Alabama
Signatory:
Thomas M. Miller, M.D., Acting State Health Officer
Alabama Department of Public Health Development
The RSA Tower
201 Monroe Street, Suite 710
P.O. Box 303017
Montgomery, AL 36104
Point of Contact:
Charles Lail
(ph) 334-206-5438
e-mail: Chuck.Lail@adph.state.al.us
Alternate POC:
Janice Cook
(ph) 334-206-5610
e-mail: Janicecook@adph.state.al.us
Alaska
Signatory:
William Streur, Commissioner
Department of Health and Social Services
Division of Health Care Services
Section of Community Health & Emergency MedicalServices
P.O. Box 110610
Juneau, AK 99811-0610
Point of Contact:
Triptaa Surve, MPH, JD, Public Health Specialist II
(ph) 907-334-2640
e-mail: Triptaa.Surve@alaska.gov
Arizona
Signatory:
Sheila Sjolander, Acting Assistant Director
Bureau of Health Systems Development
Arizona Department of Health Services
1740 W Adams, Suite 410
Phoenix, AZ 85007
Point of Contacts:
Ana Roscetti, Workforce Section Mngr.
(ph) 602-542-1066, (fax) 602-542-2011
e-mail: Rosceta@azdhs.gov
Arkansas
Signatory:
Stephanie Williams, Deputy Director
Public Health Programs
Arkansas Department of Health and Human Services
5800 West Tenth Street, Suite 400
Little Rock, AR 72204
Point of Contact:
Connie Melton
Section Chief of Health Facility Services
(ph) 501-661-2201, (fax) 501-661-2165
e-mail: Connie.Melton@arkansas.gov
California
Signatory:
Rene Mollow, Deputy Director for Health Care Benefits and Eligibility
California Department of Health Care Services
Primary and Rural Health Division
1501 Capitol Ave., MS 8000
P.O. Box 997413
Sacramento, CA 95899
Point of Contact:
April Freitas, Health Prog. Spec. 1
Primary and Rural Health Division
California Department of Health Care Services
MS 8501
P.O. Box 997413
Sacramento, CA 95899-7413
(Ph) 916-449-5757 (fax) 916-558-5494 (Main) 916-449-5770
Email: April.freitas@dhcs.ca.gov or J-1Vis WaiverProgram@dhcs.ca.gov
and/or
Emine Gunhan
Research Prog. Specialist 1
(Ph) 916-552-8687
Email: Emine.Gunhan@dhcs.ca.gov
Colorado
Signatory:
Steve Holloway
Director of Oral, Rural and Primary Care
Colorado Department of Public Health and Environment
Primary Care Office - A-5
4300 Cherry Creek Drive South
Denver, CO 80246-1530
(ph) 303-692-2470 (fax) 303-758-3448
e-mail: stephen.holloway@state.co.us
Connecticut
Signatory:
Wendy Furniss, R.N.C., MS, Acting Bureau Chief
Bureau of Healthcare Systems
410 Capitol Avenue - MS #12APP
P.O. Box 340308
Hartford, CT 06134-0308
Point of Contact:
Steve Carragher
(ph) 860-509-7576, (fax) 860-509-8457
e-mail: stephen.carragher@po.state.ct.us
Delaware
Signatory:
Karyl T. Rattay, MD, MS, FAAP, FACPM, Director,
Delaware Division of Public Health
Jesse S. Cooper Building
P.O. Box 637
Dover, DE 19903
(ph) 302-744-4818
e-mail:Karyl.Rattay@state.de.us
Point of Contact:
Theresa Strawder
655 Bay Road, Suite 206
Dover, DE 19901
(ph) 302-741-2960, (fax) 302-741-2970
e-mail: Theresa.Strawder@state.de.us
District of Columbia
Signatory:
LaQuandra Nesbitt, Acting Director
District of Columbia Department of Health
825 North Capital Street, NW, 4th Floor
Washington, DC 20002-4210
(ph) 202-442-5955
Point of Contact:
Urvi Doshi
(ph) 202-442-9168
Email: urvi.doshi@dc.gov
Florida
Signatory:
John H. Armstrong, MD.
State Surgeon General, Department of Health
4052 Bald Cypress Way
Tallahassee, FL 32399-1700
Point of Contact:
Debbie Reich
(ph) 850-245-4446 ext. 2704
(fax) 850-922-6296
e-mail: Debbie_Reich@doh.state.fl.us
Georgia
Signatory:
Patricia A. Whaley, Executive Director
Office of Rural Health Services
502 S. 7th Street
Cordele, GA 31015-1443
(ph) 229-401-3090
email: pwhaley@dch.ga.gov
Point of Contact:
David Glass
(ph) 229-401-3094, (fax) 229-401-3077
e-mail: dglass@@dch.ga.gov
Hawaii
Signatory:
Danette Wong Tomiyasu
Hawaii State Health Department
Office of Planning, Policy and Program Development
1250 Punchbowl Street, Room - 340
Honolulu, HI 96813
Point of Contact:
R. Scott Daniels
(ph) 808-961-9460, (fax) 808-961-9461
Idaho
Signatory:
Elke D. Shaw-Tulloch, State Health Official and Administrator
Idaho Department of Health and Welfare
Division of Public Health, State Office of Rural Health and Primary Care
450 West State Street, 4th Floor
P.O. Box 83720
Boise, Idaho 83720-0036
Point of Contact:
Laura Rowen
Primary Care Program Manager
(ph) 208-334-5993, (fax) 208-332-7262
e-mail: Rowenl@idhw.state.id.us
Illinois
Signatory:
Nirav Shah, M.D., J.D.
Illinois Department of Public Health
Director of Public Health
535 West Jefferson Street
Springfield, IL 62761
e-mail: director@idph.state.il.us
Point of Contact:
Bill Dart, Acting Chief
(ph) 217-782-0340, (fax) 217-782-2547
e-mail: bill.dart@illinois.gov
Local Health Departments
Indiana (317) 233-7400
Signatory:
William C. VanNess II, MD
State Health Commissioner
Indiana State Department of Health
2 North Meridian Street. 6th Floor
Indianapolis, IN 46204
Point of Contact:
Christopher Maxey
(Ph) 317-234-2888 (Fax) 317-233-7761
Email: cmaxey@isdh.in.gov
Iowa
Signatory:
Katherine (Katie) Jerkins, MPH
Iowa Department of Public Health
Bureau of Health Care Access
Lucas State Office Building, 4th Floor, SE
Des Moines, IA 50319-0075
(ph) 515-954-5674, (fax) 515-242-6384
e-mail: katherine.jerkins@idph.iowa.gov
Point of Contact:
Bobbi Buckner
(ph) 515-281-7223
e-mail: bbuckner@idph.state.ia.us
Kansas
Signatory:
Susan Mosier, MD, Interim Secretary
Kansas Department of Health and Environment
Officer of Local and Rural Health
1000 SW Jackson, Room 1051-S
Topeka, KS 66612-1290
Point of Contact:
Tabetha Mallonee
Ph. 785-296-8115
Email: TMallonee@kdheks.gov
Kentucky
Signatory and Point of Contact:
Gary L. Williams
Kentucky Department for Public Health
Health Care Access Branch
Division of Prevention and Quality Improvement
275 East Main Street, Mail Stop HS2WB
Frankfort, KY 40621
(ph) 502-564-8966 ext. 4005 (fax) 502-564-0655 e-mail: GaryL.Williams@ky.gov
Louisiana
Signatory:
Avis Richard-Griffin, Interim Director
Primary Care and Rural Health
Louisiana Department of Health & Hospitals
628 N. 4th Street, Bienville Building
P.O. Box 3118
Baton Rouge, LA 70821-3118
(ph) 225-342-2657, (fax) 225-342-5839
e-mail: Avis.Richard-Griffin@la.gov
Alternate Signatory:
Dorie Tschudy
(ph) 225-342-1583, (fax) 225-342-5839
e-mail: Dorie.Tschudy@la.gov
Maine
Signatory:
Mary C. Mayhew, Commissioner
Department of Human Services
#1 State House Station
Augusta, ME 04333-0001
Point of Contact:
Charles Dwyer, Interim Director
Maine Rural Health and Primary Care
286 Water Street, 6th Floor, SHS #11
Augusta, ME 04333-0011
(ph) 207-287-5503, (fax) 207-287-5431
e-mail: Charles.Dwyer@maine.gov
Maryland
Signatory:
Roxanne Hale, MPH Director
Office of Primary Care Access
Health System and Infrastructure Administration
Maryland Department of Health and Mental Hygiene
201 W. Preston Street, Rm. 423
Baltimore, MD 21201
(Ph) 410-767-5612
E-mail: roxanne.hale@maryland.gov
Alternate:
Karen Matsuoka, PhD Director
(410) 767-4268
Email: Karen.matsuoka@maryland.gov
Massachusetts
Signatory:
Monica Bharel
Commissioner
Department of Public Health
250 Washington Street
Boston, MA 02108-4619
Point of Contact:
Nicole Watson
(ph) 617-624-6023, (fax) 617-624-6062
e-mail: Nicole.Watson@state.ma.us
Michigan
Signatory:
Elizabeth Hertel, Director
Office of Health Policy and Innovation
Michigan Department of Community Health
Capitol View Bldg., 7th Floor
201 Townsend Street
Lansing, MI 48913 (ph) 517-335-8553
Point of Contact:
Amber Myers
(ph) 517-241-2659, (fax) 517-241-1200
e-mail: MyersA1@michigan.gov
Minnesota
Signatory:
Mr. Darwin Flores Trujillo
Provider Recruitment and Retention Coordinator
Minnesota Office of Rural Health and Primary Care
P.O. Box 64882
St. Paul, MN 55164-0882
(Ph) 651-201-3850, (Fax) 651-201-3830
Email: florestrujillo@health.state.mn.us
Mississippi
Signatory:
Mary Currier, MD, MPH
State Health Officer
Mississippi State Department of Health
State Office of Rural Health
570 East Woodrow Wilson Drive
P.O. Box 1700
Jackson, MS 39215-1700
e-mail: mary.currier@msdh.state.ms.us
Point of Contact:
Rozelia Harris
(ph) 601-576-7216
e-mail: rozelia.harris@msdh.state.ms.us
Missouri
Signatory:
Ben Harvey, Office Chief
Office of Primary Care and Rural Health
Missouri Department of Health
P.O. Box 570
Jefferson City, MO 65102
(Ph) 573-751-6219
Point of Contact:
Lee Temmen
(ph) 800-891-7415
Montana
Signatory:
Richard H. Opper, Director
Department of Public Health and Human Services
P.O. Box 4210
111 N. Sanders
Helena, MT 59604-4210
E-mail: ropper@mt.gov (ph) 406-444-5622 (fax) 406-444-1970
Point of Contact:
Ann Buss
(Ph) 406-444-4119
Email: ABuss@mt.gov
Nebraska
Signatory:
Joseph Acierno, Chief Medical Officer
Department of Health and Human Services
Division of Public Health
301 Centennial Mall South
P.O. Box 95026
Lincoln, NE 68509-5026
e-mail: Joseph.Acierno@nebraska.gov
Point of Contact:
Tom Rauner, Primary Office Director
(ph) 402-471-0148, (fax) 402-471-0180
e-mail: thomas.rauner@nebraska.gov
Nevada
Signatory:
Cody L. Phinney, Administrator
Division of Public and Behavioral Health Nevada State Health Division
4150 Technology Way, Suite 300
Carson City, NV 89706-2028
Point of Contacts:
Laura Hale
(ph) 775-684-4041
e-mail: LHale@nvhd.state.nv.us
Barbara Heywood
(ph) 775-684-4047
e-mail: BHeywood@nvhd.nv.us
New Hampshire
Signatory:
Marcella Jordan Bobinsky, MPH, Acting Director Division of Public Health Services New Hampshire Department of Health and Human Services 29 Hazen Drive Concord, NH 03301 e-mail: Mbobinsky@dhhs.state.nh.us
Alternate:
Brook Dupree, Chief
Bureau of Public Health Statistics and Informatics
Point of Contact:
Alisa Druzba, Section Administrator (ph) 603-271-5934, (fax) 603-271-4506 e-mail: Adruzba@dhhs.state.nh.us
New Jersey
Signatory:
Cathleen D. Bennett, Acting Commissioner
New Jersey Department of Health and Senior Services
Family Health Services Division
P.O. Box 360
Trenton, NJ 08625-0360
Point of Contact:
Dr. Gloria Rodriguez
(ph) 609-292-4043, (fax) 609-292-9599
New Mexico
Signatory:
Lynn Gallagher, Deputy Secretary
State of New Mexico Department of Health
1190 St. Francis Drive, N4100
P.O. Box 261110
Sante Fe, NM 87502-6110
Point of Contact:
Roxanne Koonst
Health Systems Bureau, Albuqurque, NM
(ph) 505-841-5867
e-mail: Roxanne.koonst@state.nm.us
Alternate POC:
Gabriel Chavez
(ph) 505-841-5866
e-mail: gabriel.chavez1@state.nm.us
New York
Signatory:
Lisa Ullman, Director
Center for Health Care Policy and Resource Development Center Office of Primary Care and Health Systems Management
New York State Department of Health
Empire State Plaza, Corning Tower
Albany, NY 12237
Alternate Signatory:
Keith Servis, Deputy Director, OPCHSM
Point of Contact:
Caleb Wistar, Dir. Bureau of Workforce Incentives and Investment
(Ph) 518-473-7019, (Fax) 518-486-7835 Email: caleb.wistar@health.ny.gov
North Carolina
Signatory:
Chris Collins, Acting Director
Office of Rural Rural Health and Community Care
NC Department of Health and Human Services
2009 Mail Service Center
311 Ashe Avenue
Raleigh, NC 27699-2040
(PH): 919-527-6460
Point of Contact:
Keshia Bailey, MPA
(ph) 919-527-6462
(Fax) 919-715-1503
Email: Keshia.Bailey@dhhs.nc.gov
North Dakota
Signatory:
Terry Dwelle, M.D.
State Health Officer
North Dakota Department of Health - Dept. 301
600 East Boulevard Avenue
Bismarck, ND 58505-0200
e-mail: tdwelle@state.nd.us
Point of Contact:
Gary Garland
(ph) 701-328-4839, (fax) 701-328-1890
e-mail: GGarland@state.nd.us
Ohio
Signatory:
Rick Hodges, Director of Health
Ohio Department of Health
246 North High Street
Columbus, OH 43215
e-mail: Director@odh.ohio.gov
Point of Contact:
Jennifer Bassler
(ph) 614-466-1629, (fax) 614-995-4235
e-mail: BCHS@odh.ohio.gov
Oklahoma
Signatory:
Julie Cox-Kain, Senior Deputy Commissioner
Community Health Services
Oklahoma State Department of Health
1000 N.E. Tenth Street
Oklahoma City, OK 73117-1299
e-mail: stever@health.state.ok.us
Point of Contact:
Espaniola Bowen
(ph) 405-271-8427, (fax) 405-271-5493
e-mail: Espab@health.ok.gov
Oregon
Signatory:
Marc Overbeck, Director
Oregon Department of Human Services
Oregon Health Policy and Research
1225 Ferry St. SE, First Floor
Salem, OR 97301
(ph): 503-373-1791
e-mail:marc.overbeck@state.or.us
Point of Contact:
Dia Shuhart
(ph) 503-373-0364, (fax) 503-373-0313
e-mail: Dia.Shuhart@state.or.us
Pennsylvania
Signatory:
Lauren S. Hughes, Deputy Secretary
Pennsylvania Department of Health
Division of Health Innovation
625 Forster Street, Room 802
Health and Welfare Building
Harrisburg, PA 17120-0701
(ph) 717-787-6436
Point of Contact:
Jacqueline Austin
Public Health Program Administrator
(ph) 717-772-5298, (fax) 717-705-6525
e-mail: jaaustin@pa.gov
Rhode Island
Signatory:
Michael Fine, Interim Director
Rhode Island Department of Health
Cannon Building
3 Capitol Hill
Providence,RI 02908-5097
e-mail: Michael.Fine@health.ri.gov
Point of Contact:
Jill D’Errico
Phone – 401-222-1488
Email: Jill.Derrico@health.ri.gov
South Carolina
Signatory:
Mark Jordan, Director
Office of Primary Care
Department of Health and Environment Control
2600 Bull Street
Columbia, SC 29201
e-mail: Jordanma@dhec.sc.gov (ph) 803-898-0766 (fax) 803-898-0445
South Dakota
Signatory:
Kim Malsam-Rysdon, Interim Secretary of Health
South Dakota Department of Health
Office of Rural Health
600 East Capitol Avenue
Pierre, SD 57501-3185 (ph) 605-773-3361
Point of Contact:
Jacob Parsons, Recruitment Program Coordinator
(Ph) 605-773-2679 (Fax) 605-773-5683
e-mail: Jacob.parsons@state.sd.us
Tennessee
Signatory:
John J. Dreyzehner MD, MPH, FACOEM
Commissioner of Health
Tennessee Department of Health
425 5th Avenue, North
Cordell Hull, 6th Floor
Nashville, TN 37247-0101
Point of Contact:
Ann Cranford, Director
(ph) 615-741-2101, (fax) 615-253-2100
e-mail: Ann.cranford@state.tn.us
Texas
Signatory:
Kirk Cole
Interim Commissioner
Texas Department of State Health Services
1100 West 49th Street
Austin, TX 78756-3199 (ph) 512-776-7111
Point of Contacts:
Clay Daniel
(ph) 512-776-7518 ext. 3862
e-mail: Clay.Daniel@dshs.state.tx.us
Utah
Signatory:
Marc Babitz, M.D., Director
Utah Department of Health
Office of Primary Care and Rural Health
Division of Health Systems Improvement
3760 South Highland Drive
P.O. Box 142005
Salt Lake, UT 84114-2005
e-mail: mbabitz@utah.gov
Point of Contact:
Erin L Olsen
Support Coordinator, J-1 Visa Waiver
(ph) 801-273-6618, (fax) 801-273-4146
e-mail: elolsen@utah.gov
Vermont
Signatory:
Henry Chen, MD, Commissioner
Vermont Department of Health
108 Cherry Street
P.O. Box 70
Burlington, VT 05401
e-mail: harry.chen@ahs.state.vt.us
Alternate Contact:
John A. Olson, Chief
Office of Rural Health & Primary Care
Vermont Department of Health
108 Cherry Street
P.O. Box 70
Burlington, VT 05401
(ph) 802-951-1259
e-mail: john.olson@ahs.state.vt.us
Virginia
Signatory:
Marissa J. Levine, MD
Interim State Health Commissioner
(ph) 804-864-7002 (fax) 804-864-7427
Washington
Signatory:
Renee Fullerton, Program Manager
Department of Health
Office of Community Health Services
P.O. Box 47853
Olympia, WA 98504-7834
(ph) 360-236-2814, (fax) 360-236-2830
e-mail: renee.fullerton@doh.wa.gov
West Virginia
Signatory:
Karen L. Bowling, Cabinet Secretary
Department of Health & Human Resources (WVDHHR)
Building 3, Room-206
State Capitol Complex
Charleston, WV 25305
Email: Karenbowling@wvdhhr.org (ph) 304-558-9130 (fax) 304-558-1130
Point of Contact:
Melissa Wheeler, Director
Bureau for Public Health
Office of Community and Rural Health Services
Division of Recruitment
350 Capitol Street, Room 515
Charleston, WV 25301-3716
(ph) 304-558-7056
Wisconsin
Signatory:
Karen McKeown, RN, MSN
State Health Officer and Administrator (ph) 608-266-1251
Point of Contact:
Traici N. Brockman, MPH Primary Care Analyst
(ph) 608-267-1440, (fax) 608-267-2832
Email: Traici.Brockman@dhs.wisconsin.gov
Wyoming
Signatory:
Sharla Allen, M.S.H.A., Deputy Administrator
Wyoming Department of Health
Rural and Frontier Heath Division
6101 Yellowstone Road, Suite 510
Cheyenne, WY 82002
(ph) 307-777-6970
Point of Contact:
Keri Wagner
Healthcare Workforce and Primary Care Office Manager
(ph) 307-777-6512, (fax) 307-777-3623
e-mail: Keri.Wagner@wyo.gov
Miscelleaneous Territories
Guam
Signatory:
James W. Gillan, Director
Department of Public Health and Social Services
P.O. Box 2816
Agana, Guam 96932
Point of Contact:
Cynthia Naval, MS Planner IV
(ph) 671-735-7307, (fax) 671-734-2066
e-mail: cinaval@dphss.govguam.net
Puerto Rico
Signatory:
Maria S. Conte-Miller, Executive Director
P.O. Box 11878 Caparra Heights Station
San Juan, Puerto Rico 00922-1878
(ph) 787-765-0615 (fax) 787-759-8908
Email: MConte@icf.gobieron.pr
Point of Contact:
Luis Vazquez, Assistant Director
(ph) 787-200-7165
e-mail: lavazquez@icf.gobierno.pr
Saipan (Marianas Protectorate) - (Northern Mariana Islands)
Signatory:
Shirish Balanchandra, M.D.
Commonwealth of the Northern Mariana Islands
Department of Public Health
Commonwealth Health Center
1 Lower Navy Hill
P.O. Box 500409
Saipan, MP 96950
Email: saipanbala@gmail.com
Point of Contact:
Chad C. Lowe, D.O.
(ph) +1-670-234-8950 (fax) +1-670-236-8756
e-mail: lowedo@gmail.com
Virgin Islands
Signatory:
Fern P. Clarke, Acting Commissioner
Virgin Islands Department of Health
1303 Hospital Ground, Ste. 10
St. Thomas, VI 00802-6722
Tel: (340)-774-0117 Fax: (340)-777-4001
Point of Contact:
Shaniece Charlemagne, MPH, MHA Director
VI Primary Care Office
VI Department of Health
Charles Harwood Complex
3500 Est. Richmond
Christiansted, VI 00802-4370
(ph) 340-773-1311 ext 3173, (fax) 340-773-1376
e-mail: Shaniece.charlemagne@usvi-doh.org
