Loading...
HomeMy WebLinkAbout07-03-2012 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 3, 2012 - 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 Aubum City Hall, 25 West Main Street in Aubum. Chair Kelly and the following Board members were present: Bill Petersen, John Holman, Wayne Osbome, and Kurt Vogel. Also present were Board Attomey 8teve Gross and Board Secretary DanielleDaskam. 11. AGENDA MODIFICATION A claim from Ed Sluys was added to the agenda. 111. APPROVAL OF MINUTES A. Minutes of the June 5. 2012 LEOFF Board Meetina Motion by Chair Pro Tem Petersen, second by Member Osbome to approve the June 5, 2012 minutes as distributed. MOTION CARRIED UNANIMOUSLY 5-0 N. UNFINISHED BUSINESS A. Pendinc Disabilitv Leave/Retirement An�lications TFiere was no pending disability leave/retirement application. B. Pendinci MedicaUHearinaNision Dental Claims 1 Rudv Peden Request for reimbursement of $180.00 in medical expenses for services received February 12, 2012 —April 20, 2012. —'- On June 5 and July 3, 2012, the Board tabled Mr Peden's claim pending the receipt of insurance explanation of benefds statements. No additional information was received. Motion by Chair Pro Tem Petersen, second by Member Osbome to table Mr Peden's claim until the next meeting. MOTION CARRIED UNANIMOUSLY 5-0 V. NEW BUSINESS LEOFF Board Minutes ' July 3, 2012 Page 1 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 3, 2012 - 70:00 AM -Council Conference Room A. Disabilitv Leave/Retirement Aoplicatians No applicatiori for disability leave/retirement was received. B. Anaeals/Reauests for Reconsideration No request for reconsideration was received. C. MedicaUHearinaNision Claims 1 John Baker Request for reimbursement.of denture expenses in the amount of $2,774.00 for seroices received on May 14, 2012. Motion by Chair Pro Tem. Petersen, second by Member Vogel to approve the claim in the amount of$2,774.00. MOTION CARRIED UNANIMOUSLY 5-0 2. Bruce Caldwell Request for reimbursement of dental expenses in the amount of $209.70 for services received on May 24, 2012. Mr Caldwell has not received dental reimbursement in 2012 Motion by Chair Pro Tem Petersen, second by Member Osborne to approve the claim in the amount of$209.70. MOTION CARRIED UNANIMOUSLY 5-0 3. Robert Wialev Request for reimbursement of dental expenses in the amount of $160.00 for services received on June 14, 2012. Mr Wigley has not received dental expense reimbursement this year Motion by Member Vogel, second by Member Holman to approve the claim in the amount of$160.00. MOTION CARRIED UNANIMOUSLY 5-0 4 Ed Henderson Request for reimbursement of dental expenses in. the amourit of $2,028.25 for services regeiyed on May 29 and 31, 2012. Mr Henderson's dental claims have been previously found to be medically necessary LEOFF Board Minutes July 3, 2012 Page 2 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 3, 2012 - 10:00 AM —Council Conference Room ED HENDERSON $1,200.00 BALANCE 2012 $1,200.00 April 3, 2012 $304.00 $896.00 June 5,2012 $90.25 $805.75 Motion by Chair Pro Tem Petersen, second by Member Vogel to aprpove the claim in the amount of$2,028.25. MOTION CARRIED UNANIMOUSLY 5-0 Motion by Member Holman, second by Chair Pro Tem Petersen to instruct the:Board Secretary to request a dental treatment plan and an updated/current letter of inedical necessity from Mr Henderson. MOTION CARRIED UNANIMOUSLY 5-0 5. Ravmond Sherman Request for reimbursement of dental expenses in the amount of $59.90 for services received on February 27, 2012. Mr Sherman has not received denfal reimbursement in 2012. Motion by Member Vogel, 'second ,by Chair Pro Tem Petersen to approve the claim in the amount of$59.90. MOTION CARRIED UNANIMOUSLY 5-0 6. Roaer Lee Request for reimbursement of vision expenses in the amount of $195.00 for services received on June 20, 2012. Mr Lee last received vision expense reimbursement on July 5, 2011 Motion by Chair Pro Tem Petersen, second by Member Vogel to approve the claim in the amount of $195.00 and instruct the Board Secretary to remind Mr Lee that vision expenses are reimbursed every twelve months. MOTION CARRIED UNANIMOUSLY 5-0 7 Richard Schneider Request for reimbursement of dental expenses in the amount of $270.00 for services received:on May 23, 2012. Mr Schneider has not received dental reimbursement in 2012. LEOFF Board Minutes Juty 3, 2012 Page 3 City of Aubum Law Enforcement Officers and Firefighters Disability Board Tuesday, July 3, 2012 - 10:00 AM—Council Conference Room Motion by Chair Pro Tem Petersen, second by Member Osbome to approve the claim in the amount of$270.00. MOTION CARRIED UNANIMOUSLY 5-0 8. Doris Darouah Request for reimbursement of long term care costs for the month of May 2012 in the amount of$3,064:97 Motion by Chair Pro Tem Petersen,. second by Member Vogel to approve the claim in tF9e amount of$3,064.97 MOTION CARRIED UNANIMOUSLY 5-0 9. Monroe Shronshire Request for reimbursement of dental expenses in the amount of $498.00 for services received on May 9, 2012. MONROE SHROPSHIRE 2012 $1,200.00 BALANCE $1,200.00 April 3, 2012 $150.00 $1,050.00 May 1, 2012 $150.00 $900.00 Motion by Member Vogel, .second by Chair Pro Tem Petersen to approve the claim in the amount of$498.00. MOTION CARRIED UNANIMOUSLY 5-0 10. Russ Vandver Request for reimbursement of dental e�enses in the amount of $170.00 for services received on May 17, 2012. Mr Vandver has not received reimbursement for dental expenses in 2012. Motion by Chair Pro Tem Petersen, second by Member Vogel to approve the claim in the amount of$170.00. MOTION CARRIED UNANIMOUSLY 5-0 11 Cov Franklin Grall Request for reimbursemeM of dental expenses .in the amount of $136.00 for services received on May 23, 2012. Mr Grall has not received reimbursement for dental expenses in 2012. LEOFF Board Minutes July 3, 2012 Page 4 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 3, 2012 - 10:00 AM-Council Conference Room Motion ,by Member Vogel, sepond by Chair Pro Tem Petersen to approve the olaim in the amount of$136.00. MOTION CARRIED UNANIMOUSLY 5-0 12. Ed Sluvs Request for reimburserrSent of inedical services (medical equipment) in the amount of$383.20. Mr Sluys' claim was added as an agenda modification. Motion by Member Holrrian, second by Chair Pro Tem Petersen to tabled Mr Sluys' claim pend'ing the receipt of additionat information including a statement of inedical necessity and the insurance explanation of benefits statement. MOTION CARRIED UNANIMOUSLY 5-0 D. LEOFF Board Policies and Procedures The Board reviewed the 2010-2011 Policy and Procedure Manual section by section for any needed revisions.and surveys of local vision and dental costs. The following amendments were approved. Section 1.02 Terms Motion by Member Holman, second by Member Osbome to substitute the word "shall" with the word "should" in the second sentence of Section 1.02. MOTION CARRIED UNANIMOUSLY 5-0 Section 1 13 Minutes Motion by Chair Pro Tem Petersen, second by Member Vogel to replace the term "Fire ChieP' with °Valley Regional Fire Authority Administrato�' MOTION CARRIED UNANIMOUSLY 5-0 Section 1 14 Delegation of Authority to Secretary Chair Kelly noted that Uie Board Secretary has been authorized to process claims for payment for pharmacy and Medipre reimbursement upon signature on the claim by the Police or Fire LEOFF Board Minutes Juty 3, 2012 Page 5 City oi Auburn Law Enforcement OfFcers and Firefighters Disability Board Tuesday, July 3, 2012 - 10:00 AM—Council Conference Room LEOFF Board representative. Full Board approval is not required for claims for paymeM for phartnacy and Medicare Part B reimbursement. Section 7.01 Record of Statement of Falsifieation The Board concurred to update the current reference to RCW 41.26.300 to RCW 41.26.062. Section 8.02(D)(4) related to dental expenses: Motion by Chair Pro Tem Petersen, second by Member Holman to amend the section to read: "Dentures may be approved; however, prior authorization by the Board is required. Dentures will be reimbursed to maximum amount of$�991.756.00 per plate.° MOTION CARRIED UNANIMOUSLY 5-0 Section 9.01(C) correct the scriveners error to remove the underiine from the end of the paragraph. Section 9.01(L) Motion by Chair Pro Tem Petersen, second by Member Vogel to substitute the word "surrogated" with "subrogated" MOTION CARRIED UNANIMOUSLY 5-0 Section 9.02(C)(1) related to eyeglass lenses and frames: Motion by Member Holman, second by Chair Pro Tem Petersen to add the word "progressive"to the types of covered lenses MOTION CARRIED UNANIMOUSLY 5-0 Section 9.02(C)(3) relafing to contact lenses: Motion by Chair Pro Tem Petersen, second by Member Vogel to amend the paragraph to read: " . Not to exceed $250 maximum during any twelve (12) month period including disposatile contaot lenses. LEOFF Board Minutes July 3, 2012 Page 6 City of Aubum Law Enforcement Officers and Firefighters Disability Board Tuesday, July 3, 2012 - 10:00 AM -Council Conference Room MOTION CARRIED UNANIMOUSCY 5-0 Section 9.02(E) related to vision coITective surgery• Motion by Chair Pro Tem Petersen, second by Member Osborne to amend the paragraph as follows: �aseFCorrective vsion GeKes�ieRSuraerv The Board will reimburse the member the amount of $1,000 per eye for rrective vision surgery-eNaseF . If a member is reiinbursed the $1,000 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 oontact lenses are medically necessary (Rev 57/�89�2012) MOTION CARRIED UNANIMOUSLY 5-0 Section 9.04 Skilled Nursing Facility Care Reimbursement Motion.by Membe� Osbome, second by Chair Pro Tem Petersen to remove Section 9.94(A)(1) and renumber the remaining two paragraphs. MOTION CARRIED UNANIMOUSLY 5-0 The language #o be deleted is as follows: ' • � MOTION CARRRIED UNANIMOUSLY 5-0 Section 9.10 Medical Claims for Board Required Re-examinations Correct the scrivener's error and change the reference to Washington Administrative Code (WAC) from 415-105-0901 to WAC 415-105-090. Sections 10.01 and 10.02 regarding biennial review and formal adoption of revisions to policies and procedures LEOFF Board Minutes July 3,2012 Page 7 City of Auburn Law Enforcement Officers and Firefighters Disability BoaM Tuesday, July 3, 2012 - 10:00 AM —Council Conference Room Motion by Member Os6orne, second by Member Holman to amend Sections 10.01 and 10.02 as follows: 10.01 Biennial Review These policies and p�ocedures shall be reviewed in even years in daaaar�y-Februarv to assure that: A. Provisions herein remain in conformance with Washington Statutory and Administrative Codes. B. Dollar amourrts spec�ed in schedule.s of benefits reflect current average charges in the local area. C. Provisions he�ein reflect current philosophy and intent of the Board. 10.02 Formal Adoption Revisions of the Board's policies and procedures shall be adopted no later than the regularly scheduled Board meeting in �ebiaa� Sentember of the year of review. MOTION CARRIED UNANIMOUSLY 5-0 VI. ADJOURNMENT There being no further business to come before the Board, the meeting adjoumed at 10:58 a.m. APPROVED the ��day of_�2�2012. , � Jim :elty, Chair Danielle Daskam, Board Secretary LEOFF Board Minutes July 3, 2012 Page S