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2012-10-16 Disability Board MinutesEDMONDS' DISABILITY BOARD Meeting minutes October 16, 2012 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 Manager OTHERS: Ray Ault, Advanced Hearing Systems CALL TO ORDER: Chair Ken Jones called the Board meeting to order at 8:45 am. PRESENTATION OF HEARING AID INFORMATION BY RAY AULT Ray Ault from Advancing Hearing Systems discussed hearing aid costs, features and also answered questions from the Board Hearing about hearing aids. Mr. Ault stated the following: 1. The change from analog to digital hearing aids has impacted [increased] prices. Some manufacturers have not made analog aids although this change has solved acoustic feedback issues and background noise. 2. High frequency hearing loss is common. 3. About three years ago digital aids took a large jump in performance and abilities. Second microphone addition (directional microphone) added a 30 foot radius. 4. Potential cost "impacts" - service - time and charges for time; prices can vary. In Mr. Ault's opinion, not everyone needs all the features offered on all hearing aid devices and that $4500 is the highest amount he has charged for hearing aids (perhaps up to $5000). Most of the hearing aids that are purchased through his company cost $3400-$3500 per set [pair] and that the component parts costs are nowhere near what is charged. Board Member Gary McComas inquired as to whether there was a difference between the hearing loss and the hearing aid type. Mr. Ault stated that high frequency hearing loss is common and that there is a difference in cost due to this. Board Member McComas inquired as to whether or not warranties were included with the hearing aids [sold by Advance Hearing Systems] Mr. Ault responded that they were and they usually were 1 year in duration and cost $150 generally per aid per person. Additionally, Mr. Ault stated that he would recommend a warranty of one year (including loss and damage) for repairs. Chair Ken Jones inquired as to what Advanced Hearing System's procedure is with hearing aids that can't be repaired reasonably and must be replaced and if there are ever hearing aids that truly cannot be repaired. Mr. Ault stated that there is a manufacturer in Oregon that he works with who says they can repair any type of hearing aids and that he has seen are a lot of vendors selling new hearing aids (stating that they cannot be reasonably repaired when they can). Mr. Ault further stated that there are also good reasons to have 2 hearing aids instead of one, especially with bilateral loss and that there may be a possible link between dementia and hearing loss as well as a 60% improvement in tinnitus from using hearing aids. Citizen At Large Dr. Michael Deming Ear inquired as to whether there should be a cost for ear molds for the hearing aids that sit over the ears. Mr. Ault responded that this wasn't always necessary. Council Member Joan Bloom inquired as to whether [with the recent request for reimbursement in the agenda packet of up - $7000 for a pair of hearing aids] was really too expensive. Mr. Ault responded that what other vendors decide to charge for hearing aids is their business but that he has never charged more than $4500-$5000for a pair. Council Member Adrienne Fraley-Monillas opinioned that one challenge the Board has been having is with the variety of prices for different reimbursement requests. Part of it is may be the disability of the ear and that is part of the difference. Council Member Fraley-Monillas further states that as a group it is difficult to determine what amount the Board should be reimbursing up to for hearing aids because the Board does not have the background in this area [hearing aids]. There was further discussion that followed by the Board about hearing aids. HR Manager Mary Ann Hardie suggested that perhaps the Board would like to have Mr. Ault review the LEOFF1 retiree hearing aid request on the agenda for the meeting if he would be willing. Mr. Ault affirmed that he would. The Board thanked Mr. Ault for taking the time to present information to the Board on hearing aids. APPROVAL OF MINUTES Citizen at Large Dr. Michael Deming made a motion to approve the meeting minutes of July 17, 2012. Chair Ken Jones seconded the motion. The motion carried. DISCUSS AND APPROVE CLAIMS SUMMARY REPORT: HR Manager Mary Ann Hardie reviewed the Claims Summary of July 1, 2012 up to and including September 30, 2012 as follows: SUMMARY OF CURRENT COSTS: (7/1/12 - 9/30/12) SERVICE TOTAL NUMBER OF CLAIMS COST Prescription Co -Pays 10 $891.94 Visiting Angels Nurse Care 8 $45,087.36 Purchase of Eye Glasses 3 $450.00 Medicare Premium Reimbursement 1 $1,156.80 Dental Reimbursement 0 0.00 Payment of Annual deductibles 0 0.00 Hearin Aids batteries 2 $4,150.00 Routine & Preventative Costs or costs associated with Annual Physical Exams 0 $0.00 Medical Equipment/Medically Necessary Services 1 $35.00 TOTALS: 25 $51,771.10 The total expense for the period 7/1/12 — 9/30/12 was $51,771.10 with 25 claims for the period. Ms. Hardie explained that while the total amount of claims for this period were similar to the same period in 2011, the total cost for this period was higher due to the increase in Visiting Angels Nurse Care costs (with two LEOFF 1 members using this service). The two Visiting Angels Nurse Care costs for this period was $45.087.36. Board Member MComas left the Board meeting at 9:31 am [as this was an unexpectedly long meeting and there was a meeting conflict]. There was some discussion that followed by the Board about the costs of LTC/Assisted Living Care costs and how to contain those costs given the City's budget issues. The Board requested that Ms. Hardie contacted the two LEOFF 1 retirees using the Visiting Angels Nurse Care service in order to get an update on their medical status [per the Board's Assisted Living and Long Term Care Policy] as it relates to their ongoing need for services. Ms. Hardie stated that she would contact the LEOFF 1 members of discussion and ask for an updated status to bring back to the Board at the next meeting in January. Chair Jones made a motion to approve the meeting minutes for July 1, 2012 up to and including September 30, 2012. Dr. Deming seconded the motion. The motion carried. REQUESTS FOR REIMBURSEMENT Cabulance services - $151.80 A LEOFF 1 member submitted a request for reimbursement to the Board for cabulance services in the amount of $151.80 which had been processed through Regence insurance and had been paid for up to 80% before being submitted to the Board. Chair Jones made a motion to approve the LEOFF 1 member's request for reimbursement based on medical necessity. Dr. Deming seconded the motion. The motion carried. Request for Reimbursement - Counseling Services - $65.55. A LEOFF 1 member submitted a request for reimbursement to the Board for counseling services in the amount of $65.55. Chair Jones stated that since Regence had paid a portion of this claim, this seemed to be medically necessary. There was additional discussion about the provider used (Tri-County Cabulance) who is a non-Regence network provider. FURTHER REVIEW & DISCUSSION OF HEARING AID REIMBURSEMENT POLICY & FURTHER REVIEW & DISCUSSION OF IN HOME ASSISTED LIVING CARE POLICY (008.11) Due to the unexpected length of the meeting, the Board made a determination to discuss these items and the January 2013 meeting. Ms. Hardie stated that she would provide the Board with copies of comparable cities policies for their LEOFF 1 Boards as January would be a good time to review the current Board policies (as they are to be reviewed by policy once a year) and to look at setting other policies if the Board chose to. �IETOI 7 None. The meeting adjourned 10:05 am