Introduction

For psychologists in private practice, therapeutic work is grounded in trust and continuity. But sudden incapacity or death can disrupt that trust and pose serious legal and ethical challenges. In Iowa, licensed psychologists are subject to both statutory law and regulatory obligations that reinforce the need for proactive planning.

Why Planning for the Unexpected Is Essential

Legal and Ethical Responsibilities in Iowa

Iowa law requires psychologists to ensure continuity of care and maintain secure recordkeeping:

• Iowa Administrative Code 645—241.33(154B): Psychologists must maintain patient records for at least seven years after the date of last service. For minors, records must be kept until at least one year after the patient reaches the age of majority.
• APA Ethics Code (Standard 3.12): Psychologists must “make reasonable efforts to plan for facilitating services in the event that psychological services are interrupted by factors such as illness, death, unavailability, relocation, or retirement.”

To comply with these requirements, psychologists in Iowa should:

• Designate a practice executor who can access and manage clinical records.
• Ensure the plan includes HIPAA-compliant access to encrypted and digital files.
• Create a clear record retention and destruction schedule.
• Include procedures for notifying patients and transferring records when appropriate.

Failure to take these steps could lead to:

• Patient abandonment and clinical harm.
• Breaches of confidentiality and legal violations.
• Emotional and administrative burdens for family members and colleagues.

The Role of a Professional Will

A Professional Will (or Practice Closure Plan) outlines how a psychologist’s practice should be managed in the event of incapacity or death. Key elements include:

• Practice Executor: A designated individual to carry out closure or transfer procedures.
• Patient Notification: How and when clients will be notified.
• Continuity of Care: Referral options or coordination with other clinicians.
• Confidentiality and Record Custody: Record locations, encryption passwords, and access instructions.
• Business Wrap-Up: Billing, lease termination, and insurance or licensure notifications.

Creating a fully actionable Professional Will requires thoughtful attention to detail. Plans that omit key information—such as where records are stored or how to contact a backup clinician—leave executors struggling to fulfill responsibilities during a time of crisis.

Naming a Practice Executor in Iowa

Iowa law assumes that psychologists will have adequate procedures in place to maintain continuity and confidentiality in the event of practice closure.

Best practices include:

• Naming a colleague or professional service as executor in writing.
• Providing them with detailed instructions and secure access to records.
• Including the executor’s responsibilities and authority in the professional will.

Executor Responsibilities

Upon the death or incapacitation of a psychologist, the executor must:

• Secure All Clinical Records: Immediately safeguard files, both paper and digital, to prevent unauthorized access.
• Retain Records: Maintain for at least seven years post-treatment or until age 19 for minors, in accordance with 645—241.33(154B).
• Notify Clients: Inform active and recent clients, ideally through direct communication and optional public notice.
• Coordinate with Referrals: Help clients transition to other care providers.
• Document and Comply: Keep a log of all actions taken and ensure HIPAA compliance throughout the process.

Traditional, Legal, and Professionalized Planning Approaches

Online Templates

Templates offer a quick and affordable way to create a Professional Will. However:

• They often lack specificity about state laws.
• They typically omit clinically sensitive issues like caring for vulnerable patients or encryption access.
• They may not reflect the practice’s unique administrative realities.

Using an Attorney

Some psychologists hire an attorney to draft a tailored closure plan:

• Pros: Customization to Iowa law; legal credibility with third parties.
• Cons: High hourly rates; most lawyers lack clinical knowledge or familiarity with continuity of care standards.

Naming a Colleague as Executor

Choosing a trusted colleague is common, but comes with limitations:

• Colleagues are often emotionally affected by the loss.
• Executing a full closure plan can require 40–80+ hours of work.
• Costs to the estate often exceed $10,000, or even $20,000, because of the high number of hours that must be billed.
• Risk of mistakes or delays can cause harm to clients and increase liability.

Professionalized Planning Model

A new model involves professional services that specialize in closure planning:

• Experts collaborate with clinicians to ensure all legal and clinical aspects are addressed.
• A professional executor is retained to step in immediately if needed.
• Predictable, annual retainer fees replace open-ended legal or executor costs.
• Services like TheraClosure ensure timely, ethical, and compassionate communication with clients.

Take Action Today

For psychologists in Iowa, proactive planning is not only a professional duty—it is a legal and ethical necessity.

• If you have already have a Professional Will and Executor: Use a checklist (such as this one) to ensure the Will contains all the specifics that would be necessary for an executor to execute the Will according to your wishes.  Also, be sure that you have chosen an Executor who has the time, expertise, and emotional distance to fully execute your Professional Will
• If you need to create a Professional Will: Consider the advantages and disadvantages of the options described above.
• Whatever you decide, take action before a crisis occurs.  Remember that planning for the unexpected is not just about compliance; it’s an act of care.