Question

You are the executive director of a small publicly funded behavioral health agency that serves indigent clients. After 10 years of being able to serve all clients seeking help, your agency has just received a 20% budget cut and must prioritize which services to discontinue and which clients to turn away. The community has many suggestions: stop serving undocumented immigrants and their children; stop serving substance abuse clients, limit all clients to six sessions, discontinue providing expensive services like psychiatry, lay off professional counselors and hire non-licensed paraprofessionals, stop providing counseling and instead simply offer peer self-help groups and parenting classes, serve only the most seriously ill (or the least seriously ill), and serve only children. How would you approach the difficult task of cutting services by 20% in a manner that reflects your ethical obligations as a community counselor? Would your plan differ if you were in a private sector? If yes, how? What criteria would you consider? What theoretical or standard of care practice will you follow to make a final decision about what to cut from your program? Reference the ACA and/or NAADAC Code of Ethics to support your answer.

Answer 1

It would be morally and ethically bankrupt to give priority to the ones who can afford and the ones who cannot.

The most conducive manner in which the problem could be tackled could be limiting the sessions to 6 and then recommending the clients to other psychiatrists pr psychologists for further assistance.

The standard of care would not be jeopardized and the customer health would not be held at arms length.

According to Naadac code of ethics it is rudimentary engage in non discriminatory practices and to see to one's responsibility as a community counselor.