State of Minnesota Rehabilitatin Review Panel Thurs., Jan. 5, 2006 443 Lafayette Road N. St.

Paul, MN Voting members present Dr. Joseph Sweere Sue Mauren Shirley Muelken Michele Cassidy Dennis Hollander Steve Hollander Alternates present Frank Lamp Nonvoting members excused William Martin Staff members Patricia Todd Jana Williams Penny Grev Phil Moosbrugger John O’Loughlin Jim Feckey Jeanne Gehrman Others present Nancy Caven Gary Novitzky Voting members excused Dawn Chicilo Dennis Ballinger Margaret Kasting John Williams

Call to order Dr. Sweere called the meeting to order at 1:15 p.m. Department staff members and guests were introduced. The new panel member representing labor, Shirley Muelken, was introduced. She is currently a union representative with USCW Local 79, which represents people in grocery stores, nursing homes, packinghouses and drugstores. There are also two other new members: Carl Crimmins, representing labor; and alternate Anthony Ferraro, also representing labor. They were both unable to attend the meeting. Sweere indicated that at the most recent meeting there was a brief discussion about what might constitute the quorum. There was a question whether the quorum should entail active members in each of the participating groups. In this instance, for example, there are 13 slots of official voting members of the panel; however, there are only nine active participating panel members at this time. The question is, if we were to use the 13 as our quorum determinator, then we would require seven people before we could, theoretically, do business for the official business. Sweere wondered whether, under these circumstances, a quorum could be a majority of current panel members.

It was reported that since our most recent meeting, Ed Spitler passed away, and that John O’Loughlin was recently hired in Ed’s position. Approval of minutes – Oct. 6, 2005 Sweere mentioned that under “QRC update,” the second line of the second paragraph should be: “... of these 88 complaints, 55 were filed by the same individual.” Also, under “QRC flat-fee approach,” in the second paragraph, the second sentence should be “... the commissioner regarding QRC issues, to suggest changes in legislation or rule and to provide advice ...” Sue Mauren made a motion to approve the amended minutes and Dennis Hollander seconded. The amended minutes were unanimously approved. Approval of agenda The agenda was approved as submitted. Assistant commissioner’s update Patricia Todd indicated a new emergency exit was recently installed in the Minnesota Room on the north wall of the building. She also reminded visitors to be sure they’re parked in the visitor lot, and that they sign in and out at the receptionist’s desk. Todd also reported that a new director of the Benefit Management and Resolution (BMR) unit, Penny Grev, was recently hired. Grev has had various positions within human resources. She’s worked for the Department of Corrections, the Department of Human Services, the Department of Employee Relations and has had various roles within HR. Grev has also been involved with dispute resolution and investigations. Recently, there have been two retirements in the Information Processing Center (IPC) unit: Manager Cindy Miner and Supervisor Ruth Rose. There were questions and discussion at the most recent meeting about flat-fee arrangements for QRC firms. Complaints have been resolved and the company involved is no longer requiring flat-fee agreement arrangements. Todd also indicated that at the most recent meeting, one of the common complaints or concerns with regard to QRC complaints is timeliness of filing forms and data. She was asked if forms can be accepted by the department electronically. This has been investigated and there is concern that the forms would not be encrypted, so confidential information could come through the system. Forms are now online and can be completed by purchasing and using the full version of Adobe Acrobat, not the free version that is available on the Web. The department looked at creating the forms in Microsoft Word, so people could just put the data in using the Word process, but one of our concerns is the fonts could be changed as well as the location of information, and it’s critical to our imaging system not to have the barcode tampered with. So, at this time, we are not able to accept forms electronically, but the department will continue to pursue this issue in the future. There are currently one employer and two medical practitioner vacancies; Todd asked that if anyone knows of someone who would be interested in being on the panel to let her know. Mauren indicated John Williams recently retired from the labor field and is currently working with management at the university, so he may make a good employer

representative. Todd will look into this issue to see if he would be interested in being an alternate. Legislative update Todd reported that, at this time, it doesn’t appear the Workers’ Compensation Division will have a bill this year, but there may be some cleanup issues regarding statutory language. There was a suggestion from OAH that would allow them to accept certain documents by fax. This is under discussion at the Workers’ Compensation Advisory Council. One of the biggest things the agency is working on is data privacy in the workers’ compensation area. The department is considering proposals that would specify that data that is not specifically defined as public, would be considered to be private. QRC update John O’Loughlin referred to a 2005 rehabilitation provider conduct and accountability handout, which he reported about. The department set a record in 2005, with 99 complaints. Seventy complaints were closed in 2005, and 42 are still open. O’Loughlin is currently working on trimming that backlog. There was discussion about the number of complaints filed by one person in 2005. The minutes, as amended, now included the correct number. Sweere asked what the nature of the complaints was. O’Loughlin indicated this is one individual who complained about 55 QRCs. Flat-fee pricing Steve Hollander mentioned he was pleased to hear the insurer that was imposing flat-fee pricing on QRC firms has dropped that approach since the most recent meeting of the panel. Hollander then announced that he invited job-placement vendor Gary Novitsky to address the panel about a similar issue that has arisen regarding flat-fee pricing by a jobplacement vendor. Novitsky mentioned that at least one Minnesota job-placement vendor is now using a flat-fee pricing method. He has concerns about flat-fee pricing by job-placement vendors. Novitsky is concerned there is little incentive for a vendor using this type of pricing to provide vigorous assistance to an injured worker if a case drags on without a quick placement. Sweere asked O’Loughlin for clarification about what the rules say about flat-fee pricing for job-placement vendors. O’Loughlin explained neither the statutes nor the rules specifically mention flat-fee pricing. However, there is a rule that prohibits a fee arrangement that prevents or compromises individualized assessment and services for each employee. While it is not certain that flat-fee pricing will lead to poorer service for injured workers, the concern is there may be potential for poorer service. Some have also expressed concern that injured workers may be unaware that a business agreement exists that may adversely affect the services that will be available. O’Loughlin went on to explain the workers’ compensation statute addresses obligations of QRCs to disclose potential conflicts of interest, but little is said about job-placement vendors. However, the rehabilitation rules have a provision that refers to disclosure obligations by “rehabilitation providers.” This term includes QRCs, QRC firms and job-placement vendors. While the

rules clearly indicate a QRC must inform the employee of potential conflicts of interest at the first meeting, the rules do not specify when or how a job-placement vendor would make such a disclosure. Mauren mentioned that even if the employee is informed that the job-placement vendor has agreed to a flat-fee pricing arrangement, he or she may not be in a position to understand how such an agreement could affect the services that are provided over time. With that in mind, disclosure, by itself, may not be adequate protection for injured workers. Todd mentioned that QRCs have an obligation to monitor the services provided by jobplacement vendors. So, if the job placement effort is inadequate because of flat-fee pricing or any other reason, the QRC should do what is necessary to remedy the situation. Panel members asked that department representatives address flat-fee pricing by jobplacement vendors as the next meeting of the panel. Other business Hollander announced the national conference of the International Association of Rehabilitation Professionals (IARP) will be in Minneapolis, May 19 through 21, 2006. Adjournment Michelle Cassidy made a motion to adjourn the meeting; Mauren seconded the motion.