HomeMy WebLinkAboutAgenda - 06-16-2015-11i 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 16, 2015
Action Agenda
Item No. 11-i
SUBJECT: Nursing Home Community Advisory Committee - Appointment
DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): Under Separate Cover INFORMATION CONTACT:
Membership Roster Clerk's Office, 245-2130
Recommendation
Application for Person Recommended
Interest List
Applications of Persons on the Interest List
PURPOSE: To consider making an appointment to the Nursing Home Community Advisory
Committee.
BACKGROUND: The following information is for Board consideration:
• Appointment to a one year training term (Position #2) At-Large Nursing Home
Administration for Ms. Molly Stein ending 06/16/2016.
POSITION NO. NAME SPECIAL REPRESENTATIVE EXPIRATION DATE
2 Ms. Molly Stein At-Large one year training 06/16/2016
term
NOTE - If the individuals listed above are appointed, the following vacancies remain:
• Position #1--- "At Large" position ------ expiring 01/30/2016. (All positions have
statutory requirements and each initial appointment is a one year training term.
The committee is currently reviewing for potential recommendation)
FINANCIAL IMPACT: None.
RECOMMENDATION(S): The Board will consider making an appointment to the Nursing
Home Community Advisory Committee.
2
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:
1 Evening Phone: Race: Current Appointment:
FAX: Township: Expiration: 01/30/2016
E-mail: Resid/Spec Req: At-Large Number of Terms:
Special Repr: At-Large
VACANT Day Phone: Sex: First Appointed:
2 Evening Phone: Race: Current Appointment:
FAX: Township: Expiration: 03/31/2015
E-mail: Resid/Spec Req: At-Large Number of Terms:
Special Repr: At-Large
Ms. Teri J. Driscoll Day Phone: 919-245-1127 Sex: Female First Appointed: 09/17/2013
3 Chair Evening Phone: 919-245-1127 Race: Caucasian Current Appointment: 10/07/2014
422 Hampton Pointe FAX: Township: Hillsborough Expiration: 09/30/2017
Hillsborough NC 27278 E-mail: drisco11323 @nc.rncom Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: At-Large
Mr. Jerry Schreiber Day Phone: 919 967 2962 Sex: Male First Appointed: 10/07/2014
4 Trainee Evening Phone: 919 967 2962 Race: Caucasian Current Appointment: 10/07/2014
1606 Pathway Dr FAX: Township: Chapel Hill Expiration: 10/07/2015
Carrboro NC 27510 E-mail:jrogerschreiber @gmail.com Resid/Spec Req: At-Large Number Of Terms:
Special Repr: At-Large
Ms. Sandra Nash Day Phone: 828-668-9628 Sex: Female First Appointed: 02/04/2014
5 Evening Phone: Race: Caucasian Current Appointment: 03/03/2015
600 West Poplar Ave.,Apt.239 FAX: Township: Chapel Hill Expiration: 06/30/2017
Carrboro NC 27510 E-mail: None Resid/Spec Req: At-Large Number of Terms: 2
Special Repr: Nursing Home Administration
Thursday,May 21,2015 Page 1
3
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.
Ms. Vicki Barringer Day Phone: 919-971-9333 Sex: Female First Appointed: 03/22/2012
6 Evening Phone: 919-971-9333 Race: Caucasian Current Appointment: 03/19/2013
3612 Old Vine Trail FAX: Township: Eno Expiration: 03/31/2016
Hillsborough NC 27278 E-mail: vbarringer @gmail.com Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: At-Large
Dr. William Crittenden Day Phone: 9196362016 Sex: Male First Appointed: 03/03/2015
7 Evening Phone: 9196362016 Race: Caucasian Current Appointment: 03/03/2015
4206 BRADFORD RIDGE RD FAX: Township: Bingham Expiration: 03/03/2016
EFLAND NC 272439474 E-mail: bill.seniorcare @gmail.com Resid/Spec Req: At-Large Number of Terms:
Special Repr: Nursing Home Administration
Mrs. Jerry Ann Gregory Day Phone: 919-644-8172 Sex: Female First Appointed: 12/09/2014
8 Evening Phone: 919-644-8172 Race: Caucasian Current Appointment: 12/09/2014
2224 Lebanon Rd FAX: Township: Cheeks Expiration: 12/09/2015
Efland NC 27243 E-mail: harleyphn @yahoo.com Resid/Spec Req: At-Large Number of Terms:
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: 03/22/2012
5512 Quail Hollow Drive FAX: 919-956-7703 Township: Little River Expiration: 06/30/2016
Hillsborough NC 27278 E-mail: susiedeter @yahoo.com Resid/Spec Req: At-Large Number of Terms: 1
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: 06/18/2013
118 W.Tryon St. FAX: Township: Hillsborough Expiration: 06/30/2016
Hillsborough NC 27278 E-mail: maryannpeter @earthlink.net Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: At-Large
Thursday,May 21,2015 Page 2
4
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.
Mrs. Marla Hardin Day Phone: 9197326589 Sex: Female First Appointed: 03/03/2015
11 Evening Phone: 9197326589 Race: Caucasian Current Appointment: 03/03/2015
2026 Black Walnut Farm Road FAX: Township: Eno Expiration: 03/03/2016
Hillsborough NC 27278 E-mail: mariaahardin @gmail.com Resid/Spec Req: At-Large Number of Terms:
Special Repr: Nursing Home Administration
Ms. Vibeke Talley Day Phone: 919-732-3112 Sex: Female First Appointed: 05/20/2014
12 Evening Phone: 919-732-3112 Race: Caucasian Current Appointment: 05/20/2014
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,May 21,2015 Page 3
5
Thom Freeman
From: Charlotte Terwilliger <cterwilliger @tjcog.org>
Sent: Friday, May 15, 2015 11:22 AM E
To: Thom Freeman
Cc: Teri Driscoll
Subject: Appointment Recommendation - Molly Stein
1
Hi Thom,
The Nursing Home Community Advisory Committee would like to recommend Ms. Molly Stein for a one year training
term. Ms. Stein is currently a student preparing to go to Physician Assistant school at the University of North Carolina at
Chapel Hill. She has also served as an Ambassador at Duke Regional Hospital in their emergency room. Ms.Stein has a j
passion for health care and making a difference in people's lives.
Please let me know if you need any additional information to move this recommendation forward.
Best Regards,
Charlotte
Charlotte Terwilliger, MSW
Regional Long Term Care Ombudsman
Area Agency on Aging
Triangle J Council of Governments
4307 Emperor Blvd., Suite 110, Durham, NC 27703
(o) 919-558-9401/(f) 919-998-8101
cterwilliger((Dticog.org/www.ticog.org
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.
i
t ',
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Page 1 of 2 Molly Stein
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. Molly Stein
Name Called:
Home Address: 103 Stephens Street
Chapel Hill NC 27516
Phone (Day): 954-254-2865
Phone (Evening): 954-254-2865
Phone (Cell): 954-254-2865
Email: msstein @live.unc.edu
Place of Employment: University of North Carolina at Chapel Hill
Job Title: Student
Year of OC Residence: 2012
Township of Residence: Chapel Hill
Zone of Residence:
Sex: Female
Ethnic Background: Caucasian
Community Activities/Organizational Memberships:
-Emergency Room Ambassador at Duke Regional Hospital
-Historian of Carolina Kickoff in the Campus YMCA
-Member of the Carolina Pre-Physician Assistant Association
Past Service on Orange County Advisory Boards:
N/A
Boards/Commissions applied for:
Nursing Home Community Advisory Committee
Background, education and experience relevant to this board:
I am currently a junior at the University of North Carolina at Chapel Hill studying to prepare to go
to Physician Assistant school. I have a true passion for helping people in any relation to
medicine. I cannot wait to be a physician assistant and look forward to any opportunities with
experience in the medical field before I attend graduate school. I have extensive shadowing
experience in many different realms of the medical world such as hospitals, nursing homes and
private practices. I am an emergency room ambassador at Duke Regional Hospital and have
experience interacting with patients. My grandfather is in an assisted living facility in Florida and I
am familiar with how nursing home and assisted living facilities work. Therefore, I have
experience from an employee s point of view (during nursing assistant clinicals) and from a
family member s point of view with my grandfather.
Reasons for wanting to serve on this board:
With my shadowing and volunteering experience, I am only able to do so much to help. I yearn
to be able to make a bigger difference in people s lives. I know that this position will help me do
that. Through my shadowing and nursing assistant clinicals, I saw some unjust situations which
really broke my heart and were wrong. This is what made me want to get into the field of patient
advocacy. I believe it is our responsibility to speak and act for those who cannot, especially
those susceptible to abuse and neglect. This is something that I have been wanting to do for a
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Page 2 of 2 Molly Stein
long time, and I hope that I am able to get the opportunity to help make a difference.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 3/6/2015 4:29:11 PM Date Printed: 3/11/2015
8
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person: Charlotte Terwilliger,MSW
Nursing Home Community Advisory Committee 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
E-mail: jaseradams@gmail.com Date Applied: 06/02/2015
Skills: Consultant Also Serves On:
MS. Martha Bell Day Phone: 919-968-4674 Sex: Female
100 Macrae Court Evening Phone: as above Race: Caucasian
Chapel Hill NC 27516 Cell Phone: N/A Township: Chapel Hill
E-mail: mbell968@yahoo.com Date Applied: 05/21/2015
Skills: Also Serves On:
MS. Molly Stein Day Phone: 954-254-2865 Sex: Female
103 Stephens Street Evening Phone: 954-254-2865 Race: Caucasian
Chapel Hill NC 27516 Cell Phone: 954-254-2865 Township: Chapel Hill
E-mail: msstein@live.unc.edu Date Applied: 03/06/2015
Skills: Also Serves On:
Tuesday,June 02,2015 Page 1 of 1
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Page 1 of 3 Susan Adams
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. Susan Adams
Name Called:
Home Address: 211 Hogan Woods Circle
Chapel Hill NC 27516
Phone (Day): 919-357-5541
Phone (Evening): 919-357-5541
Phone (Cell):
Email: jaseradams @gmail.com
Place of Employment: Self-employed
Job Title: Consultant
Year of OC Residence: 2004
Township of Residence: Chapel Hill
Zone of Residence: Carrboro City Limits
Sex: Female
Ethnic Background: 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,
-Received Masters of Gerontology from University of Southern California 2014 Magna
Cum Laude - Thesis title " Enviornmential and technological interventions to decrease
agitation in dementia patients"
-Founded Consulting Business CareGiving Technologies - Safer Independent Living
-Received CAPS " Certified Aging in Place Specialist" Certification from Nathional Home
Builders Association 2014
-Received Universal Design Certification from National Home Builders Association 2014
-Asked to become board member of SHARP " Senior Health Advisory Resouce
Partnership" in Orange County executive director Healther Altman
-Working closely with Dr. Cheire Rosemond at UNC for Tax incentives for livable homes
as part of the Aging in Community Series
-Speaker at Caregiver's Conference Durham and Raleigh 2015
-Speaker at Alzheimer Association Fall Conference 2015
-Became Lively partner -Award winning passive senior Monitoring system
-Member of HART Health Aging Round Table
-Recently accepted position at Carolina Villages for director of Volunteer Services
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Page 2 of 3 Susan Adams
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 notjust 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
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.
1 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:
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Page 3 of 3 Susan Adams
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: 6/2/2015 Date Printed: 6/2/2015
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Page 1 of 2 Martha Bell
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Ms. Martha Bell
Name Called:
Home Address: 100 Macrae Court
Chapel Hill NC 27516
Phone (Day): 919-968-4674
Phone (Evening): as above
Phone (Cell): N/A
Email: mbe11968 @yahoo.com
Place of Employment: Retired
Job Title: Registered Nurse - Director of Nursing
Year of OC Residence: 1995
Township of Residence: Chapel Hill
Zone of Residence:
Sex: Female
Ethnic Background: 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
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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