Amendment
Bill No. CS/HB 7157

Amendment No. 872633

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

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