OT-ethics issue at mental health clinic - who to report this to?

I work in Dialysis and I have many patients that get meds at reduced rates or free from various programs- usually from drug companies, but sometimes other programs. Most get their initial order delivered to dialysis, and then subsequent ones are delivered to their home provided there has been no adjustment to dose. These are not anything "controlled", but standard Rx meds, and usually a 3 month supply at a time. NEVER are they charged for picking up the medication.
Glad your friend has you to help him.

I can tell you that getting patients on the free medicine lists at the various companies is very difficult for the Doctor/clinic.  There is tons of paperwork.

None of the companies I am familiar with only give out one month at a time- usually 3 mos.

Why doesn't he call first before going to pick up the meds.  The clinic has no control over when the drug companies ship their medications.

Are you sure they don't check for side effects or review the med like pharmacies have to.  It is a great liability to dispense medications.

 

Next time tell him to call first.  I'm glad he is able to get the free meds

Pup

It depends on what state the person lives in. When they first started at the clinic, they should have signed a financial agreement. They are entitled to a copy of that, and any thing else they have signed. usually these financial agreements have to be updated annually. First thing is to make an appointment with the case manager or whoever does the paperwork and have them make sure the finacial agreemetn is current and the person is provided wth a copy.

 

Second thing is to talk to the nurse. while the whole business about getting the drugs delivered to the clinic is legitimate, and having them passed out by a registered "someone with a liscense to dispense medication" is a requirement of federal law under the drug enforement act (like a pharmacist or a nurse or a physicas assistant or a doctor) , perhaps a reasonable conversation with the nurse can help alleviate the problem. The nurse is probably overworked and does not have time really to see the same person twice a month either.

Also she can maybe talk to the psychaitrist, and have the doc write a Rx for a weeks worth of meds that the person fills someplace like Walmart or ??? that sells generics cheap....that way they would have a week "on hand" to tide them over until the second sample came in. Perhaps maybe not this exact solution, but something similar might work in your case.

If that doesn't work, the finacial agreement should have a contact number of someone in charge of county mental health that can act as an arbitrator between the client and the clinic. Either they would have the authority to waive the second fee, or work something out with the nurse to come to a more economical and sensible solution.

While it is true that they can "get away with" those kinds of things like charging for two appointments, it's really not technically  "illegally worng..  My personal opinion is that it is ethically outrageous to be charging that much to people on limited income for any kind of health care....but that is my opinion.

The other thing is, they may bill you for the appointment, but how are they going to collect on it, really?  It will cost them much less money and be in their best intrest time wise to work something out.

The key is to go in there with a level head, perhaps take an advocate wtih them, and  calmly explain the situation to both the nurse, the case manager, the doctor, and if needed, someone at the county who oversees that clinic. They HAVE to provide you with that information, according to federal law, and they HAVE TO have a conflict resolution office offsite.

That being said, any patient at any time has a right to complain to the AMA, (for doctors), the APA orACA (for liscened therapists) or the Board of Nursing or what ever governing body granted a person their liscence.

 

I  am just trying to point out that sometimes the paperwork does not get completed because there are so many people on a person's caseload, and usually it's not done completely on a computer, so hard to track.  Things can and do sometimes slip through the cracks.

Be a polite, assertive and knowledgeable squeaky wheel, and try to work with them a little bit. In the long run it can only help everyone.

 

The place I used to work in California had over 3000 clients and only 12 case managers and one nurse. THat translated to about 300 people for me to see each month....more than ten a day, plus emergency home visits and groups, and crisis calls. Believe me, if I could find a way to save someone from coming in twice a month, it helped a LOT.

And, at the same time, I know horribly insensitve things can and do happen. I am in no way trying t minimize the experience. you describe  The person has every right to be respected and fairly treated. Go back and look at the  financial agreement, and also the consent for treatment. Every person, regardless of county clinics or no, should look at those things. Also the patients rights. Everyone is entitled to a copy and those rights should be respected.   Good luck

One other thing I forgot....the clinics finacial aggreements in my experience are based on income and reported assets...typically from the last year.  Have them make sure that all of that information is coorct, and have them explain the 82.00 a month bind that puts a person in...perhaps there is a different way to calculate what the payment should be....some "set" fees are 41.00 a month, but if it's evaluated on a basis of a finacial statement (like bank statements or some other documentation) it MIGHT be possible to lower the fee if the state or county has a budget for extreme poverty cases or something like that. It's hard to say, because with all the recent (since 2008, 09) cuts to mental health funding, their hands may be tied, but it's worth asking. Several different people. Not everyone went to the same training.....etc).

Also they may be able to refer a person to medicaid or SSI  to start those applications if need be....

You may also want to contact the state's Dept of Mental Health. They are the "overseers" here of mental health depts. He could also check with  your local County Health Dept to see if they have a DMH dept. that can do that. I know ours do and they do not charge them to pick up the meds.