Law and Ethics Exam

5 major legal exceptions to confidentiality

Imminent danger to self, duty to warn or protect, suspected child abuse or neglect, suspected elder or dependent adult abuse, court orders (if issued by a judge)

What is privilege?

A legal term that refers to the type of information that can come out in a court proceeding

Who can waive privilege?

The holder of the privilege (the client) or the judge can waive privilege

How should an LCSW respond to a subpoena if it comes from an attorney?

Treat is as a request, not an order. Also, you always need to respond, so the first step is to contact an attorney. Contact the client to find out their wishes.

If a client requests access to records, within how many days should you allow the client to inspect them?

5 days

If a client requests access to records, within how many days should you provide a treatment summary?

10 days

If a client requests access to records, within how many days should you provide a copy of the records?

15 days

If a client requests access to records, and you believe it would be harmful for them to access these, what should you do?

Document your decision to refuse and the rationale

A client can ______ a statement to their file if the clinician agrees to do so, but the client cannot ____ existing files.

add, alter

For couple and family therapy, what do you need before you can release the records of one of the individuals involved?

You need everyone’s permission.

In what instances are an ROI not required to release client records to third parties? (2)

-If the third party is another active professional (such as client’s PCP) for diagnosis or treatment planning. This is particularly useful if a client is hospitalized.

-If the information is required as part of billing process

What requirements need to be met for a therapist to write an approval letter for an emotional support dog?

-Therapist has to have seen the client for 30+ days

-Therapist must inform the client that this is not legally a service dog

If a client comes to CA to receive gender-affirming care, California protects CA providers from…

having to participate in out-of-state investigations around such a client

What are the CA state legal requirements for providing telehealth? The clinician must…(4)

-Informs clients telehealth will be used

-Inform clients of risks and limitations

-Inform clients of licensure level

-Gather and document specific client consent for telehealth (verbal consent, documented, is OK)

What must happen at each instance of a telehealth session?

-verbally obtain and document client’s full name and current location

-verbally assess client appropriateness for telehealth

-follow best practices for security and confidentiality

-therapy must take place where the client is physically located at time of session; clinician must be qualified to treat where the client is located

what organization must a healthcare provider notify if there’s a breach in data security (HIPAA information)?

HHS - Department of Health and Human Services

Every entity covered by HIPAA is legally required to designate a…

privacy official responsible for developing and implementing the organization’s privacy policies and procedures.

are “psychotherapy notes” protected from subpoena in California?

no

how is a dependent adult defined in California?

age 18-64 who has a physical/mental limitation AND resides in California. This necessarily includes any patient in a 24-hour facility.

What are the 6 reportable forms of abuse (elder and dependent adult)?

Physical, financial, abduction, isolation, abandonment, neglect (including self-neglect)

How do you define abduction of a dependent or elder adult?

Person is taken outside of California against their will OR prevented from returning to California against their will

If you hear abuse directly from dependent adult or elder adult victim, you must report unless all 3 apply:

1) the person has been diagnosed with a mental illness that impairs reality-testing

2) clinician is not aware of any supporting evidence

3) clinician reasonably believes that abuse did not occur

Indicators that financial abuse is happening to an elder or dependent adult (6)

1) sudden change in financial status

2) valuable items or cash missing

3) unpaid bills when person has money to pay them

4) unusual or impossible financial activity

5) sudden appearance of unnecessary goods/services

6) signatures on checks don’t match the person’s signature

how quickly do you need to report elder and dependent adult abuse?

report immediately by phone and submit a written report within 2 working days

when it comes to reporting abuse, what do you do if the elder/dependent adult client is in a long-term care facility (not a state hospital or developmental center), there was no serious injury, and it was caused by a resident with dementia?

report within 24 hours to the ombudsman and to law enforcement

when it comes to reporting abuse, what do you do for abuse that occurs in a long term care facility generally?

report immediately to law enforcement and give a written report to the ombudsman

does child abuse reporting require California residency?

No

How is physical abuse to a child defined?

Intentional striking of a child that leaves an injury

What are the two exceptions to child physical abuse?

1) law enforcement and school officials

2) mutual affray

What are the two age difference categories that constitute “lewd and lascivous” behavior?

1) if one child is under 14

2) if one child is 14 or 15 and the other person is 10+ years older

how quickly do you need to report suspected child abuse?

immediately by phone and in writing within 36 hours (includes weekends)

what are the 6 indicators of a client’s intent to harm another person?

1) direct report from client

2) information from a credible third party

3) threats from client made in writing or by other means

4) indirect statements

5) threatening behaviors like stalking

6) drug or alcohol use

what are the 3 grounds for involuntarily hospitalizing a client?

1) imminent danger to self

2) imminent danger to others

3) grave disability

what are the 6 exceptions to privilege?

1) client makes mental or emotional condition an issue in a lawsuit (against an employer, for example)

2) client alleges breach of duty by therapist

3) evaluation or therapy is taking place by court order

4) defendent in criminal case requested evaluation or therapy to determine sanity

5) client is under 16, is a victim of a crime, and therapist believes that disclosure is in the client’s best interest

6) therapist sought out for purpose of committing crime or avoiding detection

who is it always up to to dtermine if an exception to privilege applies?

the judge

what type of law does unprofessional conduct concern?

administrative law

LEGALLY, sexual contact with former clients is prohibited until ____ years after the last professional contact

2

if you violate this law - sexual contact with former clients is prohibited until 2 years after the last professional contact - the BBS is required to…

revoke your license

what is advertising information required to include (5)?

1) name

2) license title

3) license number

4) if you’re not licensed, must include whether you’re under supervision

5) name of your employer

what do parity laws require?

equivalent coverage for mental health and substance use treatment as applied to physical health care

scope of practice is a ____ issue, while scope of competence is a ____ issue

legal, ethical

what is the NASW’s standard with regard to physically touching clients?

it’s allowed unless there’s a risk of psychological harm to the client