2013-04-23 Disability Board MinutesEDMONDS' DISABILITY BOARD
Meeting minutes
April 23, 2013
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:
Carrie Hite, Reporting Director for HR
Mary Ann Hardie, HR Manager
Yvonne Chan, HR Analyst
CALL TO ORDER:
Chair Ken Jones called the Board meeting to order at 8:35 am.
APPROVAL OF MINUTES
Board Member Gary McComas made a motion to approve the meeting minutes of January 13,
2013. Citizen -at -Large Dr. Michael Deming seconded the motion. The motion carried.
DISCUSS AND APPROVE CLAIMS SUMMARY REPORT:
HR Manager Mary Ann Hardie reviewed the Claims Summary of January 1, 2013 up to and
including March 31, 2013 as follows:
SUMMARY OF CURRENT COSTS: 1/1/13 - 3/31/13
SERVICE
TOTAL NUMBER OF
CLAIMS
COST
Prescription Co -Pas
20
$6,168.81
In Home Assisted Living Care
4
27,530.95
Purchase of Eye Glasses
3
424.58
Medicare Premium Reimbursement
21
24,195.90
Dental Reimbursement
5
750.00
Payment of Annual deductibles
3
807.90
Hearin Aids batteries
1
31.45
Routine & Preventative Costs or costs associated
with Annual Physical Exams
0
0.00
Medical Equipment/Medically Necessary Services
0
0.00
TOTALS:
57
$59,909.59
The total expense for the period 1/1/13 — 3/31/13 was $59,909.59 with 57 claims. Ms. Hardie
explained that due to the recent passing of a LEOFF 1 member, the Visiting Angels Nurse Care
costs had decreased. Ms. Hardie stated that, with the new insurance plan change for LEOFF 1
retirees (as of 1/1/13), that there would be a different distribution of the types of service charges
on these summaries to include an increase in deductibles, co-insurance and higher prescription
co -pays. The total Visiting Angels Nurse Care costs for the quarter were $27,530.95.
Dr. Deming made a motion to approve the claims summary report for the period 1/1/13 up to and
including 3/31/13 in the amount of $59,909.05. Board Member McComas seconded the motion.
The motion carried.
REQUESTS FOR REIMBURSEMENT
• Critical care (hospital) co-insurance- $11.28; audiology services (not covered by
Medicare) - $25.00 for a total of $36.28
• Office visit co-insurance - $10.58
• Co-insurance costs related to a partial mastectomy - $275.41
• Annual physical co-insurance cost - $162.32
Ms. Hardie explained to the Board that with the aforementioned insurance plan change, that there
was an increase in co-insurance reimbursement requests and deductibles and that a letter (with
other additional plan information) had been sent to LEOFF 1 members to remind them that they
could submit reimbursements more frequently.
Ms. Hardie further requested that the Board consider setting a policy to allow for co-insurance
reimbursement requests to be processed by HR staff (without first requiring initial submission to
the Board) with proper medical and receipt documentation based on medical necessity. Board
member McComas made a motion to approve the reimbursement requests for each of the four
LEOFF 1 members of discussion based on medical necessity as follows: 1) Critical care (hospital)
co-insurance- $11.28; audiology services (not covered by Medicare) - $25.00 for a total of $36.28,
2) Office visit co-insurance - $10.58, 3) Co-insurance costs related to a partial mastectomy -
$275.41 and 4) annual physical co-insurance cost - $162.32. Dr. Deming seconded the motion.
The motion carried.
DISABILITY BOARD POLICIES COMPARISON (COMPARATOR CITIES) & ANNUAL REVIEW
OF CURRENT CITY OF EDMONDS' DISABILITY BAORD POLICIES
As requested by the Board at the January 2013 Board meeting, HR staff compiled a comparison
of comparator cities Disability Board policies for the Board to review. Ms. Hardie distributed
copies of the comparator city Disability Board policies analysis to the Board (which included
copies of the following policies: dental, vision, long term and/or assisted living care, chiropractic,
routine physicals, smoking cessation, experimental & educations, acupuncture and acupressure,
weight loss and wellness, substance abuse and mental health services).
Long Term/Assisted Living Care/Nursing Home policies
There was some discussion that followed by the Board as to which of these comparator cities'
Board policies may want to be reviewed or discussed. Due to time limitations and the volume of
materials to review, the Board decided to review the long term/assisted living care policies and
the Edmonds' Disability Board Nursing Home and Long Term/Assisted Living Care policies. After
some discussion by the Board, Board Member McComas made a motion to revise the current
Nursing Home/Assisted Living policy (006.06) to remove the "Assisted Living" from the title of the
policy and to include the following language, "In home care assisted living costs will be reviewed
and approved by the Disability Board on a case -by -case basis. Any request for long-term nursing
assistance shall be submitted in writing by the LEOFF 1 member's physician to the Disability
Board for approval. The maximum monthly benefit amount 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." Council Member Adrienne Fraley-
Monillas seconded the motion. The motion carried. Chair Ken Jones requested that the HR staff
bring back the revised Nursing Home policy to the next Board meeting in July for final approval by
the Board. Ms. Hardie confirmed that she would bring back the revised policy to the Board for
final approval at the July meeting.
Dental Policy
The Board then reviewed the other cities' dental plans. After some discussion by the Board,
Board Member McComas requested that the HR staff contact the City's current dental provider to
see if the LEOFF 1 members are eligible for coverage through AWC and to bring that information
back to the Board meeting for further discussion. Ms. Hardie stated that she would look into this
further and report back to the Board at the July meeting.
Payment of Annual Deductibles (001.06)
Board Member McComas made a motion to revise the Payment of Annual Deductibles Board
policy to remove the "Regence Blue Shield Plan A" to be replaced with "City provided insurance."
Council Member Fraley Monillas seconded the motion. The motion carried.
Co -Insurance Policy
The Board requested that Ms. Hardie draft a co-insurance reimbursement policy (similar to the
language in the Payment of Annual Deductibles policy (001.06) to bring back to the July meeting
for review and approval. Ms. Hardie stated that she would draft a policy and bring it back to the
Board for review and approval at the next Board meeting.
After some further discussion by the Board, the Board decided to continue the review of the
current Board policies and procedures and the comparison at the July meeting.
WSLEA CONFERENCE- 5/7 — 5/10/13 in Chelan, Washington
Chair Jones stated that he will be attending the Washington State LEOFF Education Association
Conference in Chelan, Washington from May 7, 2013 — May 10, 2013 in Chelan, Washington.
Chair Jones stated that there is some discussion about possible legislation to consolidate the
Disability Boards' across the state into one (through Olympia). He further stated that he would
bring back information on this and provide a short report to the Board on the conference at the
next meeting in July.
The meeting adjourned at 9:50 am