State Accuses Health Official of Patient Ties

A top Orange County health official who also maintains a private psychology practice has been accused of “gross negligence” for allegedly maintaining a social relationship with a patient that included gifts, ski trips and an invitation to use her Jacuzzi, the Medical Board of California said in a formal complaint.

A complaint filed Feb. 13 by Thomas S. O’Connor, executive officer of the state’s Board of Psychology, said Marianne E. Maxwell, director of special projects at the County Health Care Agency, counseled a patient identified only as “JC” from November, 1983, to June, 1986. Maxwell, a full-time county employee, also runs a part-time psychology practice from an office on Bristol Street in Santa Ana.

During the patient’s therapy and after formal counseling had ended, the complaint said, Maxwell allegedly “cultivated and maintained a social relationship with JC by . . . going to lunch or dinner with JC, exchanging gifts with JC, going on ski trips and other trips with JC, inviting JC to participate in social events in (her) home and Jacuzzi and encouraging or permitting a friendship between JC and (Maxwell’s) husband.”

O’Connor recommended that Maxwell’s license to work as a psychologist be suspended or revoked if a hearing on these complaints confirms them.

Reached at her county office late Friday, Maxwell said only: “I can’t comment on that. I’m tied by confidentiality.”

An official with the Orange County Psychological Assn. declined comment on the specifics of the case.

Dr. Rosalyn M. Laudati, a board member and past president of the Orange County Psychological Assn., said psychologists’ national code of ethics expressly bars them from developing any relationship with a client outside of therapy.

“Therapy must be a sacred, special, untouchable relationship,” Laudati said. “Nobody should be confused about this.”

The American Psychological Assn.’s code “prohibits anything that is considered to be a dual relationship--anything that involves socializing or business outside of therapy,” she said.

A relationship beyond therapy, Laudati said, not only can taint the therapeutic value of treatment but in some cases might harm the patient.

Maxwell, a longtime county employee, is one of the top Health Care Agency administrators under the agency’s director, Tom Uram.

In recent months, Maxwell has been heading the county’s Perinatal Task Force, a high-level committee composed of doctors, social service providers and county officials who are investigating ways to improve prenatal and delivery services for low-income women.

Maxwell has also been a county administrative analyst and in the early 1980s was founder and then director of Indigent Medical Services, the county health insurance program for low-income residents.

Uram said late Friday that he was sorry to hear about the allegations.

But “they would have no bearing on her position” with the county, he said: “She’s not working as a psychiatrist or a psychologist with the county. She’s not in the Mental Health Department.”