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HomeMy WebLinkAboutAgenda - 03-18-2014-11b1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: March 18, 2014 SUBJECT: Board of Health — Appointments DEPARTMENT: Board of Commissioners ATTACHMENT(S): Under Separate Cover Membership Roster Recommendations Applications for Persons Recommended Applicant Interest List Applications of Persons on the Interest List Action Agenda Item No. 11 -b PUBLIC HEARING: (Y /N) No INFORMATION CONTACT: Clerk's Office, 245 -2130 PURPOSE: To consider making appointments to the Board of Health. BACKGROUND: The following appointments are for Board consideration: • Appointment to a first partial term (position #8) for Mr. Nick Galvez. • Appointment to a first full term (Position #9) for Dr. Sam Laris. POSITION NO. NAME SPECIAL REPRESENTATIVE EXPIRATION DATE 8 Mr. Nick Galvez At -Large 06/30/2015 9 Dr. Sam Laris Dentist 06/30/2016 FINANCIAL IMPACT: None. RECOMMENDATION(S): The Board will consider making appointments to the Board of Health. 2 Board and Commission Members And Vacant Positions Board of Health Meeting Times: 7:00 p.m. fourth Wednesday of each month Terms: 2 Contact Person: Cathy Femainy, Colleen Bridger Meeting Place: Chapel Hill and Hillsborough Alt. HD Positions: 11 Length: 3 years Contact Phone: 919- 245 -2415 Description: The Board of Commissioners appoints representatives of specific health - related professions and the general public to this board. It makes policy and is charged with protecting and promoting the public health in Orange County. To learn more about this Board, go to the following web address: http:// www. co.orange.nc.us /health/index.asp Dr. Susan Elmore 1 Vice -Chair 308 Glenwood Drive Chapel Hill NC 27514 Day Phone: 919 - 541 -3474 Evening Phone: 919- 967 -4172 FAX: E -mail: elmore @niehs.nih.gov Sex: Female First Appointed: 09/21/2010 Race: Caucasian Current Appointment: 06/07/2011 Township: Chapel Hill Expiration: 06/30/2014 Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: Veterinarian 06/18/2013 Mr. Matthew Kelm Day Phone: 919- 668 -5398 Sex: Male First Appointed: 06/15/2010 Evening Phone: 919- 357 -4349 Race: Caucasian Current Appointment: 06/18/2013 2 103 Lorilane Dr. FAX: 919- 681 -8187 Township: Chapel Hill Expiration: 06/30/2016 Carrboro NC 27510 E -mail: matthew.kelm @duke.edu Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: Pharmacist Mr. Michael wood Day Phone: Sex: Male First Appointed: 10/28/2008 Evening Phone: Race: Caucasian Current Appointment: 06/07/2011 3 Community Empowerment Fund FAX: 919- 732 -1303 Township: Eno Expiration: 06/30/2014 Former Homeless E -mail: Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: Citizen/Commissioner Appointment Ms L.lska Lackey Day Phone: 919- 968 -1450 Sex: Female First Appointed: 06/07/2011 Evening Phone: Race: Caucasian Current Appointment: 06/07/2011 4 507 Oak Ave FAX: Township: Chapel Hill Expiration: 06/30/2014 Carrboro NC 27510 E -mail: liska.lackey @gmail.com Resid/Spec Req: At -Large Number of Terms: 1 Special Repr: Nurse Dr. Michael Carstens Day Phone: 919 -968 -4774 Sex: Male First Appointed: 08/19/2009 Evening Phone: 857- 498 -1442 Race: Caucasian Current Appointment: 05/15/2012 5 108 Carriage Circle FAX: 919- 942 -5291 Township: Chapel Hill Expiration: 06/30/2015 Chapel Hill NC 27514 E -mail: carstensmike @hotmail.com Resid/Spec Req: At -Large Number Of Terms: 2 Special Repr: Optometrist Wednesday, March 05, 2014 Page 1 3 Board and Commission Members And Vacant Positions Board of Health Meeting Times: 7:00 p.m. fourth Wednesday of each month Terms: 2 Contact Person: Cathy Femainy, Colleen Bridger Meeting Place: Chapel Hill and Hillsborough Alt. HD Positions: 11 Length: 3 years Contact Phone: 919- 245 -2415 Description: The Board of Commissioners appoints representatives of specific health - related professions and the general public to this board. It makes policy and is charged with protecting and promoting the public health in Orange County. To learn more about this Board, go to the following web address: http:// www. co.orange.nc.us /health/index.asp Mr. Corey Davis Day Phone: 919- 968 -6308 Sex: Male First Appointed: 12/13/2011 Chair Evening Phone: Race: Caucasian Current Appointment: 05/15/2012 6 102 Barbee Court FAX: Township: Chapel Hill Expiration: 06/30/2015 Carrboro NC 27510 E -mail: coreyd @gmail.com Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: Citizen/commissioner appointment Mr. Tony Whitaker Day Phone: 919- 490 -1645 Sex: Male First Appointed: 08/19/2009 Evening Phone: 919- 321 -2922 Race: Caucasian Current Appointment: 05/15/2012 7 3725 Quail Meadow Drive FAX: 919- 403 -0336 Township: Little River Expiration: 06/30/2015 Hillsborough NC 27278 E -mail: tony.whitaker @civil- consultants.co Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: Professional Engineer VACANT Day Phone: Sex: First Appointed: Evening Phone: Race: Current Appointment 8 FAX: Township: Expiration: 06/30/2015 E -mail: Resid/Spec Req: At -Large Number of Terms: Special Repr: Citizen/Commissioner Appointment VACANT Day Phone: Sex: First Appointed: Evening Phone: Race: Current Appointment 9 FAX: Township: Expiration: 06/30/2016 E -mail: Resid/Spec Req: At -Large Number of Terms: Special Repr: Dentist Dr. Paul Chelminski Day Phone: 919 - 966 -0471 Sex: Male First Appointed: 08/19/2009 Evening Phone: 919- 932 -1755 Race: other Current Appointment: 06/18/2013 10 116 Watters Road FAX: 919- 966 -4507 Township: Chapel Hill Expiration: 06/30/2016 Carrboro NC 27510 E -mail: chelminp @med.unc.edu Resid/Spec Req: At -Large Number of Terms: 2 Special Repr: Physician Wednesday, March 05, 2014 Page 2 0 Board of Health M Board and Commission Members And Vacant Positions Meeting Times: 7:00 p.m. fourth Wednesday of each month Terms: 2 Contact Person: Cathy Femainy, Colleen Bridger Meeting Place: Chapel Hill and Hillsborough Alt. HD Positions: 11 Length: 3 years Contact Phone: 919- 245 -2415 Description: The Board of Commissioners appoints representatives of specific health - related professions and the general public to this board. It makes policy and is charged with protecting and promoting the public health in Orange County. To learn more about this Board, go to the following web address: http:// www. co.orange.nc.us /health/index.asp Dr. Bernadette Pelissier 4516 Mystic Lane Hillsborough NC 27278 Day Phone: 919 - 643 -2762 Evening Phone: 919- 643 -2762 FAX: E -mail: bpelissier @orangecountync.gov Sex: Female Race: Caucasian Township: Bingham Resid/Spec Req: At -Large Special Repr: B.O.C.C. First Appointed: 02/05/2013 Current Appointment: 02/05/2013 Expiration: 01/31/2014 Number of Terms: Wednesday, March 05, 2014 Page 3 Thom Freeman From: Donna Baker Sent: Monday, March 03, 2014 11:03 AM To: Colleen Bridger; Thom Freeman Cc: Tersee Flores Subject: RE: Board of Health recommendations Thanks Colleen. Donna Baker Clerk to the Board P.O. Box 8181 200 South Cameron St. Hillsborough, N.C. 27278 Phone: (919) 245 -2130 Fax: (919) 644 -0246 Cell: (919) 428 -3212 dbakerCf orangecountync.gov From: Colleen Bridger Sent: Monday, March 03, 2014 8:30 AM To: Donna Baker; Thom Freeman Cc: Tersee Flores Subject: Board of Health recommendations Hi Donna- At the BOH meeting on February 26, 2014, Board of Health Members reviewed applications for the two current vacancies on the board. The BOH is recommending that the Board of County Commissioners appoint the following new members: • Dentist position recommendation: Sam i.asris, is a licensed Dentist. Sam has been a dentist since 1975, beginning in public health. He has worked with both Virginia and NC Medicaid patients. He has served on the Orange Unified Transportation board (6 years), and Orange County Planning Board (3 years), and could bring a transportation /access angle to Public Health. He has been an Orange County resident for over 10 years. • At Large position recommendation: Nick Galvez is a Field Clinician /Physical Therapist with a background in healthcare administration and business management (MBA). He's worked at the Director level in multiple organizations and has experience expanding services to new market. He has board experience in Florida and is new to the area. Please let me know if you need additional information about either of these applicants or the Board's recommendations. Thanks so much! Colleen Bridger, MPH, PhD Orange County Health Director Phone -: 919 .245.2412... / Cell: - 919.612: -2053 ..... 1 ;mr,proviog h�nr'th- kw;fiog ChDnge. 7 Page 1 of 2 Nick Galvez Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Nick Galvez 403 N Elliott Road Chapel Hill NC 27514 7274189921 7274189921 7274189921 ngalvez1234 @gmail.com Bayada Home Care Field Clinician /Physican Therapist 2013 Chapel Hill Male Other Community Activities /Organizational Memberships: To Whom It Concerns: I have worked in healthcare for over 15 years and have successfully managed operations and finances for medium and large healthcare organizations. I earned an MBA with a concentration in accounting in 2004. 1 also gained the CMA certification from the Institute of Management Accountants to further my knowledge and prepare for a Director level position. In my current position as a regional manager, I helped develop new markets (Georgia) and new programs for internal and external growth. I assisted the sales team to ensure operations and new business growth was aligned with the company5ETMs long term strategic plan. The region and company has grown significantly due to my focus on new markets and new programs. I have volunteer experiences that have also contributed to my professional development. I enjoyed serving on the Hillsborough County Healthcare Advisory Board for the past 4 years and have contributed to fiscal policy development for the county healthcare plan. I also serves on the Board of Directors for the Health Council of West Central Florida to serve their mission to educate consumers in the region about healthcare issues. I held this position for 2 years while living in Florida. I am excited about getting involved in the Chapel Hill community and sharing my experiences with other like minded citizens to improve out community. Sincerely, Page 2 of 2 Nick Galvez Nick Galvez Past Service on Orange County Advisory Boards: none Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I have a background in healthcare administration and business management. I believe the combination of operations and finances are vital to a successful healthcare organization. I believe local boards need to weigh the benefits and costs of those affected by the decisions by they make. I have a desire to improve our health as a society, in the community and in our family. I believe that I can affect the changes by becoming involved in local boards and talking with other professionals about health. The affordable health care act will inevitably affect those directly and indirectly in the field of health. Reasons for wanting to serve on this board: see above Conflict of Interest: na Nursing Home Community Advisory Committee Background, education and experience relevant to this board: I have a background in healthcare administration and business management. I have worked in nursing homes as a director of therapy and also as a regional director for therapy departments. I have worked with for profit and not for profit companies that own and operate nursing homes. I believe the combination of operations and finances are vital to a successful healthcare organization. I believe local boards need to weigh the benefits and costs of those affected by the decisions by they make. I have a desire to improve our health as a society, in the community and in our family. I believe that I can affect the changes by becoming involved in local boards and talking with other professionals about health. The affordable health care act will inevitably affect those directly and indirectly in the field of health. Reasons for wanting to serve on this board: see above Conflict of Interest: na Supplemental Questions: Other Comments: This application was current on: 1/8/2014 7:47:26 AM Date Printed: 3/6/2014 9 Page 1 of 2 Sam Lasris Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Dr. Sam Lasris 7020 Caviness Jordan Rd. Cedar Grove NC 27231 919- 732 -7362 919- 732 -7362 samlasris@hotmail.com Self Employed Dentist 1977 Township of Residence: Cedar Grove Zone of Residence: Cedar Grove Twnsp Sex: Male Ethnic Background: Caucasian Community Activities /Organizational Memberships: Volunteer for the Intenational Affairs Council of North Carolina, RDU Airport and the OUTBoard. Past Service on Orange County Advisory Boards: OUTBoard and Planning Board, past member Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I have been a dentist since 1975, beginning in public health. I have accepted medicaid patients from Va throughout my career and NC medicaid patients as well. I would bring to the board first hand knowledge of the needs of the diverse population of Orange county and could serve as a liaison between the OUTBoard and the Board of Health. Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Other Comments: STAFF COMMENTS: APPLIED FOR BOARD OF HEALTH 10/4/2013. Applicant since 2000. Renewed application 10/02/01 for Recreation Parks, Economic Development, and Arts Commission. Renewed application for Planning Board on 03/08/02. Reapplied 10/19/2005 for OUT Board. Renewed application 10/26/2012 for OUT Board. ADDRESS VERIFICATION: 7020 Caviness Jordan Rd., Cedar Grove, NC is Cedar Grove Township, 10 Page 2 of 2 Sam Lasris Orange County Jurisdiction, and Agricultural Residence Zoning. This application was current on: 10/4/2013 Date Printed: 3/6/2014 Applicant Interest Listing Board of Health 11 by Board Name and by Applicant Name Contact Person: Cathy Fernainy, Colleen Bridger Contact Phone: 919- 245 -2415 Ms. Martha Bell Day Phone: 919- 968 -4674 Sex: Female 100 Macrae Court Evening Phone: as above Race: Caucasian Chapel Hill NC 27516 Cell Phone: N/A Township: Chapel Hill 03/18/2013 E -mail: mbell968@yahoo.com Date Applied: 01/09/2014 Skills: Also Serves On: Date Applied: 02/13/2012 Dr. Dawn Brezina Day Phone: 252 -315 -4650 Sex: Female Race: 2601 Red Hill Lane Evening Phone: 919- 732 -9030 Race: Caucasian Hillsborough NC 27278 Cell Phone: 03/18/2013 Township: Eno E -mail: dawnbrezina@gmail.com Date Applied: 02/13/2012 Skills: Physician Also Serves On: Ms. Jennifer BTObst Day Phone: 919- 923 -6044 Sex: Female 1000 Smith Level Rd., Apt. J -7 Evening Phone: 919- 923 -6044 Race: Caucasian Carrboro NC 27510 Cell Phone: 919- 923 -6044 Township: Chapel Hill E -mail: jbrobst@nccu.edu Date Applied: 12/18/2013 Skills: Also Serves On: Ms. Kim Calandra Day Phone: 919- 996 -0718 Sex: Female 102 A Crest Street Evening Phone: Race: Caucasian Carrboro NC 27510 Cell Phone: Township: Chapel Hill E -mail: Date Applied: 01/09/2014 Skills: Acupuncturist Also Serves On: Skills: Avid Environmentalist Also Serves On: Skills: Chinese Medicine Practitioner Also Serves On: Skills: Landscape Artist Also Serves On: Ms. Wendy Calvin Day Phone: 919- 630 -1350 Sex: Female 623 William Hooper Circle Evening Phone: Race: Caucasian Hillsborough NC 27278 Cell Phone: Township: Hillsborough E -mail: Date Applied: 03/18/2013 Skills: Also Serves On: Thursday, March 06, 2014 Page 1 of 5 Applicant Interest Listing Board of Health Ms. Barbara Chavious 401 N Nash St Hillsborough NC 27278 Skills: Public Health Dr. Steven Thomas Daniels 206 Franklin Adams Road Efland NC 27243 Skills: 12 by Board Name and by Applicant Name Contact Person: Cathy Fernainy, Colleen Bridger Contact Phone: 919- 245 -2415 Day Phone: 919- 732 -3469 Evening Phone: 919- 732 -3469 Cell Phone: E -mail: Barbara Chavious@unc.edu Also Serves On: Day Phone: 919- 732 -8213 Evening Phone: 919 -451 -1874 Cell Phone: 919 -451 -1874 E -mail: stdaniel@gmail.com Also Serves On: Cell Phone: Sex: Female Race: Caucasian Township: Hillsborough Date Applied: 11/06/2013 Sex: Male Race: Caucasian Township: Cheeks Date Applied: 01/15/2014 Ms Tamara Dempsey- Tanner Day Phone: 919- 560 -5600 Sex: Female 9900 Leslie Dirve Evening Phone: 919 -918 -4086 Race: Caucasian Chapel Hill NC 27516 Cell Phone: Township: Bingham 9192591153 E -mail: tamaradt@yahoo.com Date Applied: 01/10/2014 Skills: Healthcare Consultant Also Serves On: Date Applied: 01/17/2014 Dr. Nurum Erdem Day Phone: 9192591153 Sex: Female 10 Saint James Place Evening Phone: 9199330661 Race: Caucasian Chapel Hill NC 27514 Cell Phone: 9192591153 Township: Chapel Hill E -mail: nurumerdem@gmail.com Date Applied: 01/17/2014 Skills: Also Serves On: Nick Galvez Day Phone: 7274189921 Sex: Male 403 N Elliott Road Evening Phone: 7274189921 Race: Other Chapel Hill NC 27514 Cell Phone: 7274189921 Township: Chapel Hill E -mail: ngalvez1234@gmail.com Date Applied: 01/08/2014 Skills: Also Serves On: Mr. Zachary Giles Day Phone: 9103087228 Sex: Male 8000 Oak Pointe Court Evening Phone: 9103087228 Race: Caucasian Mebane NC 27302 Cell Phone: 9103087228 Township: Cedar Grove E -mail: zach.s.giles@gmail.com Date Applied: 02/26/2014 Skills: Also Serves On: Thursday, March 06, 2014 Page 2 of 5 Applicant Interest Listing Board of Health Mrs Linda Griffin 321 Mitchell Street Hillsborough NC 27278 Skills: Dr. Sam Lasris 7020 Caviness Jordan Rd. Cedar Grove NC 27231 Skills: Dentist Mr. Winston Liao 126 Fern Lane Chapel Hill NC 27514 Skills: Public Health Mr. Charles McMullen 108 Jones Avenue Hillsborough NC 27278 Skills: Nursing Profession Mr Ken Morgan 2720 Buckboard Drive Hillsborough NC 27278 Skills: American Heart Association Skills: United Way Board of Directors Miss Danielle Mosley 476 Melanie Court Chapel Hill NC 27514 Skills: Club Nova 13 by Board Name and by Applicant Name Contact Person: Cathy Fernainy, Colleen Bridger Contact Phone: 919- 245 -2415 Day Phone: 919- 630 -9078 Evening Phone: 919- 630 -9078 Cell Phone: 919- 630 -9078 E -mail: lgriftin2gnc.rr. com Also Serves On: Orange Unified Transportation Board Day Phone: 919- 732 -7362 Evening Phone: 919- 732 -7362 Cell Phone: Hillsborough E -mail: samlasrisghotmail.com Also Serves On: Orange Unified Transportation Board Sex: Female Race: Caucasian Township: Hillsborough Date Applied: 01/09/2014 Sex: Male Race: Caucasian Township: Cedar Grove Date Applied: 10/04/2013 Day Phone: 919 929 3123 Sex: Male Evening Phone: Race: Asian American Cell Phone: Township: Chapel Hill E -mail: Date Applied: 01/16/2013 Also Serves On: Day Phone: 9197329083 Sex: Male Evening Phone: 919- 260 -3879 Race: Caucasian Cell Phone: Township: Hillsborough E -mail: cmcmullenlgna.rr.com Date Applied: 02/10/2011 Also Serves On: Day Phone: 919 -218 -8596 Sex: Male Evening Phone: 919 -218 -8596 Race: Caucasian Cell Phone: Township: Eno E -mail: morgangk @juno.com Date Applied: 11/06/2013 Also Serves On: Also Serves On: Day Phone: 919- 309 -5685 Evening Phone: Cell Phone: E -mail: Dlynnm26ggmail.com Also Serves On: Sex: Female Race: Caucasian Township: Chapel Hill Date Applied: 06/26/2012 Thursday, March 06, 2014 Page 3 of 5 Applicant Interest Listing Board of Health Ms. Yvonne overcast 216 cobalt ridge road hillsborough NC 27278 Skills: Mr. Vince Stevens 101 Camille Ct Chapel Hill NC 27516 Skills: 14 by Board Name and by Applicant Name Contact Person: Cathy Fernainy, Colleen Bridger Contact Phone: 919- 245 -2415 Day Phone: 9197329840 Evening Phone: 9197329840 Cell Phone: 9194511901 E -mail: yovercastggmail.com Also Serves On: Day Phone: 919- 923 -2561 Evening Phone: 919- 933 -3058 Cell Phone: E -mail: vstevensgnc.rr.com Also Serves On: Sex: Female Race: Caucasian Township: Hillsborough Date Applied: 01/08/2014 Sex: Male Race: Caucasian Township: Chapel Hill Date Applied: 05/01/2012 Ms. Jaimee Watts Day Phone: 828 -381 -6246 Sex: Female 108C West Carr Street Evening Phone: Race: Caucasian Carrboro NC 27510 Cell Phone: Township: Chapel Hill E -mail: jaimee.wattsggmail.com Date Applied: 05/16/2012 Skills: Nursing Profession Also Serves On: Date Applied: 05/04/2012 Dr. Dennis Williams Day Phone: 919- 962 -7122 Sex: Male 209 Lake Manor Road Evening Phone: 919- 933 -5408 Race: Other Chapel Hill NC 27516 Cell Phone: Township: Chapel Hill E -mail: dwilliamsgunc.edu Date Applied: 05/16/2012 Skills: Also Serves On: Date Applied: 05/04/2012 Mrs. Megan Williams Day Phone: 919- 240 -4455 Sex: Female 205 Westside Drive Evening Phone: Race: Caucasian Chapel Hill NC 27516 Cell Phone: Township: Chapel Hill E -mail: mpwilliamsgunc.edu Date Applied: 05/04/2012 Skills: Nursing Professor Also Serves On: Dr Joanne Wilson Day Phone: 919 -810 -2774 Sex: Female 104 Stoneridge Drive Evening Phone: 919- 932 -5391 Race: African American Chapel Hill NC 27514 Cell Phone: Township: Chapel Hill E -mail: anteelgearthlink.net Date Applied: 07/15/2013 Skills: Medical Doctor Also Serves On: Nursing Home Community Advisory Committee Thursday, March 06, 2014 Page 4 of 5 Applicant Interest Listing Board of Health Dr. Tracey Yap 834 Providence Glen Drive Chapel Hill NC 27514 Skills: Director Skills: Nurse 15 by Board Name and by Applicant Name Contact Person: Cathy Fernainy, Colleen Bridger Contact Phone: 919 - 245 -2415 Day Phone: 502 - 686 -0016 Sex: Female Evening Phone: 919- 240 -4793 Race: Caucasian Cell Phone: Township: Chapel Hill E -mail: tracey.yap@duke.edu Date Applied: 12/02/2013 Also Serves On: Nursing Home Community Advisory Committee Thursday, March 06, 2014 Page 5 of 5 16 Page 1 of 2 ILYAMM TO,.M -11 Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Martha Bell 100 Macrae Court Chapel Hill NC 27516 919- 968 -4674 as above N/A mbe11968 @yahoo.com Retired Registered Nurse - Director of Nursing 1995 Chapel Hill Female Caucasian Community Activities /Organizational Memberships: Member, Sigma Theta Tau Vice Chair, DVAMC Veterans Mental Health Council Member, The Chapel of the Cross Volunteer, Ambulatory Care, DVAMC Member, Retired Officers Association Member, Army Nurse Corps Association (former Regional Director) Past Service on Orange County Advisory Boards: Nursing Home Community Advisory Committee Board of Health Boards /Commissions applied for: Nursing Home Community Advisory Committee Background, education and experience relevant to this board: After retiring from active duty with the Army Nurse Corps in 1995, accepted position of Director of Nursing, Carol Woods Retirement Community, serving in that capacity for 12 years, and then continued in special projects as identified by the President/CEO, Carol Woods, for another 5 years; also eventually had operational responsibility for assisted living, and infection control for the organization. Coordinated clinical assignments in long term care for nursing and nursing assistant students from DCC and NCCU. Taught fundamentals of elder care to staff and students; served as consultant with CARF and AAHSA reviewing health and service delivery standards. Reasons for wanting to serve on this board: Throughout the years at Carol Woods, I met many members of this Cmmunity Committee, through their advisory capacity; always impressed with their respect for the older adult and circumstances that lead a person(s) to seek long term care, I knew I was unable to serve this 17 Page 2 of 2 Martha Bell committee until I retired from the business of elder services. I ve continued to keep my nursing license current, attending related education offerings in the infection control, gerontology and health care for the years since retirement from full time work. While volunteering in Durham, I really want to serve my local community and continue to put my knowledge of aging services and long term care to good use. Conflict of Interest: Board of Health Background, education and experience relevant to this board: RN, BSN, MSN; attendance at 3.5 day infection control in long term care course offered by SPICE every two years; recent course attendance at offering regading CDiff; served as infection control consultant for Carol Woods Retirement Community 12 years while also serving as its Director of Nursing /Health Services. Reasons for wanting to serve on this board: Throughout the years at Carol Woods, I was often involved with Board of Health issues, including outbreak investigation, tuberculosis control, difficulties encountered in Infection Control for the older adult in a long term care /congregate living environment. I purposely kept my nursing license current despite my retirement from full time nurse because I hoped to eventually serve my community in some capacity related to my professional knowledge. I seek only an activity that will use my knowledge rather than any paid position. Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 1/9/2014 11:27:53 AM Date Printed: 3/6/2014 Page 1 of 2 Dawn Brezina Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Dr. Dawn Brezina 2601 Red Hill Lane Hillsborough NC 27278 252 - 315 -4650 919- 732 -9030 dawnbrezina @gmail.com Durham Regional Hospital Hospitalist Township of Residence: Eno Zone of Residence: At -Large Sex: Female Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: My employment has been as a physician in Internal Medicine. I have worked at academic /teaching institutions in North Carolina and in private practice. Presently I work as a hospital medicine physician for duke Health system at DRH. Volunteer Experience: I have participated on a variety of hospital committees and medicalmission trips. Over the years I have been president of the age -group swimming association and have sponsored foreigh exchange students. I also write a weekly health - education /advice column for the Wilson Daily Times (past 3 -4 years). Education: Undergraduate, medical school, residency training in internal medicine (ABIM certification) Other Comments: 19 Page 2 of 2 Dawn Brezina My husband and I have lived in NC for 25 years and have been very busy during that time, working and raising four children (3 of the 4 now graduated from UNC- Chapel). I feel that I now have the opportunity (time) to make some contributions to community. STAFF COMMENTS: Reapplied 6/14/2006 for Arts Commission, Commission for Environment, Commission for Women. Originally applied for Orange County Planning Board, Board of Health, and Hillsborough Planning Board. UPDATED APPLICATION 10/28/2010 FOR OC PLANNING BOARD. UPDATED APPLICATION 02/13/2012 FOR PLANNING BOARD.. ADDRESS VERIFICATION: 2601 Red Hil Lane is Orange County Jurisdiction, Eno Township. This application was current on: 2/13/2012 Date Printed: 3/6/2014 P Page 1 of 2 Jennifer Brobst Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Jennifer Brobst 1000 Smith Level Rd., Apt. J -7 Carrboro NC 27510 919- 923 -6044 919- 923 -6044 919- 923 -6044 jbrobst @nccu.edu NC Central University School of Law Legal Director, Center for Child and Family Health 2000 Chapel Hill C.H. City Limits Female Caucasian Community Activities /Organizational Memberships: American Bar Association North Carolina Coalition Against Sexual Assault Durham Orange Women Attorneys Friend of the Chapel Hill Public Library Past Service on Orange County Advisory Boards: none Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Currently Legal Director, Center for Child and Family Health (medico -legal focusing on at risk youth), and law professor at NCCU; former prosecutor, child advocacy center attorney, Attorney for NCCU Domestic Violence Legal Clinic; Trainer for NC Coalition Against Sexual Assault, including first trainer of Orange County Sexual Assault Response Team Reasons for wanting to serve on this board: Am in between board positions - ended final term as Rules Chair of the NC Commission for Mental Health, Developmental Disabilities and Substance Abuse last year; interested in serving my own local community; professional interest in health law Conflict of Interest: Supplemental Questions: Other Comments: Page 2 of 2 Jennifer Brobst 21 This application was current on: 12/18/2013 12:48:02 PM Date Printed: 3/6/2014 22 Page 1 of 2 Kim Calandra Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Ms. Kim Calandra 102 A Crest Street Carrboro NC 27510 919- 996 -0718 Self Acupuncturist 2008 Township of Residence: Chapel Hill Zone of Residence: Carrboro City Limits Sex: Female Ethnic Background: Caucasian Community Activities /Organizational Memberships: Currently, I am volunteer for the Town of Carrboro on the Appearance Commission. Also, I am the secretary of the non - profit organization, Weaver Community Housing Association. I operate an affordable acupuncture clinic in Carrboro. Past Service on Orange County Advisory Boards: None Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I am a Licensed Acupuncturist with 10 years of practicing experience. I obtained a Master of Oriental Medicine, and I currently own and operate an affordable acupuncture clinic in Carrboro Reasons for wanting to serve on this board: I want to represent the interests Orange County in the field of holistic healthcare. I want to raise awareness and accessibility with respect to complimentary medicine. I believe that all areas of medicine need to be publicly represented. Conflict of Interest: Perhaps owning a healthcare clinic in Orange County could create a conflict, but my interest in serving the County and volunteering on the Board is purely genuine and in dedication to the residents of Orange County Supplemental Questions: Work Experience: Acupuncturist, Chinese Medicine Practitioner, Landscape Artist 23 Page 2 of 2 Kim Calandra Volunteer Experience: 2005/2006- Secretary for the Natural Living Association of St. John's County, FL 2007 - President of the Natural Living Association of St. John's County, FL Education: University of Florida -BS Psychology Southwest Acupuncture College- Masters in Oriental Medicine Other Comments: I am an avid environmentalist especially towards Orange County. I spend my free time exploring and hiking the natural areas of the community. After reading the Inventory of Natural Areas and Wildlife Habitats for Orange County, NC, I feel compelled to hopefully have the honor to contribute and volunteer my time as a concerned citizen and ecological steward for the CFE. STAFF COMMENTS: 4/30/2012 applied for Commission for the Environment. ADDRESS VERIFICATION: 716 Churchill Drive is in Chapel Hill township, Chapel Hill Town Limits. Submitted new application 01092014 This application was current on: 1/9/2014 Date Printed: 3/6/2014 /.' Page 1 of 2 Wendy Calvin Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Ms. Wendy Calvin 623 William Hooper Circle Hillsborough NC 27278 919- 630 -1350 Office Assistant II 2011 Township of Residence: Hillsborough Zone of Residence: Hillsborough Town Limits Sex: Female Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Arts Commission Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: Public Service - library and health department. Private Sector - Bookstores, retail managment. Volunteer Experience: Program Coordinator assistant at Nursing Homes. Enviornmental Awareness club President. Various Visual Arts programs. Education: Associates Degree Bachelors Degree completion in 2012 Page 2 of 2 Other Comments: Wendy Calvin 25 STAFF COMMENTS: 09/06 applied for Arts Commission, Animal Services Advisory Board, and Board of Health. ADDRESS VERIFICATION: 623 William Hooper Circle is Hillsborough Township ETJ. This application was current on: 3/18/2013 Date Printed: 3/6/2014 P Page 1 of 2 Barbara Chavious Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. Barbara Chavious 401 N Nash St Hillsborough NC 27278 919- 732 -3469 919- 732 -3469 Barbara_Chavious @unc.edu Retired m Hillsborough Female Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: 34 years in public health in NC; 12 as a regional consultant for the State Health Department, working in 8 local health departments; 22 at The UNC School of Public Health as Associate Director of an off - campus MPH, program in Health Administration as the School's alumni Director; as a continuing education specialst; and with the development of the NC Local Health Department Accreditation Program. Volunteer Experience: Former member -at -large on the Orange County Board of Health (1992- 2000); Orange County Human Relations Commission member; OCIM volunteer; NC Public Health Assoc (member for 30 plus years; various leadership positions; American Public Health Association - member 30 years and representative from NCPHA on APHA's Governing Council for 9 years. Education: 1968 - BA - Psychology, Miami University, Oxford, Ohio; 1985 - MPH - Health Administration - UNC School of Public Health. Page 2 of 2 Other Comments: Barbara Chavious 27 I currently serve as a site visitor, representing Boards of Health for the NC Local Health Department Accreditation Program and during the past six years have served on over 15 site visit teams to other NC county Health Departments. STAFF COMMENTS: Updated application 06/16/2011. Applied for Board of Health. ADDRESS JURISDICTION: 401 Nash Street is HI Township. This application was current on: 11/6/2013 Date Printed: 3/6/2014 RW Page 1 of 1 Steven Thomas Daniels Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background Dr. Steven Thomas Daniels 206 Franklin Adams Road Efland NC 27243 919- 732 -8213 919- 451 -1874 919- 451 -1874 stdaniel @gmail.com Self Dentist 2009 Cheeks County Male Caucasian Community Activities /Organizational Memberships: NC MoM NC Dental Society Hillsborough Chamber of Commerce Hillsborough Exchange Club Past Service on Orange County Advisory Boards: None Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Dentist since 2010. MoM Clinics & experience with the SHAC Clinic @ UNC. Reasons for wanting to serve on this board: Oral health outreach Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 1/15/2014 1:37:49 PM Date Printed: 3/6/2014 e Page 1 of 3 Tamara Dempsey- Tanner Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms Tamara Dempsey- Tanner 9900 Leslie Dirve Chapel Hill NC 27516 919- 560 -5600 919- 918 -4086 tamaradt @yahoo.com Children's Developmental Services Agency Quality Assurance Coordinator 1994 Bingham Does not apply Female Caucasian Community Activities /Organizational Memberships: Orange Co. Partnership for Young Children - NC preK (formerly More at 4)Advisory Committee Orange Co. Partnership for Young Children - Funding Allocation Committee Orange Co Partnership for Young Children - Board of Directors - at will designee Orange County DSS Toy Chest volunteer Orange County Preschool Interagency Council Past Service on Orange County Advisory Boards: n/a Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: undergrad & graduate degrees in Public Health Education; over 20 years combined employment in state /local government, specifically Health & Human Services which includes a local health department; Past 15 years worked with agencies (OCPYC & CDSA)that work collaboratively with the Health Dept. to target Orange County children s needs; experience in federal and state programmatic parameters and funding requirements; experience in program evaluation and data analysis; Data entry expertise /navigation with HIS data platform; Familiarity with NCTracks List of Previous Career Positions: QA/AI Coordinator: Durham Children's Developmental Services Agency, 2006 to present Orange County Parnership for Young Children: 1999 -2004 UNC School of Health Policy & Administration: 2/99 -8/99 NCDHHS /DPH /Injury Prevention Branch: 1997 -1999 UNC Dept. of Community Pediatrics: 1995 -1997 30 Page 2 of 3 Tamara Dempsey - Catawba Co. Health Dept: 1986 -1993 Reasons for wanting to serve on this board: The Health and Human Services realm has always been my professional foundation. My tenure in a local health department and attending BOH meetings were enlightening experiences. I want to give back to my community via my professional expertise and personal interests especially as it pertains to health and well -being of Orange County s children and families. Conflict of Interest: Board of Social Services Background, education and experience relevant to this board: undergrad & graduate degrees in Public Health Education; over 20 years combined employment in state /local government, specifically Health & Human Services which includes a local health department; Past 15 years worked with agencies (OCPYC & CDSA)that work collaboratively with the Health Dept. to target Orange County children s needs; experience in federal and state programmatic parameters and funding requirements; experience in program evaluation and data analysis; Data entry expertise /navigation with HIS data platform; Familiarity with NCTracks reimbursement platform Reasons for wanting to serve on this board: The Health and Human Services realm has always been my professional foundation. I want to give back to my community via my professional expertise and personal interests especially as it pertains to health and well -being of Orange County s children and families. Conflict of Interest: Supplemental Questions: Work Experience: Children's Developmental Services Agency 2004 to present Orange Co. Partnership for Young Children, 1999 -2004 Injury Prevention Branch, NCDHHS, 1997 -1999 UNC -Dept of Community Pediatrics, 1995 -1997 Catawba County Health Department, 1986 -1993 additional applicable experiences: Conducted over 200 presentations related to public health, injury prevention, early childhood education, program development/evaluation Adjunct instructor & content specialist with FEMA/National Fire Protection Agency, 1992- 1999 Public Information Officer (on -call) Emergency Management Department, Catawba County, 1988 -1993 provided consultation on numerous early childhood education, injury prevention and public health related research efforts PT instructor UNCG Dept of Health & Human Performance; Catawba Valley Community College (Health & Safety) Volunteer Experience: Orange County Toys for Tots, 2000 - present Orange Co. Partnership for Young Children, Allocations Committee, 2005 to present Orange County Preschool Interagency Committee, 2010 - present NC Continuous Quality Improvement Committee (early intervention) NC Partnership for Children Evaluation Committee 31 Page 3 of 3 Tamara Dempsey- Triangle United Way Orange County (children and youth) Orange County Healthy Carolinians Orange County Safe Communities NFPA 1035 Public Fire Educator Professional Qualifications Committee Board Member: NC Public Health Association 1991 -97 Education: M.Ed.: Public Health Education, UNC -G BS: Public Health Education, James Madison Univ. certification: Infant Toddler Family Specialist Other Comments: The spirit of community service is an imbedded characteristic since I was raised in a home where my father modeled community service for >40 years with the county fire and rescue service. As one who has worked my entire career in health and human services, I am automatically drawn and driven to contribute to these efforts. As an Orange County resident, I am committed to supporting efforts that enhance the effectiveness and efficiency of health and human service resources within our county. I would appreciate and value to serve our community in this capacity. STAFF COMMENTS: Originally applied for Orange County Emergency Services Work Group, Board of Health, Board of Social Services 1/4/2012. ADDRESS VERIFICATION: Leslie Drive is OC Jurisdiction, Orange Grove Fire Tax, Bingham Township. Submitted new application 01102014 Added additional career background positions held 01142014. This application was current on: 1/10/2014 Date Printed: 3/6/2014 32 Page 1 of 2 �n1�i'i wi•'.Ca i Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Dr. Nurum Erdem 10 Saint James Place Chapel HIII NC 27514 9192591153 9199330661 9192591153 nurumerdem @gmail.com Volunteer Physician Samaritan Health Center Durh MD 2000 Chapel Hill Chapel Hill Township within C.H. city limits Female Caucasian Community Activities /Organizational Memberships: School Improvement Team Culbreth Middle School School Improvement Team Glenwood Elementary PTA Culbreth Middle School PTA Glenwood Elementary Volunteer Physician Samaritan Health Center Past Service on Orange County Advisory Boards: None Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I am a board certified physician in internal medicine and geriatric medicine. Currently I am a stay -at -home mom and volunteer regularly at the Samaritan Health Center in Durham. Through my training and the various settings I have practiced medicine within (skilled nursing facility, hospital, private practice, uninsured clinic, rescue mission)I feel like I have a seen the needs of many different populations. I believe these experiences as a physician (and my background with a public health education) will give me a unique perspective of the health needs of Orange county. Reasons for wanting to serve on this board: I would like to serve on this board for several reasons. Firstly, I would like to be involved in improving the health and wellness of the residents in Orange County. As well, I see this as a time of great change in our health care system (in terms of insurance coverage and delivery of care). With change comes great opportunity for improvement. Being on this board will give me the opportunity to develop a more in depth knowlege of the needs of the county and be a part of the team to establish creative solutions to meet these needs. Page 2 of 2 Conflict of Interest: Supplemental Questions: Other Comments: I1vi'ii 34 Page 1 of 2 Zachary Giles Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Mr. Zachary Giles 8000 Oak Pointe Court Mebane NC 27302 9103087228 9103087228 9103087228 zach.s.giles @gmail.com GlaxoSmithKline LC /MS Field Service Engineer 2008 Cedar Grove County Male Caucasian Community Activities /Organizational Memberships: I have ran races (5k, marathon) for the American Cancer Society. Past Service on Orange County Advisory Boards: N/A Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I have a BS in chemistry and have worked for the pharmaceutical industry for 6+ years. My sister is a pathologist fellow at UNC -CH hospitals, and I come from a family of nurses so I have been exposed to the healthcare industry for a number of years without actually being affiliated to any specific entity. Reasons for wanting to serve on this board: Everyone has experienced changes to their personal healthcare in some way, shape, or form and I want to become more involved in those changes. Conflict of Interest: 35 Page 2 of 2 Zachary Giles Mebane Board of Adjustment Background, education and experience relevant to this board: I reside in the community of Mebane and I foresee changes in the community especially in the Orange County part of the community. I would like to become involved in future zoning regulations that could affect my part of the community. I also have an MBA and my profession is more scientific so I am exploring venues to cultivate my business skill set. Reasons for wanting to serve on this board: See Above. Conflict of Interest: I live in Mebane and could be directly affected by decisions made by this board. Orange Water & Sewer Authority Board of Directors Background, education and experience relevant to this board: My mother was the town clerk for my hometown (Linden NC) and was actively involved in water /sewer planning and bill payment. and as a child I assisted her with office duties. Reasons for wanting to serve on this board: Residents in my part of the county are on well water, and it s full of particulate (red clay). This is a problem everyone in my community faces, and I would like to help bring public water /sewer to my community if possible. Conflict of Interest: I could benefit directly from decisions made by this board. Supplemental Questions: Orange Water & Sewer Authority Board of Directors Please list /explain your experience, either professionally and /or from other boards /commissions that you have in the areas of budget, personnel, and management. I have a MBA from Elon University (graduated May 2013), and my mother has worked for the public works in my hometown (Linden NC). I assisted her with office duties (i.e. billing and meter reading). In addition to the experience listed in the question above, please list the work /volunteer experience /qualifications that would add to your expertise for this board. I currently work with LC /MS analytic equipment that is used in the water testing industry (although I work in pharmaceuticals) What do you see as the responsibilities of this board, and what do you hope to accomplish if appointed? To provide clean water and functional sewer to the residents of Orange County. What is OWASA's role in growth /development issues? To provide and maintain the infrastructure needed (i.e. pipes and meters) in providing water /sewer to Orange County residents, and to ensure quality control testing on water samples. Other Comments: This application was current on: 2/26/2014 1:18:11 PM Date Printed: 3/6/2014 36 Page 1 of 1 Linda Griffin Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background Mrs Linda Griffin 321 Mitchell Street Hillsborough NC 27278 919- 630 -9078 919- 630 -9078 919- 630 -9078 Igriffin2 @nc.rr.com Duke Health System Health Center Administrator 1981 Hillsborough Female Caucasian Community Activities /Organizational Memberships: Durham Technical Community College Medical Assisting Advisory Committee. I am a Fellow of the American College of Medical Practice Executives, Member of North Carolina Medical Group Managers, former Member and National Treasurer of Neurosurgical Executives Education and Resource Society. Past Service on Orange County Advisory Boards: none Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I have been a resident of Orange County for over 30 years. My background in Health Care Administration both in Private Practice and at Duke will be a benefit to the Board Reasons for wanting to serve on this board: I have a great desire to make sure all residents of Orange County have good quality health care and am willing to help make decisions for our citizens with this in mind. Conflict of Interest: Supplemental Questions: Other Comments: This application was current on: 1/9/2014 12:38:35 PM Date Printed: 3/6/2014 37 Page 1 of 2 Winston Liao Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Mr. Winston Liao 126 Fern Lane Chapel Hill NC 27514 919 929 3123 Retired iiU't�s7 Township of Residence: Chapel Hill Zone of Residence: C.H. City Limits Sex: Male Ethnic Background: Asian American Community Activities /Organizational Memberships: St. Thomas More Caring and Sharing Center; STM School North Carolina COPD Taskforce North Carolina Public Health Association American Public Health Association Orange County Election Official Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Advisory Board on Aging Background, education and experience relevant to this board: Before my retirement on Decmeber 31, 2012, 1 was with the Chronic Disease and Injury Section, NC Division of Public Health. During my five and a half years there, I worked with the cancer, heart disease /stroke, diabetes, physical activity & nutrition, injury & violence prevention, tobacco prevention and control, and asthma branches. My work was to promote education and outreach, and intervention programs (including those for the older population), especially for adults with chronic lower respiratory diseases and their associated conditions (e.g., heart disease, diabetes, arthritis, depression, etc.). Reasons for wanting to serve on this board: Conflict of Interest: W Page 2 of 2 Winston Liao Board of Health Background, education and experience relevant to this board: Same as above. I have an MPH and completed all course work for a PhD in public health. I have served on various advisory boards, including those for the CDC, Public Health Foundation, American Lung Association, etc. I have taught public health at the University of Mississippi, conducted research in many aspects of public health and aging at RTI International and NC DPH, and practiced public health at NC DPH. I have also been active in using data to support and drive policy at the state and national levels. Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Other Comments: STAFF COMMENTS: Originally (1/17/2012) applied for Advisory Board on Aging and Board of Health. ADDRESS VERIFICATION: 126 Fern Lane is Chapel Hill Township, Chaprl Hill Jurisdiction, and Chapel Hill Town Limits. This application was current on: 1/16/2013 3:19:46 PM Date Printed: 3/6/2014 39 Page 1 of 1 Charles McMullen Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Mr. Charles McMullen 108 Jones Avenue Hillsborough NC 27278 9197329083 919- 260 -3879 cmcmullen1 @nc.rr.com retired Year of OC Residence: 1993 Township of Residence: Hillsborough Zone of Residence: Does not apply Sex: Male Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: Almost 50 yrs in various fields of nsg. Other Comments: STAFF COMMENTS: Originally applied for Nursing Home Community Advisory Committee, Adult Care Home Community Advisory Committee, and Board of Health 02/10/2011. ADDRESS VERIFICATION: 108 Jones Avenue is in Hillsborough Jurisdiction, Hillsborough Township. This application was current on: 2/10/2011 10:59:02 AM Date Printed: 3/6/2014 W Page 1 of 2 Ken Morgan Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Mr Ken Morgan 2720 Buckboard Drive Hillsborough NC 27278 919- 218 -8596 919- 218 -8596 morgangk @juno.com NAIFA North Carolina Executive Director 1982 Township of Residence: Eno Zone of Residence: - Sex: Male Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: NAIFA North Carolina, 1995 - present American Heart Association, NC, 1982 -1993 Volunteer Experience: Past President, Virginia Association of Volunteer Rescue Squads; Member Hall of Fame and Life Member; Chairman, Orange County United Way; Board of Directors, Rotary International; Personnel Advisory Committee, Orange County Education: M.Ed., Virginia Commonwealth University Other Comments: STAFF COMMENTS: Originally applied for Human Services Advisory Commission 7/20/2006. Applied for Board of Health 8/13/08. Updated application for Board of Health 05/05/2011. Applied for Orange County Emergency Services Work Group 01/02/2012. 41 Page 2 of 2 Ken Morgan ADDRESS VERIFICATION: 2720 Buckboard Drive Hillsborough, NC 27278 is Eno Township, OCPL jurisdiction. This application was current on: 11/6/2013 Date Printed: 3/6/2014 42 Page 1 of 2 Danielle Mosley Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment: Job Title: Miss Danielle Mosley 476 Melanie Court Chapel Hill NC 27514 919- 309 -5685 Dlynnm26 @gmail.com Year of OC Residence: 2011 Township of Residence: Chapel Hill Zone of Residence: C.H. City Limits Sex: Female Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Adult Care Home Community Advisory Committee Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Agricultural Preservation Board Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: Club Nova Volunteer Experience: Club Nova Page 2 of 2 Education: Attending school for ged Other Comments: Danielle Mosley 43 STAFF COMMENTS: Applied for Adult Care Home Community Advisory Committee, Board of Health, and Agricultural preservation Board on 06/26/2012. ADDRESS VERIFICATION: Melanie Court is Chapel Hill Township, Chapel Hill Town Limits. This application was current on: 6/26/2012 11:06:45 AM Date Printed: 3/6/2014 .. Page 1 of 2 yvonne overcast Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Ms. yvonne overcast 216 cobalt ridge road hillsborough NC 27278 9197329840 9197329840 9194511901 yovercast @gmail.com Duke Hospital Certified Registered Nurse Anesthetist 2007 Hillsborough Female Caucasian Community Activities /Organizational Memberships: Parent participant in there Hilltoppers 4 -H group. Active in my church United Church of Chapel Hill s youth group. Assist them in service work in Orange County and other cities. North Carolina Association of Nurse Anesthetist. Several Board positions as Secretary, District Director, Nominating Chair for several years. Have been room parent at my children s school. Secretary of the athletic booster club at oldest daughters school. Co- organizer of residents of Churton Grove to meet with Water commission on water costs of the neighborhood. Past Service on Orange County Advisory Boards: None Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: I am a Nurse Anesthetist and have been for 21 years with 16 years of nursing prior to graduate school. I have worked all over NC and currently at Duke Hospital for the past 12 years. I also do free lance work with a private surgeon in Chapel Hill. I am Masters prepared with continuous participation in educational workshops every year approximately 30 -40 hours per year. I teach a class at the Duke School of Nursing. I function as a Preceptor for Nurses training to become Certified Registered Nurse Anesthetist. In the long session of the GA 2013, 1 lobbied heavily to defeat HB 181. Reasons for wanting to serve on this board: My reason for seeking out the At Large position with the Board of Health, is to provide the Board with my healthcare expertise and be a fair representative of the residents of Orange County. Children and the elderly, are just 2 populations at risk of not receiving adequate basic healthcare and with the changes that have occurred with Medicaid and Medicare it is important 45 Page 2 of 2 yvonne overcast that these individuals do not get lost in the system or slip through the cracks. Advocacy is important and with my knowledge and expertise I can offer the Board of Health a fair representation to help meet and maintain the Boards mission of maintaining the health of the residents of Orange County. Conflict of Interest: N/A Supplemental Questions: Other Comments: This application was current on: 1/8/2014 9:01:10 AM Date Printed: 3/6/2014 .F. Page 1 of 2 Vince Stevens Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment: Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background: Mr. Vince Stevens 101 Camille Ct Chapel Hill NC 27516 919- 923 -2561 919- 933 -3058 vstevens @nc.rr.com NC Office of Rural Health Business Officer - Retired 1989 Chapel Hill Male Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: Business Officer North Carolina Office of Rural Health and Community Care 2006 - 2010. Responsibilities include development, implementation and assessment of strategies for improving prescription drug access for North Carolina residents. Advisor on all pharmaceutical issues to assure financial and programmatic compliance with programs. Clinical Pharmacist, Team Lead for Point of Sale & Drug Rebate North Carolina Office of Medicaid Management Information Systems 2005 -2006. Responsibilities include Affiliated Computer Services RFP deliverable requirements, Design, Construction, System and Integration Testing, User Acceptance Testing, Readiness Testing, Implementation and Post Implementation. Strategic National Stockpile Coordinator North Carolina Public Health Preparedness and Response 2004 -2005. Statewide responsibility for implementation of the Department of Homeland Security and the Centers for Disease Control and Prevention Strategic National Stockpile Program. Community Consultant NC Office of Rural Health, 2003 -2004. Administrative support for 47 Page 2 of 2 Vince Stevens North Carolina Senior Care Program and Prescription Assistance Programs in partnership with County Health Departments and Senior Centers Clinical Manager Advance PCS, Chapel Hill, NC 1997 -2003. Clinical and administrative support for Pharmacy Benefit Management clients. Successfully expanded sales to existing clients through relationship - building and demonstrating a thorough knowledge of products that gave credibility to product recommendations. Client base consisting of Managed Care, Employer groups, Government including Medicaid, and Blue Cross Blue Shield programs. Pharmacy Account Manager First Health Services Corporation - Chapel Hill, NC 1995 - 1997. Administrative responsibility for North Carolina State Health Plan, North Carolina and Tennessee TennCare Medicaid Programs and Blue Cross of Northeastern Pennsylvania. District Manager - Revco Drug Stores Oklahoma, Michigan, North Carolina 1973 -1994. Responsibility for retail store operations including profit & loss responsibility, training sales staff in merchandising and sales strategies, advertising and inventory control, gross margin management, human resources and personnel issues. Supervised 240 employees and 68 pharmacist Middle Management Experience Pharmacy positions at Wal -Mart, and SuperX Volunteer Experience: Chapel Hill Crime Task Force (several years ago) Education: Bachelor of Science Pharmacy, The Ohio State University Licensed Registered Pharmacist in: OH, NC Other Comments: Orig.app.11 /17/99 for Board of Health, Pharmacist Position STAFF COMMENTS: Applied 5/7/2010 for Advisory Board on Aging, Adult Care Home Community Advisory Committee, Board of Health. ADDRESS VERIFICATION: 101 Camille Ct, Chapel Hill is in Chapel Hill Township, Chapel Hill Town Limits. UPDATED APPLICATION 05/02/2012 FOR BOARD OF HEALTH. This application was current on: 5/1/2012 Date Printed: 3/6/2014 MR Page 1 of 2 Jaimee Watts Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Ms. Jaimee Watts 108C West Carr Street Carrboro NC 27510 828 - 381 -6246 jaimee.watts @gmail.com UNC Medical Center RN, BSN, ICU Nurse 2009 Township of Residence: Chapel Hill Zone of Residence: Carrboro City Limits Sex: Female Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Chapel Hill Parks and Recreation Commission Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Carrboro Recreation and Parks Commission Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: 3 Years as a Nurse at UNC, tow in trauma and one in critical care (SICU) i • Page 2 of 2 Jaimee Watts Volunteer Experience: Orange County Public Health Reserve Corps; CERT (Community Emergency Response Team) training; Carrboro Rec and Parks Committee, Healthy Carolinians Education: BSN in nursing with plans for a Masters in either Public Health Nursing or Nutrition Other Comments: STAFF COMMENTS: Applied 4/29/2010 for Board of Health, Chapel Hill Parks & Recreation Commission and Carrboro Recreation and Parks Commission. ADDRESS VERIFICATION: 108 C W Carr Street is Chapel Hill Township, Carrboro City Limits. UPDATED APPLICATION 04/30/2012 TO INCLUDE THE BOARD OF HEALTH. UPDATED APPLICATION 05/16/2012 TO INCLUDE BOARD OF HEALTH AND CHANGE OF ADDRESS. This application was current on: 5/16/2012 Date Printed: 3/6/2014 50 Page 1 of 1 Dennis Williams Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Dr. Dennis Williams 209 Lake Manor Road Chapel Hill NC 27516 919- 962 -7122 919- 933 -5408 dwilliams @unc.edu University of North Carolina Associate Township of Residence: Chapel Hill Zone of Residence: Carrboro City Limits Sex: Male Ethnic Background: Other Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Other Comments: STAFF COMMENTS: Applied 05/16/2012 for Board of Health. ADDRESS VERIFICATION: 269 Lake Manor Road is Chapel Hill Township, Carrboro City Limits. This application was current on: 5/16/2012 9:33:52 PM Date Printed: 3/6/2014 51 Page 1 of 2 Megan Williams Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening): Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Mrs. Megan Williams 205 Westside Drive Chapel Hill NC 27516 919- 240 -4455 mpwilliams @unc.edu unc -ch school of nursing clinical assistant professor 2009 Township of Residence: Chapel Hill Zone of Residence: Does not apply Sex: Female Ethnic Background: Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: Clinical Assistant Professor UNC- Chapel Hill 2003 - current Nurse Practitioner MinuteClinic 2008 - current Nurse Practitioner DUMC 2002 -2006 Volunteer Experience: Association of Nursing Students faculty Advisor North Carolina Nurses Association member 1998 - current North Carolina Nurses Association Triangle Region President Education: AS Peace College Raleigh, NC 1995 BSN UNCW Wilmington, NC 1998 MSN Duke University 2002 Other Comments: 52 Page 2 of 2 Megan Williams STAFF COMMENTS: Originally appled for Board of Health 06/06/2010. ADDRESS VERIFICATION: 205 Westside Drive is in Chapel Hill Township, Chapel Hill Town Limits.. UPDATED APPLICATION 05/04/2012 For Board of Health. This application was current on: 5/4/2012 Date Printed: 3/11/2014 53 Page 1 of 1 Joanne Wilson Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background Dr Joanne Wilson 104 Stoneridge Drive Chapel Hill NC 27514 919- 810 -2774 919- 932 -5391 antee1 @earthlink.net Duke Physician 1990 Chapel Hill Rural Area Resident Female African American Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: None Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Other Comments: STAFF COMMENTS: Applied 07/15/2013 for Adult Care Home Community Advisory Committee, Advisory Board on Aging, and Board of Health. ADDRESS VERIFICATION: 104 Stoneridge Drive is Chapel Hill Township, Orange County Jurisdiction, and (RB) Rural Buffer Zoning. This application was current on: 7/15/2013 9:53:13 PM Date Printed: 3/6/2014 54 Page 1 of 1 Tracey Yap Volunteer Application Orange County Advisory Boards and Commissions Name: Name Called: Home Address: Phone (Day): Phone (Evening) Phone (Cell): Email: Place of Employment Job Title: Year of OC Residence: Township of Residence: Zone of Residence: Sex: Ethnic Background Dr. Tracey Yap 834 Providence Glen Drive Chapel Hill NC 27514 502 - 686 -0016 919- 240 -4793 tracey.yap @duke.edu Duke University School of Nursing Assistant Professor 2011 Chapel Hill Female Caucasian Community Activities /Organizational Memberships: Past Service on Orange County Advisory Boards: Boards /Commissions applied for: Board of Health Background, education and experience relevant to this board: Reasons for wanting to serve on this board: Conflict of Interest: Supplemental Questions: Work Experience: Deputy- Director of Nursing for NIOSH sponsored Education and Research Center, University of Cincinnati Funded research grants related to long -term care Education: RN, PhD Other Comments: STAFF COMMENTS: 09/20/2011 applied for Nursing Home Community Advisory Committee, Advisory Board on Aging, and Board of Health. ADDRESS JURISDICTION: 834 Providence Glen Drive is CH Township. This application was current on: 12/2/2013 3:41:57 PM Date Printed: 3/6/2014