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Frances Martinez Application PackageMartinez Frances RNAME: Last Name First Name Middle Initial 61 Collins Ave, Apt 204 Miami BeachHOME ADDRESS: Apt No.Home No./Street City Fl 33139 State Zip Code 3059720225 9545223132PHONE: Home Work FMartinezmally@gmail.com Email Address Fort Lauderdale Street 700 SE 3 Ave, City Fl State 33316 Zip Code Address: Positive Heal Care MCO/AHF Position:Business Name:Physician/Health Care Executive Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. YesƔ5HVLGHQWRI0LDPL%HDFKIRUDPLQLPXPRIVL[PRQWKV Ɣ'HPRQVWUDWHDQRZQHUVKLSLQWHUHVWLQDEXVLQHVVLQ0LDPL%HDFKIRUDPLQLPXPRIVL[PRQWKV Ɣ$UH\RXDUHJLVWHUHGYRWHULQ0LDPL%HDFK Ɣ3OHDVHcircle one): I am now a resident of: Ɣ,DPDSSO\LQJIRUDQDSSRLQWPHQWEHFDXVH,KDYHVSHFLDODELOLWLHVNQRZOHGJHDQGH[SHULHQFH3OHDVHOLVWEHORZ Ɣ$UH\RXSUHVHQWO\DUHJLVWHUHGOREE\LVWZLWKWKH&LW\RI0LDPL%HDFK" Yes Yes South Beach No My experience comes from being Physician Board Certified in Internal Medicine, Certified HIV Expert, years in the Occupational Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3) choices will be observed by the City Clerk’s Office. (Regular Boards of City) Choice 1: Choice 2: Choice 3: Health Advisory Committee Marine and Waterfront Protection Authority Affordable Housing Advisory Committee No2. Present participation in Youth Center activities by your children Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: No Years of Service: ages, and which programs. List below: if yes, please list the names of your children, their CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM * Board members are required to file Form 1 – "Statement of Financial Interest" with the State. If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review Board, Historic Preservation Board or Planning Board, attach a copy of your currently-effectively license, and furnish the following information: Type of Professional License_______________________________ License Number ______________________________ License Issuance Date ___________________________________ License Expiration Date _______________________ Name Title MBJCC member 61 Collins Association President/Board of Directors NoƔHave you ever been convicted of a felony:If yes, please explain in detail: ƔDo you currently have a violation(s) of City of Miami Beach codes:No If yes, please explain in detail: ƔDo you currently owe the City of Miami Beach any money:No If yes, please explain in detail: ƔAre you currently serving on any City Boards or Committees:No If yes, which board? ƔWhat organizations in the City of Miami Beach do you currently hold membership in? ƔList all properties owned or have an interest in, which are located within the City of Miami Beach: Property 61 Collins Ave, Apt 204 ƔI am now employed by the city of Miami Beach:No Which department? The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is being asked to comply with federal equal opportunity reporting requirements. noneGender: Physically Challenged:No none Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino.No NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members. These laws include, but are not limited to, the following: o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459). o Prohibition from contracting with the city (Miami-Dade County Code section 2-11.1). o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach Code section 2-26). o Requirement to disclose certain financial interests and gifts (Miami-Dade County Code section 2-11.1). (re: CMB Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties (CFR 570.611). Upon request, copies of these laws may be obtained from the City Clerk. “I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Article VII – of the City Code “Standards of Conduct for City Officers, Employees and Agency Members.” I Frances Martinez agreed to the following terms on 1/13/2019 10:29:06 AM Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date CURRICULUM VITAE ___________________________________________________________ FRANCES MARTINEZ, DO, FACP, AAHIVE EMAIL: FMartinezmally@gmail.com QUALIFICATIONS: Registered Voter and Resident of Miami Beach, Florida OCCUPATION: Health Care Executive and Physician BIRTH PLACE: New York City, New York LANGUAGES: Fluent in English and Spanish COMMUNITY SERVICE ACTIVITIES: Volunteer “Public Forum” Debate Judge, 2017-Present Miami Beach Senior High PTSA, 2017-Present Miami-Dade HIV/Aids Partnership, Care and Treatment Subcommittee, 2017 to Present President, 61 Collins Association, Miami Beach, Florida, 2015-Present Medical Missions Matters (MMM) Non-Profit Organization, Operation Yuhum and New Face, Philippines, Volunteer Medical Consultant, 2010-2018 Provided Quality Medical Care Regardless of Ability to Pay, Dade and Broward Counties, 2000- 2006 Presented Free Community Lectures on Wound Care, Osteoporosis, Heart Disease, Diabetes, Thyroid Disease, Hyperbaric Medicine, Breast Cancer and Preventive Medicine, 09/97-07/06 Medical Expert, “El Oxigeno Purificador y Regenerador”, el Nuevo Herald (Miami Herald), 04/01/05 “Viva Con Salud” Radio Program, discussed health topics on Spanish Radio (live call in program) and local television health shows sponsored by Palmetto General Hospital 09/97-09/02 Miami Lakes Lions Club Member, 1997-2000 Miami Beach Jaycees (Junior Chamber of Commerce), Board of Directors, 1990, Miami Beach Jaycees, Membership Vice President, 1989 Miami Beach Jaycees, Chairperson “Electric Island Run”, Fund-Raiser for Diabetes Research, 1988 VOLUNTARY ACADEMIC POSITIONS: 08/14-12/2016 Voluntary Clinical Assistant Professor, FIU Herbert Wertheim College of Medicine 07/10-03/13 Voluntary Clinical Assistant Professor, Department of Internal Medicine, Nova Southeastern University, College of Osteopathic Medicine 07/97-10/2000 Voluntary Attending Physician, Clinical Internal Medicine, Nova Southern University/Palmetto General Hospital CURRICULUM VITAE FRANCES MARTINEZ, DO, FACP, AAHIVE PAGE 2/4 AWARDS: Above and Beyond AHF 2017, Humana Certificate of Recognition for Service 2014 Faculty Appreciation Certificates/Palmetto General Hospital/Nova Southeastern University 1997-2011 Physicians Honor Roll, Palmetto General Hospital 2002 One In A Million, Miami Beach Jaycees 1991 EFN Scholar 1990-1993 NATIONAL HISPANIC SCHOLAR 1982-1985 LULAC NATIONAL SCHOLAR 1980-1982 Dean’s List 1980-1982 EXPERIENCE: 02/16-Present Frances Martinez, D.O., FACP, AAHIVE Health Care Executive, Medical Director of Southern Bureau Florida & Georgia Managed Care Operations, Positive Health Care Partners/Aids Health Care Foundation (AHF), Managed Care Organization, Special Needs Plan, Chairperson of AHF National Credentials Committee, Board Certified Internist, Fellow of American Academy of Physicians and HIV Expert, Subject Matter Expert CMS ODAG, CDAG Fort Lauderdale, Florida 06/14-12/16 Frances Martinez, DO, FACP, MRO, SAP, FACP Medical Director of Occupational Health/Employee Health/Adult Autism Clinic , Certified Medical Review Officer (MRO), Substance Abuse Professional (SAP), Certified Medical Examiner Mount Sinai Medical Center, Miami Beach, Florida Doctor for City of Miami Beach 2015-2016, Doctor for the City of Miami and other local municipalities 2014-2016 04/13-06/14 Frances Martinez, DO Humana/Continucare Adult Center Internal Medicine Primary Care /Urgent Care Miami (Little Havana), Florida 10/00-03/13 Frances M. Mally, D.O., P.A. Private Medical Practice Civil Surgeon, Internal Medicine and Hyperbaric/Wound Care Hialeah, Florida 08/00-07/06 Frances M. Mally, DO., PA , Hyperbaric Physician and Internal Medicine, Hialeah, Florida CURRICULUM VITAE FRANCES MARTINEZ, DO, FACP, AAHIVE PAGE 3/4 Practiced Hyperbaric & Wound Care Medicine at: Palmetto General Hospital (PGH), Hialeah, Florida Memorial Hospital Regional, Hollywood, Florida Memorial Hospital Pembroke, Pembroke Pines, Florida 06/97-10/00 Frances R. Martinez Mally, DO Medical Director Geriatric Practice, Palmetto Senior Healthcare Center at Palmetto General Hospital, Hialeah, Florida 06/86-06/89 Frances R. Martinez, BS University of Miami School of Medicine, Pulmonary Research Associate, Miami, Florida 06/89-05/97 Frances R. Martinez Mally/Frances M. Mally Medical School and Residency training 06/86-06/93 Frances R. Martinez Miami Beach Jaycees/United States Junior Chamber 09/79-05/85 Frances R. Martinez Civil Service Social Security Administration Miami Beach, Florida “Stay in School Program” EDUCATION: 09/89-06/93 Southeastern University/ NOVA Southeastern, North Miami Beach, Florida Doctor of Osteopathy 09/82- 05/85 Florida International University, Miami, Florida B.S Major Biological Sciences, Minor in Chemistry 09/80-06/82 Miami Dade Community College, Miami, Florida A.A. Biology Cum Laude 08/76-06/80 Miami Beach Senior High School, Miami Beach, Florida MEDICAL TRAINING: 06/94-05/97 University of Florida/Shands, Jacksonville, Florida Internal Medicine Residency (completed) 06/93-05/94 Nova Southeastern University/Palmetto General Hospital, Hialeah, Florida Internship, Traditional Rotating Internship in Medicine and Surgery (completed) MEDICAL LICENSURE: Florida, California and Georgia active and in good standing. CURRICULUM VITAE FRANCES MARTINEZ, DO, FACP, AAHIVE PAGE 4/4 BOARD CERTIFICATION: Diplomat, American Board of Internal Medicine, 177900, expires 12/2025. OTHER CERTIFICATIONS: American Academy of HIV Medicine, AAHIVE, HIV Expert Certification, 12/2018 Fellow of the American College of Physicians (FACP), 07/2016-Present The National Registry of Certified Medical Examiners, 04/06/2015 American Association of Medical Review Officers (MRO), 09/2014 Certificate of Qualification for Substance Abuse Professionals (SAP), 08/26/2014 Clinical Hyperbaric Medicine Course and Certification, 02/26/98 PROFESSIONAL ORGANIZATIONS: Florida Association of Health Plans (FAHP) member since 2016 American College of Physicians (ACP) 2015 (member number 02833574), 1996-1998 (member number 01080155) Charter Member “Leadership Circle” Physician’s Circle of Memorial Regional Hospital Association for Advancement of Wound Care (AAWC) 02/98-2006 Undersea and Hyperbaric Medical Society 02/98-2006 HOSPITAL COMMITEES: Infection Control Committee 2016 and 2000 Wound Care Team 1998-2005 Graduate Medical Education Committee 1998-2007 Nova Southeastern University Intern & Resident Selection Committee 1998 -2007 Pharmacy and Therapeutics Committee 1999 Peer Review Committee 1996 (during residency) House Staff Cardiology Committee 1996 (during residency) PRESENTATIONS: “Medicare Risk Adjustment”, 2017-Present “Clinical Documentation Guidelines to Improve Patient Health Outcomes”, 2016 -Present “Hyperbaric Medicine and Wound Medicine”, September, 1998 Medical Grand Rounds, University of Florida/Jacksonville “Idiopathic Pulmonary Fibrosis”, November, 1997 Medical grand Rounds, University of Florida/ Jacksonville,“Sarcoidosis”, April, 1996 AMERICAN COLLEGE OF PHYSICIANS (ACP) ACTIVITIES: ACP Medical Advocate, 2017-Present, ACP Convention New Orleans 2018, ACP Convention and Convocation for Fellow of American College of Physicians(FACP) San Diego, 2017, ACP Internal Medicine Review Course San Francisco 2015, MKSAP 16, 2015, Participating in Maintenance of Certification (MOC) 2014-Present PULMONARY RESEARCH ABSTRACT PUBLICATIONS: Available on request CURRICULUM VITAE