Leoff Board - Regular Meeting

on being there, from what I understand. We can probably start the meeting.

So- Vice Chair, I believe your microphone's off. I am so sorry for the interruption.

There we go. Now my mic is on. We're waiting for Mr. Vanderveer. I think we can start the meeting prior to his arrival. We have two, I think we have two items on the agenda. I'll call the meeting to order September 16th. No, excuse me. The 21st, our last meeting was September 16th. So we'll call the meeting to order. Roll call. No, pledge allegiance. I don't normally run these meetings. Aye. Pledge allegiance to the pledge. of the United States of America, and to the Republic for which it stands, one nation, under God, indivisible, with liberty and justice for all. Thank you. If we could have a roll call, please.

Yes. Board Member Helios.

Here.

Vice Chair Taylor. Oh, I'm sorry, I did not hear you say. And then next is Council Member Schmuelko. Here. Council Member Gilliam. Present. And the Chair VanVer is currently not present, but we will see him shortly, hopefully. And with four out of five, we have a quorum.

As we speak, our chairman has arrived. So we'll hold off for just a moment.

Sorry.

We appreciate you being here nonetheless.

We're right in the middle of the roll call. I started the meeting. We're in the roll call right now. Go ahead. Would you continue the roll call, please?

And lastly, Chair Vanver.

Here.

Everybody's here.

Okay. We're... You want me to? Yeah, I'll take you. I'll let you go.

Turn on your mic. First item on the agenda.

Chair, I believe your microphone is off. Sorry for the interruption.

Kurt, hold on. Turn your mic on. Thank you.

First item on the agenda is approval of the agenda.

Motion to approve. Second.

Second. Got a motion to pass and second. Any discussion? All those in favor say aye.

Aye.

All those opposed? Motion carried.

An abstention since I was not here.

Next item is a consideration of the minutes of the September 16th, 2025 minutes. Has everybody had a chance to review them? If so, are there any additions or corrections?

Motion to approve.

Second. A motion's been made to approve and has been seconded. Is there any further discussion? Hearing and seeing none, I'll call for the question. All those in favor, say aye.

Aye.

All those opposed? Motion carried. Public comments. Do we have any public comments?

We did not get any via email to the city clerk's office, and there's no one in the audience for this evening.

Oh, okay. I noticed on here it says that the public comments will be received until 1 o'clock.

Hmm.

1 p.m., okay, we'll skip that. New business, consideration of a claim payment for left member number 31027.

Yes, I will take this from here. We have a ongoing and a prior prescription request for reimbursement. So this particular left member requests coverage for a prescription called ZepBound, which is a trizipetide. As everyone knows, it is more generally referred to as a GLP-1. Currently, the city's and Medicare, or no, this particular individual doesn't have Medicare for prescriptions, excuse me. The city's medical does not cover GLP-1s for the intended use of this particular individual. The individual's doctor did write a letter of necessity just explaining why this particular individual why they believe this particular individual would immensely benefit from this. The current amount is $1,961.69 with a potential ongoing amount of $404 monthly. So there is some information in the back of the packet including the, Oh, there was supposed to be a letter. Anyway, I can provide that to you. My apologies. I am clearly a little rusty given that we haven't had a meeting in a year. So I do apologize. There is a letter that was supposed to be attached to this that says that it is medically necessary. And I can give that letter next time as well. I do apologize that that letter is not on. on this particular Mr. Chairman, if I may.

Because it says it's so that letter is from the physician.

Yes.

Okay.

I don't Yeah, sorry. It says attachments. But when I printed the agenda item, it did not attach.

Should I go from that?

Is there First of all, we need a motion before we can discuss this.

I'll make a motion that we make that payment and continue the payments as long as the physician states that it is required. Under left one, I believe if something is recommended by a physician or a dentist, I don't think we have much of a choice but to accept those costs.

Yes, and I can confirm that the letter is from an accredited physician. The physician did state it was due to a multitude of items that the person is experiencing, including a high BMI, sleep apnea, diabetic issues, and just required for weight loss, for a significant amount of weight loss.

Did we get a second for the motion? Yes, I'll second. Ken seconded. Okay. I guess, Dana, I'd like to, personally, I'd kind of like to see the letter.

Oh, yes, absolutely.

I do apologize. It will cause diabetes, so I'm kind of confused as to... Say that again.

I'm sorry.

Pardon?

Can you say that last sentence again? I missed it.

You said something about alcohol.

Okay.

He said something causes diabetes.

What's the, has anybody else got any questions?

Okay. You were asked to repeat your sentence about alcohol. Could you repeat that?

Yes. I said it's not, well, it's not uncommon for people that have a drinking problem to have diabetes.

I think he's getting the second request mixed up with the first one.

Are you confusing the first request and the second request? Because the second one is a dependency on alcohol. The first one has nothing to do with alcohol.

Okay.

At least, yeah, there was nothing in the doctor's note that stated anything about alcohol abuse for this particular member, for the ZEPP bound.

Well, I have to apologize. I'm a little bit confused. Aren't we on the first one that has to do with the alcohol?

No.

The second one.

The second one? If I may, Chairman, we are on employee and retiree name 31027, which is the first one in our agenda here.

Okay. And my question is, I was trying to go through this stuff in a hurry this morning, and I got it mixed up.

My question is, is this a local state of Washington physician or is this retiree out of state?

This particular retiree is out of state.

Thank you.

Mr. Chair, I have a question. And maybe Dana can help me with this one. Just out of curiosity, is there a reason why our insurance does not cover this? Do you know what that reason might be?

Yes. So for what I have discussed with our current... medical provider brokers. So there's people who go out and get the medical coverage for the city. And they have explained that there is, because it's so new, it's not FDA approved for weight loss necessarily, although it is currently being tested for weight loss. And obviously they're seeing a lot of really great things come from it. I think in particular for people who are experiencing a multitude of variable health concerns like this individual, it's probably beneficial to their health as why the doctor prescribed it. But basically it's a cost issue at this point, why the city doesn't cover it because it is quite expensive, but because your group is rather small and we do get funds from the state of Washington for the left members, we have a little bit more leeway with this particular coverage. Whereas like regular city employees would not get coverage for this. They would have to pay out of pocket for that.

Did that answer your question? That did. Do we have enough in our budget to cover this indefinitely?

Yes. I mean, I think as the population of the left board members increases, as it hopefully will continue, that you guys all potentially could have greater health benefits. health concerns and greater medical bills. But as of right now, we have not reached, I looked back at our left one medical budget, and we have not exceeded our left one medical budget for more than a decade. So I think at this point in time, the $404 ongoing monthly would not be detrimental to the left board medical budget.

If other left board individuals needed the same thing, could we also provide this and medical coverage for other issues that may arise? I still believe so. Yes.

Okay.

So there's currently 35 LEF and fire pension members who utilize this. Fire pension has their own little subsection, but they are still on our medical plan. But with the LEF members specifically, we only cover the employee. And so... the member themselves. And so it is nice. And then if you have, uh, Medicare prescriptions, it is covered. They just announced something as of July 1st, that these are now covered through the Medicare, um, prescription plan, but some members don't have the Medicare prescription plan. So this is kind of where we come in. Okay.

Thank you.

I have a question if I may, um, Have you had a chance to do research if any jurisdictions in the state of Washington cover this?

So at this moment, I don't believe any jurisdictions cover it for their employees. On the left side, I'm not entirely sure. This is still really, really new. I can reach out to some contacts and ask them what they've done, and we can return back. But yeah, as of today, cities and local government agencies, this is something that is standardly not covered under the standard medical for employees.

A couple of questions. One to tag, actually not a question, a comment to tag off of that. I had the same question and just did a quick search and kind of tried to find if there was any, and it seemed similar to what you responded to, or how you responded is that it's new enough that, and these board proceedings are obscure enough that it isn't something that's newsworthy necessarily that makes the rounds with being public knowledge. Also, I found that $400 is actually fairly inexpensive, that the typical price is more like $1,300 a month. So this is – it's a discounted, probably a manufacturer's savings rate of some kind. Yes.

And this individual, when they initially – when they initially went on it, as you can see on the breakout, it was closer to $750. And this individual went out on their own and found a cheaper manufacturer's discount to bring it down to the $404.

And my question tied to that was, I don't imagine it's the case that it could go up, but is there a a procedure, something like if the price suddenly radically increased for whatever reason, would there be a review of the reimbursement?

So you guys can also, yes, we could absolutely do that. But you guys can also say that we approve the reimbursement up. yeah, of $404 a month ongoing. We can also put a timeframe attached to this. So it can be, we're going to approve this for one year. And in one year, this individual needs to come back to the board and request it again and kind of also have another letter of necessity because after a year on this medication, you could assume that maybe the individual is doing significantly better and not necessarily as medically, it may not be as medically necessary to continue on with this. So you can approve it up to a certain dollar amount. You can approve it up to a certain timeframe and then ask the individual to come back.

I got a question. Is this drug injection FDA approved?

It is FDA approved for diabetic use. And then what they're currently testing it for is for weight loss use. So the medication is FDA approved. And this particular individual does have diabetes as written on the letter of medical necessity from the doctor, which again, I sincerely apologize. I thought it printed with the packet. But I can provide that to you all afterwards. But basically, it just states that diabetes is one of the things that will be treated. But I don't think that... I'm not entirely sure what the doctor's rating is for...

This person doesn't have diabetes. They do. They do have diabetes.

Yes, they do. But I don't know if there's a threshold in which... our plan pays for it or doesn't pay for it. I don't know how, I don't know where that line is as I'm not a doctor, but their doctor has said that this is something that they want this particular person to be on.

Okay. My perception is we need more information, but I'm going to go ahead and call for the questions.

I'd like to make an amendment to include paying the fee for up to 12 months and then have that individual come back and reapply. We'll just touch base again in a year.

Do you need a second on that? Yes. I will second that.

Okay. It's been moved and seconded that we review this after one year and see if it's doing any good. Okay, so I'm going to call for the question as amended, the motion as amended. Is there any further discussion on the amendment? Hearing none, all those in favor of the amendment say aye.

Aye.

Opposed? Okay, all those in favor of the motion as amended say aye.

Aye.

Those opposed? Motion carried.

Okay, so now we're going to move on. In this one, I did put all the backup in that I redacted, which I did not do with the other one, which I absolutely will send out just so you guys have that information. Anyways, okay. This one is for a... reimbursement of an alcohol treatment program. So the total amount that the individual paid was $11,458. Again, this is for an alcohol treatment program. This particular individual paid has successfully completed that program in 2021. And this person is still abstaining from alcohol. So safe to say that this worked for this particular individual. And they did have attached, there is a HMA denial. Basically, HMA does not pay for these sort of things. Um, and so the person did get a lot of their ducks in a row. This was also something that my predecessor, Kathy McClay, for those of you who remember her, um, let me know was possibly coming up, but it was COVID. And I think this particular individual was dealing with some deaths in the family. And unfortunately we, and wasn't able to get all of the information that they needed and brought this to me earlier this year. I then went back to that person and said, hey, I'm going to need more. And so they dug up more. They brought me more. I went back to that person and said, The left board still will need more. And so they got all of the information that they needed. So it took us a little bit of time, but it's finally wrapped up. And I got all the information that I felt like would be pertinent to you all to make a decision.

And I realized that I had to rush through this stuff this morning and I didn't have a good time to read it. fully, but I don't remember seeing anything from a doctor saying that it was medically necessary.

Did I dismiss it?

It is on page 12. It says that they were admitted into the program by Lakeside Millam. So I don't, there wasn't like a necessarily, oh no, sorry, excuse me, page 11. It says it is recommended blank to attend inpatient treatment for alcohol abuse. And that was from the Summit View Clinic.

May I make a comment? Yes. I'm really proud of this individual for getting the help they needed and for staying sober even till today. I'd like to make a motion to cover these costs.

Do we have a second? I will second that. It's been moved and seconded to cover the payment for member number 32037. Is there any further discussion?

Is this a one-time bill? There's nothing ongoing after this?

No. At this point, there is nothing ongoing, and if anything arises, I will let you guys know that this would be a second time that this particular person came to the board with a claim like this, so that you guys are aware of the history there.

If I may, Chairman, I agree with Councilman Gillian that this was 2021, and this individual evidently has remained sober for five years. So I think that's great. So I highly recommend a vote of yes. You recommended what? I just recommended we pass this.

May I interject here? Any further discussion?

Yes, if I may.

Go ahead.

Just for the sake of, I'm learning as I do this, so I appreciate your patience with me. I understand there's a 90-day filing period for something like this, but you said because of COVID and you had a predecessor and deaths in the family and things like that. Is that something that we do have as a 90-day sort of filing period for this? We don't have that for this kind of thing?

No, at least for the leftward. I mean, you guys can decide whether or not it is... they've kind of missed the mark and kind of move forward with that. But in the bylaws, there's no stipulation for a timeframe, at least from my understanding. Please correct me if I'm wrong. But when I read the bylaws that there wasn't like a, a timeframe in which to apply for reimbursements, it's really subjective and it's up to you all as a group to kind of decide whether or not it's too old. this is too, if they're extenuating circumstances, things like that. Exactly.

So we have, and I am also just flipping back through, do we have, um, and I don't know that there even would be such, Oh, look, there it is. Okay. Yeah. The, I, what I was looking for was that itemized sort of list. And even though it's, that'd be a really hard thing I would imagine to, uh, sort of quantify exactly what's happening in a residential treatment for chemical dependency, but that there it is. So, yeah. And then I think, do we have any documentation from HMA about why it was?

So, yeah. So the letter from HMA denying it, um, basically it's on page 10, but, uh, HMA does not cover, um, It just says it's based on medical necessity provision, which I'm not entirely sure why that is, but it says experimental treatment, although I know Lakeside Millim is a very prominent alcohol and substance abuse clinic in this area. So I'm not – again, I'm not entirely sure. And due to HIPAA laws, I don't know all of the ins and outs of it. I just have the denial letter basically stating that – there's other things that have been denied and it's just on, you know, sometimes it's just, I don't know if the, if it wasn't, I'm not entirely sure if this is covered honestly in ours. It is, but I'm not entirely sure for what reason and what you have to code it as. So again, um,

Thank you. Sorry.

This is new for me, too. This particular one is really out there for me, so I don't know a lot about...

I feel like a relief of financial stress certainly couldn't hurt a person's sobriety, so I also would tend to suggest that we vote in favor of reimbursement for this individual.

If I may say just a side note regarding the time frame, I think this one is actually beneficial because it stayed sober that long. And so it helps us to look at it and say, no, they've fallen off twice and started again. You know, this one has stayed. So I think that is beneficial.

Often questions.

Questions been called for. Okay. All those in favor, say aye.

Aye.

Those opposed? Motion carried. And next item is a staff report.

Okay, so that would be me. We are working on updating the bylaws. They are... Archaic at best. They're quite old. So Kurt and I have been working. I have it. Kurt gave me a printout version of all the bylaws and I am going through and updating those particular items. I'm hoping by the next meeting, I'm hoping the meetings aren't just once a year meetings. because this really is a lot to come on and only have once a year, that we can, maybe we'll just schedule a meeting to discuss the changes to the bylaws and get that going. And then we can talk about the updates. So most of them will just be basic, you know, cleanup language stuff that we don't do anymore. We do not post the meeting in the Puyallup Valley Herald because that does not exist anymore. So there's things like that that are just really outdated. And then, yeah, so Kurt has gone through it. I'm going to go through it. And then Um, city clerk's office is just helping kind of update, uh, the language, uh, but nothing will be finalized until you all have a chance to look at it and approve it. So a redlined version will come to you. I promise I'll send it out on, I don't know what's happening to me. Anywho. Um, so, but we'll get there. Um, and then, uh, and we'll have, um, uh, a meeting and it might be helpful just to have a meeting just on the bylaws and updating the bylaws. So, um, Um, if there's anything in particular, uh, that you guys see is outdated, um, like I said, Kurt's already gone through it with a fine tooth comb and it looks like pretty spot on from what I can tell what I would have updated. So I think that just standardly, it's just good practice to have those be, I think the last time they were updated was 2011. So it's been a little bit, so.

Yeah, we've taken a shot one at a time at some of them, but there's just so many of them that aren't even, they're archaic.

They're archaic.

And everything's been updated. Yes.

Mr. Chair, if something's come to mind that's not on the agenda, I probably should have put it on, but that is you attended the conference in May. Yes. Was there any big item that maybe we should be aware of that went on at that conference?

there was some pretty good presentations on PDS and stress and the effects that happened later on down through the careers. And it's really tough because some of this stuff, the left statute says reasonable, necessary medical expenses, but the left statute also has some things in there that cover abuse and it's a really complicated process that we need to go through and this is the first time we've seen either one of these cases and I would say that we need to get some more information so that we can make a better, I don't want to say a better choice, a more educated choice. But there was some real good presentations over there. I will have to tell you that it ended up with a lot of the time being dedicated to the left statute and what's going on with the money grab out of there, the $3.1 billion. And it started getting into one of the things... is there's the old... Now, Puyallup doesn't have an old police fund, so you wouldn't be covered by this, but the old fire and relief pension fund, because of that, there's a provision in there to collect taxes. And there's a share of the property taxes that go into that old pension system or are designated to go into it. There's also a millage off... The city of Puyallup's fire insurance, not the city of Puyallup's, anybody that lives in the city of Puyallup, their fire insurance premiums, part of that goes into a big fund. And there's a lot of money available. And Seth Miller, who is from the Department of Retirement Systems that made a presentation, I'll be honest with you, I flat-assed him. I stood up and asked him, okay, if they take this pension fund and make the changes they're talking about, is the state going to leave those money still going to the cities? And he said, absolutely not. He didn't even hesitate. So obviously they've thought about it. And then when Matt Smith gave his presentation, the state actuary, I asked him the same question. He said the same thing without hesitation. So there was a lot of good discussion this year. And there was, of course, no decisions made, but there was a lot of good education. And it wasn't just on single topics. I had something else I was going to tell you, but I can't remember what it was.

You could email it.

What happens at 82? Okay, is there any further business to come before the board today? Okay. Hearing and seeing none, I would entertain a motion to dismiss.

So moved. Second.

Moved and seconded. All those in favor, say aye. Aye. All those opposed? Motion passed. Sorry about being late, folks. I had a long drive.