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HomeMy WebLinkAbout#4162 Administrateve procedure for assessing and determining claims under PSEBA CITY OF CANTON ORDINANCE NO. 4093 AN ORDINANCE ESTABLISHING AN ADMINISTRATIVE PROCEDURE FOR ASSESSING AND DETERMINING CLAIMS UNDER PSEBA PASSED BY THE CITY COUNCIL OF THE CITY OF CANTON THE 2 nd DAY OF JANUARY 2018. PUBLISHED IN PAMPHLET FORM BY AUTHORITY OF THE CITY COUNCIL-OF THE CITY OF CANTON, FULTON COUNTY, ILLINOIS, THIS 2 nd DAY OF JANUARY EFFECTIVE: JANUARY 2, 2018 ORDINANCE NO. 4093 AN ORDINANCE ESTABLISHING AN ADMINISTRATIVE PROCEDURE FOR ASSESSING AND DETERMINING CLAIMS UNDER PSEBA WHEREAS, the legislature granted non-home rule municipalities, such as the City of Canton, the broad authority to pass all ordinances and make all rules and regulations proper or necessary,to carry into effect the powers granted to municipalities (65 ILCS 5/1-2-1); and WHEREAS, while "non-home rule municipalities have the authority to enact ordinances, such ordinances may in no event conflict with state law or prohibit what a state statute expressly permits . . A local ordinance may impose more rigorous or definite regulations in addition to those enacted by the state legislature so long as they do not conflict with the statute." (Village of Wauconda v. Hutton,291111. App 3d 1058, 1060 (1997)); and WHEREAS, the Public Safety Employee Benefits Act ("PSEBA" or "Act") was enacted in 1997 to provide free health insurance benefits when a "full-time law enforcement, correctional or correctional probation officer, or firefighter, who suffers a catastrophic injury or is killed in the line of duty".(820 ILCS 320/10(a)); and WHEREAS, Illinois courts have noted that the legislature made certain PSEBA benefits contingent upon the existence of a catastrophic injury however, the Act does not define what qualifies as a catastrophic injury(Krohe v. City of Bloomington,204111. 2d 392, 395 (2003)); and 2 WHEREAS,Englum v. The City of Charleston, 2017 IL App (4th) 160747 (2017) found that a non-home rule municipality's ordinance establishing an administrative procedure for assessing claims under PSEBA complemented the determinations of the legislature by enacting a procedural process to fulfill the substantive requirements of the Act and such an ordinance facilitate[s] the purpose of the Act; and WHEREAS, the Court in Englum found that non-home rule municipalities have the authority to enact an ordinance establishing a local administrative procedure to determine eligibility. for PSEBA benefits; and WHEREAS, as a result of the decision in Englum, the City of Canton now desires to adopt the following ordinance and finds that it is in the best interest of the citizens' health, safety, and welfare. NOW,THEREFORE,be it ordained and enacted by the corporate authorities of the City of Canton as follows: Section 1. PURPOSE. 1 The purpose of this ordinance is to provide a fair and efficient method for determining the eligibility of a full-time employee for the benefits enumerated under PSEBA through an administrative process, including if necessary, an administrative hearing. 2 Section 2. DEFINITIONS. For the purpose of this Ordinance,the following terms will have the following meanings. These definitions are derived from the federal Public Health and Welfare Act,which was enacted in 1944 and amended in 1984 to define,by inclusion or reference,the following terms. For use in this Ordinance,provisions containing the words"mayor," "commissioner," "alderman,"or"city council"also apply to the president,trustee, councilmember and boards of trustees so far as the provisions are applicable to them. Catastrophic injury An injury, the direct and proximate consequences of which permanently prevent an individual from performing any gainful work. Gainful work Full- or part-time activity that actually is compensated or commonly is compensated. Injury A traumatic physical wound (or a traumatized physical condition of the body) directly and proximately caused by external force (such as bullets, explosives, sharp instruments, blunt objects, or physical blows), chemicals, electricity, climatic conditions, infectious disease, radiation, virii, or bacteria, but does not include' (1) Any occupational disease; or (2) Any condition of the body caused or occasioned y stress or strain. Section 3. APPLICATION PROCEDURE. As noted by the Court in Englum, "while the [Act] contained substantive requirements for section 10 eligibility, the [Act] contained no procedural requirements for determining whether a former employee met the substantive criteria." ¶ 55. This ordinance and the application procedure of this section establishes guidance on the proper procedural requirements for Public Safety Officers seeking PSEBA benefits in the City. A. Public Safety Officers, or family member(s) of an injured or deceased Public Safety Officer, ("Applicant") must file a full and complete PSEBA application in writing within thirty (30) days of filing a pension claim with the City or within thirty (30) days of the date of the adoption of this Ordinance in the event that an Applicant has filed for a PSEBA claim prior to the date of adoption of this Ordinance, whichever is later, if the 3 Applicant is seeking benefits under PSEBA. The City shall notify Applicant if the PSEBA application is incomplete and Applicant shall have five (5) days to remedy their application. Failure to timely file the full and complete application shall result in a forfeiture of the benefits under PSEBA by failure to properly submit a complete application. B. A complete PSEBA application includes the following: 1. The name of the Applicant, date of hire, detailed information regarding the incident, including information relating to how the injury was sustained in the line of duty (date, time, place, nature of injury, and other factual circumstances surrounding the incident giving rise to said claim); 2. The Applicant's firsthand knowledge explaining, to the City's satisfaction, how the injury/death directly resulted from: L Response to fresh pursuit; ii. Response to what is reasonably believed to be an emergency; iii. Response to an unlawful act perpetrated by another; or iv. Participation during the investigation of a criminal act; 3. A signed PSEBA medical authorization release which authorizes the collection of information related to the incident including,but not limited to,disability pension proceedings, worker's compensation records, and medical records and specifies the name and address for pertinent health care provider(s); 4. A signed PSEBA general information release specifying the name and signature of the Applicant or her/his authorized representative along with legal proof of said representation and name and signature of witness authorizing the collection of information pertinent to the incident review process; 5. The name(s) of witnesses to the incident; 6. The name(s) of witnesses the Applicant intends to call at the PSEBA hearing; 7. Information and supporting pension documentation filed with the appropriate pension board; 8. Information supporting the PSEBA eligibility requirements; and 9. Other sources of health insurance benefits currently enrolled in or received by the Applicant and/or family members if the Applicant is deceased. 4 C. The PSEBA application must be submitted to the City of Canton City Clerk located at 2 N. Main Street, Canton,IL 61520 in its entirety. D. The PSEBA application must be sworn and notarized to certify the truthfulness of the content of the information. A review of the application shall not occur until the application is complete. E. On the date that the PSEBA application is deemed complete by the City, the completed application shall then be submitted to the City as the Preliminary Record, and a copy of the same shall be date stamped and provided to the Applicant. F. Upon receipt of a complete application for PSEBA benefits,the City shall set the matter for an administrative hearing before a hearing officer to make a determination on whether to grant the Applicant PSEBA benefits based on the result of the administrative hearing. G. The Applicant will be given written notice of the date for the scheduled administrative hearing to be served not less than ten (10) days prior to the commencement of the hearing. If the Applicant, upon receiving written notice of the administrative hearing, cannot attend said date, the Applicant must contact the hearing officer in writing within seven (7) days after being served. The hearing officer shall establish an alternative hearing date which is within thirty (30) days of the original hearing date. Failure to appear at the administrative hearing shall result in denial of PSEBA benefits. Section 4. ADMIMSTRATIVE COMPOSITION. The administrative hearing shall be scheduled and conducted by a hearing officer whose authority and limitations are as follows: A. Authority of the hearing officer. The hearing officer shall have all of the authorities granted to her/him under common law relative to the conduct of an administrative hearing, including the authority to: 1. Preside over City hearings involving PSEBA; 2. Administer oaths; 3. Hear testimony and accept evidence that is relevant to the issue of eligibility under PSEBA; 4. Issue subpoenas to secure attendance of witnesses and the production of relevant papers or documents upon the request of the parties or their representatives; 5. Rule upon objections in the admissibility of evidence; 6. Preserve and authenticate the record of the hearing and all exhibits in evidence introduced at the hearing; and 7. Issue a determination based on the evidence presented at the hearing, the determination of which shall be in writing and shall include a written finding of fact, decision and order. 5 B. Hearing officer. The Mayor, with the advice and consent of the City Council, is hereby authorized to appoint a person to hold the position of hearing officer for each hearing on PSEBA benefits that shall come before this City. In making said selection,the following information should be considered, at a minimum: 1. The individual's ability to comply with the job description as set forth herein; and 2. The individual must be an attorney licensed to practice law in the State of Illinois and have knowledge of and experience in employment and labor law, general civil procedure, the rules of evidence, and administrative practice. Section 5. ADMINISTRATIVE HEARING. The system of administrative hearings for the determination of eligibility for benefits under PSEBA shall be initiated either by the City or by the Applicant after the submission of a full and complete PSEBA application. An administrative hearing shall be held to adjudicate and determine whether the Applicant is eligible for benefits under PSEBA. If the Applicant is found eligible,the benefits shall be consistent with the Act. A. Record. The City shall ensure that all hearings are attended by a certified court reporter and a transcript of all proceedings shall be made by said certified court reporter and a copy be provided to the Applicant within twenty-eight (28) days of the date of the administrative hearing. B. Procedures. The City and the Applicant shall be entitled to representation by counsel at said administrative hearing and present witnesses,testimony and documents,may cross- examine opposing witnesses, and may request the issuance of subpoenas to compel the appearance of relevant witnesses or the production of relevant documents. C. Evidence. The Illinois Rules of Evidence shall apply to the extent practicable unless, by such application, the Hearing Officer determines that application of the rule would be an injustice or preclude the introduction of evidence of the type commonly relied upon by a reasonably prudent person in the conduct of her or his affairs. Such determination shall be in the sole discretion of the Hearing Officer. The Hearing Officer must state on the record her or his reason for that determination. D. Final Determination. A written determination by the hearing officer of whether the petitioning Applicant is eligible for the benefits under PSEBA shall constitute a final administrative determination for the purpose of judicial review under the common law writ of certiorari. E. Burden of Proof. At any administrative hearing, the Applicant shall have the obligation and burden of proof to establish that the Applicant is eligible and qualified to receive PSEBA benefits. The standard of proof in all hearings conducted under this Ordinance shall be by the preponderance of the evidence. 6 F. Administrative Records. All records pertaining to the administrative process shall be held in a separate file under the Applicant's name with the City. Section 6. SEVERABILITY. If any provision of this Ordinance or application thereof to any person or circumstance is ruled unconstitutional or otherwise invalid, such invalidity shall not affect other provisions or applications of this ordinance that can be given effect without the invalid application or provision, and each invalid provision or invalid application of this Ordinance is severable. Section 7. CONFLICT OF LAWS. Where the conditions imposed by any provisions of this Ordinance are more restrictive than comparable provisions imposed elsewhere in any other local law, ordinance, resolution, rule or regulation,the regulations of this Ordinance will govern. Section 8. PUBLICATION OF ORDINANCE. The City Clerk shall publish this ordinance in pamphlet form. Section 9. EFFECTIVE DATE. That this Ordinance shall be in full force and effect on 2nd,January 2018 PASSED by the City Council of the City of Canton,Fulton County, Illinois at a regular meeting this 2nd—day of January,2018 upon a roll call vote as follows: AYE'S: Aldermen Justin Nelson,Angeila Lingenfelter,Tad Putrich,Angela Hale, Craig West, John Lovell,Chris Jump,Ryan Mayhew NAYE'S: None ABSENT: None APPROVED: 4V,&.*v ayor Kent Mc ell AT T: City Cle lana avley 7