§ 2-2-208. Workers' compensation.

(a)

Subject to subsection (b) below, for purposes of workers' compensation, the self-insurance fund covers all employees, as defined in Chapter 440, Florida Statutes, for injury, illness or death arising out of the course and scope of an employee's employment. The fund does not cover prisoners, road gang members, detainees, persons performing community service as part of a court sentence, or sheriff's deputies and other employees engaged in off-duty employment.

(b)

The applicable provisions of Chapter 440, Florida Statutes, as well as pertinent regulations of the Florida Department of Labor and Employment Security, the Florida Department of Administrative Hearings, the Florida Department of Insurance, and the Florida Agency for Health Care Administration, and any future additions or amendments thereto, are incorporated herein by reference, including all restrictions, limits, time constraints and exclusions from coverage. The risk manager shall ensure the RMD and outside counsel and third-party administrators (i.e., outside, private contractors handling workers' compensation matters for Manatee County) comply with all requirements of the statute and regulations, and that all appropriate benefits are provided promptly. In the event any provision of this article conflicts with the provisions of Chapter 440, Florida Statutes, the statute controls.

(c)

If an act or omission of an employee county department or an elected official results in a state department or agency imposing a fine or penalty (for example for late notification of an injury) upon the county, the fine will be paid by RMD from the self-insurance fund, and that department or elected official shall reimburse the fund for any such fines or penalties paid to the state.

(d)

The risk manager, in coordination with the clerk of the circuit court, may arrange for special checking accounts, pursuant to Section 136.091, Florida Statutes, and the county attorney may direct the advancement of funds into the account, in order that a third-party administrator may make required payments expeditiously to comply with applicable laws.

(e)

The risk manager shall ensure a third-party administrator, under contract to the county, pays all benefits within the statutorily required time limits.

(f)

The risk manager shall coordinate with the plan manager of the employee health benefits plan to ensure double payments are not made by the self-insurance fund and the plan. The fund shall reimburse the plan if medical care should have been provided under the workers' compensation coverage of this article; the fund shall also reimburse an employee for any co-payments erroneously made by the employee.

(g)

The risk manager shall ensure statutorily-mandated managed care and grievance procedures are followed. The board, as authorized by Chapter 440, Florida Statutes, or any other prevailing state or federal law, may elect to participate in managed care or opt out.

(h)

The county department or elected official for whom the injured employee works shall notify RMD immediately, via telephone or designated email that an employee has been injured, and specify which primary care medical facility is treating the injured employee.

(i)

The county department or elected official for whom the injured employee works shall ensure the employee receives treatment for emergent injuries immediately, and that alcohol or drug testing requirements are fulfilled.

(j)

For purposes of this article, the fact that an employee injured on the job has been involved in an accident is sufficient reasonable suspicion to require the employee to submit to drug or alcohol testing as part of initial treatment for nonlife-threatening injuries. If a test sample cannot reasonably be obtained during initial treatment, the concerned department shall arrange for testing as soon as reasonably practicable.

(k)

If an employee tests positive for drug or alcohol use, then the claim will be evaluated based on the facts of the incident. Following the outcome of the evaluation, there is the potential that no further benefits shall be payable. Manatee County Government is a drug free workplace.

(l)

The department or elected official shall prepare a first report of injury or illness, on forms prescribed by the appropriate state agency and email it to the RMD within twenty-four (24) hours of the injury. The RMD shall check the notice for accuracy, add any required annotations, and email a copy the same day to the contract third-party administrator. The third-party administrator shall process the claim as per the provisions set forth in Chapter 440, Florida Statutes, and any other applicable state and federal laws.

(m)

If a covered injury or illness causes an employee to be absent from work, the county department for whom the employee works shall be responsible for properly annotating time cards to reflect workers' compensation absences. When an injured employee returns to work in any capacity, the department shall immediately notify the RMD so that workers' compensation benefit payments may be adjusted accordingly.

(n)

As a condition of coverage under this section, elected officials and other units of county government shall comply with all of the provisions of under this section.

(o)

The RMD shall arrange for and pay, from its workers' compensation budget, for testing, treatment and counseling of employees who may have had a significant exposure to hazardous substances or blood-borne pathogens.

(p)

If a death or a catastrophic injury occurs as defined by Chapter 440, Florida Statutes, and/or applicable state or federal laws, or fifty (50) per cent of the excess limit of the county's workers' compensation limit is attained, the risk manager shall ensure the commercial excess re-insurer and appropriate state agencies are put on notice of the injury and potential liability.

(q)

The risk manager shall, when appropriate, obtain reimbursement from the commercial excess re-insurer for amounts paid from the self-insurance fund above the self-insured retention as per the insurance policy.

(r)

The risk manager shall, when appropriate, determine if third parties or their insurers may be liable for injuries, and if so assert, or advise the county's third party administrator to assert, any direct or subrogation claims in accordance with Chapter 440, Florida Statutes. If third-party administrator obtains reimbursement from a third-party then the third-party administrator will promptly refund or credit any monies received to the self-insurance fund.

(s)

When a judge of compensation claims enters an order directing the county or constitutional office to pay benefits, costs, and/or fees, the county attorney shall recommend to the board whether to comply with the order or to take an appeal. In order to avoid penalties and interest associated with any delay in compliance, the county attorney may pay the order without prior authorization from board subject to subsequent ratification if time does not permit board consideration.

(Ord. No. 16-26 , § 2, 10-25-16)