January 26, 2016 - Regular Meeting Agenda Item #68

Subject Healthcare Advisory Board Initial Appointment Briefings None Contact and/or Presenter Information

Andy Guyre, Human Services Division Manager Community Services, x3493

Action Requested Appoint one member to the Healthcare Advisory Board in the Category of Medically Needy Consumer of Healthcare. This member will be appointed for a two (2) year term ending September 30, 2017. Enabling/Regulating Authority

F.S. 125

Manatee County Resolution R-15-173

Background Discussion

The creation of a Healthcare Advisory Board was discussed at Work Sessions on August 4, 2015, and September 15, 2015.

On November 3, 2015, the Board of County Commissioners (BCC) authorized Resolution R-15-173 creating a Healthcare Advisory Board to evaluate, monitor, and discuss the healthcare system in Manatee County, make recommendations to the BCC, review evidence based practices and programs and how they can be applied to the County, and perform other tasks as requested by the BCC. Terms shall end on September 30 of each year as outlined above.

● During the initial appointments of Advisory Board members on December 15, 2015, no application was received for the category of Medically Needy Consumer of Healthcare. This appointment will fill that vacancy.

● The Advisory Board is composed of 11 members across the categories of Health Care, Behavior and Mental Health Care, Substance Abuse Care, Social Services, Higher Education, Medically Needy Consumer, and Business Representative knowledgeable about Health Care.

● The Advisory Board shall, to the maximum extent possible, be reflective of the diversity of the community.

● All applicants are residents of Manatee County and have demonstrated by their applications that they

Manatee County Government Administrative CenterCommission Chambers, First Floor

9:00 a.m. - January 26, 2016

have knowledge of healthcare related topics. ● None of the applicants are known to be employed by, a contractor for, or a Board Member of a company

that receives county funding. ● All applicants completed the application and supplemental questions. ● Mildred Isom did not attach a Resume or CV. All others did. ● Advisory Board members may serve no more than 2 full consecutive 3-year terms.

County Attorney Review Other (Requires explanation in field below) Explanation of Other Resolution reviewed by Robert M. Eschenfelder, Chief Assistant County Attorney Reviewing Attorney Eschenfelder Instructions to Board Records N/A Cost and Funds Source Account Number and Name N/A Amount and Frequency of Recurring Costs N/A Attachment: David Wortman.pdf Attachment: Kathleen Kevany.pdf Attachment: Mildred Isom Application.pdf Attachment: Consumer Matrix.pdf

Manatee County Government Administrative CenterCommission Chambers, First Floor

9:00 a.m. - January 26, 2016

JAN:84/26/MON, &1:46 PMCCH C1iic FAX No, 941 567 6186

MANATEE COUNTYgOARD OF COUNTY COMMISSiONERS

Advisory Board/Conimitee!Commssion you are applying for:

4d;ory ocicdAre you Willing to be considered for an alternate Bóard/Comrnittee/Commisaion Yes Q No

If applying for the SeniorAdvisory Board, are you over the age of 50: Yes 9J’ No QAre you a re9istered voter? (Need only answer if a requirement for the entity for which Yes No Qyou are applying)

Name

Address

City State [LI Zip L- 1I reside in Commission District # (can be found on back of your Voter Registration Card) j\/Year Round Resident? Yes No QDo you reside in the unincorporated area7 Yes o No

If no, please indicate city:

ThG Board of County Commissioners strisies to ensure equal acce5s for minorIties and women to serve or’ adviEary boerds/commIttes/commissiofls.

Completing this lnformstioii will help the County Commissioners Office compile information needed to

African American Asian American American Woman

Hispanic American Native American Other

EciQü1caJIse OnlyReceived:

________________________

Entered;

_______________ ___________

. Meets Qualifications: Yes_____ No______i Forwarded to Department:

____________

Acknowledgement Sent:80CC Mtg Date:

_____

Action:

_______________

Letter Sent:

___________

P. 981

P.O. Box 1000Bracionton, FL 3420-1 000

Phone: (941) 745-3709Fax: (941) 745-3790

Eniployar

Addres

Home Phone [L4A. 0Work Phone Cell Phone Li, L ç

Email

Occupation (if retired, please indicate)

Please list any governmental Advisory Boards/Committees/Commissions on which you currently serve

JAN 94/2916 MON 91:46 PM CCH Clinic FAX No, 941 567 6186 F, 992• d fl1 ZqsjiSW

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Complete the following. P/ease describe those lcels ofyour background/experience which you feel may be useful formembership an this Roard/Committee/Cornrnission.

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IMPORTANT IN FORMATION1. Eligibility for membership on certain advisory boards/committees/commissions requires a valid voter registration card.2. Membership on certain advisory boards/committees/commissions requires financial disclosure or the submission of other

information,3. Florida State Statute 119.07 designates this application as a public document to be made available for anyone requesting

to view it.4. Manatee County Land Development Code Ordinance 90-01, states that no member of the Planning Commission or

Board of Zoning Appeals shall be a member of another land development related advisory board serving unincorporatedManatee County.

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individiuars disability status. This nondiscriminationpolicy involves every aspect of the 5oard’s functions including ones access to, participation, employment, or treatment i ft programs or activities. Anyonerequiring reasonable accommodation for meetings as provided for in the Americans with Disabilites Act should contact Kaycee Ellis. three days before meeting at749-7100; TOO ONLY 749-1 coo and wait 60 seconds: FAX 745-3790

By typing my name and submitting this application, I acknowledge this constitutes my signatureunder the Florida Electronic Signature Act.

Type Name4*\’\\DR\ ga_v Date

PLEASE NOTE: Application wilt remain active for one (1) year. Resumes may be included, however, the application MUST still be completed.Read Important Information section, then sign the application.

Electronic Signature

Revised 08/01/2006

T”ianateecounty

EL 0 RDA

JAi4. 316:MON 31:46 PM CCH Clinic FAX No, 941 567 6136 F, 303

Comirnrnity Services L)epartmentHuman Services Division1112 Manatee Avenue WestradentonfL 34205Phone (941) 749 3030

I www niymanatee or

Dec.ember 16 2015

Supplemental Questions for Applicants to the Manatee CountyHealthcare Advisory Board.

Please complete all qtestlons with currcnt and aoeurat nlbnnatzon.

What is your field of expertise’> (Only one seat open during this rinouncement)

‘t2 Medically Nccdy Consumer of.Healthcare /

Are you a Manatee County esident? 9Ves No

Axe you an cmplo3 cc, contractor for owner or voting member on the Board of Directors ofny agency that receives fundingfrom Manatee County directly or indirectly7 []Ye No IfYeaexplain

__________

Please describe any special skills or knowledge that you possess telated to healthcaie that will make you a good candidate forthe Manatee Coua,ly Nealthcare Advisory Board? f •;;.

Have you ever been appointed by the Manatee County Board of County Commissioners to serve on an advisory board,including current appointments? EYes NoIf yes, which advisory boards have you served on and when?

Do you currently, or have you in the past 5 years, participated in any community health care initiatives or committees (e.g.:

Health Care Alliance, Chamber llealth Care Committee, Acute Care Con-injittee, etc.)? [Yes NoIf yes, which ones (including dates)?

Any application that does not include all 3 items below will be considered incomplete:• Advisory Board Application• This Questionnaire• A Current and Comprehensive Resume or Curriculum Vitae

Applicants will not be permitted to change information on their submitted application materiais once they have been receivedby the County.

LAItRY RUSTLE HA1LES U, SMfl’H O1iN R. CftAPIIE 1lOIN fllSAATlNO VANiSS IiAIJGI-1 ‘ C.4R0L WHTMORE * HTSY UiNAC

Dirriet .1 Dirrrki 2 Lcnicr. 1.)Isrrict4 DiStrjc’t 5 t),rfcr 6 btcrict 7

JAN,O4/2016/MON 01:46 PM CCH Clinic PAX Nt, 941 567 6136 P, 004

Kath’een T. Kevany402 2 Street, North, Bradenton Beach, FL 34217

(941) 448-5640

OVERVIEWring over eighteen years of related experience, 6 years as a medical secretary. Particular strengthsinclude organizational ability, handling multiple-priorities and attention to detail

EXPERIENCE

Personal Care Giver (Self Employed) 2011-2015• Meal Preparation• Light Housekeeping• Med Management• Supervised Patients Physical Activities• Arranged and drove to Appointments

Healthcare America Bradenton, FL 2003-2010Medical Secretary in diagnostic department• Process diagnostic orders for up to 30 doctors• Manage accounts recevable and daily report• Schedule, prepare and advise patients of diagnostic testing dates and times• Check appropriate lab results prior to tests• Advise doctors offices if authorization is required prior to testing• Document daily number of diagnostic tests performed for CEO- Inform doctors of patient no show or cancelled testing using computer system• Process paperwork for patients checking out diagnostic films• Accompany arriving patients to proper testing areas and advise technicians patients have arrived• Produce daily schedules for diagnostic technicians• Advise diagnostic technicians via phone or voice mail of incoming stat or add-on tests• Order supplies for diagnostics office• Prepare diagnostic prep kits and instructions for patients

Assist with patient flow into lab area• Prepare paperwork and orders for patients prior to test date• Collect doctors orders at offices; faxed to diagnostics department; phoned into diagnosticdepartment; received from patients at diagnostics department

Doctors at Manatee Bradenton and Ellenton, PLMedical Secreta’y (Ellenton Office) 2000-2003• Sole Medical Secretary to one internal medicine MD and one LPN• Process doctors medical orders for patients upon checkout

• Manage accounts receivable and daily report• Make bank deposits daily

Fax medical records• Prepare diagnostic test results for MD.• Maintain patient chartifile system• Open and close office, set security system

Med/cal Secretary (Bradenton Office)o Process doctor’s medical orders for patients upon checkout• Manage accounts receivable and daily report• Advised patients via phone of negative diagnostic and lab results• Maintain patientchart/file system

JAN/04/’2016/MON 01:46 PM CCH C1c FAX Mo, 941 567 6166 F, 005

Peninsula Medical Associates radenton. FLMedical Secretary to Neurosurgeons, Neurologists arid Ihy.siatrists 1998-2000• Process doctors medical orders for patients upon checkout• Process work comp orders, fax medical ‘ork camp records to Insurers for authorization• Manage accounts receivable and daily report

Columbia Blake Medical Center Bradenton, FL 1988-1998Emergency oom Registration Clerk• Responsible for interviewing patients or production of medical chart• Processing of insurance and billing information• Extensive Computer use daily

Kathleen Cevarty(9----q715

L4L 5t-4Emergency Room Unit Coordinator

• Responsible for orientation and training of all new or cross-trained Unit Coordinators for theEmergency Department• Central communicator and facilitator in emergency, disaster and life-threatening situations• Significant interaction with the public both by telephone and in person, including patients, doctors,police and press

Responsible for maintaining flow of patients through the Emergency Department

RELATED SKILLS• Expertise in Workman’s Conpensation cases and appeals, extensive typing of legal forms,researching pertinent information at the Industrial Commission• Extensive computer use daily• Certified as cardiac monitor technician• Certified in cardlo-pulrnanary resuscitation (CPR)

EDU CATIONManatee Community College, 1993-1996Credit toward Bachelor’s Degree ri Mass Communications

HONORSPhi Theta Kappa Member (Scholastic Honor Society)National Dean’s List

References available upon request

Name

Address

City

MANATEE COUNTYoiBOARDOF COUNTY COMMISSIONERS

P.O. Box 1000Bradenton, PL 34206-1000

If no, please indicate city:

Home Phone 9(//-7 L/772 Work Phone Cell Phone

Email

Employer

Address

Other

For Office Use Only’Received:___________________________Entered:Meets Qualifications: Yes_____ No_____Forwarded to Department:

___________

Acknowledgement Sent:BOCC Mtg Date:

_____

Action:

_______________

Letter Sent:

___________

JAN/04/2g16/MON 1.:,9PMv CC}1 Clinic AX No, 941 567 6186 P. 81

Phone: (941) 745-3709Fax:. (941) 745-3790

Advisory Board/Commitee/Commission you are applying for;

Are you willing to be considered for an alternate BoardiCornmitteelCommission Yes No 0If applying for the Senior Advisory Board, are you over the age of 50: Yes j No QAre you a registered voter? (Need only answer if a requirement for the entity for which Yes$ No Qyou are applying)

E rm icv€4

_1i L&}

____

State IFlorida Zip

I reside in Commission District # (can be found on back of your Voter Registration Card) l3

Year Round Resident? Yes No QDo you reside in the unincorporated area? ‘Ies No o

H -,

-j

Occupation (if retired, please indicate) ]R, “ r—

Please list any governmental Advisory Boards/CommitteesiComrnissions on which you currently serve

The Boerd of County Commlsioners strives to ensure equal access for rninorWs and women to snie on advisory boardsJcornmittesIcommlssions.Completing this information will help the County Commissioners Office cmpiIe nformtion needed to comply with Florida State Statutes 760,50.

African American Asian American fl American Woman

Hispanic American Native American

JAN/04/2C16/MON 12:8 PM CCH Clinic FAX No, 941 567 6166 F. 002

&-

IMPORTANT INFORMATLI1. Eligibility for membership on certain advisory boards/committees/commissions requires a valid voter registration card.2. Membership on certain advisory boards/committees/commissions requires financial disclosure or the submission of other

information.3. Florida State Statute 1 19.07 designates this application as a public document to be made available for anyone requesting

to view it.4. Manatee County Land Development Code Ordinance 90-01, states that no member of the Planning Commission or

Board of Zoning Appeals shall be a member of another land developrrierit related advisory board serving unincorporatedManatee County,

The Board of county Commissioners of Manata County, Florida does not disc.rimlnate upon the basis of any individiusla disability status. This nondiscriminationpolity involves every aspect of the Boards functions including ones access to, participation, employment, or treatment in its programs or activities. Anyonerequiring reasonable accommodation for meetings as provided for in the Amaricans with Disabilites Act should contact Kaycee Ellis, three days before meeting at749-7100; TOD ONLY 749-1000 and welt 60 seconds; FAX 745-3790

• By typing my name and submitting this application, I acknowledge this constitutes my signatureunder the Florida Electronic Signature Act.

Electronic Signature

PLEASE NOTE: Application will remain active for one (1> year. Resumes maybe included, however, the application MUST still be completed.Reed ImDortant Inforj1Qjj section, then sign the application.

Complete the following. P/ease describe those facets of your background/experiene which, you feel may be useful formembership on this Boar’d/CommitteeJCommission.

Type Name Date

Revised 08/01/2006

Do you currently, or have you in the past 5 years, participated in any community health care initiatiyes or committees (e.g.:Health Care Alliance. Chamber Health Care Committee, Acute Cara Committee, etc.)? EYes .•NoIf yes, which ones (including dates)?

Any application that does not include au S items below will be considered incomplete:• Advisory oard Application• This Questionnaire• A Current and Comprehensive Resume or Curriculum Vitae

Applicants will no: be permitted to change information on their submitted application materials once they have been receivedby the Coity.

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December 16. 2015

Commtnity Services DepartmentHuman Service 5 Vivision1112 Manatee Avenue WestBrdenton, FL 34205Phone: (941) 749-3030

S www.mymanatee.org

Supplemental Questions for Applicants to the Manatee County’.Healthcare Advisory Board.

please complete all questions with current and ccurato information. -

.Vhat is your field of expertise? (Only one seat open during this announcement)

“Medically I’-eedy Consumer of Healthcare

Are you a Manatee Coun ResideV? [s ENo

Are l,ou an employee, contractor for, owner or voting memer on the Board of Di.rectot of any agenc tharrtceives findingfrom Manatee County directly or indirectly? flyes Lo If Yes, - =

explain: . -

Please describe any special skills or knowledge that you possess related to healthcarc tiat will make youa.dod candidate forhe Manatee Count) Healthcaie Adisor oard9

QC-k-9-’ I LJ’ -A’\ -q, F

o- . s to. ‘- \ b deJ_- 1E,IZL

X-iave you ever been appointed by the Man C’nty Board of County Commissioners to serve on an advisory board,including current appointnents2 EYes NoIf yes, which advisory boards have you served on and when?

l.i.IkRY I S E lA 5 J. sn )i-J . (;c ‘ (N t •F’J) ‘)H CA.jL NI fM(RE ciE’lYO:tr!r-t- P 1r-i ‘ 3 Ii.ticr .1 ( Di:t ?

Matrix of Applicants for Appointment to the Healthcare Advisory Board

Medically Needy Consumer of Healthcare Category

Term Ends September 30, 2017 District Name Profession Eligibility Issues

3 Kathleen Kevany Self-Employed Personal Care Provider

2 Mildred Isom Retired Incomplete Application/Resume Not

Included

4 David Wortman Parking/Security