Court-Ordered Evaluations/ Assessments
coercive (court-ordered) assessments involve special considerations: the informed consent process is quite different than for psychotherapy.
psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions. When, despite reasonable efforts, such an examination is not practical, psychologists document the efforts they made and the result of those efforts, clarify the probable impact of their limited information on the reliability and validity of their opinions, and appropriately limit the nature and extent of their conclusions or recommendations.
Informed Consent in Assessments for court-ordered evaluations
Psychologists inform persons with questionable capacity to consent or for whom testing is mandated by law or governmental regulations about the nature and purpose of the proposed assessment services, using language that is reasonably understandable to the person being assessed.
What is HIPPA?
is the federal Health Insurance Portability and Accountability Act of 1996
What are goals of HIPPA?
increase efficiency (standardized format for electronic data). Improved privacy. Better security.
To whom does HIPPA apply?
The HIPPA provisions apply to anyone who provides health care and does electronic transmission of health care info.
What are the key areas of compliance and dates of implementation regarding HIPPA?
- Transactions (billing operations like faxing)
- Privacy (individually identifiable health care info like date of birth)
- Security (the security rule is intended to provide for the security of confidential electronic patient info)
- National provider identification
- “Red flag” rule (helps prevent identity theft).
All transaction/electronic billing must follow what federal guidelines?
HIPPA compliant software, and have a business associates agreement
what are key elements to keep your records private as a clinician?
- privacy notice forms
- Patient authorization forms
- Policy and procedure guidelines (aka disclosure statement)
- Business associate agreements
- Privacy officer
- Privacy compliance plan
- Grievance process
- Employee training
- Posted privacy notification.
HIPAA compliance privacy of records applies to….
All personal health information
HIPAA compliance security applies to….
electronically stored transmitted information
HIPAA compliance security steps include…
- security officer
- security plan
- security of documentation
what is “risk analysis” in regards to HIPAA security compliance?
identifies potential security threats and vulnerabilities such as floods, computer viruses, breaks ins, thefts, etc. The risk analysis should be documented. Safe guards implemented and documented, and policy and procedures amended to reflect these changes.
when are “business associate contracts” required?
They are required to ensure that business partners comply with security rules. Conversely, if you have no employees, it is not necessary to train staff in security requirements.
what is “scalability”
a provision that as a size and complexity of the organization increases the standard has wider implications
what are “administrative standards?” for HIPPA
they involve policies and procedures, staff training, and other strategies to carry out security policies.
what are “physical standards?” for HIPPA
they involve such steps as limiting access to areas where electronic health info is stored.
Court-ordered Evaluations and Assessments: Client
If hired by court or legal counsel the court or legal counsel is the client not the person being evaluated.
California Tarasoff Statute
- Duty to report harm to self, others, abuse, animals
- California has adopted this, but Oregon has not fully
- Start of: more important to warn than to keep confidentiality.
- 1976 court ruling off of a murder in 1968.
Tarasoff
Duty to warn: therapist can break confidentiality to warn someone if their is believed to be an imminent risk a patient will harm them.
Record Keeping
- Recordkeeping - 7 years
- Minor - 7 years after an adult
- Security - two locks
Behind double lock
Keep for 7 years and destroy
Psychotherapy notes kept separate from medical record.
Multiple Relationships
A multiple relationship is one in which a therapist is in both a therapist role and a non-therapist role simultaneously with a client or someone closely associated with or related to the client. Not necessarily illegal. Stick to do no harm and confidentiality and you’re golden.
Legal Ethics
- Laws and statutes, not guidelines. Guidelines are not legal, they are aspirations.
- Subpoena
Subpoena
- a court order requiring appearance and/or testimony
- Clinical notes need a second subpoena
- Always check the validity of the subpoena
Informed Consent
Covers supervision, confidentiality, nature and course of treatment, payment and duty to report/warn.
-in general its good for up to 6 years unless revoked in writing. records must be kept for 6 years. in OR they must be kept for 7.
Permission granted in the knowledge of the possible consequences, typically that which is given by a patient, to a doctor for treatment with full knowledge of the possible risks and benefits.
