State of Minnesota Rehabilitation Review Panel Mon., July 17, 2006 443 Lafayette Road N. St.

Paul, MN Voting members present Dr. Joseph Sweere Carl Crimmins Jonathan Hall Dennis Ballinger Anthony Ferraro Shirley Muelken Dawn Soleta Steve Hollander Sue Mauren Michele Cassidy Frank Lamp Alissa O’Hara Nonvoting members present William Martin Staff members present Patricia Todd John O’Loughlin Ralph Hapness Phil Moosbrugger Dee Torgerson Fred Charlton Jana Williams Debbie Caswell Jeanne Gehrman Others present Dotti Rottier Robert Otos Stephanie Igtanloc Voting members excused Meg Kasting

Call to order Dr. Sweere called the meeting to order at 1:09 p.m. Three new panel members were introduced: Jonathan Hall, employer alternate, from Empo Corporation; Dawn Soleta, employer representative, from The Toro Company; and Anthony Ferraro, labor representative, St. Paul Fire Fighters Local 21. Guests were then introduced. Approval of April 6, 2006 minutes John O’Loughlin indicated the following amendments should be made to the minutes. Under "QRC update," the areas where 42 disciplinary cases are cited, this number should be changed to 35. Shirley Muelken made a motion to approve the amended minutes and Carl Crimmins seconded the motion. The minutes were unanimously approved.

Approval of agenda The agenda was approved as submitted. Assistant commissioner's update Patricia Todd gave the following update. – Roslyn Wade, assistant commissioner of the Workplace Services Division, has stepped down from this position and has assumed her position as the director of Labor Standards and Apprenticeship. At this point, the assistant commissioner position is vacant. – Dee Torgerson is the new supervisor for the Vocational Rehabilitation unit in St. Paul and the outstate offices. She has a great deal of experience in regard to QRC background. A new QRC has been hired, Fred Charlton. He has been a QRC for Employee Development Corporation, as well as an occupational therapist. – The Special Compensation Fund has been renamed to be more of a reflection of what the organization does. The new name is Claims Services and Investigation (CSI). – There were two disputed rehabilitation provider registration cases discussed at the most recent meeting. These have been resolved and will not need to go through this panel. – There is a need for elections for the chairperson and vice-chairperson of the panel. Dr. Sweere was nominated as chairperson, Meg Kasting as vice-chairperson. Nominations were approved by the panel. Flat-fee pricing of job-placement services Todd indicated flat-fee pricing was a discussion item that the panel had at a previous meeting. There was some discussion at that time regarding the nature of debate that would be appropriate, given this matter could eventually be before the panel as a disciplinary issue. At the April 6, 2006 meeting, Julie Lippink of the Office of the Attorney General, clarified that the panel, in its role as policy adviser, may discuss rehabilitation topics. However, the panel should be cautious whenever addressing matters that are likely to be contested disciplinary matters. Todd reminded the panel of its dual role: one role is the legal decisionmaker regarding disciplinary cases; the other role is policy adviser to the commissioner about vocational rehabilitation matters. With regard to the flat-fee issue, the panel needs to be careful about looking into this in relation to its rules and statutes. Steve Hollander indicated several efforts have been made through the years to change the way rehabilitation providers bill their fees, from an hourly rate to a flat-fee rate. The most recent issue has to do with flat-fee pricing of job-placement services. The concern that was raised was that charging a flat rate might inhibit the provision of good, quality service. Todd indicated that it is the QRC's responsibility to complete the plan, even though a vendor is hired to help. Dr. Sweere asked whether this issue is still of concern to those who initially raised the issue. Hollander responded by saying the system is working well the way it is and that no change needs to be made at this time.

Carl Crimmins asked what happens to the person who gets referred to a vendor that uses the flat-fee billing, if the injured worker is not back to work when they’re told everything that can be done has been done? Hollander indicated the vendor involved is obligated to provide services and the QRC is obligated to supervise the vendor to make sure the services are being provided. The vendor and QRC are obligated to follow the rules to provide services to injured workers. If the QRC feels this isn’t being done, he or she could bring this to the attention of the department to get the case moving forward or transferred to someone else. Todd cautioned that it is only speculation that a flat-fee arrangement will result in a reduction in services. This is one of the key things the panel's legal advice continues to highlight. We do know the QRC has the responsibility to ensure the employee receives the services needed. The QRC also has the ability to make complaints in regard to specific services relating to a specific client. If the Department of Labor and Industry (DLI) gets an official complaint that indicates a certain placement vendor has not done everything within the requirements, this is something DLI could investigate. Hollander said one of the things that has been effective is reminding rehabilitation providers of the existing rules. Frank Lamp indicated there were concerns expressed about flat-fee pricing by several rehabilitation providers a few months ago, but there hasn’t been much discussion about that topic lately. Todd mentioned that the panel has yet to receive an official complaint from an employee adversely impacted by a flat-feepricing arrangement. Sue Mauren said that, oftentimes, the injured worker is overwhelmed by the system and may not quite understand the system, so the panel wouldn’t necessarily hear from an injured worker. Rehabilitation provider complaint process As requested by panel members at the April 2006 meeting, John O’Loughlin explained the process of investigating complaints against registered rehabilitation providers. He referred to the handout "Rehabilitation provider professional conduct investigation" and flowchart "RRP professional discipline process." He explained the complaint-handling process and clarified issues of concern to the panel members. O'Loughlin then went on to summarize his handout about investigations in the first two quarters of calendar-year 2006. Adjournment Crimmins made a motion to adjourn the meeting and Hollander seconded the motion. The meeting was adjourned at 2:08 p.m. Respectfully submitted by Chris Beaubien