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HomeMy WebLinkAbout04-07-2009 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room MINUTES 1. CALL TO ORDER Chair Jim Kelly called the meeting to order at 1.0:00 a.m. in the Council Conference Room located at Auburn City Hall, 25 West Main Street in Auburn. Chair Kelly and the following Board members were present: Chair Pro Tem Bud Larson, Member Lynn Norman, Member Virginia Haugen, and Member Bill Petersen. Also present were Board Attorney Stephen King and Board Secretary Danielle Daskam. II. AGENDA MODIFICATION Chair Kelly noted the addition of claims from Monroe Shropshire and Dave Schuur to the agenda and follow-up materials for a pending claim from Jake Evans. Chair Kelly paused the meeting to allow Board members an opportunity to review the agenda modifications. III. APPROVAL OF MINUTES A. Minutes of the March 3, 2009 LEOFF Board Meetina Motion by Chair Pro Tem Larson, second by Member Petersen to approve the March 3, 2009 minutes as distributed. MOTION CARRIED UNANIMOUSLY. 5-0. IV. UNFINISHED BUSINESS A. Pending Disability Leave/Retirement Applications There was no pending disability/leave retirement application. B. Medical/HearingNision/Dental Claims 1. James Monnett Request for reimbursement of inedical expenses in the amount of $3,633.70, Regence Claim #0817720502300 for services received on June 16, 2008. The Board tabled Mr. Monnett's claim on February 3 and March 3, 2009 pending the receipt of additional information. No new information was received. LEOFF Board Minutes April 7, 2009 Page 1 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room Motion by Chair Pro Tem Larson, second by Member Petersen to table the claim for an additional month pending receipt of the requested information. MOTION CARRIED UNANIMOUSLY. 5-0. 2. Jake Evans On March 3, 2009, the Board tabled the following claims pending the receipt of additional information, including proof of inedical necessity for the services/products -received and applicable insurance and Medicare benefits statements. a. Request for reimbursement of inedical expenses in the amount of $225.00, Regence Claim #0830595022101 for services received on September 16, 2008. b. Request for reimbursement of natural pharmacy products in the amounts of $224.53 and $124.82. c. Request for reimbursement of inedical laboratory services received on September 16, 2008 in the amount of $82.00. A letter from Jake Evans dated March 15, 2009 was distributed to the Board members in response to the Board's request for additional information. Motion by Chair Pro Tem Larson, second by Member Haugen to deny the request for reimbursement of inedical expenses in the amount of $225, Regence Claim #0830595022101 for services received on September 16, 2008. Board members discussed Policy 9.01(I) that provides that all claims, except for prescription claims and social security Medicare Part B claims, shall be submitted to the Board within 90 days of date of processing by insurance. MOTION CARRIED UNANIMOUSLY. 5-0. Motion by Chair Pro Tem Larson, second by Member Petersen to approve the request for reimbursement of natural pharmacy products in the amounts of $224.53 and $124.82. MOTON CARRIED UNANIMOUSLY. 5-0. LEOFF Board Minutes April 7, 2009 Page 2 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room Motion by Member Petersen, second by Chair Pro Tem Larson to table the claim for reimbursement of inedical laboratory services received on September 16, 2008 in the amount of $82.00 pending receipt of the Regence Explanation of Benefits Statement and Medicare Explanation of Benefits Statement. MOTION CARRIED. 4-1. Member Haugen voted no. V. NEW BUSINESS A. Disabilitv Leave/Retirement Applications 1. Rudv Peden Effective Date of Disability: March 9, 2009 Last Day of Service: March 8, 2009 On March 9, 2009, LEOFF Board Chair Kelly tentatively approved disability leave for Rudy Peden effective March 9, 2009 with last day of service on March 8, 2009, subject to full Board review and approval. Mr. Peden's application for disability leave/retirement includes physician statements from Dr. Bruce Neeley and Dr. Doug Birkebak dated March 9, 2009. Motion by Chair Pro Tem Larson, second by Member Petersen to concur with action by the Chair and approve disability leave effective March 9, 2009 with last day of service on Mach 8, 2009. MOTION CARRIED UNANIMOUSLY. 5-0. On April 1, 2009, Chair Kelly granted Mr. Peden tentative approval to return to duty effective April 6, 2009 based on a physician's statement dated March 27, 2009. Action on the return to duty is pending full Board review. . Motion by Chair Pro Tem Larson, second by Member Petersen to concur with action by the Chair and approve Mr. Peden's return to duty effective April 6, 2009. MOTION CARRIED UNANIMOUSLY. 5-0. B. Appeals/Requests for Reconsideration No request for reconsideration was received. C. Medical/Hearinq/Vision/Dental Claims LEOFF Board Minutes April 7, 2009 Page 3 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room 1. Rudy Peden Request for pre-authorization to purchase orthotics in the amount of $395.00. The agenda packet included a letter of inedical necessity from Dr. Mark T. Lewis dated March 4, 2009. Motion by Member Petersen, second by Chair Pro Tem Larson to approve the purchase of orthotics in an amount up to $395.00 plus tax. MOTION CARRIED UNANIMOUSLY. 5-0. 2. Ray Ogden Request for reimbursement of vision expenses in the amount of $189.97 for vision services received on February 11, 2009. On February 3, 2009, the LEOFF Board approved vision expenses in the amount of $169.98 for vision services received on November 21, 2007. Motion by Member Petersen, second by Chair Pro Tem Larson to approve the expenses in the amount of $189.97 for vision services received on February 11, 2009. MOTION CARRIED UNANIMOUSLY. 5-0. 3. Bruce Caldwell Request for reimbursement of inedical expenses in the amount of $231.39, Regence Claim #0904220713000 for services received on February 3, 2009. Motion by Member Petersen, second by Chair Pro Tem Larson to approve the claim in the amount of $231.39. MOTION CARRIED UNANIMOUSLY. 5-0. 4. Roqer Lee a. Request for reimbursement of dental expenses in the amount of $165.30 for services received on March 3, 2009. Mr. Lee has not received dental reimbursement in 2009. Motion by Chair Pro Tem Larson, second by Member Petersen to approve the claim in the amount of $165.30. LEOFF Board Minutes April 7, 2009 Page 4 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room MOTION CARRIED UNANIMOUSLY. 5-0. b. Request for pre-approval of dental expenses in the amount of $3,253.75. Motion by Chair Pro Tem Larson, second by Member Petersen to pre-approve dental expenses in the amount of $3,253.75 finding medical necessity. MOTION CARRIED UNANIMOUSLY. 5-0. 5. James Detrick a. Request for reimbursement of inedical expenses in the amount of $99.05, Regence Claim #0809433437800 for services received on March 27, 2008 and processed by insurance on April 9, 2008. Motion by Member Petersen, second by Member Haugen to deny the claim finding that the cl;aim falls outside the ninety (90) day limitation for filing claims pursuant to LEOFF Board Policy Section 9.01(I) and lack of proof of inedical necessity. MOTION CARRIED UNANIMOUSLY. 5-0. b. Request for reimbursement of inedical expenses in the amount of $295.00, Regence Claim #0805634085700 for services received on February 14, 2008 and processed by insurance on March 5, 2008. Motion by Chair Pro Tem Larson, second by Member Petersen to deny Mr. Detrick's claims under Items b, c, d, e, f, and g finding that either the claims fall outside the ninety (90) day limitation for filing claims pursuant to LEOFF Board Policy Section 9.01 (I) and/or lack of proof of inedical necessity. MOTION CARRIED UNANIMOUSLY. 5-0. c. Request for reimbursement of inedical expenses in the amount of $110.14, Regence Claim #0820920503900 for services received on February 14, 2008 and processed by insurance on August 6, 2008. LEOFF Board Minutes April 7, 2009 Page 5 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room See Item V.C.5.b for action on this item. d. Request for reimbursement of inedical expenses in the amount of $40.00, Regence Claim #0800840141700 for services received on November 9, 2007 and processed by insurance on January 16, 2008. See Item V.C.5.b for action on this item. e. Request for reimbursement of vision exam expenses in the amount of $45.00 for services received on November 19, 2007. See Item V.C.S.b for action on this item. f. Request for reimbursement of vision expenses in the amount of $52.22 for services received on March 12, 2008. Mr. Detrick has not received reimbursement for vision expenses in the past year. See Item V.C.5.b for action on this item. g. Request for reimbursement of vision expenses in the amount of $828.00 for services received on January 11, 2008. See Item V.C.5.b for action on this item. 6. Stan Laatsch Request for reimbursement of inedical expenses in the amount of $30.00 for medical services received on February 23, 2009. Motion by Chair Pro Tem Larson, second by Member Petersen to deny the claim finding that the medical services provided were preventative in nature. MOTION CARRIED UNANIMOUSLY. 5-0. 7. Alan Kosko Request for reimbursement of inedical expenses in the amount of $12.17 for medical services received on September 29, 2008. LEOFF Board Minutes April 7, 2009 Page 6 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room Motion by Member Petersen, second bjr Chair Pro Tem Larson to deny the claim finding that the claim falls outside the ninety (90) day limitation for filing claims pursuant to Section 9.01 (I) of the LEOFF Board Policies and Procedures. MOTION CARRIED UNANIMOUSLY. 5-0. 8. Doris Darouqh Request for reimbursement of home health care costs in the amount of $1,801.58. Motion by Chair Pro Tem Larson, second by Member Petersen to approve Ms. Darough's claim in the amount of $1,801.58. MOTION CARRIED UNANIMOUSLY. 5-0. 9. Monroe Shropshire Mr. Shropshire's claim was added to the agenda. Request for reimbursement of dental expenses in the amount of $800.00. Mr. Shropshire has not received dental expense reimbursement in 2009. Motion by Member Petersen, second by Chair Pro Tem Larson to approve the claim in the amount of $800.00 MOTION CARRIED UNANIMOUSLY. 5-0. 10. Dave Schuur Mr. Schuur's claim was added to the agenda. Request for reimbursement of vision expenses in the amount $199.97 for services received on March 20, 2009. Mr. Schuur has not received vision expense reimbursement in the last finrelve months. Motion by Member Petersen, second by Chair Pro Tem Larson to approve the claim in the amount of $199.97. MOTION CARRIED UNANIMOUSLY. 5-0. D. Correspondence No correspondence was received. LEOFF Board Minutes April 7, 2009 Page 7 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, April 7, 2009 -10:00 AM - Council Conference Room E. ADJOURNMENT - There being no further business to come before the Board, the meeting adjourned at 10:37 a.m. ' ~ APPROVED THE DAY OF MAY, 2009 Q" t~ Jim elly, Chair Danielle Daskam, Board Secretary LEOFF Board Minutes April 7, 2009 Page 8