2017-08-15T16:00:33-05:00 2016-09-30 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2015-10-01 941294954 Valley Children's Hospital VALL 5593533000 9300 Valley Childrens Place Madera CA 936368761 Michele Waldron CFO 5593533000 2017-08-11 1 Tracy S Paglia P00366884 2099556100 2017-08-11 2015 2021-01-29 14:40:06Z MICHELE WALDRON 9300 Valley Childrens Place Madera CA 936368761 764506131 0 X www.valleychildrens.org X 1949 CA PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN 14 12 3299 475 66 0 22658021 21198267 582676037 539203507 15816048 12966081 12004445 15845165 633154551 589213020 1811358 12188201 0 0 260856264 277283712 0 0 0 252415468 244272406 515083090 533744319 118071461 55468701 1092469377 1164758110 278947276 283321497 813522101 881436613 X To provide high quality comprehensive healthcare services to children regardless of their ability to pay and to continuously improve the health and well-being of children. 0 0 57642722 12188201 277766674 SEE SCHEDULE O 358872982 261436833 SEE SCHEDULE O 416515704 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 307 0 1 3299 1 0 0 0 0 0 0 0 0 0 0 X 14 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X MICHELE WALDRON CFO 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 TODD SUNTRAPAK CEO 17.50 32.50 X X 1007348 0 198763 Bruce Albright Board Member, Termed 12/31/15 1.00 X 0 0 0 Dr Linda Fraley Board member, secretary thru 1/16 1.00 1.00 X X 0 0 0 Dave Nalchajian Board Secretary 1.00 1.00 X X 0 0 0 Paul McDougal Foundation Board Chairman 1.00 1.00 X 0 0 0 Dr Robert Kubo Board member, TREASURER thru 1/16 1.00 1.00 X X 0 0 0 RILEY WALTER BOARD MEMBER 1.00 1.00 X 0 0 0 Jeff Mayer Board Member, Termed 12/31/15 1.00 X 0 0 0 Michael Hanson Board Member 1.00 X 0 0 0 Pat Ricchiuti Board Member, Termed 12/31/15 1.00 X 0 0 0 Dr Charles Smith Board Vice Chair, Deceased 8/12/16 1.00 X X 0 0 0 Bill Smittcamp Board Chair 1.00 3.00 X X 0 0 0 Kim Ruiz Beck Board Member 1.00 2.00 X 0 0 0 Jeannine Campos Grech Board TREASURER 1.00 3.00 X X 0 0 0 Dr Sahar Barayan CHIEF OF STAFF, Termed 2/2016 1.00 X 75000 0 0 Fred Laningham MD CHIEF OF STAFF 1.00 X 0 0 0 Noreen Wade Board Member, Termed 1/31/16 1.00 X 0 0 0 Jose Elgorriaga Board Member 1.00 X 0 0 0 Mendy Laval Board Member 1.00 X 0 0 0 Dr David Krause board meMBER, board chair thru 1/15 1.00 1.00 X 0 0 0 Michele R Waldron Senior VP, CFO 18.50 31.50 X 611109 0 141992 David Christensen Senior VP, CMO 18.00 27.00 X 666987 0 112581 BEVERLY HAYDEN-PUGH Senior VP, Chief Operations and Chief Nursing Offi 18.00 27.00 X 454000 0 117712 Jessie Hudgins VP, Facilities 40.00 X 380692 0 106452 Natale Ponticello JR Senior VP, Human Resources 29.00 11.00 X 378136 0 60791 Jane Willson Senior VP, Corporate Development 8.00 32.00 X 398150 0 86476 David Singh VP, Ancillary Services 40.00 X 378059 0 66386 Michael Goldring President, VCMG 12.00 28.00 X 468066 0 61129 Stephanie Vance Finance, VP 40.00 X 315540 0 73203 Joel Brownell MD VP, Chief Medical Information Officer 40.00 X 384824 0 42229 Karen Dahl VP, Quality & Patient Safety 40.00 X 336263 0 15326 Kevin Shimamoto VP and CIO 40.00 X 318168 0 11203 DANIEL DAVIS VP Clinical Ops 40.00 X 308991 0 42988 Daniel Barry VP, Revenue Cycle Mgmt 40.00 X 172717 0 9495 David Hodge Jr VP Ancillary Services 40.00 X 260374 0 36109 Richard Sakai Director Pharmacy 40.00 X 206761 0 39073 Christopher Long Exec Dir Comm & Advocacy, Termed 6/7/16 40.00 X 252934 0 30504 Paul Lilles Director, Physician Practice Services 40.00 X 212054 0 34616 Tom Cross Pharmacist 40.00 X 203610 0 42686 Yvonne Wood RN 40.00 X 202904 0 38826 Rick Wolf Former VP, General Counsel, Termed 8/21/15 40.00 X 755097 0 79332 8747784 0 1447872 602 1 1 0 Valley Children's MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 SUBSPEC PHySICIAN SERVICES 28485277 PEDIATRIC ANETHESIA ASSOCIAtes 6235 N FRESNO ST STE 103 FRESNO CA 93710 ANETHESIA/CRITICAL CARE 9566742 Sodexo Inc & Associates PO Box 360170 Pittsburgh PA 152516170 HOUSEKEEPING SERVICES 4702971 Zumwalt Construction Inc 5520 E Lamona Ave FRESNO CA 93727 Construction Services 2706254 dba Worldwide 222 S Main St Rochester MI 48307 Advertising/marketing Services 2665190 82 7233250 13390071 574946 1165400 21198267 PATIENT SERVICES 900099 535980305 535980305 MANAGEMENT SERVICES 541610 2866147 2866147 OUTSIDE LAB SERVICES 900099 357055 357055 539203507 12640876 66 12640810 862801 862801 107279 95655 11624 11624 11624 174367937 12266 174904634 13165 -536697 -899 -537596 -537596 622064 279657 342407 342407 CAFETERIA REVENUE 900099 3067445 3067445 12423689 12423689 15491134 589213020 539203507 66 28811180 11973233 11973233 214968 214968 8411651 8411651 14635 14635 184291726 146385972 37905754 14331139 11305366 3025773 54783246 40477489 14305757 15451315 11649638 3801677 2688460 82298 2606162 3061932 3061932 181941 181941 2456256 2456256 48383149 48170983 212166 5055516 5055516 76353221 67852298 8500923 5241049 5241049 4258495 3375343 883152 629656 232433 397223 369310 53808 315502 6561387 5139628 1421759 25860459 14370528 11489931 2392460 69066 2323394 Hospital Fee Program 28831662 28831662 PURCHASED SERVICES 20202872 15274544 4928328 BAD DEBT 5231182 5231182 DUES 1911194 168454 1742740 4602205 601295 4000910 533744319 416515704 117228615 0 13436 13334 161458720 159117236 452249 606581 61304184 64196786 7317968 8425855 5876710 6164921 488623309 241609188 251011261 247014121 262720053 269857676 259885083 322524401 3615078 5415799 78814635 81421400 1092469377 1164758110 63824099 54240199 129040378 123434685 86082799 105646613 278947276 283321497 X 795970464 877515448 17551637 3921165 813522101 881436613 1092469377 1164758110 X 55468701 41708898 -29263087 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 6839 0 1 352333 359172 0 Part II-B, Line 1 Valley Children's Hospital has had direct contact with and has encouraged others to have direct contact with local, state and federal legislators regarding children's health care public policy. These contacts have provided information regarding the provision of health care services to children, the anticipated effect on children's health of pending legislative proposals, and requests for assistance in supporting access to children's health care by maintaining current state and federal funding levels for Medi-Cal and other public programs. Expenses associated with this activity are less than 1% of total Hospital expenditures. Valley Children's Hospital has made no contributions to any political candidate or elected official. Salaries related to lobbying $6,839 Association Dues related to lobbying NACH 20,621 American Hospital Association 9,944 Association of American Medical Colleges 261 California Chamber of Commerce 112 California Children's Hospital Association 63,228 California Hospital Association 236,866 Hospital Council of Northern & Central Calif. 21,301 Total expenditures related to legislative matters $359,172 9727143 9727143 277767335 93986538 183780797 3714543 2504561 1209982 172427589 125208919 47218670 24986699 19909170 5077529 247014121 Limited Partnerships 322524401 F 322524401 DISPROPORTIONATE SHARE FUNDS RECEIVABLE 17304297 insurance receivable 6644357 provider fee receivable 36019306 457 trust funds 2256600 restricted cash 5950705 other 4405884 UnaMORTIZED BOND ISSUE COSTS 2173257 Advance Med Foundation 3798244 Prepaid Lease asset 2868750 81421400 MALPRACTICE RESERVE 2762000 ACCRUED PENSION LIABILITY 88590701 457 LIABILITY 2256600 1732 LIABILITY -535435 workers comp 6525560 INS LIABILITY 4157440 DC SERP LIABILITY 1889747 105646613 1 1 1 X 1 X 1 0 1 1 104102 104102 0.00020 371962984 344174808 27788176 0.00000 60454 25793 34661 0.00010 372127540 344200601 27926939 0.00030 1190224 1190224 0.00230 7456891 537408 6919483 0.01310 823507 313954 509553 0.00100 12195046 12195046 0.02310 21665668 851362 20814306 0.03950 393793208 345051963 48741245 0.03980 1 1662593 0 529801 789340 -259539 X 1 1 2 1 VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 www.valleychildrens.org 040000160 X X A 2 VALLEY CHILDREN'S HOME CARE 7555 N DEL MAR AVE FRESNO CA 93711 www.valleychildrens.org 040000160 X A Facility Reporting Group - a 0 0 1 X X X X X X X X X 13 1 1 1 1 X WWW.VALLEYCHILDRENS.ORG X 1 13 1 WWW.VALLEYCHILDRENS.ORG 0 0 1 X 200.000000000000 350.000000000000 X X X 1 1 X X X X 1 X WWW.VALLEYCHILDRENS.ORG X WWW.VALLEYCHILDRENS.ORG X WWW.VALLEYCHILDRENS.ORG X X X X X X 1 X 0 X X X X 1 X 0 1 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: VALLEY CHILDREN'S HOSPITAL, - Facility 2: VALLEY CHILDREN'S HOME CARE Facility Reporting Group - a Part V, Section B, line 5: A TOTAL OF 14 FOCUS GROUPS WERE CONDUCTED AND INCLUDED COUNTY PUBLIC HEALTH DIRECTORS, PRIMARY CARE CLINIC PROVIDERS, COMMUNITY-BASED AGENCY LEADERS, AND OTHERS. ORGANIZATIONS OR INDIVIDUALS PARTICIPATING IN THE FOCUS GROUPS INCLUDED THE FOLLOWING.- FRESNO COUNTY PUBLIC HEALTH DIRECTOR- TULARE COUNTY PUBLIC HEALTH DIRECTOR- MADERA COUNTY PUBLIC HEALTH DIRECTOR- KINGS COUNTY PUBLIC HEALTH DIRECTOR- FIRST 5 MADERA COUNTY EXECUTIVE DIRECTOR- FIRST 5 FRESNO COUNTY COMMUNICATIONS DIRECTOR- CLINICA SIERRA VISTA CHIEF EXECUTIVE OFFICER- CENTRAL VALLEY HEALTH POLICY INSTITUTE EXECUTIVE DIRECTOR FOR INPUT ON ALL COUNTIES IN THE HOSPITAL'S SERVICE AREA IN ADDITION TO THE FEEDBACK RECEIVED THROUGH THE FOCUS GROUPS, VALLEY CHILDREN'S HOSPITAL INCORPORATED INTO THE CHNA INFORMATION GATHERED BY HOSPITAL STAFF AS PART OF THEIR ACTIVE INVOLVEMENT IN A VARIETY OF COMMUNITY BASED INITIATIVES OR ORGANIZATIONS, INCLUDING THOSE LISTED BELOW. -ABC 30 FRESNO COMMUNITY ADVISORY COMMITTEE, FRESNO-BI-ANNUAL BABIES FIRST COORDINATING COUNCIL-BINATIONAL HEALTH WEEK PLANNING COMMITTEES FOR MADERA AND FRESNO COUNTIE-CALIFORNIA BREAST FEEDING COALITION COMMUNICATION COMMITTEE-CALIFORNIA CENTRAL VALLEY COALITION FOR COMPASSIONATE CARE-CALIFORNIA SAFE TEEN DRIVING COMMITTEE-CHILD ABUSE PREVENTION COUNCILS-CHILDREN'S HEALTH AND AIR POLLUTION STUDY FOR THE SAN JOAQUIN VALLEY-CENTRAL CALIFORNIA PERINATAL MENTAL HEALTH COLLABORATIVE-CENTRAL VALLEY CONCUSSION CONSORTIUM-CENTRAL VALLEY HEALTH AND NUTRITION COLLABORATIVE-CENTRAL VALLEY SCHOOL HEALTH ADVISORY PANEL-CHILDREN'S HEALTH INITIATIVE FOR FRESNO COUNTY-COUNTY PEDIATRIC DEATH REVIEW TEAMS-CRADLE TO CAREER PARTNERSHIP, FRESNO COUNTY-FRESNO BABIES FIRST BREASTFEEDING TASK FORCE-FRESNO COUNTY INTERAGENCY TEAM MEMBER-FRESNO COUNTY 5150 TASK FORCE-FRESNO COUNTY SEXUAL ASSAULT RESPONSE TEAM-FRESNO HEALTHY COMMUNITIES ACCESS PARTNERS-HEALTHY MADERA STEERING COMMITTEE-HELP ME GROW FRESNO AND KERN COUNTIES-KERN CALL TO ACTION HEALTH CARE WORK GROUP-KERN COUNTY MEDICALLY VULNERABLE INFANT PROJECT-KINGS COUNTY MULTI-DISCIPLINARY TEAM-MADERA COUNTY BREAST FEEDING COALITION-MADERA COUNTY CHILD ABUSE PREVENTION COUNCIL-MADERA COUNTY INTERAGENCY COUNCIL FOR CHILDREN-MARCH OF DIMES CENTRAL VALLEY DIVISION-MARIPOSA COUNTY INTERAGENCY TEAM MEMBER-MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE, FRESNO COUNTY-PRETERM BIRTH COLLECTIVE IMPACT INITIATIVE FOR FRESNO COUNTY-RESOURCE CENTER FOR SURVIVORS, FRESNO COUNTY RAPE CRISIS SERVICES-ROMAN CATHOLIC DIOCESE OF FRESNO, HEALTH MINISTRY OFFICE-SAFE KIDS CENTRAL CALIFORNIA-TEEN PARENT SUPPORT PROGRAM FIRST 5 FRESNO-TULARE COUNTY HEALTHY FOR LIFE COLLABORATIVE-TULARE COUNTY SEXUAL ASSAULT RESPONSE TEAM-VENTANILLA DE SALUD PROGRAM, MEXICAN CONSULATE FRESNO Facility Reporting Group - a Part V, Section B, line 6a: - ADVENTIST HEALTH CENTRAL CALIFORNIA - COMMUNITY REGIONAL MEDICAL CENTER - FRESNO HEART HOSPITAL AND SURGICAL HOSPITAL - KAISER PERMANENTE FRESNO REGION - KAWEAH DELTA HEALTH CARE DISTRICT - MADERA COMMUNITY HOSPITAL - SAINT AGNES MEDICAL CENTER - SIERRA VIEW DISTRICT HOSPITAL Facility Reporting Group - a Part V, Section B, line 13b: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES. FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. Facility Reporting Group - a Part V, Section B, line 16i: Additionally the policy is sent by US Postal Service to Community Agencies to be distributed. Facility Reporting Group - a Part V, Section B, line 22d: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES. FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. Facility Reporting Group - a Part V, Section B, line 24: If a patient did not qualify for full charitable discount, low income discount, high medical cost discount or 25% prompt pay discount then they could be charged gross charges for their services. Part I, Line 7: Charity care at cost was calculated using a cost-to-charge ratio derived from worksheet 2. The decision support system was used to calculate cost-to-charge for determining unreimbursed Medi-Cal and other means-tested government programs. This decision support system addresses all patient segments (i.e inpatient, outpatient, etc.). 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 $ 5,231,182. Part III, Line 4: Footnote describing bad debt expense: See page 15, Note 1 of the audited financial statements.Costing methodology:Allowance for doubtful accounts are estimated based on historical write-off percentages and review of large balance self-pay accounts. Doubtful accounts are written off against the allowance after adequate collection effort is exhausted and recorded as recoveries of bad debt if subsequently collected. The cost of bad debt write-offs were calculated by applying the overall cost to charge ratio of the organization to the charges written off. Part III, Line 8: Medicare allowable cost is calculated using the filed 2016 Medicare Cost Report. Medicare shortfall should be included as a component of Community Benefit because reimbursement is not negotiable and does not cover the cost to provide services. Additionally, the majority of the Hospital's Medicare patients would be covered by Medi Cal if they did not fall under the Medicare coverage option. Part III, Line 9b: Collection attempts are discontinued once charges are determined to be eligible for charity care or financial assistance; insurance collection attempts continue as appropriate. Part VI, Line 2: COMMUNITY HEALTH NEEDS ASSESSMENT: VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CONSISTENT WITH STATE AND FEDERAL LAW, VALLEY CHILDREN'S HOSPITAL COMPLETES A FORMAL CHNA AT LEAST ONCE EVERY THREE YEARS. VALLEY CHILDREN'S HOSPITAL'S 2016 COMMUNITY BENEFITS PROGRAM IS BUILT UPON THE OUTCOMES OF A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDED THE FOLLOWING ACTIVITIES:JOINT NEEDS ASSESSMENT -VALLEY CHILDREN'S HOSPITAL PARTNERED WITH HOSPITALS IN A FOUR-COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. COUNTIES COVERED INCLUDED MADERA, KINGS, FRESNO, AND TULARE. THROUGH THEIR REGIONAL HOSPITAL ASSOCIATION, THE HOSPITALS CONTRACTED JOINTLY WITH LEAP SOLUTIONS TO FACILITATE THE CHNA, WHICH WAS CONDUCTED BETWEEN OCTOBER 2012 AND FEBRUARY 2013 AND PUBLISHED IN MARCH 2013. LEAP SOLUTIONS, LLC FOLLOWED SEVERAL STEPS TO ENSURE THAT THE HOSPITALS WOULD HAVE ADEQUATE INFORMATION FROM WHICH TO IDENTIFY POSSIBLE ACTIONS. FIRST, IT WAS IMPORTANT TO REVIEW THE WORK THAT HAD BEEN DONE IN THE PAST AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. SECOND, IT WAS ESSENTIAL TO AGREE UPON THE DATA TO BE USED FOR THE REPORT IN ORDER TO APPLY A CONSISTENT SET OF KEY SOCIAL DETERMINANTS OF HEALTH IN EACH OF THE FOUR COUNTIES. THE OPPORTUNITY TO USE A COMPREHENSIVE DATA SET EMERGED AS KAISER PERMANENTE HAD LAUNCHED ITS CHNA DATA PLATFORM AND MADE IT AVAILABLE, NOT ONLY TO ITS FACILITIES BUT TO ALL COMMUNITIES INITIATING THEIR OWN NEEDS ASSESSMENT EFFORTS. GIVEN THE RESOURCES AVAILABLE FOR THIS WORK AND THE EASE OF USE FOR THIS DATA BASE, IT WAS DETERMINED THE DATA BASE WOULD SERVE AS THE PRIMARY SOURCE OF HEALTH OUTCOMES DATA ON THE POPULATIONS SERVED IN ALL FOUR COUNTIES. KAISER PERMANENTE HAS DESIGNED 80 HEALTH INDICATORS WHICH OVERLAP WITH THE HEALTHY PEOPLE 2020 INDICATORS -- THE MOST WIDELY USED LEADING HEALTH INDICATORS IN THE NATION BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE CHNA DATA PLATFORM IS A PRODUCT OF THE CENTER FOR APPLIED RESEARCH AND ENVIRONMENTAL SYSTEMS AT THE UNIVERSITY OF MISSOURI INSTITUTE OF PEOPLE, PLACE AND POSSIBILITY COMMUNITY COMMONS PROJECT.IN ADDITION TO THE INFORMATION AVAILABLE THROUGH THE CHNA DATA PLATFORM, THE HOSPITALS PLACED A STRONG EMPHASIS ON CONDUCTING FOCUS GROUPS AND INTERVIEWS OF KEY STAKEHOLDERS IN EACH COUNTY. A TOTAL OF 14 FOCUS GROUPS WERE CONDUCTED AND INCLUDED COUNTY PUBLIC HEALTH DIRECTORS, PRIMARY CARE CLINIC PROVIDERS, COMMUNITY-BASED AGENCY LEADERS, LOCAL RESIDENTS, AND OTHERS. IN ADDITION, EIGHT FACILITY CEOS OR SENIOR EXECUTIVES WERE INTERVIEWED BY PHONE OR IN PERSON AS WERE ALL FOUR COUNTY PUBLIC HEALTH DIRECTORS. THE HOSPITALS WANTED TO ENSURE THAT THE FOCUS GROUP PROCESS COULD ALSO ACCOMMODATE INDIVIDUALS UNABLE TO TRAVEL TO THE MEETINGS OR PARTICIPATE IN PERSON. SIMILARLY, THE HOSPITALS BELIEVED SOME FRONTLINE HEALTH CARE STAFF WOULD NOT BE ABLE TO BE RELEASED FROM THEIR WORK IN ORDER TO ATTEND THE FOCUS GROUPS.LEAP SOLUTIONS CREATED AND DISTRIBUTED AN ONLINE SURVEY VERSION OF THE FOCUS GROUP QUESTIONS IN ORDER TO SOLICIT INPUT. LEAP SOLUTIONS REPRESENTS A TEAM OF QUALIFIED, EXPERIENCED PROFESSIONALS THAT HAS BEEN HELPING ORGANIZATIONS FOR THE PAST 30 YEARS MAXIMIZE THEIR LEVEL OF SERVICE AND THEIR ABILITY TO AFFECT POSITIVE CHANGE. LEAP SOLUTIONS HAS SIGNIFICANT EXPERIENCE WORKING WITH BOTH GOVERNMENTAL AND COMMUNITY-BASED NON-PROFIT AGENCIES TO ASSESS THEIR CUSTOMERS' NEEDS AND TO RE-CLARIFY OR REALIGN THEIR VISION AND FOCUS TO BEST ADDRESS THOSE NEEDS. SUPPLEMENTAL ASSESSMENT ACTIVITY - IN ADDITION TO THE LEAP SOLUTIONS' FACILITATED ASSESSMENT, VALLEY CHILDREN'S HOSPITAL STAFF ACCESSED OTHER RESOURCES TO FURTHER ASSESS CHILDREN'S HEALTH CARE NEEDS THROUGHOUT THE HOSPITAL'S ENTIRE SERVICE AREA. RESOURCES INCLUDED DATA SOURCES AS WELL AS CONVERSATIONS WITH LOCAL HEALTH CARE PROVIDERS AND ADVOCATES. DATA SOURCES INCLUDED KIDSDATA.ORG, THE CALIFORNIA HEALTH INTERVIEW SURVEY DATA, THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH'S PEDIATRIC NUTRITION SURVEILLANCE DATA, AND THE CALIFORNIA CHILD WELFARE INDICATORS PROJECT AT THE UNIVERSITY OF CALIFORNIA AT BERKELEY. LOCAL PROVIDERS AND ADVOCATES CONSULTED INCLUDED FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, THE CENTRAL CALIFORNIA CHILDREN'S INSTITUTE AND THE CENTRAL VALLEY HEALTH POLICY INSTITUTE.VALLEY CHILDREN'S HOSPITAL STAFF ALSO REMAINED ACTIVELY ENGAGED IN A NUMBER OF COMMUNITY-BASED ORGANIZATIONS AND INITIATIVES IN 2016. THIS CONTINUOUS ENGAGEMENT KEPT THE HOSPITAL CLOSE TO THE ISSUES MOST IMPACTING THE HEALTH AND WELLBEING OF CHILDREN IN ITS SERVICE AREA AND ALLOWED THE HOSPITAL TO MAKE ADJUSTMENTS TO ITS COMMUNITY BENEFITS PROGRAM ACTIVITIES AS APPROPRIATE.THE PROCESSES USED AND THE DATA SOURCES ACCESSED PROVIDED A RELIABLE ASSESSMENT OF COMMUNITY HEALTH NEEDS UPON WHICH VALLEY CHILDREN'S HOSPITAL COULD ESTABLISH PRIORITIES AND ACTIONS. THE ONE GAP THAT VALLEY CHILDREN'S HOSPITAL FELT EXISTED IN THE ASSESSMENT WAS THE NEED FOR MORE IN DEPTH DIALOGUE WITH COMMUNITY RESIDENTS. WHILE INPUT FROM RESIDENTS WAS SOLICITED AND INCORPORATED INTO THE CHNA, THE TOOLS USED TO IN ASSESSMENT PROCESS NEED TO BE REVISED TO ALLOW MORE TIME FOR DIALOGUE AND EXPLORATION OF KEY ISSUES, IN ADDITION TO WRITTEN SURVEYS. Part VI, Line 3: Patient education of eligibility for assistance: Each patient that presents as a self pay patient is directed to a financial counselor. The Financial Counselor educates patients and their families about government and charity care programs and assists with related applications. If a patient is not counseled by a Financial Counselor on the date of service, follow up attempts are made by the counselors and the business office to continue to inform and educate patients of available programs. In addition, the Charity Care policy is posted on the Hospital's website and there is signage throughout the Hospital informing patients of the availability of the charity care program. Part VI, Line 4: Community Information: As the only pediatric specialty hospital located in Central California, Valley Children's Hospital's primary service area extends from San Joaquin County in the north to Kern County in the south, and from the Central Coast to the Sierra Nevada. The service area includes 11 counties and is home to over 1.3 million children ages 0-20. In 2016, Valley Children's Hospital had 12,966 inpatient cases, 121,852 Emergency Department visits and a combined 222,943 outpatient center, day surgery, radiology and laboratory visits. Medi-Cal benefits covered 76% of the hospital's total inpatient days and 77% of the outpatient visits at Valley Children's Hospital. Over 1/2 of the hospital's inpatient population consisted of children 4 years of age or younger and over 70% were an ethnicity other than Caucasian. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH: VALLEY CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE.CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - VALLEY CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, VALLEY CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, VALLEY CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. VALLEY CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. IN 2016, VALLEY CHILDREN'S HOSPITAL PROVIDED CONTINUING MEDICAL EDUCATION PROGRAMS TO OVER 400 COMMUNITY-BASED PRIMARY CARE PHYSICIANS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM THE HOSPITAL SERVED AS THE FEATURED FACULTY, PROVIDING COMMUNITY BASED PHYSICIANS WITH GUIDANCE ON HOW TO MANAGE A WIDE ARRAY OF COMPLEX PEDIATRIC MEDICAL CONDITIONS IN A NUMBER OF TOPICAL AREAS INCLUDING NEURO ONCOLOGY, INTERVENTIONAL RADIOLOGY, HAND SURGERY, BRAIN TUMORS AND MANY OTHERS . PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE HOSPITAL'S SERVICE AREA, INCLUDING BAKERSFIELD, MADERA, MERCED, MODESTO AND SAN LUIS OBISPO. DEVELOPMENTAL DISABILITIES - IN LATE 2015 AND EARLY 2016, VALLEY CHILDREN'S CONVENED A SERIES OF CONVERSATIONS WITH KEY STAKEHOLDERS, INCLUDING FIRST 5 AGENCIES AND COMMUNITY-BASED SERVICE PROVIDERS, TO DEVELOP A REGIONAL STRATEGY FOR IMPROVING THE HEALTH AND WELLBEING OF CHILDREN THROUGHOUT CENTRAL CALIFORNIA.KEY STAKEHOLDERS IDENTIFIED DEVELOPMENTAL SCREENINGS AND SERVICES AS A KEY OPPORTUNITY AND EVENTUALLY AGREED TO SUPPORT THE REGIONAL IMPLEMENTATION OF A PROGRAM CALLED HELP ME GROWN, WHICH IS A SYSTEM THAT CONNECTS AT-RISK CHILDREN WITH EARLY DETECTION AND CONNECTION TO SERVICES.AS AN EARLY ADOPTER OF HELP ME GROW IN CENTRAL CALIFORNIA, FIRST 5 FRESNO COUNTY TOOK THE LEAD ROLE IN FACILITATING ADOPTION OF HELP ME GROW BY OTHER COUNTIES. KERN AND MERCED FIRST 5 AGENCIES ARE IN THE PROCESS OF DEVELOPING AND/OR IMPLEMENTING HELP ME GROW OR SIMILAR PROGRAMS IN THEIR COUNTIES.IN 2016, VALLEY CHILDREN'S BEGAN THE PROCESS OF IMPLEMENTING HELP ME GROW IN ITS PRIMARY CARE PRACTICES IN FRESNO COUNTY AND PARTICIPATED IN DISCUSSIONS WITH BOTH THE KERN AND MERCED FIRST 5 AGENCIES REGARDING IMPLEMENTATION IN THEIR COUNTIES. ADDITIONALLY, VALLEY CHILDREN'S IS IN THE PROCESS OF ENTERING INTO AN AGREEMENT WITH HELP ME GROW IN FRESNO COUNTY TO HELP FACILITATE IMPLEMENTATION OF HELP ME GROW IN PRIMARY CARE PRACTICES THROUGHTOUT THE COUNTY.INJURY PREVENTION - VALLEY CHILDREN'S OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. IN 2016, THE PROGRAM RECORDED OVER 32,449 CONTACTS WITH CHILDREN, PARENTS, HEALTH CARE PROFESSIONALS AND OTHERS AT 175 DIFFERENT COMMUNITY, MEDIA AND PROFESSIONAL EVENTS, COVERING THE FOLLOWING TOPICS IN 2016: CHILD PASSENGER SAFETY, HELMET SAFETY, MEDICATION SAFETY, CONCUSSION, SAFE INFANT SLEEP, ABUSIVE HEAD TRAUMA, SUICIDE PREVENTION, TEEN DEPRESSION, POISON PREVENTION.IN ADDITION TO TOPICS LISTED ABOVE, VALLEY CHILDREN'S CONTINUED ITS STRONG FOCUS ON WATER SAFETY THROUGH THE KOHL'S WATER SAFETY PROGRAM - A PARTNERSHIP BETWEEN VALLEY CHILDREN'S HOSPITAL AND KOHL'S CARES. THIS PROGRAM PROVIDES BROAD-BASED AWARENESS MESSAGING, EDUCATIONAL OPPORTUNITIES AND COMMUNITY OUTREACH EVENTS TO CHILDREN AND FAMILIES ON WATER SAFETY AND DROWNING PREVENTION. THE MULTIFACETED PROGRAM AIMS TO DECREASE WATER-RELATED INJURIES AND DROWING AND IMPROVE THE HEALTH, SAFETY AND WELLBEING OF CHILDREN IN COMMUNITIES SERVED BY VALLEY CHILDREN'S AND KOHL'S DEPARTMENT STORES. THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States CA 1 HINDS HOSPICE 2490 W SHAW 100A Fresno CA 93711 770071360 501(c)(3) 7500 SPONSORSHIP RONALD MCDONALD HOUSE 9161 Randall Way MADERA CA 93636 942864490 501(c)(3) 7500 SPONSORSHIPS STAYWELL COMPANY LLC PO BOX 90477 Chicago IL 606960477 813100819 8250 Provide health information via VCH website CSUF FOUNDATION 2555 E SAN RAMON MS SB73 FRESNO CA 93748 946003272 501(c)(3) 8500 SPONSORSHIP AMERICAN HEART ASSOCIATION PO BOX 50085 Prescott AZ 86304 135613797 501(c)(3) 10000 SPONSORSHIP State Center Comm College 390 W FIR AVE STE 300 Clovis CA 93611 770190269 501(c)(3) 10000 Donation March of Dimes 7575 N Del Mar 104 Fresno CA 93711 131846366 501(c)(3) 15000 SPONSORSHIP Valley Children's Medical Group 9300 Valley Childrens Place Madera CA 936368782 464150987 501(c)(3) 11861254 Donation 7 1 NURSING SCHOLARSHIP 3 10025 EDUCATION SCHOLARSHIP - Neonatal Focus 3 5013 EDUCATION SCHOLARSHIP - Respiratory Focus 1 1670 CAFETERIA MEALS 12083 71894 FMV MEAL COUPONS FOR PATIENT FAMILIES TAXI, BUS AND TRANSIT SERVICES 761 126366 BOOK SUBSIDIzATION OF BUS AND TRANSIT SERVICES Part I, Line 2: Nursing Scholarships are designed to help employees meet financial needs that are not covered by other tuition reimbursement programs. A scholarship committee reviews applications bi-annually based on certain criteria. Recipients are chosen by the committee and the Chief Nursing Officer approves the selections. All recipients are employees of the Hospital and the Hospital is made aware when the recipient completes their education. Other services provided are purchased from various vendors and are supplied to patients and their families. The records for these purchased services are maintained by the Hospital. X X X X 1 1 0 1 1 1 1 0 0 TODD SUNTRAPAK CEO 729510 0 228374 0 49464 0 181513 0 17250 0 1206111 0 0 0 Michele R Waldron Senior VP, CFO 457726 0 120346 0 33037 0 129054 0 12938 0 753101 0 0 0 David Christensen Senior VP, CMO 521595 0 126150 0 19242 0 95331 0 17250 0 779568 0 0 0 BEVERLY HAYDEN-PUGH Senior VP, Chief Operations and Chie 348163 0 83923 0 21914 0 113399 0 4313 0 571712 0 0 0 Jessie Hudgins VP, Facilities 293010 0 68189 0 19493 0 97827 0 8625 0 487144 0 0 0 Natale Ponticello JR Senior VP, Human Resources 294741 0 75799 0 7596 0 60791 0 0 0 438927 0 0 0 Jane Willson Senior VP, Corporate Development 298242 0 76779 0 23129 0 86476 0 0 0 484626 0 0 0 David Singh VP, Ancillary Services 280874 0 78080 0 19105 0 66386 0 0 0 444445 0 0 0 Michael Goldring President, VCMG 407928 0 50616 0 9522 0 56816 0 4313 0 529195 0 0 0 Stephanie Vance Finance, VP 237904 0 58875 0 18761 0 60265 0 12938 0 388743 0 0 0 Joel Brownell MD VP, Chief Medical Information Office 305459 0 78629 0 736 0 33604 0 8625 0 427053 0 0 0 Karen Dahl VP, Quality & Patient Safety 317364 0 100 0 18799 0 15326 0 0 0 351589 0 0 0 Kevin Shimamoto VP and CIO 297978 0 0 0 20190 0 11203 0 0 0 329371 0 0 0 DANIEL DAVIS VP Clinical Ops 258003 0 43884 0 7104 0 30050 0 12938 0 351979 0 0 0 Daniel Barry VP, Revenue Cycle Mgmt 172533 0 0 0 184 0 1948 0 7547 0 182212 0 0 0 David Hodge Jr VP Ancillary Services 211837 0 36388 0 12149 0 23171 0 12938 0 296483 0 0 0 Richard Sakai Director Pharmacy 187574 0 18094 0 1093 0 34760 0 4313 0 245834 0 0 0 Christopher Long Exec Dir Comm & Advocacy, Termed 6/7 203450 0 36905 0 12579 0 21879 0 8625 0 283438 0 0 0 Paul Lilles Director, Physician Practice Service 184163 0 17643 0 10248 0 17366 0 17250 0 246670 0 0 0 Tom Cross Pharmacist 194571 0 50 0 8989 0 29748 0 12938 0 246296 0 0 0 Yvonne Wood RN 202712 0 50 0 142 0 24574 0 14252 0 241730 0 0 0 Rick Wolf Former VP, General Counsel, Termed 8 197858 0 131387 0 425852 0 70707 0 8625 0 834429 0 0 0 Part I, Lines 4a-b PART I, LINES 4A: SEVERANCE PAYMENTS TOTALLING $308,188 WERE MADE TO RICK WOLF, FORMER VP, GENERAL COUNSEL DURING THE CALENDAR YEAR AND ARE INCLUDED IN PART II, COLUMN B(III). THE SEVERANCE AGREEMENTS ARE SUBJECT TO A CONFIDENTIALITY CLAUSE. TERMS AND CONDITIONS OF THE AGREEMENTS WILL BE PROVIDED TO THE IRS UPON REQUEST. PART I, LINES 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE 1) A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), 2) A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES AND 3) A NONCONTRIBUTORY, NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (DCSERP). TODD SUNTRAPAK, JESSIE HUDGINS, NATALE PONTICELLO, MICHAEL GOLDRING, JOEL BROWNELL, DAVID HODGE JR, CHRISTOPHER LONG, AND DANNY DAVIS ARE ELIGIBLE TO CONTRIBUTE TO THE DEFERRED COMPENSATION PLAN, BUT NO CONTRIBUTIONS WERE MADE. $107,339 WAS PAID OUT OF THE DCSERP PLAN DURING THE YEAR. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN, EMPLOYER CONTRIBUTIONS TO THE DCSERP, AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/2016 ARE AS FOLLOWS: MICHELE WALDRON - DEFERRED COMPENSATION PLAN $18,000; DCSERP $69,064; CHANGE IN SERP ACTUARIAL VALUE $20,397 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $0; DCSERP $128,337; CHANGE IN SERP ACTUARIAL VALUE $17,928 BEVERLY HAYDEN-PUGH - DEFERRED COMPENSATION PLAN $18,000; DCSERP $48,073; CHANGE IN SERP ACTUARIAL VALUE $20,209 JESSIE HUDGINS - DEFERRED COMPENSATION PLAN $0; DCSERP $43,338; CHANGE IN SERP ACTUARIAL VALUE $14,269 DAVID CHRISTENSEN - DEFERRED COMPENSATION PLAN $18,000; DCSERP $73,648; CHANGE IN SERP ACTUARIAL VALUE $1,563 RICK WOLF - DEFERRED COMPENSATION PLAN $10,000; DCSERP $45,446; CHANGE IN SERP ACTUARIAL VALUE $116 JANE WILLSON - DEFERRED COMPENSATION PLAN $18,000; DCSERP $44,304; CHANGE IN SERP ACTUARIAL VALUE $7,482 DAVID SINGH - DEFERRED COMPENSATION PLAN $18,000; DCSERP $45,047; CHANGE IN SERP ACTUARIAL VALUE $0 STEPHANIE VANCE - DEFERRED COMPENSATION PLAN $18,000; DCSERP $35,956; NOT ELIGIBLE FOR SERP NATALIE PONTICELLO - DEFERRED COMPENSATION PLAN $0; DCSERP $43,378; NOT ELIGIBLE FOR SERP MICHAEL GOLDRING - DEFERRED COMPENSATION PLAN $0; DCSERP $47,364; NOT ELIGIBLE FOR SERP JOEL BROWNELL - DEFERRED COMPENSATION PLAN $0; DCSERP $28,221; NOT ELIGIBLE FOR SERP KAREN DAHL - DEFERRED COMPENSATION PLAN $17,996; DCSERP $15,326; NOT ELIGIBLE FOR SERP KEVIN SHIMAMOTO - DEFERRED COMPENSATION PLAN $18,000; DCSERP $8,473; NOT ELIGIBLE FOR SERP DAVID HODGE, DANIELLE BARRY AND DANIEL DAVIS - NOT ELIGIBLE FOR DCSERP OR SERP Part I, Line 5 An Executive Incentive Plan has been established that allows for payment of incentives based on both organization-wide and individual goals. Such goals are related to a variety of metrics including revenue, operational and quality results of the Hospital and its related entities. The Incentive Plan has been approved by the Compensation Committee of the Board of Trustees. The committee reviews the forecasted payouts at the end of each year based on the financial and operating results. Part I, Line 6 SEE EXPLANATION FOR LINE 5, ABOVE A COUNTY OF MADERA 946000518 556902DN1 2010-02-04 39512854 To refund series 2006 Bonds issued on 6/26/06. 0 0 0 A 11825000 39512855 3644537 35868318 1 0 1 1 A 0 0 0 0 0 1 0.00000 0 1 A 0 0 1 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: COUNTY OF MADERA Date the Rebate Computation was Performed: 09/30/2016 PART III, SECTION 8A & 8B CERTAIN OBSOLETE OR BROKEN EQUIPMENT WAS DISPOSED OF. IN SOME CASES, NOMINAL SCRAP PROCEEDS WERE RECEIVED. PART IV, SECTION 2 PROCEEDS USED TO REDEEM SERIES 2006 CERTIFICATES MET THE 6 MONTH EXCEPTION TO REBATE. HOWEVER, RESERVE FUND PROCEEDS ARE BEING TREATED AS SUBJECT TO REBATE. X 1 1160000 FMV X Starlight Fun Center 1 5400 COST 0 0 1 0 FORM 990 PART III, LINE 4A: Statement of Program service Accomplishments - Program Service One I. Description of Program Service One Over 60 years ago, our founding mothers had a dream to care for children in a hospital as special as its patients. Valley Children's Hospital has flourished ever since, caring for hundreds of thousands of children. Our mission guides us as we travel the road to our future alongside staff, physicians, children, families, our community and our partners throughout the region. Mission The Mission of Valley Children's Hospital is to provide high quality, comprehensive health care services to children regardless of their ability to pay, and to continuously improve the health and well-being of children. Vision Our vision captures the path we've traveled and showcases our commitment and passion to be the best. Our clear focus is to continue to provide the best care and the best quality pediatric services available anywhere with a vision to become the nation's best children's hospital. Core Values The following core organizational values guide the investments and support provided by Valley Children's Hospital's Community Benefits Program. Excellence - We depend on exceptional people to provide exceptional quality health care and services throughout Valley Children's Hospital. We set high standards and we support each other as we strive to achieve them. We invest in each other and we value the individual and cultural differences that make us strong. We are proud of our superior services as measured by quality outcomes. Compassionate Care - We treat every child, every family, each other, our visitors and our vendors with respect, kindness, hope, joy and good humor. We display our helpful, healing, family-centered spirit at every opportunity. We recognize the importance of playfulness in human interaction and in the health of children. We look for ways to ease suffering and provide comfort. Integrity - We are honest, ethical and responsible in our work and in the way we deal with others. We keep our promises and admit our mistakes. We know ourselves and we avoid hidden agendas. By the way we live our lives everyday, we are worthy of the trust people place in us. Innovation - We embrace change, creativity, continuous learning and personal growth. We incorporate new ideas, technology and methods to improve the health care and services we provide. We anticipate future trends and we create strategic plans to insure future growth and continued vitality. Collaboration - We build enduring internal and external relationships, joining with colleagues across organizational boundaries to improve the care and services we provide. We encourage and reward both individual and team achievements. We put the common good ahead of narrow interests. Stewardship - We are resourceful, adaptable and resilient. We have a "can do" attitude that gets the job done. We are fiscally responsible and efficient with our time. We protect our reserves and manage our operating costs in order to invest in the next generation of kids. We are each personally dedicated to making Valley Children's Hospital better because we were here. Commitment to the Community As a not-for-profit organization governed by its own Board of Trustees, Valley Children's Hospital is solely committed to addressing the medical needs of our region's sickest children. With 358 beds at September 30, 2016, a medical staff of over 550 physicians and approximately 3,000 total employees, Valley Children's Hospital offers accessibility to over 40 fetal, neonatal and pediatric subspecialties, all committed to providing the highest level of quality care possible. Examples include the hospital's Neonatal and Pediatric Intensive Care Units that maintain low mortality rates, when compared nationally, while treating some of the sickest children. While providing exceptional care is the single greatest contribution the hospital makes for our children and their families, the hospital also appreciates that it is uniquely positioned to support the needs of children in other ways as well. As an extension of the hospital's mission and vision, the goal of Valley Children's Hospital's Community Benefits Program is to advance the health and wellbeing of underserved, medically needy children through collaboration and common concern. II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME Service Area Demographics As the only pediatric specialty hospital located in Central California, Valley Children's Hospital's primary service area extends from South San Joaquin County in the north to Kern County in the south, and from the Central Coast to the Sierra Nevada and is home to over 1.3 million children ages 0-20. Valley Children's Hospital's Patient Volume In 2016, Valley Children's Hospital had 12,966 inpatient cases, 121,852 Emergency Department visits and a combined 222,943 outpatient center, Regional Specialty Care Center, day surgery, radiology and laboratory visits. Medi-Cal covered 76% of the hospital's total inpatient days and 77% of total outpatient visits at the hospital. Over 1/2 of the hospital's inpatient population consisted of children 4 years of age or younger and nearly 70% were an ethnicity other than Caucasian. Form 990, Part III, Line 4a III. COMMUNITY BENEFITS PROGRAM ACCORDING TO THE CATHOLIC HEALTH ASSOCIATION, COMMUNITY BENEFITS ARE GENERALLY DEFINED AS THOSE ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING IN RESPONSE TO IDENTIFIED COMMUNITY NEEDS, AND MEET AT LEAST ONE OF THE FOLLOWING OBJECTIVES: - IMPROVE ACCESS TO HEALTH CARE SERVICES - ENHANCE HEALTH OF THE COMMUNITY - ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR PRIVATE, COMMUNITY-BASED EFFORTS ALSO INCLUDED IN THE DEFINITION IS THE PROVISION OF CHARITY CARE AND THE UNREIMBURSED COST OF PROVIDING HEALTH CARE SERVICES TO THOSE ENROLLED IN PUBLIC PROGRAMS, INCLUDING MEDI-CAL. IN FY 2016, VALLEY CHILDREN'S HOSPITAL PROVIDED COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS WITHIN ITS SERVICE AREA. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS IN 2016: *COMMUNITY HEALTH EDUCATION INJURY PREVENTION VALLEY CHILDREN'S OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. THE PROGRAM RECORDED OVER 32,449 CONTACTS WITH CHILDREN, PARENTS, HEALTH CARE PROFESSIONALS AND OTHERS AT 175 DIFFERENT COMMUNITY, MEDIA AND PROFESSIONAL EVENTS. THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2016: CHILD PASSENGER SAFETY, HELMET SAFETY, MEDICATION SAFETY, CONCUSSION, SAFE INFANT SLEEP, ABUSIVE HEAD TRAUMA, SUICIDE PREVENTION, TEEN DEPRESSION AND POISON PREVENTION. IN ADDITION TO TOPICS LISTED ABOVE, VALLEY CHILDREN'S CONTINUED ITS STRONG FOCUS ON WATER SAFETY THROUGH THE KOHL'S WATER SAFETY PROGRAM - A PARTNERSHIP BETWEEN VALLEY CHILDREN'S HOSPITAL AND KOHL'S CARES. THIS PROGRAM PROVIDES BROAD-BASED AWARENESS MESSAGING, EDUCATIONAL OPPORTUNITIES AND COMMUNITY OUTREACH EVENTS TO CHILDREN AND FAMILIES ON WATER SAFETY AND DROWNING PREVENTION. THE MULTIFACETED PROGRAM AIMS TO DECREASE WATER-RELATED INJURIES AND DROWNING AND IMPROVE THE HEALTH, SAFETY AND WELLBEING OF CHILDREN IN COMMUNITIES SERVED BY VALLEY CHILDREN'S AND KOHL'S DEPARTMENT STORES. HEALTH LIBRARY VALLEY CHILDREN'S PROVIDED ACCESS TO ON-LINE EDUCATIONAL INFORMATION VIA THE HEALTH ENCYCLOPEDIA LINK ON ITS WEBSITE. HEALTH ENCYCLOPEDIA CONTAINS THOUSANDS OF PAGES OF INFORMATION ON PEDIATRIC DISEASES, CONDITIONS AND TREATMENTS, AS WELL AS SECTIONS ON HOW TO KEEP KIDS HEALTHY. THE ENCYCLOPEDIA IS AVAILABLE IN ENGLISH AND SPANISH. CANCER SURVIVORSHIP PROGRAM THE CHILDHOOD CANCER SURVIVORSHIP PROGRAM AT VALLEY CHILDREN'S PROVIDES SPECIALIZED, HIGH-QUALITY CARE TO HELP SURVIVORS OF CHILDHOOD CANCER LIVE HEALTHIER, HAPPIER LIVES. THE PROGRAM INCLUDES AN ANNUAL ASSESSMENT OF THE SURVIVOR'S HEALTH, ACADEMIC AND SOCIAL DEVELOPMENT, AND AN INDIVIDUALIZED ACTION PLAN TO ADDRESS LONG-TERM EFFECTS FROM CANCER TREATMENT. MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN VALLEY CHILDREN'S RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. THE HOSPITAL PROVIDED OUTREACH EDUCATION TO HOSPITAL STAFF AND COMMUNITY-BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, GENERAL PEDIATRIC TRAUMA, ABUSIVE HEAD TRAUMA, AND THE PREVENTION OF HUMAN TRAFFICKING OF CHILDREN. REINTEGRATION VALLEY CHILDREN'S ADAPTIVE SPORTS PROGRAM PROVIDES RECREATIONAL AND ATHLETIC EXPERIENCES FOR THOSE WITH DISABILITIES FREE OF CHARGE. IT'S DESIGNED FOR INDIVIDUALS WITH PHYSICAL AND HEALTH IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY TO SPINAL CORD INJURIES. THROUGH HARD WORK AND DETERMINATION, PARTICIPANTS LEARN THAT IT'S POSSIBLE FOR THEM, TOO, TO TAKE PART IN ATHLETIC ACTIVITIES, EXCEED EXPECTATIONS AND ACHIEVE THEIR DREAMS. THE PROGRAM OFFERS A UNIQUE OPPORTUNITY FOR PEOPLE WITH SIMILAR DISABILITIES TO COME TOGETHER AND INCREASE THEIR SOCIAL INTERACTION. PARENTS OF SPECIAL NEEDS CHILDREN ALSO HAVE THE CHANCE TO MEET OTHER PARENTS AND FIND SUPPORT, ENCOURAGEMENT AND FRIENDSHIP. ACTIVITIES OFFERED IN 2016 INCLUDED WATER SKIING, SNOW SKIING, ROCK CLIMBING, SLED HOCKEY, WHEELCHAIR BASKETBALL, KAYAKING, TENNIS, PADDLE BOARDING, CAMPING, SCUBA AND TRACK AND FIELD. * HEALTH CARE SUPPORT SERVICES VALLEY CHILDREN'S PROVIDED HEALTH CARE SUPPORT SERVICES TO HELP ADDRESS THE HEALTH CARE NEEDS OF CHILDREN AND THEIR FAMILIES, AT HOME, AT SCHOOL, AND IN THE COMMUNITY. CHILD ABUSE PREVENTION THE GUILDS OF VALLEY CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, CHILD-FRIENDLY PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF CHILDREN SUSPECTED OF BEING ABUSED OR NEGLECTED. THE CENTER'S VISION IS TO BE THE PREMIER PROVIDER IN CENTRAL CALIFORNIA FOR DIAGNOSTIC PHYSICAL ABUSE ASSESSMENTS, FOSTER CARE MEDICAL CLEARANCE EXAMINATIONS, AND PEDIATRIC SEXUAL ASSAULT EVALUATIONS INCLUDING CHILDREN WHO HAVE BEEN VICTIMS OF COMMERCIAL SEXUAL EXPLOITATION. THE CENTER'S CHILD ADVOCACY CLINIC OPERATES FIVE DAYS A WEEK AND SEES CLOSE TO 1,000 CHILDREN EACH YEAR. THE CENTER'S PROVIDERS ARE AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES ABOUT 100 CHILDREN YEARLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE FLOORS AND THE PEDIATRIC INTENSIVE CARE UNIT. THESE CHILDREN ARE EVALUATED FOR SUSPECTED PHYSICAL ABUSE, SEXUAL ABUSE AND NEGLECT. THE STAFF INCLUDES A BOARD-CERTIFIED CHILD ABUSE PEDIATRICIAN, NURSE PRACTITIONERS SPECIALIZING IN CHILD MALTREATMENT, FORENSIC NURSES, SOCIAL WORKERS, A CENTER COORDINATOR AND SUPPORT STAFF. THERE IS ONGOING COLLABORATION WITH EXTERNAL COMMUNITY PARTNERS, AND OTHER VALLEY CHILDREN'S SERVICES INCLUDING SUBSPECIALTY CLINICS, PATIENT AND FAMILY SERVICES, INTERPRETER SERVICES, RADIOLOGY, DIAGNOSTIC CLINICAL LABORATORIES, CHILD LIFE SERVICES AND PASTORAL CARE. THE CENTER WORKS CLOSELY WITH LAW ENFORCEMENT, COUNTY CHILD PROTECTIVE SERVICES (CPS) AGENCIES, AND DISTRICT ATTORNEYS' OFFICES IN CHILD MALTREATMENT INVESTIGATIONS. COLLABORATIVE EFFORTS INCLUDE CASE CONSULTATION AND MONTHLY SCAN (SUSPECT CHILD ABUSE AND NEGLECT) MEETINGS FACILITATED BY OUR CHILD ADVOCACY CLINIC IN AN EFFORT TO TRACK, MONITOR AND ADVOCATE FOR THE HEALTH AND SAFETY OF AT-RISK CHILDREN THROUGHOUT THE CENTRAL VALLEY. THE SCAN TEAM COMPRISES MULTIDISCIPLINARY MEMBERS THAT INCLUDE PHYSICIANS, NURSE PRACTITIONERS, NURSES, SOCIAL WORKERS, LAW ENFORCEMENT, CPS, ATTORNEYS, PUBLIC HEALTH AND OTHER INDIVIDUALS AND GROUPS WHEN INDICATED. THE CENTER'S EFFORTS ALSO INCLUDE PARTICIPATION IN MUTLIPLE COUNTY CHILD DEATH REVIEW TEAM (CDRT) MEETINGS. THESE MEETINGS ARE DESIGNED TO REVIEW CHILD ABUSE AND NEGLECT FATALITIES, ALONG WITH SUSPICIOUS CHILD DEATHS, TO PREVENT FUTURE FATALITIES BY IMPROVING SERVICES, ADVOCATING FOR CHANGE AND CONDUCTING PUBLIC AWARENESS ACTIVITIES. THE CENTER ALSO COLLABORATES WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTH CARE PERSONNEL, TEACHERS AND MANDATED REPORTERS OF SUSPECTED CHILD MALTREATMENT. THESE PARTNERS INCLUDE VALLEY CHILDREN'S TRAUMA DEPARTMENT'S INJURY PREVENTION TEAM, SAFE KIDS, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, COMPREHENSIVE YOUTH SERVICES, CPS, EXCEPTIONAL PARENTS UNLIMITED, SEXUAL ASSAULT RESPONSE TEAMS (SART), AND COUNTY PUBLIC HEALTH DEPARTMENTS. ADDITIONALLY, THE CENTER PROVIDES BOTH INTERVENTION AND ANTICIPATORY GUIDANCE TO OUR PATIENTS AND FAMILIES AT VALLEY CHILDREN'S. ENROLLMENT IN HEALTH INSURANCE VALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM, OR THE VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S AND/OR THE CONTRACTED VENDOR ASSISTED THE FAMILY WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. FOOD FOR FAMILIES VALLEY CHILDREN'S DIETARY DEPARTMENT PROVIDED MEAL COUPONS TO BREAST-FEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, THROUGH A PROGRAM CALLED MEALS OF THE HEART, WHICH IS SPONSORED BY RONALD MCDONALD CHARITIES OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. THE SOCIAL WORK TEAM ALSO WORKS CLOSELY WITH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM TO PROVIDE FOOD FOR ELIGIBLE FAMILIES. Form 990, Part III, Line 4a VALLEY CHILDREN'S ALSO PARTNERED WITH OTHER REGIONAL ORGANIZATIONS THAT HELP ENSURE PATIENTS' FAMILIES HAVE FOOD TO EAT, INCLUDING THE MENDIBURU MAGIC FOUNDATION BASED IN BAKERSFIELD, THE ROMAN CATHOLIC DIOCESE OF FRESNO, AND THE SWEET EATS PROGRAM. LITERACY PROGRAM Valley Children's Healthcare is uniquely positioned to make a difference in the literacy of children throughout our service area. It is the aim of our Literacy Program to put a new, age- appropriate book into the hands of every child who comes into our Hospital. Currently, we provide 1,500-2,000 new books a month to our inpatients and outpatients. Reaching our literacy goals requires much more than just handing out free books. It also requires educating parents on the importance of literacy and talking to their children. We are an important member of the Talk Read Sing campaign, started by The Children's Movement Fresno, to educate parents on the importance of talking, reading and singing to their children. Valley Children's staff co-chaired the Talk Read Sign campaign in 2016, which focused on promoting reading throughout different school districts, Head Start programs, and Women and Infant Children offices. For many families in the Central Valley, books are a luxury. The are is among the poorest in the nation with 41 percent of the area's children ages 0-5 living in households where the income is below the federal poverty level. Not coincidentally, the Valley is also one of the least literate parts of the country. Studies have shown that children from poor socio-economic environments can start kindergarten having heard 30 million fewer words than their more affluent peers. Reading to children can shift this kind of trend. However, asking financially strapped families to put books for their children ahead of other vital priorities is unrealistic. That is why our program wants to help them take the luxury out of literacy. Putting books into the hands of families that cannot afford them can go a long way in increasing literacy rates and performance in school, highlighting the importance of making books a part of normal life for every child who visits Valley Children's. TRANSPORTATION GIVEN THE CENTRAL VALLEY'S LARGELY RURAL LANDSCAPE AND HIGH CONCENTRATION OF POVERTY, TRANSPORTATION HAS LONG BEEN A CHALLENGE FOR MANY FAMILIES. VALLEY CHILDREN'S CONTINUES TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND ACCESS TO CARE. VALLEY CHILDREN'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING GAS CARDS, TAXI VOUCHERS AND / OR BUS TOKENS. VALLEY CHILDREN'S ALSO SUBSIDIZED BUS AND OTHER PUBLIC TRANSIT SERVICES FROM THE CITY OF FRESNO AND KINGS COUNTY. *SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES VALLEY CHILDREN'S SUPPORTED A NUMBER OF PROGRAMS AND ACTIVITIES TO IMPROVE THE HEALTH OF PERSONS IN THE COMMUNITY. CHILDHOOD WEIGHT MANAGEMENT VALLEY CHILDREN'S CONTINUED TO PLAY AN IMPORTANT ROLE IN 2016 SUPPORTING COMMUNITY BASED EFFORTS AT PROMOTING HEALTHY CHILDHOOD WEIGHT AND IN PREVENTING OBESITY AND TYPE II DIABETES. EXAMPLES INCLUDED VALLEY CHILDREN'S PARTICIPATION IN THE FRESNO COUNTY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP) WORK GROUP ON CHILDHOOD OBESITY AND DIABETES PREVENTION, WHICH HAS AND WILL CONTINUE TO FOCUS ON INCREASING AWARENESS, PREVENTION AND EARLY INTERVENTION FOR PRE-DIABETES AND TYPE II DIABETES. IN THE COMING YEAR, THE WORK GROUP WILL BE WORKING WITH DUNCAN HIGH SCHOOL IN FRESNO TO INCREASE THE LEVEL OF EDUCATION AVAILABLE TO STUDENTS AND STAFF REGARDING TYPE II DIABETES PREVENTION. ADDITIONALLY, VALLEY CHILDREN'S DIABETES EDUCATORS PROVIDED EDUCATION TO SCHOOL NURSES ON A NUMBER OF TOPICS IMPACTING CHILDHOOD WEIGHT AND NUTRITION BY WORKING DIRECTLY WITH INDIVIDUAL SCHOOLS AND THROUGH VALLEY CHILDREN'S SCHOOL NURSE CONFERENCE THAT ATTRACTS 150-200 SCHOOL NURSES FROM THROUGHOUT THE REGION ANNUALLY. DEVELOPMENTAL DISABILITIES In late 2015 and early 2016, Valley Children's convened a series of conversations with key stakeholders, including First 5 agencies and community-based service providers, to develop a regional strategy for improving the health and wellbeing of children throughout Central California. Key stakeholders identified developmental screenings and services as a key opportunity and eventually agreed to support the regional implementation of a program called Help Me Grow, which is a system that connects at-risk children with early detection and connection to services. As an early adopter of Help Me Grow in Central California, First 5 Fresno County took the lead role in facilitating adoption of Help Me Grow by other counties. Kern and Merced First 5 agencies are in the process of developing and / or implementing Help Me Grow or similar programs in their counties. In 2016, Valley Children's began the process of implementing Help Me Grow in its primary care practices in Fresno County and participated in discussions with both the Kern and Merced First 5 agencies regarding implementation in their counties. Additionally, Valley Children's is in the process of entering into an agreement with Help Me Grow in Fresno County to help facilitate implementation of Help Me Grow in primary care practices throughout the county. MENTAL HEALTH VALLEY CHILDREN'S PARTICIPATED IN SEVERAL COMMUNITY-BASED INITIATIVES THAT INCREASED ACCESS TO, OR COORDINATION OF, MENTAL HEALTH SERVICES FOR CHILDREN. VALLEY CHILDREN'S ADVOCATED FOR THE ESTABLISHMENT OF A 16-BED INPATIENT ADOLESCENT PSYCHIATRIC CENTER IN THE CITY OF FRESNO, AND SERVED ON THE COMMITTEE CHARGED WITH SELECTING A PROVIDER TO OPERATE THE FACILITY. ADDITIONALLY, VALLEY CHILDREN'S SERVED ON TASK FORCES CONVENED IN SEVERAL CENTRAL VALLEY COUNTIES CHARGED WITH IMPROVING POLICIES AND PROCEDURES RELATED TO THE MANAGEMENT OF PATIENTS WHO ARE BEING HELD INVOLUNTARILY DUE TO THE RISK THEY POSE TO THEMSELVES AND / OR OTHERS. SCHOOL HEALTH VALLEY CHILDREN'S HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND VALLEY CHILDREN'S FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K - 12. FORM 990 PART III, LINE 4B: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO COMMITMENT TO MEDI-CAL - Valley CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS ITS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2016, 76% OF HOSPITAL INPATIENT DAYS WERE COVERED BY MEDI-CAL. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2016 OF $90,664,956. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING VALLEY CHILDREN'S HOSPITAL, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USES TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. In 2016, Valley Children's Hospital recognized program revenue of $53,906,313, net of the hospital's quality assurance fee and hospital contributions to the California Health Foundation and Trust (CHFT). CHFT was established under the Program for the purpose of supporting charitable activities. CHARITY CARE - IN KEEPING WITH OUR MISSION, Valley CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2016, CHILDREN'S HOSPITAL PROVIDED $104,102 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, Valley CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS. Form 990, Part VI, Section A, line 2 Pat Ricchiutti, Director and Bill Smittcamp, Chairman, have a business relationship. Form 990, Part VI, Section A, line 6 The amended and restated bylaws of Valley Children's Hospital, effective 10/17/13, established Valley Children's Healthcare as the sole member of the corporation. Certain member rights, including the right to approve, fix the number, elect, and remove elected trustees, are included in these bylaws. Form 990, Part VI, Section A, line 7a See answer for line 6 above Form 990, Part VI, Section A, line 7b SEE ANSWER FOR LINE 6 ABOVE Form 990, Part VI, Section B, line 11 A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED. Form 990, Part VI, Section B, line 12c THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS. Form 990, Part VI, Section B, line 15 AS PROVIDED BY THE HOSPITAL BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE HOSPITAL AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE Form 990, Part VI, Section C, line 19 A COPY OF Valley CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF Valley CHILDREN'S HOSPITAL IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE ANNUAL FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. Form 990, Part XI, line 9: Pension-related changes other than net periodic pension cost -29,263,018. Rounding -3. INCOME FROM K-1S -66. Valley CHILDREN'S Healthcare FOUNDATION 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 942797447 PHILANTHROPY/FUNDRAISING FOR VALLEY CHILDREN'S HEALTHCARE & RELATED ENTITIES CA 501(c)(3) Line 7 VALLEY CHILDREN'S HEALTHCARE 0 Valley CHILDREN'S MEDICAL Group 9300 VALLEY CHILDRENS PLACE mADERA CA 93636 464150987 HEALTH CARE CA 501(c)(3) Line 9 VALLEY CHILDREN'S HEALTHCARE 1 Valley CHILDREN'S HEALThcare 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 464158433 Health Care CA 501(c)(3) Line 11b, II N/A 0 Mondrian International Fixed Income Fund LP 1105 N Market Street Ste 1118 Wilmington DE 19801 201575121 investment DE N/A unrelated 777586 31520392 0 0 0.65880 0 1 1 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 0 VALLEY CHILDREN'S MEDICAL GROUP B 11861254 CASH VALUE