California State University, Chico

DEPARTMENT OF HEALTH AND COMMUNITY SERVICES

HCSV 332 (was HCSV 233)

Spring 2007

Laws, Ethics, and Regulations in Health Services

Butte 229

Wednesday, 2:00 to 4:50

Richard A. Narad, D.P.A.

Phone: (530) 898-5309

Butte 627

FAX: (530) 898-5107

Email: RNARAD@CSUCHICO.EDU

Office Hours: Monday 2-5, Wednesday 10-12, or by appointment

2. Learning objectives: This course helps to meet the following objectives of the B.S., Health Science, Option in Health Services Administration:

The graduate in Health Services Administration will have knowledge, skills, and beliefs related to the health care delivery system and will:

· Be able to apply laws and regulations that impact healthcare organizations (e.g., employment, antitrust, patient consent, confidentiality);

· Discuss the major ethical issues that are affecting health care and be able to articulate their own beliefs.

The graduate in Health Services Administration will have competent communication skills, including written and spoken communication, use of electronic media, and formal presentations/business reports

· Develop a variety of communication skills

· Search websites

The complete objectives of the B.S. Health Science with an option in Health Services Administration are available at http://www.csuchico.edu/hcsv/hsa_obj.html

3. Reading Materials:

Texts:

· Pozgar, George D. Legal Aspects of Health Care Administration, 10^th Ed. (Sudbury, MA: Jones and Bartlett Publishers, 2007).

· Morrison, Eileen E. Ethics in Health Administration : Practical Approach for Decision Makers (Sudbury, MA: Jones and Bartlett Publishers, 2006).

Health administration core library:

· Slee, Vergil, Slee, Debora, & Schmidt, HJ (eds.). Slee's Health Care Terms, 4th Ed. (St. Paul, MN: Tringa Press, 2001).

· Hacker, Diana. A Pocket Style Manual, 4th Ed. (Boston: Bedford Books of St. Martin’s Press, 2004).

Other:

· California Med-Mal Summary

· ACHE position papers (posted on WebCT)

· I will email other materials on topics that may arise during the semester.

4. Course Format: Classes will combine lectures, discussions, guest speakers, and student presentations. This course will be team taught, however each instructor will be responsible for the indicated section, including grading of all assignments.

5. Grading:

Final exam......................................................................................................... 200

Midterm.............................................................................................................. 200

Projects

· Ethics cases analysis................................................................................ 150

· Legal case analyses (2 @ 150) .............................................................. 300

· Regulations search.................................................................................... 150

Subtractions

· Attendance: 50 points lost for every session missed. One excused absence will be allowed.

· Reading quizzes: Up to eight reading quizzes will be given during the semester. Failure to pass the quiz will result in 25 points being deducted from your total grade, but no additional points will be added.

Grades:

A 930 - 1000

C+ 770 - 799

A- 900 - 929

C 730 - 769

B+ 870 - 899

C- 700 - 729

B 830 - 869

D+ 660 - 699

B- 800 - 829

D 600 - 659

6. Projects and Activities:

· Ethics cases analysis: Analysis of an ethical situation, applying ethics principles to the facts

· Legal case analysis: Analysis of a legal case, applying legal rules to the facts..

· Regulations search: A summary of the regulations impacting a specific health profession or a specific type of health organization

· Class participation: Attendance is expected. Participation means more than being present in class. Students are expected to actively participate in class activities and discussions.

· Standard: This syllabus includes descriptions of each of the written assignments. General standards are described below. Students should ensure that papers and presentations include all of the required items and meet these standards.

7. Confidentiality: During this course, the instructors, guest speakers, or students may share information regarding specific organizations or individuals. Such information should be treated as confidential and not discussed outside of the classroom. If you are in doubt regarding the confidentiality of any information, consult the instructor.

8. Students must ensure that appropriate credit is given for all materials. Ideas taken from other persons must be properly cited. Any direct quote must be enclosed in quotation marks and must be cited. Any failure to follow these rules will result in no credit for the assignment and may result in further disciplinary action.

9. You should be aware that this class will be harder than most classes that you have taken. Assignments should be of the same quality that is expected of an employee in a professional position in the healthcare field. That means that grammar and spelling will be considered in grading assignments. It means that due dates and project specifications are taken seriously. It means that attendance is expected.

10. Written papers: All papers turned in for this course must comply with the following:

· You must turn in both a hardcopy (printed) version of your term paper (which I will grade and return to you) and an electronic version. The electronic version must be PC compatible and formatted as a Text (*.txt), MS-Word (*.doc), or Rich-Text-Format (*.rtf) file. The electronic version must be emailed to me as an attachment through WebCT. Papers will be checked for plagiarism at "turnitin.com".

· Use 81/2" x 11" paper, with one-inch margins on all sides.

· Papers should be typed, with all text, including quotes, double-spaced.

· Do not use covers or cover pages.

· Use Courier or Courier New 12 font

· Do not exceed the maximum length for the assignment.

· Papers should be free of typographical and spelling errors and should be grammatically correct

· Papers not meeting these standards may be returned for rewriting before they are graded. Any rewrite will result in a reduction of one grade

11. On-line resources: This class requires the use of WebCT. Class handouts and case study links will be placed on the site. Other materials and relevant linkages can be found there.

12. Disclaimer: Nothing presented in this class, including readings and discussion, should be considered as legal advice. If you have a legal concern, you should consult an attorney.

Course Schedule and Assignments
Session/Week	Topic(s)	Assignments
Week
1.	Introduction
1.	Ethics perspectives
2.	Professional/organizational ethics	Morrison-1, 2, 3, 4, 9, 10, ACHE: · Ethical Decision Making for Healthcare Executives · Impaired Healthcare Executives · Creating an Ethical Environment for Employees · Ethical Issues Related to a Reduction in Force · Ethical Issues Related to Staff Shortages
2.	Ethical issues regarding organization and staff
3.	Healthcare ethics committees	Morrison-5,6, 7,8,13,14 · ACHE Code of Ethics
3.	Codes of ethics	Morrison-5,6, 7,8,13,14 · ACHE Code of Ethics
4.	Reproduction	Pozgar-14 *ETHICS CASE STUDY*
5.	End of life decisions	Morrison-15,16 ACHE: Decisions Near the End of Life
6.	Midterm
7.	The legal system/Healthcare law	Pozgar-2, 15 Morrison-12
7.	Duty to provide healthcare	Pozgar-2, 15 Morrison-12
8.	Negligence	Pozgar-3 California Med-Mal Summary
9.	Organizational liability	Pozgar- 7,8,9,10,23
10.	Product liability	Pozgar-4, 12 *LEGAL CASE STUDY 1*
	Intentional torts/Criminal law
	Consent
11.	Contracts	Pozgar- pp. 85-95, 105-106
12.	Contracts (cont)	Pozgar-pp. 95-106 Morrison-11
	Fraud and abuse/ Corporate compliance
	Antitrust
13.	Privacy and confidentiality	Pozgar-11, 13 *LEGAL CASE STUDY 2*
13.	Licensure and credentialing regulations	Pozgar-11, 13 *LEGAL CASE STUDY 2*
14.	3^rd party payers	Pozgar-21 *REGULATIONS SEARCH*
15.	Anatomy of a lawsuit	Pozgar-6, 18, 22
16.	FINAL EXAM

Ethics analysis

Assignment: Assume that you are a member of the ethics committee for a healthcare organization and you have been asked to consult on an ethics issue.

Content: Write a memo to the chair of the ethics committee, analyzing the situation and providing a recommendation. This will include:

1. Ethics question (use one of the following formats):

· Given [uncertainty or conflict about values], what decisions or actions are ethically justifiable?

· Given [uncertainty or conflict about values], is it ethically justifiable to [decision or action]?

2. Ethically appropriate decision-maker

· Who is (are) the rightful decision maker(s) regarding the critical decision(s) in the case? Why?

3. Options available

· Describe the options that are available

· explain why each option is (or is not) deemed ethically justifiable and why (or why not)

· Is an option(s) available that all parties will agree is ethically justifiable? If so, what is it? If so, what factors exists that will or may block implementation of this option?

4. What do you recommend? How should this be implemented (who, what, when, where, why)?

Papers will be a maximum of three pages (plus endnotes, if any).

Legal case analysis

Assignment: Analyze a case that will be provided using the “IRAC” format (Issue, Rule, Application, Conclusion).

Content

1. Identify the parties to the case.

2. Identify the issue(s) in the case.

3. For each issue, state the appropriate legal rules. Apply the facts of the case to the legal rule

4. State your conclusion as to the issue(s) based on your analysis of the facts and their application to the rule.

You must address each of the elements of the cause of action:

· Torts: Duty/standard of care, breach of duty, damages, actual and proximal causation

· Contracts: Offer, acceptance, consideration

Don’t forget to identify possible defenses.

Papers will be a maximum of three pages (plus endnotes, if any).

Regulations search

Assignment: Select either a health profession or a health organization from this list. Develop a paper summarizing the regulatory requirements for this profession or organization in California.

Health professions

1. Dentist

2. Doctor of Chiropractic

3. Emergency Medical Technical –Paramedic

4. Licensed marriage and family therapist

5. Licensed vocational nurse

6. Occupational therapist

7. Optometrist

8. Osteopathic physician and surgeon

9. Pharmacist

10. Physical therapist

11. Physician and surgeon

12. Physician assistant

13. Podiatrist

14. Radiological technician

15. Registered nurse

16. Registered dental hygienist

Health organizations

1. Acute care hospital

2. Adult day health center

3. Ambulance service

4. Assisted living facility

5. Blood bank

6. Congregate care facility

7. Chronic dialysis clinic

8. Home health agencies

9. Hospice

10. Intermediate care facility

11. Medical laboratory

12. Pharmacy

13. Primary care clinics

14. Psychology clinic

15. Skilled nursing facility

Content:

Health professions

For the profession that you select, answer the following questions:

1. What is the legal name used for the profession in California?

2. What sections of California statute and regulations apply?

3. Who grants the license or certificate?

4. What training and testing is required?

5. Summarize the scope of practice. Are there any specific limits?

6. Is supervision or authorization required to provide care? If so, by whom?

7. What continuing education requirements exist?

Health organizations

For the profession that you select, answer the following questions:

1. What is the legal name used for the organization in California?

2. What sections of California statute and regulations apply?

3. Who grants the license?

4. What types of inspections are used?

5. Summarize the scope of operation. Are there any specific limits?

6. What types of staffing are required?

7. What types of equipment are required

The only sources allowed are California statutes and the California Code of Regulations. Links to these are provided in WebCT.

Papers will be a maximum of two pages (plus endnotes).