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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