CBHCM Legal and Regulatory Compliance 3 — Questions and Answers
Question 1: A client with schizophrenia refuses recommended medication. The case manager disagrees with this decision. The ethical-legal principle that MOST supports the client's right to refuse is:
- Beneficence
- Non-maleficence
- Autonomy (Correct answer)
- Justice
Correct answer: Autonomy
Autonomy supports a competent client's right to make their own decisions, including refusing treatment, even when the provider disagrees.
Question 2: Which legal standard is used to determine whether an adult client has the capacity to make informed healthcare decisions?
- The client must be free of all psychiatric symptoms
- The client must understand, appreciate, reason, and communicate a choice (Correct answer)
- The client must have a mental health professional's written approval
- The client must have no prior involuntary hospitalization history
Correct answer: The client must understand, appreciate, reason, and communicate a choice
Decision-making capacity is assessed by evaluating the client's ability to understand information, appreciate its implications, reason about choices, and communicate a decision.
Question 3: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that:
- All employers offer mental health benefits to employees
- Financial limits on mental health benefits must not be more restrictive than medical/surgical limits (Correct answer)
- Mental health treatment must be covered at 100% by all insurers
- Behavioral health providers must accept all insurance plans
Correct answer: Financial limits on mental health benefits must not be more restrictive than medical/surgical limits
MHPAEA requires that when mental health/SUD benefits are offered, the financial requirements and treatment limitations must be comparable to those for medical/surgical benefits.
Question 4: A case manager working in a school setting is asked by a teacher to share a student's mental health assessment. Under FERPA, the case manager should:
- Share records freely since the teacher works in the same school
- Obtain written parental consent before sharing records
- Share only if the teacher has a 'need to know' as defined by the school (Correct answer)
- Refuse all sharing because FERPA prohibits school record access
Correct answer: Share only if the teacher has a 'need to know' as defined by the school
FERPA allows sharing of student records with school officials who have a legitimate educational interest or 'need to know,' as determined by the school's policy.
Question 5: A behavioral health case manager suspects a colleague is impaired on the job. The MOST appropriate first step is to:
- Confront the colleague directly and warn them to stop
- Report concerns to a supervisor or the appropriate licensing board (Correct answer)
- Ignore the situation unless client harm has already occurred
- Discuss the situation openly with other colleagues
Correct answer: Report concerns to a supervisor or the appropriate licensing board
Professional ethical codes and licensure regulations require reporting an impaired colleague to a supervisor or licensing board to protect clients from harm.
Question 6: Which of the following BEST describes 'informed consent' in behavioral health case management?
- A one-time verbal agreement at the start of services
- An ongoing process ensuring clients understand services, risks, benefits, and alternatives (Correct answer)
- A legal document that eliminates the provider's liability
- A form signed only when invasive procedures are involved
Correct answer: An ongoing process ensuring clients understand services, risks, benefits, and alternatives
Informed consent is an ongoing process that requires clients to understand the nature of services, potential risks and benefits, and available alternatives.
Question 7: Under which circumstances may a behavioral health provider breach confidentiality based on the Tarasoff ruling?
- When the client has a history of violence in general
- When a client makes a credible, specific threat against an identifiable third party (Correct answer)
- When a client is diagnosed with antisocial personality disorder
- When a client refuses to take prescribed medications
Correct answer: When a client makes a credible, specific threat against an identifiable third party
The Tarasoff duty to warn requires providers to take steps to protect an identifiable third party when a client makes a specific, credible threat against them.
CBHCM Legal and Regulatory Compliance 3
A client with schizophrenia refuses recommended medication.
The case manager disagrees with this decision.
The ethical-legal principle that MOST supports the client's right to refuse is: