Recent Court Decision Does Not Mandate LEOFF 1 Dental Benefits

Recent Court Decision Does Not Mandate LEOFF 1 Dental Benefits

Contrary to what you may have heard from your LEOFF 1 retirees, a recent Washington State Court of Appeals decision does not mandate dental benefits for all LEOFF 1 retirees. Snohomish County Fire District No. 1 v. Snohomish County, 115 P.3d 1057 (2005).

The decision is troubling, however, because it affirms the authority of individual disability boards to determine which medical and dental services employers must reimburse for their LEOFF 1 retirees – even if they go way beyond the traditional understanding of "necessary medical services."

The Snohomish County Disability Board established a dental benefit for the LEOFF 1 members under their jurisdiction. Snohomish County Fire District No. 1, one of the employers affected by the decision, filed suit challenging the discretion of the Board to provide dental benefits. After losing at the superior court level, the district appealed the decision to the State Court of Appeals.

The appeals court affirmed the lower court ruling that the Snohomish County Disability Board did not exceed the authority granted to it by the legislature in RCW 41.26.150(b) – that local disability boards have the authority to determine what are reimbursable "necessary medical expenses" incurred by LEOFF 1 members. 

The decision does not mean, however, that all disability boards are required to follow suit (although others already have). Each disability board can make its own determinations about medically-necessary expenses.

Disability boards are increasingly approving claims for services and procedures (dental care, assisted living expenses, etc.) that were clearly not anticipated when the benefit was first granted to LEOFF 1 members. That’s why it’s critical for you to make sure your disability board understands the impact of these costs on your budget, encouraging them to incorporate reasonable limits into their policies.

For example, the Disability Board of the City of Wenatchee adopted a long-term care policy intended to rein in skyrocketing nursing home costs for LEOFF 1 retirees. Under the policy, the City's costs are limited to the average per-day rate of three long-term care providers located within the greater Wenatchee area. The Board also established a $4,000 monthly limit for in-home or assisted living care, and specified that in-home services do not include those of a custodial or housekeeping nature such as house cleaning, laundry services, recreational companionship, and other similar tasks.

Along with efforts made at the local disability board level, AWC continues to explore potential legislative solutions to help ease the financial burden these medical and long-term care costs have on local government budgets.

For a copy of the Snohomish County decision or the Wenatchee long-term care policy, contact Deanna Krell at AWC at deannak@awcnet.org.