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2017-10-31 Disability Board MinutesEDMONDS' DISABILITY BOARD Meeting minutes Regularly Called Meeting 10/31 /17 MEMBERS PRESENT: Ken Jones, Chair Gary McComas, Board Member Dave Teitzel, Council Member STAFF PRESENT: Scott James, Finance Director Mary Ann Hardie, Human Resources 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 9:37 am. Council Member Adrienne Fraley-Monillas and Citizen -At -Large Jim Distelhorst were unable to attend the meeting. APPROVAL OF MINUTES: Council Member Dave Teitzel made a motion to approve the 7/1/17 (regularly scheduled) and the 9/6/17 (specially called) meeting minutes. Chair Jones seconded the motion. The motion carried. DISCUSS AND APPROVE CLAIMS SUMMARY REPORT Chair Jones noted that the claims summary reflected an incorrect date of 7/1/17-9/1/17. Ms. Hardie stated that this date on this summary would be adjusted and corrected for the record. HR Analyst Emily Wagener explained that, with the LEOFF 1 member using long term care (since August of 2016), and additional reimbursements, the claims for this period are significantly higher ($90,764.38) than the same period last year. Su mary of Current Costs 7/1/2017 - 9/30/2017 SERVICE Number of Claims Total Paid for Service Board Approval 3 $ 6,022.68 Co -Insurance 1 $ 386.98 Deductible 1 $ 59.41 Dental 3 $ 402.00 Long Term Care 6 $ 114,363.05 Medical Services 4 $ 471.21 Prescription 8 $ 1,881.50 Grand Total 26 $ 123,586.83 Chair Jones made a motion to approve the claims summary in the amount of $123,586.83 for the period 7/1/17-9/30/17. Council Member Teitzel seconded the motion. The motion carried. Ms. Hardie explained that, with the additional LEOFF 1 member using long term care, this will go over the long term care budget and there will need to be an adjustment made for this year and for next year. Ms. Hardie explained that there appears to be a need for a budget adjustment that between the end of 2017 and for the 2018 budget year in the amount of approximately $156,606.93 based on the projections of expenses (if the Board continues to approve the monthly room costs at the skilled nursing facility for the LEOFF 1 member of discussion from the 9/6/18 specially called meeting and today's meeting). Finance Director Scott James was in attendance at the meeting so that he could also be aware of this impact to the budget and provide any information on actuarial report, etc. Ms. Hardie explained that the general fund and the fire pension fund for the LEOFF funds was within budget for 2017 and that the long term care fund was the only one impacted and that the Board's decision on the LEOFF 1 member's approval of nursing care costs could impact this decision. Ms. Hardie stated there would be a fourth quarter, 2017 budget amendment to adjust costs. FOLLOW UP FROM THE 4/9/17 and 9/6/17 SPECIALLY CALLED MEETING (Additional information and documentation requested of a LEOFF 1 member) BY THE BOARD FOR CONTINUING REIMBURSEMENT FOR MEDICAL SERVICES (Assisted Living Care/Long Term Care, etc.) Review of the IME report for the LEOFF 1 member of discussion from 10/19/17 Mr. James asked about whether or not the Board had caps (or maximums) on reimbursements for long term care costs in any of the Board policies. Note: Ms. Hardie stepped out of the room to get some additional materials for the Board's discussion (policy on assisted living/long term care). There was some discussion that followed by the Board about this. City Attorney Sharon Cates explained that it was at the Board's discretion to do so. Ms. Hardie explained that Citizen -At -Large Distelhorst provided an email stating his opinion (as he was not in attendance that the IME for the LEOFF 1 member of discussion appears to recommend assisted living [not skilled nursing] care. After further discussion, the Board determined that, without Citizen -At -Large Distelhorst and Council Member Fraley-Monillas in attendance at the meeting, the Board preferred to defer further discussion and action on this item to a specially called meeting in November 2017. Ms. Hardie asked for a date to be set for the specially called meeting. There were tentative dates provided for the November specially called meeting. Ms. Hardie stated she would work to put together the special meeting notice and schedule the specially called meeting for November. She further explained that she would let the LEOFF 1 member of discussion know as well that there would be a specially called meeting. REQUEST FOR REIMBURSEMENT CNA- $440.00 2 Ms. Hardie explained that one of the LEOFF 1 members using assisted living care (as approved by the Board) had used a different CNA for services (who does not work through one approved assisted living care service provider agencies) on 9/2 and 9/3/17 in the amount of $440.00 as they could not get care through the regularly agency for these dates. Chair Jones made a motion to approve the $440.00 reimbursement cost for CNA services in the amount of $440.00 based on medical necessity. Board Member McComas seconded the motion. The motion carried. Hearing Aid Purchase - $2,829.96 Ms. Hardie asked that the Board review the hearing aid purchase policy to clarify whether or not prior approval would be required by the Board before reimbursement would be allowed. Board Member McComas made a motion to approve the hearing aid purchase in the amount of up to $2,639.97, however, if the remote is medically necessary and the LEOFF 1 member provides documentation of medical necessity, this remote would also be approved for purchase as well (in the additional amount of $189.99). Council Member Teitzel seconded the motion. The motion carried. POLICY UPDATES Long Term Care Council Member Teitzel made a motion to approve the revised Long Term Care/Reimbursement Policy (08-11) to add language regarding the Board's legal right to request a second medical opinion for a LEOFF 1 member in this situation (who may bring a request to the Board for reimbursement or approval purposes for this type of service) to be paid for by the Board. Chair Jones seconded the motion. The motion carried. Prescription co -pay Council Member Teitzel made a motion to approve the update to the Prescription Co -Pay policy to include the requirement to use generic drugs first before the Board would approve a brand name prescription co -pay for reimbursement. There was further discussion that followed by the Board. There was not a second to the motion. The motion died. The Board determined that it was appropriate to bring back this policy for discussion at the next full Board meeting (in January 2018). ti19:1=1N Ms. Hardie explained that there may be a request for reimbursement brought to the Board at the next meeting for an intraocular lens in the amount of $1400.00 (although it had not been pre -approved for reimbursement/purchase by the Board under the Board policies). Chair Ken Jones adjourned the meeting at 10:32 am.