CS/HB 7157

1	A bill to be entitled
2	An act relating to reemployment services; amending s.
3	440.491, F.S.; revising the definition of the terms
4	"qualified rehabilitation provider" and "reemployment
5	assessment"; revising intent; revising and providing
6	certain carrier reporting requirements; revising
7	rehabilitation provider reporting requirements; revising
8	provisions relating to medical care coordination and
9	reemployment services; revising procedures for the
10	approval of certain formal training and education
11	programs; repealing authorization to use Workers
12	Compensation Trust Funds for certain purposes; repealing
13	rehabilitation provider qualifications; eliminating
14	certain responsibilities of the Department of Education
15	with respect to monitoring rehabilitation providers and
16	services; providing an effective date.
17
18	Be It Enacted by the Legislature of the State of Florida:
19
20	Section 1.  Section 440.491, Florida Statutes, is amended
21	to read:
22	440.491  Reemployment of injured workers; rehabilitation.-
23	(1)  DEFINITIONS.-As used in this section, the term:
24	(a)  "Carrier" means group self-insurance funds or
25	individual self-insureds authorized under this chapter and
26	commercial funds or insurance entities authorized to write
27	workers' compensation insurance under chapter 624.
28	(b)  "Department" means the Department of Education.
29	(c)  "Medical care coordination" includes, but is not
30	limited to, coordinating physical rehabilitation services such
31	as medical, psychiatric, or therapeutic treatment for the
32	injured employee, providing health training to the employee and
33	family, and monitoring the employee's recovery. The purposes of
34	medical care coordination are to minimize the disability and
35	recovery period without jeopardizing medical stability, to
36	assure that proper medical treatment and other restorative
37	services are timely provided in a logical sequence, and to
38	contain medical costs.
39	(d)  "Qualified Rehabilitation provider" means a
40	rehabilitation nurse, rehabilitation counselor, or vocational
41	evaluator providing, rehabilitation facility, or agency approved
42	by the Department of Education as qualified to provide
43	reemployment assessments, medical care coordination,
44	reemployment services, or vocational evaluations under this
45	section, possessing one or more of the following nationally
46	recognized rehabilitation provider credentials:
47	1.  Certified Rehabilitation Registered Nurse, C.R.R.N.,
48	certified by the Association of Rehab Professionals.
49	2.  Certified Rehabilitation Counselor, C.R.C., certified
50	by the Commission of Rehabilitation Counselor Certifications.
51	3.  Certified Case Manager, C.C.M., certified by the
52	Commission for Case Management Certification.
53	4.  Certified Disability Management Specialist, C.D.M.S.,
54	certified by the Certified Disability Management Specialist
55	Commission.
56	5.  Certified Vocational Evaluator, C.V.E., certified by
57	the Commission of Rehabilitation Counselor Certification.
58	6.  Certified Occupational Health Nurse, C.O.H.N.,
59	certified by the American Board of Occupational Health Nurses
60	chapter.
61	(e)  "Reemployment assessment" means a written assessment
62	performed by a qualified rehabilitation provider which provides
63	a comprehensive review of the medical diagnosis, treatment, and
64	prognosis; includes conferences with the employer, physician,
65	and claimant; and recommends a cost-effective physical and
66	vocational rehabilitation plan to assist the employee in
67	returning to suitable gainful employment.
68	(f)  "Reemployment services" means services that include,
69	but are not limited to, vocational counseling, job-seeking
70	skills training, ergonomic job analysis, transferable skills
71	analysis, selective job placement, labor market surveys, and
72	arranging other services such as education or training,
73	vocational and on-the-job, which may be needed by the employee
74	to secure suitable gainful employment.
75	(g)  "Reemployment status review" means a review to
76	determine whether an injured employee is at risk of not
77	returning to work.
78	(h)  "Suitable gainful employment" means employment or
79	self-employment that is reasonably attainable in light of the
80	employee's age, education, work history, transferable skills,
81	previous occupation, and injury, and which offers an opportunity
82	to restore the individual as soon as practicable and as nearly
83	as possible to his or her average weekly earnings at the time of
84	injury.
85	(i)  "Vocational evaluation" means a review of the
86	employee's physical and intellectual capabilities, his or her
87	aptitudes and achievements, and his or her work-related
88	behaviors to identify the most cost-effective means toward the
89	employee's return to suitable gainful employment.
90	(2)  INTENT.-It is the intent of this section to implement
91	a systematic review by carriers of the factors that are
92	predictive of longer-term disability and to encourage the
93	provision of medical care coordination and reemployment services
94	that are necessary to assist the employee in returning to work
95	as soon as is medically feasible.
96	(3)  REEMPLOYMENT STATUS REVIEWS AND REPORTS.-
97	(a)  When an employee who has suffered an injury
98	compensable under this chapter is unemployed 60 days after the
99	date of injury and is receiving benefits for temporary total
100	disability, temporary partial disability, or wage loss, and has
101	not yet been provided medical care coordination and reemployment
102	services voluntarily by the carrier, the carrier must determine
103	whether the employee is likely to return to work and must report
104	its determination to the department and the employee. The report
105	shall include the identification of both the carrier and the
106	employee, and the carrier claim number and any case number
107	assigned by the Office of the Judges of Compensation Claims. The
108	carrier must thereafter determine the reemployment status of the
109	employee at 90-day intervals as long as the employee remains
110	unemployed, is not receiving medical care coordination or
111	reemployment services, and is receiving the benefits specified
112	in this subsection.
113	(b)  If medical care coordination or reemployment services
114	are voluntarily undertaken within 60 days of the date of injury,
115	such services may continue to be provided as agreed by the
116	employee and the carrier.
117	(4)  REEMPLOYMENT ASSESSMENTS.-
118	(a)  The carrier may require the employee to receive a
119	reemployment assessment as it considers appropriate. However,
120	the carrier is encouraged to obtain a reemployment assessment
121	if:
122	1.  The carrier determines that the employee is at risk of
123	remaining unemployed.
124	2.  The case involves catastrophic or serious injury.
125	(b)  The carrier shall authorize only a qualified
126	rehabilitation provider to provide the reemployment assessment.
127	The rehabilitation provider shall conduct its assessment and
128	issue a report to the carrier and, the employee, and the
129	department within 30 days after the time such assessment is
130	complete.
131	(c)  If the rehabilitation provider recommends that the
132	employee receive medical care coordination or reemployment
133	services, the carrier shall advise the employee of the
134	recommendation and determine whether the employee wishes to
135	receive such services. The employee shall have 15 days after the
136	date of receipt of the recommendation in which to agree to
137	accept such services. If the employee elects to receive
138	services, the carrier may refer the employee to a rehabilitation
139	provider for such coordination or services within 15 days of
140	receipt of the assessment report or notice of the employee's
141	election, whichever is later.
142	(5)  MEDICAL CARE COORDINATION AND REEMPLOYMENT SERVICES.-
143	(a)  Once the carrier has assigned a case to a qualified
144	rehabilitation provider for medical care coordination or
145	reemployment services, the provider shall develop a reemployment
146	plan and submit the plan to the carrier and the employee for
147	approval.
148	(b)  If the rehabilitation provider concludes that training
149	and education are necessary to return the employee to suitable
150	gainful employment, or if the employee has not returned to
151	suitable gainful employment within 180 days after referral for
152	reemployment services or receives $2,500 in reemployment
153	services, whichever comes first, the carrier must discontinue
154	reemployment services and refer the employee to the department
155	for a vocational evaluation. Notwithstanding any provision of
156	chapter 289 or chapter 627, the cost of a reemployment
157	assessment and the first $2,500 in reemployment services to an
158	injured employee must not be treated as loss adjustment expense
159	for workers' compensation ratemaking purposes.
160	(c)  A carrier may voluntarily provide medical care
161	coordination or reemployment services to the employee at
162	intervals more frequent than those required in this section. For
163	the purpose of monitoring reemployment, the carrier or the
164	rehabilitation provider shall report to the department, in the
165	manner prescribed by the department, the date of reemployment
166	and wages of the employee. The carrier shall report its
167	voluntary service activity to the department as required by
168	rule. Voluntary services offered by the carrier for any of the
169	following injuries must be considered benefits for purposes of
170	ratemaking: traumatic brain injury; spinal cord injury;
171	amputation, including loss of an eye or eyes; burns of 5 percent
172	or greater of the total body surface.
173	(d)  If medical care coordination or reemployment services
174	have not been undertaken as prescribed in paragraph (3)(b), a
175	qualified rehabilitation service provider, facility, or agency
176	that performs a reemployment assessment shall not provide
177	medical care coordination or reemployment services for the
178	employees it assesses.
179	(6)  TRAINING AND EDUCATION.-
180	(a)  Upon referral of an injured employee by the carrier,
181	or upon the request of an injured employee, the department shall
182	conduct a training and education screening to determine whether
183	the employee is eligible for it should refer the employee for a
184	vocational evaluation and, if appropriate, approve training and
185	education or other vocational services provided by the
186	department for the employee. At the time of such referral, the
187	carrier shall provide the employee a copy of any reemployment
188	assessment or reemployment plan provided to the carrier by a
189	rehabilitation provider. The department may not approve formal
190	training and education programs unless it determines, after
191	consideration of the reemployment assessment, pertinent
192	reemployment status reviews or reports, and such other relevant
193	factors as it prescribes by rule, that the reemployment plan is
194	likely to result in return to suitable gainful employment. The
195	department is authorized to expend moneys from the Workers'
196	Compensation Administration Trust Fund, established by s.
197	440.50, to secure appropriate training and education at a
198	Florida public college or at a career center established under
199	s. 1001.44, or to secure other vocational services when
200	necessary to satisfy the recommendation of a vocational
201	evaluator. As used in this paragraph, "appropriate training and
202	education" includes securing a general education diploma (GED),
203	if necessary. The department shall establish training and
204	education standards pertaining to employee eligibility, course
205	curricula and duration, and associated costs. For purposes of
206	this subsection, training and education services may be secured
207	from additional providers if:
208	1.  The injured employee currently holds an associate
209	degree and requests to earn a bachelor's degree not offered by a
210	Florida public college located within 50 miles from his or her
211	customary residence;
212	2.  The injured employee's enrollment in an education or
213	training program in a Florida public college or career center
214	would be significantly delayed; or
215	3.  The most appropriate training and education program is
216	available only through a provider other than a Florida public
217	college or career center or at a Florida public college or
218	career center located more than 50 miles from the injured
219	employee's customary residence.
220	(b)  When an employee who has attained maximum medical
221	improvement is unable to earn at least 80 percent of the
222	compensation rate and requires training and education to obtain
223	suitable gainful employment, the employer or carrier shall pay
224	the employee additional training and education temporary total
225	compensation benefits while the employee receives such training
226	and education for a period not to exceed 26 weeks, which period
227	may be extended for an additional 26 weeks or less, if such
228	extended period is determined to be necessary and proper by a
229	judge of compensation claims. The benefits provided under this
230	paragraph shall not be in addition to the 104 weeks as specified
231	in s. 440.15(2). However, a carrier or employer is not precluded
232	from voluntarily paying additional temporary total disability
233	compensation beyond that period. If an employee requires
234	temporary residence at or near a facility or an institution
235	providing training and education which is located more than 50
236	miles away from the employee's customary residence, the
237	reasonable cost of board, lodging, or travel must be borne by
238	the department from the Workers' Compensation Administration
239	Trust Fund established by s. 440.50. An employee who refuses to
240	accept training and education that is recommended by the
241	vocational evaluator and considered necessary by the department
242	will forfeit any additional training and education benefits and
243	any additional payment for lost wages under this chapter. The
244	department shall adopt rules to implement this section, which
245	shall include requirements placed upon the carrier shall to
246	notify the injured employee of the availability of training and
247	education benefits as specified in this chapter. The Department
248	of Financial Services shall also include information regarding
249	the eligibility for training and education benefits in
250	informational materials specified in ss. 440.207 and 440.40.
251	(7)  PROVIDER QUALIFICATIONS.-
252	(a)  The department shall investigate and maintain a
253	directory of each qualified public and private rehabilitation
254	provider, facility, and agency, and shall establish by rule the
255	minimum qualifications, credentials, and requirements that each
256	rehabilitation service provider, facility, and agency must
257	satisfy to be eligible for listing in the directory. These
258	minimum qualifications and credentials must be based on those
259	generally accepted within the service specialty for which the
260	provider, facility, or agency is approved.
261	(b)  The department shall impose a biennial application fee
262	of $25 for each listing in the directory, and all such fees must
263	be deposited in the Workers' Compensation Administration Trust
264	Fund.
265	(c)  The department shall monitor and evaluate each
266	rehabilitation service provider, facility, and agency qualified
267	under this subsection to ensure its compliance with the minimum
268	qualifications and credentials established by the department.
269	The failure of a qualified rehabilitation service provider,
270	facility, or agency to provide the department with information
271	requested or access necessary for the department to satisfy its
272	responsibilities under this subsection is grounds for
273	disqualifying the provider, facility, or agency from further
274	referrals.
275	(d)  A qualified rehabilitation service provider, facility,
276	or agency may not be authorized by an employer, a carrier, or
277	the department to provide any services, including expert
278	testimony, under this section in this state unless the provider,
279	facility, or agency is listed or has been approved for listing
280	in the directory. This restriction does not apply to services
281	provided outside this state under this section.
282	(e)  The department, after consultation with
283	representatives of employees, employers, carriers,
284	rehabilitation providers, and qualified training and education
285	providers, shall adopt rules governing professional practices
286	and standards.
287	(8)  CARRIER PRACTICES.-The department shall monitor the
288	selection of providers and the provision of services by carriers
289	under this section for consistency with legislative intent set
290	forth in subsection (2).
291	(7)(9)  PERMANENT DISABILITY.-The judge of compensation
292	claims may not adjudicate an injured employee as permanently and
293	totally disabled until or unless the carrier is given the
294	opportunity to provide a reemployment assessment.
295	Section 2.  This act shall take effect July 1, 2011.

CODING: Words stricken are deletions; words underlined are additions.