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2017-11-08 Disability Board MinutesEDMONDS' DISABILITY BOARD Meeting minutes Specially Called Meeting 11/8/17 MEMBERS PRESENT: Ken Jones, Chair Gary McComas, Board Member Dave Teitzel, Council Member Adrienne Fraley-Monillas, Council Member Jim Distelhorst, Citizen -at -Large STAFF PRESENT: Mary Ann Hardie, Human Resources Emily Wagener, Human Resources Analyst Carly Derrick, Human Resources Assistant MEMBERS OF THE PUBLIC PRESENT: None CALL TO ORDER: Chair Ken Jones called the meeting to order at 9:28 am. Council Member Adrienne Fraley-Monillas was unable to attend the meeting. FOLLOW UP FROM THE 4/19/17 & 9/6/17 SPECIALLY CALLED MEETING (ADDITIONAL INFORMATION/DOCUMENTATION REQUESTED OF A LEOFF 1 MEMBER) BY THE BOARD FOR CONTINUING REIMBURSEMENT FOR MEDICAL SERVICES (ASSISTED LIVING CARE/LONG TERM CARE, ETC.) Review IME exam report for the LEOFF 1 member of discussion from 10/19/2017 At the 10/31/17 meeting, the Board had requested additional documentation from the LEOFF 1 member of discussion for continued consideration/approval determination of long term care service reimbursement costs. This information had been initially reviewed by the Board at the 10/31/17 meeting. Since not all of the Board members were available to attend the meeting (due to unexpected circumstances), the Board had requested to call a special meeting to review this information again (with the majority of the Board members present). There was some discussion that followed by the Board about the independent medical exam (second medical opinion) that had been requested by the Board of the LEOFF 1 member (that was briefly reviewed at the 10/18/17 Board meeting). Citizen -At -Large Distelhorst stated that he believed, based on the report, that the LEOFF 1 member may need assisted living and not skilled nursing care. Council Member Dave Teitzel inquired as to whether or not the LEOFF 1 member's medical prognosis was improving or declining. Citizen -At -Large Distelhorst stated that he believed the report indicated that the LEOFF 1 member was stable, but not necessarily improving and that it seemed clear to him from the report that assisted living care would be appropriate. There was further discussion that followed by the Board about the mini cognitive exam that the LEOFF 1 member completed and that the results reflected that he was not impaired in this area as well as the LEOFF 1 member's ability to get around for meals, etc. Citizen -At -Large Distelhorst stated that the cover letter provided by the independent medical examiner provided information indicating that the LEOFF 1 member would not do well living independently. Chair Jones stated that he had visited the LEOFF 1 member and was concerned about the level of care that he may need and if he would receive that same level of care (that he had observed at the facility the LEOFF 1 member is currently) if he was elsewhere. Council Member Teitzel inquired as to how often the Board would want to see updates from the LEOFF 1 member on his prognosis. There seemed to be agreement from the Board that updates every 6 months would be appropriate and would need to be provided from the LEOFF 1 member. Ms. Hardie asked the Board if: 1) the nursing care quotes received provided sufficient information for the Board to appropriately evaluate for determination approval of continued nursing care facility reimbursement costs as well as, 2) the quotes were for skilled nursing care facilities or assisted living care facilities (as there is a difference between the two). There was further discussion that followed by the Board about the LEOFF 1 member's current cost for nursing care (facility charge) that had been approved by the Board through October 2017. Review Assisted Living Care/Long Term Care quotes for reimbursement for LEOFF 1 member of discussion from the 9/6/17 specially called meeting The Board also reviewed the nursing care quotes that had been provided by the LEOFF 1 member. From the information provided, various members of the Board expressed concern with not being able to compare the quotes as different information had been provided on each quote (and not enough information had been provided with two of the quotes). The only quote that was provided that seemed to be sufficiently thorough was the quote provided by the nursing care facility that the LEOFF 1 member is currently at. Citizen -At -Large Distelhorst stated that the LEOFF 1 member appeared to need assistance with activities of daily living (ADL's) as well as instrumental activities of daily living (IADL's). The Board expressed concern about whether or not the LEOFF 1 member's medical needs would be appropriately met if the LEOFF 1 member was in a lower level of care facility (an assisted living care instead of a skilled nursing care facility). This was not clear enough for the Board to be able to determine based on the information that had been provided. After some discussion, it was recommended that, if there was going to be a request to the LEOFF 1 member to see if he was willing and able to move to a different facility, that Chair Jones (who knows the LEOFF 1 member) would reach out to him to talk to him about this. Board Member Gary McComas stated that he was very concerned that, in looking at the somewhat limited information provided, that he did not feel he had the sufficient expertise to be able to make a determination based on the comparison information (nursing care quotes) and that there must be a patient care advocacy group that could be. There was further discussion that followed by the Board about contracting services with a patient care advocate that specializes in this. After further discussion, Board Member McComas made a motion to: 1) approve the cost of the LEOFF 1 member of discussion's nursing care facility costs in the amount of $10,912 for the months of November 2017, December 2017 and January 2017 based on medical necessity; and 2) that the Board would try and located an independent patient advocate to help evaluation and direct the appropriate care for the LEOFF 1 retiree of discussion (based on the medical opinion provided by the independent, second medical opinion). Chair Jones seconded the motion carried. The motion carried. Ms. Hardie asked for clarification as to which Board members would be looking into this information for further follow up by HR. Citizen -At -Large Distelhorst stated that he would provide information for HR and Council Member Teitzel also stated that he would provide information to HR as well. Ms. Hardie stated that she would send information to the Board to consider before the next meeting (in January 2018). 2 OTHER The Board discussed upcoming meeting dates of January 18, 2017 and January 25, 2017. Chair Ken Jones adjourned the meeting at 10:35 am.