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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 c if t S ��g• �y 1 r b twc ai36 b tent to the •i' Y Diitedtcut e'I s+ 4 tl/ /' De/pcntment 3UU east Aron Sfteet ' ;', Are 27278 919-245-2411 Istrange @orangecountync.gov http://orangecountync.gov/departments/health �lFt.r i,r rice /mprov tlg health fnspi�rdnQ thong. 111,1111031 L you vo II s 1 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 19 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