HomeMy WebLinkAboutAgenda - 02-17-2004-9e2ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: February 17, 2004
Action Agenda
Item No. 9 - ~ -
SUBJECT: Adult Care Home Community Advisory Committee
DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): Under Separate Cover
Membership Roster
Letter of Recommendation
INFORMATION CONTACT:
Clerk's Office, ext. 2130, 2125, 2126, 2129
Interest List TELEPHONE NUMBERS:
Applications(s)/Resume(s) of Person(s) on Hillsborough 245-2130
the Interest List Chapel Hill 968-4501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: To consider an appointment to the Adult Care Home Community Advisory
Committee (A.C,H,C.A.C.).
BACKGROUND: The nominating committee for the Orange County Adult Care Home
Community Advisory Committee has nominated Jerry Ann Gregory for an open position on the
committee, This nomination was agreed to by the greater committee. Ms. Gregory has served
the community for many years in the field of public health nursing. She has worked with
residents of nursing and adult care homes as Guardian for the health director, In addition, she
has volunteered in a broad spectrum of community activities that make Orange County a better
place to live for all of its residents, The committee members are pleased she has chosen this
committee as a means of continuing her much valued community service.
If appointed, her term would be an initial one-year training term, after which she may become
eligible to be reappointed to a regular two-year term:
FINANCIAL IMPACT: A stipend of $13..00 is paid to each member of this Committee per each
adult care home visit participated in,
RECOMMENDATION(S): Consider appointing Ms. Jerry Ann Gregory to the Adult Care
Home Community Advisory, Committee for aone-year training term to expire March 31, 2005.
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5
Triangle 1 Council of Governments
Triangle JAreaAgency onAging--Ombudsman Program
Jill V. Passmore, Region J Lead Ombudsman
P O Box I227G
Research triangle Park, N.C. 27709
Phone (919) 558-9401
Fax (919)549-9390
To: Nancy Glover
From: Jill V. Passmore
Date: .January 22, 2004
Re: Official nomination for the Orange Adult Care Home Community Advisory Committee
Cc: Laura Deloye and Carol Gunther-Mole, OACCAC
Nancy,
I am contacting you on behalf of the Orange County Adult Care Home Community Advisory
Committee.
The nominating committee for the Orange County Adult Care Home Community Advisory
Committee has nominated Jerry Ann Gregory for an open position on the committee. This
nomination was agreed to by the greater committee. Ms. Gregory has served the community for many
years in the field of public health nursing. She has worked with residents of nursing and adult care
homes as Guazdian for the health director. In addition, she has volunteered in a broad spectrum of
community activities that make Orange County a better place to live for' all of its residents, The
committee members are pleased she has chosen this committee as a means of continuing her much
valued community service.
Please let me know:
that you have received this official nomination,
• when the nomination might be shared with the County Conunissioners and
• in what time frame the appointment might occur.
Thank you, Nancy, and do not hesitate to let me know if you need further information.. You are
welcome to email me at this address: jmuassrnore ,aol.corn or to call my cellphone at 423-1444,
Jill
.Till V. Passmore
Region .J Lead LTC Ombudsman
Triangle J Council of Governments
Triangle .J Area Agency on Aging
~,
Page 1 of 1
Jerry Ann Gregory
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Mrs. Jerry Ann Gregory
917 Crestwood Lane
Chapel Hill NC 27517
919-933-8481
919-933-8481
jkgregory@mindspring.com
Retired
Retired Public health Nurse
Chapel Hill
Female
Caucasian
1/12/1945
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Advisory Board on Aging
Work Experience:
32 years as Public Health Nurse with Orange County Health Dept, Part of job
responsibilities was providing services to Senior citizens
Served as Guardian on behalf of Health Director far clients in Community House in
Carrboro and various Rest Homes and Nursing facilities
Volunteer Experience:
PTA Thrift shop
Baker for Meals on Wheels in Chapel Hill
VA Medical Center in Dtarham doing data entry for Oncology Research nurses
Habitat far Humanity
Fund raising for Child Abuse Prevention Foundation in Durham
Fund raising for various charities sponsered by my Exchange Club
Education:
H.S.
BS in Nursing
Adult Health Assestment-UNG
Various workshops on Wellness,disease prevention,couseling,etc
Other Comments:
This application was current on: 11/2/2003 10:26:26 PM Date Printed: 2/9/2004
_.,
Applicant Interest Listing
Adult Care Home Cornmttnity Advisory Concnzittee
Ms. Alm Chamberlin
?329 Palls Dr
Chapel }lilt NC 27514
Shills: 6 A Psychology
Skills; Glcmenmry School Reader Volunteer
Skills: M I' T UNC School of Medicine
Skills: Physical Therapist
Skills: Program Coordinator
Ms. Laurin Easthom
305 Rmvc Rout
Chapel Fiill NC 27516
Skills: Dentist
by Boatd Name and by Applicant Name
Contact Pelson:
Contact Phone:
Day Phone: 919-383-8105
Evening Phone: 919-383-8105
FAR:
E-mail: ucmtdmnnearthlink net
Also Serves On:
Nsa Serves On:
Also Serves On:
Nsc Scrvcs On:
Also Scrvcs On:
Day Phone: 919-942-0001
Evening Phone: 919-773-300?
FAX: 919-773-8824
E-mail:
Nso Serves On:
Pam Tillet
919-968-2084
Sex: Female
Race: Undesignated
Township: Chapel Viill
Date Applied: 12/19/2003
Sex: female
Race:
Township: Chapel Bill
Date Applied: 10/29/2003
MIS .TBrTy Ann CrB~Ory Day Phone: 919-933-8481 Sox; Female
917 Crestwood Lane Evenli1g Pltone: 919-933-8481 Race: Caucasian
Chupcl Flitl NC 27517 FAX: Township: Chapel Flill
Eanall: jkgregoryCJmindspring cum Da[c Applied: 11/02/2003
Skills: Also Serves On:
Skills: Public Iicatth Also Serves On:
Skills: Registered Nurse Also Serves On:
MS .TOballl7a JO11$C:17 Day Pltone: 225-1925 Sox; Female
2201 f3aycourt frail Evening Phone: 245-1G37 Race: Caucasiat
FIillsborough NC 27278 FAX: Township: Plillsborough
E-mail: jjcnsenj~mindspring com Date Applied: 11/09/2003
Skills: Medical Technologist Nso Scrvcs On: Commission fbr Women
MS. FIat1C~5 )tOVO11S Day Phone: ')19-GOZ-1301 Sox: Pemate
1010 Pinehurst Drive Evening Phone: 919A29-7434 Race: Caucasian
Chapel Hill NC 27517 FAX: 919-929-7589 Township:
E-mail: Il:ovcnsnnc rr com Datc Applied: II/OSI?003
Skills: Registered Nurse Nso Serves On:
Monday, February 09, 2004 Page I of 2
/S
Applicant Interest Listing
Adult Ca~•e Home Conzntuuiry Advisory Conunittee
Ms. Judith Mitchell
3620 Dairyland Road
Iillsborough NC 27278
Skills: Community Service Volunteer
Skills: GM I
Skills: Receptionist
Ms. Sharon Pounds
200 South Dellvuc Street
Iillsborough NC 27278
Skills: Animal Wclf'are Advocate
Skills: Community Service Volunteer
Skills': Hillsborough City Limits
by Board Name and by Applicant Name
Contact Person:
Contact Phone:
Day Phone: (919)933-8381
Evening Phone: 919-933-1851
PAX: 919-933-6623
G-mail: jmilchcll58uearthlinl:net
Also Serves On:
Also Serves On:
Also Serves On:
Day Phone: 919-732-2133
Evening Phone: 919-732-2133
PAX:
E-n7ail: MrsPounds a aol cum
Also Serves On:
Also Scrvcs On:
AJso Serves On:
Pam Tillet
91~-~~s-zosa
Sex: Pcmalc
Race Caucasian
Township: Dingham
Date Applied: 11/15/2003
Sex: Pcmalc
Race: Caucasian
Township: li i Ilsboraugh
Date Applied: 12/03/2003
Monday, February 09, 200J Page 2 0( 2
o,
Page 1 of 1
Ann Chamberlin
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms. Ann Chamberlin
2329 Falls Dr.
Chapel Hill NC 27514
919-383-8105
919-383-8105
acandcm@earthlink.net
La Salle Health Care
Physical Therapist
Township of Residence: Chapel Hill
Zone of Residence: Chapel Hill Twnsp
Sex: Female
Ethnic Background: Undesignated
Date of Birth: 11/6/1957
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
La Salle Healthcare Durham, 10/03-present; Durham Reg. Hosp, 10/03 - 12/02; UNC
Schcol of Medicine, Project Mgr. Research; 10/96 - 8/00; School of Nursing, UNC 8/95 -
9/96 ,Project Mgr.; UNC Sch. Of Medicine, 4/92- 4/95; 12/86 - 12/91 Program
Coordinator, Western Man Hospital, Westfield, MT.
Volunteer Experience:
New Hope Elem. Sch. Reader, 1995-1997, 2002-2003. IFC Community Shelter, 8/96 -
5/97.
Education:
2002 MPT UNC Sch. Of Medicine, Div. Of Physical Therapy; 1984 UNC Sch. Of Public
Health, Dept„ of Health, Behavior and Health Education, 1979, B.A. Psychology, SUNY
@Binghamton.
Other Comments:
STAFF NOTES: Origninally applied 12/19/03 for Adult Care Home Community Advisory
Committee. ADDRESS VERIFICATION: 2329 Falls Drive, Chapel Hill, 27514 is in
Chapel Hill Township, Outside City Limits, Not in ETJ. MOAD,ncg.
This application was current on: 12/19/2003 Date Printed: 2/9/2004
/0
Page 1 of 1
Laurin Easthom
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Mome Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms. Laurin Easthom
305 Rowe Road
Chapel Nill NC 27516
919-942-0001
919-773-3002
919-773-8824
Medicaid Dental Center
Dentist
Chapel Hill
Female
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Currently I am a dentist (part-time) treating underprivileged children (medicaid) in
Raleigh. I have alsa been a general dentist treating adults/elderly. I also (before a
dentist) was a case manager in rehabilitatian aiding injured workers find adegtaate
employment.
Volunteer Experience:
In college, I volunteered at nursing homes assisting /entertaining residents. I was a
hospital volunteer in physical therapy for a year in my master's program at USC.
Education:
B.A. History (1986), Davidson College; M,Ed. (1988) (Master of Education) Counseling at
Univ. So, Carolina, D.D.S, & NC Chapel Hill in 1998.
Other Comments:
Original Application submitted on 10/29103 for Adult Care Home Community Advisory
Committee, I have had friends/family in nursing homes (still do). I deeply care about this
population -they have given their long lives to society and have weathered many a storm
and have so much to tell - we owe them our greatest respect in the world. They deserve
the best and demand our greatest respect and empathy. I want to help them. Address
Verification; 305 Rowe Road is in CH ETJ ctarrent 10/30/03.
This application was current on: 10/29/2003 9:49:44 PM Date Printed: 2/9/2004
//
Page 1 of 1
Johanna Jensen
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms Johanna Jensen
2201 Baycaurt Trail
Hillsborough NC 27278
225-1925
245-1637
jjensenj@mindspring,com
Medical Technologist
Township of Residence: Hillsborough
Zone of Residence: -
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 9/19/1963
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Dtake University Hospital, Medical Technologist, 5/1990- present
Volunteer Experience:
Education:
BS in Medical Technology, Medical College of Virginia
Other Comments:
STAFF NOTES: 10/03 Original appl. For CFW; ACHCAC. ADDRESS VERIFICATION:
2201 Baycourt Trail, Hillsborough is in Beckett's Ridge Subd, in Hillsborough City Limits,
In Hillsborough Township. MOADIncg .
This application was current on: 11!9/2003 Date Printed: 2/9/2004
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Frances Kovens
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms, Frances Kovens
1010 Pinehurst Drive
Chapel Hill NC 27517
919-602-1301
919-929-7434
919-929-7589
fkavens@nc.rr.com
Duke Medical Center
RN - Pt. Resource Mgr..
Female
Caucasian
6/17/1957
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Advisory Board on Aging
Work Experience:
RN 6 yrs, @ DUMC ; prior to that short term construction, UNC Hospitals
Volunteer Experience:
Hadassah, various school activities in Chapel Hill School System
Education:
BSN
Other Comments:
Due to the nature of my position @ Duke -largely discharge planning - co-ordination and
care - I feel I have knowledge of the aging population health care needs and social
network supports, Would very much want to interface with the Chapel Hill Community
efforts to provide support and resources to this grotap of citizens. Originally applied
11/5/03 far ACHCAC and ADV. Board on Aging, Address Verification:
This application was current on: 11/5/2003 Date Printed: 2/9/2004
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Judith Mitchell
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Ms. Judith Mitchell
3620 Dairyland Road
Hillsborough NC 27278
(919)933-8381
919-933-1851
919-933-6623
Email: jmitchell58@earthlink net
Place of Employment: Retired
Job Title:
Township of Residence: Bingham
Zone of Residence:
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 6/20/1940
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Currently (11/03) I am working for Home Health Solution. Was retired from as
receptionist for Carrboro Peds, And Internal Medicine, Prior to that I worked as IJNC
Student Health as a receptionist in Women's Health,
Volunteer Experience:
Department of Social Service; Orange County Fire Department -EMT -First Responder.
Education:
High School; Few courses at Community College, 18 credit hours; Adult Education
Cotarses.
Other Comments:
STAFF NOTES: Renewed app. 11/15/03 forA,C,H.CAC, Applied 1/16/2001 for Adult
Care Home Community Advisory Committee, OTHER COMMENTS: Very interested
in helping the adult mentally alert but physcially challenged live on their own. There is
nothing for them in this county. I also beleive that Senior Citizens should have better care
both physically and mentally. There are a lot of lonely seniors in just this county alone.
You may check with Chris Nutter or Heather Barrow for references. Or with any of the
Doctors at Carrboro Peds. And Internal Medicine,
This application was current on: 11/15/2003 Date Printed: 2/9/2004
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Shanon Pounds
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms, Shanon Pounds
200 South Bellvue Street
Hillsborough NC 27278
919-732-2133
919-732-2133
MrsPounds@aol.com
Alamance Commtanity College
Nursing Student and Care home
Township of Residence: Hillsborotgh
Zone of Residence: Hillsborough Town Limits
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 5/17/1973
Boards/Commissions applied for:
Animal Shelter Operations Task Force
Commission for Women
Adult Care Home Community Advisory Committee
Work Experience:
Nursing student (RN) and Family owned care home for 30 years.
Volunteer Experience:
Forsyth County Red Cross, Orange County Schools
Education:
Currently enrolled in nursing school in Alamance County.
Other Comments:
True animal lover whom adopted from the Orange County Shelter, STAFF NOTES:
Orignal application received for Animal Shelter Operations Task Force, Commission
For Women, and Adult Care Home Community Advisory Committee. ADDRESS
VERIFICATION: MOAD. 200 S. Bellevue Street, Hillsborough is within Hillsborough City
Limits, Ncg
This application was current on: 12/3/2003 t2: t4: t5 PM Date Printed: 2/9/2004