HomeMy WebLinkAboutAgenda - 03-06-2008-10gORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: March 6, 2008
SUBJECT: Nursing Home Communit
Committee-New
Action Agenda
Item No. ~r7-
No
DEPARTMENT: Board of Commissioners
ents
PUBLIC HEARING: (Y/N)
ATTACHMENT(S): Under Separate Cover
Membership Roster
Letter of Recommendation
Application(s)/Resume(s) of Person(s)
Recommended
Interest List
Application(s)/Resume(s) of Person(s) on the
Interest List
INFORMATION CONTACT:
Clerk's Office, 245-2130
PURPOSE: To consider making new appointments to the Nursing Home Community Advisory
Committee.
BACKGROUND: The Clerk's office has received recommendations from the Nursing Home
Community Advisory Committee for the following people: Ed Flowers and Pat Revels. If
appointed they will be serving cone-year training term, which will end on 2/28/2009.
FINANCIAL IMPACT: None.
RECOMMENDATION(S): Consider making new appointments to the Nursing Home Community
Advisory Committee.
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5
Angela Thompson-Rockett
From: Mary Ann Peter [maryannpeter@earthlink.net]
Sent: Tuesday, January 22, 2008 5:45 PM
To: Angela Thompson-Rockett; Jill Passmore
Subject: Recommendation for Orange County Nursing Home Community Advisory Committee
To the Baard of Orange County Commissioners,
I would like to recommend Ed Flowers for membership in the Orange County Nursing Home
Advisory Committee. He has attended a meeting of the committee in January and is an Orange
~.,,,,,+-,. ,-o~; ao„+- . ~ a, ~ Ro~ko+-t ~ ~ .u; ~nP nr; va ui 'i 'i Ghnrouah . NC . He has extensive experience
in health care and in volunteer work. We currently have three committee vacancies and I'm
certain that he will be an asset to our committee.
Sincerely,
Mary Ann Peter, Chair
Orange County Nursing Home Community Advisory Committee January 22, 2008
Angela Thompson-Rockett
From: Mary Ann Peter [maryannpeter@earthlink.net]
Sent: Thursday, January 24, 2008 6:04 PM
To: Angela Thompson-Rockett; Jill Passmore
Subject: FW: Recorhmendation for Orange County Nursing Home Community Advisory Committee
January 24, 2008
To the Orange County BOCC
I would like to recommend Pat Revels for membership in the Orange County Nursing Home
Community Advisory Committee. At the current time nine of 12 positions are filled. Ms.
Revels has submitted an application, is a resident of Hillsborough, and has attended the
January 14 meeting of the committee.
RhP ; c a rat-irPri erinnai-nr anc~ i s well.-qualified for membership in this committee. We would
like for her to be considered at the next opportunity.
Thank you for your support of this committee and the important advocacy work that is being
carried out on behalf of residents in Orange County nursing homes.
Sincerely,
Mary Ann Peter, RN, PhD
Chair, Orange County Nursing Home Community Advisory Committee
t
Page 1 of 2
Ed Flowers
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Mr Ed Flowers
2813 Beckett's Ridge Drive
Hillsborough NC 27278
919-357-9256
919-357-9256
ED_FLOW ERS@YAHOO.COM
Duke University Hospital
Senior Nuclear Medicine Technologist
Hillsborough
Does not apply
Male
Caucasian
2/10/1944
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
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 - prestnt Senior 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
Education:
High School -Southwest Forsyth
College -Mars Hill
Radiologic Technology -North Carolina Baptist Hospital
Nuclear Medicine Technology -North Carolina Baptist Hospital
Other Comments:
Extensive experience with regulatory agencies (e.g.; JCAHO, N.C.Radiation Safety,
OSHA, Nuclear Regulatory Commission) STAFF COMMENTS: Originally applied for
Nursing Home Community Advisory Community Advisory Committee on 11/18/2007.
ADDRESS VERIFICATION: 2813 Beckett's Ridge Drive, is Hillsborough Township.
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:
Mrs. Patricia Revels
329 West King Street
Hillsborough NC 27278
(919) 241-407
Same
N/A
prevels001 @nc.rr.com
Retired (June'06)
Township of Residence: Hillsborough
Zone of Residence: Hillsborough Twnshp - In City Limits
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 9!29/1946
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
30+years public education in TN,MS,SC,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
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.STAFF
COMMENTS: Originally applied for Adult Care Home Community Advisory Committee
1/24/2008. ADDRESS VERIFICATION: 329 Est King Street, Hillsborough, is in
Hillsborough Township in the city limits.
Applicant Interest Listing
Nursing Home Community Advisory Committee
by Board Name and by Applicant Name
Contact Person: Vibeke Talley, OTR/L
Contact Phone: 919-968-2087
Mr. Blake Burlclin Day Phone: 919-812-4394 Sex: Male
117 Creel St. Evening Phone: 919-812-4394 Race: Caucasian
Chapel Hill NC 27516 FAX: Township: Chapel Hill
E-mail: burlclin@email.une.edu Date Applied: 02/03/2008
Skills: Habitat for Humanity Also Serves On:
Skills: Sociology Major Also Serves On:
MS. 7eanette C1arlc Day Phone: 919-620-8662 Sex: Female
221 Rencher St Apt 3 Evening Phone: 732-7856 Race: African American
Hillsborough NC 27278 FAX: 6208662 Township: Hillsborough
E-mail: Date Applied: 02/23/2005
Skills: Nursing Home Experience Also Serves On:
Ms. Peggy Cohn Day Phone: 919-489-6624 Sex: Female
10 Bayswater Place Evening Phone: same Race: Caucasian
Chapel Hill NC 27517 FAX: Township: Chapel Hill
E-mail: peggycolml@earthlinlc.net Date Applied: 10/10/2005
Skills: Geriatric Care Also Serves On: Adult Care Home Community Advi sory Committee
Also Serves On: Advisory Board on Aging
MS. ELIZABETH CRONER
1605 N. GREENBOROUGH ROAD
CARI2BOR0 NC 27510
Skills: Retired
Day Phone:
Evening Phone:
FAX:
' E-mail:
Also Serves On:
919.933.862
Sex: Female
Race: African American
Township: Chapel Hill
Date Applied: 11/05/2005
Mr Ed Flowers
2813 Beckett's Ridge Drive
Hillsborough NC 27278
Skills: Children's Issues
Skills: Nuclear Physicist
Day Phone: 919-357-9256
Evening Phone: 919-357-9256
FAX:
E-mail: ED_FLOWERS@YAHOO.COM
Also Serves On:
Also Serves On:
Sex: Male
Race: Caucasian
Township: Hillsborough
Date Applied: 11/18/2007
Thursday, February 21, 2008 Page 1 of 2
~v
Applicant Interest Listing
Nursing Home Community Advisory Committee
by Board Name and by Applicant Name
Contact Person: Vibeke Talley, OTR/L
Contact Phone: 919-968-2087
Ms. Jane Powell Day Phone: 910-474-9083 Sex: Female
656 Craige Dorm Evening Phone: 919-914-4924 Race: African American
LJNC Chapel Hill FAX: Township: Chapel Hill
Chapel Hill NC 27514 E-mail: japo@email.unc.edu Date Applied: 09/30/2004
Skills: Cashier Also Serves On:
Skills: Community Service Volunteer Also Serves On:
Skills: Customer Service Also Serves On:
Mrs Patricia Revels
329 West King Street
Hillsborough NC 27278
Skills: Meals-On-Wheels Volunteer
Skills: Teacher
Skills: Tutor
Ms. Tammy Thacker
517 N. Hill Street
Hillsborough NC 27278
Skills: Certified Nurses Aide
Day Phone: (919) 241-407
Evening Phone: Same
FAX; N/A
E-mail: prevels001@nc.n•.com
Also Serves On:
Also Serves On:
Also Serves On:
Day Phone: 638-4387
Evening Phone:
FAX:
E-mail: gr8tpay@yahoo.com
Also Serves On:
Sex: Female
Race: Caucasian
Township: Hillsborough
Date Applied: 01/24/2008
Sex: Female
Race: African American
Township: Hillsborough
Date Applied: 02/14/2006
Thursday, February 21, 2008 Page 2 of 2
Page 1 of 1
Blake Burklin
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Mr. Blake Burklin
117 Creel St.
Chapel Hill NC 27516
919-812-4394
919-812-4394
Burklin@email.unc.edu
Johnny T Shirt
Township of Residence: Chapel Hill
Zone of Residence: Chapel Hill Twnsp
Sex: Male
Ethnic Background: Caucasian
Date of Birth: 11/15/1983
Boards/Commissions applied for:
Orange County Planning Board
Nursing Home Community Advisory Committee
Work Experience:
Harris Teeter
Triangle Sportsplex
Johnny T Shirt
Volunteer Experience:
UNC Hospital
Habitat for Humanity
Education:
B.A. in Sociology from the University of North Carolina at Chapel Hill
Other Comments:
As an undergraduate sociology major I was able to design and implement IRB approved
social research on stigmatized populations confidentially. (believe as a life long resident
of the Chapel Hill/ New Hope area, that I will have some insight the Board might find
valuable. STAFF COMMENTS: Originally applied for Orange County Planning Board
Nursing Home Community Advisory Committee on 2/3/2008. ADDRESS
VERIFICATION: 117 Creel St, Chapel Hill, is Chapel Hill township in CHP~ jurisdiction.
This application was current on: 2/3/2008 10:53:29 PM
Date Printed: 2/21/2008
~~
Page 1 of 1
Jeanette Clark
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms. Jeanette Clark
221 Rencher St Apt 3
Hillsborough NC 27278
919-620-8662
732-7856
6208662
Central Family Care
Supervisor in Charge
Hillsborough
Hillsborough ETJ
Female
African American
7/8/1955
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Joint Orange Chatham Community Action Agency
Work Experience:
I have been in the medical experience for about 12 yrs. I am a certified nurse assistant,
and a certified medical technician. I have nursing home and adult care home
experience. I supervise a group home now for mental residents
Volunteer Experience:.
I have no volunteer experience but I have done outreach before and I have a certificate
for a class I took as an outreach worker.
Education:
GED
Other Comments:
STAFF COMMENTS: Originally applied for Nursing Home CAC and Adult Care Home
Community Advisory Committee and JOCCA. ADDRESS VERIFICATION: 211 Rencher
St is in Orange County in Hillsborough Township in Hillsborough ETJ.
This application was current on: 2/23/2005 Date Printed: 2/21/2008
I3
Page 1 of 1
Peggy Cohn
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms. Peggy Cohn
Peggy
10 Bayswater Place
Chapel Hill NC 27517
919-489-6624
same
peggycohn1 @earthlink.net
retired
Geriatric Care Manager
Chapel Hill
C.H. City Limits
Female
Caucasian
8/28/1938
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
Community Health Nursing educator UNC and Penn State University
Director of Family Ties, Geriatric Care Management, State College PA
Volunteer Experience:
Nursing Home visitation
Non profit Boards in PA
Education:
BA, Wellesley
BSN, Columbia University
MPH, UNC
PhD, Penn State University College of Health and Human Developmenet
Other Comments:
STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory
Committee and NHCAC and Adv. Board on Aging 10/10!2005. ADDRESS
VERIFICATION: Mailing address listed above. Residence is 233 McCauley Street in
Chapel Hill city limits.
This application was current on: 10/10/2005 11:34:21 AM Date Printed: 2/21/2008
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ELIZABETH CRONER
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
MS. ELIZABETH CRONER
1605 N. GREENBOROUGH ROAD
CARRBORO NC 27510
919.933.862
RETIRED
Township of Residence: Chapel Hill
Zone of Residence: Carrboro City Limits
Sex:
Ethnic Background:
Date of Birth:
Female
African American
5/14/1934
Boards/Commissions applied for:
Advisory Board on Aging
Nursing Home Community Advisory Committee
Work Experience:
RETIRED FROM STATE OF OHIO, CLEVELAND DEVELOPMENTAL CENTER; STAFF
SUPV.
Volunteer Experience:
CURRENTLY ASSISTING ABUNDANT LIFE CHURCH PANTRY
Education:
HIGH SCHOOL; CONTINUED EDUCATION;
Other Comments:
STAFF COMMENTS: Originally applied for Adv. Board on Aging, Nursing Home CAC,
and Board of Social Services 11/8/2005. ADDRESS VERIFICATION: 1605 N.
Greensboro St is in Carrboro City Limits in Orange County in the Chapel Hill Township.
This application was current on: 11/5/2005 11:28:47 AM Date Printed: 2/21/2008
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Jane Powell
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms. Jane Powell
656 Craige Dorm
UNC Chapel Hill
Chapel Hill NC 27514
910-474-9083
919-914-4924
japo@email.unc.edu
Wynnsong 15 Theatre
Cashier
Chapel Hill
Chapel Hill Township within C.N. city limits
Female
African American
10/18/1983
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Affordable Housing Advisory Board
Work Experience:
Ocean Beach Club: waitress and secretary, Dairy Queen: cashier, Wynnsong 15: cashier.
Volunteer Experience:
Volunteer with Public Service Scholars. Volunteer at Dobbins Hill apartments on
Mondays, Volunteer at UNC Hospital on Mondys. DO other volunteering when needed.
Education:
High School-Lumberton Senior High School, attending UNC Chapel, BS Nursing
Other Comments:
STAFF COMMENTS: Originally applied for Nursing Home Community Advisory
Committee, Affordable Housing Advisory Board, and Animal Shelter Operations Task
Force. ADDRESS VERIFICATION: 656 Craige Darm is on the campus of UNC-Chapel
Hill and is located off of Manning Drive in Orange County, in the Chapel Hill Township in
the City Limits.
This application was current on: 9/30/2004 Date Printed: 2/21/2008
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Tammy Thacker
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms. Tammy Thacker
517 N. Hill Street
Hillsborough NC 27278
638-4387
gr8tpay@yahoo.com
Aryzen Health and Wellness
President and CAN II
Hillsborough
Hillsborough Town Limits
Female
African American
5/31 /1968
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Work Experience:
I have been in Health Care for over 15 years and I have a good knowledge base about
the elderly. I understand people need and what it takes to live in a safe environment.
Volunteer Experience:
I have volunteered in the classrooms of my children.
Education:
Certified CNA I and II. Certified EKG technician and Certified Medication Technician.
Other Comments:
STAFF COMMENTS: Originally applied for Adult Care Home and Nursing Home Care
Advisory Boards and Advisory Board on Aging 2/14/2006. ADDRESS VERIFICATION:
517 Hill Street is in the Town of Hillsborough in Orange County.
This application was current on: 2/14/2006 Date Printed: 2/21/2008