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2008-811-Minutes for Meeting July 21,2008 Recorded 8/22/2008COUNTY NANCYUBLANKENSHIP,FCOUNTY CLERKDS CJ Z448'811 COMMISSIONERS' JOURNAL 08/22/2008 08:15:20 AM VIII I IIIIIIIIIIIIIIIIIII VIII 200 -813 Do not remove this page from original document. Deschutes County Clerk Certificate Page If this instrument is being re-recorded, please complete the following statement, in accordance with ORS 205.244: Re-recorded to correct [give reason] previously recorded in Book or as Fee Number and Page Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.orc MINUTES OF WORK SESSION DESCHUTES COUNTY BOARD OF COMMISSIONERS MONDAY, JULY 219 2008 Present were Commissioners Tammy Melton and Michael M. Daly; Commissioner Dennis R. Luke was out of the office. Also present were Dave Kanner, County Administrator; Erik Kropp, Deputy County Administrator; Timm Schimke, Solid Waste Department; Ronda Connor, Personnel; and David Inbody; Assistant to the Administrator. No representatives of the media or other citizens were present. The meeting began at 1: 30 p. m. 1. Discussion of 2008-09 Health Benefit Plan Renewal Considerations and EBAC Recommendations. Ronda Connor explained the proposed changes, which have been reviewed by EBAC and recommended for approval. (A copy of the recommendations are attached for reference.) DALY: Move approval of EBAC recommendations to the plan. MELTON: Second. VOTE: MELTON: Yes. DALY: Yes, 2. Discussion of Proposed Administrative Policy on Family and Medical Leave. Erik Kropp gave an overview of the item, which includes items requiring Board action. DALY: Authorize approval of Policy, as submitted. MELTON: Second. Minutes of Administrative Work Session Monday, July 21, 2008 Page 1 of 2 Pages VOTE: MELTON: Yes. DALY: Yes. 3. Economic Development Grant Requests. • Fair & Expo Center - Fair Bus Program • Bend Spay & Neuter Project - Educational Campaign • Sisters Organization for Activities & Recreation - Scholarship Because Commissioner Luke was not present, these were delayed until the Wednesday, July 23 work session. 4. Update of Commissioners' Meetings and Schedules. None were discussed 5. Other Items. None were discussed. Being no further discussion, the meeting adjourned at 2:55 p.m. DATED this 21St Day of July 2008 for the Deschutes County Board of Commissioners. -u. iC . R. Luke, Chair ATTEST: Recording Secretary Minutes of Administrative Work Session Monday, July 21, 2008 Page 2 of 2 Pages Tamln~r-(Bafiey) Melton, Vice Chair Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org WORK SESSION AGENDA DESCHUTES COUNTY BOARD OF COMMISSIONERS 1:30 P.M., MONDAY, JULY 21, 2008 1. Discussion of 2008-09 Health Benefit Plan Renewal Considerations - Ronda Connor 2. Discussion of Proposed Administrative Policy on Family and Medical Leave - Erik Kropp 3. Economic Development Grant Requests: • Fair & Expo Center - Fair Bus Program • Bend Spay & Neuter Project - Educational Campaign • Sisters Organization for Activities & Recreation - Scholarship 4. Update of Commissioners' Meetings and Schedules 5. Other Items PLEASE NOTE: At any time during this meeting, an executive session could be called to address issues relating to ORS 192.660(2) (e), real property negotiations; ORS 192.660(2) (h), pending or threatened litigation; or ORS 192.660(2) (b), personnel issues Meeting dates, times and discussion items are subject to change. All meetings are conducted in the Board of Commissioners' meeting rooms at 1300 NW Wall St., Bend, unless otherwise indicated. Ifyou have questions regardinga meeting, please call 388-6572. Deschutes County meeting locations are wheelchair accessible. Deschutes County provides reasonable accommodations for persons with disabilities. For deaf, hearing impaired or speech disabled, dial 7-1-1 to access the state transfer relay service for TTY. Please call (541) 388-6571 regarding alternative formats or for further information. 2008/2009 Health Benefit Plan Renewal Considerations EBAC Recommendations for consideration of vote by BOCC • Modify preventative care benefit to $750 annual allowance, with no age or frequency limitations. Reason: Highly encourage employees to utilize the preventative care benefit in order keep employees healthy and plan expenses minimized. Estimate of financial impact to plan: An additional $280,000 would be paid based on last year's claims. Additional claims could be expected based on the increase in the benefit. The intent would be that this additional expense in preventative care would offset further invasive treatments for conditions previously undiscovered. Approved by EBAC 06/17/2008. • Modify the Colonoscopy/ EBT benefit to 80/20 no deductible regardless of reason for acquiring service. Reason: Eliminate the two different ways for these services to be paid. This has been very confusing since the Alternative care benefit was opened up to include the screening of Colonoscopies and EBTs. Most common misunderstanding about our coverage. The out of pocket payment for the patient can vary greatly depending on the way the claim is billed. Estimate of financial impact to plan: It is unknown if this benefit would increase expenses given the current way the claims are paid with the alternative care benefit. A total of 67 colonoscopies and 10 EBTs have been performed since 08/01/07. Again, the intent with eliminating the deductible and alternative care issue from this benefit would to encourage proper early screening for early detection of issues. Approved by EBAC 06/17/2008. - 1 - • Remove CoPay from Well Baby Care and increase number of allowed visits to be consistent with the American Academy of Pediatric recommendations (10). Reason: CoPays are not required for other preventative care visits (those age two and over). Interest in consistency. Current plan limitation of eight visits requires employees to pay 100% of the two additional visits. Estimate of financial impact to plan: An additional $2,025 would be spent based the 135 visits that were paid since 08/01/07. It is unknown how much the expense of the two additional visits would be to the plan as it is unknown how many services are not being billed based on the plan limitation. Approved by EBAC 06/17/2008. • Remove 24 month waiting period for Organ Transplants for newborns. Reason: The intent of this restriction is on new people coming to the plan through employment or dependency. The intent is not to require a newborn to wait 24 months for a lifesaving transplant. Estimate of financial impact to the plan: Deschutes County has had no experience with an organ transplant, while these cases are rare; they are costly once a transplant is required. Approved by EBAC 07/15/2008. • Remove Alternative Care benefit from Stop Loss coverage. Reason: Realize premium savings on stop loss coverage. Treat the Alternative Care benefit the same as Vision and Dental. Estimate of financial impact to the plan: Estimated at a 3% savings to the Aggregate premium and %2% to the Specific premium. In this current plan year we would have saved $9,300.00 in the Aggregate premium and $21.65 to the Specific premium. Approved by EBAC 06/17/2008. • Increase to the Organ Transplant benefit -2- Reason: Benefit allowances do not reflect current trend in coverage. Could possibly hinder patient being considered for transplant. Estimate of financial impact to plan: Possibility to increase individual claim payout significantly. Approved by EBAC 07/15/2008 • Increase Orthodontic benefit Reason: Multiple requests for this increase Estimate of financial impact to plan: Based on claims paid in current plan year, plan would have realized $23,000 in additional expenses. Further expenses could be incurred based on attracting more people to the benefit. Approved by Renewal EBAC 07/15/2008. • Add language to the plan to allow for termination of coverage for fraud/ misrepresentation. Reason: Protection of the plan assets Estimate of financial impact to the plan: None Approved by EBAC 07/15/2008. -3- Informational Items for BOCC that require no action • Stop Loss Renewal Approved by Renewal Committee 06/20/08. Contacted HCC and locked in rates. Total Possible plan benefit expenses based on current plan year data: $330,000. This does not include an estimate for increased claims expense related to the increase to the organ transplant benefit, not the adjustment of the colonoscopy/ EBT benefit. • Add State-Mandated Benefits Reason: Required as a health insurer in the state of Oregon Items to be added: Pervasive Developmental Disorders ORS 743A.190 Prostate Specific Antigen tests and Prostate exams ORS 743A.120 Colonoscopy/Sigmoidoscopy ORS 743A.124 Cochlear Implants ORS 743A.140 Estimate of financial impact to the plan: Unknown • Change in Preferred Provider Organization Reason: Some significant errors with our current PPO. The possibility for ease of administration and reported additional discounts received by the plan. Estimate of financial impact to the plan: Currently unknown- will report back. Investigate further -for January eNbct%ve mate an _nssructic. of renew'ai committee on 06/20/2008. • Add marriage and family counseling as a benefit in the outpatient mental health benefit Reason: Multiple requests for this benefit -4- Estimate of financial impact to plan: Currently unknown- will report back. Pended by renewal committee 06/20/2008 for further investigation into EAP alternatives • Coverage for Chinese herbs and supplements Reason: Request from employee Estimate of Financial impact to plan: Unknown Renewal Committee declined to consider addition of benefit on 06/20/2008 -5- ES, Deschutes County Administrative Policy No. HR-X 0 2{ Effective Date: TBD FAMILY AND MEDICAL LEAVE POLICY STATEMENT OF POLICY It is the policy of Deschutes County to comply with the provisions of the federal Family and Medical Leave Act (FMLA) and the Oregon Family Leave Act (OFLA). APPLICABILITY This policy applies to all eligible Deschutes County employees. POLICY AND PROCEDURES General This policy informs County employees about protected leave outlined in FMLA and OFLA. Whichever act provides the greater benefit to the employee will be applied. Although not every detail of these laws can be included in this policy, the County will administer protected leave in accordance with all applicable state and federal laws. Employee Eligibility FMLA To qualify for FMLA, an employee must have been employed by the County for at least 12 months and have worked at least 1,250 hours in the previous 12 months. OFLA To qualify for OFLA, an employee must have been employed by the County for an average of 25 hours or more per week for 180 calendar days before leave begins. However, employees taking leave due to the birth of a child or newly adopted or placed foster child become eligible after being employed for 180 calendar days, without regard to the number of hours worked per week. Qualifying Events for Leave a. Under FMLA, employees are entitled to take family medical leave in the following situations: 1) When the employee has a "serious health condition" (defined further below), which renders the employee unable to perform the functions of their position. 2) To care for a family member with a "serious health condition." Under FMLA, family member is defined as a spouse, parent, or child, or someone with whom the employee has an "in loco parentis" relationship. "In loco parentis" is defined as a person with whom an Policy No. HR-X, Family and Medical Leave Page 1 employee has developed a parent/child relationship in the absence of a biological or adoptive parent. 3) For the birth or adoption of a child, or for the placement of a child in foster care with the employee. This is often referred to as "parental leave." 4) Immediate family members (spouses, parents, and children) as well as next of kin (nearest blood relative) of an Armed Forces service member who suffers a serious injury or illness while in military service are entitled to take up to 26 weeks of FMLA leave to care for that service member during a 12-month period. The expanded leave to care for injured service members is only available during a single 12-month period. 5) "Any qualifying exigency" arising out of the fact that the spouse, son, daughter, or parent of the employee is on active duty, or has been notified of an impending call to active duty status, in support of a contingency of operation. "Qualifying exigency" may include child or elder care (even without a serious health condition), or helping the family member prepare for departure for duty. b. In addition, employees are entitled to take family medical leave in the following situations under Oregon law (OFLA): 1) To provide home care for a child under the age of 18 with a non-serious health condition, provided another family member is not willing and able to care for the child; or 2) To care for a child age 18 or over, parent-in-law, grandparent, grandchild, same-sex domestic partner, or child or parent of same-sex domestic partner who has a "serious health condition." Serious Health Condition A serious health condition means an illness, injury, impairment or physical or mental condition that involves: 1) Inpatient care (overnight hospital stay). 2) A critical illness or injury diagnosed as terminal or which possesses an imminent danger of death. 3) A period of incapacity for more than three consecutive calendar days, and any subsequent treatment period of incapacity relating to the same condition, which also involves: a. Two or more treatments by a health care provider, or b. Treatment by a health care provider on at least one occasion, with a regimen of continuing treatment (e.g., prescription drugs.) 4) Permanent or long-term incapacity due to a condition for which treatment may not be effective, such as Alzheimer's disease, severe stroke, clinical depression, or terminal stages of a disease. 5) Absences for pre-natal care or pregnancy-related disability. Policy No. HRA, Family and Medical Leave Page 2 6) Absences for "chronic" serious health conditions, including, but not limited to diagnosed migraines, asthma, diabetes or epilepsy. 7) Absences to receive multiple treatments for restorative surgery after an accident or injury, or conditions that, if not treated, would likely result in an incapacity of more than three consecutive calendar days without medical intervention or treatment. Some examples of relatively common conditions that might qualify for family leave are: 1) Outpatient surgery, when incapacitated for more than three calendar days and prescription drugs (such as pain killers, anti-inflammatories, or antibiotics) are prescribed. 2) Treatment for the employee or a qualifying family member for Alzheimer's disease, stroke, clinical depression, or the terminal stages of a disease. 3) Multiple recurring treatments such as chemotherapy or radiation treatments for cancer. 4) Absence for alcohol or drug treatment, if the employee is attending a recognized treatment program. Attendance in such programs does not negate potential employment action by the County in accordance with applicable drug/alcohol policies. Some examples of common illnesses which generally do not qualify as a serious health condition are: 1) Ordinary temporary conditions, including common colds, flu, earaches, hay fever and other nasal or sinus allergies, upset stomach, sore throat, headaches (other than diagnosed migraines), routine orthodontia or dental problems including periodontal disease and routine examinations. 2) Job or personal stress (mental illness resulting from stress may be considered a serious health condition). 3) Cosmetic treatments, unless inpatient care is required or complications arise. Duration of the Leave Qualifying employees are entitled to 12 weeks of family medical leave in a "rolling" 12 month period. A "rolling" 12 month period is determined by "looking backward" from the first day the employee will be out on qualifying leave. For parental leave, the 12 weeks of leave must be taken and concluded within one (1) year from the date of birth or placement of the child. The twelve weeks may be split into no more than two separate blocks of time. Under OFLA, additional time may be available for female employees who suffer from a disability resulting from pregnancy or childbirth, as well as additional time off to care for a child with a non-serious health condition that requires home care. Employees are encouraged to contact the Personnel Department to determine if they are eligible for extended leave time under these circumstances. When family members who are each employed by the County wish to take leave under this policy at the same time, their ability to do so may be limited in certain circumstances, such as when they wish to take Policy No. HRA, Family and Medical Leave Page 3 parental leave together or when they wish to take leave at the same time to care for a parent suffering from a serious health condition. When family members who are each employed by the County wish to take leave at the same time, they are encouraged to contact the Personnel Department to determine if they are eligible to do so. Concurrent Leaves To the extent permissible under law, OFLA and FMLA leave will run concurrently. However, the County will administer FMLA and OFLA policies in such a way that will provide the greatest benefit to the employee. OFLA leave cannot run concurrently with worker's compensation leave when an employee's absence is due to an on-the-job injury unless the employee has refused a suitable offer of light duty or modified employment. FMLA leave will run concurrently with a worker's compensation leave. Notice Required by Employee When the leave is anticipated, the employee must apply for family medical leave at least thirty (30) calendar days in advance of the leave by obtaining a "Family and Medical Leave Request Form" from their supervisor. Furthermore, if the leave is foreseeable, the employee must make reasonable efforts to schedule leave in a way that does not unduly disrupt the operation of the employee's department. If an employee fails to give at least thirty (30) days' notice of foreseeable leave, and has no reasonable excuse, the County may delay the start of leave until at least 30 days after the notice was actually given by the employee. If leave is required because of a medical emergency or other unforeseeable event, the employee must inform their supervisor within three working days so the form can be mailed to the employee. Completed forms are to be returned to the employee's supervisor so they can be forwarded to the Personnel Department to determine if the leave meets the qualification criteria. It is the responsibility of the employee's supervisor to ensure Family and Medical Leave Request Forms are completed and submitted to the Personnel Department as quickly as possible. When the Family and Medical Leave Request Form is received by the Personnel Department, and the condition is anything other than a serious health condition of the employee or family member, the employee will have a Family and Medical Leave Designation Notice mailed to their home. If the employee or family member has a serious health condition, the employee will receive a provisional Family and Medical Leave Designation Notice, and the county will require the completion of a Medical Certification Form. The Medical Certification Form must be completed by the employee's health care provider and returned to the Personnel Department within fifteen (15) calendar days from the date on the Family and Medical Leave Designation Notice. The County's designation of the leave under either FMLA or OFLA will remain provisional until the Medical Certification Form is received by the Personnel Department. Failure to provide the Medical Certification Form may result in denial of the rights and protections of FMLA and OFLA. If the serious illness is related to a family member, the attending health care provider must indicate on the Medical Certification Form that the employee is needed to provide care. When the medical certification is unclear, or its validity is in question, the County may require the employee or family member to obtain a second or third opinion at the County's expense. Policy No. HR-X, Family and Medical Leave Page 4 If the leave extends beyond a period of one (1) year, such as with intermittent serious health condition leave, the County may require periodic re-certifications by a health care provider that there is a continuing need for leave. If the family medical leave is for the employee's own serious health condition, he/she may, at the County's discretion, be required to furnish a "Release to Return to Work" from his/her health care provider upon return to work. Obligation to Designate Leave Deschutes County is obligated under the law to designate family medical leave when it becomes aware of a situation that clearly meets the leave criteria. It is the policy of Deschutes County that employees are to follow the above procedures for notifying the County of their potential leave. However, if the leave clearly meets the leave criteria, the County will designate the leave beginning the first day of absence for the qualifying leave. The employee cannot delay the start date of family medical leave by declaring the first part of leave as "vacation" leave. Confidentiality Supervisors are required to keep medical information confidential and FMLA/OFLA documents and forms in a file separate from the employee's personnel file. Intermittent or Reduced Schedule Leaves For serious health conditions, family medical leave may be taken on an intermittent basis or a reduced schedule if medically necessary. Details of the proposed schedule will be verified by the certifying medical professional on the Medical Certification by Physician or Practitioner Form. Intermittent leave or a reduced schedule is not allowed upon the birth or adoption of a child, except for the required legal process leading to the adoption of a child or the placement of a foster child. Upon department head approval, parental leave will be limited to two periods of time off, not to exceed 12 weeks, and must be concluded within one year from the date of birth or placement of the child. Status Reports While on family medical leave, the employee's supervisor is entitled to periodic reports of status and intent of return to work from the employee, at intervals determined by the supervisor. The supervisor must take into account all of the relevant facts and circumstances related to the individual employee's leave situation when considering such reports, how often such reports are required, and how such reports will affect the length of the employee's leave. Use of Accrued Leave Employees are required to use any available accrued paid leave beginning with the first day that they are out on a qualifying leave. Compensatory time may not be used until all other leave banks have been exhausted. During the leave period, the employee must continue to use allowable paid leave available to the employee before going on unpaid leave. If the day before and after a holiday are unpaid leave, the holiday will also be unpaid. Employees will not accrue paid leave during any part of their leave in which they are absent without pay. Policy No. HR-X, Family and Medical Leave Page 5 Tracking of Leave Employees are responsible for informing their supervisors of absences that are related to an FMLA or OFLA event. Both employees and supervisors are responsible for ensuring such absences are clearly noted on timesheets so the amount of FMLA/OFLA leave may be accurately tracked. Benefit Continuation Employees on family leave who are eligible for leave under FMLA will have their benefits continued under the same terms and conditions as when they were an active employee during the period of qualified leave. However, employees who are on unpaid leave that is covered only under OFLA are not entitled to have their health insurance paid by the County. An employee granted unpaid leave only under OFLA will be responsible for the entire cost of the health insurance premium while on OFLA leave, if the employee chooses to continue coverage while on OFLA leave. Employee contributions towards benefits will be made either through payroll deduction (when using paid leave) or by direct payment to the county (while on unpaid leave.) The employee will be advised in writing at the beginning of the leave period as to the method of payment and due date of premiums. Employee contribution amounts are subject to any change in rates that occur while the employee is on leave. Reinstatement Employees returning from family medical leave will be reinstated to the same or an equivalent position with equivalent benefits, pay and other terms and conditions of employment and employment status (for example, if the employee was on a work plan or had progressive discipline before the leave, these corrective steps will resume), unless their former positions have been eliminated in circumstances under which the law does not require reinstatement. The employee's restoration rights are the same as they would have been had the employee not been on leave. Therefore, if an employee's position would have been eliminated or the employee would have been terminated but for the family medical leave, the employee would not have the right to be reinstated upon return from leave. If an employee is on probationary status while on approved family medical leave, and the leave exceeds more than two weeks, the employee's probationary period will be extended by the length of the leave. Failure to Return from Leave An employee returning to work from family medical leave must return to his/her regular work schedule (the standard hours per month established for his/her position) unless a change or modification of the employee's schedule is approved in advance by the employee's supervisor before the employee returns to work. If an employee fails to return to work after exhausting family medical leave, his/her employment may be terminated in accordance with applicable laws, county policies, and union contracts. If the employee voluntarily terminates employment during an approved leave or does not return to work for at least thirty (30) days at the end of the leave, the employee may be required to repay the County for the employer-paid portion of the health insurance premium during any unpaid FMLA period. This provision will not apply if the employee is unable to return to his/her regular work schedule for reasons beyond the employee's control, such as severe deterioration of the health status of the employee or the family member, or the employee elects retirement. If failure to return is due to continuation, recurrence or onset of a serious health condition, medical certification may be required within thirty (30) days from the date the County requests the information. Policy No. HR-X, Family and Medical Leave Page 6 Retaliation or Discrimination Employees are protected against retaliation or discrimination in any manner as a result of the exercise of the right to FMLA or OFLA leave. Any employee violating this provision is subject to discipline. Approved by the Deschutes County Board of Commissioners on DATE. Dave Kanner County Administrator Policy No. HR-X, Family and Medical Leave Page 7