Responding to a Board Complaint About Records, Termination, and Confidentiality
Dr. Lena Ortiz, a licensed psychologist in Fort Collins, receives a certified letter from the Colorado Division of Professions and Occupations, Office of Investigations. A former client, Ms. P, filed a complaint alleging that Dr. Ortiz terminated therapy abruptly after 10 sessions, refused to release her records unless she paid a $600 outstanding balance, and disclosed her diagnosis to Ms. P's employer without a release. The letter requests a written response within 20 days and copies of the treatment record. Dr. Ortiz is panicked. She wants to call Ms. P to 'clear things up' and to add late entries to the record explaining that Ms. P was 'noncompliant.' She asks whether she should do that and what her obligations are.
1. How should Dr. Ortiz respond to the Board's investigation? What should she not do?
Read the worked answer
Dr. Ortiz should treat the letter as a formal Board investigation. She should not contact Ms. P directly; doing so can be seen as intimidation or an attempt to influence the complaint. She should not alter, add to, or destroy the treatment record. Late entries can be legitimate if clearly dated and identified as late, but adding self-serving explanations after a complaint looks like spoliation and undermines credibility. She should preserve all records, emails, texts, billing documents, and appointment logs. She should respond in writing within the 20-day deadline, preferably with legal counsel, and provide the requested records (redacting third-party information as required). She must cooperate; failure to cooperate is a separate violation. She should not discuss the investigation with colleagues or on social media.
2. Analyze the substantive allegations: records, termination, and confidentiality. What are the likely Board concerns and possible outcomes?
Read the worked answer
The Board will examine three issues. First, withholding records for an unpaid $600 balance: Colorado law and Board rules generally require provision of records needed for continuity of care and do not permit using them as leverage for payment; a reasonable copying fee may be charged. Second, abrupt termination after 10 sessions may constitute abandonment if Ms. P needed ongoing care and no referral or transition was provided. Third, disclosing diagnosis to the employer without a signed release may violate confidentiality, HIPAA, and Board rules. The Board could open an investigation, seek a settlement, or file formal charges. Outcomes range from a letter of admonition to probation, fines, suspension, or revocation, depending on harm and prior history. Dr. Ortiz should provide the records, review her termination and release policies, and consider ethics consultation or CPD. She should not minimize the allegations.