Spotlight on Women’s Health

Women’s Assessment Tool for Comprehensive Health: 

The WATCH Self-Assessment National Roll-Up

Sally Haskell, MD

Deputy Chief Consultant for Clinical Operations 

Director of Comprehensive Women’s Health

Patient Care Services, Women’s Health Services
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Outline

• Overview of the Challenge

• Understanding the State of Women Veterans Health Care

• WATCH Initiative: Methods

• Results

• VSSC Report

• Capabilities

– Self Assessment

– Site Assessments

• Limitations 

• Conclusions

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Poll Question #1

• What is your primary role in VA? 

– student, trainee, or fellow

– clinician

– researcher

– Women Veteran Program Manager

– Other Management/Leadership
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Overview of the Challenge

• The number of women Veterans using Veterans Health 

Administration (VHA) services has doubled in the past 

decade1 

• In 2008, the Under Secretary of Health Work Group 

released a report surveying the current state of health 

care delivery to women Veterans

– Noted gaps in current health care delivery to women Veterans

– Recommended conducting site assessments to better 

understand the delivery of care to women Veterans

1 Frayne SM, Phibbs CS, Friedman SA, Berg E, Ananth L, Iqbal S, Hayes PM, Herrera L. Sourcebook: Women Veterans in the Veterans Health 

Administration. Volume 1. Sociodemographic Characteristics and Use of VHA Care. Women’s Health Evaluation Initiative, Women Veterans Health 

Strategic Health Care Group, Veterans Health Administration, Department of Veterans Affairs, Washington DC. December 2010.

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Overview of the Challenge

• Since the 2008 report:

– Placement of full-time Women Veterans Program Manager 

(WVPM) at every facility (December 2008)

– Implementation of comprehensive primary care for women’s 

health (VHA Handbook 1330.01: Health Care Services For 

Women; released May 2010)

– Changing the language, practice and culture of VA to be more 

inclusive of women Veterans

• Gaps still exist in some Women’s Health (WH) Programs 

indicating a need for continued assessment

5 
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Understanding the State of 

Women Veterans Health Care

• WH Services created a tool to assess the development of 

Women’s Health Program capabilities during site visits

– A randomly chosen sample of sites have been visited each fiscal year

– # sites visited as of 5/16/2013

• Women’s Assessment Tool for Comprehensive Health 

(WATCH) Initiative Self-Assessment

– The site visit assessment tool’s questions were expanded

– Self-Assessment conducted by all WH Programs

– Provides all facilities the opportunity to focus on the requirements for 

achieving comprehensive health care for women Veterans outlined in 

the revision of VHA Handbook 1330.01, Health Care Services for 

Women Veterans (released May 2010).

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

WATCH Initiative: Methods

• Administered as an online survey for Fiscal Years (FY) 

2010, 2011, and 2012

• Self-assessments were reviewed by facility and VISN 

leadership before submission

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

WATCH Initiative: Methods

• FY12 Design

– Part A: Healthcare System Survey

• Characteristics of the WHP at the HCS level 

• Demographics, enrollment and utilization data for women 

Veterans served at the HCS

• Program management staff and strategic planning

• Program capabilities leveraged from site assessment tool

– Part B: Site Specific Survey 

• Completed for each Medical Center and CBOC 

• Models of primary care delivery

• Designated WH Primary Care Providers/PACT

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

WATCH Initiative: Methods

• WVPMs completed self-assessments of their WH 

Programs for 140 Healthcare Systems (HCS) in FY11 and 

FY12

• A HCS contains one parent site defined by the Veteran Affairs Site 

Tracking (VAST) and all sites affiliated with that parent

• Sites included in the self-assessment 

• FY11 and FY12 assessments included drop-down menus for the sites in 

each HCS based on VAST

• FY11 analysis included additional primary care sites that were not 

listed in VAST (e.g. satellite clinics without independent station IDs)

• FY12 analysis only included primary care sites that were found on the 

VAST list

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Methods 

2 Medical Centers were excluded from FY11 analysis and 4 

Medical Centers were excluded from FY12 analysis because 

they did not provide primary care services

10

Fiscal Year 2011 Fiscal Year 2012

Medical Centers 150 148 

CBOCS 795 743 

Total Sites 945 891 
VETERANS HEALTH ADMINISTRATION

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Women Veteran Enrollment2 

• 583,580 unique women Veterans were enrolled in the VHA in FY12

• Age of women Veterans enrolled in VHA in FY12

Age Range Number of Unique Women Veterans Enrolled in VHA3

Under 29 years old 63,188

30-44 years old 171,719

45-64 years old 226,657

65-84 years old 53,800

Over 88 years old 24,447

2Per VSSC WATCH Briefing Book on 5/10/2013 with priority 99 (Unknown) excluded when applicable: 

http://reports2.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?%2fPMR%2fWomenVeterans%2fWV_Profile_Main&rs:Command=Render

3Total does not equal 583,580 due to unknowns in the Current Enrollment Cube

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

VHA Utilization by Women Veterans2 

• 362,939 unique women Veterans received care from the VHA in FY12

• Of those women, 64,262 were from the Operation Iraqi Freedom/Operation 

Enduring Freedom/Operation New Dawn (OIF/OEF/OND) cohort

• Age of women Veterans receiving care from the VHA in FY12: 

Age Range Number of Unique Women Veterans 

Receiving Care from VHA

Under 29 years old 47,346

30-44 years old 110,279

45-64 years old 185,224

65-84 years old 34,986

Over 85 years old 15,067

2Per VSSC WATCH Briefing Book on 5/10/2013 with priority 99 (Unknown) excluded when applicable: 

http://reports2.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?%2fPMR%2fWomenVeterans%2fWV_Profile_Main&rs:Command=Render

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

VHA Utilization by Women Veterans2 

Stop Code Number of Unique 

Women Veterans

(323) Primary Care/Medicine 230,848

(322) Comprehensive Women’s Primary Care Clinic 114,184

(404) Gynecology 45,565

(704) Women’s Gender-Specific Preventive Care 12,898

(426) Women’s Surgery 1,011

(130) Emergency Department 80,174

2Per VSSC WATCH Briefing Book on 5/10/2013 with priority 99 (Unknown) excluded when applicable: 

http://reports2.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?%2fPMR%2fWomenVeterans%2fWV_Profile_Main&rs:Command=Render

• Number of unique women Veterans receiving care per stop code in FY12 (Note: 

women can be seen in more than one stop code):

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

VHA Utilization by Women Veterans

21

0%

20%

40%

60%

80%

100%

323 Primary Care/Medicine 322 Comprehensive 

Women's Primary Care

704 Women's Gender 

Specific Preventive Care

Percent of Clinics

Stop Codes

Stop Codes Used for Comprehensive Primary Care

Model 1 (n=783) Model 2 (n=101) Model 3 (n=79)
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Women Veterans’ Diagnoses2 

ICD-9 Code and Description Number of Unique Women Veterans with Diagnosis

(401.9) Hypertension 58,902

(311.) Depressive Disorder 46,632

(309.81) Posttraumatic Stress Disorder 43,734

(724.2) Lumbago 40,056

(250.00) Diabetes Mellitus without Complication 28,731

(272.4) Hyperlipidemia 28,207

(719.46) Joint Pain-Lower Leg 22,461

(300.00) Anxiety State 20,664

(296.30) Recurrent Depressive Disorder 17,002

(346.90) Migraine 16,461

• Ten most common ICD-9 codes used for women Veterans in FY12:

2Per VSSC WATCH Briefing Book on 5/10/2013 with priority 99 (Unknown) excluded when applicable: 

http://reports2.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?%2fPMR%2fWomenVeterans%2fWV_Profile_Main&rs:Command=Render

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Women Veterans Health Committee &

Strategic Planning 

• 97% of 140 Healthcare Systems had a Women Veterans Health Committee

• 46 % of 140 Healthcare Systems had a written strategic plan for their WH Program

 

23

0%

20%

40%

60%

80%

100%

8 7 7 6 5 5 7 3 8 4 7 7 10 8 8 8 5 5 10 6 6

Percent of Healthcare Systems 

Number of HCS per VISN

Percent of Healthcare Systems (HCS) with a Written Strategic Plan for 

their Women's Health Program by Veterans Integrated Service Network 

(VISN) in Fiscal Year 2011 and 2012

FY 2011 FY 2012
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Key Personnel of the WH Program

• Women Veteran Program Managers (WVPM) for 140 HCSs:

– 131 HCSs had at least one full-time WVPM4 

– 4 HCS had a part-time WVPM

– 4 HCSs had their WVPM position filled in an “acting/interim” capacity

– 1 HCS did not have their WVPM position filled

• WH Medical Director or Champion for 140 HCSs:

– 126 HCSs had WH Medical Director and/or a WH Champion

– 14 HCSs had neither identified 

• CBOC WH Liaison for 1395 HCSs:

– 122 of 139 Healthcare Systems had a WH Liaison at each CBOC

4Note: Two HCSs had a second WVPM

5Note: One HCS did not have any CBOCs

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Key Personnel of the WH Program

25

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Other

Social Worker

RN

NP

PA

MD

Percent of WVPMs (n=1374) 

Professional Designation of Women Veteran Program Managers 

(WVPM)

Professional Designation

4Note: Two HCSs had a second WVPM
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Key Personnel of the WH Program

26

0% 20% 40% 60% 80% 100%

Other

NP

DO

MD

Percent of WHMDs (n=93)

Professional 

Designation

Professional Designation of Women's Health Medical Director (WHMD)

0% 20% 40% 60% 80% 100%

Other

Percent of WHMDs (n=93)

Gynecology

Family Practice

Internal Medicine

Clinical Specialty

Clinical Specialty of Women's Health Medical Director (WHMD)
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Comprehensive Primary Care

• Provision of complete primary care and care coordination by 

one primary care provider at one site

• The primary care provider should, in the context of a 

longitudinal relationship, fulfill all primary care needs, 

including: 

• Care for acute and chronic illness

• Gender-specific primary care

• Preventive services

• Mental health services

• Coordination of care

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Comprehensive Primary Care

28

0%

20%

40%

60%

80%

100%

Healthcare Systems VHA Sites (Medical Centers and CBOCs)

Percent Delivering Primary Care

Percent of healthcare systems and VHA sites that delivered 

comprehensive primary care in FY11 and FY12

FY11 FY12
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Comprehensive Primary Care

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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

A B C D E F G H I J K L M N O P Q R S T U

Percent of Sites

VISN

Percent of Sites Delivering Comprehensive Primary Care by VISN in 

Fiscal Year 2011 and Fiscal Year 2012

FY11 FY12
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Designated WH 

Primary Care Provider (PCP) 

• Definition

– PCP who is interested and proficient in Women’s Health

– Preferentially assigned women Veterans within their 

primary care panels 

• Proficiency

– WH PCP panels should be comprised of at least 10% 

female patients 

– If panels are less than 10% women, an alternative plan to 

ensure ongoing proficiency must be implemented at a 

local level

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Designated WH 

Primary Care Provider

31

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Healthcare Systems VHA Sites (Medical Centers and CBOCs)

Percent of healthcare systems and VHA sites with a Designated 

Women's Health Primary Care Provider (WH PCP) in FY11 and FY12 

FY11 FY12

Percent with a Designated WH PCP 
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Designated WH 

Primary Care Provider

• 66% of women assigned to a primary care panel in the Primary Care Management 

Module (PCMM) were assigned to a Designated WH PCP

32

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

A B C D E F G H I J K L M N O P Q R S T U

Percent of Women

VISN

Percent of Women Assigned to a Designated Women's Health 

Primary Care Provider by VISN in Fiscal Year 2011 and 2012

FY11 FY12
May 16, 2013

VETERANS HEALTH ADMINISTRATION

WH Models of Care

• Comprehensive Primary Care should be delivered by 

a designated WH PCP in one of three models:

– Model 1: General Primary Care Clinics 

– Model 2: Separate but Shared Space

– Model 3: Women’s Health Center (WHC)

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

WH Models of Care

Models of Care 

Available Per Site

No. of Medical 

Center Sites

(n=148) 

No. of CBOC 

Sites (n=743) 

Total Sites 

(n=891) 

Model of Care 1 only 49 662 711 

Model of Care 2 only 18 59 77 

Model of Care 3 only 26 5 31 

Model of Care 1 and 2 16 8 24 

Model of Care 1 and 3 39 9 48 

• Each VA Medical Center and/or CBOC may offer 1 or 

more models of care onsite for women Veterans’ 

Primary Care

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

WH Models of Care

• Models of Care available as of 9/30/2011: 

35

140 Healthcare Systems

150 VA Medical 

Centers

795 Community 

Based Outpatient 

Clinics

35 Model 2 

Clinics

736 Model 1 

Clinics

66 Model 2 

Clinics

9 Model 3 

Clinics

97 Model 1 

Clinics

66 Model 3 

Clinics
May 16, 2013

VETERANS HEALTH ADMINISTRATION

WH Models of Care

• Models of Care available as of 9/30/2012:

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Patient Aligned Care Teams (PACT)

• WH PACT Teamlets should include

– Designated WH PCP 

– Recommended 3:1 staffing ratio (three support staff to one 

PCP) 

• 66% of the 891 sites delivering primary care had at 

least 1 WH PACT Teamlet 

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Patient Aligned Care Teams (PACT)

38

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

A B C D E F G H I J K L M N O P Q R S T U

Percent of Sites 

VISN

Percent of Sites with at least 1 WH PACT Teamlet by VISN

FY11 % FY12 %
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Patient Aligned Care Teams (PACT)

• 70% of Designated WH Primary Care Providers are assigned to 

a WH PACT Teamlet in PCMM (*WH*)

39

0%

20%

40%

60%

80%

100%

Percent of Designated WH PCP 

1 2 3 4 5 6 7 8 9 10 11 12 15 16 17 18 19 20 21 22 23

VISN

Percent of Designated Women's Health Primary Care Providers (WH 

PCP) assigned to a WH PACT Teamlet
May 16, 2013

VETERANS HEALTH ADMINISTRATION

PACT STAFFING

40

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Percent WH PACT 

Teamlets with 3:1 

Staffing Ratio

Percent WH PACT 

Teamlets with a 

Registered Nurse

Percent WH PACT 

Teamlets with a Clerk

Percent WH PACT 

Teamlets with a Health 

Tech or LPN or LVN

Women's Health PACT Staffing

Model 1 Model 2 Model 3
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Extended Hours for Primary Care

• 28 Medical Centers and 57 CBOCS had extended 

primary care hours in FY12.

41

0%

5%

10%

15%

Extended Evening 

Hours

Extended Morning 

Hours

Extended Saturday 

Hours

Extended Sunday 

Hours

Percent of Sites 

Type of Extended Hours

Percent of Sites with Extended Primary Care Hours in FY12

Medical Center (n=148) Community Based Outpatient Clinic (n=743)
May 16, 2013

VETERANS HEALTH ADMINISTRATION

WH Specialty Services

42

0%

20%

40%

60%

80%

100%

Mental Health Specialty 

Gynecology

Social Work Pharmacy

Percent of Medical Center Primary 

Care Clinics

Co-located Services in Primary Care

Co-located Specialty Services in Medical Center Primary Care Clinics

Model 1 (n=104) Model 2 (n=34) Model 3 (n=65)
May 16, 2013

VETERANS HEALTH ADMINISTRATION

WH Specialty Services

43

0%

20%

40%

60%

80%

100%

Mental Health Specialty Gynecology Social Work Pharmacy

Percent of CBOC Primary Care Clinics

Co-located Services in Primary Care

Co-located Specialty Services in CBOC Primary Care Clinics

Model 1 (n=679) Model 2 (n=67) Model 3 (n=14)
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Co-located Services in WH Centers (Model 3)

• As of 9/30/2012, the 79 WH Centers offered the following additional co-located services 

with primary care: 

Type of Co-located 

Specialty Service

No. of WH Centers 

with the Co-located 

Service

Percent of 

79 WH Centers

Breast Surgery Clinic 12 17% 

Health Behavior Coordinator 25 36% 

Nutrition 22 32% 

OEF/OIF/OND 23 33% 

MOVE! 23 33% 

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Specialty Gynecology Services

• Services by a provider trained in general 

gynecological care or subspecialty gynecological care 

• Screening Pap and Breast exams performed by a nongynecologist or non-gynecology advanced nurse 

practitioner do not fall into this category

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Specialty Gynecology Services

46

0%

All Model 1 

Clinics (n=783)

All Model 2 

Clinics (n=101)

All Model 3 

Clinics (n=79)

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Percent of Clinics

Location where specialty gynecology is reported to be 

received most often by model of care

At this clinic

At another clinic within this VA Site

At another site within this Healthcare 

System: within 50 miles

At another site within this Healthcare 

System: more than 50 miles

At another VA outside this Healthcare 

System: within 50 miles

At another VA outside this Healthcare 

System: more than 50 miles

Through non-VA (fee) care/contract 

services: within 50 miles
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Specialty Gynecology

47

0% 

Medical Center 

Model 1 Clinics 

(n=104) 

Medical Center 

Model 2 Clinics 

(n=34) 

10% 

20% 

30% 

40% 

50% 

60% 

70% 

80% 

90% 

100% 

Medical Center 

Model 3 Clinics 

(n=65) 

Location where specialty gynecology is reported to be 

received most often in Medical Centers by model of care

At this clinic

At another clinic within this VA Site

At another site within this Healthcare 

System: within 50 miles

At another site within this Healthcare 

System: more than 50 miles

At another VA outside this Healthcare 

System: within 50 miles

At another VA outside this Healthcare 

System: more than 50 miles

Through non-VA (fee) care/contract 

services: within 50 miles

Percent of Clinics
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Specialty Gynecology

48

0% 

CBOC Model 1 

Clinics (n=679)

CBOC Model 2 

Clinics (n=67)

10% 

20% 

30% 

40% 

50% 

60% 

70% 

80% 

90% 

100% 

CBOC Model 3 

Clinics (n=14)

Percent of Clinics

Location where specialty gynecology is reported to be 

received most often in CBOCs by model of care

At this clinic

At another clinic within this VA Site

At another site within this Healthcare 

System: within 50 miles

At another site within this Healthcare 

System: more than 50 miles

At another VA outside this Healthcare 

System: within 50 miles

At another VA outside this Healthcare 

System: more than 50 miles

Through non-VA (fee) care/contract 

services: within 50 miles
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Self-Assessment Report 

49

http://reports2.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?%2fPMR%2fWomenVeterans%2fWATC

H_Survey%2fWATCH&rs:Command=Render
May 16, 2013

VETERANS HEALTH ADMINISTRATION

Capabilities Self-Assessment

• FY12 data roll-up is in progress

• The FY11 self assessment data for the four program 

components are shown in charts that follow.

– WH Program

– Health Care Services

– Outreach, Communication And Collaboration

– Patient Centered Care/PACT

• Four components include 35 capabilities in FY11 and 36 

capabilities in FY12 

• Scored on a 4-point Likert scale (1-Needs Development; 2-

Being Developed; 3-Developed; 4-Highly Developed)

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VETERANS HEALTH ADMINISTRATION

Self-Assessment FY11

Development of Women’s Health Capabilities: 

PROGRAM

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Self-Assessment FY11

Development of Women’s Health Capabilities: 

HEALTH CARE SERVICES

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Self-Assessment FY11

Development of Women’s Health Capabilities: 

OUTREACH, COMMUNICATION AND COLLABORATION

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Self-Assessment FY11

Development of Women’s Health Capabilities: 

PATIENT CENTERED CARE

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Site Visit 

Development of Women’s Health Capabilities: 

PROGRAM 

n = 58 facilities as of 4/2/2013

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Site Visit 

Development of Women’s Health Capabilities: 

HEALTH CARE SERVICES 

n = 58 facilities as of 4/2/2013

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VETERANS HEALTH ADMINISTRATION

Site Visit 

Development of Women’s Health Capabilities: 

OUTREACH, COMMUNICATION, AND COLLABORATION

n = 58 facilities as of 4/2/2013

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VETERANS HEALTH ADMINISTRATION

Site Visit 

Development of Women’s Health Capabilities: 

PATIENT CENTERED CARE / PACT

n = 58 facilities as of 4/2/2013

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VETERANS HEALTH ADMINISTRATION

Site Visit versus Self-Assessment

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VETERANS HEALTH ADMINISTRATION

Data Limitations

• Accuracy limited to respondent’s assessment

• Data validation

– Outliers were confirmed with WVPMs

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Findings and Conclusions

• Less than half of the 140 HCSs had a written strategic 

plan for provision of services to women Veterans

• Most HCSs had the required WH Program personnel 

positions filled including a WVPM and all CBOC 

liaisons

• Most HCSs had the recommended WH Program 

personnel positions filled including a WH Medical 

Director or WH Champion

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May 16, 2013

VETERANS HEALTH ADMINISTRATION

Findings and Conclusions

• All 140 Healthcare Systems had a Designated WH 

PCP and provided comprehensive primary care to 

women Veterans in at least one of their sites

• Over 50 sites implemented comprehensive primary 

care between FY11 and FY12 so that only 14% of the 

891 primary care sites across VHA did not have the 

capability

• Despite enhanced comprehensive primary care 

implementation, 34% of women are not assigned to 

a Designated WH PCP

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VETERANS HEALTH ADMINISTRATION

Acknowledgements

• Nicole Hampton

• Lorraine Callahan

• Lori Cooper

• Ruthie Shulaw-Grogg

• Anu Torgal

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