COMMITTEE
OF THE WHOLE
May 8, 2008
** NOT APPROVED **
The meeting was called to order at 7:00 p.m. by Chairman
Curtis W. Crandall, who then led in the Pledge of Allegiance to the Flag. Invocation was led by Mr. Pullen.
Roll Call: Chairman C. Crandall, G. Benson, D. Burdick, W. Dibble, D. Fanton, W.
Hall, T. Hopkins, K. Kruger, M. McCormick, T. O’Grady, D. Pullen, B. Reynolds,
D. Russo, R. Truax, N. Ungermann
Others
Present: A. Finnemore, P. Gallmann, R. Hall, J. Margeson, T.
Miner, B. Riehle, R. Swarthout, W. Tompkins;
Media: K. Doyle, Olean Times Herald; B. Quinn,
Wellsville Daily Reporter
Guests: Insurance Representatives: Richard
Ewell, Richardson & Stout Insurance; Ron Oettel, Regional Director,
Provident Benefits;
Allegany
Allegany
Volunteer Firemen’s Association of
Chairman Curtis W. Crandall’s Opening Remarks:
Chairman Crandall introduced the guests, and summarized
that the purpose of the meeting was for an insurance presentation and to
discuss thoughts and ideas and field questions from the emergency responder
groups. Those attending from the three
groups listed above represent 1,278 Volunteer Firemen and 174 Emergency Medical
Service personnel.
Sheriff William R. Tompkins’ Comments:
Sheriff Tompkins spoke on dispatch communication issues. He gave an update about what they’re doing in
the
Chairman Crandall commented on the excellent conversation
at the Public Safety Committee meeting on May 7 with the Sheriff, Russ Hall, and
the Legislators, about
Insurance Presentation:
Richard L. Ewell, Richardson & Stout Insurance, was
recently asked by a fire company about accident insurance. Provident has the most comprehensive policy Mr.
Ewell could find. This is important
coverage, and he felt all the emergency responders in the County should have
it. He gave a presentation at the
Personnel Committee meeting and was asked to come tonight.
Ron Oettel, Regional Director, Provident Benefits, gave a
short history of the agency and summarized benefits provided for emergency
services organizations. In the
beginning, their coverage looked like Workers’ Compensation, but then evolved
into supplemental coverage to fill gaps in Workers’ Compensation coverage. Provident provides financial benefits for
firefighters and their families if they are hurt or killed while serving their
communities. All classes of membership
are covered. The definition of when
coverage is provided is very broad, including all normal activities of the
organization, beginning when the insured interrupts his normal routine to act
on behalf of the organization and ending when he returns to normal activities. Coverage is also provided for heart attacks
and when acting in the capacity of a “good Samaritan,” providing the action is
within the scope of training. A
highlight of the five major benefit categories includes:
1. Death
Benefit or “Principal Sum” of the policy
·
In the event of a
death from a covered injury or illness, the Principal Sum would be paid to the
beneficiary
·
The Principal Sum
amount is the benefit limit for many other benefits in the policy such as
Dismemberment, Permanent Physical Impairment, and Cosmetic Disfigurement from
Burns
·
Numerous other
benefits fall under the “Death Benefit” section
2. Impairment
Benefits
·
Dismemberment
Benefits, Loss of Vision, Loss of Hearing
·
Permanent
Physical Impairment for Injuries and Illnesses
3. Income
Protection
·
Pays Weekly
Disability Benefits for covered injuries and illnesses
·
Total
Disabilities caused by injuries are payable up to your lifetime
·
Total
Disabilities caused by illnesses are payable up to age 67 or five years,
whichever is greater
·
Partial Disabilities
are payable up to age 67 or five years, whichever is greater, or normal
retirement age
·
First Week
Disability benefit of up to $1,000 in all policies
·
Cost of Living
Adjustments allow your benefit to grow to 300 percent of the original limit
4. Medical
Expense
·
Provided for
Injuries and Illnesses
·
Plastic Surgical
Expense Benefit
5. Family
Assistance
·
Hospital
Confinement
·
Family Expense
Benefit – if you need medical treatment as a result of a covered injury or
illness, and any immediate member of your family accompanies you for treatment
or helps to treat you, we will pay reasonable and customary expenses incurred
including the lost gross wages of that immediate family member
·
Mental Stress
Management
·
Traumatic
Incident
·
Health Insurance
Premium Benefit
Mr. Oettel offered to do presentations at individual fire
companies. Provident’s policy would be
considered supplemental to Workers’ Compensation, with some benefits that
resemble disability, and some benefits that are stand-alone. Coverage is not contingent on Workers’
Compensation findings, and if Workers’ Compensation coverage is not there, they
are. Their claims service is the most
important aspect of the business.
Discussion with Fire Service Representatives:
Jeff Luckey thanked the Board for the invitation to
discuss concerns of the fire service agencies.
He provided copies of “Injured in the Line of Duty, A Volunteer
Firefighter’s and Ambulance Worker’s Guide to NYS Benefits” (copy attached to
original minutes). A listing of six main
issues or concerns that the agencies would like to have addressed was presented
by Mr. Luckey, Mr. Richardson, and Mr. Stearns:
1. Some
of the 1,278 Firemen and their families have lost faith in the Self-Insurance
system. How do we convince our members
to continue providing emergency service as we are trained to do? A fire chief recently remarked that several
members expressed concerns about coverage being provided if needed, and some
spouses don’t want them to participate because they may not be covered on
compensable cases. The agencies are
losing membership. It was already
difficult to recruit members due to multiple jobs and family responsibilities,
but now there is an additional challenge in finding new members when they are unsure
if coverage will be there when needed.
2. Would
you, the
(Department
name) hereby issues the following policy statement:
All
members are expected to remain on duty at all times when present within the
district, except when prohibited from responding as required by other policies
of the Department (such as due to alcohol or physical disability). It is the responsibility of any member of
this Department to become involved in a rescue when able to do so. The manner and method of how a member becomes
involved is up to that individual member, whether it be by rendering medical
aid, performing rescue services, calling 911, assisting in extrication, or fire
police matters. It is the full intent of
this Department that any member performing services to the public as a
firefighter shall be protected by all available insurances, including but not
limited to VFBL. Firefighters are hereby
authorized to take any necessary and reasonable action to protect themselves
and the public during an emergency, regardless of whether or not the Department
has yet been activated.
All
emergency services members expect to be covered by insurance when performing
services they were trained for. This covers
some of the “good Samaritan” idea.
3. Would
you consider having a committee set up to advise the Executive Secretary on
controverted decisions involving Fire Department claims if needed? Our suggestion would be to have one
representative each from the Allegany County Volunteer Firemen’s Association,
the Allegany County Fire Advisory Board, and the Allegany County Fire Chiefs’
Association. These members would be
elected by their associations annually.
This group would meet with the Executive Secretary and be able to give their
respective groups some insight as to how and why decisions are made the way
they are. This group would only
meet on cases that were controverted. We
would ask that department names and names of individuals involved be kept from
this group. Any member of this group
that has prior knowledge of an incident should be replaced with an alternate
member. The understanding is that
presently most controverted cases are decided by one person, and we are
interested in correcting the situation.
The blame or responsibility shouldn’t be placed on one person. The proposed committee would be allowed to
have input on how decisions are made and the opportunity to express
concerns. It would protect and keep open
the lines of communication in these cases.
4. When
a claim is filed, what is the procedure that the Self-Insurance Plan follows? Is there a certain dollar amount or type of
claim that changes this procedure? Does
the Executive Secretary have a written protocol? Emergency Services personnel are provided
with a manual that includes guidelines on filing forms in a timely manner, and
indicates that the Executive Secretary will then issue a decision on whether a
claim is payable, but it doesn’t state how.
The Executive Secretary obviously follows Workers’ Compensation Law, but
they have not seen the guidelines that are followed. They would like to have written guidelines to
give them a better idea of what is covered and how decisions are made.
5. We acknowledge
that there is a system in place to address Fire Department issues. But there has been a lack of participation from
both sides. The Public Safety Committee
changed their meeting times from evenings to days. This puts a burden on the Fire Advisory Board
representatives who have to leave their jobs to come to the meetings. Public Safety Committee members are not attending
Fire Advisory Board meetings. We feel we
need to have better communication and participation from the Public Safety
Committee.
6. There
have been concerns from our members about the radio system and procedures. We feel the basic system is good, but there
is room for improvement. Changes have
been made to procedures with no consultation.
We are still gathering information and welcome the Sheriff’s invitation
to conversation.
Chairman Crandall questioned if the concern is whether the
County is self-insured versus having a different insurance policy in place, or
how the Self-Insurance Fund is perceived to be handled and claims accepted or
denied. Mr. Luckey responded that it is
both. If the Self-Insurance Plan is
handled in a way that it appears to be a good policy, that’s good; but when there
is doubt or a question of whether a procedure is beneficial, there is a problem
with being self-insured. Chairman
Crandall noted that we could tie a couple of other concerns with this, such as
the formation of a committee to meet and talk about claims with the Workers’ Compensation
Administrator, ways to improve the self-insurance system now in place, protocol
for determining claims, policy, and procedure.
Chairman Crandall noted that he has learned through his own research
over the past year, that ideally it doesn’t make a difference whether the
County is self-insured or has a policy through an insurance company or independent
administrator; the determination lies within the Workers’ Compensation Law and New
York State Law. Interpretation and procedure
is where the question lies. Actually, if
the County was covered through a larger insurance company, there is the
conception that a lot of claims would just go through, when the opposite is true;
they often deny claims.
Mr. Reynolds noted that he appreciated Mr. Luckey’s comments
and realized that one place we fall short is not involving the firemen in
decisions. The advisory committee is a good
idea. Policies and procedures can be
given to the groups, but it would also be a good idea to involve them. The “good Samaritan” issue should also be
discussed to see what can be done. We
can work together to bring this to fruition.
Mr. Truax also agreed with the idea of an advisory
committee, and felt a representative from the Board of Legislators should also
be on the committee to bring issues back to the Board. The
Chairman Crandall commented that some of these ideas
sound good, but what seems practical and makes common sense isn’t always
possible if there is a legality that would preclude it. Also, knowing and clarifying the policy and
protocol for determination of claims as noted in #4 might address other
concerns like the loss of faith and the formation of a committee to work with the
fund administrator. Understanding policy
and procedure would be a good place to start.
Mr. Pullen noted that the Personnel Committee has never
voted or had any input on the processing of claims; the Board of Legislators
has nothing to do with it. Claims are
governed by Workers’ Compensation Law and coverage is defined by law. The County provides coverage identical to
what would be covered by an insurance company, but basically insurance
companies are in business to collect premiums, not pay claims. Claims don’t increase or decrease due to self-insurance,
which is not handling the coverage for profit.
Local communities ultimately pay for the benefits administered by the
program. No particular agency needs to
choose the Self-Insurance Plan, but can choose another company. The Self-Insurance Plan has been there for
years, and undoubtedly there are ways to improve the system, but the further
the insurance goes from the County, the less input and responsiveness we’ll
have. Mr. Pullen endorsed the services
of the County’s volunteers and recognized the need to address their loss of
faith, but reiterated that the existing Workers’ Compensation coverage is
defined by the New York State Workers’ Compensation Law, not this Board of
Legislators. The
Mr. Kruger noted that he attended a couple of Fire Advisory
Board meetings and was confused by the layers of coverage. Clarification is needed, and that will only
happen if we have a committee in place to carry information back and forth. It appears to the firemen that the Self-Insurance
Plan doesn’t like to pay claims. If
anything positive can come of this, it would be clarification of self-insurance
definitions and limiting the time period between claim and payment. Mr. Kruger supports the firemen’s efforts. Part of the problem with recruiting
volunteers is that they’re worried about what will happen if they’re hurt. If they were given a copy of the policy and an
explanation as to why determinations are made, it would be a huge step in avoiding
future problems and resolving some of their concerns. The core of this problem is lack of
explanation; even if the firemen don’t agree, at least they would have an
explanation. Mr. Kruger commented that
he appreciates the firefighters’ time. For
every ten hours of active service, seven are spent raising money to support
their activities, saving taxpayers’ dollars.
So it’s not just the up-front savings we see by their activities, but
the unnoticed time they spend supporting their own costs.
Mr. Luckey pointed out that the firefighters don’t have
an agent speaking on their behalf and pointing out critical points in Workers’
Compensation claim determinations. That
would be part of the idea of a committee, and he agreed with having a Board
member included. Chairman Crandall noted
that if the County ends up with a different system in place, either self-funded
or not, he’s not sure how the committee would work with a more remote agent or
company handling the claims. Everyone
might feel more comfortable and not need that input, but it also might not be
something practical from the administrator’s point of view, and maybe not even
legal. We need to look at how the Self-Insurance
Fund is administered now versus other ways to do it.
Mr. Wilson pointed out that if a person has a claim with
other insurances, the agent really doesn’t know what happened and right away
denies the claim. With self-insurance, you
may have to pay first and be reimbursed, but at least there is someone there to
talk to. It’s time for one of the legislators
that knows about insurance to take over the plan administration and have representatives
from all the groups work together. Phone conversations will not solve the
problems. Chairman Crandall commented
that no matter who makes the decision, whether it’s self-insurance with a local
administrator or an insurance company, with the insurance, it would be rare to talk
with someone making the decision. Mr.
Wilson stated that claimants will be better off talking with a local person,
rather than someone on the phone. Mr.
Truax commented that he would not support any change that didn’t include having
a local representative to talk to.
Mr. Pullen pointed out that when dealing with larger
insurance companies, there is a local agent that acts as a go-between. Our Self-Insurance Plan is small enough that
we have only the Executive Secretary and we don’t get to the level where an
agent advocates for the policy holder.
The problem is logistics and overhead for the program. However, Mr. Pullen doesn’t see the Executive
Secretary in an adversarial role; he is there to administer the program according
to the law. Self-insurance requires the
County and one other entity in the County to agree to participate. We have had good service at a good cost. Of course, we’re always trying to not have
claims and to avoid accidents, but the other part is that not every injury or
loss is covered under any policy. We’re
getting Workers’ Compensation coverage for what’s covered under the law. Previously the Personnel Committee directed
going to the Fire Advisory Board to address issues such as the definition of a member
and who is covered under Workers’ Compensation.
That’s only the tip of the iceberg.
Communication is needed, and we haven’t succeeded as well as we could
have. Mr. Luckey noted that the
committee idea would help with that communication.
Chairman Crandall questioned the wording of the sample
resolution in #2. At first glance, it
makes sense, but if the resolution goes above and beyond what the laws read, it
could be a major decision of this Board.
The resolution is in support of the firemen and expedience in clarifying
and administering what’s in the law, but if it goes on and uses the “good Samaritan”
idea and goes beyond what the law covers, we need to clarify the wording and
what the bottom line of the resolution is.
Mr. Luckey explained that “good Samaritan” is used only
to clarify that gray area of the period of time prior to the tones going off. If a fireman responds within his fire
district in the capacity as trained before the tones go off, he is acting in the
line of duty. They are not just covered
when the tones go off. For instance,
firemen are covered for attending meetings.
Mr. Luckey is covered for this meeting because he was asked to come
speak as a representative of his fire company.
This resolution would address that gray area of assisting someone prior
to tones going off.
Mr. Truax noted that the booklet handed out by Mr. Luckey
covers most of the situations referred to, regardless of tones, under the line
of duty section. He’s not sure if these
concerns will require a change in law, or just interpretation.
Mr. Pullen commented on earlier discussions he has had
with Mr. Luckey on when coverage kicks in, where it applies, and so on. Coverage depends on where the incident takes
place and where the fireman is a member.
There are state agencies and legal counsel that could help with drawing
up the language for legislation changes for this Board to review. That would be a good place to begin if we need
legislation from
Mr. Luckey requested that the
Chairman Crandall commented on the regular attendance of
Board members at the Fire Advisory Board meetings mentioned in #5. He apologized and noted there should be
someone from the Public Safety Committee or himself or a couple of legislators attending
on a regular basis. This concern is easy
to clear up and is very important. It
goes back to communication and to comments made by the Sheriff – we have to
know what the others are doing. Chairman
Crandall noted that he and the Public Safety Committee members are notified of
Fire Advisory Board meeting dates, and he will see that everyone on the Board
is notified. Mr. Kruger noted that no
Board member is attending EMS Council meetings, so legislators will need
notification of those meetings also.
Chairman Crandall remarked on the radio system and
procedures in the E-911 Dispatch Center, referring back to the Sheriff’s
comments. Some excellent points and
ideas were discussed in the last Public Safety Committee toward getting the
users of the 911 system to understand equipment changes and software updates. He pointed out that just a few years ago, if
there was an emergency situation someone ran next door or drove somewhere to
make a call and maybe a few neighbors called.
Now cars stop and make cell phone calls, and it’s not unusual for Dispatch
to receive a couple dozen calls. When the
need arises, it’s important that the technology and training are there, and it
all comes down to communication. For all
the cell phones, software, equipment, and the millions spent on technology for
communication on an instant basis, we still don’t have good communication
between ourselves.
Regarding the radio concern, Mr. O’Grady noted that about
five years ago, there was a committee to address communication which was spearheaded
by the Sheriff at that time. It seemed
to be a good channel of communication, and the only time for police and firemen
from different parts of the County to express their concerns with the
Sheriff Tompkins responded that one of his concerns would
be the additional time commitment for the volunteers, but it’s a great idea. With all the technology and equipment they do
have, they can address any issues or concerns.
The answer is there. He wants to
see the users, the Firemen and
Chairman Crandall felt these issues should be referred to
the Public Safety Committee, and he will speak with the
Chairman Crandall thanked those in attendance representing
over 1,200 firemen. Their membership constitutes
half of what the Self-Insurance Plan covers for employees and volunteers of the
County, Towns, Villages, Firefighters, and
Adjournment: the meeting was adjourned at 9:00 p.m.
Respectfully submitted,
Adele Finnemore, Journal
Clerk