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HomeMy WebLinkAboutMINUTES - 11142006 - C.47 I s E..t o� TO: I BOARD OF SUPERVISORS = •S =�.� Contra FROM: William Walker, M.D., Health Services Director o, Ji;i�ri;,. _ ;;z Costa DATE: November 14, 2006 Y _ ___:`_. A �o�� County SUBJECT: APPOINTMENT TO THE EMERGENCY MEDICAL CARE COMMITTEE I � SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUNDIAND JUSTIFICATION i RECOMMENDATION: APPOINT the following people to the EmergencyiMedical Care Committee for a two-year term with an expiration date of September 30, 2008: American Red Cross Representative American Red Cross Alternate Paula Andrews Donna Hoffman Base Hospital — Contra Costa Contract California Highway Patrol Representative Representative Mark Mulgrew Lori Altabet Communications Center Managers' Contra Costa Police Chiefs' Association Representative Association Representative Tim Hennessy Charles Gibson CONTINUED ON ATTACHMENT: __GYES SIGNATURE: .RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE PPROVE OTHER �I SIGNATURE(S): � ACTION OF BO D NI�pV,» e►r T, 2XQb APPROVE AS RECOMMENDED O HER VOTE OF SUPERVISORS / I HEREBY CERTIFY THAT THIS IS A TRUE V UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD ` AYES: NOES: aF SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: n I �� ATTESTED 1�LbV� 2-CM I JOHN CULLEN,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact,Person: Art Lathrop (925) 646=4699 Cc: EMS Health Service Admin, 9Y: DEPUTY i i I Contra Costa Sheriff— Coroner Hospital Council — East Bay Alternate Alternate Jeffrey Leinen, MD Kevin Ryan I 4 Public Managers' Association Trauma Center— Contra Costa Contract Alternate Alternate Scott Hanin Kristin Santos, RN I I� IE , 4 li I li I I, I I I I. I I � I I li y If i II i II I I� I II I ( i I� I q I li I I (i li I is I 4 14 II I I� I li I Page 2 Ij � i I � I TO: BOARD OF SUPERVISORS —_• Contra _ � FROM Costa William Walker, M.D., Health Servicgs Director o� �:�.;,;�;,,w� •`s DATE: November 14' I 2006 ~` v County _ .•fir sra'couK'� I SUBJECT: RE-APPOINTMENT TO THE EMERGENCY MEDICAL CARE COMMITTEE I i SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: II I RE-APPOINT the following people to the Emergency Medical Care Committee for a two- year term with an expiration date of September 30, 2008: I Alameda-Contra Costa Medical Ambulance Providers—Contra Costa Association Alternate Contract Representative Catherine Hurt, MD Leslie Mueller I, I Emergency Department Physician Emergency Department Physician Representative Alternate Ellen Leng, MD Allan Drabinsky, MD Ij I EMS Training Institution Representative Contra Costa Sheriff— Coroner Susan Garske Representative Lisa Hoffman CONTINUED ON ATTACHMENT:--YES SIGNATURE: !RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE (APPROVE +_ OTHER I I I I j I SIGNATURE(S): I ACTION OF BOARD ON APPROVE AS RECOMMENDED OTHER . � I I� II I II I VOTE IOF SUPERVISORS. I�HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN l AND ENTERED ON THE MINUTES OF THE BOARD AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN. II ABSENT: ABSTAIN: Ij I ATTESTED JOHN CULLEN,CLERK OF THE BOARD OF j SUPERVISORS AND COUNTY ADMINISTRATOR Contact Person: Art Lathrop (925) 646-4690 CC: EMS Health Service Admin_ DEPUTY Ij Ij I r ' I � I � I � I Hospital Council — East Bay Pdblic Provider Field Paramedic Representative Representative Renee Juster, RN D�rreil Lee 11 1 Trauma Center— Contra Costa Contract Representative Kacey Hansen, RN I � I I 1 I I I I I I j 1 I I I I I I � I i I I I I 1 1 I I I I' I I II I I.i 1 l 1 I 1 I I I I I I I I I 1 I 1 l; 1 I' I 1' I 1 I 1 I I I I 1 li 1 Ij I II I II I li 1 li 1 I I 1' I I I' I I' I I' I li Page 2 1 II I li I LKovalef@hsd.cccount To: JLatteri@hsd.cccounty.us y.us cc: 4 09/19/2006 01:15 PM Subject: ACCMA representatives on EMCC Below is the ACCMA nomination/alternate for EMCC. L Lauren Kovaleff, Assistant Director Contra Costa County EMS 1340 Arnold Dr. , Suite 126 Martinez, CA 94507 (925) 646-4402 or (925) 646-4690 ext208 fax: , (925) 313-8381 Please note new email address: lkovalef@hsd.cccounty.us ----i Forwarded by Lauren Kovaleff/Ccchsd on 09/19/2006 01:15 PM ----- "Donald Waters" <dwaters@accma.or To: <lkovalef@hsd.cccounty.us> g> cc: " 'Paul M. Freitas'" <pmfreitas@pacbell.net>, " 'Katie Hurt'" <hurtkatie@comcast.net> 09/19/2006 12: 47 Subject: ACCMA representatives on EMCC PM Lauren: In follow-up to our conversation at the EMCC meeting last week, this is to confirm that the ACCMA wishes to reappoint Doctor Paul_ Freitas to serve as our representative and Doctor Catherine Hurt' to serve as our Alternate Representative .on the Contra Costa Emergency Medical Care Committee: Should you need any further information please contact me. Thanks. Donald Waters, Assistant Executive Director Alameda-Contra Costa Medical Association 6230 Claremont Avenue Oakland, CA 94618 Ph: (510) 654-5383 FAX: (510) 654-8959 E-mail: dwaters@accma.org QS N; 143'7q `1 Z1� 3i 1 CONTRA COSTA COUNTY ADVISORY BOARDS,COMMISSIONS,OR COMMITTEES APPLICATION FOILM Name of Advisory Body applying for ��_..___: ._�.� -_ —•, iii r�Application Form must be typed or hand printed Name of Applicant: C(;�I'uinu �1• Lri _ Home Addrress: hynf;a �t/ N.� rk � City: l -+_1[WJ State: ZIP: q�7 Home Phone: rj � �1 71-(0b Work Phone: Signature: Date: Personal Experiences,Skills,and Interests Education/Background: Occupation/Employer: J Cc�„��fr1YU(C �`�(:� � by ��(;d���S 1 Community Activities: Special Interests: Information: I. File completed application with Clerk of the Board.651 fine Street, Room 106, Martinez,CA 94553, 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements, 3. Address and other contactinformation provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a mnnth_ 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. if you wish you may attach yoar resume. Q�Qbt?a 90i L6££015 09:01 900Z'60 100 r "Mueller, Leslie" To: <LKovalef@hsd.co.contra-costa.ca.us> ' <Leslie_Mueller@amr cc: ems.com> Subject: EMCC 09/13/2006 02:57 PM Lauren- This is to advise you that I am interested in serving as the Ambulance Providers representative to the EMCC. If another agency wishes to serve as well, I would accept the alternate role. Thank you, Leslie Leslie K. Mueller Director of Operations American Medical Response Contra Costa County Division 5151 Port Chicago Highway Concord, CA 94520 Office: 888 267-6591 x88024 Nextel: 925 250-5835 Fax: 925 602-1306 The information in this e-mail transmission,or the documents accompanying this e-mail transmission,may contain confidential health information that is legally protected by state and federal law, including,but not limited to the Health Insurance Portability and Accountability Act of 1996 and related regulations. This information is intended only for the use of the individual or entity to whom this e-mail transmission is addressed. If you are not the intended recipient of this information,or if you are not properly authorized to receive this information;you are hereby notified that any disclosure,copying,distribution or action taken in reliance on the contents of this e-mail or the attached documents is strictly prohibited.If you have received this information in error,please notify the sender immediately by sending a reply e-mail indicating that you have arranged for the deletion of this a=mail and a destruction of this e-mail and any attached documents. i . r CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM � . Name of Advisory Body applying for Application Form must be typed or hand printed Name of Applicant: k-ki t'C e—,,( I �— Home Address: l a 10 (W moi/ 1.) U 0 i-0 P)"ezC City: 0aj V'I,u 1L �G�—�—� State:C +— ZIP: Home Phone; a F 7— 9 "S-w Work Phone: Signature: Date: P rson xperiences, Skills, and Interests Education/Background: Occupation/Employer: Community Activities: Special Interests: Information: 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resume. i I i I r I I ti h II I li I I I II LKovalef@hsd.cccount To: JLatteri@hsd.cccou6ty.us y.us cc: 08/09/2006 11:39 AM Subject: RE: EMCC nominations I -direction on sending requests � I I So we have a change on the trauma alternate already. Would you please note this onithe email from Bev? Bev might resend as well--will let you know. Lauren � I i I Lauren Kovaleff, Assistant Director Contra Costa County'EMS I 1340 Arnold Dr. , Suite 126 Martinez, CA 94507 (925) 6,46-4402 or (925) 6;46-4690 ext208 fax: (925) 313-8381 I I Pleasejnote new email address: lkovalef@hsd.cccounty.us ----- Forwarded by Lauren Kovaleff/Ccchsd on 08/09/2006 11:37 AM ----- I I I "Kacey Hansen" <Kacey.Hansen@johnmuir I To: <LKovalef@hsd.cccounty.us>, "Bev Jones" <Bev.IJones@johnmuirhealth.com> health.com> cc: "Julie Crouse" <Julie;.Crouse@johnmuirhealth.com> I Subject: RE: EMCC nominations - direction on sending requests 08/09/2006 10:49 AM i I , I i I I I i I i I i I One change - please make Kristin Santos my alternative. i I I KaceylA. Hansen, RN Trauma Program Director John Muir Medical Center - Walnut Creek Campus 1601 IYgnacio Valley Road I Walnut Creek, CA 94598 Ph. 9'25-947-5224 Fax 9'25-947-3220 I I ----;Original Message----- From:l LKovalef@hsd.cccounty.us [mailto:LKovalef@hsd.cccounty.us] Senti! Tuesday, August 08, 2006 5:21 PM To: Bev Jones Cc: Kacey Hansen; Julie Crouse Subject: RE: EMCC nominations - direction on sending requests li I li I Thanks, Bev - I 'll go ahead and process them for Board of Sups appolintment. Lauren Lauren Kovaleff, Assistant Director Contlira Costa County EMS 13401 Arnold Dr. , Suite 126 li I II I Ij I Ij I Ii I I� I li i i I I I i I I .I I I I. I I Martinez, CA 94507 (925) 646-4402 or (925) 646-4690 ext208 fax: (925) 313-8381 I Please 'note new email address: lkovalef@hsd.cccounty.us I � I I I � I I I i I "Bev Jones" I I I. I r <Bev.Jones@johnmuir To: <LKovalef@hsd.cccounty.us> I. I I i! health.com> I cc: "Kacey Hansen" <Kacey.Hansen@johnmuirhealth.com>, "Julie Crouse" I I <Julie.Crouse@johnmuirhealth.com> I I 1 08/08/2006 05:11 PM Subject: RE: EMCC nominations - direction on sending requests I I I I I I I I I i I I i I I i I i I I My recommendations would be the following; I Base Station Rep--Lori Altabetiwith Julie Crouse being the alternative. I Trauma representative-Kacey Hanson with Dee Scott being the alternative. I ----;Original Message----- From: LKovalef@hsd.cccounty.us [mailto:LKovalef@hsd.cccounty.us] Sent:' Tuesday, August 08, 2006 1:50 PM To: Bev Jones Subject: RE: .EMCC nominations - direction op sending requests I: I I I, I For base we currently have Julie Crouse as member and Lori as alternate, although Lori attends the meetings. For trauma we currently have Kacey as member and no one as alternate. !1 1 I Lauren Kovaleff, Assistant Director Contra Costa County EMS 1340IIArnold Dr. , Suite 126 Martinez, CA 94507 (9251) 646-4402 or (9251) 646-4690 ext208 fax:i1 (925) 313-8381 Plealse note new email address: lkovalef@hsd.cccounty.us Ij li I �! I I I I I I� I I� I I� I 1j I 11 I 11 I �I I I� I i I I I i I I I I. I I I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM I i I Name of Advisory Body applying for i I Application Form must be typed or hand printed Name of Applicant: 1—n�( / AL An_ �C Home AddriC I'ess: } i ��<� -f- i City: C State: �� ZIP: Home Phone: g Z S Work Phone: Z 1Z 7 3 I Signature: Date: I I � Personal Experiences, Skills, and Interests Education/Background: i I � I i I i I Occupation/Employer: i I I � I i I � I I Community Activities: � I I I I I I � � I I ' Special Interests: I � I I Information: I I I � 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or,in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resumd. i F I I� I V I I� I ' I "Scott Daly" To: <Jlatteri@hsd.cccounty.us> ` <SDaly@so.co.contra- cc: "Dale Morrison" <DMorr@so.co.contra-costa.ca.us>, "Kevin Ryan" ' costa.ca.us> <KRyan@so.co.contra-costa.ca.us>,"Lisa Hoffmann" <LHoff@so.co.contra-costa.ca.us> 08/17/2006 03:49 PM Subject: Representative--Contra Costa Emergency Medical Care Committee (EMCC) At your request, the Office of the Sheriff, Contra Costa County, has designated a representative and an alternate for the next term of the Emergency Medical Care Committee. Communications Director' Lisa -Hoffmann -will w remain as our primary representative, Captain Kevin Ryan ill now be our alternate. If you have any questions, I can be reached at (925) 313-2740. 10/05/2006 18:04 9253132479 CCC SHERIFF DISPATCH PAGE 02 CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM Name of Advisory Body applying for: Emergency Medical Care Committee Application Form must be typed or hand printed Name of Applicant: Lisa Hoffmann Home Address2226 Greenidge Drive City: El Sobrante State: CA Zip: 94803 Home Phone: 510-758-53,2S Work Phone: 925-313-2454 Signature: Date: - - V Personal Experiences,Skills,and Interests Education/Background: Occupatcon/Employer: Communications Center Director for the Contra Costa County Office ofthe.Sheriff 651 Pine Street,Martinez, CA.94553 925-313-2454 Community Activities: Special Interests: Information: I File completed application with Clerk of the Board. 651 Pine Street,Room 106,Martinez, CA 94553, 2 Members of some advisory bodies may be required to file annual Conflict of Interest Statements, 3 Address and other contact information provided on this application will be accessible to the general public. 4 Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation- 5 Meetings may be held either in the evenings or during the day,usually once or twice a month, 6 Some boards assign members to subcommittees or work groups requiring additional time- 7 If you wish you may attach.your resume. Contra Costa Emergency Medical Care Committee -F; Emergency Department Physician Representative From Dr. Alice Hunter I am recommending the following individual for appointment by the Contra Costa Board of Supervisors as the Emergency Department Physician representative to the Contra Costa Emergency Medical Care Committee as either a member or alternate member. Name: �—�- ' L Address: 11 J C Phone #: e-mail: i J Employer: You may either mail this form to the EMS Agency at 1340 Arnold Drive, Suite 126, Martinez, CA 94553, or you may email the information to jlatteri@hsd.cccounty.us. You will be notified once the Board of Supervisors makes the Emergency Department Physician appointment. John Muir Medical Center, Walnut Creek i PHaII hsd.cccoun @ ty.0 To: JLatteri@hsd.cccounty.us s cc: Ikovalef@hsd.cccounty.us 08/28/2006 03:11 PM Subject: EMCC Member Nom Dr. Leinen, Medical Director, Sutter Delta, called to nominate Ellen Leng as the ED Physicians' representative to the EMCC. He called his nom in since Friday was the deadline, he will also forward a note. Pam Hall EMS Contra Costa County. 1340 !Arnold, Suite 126 Martinez, CA 94509 Ph: 925 646-4690 Fx: 925 646-4379 I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM Name of Advisory Body applying for plication Form must be typed or hand printed Name of Applicant: Ore. V�U'�� Home Address: ` �� 7) CGS,,°—j City: Uy �,� L�'��L State: ZIP: `l Home Phone: ^ Z `} Work Phone: Signature: Date: ( � Personal Experiences, Skills,and Interests Education/Background: t Sties ,, Occupation/Employer: 1 1 e�.n Community Activities: Special Interests:. lr�ti� S Information: 1. File completed application with Clerk of the Board. 651 Pine Street,Room 106,Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some-boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resume. ri i David Birdsall To: jlatteri@hsd.ccdounty.us <MDBirdsall@aol.com> m-Allan Drabinsky<APDMED@aol.com> Subject: Dr.Allan Drabinsky 09/13/2006 09:09 PM I I I To whom it may concern: I would like to nominate Dr. Drabinsky to Icontinue on the EMCC committee. I believe that he would be a valuable asset to this group. Sincerely, David A Birdsall MD Medical Director John Muir Concord Campus Emergency Department I I I I I I I I I I I I I I I I I I I I I I I I I � I I I I I I I i I � I I i I I I �! I � I � I I i I I I I I I I =R i CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM Name of 'Advisory Body applying for Application Form must be typed or hand printed Name of Applicant: &I AA, Jbm&xysley Home Address: 302 City: A-)RzQ 61K 6KE&1<- State: C-4 ZIP: Home Phone: . -' �� � � Work Phone: w Signature: � —�-- � ��� Date: i" Personal Experiences, Skills, and Interests Education/Background: /h Occupation/Employer: Community Activities: Special Interests: Information: 1. File completed application with Clerk of the Board. 651 Pine Street,Room 106,Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this I application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. i 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resume. �I I Contra Costa Emergency Medical Care Committee EMS Training Institutio6 Representative Received from Susan Garske I am recommending the following individual for appointment by the Contra Costa Board of Supervisors as the EMS Training Institution representative to the Contra Costa Emeraenry Medical Care Committee as either a member or alternate member. Name: Address: Phone #: ��S �6 ,y� ��j ��(J k Z-7 3 rr II D le-mail: Y1��c `tri 14 �' S(f, ,A-r. I� iEmployer: i You may either mail this form to the EMS Agency at 1340 Arnold Drive, Suite 126, Martinez, CA 94553, or you may email the information to jlatteri@hsd.cccounty.us. You will be notifigd once the Board of Supervisors (makes the EMS Training Institution appointment. Mt. Diablo Adult Education I I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS,OR CONIMI <'TEES APPLICATION FORAM Name of Advisory Body applying for Application Form must be typed or hand printed Name of Applicant: k Home Mdress: /0 4,0 h City: i i c-i`q tate: C4- Zlp: 7� ` - r " �� � 7 �U X �� YHome Phone: Signature: �y: �. Date fZSIXA26 .Personal Experiences,Shills,and Interests Education/Background: Occupation/Employer: ald��ua. r a dv Hcf ail. 14-aLu It c ta. ja,� Community Activities: Special Interests: Information: 1. File completed application with Clerk of the Board. 651 Pine Street,Room 106,Martinez,CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resume. � I I , I I •f i I I J I I i it I II I "Rebecca Rozen" To: <jlatteri@hsd.cccounty.us> <rrozen hos italcoun cc: cil.net> Subject: Nominations for the Emergency Medical Care Committee . '-. + 10/16/2006 04:12 PM � I . I i Juleine, The Hospital Council, East Bay Section is pleased to submit our recommendations below for a member and alternate member to serve on the Contra Costa Emergency Medical Care Committee. I look forward to hearing back from you regarding the appointments. Thank you! I Rebecca I Member Recommendation -Renee Juster, RN Director of Emergency Services John Muir Medical Center, Concord 2540 East Street Concord, CA 94520 (925) 674-2337 . renee.juster@johnmuirhealth.com Alternate Recommendation Jeffrey J. Leinen, MD, FACEP Medical Director, Emergency Department Sutter Delta Medical Center 3901 Lone Tree Way Antioch, CA 94509 (925) 779-7273 —office I I (707) 318-5903—cell leinenmd@comcast.net I I Rebecca Rozen Regional Vice President I � I i I � I � I � I i� i I � Oct 17 06 01:31pp.2 I I ' II ' CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS,OR COMAUTTEES APPLICATION FORM I Name of Advisory Body applying for le � �� 6ommlMee�- i Application Form mast be typ d or hand printed /, c Name of Applicant: i?e4q 1C'L �U J 'vl Home Address: \ v City: State: ZIP: O. ! 1 Home Phone: �oZ —��� >� Work Phone: a�� — I Signature: Date: Personal Experi aces,Skills,and Interests Education/Background: I Occupation/Employer: J\ se To n Community Activities: �" 64- Gam' Co C" C� p uS I Special Interests: i I Information: I ' 1. File completed application with Clerk of the Board. 65],Pine Street,Room 106,Martinez,CA 94553. 2. Members of some advisory bodies may be required to fide annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. lfl:you wish you may attach your resum6. I I I � . I - ' Oct 16 06 09:15a p.1 � i I I I I (CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMWITTEES APPLICATION FORM i • I Name of Advisory Body applying for Application Form must be typed or hand printed Name of Applicant: '1T5 Home Address: 6 �R ��� ✓ C' �� f d City: G✓ � State: Ga ZIP: Home Phone: `7 T- a�� �� 6 Work Phone: 7 d 7 - 3 I I o , I Signature: I Date: Personal;Experienc Ils,and Interests I . • I i I 1 CALIFORNIA EMERGENCY JWPHYSICIANS MEDICAL GROUP Occupatiotv'Employe r: Jeffery J. Wrien, MD, FACEP ED Medical Director i I i I i I Sutter pelta Medical Center 3901 Lone Tree Way ED 925.779.7273 1tleS: Antioch.CA 94509 Admin.Office 925.779.3522 I , I I I , I i I I I I I I S terests. I I I I I I I I Information: 1. File completed application with Clerk of the Board.651 Pine Street, Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements, 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resum6. II II I I I II I it I I I I I� I i LKovalef@hsd.cccount To: JLatteri@hsd.cccounty.us y.us cc: Subject: FW: EMCC 08/28/2006 03:40 PM Here's another - hope not too informal. This is for the Public Paramedic position. i. Lauren Kovaleff, Assistant Director Contra Costa County EMS . 1340I!Arnold Dr. , Suite 126 Martinez, CA 94507 (925)1 646-4402 or (925j 646-4690 ext208 fax: � (925) 313-8381 Please note new email address: lkovalef@hsld.cccounty.us ----- Forwarded by Lauren Kovaleff/Ccchsd on 08/28/2006 03:40 PM ----- "Cox, Bob" <BCox@mofd.org> To: <LKovalef@hsd.co.contra-costa.ca.us> cc: 08/28/2006 03:30 Subject: FW: EMCC PM Hi Lauren, .. I hope this isn't too late? Bob Bob Cox Battalion Chief - Training/EMS Moraga-Orinda Fire District office: (925) 258-4511 cell: (925) 260-4098 fax 1: (925) 376-1699 I ' I i -----Original Message----- From: Lee, Darrell Sent: Monday, August 14, 2006 9:26 PM To: Cox, Bob Subject: EMCC Here's my letter to support my intereist in the Public Provider Paramedic Darrell R. Lee Captain Paramedic /EMS Coordinator .i Moraga-Orinda Fire District DHS/ FEMA/ DMAT CA-6 j 925.258.4599 925.260.5284 Nextel (See attached file: EMCC Application Letter 06.doc) i EMCC Application Letter 06.doc I i Y CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM Name ofAdviso Bod applying for m C rY Y Application Form must be typed or hand printed Name of Applicant: Home Address: I City: -���+k S�tate: C4 zip: X1 3 Home Phone: O �� Work Phone: Signature: Date: 1 Q i Personal Experiences, Skills, and Interests Education/Background: I i Occupatiin/Employer: ,f:,,y C a Community Activities: Gal Special Interests: C—yv�GC Information: 1. File completed application with Clerk of the Board. 651 Pine Street,Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez o in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a month. 6. Some boards assign members to subcommittees or wort groups requiring additional time. 7. If you wish you may attach your resum6. fI I • I I• I _ + I 'I I I ' I I I I I I �I LKovalef@hsd.cccount To: JLatteri@hsd.cccodnty.us y.us cc: w �I 08/09/2006 11:39 AM Subject: RE: EMCC nominations-direction on sending requests I So we have a change on the trauma alternate already. Would you please note this on the email from Bev? Bev might resend; as well--will let you know. Lauren i Lauren 'Kovaleff, Assistant Director Contra.Costa County EMS 1340 Arnold Dr. , Suite 126 Martinez, CA 94507 (925) 646-4402 or (925) 646-4690 ext208 fax: (925) 313-8381 Please note new email address: lkovalef@hsd;cccounty.us ----- Forwarded by Lauren Kovaleff/Ccchsd on �08/09/2006 11:37 AM ----- I "Kacey Hansen" <Kacey.Hansen@johnmuirl To: <LKovalef@hsd.cccounty.us>, "Bev Jones" <Bev.Jones@johnmuirhealth.com> health.com> cc: "Julie Crouse" <Julie.Crouse@johnmuirhealth.com> Subject: RE: EMCC nominations - direction on sending requests 08/09/2006 10:49 AM i I i I I I I I I I I I I I One change - please make Kristin Santos my alternative. I Kacey A. Hansen, RN Trauma Program Director John[Muir Medical Center - Walnut Creek Campus 16011.Ygnacio Valley Road Walnut Creek, CA 94598 Ph. 925-947-5224 Fax 925-947-3220 � I ' I ----�-Original Message----- From: LKovalef@hsd.cccounty.us [mailto:LKovalef@hsd.cccounty.us] Sent: Tuesday, August 08, 2006 5:21 PM To: jBev Jones Cc: lKacey Hansen; Julie Crouse Subject: RE: EMCC nominations - direction on sending requests I I I I I Thanks, Bev - I'll go ahead and process them for Board of Sups applointment. Lauren li I Lauren Kovaleff, Assistant Director CoAra Costa County EMS 13410 Arnold Dr. , Suite 126 II I j! I I� I i I II I I � Martinez, CA 94507 (925) 646-4402 or i (925) 646-4690 ext208 fax: (925) 313-8381 I i Please' note new email address: lkovalef@hsd.cccounty.us i "Bev Jones" i <Bev.Jones@johnmuir To: <LKovalef@hsd.cccounty.us> i health.com> cc: "Kacey Hansen" <Kacey.Hansen@johnmuirhealth.com>, "Julie Crouse" <Julie.Crouse@johnmuirhealth.com> 08/08/2006 05: 11 PM Subject: RE: EMCC nominations - direction on sending requests My recommendations would be the following; Base Station Rep--Lori Altabet with Julie Crouse being the alternative. _ Trauma representative-Kacey Hanson with Dee Scott being the alternative. i ----Original Message----- From: LKovalef@hsd.cccounty.us [mailto:LKovalef@hsd.cccounty.us) Sentl`. Tuesday, August 08, 2006 1:50 PM To: Bev Jones Subjiect: RE: EMCC nominations - direction on sending requests I � For ,base we currently have Julie Crouse as member and Lori as alternate, although Lori attends the meetings. , Foritrauma we currently have Kacey as member and no one as alternate. Lauren Kovaleff, Assistant Director i Contra Costa County EMS 1340 Arnold Dr. , Suite 126 Martinez, CA 94507 (925) 646-4402 or (925) 646-4690 ext208 fax: (925) 313-8381 Please note new email address: lkovalef@hsd.cccounty.us f ' . i I � I I � I I i I � i i �I i Oct 20 06109: 20a P• 1 I I I I I I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM Name of Advisory Body applying for Eire e d�ie��-/ Application Form must be typed or hand printed Name of Applicant: A—'a 44errte Address: /6 O/ City: State: Cq ZIP: 9'/S99 I HrnriePhone: Work Phone: I Signature: Date: Personal Experiences, Skills,and Interests 4Q (/(L 7'� C f e Education/Background: I . i I i I Occupati LEmployer: ' VN rv,v v- m e�• i, I I I Community Activities: I II i . I Post-it°'Fax Note 7871 Dat1 t. pg0ZaLaes TqV�/ �/;J coJoePt. co. Special IIterests: /n Phone# Phone# 951-7-5:2-2-91' I, Fax# 3/3 —83 4/ Fax# I• � Information: i 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106,Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resume. II I I i i Contra Costa Emergency Medical Care Committee American Red Cross Representative (Received from Paula Andrews) i I am recommending the following individuals for appointment by the Contra Costa Board of Supervisors as the representative to the Contra Costa Emeraencv Medica! Care Committee as eitheria member or alternate member. Member Recommendation Name: 4 F w II Address: �� 7 /7/�z �L p2 'I Phone #: I, I e mail: pC�)uL_ a i a Co.) S be. v�c? n if I Employer: AperiCan leed (�-os5 JLOZ410 eer Alternate Recommendation Name: 6112sa 40�EVYVIr. I Address: I II � Phone itI e-mail: 01 I Employer: DS> i I li You may either mail this form to the EMS Agency at 1340 Arnold Drive, Suite 126, Martinez, CA 94553, or you may email;the information to jlatteri@hsd.cccounty.us. You will be notified once the Board of Supervisors I. makes the American Red Cross appointments. I I I, li it i it I i I I I I I I I ( I I I I I I I , I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM /J Name of Advisory Body applying for 6/Y!f gCFW C I-� rn f D i C A I- Od re Application Form must be typed or hand printed Name of Applicant: 7a u c. a -J -AA-1 D 2 0 w Home Address: d,4 Z,E City: P L EA S A N r 4 :1,1, State: CA ZIP: Home Phone:C�1' 5) G v Y 3 3 Work Phone: N//I II Signature: ', Date: Personal Experiences, Skills, and Interests Education/Background: re r- i n v s'r ti i I I ' � I Occupatiori/Employer: e.T i rz r v 1J I I, I ' i I � I Community Activities: I ' i .i Special Interests: I I ' I ' Information: 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106,Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. I; 4. Meetings of advisory bodies may be held in Martinez or,in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resum6. I ' I � I I I ' � I COWR-A COSTA COUNTY ADVISORY BOARDS, co-:mf.Ni rr-rEES A.-PPI.-KATION F Of N.anie ofA.dvlsory Rody applying I')r Application Form must he typed or hand I)HF �A Nanj�e oi- /-�ppj ICIIIIII: 'U Home Address., T- S lite: C I t Hoi ie Phone- Pht e: oi SW,katLIN: Personal Experiences, Skills, and Intuests I 4 V 06C u Pa t 1,C-)n/1---m P 10' e I" It i Ce'immunity Activities: I ~ I I I I I Contra Costa Emergency Medical Care Committee California Highway Patrol Representative From Captain Jim Cahoon I I I am recommending the following individuals for appointment by the Contra Costa Board of Supervisors as the representative to the Contra Costa Emergency Medical Care Committee as either a member or alternate member. I , -- I I I Member Recommendation Name: �AUL6&Z-,_j II I I I Address: .Soo k Q LSM +2-D li I Phone #: 9225- C.q(,- q 18.0 II I I e-mail: M aty L-G2.F-00 e,*f. C4. 6oV I I I I Employer: CALjr-arLJ ,A J1r.14-WAY el*-MOL- I � Alternate Recommendation Name: L--r. C LAWa wP�u..Ac I i � I Address: _Sc�o 6 LURA AAAf1-T,rj Z? G4 '-f q5�5_3 I I I� I Phone #: y�-�- 6Y6_ rf99 I II I e-mail: c wAL.L_,4c::& {P.C A. !tea v I I Employer: r ,q.`,FrL#jt,4 th6.A .,*Y P.+�26� I i li I You may either mail this form to the EMS Agency at 1340 Arnold Drive, Suite 126, Martinez, CA 94553, or you may email;the information to jlatteri@hsd.cccounty.us. You will be notified once the Board of Supervisors ;makes the California Highway Patrol appointments. li I I I I� I II I� I li , � I r I I OCT-06-2006 11:27 CHP MARTINEZ 9256464990 P.02 I I I I (CONTRA COS'T'A COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM II I I I I I Name of Advisory Body applying forCs Kga-Ga,s c.•t KtO&c:4L c6" c t-4&k i-r ee I I Application Form must be typed or hand printed I I Name of Applicant: _t-AIAN11, P4ULt6&Z1.J - Home Address; seat S i or-A P.&A0 City: Staite: _CA ZIP: 94(S53 � I - Home Phone: Work Phone; 4 Z S 6q&- u 9ro I� I I I Signature. i Date: j o lG/o i Personal Experiences,Skills, and Interests I Education/Background: I I I � I I i I I I I I Occupation Employer: L �,--r,�,.�,a.,�r� CA. R i cs K0hy ?&-r2*L I I I I I I I I I I I I Community Activities: � I I I I I I � I I I I , Special Interests: I I I I I I , I I Information: 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file iannual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the iday,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resum6. I � I I I � TOTAL P.02 I I I ' , I I I r I I I I a i I I I II "Tim Hennessy" To: <latteri hsd.cccount •us> <THenn@so.co.contra- cc: <bfins@cccfpd.org>, "Lisa Hoffmann" costa.ca.us> <LHoff@so.co.contra-costa.ca.us>, <Csuter@srvfire.gov> 08/18/2006 01:03 PM Subject: CCMA Appointees for EMCC I I I will: be the CCMA member.; I I I Tim Hennessy Contra' Costa County Office of the Sheriff 40 Glacier Drive Martinez, CA 94553 thenn@.i,so.cccounty.us lI I I Voice:) 925.313.2461 Cell: ;925.595.3859 I I I I My alternate will be Brent Finster. His contact info remains the same. - I Please contact me should you have any questions. I I I I I I Tim Hennessy, ENP Communications Training Supervisor Contra Costa County Office of the Sheriff 40 Glacier Drive Martinez, CA 94553 I I Voice': 925.313.2461 Fax: ;925.313.2479 I Email: thenn@so.co.contra-costa.ca.us I I I I I I I I I I I I I I I: I I I I I I I I I I I I I I I I I I I I I I, I I I. I I. I � I I I I II I I I I I I I I I I I ' I I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM I �Name of Advisory Body applying for M C--� _ I Application Form must be typed or hand printed Name of Applicant: '11A4 Off! /-/-U/Vit/t53 I ' � Home Address: POL-I C gag c Gi City: _&Ael-ZA EL State: 0y ZIP: G!c/C'">Z Home Phone: Work Phone: Lj Z S44 Signatur . '-4 Date: ( 3-. I Personal Experiences, S "' , anderests Education/Background: I I C44uLumi6-4-T/avS Jnr ) Occupation/Employer: I I � I I Community Activities: I I I I I I I Special Interests: ,Vt LA;n C&SciAU tJ l N(ii� �3 I Information: 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or workgroups requiring additional time. 7. If you wish you may attach your resume. ' I ' ' I ' I I I I I I. "Aaron Baker" To: <jlatteri@hsd.cccounty.us> ,`:• <abaker@ci.pittsburg.c cc: "C Gibson"<CGibson@dvc.edu> a.us> Subject: Contra Costa County Police Chiefs'Assoc. A-Z 09/29/2006 09:40 AM I I I Good morning Ms. Latteri. The Contra Costa County Police Chiefs'Association would like to recommend Chief Charles Gibson as our representative for appointment to the Contra Costa Emergency Medical Care Committee (EMCC). Chief Gibson is.the Police Chief for the Contra Costa Community College District, is highly recommended by our Association, and would be an excellent committee member. I strongly recommend Chief Gibson for this appointment by the Board of Supervisors. Feel free to contact me should you have any questions at(925)252-4987, or reply to this email. Chief Gibson's can be reached at: Chief Charles Gibson CCC Community College District 500 Court St. Martinez, CA 94553-1278 Business telephone: 686-5547 Email: cgibson@dvc.edu I I I I Sincerely, I Aaron L. Baker, Pittsburg Police Chief Chairman, CCC Chiefs' Assoc I I I I I I � I I I I I I I I I I I I I I I I I I I I I . I I I I I I I I I I I I I I I i I I I I I I I I I I I OCT-2-2006 02:23P FROM:DISTRICT POLICE DVC 9256850812 TO:19253138391 P.1 � I I I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM i Name of Advisory Body applying for SNI c C Application Form must be tybed or hand printed �y L I Name of Applicant: 0—�A.V I CS f� t b�SD,J Home Address: Pt').Zo x OR 111.3 I City: ICL .SBARAA L State: ZIP: 9� Home Phone: 1® d� — �'aD� Work Phone: 02.:�i Q I I Signature: i Date: . Personal Experiences,Skills,and Interests Education/Background: I I I I � I Occupation/Employer: P6 NO—;:' ate i I � I � I � I r' Community Activities: � I � I � I i I Special Interests: i I I I Information: I I I. File completed application with Clerk of the Board. 651, Pine Street, Room 106, Martinez,CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on thisl application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If,you wish you may attach your resum6. II I I II I i I • I I "Scott Daly" To: <Jlatteri@hsd.eccounty.us> <SDaly@so.co.contra- cc: "Dale Morrison'<DMorr@so.co.contra-costa.ca.us>,"Kevin Ryan" costa.ca.us> <KRyan@so.co.contra-costa.ca.us>,"Lisa Hoffmann" <LHoff@so.col.contra-costa.ca.us> 08/17/2006 03:49 PM Subject: Representatives Contra Costa Emergency Medical Care Committee (EMCC) I At your request, the Office of the Sheriff,) Contra Costa County, has designated a representative and an alternate for the next term of the Emergency Medical Care Committee. Communications Director Lisa Hoffmann will remain as our primary representative, Captain Kevin Ryan will now be our alternate. lI If you have any questions, I can be reached at (925) 313-2740. I � I II I •j I I I I I I I I I I I I I I I I I I I I I I I • I I I I j I I; I II i • I� I OCT. 23. 2006 9:51AM EMERGENCY SERVICES I N0. 0319 P. 2 I CONTRA COSTA COUNTY ADVISORY iOARDS,CONaUSSIiONS,OR COMMMES APPLICATION FORM I Name of Advisory Y applying Bodfor Application Form must be typed or hand printed Name of Applicant:_KEVIN PYAV i Home Address: &Q G LAX-1 F. DR, City: NAT &)F-Z' State:-CA-_,Zw: g�{5 Home Phone: - Work Phone: }_ �{vre'- �{ G r I Signature: — I Date: /a- 17-Ore _ Personal Eape ences,Shills ind Interests 1 Education/Background:- BA ducation/Backgrou nd:$A STATE uui V, OF A;EW YOU, FR O010A - LAIA/ i TcJ5T 1 cE I Occupation/Employa. cAPTA1ti - oFF1cz DF TRS SHFkiFF cuRAwTz,Y 5EAvWce AS TT45 FMF-AGFWC'Y vAcF-6 DIV15110Al CoMMAA)D P2 AA1, 1AEt--rO� of: 7-HF— OFFt cZ 04-- 5mgArSEWCY 1 SERvt 6 S Community Activities: I Special Interests: I Information: 1_ File completed application with Clerk-of the Board. 651 Pine Street,Room 106,Martinez,CA 94553. 2. Members of soxne advisory bodies may be required to file anmial Conflict of Xuterest Statements. 3. Address and other contact information provided on this 6pplication will be accessible to the general public. 4_ Meetings of advisory bodies may be held in Martinez of in areas not accessible by public transportation. 5. Meetings may be held either in the evenWgs or during The day,usually once or twice a mowk 6. "§ome boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resum6. I� I Ij I . I . i i i 1 i i i i r 'Rebecca Rozen" To: <jlatteri@hsd.cccounty.us> <rrozen hos italcoun cc: ' cil.net> Subject: Nominations for the Emergency Medical Care Committee 10/16/2006 04:12 PM Juleine, The Hospital Council, East Bay Section is pleased to submit our recommendations below for a member and alternate member to serve on the Contra Costa Emergency Medical Care Committee. I look forward to hearing back from you regarding the appointments. Thank you! Rebecca Member Recommendation Renee Juster, RN Director of Emergency Services John Muir Medical Center, Concord 2540 East Street Concord, CA 94520 (925) 674-2337 renee.juster@johnmuirhealth.com Alternate Recommendation Jeffrey J. Leinen, MD, FACEP Medical Director, Emergency Department Sutter Delta Medical Center 3901 Lone Tree Way Antioch, CA 94509 (925)779-7273 —office (707) 318-5903 —cell leinenmd@comcast.net Rebecca Rozen Regional Vice President i i r Oct 17 06 01:31p p.2 I ' I. CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COIVINUTTEES APPLICATION FORM J ltiT amc of Advisory Body applying for Application Form must be typ d or hand printed Name of Applicant: I?e4n+ Home Address: \ v-�— City: 1�i�4State: C- _ZIP: Home Phone: Clot Work Phone: q a�` 6 —7 9 a Signature: R W o Date: l r Personal Experi nces,Skills,and Interests Education/Background: Occupation/Employer: Jae �G-'4 ( Gommuni ry Activities: 6zl '/ cc)J/C, us Special Interests: Information: 1. File completed application with Clerk of the Board. 651 Pine Street,Room 106,Martinez,CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If.you wish you may attach your resum6. • I I * Oct 13 06 09:15a 1 p.1 •, 1 /x/ ee � I (CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM • I I Name of Advisory Body applying for � G c-- Application Application Form must be typed dr hand printed I Name of Applicant: '1'�5 "�I-" y --Ir L 119--.;"-" Home Address: e CP �< ��� Y C. e- 'e— city: e-Ciry: State G 4- ZIP: Home Phone: ' r -7 2 a/_ �� 6 Work Phone: 7 0 7 - 3 /g- .9-"r D ,7 . I I Signature: Date: �� / G Personal Erperienc • lis,and Interests I • I I ,CALIFORNIA EMERGENCY( BPHYSICIANS 1 MEDICAL GROUP Occupatioty Employer: Jeffery J. Leinen, MD, FACEP ED Medical Director I I I Sutter Delta Medical Center 3901 Lone Tree Way I ED 925.779.7273 C1?t ItieS: Antioch,CA 94509 1 Admin.Office 925.779.3522 I I I I I I I I S nterests: I 1 I 1 Information: I 1. File completed application with Clerk of the Board. 651 Pine Street, Room 106; Martinez, CA 94553, 2. Members of some advisory bodies may be required to file annual Conflict of interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the day, usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you wish you may attach your resumd. I 1 � I I I 1 I� I I II 1 III 1 I I I I I I "Scott Hanin" To: <jlatteri@hsd.cccounty.us> <shanin@ci.el-cerHto.c cc: a.us> Subject: EMCC 09/19/2006 03:04 PM I I I The PMA Appointments are: I Belinda Espinosa, CM—Pinole- Bespinosa(aDci.ginole.ca.us I And myself as Alternate Scott Hanin' City Manager I City of EI Cerrito shanin(a)_ci.el-cerrito.ca.us 10890 San Pablo Avenue EI Cerrito, CA 94530 510-215-4301 I www.el-cerrito.org I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I ' I ' I I I I ' I I I ' I I ' I • I I CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR COMMITTEES APPLICATION FORM I I Name of Advisory Body applying for: Emergency Medical Care Committee I Application Form must be typed or hand printed I Name of Applicant: Ilome Address: 1 Fletcher Court I City: State: LII': Alameda, CA 94501 1 Home Phone: 510- - 308 Work Phone: 510-215-4:01 I I Signature: _ I Date: OCtuber 5,2006 I Personal Experiences,Skills,and Interests Ed ucation/Back ground, I I I I I I Occupation/Employer: City of El Cerrito, City Manager I I I I I I Cornununity Activil.ies: I I I I I I I Special Interests: I I I I Information: I 1 File completed application with Clerk of the Board. 6S 1 Pine Street,Room 106, Martinez,CA 04553. file 2 Members of some advisory bodies may be required tole annual Conflict.of Interest Statements. 3 Address and other contact information provided on this application will be accessible to the general public. 4 Meetings of advisory bodies may be held in Martinezlor in areas not accessible by public transportation. 5 Meetings may be held either in the evenings or during the day, usubtlly once or twice a month. is Some hoards assign members to subcommittees or work groups requiring additional time. 7 If you wish you may attach your resume. I I I I I I :woad OT:TT 9002-22-130 T,T'd OSHS03:01 y, I I I ' - I I I I LKovalef@hsd.cccount To: JLatteri@hsd.cccounty.us y.us cc: I 08/09/2006 11:39 AM Subject: RE: EMCC nominations-direction on sending requests I I I So we have a change on the trauma alternate already. Would you please note this on the email from Bev? Bev might resena as well--will let you know. Lauren I Lauren Kovaleff, Assistant Director Contra Costa County EMS 1340 Arnold Dr. , Suite 126 Martinez, CA 94507 (925) 646-4402 or (925) 646-4690 ext208 I fax: (925) 313-8381 I Please note new email address: lkovalef@hsd.cccounty.us -�--- Forwarded by Lauren Kovaleff/Ccchsd on 08/09/2006 11:37 AM ----- "Kacey Hansen" <Kacey.Hansen@johnmuir To: <LKovalef@hsd.cccounty.us>, "Bev Jones" <Bev.Jones@johnmuirhealth.com> health.com> I cc: "Julie Crouse" <Julie.Crouse@johnmuirhealth.com> Subject: RE: EMCC nominations - direction on sending requests 08/09/2006 10: 49 AM I I I I I I One change - please make .Kristin Santos my ;alternative. Kacey A. Hansen, RN Trauma Program Director John Muir Medical Center - Walnut Creek Campus 1601 Ygnacio Valley Road Walnut Creek, CA 94598 Ph. 925-947-5224 Fax 925-947-3220 I -----Original Message----- From: LKovalef@hsd.cccounty.us [mailto:LKovalef@hsd.cccounty.us] Sent: Tuesday, August 08, 2006 5:21 PM To: Bev Jones Cc: Kacey Hansen; Julie Crouse Subject: RE: EMCC nominations - direction on sending requests I I Thanks, Bev - I'll go ahead and process them for Board of Sups appointment. Lauren � I Lauren Kovaleff, Assistant Director I Contra Costa County EMS 1346 Arnold Dr. , Suite 126 �I I it I I� I I I ' I I I Martinez, CA 94507 (925)1646-4402 or (925)1646-4690 ext208 fax: (925) 313-8381 Please note new email address: lkovalef@hsd.cccounty.us I I I "Bev Jones" I <Bev.Jones@johnmuir To: <LKovalef@hsd.cccounty.us> health.com> . cc: "Kacey Hansen" <Kacey.Hansen@johnmuirhealth.com>, I"Julie Crouse" <Julie.Crouse@johnmuirhealth.com> I 08/08/2006 05: 11 PM Subject: RE: EMCC nominations - direction on sending requestsl I I I I I I I My recommendations would be the following; ) Base Station Rep--Lori Altabet with Julie Crouse being the alternative. Trauma representative-Kacey Hanson with Dee Scott being the alternative. I I -----Original Message----- I From: LKovalef@hsd.cccounty.us [mailto:LKovalef@hsd.cccounty.us] Sent: Tuesday, August 08, 2006 1:50 PM To: Bev Jones Subject: RE: EMCC nominations - direction on sending requests I For base we currently have Julie Crouse aslmember and Lori as alternate, although Lori attends the meetings. I For trauma we currently have Kacey as member and no one as alternate. I Lauren Kovaleff, Assistant Director Contra Costa County EMS 1340 Arnold Dr. , Suite 126 Martinez, CA 94507 (925) 646-4402 or (925) 646-4690 ext208 fax (925) 313-8381 I I Please note new email address: lkovalef@Hsd.cccounty.us �I I � I � I �I I I i I� i Oct 06 06 02: 41p P• 2 ,n � I I I ;CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS, OR ! COMMITTEES APPLICATION FORM I I Name of Advisory Body applying for W]fl,{•o��n� Meo(, .C4.( C.Alf e- C4wrwrl tfe,e' I Application Form must be typed or hand printed Name of Applicant: k-V Sti'y S&*%_to-r Home Address: (60t l g y A 6 o City: W 0 j K Ur C*'Ie K State: CA ZIP: 9Lt s 7 g Home Phone: 925- 'T47- Work Phone: 12-9- `[`f 7` S22L- I I Signature: r'<AAj_k�,�^M }- I Date: to- 6--o6 I Personal Experiences, Skills, and Interests Education/Background: I I I I I I Occupation/Employer: Trau wt a Gl i►��ca,( ti u►�se S�'c.{a.t'�s� Jo ItiK M t c,c r M eb Ca,{ CClk te,*-- Wal n uT cam P us I I Community,Activities: I I I I I I Special Interests: I I I Information: I ! I 1. File coinpleted application with Clerk of the Board. 651 Pine Street, Room 106, Martinez, CA 94553. 2. Members rof some advisory bodies may be required to file'annual Conflict of Interest Statements. 3. Address and other contact information provided on this application will be accessible to the general public. r 4. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 5. Meetings may be held either in the evenings or during the'day,usually once or twice a month. 6. Some boards assign members to subcommittees or work groups requiring additional time. 7. If you ;wish you may attach your resume. I' I II I I I I