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

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