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03-2610 3-�v� Council File # Crreen Sheet # 205355 RESOLUTION CITY OF SA1NT PAUL, MINNESOTA Presented By Referred To 0 Committee: Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 14 20 Dr. Charles Crutchfield - term eapares March 1, 2005 Kalia Lo - term expires March 1, 2005 Laurie Richards - term expires March 1, 2005 Dr. Dang Tran - term expires March 1, 2005 RESOLVED, that the Saint Paul City Council consents to and approves the appointments, made by the Mayor, of the following individuals to serve on the Joint City/County Health Services Advisory Committee. APPOINTMENTS D3•�� DFPARTMENT/OFFICNCOUNCIL DATEINITIATm � ' y or�s Office March 12 Zoo GREEN SHEET No 205355 COIJTACT PERSOPIB PHONE � Initl� �nnbUData Rurt Schultz o[nu��roa[crort a,rcou+ci MUST BE ON GOUNCILAGENDA BY (DATq March 19, 2003 Assicx NUMBERFOR �GIYATiORMEY pIYCLGK ROVfING ORDER ❑ f1lRI�CIaLfEnVICFJOR ❑ A1n11CJSlfFnV�ACRC ❑ 1111YOR(ORA4314TA1!!) ❑ TOTAL # OF SIGNATURE PAGES (CLIP ALL LOCATIONS FOR SIGNATURE) CTION RE�UESTm � - - Approving the appointment of Dr. Charles Crutch£ield, Ralia Lo, Laurie Richards, and Dr. Dang Tran.to the Joint City/County Health Services Advisory Co�ittee. RECAMMENDATION prove (A) w Reject (R) VERSONALSERViCE CONlRACfS MUSTANSWEIITHE FOLLOWING QIIESTiONS: i. Has this pe�soNfirm ever wnrked under a conGact ta fhis departmerit? PLANNING CAMMISSION VES NO CIB COMMITTEE 2. Has Mis persoMrm ever been a dry empbyee? CIVILSERV�CECOMMISSION � VES NO 3. Do� this per�im posaess a sidll not normellypossessed by arry curreM city employee? YES NO � 4. lsthis peiso�im atargeted verdoYt YES NO E�lain all yes answers on separate sheet and attach to preen sheet MITIATMG PROBLEtA ISSUE, OPPOR7UNIN (Who, What, Wheq Where, Why) ADVANTAGESIFAPPROVED DISADVANTAGES IFAPPROVED DISADVANTAGES IF NOTAPPROVED - TOTALAMOUN70FTRANSACTIONf COST/REVENUEBUDGEfED(CIRCLEONE) YES NO FUNDING SOURCB ACTMTY NUMBER � FlNPNGIALWFORMATION(EXPWN) �� n. ��;v� . ., � r� �a03 d�.7,bi CITY OF SAINT PAUL Randy C. Ke[ly, Mayor To: From: Date: '� 390 CiTy Hal[ IS West Kel[ogg Boulevard Saint Paul, MN 55102 Saint Paul Citv Councilmembers Council President Dan Bostrom Councilmember 7ay Benanav Councilmember Jerry Blakey Councilmember Chris Coleman Councilmember Patrick Harris Councilmember Kathy Lanhy Councilmember 7ames Reiter Kurt Schultz Assistant to the Mayor March 12, 2003 Telephone: 651-266-8510 Facsimile: 651-266-8513 Joint City/County Health Services Advisory Committee Mayor Kelly has recommended the appoinhnent of Dr. Charles Crutchfield, Kalia Lo, Laurie Richards and Dr. Dang Tran to the 7oint City/County Health Services Advisory Committee. The terms of each of these individuals shall expire on March 1, 2005. Attached is a copy of the resolution nominating these individuals as well as their applications. Please remember that certain information on the applications is classified as private and should not be released to the public. Feel free to contact me at 266-6590 if you have any questions regarding these appoinhnents. Attachxnents cc. Richard Ragan � � D 3 • 2�i RFCEliI�� Application for Committee, Soard, or Commission Please return to Mark Engebretson Mayor's Office, Room 390 City Hall 15 West Kellogg Blvd., Saint Paul, MN 55102 - Phone:651-266-8533 Fax:651-266-8513 JAN 2 7 2003 MAYOR'S OfFiCE The Minneso[a Government Data Practices Act (Mmnesota Statutes Chapter 13) governs the Ci[y's use of the -- information contained in this application. Some of the information sought in this application is private data under ihe AcL The reque5ted information will be used by [he appointing authority to carry out Che City's official appointment responsibilitie5. You are not required to provide any inFormation. However, failure ro answer the application questions may cause [he appointing authority to reject your application. The majority of items contained in this application are public, inctuding name, address, employment, skiils, training and experience, and are therefore availabie to anyone reques��ng it. The remaining items on the application form are classified as private. The private data is available ouly to you and [o o[herpFrsons in the C�ty who, bey5pse of work assignments, reasonably require access to the information. Name Home address Telepnones Plcase include Area i E-mail address 7D rza�or� -' [ree[ �r�\��it Planning District Council Preferred mailing address Occupation C Place of employment Employment address _ Committee(s) applied for S57b� zip ��3 �. City Council Ward_� � s[a[e 63 U �UC_• �� 5( What skills/training or experience do you possess for the committee(s) for which you seek appointment? Yus� . vi � � ,� � Personal Ref rences Name � j �'�,L}� Address !`CZ N� ��li� Telephones �pJ ( ��{�P PleaSe includ rea Codes home Name d.,� � Address _�QO 0,3•2101 � � 7 l � G�U-� VV�dL S S��`f �r�� (z(� v wor other zc c �� a.u.� �a � S Stvi �f �G� � I � 3I - 3'19 � �� wo k � other ./�� —�—� . ,c�. r� � (� � � x1 �. „ . . 0 G�l .� s / Telephones � ( c��a. Please include�.eY Codes home m Name �[nj,rU` Address �' � Telephones �'b'( Pleaseinclnde Area Codes h (Q` `� I.CeCp woik Reasons for your interest in this particular committee otnez Have you had previous contact with the committee for which you are making application? If so, when, and under what circumstances? In an attempt to ensure that committee representation reflects the makeup of our community, please check the box applicable to you. This information is strictly voluntary. � White (Caucasian) � Hispanic lack (African-American) � Asian or Pacific Islander � American Indian oz Alaskan Eskimo Male Female � Date of birth Disabled: � Yes No If special accommodations are needed, please specify �Tnw Aid vnn hPar ahmit this nnenina� FRX N0. :6517724791 Dee. 86 2092 03:04PM P2 r �� - � f Application for Committee, Board, or Commission Please return to AMark Engebretson Mayor's Office, Room 390 City fTall 15 West Keilogg 81vd., Saint Paul, MN 55102 Phonc:651-266-8533 Fax:651-266-8513 The Minnexota Governroeni Data Practices Ace (Minncsoes S�atucet frap[er 73) go�erns che C�ty's usc of [he iniorma�ion conrained in �his applicseion, Some of the informaiion sought in this applicarion is Qrivs�c dara under �hc Ac�. Thz requuted informatiun wi11 he used by thc appoinung uuihuriiy to wrry aut [he Cuy's officia] appoin�menl responsibilities. Yuu ar< out rcquired tu provide sny infarenacion. However, Eai4uro to answer the spplication que;tionr msy cuuse the sppointing suthurity to rcject your ppplica�ion. The majority of items contained in [his application ate pubhc, includiog namc, address, employmena, skills, [raining and expariance, and are e�crefore avaitable to anyone requesting i[. Thc remsining iecmx nn tho spplicaliuo form are classi[icd as p�iva�e. The priva[e dmia it nvailablt only tu yuu and tu o[hcr persuns in ehe Ciry who, 6eesucc of..ork assigmnenis, ressonably require access �o the inCorma�iun. Namc Kalia Lo Ciome address 956 Meadow Ave, Shoreview, MN 55126 str<er mp staw i p Tetephones (651) 765-9257 (651) 772-4788 (651) 772-4791 PleqSe IncluJcArn loJea hom< wo� xx E-mail address klo@wahivomen.orx Planning Distric[ Council �pistricc 5 City Couttcil Ward Preferred mailing address . 06 K"ny Foad. St. Paul MN 55726 sircot City ntaw e,p Occupation /�SSOC�qrP Dirnctor Placeofemployment y��man'� Acaociation of Hmonp Tgn Tnr Employment address 506 xP„nv R�ad �� p i a.rt. 55176 Committee(s) applied for �r_ pa,�1 Ramc �, r ry uoa�th SPr�;�ac ad, ia�,-� r irr Whac skills/training or experienee do ye�u possess for the committee(s) for which you seek appointment'? S have a harhalor d@grgp i_ �Communitv Healrh F�i�r i a a school health educstion. I have worked with community agency co promote health and wellness. Cur entl I 8m a volunteer member of HOPE Academ v k their community partnership team� I hsve developed, 3mplemented, and presented on health and nutr3tion. domes volience on famllies. and is a sexual assualt advocate.� I am also working on the Hmong Taek Force and Latino Taek Force fot the East Side of SL. Paul. As the Ass ociate Director. I oversee the wellness of the staff and Provide educational sessions for staff to reduce atrese and burn-out. In additlon, I have eroerience in vrovidine oarentins education page 1 of2 FRX N0. :6517724791 Dec. 06 2002 03:04PM P3 p 3��► , eTSOnal References Name � van� Address 506 Kenny Road, St. Paul, M�iI 55126 Tcicphoncs (651) 772-4788 Ylessc inciu0e Area Codes homc worA othcr Nnme ' " " �� . .- .. „v � Telephones Ylcnscinclude Arca Codes homc S1) 266-8710 wprk othe[ Nsme Healther Bauin Address 1280 Arcade Street, St. PauL MN 5 Telephones f 51) 77L_n'iG4 Plesae iodude Area Cudos homc work uchcr Reasons for your interest in this particular committee g$msey Countv Health Services -. . .- . . .- . . .- . . -. in helpin� to make decision about the we11—being of the people of St. Paul. I 19kP to see thp ci[v�out efforra Pow rd h-alch iaa�a�a tha rala�,ac � y]7 hni� gTOUp. Hnve you had pxevious contact with the committee for which you are making application? if So, whcn, and undcr whal circumstanccs? No Tn nn ntcemp[ to ensure that committee representntion reflects the makeup of our community, please check the box Applicable to you. This infotmution is stsictly valuntary. � White (Caucasian) � Hispauic �Black (African-American) Q Asian or Pacific C,lander � Amcrican Indian or Ataskan Eskimo � Male Female � Date of birth 5�18.�6? Disablcd: � Yes No a If special accommodations arc nccded, glease speciCy How did you hear about this opening? From Actorney�$ia Lo page 2 of 2 � i D3- � �.-,,r�` ,-- � Q ��5(O qrrG�U�� Application for Committee, Board, or Commission Please return to Mark Engebretson �PR t 1 20�j2 Mayor's Office, Room 390 City Hall I S West Kellogg Blvd., Saint Paul, MN 55102 �^n �,{ �,:,^ Phone:651-266-8533 Fax:651-266-8513 The Minnesota Governmen[ Data Practices Act (Minnesota Statutes Chap�er 13) governs the City's use of the informatioa contained ia this application. Some of che informa[ion sought in this apptication is prirace da�a under the Act. The requested information will be used by �he appointing authority to caxry out the City's official appointment responsibifities. You are no[ required to procide any infoxmation. However, failure to answer thz appllcation questions may cause the appointing authority to xejeci your application. The majority of items con�ained iu [his applicatiop are public, including name, address, employment, skills, [raining and experience, and are therefore available to anyone requesting iL Thz remaining items on t0e application form are classified as priva[e. The private da[a is available ouly to you and [o oth�� persons in tite City who, be�use of work assignmen[s, reasonably require access [o [he information. Name Home address ,e(E /C L�Li,2D � � � -�'/ !� �t. E � TeleQhones �'�/ o2al�— Please in clutle Area Coees E-mail address �� ..--�: Planning District Council Preferred mailing address Occupation Place of employment Employment address � Committee(s) applied for ��,��//CEs �/Dr/iSO, �� - 'YnE �ja �m� treet '/ET /7/�� ' �y 03P/T, ' � �i1G� �T ��u� - ��i City Council Ward � S� �,f �r. �S� (, UU 5 �io cTH What skillsltraining or experience do you possess for the committee{s) for which you seek appointment? _ I have been professionalty empioyed in health care and education �ince 1978 and have experience in Third World, rural and urban medical — settings. I have had the honor of working with peopie from many _ nationalities and economic backgrounds. I am currently employed at Regions Hospital as a clinicat dietitian. — I completed a Master of Science Degree in Administrative _ Leadership/Supervision in Education from the University of Wisconsin Milwaukee in 1985 and have a Bachelor of Science Degree in Ciinicai — Dietetics from Mount Mary Coliege in Wisconsin. _ f have worked on numerous committees. t am currentiy serving as Treasurer for the City Walk Condominium Association Board of Directors. — think that 1 couid be a productive member of the St. Paul-Ramsey County _ Health Services Advisory Committee. page 1 of2 /� �.11�L� Q�Gr��?Gf �pdilme . � � :.��,: tcegions riospital References Name Address Tetephones Please include Area Name � / //�� home Address � � Yni Manchanda Direcior Food & Nutrition Services 640 Jackson St StPaul, MN 551 0 7-25 95 �ni.T.Manchanda�HealthPaRners.com (651) 254-4243 (657) 254-9927 Fax -- - � — � — work �j�o �h.o/�f- ��, �, G Telephones �� a�j / — �� / Please iuclude Area Codes home Name Address Telephones ( (p�l Please iuclude Area Cod 7`7`D/Ll��( �" �� 't E o1Z � ��''t 1 c`�'1 / � ( es home work � n� 03 • 2.to I – other (G Da.tcC /�i1�a'aQ'.P�(i ��vl � �a��a /� other _ So// � „i_ ,. /1 ��,/ ��io/ � �l work other xeasons t'or your in For many years I have been a paid empioyee in the health care industry. I now have an interest in, and feel qualified to "advise, consult with or make recommendations to the Saint Paul City Councii and the Ramsey County Board of Health on matters relating to policy development, legisfation, maintenance, funding, and evatuation of communiiy heafth services." Have you had previous contact with the committee for which you are making appSicatlonY If so,F4hen, and under what circumstances? .°��(�_ � �i77 /Jl/fi� �J ��¢- �JrYill7CL/Jl� - �f� 11�Cl2kIP� Q- �U1h�DtUr1 �,/.(��niniCcrn QnGL� inC�✓e�C /7P/Le �Din �02Z` n- t��Tnt�. dh. �y �� 1. In an attempt to ensure that committee iepresentation reflects makeup o`fo please check the box applicable to you. This information is strictly voluntary. � White (Caucasian) � Hispanic � Black (African-American) � Asian or Pacific Islander � American Indian or Alaskan Eskimo � Male Female � Date of birth Disabled: � Yes No � If special accommodations are needed, please specify 0 How did you hear about this opening? ��G �Jn�� °�� '' �'j/ ,;�s (' � �S - �.cc��t� �z �rii� �oc�� o��f�ons " i� ��ie �� u� io�,� / page 2 of 2 b, 03 -2�i ,ra K r�r�;�!Eo Application for Committee, Board, or CommissionFEB 2� 2t�u3 Please return to Mark Engebretson Mayor's Office, Room 390 City Hall 15 West Kellogg Blvd., Saint Paul, MN 55102 (UihI�OR'S CYr;�;,�_ Phone:651-266-8533 Fax:651-266-8513 The Minnesota Governmeut Data Practices Act (Minnesota Statutes Chapter 13) go�erns the City's use of the information contained in this application. Some of the information sought in this application is private data under the Act. The requested information will be used by the appoineing authority to carry oui the City's official appointment responsibilities. You are not required to provide any information. However, failure to answer the application questious may cause the appointing authority to reject your application. The majority of items contained in this application are public, including name, address, employment, skills, training and experience, and are thereFore available to anyone requesting iL Yhe romaining items on the application form are classified as private. The private data is available only to you and to other persons in the City who, because of work assignments, roasonably require access to the information. Name � f�.t/ �- ��, �.L( /� Home address �� l��'�� Gff6u� it/� ��i�i Telephones 76 s � �'�o'+ - 3� 3s� ��3��5�- PleaseinclndeAreaCodes h � /if.r/ S S �/ 3 C� ome work (ax E-mail address �� j��,✓ p� � � j�F� ( v ,,,� Planning District Council Preferred mailing address �p.�-e s[ree[ Occupation �t`�%S�C<�i.� � City Council Ward Place of employment Gv<��r3�� .�-c/� �� 4�-� �O Employment address /3 g� y ��-Jv� ,� Cl/� ��. �J�� o�� S s�3� cF Committee(s) applied for Sj'��' /�,�,�•rj2r L9�.—iy �� f,�� /{/�r/S � % �D.�e��-e2 What skills/training or experience do you possess for the commit[ee(s) for which you seek appointment? /��/ li�r' �2�F. .F.--t� s-d c� c�'� -f3 � ��CY .�I�YS�c .`�,.i f��L� � �Lz �Q �f v�Gv�Fr�.�2 �PO„ysz v'��-2_ D^� f{�C/�!� /f�� S<9-. l.D"`<lv�s-'ce (� �Y /Z�-S' ��-'- Cl �F% S� � J U SPjG l/ S � y/ �I� � ` G�K � ��. S fS Cl � ��.�—i�/„?� � '� � /�'F91� page 1 of 2 03-2�� Personal References Name ��--� �� Address �3 �/� � �FwlCd c✓SI�Ti� 1��.�--s� �� Telephones � 6 3 � 5' Pleaseinelude Area Codes home Name /fs✓A.--� Address �3��{S �o, — S'7 U U work �� 33 Telephones(�,,�D � 73a - 7� � Piease inciude Area Co es home Name �� 2�-y✓ Address �U� 3 /�le�f�-�'�'� Telephones � �6 3�� ' �/ � � � Please include Are� a Cod¢s home �� 1^�l�cJr/_e �tac/ other �f�-- woTk other � P—e.c) � 5�.. work other � 3y� �/! ,�j_2 �� !� °- }� J C�S � � ( Reasons for your interest in this particular committee ` GeJpvG� G//� � �'� � � l�fr.e°c oyJ� i��j�iS o� �/ � �%� G��e iS.��.�-2 FiL9wC /�{� i/- -e� /�� 1^-� � � ��T�i�-�.¢ ,Olf`/ F� Gi�f-� ��7�i ��e-c�i�z�/ �7:s ,✓� ��c.f( �/L �'N �`fc- Sl v� �.'.ico9 Have you had pre ious contact with the committee for which you are making application? If so, when, and under what circumstances? N !� In an attempt to ensure that committee representation reflects the makeup of our community, please check the box applicable to you. This information is strictly voluntary. � White (Caucasian) � Hispanic �Black (African-American) �t�sian or Pacific Islander � American Indian or Alaskan Eskimo �'1Glale Female � Date of birth �"�� Disabled: � Yes N� If special accommodations are needed, please specify How did you hear about this opening? _ �C (}��,1-�i �`d—c� � j7j,'�..�y /,,,� � page 2 of 2