The ethical issues, in this case, is the Medicaid waiver agency trying to buy out a client by providing a personal care attendant to cover for the behavioral services that were billed but not provided.
It shows that the Medicaid waiver agency is acting irresponsibly by not offering the services the client require and balancing it out with others to avoid a legal implication (Bailey & Burch, 2016).
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I think the best way is reporting the Medicaid waiver agency to a higher health department. The resources available in the health department will make sure that the agency takes responsibility for its actions by providing any services a client requires and not replacing it with others.
There are several stakeholders in this case. There is the client who received a different service other than the one they required desperately. The personal care attendant will verify the other service provided instead of the order (Bailey & Burch, 2016). I will act as a stakeholder as I witnessed the case where the family did not get the services they needed desperately.
Before I decide to report the case, I will talk with the management at the Medicaid waiver agency and establish why they did not offer the services the client required (Bailey & Burch, 2016). Maybe there is a good reason that the services would not be provided at that time. I would also ask if it would be possible for the Medicaid waiver agency to provide the needed services and also ensure that the family does not lose the personal care attendant.
If I report Medicaid waiver agency to a higher authority, chances of hurting the reputation of the business will be high. Medicaid waiver agency may also be required to withdraw the services of the personal care attendant, yet the family feels that the best services were offered.
The ethical decisions would be thus talking about the issues with the Medicaid waiver agency and the family for the reasons for not providing the urgent services to be explained. I would also ask the agency to always communicate to a client when they will not offer certain services, instead of balancing it out with a different service.
Reference
Bailey, J. S., & Burch, M. R. (2016). Ethics for behavior analysts (3rd ed.). New York, NY: Routledge.
