Basic information

The Health Evidence Review Commission's primary work is to prioritize health services which determine whether services are covered benefits for over 1 million people who are members of the Oregon Health Plan. Decisions are made base on the best available evidence as well as other factors including values and preferences or patients and communities, health equity considerations and delivery system factors.

Staff collect this information to supplement information supplied in Workday for applicants for HERC members. HERC members are appointed by the Governor subject to Senate confirmation; for subcommittees, this form serves as the application process, and the Commission itself appoints members. 

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* 1. I understand that any information provided in this HERC and HERC subcommittee application is a matter of public record and could be disclosed to the public if someone requests the information in a public records request. 

You are not required to share any information about personal identities or health conditions. The information collected is based on REALD, which by law is collected in Oregon health care settings. This FAQ is available to contextualize the questions and possible answers.

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* 2. If you are applying for a subcommittee role, please upload your resume or curriculum vitae. Acceptable formats include PDF, DOC, and DOCX. (if you are applying for a Commission position, you will upload this in WorkDay, you don't need to upload it here).

If you are having trouble, please email HERC.Info@dhsoha.state.or.us for help.

PDF, DOC, DOCX file types only.
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* 3. Which subcommittee(s) would you be interested in joining? (Check all you would be willing to serve on, but each person would only serve on one subcommittee.)

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* 4. Full Name

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* 5. Preferred Pronouns

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* 6. Email Address

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* 7. Phone Number

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* 8. Principal occupation or advocacy role

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* 9. Professional license type (if any)

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* 10. Other relevant memberships/affiliations

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* 11. Please explain your interest and qualifications for subcommittee membership. Special consideration will be given to:
- relevant clinical expertise or training,
- experience evaluating clinical evidence regarding medical conditions and health services,
- experience with health benefit policy and administration, or
- experience (personal, volunteer or professional) with health care consumer issues

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* 12. Do you have experience living or working in urban, suburban, rural or frontier areas? (Select all that apply)

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* 13. Area(s) of expertise. Please check all that apply:

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* 14. Please provide a brief description of your experience in one areas checked above and how these experiences might prepare you for your work with the HERC.

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* 15. If you answered Yes to Question #13, please describe any lived experiences relevant to health equity and why health equity is important to you, including any experience you have working to advance health equity:

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* 16. Please identify any relevant sector that you are in. Check all that apply:

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