HomeMy WebLinkAboutAgenda - 06-07-2016-11-d - Board of Health – Appointments 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 7, 2016
Action Agenda
Item No. 11-d
SUBJECT: Board of Health — Appointments
DEPARTMENT: Board of Commissioners
ATTACHMENT(S): INFORMATION CONTACT:
Membership Roster Donna Baker, Clerk to the Board
Recommendation 919-245-2130
Applications for Persons Recommended
Attendance Records
Interest List
Applications of Persons on the Interest
List
PURPOSE: To consider making appointments to the Board of Health.
BACKGROUND: The following information is for Board consideration:
• Appointment to a first full term (Position #2) "At-Large Pharmacist" representative for Dan
Dewitya expiring 06/30/2019.
• Appointment to a second full term (Position #9) "At-Large Dentist" representative for Dr.
Sam Lasris expiring 06/30/2019.
• Appointment to a third full term (Position #10) "At-Large Physician" representative for Dr.
Paul Chelminski expiring 06/30/2019.
POSITION NAME SPECIAL REPRESENTATIVE EXPIRATION DATE
NO.
2 Dan Dewitya At-Large Pharmacist 06/30/2019
9 Dr. Sam Lasris At-Large Dentist 06/30/2019
10 Dr. Paul Chelminski At-Large Physician 06/30/2019
SPECIAL NOTATION — In January 2016 the Board of Health voted to change the terms of
each position to three (3) terms in accordance with NCGS 130A-35 from two (2) terms as
has been the standard. Therefore each member in good standing will be eligible to serve
three (3) three (3) year terms.
NOTE - If the individuals listed above are appointed, the following vacancies remain:
• None
FINANCIAL IMPACT: None
2
SOCIAL JUSTICE IMPACT: Enable Full Civic Participation. Ensure that Orange County
residents are able to engage government through voting and volunteering by eliminating
disparities in participation and barriers to participation.
RECOMMENDATION(S): The Manager recommends that the Board consider making
appointments to the Board of Health.
3
Board and Commission Members
And Vacant Positions
Board of Health
Meeting Times: 7:00 pm fourth Wednesday of each month Terms: 3 Contact Person: LaToya Strange
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 Sex: Female First Appointed: 09/21/2010
1 Evening Phone:919-967-4172 Race:Caucasian Current Appointment: 09/16/2014
308 Glenwood Drive FAX: Township: Chapel Hill Expiration: 06/30/2017
Chapel Hill NC 27514 E-mail:elmore@niehs.nih.gov Resid/Spec Req: Number of Terms: 2
Special Repr: Veterinarian
Dan Dewitya Day Phone:919-906-6762 Sex: Male First Appointed: 03/03/2015
2 Evening Phone:919-906-6762 Race:Asian American Current Appointment: 03/03/2015
112 Bolinwood Dr FAX: Township: Chapel Hill Expiration: 06/30/2016
Chapel Hill NC 27514-2643 E-mail:dan.dewitya @gmail.com Resid/Spec Req: At-Large Number of Terms:
Special Repr: Pharmacist
Jessica Frega Day Phone:919-426-9465 Sex: Female First Appointed: 06/16/2015
3 Evening Phone:919-426-9465 Race:Caucasian Current Appointment: 06/16/2015
1511 Park Lane FAX: Township: Hillsborough Expiration: 06/30/2017
Hillsborough NC 27278 E-mail:jessicalois @gmail.com Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: Citizen/Commissioner Appointment
Liska Lackey Day Phone:919-968-1450 Sex: Female First Appointed: 06/07/2011
4 Chair Evening Phone: Race:Caucasian Current Appointment: 09/16/2014
507 Oak Ave FAX: Township: Chapel Hill Expiration: 06/30/2017
Carrboro NC 27510 E-mail: liska.lackey@gmail.com Resid/Spec Req: At-Large Number of Terms: 2
Special Repr: Nurse
Reena Mehta Day Phone:919-943-9039 Sex: Female First Appointed: 06/16/2015
5 Evening Phone:919-943-9039 Race:Other Current Appointment: 06/16/2015
1400 Starmont Drive FAX: Township: Hillsborough Expiration: 06/30/2018
Hillsborough NC 27278 E-mail:reenagupta429 @gmail.com Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: Optometrist
Monday,May 23,2016 Page 1
4
Board and Commission Members
And Vacant Positions
Board of Health
Meeting Times: 7:00 pm fourth Wednesday of each month Terms: 3 Contact Person: LaToya Strange
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
Barbara Chavious Day Phone:919-732-3469 Sex: Female First Appointed: 09/15/2015
6 Evening Phone:919-732-3469 Race:Caucasian Current Appointment: 09/15/2015
401 N Nash St FAX: Township: Hillsborough Expiration: 06/30/2018
Hillsborough NC 27278 E-mail:Barbara_Chavious@unc.edu Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: Citizen/commissioner appointment
. Timothy Smith Day Phone:919-616-6491 Sex: Male First Appointed: 09/15/2015
7 Evening Phone:919-616-6491 Race:Caucasian Current Appointment: 09/15/2015
1107 Tupelo Drive FAX: Township: Hillsborough Expiration: 06/30/2018
Hillsborough NC 27278 E-mail:tsmith @ppaengineering.com Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: Professional Engineer
Nick Galvez Day Phone: 727-418-9921 Sex: Male First Appointed: 03/18/2014
8 Vice-Chair Evening Phone: 727-418-9921 Race:Other Current Appointment: 06/16/2015
403 N Elliott Road FAX: Township: Chapel Hill Expiration: 06/30/2018
Chapel Hill NC 27514 E-mail:ngalvez1234 @gmail.com Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: Citizen/Commissioner Appointment
Dr. Sam Lasris Day Phone:919-732-7362 Sex: Male First Appointed: 03/18/2014
9 Evening Phone:919-732-7362 Race:Caucasian Current Appointment: 03/18/2014
7020 Caviness Jordan Rd. FAX: Township: Cedar Grove Expiration: 06/30/2016
Cedar Grove NC 27231 E-mail:samlasris @hotmail.com Resid/Spec Req: At-Large Number of Terms: 1
Special Repr: Dentist
Dr. Paul Chelminski Day Phone:919-966-0471 Sex: Male First Appointed: 08/19/2009
10 Evening Phone:919-932-1755 Race:Other Current Appointment: 06/18/2013
116 Waiters 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
Monday,May 23,2016 Page 2
5
Board and Commission Members
And Vacant Positions
Board of Health
Meeting Times: 7:00 pm fourth Wednesday of each month Terms: 3 Contact Person: LaToya Strange
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
Mia Burroughs Day Phone:919-932-6282 Sex: Female First Appointed: 01/27/2015
11 Evening Phone:919-932-6282 Race:Caucasian Current Appointment: 01/27/2015
110 Cedar Hills Drive FAX: Township: Chapel Hill Expiration: 02/29/2016
Chapel Hill NC 27514 E-mail:mburroughs @orangecountync.gov Resid/Spec Req: At-Large Number of Terms:
Special Repr: B.O.C.C.
Monday,May 23,2016 Page 3
6
Thom Freeman
From: LaToya Strange
Sent: Thursday, March 31, 2016 12:21 PM
To: Thom Freeman
Cc: Colleen Bridger; Meredith Stewart
Subject: BOH Reappointments
Thom,
This email is to affirm that we will have three BOH recommended reappointment actions to place on the BOCC June 8th
agenda. They are:
Paul Chelminski—3rd term recommendation
Dan Dewitya—15t full term recommendation
Sam Lasris—2nd term recommendation
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7
Page 1 of 2 Dan Dewitya
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dan Dewitya
Name Called:
Home Address: 112 Bolinwood Dr
Chapel Hill NC 27514-2643
Phone (Day): 919-906-6762
Phone (Evening): 919-906-6762
Phone (Cell): 919-906-6762
Email: dan.dewitya @gmail.com
Place of Employment: Lincoln Community Health Center
Job Title: Pharmacist
Year of OC Residence: 1985
Township of Residence: Chapel Hill
Zone of Residence:
Sex: Male
Ethnic Background: 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 pharmacya€TMs 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 (DRAG 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 Seniorsa€TM Health
Insurance Information Program (SHIIP)and became a SHIIP counselor to help seniors navigate
Medicare. I am also a member of Senior PharmAssista€TMs formulary committee.
http://www.ncdoi.com/shiip/http://seniorpharmassist.org/
Reasons for wanting to serve on this board:
8
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
9
Page 1 of 2 Sam Lasris
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Sam Lasris
Name Called:
Home Address: 7020 Caviness Jordan Rd.
Cedar Grove NC 27231
Phone (Day): 919-732-7362
Phone (Evening): 919-732-7362
Phone (Cell):
Email: samlasris @hotmail.com
Place of Employment: Self Employed
Job Title: Dentist
Year of OC Residence: 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: 12/27/2013
11
Page 1 of 4 Paul Chelminski
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Paul Chelminski
Name Called:
Home Address: 116 Watters Road
Carrboro NC 27510
Phone (Day): 919-966-0471
Phone (Evening): 919-932-1755
Phone (Cell):
Email: chelminp @med.unc.edu
Place of Employment: UNC Department of Medicine
Job Title: Associate Professor of Medicine
Year of OC Residence:
Township of Residence: Chapel Hill
Zone of Residence: . . .
Sex: Male
Ethnic Background: Other
Community Activities/Organizational Memberships:
Past Service on Orange County Advisory Boards:
Boards/Commissions applied for:
Supplemental Questions:
Work Experience: Clinical Associate Professor of Medicine, University of North Carolina
School of Medicine, Department of Medicine, September 2008 to present.
Clinical Assistant Professor of Medicine, University of North Carolina School of Medicine,
Department of Medicine, 2003 through August 2008.
Adjunct Clinical Assistant Professor of Family Medicine, University of North Carolina
School of Medicine, Department of Family Medicine, 2004 to present.
Staff Physician, Chatham Hospital, Siler City, NC, 1999 to present.
Clinical Instructor in Medicine, University of North Carolina School of Medicine,
Department of Medicine, 1999-2003.
Clinical Instructor in Family Medicine, University of North Carolina School of Medicine,
Department of Family Medicine, 1999-2003.
Clinical Instructor in Pediatrics, University of North Carolina School of Medicine,
Department of Pediatrics, 1999-2003.
12
Page 2 of 4 Paul Chelminski
Attending Emergency Department Physician, Chatham Hospital, Siler City, NC, 1999-
2001 (fulltime), 2001-2003 (part-time).
Attending Inpatient Physician, Chatham Hospital, Siler City, NC,1999-2001 (fulltime),
2001-2003 (part-time).
Attending Outpatient Physician, Chatham Primary Care, 311 North Fir Avenue, Siler City,
NC, 1999-2001.
Resident in Internal Medicine and Pediatrics, the University of North Carolina Hospitals,
Chapel Hill, NC, 1995-1999.
Research Assistant, University of North Carolina at Chapel Hill Department of
Pharmacology, lab of Eugene Scarborough, PhD, 3/1991-7/1991.
Research Specialist, University of Pennsylvania, Department of Biochemistry and
Biophysics, lab of P. Leslie Dutton, PhD. 1988-1990 (worked fulltime while taking
premedical curriculum at night).
Intern, The Wilson Quarterly, The Woodrow Wilson International Center, Smithsonian
Institution, Washington, DC, 1988 (authored book reviews and periodical summaries, copy
editing, fact checking, conducted interviews, performed research in Library of Congress).
Volunteer, The United States Peace Corps, Mali, West Africa, Community Development
Volunteer involved in dissemination of improved woodstove technology, sustainable
forestry, and obtaining funding for a maternity ward in a rural community through the
United States Agency for International Development, 1985-1987.
"Jug Hustler," La Companie Generale de Geophysique, performed manual laborer on a
seismic team in northeastern mountains of France. Work involved planting miles of
seismic sensors in ground and conducting controlled explosions, summer 1981.
Volunteer Experience: North Carolina State Government Service
Chairman, Subcommittee on Public Education for Proposed Controlled Substance
Prescription Monitoring Program/Legislation in North Carolina under the aegis of
Leadership Committee on Unintentional Drug Deaths, North Carolina Department of
Health and Human Services, Injury Prevention Unit. Was the sole physician and clinician
among leadership team that developed and lobbied for legislation that implemented a
prescription drug monitoring system intended to stem epidemic of prescription opioid
abuse in North Carolina. All North Carolina physicians can now access system; more
information available at http://www.ncdhhs.gov/mhddsas/controledsubstance/index.htm.
Served from 2002 through 2006.
Member North Carolina Medical Society Prescription Drug Abuse Forgery and Diversion
Task Force. Provided expert background information and testimony to promote passage
of enabling legislation for statewide prescription drug monitoring program. Testimony also
intended to promote acceptance of system by physicians. Task force active in 2006 and
13
Page 3 of 4 Paul Chelminski
attended 4 meetings.
Testimony provided to North Carolina State Health Director, North Carolina
Epidemiologists and representatives of professional and commercial pharmacy
organizations regarding the preparation of legislation creating statewide electronic public
health surveillance system to monitor controlled substance prescriptions, 3 April 2005.
Testimony occurred under auspices and authority of Leadership Committee on
Unintentional Drug Deaths, North Carolina Department of Health and Human Services,
Injury Prevention Unit.
Testimony provided to North Carolina Secretary of Health and Human Services and North
Carolina Attorney General regarding preparation of legislation creating statewide
electronic public health surveillance system to monitor controlled substance prescriptions,
17 March 2005. Testimony occurred under auspices and authority of Leadership
Committee on Unintentional Drug Deaths, North Carolina Department of Health and
Human Services, Injury Prevention Unit.
Member of Leadership Committee on Unintentional Drug Deaths, North Carolina
Department of Health and Human Services, Injury Prevention Unit. 2004-2005: 12 Oct.
2004, 25 January 2005.
Education: Masters in Public Health, University of North Carolina at Chapel Hill, Public
Health Leadership, 2003
Primary Care Research Fellow (NRSA), The Cecil G. Sheps Center for Health Services
Research, University of North Carolina at Chapel Hill, 2001-2003 Robert Wood Johnson
core Curriculum (through Robert Wood Johnson Clinical Scholars Program), University of
North Carolina at Chapel Hill, 1001-2002. Doctor of Medicine with Honors, Uinversity of
North Carolina at Chapel Hill School of Medicine, 1995 Post-Baccalaureate Pre-Health
Program (no degree), University of Pennsylvania, 1988-1990. Bachelor of Arts (Magna
cum laude), Duke University, Medieval and Renaissance Studies, 1985. High School
Diploma, Deerfield Academy, Deerfield Massachusetts, 1981,
Other Comments:
Outpatient Chief Resident in Internal Medicine: Developed position description for first
outpatient chief resident in Department of Medicine to complement three existing hospital-
based chief residents. Proposal presented to department's educations committee and
leadership in spring of 2008 and approved by committee and chairman of medicine. First
outpatient chief to start in June 2008. continuity Elective for Internal MedicineInterns:
Developed and implemented one month outpatient rotation. Residents rotatethrough
several modules including: acute care, diabetes care, anticoagulation, chronic pain
management continuity clinic, travel clinic, and one-on-one preceptorship with attending
physician . January 2008 to present. Ambulatory Care Seminar, University of North
Carolina at Chapel Hill Internal Medicine Clinic: Established weekly noon seminarin
department of medicine devoted to dealing with issues in ambulatory medicine.
Multidisciplinary conference with attendees including medical students and residents,
pharmacy students and residents as well as medicine faculty. Archive of conferences
14
Page 4 of 4 Paul Chelminski
availabe at: http://www.med.unc.edu/medicine/generalm/Wednesday
AmbulatoryCareSeminar.htm. 2007 to present. Quality Improvement Curriculum, Have
implemented systematic quality improvement curriculum for resident physicians and
senior medical students rotating through University of North Carolina at Chapel Hill
Internal Medicine Clinic. Specifics of curriculum and projects completed to date availabe
at http://www.med.unc.edu/medicine/generalm/quality.html#reports. Hypertension Quality
Improvement Initiative: Using internet-based patient registries all internal medicine
residents review the outcomes of their patients with hpertension through electronic chart
review and calculate overall cardiovascular risk. Information is used to target high risk
patients and those with poorly controlled hpertension for intensification of medical
management within UNC Internal Medicine Clinic. Residents were instrumental in
developing management algorithms. They are engaged in Plan-Do-Study-Act cycles that
are patient outcome-based. Initiative satisfies internal medicine core competencies of
practice-based learning and system-based practice. 2006 to present. Same Day Clinic,
University of North Carolina at Chapel Hill Internal Medicine Clinic: In 2005-6, was
charged by the leadership of the Department of Medicineand Division of General Internal
Medicine to structure and develop the Internal Medicine Same Day clinic as a model
venue for delivering efficient, high quality acute care within a teaching curriculum. 2005 to
present. Contiuity of Elective for Internal Medicine Residents: Developed and
implemented continuous two month outpatient rotation for Internal Medicine Residents.
Residents rotate through several modules including: acute care, anticoagulation, diabetes
cae, chronic pain management, continuity clinic, travel clinic, and one-on-one
preceptorship with attending physician. 2005 to present. STAFF COMMENTS: Originally
applied for Board of Health 1/26/2009. ADDRESS VERIFICATION: 116 Watters Road,
Carrboro is Chapel Hill Township, CA City Limits.
This application was current on: 1/26/2009 1:05:08 PM Date Printed: 12/31/2013
15
BOCC Attendance Report For Advisory Boards
Board of Health Jan /2015 — March /2016
Member Appointed Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
Paul Chelminski 08/19/2009 A A P A P P P P A A AP P
Sam Lasris 03/18/2014 P P P A AP P PP P AP P
Dan Dewitya 03/08/2015 P PP PP P PP P P AP
P: Present A:Absent
Current through-03/31/2016
16
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person: LaToya Strange
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 Res.Eligibility: Carrboro City Limits
Date Applied: 05/23/2016
Skills: Also Serves On:
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: Township: Chapel Hill
E-mail: bdeckeninc @gmail.com Res.Eligibility: Carrboro Transition Are
Date Applied: 05/11/2016
Skills: Environmental Scientist Also Serves On:
Skills: Phannacist Also Serves On:
Skills: Real Estate Broker Also Serves On:
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: lgriffin2 @nc.rr.com Res.Eligibility:
Date Applied: 05/08/2016
Skills: Also Serves On:
Greg Hughes Day Phone: 919-928-6438 Sex: Male
1601 Dunn Place Evening Phone: 919-928-6438 Race: Caucasian
Hillsborough NC 27278 Cell Phone: 919-928-6438 Township: Hillsborough
E-mail: Hugo1380 @gmail.corn Res.Eligibility: C.H.City Limits
Date Applied: 05/11/2016
Skills: Also Serves On:
Dr Daniel Kemp Day Phone: 336-406-7871 Sex: Male
2007 Starterwood Ln Evening Phone: 336-406-7871 Race: Other
Hillsborough NC 27278 Cell Phone: 3364067871 Township: Bingham
E-mail: spartan1999 @gmail.com Res.Eligibility:
Date Applied: 05/05/2016
Skills: Also Serves On:
Monday,May 23,2016 Page 1 of 3
17
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person: LaToya Strange
Board of Health Contact Phone: 919-245-2411
Patrick Murphy Day Phone: 919-304-9759 Sex: Male
1500 Prairie Court Evening Phone: 919-304-9759 Race: Caucasian
Mebane NC 27302 Cell Phone: 919-304-9759 Township: Cheeks
E-mail: Counseling@PatrickMurphyLPC.com Res.Eligibility: County
Date Applied: 05/05/2016
Skills: Also Serves On:
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: pedrozaantonia @yahoo.com Res.Eligibility: Hillsborough ETJ
Date Applied: 05/11/2016
Skills: Also Serves On:
Katy Stewart Day Phone: 9196915555 Sex: Female
8407 NC 57 Evening Phone: 9196915555 Race: Caucasian
Rougemont NC 27572 Cell Phone: 9196915555 Township: Hillsborough
E-mail: katystewl @gmail.com Res.Eligibility:
Date Applied: 01/15/2016
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.stinnan @grnail.com Res.Eligibility: County
Date Applied: 05/08/2016
Skills: Also Serves On:
Diane Uzarski Day Phone: 9196688595 Sex: Female
3017 Pleasant Green Rd Evening Phone: 9193097974 Race: Caucasian
Durham NC 27705 Cell Phone: 9193097974 Township: Eno
E-mail: diane.uzarski @drn.duke.edu Res.Eligibility: County
Date Applied: 05/05/2016
Skills: Also Serves On:
Monday,May 23,2016 Page 2 of 3
18
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person: LaToya Strange
Board of Health Contact Phone: 919-245-2411
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: 919-602-2440 Township: Chapel Hill
E-mail: dwilliams @unc.edu Res.Eligibility: Carrboro City Limits
Date Applied: 05/05/2016
Skills: Also Serves On:
Geraldene Yagnow Day Phone: 919-696-5420 Sex: Female
1113 Saluda Ct Evening Phone: 919-696-5420 Race: Caucasian
Chapel Hill NC 27514 Cell Phone: 919-696-5420 Township: Chapel Hill
E-mail: geri.yagnow @nc.rr.com Res.Eligibility: Chapel Hill Township
Date Applied: 05/05/2016
Skills: Also Serves On:
Dr. Tracey Yap Day Phone: 502-686-0016 Sex: Female
834 Providence Glen Drive Evening Phone: 919-240-4793 Race: Caucasian
Chapel Hill NC 27514 Cell Phone: Township: Chapel Hill
E-mail: tracey.yap @duke.edu Res.Eligibility:
Date Applied: 05/11/2016
Skills: Director Also Serves On:
Skills: Nurse Also Serves On:
Monday,May 23,2016 Page 3 of 3
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Page 1 of 2 Debra Aycock
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Debra Aycock
Name Called:
Home Address: 301 Tramore Drive
Chapel Hill NC 27516
Phone (Day): 919-817-6037
Phone (Evening): 919-817-6037
Phone (Cell): 919-817-6037
Email: debaycock22 @gmail.corn
Place of Employment: Retired after 11 years at BCBSNC
Job Title: Clinical Pharmacist
Year of OC Residence: 1984
Township of Residence: Chapel Hill
Zone of Residence: Carrboro City Limits
Sex: Female
Ethnic Background: 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:
20
Page 2 of 2 Debra Aycock
Other Comments:
This application was current on: 5/23/2016 Date Printed: 5/23/2016
21
Page 1 of 2 Brian Decker
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Brian Decker
Name Called:
Home Address: 109 Dublin Road
Chapel Hill NC 27516
Phone (Day): 919-360-6529
Phone (Evening): 919-360-6529
Phone (Cell):
Email: bdeckerunc @gmail.com
Place of Employment: CVS Health
Job Title: Staff Pharmacist
Year of OC Residence: 2000
Township of Residence: Chapel Hill
Zone of Residence: Carrboro Transition Area
Sex: Male
Ethnic Background: 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
22
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:
Formerly sat 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 I 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: 5/11/2016 Date Printed: 5/11/2016
23
Page 1 of 1 Linda Griffin
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Linda Griffin
Name Called:
Home Address: 321 Mitchell Street
Hillsborough NC 27278
Phone (Day): 919-630-9078
Phone (Evening): 919-630-9078
Phone (Cell): 919-630-9078
Email: Igriffin2 @nc.rr.com
Place of Employment: Duke Health System
Job Title: Retried - Health Center Administrator
Year of OC Residence: 1981
Township of Residence: Hillsborough
Zone of Residence:
Sex: Female
Ethnic Background: 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: 6/2/2015 Date Printed: 5/4/2016
24
Page 1 of 1 Greg Hughes
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Greg Hughes
Name Called:
Home Address: 1601 Dunn Place
Hillsborough NC 27278
Phone (Day): 919-928-6438
Phone (Evening): 919-928-6438
Phone (Cell): 919-928-6438
Email: Hugo1380 @gmail.com
Place of Employment: Durham VA Medical Center
Job Title: Chief, Social Work Service
Year of OC Residence: 2008
Township of Residence: Hillsborough
Zone of Residence: C.H. City Limits
Sex: Male
Ethnic Background: Caucasian
Community Activities/Organizational Memberships:
Orange County Rec - Basketball Coach
HYAA Baseball - Coach
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 worked in public health and mental health for over 25 years.
Reasons for wanting to serve on this board:
I would like to be more involved in my community.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 5/11/2016 Date Printed: 5/11/2016
25
Page 1 of 2 Daniel Kemp
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr Daniel Kemp
Name Called:
Home Address: 2007 Starterwood Ln
Hillsborough NC 27278
Phone (Day): 336-406-7871
Phone (Evening): 336-406-7871
Phone (Cell): 3364067871
Email: spartan1999 @gmail.com
Place of Employment: Quintiles and UNC
Job Title: Director of Process Quality Assurance and Director
Year of OC Residence: 2013
Township of Residence: Bingham
Zone of Residence:
Sex: Male
Ethnic Background: 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. I
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:
26
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. I
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: 5/5/2016 Date Printed: 5/5/2016
27
Page 1 of 2 Patrick Murphy
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Patrick Murphy
Name Called:
Home Address: 1500 Prairie Court
Mebane NC 27302
Phone (Day): 919-304-9759
Phone (Evening): 919-304-9759
Phone (Cell): 919-304-9759
Email: Counseling @PatrickMurphyLPC.com
Place of Employment: Patrick Murphy MA, LPC
Job Title: Licensed Professional Counselor
Year of OC Residence: 2006
Township of Residence: Cheeks
Zone of Residence: County
Sex: Male
Ethnic Background: Caucasian
Community Activities/Organizational Memberships:
None current.
Former: National Association of Forensic Counselors
Past Service on Orange County Advisory Boards:
I am serving on no other advisory boards
Boards/Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
I have a BA in psychology and an MA in Counseling Psychology. I am also a Licensed
Professional Counselor in North Carolina. I have worked in government agencies, non-profit
agencies, and for-profit community clinics. My experience has been primarily with the poor and I
am regularly in contact with community and government stakeholders.
Reasons for wanting to serve on this board:
Mental health is changing, and many have access only through state and county services. The
quality of a community s mental health infrastructure can affect the economic stability of its
citizens and the services that support them. Inadequate access can put a strain on emergency,
law enforcement, and judicial resources.
Conflict of Interest:
Supplemental Questions:
Other Comments:
28
Page 2 of 2 Patrick Murphy
This application was current on: 5/5/2016 Date Printed: 5/5/2016
29
Page 1 of 2 Antonia Pedroza
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Antonia Pedroza
Name Called:
Home Address: 409 Saint Marys Road
Hillsborough NC 27278
Phone (Day): 252-738-3770
Phone (Evening): 919-760-0210
Phone (Cell): 919-760-0210
Email: pedrozaantonia @yahoo.com
Place of Employment: Vance County Government
Job Title: DSS Director
Year of OC Residence: 2002
Township of Residence: Hillsborough
Zone of Residence: Hillsborough ETJ
Sex: Female
Ethnic Background: Hispanic
Community Activities/Organizational Memberships:
none in Orange
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 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:
OPC Oversight Board
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:
30
Page 2 of 2 Antonia Pedroza
Work Experience: Human Services: over 25 years
Special Education (Durham County Schools)
Community Rehabilitation Programs
Durham County DSS
Volunteer Experience: Special Olympics
Red Cross (WIC) program
Education: Masters in Business Admin. (Pfeiffer)
Masters in Health Admin. (Pfeiffer)
BA in Business Admin. (Mount Olive)
Associates in Arts (DTCC)
Other Comments:
STAFF COMMENTS: Originally applied for Human Relations Committee 7/29/09.
ADDRESS VERIFICATION: 409 Saint Marys Road, Hillsborough is Hillsborough
township, HI jurisdiction.
This application was current on: 5/11/2016 Date Printed: 5/11/2016
31
Page 1 of 2 Katy Stewart
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Katy Stewart
Name Called:
Home Address: 8407 NC 57
Rougemont NC 27572
Phone (Day): 9196915555
Phone (Evening): 9196915555
Phone (Cell): 9196915555
Email: katystew1@gmail.com
Place of Employment: Self employed
Job Title: RN
Year of OC Residence: 1997
Township of Residence: Hillsborough
Zone of Residence:
Sex: Female
Ethnic Background: Caucasian
Community Activities/Organizational Memberships:
I am currently exploring ways to get involved with my community and advocate for the
clientele that I have been caring for my whole career. I have been a nurse for 25 years. I
have worked with the geriatric community during those years with 22 years spent in
hospice care. I have recently decided to work for myself and care for those as I can. I am
researching housing for the elderly and terminally ill. I want to provide a safe caring
environment for this population. I believe I have many years of experience to offer.
Past Service on Orange County Advisory Boards:
None
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Background, education and experience relevant to this board:
25 years in nursing of the elderly. Head of hospice care during most of my career.As well as
home health care, visiting most of all care homes in the 25 mile radius.
Reasons for wanting to serve on this board:
I would like to offer my knowledge that I have have gained in this field in a constructive, helpful
way. I want to be a patient advocate, speak for a population I know very well.
Conflict of Interest:
32
Page 2 of 2 Katy Stewart
Advisory Board on Aging
Background, education and experience relevant to this board:
As I stated above, 25 years in nursing of the elderly. Head of hospice care during most of my
career. As well as home health care, visiting most of all care homes in the 25 mile radius. I want
to be a patient advocate, speak for a population I know very well.
Reasons for wanting to serve on this board:
I want to offer any knowledge I have gained to speak for this population.
Conflict of Interest:
Board of Health
Background, education and experience relevant to this board:
As I stated above, 25 years in nursing of the elderly. Head of hospice care during most of my
career. As well as home health care, visiting most of all care homes in the 25 mile radius. I want
to be a patient advocate, speak for a population I know very well.
Reasons for wanting to serve on this board:
I want to be a patient advocate, speak for a population I know very well.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 1/15/2016 10:39:15 AM Date Printed: 5/4/2016
33
Page 1 of 2 Edward Stirman
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Edward Stirman
Name Called:
Home Address: 554 E Hatterleigh Ave
Hillsborough NC 27278
Phone (Day): 919-241-4912
Phone (Evening): 919-241-4912
Phone (Cell): 423-677-3295
Email: monty.stirman @gmail.com
Place of Employment: retired
Job Title: retired
Year of OC Residence: 2012
Township of Residence: Hillsborough
Zone of Residence:
Sex: Male
Ethnic Background: 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:
34
Page 2 of 2 Edward Stirman
This application was current on: 3/13/2014 2:40:34 PM Date Printed: 3/14/2014
35
Page 1 of 2 Diane Uzarski
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Diane Uzarski
Name Called:
Home Address: 3017 Pleasant Green Rd
Durham NC 27705
Phone (Day): 9196688595
Phone (Evening): 9193097974
Phone (Cell): 9193097974
Email: diane.uzarski @dm.duke.edu
Place of Employment: Duke University School of Nursing
Job Title: Chief of Staff to the Dean
Year of OC Residence: 2005
Township of Residence: Eno
Zone of Residence: County
Sex: Female
Ethnic Background: Caucasian
Community Activities/Organizational Memberships:
American Red Cross - Disaster Team volunteer since 2003
Previous Vice Chair of Board - San Francisco YMCA
Volunteer with the YMCA of High Point, NC.
Past Service on Orange County Advisory Boards:
I am interested in serving on the Department of Health Advisory Board. I am a doctoral of
nursing practice candidate at Duke University, and have a background in health policy,
injury prevention and emergency nursing.
Boards/Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
As an RN with 34 years of experience in intensive care and emergency nursing,' 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.
36
Page 2 of 2 Diane Uzarski
Conflict of Interest:
Supplemental Questions:
Other Comments:
Completed doctoral degree of nursing practice with new credentials: Diane Uzarski, DNP
MPH RN.
This application was current on: 5/5/2016 Date Printed: 5/5/2016
37
Page 1 of 1 Dennis Williams
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Dennis Williams
Name Called:
Home Address: 209 Lake Manor Road
Chapel Hill NC 27516
Phone (Day): 919-962-7122
Phone (Evening): 919-933-5408
Phone (Cell): 919-602-2440
Email: dwilliams @unc.edu
Place of Employment: University of North Carolina
Job Title: Faculty
Year of OC Residence: 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
38
Page 1 of 1 Geraldene Yagnow
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Geraldene Yagnow
Name Called:
Home Address: 1113 Saluda Ct
Chapel Hill NC 27514
Phone (Day): 585-615-6100
Phone (Evening): 585-615-6100
Phone (Cell): 585-615-6100
Email: geri.yagnow @nc.rr.com
Place of Employment: Retired
Job Title: Registered Nurse
Year of OC Residence: 2015
Township of Residence: Chapel Hill
Zone of Residence: Chapel Hill Township within C.H. city limits
Sex: Female
Ethnic Background: Caucasian
Community Activities/Organizational Memberships:
New resident in 2015
Past Service on Orange County Advisory Boards:
First application for service in Orange County.
Boards/Commissions applied for:
Board of Health
Background, education and experience relevant to this board:
Thank you for your review of my volunteer application. My background relevant to the Board of
Health as a registered nurse and certified case manager. I have clinical and case management
experience at inpatient and outpatient levels of care.
Reasons for wanting to serve on this board:
New to community,again, thank you again for your review of my application. I would like to serve
on the Board of Health to promote the cause that I care most about- health and well-being.
Conflict of Interest:
Supplemental Questions:
Other Comments:
This application was current on: 3/10/2015 9:37:47 AM Date Printed: 5/4/2016
39
Page 1 of 1 Tracey Yap
Volunteer Application
Orange County Advisory Boards and Commissions
Name: Dr. Tracey Yap
Name Called:
Home Address: 834 Providence Glen Drive
Chapel Hill NC 27514
Phone (Day): 502-686-0016
Phone (Evening): 919-240-4793
Phone (Cell):
Email: tracey.yap @duke.edu
Place of Employment: Duke University School of Nursing
Job Title: Assistant Professor
Year of OC Residence: 2011
Township of Residence: Chapel Hill
Zone of Residence:
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: 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: 5/11/2016 Date Printed: 5/23/2016