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
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A Criminal Offense On Your Record Can Prevent You from Obtaining Your License in Florida

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

Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry out any other disciplinary action the court has ordered, you expect the consequences to be over. In many cases, the arrest and offense can even be sealed or expunged so that it is no longer on your record. However, in the case of someone who desires to apply for a license in the health care field or who is already licensed, this is not the end of the consequences you will face.

For healthcare professionals, a criminal charge can mean being disqualified from obtaining a license or losing your license to practice. Conviction of certain criminal offenses may even mean exclusion from being a Medicare provider or termination from the state Medicaid Program, which can also be grounds for revoking your license. Criminal charges against a health professional can have serious and long-lasting consequences.

How Criminal Charges Impact Your Professional License.

Licensing authorities are charged by statute with protecting the general public, not the individuals they regulate. Most state laws regulating health practitioners include criminal convictions as one of the grounds for denial or discipline of a professional license. Some state laws (for example, Florida’s) allow the state licensing authority to impose discipline upon a nolo contendere (no contest) plea or even when adjudication is withheld or deferred by the court.

State regulatory authorities can and do impose discipline based on the facts underlying a conviction, even when the conviction itself is not directly related to the practice of a profession. For example, a conviction for driving under the influence (DUI) or reckless driving may raise the question with the licensing authority of whether the practitioner could be impaired or reckless while providing patient care. The licensing authority will likely investigate these matters and the facts underlying the offense to determine if the practitioner threatens the public.

Therefore, if you have been arrested for DUI, disorderly conduct, assault, or any other misdemeanor, you can anticipate that the state, the Department of Health (DOH), or the Department of Licensing and Regulatory Affairs will start an investigation. You must retain an attorney who can immediately defend your freedom during your criminal case and protect your livelihood during licensing proceedings.

Mandatory Report of Conviction of Felony or Misdemeanor Charge.

In the event of a conviction, this may trigger a required report to the state licensing board within a certain period. Some states only require a report at the time of renewal of the license. Other states require a report within thirty days of the disposition of the offense. Still others, like Florida, may have multiple actions the provider must take in such instances.

For example, certain licensed health professionals in Florida must maintain an online provider profile. Those who must maintain a profile in Florida include medical doctors, podiatrists, nurse practitioners, and chiropractors. State law requires that for any change in the information required on the profile (a conviction, for example), the profile must be updated within fifteen (15) days. In addition, Florida law requires a written report be made to the professional licensing board of any licensed health provider within thirty (30) days of the disposition of the offense.

Suppose you have been arrested and are facing felony or misdemeanor charges. In that case, you must seek the advice and experience of an attorney who can help you and your criminal defense attorney to analyze different outcomes to help protect your license.

Health professionals who have been arrested generally want their criminal cases resolved as quickly and quietly as possible. Unfortunately, they may inadvertently accept a plea arrangement that results in later severe discipline or revocation of their professional license. All health professionals and their criminal defense attorneys should consider the consequences of the practitioner’s license before accepting a plea arrangement and should consult with an experienced health law attorney. Click here to read one of our prior blogs for more information on this. 

Remember, your health profession is probably your only means of support. You must realize that you may need additional legal help from an experienced healthcare attorney to maintain it.

The disciplinary process is often long and extremely costly. The effects of discipline on your license can follow you for the remainder of your career and is publicly available to anyone who cares to look. If you have been arrested, it is strongly recommended that you retain an experienced healthcare attorney who can advise you and your criminal counsel on the effects of a potential outcome on your license.

Contact Health Law Attorneys Experienced in Handling Licensure Matter and Disciplinary Matters.

The Health Law Firm routinely represents physicians, pharmacists, dentists, nurses, mental health counselors, social workers, and other health practitioners in licensure matters. We frequently consult with criminal defense attorneys regarding defense strategies tailored to minimizing criminal sanctions while at the same time preserving the practitioner’s license.

To contact The Health Law Firm, 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 Ave., 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.

KeyWords: Health care license defense representation, professional license legal defense, representation for professional license suspension, reporting physician arrests and convictions, health care license defense attorney, medical license defense attorney, reporting criminal conviction for doctor or health professional, report arrest for physician or health professional, mental health counselor defense lawyer, representation for physician criminal charges, representation for nurse criminal charges, representation for dentist criminal charges, Department of Health (DOH) conviction report, misdemeanor offense physician lawyer, Department of Health (DOH) investigation defense attorney, DOH complaint investigation legal defense representation, DOH defense attorney, legal representation in DOH investigation, representation for license suspension, license revocation attorney, representation for health care professionals, legal representation for administrative hearing, representation for administrative appeals, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law defense attorney, Medicare exclusion defense attorney, Office of Inspector General (OIG) exclusion defense lawyer, legalrepesntatin in Office of Inspector General (OIG) exclusion, Office of the Inspector General (OIG) health care complaint, defense of relinquishment of DEA number, DEA order to show cause (OSC) hearing attorney

“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 |2024-03-14T09:59:13-04:00January 26, 2024|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on A Criminal Offense On Your Record Can Prevent You from Obtaining Your License in Florida
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A Criminal Record Can Prevent You from Obtaining Your License in Florida

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

Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry out any other disciplinary action the court has ordered, you expect the consequences to be over. In many cases, the arrest and offense can even be sealed or expunged so that it is no longer on your record. However, in the case of someone who desires to apply for a license in the health care field or who is already licensed, this is not the end of the consequences you will face.

For healthcare professionals, a criminal charge can mean being disqualified from obtaining a license or losing your license to practice. Conviction of certain criminal offenses may even mean exclusion from being a Medicare provider or termination from the state Medicaid Program, which can also be grounds for revoking your license. Criminal charges against a health professional can have serious and long-lasting consequences.

How Criminal Charges Impact Your Professional License.

Licensing authorities are charged by statute with protecting the general public, not the individuals they regulate. Most state laws regulating health practitioners include criminal convictions as one of the grounds for denial or discipline of a professional license. Some state laws (for example, Florida’s) allow the state licensing authority to impose discipline upon a nolo contendere (no contest) plea or even when adjudication is withheld or deferred by the court.

State regulatory authorities can and do impose discipline based on the facts underlying a conviction, even when the conviction itself is not directly related to the practice of a profession. For example, a conviction for driving under the influence (DUI) or reckless driving may raise the question with the licensing authority of whether the practitioner could be impaired or reckless while providing patient care. The licensing authority will likely investigate these matters and the facts underlying the offense to determine if the practitioner threatens the public.

Therefore, if you have been arrested for DUI, disorderly conduct, assault, or any other misdemeanor, you can anticipate that the state, the Department of Health (DOH), or the Department of Licensing and Regulatory Affairs will start an investigation. You must retain an attorney who can immediately defend your freedom during your criminal case and protect your livelihood during licensing proceedings.

Mandatory Report of Conviction of Felony or Misdemeanor Charge.

In the event of a conviction, this may trigger a required report to the state licensing board within a certain period. Some states only require a report at the time of renewal of the license. Other states require a report within thirty days of the disposition of the offense. Still others, like Florida, may have multiple actions the provider must take in such instances.

For example, certain licensed health professionals in Florida must maintain an online provider profile. Those who must maintain a profile in Florida include medical doctors, podiatrists, nurse practitioners, and chiropractors. State law requires that for any change in the information required on the profile (a conviction, for example), the profile must be updated within fifteen (15) days. In addition, Florida law requires a written report be made to the professional licensing board of any licensed health provider within thirty (30) days of the disposition of the offense.

Suppose you have been arrested and are facing felony or misdemeanor charges. In that case, you must seek the advice and experience of an attorney who can help you and your criminal defense attorney to analyze different outcomes to help protect your license.

Health professionals who have been arrested generally want their criminal cases resolved as quickly and quietly as possible. Unfortunately, they may inadvertently accept a plea arrangement that results in later severe discipline or revocation of their professional license. All health professionals and their criminal defense attorneys should consider the consequences of the practitioner’s license before accepting a plea arrangement and should consult with an experienced health law attorney. Click here to read one of our prior blogs for more information on this. 

Remember, your health profession is probably your only means of support. You must realize that you may need additional legal help from an experienced healthcare attorney to maintain it.

The disciplinary process is often long and extremely costly. The effects of discipline on your license can follow you for the remainder of your career and is publicly available to anyone who cares to look. If you have been arrested, it is strongly recommended that you retain an experienced healthcare attorney who can advise you and your criminal counsel on the effects of a potential outcome on your license.

Contact Health Law Attorneys Experienced in Handling Licensure Matter and Disciplinary Matters.

The Health Law Firm routinely represents physicians, pharmacists, dentists, nurses, mental health counselors, social workers, and other health practitioners in licensure matters. We frequently consult with criminal defense attorneys regarding defense strategies tailored to minimizing criminal sanctions while at the same time preserving the practitioner’s license.

To contact The Health Law Firm, 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 Ave., 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.

KeyWords: Health care license defense representation, professional license legal defense, representation for professional license suspension, reporting physician arrests and convictions, health care license defense attorney, medical license defense attorney, reporting criminal conviction for doctor or health professional, report arrest for physician or health professional, mental health counselor defense lawyer, representation for physician criminal charges, representation for nurse criminal charges, representation for dentist criminal charges, Department of Health (DOH) conviction report, misdemeanor offense physician lawyer, Department of Health (DOH) investigation defense attorney, DOH complaint investigation legal defense representation, DOH defense attorney, legal representation in DOH investigation, representation for license suspension, license revocation attorney, representation for health care professionals, legal representation for administrative hearing, representation for administrative appeals, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law defense attorney, Medicare exclusion defense attorney, Office of Inspector General (OIG) exclusion defense lawyer, legalrepesntatin in Office of Inspector General (OIG) exclusion, Office of the Inspector General (OIG) health care complaint, defense of relinquishment of DEA number, DEA order to show cause (OSC) hearing attorney

“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 |2024-03-14T09:59:14-04:00January 9, 2024|Categories: Massage Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on A Criminal Record Can Prevent You from Obtaining Your License in Florida
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From the archives: A Criminal Offense Can Prevent You from Obtaining Your License in Florida

Previously published on October 14, 2022
Attorney & Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Someone arrested for a criminal offense knows that it can lead to a criminal record that may or may not be on your record for the rest of your life. However, once you pay your fine and carry out any other disciplinary action the court has ordered, you expect the consequences to be over. In many cases, the arrest and offense can even be sealed or expunged so that it is no longer on your record. However, in the case of someone who desires to apply for a license in the health care field or who is already licensed, this is not the end of the consequences you will face.

For healthcare professionals, a criminal charge can mean being disqualified from obtaining a license or losing your license to practice. Conviction of certain criminal offenses may even mean exclusion from being a Medicare provider or termination from the state Medicaid Program, which can also be grounds for revoking your license. Criminal charges against a health professional can have serious and long-lasting consequences.

How Criminal Charges Impact Your Professional License.

Licensing authorities are charged by statute with protecting the general public, not the individuals they regulate. Most state laws regulating health practitioners include criminal convictions as one of the grounds for denial or discipline of a professional license. Some state laws (for example, Florida’s) allow the state licensing authority to impose discipline upon a nolo contendere (no contest) plea or even when adjudication is withheld or deferred by the court.

State regulatory authorities can and do impose discipline based on the facts underlying a conviction, even when the conviction itself is not directly related to the practice of a profession. For example, a conviction for driving under the influence (DUI) or reckless driving may raise the question with the licensing authority of whether the practitioner could be impaired or reckless while providing patient care. The licensing authority will likely investigate these matters and the facts underlying the offense to determine if the practitioner threatens the public.

Therefore, if you have been arrested for DUI, disorderly conduct, assault, or any other misdemeanor, you can anticipate that the state, the Department of Health (DOH), or the Department of Licensing and Regulatory Affairs will start an investigation. You must retain an attorney who can immediately defend your freedom during your criminal case and protect your livelihood during licensing proceedings.

Mandatory Report of Conviction of Felony or Misdemeanor Charge.

In the event of a conviction, this may trigger a required report to the state licensing board within a certain period. Some states only require a report at the time of renewal of the license. Other states require a report within thirty days of the disposition of the offense. Still others, like Florida, may have multiple actions the provider must take in such instances.

For example, certain licensed health professionals in Florida must maintain an online provider profile. Those who must maintain a profile in Florida include medical doctors, podiatrists, nurse practitioners, and chiropractors. State law requires that for any change in the information required on the profile (a conviction, for example), the profile must be updated within fifteen (15) days. In addition, Florida law requires a written report be made to the professional licensing board of any licensed health provider within thirty (30) days of the disposition of the offense.

Suppose you have been arrested and are facing felony or misdemeanor charges. In that case, you must seek the advice and experience of an attorney who can help you and your criminal defense attorney to analyze different outcomes to help protect your license.

Health professionals who have been arrested generally want their criminal cases resolved as quickly and quietly as possible. Unfortunately, they may inadvertently accept a plea arrangement that results in later severe discipline or revocation of their professional license. All health professionals and their criminal defense attorneys should consider the consequences of the practitioner’s license before accepting a plea arrangement and should consult with an experienced health law attorney. Click here to read one of our prior blogs for more information on this. 

Remember, your health profession is probably your only means of support. You must realize that you may need additional legal help from an experienced healthcare attorney to maintain it.

The disciplinary process is often long and extremely costly. The effects of discipline on your license can follow you for the remainder of your career and is publicly available to anyone who cares to look. If you have been arrested, it is strongly recommended that you retain an experienced healthcare attorney who can advise you and your criminal counsel on the effects of a potential outcome on your license.

Contact Health Law Attorneys Experienced in Handling Licensure Matter and Disciplinary Matters.

The Health Law Firm routinely represents physicians, pharmacists, dentists, nurses, mental health counselors, social workers, and other health practitioners in licensure matters. We frequently consult with criminal defense attorneys regarding defense strategies tailored to minimizing criminal sanctions while at the same time preserving the practitioner’s license.

To contact The Health Law Firm, 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 Ave., 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.

KeyWords: Health care license defense representation, professional license legal defense, representation for professional license suspension, reporting physician arrests and convictions, health care license defense attorney, medical license defense attorney, reporting criminal conviction for doctor or health professional, report arrest for physician or health professional, mental health counselor defense lawyer, representation for physician criminal charges, representation for nurse criminal charges, representation for dentist criminal charges, Department of Health (DOH) conviction report, misdemeanor offense physician lawyer, Department of Health (DOH) investigation defense attorney, DOH complaint investigation legal defense representation, DOH defense attorney, legal representation in DOH investigation, representation for license suspension, license revocation attorney, representation for health care professionals, legal representation for administrative hearing, representation for administrative appeals, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law defense attorney, Medicare exclusion defense attorney, Office of Inspector General (OIG) exclusion defense lawyer, legalrepesntatin in Office of Inspector General (OIG) exclusion, Office of the Inspector General (OIG) health care complaint, defense of relinquishment of DEA number, DEA order to show cause (OSC) hearing attorney

“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 |2024-03-14T09:59:14-04:00January 8, 2024|Categories: Marijuana Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |1 Comment
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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
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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
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Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

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 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them 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 |2024-03-14T09:59:17-04:00October 23, 2023|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)
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Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

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 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them 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 |2024-03-14T09:59:19-04:00September 21, 2023|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)
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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
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Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients.  These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc.  Often these individuals need to remember that if they apply for a job with a new employer or are working for a large corporation or the government, they are subject to employer-ordered drug screenings.  Most problems arise when the professional has applied to a hospital or a placement agency for work in a hospital and they must submit to a pre-employment drug test.
The client often contends that the result is a false positive and that some other substance must be responsible for it.

A positive result for any drug for which you do not have a valid prescription from a physician, including marijuana, will cause you to be eliminated from consideration for a new job or terminated from a current position and a complaint against your professional license, which could cause you to lose it.  We are routinely called on to defend such situations.

Series of Blogs to Discuss Substances that Can Mimic Prohibited Drugs on Drug Tests.

In the years I have been doing this, I have encountered many cases in which other substances have caused a positive result for a prohibited substance on a drug screening test.

In this series of blogs, I intend to discuss some of the substances scientifically shown to cause false positives on employer-ordered drug screening tests.  This is the first in the series.

Over-the-Counter Medications Mimicking Amphetamines on Drug Tests.

Following is a discussion of substances that can cause a false positive for amphetamines on a urinalysis drug test.  This material comes from an article in Case Reports in Psychiatry published in 2013. (Ref. 1)
Many prescription pharmaceuticals and over-the-counter (OTC) medications have been previously reported in the literature to cause a false-positive result for amphetamines on urine drug screens. Many OTC medications have been reported in scientific literature to produce false positives for amphetamines on urine drug screenings, chiefly antihistamines.

The OTC medications that have been documented to and are well known as causing false positives for amphetamines on drug tests include nasal decongestants, Vicks inhaler, MDMA (3,4-Methylenedioxy methamphetamine;  commonly known as ecstacy, molly, mandy or X), and pseudoephedrine.  (Refs. 1-5)  Some of these are prohibited medications that cannot be prescribed and are only available as “street drugs” such as MDMA.

Prescription Medications Documented as Mimicking Amphetamines.

Prescription medications known to have mimicked amphetamines on testing include antipsychotics and antidepressants.  (Refs. 1 & 2)
The prescription medications known to cause false-positive amphetamine urine drug screen include fluoxetine, selegiline, ranitidine, trazodone, nefazodone, brompheniramine, phenylpropanolamine, chlorpromazine, promethazine, ephedrine, methamphetamine, and labetalol.  (Refs. 2-5)  However, the fact that the individual taking the drug test might have a prescription for one of these might cause the employer to disqualify the employee or potential employee from consideration for the job.
Bupropion (an atypical antidepressant that inhibits norepinephrine and dopamine re-uptake), is a drug used to treat depression and smoking cessation, but may also be used off-label to treat ADHD.  It has also been documented as causing false positive results for amphetamines on drug screenings.  (Ref. 6)
The drug atomoxetine has metabolites that are similar to those of amphetamines (phenylpropan-1-amine verses phenyl-propan-2-amine).  This could also result in a false positive on a urine drug screen.  (Ref. 1)

 

Other Discussions in Future Blogs.

In future blogs, I intend to discuss false positive claims associated with use of ibuprofen, amoxicillin, coca leaf tea, poppy seeds and other common substances and medications.  Stay tuned.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

References:

1. Fenderson JL, Stratton AN, Domingo JS, Matthews GO, Tan CD. Amphetamine positive urine toxicology screen secondary to atomoxetine. Case Rep Psychiatry. 2013;2013:381261. doi: 10.1155/2013/381261. Epub 2013 Jan 30. PMID: 23424703; PMCID: PMC3570929.
(Accessed on May 20, 2023.)
2. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010 Aug 15;67(16):1344-50. doi: 10.2146/ajhp090477. PMID: 20689123.
3. Vincent EC, Zebelman A, Goodwin C, Stephens MM. Clinical inquiries. What common substances can cause false positives on urine screens for drugs of abuse? J Fam Pract. 2006 Oct;55(10):893-4, 897. PMID: 17014756.
4. Rapuri SB, Ramaswamy S, Madaan V, Rasimas JJ, Krahn LE. ‘Weed’ out false-positive urine drug screens. Current Psychiatry. 2006;5(8):107–110. [Google Scholar]
5. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc. 2008 Jan;83(1):66-76. doi: 10.4065/83.1.66. Erratum in: Mayo Clin Proc. 2008 Jul;83(7):851. PMID: 18174009.
6. Reidy L, Walls HC, Steele BW. Crossreactivity of bupropion metabolite with enzyme-linked immunosorbent assays designed to detect amphetamine in urine. Ther Drug Monit. 2011 Jun;33(3):366-8. doi: 10.1097/FTD.0b013e3182126d08. PMID: 21436763.

 

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 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them 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 |2024-03-14T09:59:22-04:00August 23, 2023|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)
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“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A.
The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.
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