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DEPARTMENT OF HEALTH, BOARD OF PSYCHOLOGY vs GEORGE VON HILSHEIMER, 94-000083 (1994)

Court: Division of Administrative Hearings, Florida Number: 94-000083 Visitors: 11
Petitioner: DEPARTMENT OF HEALTH, BOARD OF PSYCHOLOGY
Respondent: GEORGE VON HILSHEIMER
Judges: DANIEL M. KILBRIDE
Agency: Department of Health
Locations: Orlando, Florida
Filed: Jan. 06, 1994
Status: Closed
Recommended Order on Thursday, December 18, 1997.

Latest Update: May 18, 1999
Summary: In re: Case No. 94-0083 Whether disciplinary action should be taken against the Respondent's license to practice psychology, by violating of Section 490.009(2)(s), Florida Statutes, by undertaking activities for which the licensee is not qualified by training, experience, or licensure. As to DOAH Case No. 96-00819 Whether disciplinary action should be taken against Respondent's license to practice psychology by violating Section 490.009(2)(s), Florida Statutes, by having failed to meet the minim
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94-0083

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS


AGENCY FOR HEALTH CARE )

ADMINISTRATION, )

)

Petitioner, )

)

vs. ) Case Nos. 94-0083

) 96-0819

GEORGE VON HILSHEIMER, )

)

Respondent. )

)


RECOMMENDED ORDER


A formal hearing was held by the Division of Administrative Hearings, before Administrative Law Judge, Daniel M. Kilbride, in Orlando, Florida, on March 4, 5, 6, 7, and May 28 and June 19, 1997. The following appearances were entered:

APPEARANCES


For Petitioner: Natalie Duguid, Senior Attorney

Angela T. Hall, Staff Attorney

Agency for Health Care Administration 2727 Mahan Drive

Tallahassee, Florida 32308


For Respondent: Joseph A. Scarlett, III, Esquire

208 West Howry Avenue Deland, Florida 32720


STATEMENT OF THE ISSUES


In re: Case No. 94-0083


Whether disciplinary action should be taken against the Respondent's license to practice psychology, by violating of Section 490.009(2)(s), Florida Statutes, by undertaking activities for which the licensee is not qualified by training,

experience, or licensure.

As to DOAH Case No. 96-00819


Whether disciplinary action should be taken against Respondent's license to practice psychology by violating Section 490.009(2)(s), Florida Statutes, by having failed to meet the minimum standards of performance in professional activities when measured against generally prevailing peer performance, including the undertaking of activities for which the licensee is not qualified by training or experience (2 counts).

Whether Respondent violated Section 490.009(2)(q), Florida Statutes, by violating provisions of Chapter 490, Chapter 455, or any rules adopted pursuant thereto.

Whether Respondent violated Section 490.009(2)(v), by failing to maintain in confidence a communication made by a patient or client in the context of such services, except by written permission or in the face of a clear and immediate probability of bodily harm to the patient or client or to others.

Whether Respondent violated Section 490.009(2)(m), Florida Statutes, by soliciting patients or clients personally, or through an agent, through the use of fraud, intimidation, undue influence, or a form of overreaching or vexatious conduct.

PRELIMINARY STATEMENT


On July 23, 1993, Petitioner filed a two-count administrative complaint against Respondent. Respondent filed an answer denying the allegations and requested a formal hearing.

On December 20, 1993, this matter was referred to the Division of

Administrative Hearings for a formal hearing and this matter was set for hearing. Due to the Respondent's serious medical condition, this matter was continued for an extended period of time. This matter was then re-set and continued again, at the request of the parties. Petitioner's Motion for Default Judgment was denied by order, dated May 6, 1996.

On December 22, 1995, Petitioner filed a separate five-count Administrative Complaint, charging Respondent with various violations of Chapter 490, Florida Statutes. Respondent filed an Election of Rights on February 1, 1996, which denied the allegations and requested a formal hearing. This matter was referred to DOAH on February 9, 1996. Respondent's Motion to Consolidate was granted on March 18, 1996. Following several more continuances, the formal hearing in these consolidated matters was commenced on March 4, 1997. At the hearing, Petitioner voluntarily dismissed count two of the Administrative Complaint, in Case No. 94-0083. Testimony in these matters was not completed within the time allotted and the hearing was reset for May 28 and 29, 1997. Following completion of the testimony May 28th, Respondent was stricken seriously ill and the hearing was suspended. Upon agreement of the parties and with the consent of the Respondent, testimony in this case was completed on June 19, 1997, without the presence of Respondent. Respondent was represented by counsel at all times during these proceedings.

At the hearing, Petitioner called thirteen witnesses,

including expert witnesses, and thirty-one exhibits were admitted in evidence. Respondent testified in his own behalf and offered the testimony of twenty-eight witnesses. Nineteen exhibits were admitted in evidence on behalf of Respondent.

A transcript of the proceedings was prepared and filed.


Following the granting of a request for extension of time to file proposed recommended orders and memoranda, both parties filed their proposals. Following a thorough review of the testimony and documentary evidence, and having given careful consideration to the parties' proposals, the following findings of fact are determined.

FINDINGS OF FACT


as to Case No. 94-0083


  1. Respondent is a psychologist, licensed in the State of Florida with license number PY 0002281. Respondent does not hold a license in Florida as a health care provider.

  2. Psychologists are involved in health psychology and behavioral medicine. Psychologists frequently treat disorders such as obesity, smoking, hypertension, coronary prone behavior patterns, cancer, and chronic pain.

  3. It is appropriate for a psychologist to be involved with the treatment of these disorders, as a psychologist. It is not routine for a psychologist to act as a physician's assistant.

  4. Respondent was the owner and Director of Associated Health Professionals (AHP) which operated in the 1980's and early

    1990's in Maitland, Florida. It provided interdisciplinary health care to patients, including general medical, psychological services and an allergy clinic.

  5. In an allergy practice, the physician is the only person who orders allergy tests, determines which tests need to be


    performed, reviews test results, determines the course of treatment, and determines which medications to prescribe.

  6. Hormones such as testosterone, estrogen, and progesterone always require a prescription by a physician.

  7. As a psychologist, Respondent ran a specialized allergy clinic, yet he failed to hire physicians with special training in allergies.

  8. The Respondent functioned in multiple roles by acting as a medical assistant to the physicians in the allergy clinic and by providing therapy.

  9. Patients frequently reported to AHP on weekends for allergy testing, glucose tolerance tests, EKGs, and blood work. If the tests were not ordered during the week, Respondent ordered them to be performed on the weekends.

  10. AHP sent blood work to an outside laboratory. When test results came in, they were given to the medical director. Respondent also reviewed them if they were allergy related.

  11. Staff meetings were held at AHP once or twice weekly in order to discuss current patients or administrative business.

    Respondent typically conducted these meetings.


  12. The medical director did not instruct the technicians regarding the treatment of each patient. The treatments were dictated by protocols which had been put into place by a Dr. Hoover, a prior Medical Director at AHP. Once allergy testing was performed, treatment was dictated by these protocols.


  13. Once a patient was established and treatment was begun, the staff just followed protocol. They did not confer with the doctor after each patient visit.

  14. If there were no physicians on duty at AHP on Saturdays, the clinic had a phone number of a physician who was on call for them.

  15. Jack H. Van de Car, D.O. is an osteopathic physician who held the position of Medical Director at AHP for approximately 16 months from December 1987, through May 1989.

  16. Dr. Van de Car provided medical supervision of the allergy clinic. However, there were treatment protocols in place for the allergy clinic when he arrived at AHP.

  17. Dr. Van de Car's training in allergy consists of seminars, six weeks of training during medical school in 1963, and general medical practice.

  18. Only in unusual cases would Respondent or Dr. Van de Car alter the "standard" treatment plan dictated by the

    protocols.


  19. Dr. Van de Car would examine allergy patients and then refer them to the allergy lab. He did not test patients for allergies.

  20. Respondent was the Director in charge of AHP. He was in the allergy lab on a daily basis. Respondent and Dr. Van de Car reviewed allergy test result summaries. Dr. Van de Car did not review results of all allergy tests which were performed in the clinic. Respondent would interpret allergy test results and offer suggestions as to how they should be interpreted.

  21. A form, signed by Dr. Van de Car, appoints Respondent as Dr. Van de Car's medical assistant. This form would entitle Respondent to perform the enumerated procedures at Dr. Van de Car's direction while in the allergy lab.

  22. Dr. Van de Car was the only person at AHP licensed to issue prescriptions.

  23. On two occasions, Dr. Van de Car found that prescriptions had been renewed in his absence by Respondent. Despite the fact that these were not new prescriptions, Dr. Van de Car was concerned because he would not have renewed them himself but would have chosen to try a new prescription. Dr. Van de Car met with the Respondent and asked him not to repeat that procedure again.

  24. Respondent performed procedures which were not ordered by Dr. Van de Car and which would not have been ordered by him.

  25. Dr. Van de Car discontinued his practice at AHP in May 1989, and was replaced by William Rick, who he believed to be licensed in Florida as a physician.

  26. Andrew Feldman, D.O. was hired by Respondent as the Medical Director for AHP sometime in 1990 and remained until the summer of 1992.

  27. Dr. Felman had no rotation in allergy and no internship. He had taken approximately four to five courses in allergy in medical school. Dr. Felman is certified in Family Practice.

  28. Dr. Feldman normally did not report to the clinic on Saturdays.

  29. Respondent was not appointed as Dr. Feldman's medical assistant in the allergy lab. Respondent continued to work in the allergy lab on a regular basis.

  30. Solomon Klotz, M.D., is a physician specializing in allergy and clinical immunology. He has practiced in Florida since 1945.

  31. Dr. Klotz trained Respondent in immunology and allergies and at one time permitted Respondent to perform a study on "end point titration" in his clinic. However, Dr. Klotz was not comfortable with this method of treatment as he was unable to determine honestly if the treatment was producing a purely placebo effect or whether it was truly scientific.

  32. When Dr. Klotz's son, a physician, and Stephen

    Rosenburg, M.D., an associate in the practice, both expressed discomfort with Respondent's study, Dr. Klotz discontinued the study.

  33. Dr. Klotz himself ceased utilizing end point titration as a treatment method in favor of more proven methods.

  34. Lawrence Siegel, M.D., Ph.D., is an allergy physician who has been licensed in Florida since 1981. He has a Ph.D. in biochemistry and immunology. Dr. Siegel is board certified in pediatrics, allergy and immunology, and diagnostic laboratory immunology. He maintains a private practice which is devoted entirely to allergy patients. Dr. Siegel testified as an expert in the practice of medicine and allergy and immunology.

  35. Dr. Siegel reviewed Respondent's chart for Scott Donley. Dr. Siegel recounts Scott Donley was treated at AHP using the method known as "end point titration." In this method, after a patient has had initial testing to determine what he or she is allergic to, the person doing the testing takes every single individual allergen the person was tested for and tries to determine at what point the test changes from positive to negative.

  36. This technique is no longer used by most Florida allergists, as it involves a lot of testing and needles.

  37. In 1981, the American Academy of Allergy published a statement regarding end point titration. It stated that end point titration has no plausible or immunologic basis when used

    as a method of treatment and diagnosis of allergic disease. Four controlled clinical studies showed this method to be ineffective.

  38. The use of end point titration is not commonly used in the State of Florida, but its use is not below the standard of care for patients in Florida.

  39. Even if a person worked under the supervision of an allergist, that person could not legally practice medicine, order tests, or interpret them.

  40. The performance of a skin test can be left to the medical technician, but the interpretation should be done by a physician and noted in the chart.

  41. Scott Donley was first presented to Associated Health Professionals (AHP) in 1988 during his senior year of high school for treatment of allergies.


  42. Scott was a golfer, and was having a problem with allergies on the golf course. At the time, he was the #1 seed on his high school golf team.

  43. Scott's mother, Patricia Donely, was referred to the Respondent and the clinic by the owner of a health food store in Deland, Florida.

  44. At his first appointment, Scott was seen by Jack Van de Car, D.O. who gathered a patient history and performed a physical examination. Dr. Van de Car examined Scott at this time and

    referred him to the allergy clinic.


  45. After his first appointment, Scott saw Dr. Van de Car for chiropractic manipulations and electric stimulation treatment. He also prescribed medication for allergy, pain, and muscle relaxants.

  46. Generally, Scott saw the AHP staff and Respondent. On a typical day, Respondent would come into the room, review Scott's chart for the previous day, and dictate the day's treatment. It was Respondent who discussed Scott's allergy treatment with him. It was Respondent who corresponded with Patricia Donley regarding her son's treatment. If she had questions, Respondent would answer them for her.

  47. Respondent was the primary treating health care provider of Scott Donley.

  48. Scott underwent a series of procedures known as "end point testing" or "end point titration." He tested positive on

    132 out of 136 allergens.


  49. Scott was placed on a very strict diet and was given vitamins and injections of progesterone, testosterone and estrogen. He was also instructed to take Vitamin E.

  50. Scott's diet prohibited him from eating regular bread. He ate millet bread and millet muffins. Scott lost 35 pounds due to his change in diet.

  51. At one point, the Respondent advised Mrs. Donley to

    wash Scott's food in bleach; however, she refused.


  52. At first, Scott presented to AHP on what would be considered a normal appointment schedule.

  53. When his condition did not improve, Scott and his parents suggested to Respondent that Scott withdraw from his senior year of high school in order to report to AHP on a daily basis for testing. Scott withdrew from school.

  54. For a period of four or five months, Scott reported to AHP six days a week for eight hours a day in order to undergo end point testing.

  55. Occasionally Scott was hooked up to a black box referred to as "the Lollapalooza." This was a black box with clips which attached to Scott's earlobes. Electrical current was administered through the clips.

  56. Soon Scott was taught how to inject himself. Scott was ordered to give himself multiple injections daily.

  57. On at least two occasions, Scott suffered allergic reactions which required the insertion of an I.V. On one of these occasions, Scott's father, Mark Donley, was summoned to AHP. Mr. Donley was told that Scott had reacted to one of his medications and that they were flushing out his system. Mr. Donley witnessed Respondent inserting an I.V. into his son's arm and giving instructions to Kelly Luther, the nurse.

  58. Scott came to AHP on Saturdays for more end point testing.

  59. On occasion, Scott also received massage therapy from the Respondent.

  60. Scott's condition deteriorated over time. Scott described his condition as a general weakening. Scott began to experience arthritis-like symptoms, with stiffness in the mornings and swelling in his hands.

  61. Scott was forced to wear a mask on the golf course due to his allergic reactions.

  62. During this period of time, Scott sought psychotherapy from the Respondent, on an occasional basis, due to the severe diet and changes in his social life.

  63. When Scott's condition began to worsen, Mrs. Donley expressed an interest in getting a second opinion. Respondent did not encourage her to do so.

  64. Scott remained a patient at AHP from November 1988, until December 1989.

  65. When Scott's condition still did not improve, Scott was taken to Shands Hospital in Gainesville, Florida for an evaluation. The physician at Shands diagnosed Scott as being free of disease. He ceased Scott's medications and vitamins and took him off of the special diet.


  66. Respondent criticized Shands Hospital in a letter to Patricia Donely.

  67. Scott's physical condition gradually improved and he is

    currently employed as an Assistant Golf Professional in Jacksonville, Florida.

  68. Respondent's treatment records for Scott Donley were predominately medical. There were no treatment goals or plans, nor any progress notes of therapy. There should have been two patient records, one for medical treatment and one for psychotherapy.

  69. Billing records indicate physician visits were performed, but the record does not contain any physician notes.

  70. Scott's allergy treatment at AHP was below the standard of care in the State of Florida. There was very little physician involvement in the case. There was no physician examination at each patient visit. There was insufficient physician documentation as to testing and treatment performed between doctor's visits. There was no evaluation of whether the treatment was or was not working, just more and more testing. There was no discernible treatment plan or goals.

  71. Respondent denies diagnosing treatment for Scott Donley and denies ever prescribing medication for patients. He also states that he never started a psychotherapy chart on Scott Donley. His denial of diagnosing treatment for Scott Donley is not credible.

  72. Respondent practiced beyond the scope of his license as a psychologist in his treatment of Scott Donley.

    FINDINGS OF FACT

    as to Case No. 96-0819


  73. Charlotte Carnegie was presented to the Respondent in May 1993, during her dissolution of marriage to Robert Carnegie.

  74. Charlotte Carnegie was evaluated by Respondent but was never treated by him.

  75. Robert Carnegie is an engineer who has been employed at Lockheed-Martin for approximately fourteen years.

  76. Carnegie first met Respondent during his dissolution of marriage proceeding in mid-1993 when Blair Johnson, his wife's attorney, suggested that Charlotte Carnegie and Robert Carnegie see Respondent for an evaluation. This suggestion was in anticipation that there might be a custody issue concerning their child, Yvonne, who was at that time eight years of age.

  77. Carnegie presented to the Respondent for an interview and subsequently returned for further appointments. Carnegie considered himself a client of Respondent.

  78. Respondent also considered Carnegie a client.


  79. Carnegie did not waive his privilege of client/psychologist confidentiality.

  80. When Respondent learned that Carnegie was involved with Anita Duffy, who is now married to Mr. Carnegie, Respondent requested an appointment with her as well, due to her interaction with Yvonne.

  81. During this time, Respondent had therapy sessions with Charlotte Carnegie, Yvonne Carnegie, Robert Carnegie, and Anita

    Duffy.


  82. During their therapy sessions, Respondent referred to Yvonne as his "granddaughter" and requested her to call him "Grandpa" as a technique for the child to relate and confide in him.

  83. On one occasion in the fall of 1993, the Respondent invited Charlotte and Yvonne Carnegie to see The Nutcracker, a ballet, along with the Respondent and his wife and several other adults and children.

  84. In July 1994, Robert Carnegie received a letter in the mail dated July 20, 1994, which was signed by Respondent.

  85. Mr. Carnegie received virtually the same letter in the mail again, re-typed and dated July 21, 1994, this time signed by Charlotte Carnegie.

  86. Respondent had quoted it to Charlotte Carnegie who then re-wrote it and sent it to Carnegie.

  87. Robert Carnegie and Charlotte Carnegie agreed to shared parental responsibility of Yvonne. Charlotte has primary residential custody.

  88. After the dissolution was final, Robert Carnegie stopped his sessions with the Respondent. He then obtained a Court Order causing the Respondent to cease treatment of Yvonne.

  89. Because Carnegie felt that Respondent was rendering legal advice to his wife during the dissolution proceedings, he reported Respondent to The Florida Bar.

  90. When Carnegie obtained a copy of Respondent's response to the complaint, he found that the response contained


    confidential information divulged during his therapy sessions with Respondent.

  91. A psychologist does not give confidentially protected information divulged to them.

  92. Mr. Carnegie tried repeatedly to obtain a copy of his, Anita's, and Yvonne's treatment records from the Respondent.

  93. At first, Respondent refused to turn over the records and proceeded to exchange letters with Carnegie which contained insults and insinuations.

  94. The Respondent also sent copies of his letters to Blair Johnson, Charlotte Carnegie's attorney.

  95. The letters to Carnegie were unprofessional.


  96. It is inappropriate to write letters to clients which cause psychological distress. When a psychologist does not like his client, the appropriate action would be referral to another practitioner.

  97. Respondent gave several reasons for not relinquishing the records: he stated he would only release the records to a Ph.D. psychologist; and he needed Charlotte Carnegie's permission to release the records, and she refused to release them. He also attempted to bill Carnegie $1.00 per page for her records or

    $50.00 for a computer diskette.

  98. Respondent never released the records to Carnegie.


  99. In a joint custody situation, both parents have a legal right to understand what is happening with their child. A psychologist would be wrong not to deliver up the records. If a child's parents want the records, even if the child does not want the records released, the psychologist should release the records unless their release would somehow bring harm to the child.

    There is no information in Respondent's records indicating he felt that release of the records would bring harm to Yvonne.

  100. Respondent violated provisions of Chapter 490 and rules of the Board of Psychology by failing to release the records.

  101. Anita Carnegie is an electrical engineer. She has a bachelor's degree in engineering with a background in space technology and physics.

  102. In mid-1993, Robert Carnegie was going through a dissolution of marriage. Because Anita was seeing Robert socially, and because she was also in the midst of a custody battle herself, she agreed to be evaluated by Respondent.

  103. Respondent performed a psychological evaluation of Anita Carnegie and pronounced her "normal."

  104. Anita Carnegie requested her treatment records from Respondent three times. She was first requested to sign a release form, which she did. She was then informed by Respondent that he had discussed the matter with Charlotte Carnegie and

    Blair Johnson and that if she wanted her records, she could pay


    $1.00 per page.


  105. Respondent failed to release the records.


  106. Respondent also sent letters to Anita Carnegie's children, Christina and David Alessandro, offering to provide them with psychotherapy. Respondent gave Anita copies of the


    letters. Christina was sixteen years old at the time and David was thirteen.

  107. Respondent's letters to Christine Alessandro and David Alessandro encourage the children to come in for therapy. Psychologists have influence and power which can not be misused in sending letters to children who are not in an easy position to say no or to ignore or to be able to weigh or evaluate the appropriateness of the request.

  108. This type of solicitation is inappropriate.


  109. Respondent engaged in inappropriate patient solicitation by writing directly to Anita Carnegie's minor children.

  110. According to Blair Johnson, Charlotte Carnegie's attorney, there was an implicit agreement that all information gathered in Respondent's sessions would be shared among the parties.

  111. Mr. Johnson does agree however, that in a shared parental responsibility situation, both parents are entitled to

    the child's medical records.


  112. During the course of her representation, Tanya Plaut, Esquire, Robert Carnegie's attorney in his dissolution matter, received a psychological evaluation of Robert Carnegie in the mail. There was no cover letter attached. The report was signed by Respondent. Ms. Plaut was surprised to receive the report as she had no written waiver of the privilege of confidentiality. Carnegie was very upset to learn that the report had been released.

  113. In the Carnegie case, it was not clear exactly to whom Respondent was providing therapy. There was much confusion as to who was the actual identified client or patient. There is evidence he saw many of the family members for testing and counseling. His records indicate he performed psychological testing on Robert Carnegie and Anita Carnegie. Respondent provided therapy for the child, Yvonne.

  114. Yvonne Carnegie was the identified client. However, Anita Carnegie and Robert Carnegie's records should have been kept confidential. They were seeing Respondent as a psychologist even if it was on behalf of his daughter.

  115. Respondent violated Robert Carnegie's client confidentiality in his letter to The Florida Bar, and by remitting copies of clinical evaluations to Charlotte Carnegie's attorney, Blair Johnson, without a signed release.

  116. A psychologist is not permitted to release records to

    an attorney without a signed release.


  117. Patient confidentiality is a major tenet for psychotherapy to work. Sessions must be kept confidential as people give thoughts and feelings in describing their past. People have a right, when they speak to a psychotherapist, to have that information kept confidential.

  118. The duty of confidentiality continues even after a patient ceases treatment, absent a court order or a waiver signed by the patient.

  119. A psychologist is prohibited from engaging in dual or multiple relationships with a patient or client.

  120. The Respondent did not engage in a dual relationship with Charlotte and Yvonne Carnegie. However, he did engage in unprofessional behavior toward Robert Carnegie.

  121. Respondent's records contained little, if any, documentation regarding therapy or treatment goals.

  122. Respondent did not practice psychology below the standard of care in the State of Florida in this case.

    CONCLUSIONS OF LAW


  123. The Division of Administrative Hearings has jurisdiction over the parties and subject matter of this cause, pursuant to Section 120.57(1), Florida Statutes.

  124. Pursuant to section 490.009, Florida Statutes, the Board of Psychology is empowered to revoke, suspend, or otherwise discipline the license of a psychologist for the violations of

    Chapter 490, Florida Statutes, charged in this proceeding.


  125. Disciplinary license proceedings are penal in nature. State ex rel. Vining v. Florida Real Estate Commission, 281 So. 2d 487 (Fla. 1973). In this disciplinary licensing proceeding, Petitioner must prove the alleged violations of Section 490.009, Florida Statutes, by clear and convincing evidence. Ferris v. Turlington, 510 So. 2d 292 (Fla. 1st DCA 1987).

    As to Case No. 94-0083


  126. Petitioner has proven by clear and convincing evidence in this cause that Respondent violated Section 490.009(2)(s), Florida Statutes, by undertaking activities for which the licensee is not qualified by training, experience, or licensure.


    As to Case No. 96-0819


  127. As to Counts I and III, Petitioner has failed to prove by clear and convincing evidence and testimony in this cause that Respondent violated Section 490.009(2)(s), Florida Statutes, by having failed to meet the minimum standards of performance in professional activities when measured against generally prevailing peer performance, including the undertaking of activities for which the licensee is not qualified by training or experience.

  128. As to Count II, Petitioner has proven by clear and convincing evidence that Respondent violated Section 490.009(2)(q), Florida Statutes, by violating provisions of

    Chapter 490, Chapter 455, or any rules adopted pursuant thereto by failing to release patient records to Robert Carnegie and of his daughter, Yvonne Carnegie.

  129. As to Count IV, Petitioner has proven by clear and convincing evidence that Respondent violates Section 490.009(2)(v), by failing to maintain in confidence a communication made by a patient or client in the context of such services, except by written permission or in the face of a clear and immediate probability of bodily harm to the patient or client or to others.

  130. As to Count V, Petitioner has proven by clear and convincing evidence and testimony in this cause that Respondent violated Section 390.009(2)(m), Florida Statutes, by soliciting patients or clients personally, or through an agent, through the


    use of fraud, intimidation, undue influence, or a form of overreaching or vexatious conduct.

  131. The rules governing disciplinary proceedings of the Board of Psychology, found at Rule 21U-18.003, Florida Administrative Code, provide a range of penalties for violations of the provisions of the above-referenced sections of Florida Statutes.

  132. Rule 21U-18.003(2), Florida Administrative Code, provides a list of aggravating and mitigating circumstances which the Board may consider when imposing its penalty. Those

    considerations include but are not limited to the following:


    1. the harm caused to the patient.

    2. the danger to the public;

    3. the number of repetitions of offenses;

    4. any efforts the licensee has made toward rehabilitation;

    5. the actual knowledge of the licensee pertaining to the violation; and

    6. attempts by the licensee to correct or stop violations or refusal by the licensee to correct or stop violations.


  133. In Count I of Case No. 94-0083, the punishment in this case should be severe enough to be a deterrent to the Respondent to prevent acts such as those at issue from occurring again.

  134. In the Counts II, IV and V, these offenses are not severe in nature, and an administrative fine is sufficient to prevent a recurrence of this conduct in the future.

RECOMMENDATION


Upon the foregoing findings of fact and conclusions of law, it is

RECOMMENDED that the Board find the Respondent guilty of violating Section 490.009(2)(s), Florida Statutes (1 count), in regard to DOAH Case No. 94-0083; not guilty as to Counts I and III in DOAH Case No. 96-0819; guilty of violating Sections 490.009(2)(q), Florida Statutes, Section 490.009(2)(v) Florida Statutes, and Section 490.009(2)(m), Florida Statutes (Counts II, IV and V) in Case No. 96-0819. It is further

RECOMMENDED, as punishment therefore:


The license of George Von Hilsheimer, Ph.D., be suspended for a period of six months followed by a period of probation of

one year; that he pay an administrative fine of $2,000, pay the costs of the prosecution of this matter, and that the Board impose such other and necessary conditions on Respondent's probation as they deem necessary and appropriate.

DONE AND ENTERED this 18th day of December, 1997, at Tallahassee, Leon County, Florida.


DANIEL M. KILBRIDE

Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(850) 488-9675 SUNCOM 278-9675

Fax Filing (850) 921-6847


Filed with the Clerk of the Division of Administrative Hearings this 18th day of December, 1997.


COPIES FURNISHED:


Joseph Alexander Scarlett, III, Esquire

208 West Howry Avenue DeLand, Florida 32720


Nancy M. Snurkowski, Esquire

Agency for Health Care Administration Post Office Box 14229

Tallahassee, Florida 32317


Jerome W. Hoffman, General Counsel Agency for Health Care Administration 2727 Mahan Drive

Tallahassee, Florida 32308


Dr. Kaye Howerton, Executive Director Agency for Health Care Administration Board of Psychology

Northwood Centre

1940 North Monroe Street Tallahassee, Florida 32399-0792

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS


All parties have the right to submit written exceptions within 15 days from the date of this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the final order in this case.


Docket for Case No: 94-000083
Issue Date Proceedings
May 18, 1999 Opinion filed.
May 13, 1998 Final Order filed.
Jan. 29, 1998 (From A. Cox) Notice of Substitute of Counsel filed.
Dec. 18, 1997 Recommended Order sent out. CASE CLOSED. Hearing held 03/04-07/97 & 05/28/97 & 06/19/97.
Sep. 05, 1997 (From N. Snurkowski) Notice of Substitution of Counsel filed.
Sep. 02, 1997 Petitioner`s Proposed Recommended Order filed.
Aug. 28, 1997 Order sent out. (PRO`s due by 9/2/97)
Aug. 27, 1997 (Petitioner) Emergency Motion for Extension of Time to Submit Proposed Recommended Order filed.
Aug. 25, 1997 Order sent out. (PRO`s due by 8/25/97)
Aug. 25, 1997 Respondent`s Memorandum Continued; Findings of Fact and Conclusions of Law; Conclusions of Law; Findings of Fact filed.
Aug. 14, 1997 Respondent`s Memorandum; Motion for Enlargement of Time filed.
Jul. 23, 1997 (Volumes I & 2 for 5/28/97; I Volume on 6/19/97) Transcript filed.
Jul. 21, 1997 CC: Letter to Natalie Duguid from Joseph Alexander (RE: enclosing letters referenced to Mr Von Hilsheimer`s illness) filed.
Jun. 19, 1997 CASE STATUS: Hearing Held.
Jun. 12, 1997 (7 Volumes) Transcript filed.
Jun. 05, 1997 Notice of Hearing sent out. (hearing set for 6/19/97; 9:00am; Orlando)
Jun. 03, 1997 Letter to Judge Kilbride from Joseph Scarlett (RE: events following the recess of hearing) filed.
May 29, 1997 Order of Continuance sent out. (hearing cancelled; Respondent to file status by 7/1/97)
May 28, 1997 Hearing Partially Held, continued to date not certain.
May 27, 1997 Letter to Judge Kilbride from J. Scarlett Re: Requesting telephone hearing; Motion for Leave to Supplement Respondent`s Witness List filed.
Apr. 07, 1997 Notice of Hearing sent out. (hearing set for May 28-30, 1997; 9:00am; Orlando)
Mar. 04, 1997 Hearing Partially Held, continued to date not certain.
Feb. 25, 1997 (Joint) Prehearing Stipulation filed.
Feb. 18, 1997 (Petitioner) Notice of Taking Deposition In Lieu of Live Testimony (filed via facsimile).
Feb. 18, 1997 (Petitioner) Notice of Taking Deposition In Lieu of Live Testimony (filed via facsimile).
Dec. 31, 1996 (Respondent) (2) Notice of Taking Depositions filed.
Dec. 13, 1996 Letter to Judge Kilbride from B. Swainston Re: Request for subpoenas filed.
Dec. 02, 1996 Order Continuing Hearing sent out. (hearing rescheduled for March 4-7, 1997; 1:00pm; Orlando)
Nov. 27, 1996 Respondent`s Motion to Continue Hearing (filed via facsimile).
Nov. 05, 1996 Order Continuing Hearing sent out. (hearing rescheduled for Dec. 10-13, 1996; 9:00am; Sanford)
Oct. 31, 1996 (Angela Hall) Amended Notice of Appearance (filed via facsimile).
Oct. 18, 1996 (From A. Hall) Notice of Appearance filed.
Oct. 14, 1996 (Joint) Motion for Continuance filed.
Sep. 12, 1996 Notice of Serving Petitioner`s First Set of Interrogatories, Request for Admissions, and Request for Production (for case no. 96-819) filed.
Aug. 05, 1996 (Joint) Stipulation for Substitution of Counsel; Order Granting Substitution of Counsel (for Hearing Officer signature) filed.
Jul. 31, 1996 Respondent`s Supplemental Witness List filed.
Jul. 25, 1996 Respondent`s Preliminary Witness List filed.
Jun. 18, 1996 Order Continuing Hearing sent out. (hearing reset for Nov. 4-8, 1996; 1:00pm; Orlando)
Jun. 13, 1996 (Petitioner) Notice of Unavailability filed.
Jun. 05, 1996 (Petitioner) Motion for Continuance filed.
May 29, 1996 (Petitioner) Notice of Substitution of Counsel filed.
May 06, 1996 Order sent out. (Respondent`s motion for entry of default judgment is denied)
Apr. 29, 1996 (Respondent) Motion for Entry of Default Judgment Against Petitioner (for case no. 96-819) filed.
Apr. 24, 1996 (Respondent) Motion for Entry of Default Judgment Against Petitioner; Default (unsigned); Cover Letter filed.
Apr. 12, 1996 Notice of Intent; Status Report; Notice of Filing Original Interrogs; Interrogs.; Notice of Filing Original Answers to Interrogs. filed.
Apr. 04, 1996 (Petitioner) Notice of Service of Answers to Respondent`s Interrogatories filed.
Apr. 03, 1996 (Petitioner) Status Report filed.
Mar. 18, 1996 Order of Consolidation sent out. (Consolidated cases are: 94-0083 & 96-0819)
Mar. 18, 1996 Notice of Hearing and Initial Prehearing Order sent out. (hearing set for Sept. 9-13, 1996; 1:00pm; Orlando)
Mar. 06, 1996 (Petitioner) Status Report filed.
Mar. 01, 1996 (Respondent) Propounds Interrogatories Numbered 1 through 14 to Petitioner (Untitled) filed.
Feb. 27, 1996 Respondent`s Motion to Consolidate (with DOAH Case No/s. 96-819, 94-83) filed.
Dec. 04, 1995 Order Granting Substitution of Counsel sent out. (Kenneth E. Brootenis substituted as counsel of record for Respondent)
Dec. 01, 1995 (Petitioner) Status Report filed.
Dec. 01, 1995 (Respondent) Stipulation for Substitution of Counsel; Order Granting Substitution of Counsel (for Hearing Officer Signature) w/cover letter filed.
Aug. 29, 1995 Order sent out. (Parties to file status report by 12/1/95)
Jul. 11, 1995 Order sent out. (Parties to file status report by 8/25/95)
Jun. 26, 1995 (Petitioner) Status Report filed.
Jun. 26, 1995 (Petitioner) Status Report filed.
Mar. 20, 1995 Order of Abatement sent out. (Parties to file status report by 6/25/95)
Mar. 15, 1995 (Petitioner) Response to Hearing Officer`s Order filed.
Aug. 31, 1994 Letter to Judge Kilbride from J. Alexander (RE: enclosing patient procedure history); CC: Letter from P. Jamnadas filed.
Aug. 29, 1994 Letter to Judge Kilbride from Joseph Alexander Scarlett, III w/documents filed.
Apr. 26, 1994 Order Continuing Hearing sent out. (hearing date to be rescheduled at a later date; parties to file report on medical condition and ability to participate in hearing by 7/15/94)
Apr. 21, 1994 (Petitioner) Response to Respondent`s Motion to Continue Hearings filed.
Apr. 18, 1994 (Respondent) Motion for Continuance filed.
Feb. 24, 1994 Notice of Hearing and Initial Prehearing Order sent out. (hearing set for 5/26-27/94; 1:00pm; Orlando)
Feb. 22, 1994 (Petitioner) Response to Order filed.
Jan. 31, 1994 Order sent out. (Re: Motion for Extension of Time Granted)
Jan. 25, 1994 (Petitioner) Motion to Extend Time to File Response to the Initial Order filed.
Jan. 13, 1994 Initial Order issued.
Jan. 06, 1994 Administrative Complaint filed.
Dec. 20, 1993 Agency referral letter; Election of Rights; Answer to Administrative Complaint; Notice of Appearance (J. Scarlett) filed.

Orders for Case No: 94-000083
Issue Date Document Summary
Apr. 20, 1998 Agency Final Order
Dec. 18, 1997 Recommended Order Respondent was guilty of undertaking activities not qualified for, of failure to release records, of breach of confidence, and of improper solicitation. Respondent was found not guilty on two counts.
Source:  Florida - Division of Administrative Hearings

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