Follow These Simple Rules To Keep Your License & Avoid Complaints If You Are a Counselor or Psychotherapists

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

I represent many mental health counselors, social workers, psychologists, and professional counselors, defending them on complaints being investigated against their professional licenses. Many complaints and investigations arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing these cases, I have drawn up a list of a few simple “bright line” rules that can help save you many hours of stress and mental anguish as well as thousands of dollars in attorney’s fees and costs defending yourself

These “rules” may seem to be common sense, but there they are, anyway:

1. DO NOT ever meet the client at an outside social activity or attend a social event with the client. This includes “just dinner” or “just-drinks.”

2. DO NOT text the client. Texting is not secure and leads to casual and unprofessional thinking and conversation with the client. Many health care institutions prohibit their physicians and employees from texting with clients because of the HIPAA Security and Privacy Rules. You can use that as an excuse if you need one.

3. DO take a screenshot and print out the text when you violate the above rule. Place it in the client’s health record because you will probably be seeing it again, attached to a complaint.

4. DO send an e-mail or, better yet, a professional letter to the client, instead of texting the client. Print out a copy and place it in the client’s health record, because you will probably see it again.

5. DO NOT EVER make any suggestive or sexual remarks to the client in any communications, oral or written or text, or e-mail. In fact, DON’T even think about it. This includes off-color jokes and comments.

6. DO immediately terminate the relationship with the client, transferring care to a different therapist, if the client suggests anything of a sexual nature involving you.

7. DO NOT talk about other clients with the client.

8. DO NOT talk about your own personal life with the client. Especially DO NOT let the client have your personal home address or personal e-mail address.

9. DO NOT ever have sex with a client or former client. DO NOT even think of it. If you start to think of it, see Rule 6, above. Consider clients and former clients “off-limits” no matter how much you are tempted. If you are religious, just consider this as an attempt by Satan to seduce you. If it works, you are going to be in Hell, even before you die.

10. DO know what professional boundaries are and DO NOT cross them. This includes allowing a personal relationship to grow between you and the client, and includes selling anything to the client (e.g., Girl Scout cookies, tickets to a charitable event, Amway products, candy bars for your kids’ school band, etc.), agreeing to meet the client at any outside event, accepting gifts from the client, hiring the client to work for you, accepting “voluntary” services from the client (including volunteering to work in your office). If you need a friend that bad, terminate the therapist-client relationship and see Rule 6, above.

11. DO know that if you have even a suspicion that your therapist-client relationship is getting out of bounds, then it already is out of bounds. See Rule 6, above.

12. DO call a professional therapist colleague who is more senior to you and consult her or him about the “situation” if you think there may be a “situation.”

These may sound like “no-brainers” to you, but you would be surprised at how many complaints against licensed counselors and psychologists there are as a result of violating one or more of these “rules.”

(Note: These “rules” are just guidelines meant to help you keep out of trouble; these are not meant to be enforced against anyone, nor do they create or represent any “standard of care.”)

For additional information on how our firm can assist you in matters like this, click here to read one of our prior blogs.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:11-04:00February 21, 2024|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Follow These Simple Rules To Keep Your License & Avoid Complaints If You Are a Counselor or Psychotherapists

Tele-behavioral Health: Important Legal Considerations for Mental Health Providers

By Amanda I. Forbes, J.D.

Starting in 2020 and throughout the COVID-19 pandemic, tele-behavioral health services, also known as “e-counseling,” rapidly expanded. Because individuals were quarantined or fearful to venture out, remote mental health care services became very popular among patients. A study published in The Journal of the American Medical Association (JAMA), including 36 million working-age individuals, revealed that tele-health services increased by 766% in the first three months of the pandemic.

Thanks to remote services like tele-behavioral health, the doctor’s “house call” is making a comeback;  but instead of ringing the doorbell, your doctor will be ringing your smartphone.

What is Tele-behavioral Health?

The National Institute of Mental Health defines telebehavioral health as “the use of telecommunications or videoconferencing technology to provide remote mental health services.” Providers can use video conferencing, text messaging, or smartphone apps. Additionally, many different types of behavioral health services are available remotely.
The U.S. Department of Health and Human Services (HHS) says remote visits are a safe and convenient way for mental and behavioral health providers to offer services such as:

1. One-on-one and group therapy
2. Substance abuse counseling
3. Medication management and prescribing
4. Anxiety and depression monitoring
5. Mental health screening
6. Referrals

What Are the Potential Benefits?
Tele-behavioral health services enable clinicians to reach more patients, such as people living in rural areas, working irregular hours, and homebound patients. It removes patient barriers to attending in-person appointments, such as taking time off work, transportation, and arranging childcare.

The Downside to Tele-behavioral Health.

In addition to its convenience, tele-behavioral health also ushers in a new era of risks for treatment providers to be aware of.  It’s particularly true if the counseling occurs via text or a similar instant messaging application. As a licensed mental health care professional, you must know about liability exposures and ways to improve patient safety.
Click here to read about a case study demonstrating the issues that can arise when conducting tele-behavioral health.
When it comes to tele-behavioral health services and technology, there are significant legal considerations to think about.
To make sure you can provide remote counseling effectively while handling the risks that come with it, follow these risk management tips and recommendations:

1. Obtain the necessary training to provide telebehavioral health services. Take continuing education units (CEUs) in tele-behavioral health and retain any certificates of completion associated with those CEUs.

2. Determine whether tele-behavioral health treatment is in the client’s best interest. The provider should consider the following: Can the client effectively use the technology required for tele-behavioral health?  Does the client’s insurance cover telebehavioral health services?  Is the client emotionally and cognitively compatible with this treatment modality?

3. Obtain informed consent from the client.  In addition, document the purpose of the counseling, the use of technology to facilitate the tele-behavioral health services, and confidentiality and privacy. Obtain informed consent by having the client sign a consent form.  Have a document record of the consent process and consent form in the client’s file.

4. Providers must adhere to encryption standards. Some examples are using a secure platform, ensuring that the vendor signs a HIPAA Business Associate Agreement, which is required by HIPAA laws and regulations, and stating the vendor will follow federal privacy requirements.
5. Ensure client confidentiality by advising them of their responsibility to be in a private space during the telebehavioral health session. Document this discussion and include this as part of your agreement with the client.

6. Providers must check their state and third-party requirements related to tele-behavioral health services, credentialing, and licensure. Contact your respective licensing board for additional information and consult a health law attorney if unsure.

To read one of our prior blogs on telehealth services and learn more information on this growing area of practice, click here.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. We also defend health professionals and health facilities in general litigation matters and business litigation matters.
To contact The Health Law Firm, please call (407) 331-6620 or toll-free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Counselor Liability Claim Report: 2nd Edition.”CNA AND HPSO COUNSELOR SPOTLIGHT: Telebehavioral Health”. Healthcare Providers Service Organization (HPSO). (2019). https://www.hpso.com/getmedia/f9369f13-7035-4955-bcb6-9843b9ff44c2/counselor-spotlight-telebehavioral-health.pdf 
Department of Health and Human Services (HHS). “Telehealth and behavioral health”. (July 25, 2023).https://telehealth.hhs.gov/patients/telehealth-and-behavioral-health#:~:text=Telehealth%20is%20a%20safe%20and,a%20long%2Dterm%20treatment%20plan. 
National Institute of Mental Health (NIMH). “What is Telemental Health?” (Accessed on December 12, 223). https://www.nimh.nih.gov/health/publications/what-is-telemental-health 


About the Author:
Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or toll-free: (888) 331-6620.


Attorney Positions with The Health Law Firm.
The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2024 The Health Law Firm. All rights reserved. No part of this work may be reproduced in any fashion in any medium for any purpose without the written permission of the copyright owner.  The copyright owner asserts the right to have its name associated with the use of any part of this work.
By |2024-03-14T09:59:14-04:00January 2, 2024|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Tele-behavioral Health: Important Legal Considerations for Mental Health Providers

Mental Health Counselors and Psychotherapists: Simple Rules for Keeping Your License and Avoiding Complaints

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

I represent many mental health counselors, social workers, psychologists, and professional counselors, defending them on complaints being investigated against their professional licenses. Many complaints and investigations arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing these cases, I have drawn up a list of a few simple “bright line” rules that can help save you many hours of stress and mental anguish as well as thousands of dollars in attorney’s fees and costs defending yourself

These “rules” may seem to be common sense, but there they are, anyway:

1. DO NOT ever meet the client at an outside social activity or attend a social event with the client. This includes “just dinner” or “just-drinks.”

2. DO NOT text the client. Texting is not secure and leads to casual and unprofessional thinking and conversation with the client. Many health care institutions prohibit their physicians and employees from texting with clients because of the HIPAA Security and Privacy Rules. You can use that as an excuse if you need one.

3. DO take a screenshot and print out the text when you violate the above rule. Place it in the client’s health record because you will probably be seeing it again, attached to a complaint.

4. DO send an e-mail or, better yet, a professional letter to the client, instead of texting the client. Print out a copy and place it in the client’s health record, because you will probably see it again.

5. DO NOT EVER make any suggestive or sexual remarks to the client in any communications, oral or written or text, or e-mail. In fact, DON’T even think about it. This includes off-color jokes and comments.

6. DO immediately terminate the relationship with the client, transferring care to a different therapist, if the client suggests anything of a sexual nature involving you.

7. DO NOT talk about other clients with the client.

8. DO NOT talk about your own personal life with the client. Especially DO NOT let the client have your personal home address or personal e-mail address.

9. DO NOT ever have sex with a client or former client. DO NOT even think of it. If you start to think of it, see Rule 6, above. Consider clients and former clients “off-limits” no matter how much you are tempted. If you are religious, just consider this as an attempt by Satan to seduce you. If it works, you are going to be in Hell, even before you die.

10. DO know what professional boundaries are and DO NOT cross them. This includes allowing a personal relationship to grow between you and the client, and includes selling anything to the client (e.g., Girl Scout cookies, tickets to a charitable event, Amway products, candy bars for your kids’ school band, etc.), agreeing to meet the client at any outside event, accepting gifts from the client, hiring the client to work for you, accepting “voluntary” services from the client (including volunteering to work in your office). If you need a friend that bad, terminate the therapist-client relationship and see Rule 6, above.

11. DO know that if you have even a suspicion that your therapist-client relationship is getting out of bounds, then it already is out of bounds. See Rule 6, above.

12. DO call a professional therapist colleague who is more senior to you and consult her or him about the “situation” if you think there may be a “situation.”

These may sound like “no-brainers” to you, but you would be surprised at how many complaints against licensed counselors and psychologists there are as a result of violating one or more of these “rules.”

(Note: These “rules” are just guidelines meant to help you keep out of trouble; these are not meant to be enforced against anyone, nor do they create or represent any “standard of care.”)

For additional information on how our firm can assist you in matters like this, click here to read one of our prior blogs.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:15-04:00December 27, 2023|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Mental Health Counselors and Psychotherapists: Simple Rules for Keeping Your License and Avoiding Complaints

Top 5 Reasons Professional Counselors and Psychotherapists Receive Complaints Against Their Licenses;  What to Do to Prevent It

By Michelle E. Missigman, J.D., Attorney, The Health Law Firm

What is a Licensure Complaint?

A licensure complaint against a professional counselor, mental health counselor, or other psychotherapist is usually initiated by the filing of a complaint with the professional board or other regulatory authority.  Although some states authorize the licensing board to investigate and resolve such complaints, in other states, there may be an “umbrella” agency that receives them and investigates them.  For example, in Florida, the Florida Department of Health (or “DOH”) will receive and investigate complaints. In Colorado, the Division of Regulatory Agencies (or “DORA”). In Washington, D.C., the D.C. Department of Health (or “DC Health”), receives and investigates them.
Regardless, you will receive written notification, usually via U.S. mail, that an investigation has been opened against you.  This is a major reason that you must keep your physical address and e-mail address up to date with all states in which you are licensed and with all certification boards at all times.

Regardless, the appropriate government regulatory authority will open and conduct an investigation into whatever complaint is filed.

What to Do When Notified of an Investigation.

If you are notified that you are under investigation, it is crucial that you immediately obtain an experienced healthcare attorney to represent you and that you notify your professional liability insurer about the complaint.  In most cases, your professional liability insurance will include coverage for defense legal fees involved in defending a case against her license.
It is important that you do not speak with an investigator until you consult with an attorney.  The decision on whether or not to make a statement or respond to questions from the investigator will depend on state law and the circumstances of the case. In some states, there is no obligation to cooperate with such an investigation. This is why it is so important to consult with an experienced attorney first.
When the investigation is completed, you may have the right to obtain a copy of the investigation and/or file a rebuttal to it. Again, this will depend on state law. In Florida, you do have such a right and it is usually crucial to do this. In many cases, a detailed, well-documented rebuttal statement may result in a dismissal of the case.
Ultimately, there will be a screening by the licensure board or a committee of the licensure board. It may make a finding that the complaint is meritless or that there is no probable cause to suspect that an actual offense has been committed. This will usually result in a dismissal of the case would no further action is required.

However, if the licensing authority does find the allegations that launched the investigation to be accurate, it may recommend that formal administrative charges be filed and that disciplinary action be undertaken. At this point, you will have the opportunity for a hearing in order to contest the facts and circumstances surrounding the complaint and to show that you are not guilty of any violations.

Who Can Make a Complaint?

A complaint can be filed against a counselor by a current or former client, a member of a client’s family or social circle, a colleague, a present or past employer, a law enforcement authority, a health insurer, the Medicaid Program, or another regulatory agency.  In effect, a complaint can be filed by anyone. In many instances, the licensing authority will be notified by receiving an arrest record or receiving a newspaper report or other media report. However, most complaints are filed by disgruntled patients and competitors of the psychotherapist.

What Are the Top Reasons that Professional Counselors Receive Complaints?

According to a national professional liability insurance company that insures psychotherapists,
the following are the most frequent grounds for licensing board complaints against counselors:
1. Sexual Misconduct,
2. Failure to Maintain Minimal Professional Standards,
3. Breach of Confidentiality,
4. Reporting to Third Parties, and
5. Failure to Practice Within Boundaries of Competence.

Source:  Healthcare Providers Insurance Organization (HPSO) Counselor Liability Claim Report.

How Can I Avoid Receiving Discipline from my Licensing Board?

As the average number of complaints against psychotherapists continues to rise, it is imperative that counselors document their clinical case notes appropriately and keep their client relationships professional at all times.  When the boundaries between counselor and client begin breaking down, it becomes impossible to tell what information the counselor should document and/or keep confidential.
Not having a record of client interaction places the counselor in a difficult position should they receive a board complaint.  Without documentation of the counselor’s decision-making based on what the client did or said, the counselor will have no record to support them during an investigation.  It becomes a case of the counselor’s word against the word of a disgruntled client.  Properly maintaining clinical case notes is not only a crucial part of the counselor’s obligation to their client, but it also serves as crucial supporting evidence during a board investigation.

For more information on how our firm can help defend you and your mental health counselor’s license, click here to read one of our prior blogs.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: Michelle E. Missigman is an attorney at The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.


Attorney Positions with The Health Law Firm.
The Health Law Firm always seeks qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2024-03-14T09:59:16-04:00November 20, 2023|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Top 5 Reasons Professional Counselors and Psychotherapists Receive Complaints Against Their Licenses;  What to Do to Prevent It

The Do’s and Don’ts If You Are Under Investigation For Discipline on Your Professional License, Part 2

Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

You are reading Part 2 of this blog series. To read Part 1, click here.

If you are notified that you are under investigation, DO NOT take the easy way out by immediately relinquishing your license. And DO NOT hide your head in the sand by thinking the case will just go away on its own. DO NOT think that you can just talk to the investigator, explain your side, and the case will go away. Also, DO NOT request an informal hearing or agree to a settlement agreement (consent order) in which you admit the facts alleged against you are all true.  If you do this you are, in effect, “pleading guilty.” If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

DO immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  These attorneys are out there, but you may have to search for one.  Do this before you talk to or make any statement (oral or written) to an investigator.

DO purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not.  This insurance is cheap and will provide you with needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  However, beware of the insurance policy that only covers professional license defense related to a malpractice claim.

DO NOT count on your employer to provide this type of insurance for you. In fact, most of such complaints against your license may well be filed by your employer or ex-employer.

If you are a traveling nurse or other contract or temporary type of health professional, always purchase your own insurance.

Our Advice On Professional Liability Insurance.

We strongly encourage nurses, mental health counselors, and all licensed health professionals and facilities to purchase independent insurance coverage.  Make sure it covers professional license complaint defense expenses under all circumstances.

Also, make sure you have enough coverage to actually get you through a hearing. For example, $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase;   $50,000 may be adequate, but $75,000 or $100,000 may be what you need in such a situation.  You can usually buy the higher limits for a few dollars more (and I do mean only a few). If necessary, such insurance is usually cheap enough that you can actually purchase two or more different policies.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you. We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have dealt with in the past which provide an inexpensive quality insurance product for professional license defense costs include CPH & Associates Insurance, Nurses Service Organization (NSO) insurance, Healthcare Providers Organization (HPSO) Insurance, and Lloyd’s of London Insurance.

To learn more, visit our Video Q&A section on our website and watch our video titled, “Should I voluntarily relinquish my professional license because I am being investigated?” and visit our YouTube page.

Click here to read one of our prior blogs for even more information on how to fight back against adverse NPBD reports.

Don’t forget to read part one of this blog series here!

Contact Health Law Attorneys Experienced with Investigations of Healthcare Professionals.

The attorneys of The Health Law Firm provide legal representation to medical professionals in Department of Health (DOH) investigations, licensing matters and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

Additional Negative Consequences for Discipline on Your Professional License, Part 1 of 2

Attorney and Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Do you have a medical, pharmacist, counselor, or nursing license in more than one state?  Do you have a license in more than one profession?  Have you been notified that an investigation has been opened against your professional license?  Are you thinking about resigning your professional license or voluntarily relinquishing (giving up) your license?  Then you should be aware of some important facts you may not have known.

First, you should never voluntarily relinquish or resign your professional license after you know that an investigation has been opened or that disciplinary action has been taken against you.  A resignation is considered to be a “disciplinary relinquishment” and is treated the same as if your license had been revoked on disciplinary grounds.

Second, this will be reported to other states, professional agencies, the National Practitioner Data Bank (NPDB), and to any certifying bodies for certifications you have. It will also be reported to other national professional bodies (such as the National Council of State Boards of Nursing, the National Association of Boards of Pharmacy, or the American Board of Internal Medicine).  Other states and other professional boards will most likely initiate disciplinary action based on the report of the first one.

Protect Your License from These Types of Adverse Actions.

Following is a list of some of the adverse actions you can expect to be taken after discipline on your license (or if you give up your license after receiving notice of investigation):

1. A mandatory report to the National Practitioner Data Base (NPDB) which remains there for 50 years. Note: The Healthcare Integrity and Protection Data Bank HIPDB have now merged into the NPDB.

2. The action must be reported to and included in the Department of Health (DOH) profile that is available to the public online (for those having one) and remains for at least ten years.

3. Any other states or jurisdictions in which the professional has a license will also initiate an investigation and possible disciplinary action against him or her in that jurisdiction.  (Note:  I have had two clients who had licenses in seven or more other states; even states where the license was no longer active initiated action).

4. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) will take action to exclude the provider from the Medicare Program.  If this occurs (and many of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the HHS OIG.

a.  Note that if this happens, you are prohibited by law from working in any position in any capacity for any individual or business, including hospitals, nursing homes, home health agencies, physicians, medical groups, insurance companies, etc., that contract with or bill Medicare or Medicaid.  This means, for example, you are prohibited from working as a janitor in a nursing home that accepts Medicare or Medicaid, even as an independent contractor.

b.  Also, if this happens, you are also automatically “debarred” or prohibited from participating in any capacity in any federal contracting, and you are placed on the U.S. General Services Administration’s (GSA) debarment list.  This means you are prohibited by law from working in any capacity for any government contractor or anyone who takes government funding.  This applies, for example, to prevent you from being a real estate agent involved in selling property financed by a government-backed loan, prohibited from working for an electrical company that bids on contracts for government housing projects, working as a school teacher in a public school, etc.

c.  Additionally, if this happens, your state is required to terminate you “for cause” from the state Medicaid Program.  In many states, this will also be an additional ground for revocation of your license.

5. Any profile or reporting system maintained by a national organization or federation (e.g., NURSYS profile maintained by the National Council of State Boards of Nursing, American Medical Association physician profile, or the Federation of State Board of Physical Therapy profile) will include the adverse action in it, generally available to the public.

6. If you are a nurse practitioner or other professional with clinical privileges at a hospital, nursing home, HMO, or clinic, action will be taken to revoke or suspend the clinical privileges and staff members if you have such. This may be in a hospital, ambulatory surgical center, skilled nursing facility, staff model HMO, or clinic.  This will usually be for physicians, physician assistants (PAs), advanced registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), nurse midwives, or certified nurse anesthetists (CNAs), podiatrists, clinical psychologists or clinical pharmacists.

7. Third-party payors (health insurance companies, HMOs, etc.) will terminate the professional’s contract or panel membership with that organization.

8. The U.S. Drug Enforcement Administration (DEA) will act to revoke the professional’s DEA registration if he or she has one.

9. Many employers will not hire you or will terminate your employment if they discover your license has been disciplined in another state.

What Should and Shouldn’t You Do?

If you find yourself notified that you are under investigation, don’t take the easy way out by immediately relinquishing your license. Don’t hide your head in the sand by thinking the case will just go away on its own. Do not request an informal hearing or a settlement agreement in which you admit the facts alleged against you are all true.  If you do this, you are “pleading guilty.” If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

Do immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  They are out there, but you may have to search for one.  Do this as soon as you get notice of any investigation and especially before you have talked to or made any statement (including a written one) to any investigator.

Do purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not.  This insurance is cheap and will provide needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  Beware of the insurance policy that only covers professional license defense if it is related to a malpractice claim.

Professional Liability Insurance.

We strongly encourage all licensed health professionals and facilities to purchase their own, independent insurance coverage.  Make sure it covers professional license defense under all circumstances.  Make sure you have enough coverage to actually get you through a hearing. $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase;  $50,000 may be adequate but $75,000 or $100,000 may be what you really need in such a situation.  For a few dollars more (and I do mean only a few) you can usually purchase the higher limits.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you.

We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have encountered in the past that provide an inexpensive top quality insurance product for professional license defense costs include CPH & Associates Insurance, Nurses Service Organization (NSO) insurance, Healthcare Providers Organization (HPSO) Insurance, and Lloyd’s of London Insurance.

To learn more, visit our Video Q&A section on our website and watch our video titled, “Should I voluntarily relinquish my professional license because I am being investigated?” Additionally, click here to read one of our prior blogs for even more information on how to fight back against adverse NPBD reports.

Contact Health Law Attorneys Experienced with Investigations of Healthcare Professionals.

The attorneys of The Health Law Firm provide legal representation to medical professionals in Department of Health (DOH) investigations, licensing matters, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:18-04:00October 5, 2023|Categories: Dental Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Additional Negative Consequences for Discipline on Your Professional License, Part 1 of 2

Mental Health Counselors: Follow These Rules To Prevent Complaints and Keep Your Professional License

Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Licensed mental health counselors, psychologists, and other mental health care professionals are potential targets of licensure complaints from clients in any practice setting. Many legal situations and cases arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing the many disciplinary complaints and lawsuits I have handled, I have put together a list of simple “straightforward” rules. Following these rules can help save you many hours of stress and mental anguish and thousands of dollars in attorney’s fees and costs defending yourself.

These rules may appear to be so simple you would classify them as “common sense.” But you would be surprised at how often they are violated by even the best, most conscientious counselors.

These “Rules” May Seem Common Sense, But You Might Be Surprised:

1. DO NOT ever meet the client at an outside social activity or attend a social event with the client. These events include things like “just dinner” or “drinks.” Keep it professional.

2. DO NOT text the client. Texting is not secure and leads to casual and unprofessional thinking and conversations with the client. Many health care institutions prohibit their physicians and employees from texting with clients because of the HIPAA Security and Privacy Rules. You can use that as an excuse if you need it.

3. DO send an e-mail or a professional letter to the client instead of texting. Print out a copy and place it in the client’s health record because you will probably see it again.

4. DO NOT EVER make any suggestive or sexual remarks to the client in any communications, oral or written, text or e-mail. DON’T even think about it. This includes off-color jokes and comments.

5. DO immediately terminate the relationship with the client, transferring care to a different therapist, if the client suggests anything of a sexual nature involving you.

6. DO NOT talk about other clients with the client.

7. DO NOT talk about your personal life with the client. Especially DO NOT let the client have your private home address or personal e-mail address. Note that you can have your personal address excluded from most public licensing sites and directories.

8. DO NOT ever have a sexual relationship with a client or former client. Consider clients and former clients “off-limits.” See Rule 5 above

9. DO know what professional boundaries are and NEVER cross them. This includes allowing a personal relationship to grow between you and the client, selling anything to the client (e.g., Girl Scout cookies, candy bars for your kids’ school band, tickets to charity events, washing powder, plastic sealable containers, etc.).

10. DO know if you have a suspicion that your therapist-client relationship is getting out of bounds; it probably already is. See Rule 5, above.

11. DO call a more senior professional colleague to you and consult them about the “situation” if you think there is one.

These may sound like “no-brainers” to you, but you would be surprised at how many complaints against licensed mental health counselors and psychologists there are because of violating one or more of these “simple rules.”

(Note: These “rules” are merely guidelines meant to help you keep out of trouble; these are not rules meant to be enforced on anyone, nor are they meant to create or represent any “standard of care.”)

For additional information on how our firm can assist you in matters like this, click here to read one of our prior blogs.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

 

By |2024-03-14T09:59:21-04:00September 10, 2023|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Mental Health Counselors: Follow These Rules To Prevent Complaints and Keep Your Professional License

Mental Health Counselors and Psychotherapists: Follow These Simple Rules for Keeping Your License and Avoiding Complaints

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

I represent many mental health counselors, social workers, psychologists, and professional counselors, defending them on complaints being investigated against their professional licenses. Many complaints and investigations arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing these cases, I have drawn up a list of a few simple “bright line” rules that can help save you many hours of stress and mental anguish as well as thousands of dollars in attorney’s fees and costs defending yourself

These “rules” may seem to be common sense, but there they are, anyway:

1. DO NOT ever meet the client at an outside social activity or attend a social event with the client. This includes “just dinner” or “just-drinks.”

2. DO NOT text the client. Texting is not secure and leads to casual and unprofessional thinking and conversation with the client. Many health care institutions prohibit their physicians and employees from texting with clients because of the HIPAA Security and Privacy Rules. You can use that as an excuse if you need one.

3. DO take a screenshot and print out the text when you violate the above rule. Place it in the client’s health record because you will probably be seeing it again, attached to a complaint.

4. DO send an e-mail or, better yet, a professional letter to the client, instead of texting the client. Print out a copy and place it in the client’s health record, because you will probably see it again.

5. DO NOT EVER make any suggestive or sexual remarks to the client in any communications, oral or written or text, or e-mail. In fact, DON’T even think about it. This includes off-color jokes and comments.

6. DO immediately terminate the relationship with the client, transferring care to a different therapist, if the client suggests anything of a sexual nature involving you.

7. DO NOT talk about other clients with the client.

8. DO NOT talk about your own personal life with the client. Especially DO NOT let the client have your personal home address or personal e-mail address.

9. DO NOT ever have sex with a client or former client. DO NOT even think of it. If you start to think of it, see Rule 6, above. Consider clients and former clients “off-limits” no matter how much you are tempted. If you are religious, just consider this as an attempt by Satan to seduce you. If it works, you are going to be in Hell, even before you die.

10. DO know what professional boundaries are and DO NOT cross them. This includes allowing a personal relationship to grow between you and the client, and includes selling anything to the client (e.g., Girl Scout cookies, tickets to a charitable event, Amway products, candy bars for your kids’ school band, etc.), agreeing to meet the client at any outside event, accepting gifts from the client, hiring the client to work for you, accepting “voluntary” services from the client (including volunteering to work in your office). If you need a friend that bad, terminate the therapist-client relationship and see Rule 6, above.

11. DO know that if you have even a suspicion that your therapist-client relationship is getting out of bounds, then it already is out of bounds. See Rule 6, above.

12. DO call a professional therapist colleague who is more senior to you and consult her or him about the “situation” if you think there may be a “situation.”

These may sound like “no-brainers” to you, but you would be surprised at how many complaints against licensed counselors and psychologists there are as a result of violating one or more of these “rules.”

(Note: These “rules” are just guidelines meant to help you keep out of trouble; these are not meant to be enforced against anyone, nor do they create or represent any “standard of care.”)

For additional information on how our firm can assist you in matters like this, click here to read one of our prior blogs.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:39-04:00May 21, 2021|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Mental Health Counselors and Psychotherapists: Follow These Simple Rules for Keeping Your License and Avoiding Complaints
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