HomeMy WebLinkAbout05-07-2001 City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - 10:00 AM - Conference Room '1
MINUTES
I. CALL TO ORDER
Chair Jim Kelly called the meeting to order at 10:00 AM in Conference Room 1
located at Auburn City Hall, 25 West Main Street, Auburn, WA. Members
present included Chair Kelly, Chair Pro Tem Bud Larson, Member Jeanne
Barber, Member Stacey Brothers, and Member Russ Vandver. Others present
included Mayor Charles A. Booth, Personnel Director Brenda Heineman,
Associate City Attorney Karen Gulliver and Board Secretary Danielle Daskam.
II. APPROVAL OF MINUTES
A. Minutes of the April 2, 2001 LEOFF Board Meeting
Motion by Member Brothers, second by Member Barber to approve the
April 2, 2001 LEOFF Board minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 5-0.
III. UNFINISHED BUSINESS
A. Pending Disability Leave/Retirement Applications
1. Harold F. Philbin
Effective Date of Disability: April 1, 2001
Last Day of Service: March 31, 2001
On April 2, 2001, the LEOFF Board approved disability leave for
Mr. Philbin effective April 1, 2001 with last day of service on March
31, 2001. Mr. Philbin submitted an attending physician's statement
from Ronald B. Kuppersmith, MD dated April 13, 2001.
Board members reviewed the physician's statement for the month
of May.
Motion by Member Larson, second by Members Brothers to accept
the physician's report for Mr. Philbin and continue Mr. Philbin's
disability leave for an additional thirty days or until cessation of
disability, whichever occurs first.
LEOFF Board Minutes
May 7, 2001
Page 1
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - 10:00 AM - Conference Room I
MOTION CARRIED UNANIMOUSLY. 5-0.
B. Claims
1. Richard Huseby
a. Regence Explanation of Benefits Claim No. 0029810230900
processed on October 24, 2000 and Medicare Explanation
of Benefits Statement dated August 4, 2000 for medical
services received on May 16, 2000 in the amount of
$210.00.
On December 4, 2000, the LEOFF Board tabled Mr. Huseby's
claim pending the receipt of additional information documenting the
medical necessity of the medical services received. On December
18, 2000, Mr. Huseby submitted a letter from Dr. David Wukasch
regarding Mr. Huseby's medical condition. On January 2, 2001,
the LEOFF Board tabled Mr. Huseby's claim and requested that he
resubmit his claim to Regence with the additional information
provided by his physician. The Board tabled Mr. Huseby's claim on
February 5, March 5, and April 2, 2001 pending additional
information.
On April 4, 2001, the LEOFF Board Secretary received a copy of a
February 26, 2001 letter from Regence addressed to Dr. David
Wukasch regarding Mr. Huseby's claim.
Board members reviewed the February 26, 2001 letter from
Regence in which Regence explains that their original denial of
benefits was correct because the documentation supports a routine
physical exam, which is not a covered benefit.
Motion by Member Brothers, second by Member Larson to deny
Mr. Huseby's claim because the medical services received were
preventative measures.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
May 7, 2001
Page 2
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - 10:00 AM - Conference Room 1
2. Clifford Phillips
a. Request for authorization to purchase hearing aids, from
other than the Board designated hearing aid provider, in the
amount of $4,200.00.
On April 2, 2001, the LEOFF Board considered Mr. Phillips' request
for pre-approval of hearing aid expenses from other than the Board
designated hearing aid provider. Mr. Phillips resides approximately
138 miles from the nearest Costco Hearing Aid Center.
The Board tabled Mr. Phillips' claim pending information from
Costco (the Board designated hearing aid provider) as to their
charge for equivalent hearing aids. Ms. Shirley Haarhues,
Manager of the Federal Way Costco Hearing Aid Center, reviewed
the information received from Mr. Phillips' and submitted a letter to
the Board dated April 11, 2001.
Board members reviewed the letter received from the Costco
Hearing Aid Center and the information submitted with Mr. Phillips'
original .claim. The cost of an equivalent hearing aid from Costco is
$999.00 per each hearing aid. Committee members discussed the
Board's policy which provides that the Board can authorize
payment for hearing aid(s) up to an amount determined by the
LEOFF Board designated hearing aid prorider, Costco. Mr. Phillips
requests to purchase hearing aids from an audiologist located in
Wenatchee.
Motion by Member Larson, second by Member Brothers to approve
payment of $1,998.00 towards the purchase of two hearing aids
which is a reimbursement rate based on the April 11, 2001 letter
from the Manager of the Costco Hearing Aid Center.
MOTION CARRIED. 4-1. Member Barber voted no.
LEOFF BoardMinutes
May 7, 2001
Page 3
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - 10:00 AM - Conference Room I
3. Murray Board
a. Regence Explanation of Benefits Statement No.
0102210070300 processed on February 21, 2001, for
services received on September 12, 2000, in the amount of
$143.00.
On April 2, 2001, the LEOFF Board tabled Mr. Board's claim
pending receipt of additional information from the Association of
Washington Cities Trust (AWC) regarding the Explanation of
Benefits Statement and benefit level for ambulance services.
The Board reviewed a letter dated April 26, 2001 from Carol L.
Wilmes, AWC Benefits Program Coordinator, containing the
additional information requested by the Board.
Motion by Member Brothers, second by Member Vandver to
approve Mr. Board's claim in the amount of $143.00.
MOTION CARRIED UNANIMOUSLY; 5-0.
4. Ed Henderson
a. Regence Explanation of Benefits Statement No,
0036410108800 processed on January 17, 2001 for
services received on September 29, 2001 in the amount of
$25.00; and
b. Regence Explanation of Benefits Statement No.
0036410108700 processed on January 17, 2001 for
services received on October 6, 2001 in the amount of
$25.00.
On April 2, 2001, the LEOFF Board tabled Mr. Henderson's request
for reimbursement of blood bank charges on September 29 and
October 6, 2000 in the amount of $50.00 pending receipt of
Regence Explanation of Benefits Statements. Mr. Henderson
subsequently provided the Regence Explanation of Benefits
Statements.
LEOFF Board Minutes
May 7, 2001
Page 4
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - 10:00 AM - Conference Room 1
Motion by Member Barber, second by Member Brothers to approve
Mr. Henderson's claims in the total amount of $50.00.
MOTION CARRIED UNANIMOUSLY.
IV. NEW BUSINESS
A. Disability Leave/Retirement Applications
There was no new application for disability leave/retirement.
B. Appeals
There was no request for reconsideration/appeal.
C. Medical Claims
1. John Wickstrom
a. Request dated April 13, 2001, for authorization to purchase
hearing aids, from other than the Board designated hearing
aid provider (Belltone), in the amount of $2,598.00.
Motion by Member Larson, second by Member Brothers to
table Mr. Wickstrom's request pending information from
Costco as to their charge for equivalent hearing aids.
MOTION CARRIED UNANIMOUSLY. 5-0.
b. Request dated March 30, 2001 for reimbursement of lenses
expense in the amount of $104.00.
Motion by Member Vandver, second by Member Larson to
table Mr. Wickstrom's claim for reimbursement of lenses
expense pending the receipt of additional information
confirming that Mr. Wickstrom has submitted his claim to the
insurance company, Vision Service Plan.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
May 7, 2001
Page 5
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - 10:00 AM - Conference Room 1
2. Raymond E. Sherman
a. Regence Explanation of Benefits Statement No.
0105410727800 processed on March 14, 2001 for services
received on February 13, 2001 in the amount of $14.00.
Motion by Member Brothers, second by Member Vandver to
deny Mr. Sherman's claim as the services received are
preventative and not medically necessary.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. Sammy Mulkey
a. Request for reimbursement of eye exam co-pay in the
amount of $10.00 for services received on April 16, 2001.
Motion by Member Vandver, second by Member Barber to
approve Mr. Mulkey's claim in the amount of $10.00
MOTION CARRIED UNANIMOUSLY. 5-0.
4. Doris G. Darough
a. Regence Explanation of Benefits Statement No.
0101700238600 processed on January 31, 2001 for
services received on January 11, 2001 in the amount of
$35.00.
Motion by Member Vandver, second by Member Barber to
table Ms. Darough's claim and advise Ms. Darough that she
must first submit the claim to Medicare as primary and then
Regence BlueShield as secondary insurance.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
May 7, 2001
Page 6
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, May 7, 2001 - '10:00 AM - Conference Room I
5. Richard Huseby
a. Request for reimbursement of hearing aid repairs received
on April 2, 2001 in the amount of $121.97.
Board members reviewed Mr. Huseby's claim for
reimbursement of hearing aid repairs and questioned
whether the same repairs had been made in the recent past.
Motion by Member Vandver, second by Member Barber to
table Mr. Huseby's claim pending the receipt of additional
information.
MOTION CARRIED UNANIMOUSLY. 5-0.
D. Correspondence
1, Letter dated April 25, 2001 addressed to LEOFF Police
Representative Jim Kelly from Bruce Caldwell.
Chair Kelly acknowledged the receipt of Mr. Caldwell's letter. No
response to the letter is required.
V. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:38 AM.
APPROVED THE ' DAY OF JUNE, 2001.
'C~ air (/ Secretary
LEOFF Board Minutes
May 7, 2001
Page 7