How can you resolve the issue in case # 27 and 28

Team Discussion

Case Study #27:

Primary Ethical Issue: In my consulting job as a behavior analyst, I have been working with a consumer who is a recipient of Medicaid waiver services. Recently, there was a breakdown in the service authority approval process, meaning that my upcoming hours were not approved in writing. Should I still provide behavior analysis and oversight even if I do not have a written authorization? I know it sounds like an obvious yes, but legally the rules say that if my hours are not approved in advance the agency does not have to pay me.

Ethical Guideline(s) Addressed in this Case:

2.09 Disclosures.

(a) Behavior analysts disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose, such as (1) to provide needed professional services to the individual or organizational client, (2) to obtain appropriate professional consultations, (3) to protect the client or others from harm, or (4) to obtain payment for services, in which instance disclosure is limited to the minimum that is necessary to achieve the purpose.

(b) Behavior analysts also may disclose confidential information with the appropriate consent of the individual or organizational client (or of another legally authorized person on behalf of the client), unless prohibited by law.

2.13 Fees, Financial Arrangements and Terms of Consultation.

(a) As early as is feasible in a professional or scientific relationship, the behavior analyst and the client or other appropriate recipient of behavior analytic services reach an agreement specifying compensation and billing arrangements.

(b) Behavior analysts’ fee practices are consistent with law and behavior analysts do not misrepresent their fees. If limitations to services can be anticipated because of limitations in financing, this is discussed with the patient, client, or other appropriate recipient of services as early as is feasible.

(c) Prior to the implementation of services the behavior analyst will provide in writing the terms of consultation with regard to specific requirements for providing services and the responsibilities of all parties (a contract or Declaration of Professional Services).

2.14 Accuracy in Reports to Those Who Pay for Services.

In their reports to those who pay for services or sources of research, project, or program funding, behavior analysts accurately state the nature of the research or service provided, the fees or charges, and where applicable, the identity of the provider, the findings, and other required descriptive data.

1.04: Integrity

(a) “Behavior analysts are truthful and honest. The behavior analyst follows through on obligations and professional commitments with high quality work and refrains from making professional commitments that he/she cannot keep” (p. 60).

How can youresolve the issue from case #27?

Team Discussion: Lesson 3                                                                                                    3

Case Study #229:

Primary Ethical Issue: Third-party payers for services are starting to employ behavior analysts to review behavior programs provided by other analysts. While this is better than psychologists or bean counter reviewing behavior plans, are the behavior analysts who are employed to review the plans unethical because they are making decisions about services without observing the client, reviewing data, and so forth?

Ethical Guideline(s) Addressed in this Case:

2.05 Third-Party Requests for Services.

(a) When a behavior analyst agrees to provide services to a person or entity at the request of a third party, the behavior analyst clarifies to the extent feasible, at the outset of the service, the nature of the relationship with each party. This clarification includes the role of the behavior analyst (such as therapist, organizational consultant, or expert witness), the probable uses of the services provided or the information obtained, and the fact that there may be limits to confidentiality.

(b) If there is a foreseeable risk of the behavior analyst being called upon to perform conflicting roles because of the involvement of a third party, the behavior analyst clarifies the nature and direction

of his or her responsibilities, keeps all parties appropriately informed as matters develop, and resolves the situation in accordance with these Guidelines.

2.06 Rights and Prerogatives of Clients.

(a) The behavior analyst supports individual rights under the law.

(b) The client must be provided on request an accurate, current set of the behavior analyst’s credentials.

(c) Permission for electronic recording of interviews and service delivery sessions is secured from clients and relevant staff of all other settings. Consent for different uses must be obtained specifically and separately.

(d) Clients must be informed of their rights, and about procedures to complain about professional practices of the behavior analyst.

(e) The behavior analyst complies with all requirements for criminal background checks.

2.07 Maintaining Confidentiality.

(a) Behavior analysts have a primary obligation and take reasonable precautions to respect the confidentiality of those with whom they work or consult, recognizing that confidentiality may be established by law, institutional rules, or professional or scientific relationships.

(b) Clients have a right to confidentiality. Unless it is not feasible or is contraindicated, the discussion of confidentiality occurs at the outset of the relationship and thereafter as new circumstances may warrant.

(c) In order to minimize intrusions on privacy, behavior analysts include only information germane to the purpose for which the communication is made in written and oral reports, consultations, and the like.

(d) Behavior analysts discuss confidential information obtained in clinical or consulting relationships, or evaluative data concerning patients, individual or organizational clients, students, research participants, supervisees, and employees, only for appropriate scientific or professional purposes and only with persons clearly concerned with such matters.

2.08 Maintaining Records.

Behavior analysts maintain appropriate confidentiality in creating, storing, accessing, transferring, and disposing of records under their control, whether these are written, automated, or in any other medium. Behavior analysts maintain and dispose of records in accordance with applicable law or regulation, and corporate policy, and in a manner that permits compliance with the requirements of

these Guidelines.

3.04 Consent-Client Records.

The behavior analyst obtains the written consent of the client or client-surrogate before obtaining or disclosing client records from or to other sources, including clinical supervisor.