1. The Most Important Piece: Integrity & Standard of Conduct
David Way MAIS, CHC
2. What Drives Us to do the RIGHT Thing
Effective ethicsand compliance programs
are key factors in achieving a culture of
integrity
within your Community Center.
3. ETHICS
• Ethics is about doing the right
thing, every time.
• Ethical Behavior is rooted in values
by which people live their lives,
not the regulations
• Compliance is about following the
rules.
COMPLIANCE
Compliance & Ethics
What is the Difference?
Ethics and compliance are different
from each other, and both are
critical to our organization’s
success
MUST HAVE BOTH
4. • Focusing training
and establishing
procedures that
clearly articulate
your
organizations
ethics shapes
peoples
behaviors.
• Quality is a
vitally important
measure of
compliance. If
people want and
strive to do their
best excellence
will be the by
product.
• Compliance will
happen.
The Continuum
A natural progression to compliance.
5. Standards and Procedures
• The pathway to create a culture of
integrity is to communicate to
employees the standards and
procedures to which they should
adhere. Organizations were urged to
develop and distribute these standards
and to further communicate their high
importance. Today, these standards are
commonly called an organization’s
Code of Conduct. They are the
expression of expected behaviors, and
often become a key element in the
evaluation of employees.
6. Education and Training
• Crucial to a company’s ability to create a
culture of integrity is to communicate to
employees the standards and procedures
to which they should adhere. You are
urged to develop and distribute these
standards and to further communicate
their high importance. Today, these
standards are commonly called an
organization’s Code of Conduct. They are
the expression of expected behaviors, and
often become a key element in the
evaluation of employees.
7. Risk Based Training
Is your training relevant?
• From a design perspective, training is
often created in an utterly wholesale
manner, so that, for instance, case
managers, those in finance and senior
managers are all being given the same
compliance training even though their
risks and responsibilities differ
significantly. Perhaps worse, from a
deployment perspective, training is
often disconnected from risk-causing
events or other contexts in which C&E
messages could be more effectively
conveyed.
8. Auditing and Monitoring
• Organizations should employ a means to
audit and monitor internal systems and
verify compliance. Many monitoring
practices can be used, but regular audits
performed by either an internal or
external auditors are recommended.
These audits should focus on all Center
divisions, specifically relationships with
third-party contractors and compliance in
relationship to laws governing kickback
arrangements, false claims act, financial
and accounting procedures, and
Medicare, Medicaid, and other federal
health care programs.
9. Reporting
• To empower every employee as a
member of the compliance team,
organizations should create a reporting
mechanism for employees to voice
allegations or concerns without fear of
retaliation. This standard has, of course,
grown into an even stricter guideline with
introduction of the Sarbanes-Oxley Act of
2002 that governs publicly traded
companies. Today, many organizations
utilize unbiased third-party vendors who
offer anonymous telephone and Web site
reporting for allegations of fraud,
misconduct, and noncompliance.
10. Enforcement and Discipline
• To set up these rules and standards there
must be consequences and those
consequences should be levied
consistently regardless of the employee’s
stature within the organization. The
Sentencing Guidelines state specifically
that enforcement should be consistent
with appropriate disciplinary action.
• Use your Standard of Conduct as focal
point.
11. Response and Prevention
• Finally, the organization must respond.
Even with standards and procedures in
place and an avenue for employees to
voice concerns, progression and
improvement will not occur unless the
organization responds to the offense and
continues to make concerted efforts
toward preventing similar conduct.
12. Practical Approaches
• Education must be relevant and, yes, exciting.
• CEU program
• Rewards/recognition
• Monthly Focus…Commitment, Stewardship etc.
• What is the role; case manager, accountant, volunteer?
• What are you doing?
Innovative education
13. Practical Approaches
• Incentives help drive behavior!
• There is certainly controversy regarding
incentives…BUT
• The Federal Sentencing Guidelines 2004 revisions state
• (6) The organization’s compliance and ethics program
shall be promoted and enforced consistently throughout
the organization through (A) appropriate incentives to
perform in accordance with the compliance and ethics
program. USSG section 8B1.2 (b)(6)
Using Incentives
14. Practical Approaches
• People should not be rewarded for doing their jobs
• How can you possibly evaluate someone’s virtue or
ethics
• The area is too subjective
• Incentives can be used against the organization
• Does this put the compliance profession in the role of human
resources?
Objections to incentives
15. Practical Approaches
• The United States Government tells us to use them.
• The Working Group on Bribery of the Organization for Economic
Cooperation and Development, representing 38 nations issued
the “Good Practice Guidance” listing 12 elements
• (9) appropriate measures to encourage and provide positive support for
the observance of ethics and compliance programs or measures against
foreign bribery, at all levels of the company;
Reasons for Using Incentives
16. Practical Approaches
• Peter Drucker
• [C]hanging habits and behavior requires changing recognitions and
rewards. People in organizations, we have known for a century, tend to
act in response to being recognized and rewarded—everything else is
preaching…The moment they realize that the organization rewards for
the right behavior they will accept it.
Reasons for Using Incentives
17. Practical Approaches
• Incentivizing
• Personnel Evaluations
• Uses the code of conduct
• Actively takes steps to implement the compliance program and the code of
conduct
• What else?
• Input on Promotions
• The reverse: Sentencing guidelines for item 3, goes on
to state that companies need to avoid promoting
people who have engaged…in conduct inconsistent
with an effective compliance and ethics program.
Putting it all together
