How to Handle a Licensing Board Complaint

Course excerpt from Therapy Tidbits – May/June 2017

Investigation Notice Not Cause for Panic –

Investigation Notice Not Cause for Panic Every state regulates the practice of psychology. The simplest regulation is that state licensing is required to call oneself a psychologist. A person may have a PhD or a PsyD, but unless the person has a license or works for an educational institution, he or she is not a psychologist.

With a state license comes board oversight to police unprofessional practices. The purpose of a licensing board is to assure that the public is not harmed.

A psychologist is considerably more likely to receive a board complaint than be sued. The reason is that in order to bring a suit there has to be a demonstrable cause of action, proof of damage to the person who wants to sue and a lawyer who is willing to take the case. It is much easier to file a complaint with the state licensing board.

Most complaints arise out of an outcome that makes the complainant feel wronged and filing a complaint is a means to validate that feeling. That does not make that person right, only angry.

The receipt of a complaint can cause anxiety in the psychologist for many reasons. Significant is the fact that most practitioners take the complaint personally and can’t see the motivation of the complainant, only that they intended to provide quality care. In reality most complaints are dismissed at the investigatory stage and there is no official record that they were even filed.

State boards deal with complaints in three phases. The opening phase is the investigatory stage. This is usually the first notice the practitioner has of a problem. A written response and a copy of the chart being sent to the board is required.

If the board thinks it is warranted, the next phase will be a formal inquiry. This can entail testimony and experts to support the complaint about the care provided. Depending on the state, this may take place at a board hearing or in front of an administrative law judge.

Some states employ another step after the administrative law judge with a formal hearing in front of the board. This process can be time consuming and expensive. This doesn’t even include an appeal to the state judicial system.

As almost all malpractice insurance policies provide some coverage for state board complaints, the first thing a policyholder should do is contact the insurance carrier. Insurers are a source of advice and, if needed, a referral to an attorney who is familiar with the complaint process. It is not advisable to try to face the board alone. Even if the complaint is frivolous, the board must take it seriously.

Many psychologists have tried self-representation and found themselves with some sort of sanction that now has to be explained. Additionally, a lot of boards invite the psychologist to sign a consent agreement to put the matter to rest. This may seem innocuous and a quick and easy means to end the matter, but it means that the practitioner has agreed that he or she has done something wrong.

With this agreement, the complainant can now sue and be fairly assured of winning. So it is very important that the practitioner understand his or her malpractice insurance coverage and feel free to contact the carrier if notified a complaint has been filed.

As with most aspects of claims against psychologists, a lot of board complaints arise out of the fractioning of a family unit – such as in a divorce – and the subsequent intervention of a psychologist. It is not unusual for a “custody evaluator” to be named in a complaint. This is the only way to bring an action against a court-appointed individual. Immunity from litigation will protect against a lawsuit but it won’t stop a board from investigating.

Most states have passed laws that allow regulatory agencies access to patient charts. There is even an exception in HIPPA that allows this. That means the board will be looking at the notes that document a course of treatment. They will be making decisions about the psychologist’s career based upon that documentation. This is another example of where the “less is more” theory of note taking breaks down.

The usual risk management strategies apply. As always, your notes are your main defense. Failure to have them just means you will have another problem. In fact, notes are the only way to survive a board complaint.

State boards are consumer protection organizations. They are there to protect the public from allegedly unqualified practitioners. It is important to recognize that a proper defense comes from a clear and documented clinical process.

So as practicing psychologists, protect yourselves by documenting your treatment of patients. If you receive notice of a complaint, don’t panic. Contact your insurance carrier and follow the advice you will be given.

By Eric. C Marine – vice president of claims and risk management for the American Professional Agency Inc. He has more than 35 years involved in the insurance claims business and more than 20 years in all facets of professional liability claims. He writes and speaks nationally on the subject.

Therapy Tidbits – May/June 2017Therapy Tidbits – May/June 2017 is a 1-hour online continuing education (CE) course that covers a variety of therapy topics in a succinct and reader-friendly format.

The articles included in this course are:

  • Advocates in Field of Aging Hear Strong Call to Action – Highlights focus points of the ASA conference in March: critical social and political issues affecting older Americans and how the ASA is urging member support to protect them.
  • Cost-Containment Restricts Treatment for PTSD – A warzone PsyD is told her patient is receiving, “entirely too much treatment,” after reimbursement allowances by insurers fall substantially.
  • Hoffman Report Triggers Defamation Suit Against APA – Plaintiffs damaged by Hoffman Report claim bias and “blind-following” in case brought against him and numerous others alleged to be complicit in defaming.
  • Investigation Notice Not Cause for Panic – Illuminates steps you can take to prepare yourself and your practice, now and ahead of time, for the inevitable complaint.
  • Proponent of Internet Tests Contends They Eliminate Bias – Explores how the “human factor” can play a significant role in candidate deception.
  • Psychologists Best to Assess Concussions, Gender Effects – Discusses the importance of including the discipline of psychology when addressing the complex effects of concussions.
  • Brain Hacking: Tech Companies Hijack Your Attention – Focuses on the modern compulsion to keep tabs on our electronic communications and social media as well as tactics to combat such distractions.
  • Duty to Warn: Don’t Get Distracted by Legal Cases – Evaluates that laws may change, but the focus of “duty to warn” stays the same.
  • MMPI-2 Book is Excellent Reference Text – Promotes the many benefits of using the MMPI-2 as a resource material for psychology-based professions.


Course #11-10 | 2017 | 16 pages | 10 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Medicare Payments to Focus on Value not Volume

By Paula Hartman-Stein, PhD

Psychologists will have a two-year reprieve from reporting quality measures for Medicare patients beginning January 2017, according to the Center for Medicare and Medicaid Services (CMS). The Physician Quality Reporting System (PQRS) that began in 2007 is being phased out in December. Although that may be a relief to those who opposed it, psychologists will also not be eligible to receive bonuses under the new system until 2021.

“Medicare is going through significant changes,” said Acting CMS Administrator Andy Slavitt during a May conference call for providers, adding, “We lived in fear of payment reduction from the Sustainable Growth Rate (SGR) but will its replacement be a better place?”

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), legislation that passed with bi-partisan support, repeals the SGR formula that calculated payment cuts for all providers. MACRA creates a new framework for rewarding clinicians for providing higher quality care by establishing two tracks for payment, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

MIPS ScoringAccording to Slavitt, CMS released a proposed rule about the new quality performance system that is based on three principles: making the work for providers more patient-centric to support patient needs and coordinate services; more practice driven, allowing providers to select measures most appropriate for their population, and simpler to reduce duplication.

The Merit-based Incentive Payment System (MIPS) consolidates three existing quality reporting programs: PQRS, the Value-Based Payment Modifier (VBPM) and meaningful use (MU). The system also adds a new program, clinical practice improvement activities (CPIA).

MIPS is designed to change the payment structure away from volume to value as Medicare moves away from traditional fee-for-service. The four components of MIPS will determine an overall composite performance score from 1 to 100, with differing weights assigned to the factors. The components are quality (worth 50 percent), resource use (10 percent), clinical practice improvement activities (15 percent) and advancing care information (25 percent).

MIPS will impact reimbursement by assessing providers on each of the categories and assigning an overall score. Physicians whose scores fall below a predetermined threshold will receive a penalty up to 4 percent and those with scores above the threshold will be awarded a bonus up to 9 percent in 2019 based on their performance in 2017. Psychologists can begin to participate in 2019.

Exemptions from MIPS include clinicians in their first year of billing Medicare and providers whose volume of Medicare payments is less than $10,000 in claims per year and provide services to 100 or fewer Medicare patients. The bonuses may go up to 12 percent if large numbers of providers are penalized, according to CMS. Because the adjustments and bonuses are made in a budget neutral manner the money for the bonuses comes from those who are penalized.

Specific requirements for psychologists and other non-physician groups have yet to be determined. CMS encouraged psychologists to volunteer to participate in 2017 to get a head start on what will be required in the future.

The official comment period about the MIPS proposed rule ended June 27. “Psychologists should understand that if they do not report any measures under MIPS, once they become eligible they will end up with a very low composite score and should expect to see significant reductions in their Medicare payments,” according to an Information Alert from Doug Walter, associate executive director for Government Relations for the APA’s Practice Organization.

Read more in Therapy Tidbits – July/August 2016, a 1-hour online continuing education (CE) course that discusses a variety of psychotherapy topics.

Paula Hartman-Stein, PhD, a clinical psychologist, consultant, and Medicare correspondent for The National Psychologist newspaper, was the Chair of the first psychology and social work Expert Work Group to develop quality measures. Currently she serves on the expert panel for the Elder Maltreatment screen. Dr. Hartman-Stein graduated from Kent State University and obtained the interdisciplinary geriatric clinical development award through Case Western University. For over 20 years she has worked at the Center for Healthy Aging, a private practice in Kent, Ohio. A prolific writer, she has two edited books, Innovative Behavioral Healthcare for Older Adults (1998) and Enhancing Cognitive Fitness in Adults (2011), numerous book chapters and refereed publications on healthy aging and psychology practice issues, and over 100 news articles.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for this program and its content. Professional Development Resources is also approved by the Florida Board of Psychology and the Office of School Psychology and is CE Broker compliant (#50-1635).

 

Online Continuing Education Course Sale

By Professional Development Resources

Save on online continuing education (CE/CEU) courses when they’re on sale! New monthly specials are available now @ www.pdresources.org.

Online CE Course Sale

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

Unusual Paraphilias – New Online CE Course

By: Louis R. Franzini, PhD

Unusual Paraphilias is a new 1-hour online continuing education (CE/CEU) course that describes a number of paraphilias and specific fetishes, which are generally quite rare but still fascinating…

Unusual ParaphiliasA paraphilia involves stimulating sexual arousal in someone by an object or fantasy that for most people is commonplace and not sexually related, either directly or symbolically. What you will learn in this course is that there is a clear continuum of unusualness for paraphilias. There are some familiar ones and there are also very many paraphilias reported in the clinical literature which are indeed extremely unusual. This course will include discussions of the eight standard Paraphilic Disorders included in the DSM-5: 1) Voyeuristic Disorder, 2) Exhibitionistic Disorder, 3) Frotteuristic Disorder, 4) Sexual Masochism Disorder, 5) Sexual Sadism Disorder, 6) Pedophilic Disorder, 7) Fetishistic Disorder, and 8) Transvestic Disorders, as well as a number of additional paraphilias and specific fetishes, which are generally quite rare. Course #10-85 | 2015 | 15 pages | 6 posttest questions

Click here to enroll!

This online course provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account after purchasing) and mark your answers on while reading the course document. Then submit online when ready to receive credit.

ABOUT THE AUTHOR:

Louis R. Franzini, PhD, received his B.S. degree in Psychology from the University of Pittsburgh, his M.A. degree in Clinical Psychology at the University of Toledo, and his Ph.D. in Clinical Psychology from the University of Pittsburgh. He then completed a Postdoctoral Fellowship in Behavior Modification at the State University of New York at Stony Brook (now Stony Brook University). Following the postdoctoral program Dr. Franzini joined the Psychology Department at San Diego State University, where he spent his entire academic career. He retired as Emeritus Professor of Psychology. His international academic experience included appointments as Distinguished Professor of Psychology at the Universite Catholique de Louvain, Louvain-le-Neuve, Belgium and Senior Fellow in the School of Accountancy and Business, Human Resource and Quality Management Division at Nanyang Technological University, Singapore. Dr. Franzini is licensed as a psychologist in Florida and in California.

CE INFORMATION:

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

Related Articles:

Cultural Formulation Interview

By NAMI and APA

cultural competence in healthcarePsychiatric and mental health in America has not succeeded at engaging people diagnosed with mental illness in their own care and empowering them and their families to become true partners with their providers. Misunderstandings and miscommunications can lead to dissatisfaction with treatment and sometimes even discontinuation. But when the whole of a person is taken into account, not only is the person likely to stay in treatment, they are likely to have a greater chance of recovery.

The APA is offering the Cultural Formulation Interview (CFI), including the Informant Version, and the Supplementary Modules to the Core Cultural Formulation Interview for further research and clinical evaluation. They should be used in research and clinical settings as potentially useful tools to enhance clinical understanding and decision-making and not as the sole basis for making a clinical diagnosis. Additional information can be found in DSM-5 in the Section III chapter “Cultural Formulation.” The APA requests that clinicians and researchers provide further data on the usefulness of these cultural formulation interviews at http://www.dsm5.org/Pages/Feedback-Form.aspx.

Online assessment measures, including the CFI, are available @ http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures#Cultural.

The Cultural Formulation Interview (CFI) is a set of 16 questions that clinicians may use to obtain information during a mental health assessment about the impact of culture on key aspects of an individual’s clinical presentation and care.

The goal of the CFI is to lay the foundation for person-centered care and shared decision-making by encouraging clinicians to engage people seeking services and their families, from the very start, in a dialogue about how their cultural identities, values and prior experiences shape their care expectations and goals. But the CFI remains an underdeveloped tool. Clinicians and people living with mental illness need to know that it exists, and to use it to build a new type of partnership, without prejudice or stereotypes. All people diagnosed with mental illness have cultural identities, and our mental health system cannot expect any one of them to leave who they are at the door.

California Psychologist Continuing Education Special

By Gina Ulery

California-licensed psychologists are required to earn 36 hours of continuing education (CE) during each 2-year renewal period. A maximum of 75% (27 hours) are allowed from APA-approved online continuing education courses.

APA-Approved Sponsor

Professional Development Resources,an APA-approved sponsor of online continuing education for psychologists, offers California-licensed psychologists 20% off of all courses (up to 27 hours per renewal allowed) for their license renewal. Over 100 online and video CE courses are available and can be completed online, anytime. Courses are valid for 3 years from purchase date. 20% discount will automatically apply at checkout. If for any reason it doesn’t, enter coupon code PDRPC197 to apply. Coupon expires 12/31/2015.

Laws & Ethics Requirement

Any person renewing or reactivating his or her license shall certify under penalty of perjury to the Board of Psychology as requested on the application for license renewal, that he or she has obtained training in the subject of laws and ethics as they apply to the practice of psychology in California. The training shall include recent changes/updates on the laws and regulations related to the practice of psychology; recent changes/updates in the Ethical Principles of Psychologists and Code of Conduct published by the American Psychological Association; accepted standards of practice; and other applications of laws and ethics as they affect the licensee’s ability to practice psychology with safety to the public.

Under the current regulations, there is no hour requirement or certificate required for Laws & Ethics. Licensees must check a box self-certifying that they have kept abreast of changes to laws (statutes and regulations) and ethics. There is no specified method regarding how the information must be obtained. Licensees can take a continuing education course, review Web sites, participate in grand rounds, etc.

A licensee shall maintain documentation of completion of continuing education requirements for four (4) years following the renewal period, and shall submit verification of completion to the Board upon request.

 

Unusual Psychosexual Syndromes, Part 2: Erotomania & Frottage

By: Louis R. Franzini, PhD

New 2-Hour Online Continuing Education (CE/CEU) Course

Unusual Psychosexual Syndromes, Part 2: Erotomania & FrottageUnusual Psychosexual Syndromes, Part 2: Erotomania & Frottage is a new 2-hour online continuing education (CE/CEU) course that presents two of the most unusual human sexual behavior disorders. Each syndrome is a relatively rare, yet extraordinarily intriguing pattern of behavior. These men and women have fashioned highly unorthodox means of gratifying their basic needs for love and attention. These syndromes are typically ignored or receive only mere mentions in most abnormal psychology textbooks. Yet, these individuals could very well appear in mental health professionals’ practices as inpatients or outpatients. They all have clear forensic implications as well. Erotomania and frottage are presented with a full description of typical symptoms, relevant case histories, brief theoretical descriptions from the psychodynamic and behavioral perspectives, and the recommended treatments according to the best available current knowledge. Course #20-93 | 2014 | 22 pages | 25 posttest questions

This online course provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account after purchasing) and mark your answers on while reading the course document. Then submit online when ready to receive credit.

About the Author:

Louis R. Franzini, PhD, received his B.S. degree in Psychology from the University of Pittsburgh, his M.A. degree in Clinical Psychology at the University of Toledo, and his Ph.D. in Clinical Psychology from the University of Pittsburgh. He then completed a Postdoctoral Fellowship in Behavior Modification at the State University of New York at Stony Brook (now Stony Brook University). Following the postdoctoral program Dr. Franzini joined the Psychology Department at San Diego State University, where he spent his entire academic career. He retired as Emeritus Professor of Psychology. His international academic experience included appointments as Distinguished Professor of Psychology at the Universite Catholique de Louvain, Louvain-le-Neuve, Belgium and Senior Fellow in the School of Accountancy and Business, Human Resource and Quality Management Division at Nanyang Technological University, Singapore. Dr. Franzini is licensed as a psychologist in Florida and in California.

CE Information:

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

Group Work: Developing and Facilitating Groups

By: Amy Burzinski, LISW

Group Work: Developing and Facilitating GroupsGroup Work: Developing and Facilitating Groups is a new 1-hour online video-based continuing education (CE/CEU) course that describes various models of group work and addresses the aspects of group psychotherapy with adolescents that distinguish it from individual therapy, and techniques for identifying and working with difficult behavior. How is adolescent group work different from individual work with youth? What are the advantages? The challenges? This course will address how therapists and group leaders can work with youth who are dealing with negative life experiences to address cognitive change, strength mobilization and developing effective coping techniques. Course #10-83 | 2014 | 70 minute video | 7 posttest questions

This online video streaming course provides instant access to the course video, course handout and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account) and mark your answers on while viewing the video. Then submit online when ready to receive credit.

CE INFORMATION:

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

ABOUT THE AUTHOR:

Amy Burzinski, LISW, is a Licensed Independent Clinical Social Worker. Amy received her Master’s in Social Work from Columbia University in 1989 and has additional training in psychotherapy and psychodrama. Ms. Burzinski has worked in a variety of mental health settings some of which include serving as director of an employee assistance program for the city of New York, coordinator for victims of domestic violence program and a clinician for New York University’s Faculty and Staff Assistance Program.

Pick ANY 3 and 1 is FREE!

By Gina Ulery

New Deal of the Week!

Time to mix things up! Instead of selecting a handful of courses for you, we’ve decided to let YOU choose. Introducing our new deal of the week:

Pick ANY 3 and 1 is FREE!

CE Deal of the Week

Pick any 3 courses and the lowest priced third course is on us! All 3 courses must be purchased together for the free course to be deducted at checkout. Multiple orders and coupons are welcome.

Sale effective Thursday, October 23 through Wednesday, October 29, 2014.
Offer valid on future orders only.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; by the National Board of Certified Counselors (NBCC ACEP #5590); by the Association of Social Work Boards (ASWB Provider #1046, ACE Program); by the American Occupational Therapy Association (AOTA Provider #3159); by the American Speech-Language-Hearing Association (ASHA Provider #AAUM); by the Commission on Dietetic Registration (CDR Provider #PR001); by the California Board of Behavioral Sciences (#PCE1625); by the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), Speech-Language Pathology and Audiology, and Occupational Therapy Practice (#34); by the Ohio Counselor, Social Worker & MFT Board (#RCST100501); by the South Carolina Board of Professional Counselors & MFTs (#193); and by the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).