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Home My WebLink AboutAgenda Packet 02/28/2005pORTANGELES WASHINGTON, U.S.A. CITY COUNCIL SPECIAL MEETING February 8, 2005 CALL TO ORDER - SPECIAL MEETING: ROLL CALL: Members Present: Mayor Headrick ~/' Councilmember Braun Councilmember Erickson Councilmember Munro Councilmember Pittis Councilmember Rogers v/ Councilmember Williams Staff Present: Manager Quinn t,/ Attorney Bloor v/ Clerk Upton v,7- B. Collins G. Cutler D. McKeen T. Riepe Y. Ziomkowski Othel: Staff Present: III. PLEDGE OF ALLEGIANCE: Led by:. ~ DATE: TO: FROM: SUBJECT: pORTANC;ELES WASHINGTON, U.S.A. CITY COUNCIL MEMO February 8, 2005 CITY COUNCIL Becky J. Upton, City Clerk/Management Assistant Planning Commission Interviews The City Council set a special meeting for Tuesday, February 8, 2005, to conduct interviews for the Planning Commission. Box lunches will be served at 5:00 p.m. in the Caucus Room, and the first interview will follow at 5:30 p.m. .~ The remainder of the applicants will be interviewed at a special meeting of the City Council on Tuesday, February 15, 2005, starting at 4:00 p.m. The regular City Council meeting will then follow at 6:00 p.m. The schedule for February 8, 2005, is set forth below, and the applications are attached for your review. It is my understanding that suggested questions for the interviews have been provided to you under separate cover. 5:30 p.m. 5:45 p.m. 6:00 p.m. 6:15 p.m. 6:30 p.m. 6:45 p.m. 7:00 p.m. 7:15 p.m. 7:30 p.m. 7:45 p.m. Ruth Hoham Edward Zoble Kevin Snyder Michael "Doc" Reiss John Matthews John Gilmore Peter Ripley Donald Schuba Elizabeth "Betsy" Wharton David Johnson Attachments pORTANGELES WASHINGTON, U, S. A. CITY OF PORT ANGELES CITY CLERK Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: Board or Commission Full Name Applicant Name and General Information Zip Code First M1 Last Home street address City State Home ph~one number Work phone number Date of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information (circl¢on¢) Are you currently a City employee? Yes ~ Are you a citizen of the United States? ~ No Are you a City residentg~ No Do you own/manage a business in the City? Yes ~ Do you hold any professional licenses, registrations or certificates in any field (list below)? Yes ~ Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so, please explain: ~ * In compliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience first (or elaborate on a resume if you prefer) Employer Your Title Brief job descril~ion Employer Your Title Brief job description From (M/Y) To (M/Y) Frdm (M/Y) To (M/Y) Employer Your Title From (M/Y) To (M/Y) Brief job description Education List most recent experience first ]nstitutionTLocation Credits earned/Major area of study (~No Graduated? Institution/Location ~ ¢0 Credits earned/l~lajor area of stu~ty Graduated? Yes No Institution/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years 1. Organization and location Group's purpose/objective # of members Brief description of your participation 2. Organization and location Group's purpose/objective # of members Brief description of your participation Why are you interested in serving on this particular Board or Commission? (OVER) What in your background or experience to you think would help you in serving on this Board: What is your understanding of the responsibilities of this particular Board/Commission? Please feel free to add any additional comments you might wish to make regarding your application: Date Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 pORTAN_GELES WASHINGTON, U.S.A. CITY OF PORT ANGELES CITY CLERK Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: Board or Co~ssion Full N~e Applicant Name and General information First MI Last Home street address Zip Code City State Home phone number Work phone number Date of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history cheek to ensure compliance with 2.26.020 PAMC) Certification and Location information (circ~=o.e) Are you currently a City employee? Yes ~ Are you a citizen of the United States? ~ No Are you a City resident?Q~ No Do you own/manage a business in the City?: Yes ~ Do you hold any professional licenses, registrations or certificates in any field (list below)? ~ No Are you'aware of any conflict of interest which might arise by yom service on a City Board or Commission? If so, please explain: i90 In compliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 4174634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience f~rst (or elaborate on a resume if you prefer) Bmployer Brief job d~scripti°n · E~loyer ' ~o~ Titl~ .... From (~) To (~) Bdefjob description ' Your Title F[0m (M/Y) To (M/Y) Employer Your Title From (M/Y) · To (M/Y) Brief job description Education List most recent experience first {~No l.nstitufion/Location 2. 0~ ~ ctlOof~lOKTl Credits earned/Mai or area of study Credits earned/Major area of study Institution/Location Graduated? No Graduated? Ihstimtion/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years Organization and location ~}q~ Group's purpose/objective Brief description of your palticipation Organization and location Group's purpose/objective Brief description of your participation # of members # of members Why are you interested in. serving on this~particular Board or Cornn~,ssion?_. (OVER) What in your background or exl~erience to you think would help you in serv?g on this Board~: ~)Ol~ ~o ~0'~13 What is your understanding of the responsibilities of this particular Board/Commission? Please feel free to add any additional comments you might wish 1;o make regarding your application: Apphcant Signature\ ~ ~'~ Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 Date 10/02 1928 W. 7~ Str~t Po~t Angeles, WA 98363 360 452 5446 ~sOeiz~mindsmine.com Edward J. Zoble, Ph.D. 2001- Present Self Employed Clients are hospitals, unions, inpatient units, physician practices, and community mental health centers. anac ment consur g Interim Director Assignments Strategic Planning and Marketing Clinical Supervision Revenue Enhancement Cost Containment and Process Improvement 199%2001 Swedish Medical Center Seattle, WA Swedish Medical Center is a three campus, 1200-bed, tertiary care facility with 7000 employees, 1800 physicians, and an operating budget of $950 million. Was hired by the CEO to assist with the development of an improved system of management. Senior Internal Consultant Reported Directly to CEO - Member of Executive Steering Group Restructured System-Wide Management Organization Restructured System-Wide Management Information System Developed Improved Organizational Communication System Member of Strategic Planning and Quality Management Groups Facilitated Swedish-Providence Merger Member of Executive Budget Team Interim Director of Behavioral Services 1995-1996 Kitsap Mental Health Services Bremerton, WA The sole mental health center for this county. Directed a large adult outpatient service with specialized services for the chronically mentally ill. The program was in transition from fee-for-service to capitation. Responsible for managing the transition. Director of Adult Clinical Services Clinical Supervision of Team Managers Budget Responsibility Regulatory Compliance and Program Development Designed System for Efficient Clinical Documentation 1975-1995 C. F. Menninger Memorial Hospital Topeka, KS Psychiatric treatment facility with an international reputation and a longstanding commitment to education and research. Full responsibility for all operations, outcomes, and financial performance. The hospital had 500 employees and a budget of $40 million. Managed 166-Bed Closed-Staff Facility and Outpatient Clinics Supervised all Directors and Managers Through Administrative Slxucture Developed a Successful International Marketing Program Coordinated a Complete Campus Replacement Project Managed Medical Staff Taught in Residency Program Treated Patients in an Outpatient Clinic 1971-1974 Veterans Administration Hospital Buffalo, NY Clinical Psychologist Ward Manager for half of 30-Bed Inpatient Psychiatric Unit Coordinated Program of Fifteen Clinical Psychology Hospital Interns Clinical Associate Professor at SUNY Masters Degree ~n Healthcare Administration 1976 University of Minnesota Ph.D. in Clinical Psychology 1971 University o f Cincinnati Masters Degree in Clinical Psychology 1969 University of Cincinnati Bachelors Deg~e in Psychology with Honors 1968 Franklin and Marshall College ~s~ and Licensed Clinical Psychologist in the State of Washington Member of the American Psychological Association Since 1973 Honorary Graduate, Karl Menninger School of Psychiatry, 1991 2002-2004 2002-2004 2003-2004 Member, Columbian Newspaper Advisory Council Member, Sheriffs Citizen Advisory Board Volunteer, Northwest Mental Health 1999-2002 Mentor, Faculty Development Program, Univemity of Washington 1999-2002 Preceptor, Carlson School of Management, University of Minnesota 1991-1993 Vice President, Central Neuropsychiatric Hospital Association 1988-1991 Board Member, National Association of Private Psychiatric Hospitals 1985-1988 Hospital Board, Blue Cross of Kansas 1984-1986 President, Topeka Hospital Association 1974-1976 N1MH Fellowship in Healthcare Adminislration 1969-1971 Clinical Psychology Intern, Veterans Hospital, Cincinnati, Ohio 1968-1969 Research Assistant, Psychology Department, University of Cincinnati · CITY OF PORTANGELE CITY CLERK Application for Appointment to'a Board, C0mmission,'or Committee Board, Commission, or Committee to which you are seeking appointment: Board or commission Full Name Applicant Name and General Information' First MI Last Home s~'ect address City Home phone number State zip Code Work phone number Date of Birth (To he completed olil7 b~, applicants for Law ]~nforcement Adviser)' Board for purposes of criminal histor~ chech to ensure compliance with 2.26.020 PAMC) Certification and Location Information Arc you currently a City employee? Yes ~ Arc you, a citizen of thc United States? (~) No Are you a CitY resident?~lNo Do you own/manage a business in the City? YeO Do you hold any professional licenses, registratiom or certificates in any field (list below)? ..... ' ' ' If so, Arc you aware of any conflict of interest which rmght arise by your service on a City Board or Commission? please explain: In compliance with the'American Disabilities Act, if you will need special accormnodations because of a physical limitation, please contact the City Clerk, '417-4634, so appropriate arrangements can be made. ..... ' (OVER) Work Experience List most recent experience first (or elaborate on a rest'ne if you prefer) Employer Your Title Brief job description ! From (M/Y) To (M/Y) Employer Yom Title From (M/Y) To (IvITY) Brief job description ' ' ' 3. Employer Yom Title From (MP/) To (M/Y) Brief job description Education List most recent experience first Credits earned/Major area of study ~ No Graduated? Insatuuo~Locat~on L. Credits earned/Major area of study Graduated? Yes No 3. Institution/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years OrganizatiJn and location Group's purpose/objective Brief description of your participation I ~ Organization a~ location Group's purpose/objective Brief description of your participatiofl (J # of members # of members Why are you interested in serving on tiffs particular Board or Commission? (OVER) Whatin your background or experience to you think would help you in serving on this Board: What is your tmderstanding of the responsibilities of tl~i,'s particular Board/Con~..'s3i~on? ~ / - Please feel free to add any additional comments you might wish to make regarding your application: Al~plic~nt SignatUre ' Date . Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 pORTA.NGELES Application for Appointment to a Board, Commission, or Committee Board, Commission, or Co~rnmittee to which you are seeking appointment: Board or Commi~on Fu Applicant Name and General Information First MI Last Home street address City State Home phone number Zip Code /7'/ 2 7?7 Work phone number Date of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information (circ~one) Are you currently a City employee? Ye~ Are you a citizen of the United State~ No Are you a City reside~No Do you own/manage a business in the City~) No Do you hold any professional licenses, registrations or certificates in any field (list below)?,_ Yes No Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so, please explain: ..r~ In compliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience first (or elaborate on a resume if you prefer) I. Your Title From (M/Y) To (M/Y) Employer Brief job ~scription Employer B;iefjob des~ption c ,~-~.-~.d Your Title (~/Y) To (M/Y) Employer ! Your Title From (M/Y) To (M/Y) Brief job description Education List most recent experience first Institution/Location J Institution/Location Credits earned/Major area of study Credits earned/MajOr area of study (~No Graduated? 4:5 ° Graduated? Yes No Institution/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years Organization and location Group's purpose/objecti~t Bric f descriptioff"of ~our pan?ipation / Organization and location Group's purpose/olSjecuve ~ ,r m--- rv ge__ C-,~I'.~P r.~?~u .. B{ief descripti6n of your participation # of membem # of members WhZ are you int?rested in serving on this particular Board (OVER) What in your background or experience to you think would help you in serving on this Board: ~.j. Lo..n~P. /'?~- ~at is your u~derstanding of the responsibilities of thi~panicular Boar~Commission?~ Please feel free to add any additional comments you might wish to make regarding yo~ur application: Applicant Signature Date r r Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 WASHINGTON, CiTY OF PORT ANGELES CITY CLERK Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: Board or Commission Full Name Applicant Name and General Information First MI Last Home street address City State Zip Code Home phone numb~ Work phone number Date of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information Are you currently a City employee? Yes ~ Ale you a citizen of the United States?(~No Are you a City resident? ~.)No Do you own/manage a business in the City? Ye~ Do you hold any professional licemes, registrations or certificates in any field (list below)? Yes No Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so, In corrrpliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List frost recent experience fast (or elaborate on a resume if you prefer) Employer Your Titl~ FroTM (M/Y) To (MIY) Brief job description Emt~loyer Yo~ tiae F~m (~) Brief job. description 3. To (M/Y) Employer' ' ' Your Tide ' From (M/Y) To (M/Y) Brief job description Education List most recent experience fast !restitution/Location Credits earned/Major area of study Yes No Graduated? Yes No InstimtionfLocation Credits earned/Major area of study Graduated? Yes No 3. Institution/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years Organization and location / Group's purpose/objective / # of members Bfiefdescfipfionofyo~p~icipafion / c.o.~a,~ ~,~ ~ co~9~e~.X ~,~. Organization and location Brief description of your participation Group's purpose/objective # of members Why are you interested in serving on this pamcular Board ~ ~,~k e~,to7 ~',i~ ~ ~,~11~ (OVER) What in your background or experience to Yo~U think would help you in serving on. ~this Board: ~at is yom ~dersm~g of Ap~icant Signal"r/ oz- ~/- Date Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: B s ull Applicant Name and General information First MI me street addres -3 City State Home phone number Last Zip Code Work phone number Dat~ of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PANIC) Certification and Location information (ci~¢~eone) Are you currentlY a City employee? Yes (~ Are you a citizen oft_he United States?(~s No Are you a City resident? Q No Do you own/manage a business in the City? Yes(~ Do you hold any professional licenses, registrations or certificates in any field (list below)? Yes No Are you aware of any~conflict of interest which might arise by your service on a City Board or Coiiuidssion? If so, please explain: ~,~ (3 In compliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience first (or elaborate on a resume if you prefer) E~loyar Yom Tide From (~) To Brief job description E~loy~ 3 I Yo~ Title From (~) To (~) Bfiefjobdescfipfion ~ciaW~t~ 9~, ' I I E~loyer Yom Tide From (~) To (~) Brief job description Education List most recent experience fa-st ~ No Institution/Location Credits eamcd/IVlaj or area of study ~raduated? GNo Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years Organization and location Group's purpose/objective # of members Brief description of your participation 2. OrganiCation and location Group's purpose/objective # of members Brief description of your participation ,Why are you interested in serving on this particular Board or Commission? ~ 9~-oe~ c~, ~,.l~e~k (OVER) What in your background or.experience to. you think would hel~you in ser~g on tthis Board: ~at is yo~ ~d~ri~d~g of ~e [esp~ibiliges of ~s p~cul~ Boa~Cona,~ssion? ~ Please feel ~ to add ~y addifioml go--nm you ~ght ~sh to ~ke reg~d~ yo~ ~ppli~on: (~licant Signature Date Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10)02 pORTA.NGELES WASHINGTON, CITY OF PORT ANGELES CITY CLERK Application for Appointment to a Board, Commission, or Committee L~ard, Commission, or Committee to which you are seeking appointment: Board or Commission Full Name A~)lic/~nt Name and General Information First MI Last ~)~m~ 7~,~t address City State Zip Code Home ~hone ~umber Work phone number Date of Bi~h (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information (circ]¢on¢) Are you currently a City employee? Yes{~ Are you a citizen of the United States?~'~ No Are you a City resident?~S No Do you own/manage a business in the City?~s No Do you hold any professional licenses, registrations or certificates in any field (list below)? Yes No Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so, please explain: In compliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience first (or elaborate on a resume if you prefer) Employer Your Title From (M/Y) To (M/Y) Brief job description Employer Brief job description Your Title From (M/Y) To (M/Y) Employer Your Title From (M/Y) To (M/Y) . t Brief job description Education List most recent experience first Institution/Location Institution/Location Credits earned/Major area of study C ' amed/Major area of study Graduated? Graduated? Yes No Institution/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years 1. Organization and location Group's purpose/objective # of members Brief description of your participation 2. Organization and location Group's purpose/objective # of members Brief description of your participation Why are you interested in serving on this particular Board or Commission? (OVER) What in your background or e~xperience to yo,u, think would help you in s~rvtng~oD this Board: t,Sza ,~ ~'z~Z'/~ ~.-r, What is your understanding 9f tile respgytsibilities of this part3cul~r Boar~Commissi9~)? Tjw''/O/~? ~'~t rz,.v~ ., pr~,~y~¢~,~' p4(pe r.~_clp.4~.~--d~.~ p f-~c,~-p o'~ ~,~ Please feel free to add any additional comments you might wish to make regarding your application: Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 CITY OF PORT ANGELES CITY CLERK Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: Board or Commission Full Name Applicant Name and General Information First MI Last Home street address city Home phone number State Zip Code Work phone number Date of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information (Circle one) Are you currently a City employee? Yes ~ Are you a citizen of the United States? ~ No Are you a City resident? ~) No Do you own/manage a business in the City? ~ No Do you hold any professional licenses, registrations or certificates in any field (list below)? Yes ~ Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so, please explain: ~,'~/,d~ In compliance with the American Disabilities Act, if you will need special accommodations because ora physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience first (or elaborate on a resume if you prefer) Employer I Your Title Brief job description From (M/Y) To (M/Y) Employer Brief job description Your Title From (M/Y) To (M/Y) Employer Your Title From (M/Y) To (M/Y) Brief job description Education List most recent experience first Institution/Location Credits e~tmed/Major area of study Institution/Location { Credits earned/Major area of study ~)No Graduated? Graduated? Yes No Institution/Location Credits earned/Major area of study Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years Graduated? Organization and location Group's purpose/objective Brief des-c~'iption &your participation Organization and location Group's pu~ose/objective # of members # &members Brief description of your participation Why are you interested in serving on this particular Board or Commission? (OVER) What in your background or experience to you think would help you in serving on this Board: What is your understanding of the responsibilities of this particular Board/Commission? Please feel free to add any additional comments you might wish to make regarding your application: AppliCant Signatur~ /' Date Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 p__ORTA_NGELES CITY OF PORT ANGELES J CITY CLERK J Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: Board or C~om~nission-Full Name (2) Applicant Name and General Information(J'l:~ ~+~ ~ ~ ~~ ( ~ ~ ~ First ' - ' MI Home street address City 0 State $~o q ~q ~ooC, Home phone number Zip Code (wC~ /-IL~ I - o~L,~. ork-phone number Date of Birth (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information (Circt¢one) Are you currently a City employee? YeQ Are you a citizen of the United State~ No Are you a CiW resident~ No Do you own/manage a business in the City? Yes~ Do you hold any professiona'-'~l licerises, registxations or certificate2 in any field (list below)-- QNo Are you aware of any conflict of interest which might arise by your service on a City Board or comnnssion? If so, please explain: ~ I) In compliance with the American Disabilities Act, if you will need special accommodations because of a physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. (OVER) Work Experience List most recent experience first (or elaborate on a resume if you prefer) Employer i From (M/Y) To (m~) Brief job description 2. Employer Your Title From (M/Y) To (M/Y) Brief job description 3. Employer Your Title From (M/Y) To (M/Y) Brief job description Education List most recent experience first Yes No ]. Institution/Location Credits earned/Major area of study Graduated? Yes No 2. Institution/Location Credits eamed/Maj or area of study Graduated? Yes No 3. Institution/Location Credits earned/Major area of study Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years 1. Organization and location Group's purpose/objective # of members Brief description of your participation 2. Organization and location Group's purpose/objective # of members Brief description of your participation Why are you interested in serving on this particular Board or Comm/ssion? I ~ ~ ~ K~~ · aence to u think would hel ou in serving on this Board' What in your b~ckgrpuna or exper' yp r~ P Yl ~ ~, ' What is your understanding of,~e respomibilitie~ of~t~s paaicul~ Bqar~C~ssion? } V~ Ple~se~fe~ee to add ~} additional coments you ~t Msh~e reg~dmg yo~ &pplicafion: Date Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02 BETSY WHARTON 3207 S. Maple Street PORT ANGELES, WASHINGTON Home: (360) 457-9006 bewharton~msn.com EDUCATION Masters in the Science of Nursing 1987 University of Tennessee, Knoxville B.A. 1984; Major: Biology Westem Washington University, Bellingham CERTIFICATION Washington State Registered Nurse RN00104322 WORK EXPERIENCE Community Health Nurse: November 2001- 2003 First Step Family Support Center, Port Angeles, Washington Responsibilities: Provision of Maternal Support Services and Case Management through First Steps program for low-income pregnant women and families with young children. Community Health Nurse: September 2000 - June 2001 Family Home Care, Spokane Washington Responsibilities: same as above Outreach Nurse at Homeless Shelter: February - June, 1998 Seattle Emergency Housing/Country Doctor Community Clinic Responsibilities: Provision of public health nursing services to homeless families at a 30 day emergency housing program. Worked with a diverse population including refugees, persons with mental health and substance use issues and victims of domestic violence. Community Health Nurse: July 1996 - July 1997 Sage Memorial Hospital; Ganado, Arizona Responsibilities: Provision of home health care to rural community on Navajo reservation. Common referrals included diabetes, domestic violence and other social problems, women's health and post-par'tm follow-up, etc. School nursing for three elementary boarding schools. Director of Nursing Services: 1993 - April 1996 Rosehedge House; Seattle, Washington Responsibilities: Provision of direct care and behavioral support for residents living with end-stage AIDS. Patient population included high proportion of persons with psychiatric disorders and/or addiction issues. Administrative duties included supervision and support of 30-40 nursing and attendant staff, coordination of staff education, admissions, CQI, infection control, personnel management, budgeting, and strategic planning. RN Case Manager/Clinical Supervisor: 1990 - 1993 Community Home Health Care; Seattle, Washington Responsibilities: Provision of direct patient care to home care clients, including AIDS, geriatrics, hospice, and IV therapy. Supervision and support of RN and home health aide staff. 24 hour on-call for IV therapy and hospice clients Instructor, Medic Training Program: 1989 - 1990 International Medical Corps; Peshawar, Pakistan Responsibilities: Clinical and didactic instruction for primary health care training progran~ for Afghan refugees. Initimion of pediatric malnntrition program. Adult Medical Surgical Nurse: 1988-1989 Mercy Medical Center; Durango, Colorado Responsibilities: Provision of direct patient care on in-patient unit. Outdoor Leadership Instructor: 1984-1987 Outward Bound School; Colorado, Utah and North Carolina Responsibilities: Instruction of leadership and wilderness skills, group facilitation and conflict resolution. Coordinated program for women with breast cancer. Publications Rabbi's Garage, personal essay published in the Mid- America Review - Fall 2001 Daughters of the Desert: Stories of Women from the Jewish, Christian and Islamic .Traditions. Published by: Skylights Path. Due out in April, 2003. Additional Activities Clinical Faculty, University of Washington School of Nursing, inactive Master in Fine Arts candidate in Creative Writing at Eastern Washington University References Available on Request pORTANGELE$ CITY OF PORT ANGELES CITY CLERK Application for Appointment to a Board, Commission, or Committee Board, Commission, or Committee to which you are seeking appointment: Board or Commh~TOn Full Name Applicant Name and General Information First MI Home street address City ,4 State omc phone numar Last Zip Code Work phone number Date of'Birth I (To be completed only by applicants for Law Enforcement Advisory Board for purposes of criminal history check to ensure compliance with 2.26.020 PAMC) Certification and Location Information (cir0~eo.¢) Are you currently a City employee? Yes(~ Are you a citizen &the United States?(~No Are you a City resident?{~)No Do you own/manage a business in the City? Yes (~ Do you hold any professional licenses, registrations or certificates in any field (list below)? Yes No Are you aware of any conflict of interest which might arise by your service on a City Board or Commission? If so, please explain: Iqe~cv¢-,. in compliance with the American Disabilities Act, if you will need special accommodations because ora physical limitation, please contact the City Clerk, 417-4634, so appropriate arrangements can be made. lOVER) Work Experience ~ List most recent experience first (or elaborate on a resume if you prefer) Employer ~[ Y~ur Title ~ From (M/Y) To (M/Y) ~riefjob description Employer Your Title From (M/Y) To (M/Y) Brief job description Employer Your Title From (M/Y) To (M/Y) Brief job description Education List most recent experience first Institution/Location Credits earned/Major area of study Yes No Graduated? Institution/Location Institution/Location Credits eame~ajor area of study Graduated? Credits eame~ajor ~ea o~s~dy Graduated? Charitable, Social, and Civic Activities and Memberships List major activities you have participated in during the last five years Organization and location Group's purpose/objective tl of members Brief description of your participation 2. Organization and location Group's purpose/objective # of members Brief description of your participation What in your background or experience to you thi,nk would help you in serving on this~oatd: . What is your understandi,ng of the responsibilities of this particular Board/Commisiion? Please feel free to add any additional comments you might wish to make regarding your application: Applicant Sil~u re Date Submit completed forms to: Office of the City Clerk City of Port Angeles 321 E. 5th Street P. O. Box 1150 Port Angeles, Washington, 98362 10/02