2018-08-14T15:12:02-05:00 2017-09-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2016-10-01 911250116 SEATTLE CHILDREN'S HEALTHCARE SYSTEM SEAT 2069874846 PO BOX 5371 MS RC-507 SEATTLE WA 981455005 SUZANNE BEITEL SENIOR VP & CFO 2069874846 2018-08-10 1 JANE M SEARING P00000565 4254544919 2018-07-16 2016 2022-09-23 18:48:47Z JEFF SPERRING MD PO BOX 5371 MS RC-507 SEATTLE WA 981455005 495506943 0 X WWW.SEATTLECHILDRENS.ORG X 1984 WA THE PROVISION OF QUALITY HEALTH CARE SERVICES TO INFANTS, CHILDREN AND ADOLESCENTS. 23 20 11 23 995139 845917 3481940 3911423 22470468 10206314 20598378 20445635 72509 14780 46623295 34578152 0 0 0 0 2035005 2067790 0 0 0 6667846 2826093 8702851 4893883 37920444 29684269 752858121 816917192 16851985 6944411 736006136 809972781 X SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) IS ENGAGED IN ACTIVITIES RELATING TO THE PROVISION OF HEALTH CARE SERVICES TO INFANTS, CHILDREN, AND ADOLESCENTS, DELIVERING AND IMPROVING THE DELIVERY AND THE QUALITY OF THOSE SERVICES THROUGH RESEARCH, EDUCATION, AND CONTRIBUTIONS TO OR FOR THE BENEFIT OF TAX-EXEMPT ORGANIZATIONS WHICH PROVIDE HEALTH CARE SERVICES, PRIMARILY SEATTLE CHILDREN'S HOSPITAL. 0 0 1585342 0 10073910 SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S PROGRAM OPERATING COSTS ARE RELATED TO ACTIVITIES INCURRED TO PROVIDE, DIRECTLY OR INDIRECTLY, HEALTH CARE OR HEALTH RELATED SERVICES APPROPRIATE FOR THE SPECIAL NEEDS OF INFANTS, CHILDREN AND ADOLESCENTS, DELIVERING AND IMPROVING THE DELIVERY OF THOSE SERVICES AND/OR THE QUALITY OF THOSE SERVICES THROUGH RESEARCH, EDUCATION, AND CHILD ADVOCACY. PROGRAM REVENUE IS PRIMARILY RELATED TO SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S PROGRAM RELATED JOINT VENTURE WITH SEATTLE CANCER CARE ALLIANCE (SCCA), A NOT-FOR-PROFIT CORPORATION FORMED IN 1998 BY SEATTLE CHILDREN'S HEALTHCARE SYSTEM, THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, AND FRED HUTCHINSON CANCER RESEARCH CENTER FOR THE PURPOSE OF OFFERING A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES. 157443 0 132404 OCCUPANCY AND OTHER COSTS RELATED TO THE OPERATION OF THE SAND POINTMEDICAL CENTER BUILDING WHICH IS RENTED TO SEATTLE CHILDREN'S HOSPITAL.THE RENTED SPACE IS USED TO DELIVER HEALTHCARE SERVICES TO INFANTS,CHILDREN AND ADOLESCENTS. 1742785 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 7 0 1 11 1 1 1 0 0 0 0 0 0 0 0 0 X 23 20 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X WARREN E HEWITT VP FINANCE 2069874846 4300 ROOSEVELT WAY NE 5TH FLOOR SEATTLE WA 981054718 X DEAN ALLEN TRUSTEE 4.00 0.00 X 0 0 0 JOEL BENOLIEL TREASURER 2.00 0.00 X X 0 0 0 SUSAN BETCHER TRUSTEE 5.00 0.00 X 0 0 0 PAT CHAR TRUSTEE 3.00 0.00 X 0 0 0 MICHAEL DELMAN TRUSTEE 3.00 0.00 X 0 0 0 ROY DIAZ PHD TRUSTEE 3.00 0.00 X 0 0 0 ROBERT FLOWERS TRUSTEE 1.00 1.00 X 0 0 0 COLIN FOX PHD TRUSTEE 3.00 0.00 X 0 0 0 DEBORAH HAUG TRUSTEE 2.00 0.00 X 0 0 0 JUDY HOLDER TRUSTEE 5.00 0.00 X 0 0 0 CYNTHIA HUFFMAN TRUSTEE 2.00 0.00 X 0 0 0 JIM LADD TRUSTEE 3.00 0.00 X 0 0 0 MONA LEE LOCKE TRUSTEE 2.00 0.00 X 0 0 0 PATRICIA LOERA TRUSTEE 2.00 0.00 X 0 0 0 SUSAN MASK SECRETARY 2.00 0.00 X X 0 0 0 JEFF NITTA TRUSTEE 3.00 0.00 X 0 0 0 JUDITH PIERCE TRUSTEE 2.00 0.00 X 0 0 0 MICHAEL REEVES TRUSTEE 2.00 0.00 X 0 0 0 ROB ROSKIN MD TRUSTEE 2.00 0.00 X 0 0 0 NANCY SENSENEY CHAIR 8.00 2.00 X X 0 0 0 MICHELE SMITH TRUSTEE 2.00 3.00 X 0 0 0 CHARLES STEVENS VICE CHAIR 3.00 0.00 X X 0 0 0 ALVIN WINTERROTH TRUSTEE 2.00 0.00 X 0 0 0 JEFF SPERRING MD CEO/NON-VOTING EX OFFICIO TRUSTEE 16.00 39.00 X 201359 619864 164018 KELLY WALLACE SENIOR VP & CHIEF FINANCIAL OFFICER 14.00 41.00 X 450521 630379 112969 WARREN HEWITT VP - FINANCE 14.00 41.00 X 14640 335837 39101 LISA HAYWARD SR VP & GENERAL COUNSEL 55.00 0.00 X 315657 1077 72711 DONNA REINHART DIRECTOR OF TREASURY SERVICES 20.00 20.00 X 94975 100146 31400 SAMANTHA SLOANE CONTROLLER 12.00 38.00 X 12472 169155 10638 MICHAEL JOO CORPORATE ACCOUNTANT 40.00 0.00 X 105545 893 33982 THOMAS HANSEN MD CEO THRU MAY 2015 0.00 45.00 X 727972 434658 27888 SANFORD MELZER MD FORMER SR VP-CHIEF STRATEGY OFFICER 0.00 55.00 X 0 712897 115425 JODI LONG FORMER ASSOCIATE GENERAL COUNSEL 0.00 45.00 X 0 270042 33553 1923141 3274948 641685 5 1 1 0 THE BOSTON CONSULTING GROUP INC 2501 N HARWOOD STE 2200 DALLAS TX 75201 HEALTHCARE SERVICES CONSULTING 2987125 WELLINGTON TRUST COMPANY NA PO BOX 13766 NEWARK NJ 071880766 INVESTMENT MANAGEMENT 685432 THE CHARTIS GROUP LLC DEPARTMENT 5925 CAROL STREAM IL 601225925 HEALTHCARE SERVICES CONSULTING 573382 SANDERSON ASSET MANAGEMENT 250 S WACKER DRIVE STE 220 CHICAGO IL 60606 INVESTMENT MANAGEMENT 448932 HIGHCLERE INTERNATIONAL INVESTORS 253 BAYBERRY LANE WESTPORT CT 06880 INVESTMENT SERVICES 341514 9 3911423 190375 3911423 SERVICES THROUGH SCCA 900099 9566000 9566000 MEDICAL CLINIC RENTAL 900099 507910 507910 RENT FROM AFFILIATES 900099 132404 132404 10206314 5420317 5420317 61650 62394 -744 -744 -744 475884668 7047 460852402 13995 15032266 -6948 15025318 995139 14030179 PROPERTY TAX REFUND 900099 15524 15524 15524 34578152 10206314 995139 19465276 X 1494098 1494098 76686 76686 316472 316472 27996 27996 48012 48012 104526 78890 25636 196080 196080 1189017 1189017 43365 2768 40597 2495 2472 23 1083574 89402 994172 2602 2602 61917 61917 62365 62365 UBI TAXES 168252 168252 LICENSES AND TAXES 57 57 16369 13238 3131 4893883 1742785 3151098 0 0 6703446 1283294 275457 30918213 11678774 17367 0 6810384 349058 6507337 6461326 181041970 202201193 380305252 421654011 138576625 148486105 14208063 19456880 752858121 816917192 599460 473192 62664 56967 16189861 6414252 16851985 6944411 X 547394579 606710681 20800977 24850820 167810580 178411280 736006136 809972781 752858121 816917192 X 29684269 44688272 -405896 X 0 1 X 1 0 X 2161183 85550850 16448308 3481940 3911423 111553704 2161183 85550850 16448308 3481940 3911423 111553704 111553704 3572498 5789988 4396810 4690718 5481967 23931981 187829 933940 1424823 845907 3392499 80585 74305 15524 170414 139048598 53204577 0.80230 0.82000 X SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME: 2014 PROPERTY TAX REFUND: $80,585 2015 PROPERTY TAX REFUND: $74,305 2016 PROPERTY TAX REFUND: $15,524 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 357825000 454000 48663000 3418000 403524000 331943000 232000 29179000 3529000 357825000 337769000 203000 -2586000 3443000 331943000 310474000 239000 30295000 3239000 337769000 278449000 492000 34591000 3058000 310474000 0.85280 0.10830 0.03890 0 0 705855 4572378 5278233 1322774 326091 996683 194795 20996 173799 10975 1189 9786 3607 782 2825 6461326 POOLED INVESTMENTS 279872111 C CHARITABLE REMAINDER UNITRUSTS 804933 C PERPETUAL & TESTAMENTARY TRUSTS 134527847 C GIFT ANNUITIES 3086940 C DEFERRED COMPENSATION PLANS 2874860 C OTHER ALTERNATIVE INVESTMENTS 487320 C 421654011 INVESTMENT IN SCCA 144266666 C INVESTMENT IN SYZYGY LLC 3913860 C ACCRUED INTEREST 305579 F 148486105 ANNUITIES AND TRUSTS PAYABLE 1781214 DEFERRED COMPENSATION PAYABLE 2874858 PAYABLE TO AFFILIATES 1729117 OTHER PAYABLES 29063 6414252 X PART V, LINE 4: SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) AND SEATTLE CHILDREN'S HOSPITAL (SCH) SHARE IN A UNIFIED ENDOWMENT FUND (UEF) THAT IS MANAGED BY SCHS. SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S TEMPORARILY AND PERMANENTLY RESTRICTED ASSETS REFLECT ENDOWMENTS WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL. PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS GRANTED SCHS, AND EACH OF THE CONTROLLED CORPORATIONS LISTED ABOVE, EXEMPTION FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (IRC) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE IRC FORMED TO OPERATE FOR CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND MEDICAL PURPOSES. DURING 2017 AND 2016, SCHS DID NOT RECORD ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 109722366 NORTH AMERICA 0 0 INVESTMENTS 1302106 0 0 0 0 0 0 111024472 0 111024472 1 0 0 0 1 0 PART I, LINE 3: THE ACCRUAL METHOD WAS USED TO ACCOUNT FOR INVESTMENTS. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 JEFF SPERRING MD CEO/NON-VOTING EX OFFICIO TRUSTEE 199205 597615 0 24 2154 22225 128808 9938 6318 18954 336485 648756 0 0 KELLY WALLACE SENIOR VP & CHIEF FINANCIAL OFFICER 126244 378731 63356 190068 260921 61580 78513 13220 5309 15927 534343 659526 259938 0 WARREN HEWITT VP - FINANCE 14299 232948 0 62417 341 40472 0 18550 1285 19266 15925 373653 0 0 LISA HAYWARD SR VP & GENERAL COUNSEL 282811 0 25000 640 7846 437 44838 0 27873 0 388368 1077 0 0 DONNA REINHART DIRECTOR OF TREASURY SERVICES 88353 92827 6622 6790 0 529 6468 6468 9232 9232 110675 115846 0 0 SAMANTHA SLOANE CONTROLLER 9526 144941 2946 24111 0 103 111 1316 627 8584 13210 179055 0 0 THOMAS HANSEN MD CEO THRU MAY 2015 0 186733 0 245686 727972 2239 0 18457 0 9431 727972 462546 727972 0 SANFORD MELZER MD FORMER SR VP-CHIEF STRATEGY OFFICER 0 408997 0 238348 0 65552 68517 18550 0 28358 68517 759805 0 0 JODI LONG FORMER ASSOCIATE GENERAL COUNSEL 0 249695 0 19793 0 554 0 18357 0 15196 0 303595 0 0 PART I, LINE 1A THE CHIEF EXECUTIVE OFFICER IS PROVIDED MEMBERSHIP TO THE RAINIER CLUB. ANNUAL DUES ARE REPORTED AS TAXABLE COMPENSATION. PART I, LINE 4B THE FOLLOWING PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: KELLY WALLACE - $74,106 DEFERRED COMPENSATION, $259,938 REPORTABLE PAYMENT. JEFF SPERRING MD - $125,496 DEFERRED COMPENSATION. LISA HAYWARD - $42,202 DEFERRED COMPENSATION. THOMAS HANSEN MD - $727,972 REPORTABLE PAYMENT. SANFORD MELZER MD - $68,517 DEFERRED COMPENSATION. PART II, COLUMN (F): THE FOLLOWING RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, WHICH IS BEING REPORTED IN COLUMN (B)(III). THIS COMPENSATION WAS REPORTED IN COLUMN (C) IN PRIOR FORMS 990: KELLY WALLACE - $259,938 THOMAS HANSEN MD - $727,972 X 16 190375 MARKET VALUE 0 0 1 1 PART I, COLUMN (B): LINE 9 - 16 CONTRIBUTIONS OF VARIOUS AMOUNTS OF SECURITIES PART I, LINE 32B: SEATTLE CHILDREN'S HOSPITAL FOUNDATION AND SEATTLE CHILDREN'S HOSPITAL GUILD ASSOCIATION (RELATED ORGANIZATIONS) SOLICIT BOTH CASH AND NON-CASH GIFTS ON BEHALF OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS). FORM 990, PART I, LINE 6: 23 MEMBERS OF THE BOARD OF TRUSTEES PERFORM THEIR DUTIES UNCOMPENSATED. FORM 990, PART VI, SECTION A, LINE 2 JEFF SPERRING HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, JOEL BENOLIEL, SUSAN BETCHER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, ROBERT FLOWERS, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, JIM LADD, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, ROB ROSKIN, NANCY SENSENEY, MICHELE SMITH, CHARLES STEVENS, KELLY WALLACE, AND ALVIN WINTERROTH. WARREN HEWITT HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, JOEL BENOLIEL, SUSAN BETCHER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, ROBERT FLOWERS, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, JIM LADD, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, ROB ROSKIN, NANCY SENSENEY, MICHELE SMITH, JEFF SPERRING, CHARLES STEVENS, KELLY WALLACE, AND ALVIN WINTERROTH. KELLY WALLACE HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, JOEL BENOLIEL, SUSAN BETCHER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, ROBERT FLOWERS, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, JIM LADD, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, ROB ROSKIN, NANCY SENSENEY, MICHELE SMITH, CHARLES STEVENS, AND ALVIN WINTERROTH. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT AND INDEPENDENT TAX PROFESSIONALS PRESENT AND REVIEW THE FORM 990 WITH THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF TRUSTEES. AFTER REVIEW BY THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE AND PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE, THE ENTIRE BOARD OF TRUSTEES RECEIVES A COPY OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM REQUIRES AN ANNUAL SURVEY OF ALL BOARD MEMBERS OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM, MEMBERS OF THE MEDICAL LEADERSHIP, STAFF MEMBERS OCCUPYING ROLES WITH A DEGREE OF AUTHORITY AND MEMBERS OF SEATTLE CHILDREN'S HOSPITAL'S PHARMACY AND THERAPEUTICS COMMITTEE. THE SENIOR VICE PRESIDENT/GENERAL COUNSEL OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM, ACTING UNDER THE OVERSIGHT OF THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF TRUSTEES, OVERSEES THE REVIEW OF ALL DISCLOSURES AND ESTABLISHES AND OVERSEES ANY NECESSARY MANAGEMENT PLANS RELATED TO THEM. IN GENERAL, WHEN A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE THEMSELVES FROM PARTICIPATION IN ANY BOARD DISCUSSION OR OTHER DECISION MAKING REGARDING THE TRANSACTION AND REFRAIN FROM VOTING ON OR DECIDING ANY ISSUES RELATING TO THE CONFLICTING INTEREST. ANY PERSON COVERED BY THE POLICY WHO ENGAGES IN CONDUCT THAT VIOLATES THE POLICY OR PURSUES A TRANSACTION OR EVENT FOLLOWING DISAPPROVAL BY THE BOARD OR THE CHIEF EXECUTIVE OFFICER MAY, IN THE DISCRETION OF THE BOARD OR THE CHIEF EXECUTIVE OFFICER IN ACCORDANCE WITH THEIR RESPECTIVE AUTHORITY, BE REMOVED IMMEDIATELY FROM HIS OR HER DUTIES WITH SEATTLE CHILDREN'S HEALTHCARE SYSTEM AND/OR TERMINATED IN HIS OR HER EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION FALLS WITHIN THE PURVIEW OF THE MANAGEMENT DEVELOPMENT AND COMPENSATION COMMITTEE ("MDCC") OF THE BOARD OF TRUSTEES. PURSUANT TO THE BOARD-APPROVED MDCC CHARTER, THE MDCC ENGAGES AN INDEPENDENT THIRD-PARTY CONSULTANT EXPERT IN THE COMPENSATION OF EXECUTIVES AND OTHER TOP MANAGERS OF NONPROFIT HOSPITALS AND HEALTH CARE SYSTEMS. WITH APPROPRIATE COMPARABILITY DATA PROVIDED BY ITS CONSULTANT (COMPRISING MARKET DATA REGARDING COMPENSATION PAID FOR COMPARABLE SERVICES IN COMPARABLE ORGANIZATIONS), THE MDCC ENGAGES IN AN ANNUAL REVIEW AND ASSESSMENT OF THE SEATTLE CHILDREN'S HEALTHCARE SYSTEM EXECUTIVE COMPENSATION PROGRAM (BASE, INCENTIVE COMPENSATION, AND EMPLOYER-PAID BENEFITS) TO DETERMINE COMPETITIVENESS. BASED ON THIS EXPERT ANALYSIS AND ON RELEVANT PERFORMANCE INFORMATION FOR THE EXECUTIVES IN QUESTION AND THE ORGANIZATION AS A WHOLE, THE MDCC PRESENTS A RECOMMENDATION TO THE BOARD REGARDING THE TOTAL COMPENSATION PACKAGE FOR EACH OF THE EFFECTED EXECUTIVES, INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND KEY EMPLOYEES. THE FULL BOARD REVIEWS THE RECOMMENDATIONS AS WELL AS ALL RELEVANT COMPARABILITY DATA AND THE GOALS OF THE ORGANIZATION IN MAKING ITS FINAL DECISION. IN DOING SO IT RELIES ON THE EXPERT ANALYSIS TO DETERMINE THAT COMPENSATION IS REASONABLE AND WITHIN THE "BOUNDS OF COMPETITIVE PRACTICE". ALL DELIBERATIONS AND DECISIONS OF THE MDCC AND FULL BOARD ARE DOCUMENTED IN THE BOOKS AND RECORDS IN ACCORDANCE WITH GENERAL ADMINISTRATIVE PROVISIONS AND PROCEDURES WITHIN THE BYLAWS. THE PROCESS FOLLOWED BY THE MDCC AND THE FULL BOARD SATISFIES BEST GOVERNANCE PRACTICES AND ALSO MEETS THE REGULATORY REQUIREMENTS NECESSARY TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO THE BOARD'S DECISION. FORM 990, PART VI, SECTION C, LINE 19 SEATTLE CHILDREN'S HEALTHCARE SYSTEM MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII: INDIVIDUALS REPORTED AS FORMER OFFICERS, KEY EMPLOYEES, OR HIGHLY COMPENSATED EMPLOYEES OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM ARE NO LONGER CURRENT EMPLOYEES OF THE ORGANIZATION AND THEREFORE NO COMPENSATION IS REPORTED IN PART VII, COLUMN (D). HOWEVER, SINCE THEY WERE REPORTED ON THE ORGANIZATION'S RETURN WITHIN THE LAST FIVE YEARS AND ARE STILL EMPLOYEES AND CONTINUE TO RECEIVE COMPENSATION FROM RELATED ORGANIZATIONS, THEY ARE REQUIRED TO BE DISCLOSED ALONG WITH THEIR COMPENSATION IN PART VII, COLUMNS (E) AND (F). FORM 990, PART IX, COLUMN (D): ALTHOUGH SEATTLE CHILDREN'S HEALTHCARE SYSTEM HAS SUBSTANTIAL CONTRIBUTION REVENUE, IT DOES NOT INCUR FUNDRAISING EXPENSES. ALL FUNDRAISING ACTIVITIES AND CONTRIBUTIONS TO SEATTLE CHILDREN'S HEALTHCARE SYSTEM ARE CONDUCTED BY RELATED ORGANIZATIONS. SEE ADDITIONAL DESCRIPTION FOR SCHEDULE M, LINE 32. FORM 990, PART XI, LINE 9: PERPETUAL TRUST WRITTEN OFF FINANCIAL STATEMENTS -405,060. DISTRIBUTION TO ANNUITANTS -836. 2017/2018 COMMUNITY BENEFIT REPORT LETTER FROM OUR CHIEF EXECUTIVE OFFICER FOR THE FIRST 46 YEARS OF OUR HISTORY, SEATTLE CHILDREN'S WAS LOCATED ATOP QUEEN ANNE HILL, ABOVE THE COMMUNITY WE SERVE. BUT ABOVE HAS NEVER MEANT APART. CARING FOR THE CHILDREN AND FAMILIES IN OUR REGION MEANS WORKING WITH AND WITHIN COMMUNITIES TO CREATE SAFER AND HEALTHIER PLACES TO LIVE. THIS SPIRIT OF OUTREACH LIVES IN OUR MANY PARTNERSHIPS WITH PEOPLE AND ORGANIZATIONS WHO WORK WITH US TO MEET SOME OF THE MOST URGENT HEALTH NEEDS IN OUR REGION. TOGETHER WITH FAMILIES, COMMUNITY-BASED ORGANIZATIONS, DONORS, PUBLIC HEALTH DEPARTMENTS AND OTHERS, SEATTLE CHILDREN'S SEEKS TO: - ENHANCE ACCESS TO MENTAL AND BEHAVIORAL HEALTH. - IMPROVE COORDINATION OF CARE FOR CHILDREN WITH CHRONIC CONDITIONS. - EXPAND ACCESS TO HEALTHY EATING AND ACTIVE LIVING, INCLUDING FIGHTING FOOD INSECURITY. - DECREASE INCIDENTS OF SUICIDE AND INCREASE VIOLENCE PREVENTION ACTIVITIES. I'M PLEASED TO SHARE THE HIGHLIGHTS OF SEATTLE CHILDREN'S COMMUNITY BENEFIT ACTIVITIES OVER THE PAST YEAR. AS YOU TURN THE PAGES OF THIS REPORT, YOU WILL READ ABOUT OUR PARTNERSHIP WITH HIGHLINE PUBLIC SCHOOLS TO INSPIRE CAREERS IN BIOMEDICAL RESEARCH AND HEALTHCARE; A NETWORK THAT UNITES PEOPLE FROM ALL PERSPECTIVES TO ADDRESS FIREARM SAFETY; A MOM'S ENDURING GRATITUDE FOR OUR UNCOMPENSATED CARE PROGRAM; AND MUCH MORE. ALTHOUGH OUR WORK IS FAR FROM DONE, WITH THE SUPPORT OF OUR MANY PARTNERS WE WILL CONTINUE OUR RELENTLESS WORK TO CREATE A HEALTHIER COMMUNITY. SINCERELY, JEFF SPERRING, MD CHIEF EXECUTIVE OFFICER WHAT IS COMMUNITY BENEFIT? A COMMUNITY BENEFIT IS A PROGRAM OR SERVICE THAT MEETS AT LEAST ONE OF THESE OBJECTIVES: - IMPROVES ACCESS TO HEALTHCARE. - ENHANCES THE HEALTH OF THE COMMUNITY. - ADVANCES MEDICAL OR HEALTH KNOWLEDGE. - RELIEVES OR REDUCES THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. COMMUNITY BENEFITS ARE CLASSIFIED AS UNCOMPENSATED CARE, RESEARCH, HEALTH PROFESSIONS EDUCATION AND COMMUNITY HEALTH IMPROVEMENT. COMMUNITY BENEFIT IS ALSO THE BASIS OF THE TAX-EXEMPTION OF NONPROFIT HOSPITALS. TOTAL 2017 INVESTMENT IN THE COMMUNITY: $245,893,000* UNCOMPENSATED CARE & MEDICAID SHORTFALL: $164,605,000 HEALTH PROFESSIONS EDUCATION: $24,802,000 RESEARCH: $44,090,000 COMMUNITY PROGRAMS AND SERVICES: $12,396,000 *DOES NOT INCLUDE GRANTS AND CONTRIBUTIONS SEATTLE CHILDREN'S RECEIVED THAT SUPPORT COMMUNITY BENEFIT PROGRAMS COMMUNITY PROGRAMS AND SERVICES A HOSPITAL CANNOT FULFILL ITS MISSION WORKING ENTIRELY WITHIN ITS WALLS. SEATTLE CHILDREN'S STAFF AND PROVIDERS REACH BEYOND OUR CAMPUS EVERY DAY TO CREATE SAFER AND HEALTHIER COMMUNITIES. IN COLLABORATION WITH OTHERS, WE STRIVE TO PREVENT UNDERLYING CAUSES OF ILLNESS AND INJURY, PROVIDE A VOICE FOR FAMILIES WHO AREN'T ALWAYS HEARD, AND PROMOTE PUBLIC POLICIES THAT IMPROVE CHILD HEALTH. GENDER CLINIC MEETS GROWING NEED A RECENT STUDY SHOWS THE NUMBER OF PEOPLE WHO IDENTIFY AS TRANSGENDER IS GROWING - NOW ABOUT ONE IN EVERY 200 PEOPLE IN THE U.S. THE NEW GENDER CLINIC AT SEATTLE CHILDREN'S IS ONE OF A GROWING NUMBER OF PEDIATRIC CLINICS AROUND THE COUNTRY THAT PROVIDE GENDER-AFFIRMING TREATMENT FOR YOUNG PEOPLE WHOSE GENDER IDENTITY IS DIFFERENT FROM THEIR SEX ASSIGNED AT BIRTH. THE CLINIC RECEIVED 550 REFERRALS IN ITS FIRST YEAR OF OPENING. FEW PEDIATRIC PROVIDERS ARE PREPARED TO MEET ALL OF THE COMPLEX NEEDS OF TRANSGENDER YOUTH. LED BY DR. DAVID INWARDS-BRELAND, THE GENDER CLINIC BRINGS TOGETHER PROVIDERS WITH EXPERTISE IN ADOLESCENT MEDICINE, ENDOCRINOLOGY AND BEHAVIORAL MEDICINE WHO WORK CLOSELY TO COORDINATE CARE AND FOLLOW CONSISTENT GUIDELINES. SERVICES INCLUDE READINESS DISCUSSION, PUBERTAL BLOCKERS AND CROSS-SEX HORMONES. REQUESTS FOR SURGERY ARE REFERRED TO EXTERNAL PROVIDERS. TRANSGENDER YOUTH EXPERIENCE HIGHER RATES OF ANXIETY, DEPRESSION, SUBSTANCE ABUSE AND SUICIDE THAN THEIR PEERS. RESEARCH SHOWS THAT DELAYS IN OBTAINING GENDER-AFFIRMING TREATMENT ARE LINKED TO FURTHER PSYCHIATRIC PROBLEMS DOWN THE ROAD. THAT'S WHY THE GENDER CLINIC IS SUCH AN IMPORTANT STEP FORWARD, SAYS INWARDS-BRELAND. "BY MEDICALLY AFFIRMING THEIR GENDER IDENTITY, WE CAN MAKE A DIFFERENCE FOR THESE KIDS," HE SAYS. PUTTING RESEARCH INTO SCHOOLS HIGH SCHOOL STUDENTS AT THE PUGET SOUND SKILLS CENTER (PSSC) IN THE HIGHLINE SCHOOL DISTRICT ARE EXPERIENCING FIRST-HAND THE RESEARCH DONE AT SEATTLE CHILDREN'S RESEARCH INSTITUTE. DR. AMANDA JONES, DIRECTOR OF OUR SCIENCE EDUCATION DEPARTMENT, COLLABORATED WITH A SCIENCE, TECHNOLOGY, ENGINEERING AND MATH (STEM) SPECIALIST AT THE SCHOOL DISTRICT TO CREATE THE BIOMEDICAL RESEARCH AND GLOBAL HEALTH PROGRAM - PART OF A PLAN TO BUILD A PIPELINE OF SCIENCE EDUCATION PROGRAMS THAT SPANS ELEMENTARY SCHOOL THROUGH COLLEGE. DR. NOELLE MACHNIKI, A MEMBER OF THE INSTITUTE'S SCIENCE EDUCATION DEPARTMENT, TEACHES THE YEAR-LONG PROGRAM, HELD IN THE PSSC'S NEW HEALTH SCIENCES BUILDING. THE PSSC DRAWS STUDENTS FROM 22 HIGH SCHOOLS IN THE HIGHLINE, FEDERAL WAY, TUKWILA AND TAHOMA SCHOOL DISTRICTS. THE 19 STUDENTS ENROLLED IN THE PROGRAM MEET IN A LAB WITH STATE-OF-THE-ART EQUIPMENT RARELY SEEN OUTSIDE A PROFESSIONAL FACILITY. THE CURRICULUM IS BASED ON THE CUTTING-EDGE RESEARCH DONE AT THE INSTITUTE. BY BUILDING A STRONG FOUNDATION IN BIOLOGICAL AND LABORATORY SCIENCES AND ADDRESSING EMERGING TECHNOLOGIES, THE PROGRAM PREPARES STUDENTS FOR MANY CAREER OPPORTUNITIES IN BIOMEDICAL RESEARCH AND HEALTHCARE. "A CAREER IN RESEARCH OR HEALTH SCIENCES CAN SEEM INTIMIDATING BECAUSE THE PATHWAY ISN'T ALWAYS CLEAR," MACHNICKI SAYS. "MY HOPE IS THAT STUDENTS SEE SCIENCE AS A VIABLE CAREER OPTION AND HAVE THE CONFIDENCE TO PURSUE A HIGHER DEGREE IN STEM OR APPLY FOR AN ENTRY LEVEL LAB POSITION." RESEARCH RESEARCH IS AN ESSENTIAL PART OF OUR MISSION TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. WE'RE COMMITTED TO TRANSLATING OUR DISCOVERIES INTO NEW AND BETTER THERAPIES SO THAT ALL OF OUR PATIENTS - AND CHILDREN AROUND THE WORLD - BENEFIT FROM OUR WORK. DIET QUELLS CROHN'S WITHOUT MEDS INFLAMMATORY BOWEL DISEASE (IBD), BOTH CROHN'S AND ULCERATIVE COLITIS, STRIKES WHEN THE IMMUNE SYSTEM ATTACKS THE DIGESTIVE TRACT. THIS CAN SAP A CHILD'S ENERGY, HALT GROWTH AND SPARK INCESSANT DIARRHEA. STANDARD TREATMENT FOR INFLAMMATORY BOWEL DISEASE INCLUDES MEDICATIONS THAT SUPPRESS THE IMMUNE SYSTEM. BUT THOSE MEDICATIONS DON'T ALWAYS WORK AND CAN LEAVE PATIENTS VULNERABLE TO INFECTIONS AND OTHER SERIOUS CONDITIONS. DR. DAVID SUSKIND IS LEADING RESEARCH ON THE SPECIFIC CARBOHYDRATE DIET (SCD), WHICH HAS HELPED SOME PATIENTS ACHIEVE REMISSION WITHOUT MEDICATION. "THE SCD IS A WHOLE FOODS DIET WHICH ELIMINATES GRAINS, MOST MILK PRODUCTS AND SWEETENERS OUTSIDE OF HONEY. MANY OF OUR PATIENTS HAVE HAD SUCCESS WITH IT, HOWEVER WE ARE STILL RESEARCHING DIFFERENT COMBINATIONS OF FOODS TO IMPROVE PATIENTS' OUTCOMES," SUSKIND SAYS. "WE WANT TO HELP MORE CHILDREN WHO SUFFER FROM IBD LEAD HEALTHY ACTIVE LIVES AND POTENTIALLY FIND ANSWERS WHICH WILL LEAD TO A CURE." SUSKIND IS CONDUCTING A STUDY WHICH EXAMINES THE EFFECT OF DIFFERENT VERSIONS OF THE SCD IN PATIENTS WITH IBD. IN ADDITION, PATIENTS' GUT BACTERIA ARE BEING EXAMINED BEFORE AND AFTER THE DIET. THIS COULD HELP HIS TEAM PINPOINT WHICH SPECIFIC BACTERIA CONTRIBUTE TO IBD. "WE'RE HOPING TO SHOW EXACTLY HOW THE DIET CHANGES THE MICROBIOME AND QUIETS DOWN THE IMMUNE SYSTEM," SUSKIND SAYS. "THIS RESEARCH HAS IMPLICATIONS NOT ONLY FOR IBD BUT ALSO MANY OTHER DISEASES WHICH ARE TRIGGERED BY THE FECAL MICROBIOME." BETTER DIETS THROUGH DATA FOR REFUGEES BETWEEN 2,000 AND 3,000 REFUGEES SETTLE IN WASHINGTON EVERY YEAR - NEARLY HALF UNDER THE AGE OF 20. MANY ARRIVE WITH AT LEAST ONE FORM OF MALNUTRITION. DR. BETH DAWSON-HAHN IS WORKING TO BETTER UNDERSTAND THE NUTRITIONAL RISKS OF CHILD REFUGEES WHEN THEY ARRIVE, HOW THEY CHANGE AS THEY GET USED TO THEIR NEW ENVIRONMENT, AND HOW TO TEACH REFUGEE FAMILIES ABOUT BUYING AND PREPARING HEALTHY FOOD THEY MAY NEVER HAVE TRIED BEFORE. DAWSON-HAHN CO-LED A STUDY THAT ANALYZED GOVERNMENT HEIGHT AND WEIGHT DATA COLLECTED FROM REFUGEES BEFORE THEY LEAVE THEIR HOME COUNTRY. "WE FOUND THAT NEARLY ONE-HALF OF ALL REFUGEE CHILDREN HAD AT LEAST ONE FORM OF MALNUTRITION, AND THERE WAS, AS WE SUSPECTED, A DOUBLE BURDEN OF SOME CHILDREN BEING UNDERWEIGHT AND OTHERS BEING OVERWEIGHT," SHE SAYS. DATA FROM THE STUDY WILL HELP HEALTHCARE PROVIDERS AND NUTRITION PROGRAMS LIKE WOMEN, INFANT AND CHILDREN (WIC) UNDERSTAND THE DIFFERENCES AND SIMILARITIES BETWEEN REFUGEES FROM DIFFERENT COUNTRIES - AND BETWEEN CHILDREN WHO ALREADY LIVE HERE. "IN A BUSY CLINIC, IT'S EASY FOR PROVIDERS TO LUMP ALL REFUGEES TOGETHER, NOT NECESSARILY KNOWING THAT IRAQI CHILDREN MIGHT BE MORE LIKELY TO BE OVERWEIGHT THAN CHILDREN FROM BURMA, FOR EXAMPLE," DAWSON-HAHN SAYS. HEALTH PROFESSIONS EDUCATION TRAINING DOCTORS AND NURSES IS AN INVESTMENT IN THE HEALTH OF FUTURE GENERATIONS. BY HOSTING THE UNIVERSITY OF WASHINGTON'S PEDIATRIC RESIDENCY AND FELLOWSHIP PROGRAMS AS WELL AS TRAINING PROVIDERS FROM OTHER SCHOOLS, SEATTLE CHILDREN'S ENSURES CONTINUED ACCESS TO SPECIALIZED PEDIATRIC CARE. WE ALSO PROVIDE CONTINUING MEDICAL EDUCATION TO HUNDREDS OF HEALTHCARE PROFESSIONALS ALREADY CARING FOR KIDS IN THE COMMUNITY. PROVIDING SPECIALIZED EXPERIENCE THE ADVANCED PRACTICE PROVIDER (APP) FELLOWSHIP PROGRAM AT SEATTLE CHILDREN'S PROVIDES SPECIALIZED TRAINING TO NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS WHO ARE NEW TO WORKING WITH PEDIATRIC PATIENTS IN THE APP ROLE. "NURSE PRACTITIONERS COME OUT OF SCHOOL WITH A LOT OF KNOWLEDGE, BUT THE MAJORITY OF NEW HIRES ARE NEW GRADUATES OR HAVE NO EXPERIENCE IN THE SPECIALTY IN WHICH WE HIRED THEM," SAYS RONNA SMITH, DIRECTOR OF THE APP FELLOWSHIP PROGRAM. DURING THE ONE-YEAR PROGRAM, FELLOWS SPEND 70% OF THEIR TIME PROVIDING CLINICAL CARE ALONGSIDE AN EXPERIENCED NURSE PRACTITIONER, 20% OF THEIR TIME OBSERVING IN A CLINICAL AREA AND 10% OF THEIR TIME ATTENDING A WEEKLY LECTURE SERIES. THE GOAL IS TO HIRE THE FELLOWS BY THE END OF THE PROGRAM. KAITLIN HOBAN SPENT SIX YEARS AS A REGISTERED NURSE AT CHILDREN'S BEFORE BECOMING A NURSE PRACTITIONER AND JOINING THE FIRST COHORT OF FOUR AAP FELLOWS. "THE GREATEST PART OF THE PROGRAM IS THAT I AM EXPECTED TO BE A LEARNER AND TO ASK QUESTIONS," HOBAN SAYS. "THE FELLOWSHIP IS PUSHING US TO BE INDEPENDENT WHILE LEARNING AS MUCH AS WE CAN FROM AS MANY DIFFERENT SERVICES TO MAKE US MORE WELL-ROUNDED." ELISE COLE, A CERTIFIED NURSING ASSISTANT ON THE MEDICAL UNIT TALKS WITH CHRISTINA FINCH, A NURSING PROFESSIONAL DEVELOPMENT SPECIALIST WITH THE NURSE RESIDENCY PROGRAM. SUPPORTING FIRST-YEAR NURSES STARTING A NEW CAREER IS NEVER EASY, BUT WHEN THE JOB INVOLVES CARING FOR SERIOUSLY ILL CHILDREN, IT CAN BE ESPECIALLY CHALLENGING. THAT'S WHY SEATTLE CHILDREN'S LAUNCHED A NEW NURSE RESIDENCY PROGRAM FOR REGISTERED NURSES HIRED WITH LESS THAN ONE YEAR OF EXPERIENCE. "WHEN YOU'RE STARTING OFF AS A NURSE, YOU NEED TO BE IN A PLACE WHERE YOU CAN SAY THAT YOU DON'T KNOW SOMETHING, ADMIT ERRORS AND PULL IN OTHERS FOR SUPPORT," SAYS TAMARA LEWIS, WHO WAS PART OF THE PROGRAM'S FIRST CLASS OF 42 NURSES. HAVING PEERS GOING THROUGH THE EXPERIENCE WITH YOU IS ALSO VITALLY IMPORTANT." NURSES ATTEND 21 FOUR-HOUR CLASSES WHERE THEY WORK ON DIFFERENT SKILLS, RUN THROUGH CASE SCENARIOS, LEARN ABOUT POLICIES AND PROCEDURES, LISTEN TO SPEAKERS, AND PARTICIPATE IN SIMULATION TRAINING. NURSES ALSO DISCUSS COPING SKILLS FOR DEALING WITH THE EMOTIONS THAT CAN ARISE FROM CARING FOR KIDS WITH LIFE-THREATENING CONDITIONS. "MANY NURSES COME IN AND THEY'RE SUPER EXCITED AND TERRIFIED AT THE SAME TIME," SAYS STEPHANIE POMMER, MANAGER OF THE PROGRAM. "IT IS THE RIGHT THING TO DO TO HELP NEW GRADS DEVELOP THEIR KNOWLEDGE, BUILD THEIR SKILLS AND WALK BESIDE THEM IN WHAT CAN BE A REALLY CHALLENGING FIRST YEAR ON THE JOB." UNCOMPENSATED CARE THE COST OF MEDICAL CARE SHOULD NEVER STAND BETWEEN A CHILD AND THEIR ABILITY TO LIVE THE HEALTHIEST AND MOST FULFILLING LIFE POSSIBLE. OUR FINANCIAL ASSISTANCE PROGRAM HONORS OUR FOUNDING PROMISE TO CARE FOR EVERY CHILD WHO NEEDS US REGARDLESS OF A FAMILY'S ABILITY TO PAY. IN 2017 WE PROVIDED OVER $164 MILLION IN UNCOMPENSATED CARE TO CHILDREN IN WASHINGTON, ALASKA, MONTANA AND IDAHO. REPAYING A DEBT OF GRATITUDE WITHIN THE NEATLY WRITTEN LEDGER DETAILING THE COST TO SAVE A LIFE, ONE NUMBER STANDS OUT TO DARCY SIEPAK - $2,096.34. THAT WAS THE AMOUNT OF THE BILL FROM SEATTLE CHILDREN'S THAT INSURANCE DID NOT COVER 42 YEARS AGO WHEN DARCY'S DAUGHTER WAS BORN THREE MONTHS PREMATURE AND THEN 10 WEEKS LATER - ONLY DAYS AFTER GOING HOME - NEEDED EMERGENCY HEART SURGERY. ONCE THE CHILD RECOVERED SHE WAS FREE TO GO HOME FOR GOOD. BUT AFTER MONTHS IN THE HOSPITAL AND A MAJOR SURGERY, DARCY, WHO ALSO HAD A TODDLER, WAS WORRIED THE FAMILY WOULD HAVE TO SELL THEIR HOUSE TO PAY THE MEDICAL BILLS. THE STRESS DISAPPEARED WHEN CHILDREN'S SAID THEY WOULD COVER WHAT SHE OWED. "THE ENTIRE TIME WE WERE IN THE HOSPITAL, EVERYONE MADE US FEEL LIKE ALL WE NEEDED TO CONCENTRATE ON WAS OUR DAUGHTER," DARCY RECALLS. AND AFTER ALL WE'D BEEN THROUGH, IT WAS SUCH A RELIEF TO KNOW WE COULD STAY IN OUR HOME. NOT LONG AGO DARCY CAME ACROSS THE LEDGER WITH HER DAUGHTER'S DOCTOR BILLS AND PAYMENTS - INCLUDING THE AMOUNT CHILDREN'S COVERED. "I ALWAYS FELT THAT IF SOMEONE WAS GOOD ENOUGH TO GIVE ME A GIFT, I SHOULD GIVE IT BACK IF I CAN." SHE SAYS. "WHEN I SAW THE LEDGER, I THOUGHT NOW'S THE TIME. I'M GOING TO PAY IT BACK." CLINIC'S ONE-STOP CARE IS A 'LIFESAVER' MARVA HARRIS IS THE GRANDMOTHER OF TWO GROWING BOYS, BUT SHE'S ALSO THEIR GUARDIAN AND SOLE PROVIDER AND WORKS AS A MIDDLE SCHOOL SECURITY OFFICER. THAT'S A LOT FOR ONE PERSON TO HAVE ON THEIR PLATE, BUT MARVA ISN'T ALONE IN HELPING HER GRANDSONS GROW UP STRONG AND HEALTHY. THE ODESSA BROWN CHILDREN'S CLINIC (OBCC) PROVIDES A WIDE RANGE OF MEDICAL, DENTAL AND MENTAL HEALTH CARE THAT HELPS HARRIS'S ELDEST GRANDSON, 14, AND HER YOUNGER GRANDSON, 4, THRIVE. "I CALL IT ONE-STOP SHOPPING AND THAT'S BEEN A LIFESAVER FOR ME," SAID MARVA, WHO IS 62. "WITH MY JOB, IT'S ALMOST IMPOSSIBLE TO GET AWAY FROM WORK. I DON'T KNOW WHAT I'D DO IF I HAD TO RUN ALL OVER THE CITY TO TAKE THE BOYS TO DIFFERENT DOCTORS' OFFICES." THE OBCC IS A COMMUNITY CLINIC OPERATED BY SEATTLE CHILDREN'S THAT SERVES FAMILIES REGARDLESS OF THEIR ABILITY TO PAY. BESIDES OFFERING NUMEROUS SERVICES UNDER ONE ROOF, IT BUILDS A BRIDGE OF PERSONAL COMPASSION BETWEEN FAMILIES AND CLINIC PROVIDERS. "WHEN WE COME FOR CHECKUPS, DR. SHAQUITA BELL ALWAYS ASKS ME, 'MARVA, HOW ARE YOU DOING? WHAT DO YOU NEED?' THE FIRST TIME SHE SAID THAT, I FELL IN LOVE WITH HER," MARVA RECALLED. "SHE'S NOT ONLY CONCERNED ABOUT THE BOYS, SHE'S CONCERNED ABOUT ME. THE RAPPORT I HAVE WITH DR. BELL AND THE SUPPORT SHE OFFERS MEAN THE WORLD TO ME." OUR COMMUNITY BENEFIT PRIORITIES OUR 2016-2019 COMMUNITY HEALTH ASSESSMENT IDENTIFIES FOUR URGENT HEALTH NEEDS FOR THE CHILDREN, TEENS AND FAMILIES WE SERVE. WORKING WITH OUR PARTNERS IN THE COMMUNITY, WE MADE SIGNIFICANT PROGRESS IN EACH OF THE FOUR PRIORITY AREAS. HERE ARE SOME OF OUR ACCOMPLISHMENTS. HEALTHY EATING, ACTIVE LIVING AND FOOD SECURITY GROWING BODIES NEED NUTRITION AND EXERCISE TO THRIVE AND DEVELOP. WE WORK WITH FAMILIES AND PARTNERS IN THE COMMUNITY TO FIGHT HUNGER, IMPROVE ACCESS TO NUTRITIOUS FOOD AND INCREASE OPPORTUNITIES FOR CHILDREN AND FAMILIES TO BE PHYSICALLY ACTIVE. HELPING FAMILIES ACT! HEALTHY CHILDREN ARE BORN IMITATORS. IF THE REST OF THE FAMILY EATS WELL, THEY ARE MORE LIKELY TO EAT WELL. IF THE REST OF THE FAMILY PLAYS MORE, THEY ARE MORE LIKELY TO DO THE SAME. THAT'S THE PREMISE BEHIND ACTIVELY CHANGING TOGETHER (ACT!), A NUTRITION AND EXERCISE PROGRAM FOR OBESE AND OVERWEIGHT CHILDREN THAT ENGAGES THE ENTIRE FAMILY IN ACTIVITIES THAT FIGHT OBESITY BY HELPING FAMILIES SHARE A HEALTHIER LIFESTYLE. SPONSORED BY SEATTLE CHILDREN'S AND THE YMCA, THE PROGRAM IS OFFERED IN 20 LOCATIONS RANGING FROM OLYMPIA TO MARYSVILLE TO YAKIMA AND HAS HELPED HUNDREDS OF CHILDREN AND THEIR FAMILIES SINCE IT STARTED IN 2004. CHILDREN WHOSE BODY MASS INDEX EXCEEDS THE 85TH PERCENTILE ARE REFERRED TO ACT! BY THEIR HEALTHCARE PROVIDERS. THEY AND THEIR FAMILIES ATTEND 12-WEEKLY SESSIONS AND GET FREE YMCA MEMBERSHIPS TO USE BETWEEN SESSIONS DURING THAT TIME. LED BY A NUTRITIONIST AND A PHYSICAL ACTIVITY COACH, THE 90-MINUTE SESSIONS - OFFERED IN THE FALL AND WINTER - TEACH CHILDREN AND FAMILIES HOW TO READ FOOD LABELS AND PREPARE HEALTHY/LOW-COST SNACKS WHILE INTRODUCING THEM TO A WIDE RANGE OF ACTIVITIES FROM SWIMMING TO WEIGHTLIFTING TO KARATE. ATHLETIC TRAINERS KEEP KIDS SAFELY IN THE GAME SPORTS ARE A FUN AND HEALTHY WAY FOR CHILDREN TO STAY ACTIVE, BUT THERE IS ALWAYS THE RISK OF INJURY. YOUNG ATHLETES FROM 39 LOCAL SCHOOLS COUNT ON A TEAM OF 48 LICENSED ATHLETIC TRAINERS FROM SEATTLE CHILDREN'S TO PREVENT, TREAT AND RECOVER FROM SPORTS INJURIES. THE ATHLETIC TRAINERS WORK ON CAMPUS. IN ADDITION TO DEALING WITH INJURIES, THEY ADVISE ATHLETES, COACHES AND PARENTS ABOUT NUTRITION, CONDITIONING, AND OTHER STRATEGIES TO IMPROVE BOTH PERFORMANCE AND SAFETY. "PEOPLE SEE US ON THE SIDELINES AND THINK OF US AS THE INDIVIDUALS WHO GIVE WATER TO ATHLETES," SAYS TARA PEERENBOOM, WHO IS THE ATHLETIC TRAINER AT HAZEN HIGH SCHOOL IN RENTON. "THEY DON'T SEE THE TIME WE SPEND IN THE ATHLETIC TRAINING ROOM BEFORE, AFTER, AND DURING A GAME OR PRACTICE. WE'RE NOT JUST MEDICAL PROVIDERS. OUR ATHLETES TRUST US, AND WE'RE THERE FOR THEM DURING DIFFICULT TIMES." THE ATHLETIC TRAINERS PUT THE HEALTH OF CHILDREN FIRST, BUT STRIVE TO MINIMIZE TIME LOST TO INJURY. "IF A LOT OF MY ATHLETES ARE NOT ABLE TO PARTICIPATE IN THEIR SPORT, THEN I'M NOT DOING A VERY GOOD JOB," PEERENBOOM SAYS. "OUR GOAL IS TO KEEP KIDS HEALTHY AND ON THE FIELD." COORDINATED CARE FOR CHILDREN AND TEENS WITH CHRONIC CONDITIONS CONNECTING CHILDREN WITH THE CARE THEY NEED REQUIRES COORDINATION AMONG PROVIDERS INSIDE THE HOSPITAL AND BETWEEN THE HOSPITAL AND THE COMMUNITY - ESPECIALLY IF A CHILD HAS A COMPLEX CHRONIC CONDITION. SEATTLE CHILDREN'S STRIVES TO IDENTIFY CHILDREN WITH MEDICAL COMPLEXITY, COORDINATE THEIR CARE ACROSS ALL SERVICES AND SUPPORT THEIR TRANSITION TO ADULT CARE TO HELP THEM REACH THEIR FULL POTENTIAL. CENTER CONNECTS TEENS TO CARE OUR ODESSA BROWN CHILDREN'S CLINIC (OBCC) OPERATES A FREE TEEN HEALTH CENTER AT GARFIELD HIGH SCHOOL. OPEN DURING SCHOOL HOURS, THE CENTER PROVIDES STUDENTS FROM GARFIELD AND NOVA HIGH SCHOOL WITH COORDINATED MEDICAL, NUTRITIONAL, AND MENTAL HEALTH SERVICES WHILE PROMOTING HOW TO LIVE HEALTHIER LIFESTYLES THROUGH EDUCATION AND COUNSELING. A TEAM OF SEATTLE CHILDREN'S PROVIDERS WORKS AT THE CENTER. A NURSE PRACTITIONER PROVIDES CARE FIVE DAYS A WEEK WHILE A MENTAL HEALTH SPECIALIST, A NUTRITIONIST, AND A PSYCHIATRIST SEE STUDENTS ON VARIOUS OTHER DAYS. IN CONSULTATION WITH THE SCHOOL NURSE, THE TEEN HEALTH CENTER OFFERS BASIC CARE TO STUDENTS BASED ON PARENTAL CONSENT - EVERYTHING FROM VACCINES TO SPORTS PHYSICALS TO TREATING SPRAINED ANKLES. THE CENTER ALSO PROVIDES CONFIDENTIAL MENTAL HEALTH AND REPRODUCTIVE SERVICES. IF A STUDENT'S NEEDS CANNOT BE MET ON SITE, THE CENTER CONNECTS THEM WITH THE OBCC OR PUBLIC HEALTH - SEATTLE & KING COUNTY. "WITHOUT US, STUDENTS MIGHT NOT KNOW WHAT TO DO OR WHERE TO GO FOR THE HELP THEY NEED," SAYS JAHTIA BENTON, CENTER COORDINATOR. HIGH SCHOOL CAN BE FULL OF UPS AND DOWNS. SOMETIMES THE ONLY THING STUDENTS WANT IS A FEW MINUTES TO CHILL IN THE TEEN HEALTH CENTER'S WELCOMING ENVIRONMENT. "THEY APPRECIATE THE CENTER A LOT," BENTON SAYS. "THEY ALWAYS SAY HOW GRATEFUL THEY ARE FOR HAVING A SAFE SPACE. THEY CAN COME HERE WITHOUT BEING JUDGED." TRANSITIONING TO ADULT CARE WHEN AN ADOLESCENT WITH A CHRONIC ILLNESS OUTGROWS PEDIATRIC CARE, THE NEXT STEP - THE TRANSITION TO ADULT CARE - CAN FEEL LIKE A GIANT LEAP. "ADULT CARE IS A TOTALLY DIFFERENT WORLD," SAYS PARENT LISA PETKE. PETKE WAS ONE OF EIGHT FAMILY MEMBERS OF SEATTLE CHILDREN'S PATIENTS WHO HELPED MAKE THE LEAP LESS DAUNTING THROUGH THEIR WORK ON THE ADOLESCENT TRANSITION TASK FORCE. PETKE HAS BEEN A FOSTER PARENT TO A CHILD WHO HAS MULTIPLE DISABILITIES, SINCE THE CHILD WAS 8. THIS CHILD'S TRANSITION TO ADULT CARE WAS FILLED WITH UNKNOWNS, PETKE RECALLS. "WE WERE GIVEN THE NAMES OF SOME ADULT DOCTORS AND THAT WAS THE WHOLE PROCESS," SHE RECALLS. "I DON'T EVEN KNOW WHAT QUESTIONS TO ASK." FAMILIES TODAY HAVE ACCESS TO MUCH MORE INFORMATION THANKS TO A CHECKLIST OF QUESTIONS AND A GUIDE TO HELPFUL RESOURCES DEVELOPED BY THE TASK FORCE AND POSTED ON THE CHILDREN'S WEBSITE. "IT PUTS KEY CONCERNS ON THEIR RADAR LIKE HOW DO I TEACH MY TEEN TO MANAGE THEIR OWN CARE AND WHAT ELEMENTS OF THEIR MEDICAL RECORD ARE CRITICAL FOR NEW PROVIDERS TO KNOW," SAID JOY GEHNER, A SENIOR FAMILY ADVISOR AT CHILDREN'S. IT WON'T BE TOO LONG BEFORE PETKE EXPERIENCES THE TRANSITION TO ADULT CARE ONCE AGAIN, THIS TIME WITH HER SON, CURRENTLY 15, WHO IS LIVING WITH THE CHRONIC SIDE EFFECTS OF CHEMOTHERAPY AND RADIATION TO TREAT BRAIN AND SPINAL TUMORS. "WITH MY FIRST CHILD, I DIDN'T KNOW HOW TO PREPARE. NOW, I'M VERY AWARE OF WHAT TO EXPECT WITH MY SON AND NOT SO ANXIOUS," PETKE SAYS. SUICIDE AND VIOLENCE PREVENTION A CHILD OR TEEN IS KILLED BY GUNFIRE EVERY NINE DAYS IN WASHINGTON. AN AVERAGE OF TWO YOUTH DIE BY SUICIDE EACH WEEK - ONE THIRD THROUGH THE USE OF A FIREARM. SEATTLE CHILDREN'S WORKS TO PROMOTE FIREARM SAFETY AND ADDRESS THE UNDERLYING CAUSES OF YOUTH VIOLENCE AND SUICIDE. UNITING AROUND FIREARM SAFETY FOUNDED IN PART BY SEATTLE CHILDREN'S, THE WASHINGTON STATE FIREARM TRAGEDY PREVENTION NETWORK HAS MET FOUR TIMES SINCE IT WAS FORMED IN 2016 TO PROVIDE A FORUM FOR INDIVIDUALS AND ORGANIZATIONS FROM EVERY PERSPECTIVE TO DISCUSS AND SHARE SOLUTIONS TO FIREARM TRAGEDY. "THE BIG WIN IS BRINGING EVERYONE TOGETHER TO TALK ABOUT OUR SHARED GOALS AROUND KEEPING CHILDREN AND FAMILIES SAFE," SAYS NETWORK COORDINATOR CHELSIE GALLAGHER OF SEATTLE CHILDREN'S. "WE APPROACH FIREARM TRAGEDY PREVENTION FROM A SAFETY, LEARNING, SHARING AND COLLABORATING PERSPECTIVE. THE RESPONSE HAS BEEN INCREDIBLE." CHILDREN'S CO-LEADS THE NETWORK ALONG WITH PUBLIC HEALTH - SEATTLE & KING COUNTY, THE HARBORVIEW INJURY PREVENTION AND RESEARCH CENTER AND THE WASHINGTON CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS. LEARNING TO COMMUNICATE FIREARM SAFETY MESSAGES EFFECTIVELY IS AN IMPORTANT FOCUS. "IF YOU ARE GOING TO MESSAGE TO PEOPLE WHO OWN FIREARMS, YOU HAVE TO APPROACH IT FROM A LENS OF UNDERSTANDING AND CULTURAL ACCEPTANCE," GALLAGHER SAYS. IDENTIFYING EVIDENCE-BASED PROGRAMS THAT PROMOTE FIREARM SAFETY IS ANOTHER PRIORITY. "ONE EXAMPLE IS THE SEATTLE CHILDREN'S COMMUNITY SAFE FIREARM STORAGE GIVEAWAY WHERE WE TRAVEL AROUND THE STATE GIVING OUT FREE LOCK BOXES AND TRIGGER LOCKS AND EDUCATING PEOPLE ON HOW TO USE THEM," GALLAGHER SAYS. "WE'VE EVALUATED THAT PROGRAM AND THE EVIDENCE SHOWS THAT PEOPLE ARE USING THE DEVICES AFTER ATTENDING AN EVENT." WORKING TO REDUCE SUICIDE RISK A 2013 SURVEY BY THE CENTERS FOR DISEASE CONTROL FOUND THAT MORE THAN 13% OF TEENS NATIONWIDE SERIOUSLY CONSIDERED SUICIDE IN THE PREVIOUS 12 MONTHS. MORE THAN 10% MADE A PLAN, 8% ATTEMPTED SUICIDE, NEARLY 4% NEEDED MEDICAL ATTENTION AND ONE IN 1,000 DIED. THE SURVEY ALSO SHOWED THAT 15% OF TEENS HAD AT LEAST ONE EPISODE OF NON-SUICIDAL SELF INJURY. IN WASHINGTON STATE, SUICIDE IS THE SECOND LEADING CAUSE OF INJURY DEATH TO YOUTH AGES 10 TO 24. BETWEEN 2009 AND 2013, AN AVERAGE OF TWO YOUTH DIED BY SUICIDE EACH WEEK ACROSS THE STATE. DR. ELIZABETH MCCAULEY IS EXAMINING THE EFFECTIVENESS OF TWO APPROACHES TO REDUCING THE RISK OF SELF-HARM OR SUICIDE AMONG YOUTH. ONE APPROACH FOCUSES ON ENHANCING SUPPORT AND THE OTHER ON DEVELOPING COPING SKILLS TO REDUCE DISTRESS AND SOLVE PROBLEMS. RESEARCH HAS SHOWN THAT ONE IN FIVE TEENS WILL GO THROUGH A PERIOD OF MAJOR DEPRESSION - A LEADING RISK FACTOR FOR SELF-HARM AND SUICIDE - BY THE AGE OF 18. OTHER RISK FACTORS RANGE FROM ANXIETY TO FAMILY STRIFE TO SUBSTANCE ABUSE. TO DATE, THERE ARE NO PROVEN INTERVENTIONS TO REDUCE SUICIDE RISK, SO STUDY FINDINGS HOLD GREAT PROMISE FOR INCREASING USEFUL STRATEGIES FOR WORKING WITH THESE HIGH-RISK YOUTH. MENTAL AND BEHAVIORAL HEALTH PHYSICAL AND MENTAL HEALTH GO HAND IN HAND IN HELPING CHILDREN GROW AND DEVELOP TO THEIR FULL POTENTIAL. OUR MENTAL AND BEHAVIORAL HEALTH EXPERTS WORK TO UNDERSTAND AND TREAT THE CAUSES OF CONDITIONS LIKE DEPRESSION AND ADDICTION WHILE EXPANDING THE COMMUNITY'S CAPACITY TO SERVE MORE FAMILIES THROUGH EDUCATION, RESEARCH AND CARE COORDINATION. PEARL GUIDES ADHD TREATMENT MANY CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) OR RELATED BEHAVIOR CHALLENGES GET DIAGNOSIS AND MEDICINE FROM THEIR PRIMARY CARE PROVIDER. BUT SOME HAVE SUBTLE ADHD THAT IS HARD TO DIAGNOSE OR THAT IS COMPLICATED BY OTHER ISSUES. THE PROGRAM TO ENHANCE ATTENTION, REGULATION AND LEARNING (PEARL) AT SEATTLE CHILDREN'S HELPS THOSE CHILDREN AND THEIR FAMILIES BY PROVIDING THOROUGH EVALUATIONS THAT CAN GUIDE THE TREATMENT OF LEARNING, ATTENTION AND BEHAVIOR PROBLEMS. THE CLINIC SERVED MORE THAN 700 CHILDREN AGES 5 AND OLDER IN 2017. BESIDES EXPERT DIAGNOSIS, PEARL OFFERS GROUP TREATMENT PROGRAMS THAT TEACH FAMILIES SKILLS TO MANAGE THE MANY ISSUES THAT STEM FROM DISRUPTIVE BEHAVIOR DISORDERS AT HOME, SCHOOL AND ELSEWHERE. ONE PROGRAM SERVES PARENTS OF YOUNG CHILDREN, ONE SERVES ADOLESCENTS AND ONE - NEW LAST YEAR - SERVES PARENTS OF ADOLESCENTS. "PARENTS OF TEENS TOLD US THEY COULDN'T FIND HELP IN THE COMMUNITY FOR ADDRESSING THE DAILY STRESS THEY AND THEIR CHILDREN FACE," SAID ERIN SCHOENFELDER GONZALEZ, DIRECTOR OF BEHAVIORAL TREATMENTS FOR THE CLINIC. "WHEN PARENTS GET FRUSTRATED, KIDS FEEL LIKE EVERYONE IS ANGRY WITH THEM AND IT BECOMES A NEGATIVE CYCLE THAT CAN GET FAMILIES IN A VERY STUCK PLACE." PEARL ALSO GIVES FAMILIES ACCESS TO THE LATEST TREATMENT THOUGH RESEARCH STUDIES. THE CLINIC IS CURRENTLY ENROLLING PATIENTS IN A STUDY ASSESSING MEDICATIONS FOR CHILDREN WITH ADHD AND IMPULSIVE AGGRESSION, AND WILL SOON ENROLL FOR A PROGRAM THAT HELPS FAMILIES MANAGE ADHD SYMPTOMS THROUGH EXERCISE. PAL SHRINKS ANTI-PSYCHOTIC USE A TELEPHONE CONSULTATION SYSTEM LAUNCHED BY SEATTLE CHILDREN'S HAS DECREASED THE PRESCRIPTION OF ANTIPSYCHOTICS BY NEARLY HALF FOR CHILDREN ENROLLED IN WASHINGTON STATE'S MEDICAID PROGRAM, ACCORDING TO STUDY LED BY DR. REBECCA BARCLAY. THE 49% REDUCTION IN PRESCRIPTIONS BETWEEN 2006 AND 2013 CAME AFTER THE INTRODUCTION OF THE PARTNERSHIP ACCESS LINE (PAL). THE SYSTEM, THE SECOND OF ITS KIND IN THE COUNTRY, ALLOWS PRIMARY CARE PROVIDERS TO CONSULT ON-DEMAND DIRECTLY WITH CHILD PSYCHIATRISTS AFFILIATED WITH CHILDREN'S AND THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, AND FACILITATES SECOND OPINION CONSULTATIONS FOR YOUTH WITH ATYPICAL PSYCHIATRIC MEDICATION REGIMENS. THE USE OF ANTIPSYCHOTICS TO TREAT CHILDREN HAD BEEN STEADILY INCREASING, WHICH IS A CONCERN BECAUSE SIDE EFFECTS LIKE HIGH CHOLESTEROL AND WEIGHT GAIN CAN CONTRIBUTE TO FUTURE HEALTH COMPLICATIONS. "ANTIPSYCHOTICS ARE HELPFUL AND NECESSARY IN MANY SITUATIONS, BUT WE WANT TO MAKE SURE WE'RE RESERVING THEIR USE FOR WHEN ABSOLUTELY APPROPRIATE," BARCLAY SAID. PAL ADDRESSES A STATEWIDE SHORTAGE OF CHILD PSYCHIATRISTS BY GIVING PRIMARY CARE PROVIDERS A RESOURCE FOR BETTER MEETING MENTAL AND BEHAVIORAL HEALTH NEEDS IN THEIR COMMUNITIES - INCLUDING MAKING DECISIONS ABOUT WHEN TO USE MEDICATIONS LIKE ANTIPSYCHOTICS. "WE HAVE RECEIVED THOUSANDS OF CALLS FROM PROVIDERS SINCE PAL WAS IMPLEMENTED," SAID DR. ROBERT HILT, WHO LEADS THE PROGRAM. A PAL PLUS PILOT PROGRAM WAS ALSO INTRODUCED IN 2017 TO PROVIDE IN-PERSON COUNSELING SESSIONS WITH LOCAL BEHAVIORAL HEALTH PROVIDERS FOR CHILDREN FROM UNDER-RESOURCED FAMILIES IN BENTON AND FRANKLIN COUNTIES. SHARING A COMBINATION FOR BETTER HEALTH BY FOLLOWING FIVE TIPS REPRESENTED BY THE NUMBERS 7-5-2-1-0, ALL CHILDREN AND THEIR FAMILIES CAN TAKE SMALL BUT POWERFUL STEPS TOWARD A HEALTHIER LIFESTYLE. SEATTLE CHILDREN'S WORKS IN THE COMMUNITY TO ENCOURAGE ALL CHILDREN AND THEIR FAMILIES TO FOLLOW 7-5-2-1-0. START THE DAY WITH BREAKFAST 7 DAYS A WEEK. EAT 5 SERVINGS OF FRUITS AND VEGETABLES A DAY. KEEP SCREEN TIME UNDER 2 HOURS A DAY. BE ACTIVE FOR AT LEAST 1 HOUR A DAY. AIM FOR 0 SUGAR-SWEETENED DRINKS. YOUR MENTAL HEALTH FIRST AID CLASS OFFERED SEATTLE CHILDREN'S IS EXCITED TO PARTNER WITH KING COUNTY AND CHAD'S LEGACY TO OFFER YOUTH MENTAL HEALTH FIRST AID. THIS 8-HOUR CLASS IS FOR ADULTS WHO REGULARLY INTERACT WITH ADOLESCENTS AGES 12 TO 18. YOUTH MENTAL HEALTH FIRST AID WILL IMPROVE YOUR KNOWLEDGE OF MENTAL HEALTH AND SUBSTANCE USE PROBLEMS, AND WILL TEACH YOU HOW TO CONNECT YOUTH WITH CARE WHEN NEEDED. FOR MORE INFORMATION AND TO REGISTER, VISIT: HTTP://WWW.SEATTLECHILDRENS.ORG/CLASSES-COMMUNITY/ CURRENT-CLASS-OFFERINGS/YOUTH-MENTAL-HEALTH-FIRST-AID/. 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