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HomeMy WebLinkAboutAgenda - 02-17-2015-11cl ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: February 17, 2015 Action Agenda Item No. 11 -c SUBJECT: 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 Office, 245 -2130 Recommendations Applications for Persons Recommended Interest List Applications of Persons on the Interest List PURPOSE: To consider making appointments to the Nursing Home Community Advisory Committee. BACKGROUND: The following information is for Board consideration: • Appointment to a first full term (Position #5) At -Large Nursing Home Administration for Ms. Sandra Nash ending 06/30/17. • Appointment to a one year training term (Position #7) At -Large Nursing Home Administration for Mr. Bill Crittenden ending 02/03/2016. • Appointment to a one year training term (Position #11) At -Large Nursing Home Administration for Ms. Maria Hardin ending 02/03/2016. POSITION NO. NAME SPECIAL REPRESENTATIVE EXPIRATION DATE 5 Ms. Sandra Nash At -Large Nursing Home 06/30/2017 Administration 7 Mr. Bill Crittenden At -Large one year training 02/03/2016 term 11 Ms. Maria Hardin At -Large one year training 02/03/2016 term NOTE - If the individuals listed above are appointed, the following vacancies remain: • None. FINANCIAL IMPACT: None. RECOMMENDATION(S): The Board will consider making appointments to the Nursing Home Community Advisory Committee. 2 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee L 2 Meeting Times: 5:30 p.m. Every other 1st Tuesday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: United Church of CH - 1321 ML King Blvd 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 specialized training and support. Dr. Tracey Yap 834 Providence Glen Drive Chapel Hill NC 27514 Mr Elijah (Ed) Flowers, III 2813 Beckett's Ridge Drive Hillsborough NC 27278 Ms. Teri J. Driscoll 3 Chair 422 Hampton Pointe Hillsborough NC 27278 Mr. Jerry Schreiber 4 Trainee 1606 Pathway Dr Carrboro NC 27510 5 Ms. Sandra Nash 600 West Poplar Ave., Apt. 239 Carrboro NC 27510 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 - 245 -1127 Evening Phone: 919- 245 -1127 FAX: E -mail: drisco11323 (onc.rr.com Day Phone: 919 967 2962 Evening Phone: 919 967 2962 FAX: E -mail: jrogerschreiber @gmail.com Day Phone: 828- 668 -9628 Evening Phone: FAX: E -mail: None Sex: Female First Appointed: 12/13/2011 Race: Caucasian Current Appointment: 02/19/2013 Township: Chapel Hill Expiration: 01/30/2016 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Resid/Spec Req: At -Large Sex: Male First Appointed: 03/06/2008 Race: Caucasian Current Appointment: 02/21/2012 Township: Hillsborough Expiration: 03/31/2015 Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: At -Large Resid/Spec Req: At -Large Sex: Female First Appointed: 09/17/2013 Race: Caucasian Current Appointment: 10/07/2014 Township: Hillsborough Expiration: 09/30/2017 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Resid/Spec Req: At -Large Sex: Male First Appointed: 10/07/2014 Race: Caucasian Current Appointment: 10/07/2014 Township: Chapel Hill Expiration: 10/07/2015 Resid/Spec Req: At -Large Number of Terms: Special Repr: At -Large Sex: Female First Appointed: 02/04/2014 Race: Caucasian Current Appointment: 02/04/2014 Township: Chapel Hill Expiration: 02/04/2015 Resid/Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Thursday, February 05, 2015 Page 1 3 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee 2 7 8 7 10 Meeting Times: 5:30 p.m. Every other 1st Tuesday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: United Church of CH - 1321 ML King Blvd 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 specialized training and support. Ms. Vicki Barringer Day Phone: 919 - 971 -9333 Evening Phone: 919- 971 -9333 3612 Old Vine Trail FAX: Hillsborough NC 27278 E -mail: vbarringer @gmail.com VACANT Day Phone: Evening Phone: FAX: E -mail: Mrs. Jerry Ann Gregory Day Phone: 919 - 644 -8172 Evening Phone: 919- 644 -8172 2224 Lebanon Rd FAX: Efland NC 27243 E -mail: harleyphn @yahoo.com Ms. Susan Deter Day Phone: 919 -682 -4124 Evening Phone: 919- 479 -0574 5512 Quail Hollow Drive FAX: 919 - 956 -7703 Hillsborough NC 27278 E -mail: susiedeter @yahoo.com Dr Mary Ann Peter Day Phone: 919 - 732 -6073 Evening Phone: 118 W. Tryon St. FAX: Hillsborough NC 27278 E -mail: maryannpeter @earthlink. net Sex: Female First Appointed: 03/22/2012 Race: Caucasian Current Appointment: 03/19/2013 Township: Eno Expiration: 03/31/2016 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Sex: Female Sex: First Appointed: Race: Current Appointment: Township: Expiration: 02/04/2015 Resid/Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Sex: Female First Appointed: 12/09/2014 Race: Caucasian Current Appointment: 12/09/2014 Township: Cheeks Expiration: 12/09/2015 Resid/Spec Req: At -Large Number of Terms: Special Repr: At -Large Sex: Female First Appointed: 04/19/2011 Race: Caucasian Current Appointment: 03/22/2012 Township: Little River Expiration: 04/19/2015 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Sex: Female First Appointed: 01/24/2012 Race: Caucasian Current Appointment: 06/18/2013 Township: Hillsborough Expiration: 06/30/2016 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: At -Large Thursday, February 05, 2015 Page 2 0 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1st Tuesday starting with Jan. Terms: 2 Contact Person: Charlotte Terwilliger, MSW Meeting Place: United Church of CH - 1321 ML King Blvd 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 specialized training and support. VACANT Day Phone: Sex: First Appointed: 11 Evening Phone: Race: Current Appointment: FAX: Township: Expiration: 02/04/2015 E -mail: Resid/Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Ms. Vlbeke Talley Day Phone: 919- 732 -3112 Sex: Female First Appointed: 05/20/2014 Evening Phone: 919- 732 -3112 Race: Caucasian Current Appointment: 05/20/2014 12 134 East Tryon Street FAX: 968 -2017 Township: Hillsborough Expiration: 12/31/2016 Hillsborough NC 27278 E -mail: vibandjoe @hotmail.com Resid/Spec Req: At -Large Number of Terms: Special Repr: Nursing Home Administration Thursday, February 05, 2015 Page 3 Thom Freeman From: Ed Flowers <ed_ #lowers @yahoo.com> Sent: Friday, January 09, 2015 9:32 AM To: Thom Freeman Cc: Charlotte Terwilliger, Teri Driscoll Subject: Sandra Nash (formerlu Jones) Thom Sandra Nash has completed her one year provisional membership on the Orange County Nursing Home Community Advisory Committee. She is exercising the option of continuing as a member of the OCNHCAC. Please record her position as active. "We choose our joys and sorrows long before we experience them.. " Kahlil Gibran 1 Thom Freeman From: Ed Flowers <ed_flowers @yahoo.com> Sent: Wednesday, January 21, 2015 4 :21 PM To: Thom Freeman Cc: Bill Crittenden; Maria Hardin; Charlotte Terwilliger; Teri Driscoll Subject: Re: Potential new members of the Orange County Nursing Home Community Advisory Committee Yes. "You can easily judge the cha -ractel ofa man by how he treats those who can do nothing for him." Johann Wolfgang von Goethe htt tiv ww. godtube, com watch ?v= WP6KW7NX &utm source= GodTub e %20Must- See %20Video &utrn medium = email &utm campaign =01 f 20/2015 From: Thom Freeman <tfreeman @o rang ecou ntync. gov> To: Ed Flowers <ed_ flowers @yahoo.com> Cc: Bill Crittenden <bill @senior- care- management.com >; Maria Hardin <mariaahardin @g mail. com >; Charlotte Terwilliger <cterwilliger @tjcog.org >; Teri Driscoll <drisco11323 @nc.rr.com >; Orange County Nursing Home Community Advisory Committee <ocnhaclist @yahoogro ups. com> Sent: Wednesday, January 21, 2015 2:50 PM Subject: RE: Potential new members of the Orange County Nursing Home Community Advisory Committee Hi Ed, I assume these are 1 year training appointments? Thanks, Thom From: Ed Flowers [mailto:ed_flowers @yahoo.com] Sent: Thursday, January 08, 2015 6:30 PM To: Thom Freeman Cc: Bill Crittenden; Maria Hardin; Charlotte Terwilliger; Teri Driscoll; Orange County Nursing Home Community Advisory Committee Subject: Potential new members of the Orange County Nursing Home Community Advisory Committee Thom 7 We invited Bill Crittenden and Maria Hardin to the OCNHCAC meeting this past Tuesday. The purpose of this invitation was to let Bill and Maria see what our committee does. After reviewing their applications, our committee voted to invite both Bill and Maria to be members of the OCNHCAC. Please send this recommendation to the Orange County Board of Commissioners for their approval. Please let me know if there are questions or if additional information is needed. Thank you Ed Flowers Chairperson OCNHCAC "We choose our joys and sorrows long before we experience them.." Kahlil Gibran z Page 1 of 2 Sandra Nash Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Sandra Nash 600 West Poplar Ave., Apt. 239 Carrboro NC 27510 828 - 668 -9628 828 - 712 -2362 None Retired RN, Teacher 2012 Chapel Hill Carrboro City Limits Female Caucasian Community Activities /Organizational Memberships: Volunteer at McDougle Elementary School - 2nd Grade Reading and Writing Volunteer Leukemia & Lymphoma Society Volunteer Ronald McDonald House (UNC Childrens Hospital) Volunteer Literacy Council- Tutoring in Reading & Math for a 70 year old illiterate lady. Active in my church. Active in my Church Past Service on Orange County Advisory Boards: None Boards /Commissions applied for: Advisory Board on Aging Background, education and experience relevant to this board: I am aged - recently became 70 - and I am slightly handicapped and live in a senior independent apartment complex where I see the reality of aging at every level - economically, socially, healthwise, mentally, emotionally. With my background in geriatrics I can be very discerning as to the blessings and problems of aging. Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Other Comments: 9 Page 2 of 2 Sandra Nash STAFF COMMENTS: Originally applied for Nursing Home Committee and Advisory Board on Aging 01/24/2013. ADDRESS VERIFICATION: 600 West Poplar Avenue, Apt. 239, is Carrboro Jurisdiction, Carrboro City Limits, Chapel Hill Township. This application was current on: 10/1/2014 Date Printed: 2/5/2015 10 Page 1 of 2 William Crittenden Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Dr. William Crittenden 4206 BRADFORD RIDGE RD EFLAND NC 272439474 9196362016 9196362016 9196362016 bill.seniorcare @gmail.com Senior Care Management Associates Geriatric Care Manager 2005 Bingham Male Caucasian Community Activities /Organizational Memberships: Member - United Church of Chapel Hill\ Member - Hillsborough- Orange County Chamber of Commerce Member - Hillsborough Leads Group Member - Chapel Hill Leads Group Past Service on Orange County Advisory Boards: Orange County Dept. of Aging Planning Committee Boards /Commissions applied for: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: I have over 20 years of experience in assisting seniors to maintain their independence, dignity, and self- respect by providing appropriate health care and housing services, emotional support and psychological support and intervention as well as consultation regarding available community resources. I have an earned doctoral degree in marriage and family counseling and have provided chaplaincy services in psychiatric and general hospitals, developed and firected a marriage and family counseling service based in a hospital setting and served as the Executive Director of continuing care retirement communities including assisted living and skilled nursing facilities. Reasons for wanting to serve on this board: I have been involved in a wide variety of senior care services throughout my career and would look forward to bringing my background and experience to the Adult Care Home Community Advisory Committee. Conflict of Interest: Supplemental Questions: Page 2 of 2 Other Comments: William Crittenden 11 This application was current on: 7/28/2014 10:29:42 AM Date Printed: 2/5/2015 12 Page 1 of 2 Maria Hardin Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Mrs. Maria Hardin 2026 Black Walnut Farm Road Hillsborough NC 27278 9197326589 9197326589 9192595704 mariaahardin @gmail.com Ebenezer Baptist Church Preschool Director 2006 Hillsborough Female Caucasian Community Activities /Organizational Memberships: I have been involved with The PTA, Character Ed. program in the middle schools, outreach to Nursing /Assisted Living with our Church for many years, Durham Rescue Mission as well. Past Service on Orange County Advisory Boards: I am not currently serving on any boards or have I in the past. My father is currently living in a assisted living center in Hillsborough, and I would like to be a part of a group that is helping. Boards /Commissions applied for: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: I have always had a love for senior citizens they have so much wisdom to share, growing up my Grandfather lived with us and I spent a lot of time at the senior center helping and as an adult my Mom spend several years in both assisted living and nursing home, and now my Dad is living in a memory care area of a assisted living center. I spend a lot of time each week with the residents. Reasons for wanting to serve on this board: This is one of the most important boards that Orange Co. can have, we have so many Seniors living at Nursing homes or assisted living that do not have family or friends who can help and support them, our seniors are so important to our history of this town, state and country. Conflict of Interest: Supplemental Questions: Page 2 of 2 Other Comments: I►VAFMIFTior, 13 This application was current on: 11/5/2014 12:58:22 PM Date Printed: 11/6/2014 14 Applicant Interest Listing by Board Name and by Applicant Name Nursing Home Community Advisory Committee Contact Person: Charlotte Terwilliger, MSW Contact Phone: 919 - 558 -9401 Ms. Susan Adams Day Phone: 919- 357 -5541 Sex: Female 211 Hogan Woods Circle Evening Phone: 919- 357 -5541 Race: Caucasian Chapel Hill NC 27516 Cell Phone: Township: Chapel Hill Caucasian E -mail: jaseradams@gmail.com Date Applied: 10/07/2013 Skills: Consultant Also Serves On: Township: Ms. Martha Bell 100 Macrae Court Chapel Hill NC 27516 Skills: Day Phone: Evening Phone: Cell Phone: E -mail: Also Serves On: 919- 968 -4674 as above N/A mbe11968@yahoo.com Sex: Race: Township: Date Applied: Female Caucasian Chapel Hill 01/09/2014 Dr. William Crittenden Day Phone: 9196362016 Sex: Male 4206 BRADFORD RIDGE RD Evening Phone: 9196362016 Race: Caucasian EFLAND NC 272439474 Cell Phone: 9196362016 Township: Bingham E -mail: bill.seniorcare@gmail.com Date Applied: 07/28/2014 Skills: Also Serves On: Nick Galvez Day Phone: 7274189921 Sex: Male 403 N Elliott Road Evening Phone: 7274189921 Race: Other Chapel Hill NC 27514 Cell Phone: 7274189921 Township: Chapel Hill E -mail: ngalvez1234@gmail.com Date Applied: 01/08/2014 Skills: Also Serves On: Board of Health Mrs. Maria Hardin 2026 Black Walnut Farm Road Hillsborough NC 27278 Skills: Day Phone: 9197326589 Evening Phone: 9197326589 Cell Phone: 9192595704 E -mail: mariaahardin@gmail.com Also Serves On: Sex: Female Race: Caucasian Township: Eno Date Applied: 11/05/2014 Thursday, February 05, 2015 Page 1 of 1 15 Page 1 of 2 Susan Adams Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Susan Adams 211 Hogan Woods Circle Chapel Hill NC 27516 919- 357 -5541 919- 357 -5541 jaseradams @gmail.com Self- employed Consultant 2004 Chapel Hill Carrboro City Limits Female Caucasian Community Activities /Organizational Memberships: IFC - Orange County Homeless Shelter, Galloway Ridge - Volunteer, Care Ministry - Newman Center, Coastal Pines of North Carolina - troop 862 - Adult Volunteer, Treasurer 2007 -2012, AARP, GSA - Gerontological Society of America MAC Committee - Mandarin Advisory Council for the Dual Language Program for Chapel Hill Carrboro City School District, Newman center outreach care ministry, MAC -dual language for Mandarin Chinese advisory board for school system, NAHB - National Home Builders Association Orange , Chatham and Durham counties - remodeler s council, National Gerontology Society, AARP, Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Advisory Board on Aging Background, education and experience relevant to this board: I am energized by solving problems and taking on challenges. With over 1 person turning 50 every second due to the dramatic achievements in public health, Orange County is poised to see a 67% increase in persons over 65 and a 43% increase in persons over 85 in the next 10 years. This trend continues through 2030 when persons over 65 will again increase by 42% and over 85 by 70 %. Orange county is a leader in serving its senior population and I want to contribute to preparing and meeting these needs throughout the next 20 years. Although I worked as a chemical engineer for 15 years, I recently returned to school to get a BA in Multidisciplinary studies, with an emphasis on social sciences and the Socio- Ecological Model which shows that the health of an individual is based not just on the person but withing the greater context of his relationships, his community and his society. Because of my interest in the aging process, I am currently completing a Masters in Gerontology from the University of Southern California. Through this program I have been able to receive the training and tools that will aid me in pursuing my goal of improving the disparity in the aging experience between the 16 Page 2 of 2 Susan Adams different economic classes. The research area where I am basing my concentration consists of early depression intervention for the home caregiver. Many home caregivers are thrust into their duties with little to no training and as more residents, especially in the rural areas, are deciding to age in place there will be a need for increased programs to address the adult child or spousal caregiver, many of whom are over 50. I am excited to be beginning this new phase of my life as I turn 50, and consider myself to be a life -long learner who believes that we are all part of something larger and there is purpose to all our lives. My belief system influences all I do and I value responsibility and high ethical standards. I believe that the strategic methods of problem solving I utilized as an engineer allows me to find and evaluate alternatives and seek innovative ways to get things done. I believe in community involvement as I was a member of the School Improvement Team (SIT) committee for McDougle Middle School for 2 years, worked as a volunteer at the Chapel Hill Museum for 3 years, and have been a member of the MAC - Mandarin Advisory Council for the dual language program in CHCCS since it began and my daughter has been part of the program for the past 8 years. As my children are growing up and moving on to new goals, I feel that I too must focus my time and energies on the future. I appreciate your time in considering me for this position. Reasons for wanting to serve on this board: Conflict of Interest: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: I am graduating with my Masters of Arts in Gerontology in May 2014 from the University of Southern California. My BS is multi disciplinary in psychology and public health. My concentration of study is in environmental interventions to decrease agitation in persons with dementia. I currently volunteer at Galloway Ridge and care part time for my elderly parents who I relocated to Chatham County in 2008. Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Other Comments: STAFF COMMENTS: Applied 2/1/2013 for Advisory Board on Aging. Applied 10/4/2013 for Nursing Home CAC. ADDRESS VERIFICATION: 211 Hogan Woods Circle is Chapel Hill Township, Carrboro Jurisdiction, Carrboro City Limits. This application was current on: 10/7/2013 Date Printed: 10/21/2014 17 Page 1 of 2 ILYAMM TO,.M -11 Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Martha Bell 100 Macrae Court Chapel Hill NC 27516 919- 968 -4674 as above N/A mbe11968 @yahoo.com Retired Registered Nurse - Director of Nursing 1995 Chapel Hill Female Caucasian Community Activities /Organizational Memberships: Member, Sigma Theta Tau Vice Chair, DVAMC Veterans Mental Health Council Member, The Chapel of the Cross Volunteer, Ambulatory Care, DVAMC Member, Retired Officers Association Member, Army Nurse Corps Association (former Regional Director) Past Service on Orange County Advisory Boards: Nursing Home Community Advisory Committee Board of Health Boards /Commissions applied for: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: After retiring from active duty with the Army Nurse Corps in 1995, accepted position of Director of Nursing, Carol Woods Retirement Community, serving in that capacity for 12 years, and then continued in special projects as identified by the President/CEO, Carol Woods, for another 5 years; also eventually had operational responsibility for assisted living, and infection control for the organization. Coordinated clinical assignments in long term care for nursing and nursing assistant students from DCC and NCCU. Taught fundamentals of elder care to staff and students; served as consultant with CARF and AAHSA reviewing health and service delivery standards. Reasons for wanting to serve on this board: Throughout the years at Carol Woods, I met many members of this Cmmunity Committee, through their advisory capacity; always impressed with their respect for the older adult and circumstances that lead a person(s) to seek long term care, I knew I was unable to serve this Page 2 of 2 Martha Bell committee until I retired from the business of elder services. I ve continued to keep my nursing license current, attending related education offerings in the infection control, gerontology and health care for the years since retirement from full time work. While volunteering in Durham, I really want to serve my local community and continue to put my knowledge of aging services and long term care to good use. Conflict of Interest: Board of Health Background, education and experience relevant to this board: RN, BSN, MSN; attendance at 3.5 day infection control in long term care course offered by SPICE every two years; recent course attendance at offering regading CDiff; served as infection control consultant for Carol Woods Retirement Community 12 years while also serving as its Director of Nursing /Health Services. Reasons for wanting to serve on this board: Throughout the years at Carol Woods, I was often involved with Board of Health issues, including outbreak investigation, tuberculosis control, difficulties encountered in Infection Control for the older adult in a long term care /congregate living environment. I purposely kept my nursing license current despite my retirement from full time nurse because I hoped to eventually serve my community in some capacity related to my professional knowledge. I seek only an activity that will use my knowledge rather than any paid position. Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 1/9/2014 11:27:53 AM Date Printed: 1/9/2014 19 Page 1 of 2 Nick Galvez Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Nick Galvez 403 N Elliott Road Chapel Hill NC 27514 7274189921 7274189921 7274189921 ngalvez1234 @gmail.com Bayada Home Care Field Clinician /Physican Therapist 2013 Chapel Hill Male Other Community Activities /Organizational Memberships: To Whom It Concerns: I have worked in healthcare for over 15 years and have successfully managed operations and finances for medium and large healthcare organizations. I earned an MBA with a concentration in accounting in 2004. 1 also gained the CMA certification from the Institute of Management Accountants to further my knowledge and prepare for a Director level position. In my current position as a regional manager, I helped develop new markets (Georgia) and new programs for internal and external growth. I assisted the sales team to ensure operations and new business growth was aligned with the company5ETMs long term strategic plan. The region and company has grown significantly due to my focus on new markets and new programs. I have volunteer experiences that have also contributed to my professional development. I enjoyed serving on the Hillsborough County Healthcare Advisory Board for the past 4 years and have contributed to fiscal policy development for the county healthcare plan. I also serves on the Board of Directors for the Health Council of West Central Florida to serve their mission to educate consumers in the region about healthcare issues. I held this position for 2 years while living in Florida. I am excited about getting involved in the Chapel Hill community and sharing my experiences with other like minded citizens to improve out community. Sincerely, P Page 2 of 2 Nick Galvez Nick Galvez Past Service on Orange County Advisory Boards: none Boards /Commissions applied for: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: I have a background in healthcare administration and business management. I have worked in nursing homes as a director of therapy and also as a regional director for therapy departments. I have worked with for profit and not for profit companies that own and operate nursing homes. I believe the combination of operations and finances are vital to a successful healthcare organization. I believe local boards need to weigh the benefits and costs of those affected by the decisions by they make. I have a desire to improve our health as a society, in the community and in our family. I believe that I can affect the changes by becoming involved in local boards and talking with other professionals about health. The affordable health care act will inevitably affect those directly and indirectly in the field of health. Reasons for wanting to serve on this board: see above Conflict of Interest: na Supplemental Questions: Other Comments: This application was current on: 1/8/2014 7:47:26 AM Date Printed: 2/5/2015