The URL can be used to link to this page

Home My WebLink AboutAgenda - 08-19-2008- 10cORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: August 19, 2008 Action Agenda Item No. 10-c SUBJECT: Nursing Home Community Advisory Committee-New Appointment DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Under Separate Cover Membership Roster Letter of Recommendation Application(s)/Resume(s) of Person(s) Recommended Interest List Application(s)/Resume(s) of Person(s) on the Interest List INFORMATION CONTACT: Clerk's Office, 245-2130 PURPOSE: To consider making one new appointment to the Nursing Home Community Advisory Committee. BACKGROUND: The Clerk's office has received a recommendation from the Nursing Home Community Advisory Committee for Tiffany Washington. If appointed she will be serving aone- yeartraining term, which will end on 6/24/2009. FINANCIAL IMPACT: None. RECOMMENDATION(S): Consider making one new appointment to the Nursing Home Community Advisory Committee. Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1st Monday starting with Jan. Terms: 2 Contact Person: Vibeke Talley, OTR/L Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919-968-2087 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. Mr. Arthur St. John Day Phone: 919-968-3003 Sex: Male First Appointed: 01/24/2005 Evening Phone: 919-968-3003 Race: Caucasian Current Appointment: 06/13/2006 1 101 Hayworth Drive FAX: Township: Chapel Hill Expiration: 01/30/2009 Chapel Hill NC 27517 E-mail: st1299@bellsouth.net . Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: At-Large Mr. Ed Flowers Day Phone: 919-403-1965 Sex: Male First Appointed: 03/06/2008 Evening Phone: 919-967-5693 Race: Caucasian Current Appointment: 03/06/2008 2 101 Parkside Circle FAX: 919-403-8965 Township: Chapel Hill Expiration: 03/31/2009 Chapel Hill NC 27516 E-mail: edflowers@mindspring.com Resid/SpeC Req: At-Large Number of Terms: Special Repr: At-Large Mrs. Patricia Revels Day Phone: (919) 241-407 Sex: Female First Appointed: 03/06/2008 Evening Phone: Same Race; Caucasian Current Appointment: 03/06/2008 3 329 West King Street FAX: N/A Township: Hillsborough Expiration: 03/31/2009 Hillsborough NC 27278 E-mail: prevels001 @nc.n•.com Resid/SpeC Req: At-Large Number of Terms: Special Repr: At-Large Ms. Sharon Karnash Day Phone: 919-479-5661 Sex: Female First Appointed: 06/12/2007 Evening Phone: same Race: Caucasian Current Appointment: 06/12/2007 4 5513 Quail Hollow Drive FAX: Township: Little River Expiration: 06/30/2003 Hillsborough NC 27278 E-mail: sharon.kamash@duke.edu Resid/Spec Req: At-Large Number of Terms: 0 .Special Repr: At-Large Mr. Mario C. Battigelli Day Phone: 919-942-5756 Sex: Male First Appointed: 04/03/2001 Evening Phone: Race: Caucasian Current Appointment: 06/07/2005 5 1307 Wildwood Drive FAX: Township: Chapel Hill Expiration: 06/30/2008 Chapel Hill NC 27514 E-mail: MAGIBAT@AOL.COM Resid/Spec Req: At-Large Number of Terms: 2 Special Repr: Nursing Home Ad ministration Monday, June 09, 2008 Page 1 1''' Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other lst Monday starting with Jan. Tetras: 2 Contact Person: Vibeke Talley, OTR/L Meeting Place: Seymour Center Positions: 12 Length: 3 yeazs Contact Phone: 919-968-2087 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. Susan Taylor Day Phone: 919-256-1048 Sex: Female First Appointed: 08/21/2007 6 Evening Phone: 919-357-6639 Race: Caucasian Current Appointment: 08/21/2007 2103 Baycourt Trail FAX: Township: Hillsborough Expiration: 09/30/2008 Hillsborough NC 27278 E-mail: staylor20@nc.rr.com Resid/Spec Req: At-Large Number of Terms: Special Repr: Nursing Home Administration Ms. Sue Waters Day Phone: 919-643-2040 Sex: Female First Appointed: 09/21/2004 7 Evening Phone: 919-643-2040 Race: Caucasian Current Appointment: 11/15/2005 608 Red Fox Trail FAX: Township: Hillsborough Expiration: 09/30/2008 Hillsborough NC 27278 E-mail: ronwaters@earthlink.net Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: At-Large VACANT Day Phone: Sex: First Appointed: 8 Evening Phone: Race: Current Appointment: FAX: Township: Expiration: 06/30/2009 E-mail: Resid/Spec Req: At-Large Number of Terms: Special Repr: At-Large Ms. Mary Ann Peter Day Phone: 919-732-6073 Sex: Female First Appointed: 06/03/2003 9 Chair Evening Phone: 919-732-6073 Race: Caucasian Current Appointment: 06/12/2007 118 W. Tryon Street FAX: Township: Hillsborough Expiration: 06/30/2009 Hillsborough NC 27278 E-mail: maryannpeter@earthlink.net Resid/Spec Req: At-Large Number of Terms: 2 Special Repr: At-Large Ms. Patricia Koch Day Phone: 942-6637 Sex: Female First Appointed: 06/19/2006 10 Evening Phone: same Race: Caucasian Current Appointment: 06/12/2007 1540 Ferrell Rd FAX: Township: Chapel Hill Expiration: 06/30/2009 Chapel Hill NC 27517 E-mail: pkoch@mindspring.com Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: At-Large Monday, June 09, 2008 Page 2 Board and Commission Members And Vacant Positions Nursing Home Community Advisory Committee Meeting Times: 5:30 p.m. Every other 1st Monday starting with Jan. Terms: 2 Contact Person: Vibeke Talley, OTR/L Meeting Place: Seymour Center Positions: 12 Length: 3 years Contact Phone: 919-968-2087 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. Anne Winfield Day Phone: 919-419-9139 Sex: Female First Appointed: 10/17/2006 11 Evening Phone: Race: Caucasian Current Appointment: 12/03/2007 6712 Pauline Drive FAX: Township: Chapel Hill Expiration: 12/31/2010 Chapel Hill NC 27514 E-mail: abwinfield@mindspring.com Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: Nursing Home Administration Mrs. Carol Hierman Day Phone: 919/644/8414 Sex: Female First Appointed: 10/17/2006 12 Evening Phone: same Race: Caucasian Current Appointment: 12/03/2007 1028 Lakeview Dr. FAX: same Township: Cedar Grove Expiration: 12/31/2010 Cedar Grove NC 27231 E-mail: donhierman@aol.com Resid/Spec Req: At-Large Number of Terms: 1 Special Repr: Nursing Home Administration --ice Monday, June 09, 2008 Pa e 3 g -----Original Message----- From: Mary Ann Peter [mailto:maryannpeter~earthlink.net] Sent: Monday, June 09, 2008 8:52 AM To: Donna Baker Cc: Jill Passmore Subject: Tiffany Washington nomination for nursing home committee To: Orange County Board of County Commissioners Barry Jacobs, Chairman From: Mary Ann Peter Chair, Orange County Nursing Home Community Advisory Committee Re: Nomination for OCNHCAC June 9, 2008 We are pleased to recommend Tiffany Washington for membership on the committee. Ms Washington is a PhD student in the UNC-Chapel Hill School of Social Work and is a resident of Orange County. She has attended a committee meeting and has submitted her application stating her interest. We would be very fortunate to have someone with her qualifications and interest in long term care as a member of this committee. We hope that you will appoint her at the next opportunity. Thank you most sincerely for your support of this committee. 1 ,,; z ,~ Page 1 of 2 Tiffany Washington 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. Tiffany Washington 515 Hinton James Drive #138 (mail: PO Box 746) Chapel Hill NC 27514 (336)339-8144 twashing@email.unc.edu UNC Chapel Hill - DHRE Community Manager Chapel Hill Does not apply Female African American 5/29/1978 Boards/Commissions applied for: Nursing Home Community Advisory Committee Adult Care Home Community Advisory Committee Advisory Board on Aging Work Experience: 02-05 Medical Social Worker Northside Dialysis Center Winton Salem 03-05 Medical Social Worker Amedisys Home Health Winston Salem 05-07 Patient Services Coordinator, Southeastern Kidney Council Raleigh 05-07 Medical Social Worker, Gentiva Home Health, Raleigh, NC Volunteer Experience: National Kidney Foundation UNC Kidney Center March of Dimes Buckle up America American Red Cross Education: 1996-2000 UNC Chapel Hill - BA 2000-2002 UNC Greensboro/NCA&TSU - Master of Social Work 2007-present UNC Chapel Hill -PhD in Social Work Other Comments: I have 2 years experience investigating complaints and grievances of dialysis and transplant patients in North Carolina, South Carolina, and Georgia. My research area is n Page 2 of 2 Tiffany Washington health and aging. I enjoy volunteer work and community service. STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee, Adult Care Home Community Advisory Committee and Advisory Board on Aging on 5/5/2008. ADDRESS VERIFICATION: 515 Hinton James Drive #138 is in Chapel Hill township UNC jurisdiction. This application was current on: 5/5/2008 11:12:32 PM Date Printed: 6/9/2008 S Applicant Interest Listing Nursing Home Community Advisory Committee by Board Name and by Applicant Name Contact Person: Vibeke Talley, OTR/L Contact Phone: 919-968-2087 Mr. Blake Burklin 117 Creel St. Chapel Hill NC 27516 Skills: Habitat for Humanity Skills: Sociology Major Ms. Jeanette Clark 221 Rencher St Apt 3 Hillsborough NC 27278 Skills: Nursing Home Experience Day Phone: 919-812-4394 Evening Phone: 919-812-4394 FAX: E-mail: burklin@email.unc.edu Also Serves On: Also Serves On: Day Phone: 919-620-8662 Evening Phone: 732-7856 FAX: 6208662 E-mail: Also Serves On: Sex: .Male Race; Caucasian Township: Chapel Hill Date Applied: 02/03/2008 Sex: Female Race: African American Township: Hillsborough Date Applied: 02/23/2005 Ms. Peggy Cohn 10 Bayswater Place Chapel Hill NC 27517 Skills: Geriatric Care MS. ELIZABETH CRONER 1605 N. GREENBOROUGH ROAD CARRBORO NC 27510 Skills: Retired Day Phone:. 919-489-6624 Sex: Female Evening Phone: same Race: Caucasian FAX: Township: Chapel Hill E-mail: peggycohnl@earthlink.net Date Applied: 10/10/2005 Also Serves On: Adult Care Home Community Advisory Committee Also Serves On: Advisory Board on Aging Day Phone: 919.933.862 Sex: Female Evening Phone: Race: African American FAX: Township: Chapel Hill E-mail: Date Applied: 11/05/2005 Also Serves On: Mr Ed Flowers Day Phone: 919-357-9256 Sex: Male 2813 Beckett's Ridge Drive Evening Phone: 919-357-9256 Race: Caucasian Hillsborough NC 27278 FAX: Township: Hillsborough E-mail: ED_FIAWERS@YAHOO.COM Date Applied: 11/18/2007 Skills: Children's Issues Also Serves On: Skills: Nuclear Physicist Also Serves On: Monday, June 09, 2008 Page 1 of 2 1 Applicant Interest Listing by Board Name and by Applicant Name Contact Person: Vibeke Talley, OTR/L Nursing Home Community Advisory Committee contact Phone: 919.968-ZOB~ Ms. Jane Powell 656 Craige Dorm UNC Chapel Hill Chapel Hill NC 27514 Skills: Cashier Skills: Community Service Volunteer Skills: Customer Service Ms. Tammy Thacker 517 N. Hill Street Hillsborough NC 27278 Skills: Certified Nurses Aide Day Phone: 910-474-9083 Evening Phone: 919-914-4924 FAX: E-mail: japo@email.unc.edu Also Serves On: Also Serves On: Also Serves On: Day Phone: 638-4387 Evening Phone: FAX: E-mail: gr8tpay@yahoo.com Also Serves On: Sex: Female Race: African American Township: Chapel Hill Date Applied: 09/30/2004 Sex: Female Race: Akan American Township: Hillsborough Date Applied: 02/14/2006 Ms. Tiffany Washington Day Phone: (336)339-8144 515 Hinton James Drive #138 (mail: PO Box 746) Evening Phone: Chapel Hill NC 27514 FA}~; E-mail: [washing@email.unc.edu Skills: Social Worker Also Serves On: Sex: Female Race: African American Township: Chapel Hill Date Applied: 05/05/2008 Monday, June 09, 2008 Page 2 of 2 f C~ Page 1 of 1 Blake Burklin Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone: (Day) Phone: (Evening) Fax: Email: Place of Employment: Job Title: Mr. Blake Burklin 117 Creel St. Chapel Hill NC 27516 919-812-4394 919-812-4394 burklin@email.unc.edu Johnny T Shirt Township of Residence: Chapel Hill Zone of Residence: Chapel Hill Twnsp Sex: Male Ethnic Background: Caucasian Date of Birth: 11/15/1983 Boards/Commissions applied for: Orange County Planning Board Nursing Home Community Advisory Committee Work Experience: Harris Teeter Triangle Sportsplex Johnny T Shirt Volunteer Experience: UNC Hospital Habitat for Humanity Education: B.A. in Sociology from the University of North Carolina at Chapel Hill Other Comments: As an undergraduate sociology major I was able to design and implement IRB approved social research on stigmatized populations confidentially. (believe as a life long resident of the Chapel Hill/ New Hope area, that I will have some insight the Board might find valuable. STAFF COMMENTS: Originally applied for Orange County Planning Board & Nursing Home Community Advisory Committee on 2/3/2008. ADDRESS VERIFICATION: 117 Creel St, Chapel Hill, is Chapel Hill township in CHPL jurisdiction. This application was current on: 2/3/2008 10:53:29 PM Date Printed: 6/9/2008 Page 1 of 1 Jeanette Clark 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. Jeanette Clark 221 Rencher St Apt 3 Hillsborough NC 27278 919-620-8662 732-7856 6208662 Central Family Care Supervisor in Charge Hillsborough Hillsborough ETJ Female African American 7/8/1955 Boards/Commissions applied for: Nursing Home Community Advisory Committee Joint Orange Chatham Community Action Agency Work Experience: 1 have been in the medical experience for about 12 yrs. I am a certified nurse assistant, and a certified medical technician. I have nursing home and adult care home experience. I supervise a group home now for mental residents Volunteer Experience: I have no volunteer experience but I have done outreach before and I have a certificate for a class I took as an outreach worker. Education: GED Other Comments: STAFF COMMENTS: Originally applied for Nursing Home CAC and Adult Care Home Community Advisory Committee and JOCCA. ADDRESS VERIFICATION: 211 Rencher St is in Orange County in Hillsborough Township in Hillsborough ETJ. This application was current on: 2/23/2005 Date Printed: 6/9/2008 ~- Page 1 of 1 Peggy Cohn 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: Ms. Peggy Cohn Peggy 10 Bayswater Place Chapel Hill NC 27517 919-489-6624 same peggycohn1 @earthlink.net retired Geriatric Care Manager Chapel Hill C.H. City Limits Sex: Female Ethnic Background: Caucasian Date of Birth: 8/28/1938 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: Community Health Nursing educator UNC and Penn State University Director of Family Ties, Geriatric Care Management, State College PA Volunteer Experience: Nursing Home visitation Non profit Boards in PA Education: BA, Wellesley BSN, Columbia University MPH, UNC PhD, Penn State University College of Health and Human Developmenet Other Comments: STAFF COMMENTS: Originally applied for Adult Care Home Community Advisory Committee and NHCAC and Adv. Board on Aging 10/10/2005. ADDRESS VERIFICATION: Mailing address listed above. Residence is 233 McCauley Street in Chapel Hill city limits. This application was current on: 10/10/2005 11:34:21 AM Date Printed: 6/9/2008 ~3 Page 1 of 1 ELIZABETH CRONER 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. ELIZABETH CRONER 1605 N. GREENBOROUGH ROAD CARRBORO NC 27510 919.933.862 RETIRED Township of Residence: Chapel Hill Zone of Residence: Carrboro City Limits Sex: Ethnic Background: Date of Birth: Female African American 5/14/1934 Boards/Commissions applied for: Advisory Board on Aging Nursing Home Community Advisory Committee Work Experience: RETIRED FROM STATE OF OHIO, CLEVELAND DEVELOPMENTAL CENTER; STAFF SUPV. Volunteer Experience: CURRENTLY ASSISTING ABUNDANT LIFE CHURCH PANTRY Education: HIGH SCHOOL; CONTINUED EDUCATION; Other Comments: STAFF COMMENTS: Originally applied for Adv. Board on Aging, Nursing Home CAC, and Board of Social Services 11/8/2005. ADDRESS VERIFICATION: 1605 N. Greensboro St is in Carrboro City Limits in Orange County in the Chapel Hill Township. This application was current on: 11/5/2005 11:28:47 AM Date Printed: 6/9/2008 ly Page 1 of 2 Ed Flowers 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: Mr Ed Flowers 2813 Beckett's Ridge Drive Hillsborough NC 27278 919-357-9256 919-357-9256 ED_FLOW ERS@YAHOO.COM Duke University Hospital Senior Nuclear Medicine Technologist Hillsborough Male Caucasian 2/10/1944 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: 1965 - 1970 Nuclear Medicine Technologist NC Baptist Hospital 1970 - 1976 Chief Nuclear Medicine Technologist Duke Medical Center 1976 - 1991 Technical Administrator -Nuclear Medicine -Duke Medical Center 1991 - prestnt Senior Nuclear Medicine Technologist Volunteer Experience: Durham Congregations in Action Yokefellows -Durham County- Alamance/Orange Counties Durham Nursery School Advisary Committee Blowing Rock Conference Center Board of Directors -Treasurer Education: High School -Southwest Forsyth College -Mars Hill Radiologic Technology -North Carolina Baptist Hospital Nuclear Medicine Technology -North Carolina Baptist Hospital Other Comments: Extensive experience with regulatory agencies (e.g., JCAHO, N.C.Radiation Safety, OSHA, Nuclear Regulatory Commission) STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Community Advisory Committee on 11/18/2007. ADDRESS VERIFICATION: 2813 Beckett's Ridge Drive, is Hillsborough Township. 15 Page 1 of 1 Jane Powell 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: Ms. Jane Powell 656 Craige Dorm UNC Chapel Hill Chapel Hill NC 27514 910-474-9083 919-914-4924 japo@email.unc.edu Wynnsong 15 Theatre Cashier Chapel Hill Zone of Residence: Chapel Hill Township within C.H. city limits Sex: Ethnic Background: Date of Birth: Female African American 10/18/1983 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: Ocean Beach Club: waitress and secretary, Dairy Queen: cashier, Wynnsong 15: cashier Volunteer Experience: Volunteer with Public Service Scholars. Volunteer at Dobbins Hill apartments on Mondays, Volunteer at UNC Hospital on Mondys. DO other volunteering when needed. Education: High School-Lumberton Senior High School, attending UNC Chapel, BS Nursing Other Comments: STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee, Affordable Housing Advisory Board, and Animal Shelter Operations Task Force.. ADDRESS VERIFICATION: 656 Craige Dorm is on the campus of UNC-Chapel Hill and is located off of Manning Drive in Orange County, in the Chapel Hill Township in the City Limits. This application was current on: 9/30/2004 Date Printed: 6/9/2008 ~W Page 1 of 1 Tammy Thacker 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. Tammy Thacker 517 N. Hill Street Hillsborough NC 27278 638-4387 gr8tpay@yahoo.com Aryzen Health and Wellness Presiden# and CAN II Township of Residence: Hillsborough Zone of Residence: Hillsborough Town Limits Sex: Female Ethnic Background: African American Date of Birth: 5/31/1968 Boards/Commissions applied for: Nursing Home Community Advisory Committee Work Experience: I have been in Health Care for over 15 years and I have a good knowledge base about the elderly. I understand people need and what it takes to live in a safe environment. Volunteer Experience: I have volunteered in the classrooms of my children. Education: Certified CNA I and II. Certified EKG technician and Certified Medication Technician. Other Comments: STAFF COMMENTS: Originally applied for Adult Care Home and Nursing Home Care Advisory Boards and Advisory Board on Aging 2/14/2006. ADDRESS VERIFICATION: 517 Hill Street is in the Town of Hillsborough in Orange County. This application was current on: 2/14/2006 Date Printed: 6/9/2008