HomeMy WebLinkAboutMINUTES - 09261995 - SD3 TO 1OARb OF SUPERVISORS
MARK FINUCANE,HEALTH SERVICES DIRECTOR ^,�,.,
FROM . Contra
September 26, 1995 COS a
DATE : ( f'y '�/
APPOINTMENTS TO THE MANAGED CARE COMMISSION vvvvvvi �►J
SUBJECT:
SPECIFIC REQUEST(S) OR RECOMMENDATIONS) & BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS:
A. APPOINT the individuals on list below to the Managed Care Commission(MCC)which
was established by the Board on May 16, 1995 (Attachment#1: Board Order of May 16,
1995).
B. DISSOLVE the HMO Advisory Board (also known as the CCHP Advisory Board) and
the Medi-Call Advisory Planning Commission(MAPC) effective September 30, 1995.
C. THANK the members of the CCHP Advisory Board and the MAPC and authorize
Certificates of Appreciation signed by the Chair of the Board to be sent to them.
Managed Care Commission Appointment Recommendations
I CCHP Medi-Cal Subscriber.- Doe Sofford
2407 Sycamore Avenue
Concord, CA 94520
1 CCHP Medicare Subscriber: (vacant)
1 CCHP Commercial Subscriber: Carl Doolittle
14 Dandridge Place
Pittsburgh, CA 94565
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CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOAAD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ONS pt-PMUE-f' _: APPROVED AS RECOMMENDED X OTHER _
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
X UNANIMOUS (ABSENT ----------- AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
CC: ATTESTED ..Steix�fi 2.,
PHIL BATCHELOR, CLERK OF THE BOARD OF
SUPERVISOR AND COUNTY ADMINISTRATOR
BY DEPUTY
M382 1-83
t f'
page two
1 Person sensitive to
medically indigent health care needs: Evelyn Rinzler
Contra Costa Legal Services
1017 Macdonald Avenue
Richmond, CA 94809
1 Physician: Kent Sack M.D.
4651 Pleasant Hill Rd. East
Martinez, CA
1 Other Provider: Joan Lautenberger R.N.
3979 S. Peardale Drive
Lafayette, CA 94549
9 At Large Members:
Mary Lavender Fujii Jeffrey Kalin
1136 Lindell Drive 1014 Camino Verde Circle
Walnut Creek, CA 94596 Walnut Creek, CA 94596
Michael Garcia Rosalind Love
2409 Saddleback Drive 231 Piedmont Lane
Danville, CA 94506 Pittsburg, CA 94565
Frances Greene Jack McGervey
56 Barrie Drive 23 Marlee Road
Pittsburg, CA 94565 Pleasant Hill, CA 94523
Michael Barris 'Raymond Smart
P. O. Box 6277 1158 Panoramic Drive
Moraga, CA 94556 Martinez, CA 94553
Reverend Curtis Timmons
P.O. Box 8213
Pittsburg, CA 94565
FINANCIAL IMPACT:
Funding for staff and committee functions comes from Local Initiative development funds from
the State and Federal government and from Medi-Cal capitation payments by the State.
BACKGROUND/REASON FOR RECOMMENDATION:
The Board of Supervisors, on May 16, 1995, established a Managed Care Commission (MCC)
which integrates the functions and duties of the current Contra Costa Health Plan Advisory
Board(CCHP Advisory Board) and the Medi-Cal Advisory Planning Commission(MAPC) and
further directed that upon the appointment of members of the MCC the CCHP Advisory Board
and the MAPC be dissolved.
The Board further approved a document which establishes the functions and duties and
community participation for the MCC;defines six MCC standing committees,their membership
and functions; and establishes membership criteria and the appointment and transition process for
the MCC.
The recommendations put forth herein are the product of a Joint Screening Committee which was
elected by both the CCHP Advisory Board and MAPC to recruit, interview, and recommend
appropriate candidates for the positions on the MCC. The Joint Screening Committee, with
CCHP staff, widely publicized the MCC position vacancies throughout the entire county by
means of all major news and electronic media, public service announcements, and letters to
interested parties. There were approximately 30 applications received. All those individuals so
interested were interviewed by members of the Committee or staff. Applications of
recommended candidates are attached. (Attachment#2)
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page three
The recommendations herein meet the Board's criterion that a majority of the appointments be
from the existing advisory bodies i.e. CCHP Advisory Board and MAPC. They fulfill the
criteria established for the positions. These recommendations are being put forth with one
position still vacant. The Committee is still recruiting for a Medicare member of CCHP. When a
suitable candidate is found a further recommendation will come before the Board. There is the
desire to proceed without this position filled at this time so that implementation of the MCC will
not be delayed and the work of this important commission is allowed to commence.
Tc�, rBOARD OF SUPERVISORS
FROM: Mark Finucane t.N it
Health Services Director
Costa
DATE: May 4, 1995 Cain
SUBJECT. ReEtructure of Contra Costa Health Plan Advisory Board and 'Aedi-Cal r,dvisory
Planning Commission into the establishmei,t of a Managed Care Commission.
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS:
A. ESTABLISH the Managed Care Commission (MCC) Which integrates th, furi,:tions
and duties of the current Contra Costa Health Plan Advisory Board (Advisory Board)
and the Medi-Cal Advisory Planning Commission (MAPC) and upon the appointment
of members of the MCC dissolve the CCHP Advisory Board and the MAPC.
B. APPROVE the attached document which establishes the functions and duties and
community participation for the MCC; and defines six MCC standing conunittees,
their membership and functions; and establishes membership criteria and the
appointment and transition process for the MCC.
FINANCIAL IMPACT:
Funding for staff and committee functions comes from Local Initiative development funds
from the State and Federal government and from Medi-Cal capitation payments by the State.
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)'.
ACTION OF BOARD ON May 16 , 1995 APPROVED AS RECOMMENDED _� OTHER _
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
X UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES. AND ENTERED ON THE ;MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
Contact : Milt Camhi 313-5004
cc: Health Services Director ATTESTED May_ 16,___1995
Contra Costa Health Plan PHIL BATCHELOR. CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
P�Pll
BY DEPUTY
M382 "7-83
BACKGROUND/ REASON FOR RECOMMENDATION:
Restructuring of the Contra Costa Health Plan (CCHP) guidance mechanism is essential in
light of the impending Local Initative changes required by the State Medi-Cal program and
the advent of intense competition for Medi-Cal enrollment by managed care organizations.
In Contra Costa County there will be two or more private HMOs competing with CCHP both
for current CCHP Medi-Cal enrollees and for the Medi-Cal beneficiaries in Fee-for-Service
who must select an HMO within the year. There will be rigorous competition to sign up all
these Medi-Cal beneficiaries. The County Board of Supervisors needs to have the benefit of
a unified advisory panel to help the Board make the critical service and operating decisions
that will allow CCHP to meet its competition. Currently CCHP has two advisory bodies; the
Advisory Board and the MAPC. Much of their work intersects and overlaps.
Currently the Advisory Board functions in an advisory capacity to CCHP on all aspects of the
health plan, including Medi-Cal, Medicare and commercial and Basic Adult Care membership
issues. The MAPC was created to ensure provider, beneficiary, and community input to the
development of the Medi-Cal Local Initiative. It has a September 1996 sunset date and the
term of office for its members expires December 31, 1995. With the major influx of Medi-
Cal members and the need for continued input from the community, joining of the functions
and duties of both bodies is warranted and the resultant streamlining is beneficial.
The CCHP Advisory Board and the MAPC met independently several times, met together,
and formed a Joint Work Group in order to formulate a plan of restructuring. Options were
examined with the assistance of Dr. Henrik Blum, Professor Emeritus UC Berkeley, who
served as a consultant on the project. The proposed Managed Care Commission
recommendations were adopted unanimously by the CCHP Advisory Board; unanimously by
the Joint Work Group; unanimously by the MAPC Executive Committee; by a majority of the
full MAPC; and unanimously by the Board of Supervisors on April 11, 1995.
ATTACHMENT #1:
BOARD ORDER OF
MAY 16, 1995
,
CONTRA COSTA COUNTY MANAGED CARE COMMISSION
OVERVIEW
The Managed Care Commission is a 15 member Advisory Body appointed by the
Board of Supervisors to act as the guidance mechanism of CCHP. The MCC replaces
the CCHP Advisory Board and the MAPC and takes on the functions of both bodies.
Meetings of the MCC and its committees are open to the public, consistent with the
Ralph M. Brown Act and County statutes. 'Work of the committees, once accepted by
the MCC, would be the basis for MCC advice to relevant bodies including the Board
of Supervisors, the State Department of Health Services, the Federal Health Care
Financing Administration, among other agencies.
FUNCTIONS AND DUTIES
Functions and duties of the MCC will include:
a. Cover the health care concerns for the Medi-Cal, Medicare, Commerical and
Medically Indigent persons served by the County.
b. Assure provider, consumer and community, as well as gender, ethnic, cultural
and geographically diverse population input to deliberations and decision-
making. (The Board of Supervisors does this by its requirements for
membership on the MCC and the MCC does likewise by its appointments to its
committees.)
C. Do long range planning and policy formulation and make recommendations to
Board of Supervisors, County HSD Director and Executive Director of
CCHP/Local Initiative.
d. Study and make recommendations to the Executive Director of CCHP on
operational objectives, policies and procedures and recommend changes as well
as revised service, product development, marketing, and data gathering
priorities.
e. Assure effectiveness, quality (including good outcomes), efficiency, access,
acceptability of CCHP services by ongoing as well as periodic formal reviews
of information produced by an up-to-date Management Information System and
other sources.
f. Regularly review the CCHP operational budget and amendments thereto.
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g. Review, analyze and advise the.Board of Supervisors, HSD Director and
Executive Director of CCHP of the overall.progress, constraining or threatening
needs and special problems of CCHP.
h. Encourage public understanding of CCHP and provide support throughout the
County for its development.
i. Prioritize and assign issues to appropriate committees.
CONVV flTTEE STRUCTURE: MEMBERSHIP: AND FUNCTIONS
1. There will be an Executive Committee of the MCC with at least one member who is a
subscriber member of the CCHP.
2. There will be six standing committees of the MCC with names and functions as
follows:
a. Health Care Delivery and Quality 4aintenance
Study outcomes of delivery approaches, of regionalization of services, of
modes of access, of modes of treatment and of follow-up to determine if
desired objectives are met. Make recommendations.
b. Finance and Management
Study budgets, expenditures, income streams and discrepancies between
budgeted versus actual occurrences. Create and maintain up-to-date financial
practices. Maintain forward looking personnel practices. Review and
coordinate with County business and personnel practices. Make
recommendations.
C. Product Development and Marketing
Study needs of current and potential subscribers for scope of services, scope of
benefits, coverage, price, access, acceptability, satisfaction including concerns
of providers. Examine patterns of enrollments and disenrollments of.CCHP
members and of competitors. Study alternative procedures. Make
recommendations.
d. Provider Issues
Determine and analyze issues of recruitment, retention, satisfaction, loss of
providers, as well as factors affecting productivity, patient relations, means of
covering hard to serve areas, seniority, bonuses, termination, interprofessional
relationships, utility of teams, accessibility, referral and specialist issues, as
well as provider concerns regarding facilities. Make recommendations.
e. Member and Consumer Advocacy
Obtain feedback from current and potential subscribers, analyze issues raised,
also trends of difficulties and desires, geographic, gender, ethnic and other
facets of consumer concerns, and cover access and beneficiary. issues, overview
grievance procedures. Make recommendations.
f. Plannine, Governance and By Laws
Crucial long term function is to carry out continuing study of impending and
threatened Federal and State program and financing changes and their
relationship to CCHP growth trends and functional needs. Create plans
accordingly and recommend policy, structural and governance changes, as well
as strategic plans.
I .There may be Ad Hoc Committees of the MCC. These will be created by the MCC
for special issues or concerns that do not fit into the work of the standing committees
or that may involve several of them. The assignment, membership, and duration will
be set by the MCC.
4. Committee chairs must be members of MCC. Committee members need not be
members of MCC. In addition to the 15 Commission members any individual or
organization may attend and participate on any appropriate committee that is
established.
5. MCC committee chairs are appointed by the MCC chair (initially co-chairs).
MCC 11IE)\IEBERSHIP, APPOINTMENTS: AND TRANSITION PROCEDURES
1. The Board of Supervisors as a whole shall make the appointments to the MCC. There
will be 15 appointed members of the MCC: no less than one Medi-Cal subscriber, one
Medicare subscriber; one commerical subscriber; one person sensitive to medically
indigent health care needs; one physician, non-contracting; one other provider, non-
contracting; and no less than nine at large members, non-contracting.
2. The Board of Supervisors appointments reflect the County's ethnic, cultural, gender
and geographic diversity.
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3. The Board of Supervisors will appoint members of the MCC who are dedicated,
health-care interested, capable, public-spirited individuals, who want to make CCHP an
outstanding health care plan. The Board of Supervisors will not select individuals
because they fit any specific skill or area of expertise. However, it list of desirable
capacities appears below to be used in making the choices for the members to be
appointed. These are in noway prerequisites for a position on the MCC, but do bring
valuable areas of experience to the MCC when present in a suitable candidate:
Ambulatory care
Business interests
Consumer advocacy
Evaluation of outcomes
Finance
Health care law
Health Issues: children„ women, elderly, cultural,
ethnic, linguistic, disabled
HMO administration
Labor
Marketing
Nursing administration and practice
Nutrition education and. services
Personnel
Public health and prevention
4. They are voluntary, unpaid positions, but actual and necessary expenses are to be
reimbursed as per County practice.
1110TIAL APPOINTNfENTTS
1. In the first round of.MCC appointments, the ;Board will endeavor to appoint a
majority from current members of the HMO Advisory Board and MAPC bodies if
there is sufficient interest and expertise among the current eligible membership.
2. Term of office is for three years. Persons who are involved as contractors with CCHP
cannot be members of the MCC nor can Health Services Department employees.
Once selected by the Board of Supervisors, the 15 initial appointees will be choserf^by
lottery, 1/3 for 1 year, 1/3 for 2 year term, and 1/3 for 3 year term.
3. Reappointment can be made to a maximun of 2 consecutive full 3 year terms.
Subsequently, after an absence of I year, a former MCC member can be appointed for
a full term.
4. Initially the current chairs of the MAPC and HMO Advisory Board will be appointed
to the MCC as part of the majority who are drawn from the current MAPC and
Advisory. Board. They will serve as interim co-chairs of the MCC for a period not to
exceed 4 months. They will appoint the initial committee chairs -and members of the
MCC standing committees. The MCC will elect its chair once the co-chair term is
over.
5. A special recommendation committee of 2 members each from the MAPC and the
Advisory Board, and CCHP Executive Director or his designee(s), will recruit widely
for MCC applicants, assure that all applications including those of current eligible
HMO Advisory Board and MAPC members are forwarded to the Board of
Supervisors, and recommend to the Board initial members for the MCC.
6. The Director of Health Services is an ex-officio, non-voting member.
7. The Executive Director of CCHP is an ex-officio, non-voting member.
8. The Board of Supervisors function as ex-officio, non-voting members.
BY LAWS
The MCC shall establish By-Laws which include officers; member absence policies; rules of
procedures; conduct of business; and establishment of rules for a quorum.
CONFLICT OF INTEREST
Board Policy for Managed Care Commission.
A. Even though persons who are involved as contractors with CCHP cannot be
members of the MCC, in the course of MCC business, issues or events may
arise that could possibly constitute a conflict of interest for members.
Therefore, MCC members must file an initial and annual conflict of interest
statement. Failure to file such a statement may result in the member's removal.
B. Members may participate on issues in all discussions including those having a
direct financial impact on the members and/or their institutions. However, no
member may vote on an issue in which the member and/or the member's
organization or their immediate family member(s) has a direct financial conflict
of interest.
STAFFING
The MCC and its committees will be staffed by Contra Costa Health Plan and County
Health Services Department administrative staff.
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ATTACHMENT #2:
APPLICATIONS
r CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE!
APPLICATION FORM
Name of advisory board applying for: Managed Care Commission (MCC
(Application Form must be typed or hand printed.)
llttt^ "1'ersans aha rare tnvolued tsontr�tctxs zo�th 'crvlla ref zhe
near can Ills S�rvaces Deiartment }'e :;."
Please answer.•
Are you currently employed by CCHP or HSD? yes+no�—Z
if yes, please explain
Are you or your employer now a contractor to CCHP? yes_ no s/
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes_ no t/f yes, please explain
Name of Applicant: jbOC Sac—Forrk
Home Address: a X107 S LA(-c' rv^oy"- A ve' Home Phone:
C,crc;cA I CA qysac
Business Address: Work Phone:
Signature: Date:
Personal Experience, Skills and Interests
Education/Background: K� y�k� ' C-Ok ayov, ,_ C)vt, '���`^' CQ <<`��-
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INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
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Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan.The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, please complete the questionnaire below.
Your name:
1. Are you a member of CCHP? V)(\e At' ^�,( rV,,tj.
2. How long have you been a resident of Contra Costa County? -30
3. Have you served on the CCHP Advisory Board) How long? '/
4. Have you served;on the Medi-Cal Advisory Planning Commission? _How long?
5. In which area of the County do you reside (East, West, Central?)CXA _How long? -'�O
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"?
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(z)I worked as Human Resources Specialist for IBM)
a. Ambulatory care
b. Business interests
C. Consumer advocacy
d. Evaluation of outcomes
e. Finance
f. Health care law
g. Health Issues: children, women, elderly, cultural, ethnic, linguistic, disabled
fie.Gl4, )SS,.tfS Cl c.onceyrr%1 10 Viae n�Itcd&
a,,A rn[.c, c. l,l i 11
h. HMO administration
is Labor
(Please continue on reverse side)
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j. M,2rketing• G
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel
n. Public health and prevention
o. Other 1 +
8. Why do you want to be a member of the Managed Carne Commission and what do you believe
you can contribute? k)c.r,A- 42` p- pproc i,,Vg.Y- o��1,.Q( YY\L k T�-o ��-v V ile
F 1 ` h
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C"S (pZL k` C�S t_ (� I G-A;r G v, 0,AA
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance_
b. Finance and Management
C. Product Development and Marketing
d. Provider Issues
C. Member and Consumer Advocacy
f. Planning, Governance and By-Laws
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
FEU LOCALI MARTINEZ 5102281"Vw P.03
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APPLICATION FO
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Form with be Wed or lwr pri red)
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se yos� turre►trly employed by CCFJP or,#$2)? yes no
yes,P e explain
re y0j, or your employer nom a<cancrarcor;ro CY.HP? yes no� +
ye41 n�OQte Quin
re you an ter?irrirh an o I 1
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Name,of Applicant. 000b" Ile
Home Address: 00,0V R i(RC)t #a/- ome Pho e: o
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;!Business Address: ' ork Phone, s l �44_
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ersen Experience, Skills and Interests i
Educa�ion/Background: v `
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pecizJ Interests: 4214"a l i f G Uk I f I
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l., A-Urn completed appliewtion to Lynn Morris;Conch Costa]FIc3it Pl.sn, S9>
facer j venue,Suit ,
ttineL CA 94553,FAX*(S10) 313.6M2
i 1.: 1.1 mbers of some advisory 4c.4cj may be regained to free anauaI u ice of Inti=1 tetmitnu.
3.! X1 etints of advisory bodies may 6e belt? in ?rianirteZ or in area accessible
j 4.11 AJ Brings may be hc{d d:Ftcr in the ercnia o duriu the �'P41 c 2nnsporta 1
8s € ys, 311}•once oritwice cnu►nth, +.
1 5.1{ Some boarii; assign rejembers 10 commuters or;work group rcquir aL 2"tinnatr1me.
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by do you want to bei tkczlber of the Manage Care mmission+and hat'do yol
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c MCC mill have six Vanding eommirrees. Please rank to 6 (1 b 1/6 CASI) cam it tcs on
hick y u t►•ould be interned in serving as a member.
a. H -Oth Care Delivery and Quality Alaiatensace
b Finan" and Miaagement '57
C. Product Development and Muketing
e_ Member and Consumer Advocacy.___ t I
I. i. PI kArn ng.'Govemance and BYLAWS j
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1 f I1 i Applications roust be recrn-ed
i t by August 3y 1995 at:
I! CCHP Managed Cue Conmtissio I +
(
595 Centex Avenue, Suite #100 �
�� Martinez, C.A 94553 I
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t CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE"
APPLICATION FORM
Name'of advisory board applying for: Managed Care Commission (MCC
(Application Form must be typed or hand printedl:..
vt� "I'srsons a are �nvolz3ed.a�cvr�tx�tt�ra zextt�a � �cannot.beb t�f e �C
:.:.................... ... ...............
r�> r cyan HItSarva 3rtnQn� 53znplre�s
.................. ... .... .
Please answer:
Are you currently employed by CCHP or HSD? yes nom/
if yes, please explain.
Are you or your employer now a contractor to CCHP? yes_ no_j.:,:�
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes, noeyes, please explain
Name of Applicant. k vdyn3��r-
. Home Address: 3 S,� s ��r'������
��c� Home Phone:
Business Address: Work Phone: 2-s s `75 5--Y
(�'JN,
Signature: Date:
GCc e r, Cc /v S
Personal Experience, Skills and Interests
Education/Background: f' - .2'Y�' t= r, ��+ f o-5 G f1�L,
/r) 26 - L �j'1 s �
/ _I /� /
Occupation: CG(_ S`C
J
3j,-)4
. rcd/. ('o
Community Activities:
C•cfv�"P---- /y�, �e d�'hF�-- <<+m� ty� ���E� !-IG�Qj '"�
Special Interests:
L1 S I C.
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4., Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
�. Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable,public-
spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application,please complete the questionnaire below.
Your name:
1. Are you a member of CCHP? A)
2. How long have you been a resident of Contra Costa County?
J
3. Have you served on the CCHP Advisory Board? Nc How long?
4. Have you served on the Medi-Cal Advisory Planning Commission? Y How long?
r M 1 <c
5. In which area of the County do you reside (East, West, Central?) How long? S c.
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"?
. �,L�'7 ' t'�" `�i�{ h�}fin �- �'1 G i'✓;C1 t�;
J
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialist for IBM)
a. Ambulatory care
b. Business interests
C. Consumer advocacy / v o�i� { �:.- `)e e� i— �� I f 1ee�i i.c>
d. Evaluation of outcomes
C. Finance
f. Health care law �L��` �'-� -110 i
g. Health Issues: children,women, elderly, cultur , ethnic,linguistic, disabled
L
c` r:ic �` h v;c�:c rcbjN i'f SSS' C—� Isc-A ell
h. HMO administration
L Labor
(Please continue on reverse side)
j. Marketing
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel (-VC's e VC'C�' C'I V/ I'h p r- 30Onel
n. Public health and prevention /LJc C ;,p a1 P,2T
o. Other
8. Why do you want to be a member of the Managed Care Commission and what do you believe
you can contribute? //��5 '�l
c' ' C mit 11A !l�y CSD �r l fl cam'
1
C^ �-)(4-)9.1 I C C (JeK
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving asa me ber:
a. Health Care Delivery and Quality Maintenance_
b. Finance and Management
C. Product Development and Marketing
d. Provider Issues Z
e. Member and Consumer Advocacy j
f. Planning, Governance and By-Laws
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE:
APPLICATION FORM
Name,of advisory board applying for: Managed Care Commission (MCC
(Application Form must be typed or hand printed.)
oto "I'srsans are �nvolz3ed as C�nraGliP?3 nthnnvt bebrs o x8. 1C
nor
can �e�zltb Serv;xt es Deirirtmen3npes<"
.... .. .
Please answer*.*
Are you currently employed by CCHP or HSD? yes no
if yes, please explain
Are you or your employer now a contractor to CCHP? yes_ no
if yes, please explain
Are you associated with an .organization that currently or plans to contract with CCHP?
yes! noV' if yes, please explain
NP-me of Applicant:
Home Address:-'10S-1 /ii�f} 14�K �� Home Phone:
y3r/
Business Address:
A,- �G Work Phone:
Signatur��i','/ k
: / Date: lf.�J
7�
Personal Experience, Skills and Interests
Education/Background:
Occupatiolffa- /�;1 - .� /
Community Activities: rv,4 � /i'4�/`l/�S 5"SLG-0//4' 1 1457 x/12^2 WIZI
Tia 6
Special interests:
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-careinterested, capable, public-
spirited and who want to make'CCHP an outstanding health care plan. The capacities listed below will be.used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the c n deration of your application, le complete the questionnaire below.
Your name: /
1. Are you a member of CCHP?
2. How long have you been a resident of Contra Costa County?
3. Have you served on the CCHP Advisory Board? How long?
4. Have you served on the Medi-Cal Advisory Planning Commission? 4e How long?
5. In which area of the County do you reside (East, West, Central?&LAow long?�S� ! '
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
iversiyo Contr Costa'County")
�- r
A
�vw�
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialist for IBM) / �� �A�
a. Ambulatory care IvIiief
( 2G r AL�i`
b. Business interests ,�� /�CC�c�i?O�jtG�il. �97✓/ �����
C. Consumer advocacy
j � ��/ J ��
d. Evaluatior_ of ontcc^,es ��- �//tom '�� `/f/ S`J� x-
e. Finance
f. Health care law
g. Health Issue : c ldren, wonen, eoderly, cultural, ethnic, linguistic, disabled
aac2� / /
h. HMO administration
i. Labor
(Please continue on reverse side)
j. Marketing'
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel 7 ljdl
n. Public health and prevention
o. Other
8. Why do you want to be%ne.mb-r, o. elle Mara e ' C .re Cu ssion and what do you b lieve
you can contr� b ute? %� Ey YZ✓' �� CLQ G
l4o,4^
i
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance—
b.
aintenanceb. Finance and Management
C. Product Development and Marketing 5
d. Provider Issues
e. Member and Consumer Advocacy
f. Planning, Governance and By-Laws
I
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
'CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE:
APPLICATION FORM
Name of advisory board applying for: Managed Care Commission (MCC)
(Application Form must.be typed or bandprinted.)
1?�rsans a are tnvo rzs�7rgttrszstla 'c`trnnvt be rlars of e '
r rartleIt3 Sexvac Dej�as SD . p ' :;'`
....
Please answer. /
Are you currently employed by CCHP or HSD? yes—no
if yes, please explain
Are you or your mplover now a contractor to CCHP? � no ✓. 2�
if yes, please explain ,. � �� a .h s Ta ayf p,;
Are you associated with an organization that currently or plans to contract with CCHP?
yes_ no_if yes, please explain
a..�e of Applicant: ��,z n �, L a
Home Address: 3c/7L? Betz t-ale
f f�., f;`ft; Com- '::? ����r�� Home Phone: ,S-(c�,zfS3
LCZ t
Business Address: j, Work Phone:
Signature: �7
� Date: t)I"'— z"
Personal Experience, Skills and Interests
Education/Background: G or;,e: (� G�. (6/'� <''y ,,,�2"
Occupation: /Y G"4az {f �•� q il:5�e_
Communitv Activities: j� Cl/�
Special Interests:
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
4
Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested; capable, public-
spirited and who want to make CCHP an outstanding health care plan..The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC,but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application,please complete the questionnaire below.
Your name:
1. Are you a member of CCHP?-/he
2. How long have you been a resident of Contra Costa County? Z
3. Have you served on the CCHP Advisory Board? N,LHow long?
4. Have you served on the Medi-Cal Advisory Planning Commission? .iii How long?
j
5. In which area of the County do you reside (East, West, en .al? 11""t*
How long? 2-
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County")
�'�
7. Indicate area/s in w1iich you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)1 worked as Human Resources Specialist for IBM)
a. Ambulatory care
b. Business interests
sn /� i-f 6+.1.. C
C. Consumer advocacy( , /�2 e'_ ` C�1. r•�„ �t >G2C�Z�, [.f �
d. Evaluation of outcomes
e. Finance /
f. Health care law
g. alt Issues: children, women, elderly, cultural, ethnic, li istic, disabl d
G
h. HMO administration
I. Labor
(Please continue on reverse side)
j. Marketing
c
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel
e,
n. Public health and prevention
o. Other
8. Why do you want to be a member of the Man ged Care Commission and what do you belie e
� �y u can contribute? A
�t�i1C1;�!
{/ `"✓LLQ Z \ -_vri J
9. The MCC will have six standing committees. Please rank 1 to 6 1 best/6 least committees on
�
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance
b. Finance and Management
C. Product Development and Marketing 3
d. Provider Issues
e. Member and Consumer Advocacy
f. Planning, Governance and By-Laws
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
-CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE.
APPLICATION FORM
Name of advisory board applying for: Managed Care Co!/mi ss i on (MCC)
(Application Form must be typed or hand printed.)
erre „"1'ersans wa are tnvofzjed its ..rzt ' nvx1fZe
mor ran Hm ib , ervac3es De 4r*OfSD x lrr, e s "
Please answer.•
Are you currently employed by CCHP or HSD? yes no x
if yes, please explain
Are you or your employer now a contractor to CCHP? yes no x
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes__ no x if yes, please explain
Name of Applicant:
Mary Lavender Fujii
Home Address: Home Phone:
1136 Lindell Drive (510) 944-9772
Business Address: Walnut Creek, CA 94596 Work Phone:
1700 Oak Park Blvd. , A-2 (510) 646-6540
Signature: Pleasant Hill, CA 94523 Date: 7/13/95
i/
Personal Experience, Skills and Interests
Education/Background:
BA Sociology; MS Nutritional Sciences ; Registered Dietitian
Public health nutrition, program administration, public policy
Occupation:
Nutritionist with the University of California Cooperative
Extension. Administrator and educational resource for low-
income nutrition education programs . Nutrition and food sanita-
Cion ons ltation for emergency food distribution sites .
ommunity Activities:
Food and Nutrition Policy Consortium, Hunger Task Force, Contra
Costa County Nutrition Council , California Nutrition Council,
California and American Dietetics Association,CA Hunger Action C
Special Interests:
Food Security (Hunger) public policy, preventive health service3 ,
Director on the Board of the Contra Costa Food Bank.
----------------
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable,public-
: spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present.in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, please complete the questionnaire below.
Yourname: Mary Lavender Fujii
1. Are you a member of CCHP? no
2. How long have you been a resident of Contra Costa County? 11 years
3. Have you served on the CCHP Advisory Board? no How long?
4. Have you served on the Medi-Cal Advisory Planning Commission? yeS How long? 1 . 5 3TP
5. In which area of the County do you reside (East, West, Central?)Cent r a lHow long? 11 years
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"?
I am a woman living in a bi-cultural (Asian) family (11 years) .
7. Indicate areals in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialist for IBM)
a. Ambulatory care Nutritionist at health clinic for prenatal and infants .
b. Business interests Board of Directors (President) of Food Bank - 8 years
C. Consumer advocacy Founder and chair Hunger Task Force; Food and Nutrition
Policy Consortium
d. Evaluation of outcomes Program evaluation and educational research for
nutrition education.
e. Finance Prog am admires ration with hnrigQts tit=tn$2 . 5M Statewide and
County
f. Health care law
g. Health Issues: children, women, elderly, cultural, ethnic, linguistic, disabled
low income families , ethnic diversity, cultural sensitivity for
nutrition and health education
h. HMO administration
i. Labor Supervised small gaffs
(Please continue on reverse side)
j. Marketiz;gPromotion of nutrition and health education programming.
. I
k. Nursing administration and practice onP year of „nr1Prgrarl„ate nursing training:
1. Nutrition education and services 17 years professional nutrition education; 1 year
clinical nutrition experience.
M. Personnel supervised a small staff (4 people)
n. Public health and prevention Nutrition Pxperiennp is in the public health arena,
with emphasis on prevention health education.
o. Other
S. Why do you want to be a member of the Managed Care Commission and what do you believe
you can contribute? I care deeply about the people who are hein_g ushered
into managed care . I would like to continue my efforts to get cost-
e ective, proven medical practices, such as medical nutrition therapy
integrated into care . I offer my experience on MAPC- my professional
nutrition and management experience .
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance_
b. Finance and Management 4
C. Product Development and Marketing 3
d. Provider Issues 6
e. Member and Consumer Advocary 2
f. Planning, Governance and By-Laws 5
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
t•
f
Y
Contra Costa County July 28, 1995
FOOD & NUTRITION
Policy Consortium
Working to reduce chronic disease & Lynn Moms
promote good health for Contra Costa Contra Costa Health Plan
County residents by assuring access to
adequate and nutritious food. 595 Center Avenue
Suite 100
Martinez, CA 94553
Member Organizations /
Dear Lynn,
American Cancer Society
Contra Costa Unit
American Heart Association Here's my application for the new Managed Care Commission;
Contra Costa Chapter
Head Start
Contra Costa Child Care Council I noticed in the July MAPC Report that the interviews for the/MCC are
Contra Costa Food Bonk being held August 15th. I will be out of town August 1 through the 14th.
Contra Costa Board of Supervisors
Contra Costa Health Coalition I trust that this vacation will not interfere with my candidacy for MCC.
Contra Costa Hunger Task Force Please feel free to call me at home and leave a message regarding an
Contra Costa County I
Nutrition Council interview on my machine. We will be picking up messages from time to
Contra Costa County
Wellness Program time while we are away.
Diablo Valley Dietetic Association
CHDP-Child Health and Thanks
Disability Prevention Program ,
Prevention Program
Senior Nutrition Program
TAP-Teenage Program
WIC-Women, Infants&Children
Supplemental Food Program
Public Employees Union, Local One
Public and Environmental Mary ender Fujii
Health Advisory Board Chair, Hunger Task Force
Department of Social Services
Food Stamp Program
University of Califonia Co-op
Extension, Expanded Food and
Nutrition Education Program
PKEVENTION PROGPAM
Contra Costa County '
Health Services Dept.
75 Santa Barbara Rd.
Pleasant Hill, CA 94523
(510) 646-6511
FAX (510) 646-6520
11 '
I
JUL '1 9 W5
CONTRA COS'T'A COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE:
APPLICATION FORM '
Name of advisory board applying for: Managed Care Commission (MCC1
(Application Form must be typed or hand printed)
�Yv�� persons are tnvolued.a:�:.:tnn.�ra�ton � P�ttr�oi i�� of ,�iC
. ...... .....................
.... ............
max. t,t��lenit3� Ser�nt�es D �xn�nt .......... i
Please answer: ii�
Are you currently employed by CCHP or HSD? yes no x f
if yes,please explain
Are you or your employer now a contractor to CCHP? yes nom_
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes no x if yes, please explain
i
J
Name of Applicant: Michael J. Garcia
Home Address: 2409 Saddleback Drive Home Phone: 510-838-7!355
Danville, CA 94506 1
510-823-8484
Business Address: Room 1E501 Work Phone:
2600 Camino Ramon
Signature: San Ramon, CA 94583 Date: July 14, 1995
Personal Experience, Skills and Interests 1
Education/Background: BA in Mathematics
BA in Economics
Certified Employee Benefit Specialist
I
Occupation: Pacific Bell
Executive Director
Functional Responsibility: Reengineering of all
Human Resources processes for entire Company.
i
Community Activities: Advisory Board Member - Contra Costa Health Plan
Group Commander - California Air National Guard
i
Special Interests: Reading
Gardening
Family Activities I�
1
INFORMATION: !
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX k (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. i
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
I
i
• • Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan.The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic,gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application,please complete the questionnaire below.
Your name: Mi rh P1 .T_ Garri a
1. Are you a member of CCHP? Yes
2. How long have you been a resident of Contra Costa County? 25 Years
3. Have you served on the CCHP Advisory Board?Yes How long? 9 Years
4. Have you served on the Medi-Cal Advisory Planning Commission? No How long? ---
5. In which area of the County do you reside (East, West, Central?)Central How long? 5 Years
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"?
I am a. hispanic resident of Danville, CA.
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)1 worked as Human Resources Specialist for IBM)
a. Ambulatory care
b. Business interests I have 5 years experience as a Director of Health and
Welfare Plans for Pacific Bell.
C. Consumer advocacy
d. Evaluation of outcomes
C. Finance I have participated on the Finance Committees of Golden Carousel
Real Estate and the Contra Costa Health Plan. I also have experience
in Financial Management with Pacific Bell
f. Health tare law
g. Health Issues:children, women,elderly, cultural, ethnic,linguistic,disabled
h. HMO administration
i. Labor
(Please continue on reverse side)
j. Marketing I have served on the Marketing Committee of the Contra Costa
Health Plan
i
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel
n. Public health and prevention
o. Other
8. Why do you want to be a meniber of the Managed Care Commission and what do you believe
you can contribute? I would like to be a value-added member of the MCC enabling the
Contra Costa Health Plan and the Medi-Cal Advisory Planning Commission to success-
fully transition to become the premier provider ot manager care in Contra Costa
or
the success of the Managed Care Commission.
9. The MCC will have six standing committees. -Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance 3
b. Finance and Management 1
c. Product Development and Marketing 9
d. Provider Issues 6
C. Member and Consumer Advocacy
f. Planning, Governance and By-Laws 4
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
Date: July 15, 1995
To: Joint Screening Committee
From: Michael J. Garcia
Pacific Bell, Executive Director
Subjcci. Appiicaiion Submission
I would like to be considered"for a position on the Managed Care Commission. I
believe I am uniquely qualified for the assignment based on my business background
in human resources and finance. In addition, I am a Certified Employee Benefit
Specialist and have nine years of experience as and advisory board member of the
Contra"Costa Health Plan. I have lived in Contra Costa County for twenty-five years
and have a strong desire to insure that the County continues to provide outstanding
health care.
Attached is the Managed Care Commission Application Form and resume outlining
my background and interests.
I look forward to being interviewed for a position on the Managed Care Commission.
R
Michael J. Garcia
2409 Saddleback Drive
Danville,CA 94506
(510)823-8484(W), (510)838-7355(H)
Goal:1 would like to be a value-added member of the Managed Care Commission enabling the Contra Costa Health
Plan and the Medi-Cal Advisory Planning Commission to successfully transition to become the premier provider of
managed care in Contra Costa County, serving the Medi-Cal, Medicare. Commercial and Medically Indigent
population.
Professional Experience
Pacific Bell
Fourteen years experience in computer.systems. Extensive background and knowledge in Software
Quality Assurance and Project Management associated with mainframe and client-server technologies.
S--.,:yeas exp:ence in T_-ILman??ssxxces. Ass ga=.'s in the adniinis—uaticn and pl=xdng of ILLalth
and welfare, savings and retirement plans. Ten years experience in the management of a Health
Maintenance Organization as an advisory board member.
One year as a member of the Core Process Reengineering Team. Team Leader for the analysis of all
Human Resource functions and processes to develop opportunities for dramatic improvement and
reengineering
Pacific Telesis Group
Two years experience in Financial-Management. Managed the financial aspects of the business
planning process and monthly budget cycle for all subsidiaries of the Pacific Telesis Group.
Education
University of California,Berkeley: BA in Mathematics;BA in Economics
University of Chicago:Certification in Data Processing
Wharton School of Business:Certified Employee Benefit Specialist
Stanford University:Advanced Management College Program
Harvard University:Managing the Information Resource Program
Organizations
California Air National Guard,Group Commander(1967-Present)
Advisory Board,Contra Costa Health Plan(1986 -Present)
Board of Directors,Western Medical Review(1986-1990)
Board of Directors,Golden Carousel Real Estate(1988-1989)
Memberships
International Foundation of Employee Benefit Plans
National Guard Association
Who's Who in California -
5104327473 PSCC 999 P02 AUG 01 '95 14:39
C 3N'I'K.k COSTA 'COUNTY ADVISORY BOARDS, COMMISSIONS, 0011-9 41TEE
APP .I+CATION FORINT
?,;rime of advisory board applying for. Hanagkd Cam COtl IsSiQ0 C1
(Application Farm mwt he typed or hand p7inoo4)
NEW:::
r ..y
Am ypte currently employed by CCHP or HSD? yes no$
i(yes,pdestcse exp fain n a
A e-you or your employer noir,a contractor to CCHN yes nax—
i}'yes,please erp.Qin n!a
Are yog associat4 with an organization that currently or plans to contrrcct with CCH1--'?
)ttc _ rw g if yes,please explain n1$
14am,e of Applicant: Frances Greene
56 Barrie Drive (510)432--45 66
1 tome Address: Pittsburg, Ca 94565 Home Phone:
Business Address: 1760 Chester Drive Work Phone: (510)439-2061
Pittsburg, Ca 94565
signature., ���f_ �..�' Date: 7-25-95
Personal Experience, Skills and Interests
education/Background: H.A. in Business Administration
Various certificates and continuation classes in Business, Early Childhood
1?eve1opment/-.ducatiou. Life-time Children's Center Pezmit
CiCCupation:' Executive Director of the Pittsburg Pte_School Coordinatinf;
Council, Inc
0;�mmunity, ACiviti s: involved with various community activities, such a,s
a:lvucacy forotneeas, hungry, senior citizens, children, active in local
claurckt
Spe6al Interests
Children, seniors
I�s1RMATIaN:
I. Return competed application to Lynn Mortis,Contra Costa Health Plan,595 Center Avenue,Suitf 100,
Martinez, CA 94553;PAX 0(510)313-6002
z. Members of s Awa adAsory bodies may be required to file wnual Conflict of Interest Statements.
3. Meetings of aaivisory bodies may be beld in Man;nta or in areas not accessible by public tramportan;oo.
4. Meetingi may be held either in the evenings or durizg the days,t>sually once or twice a month.
5. Some boards;ssigu members to wriumittces or work groups requiring additional time.
5104327473 PSCC 999 P03 AUG 01 '95 14:39
{
IL Kerma$sdm ais MdOn s<nd practice Yes, I am a LNA
Provide these services
I. Nutrition cd CMion and service
m Personnel
Oversee 53 staff
n. Public hcahh and ptrwacka Very active component of our Agency
o. Qtber
8 Wh.i, do you want to be a member of the Managed Care Commission and what do you be"I je
yoU can contribul:e?_ I will add diversity to the Mana€;ed Care C2Mission, _aid .I t,.3 e
a %,ariety of ecperienees that will enhance the Commissions view point of Xara,3 d
—CW..a. T" aavi aaperiev,ce as a care provider, etc., and am f maliar with tKa'ne ; Cere.
9 The! MCC will hive six standing comrrn trees. Please rank 1 to 6 (1 best/6 least) convnli.ttec s )n
whic,h you would be interested in serving as a member:
a. Health rare:Deliveryand Quality Meinteaaace 3
b. 1~inance and'Aanagement
C. Product Drvs3opment and Marketing �
d_ Provider hzu m.
C. Membet and Coast=er Advocacy 1
f. Planning,Governanet and By-Laws 5
Applications must be received
by August 1, 1995 at:
CCH? Managed Care Commission
595 Centex Avenue, Suite #10a
Martinm CA 94553
s
CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE,
APPLICATION FORM
�t
Name of advisory board applying for: Managed Care Commission (MCC
(Application Form must be typed or hand printed.)
1 � " ersvns;�¢,bv are �notz�edas conftirs ......nthCof zhe l!!ICC
.::::.::.::....:.......::::...............::..:....:.....:::....::..:...:::::::::.
nor uanletlt3a Servtres IDerartmcnt . »xporet's
Please answer:
Are you currently employed by CCHP or HSD? yes_no
if yes, please explain
Are you or your employer now a contractor to CCHP? yes no
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes_ no please explain
Name of Applicant:
Home Address: A910X 6 z 7 7 Home Phone:
Business Address: �yS.S� Work Phone
"//Z- ZZZ3
Signature: c5e-- 0 G O OIj
i-7ti/
Personal Experience, Skills and Interests
Education/Background:
Occupation:. v_
Community Activities:
Special Interests:
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94,=•53; FAX k (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in.Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are m no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, please complete the questionnaire below.
Your name:
1. Are you a member of CCHP? 126
2. How long have you been a resident of Contra Costa County?
3. Have you served on the CCHP Advisory Board? How long?
4. Have you served on the Medi-Cal Advisory Planning•Commission-ve-s How ong?
5. In which area of the County do, you reside (East, West, ntra ) How long?
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"?
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialist for IBM)
a. Ambulatory care
b. Business interests
C. Consumer advocacy
d. Evaluation of outcomes
e. Finance
f. Health care law
g. Health Issues: children, women, elderly, cultural, ethnic, linguistic, disabled
h. HMO administration
i. Labor
(Please continue on reverse side)
j. Marketing
�J
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel
n. Public health and prevention
o. Other
8. Why do you want to be a member of the Managed Care Commission and what do you believe
you can contribute?
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance _
b. Finance and Management _
C. Product Development and Marketing _
d. Provider Issues
e. Member and Consumer Advocacy _
f. Planning, Governance and By-Laws _
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
1. BIOGRAPHICAL SKETCH
Dr.Michael G.Harris is a graduate of the University of California School of Optometry
where he received his Bachelor of Science,Master of Optometry,Doctor of Optometry,and Master
of Science in Physiological Optics degrees. He is a Clinical Professor and Senior Lecturer at the
University of California,where he serves as Chief of the Contact Lens Clinic and Director of the
Residency Program. •
Dr.Harris is a member of the Food and Drug Administration Ophthalmic Devices Panel.
He is a Fellow of the American Academy of Optometry and Past Chairman of its Section on
Cornea and Contact Lenses,of which he is a Diplomate. He is a Fellow of the Prentice Society
and a member of its Board of Directors. He is a member of the California Optometric Association,
the American Optometric Association,the American Association for the Advancement of Science,
the American Society of Law and Medicine,the British Contact Lens Association and the American
Public Health Association. He is Chairman of the Judicial Committee of the American Academy of
Optometry,a Councillor of the International Society for Contact Lens Research,and an honorary
member of the Mexican Society of Contactology.
Dr. Harris has done extensive research on contact lenses and corneal physiology. He has
lectured throughout the world and has authored over 130 scientific papers and articles on the
subjects of contact lenses,corneal physiology,optometric jurisprudence,and hypnosis. He has
edited two texts on special contact lens procedures and has contributed chapters on contact.lenses
and jurisprudence to several books. Dr.Harris serves as consulting editor to The Journal of
American Optometric Association, Contact Lens Spectrum,The Manual of Clinical Optomea and
Optometry Clinics. He is a consultant on the subjects of optometric jurisprudence, corneal
physiology, general optometric procedures,contact lenses,and hypnosis to numerous educational,
professional,industrial, and governmental organizations.
Page 1
In 1966,Dr.Harris received the first Doctor of Optometry degree granted by the University
of California. In 1967,Dr.Harris became the youngest person elected to Fellowship in the
American Academy of Optometry.He was honored with the first John de Carle Visiting
Professorship at City University,London,England and a University of California Faculty
Fellowship. He has been a Visiting Research Fellow at:the University of New South Wales and a
Senior Visiting Research Scholar and Visiting Research Fellow at the Corneal Biophysics
Laboratory at the University of Melbourne.
Dr. Harris received his Juris Doctor degree from John F.Kennedy University School of
Law. He is a practicing attorney-at-law and a member of the State Bar of California,the American
Bar Association and the American Trial Lawyers Association.
In addition to his professional activities,Dr.Harris has been active in civic and community
affairs. He is a member of the Town Council of Moraga,California. Prior to his election, he was
a member of the Moraga Planning Commission and served two terms as its Chairman. He was'a
founding member and former Chairman of the Young.Adults'Division of the Jewish Welfare
Federation. He was the Commissioner of the Sunday Football League of Contra Costa County.
He is a member of the Board of Directors of the JFK University School of Law Alumni
Association. Dr. Harris has been a member of the Board of Directors of the Jewish Community
Relations Council of the Greater East Bay,Temple Isaiiah of Lafayette,California and the
Campolindo Homeowners Association.
Dr. Harris' biography has been cited in numerous reference books,including Wbo's Who
in the West, Who's Who in the United States,The Di tiongy of International Biography,Who's
Who in California,Who's Who in the World,Who's Vho in American Law,Who's Who in
Science and Engineering, and Who's Who in Emerging Le ders.
July 1993
Page;2
2. VITAL STATISTICS
a. Personal
1) Date of birth, September 20, 1942
2) Place of birth, San Francisco, California
b. Optometry practice
1) 1965 - 1967 Associate practice with Harvey Arnold,O.D.,Oakland,
California
2) 1967 - 1968 Associate practice with M.S. Simon, O.D., San Francisco,
California
3) 1972 - 1976 Private practice,Oakland,California
C. Law practice
1) 1985-present Private practice,Moraga, California
2) 1986 - 1987 Associate practice, Sweet &Kleinman,Lafayette,California
d. Consulting practice
1) 1968 - 1969 Columbus, Ohio
2) 1966 - 1973 Daly City,California
3) 1973-present Moraga, California
e. Awards and honors
1) 1964 - 1966 George Schneider Memorial Scholarship,University of
California, Berkeley, California
2) 1965 - 1966 California Optometric Association Auxillary Scholarship,
University of California, Berkeley, California
3) 1971 Summer Faculty Fellowship,University of California,.
Berkeley, California
4) 1984 John de Carle Visiting Professorship, City University,
London,England
5) 1987 Commencement Speaker,University of California School of
Optometry,Berkeley,California
6) 1989 Visiting Research Fellow, Cornea and Contact Lens
Research Unit,The University of New South Wales, School
of Optometry, Sydney, Australia
Page 3
7) 1989 Senior Visiting Research Scholar,Corneal Biophysics
Laboratory,University of Melbourne,Department of
Optometry,Parkville,Victoria,Australia
8) 1992 Visiting Research Fellow,Corneal Biophysics Laboratory,
University of Melbourne,Department of Optometry,
Carlton,Victoria,Australia.
f. Addresses
5 Benedita Place
Moraga, California 94556
(Home and private office)
University of California
School of Optometry
Berkeley,California 94720
(510) 642-2233
(510) 643-5109 (FAX)
Page.4
3. DEGREES AND CERTIFICATES
1964 Bachelor of Science,Highest Honors,University of California,Berkeley,
California
1965 Certificate of Completion, School of Optometry,University of California,
Berkeley,California
1965 Master of Optometry,University of California,Berkeley,California
1965 Certificate of Completion,National Board of Examiners in Optometry,Parts
I;IIand III
1965 Diplomate,National Board of Examiners in Optometry
1965 Certification of Registration,Optometrist, State of California
1966 Doctor of Optometry,University of California,Berkeley,California
1968 Master of Science,Physiological Optics,University of California,
Berkeley, California
1969 Certificate of Registration,Optometrist, State of Ohio
1985 Juris Doctor, John F. Kennedy University,Walnut Creek, California
1985 Member, State'Bar of California
1985 Member,United States District Court, Northern District of California
Page 5
4. TEACHING APPOINTMENTS AND COMMr?TEES
1965 Clinical Associate in Optometry„University of California, School of
Optometry,Berkeley,California
1967 Clinical Instructor in Optometry,University of California, School of
Optometry,Berkeley,California
1968 Instructor,The Ohio State University of College of Optometry,Columbus,
Ohio
1968 Co-ordinator,Contact Lens Clinic,The Ohio State University College of
Optometry, Columbus,Ohio
1968 Clinical Advisory Committee,The Ohio State University College of
Optometry,Columbus,Ohio
1969 Assistant Clinical Professor,University of California, School of
Optometry,Berkeley, California
1969 Assistant Director,Contact Lens Clinic,University of California, School of
Optometry,Berkeley, California
1970 Co-ordinator,Faculty Seminar Series, University of California, School of
Optometry,Berkeley, California
1971 Faculty Representative,Clinic Beautification Committee,University of
California, School of Optometry,Berkeley,California
1971 Assistant Chief, Contact Lens Service,University of California, School of
Optometry,Berkeley, California
1973 Associate Clinical Professor,University of California, School of
Optometry, Berkeley, California
1973 Director, Contact Lens Extended Care Clinic,University of California,
School of Optometry,Berkeley, California
1974 Budget Allocation Committee,University of California, School of
Optometry,Berkeley, California
1974 Ad Hoc Committee on Admission Procedures,University of California,
School of Optometry,Berkeley,California
1974 Ad Hoc Committee on Annual Report,University of California, School of
Optometry, Berkeley,California
1974 Chairman,Library Committee,University of California, School of
Optometry,Berkeley, California
1974 Chairman, Committee on Judging 4th Annual Senior Research Projects,
University of California, School of Optometry, Berkeley, California
Page 6
r
1975 Committee on Institutional Self Study,University of California, School of
Optometry,Berkeley, California
1976 Associate Chief,Contact Lens Service,University of California,School of
Optometry,Berkeley,California
1976 Lecturer,University of California, School of Optometry, Berkeley,
California
1976 Committee on Teaching,University of California, School of Optometry,
Berkeley,California
1976 Chairman,Faculty Fund Raising Committee,University of California,
School of Optometry, Berkeley,California
1977 Ad Hoc Committee on Annual Report,University of California,School of
Optometry,Berkeley, California
1978 Curriculum Committee,University of California, School of Optometry,
Berkeley, California
1979 Committee for Minor Hall,University of California, School of Optometry,
Berkeley,California
1979 Committee on Teaching,University of California, School of Optometry,
Berkeley,California
1980 Curriculum Committee,University of California, School of Optometry,
Berkeley, California
1980 Senior Lecturer,University of California, School of Optometry,Berkeley,
California
1981 Chairman, Multimedia Committee,University of California, School of
Optometry,Berkeley, California
1981 Co-Chairman, Committee on Faculty Group Practice, University of
California, School of Optometry, Berkeley,California
1981 Core Grant Committee,University of California, School of Optometry,
Berkeley, California
1981 Training Grant Committee in Physiological Optics,University of California,
School of Optometry, Berkeley, California
1982 Secretary of the Faculty,University of California, School of Optometry,
Berkeley, California
1982 Co-Chairman,Clinical Professors' Series Committee, University of
California, School of Optometry, Berkeley, California
1982 Chairman, Physical Planning and Equipment Committee,University of
California, School of Optometry, Berkeley, California
Page 7
1982 Member,Council on Optometric Education Study Review,University of
California,School of Optometry„ Berkeley,California
1983 Chief,Contact Lens Clinic,University of California, School of Optometry,
Berkeley, California
1983 Secretary of the Faculty,University of California, School of Optometry,
Berkeley,California
1983 Co-Chairman, Clinical Professors' Series Committee,University of
California,School of Optometry„ Berkeley,California
1983 Chairman,Physical Planning and Equipment Committee,University of
California, School of Optometry., Berkeley,California
1983 Member,Council on Optometric Education Study Review,University of
California,School of Optometry., Berkeley,California
1984 Vice-chairman of the Faculty,University of California,School of
Optometry,Berkeley, California
1984 Member, Curriculum Committee:,University of California,School of
Optometry,Berkeley, California
1984 John de Carle Visiting.Professor,City University,London,England
1985 Vice-chairman of the Faculty,University of California, School of
Optometry,Berkeley, California
1985 Member, Curriculum Committee,University of California, School of
- Optometry, Berkeley, California
1986 Clinical Professor of Optometry,University of California, School of
Optometry,Berkeley, California
1986 Member,Ad Hoc Committee,Promotions,University of California, School
of Optometry, Berkeley, California
1986 Member,Core Grant Committee:,University of California, School of
Optometry,Berkeley, California
. 1986 Co-chairman, Committee on Faculty Group Practice,University of
California, School of Optometry, Berkeley, California
1986 Co-founder,Morton D. Sarver Memorial Fund, University of California,
School of Optometry, Berkeley, California
1986 Member,Morton D. Sarver Memorial Fund Committee,University of
California, School of Optometry, Berkeley,California
1986 Co=founder,Morton D. Sarver Laboratory for Corneal and Contact Lens
Research,University of California, School of Optometry, Berkeley,
California
Page 8
1986 Member,Morton D. Sarver Laboratory for Corneal and Contact Lens
Research,University of California, School of Optometry,Berkeley,
California
1987 Member,Morton D. Sarver Fund Advisory Committee,University of
California, School of Optometry,Berkeley,California
1987 Co-chairman,First Annual Morton D. Sarver Lecture Series on Contact
Lenses,University of California, School of Optometry,Berkeley,
California
1987 Member,Ad Hoc Committee,Promotions,University of California,School
of Optometry, Berkeley, California
1988 Co-chairman, Second Annual Morton D. Sarver Lecture Series on Contact
Lenses,University of California, School of Optometry,Berkeley,
California
1988 Member, Curriculum Committee,University of California, School of
Optometry,Berkeley, California
1989 Member, Computer Implication Committee,University of California,
School of Optometry,Berkeley, California
1989 Member,Ad Hoc Committee, Promotion,University of California, School
of Optometry, Berkeley,California
1989 Member,Teaching Evaluation Committee,University of California,School
of Optometry, Berkeley,California
1989 Co-chairman,Third Annual Morton D. Sarver Lecture Series in Contact
Lenses, University of California, School of Optometry, Berkeley,
California
1989 Chairman,Admissions Committee,University of California, School of
Optometry, Berkeley, California
1989 Chairman,Internal Department Review,University of California, School of
Optometry, Berkeley, California
1989 Visiting Research Fellow,Cornea and Contact Lens Research Unit,The
University of New South Wales School of Optometry, Sydney,Australia
1989 Senior Visiting Research Scholar, Corneal Biophysics Laboratory,
University of Melbourne,Department of Optometry, Parkville, Victoria,
Australia
1990- Co-chairman,Fourth Annual Morton D. Sarver Lecture Series in Contact
Lenses, University of California, School of Optometry, Berkeley,
California
1990 Member, Curriculum Committee,University of California, School of
Optometry,Berkeley, California
Page 9
1990 Member,Ad Hoc Committee, Promotion,University of California, School
of Optometry, Berkeley,California
1990 Member,Residency Committee,University of California, School of
Optometry,Berkeley, California
1991 Co-Chairman,Fifth Annual Morton D. Sarver Lecture Series on Contact
Lenses,University of California,School of Optometry,Berkeley,
California
1991 Member,Curriculum Committee:,University of California, School of
Optometry,Berkeley, California
1991 Member, Ad Hoc Committee,Promotions,University of California,School
of Optometry,Berkeley,California
1991 Member,Program Planning Committee,University of California,Berkeley,
California
1991 Chairman,Parking Committee,University of California, School of
Optometry,Berkeley, California
1991 Member,Residency Committee,University of California, School of
Optometry,Berkeley, California
1992 Co-Chairman, Sixth Annual Morton D. Sarver Lecture Series on Contact
Lenses, University of California, School of Optometry,Berkeley,
California
1992 Member, Curriculum Committee,University of California, School of
Optometry, Berkeley, California
1992 Member,Ad Hoc Committee,Promotions,University of California,
School of Optometry,Berkeley,California
1992 Member,Program Planning Committee,University of California,Berkeley,
California
1992 Chairman, Parking Committee,University of California, School of
Optometry, Berkeley, California
1992 Member, Residency Committee, University of California, School of
Optometry, Berkeley, California
1992 Visiting Research Fellow,Corneal Biophysics Laboratory,University of
Melbourne,Department of Optometry, Carlton, Victoria,Australia
1993 Director, Residency Program,University of California, School of
Optometry,Berkeley, California
1993 Ad Hoc Committee,Promotions,University of California, School of
Optometry, Berkeley, California
Page 10
1993 Curriculum Committee,University of California, School of Optometry,
Berkeley,California
1993 Faculty Practice Plan Review Committee,University of California, School
of Optometry, Berkeley, California
1993 Long-Range Planning Committee,University of California, School of
.Optometry, Berkeley, California
Physical Resource and Teaching,Research,and Administrative
Services Sub-committee
Student Recruitment(OD Program)Sub-committee
1993 Chair,Parking Committee,University of California, School of Optometry,
Berkeley,California
1993 Program Planning Committee,University of California, School of
Optometry, Berkeley, California
1993 Residency Committee,University of California, School of Optometry,
Berkeley,California
1993 Teaching Evaluation Committee,University of California, School of
Optometry,Berkeley, California
1993 Co-founder and Member,Morton D. Sarver Laboratory for Corneal and
Contact Lens Research,University of California, School of Optometry,
Berkeley, California
1993 Co-chair, Seventh Annual Morton D. Sarver Lecture Series on Contact
Lenses, University of California, School of Optometry,Berkeley,
California
1993 Member,Academic Affairs Committee,University of California, School of
Optometry, Berkeley, California
Page 11
5. COURSES TAUGHT
Optometry 100,History of Optometry,invited lectures
Optometry 100,Introduction to Optometry
Optometry 108 A-C,Introduction to Optometry
Optometry 120A-B,Clinical Examination
Optometry 120A-B,Clinical Examination of the Visual System
Optometry 126,Ametropia and Emmetropia
Optometry 126,Epidemiology of Refractive Error
Optometry 127,Refraction of the Eye
Optometry 127A,Clinical Examination of the Visual System
Optometry 142,Pediatric Optometry
Optometry 158B, Pediatric Optometry
Optometry 160,Binocular Vision and Perception
Optometry 160A, Contact Lenses:Examination of the Contact Lens Patient
Optometry 160B,Contact Lenses: Principles and Practice
Optometry 160C, Contact Lenses:Advanced Techniques
Optometry 160A-C, Contact Lenses
Optometry 161, Contact Lenses
Optometry 161A-B, Contact Lenses
Optometry 161 C-D,Advanced Contact Lenses
Optometry 162, Contact Lenses
Optometry 170B,Practice of Optometry
Optometry 178,Applied Psychology for Optometrists
Optometry 178,Patient Management and Cor nmunication
Optometry 185,Practice Management
Optometry 190A-B,Optometry Research Project
Optometry 190A-C, Senior Research Project
Page 12
CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE.
APPLICATION FORM
Name of advisory board applying for: Managed Care Coffinission (MCC
(Application Form must be typed or hand printed.)
Iflte: " srsons are tnvvlved itsor� r , rs zu�thnr�x b >?rs txf xheX.
nix Herzzltla , extnces 1exirtent ;SD errxplWees
Please answer:
Are you currently employed by CCHP or HSD? yes no
if yes, please explain i
Are you or your employer now a contractor to CCHP? yes_ no-.-4:L"-
if
ov'if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes_ nojZif yes, please explain
Name of Applicant: g2:7��,e E-- k,�q i
Home Address: /z��t �}�ti r�.zC�� �i:E'�E Home Phone: �%G�9 � 13
i�cJ�t F 4"t SEE Ll 9 5 9
Business Address: 3�3& Work Phone: 7:
ySZ�E /' �,r_ 15 733" 3'.�V
-4 ti 4;:Z-,4a c}'� �.� �r�l3Ga'
Signature: Date:
Personal Exp/,i,.ce/, S/k�ills and Interests
Education/Background: rz
-�
Occupation: ��•g/i.,4E�' G,� ��. ,� icy G
Community Activities:
Special Interests:
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible.by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
Supplemental MCC Application Information
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites.for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic,gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, lease complete the questionnaire below.
Your name:
1. Are you a member of CCHP? /V1U
2. How long have you been a resident of Contra Costa County?
3. Have you served on the CCHP Advisory Board? How long? t y5.
4. Have you served on the Medi-Cal Advisory Planning Commission. IV How long?
5. In which area of the County do you reside (East, West, Central?) ill How long?
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa.0unty"?
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialiste jor IBM)
a. Ambulatory care �",�!?,� /!? .�f%�L��II:Q Cel �5
b. Business interests
C. Consumer advocacy
d. Evaluation o outcomes //A!/C
%.-4�� s `tEs
e. Finance /�Ie5: g" !9/Gr
f. Health care la _[/iV /5�
g. Health ssues hildoh, women, elderly, cult}�ral, a hn , lin istic, disabled
h. HMO administration
i. Labor / .
(Please continue on reverse side)
j. Marketing
k. Nursing administration and practice Vii' Almf 51,<y
i� �. E12,S, �✓fy ���;c
/,3 fl/r"
1. Nutrition education and services
m. Personnel /UC
n. Public health and prevention �/�C��OG/j �JL/t 61Y
AAU/
o. Other
8. Why do you want to be a member oft a Managed Car Commission and what do you believe
you can contribute? r%�W 1�.�� .,9 i, 1 iV
/, ss r�o
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance "
b. Finance and Management
C. Product Development and Marketing '
d. Provider Issues
e. Member and Consumer Advocacy �}
f. Planning, Governance and By-Laws C�
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
5104327473 PSCC 001 P01 AUG 01 195 15:04
CC►NTIU, COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COm.] [I'['T.!
t APPLICATION FORM
Nuim of advisory board applying for: Managed Cdm =7SS7QR (PU
(Applxwwn Form meat be typed or bund printed)
(pfC
.a
PIZ;ansuwr:
A T you c rrent,y employed by CCHP or HSD? yes nom
if yo,please ap,'ain
A;-e you or your employer now a contractor to cchw yes_ rnoy
tf;yes,please exp,`air;
A.-,e you associat>d with an organaati4M that currently or plans to contract Udth CCHT?
)*II no j&yes,please explain
:Name of App'icant; Rosalind Marie Love
Eiomz Addres,: 231 Piedmont Lane Home Phone;(510)
Pittsburg, CA 94565
11,usiness Address: Work Phone:
,.`signature: Date: August 1 , 199_`.
Personal Experience, Skills and Interests
,[:;duration/Background: 1981-1984 Associate in Arts in Liberal, Arl-:
January 26, 1984, Los modanos College,
Pittsburg, CA 94565.
1'0=patiou: Classroom Aisle, Special Education, witt..
the Pittsburg Unified School Districit
from 1987 to present.
(I,'ommunity activities: Haitserved as a Commissioner on the MA1,C
SiUOO December 1994.:
I3as�� sermed as Sup-qrintcudelat.- of:.:8undgy .,._
School at New Bethel"Misri16nary✓Ch rb35";lit t'sburg, Ca;
Special Interests:
I enjoy sewing ;.: eae�, .rxg,:end volunteering
at my daughter's elementary school.
brroRmATiON:
1. Return coinpleted application to Lynn Morris,Contra Costa Health Plan, 595 Center Aveatse,Suite l JC,
Martinez, ;A 94553;FAX#(510) 313-6002
2. Members c f some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advi:•ory bodies may be held iu Martinez or in areas aot accessible by public transpo rtatioa
4- Meetings may be held either in the eveJnings or during the days, usually once or twice a montb.
5. Some boarla assign m.Cmbers to committees or worts groups requiring additional time.
001 P02 AUG of '95 16:04
510432747-,31 PSCC
cti
j. Marketing,(sr) . My_expgri jerice &s a- staff n the LMC EXI- 0 i e RCe.
k Nun*ad mini rani=and practice
L Nutrition a duca don and scmices
in, Personnel
A. Public heahh and prevemiop Tzalaing ils a Rargt Eduratpr with Q.A T.li.,
o. Ocher(x) I have Rrayided in-home care for the elderly.
F Wfl.Y do you wrist to be a member of the Managed Care Commission and what do you bvt ve
ypit can contribxute? T want to be a member of MCC because I feel_tE�t_� s 'nn
Afrt,,: America who is- head of hou;�ehol.d, 14at I Mta_ybe be able tD 565 •e
some„ 1,nsight-<<s to our needs and concerns not-only out IY., b� .,a.:� ,o
over a broad -vecturm of: middlg_� J;ass Amrrica..
9. The MCC kill hr ve six standing committees. Please rank 1 to b (1 best/6 least) comnaittm!; ,n
whj,I you would be interested in serving as a member;
a. Health Care DeEvery and(duality Maint=wxr 3
b. Finance and k1magement
C. Product Deve)opment.aud Markc6ng, 4
d Provider Issue 1-
C. Member and Cbmmer AdvotacX 2
f. Platuling,Gov mance and By-laws
Applications must be received.
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA.94553 `{
I
i
I
3104327473 PSCC
• 002 P01 AUG 01 '95 16:07
SupplemenW MCC Application Information .
r Tee:Eoard of Supervisors is saucing to stppoint nIttu e°ss of dhe MCC who arae dedwatrd, healtb-care inures"$,c4pA,'I6,ptd;N
Awj sad s,ho want to ma[p;CCIp au outaInding health care plan The capacities listed trelovr wil!be usod is mXnp
d owes for the appointments. These'are in no wzy prereeluisius for a position an the MCC,but they do indicate ve tuahle ,: a c t
r peiience far the MCC when present in a suitable eaadittate. In additiau, the Board is snaking to make appaintmenes t6;t r [ec
t)a cultural,m6ic,gen&r an+l geographical diversity of Contra Costse County-
12
ounty-1x order w assist in the consideraton of your SpP C4dOn,please complete the queStimmairr. beli.- .
"our names:
An you a member of CCHP?
How long have you been a resident of Contra Costa County? 17 yearg
i. Have you served on the CCI3.P Advisory Board?NO How long?
}. Ijave you serval"on the Medi-Cal Advisory Planning Cominission? XesHow longi 7 r is 3
5. In which area of the County do you reside (East, West, Central)) East_ Hoar
6. How would your membership help the MCC "reflect the cultural, ethnic, gender a1t.d g..,; ~alhical
diversity of Contra Costa County"?
I am a Afvo--American female, head of household with minor 4::h:i l l f
7. Indicate areas in which you have specW training or work experience and briefly what i:.' t i>
o r has been:
g, exarrspls:Person,nd N I uwked os Hrari m Ras wrc+ss SpeAdist for JBAV
! a. Ambulstcry care
1
te. Bessiness iatereats
i
1
e. Consu mr advocacy
j
I d_ Evoluati(•a of outcomes
r
1
i
Finance
J
1
!
Health care law
i
i;. Hcalth issues;children, women,elderly,cultural,ethnic,lin ob 1111�it,disabled
Was trailed as a drug prevention faciiiatorirt the D,A.T.E. -111 kram,
h. HMO administradon
i. Labor
i —
i
(PItm condaue on revctse side
+ { • • , • 4t
- CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, COMMITTEE
APPLICATION FORM
Name of advisory board applying for: Managed Care Corrmi ss i on (MCC)
(Application Form must be typed or hand printed.)
Ian rs la CWztnas be xexnlrf e
r cz>re e .1 ,Servares De artrxlerst HSD xnplcxye s
Please answer.-
Are you currently employed by CCHP or HSD? yes no_X-
if yes, please explain
Are you or your employer now a contractor to CCHP? yes_ no-X
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes_ no-( if yes, please explain
Name of Applicant: \J A Cry M C G
Home Address: 13 fAAk L GZ-Z �1R b Home Phone: 9 3 2 / 3 7
Business Address: Nu,—'C Work Phone: V cti'e
Signature: /m ` -�-�''� Date: 07/
Personal Experience, Skills and Interests
Education/Background: i
Occupation: C T r 2 EI-) 14 u M A)U P-(-:3&<,L-/2C-6S
KA15C2 PfVM , Mt-PICAz
Community Activities: e C H
Special Interests: �A }A-&frb cA--f-
1NFORTIAMN:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553; FAX # (510) 313-6002
2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
Supplemental MCC Application.Information "
'. The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, please complete the questionnaire below.
Your name: c_,V 6-Y
1. Are you a member of CCHP? N O
2. How long have you been a resident of Contra Costa County? S
3. Have you served on the CCH? Advisory Board? `, E How long?
4. Have you served on the Medi-Cal Advisory Planning Commission? 'r How long?r 2
5. In which area of the County do you reside (East, West, Central?) long? 4G 'CARS
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"?
/tet A-L_C
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)1 worked as Human Resources Specialist for IBM)
a. Ambulatory careK� jSi M circ% l 2S CSC ' �"i 25
b. Business interests r-A r 5 EYL M t')r CfL 5 C C � 2 S
C. Consumer advocacy
d. Evaluation of outcomes
C. Finance reg-15672 M i_7)[cA--f— C C[P-P g y 0-
f.
f. Health care 5�- 5'2 S
g. Health Issues: children, women, elderly, cultural, ethnic,linguistic, disabled
h. HMO administration k:L74q 5 V Ell C/-t- (Y }-2$ F, v�5
i. Labor
15 Cct..Ct=-9:-i
I
j. Marketing `•
k. Nursing administration and practice �9fryA-/_ alit /y`/i_ 77, 7P
(J'E— t_-:PM C f r'k F-b i;cp�.Cn:/�ZL Cyz�J r r r,c�C �C`Z7V T'!`�� c+t— kA.) ' S
1. Nutrition education and services
M. Personnel G f % e- C 07-1 ()F_
n. Public health.and prevention
o. Other
8. Why ,io you want to be a member of the Managed Care Commission and what do you believe
you can contribute? y ?C-Zr E.'e_ M C-la K F-6jC.C- 41-1 )
C rL f-t !� A-7) ;' 8 C74 P_h / M.4%I� G C X���=l Cxr C C, i A,r r L �_ i c
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance_
b. Finance and Management S .1% ti. C A-9E
L`r N C-
c. Product Development and Marketing ( V') A'r" r) ,
�7 C
d. Provider Issues
e. Member and Consumer Advocacy_A_:4__
f. Planning, Governance and By-Laws '46 -3
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite # 100
Martinez, CA "94553
CONTRA. .COSTA COUNTY ADVISORY BOARDS, COMMISSIONS; COMMIT',,
APPLICATION FORM
Name of advisory board applying for: Managed Care Comi ss ion (MCC�
(Application form must be typed or hand printed)
Note' "1'er<ons`�uho are Involved as�vntractors'wsth 1CUP tannvt iv MM s of the MCC
nor can Ieafth Services Devartment pw Pm ogees "
Please answer.
Are you currently employed by CCHP or HSD? yes-no X
if yes, please explain
Are you or your employer now a contractor to CCHPl yes no x
if yes, please explain turnmconTractssw contracted
I t{1 s�n�otmaeed r t ce I Care Network,vhp In
direcalCare Ne but an indir
Are you associated with an organization that currently or plans to contras with CCHP?
yeses na_ifyes, please explain as per above assoctation
Name of Applicant: Raymond L. Smart RPh
Home Address: 1158 Panoramic Dr. Home Phone:t5101 229-3540
Martinez, Ca. 94553
Business Address: 2068 S a 1 v 1 o St. Work Phone: (510)685-8551
Concord, Ca. 94520
Signature: �/ � Date: 7-29-95
Personal Experience, Skills and Interests
Education/Background: B.S. in Pharmacy from University of the Pacific
Stockton, Ca.
Pharmacy Officer in U.S.Army Medical Corps.
Occupation: Pharmacist
Community- Acti%-ities:Have served two years on the Medical Advisory Planning
Commission.
I have been active on the ContraCosta Pharmacists Assoc.
board of directors for the past 20 years, as well as,
special Interests: the California Pharmacists Assoc. The last 4 years on
the Board of Trustees. within the state assoctation
I have served on their Governmental Affairs and
Professional Affairs committees.
ItiTorUNLATION:
? Re-.urn completes appl.icaG.-Nn tc Lynn Morris, Contra Costa Health Plan, 595 Center Avenue. Sui:c F:'—
Maninez, CA 945;3; FAX p (31:; 313.6�C2
2. Members of some ad%ison, bodies may be required to file annual Conflict of Interest Statemer.t,
?. Meetings of ad%isen bodies mat be held in Martinez or in areas not accessible by public
4. Mcetin_s rnav he held either in the evenings or during the days, usually once or tR•ice a month.
5. St,n;e board, assign members to committees or work groups requiring additional time.
Supplemental MCC Application Information '
The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC,but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, please complete the questionnaire below.
Your name: Raymond L. Smart
1. Are you a member of CCHP? No
2. How long have you been a resident of Contra Costa County? 26 years
3. Have you served on the CCHP Advisory Board? no How long?
4. Have you served on the Medi-Cal Advisory Planning Commission? y e s How long? 2 y a,,r s
5. In which area of the County do you reside (East, West, Central?)C e n t r a l How long? 2 6 y e a r s
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Contra Costa County"? I am from Martinez )wlthin the North Central part
of the county and have worked with Medical and HMO patients for 26 years having started with
County patients in the early 1970' s.
7. Indicate area/s in which you have special training or work experience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialist for IBM)
a. Ambulatory care I have counseled and filled prescriptions for CCHP patients since its
inception.
b. Business interests same as above
C. Consumer advocacy Have been involved with Drun Utilization Review as a means
of controlling over medication and useage.
d. Evaluation of outcomes
e. Finance
f. Health care law
g. Heahh Issues: children, women, elderly, cultural, ethnic, linguistic, disabled
h. H1,10 administration
I. Labor
(Please continue on reverse side)
j- Marketing
1
k. Nursing administration and practice
1. Nutrition education and services
M. Personnel
n. Public health and prevention
o. Other
8. Why do you want to be a member of the Managed Care Commission and what do you believe
you can contribute? I think I can bring the exper ince of working with rece;yents and
providers of MediCal and HMO care for the past 26 years. The face of medical care
Is changing rapidly, and someone Invo,lved with It on a day by day basis sees a lot
of what is happening both with rece peen s and providers. This can help wiTn 7e
advising an a
9. The MCC mill have six standing committees. Please rank 1 to 6 (1 best/6 least) committees on
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance 3
b. Finance and Management 4
C. Product Development and Marketing 6
d. Provider Issues 1
e. Member and Consumer Advocacy 2
f.
Planning. Governance and By-Laws 5
i Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553
� e ,
JUL 12 IM
CONTRA. COSTA COUNTY ADVISORY BOARDS, COMMIS610NS, COMMITTEE
APPLICATION FORM
Name of advisory board applying for: Managed Care Conmiss ion (MCC)
(Application Form must be typed or hand printed.)
amore: "1�$rsvns are tnvot�z3edortratt�rsA nrra� e: bets of h
xe 'w
:. ..::..: .....::.::;.::::....::.::.:: .... ...........................::..:.:.<:
nor carz ea ,Services 3 a Qnr D
Please answer.•
Are you currently employed by CCHP or HSD? yes_no-Z�
if yes, please explain
Are you or your employer now a contractor to CCHP? yes_ no
if yes, please explain
Are you associated with an organization that currently or plans to contract with CCHP?
yes nozf yes, please explain
Name of Applicant: TH, D i
HomeAddress: J J Home Phone: 7 7 7- g )
Business Address. Work Phone: 7S3- 18 3 C`
G p
Si nature: Date:
7
Personal Experience, Skills and Interests
Education/Background:
O cupation:
CommunitActivities:
Special Interests:
_f
c
INFORMATION:
1. Return completed application to Lynn Morris, Contra Costa Health Plan, 595 Center Avenue, Suite 100,
Martinez, CA 94553;FAX # (510) 313-6002
2. Members of some advisory bo es may a required to file annual Conflict of Interest Statements.
3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation.
4. Meetings may be held either in the evenings or during the days, usually once or twice a month.
5. Some boards assign members to committees or work groups requiring additional time.
Supplemental MCC Application Information.
y The Board of Supervisors is seeking to appoint members of the MCC who are dedicated, health-care interested, capable, public-
spirited and who want to make CCHP an outstanding health care plan. The capacities listed below will be used in making the
choices for the appointments. These are in no way prerequisites for a position on the MCC, but they do indicate valuable areas of
experience for the MCC when present in a suitable candidate. In addition, the Board is seeking to make appointments that reflect
the cultural, ethnic, gender and geographical diversity of Contra Costa County.
In order to assist in the consideration of your application, please complete the questionnaire below.
Your name:
1. Are you a member of CCHP?
2. How long have you been a resident of Contra Costa County? Li 17
3. Have you served on the CCHP Advisory Board?_U�LHow long?
4. Have you served on the Medi-Cal Advisory Planning Commission?�How long?
5. In which area of the County do you reside (Eas , West, Central?) How long? Q
?a��,
6. How would your membership help the MCC "reflect the cultural, ethnic, gender and geographical
diversity of Cotra Costa County"? N
ta,C� 3
7. Indicate area/�i �,hich you hav special training or ork e erience and briefly what that is
or has been:
(for example:Personnel(x)I worked as Human Resources Specialist for IBM)
a. Ambulatory care
b. Business interests
C. Consumer advocacy c),r�
d. Evaluation of outcomes
e. Finance
f. Health care law
g. He th sues: childre women, elderly, cultural, ethnic,linguistic, disabled
( �
h. HM administration
i. Labor
(Please continue on reverse side)
- a
artetin .s l�'� Gti►�-�
k. Nursing administration and practice
1. Nutrition education and services
In. Personnel
n. Public health and prevention Ck
o. Other
8. Why do you want to be a ember of the Managed Care Commission and wha�do oubelieve
y u can contribute?
9. The MCC will have six standing committees. Please rank 1 to 6 (1 best/6 leasAmmittees
which you would be interested in serving as a member:
a. Health Care Delivery and Quality Maintenance_
b. Finance and Management
C. Product Development and Marketing
d. Provider Issues
C. Member and Consumer Advocacy
f. Planning, Governance and By-Laws
Applications must be received
by August 1, 1995 at:
CCHP Managed Care Commission
595 Center Avenue, Suite #100
Martinez, CA 94553