAN
• Do not do less work than assigned:
– When you fail or forget to do all the tasks assigned, you may put
your Consumer at risk.
– As a result of your failure to act, you might be found negligent.
– It is important that you understand the care or support plan for
the Consumer.
– You must do all the tasks assigned to you as described in the
plan—not more and not less.

11. ETHICAL AND LEGAL
ISSUES
FOLLOW THE SERVICE PLAN
• Avoid doing careless or low-quality work.
– Performing tasks carelessly might make you liable for the
damages or injuries that result.

12. ETHICAL AND LEGAL
ISSUES
RIGHTS OF A Consumer
• Consumers have the right to:
– Considerate and respectful treatment and care.
– Not be abused emotionally, sexually, financially, or physically.
– Design their treatment or service plan, decide how their services
will be provided, and who will deliver those services (including
requesting a change of caregiver).
– Receipts or statements for their fee-based service.
– Refuse treatment.
– Privacy.
– File a complaint with the agency.
– Confidential handling of their personal information.

13. ETHICAL AND LEGAL
ISSUES
RIGHTS OF A Consumer
• Consumer choice:
– These Consumer rights are based on principles of self-
determination and Consumer choice.
– Consumers choose which services they want to receive.
– They may also choose how services are provided.
– The Consumer has the right to refuse.
– Each person chooses what clothes to wear and what foods to
eat.
– Having choices improves well-being and makes the person more
independent.

14. ETHICAL AND LEGAL
ISSUES
PRIVACY AND CONFIDENTIALITY
• Health Insurance Portability and Accountability Act
of 1996 (HIPAA):
– HIPAA is a law that keeps the identifiable health information
about our Consumers confidential.
– It includes what must be done to maintain this privacy and
punishments for anyone caught violating Consumer privacy.
– The Office of Civil Rights of the U.S. Department of Health and
Human Services is the agency authorized to enforce HIPAA’s
privacy regulations.
– The regulations took effect on April 14, 2003.
– The rules on confidentiality in HIPAA are enforced by law.

15. ETHICAL AND LEGAL
ISSUES
PRIVACY AND CONFIDENTIALITY
• Purpose of confidentiality:
– Our Consumers need to trust us before they will feel comfortable
enough to share any personal information with us.
– In order for us to provide quality care, we must have this
information.
– They must know that whatever they tell us will be kept private
and limited to those who need the information for
treatment, payment, and health care operations.

16. ETHICAL AND LEGAL
ISSUES
PRIVACY AND CONFIDENTIALITY
• What is confidential?
– All information about our Consumers are considered private or
confidential.
– Whether written on paper, saved on a computer, or spoken
aloud.
– This includes their name, address, age, Social Security number,
and any other personal information.
– It also includes the reason the Consumer is sick, the treatments
and medications he/she receives, caregiver information, any
information about past health conditions, future health plans, and
why the Consumer is open to services.

17. ETHICAL AND LEGAL
ISSUES
PRIVACY AND CONFIDENTIALITY
• Communication:
– Spoken communication runs the range from conducting
Consumer interviews, paging Consumers, whispering in
corridors, to talking on telephones.
– Written communication includes the hard copy of the medical
record, letters, forms, or any paper exchange of information.
Electronic communication includes computerized medical
records, electronic billing and e-mail.
– If you reveal any of this information to someone who does not
need to know, you have violated a Consumer’s confidentiality,
and you have broken the law.

18. ETHICAL AND LEGAL
ISSUES
PRIVACY AND CONFIDENTIALITY
• Consequences for not keeping confidentiality:
– The consequences will vary, based on the severity of the
violation, whether the violation was intentional or unintentional.
– Depending on the violation agencies may be fined by the
government if they are found to be in non-compliance with
HIPAA regulations.
– Agencies and their employees can receive civil penalties up to
$25,000 for the violation.
– Agencies and their employees can also receive criminal
penalties up to a $250,000 fine and/or 10 years in prison for
using information for commercial or personal gain or malicious
harm.

19. ETHICAL AND LEGAL
ISSUES
PRIVACY AND CONFIDENTIALITY
• Important:
– If you notice a breach of confidentiality, inform your supervisor
immediately.
– Do not repeat the Consumer’s information to anyone.
– Remind the person that told you the personal information about
confidentiality requirements.

20. ETHICAL AND LEGAL
ISSUES
NEED TO KNOW RULE
– This rule is really common sense.
– If you need to see Consumer information to perform your job,
you are allowed to do so.
– But, you may not need to see all the information about every
Consumer.
– You should only have access to what you need to in order to
perform your job.
– There may also be occasions when you will have access to
confidential information that you don’t need for your work.
– For example, you may see information on whiteboards or
sign-in sheets. You must keep this information confidential.

21. ETHICAL AND LEGAL
ISSUES
NEED TO KNOW RULE
– There’s no doubt that you will overhear private health information
as you do your day-to-day work.
– As long as you keep it to yourself, you have nothing to worry
about.
– In the course of doing your job, you may also find that
Consumers speak to you about their condition.
– Although there’s nothing wrong with this, you must remember
that they trust you to keep what they tell you confidential.
– Do not pass it on unless it involves information the professional
staff needs to know to do their jobs.
– Tell the Consumer that you will be sharing it with the
professional staff or encourage them to tell the information
themselves.

22. ETHICAL AND LEGAL
ISSUES
ALLOWING DECISIONS ABOUT SERVICES
• Consumers choices:
– The DCW should respect the Consumers choices.
– When a person is not allowed to make decisions about
services, that takes away from his/her rights.
– As a DCW, if you are concerned about a choice, explain why you
are concerned, discuss an alternative, contact your supervisor
for instructions, and document what you did.

23. ETHICAL AND LEGAL
ISSUES
ALLOWING DECISIONS ABOUT SERVICES
• Promote independence:
– Independent living and self-determination are values that stress
dignity, self responsibility, choices and decision making.
– Independent living is the freedom to direct one's own life.
– Each Consumer has the right to optimize his or her personal
ability and fully integrate into the community.

24. ETHICAL AND LEGAL
ISSUES
ALLOWING DECISIONS ABOUT SERVICES
– You get to be in charge of your own life.
– You might seek advice, but you make decisions for yourself.
– You know what is best for you.
– It does not mean doing everything all by yourself.
– You might need assistance around your home.
– You choose who assists you.
– You pursue your dreams.
– You explore your potential, talents and abilities.
– It means having the freedom to fail and learn from your failures as
well as experience successes, just as non-disabled people do.
– The opportunity for independent living and self-determination is
essential to the well being of people with disabilities.

25. ETHICAL AND LEGAL
ISSUES
ALLOWING DECISIONS ABOUT SERVICES
– We promote and value equal opportunity, full integration and
Consumer choice.
– We promote the achievement of full rights and empowerment of
all persons with disabilities.
– We promote the full participation of people with disabilities in the
cultural, social, recreational and economic life of the community.
– We promote Consumer choice/control—the Consumer’s right to
make informed decisions regarding his or her best interests in all
aspects of life.
– We promote the involvement of people with disabilities in the
decision-making process of community programs and services.

26. ETHICAL AND LEGAL
ISSUES
LIVING WILL
• Living will:
– Legal document that outlines the medical care a Consumer
wants or does not want if he or she becomes unable to make
decisions.
– An example would be the use of a feeding tube.

27. ETHICAL AND LEGAL
ISSUES
DURABLE MEDICAL POWER OF ATTORNEY
• Durable medical power of attorney:
– Legal document that designates another person to act as an
agent or a surrogate in making medical decisions if the
Consumer becomes unable to do so.

28. ETHICAL AND LEGAL
ISSUES
“ORANGE FORM”
• The Pre-Hospital Medical Care Directive, also known as the
“orange form” or a DNR:
– This is a special advance directive.
– This form says that if the heart stops beating or breathing stops,
the Consumer does not want to receive cardiopulmonary
resuscitation (CPR) under any circumstances.
– This special form, which is bright orange in color, notifies the
paramedics and emergency medical services people that this
choice has been made.

29. ETHICAL AND LEGAL
ISSUES
“ORANGE FORM”
• When a Consumer has an Orange form:
– When the DCW notes that the Consumer has an orange
form, the DCW should contact his/her supervisor to determine
the policies and procedures related to CPR for the Consumer.
– It is also important to remember that the orange form only covers
cardiac and respiratory arrest.
– If the Consumer has another type of medical emergency, the
DCW should provide first aid measures, including calling 911 as
indicated.