Week 8-10 Flashcards
3 Primary Entities of Policy Process
1) US Congress (House of Reps, Senate)
2) President
3) Special Interest Groups
Legislative Process
Speaker of the House and Majority leader of Senate hear bills (proposed laws), schedule hearings, join committees to listen to bills, resolve differences between House and Senate
President roles in policy making
- sets the agenda
- lets congress know what he/she would have passed into law
*puts pressure on congress via constituents to accomplish items on agenda
3 Branches of Government
Executive - President
Legislative - Congress
Judicial - Supreme Court
Executive Branch
The executive branch has appointees who have large impact on policy development. They are responsible for taking the law passed and establishing the rules and regulations to realize them in programs that work
-Dept of Education
-Dept of Health & Human Services
-US Dept of Justice
IDEA
-requires public schools to develop appropriate individualized education plans for each child
-each students IEP must be developed by a team of knowledgable persons and must be reviewed at least annually
-team must be child’s teacher, child, special educator, and other at parent’s discretion
PACs
-Political Action Committees are formed to raise and contribute to the campaigns of candidates likely to advance a particular groups and interests
Examples of Legislature that Influenced OT
1) Education for all Handicapped Children Act of 1975 and IDEA
-all public schools must provide equal access to children with physical and mental disabilities
2) Medicare Part B 1987
-provision to cover OT as a free standing service under Medicare Part B
3) ADA 1990
-cicil rights law for people with disabilities
4) HIPPA 1996
-protects health insurance coverage for workers and families when they change or lose their jobs and identifies who are the health care providers, insurance plans, and addresses security and privacy of health data
5) Balanced Budget Act 1997
-medicare adopted a new approach for payment of services
regulations
rules that implement laws on a state or national basis (provide foundation for public policy)
policy
rules that regulate behaviors in an organization or an a larger scale like public policy, regulates behavior in the public area
Hiring and Firing Practices
Hiring: a match between the candidates skills and abilities to do the job requirements (can’t consider race, sex, age, disability, religion, etc)
Firing: cannot use discriminatory or other illegal reasons to terminate
FMLA (Family Medical Leave Act of 1993)
allows employees to take 12 weeks off work (pay is not mandatory) for health/family related issues: birth or adoption of child, taking care of sick child, spouse, parent
ADA (Americans with Disabilities Act 1990)
ensures that disabled individuals are treated fairly and this includes at their place of work
privacy
right of patients to be left alone, free from intrusion and to choose whether or not to share one’s self
confidentiality
implies a trust in private communications
liability
OTs are responsible for performing accurate assessments, developing sound plans of care, delivering proper clinical interventions, doing no harm
Legal claims are civil, criminal, tort law
Tort Law
Battery & Assault: intentional harm
-battery: person intentionally comes in physical contact with another person without their permission (must prove touch occured, that it was intentional, that is caused harm)
-assault: must appear the threat is imminent, person feels threatened
Intentional Infliction of Emotional Distress
* Through extreme and outrageous conduct, someone intentionally causes severe emotional or mental distress
Negligence
* Failure to exercise the standard of care a reasonable person would
* Not intentional or reckless, it is careless
Malpractice
* “Improper or unethical conduct or unreasonable lack of skill by a holder
of a professional or official position”
Medicare Fraud and Abuse
- Fraud: “intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes knowing that the deception could result in some unauthorized benefit to himself or some other person”
- Abuse: incidents or provider practices that are inconsistent with accepted sound
medical practice
Antikickback Statute
this law makes it a criminal offense to knowingly and willfully pay for or
receive ay remunerations for referrals for items or services that are paid for by a federal health program
Stark Law
This is the Physician Self-Referral Prohibition Statute. Doctors are not supposed to
refer patients for certain designated health services (OT is one of those services), in an entity where that doctor has a financial relationship
False Claims Act
makes a person who knowingly submits a false claim to the federal government liable for that behavior.
Anyone found liable for this will owe the government damages up to 3x the original erroneous payment + mandatory penalties
Requisite Managerial Authority
The level of control and discretion that a
manager must have to be fairly held
responsible for the outcomes of work groups
* Hire and fire employees
* Determine rewards
* Determine promotions
* Determine assignment of work
* planning, organizing and staffing, directing, controlling
fiscal year
A fiscal year is a period consisting of one
budget cycle that coincides with a calendar
year (January 1 to December 31) or with
another cyclical calendar (e.g., many
organizations operate on a fiscal year that
runs from July 1 to June 30)
Training, Education, and Development
Training activities are related to improving
an employee’s capacity to perform his or her
current job, such as learning a new
treatment technique related to a patient
population that he or she currently treats.
Education activities are related to improving
an employee’s capacity for a specific but
future job, such as a staff therapist taking an
introductory course on supervising others.
Development activities are related to overall
capacities that may be used in any job, such
as time management or communication
skills.
