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2012-04-18 Disability Board MinutesEDMONDS DISABILITY BOARD Meeting minutes April 18, 2012 MEMBERS PRESENT: Ken Jones, Chair Joan Bloom, Council Member Adrienne Fraley-Monillas, Council Member Dr. Michael Deming, Citizen at Large STAFF PRESENT: Carrie Hite, Parks, Recreation & Cultural Services Director/Reporting Director of HR Mary Ann Hardie, HR Manager CALL TO ORDER: Chair Ken Jones called the Board meeting to order at 8:32 am. Board Member Gary McComas was unable to attend the meeting. Citizen at Large Dr. Michael Deming arrived at the meeting at 8:39 am. OTHER: Parks, Recreation & Cultural Services Director/Reporting Director of HR Carrie Hite stated that she wanted to make the Board aware that the City [through a Health Benefits Committee made up of members of all represented and non -represented employee groups] is currently looking at another health care plan and that there may be a transition to the new plan (which would include LEOFF 1 members and other retirees currently on the AWC plans). Carrie further stated that, at this time, the City is looking at options but that she did not have detailed information for the Board to look at during the meeting. There was some discussion that followed by the Board about this topic including: 1) what some of the types of options may be (including self -funded and fully -funded insurance plans); 2) whether or not supplemental Medicare plans were being examined; and 3) that one of the important goals with this process is to ultimately reduce health insurance costs to the City. There was some further discussion that followed by the Board about self-insurance and the previously unsuccessful experience with self-insurance at the City. APPROVAL OF MINUTES Council Member Adrienne Fraley-Monillas made a motion to approve the meeting minutes of January 24, 2012. Chair Jones seconded the motion. The motion carried. DISCUSS AND APPROVE CLAIMS SUMMARY REPORT: HR Manager Mary Ann Hardie reviewed the Claims Summary of January 1, 2012 up to and including March 31, 2012 as follows: SUMMARY OF CURRENT COSTS: (1/1/12 - 3/31/12) SERVICE TOTAL NUMBER OF CLAIMS COST Prescription Co -Pas 24 $8,244.85 Visiting Angels Nurse Care 7 44,289.00 Purchase of Eye Glasses 3 369.00 Medicare Premium Reimbursement 21 23,250.40 Dental Reimbursement 3 397.00 Payment of Annual deductibles - - Hearing Aids - - Routine & Preventative Costs or costs associated with Annual Physical Exams - - - - Medical Equipment/Medically Necessary Services 1 68.00 TOTALS: 59 $76,618.25 The total expense for the period 1/1/12 — 3/31/12 was $76,618.25 with 59 claims for the period. Ms. Hardie explained that the total cost for this period is considerably higher than the expense for the same period in 2011 due to the increase in Visiting Angels Nurse Care costs (with two LEOFF 1 members using this service). Additionally, the majority of the Medicare premium reimbursements (21) were received and reimbursed during this period. There was some discussion that followed by the Board about: 1) the continuing increase in cost of the in home assisted living care and potential long term care costs being incurred by the City; 2) the current policy and if there was a need to review the application of the policy from a cost perspective and; 3) whether or not the Board wanted to consider offering respite care reimbursement as part of the policy. Ms. Hardie stated that the City's current LEOFF 1 actuarial study [on total estimated LEOFF 1 costs] was in the process of being finalized and that more information would be brought back to the Board at the July 2012 meeting. Chair Jones made a motion to approve the expenditures for the period 1/1/12 — 3/31/12 and Council Member Fraley-Monillas seconded the motion. The motion carried. REQUESTS FOR REIMBURSEMENT Medical services in the amount of $50.34 A LEOFF 1 member submitted a request for reimbursement to the Board in the form of a Regence Explanation of Benefits form (EOB) in the amount of $50.34. Ms. Hardie explained that she had checked with Regence to determine if this was a provider write-off for service charges or for some other type of non -covered insurance charge and it appeared that this charge was for no - contracted provider services. The Board requested that the LEOFF 1 member provide additional information to include a copy of the bill that was received by the member (as a result of the EOB) in order to make a determination as to whether or not this would be eligible for reimbursement based on medical necessity. Ms. Hardie stated that she would inform the LEOFF 1 member of the Board's request. Dental Services in the amount of $150.00 A LEOFF 1 member submitted a request for reimbursement to the Board in the form of parts of his/her on line checking account transaction register as proof of purchase for dental insurance that was purchased for a number of months [at $45.75 per month]. There was some discussion that followed since the Board's Dental Expense Reimbursement Policy does not address whether or not dental insurance is an expense that may be reimbursed under the policy. Additionally, the documentation submitted does not show proof that the insurance was purchased for the LEOFF 1 member of discussion. For these reasons, the Board requested that the LEOFF 1 member provide additional information in the form of a receipt for dental expenses (for the LEOFF 1 member) for this period from the dental provider as noted in the Dental Expense Reimbursement Policy. Ms Hardie stated that she would inform the LEOFF 1 member of the Board's request. Copy of medical records in the amount of $33.65 A LEOFF 1 member submitted a copy of a bill for medical records to the Board for reimbursement consideration. There was some discussion that followed by the Board as to whether or not this service was reimbursable based on medical necessity. The Board determined that this service was not reimbursable based on medical necessity unless the LEOFF 1 member could provide additional information on these services. Ms. Hardie stated that she would inform the LEOFF 1 member of the Board's decision. Medical services in the amount of $173.00 A LEOFF 1 member submitted a request for reimbursement to the Board in the form of an EOB from Regence in the amount of $173.00 for medical services from Tri-City Cabulance. The Board requested that the LEOFF 1 member provide additional information in the form of a receipt for expenses noted in the EOB from Tri-City Cabulance in order to further consider this reimbursement request. Ms Hardie stated that she would inform the LEOFF 1 member of the Board's request. Hearing aids in the amount of $3,034.00 A LEOFF 1 member submitted a request for reimbursement to the Board in the amount of $3,034.00 for the purchase of two hearing aids. Per the Board's Hearing Aid Reimbursement Policy, the LEOFF 1 member had hearing aids that had been purchased more than 36 months ago and they were able to be repaired. The documentation provided by the LEOFF 1 member's audiologist clarified that the hearing aids that the LEOFF 1 member had could be repaired, but it was not cost effective to do so [since replacement would likely be inevitable]. In consideration of the documentation provided, Chair Jones made a motion to approve the reimbursement request for the LEOFF 1 member of discussion in the amount of $3,034.00 based on medical necessity. Citizen at Large Dr. Michael Deming seconded the motion. The motion carried. REVIEW OF INFORMATION FROM RIP CURTIS ON LONG TERM CARE INSURANCE Ms. Hardie provided attendees with a sample cost sheet of long term insurance (through Rip Curtis) which was requested at the last meeting by the Board. Ms. Hardie further explained that she had contacted John Hancock and AWC to see if our LEOFF 1 members were eligible for long term care insurance benefits through both organizations and was redirected to Rip Curtis. There was some discussion that followed by the Board about the information provided and what the other cities and counties may be doing with their long term care situations. Chair Jones stated that said that he could bring back information to the Board from the Washington State LEOFF Education Association (WSLEA) conference (next month) that will include the other city and county Disability Board [long term care] policies. Ms. Hardie stated that she had also requested copies of long term care policies from the other cities and counties but that not all the information has been received back. There was further discussion that followed by the Board about the cost of long term care. Ms. Hardie pointed out that the Board has the authority to make decisions about setting pay limits for any policies [and reimbursements]. After further discussion the Board determined that long term care would not be further considered at this time. REVIEW LETTER DRAFT TO BE SENT BY THE BOARD TO A LEOFF 1 MEMBER NOTIFYING THE MEMBER TO CONTACT THE DISABILITY BOARD DIRECTLY FOR REIMBRUSEMENT REQUESTS Ms. Hardie provided the Board with a draft letter for approval to be sent by the Board to a LEOFF 1 member to direct them to [only] communicate with and directly to Board (not Human Resources). Chair Jones explained that he has been in communication with the LEOFF 1 member about some reimbursement issues and that the Board appreciated the Ms. Hardie's work in preparing this letter for the Board. Ms. Hardie explained that the city attorney had reviewed this letter as well. Dr. Deming moved to approve the draft letter to be sent by the Board to the LEOFF 1 member, Council member Joan Bloom seconded the motion. The motion carried. Chair Jones signed the letter and Ms. Hardie stated that she would mail out the letter to the LEOFF 1 member. POSSIBLE FURTHER DISCUSSION/REVIEW OF THE APPROVED IN HOME CARE ASSISTED LIVING POLICY AND PROCEDURE (008.11) There was some discussion that followed by the Board about the need to review and make revisions to the Disability Board's In Home Care Assisted Living Policy and Procedure (008.11). Council Member Bloom (who has extensive experience in this field) expressed concern about the need for a more definitive policy which may help contain potentially escalating costs. Ms. Hardie suggested that given Council member Bloom and Council Member Fraley-Monillas' much appreciated experience and expertise, they could review the policy and bring it back to the Board for further discussion and changes. Council Member Bloom and Council member Fraley-Monillas pointed out that since Chair Jones would be bringing information back from the WLSEA conference that they would wait until Chair Jones had the information from the conference to send to Ms. Hardie (who will forward the information along after receipt). UDPATE TO THE BOARD REGARDING A LEOFF 1 MEMBER'S CONDITION Ms. Hardie stated that she had spoken to the spouse of one of the LEOFF 1 members using the Visiting Angels Nurse Care services as the Board had requested at the last meeting. Based on the conversation with the spouse, it appeared that the LEOFF 1 member's condition had not improved. Additionally, the spouse of the LEOFF 1 member expressed appreciation to the Board for the continued concern. There was some discussion that followed by the Board about the impact on the family members who were providing some caregiving services (although not being paid to do so) and the consideration of respite care in the long term care and in home assisted living care policies. Council member Fraley-Monillas pointed out that Ms. Hardie may want to mention that there is a new nursing home facility called Rosewood Court in Edmonds that the LEOFF 1 member could consider if needed. DISCUSSION OF THE UPCOMING 2012 WLSEA CONFERENCE (5/8 — 5/10/12) IN CHELAN, WASHINGTON Ms. Hardie provided the Board with copies of the registration and agenda for the upcoming WSLEA conference. Chair Jones stated he would be attending and that he found the actuarial report from the state is always very helpful. Ms. Hardie stated that she had already registered Chair Jones for the conference since early registration was due by 4/20/12. Additionally, per her discussion with Finance, that there was a need for clarification about the policy for reimbursement for travel, meals and accommodations for the conference for auditing purposes. There was a short discussion that followed by the Board about this. As a result, it was determined that:) 1) If attendees would like to submit reimbursement requests for travel expenses [mileage] that this would be up to the attendee to do so; 2) no meal tickets for guests attending the conference would be purchased by the Board although meals for attendees would be paid for and; 3) that lodging (hotel rooms) for the conference for attendees would be paid for but that any miscellaneous room charges would not be. NEW BUSINESS None. The Disability Board meeting adjourned at 9: 58 am.