§ 49.72. Responsibilities to clients/patients.

 (a)  Competency.

   (1)  In all communications with, or regarding, specific existing or prospective clients/patients, licensees may not misrepresent directly, indirectly or by implication their professional qualifications such as education, specialized training, experience or areas of competence.

   (2)  Licensees may practice only within the competency areas for which they are qualified by education, training and experience. Licensees may utilize only those testing and assessment instruments relevant to the needs of the client/patient and for which the licensees have been trained.

   (3)  Licensees shall maintain appropriate standards of care. The appropriate standard of care is defined as what an ordinary, reasonable licensee would have done in a similar circumstance. In areas in which recognized standards do not yet exist, licensees shall take whatever precautions are necessary to protect the welfare of their clients/patients.

   (4)  Licensees shall maintain knowledge of current scientific and professional information related to the services they render.

   (5)  Licensees shall refer a client/patient to another professional and take steps to facilitate an orderly transfer of responsibility when the client’s/patient’s needs exceed the licensee’s competence level. Licensees shall notify the client/patient promptly of the need to refer and seek the referral and transfer of services in relation to the clients’/patients’ needs and preferences.

 (b)  Informed consent.

   (1)  Licensees shall inform clients/patients in writing of:

     (i)   The purpose of the services being provided.

     (ii)   Risks and limits related to the services that are known to the licensee.

     (iii)   Reasonable alternatives to the services being provided.

     (iv)   Relevant costs, billing and overdue collection policies and their potential effect on the continuation of the professional relationship.

     (v)   The clients’/patients’ right to refuse or withdraw consent, and the time frame covered by the consent.

     (vi)   Other information the licensees reasonably might expect to affect the clients’/patients’ decisions to enter into or continue the professional relationship.

   (2)  Licensees shall use clear and understandable language when providing the information in paragraph (1) to clients/patients.

   (3)  Licensees shall provide services to clients/patients only in the context of a professional relationship based on valid informed consent.

   (4)  In instances when the client/patient is unable to read or understand the informed consent document or has trouble understanding the primary language contained in the informed consent document, licensees shall take steps to ensure the client’s/patient’s comprehension including providing a detailed verbal explanation or arranging for a qualified interpreter or translator, as needed. If a client/patient is not competent to provide informed consent because of age or mental condition, the licensee shall obtain consent from the client’s/patient’s parent, guardian, court-appointed representative or the holder of the client’s/patient’s power of attorney.

   (5)  When a client/patient is receiving legally-mandated services, licensees shall provide information about the nature and extent of the services and about the client’s/patient’s rights to the client/patient, or the client’s/patient’s parent, guardian, court-appointed representative or the holder of the client’s/patient’s power of attorney, as applicable.

   (6)  Licensees who provide services by means of electronic means shall inform the client/patient of the reasonably foreseeable limitations and risks associated with those services.

 (c)  Delegation. A licensee may not delegate professional responsibilities to another person when the licensee delegating the responsibilities knows or has reason to know that the other person is not qualified by training, experience or licensure to perform those responsibilities.

 (d)  Confidentiality and privacy.

   (1)  Licensees shall have a primary obligation to protect the client’s/patient’s right to confidentiality and privacy as established by law and professional standards of practice. Confidential and private information shall only be revealed to others when the client/patient, or the client’s/patient’s parent, guardian, court-appointed representative or the holder of the client’s/patient’s power of attorney, has given informed consent, except in those circumstances in which failure to do so would violate a court order or specific Federal or State privacy statutes or regulations, or result in clear and present danger to the client/patient or others. Unless specifically contraindicated by such situations, a client/patient shall be informed and written consent shall be obtained before the confidential and private information is revealed.

   (2)  Licensees shall discuss with clients/patients and the client’s/patient’s parent, guardian, court-appointed representative or the holder of the client’s/patient’s power of attorney, the nature of confidentiality and the limitation of the clients’/patients’ right to confidentiality. Licensees shall review with clients/patients circumstances when confidential information may be requested and when disclosure of confidential information is legally required. This discussion shall occur as soon as possible in the professional relationship and as needed throughout the course of the relationship.

   (3)  When licensees provide services to families, couples or groups, licensees shall seek agreement among the parties involved concerning each individual’s right to confidentiality and obligations to preserve the confidentiality of information shared by others. Licensees shall inform participants in family, group or couples counseling that the licensee cannot guarantee that all participants will honor the agreements. In the context of couple, family or group treatment, the licensee may not reveal any individual’s confidences to others in the client unit without the prior written permission of that individual.

   (4)  Licensees shall take reasonable steps to protect the confidentiality of information transmitted to other parties through the use of computers, electronic mail, facsimile machines, telephones and telephone answering machines, and other electronic or computer technology.

 (e)  Termination of services.

   (1)  Licensees may terminate services only after giving careful consideration to factors affecting the professional relationship and making an effort to minimize possible adverse effects. If an interruption or termination of services is anticipated, notification and referral for continued services shall be provided to the client/patient.

   (2)  Licensees may terminate services to a client/patient who has not paid an overdue fee balance if the following conditions are met:

     (i)   The financial contractual arrangements have been made clear to the client/patient.

     (ii)   The client/patient does not pose an imminent danger to self or others.

     (iii)   The clinical and other consequences of the current nonpayment have been addressed and discussed with the client/patient.

 (f)  Discrimination. Licensees shall comply with existing Federal and State antidiscrimination laws and may not practice, condone, facilitate or collaborate with any form of discrimination prohibited by those laws.

 (g)  Conduct with clients/patients.

   (1)  Licensees may not physically or verbally abuse or threaten clients/patients or family members of clients/patients.

   (2)  Licensees may not use derogatory language in their written or verbal communications to or about clients/patients. Licensees shall use accurate and respectful language in communications to and about clients/patients.

Source

   The provisions of this §  49.72 adopted September 17, 2010, effective September 18, 2010, 40 Pa.B. 5320.



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