2021-07-14T18:10:34-05:00 2020-08-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2019-09-01 941156276 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER FRES 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 DEBORAH MOFFETT VP, FINANCE 5594596000 2021-07-13 1 TRACY S PAGLIA P00366884 2099556100 2021-07-13 2019 2022-09-23 18:48:47Z CRAIG S CASTRO 1560 E SHAW AVENUE FRESNO CA 93710 2170098233 0 X WWW.COMMUNITYMEDICAL.ORG X 1947 CA FCH&MC MEETS THE MEDICAL NEEDS OF ITS COMMUNITY THROUGH ITS ACUTE-CARE HOSPITALS AND FACILITIES. 15 12 7691 700 19330320 413115 6183358 18863970 1741567300 1750632391 37996065 23731476 7624031 5940909 1793370754 1799168746 32721758 16161305 0 0 764250721 796465489 0 0 0 840961157 903944403 1637933636 1716571197 155437118 82597549 2251530740 2521392526 838191327 1000740111 1413339413 1520652415 X FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER'S (FCH&MC'S) MISSION IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROMOTE MEDICAL EDUCATION. 0 0 1559503420 16161305 1731604953 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER OPERATES THREE ACUTE HOSPITALS AND NUMEROUS OUTPATIENT CENTERS, CLINICS AND OTHER SERVICES WHICH MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL DETAILS.- COMMUNITY REGIONAL MEDICAL CENTER. CRMC IS A TERTIARY ACUTE CARE FACILITY THAT PROVIDES THE PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA WITH THE FOLLOWING SERVICES: (I) THE CENTRAL VALLEY'S ONLY LEVEL I TRAUMA CENTER, (II) THE COMMUNITY REGIONAL BURN CENTER, (III) A LEVEL III NEONATAL INTENSIVE CARE UNIT, (IV) COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES, INCLUDING TECHNOLOGICALLY ADVANCED MEDICAL/SURGICAL SPECIALTIES SUCH AS CARDIOVASCULAR, NEUROSCIENCE, ORTHOPEDICS AND WOMEN'S AND CHILDREN'S SERVICES, (V) THE COMMUNITY FAMILY BIRTH CENTER, (VI) GENERAL AND SPECIALTY INTENSIVE CARE UNITS, (VII) THE LEON S. PETERS REHABILITATION CENTER, (VIII) INPATIENT AND OUTPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) DIALYSIS TREATMENT FACILITIES, (XI) DIAGNOSTIC RADIOLOGY SERVICES, (XII) SHORT STAY SURGERY SERVICES, (XIII) A CARDIOVASCULAR CARE UNIT, AND (XIV) 24 HOUR EMERGENCY SERVICES. CRMC IS ALSO A TEACHING HOSPITAL THAT IS AFFILIATED WITH UCSF. THE MAIN CAMPUS OF CRMC CONSISTS OF A HOSPITAL BUILDING WITH FIVE AND 10-STORY WINGS, CONNECTED TO A FIVE STORY TRAUMA AND CRITICAL CARE BUILDING. CRMC ALSO PROVIDES (I) BEHAVIORAL HEALTH SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC"), (II) SUBACUTE AND SKILLED NURSING SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER ("CSTCC"), AND (III) HIV AND OMFS SERVICES ARE OFFERED AT THE DERAN KOLIGIAN AMBULATORY CARE CENTER LOCATED ON THE CRMC MAIN CAMPUS (THE "FRESNO CAMPUS"). - CLOVIS COMMUNITY MEDICAL CENTER. CCMC IS LOCATED IN THE CITY OF CLOVIS (WHICH IS CONTIGUOUS TO THE CITY OF FRESNO), WHERE IT SERVES THE PRIMARY SERVICE AREA AND, TO A LESSER DEGREE, THE SECONDARY SERVICE AREA. THE CMC CAMPUS IN CLOVIS (THE "CLOVIS CAMPUS") INCLUDES THE MAIN FACILITY, WHICH CONSISTS OF AN ACUTE CARE HOSPITAL WITH A FIVE-STORY TOWER AND A THREE-STORY TOWER CONNECTED TO AN OUTPATIENT SURGERY/ENDOSCOPY/DIAGNOSTIC CENTER. THE FACILITY HAS ALL PRIVATE ROOMS. THE FACILITY PROVIDES: (I) COMPREHENSIVE MEDICAL AND SURGICAL CAPABILITIES, (II) 24-HOUR EMERGENCY CARE, (III) AN INTENSIVE CARE UNIT, (IV) THE COMMUNITY FAMILY BIRTH CENTER, (V) THE MARJORIE E. RADIN BREAST CARE CENTER (VI) SHORT STAY AND INPATIENT SURGICAL SERVICES, INCLUDING ROBOTICS AND ADVANCED MINIMALLY INVASIVE SURGERY, (VII) A LEVEL II NEONATAL INTENSIVE CARE UNIT, (VIII) INPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) ADVANCED DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, AND (XI) INVASIVE AND NON-INVASIVE CARDIAC SERVICES. OTHER FACILITIES AND SERVICES PROVIDED ON THE CLOVIS CAMPUS INCLUDE: (I) AN OUTPATIENT WOUND CARE CLINIC WITH TWO HYPERBARIC OXYGEN CHAMBERS, (II) AN OUTPATIENT PHYSICAL REHABILITATION CLINIC, INCLUDING LYMPHEDEMA THERAPY, (III) COMMUNITY CANCER INSTITUTE (CCI), A THREE-STORY BUILDING WHICH IS CENTRAL CALIFORNIA'S PREMIER COMPREHENSIVE CANCER CARE CENTER - AND THE ONLY ONE IN THE AREA WITH MANY OUTPATIENT SERVICES IN A SINGLE LOCATION, AND (IV) THE H. MARCUS RADIN CONFERENCE CENTER, WHICH OPENED IN 2012 AND PROVIDES A 214- SEAT AUDITORIUM THAT IS FULLY INTEGRATED FOR TRAINING IN CMC'S OPERATING ROOMS AND FOR BROADCASTING OTHER EVENTS, AND TWO STATE-OF-THE-ART COMPUTER TRAINING LABS.- FRESNO HEART AND SURGICAL HOSPITAL. HEART HOSPITAL IS AN ACUTE CARE FACILITY WITH ALL PRIVATE ROOMS LOCATED IN THE CITY OF FRESNO OVERLOOKING WOODWARD PARK IN NORTHEAST FRESNO. THE FACILITY OPENED IN OCTOBER 2003 AND PROVIDES THE PRIMARY AND SECONDARY SERVICE AREAS WITH (I) CARDIOLOGY AND CARDIAC SURGERY SERVICES, (II) VASCULAR SURGERY SERVICES, AND (III) BARIATRIC AND OTHER MINIMALLY INVASIVE SURGERY SERVICES. THE ORGANIZATION IS THE PRINCIPAL TEACHING HOSPITAL IN THE CENTRAL VALLEY THROUGH A GRADUATE MEDICAL EDUCATION PROGRAM AFFILIATED WITH THE UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO MEDICAL EDUCATION PROGRAM. CMC SUPPORTS A FULLY ACCREDITED EDUCATIONAL PROGRAM WITH CALIFORNIA STATE UNIVERSITY, FRESNO, BY PROVIDING CLINICAL EXPERIENCE TO ITS NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND DIETETIC STUDENTS. ADDITIONALLY, THE ORGANIZATION PROVIDES CLINICAL EXPERIENCE TO FRESNO CITY COLLEGE'S NURSING, SURGERY AND RADIOLOGY TECHNOLOGY STUDENTS. CMC ALSO PROVIDES CLINICAL EXPERIENCE TO STUDENTS IN THE SAN JOAQUIN VALLEY COLLEGE LVN TO RN PROGRAM, FRESNO ADULT SCHOOL AND CLOVIS ADULT SCHOOL LICENSED VOCATIONAL NURSE PROGRAMS, AS WELL AS STUDENTS IN MANY OTHER PROGRAMS AT AREA COMMUNITY COLLEGES. EACH OF THE THREE ACUTE HOSPITALS CONDUCTS EDUCATIONAL PROGRAMS FOR THE BENEFIT OF PHYSICIANS, NURSES, TECHNICIANS, MANAGEMENT PERSONNEL, EMPLOYEES, AND THE PUBLIC. IN ADDITION, CMC SPONSORS NUMEROUS HEALTH PROMOTION AND EDUCATION PROGRAMS FOR ITS EMPLOYEES AND MEMBERS OF THE COMMUNITY IN MANY AREAS, INCLUDING ASTHMA, DIABETES, NUTRITION AND WEIGHT CONTROL, STRESS MANAGEMENT, HEALTH AND WELLNESS, AND SMOKING CESSATION. THE ORGANIZATION IS AN ACTIVE PARTNER IN SEVERAL COMMUNITY SERVICE PROJECTS SUPPORTING EDUCATION IN HEALTH CAREERS FOR HIGH SCHOOLS AND OTHER COMMUNITY GROUPS. TO ADDRESS THE NATION-WIDE NURSING SHORTAGE, THE ORGANIZATION HAS IMPLEMENTED SEVERAL SYSTEM-WIDE INITIATIVES TO INCREASE RECRUITMENT AND RETENTION INCLUDING THE IMPLEMENTATION OF A NURSE RESIDENCY PROGRAM AND CLINICAL LADDER, BOTH DESIGNED TO EXPAND THE EDUCATION OF NEW NURSES AND PROMOTE RETENTION OF A HIGHER PERCENTAGE OF THESE NURSES. 1559503420 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 7691 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 CA X DEBORAH MOFFETT 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 TIM JOSLIN - PRESIDENT CHIEF EXECUTIVE OFFICER THRU 07/20 55.00 5.00 X 0 1043094 813046 CRAIG CASTRO - PRESIDENT CHIEF EXECUTIVE OFFICER AS OF 07/20 55.00 5.00 X 0 1292139 41142 CRAIG WAGONER EVP, CHIEF OPERATING OFFICER 55.00 5.00 X 0 1177294 31118 THOMAS UTECHT SVP, CHIEF QUALITY OFFICER 50.00 5.00 X 889679 0 40484 JOSEPH NOWICKI SVP, CORPORATE CFO 55.00 5.00 X 0 897998 35434 ALDO DE LA TORRE SVP, NETWORK DEVELOPMENT 50.00 5.00 X 0 822540 31809 ROBYNN L VAN PATTEN SVP CHIEF LEGAL OFFICER THRU 6/19 50.00 5.00 X 0 741309 31906 WANDA HOLDERMAN SVP, CHIEF CLINICAL INTEGRA 50.00 5.00 X 675808 0 30059 CHRISTOPHER NEUMAN CHIEF OPERATING OFFICER 50.00 5.00 X 570411 0 32177 TRACY KIRITANI CHIEF FINANCIAL OFFICER 50.00 5.00 X 573643 0 27541 CARLA MILTON SVP, HUMAN RESOURCES 50.00 5.00 X 0 542627 34687 JEFFREY THOMAS CHIEF MEDICAL & QUALITY OFFICER 50.00 5.00 X 532573 0 20362 BRIANNE L MARRIOTT SVP, CHIEF LEGAL OFFICER 50.00 5.00 X 0 354988 31509 PATRICK T RAMIREZ SVP, COMMUNITY PROVIDER NETWORK 50.00 5.00 X 0 249676 28124 MICHELLE VON TERSCH SVP, COMMUNICATION & LEGISLATIVE AFFAIRS 50.00 5.00 X 0 237543 33765 AJIT ARORA MD BOARD MEMBER 1.40 0.50 X 0 200700 0 FARID ASSEMI CHAIR AS OF 01/20 1.40 0.50 X X 0 0 0 LINZIE DANIEL CHAIR THRU 12/19 1.40 0.50 X X 0 0 0 ROGER STURDEVANT CHAIR ELECT 1.40 0.50 X X 0 0 0 SUSAN ABUNDIS SECRETARY 1.40 0.50 X X 0 0 0 RONALD BIERMA MD BOARD MEMBER AS OF 01/20 1.40 0.50 X 0 0 0 KEITH BOONE MD BOARD MEMBER 1.40 0.50 X 0 0 0 TERRANCE BRADLEY EDD BOARD MEMBER 1.40 0.50 X 0 0 0 JERRY COOK BOARD MEMBER 1.40 0.50 X 0 0 0 MANUEL CUNHA JR BOARD MEMBER THRU 12/19 1.40 0.50 X 0 0 0 GREG ESTEP BOARD MEMBER AS OF 01/20 1.40 0.50 X 0 0 0 REN IMAI MD BOARD MEMBER 1.40 0.50 X 0 0 0 JOSEPH JONES PHD BOARD MEMBER AS OF 01/20 1.40 0.50 X 0 0 0 KAREN MCCAFFREY BOARD MEMBER 1.40 0.50 X 0 0 0 JOHN MCGREGOR BOARD MEMBER 1.40 0.50 X 0 0 0 RUTHIE QUINTO BOARD MEMBER 1.40 0.50 X 0 0 0 DAVID SLATER MD BOARD MEMBER THRU 12/19 1.40 0.50 X 0 0 0 CHANDRASEKAR VENUGOPAL MD BOARD MEMBER 1.40 0.50 X 0 0 0 3242114 7559908 1263163 1627 0 1 0 CLARK CONSTRUCTION 677 D N MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 CONSTRUCTION SERVICE 68293221 SYNTHES USA PO BOX 32639 PALM BEACH GARDENS FL 33420 MEDICAL 4819947 ANGELICA PO BOX 51669 LOS ANGELES CA 90051 LINEN SERVICES 2600029 PATTON AIR CONDITIONING 272 N PALM AVE FRESNO CA 93701 CONSTRUCTION SERVICE 2423826 COMMUNITY MEDICAL IMAGING 1867 E FIR AVE STE 104 FRESNO CA 93720 MEDICAL 1857915 35 7411155 1704828 9747987 18863970 MEDICAL SERVICE 622110 1708924007 1708924007 GRANTS AND CONTRACTS 622110 23763540 23763540 PHARMACY SALES 446110 18167555 232241 17935314 INCOME FR PARTNERSHIPS 622110 -222711 -1314835 1092124 1750632391 21253937 21253937 373322991 84035 370192889 736598 3130102 -652563 2477539 2477539 HOSPITAL CAFETERIA REV 722320 5638027 5638027 PARKING AND SECURITY 812930 302882 302882 5940909 1799168746 1731604953 19330320 29369503 X 16161305 16161305 8973189 8973189 419624 419624 640758209 557459642 83298567 20834033 18125609 2708424 78521219 68313461 10207758 46959215 40854517 6104698 1065547 1065547 1591207 1591207 281834436 269891612 11942824 2151840 2151840 4542952 4542952 24059439 20209928 3849511 598366 502628 95738 124140 124140 16960853 14247116 2713737 75106139 63089157 12016982 10496056 8816687 1679369 MEDICAL SUPPLIES 297552174 297552174 MEDI-CAL PROVIDER FEE 134413227 134413227 MINOR EQUIPMENT 28383426 28383426 PROVISION FOR BAD DEBT 502123 502123 24562478 20437044 4125434 1716571197 1559503420 157067777 0 126857816 125671755 205931145 220449663 13616559 14537294 2574521 3192472 14442369 20566102 54734677 30674661 1684411182 652263890 925234499 1032147292 630344833 804312854 42572565 28062783 235221756 241777650 2251530740 2521392526 257883364 311252050 525385802 514327643 5090849 5834203 49831312 169326215 838191327 1000740111 X 1413339413 1520652415 1413339413 1520652415 2251530740 2521392526 82597549 24715453 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 16089024 15265158 31354182 1000209241 303468306 696740935 6218953 4368465 1850488 479562102 344427119 135134983 167066704 167066704 1032147292 OTHER ASSETS 17003513 RECEIVABLE FROM AFFILIATES 218157604 SUPPLEMENTAL FUNDING 6616533 241777650 ASSET RETIREMENT OBLIGATION 5497634 GROUP HEALTH 2352166 MALPRACTICE - IBNR 4323000 WORKERS COMPENSATION RESERVE 34963000 PHYSICIAN GUARANTEE PAYABLE 277064 LEASE LIABILITY 32781610 DEFERRED TAXES 15142204 MEDICARE ACCELERATED PAYMENT PAYABLE 73989537 169326215 FORM 990, SCHEDULE D, PART X, LINE 2: THERE IS NO FOOTNOTE FOR FIN 48 IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DUE TO IMMATERIALITY. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 23339028 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES CAPTIVE INSURANCE 8225556 0 0 0 0 0 0 31564584 0 31564584 1 0 1 0 0 0 PART I, LINE 3: ACCRUAL METHOD PART III ACCOUNTING METHOD: 1 1 X 1 X 400.000000000000 1 X 1 1 0 1 1 12974501 12974501 0.00760 316345000 202105000 114240000 0.06660 329319501 202105000 127214501 0.07420 1454899 1454899 0.00080 51728451 5638708 46089743 0.02690 1 157224 157224 0.00010 5 171503 171503 0.00010 6 53512077 5638708 47873369 0.02790 6 382831578 207743708 175087870 0.10210 4 3960 148630 148630 0.00010 1 79 11287 11287 0.00000 1 3183 3183 0.00000 2 39 5829 5829 0.00000 8 4078 168929 168929 0.00010 1 502123 0 279691942 332252535 -52560593 X 1 1 1 CA IMAGING INSTITUTE LLC MEDICAL IMAGING 0.50000 0.00000 0.50000 2 AMI REALTY PARTNERS LP PROPERTY MANAGEMENT 0.50000 0.00000 0.50000 3 1 COMMUNITY REGIONAL MEDICAL CENTER 2823 FRESNO ST FRESNO CA 93721 WWW.COMMUNITYMEDICAL.ORG 040000096 X X X X X A 2 CLOVIS COMMUNITY MEDICAL CENTER 2755 HERNDON CLOVIS CA 93612 WWW.COMMUNITYMEDICAL.ORG 040000004 X X X A 3 FRESNO HEART AND SURGICAL HOSPITAL 15 E AUDUBON FRESNO CA 93720 WWW.COMMUNITYMEDICAL.ORG 040000096 X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 19 1 1 0 1 X SEE PART V X SEE PART V X 1 19 1 SEE PART V 0 1 X 400.000000000000 350.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: COMMUNITY REGIONAL MEDICAL CENTER, - FACILITY 2: CLOVIS COMMUNITY MEDICAL CENTER, - FACILITY 3: FRESNO HEART AND SURGICAL HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONSISTS OF PRIMARY DATA FROM MORE THAN 1,000 PARTICIPANTS IN INDIVIDUAL INTERVIEWS, MULTI-LANGUAGE FOCUS GROUPS, AND ONLINE SURVEYS. PARTICIPANTS INCLUDED REPRESENTATIVES FROM AND USERS OF HEALTH IMPROVEMENT PROGRAMS AIMED AT LOW-INCOME, VULNERABLE POPULATIONS, AND SERVING CHILDREN, HOMELESS, LGBTQ+, VETERANS, SENIORS, TRIBAL COMMUNITIES, AS WELL AS AFRICAN AMERICAN, HMONG, LATINO AND SPANISH-SPEAKING POPULATIONS. SECONDARY DATA WAS COLLECTED USING GOVERNMENT AND OTHER RESOURCES, SUCH AS THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, HEALTH RESOURCES AND SERVICES ADMINISTRATION, AND THE ROBERT WOOD JOHNSON'S COUNTY HEALTH RANKINGS AND ROADMAPS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: FOURTEEN FACILITIES OVER FOUR CENTRAL VALLEY COUNTIES COLLABORATED ON THIS REPORT. THE PARTICIPATING HOSPITALS WERE: COMMUNITY REGIONAL MEDICAL CENTER, CLOVIS COMMUNITY MEDICAL CENTER, FRESNO HEART AND SURGICAL HOSPITAL, ADVENTIST HEALTH-CENTRAL VALLEY NETWORK (HANFORD, REEDLEY, AND SELMA), COALINGA MEDICAL CENTER (CLOSED), KAISER PERMANENTE-FRESNO SERVICE AREA, KAWEAH DELTA HEALTH CARE DISTRICT, MADERA COMMUNITY HOSPITAL, SAN JOAQUIN VALLEY REHABILITATION HOSPITAL, SAINT AGNES MEDICAL CENTER, SIERRA VIEW MEDICAL CENTER, AND VALLEY CHILDREN'S HEALTHCARE. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING THE HEALTH NEEDS IN THE REPORT THROUGH A DIRECT PROGRAM/SERVICE APPROACH AS WELL AS A LEADERSHIP AND PARTICIPATION IN BROAD MULTI-STAKEHOLDER COLLABORATIVES THAT INCLUDE PUBLIC HEALTH, COMMUNITY-BASED ORGANIZATIONS, SCHOOLS, BUSINESS AND OTHERS. COLLABORATIVES PROVIDE COMMUNITY-WIDE, TARGETED APPROACHES TO ADDRESS THE REGION'S COMPLEX HEALTHCARE NEEDS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: MEDICAL EXPENSES FOR PATIENTS OR THEIR FAMILY (INCURRED AT CMC OR OTHER PROVIDERS IN THE LAST 12 MONTHS) EXCEEDS 10% OF THE PATIENT'S FAMILY INCOME. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16J: OSHPD HAS CREATED A WEB-BASED SYSTEM THAT WILL ALLOW USERS TO SEARCH, COMPARE, AND VIEW EACH HOSPITAL'S SUBMITTED CHARITY CARE POLICY, DISCOUNT PAYMENT POLICY, ELIGIBILITY PROCEDURES, REVIEW PROCESS, AND APPLICATION FORM. ACCESS OSHPD'S HOSPITAL FAIR PRICING SEARCH SYSTEM AT: HTTPS://SYFPHR.OSHPD.CA.GOV/#FRESNO-COUNTY FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 23: UNDER CALIFORNIA LAW (AB 774), THE MAXIMUM THAT A FAP-ELIGIBLE PATIENT MAY BE CHARGED IS THE REIMBURSEMENT RATE OF ANY GOVERNMENT-SPONSORED HEALTH PROGRAMS IN WHICH THE HOSPITALPARTICIPATES. PART V, SECTION B, LINES 7A AND 7B: HOSPITAL FACILITY'S WEBSITE WHERE THE CHNA REPORT IS AVAILABLE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFITOTHER WEBSITE WHERE THE CHNA REPORT IS AVAILABLE:HTTPS://WWW.HOSPITALCOUNCIL.ORG/SITES/MAIN/FILES/FILE-ATTACHMENTS/FINAL_CENTRAL_VALLEY_CHNA_3.18.PDF?1553209460 PART V, SECTION B, LINE 10: HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP A PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CARE 4 1 - COMMUNITY CANCER INSTITUTE 785 NORTH MEDICAL CENTER DR W CLOVIS CA 93611 OUTPATIENT CANCER CENTER 2 - DERAN KOLIGIAN AMBULATORY CARE CENTER 290 N WAYTE LANE FRESNO CA 93701 CLINICS: OMFS SURGERY, HIV/AIDS 3 - COMMUNITY BEHAVIORAL HEALTH CENTER 7171 N CEDAR AVE FRESNO CA 93720 PSYCHIATRIC CARE FACILITY 4 - COMMUNITY SUBACUTE TRANSITIONAL CARE CEN 3003 MARIPOSA ST FRESNO CA 93703 SKILLED NURSING AND SUBACUTE CARE PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS ISSUED BY COMMUNITY MEDICAL CENTERS (CMC), A DBA USED BY THE THREE HOSPITALS THAT COMPRISE THE ORGANIZATION. PART I, LINE 7: COSTING METHODOLOGY: CHARITY CARE IS ESTIMATED BY CALCULATING THE RATIO OF COST PER ADJUSTED PATIENT DAY (EXCLUDING BAD DEBTS) AND THEN MULTIPLYING THAT RATIO BY THE ADJUSTED PATIENT DAYS ASSOCIATED WITH CHARITY CARE PATIENTS. CMC DOES NOT UTILIZE A COST ACCOUNTING SYSTEM TO ESTIMATE THE COST OF CHARITY CARE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 502,123. PART II, COMMUNITY BUILDING ACTIVITIES: CMC'S EFFORTS TO IMPROVE THE COMMUNITY'S HEALTH STATUS ARE VARIED AND WIDE-RANGING. FROM SOPHISTICATED MEDICAL RESEARCH THAT ADDRESSES THE VALLEY'S UNIQUE HEALTH NEEDS TO HOME VISITS FOR ASTHMA PATIENTS, COMMUNITY STRIVES TO RESPOND TO THE MOST PRESSING HEALTH NEEDS IN OUR REGION. THE CHNA HELPS PROVIDE US WITH A "ROADMAP" FOR OUR COMMUNITY HEALTH IMPROVEMENT EFFORTS. BELOW IS A SNAPSHOT OF CMC'S SIGNATURE COMMUNITY BENEFIT PROGRAMS FOR FISCAL YEAR 2020. THIS REPORT AND OUR FUTURE FISCAL YEAR 2021 COMMUNITY BENEFIT ACTIVITIES ADDRESS CMC'S 2019 IMPLEMENTATION PLAN. ACTIVITIES RELATED TO THESE TWO REPORTS ARE IN RESPONSE TO THE 2019 CHNA IDENTIFIED HEALTH NEEDS.IN GOOD FAITH, CMC STRIVES TO SERVE THE IDENTIFIED HEALTH NEEDS DIRECTLY OR AS A SUBJECT MATTER EXPERT. WHILE CMC PARTICIPATES IN LOCAL AND REGIONAL COLLABORATIVE EFFORTS AROUND ALL 13 IDENTIFIED HEALTH NEEDS, CMC'S IMPLEMENTATION PLAN PRIMARILY FOCUSES ON ADDRESSING THE TOP FIVE HEALTHCARE NEEDS IDENTIFIED.COVID-19 COMMUNITY BENEFIT IMPACTIN EARLY MARCH 2020, SHELTER-IN-PLACE ORDERS DUE TO COVID-19 WERE MANDATED BY COUNTY AND STATE PUBLIC HEALTH AUTHORITIES IN CMC'S SERVICE AREA. THESE ORDERS SIGNIFICANTLY ALTERED OUR INTERNAL AND EXTERNAL CLINICAL AND COMMUNITY-BASED ACTIVITIES. ALL CMC FACILITIES IMPLEMENTED STRICT LIMITS ON VISITORS AND PERSONS ACCOMPANYING PATIENTS. THESE LIMITS IMPACTED SEVERAL COMMUNITY BENEFIT ACTIVITIES INCLUDING: STUDENT NURSING IN-SERVICE EDUCATION, IN-FACILITY VOCATIONAL TRAININGS, IN-PERSON SUPPORT GROUPS AND OTHERS. COVID-19 RESTRICTIONS GAVE WAY TO INNOVATIVE PATIENT AND GENERAL PUBLIC OUTREACH EFFORTS WITH THE USE OF ONLINE MEETING PLATFORMS, SOCIAL MEDIA AND VIDEO MESSAGING. CMC ALSO COLLABORATED WITH A BROAD PARTNERSHIP OF COMMUNITY GROUPS AND AREA HOSPITALS TO HELP MEET THE IMMEDIATE NEEDS OF FAMILIES IMPACTED BY THE PANDEMIC. PART II: HEALTH NEED 1 - ACCESS TO CAREGRADUATE MEDICAL EDUCATIONCMC SHARES A STRONG PARTNERSHIP WITH THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO FRESNO. UCSF FRESNO, ESTABLISHED IN 1975, HELPS ADDRESS THE REGION'S NEED FOR PHYSICIANS. THROUGH THE PARTNERSHIP, CMC HAS MORE THAN 200 RESIDENTS TRAINING IN EIGHT SPECIALTIES, A DENTAL ORAL MAXILLOFACIAL SURGERY RESIDENT, AND MORE THAN 50 FELLOWS TRAINING IN 19 SUBSPECIALTIES. IN ADDITION, MORE THAN 300 THIRD- AND FOURTH-YEAR MEDICAL STUDENTS ARE TRAINED ANNUALLY ON A ROTATING BASIS IN OUR HOSPITALS. UCSF'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION (SJV PRIME) LAUNCHED IN 2018 WITH SIX MEDICAL STUDENTS. ROTATING MEDICAL STUDENTS INCLUDE THOSE IN UCSF'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION (SJV PRIME), WHICH LAUNCHED IN 2019 WITH SIX MEDICAL STUDENTS. TWELVE MEDICAL STUDENTS WERE ENROLLED IN THE PROGRAM IN 2020. THE SJV PRIME TRAINS LOCAL STUDENTS TO PROVIDE CULTURALLY COMPETENT, ACCESSIBLE CARE IN THE SAN JOAQUIN VALLEY. UCSF FRESNO PROVIDES TRAINING IN 19 FELLOWSHIPS: -ACUTE CARE SURGERY -ADVANCED CARDIOVASCULAR IMAGING-CARDIOVASCULAR DISEASE -COMMUNITY PEDIATRICS -EMERGENCY MEDICINE EDUCATION -EMERGENCY ULTRASOUND -GASTROENTEROLOGY -HEAD AND NECK ONCOLOGY AND MICROVASCULAR RECONSTRUCTION -HEMATOLOGY/ONCOLOGY-HIV -HOSPICE AND PALLIATIVE CARE -HOSPITAL MEDICINE -INFECTIOUS DISEASES -INTERVENTIONAL CARDIOLOGY -MATERNAL CHILD HEALTH -PULMONARY/CRITICAL CARE -SLEEP MEDICINE -SURGICAL CRITICAL CARE -WILDERNESS MEDICINE UCSF FRESNO HAS EIGHT MEDICAL RESIDENCY PROGRAMS:-EMERGENCY MEDICINE-FAMILY AND COMMUNITY MEDICINE -INTERNAL MEDICINE-OBSTETRICS/GYNECOLOGY -ORTHOPAEDIC SURGERY -PEDIATRICS -PSYCHIATRY -SURGERY THROUGH ITS PARTNERSHIP WITH UCSF, DURING THE TAX YEAR CMC TRAINED 211 RESIDENTS/FELLOWS. MEDICARE REIMBURSED CMC FOR THE EXPENSES OF 126 OF THOSE RESIDENTS/FELLOWS, THEREBY CMC FULLY FUNDING 85.UCSF FRESNO ALSO PROVIDES TRAINING IN THREE PHYSICIAN ASSISTANT RESIDENCY PROGRAMS, INCLUDING ACUTE CARE TRAUMA; EMERGENCY MEDICINE AND ORTHOPEDIC SURGERY. NEARLY 50% OF GRADUATING RESIDENTS STAY IN THE CENTRAL VALLEY TO PRACTICE MEDICINE, MAKING THIS PROGRAM CRITICAL TO ADDRESSING THE REGION'S ACCESS TO CARE ISSUES DETAILED IN THIS REPORT. DURING THE LAST 10 YEARS, CMC HAS INVESTED NEARLY $540 MILLION IN TOTAL MEDICAL EDUCATION OPERATING EXPENSES. CMC INVESTS MORE THAN $51 MILLION ANNUALLY IN THE EDUCATION PROGRAM, OF WHICH ONLY ABOUT $14.6 MILLION IS REIMBURSED ANNUALLY THROUGH FEDERAL GME FUNDING.AS PART OF THE ROBUST MEDICAL EDUCATION PROGRAM, 250 RESEARCH STUDIES WERE CONDUCTED AT CMC FACILITIES AND IN THE COMMUNITY. CMC-LED STUDIES INCLUDE CMC'S PATIENTS OR PATIENT DATA AND COMMUNITY MEMBER PARTICIPATION. STUDIES CONDUCTED BY CMC AND UCSF RESEARCHERS ADDRESS SPECIFIC VALLEY ISSUES INCLUDING VALLEY FEVER, THE LINK BETWEEN PESTICIDES AND DISEASE, AND PRE-TERM BIRTH AMONG VULNERABLE POPULATIONS INCLUDING HMONG, LATINOS AND AFRICAN AMERICANS.NURSING IN-SERVICE EDUCATIONTHROUGH PARTNERSHIPS WITH OVER 20 UNIVERSITIES, COLLEGES AND ADULT SCHOOLS, CMC IS A REGIONAL LEADER IN THE TRAINING OF THE NEXT GENERATION OF HEALTH PROFESSIONALS. NURSING STAFF AT CMC ACUTE AND SUB-ACUTE CARE FACILITIES PROVIDE HANDS-ON TEACHING IN A WIDE VARIETY OF MEDICAL DISCIPLINES INCLUDING LABOR AND DELIVERY, ONCOLOGY, BURN, NEUROLOGY, DIALYSIS, EMERGENCY MEDICINE, BEHAVIORAL HEALTH, MEDICAL-SURGICAL CARE, INTENSIVE CARE AND MORE. ON AVERAGE, THERE ARE OVER 100 STUDENTS WORKING TOWARD PROFESSIONAL LICENSURE WHO ROUND ALONGSIDE OUR NURSES DAILY. THESE NURSING STUDENTS ARE ENROLLED IN PROGRAMS INCLUDING REGISTERED NURSE, ASSOCIATE, BACHELORS OR MASTER'S DEGREES IN NURSING, FAMILY NURSE PRACTITIONER AND CLINICAL NURSE SPECIALIST. STUDENTS COME FROM THE FOLLOWING HIGHER EDUCATION INSTITUTIONS:-ASPEN UNIVERSITY -BRANDMAN UNIVERSITY -CALIFORNIA STATE UNIVERSITY, FRESNO-COLLEGE OF THE SEQUOIAS-FRESNO ADULT SCHOOL-CITY COLLEGE-CANYON UNIVERSITY -GURNICK ACADEMY OF MEDICAL ARTS -MADERA CENTER -NATIONAL UNIVERSITY -SAMFORD UNIVERSITY-SAN JOAQUIN VALLEY COLLEGE-UNIVERSITY OF COLORADO, DENVER-UNIVERSITY OF MISSOURI SINCLAIR SCHOOL OF NURSING-UNIVERSITY OF PHOENIX -UNIVERSITY OF SOUTH ALABAMA FRESNO -UNIVERSITY OF TEXAS-ARLINGTON GRAND -WALDEN UNIVERSITY -WEST COAST UNIVERSITY-WEST HILLS COMMUNITY COLLEGE -WESTERN GOVERNORS UNIVERSITY IN FISCAL YEAR 2020, CMC NURSES PROVIDED CLOSE TO 75,000 HOURS OF HANDS-ON, IN-SERVICE EDUCATION TO NURSING STUDENTS IN CMC FACILITIES. STUDENTS LEARN AND WORK ALONGSIDE OUR NURSES AS PART OF THEIR DEGREE AND OR LICENSURE PROGRAM. DUE TO COVID-19, ADDITIONAL PERSONS ENTERING CMC FACILITIES WERE STRICTLY LIMITED AS OF EARLY MARCH 2020. CMC VISITOR RESTRICTIONS HALTED ALL NURSING STUDENT EDUCATION ACTIVITIES FROM MID-MARCH TO EARLY JUNE 2020.FRESNO MEDICAL RESPITE CENTERCMC IS A FOUNDING HOSPITAL PARTNER IN THE FRESNO MEDICAL RESPITE CENTER ESTABLISHED IN JULY 2011. THE CENTER PROVIDES 12 BEDS FOR HOMELESS MEN AND WOMEN AT THE FRESNO RESCUE MISSION IN DOWNTOWN FRESNO. THE RESPITE CENTER OFFERS A 'SAFE DISCHARGE' PLACE FOR HOMELESS TO CONTINUE THEIR RECOVERY. RESEARCH SHOWS HOMELESS PATIENTS STAY 4.5 DAYS LONGER IN HOSPITALS, POST INPATIENT STAY, COMPARED TO PATIENTS WITH SOCIAL SUPPORT. THE CENTER PROVIDES A SAFE DISCHARGE ALTERNATIVE, REDUCING A PATIENT'S LENGTH OF STAY IN THE HOSPITAL. RESPITE BEDS ARE AVAILABLE TO PATIENTS FROM ALL LOCAL AREA HOSPITALS.CRMC'S HOME HEALTH CLINICAL STAFF AND CASE MANAGERS PROVIDE RESPITE CENTER PATIENTS WITH COORDINATED HEALTHCARE AND LINKAGES TO SOCIAL AND COMMUNITY RESOURCES. IN FISCAL YEAR 2020, CRMC CONTRIBUTED $102,000 TO THE FRESNO MEDICAL RESPITE CENTER AND PROVIDED CARE TO NEARLY 240 PATIENTS, SAVING OVER 3,000 IN-PATIENT DAYS. SINCE THE PROGRAM'S LAUNCH, CMC HAS CONTRIBUTED MORE THAN $636,000 IN FUNDING. HOMELESS PATIENT DISCHARGE (SB 1152) AS THE REGION'S SAFETY NET HOSPITAL SYSTEM, CMC HAS CONSISTENTLY SERVED HOMELESS PATIENTS WITH QUALITY CARE AND DIGNITY. IN COMPLIANCE WITH CALIFORNIA SENATE BILL 1152, AS OF JANUARY 2019, ALL STATE HOSPITALS ARE TASKED WITH TRACKING THE NUMBER OF HOMELESS PEOPLE SERVED AND IMPLEMENTING A COMPREHENSIVE DISCHARGE PLAN. THE PLAN REQUIRES ALL DISCHARGED PATIENTS RECEIVE WEATHER-APPROPRIATE CLOTHING AND SHOES, TRANSPORTATION, MEDICATION AND CONNECTIONS TO A SAFE DESTINATION WITHIN 30 MILES OF THE HOSPITAL. IN FISCAL YEAR 2020, CMC SERVED MORE THAN 4,000 HOMELESS PATIENTS IN OVER 10,000 ENCOUNTERS, PROVIDING EACH ONE WITH A SAFE AND DIGNIFIED DISCHARGE. THROUGHOUT THE YEAR, CMC STAFF DONATE NEW SHOES AND GENTLY USED CLOTHING FOR HOMELESS PATIENTS WHO NEED WEATHER APPROPRIATE ATTIRE BEFORE BEING DISCHARGED. HOSPITAL PRESUMPTIVE ELIGIBILITYIN PARTNERSHIP WITH FRESNO COUNTY'S DEPARTMENT OF SOCIAL SERVICES (DSS), CMC CONTINUES TO PROVIDE IN-HOSPITAL ENROLLMENT FOR UNINSURED PATIENTS WHO "PRESUMPTIVELY" QUALIFY FOR MEDI-CAL. THROUGH THE HOSPITAL PRESUMPTIVE ELIGIBILITY (HPE) PROGRAM, CRMC ADMITTING STAFF ENROLL PATIENTS IN MEDI-CAL COVERAGE WHO LIKELY QUALIFY FOR THE PROGRAM BASED ON THEIR CURRENT ENROLLMENT IN OTHER SOCIAL AND PUBLIC ASSISTANCE PROGRAMS. HPE ENROLLMENT PROVIDES UNINSURED PATIENTS "REAL TIME" COVERAGE FOR THEIR VISITS AND ANY CARE APPOINTMENTS UP TO 90 DAYS PRIOR. ONCE A PATIENT IS ENROLLED VIA HPE, THE PATIENT HAS 60 DAYS TO PROVIDE QUALIFYING DOCUMENTATION TO FRESNO COUNTY DSS IN ORDER TO RECEIVE PERMANENT COVERAGE. IN FISCAL YEAR 2020, CRMC AND CCMC ADMITTING STAFF ENROLLED NEARLY 1,800 UNINSURED PERSONS IN MEDI-CAL THROUGH THE HPE PROGRAM. PART II: HEALTH NEED 2 - OBESITY/HEALTHY EATING ACTIVE LIVING/DIABETESCOMMUNITY DIABETES EDUCATION CMC'S COMMUNITY DIABETES EDUCATION (CDE) SERVES PATIENTS FROM FRESNO AND FIVE AREA COUNTIES AT ITS DOWNTOWN CRMC CAMPUS. THE CENTER IS THE ONLY AMERICAN DIABETES ASSOCIATION-RECOGNIZED EDUCATION PROGRAM IN FRESNO COUNTY. IT PROVIDES CARE TO A HIGH PERCENTAGE OF PATIENTS WHO ARE OTHERWISE UNABLE TO RECEIVE DIABETES SELF-MANAGEMENT EDUCATION, INCLUDING BILINGUAL SERVICES TO A HIGH CONCENTRATION OF SPANISH-SPEAKING PATIENTS. THE CDE IS ALSO ONE OF TWO CALIFORNIA PUBLIC HEALTH DEPARTMENT-ACCREDITED SWEET SUCCESS AFFILIATES IN FRESNO COUNTY. THE SWEET SUCCESS PROGRAM TARGETS WOMEN DIAGNOSED WITH DIABETES DURING PREGNANCY. THE PROGRAM IS STAFFED BY REGISTERED NURSES AND REGISTERED DIETITIANS ALL ARE DIABETES CARE AND EDUCATION SPECIALIST-CERTIFIED. CDE STAFF PROVIDE EDUCATION TO WOMEN AND THEIR FAMILIES ON HEALTHY EATING HABITS AND CONTROLLING DIABETES DURING PREGNANCY. LAST YEAR, THE CDE PROVIDED DIABETES MANAGEMENT EDUCATION AND SERVICES TO MORE THAN 1,600 PATIENTS, WITH OVER 5,500 VISITS, 55% OF THESE PATIENTS WERE COVERED BY MEDI-CAL. COMMUNITY DIABETES EDUCATION STAFF PARTICIPATED IN:-MONTHLY TRAINING FOR THE CALIFORNIA DIABETES AND PREGNANCY PROGRAM SWEET SUCCESS PROGRAM -MONTHLY HANDS-ON TRAINING FOR UCSF FRESNO MEDICAL EDUCATION STUDENTS, FAMILY HEALTH AND INTERNAL MEDICINE INTERNS, RESIDENTS AND FACULTY -DIABETES MEDICATION MANAGEMENT CLINIC AT CRMC'S NORTH MEDICAL PLAZA, PROVIDING PATIENTS WITH MEDICATION SUPPORT TO IMPROVE BLOOD GLUCOSE LEVELS -MEDICAL RESIDENT TEACHING-REGISTERED NURSE RESIDENCY TRAINING-FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP'S (FCHIP) DIABETES COLLABORATIVE MONTHLY MEETINGS AS SUBJECT MATTER EXPERTSBARIATRIC SUPPORT GROUPSTO SUPPORT PATIENTS AND FAMILIES OF INDIVIDUALS WHO HAVE UNDERGONE OR ARE CONSIDERING BARIATRIC SURGERY, CMC HOSTS A SERIES OF NO-COST, VIRTUAL SUPPORT GROUPS. TOPICS FOR CMC'S BARIATRIC SUPPORT GROUPS INCLUDE: EXERCISE AND NUTRITION, WELLBEING, CHAIR YOGA AND A GENERAL SUPPORT CONVENING. EACH INTERACTIVE SESSION IS HOSTED BY A REGISTERED DIETICIAN OR LICENSED CLINICAL SOCIAL WORKER. SESSIONS ARE OPEN TO THE PUBLIC, REGARDLESS OF WHERE THEY RECEIVE OR PLAN TO RECEIVE BARIATRIC TREATMENT. IN FISCAL YEAR 2020, CMC HOSTED 64 SUPPORT GROUPS THAT WERE EITHER 30 MINUTES OR ONE HOUR IN DURATION. KNOW YOUR NUMBERS COMMUNITY HEALTH FAIRSCMC IS A PARTNER IN CENTRO LA FAMILIA'S LATINO HEALTH WORKGROUP WHICH INCREASES AWARENESS AND RESOURCES TO LOW-INCOME PEOPLE LIVING WITH CHRONIC DISEASE IN THE CENTRAL VALLEY. THE WORKGROUP COMPRISES HEALTHCARE, PUBLIC HEALTH, HEALTH PLAN AND NON-PROFIT ORGANIZATIONS. IN NOVEMBER 2019, THE WORKGROUP HOSTED A NO-COST, KNOW YOUR NUMBERS OR CONOZCA SUS NMEROS BILINGUAL SCREENING AND RESOURCE HEALTH FAIR ON CRMC'S CAMPUS. AT THIS FREE EVENT, CRMC COMMUNITY DIABETES EDUCATION STAFF PROVIDED ON-SITE BLOOD SUGAR TESTING. EVENT PARTNERS ALSO OFFERED BLOOD PRESSURE, A1C, RETINAL EYE EXAMS AND BODY MASS INDEX SCREENINGS, AS WELL AS HEALTH INFORMATION BOOTHS. MORE THAN 50 FAMILIES PARTICIPATED IN THE EVENT.FRESNO DIABETES COLLABORATIVETHE FRESNO DIABETES COLLABORATIVE WORKS TO PROVIDE LOCAL RESOURCES AND AWARENESS ON DIABETES SELF-MANAGEMENT AND PREVENTION. SINCE DECEMBER 2016, CMC HAS LED FCHIP'S MONTHLY DIABETES COLLABORATIVE WORKGROUP. THE COLLABORATIVE ENGAGES A BROAD GROUP OF COMMUNITY PARTNERS INCLUDING HEALTHCARE PROVIDERS, PUBLIC HEALTH, CLINICS, HEALTH EDUCATORS AND HEALTH PLANS. IN ADDITIONAL TO CMC, VALLEY CHILDREN'S HEALTHCARE AND SAINT AGNES ARE ALSO ACTIVE FCHIP PARTICIPANTS. CMC HELPED WRITE A GRANT PROPOSAL THAT THAT RESULTED IN A $75,000 AWARD IN 2020 TO HIRE EIGHT PROMOTORAS OR COMMUNITY HEALTH WORKERS. THE GRANT, IN COLLABORATION WITH LOCAL NON-PROFIT EVERY NEIGHBORHOOD PARTNERSHIP, EDUCATES TRUSTED NEIGHBORHOOD COMMUNITY LEADERS ON THE PROMOTORA HEALTH PROMOTION MODEL WITH A FOCUS ON ACCESS TO CARE AND CHRONIC DISEASE MANAGEMENT. PROMOTORAS ENGAGE LATINO, HMONG AND AFRICAN AMERICAN FAMILIES AND INDIVIDUALS AT RISK OF DEVELOPING DIABETES AND CHRONIC DISEASE CONDITIONS IN SOUTHEAST AND SOUTHWEST METROPOLITAN FRESNO. DUE TO COVID-19 HEALTH RESTRICTIONS, HEALTH ACCESS AND CHRONIC DISEASE MANAGEMENT TRAININGS ARE CONDUCTED ONLINE. THE GRANT RUNS THROUGH JUNE 2021.SINCE MARCH 2017, CMC HOSTS THE WWW.FRESNODIABETES.ORG ON ITS WEB SERVERS AND LEADS ALL WEBSITE ADMINISTRATOR DUTIES. THE REDESIGNED SITE PROVIDES INFORMATION IN ENGLISH AND SPANISH OF ALL RELEVANT PROGRAMS PROVIDED BY COLLABORATIVE PARTNERS. THIS INCLUDES LINKS TO A DIABETES RISK QUIZ TO IDENTIFY THE PREVALENCE OF DIABETES AND ENCOURAGE PEOPLE TO TAKE CONTROL OF THEIR HEALTH. THE COLLABORATIVE'S RESOURCE WORKGROUP, IN PARTNERSHIP WITH TULARE COUNTY'S ALLIANCE FOR MANAGEMENT & EDUCATION OF DIABETES (TAME), HOSTED THE ANNUAL FRESNO/TULARE DIABETES SYMPOSIUM FOR THE SECOND YEAR IN A ROW. THE SYMPOSIUM PROVIDES CONTINUING MEDICAL EDUCATION FOR PHYSICIANS AND ALLIED MEDICAL PROVIDERS CARING FOR DIABETES PATIENTS. THE EVENT, INITIALLY PLANNED IN MARCH 2020, INCLUDED EDUCATION ON ENGAGEMENT STRATEGIES FOR DISENGAGED PATIENTS AND INSULIN MEDICATION THERAPIES. DUE TO COVID-19, THE EVENT WAS POSTPONED AND RESCHEDULED AS AN ONLINE SEMINAR SERIES WITH TRAININGS HELD IN SEPTEMBER AND OCTOBER 2020. OVER 100 PHYSICIANS, NURSES, DIETICIANS AND ALLIED HEALTH PROFESSIONALS FROM FRESNO, TULARE AND KINGS COUNTIES PARTICIPATED IN THE TRAININGS. IN RESPONSE TO DIABETES-SPECIFIC NEEDS DURING THE COVID-19 HEALTH EMERGENCY, COLLABORATIVE PARTNERS DRAFTED A PATIENT RESOURCE GUIDE. THE ONLINE GUIDE, AVAILABLE AT WWW.FRESNODIABETES.ORG, PROVIDES INFORMATION ON NO-COST, LOW-COST AND DISCOUNTED COMMUNITY RESOURCES IN FRESNO COUNTY. THE GUIDE PROVIDES INFORMATION ON RESOURCES AVAILABLE IN BOTH ENGLISH AND SPANISH. THESE DIABETES-SPECIFIC RESOURCES INCLUDE: FOOD ACCESS, DISCOUNT MEDICATION PROGRAMS, HEALTHCARE SUPPORT SERVICES, GLUCOSE MONITORING DEVICES AND ONLINE PHYSICAL FITNESS, MENTAL HEALTH, SUPPORT GROUPS AND SELF-MANAGEMENT CLASSES. THIS INFORMATION WAS SHARED WITH LOCAL ORGANIZATIONS AND AGENCIES AND WAS A WELCOMED TOOL AS PATIENTS LEARNED TO NAVIGATE THEIR HEALTH NEEDS ONLINE WHILE SHELTERING-IN-PLACE.NEIGHBORHOOD DANCE CMC PROVIDED EVERY NEIGHBORHOOD PARTNERSHIP (ENP) $8,500 FOR ITS NEIGHBORHOOD DANCE FITNESS PROGRAM. THE PROGRAM WAS CREATED IN JULY 2018 AFTER A SERIES OF COMMUNITY MEETINGS WITH SOUTHEAST AND SOUTHWEST FRESNO NEIGHBORHOOD PARENTS, LOCAL NON-PROFIT ORGANIZATIONS AND HEALTHCARE PROVIDERS. PARTICIPANTS EXPRESSED THE NEED TO EXERCISE IN SAFE SPACES WITH CONSISTENT CLASS SCHEDULES. THE GROUP SOUGHT FUNDING FOR A PROGRAM TO TRAIN LEADERS TO BECOME NEIGHBORHOOD DANCE CLASS INSTRUCTORS. PROGRAM FUNDING HELPED PAY FOR AN INSTRUCTOR TO TEACH NEIGHBORHOOD LEADERS LATIN DANCE FITNESS ROUTINES AND PURCHASE SOUND SYSTEMS FOR 12 SITES. IN FISCAL YEAR 2020, THE PROGRAM CONTINUED CLASSES IN 14 SITES INCLUDING FRESNO UNIFIED ELEMENTARY AND HIGH SCHOOLS, COMMUNITY CENTERS AND A LOCAL PLAYGROUND. ALL NEIGHBORHOOD DANCE CLASSES ARE HELD IN SOUTHEAST AND SOUTHWEST FRESNO AND ARE FREE AND OPEN TO THE PUBLIC. THE MAJORITY OF DANCE FITNESS PARTICIPANTS ARE LATINO AND AFRICAN AMERICAN. FROM JANUARY 2020 TO MARCH 2020, NEIGHBORHOOD DANCE INSTRUCTORS LED 164 IN-PERSON CLASSES, ATTENDED BY MORE THAN 1,200 PARTICIPANTS. AT THE TIME, INSTRUCTORS PROVIDED UP TO 10 CLASSES PER WEEK.IN RESPONSE TO THE COVID-19 HEALTH EMERGENCY, INSTRUCTORS LEARNED TO USE FACEBOOK LIVE TO HOST FREE, LIVE-STREAMED CLASSES. BETWEEN MARCH 2020 AND AUGUST 2020, OVER 250 FACEBOOK LIVE NEIGHBORHOOD FITNESS CLASSES WERE LED BY ENP DANCE FITNESS INSTRUCTORS. IN THAT TIME, ENP'S NEIGHBORHOOD FITNESS FACEBOOK PAGE GREW FROM 69 USERS TO OVER 400. THE ONLINE DANCE CLASSES AVERAGE 130 WEEKLY USERS. PARTICIPANTS' REPORTED RESULTS INCLUDE INCREASED SELF-ESTEEM, A HEIGHTENED SENSE OF COMMUNITY AND WEIGHT LOSS. SINCE THE PROGRAM'S LAUNCH, MORE THAN 50 NEIGHBORHOOD LEADERS HAVE BEEN TRAINED TO LEAD DANCE FITNESS CLASSES. CMC HELPED TO JUMPSTART THIS PROGRAM WITH AN $11,000 INITIAL INVESTMENT; TO DATE, CMC'S PROGRAM CONTRIBUTIONS TOTAL $29,500.HEALTH NEED 3 - MATERNAL AND INFANT HEALTHMOTHER'S RESOURCE CENTER CMC IS A CHAMPION OF BREASTFEEDING EDUCATION FOR MOTHERS-TO-BE AND PROVIDES SUPPORT SERVICES FOR NEW MOTHERS THROUGHOUT THE CENTRAL VALLEY. SERVICES RANGE FROM PRENATAL BREASTFEEDING EDUCATION TO OUTPATIENT CONSULTATIONS FOLLOWING DELIVERY. IN FISCAL YEAR 2020, THE MOTHER'S RESOURCE CENTER PROVIDED MORE THAN 10,000 INPATIENT BREASTFEEDING CONSULTATIONS BY INTERNATIONAL BOARD-CERTIFIED LACTATION CONSULTANTS. THE CENTER'S 3M CLUB (MOMMIES MAKING MILK) HAD MORE THAN 670 PARTICIPANT MOMS WHOSE BABIES WERE IN THE NICU. PARTICIPATING IN THE IN-HOSPITAL 3M CLUB REMAINS A HUGE INFLUENCE ON THE HEALTH AND LONGEVITY OF BREASTFEEDING FOR THESE TINY PATIENTS. PART II: SINCE JUNE 2017, THE CENTER HOSTS BREASTFEEDING CLASSES IN BOTH ENGLISH AND SPANISH. IN FISCAL YEAR 2020, THE CENTER OFFERED SUPPORT AND EDUCATION IN AN OUTPATIENT GROUP SETTING TO NEARLY 80 NEW PARENTS WHO WERE EITHER RETURNING TO WORK, ARE PARENTS TO TWINS OR HAVE SPECIAL NEEDS BABIES. CMC'S TOTAL INVESTMENTS IN OUTREACH AND EDUCATION FOR NEW MOTHERS AND THEIR FAMILIES IN FISCAL YEAR 2020 WAS NEARLY $160,000. DUE TO COVID-19 RESTRICTIONS, THE MOTHER'S RESOURCE CENTER OFFERED IN-PERSON, PRIVATE EDUCATION SESSIONS UP UNTIL MARCH 2020. THE CENTER CONTINUES OFFERING BREASTFEEDING EDUCATION CLASSES OVER THE PHONE OR VIA SECURE VIDEO CHAT. ADDITIONAL SUPPORT FOR FAMILIES OF CHILDREN AGES 0 TO 3 CMC ALSO CONTRIBUTED $5,000 TO CENTRAL CALIFORNIA FOOD BANK'S PROGRAMS ASSISTING FAMILIES WITH YOUNG CHILDREN. CMC'S FUNDING HELPED AUGMENT AN EXISTING DIAPER SUPPLY PROGRAM BY ALSO PROVIDING FOOD FOR THESE FAMILIES. IN ADDITION TO DIAPERS, THE FAMILIES OF NEARLY 5,800 CHILDREN AGES 0 TO 3 ALSO RECEIVED SHELF-STABLE AND FRESH FOOD ITEMS. CMC HOME HEALTH NURSES ALSO HELPED DELIVER BOXES OF FOOD TO HOMEBOUND PATIENTS WITH INJURIES OR HEALTH CONDITIONS THAT PUT THEM AT GREATER RISK DURING THE COVID-19 PANDEMIC.HEALTH NEED 4 - MENTAL HEALTHINVOLUNTARY MENTAL HEALTH HOLDS MENTAL HEALTH CHALLENGES IN THE CENTRAL VALLEY ARE WELL-DOCUMENTED. FRAGMENTED PUBLIC SERVICES, LIMITED PRIVATE SECTOR RESOURCES AND INCREASING DEMANDS FOR MENTAL HEALTHCARE HAVE PUT PRESSURE ON ALL PARTS OF THE CARE CONTINUUM. THIS IS VISIBLE AT CMC'S TWO EMERGENCY ROOMS. CRMC AND CCMC EMERGENCY DEPARTMENTS CONTINUE OFFERING CRISIS INTERVENTION AND PROVIDE 5150/1799 "INVOLUNTARY HOLD" PROTOCOLS IN CONJUNCTION WITH FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH. CASE MANAGERS COORDINATE PATIENT CARE WITH CMC'S BEHAVIORAL HEALTH CENTER AND FRESNO COUNTY'S BEHAVIORAL HEALTH SERVICES. CASE MANAGERS CONNECT PATIENTS TO SOCIAL AND COMMUNITY SUPPORT SERVICES. IN FISCAL YEAR 2020, CRMC'S EMERGENCY DEPARTMENT RECEIVED 4,042 PATIENTS PLACED UNDER INVOLUNTARY HOLDS REQUIRING CASE MANAGEMENT SERVICES, 338 OF THESE WERE PEDIATRIC PATIENTS. CCMC'S EMERGENCY DEPARTMENT RECEIVED 1,344 PATIENTS UNDER INVOLUNTARY MENTAL HEALTH HOLDS, 151 OF THESE WERE PEDIATRIC PATIENTS. COMMUNITY CONVERSATIONS ON MENTAL HEALTH CMC IS AN ACTIVE PARTNER IN THE 'COMMUNITY CONVERSATIONS ON MENTAL HEALTH' COLLABORATIVE. THE CROSS-SECTOR COLLABORATIVE, CONSISTING OF BEHAVIORAL HEALTH, HEALTHCARE, MENTAL HEALTH PROVIDERS, NON-PROFIT ORGANIZATIONS AND LAW ENFORCEMENT SEEKS EFFECTIVE SERVICE DELIVERY TO FAMILIES AND INDIVIDUALS SUFFERING FROM MENTAL HEALTH ILLNESSES. IN ADDITION TO CMC, PARTICIPATING HOSPITALS INCLUDE VALLEY CHILDREN'S HEALTHCARE, SAINT AGNES AND KAISER PERMANENTE.THE COLLABORATIVE DEVELOPED A COUNTY BEHAVIORAL HEALTH SCREENING THAT IDENTIFIES VULNERABLE FAMILIES AND INDIVIDUALS NEEDING APPROPRIATE COMMUNITY RESOURCES. FRESNO COUNTY'S MULTI-AGENCY ACCESS PROGRAM (MAP) SCREENING TOOL HELPS LINK THOSE IN NEED TO A VARIETY OF SOCIAL AND HEALTH SERVICES. THE 80-QUESTION SCREENING IDENTIFIES IMMEDIATE AND LONG-TERM NEEDS. MAP SERVES FAMILIES AT EIGHT SITES IN FRESNO COUNTY AND OPERATES A MOBILE BUS TO SERVE RURAL AREAS INCLUDING HURON, CANTUA CREEK, MENDOTA, FIVE POINTS AND OTHERS. IN FISCAL YEAR 2020, THE MAP COLLABORATIVE ASSISTED OVER 3,600 INDIVIDUALS WITH MORE THAN 10,000 CLIENT CONTACTS. CMC CASE MANAGEMENT AND PUBLIC AFFAIRS STAFF SERVE ON THE COLLABORATIVE PROVIDING TECHNICAL ASSISTANCE AND EXPERTISE. SINCE NOVEMBER 2017, CMC HAS HOSTED A MAP SITE AT THE CRMC DOWNTOWN HOSPITAL CAMPUS. IN FISCAL YEAR 2020 MORE THAN 160 INDIVIDUALS AND FAMILIES RECEIVED ASSISTANCE AT THE CRMC MAP SITE. FAMILIES AND INDIVIDUALS AT THE DOWNTOWN SITE WERE LINKED TO A WIDE VARIETY OF SERVICES INCLUDING HOUSING, HEALTH COVERAGE RENEWAL, EMERGENCY AND LONG-TERM HOUSING ASSISTANCE, EMERGENCY FOOD AID AND ENERGY ASSISTANCE. COVID-19 VISITOR RESTRICTIONS AT CRMC RESULTED IN THE CLOSURE OF THE IN-HOSPITAL MAP SITE IN MARCH 2020. PLANS TO RE-OPEN THE SITE WILL BE REVISITED WHEN PUBLIC HEALTH RESTRICTIONS ARE LIFTED. IN FISCAL YEAR 2019, THE MAP POINT AT CRMC SERVED 200 FAMILIES.MENTAL WELLNESS AND RESILIENCY PROGRAMS AT CLOVIS UNIFIED SCHOOL DISTRICT CMC HAS CONTRIBUTED OVER $200,000 SINCE 2018 TO THE FOUNDATION FOR CLOVIS SCHOOLS FOR MENTAL HEALTH PROGRAMS AIMED AT CLOVIS UNIFIED K-12 STUDENTS AND FAMILIES. EFFORTS TO ADDRESS SOCIAL AND EMOTIONAL ISSUES AMONG THE DISTRICT'S YOUTH ARE IN RESPONSE TO INCIDENTS OF SUICIDE, ANXIETY OVER RACIAL ISSUES AND INCREASED MENTAL HEALTH INVOLUNTARY HOLDS AMONG THE AREA'S YOUTH. CMC FUNDING INCREASED ACCESS TO MENTAL WELLNESS SERVICES TO STUDENTS SUFFERING FROM ISOLATION AND ANXIETY DURING COVID-19 DISTANCE LEARNING. CUSD PSYCHOLOGISTS HOLD VIRTUAL "CHECK-INS" WITH STUDENTS WHO MAY EXPERIENCE STRESS, DEPRESSION OR ANXIETY WHILE LEARNING VIRTUALLY. THESE CONNECTIONS ARE PROVIDED AS ONE-ON-ONE VIRTUAL SESSIONS. ON AVERAGE, PSYCHOLOGISTS MAKE 280 DAILY CONNECTIONS WITH STUDENTS NEEDING MENTAL OR EMOTIONAL SUPPORT. TO HELP STUDENTS STRUGGLING WITH ISOLATION AND ANXIETY AS A RESULT OF DISTANCE LEARNING, CUSD PSYCHOLOGISTS DEVELOPED A SERIES OF INFORMATIVE VIDEOS. THE "TOGETHER, WE'VE GOT THIS!" VIDEO SERIES PROVIDES STUDENTS AND FAMILIES WITH RESOURCES ON STAYING CONNECTED WITH OTHERS AT A DISTANCE, HEALTHY CONVERSATIONS AND TIPS FOR EASING ANXIETY. THE ONLINE VIDEOS ARE AVAILABLE IN ENGLISH, SPANISH, HMONG AND PUNJABI ON THE DISTRICT'S WEBSITE. CUSD ALSO PROVIDES "VIRTUAL CALMING ROOMS" OPEN TO STUDENTS AND FAMILIES. THESE VIRTUAL SPACES DEVELOPED DURING THE CURRENT COVID-19 DISTANCE LEARNING PERIOD, PROVIDE INDIVIDUALS WITH TOOLS AND STRATEGIES TO HELP MANAGE EMOTIONS. THE CALMING ROOMS ARE GAINING POPULARITY AND THE DISTRICT IS SEEING INCREASED USE BY BOTH STUDENTS AND PARENTS.AS A RESULT OF CMC'S FUNDING, CUSD CREATED THE WEST WELLNESS CENTER AT CLOVIS WEST HIGH SCHOOL DURING THE 2019-2020 SCHOOL YEAR. THE CENTER PROVIDES RESOURCES AND TOOLS TO HELP STUDENTS IDENTIFY AND MANAGE THEIR EMOTIONAL WELL-BEING WITH EVIDENCE-BASED CURRICULUM. BETWEEN OCTOBER 2019 AND MARCH 2020, MORE THAN 70 STUDENTS RECEIVED DIRECT ASSISTANCE FROM THE CENTER. CMC'S FUNDING DIRECTLY SUPPORTED CUSD'S PROJECT SMART AT CLOVIS COMMUNITY'S DAY SCHOOL, A MENTORING PROGRAM FOR AT-RISK STUDENTS IN FOURTH TO EIGHTH GRADE. PROJECT SMART MENTORING HELPS STUDENTS WITH INTERPERSONAL SKILLS DEVELOPMENT, ACADEMIC TUTORING AND COUNSELING. THE PROGRAM HAS RESULTED IN REDUCED JUVENILE DELINQUENCY AND INCREASED ACADEMIC ACHIEVEMENT. SPIRITUAL AND MENTAL HEALTH RESILIENCY TARGETING HARD-TO-REACH POPULATIONS CMC PROVIDED $15,000 TO THE CLINICAL PASTORAL EDUCATION OF CENTRAL CALIFORNIA (CPECC) TO PROVIDE SPIRITUAL AND SOCIAL SUPPORT SERVICES TO RURAL ISOLATED GROUPS SUCH AS FARM AND CONSTRUCTION WORKERS THROUGHOUT THE CENTRAL VALLEY AND THE STATE. SPANISH-LANGUAGE ASSISTANCE IS PROVIDED TO WORKERS FROM MEXICO AND CENTRAL AMERICA. BETWEEN JANUARY AND AUGUST 2020, CPECC CHAPLAINS PROVIDED SPIRITUAL AND RESILIENCY SUPPORT TO 500 FARM LABOR SUPPORT STAFF AND NEARLY 6,000 TEMPORARY MIGRANT LABORERS EMPLOYED UNDER H-2A VISAS. FOREIGN H-2A WORKERS LABOR IN AGRICULTURAL AND FARMING OPERATIONS IN THE VALLEY AND THROUGHOUT THE STATE ARE OFTEN IN SOCIALLY AND GEOGRAPHICALLY ISOLATED SITUATIONS. CPECC CHAPLAINS PROVIDE SPIRITUAL SUPPORT IN DEALING WITH DRUG AND ALCOHOL ADDICTION, CONFLICT MANAGEMENT, SHORT AND LONG TERM ILLNESS AND GRIEF AND BEREAVEMENT. IN FISCAL YEAR 2020, CPECC CHAPLAINS MADE OVER 6,500 IN-PERSON AND PHONE CONNECTIONS WITH FARM WORKERS STRUGGLING WITH ISOLATION AND DEPRESSION. AS A RESULT OF COVID-19, CPECC'S CHAPLAINS ADJUSTED FARM WORKER OUTREACH STRATEGIES TO ENSURE SAFE CONNECTIONS WITH WORKERS NEEDING MENTAL WELLNESS AND SPIRITUAL SUPPORT. CPECC CHAPLAINS ESTABLISHED PHONE AND TEXTING AS A PRIMARY CONTACT METHOD. FOR WORKERS WITH LINKS TO SOCIAL MEDIA, CPECC CHAPLAINS OPENED A PRIVATE FACEBOOK GROUP. THE GROUP PROVIDES SPANISH-LANGUAGE VIDEOS CONTAINING ENCOURAGING MESSAGES, HEALTH EDUCATION AND COMMUNITY RESOURCES. CURRENTLY, THE PRIVATE GROUP HAS 3,000 ACTIVE SPANISH-LANGUAGE USERS.BOYS AND YOUNG MEN OF COLOR INITIATIVE CMC PROVIDED $1,500 TO YOUTH LEADERSHIP INSTITUTE'S (YLI) MENTAL HEALTH AND RESILIENCY PROGRAMS TARGETING AT-RISK BOYS AND YOUNG MEN OF COLOR IN SOUTHWEST FRESNO. BETWEEN APRIL AND AUGUST 2020, YLI PROVIDED WEEKLY MENTORSHIP, LIFE SKILLS DEVELOPMENT AND INTERGENERATIONAL GROUP HEALING THROUGH ITS HEALING CIRCLES TO NEARLY 40 YOUNG MEN. PARTICIPANTS INCLUDED YOUTH WHO IDENTIFIED AS LATINO, AFRICAN AMERICAN AND ASIAN PACIFIC ISLANDERS LIVING IN SOUTHWEST FRESNO. AS A RESULT OF COVID-19 IN-PERSON GATHERING RESTRICTIONS, YLI'S HEALING CIRCLES ARE CONDUCTED ONLINE. THE "SAFE SPACE AND CONFIDENTIAL GATHERINGS HOST BETWEEN 5 AND 10 YOUNG MEN WHO CONNECT VIRTUALLY TO DISCUSS PERSONAL HARDSHIPS. PART II: THE YOUNG MEN ARE LED BY PEER COUNSELORS AND MENTORS WHO PROVIDE ENCOURAGEMENT, GUIDANCE AND SUPPORT. YLI ALSO HOSTS WEEKLY ONLINE JOURNALING, MEDITATION AND SOCIAL INTERACTION SESSIONS TO MOTIVATE HUMAN CONNECTIONS DURING THE PANDEMIC. YLI STAFF REPORT WITNESSING INCREASED ENGAGEMENT, DECREASED ANXIETY, BOOSTS IN MORALE AND POSITIVE MENTAL HEALTH DAYS AMONG BOYS AND YOUNG MEN PARTICIPATING IN THE VIRTUAL SESSIONS. YOUTH MENTAL HEALTH AND RESILIENCY CONNECTIONS CMC PROVIDED $5,000 TO CARE FRESNO'S CHILDHOOD RESILIENCY EFFORTS. CARE FRESNO'S STAFF LIVE AND WORK IN SOCIO-DISADVANTAGED NEIGHBORHOODS AND APARTMENT COMPLEXES IN SOUTHWEST FRESNO. STAFF WORK CLOSELY WITH CHILDREN AND FAMILIES PROVIDING ACADEMIC, SOCIAL AND EMOTIONAL ASSISTANCE. DUE TO COVID-19 GATHERING RESTRICTIONS, CARE FRESNO MODIFIED ITS IN-PERSON OUTREACH TO CHILDREN, TEENS AND FAMILIES SERVED IN SOUTHEAST AND SOUTHWEST FRESNO. FROM MARCH TO AUGUST 2020, CARE FRESNO STAFF CONTACTED FAMILIES FOR MENTAL HEALTH AND RESOURCE CONNECTIONS VIA PHONE, TEXT AND SOCIAL MEDIA. CARE FRESNO STAFF WERE IN CONSTANT COMMUNICATION WITH THE FAMILIES OF 260 CHILDREN PROVIDING EMOTIONAL SUPPORT AND LINKAGES TO UTILITY AND FOOD ASSISTANCE. IN TOTAL, CARE FRESNO MADE OVER 1,400 CONNECTIONS WITH PARENTS AND CHILDREN. CARE FRESNO SERVES LATINO, AFRICAN AMERICAN AND SOUTHEAST ASIAN FAMILIES. CARE FRESNO'S IN-NEIGHBORHOOD CARE CLUB, WHICH PROVIDES ACADEMIC TUTORING TO LOW-INCOME STUDENTS, MODIFIED ITS OUTREACH DURING COVID-19. INSTEAD OF IN-PERSON GROUP SETTINGS, CARE FRESNO TUTORS DELIVER HOMEWORK AND READING PACKETS TO STUDENTS REQUIRING ADDITIONAL ACADEMIC INSTRUCTION. TUTORS CONNECT WITH STUDENTS EITHER IN-PERSON, AT THE REQUIRED 6-FOOT DISTANCE WHILE WEARING MASKS, OR VIA PHONE, TEXT AND SOCIAL MEDIA.CMC FUNDING PROVIDES SUPPORT FOR CARE FRESNO'S CARE CLUB AND MENTAL HEALTH SUPPORT FOR FAMILIES LIVING IN THE FOLLOWING FRESNO NEIGHBORHOODS: COURTYARD AT CENTRAL PARK, KING'S PALACE APARTMENTS, SUMMERSET VILLAGE APARTMENTS, CEDAR AND SEQUOIA COURTS.HEALTH NEED 5 - ECONOMIC SECURITYLOCAL CLOSURES DUE TO COVID-19 PUBLIC HEALTH DIRECTIVES RESULTED IN WIDESPREAD BUSINESS SHUTDOWNS, SIGNIFICANT JOB LOSSES AND FURLOUGHS. LOCAL NEEDS SERVED BY COMMUNITY NON-PROFIT ORGANIZATIONS AND HOSPITALS INCLUDED RENTAL/HOUSING, UTILITY AND FOOD EMERGENCIES. CMC RECEIVED MULTIPLE URGENT REQUESTS FOR FOOD ACCESS AID BY THE CENTRAL CALIFORNIA FOOD BANK AND FRESNO METRO MINISTRY WHO WERE SEEING A MORE THAN 40% INCREASE IN NEED. FOOD ASSISTANCE ORGANIZATIONS REPORTED THAT CLOSE TO 25% OF THOSE SEEKING AID WERE REQUESTING IT FOR THE FIRST TIME. FRESNO METRO MINISTRY CMC CONTRIBUTED $100,000 TO FRESNO METRO MINISTRY'S FOOD TO SHARE PROGRAM. THE PROGRAM OPERATES A FLEET OF TRUCKS THAT COLLECT EXCESS FOOD FROM LOCAL FARMERS, GROCERS, FOOD PROCESSORS AND SCHOOL DISTRICTS. THE COLLECTED FOOD, INCLUDING FRESH PRODUCE AND PACKAGED FOOD ITEMS, IS REDISTRIBUTED TO LOW-INCOME NEIGHBORHOODS CLASSIFIED AS "FOOD DESERTS" DUE TO LACK OF ACCESSIBLE GROCERY STORES.PRIOR TO COVID-19, FOOD TO SHARE DISTRIBUTED AN ESTIMATED 1 MILLION POUNDS OF FOOD. CMC'S CONTRIBUTION WILL ASSIST THE PROGRAM IN ADDING A SIGNIFICANT INCREASE IN FOOD COLLECTION SITES TO ADDRESS THE COMMUNITY'S PRESSING NEED. FRESNO METRO MINISTRY PARTNERSHIPS HAVE SECURED FOOD DISTRIBUTIONS TO SEVERAL RURAL COMMUNITIES INCLUDING MENDOTA, SAN JOAQUIN, BIOLA, ORANGE COVE, PARLIER AND OTHERS. FRESNO ECONOMIC OPPORTUNITIES COMMISSIONIN AUGUST 2018, CMC PROVIDED $25,000 TO FRESNO ECONOMIC OPPORTUNITY COMMISSION FOR ITS FOOD EXPRESS BUS SERVING HEALTHY MEALS TO LOW-INCOME CHILDREN DURING SCHOOL BREAKS. THE BUS PROVIDES MEALS TO CHILDREN UP TO THE AGE OF 18, WHO MAY OTHERWISE GO HUNGRY. DURING THE COVID-19 SHUTDOWN BETWEEN APRIL 2020 AND AUGUST 2020, THE FOOD EXPRESS BUS SERVED NEARLY 100,000 MEALS TO CHILDREN IN THE FOLLOWING SOUTHEAST AND SOUTHWEST FRESNO NEIGHBORHOODS: MANCHESTER MALL, CARY PARK, KAISER PARK, WEST FRESNO LIBRARY AND NEIGHBORHOOD THRIFT. WORKING COLLABORATIVELY, PROJECT FUNDERS INCLUDED VALLEY CHILDREN'S HEALTHCARE, SAINT AGNES MEDICAL CENTER AND FRESNO COUNTY OFFICE OF EDUCATION.PROJECT SEARCH CMC PROUDLY SERVES AS A VOCATIONAL TRAINING SITE FOR DISABLED ADULTS THROUGH PROJECT SEARCH. THE PROGRAM IS A COLLABORATION WITH BEST BUDDIES, A NON-PROFIT ORGANIZATION THAT HELPS ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. PROJECT SEARCH PARTICIPANTS RECEIVE THE EXPERIENCE NECESSARY TO FIND AND MAINTAIN EMPLOYMENT. THE PROGRAM ALLOWS PARTICIPANTS TO LEARN AND WORK ALONGSIDE CMC STAFF IN SEVERAL CLINICAL AND NON-CLINICAL AREAS INCLUDING: NICU, ANTEPARTUM, POSTPARTUM, ENVIRONMENTAL SERVICES, MATERIALS MANAGEMENT, KITCHEN AND PLANT OPERATIONS. IN FISCAL YEAR 2020, CMC HOSTED 12 PROJECT SEARCH PARTICIPANTS. NINE BEST BUDDY PARTICIPANTS GAINED EMPLOYMENT AS A RESULT OF THEIR EXPERIENCE AT CMCAND FIVE CURRENTLY WORK AT CMC FACILITIES. DUE TO COVID-19 HOSPITAL VISITOR RESTRICTIONS, PROJECT SEARCH PARTICIPANTS WERE ABLE TO TRAIN AT CMC FACILITIES UP UNTIL MID-MARCH 2020. THE PROGRAM IS TENTATIVELY SCHEDULED TO RESUME SOMETIME IN CALENDAR YEAR 2021. PATIENT FINANCIAL NAVIGATOR PROGRAMIN MAY 2019, COMMUNITY CANCER INSTITUTE (CCI) HIRED A FINANCIAL COUNSELOR TO HELP CANCER PATIENTS AND FAMILIES NEEDING SUPPORT TO NAVIGATE THE COSTS OF CARE. THE FINANCIAL COUNSELOR MEETS WITH PATIENTS, REVIEWS THEIR TREATMENT PLAN AND PROVIDES A GUIDE TO HELP PATIENTS ENSURE THEY CAN RECEIVE THE CARE THEY NEED WITHOUT WORRYING ABOUT FINANCES. THE COUNSELOR HELPS PATIENTS UNDERSTAND THEIR INSURANCE COVERAGE AND ALSO LINKS PATIENTS TO COMMUNITY FINANCIAL AND SOCIAL RESOURCES. IN FISCAL YEAR 2020, CCI'S FINANCIAL COUNSELOR PROVIDED ASSISTANCE TO NEARLY 500 PATIENTS; MORE THAN 50 OF THOSE RECEIVING AID WERE COVERED BY MEDI-CAL. FINANCIAL ASSISTANCE IS PROVIDED IN BOTH ENGLISH AND SPANISH.HEALTH NEED 7 - SUBSTANCE ABUSE AND TOBACCOBRIDGE OPIOID TREATMENT PROGRAM CRMC IS ONE OF NEARLY 50 CLINICAL SITES IN THE STATE OF CALIFORNIA PARTICIPATING IN THE OPIOID TREATMENT BRIDGE PROGRAM. THE MEDICATION FOR THE EVIDENCE-BASED ADDICTION TREATMENT IS ACCESSIBLE 24 HOURS A DAY, 7 DAYS A WEEK AT CRMC'S EMERGENCY DEPARTMENT. THE BRIDGE PROGRAM PROVIDES INDIVIDUALS WITH BUPRENORPHINE MEDICATION TO SUPPRESS CRAVINGS AND WITHDRAWAL SYMPTOMS. THE TREATMENT PROVIDES PATIENTS WITH IMMEDIATE ATTENTION IN THE EMERGENCY ROOM SETTING, RATHER THAN BEING REFERRED TO A REHABILITATION CENTER, WHICH IN MANY CASES CAN TAKE WEEKS OR MONTHS. IN FISCAL YEAR 2020, THE PROGRAM PROVIDED TREATMENT TO 20-30 PATIENTS A MONTH. SINCE THE PROGRAM'S LAUNCH, MORE THAN 300 PATIENTS HAVE RECEIVED TREATMENT.HEALTH NEED 8 - VIOLENCE AND INJURY PREVENTIONTRAUMA PREVENTION PROGRAM AS THE ONLY LEVEL 1 TRAUMA CENTER AND COMPREHENSIVE BURN CENTER BETWEEN LOS ANGELES AND SACRAMENTO, CRMC'S SKILLED AND DEDICATED PHYSICIANS AND STAFF PROVIDE TRAUMA SERVICES TO PATIENTS WELL BEYOND THE HOSPITAL'S TYPICAL SERVICE AREA. SINCE 2015, CRMC HAS EMPLOYED A FULL-TIME INJURY PREVENTION SPECIALIST. THE PREVENTION SPECIALIST IDENTIFIES THE MOST COMMON CAUSES OF INJURY AND DEATH SEEN AT THE TRAUMA CENTER BY USING THE HOSPITAL'S TRAUMA REGISTRY. THE INJURY SPECIALIST IDENTIFIES THE TOP INJURY CAUSES AND PROVIDES COMMUNITY-WIDE PREVENTION INFORMATION AND SUPPORT. THROUGH EDUCATION AND ENVIRONMENTAL MODIFICATION, THE SPECIALIST WORKS TO REDUCE THE INCIDENCE OF INJURY, DISABILITY AND DEATH DUE TO TRAUMA. IN FISCAL YEAR 2020, CRMC'S TRAUMA PROGRAM LED THE FOLLOWING OUTREACH AND EDUCATION PROGRAMS:SCHOOL OUTREACH - CRMC'S TRAUMA AND INJURY PREVENTION PROGRAM SPECIALIST PARTNERS WITH LAW ENFORCEMENT AND OTHER COMMUNITY ENTITIES TO EDUCATE TEENS ON THE DANGERS OF DISTRACTED AND RECKLESS DRIVING, BICYCLE AND PEDESTRIAN SAFETY, CONCUSSION AWARENESS AND DROWNING PREVENTION. THROUGH A VARIETY OF CURRICULUM AND PROGRAMS INCLUDING IMPACT TEEN DRIVERS AND REALITY TOUR, THE TRAUMA PREVENTION SPECIALIST PROVIDED EDUCATION TO NEARLY 150 MIDDLE AND HIGH SCHOOL STUDENTS FROM FRESNO AREA SCHOOLS. CAR SEAT SAFETY CHECKS - CRMC PROVIDED GROUP AND INDIVIDUAL CAR SEAT SAFETY AND EDUCATION TRAININGS THROUGHOUT THE YEAR. THESE TRAININGS ARE PROVIDED TO PARENTS IN BOTH ENGLISH AND SPANISH. SAFETY EDUCATION TRAININGS INCLUDED PROPER CAR SEAT INSTALLATION AND CHILD PLACEMENT RELATED TO LEGAL AGE AND WEIGHT REQUIREMENTS. CRMC'S TRAUMA PREVENTION TEAM HELD A PUBLIC EVENT AND DISTRIBUTED NEARLY A DOZEN CAR SEATS TO LOW-INCOME FAMILIES. DUE TO COVID-19 RESTRICTIONS, SOME PLANNED COMMUNITY-WIDE EVENTS WERE CANCELLED. OLDER ADULT DRIVING SAFETY - IN RESPONSE TO INCREASED VEHICULAR ACCIDENTS AMONG OLDER ADULTS, CRMC'S TRAUMA PREVENTION TEAM OFFERED NO-COST DRIVER SAFETY CLASSES. CRMC HOSTED AARP'S FREE SMART DRIVING CLASS IN OCTOBER 2019. NEARLY 20 OLDER ADULTS AND THEIR CAREGIVERS ATTENDED. PART II: SEXUAL ASSAULT FORENSIC EXAMINERS (SAFE) PROGRAM THE CRMC EMERGENCY DEPARTMENT OPERATES THE SEXUAL ASSAULT FORENSIC EXAMINERS (SAFE) PROGRAM. SAFE PROVIDES ROUND-THE-CLOCK, IN-HOSPITAL TESTING AND EXAMINATIONS FOR SEXUAL ASSAULT AND RAPE VICTIMS. SPECIALLY-TRAINED NURSES COLLECT, PRESERVE AND SECURELY STORE EVIDENCE OBTAINED FROM ADULT AND PEDIATRIC VICTIMS AND SUSPECTS. CRMC NURSES ALSO SERVE AS EXPERT COURT WITNESSES. IN CONJUNCTION WITH THE CHILDREN'S HEALTH CENTER LOCATED ON CRMC'S CAMPUS, SAFE STAFF PROVIDE COMPREHENSIVE FOLLOW-UP EVALUATIONS FOR CHILD VICTIMS OF SEXUAL ABUSE. PROGRAM NURSES ALSO ASSIST IN CONNECTING VICTIMS AND FAMILIES TO COUNSELING SERVICES. IN FISCAL YEAR 2020, CRMC SAFE NURSES PROVIDED ASSISTANCE TO 109 PATIENTS.HEALTH NEED 9 - CLIMATE AND HEALTHIN-HOSPITAL GREEN INITIATIVES CMC'S SUSTAINABILITY TEAM CONTINUOUSLY SEEKS INNOVATIVE WAYS TO REDUCE AND RECYCLE CLINICAL AND NON-CLINICAL WASTE INCLUDING PAPER, SHARPS, DISPOSABLE LEAD WIRES AND CLOTH TOWELS FROM OPERATING ROOMS. THE SUSTAINABILITY TEAM IS MADE UP OF CMC EMPLOYEES WHO VOLUNTEER THEIR TIME TO RESEARCH AND SET UP PROGRAMS TO MAKE THE HOSPITAL GREENER. PARTICIPATING MEMBERS COME FROM CLINICAL, QUALITY, MATERIALS MANAGEMENT, NUTRITION AND OTHER CMC DEPARTMENTS. IN FISCAL YEAR 2020, CMC'S GREEN EFFORTS DIVERTED NEARLY 452,000 POUNDS OF WASTE FROM LOCAL LANDFILLS THROUGH ITS RECYCLING PROGRAM. RECLAIMED WATER IS ALSO UTILIZED AT CCMC FOR ALL ITS LANDSCAPING IRRIGATION RECYCLING AN AVERAGE OF 3.5 MILLION GALLONS OF WATER EACH MONTH THROUGH A COLLABORATION WITH THE CITY OF CLOVIS. CMC HAS ALSO INCREASED THE NUMBER OF RECHARGEABLE CAR STATIONS AT ITS FACILITIES BY INSTALLING 59 NEW CHARGING STATIONS AT CRMC, CCMC AND CORPORATE ADMINISTRATIVE OFFICE BUILDING PARKING LOTS. IN TOTAL, CMC HAS 134 CLEAN VEHICLE CHARGING STATIONS AVAILABLE TO THE PUBLIC, EMPLOYEES AND PHYSICIANS, FREE OF CHARGE. CMC'S CLEAN ENERGY EFFORTS ARE IN RESPONSE TO CALIFORNIA'S 50 PERCENT RENEWABLE ENERGY MANDATE BY 2045. PERSONAL PROTECTIVE EQUIPMENT (PPE) CMC'S GREEN HOSPITAL EFFORTS DURING THE COVID-19 PUBLIC HEALTH EMERGENCY TARGETED INCREASED HOSPITAL WASTE, SPECIFICALLY INCREASED USE OF ONE-TIME PERSONAL PROTECTIVE EQUIPMENT (PPE). CMC'S WASTE REDUCTION EFFORTS DIVERTED OVER 95,000 POUNDS OF PPE FROM LOCAL LANDFILLS. THE DIVERTED WASTE WAS COLLECTED FROM CMC FACILITIES IN JUST FOUR MONTHS, FROM MAY TO AUGUST 2020.HEALTH NEED 10 - CARDIOVASCULAR DISEASE/STROKEWOMEN'S HEART HEALTH FAIR IN FISCAL YEAR 2020, CMC DONATED $5,000 TO THE UCSF WOMEN'S HEART FAIR. THE ANNUAL HEART FAIR OFFERS FREE HEALTH SCREENINGS, LECTURES AND PRIZES AND IS OPEN TO THE PUBLIC. DUE TO COVID-19 RESTRICTIONS ON PUBLIC GATHERINGS, THE FAIR SCHEDULED LATE FEBRUARY 2020 WAS POSTPONED TO SPRING 2021.HEALTH NEED 11 - ASTHMAPEDIATRIC ASTHMA PROGRAM CMC'S PULMONARY REHABILITATION PROGRAM PROVIDES DISEASE MANAGEMENT EDUCATION AND SUPPORT FOR PARENTS. A RESPIRATORY CARE PRACTITIONER ASSISTS PARENTS AT A SOUTH-CENTRAL FRESNO CLINIC, ONE OF THE CITY'S MOST UNDERSERVED AREAS. PARENTS RECEIVE TWO, ONE-HOUR SESSIONS WITH ADDITIONAL EDUCATION AS NEEDED. PATIENTS RECEIVE AN INDIVIDUALIZED "ASTHMA ACTION PLAN," ADDRESSING LUNG PHYSIOLOGY, ASTHMA ATTACK SYMPTOMS AND TRIGGERS, EFFECTIVE MANAGEMENT STRATEGIES AND PROPER MEDICATION AND INHALER USE. IN FISCAL YEAR 2020, THE PROGRAM SERVED 139 PATIENTS AND PROVIDED SPANISH AND ENGLISH HEALTH EDUCATION. IN MARCH 2020, THE PROGRAM ADOPTED SOCIAL DISTANCING AND MASKING PROTOCOLS IN RESPONSE TO COVID-19. SINCE JULY 2020, THE PROGRAM OFFERS TELEHEALTH VISITS TO PATIENTS AND FAMILIES.HEALTH NEED 12 - HIV/AIDS/SEXUALLY TRANSMITTED INFECTIONSSPECIAL SERVICES CLINIC CMC SERVES AS GRANT ADMINISTRATOR FOR THE FEDERAL RYAN WHITE HIV/AIDS PROGRAM PROVIDING LIFE-SAVING CARE FOR CENTRAL VALLEY HIV/AIDS PATIENTS. CMC PARTNERS WITH FAMILY HEALTH CARE NETWORK'S (FHCN) SPECIAL SERVICES CLINIC TO PROVIDE VITAL AND TIMELY HEALTHCARE AND CASE MANAGEMENT SERVICES FOR PATIENTS AND FAMILIES. FHCN'S CLINICAL STAFF AND PHYSICIANS PROVIDE PATIENTS WITH DIRECT MEDICAL CARE AND CASE MANAGEMENT WHILE CMC SERVES AS THE FISCAL AND REPORTING ENTITY. IN FISCAL YEAR 2020, THE SPECIAL SERVICES CLINIC PROVIDED CARE TO NEARLY 1,500 PATIENTS WITH OVER 9,300 VISITS UNDER THE FEDERAL RYAN WHITE GRANT.HEALTH NEED 13 - CANCERCANCER SUPPORT GROUPS CCI HOSTS SEVERAL SUPPORT GROUPS FOR CANCER SURVIVORS AND THEIR FAMILIES. THE SUPPORT GROUPS, HELD IN BOTH ENGLISH AND SPANISH, ARE OPEN TO ALL PERSONS TOUCHED BY CANCER, REGARDLESS OF WHERE THEY RECEIVE CANCER CARE. CCI SUPPORT GROUPS HOST COHORT CANCER AND WELLBEING SUPPORT SESSIONS INCLUDING: WOMEN FOR UNITY, MINDFULNESS MEDITATION, PROSTATE, BRAIN TUMOR, BREAST AND HEAD AND NECK CANCER. IN FISCAL YEAR 2020, CCI HELD 44 IN-PERSON SUPPORT GROUPS. EACH SUPPORT GROUP SESSION RUNS BETWEEN ONE AND TWO HOURS. AS A RESULT OF COVID-19 HOSPITAL RESTRICTIONS, CCI'S CANCER SUPPORT GROUPS WERE MOVED TO A VIRTUAL PLATFORM. FROM JUNE TO AUGUST 2020, CCI HOSTED 49 SUPPORT GROUPS BOTH IN-PERSON AND VIRTUALLY.COMMUNITY BUILDING ACTIVITIESCMC RECOGNIZES THAT HEALTH AND WELLBEING CANNOT BE ACHIEVED BY ONE SOLE ENTITY. POSITIVE OUTCOMES IN THE REGION'S IDENTIFIED HEALTH NEEDS REQUIRE WIDE-REACHING COLLABORATION. CMC JOINED VALLEY CHILDREN'S HEALTHCARE, SAINT AGNES MEDICAL CENTER AND KAISER PERMANENTE, COMMUNITY CLINICS, HEALTH PLANS, THE PUBLIC HEALTH DEPARTMENT, LOCAL ORGANIZATIONS AND OTHERS TO ADDRESS PRESSING HEALTH ISSUES. CMC PARTICIPATED IN SEVERAL COMMUNITY-WIDE HEALTH INITIATIVES AND ACTIVITIES, INCLUDING: FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP) CMC JOINED THE FCHIP LEADERSHIP TEAM IN JANUARY 2017. THIS STEERING COMMITTEE PROVIDES GUIDANCE AND DIRECTION FOR FIVE WORKGROUPS THAT INCLUDE THE DIABETES COLLABORATIVE, FRESNO FOOD SECURITY NETWORK, HEALTH LITERACY AND EMPOWERMENT, LAND USE AND PLANNING, TRAUMA AND RESILIENCE AND THE FRESNO COUNTY TOBACCO COALITION. IN MAY 2020, CMC CONTRIBUTED $5,000 TO SUPPORT THE COLLABORATIVE WORK THAT FCHIP LEADS IN FRESNO COUNTY, WITH PARTICULAR FOCUS ON THE AREA'S TOP IDENTIFIED HEALTH NEEDS. IN ADDRESSING THOSE NEEDS, FCHIP'S DIABETES COLLABORATIVE, FOOD SECURITY AND TRAUMA AND RESILIENCE WORKGROUPS HAVE MADE MEANINGFUL ADVANCES TOWARD IMPROVING THE HEALTH OF VULNERABLE POPULATIONS IN THE COUNTY, WITH PARTICULAR EMPHASIS IN SOUTHEAST AND SOUTHWEST METROPOLITAN FRESNO.FCHIP FOOD SECURITY WORKGROUP THE FCHIP FOOD SECURITY WORKGROUP EXPANDS ACCESS TO HEALTHY FOOD THROUGH DIRECT COMMUNITY FOOD DISTRIBUTIONS TO A NETWORK OF 49 NON-PROFIT ORGANIZATIONS SERVING LOW-INCOME RESIDENTS. THESE FOOD DELIVERIES ARE MADE TO METROPOLITAN FRESNO AREAS CLASSIFIED AS "FOOD DESERTS." FAMILIES PICK UP FOOD ITEMS EITHER ON A WEEKLY OR MONTHLY BASIS AT NEIGHBORHOOD CHURCHES, COMMUNITY CENTERS, PUBLIC HOUSING COMPLEXES AND OTHERS. DISTRIBUTED FOOD INCLUDES FRESH FRUITS, VEGETABLES AND A VARIETY PROTEINS AND STAPLES RECOVERED FROM SCHOOLS, GROCERS, FARMERS, PROCESSORS AND BACKYARD GLEANINGS. COOKING MATTERS CLASSES HOST BETWEEN 8-10 RESIDENTS WHO LEARN TO COOK HEALTHY AND AFFORDABLE DISHES FROM LOCAL CHEFS AND NUTRITIONISTS. RESIDENTS TAKING THE CLASSES REPORT INCREASED HEALTHY EATING BEHAVIORS AND CONFIDENCE IN COOKING NUTRITIOUS MEALS. COOKING MATTERS CLASSES ARE LED IN BOTH ENGLISH AND SPANISH AND TAUGHT BY FRESNO CITY COLLEGE AND FRESNO STATE DIETETICS STUDENTS AS WELL AS FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH AND FRESNO METRO MINISTRY STAFF. DESPITE BEING THE TOP AGRICULTURAL PRODUCER IN THE NATION, FRESNO IS THE THIRD HIGHEST U.S. CITY FACING FOOD HARDSHIP. MANY FRESNO COUNTY COMMUNITIES AND RURAL AREAS LACK ACCESS TO FRESH, HEALTHY AND AFFORDABLE FOOD. WITH THIS IN MIND, FCHIP'S FOOD SECURITY WORKGROUP ESTABLISHED THE YOVILLE GARDEN FARM PROJECTA JOINT COMMUNITY PROJECT MAINLY TENDED BY LATINO AND AFRICAN AMERICAN COMMUNITY MEMBERS. THE COMMUNITY GARDEN, IN PARTNERSHIP WITH THE FRESNO HOUSING AUTHORITY, IS LOCATED IN A SEVEN-ACRE LOT ADJACENT TO A 69-UNIT LOW-INCOME HOUSING COMPLEX IN SOUTHWEST FRESNO. THE GARDEN, OPENED TO THE PUBLIC IN OCTOBER 2019. YOVILLE GARDEN FEATURES ORGANIC, SUSTAINABLE AND SELF-SUFFICIENT GARDENING TECHNIQUES. THE GROUNDS CONTAIN NATIVE HEDGEROWS, FRUIT TREES, A GREENHOUSE, WALKING PATHS AND COMPOSTING SITES. LOCATED IN AN ECONOMICALLY DISADVANTAGED CITY AREA, THE YOVILLE GARDEN IS A COMMUNITY GATHERING AND ENGAGEMENT HUB. SINCE ITS OPENING, MORE THAN 1,100 RESIDENTS HAVE ENGAGED IN GARDEN ACTIVITIES; 62 GARDENING PLOTS HAVE BEEN ESTABLISHED AND 14 ACTIVE GARDENERS TEND THE GROUNDS. PART II: FCHIP TRAUMA AND RESILIENCE WORKGROUP FCHIP'S TRAUMA AND RESILIENCE WORKGROUP WORKS TO CREATE A TRAUMA-INFORMED COMMUNITY TO SUPPORT VULNERABLE RESIDENTS WHO HAVE EXPERIENCED ADVERSE CHILDHOOD EXPERIENCES (ACES). ACCORDING TO THE CDC, ACES CAN HAVE NEGATIVE, LONG-TERM IMPACT ON HEALTH IN ADULTHOOD, INCLUDING OBESITY AND DETRIMENTAL HEALTH BEHAVIORS SUCH AS ALCOHOL AND DRUG ABUSE. UNDERSTANDING THE ROOT CAUSES OF ACES IS THE FIRST STEP TOWARDS HEALING. NEW RESEARCH SHOWS THAT ADULTS WHO HAVE SUFFERED PAST TRAUMA CAN RESTORE THEIR BRAINS AND BODIES MANY YEARS AFTER SUFFERING ACES. IN FISCAL YEAR 2020, OVER 900 LEADERS FROM LOCAL HEALTHCARE, K-12, HIGHER EDUCATION, GOVERNMENT, NON-PROFIT AGENCIES AND RESIDENTS RECEIVED THE WORKGROUP'S COMMUNITY RESILIENCE INITIATIVE (CRI) TRAININGS. THE CRI CURRICULUM IS A TWO-PART TRAINING FOCUSING ON THE BRAIN SCIENCE BEHIND TRAUMA AND RESILIENCE AND PREVENTION STRATEGIES ADDRESSING TRAUMA'S HIDDEN EFFECTS.FRESNO MADERA CONTINUUM OF CARE (FMCOC) FMCOC IS A TWO-COUNTY, CROSS-SECTOR COLLABORATIVE THAT IDENTIFIES AND PETITIONS STATE AND FEDERAL FUNDING FOR HOUSING ASSISTANCE AND RESOURCES FOR HOMELESS INDIVIDUALS. CREATED IN 2002, FMCOC PARTNERS MEET MONTHLY AND PARTICIPANTS INCLUDE COUNTY SOCIAL SERVICE AGENCIES, NATIVE AMERICAN, VETERAN AND SENIOR-SERVING ORGANIZATIONS, HEALTH CARE PROVIDERS, SAINT AGNES MEDICAL CENTER, THE HOSPITAL COUNCIL, CORRECTIONS AND MENTAL HEALTH SERVICE PROVIDERS. THE COLLABORATIVE EFFORT HAS OVERSEEN THE LOCAL DISTRIBUTION OF MILLIONS OF DOLLARS TO ASSIST IN EMERGENCY AND LONG-TERM HOUSING FOR VULNERABLE INDIVIDUALS, FAMILIES AND VETERANS. CMC PARTICIPATES AS AN FMCOC VOTING MEMBER HELPING GUIDE PROGRAM FUNDING FOR RAPID REHOUSING EFFORTS, EMERGENCY SHELTERS AND THE ANNUAL POINT IN TIME COUNT, AN ANNUAL CENSUS OF HOMELESS INDIVIDUALS. DURING THE COVID-19 PANDEMIC, THE FMCOC COLLABORATIVE SECURED $2.5 MILLION FROM THE CARES ACT'S EMERGENCY SOLUTIONS GRANTS. THESE FUNDS WILL HELP LOCAL AGENCIES SERVING HOMELESS INDIVIDUALS AND FAMILIES WITH RAPID REHOUSING, INFECTION PREVENTION AND MITIGATION EFFORTS, EMERGENCY SHELTER AND QUARANTINE LODGING ASSISTANCE.COMMUNITY HEALTH EDUCATION AND SUPPORTTHE FOLLOWING INVENTORY OF COMMUNITY BENEFIT ACTIVITIES INCLUDES EDUCATIONAL PROGRAMS AND SUPPORT PROVIDED BY PHYSICIANS, STAFF AND VOLUNTEERS OF CMC. CHRONIC KIDNEY DISEASE: DIALYSIS OPTIONS CMC IS AMONG THE LARGEST PROVIDERS OF DIALYSIS SERVICES IN THE CENTRAL VALLEY, ANNUALLY SERVING OVER 10,000 PATIENT VISITS. CMC OFFERS DIALYSIS SERVICES TO ALL AGE GROUPS AND ETHNIC BACKGROUNDS AND PROVIDES ENGLISH AND SPANISH EDUCATIONAL MATERIALS. CMC'S PRIME DIALYSIS EDUCATION PROGRAM, OPTIONS, A PATIENT-CENTERED INFORMATION AND SUPPORT SERVICE FOR INDIVIDUALS WITH CHRONIC KIDNEY DISEASE. CMC PARTICIPATES IN THE NATIONAL KIDNEY FOUNDATION'S KIDNEY EARLY EVALUATION PROGRAM OR KEEP HEALTHY COMMUNITY-BASED INITIATIVE TO EDUCATE THE PUBLIC ABOUT KIDNEY HEALTH, RISK FACTORS AND STEPS TO REDUCE RISK. ON NOVEMBER 2019, VOLUNTEERS AND EMPLOYEES FROM CCMC DIALYSIS CENTER AND CRMC'S OUTPATIENT DIALYSIS CENTER TEAMED UP WITH THE NATIONAL KIDNEY FOUNDATION, FRESNO'S MEXICAN CONSULATE AND FAMILY HEALTH CARE NETWORK TO INFORM LATINO, SPANISH-SPEAKING PATIENTS ABOUT RENAL FAILURE RISKS INCLUDING DIABETES AND HIGH BLOOD PRESSURE. PARTICIPANTS RECEIVED ON-SITE KIDNEY SCREENINGS, BODY MASS INDEX, BLOOD PRESSURE CHECKS AND KIDNEY HEALTH INFORMATION. THE EVENT SERVED 55 PARTICIPANTS.HEALTHQUEST SERIES CMC'S IN-PERSON HEALTHQUEST SEMINARS FEATURE PHYSICIANS AND MEDICAL EXPERTS DISCUSSING PUBLIC INTEREST HEALTH TOPICS. HEALTHQUEST IN-PERSON LECTURES ARE HELD ON CCMC AND CRMC CAMPUSES AND ARE PROVIDED TO THE PUBLIC AT NO CHARGE. IN FISCAL YEAR 2020, CMC HOSTED SIX HEALTHQUEST LECTURES ON TOPICS RELATED TO REGIONAL IDENTIFIED HEALTH NEEDS. THESE SEMINARS INCLUDED: CANCER AWARENESS, DIABETES PREVENTION AND MANAGEMENT, HEART DISEASE AND STROKE. ON AVERAGE, HEALTHQUEST SEMINARS ARE ATTENDED BY 150 PARTICIPANTS. DURING COVID-19, CMC'S HEALTHQUEST SERIES MOVED TO AN ONLINE PLATFORM. SINCE MAY 2020, HEALTHQUEST HOSTED SEVEN VIRTUAL HEALTH EDUCATIONAL SEMINARS. TOPICS FOR HEALTHQUEST'S ONLINE SEMINARS INCLUDED HEART HEALTH, ASTHMA AND ALLERGIES AND IMMUNE SYSTEM-BOOSTING SIMPLE EXERCISES. ON AVERAGE, HEALTHQUEST HOSTED 159 INDIVIDUALS FOR THE ONLINE HEALTH CLASS. MEDWATCH TODAY TELEVISION SERIES IN AN EFFORT TO INCREASE PUBLIC AWARENESS OF TIMELY HEALTH TOPICS, CMC PRODUCES A WEEKLY TELEVISION SHOW, MEDWATCH TODAY. THE SERIES FEATURES TOPICS THAT INCLUDE MENTAL HEALTH, PEDIATRIC ASTHMA, HEART DISEASE, DIABETES PREVENTION AND MANAGEMENT AND MANY OTHERS. THE SHOW AIRS SATURDAYS ON NBC 24 AND SUNDAYS ON CBS 47.IN FISCAL YEAR 2020, MEDWATCH TODAY PRODUCED AND BROADCAST 30 SEGMENTS THAT ADDRESSED 9 OF THE 13 REGIONAL IDENTIFIED HEALTH NEEDS. A TOTAL OF 14.1 MILLION HOUSEHOLDS VIEWED MEDWATCH TODAY CONTENT IN FISCAL YEAR 2020, WITH AN AVERAGE OF 5,227 HOUSEHOLDS TUNING IN PER EPISODE. ADDITIONALLY, CONSUMERS HAVE VIEWED MORE THAN 4,400 HOURS OF MEDWATCH TODAY CONTENT ONLINE AS AN ON-DEMAND VIDEO HEALTH EDUCATION RESOURCE.SPANISH HEALTH EDUCATION SEGMENTS CMC STRIVES TO PROVIDE TIMELY AND RELEVANT HEALTH INFORMATION TO SPANISH-SPEAKING AUDIENCES. CMC PRODUCED FIVE EDUCATIONAL VIDEOS INCLUDING: GESTATIONAL DIABETES AWARENESS, INFLUENZA PREVENTION, SWIMMING SAFETY, AND BICYCLE AND PEDESTRIAN SAFETY. IN RESPONSE TO COVID, CMC PRODUCED SEVERAL INFORMATIONAL SPANISH-LANGUAGE VIDEOS ON PROPER MASK USAGE AND CARE; SOCIAL DISTANCING WHILE SHOPPING AND DOMESTIC VIOLENCE AWARENESS DURING SHELTER-IN-PLACE RESTRICTIONS. ALL SEGMENTS WERE BROADCAST ON OUR COMMUNITY PARTNERS' SOCIAL MEDIA PAGES AND DISTRIBUTED TO CENTRAL VALLEY COMMUNITY-SERVING AGENCIES AND ORGANIZATIONS VIA COLLABORATIVE PARTNER EMAIL DISTRIBUTION LISTS REACHING MORE THAN 1,000 REPRESENTATIVES FROM LOCAL COMMUNITY BENEFIT ORGANIZATIONS. KERMAN HIGH MEDICAL ROP CMC CONTRIBUTED $7,500 WORTH OF HOSPITAL-GRADE MEDICAL EQUIPMENT TO KERMAN HIGH SCHOOL'S MEDICAL REGIONAL OCCUPATIONAL PROGRAM (ROP). MEDICAL EQUIPMENT PROVIDED INCLUDED: IV POLES AND PUMPS, A GURNEY, EKG AND ULTRA SOUND MACHINES, SURGICAL EQUIPMENT, WHEELCHAIRS AND OTHER ITEMS. KERMAN HIGH MEDICAL PATHWAY INSTRUCTORS USE THE EQUIPMENT FOR HANDS-ON LESSONS THAT ACCOMPANY TEXTBOOK INSTRUCTION. SINCE THE ADDITION OF THE MEDICAL EQUIPMENT, INSTRUCTORS REPORT INCREASED STUDENT ENROLLMENT IN THE MEDICAL EDUCATION PATHWAY PROGRAM. IN THE 2019-2020 SCHOOL YEAR, THE ROP MEDICAL PROGRAM GREW FROM 22 STUDENTS TO 88 CURRENT PARTICIPANTS, MANY FROM UNDERSERVED HOUSEHOLDS AND ENGLISH LANGUAGE LEARNERS.DUE TO COVID-19 SCHOOL DISTANCE LEARNING DIRECTIVES, KERMAN MEDICAL CAREER INSTRUCTORS RECORDED INSTRUCTIONAL VIDEOS USING THE CMC-DONATED MEDICAL EQUIPMENT. TAPED VIDEOS INCLUDED "HOW-TO" LESSONS ON WHEELCHAIR AND GURNEY TRANSPORT, PROPER PATIENT PLACEMENT AND CARE USING A MEDICAL LIFT AND DRESSING CHANGES. KERMAN HIGH INSTRUCTORS TEAMED-UP WITH CLOVIS EAST TEACHERS TO COLLABORATIVELY CREATE THE VIDEOS. STUDENTS FROM BOTH HIGH SCHOOLS ARE NOW ABLE TO VIEW THE VIDEO LESSONS AS PART OF THEIR DISTANCE-LEARNING CURRICULUM. FRESNO AREA COLLEGE NIGHT COMMUNITY CARE HEALTH (CCH), A CMC SUBSIDIARY AND INSURANCE PLAN, FUNDED FRESNO COUNTY SUPERINTENDENT OF SCHOOLS' ANNUAL FRESNO AREA COLLEGE NIGHT FOR 5,000 HIGH SCHOOL STUDENTS AND PARENTS. GENERAL COLLEGE PLANNING INFORMATION WAS PROVIDED ON TOPICS THAT INCLUDED THE COLLEGE ADMISSIONS PROCESS, FINANCIAL AID AND SCHOLARSHIPS. EVENT BREAKOUT SESSIONS WERE AVAILABLE IN ENGLISH, SPANISH AND HMONG. THE FREE EVENT, HELD SEPTEMBER 2020, WAS OPEN TO HIGH SCHOOL STUDENTS, MANY WHO ARE FIRST IN THEIR FAMILY TO ATTEND COLLEGE.CENTRAL UNIFIED SCHOLARSHIPS IN FISCAL YEAR 2020, CCH COMMITTED TO PROVIDING SCHOLARSHIP FUNDS FOR LOW-INCOME SENIORS FROM CENTRAL UNIFIED. CCH FUNDING, WITH THAT OF OTHER COMMUNITY PARTNERS, WILL ENABLE THE FOUNDATION FOR CENTRAL SCHOOLS TO PROVIDE SIX $2,500 SCHOLARSHIPS FOR LOW-INCOME STUDENTS. SCHOLARSHIPS WILL HELP STUDENTS PAY FOR COLLEGE, VOCATIONAL OR TRADE SCHOOL NEEDS. PEDIATRIC HEALTH EDUCATION FAIR CRMC'S PEDIATRIC HEALTH DEPARTMENT HOSTED FALL-O-WEEN, A FREE NEIGHBORHOOD-CENTERED FALL FESTIVAL ON THE HOSPITAL'S DOWNTOWN CAMPUS. MORE THAN 300 PARENTS AND CHILDREN WERE INVITED ON CAMPUS TO ENJOY MUSIC, GAMES, TREATS AND RECEIVE BILINGUAL HEALTH PREVENTION EDUCATION ON ASTHMA, BICYCLE AND PEDESTRIAN SAFETY, BURN SAFETY AND OTHERS. THE EVENT TARGETED SOUTHEAST AND SOUTHWEST FRESNO ELEMENTARY AND MIDDLE SCHOOLS IN ECONOMICALLY-DISADVANTAGED NEIGHBORHOODS. INVITED SCHOOLS INCLUDED JEFFERSON, YOKOMI, VANG PAO, LOWELL AND BIRNEY ELEMENTARY SCHOOLS. THE MAJORITY OF THE STUDENTS THAT ATTEND THESE SCHOOLS ARE OF AFRICAN AMERICAN, LATINO AND SOUTHEAST ASIAN BACKGROUNDS. PART II: END-OF-THE-YEAR CONTRIBUTIONS CCH FUNDING PROVIDED THANKSGIVING MEALS TO NEEDY FAMILIES IN PARTNERSHIP WITH CATHOLIC CHARITIES. AS PART OF CATHOLIC CHARITIES' 10TH ANNUAL TURKEY DRIVE, NEARLY 1,200 LOW-INCOME FAMILIES RECEIVED A TURKEY HOLIDAY MEAL BOX IN 2019. CCH ALSO FUNDED CATHOLIC CHARITIES' "ADOPT A FAMILY" HOLIDAY GIFT PROGRAM FOR LOW-INCOME CHILDREN AND FAMILIES. THE PROGRAM GIFTS CHILDREN JACKETS, BLANKETS AND OTHER WINTER WEATHER ITEMS DURING ITS END-OF-YEAR FESTIVITIES. VOLUNTEER SERVICES VOLUNTEERS ARE AN ESSENTIAL PART OF CMC'S MISSION TO IMPROVE THE HEALTH OF THOSE WE SERVE AND OF OUR COMMUNITY. AT CRMC, 400 VOLUNTEERS PROVIDED NEARLY 17,600 HOURS OF SERVICE TO THE HOSPITAL AND OUR PATIENTS BEFORE COVID-19 VISITOR RESTRICTIONS WERE IMPOSED IN MARCH, SUSPENDING VOLUNTEER ACTIVITIES. THIS EQUATED TO 14.9 FULL TIME EMPLOYEES IN FISCAL YEAR 2020 FOR THE 6.5 MONTHS THAT VOLUNTEERS WERE ALLOWED IN THE HOSPITAL. AT CCMC, NEARLY 260 VOLUNTEER CHAPLAINS, ADULTS, GUILD MEMBERS, YOUTH AND STUDENT VOLUNTEERS PROVIDED OVER 13,700 HOURS OF SERVICE, EQUATING TO AN AVERAGE OF 12.3 FULL TIME EMPLOYEES DURING THE 6.5 MONTHS VOLUNTEERS WERE WORKING IN THE HOSPITAL DURING FISCAL YEAR 2020. OUR VISITOR AND VOLUNTEER RESTRICTIONS CURRENTLY REMAIN IN EFFECT.COVID-19 PUBLIC EDUCATION CMC LED A MULTI-LINGUAL PUBLIC EDUCATION CAMPAIGN TO INFORM THE PUBLIC ON COVID-19 PREVENTION AND SYMPTOMS. IN COORDINATION WITH FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH, CMC PRODUCED MULTI-PLATFORM EDUCATIONAL MATERIALS INCLUDING ENGLISH AND SPANISH-WRITTEN ONLINE ARTICLES AND VIDEOS. TOPICS INCLUDED THE IMPORTANCE OF PROPER HAND SANITATION, SOCIAL DISTANCING, MASK USAGE, MENTAL HEALTH RESILIENCY DURING SHELTER IN PLACE ORDERS AND OTHERS. CMC'S COMMUNICATIONS TEAM ALSO DESIGNED A SERIES OF INFOGRAPHICS HIGHLIGHTING BEST MASK USAGE AND SOCIAL DISTANCING PRACTICES TO AVOID COVID-19. THESE INFOGRAPHICS WERE TRANSLATED INTO SPANISH, HMONG AND PUNJABI. THE COVID-19 EDUCATIONAL GRAPHICS WERE DISTRIBUTED TO MORE THAN 1,000 COMMUNITY LEADERS FROM NON-PROFIT ORGANIZATIONS, PUBLIC HEALTH AGENCIES, HEALTH PLANS AND LOCAL SCHOOL DISTRICTS VIA FCHIP'S LIST SERVE AND CENTRAL VALLEY COMMUNITY FOUNDATION'S WEEKLY COVID-19 INFORMATIONAL CALL FOR VALLEY NON-PROFITS.ON-SITE BLOOD DRIVES DURING THE COVID-19 PUBLIC HEALTH EMERGENCY, THE CENTRAL VALLEY SAW SERIOUS DECLINES IN LOCAL BLOOD SUPPLIES. TO HELP INCREASE THE AVAILABILITY OF BLOOD RESOURCES IN OUR REGION, CMC ORGANIZED A SERIES OF BLOOD DRIVE EVENTS ON OUR CAMPUSES. IN FISCAL YEAR 2020, CMC HOSTED THREE EVENTS ON THE FOLLOWING CAMPUSES: CLOVIS COMMUNITY MEDICAL CENTER, COMMUNITY REGIONAL MEDICAL CENTER AND FRESNO HEART & SURGICAL HOSPITAL. NEARLY 130 CMC EMPLOYEES PARTICIPATED IN THE VOLUNTEER BLOOD DRIVES, WHICH PRODUCED BLOOD UNITS FOR DISTRIBUTION THROUGHOUT THE CENTRAL VALLEY REGION. PART III, LINE 2: ADJUSTMENT DUE TO THE PATIENT'S ABILITY TO PAY DUE TO A BANKRUPTCY ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 3: CMC DOES NOT RECOGNIZE ANY PORTION OF ITS BAD DEBT EXPENSE AS A COMMUNITY BENEFIT. PART III, LINE 4: FOOTNOTE FOR BAD DEBT EXPENSE: SEE AUDITED FINANCIAL STATEMENTS NOTE 3, PAGE 17.FOOTNOTE FOR ACCOUNTS RECEIVABLE: SEE AUDITED FINANCIAL STATEMENTS NOTE 2, PAGE 12. PART III, LINE 8: MEDICARE SHORTFALL: THE MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFIT BECAUSE: (1) NONNEGOTIABLE MEDICARE RATES ARE SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; AND (2) BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES.COSTING METHODOLOGY: INPATIENT CARE SERVICES, SKILLED NURSING SERVICES, REHABILITATION SERVICES, AND CERTAIN OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DIAGNOSIS. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. CERTAIN INPATIENT NONACUTE SERVICES AND MEDICAL EDUCATION COSTS RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST-BASED REIMBURSEMENT METHODOLOGY. PROFESSIONAL SERVICES ARE REIMBURSED BASED ON A FEE SCHEDULE. PART III, LINE 9B: THOSE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE GENERALLY SUBJECT TO THE NORMAL COLLECTION PROCEDURES FOR ALL PATIENTS. THE FOLLOWING SPECIAL CIRCUMSTANCES MAY APPLY: (1) RYAN WHITE PATIENTS ARE NOT SUBJECT TO COLLECTIONS ACTIVITY. (2) FOR PATIENTS WHO LACK HEALTH INSURANCE COVERAGE, HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED COVERAGE OR FOR CMC'S CHARITY/DISCOUNTED CARE, OR HAVE OTHERWISE INDICATED THEY MAY QUALIFY FOR SUCH PROGRAMS, CMC WILL NOT KNOWINGLY SEND THE BILL TO A COLLECTION AGENCY PRIOR TO 150 DAYS FROM THE INITIAL TIME OF BILLING. (3) FOR PATIENTS WHO LACK HEALTH INSURANCE COVERAGE, HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED COVERAGE OR FOR CMC'S CHARITY/DISCOUNTED CARE, OR HAVE OTHERWISE INDICATED THEY MAY QUALIFY FOR SUCH PROGRAMS, CMC WILL NOT FILE A CIVIL ACTION AGAINST THE PATIENT DUE TO NONPAYMENT UNTIL AFTER 150 DAYS FROM INITIAL BILLING. (4) IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER THIS POLICY, AND IS REASONABLY COOPERATING WITH THE HOSPITAL IN AN EFFORT TO SETTLE AN OUTSTANDING BILL, CMC WILL NOT SEND THE UNPAID BILL TO AN OUTSIDE COLLECTION AGENCY IF THE HOSPITAL KNOWS THAT DOING SO MAY NEGATIVELY IMPACT A PATIENTS CREDIT. CMC WILL NOT SEND SUCH A PATIENT'S ACCOUNT TO AN OUTSIDE COLLECTION AGENCY WITHOUT A WRITTEN AGREEMENT THAT THE COLLECTION AGENCY WILL COMPLY WITH CMC'S COLLECTION POLICIES. (5) THE 150-DAY GRACE PERIOD DISCUSSED ABOVE WILL BE EXTENDED IF THE PATIENT HAS A PENDING APPEAL FOR THE COVERAGE OF SERVICES UNTIL A FINAL DETERMINATION OF THAT APPEAL IS MADE, IF THE PATIENT MAKES A REASONABLE EFFORT TO COMMUNICATE WITH THE HOSPITAL ABOUT THE PROGRESS OF ANY PENDING APPEALS. PENDING APPEALS INCLUDE: (A) GRIEVANCE AGAINST A CONTRACTING HEALTH SERVICE PLAN; (B) AN INDEPENDENT MEDICAL REVIEW UNDER THE CALIFORNIA INSURANCE CODE; (C) FAIR HEARING FOR A REVIEW OF A MEDI-CAL CLAIM PURSUANT TO THE WELFARE AND INSTITUTIONS CODE; AND (D) APPEAL REGARDING MEDICARE COVERAGE CONSISTENT WITH FEDERAL LAW AND REGULATIONS. PART VI, LINE 2: AS PART OF THE AFFORDABLE CARE ACT, THE ORGANIZATION PARTNERED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA AND A DOZEN OTHER VALLEY HOSPITALS TO PUBLISH A COMMUNITY NEEDS ASSESSMENT IN 2019. ADDITIONALLY, EACH OF OUR THREE HOSPITALS DEVELOPED IMPLEMENTATION PLANS TO ADDRESS SOME OF THE KEY NEEDS IDENTIFIED IN THE REPORT. PART VI, LINE 3: COMMUNICATION OF FINANCIAL ASSISTANCE POLICIES WITH PATIENTS AND THE PUBLIC:1. CMC SHALL POST NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME, UNINSURED AND UNDER-INSURED PATIENTS. THESE NOTICES WILL BE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL, INCLUDING BUT NOT LIMITED TO:A. ADMITTING/REGISTRATION;B. CASHIER WINDOWS;C. EMERGENCY DEPARTMENT; ANDD. OTHER APPROPRIATE OUTPATIENT SETTINGS.2. THESE POSTED NOTICES REGARDING FINANCIAL ASSISTANCE POLICIES SHALL CONTAIN BRIEF INSTRUCTIONS ON HOW TO APPLY FOR CHARITY CARE OR A DISCOUNTED PAYMENT. THE NOTICES WILL ALSO INCLUDE A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION.3. CMC WILL ENSURE THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES INCLUDING THE RYAN WHITE PROGRAM. TRAINING WILL BE PROVIDED TO STAFF MEMBERS (E.G., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS.4. WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, EMPLOYEES WILL ATTEMPT TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.5. PATIENTS (ADMITTED PATIENTS, AS WELL AS THOSE WHO RECEIVE EMERGENCY OR OUTPATIENT CARE) WILL BE GIVEN WRITTEN NOTICE REGARDING FINANCIAL ASSISTANCE, INCLUDING ELIGIBILITY AND CONTACT INFORMATION THAT IS IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT, AS DETERMINED BY CALIFORNIA INSURANCE CODE SECTION 12693.30 (POPULATIONS OVER 5% SERVED BY THE HOSPITAL) AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.6. CMC WILL SHARE ITS POLICY WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS.7. THE RYAN WHITE SLIDING FEE SCALE IS UPDATED YEARLY ACCORDING TO THE FEDERAL POVERTY GUIDELINES.8. ALL PATIENTS WHO POTENTIALLY QUALIFY FOR DISCOUNTS FOR SERVICES UNDER RYAN WHITE WILL HAVE THEIR FINANCIAL ELIGIBILITY TESTED EVERY SIX MONTHS. THE FINANCIAL ASSISTANCE POLICY AND THE APPLICATION ARE ALSO PUBLISHED IN CMC'S WEBSITE. PART VI, LINE 4: SERVICE AREA: COMMUNITY IS HEADQUARTERED IN FRESNO, PROVIDING THE SAN JOAQUIN VALLEY WITH ACUTE CARE, OUTPATIENT CENTERS, CLINICS, HOME CARE, COMMUNITY EDUCATION, PHYSICIAN GROUPS AND A PHYSICIAN RESIDENCY PROGRAM IN CONJUNCTION WITH THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO (UCSF). WITH MORE THAN 8,600 EMPLOYEES, 1,400 AFFILIATED PHYSICIANS AND NEARLY 700 VOLUNTEERS, COMMUNITY HAS A 15,000-SQUARE-MILE PRIMARY SERVICE AREA. THAT INCLUDES FRESNO, MADERA, KINGS, TULARE AND MARIPOSA COUNTIES. THE AREA IS AS LARGE AS RHODE ISLAND, CONNECTICUT AND NEW JERSEY COMBINED. COMMUNITY ALSO OPERATES THE ONLY COMBINED BURN AND LEVEL 1 TRAUMA UNITS BETWEEN LOS ANGELES AND SACRAMENTO, PROVIDING CRITICAL CARE AND OTHER SPECIALTY SERVICES TO PATIENTS FROM WELL OUTSIDE THE PRIMARY SERVICE REGION. THOSE UNITS ARE LOCATED AT COMMUNITY REGIONAL MEDICAL CENTER (COMMUNITY REGIONAL), WHICH ALSO OPERATES ONE OF THE BUSIEST HOSPITAL EMERGENCY DEPARTMENTS IN THE NATION.BOARD OF TRUSTEES: COMMUNITY IS GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES COMPRISED OF LOCAL CIVIC LEADERS AND PHYSICIANS. THE TRUSTEES PROVIDE VISION AND POLICY DIRECTION. THIS PROCESS INCLUDES AN ANNUAL REVIEW OF THE PRIOR FISCAL YEAR AND A COMMUNITY-NEEDS EVALUATION TO PRIORITIZE OPERATIONAL ISSUES AND PROVIDE DIRECTION. THE CORPORATE BOARD IS ALSO ACTIVELY INVOLVED IN APPROVING FISCAL APPROPRIATIONS FOR COMMUNITY BENEFITS PROGRAMS, OUTREACH SERVICES AND EDUCATION, AS WELL AS TRADITIONAL CHARITY CARE AND UNPAID COSTS OF PUBLIC PROGRAMS FOR THE MEDICALLY UNDERSERVED. CORPORATE BOARD MEMBERS, PHYSICIANS AND COMMUNITY'S LEADERSHIP TEAM HAVE HELPED IDENTIFY AND FUND COMMUNITY BENEFITS PROGRAMS. PART VI, LINE 5: CMC'S COMMITMENT TO COMMUNITY BENEFIT IS DEMONSTRATED AT EVERY LEVEL OF THE ORGANIZATION. EVIDENCE OF OUR MISSION IS THE CONTINUAL INVESTMENT IN IMPROVING THE HEALTH OF THOSE WE SERVE AND IN THE COMMUNITY THAT OUR MORE THAN 10,000 EMPLOYEES, PHYSICIANS AND VOLUNTEERS AND NEARLY 300,000 PATIENTS CALL "HOME." OVER THE PAST TWO DECADES, NO OTHER HOSPITAL ORGANIZATION IN THE SAN JOAQUIN VALLEY HAS INVESTED MORE TO ENSURE HEALTHCARE ACCESS TO ALL PEOPLE OF THIS GROWING REGION.THE BOARD OF TRUSTEES REVIEWS THE COMMUNITY NEEDS ASSESSMENT, THE ANNUAL COMMUNITY BENEFIT REPORT AND OUR IMPACT ON THE AREAS OF GREATEST NEED. SENIOR MANAGEMENT ENCOURAGES INITIATIVES TO EXPAND ACCESS TO HEALTHCARE SERVICES IN OUR COMMUNITY AND IS COMMITTED TO INVESTING IN AND PARTNERING WITH LOCAL, NON-PROFIT ORGANIZATIONS WORKING IN SOCIO-ECONOMICALLY DISADVANTAGED NEIGHBORHOODS AND RURAL POPULATIONS. A MULTI-STAKEHOLDER COMMITTEE ENSURES THE BOARD AND SENIOR MANAGEMENT DIRECTIVES ARE FULFILLED AND APPROVES FINANCIAL ALLOCATIONS TO COMMUNITY BENEFIT PROGRAMS, OUTREACH AND EDUCATION.MANY CMC LEADERS AND STAFF MEMBERS PARTICIPATE IN A WIDE ARRAY OF COMMUNITY-SERVICE ORIENTED GROUPS, EXTENDING OUR COMMUNITY BENEFIT OUTREACH FAR BEYOND DOLLARS INVESTED. COMMUNITY BENEFIT AND COMMUNITY SERVICE ARE AT THE HEART OF OUR HEALTHCARE SYSTEM. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 FAMILY HEALTHCARE NETWORK 305 W CENTER AVE VISALIA CA 93291 942525145 501(C)(3) 500000 TRANSITION GRANT UCSF FOUNDATION 155 N FRESNO ST FRESNO CA 93701 942829914 501(C)(3) 300000 MEDICAL EDUCATION FRESNO RESCUE MISSION INC PO BOX 1422 FRESNO CA 93716 941279785 501(C)(3) 102200 DONATION FOR HOMELESS RESPITE CARE SANTE HEALTH FOUNDATION 7370 NORTH PALM AVE FRESNO CA 93711 200517238 501(C)(3) 15259105 TO SUPPORT EFFORTS TO RECRUIT NEEDED SPECIALIST AND PRIMARY CARE PHYSICIANS 4 0 PART I, LINE 2: THE ORGANIZATION DOES NOT HAVE A GRANT PROCEDURE FOR MONITORING THE USE OF FUNDS OTHER THAN FOR USE OF GRANTS BY SANTE HEALTH FOUNDATION. CMC IS PURSUING ITS RIGHT TO AUDIT THE GRANTS IT MADE TO SANTE HEALTH FOUNDATION TO VERIFY THAT THE GRANTS WERE USED IN ACCORDANCE WITH THE TERMS OF THE GRANT AGREEMENTS, WHICH REQUIRE THAT THEY BE USED EXCLUSIVELY FOR CHARITABLE PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3). X 1 1 X X X X 1 1 0 1 1 1 1 0 0 TIM JOSLIN - PRESIDENT CHIEF EXECUTIVE OFFICER THRU 07/20 0 893716 0 0 0 149378 0 800612 0 12434 0 1856140 0 0 CRAIG CASTRO - PRESIDENT CHIEF EXECUTIVE OFFICER AS OF 07/20 0 831439 0 255828 0 204872 0 19600 0 21542 0 1333281 0 81345 CRAIG WAGONER EVP, CHIEF OPERATING OFFICER 0 764810 0 208062 0 204422 0 16800 0 14318 0 1208412 0 88218 THOMAS UTECHT SVP, CHIEF QUALITY OFFICER 599982 0 174029 0 115668 0 19600 0 20884 0 930163 0 70120 0 JOSEPH NOWICKI SVP, CORPORATE CFO 0 610177 0 173214 0 114607 0 16800 0 18634 0 933432 0 71763 ALDO DE LA TORRE SVP, NETWORK DEVELOPMENT 0 520730 0 157983 0 143827 0 11200 0 20609 0 854349 0 55454 ROBYNN L VAN PATTEN SVP CHIEF LEGAL OFFICER THRU 6/19 0 227245 0 85336 0 428728 0 12799 0 19107 0 773215 0 103094 WANDA HOLDERMAN SVP, CHIEF CLINICAL INTEGRA 444113 0 130559 0 101136 0 16800 0 13259 0 705867 0 58998 0 CHRISTOPHER NEUMAN CHIEF OPERATING OFFICER 401578 0 97386 0 71447 0 14000 0 18177 0 602588 0 0 0 TRACY KIRITANI CHIEF FINANCIAL OFFICER 407862 0 82056 0 83725 0 19600 0 7941 0 601184 0 0 0 CARLA MILTON SVP, HUMAN RESOURCES 0 385977 0 121908 0 34742 0 16800 0 17887 0 577314 0 0 JEFFREY THOMAS CHIEF MEDICAL & QUALITY OFFICER 446001 0 82296 0 4276 0 0 0 20362 0 552935 0 0 0 BRIANNE L MARRIOTT SVP, CHIEF LEGAL OFFICER 0 273652 0 20216 0 61120 0 14000 0 17509 0 386497 0 0 PATRICK T RAMIREZ SVP, COMMUNITY PROVIDER NETWORK 0 208103 0 39909 0 1664 0 8566 0 19558 0 277800 0 0 MICHELLE VON TERSCH SVP, COMMUNICATION & LEGISLATIVE AFF 0 197055 0 37931 0 2557 0 16512 0 17253 0 271308 0 0 AJIT ARORA MD BOARD MEMBER 0 200700 0 0 0 0 0 0 0 0 0 200700 0 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR WANDA HOLDERMAN AND THOMAS UTECHT. THIS COMPENSATION IS TAXABLE TO EACH EXECUTIVE. PART I, LINES 4A-B LINE 4A: TIM JOSLIN AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, ENTERED INTO A SEVERANCE AGREEMENT WHEREBY TIM JOSLIN WILL RECEIVE 52 BIWEEKLY PAYMENTS FOR $34,616 BEGINNING 07/18/2020 AND ENDING 07/02/2022. THESE PAYMENTS ARE NOT REFLECTED ON SCHEDULE J, PART II AS THEY BEGAN IN CALENDAR YEAR 2020. WANDA HOLDERMAN AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, ENTERED INTO A SEVERANCE AGREEMENT WHEREBY WANDA HOLDERMAN WILL RECEIVE 39 BIWEEKLY PAYMENTS OF $17,705 BEGINNING 08/01/2020 AND ENDING 01/15/2022. THESE PAYMENTS ARE NOT REFLECTED ON SCHEDULE J, PART II AS THEY BEGAN IN CALENDAR YEAR 2020. LINE 4B: DURING THE YEAR, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, MADE A CONTRIBUTION OF $783,812 TO A SERP PLAN FOR TIM JOSLIN. LINE 4B: DURING THE YEAR, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, MADE THE FOLLOWING DISTRIBUTIONS FROM THE SERP PLAN OF FOR THE FOLLOWING INDIVIDUALS: - CRAIG CASTRO $81,345 - WANDA HOLDERMAN $58,999 - JOSEPH NOWICKI $71,763 - THOMAS UTECHT $70,120 - CRAIG WAGONER $88,218 LINE 4B: SELECT INDIVIDUALS AGREED TO PARTICIPATE IN A CAP-EX PLAN. SEE SCHEDULE L, PART V FOR A BROADER DESCRIPTION. PART I, LINE 5 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION'S EXECUTIVE INCENTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD KEY MEMBERS OF THE EXECUTIVE TEAM FOR MEETING SPECIFIC AND MEASURABLE GOALS AT THE HEALTH SYSTEM AND INDIVIDUAL LEVELS. THE MAIN OBJECTIVES ARE: - MOTIVATE EXECUTIVES AND REWARD THEM FOR IMPROVING CMC'S OPERATIONAL PERFORMANCE; - INCREASE COMMUNITY INVOLVEMENT AND EFFECTIVENESS; - INCREASE EXECUTIVE COMMITMENT TO CMC'S SHORT AND LONG TERM GOALS; - PROVIDE EXECUTIVES WITH COMPETITIVE BUT REASONABLE COMPENSATION; - AND ATTRACT AND RETAIN HIGHLY TALENTED EXECUTIVES THAT ARE CRITICALLY IMPORTANT TO THE SUCCESS OF THE ORGANIZATION. PART I, LINE 6 SEE RESPONSE FOR QUESTION 5. A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TVWO 2015-07-01 128617535 CONSTRUCTION & REFUNDING 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TS20 2017-02-01 429863267 CONSTRUCTION & REFUNDING 0 0 0 A 10362535 128617535 1793836 50000000 76823699 2015 0 1 1 1 B 59430457 430205457 2780950 50342190 377082317 2018 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, COLUMN F: ROW A: SERIES 2015 BONDS REFUNDED A PORTION OF THE SERIES 2007 BONDS OUTSTANDING WITH A PAR AMOUNT OF $74,025,000. ROW B: SERIES 2017 REFUNDED THE FOLLOWING: REFUNDED A PORTION OF THE SERIES 2007 BONDS OUTSTANDING WITH A PAR AMOUNT OF $213,100,000; SERIES BONDS 2009 PAR AMOUNT $182,365,000. SCHEDULE K, PART II, LINE 3: COLUMN B: TOTAL PROCEEDS OF ISSUE = ISSUE PRICE + PROJECT FUND EARNINGS OF $342,190. SCHEDULE K COMBINED SUPPLEMENTAL INFORMATION: THE ORGANIZATION AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HAVE ESTABLISHED AN OBLIGATED GROUP TO ACCESS CAPITAL MARKETS. THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY LIABLE FOR LONG-TERM DEBT OUTSTANDING UNDER THE OBLIGATED GROUPS MASTER TRUST INDENTURE. THE ORGANIZATION IS THE PRIMARY BENEFICIARY OF THE TAX-EXEMPT BOND PROCEEDS AND FILES SCHEDULE K FOR THE BENEFIT OF ALL MEMBERS OF THE OBLIGATED GROUP. TIM JOSLIN OFFICER SPLIT INTEREST INSURANCE X 5789822 5874499 0 1 1 CRAIG CASTRO OFFICER SPLIT INTEREST INSURANCE X 2630651 2671448 0 1 1 JOSEPH NOWICKI OFFICER SPLIT INTEREST INSURANCE X 1382253 1403689 0 1 1 CRAIG WAGONER KEY EMPLOYEE SPLIT INTEREST INSURANCE X 986225 1001520 0 1 1 ALDO DE LA TORRE KEY EMPLOYEE SPLIT INTEREST INSURANCE X 952628 967402 0 1 1 CARLA MILTON KEY EMPLOYEE SPLIT INTEREST INSURANCE X 706907 717870 0 1 1 ROBYNN VAN PATTEN KEY EMPLOYEE SPLIT INTEREST INSURANCE X 690388 701095 0 1 1 BRIANNE L MARRIOTT KEY EMPLOYEE SPLIT INTEREST INSURANCE X 823753 825159 0 1 1 MICHELLE VON TERSCH KEY EMPLOYEE SPLIT INTEREST INSURANCE X 373758 374612 0 1 1 14537294 MATTHEW JOSLIN FAMILY MEMBER OF TIM JOSLIN, AN OFFICER OF FCH&MC. 243403 SALARIES AND WAGES 0 CHRIS-ANN VENUGOPAL FAMILY MEMBER OF C. VENUGOPAL, MD, A MEMBER OF FCH&MC'S BOARD OF TRUSTEES 176221 SALARIES AND WAGES 0 PART II: (C) PURPOSE OF LOAN:THE ORGANIZATION HAS ENTERED INTO COLLATERAL ASSIGNMENT SPLIT DOLLAR AGREEMENTS WITH THE PERSONS LISTED ON SCHEDULE L, PART II UNDER TREAS. REG. SECTION1.7872-15(E)(5)(II). THE ORGANIZATION HAS INVESTED AMOUNTS LISTED IN COLUMN (E) INTO THE PLANS AND IS ENTITLED TO RECEIVE A RETURN OF THESE FUNDS, PLUS AN INTEREST RATE UPON THE DEATH OF THE NAMED PERSON. FORM 990, PART V, LINES 1 & 2: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA IS THE COMMON PAYMASTER FOR THE ORGANIZATION, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION, AND ITSELF. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA (CHCC) IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A CHCC IS THE SOLE MEMBER OF FCH&MC. IT HAS THE SOLE AND EXCLUSIVE RIGHT TO ELECT ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CHCC IS THE SOLE MEMBER OF THIS ENTITY. AS SUCH, IT HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310-5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE MOST RECENT AMENDED ARTICLES OF INCORPORATION PROVIDES THAT UPON DISSOLUTION ALL REMAINING ASSETS WILL BE DISTRIBUTED TO CHCC OR ITS SUCCESSOR. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE FORM IS REVIEWED AT A MEETING OF THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER COMMITTEE WITH BOARD DELEGATED POWERS ALSO COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT PRIOR TO THE ASSIGNMENT OF THEIR DUTIES AND THEREAFTER ON AN ANNUAL BASIS. THE STATEMENT ASKS SPECIFIC QUESTIONS THAT WOULD DETERMINE IF THERE ARE CONFLICTS OF INTERESTS. CMC'S CHIEF AUDITOR, ETHICS & COMPLIANCE OFFICER, AND CHIEF LEGAL OFFICER REVIEW THE RESPONSES AND DETERMINE WHETHER THERE IS A CONFLICT BASED ON POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DIRECTOR, PRINCIPAL OFFICER, OR MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL BE REMOVED FROM DECISION MAKING AS IT PERTAINS TO THAT CONFLICT. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS-LENGTH BARGAINING; 2) WHETHER ARRANGEMENTS FOR PHYSICIAN AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15A: CHCC, THE SOLE MEMBER OF FCH&MC, ESTABLISHES COMPENSATION FOR THE CEO. FORM 990, PART VI, SECTION B, LINE 15 RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION RESTS WITH THE BOARD'S EXECUTIVE COMPENSATION SUBCOMMITTEE. THE COMMITTEE WILL "CONSIDER ALL MATTERS INVOLVING COMPENSATION AND BENEFITS OF (I) CORPORATE OFFICERS WHO ARE CLASSIFIED AS "DISQUALIFIED PERSONS" PURSUANT TO INTERNAL REVENUE CODE SECTION 4958; (II) ALL OTHER CORPORATE OFFICERS WHO ARE SENIOR VICE PRESIDENTS AND EXECUTIVE VICE PRESIDENTS AND (III) THE PRESIDENT/CHIEF EXECUTIVE OFFICER." THROUGH THE EXECUTIVE COMPENSATION SUBCOMMITTEE, THE BOARD HAS ENGAGED SULLIVAN, COTTER AND ASSOCIATES, INC. TO CONDUCT A TOTAL COMPENSATION REVIEW FOR THOSE INDIVIDUALS IDENTIFIED IN THEIR SCOPE OF RESPONSIBILITY WHICH INCLUDED THE USE OF COMPARABILITY DATA AND DOCUMENTATION OF THE FINDINGS REPORTED TO THE COMMITTEE. THIS PROCESS WAS MOST RECENTLY COMPLETED IN NOVEMBER, 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 175,855,969. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,855,969. MD SUPERVISORY FEES: PROGRAM SERVICE EXPENSES 12,304,330. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,304,330. CONSULTING & MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 154,243. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,243. MEDICAL PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 13,151,177. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,151,177. LINEN SERVICES: PROGRAM SERVICE EXPENSES 3,319,258. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,319,258. AMBULANCE SERVICE: PROGRAM SERVICE EXPENSES 3,370,824. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,370,824. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 61,890,054. MANAGEMENT AND GENERAL EXPENSES 11,788,581. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,678,635. FORM 990, PART I, LINE 6: FCH&MC BEGAN THE YEAR WITH APPROXIMATELY 700 VOLUNTEERS THOUGH DUE TO THE COVID-19 PANDEMIC, THERE WERE NO VOLUNTEERS AT THE END OF THE YEAR DUE TO RESTRICTIONS FOR ADDITIONAL NON-ESSENTIAL PERSONNEL IN THE HOSPITAL'S FACILITIES. CRMC CARDIOVASCULAR CO-MANAGEMENT LLC 789 N MEDICAL CTR DR EAST CLOVIS CA 93611 INACTIVE CA 0 0 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER CRMC ORTHOPEDIC CO-MANAGEMENT LLC 789 N MEDICAL CTR DR EAST CLOVIS CA 93611 INACTIVE CA 0 0 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER FRESNO HEART AND SURGICAL HOSPITAL 789 N MEDICAL CTR DR EAST CLOVIS CA 93611 INACTIVE CA 0 0 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA PO BOX 1232 FRESNO CA 93715 942864615 SUPPORTING ORGANIZATION CA 501(C)(3) LINE 12B, II N/A 1 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION PO BOX 1232 FRESNO CA 93715 770191730 SUPPORTING ORGANIZATION CA 501(C)(3) LINE 7 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA 1 COMMUNITY HEALTH PARTNERS 789 MEDICAL CENTER DRIVE EAST CLOVIS CA 93611 852103299 HEALTHCARE CA 501(C)(3) LINE 7 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER 1 AMI REALTY PARTNERS LP 1867 E FIR SUITE 104 FRESNO CA 93720 203709876 REAL PROPERTY RENTAL CA FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER EXCLUDED 112103 302419 0 787 1 0.50000 CALIFORNIA IMAGING INSTITUTE LLC 1867 E FIR SUITE 104 FRESNO CA 93720 203766736 MEDICAL IMAGING CA FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER UNRELATED 965717 7328108 0 965717 0 0.50000 COMMUNITY INSURANCE SERVICES COMPANY 789 N MEDICAL CTR DR EAST CLOVIS CA 93611 980674776 INSURANCE CJ FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER C 8140166 23339028 1.00000 1 COMMUNITY CARE HEALTH PLAN INC 789 N MEDICAL CTR DR EAST CLOVIS CA 93611 273353543 HEALTH CARE PLAN CA FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER C 60862143 18528728 1.00000 1 COMMUNITY HEALTH ENTERPRISES INC 789 N MEDICAL CTR DR EAST CLOVIS CA 93611 770175659 PHARMACY SALES CA COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA C 1 0 1 1 1 0 0 0 0 0 1 1 0 1 1 1 1 0 1 1 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION C 7411155 CASH COMMUNITY INSURANCE SERVICES COMPANY R 8225556 CASH AMI REALTY PARTNERS LP S 63076 CASH CALIFORNIA IMAGING INSTITUTE LLC S 725000 CASH