manatee county government administrative center commission ...€¦ · cheri coryea, deputy county...

33
May 8, 2018 - Regular Meeting Agenda Item #35 Subject Health Care Advisory Board - Appointment Briefings Briefing Provided Upon Request Contact and/or Presenter Information Ava Ehde, Interim Director, Neighborhood Services Dept., ext 6301 Joshua T. Barnett, Health Care Services Manager, ext 3978 Cheri Coryea, Deputy County Administrator, ext 3468 Action Requested Appointment of one individual to fill the Business seat on the Health Care Advisory Board. Enabling/Regulating Authority Resolution 17-035 Background Discussion The Business seat became vacant due to a resignation. Four applicants, Bryan Boudreaux, David Andrew Bowman Sr., Pierrette Kelly, and Kimberly Sand, provided their interest to fill this seat. Resolution R-17-035 establishes roles and responsibilities of the Health Care Advisory Board (HCAB) as directed by the Board of County Commissioners (BCC). The HCAB evaluates and monitors the Health Care System in Manatee County. The HCAB does not self-assign projects. The BCC provides the HCAB with top priorities to work on annually and to report back to them. When available, County staff assists the HCAB. The HCAB reviews evidenced based practices. The HCAB meets a minimum of eight times yearly. The HCAB provides written and or verbal reports to the BCC to provide background into the research they conduct and that may include recommendations. County Attorney Review Not Reviewed (No apparent legal issues) Explanation of Other Manatee County Government Administrative Center Commission Chambers, First Floor 9:00 a.m. - May 8, 2018

Upload: others

Post on 25-May-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

May 8, 2018 - Regular Meeting Agenda Item #35

Subject Health Care Advisory Board - Appointment Briefings Briefing Provided Upon Request Contact and/or Presenter Information

Ava Ehde, Interim Director, Neighborhood Services Dept., ext 6301

Joshua T. Barnett, Health Care Services Manager, ext 3978

Cheri Coryea, Deputy County Administrator, ext 3468

Action Requested Appointment of one individual to fill the Business seat on the Health Care Advisory Board. Enabling/Regulating Authority Resolution 17-035 Background Discussion

● The Business seat became vacant due to a resignation. Four applicants, Bryan Boudreaux, David Andrew Bowman Sr., Pierrette Kelly, and Kimberly Sand, provided their interest to fill this seat.

● Resolution R-17-035 establishes roles and responsibilities of the Health Care Advisory Board (HCAB) as directed by the Board of County Commissioners (BCC).

● The HCAB evaluates and monitors the Health Care System in Manatee County. ● The HCAB does not self-assign projects. ● The BCC provides the HCAB with top priorities to work on annually and to report back to them. ● When available, County staff assists the HCAB. ● The HCAB reviews evidenced based practices. ● The HCAB meets a minimum of eight times yearly. ● The HCAB provides written and or verbal reports to the BCC to provide background into the research

they conduct and that may include recommendations.

County Attorney Review Not Reviewed (No apparent legal issues) Explanation of Other

Manatee County Government Administrative CenterCommission Chambers, First Floor

9:00 a.m. - May 8, 2018

vtessmer
New Stamp
vtessmer
Typewritten Text
vtessmer
Typewritten Text
vtessmer
Typewritten Text
Bryan Boudreaux appointed
Page 2: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Reviewing Attorney N/A Instructions to Board Records Please send a copy of the approved agenda item to Joshua Barnett ([email protected]) and Marianne Lopata ([email protected]). Cost and Funds Source Account Number and Name N/A Amount and Frequency of Recurring Costs N/A Attachment: Current Positions & Names.pdf Attachment: HCAB Business Application Matrix 042018.pdf Attachment: HCAB Boudreaux Bryan 04.10.18.pdf Attachment: HCAB Bowman David Andrew 04.11.18.pdf Attachment: HCAB Kelly Pierrette 04.02.18.pdf Attachment: HCAB Sand Kim 03.30.18.pdf

Manatee County Government Administrative CenterCommission Chambers, First Floor

9:00 a.m. - May 8, 2018

vtessmer
Typewritten Text
Emailed 5/9/18
Page 3: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

DISTRICT

CURRENT HCAB MEMBERS (13)

CATEGORIES – HEALTH CARE ADVISORY BOARD – APRIL 2018

** AfricanAm (>1) ***Hispanic (>1)

HEALTH CARE

MENTAL HEALTH

SUBSTANCE ABUSE

SOCIAL SERVICES

HIGHER EDUCATION

CONSUMER (2)

MEDICAL CARE

(PRACTICING PHYSICIAN)

BUSINESS (5)

VACANT VACANT

1 James Nguyen, MD

2 Bonnie Ramseur**

Kirk Zeppi, LMHC

3 Ray Fusco, MBA, RN

3 Thomas Skoloda, PhD

3 Arthur Cohen, MD, JD

3 Ernest “Sandy” Marshall, JD

4 Dan Austin, MA

4 JoOni Anbar**

5 Francis Curd, DDS, DMD**

5 Barbara Shubert, MS

5 Lori Dengler, MBA, MSN, ARNP, FNP-C

Page 4: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Health Care Advisory Board – Candidate Matrix

Business Seat – appoint one (1) due to Vacancy

Business Seats – (not affiliated with any agency receiving county funds) – appoint one (1); Appointment term expires 09/30/2018

Commission District

Applicant Profession Education/Experience/Employment Current Advisory Board Member

5 Bryan

Boudreaux Commercial Banker,

Regions Bank

Education: BS Bachelor of Sciences in Business Administration, University of Delaware. Leadership Manatee 2014. Experience: 7+ years commercial banking in Manatee County, 12+ years total. Former Delaware business restaurateur. Acknowledges understanding of healthcare challenges of employees. Wife is a P.A. Affiliation with any agency receiving county funds: None

No

1 David Andrew Bowman (Sr.)

Business and Financial

Consultant, Citadel Financial Services,

LLC

Education: BS Bachelor Science in Business Administration, The Citadel; Florida Life/Health/Variable Annuities Licenses. Experience: 30 years as a business owner, Life/Health insurance industry. President and Board member to several national tech companies. 10 years e as a regulatory auditor for State of Florida. Affiliation with any agency receiving county funds: None

No

3 Pierrette Kelly Consultant to the

Patterson Foundation

Education: Bachelors in Business Administration and Social Work, West Virginia University; International Business Administration and Marketing, Limerick University, Ireland. Experience: 25 years working as CEO of a Community Service Agency providing variety of prevention and parenting programs. Child health advocate and oral health advocate. County’s Children’s Services Advisory Board member. Affiliation with any agency receiving county funds: None

No

1 Kimberly Sand,

DNP, ARNP Nurse Practitioner

for Mosaic

Education: DNP Doctor of Nurse Practice, University of South Florida; MSN Masters of Science in Nursing, Rutgers University; BSN Bachelor of Science in Nursing, Cedarville University, Ohio. Experience: 20 years experience as a Board Certified Nurse Practitioner focused on cardiovascular risk assessment and prevention, addressing health risk factors on a community scale. Clinical Adjunct Professor in Graduate Primary Care, USF. Wellness Nurse Practitioner at Mosaic. Affiliation with any agency receiving county funds: None

No

Page 5: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700

Bradenton, FL 34205 Fax: (941) 745-3790

www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race African American Asian American Caucasian

Hispanic American Native American Other _______________________

kgodbee
Typewritten Text
Page 6: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 2

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

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Page 7: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 3

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: [email protected]

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
Page 8: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc.Big Brothers/Big Sisters of the Suncoast Boys & Girls Clubs of Manatee Centerstone of FloridaCommunity HavenD.L. Randall FoundationEarly Learning Coalition of Manatee County Easter Seals of SW FloridaEducational Consultants Consortium Exchange Club Family Partnership Center Family Network on Disabilities Family Resources Feeding Empty Little TummiesFoundation for Dreams Hope Family Services

Insight Counseling ServicesManatee Children’s Services, Inc. Manatee Community Action Agency Manatee County Girls Club (Just for Girls) Meals on Wheels Plus of Manatee Myakka City Community Center Pace Center for Girls Palmetto Youth Center Sarasota Family YMCA Sarasota Manatee Assn. for Riding Therapy School District of Manatee County Selah Freedom, Inc.Tallevast Community Center The Salvation Army United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Children's Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 9: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 5

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

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

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 Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 10: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

BRYAN BOUDREAUX 6120 46th Lane E Bradenton, FL 34203 (941) 993-2023 [email protected]

CAREER OBJECTIVE Dynamic, accomplished banking sales strategist looking to utilize aggressive sales leadership abilities to meet the ever-changing goals within the banking industry and the local market. Continuously seeking to increase strong relationships within my organization and community to more effectively deliver banking solutions and superior customer service.

SUMMARY OF QUALIFICATIONS Management, sales, and client relations experience spanning banking, hospitality, telecommunications, and real estate industries. Record of training and motivating team members to surpass individual and corporate goals. Outstanding team building, listening, and presentation skills. Demonstrated ability to strengthen existing client relationships and grow a portfolio through prospect acquisition.

PROFESSIONAL EXPERIENCE REGIONS BANK

Vice President, Commercial Banking Relationship Manager (01/2012- Present) • Identify, target, and convert prospects into portfolio clients in the $1MM-20MM annual revenue

segment. • Provide a full suite of commercial lending and deposit services solutions • Develop existing relationships and leverage line of business partners to maximize client experience and

revenue to the organization Accomplishments

• Achieved Chairman’s Club production level award 2014 and 2015 (Top 10% of business group) • Portfolio growth from $12MM to $47MM in 5 years. • SBA Specialist and Team Leader with mentor responsibility to branch management. • Regions “Top Producer” Award recipient for November 2015 • 2017 Production over 108% of goal (1 of 3 in WFL Team to accomplish) • Bank Liaison to the Manatee Dental Society and Manatee Medical Society

BANKUNITED

Vice President, Business Development Officer (01/2011-12/2011)

• Relationship banker for business clients; responsible for managing deposit, lending, and treasury management solutions.

• Specialize in identifying prospects to grow market share of a new commercial bank through business networking and new client acquisition.

• Provide direct support to WFL market managers as a commercial lending specialist.

REGIONS BANK Vice President, Hub and Spoke Branch Manager (10/2007 – 12/2010) Assistant Branch Manager (06/2006 – 10/2007)

• Responsible for the overall management of two banking centers with particular emphasis on outside business development to grow loan portfolio and deposit base.

• Identified, hired, and trained multiple associates who have rapidly progressed to leadership positions

Page 11: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

• Successfully managed two sales teams and developed strong customer relationships through referrals to multiple lines of business within the organization.

Accomplishments

• Achieved Chairman’s Club production level (Top 10% of organization) 2007, 2008, 2009. • Recipient of the Sarasota/Bradenton Employee Retention Award 2007-2008

BANK SHOTS BAR AND RESTAURANT, BANK SHOTS STANTON, BANK SHOTS BEAR, SCOTLAND YARD PUB

AND RESTAURANT

Owner and General Manager (01/1998 – 12/2004) • Planned, launched, developed, and managed all aspects of operations for 4 bar/restaurants. • Selected location, negotiated leases, and oversaw design and construction. • Managed advertising, promotions, and customer relations. • Recruited, trained, and supervised qualified and diligent team of 60 employees. • Oversaw risk management, inventory control, vendor negotiations, and budgeting. • Negotiated successful and profitable sale of 2 locations.

EDUCATION UNIVERSITY OF DELAWARE

Bachelor of Science: Business Administration, 1990

COMMUNITY LEADERSHIP ➢ Treasurer, We Care Manatee ➢ Board of Governors, Lakewood Ranch Medical Center ➢ Leadership Manatee, Class of 2014-2015 ➢ Former Member, LWR Kiwanis ➢ Mentor, Take Stock In Children ➢ Volunteer for Easter Seals, Multiple Sclerosis Society, and Manatee County Substance Abuse Coalition. ➢ Fundraising Committee for Heal Autism Now Delaware (HAND Foundation). Raised $50K through

special events over a two year period.

Page 12: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700

Bradenton, FL 34205 Fax: (941) 745-3790

www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race African American Asian American Caucasian

Hispanic American Native American Other _______________________

kgodbee
Typewritten Text
Page 13: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 2

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

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Page 14: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 3

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: [email protected]

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
Page 15: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc.Big Brothers/Big Sisters of the Suncoast Boys & Girls Clubs of Manatee Centerstone of FloridaCommunity HavenD.L. Randall FoundationEarly Learning Coalition of Manatee County Easter Seals of SW FloridaEducational Consultants Consortium Exchange Club Family Partnership Center Family Network on Disabilities Family Resources Feeding Empty Little TummiesFoundation for Dreams Hope Family Services

Insight Counseling ServicesManatee Children’s Services, Inc. Manatee Community Action Agency Manatee County Girls Club (Just for Girls) Meals on Wheels Plus of Manatee Myakka City Community Center Pace Center for Girls Palmetto Youth Center Sarasota Family YMCA Sarasota Manatee Assn. for Riding Therapy School District of Manatee County Selah Freedom, Inc.Tallevast Community Center The Salvation Army United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Children's Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 16: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 5

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

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

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 Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 17: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Page | 1  

D. ANDREW BOWMAN, SR. (Andy) 941.545.7301 • [email protected] CRD 4254687  SKILLS  Relate well to people of diverse backgrounds, developing enduring relationships that foster trust.  Perceive motivations in others, encouraging them to produce results based on their goals and commitments.  Sales track record in relationships with sophisticated, large accounts.  Utilize time management skills and leadership performance techniques to facilitate productivity.  Approach projects with ambitious, self‐motivated, and highly entrepreneurial spirit.  Serial Entrepreneur   EXPERIENCE  2016‐Present  ERT Consultant     National Elite Resource Team Member  Consultants to trusted advisors. Helping CPA firms deliver enhanced value to their clients by transforming them from the reactionary reporting provider into the proactive and holistic advisor. To help business owners and CPAs uncover and implement under‐utilized tax strategies and cost savings.  2016‐Present  MaxMyBenes.com    National Managing Member  Employee benefits company that utilizes patented technology to provide credit fraud protection, account aggregation, debt elimination, wealth accumulation, and financial freedom.  2011‐Present   MoneyAbilty.com    National Executive  Technology company utilizing proprietary and patented system to empower consumers to eliminate debt, build wealth, avoid fraud, and enjoy financial freedom.  2010‐Present  Communion Solutions, LLC  Sarasota, FL Managing Member  Manufacture and market a device that fills communion cups in a sanitary and efficient manner.   2005‐Present  Citadel Financial Services, LLC  Bradenton, FL Financial Advisor  Manage client relationships and investments.  

Page 18: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Page | 2  

Registered representative series 7, series 66, series 65, series 63, life and health insurance licensed.  2007‐Present   World Equity Group, Inc.  Bradenton, FL Financial Advisor  Present senior wealth preservation and retirement investing seminars.  College Planning  Manage client relationships and investments.  Registered representative series 7, series 66, series 65, series 63, life and health insurance licensed.  2004‐2007   Intersecurities, Inc            Bradenton, FL Financial Advisor   College Planning  2002‐2004  High Mark Securities, Inc  Sarasota, FL Financial Advisor.  Present senior wealth preservation and retirement investing seminars.  Manage client relationships and investments.  Four Hundred Twenty thousand dollars annual GDC.  Registered representative series 7, series 66, and insurance licensed.  1999–2002     Bowman & Associates        Sarasota, FL Sole Proprietor.   Owner of estate planning practice.  Manage client relationships and investments.  Administer compliance requirements and client records.  Registered representative series 7, series 66, and insurance licensed.  1998–1999   Woodbridge Sterling Funding, LLC   New York, NY Vice President Real Estate Investments  Develop organizational structure for asset management department.   Direct acquisition of assets and cash flows.  Manage internal portfolio of assets.  Negotiate the sale of company held assets. 

Page 19: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Page | 3  

 Install staff and train office personnel.  1996–1998   Fiduciary Funding, Inc    Tallahassee, FL Mortgage Officer  Purchased $30 million in Real Estate backed assets.  Developed nationwide client base.  Presented industry related seminars.  1995–1996   State of Florida     Tallahassee, FL Accountant IV  Administered $30 million in federal grant dollars annually.  Audited Departmental disbursement system.  Performed supportive accounting work.  1986–1995     State of Florida     Jacksonville, FL Accountant IV  Audit the financial records of agribusinesses and state agencies.  Plan, direct, and report on all phases of audit function.  Administer state regulations and collection of fees.  Train and supervise audit personnel.  EDUCATION 1980–1984  The Citadel      Charleston, SC  BS, Business Administration.  1976‐1980  Southeast High School    Bradenton, FL  PERSONAL  Reside on my family farmstead on the Manatee River with my wife of thirty‐four years.  Served on several boards of directors of local charities.   

Page 20: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700 Bradenton, FL 34205 Fax: (941) 745-3790 www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip

Are you registered to vote in Manatee County?

(This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5

(This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________

The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female

Race

African American Asian American Caucasian

Hispanic American Native American Other _______________________

Page 21: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 2

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

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Page 22: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 3

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.

3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds forremoval.

4. Florida State Statute 119.07 designates this application as a public document to be made available foranyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying

and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I

understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission

rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further

hereby acknowledge that should my professional, residential or other status change subsequent to my appointment

to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true

and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below.

Mail: Board of County Commissioners 1112 Manatee Avenue West, Suite 902

ATTN: Advisory Boards

Bradenton, FL 34205

You may also fax or email your application, as follows:

Fax: 941-745-3790

Email: Save this pdf form to your computer and then

attach it to an email. Email to this address:

[email protected]

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

Page 23: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc.Big Brothers/Big Sisters of the Suncoast

Boys & Girls Clubs of Manatee Centerstone of FloridaCommunity Haven

.L. andall FoundationEarly Learning Coalition of Manatee County

Easter Seals of S FloridaEducational Consultants Consortium

Exchange Club Family Partnership Center

Family Network on Disabilities

Family Resources

Feeding Empty Little TummiesFoundation for Dreams

Hope Family Services

Insight Counseling ServicesManatee Children’s Services, Inc. Manatee Community Action Agency

Manatee County Girls Club (Just for Girls)

Meals on Wheels Plus of Manatee Myakka City Community Center

Pace Center for Girls

Palmetto Youth Center

Sarasota Family YMCA Sarasota Manatee Assn. for Riding Therapy

School District of Manatee County

Selah Freedom, Inc.Tallevast Community Center

The Salvation Army

United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Children s Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 24: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 5

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

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

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 Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 25: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

P I E R R E T T E G . K E L L Y

OBJECTIVE

My personal mission is to contribute to the success of the

Healthcare Advisory Board in the most ethical and professional

manner, by providing experienced leadership, knowledge, and

skills that ensure excellence in execution of all the organizations

strategic objectives.

EXPERIENCE

2016- Present The Patterson Foundation Suncoast Campaign for Grade

Level Reading -Consultant - Children’s Health Initiative

The Suncoast Campaign for Grade-Level Reading is a community-wide

effort in Manatee and Sarasota counties to help all children, especially

those from low-income families, succeed in school by ensuring they read

on grade level by the end of third grade, addressing the most common

issues and obstacles that influence a child’s ability to read: Parents, Health,

School Readiness, and Summer Learning.

2012- Trinity Resources V.P. Charitable Organization Innovation

1989- November 2012 - Anna Maria Island Community Center, Anna

Maria Fl. Executive Director

Developed and implemented a multiyear campaigns, raised over 4.4

million to build a state of the art Community Center.

Provided leadership to Board, staff, volunteers, and managed annual

operating budget in excess of 1 million dollars.

Received the Charity Navigator 4 Star Award for outstanding financial

management.

1994 Established Endowment Trust Fund, Planned Giving Board to

support the future of the organization.

Improved fund raising developed community corporate partners,

expanded grant writing efforts to increase annual budget from $80,000

in 1989 to over $1,000,000 per annum from 2007 through 2012.

Established Annual Fund and planned giving campaigns.

Conducted Strategic-planning workshops with the Board and staff to

develop, to review and align priorities for vision, mission, employee

handbook, policies and procedures and marketing materials and

development.

Implemented annual strategic plan.

Increased number of program participants from 250 to over 3000 and

increased annual hours of service from 22,000 hours to 2 million plus.

Implemented program outcome management as tool for improving

program quality and accountability.

1987–1989 Physicians Weight Loss Lakeland- Bradenton- Winter Haven Fl.

Area Manager -Health- Nutrition

Increased sales from $9,000 per month to over $540,000 first year, opened

two additional facilities in Winter Haven and Bradenton

Managed and trained staff and site supervisors at 3 successful locations

Implemented training for new recruits improved effectiveness and

profitability.

Page 26: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

1979–1986 Futurity ltd. International Marketing - Ireland

Marketing Director and Partner

Developed local and international markets for Irish Designers

Successfully represented Bunratty Cottage, international designer Vonnie

Reynolds to high-end show rooms in New York, Dallas and San Francisco,

Washington D.C. significantly increased sales and expanded markets also

represented Hourihan, Stackpool, Erridge and Jerpoint crystal

Conducted Marketing Workshops for Coras Trachtala the Irish Export

Marketing Board. Received Grants for product design and marketing

Guest Lecturer Limerick University

QUALIFICATIONS & EDUCATION_____________________________________________________

Research Data Management and Sharing –MOOC Lic. L7BDT6F27YSJ

How to Change the World – MOOC Wesleyan University

Critical Thinking on Global Issues- MOOC University of Edinburgh

Inspiring Leadership through Emotional Intelligence -MOOC

Case Western Reserve University

2006 - Sarasota Community Foundation-“For Good For Ever” Advanced

Planned Giving

Indiana University Center on Philanthropy -Sarasota Fl.

Fundraising, Grant Writing, Building Annual Fund, Planned Giving

1980-1982 – Limerick University, Limerick Ireland

International Business Administration & Marketing

1969–1972 West Virginia University Morgantown, W.V.

Business Administration, Social Work.

PROFESSIONAL STRENGTHS

A seasoned professional with excellent leadership, management &

fund development skills. Experienced in strategic development,

capital campaign’s, planned giving, special events, grant writing,

public speaking, creative, energetic, focused, optimistic and

resourceful.

ACTIVITIES & PROFESSIONAL ORGANIZATIONS

Suncoast Campaign for Grade-Level Reading Community Engagement

Manatee County Children’s Services Advisory Board

V.P. St. Mary Star of the Sea Pastoral Council

Community Emergency Response Team member 2010

Leadership Manatee 1998

Association of Fundraising Professionals since 1993

Mayors Drug Free Communities Committee Board of Directors 1993

Recipient of the H. Bunell Humanitarian Award 1990

International Women’s Organization Ireland -President

Professional Women’s Network -President

P I E R R E T T E K E L L Y P H O N E ( 9 4 1 ) 7 7 9 - 2 0 4 5 M O B I L E 1 ( 9 4 1 ) 9 6 2 - 3 4 5 2

E - M A I L P K E L L Y @ T A M P A B A Y . R R . C O M 2 0 4 2 8 4 S T . C I R C L E N . W . B R A D E N T O N , F L . 3 4 2 0 9

Page 27: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 1

MANATEE COUNTY BOARD OF COUNTY COMMISSIONERS 1112 Manatee Avenue West, Suite 902 Phone: (941) 745-3700

Bradenton, FL 34205 Fax: (941) 745-3790

www.mymanatee.org/advisory_boards

APPLICATION for

ADVISORY BOARD/COMMITTEE/COMMISSION PLEASE TYPE OR PRINT IN INK

For which Advisory Board are you applying? A separate application is required for each advisory board.

Name of Advisory Board:

Some advisory board positions have specific requirements for applicants. For more information

please click on this link to the Manatee County website at: www.mymanatee.org/advisory_boards.

Please specify the seat you are interested in:

Name

Home Street Address

Home Mailing Address

City, State, Zip

Home Phone Work Phone Cell Phone

Email address

Occupation (if retired, please indicate)

Business name

Business street address

City, State, Zip Are you registered to vote in Manatee County? (This is a requirement of certain boards/commissions) Yes No

I reside in County Commission District # 1 2 3 4 5 (This can be found on your Voter Registration Card or click on this link to a County Commission District Map)

Do you reside in unincorporated Manatee County? Yes No

If No, please indicate the City ____________________ The Board of County Commissioners strives to ensure equal access for minorities and women to serve on advisory boards/committees/commissions. Providing this information will help Manatee County compile information needed to comply with the reporting requirement in Florida State Statute 760.80.

Gender Male Female Race African American Asian American Caucasian

Hispanic American Native American Other _______________________

kgodbee
Typewritten Text
Page 28: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2016 2

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

Please list any Manatee County Advisory Boards/Committees/Commissions on which you have previously served (include dates of your service).

Why do you want to serve on this Advisory Board or Committee?

Describe your education and experience that will provide a benefit to this Advisory Board.

List your professional credentials, licenses or certificates that are relevant to this Advisory Board.

List organizations and positions in which you serve in local civic or community groups.

Do you or your immediate family members have or hold any employment or contractual relationship with any business entity or agency which does business with or receives funding from Manatee County Government? Yes No If yes, please explain.

Do you know of any other reason that would prohibit you from serving on this board that could be deemed as a conflict of interest? Yes No If yes, please explain.

If you are appointed, are there any days of the week or months of the year you will be unavailable to serve due to job or travel? Yes No If yes, please explain.

Page 29: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 3

IMPORTANT INFORMATION 1. For questions regarding a specific advisory board, committee, or commission, including the duties and

requirements, please contact the County staff liaison listed on that board’s webpage.2. Certain advisory boards, committees, and commissions have specific membership requirements including a

valid voter registration card, financial disclosure and/or the submission of other information.3. Attendance is required at advisory board meetings. Three unexcused absences may be grounds for

removal.4. Florida State Statute 119.07 designates this application as a public document to be made available for

anyone requesting to view it. If you qualify for exemption from public disclosure under the terms of thisstatute, please explain:_________________________________________________________________________________

5. Advisory boards, committees or commissions having the authority to make factual determinations, reviewpermit applications, issue permits, grant variances, or impose fines exercise a part of the County’s sovereignpowers and members are prohibited by Florida law from holding more than one such position. If youcurrently hold another state, municipal or county government appointment, County staff will assist inconfirming your eligibility to serve on the board for which you are applying.

NOTICE Applications must be complete and signed to be valid. Resumes may not be substituted for the sections on the application but you may include extra pages to provide additional information. Applications will not be processed unless each section has been completed and all supplemental information sought by County staff has been provided. Applicants will not be permitted to change information on their submitted application materials once they have been received by the County.

The following advisory boards require a questionnaire that must also be completed and a current resume for the applicant to be considered for appointment. See pages 4 and 5 of this form.

Children’s Services Advisory Board – page 4 Healthcare Advisory Board – page 5

Please sign and date below

I have reviewed the qualifications of this position and the duties of the board or commission for which I am applying and certify that I am fully able to serve. I agree to commit the necessary time to fulfill these responsibilities. I understand that I am offering my service without compensation. I agree to abide by all Manatee County Commission rules and policies either published or in effect by usage, and all regulations and laws of the State of Florida. I further hereby acknowledge that should my professional, residential or other status change subsequent to my appointment to this board or commission, I have a continuing obligation to inform the County’s staff liaison of that change to the extent it may alter my eligibility to continue in service.

By typing my name and submitting this application, I confirm that the information provided in this application is true and complete, and this constitutes my signature under the Florida Electronic Signature Act.

Electronic Signature Type or Sign Name Date

Your application may be mailed to the address below. Mail: Board of County Commissioners

1112 Manatee Avenue West, Suite 902 ATTN: Advisory Boards Bradenton, FL 34205

You may also fax or email your application, as follows: Fax: 941-745-3790 Email: Save this pdf form to your computer and then attach it to an email. Email to this address: [email protected]

The Board of County Commissioners of Manatee County, Florida does not discriminate upon the basis of any individual’s disability status. This non-discrimination policy involves every aspect of the Board’s functions including one’s access to, participation, employment, or treatment in its programs or activities. Anyone requiring reasonable accommodation for meetings as provided for in the Americans with Disabilities Act should contact the Citizens Action Center, three days before a meeting at 742-5800; TDD ONLY 742-5802 and wait 60 seconds; or FAX 745-3790.

kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
kgodbee
Typewritten Text
Page 30: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 4

Supplemental Questions for Applicants to the Manatee County Children’s Services Advisory Board

Please complete all questions with current and accurate information.

Are you affiliated with any agency that receives Children’s Services dedicated millage funds from Manatee County? Affiliated means: an employee of the agency; owner of the agency; voting member on the agency’s Board of Directors; contract with the agency, or indirect contract with the agency.

Yes No

If yes, please select the agency from the list below. Check all that apply:

AMIkids Manatee, Inc.Big Brothers/Big Sisters of the Suncoast Boys & Girls Clubs of Manatee Centerstone of FloridaCommunity HavenD.L. Randall FoundationEarly Learning Coalition of Manatee County Easter Seals of SW FloridaEducational Consultants Consortium Exchange Club Family Partnership Center Family Network on Disabilities Family Resources Feeding Empty Little TummiesFoundation for Dreams Hope Family Services

Insight Counseling ServicesManatee Children’s Services, Inc. Manatee Community Action Agency Manatee County Girls Club (Just for Girls) Meals on Wheels Plus of Manatee Myakka City Community Center Pace Center for Girls Palmetto Youth Center Sarasota Family YMCA Sarasota Manatee Assn. for Riding Therapy School District of Manatee County Selah Freedom, Inc.Tallevast Community Center The Salvation Army United Community Center

Please explain the affiliation you have with the above agencies:

An application to the Children's Services Advisory Board requires a current and comprehensiveresume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 31: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

Application Form 2017 5

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

Please complete all questions with current and accurate information.

What is your field of expertise? (Please indicate all that apply)

Healthcare

Behavioral/Mental Healthcare

Substance Abuse Care

Social Services

Higher Education

Medically Needy Consumer of Healthcare

Representative of the business community not listed above (please explain below)

Are you an employee, contractor for, owner or voting member on the Board of Directors of any agency that receives funding from Manatee County directly or indirectly? Yes No If Yes, please explain:

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 Health Care Committee, Acute Care Committee, etc.)?

Yes No

If yes, which ones? (include dates of service)

An application to the Healthcare Advisory Board requires a current and comprehensive resume or curriculum vitae, which may be emailed along with your application to [email protected], or may be mailed or faxed to Manatee County at the address and fax number provided on page 3.

Page 32: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

KIMBERLY A. SAND

510 Planters Manor Way, Bradenton, Fl | 941-704-9754 | [email protected]

EDUCATION

University of South Florida

D.N.P. 2017

Rutgers University, Newark, NJ

M.S.N. 1997

Cedarville University, Cedarville, OH

B.S.N. 1990

AWARDS

Phi Kappa Phi, University of South Florida 2017

Sigma Theta Tau Scholarship, Delta Beta Chapter, University of South Florida 2016

Sigma Theta Tau, Rutgers University 1996

Academic Nursing Achievement Award, Cedarville University 1990

Alumni Scholarship Award, Cedarville University 1989

PROFESSIONAL EXPERIENCE

Ingenios Health, Manatee County

• Home Health Adult Nurse Practitioner

• Perform in-home health risk assessments for long term care insurance 2018

University of South Florida, College of Nursing

• Clinical Adjunct Professor in Graduate Primary Care 2018

Healthstat Inc., Charlotte, NC

• Wellness Nurse Practitioner at Mosaic 2015-present

• Spearheaded a QI project which increased provider utilization of ASCVD risk analysis

• Collaborated with client to develop mass mailer with employee biometric results

• Focus on wellness/prevention utilizing evidence based guidelines

• Functioned as solo provider for primary care and acute injury care

Carlos Arias, MD, Bradenton, FL

• Adult Nurse Practitioner 2004 – 2015

• Provided primary care for young adults through geriatrics

• Emphasized cardiovascular prevention and screening

• Key provider for women’s health and routine gynecological exams

Logistics Health Incorporated, La Crosse, WI

• Reserve health readiness contract Nurse Practitioner 2008-present

• Administer periodic health assessments for reserve troops to determine deployment

readiness

US Healthworks, Bradenton, FL (Per-Diem)

• Urgent Care/Occupational Nurse Practitioner 2006 – 2011

• Worker’s Compensation evaluation and treatment

• Episodic and acute care treatment

Pfizer, Inc., Morris Plains, NJ

• Occupational Nurse Practitioner 1997 - 2001

• Performed surveillance exams for scientists

• Provided episodic and primary care for all employees

Newark Beth Israel Medical Center, Newark, NJ

• Emergency room staff and charge nurse 1990 - 1997

Page 33: Manatee County Government Administrative Center Commission ...€¦ · Cheri Coryea, Deputy County Administrator, ext 3468 ... Nursing, Cedarville University, Ohio. Experience:

KIMBERLY A. SAND PAGE 2

MEMBERSHIPS/CERTIFICATIONS

Phi Kappa Phi Current

Sigma Theta Tau Current

American Association of Nurse Practitioners Current

Adult Nurse Practitioner Certification by American Nurses Credentialing Center 1997-present

PROFESSIONAL DEVELOPMENT

Invited Oral presenter at USF Research Day 2018

Sigma Theta Tau Research Day Presenter 2018

AACN Policy Summit, Washington, DC 2017

Presented QI project at Grand Rounds during Healthstat Annual Meeting 2017

Sigma Theta Tau, Delta Beta Chapter Board Member 2016-present

COMMUNITY SERVICE

Volunteer at Remote Area Medical 2016

Created and currently direct all RN first responder team for local church 2015-present

Perform annual scoliosis screening for private middle school 2013-2016

Featured on local cable news channel educating public on need for wellness exams 2013

Health Promotion speaker at church women’s meetings 2012