The 2014 ACA Code of Ethics encourages consultants to “make a contribution to society by using part of their professional activity in services for which there is little or no financial return.”
This is an important tenet of the counseling profession that promotes counselors' empathy and reputation for social justice. However, advising customers for a reduced fee or free of charge – pro bono – in a private practice environment is associated with some restrictions.
John Duggan, senior manager of education and training for the American Counseling Association, emphasizes that private practitioners who have contracts with third parties, such as: B. Agreements to accept customers from an employee benefit program, Medicaid, or elsewhere must do so. Take positive action to avoid risk if they charge anything other than the same service rate for 100% of their caseload. There are several reasons for this:
The charging of different rates for services reimbursed through federally funded programs puts the practitioner at risk of fraud allegations or investigations by the U.S. Centers for Medicare & Medicaid Services (CMS). In general, Medicaid and other liability insurance policies prohibit practitioners from renouncing copays.
Insurance companies may be unwilling to adhere to a fee schedule when a doctor charges different customers different fees for the same contracted service.
Offering compensation to customers is unethical and potentially illegal (see Standard A.10.b. of the 2014 ACA Code of Ethics). Although there are exceptions, copay / fee waiver and under-billing are potential HIPAA violations.
Last – and perhaps most importantly – Standard C.5. of the Code of Ethics prohibits discrimination in professional advice. Offering different fees to different clients could potentially open a health care professional's business to allegations of discrimination or lawsuits, Duggan says.
The only private practice scenario that would be excluded from the above points would be if a consultant has no existing contracts with third parties and treats 100% self-paying customers without insurance, he states.
"It is ethically important to prioritize our work, which is gratuitous," says Duggan, a licensed professional advisor and licensed clinical professional advisor. “The bottom line, however, is that professional advisors running a healthcare company should also act as ethical businesspeople. Always consider ethical, legal, and compliance issues before reducing fees, copays / fees, or sub-billing. "
Duggan points out that there are many ways a counselor can volunteer without advising clients about their practice load. Volunteering or scaled-down community work – from public speaking or conducting workshops to responding to mental health in disaster situations – can be a rewarding way for counselors to give back.
There are also organizations and agencies that facilitate the advice of clients outside the existing number of cases of a clinician. Duggan cites the Pro Bono Counseling Project (probonocounseling.org) as an example. The Maryland-based nonprofit connects limited-income clients who are uninsured or underinsured with volunteer practitioners for free mental health care.
When it comes to managing the nuances of pro bono work, Duggan suggests that consultants refer to ACA's numerous resources, particularly the 2014 ACA Code of Ethics (including standards C.1. And I.1.b.) and The Counselor and the Law: A Guide to Legal and Ethical Practice by Anne Marie "Nancy" Wheeler and Burt Bertram, especially Chapter 3 (available at Counseling.org/store). Practitioners may also want to seek advice from a lawyer.
<img data-attachment-id = "24761" data-permalink = "https://ct.counseling.org/2021/03/pro-bono-counseling-how-to-make-it-work/pro_bono / "data-orig-file =" https://ct.counseling.org/wp-content/uploads/2021/03/Pro_Bono.jpg "data-orig-size =" 1250,833 "data comments opened =" 1 " data-image-meta = "{" aperture ":" 0 "," credit ":" "," camera ":" "," caption ":" "," created_timestamp ":" 0 "," copyright ":" "," focal_length ":" 0 "," iso ":" 0 "," shutter_speed ":" 0 "," title ":" "," Orientation ":" 1 "}" data-image-title = "Pro_Bono "data-image-description ="
Block letters in which "pro bono" is written on a dark background
"data-medium-file =" https://ct.counseling.org/wp-content/uploads/2021/03/Pro_Bono-300×200.jpg "data-large-file =" https://ct.counseling.org /wp-content/uploads/2021/03/Pro_Bono-1024×682.jpg "load =" lazy "class =" aligncenter wp-image-24761 "src =" https://ct.counseling.org/wp-content/uploads /2021/03/Pro_Bono-1024×682.jpg "alt =" "width =" 370 "height =" 246 "/>
****
ACA Code of Ethics 2014, Standard C.6.e.
"Consultants make reasonable efforts to provide services to the public for which there is little or no financial return (e.g. speaking with groups, exchanging professional information, offering reduced fees)."
The full ACA Code of Ethics can be found at Counseling.org/ethics
ACA members with additional questions can arrange practice or ethics counseling with ACA counseling specialists by emailing [email protected].
****
Pro bono: opportunities
Be aware of the potential for customer exploitation, pay attention to their weaknesses and consider their best interests in all professional decisions.
Look for opportunities to serve your local community by offering some pro bono services that leverage your unique interests and skills (e.g. speaking, teaching, mentoring, leading support groups, volunteering at a local nonprofit clinic) .
Remember: pro bono services are subject to the same strict ethical standards as any other advisory service. Practitioners who provide clinical mental health services must also comply with state and federal laws.
Source: John Duggan, Senior Manager, Continuing Education and Training, American Counseling Association
****
Read more
Counselors entering a private practice are often confronted with the pressure that exists between their desire for sensitive, customer-oriented care and the need to make a profit. Counseling Today will cover this topic extensively in the April magazine's cover article, "Finding Balance in Counseling Private Practice."
****
Opinions and statements in articles appearing on CT Online should not be assumed to reflect the opinions of the editors or guidelines of the American Counseling Association.
