STATE OF FLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING

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1 STATE OF FLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO KEITH L. HERBERT, L.C.S.W. RESPONDENT. ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling against Respondent,, and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of clinical social work pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 491, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed clinical social worker within the State of Florida, having been issued license number SW2604 on or about August 3, 1990.

2 3. Respondent was also licensed as a clinical soda{ worker in the state of New York, having been issued licensed number on or about September 1, Respondent's address of record is 60 Tall Oaks Drive, Kingston, New York Respondent had his license to practice social work acted against by another state when the New York State Board for Sodal Work accepted Respondent's voluntary relinquishment of his license to practice as a licensed clinical social worker in the state of New York on or about March 13, On or about September 20, 2017, Respondent was excluded from Medicare and all federal health care programs by the United States Department of Health and Human Services due to his license to practice social work being surrendered to the New York State Board for Social Work. COUNT I 7. Petitioner realleges and incorporates paragraphs one (1) through six (6) as if fully incorporated herein. 8. Section (1)(b), Florida Statutes (2017), provides that having a license, registration, or certificate to practice a comparable

3 profession revoked, suspended, or otherwise acted against, including the denial of certification or licensure by another state, territory, or country is grounds for discipline. 9. On or about November 22, 2016, Respondent had his license to practice social work acted against by another state when the New York State Board for Social Work accepted Respondent's voluntary relinquishment of his license to practice as a licensed clinical social worker in the state of New York. 10. Based on the foregoing, Respondent violated Section (1)(b), Florida Statutes (2017), when the New York State Board for Social Work accepted Respondent's voluntary relinquishment of license. COUNT H 11. Petitioner realleges and incorporates paragraphs one (1) through six (6) as if fully incorporated herein. 12. Section (1)(w), Florida Statutes (2017), provides that violating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto shall be grounds for discipline. 13. Section (1)(kk), Florida Statutes (2017), provides that being terminated from the state Medicaid program pursuant to Section

4 , any other state Medicaid program, or the deferral Medicare program, unless eligibility to participate in the program from which the practitioner was terminated has been restored. 14. On or about September 20, 2017, Respondent was excluded from Medicare and all federal health care programs by the United States Department of Health and Human Services. 15. Based on the foregoing, Respondent violated Section (1)(w), Florida Statutes, through a violation of (1)(kk), when he was excluded from Medicare and all federal health care programs by the United States Department of Health and Human Services. WHEREFORE, Petitioner respectfully requests that the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the Board deems appropriate. {Remainder of Page Intentionally Left Blank}

5 SIGNED this day of Celeste Philip, M.D., M.P.H. Sure - I General and Secretary CLERK FILED DEPARTMENT OF HEALTH DEPUTY CLERK Angel Sanders DATE SEP f 11 Derrick IIIFIIPIT c urrvows Assistant General Counsel Florida Bar # DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida Phone FAX derrick.mcburrows@flhealth.gov PCP Date: 9/5/2018 PCP Members: Barlow and Bolhouse

6 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section and , Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule (2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule (4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule (5), Florida Administrative Code. Please be advised that mediation under Section , Florida Statutes, is not available for administrative disputes involving this agency action. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section (4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed

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