This is not a document of professional consultation, or legal testimony. It provides perspective on a topic that is similar to the lack of a national standard in sex assault issues, where things appear to be unsupervised and even askew with the possibility of getting a pure read.
Does use of contractors dilute reporting, evaluations, investigations and court processes further, making them less likely to fairly be processed? Does the use of contractors further and increase the chances of generating a desired result, instead of an objective result by diluting accreditation, accountability and demanding accuracy?
Nationally, over many environments, it has become popular to use contractors. Contractors are hired for a task, and it is up to the employer and contractor to determine fair market value for the service. Also, the use of students, who work for HHS or other agencies while attending PhD or Master's or Medical training programming on a federal scholarship that splits the student's time between working at an agency as a student, and attending school. The agency work is a paid practicum ( supervised professional practice towards their degree). They may also receive a stipend for living, books, food, transportation, etc.
Are contractors more or less likely to be persuaded to return a certain result, if their bread and butter is contingent upon pleasing their payor, in this case the court service system or other state based system?
Little is said about quality, ethics, standards and service. For whatever reason, mental health contracts are mysterious to people in general and it gets more mystical as the processes advance to court testimony from the mental health professional. In Oklahoma, there is a practice law that is disregarded by Judges and lawyers alike, that one cannot process child custody without specialized credentials. Some states don't have such a credential or a law, so there is no bypassing, there is just no standard. Addictions credentials are becoming more popular, but Oklahoma has a waivering law on who is and is not qualified to care for the addicted, and process evaluations or court requirements based upon such an assessment.
It waivers within the ultimate State office over it ( which is headed by an unlicensed dually degreed individual) and in courts, child custody,probations and social services agencies.
Often the person drafting the contract has no training as a licensed mental health professional and that immediately colors the contract, limiting possible scope.
Second the contract writer often has no understanding of the scope of mental health or addictions practice FORENSICALLY or otherwise, and has few or no requirements on the structure of the service rendered. This colors what the consumer or court get as a result.
Contractor misconduct or mismanaged process is left up to the licensure board to decide, but the licensure board doesn't get involved unless there is a consumer complaint. The contractor and contracting agency part ways at the contract. The contracting agency has no accountability to the actions of the contractor. The contracting group may contract with a contractor, who in turn SUBCONTRACTS with service providers, and in that case, the initial contract issuer signs with a contractor who signs with another contractor to get the job done. So, accountability to the consumer is diluted with each ring on the tree.
This does not include the issue of the contractor DBA ( a business that does assessments or counseling or both, who is listed as "doing business as", where the general public has no idea who is behind the ownership of the place a consumer goes to get a service.
The consumer often does not know the agency, who owns it or governs the evaluator or the paysource which pays for the job."Court" may use a variety of funding sources to pay for an evaluation, as may any contract holder (DOT, HHS, Probation and Parole, ACF). It is also not true that merely asking would return an accurate answer in a timely manner.
If there is a consumer complaint about a provided service, the licensure board does not necessarily take the information to law enforcement or even to a court process, as a prosecutor has to have an interest for it to go forward. So, even if it gets a review and finding, informally or formally, there is no requirement that this be rolled to prosecution of the contracting professional in mental health, medicine or addictions.
It is remarkable that across the United States, it is accepted that ONLY an MD can diagnose and within the medical community, formal diagnosis of addictions or mental health issues must come from a psychiatrist. One can be a physician, and a psychiatrist, and not be what is called "Board Certified", which means the person has had specialized training and has passed certain tests and hurdles to have a clear qualification of the exact issue.
It is common for unlicensed persons in reports and otherwise to drop two cents verbally or on paper and courts to hold those as truth, without verification. Records held at non-medical agencies have no HIPAA requirements to be accurate, to be protected and to be controlled. Most agencies use both computerized and hand written documents to achieve a file for any service. This includes the same type of agencies above, and courts.
Pay sources often determine what the very minimum requirements of the evaluations service are, but this does not employ standards of the mental health or addictions industry, state of the art practices ( the very best way to go about that exact action), or any version of consumer safety. So, who pays for the service has some say over the service as it happens. The pay source may or may not be clear to the consumer or the court and confirmation of the paysource may ALSO be cloaked from the consumer, backed up by a custom, policy or law. http://www.examiner.com/article/policy-custom-or-law-oklahoma-courtrooms. Medicaid, Sexual Assault Federal Funding for investigations like SANE medical evaluations and such seem clear. What other funds might pay for evaluations or if the consumer might be held financially responsible in the immediate or over time, is an issue that is probably handled in each venue.
The consumer has little or no recourse between systems involved in "ordered" forensic evaluations, and no consent is required in most states to explain rights, sign consents or provide alternatives to respond to the order. Though professional mental health custom says it should be.
One of the nifty things about inaccuracies, is that most states have a law, that holds investigative agencies not liable (That is right, not EVER liable http://www.examiner.com/article/understand-which-federal-law-must-change... ) for problems in investigations, falsifications, poor/tampered with or damaged information. As a matter of fact, purity, accuracy and verifiability are all subjective, not objective. Subjective means that the evaluator gets to pick whatever goes in the report, because they are on their own to decide content.
Testimony, documents and care plans often don't get a once over by a pay source as they might in the private insurance sector, as noone is assigned to look at best practices ( what the industry has said is the best right way to get to answers) , efficiency, and effectiveness or accuracy.
Typically, the public is blind to this, and only discovers the concern when something goes awry.
Courts, perhaps on the arm of other services they cross paths with, like DUI, Child Abuse, Child Custody, Sex Assault and Child or Adult Sex Assault, chaos can ensue across the United States as the courts make use of "forensic" mental health evaluations, with little or no qualifications placed upon :
1.) The evaluation Who, when, why or what is to be considered does not have to be defined. In true mental health or addictions services, there is a puzzle to be solved, an exact question to be answered. It is called ruling out. Many concepts of what the problem might be made of are considered based upon observation and report from the person, and together the evaluator and the consumer collect information to determine what to do next. Complex questions are weighed with exact and appropriate tools to define soundly a course of needed care, or to rule out unneeded care.
2.) Who an evaluator may be. Use of unlicensed students, students under supervision or contractors are all undefined and no specialty credential for forensic evaluator required. A forensic evaluator credential demands that the person have an understanding of acceptable standards, tools and styles of reporting that are objective versus subjective giving a clean report. Even with this, if state law, licensure law and court custom or policy don't demand this at the same time, it is merely a flopping fish used by attorneys or the Judge randomly and capriciously? The pieces aren't interlocking and there is no move nationally to focus this.
3.) Confidentiality includes Signed permission to use of students or other unqualified individuals as executors of the evaluation, observers or otherwise to be handling records, transcribing data or otherwise contributing to results. It would be considered grossly unprofessional to use a student in a forensic evaluation. Recordings, whether audio or visual are to be identified up front, with papers signed regarding same. Who owns the forensic tapes, is typically determined by the pay source. The consumer often does not see this contract, and does not know to ask about any of this.
4.) The source of information used in the evaluation What resources the evaluator may or may not use, and whether or not these must go through any process of verification, or be considered best practices, reliable methods of evaluation. Who is responsible for determining if information is skewed or tipped is undefined, and often left to final processes of court staff, Judge, attorney or State prosecutions to determine or deny if any question exists in these methods. The evaluator, the staff, nor the report is under no obligation to be a.) accurate, b.) objective c.) accountable d.) verifiable.
5.) The method (s) information is obtained what testing or interview methods are allowed, as the people drafting the contract with the contractors have failed to use materials
6.) Contractors have no accountability, because the contracting source holds a contract that says they only ask for some service and any disputes are between the consumer and the contractor. So, other than the consumer having to go through multiple processes to address the falacies introduced, created, caused or supported by faulty assessments ( the licensure board, civil courts) there really is no 1 place to get an answer for defining a faulty result, or to get accountability. In cases of children, or the infirm, time is of the essence on mismanaged case data, and the turn around has no expedited processes.
See the photo that accompanies this article, and note that there are some odd blank spots. Please note that there is no identifying information on possible duplication of identity for either party. Please note that the testing was sent to a third state.
Y. Gerald Augustin, a psychologist out of North Atlanta, identified that this writer was a LIAR, and some harsher, permanent terms because Gerald Augustin personally did not believe that this writer's daughter, ALLYSON WINSLOW was also the daughter of the Reverend Geoffrey Michael St. John Hoare, of Atlanta. Guess what!
And though Gerald Augustin was confronted about his fabrication at the time Gerald Augustin stated that it could not possibly be true, with his licensed signature in writing, and under oath. Gerald Augustin persisted his unverified account was sole truth. Guess WHAT!
Gerald Augustin did not ask for medical testing, which would have been the professional standard to match the problem at hand. As a licensed psychologist, not only was he not medically qualified ( and it is illegal in the State of Georgia to practice medicine without a MEDICAL LICENSE) to say what he did, but NOONE in the court asked that he provide any version of proof. Noone.
Gerald Augustin had used a student and various others to do his "evaluation". Gerald Augustin has even to date, not been held accountable by the Georgia Licensing Board over psychologists, and his contracts all remain intact. http://sos.ga.gov/index.php/licensing/plb/44 Nor has the unlicensed student (s), nor the agency where he performed the evaluation. Nor the persons who provided him with records regarding same. Gerald Augustin contract did not require accuracy.
Gerald Augustin fallacies are not Gerald Augustin's fault. As a matter of fact, there is nobody at fault, but it is a LOT of fun to cause chaos on the arm of a payor, a court and an major state agency? It is called "systems induced trauma" and it is part of the cradle to prison pipeline. http://www.examiner.com/article/counteracting-convenient-ignorance. It isn't necessary, but there is noone to investigate and stop it, set a better standard and stop it.
Peers of Gerald Augustin saw the report in the immediate and expresses disbelief and concern. Reports identified it no documentation of verification presented ( he didn't have to) and called it cook-booking, using a computer program to run a report, maximizing suspected, not confirmed acuity. ( Plugging in information that the computer cannot discern and using that report without verifying, balancing and craft used to write a professionally licensed report).
Psychology and other mental health peers did not have any obligation to report his behavior, or his style of service or his inaccuracies. No standard of service, illustrated in law or policy improvement followed their discovery. Nor did the agency who housed his work, the state or the HHS ( Health and Human Services), OCR Office of Civil Rights) or ACF ( Administration to Children and Families).
The contracting agency has no accountability to this day to the work product ( the finished papers, words and court testimony).
Dr. Augustin is a provider over every surrounding county in the Atlanta area, providing reports on unsupervised contracts. http://optimalpsych.com/ But the payor law or policy doesn't have a system to audit, or measure this.
The hosting facility where Gerald Augustin walked on as a provider also had no accountability to his work product ( his homework when he turns in a report, writes notes or makes a court appearance).
National standards for sex assault reporting, record keeping, verification, use of students, use of licensed professionals , investigations and court need to happen now, President Obama.
Please stop the obstructionism, the unfettered vomiting of inaccuracies that renewably victimize. Without recourse, without supervision, without advanced investigations, we are all unprotected from random acts of violence without a comprehensive response about this issue. Laws and practices and national standards need to be in place to protect, and serve.
It is unacceptable http://en.wikipedia.org/wiki/Caveat_emptor to not have a verified, secure service, which is protective and advocates for accuracy.
For any category previously mentioned, but highlighted for the issue of sexual assault, because right now, sex assault is "the gift that keeps on giving" and it marginalizes and revictimizes.