Findings Of Fact In 1984, petitioner, Louise Blair, visited the Miami office of respondent, Department of Labor and Employment Security, Division of Vocational Rehabilitation (Division), for the purpose of seeking vocational rehabilitation (VR) services. Through the use of federal funds, the Division provides such services to eligible persons. Although Blair indicated she received various services in 1984 and 1985, Division records produced at hearing reflect she was not formally enrolled as a client until October, 1986. To be eligible for VR services, a person must (a) have a physical or mental disability, (b) show that the disability is a substantial handicap to employment, and (c) show that VR services would reasonably be expected to render that person fit to engage in a gainful occupation. Once a person is certified as eligible for VR services, an individual written rehabilitation program (IWRP) must be prepared by a counselor and approved by the Division. The IWRP identifies, among other things, the determination and achievement of a vocational goal. The IWRP must be reviewed annually, and it remains in effect until services are terminated or the plan is changed. Services may include counseling, medical treatment and grant funds for training in a marketable skill. Blair was classified as eligible for Division assistance due to both physical and mental disabilities. Her IWRP was reduced to writing on October 12, 1986. The plan called for business and clerical training at United Business Institute (UBI) in Miami from October, 1986 through May, 1987. Funds for the UBI tuition had already been obtained by Blair through a student grant and a federal loan program. Blair's long-term goal was to obtain a marketable skill (typing) which could then be used as an employment tool. The specific VR services to be rendered Blair were counseling by a Division counselor, eyeglasses for her failing eyesight, and payment for medication for gastric ulcers. She was also sent on one occasion to Jackson Memorial Hospital in Miami to be examined by an internist. As it turned out, Blair only stayed at UBI for about three weeks. She left because the school furnished inadequate instruction. After Blair complained to the State Department of Education, UBI gave her a full refund of her money. Blair had the money transferred to Barry College (Barry) in Miami where she enrolled as a student for one semester. She reenrolled at Barry for a second semester (spring of 1987) but was late in filling out her application for a student loan. Even though she did not obtain a loan, Blair remained at Barry for the semester without paying tuition. Barry now wants the money owed for tuition and will not allow Blair to re-enroll until it is paid. Blair accordingly requested that the Division pay for her tuition as a VR service. However, applicable federal regulations, which are binding on the Division, do not allow an IWRP to be altered after the fact or for the Division to pay for services after they are rendered. In other words, the Division cannot authorize payment for an educational service after the student has already enrolled at the college. Since Blair was enrolled in Barry before she requested a modification of her IWRP, the Division is prohibited from reimbursing Blair for her tuition. Besides needing prior authorization for a service, a client must also have a psychological evaluation performed to determine if the client would benefit from a college education. In Blair's case, an after-the-fact evaluation was made on May 4, 1988, presumably to assist the Division in countering Blair's claim. The results of the evaluation were not made a part of the record, and the counselor's testimony as to what it said is inadmissible hearsay. However, after meeting with Blair and reviewing her file, Blair's counselor made a recommendation that Blair would not benefit from a college education. At hearing Blair contended that she had a difficult time arranging an appointment to see a counselor and then having a meaningful session to develop an IWRP. This was probably attributable to the fact that her counselor was carrying a case load of 100 active clients at the time. In any event, an IWRP was prepared and signed on October 12, 1986, and was binding on the client. She also contended that she told the counselor that she was attending Barry University before her plan was prepared. Even if this was true, it was still necessary to obtain approval for tuition payment prior to enrolling at the college. Blair did not do this. Therefore, the agency properly denied her request.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that petitioner's request for modification of her IWRP or approval for college tuition payments be denied. DONE AND ORDERED this 20th day of June, 1988, in Tallahassee, Leon County, Florida. DONALD R. ALEXANDER Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 20th day of June, 1988. COPIES FURNISHED: Ms. Louise Blair 652 Northwest 100th Street Miami, Florida 33150 E. Ellen Winslow, Esquire 131 Montgomery Building 2562 Executive Center Circle East Tallahassee, Florida 32399-2152 Hugo Menendez, Secretary Department of Labor and Employment Security 206 Berkeley Building 2590 Executive Center Circle East Tallahassee, Florida 32399-2152 Steve Barron, Esquire General Counsel 131 Montgomery Building 2562 Executive Center Circle East Tallahassee, Florida 32399-2152
The Issue Whether Petitioner is entitled under Florida’s workers’ compensation laws to payment for professional services to an injured worker for the billings identified by the three notices of disallowance at issue in this consolidated proceeding.
Findings Of Fact The claimant, a male, was born July 21, 1961. On February 17, 1995, the claimant sustained a severe traumatic brain injury (TBI) and other injuries during the course of his employment with the City of Hollywood, Florida. At all times relevant to these proceedings, the claimant has been receiving benefits pursuant to the Florida workers’ compensation laws. At all times relevant to this proceeding, the carrier has been the workers’ compensation carrier for the employer. At all times relevant to this proceeding, the claimant has lived in a home purchased for him by the carrier. The claimant has a life estate in the home and the carrier has the remainder interest. The claimant lives in the home with his mother and has 24-hour attendant services paid for by the carrier. The carrier has purchased a van for the claimant, which his attendant uses to transport the claimant to therapy and other appointments. The claimant has a history of mental illness dating to his teenage years, when he was diagnosed with schizophrenia. As a result of his injury and his illness, the claimant acts out periodically and becomes physically resistive to those trying to care for him. At all times relevant to this proceeding, Petitioner has been a provider of rehabilitation services to various patients, including those with TBI. Dr. Marie DiCowden, a psychologist, is the founder and director of Petitioner. Dr. DiCowden described Petitioner as being a health care community that provides an integrated administration for a long continuum of care post acute rehabilitation through community reintegration using health promotion, prevention, and integrated primary care. Petitioner is accredited by two national accrediting organizations referred to by the acronyms CARF (Commission on Accreditation of Rehabilitation Facilities) and CORF (Commission on Outpatient Rehabilitation Facilities). Petitioner is also certified by the Florida Division of Vocational Rehabilitation (formerly housed in the Department of Labor and now housed in the Department of Education), the Florida Division of Workers’ Compensation, and by the Florida Brain and Spinal Cord Injury Program.4 As a result of his accident, the claimant was in a coma for several weeks. He was hospitalized (first in an acute care facility and subsequently in two different rehabilitation hospitals) until December 28, 1995, when he was placed in Whitehall Nursing Home. Whitehall was not an appropriate placement for the claimant because of his behavior and his need for rehabilitation services. On March 27, 1996, Yvonne Beckman, a rehabilitation nurse consultant employed by the carrier, referred the claimant to Petitioner for an evaluation. Shortly before that referral, the claimant had been evaluated by two neuropsychologists (Dr. Jorge A. Herra and Dr. Lee. H. Bukstel), who had opined that the claimant would benefit from rehabilitation services. Ms. Beckman asked Dr. DiCowden to recommend a neurologist who practiced in South Florida. In response, Dr. DiCowden gave Ms. Beckman the names of three neurologists, one of whom was Dr. Paul Wand. Ms. Beckman authorized Dr. Wand to provide services to the claimant. Dr. Wand prescribed continued rehabilitation services for the claimant at Petitioner’s facility. The services at issue in this proceeding were provided by Petitioner pursuant to prescriptions from Dr. Wand.5 Prior to accepting the claimant, Dr. DiCowden informed a representative of the carrier that Petitioner would accept the claimant as a patient in its brain injury program and estimated the annual costs to be $200,000.00. The claimant began receiving rehabilitation services from Petitioner five days a week beginning August 1, 1996. The claimant received from Petitioner’s staff physical therapy, occupational therapy, cognitive retraining, speech training, language training, psychological services, art therapy, music therapy, and yoga therapy. The claimant continued to receive those rehabilitation services from Petitioner (five days a week) from August 1996 to the date of the hearing (and presumably to date). The authorization for the provision of rehabilitation services to the claimant was periodically reviewed by the carrier. In November 1998, the carrier had the claimant examined by Dr. Richard Bailyn (a neurologist) and by Dr. Kevin Lapinski (a neuropsychologist). Those doctors opined that the claimant was not benefiting from cognitive retraining, occupational therapy, speech therapy, or language therapy at Petitioner’s facility. They further opined that the claimant required an activity program to satisfy his recreational and stimulation needs, but that such a program did not require Petitioner’s facility since the claimant’s aide could be trained to provide those services. Dr. Bailyn was of the opinion that as of November 1998 the various therapies provided by Petitioner’s facility to the claimant were not reasonable and were not medically necessary. Section 440.13(6), Florida Statutes, requires a carrier to review bills by providers of medical services as follows: (6) UTILIZATION REVIEW.--Carriers shall review all bills, invoices, and other claims for payment submitted by health care providers in order to identify overutilization and billing errors, including compliance with practice parameters and protocols of treatment established in accordance with this chapter, and may hire peer review consultants or conduct independent medical evaluations. Such consultants, including peer review organizations, are immune from liability in the execution of their functions under this subsection to the extent provided in s. 766.101. If a carrier finds that overutilization of medical services or a billing error has occurred, or there is a violation of the practice parameters and protocols of treatment established in accordance with this chapter, it must disallow or adjust payment for such services or error without order of a judge of compensation claims or the agency, if the carrier, in making its determination, has complied with this section and rules adopted by the agency. As required by Section 440.13(6), Florida Statutes, the carrier conducted a utilization review of the services provided by Petitioner to the claimant beginning in late 1999. The carrier retained Dr. Thomas G. Hoffman to review the claimant’s medical records and to express opinions pertaining to the services provided to him by Petitioner. On April 10, 2000, Dr. Hoffman submitted a report that included several conclusions, including those that follow. The claimant has severe, residual deficits as a result of his accident. He requires 24-hour attendant care. There is no reasonable expectation for further improvement. The therapy he was receiving at that time (and still receives) was not reasonable or medically necessary. The therapy was excessive in frequency and duration. Dr. Hoffman’s deposition testimony was consistent with his written report. The carrier retained Dr. Victor B. Robert to review the claimant’s medical records and to express opinions pertaining to the services provided to him by Petitioner. On June 19, 2000, Dr. Robert submitted a report that included several conclusions, including those that follow. The treatment rendered by Petitioner was excessive in frequency and duration. The claimant reached an improvement plateau in early 1997 and therapy was thereafter needed only for maintenance reasons. Dr. Robert’s testimony was consistent with his written report. The carrier retained International Assessment Systems, Inc. (IAS), a professional association of various medical practitioners, to conduct an independent neurological, neuropsychological, and psychological examination of the claimant. On September 22, 2000, IAS submitted a report (Intervenors’ Exhibit 8) based on the examinations of claimant and the review of his medical records by Dr. Kenneth C. Fischer, Dr. Alan J. Raphael, and Dr. Charles J. Golden. The report included several observations and conclusions, including those that follow. The testimony of Drs. Fischer, Raphael, and Golden was consistent with the written report they prepared for IAS. Pages 12-13 of the IAS report contain the following: [The claimant] was oriented to person, but not to place or time. He did not know the current day, date, month, or year. His sensorium was significantly impaired. His mood was volatile, ranging from normal to agitated. His affect was similarly labile, at times he was placid, laughing, and able to converse at a basic level, however he was also quite violent. Attention and concentration were significantly impaired. His receptive, expressive and fluency language capabilities were similarly impaired, although, as noted, he was capable of basic/functional [sic] communication. There were no direct indications of hallucinatory or delusional phenomena, however, based on his behavior, it is likely that some hallucinatory or delusional phenomena were present. His reality testing and insight were significantly impaired. During his repeated fits of anger, he often uttered suicidal and homicidal threats, however there was no evidence of actual intent or plan. He showed no ability to monitor his own safety. Page 15 of the IAS report contains the following: From a neuropsychological and psychological perspective, there were gross impairments noted in his cognitive abilities and emotional functioning. . . . He has been afforded considerable time to maximize his cognitive recovery at this point. It is clear that he has plateaued with regard to cognitive improvement. He will not benefit from continued rehabilitation efforts, although he will require continued stimulation to avoid further cognitive decline. His mood and labile affect may also be benefited by continued stimulation in terms of recreational activities to provide appropriate quality of life.6 Page 17 of the IAS report contains the following under the heading “Neurologic Impression”: . . . I [Dr. Fischer] would recommend that he be placed in a supervised residential setting which will give better protection for him and his caregivers than his present home setting. As the patient is four and a half years status post-injury, specific rehabilitative and therapeutic endeavors will have no benefit and are unwarranted. This would relate to hyperbaric oxygen and cognitive rehabilitation was well as any form of physical, occupational, or speech therapies. Page 19 of the IAS report contains the following: [The claimant] was certainly aided by initial removal from the nursing home and receiving cognitive and physical therapies at Biscayne. However, he has long since reached a plateau in his improvement and no further improvement can be expected at this time. Maximum medical improvement should have been reached within 18 to 24 months post-injury. Any treatment after that time would be palliative or maintenance-oriented (sic). Therefore, the treatment prescribed by Dr. Wand became unreasonable and medically unnecessary several years ago. Page 20 of the IAS report reflects the opinion that while the treatments at Petitioner’s facility were excessive in all respects, the claimant does require maintenance rehabilitation services. It is opined that cognitive retraining is no longer appropriate, but that cognitive tasks and games are appropriate in a recreational setting. By letter dated October 27, 2000, the carrier, through its counsel, advised Petitioner that based on its Utilization Review investigation, it had concluded that as to the identified dates of service “. . . there has been overutilization and/or misutilization since the treatment has been excessive and not medically necessary.” This Letter of Disallowance was the first of a series of letters sent by counsel for the carrier to Petitioner, and frames the issues for all of the disallowances at issue in this proceeding. Thereafter, Petitioner timely disputed the carrier’s basis for disallowing its services to the claimant and petitioned the Respondent to resolve the dispute. The total amount disallowed and at issue in this consolidated proceeding is $615,587.00. Respondent employed four Expert Medical Advisors (EMAs) to perform peer review and assist it in resolving the dispute involving the rehabilitation services provided the claimant by Petitioner. Respondent employed Dr. Fernando G. Miranda, Dr. Jorge Villalba, Dr. Gerard P. Garcia, and Dr. David McCraney to serve as EMAs.7 Each of these doctors prepared a report following his review and each sat for deposition. Dr. Miranda’s report, dated September 17, 2001, is attached to his deposition (Intervenors’ Exhibit 17). The report included several conclusions, including those that follow. The referral for intensive multi-disciplinary treatment at Petitioner’s facility is no longer medically necessary. The services provided by Petitioner are excessive in frequency and duration and he will not further improve with speech therapy, cognitive retraining, occupational therapy, or individual psychotherapy. Maintenance physical therapy is recommended. Dr. Miranda testified in his deposition that the recommended physical therapy could be performed by the claimant’s attendant. Dr. Miranda’s deposition testimony was consistent with his written report. Dr. Villalba’s report dated October 15, 2001, is attached to his deposition (Intervenors’ Exhibit 19). The report included several conclusions, including those that follow. The claimant reached maximum medical improvement between February 1996 and October 1997. Dr. Villalba described the services provided by Petitioner to claimant “clearly not medically necessary” after October 1997. He also opined that the claimant will require maintenance physical therapy, occupational therapy, and speech and language therapy on a continuing basis. Dr. Villalba’s deposition testimony was consistent with his written report. Dr. Garcia’s undated report was prepared during the second week of October, 2001, and is attached to his deposition (Intervenors’ Exhibit 16). The report included several conclusions, including those that follow. The claimant should be on a maintenance program and Petitioner’s treatment was excessive. The claimant is unlikely to make further neuropsychological improvement, but he should be treated by a psychiatrist for his schizophrenia. Dr. Garcia’s deposition testimony was consistent with his written report. Dr. McCraney’s report dated November 18, 2001, is attached to his deposition (Intervenors’ Exhibit 18). The report included several conclusions, including those that follow. While the care provided Petitioner appears to be excellent, the claimant is far beyond the point where Petitioner’s therapies would be reasonable or medically necessary. Dr. McCraney’s deposition testimony was consistent with his written report. Dr. DiCowden testified at length about the various services her facility provides the claimant and the records her staff generates as a result of those services. Dr. DiCowden testified that her staff is well-trained in assessing the functional status of rehabilitation patients using nationally recognized assessment methodologies. FIN-FAM, acronyms for “Functional Independence Measures” and “Functional Assessment Measures” is one assessment measure used by Petitioner’s staff. The FIN-FAM measure purports to quantify a patient’s progress or lack thereof and can be used by staff as a tool in developing treatment strategies. Dr. DiCowden presented a chart of the FIN-FAM scores for the claimant for the periods at issue in this proceeding. The chart, prepared for this litigation, reflects steady functional improvement of the claimant. Dr. DiCowden further testified that Petitioner’s staff uses a scale of cognitive functioning developed by a rehabilitation facility known as Rancho Los Amigos Hospital, which measures a patient’s response to stimuli on a scale of Ranch Level I (no response) to Ranch Level VII (appropriate response). She asserts that the measurement of the claimant’s status using the Rancho methodology reflect that the claimant has improved over the years. In support of its position that the claimant steadily progressed while undergoing therapy at its facility, Petitioner presented the testimony of Drs. Antonio Puente, Vernando Batas, and Richard Kishner who observed the claimant at Petitioner’s facility on June 23, 2003, September 13, 2003, and February 24, 2004, respectively. Each of these witnesses had the subjective impression that the claimant was benefiting from therapy at Petitioner’s facility. Petitioner asserts that the FIN-FAM scores, the Rancho Levels, and the testimony of its experts establish that the claimant is benefiting from therapy. That assertion is rejected as being contrary to the greater weight of the credible evidence. The FIN-FAM scoring and the Rancho scale depend on the subjective impressions of the various therapists who treat the claimant at Petitioner’s facility and the record reflects that the scoring was done on an irregular basis.8 Dr. DiCowden adamantly disagreed with the contention that the rehabilitation services provided by her facility is not reasonable or medically necessary. All evidence presented by Petitioner, including Dr. DiCowden’s testimony, has been carefully considered by the undersigned in resolving the conflicts in the evidence. At best, Petitioner established that the claimant made some unquantified amount of progress in the highly structured therapeutic setting at Petitioner’s facility. Intervenors’ experts clearly established that any progress made by the claimant in therapy did not transcend that therapeutic setting to the real world. Petitioner failed to establish by a preponderance of the evidence that the rehabilitation services it provided the claimant were appropriate and medically necessary. To the contrary, the greater weight of the credible evidence established that at all times relevant to this proceeding the rehabilitation services provided by Petitioner to the claimant have been excessive and that those excessive services have been neither reasonable nor medically necessary.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Agency for Health Care Administration issue a final order that sustains the disallowances at issue in this consolidated proceeding. DONE AND ENTERED this 15th day of June, 2004, in Tallahassee, Leon County, Florida. S CLAUDE B. ARRINGTON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 15th day of June, 2004.
The Issue The issue is whether Petitioner's request for an exemption from disqualification from employment in a position of special trust should be granted.
Findings Of Fact Based upon all of the evidence, the following findings of fact are determined: This case involves a request by Petitioner, Sylvan L. Stahl, Jr., for an exemption from disqualification from employment in a position of special trust. If the request is approved, Petitioner's wife would be allowed to operate a child day care center in her home, a position she is now barred from holding because her husband has a disqualifying offense and lives in the same household. Respondent, Department of Children and Family Services (DCFS), is the state agency charged with the responsibility of approving or denying such requests. In a preliminary decision entered on February 13, 1998, a DCFS committee denied the request. Petitioner is now barred from employment in which he would have contact with children because of a disqualifying offense which occurred in September 1989. At that time, Petitioner was arrested in Citrus County, Florida, for the offense of armed robbery, a felony under Chapter 812, Florida Statutes (1989). Although the documents pertaining to the offense were not made a part of this record, Petitioner established that in September 1989, he attempted to rob a bank with a firearm. Under a plea bargain arrangement with the prosecutor, he pled guilty to the charge and was sentenced to four and one-half years in prison, to be followed by ten years of supervised probation. Petitioner served only the three-year mandatory minimum sentence, and he then successfully completed his probation after only three years. No person was injured during the incident. After being released from prison, Petitioner worked for three years with a pallet firm owned by his father, rising to the position of supervisor. During his three-year tenure with the firm, Petitioner increased the size of the company from five to twenty employees. For the last six months or so, Petitioner has been employed by Emergency One, an Ocala firm which manufactures fire trucks. He also has a second job with his brother-in-law's landscaping firm. The two jobs require that Petitioner begin his work day at 7:00 a.m. and that he continue working until 1:30 a.m. Petitioner's wife intends to operate a small day care center out of the family home. It is fair to infer that due to Petitioner's lengthy working hours, he will spend little, if any, time at his home while the children are entrusted to his wife's care. Since his arrest and plea of guilty almost nine years ago, Petitioner has had no other blemishes on his record. He has been steadily employed since 1994 in positions of responsibility. Petitioner is married to a minister's daughter, has a young child, and has recently purchased a new home. Letters received in evidence corroborate the testimony of him and his wife that he will pose no threat to children if the exemption is granted. Petitioner expressed remorse for his actions in 1989, calling his conduct "stupid," and indicating he was "confused" at that time. Given his continuous employment history, good conduct during his shortened probation period, stable family life, and the time elapsed since the disqualifying offense, it is found that Petitioner is sufficiently rehabilitated to justify granting the exemption.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that the Department of Children and Family Services enter a final order granting Petitioner's request for an exemption from disqualification from employment in a position of special trust. DONE AND ENTERED this 14th day of May, 1998, in Tallahassee, Leon County, Florida. DONALD R. ALEXANDER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 14th day of May, 1998. COPIES FURNISHED: Gregory D. Venz, Agency Clerk Department of Children and Family Services Building 2, Room 204Z 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Richard A. Doran, Esquire Department of Children and Family Services Building 2, Room 204 1317 Winewood Boulevard Tallahassee, Florida 32399-0700 Sylvan L. Stahl, Jr. 11848 Southeast 71st Avenue Road Belleview, Florida 34420 Ralph J. McMurphy, Esquire Department of Children and Family Services 1601 West Gulf Atlantic Highway Wildwood, Florida 34785
The Issue Whether Petitioner was discriminated against in employment by reason of his race.
Findings Of Fact Petitioner was employed by the Hillsborough Corrections Institute on October 19, 1990 as a trainee and entered the Corrections Officer Academy (Academy) the following Monday, October 22, 1990. The Academy is run by Hillsborough Community College under the guidelines established by the Florida Division of Criminal Justice Standards and Training Commission. Completion of the Academy is a prerequisite for certification. Section 943.13, Florida Statutes. After successfully completing the Academy the trainees are promoted to probation correction officers for nine months and assigned to a correction facility. Petitioner, while in the Academy, reinjured a military service connected injury and was unable to attend and participate in the self-defense portion of the curriculum while it was given. He presented a doctor's certificate that he should avoid walking or running exercises for a prolonged period of time (Exhibit 4). Petitioner was advised more than once that he would need to take the self-defense portion of the Academy curriculum before he could be certified and that he had six months in which to take this portion of the training. At least two and possibly three classes were available to Petitioner during the six month period following the graduation of his class in which he could have taken the Self-Defense portion of the curriculum. Petitioner attended the graduation ceremonies with his class but he did not receive a certificate that he had completed the Academy. Immediately following the graduation ceremony Petitioner received the same 10% pay raise the other trainees received. Hillsborough Correction Institute (HCI) was not aware that Petitioner had not successfully completed the Academy until May 2, 1991. At this time the personnel manager at HCI accompanied by Major Berry went to the superintendent with the problem and recommended Petitioner's dismissal. With HCI laboring under the false assumption that Petitioner had completed the Academy and was eligible for certification, he had been allowed to work in the prison compound. Since only certified correctional officers are allowed to so work, the Institute was exposed to legal liability if any injury had occurred to a prisoner or a corrections officer and Petitioner had been involved in the incident. Effective May 6, 1991, Petitioner was terminated because he had not successfully completed the Academy within the time specified. Petitioner contends that two white correction officer trainees were treated differently than he was treated, but could testify only to what he had heard from other correction officers. The two trainees referred to by Petitioner were David Collins and a Ms. Duhamel. Respondent presented evidence (Exhibit 2) that Collins had been a corrections officer in another state. His application for employment at HCI was sent to the Florida Department of Law Enforcement (FDLE) for review of his training. FDLE advised HCI that Collins needed only 40 hours of additional training and he was enrolled at Hillsborough Community College. Subsequent to the completion of this training, FDLE found they had made an error and Collins needed an additional 40 hours of training. He was sent back to Hillsborough Community College for this training. Ms. Duhamel received work related injuries to her back while she was taking the self-defense training and was placed on Workers' Compensation for an extended period. She was subsequently certified after successfully completing all of the hours and courses required at the Academy. Petitioner presented no evidence that his race played any part in the decision to terminate his employment. Despite this lack of evidence from Petitioner, Respondent presented evidence that all trainees who do not complete the Academy are terminated in employment and cited four specific instances in which three of the dismissed trainees were white.
Recommendation It is recommended that a final order be entered dismissing the petition for relief from an unlawful employment practice filed by Christopher Hooks against the Florida Department of Corrections. DONE AND ENTERED this 10th day of November, 1992, in Tallahassee, Florida. K. N. AYERS Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 10th day of November, 1992. COPIES FURNISHED: Lynne T. Winston, Esquire Department of Corrections 2601 Blair Stone Road Tallahassee, Florida 32399-2500 Christopher Hooks Post Office Box 310623 Tampa, Florida 33602 Dana Baird, General Counsel Harry K. Singletary, Jr., Sec. Commission on Human Relation Department of Corrections Building F, Room 240 2601 Blair Stone Road 325 John Knox Road Tallahassee, Florida 32399-2500 Tallahassee, FL 32303 4149 Louis A. Vargas Margaret Jones, Clerk General Counsel Commission on Human Relation Department of Corrections Building F, Room 240 2601 Blair Stone Road 325 John Knox Road Tallahassee, Florida 32399-2500 Tallahassee, FL 32303 4149
Findings Of Fact Petitioners Gary M. Piccirillo ("Piccirillo"), Douglas L. Adams ("Adams"), and George Crain ("Crain") each are inmates who are presently incarcerated and within the custody of Respondent, Department of Corrections. At the time of final hearing in this cause, each of the Petitioners was incarcerated in Union Correctional Institution, Raiford, Florida. At the time of final hearing in this cause, both Petitioner Adams and Petitioner Crain had been classified as "close custody" in accordance with the provisions of Rule 33-6.09(4), Florida Administrative Code. Petitioner Piccirillo had been classified as "medium custody" in accordance with that same rule. The custody status of each of these inmates had been reviewed and established within the last six months prior to final hearing. In addition to challenging the validity of Rule 33-9.07(4), Florida Administrative Code, Petitioners also challenge the validity of Department of Corrections' Policy and Procedure Directive No. 4.07.40 issued April 27, 1977, and revised March 10, 1982, as an unpromulgated rule. Specifically, Petitioners contend that Section IXB conflicts with certain provisions of Section 945.091, Florida Statutes, and is, therefore, invalid. Specifically the Policy and Procedure Directive in the above referenced section provides that: The department will permit considera- tion for work release 18 months prior to release. However, normally such consideration will be given within the last nine months prior to the presumptive parole release date or expiration or [sic]. . . .
The Issue The ultimate issue in this case is whether Janna Preissig is eligible for vocational rehabilitation benefits for which she has applied on three separate occasions. 1/ Ms. Preissig contends that she is eligible. The Department of Health and Rehabilitative Services (hereinafter "the Department" or "DHRS") contends that Ms. Preissig is ineligible on the grounds that vocational rehabilitation services may not reasonably be expected to render Ms. Preissig fit to engage in a gainful occupation.
Findings Of Fact Based on the stipulations of the parties, the exhibits admitted into evidence, and the testimony of the witnesses at hearing, I make the following finds of fact: The Petitioner, Ms. Janna Preissig, most recently applied for vocational rehabilitation services on January 17, 1984. Ms. Preissig applied for such benefits twice before, once in 1982 and once in 1983. Both of her prior applications were denied. Ms. Preissig is a 32-year-old, single, white, female with a long history of unsuccessful efforts at employment corresponding to a long history of mental problems. Her only period of regular employment was a three and one-half year period during which she was in the U.S. Army working as a supply clerk. She has obtained numerous other jobs from time to time, but is always fired after a short period of time due to her mental condition. Since childhood Ms. Preissig has suffered from severe mental problems. As early as age thirteen she was hospitalized for psychiatric problems for approximately one year. During the hospitalization she was subjected to at least 20 electrical shock treatments. She believes that some of her current problems are the result of the electrical shock treatments. Ms. Preissig has a long history of both inpatient and outpatient treatment for psychiatric disorders since her initial hospitalization at age thirteen. In addition to her difficulties in retaining employment, Ms. Preissig also has difficulties with social adjustment. She has a long history of vagrancy. Ms. Preissig has a long history of being uncooperative with treatment plans. She has been discharged from inpatient treatment because of disruptive conduct which interfered with the treatment of other patients. She has been suspended from outpatient treatment programs for breaking rules. She has a poor attendance record at outpatient treatment programs. She also has a negative attitude towards the treatment programs she has been exposed to and does not believe she is likely to receive any benefit from the treatment programs which have been recommended for her. Due to the nature of Ms. Preissig's mental condition and her uncooperative attitude towards the treatment which has been recommended for her and made available to her, the prognosis for significant improvement in her present condition is poor. Her present condition was summarized as follows by Dr. Michael C. Berg: She is at present, and previously, quite unable to hold gainful employment because of the presence of severe mental impairment, paranoia, which is long-standing and with a poor prognosis. Not only is she unemployable, but she lacks the basic living and social skills necessary for an independent life without some supervision, structure, and assistance with accommodation. This condition will not, in my opinion, significantly improve over the next 12 months. As a result of Ms. Preissig's current mental condition, which is not expected to improve over the next twelve months (and which may last much longer if she fails to cooperate with the treatment program), she is not fit to engage in a gainful occupation. Further, because of Ms. Preissig's current mental condition, vocational rehabilitation services would not render her fit to engage in a gainful occupation. The sine qua non to her ability to engage in a gainful occupation is some significant improvement in her current mental condition.
Recommendation On the basis of all of the foregoing, it is recommended that the Department of Health and Rehabilitative Services issue a Final Order denying Ms. Janna Preissig's application for vocational rehabilitation services. DONE and ORDERED this 18th day of October, 1984, at Tallahassee, Florida. MICHAEL M. PARRISH Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 18th day of October, 1984.
The Issue Whether Petitioner's request for exemption pursuant to Section 400.512, Florida Statutes, should be granted.
Findings Of Fact On May 21, 1990, Petitioner, Orlando Rueda (Rueda), was arrested on charges of sexual battery on a child. The charges arose from incidents which occurred in 1983. On September 5, 1991, Rueda plead nolo contendere to five counts of attempted sexual battery on a child, Sections 777.04(1) and 794.011(2), Florida Statutes, and to two counts of indecent assault, Section 800.041(1), Florida Statutes. Adjudication was withheld, and Rueda was sentenced to five years probation, the terms of which included no contact with the victim or his family, no employment involving children, and a psychological evaluation. Rueda maintains that he is not guilty of the crimes for which he pled nolo contendere but states that because of financial difficulties in continuing with his defense and of the possibility that he could be sentenced to life imprisonment if he were found guilty, he pled nolo contendere rather than go to trial. On August 27, 1993, Rueda was arrested for driving with a suspended license. On September 17, 1993, his probation officer executed an affidavit of violation of probation indicating that Rueda violated probation by driving with a suspended license and failing to file with his probation officer a full report of having been arrested for driving with a suspended license. Rueda was arrested and charged with violation of probation. On October 18, 1993, Rueda admitted to the charge of violation of probation. The court revoked Rueda's probation and sentenced him to another five-year term of probation and ordered Rueda to attend a sex offender program at R.E.A.C.H. once a week. The court modified the probation by order dated May 31, 1994, to require attendance at the Fifth Street Counseling Center in place of attendance at R.E.A.C.H. Rueda was to remain in the Fifth Street Counseling Center program until further notice from the program. The program at the Fifth Street Counseling Center was headed by William Rambo, a clinical social worker. Rueda began his treatment with Mr. Rambo in June 1994. The treatment program is for a minimum of four years. The first phase, which usually lasts a year, consists of intensive weekly therapy sessions in which the patient deals with the allegations of the original sexual offense. The second phase is designed to last a minimum of one year and is a less intensive phase with bi-weekly group sessions. The emphasis in the second phase is on current functioning and monitoring of the patient's stability. The final phase is designed for two years and allows the patient to demonstrate continued stability. On January 31, 1996, Rueda admitted to his probation officer that he had used cocaine on January 24, 1996. Rueda also admitted to the use of cocaine to a Secret Service Agent, who was questioning Rueda about an incident involving a counterfeit fifty-dollar bill. Rueda said that he had been drinking with friends when one of them went to purchase cocaine. The drug was put into a cigarette, which Rueda and his friends smoked. As a result of the incident involving his use of cocaine, on February 26, 1997, the court ordered two years of community control, followed by ten years of probation which began on April 4, 1996. Community control is a form of house arrest and sometimes involves wearing an electronic monitoring device. Rueda was required to wear an electronic monitor for one year. Barring any further violations of probation, Rueda's probation is due to expire in 2008. On May 12, 1997, Rueda wrote a letter to the Respondent, Agency for Health Care Administration (Agency), requesting an exemption and outlining his criminal background. His letter did not include any information concerning the January 1996, cocaine- related violation. On December 8, 1997, the Agency granted Rueda an informal hearing before an informal hearing committee on his request for an exemption. During the informal hearing, the committee specifically asked Rueda to describe any special conditions of his probation. Petitioner did not volunteer that at the time of the informal hearing that he was being required to wear an electronic monitor. The informal committee had learned about the electronic monitor from Rueda's probation officer. Rueda did not reveal that he was wearing a monitor until the committee specifically asked whether he was under electronic monitoring. Rueda is still in the first phase of his treatment with Mr. Rambo. Part of the reason that he has not completed the first phase is that each time he violated probation, the probation period would begin anew, and Rueda would have to begin the first phase anew. However, based on the testimony of Mr. Rambo, Rueda has made progress in his treatment, but he has not completed his treatment program. Other than the incidents for which Rueda plead nolo contendere, Rueda has not been involved in any incidents of sexual battery or indecent assault.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a Final Order be entered denying Orlando Rueda's request for an exemption. DONE AND ENTERED this 23rd day of December, 1998, in Tallahassee, Leon County, Florida. SUSAN B. KIRKLAND Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 23rd day of December, 1998. COPIES FURNISHED: Sam Power, Agency Clerk Agency for Health Care Administration Fort Knox Building 3 2727 Mahan Drive, Suite 3431 Tallahassee, Florida 32308 Paul J. Martin, General Counsel Agency for Health Care Administration Fort Knox Building 3 2727 Mahan Drive, Suite 3431 Tallahassee, Florida 32308 Jennifer A. Steward, Senior Attorney Agency for Health Care Administration 1400 West Commercial Boulevard, Suite 110 Fort Lauderdale, Florida 33309 Kevin J. Kulik, Esquire 600 South Andrews Avenue, Suite 500 Fort Lauderdale, Florida 33301
The Issue The issue for determination is whether Mr. Johnson is eligible for vocational rehabilitation services or whether, as proposed by the agency, his file should be closed.
Findings Of Fact Jefferson Johnson applied for services from the Division of Vocational Rehabilitation (agency) and on November 13, 1997, executed an "Agreement of Understanding" describing eligibility criteria and various client rights and responsibilities. More specifically, the agreement provides, in pertinent part: ELIGIBILITY The Division of Vocational Rehabilitation (DVR) provides employment-related services to those persons who are eligible. To be eligible: You must have a physical, mental or emotional impairment that interferes with employment. It must be determined that Vocational Rehabilitation (VR) services will benefit you in becoming employed or in keeping your job. You must require VR services to become or remain employed. YOUR RIGHTS You have the right to: an evaluation to determine if you are eligible for services; written notice if you are determined to be ineligible for services; appeal any decision concerning denial, provision, delivery, or change of service; participate fully in all decisions. YOUR RESPONSIBILITIES It is very important that you participate in decisions about your employment. Your responsibilities are to: Keep appointments or request in advance that they be changed; participate actively in the planning of your individualized Written Rehabilitation Program (IWRP); cooperate with your counselor in all parts of your rehabilitation; provide all available medical information related to your rehabilitation program. (Petitioner's Exhibit A) There is no dispute that Petitioner has an impairment that interferes with employment. Melissa Kirkland has a Master's degree in counseling and is experienced in working with individuals with mental and emotional impairments. She was assigned Mr. Johnson's case and reviewed his medical records. She also began working with him on developing an assessment of his work-readiness. Mr. Johnson, who has some paralegal training from Rollins College, desires placement in a legal office that does advocacy for disabled persons. He feels that a lawyer should be able to evaluate his work-readiness. Based on Mr. Johnson's interactions with her and on her review of his medical records, Ms. Kirkland recognizes in her client certain problems common to persons with mental health impairments: hostile or confrontational interactions with others, difficulty concentrating, punctuality problems, and lack of appropriate hygiene. Work-readiness requires that those problems be remediated. The remediation cannot be accomplished in a regular job placement but requires the intervention and involvement of skilled counselors and staff. Those counselors are available though the Seminole County Mental Health Center's "job store," a sheltered workshop setting that would provide evaluation and skills training that Mr. Johnson needs before he can benefit from the agency's placement services. The skills that he needs are not related to substantive knowledge in his chosen field or career, but rather are the more basic skills that would enable him to get to work on time, properly groomed, and able to get along with the supervisors and co-workers. The "job store" is the only resource available in Mr. Johnson's geographical area that can provide the assessment and training he needs to become work ready and able to benefit from further vocational rehabilitation services. Mr. Johnson, however, refuses to sign the individualized written rehabilitation plan prepared by Ms. Kirkland and he refuses to participate in the job store even for the few months that Ms. Kirkland recommends. It is this refusal to obtain essential services, and not his profanity over the telephone and in the agency office, that caused Ms. Kirkland to appropriately terminate the agency's services to Mr. Johnson.
Recommendation Based on the foregoing, it is hereby RECOMMENDED: that the agency enter its final order terminating services to Petitioner without prejudice to his right to reapply. DONE AND ENTERED this 2nd day of November, 1998, in Tallahassee, Leon County, Florida. MARY CLARK Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 2nd day of November, 1998. COPIES FURNISHED: Michael A. Greif, Senior Attorney Department of Labor and Employment Security 307 Hartman Building 2012 Capital Circle Tallahassee, Florida 32399-2189 Jefferson W. Johnson 4416 South Lake Orlando Parkway Orlando, Florida 32808 Douglas I. Jamerson, Secretary Department of Labor and Employment Security 303 Hartman Building 2012 Capital Circle, Southeast Tallahassee, Florida 32399-2152 Edward A. Dion, General Counsel Department of Labor and Employment Security 307 Hartman Building 2012 Capital Circle, Southeast Tallahassee, Florida 32399-2152
Findings Of Fact Petitioner, William Joel Keel, is an inmate at the correctional institution in Raiford, Florida. The Union Correctional Institution is a confinement facility operated by the Respondent, Department of Corrections. Section 945.091, Florida Statutes, permits the Respondent to adopt rules and regulations which modify the limits of an inmate's confinement under specified conditions. In January 1986, the figures of the statistics of the Department of Corrections reflect that there were approximately 1300 new commitment intakes per month. As the year 1986 progressed up through the months of April and May, this rate went up to approximately 1400 to 1600 per month, and in June, the figure stood at 1680 new commitment intakes; a new record. This record, however, has been broken since that time with a monthly intake of 1700. This large number of intakes created a terrible strain on the system which at the time had reached the federal standards and the state cap on inmate strength of 98 percent. These caps are placed on inmate strength as an effort to reduce the extreme safety and security problems created by inmate overcrowding. Because there was no new staff assigned to the Department of Corrections during the period of this increase, the staff/inmate ratio decreased as the hot summer months approached with the pressure that the climate imposes. Both interior and perimeter security of the various institutions within the Department of Corrections became more and more strained. The stress on staff caused an increase of absenteeism and illness. In addition, during this period of increased temperature and the concomitant stress related thereto, assaults and escapes become a greater and greater problem. In June 1986, the inmate population in the Florida prison system went up to 99 percent, a figure approved by the Florida Legislature due to a change brought about by an automated accounting system for prisoners. The achievement of the 99 percent plus prison population constituted an "emergency" due to overcrowding. As a result, it became obvious that there was a need to increase the number of inmates eligible for pre-expiration of sentence release. Consistent therewith was the need to establish a fair and objective way of placing inmates into this pre-release program that would protect the public. It was determined necessary to screen out from participation in the program certain prohibited types of inmates such as sex offenders unless they have been cleared and determined to be harmless. Up to the point of this determination, there appeared to be no substantial or valid guidelines. Another intent of the framers of this emergency rule was the desire to set up a procedure to remove inmates placed into the pre-release program from the program for cause in accordance with due process and constitutionality. It was deemed necessary to make clear within the parameters of the program and within the instructions for the program what had to be done and how it was to be accomplished. Nonetheless, the overriding consideration which constituted the "emergency" situation was the overpopulation in the prison system. As a result, the Department of Corrections in July 1986 promulgated and published its Emergency Rule 33ER 86-3 dealing with supervised community release which rule was to take effect upon being filed with the Department of State. This rule provided that all inmates who are within 90 days of their release date will be eligible for placement on supervised community release if they meet certain specified requirements. The emergency rule listed as the basis therefor, "this emergency rule is necessary to protect the health, safety and welfare of the people of the State of Florida by providing criteria that the inmates to be placed in supervised community release must meet to help assure the safety of the public." It goes on also to indicate that the rule is necessary to prescribe appropriate sanctions for inmates within the program in the event they violate the terms and conditions of the release agreement. The program provides that the initial process is for the staff within the Department of Corrections to screen all inmates within 90 days of the end of their sentence. It was envisioned as an extension of the work release program already existing. It is for that reason that only those on or eligible for work release can participate in this new program. This is consistent with the statutory mandate to include in pre-release programs only trustworthy inmates. Inmates are also screened to ensure that they have demonstrated this trustworthiness by performing well in the more restrictive work release program. Other methods of demonstrating trustworthiness and eligibility is for the inmate to invest time in self-improvement projects such as the GED Program and to have through his past practice, shown that he will return to the prison setting at night. This screening is done monthly of all inmates with a temporary release date of 120 days in the future. By so doing, this gives the staff 30 days to develop a plan for the individual inmate to ensure a stable environment for the inmate to go to. Prior to the implementation of Chapter 86-46, Laws of Florida, the statutory authority for the current program, there was no provision for the program in issue. As soon as this law was passed the legal staff within the Department of Corrections prepared the instant emergency rule as soon as possible. Had they not been able to do an emergency rule and had the regular rulemaking process been necessary, it is most likely that they would not have had established criteria and guidelines to apply to those who had to be released due to the fact that the prison population had reached the statutory cap. In fact, it was shown that state attorneys would not cooperate with the Department of Corrections and process violations of the program unless there were specific guidelines contained therein, and, since it was necessary to reduce the inmate population, it was therefore necessary to utilize the emergency role process. With that in mind, the safety of the public into which these inmates would be released was the primary concern and generated the need to ensure that only qualified and safe inmates were released. Under the new statute and the emergency rule, 1125 inmates have been released as of the date of the hearing. Approximately 750 inmates are in the program at any given time. As a result of the implementation of this program, the prison population has dropped and remained within the new 99 percent of capacity state cap. Experience with the programs so far has shown that the inmates in the program have been guilty of only minor violations such as assault on witnesses, DWI, simple assault, and larceny. And all of these offenses came up after implementation of the emergency rule. In the case of misconduct by a released inmate which does not result in immediate charges and incarceration, such as leaving the county where placed or the state, the disciplinary team from the Department of Corrections will evaluate the inmate and impose the penalty. These penalties could include removal of gain time while still remaining within the program up to removal from the program and loss of gain time. Conditions of enrollment in the program include, as to the inmate, that he (a) stay in the area where assigned; (b) refrain from the use of drugs; (c) comply with instructions given; (d) pay court costs imposed; and (e) pay a $30 a month fee to the Department of Corrections to cover administrative costs. Though the emergency rule appears to be working satisfactorily, the Department of Corrections is in the process of regular rulemaking to adopt a permanent rule identical to the emergency rule in issue here.
