Core Functions and Shifting the Risk

Avoiding Malpractice: Tips for Social Workers to Manage Risk

Social Worker Core Functions and Shifting the Risk

Social Work is a profession and academic discipline that improves the quality of life and well-being of individuals, groups, and communities by direct practice, policy development, organizing communities and outreach, and crisis intervention. Social workers undergo demanding educational requirements. Formal and robust training, and adhere to governmental regulatory requirements, HIPAA, and state licensing requirements. The purpose of all of this action is to help people and society in general.

Popple and Leighninger in Social Work, Social Welfare, American Society; Boston: Allyn & Bacon, 2011, list seven core functions that the social worker profession draws from in human development and the reconciliation of the complexity of interactions between human beings and their environment. These seven core functions include:

  1. Engagement,
  2. Assessment,
  3. Planning,
  4. Implementation,
  5. Monitoring/Evaluation,
  6. Supportive Counseling, and
  7. Graduated Disengagement.

As always, the NASW supports its social worker members in many ways. NASW Assurance Services augments this support with practical solutions and insurance protection. Let’s take a look at the Popple and Leighninger framework in the context of shifting risk to your insurance carrier.

  1. Engagement: “The social worker must first engage the client in early meetings to promote a collaborative relationship.” This is where malpractice liability exposure, cyber liability exposure, and general liability exposure begin the social worker’s risk exposure. The social worker must buy insurance coverage to protect against risks. Examples of risk elements include proper practice techniques, documentation creation and protection, client records management and retention, and even accidents in the workplace.
  2. Assessment: “Data must be gathered that will guide and direct a plan of action to help the client.” This is a particularly important core function from an insurance perspective. When information is documented, these records become client records subject to recent HIPAA legislation, that holds the social worker liable for breach by third parties. Also, these client records become subject to potential and eventual subpoenas and related social worker depositions. What the social worker says in writing and verbally can be used against the social worker in licensing board inquiries and in court. Even how the client records are stored on-premises, or with a third party, or even moved by a third party is relevant. Risks increase exponentially.

    This is a very serious matter. For example, in 2013, Congress added third party breach liability to HIPAA, specifically HIPAA HITECH 45 CFR part 160 which holds social workers liable for a third-party data breach. Violation of this law has civil penalties up to $25,000 for accidental breach by the social worker’s records management company provider or even a mover hired to relocate the social worker’s office or files. Criminal penalties range up to 10 years in jail and $250,000 in fines.

  3. Planning: “Negotiate and formulate an action plan.”

  4. Implementation: “Promote resource acquisition and enhance role performance.”

  5. Monitor/Evaluation: “On-going documentation through short-term goal attainment of the extent to which client is following through.”

  6. Supportive Counseling: “Affirming, challenging, encouraging, informing, and exploring options.”

  7. Graduated Disengagement: “Seeking to replace the social worker with a naturally occurring resource.”

Core functions 3 through 6 require thorough and careful records management combined with proper practice conduct. NASW Assurance Services provides regularly offered Risk Management Seminars throughout the U.S. available to both NASW members, and to non-NASW members which share best practices and how best to engage clients and application of practice methods.

NASW Assurance Services offers free access to the NASW Assurance Services Help Line specifically designed for NASW Assurance Services customer insureds only. This Help Line engages with risk advisors and lawyers nationally for immediate assistance regarding practice matters and potential insurance claims. There is no cost to the NASW Assurance Services insured customers since they are policyholders of one of the NASW Risk Retention Group’s insurance policies such as Professional Liability, General Liability, or Cyber Liability.

Regarding point #7, the “Graduated Disengagement” of a client, there are several best practices steps discussed in the NASW Assurance Services Risk Management Seminars that are best practices to follow. When terminating a client, insurance liability claims regarding that the client may surface many years after the treatment is terminated. Client records must continue to be guarded securely and liability insurance maintained.

There is no doubt that social work is a noble profession with implicit values of service, social justice, human dignity, integrity, and clinical competence. Despite all of the sincere devotion provided by social workers, they need to be protected by shifting risks to insurance plans, such as the endorsed series of NASW ASI insurance plans that are owned and controlled by social workers.

Published April 2015

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