Informed Consent and Recordkeeping

Write a 750-1,000-word paper on community wellness and mental health care recordkeeping and documentation.

For this paper, write from the perspective that you are an administrator (Director, Executive Director) in the field. Provide a thoughtful response to each of the following three sections, including SPECIFIC concrete examples to illustrate your ideas. Use the section headings provided below to separate each section of your paper.

Your final deliverable should be one cohesive paper addressing all three sections along with an “introduction and conclusion.”

Use the HIPAA websites provided in your topic materials folder and use two more resources that you have researched for a minimum of four resources (student only access is attached in PDF)

HIPAA Privacy Rights site.
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html

HIPAA Individuals site.
https://www.hhs.gov/hipaa/for-individuals/index.html

HIPAA for Professionals, from the HHS.gov website (2017).
https://www.hhs.gov/hipaa/for-professionals/index.html#:~:text=HIPAA%20for%20Professionals.%20This%20Rule%20set%20national%20standards,who%20conduct%20the%20standard%20health%20care%20transactions%20electronically

Mental Health Bill of Rights, from the Healthy Place website (2009).
https://www.healthyplace.com/other-info/psychiatric-disorder-definitions/mental-health-bill-of-rights

Informed Consent FAQs, from HHS.gov website.
https://www.hhs.gov/ohrp/regulations-and-policy/guidance/faq/informed-consent/index.html

Closed Medical Records Reviews: TJC Survey Feedback, by Barrins & Associates Consulting (2018).
https://barrins-assoc.com/tjc-cms-blog/hospitals/closed-medical-records-reviews-tjc-survey-feedback/

HIPAA Compliance Tips for Behavioral Health Professionals, from Briefings on HIPAA (2019): PDF attached

HIPAA Compliance a Concern as Working from Home Becomes Norm, from Healthcare Risk Management (2020): PDF attached

Section 1: Client Rights and Informed Consent
Describe the informed consent process and how it protects client rights. Include the following in this section of your paper:

1. Billing
2. Right to privacy
3. HIPAA compliance
4. Compliance with authority/or oversight requirements for incorporating informed consent into practice

Section 2: Client Record-Keeping
Describe the role of client record-keeping in protecting a client’s right to a professional standard of care.

Section 3: Electronic Medical Records
Explain at least two pros and two cons for an electronic method of client records. Consider the following in this section of your paper:

1. What privacy safeguards are currently in place?
2. What is the ease of access for the client?
3. What support might be needed to assist clients in accessing their medical information via an electronic method?

This assignment uses a rubric. Please review the rubric before beginning the work to become familiar with the expectations for successful completion.

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