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Responding to an Inquiry and Investigation

If you received an inquiry letter from the Board, this generally means that a complaint and possibly evidence have been submitted to the Board, and the Ethics Committee has done an initial review. In other cases, the Board may initiate “staff-opened” cases where the staff has received information from various sources including renewals, government agencies, and the news media. Generally, the Board will send you an initial letter and request that you respond to the allegations. Depending on the facts of the case, an investigator for the Board may be assigned at some point in the process to gather additional information and prepare a summary report for the Ethics Committee, who makes recommendations to the Board on how to proceed.

In drafting a response, it is important for you to include all information and documentation necessary to fairly and fully respond to the allegations. However, it is equally important for you to include only the pertinent information and documentation. We help our clients make these judgments and determinations from an objective standpoint and with experience in defending LCMHC Board matters. We regularly assist clients with written responses and in dealing with the stress that typically comes with defending such matters.

After receiving the written response, the Ethics Committee may close the case without taking further action; investigate further; recommend an informal conference with the licensee; or send a Charge Letter commencing a formal hearing.

Informal Conferences

Prior to the Board commencing a formal public hearing, the Ethics Committee may determine it is appropriate to hold an informal conference. The LCMHC may agree to attend this informal conference and be represented by an attorney. At the conference, a Board member and the LCMHC meet to consider the possibility of disposing of the dispute without a hearing. One or more of the following dispositions may occur at or after an informal conference:

  1. Recommend to the Board dismissal with no action;
  2. Recommend to the Board resolution by consent; or
  3. Schedule a formal contested case hearing and issue a Charge Letter to the LCMHC.

Settlement

At the informal conference, the licensee may be offered a resolution of the case, which is followed by a proposed consent order. All matters contained in the consent order must be agreed to by the Board member and the LCMHC or other licensee and then ultimately approved by the full Board.

We help our clients evaluate and determine whether they should accept a proposed consent order, including whether to negotiate the terms, or in some cases request reconsideration of the Ethics Committee’s decision. The Board has more flexibility regarding disciplinary actions in negotiating and entering into consent orders than it does after formal hearings. This flexibility is one reason we attempt whenever possible to reach a consent order and avoid a formal hearing for clients if a matter reaches this stage of the proceedings.

Public Hearing

If the matter is not dismissed and a settlement cannot be reached, the case will be scheduled for a formal public hearing. The Board will give the licensee a notice of hearing, which hearing is conducted by the Board members. The LCMHC has the right to present evidence in defense, including calling witnesses, introducing exhibits, making objections, cross-examining witnesses called by the Board, and making a closing argument. If they have not done so already, many LCMHCs/licensees decide that they need to retain a firm or attorney to represent them at the formal hearing stage.

Possible Discipline and Outcomes of the Public Hearing

The Board may suspend, or revoke licensure, discipline, place on probation, limit practice, or require examination, remediation, or rehabilitation of any LCMHC or other licensee on one or more of the following grounds:

  • Has been convicted of a felony or entered a plea of guilty or nolo contendere to any felony charge under the laws of the United States or of any state of the United States;
  • Has been convicted of or entered a plea of guilty or nolo contendere to any misdemeanor involving moral turpitude, misrepresentation, or fraud in dealing with the public, or conduct otherwise relevant to fitness to practice clinical mental health counseling, or a misdemeanor charge reflecting the inability to practice clinical mental health counseling with due regard to the health and safety of clients or patients;
  • Has engaged in fraud or deceit in securing or attempting to secure or renew a license or has willfully concealed from the Board material information in connection with an application for a license or renewal of a license under this Article;
  • Has practiced any fraud, deceit, or misrepresentation upon the public, the Board, or any individual in connection with the practice of clinical mental health counseling, the offer of clinical mental health counseling services, the filing of Medicare, Medicaid, or other claims to any third-party payor, or in any manner otherwise relevant to fitness for the practice of clinical mental health counseling;
  • Has made fraudulent, misleading, or intentionally and materially false statements pertaining to education, licensure, license renewal, certification as a health services provider, supervision, continuing education, any disciplinary actions or sanctions pending or occurring in any other jurisdiction, professional credentials, or qualifications or fitness for the practice of clinical mental health counseling to the public, any individual, the Board, or any other organization;
  • Has had a license or certification for the practice of clinical mental health counseling in any other jurisdiction suspended or revoked, or has been disciplined by the licensing or certification board in any other jurisdiction for conduct which would subject him or her to discipline;
  • Has violated any provision of this Article or any rules adopted by the Board;
  • Has aided or abetted the unlawful practice of clinical mental health counseling by any person not licensed by the Board;
  • Has been guilty of immoral, dishonorable, unprofessional, or unethical conduct;
  • Has practiced clinical mental health counseling in such a manner as to endanger the welfare of clients;
  • Has demonstrated an inability to practice clinical mental health counseling with reasonable skill and safety by reason of illness, inebriation, misuse of drugs, narcotics, alcohol, chemicals, or any other substance affecting mental or physical functioning, or as a result of any mental or physical condition;
  • Has practiced clinical mental health counseling outside the boundaries of demonstrated competence or the limitations of education, training, or supervised experience;
  • Has exercised undue influence in such a manner as to exploit the client, patient, student, supervisee, or trainee for the financial or other personal advantage or gratification of the licensed clinical mental health counselor associate, clinical mental health counselor, or a third party;
  • Has harassed or abused, sexually or otherwise, a client, patient, student, supervisee, or trainee;
  • Has failed to cooperate with or to respond promptly, completely, and honestly to the Board, to credentials committees, or to ethics committees of professional associations, hospitals, or other health care organizations or educational institutions, when those organizations or entities have jurisdiction;
  • Has refused to appear before the Board after having been ordered to do so in writing by the chair;
  • Has a finding listed on the Division of Health Service Regulation of the Department of Health and Human Services Health Care Personnel Registry

The Board may, in lieu of denial, suspension, or revocation, take any of the following disciplinary actions: (1) Issue a formal reprimand or formally censure the applicant or licensee; (2) Place the applicant or licensee on probation with the appropriate conditions on the continued practice of clinical mental health counseling deemed advisable by the Board; (3) Require examination, remediation, or rehabilitation for the applicant or licensee, including care, counseling, or treatment by a professional or professionals designated or approved by the Board; (4) Require supervision of the clinical mental health counseling services provided by the applicant or licensee by a licensee designated or approved by the Board; (5) Limit or circumscribe the practice of clinical mental health counseling provided by the applicant or licensee with respect to the extent, nature, or location of the professional counseling services provided, as deemed advisable by the Board; or (6) Discipline and impose any appropriate combination of the types of disciplinary action listed above.

In addition, the Board may impose conditions of probation or restrictions on continued practice of clinical mental health counseling at the conclusion of a period of suspension or as a requirement for the restoration of a revoked or suspended license. The Board may assess costs of disciplinary action against an applicant or licensee.

Appeal of a Disciplinary Order and other Court Proceedings

An order issued by the Board imposing discipline may be appealed to Superior Court. Generally, it is much more difficult for a licensee to prevail once the matter reaches the court system on an appeal, even if s/he retains legal counsel at that point.

When considering the issue of whether an applicant or licensee is physically or mentally capable of practicing clinical mental health counseling with reasonable skill and safety with patients or clients, upon a showing of probable cause to the Board that the applicant or licensee is not capable of practicing clinical mental health counseling with reasonable skill and safety with patients or clients, the Board may petition a court to order the applicant or licensee in question to submit to a psychological evaluation by a psychologist or a physical evaluation by a physician.

If you have received a letter from the Board staff or have a pending formal hearing, you should consider retaining a firm like ours that has experience representing applicants, LCMHCs and other licensees before the North Carolina Board of Licensed Clinical Mental Health Counselors. Disciplinary action could have a significant and permanent impact on your license in NC and other states, which also can substantially affect you financially and personally. Hiring an experienced law firm can be an investment in your professional future as a LCMHC. Our general explanation of board procedures has a more detailed discussion of how we may be able to assist you in informal proceedings and formal proceedings.

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