Reporting Suspected Abuse: those reports are highly confidential!

This is a reminder: reports that clinicians make of suspected abuse are highly confidential. Under California law, reports of suspected child abuse and information contained in those reports may only be disclosed to persons or agencies who coordinate the investigation of these reports.

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Should HIPAA matter to clinicians who aren’t covered under HIPAA?

If you aren’t a “covered entity” (the term HIPAA uses to identify healthcare providers under its authority) do you need to care what HIPAA says? In these situations is HIPAA irrelevant? The answer is both “yes” and “no.”

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So You’ve Been Asked to Write a Declaration……

The question of what to do when asked to author or sign a declaration on behalf of a patient is a stressful dilemma for most practitioners. This usually occurs when a patient is in the midst of litigation and the patient or the patient’s attorney believes that a statement from the practitioner would be helpful.

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Psychotherapist-Patient Privilege for Private Sex Offender Treatment?

On February 20th, 2008, the Court of Appeal of the state of California, Second Appellate District, published an opinion in the nature of the psychotherapist-patient privilege for convicted sex offenders undergoing voluntary psychotherapy.

The question the court faced was this: if a convicted sex offender (SO) is required to undergo psychotherapy as a part of his/her parole, and the SO sees a private psychotherapist in addition to the treatment mandated under the terms of his/her parole, does the State of California have the power to compel the parolee to waive his/her right to confidentiality?

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Does Premature Termination Constitute Abandonment?

Most clinicians have encountered multiple situations where a patient attends a limited number of sessions and decides to end the treatment relationship, either by no-showing for successive appointments or by declaring that they wish to end the treatment relationship. This can present some difficulty when we believe that such a termination is inadvisable. Many of us have experienced the tension between respecting the wishes of our patients and not wishing to endorse a plan of action that we feel is clinically contraindicated. Most clinicians have wondered whether there is an appropriate legal and/or ethical course of action to take in such circumstances. Professional licenses represent large investments of time and money, and as such we are understandably wary of any situation that could risk these qualifications.

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What happens when confidential information gets into the wrong hands?

This is a particularly troublesome dilemma and one that most clinicians dread.  We take great care to avoid such a situation, and in the event that a fax or letter gets to the wrong person most clinicians are unsure about whether the unintended recipient has any legal responsibilities to avoid further disclosure.  Another common question is whether unintentional disclosures such as these render the information non-confidential. 

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Those Confidentiality Disclaimers At The End Of Your Email……..

Huge numbers of clinicians have disclaimers at the end of email messages that say something like this:

“The information contained in this email is CONFIDENTIAL. If you have received this message in error or without the express direction of the original author, please notify the sender and delete this email immediately.”

But what does that mean? Should you have one of these disclaimers? And if you do, does it have any effect?

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Supervision vs. Consultation: what you need to know

The following article was authored by myself and A. Steven Frankel, Ph.D., J.D. It appeared in a slightly shorter format in the July/August 2007 issue of The California Psychologist, the newsletter of the California Psychological Association.

In this article we will discuss an oft-overlooked topic: understanding the difference between supervision and consultation.

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Employer, Employee, or Subcontractor: what is your status?

With apologies to Joyce McDougall, this is a plea for a measure of formality:

Are you an employee or a subcontractor? Do you have employees or subcontractors working for you? How do you know? Sometimes the job title doesn’t match the responsibilities, and when that happens confusion makes its grand entrance. Part of this difficulty is the natural result of importing employment classifications originally designed for industry into the field of healthcare.

It seems obvious, but the business of mental health practice isn’t the same as that of a retail establishment. It also isn’t the same as a factory or restaurant. Yet, mental health practitioners utilize the same body of law to address workplace disputes and this can result in some confusion. Ultimately the determination of employee/subcontractor status is usually determined by consulting the Internal Revenue Code, but that doesn’t stop employers, employees, and subcontractors alike from trying to gain an advantage via these labels.

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HIPAA: Once a covered entity, always a covered entity?

Rightly or wrongly, HIPAA is perceived by many clinicians as an administrative nightmare. For those who aren’t already compliant, the task of becoming HIPAA compliant isn’t one that clinicians relish. Most clinicians who have practices that need to be HIPAA compliant accomplished this task a long time ago.

For those who/that are covered entities, is there a way to get away from HIPAA? Can clinicians who no longer wish to be “covered entities” opt out of compliance with HIPAA?

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