Ethics Final OT
What is NBCOT & what does it do?
NBCOT is a private, not-for-profit, non-governmental credentialing organization that oversees and administers entry level certification for occupational therapists and occupational therapy assistants. This examination is what the SRBs use as one of the criteria for licensure. Also, NBCOT uses the examination as one of the criteria for initial NBCOT certification. NBCOT certifies eligible individuals as Occupational Therapist Registered OTR, and COTA. These trademarks are owned by the NBCOT.
What does NBCOT certification indicate?
Certification by NBCOT indicates to the public that educational, fieldwork, and examination requirements have been met by the OTR or COTA.
NBCOT (six disciplinary actions of the certification)
1) ineligibility for certification 2) reprimand 3) censure 4) probation 5) suspension 6) revocation
What is AOTA & what does it do?
AOTA is a voluntary membership organization that represents and promotes the profession and the interests of individuals who choose to become members. AOTA has no direct authority over non-members.
AOTA (five disciplinary actions of the membership)
1) reprimand 2) censure 3) probation 4) suspension 5) revocation
State Regulatory Board (SRB's) What are they & what do they do?
SRB's are also known as councils or advisory committees. SRB's are public bodies that are created by state legislatures to ensure the health and safety of the citizens of that particular state. State regulation may be in the form of license, registration, certification, or title protection. Only those states with license, registration or certification have regulatory boards. States with title protection do not. Each SRB has direct jurisdiction over practitioners who are licensed or regulated in that state. Also, they can discipline members of a profession practicing in that state if they have caused harm to residents of that state. They can conduct investigations, get witnesses, as well as impose fines or recommend imprisonment. SRB can cause one to loose their license if violations occur & impose monetary fines.
What is the SRB in NEW YORK?
The state regulatory board in New York is the NY state department of education.
Ethics Commission? (EC) What body is it under?
The EC is volunteer-sector component of AOTA that is responsible for writing, revising, and enforcing the OT Code Of Ethics.
Two roles of the EC?
education & enforcement!
Members of the EC?
a total of 7 members (Ot, Ota, an educator, a practitioner, a member at large, and two public members, including the chair person)
The EC chair person serve time TOTAL?
1 year = chair person elect, 3 years as chair person. total = 4 years. The chair person serves one term, but EC members have the possibility to serve a max of two consecutive terms.
Certification? What do you need to get in order to get a certification besides just going to school?
The requirements for getting a certification from NBCOT are: educational, fieldwork, and examination. (also don't forget to file for graduation in LaGuardia Community College)
During internship (a.k.a fieldwork) you need to get supervised. There are 2 types of supervision. What are they?
Type 1: indirect : the person supervising you checks on you from time to time.
Type 2 : direct : the person supervising you is sitting next to you are observing you. Immediate feedback on your actions.
Supervision of OTA in New York?
Direct supervision required: shall include meeting with and observing the occupational therapy assistant on a regular basis in order to review the implementation of treatment plans & to foster professional development.
Once you get certified by the NBCOT as an COTA, how do you maintain your status of being certified? How do you maintain certification? When do you get re-certified by the NBCOT? How?
Initial certification is just the beginning of your journey with NBCOT – the organization believes that continually supporting certificant's practice has long term benefits for all stakeholders: clients, client's families, employers, payers, regulators, and educators. NBCOT certification is granted for a three-year period. 36 professional development (education) units need to be gained during those 3 years. (PDU's) Complete renewal application.
How many continuing education credits a.k.a professinal development units (PDU's) do you need to complete in 3 years in order to get re-certified?
What is STARK LAW?
The term "stark law" commonly refers to Section 1877 of the Social Security Act, which prohibits physicians from referring patients to health care entities with which they (or their immediate family) have a financial relationship for services that Medicare or Medicaid might pay.
What year was the STARK LAW enacted?
This law was enacted in 1989 and modified in 1993 and applied OT & PT to it.
What does the New York State SRB grant?
permission to practice (license)
What can't the COTA do without an OT?
Complete a whole evaluation by themselves.
Occupational Therapy educational levels levels?
COTA = certified occupational therapy assistant (associate degree)
OTR = registered occupational therapist (master's level)
PhD = doctorate level in occupational therapy
ALL THREE HAVE TO BE accredited programs.
If a person is not able to take the certification for some reason in N.Y.S one can get a temporary permit for a period of?
rights as a student member of NYSOTA.org?
As a NYSOTA member, you will be represented in the NYS Legislature, with the Department of Health, Education and other state agencies as well as through the State Board for Occupational Therapy. Be sure your voice is heard by becoming a member today!
Members enjoy timely electronic notifications on issues effecting their practice and a host of other benefits, including:
what is NYSOTA?
The New York State Occupational Therapy Association! Free for students.
"Our mission is to promote the profession of occupational therapy and to represent the occupational therapy practitioners who work and live in New York State"
benefits of being a member of the AOTA.
AOTA membership benefits are designed to meet your professional needs and advance your career. Make sure you know about all of that’s available to you—
Professor Elmore mentioned this to be a benefit of being a member of AOTA:
"One benefit of AOTA is that it is our national organization & they have information regarding areas of practice & information regarding important legislation and ethics."
Medical Form? Know which vaccinations you need!
The State of New York requires all students born on or after January 1, 1957 to present proof of immunity against measles,mumps, and rubella (MMR). Acceptable proof of immunizationmust include two doses of measles vaccine and one dose of mumpsand rubella vaccine.
File for graduation!
Professional Attire as OT's/COTA's?
Identification Tag (ID) needs to be present & visible at all times.
How many levels of fieldwork are required?
Three levels of fieldwork are required.
ACOTE? What is it & what does it do?
Compliance with accreditation standards for occupational therapy educational programs is the responsibility of the Accreditation Council for Occupational Therapy Education (ACOTE)
HIPAA? What is HIPPA & what year was it created?
HIPAA is the Health Insurance Portability and Accountability of 1996. HIPAA is a confidentiality and privacy statute that requires individually identification health information to be held confidential in all forms of communication (e.g, verbal, written, electronic) unless explicitly permitted by an individual.The Department of Health and Human Services holds enforcement powers and may seek civil penalties and criminal punishments against people who violate HIPAA standards.
HIPAA is confidentiality and privacy statue that requires individually identifiable heath information to be held confidential in all forms of communication unless explicitly permitted by an individual.
In order to discuss or share patient information one needs a _____ from that person or their guardian.
What is Value - Based Proposal?
VBP: gives incentives to health care providers that show valuable actions like efficiency in using resources and providing high-quality care, reinforcing good organization.
Student Evaluation Form (fieldwork experience form) What is it & who reviews and signs it.
This form reviews the progress of the student. SEFWE- Student Evaluation of the Fieldwork Experience, at the final meeting with the supervisor, this form is reviewed with the student's fieldwork supervisor and signed by both the student and the supervisor. Copies are submitted to the fieldwork site and to the academic coordinator of the student's college and may be reviewed by future students.
Purpose of FWPE - Fieldwork Performance Evaluations is?
to evaluate whether a student is competent for entry level practice.
When is FWPE reviewed & signed?
When you are done with fieldwork.
We have to honor a ___?
"no" a.k.a a person's right to refuse or discontinue treatment of our services.
Who is qualified to make a disability determination?
The ADA (American Disabilities Act) of the Rehabilitation Act of 1973. There are specific requirements for diagnosis and documentation in order to qualify for protection under ADA as an individual with a disability.
Who can determine that a person is disabled under ADA?
A diagnosis must be made and documented by a qualified professional, such as a physician, neuro psychologist, or educational psychologist.
COTA responsibilities: during treatment/delivery of service
all OT personal have an obligation to maintain the code and ethic standards and to promote it among there colleagues. Every OT and OTA has a professional responsibility to ensure that he or she is in compliance with legal statutes and ethical principles when providing care.
Minimum recommended supervision?
COTA with 2 years of experience
Professional Liability Policy?
It's Malpractice Insurance Protection.
You're good at what you do, you're careful, and you believe in
the innate goodness in people. Because of this, you believe you don't
need individual professional liability protection. Unfortunately, in
these litigious times, the chances of you getting sued are
Without the right malpractice protection, you jeopardize your professional goals, placing your career, your personal assets and your family's financial future in serious danger. So why would you take the risk of practicing your profession without protecting your most valuable asset-YOU?
Disciplinary Defense Coverage. Most employers, by and
large, do not provide this in their plan. If your employer, or a
client complains about you to the Board responsible for defining the
standards of practice for your license or certifying body,
accreditation or certification, it can result in hearings and a trial.
Even if the complaint is dismissed, you could still be left with hefty
Personal Injury Protection. This feature covers you, up to the applicable limits of liability, from charges or slander, libel, assault and battery, privacy violation and other alleged personal injuries committed in the conduct of your professional services.
should be provided to entry level practitioners by providing direct, onsite, daily contact to practitioners who have less than one year experience.
After the OTA pass the entry level and have greater competence. This consists of face to face meetings that occur at specific time intervals. A variety of methods could be used such as observation of treatment, documentation review, and written or electronic communication.
level 1 fieldwork :
a student can be supervised by qualified personnel including, but not limited to, occupational therapy practitioners with initial national certification, psychologists, physician assistants, teachers, social workers, nurses, and physical therapists.
level II fieldwork :
an occupational therapist can supervise an occupational therapy student as long as the therapist meets state regulations and has a minimum of 1 year of practice experience subsequent to the requisite initial certification. An occupational therapist or occupational therapy assistant who meets state regulations and has 1 year of practice experience subsequent to the requisite initial certification can supervise an occupational therapy assistant student.
timeframe to complete fieldwork after didactic portion :
Student Evaluation of the Fieldwork Experience: when reviewed and signed?
during the middle and end of fieldwork
Feedback to fieldwork student why important?
To review progress of the student and to improve skills and determine what the student must work on
When were the basic principles of Occupational Therapy Association first proposed?
Principles of the AOTA Code of Ethics & Ethic Standards?
Beneficence, Nonmaleficence, Autonomy and confidentiality, Social Justice, Procedural Justice, Veracity, Fidelity)
demonstrate a concern for well-being & safety of recipients of services
A-Respond to requests for OT services in a timely manner
B-Provide evaluation and a plan of intervention for recipients of OT services specific to their needs
C-Reevaluate and reassess recipients of service in a timely manner to see if goals are being met and if plan should be revised
D-Avoid inappropriate use of outdated or obsolete test or assessment or data obtained fro such test in making intervention decisions and recommendations
E-Provide OT services that are within each practitioner’s level of competence and scope of practice
F-Use to the extent possible evaluation, planning, intervention techniques and therapeutic equipment that are evidence based and within the recognized scope of OT practice
G-Take responsible steps (continuing ed, research, supervision, training) and use careful judgement to ensure their own competence and weigh potential for client harm when generally recognized standards do not exist in emerging technology or areas of practice
H-Terminate OT services in collaboration with the service recipient or responsible party when the needs and goals of patient have been met or shen services no longer produce a measurable change or outcome
I-Refer to other healthcare specialists solely on the basis of the needs of the client
J-Provide OT education, continuing ed, instruction and training that are within the instructor’s subject are of expertise and level of competence
K-Provide students and employees with information about the Code and Ethics Standards, opportunities to discuss ethical conflicts and procedures for reporting unresolved ethical conflicts
L-Ensure that OT research is conducted in accordance with currently accepted ethical guidelines and standards for the protection of research participants and the dissemination of results
M-Report to appropriate authorities any acts in practice, education and research that appear unethical or illegal
N-Take responsibility for promoting and practicing OT on the Basis of current knowledge and research and for further developing the professional body of knowledge
intentionally refrain from actions that cause harm to others-
A-Avoid inflicting harm to OT patient, students, research participants or employees
B-Make every effort to ensure continuation of treatment or transition of services if the current provider is unavailable due to medical or other absence or loss of employment
C-Avoid relationships that exploit the recipient of services, students, research participants or employees physically, emotionally, psychologically, financially, socially or in any other manner that conflicts or interferes with professional judgement and objectivity
D-Avoid sexual relationships, consensual or nonconsensual, with any recipient of service, family member or significant other, student, research participant or employee while a OT relationship exists (OT practitioner, educator, researcher, supervisor, or employee)
E-Recognize and take appropriate action to remedy personal problems and limitations that might cause harm to recipients of service, colleagues, students, research participants or others
F-Avoid alcohol and drugs that may compromise OT services, education or research
G-Avoid situations where practitioner, educator, researcher or employer is unable to maintain clear professional boundaries or objectively to ensure the safety and well being of recipients of service, students, RP, and employees
H-Maintain awareness of and adherence to the Code and Ethics Standards when participating in volunteer roles
I-Avoid compromising client rights or well being based on arbitrary administrative directives by exercising professional judgement and critical analysis
J-Avoid exploiting any relationship established as an OT or OTA to further one’s own physical, emotional, financial, political, or business interest at the expense of the best interest of recipients of services, students, RP, Emp, or colleagues
K-Avoid participating in bartering for services because of the potential for exploitation and conflict of interest unless there are clearly no contraindications or bartering is culturally appropriate custom
L-Determine the proportion of risk to benefit for participants in research prior to implementing a study
AUTONOMY & CONFIDENTIALITY:
respect the right of individual to self-determination, protect a client’s confidentiality
Autonomy is the self-determination principle
You need to acknowledge a person’s right to hole view, to make choices and to take actions based on personal values and beliefs.
Important in healthcare ethics-the right to make care decisions that impact the person receiving services. The decision should reside with that person.
A-Establish a collaborative relationship with recipients of service, including families, significant others, and caregivers in setting coals and priorities throughout the intervention process. This includes full disclosure of any benefits, risks and potential outcomes of any interventions; the personnel who will be providing the interventions and/or any reasonable alternatives to the proposed interventions
B-Obtain consent before administering any OT services, including evaluation and ensure that recipients of service (or legal rep) are kept informed of the progress in meeting goals specified in the plan of intervention/care. If the service recipient cannot give consent, the practitioner must be sure that the consent has been obtained from the person who is legally responsible for that recipient
C-Respect the recipient of service’s right to refuse OT services temporarily or permanently without negative consequences
D-Provide students with access to accurate info regarding educational requirements and academic policies and procedures relative to the OT program/educational institution
E-Obtain informed consent from participants involved in research activities and ensure that they understand the benefits, risks and potential outcomes as a result of their participation as research subjects
F-Respect research participant’s right to withdraw from a research study without consequences
G-Ensure that confidentiality and the right to privacy are respected and maintained regarding all information obtained about recipients of service, students, research participants, colleagues or employees. The only exceptions are when a practitioner or staff member believes that an individual is in serious or imminent harm. Laws and regulations require disclosure to appropriate authorities without consent
H-Maintain the confidentiality of all verbal, written, electronic, augmentative and nonverbal communications including compliance with HIPPA regulations
I-Take appropriate steps to facilitate meaningful communication and comprehension in cases in which the recipient of service, student, or research participant has limited ability to communicate (aphasia or differences in language, literacy, culture)
J-Make every effort to facilitate open and collaborative dialogue with clients and/or responsible parties to facilitate comprehension of services and their potential risks/benefits
provide services in fair & equitable manner; fair, equitable and appropriate distribution of resources. Individuals and groups should receive fair treatment and an impartial share of the benefits of society.
A-Uphold the profession’s altruistic responsibility to help ensure the common good
B-Take responsibility for educating the public and society about the value of OT services in promoting health and wellness and reducing the impact of disease and disability
C-Make every effort to promote activities that benefit the health status of the community
D-Advocate for just and fair treatment for all patients, clients, employees, and colleagues, and encourage employers and colleagues to abide by the highest standards of social justice and the ethical standards set forth by the OT profession
E-Make efforts to advocate for recipients of OT services to obtain needed services through available means
F-Provide services that reflect an understanding of how OT service delivery can be affected by factors such as economic status, age, ethnicity, race, geography, disability, marital status, sexual orientation, gender, gender identity, religion, culture and political affiliation
G-Consider offering pro bono (for the good) or reduced fee OT services for selected individuals when consistent with guidelines of the employer, third party payer and/or government agency
OT should comply w/ institutional rules, local, state, federal & international laws & AOTA documents applicable to profession of OT
Procedural justice is based on the concept that procedures and processes are organized in a fair manner and that policies, regulations and laws are followed
OTs are required to uphold current reimbursement regulations and state/territorial laws governing the profession. Ot’s are ethically bound to be aware of organizational policies and practice guidelines set by regulatory agencies designed to protect patients
A-Be familiar with and apply the code and ethics standard to the work setting and share them with employers, employees, colleagues, students and researchers
B-Be familiar with and seek to understand and abide by institutional rules and when those rules conflict with ethical practice, take steps to resolve the conflict
C-Be familiar with revisions in those laws and AOTA policies that apply to the profession of OT and inform employers, employees, colleagues, students and researchers of those changes
D-Be familiar with established policies and procedures for handling concerns about the COde of Ethics Standards, including familiarity with national , state, local district and territorial procedures for handling ethics complaints as well as policies and procedures created by AOTA and certification, licensing and regulatory agencies
E-Hold appropriate national, state or other requisite credentials for the OT serves they provide
F-Take responsibility for maintaining high standards and continuing competence in practice, education and research by participating in professional development and educational activities to improve and update knowledge and skills
G-Ensure that all duties assumed by or assigned to other OT personnel match credentials, qualifications, experience and scope of practice
H-Provide appropriate supervision to individuals for whom they have supervisory responsibility in accordance with AOTA official documents and local, state and federal or national laws, rules, regulations, policies, procedures, standards and guidelines
I-Obtain all necessary approvals prior to initiating research activities
J-Report all gifts and remuneration from individuals, agencies or companies in accordance with employer policies as well as state and federal guidelines
K-Use funds for intended purposes, and avoid misappropriations of funds
L-Take reasonable steps to ensure that employers are aware of OT’s ethical obligations as set by the Code and Ethics Standards and of the implications of those obligations for OT practice, ed, and research
M-Actively work with employers to prevent discrimination and unfair work practices and advocate for employees with disabilities to ensure the provisions of reasonable accommodations
N-Actively participate with employers in the formulation of policies and procedures to ensure legal, regulatory and ethical compliance
O-Collect fees legally. Fees shall be fair, reasonable and commensurate with services delivered. Fee schedules must be available and equitable regardless of actual payer reimbursements/contracts
P-Maintain the ethical principles and standards of the profession when participating in a business arrangement as owner, stockholder, partner or employe and refrain from working for or doing business with organizations that engage in illegal or unethical business practices
provide comprehensive, accurate & objective info when representing profession
Based on virtues of truthfulness, candor and honesty
Refers to the comprehensive, accurate and objective transmission of information and includes fostering the client’s understanding of such information.
Based on respect due to others
OT must not deceive the listener; speak truthfully
Must provide truthful information to patient
Patient must understand the OT
Establishes trust and strengthens professional relationships
A-Represent the credentials, qualifications, education, experience, training, roles, duties, competence, views contributions and findings accurately in all forms of communication about recipients of service, students, employees, research participants, and colleagues
B-Refrain from using or participating in the use of any form of communication that contains false or misleading statement or claims
C-Record and report in an accurate and timely manner and in accordance with applicable regulations, all info related to professional activities
D-Ensure that documentation for reimbursement purposes is done in accordance with applicable laws, guidelines and regulations
E-Accept responsibility for any action that reduces the public’s trust in OT
F-Ensure that all marketing and advertising are truthful and presented to avoid misleading recipients of service, students, RP or the public
G-Describe the type and duration of OT services accurately in professional contracts including the duties and responsibilities of all involved parties
H-Be honest, fair, accurate, respectful and timely in gathering and reporting fact based info regarding employee job performance and student performance
I-Give credit and recognition when using the work of others in written, oral or electronic media
treat colleagues & other professionals w/ respect, fairness, discretion & integrity; faithfulness & loyalty
A-Respect the traditions, practices, competencies and responsibilities of their own and other professions as well as those of the institutions and agencies that constitute the working environment
B-Preserve, respect and safeguard private information about employees, colleagues and students unless otherwise mandated by national, state or local laws or permission to disclose is given by the individual
C-Take adequate measures to discourage, prevent, expose, and correct any branches of the COde and Ethics Standards and report any breaches of the former to the appropriate authorities
D-Attempt to resolve perceived institutional violations of the Code and Ethics Standards by utilizing internal resources first
E-Avoid conflicts of interest of conflicts of commitment in employment, volunteer roles or research
F-Avoid using one’s position (employee or volunteer) of knowledge gained from that position in such a manner that gives rise to real or perceived conflict of interest among the person, the employer, or the Association members and/or other organizations
G-Use conflict resolution and/or alternative dispute resolution resources to resolve organizational and interpersonal conflicts
H-Be diligent stewards of human, financial and material resources of their employers and refrain from exploiting these resources for personal gain
it refers to the process of actively developing and practicing appropriate, relevant and sensitive strategies and skills in interacting with culturally different persons.
separate our values and culture from the patient’s
Competence in practice
learning new patterns of behaviors and effectively applying them in appropriate settings.
completed the training, you did your internship, you follow the moral ethical principles, continue with continuing education, you don’t practice beyond the scope of your training or your experience at that level
Which agency creates the laws that define the scope of practice?
AOTA 84, State lincensure laws
using the thoughts, writings, inventions,ect. of another without giving credit to them. "occupational therapy personnel shall not plagiarize the work of others."
Occupational therapy addresses:
the physical, cognitive, psychosocial, sensory, and other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Ethical action is:
a manifestation of moral character and mindful reflection
Enforcement Procedures for the OT Code of Ethics and Ethics Standards:
Introduction, Complaints, EC review and investigations, EC review & decision, the disciplinary council, appeal process, notification, records and reports, publication, modification.
The EC of AOTA was established in
The NBCOT formed in
altruism, equality, freedom, justice, dignity, truth, and prudence.
Complaint can't be announced after it has occurred more than
7 years prior to the filing of the complaint.
the progressive era
(1890-1914) influenced occupational therapy as it was formally organized.
the ota position was not created untill the year
eleanoe clarke slagle lectureship and award of merit was established in ____ to _____
1953; to recognize the value of professional contributions. Given to 44 individuals (2010)
Activities Of Daily Living: significant info
Physician Howard Rusk working with returning soldiers after WWII. Institute for the Crippled and Disabled in New York City.
Prescription vs. Referral
in 1969 the first statement to occupational therapy referral was adopted by the AOTA.
before you sign the dotted line..
always read what you are signing
if you offer your product to a patient..
always say you will have financial gain from it. and provide other options on a list.
learning to abide with the recipients of occupational therapy may be one of the most important ways to safeguard against patient abandonment.
In a contract, an integration clause reflects:
the written terms of a contract are the full and final agreement.
In what year was the Americans with Disabilities Act enacted?
When a physician refers his or her patients to health care entities with which they (or immediate family) have financial relationship for services that Medicaid or medicare would pay, he is violating what specific law?
The following are reasons why documentation is important, except:
Documentation allows OT to treat and bill the patient for the length of time the therapist deems acceptable.
The Sensory Learning Program is a approach that simultaneously stimulates the visual, auditory, and vestibular systems with light, sound, and motion to assist with developmental learning. What year was this approach developed?
Who do Occupational Therapy Assistants work under and need to be supervised by?
1) Which of these situations is unethical but not illegal?
Not seeking continuing education and using outdated techniques
According to skilled nursing facility Part A rules, what percentage of a patient's weekly therapy can be group therapy and how many people are allowed in the group?
25% group therapy, 4 or fewer patients per group
When was the "Stark law" enacted?
Which agency states that occupational therapy personnel shall give credit and recognition when using the work of others in written, oral, or electronic media?