Cc —€ STATE OF FLORIDA | ays Bn DEPARTMENT OF HEALTH UO a ore HOY DEPARTMENT OF HEALTH, BOARD OF CLINICAL +, 29 p 3 35 SOCIAL WORK, MARRIAGE AND FAMILY THERAPY A yt i a AND MENTAL HEALTH COUNSELING, MIN fs Rev MEARIN ge VE Petitioner, $ vs. AHCA Case Number: 2000-01086 JEFFREY DALIA, OD- UTA PL Respondent. / ADMINISTRATIVE COMPLAINT Petitioner, DEPARTMENT OF HEALTH, hereinafter referred to as “Petitioner,” files this Administrative Complaint before the Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling, against JEFFREY DALIA, hereinafter referred to as “Respondent,” and alleges: 1. Effective July 1, 1997, Petitioner is the state agency charged with regulating the practice of mental health counseling pursuant to section 20.43, Florida Statutes; Chapter 456, Florida Statutes (formerly Chapter 455, Part II; see Chapter 2000-160, Laws of Florida); and Chapter 491, Florida Statutes. Pursuant to section 20.43 (3)(g), Florida Statutes, the Department has contracted with the Agency for Health Care Administration to provide consumer complaint, investigative, and prosecutorial services required by the Division of Medical Quality Assurance, councils, or boards, as appropriate. 2. Respondent is, and has been at all times material hereto, a licensed mental health counselor in the State of Florida, having been issued license number MH 2753. 3. The last address of record for the Respondent is 1501 South Flagler Drive, #7-F, West Palm Beach, Florida 33401-7170. C c 4. On or about October 25, 1998, the Complainant wrote to the Respondent and requested a copy of her minor child’s (BC) counseling records. 5. Ina letter dated October 29, 1998, the Respondent stated that: he had obtained a release from the child’s custodial parent; the Complainant was entitled to the information in the records but not the records themselves; and that he would provide the Complainant with a summary of the records for an administrative fee of $150.00. 6. In response to a request for records, the standard practice is to charge a reasonable photocopying fee. Based on the foregoing, the Respondent is subject to discipline for violating section 491.009(2)(q), Florida Statutes, through a violation of section 455.667(4), Florida Statutes [presently section 456.057(4), Florida Statutes], for failing to make available upon written request copies of treatment records or reports and section 491.009 (2)(q), Florida Statutes, through a violation of section 455.667(16), Florida Statutes, [presently 456.057(16), Florida Statutes], for offering to provide records at a cost greater than the actual photocopying costs. C C¢ WHEREFORE, Petitioner respectfully requests the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling to enter an order imposing one or more of the following penalties: revocation or suspension of Respondent's license; restriction of Respondent's practice; imposition of an administrative fine; issuance of a reprimand; placement of the Respondent’s license on probation for a period of time and subject to terms and/or conditions; and/or any other relief which the Board deems appropriate. SIGNED this NY day of __( Xbyloev , 2000. Robert G. Brooks, M. D. By: Nancy M. Snurkowski Chief Attorney Genera! Counsel’s Office - MQA Practitioner Regulation — Legal _ COUNSEL FOR PETITIONER: ‘Deborah B. Loucks 2 L Senior Attorney Florida Attorney Number: 0169889 DEPARTMENT OF HEALT: Agency for Health Care Administration DEPUTY CLERK Practitioner Regulation — Legal CLERK Uehi Rk. Ken on Post Office Box 14229, Mail Stop #39 Tallahassee, Florida 32317-4229 DATE. lo Jas lds (850) 487-9694 PEP Dete: (0 ft3/om

Docket for Case No: 00-004784PL