HomeMy WebLinkAbout03-07-2006
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 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 February 7.2006 Reoular LEOFF Board Meetino
Motion by Chair Pro Tem Larson, second by Member Thordarson to
approve the February, 2006 minutes as distributed.
MOTION CARRIED. 5-0.
III. UNFINISHED BUSINESS
A. Pendino Disability 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 submitted physician's
statements from Dr. Sands dated January 23, 2006 and from Dr.
Williard dated February 27, 2006.
Mr. Vandver was in attendance and reported on the status of his
condition and treatment. Mr. Vandver will be referred to the
University of Washington for further treatment.
Motion by Chair Pro Tem Larson, second by Member Thordarson
to continue Mr. Vandver's disability leave for an additional month or
until cessation of disability, whichever occurs first.
MOTION CARRIED. 4-0. Member Vandver abstained from voting.
LEOFF Board Minutes
March 7, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
Chair Kelly spoke regarding the policy requirement to have the
Board physician examine applicants for disability retirement during
the fifth month of disability leave. Board members discussed Mr.
Vandver's existing record of disability and whether an additional
examination by the Board physician is necessary or of any further
value.
Board Attorney Beck spoke regarding the Board's need to
determine whether the disability was incurred in the line of duty or
not. According to the statute, the Board must consider the
following factors when determining whether the disability is an
occupational disease incurred in the line of duty: use of tobacco
products, lifestyle, physical fitness and weight, heredity factors, and
other exposure sources.
Chair Kelly suggested that Mr. Vandver be directed to obtain the
necessary information, which would otherwise be obtained from an
independent examination, from his treating physicians for review by
the Board at the next meeting.
Motion by Chair Pro Tem Larson, second by Member Wagner to
address correspondence to Mr. Vandver directing him to obtain the
necessary information, which would otherwise be obtained from an
independent examination, from his treating physician(s) for review
by the Board at the next meeting.
Mr. Vandver requested that the Board continue to consider his
original cause for disability leave as well as his most recently
diagnosed condition.
Board Attorney Beck suggested that each condition be evaluated
separately.
Chair Pro Tem Larson explained that the intent of his motion is to
obtain evidence from Mr. Vandver's treating physicians to
determine disability leave retirement rather than utilizing the
Board's physician.
MOTION CARRIED. 4-0. Member Vandver abstained from voting.
B. Medical/HearinoNision Claims
There was no pending claim.
IV. NEW BUSINESS
LEOFF Board Minutes
March 7, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
A. Disability Leave/Retirement Applications
No new application for disability leave/retirement was received.
B. Appeals/Reauests for Reconsideration
No appeal or request for reconsideration was filed.
C. Medical/HearinoNision Claims
1. Stan Laatsch
Request for reimbursement of vision expenses (lenses) in the
amount of $97.00 dated January 24, 2006. (Mr. Laatsch has not
received vision expense reimbursement within the last year.)
Motion by Chair Pro Tem Larson, second by Member Vandver to
approve Mr. Laatsch's claim in the amount of $97.00
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Russ Vandver
a. Claim for Regence Explanation of Benefits Statement
#0601332386400 processed on January 25, 2006 for
medical services received on October 5 and December 13,
2005 in the amount of $118.43.
Motion by Chair Pro T em Larson, second by Member
Thordarson to approve Mr. Vandver's claim in the amount of
$118.43.
MOTION CARRIED. 4-0. Member Vandver abstained.
b. Claim for reimbursement of medical expenses incurred on
January 31,2006 in the amount of $120.00
Chair Kelly noted that the claim was not accompanied by an
explanation of benefits statement.
Mr. Vandver explained that the billing was not transmitted to
Regence as it was not a covered expense. The billing is for
the dictation and transcription of a letter by one of his
treating physicians as requested by the Board.
Motion by Chair Pro Tem Larson, second by Member
Thordarson to waive the requirement for the explanation of
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March 7, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 - 10:00 AM - Council Conference Room
benefits statement and approve the claim in the amount of
$120.00.
Upon further discussion and review of the Board policies,
Chair Pro Tem Larson withdrew his motion.
Motion by Chair Pro T em Larson, second by Member
Thordarson to table the claim and request that the claimant,
Mr. Vandver, submit the expense to Regence and submit
the explanation of benefits statement to the Board.
MOTION CARRIED. 4-0. Member Vandver abstained.
3. Ed Henderson
Request for reimbursement of vision expenses in the amount of
$212.01 dated February 27, 2006. (Mr. Henderson has not
received vision expense reimbursement within the last year.)
Motion by Member Thordarson, second by Chair Pro Tem Larson
to approve the claim in the amount of $200 pursuant to Board
policy.
MOTION CARRIED UNANIMOUSLY. 5-0.
D. Discussion
1. Policy and Procedure Manual Review
LEOFF Board 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 mayare 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 disability leave.
. Amend Policy 8.02(D) to read as follows:
LEOFF Board Minutes
March 7, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
Dental expenses will not be considered necessary medical
services except in those circumstances 'Nhere 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 v.'ay of curing or correcting an existing health
problem (See also section 8.03{B}).
Dental Expenses:
The Board recoonizes that there is an increasino amount of
medical evidence to support the assertion that poor dental
health can result in a wide variety of other medical problems.
Therefore, the followino dental benefits are provided:
1) Dental charoes incurred by a member who sustains
an accidental iniury to his or her teeth shall be paid.
2) The expense of one (1) oeneral dental checkup each
year will be covered for each member up to an annual
maximum amount of $
3) No more than two (2) dental c1eaninos each year will
be covered for a member, unless it is determined, in
the discretion of the Board, that a more freQuent
c1eanino schedule is medically necessary in a
particular case or for a particular member. Routine
cleaninos will be reimbursed at an annual maximum
amount of $
4) The dental expenses incurred by a member for
routine dental and periodontal work, as may be found
by the Board to be medically necessary, will be
covered.
5) No dental expenses incurred by a member for dental
services or work which is purely 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
necessity.
6) Dental expenses incurred by a member for teeth
whitenino will not be approved.
7) Dentures?
Board members reviewed the cost survey for annual dental
exams, x-rays, c1eanings and dentures. Members
suggested averaging the regional survey of costs for a
routine exam and x-rays as one benefit amount for one
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March 7, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
LEOFF Board Minutes
March 7, 2006
Page 6
annual dental checkup. Additionally, the Board
recommended averaging the regional survey of costs for
c1eanings to determine the maximum annual benefit for
c1eanings.
Board members suggested changing item 4 above to read
as follows: "Dental expenses incurred by a member for
routine dental and periodontal work must be medically
necessary and receive prior approval of the Board."
Board members suggested providing for the following
language for dentures under item 7 above: "Dentures may
be approved; however, prior authorization by the Board is
required. Dentures will be reimbursed to a maximum
amount of (average of regional cost survey as provided in
March 7, 2006 agenda packet) per plate."
. Amend Policy 8.03(B) regarding dental charges as follows:
Dental charges incurred by a member who sustains an
accidental injury to his/her teeth and '.vho commences
treatment by a legally licensed dentist '.vithin ninety (90) days
after the accidentDental expenses as identified in Policy
8.02(D);
. Amend Policy 8.03(B) regarding nursing home confinement
to read as follows:
Nursing home confinement or hospital care extended facility
(see policy 9.04 and 9.05);
. Amend Policy 9.04(D) 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. Additionally. if an eligible member elects to
not subscribe or participate in a City-provided lono-
term care insurance plan. benefits under this section
may be reduced or reiected.
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
LEOFF Board Minutes
March 7, 2006
Page 7
. Amend Policy 9.05(A) to add the following item:
9. If an elioible member elects to not subscribe or
participate in a City-provided home health care insurance
plan or lono-term care insurance plans that provides home
health care benefits, benefits under this section may be
reduced or reiected.
. 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 Tuesday 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. Eyeolass Lenses and Frames:
$200225.00 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.
2. Second Pair: A second pair of
monofocal (Le. computer) glasses shall be approved
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
only if prescribed by an ophthalmologist or licensed
optometrist. The maximum cost of the second pair
shall not exceed $~225 per single set of frames
and pair of lenses not more than once in a twenty-
four (24) consecutive months.
3. Contact Lenses: $-Um125.00 per lens
not to exceed $2QQ-250 maximum during any twelve
(12) month period including disposable contact
lenses.
Board members reviewed the regional survey cost of vision
lenses and frames and agreed with the above-reflected
adjusted reimbursement rates.
. 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 .
Board members reviewed the survey of laser vision costs
and agreed with the proposed adjustment in the
reimbursement rate.
. 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.
The final draft of the proposed amendments will be presented to
the Board for adoption at the April 4, 2006 meeting.
V. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 11 :06 a.m.
LEOFF Board Minutes
March 7, 2006
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, March 7, 2006 -10:00 AM - Council Conference Room
APPROVED THE L\. --\-~ DAY OF APRIL, 2006.
, iUS:ttIJa~J
LEOFF Board Minutes
March 7, 2006
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