Rationale: The following assignment was selected from the Human Resources class. It shows some of the skills and competencies I have learned in demonstrating principles of ethical reasoning and professional practice implicit in public health decisions to improve the public’s health. For this assignment, we were to work as a group to develop a new employee orientation on an organization. We were to cover some overall aspects of the organization and some of the main policies including benefits, size, history, security, discipline, and the ethical decisions that may be faced at the organization. We chose to right about the facility that I work in and provided many details about its functions, the different roles employees have, benefits, etc. I wrote about the ethical framework of the organization. I wrote about a few of the ethical decisions that staff may face every day: medications, treatment, and transfers. Many people with mental illness are prescribed medications; we believe in choice, but sometimes and person is violent and too ill and refuses to take them. We may have to go through a process that forces medications which may be difficult for people to understand. Some staff may find it difficult to treat some of the patients that we treat; they are forensic patients, meaning they have committed some type of crime, some of them are very bad, and some staff may feel these people do not deserve to be treated. Doing therapy with that person every day may be very difficult for the staff member, but it is a struggle that they have to accept because we believe in helping all individuals. There is the opposite dilemma for some staff. We can be slow to transfer someone out of the facility into a less- restrictive setting because we have to take not only the patient’s progress into
Transcript
Rationale:The following assignment was selected from the Human Resources class. It shows some of the skills and
competencies I have learned in demonstrating principles of ethical reasoning and professional practice implicit in public health decisions to improve the public’s health. For this assignment, we were to work as a group to develop a new employee orientation on an organization. We were to cover some overall aspects of the organization and some of the main policies including benefits, size, history, security, discipline, and the ethical decisions that may be faced at the organization. We chose to right about the facility that I work in and provided many details about its functions, the different roles employees have, benefits, etc. I wrote about the ethical framework of the organization. I wrote about a few of the ethical decisions that staff may face every day: medications, treatment, and transfers. Many people with mental illness are prescribed medications; we believe in choice, but sometimes and person is violent and too ill and refuses to take them. We may have to go through a process that forces medications which may be difficult for people to understand. Some staff may find it difficult to treat some of the patients that we treat; they are forensic patients, meaning they have committed some type of crime, some of them are very bad, and some staff may feel these people do not deserve to be treated. Doing therapy with that person every day may be very difficult for the staff member, but it is a struggle that they have to accept because we believe in helping all individuals. There is the opposite dilemma for some staff. We can be slow to transfer someone out of the facility into a less-restrictive setting because we have to take not only the patient’s progress into account but what their crime was and whether we believe no one else will get hurt. We have to weigh the risk to society with the patient’s rights. This fits with this competency because I was able to show the ability to demonstrate ethical reasoning in making health decisions in an organization and how those decisions could contribute to improving health.
Fulton State Hospital
A forensic psychiatric hospital
Objectives❖ Learn about Fulton State Hospital (FSH)
❖ Identify a few of the legal and ethical frameworks
❖ Review a vacant Case Manager job description
❖ Identify training and development needs
❖ Review some of the New Hire Orientation training
❖ Understand Performance Management in the organization
❖ Identify current trends in healthcare and HR at FSH
Overview❖ FSH is a long-term forensic psychiatric hospital❖ Public, government funded, not-for-profit hospital❖ Census is about 340 with a capacity of 376❖ 85% male patient population❖ 55% white; 42% African American; 2% Hispanic;
1% Asian❖ Average Length of Stay is 4.5 years❖ 1200 employees including approximately 900 in
direct-care roles
Overview❖ Maximum, intermediate, and minimum security
settings
❖ Seriously mentally ill with diagnoses of schizophrenia, bipolar disorder, borderline personality disorder, intellectual disabilities, autism, impulse disorder, etc
❖ Nationally known evidence-based programming ➢ Social Learning Program➢ New Outlook Program➢ Competency Restoration Program
Legal Concerns at FSH
❖ FSH is an equal opportunity employer➢ Diversity leads to a stronger, more innovative
organization ➢ Employment is based on personal capabilities and
qualifications without discrimination ❖ Several Laws that guide our processes
➢ Civil Rights act of 1964➢ Equal Pay Act of 1963➢ Age Discrimination in Employment Act of 1967➢ Americans with Disabilities Act of 1990
HR Legal Frameworks
Equal Employment Opportunity Commission (EEOC)
❖ Enforcement of the aforementioned laws is the responsibility of the EEOC.
❖ EEOC holds the greatest influence in enforcing the laws of any federal agency.
❖ Prosecutes accused employers.❖ For additional EEOC information and guidance,
❖ Ethical decision making process➢ respecting the right to make treatment
choicesDaily ethical decisions may include:
❖ Medications ➢ forced ➢ side-effects➢ quality of life
Ethical Decisions (continued)
❖ Treating a forensic patient ➢ the patient➢ the victims➢ the families➢ society
❖ Transferring a client➢ when they do not want to go➢ when you are worried about the next provider’s
care
❖ Psychiatrists
❖ Medical physicians
❖ Psychologists
❖ Nurses
❖ Case Managers
❖ Social Workers
❖ Rehab services
❖ Environmental Services
❖ Dietary staff
❖ Maintenance staff
❖ Forensic Rehabilitation Specialists
❖ Accountants
❖ Chief Operating Officer
❖ Administrative Assistants
❖ Ward Clerks
❖ Security Officers
❖ Research Analysts
❖ Infection Control Nurse
❖ Occupational Therapists
❖ Director of Treatment Services
❖ Electricians
Positions/Roles at Fulton State Hospital
HR Responsibilities
❖ Interview/Hire❖ Train employees❖ Educate employees on HR
processes❖ Provide recognition to
employees❖ Help the HR dept monitor TJC
HR standards❖ Review competency
forms/audit HR files
HR Responsibilities Specific to New Hire
Potential opening for case manager at Fulton❖ Advertise position/provide job
description❖ Interview/Hire❖ Train employees❖ Educate employees on HR processes
(Orientation)❖ Maintain performance records
Case Manager Responsibilities❖ Direct supervision of patients to ensure safety and well being of clients
and staff
❖ Participation in individualized care plans for individual clients
❖ Works collaboratively with other treatment staff to ensure clients are meeting daily and weekly goals
❖ Promoting healthy behaviors of clients
❖ Utilizes evidence based interventions and strategies to promote health, growth and development
❖ Communicates effectively with fellow staff members and treatment team
❖ Participate in daily and weekly rounds
❖ Conduct therapeutic milieu activities and groups independently
❖ Works to support a diverse population at Fulton
Case Manager Requirements
Case managers are required to have:❖ a bachelor’s degree in psychology or related field
❖ at least one year of psychiatric care managing in residential facility
❖ the ability to prioritize information and tasks
Case managers must:❖ be a legal resident of the United States❖ have valid drivers license ❖ be CPR and first aid certified ❖ be proficient in Microsoft Office
Preferred requirements:❖ Bi-lingual in Spanish
Training Needs and Development
PLAN STRATEGY
DATA COLLECTION
DATA ANALYSIS
IMPLEMENTATION
EVALUATION, REVIEW,
ASSESSMENT
Training Needs and Development
❖ Cultural Competency➢ Understanding religious and cultural beliefs
of patients➢ Strengthening the ability to work with
employees of all backgrounds❖ Employee Development
➢ Leadership Training ➢ CEUs
New Hire Orientation
❖Mission, Vision and Values❖History of Fulton State Hospital❖Benefits❖Computer Access, Security and Internet Use❖HIPAA, Incident Reporting and Grievances❖EEO and Diversity❖Disciplinary Process ❖Staff recognition
Mission, Vision and Values
❖ Mental illness affects many people and their families
❖ Every individual is worth helping❖ Everyone should be given hope that they can
excel in life❖ We partner with the individual, the families, and
the community❖ Recovery is the ultimate goal
Our prime purpose in this life is to help others. And if you can't help them, at least don't hurt them.
~Dalai Lama
History of Fulton
❖ Opened in 1851❖ At one time housed over 5000 patients, census is
currently 340
❖ Treating seriously mentally ill people
❖ Nationally known evidence-based programming for our patients
❖ SMART program—crisis management program developed by our staff
Benefits
❖ Work hours vary by department/hospital needs.
❖ Probationary period lasts 6 months, but can be extended
❖ 12 holidays per year (comp-time is earned if working)
❖ Employees earn 10 hours of vacation and sick time every month
Benefits Continued
❖ 3 types of health insurance options➢ HMO with smaller monthly premium but higher
deductible ($600)➢ HMO with higher monthly premium but higher
deductible ($300)➢ High-Deductible Health Plan (very small monthly
premium, but large deductible ($1500)❖ Flexible Spending Account❖ Dental and Eye insurance at an additional cost❖ Life insurance
Computer Access, Security and Internet Use
❖ Computer Access➢ Everyone needs at least email access, this is an
important tool in the communication process at the facility
❖ Security➢ This is a highly secured environment➢ Contraband and weapons take many different forms
❖ Internet use➢ Employees have access to the internet (email doesn’t
work without it)➢ Internet use must be business related
HIPAA, Incident Reporting and Grievances
❖ Health Insurance Portability and Accountability Act➢ Privacy is very important to our patients and their
families❖ Incident Reporting
➢ Incident reporting allows the facility to collect data on safety and security in the hospital.
❖ Grievances ➢ Grievances are about employees (if you think a
supervisor is treating you unfairly, another employee is rude or harassing you, or complaints about work conditions)
Disciplinary Process
❖ Written Reprimand is the first step in the disciplinary process
❖ Unacceptable Conduct Notice is the second step
❖ Suspension is the third step❖ Dismissal is the final step❖ Union and arbitration rights
Security
❖ This is a highly secure environment
❖ Contraband comes in many different forms. Here are a few examples:
➢ Compact mirrors
➢ Some combs
➢ Certain pens and notebooks
➢ And most importantly, cell phones!
❖ Weapons take many different forms, vigilance and critical thinking are key
Staff Recognition
❖ Employee of the month (small monetary reward and parking space)
❖ Employee of the year (monetary reward)❖ Department and discipline recognition (shirts,
cups, pens, celebrations)❖ Years of Service Awards❖ “Seen Doing Good” Awards❖ Recognition Hotline
Performance Management
A systematic process by which an agency involves its employees, as individuals and members of a
group, in improving organizational effectiveness in the accomplishment of agency
mission and goals.
PlanningMonitoring
DevelopingRating
Rewarding
Job Performance Data
Data collected from employee performance is typically used for:
❖ administrative decisions (e.g. promotions, raises)❖ developmental purposes❖ to help an employee recognize strength and
weaknesses
Never mistake activity with accomplishment. ~ John
Wooden
Employee Performance Plan
A performance plan is created with 1 to 3 elements defined by federal regulations.
Critical Element ❖ required in a performance plan❖ a duty of great importance that directly affects
performance rating and summary level❖ a responsibility which the employee is expected to have
control over
Employee Performance Plan
Non-Critical Element
Additional Performance Element
❖ optional❖ a dimension of
performance that is important but not of such importance that one would fail if the standard is not met
❖ it is used to give a summary level
❖ optional❖ a dimension of
performance that’s important but doesn’t affect the summary level
PassageP❖ Passage of the Patient Protection and Affordable Care Act (“Obamacare”)
❖ Competition for positions and/or employees❖ Economic uncertainty❖ Becoming more goal and results oriented;
playing role in organizational strategic planning
❖ Utilization of software as a service❖ Changes in recruitment processes
Trends Affecting HR at Fulton
❖ Implementation of PPACA and expanded Medicaid coverage
❖ Increased training and planning❖ Staff recruitment and retention❖ Technology advances❖ Economic uncertainty
ReferencesAppone. (2013). Audit Inpatient Mental Health Worker/Case Manager. Retrieved from https://www.appone.com/maininforeq.asp?Ad=171995&R_ID=758092&Refer=http://www.indeed.com/q-Inpatient-Mental-Health-Counselor-jobs.html&B_ID=44
Brown, J. (n.d.). Employee orientation: keeping new employees on board! Retrieved from http://ipma-hr.org/sites/default/files/pdf/hrcenter/Employee%20Orientation/cpr_eo_Overview.pdf.
Fried, B. J. & Fottler, M. D. (2011). Fundamentals of Human Resources in Healthcare. Chicago, IL: Health Administration Press
Industry Resource Articles (n.d.). HR Trends in Health Care Companies. Retrieved from http://www.unicornhro.com/articles/hr-trends-in-health-care-companies
Missouri Department of Mental Health (DMH) (2014). Fulton State Hospital. Retrieved from
http://dmh.mo.gov/fulton/Office of Personnel Management. (n.d.). Performance Management Overview and History. Retrieved from
Office of Minority Health. (2013). What is cultural competency? Retrieved from http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=11
Parker, F. (2007) Ethics Column: "The Power of One" OJIN: Online Journal of Issues in Nursing. Vol. 13, No. 1. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Ethics/Power.html
World Health Organization. (n.d.). Mental Health Policy and Service Guidance Package: Human Resources and Training in Mental Health. Retrieved from http://www.who.int/mental_health/policy/Training_in_Mental_Health.pdf
