California State University, Chico

DEPARTMENT OF HEALTH AND COMMUNITY SERVICES

HCSV 332

Spring 2009

Laws, Ethics, and Regulations in Health Services

Butte 229

Tuesday/Thursday 3:30 to 4:45

Richard A. Narad, D.P.A., J.D.

Phone: (530) 898-5309

Butte 627

FAX: (530) 898-5107

Email: RNARAD@CSUCHICO.EDU

Office Hours: Monday 2-5, Tuesday 1-3, or by appointment

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

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: (posted on WebCT)

· ACHE position papers

· California Med-Mal Summary

· Case: Tempchin v. Sampson

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

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.

Grading:

· Ethics case analysis............................................................................................. 200

· Legal case analyses (2 @ 200) ......................................................................... 400

· Regulations search............................................................................................... 200

· Final case study ................................................................................................... 200

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

Projects and Activities:

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

· Legal case analysis: Analysis of a legal fact pattern, 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.

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.

Plagiarism: 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.

Expectations: 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.

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

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.

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
Week	Topic(s)	Readings/ Assignments
1.	Introduction Ethics perspectives	Morrison-1, 2, 3, 4
2.	Professional/organizational ethics Ethical issues regarding organization and staff	Morrison-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
3.	Healthcare ethics committees Codes of ethics	Morrison-5,6, 7,8,13,14 ACHE Code of Ethics
4.	The legal system/Healthcare law Anatomy of a lawsuit	Pozgar-2, 6; Morrison-12 Ethics case study
5.	Duty to provide healthcare Consent	Pozgar-12, 15
6.	Negligence	Pozgar-pp. 27-37; Ch. 18, 22 California Med-Mal Summary Tempchin v. Sampson
7.	Organizational liability	Pozgar-8,9,10,23
8.	Review Legal Case #1 Product liability Intentional torts/Criminal law	Pozgar-pp. 37-50; Ch. 4 Legal case study 1
9.	Contracts	Pozgar- pp. 71-81
10.	Contracts (cont) Business organizations	Pozgar- 7; Morrison-11
11.	Fraud and abuse/ Compliance Antitrust	Pozgar- pp. 82-90 Legal case study 2
12.	Privacy and confidentiality Licensure and credentialing regulations	Pozgar-11, 13
13.	3^rd party payers Bioethics overview	Pozgar-21 Regulations search
14.	Reproduction	Pozgar-14
15.	End of life decisions	Morrison-15,16 ACHE: Decisions Near the End of Life
16.	FINAL EXAM

Ethics analysis

Assignment: Analyze an ethical issue and provide a recommendation

Content:

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. 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?

3. 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 analyses

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.

4. Analyze the case, applying the facts of the case to each element of the legal rule.

5. 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. Acupuncturist

2. Dentist

3. Doctor of Chiropractic

4. Emergency Medical Technical –Paramedic

5. Licensed marriage and family therapist

6. Licensed midwife (non-RN)

7. Licensed vocational nurse

8. Occupational therapist

9. Optometrist

10. Osteopathic physician and surgeon

11. Pharmacist

12. Physical therapist

13. Physician and surgeon

14. Physician assistant

15. Podiatrist

16. Radiological technician

17. Registered nurse

18. Registered dental hygienist

Health organizations

1. Acute care hospital

2. Adult day health center

3. Alternative birthing center

4. Ambulance service

5. Ambulatory surgery center

6. Assisted living facility

7. Blood bank

8. Chemical dependency recovery hospitals

9. Congregate care facility

10. Correctional treatment center

11. Chronic dialysis clinic

12. Home health agency

13. Hospice

14. Medical laboratory

15. Neonatal intensive care unit

16. Pharmacy

17. Primary care clinic

18. Psychology clinic

19. Skilled nursing facility

20. Telephone medical advice services

21. Trauma center

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, the California Code of Regulations, and websites operated by the regulatory agency identified in your paper. Links to the statutes and codes are provided in WebCT.

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