HomeMy WebLinkAboutAgenda - 06-26-2003-2aORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 23, 2003
Action Agenda
Item No. ~ - q
Deferred from June 17, 2003.
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
Applications/Resumes of Persons Being
Recommended
Interest List
INFORMATION CONTACT:
Clerk's Office, ext. 2130, 2125, 2126, 2129
TELEPHONE NUMBERS:
Hillsborough
Chapel Hill
Durham
Mebane
245-2130
968-4501
688-7331
336-227-2031
PURPOSE: To consider the appointment of two members to the Adult Care Home Community
Advisory Committee.
BACKGROUND: In May, the BOCC approved adding four additional seats to this Committee,
bringing it to 12 seats. With Sue Coppola's second term expiring June 30, 2003, there will be
four At-Large vacancies.
The Committee has reviewed the available applicants and has recommended appointment of
the following: Ms. Carla Julian and Mr. Caleb Moore to At-Large positions for initial one-year
training terms to expire June 30, 2004.
FINANCIAL IMPACT: None.
RECOMMENDATION(S): Consider making appointments to the Adult Care Home
Community Advisory Committee as the Board may decide.
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Nancy Glover Fw ACHCAC -List of Interested Volunteers
From: "Margaret Brown" <mwbrown@mindspring.com>
To: "Donna Baker" <dbaker@co.orange.nc.us>
Date: 5/30103 6:46AM
Subject: Fw: ACHCAC -List of Interested Volunteers
----- Original Message -----
From: Carol Gunther-Mohr
To: 'Nancy Glover'
Cc: 'Pam Tillett' ;Jill Passmore ;Jill Passmore ;Margaret Brown
Sent: Tuesday, May 27, 2003 7:25 PM
Subject: RE: ACHCAC -List of Interested Volunteers
Dear Nancy,
I have polled the ACHCAC about the nominations and I have their approval on the following:
1. For the member slot being vacated by Sue Coppola (term expires 6/30/03) we nominate Carla Julian
and request that her nomination be presented to the Commissioners at the June 3rd meeting.
2. For ONE of the newly create~ositions (1 of 4) we nominate Caleb Moore Yo orwarded his
application to me in January and I have confirmed that a is still interested in serving.) We request that his
nomination be presented to the Commissioners at the June 3rd meeting.
3. We request that the Commissioners approve the renewed nominations for two members -Cherie
Rosemond and Florence Soltys - at the June 3rd meeting.
4. For the additional THREE newly created positions, we will continue to find suitable applicants. I have
been in touch with the interested volunteers (people who have applied) and only one -Jerry Kruter - is
considering the position.
5. Your suggestion that Pam Tillett send a letter to the facilities to see if they have someone to nominate
is a good idea. I don't think we should hold these positions vacant if the facilities. don't nominate anyone
suitable.
6. Your suggestion that we are required to have a "Mental Health" representative I don't think is
accurate. We no longer visit the Developmentally Disabled Homes and so I don't see how we could be
required to have someone with this expertise. We are certainly are open to having someone with this
background.
Thank you for your assistance in bringing these 4 NOMINATIONS to the BOCC.
Sincerely,
Carol
. !~
FOR OFFICE USE ONLY
P' ~ o~ ~ L'ar~a- Nl ~u~i un
VOLUNTEER APPLICATION
ORANGE COUNTY ADVISORY BOARDS AND COMMISSIONS
If you are an Orange County resident, at least 18 years old, and willing to volunteer your time and
expertise to your community, please complete this application and return to; 22 ~n 2
~~LS~ V'15
Orange County Board of Commissioners' Office ~ ~~
P.O. Box 8181 !:
Hillsborough, NC 27278 ~ ~.5 ~~ _
Phone (919) 245.2125; 245.2129; 245-2130; 732-8181 ~'
Fax: (91/9~)/644-0246 Email: ncglover~co.orange.nc.u -..__...,._ ..
NAME: ~Q~ ~' a 1 ' ( ~~ ~ i GL(1 . ,. ~ - ..._ __.._ _~---~.~
WOME ADDRESS: ~~ ~~~~~ ~ ~ ~/~ ~/~,
CITY• '~- 5 ~ n ~' O (1 ~ N C - - zip Code: 7 7 .
PHONE: (Day) 9~y ~ ~~ /9~,(,Evening/late) _~ ~-t1Y1~__ (F~) ~CC,~r1 °V _
EMAIL: ~r ~a~ ~ I C.~(1 e (~~ . ('(1 ~ ~~ m
PLACE OF EMPLOYMENT: LLQ~. ~~ I--~ _ JOB TITLE: _9 (~ f;,~Q Tt`, ~~'
IN ORDER.TO ASSURE COUNTYWIDE REPRESENTATION PLEASE LNDlCATE YOUR TOWNSHIP
OF RESIDENCE:
C Bingham C Cheeks }~Hilisborough C Eno C Chapel Hill C Little River C Cedar Grove
IN ADDITION, PLEASE INDICATE IF YOU LIVE IN ONE OF THE FOLLOWING AREAS:
C Joint PlanningAnea. C Extraterritorial.Area C Transition Area
WE ASK YOUR HELP IN ASSURING DIVERSITY OF MEMBERSHIP BY AGE, GENDER AND RACE,
BY ANSWERING THE FOLLOWING QUESTIONS: C Male Female
ETHNIC BACKGROUND: C African American~Caucasian C Hispanic C Native American
C Other DATE OF BIRTH: _
PLEASE LIST (IN ORDER.OF PREFERENCE) THE.BOARDS/COMMISSIONS ON WHICH YOU
WOULD BE WILLING TO S RVE.
WORK DCPERIENCE: __
S~ se S(.cn'1~
T
VOLUNTEER EXPERIENCE: _ ~ P t~_ ~~~GL;GI` 1 ~~~~~~u~'f P
FOR OFFICE USE ONLY
P- ?, ,off ~' ~; u.r ~ a M, ~u ~i ~
EDUCATION: Cl,
OTHER COMMENTS:
\ Y
How did you become aware of Orange County volunteer opportunities? (Please check all that
apply): C Newspaper County Web Page C Current Orange County Volunteer
C Radio .:C. T V. Other r~t'C`Pr~+ MF m b~P.s ~C ~~, ~~
Gt. [ rect.~Q ~ Re~iS~e9 ~o~ A e+~ e ~ c o~~~~-~a~ ~ ;~ (( `~""~.,.~s~sm
ETHICS GUIDELINES FOR °n ~G` ~rt~ _
' ~' COUNTY~ADVISORY'BOARDS AND COMMISSIONS ~ ~~
I agree by my signature below that, if appointed, l pledge to comply with the fallowing ethics guidelines for
advisory boa+'ds.and.commissions as adopted.by the Orange County Board of Commissioners.
Members of advisory boards and commissions shall not discuss, advocate, or vote on any matter in
which they have a conflict or. potential conflict of interest or an interest which reasonably might
appear to be in conflict with the concept of fairness in dealing with public business. A corrfl~t of
interest-or-a.potential conflict occurs if a member. has a.separate, private, or monetary interest, either
diced or indirect, in any issue or transaction under consideration. Any member who violates this
provision may be subject to. removal from the board or commission.
If an advisory board or commission member believes he/she has a conflict or potential conflict of
interest an a particular issue, then that member should state this belief b the other members of
his/her respective advisory board or commission during the board Or commission's public meeting.
The member should state the nature of the conflict, detailing that he/she has a separate, private, ar
monetary interest, either direct or indirect, in the issue or transaction under consideration. The
member should then excuse himselflherself from considering-and voting on the matter. In cases
where an advisory board or commission member deck~res a conflict or potential conflict of interest,
the member shall.excuse himself/herself from the board table/voting area until all discussion,
c~tsideretion, and voting is completed on the matter in question.
• Any advisory board.oc commission member having.questions orneeding assistance regarding the
interpretation of these ethics guidelines or other conflict of interest matters should contact the
.._ .administrative staff.for the respective board~or commission.. Staff will assist the member with
questions and interpretations and may provide a recommendation on whether or not the advisory
board or commission.member should.excuse himself/herself from.votin~. The member may request
that the staff respond in writing, Staff may contact the County Managef for any additional assistance.
If appointed, I agree to attend athree-hour orientation which will give an overview of how Orang® County
Government operates and its relationship to other governmental units.
Signature
~{ D 3
Da e
voLDi51c3: Al+PLCTH; H: ~...V~OIAPPL. Doc
g
P 3 ~~
Carla Julian Cu~~o.. {V~~ 3-u 1-an
2320 George Anderson Drive
ITillsborough, NC 27278
Tele hone: 919 732-5192 --~ Email; cazla'uli c.rr. cam
PR-. 4~•E
Experienced registered nurse currently completing degree requirements for Master of Public Health and
Interdisciplinary Certificate in Aging. Anticipated graduation May 2003. Current interests include
project management, continuous quality improvement management principles, and community planning
initiatives across the continuum of long-term care. Very motivated with excellent organizational and
analytical skills. Other areas of strength include:
• Project Management • Written and Verbal Communication
• Research Data Collection and Analysis
• Detailed Analysis of Medical Records
• Interdisciplinary Teamwork
• Meeting Organization and Facilitation
• Policy and Procedure Development - --
ACHIEVEMENT ffiGH_LIGHTS
• Interdepartmental Collaboration
• Staff Management and Leadership
• Case Management Software Training and
Support
Assistant Director of SORT (Special Operations Response Team) Research project (2001-2002)
Assisted principle investigator with completion of pilot needs assessment of six North Carolina counties
to assess difficulties encountered responding to special needs populations during Hurricane Floyd.
Primary responsibilities included student team management for development of needs assessment
questionnaires and data collection, entry and analysis.
Duke University Medical Center Long Term Care Resources Program
Leadership in an Aging Society 2002 Sommer Intern
Worked with Director of Orange County Department on Aging in Chapel Hill, NC on the development
of a Long Term Caze Facility Roundtable to improve quality. Organized planning task force to define
tazget population, structure, and mission of the Roundtable. Organized and scheduled all meetings and
prepared all documents including. agendas, meeting minutes, operational guidelines, and County
Commissioner agenda abstract. In May 2003 will become chair of the Roundtable steering committee.
Legal Norse C.ousultant/Nurse Paralegal (1995-2001)
Assisted defense and plaintiff attorneys with investigation of medical malpractice cases. Responsibilities
included: review and summary of medical records, medical reseazch, preparation of detailed reports,
identification of and communication with expert witnesses, trial preparation, and communication with
clients throughout the investigation of their medical negligence claims.
woRx HISTORY
.,__._
Habbard Team Member (Collaborative Clinical Practice in Geriatrics) (Jan. 2003 to present)
Teaching Assistant (January 2003 to present)
Research Assistant (August 2002 to November 2002)
Assistant Director of SORT Research Project (August 2001 to August 2002)
Apri12003
y
- P~ ~ ~' ~' far la M. Su I ~ a~,
arse Paralegal, Medical Review Team
Yo M e enderso P.A. - Ra1ei NC Ma 1995 to ov ber 1997
Legal Nurse Consultant/Nurse Paralegal
Duke Univ i M Center - Du NC April 1992 to Mar,, h~98
Coronary Care Unit -Staff Nurse, Charge Nurse, Heart Center Bed Management
Blue Cr s/Bl a Shield of North _aroh~ _ Durhart~ NC Feb 1991 to April 1992
Senior Medical Review Analyst
Other ement an Clinical Experience
Staff NurseJCharge Nurse -Cardiac Telemetry Unit, UNC Hospitals, Chapel Hill, NC, 1989 to 1991
Staff Nurse -Cardiac Telemetry Unit, Wake Medical Center, Raleigh, NC, 1988 to 1989
~Cliuical Nurse Supervisor I -Medicine Service, UNC Hospitals, Chapel Hill, NC, 1987 to 1988 -
Staff Nurse/Charge NuiselPreceptor -Hematology/Oncology Unit, UNC Hospitals, 1985 to 1987
EDUCATION
D ree Goals: ter of Public Health Interdisci line Certificate in A in
Public Health Leadership Program, School of Public Health, University of North Carolina at Chapel Hill
Anticipated Graduation: May 2003
B elor of Science in Nursing
The University of North Carolina at Chapel Hill -1990
Diploma in Nursing
The Ohio Valley Hospital School of Nursing, Steubenville, Ohio -1984
VOLUN ~ E W RI{
• Orange Cou~y Long Term Care Roundtable, Steering Committee Chair
~e~g May 2003)
• Orange County Adult Care Home Commurrity Advisory Committee (Beginning May 2003)
Chapel Hill Rehabilitation and Healthcare Center (Ian. 2003 to present)
• "A Helping Hand", Orange County, North Carolina (Aug 2000 to Aug 2001)
(Provided companionship and homemaker services to the elderly and disabled adults)
• Guardian Ad Litem for Orange and Chatham Counties, North Carolina (1993 to 1996)
(Court appointed advocate for children involved in court system due to abuse or neglect)
ME~~~.~
Delta Omega, Theta Chapter, Honorary ,Public Health Society
• American Public Health Society
• American Society on Aging
References available upon request
Apri12003
____.~o
~~;
,~
VOLUNTEER APPLICATION
ORANGE COUNTX BOARDS AND COMMISSIONS
If you are an Orange County resident, at least 18 pears old, and willing to
volunteer your time and expertise to your community, please complete and
return to:
' ~ County Commissioners' Office
P. 0. Box 8181
Hillsborough, NC 27278 .
NAME: Caleb II. Moore
HOME ADDRESS: 804~Faucette Mill Road •
Hillsborough, NC Zip Code 27278
TELEPHONE: (W)
(H) 732-2402
PLACE OF EMPLOYMENT: Retired ~~
JOB TITLE: Retired Educator (School Band)
ON REVERSE SIDE LIST JOB, VOLUNTEER, AND EDUCATIONAL EXPERIENCE AND/OR SILLS
I WOULD LIKE FOR US TO CONSIDER.
IN ORDER TO ASSURE COUNTYWIDE REPRESENTATION PLEASE INDICATE YOUR TOWNSHIP OF
RESIDENCE:
Bingham Cheeks
Hillsborough X Eno
Chapel Hall Little River
Cedar Grove
WE ASK YOUR HELP IN ASSURING DIVERSITY OF MEMBERSHIP BY AGE, GENDER AND RACE,
BY ANSWERING THE FOLLOWING QUESTIONS:
Male - X
Female
DATE OF BIRTH:
ETHNIC BACKGROUND:
African American
Caucasian
Native American
X Hispanic
Other
PLEASE LIST (IN ORDER OF PREFERENCE) THE BOARDS/COMMISSIONS ON WHICH YOU
WOULD BE WILLING TO SERVE.
A•~.Oranae County Arts Commission
4.
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2
Please list any work, volunteer, and/or educational experience you would like
to have considered in the review of your application.
WORK EXPERI~E:
VOLUNTEER EXPERIENCE:
EDUCATIONAL EXPER,~ENCE: '
OTHER COMMENTS•
How did you become aware of~o.range county volunteer opportunities?
(Please specify): Newspaper
Current Orange County Volunteer
Radio
T.V.
Other
If appointed, I agree to attend a 3 hour orientation which will give an
overview of how Orange County Government operates and what its relationship
is to other governmental units.
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Applicant Interest Listing
by Board Name and by Applicant Name
Contact Person: Pam Tillet
Adult Care Home Community Advisory Committee Contact Phone: 919-968-2084
Ms. Carla M. Julian
2320 George Anderson Drive
Hillsborough NC 27278
Skills: Registered Nurse
Mr. Caleb Moore
804 Faucette Mill Road
Hillsborough NC 27278
Skills: Citizen - At-Large
Skills: Community Service Volunteer
Day Phone: 919-732-5192 Sex: Female
Evening Phone: same Race: Caucasian
FAX: same Township: Hillsborough
E-mail: carlajulianenc.rr.com Date Applied: 04/15/2003
Also Serves On:
Day Phone: 919-732-2402 Sex: Male
Evening Phone: 919-732-2402 Race: African American
FAX: Township: Hillsborough
E-mail: Date Applied: 07/31/2002
Also Serves On: DTCC Satellite Campus A.C.P.N.A.
Friday, June 06, 2003 Page 1 of 1