HomeMy WebLinkAboutAgenda - 02-17-2015-11bi
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: February 17, 2015
SUBJECT: Board of Health —Appointment
DEPARTMENT: Board of Commissioners
ATTACHMENT(S): Under Separate Cover
Membership Roster
Recommendation
Application for Person Recommended
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 an appointment to the Board of Health.
BACKGROUND: The following appointment is for Board consideration:
• Appointment to a partial term (position #2) At -Large Pharmacist for Mr. Dan Dewitya
expiring 06/30/2016.
POSITION NO.
NAME
SPECIAL REPRESENTATIVE
EXPIRATION DATE
2
Mr. Dan Dewit a
At-Large Pharmacist
06/30/2016
NOTE - If the individuals listed above are appointed, the following vacancies remain:
• No vacancies.
FINANCIAL IMPACT: None.
RECOMMENDATION(S): The Board will consider making an appointment 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: Tersee Flores
Meeting Place: Chapel Hill and Hillsborough Alt. HD Positions: 11 Length: 3 years Contact Phone: 919- 245 -2411
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 Day Phone: 919 - 541 -3474
1 Vice -Chair Evening Phone: 919- 967 -4172
308 Glenwood Drive FAX:
Chapel Hill NC 27514 E -mail: elmore @niehs.nih.gov
VACANT Day Phone
2 Evening Phone:
FAX:
E -mail:
VACANT Day Phone
3 Evening Phone:
FAX:
E -mail:
Ms Liska Lackey Day Phone: 919 - 968 -1450
4 Evening Phone:
507 Oak Ave FAX:
Carrboro NC 27510 E -mail: liska.lackey @gmail.com
Dr. Michael Carstens Day Phone: 919 - 968 -4774
5 Evening Phone: 857- 498 -1442
108 Carriage Circle FAX: 919- 942 -5291
Chapel Hill NC 27514 E -mail: carstensmike @hotmail.com
Sex: Female First Appointed: 09/21/2010
Race: Caucasian Current Appointment: 09/16/2014
Township: Chapel Hill Expiration: 06/30/2017
Resid/Spec Req: Number of Terms: 2
Special Repr: Veterinarian
Sex: First Appointed:
Race: Current Appointment
Township: Expiration: 06/30/2016
Resid/Spec Req: At -Large Number of Terms:
Special Repr: Pharmacist
Sex:
First Appointed:
Race:
Current Appointment
Township:
Expiration:
06/30/2014
Resid/Spec Req: At -Large
Number of Terms:
Special Repr: Citizen/Commissioner
Appointment
Sex: Female
First Appointed:
06/07/2011
Race: Caucasian
Current Appointment:
09/16/2014
Township: Chapel Hill
Expiration:
06/30/2017
Resid/Spec Req: At -Large
Number of Terms:
2
Special Repr: Nurse
Sex: Male
Race: Caucasian
Township: Chapel Hill
Resid/Spec Req: At -Large
Special Repr: Optometrist
First Appointed: 08/19/2009
Current Appointment 05/15/2012
Expiration: 06/30/2015
Number of Terms: 2
Friday, February 06, 2015 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: Tersee Flores
Meeting Place: Chapel Hill and Hillsborough Alt. HD Positions: 11 Length: 3 years Contact Phone: 919- 245 -2411
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
6 Chair Evening Phone:
102 Barbee Court FAX:
Carrboro NC 27510 E -mail: coreyd @gmail.com
Mr. Tony Whitaker Day Phone: 919 - 490 -1645
7 Evening Phone: 919- 321 -2922
3725 Quail Meadow Drive FAX: 919- 403 -0336
Hillsborough NC 27278 E -mail: tony.whitaker @civil- consultants.co
Nick Galvez Day Phone: 7274189921
8 Evening Phone: 7274189921
403 N Elliott Road FAX:
Chapel Hill NC 27514 E -mail: ngalvez1234 @gmail.com
Dr. Sam L.asris Day Phone: 919 - 732 -7362
9 Evening Phone: 919- 732 -7362
7020 Caviness Jordan Rd. FAX:
Cedar Grove NC 27231 E -mail: samlasris @hotmail.com
Dr. Paul Chelminski Day Phone: 919 - 966 -0471
10 Evening Phone: 919- 932 -1755
116 Watters Road FAX: 919- 966 -4507
Carrboro NC 27510 E -mail: chelminp @med.unc.edu
Sex: Male
First Appointed:
12/13/2011
Race: Caucasian
Current Appointment:
05/15/2012
Township: Chapel Hill
Expiration:
06/30/2015
Resid/Spec Req: At -Large
Number of Terms:
2
Special Repr: Citizen/commissioner appointment
Appointment
Sex: Male
First Appointed:
08/19/2009
Race: Caucasian
Current Appointment:
05/15/2012
Township: Little River
Expiration:
06/30/2015
Resid/Spec Req: At -Large
Number of Terms:
2
Special Repr: Professional Engineer
Special Repr: Dentist
Sex: Male
First Appointed:
03/18/2014
Race: Other
Current Appointment:
03/18/2014
Township: Chapel Hill
Expiration:
06/30/2015
Resid/Spec Req: At -Large
Number of Terms:
Special Repr: Citizen/Commissioner
Appointment
Sex: Male
First Appointed:
03/18/2014
Race: Caucasian
Current Appointment:
03/18/2014
Township: Cedar Grove
Expiration:
06/30/2016
Resid/Spec Req: At -Large
Number of Terms:
1
Special Repr: Dentist
Sex: Male
Race: other
Township: Chapel Hill
Resid/Spec Req: At -Large
Special Repr: Physician
First Appointed: 08/19/2009
Current Appointment: 06/18/2013
Expiration: 06/30/2016
Number of Terms: 2
Friday, February 06, 2015 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: Tersee Flores
Meeting Place: Chapel Hill and Hillsborough Alt. HD Positions: 11 Length: 3 years Contact Phone: 919- 245 -2411
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
Ms. Mia Burroughs
110 Cedar Hills Drive
Chapel Hill NC 27514
Day Phone: 919- 932 -6282
Evening Phone: 919- 932 -6282
FAX:
E -mail: mburroughs @orangecountync.gov
Sex: Female
Race: Caucasian
Township: Chapel Hill
Resid/Spec Req: At -Large
Special Repr: B.O.C.C.
First Appointed: 01/27/2015
Current Appointment: 01/27/2015
Expiration: 02/29/2016
Number of Terms:
Friday, February 06, 2015 Page 3
Thorn Freeman
From:
Tersee Flores
Sent:
Thursday, January 22, 2015 10:55 AM
To:
Thom Freeman
Cc:
Colleen Bridger
Subject:
Board of Health recommendations
Attachments:
Dan Dewitya Database Application.pdf
Hi Thom,
The Board of Health members reviewed applications for the Pharmacy vacancy on the hoard. The BOH is recommending
that the Board of County Commissioners appoint Dan Dewitya for the pharmacist position. Attached is Dan Dewitya
volunteer application.
Please let me know if you need additional information.
Thank you,
Tersee Efores
Administrative Assistant II to
Dr. Colleen Bridger MPH, PHD
Orange County Health Department
300 West Tryon Street, Hillsborough, NC 2 72 78
Office: 919- 245 - 2411
Fax: 919- 245 -0896
iflores a,or- aragecouiityrac.gov
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1
Page 1 of 2
Dan Dewitya
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:
Dan Dewitya
112 Bolinwood Dr
Chapel Hill NC 27514 -2643
919- 906 -6762
919- 906 -6762
919- 906 -6762
dan.dewitya @gmail.com
Lincoln Community Health Center
Pharmacist
1985
Chapel Hill
Male
Asian American
Community Activities /Organizational Memberships:
NC State Medical Assistance Team (SMAT)Duke Regional Advisory Committee (DRAC);
Ajunct Assistant Professor UNC Eshelman School of Pharmacy; University of Florida
College of Pharmacy preceptor; NC Seniors Health Insurance Information Program
(SHIIP) counselor; Senior PharmAssist Formulary Committee; NCCU School of Nursing
guest lecturer; North Carolina Association of Pharmacists
Past Service on Orange County Advisory Boards:
I have never served on any Orange County Advisory Boards.
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
I have been a pharmacist for more than 15 years at Lincoln Community Health Center, whose
goal is ensuring equal and fair access to high - quality health care. I am the formulary manager at
the clinic, help ensure the pharmacyaETMs Medicaid compliance and serve on the Environment
of Care Committee. http: / /www.lincolnchc.org/
During that time I have also served as an adjunct assistant professor with UNCa €TMs Eshelman
School of Pharmacy and a preceptor with the University of Florida College of Pharmacy where I
had the opportunity to train future pharmacists.
I have been a member of the North Carolina State Medical Assistance Team (NC SMAT) Duke
Regional Advisory Committee (DRAC NC -400) since 2011 and will begin serving as an advisor
to the SMAT steering committee. http: / /trauma.duhs.duke.edu /disaster - response /nc400 -smat
Last year, I completed training with the NC Department of Insurance SeniorsaETM Health
Insurance Information Program (SHIIP) and became a SHIIP counselor to help seniors navigate
Medicare. I am also a member of Senior PharmAssistaETMs formulary committee.
http: / /www.ncdoi.com /shiip/ http: / /seniorpharmassist.org/
Reasons for wanting to serve on this board:
7
Page 2 of 2
Dan Dewitya
My volunteer activities have centered on organizations where I can apply my training in
promoting public health. I feel very fortunate with the opportunities I have received and see this
as a chance to be able to contribute to my community.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 11/14/2014 3:46:07 PM Date Printed: 11/17/2014
Applicant Interest Listing
by Board Name and by Applicant Name
Contact Person:
Tersee Flores
Board Of Health
Contact Phone:
919- 245 -2411
Debra Aycock
Day Phone:
919 - 817 -6037
Sex:
Female
301 Tramore Drive
Evening Phone:
919 -817 -6037
Race:
Caucasian
Chapel Hill NC 27516
Cell Phone:
919 -817 -6037
Township:
Chapel Hill
E -mail:
debaycock22@gmail.com
Date Applied:
02/10/2015
Skills:
Also Serves On:
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
E -mail:
mbell968@yahoo.com
Date Applied:
01/09/2014
Skills:
Also Serves On:
Ms. Jennifer Brobst
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. Barbara ChavioAS
Day Phone:
919- 732 -3469
Sex:
Female
401 N Nash St
Evening Phone:
919- 732 -3469
Race:
Caucasian
Hillsborough NC 27278
Cell Phone:
919- 943 -5319
Township:
Hillsborough
E -mail:
Barbara Chavious@unc.edu
Date Applied:
02/06/2015
Skills: Public Health
Also Serves On:
Dr. Steven Thomas Daniels
Day Phone:
919- 732 -8213
Sex:
Male
206 Franklin Adams Road
Evening Phone:
919 -451 -1874
Race:
Caucasian
EYland NC 27243
Cell Phone:
919 -451 -1874
Township:
Cheeks
E -mail:
stdaniel@gmail.com
Date Applied:
01/15/2014
Skills:
Also Serves On:
Wednesday, February 11, 2015
Page
1 of 5
Applicant Interest Listing
by Board Name and by Applicant Name
9
Wednesday, February 11, 2015 Page 2 of 5
Contact Person:
Tersee Flores
Board Of Health
Contact Phone:
919- 245 -2411
Dr Brian Decker
Day Phone:
919.360.6529
Sex:
Male
109 Dublin Road
Evening Phone:
919.360.6529
Race:
Caucasian
Chapel Hill NC 27516
Cell Phone:
919.360.6529
Township:
Chapel Hill
E -mail:
bdeckeruncggmail.com
Date Applied:
11/03/2014
Skills:
Also Serves On:
Skills: Environmental Scientist
Also Serves On:
Skills: Pharmacist
Also Serves On:
Skills: Real Estate Broker
Also Serves On:
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
E -mail:
tamaradtgyahoo.com
Date Applied:
01/10/2014
Skills: Healthcare Consultant
Also Serves On:
Board of Social Services
Dan DeWitya
Day Phone:
919- 906 -6762
Sex:
Male
112 Bolinwood Dr
Evening Phone:
919- 906 -6762
Race:
Asian American
Chapel Hill NC 27514-2643
Cell Phone:
919- 906 -6762
Township:
Chapel Hill
E -mail:
dan.dewityaggmail.com
Date Applied:
11/14/2014
Skills:
Also Serves On:
Dr. NArum 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:
nurumerdemggmail.com
Date Applied:
01/17/2014
Skills:
Also Serves On:
Mrs. Jessica Frega
Day Phone:
919 426 9465
Sex:
Female
1511 Park Lane
Evening Phone:
919 426 9465
Race:
Caucasian
Hillsborough NC 27278
Cell Phone:
919 426 9465
Township:
Hillsborough
E -mail:
jessicaloisggmail.com
Date Applied:
10/30/2014
Skills:
Also Serves On:
Wednesday, February 11, 2015 Page 2 of 5
10
Applicant Interest
Listing
by Board Name and by Applicant Name
Caucasian
Township:
Contact Person:
Tersee Flores
02/05/2015
Board Of Health
Contact Phone:
919- 245 -2411
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.gilesggmail.com
Date Applied:
02/26/2014
Skills:
Also Serves On:
Mrs Linda Griffin
Day Phone:
919- 630 -9078
Sex:
Female
321 Mitchell Street
Evening Phone:
919- 630 -9078
Race:
Caucasian
Hillsborough NC 27278
Cell Phone:
919- 630 -9078
Township:
Hillsborough
E -mail:
lgriffin2gne.rr.com
Date Applied:
01/09/2014
Skills:
Also Serves On:
Dr Daniel Kemp
Day Phone:
3364067871
Sex:
Male
2007 Starterwood Ln
Evening Phone:
3364067871
Race:
Other
Hillsborough NC 27278
Cell Phone:
3364067871
Township:
Bingham
E -mail:
spartanl999ggmail.com
Date Applied:
07/02/2014
Skills:
Also Serves On:
Dr. Michelle McKee
Day Phone:
828- 230 -9624
Sex:
Female
2108 Country Air Lane
Evening Phone:
919- 644 -7849
Race:
Caucasian
Hillsborough NC 27278
Cell Phone:
828 -230 -9624
Township:
Hillsborough
E -mail:
mckeetarheelgyahoo.com
Date Applied:
11/20/2014
Skills:
Also Serves On:
Mr. Steven Moore
Day Phone:
9199298995
Sex:
Male
913 Roosevelt Dr
Evening Phone:
9199298995
Race:
Caucasian
Chapel Hill NC 27514
Cell Phone:
9199298995
Township:
Chapel Hill
E -mail:
mooresgcampb ell. edu
Date Applied:
11/16/2014
Skills:
Also Serves On:
Mr Ken Morgan
2720 Buckboard Drive
Hillsborough NC 27278
Skills: American Heart Association
Skills: United Way Board of Directors
Day Phone: 919- 218 -8596
Evening Phone: 919 -218 -8596
Cell Phone:
E -mail: morgangk @juno.com
Also Serves On:
Also Serves On:
Sex:
Male
Race:
Caucasian
Township:
Eno
Date Applied:
02/05/2015
Wednesday, February 11, 2015 Page 3 of 5
Applicant Interest Listing
Board of Health
Miss Danielle Mosley
476 Melanie Court
Chapel Hill NC 27514
Skills: Club Nova
Ms. Yvonne Overcast
216 cobalt ridge road
hillsborough NC 27278
Skills:
11
by Board Name and by Applicant Name
Contact Person: Tersee Flores
Contact Phone: 919- 245 -2411
Day Phone: 919- 309 -5685
Evening Phone:
Cell Phone:
E -mail: Dlynnm26@gmail.com
Also Serves On:
Day Phone: 9197329840
Evening Phone: 9197329840
Cell Phone: 9194511901
E -mail: yovercastggmail.com
Also Serves On:
Sex:
Female
Race:
Caucasian
Township:
Chapel Hill
Date Applied:
10/01/2014
Sex:
Female
Race:
Caucasian
Township:
Hillsborough
Date Applied:
01/08/2014
Ms. Antonia Pedroza
Day Phone:
252- 738 -3770
Sex:
Female
409 Saint Marys Road
Evening Phone:
919- 760 -0210
Race:
Hispanic
Hillsborough NC 27278
Cell Phone:
919- 760 -0210
Township:
Hillsborough
E -mail:
pedrozaantoniagyahoo.com
Date Applied:
08/13/2014
Skills:
Also Serves On:
Human Relations Commission
Dr. Todd Sega
Day Phone:
8144905120
Sex:
Male
1113 Arborgate Cir
Evening Phone:
8144905120
Race:
Caucasian
Chapel Hill NC 27514
Cell Phone:
8144905120
Township:
Chapel Hill
E -mail:
toddsegaggmail.com
Date Applied:
11/20/2014
Skills:
Also Serves On:
Dr. Edward Stirman
Day Phone:
919 -241 -4912
Sex:
Male
554 E Hatterleigh Ave
Evening Phone:
919 -241 -4912
Race:
Caucasian
Hillsborough NC 27278
Cell Phone:
423 - 677 -3295
Township:
Eno
E -mail:
monty.stirmanggmail.com
Date Applied:
03/13/2014
Skills:
Also Serves On:
Ms. Diane Uzarski
3017 Pleasant Green Rd
Durham NC 27705
Skills:
Day Phone: 9196688595
Evening Phone: 9193097974
Cell Phone: 9193097974
E -mail: diane.uzarskigdm. duke. edu
Also Serves On:
Sex:
Female
Race:
Caucasian
Township:
Eno
Date Applied:
09/29/2014
Wednesday, February 11, 2015 Page 4 of 5
12
Applicant Interest
Listing
by Board Name and by Applicant Name
Sex:
Male
Contact Person: Tersee Flores
Board Of Health
9194936310
Contact Phone: 919- 245 -2411
Mr. Leroy Werley
Day Phone:
919- 933 -3099 Sex: Male
6916 Turkey Farm Rd.
Evening Phone:
919- 933 -3099 Race: Caucasian
Chapel Hill NC 27514
Cell Phone:
919 -210 -6604 Township: Chapel Hill
Date Applied:
E -mail:
Lwerley3@gmail.com Date Applied: 10/31/2014
Skills: Pharmacist
Also Serves On:
Female
Dr. Delbert Williams
Day Phone:
9194936310
Sex:
Male
7110 Pine Hill Road
Evening Phone:
9194936310
Race:
Caucasian
Durham NC 27707
Cell Phone:
9198013552
Township:
Chapel Hill
07/15/2013
E -mail:
delwilliams@nc.rr.com
Date Applied:
06/25/2014
Skills:
Also Serves On:
Sex:
Female
Evening Phone:
Dr. Dennis Williams
209 Lake Manor Road
Chapel Hill NC 27516
Skills:
Dr Joanne Wilson
104 Stoneridge Drive
Chapel Hill NC 27514
Skills: Medical Doctor
Dr. Tracey Yap
834 Providence Glen Drive
Chapel Hill NC 27514
Skills: Director
Skills: Nurse
Day Phone:
919- 962 -7122
Evening Phone:
919- 933 -5408
Cell Phone:
919- 602 -2440
E -mail:
dwilliams@unc.edu
Also Serves On:
Sex:
Male
Race:
Other
Township:
Chapel Hill
Date Applied:
11/15/2014
Day Phone:
919 -810 -2774
Sex:
Female
Evening Phone:
919- 932 -5391
Race:
African American
Cell Phone:
Township:
Chapel Hill
E -mail:
anteel@earthlink.net
Date Applied:
07/15/2013
Also Serves On:
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:
02/05/2015
Also Serves On:
Nursing Home Community Advisory
Committee
Wednesday, February 11, 2015 Page 5 of 5
13
Page 1 of 2
Debra Aycock
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:
Debra Aycock
301 Tramore Drive
Chapel Hill NC 27516
919- 817 -6037
919- 817 -6037
919- 817 -6037
debaycock22 @gmail.com
Retired after 11 years at BCBSNC
Clinical Pharmacist
1984
Bingham
Female
Caucasian
Community Activities /Organizational Memberships:
Durham - Orange Pharmacists Association
American Society of Health- System Pharmacists
Regular blood donation at Red Cross
Donate and have volunteered at TABLE, Inc.
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 graduated from UNC -CH with a BS Pharmacy degree, and from Virginia Commonwealth
University with a Doctor of Pharmacy degree. I have been a registered pharmacist for 35 years
and have worked in a variety of settings, most recently at Blue Cross & Blue Shield of NC. I have
also worked at Kaiser Permanente (clinical pharmacy coordinator), John Umstead Hospital (now
Central Hospital), AccessCare, and Piedmont Health Services (formerly Orange- Chatham
Health Services, a local network of community health centers. I understand general clinical
pharmaceutical care including mental health, Medicare Part D, community health center care,
and insurance coverage.
Reasons for wanting to serve on this board:
I believe I can be of assistance to the Board of Health with my varied background in pharmacy
care. Now that I am retired, I have time to devote to it and would enjoy the opportunity.
Conflict of Interest:
Supplemental Questions:
14
Page 2 of 2 Debra Aycock
Other Comments:
This application was current on: 2/10/2015 4:11:43 PM Date Printed: 2/11/2015
15
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
16
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: 1/9/2014
17
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
This application was current on: 12/18/2013 12:48:02 PM Date Printed: 12/19/2013
19
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
P
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: 9/4/2014
21
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.
22
Page 2 of 2
Other Comments:
Barbara Chavious
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: 12/27/2013
23
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: 7/17/2014
/.'
Page 1 of 2
Brian Decker
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. Brian Decker
109 Dublin Road
Chapel Hill NC 27516
919- 360 -6529
919- 360 -6529
bdeckerunc @gmail.com
CVS Health
Staff Pharmacist
2000
Chapel Hill
Carrboro Transition Area
Male
Caucasian
Community Activities /Organizational Memberships:
UNC Eshelman School of Pharmacy Preceptor. Member North Carolina Association of
Pharmacists.
Past Service on Orange County Advisory Boards:
Carrboro Northern Transition Area Advisory Board. Chapel Hill Bicycle & Pedestrian
Advisory Board.
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
I am a practicing pharmacist and preceptor to student pharmacists. I will bring my knowledge of
current community pharmacy practice, my relationship with the academy and the energy of
students to the board.
Reasons for wanting to serve on this board:
Many of the health issues my patients face are rooted in, what I view as, public health problems:
access and health literacy.
Conflict of Interest:
I am employed as a pharmacist with CVS Health. Any programs or partnerships with community
pharmacies that involved pecuniary gain could be construed as conflicting. I would seek to
recuse myself from any votes or actions related to this.
Supplemental Questions:
Work Experience: Real Estate Broker - Brian Decker Properties with Fonville Morisey in
Chapel Hill; Manager - Franklin Street Cycles in Chapel Hill
25
Page 2 of 2
Brian Decker
Environmental Scientist - Retec in Chapel Hill; CVS Pharmacy: Technician & Intern
Volunteer Experience: Current Vice - Chair, former Chair, of the Chapel Hill Bicycle and
Pedestrian Advisory Board; Member of the Chapel Hill Streetscape Review Committee;
Past Member of the Chapel Hill Northern Area Task Force; Founding Member of the
Triangle Off Road Cyclists; I am a former member of NTAAC. I am Chair of the Student
Political Action Network.
Education: BA Environmental Science - University of Arizona.; UNC PharmD - to be
completed 2014.
Other Comments:
Currently sit on the NTAAC as a Carrboro seat.STAFF COMMENTS: Originally applied
for Carrboro Northern Transition Area Advisory Committee 2/2/2008. STAFF
COMMENTS: 09/21/2011 1 want to continue to help Carrboro and Orane County be a
great place to live and work while adamting to the future /applied for Carrboro Northern
Transition Area Adisory Committee. ADDRESS VERIFICATION: 109 Dublin Road,
Chapel Hill is Chapel Hill Township, CAPL jurisdiction.
Updated application 11/03/2014.
This application was current on: 11/3/2014 Date Printed: 11/4/2014
R
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
27
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
R
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: 1/14/2014
e
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
31
Page 1 of 2
Jessica Frega
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. Jessica Frega
1511 Park Lane
Hillsborough NC 27278
919 426 9465
919 426 9465
919 426 9465
jessicalois @gmail.com
Community Care of North Carolina
Program Analyst
2009
Hillsborough
County
Female
Caucasian
Community Activities /Organizational Memberships:
American Public Health Association
UNC -CH Gillings School of Public Health Alumnus
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 am a Masters of Public Health graduate from the Maternal and Child Health department at
UNC -CH Gillings School of Public Health. By training, I am an adept data analyst specializing in
health informatics and am proficient in analytics using SAS and even Excel. I have volunteered
in the past at the Dare County Department of Public Health, assisting with their Community
Health Assessment.
Reasons for wanting to serve on this board:
I am interested in the health of our community in Orange County and I am interested in giving
back to my community via some kind of civil service. The Board of Health feels like an
appropriate fit.
Conflict of Interest:
I work for an organization that is contracted by NC Medicaid to manage various aspects of the
Medicaid population in the state. I am not sure if this would cause a problem for the Board, but it
would not cause a problem for my employer.
Supplemental Questions:
Page 2 of 2
Other Comments:
Jessica Frega
32
This application was current on: 10/30/2014 12:53:04 PM Date Printed: 10/31/2014
33
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:
34
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: 2/27/2014
35
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: 1/9/2014
36
Page 1 of 2
Daniel Kemp
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 Daniel Kemp
2007 Starterwood Ln
Hillsborough NC 27278
3364067871
3364067871
3364067871
spartanl999@gmail.com
GlaxoSmithKline
Director Quality and Risk Management
2013
Bingham
Male
Other
Community Activities /Organizational Memberships:
As I have recently moved to orange county I do not have any community memberships.
However, I am a board certified toxicologist and member of the Society of Toxicologic
Pathology, Society of Toxicology (SOT) and the American College of toxicology. As well
as vice president of the Drug Discovery Specialty section of SOT.
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 BS in Biochemistry and a PhD in toxicology from the University of North Carolina at
Chapel Hill. I am certified by the American Board of Toxicology and a standing member of all
toxicology societies (Society of Toxicology, American College of Toxicology and Society of
Toxicologic Pathology). I have experience with the use of both small animals and large animals
in terms of drug development, and am vice president of the Drug Discovery Specialty Section of
SOT. I am also the past president of the Invitro and alternative animal models specialty section.
have worked in all phases of drug development from early discovery to clinical trials and I feel
this experience makes me well suited for this board.
Reasons for wanting to serve on this board:
I have dedicated my career to the improvement of human health by believing my role in my
industry is here to improve the quality of human life by enabling people to do more, feel better
and live longer. This board dove -tails nicely with those beliefs and would allow me to give back
to the community that I live in.
Conflict of Interest:
37
Page 2 of 2 Daniel Kemp
Animal Services Advisory Board
Background, education and experience relevant to this board:
I have a BS in Biochemistry and a PhD in toxicology from the University of North Carolina at
Chapel Hill. I am certified by the American Board of Toxicology and a standing member of all
toxicology societies (Society of Toxicology, American College of Toxicology and Society of
Toxicologic Pathology). I have experience with the use of both small animals and large animals
in terms of drug development, and am vice president of the Drug Discovery Specialty Section of
SOT. I am also the past president of the Invitro and alternative animal models specialty section.
have been responsible for the care treatment and well being of animals throughout my career. I
feel this experience makes me well suited for this board.
Reasons for wanting to serve on this board:
I deeply care for animals that we have been given the luxury to care for and I would like to show
this support and give back to my community by serving on this board.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 7/2/2014 10:34:08 AM Date Printed: 7/3/2014
W
Page 1 of 2
Michelle McKee
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. Michelle McKee
2108 Country Air Lane
Hillsborough NC 27278
828 - 230 -9624
919- 644 -7849
828 - 230 -9624
mckeetarheel @yahoo.com
Formerly AstraZeneca
Senior Regional Scientific Manager /Director of Med
2003
Hillsborough
Female
Caucasian
Community Activities /Organizational Memberships:
Co- Creator of Tar Heel Tots (Community Fist -Time Moms Group)
Member or Little Sprouts (Community First -Time Moms Group)
Member of Fox Hill Farms Book Club
I am interested in becoming more formally involved in the local community
Past Service on Orange County Advisory Boards:
I have not currently or in the past served on any Orange County Advisory Boards.
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
I have been a licensed pharmacist in North Carolina for over 16 years. I graduated from the
University of North Carolina at Chapel Hill, where I received my Doctor of Pharmacy degree. I
further specialized by completing a drug information residency at Campbell University School of
Pharmacy. My breadth of experiences in the retail, hospital, industry, and academia sectors
allows me to understand the needs and challenges of patients within the community.
Reasons for wanting to serve on this board:
As the mother of a small child and the daughter of an aging, sick parent, I have been searching
for an opportunity to use my pharmacy talents without the constraints of traditional pharmacy
employment. In addition, I strongly value community service and wish to further integrate myself
within Orange County.
Conflict of Interest:
Supplemental Questions:
Page 2 of 2
Other Comments:
I►VAIRi - 1raLVAM M-
39
This application was current on: 11/20/2014 9:37:02 PM Date Printed: 12/5/2014
W
Page 1 of 1
Steven Moore
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
Steven Moore
913 Roosevelt Dr
Chapel Hill NC 27514
9199298995
9199298995
9199298995
moores @campbell.edu
Campbell Univ College of Pharmacy
Adjunct Asst Professor
1998
Chapel Hill
Male
Caucasian
Community Activities /Organizational Memberships:
Chair, Chapel Hill Cemeteries Advisory Board
Fellow, American Society of Health System Pharmacists
Fellow, Royal Society for Public Health
Past Service on Orange County Advisory Boards:
N/A
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
Career with US Public Health Service (activity in health education, emergency preparedness and
response, aging, disease prevention and health promotion, personal staff for 4 Surgeons
General)
Board Certified in Public Health Pharmacy (RSPH)
Curriculum coursework (Campbell)lntroduction to Public Health
Reasons for wanting to serve on this board:
Knowledge and experience in public health pharmacy
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 11/16/2014 2:17:47 PM Date Printed: 11/17/2014
41
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.
Page 2 of 2
Ken Morgan
42
ADDRESS VERIFICATION: 2720 Buckboard Drive Hillsborough, NC 27278 is Eno
Township, OCPL jurisdiction.
This application was current on: 11/6/2013 Date Printed: 12/27/2013
43
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
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: 12/27/2013
45
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
ER
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: 9/4/2014
47
Page 1 of 2
Antonia Pedroza
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. Antonia Pedroza
409 Saint Marys Road
Hillsborough NC 27278
252 - 738 -3770
919- 760 -0210
919- 760 -0210
pedrozaantonia @yahoo.com
Vance County Government
DSS Director
2002
Hillsborough
Female
Hispanic
Community Activities /Organizational Memberships:
none in Orange
Past Service on Orange County Advisory Boards:
N/A
Boards /Commissions applied for:
Human Relations Commission
Background, education and experience relevant to this board:
My entire career has been focused on serving people who are living in poverty and /or
experiencing poverty due to barriers to employment including disabilities, lack of education and
experience.
Reasons for wanting to serve on this board:
I live in Orange County and want to participate in community in a meaningful way.
Conflict of Interest:
Board of Health
Background, education and experience relevant to this board:
I have a Master in Health Administration and a Master in Business Administration.
The work I do as a DSS Director is often related to health and well- being.
Reasons for wanting to serve on this board:
I would like to serve my community.
Conflict of Interest:
MN
Page 2 of 2
OPC Oversight Board
FAR •M1111 T- 001 1
Background, education and experience relevant to this board:
Prior to working in Social Services, I worked with person with disabilities in Orange County. I
have over 25 years of experience working with person with a wide range of disabilities.
Reasons for wanting to serve on this board:
I have always been an advocate for person with disabilities.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 8/13/2014 5:32:48 PM Date Printed: 8/14/2014
i •
Page 1 of 3
Todd Sega
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. Todd Sega
1113 Arborgate Cir
Chapel Hill NC 27514
8144905120
8144905120
8144905120
toddsega @gmail.com
Pharmacy Quality Solutions
Manager of Payer Relations
2014
Township of Residence: Chapel Hill
Zone of Residence: Chapel Hill Township within C.H. city limits
Sex: Male
Ethnic Background: Caucasian
Community Activities /Organizational Memberships:
Due to establishing residence less than four weeks ago, past community activities are
listed:
*Volunteer Pharmacist - The Care Clinic, Fayetteville, NC. Helped staff the pharmacy
along with physicians and dentists for underserved, working individuals in cumberland
county.
*Medication Review Sessions - Edinboro United Methodist Church, Edinboro, PA.
Conducted medication reviews and education sessions for the congregation at a
hometown church.
*Prescription Drug Abuse Educator - Developed a prescription drug abuse presentation
targeted to 5th grade students in local schools around Northwest Ohio. The session
included slides, a pledge, and wristband after completing the pledge which resulted in
some students identifying abuse even at 11 -12 years of age.
Organizational Memberships:
*Academy of Managed Care Pharmacy
*National Community Pharmacists Association
*Ohio Pharmacists Association
*North Carolina Association of Pharmacists
Past Service on Orange County Advisory Boards:
None
50
Page 2 of 3 Todd Sega
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
As medical professionals, we strive to improve the health related quality of life of those that we
serve. From a broader perspective, all of those on the care team contribute in unique ways
hoping that individual care results in improved health for the population and the community in
which we live.
To be sure, this belief has been held in earnest throughout my training and carried through as a
licensed pharmacist. I have served in several capacities where I have educated individuals on
the key role pharmacists can have on improving outcomes. In addition, I have advocated for
expanded roles for pharmacists knowing the impact that can be achieved through increased
involvement on care teams.
I have practiced in a community setting which allows me to understand the unique challenges
front -line community pharmacists face on a daily basis. At the same time, this experience
allows me to recognize the often uncapitalized opportunities pharmacists and pharmacies can
have on improving overall population health.
I have also served as a staff pharmacist at the Academy of Managed Care Pharmacy (AMCP),
which allowed me to develop a stronger understanding of how clinical decisions and programs
can affect a large population. Furthermore, serving in a membership society provided valuable
experience to represent the needs, ideas, and goals of passionate members practicing in a
particular area of the profession. I believe that this experience would correlate well to the Board
of Health as those selected to serve in this capacity need to constantly represent and be
cognizant to the needs of the community.
In addition, due to my unique volunteer experience and work with prescription drug abuse
awareness programs, I believe that I could successfully leverage that experience to deploy
similar programs throughout the schools in Orange County. Prescription drug abuse is
unfortunately becoming the number one cause of accidental death as it is even surpassing
vehicle accidents in some states and counties, and would suspect that Orange County hasn t
been immune to these statistical trends.
Reasons for wanting to serve on this board:
As I mentioned, I believe that healthcare professionals have a duty to serve the public and be
active in the communities where they reside. Therefore, I enjoy to become actively involved and
participate along with others sharing a similar view to work towards improving the individual lives
for community betterment.
I believe that my unique experiences, when combined with the valuable expertise of others on
the board, would help contribute to improving and protecting the health - related quality of life for
those residing in Orange County.
I would also like to serve in this capacity so I can understand how to better leverage pharmacists
and educate the public on how to utilize their pharmacist for improved outcomes and assistance.
Ultimately, the opportunity would allow me to exercise my passion for the profession and
maximize the impact that pharmacists can have on the health of those that reside in Orange
County.
Conflict of Interest:
Supplemental Questions:
Page 3 of 3
Other Comments:
Todd Sega
51
This application was current on: 11/20/2014 8:54:49 PM Date Printed: 12/5/2014
52
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
53
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: 12/30/2013
54
Page 1 of 2
Edward Stirman
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. Edward Stirman
554 E Hatterleigh Ave
Hillsborough NC 27278
919- 241 -4912
919- 241 -4912
423 - 677 -3295
monty.stirman @gmail.com
retired
retired
2012
Hillsborough
Male
Caucasian
Community Activities /Organizational Memberships:
none
Past Service on Orange County Advisory Boards:
none
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
family practice physician in practice in TN for 34 years
Reasons for wanting to serve on this board:
would like to volunteer in area more likely to have some expertise
Conflict of Interest:
Hillsborough Planning Board
Background, education and experience relevant to this board:
physician from TN- retired
Reasons for wanting to serve on this board:
interested in helping Hillsborough improve
Conflict of Interest:
Supplemental Questions:
Other Comments:
Page 2 of 2
Edward Stirman
55
This application was current on: 3/13/2014 2:40:34 PM Date Printed: 3/14/2014
56
Page 1 of 2
Diane Uzarski
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. Diane Uzarski
3017 Pleasant Green Rd
Durham NC 27705
9196688595
9193097974
9193097974
diane.uzarski @dm.duke.edu
Duke Translational Research Institute
Project Leader, Associate Director of Biobanking
2005
Hillsborough
Female
Caucasian
Community Activities /Organizational Memberships:
American Red Cross - Disaster Team volunteer since 2003
Previous Vice Chair of Board - San Francisco YMCA
Past Service on Orange County Advisory Boards:
I am interested in serving on the Department of Health Advisory Board. I
nursing practice candidate at Duke University, and have a background in
injury prevention and emergency nursing.
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
am a doctoral of
health policy,
As an RN with 34 years of experience in intensive care and emergency nursing,l have a broad
understanding of our health care system from preventive care to treatment issues. I received a
master of public health degree from UC Berkeley, and became active in county wide injury
prevention strategies by managing a local coalition. I am currently completing my doctoral in
nursing practice at Duke University, and have broadened my understanding of health care
access and policy issues on a local, state and federal level.
Reasons for wanting to serve on this board:
I believe that both my recent academic and 34 years of experience in health care have given me
a deep understanding of our current health care challenges including health care access issues,
health education,and prevention challenges presenting county government today. I have actively
and effectively participated in board work, and am a positive contributor. The ability to carefully
weigh and analyze issues is a personal strength that I believe may assist me to be an effective
advisor to a Board of Health. I believe in Orange County and its ability to make decisions to
improve the health and well being of its residents.
Conflict of Interest:
Page 2 of 2
Supplemental Questions:
Other Comments:
Diane Uzarski
57
This application was current on: 9/29/2014 10:49:18 AM Date Printed: 9/30/2014
Page 1 of 2
Leroy Werley
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. Leroy Werley
6916 Turkey Farm Rd.
Chapel Hill NC 27514
919- 933 -3099
919- 933 -3099
919- 210 -6604
Lwerley3 @gmail.com
Retired
Was Director of Pharmacy at Durham County Publi
1990
Chapel Hill
County
Male
Caucasian
Community Activities /Organizational Memberships:
NC SHIIP counselor
Healthy Carolinians of Orange County
IFC
NC Food Bank
Carrboro Arts Center volunteer
OLLI classes
Chapel Hill Carrboro School volunteer with ESL class
Chapel in the Pines Hand Bell choir
Medical Reserve Corps volunteer
Past Service on Orange County Advisory Boards:
Orange County Board of Health 2000 -2004
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
Graduated from UNC School of Pharmacy 1974, worked in community pharmacy for18 years,
was Director of Pharmacy at Durham County Department of Public Health forever 21 years.
Having served on the Board of Health ten years ago I understand the role required.
Reasons for wanting to serve on this board:
I have spent my adult life serving the community. Now that I have retired I want to continue with
that goal. Using my pharmaceutical knowledge, my communication skills and my volunteering
heart I bring them to the table of the Board.
Conflict of Interest:
59
Page 2 of 2 Leroy Werley
Supplemental Questions:
Other Comments:
Orig. app. 11/19/99 for Board of Health, Pharmacist Position. WORK EXP: Director of
Pharmacy, Durham County Health Department, 7+ yrs; Was a member of the leadership
team, work with community outreach programs, supervisor and team leader, safety officer
for the health dept., member of numerous groups and committees, and help coordinate
health dept. and jail pharmaceutical services. VOLUNTEER EXP: Taught Sunday
School and Vacation Bible School; Helped coach youth soccer and other teams.
Volunteered sign language for hearing impaired; Worked with Boy & Girl Scout troops;
Taught summer 4 -H classes; Guest speaker in public schools promoting pharmacy;
Volunteered hundreds of hours as a clown /magician at nursing homes, day cares
hospitals, clinics, neighborhood health fairs, & other health dept. functions; Shelters and
thrift shops; Community outreach programs. EDUCATIONAL EXP: My unique talents in
blending my varied experiences has helped me to teach youth, work with the elderly, train
pharmacists and technicians, and be a prreceptor to several pharmacy students. I
continue to educate myself in pharmaceutical areas by attending many more C.E.'s than
is required. COMMENTS: I think that I am in the unique position of understanding public
health because of my work exp. and my volunteer experience and the fact that we have a
vital and functioning pharmacy outreach here at the Durham County Health Dept.
Updated Application 10/31/2014.
This application was current on: 10/31/2014 Date Printed: 10/31/2014
.1
Page 1 of 2
Delbert 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:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Dr. Delbert Williams
7110 Pine Hill Road
Durham NC 27707
9194936310
9194936310
9198013552
delwilliams @nc.rr.com
NC DHHS /Division of Public Health (Retired)
Head, Communicable Disease Surveillance Unit
1990
Chapel Hill
Male
Caucasian
Community Activities /Organizational Memberships:
None
Past Service on Orange County Advisory Boards:
None
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
I served for over 20 years in the NC Division of Public Health Communicable Disease Branch as
the chief of the statewide communicable disease surveillance unit. My academic background is
a combination of microbiology, biochemistry and botany with a concentration on organism
interactions. My tenure in DPH introduced me to health outcomes and mechanisms to measure
those outcomes. My training in the biological sciences as well as the activities related to health
policy development has given me a unique view of how policy development and impact must be
balanced to improve the public health for residents.
Reasons for wanting to serve on this board:
While I was employed I realized the impact the local Boards of Health had on how our public
health actions could be put into place in NC. I think I have a somewhat unique perspective to
bring to the Board to ensure that Orange County continues to be a leader in public health
activities that are supported at the local level. I also know the current health director and am
fully in support of her leadership and expertise.
Conflict of Interest:
Supplemental Questions:
Page 2 of 2
Other Comments:
1110 I074 iiV IIIIFiiiv
61
This application was current on: 6/25/2014 10:15:57 PM Date Printed: 6/27/2014
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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
919- 602 -2440
dwilliams @unc.edu
University of North Carolina
Faculty
1996
Township of Residence: Chapel Hill
Zone of Residence: Carrboro City Limits
Sex: Male
Ethnic Background: Other
Community Activities /Organizational Memberships:
Active in the University community including volunteer efforts at the IFC homeless shelter
clinic, and a volunteer for the Health Dept Emergency Services response.
Past Service on Orange County Advisory Boards:
Boards /Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
As a pharmacist, I hope to bring knowledge and insights related to pharmacy related services.
Reasons for wanting to serve on this board:
I am interested in service to my profession and my community.
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.
Updated application 11/15/2014.
This application was current on: 11/15/2014 Date Printed: 11/17/2014
63
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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
anteel@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:
Nursing Home Community Advisory Committee
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.
Page 2 of 2
Joanne Wilson
M.,
This application was current on: 7/15/2013 9:53:13 PM Date Printed: 12/30/2013
65
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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: 12/31/2013