HomeMy WebLinkAbout04-05-2005
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, April 5, 2005 - 10:00 AM - Council Conference Room
MINUTES
I. CALL TO ORDER
Chair Jim Kelly called the meeting to order at 10:00 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-at-Iarge), Member Bill Peloza, Member Roger Thordarson, and
Member Russ Vandver. Also present were Board Attorney Joseph Beck and
Board Secretary Danielle Daskam.
II. APPROVAL OF MINUTES
A. Minutes of the March 1. 2005 LEOFF Board Meetinq
Motion by Chair Pro Tem Larson, second by Member Thordarson to
approve the March 1, 2005 minutes.
MOTION CARRIED UNANIMOUSLY. 5-0.
III. UNFINISHED BUSINESS
A. Pendinq Disabilitv Leave/Retirement Applications
There was no pending disability leave/retirement application.
B. Medical/HearinqNision Claims
There was no pending claim.
IV. NEW BUSINESS
A. Disabilitv Leave/Retirement Applications
There was no new disability leave/retirement application.
B. Appeals/Requests for Reconsideration
No appeal or request for reconsideration was filed.
C. Medical/HearinqNision Claims
1. Rav Oqden
Request for pre-approval of medic alert service.
Board members reviewed the information received from Mr.
Ogden.
LEOFF Board Minutes
April 5, 2005
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, April 5, 2005 -10:00 AM - Council Conference Room
Motion by Chair Pro Tem Larson, second by Member Vandver to
table the claim pending the receipt of additional information to
include the type of device, the vendor name, the cost of the
service, and a letter from the treating physician supporting the
medical necessity.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Edward Sluys
Request for reimbursement of vision expenses in the amount of
$75.00. (Mr. Sluys was approved for $200.00 in vision expenses on April 6,
2004.)
Board members reviewed Mr. Sluys' claim.
Motion by Member Peloza, second by Chair Pro Tem Larson to
approve vision expenses in the amount of $75.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. Ed Henderson
Request for reimbursement of (Medicare) claim #11-05025-241-
830 (no Regence EOB submitted) for medical services received on
January 21, 2005 and processed by Medicare on February 11,
2005 in the amount of $23.30.
Board members reviewed Mr. Henderson's claim. Board members
noted that no Regence explanation of benefits statement was
submitted with the documentation.
Motion by Member Peloza, second by Chair Pro Tem Larson to
table the claim pending receipt of the Regence Explanation of
Benefits statement, pursuant to Board Policy 9.01.
MOTION CARRIED UNANIMOUSLY. 5-0.
Chair Kelly also requested that the Secretary return Mr.
Henderson's unsigned claim form for his signature.
4. John T. Calkins
Request for reimbursement of Regence Claim #0500432571900
for medical services received on December 8, 2004 and processed
by Regence on January 21,2005 in the amount of $274.00.
LEOFF Board Minutes
April 5, 2005
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, April 5, 2005 - 10:00 AM - Council Conference Room
Board members reviewed Mr. Calkins' claim. Board members
noted that the medical services were denied coverage by Regence
as routine, preventative or elective treatment.
Member Peloza suggested that the claimant appeal Regence's
decision to not cover the medical services.
Following further discussion, it was suggested that the Association
of Washington Cities Benefits Trust representative review the claim
and the decision by Regence to deny coverage.
Motion by Member Vandver, second by Member Peloza to table the
claim, transmit a letter to the claimant requesting that he appeal
Regence's decision, and the Secretary request the Association of
Washington Cities Benefits Trust representative review the claim
and the decision of Regence to deny coverage for the medical
services.
MOTION CARRIED UNANIMOUSLY. 5-0.
5. Russ Vandver
Request for reimbursement of Regence Claim #0506332440900
for medical services received on February 8 and 22, 2005 and
processed by insurance on March 9, 2005 in the amount of
$159.62.
Board members reviewed Mr. Vandver's claim.
Motion by Member Peloza, second by Chair Pro Tem Larson to
approve the claim in the amount of $159.62.
MOTION CARRIED. 4-0. Member Vandver abstained.
D. Discussion
1. Draft Policy Relatinq to Alternative Medicine
Board members discussed the proposed policy for naturopathic
and alternative medicine [Policy 8.03(B) (part)]. The proposed
policy amendment as presented by Board Attorney Beck reads as
follows:
8.03 (B) (part)
LEOFF Board Minutes
April 5, 2005
Page 3
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, April 5, 2005 - 10:00 AM - Council Conference Room
Naturopathic and Alternative Medicine (Acupuncture, Massage
Therapy, etc.) - This paragraph applies to services provided by the
following treatment providers: acupuncturist, dietician, massage
therapist and naturopathic physician. To qualify for benefits under
this section all providers must be properly licensed. A maximum
allowance of $750.00 per year will be allowed. Members obtain
prior authorization. The member shall submit a written request to
the LEOFF Board. The request for authorization (11ust include the
medical necessity for the treatment, an outline of the proposed
treatment program, expected restoration goals and the expected
length of treatment will be required. Failure to provide and prove
the information required in the preceding sentence may result in
the denial of benefits. Any additional services, beyond the benefits
of this section, are subject to Board review and approval.
Motion by Member Peloza, second by Member Thordarson to
approve the policy amendment 8.03 (B) (part) as presented by
Attorney Beck.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Policy Manual, Appendix A
Member Peloza noted that Appendix A of the Board policy manual
is out of date. Chair Kelly requested the Secretary update the
Appendix to reflect current membership.
3. LEOFF Conference
Member Vandver will be attending the upcoming LEOFF
Conference in Chelan.
V.
ADJOURNMENT
There being no further
adjourned at 10:31 a.m.
2 í<')
APPROVED THE .)'-
business to come before the Board, the meeting
DAY OF¡n",::~
, 2005.
Jim
'.1
LEOFF Board Minutes
April 5, 2005
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