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2012-01-24 Disability Board MinutesEDMONDS DISABILITY BOARD Meeting minutes January 24, 2012 ­'. i7�,, MEMBERS PRESENT: Ken Jones, Chair Gary McComas, Board Member Joan Bloom, Council Member Adrienne Fraley-Monillas, Council Member Dr. Michael Deming, Citizen at Large STAFF PRESENT: Mary Ann Hardie, HR Analyst CALL TO ORDER: Chair Ken Jones called the Board meeting to order at 8:36 am. Citizen at Large Dr. Michael Deming arrived at the meeting at 8:40 am. Council Member Joan Bloom [who was elected to a 4 year council term on 1/12/12] was welcomed to the Board. Chair Jones explained that the Board administers the medical necessary reimbursements for the City's LEOFF 1 retirees and has the authority and discretion to make rules and policies (which may be based on past Board practices) regarding reimbursement requests by LEOFF 1 retirees for medically necessary services. It was noted that there are no currently active LEOFF 1 members employed at the City and that there are approximately 33 current LEOFF 1 retirees. Additionally, Chair Jones extended an offer to Council Member Bloom to arrange a meeting time (outside of the one meeting per quarter) to further discuss the Disability Board functions, etc. REAPPOINTMENT OF CITIZEN AT LARGE (DR. MICHAEL DEMING) TO SERVE ANOTHER TERM ON THE BOARD: Dr. Michael Deming's term as Citizen At Large on the Board expired on 12/31/11 and Dr. Deming had expressed an interest to serve another term on the Board. Chair Jones pointed out that Dr. Deming had served for several terms on the Board and that his service was appreciated by the Board. Chair Jones made a motion to reappoint Dr. Deming to another term on the Disability Board (through 12/31/13). Council Member Adrienne Fraley-Monillas seconded the motion. The motion carried. Ms. Hardie distributed new copies of the Board member term appointment and expiration dates, including Council Member Bloom's new term on the Board (through 12/31/13) and Dr. Deming's new term on the Board (through 12/31/13). APPROVAL OF MINUTES Council Member Fraley-Monillas made a motion to approve the meeting minutes of October 18, 2011. Chair Jones seconded the motion. The motion carried. DISCUSS AND APPROVE CLAIMS SUMMARY REPORT: HR Analyst Mary Ann Hardie reviewed the Claims Summary of October 1, 2011 up to and including December 31, 2011 as follows: SUMMARY OF CURRENT COSTS: (10/1/11 - 12/31/11) SERVICE TOTAL NUMBER OF CLAIMS COST Prescription Co -Pas 16 $3,031.36 Visiting Angels Nurse Care 6 28,615.00 Purchase of Eye Glasses - - Medicare Premium Reimbursement 1 1,158.00 Dental Reimbursement 4 398.00 Payment of Annual deductibles - - Hearing Aids - - Routine & Preventative Costs or costs associated with Annual Physical Exams - - - - Medical Equipment/Medically Necessary Services 4 778.72 TOTALS: 31 $33,981.08 The total expense for the period 10/1/11 — 12/31/11 was $33,981.08 with 31 claims for the period. Ms. Hardie explained that the total cost for this period is higher than the expense for the same period in 2010 due to the increase in Visiting Angels Nurse Care costs (with two LEOFF 1 members using this service). Council Member Fraley-Monillas made a motion to approve the expenditures for the period 10/1/11 — 12/31/11 and Chair Jones seconded the motion. The motion carried. REQUESTS FOR REIMBURSEMENT Request for Reimbursement for services at Algodones Optical in the amount of $90.00 & Request for Reimbursement for a spinal adjustment from Dr. Alvaro Aburto in the amount of $35.00 A LEOFF 1 member submitted a request for reimbursement to the Board from Algodones Optical ($90.00) and from Dr. Alvaro Aburto ($35.00). Ms. Hardie explained that with the normal reimbursement request process, the LEOFF 1 members submit (to the Board) a copy of required documentation for the medical services provided (such as the Regence Explanation of Benefits- EOB letter) in order to show that the services were first processed for payment coverage through Medicare and Regence. Chair Jones further explained that he had been in communication with the LEOFF 1 member of discussion (who had been asked to contact the Disability Board directly for reimbursement requests) about this reimbursement. The LEOFF 1 member had received medical services outside of the country (in Mexico) and these items were not processed by the service provider through either Medicare or Regence (as confirmed through Regence by Ms. Hardie). There was some discussion that followed by the Board about the requirement and need to submit appropriate documentation. Chair Jones suggested that he would contact the LEOFF 1 member of discussion and request that he or his service provider submit these items for reimbursement to Medicare and Regence for processing (before the Board would be able to further consider the reimbursement requests). Dr. Deming made a motion to approve Chair Jones' suggestion as noted. Chair Jones seconded the motion. The motion carried. REVIEW OF A LETTER SENT TO A LEOFF 1 MEMBER NOTIFYING THE MEMBER TO CONTACT THE DISABILITY BOARD DIRECTLY FOR REIMBURSEMENT REQUESTS Ms. Hardie explained that she had contacted Chair Jones after a meeting held with the Mayor, her supervisor, and the City Attorneys due to the continued inappropriate nature and demeanor in verbal communication directed toward the City HR staff by the same LEOFF 1 member (regarding the reimbursement requests from Algodones Optical & spinal adjustment from Dr. Alvaro Aburto). Ms. Hardie further explained she had requested that Chair Jones communicate to the LEOFF 1 member of discussion that all reimbursement requests should be directed only to the Disability Board. Council Member Fraley-Monillas recommended that a follow up letter from the Board be sent to the LEOFF 1 member of discussion affirming this request by Ms. Hardie. Dr. Deming made a motion to approve the drafting of a letter to the LEOFF 1 member of discussion directing him to communicate only and directly with the Disability Board for reimbursement requests. Chair Jones seconded the motion. The motion carried. Ms. Hardie stated that she would bring back a draft letter for the Board's review and approval as requested at the next Board meeting. REVIEW AND APPROVAL OF A LEOFF 1 MEMBER'S ADDITIONAL SERVICE HOURS REQUEST THROUGH VISITING ANGELS NURSE CARE SERVICES A LEOFF 1 member using Visiting Angels Nurse Care Services submitted a request for approval of reimbursement to the Board for additional service hours (8 hours on Saturdays). There was some discussion that followed by the Board about the ongoing use of Visiting Angels Nurse Care Services (in home assisted living care services) by two LEOFF 1 members that were unable to use nursing care facilities. Council Member Fraley-Monillas expressed concern for the expenses of these services and their impact on the City's financial condition and likely grim financial condition in 2013 (without a levy passing this year) as well as the need to look at ways to reduce expenses (in all areas of the budget) when possible. Board Member Gary McComas stated that the Board has always been conscious of this concern and that the Board has been [careful and responsible] in managing reimbursement requests during the City's lean and better financial periods. Chair Jones stated that there was a LEOFF 1 actuarial study (of the total estimated LEOFF 1 financial cost) performed by a third party for the City and that a study had been done some time ago. Council Member Fraley-Monillas asked when another such study may be performed. Ms. Hardie responded that the last actuarial study had been done about 2 years ago and that every 2- 3 years Milliman has done an actuarial study coordinated through finance. Ms. Hardie stated that she would check with the Finance Director, Shawn Hunstock, to see when the next study would be conducted and that she would have him come to a future Board meeting to discuss/explain the results of the study. There was additional discussion by the Board about possibly using long term care (LTC) insurance options for LEOFF 1 retirees (if available). Board Member McComas made a motion to approve having Ms. Hardie contact AWC to explore LTC information for LEOFF 1 retirees and to bring that information back to the Board for review at the next meeting. Chair Jones seconded the motion. The motion carried. Ms. Hardie stated that she would contact AWC and request information about the availability of LTC to bring back to the Board at the next meeting. REVIEW OF THE APPROVED IN HOME CARE ASSISTED LIVING POLICY AND PROCEDURE (008.11) Ms. Hardie explained that at the last meeting in October 2011, the Board had approved an In Home Assisted Living Policy, a copy of which was distributed to the Board. The Board reviewed the policy and procedure. Council Member Bloom expressed concerns about the language in the policy (being specific and inclusive enough). Ms. Hardie explained that a copy of the policy would be disseminated to all LEOFF 1 retirees and that the policy had been approved but could be reviewed at any time by the Board for necessary changes. The Board additionally requested that Ms. Hardie contact one of the LEOFF 1 members using Visiting Angels Nurse Care Services (who has been using Visiting Angels Nurse Care Services for several years now) to inquire as to how the LEOFF 1 member was doing on the Board's behalf. Ms. Hardie stated she would contact the LEOFF 1 member per the Board's request and let the Board know the status of the LEOFF 1 member at the next Board meeting. REVIEW OF MEDICARE PART C Ms. Hardie provided information from Medicare regarding Medicare Part C. Ms. Hardie explained that at the last Board meeting, Chair Jones had been told by his medical clinic (the Everett Clinic) that as of 1/1/12 all Medicare Part A and Part B members must select a Medicare Advantage plan (Medicare Part C) unless they were a retiree on a government or private insurance plan. Ms. Hardie further explained that she had contacted other city and county disability boards in the state to find out if their LEOFF 1 members had any similar experiences. Per the information from Medicare and the other city and county boards, Medicare Part C is not required for LEOFF 1 members. Any LEOFF 1 member who is informed that they must join the Medicare Part C from their service provider or clinic should have their clinic contact Regence directly (888) 849-3658. Chair Jones thanked Ms. Hardie for providing this information to the Board. NEW BUSINESS None. The Disability Board meeting adjourned at 9: 47 am.