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
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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