HomeMy WebLinkAbout02-01-2011
. City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 1, 2011 -10:00 AIVI - Council Conference Room
61AIEVUTES
1. CALL TO ORDER
Cliair Jim Keily called the meeting to order at 10:00 a.m. in the Council
Conference Room located_ at Aubum 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, and Member Bill Petersen. Member. Virginia _
Haugen was excused. Also pcesent were Board Attorney Sfeve Gross and
Board Secrefa_ry Danielle Daskam.
!I. AGENDA MODIFICATIONS ,
Claims from Coy Franklin Grall, Richard Schneider, and Jim Kelly were added to
the agenda. III. APPROVAL OF MINUTES
A. Minutes of the Januarv 4; 2011 LEOFF Board Meetinq
Motion by Chair Pro Tem Larson, second by Member Petersen to approve
, 2011 minutes as distributed.
- the Jan,ua 4ry
MOTION CARRIED UNANIMOUSLY. 4-0.
IV. UNFINISHED BUSINESS
A. PendinQ Disability Leave/Retirement Applications
There was no pending disability leave application for review.
B. Pendinq MedicaUHearinQNision Dental Claims
1. Bruce Caldwell Request #or reimbursement of inetlical expenses in the amount of
$500.00, Regence Claim No, 1024720055400; for services
received on ApriF 2, 2009 and last processed by insurance on
September 8, 2010.
On November 2 and December 7, 2010, and January 4, 2011, 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 Petersen to
deny #he claim due to lack of information.
LEOFF Baard Minutes February 1, 2011 ,
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 1, 2011 -10:00 AM - CounciY Conference Room
MOTION CARRIED UNANIMOUSLY. 4-0.
2. Michael Corkins
Request for reimbursement of inedical 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 benefits statement(s).
On January 4, 2011, the Board received the Regence explanation
of benefits statement. The Board fabled Mr. Corkins': claim pending
additional„ information from the senrice (ambulance) provider and
Regence. On January 4, 201.1, subsequent to the LEOFF Board
meeting, the Board Secretary contacted the ambulance company
that provided the services to Mr. Corkins and confirmed payment in
- full by Medicare and Regence. There is no balance owing, and Mr.
Corkins had not made a personal payment to the ambulance
company.
Motion by Member Petersen, second by Chair Pro Tem Larson to
deny the claim finding that insurance paid the provider in full.
MOTION CARRIED UNANIMOUSLY. 4-0. .
3. Doris Gail DarouQh
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: f
hours per day: On January 4, 2011, the Board tabled Ms,
Darough's -request pending an independent assessment of Ms.
Darough's home care needs. An assessment of Ms. Dacough was
conducted by Long Term Solutions on January 26, 2011- and is
enclosed for the Board's review.,
Chair Kelly, reported that he spoke with the daughter of Ms..
Darough, who advised that Ms. Darough will be moving #o a nursing
facility and will not be seeking full-time in home care. Ms..
Darough's request _ for full-time in-home care is withdrawn. The
Board reviewed and acknowledged receipt of the independent
assessment conducted for Ms. Darough.
V. NEW BUSINESS
A. Disabilitv Leave/Retirement Applications
LEOFF Board Minutes
- February 1, 2011
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 1, 2011 -10:00 AM - Council Conference Room ,
No new application for disability leave/retirement was submitted.
B. Appeals/ReQUests for Reconsideration '
No request for reconsideration was received.
C. IVledicaUHearinqlV_ision Claims
1. Michael Darbv
Request for reimbursement of 2010 dental expenses in the amount
of $163.00 for services received on December 23, 2010. Mr. Darby
did not receive dental reimbursement in 2010.
Motion by Member Petersen, second by Chair Pro Tem Larson to
approve the claim in the amounfi of $163.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
2. . Bruce Caldwell .
Request for reimbursement of inedical expenses in the amount of
$99.99.
Motion by Chair Pro Tem Larson, second by member Petersen to
table Mr. CaldwelPs claim pending . the receipt of additional
- information including proof of inedical necessity for the medical
device. MOTION CARRIED UNANIMOUSLY. 4-0.
3. Don Webb '
Request for reimbursement of dental expenses in the amounf of
$247.00 for services received on January 14, 2011. Mr. Webb has
not received dental reimbursemenf in 2011.
Motion by Member Petersen; second by Chair Pco Tem Larson to
approve. Mr. Webb's claim in the amount of $247.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
4. Ed Wolters Request for reimbursement of 2010 dental expenses in the amount
of $245.00 for services received on June 24 and September 28,
2010.
ED WOLTERS 2010 $1,200.00 BALANCE
LEOFF Board Minutes
February 1; 2011 Page 3
Cify of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday; February 1, 2011 -10:00 AM - Council Conference Room
$1,200.00
April 6, 2010 $925.00 $275.00
Motion by Member. Petersen, second by Chair,-Pro Tem Larson to
appr.ove Mr. Wolters' claim in the amount of $245.00.
MOTION CARRIED UNANIMOUSLY. ,4=0. 5. John BurQess
Request for reimbursement of bision expenses in the amount of
$333.00 for services receivetl on December 8, 2010. Mr. Burgess
has not received vision expense reimbursement in the past year.
Motion by Member Petersen, second by Chair Pro Tem Larson to
approve the claim in the amount of $270.00, which is the policy
annua( maximum reimbursement for vision expenses.
MOTION CARRIED UNANIMOUSLY. 4-0.
6. Doris DarouQh
a. Request for reimbursement of long term health care costs in
the:amount of $1,196:74 for the period October 1-31, 2010.
b. Request for reimbursement of long term health care costs in
the amount of $1,208.80 for the period November 1-30,
2010.
Motion by Chair Pro Tem Larson, second by Member Petersen to
approve Ms. Darough's claims in the amounts of $1,196.74 and
$1,208.80.
MOTION CARRIED UNANIMOUSLY: .4-0.
7. Coy Franklin Grall
Request for, reimbursement of dental expenses in the amount of
$119.00 for services received on :January 25, 2011. Mr. Grall has
not received dental reimbursement in 2011.
Motion by Member Petersen, second by Chair Pro Tem Larson to ,
approve Mr: Grall's claim in tFie amount of $119.00.
LEOFF Board Minutes
February 1, 2014
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City of Auburn, Law Enforcement Officers and Firefghters Disability Board
Tuesday, February 1, 2011 -10:00 AM - Council. Conference Room .
MOTION CARRIED UNANIMOUSLY. 4-0.
8. Richard Schneider
Request for reimbursement of dental expenses in the amount of
$1,302.00 for services received on January 25, 2011.. Mr. ~ . Schneider has not received dental reimbursement in 2011.
Motion by Member Petersen, second by Chair Pro Tem Larson to
approve the claim in the amount of $1,200, which is the policy
annual reimbursement rate for denfal expenses, and direct the
: Board Secretary to send a letter to Mr. 5chneidec advising that he
may submit the balance of his dental expense with proof of inedical
necessity. .
MOTION CARRIED UNANIMOUSLY. 4-0.
_ At this time, Chair Kelly relinquished the Chair to Chair Pro Tem Larson.
9: Jim Kellv
- a. Request for reimbursement of inedical expenses in the
amount of $130.00, Regence . Explanation of Benefits
statements #1034331928300 and #1034331928400, for
- services received on December 2 and 7, 2010 and last
processed by insurance on December 22, 2010.
Motion by Member Petersen, second by Member Norman to
approve the claim in the amount of $130.00.
MOTION CARRIED. 3-0. Mr. Kelly abstained.
b. Request for reimbursement of medical expenses in the
amount of $65.00, Regence Explanation of Benefits
stafement #1035131864600 for services received on
December 14, 2010 and last processed by insurance on
December 29, 2010.
Motion by Member Petersen, second by Member Norman to
approve the claim in the amount of $65.00 .
MOTION CARRIED. 3-0. Mr. Kelly abstained.
10. Jim Kellv LEOFF Board Minutes
February 1, 2011
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City of Auburn Law Enforcement Officers and Firefghters Disability Board
Tuesday, February 1, 2011 -10:00 AM - Council Conference Room
Request for reimbursement of dental expenses in the amount of
$4,300 for senrices received on December 16, 2010.
Board members reviewed Mr. Kelly's claim and supporting
documentation relating to medical necessity of the dental expenses, including letters from Dr. Woo and Dr. Pavalunas.
Motion by Member. Petersen, second by Member Norman to
approve the claim in the amount of $4,300. MOTION CARRIED. 3-0. Mr. Kelly abstained.
Chair Pro Tem Larson requested that the Secretary enter into the
record that Mr. Kelly's future dental expenses are to be considered
medically necessary. Board members concurred.
VI. ADJOURNMENT There being no further business to come before the Board, the meeting
adjourned at 10:20 a.m.
- APPROVED THE I~ DAY OF MARCH, 2011
Jim Kelly, Chair Da 'elle Daskam, Board Secretary
,
LEOFF Board Minutes
February 1, 2011
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