CCM Ethics, Advocacy, & Legal Issues 2 — Questions and Answers
Question 1: A case manager discovers that a client's family member has been making financial decisions without the client's consent. Which legal concept is most relevant to this situation?
- Informed consent
- Elder financial abuse (Correct answer)
- Therapeutic privilege
- Beneficence
Correct answer: Elder financial abuse
Unauthorized financial decision-making by a family member constitutes elder financial abuse, a reportable legal violation.
Question 2: Under HIPAA, which of the following is a permitted disclosure of protected health information WITHOUT patient authorization?
- Sharing records with the patient's employer
- Disclosing to a marketing firm for outreach
- Reporting to public health authorities for disease surveillance (Correct answer)
- Sending records to a family member for convenience
Correct answer: Reporting to public health authorities for disease surveillance
HIPAA permits disclosure to public health authorities for surveillance, investigation, and prevention of communicable diseases without patient authorization.
Question 3: A client with moderate dementia refuses a recommended medication. The case manager should FIRST:
- Override the refusal and administer the medication
- Assess the client's decision-making capacity (Correct answer)
- Immediately seek a court-appointed guardian
- Document the refusal and take no further action
Correct answer: Assess the client's decision-making capacity
Assessing decision-making capacity is the first step before determining the appropriate course of action regarding a refusal.
Question 4: The ethical principle of JUSTICE in case management is best demonstrated by:
- Ensuring a client receives all possible treatments regardless of cost
- Allocating scarce resources fairly and equitably across a client population (Correct answer)
- Telling clients only what they need to know to comply with treatment
- Prioritizing the wishes of the healthcare team over the client
Correct answer: Allocating scarce resources fairly and equitably across a client population
Justice requires fair and equitable distribution of resources and services across populations without discrimination.
Question 5: A case manager is pressured by a supervisor to deny a medically necessary service to reduce costs. The MOST appropriate response is to:
- Comply with the supervisor to maintain employment
- Advocate for the client and escalate through proper channels (Correct answer)
- Immediately report the supervisor to state licensing boards
- Discharge the client to avoid the conflict
Correct answer: Advocate for the client and escalate through proper channels
Case managers are ethically obligated to advocate for clients and use internal escalation channels when client rights are at risk.
Question 6: Which document specifically designates another person to make healthcare decisions on a patient's behalf if the patient becomes incapacitated?
- Living will
- DNR order
- Durable power of attorney for healthcare (Correct answer)
- POLST form
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare (healthcare proxy) designates a specific individual to make medical decisions when the patient cannot.
Question 7: A case manager who fails to report suspected child abuse in a state with mandatory reporting laws may face:
- Only internal disciplinary action
- Civil and criminal liability (Correct answer)
- Loss of CCM certification only
- No consequence if abuse is not confirmed
Correct answer: Civil and criminal liability
Failure to report suspected child abuse as a mandated reporter can result in both civil and criminal penalties under state law.
CCM Ethics, Advocacy, & Legal Issues 2
A case manager discovers that a client's family member has been making financial decisions without the client's consent.
Which legal concept is most relevant to this situation?