Lack of adequate planning for the closure of a member’s practice, especially when this is sudden or unexpected, can lead to difficulties for clients and patients. Such difficulties can include obstacles and longer than necessary delays in accessing continued care and or accessing records. In the event of incapacity or death, a member’s next of kin or estate trustee may also face avoidable challenges if arrangements were not made for a smooth transfer of administrative responsibilities.
The College’s Standards of Professional Conduct (2017) address the need to ensure continuous access to records. Information about these Standards, as well as advice from both the College and the Office of the Privacy Commissioner of Ontario was recently provided to members in the April 2018 e-Bulletin: Health Records: Succession Planning for Health Information Custodians.
The Association of State and Provincial Psychology Boards has recently published Guidelines for Closing a Psychology Practice which go beyond the responsible transfer of responsibility for records to address a number of other related important issues. The Guidelines address the steps necessary to ethically prepare for and close a psychology practice. In addition to providing guidance, it also offers samples of professional wills, notices to clients, and a checklist to prepare for the eventual closing of one’s practice.
While the creation of a Professional Will is not a requirement in Ontario at this time, members are urged to review the Guidelines and consider whether creating one would be prudent for them at this time. The section on Professional Wills sets out the steps to be taken by the named Professional Executor in the event of the member’s incapacity or death. The Guidelines suggest that the Professional Executor should be a person who understands and appreciates the responsibility to which they are agreeing. This would include an understanding of the relevant legislation and the standards of the profession related to client/patient care and clinical health records. Ideally, this person should be a member of the profession, or if this is not possible, a member of another regulated health profession.
The responsibilities of the Professional Executor may include:
- Securing client records immediately upon notification of the need to close the practice;
- Managing client records, as required by Standards of Professional Conduct (2017) and the applicable legislation;
- Managing all active cases;
- Providing all active clients/patients with appropriate and timely notification of the closure of the practice including the identification and contact information for the person who has responsibility for their health record and how the record can be accessed.
- Offering assistance in finding another service provider;
- Arranging for a public notice of the closure of practice
in the communities in which the colleague practiced, identifying who has responsibility for the clinical records and how the records can be accessed;
- Providing notice of the closure on the practice website, email account, voicemail system, and/or answering service, if applicable, and maintaining the systems for a reasonable period before shutting them down; and,
- Addressing any administrative issues pertaining to the closure of the practice, e.g. cancellation of leases, closing of the financial accounts and payment of outstanding debts from the business account.
The Guidelines also address such practical issues as:
- Arrangements for a copy of a Professional Will to beprovided to the Professional Executor
- The need to apprise family members of plans regarding the closure of the practice;
- Compensation to be paid to the Professional Executor,
as well as any funds set aside or available to cover expenses incurred for such things as record retention and management, liability claims against the practice, and the coverage of administrative costs for the close of the practice;
- The location of all records (client/patient, financial, insurance, etc.), office and file cabinet keys, computer passwords, test materials, appointment books, electronic devices, etc.; and,
- The need to ensure that clients/patients understand that access and control of their records will be undertaken by the Professional Executor in the event of the member’s death or incapacity.
Members may find the Checklist provided in the ASPPB Guidelines very useful in considering the steps to take in preparation for the eventual closing of their practice. Note that this Checklist was developed by the College of Psychologists of British Columbia and therefore, the references to “relevant Codes” relate to British Columbia documents although, for the most part, they would be consistent with expectations and/or good practice in Ontario.