HomeMy WebLinkAbout01-04-2011
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, January 4, 2011 -10:00 AM - Council Conference Room
,
MINUTES
1. 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 Sfreet in Aubum:
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 Attomey Doug Ruth and Board Secretary
Danielle Daskam.
IL ELECTOON OF CHAIRPERSON.AND CHAIRPERSON PRO TEBYIPORE
Section 1,05 of the LEOFF Board Policies and Procedures provides that at the
frst meeting-of each year, the members shall elect from among the members, a
_ member to serve as Chairperson and a member to serve as Chairperson pro
tempore.
Motion by Member Petersen, second by Member Norman to nominate and elect
Jim Kelly as Chairperson for the year 2011 and Bud Larson as Chairperson Pro
Tem for the year 2011.
MOTION CARRIED UNANIMOUSLY. 5-0.
III. AGENDA MODIFICATION
A request from Doris Gail Darough relating to an increase in home health care
services was added to the agenda.
N. APPROVAL OF IWINUTES
A. Minutes of the December 7, 2010 LEOFF Board Meetinq Motion by Chair Pro Tem Larson, second by Member Petersen to approve
the December 7, 2010 minutes as distributed.
MOTION CARRIED. 5-0.
V. UNFINISHED BUSINESS A. Pendin4 DisabilitvLeaveLRetirement Applications
There was no pending disability leave applicat'ion for review.
B. Pending Medical/Hearing/Vision Dental Claims
, 1. Bruce Caldwell
LEOFF. Board Minutes - •
January 4, 2011
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, January 4, 2011 -10:00 AM - Council Conference Room
a. Request for reimbursement of medical expenses in the
amount of $97.93 for services received on July 31, 2010.
b. Request for reimbursement of medical expenses in. the
amount of $1,100.00 for secvices received on August 3-5, 2010.
On October 5, November 2, and December 7, 2010, the Board
tabled Mr. Caldwell's claims pending receipt of the Medicare
' explanation of benefits statements and additional information. No
` new information was received. Motion by Chair Pro Tem Larson, second by Member Petersen to
deny the claims due to lack `of response to the Board's request for
additional information.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Bruce Caldwell
Request for reimbursement, of medical expenses in the amount of
$500.00, Regence Claim No. 1024720055400, for services
received on April 2, 2009 and last' processed by insurance on
September 8, 2010.
- On November 2 and December 7, 2010, the Board tabled Mr.
Caldwell's claim pending the receipt of additional information. No
new information was received.
Motion by Chair Pro Tem Larson, second by Member Pefersen to
table the claim an additional month pending receipt of the
additional requested information.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. Michael Corkins
Request for reirnbursement of medical expenses in the amount of
$135.18 for services received on August 31, 2010: '
On December 7, 2010, the Board:tabled Mr. Corkins' claim pending
the receipt of the insurance explanation, of benefts statement(s).
Mr. Corkins submitted a Regence explanation of benefits statement
in response fo the Board's request.`
LEOFF Board Minutes
January 4, 2011 .
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, January 4, 2011 -10:00 AM - Council Conference Room
Upon further review of the Regence Explanation of Benefits
statement, Board members questioned the amount unpaid by
Medicare and Regence, if any.
Motion by Chair Pro Tem Larson, second by Member Petersen to
table the claim until the next meeting pending receipt of addifional
information regarding the claim, specifically clarification of the
charges and the explanation of,benefits statement.
MOTION CARRIED UNANIMOUSLY. 5-0.
Chair Kelly requested that the Board Secretary contact the senrice
(ambulance) provider and Regence for further clarification of the
claim:
VI: NEW BUSINESS
A. Disabilitv Leave/Retirement Applications
No new application for disability leave/retirement was submitted.
B. Appeals/ReQUests for Reconsideration
No request for reconsideration was received:
C. Medical/HearinqNision Claims
1. Robert Wiglex
Request for reimbursement of dental expenses in the amount of
$475.00 for services received on December 2 and 9, 2010. Mr.
`Wigley has not received dental reimbursement in 2010.
Motion by Member Petersen, second by Chair Pro Tem Larson to
approve the claim in the amount of $475.00.
MOTION CARRIED'UNANIMOUSLY. 5-0.
2. Theodore Lindback
Request for reimbursement of dental expenses in the amount of .
$166.35 for services received on November 3, 2010.
THEODORE
LINDBACK 2010 $1,200.00 BALANCE
. $1,200.00
Date Claim Approved
June 1, 2010 $244.15 $955.85 ,
LEOFF Board Minutes
January 4, 201.1 -
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, January 4, 2011 -10;00 ANS - Council Conference Room
Motion by Member Petersen, second by Chair Pro Tem Larson to
, approve the claim in the. amount of $166.35.
- MOTION CARRIED UNANIMOUSLY. 5-0. 3. James Fisk .
Request for reimbursement of dental expenses in the amounfi of
. $210.00 for services received on December 14, 2010.
JAMES FISK 2010 $1,200.00 BALANCE
$1,200.00
~ Date Claim APproved '
December 7, 2010 $39.00 $1,161.00
Motion by Member Petersen, second by Chair Pro Tem Larson to
approve the claim in the amount of $210.00.
' MOTION CARRIED UNANIMOUSLY. 5-0.
At this time, Chair Kelly relinquished the Chair to Chair Pro Tem Larson.
4. Jim Kellv
a. Request for reimbursement of inedical expenses in the
amount, of $260.00, . Regence Explanation of Benefits
statements #103363.181`1600 and #1033631811700, for
services received on October 26 and 28 and November 2
and 4, 2010 and last processed by insurance on December
15, 2010.
Motion by Member Petersen, second by Member Norman to
approve the claim in the amount of $260.00.
MOTION CARRIED UNANIMOUSLY. 4-0. Jim Kelly
abstained. "
b. Request for reimbursement of inedical expenses in the
amount of $65.00, Regence Explanation of Benefits
statement 11033532035700 and last processed by
insurance on November 30, 2010.
LEOFF Board Minutes
January 4, 2011
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Cify of Aubum Law Enforcement Officers and Firefghters Disability Board ~
Tuesc9ay, January 4, 2011 -10:00 AAA - Council Conference Room .
Motion by Member Petersen, second by Member Norman to
approve the claim in the amount of $65:00.
MOTION CARRIED UNANIMOUSLY. 4-0. Jim Kelly
abstained. ,
, c. Request for reimbursement. of inedical expenses in the
amount of $65.00, Regence Explanation of Benefts
statement #1032231859600 and lasf processed by
insurance on December 1, 2010.
Motion by Member Petersen, second by Me.mber Norman to
approve the claim in the amount of $65.00. '
MOTION CARRIED UNANIMOUSLY. 4-0. Jim Kelly
abstained.
d. Letter dafed December 15, 2010 addressed to the LEOFF
Board from Dr. Robert Pavalunas, DDS, regarding James
Kelly and letter dated December 30, 2010.
Board members reviewed the letter #rom Dr. Pavalunas
regarding the medical necessity of dental care for Mr. Kelly.
Motion by Member Petersen, second by Chair Pro Tem
Larson to pre-approve the dental services for Mr. Kelly as
described in Dr. Pavalunas December 15, 2010 letter to the
Board.
MOTION CARRIED. 3-1. Member Haugen voted no and
Mr. Kelly abstained.
Mr. Kelly resumed the Chair at this time. 5. Doris Gail Darouqh
Ms. Darough`s request was submitted.as an agenda modification.
. Ms. Darough is currently receiving home health care services,
which expenses have been reimbursed by Allianz Long Term Care
Insurance and the Board.,'Ms. Darough is requesting pre-approval
to increase home health care services from 12 hours per day to 24
hours per day. LEOFF Board Minutes
January 4, 2011
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City of Auburn Law Enforcement Officers and Firefighters Disability Board ~
Tuesday, January 4, 2011.-10:00 AM - Council Conference Room
Chair Kelly referred the Board to Policy 9.05 relating to home health care reimbursement and Policy 9.04 relating to skilled
nursing care which provide in part that the Board may reimburse an
amount not to exceed the daily benefit for nursing care under the
City's existing long term care insurance. Board Secretary Daskam
advised that in July 2010 the daily benefit rate was $234.00 per
month.
Chair Kelly further noted that Policy 9.05 also provides that the
Board reserves the right to have an independent assessrnent
, agency evaluate the member's home health care needs.
Motion by Chair Pro Tem Larson, second by Member Petersen to
authorize an independent assessment of Ms. Darough's home
. health care needs.
MOTION CARRIED UNANIMOUSLY. 5-0.
VII. ADJOURNMENT -
. There being no further business to come before the Board, the meeting
adjourned at 10:21 a.m.
Sr.
APPROVED THE DAY OF FEBRUARY, 2011
Ji Kelly, Chair ` Danielle Daskam, Board Secretary
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LEOFF Board Minutes
January 4, 2011
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