Loading...
HomeMy WebLinkAboutAgenda - 05-02-2017-11-a - Adult Care Home Community Advisory Committee – Appointments 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: May 2, 2017 Action Agenda Item No. 11-a SUBJECT: Adult Care Home Community Advisory Committee —Appointments DEPARTMENT: Board of Commissioners ATTACHMENT(S): Under Separate Cover INFORMATION CONTACT: Membership Roster Clerk's Office, 919-245-2130 Recommendation Applications for Persons Recommended Attendance Record Interest List Applications of Persons on the Interest List Adult Care Home Community Advisory Committee By-Laws PURPOSE: To consider making appointments to the Adult Care Home Community Advisory Committee. BACKGROUND: The following information is for Board consideration: (NOTE: For the Adult Care Home Community Advisory Committee, the By-Laws state that the appointees, post the one year training term, are eligible for three (3) two (2) year terms). • Appointment to a first full term (Position #1) "At-Large" position for Cresha (Christine) Cianciolo expiring 03/31/2019. • Appointment to a third full term (Position #4) "At-Large" position for Max Mason expiring 06/30/2019. • Appointment to a partial* term (Position #8) "At-Large" position for Gloria Brown expiring 06/30/2018. (*See note at the end of the abstract). • Appointment to a partial** term (Position #9) "At-Large" position for William Lang expiring 03/31/2019. (**See note at the end of the abstract). • POSITION NO. NAME SPECIAL REPRESENTATIVE EXPIRATION DATE 1 Cresha (Christine) At-Large 03/31/2019 Cianciolo 4 Max Mason At-Large 06/30/2019 8 Gloria Brown At-Large 06/30/2018 9 William Lang At-Large 03/31/2019 2 NOTE - If the individuals listed above are appointed, the following vacancies remain: • None. FINANCIAL IMPACT: None. SOCIAL JUSTICE IMPACT: Enable Full Civic Participation. Ensure that Orange County residents are able to engage government through voting and volunteering by eliminating disparities in participation and barriers to participation. RECOMMENDATION(S): The Manager recommends that the Board consider making appointments to the Adult Care Home Community Advisory Committee. *NOTE: Gloria Brown has fulfilled her one year training term which began on 12/15/2015 and ended 12/15/2016. The committee was a bit late getting the recommendation in. Position #8, at the time of her one year training appointment, had an expiration date of 06/30/2018 and this date remains in place. She is therefore completing a "Partial Term" as the result of being less than a full two year term by ending on 06/30/2018). (**NOTE: William Lang has fulfilled his one year training term which began on 01/21/2016 and ended 01/21/2017. Position #9, at the time of his one year training appointment, had an expiration date of 03/31/2019 and this date remains in place. He is therefore completing a "Partial Term" as the result of being less than a full two year term by ending on 03/31/2019). 3 Board and Commission Members And Vacant Positions Adult Care Home Community Advisory Committee Meeting Times: 3:30 pm-5:00 pm Bi-monthly Terms: 3 Contact Person: Autumn Cox Meeting Place: Positions: 12 Length:2 years Contact Phone: 919-558-9401 Description: Members are appointed by the Board of Commissioners to at-large positions. There is an initial one-year training term with subsequent eligibility for three additional two-year terms.This committee works to maintain the intent of the Adult Care Home Residents`Bill of Rights for those residing in licensed adult care homes. The members of this committee also promote community involvement and cooperation with these homes to ensure quality care for the elderly and disabled adults. Mrs Cresha(Christine) Cianciolo Day Phone:919-489-8539 Sex: Female First Appointed: 06/21/2016 1 Evening Phone:919-489-8539 Race:Caucasian Current Appointment: 06/21/2016 7704 Amesbury Drive FAX: Township: Chapel Hill Expiration: 06/21/2017 Chapel Hill NC 27514 E-mail:c.a.cianciolo@gmail.com Resid/Spec Req: At-Large Number of Terms: Special Repr: Daniel Hatley Day Phone:919-200-0822 Sex: Male First Appointed: 08/17/2010 2 Evening Phone:309-252-1169 Race:Caucasian Current Appointment: 10/06/2015 1308 Leclair St. FAX: 888-514-4878 Township: Chapel Hill Expiration: 10/31/2017 Chapel Hill NC 27517 E-mail:dan@hatleylawoffice.com Resid/Spec Req: At-Large Number of Terms: 3 Special Repr: DD/MR Deborah Rider Day Phone:919-818-6489 Sex: Female First Appointed: 06/19/2012 3 Evening Phone:919-732-9476 Race:Caucasian Current Appointment: 06/21/2016 2314 Red Oak CT. FAX: Township: Hillsborough Expiration: 06/30/2018 Hillsborough NC 27278 E-mail:driderl736 @gmail.com Resid/Spec Req: At-Large Number of Terms: 2 Special Repr: Max Mason Day Phone:919-649-7937 Sex: Male First Appointed: 06/07/2011 4 Chair Evening Phone: Race:Caucasian Current Appointment: 10/06/2015 821 Tinkerbell Rd. FAX: Township: Chapel Hill Expiration: 06/30/2017 Chapel Hill NC 27517 E-mail:maxomason@yahoo.com Resid/Spec Req: At-Large Number of Terms: 2 Special Repr: Dr. Anthony John Vogt Day Phone:919-929-8646 Sex: Male First Appointed: 10/16/2012 5 Evening Phone:919-929-8646 Race:Caucasian Current Appointment: 10/06/2015 713 W.Barbee Chapel Road FAX: Township: Chapel Hill Expiration: 10/31/2017 Chapel Hill NC 27517 E-mail:ajvogt@earthIink.net Resid/Spec Req: At-Large Number of Terms: 2 Special Repr: Wednesday,April 26,2017 Page 1 4 Board and Commission Members And Vacant Positions Adult Care Home Community Advisory Committee Meeting Times: 3:30 pm-5:00 pm Bi-monthly Terms: 3 Contact Person: Autumn Cox Meeting Place: Positions: 12 Length:2 years Contact Phone: 919-558-9401 Description: Members are appointed by the Board of Commissioners to at-large positions. There is an initial one-year training term with subsequent eligibility for three additional two-year terms.This committee works to maintain the intent of the Adult Care Home Residents`Bill of Rights for those residing in licensed adult care homes. The members of this committee also promote community involvement and cooperation with these homes to ensure quality care for the elderly and disabled adults. Suzanne Haff Day Phone:919-933-9329 Sex: Female First Appointed: 12/09/2014 6 Evening Phone:919-933-9329 Race:Caucasian Current Appointment: 12/15/2015 107 Hunter Hill Road FAX: Township: Chapel Hill Expiration: 10/31/2017 Chapel Hill NC 27516 E-mail:suzhaff@gmail.com Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: A Yvonne Mendenhall Day Phone:919-968-7874 Sex: Female First Appointed: 12/09/2014 7 Evening Phone:919-968-7874 Race:Caucasian Current Appointment: 12/15/2015 304 W Barbee Chapel Rd FAX: Township: Chapel Hill Expiration: 10/31/2017 Chapel Hill NC 27517 E-mail:menholiday@aol.com Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: Gloria Brown MSW Day Phone:919 537-7485 Sex: Female First Appointed: 12/15/2015 g One Year Training Term Evening Phone:919 245-1025 Race:African American Current Appointment: 12/15/2015 2200 Old Forest Drive FAX: Township: Hillsborough Expiration: 12/15/2016 Hillsborough NC 27278 E-mail:browng @piedmonthealth.org Resid/Spec Req: At-Large Number of Terms: Special Repr: William Zang Day Phone:2022151131 Sex: Male First Appointed: 01/21/2016 g One Year Training Term Evening Phone:2022151131 Race:Caucasian Current Appointment: 01/21/2016 106 Hayes Street FAX: Township: Hillsborough Expiration: 01/21/2017 Hillsborough NC 27278 E-mail:wglangl9540dgmail.com Resid/Spec Req: At-Large Number of Terms: Special Repr: Dr. Beverly Foster Day Phone:919 966-4995 Sex: Female First Appointed: 06/18/2013 10 Evening Phone:919 967-2930 Race:Caucasian Current Appointment: 06/21/2016 2454 Springview Trail FAX: 919 843-6212 Township: Chapel Hill Expiration: 06/30/2018 Chapel Hill NC 27514 E-mail: Bev_Foster@unc.edu Resid/Spec Req: At-Large Number of Terms: 2 Special Repr: Wednesday,April 26,2017 Page 2 5 Board and Commission Members And Vacant Positions Adult Care Home Community Advisory Committee Meeting Times: 3:30 pm-5:00 pm Bi-monthly Terms: 3 Contact Person: Autumn Cox Meeting Place: Positions: 12 Length:2 years Contact Phone: 919-558-9401 Description: Members are appointed by the Board of Commissioners to at-large positions. There is an initial one-year training term with subsequent eligibility for three additional two-year terms.This committee works to maintain the intent of the Adult Care Home Residents`Bill of Rights for those residing in licensed adult care homes. The members of this committee also promote community involvement and cooperation with these homes to ensure quality care for the elderly and disabled adults. James Bartow Day Phone:919 932-2682 Sex: Male First Appointed: 02/18/2014 11 Evening Phone:919 932-2682 Race:Caucasian Current Appointment: 10/21/2014 118 Collums Rd FAX: Township: Chapel Hill Expiration: 10/31/2017 Chapel Hill NC 27514 E-mail:jmsbartow@gmail.com Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: Deborah Stewart Day Phone:919-210-4857 Sex: Female First Appointed: 12/09/2014 12 Evening Phone:919-210-4857 Race:Caucasian Current Appointment: 12/09/2014 1405 Buckhorn Rd. FAX: Township: Cheeks Expiration: 10/30/2017 Mebane NC 27302 E-mail:deb.k.stewart@gmail.com Resid/Spec Req: At-Large Number of Terms: Special Repr: Wednesday,April 26,2017 Page 3 6 Date: April 20, 2017 To: Orange County Board of Commissioners From: Maxwell Mason, Chair Adult Care Home Community Advisory Committee Re: Reappointment of: Christine (Cresha) Cianciolo William Lang Gloria Brown On behalf of the Orange County Adult Care Home Community Advisory Committee, I would like to take the opportunity to recommend Christine Cianciolo,William Lang, and Gloria Brown for reappointment on our committee. These three members are the newest to our committee, yet they have already gained considerable experience in their roles due to their commitment to our important work. They each leverage their new skills with experience from very relevant and related professional backgrounds to ensure a positive living environment for the county's senior population residing in adult and family care homes. Their meeting attendance has been strong, with any absence reported well in advance. They have also completed site visit reports and take care in documenting the details of the visits. Each of these members truly is an excellent representative of the County. I can sincerely say that each of these individuals has a very obvious passion for ensuring that long term care residents receive the best quality of care in a safe living environment. Please let me know if you need any additional information to move this recommendation forward. 7 April 10, 2017 To: Orange County Board of Commissioners From: Autumn Cox Regional Long Term Care Ombudsman Re: Reappointment of Max Mason On behalf of the Orange County Adult Care Home Community Advisory Committee, I would like to take the opportunity to recommend Max Mason for reappointment on the committee. He is very dedicated, and has a passion for ensuring that long-term care residents receive the best quality of care in a safe living environment. Max is the chair of the Adult Care Home Committee so he attends and leads all of the meetings and does his assigned site visits. He is a great choice for this committee and there is no doubt he will continue to do excellent advocacy work for the residents in Orange County. Please let me know if you need any additional information to move this recommendation forward. 8 Page 1 of 2 Cresha (Christine) Cianciolo Volunteer Application Orange County Advisory Boards and Commissions Name: Mrs Cresha (Christine) Cianciolo Name Called: Home Address: 7704 Amesbury Drive Chapel Hill NC 27514 Phone (Day): 919-489-8539 Phone (Evening): 919-489-8539 Phone (Cell): 919-260-0353 Email: c.a.cianciolo @gmail.com Place of Employment: Retired Job Title: Volunteer Year of OC Residence: 1989 Township of Residence: Chapel Hill Zone of Residence: Chapel Hill Township within C.H. city limits Sex: Female Ethnic Background: Caucasian Community Activities/Organizational Memberships: Board of Directors Community Home Trust Board of Directors Friends of the Chapel Hill Public Library Co-manager Friends Book Store (Chapel Hill Public Library) Volunteer Duke HomeCare and Hospice Volunteer Music and Memory Program at Carol Woods Member Henry Clark Society Habitat of Humanity Past Service on Orange County Advisory Boards: None Boards/Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: As a Registered Nurse, I was privileged to serve in several arenas. The first decade of my career was in Critical Care, working in the Emergency Room, Surgical Intensive Care and Coronary Care units. I later became a Study Coordinator recruiting patients for research studies at large University Medical Centers. The remaining two decades were spent as a Clinical Trials Coordinator, training and monitoring physicians and nurses conducting clinical trials to ensure they were complying with the CFR(Code of Federal Regulations, specifically 21 CRF50). These provisions provide for the protection of human rights in subjects participating in research studies. It is clear to me that these guidelines can apply to any human in a vulnerable position. Although this work was demanding and challenging, it has enhanced my ethical standards, of which I am proud. It has also required me to be organized and detailed. After retiring three years ago, I have volunteered with Duke HomeCare and Hospice to provide support and comfort to those at the end of life and their families. This effort has provided me access to several extended care facilities in the area, observing firsthand the treatment and management of the residents (good and bad). I am also involved with the Music and Memory program at Carol Woods. There I partner with 9 Page 2 of 2 Cresha (Christine) elders suffering with either physical or cognitive challenges to develop a music playlist to meet their individual tastes. This effort has provided me the satisfaction of witnessing the healing powers of music. The adventure of providing a personalized music playlist for patients with limitations is both challenging and humbling. I have been on the Board of the Community Home Trust since 2010. This has allowed me to further my desire to ensure that affordable housing is available for those who serve our community(teachers, UNC housekeepers, policemen, firemen)as well as single parents or the elderly. I am also on the Board of the Friends of the Chapel Hill Public Library(and co-manage the Friends Book Store),where I help to raise funds that support the library in providing programs for both adults and children. I am dedicated to both these Boards and enjoy being part of teams, working together to further our missions. Reasons for wanting to serve on this board: I would be interested in serving on this board as I am passionate about the welfare and needs of the elderly. As a nurse, I have seen the need for patient advocates to guide and educate the patient in their course of treatment and care. I have seen weekly changes in clients in extended care facilities that often go a€°'unseena€TM by staff who see and attend to them daily. Often, there is no interested family member available to assist in making life changing decisions or in determining if a resident s needs are being met. I feel that with my background, I am able to assess and plan for a population that is often a€°'under-serveda€TM. I would be honored to be considered for this role. Conflict of Interest: I am married to a Chapel Hill government official. Supplemental Questions: Other Comments: This application was current on: 1/18/2016 4:16:04 PM Date Printed: 1/19/2016 10 Page 1 of 2 Max Mason Volunteer Application Orange County Advisory Boards and Commissions Name: Mr. Max Mason Name Called: Home Address: 821 Tinkerbell Rd. Chapel Hill NC 27517 Phone (Day): 919-649-7937 Phone (Evening): Phone (Cell): Email: maxomason @yahoo.com Place of Employment: Principle Long Term Care, Inc. Job Title: Development Coordinator Year of OC Residence: 1978 Township of Residence: Chapel Hill Zone of Residence: Does not apply Sex: Male Ethnic Background: Caucasian Community Activities/Organizational Memberships: Past Service on Orange County Advisory Boards: Boards/Commissions applied for: Supplemental Questions: 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 11 Page 2 of 2 Max Mason (1/24/2011) for Nursing Home Community Advisory Committee. ADDRESS VERIFICATION: 821 Tinkerbell Road is in Chapel Hill Township. This application was current on: 1/25/2011 9:11:51 AM Date Printed: 12/31/2013 12 Page 1 of 2 Gloria Brown MSW Volunteer Application Orange County Advisory Boards and Commissions Name: Mrs. Gloria Brown MSW Name Called: Home Address: 2200 Old Forest Drive Hillsborough NC 27278 Phone (Day): 919 537-7485 Phone (Evening): 919 245-1025 Phone (Cell): 919 245-1025 Email: browng @piedmonthealth.org Place of Employment: Piedmont Health Services Inc. Job Title: Executive Administrator to CEO and Board Liaison Year of OC Residence: 2003 Township of Residence: Hillsborough Zone of Residence: Sex: Female Ethnic Background: African American Community Activities/Organizational Memberships: Work with Seniors, LGBT, and Homeless populations with my professional work, Community Outreach and voter registration events at churches and other groups for Piedmont. Member of Sportsplex. Group at work serves meals quarterly at SECU CH, member of White Rock Baptist Church in Durham and very active with the Titus Women s Ministry. Alumni Yeshive University WSSW, UNCG, and Valencia Community College. Former member of the IFC BOD and NASW Past Service on Orange County Advisory Boards: None Boards/Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: I have a BSW, MSW in Social Work. My Mother was diagnosed with Dementia when I was a Senior at UNCG, so I have personal experience knowing what it take to ensure that Seniors living in our community are safe and free from harm. It was a challenge as she had to be in a nursing home for 1 month for therapy but then I was able to take her to her home and her sister stayed with her. I got a sitter for Mon-Fri and Sat and Sun I oversaw her care. Piedmont Health SeniorCare is one of the programs where I work www.pace4you.org this program ensures that participants have the best of care and once they become a participant their depression scores decrease because they have interactions with others and people care about their well being. I like learning and believe that quality care is#1 and it is important that someone can be an advocate for a senior when they are not being treated fairly. Reasons for wanting to serve on this board: 13 Page 2 of 2 Gloria Brown MSW I will soon have a new postion Special Assistant to the CEO where one of the main groups that I will connect with will be seniors. So I talked with Brian Toomey, CEO about the information in Orange Briefs Sun Oct 25, 2015. It is important that residents of Adult Care Homes have access to quality affordable health care, dental care, proper nutricious food, Be Active to promote wellness and that they are treated properly by the owner of the Adult Care Homes. Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 10/29/2015 2:51:10 PM Date Printed: 10/29/2015 14 Page 1 of 2 William Lang Volunteer Application Orange County Advisory Boards and Commissions Name: Mr William Lang Name Called: Home Address: 106 Hayes Street Hillsborough NC 27278 Phone (Day): 2022151131 Phone (Evening): 2022151131 Phone (Cell): 2022151131 Email: wglang1954 @gmail.com Place of Employment: American Association of Colleges of Pharmacy Job Title: Senior Policy Advisor Year of OC Residence: 2013 Township of Residence: Hillsborough Zone of Residence: Hillsborough Town Limits Sex: Male Ethnic Background: Caucasian Community Activities/Organizational Memberships: Volunteer- Meals on Wheels/OCIM Past Service on Orange County Advisory Boards: None Boards/Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: Extensive experience in law and regulation associated with home and community-based programs and services both at the state (NC)and federal levels. Masters in Public Health. Former Director of Government Affairs for Association of home and hospice care of NC. Mentored by Karen Gottovi and Betty Wiser(former state representatives/Director of State Agency for Aging)...important advocates for older adults, disabled and those served by adult care homes and other community-based programs. Reasons for wanting to serve on this board: Adult care homes play an important role in the continuum of care for older adults and the disabled. The challenges of effective and efficient operation of adult care homes can only be met through partnership between home operators, regulators and community advocates. Bringing stakeholders together to create positive and sustained efforts for service and program improvement is an important aspect of my work that can be translated easily to my role as an advisory board member. Conflict of Interest: No Supplemental Questions: 15 Page 2 of 2 William Lang Other Comments: This application was current on: 11/4/2015 9:54:23 AM Date Printed: 11/5/2015 U" .1111 U" U" .1111 ®©i©i ti ®©v©v2 t co A O C\I iiii tt O w cu iaaaa; a Q ®iiii O LL GA U O Qi %aaaa; aaG;'L, f ®©�©� U Q C i U U r U - m o w N N N N Q _ N o N N 0 0 — o z co co z o z o N W M 17 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Autumn Cox Adult Care Home Community Advisory Committee contact Phone: 919-558-9401 Dr. Michael C. Joseph Day Phone: 919-923-3907 Sex: Male 506 Silver Fox Circle Evening Phone: 919-923-3907 Race: African American Hillsborough NC 27278 Cell Phone: 919-923-3907 Township: Hillsborough E-mail: mcjosephmd @nc.rr.com Res.Eligibility: Hillsborough ETJ Date Applied: 02/02/2017 Skills: Also Serves On: Jacqulyn Podger Day Phone: 919-740-8814 Sex: Female 719 New Hope Church Rd. Evening Phone: 919-240-7633 Race: Caucasian Chapel Hill NC 27516 Cell Phone: 919-740-8814 Township: Chapel Hill E-mail: jacannpod @gmail.com Res.Eligibility: County Date Applied: 04/18/2017 Skills: Also Serves On: Human Relations Commission Skills: Also Serves On: Nursing Home Community Advisory Committee Katy Stewart Day Phone: 9196915555 Sex: Female 8407 NC 57 Evening Phone: 9196915555 Race: Caucasian Rougemont NC 27572 Cell Phone: 9196915555 Township: Hillsborough E-mail: katystewl @gmail.com Res.Eligibility: Date Applied: 03/31/2017 Skills: Also Serves On: Thursday,April 27,2017 Page 1 of 1 18 Page 1 of 1 Michael C. Joseph Volunteer Application Orange County Advisory Boards and Commissions Name: Dr. Michael C. Joseph Name Called: Home Address: 506 Silver Fox Circle Hillsborough NC 27278 Phone (Day): 919-923-3907 Phone (Evening): 919-923-3907 Phone (Cell): 919-923-3907 Email: mcjosephmd @nc.rr.com Place of Employment: Retired Job Title: N/A Year of OC Residence: 2004 Township of Residence: Hillsborough Zone of Residence: Sex: Male Ethnic Background: African American Community Activities/Organizational Memberships: Friends of the Orange County Library(FOCL), free middle school math tutoring (grades 7&8). Peer leadership in Chapel Hill (12 - lecture course on common medical issues in seniors). Past Service on Orange County Advisory Boards: None. Boards/Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: I am a physician with 30 years experience in drug safety and clinical studies, covering adult 18- 65. Reasons for wanting to serve on this board: I dealt with 3 assisted living facilities in NC with my mother from age 83-91. I am now working on my 97 year old mother in law s placement. Conflict of Interest: Supplemental Questions: Boards/Commissions appointments: Other Comments: This application was current on: 2/2/2017 11:38:55 AM Date Printed: 2/6/2017 19 Page 1 of 2 Jacqulyn Podger Volunteer Application Orange County Advisory Boards and Commissions Name: Jacqulyn Podger Name Called: Home Address: 719 New Hope Church Rd. Chapel Hill NC 27516 Phone (Day): 919-740-8814 Phone (Evening): 919-240-7633 Phone (Cell): 919-740-8814 Email: jacannpod @gmail.com Place of Employment: retired Job Title: former Duke employee 14 years Year of OC Residence: 2008 Township of Residence: Chapel Hill Zone of Residence: County Sex: Female Ethnic Background: Caucasian Community Activities/Organizational Memberships: 1. Senior Health Insurance Information Program Counselor 2. A Helping Hand Volunteer and Pro Bono Hero 3. Board Member Junior Leadership of Durham Past Service on Orange County Advisory Boards: Former Adult Home Advisory Committee for Durham County Boards/Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: Previous experience with the Adult Care Home Advisory Committee in Durham County along with current commitment to SHIIP and A Helping Hand. Both commitments are volunteer and I work with seniors in Orange County and am aware of the problems facing an aging population. I believe I can offer a perspective unique to my experience in providing front line services. Reasons for wanting to serve on this board: I have a passion for working with seniors and would like to contribute in a way that can influence decision making at a county and state level. Conflict of Interest: 20 Page 2 of 2 Jacqulyn Podger Advisory Board on Aging Background, education and experience relevant to this board: Durham County along with current commitment to SHIIP and A Helping Hand. Both commitments are volunteer and I work with seniors in Orange County and am aware of the problems facing an aging population. I believe I can offer a perspective unique to my experience in providing front line services. Reasons for wanting to serve on this board: I have a passion for working with seniors and would like to contribute in a way that can influence decision making at a county and state level. Conflict of Interest: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: Durham County along with current commitment to SHIIP and A Helping Hand. Both commitments are volunteer and I work with seniors in Orange County and am aware of the problems facing an aging population. I believe I can offer a perspective unique to my experience in providing front line services. Reasons for wanting to serve on this board: I have a passion for working with seniors and would like to contribute in a way that can influence decision making at a county and state level. Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 5/23/2016 12:37:29 PM Date Printed: 5/23/2016 21 Page 1 of 2 Katy Stewart Volunteer Application Orange County Advisory Boards and Commissions Name: Katy Stewart Name Called: Home Address: 8407 NC 57 Rougemont NC 27572 Phone (Day): 9196915555 Phone (Evening): 9196915555 Phone (Cell): 9196915555 Email: katystew1@gmail.com Place of Employment: Self employed Job Title: RN Year of OC Residence: 1997 Township of Residence: Hillsborough Zone of Residence: Sex: Female Ethnic Background: Caucasian Community Activities/Organizational Memberships: I am currently exploring ways to get involved with my community and advocate for the clientele that I have been caring for my whole career. I have been a nurse for 25 years. I have worked with the geriatric community during those years with 22 years spent in hospice care. I have recently decided to work for myself and care for those as I can. I am researching housing for the elderly and terminally ill. I want to provide a safe caring environment for this population. I believe I have many years of experience to offer. Past Service on Orange County Advisory Boards: None Boards/Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: 25 years in nursing of the elderly. Head of hospice care during most of my career.As well as home health care, visiting most of all care homes in the 25 mile radius. Reasons for wanting to serve on this board: I would like to offer my knowledge that I have have gained in this field in a constructive, helpful way. I want to be a patient advocate, speak for a population I know very well. Conflict of Interest: 22 Page 2 of 2 Katy Stewart Advisory Board on Aging Background, education and experience relevant to this board: As I stated above, 25 years in nursing of the elderly. Head of hospice care during most of my career. As well as home health care, visiting most of all care homes in the 25 mile radius. I want to be a patient advocate, speak for a population I know very well. Reasons for wanting to serve on this board: I want to offer any knowledge I have gained to speak for this population. Conflict of Interest: Board of Health Background, education and experience relevant to this board: As I stated above, 25 years in nursing of the elderly. Head of hospice care during most of my career. As well as home health care, visiting most of all care homes in the 25 mile radius. I want to be a patient advocate, speak for a population I know very well. Reasons for wanting to serve on this board: I want to be a patient advocate, speak for a population I know very well. Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 1/15/2016 10:39:15 AM Date Printed: 5/4/2016 23 APPROVED 11/8/2012 ADULT CARE HOME COMMUNTY ADVISORY COMMITTEE POLICIES AND PROCEDURES SECTION I: SCOPE A. Purpose 1. To establish a policy and procedures whereby the Orange County Board of Commissioners will establish the specific policies and procedures governing the Adult Care Home Community Advisory Committee ("Committee"). 2. The Orange County Board of Commissioners may appoint an advisory board whose duty is to serve in an advisory capacity to the Orange County Department on Aging and Department of Social Services to work to maintain the intent of the Adult Care Home Residents' Bill of rights within the licensed adult care homes in Orange County. B. Authority 1. North Carolina General Statute § 153A-76 grants boards of county commissioners the authority to establish advisory boards. 2. North Carolina General Statute § 131D-31(b) grants the authority to the board of county commissioners to establish the Adult Care Home Community Advisory Committee. 3. The Orange County Advisory Board Policy serves as the underlying policy document to which the Adult Care Home Community Advisory Committee, in addition to this policy and procedure document, is subject. The Orange County Advisory Board Policy is attached hereto as "Exhibit A". 4. In the event that there is a conflict between the Orange County Advisory Board Policy and this Policies and Procedures document this Policies and Procedures document shall control. C. Charge 1. The charge of Committee shall carry out the purpose and function of the Adult Care Home Community Advisory Committee as provided in N.C. Gen. Stat. §§131D-31 and 131 D-32. D. Definitions 1. "Adult care home" is an assisted living residence in which the housing management provides 24-hour scheduled and unscheduled personal care services to two or more residents, either directly or, for scheduled needs, through formal written agreement with licensed home care or hospice agencies. Some licensed adult care homes provide supervision to persons with cognitive impairments whose decisions, if made independently, may jeopardize the safety or well-being of themselves or others and therefore require supervision. Medication in an adult care home may be administered by designated, trained staff. Adult care homes that provide care to two to six unrelated residents are commonly called family care homes. Adult care homes and family care homes are subject to licensure by the Division of Health Service Regulation. 2. "Family care home" means an adult care home having two to six residents. The structure of a family care home may be no more than two stories high and none of the aged or physically disabled persons being served there may be housed in the upper story without provision for two direct exterior ground-level accesses to the upper story. 24 APPROVED 11/8/2012 SECTION II: GOALS AND OBJECTIVES A. Goals 1. The Committee shall maintain the intent of the Adult Care Home Resident's Bill of Rights within the licensed adult care home in Orange County. 2. The Committee shall promote community involvement and cooperation with adult care homes to ensure quality care for older persons and disabled adults in Orange County. B. Objectives 1. The Committee shall serve as the nucleus for increased community involvement with adult care homes and their residents. 2. The Committee shall promote community education and awareness of the needs of aging and disabled persons who reside in adult care homes, and shall work towards keeping the public informed about aspects of long-term care and the operation of adult care homes in Orange County. 3. The Committee shall develop and recruit volunteer resources to enhance the quality of life for adult care home residents. 4. The Committee shall establish linkages with the adult care home administrators and the department of social services for the purpose of maintaining the intent of the Adult Care Home Residents' Bill of Rights. 5. The Committee shall apprise itself of the general conditions under which the persons are residing in the homes, and shall work for the best interests of the persons in the homes. This may include assisting persons who have grievances with the home and facilitating the resolution of grievances at the local level. The identity of any complainant or resident involved in a complaint shall not be disclosed except as permitted under the Older Americans Act of 1965, as amended, 42 U.S.C. § 3001 et seq. The Committee shall notify the enforcement agency of all verified violations of the Adult Care Home Residents' Bill of Rights. 6. The Committee or subcommittee may communicate through the committee chair with the Department of Health and Human Services, the Orange County Department of Social Services, or any other agency in relation to the interest of any resident. 7. Visitation. The Committee shall quarterly visit the adult care homes with 10 or more beds it serves. For each official quarterly visit, a majority of the committee members shall be present. ii. A minimum of three members of the committee shall make at least one visit annually to each other type of adult care home licensed in the county. iii. In addition, each committee may visit the adult care homes it serves whenever it deems it necessary to carry out its duties. iv. In counties with subcommittees, the subcommittee assigned to a home shall perform the duties of the committee under this subsection, and a majority of the subcommittee members must be present for any visit. v. When visits are made to group homes for developmentally disabled adults, rules concerning confidentiality as adopted by the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services shall apply. vi. The individual members of the committee shall have the right between 10:00 a.m. and 8:00 p.m. to enter the facility the committee serves in order to carry out the members' responsibilities. Where a subcommittee or subcommittees have been established, this right of access shall be 25 APPROVED 11/8/2012 limited to members of the subcommittee which serves that home. A majority of the committee or subcommittee members shall be present to enter the facility at other hours. vii. Before entering any adult care home, the committee or members of the committee shall identify themselves to the person present at the facility who is in charge of the facility at that time. 8. The Committee shall prepare reports as required by the Department of Health and Human Services containing an appraisal of the problems of adult care homes facilities as well as issues affecting long-term care in general. Copies of the report shall be sent to the Board of County Commissioners, Orange County Department of Social Services and the Division of Aging. SECTION III: MEMBERSHIP A. Authority 1. North Carolina General Statute § 153A-76 grants boards of county commissioners the authority to establish advisory boards and to appoint members to and remove members from those advisory boards. In acting on this authority the Orange County Board of Commissioners hereby establishes certain general conditions to which applicants and members of advisory boards should conform. 2. North Carolina General Statute § 131D-31(b) provides the establishment, appointment of committees and the number of members on a committee. B. Composition 1. The Committee shall be composed of the following: a. If the County has one, two, or three adult care homes with 10 or more beds, the Committee shall have five members; or b. If the County has four or more adult care homes with 10 or more beds, the Committee shall have one additional member for each adult care home with 10 or more beds in excess of three, and may have up to five additional members at the discretion of the Board of County Commissioners, not to exceed a maximum of 25 members. i. If the County has four or more adult care homes with 10 or more beds, the Committee shall establish a subcommittee of no more than five members and no fewer than three members from the committee for each adult care home in the county. ii. Each member must serve on at least one subcommittee. c. If the County has no adult care homes with 10 or more beds, the Committee shall have five members. 2. The Committee must have, regardless of the number of members, at least one member involved in the area of mental retardation. 3. Of the total number of members, a minority (not less than one-third, but as close to one-third as possible) shall be chosen from among persons nominated by a majority of the chief administrators of adult care homes in the County. If the adult care home administrators fail to make a nomination within 45 days after written notification has been sent to them requesting a nomination, these appointments may be made without nominations. 4. Each member must be a resident of Orange County. 5. No person or immediate family member of a person with a financial interest in a home served by the Committee, or employee or governing board member of a home served by the Committee, or immediate family member of a resident in a home served by the Committee may be a member of that Committee. 26 APPROVED 11/8/2012 6. Members of the Committee shall serve without compensation, but may be reimbursed for actual expenses incurred by them in the performance of their duties. 7. The names of the Committee members and the date of expiration of their terms shall be filed with the Division of Aging, Department of Health and Human Services. 8. Ex- Officio Members. Any County Commissioner serving on the Committee shall serve as an ex officio member. Up to one (1) ex officio member may be appointed by the Orange County Board of Commissioners and shall serve one year or until they are reappointed or the appointment of their successors. 9. Officers. The Committee shall elect from its members a chair, to serve a one-year term. C. Terms of Office 1. Each committee member shall serve an initial term of one year. Any person reappointed to a second or subsequent term shall serve a two-or three-year term at the discretion of the County Commissioners to ensure staggered terms of office. D. Vacancy 1. Any vacancy shall be filled by appointment of a person for a one-year term. If this vacancy is in a position filled by an appointee nominated by the chief administrators of adult care homes within the County, then the County Commissioners shall fill the vacancy from persons nominated by a majority of the chief administrators. If the adult care home administrators fail to make a nomination by registered mail within 45 days after written notification has been sent to them requesting a nomination, this appointment may be made without nominations. If the County Commissioners fail to fill a vacancy, the vacancy may be filled by the Assistant Secretary for Aging, Department of Health and Human Services no sooner than 45 days after the Commissioners have been notified of the appointment or vacancy. SECTION IV. MEETINGS A. Staffing 1. Orange County staff may serve a support function to advisory boards upon the approval of the Orange County Manager. B. Agendas 1. Items for agendas shall be approved by the Committee Chair and staff. C. Reports 1. Any written communication made by a member of adult care home advisory committee within the course and scope of the member's duties, as specified in G.S. 131 D-32, shall be privileged to the extent provided in this subsection. This privilege shall be a defense in a cause of action for libel if the member was acting in good faith and the statements and communications do not amount to intentional wrongdoing. SECTION V. ORIENTATION A. Attendance 1. Each member shall attend an orientation presented by the Department on Aging to familiarize the advisory board members with the operation of County 27 APPROVED 11/8/2012 government, the Department on Aging rules, and the operating procedures of the advisory board. 2. Each voting member will be encouraged to complete the orientation within two months of his or her appointment. B. Training. 1. The Division of Aging, Department of Health and Human Services, shall develop training materials, which shall be distributed to each committee member. Each committee member must receive training as specified by the Division of Aging prior to exercising any power under G.S. 131D-32. SECTION VI. INSURANCE A. Liability 1. To the extent that any adult care home advisory committee or any member is covered by liability insurance, that committee or member shall be deemed to have waived the qualified immunity herein to the extent of indemnification by insurance. SECTION VII. BY-LAWS A. By-Laws 1. Any Bylaws adopted by the Adult Care Home Community Advisory Committee are void and no further bylaws shall be adopted. Procedure shall be governed solely by this policy document and the General Advisory Board Policy Document. 2. Should the Adult Care Home Community Advisory Committee determine modifications to policies and procedures are necessary the Adult Care Home Community Advisory Committee may petition the Board of County Commissioners for such modifications. 3. Should the General Assembly amend sections of the North Carolina General Statutes Chapter 131D, Article III pertaining to the Adult Care Home Community Advisory Committee such amendments shall be incorporated into these Adult Care Home Community Advisory Committee Policies and Procedures with no additional action of the Board of County Commissioners.