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HomeMy WebLinkAboutAgenda - 02-21-2012-12bORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: February 21, 2012 Action Agenda Item No. r - ~ SUBJECT: Orange County Nursing Home Community Advisory Committee - Appointments DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Under Separate Cover INFORMATION CONTACT: Membership Roster Clerk's O~ce, 245-2130 Letter Of Recommendation Application(s)/Resume(s) of Person(s) for consideration Applicant Interest List Application(s)/Resume(s) of Person(s) on the Interest List PURPOSE: To consider making appointments to the Orange County Nursing Home Community Advisory Committee. BACKGROUND: The following appointments are for Board consideration: • Appointment to a second term for Mr. Elijah (Ed) Flowers, III. If appointed Mr. Flowers will be serving a second full term expiring 03/31/2015. • Appointment to a second term for Mrs. Patricia Revels. If appointed Mrs. Revels will be serving a second full term expiring 03/31/2015 Position Number S ecial Re resentation Ex iration Date 2 Mr. Eli'ah Ed Flowers, III At-Lar e 03/31/2015 3 Mrs. Patricia Revels At-Lar e 03/31/2015 FINANCIAL IMPACT: None RECOMMENDATION(S): Consider making appointments to the Orange County Nursing Home Community Advisory Committee. Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1st Monday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919 -558 -9401 Description: All appointments are made by the Board of Commissioners. This committee helps to maintain the intent of the Residents' Bill of Rights, promotes community involvement and provides public education on long -term care issues The regional ombudsman with Triangle J Council of Governments provides spwialized training and support. 1 Dr. Tracey Yap 834 Providence Glen Drive Chapel Hill NC 27514 Mr Elijah (Ed) Flowers, III 2 Chair 2813 Beckett's Ridge Drive Hillsborough NC 27278 Mrs. Patricia Revels 3 329 West King Street Hillsborough NC 27278 Ms. Sharon Karnash 4 5513 Quail Hollow Drive Hillsborough NC 27278 VACANT 5 Monday, January 30, 2012 Day Phone: 502.686.0016 Evening Phone: 919.240.4793 FAX: E -mail: tracey.yap @duke.edu Day Phone: 919 - 357 -9256 Evening Phone: 919- 357 -9256 FAX: E -mail: ED_FLOWERS @YAHOO.COM Day Phone: (919) 2414071 Evening Phone: Same FAX: N/A E -mail: prevels001 @nc.rr.com Day Phone: 919- 479 -5661 Evening Phone: same FAX: E -mail: Sharon.karnash @gmail.com Day Phone: Evening Phone: FAX: E -mail: Sex: Female Race: Caucasian Township: Chapel Hill Resid/Spec Req: At -Large Special Repr: At -Large First Appointed: 12/13/2011 Current Appointment: 12/13/2011 Expiration: 01/30/2013 Number of Terms: Sex: Male First Appointed: 03/06/2008 Race: Caucasian Current Appointment: 03/17/2009 Township: Hillsborough Expiration: 03/31/2012 Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: At -Large Sex: Female First Appointed: 03/06/2008 Race: Caucasian Current Appointment: 03/17/2009 Township: Hillsborough Expiration: 03/31/2012 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Sex: Female First Appointed: 06/12/2007 Race: Caucasian Current Appointment: 04/19/2011 Township: Little River Expiration: 06/30/2014 Resid /Spec Req: At -Large Number of Terms: 2 Special Repr: At -Large Sex: First Appointed: Race: Current Appointment: Township: Expiration: 06/30/2008 Resid /Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Page 1 N Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1st Monday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919 -558 -9401 Description: All appointments are made by the Board of Commissioners. This committee helps to maintain the intent of the Residents' Bill of Rights, promotes community involvement and provides public education on long -term care issues The regional ombudsman with Triangle J Council of Governments provides sptcialized training and support. Ms Verna Dunn Day Phone: 281 -855 -8551 Sex: Female First Appointed: 10/18/2011 6 Evening Phone: 281- 855 -8551 Race: Caucasian Current Appointment: 10/18/2011 503 Carl Drive FAX: Township: Chapel Hill Expiration: 09/30/2012 Chapel Hill NC 27516 E -mail: springfinal @gmail.com Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: Nursing Home Administration Ms Sarah Lowman Day Phone: 919 - 259 -0053 Sex: Female First Appointed: 06/01/2010 7 Evening Phone: same Race: Caucasian Current Appointment: 04/19/2011 316 Standish Drive FAX: Township: Chapel Hill Expiration: 06/01/2014 Chapel Hill NC 27517 E -mail: sarah_lowman@med.une.edu Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Dr. Mario Battigelli Day Phone: 919- 942 -5756 Sex: Male First Appointed: 03/16/2010 8 Evening Phone: Race: Caucasian Current Appointment: 04/19/2011 1307 Wildwood Drive FAX: Township: Chapel Hill Expiration: 03/16/2014 Chapel Hill NC 27514 E -mail: mcbattigelli @gmail.com Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Ms. Susan Deter Day Phone: 919 -682 -4124 Sex: Female First Appointed: 04/19/2011 9 Evening Phone: 919- 479 -0574 Race: Caucasian Current Appointment: 04/19/2011 5512 Quail Hollow Drive FAX: 919- 956 -7703 Township: Little River Expiration: 04/19/2012 Hillsborough NC 27278 E -mail: susiedeter @yahoo.com Resid /Spec Req: At -Large Number of Terms: Special Repr: At -Large Dr Mary Ann Peter Day Phone: 919- 732 -6073 Sex: Female First Appointed: 01/24/2012 10 Evening Phone: Race: Caucasian Current Appointment: 01/24/2012 118 W. Tryon St. FAX: Township: Hillsborough Expiration: 06/30/2013 Hillsborough NC 27278 E -mail: maryannpeter @earthlink.net Resid /Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Monday, January 30, 2012 Page 2 W Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other Ist Monday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919 -558 -9401 Description: All appointments are made by the Board of Commissioners. This committee helps to maintain the intent of the Residents' Bill of Rights, promotes community involvement and provides public education on long -term care issues The regional ombudsman with Trianoe J Council of Governments provides specialized training and support. VACANT Day Phone: Sex: First Appointed: 11 Evening Phone: Race: Current Appointment: FAX: Township: Expiration: 12/31/2010 E -mai1: Resid/Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration VACANT Day Phone: Sex: First Appointed: 12 Evening Phone: Race: Current Appointment: FAX: Township: Expiration: 12/31/2010 E -mail: Resid /Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Monday, January 30, 2012 Page 3 ,A 5 leanette Jones From: Charlotte Terwilliger <cterwilliger@tjcog.org> Sent: Monday, January 30, 2012 2:08 PM To: Jeanette Jones Subject: Reappointments to the NH CAC Dear Jeanette, I am sending this email to recommend two reappointments to the Nursing Home Community Advisory Committee. 1. Ed Flowers for a second full term. During the past 3 years Mr Flowers attended all of the business meetings and has actively participated in all of his assigned quarterly facility visitations. Mr Flowers is also currently serving as the committee's Chair. His leadership skills and his active participation are invaluable to the committee's success. 2. Patricia Revels for a second full term. During the past 3 years Ms Revels attended 10 out of 15 business meetings and participated in all of her assigned quarterly facility visitations. Ms Revels is a strong advocate for Orange County residents living in long term care facilities and is an important addition to our committee. Please let me know if you need additional information to move these recommendations forward. Thank you. Sincerely, Charlotte Charlotte Terwilliger Ombudsman - Orange and Chatham Counties Area Agency on Aging Triangle 1 Council of Governments PO Box 12276 / RTP, NC 27709 (o) 919-558-9401 / (f) 919-998-8101 cterwilli~er@tlcog.or~ / www.tico~.or~ Street Addresss: 4307 Emperor Blvd., Suite 110, Durham, NC 27703 E-Mail correspondence to and from this address is subject to the North Carolina Public Records Act and may be disclosed to third parties unless made confidential under applicable law. 1 6 Page 1 of 2 Elijah (Ed) Flowers, III Volunteer Appiication Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Mr Elijah (Ed) Flowers, III 2813 Beckett's Ridge Drive Hillsborough NC 27278 919-357-9256 919-357-9256 ED_FLOWERS@YAHOO.COM Duke University Hospital Senior Nuclear Medicine Technologist 2002 Hillsborough Male Caucasian Date of Birth: 2/10/1944 Boards/Commissions applied for: Work Experience: 1965 - 1970 Nuclear Medicine Technologist NC Baptist Hospital 1970 - 1976 Chief Nuclear Medicine Technologist Duke Medical Center 1976 - 1991 Technical Administrator - Nuclear Medicine - Duke Medical Center 1991 - present Senior Nuclear Medicine Technologist 1965 - 2008 Nuclear Medicine Technologist ~ Volunteer Experience: Durham Congregations in Action Yokefellows - Durham County - Alamance/Orange Counties Durham Nursery School Advisary Committee Blowing Rock Conference Center Board of Directors - Treasurer Orange County Nursing Home Community Advisory Committee (current), Senior Care Bears (current), Friends of the Orange County Public Library Yokefellows 1974 - current, Durham County Daycare Board of Directors (1973 - 1981), Blowing Rock Conference Center (1989 - 2003) Education: High School - Southwest Forsyth College - Mars Hill Radiologic Technology - North Carolina Baptist Hospital Nuclear Medicine Technology - North Carolina Baptist Hospital , High school - College - Radiologic Technology - Nuclear Medicine Technology Other Comments: 7 Page 2 of 2 Elijah (Ed) Flowers, III Extensive experience with regu~atory agencies (e.g., JCAHO, N.C.Radiation Safety, OSHA, Nuclear Regulatory Commission) Currently serving on the Nursing Home Community Advisory Committee, currently serving on the Senior Care Board of Directors. STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Community Advisory Committee on 11/18/2007. Applied 10/18/2010 for Advisory Board on Aging and Nursing Home Community Advisory Committee. ADDRESS VERIFICATION: 2813 Beckett's Ridge Drive, is Hillsborough Township, Hillsborough Jurisdiction. This application was current on: 10/18/2010 Date Printed: 1/30/2012 8 Page 1 of 2 Patricia Revels Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Mrs. Patricia Revels 329 West King Street Hillsborough NC 27278 (919) 241-4071 Same N/A prevels001 @nc.rr.com Retired (June'06) Hillsborough Hillsborough Twnshp - In City Limits Female Caucasian 9/29/1946 Boards/Commissions applied for: Work Experience: 30+years public education in TN,MS,SG,GA,KY 12years secondary classroom teacher--social studies 15years counselor (3 years k-8) (12 years secondary) 3years teacher/counselor in an Alternative School Volunteer Experience: Foster Care Services Meals-on-Wheels Tutor--Each-One-Teach-One Reading program) Adult Education--preparation for GED Friends of the Library, Orange County, Historical Foundatin of Orange Co. and Chapel Hill. Currently serving on the Nursing Home Community Advisory Committee. Education: M.A. Vanderbilt University (23+ hrs. graduate studies) B.A. George Peabody College For Teachers High School Diploma, Louisville, KY Other Comments: Advocacy for people who often lack the skills and resources to effectively speak for themselves has always been an important part of my personal and professional life. I look forward to serving and working with others on behalf of nursing home clients. I have lived in different states and have diverse experience working with all people. I support 9 Page 2 of 2 Patricia Revels use of the library in personal and professional life. STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory Committee 1/24/2008. Applied for Hyconnechee Regional Library 3/27/09. ADDRESS VERIFICATION: 329 East King Street, Hillsborough, is in Hillsborough Township in the city limits. This application was current on: 1/24/2008 11:36:09 AM Date Printed: 1/30/2012 10 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Charlotte Terwilliger MSW Nursing Home Community A dvisory Committee , Contact Phone: 919-558-9401 MS. ViCICl B1II'1rigeT Day Phone: 919-971-9333 Sex: Female 3612 Old Vine Trail Evening Phone: 919-971-9333 Race: Caucasian Hillsborough NC 27278 FAX: Township: Eno E-mail: vbarringer@gmail.com Date Applied: O1/27/2012 Skil(s: Animal Welfaze Advocate Also Serves On: Skills: Financial Officer Also Serves On: Skills: Long-Term Caze Also Serves On: Skills: Pet Therapy Also Serves On: Mr. Jack S. Chestnut Day Phone: 919-732-1242 Sex: Male 4303 Hope Valley Drive Evening Phone: 919-732-1242 Race: Caucasian Hillsborough NC 27278 FAX: Township: Hillsborough E-mail: jackchestnut@!aol.com Date Applied: OS/24/2010 Skills: . C.H. SENIOR CNTR. PROGR. PART Also Serves On: Skills: Cazol Woods Retirement Center Also Serves On: Skills: HUD202 Housing for Elderly Boazd M Also Serves On: Ms. T. L. Crews 4921 Guess Rd RougmeontNC 27572 Skills: School Principal Skills: Tutor Dr. Beverly Foster 2454 Springview Trail Chapel Hill NC 27514 Skills: Nursing Management Education Day Phone: 919 732-6974 Evening Phone: 919 732-6974 FAX: E-mail: crewsez@aol.com Also Serves On: Also Serves On: Day Phone: 919 966-4995 Evening Phone: 919 967-2930 FAX: 919 843-6212 E-mail: Bev_Foster@unc.edu Also Serves On: Sex: Female Race: African American Township: Little River Date Applied: 08/21/2011 Sex: Female Race: Caucasiazi Township: Chapel Hiil Date Applied: 02/10/2011 MS Joyce Jefferies Day Phone: (919~25-3597 Sex: Female 4820 NC Hwy 54 West Evening Phone: (919)720-6115 Race: African Americaz~ Chapel Hill NC 27516 FAX: (919)425-3529 Township: Chapel Hill E-mail: joyceJefferies@dentistry.unc.edu Date Applied: I1/03/2010 Skills: Administrative Assistant Also Serves On: Monday, January 30, 2012 Page 1 of 2 11 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Charlotte Terw illiger, MSW Nursing Home Community A dvisory Committee Contact Phone: 919-558-9401 Ms. Sandra Lemons Day Phone: 9199718385 Sex: Female 1321 Brookhollow Road Evening Phone: 9199718385 ~y~e: Caucasian Efland NC 27243 FAX: Township: Cheeks E-mail: SandraL@umrh.org Date Applied: 02/11/2011 Skills: Administrative Assistant Also Serves On: Mr. Max Mason Day Phone: 9196497937 Sex: Male 821 Tinkerbell Rd. Evening Phone: Race: Caucasian Chapel Hill NC 27517 FAX: Township: Chapel Hill E-mail: maxomason@yahoo.com Date Applied: O1/25/2011 Skills: Long-Term Caze Also Serves On: Adult Caze Home Community Advisory Committee Skills: Public Health Mr. Charles McMullen Day Phone: 9197329083 Sex: Male 108 Jones Avenue Evening Phone: 9192603879 RaCe: Caucasian Hillsborough NC 27278 FAX: Township: Hillsborough E-mail: cmcmullenl@nc.rr.com Date Applied: 02/10/2011 Skills: Nursing Profession Also Serves On: Adult Caze Home Community Advisory Committee Ms. Vickie Webb Day Phone: 919-491-1073 Sex: Female 150 Lawndale Ave Evening Phone: 919-241-4482 Race: African American Hillsborough NC 27278 FAX: 919-560-1107 Township: Hillsborough E-mail: jb29@nc.rr.com Date Applied: 02/10/2011 Skills: Accounting Experience Also Serves On: Ms. Tiki Windley Day Phone: 919-969-8583 Sex: Female 119 Cynthia Drive Evening Phone: 919-942-4392 Race: ~can American Chapel Hill NC 27514 FAX: Township: Chapel Hill E-mail: tiki_windley@yahoo.com Date Applied: OS/27/2010 Skills: Financial Advisor Also Serves On: Monday, January 30, 2012 Page 2 of 2 12 Page 1 of 2 Vicki Barringer Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of f~C Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Ms. Vicki Barringer 3612 Old Vine Trail Hillsborough NC 27278 919-971-9333 919-971-9333 vbarringer@gmail.com N/A 2000 Eno Female Caucasian Boards/Commissions applied for: Nursing Home Communiry Advisory Committee Animal Services Advisory Board Work Experience: 1983 - 1984: Business and Finance Intern. 1984 - 1986: Assistant to University controller, Duke Departments. 1987 - 1991: Finance Manager, Division of Family Medicine, Duke-Watts Residency Training Program and Durham Health Care, Inc. 1991 - 1994: Administrator, Division of Family Medicine, Duke University. 1994 - 2005 Director of Finance, The Forest at Duke, Inc., 2005 - 2008: Chief Compliance Officer, Kuhn & Carson, Inc., Durham, NC. 2008: Director of Finance, Duke University: the Fuqua School of Business. 2009 - 2011: Director of Finance and Chief Financial Officer, Galloway Ridge, Inc., Pittsboro, NC Volunteer Experience: Pet Pals, Member (Pet Assisted Therapy & Activities in Orange County Schools). Finance Committee, First Baptist Church of Hillsborough, NC Association of Non-Profit Homes for the Aging, Treasurer (1999 - 2001); NC Association of Non-Profit Homes for the Aging, Board Member (2001 - 2003); Volunteer pet therapy in assisted living and skilled nursing facilities. Education: BA Accounting - NC State University (1983); Master of Business Administration - Duke: the Fuqua School of Business (1990). Other Comments: 13 Page 2 of 2 Vicki Barringer 1) I have both a passion for senior living as well as genuine love and respect for older adults. 2) I love animals and want our county to allocate appropriate resources to animal services for the protection of animals and citizens and humane treatment of the animals. STAFF COMMENTS: Applied 01/27/2012 for Nursing Home Community Advisory Committee and Animal Services Advisory Board. ADDRESS VERIFICATION: Old Vine Trail is Orange County Jurisdiction, Orange Fire Tax, and Eno Township. This application was current on: 1/27/2012 Date Printed: 1/30/2012 14 Page 1 of 2 Jack S. Chestnut Volunteer Appiication Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Mr. Jack S. Chestnut 4303 Hope Valley Drive Hillsborough NC 27278 919-732-1242 919-732-1242 jackchestnut@!aol.com Retired Township of Residence: Hillsborough Zone of Residence: . . . Sex: Male Ethnic Background: Caucasian Date of Birth: 12/6/1944 Boards/Commissions applied for: Nursing Home Communiry Advisory Committee Work Experience: Director, Community Contact/Special Project, Carol Woods Retirement Center. 21 years at Carol Woods Retirement Community as Director of Residential services. Responsible for housing issues- maintenance, remodeling, etc.l worked for Carol Woods Retirement Center for 30 years. The first 20years I was the Director of Facility Services . The last 10 years I was the Director of Community Contacts and Special Projects. Volunteer Experience: Chair of the Advisory Board on Aging; OC Affordable Hosing Board; Chapel Hill Friends Board. (Current 1/13/04) ; Board Member- Adailade Walters Housing (HUD 202) - 8 years; Rotarian- 9 years- volunteer repair of low income elderly homes; Friends of the Chapel Hill Senior Center -board, Chapel Hill/Carrboro Sunrise Rotary Board Member, Orange County Capital Needs Task Force Member, New Hope springs Homeowners Association Board Member, North Carolina Independent Housing with services advisory committee.Attended Yuba City College, Have had many training work shops. 30 years of experience working with Seniors.Attended Yuba City College, Have had many training work shops. 30 years of experience working with Seniors.Attended Yuba City College, Have had many training work shops. 30 years of experience working with Seniors. have served on the Advisory Board on Aging, Both Senior Center Boards, Senior Care of Orange County Adult Day Health Program and other boards. Education: 15 Page 2 of 2 Jack S. Chestnut High School - Diploma - Kansas City, KS Yuba City College- graduate study; American Association of Homes and Services for the Aging - certification for Retirement Housing Professionals Attended Yuba City College, Have had many training work shops. 30 years of experience working with Seniors. Other Comments: Awarded title of Retirement Housing Professional by the American Association of Homes and Services to the Aging Awarded Environmental Services Award in 1997 by the North Carolina Association of Non-Profit Homes for the Aging Awarded Rotarian of the Year in 1998 for the Chapel Hill/Carrboro Sunrise Rotary. STAFF NOTES: Renewed application 1/12/04 for Southern Orange Senior Center (New) Design Committee. Renewed 5/24/01 for AHAB. Renewed application 12/14/2000 for Advisory Board on Aging. Renewed application 08/16/00 for Commissioners Affordable Housing Task Force. Applied 09/30/1999 for Master Aging Plan Task Force. Applied for Nursing Home Community Advisory Committee 5/24/2010. ADDRESS VERIFICATION: 4203 Hope Valley Drive, Hillsborough is in Chapel Hill Township and Orange County Jurisdiction. This application was current on: 5/24/2010 Date Printed: 1/30/2012 16 Page 1 of 2 T. L. Crews Volunteer Application Orange County Advisory Boards and Commissions Name: Name Cailed: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Ms. T. L. Crews 4921 Guess Rd Rougmeont NC 27572 919 732-6974 919 732-6974 crewsez@aol.com Retired Public School Adminstrator Senior Director Programs for Exceptional Children 1996 Little River Female African American Boards/Commissions applied for: Human Relations Commission Adult Care Home Community Advisory Committee Nursing Home Community Advisory Committee Work Experience: Currently serving as Executive Director for the Little River Community Complex Durham Public Schools worked in adminstrative leadership in the Exceptional Children's Program. Retired in 2005 as Director of the system's Exceptional Children's Program; at the request of the superintendent I returned to provide training and assistance to the new Director when appointed. Volunteer Experience: Worked with children in placement through Durham Social Services and court system. I reviewed files and collected relevant data for attorneys to use in court custody and placement hearings Tutored young adults and children Volunteered in a university sponsored child development center Currently Executive Director of Little River Community Complex Education: 17 Page 2 of 2 T. L. Crews M.ED in Special Education BA in history with minor in education Hold Principal Certification State Licensed in areas of LD/BED/DD Other Comments: I have spent most of my life working to better provide assistance to infants, children, young adults, those at risk, and senior citizens. As a result of spending days and nights in several nursing homes sitting with elderly parents and relatives, I've gained a deeper understanding and compassion for elderly residents and workers in nursing facilities. STAFF COMMENTS: 08/23/2011 Applied to serve on Human Relations Commission, Adult Care Home Community Advisory Committee, and Nursing Home Community Advisory Committee. ADDRESS VERIFICATION: 4921 Guess Road is in Little River Township, Orange County Jurisdiction. This application was current on: 8%21/2011 11:48:53 AM Date Printed: 1/30/2012 18 Page 1 of 2 Beverly Foster Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Dr. Beverly Foster. 2454 Springview Trail Chapel Hill NC 27514 919 966-4995 919 967-2930 919 843-6212 Bev_Foster@unc.edu UNC-Chapel Hill School of Nursing Faculty and Undergraduate Program Director 1981 Chapel Hill Does not apply Female Caucasian 1/13/1943 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: Preparation of undergraduate baccalaureate students for nursing licensure and practice; program administration and teaching. Direct patient care in the areas of adult acute care and maternal child. Volunteer Experience: Orange County Board of Health, member and chair. Senior Center Wellness Advisory Board, member and chair. North Carolina Board of Nursing, member and chair. Governor's Task Force for Healthy Carolinians (current). Foundation for Nursing Excellence, member and chair (current) Program accreditor for nursing (CCNE) (current) Education: BSN (1964), Syracuse University MSN (1976), UCLA MPH,(1981), University of Hawaii PhD,(1993), UNC-Chapel Hill Other Comments: I have not recently been involved in local community service and wish to again become active locally. My mother was rather briefly in two skilled nursing facilities in Orange County prior to her death a few years ago, and I became aware of the needs for 19 Page 2 of 2 Beverly Foster monitoring and service improvement in this area. At my age I realize I may be a user of these services myself! I believe my background in nursing education, accreditation and regulation may be of use to the committee. STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee 2-10-2011. ADDRESS JURISDICTION: 2454 Springview Trail, CH, is in CH Township and CH Jurisdiction. This application was current on: 2/10/2011 7:20:17 AM Date Printed: 1/30/2012 20 Page 1 of 2 Joyce Jefferies Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Ms Joyce Jefferies 4820 NC Hwy 54 West Chapel Hill NC 27516 (919)425-3597 (919)720-6115 (919)425-3529 joyceJefferies@dentistry. unc.ed u UNC School of Dentistry Administrative Assistant Township of Residence: Chapel Hill Zone of Residence: Does not apply Sex: Female Ethnic Background: African American Date of Birth: 7/23/1955 Boards/Commissions applied for: Work Experience: Employed by UNC Hospitals and UNC-Chapel Hill since 1973 first as a dietary assistant now an Administrative Assistant in Dentistry where I perform a variety of functions including accounting, billing, preparing check requests to pay bills, arranging travel, coordinating meetings, preparing meeting agendas, ordering supplies, budgeting, preparing reports, drafting letters, etc. I would like to serve on the Advisory Boards because I am experiencing first-hand, in regards to my elderly mother, in trying to find an affordable assisted-living facility in good standard that really uphold the care and the best interest of their residents. Also the assurance of knowing that these facilities are being governed by guidelines, rules and regulations that they have to adhere to and that there are committees to visit these faciliteis to ensure that these guidelines are being carry out. It is difficult enough to have to place our elderly family members in a facility but having the reassurance in knowing that they are being well taken care of makes this transition a lot more bearable. Volunteer Experience: I volunteer at my church, Hospitality- serving guests of the Pastor and greeting members as they enter the church, Sisters of Jubilee- visiting the Women prisons in Raleigh, organizing birthday parties, prayer and fellowship, visiting the sick and shut in. Education: I received my GED from Durham Technical Institute and enrolled in the Business Administration Associate Degree Program, also at Durham Tech. 21 Page 2 of 2 Joyce Jefferies Other Comments: I feel that I am at the place in my life mentally, physically and spiritually where I have a lot to offer in reaching out and assisting others through community involvement, etc. I look at volunteering as a personal committment just as rewarding to me as to the area that I am volunteering in. I get a joy in being able to be a contributor and not just to try and make a difference. I enjoy working with others in like causes and like minds, even though having different approaches but seeking to reach the same goal. STAFF COMMENTS: Originally applied 11-3-2010 for Adult Care Home Community Advisory Committee, Nursing Home Community Advisory Committee, Advisory Board on Aging. ADDRESS VERIFICATION: 4820 NC Highway 54 West is in Bingham Township and Orange County Jurisdiction. This application was current on: 11/3/2010 2:36:29 PM Date Printed: 1/30/2012 22 Page 1 of 1 Sandra Lemons Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Ms. Sandra Lemons 1321 Brookhollow Road Efland NC 27243 9199718385 9199718385 SandraL@umrh.org Croasdaile Village Administrative Assistant Plant Operations 1955 Cheeks Female Caucasian 10/6/1955 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: UNC-CH Medical School Admissions Office 16 yrs; Orange County Schools 7 yrs; Croasdaile Village 3 yrs Volunteer Experience: School and Church Education: Chapel Hill High School; King's College, Charlotte NC; King's College, Raleigh NC Other Comments: Working for a large retirement center with several levels of care including skilled nursing, I know the importance of quality care for residents. I am required to complete online staff development on Resident Rights, Preventing Resident Abuse, Sexual Harassment, HIPPA, Corporate Compliance; Alzheimer's; Slips, Trips and Falls to name a few. I feel that I could serve Orange County with this knowledge to make sure that the facilities in our county give the best quality care and safest living environment to residents. STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee 02/11/2011. ADDRESS VERIFICATION: 1321 Brookhollow Road, Efland; NC is in Orange County Jurisdiction, Cheeks Township. This application was current on: 2/11/2011 8:48:46 AM Date Printed: 1/30/2012 23 Page 1 of 2 Max Mason Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Mr. Max Mason 821 Tinkerbell Rd. Chapel Hill NC 27517 9196497937 maxomason@yahoo.com Principle Long Term Care, Inc. Development Coordinator 1978 Chapel Hill Does not apply Male Caucasian 7/27/1977 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: Development Coordinator for one of NC's largest long term care providers. Plan for development of nursing facilities, hospices, and home health agency. Administrator for residential recovery facility for pregnant women who struggled with substance abuse. Volunteer Experience: Serve on the Community Grantmaking Committee at the Triangle Community Foundation. Board Member, Chrysalis Foundation for Mental Health Member of APPLES Service Learning program at UNC-Chapel Hill as undergraduate. Education: BA, History, UNC-Chapel Hill MA, Slavic Languages & Literatures, UNC-Chapel Hill Current student (part-time): Masters of Healthcare Administration, UNC-Chapel Hill Gillings School of Public Health Other Comments: As noted, I am presently a student in public health and currently work in the field of long term care; thus, I have a great interest in the issues affecting nursing facility residents. Given my experience and familiarity with this segment of the health care system, I believe I would be a valuable addition to this committee. STAFF COMMENTS: Originally applied (1/24/2011) for Nursing Home Community Advisory Committee. ADDRESS VERIFICATION: 821 Tinkerbell Road is in Chapel Hill Township. 24 Page 2 of 2 Max Mason This application was current on: 1/25/2011 9:11:51 AM Date Printed: 1/30/2012 25 Page 1 of 1 Charles McMullen Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Mr. Charles McMullen 108 Jones Avenue Hillsborough NC 27278 9197329083 9192603879 cmcmullen1 @nc.rr.com retired 1993 Hillsborough Does not apply Male Caucasian 8/22/1946 Boards/Commissions applied for: Nursing Home Community Advisory Committee Board of Health Work Experience: Almost 50 yrs in various fields of nsg. Volunteer Experience: Education: Other Comments: STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee, Adult Care Home Community Advisory Committee, and Board of Health 02/10/2011. ADDRESS VERIFICATION: 108 Jones Avenue is in Hillsborough Jurisdiction, Hillsborough Township. This application was current on: 2/10/2011 10:59:02 AM Date Printed: 1/30/2012 26 Page 1 of 2 Vickie Webb Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Date of Birth: Ms. Vickie Webb 150 Lawndale Ave Hillsborough NC 27278 919-491-1073 919-241-4482 919-560-1107 jb29@nc. rr.com City of Durham Billing Specialist 1989 Hillsborough Does not apply Female African American 9/28/1956 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: My work experience is limited to providing in home care to the elderly who wish to remain in their homes as long as possible. I provided basic daily assistance with medication, and personal hygiene, as well as food preparation. Volunteer Experience: My volunteer experience is limited to the time I spent in a nursing facility in which my mother was a resident, and I would go in a help with feedings and companionship of some selected residents Education: I have a high school diploma, and am currently enrolled in an online course to obtain an Associates degree in Arts with a foundation in business, and am due to graduate in September 2011. Other Comments: I am interested in serving on this committee because I care about people. I especially care about the people who can not longer care, or speak for themselves. During my mothers stay at a local nursing home, I was an advocate for her as well as other residents who either had no family or distant family. I got along well with the staff of the facility and was very much respected as well as showing respect for the jobs they performed. STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee 02/10/2011. ADDRESS VERIFICATION: 150 Lawndale Avenue is 27 Page 2 of 2 Vickie Webb in Hillsborough Jurisdiction, Hillsborough Township. This application was current on: 2/10/2011 10:20:40 PM Date Printed: 1/30/2012 28 Page 1 of 2 Tiki Windley Volunteer Application Orange County Advisory Boards and Commissions Name: Ms. Tiki ~ndley Name Called: Home Address: 119 Cynthia Drive Chapel Hill NC 27514 Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: 919-969-8583 919-942-4392 tiki windley@yahoo.com MDC, inc. Program Manager 2007 Chapel Hill Female African American Date of Birth: 11/6/1971 Boards/Commissions applied for: Board of Social Services Nursing Home Community Advisory Committee Adult Care Home Community Advisory Committee Human Relations Commission Work Experience: MDC, Inc. 2006 to Present Program Manager whose duties include meeting facilitation, training, free tax preparation, asset-building and making presentations. Prior experience includes teaching financial Iiteracy to high school students and their families, housing counseling, working with ex-offenders and community engagement and organization. Current experience includes meeting facilitation, training, oral presentations, community engagement and organization. Prior experience includes teaching financial literacy to high school students, asset education, free tax preparation an housing counseling. Volunteer Experience: Meeting facilitation, event planning, volunteer supervision Site coordinator for free tax preparation site Escort for Project Homeless Connect (Orange County) smith Middle School School Improvement Team Triangle United Way Orange Accountability Committee Triangle United Way Regional Initiative Task Force 29 Page 2 of 2 Tiki Windley NC Indian Economic Development Initiative Project G-7 Steering Committee Assets Educator: Community Success Initiative NC Second Chance Alliance Escort, Project Homeless Connect (Orange County) 2009 Chairman, Guest Outreach, Project Homeless Connect, 2010 Triangle United Way Orange Accountability Committee Triangle United Way Regional Task Force Initiative Assets educator, Community Success Initiative Project G-7 Steering Committee, NC Indian Economic Development NC Second Chance Alliance NC Assets Alliance Escort, Project Homeless Connect (Orange County) 2009 Chairman, Guest Outreach, Project Homeless Connect, 2010 Triangle United Way Orange Accountability Committee Triangle United Way Regional Task Force Initiative Assets educator, Community Success Initiative Project G-7 Steering Committee, NC Indian Economic Development NC Second Chance Alliance NC Assets Alliance Escort, Project Homeless Connect (Orange County) 2009 Chairman, Guest Outreach, Project Homeless Connect, 2010 Triangle United Way Orange Accountability Committee Triangle United Way Regional Task Force Initiative Assets educator, Community Success Initiative Project G-7 Steering Committee, NC Indian Economic Development NC Second Chance Alliance NC Assets Alliance Education: Bachelor of Science, Elizabeth City State University 1997 Master of Public Administration, NC Central University, 2010 Elizabeth City State University, 1997 Master in Public Administration NC Central University, December 2010 Other Comments: I would like to provide a voice for those citizens who feel they are unheard in our community. STAFF COMMENTS: Originally applied for Commission for Women, Board of Social Services & Adult Care Home Community Advisory Committee 10/6/09. Aopplied for Human Relations Commission, Board of Social Services, & Nursing Home Community Advisory Committee 05/27/2010. ADDRESS VERIFICATION: 119 Cynthia Drive, Chapel Hill is Chapel Hill township, CH jurisdiction. This application was current on: 5/27/2010 Date Printed: 1/30/2012