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Exposure and Risk Management in the Social Services April 13, 2011

2011 PCCYFS Annual Spring Conference Making A Difference for 35 Years… One Child at a Time April 13-14. Wolverine Loss Control Services. “We’re Aggressive About Your Safety”. Exposure and Risk Management in the Social Services April 13, 2011 Brian M. Block, ARM, ARM-P

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Exposure and Risk Management in the Social Services April 13, 2011

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  1. 2011 PCCYFS Annual Spring ConferenceMaking A Difference for 35 Years…One Child at a TimeApril 13-14

  2. Wolverine Loss Control Services “We’re Aggressive About Your Safety” Exposure and Risk Management in the Social Services April 13, 2011 Brian M. Block, ARM, ARM-P Managing Director

  3. AGENDA • Introduction and Welcome • Overview of Goals • Definition Ethics in Social Services • Definition and Principles of An Ethical Audit • Defining Negligence • Defining the Duty of Care Standard • Discussion: What’s Wrong With This Picture • Q&A

  4. GOALS • Learn a Functional Definition of Ethics for Social Services • Understand the Principles and Techniques of A Personal Ethical Audit • Learn to Use the Principles of An Organizational Ethical Audit • Understand the Expectations of the Duty of Care • Avoid Practicing Negligently • Learn to Differentiate and Solve Ethical Dilemmas

  5. ETHICS • A SET OF PRINCIPLES, PROTOCOLS, PROFESSIONAL RESPONSIBILITIES AND ACCOUNTABILITIES DEFINING THE PARAMETERS OF HIGH QUALITY CARE. • THE RULES OF RECOGNIZED CONDUCT

  6. ETHICS • INVOLVES CHOOSING RIGHT FROM WRONG OR MAKING THE “MORAL” CHOICE • IS DRIVEN BY “DO NO HARM” • AND IS ASSOCIATED WITH THE TENANTS OF PERFORMANCE IMPROVEMENT: “DO THE RIGHT THING AND DO THE RIGHT THING WELL”

  7. ETHICAL PRINCIPLES • Recognize that we serve in a position of public trust • Do not use a public position to obtain advantages or favors • Use information gained from our positions only for the benefit of those we are entrusted to serve • Conduct our personal affairs in such a manner that we cannot be improperly influenced in the performance of our duties

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

  9. ETHICAL PRINCIPLES • Acknowledge that job descriptions are meant to produce behaviors in accordance with recognized definitions of the field and the organization’s needs • Orient new employees to the organization's ethics program during new employee orientation • Review the ethics management program in management training experiences and have systems in place to resolve ethical issues • Deliver accurate and timely information to the public

  10. WHY ETHICS? • To build and comply to a common set of values upon which we fashion our professional work activities. • To assure the welfare and protection of the individuals and groups with whom we work. • To assist ourselves and other professionals to recognize the boundaries related to their competence and the limitations of their expertise. • To provide the general public a set of standards upon which to build expectations and accountability regarding our profession.

  11. AN ETHICAL AUDIT - PROCESSES • Gather and Analyze Empirical Trend Data That Summarizes Actual Ethics, Complaints and Lawsuits • Review Organizational Policy & Procedures for Handling Ethical Issues, Dilemmas and Decisions • Identify Ethical Hazards Within Organization, Within Divisions, Within Departments and Within Programs

  12. AN ETHICAL AUDIT - PROCESSES • Develop a Risk Grid Rating Identified Ethical Hazards Using a 4-point Scale of No Risk, Minimal Risk, Moderate Risk and High Risk • Develop and Implement an Action Plan for All Ethical Hazards • Monitor Action Plan(s)

  13. CLINICAL MIDDLE MANAGER ROLE AND FUNCTION • CARE, CUSTODY, AND CONTROL • OVERSIGHT – Ethics on a Global Scale • SUPERIVSION – Ethics of the Organization • EMPLOYEE COMPETENCY • SERVICE PROVIDER

  14. NEGLIGENCE A SECOND 5-PART TEST • Scope of Service? • Performance of An Ability or Skill? • Does the Public Believe You’re The Expert? • Did Harm Come To Another Person In Care? • Could Anything Have Been Done To Prevent The Harm From Occurring? …and…

  15. NEGLIGENCE …and… To What Standard of Care Is Your Organization Being Held?

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

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

  18. TYPES OF LIABILITY • STRICT LIABILITY – It’s All Your Fault • VICARIOUS LIABILITY – You Should Have Known What They (S/He) Were Doing • CONTRIBUATORY LIABILITY – We Both Should Have Known Better

  19. DUTY OF CARE STANDARD • The average practitioner or customary practice standard examines negligence strictly from the perspective of employee or organizational competence. • Sometimes referred to as a niche standard, it assumes that the organization or professional’s practice is limited in its scope of service to those things recognized as being done well or competently by the professional or organization.

  20. DUTY OF CARE OWED • The reasonably prudent practice standard uses a perspective of accepted practices by the field in the most general terms. • Current organizational licensure and accreditation, primary source verification and employee licensure, supervision and training would be factors considered average practitioner and/or customary practice standards. • Peers, “trade associations”, licensing and accrediting bodies related to the various types of Health and Human Service organizations or businesses promulgate these standards.

  21. DUTY OF CARE OWED • The standard of excellence is the most subjective practice standard and is given to the whims of the general public. • “Do No Harm” or “Do The Right Thing and Do The Right Thing Well?” • Zero tolerance for going outside the strict definition of the obligation or duty owed no matter how that agreement is reached. • If not written agreements that are unspoken, implicit, inferred, implied, or unstated remain open to interpretation.

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

  23. NEGLIGENCE • Scope of Service? • customary practice standard • Performance of An Ability or Skill? • mandate to follow a standard of care • reasonably prudent practice standard • Does the Public Believe You’re The Expert? • standard of excellence • Did Harm Come To Another Person In Care? • reasonably prudent person practice standard • Could Anything Have Been Done To Prevent The Harm From Occurring? • standard of excellence …therefore… To What Standard of Care Is Your Organization Being Held?

  24. WHAT’S WRONG WITH THIS PICTURE? • So How Did The Paper Find Out? • I’m Sorry I’ll Have To Resign • I Reserve The Right To Not Serve You • I Reserve The Right To No Longer Get Service From You • We Have Someone Here That’s Yours • Teletherapy? • Crisis Worker Is Whom? • And Our Client Demographic Is? And Our Direct Care Demographic Is?

  25. WHAT’S WRONG WITH THIS PICTURE? • But S/He Didn’t Have Anywhere To Go For The Holidays • What’s A Middle Seat? • Foster Mom’s New Boyfriend • Wait Right There or Sure, Go Ahead Outside and Have A Smoke • You Knew She Was A Runaway Risk • Sorry We Forgot To Pick You Up • So How Far Can S/He Get In 8 Hours?

  26. WHAT’S WRONG WITH THIS PICTURE? • He Only Fell Off Playground Equipment • So, What’s One Visit I Forgot? • Can’t I Hire Him Part Time? • The Program Needs Your Cash Donation • It’s 4:55 p.m. on a Friday Afternoon

  27. QUESTIONS AND ANSWERS

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