2020-02-25 Disability Board MinutesEDMONDS' DISABILITY BOARD
Meeting Minutes
Regularly Called Meeting
2/25/2020
MEMBERS PRESENT:
Ken Jones, Board Chair
Gary McComas, Board Member
Susan Paine, Council Member
Vivian Olson, Council Member
Jim Distelhorst, Citizen -at -Large
STAFF PRESENT:
Carly Derrick, Human Resources Assistant
Emily Wagener, Human Resources Analyst
Sharon Cates, City Attorney
MEMBERS OF THE PUBLIC PRESENT:
None
CALL TO ORDER:
Chair Ken Jones called the meeting to order at 10:00 AM.
MEMBER'S LIST UPDATE:
Chair Jones gave an overview of the different members (composition) of the board for the benefit of the
newly appointed council members and welcomed council members Susan Paine and Vivian Olson.
Chair Jones mentioned that Board Member Gary McComas' term was set to expire at the end of April.
HR Analyst Emily Wagener asked Board Member McComas if he was interested in serving another
term. Board Member McComas indicated that he was interested in serving another term. Ms. Wagener
indicated that HR would make sure voting forms were sent out to members.
APPROVAL OF MINUTES:
Citizen -at -Large Jim Distelhorst moved to approve the minutes from the regularly scheduled
10/29/2019 meeting. Chair Jones seconded the motion. The motion passed.
DISCUSS AND APPROVE CLAIMS SUMMARY REPORT
Chair Ken Jones introduced the claims summary report for the fourth quarter of 2019. HR Assistant
Carly Derrick spoke briefly about the claims summary report, indicating that it was similar to the same
period of time for the prior year. There was some discussion among the board about expected price
increases through time (for things such as Medicare Premiums and prescription co -pays).
Summary of Current Costs
10/01/2019 - 12/31/2019
SERVICE
Number of Claims
Total Paid for Service
Dental Expenses
3
$ 1,377.00
Eyeglasses
1
$ 225.00
Hearing Aids
1
$ 230.00
Long Term Care
7
$ 45,123.56
Edmonds Disability Board- 2/25/2020
Summary of Current Costs
10/01/2019 - 12/31/2019
SERVICE
Number of Claims
Total Paid for Service
Medical Services
5
$ 2,601.62
Medicare Premium
1
$ 1,608.00
Prescription
10
$ 3,169.64
Grand Total
28
$ 54,334.82
Chair Jones brought up Long-term care as the board's known high cost item and asked HR to provide
an update on the status of related expenses for LEOFF 1 members. Ms. Wagener explained that due to
a recent passing there was only one member currently using the Long-term care funds, which meant
that there was an overallocation of funds in the amount of about $179,000 to Long-term care expenses
for 2020 as this time. Additionally, a member's spouse reached out to Ms. Derrick about a potential
need for services but HR has not heard an update on this request.
There was some discussion among the board about the cost of Long-term care services and also the
Fireman's Pension Fund. Chair Jones made a motion to approve the claims summary for the
period 10/1/2019 - 12/31/2019 in the amount of $54,334.82. Citizen -at -Large Distelhorst seconded
the motion. The motion carried.
Ms. Wagener asked if the Board wanted to discuss the Long-term care budget going forward since there
was an expected surplus. Council Member Vivian Olson asked for clarification on what would happen in
the case a member chose to enter Long-term care where the cost was higher than what the board had
approved. Ms. Wagener responded that the member would need to pay the difference in cost and that
this situation has occurred previously with other members. Chair Jones spoke a bit about the process the
board goes through when reviewing Long-term care services for members.
Council Member Susan Paine asked if the board was to remove some of the available budget from the
Long-term care fund, how would the money be reallocated if it was later needed? Ms. Wagener indicated
that the funds could be easily replaced through the budget amendment process. Council Member Paine
also asked if we had surveyed member's medical needs in regards to planning. Ms. Wagener confirmed
that this was not something that had been done. Board Member McComas confirmed that requests come
in at the member's interest and due to HIPPA we have issues with requesting this type of information.
Chair Jones added that the board has had studies completed in the past to see if it would be cost-effective
to purchase Long-term care insurance. It has regularly come up that it is not cost effective and the overall
length of time someone is under this type of care tends to be limited in most situations. Ms. Wagener
confirmed that the Board looked at Long-term care insurance within the last year and found that it would
not only be cost prohibitive, but that there are not very many companies offering the service any longer.
REVIEW/DISCUSSION OF A REQUEST FOR REIMBURSMENT FOR HEARING AID
REPLACEMENT.
Ms. Wagener explained that this member had received hearing aids in the past and that the supporting
meeting minutes from 2005 from that approved purchase in the amount of $5,000 were included for the
board's review. Ms. Wagener clarified that this was being brought to the board because these original
hearing aids were purchased prior to the creation of the hearing aid policy that allows HR to approve
replacements without board approval. Ms. Wagener expressed that she wanted to make sure HR was
OK to move forward with this reimbursement.
There was some discussion about the dollar amount being requested. Ms. Wagener clarified that the
hearing aides being requested were provided by Costco, which aligns with the current policy. Ms.
Wagener further added that the member was requesting approval for a wireless connection piece that
Page 2 of 4
Edmonds Disability Board- 2/25/2020
the board would need to approve separately and that similar items had not been approved by the board
in the past since it is considered a luxury and not medically necessary.
There was some further discussion about the cost of the reimbursement request along with the earmold
request and expectation of use in the long-term. Citizen -at -Large Distelhorst clarified that the current
request falls in line with the current policy and the only piece that would not was the wireless device.
Ms. Wagener confirmed this was correct, adding again that the original hearing aid purchase was
approved prior to the creation of the current policy.
Chair Jones explained that the Costco membership was still $60 and that the board is required to pay
for that, per policy. Chair Jones gave some background on this, indicating that the Board has chosen to
use Costco as the price comparison for hearing aid reimbursement approvals and to allow for this, also
chose to pay the cost of membership if they request for reimbursement. Citizen-at-Lage Distelhorst
added that recent Consumer Reports rated Costco very high nationally in terms of quality and cost. Ms.
Wagener explained that if a member chose to purchase hearing aides at a rate higher than Costco and
could not support the request with medical documentation, they would need to pay the difference,
similar to the Long-term care discussed earlier.
Chair Jones moved for approval of hearing aides for this member, including the earmolds but
not the wireless device. Citizen -at -Large Distelhorst seconded. The motion carried.
Council Member Olson asked if the Long-term care budget option had been resolved. Ms. Wagener
responded that she did not hear clearly if the board wanted to reduce funds. Council Member Olson
indicated that because an inquiry had already been received, the funds should remain. There was
concurrence among board members. Ms. Wagener indicated that HR would give the board an update
at the next meeting regarding the member whose spouse had reached out.
REVIEW/DISCUSSION OF A MEMBER'S PASSING, THEIR PRIOR LONG-TERM CARE FACILITY
MOVEMENT AND A REQUEST FOR REIMBURSEMENT OF A $2,000 DEPOSIT.
Ms. Wagener explained to the board that this member had moved facilities, unknown to HR until after
the move. Ms. Wagener continued that the cost of the new facility was less than what the board had
initially approved ($310/day) so HR moved forward with reimbursing facility and care charges. Ms.
Wagener added that the member was seeking reimbursement for the $2,000 deposit that they were
required to pay prior to entry. Ms. Wagener confirmed this deposit was only refundable up until the
member moves in to the facility and that the board had previously approved a similar charge for another
member last year.
Ms. Wagener also told the board that this member recently passed away and HR had only been notified
on the preceding Friday. There was some discussion among the board about the member's move to a
new facility and request for reimbursement of the deposit.
Board Member McComas made a motion to approve the reimbursement of the $2,000 move -in
fee. Chair Jones seconded. The motion carried.
REVIEW/DISCUSSION OF A LEOFF 1 MEMBER'S REQUEST FOR ADDITIONAL DENTAL
EXPENSES IN THE AMOUNT OF $2,340.
Ms. Derrick clarified that this was more for dentures instead of dental expenses and that the member
hopes because they have not previously submitted for dental reimbursement the board might consider
the request for $2,340. There was some discussion on the documentation that was submitted by the
member to support their request. It was asked if this had come up before and Ms. Wagener indicated
she was not aware that it had. Chair Jones indicated that this went beyond quality of life because it is
Page 3 of 4
Edmonds Disability Board- 2/25/2020
necessary to be able to chew food. There was additional discussion about the total amount of the
request and as to why no denture policy has been created or needed by the board.
Citizen -at -Large Distelhorst talked about dental expenses being medically significant for overall health.
Chair Jones indicated that the member went to a denturist which would likely be a lower cost than an
actual dentist. Ms. Wagener indicated that it seemed the board could approve this expense as an
outlier under the dental policy even though it is not explicitly called out. Ms. Wagener also brought up
the fact that the RCW for medical services calls out dental care being a covered benefit when it is due
to an accident and although dental care is important in overall medical health, it is important to keep
them somewhat separated for reimbursement purposes and is why the board created a separate policy.
There was discussion among the board about what other boards might do regarding dentures and
dental care. The board discussed that previous surveys had indicated some other boards are very
generous and others very limited in their dental expense reimbursement and that denture coverage was
unknown. Ms. Wagener confirmed that the board had reviewed Dental Insurance in the past for
members which was not cost-effective so the board decided to allow members to purchase their own
coverage up to the policy limit.
After a brief discussion. Council Member Olson made a motion to pay for this member's denture
expense in the amount of $2,340. Chair Jones seconded. The motion carried.
REVIEW DENTAL POLICY 02-05
The board discussed the current dental policy in depth. Council Member Olson made note that
members can request beyond policy limits in certain situations so it would be possible to leave things
as they are. Ms. Wagener explained that there had been a request in the prior year for additional
cleaning costs and the board had considered that cleanings are being done more often (3 times per
year is common) and the $175 is not enough to cover that. Chair Jones agreed, indicating that even
$350 would not cover 3 cleanings based on his conversation with his dentist. Ms. Wagener told the
board that increasing the amount would limit the number of claims that would need to come before the
board since HR would be able to approve them based off of policy.
After some additional discussion and concurrence among the board, Board Member McComas made
a motion to increase the annual Dental Services benefit from $175 to $700 per year and include
language that, upon prior approval, reimbursement for denture services may be covered on a
case -by -case basis. Council Member Paine seconded. The motion passed.
Ms. Wagener asked the board to confirm when the effective date of this new benefit would be. The
board agreed that once it is approved, it would be effective retroactive to January 1, 2020.
OTHER
Chair Jones discussed a prior issue known to the board regarding the board direct -paying of medical
bills, specifically first month care services for Long-term care. Chair Jones explained that an opinion was
released that indicated boards were not expected to direct pay for expenses and that reimbursement was
acceptable. Chair Jones recommended the board continues with our process as has been established.
There was some discussion regarding the next board meeting and agreed on April 15, 2020 at 10:00 AM.
Ms. Wagener indicated she would include policy review for the board since they are intended to be looked
at on an annual basis.
Chair Jones adjourned the meeting at 10:55 AM.
Page 4of4