HomeMy WebLinkAbout04-04-2006
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 -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 Roger Thordarson, Member Rich Wagner,
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 7. 2006 ReQular LEOFF Board MeetinQ
Motion by Chair Pro Tem Larson, second by Member Thordarson to
approve the March 7, 2006 minutes as distributed.
MOTION CARRIED. 5-0.
III. UNFINISHED BUSINESS
A. PendinQ Disabilitv Leave/Retirement Applications
1 . Russ Vandver
Effective Date of Disability: November 1, 2005
Last Day of Service: October 31, 2005
On November 1, 2005, the LEOFF Board approved disability leave
for Mr. Vandver effective November 1, 2005 with last day of service
on October 31, 2005.
Mr. Vandver's disability leave will conclude May 1, 2006.
Mr. Vandver submitted a physician's report from his attending
physicians Dr. William Williard dated March 23, 2006, and Dr. Andy
Sands dated March 27, 2006, which were included in the agenda
packet, together with Mr. Vandver's medical record to date and the
position description for Fire Chief. Also distributed during the
meeting was a letter from Assistant Fire Chief Stan Laatsch dated
March 30, 2006 regarding Fire Chief Russ Vandver.
Fire Chief Vandver addressed the Board. He reviewed the history
of his illness, the diagnoses, and the treatment thus far and
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April 4, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 -10:00 AM - Council Conference Room
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April 4, 2006
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anticipated future treatment. Mr. Vandver stated that he had asked
Assistant Fire Chief Stan Laatsch, who he has known and worked
with over the past thirty years, to provide the Board with a letter
relating his knowledge of Mr. Vandver's health.
Chair Kelly noted that at the last meeting, the Board elected to not
send Mr. Vandver to the Board physician, but instead acquire
written documentation from Mr. Vandver's attending physicians.
The attending physician reports are included in the agenda packet.
Chair Kelly reviewed Sections 4.02 and 4.03 of the LEOFF Board
Policies and Procedures Manual regarding granting disability
retirement.
Board members discussed the presumption of occupation of
disease for fire fighters pursuant to RCW 51.32.185 and its
applicability to Mr. Vandver's disability application.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to grant Mr. Russ Vandver disability retirement effective May 1,
2006 with last day of disability leave on April 30, 2006.
MOTION CARRIED. 4-0. Member Vandver abstained.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to find that Mr. Vandver's disabilities, as diagnosed by the treating
physicians, Dr. Andy Sands and Dr. William Williard, were incurred
in the line of duty.
MOTION CARRIED. 4-0. Member Vandver abstained.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to find that Mr. Vandver's disabilities were not incurred in other
employment.
MOTION CARRIED. 4-0. Member Vandver abstained.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to find that Mr. Vandver would not be able to return to duty as Fire
Chief, pursuant to the medical evidence on record.
MOTION CARRIED. 4-0. Member Vandver abstained.
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4,2006 -10:00 AM - Council Conference Room
Motion by Chair Pro Tem Larson, second by Member Thordarson
to instruct the Attorney and Secretary to draft the appropriate
decision and order before April 30, 2006 for signature by Board
members.
MOTION CARRIED. 4-0. Member Vandver abstained.
B. Medical/HearinQNision Claims
1 . Russ Vandver
Claim for reimbursement of medical expenses incurred on January
31, 2006 in the amount of $120.00
On March 7, 2006, the LEOFF Board tabled the above claim
pending receipt of the Regence explanation of benefits statement.
No new information was received.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to table Mr. Vandver's claim until the next Board meeting.
Mr. Vandver advised that his medical provider billed the insurance
company and an explanation of benefits statement is anticipated.
MOTION CARRIED. 4-0. Member Vandver abstained.
IV. NEW BUSINESS
A. Disabilitv Leave/Retirement Applications
No new application for disability leave/retirement was received.
B. Appeals/Requests for Reconsideration
No appeal or request for reconsideration was filed.
C. Medical/HearinQNision Claims
1. Jim Kellv
Regence explanation of benefits statement claim #0604432622900
in the amount of $25.04 for services received on February 9, 2006
and processed by Regence on March 1, 2006.
Chair Kelly relinquished the chair to Chair Pro Tem Larson prior to
consideration of Mr. Kelly's claim.
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April 4, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 - 10:00 AM - Council Conference Room
Motion by Member Vandver, second by Member Thordarson to
approve Mr. Kelly's claim in the amount of $25.04.
MOTION CARRIED. 4-0. Mr. Kelly abstained.
Chair Pro Tem Larson returned the Chair to Mr. Kelly.
2. Russ Vandver
a. Regence explanation of benefits statement claim
#0602032514800 in the amount of $20.11 for services
received on December 16, 2005 and processed by Regence
on February 1, 2006; and Regence explanation of benefits
statement claim #0603732833300 in the amount of $103.51
for services received on November 16, 2005 and processed
by Regence on February 22, 2006 for a total claim of
$123.62.
Motion by Chair Pro Tem Larson, second by Member
Thordarson to approve the claim in the total amount of
$123.62.
MOTION CARRIED. 4-0. Member Vandver abstained.
b. Regence explanation of benefits statement claim
#0605933870800 in the amount of $160.65 for services
received on February 16, 2006 and processed by Regence
on March 15, 2006.
Motion by Member Thordarson, second by Chair Pro Tem
Larson to approve the claim in the amount of $160.65.
MOTION CARRIED. 4-0. Member Vandver abstained.
3. Bruce Caldwell
Regence explanation of benefits statement claim #0605532521700
in the amount of $48.23 for services received on February 21, 2006
and processed by Regence on March 15, 2006.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to approve Mr. Caldwell's claim in the amount of $48.23.
MOTION CARRIED UNANIMOUSLY. 5-0.
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April 4, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 -10:00 AM - Council Conference Room
4. Richard Husebv
Request for reimbursement of vision expenses (lenses & frames)
incurred on February 9, 2006 in the amount of $119.98. (Mr.
Huseby has not received vision expense reimbursement in Jhe last
year.)
Motion by Chair Pro Tem Larson, second by member Thordarson
to approve Mr. Huseby's claim in the amount of $119.98.
MOTION CARRIED UNANIMOUSLY. 5-0.
5. Rav OQden
Mr. Ogden has submitted letters from Public Healthcare Services
District #3 dated March 7, 2006, and OceanView Convalescent
Center dated March 23, 2006 for pre-approval of assisted living
expenses under the Board's skilled nursing home or home health
care policy.
Mr. Ogden is not enrolled in the City's long-term health care
insurance as he was not eligible at the time of enrollment. Board
members reviewed Mr. Ogden's letters from Public Healthcare
Services and OceanView Convalescent.
Board members noted there were no details on the cost of Mr.
Huseby's proposed assisted living arrangements.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to table Mr. Ogden's request pending the receipt of additional
information including the fiscal impact and the specific medical
necessity.
MOTION CARRIED UNANIMOUSLY. 5-0.
6. Bruce Caldwell
The following claim was added as an agenda modification.
Regence explanation of benefits statement claim #060033297300
in the amount of $48.23 for services received on December 21,
2005 and processed by Regence on January 11, 2006.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to approve Mr. Caldwell's claim in the amount of $48.23.
MOTION CARRIED UNANIMOUSLY. 5-0.
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April 4, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 - 10:00 AM - Council Conference Room
D. Discussion
1. Policv and Procedure Manual Review
LEOFF Board members reviewed the following proposed
amendments to the LEOFF Board Policy and Procedure Manual:
. Policy 1.11 (E)( 1) delete the word "and" at the end of the first
line of the paragraph.
. Amend Policy 3.05, second paragraph, to read as follows:
All law enforcement officers and firefighters who qualify for
disability leave mavare encouraged to use department sick
leave, if available, until the City of Auburn LEOFF Board
meets at its regularly scheduled meeting and has reviewed
and approved the application for disability leave. Sick leave
is not reimbursed upon approval of disabilitv leave.
. Amend Policy 8.02(0) to read as follows:
Dental expenses '.viII not be considered necessary medical
services except in those circumstances where they are
incurred by a member who sustains an accidental injury to
his/her teeth and commenced treatment within ninety (90)
days after the accident, unless said treatment can be
justified by the 'Nay of curing or correcting an existing health
problem (See also section 8.03{B}).
Dental Expenses:
The Board recognizes that there is an increasinQ amount of
medical evidence to support the assertion that poor dental
health can result in a wide variety of other medical problems.
Therefore, the following dental benefits are provided:
1) Dental charQes incurred bv a member who sustains
an accidental injury to his or her teeth shall be paid.
2) The expense of one (1) general dental checkup each
year will be covered for each member up to an annual
maximum amount of $101.00.
3) No more than two (2) dental cleaninqs each year will
be covered for a member. unless it is determined. in
the discretion of the Board, that a more frequent
cleaning schedule is medically necessary in a
particular case or for a particular member. Routine
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April 4, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 - 10:00 AM - Council Conference Room
LEOFF Board Minutes
April 4, 2006
Page 7
c1eanings will be reimbursed at an annual maximum
amount of $192.00.
4) Dental expenses incurred by a member for routine
dental and periodontal work must be medically
necessary and receive prior approval of the Board.
5) No dental expenses incurred bv a member for dental
services or work which is purelv cosmetic in nature
will be approved or paid, except in unusual
circumstances, and then only with the prior written
approval of the Board and based upon medical
necessitv.
6) Dental expenses incurred bv a member for teeth
whiteninq will not be approved.
7) Dentures may be approved; however. prior
authorization by the Board is required. Dentures will
be reimbursed to a maximum amount of $1.387.00
per plate.
. Amend Policy 8.03(B) regarding dental charges as follows:
Dental charges incurred by a member 'Nho sustains an
accidental injury to his/her teeth and 'Nho commences
treatment by a legally licensed dentist '.vithin ninety (90) days
after the accidentDental expenses as identified in Policv
8.02(0);
. Amend Policy 8.03(B) regarding nursing home confinement
to read as follows:
Nursing home confinement or hospital care extended facility
(see policv 9.04 and 9.05);
. Amend Policy 9.04(0) to read as follows:
D. All charges must be submitted to the appropriate
insurance carriers, Medicare, Medicaid or other
available long-term care insurance before submission
to the Board. The Board may reduce the amount of
reimbursement for skilled nursing facility care by the
amount a LEOFF I member receives from these other
sources. Additionallv, if an eliqible member elects to
not subscribe or participate in a City-provided lonq-
term care insurance plan, benefits under this section
may be reduced or rejected.
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 - 10:00 AM - Council Conference Room
LEOFF Board Minutes
April 4, 2006
Page 8
. Amend Policy 9.05(A) to add the following item:
9. If an eliqible member elects to not subscribe or
participate in a City-provided home health care insurance
plan or long-term care insurance plans that provides home
health care benefits. benefits under this section may be
reduced or rejected.
. Amend Policy 9.01 (E) to reflect the current meeting day as
follows:
E. Submit the claim with the above information to your
LEOFF Representative by the last Tuesday of the
month. LEOFF Board agendas are prepared the last
Wednesday of the month and mailed to each Board
member at their last address of record. Any claims
submitted after that date will be held until the next
regularly scheduled LEOFF Board meeting, the first
Monday Tuesdav of each month.
. Amend Policy 9.02(C)(1), (2) and (3) (reimbursement rates)
as follows:
C. Vision Benefits
Payments for eyeglasses and contact lenses, plus the
reasonable costs of necessary eye examination
services of a licensed ophthalmologist or optometrist,
will be approved pursuant to the authority granted to
the Board under RCW 41.26.150, if eyeglasses are
prescribed by an ophthalmologist or optometrist.
The Board will approve payment for one pair of
eyeglasses or contact lenses, at the member's option
or as prescribed, to correct vision when required for a
new prescription in accordance with the following
schedule:
1. EveQlass Lenses and Frames:
$~225.00 maximum per single set of frames and
pair of lenses not more than once every twelve (12)
consecutive months. Lenses covered include single
vision, bifocal, or trifocal lenses.
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 -10:00 AM - Council Conference Room
LEOFF Board Minutes
April 4, 2006
Page 9
2. Second Pair: A second pair of
monofocal (i.e. computer) glasses shall be approved
only if prescribed by an ophthalmologist or licensed
optometrist. The maximum cost of the second pair
shall not exceed $WG-225 per single set of frames
and pair of lenses not more than once in a twenty-
four (24) consecutive months.
3. Contact Lenses: $WQ125.00 per lens
not to exceed $;w.Q-250 maximum during any twelve
(12) month period including disposable contact
lenses.
. Amend Policy 9.02(D) laser vision correction reimbursement
rate as follows:
D. Laser Vision Correction
The Board will reimburse the member the amount of
$700 per eye for Radial Keratotomy (RK) surgery or
laser eye surgery (LASIK and RK). If a member is
reimbursed the $+00-725 per eye for the surgery, he or
she will not be reimbursed for eyeglasses or contact
lenses during the subsequent two calendar years,
unless eyeglasses or contact lenses are medically
necessary.
. Appendix A and the manual's cover page will be amended to
reflect the current membership and member information.
. Incorporate amendments to Policy 8.03(B) and Policy 9.01 (I)
adopted during 2005.
Motion by Chair Pro Tem Larson, second by Member Vandver to
approve the foregoing amendments to the LEOFF Board Policy
and Procedure Manual.
MOTION CARRIED UNANIMOUSLY. 5-0.
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday April 4, 2006 - 10:00 AM - Council Conference Room
v. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:45 a.m.
0J
APPROVED THE if . DAY OF MAY, 2006.
QQAM~ k~~/
Jim Kelly, Chair
JJ~~
Danielle Daskam, Secretary
LEOFF Board Minutes
April 4, 2006
Page 10