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HomeMy WebLinkAbout12-03-2013 Gity of Aubum Law Enforcement Officers and Firefighters Disability Board Tuesday, December 3, 2013 - 10c00 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 on the first floor of Aubum City Hall, 25 Wesf Main Street in Auburn. Members present included Chair Kelly, Chair Pro Tem Biil Petersen, Member John Holman, Member Wayne Osborne;and Member-at- large Kurt VogeL Also present were Board Attomey Steve Gross, Employee Relations and Compensation Manager Aaron Barber and Board Secretary Danielle Daskam. 11. AGENDA MODIFICATIONS Glaims from Doris Darough, James Fisk, Fred Fisher, Robert Almy, and Don Webb were added to the agenda. III. APPROVAL OF MINUTES A Minutes of the November 5. 2013 LEOFF Board Meetinq Motion by Member Osbome, second by Member Holman to approve the. minutes as distributed. MOTION CARRIED UNANIMOUSLY. 5-0 N. UNFINISHED BUSINESS A. Pendinq Disabilitv Leave/Retirement Applications There was no pending disability leave/reti�ement application. B. Pendinp MedicaUHearinaNision Dental Claims 1. Ed Henderson* a. Request for reimbursemeM of dental expenses in the amount of $1;230.25 for services received on September 3 and 19, 2013. Mr. Henderson's dental expenses have previously proven to be medically necessary. On November 5, 2013, the Board tabled Mr. Henderson's claim pending the receipt ofthe prognosis of future dental needs from Mr. Henderson's denFist. After the Board meeting on November 5, 2013, the enclosed response was received from Mr. Henderson and his dentist. LEOFF Board Minutes December 3, 2013 Page 1 City ofAuburn Law Enforcement Officers and Firefighters Disability Board Tuesday, December 3, 2013 - 10:00 AM —Council Conference Room Motion by Member Vogel, second by Chair Pro Tem Petersen to approve the claim as submitted. MOTION CARRIED UNANIMOUSLY. 5-0 b. Request for reimbursement of inedical equipment expenses in the amount of $7,234:30. On November 5, 2013, a motion to deny Mr. Henderson's claim was tabled until the December 3, 2013 meeting. BoaM Attomey Gross reported that he researched the law, other jurisdiction's policies, and Medicare and Medicaid regarding reimbursement of inedical equipment expense and did not find anything on ,point. He found among other jurisdictions reim6ursement is not approved if the equipment has a non-medical use or function. In other words, the equipment must assist the memberin recovering from an injury or illness. Attorney Gross also reported that many jurisdictions require pre-approval, a. prescription, and submission of the expense to insurance prior to consideration of any claim for reimbursement of 4he medical equipment expense. Member Holman stated in some cases there is no recovery, but the equipment is adaptive. Member Holman stated the stair climberwill enable the�etiree to stay in his own home. Board Secretary Daskam reported that per the instructions of the Board, a letter was sentto Mr. Henderson requesting proof that the expense had been submitted to Medicare and Regence. Board Secretary Daskam also advised that in a telephone conversation, Mr. Henderson indicated he would not pursue the claim further. Motion by Chair Pro Tem Petersen, second by Member Vogel to table the claim until further information is received from Mr. Henderson. MOTION CARRIED UNANIMOUSLY. 5-0 V. NEW BUSINESS A. Disabilitv Leave/Retirement Aoplications No application for disability leavehetirement was received. LEOFF Board Minutes December 3,2013 Page 2 City of Aubum Law Enforcement Officers and Firefighters Disability Board 7uesday, December 3, 2013 - 70:00 AM —Council Conference Room B. Appeals/Reauests for Reconsideration No request for reconsideration was received. C. Medical/HearinqNision/Dental Claims 1. Cov Franklin Grall Request for reimbursement of dental expenses in the amount of $170.00 for services received on November 7, 2013. COY FRANK GRALL $1,200.00 BALANCE 2013 $1,200.00 May 7, 2013 $94.00 $1,106.00 Motion by Chair P.ro Tem Petersen, second by Member Holman to approve the claim in the amount,of$170.00. MOTION CARRIEDUNANIMOUSLY. 5-0 2. Marion Dukes Request for reimbursement of dental expenses in the amount of $1,553.90 for services received on September 26 and November 6, 2013. MARION DUKES $1,200.00 BALANCE 2013 $1,200.00 June 4, 2013 5210.60 $989.40 Motion by Member Vogel, second by Chair Pro Tem Petersen to approve the claim in the amount of$1,553.90 due to an accident. MOTION CARRIED UNANIMOUSLY. 5-0 3. Murrav Board Request for reimbursement of dental expenses in the amount of $277.00 for services received on November 13, 2013. MURRAY BOARD $1,200.00 BALANCE 2013 $1,200.00 June 4, 2013 $212.00 $988.00 LEOFF Board Minutes December 3, 2013 Page 3 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, December 3, 2013 - 10:00 AM —Council Conference Room Motion by Member Holman, second by Chair Pro Tem Petersen to approve the claim in4he amouM of$277.00. MOTION CARRIED UNANIMOUSLY. 5-0 4. William Pitzl Reque§t for reimbursement of dental expenses in the amount of $240.30 for services received on November 1, 2013. Bill Pitzl 2013 $1,200.00 BALANCE $1,200.00 Date Claim Approved June 4, 2013 $369.90 $830.10 August 6, 2013 $212.40 $617.70 Motion by Chair Pro Tem Petersen, second by Member Vogel to approve the claim in the amount of$240.30. MOTION CARRIED UNANIMOUSLY. 5-0 5. Loren Anderson. Request for reimbursement of dental expenses in the :amount of $412.30 for services received on July 11, 2013 and October 9, 2013. LOREN ANDERSON 2013 $1,200.00 BALANCE $1,200.00 February 5, 2013 5433.20 5766.80 Motion by Chair Pro Tem Petersen, second by Member Vogel to approve the claim in the amount of$412.30. MOTION CARRIED UNANIMOUSLY. 5-0 6. Ed WoRers a. Request for reimbursement of inedical expenses in the amourrt of$59.77 forservices received on August 9, 2013 LEOFF Board Minutes December 3,2013 Page 4 City ofAubum Law Enforcement Officers and Firefighters Disability Board Tuesday, December 3, 2013 - 10:00 AM — Council Conference Room Motion by Chair Pro Tem Petersen, second by Member Osbome to tabie the claim pending the receipt of the Medicare and insurance explanation of benefds statements. MOTION CARRIED UNANIMOUSLY. 5-0 b. Request for reimbursement of inedical expenses in the amount of$7.44 forservices received on March 28, 2013. Motion by Chair Pro Tem Petersen, second by Member Vogel to table the claim pending the receipt of the Medicare and insurance explanation of benefits statements. MOTION CARRIED UNANIMOUSLY. 5-0 c. Request for reimbursement of dental expenses in the amount of$130.00 for services received on September 19, 2013. ED WOLTERS 2013 $1,200.00 BALANCE $1,200.00 June 4, 2013 $115.00 $1,085.00 . July 2, 2013 $205.00 $880.00 Motion by Chair Pro Tem Petersen, second by Member Vogel to apprbve the olaim in the amourit of$130.00. MOTION CARRIED UNANIMOUSLY. 5-0 7. Doris Darouah Request for reimbursement of long term/home health care costs in the amount of$8,100.00 for the month November 2013. Motion by M_ember Holman, second by Chair Pro Tem Petersen to approve the claim in the amount of$8,100.00. MOTION CARRIED UNANIMOUSLY. 5-0 8. James Fisk Requesf for reimbursement of dental expenses in the amount of $119.00 for services received on November 26, 2013. Mr. Fisk has not received dental expense reimbursement in 2013. LEOFF Board Minutes December 3, 2013 Page 5 City of Auburn Law Enforcement Offcers and Firefighters Disability Board Tuesday, December 3, 2013 - 10:00 AM — Council Conference Room Motion by Memtier Osborne, second by Member Holman to approve the claim in 4he amount of$119.00. MOTION CARRIED UNANIMOUSLY. 5-0. 9. Fred Fisher Request for reimbursement of dental expenses in the amount of $63.00 for services received on October 23, 2013. Mr. Fisher has not received dental expense reimbursement in 2013. Motion by Member Osborn,e, second by Member Vogel to approve the claim in the amount of$63.00. MOTION CARRIED UNANIMOUSLY. 5-0 10. Robert Almv Request for reimbursement of dental expenses in the amount of $153.00 for services received on July30, 2013. ROBERTALMY 2013 $1;200.00 BALANCE $1,200.00 Feb 5, 2013 $109.00 $1,091.00 Motion by Member Osbome, second by Chair Pro Tem Petersen , to approve the claim in the'amount of$153.00. MOTION CARRIED UNANIMOUSLY. 5-0 11. Don Webb Request for reimbursement of dental expenses in the amount of $247.00 for services received on November 15, 2013. DON WEBB 2013 $1,200.00 BALANCE $1,200.00 February 5, 2013 $125.00 51,075.00 Apri12, 2013 $210.00 $865.00 June 4, 2013 $370.00 $495.00 July 2, 2013 $65.00 $430.00 Motion by Member Osbome, second by Chair Pro Tem Petersen to approve the claim in the amount of$247.00. MOTION CARRIED UNANIMOUSLY. 5-0 LEOFF Board Minutes December 3, 2013 Page 6 City ofAuburn Law Enforcement Officers and Eirefighters Disability Board Tuesday, December 3, 2013 - 10:00 AM —Council Conference Room D. Other Discussion 1. Medicare Advantage Program Employee Relations and Gompensation Manager Barbec was in attendance to answer questions regarding any services not covered by the new Medicare Advantage Program and any non- paRicipating providers. Mr. Barber stated that any services not covered would be handled as they are now and submitted to the LEOFF Board for determination of whetherthe expense was a reasonable medical expense and eligible for reimbursement. Should there be any changes in non-contracted providers, the Association of Washington Cities Trust would be contacted to determine whether a separate arrangement exists. Chair Pro Tem Petersen inquired how a current retiree who is enrolled in Group Health will be affected. Mr. Barber stated the Association of Washington Cifies may retain 4he Group Health subscriber on Plan A. Attorney Gross reported RCVN 41.26.150(2) states that medical services payable will be reduced by any amount received or eligible to be received. Board members spoke regarding the need to revise the Board policies and procedures to allow flexibil"ity to approve claims consistent with the state statute and to allow the Board the ability to consider claims on a case by case basis. Mr. Barber encouraged the Board to monitor non-participating provider claims. 2. LEOFF 1 Police Representative Election Board Secretary Daskam provided the results for the LEOFF 1 Police representative election. Thirty-three ballots were mailed and 28 ballots were retumed. James Kelly was elected as the Police representafive. The vofing results are as follows: Kelly 16 LEOFF Board Minutes December 3,2013 Page 7 City ofiAubum Law Enforcement Officers and Firefighters Disability Board Tuesday, December 3, 2073 -10:00 AM—Council Conference Room Phillips 8 Bourdage 4 Wickman 0 3. Home Care Monitoring MemberOsbome inquired whether there is a need to follow-up on home health care conditions for retirees. Members indicated an _ irrterest in obtaining copies of State inspection reports for nursing homes or home heaRh care facilities in which LEOFF 1 retirees reside. Chair Pro Tem Petersen offered to follow-up on this inquiry. Chair Kelly reported that home heafth care givers are licensed annually. VI. ADJOURNMENT There being no furthec business to come before the Board, the meeting adjourned at 10:40 a.m. APPROVED this �day of January, 2014. � � Chair Da ielle Daskam, Board Secretary LEOFF Board Minutes December 3, 2013 Page 8