3.5 Who’s Really the Boss?
By now you may be wondering who is actually in charge of human services agencies, whether they are private or public. Public agency employees in Oregon are responsible to be in compliance with the following entities:
- federal and state laws
- Oregon Administrative Rules (OARs)
- all applicable (statewide) policies of the Oregon Department of Administrative Services (DAS)
- the central administrative agency of Oregon state government
- all applicable ODHS or OHA (agency) policies, processes or procedures
- provisions of collective bargaining agreements (for represented employees) (State of Oregon, 2022)
That is a lot of regulatory oversight! Private agency employees are not immune from oversight, as they too must comply with federal and state laws and OARs. They also are responsible to comply with agency policies and accreditation regulations. It is easy to understand why a service user experiences delays in services when the systems created to serve them get bogged down with the bureaucracy designed to keep the service user safe. However just because it can be explained, that doesn’t mean it is acceptable to delay services due to red tape, and by understanding a little about who governs what can help explain the process and improve it.
3.5.1 Regulatory Requirements
For an agency to provide services they must acquire permission to work with humans. For public agencies, that authority is given by the legislature, and for private agencies they must apply for a license and in some cases, become accredited by regulatory organization, such as Joint Commission on Accredited Health Organizations (JCAHO), Commission on Accreditation of Rehabilitation Facilities (CARF), or Council on Accreditation (COA) and demonstrate compliance with applicable laws, statutes, and regulations. Let’s break those down.
3.5.1.1 Law, statutes, and regulations
Laws are defined as a rule, usually made by a government, that is used to order the way in which a society behaves. Laws can be federal, state, or local, and follow a strict hierarchy of authority. Agencies must comply with the most restrictive law when writing policies. Laws are cumulative and are in effect until a new law is passed or the law is repealed. Statutes are also laws, but are not cumulative and have been developed by a governing body such as a city council, state legislature, or national legislature.
Regulations have the next level of authority and are generally developed within an act the legislature passes. Acts, such as the Civil Rights Act, are time limited and need to be renewed, which means that regulations, unlike laws, are also time limited and subject to renewal.
Oregon Administrative Rules (OARs) are developed by the public agency, board, or commission to explain how to implement the ORSs (Oregon Revised Statutes) they oversee. Private agencies must be familiar with all laws and regulations to ensure they have written the correct policies and procedures and are implementing them appropriately. Depending on their license, private agencies are monitored and reviewed by a public agency every 1–2 years. Failure to be in compliance with all laws and regulations can result in the loss of licensure and in ability to continue to provide services. Knowing your agency’s policies and procedures
3.5.1.2 Accreditation
Some agencies add another layer of regulations by becoming certified or accredited. The accreditation process requires the agency to rigorously assess themselves using a very detailed checklist. The benefits of accreditation include increased reputation, more thorough strategic planning, increased accountability, and help ensuring compliance with federal and state laws. Also, having an external review gives an agency a different perspective into the quality of their services, paperwork, and processes. Some grants and other funding streams require an agency to be accredited to apply for funding, and some states make accreditation as part of their licensing requirements.
3.5.2 Getting the Most from the Board of Directors
The last level of external structure and monitoring is the agency’s board of directors (BOD). BODs come in many sizes and can have a variety of roles to the agency. Some BODs are active and get involved in the day-to-day functioning while others are passive and only communicate with the senior leadership. The purpose of a BOD is to provide oversight, prevent fraud, and ensure agency monies, policies, and procedures are ethical and legal. Board members can be held personally liable if they fail to provide an agency with oversight.
In general, BODs have three primary duties; duty of care, duty of loyalty, and duty of obedience. Duty of care requires BODs to review agency incorporation documents, such as the article and bylaws, and update them regularly. Duty of loyalty requires members to act in the best interest of the agency and avoid conflict of interests where the member would experience personal gain. For example, if a member were a real estate agent, they could advise the agency on a real estate purchase, but could not be the listing or selling agent. The final duty is obedience and that is in reference to ensuring the agency is not operating outside of the scope of service as defined by the agency’s rules, policies, and bylaws (Kester & Miller, n.d.).
Board members serve for a variety of reasons. For some, it is a leadership opportunity where they can grow their skills outside of their current employment. Others find networking with other board members and increasing their knowledge of a new organization to be enough, while others are motivated to make a difference beyond donating money to a good cause. They desire to be part of the solution for a human problem.
Here are some questions about regulatory bodies that you as an intern might find helpful include:
- Does the agency hold any certifications or accreditations?
- How does the agency stay current on changing laws and regulations?
- What is the board of directors’ role in the agency?
- Have you ever attended a board meeting?
- What licenses does the agency hold?
- When is the next licensing audit?
Understanding the regulatory requirements can often offer a deeper understanding of the whys and hows of service provision.
3.5.3 Licenses and Attributions for Who’s Really the Boss
“Who’s Really the Boss” by Sally Guyer MSW is licensed under CC BY 4.0.