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Home My WebLink AboutAgenda - 03-14-2023 Work Session; 8 - Nursing Home Community Advisory Committee – Appointment Discussion 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: March 14, 2023 Action Agenda Item No. 8 SUBJECT: Nursing Home Community Advisory Committee — Appointment Discussion DEPARTMENT: Board of Commissioners ATTACHMENT(S): INFORMATION CONTACT: Recommendation Clerk's Office, 919-245-2125 Member and Applicant Summary Sheet Application of Person Recommended Applications of Other Applicants — No eligible applicants at this time Membership Roster Applicant Interest List PURPOSE: To consider an appointment to the Nursing Home Community Advisory Committee. BACKGROUND: The Nursing Home Community Advisory 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. The Board of County Commissioners appoints all ten (10) members. REMINDER: As of July 1, 2017, House Bill 248 was adopted by the North Carolina General Assembly regarding the training period for pending members of the "Adult Care Home Community Advisory Committee and Nursing Home Community Advisory Committee". Applicants will be selected from the county "Applicant Interest List" for a condensed training and if the applicant successfully completes the training, the individual would be recommended for appointment. Therefore, when an applicant is recommended for appointment, it would initially be for a one year preliminary term and the training will have already been completed. The following individual is recommended for Board consideration: NAME POSITION TYPE OF EXPIRATION DESCRIPTION APPOINTMENT DATE TERM Shade Little At-Large First Full Term 03/31/2026 SPECIAL NOTATION: None of the other applicants have completed the mandatory pre- appointment training, and are therefore not eligible for appointment at this time. 2 If the individual listed above is appointed, the following vacancies remain: POSITION EXPIRATION VACANCY INFORMATION DESCRIPTION DATE At-Large 06/30/2025 Vacant since 08/25/2021 At-Large 09/30/2023 Vacant since 11/06/2019 Nursing Home 06/30/2023 Vacant since 12/12/2018 Administration At-Large 03/31/2026 Vacant since 06/21/2017 FINANCIAL IMPACT: There is no financial impact associated with this item. SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goal is applicable to this item: • GOAL: 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. ENVIRONMENTAL IMPACT: There is no Orange County Environmental Responsibility Goal impact associated with this item. RECOMMENDATION(S): The Manager recommends that the Board discuss an appointment to the Nursing Home Community Advisory Committee. f 3 a STATf a NC DEPARTMENT OF ROY COOPER - Governor HEALTH AND MANDY COHEN,MD,MPH • Secretary HUMAN SERVICES JOYCE MASSEY-SMITH,MPA - •`@""""°"• Director,Division of Aging and Adult Services DIVISION OF AGING AND ADULT SERVICES OFFICE OF THE STATE LONG-TERM CARE OMBUDSMAN Date of Attestation January 3111, 2023 Statement of Attestation CAC Member Name: Shade Little This document verifies that Shade Little, a new member of the Orange County Nursing Home Community Advisory Committee has completed the "HB248-Final Rule Update% Community Advisory Committee update training authorized by the Office of the State Lonca-Term Care Ombudsman conducted in Orange. NC on 113112023. Your signature below indicates your acknowledgement to abide by HB 248, the Final Rule, and the Policies and Procedures of the Long-Term Care Ombudsman Program. It also acknowledges your agreement to follow the Community Advisory Committee processes: ❖ Certification and Designation Process ❖ Appointment Process ❖ Suspension of Designation Process ❖ Reinstatement of Designation Process ❖ Removal of Designation Process You may contact Victor Orija, State Long-Term Care Ombudsman at(919) 855-3426, if you require additional information. CAC Member: Shade Little Regional Ombudsman: Date: 1 *4- 2 � 3 Date: Z� Address 2. �OL11� State Ombudsman: City/State/ZIP:C� � Date: WWW.NCDHHS.GOV TEL 919-855-3400-FAx 919-733-0443 LOCATION:693 PALMER DRIVE•TAYLOR HALL-RALEIGH,NC 27603 MAILING ADDRESS: 2101 MAIL SERVICE CENTER-RALEIGH,NC 27699-2101 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Created With Tiny Scanner 4 Nursing Home Community Advisory Committee Members and Applicants Name Member or Applicant? Gender Identity Race/Ethnic Background Age Range Township Also Serves on Carol Kelly Member Female White Chapel Hill Jacqulyn Podger Member Female White Chapel Hill Martha Bell Member Female White Chapel Hill Stephanie Boswell Member Female White Hillsborough Vibeke Talley Member Female White Hillsborough VACANT VACANT VACANT VACANT VACANT Angela Burnette Applicant Female White 35-59 Eno Cheryl B.Jones Applicant Female White 60+ Eno Erica Janko Applicant Female White 18-34 Chapel Hill Judith Causey Applicant Female White 60+ Little River Kelly Kester Applicant Female White 35-59 Hillsborough Robert Ashburn Applicant Male White 60+ Hillsborough Thomas Hardin jAppliant Imale lWhite 60+ ICheeks 5 Page 1 of 2 Shade Little Volunteer Application Orange County Advisory Boards and Commissions Name: Shade Little Name Called: Home Address: 229 Weaver Road Chapel Hill NC 27514 Phone: 919-283-8730 Email: shadekslittle@gmail.com Year of OC Residence: 1971 Township of Residence: Chapel Hill Zone of Residence: C.H. City Limits Gender Identity: Male Ethnic Background: Other Age Range: 60+ Community Activities/Organizational Memberships: Adult Home Care CAC Past Service on Orange County Advisory Boards: Adult Home Care CAC Boards/Commissions applied for: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: old Reasons for wanting to serve on this board: help Contribution to the diversity of viewpoints on this board: not sure Conflict of Interest: Boards/Commissions appointments: Adult Care Home Community Advisory Committee Application Date: 8/9/2018 Background, education and experience relevant to this board: I am old. Reasons for wanting to serve on this board: Ensure my cohorts live well. Conflict of Interest: Other Comments: 6 Page 2 of 2 Shade Little This application was current on: 1/6/2023 2:17:29 PM Date Printed: 1/10/2023 7 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 pm First Tuesday of every other month Contact Person:Autumn Cox Meeting Place: Seymour Center,2551 Homestead Rd.,Chapel Hill Contact Phone: 919-558-9401 Positions: 10 Length:3 years Terms: 2 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 1 First Appointed: Gender Identity: Township: Current Appointment: Ethnic Background: Residency Req: At-Large Expiration: 01/31/2025 Age Range: Special Repr: At-Large Number of Terms: VACANT 2 First Appointed: Gender Identity: Township: Current Appointment: Ethnic Background: Residency Req: At-Large Expiration: 06/30/2025 Age Range: Special Repr: At-Large Number of Terms: VACANT 3 First Appointed: Gender Identity: Township: Current Appointment: Ethnic Background: Residency Req: At-Large Expiration: 09/30/2023 Age Range: Special Repr: At-Large Number of Terms: Stephanie Boswell 4 First Appointed: 09/04/2018 Gender Identity: Female Township: Hillsborough Current Appointment: 10/06/2020 Ethnic Background: White Residency Req: At-Large Expiration: 06/30/2023 Age Range: Special Repr: At-Large Number of Terms: 1 VACANT 5 First Appointed: Gender Identity: Township: Current Appointment: Ethnic Background: Residency Req: At-Large Expiration: 06/30/2023 Age Range: Special Repr: Nursing Home Administration Number of Terms: Jacqulyn Podger 6 First Appointed: 09/17/2019 Gender Identity: Female Township: Chapel Hill Current Appointment: 04/05/2022 Ethnic Background: White Residency Req: At-Large Expiration: 03/31/2025 Age Range: 60+ Special Repr: At-Large Number of Terms: 1 Monday,March 6,2023 Page 1 8 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 pm First Tuesday of every other month Contact Person:Autumn Cox Meeting Place: Seymour Center,2551 Homestead Rd.,Chapel Hill Contact Phone: 919-558-9401 Positions: 10 Length:3 years Terms: 2 VACANT 7 First Appointed: Gender Identity: Township: Current Appointment: Ethnic Background: Residency Req: At-Large Expiration: 03/31/2026 Age Range: Special Repr: At-Large Number of Terms: VACANT 8 First Appointed: Gender Identity: Township: Current Appointment: Ethnic Background: Residency Req: At-Large Expiration: 03/31/2026 Age Range: Special Repr: At-Large Number of Terms: Dr Carol Kelly 9 First Appointed: 09/20/2016 Gender Identity: Female Township: Chapel Hill Current Appointment: 11/01/2022 Ethnic Background: White Residency Req: At-Large Expiration: 12/31/2023 Age Range: Special Repr: Nursing Home Administration Number of Terms: 3 Vibeke Talley 10 Chair First Appointed: 05/20/2014 Gender Identity: Female Township: Hillsborough Current Appointment: 11/01/2022 Ethnic Background: White Residency Req: At-Large Expiration: 12/31/2023 Age Range: Special Repr: Nursing Home Administration Number of Terms: 3 Monday,March 6,2023 Page 2 9 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Autumn Cox Nursing Home Community Advisory Committee Contact Phone: 919-558-9401 Rev. Dr. Robert Ashburn Gender Identity: Male Date Applied: 01/24/2022 Ethnic Background: White Township: Hillsborough Age Range: 60+ Zone of Residence: County Also Serves On: Mrs Angela Burnette Gender Identity: Female Date Applied: 08/05/2022 Ethnic Background: White Township: Eno Age Range: 35-59 Zone of Residence: County Also Serves On: Judith Causey Gender Identity: Female Date Applied: 09/26/2022 Ethnic Background: White Township: Little River Age Range: 60+ Zone of Residence: County Also Serves On: Mr. Thomas Hardin Gender Identity: Male Date Applied: 03/15/2021 Ethnic Background: White Township: Cheeks Age Range: 60+ Zone of Residence: County Also Serves On: Ms. Erica Janko Gender Identity: Female Date Applied: 07/18/2022 Ethnic Background: White Township: Chapel Hill Age Range: 18-34 Zone of Residence: Carrboro City Limits Also Serves On: Cheryl B. Jones Gender Identity: Female Date Applied: 08/10/2021 Ethnic Background: White Township: Eno Age Range: 60+ Zone of Residence: County Also Serves On: Monday,March 6,2023 Page 1 of 2 10 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Autumn Cox Nursing Home Community Advisory Committee Contact Phone: 919-558-9401 Kelly Kester Gender Identity: Female Date Applied: 02/12/2021 Ethnic Background: White Township: Hillsborough Age Range: 35-59 Zone of Residence: Hillsborough Town Limits Also Serves On: Shade Little Gender Identity: Male Date Applied: 01/06/2023 Ethnic Background: Other Township: Chapel Hill Age Range: 60+ Zone of Residence: C.H.City Limits Also Serves On: Adult Care Home Community Advisory Committee Monday,March 6,2023 Page 2 of 2