Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2023-02-24 Disability Board Packet
EDMONDS DISABILITY BOARD MEETING NOTICE AND AGENDA REGULAR MEETING Friday, February 24, 2023 Fourtner Room City Hall 11:00 am • CALL TO ORDER • DISCUSS AND APPROVE CLAIMS SUMMARY REPORT A. For the period 01 /01 /2022 — 12/31 /2022 • BUSINESS B. Review/discuss LEOFF 1 member's increase in LTC services (+$325.00/month effective 1/1/2023) C. Review/Discuss LEOFF 1 member's request for LTC services D. Discuss potential of renaming Disability Board E. Review/Revise Board Policies 1. 004-06 Hearing Aids (last reviewed and revised 7/19/2018) 2. 008-11 Long Term Care (last reviewed and revised 7/2015) • OTHER o Next Board Meeting date (April 2023) Page 1 CITY OF EDMONDS DISABILITY BOARD CLAIMS SUMMARY 01 /01 /2022 to 12/31 /2022 CLAIM NO. SERVICE RCW/PAST PRACTICE COST 1 Long Term Care 008-11 $ 5,700.00 2 Prescription 010-15 $ 83.46 Dental Expenses 002-05 $ 190.00 3 Prescription 010-15 $ 50.71 Long Term Care 008-11 $ 3,021.00 4 Prescription 010-15 $ 676.80 5 Prescription 010-15 $ 140.00 Medical Services RCW $ 238.06 6 Medicare Premium 005-06 $ 1,782.00 Long Term Care 008-11 $ 5,700.00 6* Long Term Care 008-11 $ 5,700.00 7 Prescription 010-15 $ 1,528.51 Medical Services RCW $ 70.00 Medicare Premium 005-06 $ 1,735.00 Dental Expenses 002-05 $ 700.00 8 Prescription 010-15 $ 333.91 Medical Services RCW $ 1,413.00 Medicare Premium 005-06 $ 1,782.00 Dental Expenses 002-05 $ 700.00 9 Prescription 010-15 $ 40.04 Medicare Premium 005-06 $ 1,782.00 Long Term Care 008-11 $ 3,021.00 10 Medicare Premium 005-06 $ 1,698.00 11 Prescription 010-15 $ 242.49 Medical Services I RCW $ 192.85 1 Medicare Premium 005-06 $ 1,446.00 Disability Board 2022 YTD City of Edmonds - Human Resources Department Page 1 Eyeglasses 003-02 $ 225.00 Dental Expenses 002-05 $ 269.10 12 Medicare Premium 005-06 $ 1,782.00 13 Prescription 010-15 $ 151.47 Medical Services RCW $ 203.00 Medicare Premium 005-06 $ 1,782.00 14 Prescription 010-15 $ 19.10 Medical Services RCW $ 38.00 Medicare Premium 005-06 $ 1,542.00 15 Prescription 010-05 $ 112.13 Medicare Premium 005-06 $ 1,782.00 Dental Expenses 002-05 $ 129.00 16 Prescription 010-15 $ 366.93 Medical Services RCW $ 276.16 Medicare Premium 005-06 $ 1,782.00 Dental Expenses 002-05 $ 275.00 17 Prescription 010-15 $ 486.10 Medical Services RCW $ 300.00 Medicare Premium 005-06 $ 1,782.00 Eyeglasses 003-02 $ 149.98 Dental Expenses 002-05 $ 202.20 18 Prescription 010-15 $ 27.51 Long Term Care 008-11 $ 3,021.00 19 Long Term Care 008-11 $ 900.00 20 Medicare Premium 005-06 $ 1,782.00 21 Prescription 010-15 $ 117.75 Medicare Premium 005-06 $ 1,470.00 22 Prescription 010-15 $ 459.11 Medicare Premium 005-06 $ 1,782.00 23 Prescription 010-15 $ 255.19 Disability Board 2022 YTD City of Edmonds - Human Resources Department Page 2 24 Medicare Premium 005-06 $ 1,662.00 25 Prescription 010-15 $ 188.78 Medicare Premium 005-06 $ 1,782.00 26 Prescription 010-15 32.18 Medical Services RCW $ 224.73 Dental Expenses 002-05 $ 167.00 27 Prescription 010-15 $ 47.91 Medical Services RCW $ 144.88 Long Term Care 008-11 $ 3,021.00 28 Long Term Care 008-11 $ 6,000.00 29 Prescription 010-15 $ 40.00 Medical Services RCW $ 322.05 30 Prescription 010-15 $ 35.40 Medical Services RCW $ 207.85 Long Term Care 008-11 $ 3,021.00 31 Medicare Premium 005-06 $ 1,782.00 32 Prescription 010-15 $ 114.54 Medical Services RCW $ 50.00 33 Long Term Care 008-11 $ 6,000.00 34 Prescription 010-15 $ 35.40 Long Term Care 008-11 $ 3,021.00 35 Prescription 010-15 $ 220.35 Medical Services RCW $ 258.91 36 Dental Expenses 002-05 $ 700.00 Deductibles 001-06 $ 233.00 37 Long Term Care 008-11 $ 6,000.00 38 Prescription 010-15 $ 70.80 Medical Services RCW $ (119.73) Long Term Care 008-11 $ 3,021.00 39 Prescription 010-15 $ 1,221.69 Medicare Premium 005-06 $ 1,782.00 40 Medical Services RCW $ 96.00 Eyeglasses 003-02 $ 259.98 Dental Expenses 002-05 $ 700.00 Long Term Care 008-11 $ 3,021.00 41 Medical Services RCW $ 233.00 42 Prescription 010-15 $ 119.79 Dental Expenses 002-05 $ 167.00 Prescription 010-15 $ 44.38 Disability Board 2022 YTD City of Edmonds - Human Resources Department Page 3 43 Long Term Care 008-11 $ 3,292.89 44 Long Term Care 008-11 $ 6,000.00 45 Long Term Care 008-11 $ 6,000.00 46 Prescription 010-15 $ 128.66 Medical Services RCW $ 131.21 47 Prescription 010-15 $ 231.38 48 Prescription 010-15 $ 84.02 Long Term Care 008-11 $ 3,292.89 49 Long Term Care 008-11 $ 6,000.00 50 Prescription 010-15 $ 31.00 Long Term Care 008-11 $ 3,292.89 51 Long Term Care 008-11 $ 6,000.00 52 Prescription 010-15 $ 661.43 Medical Services RCW $ 105.94 Dental Expenses 002-05 $ 700.00 53 Long Term Care 008-11 $ 6,000.00 54 Prescription 010-15 $ 31.00 Long Term Care 008-11 $ 3,292.89 54 � Total Approved Claims I Total Reimbursed $ 154,641.65 Disability Board 2022 YTD City of Edmonds - Human Resources Department Page 4 Current and Historial Claim Count & Costs Summary of Current Costs 01 /01 /2022 - 12/31/2022 SERVICE Number of Claims Total Paid for Service Deductibles 1 $ 233.00 Dental Expenses 12 $ 4,899.30 Eyeglasses 3 $ 634.96 Long Term Care 24 $ 103,339.56 Medical Services 19 $ 4,385.91 Medicare Premium 19 $ 32,719.00 Prescription 35 $ 8,429.92 Grand Total 113 $ 154,641.65 Summary of Historical Costs 01 /01 /2021 - 12/31/2021 SERVICE Number of Claims Total Paid for Service Deductibles 1 $ 157.64 Dental Expenses 9 $ 2,372.50 Eyeglasses 5 $ 814.98 Hearing Aids 3 $ 4,049.28 Long Term Care 23 $ 108,759.00 Medical Services 19 $ 3,556.85 Medicare Premium 21 $ 33,265.00 Prescription 35 $ 6,167.47 Grand Total 116 $ 158,985.08 Disability Board 2021 Q4 [12/31/2021] City of Edmonds - Human Resources Department Page 5 CURRENT SUMMARY OF COST BY BARS NUMBER 01/01/2022 - 12/31/2022 LEOFF 1 Fund BARS NUMBER ANNUAL YTD EXPENDITURE BALANCE % USED APPROPRIATION 009.000.39.517.20.23.00 $64,000.00 $48,210.96 $15,789.04 75.33% Reimbursement Benefits 009.000.39.517.20.23.10 $142,650.00 $87,411.10 $55,238.90 61.28% Premium Benefits 009.000.39.517.20.29.00 $252,990.00 $97,590.63 $155,399.37 38.57% In Home/Assisted Living 009.000.39.517.20.41 - 49 $7,500.00 $489.00 $7,011.00 6.52% Proff. Svcs, Travel, Misc. Expenses TOTAL: $467,140.00 $233,701.69 $233,438.31 50.03% Fireman's Pension Fund BARS NUMBER ANNUAL YTD EXPENDITURE BALANCE % USED APPROPRIATION 001.000.39.517.20.23.20 $25,000.00 $5,515.20 $19,484.80 22.06% Reimbursement Benefits 001.000.39.517.20.23.10 $14,560.00 $12,597.30 $1,962.70 86.52% Premium Benefits 001.000.39.517.20.29.00 $70,944.00 $86,136.64 ($15,192.64) 121.41% Pension and Disability Payments 001.000.39.517.20.41.00 $1,200.00 $0.00 $1,200.00 0.00% Professional Svcs. TOTAL: $111,704.00 $104,249.14 $7,454.86 93.33% Disability Board 2021 Q4 [12/31/2021] City of Edmonds - Human Resources Department Page 6 HISTORICAL SUMMARY OF COST BY BARS NUMBER 01/01/2021 - 12/31/2021 LEOFF 1 Fund BARS NUMBER ANNUAL YTD EXPENDITURE BALANCE % USED APPROPRIATION 009.000.39.517.20.23.00 $64,000.00 $67,095.45 -$3,095.45 104.84% Reimbursement Benefits 009.000.39.517.20.23.10 $142,650.00 $83,404.42 $59,245.58 58.47% Premium Benefits 009.000.39.517.20.29.00 $252,990.00 $114,459.00 $138,531.00 45.24% In Home/Assisted Living 009.000.39.517.20.41 - 49 $7,500.00 $17,000.00 ($9,500.00) 226.67% Proff. Svcs, Travel, Misc. Expenses TOTAL: $467,140.00 $281,958.87 $185,181.13 60.36% Fireman's Pension Fund BARS NUMBER ANNUAL YTD EXPENDITURE BALANCE % USED APPROPRIATION 617.000.51.589.40.23.00 $10,000.00 $6,466.63 $3,533.37 64.67% Reimbursement Benefits 617.000.51.589.40.23.10 $14,560.00 $14,820.84 ($260.84) 101.79% Premium Benefits 617.000.51.589.40.29.00 $70,407.00 $65,710.99 $4,696.01 93.33% Pension and Disability Payments 617.000.51.589.40.41.00 $1,200.00 $0.00 $1,200.00 0.00% Professional Svcs. TOTAL: $96,167.00 $86,998.46 $9,168.54 90.47% Disability Board 2021 Q4 [12/31/2021] City of Edmonds - Human Resources Department Page 7 ON Pacifica Senior Living 1775 Hancock St suite #200 San Diego, CA 92110 November 21, 2022 Dear At Pacifica Senior Living, we are devoted to meeting the needs of all of the residents who make Pacifica their home. To ensure this happens, we continually analyze the market, our operations, and financial strength. Like all providers, over the course of the last year we have continued to experience increases in all costs associated with operating our community, delivering care, and providing quality services. To help Pacifica Senior Living remain competitive, will be implementing the below rent increase effective January 1, 2023 ( Current Monthly Rate i $4,000.00 New Monthly Rate $4,325.00 It has been our pleasure to serve you and we look forward to another year. We will continue striving to provide the highest quality care at the most reasonable rates. We thank you for your continued support. If you have any questions, please contact the executive director. Brandy Harris Executive Director (425) 771-7700 This letter will serve as an addendum to your original Resident Agreement and per State Regulations we must provide 30.00-day notification of any rental increase. We ask that you sign and date this letter and return it to the Business Office Manager. Resident or Responsible Party's Signature: Date: 18625 60th Ave West • Lynnwood WA, 98037 • T: (425) 771-7700 www, acificaseniorlivin .com C Pine Family Practice 2240 E. Lincoln Ave Sunnyside, WA 98944 Phone (509) 836-2367 Fax (888) 927-0390 pinefamilypractice@gmail.com To whom it may concern: s been a patient of mine since September 2016. He has regressed in the last year. He was referred to Dr Sloop, the neurologist, who states that he has early stages of Alzheimer's. He requires 24- hour medical supervision as he has had frequent falls, incontinence of urine, and requires reminders to take his medication. He needs to be in a medical facility to receive the necessary medical care. Sincerely, Mary Pine, PAC Regarding pre assessment for. 3ased on the information we received would need a memory care unit. We do not have one available immediately as we have a waiting list. According to a pre - assessment and if or when we have a room available care would be as follows. Studio Room Rate : $ 4,449.50 Care Rate $27 Per Point @ 95 Points : $ 2,565 Estimate Monthly Total : $7,014.50 Liz Villa Community Relations and Marketing Director Sun Terrace Prosser 2131 Wine Country RD Prosser wa 99350 O) 509-786-3300 C) 509-830-5652 F) 509-786-3350 Send Involcesto: InvolcV45 re enc - aeifEc.com Sun Terrace Prosser A Rerimpiew and Asswed Living Community ~ A REGENCY PACIFIC COMMUNITY Find us on Facebook at: lobs at Regency -� LIKE @WAh eal th action Network Page to support our, Washington Seniors! 906 Noi-th ve, Sunnyside, W-A, 98944 Pride .'Community Pride Senior Living � P: 1-509-839-4663, F: 1-509-839-6301 FOR OFFICI CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Email: info@cpride.org USE OIL L) Resident Assessments and Service Plans Resident Details: Name: .................................................................,.....................................,.................................... Date of Admission ...................................... Physician: Emergency Contacts: Emergency Contacts: Power of Attorney: Code Status. Date of Birth: ...... City: City: City: City: POLST form available Phone no: Phone no: Phone no: Phone no: POLST form not available. WAC 388-78A-2100: Monitoring residents' well-being. The staff (assisted living facility) must: (1) Observe each resident consistent with his or her assessed needs and negotiated service agreement; (2) Identify any changes in the resident's physical, emotional, and mental functioning that are a: (a) Departure from the resident's customary range of functioning; or (b) Recurring condition in a resident's physical, emotional, or mental functioning that has previously required intervention by others. (3) Evaluate, in order to determine if there is a need for further action: (a) The changes identified in the resident per subsection (2) of this section; and (b) Each resident when an accident or incident that is likely to adversely affect the resident's well- being, is observed by or reported to staff persons. (4) Take appropriate action in response to each resident's changing needs. WAC 388-78A-2100: On -going assessments. The assisted living facility must: (1) Complete a full assessment addressing the elements set forth in WAC 388-78A-2090 for each resident at least annually; (2) Complete an assessment specifically focused on a resident's identified problems and related issues: (a) Consistent with the resident's change of condition as specified in WAC 388-78A-2120; (b) When the resident's negotiated service agreement no longer addresses the resident's current needs and preferences; (c) When the resident has an injury requiring the intervention of a practitioner. (3) Ensure the staff person performing the on -going assessments is qualified to perform them. Phone: 1-509-839-4663. Fax: 1-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Updated 11 /1112022. Pride 906 Notch kve, Sunnyside, NVA 98944 Community Pride Senior Living P: 1-509-8�9-4663, F: 1-509-839-6301 FOR OFFICI CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSETO PERFECT. Entail: info [@l,cpflde.oYg USE ONL `J I Aedvky 1 Pokft t Prellminary Negotiated Reviaed Care Plans t as authorized by nurselmanager Care Plant Care Plant' Care Plan Assessment dates: ............ .............................. ................ 1) Bed Linen Changes Date Date Date Date Date Date pate e Once per week 50 More than once per week 100 10,0 0 Daily Bed Changes 200 2) Continence o Supervising/Cueing 100 e Standby assist to bathroom 150 I �( I o Commode or urinal in room/urinary catheter 200 o Protective products required 200 �00 Urine incontinence 300 30D e Bowel incontinence or constipation 200 o Total assist in bathroom 400 o Incontinence on floor or furniture 300 o Refusal to wear protective products 250 3) Bathing m Standby assist only 75 a Moderate assist/One person assist 100 i D Q ;L--r 6V 44,,v-t a Maximum assistrrwo person assist 200 n Skin problem that needs monitoring 250 e Protective or preventive skin care 100 e Refuses or difficulty with bathing 300 a Bed baths 400 Phone: 1-509-839.4663. Fax: 1-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Updated I I/1 t 2022. Pride 906 North .I� P, Sunn side, WA 98944 Community Pride Senior Living P: 1-509-8 9-4663, F: 1- 509-839-6301 CLOSE TO FRIENDS, CLOSE 70 FAMILY. CLOSE ;o PERFECT. Ew is iufo@cpHde.org A 1 4) Dressing a Minimal assist[lay out clothes • Changes clothes during the day e Moderate assist with dressing o Total assist with dressing e Special equipment- Wedge/ Foot cradle/Ted hose/Other 5) Hygiene Oral- Cueing and Supervising Oral- Moderate assist (Clean dentures) • Oral- Total assistance/oral care given • Other- Shaving[ Combing hair! Nail care 6) Activities C Require suggestion for activities o Requires cueing to stay on task • Requires assistance to perform task 7) Behavior m Behavior causing problems with other home residents ® Verbal abuse Hiding, Hoarding, Rummaging in own or others belongings ti Argumentative with others a Aggressive/ Intimidating/ Assauftive/ Combative Easily worried/ agitated/ irritable e Eats non -edible objects or Inappropriate toileting activity FOR OFFICF USE ONL) P&ft j PMJ1Mk-y,, Negotiated Revised Care Plans 4 as authorized by nursa/manager Care Plan L Care Plan Care Plar Assessment dates: ...... .............. ... ------- Date Date Date 'Date Dale Date Rate 75 150 200 300 100 50 100 150 100 ?-6 a Sri 50 S0 75 100 500 300 400 400 400 300 400 Phone: 1-509-839-4663. Fax: i-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Updated 11[l1/2022. Price 906 Noilh Ave, SunUYSide, WA 98944 .: ,, Cammunfty Pride Senior Living P: 1-509-834-4663, F: 1-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY, CLOSE TO PERFECT, F-w tit: iufo@cpride.oi g Activity t 8) Medications • Reminders to take medication ® Give/administer medications Delegated duties Le eye or ear drops, nebulizer treatment. Note: Nurse delegation fee are additional. 1-5 items,300 6-10 items-400 10+ items-500 • Blood glucose monitoring • Insulin usage • Sliding scale insulin 9) Ambulation Minimal Assist/ supervision • Moderate Assist, one person assist or uses assistive devices) • Total assist, Two person assist or wheelchair Assist • Bala nce/FaII/Safety Measures i.e. sensor pads required. 10) Mealtime • Extra food preparations • Special diet and foods • Feed occasionally • Has many food dislikes • Disruptive at mealtime • Full assist with meals/ PEG tube feeding • Refuses to eat, supplemental meals or ensure Feed meals in resident's room FOR OFFICI USE ONL) Points 1 MWirninary Negotiated Revised Care Plana 4 as witio/lzed by nurse/manager Care Plan 4 Care Plan 1 Care Plan Assessment dates: kinb$ .......... ... ............ I ...... ....... ...... Date Date Date Date Date Date Date 100 200 300 31b0 400 500 300 450 500 50 75 150 rP 200 a-00 50 200 100 100 250 300 200 50 Phone: 1-509-839-4663. Fax: 1-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY, CLOSE TO PERFECT. Upated 11/11/2022. 906 North Ave, Sunnyside, WA 98944 Pride P' Community Pride Senior Living I-509-839-4663, F: 1-509-839-6301 FOR OFFICI CLOSE TO FRIENDS, CLOSE TO FAMILY, CLOSE TO PERFECT, Emafi: info@cpiide.org USE ONL) Activity 1 PdrRs 4 P"ON4wo 140d Revised Care Plans 1 as suthortmd by numejrnsnager Care Plant Care Plano Care Plan Assessment dates: se'1j3... ........ ...I—' I ............................. ........................... 11) Laundry Date Date Date Date Date Date Date o Personal laundry i time weekly 0 ® Personal laundry 2 times weekly 50 rQ s Personal laundry 34 times weekly 100 • Personal laundry daily 150 12) Evacuation needs In emergency o Standby Assist/cue to evacuate 50 • Moderate Assist to evacuate 100 o Full assist to evacuate 200 '-0lu 13) Oxygen, health monitoring and special requests o Oxygen -As needed 100 Oxygen- Full time 200 Blood pressure monitoring 100 o Weight monitoring 100 • Urinary Tract Infection Monitoring 100 Special requests- Foot soaks/ Assistance 100 with hearing aids/ Other 14) Confusion • Occasional Confusion 200 '-�Vp • Rummaging in their own belonging 200 e Occasionally stays awake at night 300 • Disrobes during the day 200 ■ Requires Constant Monitoring during day 350 and night • Usually/always confused 300 • Wandering Away from the Facility or at night 600 Total Score Level of Care Level of Care Rate Phone: 1-509-839-4663. Fax: 1-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT, Updated 11/11/2022. Pride 906 North Ave, Sunnyside, WA 98944 Community Pride Senior Living P: 1-509-839-4663, F: 1-509-839-6301 FOR OFFICI CLOSE TO FRIENDS. CLOSE TO FAMILY, CLOSE TO PERFECT. Email: iufo@.cptide.org USE ONLS Point Level of 2016 2017 2018 2019 2020 2021 System Care Fee Fee Fee Fee Fee Fee 0-300 1 $2800 $2900 $3000 $3100 $3200 301-600 2 $3000 $3100 $3200 $3300 $3400 601-750 3 $3200 $3300 $3400 $3500 $3600 751-900 4 $3400 $3500 $3600 $3700 $3800 901-1100 5 $3600 $3700 $3800 $3900 $4000 1101-1350 6 $3800 $3900 $4000 $4100 $4200 1351-1550 7 $4000 $4100 $4200 $4300 $4400 1651-1700 8 $4200 $4300 $4400 $4500 $4600 1701-1900 9 $4400 $4500 $4600 $4700 $4800 1901-2100 10 $4600 $4700 $4800 $4900 $5000 2101-2300 11 $4700 $4800 $4900 $5000 $5100 2301-2500 12 $5000 $5100 $5200 $5300 $5400 2501-2700 13 $5200 $5300 $5400 $5500 $5600 2701-2900 14 $5400 $5500 $5600 $5700 $5800 2901-3100 15 $5600 $5700 $5800 $5900 $6000 %t4& '�o Note: _ a) For each 200 points increase above 3100, rate increases by an additional $50. b) Level of care yearly rate increases: $100 in 2017, $100 in 2018, $100 in 2019, and $100 in 2020. c) Beginning 2021, and each year thereafter, Community Pride rates will be adjusted based on the Washington State Consumer Price Index. d) Any rate changes will be effective from the next billing cycle/month. Additional services/fees not included in the basic services rate: Tray service to $3.00 per meal. Apartment/Room e Guest meals Breakfast- $4.00, Dinner- $7.00, Supper- $5.00 24-hour advance notice for guests requested. m Suites fee guidance a) One -bedroom suites: Additional $500/month. b) If a studio suite is shared = (Client A + Client B) Basic services Rates less $500 sharing discount, divided equally. If you are a couple, you will be informed if extra discounts are available. Phone: 1-509-839-4663. Fax: 1.509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Updated 11/11/2022 906 North Ave, Sunnyside, WA 98944 Pride Community Pride Senior Living P: 1-5©9-839-4663, F: 1-Sp9-839-63p1 FOR OFFICI CLOSETO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Email: info@cpiide.org USE ONI.,) Total Monthly Service Fee Assessment date f l"1 ` 1� �I a) Level ofu g Care Rate b) Additional services/fees c) Recurring Discounts and allowances Total($ , (a) + (b) - (c) Note: ® For new residents, this rate will be effective upon admission, up -to 30 days from now or on the next payment due date. . A deposit of $ 500.00 is required to reserve a bed. This deposit goes towards the first month's charges upon client move in unless the reservation is canceled and the amount refunded. Please write a check payable to Community Pride Senior Living to confirm your reservation. ® Other non -recurring move -in discounts and allowances may appear on your first invoice. ® The management reserves the right to discharge a resident if the staff cannot meet his/her needs. Before that time, the management, the resident and or the resident representative will discuss any and all possible interventions to avoid a discharge. A thirty day notice will be given to discharges unless there is a potential danger to the resident or to the staff or other residents. Signatures Assessment date Signature: Signature: Signature: Signature: Signature: Signature: Signature: Resident's signature Date: Date: Date: Date: Date: Date: Date: Resident's legal Signature: Signature: Signature; Signature: Signature: Signature: Signature: representative, if applicable Date: Date: Date: Date: Dat(?; Date: Date. - Facility Signature: Signature: Signature: Signature: Signature: Signature: Signature: representative Date: oil III �--ox) Date: Date: Date: Dafe: Date: Date: Phone: 1-509-839-4663, Fax: 1-509-839-6301 CLOSE TO FRIENDS. CLOSE TO FAMILY. CLOSE TO PERFECT. Updated 11 /11 /2022 A. S. C. [I SNF Utilization Review Skilled - V 4 Resident: Effective Date: 0210712023 08:46 Location:100 Hall 112 B Initial Admission: VW612023 Admission: 0110612023 Date of Birth,11102/1930 Score: NA Category: NA Physician: Parls, George Skilled Billing 1. Primary Diagnosis: 930.9 ALZHEIMER'S DISEASE, UNSPECIFIED 2. Clinical Category a) Major joint replacement or spinal surgery b) Acute neurologic c) Non Orthopedic surgery d) Non -Surgical Orthopedic/Musculoskeletal e) Orthopedic surgery except major joint replacement or spinal surgery f) Medical Management g) Cancer h) Pulmonary i) Cardiovascular and coagulation J) Acute Infections LOS/DC Date 1. Anticipated length of stay (Days): _ _-.- __-- _...... I_34 2. Anticipated discharge date: 02/ 1612023 3. Discharge Location. - Planning for transition to ALF or long-term care in this setting. — Skilled Nursing and Rehabilitation Services 1. Describe Skilled Nursing Care Services, progress from last week, continued Skilled Needs, and IDT discussion. NOTE: If therapy is Involved, refer to therapy visit notes/evaluations. - med/pain management - Care pIan ning - diabetic management - treatment for pneumonia (1/13 completed) PT/OT - - IDT Functional Goals (GG) Only Required to Choose ONE Goal Select all that apply: 1. I:.] Eating 2. (_ I Oral hygiene 3. l I Tolleting hygiene 4, I.:_l Shower/Bathe Self 5. I J Upper Body Dressing 6. G .7 Lower Body Dressing 7. L._.I Putting on/Taking Off Footwear g, I_ I Roll left and right 9.-I Sit to lying 10. L] Lying to sitting on side of bed 11. L I Sit to stand Page 1 of 3 SNF Utilization Review Skilled - V 4 E. F Resident: Cooper, Jack (4662) 12. (`� Chair/Bed to Chair transfer 12a. Functional Ability Goal: 8) Independent 5) Set up/clean up assistance 4) Supervision/touching assistance 3) Partlallmoderate assistance 2) Subtantlal/maximal assistance 13. El Toilet transfer 14. ED Car Transfer 15, 1-1 Walk 10 feet 16. I I Walk 50 feet with 2 turns 17. l!..`I Walk 150 feet 18. I I Walking 10 feet on uneven surfaces 19. I! -I One step (curb) 20. L] Four steps (stairs) 21. El Twelve steps (stairs) 22. fJ Picking up object 23, IT-1 Wheel 50 feet with 2 turns 24. I-_] Wheel 150 feet 25. Progress toward GG IDT goal(s)_ Max assist with FWW. now is min assist Self Medication and Resident/Family Education 1, Nursing Information - - Pain, management, care f -� planning, pain management, pulmonary management, diabetic management_ 2. Skilled Therapy Information _-- _P _ Bed mobility - Min -Mod A 1 Transfers - Min A 1PA with FWW Gait - 347ft. FWW CGA Dressing - UBIMin assist. LB/Min A. Footwear/Min Toilet transfer - Min A Eating - SP Working on - Strenght, Endurance and Pain. Pain has improved. focus on standing/balance Discharge Plan 1. Describe current progress, lack of progress or barriers towards discharge goals: _ _ _ _ ---- _--. Care Conference: 0210112023 RIMS Score: 11 /15 PHQ9 Score: 2/27 MCD Status: NIA; does not qualify. HCS Case Manager: N/A Discharge Planning: Living at home with spouse, but family is planning for transition to ALF or LTG in this setting due to his level of care needs. Family will be touring ALF settings in the area for possible transfer. Family will be looking Into places offering memory care services....- 2. identify any discharge planning needs, j HOME DME- He was not using assistive devices at home. He has 2-3 steps to entry of home. Potential DME Needs: FWW W/c - - - - - G. IDT IDT Member Name and Title Jessica Clapp BSW 2. Page 2 of 3 SNF Utilization Review Skilled - V 4 Resident Cooper, Jack (4662) 3. _ _ _ _ _ _ --- ----- Yesennla Diaz LPNIMDS Rina Campos/Emily Rady LPN/RCM 4. Jaynes Duncan admin. -- 5. Lisa Edwards DOR I- - - - - 6. Cruz Hall BOM ` Signed By Signed Date II yesennia diaz, MDS Coordinator/Resident Care Manager [e-SIGNED] 02/08/2023 Page 3 of 3 Physical Therapy Treatment Encounter Note(s) Provider. Prestige Cara S Rehab- Sunnyside Cooper, Jack [denSip0ali0n Inform•"__ � --� — �_-- — — Patient: MRN: 4062 DOB: Date of Service: 2181202.3 Completed pate: 21612023 Cerdf0Pii1mana0y1Pern SiaNi Vllal Slgne BP {Syalo CfrllatiN[c}: 143164; Pulse Rste - 72 beals/min; 02 Saturation - g2 percent Pain Pain-0/10 CPreada.r am,d (oWAO in with 07530 97530: PT endtrensferredfachod pi pg0µrrsg'JssWcgpswHaMlfromEaBryOlbemiW. pi WC WC•TMpotflarWedW FWW x3Wisand hen m9after mash ldat 250, 90n and 141n vMh SBA. PI panamwd6 gall speed Nato wall trenefarleeln WC—FW W w@ndng i3.12" Nags hie iraslesl lima holne 5 Paeewilh 1.2 min Taal padods betweaneach aloe. S7110 97110: Pt psdormsd sesled misled LE oigaamterx 18 mina (ornniq s) at L4 and reached 84% aclldty level Pt parf*ynod PREP to the eLES canal sling of oper*loaed IdnsOe ears %till 41W 0111r4i YAP and We (bend x m hM6 raps I fallgua vJth Iroquant rest periods, Ctkdesl Process Measures this an Plan - Cardlo0 guldal4:e1 for jud noderala chic pat entAwragekWOV for easSim momus (60•asA HRR or RPE 1`147) RddJUOnarAneryatar "Ong Preaaullonr Precaudens: Ape: 92 RasWW Pulse: e3 otagnasls: GV. pain Pt Typo 2 Coats: Bed I, TF MI. gall MI Fall Risk: Very High W8: Full Caldlaa Rbk tow Bela Biockers: Yes Gail Speed: HIRT: SPPB: W12SMWT:0 PT Recart 21Ef23 Pt needs can ba met vAlh group andlor concurrent Iherapy. odginal Signature: Elecimnlcafly signed by John L Butts, PT 21612023 06:43A5 PM PST oats Date of Service: V312023 Completed Data: 21312023 Cardrapfi)nwnvry 1 Pa In Sferar Ulbl Signs BP (Syslowolastdlo} 137184; Pulse Rate-06 bastWerk 02 fSlAwO n a 01 percent Pain Pain -0110 CPi Cods 6Wad 97630 97630: PT approached pt eltilog In We end he agread l0 Oserapy. PI pedomwd ITansfen vA1h mfnA Iaf:oNing Instruction In iechnnlqua Isom WC�Chdr, WCvMatlaws and WCc�FW W x3 trials to walk f05104110 MA uti25R, Mt and t0611 With SBA. PI Mended wrhel cues 10 aiaa0 mcmupright and LAS k � 52 16,1405 of to Ifteocasoncurfanl his pmmsical N t�luhed 2.3 min real beak t*ivmn each walk secondary to { 97110 $7510: Pr pPrforrrsad aee'.ed resisted LE argw"ter (Nusiep)x 18 mine including IIm (w s6109 and Iak)ng pi oil of bike, at L3 and ho ieachd.35 mtiae. PT faciPalod obaaglh ROM and endara mW'h dpeNclosad kl"Lro mts tomeBLEs x1+'.a sealed at mat We nilh 41b anWo wit and 01ue 0and x rn r1pie raps 10 fadgue Hold ffegaunl rest ttraalrs aearldary to to e, c6loal Pruus Muaurw Clinical Process Measures this session . Coo; me guidelines for lova'mod9MIS rfak palleMAverago inlenslty for Snssan Vigorous (80-851/6 HRR or RPE 14-17) Page 1 of 4 Physical Therapy Treatment Encounter Note(a) Provider. PM1190Cam&Rehab -Sursryakts k ddlflarulAnalysls?eallnp — --- ---- - _ - Preaeullone PrecaulWns:Aga@2 Robing pulas;63 �- 111400519; GLF, pain Pt Type: 2 Gents: Bad I, TV Mi, qto MI Feh Melt-, Vary Ho we: Fun C Nolao Rrgk; Low Beta Blockere: Yee Galt Speed: HIRT: SPPB; 0112 SMWr: o PT Recert 210/23 Pt needs can be met with group and/or 00ncurrenl therapy. Odginel Signature; EIKIMnicalyalgnad by John L Buns, PT 213/2023 04:1tai PM PST Hula bats of 9ar0ce: 21212023 C�mpl@ted Date: 2131Z023 Funcllamel Parfomns6c o 61 FfladNmrff Transfers Treaters -CGA. hands an assist requtrad I ormore cues forrnajwity or laak; Numbest Person Assist- Tranafen t- on asalgl., AaalslHa QOvtea OWN Transfers - FW W Cardf"ln+ nsrylNIB sfehra Pain Pain �0/f0 CPT Codes sided 97530 97530: Thrnapaudc Aallvlgas: uanarer Iraiektg tolncregseivnetlonal la3k perlatnsnca, dynamtg baYanca acllvilles while slendng, igcl0[sLbn d posture/ eonlyd and crossing M14100 1e 19c6ita:1 lndepartdence In funcl;ongt 3"1 perromtance. 97110 97110: muafep L4 limas 15 minute, with a taeus ofincveerin0 SPM over 40IN comerdredon on activity lolemnce for task —vollon as mo as wrongthing or BLE's 10 Pronme unproved rnohiGty and balonm C717dCa! Arnases Maaeurer ClInloal Process Mearuns this session • Cordlae e4ldOW5 ror krNmademla risk pe00nl,UErLE sirengthankq 0t least 0o% 1RM (i3.15 raps A }iPE I2-fyj,l4-rlverdge laienslly f $r geos;" tr.0deraid (4040% HRR of RPE 12.13) 6dRaFinel atilu:l.r! .lr... Page 2 or 4 Phyalcal Therapy Treatment Encounter Note(s) Prodder. Prestige Care&Rehab -Sunnyslde Precautions Preceullons: Aye; e2 Resting Pulse: e3 Diagnosis:OLF, pain PI Type:2 C; ca:a. Bed I, TF MI, gall MI Fall Risk: Very High WB: Fug Cardiac Risk: Low Beta Mockers: Yes Oall Speed: HIR1: SPPB; 0/126rAWT:0 PT Recerl; M23 PI needs can be metWth group andlor concurrent therapy. PTA VV2023 09:59:33 PM PST Origins] Signature: Dale Revision Signature: Electrontcaly stoned by Use Edwards, PTA 2/3l2023 1025:23 PM PST Dale [Jack Cooper] : Treatment Encounter Note(s) Discipline: PT tale of Service: 211112027 Completed Date: ZM202 uncaw"I Porfurmonca of Enoounfrr jd Tranclero cues for ma)Crdycl ire k; Nunlj ref Perm Afor Ari lit- T akne a *1�personcassist de aAs hshow p bul nooke MaingTfonsfen More FWW Pegs 3 of 4 Physical Therapy Treatment Encounter Note(s) Provider, Prestrge Care a Rehab. Surinyskfe Cart -Leval GallLevel -SBA-mqurasciasesupforrn%*ofloskfor safetymsYlncludaAnt upbut nopfiyslculcanledhIorMGM forwas ns*wRy of task Dlslanca 4eye1 Ssaiceas • 470 fast QU to gym, W tovards room oflar eKcrclsss.j; AD Level Surfaces - G All I.eHI - Frcfll Mhealed Yral ke! C erdlopwfmoheryl Parr siefus Pain Pin a Will CPTCedu BINad 97116 97116: Th9r3plal fad liolad 061 tniho g before and char eaerdisas. PI Mlllally denaased near soda! gall bAlrurg In both d4ec0ons. PI did have Increased go wilhgood atepknptn aid gait epaod, both 1.32ara lncrosaed ro 1.811ge. ll Speed tempered to pddrprogrs°s mpon, 97630 07630: ThemW assessed pi balanrew th SPPS, ptwlih Adnle smmas Iasi lUm but had Increased gait speed but decmesad sbr7ity for land" s lane, Able 10 stand 00100r 61Konds Instead of 10. 97110 07110! UWAPlal facilitated dosed chain exercise on NuStep with pt at 27SPM, able to Increase 10 36 SPM When Instructed bul would slow dwm agar about 2 mkwlee, 17AWfb* TeafA 7 Mrs urea SPPB Was SPPB Adan[slared7 + Yes; Foal Together • 1; Sem1•Tandmn a 1; Tandem u 1; Cell Speed • 2: Seconds to walk I3, 12 h - 7.28; N,6-. SPPD r 0"' Speed - Front Wde:ed V'Mw,, Ch Ar Stand aS • 0; Total SPPB • 6 GYNl1ce1 PioosdrA Maas uraA Claleal Process Measures this session a Cardlaeguldolinos for krrdmsderdla fak pa0enl, WA9 practice 4h wd"Iy bs too and balance demands Addll6iral AaAlysh7,;s flpg Prad sutlors PraasWfnas' Ag : 92 Ressog Pu'sa; 63 Olagnoals: CLF, pain PI Typo:? Goats: Bed I, TP Mt, goh Mi Fairmsk: VeryHigh WS:Full Care" RIM L Loa+ Bale Blockers: Yes GahSpsed; HIRT: SPPB; 0112 eMWT:0 PT RecerC 218123 PI needs can be met with group and/or concurrent therapy, Original Signature; ElecbMnrcagysigned by Robert B Delorms, PT 2/12023 05:41:23 PM PST Pale Page 4 0f 4 Occupational Therapy Treatment Encounter Note(s) Provider. PresllgeCare&Rehab-Sunny/Idw ldenit0rarllonlMarmalloar Pattanl: Cooper, Joa DOB: IW1930 MRN; 4552 Date of Sery(ce: 2l712023 Completed hate: 2f7 023 Pain Paln'W10 CP1 Lbdq 9ti!/d d/oft FW W to 97530 97631 Fastanding %Hlh FW Wpl aloodx0il CGASor `2 m+wlesvAlhsie tOB. FF ell/mafed han Fate reach farbakowt. PI was wry fatigued aft"/bow today and difficulty OWN AWOM 01110 07110: BUE exen bike to Increase utMrylWomnce and ot<ength. PicomPlsted 15 minutes an leval4. Clinical Process Mooswas %his session' Tharephl0nked Mxs py /oliNOos and Owl to out Precautions Pnuullena:A-jc-U RolftPulse:93 OWlinnls: GLF, Pain PI TWm:2 Fail Risk: Varylegh WB:Full Oar"a Rkk Low Bola awki rs: Yes Ocolarr. Ielumhomawmwlf K91) Euttipouned: norm SLUMS: 0130 SE. NJA Culp: H 31. L 39 Odginel Slgnaturc — Paeotrontedy sinned by AmondaJ Ford, OTA 4y712o2304:12:19 PM PST Data Date: of SerVICE' 212)2023 Pain Pain - W10 cPT Codoe aSHd us. PI requtrad coo 27530 97530: Fee9datad Iranarere wdlh FWW In erdar lopromdo h'nproved INO end saleryv,101 ADL I[ansi vcs toraerey and COA for$TS and ffonslerwiri FWW. No the dudng Ir¢nsfero. 91110 97t19: SUE exonWkeloinomeseec9vifytolerance and strength for Improved INDwlihlasksorcholce.Ptcompleted15 nnutes on lewl4. - COrdcal Process Mea/ures ants aaarion �Thorapls! finked 0urapy aGa40es and el[od to gaai AddlllonetRie/7ysle/Tdallnp — —_J Pagel of 3 Occupational Therapy Treatment Encounter Note(s) Prwlder. Prestige Care a Rehab. Sunnyslde Preaautlons PtwcaulWos:Aga; 92 Reaif g puha: $3 M911211s• ALP, Pain PITyps: 2 Fat Risk; VhyHkM We: Full Cardiac Risk: Low Bola Blacken: Yal DC 00M relum horns w9h %WfrBU EgWp owned: nopa SLVW, w30 SE! NA GO: R 31, L 39 Odglnai Signature: EWetronloalyeigned by Amanda J Ford, OTA 2/2/2023 03:51:27 PM PST c+ta Date of SO7VICe;113112023 CCmpldted Date: 2JI12023 Caraflopir&"ryl Pain 8tebfa Pain Psln•N10 CPTCcllw BINad 97530 97630; Fac7isted alwaiirg be Nr,;Vtoiafance Ydde areas stl So IR row !k0 rAlh COA and no LOB dQh(, balm PW f and safatyYnlh Auto of cock*. Pt stood slandinglsllling. 0 aWh�•Pl wea able to aiand rot—lamtnules. Oeo vice for hand placement during 97110 97110: BUE ex on omnlcyc!o to Incteaee X1110ytderanee end alrenglh, pt GwVdled 15 minutes on low a- Clfnlcat Process Measures thls sesslaa • The s� a! Naked the aW aatidtiaa and I ddfflon e f t 4 n a1yalF7w rinp Preeaullons I'mcn0ons;Age:92 RastingPu 663 Olagno s: e3LF, pah Ptlype:2 Fall Risk Vary High wB: Full CuCab Risk: tow Bala HbOore: Yes or ptow ri hang w1b w9a71700 Equip armed: none SLUMS. 940 SE: NIA Gdp: R 31, L39 Original Signature: l:Icctrchlcaliy alpe.ed byAmanda J Ford, OTA 2/1/2023 08:30:30 AM PST Data I]ato Of SB1VlCe: IJ3012023 Cornpfeted Date: 1130121)h Reason for Mlssed Session: Ptetated he was "too fatigued today". funodonal PedaFinanaa of F.geWrxy7 Page 2 of 3 Occupational Therapy Treatment Encounter Note(s) Provider. Presage Care B Rehab- Sunayslde Skill Slu"fed Ssnlees: PI slated he wns'loa raugued today' CaMlopaftnW Pale aptrra Pain Paln • Dl10 Cikrkaf Pmcfaa afaauraa CwnScat Placass Meaaoraa Ih1s awslon � None orthass 44d0jahol Anob addD4VAp Precautions Prsasullow Ati c 02 RestIng Pules: 63 Olagn¢als: GLF, pain Filype; 2 Fall Risk: Very Nigh WB: FWI Cardiac Risk Law Bete Stockers: Yea CCy+ n: FdWri hwe vAlh WISMSD Equ6panned noes SLUMS: 9M S£ WA Grim:R31.L34 OrlglnalSIDARturC Elecimnlcally$WnedbyAmandoJFo4OTA t130l202303:37:47PMPST oa:a Page 3 of 3 Derrick, Carl From: Neill Hoyson, Jessica Sent: Thursday, February 16, 2023 10:35 AM To: Derrick, Carly Cc: Sharon Cates Subject: RE: Disability Board Meeting Great. Follow up question on the name for either of you. It came up that some of the public think the name is confusing given that it really isn't dealing with City disability issues but rather retiree health care benefits. Do either of you know if the name is required per RCW or if we could rename it? Jessica Neill Hoyson (she/her), SPHR, CLRP Director of Human Resources City of Edmonds Ofc: (425)771-0258 Cell: (425) 315-5895 Fax: (425) 275-4806 " Irr 04-06 City of Edmonds Disability Board POLICY AND PROCEDURE Effective Approved by the Board at the May 3, 2006 meeting Revised: Approved by the Board at the January 24, 2007, January 21, 2010, July 2015, March 3, 2015 and April 20, 2018 and July 19, 2018 meeting(s) SUBJECT: HEARING AIDS #04-06 A benefit is provided by the City of Edmonds Disability Board for both hearing tests (once every three years) and hearing aids as follows: • Preapproval from the Board is required for the intial purchase of any hearing aids or the replacement of hearing aids. HR may approve hearing aid purchase reimbursement up to the maximum allowed by this policy for any replacement hearing aids. • Hearing aid claims must be accompanied by supporting documentation from a licensed physician or hearing specialist. The reimbursement cost for the purchase of hearing aids will be based on the current rates charged by Costco. The purchase of hearing aid insurance and/or a warranty at time of purchase is also required and will be reimbursed by the Board. For the replacement of hearing aids, HR staff has the authority to process these requests provided they meet the policy guidelines. Additionally, if any member does not have a Costco membership and a membership is required to purchase the hearing aids (which have been approved for purchase by the Board), the Board will provide a reimbursement for the cost of the annual Gold Star membership for the LEOFF 1 retiree. • HR staff has the authority to process Board pre -approved hearing aid purchase requests for reimbursement with the appropriate supporting documentation from a licensed physician and/or hearing specialist up to the current rate charged by Costco for hearing aids. Replacement of hearing aids will only be covered after 36 months and if the current hearing aid cannot be reasonably repaired, presuming the hearing aid is not covered by warrantee or insurance. The Disability Board will consider replacement of hearing aids after 36 months if a different model or style of hearing aid is needed due to a significant hearing change or if a new hearing aid significantly accommodates the members hearing loss. In most cases, HR may approve replacement hearing aid purchase reimbursement requests up to the limits set by this policy. City of Edmonds — Disability Board 9/26/2018 • The cost of batteries is covered under this policy. NOTE: Any special needs above and beyond the dollar amount set in this policy are subject to appeal by the LEOFF 1 member to the City of Edmonds Disability Board with appropriate medically necessary documentation. This policy will be reviewed by the Disability Board on an annual basis. 08.11 Im City of Edmonds Disability Board POLICY AND PROCEDURE Effective: As approved by the Board at the October 18, 2011 Disability Board Meeting Revised: Approved by the Board at the July 2015 Disability Board Meeting. SUBJECT: LONG TERM CARE REIMBURSEMENT POLICY IN HOME CARE AND/OR ASSISTED LIVING CARE NURSING HOME CARE and/or ADULT FAMILY HOME CARE). #08-11 A benefit is provided by the City of Edmonds Disability Board for the reimbursement/payment of long term care (LTC) costs. LTC includes in home and/or assisted living care, nursing home care and/or adult family home care costs. • Pre -approval, whenever feasibly possible, is required by the Board. The Disability Board requires written notification if the LEOFF 1 member enters a long-term care facility or if the member changes facilities. • Any LTC costs will be reviewed and approved by the Disability Board on a case -by - case basis. • Any request for LTC costs shall be submitted in writing by the LEOFF 1 member's physician to the Disability Board for approval. The maximum monthly benefit amount for any long term care services shall be based on the average cost of three (3) private nursing facilities within the LEOFF 1 member's living area at the 24 hour a day, semi -private room rate. • Any charges for services associated with in -home care must be substantiated by a physician's report of medical necessity. • The Disability Board has the right to request additional examinations by the Board physician in order to obtain needed information regarding any requests for payment of services. Recertification of medical necessity may be required at a minimum of every (6) months (or sooner as determined by the Board). • In -home services not covered are those of a custodial or housekeeping nature such as: house-cleaning, laundry services, recreational companionship and other homemaker tasks. • Only those LTC services provided by a bonded and licensed provider shall be considered for approval. • All services will be reviewed and approved by the Disability Board based on medical necessity and the documentation provided by the member and their health care provider in accordance with RCW 41.26. NOTE: Any special needs above and beyond the dollar amount set in this policy are subject to appeal by the LEOFF 1 member to the City of Edmonds Disability Board with City of Edmonds — Disability Board 7/18/2017mah appropriate medically necessary documentation. This policy will be reviewed by the Disability Board on an annual basis.