ANNA joins The Center for Telemedicine Law and other organizations in supporting additional funding for the advancement of telehealth funding

Center for Telemedicine Law

1301 K Street NW, East Tower, 9th Floor

Washington DC 20005-3317

202.230.5090 Main | 202.230.5303 Fax

www.ctl.org | telemedicine@ctl.org

July 8, 2005

The Honorable Arlen Specter

Chair, Appropriations Subcommittee

on Labor, Health and Human Services

& Education

United States Senate

Washington, DC 20510

The Honorable Tom Harkin

Ranking Member, Appropriations Subcommittee

on Labor, Health and Human Services,

& Education

United States Senate

Washington, DC 20510

Dear Senators Specter and Harkin:

On behalf of the more than 200 individuals and telemedicine organizations listed below and the health communities that we represent, we are writing to urge you to support a programmatic increase in the funding of an additional $10,000,000 for such programs and activities, including $2,500,000 for a minimum of 10 telehealth resource centers which provide assistance with respect to technical, legal and regulatory, service delivery or other related barriers to the deployment of telehealth technologies, $5,000,000 for network grants and demonstration or pilot projects for telehomecare, and $2,500,000 for grants to carry out programs under which health licensing boards of various States cooperate to develop and implement policies that will reduce statutory and regulatory barriers to telehealth. As you are aware, telemedicine offers both underserved and hard to reach communities much needed expanded access to quality health care services.

Congress has often expressed support for telemedicine services and has passed additional telehealth provisions as part of the Health Safety Net Amendments Act. Unfortunately, Congress’ financial support for the Office for the Advancement of Telehealth (OAT) has declined in recent years and the provisions authorized by the Health Safety Net Amendments Act have not yet been funded.

An increase of $10 million would help improve access in underserved areas of the country by restoring funding for OAT and providing support for the Health Safety Net Amendments Act telehealth programs. Specifically, the increase allocates $5 million for grants to fund the telemedicine networks and demonstration projects for telehomecare, $2.5 million for grants to coordinate state licensing programs so that underserved and hard to reach communities have properly trained health care professionals, and $2.5 million for telemedicine resource centers.

This is a small amount of money for a very important purpose. Without this support, the stability of the existing telemedicine services in this country will be severely threatened. OAT provides critical technical assistance to telehealth projects throughout the country.

We thank you for your support of this important issue. Should you have any questions or need more information about the increase in funding for the telehealth services provided in your state, please do not hesitate to contact any of the individuals or organizations listed below.

Sincerely,

Jackie Eder-Van Hook

Executive Director

The undersigned support an increase in programmatic funding for the Office for the Advancement of Telehealth:

Bob Waters

Executive Director

Home Care Technology Association of America

Washington, D.C.

James N. Thompson, M.D.

President and Chief Executive Officer

Federation of State Medical Boards

Dallas, TX

Jeremy Bonfini

Intel Corporation

Consumer Health Access Through Technology Coalition

Washington, D.C.



Val Halamandaris

President

National Association for Home Care and Hospice

Washington, D.C.



Jonathon Linkous

Executive Director

American Telemedicine Association

Washington, D.C.



Alan Morgan

Interim Executive Director

National Rural Health Association

Washington, D.C.



Laura J. Redoutey

President

Nebraska Hospital Association

Lincoln, NE



Curtis Rooney, J.D.

Senior Associate Director

American Hospital Association

Washington, D.C.



Terry Rabinowitz, M.D., FAPA, FAPM

Associate Professor of Psychiatry and of Family Medicine

Clinical Director of Telemedicine

Director, Psychiatric Consultation Service

University of Vermont College of Medicine and Fletcher Allen Health Care

Burlington, VT



Nancy J. Sharp, MSN, RN, FAAN

Telehealth Issues Consultant

American College of Nurse Practitioners

Bethesda, MD



John Zauher

Director, Telemedicine Serves Partners in Health Telemedicine Network

St. Vincent Healthcare

Billings, MT



Joseph D’Iorio

Manager TeleHealth Solutions

TANDBERG

Peabody, MA



Nancy Brown, MLS

Project Director

Telemedicine Research Center

Portland, OR



Dr. Denise Henry

Director

Telemedicine & Telehealth Technologies

Southfield, MI



Scott Echerer

Director

Rural Telemedicine Cooperative, Inc.

Lexington, SC



Sally Davis

Program Director/Telehealth

Marquette General Health System

Marquette, MI



Ann Bailey Bynum, Ed.D.

Director, UAMS Rural Hospital Telehealth Program

University of Arkansas for Medical Sciences

Little Rock, AR



Leo C. Loevner

Chief Operating Officer

T-Med Behavioral

Fairfax, VA



Loretta Schlachta-Fairchild, RN, Ph.D., CHE

President & CEO

iTelehealth Inc.

Frederick, MD



Joseph L. Ternullo, CPA, JD

Associate Director, Telemedicine

Partners Healthcare System

Lynnfield, MA



Timothy C. Cox

President

Northland Healthcare Alliance

Bismark, ND



John Edwards

Executive Chairman

The Telework Coalition

Washington, D.C.



Donna K. Hammack

Chief Development Officer

Saint Elizabeth Health Systems

Lincoln, NE



Dolores E. Battle, Ph.D.

President

American Speech-Language-Hearing Association

Rockville, MD



J.R.B. Hutchinson, M.D.

CEO

Hutchline

Atlanta, GA



Gail P. Barker, MBA, Ph.D.

UltraClinics Inc.

Tucson, AZ



Daniel A. Schonwald

Chief Operating Officer

Professional Corporation of Psychiatry, Inc.

Oklahoma City, OK



Joseph Tracy

Executive Director of Telehealth

University of Missouri Health Care

Columbia, MO



Karen Edison, M.D.

Chair – Dermatology

Co-Chair MU Center for Health Policy

Medical Director of Telehealth

University of Missouri Health Care

Columbia, MO



Weldon D. Webb

Director

Office of Rural Health Programs

University of Missouri School of Medicine

Columbia, MO



David A. Fleming, M.D., FACP

Associate Professor of Medicine and Director, Center for Health Ethics

Department of Health Management and Informatics

University of Missouri School of Medicine

Columbia, MO



Jan M. Sunday

Director – Healthcare/Telehealth SBC SW

SBC Communications, Inc.

Hurst, TX



Craig D. Frazier

Vice President, General Manager – Extended Care Solutions Group

McKesson Corporation

Springfield, MO



Marjorie Walsh

Director, Patient Care Services

VNA, Western Pennsylvania

Butler, PA



Brett Orris

Director

VNA Medical Equipment and Supplies

Butler, PA



Cindy Clark

Director, IS

VNA, Western Pennsylvania

Butler, PA



Raymond E. Helms, MPH

Administrator

ComfortCare Home Health & Hospice

Chesapeake, VA



Imelda Angat, RN

Director of Patient Services

ComfortCare Home Health & Hospice

Chesapeake, VA



Gary Bowers

Executive Director

Western North Carolina Health Network

Asheville, NC



James A. Leja Ph.D.

Associate Dean of Graduate and International Studies

College of Health and Human Services – Western Michigan University

Kalamazoo, MI



Steven C. Trout

Executive Director

Southern Consortium for Children

Athens, OH



Chris Jones

Programmer Analyst IV

Wake Forest University School of Medicine

Winston-Salem, NC



Stuart M. Speedie, Ph.D.

Professor and Director – Fairview University of Minnesota Telemedicine Network

University of Minnesota

Minneapolis, MN



Robin Keith

President

Nevada Rural Hospital Partners

Reno, NV



Jane Smith Patterson

Executive Director

e-NC Authority

Raleigh, NC



Ron Jacobson

Regional President

Avera St. Luke’s

Aberdeen, SD



Mary DeVany

Manager

Avera McKennan Telehealth Network

Sioux Falls, SD



Catherine S. Britain

Chair

Telehealth Alliance of Oregon

Portland, OR



The Telehealth Alliance of Oregon

Portland, OR



Sylvia Temlitz, MA, RN, CHPN

Home Care/Hospice Director

Lakeview Medical Center

Rice Lake, WI



Joy Tkachuck

Program Manager – Videoconferencing/Telemedicine Network

Allina Health System

Minneapolis, MN



Peter J. Kragel, M.D.

Director

East Carolina University Telemedicine Center

Greenville, NC



Kathy Apple

Executive Director

National Council of State Boards of Nursing

Chicago, IL



Kristin Hellquist

Director of Policy and Government Relations

National Council of State Boards of Nursing

Chicago, IL



Gregory L. Smith

President

Greg Smith and Associates

Manhattan, KS



John Rao

President

Secure Medical Inc.

Tempe, AZ



Jana Lindsey, RN

Shriners Hospitals for Children

Honolulu, HI



Katherine Yvette Vigil

Telemedicine Director

Shriners Hospitals for Children

Salt Lake City, UT



Jan Smith

President

Montana Healthcare Telecommunications Alliance

Billings, MT



John Heard, Ph.D.

Vice President

A.T. Still University

Kirksville, MO



Kay Thiel

Business Administrator

High Plains Rural Health Network

Brush, CO



Teresa A. Dolan, D.D.S, M.P.H.

Professor and Dean – College of Dentistry

University of Florida

Gainesville, FL



Rex E. Gantenbein, Ph.D.

Director, Center for Rural Health Research and Education

College of Health Sciences, University of Wyoming

Laramie, WY



John M. Boehme

Associate Dean for Academic Computing and Information Sciences

Wake Forest School of Medicine

Winston-Salem, NC



Dale C. Alverson, M.D.

Medical Director

University of New Mexico Center for Telehealth

Albuquerque, NM



Harold M. Maurer, M.D.

Chancellor

University of Nebraska Medical Center

Omaha, NE



Jana Katz-Bell, M.P.H.

Chief Administrative Officer – Center for Health & Technology

University of California-Davis Health System

Sacramento, CA



Kathy J. Chorba

Telemedicine Program Operations Manager

University of California-Davis

Sacramento, CA



Fred Eastman

Project, Programming & Administrative Services Director

Midwest Rural Telemedicine Consortium

Des Moines, IA



Thelma McClosky Armstrong

Director

Eastern Montana Telemedicine Network

Billings, MT



Marta J. Petersen, M.D.

Director

Utah Telehelath Network

Salt Lake City, UT



Karyn Sowa

REACH Montana Telemedicine Network Coordinator

Benefis Healthcare

Great Falls, MT



Jack King

Executive Director

Northcentral Montana Healthcare Alliance

Great Falls, MT



Lisa Cone

Managing Director for Homecare

Cerner Corporation

Overland Park, KS



Rob Sprang

Director

Kentucky TeleCare

Lexington, KY



Ryan J. Spaulding, Ph.D.

Director

University of Kansas Medical Center

Kansas City, KS



Lisa J. Roberts, Ph.D.

Cindy Uselman

RN Manager, Grants and Program Development

Tri-County Hospital

Wadena, MN



Daniel R. Plotkin

eHealth Program Administrator

Childrens Hospital Los Angeles

Los Angeles, CA



Jose C. Polido, DDS, MS

Head, Division of Dentistry

Childrens Hospital Los Angeles

Los Angeles, CA



Mark M. Urata, M.D., DDS

Director of Craniofacial Surgery

Childrens Hospital Los Angeles

Los Angeles, CA



Kathy Scott, RN, BSN

Director

Tillamook Home Care Services

Tillamook, OR



A. Corrie Hall

Chief Operating Officer

Kare-In-Home Health Services

Biloxi, MS



Linda Russell

Agency Director

Home Health Services of Self Regional Healthcare

Greenwood, SC



Nancy J. Sharp, MSN, RN, FAAN

Health Policy Consultant

American Nephrology Nurses' Association

Bethesda, MD



Ellen S. Phillips, MSW

Executive Director

Visiting Nurse Association of Wallingford, Inc.

Wallingford, CT



Beth A. Shambaugh, RN, BS

Executive Director

Visiting Nurse Association of Central Pennsylvania, Inc.

Harrisburg, PA



Carl W. Taylor

Assistant Dean

University of South Alabama

Mobile, AL



Thomas E. Norris, M.D.

Vice Dean for Academic Affairs, School of Medicine

University of Washington

Seattle, WA



Cara Towle, RN, MSN

Director, Telehealth Services, School of Medicine

University of Washington

Seattle, WA



Carolyn Neiswender

Director

Memorial Home Care Services

Yakima, WA



Anthony J. Zizzamia, Jr.

Executive Director

Liberty Home Care

Wilmington, NC



Keith Crownover

Director, Home Health Services

Siemens Health Services, Inc.

Altoona, PA



Jeffrey C. Bauer, Ph.D.

Senior Vice President

ACS Healthcare Solutions

Tuscon, AZ



Sherri Lazear

Business Manager

Viterion TeleHealthcare, LLC

Tarrytown, NY



Louanna L. Theurer

Grant Administrator

University of Utah Burn Center

Salt Lake City, UT



Scott Feindberg

Senior Gratns Manager

TANDBERG

Peabody, MA



Tami Siedler

AVP Operatoins

Selfhelp Community Services

New York, NY



Jake A. Levy

CEO

CareKeeper Software, Inc.

Atlanta, GA



Michele A Quirolo

President/CEO

Visiting Nurse Association of Hudson Valley

Mt. Kisco, NY



Doug Karr, MHS

CEO

American Teleradiology Nighthawks

Edgewater, MD



Meryl Weinberg

Executive Director

NYCHHC Health & Home Care

New York, NY



Gail Jurasek

Executive Director

North Country Home Health & Hospice

Littleton, NH



Sharon Meister, RN Ms

Director

Mercy Homecare and Hospice

Clinton, IA



Cynthia Clark

Quality Manager

Carondelet Home Care Services

Overland Park, MS



Cindy Campbell

CEO

Nobitas, Inc.

San Diego, CA



Deborah E. Seale

Executive Director

Telehealth Networks & Programs, Southern Illinois University School of Medicine

Springfield, IL



Barbara A. Nelson

Administrator

Advanced Home Health Care, Ltd.

Burlington, IA



Gene Tischer

Executive Director

Associated Home Health Industries of FL, Inc.

Sarasota, FL



Carolyn Hutcherson

Executive Director

American College of Nurse Practitioners

Washington, DC



Joanne Handy

President and CEO

Visiting Nurse Association of Boston

Boston, MA



Denise Waibel-Rycek, RN, MS

Chair, Government/Reimbursement Committee

Nebraska Association of Home and Community Health Agencies

Lincoln, NE



Maureen Cormier

Director of Quality

Hallmark Health VNA

Malden, MA



J. Steven Cline, D.D.S., M.P.H.

Epidemiology Section

Division of Public Health

North Carolina Department of Health and Human Services

Raleigh, NC



Francine Wheelock, PT, MPA

Director Program Development and Rehabilitation Services

HealthReach HomeCare & Hospice

Waterville, ME



Pamela A. Steding

President/CEO

CHRISTUS HomeCare

San Antonio, TX



Greg Beck, MHA

Program Manager

Clarian Health Partners

Indianapolis, IN



Kathleen F. Rose

President/CEO

Vineyard Nursing Association

Oak Bluffs, MA



Joseph H. Pickering, Jr.

Executive Director

Community Health and Counseling Services

Bangor, ME



Michelle Hosler, RN, BSN, PHN

Director/Administrator

SunHealth Home Care

Sun City West, AZ



Vivian Leigh McLaughlin

Director of HealthCare Innovations & Grant Programs

Providea, Inc.



Dorothy J. Brown

Home Care Director

Rapid City Regional Hospital, Home Care Dept.

Rapid City, SD



Rose Higgins

President

iMetrikus, Inc.

Carlsbad, CA



Jeffrey C. Bauer, Ph.D.

Senior Vice President

ACS Healthcare Solutions

Dallas, TX



Joan Altomonte, P.H.N., M.A.

Director of Patient Services

YAI Home Health Services

New York, NY



Margaret Warden

President/CEO

Visiting Nurse Association of Utica & Oneida Co., Inc.

Utica, NY



Kathleen Quinn, RN, BS

Director of Patient Services

Living Resources Certified Home Health Agency

Schenectady, NY



Linda Barkan, DPS

Able Health Care Service



Nina M. Antoniotti, RN, MBA, Ph.D.

Program Director

Marshfield Clinic TeleHealth Network, Marshfield Clinic

Marshfield, WI



Ellen S. Phillips, MSW

Executive Director

Visiting Nurse Association of Wallingford, Inc.

Wallingford, CT



Beth A. Shambaugh, RN, BS

Executive Director

Visiting Nurse Association of Central Pennsylvania, Inc.

Harrisburg, PA



Roberta Greengold

Executive Director, Home Health Services

The Brooklyn Hospital Center – Home Health Services

Brooklyn, NY



Barbara Knott

VP of Home Care

Schervier Nursing Care Center

Bronx, NY



Rick Pollack

Executive Vice President

American Hospital Association

Washington, D.C.



Linda Rashba, RN, MS

Administrator

Saint Francis Hospital Certified Home Health Services

Poughkeepsie, NY



Suzann VanBuskirk, BSN, RN, CNN

President

American Nephrology Nurses' Association

Pitman, NJ



Joan R Price RN, PNP, AE-C

Nurse Educator

Pittsburgh, PA



Marcia P. Reissig, RN, MS, CHCE

President & CEO

Partners Home Care

Waltham, MA



Dave Hickman, RN, FACHE

Director of Clinical Integration

Mercy Health Network

Des Moines, IA



Kim Pestour, RN, BSN, MS

Director

Lutheran Long Term Home Health Care Program

Brooklyn, NY



Anne Calvo

Administrator

Winthrop University Hospital – Home Health Agency

Mineola, NY



Jay J. Weil, III

Chief Financial Officer

R&R Home Care, Inc.

Mandeville, LA



Lyn R. Tindall, M.S., CCC-SLP

Speech-Language Pathologist

Lexington, KY



Catherine Pignatello

Administrator

Nyack Hospital Home Care

Nyack, NY



Paula Knoll

Director of Clinical Services

Fulton County Nursing Service

Gloversville, NY



Laurie Chichester

Vice President – Home Care

Metropolitan Jewish Home Care

New York, NY



Jayne O’Leary, RN

Director, Performance Improvement/Staff Development

Winthrop University Hospital – Home Health Agency

Mineola, NY



Marianne Grady, RN

Director of Long Term Health Care Program

Winthrop University Hospital – Home Health Agency

Mineola, NY



Miriam Burns

Director of Government Relations

Selfhelp Community Services, Inc.

Brooklyn, NY



Dianne Newberry, BSN, MHA

Statewide Manager – Case Management/Home Care Coordination

Centura Health at Home

Denver, CO



Jane Qiu

Director/Social Worker

Selfhelp Prince Street Senior Center

Flushing, NY



Karen O’Kane

Assistant Vice President – Continuing Care

Brookhaven Memorial Hospital Medical Center Home Health Agency

Patchogue, NY



Martin Kosich, DDS, MD

Director of Public Health

Greene County Public Health Nursing Service

New York



Justine DiPalma

Social Worker

Selfhelp Queensview/North Queensview

Long Island City, NY



Mary Hayes

Program Director

Selfhelp Queensview/North Queensview

Long Island City, NY



Dale F. Andres, D.O.

Executive Committee Chair

Midwest Rural Telemedicine Consortium

Des Moines, IA



Lois Moses

Vice President – Quality Improvement

VNA of Staten Island

Staten Island, NY



Rochelle Eggleton

Director of Home Health

Lourdes at Home

Binghamton, NY



Nat Gist

President

TeleMed Consultants

Richmond, TX



Rick W. Hartwig

Regional Director

OMNI Home Care

Oviedo, FL



Rachel Epstein, LMSW

Program Driector

Selfhelp Austin Street Senior Center

Forest Hills, NY



Julia J. Hopple

VNA President

VNA Home Health – WellSpan

York, PA



Mary Myers, MBA, RN

Telehealth Consultant

Digital Visual Innovations, LLC

Hickory Corners, MI



John W. Allen

President/CEO

Good Samaritan Health System

Kearney, NE



John J. Ayoub

Vice President, Mission Integration

Good Samaritan Health System

Kearney, NE



Mardi Jones

Vice President, Continuing Care

Caritas Health Services

Bardstown, KY



Lesley Bollwitt

Director of Grants and Special Projects

Good Samaritan Hospital Foundation

Kearney, NE



John Mengenhausen

CEO

Horizon Health Care, Inc.

Howard, SD



Scott Weatherill

IT Supervisor

Horizon Health Care, Inc.

Howard, SD



Victoria G. Hines

President and CEO

Visiting Nurse Service of Rochester and Monroe County, Inc.

Webster, NY



William Belecz

Vice President, Information Systems

Visiting Nurse Service of Rochester and Monroe County, Inc.

Webster, NY



Timothy Ashe

Vice President, Clinical Operations

Visiting Nurse Service of Rochester and Monroe County, Inc.

Webster, NY



Linda Winter

Business Development

Phonoscope Health Network

Houston, TX



Nat Gist

Business Development

Phonoscope Health Network

Houston, TX



Niké Luqman

Business Development

Phonoscope Health Network

Houston, TX



Ted Viens

Special Projects Engineer

Phonoscope Health Network

Houston, TX



Jennifer Yu

ESL Teacher

Selfhelp Prince Street Senior Center

Flushing, NY



Karen Chen

Community Worker

Selfhelp Prince Street Senior Center

Flushing, NY



Andrea L. Devoti

Vice President and Chief Operating Officer

Neighborhood Health Agencies, Inc.



Robert Lodge, LCSW

Training Specialist – Sunshine National Training Center, Office of Care Coordination

Veterans Health Administration, North Florida/South Georgia Veterans Health System

Lake City, FL



Dan Van Roekel

Sioux Valley Telehealth

Sioux Falls, SD



Sioux Valley Telehealth

Sioux Falls, SD



Denise Waibel-Rycek, RN, MS

Director, Home Care Services

Good Samaritan Hospital Home Care

Kearney, NE



Patricia M. Kelleher

Executive Director

Home and Health Care Association of Massachusetts

Massachusetts



Donna Grimm

President/CEO

Community Health Professionals

Van Wert, OH



Linda Michielson

Director of Public Health

Wayne County Public Health Service

Wayne County, NY



Lois Schuller

Director

Sioux Valley Visiting Nurses

Sioux Falls, SD



Maria Dixon

Selfhelp Community Worker

Selfhelp Community Services, Inc.

Maspeth, NY



Donna DelCiclo

Program Director

Selfhelp Community Services, Inc.

Maspeth, NY



David Crespo

Selfhelp Community Services, Inc.

Maspeth, NY



Norma Rivera

Senior Aide Outreach

Selfhelp Community Services, Inc.

Maspeth, NY



Shari Deutscher

Social Worker

Selfhelp Community Services

Queens, NY



Hawaii Board of Nursing

Hawaii



Utah Board of Nursing

Utah



Laura Poe

Executive Officer

Utah Board of Nursing

Utah



South Dakota Board of Nursing

South Dakota



Gloria Damgard

Executive Officer

South Dakota Board of Nursing

South Dakota



Iowa Board of Nursing

Iowa



Lorinda Inman

Executive Officer

Iowa Board of Nursing

Iowa



Arkansas Board of Nursing

Arkansas



Faith Fields

Executive Officer

Arkansas Board of Nursing

Arkansas

The Nurse Licensure Compact Administrators (NLCA)



Margaret Donahue

Vice President, Community Programs

St. Mary’s Hospital for Children

Bayside, NY



Joseph A. Tracy

President

Center for Telemedicine Law

Washington, D.C.



Nina Antoniotti, RN, MBA, PhD

Vice President

Center for Telemedicine Law

Washington, D.C.



Jana Katz-Bell

Secretary-Treasurer

Center for Telemedicine Law

Washington, D.C.



Karen Rheuban, M.D.

Board Member

Center for Telemedicine Law

Washington, D.C.



Curtis Rooney, J.D.

Board Member

Center for Telemedicine Law

Washington, D.C.



Rob Sprang

Board Member

Center for Telemedicine Law

Washington, D.C.



Ryan J. Spaulding, Ph.D.

Center for Telemedicine Law

Washington, D.C.



Dr. Janet L. Grady

Principal Investigator, Nursing Telehealth Applications Initiative

Chairperson, Division of Nursing

Mount Aloysius College

Cresson, PA

North Carolina Board of Nursing



Polly Johnson

Executive Officer

North Carolina Board of Nursing

Raleigh, NC



Vivian Matias

Director

Cabrini Center for Nursing and Rehab LTHHCP

New York, NY



Dr. Dev A. Brar

President

Nightingale Home Health Care

Carmel, IN



Christine Sakuda

Information Officer

Hawaii Primary Care Association

Honolulu, HI



Texas Board of Nursing

Austin, TX



Kathy Thomas

Executive Officer

Texas Board of Nursing

Austin, TX



Susan A. Randolph, MSN, RN, COHNS, FAAOHN

President

American Association of Occupational Health Nurses, Inc.

Atlanta, GA



Joyce Dombrouski

Vice President of Nursing

St. Patrick Hospital

Missoula, MT