2014-08-11T14:05:20-05:00 2013-09-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2012-10-01 910564748 SEATTLE CHILDREN'S HOSPITAL SEAT 2069874846 PO BOX 5371 MS RC-507 SEATTLE WA 981455005 KELLY A WALLACE 2069874846 2014-08-11 1 JANE M SEARING P00000565 4254544919 2014-07-28 2012 2015-11-30 17:44:51Z THOMAS HANSEN MD PO BOX 5371 MS RC-507 SEATTLE WA 981455005 1120942026 0 X WWW.SEATTLECHILDRENS.ORG X 1907 WA AT SEATTLE CHILDREN'S HOSPITAL, WE WILL PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. 26 24 5745 747 1356732 144624 108394674 128241214 835717564 895336596 22099184 21465736 6045504 6537152 972256926 1051580698 1292736 4170653 0 0 416297033 453413364 0 0 0 410603909 435967693 828193678 893551710 144063248 158028988 1854709908 2010084492 769841875 732894462 1084868033 1277190030 WE BELIEVE ALL CHILDREN HAVE UNIQUE NEEDS AND SHOULD GROW UP WITHOUT ILLNESS OR INJURY. WITH THE SUPPORT OF THE COMMUNITY AND THROUGH OUR SPIRIT OF INQUIRY, WE WILL PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. (SEE THE COMMUNITY BENEFIT REPORT IN SCHEDULE O.) 0 0 708997959 4144023 890553014 PATIENT CARE: SEATTLE CHILDREN'S HOSPITAL (SEATTLE CHILDREN'S) PROVIDES SUPERIOR MEDICAL CARE TO CHILDREN FROM WASHINGTON, ALASKA, MONTANA AND IDAHO, SERVING THE LARGEST GEOGRAPHICAL AREA OF ANY CHILDREN'S HOSPITAL IN THE UNITED STATES. IN ADDITION, FAMILIES LIVING BEYOND OUR PRIMARY SERVICE REGION INCREASINGLY SEEK CARE FROM OUR WORLD-RENOWNED SPECIALISTS IN PROGRAMS SUCH AS CANCER, ORGAN TRANSPLANTS AND CRANIOFACIAL SPECIALTIES. IN FISCAL YEAR 2013, SEATTLE CHILDREN'S MEDICAL TEAM TREATED KIDS OF ALL AGES DURING 357,206 PATIENT VISITS, INCLUDING 14,494 ADMISSIONS TO THE HOSPITAL AND 34,825 VISITS TO OUR EMERGENCY ROOM. WE PERFORMED 14,815 DAY SURGERIES AND CARED FOR CHILDREN DURING 293,072 APPOINTMENTS IN OUTPATIENT CLINICS. 103068607 26630 8492312 RESEARCH: BECAUSE RESEARCH IS THE FOUNDATION OF SEATTLE CHILDREN'S MISSION TO PREVENT, TREAT, AND ELIMINATE PEDIATRIC DISEASE, SEATTLE CHILDREN'S INVESTED $29 MILLION IN RESEARCH DURING FISCAL YEAR 2013. SEATTLE CHILDREN'S INVESTIGATORS ARE ADVANCING SCIENTIFIC UNDERSTANDING OF IMPORTANT BIOLOGICAL PROCESSES AND INFLUENCING THE PRACTICE OF PEDIATRICS AROUND THE WORLD. 26510609 1443188 EDUCATION: SEATTLE CHILDREN'S IS THE MAJOR RESOURCE FOR PEDIATRIC GRADUATE MEDICAL EDUCATION PROGRAMS IN OUR REGION. RESIDENTS AND FELLOWS FROM 89 PROGRAMS ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) PLUS 5 PROGRAMS ACCREDITED BY THE AMERICAN DENTAL ASSOCIATION (ADA) HAD RESIDENTS OR FELLOWS AT SEATTLE CHILDREN'S IN ACADEMIC YEAR 2013. SEATTLE CHILDREN'S HAS DEVELOPED CURRICULUM AND EVALUATION METHODS THAT ASSESS AND ASSURE RESIDENT COMPETENCY IN SIX MAIN AREAS: PATIENT CARE, MEDICAL KNOWLEDGE, PRACTICE-BASED LEARNING, INTERPERSONAL AND COMMUNICATIONS SKILLS, PROFESSIONALISM, AND SYSTEM-BASED PRACTICE. 838577175 1 1 0 1 0 1 0 0 0 1 1 1 0 0 1 0 1 1 0 0 1 1 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 1 465 0 1 5745 1 1 1 0 0 0 0 0 0 0 0 0 X 26 24 1 0 0 0 1 1 1 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 DEAN ALLEN 2.00 0.00 X 0 0 0 LIBBY ARMINTROUT 1.00 0.00 X 0 0 0 ROBB BAKEMEIER 9.00 0.00 X 0 0 0 JOEL BENOLIEL 3.00 0.00 X 0 0 0 SUSAN BETCHER 3.00 0.00 X 0 0 0 ROSS BOGUE 1.00 0.00 X 0 0 0 PAT CHAR 1.00 0.00 X 0 0 0 MICHAEL DELMAN 3.00 0.00 X X 0 0 0 ROY DIAZ 4.00 0.00 X 0 0 0 ROBERT FLOWERS 5.00 1.00 X X 0 0 0 MARY ANN FLYNN 3.00 0.00 X 0 0 0 DEBORAH HAUG 3.00 0.00 X 0 0 0 JUDY HOLDER 7.00 0.00 X X 0 0 0 CYNTHIA HUFFMAN 3.00 0.00 X X 0 0 0 JIM LADD 6.00 0.00 X 0 0 0 MONA LEE LOCKE 1.00 0.00 X 0 0 0 PATRICIA LOERA 3.00 0.00 X 0 0 0 SANDRA MADRID 2.00 0.00 X 0 0 0 SUSAN MASK 3.00 0.00 X 0 0 0 JEFF NITTA 5.00 0.00 X 0 0 0 LAURIE OKI 2.00 1.00 X 0 0 0 JUDITH PIERCE 5.00 0.00 X 0 0 0 MICHAEL REEVES 2.00 0.00 X 0 0 0 ROB ROSKIN MD 3.00 0.00 X 0 0 0 NANCY SENSENEY 4.00 0.00 X X 0 0 0 PETE SHIMER 2.00 1.00 X 0 0 0 MICHELE SMITH 2.00 1.00 X 0 0 0 CHARLES STEVENS 5.00 0.00 X 0 0 0 THOMAS HANSEN MD 31.00 30.00 X 548931 2137798 238410 KELLY WALLACE 41.00 15.00 X 432031 2372583 152677 PATRICK HAGAN 55.00 0.00 X 764355 3366467 133511 DAVID FISHER MD 55.00 1.00 X 685381 0 125909 LISA BRANDENBURG 55.00 2.00 X 633410 0 118627 SANFORD MELZER MD 41.00 14.00 X 289702 263846 100892 JAMES HENDRICKS MD 55.00 0.00 X 442037 0 87976 EDWIN WRIGHT 55.00 0.00 X 465535 0 60108 JEFFREY SCONYERS 27.50 27.50 X 203960 198825 81484 STEVEN HURWITZ 55.00 0.00 X 403607 0 34151 SUSAN HEATH 55.00 0.00 X 398479 0 24108 DREXEL DEFORD 55.00 0.00 X 349756 0 57411 CINDY EVANS 55.00 0.00 X 367311 0 34343 SUZANNE PETERSEN 55.00 0.00 X 354502 0 38208 CARA BAILEY 55.00 0.00 X 340700 0 25910 ERIK LAUSUND 55.00 0.00 X 302969 0 28177 JENNIFER ABERMANIS 55.00 0.00 X 283011 0 37629 WARREN HEWITT 55.00 0.00 X 275874 0 29749 TODD JOHNSON 55.00 0.00 X 265696 0 35188 JUDY DOUGHERTY 55.00 0.00 X 257379 0 29375 RUTH BENFIELD 55.00 0.00 X 254484 0 29404 STEPHANIE AXELROD 55.00 0.00 X 212744 0 35113 DOUGLAS PICHA 5.50 50.50 X 53323 976575 87590 JOE RUTLEDGE 55.00 0.00 X 428169 0 30997 CRAIG RUBENS 55.00 0.00 X 418567 0 25429 DAVID BRAUNER 55.00 0.00 X 399384 0 32720 ANNE MANKTELOW 55.00 0.00 X 368586 0 19744 10199883 9316094 1734840 686 0 1 0 SELLEN CONSTRUCTION 227 WESTLAKE AVENUE NORTH SEATTLE WA 98109 CONSTRUCTION 82956492 CHILDREN'S UNIVERSITY MEDICAL GROUP PO BOX 50010 SEATTLE WA 98105 PHYSICIAN SERVICES 71506306 UNIVERSITY OF WASHINGTON PO BOX 358220 SEATTLE WA 98195 RESIDENTS & INTERNS 33484929 DENALI ADVANCED INTEGRATION 17735 NE 65TH STREET SUITE 130 REDMOND WA 98052 IT SERVICES 5614459 SEATTLE CANCER CARE ALLIANCE 825 EASTLAKE AVENUE EAST SEATTLE WA 98109 PATIENT SUPPORT SERVICES 4184040 216 52928641 57353216 17959357 10219197 128241214 PATIENT SVC REVENUES 621500 883610269 883610269 OTHER HEALTHCARE SVCS 621500 10967053 9610321 1356732 WHALE GIFT SHOP 453220 506474 506474 INVESTMENT PROV CHILD 621500 252800 252800 895336596 11434768 11434768 1957746 572512 1385234 1385234 1385234 78004815 814969 67774448 1014368 10230367 -199399 10030968 10030968 CAFETERIA 722212 2865336 2865336 PARKING 812930 2286582 2286582 5151918 1051580698 893473390 1356732 28509362 3001860 3001860 134085 134085 1034708 1034708 8453638 8453638 178413 167830 10583 344649923 324206148 20443775 20276817 19074047 1202770 52650242 49527161 3123081 27204331 25590638 1613693 1098963 1033775 65188 326460 307095 19365 318904 318904 456633 429547 27086 76280687 71755907 4524780 2100318 1975732 124586 106908663 100567108 6341555 10527591 9903121 624470 17417158 16384016 1033142 4477164 4211590 265574 961067 904059 57008 19190462 18052132 1138330 60831278 57222918 3608360 4406226 4144860 261366 PHYSICIANS SERVICES 93801972 93801972 LICENSES & TAXES 22960874 21598892 1361982 BAD DEBTS 2464077 2464077 UBI TAXES 73216 73216 11365980 10691777 674203 893551710 838577175 54974535 0 21020376 29401093 18033375 21140771 6246789 4645575 141313906 137800897 62099 0 9106326 9618249 8254028 9007524 1363712951 499174337 825349197 864538614 544088259 607881968 180103426 222140302 69742637 74067137 7115152 6780607 24274338 23061755 1854709908 2010084492 147256105 129237978 519876419 510954637 29856758 29856758 72852593 62845089 769841875 732894462 X 849143191 1019483420 78379911 97054386 157344931 160652224 1084868033 1277190030 1854709908 2010084492 X 158028988 18868542 15424467 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 318904 318904 892574310 892893214 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 247092 267015 272966 318904 1105977 250000 250000 250000 250000 1000000 1500000 3 11660 40384 918950 1 1 285708000 4773000 34516000 6778000 318219000 249976000 2947000 38833000 6048000 285708000 250467000 2576000 2474000 5541000 249976000 224924000 2946000 27782000 5185000 250467000 221932000 8002000 -179000 4831000 224924000 0.50620 0.39740 0.09640 0 1 1 168020537 168020537 768748205 223373560 545374645 15514331 7493849 8020482 384392998 264798872 119594126 27036880 3508056 23528824 864538614 POOLED INVESTMENTS 216684400 C DEFERRED COMPENSATION PLANS 5410502 C OTHER ALTERNATIVE INVESTMENTS 45400 C 222140302 SWAP MTM VALUE - SERIES 2012C & D 20400357 PAYABLE TO SCHS - STEWART PLACE 21021249 DEFERRED COMPENSATION PLAN PAYABLE 5410502 DEFERRED AND OTHER LIABILITIES 15050454 PAYABLE TO AFFILIATE 962527 62845089 1072172743 18868542 1150991 20019533 1052153210 -572512 -572512 1051580698 879850746 -10780254 -10780254 890631000 456633 2464077 2920710 893551710 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SEATTLE CHILDREN'S HOSPITAL AND SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) SHARE IN A UNIFIED ENDOWMENT FUND (UEF) THAT IS MANAGED BY SCHS. SEATTLE CHILDREN'S HOSPITAL'S TEMPORARILY AND PERMANENTLY RESTRICTED ASSETS REFLECT ENDOWMENTS WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN SCHS 4,071,701. BAD DEBT EXPENSE -2,464,077. INVESTMENT EXPENSES -456,633. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -572,512. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 572,512. CHANGE IN VALUATION OF INTEREST RATE SWAP AGREEMENTS -11,352,766. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,464,077. 1 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES LEADERSHIP TRAINING IN JAPAN ON CONTINUOUS PERFORMANCE IMPROVEMENT FOR 50 PARTICIPANTS 1209665 NORTH AMERICA 0 0 GRANTS TO RECIPIENTS LOCATED IN THE REGION 1034708 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES PURCHASE OF MEDICAL SERVICES AND SUPPLIES 898912 NORTH AMERICA 0 0 PROGRAM SERVICES PURCHASE OF MEDICAL SERVICES AND SUPPLIES 859290 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES PURCHASE OF MEDICAL SERVICES AND SUPPLIES 12705 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES PURCHASE OF MEDICAL SERVICES AND SUPPLIES 3057 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES PURCHASE OF MEDICAL SERVICES AND SUPPLIES 301 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 176535 NORTH AMERICA 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 103176 SOUTH ASIA 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 51489 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 10539 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND AID SITES 21165 SOUTH AMERICA 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 12327 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 6080 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES TRAVEL TO MEDICAL CONFERENCES AND MEETINGS 2068 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES PARTNERS IN AFRICA CLEFT TRAINING 103151 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES TRAVEL/EVENTS - GLOBAL ALLIANCE TO PREVENT PREMATURITY & STILLBIRTH (GAPPS) PROGRAM 26526 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES TRAVEL/EVENTS - GLOBAL ALLIANCE TO PREVENT PREMATURITY & STILLBIRTH (GAPPS) PROGRAM 22353 SOUTH ASIA 0 0 PROGRAM SERVICES TRAVEL/EVENTS - GLOBAL ALLIANCE TO PREVENT PREMATURITY & STILLBIRTH (GAPPS) PROGRAM 18026 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TRAVEL/EVENTS - GLOBAL ALLIANCE TO PREVENT PREMATURITY & STILLBIRTH (GAPPS) PROGRAM 12457 SOUTH AMERICA 0 0 PROGRAM SERVICES TRAVEL/EVENTS - GLOBAL ALLIANCE TO PREVENT PREMATURITY & STILLBIRTH (GAPPS) PROGRAM 10896 NORTH AMERICA 0 0 PROGRAM SERVICES TRAVEL/EVENTS - GLOBAL ALLIANCE TO PREVENT PREMATURITY & STILLBIRTH (GAPPS) PROGRAM 9437 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES EFFORTS FOR THE PREVENTION OF AIDS 82178 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES PEDIATRIC HEALTHCARE IN KENYA - GLOBAL HEALTH PATHWAY RESIDENCY PROGRAM 26968 0 0 0 0 0 0 4195173 518836 4714009 NORTH AMERICA PREVENTING PRETERM BIRTH INITIATIVE 301520 WIRE TRANSFER NORTH AMERICA PREVENTING PRETERM BIRTH INITIATIVE 460000 WIRE TRANSFER NORTH AMERICA PREVENTING PRETERM BIRTH INITIATIVE 273188 WIRE TRANSFER 3 0 0 0 0 0 0 0 PROCEDURE FOR MONITORING GRANTS OUTSIDE THE U.S.: SCHEDULE F, PART I, LINE 2: ORGANIZATIONS SELECTED AS GRANTEES UNDER THE GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH (GAPPS) PROGRAM ARE REQUIRED TO PROVIDE WRITTEN AND FINANCIAL REPORTS. THESE REPORTS ARE PREPARED ON AN INTERIM BASIS AS WELL AS AT THE END OF THE FISCAL YEAR. ADDITIONALLY, PRINCIPAL INVESTIGATORS HAVE QUARTERLY CHECK-IN PHONE CALLS AND ATTEND AN ANNUAL INVESTIGATORS MEETING IN SEATTLE TO REPORT ON THEIR PROGRESS. METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: THE ACCRUAL METHOD WAS USED TO ACCOUNT FOR EXPENDITURES. 1 1 X 1 X 400.000000000000 1 X 849.000000000000 1 1 0 1 1 1 19851 14060000 14060000 0.01580 17 137130 318070000 214886000 103184000 0.11580 18 156981 332130000 214886000 117244000 0.13160 120 14404906 689318 13715588 0.01540 94 26510609 4493648 22016961 0.02470 9 96413621 4671036 91742585 0.10300 11 844739 844739 0.00090 234 138173875 9854002 128319873 0.14400 252 156981 470303875 224740002 245563873 0.27560 2 45516 45516 0.00010 1 5350 5350 0.00000 10 637207 637207 0.00070 2 17109 17109 0.00000 1 4217 4217 0.00000 2 8947 8947 0.00000 7 82927 82927 0.00010 2 250975 250975 0.00030 27 1052248 1052248 0.00120 1 1055009 2605619 4086052 -1480433 X 1 1 1 NA 1 1 SEATTLE CHILDREN'S HOSPITAL

4800 SAND POINT WAY NE SEATTLE WA 98105

WWW.SEATTLECHILDRENS.ORG X X X X X X SEATTLE CHILDREN'S HOSPITAL 1 1 X X X X X X X X X X 12 1 0 1 X X X X X X X X 1 0 1 1 400.000000000000 1 849.000000000000 1 X X X X 1 1 X X X X X X 1 0 1 X 0 0 19 RESEARCH INSTITUTE OLIVE LAB

1100 OLIVE WAY SUITE 100 SEATTLE WA 98101

PEDIATRIC RESEARCH RESEARCH INSTITUTE BUILDING 1

1900 NINTH AVE SEATTLE WA 98101

PEDIATRIC RESEARCH RESEARCH INSTITUTE WEST 8TH

2001 EIGHTH AVE SUITE 400 SEATTLE WA 98121

PEDIATRIC RESEARCH BELLEVUE CLINIC & SURGERY CENTER

1500 116TH AVE NE BELLEVUE WA 98004

CLINIC, SUB SPECIALITY SERVICES, URGENT CARE AND SURGERY CENTER HOME CARE SERVICES

2525 220TH STREET SE SUITE 200 BOTHELL WA 98201

PEDIATRIC HOME CARE SERVICES THAT SUPPORT HOSPITAL SEATTLE CHILDREN'S AT OVERLAKE

1135 116TH AVE NE SUITE 400 BELLEVUE WA 98004

SUB SPECIALITY CARE ODESSA BROWN CHILDREN'S CLINIC

2101 E YESLER WAY SEATTLE WA 98122

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE SEATTLE CHILDREN'S AUTISM CENTER

4909 25TH AVE NE SEATTLE WA 98105

AUTISM CLINIC SEATTLE CHILDREN'S FEDERAL WAY CLINIC

34503 9TH AVE S SUITE 300 FEDERAL WAY WA 98003

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE SEATTLE CHILDREN'S MILL CREEK CLINIC

12800 BOTHELL EVERETT HWY SUITE 150 EVERETT WA 98208

CLINIC, SUB SPECIALITY SERVICES, AND URGENT CARE SOUTH SOUND CARDIOLOGY CEDAR MED CTR

1901 S CEDAR ST SUITE 103 TACOMA WA 98405

CARDIOLOGY CLINIC ANCHORAGE CLINIC

3260 PROVIDENCE DRIVE ANCHORAGE AK 99508

CARDIOLOGY CLINIC SEATTLE CHILDREN'S EVERETT CLINIC

900 PACIFIC AVE SUITE 100 EVERETT WA 98201

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE SEATTLE CHILDREN'S OLYMPIA CLINIC

615 LILLY ROAD MEDICAL BLDG SUITE 140 OLYMPIA WA 98506

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE SEATTLE CHILDREN'S TRI-CITIES CLINIC

900 STEVENS DR SUITE 204 RICHLAND WA 99352

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE MONTANA CARDIOLOGY PRACTICE

2835 FORT MISSOULA ROAD MISSOULA MT 59804

CARDIOLOGY CLINIC SEATTLE CHILDREN'S WENATCHEE CLINIC

526 N CHELAN AVE SUITE B WENATCHEE WA 98801

PEDIATRIC MEDICAL CLINIC CHILDREN'S ORTHOTICS & PROSTHETICS

4575 SAND POINT WAY NE SUITE 106 SEATTLE WA 98105

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE SEATTLE CHILDREN'S DENTAL SURGERY CTR

6222 NE 74TH STREET SEATTLE WA 98115

PEDIATRIC DENTAL CARE PART I, LINE 3C: SEATTLE CHILDREN'S HOSPITAL (SEATTLE CHILDREN'S) USES THE FEDERAL POVERTY GUIDELINES (FPG) AS ITS PRIMARY CRITERIA FOR QUALIFYING PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE. FAMILIES WITH INCOME BELOW OR EQUAL TO 400% FPG QUALIFY FOR FINANCIAL ASSISTANCE. FURTHERMORE, SEATTLE CHILDREN'S RECOGNIZES THAT FAMILIES WHO HAVE HIGH BALANCES, EVEN WITH HIGHER INCOMES, CAN EXPERIENCE FINANCIAL HARDSHIP. RESPONSIBLE PARTIES WHOSE INCOME IS BETWEEN 400% AND 849% FPG, AND WHO HAVE INCURRED SIGNIFICANT ACCOUNT BALANCES, AND WHO ARE NOT ELIGIBLE FOR FUNDING FROM OTHER SOURCES ARE ALSO ELIGIBLE FOR DEDUCTIBLE FINANCIAL ASSISTANCE WHEREBY THEY ARE RESPONSIBLE FOR PAYING A DEDUCTIBLE PROPORTIONATE TO THEIR INCOME AND SEATTLE CHIDREN'S FINANCIAL ASSISTANCE FUNDS THE REMAINING BALANCES. FAMILIES WHO RECEIVE A DENIAL OF FINANCIAL ASSISTANCE BASED ON THE FPG AND FAMILY SIZE INFORMATION ARE ALLOWED TO APPEAL THE DENIAL BY PROVIDING INFORMATION ABOUT ADDITIONAL CIRCUMSTANCES IMPACTING THEIR FINANCIAL SITUATION SUCH AS EXCESSIVE MEDICAL DEBT. THE SENIOR DIRECTOR OF REVENUE CYCLE OR CHIEF FINANCIAL OFFICER MAY ADMINISTRATIVELY APPROVE FINANCIAL ASSISTANCE BASED ON THIS ADDITIONAL INFORMATION. THESE SAME INDIVIDUALS CAN ALSO GRANT FINANCIAL ASSISTANCE IN RARE CASES BASED ON SOCIOECONOMIC OR OTHER FACTORS SUCH AS KNOWLEDGE THAT THE PATIENT IS HOMELESS, OR DUE TO OTHER REASONS WHEN THE STANDARD APPLICATION PROCESS FOR FINANCIAL ASSISTANCE IS NOT LIKELY TO BE SUCCESSFULLY COMPLETED EVEN THOUGH THE PATIENT CAN BE REASONABLY PRESUMED TO QUALIFY FOR FINANCIAL ASSISTANCE. PART I, LINE 6: SEATTLE CHILDREN'S PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS AVAILABLE TO THE GENERAL PUBLIC. SEATTLE CHILDREN'S APPLIES THE CATHOLIC HEALTH ASSOCIATION PRINCIPLES AND USES THE "CBISA LYONS" SOFTWARE TO ACCUMULATE THE INFORMATION INCLUDED IN ITS ANNUAL COMMUNITY BENEFIT REPORT. SEE SCHEDULE O FOR THE FULL 2013 COMMUNITY BENEFIT REPORT OR VISIT WWW.SEATTLECHILDRENS.ORG/COMMUNITYBENEFIT. PART I, LINE 7: IN ACCORDANCE WITH ITS MISSION TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE, SEATTLE CHILDREN'S HOSPITAL COMMITS SIGNIFICANT RESOURCES TO PROMOTE THE HEALTH AND WELL-BEING OF CHILDREN. IN SUPPORT OF THIS ENDEAVOR, SEATTLE CHILDREN'S RECOGNIZES THAT SOME OF ITS MOST FRAGILE CONSTITUENTS ARE CHILDREN WHOSE FAMILIES ARE FINANCIALLY OR MEDICALLY INDIGENT. TO THAT END, SEATTLE CHILDREN'S PROVIDES MEDICAL TREATMENT TO CHILDREN WHOSE FAMILIES ARE UNABLE TO PAY FOR SUCH TREATMENT. SEATTLE CHILDREN'S ENSURES THAT FINANCIAL ASSISTANCE, EDUCATION, RESEARCH AND OTHER SPONSORED COMMUNITY PROGRAMS BENEFIT ALL CHILDREN, REGARDLESS OF ECONOMIC STATUS. THEREFORE, SEATTLE CHILDREN'S MAINTAINS CHARITY AND COMMUNITY BENEFIT PROGRAMS, WITHIN LIMITS, THAT ARE AVAILABLE TO THE ENTIRE COMMUNITY, WITH EQUAL CONSIDERATION FOR THOSE THAT ARE POOR AND UNDERSERVED.THE CATEGORIES INCLUDED AS PROGRAMS AND SERVICES FOR THE POOR AND THE UNDERSERVED ARE AS FOLLOWS:FINANCIAL ASSISTANCE - REPRESENTS THE ESTIMATED COST OF CARE PROVIDED TO CHILDREN WHO ARE UNINSURED OR UNDERINSURED AND WHOSE FAMILIES CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. SEATTLE CHILDREN'S PROVIDES FINANCIAL ASSISTANCE IN ACCORDANCE WITH ITS FINANCIAL ASSISTANCE POLICY BASED ON FAMILY NEED AND MAINTAINS RECORDS TO IDENTIFY THE LEVEL OF ASSISTANCE IT PROVIDES. THE DETERMINATION OF FAMILY NEED IS EVALUATED DURING A PATIENT'S COURSE OF CARE AND CAN BE UPDATED AFTER CARE IS COMPLETE. THE ESTIMATED COST OF FINANCIAL ASSISTANCE REPORTED ON LINE 7A IS BASED ON THE RATIO OF TOTAL PATIENT CARE COSTS AS A PERCENTAGE OF GROSS PATIENT CARE CHARGES. THIS COST-TO-CHARGE RATIO IS DERIVED FROM SCHEDULE H WORKSHEET 2 AND IS APPLIED TO GROSS CHARGES RELATED TO FINANCIAL ASSISTANCE SERVICES, RESULTING IN THE ESTIMATED COST OF PROVIDING FINANCIAL ASSISTANCE.UNREIMBURSED MEDICAID - REPRESENTS THE ESTIMATED COST OF PROVIDING SERVICES TO PATIENTS COVERED UNDER MEDICAID IN EXCESS OF PAYMENTS FROM ALL SOURCES. THE ESTIMATED COST OF SERVICES PROVIDED TO MEDICAID PATIENTS REPORTED ON LINE 7B IS BASED ON A RATIO OF TOTAL PATIENT CARE COSTS AS A PERCENTAGE OF TOTAL GROSS PATIENT CARE CHARGES. THIS COST-TO-CHARGE RATIO IS DERIVED FROM SCHEDULE H WORKSHEET 2 AND IS APPLIED TO GROSS CHARGES RELATED TO SERVICES PROVIDED TO MEDICAID PATIENTS, RESULTING IN THE ESTIMATED COST OF PROVIDING CARE TO THESE PATIENTS.OTHER BENEFITS - REPRESENTS THE COST OF PROVIDING SERVICES FOR THE BENEFIT OF THE ENTIRE COMMUNITY. THESE BENEFITS INCLUDE RESEARCH, EDUCATION AND VARIOUS OTHER COMMUNITY-BASED HEALTH CARE PROGRAMS. THE MAJORITY OF THESE BENEFITS ARE FOR PEDIATRIC RESEARCH AND GRADUATE MEDICAL EDUCATION. NO COSTING METHODOLGOY IS USED IN REPORTING THE AMOUNTS OF OTHER BENEFITS REPORTED ON LINES 7E THROUGH 7I. THESE AMOUNTS ARE REPORTED AT COST. PART I, LINE 7, COLUMN (F) AND PART II, COLUMN (F): BAD DEBT EXPENSE OF $2,464,077 INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) WAS EXCLUDED FROM THE TOTAL EXPENSE FIGURE WHEN CALCULATING PERCENT OF TOTAL EXPENSE. PART II: AS PART OF OUR MISSION TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE, SEATTLE CHILDREN'S MAKES PROACTIVE AND STRATEGIC INVESTMENTS TO HELP CHILDREN AND FAMILIES BE AND STAY HEALTHY IN THE PLACES WHERE THEY LIVE, PLAY AND LEARN. WE WORK WITH OUR COMMUNITIES TO ADDRESS SOME OF THE SOCIAL AND ECONOMIC CAUSES OF HEALTH PROBLEMS SUCH AS EDUCATION, HOUSING, SOCIAL SUPPORT AND THE BUILT ENVIRONMENT. SOME EXAMPLES OF OUR COMMUNITY BUILDING ACTIVITIES INCLUDE:- THROUGH A PARTNERSHIP WITH PUGET SOUND BIKE SHARE, WE ARE MAKING BIKE HELMETS AVAILABLE AT A NETWORK OF BIKE-SHARE STATIONS IN THE SEATTLE AREA. PUGET SOUND BIKE SHARE WILL OPEN THE FIRST 50 RENTAL SITES, INCLUDING ONE AT SEATTLE CHILDREN'S, IN 2014. THE STATION WILL OFFER ACCESS TO A BRAND NEW FORM OF TRANSPORTATION. - THE CONTINUOUS PERFORMANCE IMPROVEMENT (CPI) TEAM PROVIDES TOURS AND TRAINING TO LOCAL AND STATE GOVERNMENT EMPLOYEES TO HELP IMPROVE THE GOVERNMENT'S ABILITY TO SUPPORT THE CITIZENS OF THE STATE OF WASHINGTON THROUGH LEAN METHODOLOGY, WHICH AIMS AT REDUCING COSTS. THE PROGRAM PROVIDES OPPORTUNITIES TO SEE THE WORK IN ACTION, VALIDATE THINKING AND INSPIRE IMPROVEMENT ACTIVITIES. - OUR CLINICAL AND NON CLINICAL STAFF PROVIDE LECTURES, TOURS, MENTORING AND SHADOWING OPPORTUNITIES THAT DISCUSS EMPLOYMENT OPPORTUNITIES IN HEALTHCARE TO UNDERSERVED STUDENTS AND PEOPLE FROM DIVERSE BACKGROUNDS. ONE OF THE PROGRAMS REACHES OUT TO PEOPLE WHO ARE PLANNING TO ATTEND MEDICAL SCHOOL TO INCREASE THEIR SKILLSET WHEN APPLYING. - BY POOLING FINANCIAL RESOURCES FROM SEATTLE CHILDREN'S AND METRO, THE TRANSIT NOW PARTNERSHIP MAKES MORE TRANSIT SERVICE AVAILABLE TO COMMUNITIES IN THE NORTHEAST SEATTLE AREA. - IN PARTNERSHIP WITH KING COUNTY METRO TRANSIT, 5,000 HOUSEHOLDS RECEIVED MESSAGES THAT ENCOURAGE RIDING TRANSIT, WALKING, BIKING AND CARPOOLING AS ALTENATIVES TO DRIVING ALONE. SEATTLE CHILDREN'S ALSO SUPPORTED THE PRODUCTION OF A MAP WITH NEIGHBORHOOD WALKING ROUTES, IN PARTNERSHIP WITH FEET FIRST, A LOCAL NON-PROFIT THAT ENCOURAGES PEOPLE TO WALK MORE. - THE PASTORAL CARE DEPARTMENT OFFERS SPIRITUAL AND RELIGIOUS SERVICES, INCLUDING CATHOLIC MASS IN ENGLISH AND SPANISH, HANNUKAH AND OUR LADY OF GUADALUPE CELEBRATION, FOR PATIENTS, FAMILIES, VISITORS AND COMMUNITY MEMBERS. - STAFF FROM THE CENTER FOR DIVERSITY AND HEALTH EQUITY COORDINATE AND SUPPORT SEATTLE CHILDREN'S EMPLOYEES WHO VOLUNTEER AT THE MARTIN LUTHER KING, JR. DAY OF SERVICE HOSTED BY UNITED WAY OF KING COUNTY. VOLUNTEERS PROVIDE NON-PROFIT ORGANIZATIONS WITH MUCH NEEDED SKILLED AND PASSIONATE WORKERS.- SEATTLE CHILDREN'S PROVIDES CASH CONTRIBUTIONS AND SPONSORSHIPS TO COMMUNITY ORGANIZATIONS TO SUPPORT OUR COMMUNITIES' ECONOMIC DEVELOPMENT, EARLY CHILDHOOD DEVELOPMENT, EDUCATION AND SOCIAL SUPPORT SYSTEMS. PART III, LINE 4: THE FOLLOWING TEXT DESCRIBING BAD DEBTS IS FOUND WITHIN FOOTNOTE (1)(K) TO THE AUDITED FINANCIAL STATEMENTS:"THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS DETERMINED FROM AN EVALUATION OF POTENTIALLY UNCOLLECTIBLE PORTIONS OF ALL PATIENT ACCOUNTS RECEIVABLE AND RECOGNIZED IN THE PERIOD THE SERVICES ARE PROVIDED. THE PROVISION VALUATION IS BASED ON ANALYSIS OF CURRENT AND PAST-DUE ACCOUNTS, COLLECTION EXPERIENCE IN RELATION TO AMOUNTS BILLED AND OTHER RELEVANT INFORMATION. THE PROVISION, LESS ANY WRITE-OFFS IS RECORDED NET WITH ACCOUNTS RECEIVABLE IN THE ACCOMPANYING BALANCE SHEETS. THE HOSPITAL'S PROVISION FOR DOUBTFUL ACCOUNTS WAS 63% AND 64% OF SELF-PAY ACCOUNTS RECEIVABLE AS OF SEPTEMBER 30, 2013 AND 2012." PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE OBTAINED DIRECTLY FROM THE MEDICARE COST REPORT AND ARE DETERMINED IN ACCORDANCE WITH THE MEDICARE PRINCIPLES OF REIMBURSEMENT. THE MAJORITY OF SEATTLE CHILDREN'S MEDICARE PATIENTS ARE CHILDREN WITH END STAGE RENAL DISEASE (ESRD) THAT INCLUDES DIALYSIS CARE AND OFTEN KIDNEY TRANSPLANT ALONG WITH OTHER RELATED SERVICES. THE ESRD CARE OFTEN RESULTS IN LONGER LENGTH OF STAY AND HIGHER ACUITY. MEDICARE REIMBURSEMENT FOR THESE SERVICES IS SUBJECT TO THE LIMITS OF THE TAX EQUITY AND FISCAL RESPONSIBILITY ACT, WHICH ARE OFTEN BELOW SEATTLE CHILDREN'S COST. THE ACTUAL SHORTFALL IN COST REIMBURSEMENT SHOULD AT LEAST BE TREATED AS COMMUNITY BENEFIT. PART III, LINE 9B: SEATTLE CHILDREN'S BUSINESS SERVICES DEPARTMENT USES A STANDARD, RESPECTFUL PROCEDURE FOR RESOLVING UNPAID PATIENT BALANCES. A. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES.B. SEATTLE CHILDREN'S PROVIDES A STANDARD 25% DISCOUNT ON HEALTH CARE SERVICES TO PATIENTS WHO ARE UNINSURED IN ACCORDANCE WITH ORGANIZATIONAL POLICIES AND PROCEDURES. THIS DISCOUNT ALIGNS WITH OR IS LOWER THAN DISCOUNTS PROVIDED TO COMMERCIAL INSURERS.C. ADDITIONALLY, SEATTLE CHILDREN'S ATTEMPTS TO ACCOMMODATE U.S. FAMILIES WHO DESIRE TO SET UP REASONABLE INTEREST-FREE PAYMENT PLANS.D. IF A PATIENT ACCOUNT BALANCE REMAINS UNPAID AFTER STANDARD INTERNAL COLLECTION PROCEDURES HAVE BEEN FOLLOWED, AND IF THE FAMILY HAS NOT APPLIED FOR OR DOES NOT QUALIFY FOR SEATTLE CHILDREN'S FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE WILL BE WRITTEN OFF AS BAD DEBT IN ACCORDANCE WITH STANDARD PROCEDURAL TIMELINES. - UPON RECEIPT OF A PERSONAL BANKRUPTCY NOTICE, SEATTLE CHILDREN'S IDENTIFIES ANY OUTSTANDING ACCOUNT BALANCES FOR THE ASSOCIATED PATIENT AND WRITES OFF THESE BALANCES AS BAD DEBT. - SEATTLE CHILDREN'S FINANCE DEPARTMENT MONITORS THE PORTION OF OUTSTANDING ACCOUNTS RECEIVABLE THAT IS CLASSIFIED AS BAD DEBT FOR SIGNIFICANT VARIANCES. - SEATTLE CHILDREN'S STANDARD PRACTICE IS TO COLLECT ON OUTSTANDING PATIENT ACCOUNTS USING INTERNAL RESOURCES. 1. REPORTS ARE NOT SENT TO CREDIT AGENCIES. 2. COLLECTION AGENCIES WILL NOT BE USED TO COLLECT ANY OUTSTANDING PATIENT ACCOUNT EXCEPT AS SPECIFICALLY AUTHORIZED BY THE SENIOR DIRECTOR OF REVENUE CYCLE. 3. THE USE OF COLLECTION AGENCIES WILL ONLY BE PERMITTED IN VERY RARE SCENARIOS WHERE THE FAMILY RESIDES OUTSIDE OF SEATTLE CHILDREN'S SERVICE AREA (E.G., INTERNATIONAL PATIENTS). 4. SEATTLE CHILDREN'S WILL NOT FILE A LIEN AGAINST A PATIENT'S OR FAMILY'S PRIMARY RESIDENCE TO SECURE PAYMENT ON PATIENT ACCOUNT BALANCES. PART III, LINE 2: THE TOTAL AMOUNT OF BAD DEBT EXPENSE PROVIDED IS BASED ON THE RATIO OF TOTAL PATIENT CARE COSTS AS A PERCENTAGE OF GROSS PATIENT CARE CHARGES. THIS COST RATIO IS APPLIED TO GROSS BAD DEBT EXPENSE, RESULTING IN BAD DEBT EXPENSE AT COST. SEATTLE CHILDREN'S CHARACTERIZES SELF PAY AS BAD DEBT WHEN A FAMILY IS EITHER NOT ELIGIBLE OR HAS NOT APPLIED FOR FINANCIAL ASSISTANCE AND IS UNWILLING OR UNABLE TO PAY AN OUTSTANDING ACCOUNT BALANCE. THE MOST COMMON PATIENT BAD DEBT SCENARIOS INCLUDE UNPAID SELF PAY PORTIONS OF ACCOUNT BALANCES AFTER INSURANCE OR THIRD PARTY ASSISTANCE PAYMENTS OR UNPAID ACCOUNT BALANCES AFTER A BANKRUPTCY FILING. SEATTLE CHILDREN'S IS SENSITIVE TO THE FINANCIAL HEALTH OF FAMILIES AND RECOGNIZES THAT FAMILY FINANCIAL CONCERNS MAY NOT ALWAYS BE EFFECTIVELY COMMUNICATED. SEATTLE CHILDREN'S IS COMMITTED TO MANAGING COLLECTION EFFORTS INTERNALLY, IN A RESPECTFUL MANNER AND WITHOUT USING EXTERNAL COLLECTION OR CREDIT AGENCIES, EXCEPT IN LIMITED CIRCUMSTANCES SUCH AS INTERNATIONAL PATIENTS. SINCE ALL COLLECTION EFFORTS ARE MANAGED INTERNALLY, IN A RESPECTFUL MANNER, SEATTLE CHILDREN'S DOES NOT DISCLOSE ITS COLLECTION PRACTICE IN THE FOOTNOTES OF THE FINANCIAL STATEMENTS. SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 1J: IN 2013, SEATTLE CHILDREN'S CONDUCTED ITS FIRST COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO:- UNDERSTAND HEALTH AND SAFETY ISSUES FACING UNDERSERVED POPULATIONS WHO EXPERIENCE HEALTH DISPARITIES, USING EXISTING DATA AND THE PERSPECTIVES OF COMMUNITY STAKEHOLDERS AND FAMILIES.- IDENTIFY STRENGTHS, EXISTING PROGRAMS AND ACTIVITIES THAT ARE HELPING THE COMMUNITY THRIVE.- INFORM OUR COMMUNITY BENEFIT EFFORTS BY DETERMINING WHERE THE COMMUNITY NEEDS ALIGN WITH SEATTLE CHILDREN'S STRATEGIC PLAN OR AREAS IN WHICH WE HAVE SIGNIFICANT EXPERTISE.THROUGH THIS FIRST THOROUGH CHNA, WE HAVE GAINED A BETTER UNDERSTANDING OF THE NEEDS AND RESOURCES OF THE COMMUNITIES WE SERVE. THE NEEDS ASSESSMENT LAYS THE FOUNDATION FOR OUR COMMUNITY BENEFIT PLAN, WHICH WILL GUIDE HOW WE WILL CONTINUE TO FULFILL OUR COMMITMENT TO CHILDREN, TEENS AND FAMILIES, IN PARTNERSHIP WITH HEALTH ORGANIZATIONS, GOVERNMENT, BUSINESSES AND COMMUNITIES.SEATTLE CHILDREN'S CHNA HIGHLIGHTS JUST A FEW OF THE MANY DEDICATED GOVERNMENT, NONPROFIT AND PRIVATE ORGANIZATIONS SERVING OUR COMMUNITY'S MOST VULNERABLE POPULATIONS. COALITIONS SUCH AS CHILDHOOD OBESITY PREVENTION COALITION AND THE HEALTH COALITION FOR CHILDREN AND YOUTH ARE POWERFUL ADVOCATES FOR CHILDREN AND FAMILIES. ORGANIZATIONS AND PROVIDERS LIKE COMMUNITY HEALTH CLINICS, UNIVERSITY OF WASHINGTON, HARBORVIEW MEDICAL CENTER, YAKIMA CHILDREN'S VILLAGE, YOUTHCARE, THE CHILDREN'S ALLIANCE AND WITHINREACH OFFER EDUCATION, ADVOCACY, CLINICAL CARE, RESEARCH AND DIRECT SERVICES TO HELP CHILDREN, YOUTH AND FAMILIES GET THE HEALTHCARE AND PREVENTIVE SERVICES THEY NEED. STATE AND LOCAL PUBLIC HEALTH DEPARTMENTS ARE KEY TO GETTING ESSENTIAL DATA AND TO HELPING FOSTER PROGRAM, POLICY AND SYSTEM CHANGE.AS WITH ANY RESEARCH EFFORT, WE FACED SOME LIMITATIONS. FOR EXAMPLE, WE ENCOUNTERED INCONSISTENT AGE GROUPINGS IN EPIDEMIOLOGICAL AND OUTCOME DATA; INCONSISTENT LIFE-STAGE CATEGORIES, SUCH AS WHEN A CHILD IS CONSIDERED AN ADULT; AND INCONSISTENT DEFINITIONS OF CERTAIN TERMS SUCH AS "HISPANIC" AND "COMMUNITY." THROUGHOUT THIS REPORT, WE HAVE USED THE DESIGNATIONS OF ETHNIC AND NATIONAL GROUPS THAT ARE USED IN THE DATA CITED. WHILE WE GATHERED COMMUNITY INPUT FROM A WIDE RANGE OF STAKEHOLDERS, LIMITED RESOURCES MADE IT IMPOSSIBLE TO REACH ALL OF OUR CONSTITUENTS. WE HAD LESS FEEDBACK FROM COMMUNITY LEADERS OUTSIDE OF KING COUNTY AND HELD JUST THREE FOCUS GROUPS. WE CONSIDER THIS ASSESSMENT TO BE A STARTING POINT AND LOOK FORWARD TO CONTINUING TO BETTER UNDERSTAND THE STRENGTHS AND NEEDS OF THE COMMUNITIES WE SERVE.IN THE CHNA, THE FOLLOWING THEMES EMERGED FROM OUR QUALITATIVE RESEARCH:- POVERTY PLAYS A LARGE ROLE IN FAMILIES' ABILITY TO ACCESS SERVICES.- OBESITY IS A SHARED CONCERN. CONTRIBUTING FACTORS INCLUDE LIMITED SCHOOL-BASED PHYSICAL EDUCATION, NEIGHBORHOODS THAT ARE NOT CONDUCIVE TO PHYSICAL ACTIVITY, A LACK OF HEALTHY FOODS IN SCHOOLS AND LOCAL STORES, AND THE HIGH COST OF SPORTS AND RECREATION OPPORTUNITIES. ACCESS TO MENTAL HEALTH SERVICES IS LACKING. - MENTAL HEALTH SERVICES ARE NOT LOCALLY AVAILABLE AND COST TOO MUCH MONEY. INDIVIDUALS MAY NOT SEEK MENTAL HEALTH SERVICES BECAUSE OF THE STIGMA ASSOCIATED WITH MENTAL ILLNESS. - PARENTS WANT MORE INFORMATION TO BE READILY AVAILABLE TO THEM, GRANDPARENTS AND OTHER CAREGIVERS ABOUT HOW TO KEEP THEIR CHILDREN SAFE AND HEALTHY. THEY FACE CHALLENGES WITH NAVIGATING THE HEALTHCARE SYSTEM. - COMMUNICATION BETWEEN HEALTHCARE PROVIDERS, SCHOOLS AND FAMILIES IS CRITICAL TO GOOD HEALTH.- RURAL WASHINGTON AND SOUTH KING COUNTY ARE GEOGRAPHIC AREAS IN NEED. TEENS, REFUGEES AND IMMIGRANT FAMILIES ARE UNDERSERVED POPULATIONS. - CULTURALLY RELEVANT SERVICES ARE NEEDED. LANGUAGE, IMMIGRATION STATUS, COST, TRANSPORTATION AND LACK OF EDUCATION ABOUT THE HEALTHCARE SYSTEM ARE BARRIERS IN KNOWING ABOUT AND ACCESSING SERVICES AND ACTIVITIES.ASSESSMENT RESULTS HAVE VALIDATED OUR EXISTING WORK AND HAVE HELPED US PRIORITIZE WHERE AND HOW TO FOCUS OUR NEW WORK. HOWEVER, GIVEN THE COMPLEXITY OF COMMUNITY NEEDS AND THE FINITE RESOURCES AVAILABLE TO MEET THEM, WE HAVE DIFFICULT CHOICES. WE BELIEVE THAT BY WORKING IN PARTNERSHIP WITH OTHERS, OUR EFFORTS WILL HAVE RIPPLE EFFECTS THROUGHOUT THE COMMUNITY.FOR SEATTLE CHILDREN'S COMMUNITY BENEFIT PLAN, WE HAVE IDENTIFIED FIVE PRIORITY AREAS: - ACCESS TO HIGH QUALITY HEALTHCARE- COORDINATED CARE FOR CHILDREN AND TEENS WITH CHRONIC CONDITIONS- HEALTH EQUITY AND ACCESS IN SOUTH KING COUNTY- OBESITY - MENTAL AND BEHAVIORAL HEALTHWE WILL ALSO BE SUSTAINING FOUR OTHER COMMUNITY BENEFIT PROGRAMS:- ADOLESCENT HEALTH- INJURY PREVENTION (BOTH INTENTIONAL AND UNINTENTIONAL INJURY)- SERVICES FOR CHILDREN WITH SPECIAL NEEDS- PARENT AND FAMILY EDUCATION AND RESOURCESOUR PRIORITIES HAVE BEEN APPROVED BY THE SEATTLE CHILDREN'S HOSPITAL BOARD OF TRUSTEES (THE ULTIMATE GOVERNING BOARD OF THE ORGANIZATION) AND WILL BE INCORPORATED INTO THE HOSPITAL'S OPERATING, COMMUNITY OUTREACH AND STRATEGIC INITIATIVES.THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON OUR WEBSITE: WWW.SEATTLECHILDRENS.ORG/COMMUNITYHEALTHASSESSMENT.THE COMMUNITY BENEFIT IMPLEMENTATION PLAN IS AVAILABLE ON OUR WEBSITE: WWW.SEATTLECHILDRENS.ORG/COMMUNITYBENEFIT. SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 3: IN THE 2013-2016 COMMUNITY HEALTH NEEDS ASSESSMENT, SEATTLE CHILDREN'S COMPILED EXISTING CHILD AND ADOLESCENT HEALTH DATA TO DESCRIBE SOCIAL DETERMINANTS OF HEALTH AND SOLICITED DIRECT FEEDBACK FROM COMMUNITY STAKEHOLDERS AND FAMILIES. TO GATHER INFORMATION AND ASSESS COMMUNITY NEEDS AND STRENGTHS, WE CONDUCTED:- A REVIEW OF PUBLIC HEALTH INDICATORS AND AREA DEMOGRAPHICS FROM EXISTING SOURCES- AN ONGOING DATA ANALYSIS WITH OUR LOCAL PUBLIC HEALTH DEPARTMENT- AN ONLINE SURVEY OF 74 COMMUNITY LEADERS REPRESENTING 57 CHILD HEALTHRELATED ORGANIZATIONS ACROSS THE STATE THAT SERVE POPULATIONS THAT ARE HISTORICALLY UNDERSERVED OR ARE EXPERIENCING HEALTH DISPARITIES- INTERVIEWS WITH CHILDREN'S PHYSICIANS AND STAFF LEADERS, 10 PUBLIC HEALTH EXPERTS AND COMMUNITY REPRESENTATIVES- PARENT LISTENING GROUPS (IN ENGLISH, SPANISH AND WITH OUR FAMILY ADVISORY COUNCIL)WE USED TWO FRAMEWORKS, THE SOCIAL-ECOLOGICAL AND THE SPECTRUM OF PREVENTION MODELS TO GATHER BACKGROUND ON 24 AREAS OF NEED, INCLUDING ASTHMA, INJURIES, MENTAL HEALTH, OBESITY, ORAL HEALTH, ACCESS TO CARE, AND CHILDREN WITH CHRONIC CONDITIONS. WE ALSO REVIEWED EXISTING STRENGTHS, PROGRAMS AND SERVICES THAT FOCUS ON CHILD AND TEEN HEALTH AND SAFETY ISSUES. SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 12H: DUE TO SOCIOECONOMIC OR OTHER FACTORS SUCH AS KNOWLEDGE THAT THE PATIENT IS HOMELESS, THE STANDARD APPLICATION PROCESS FOR FINANCIAL ASSISTANCE IN RARE CASES MAY NOT BE COMPLETED. IN CASES WHERE A PATIENT CAN BE REASONABLY PRESUMED TO QUALIFY FOR FINANCIAL ASSISTANCE IN THE ABSENCE OF RECEIVING ALL REQUIRED INFORMATION, THE SENIOR DIRECTOR OF REVENUE CYCLE OR THE CHIEF FINANCIAL OFFICER MAY ALSO APPROVE PATIENT ACCOUNT BALANCE WRITE-OFFS TO FINANCIAL ASSISTANCE. PART VI, LINE 2: AS PART OF SEATTLE CHILDREN'S STRATEGIC PLAN DEVELOPMENT, RESEARCH HAS BEEN DONE TO IDENTIFY SPECIALTY CARE, MENTAL HEALTH AND EMERGENCY CARE ACCESS AND SHORTAGE ISSUES; ASSESS THE ONGOING NEED FOR UNCOMPENSATED CARE SUPPORT; AND DETERMINE POTENTIAL PARTNERSHIPS TO BETTER ADDRESS THE HEALTH CARE NEEDS OF ALL CHILDREN IN OUR REGION. ADDITIONALLY, NUMEROUS PROGRAMS AND DEPARTMENTS IN THE HOSPITAL CONDUCT NEEDS ASSESSMENTS TO IDENTIFY HEALTH PROMOTION, HEALTH CARE AND HEALTH DISPARITIES THAT IMPACT THE HEALTH OF CHILDREN AND FAMILIES. PART VI, LINE 3: INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE TO EVERY FAMILY THAT COMES TO SEATTLE CHILDREN'S, WHETHER FOR AN INPATIENT STAY, CLINIC VISIT, SURGERY OR THROUGH THE EMERGENCY DEPARTMENT. SIGNAGE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IS AVAILABLE IN OUR PRIMARY LANGUAGES: ENGLISH, SPANISH, RUSSIAN AND VIETNAMESE. APPLICATION FORMS ARE AVAILABLE IN ENGLISH AND SPANISH. IN PERSON INTERPRETERS AND THE HOSPITAL'S SPEAK LINE, WHICH ACCESSES TELEPHONE INTERPRETATION, HELP PROVIDE INFORMATION TO FAMILIES WITH LIMITED ENGLISH PROFICIENCY INFORMATION ABOUT FINANCIAL ASSISTANCE. AN APPLICATION FORM IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE. ALL REGISTRATION DESKS HAVE FINANCIAL ASSISTANCE INFORMATION VISIBLE AND AVAILABLE. EVERY INPATIENT AND EMERGENCY DEPARTMENT FAMILY IS OFFERED FINANCIAL ASSISTANCE INFORMATION, WHETHER OR NOT THEY HAVE INSURANCE. ALL HOSPITAL BILLS INCLUDE A STATEMENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IF HELP IS NEEDED IN PAYING A BILL, REGARDLESS OF INSURANCE STATUS.FINANCIAL COUNSELORS ARE AVAILABLE TO MEET INDIVIDUALLY WITH FAMILIES TO HELP DETERMINE WHAT ASSISTANCE THEY MAY QUALIFY FOR AND TO HELP THEM COMPLETE AND SUBMIT FORMS. THEY ARE LOCATED ON THE SEATTLE CHILDREN'S MAIN CAMPUS NEXT TO THE AMBULATORY CHECK IN AREA TO FACILITATE ACCESS. THE FINANCIAL COUNSELORS RECEIVE INFORMATION THROUGH THE SCHEDULING SYSTEM THAT IDENTIFIES UNINSURED OR UNDERINSURED FAMILIES. FINANCIAL COUNSELORS CONTACT FAMILIES TO CLARIFY ASSISTANCE AVAILABLE AND TO OFFER THEIR HELP WITH APPLYING FOR ASSISTANCE. THEY HELP FAMILIES DETERMINE IF THEY QUALIFY FOR OTHER SOURCES OF FUNDING, INCLUDING MEDICAID. SOCIAL WORKERS ALSO HELP SCREEN FAMILIES FOR FINANCIAL NEEDS AND REFER PATIENTS TO FINANCIAL COUNSELORS. PART VI, LINE 4: SEATTLE CHILDREN'S SERVES AS THE PEDIATRIC AND ADOLESCENT MEDICAL CENTER FOR WASHINGTON, ALASKA, IDAHO AND MONTANA, THE LARGEST GEOGRAPHICAL AREA OF ANY CHILDREN'S HOSPITAL IN THE UNITED STATES. WE PRIMARILY SERVE CHILDREN FROM BIRTH TO 21 YEARS OLD, MOST OF WHOM ARE FROM WASHINGTON STATE. OVER 45% OF OUR PATIENTS ARE ON MEDICAID, ON A SIMILAR LOW INCOME INSURANCE PROGRAM, OR ARE UNINSURED. OUR 2013-2016 CHNA CENTERS ON THE NEEDS OF FAMILIES, CHILDREN AND YOUTH OF WASHINGTON STATE AND, SPECIFICALLY, KING COUNTY, WITH A SPECIAL FOCUS ON SOUTH KING COUNTY. SOUTH KING COUNTY IS DEFINED AS THE AREA THAT COVERS THE CITIES OF BURIEN, TUKWILA, RENTON, SEATAC, KENT, DES MOINES, COVINGTON, MAPLE VALLEY, FEDERAL WAY, AUBURN, BLACK DIAMONG, ALGONA, PACIFIC AND ENUMCLAW AND THE UNINCORPORATED COMMUNITY OF WHITE CENTER. THE REPORT ALSO PROVIDES A GENERAL OVERVIEW OF ACCESS TO HEALTHCARE ACROSS THE REGION. CHNA RESEARCH YIELDED THE FOLLOWING STATE AND COUNTY DEMOGRAPHICS:- THERE ARE 1,721,457 CHILDREN IN WASHINGTON STATE, OR 26.7% OF THE TOTAL POPULATION. IN KING COUNTY, 24% OF THE RESIDENTS ARE UNDER 19 YEARS OLD. IN SOUTH KING COUNTY, CHILDREN ACCOUNT FOR 27.5% OF THE POPULATION.- IN WASHINGTON STATE, 18% OF CHILDREN LIVE IN POVERTY AND 7% LIVE IN EXTREME POVERTY (THEIR FAMILIES HAVE INCOMES LESS THAN 50% OF THE FEDERAL POVERTY LEVEL). IN KING COUNTY, 15% OF CHILDREN LIVE IN POVERTY, AND 5% IN EXTREME POVERTY. NEARLY ONE OUT OF FOUR FAMILIES IN TUKWILA IS LIVING BELOW THE POVERTY LEVEL.- UNEMPLOYMENT GREW FROM 4.9% IN 2006 TO 9.2% IN 2011. ABOUT 50,000 CHILDREN IN WASHINGTON STATE LIVE IN HOMES WHERE NO ADULTS WORK.- SINCE 2005, GRADUATION RATES HAVE INCREASED ACROSS ALL ETHNICITIES IN WASHINGTON STATE AND KING COUNTY. HIGH SCHOOL GRADUATION RATES ARE ALMOST 80% FOR ALL STUDENTS IN THE STATE.- FROM 2008 TO 2009, FAMILY HOMELESSNESS IN WASHINGTON STATE ROSE 9.2%, COMPARED TO A NATIONAL INCREASE OF ONLY 2.7%. THE 2010 KING COUNTY ONE NIGHT COUNT IDENTIFIED 8,937 HOMELESS PEOPLE ON ONE JANUARY NIGHT. THIS INCLUDED 6,178 PEOPLE IN EMERGENCY SHELTERS AND TRANSITIONAL HOUSING PROGRAMS. 55% WERE FAMILIES WITH CHILDREN.- THE OVERALL CRIME RATE IN WASHINGTON STATE HAS DROPPED STEADILY FROM A HIGH OF 52.9 OFFENSES (PER 1,000 CITIZENS) IN 2005 TO 38.3 IN 2011.- IN 2008, 10,571 CHILDREN WERE IN FOSTER CARE IN WASHINGTON. CHILDREN IN FOSTER CARE USE MENTAL HEALTH SERVICES 8 TO 11 TIMES MORE THAN OTHER LOW-INCOME AND GENERALLY HIGH-RISK CHILDREN IN THE MEDICAID PROGRAM.HEALTH AND SAFETY STATISTICS REVEAL AREAS OF GREAT NEED:- ALL COUNTIES IN WASHINGTON, EXCLUDING KING COUNTY, HAVE A SHORTAGE OF PRIMARY, MENTAL OR DENTAL CARE PROVIDERS.- THE LEADING CAUSES OF DEATH AMONG WASHINGTON CHILDREN ARE UNINTENTIONAL INJURIES, BIRTH DEFECTS, SUICIDE, MATERNAL COMPLICATIONS, SUDDEN INFANT DEATH SYNDROME (SIDS), CANCER, PREMATURITY AND HOMICIDE. - FROM 2006 TO 2010, THE LEADING CAUSES OF INJURY DEATHS WERE SUFFOCATION, HOMICIDE AND MOTOR VEHICLE CRASHES IN CHILDREN BIRTH TO 1 IN WASHINGTON STATE. IN CHILDREN AGES 1 TO 4, THE LEADING CAUSES OF INJURY DEATHS WERE DROWNING, HOMICIDE AND MOTOR VEHICLE CRASHES. IN CHILDREN 5 TO 14, THEY WERE MOTOR VEHICLE CRASHES AND DROWNING. IN TEENS AGES 15 TO 19, THE LEADING CAUSES OF INJURY DEATHS WERE MOTOR VEHICLE CRASHES, SUICIDE AND POISONING.- IN A SURVEY OF PEDIATRICIANS IN WASHINGTON STATE, 47.9% REPORTED ACCEPTING ALL NEW MEDICAID PATIENTS. LOW PROVIDER PAYMENT WAS THE NUMBER ONE BARRIER TO PARTICIPATION IN MEDICAID.- YOUTH WITH DISABILITIES IN WASHINGTON ARE MORE LIKELY TO BE AT RISK FOR UNINTENTIONAL INJURY, DEPRESSION, SUICIDE, PHYSICAL ABUSE, SEXUAL ABUSE, AND THE USE OF CIGARETTES, ALCOHOL AND MARIJUANA.- CHILDREN WITH CHRONIC CONDITIONS (14.3% IN WASHINGTON; 13.9% IN THE U.S.) ARE LESS LIKELY TO HAVE A MEDICAL HOME, TO HAVE EASY ACCESS TO OBTAINING NEEDED REFERRALS, AND TO HAVE ADEQUATE INSURANCE.- OF WASHINGTON HIGH SCHOOL STUDENTS, 11% ARE OBESE (9% IN KING COUNTY) AND 14% TO 16% ARE OVERWEIGHT (21% IN KING COUNTY).- IN WASHINGTON, 25% OF STUDENTS IN 8TH GRADE, 30% OF STUDENTS IN 10TH GRADE AND 28% OF STUDENTS IN 12TH GRADE REPORTED EXPERIENCING DEPRESSIVE FEELINGS.- OF CHILDREN AGES 2 TO 17, 12% HAVE ONE OR MORE EMOTIONAL, BEHAVIORAL OR DEVELOPMENTAL CONDITION.- WASHINGTON HAS THE HIGHEST NATIONAL RATES OF REQUESTED EXEMPTIONS FROM SCHOOL IMMUNIZATIONS.- COMPARED TO OTHER REGIONS OF KING COUNTY, SOUTH KING HAS THE HIGHEST RATES OF: UNINSURED CHILDREN BIRTH TO 17; POOR MATERNAL AND CHILD HEALTH; HOSPITALIZATION FOR CHILDREN AGES 0 TO 17 INJURED BY MOTOR VEHICLE CRASHES, FIREARMS (UNINTENTIONAL AND ASSAULT), POISONING, FALLS AND SUFFOCATION; AND TEEN OBESITY AND RISK OF OVERWEIGHT. PART VI, LINE 5: SEATTLE CHILDREN'S IS GOVERNED BY A BOARD OF TRUSTEES, CONSISTING OF BETWEEN 20-30 VOTING TRUSTEES WHO ARE MEMBERS OF THE LOCAL COMMUNITY. SEATTLE CHILDREN'S FUNCTIONS THROUGH COMMITTEES THAT ARE STAFFED WITH TRUSTEES OF RESPECTIVE BOARDS WHO HAVE SIGNIFICANT EXPERIENCE AND SKILLS REQUIRED BY THAT COMMITTEE, AND IN SOME CASES INCLUDE OUTSIDE MEMBERS WHO ARE NOT TRUSTEES WHEN THEIR KNOWLEDGE OR EXPERIENCE WOULD CONTRIBUTE TO THE WORK OF THE COMMITTEE. SEATTLE CHILDREN'S ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO CERTAIN QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OF ITS DEPARTMENTS. SEATTLE CHILDREN'S ALSO HAS REGIONAL STRATEGIC AFFILIATIONS WITH THE FOLLOWING ENTITIES:- UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM)SEATTLE CHILDREN'S HAS HAD A FORMAL AFFILIATION WITH THE UWSOM SINCE 1974. SCH PROVIDES THE PEDIATRIC COMPONENT OF THE UWSOM UNDERGRADUATE MEDICAL EDUCATION PROGRAM AS WELL AS THE HOSPITAL-BASED PEDIATRIC TRAINING EXPERIENCE FOR ALL POST-GRADUATE PROGRAMS.THE UWSOM, A REGIONAL RESOURCE FOR WASHINGTON, WYOMING, ALASKA, MONTANA, AND IDAHO, IS A NATIONALLY AND INTERNATIONALLY RECOGNIZED LEADER IN MEDICAL EDUCATION, PATIENT CARE, SCIENTIFIC RESEARCH AND COMMUNITY SERVICE. THE UWSOM HAS 30 DEPARTMENTS, MANY CENTERS AND NUMEROUS AFFILIATIONS THROUGHOUT THE FIVE-STATE REGION. THE UWSOM OFFERS EXTENSIVE TRAINING PROGRAMS IN THE BASIC MEDICAL SCIENCES, PRIMARY CARE AND THE SPECIALTIES OF CLINICAL MEDICINE. IT HAS A FULL-TIME REGULAR AND RESEARCH FACULTY OF APPROXIMATELY 2,400. IN ADDITION TO TRAINING FUTURE PHYSICIANS, THE FACULTY ALSO TEACHES GRADUATE AND UNDERGRADUATE STUDENTS IN MANY DISCIPLINES, AND 4,600 VOLUNTEER AND PART-TIME CLINICAL FACULTY MEMBERS TEACH STUDENTS IN TOWNS AND CITIES ACROSS THE REGION. THE UWSOM IS AFFILIATED WITH THE 450-BED UNIVERSITY OF WASHINGTON MEDICAL CENTER AND THE 413-BED HARBORVIEW MEDICAL CENTER, WITH WHICH SCH SHARES A DESIGNATION AS A PEDIATRIC LEVEL I TRAUMA CENTER.- CHILDREN'S UNIVERSITY MEDICAL GROUP (CUMG)SEATTLE CHILDREN'S HEALTHCARE SYSTEM AND THE UNIVERSITY OF WASHINGTON (THE "UW") JOINTLY CONTROL CUMG, A WASHINGTON NONPROFIT CORPORATION AND A 501(C)(3) ORGANIZATION. CUMG IS A PEDIATRIC PRACTICE PLAN THAT EMPLOYS AND MANAGES THE CLINICAL PRACTICES OF APPROXIMATELY 500 PROFESSIONAL MEMBERS WHO ARE BOTH MEMBERS OF SCH MEDICAL STAFF AND PEDIATRIC FACULTY MEMBERS OF THE UWSOM.- PROVIDENCE-CHILDREN'S NEONATAL SERVICES, LLCSEATTLE CHILDREN'S PARTICIPATES IN A JOINT VENTURE WITH PROVIDENCE EVERETT MEDICAL CENTER (PEMC), AN UNRELATED COMMUNITY-BASED HOSPITAL LOCATED IN EVERETT, WASHINGTON. CHILDREN'S AND PEMC EACH OWN A 50% INTEREST IN PROVIDENCE-CHILDREN'S NEONATAL SERVICES, LLC (PCNS). PCNS MANAGES THE OPERATIONS OF THE NEONATAL INTENSIVE CARE UNIT AT PEMC AND PROVIDES NEONATAL NURSE PRACTITIONER SERVICES TO PEMC.- SEATTLE CANCER CARE ALLIANCETHE SEATTLE CANCER CARE ALLIANCE (SCCA), A WASHINGTON NONPROFIT CORPORATION AND 501(C)(3) ORGANIZATION, OFFERS A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES. ITS MEMBERS ARE SEATTLE CHILDREN'S HEALTHCARE SYSTEM, THE UW, AND THE FRED HUTCHINSON CANCER RESEARCH CENTER. SCCA OPERATES AN AMBULATORY CANCER CARE SERVICES FACILITY AND A 20-BED LICENSED HOSPITAL INSIDE UWMC. 1 ALASKA MARINE SAFETY EDUCATION ASSOCIATION 2924 HALIBUT POINT RD SITKA AK 99835 920129584 501(C)(3) 10000 FUNDING FOR COLD-WATER SAFETY AND SURVIVAL TRAINING FOR TEACHERS AND SCHOOL CHILDREN ALASKA NETWORK ON DOMESTIC VIOLENCE AND SEXUAL ASSAULT 130 SEWARD ST SUITE 214 JUNEAU AK 99801 920087216 501(C)(3) 17042 TRAINING FOR MALE MENTORS CONNECTING WITH YOUNG MEN IN SOUTHEAST ALASKA AMERICAN HEART ASSOCIATION 710 SECOND AVE SUITE 900 SEATTLE WA 98104 135613797 501(C)(3) 8700 ANCHORAGE HEART WALK, ALASKA HEART RUN, AND HEARTCHASE TRI-CITIES SPONSORSHIPS ASSOCIATED RECREATION COUNCIL 100 DEXTER AVE N SEATTLE WA 98109 510208303 501(C)(3) 11000 SWIMMING SCHOLARSHIPS AND BIG DAY OF PLAY SPONSORSHIP CASE WESTERN RESERVE UNIVERSITY 10900 EUCLID AVENUE CLEVELAND OH 441067006 341018992 501(C)(3) 306515 GAPPS SUBGRANT: PREVENTING PRETERM BIRTH INITIATIVE AWARD CHILDREN'S ALLIANCE 718 6TH AVE S SEATTLE WA 98104 910982879 501(C)(3) 7780 ANNUAL VOICES FOR CHILDREN'S LUNCHEON SPONSORSHIP CINCINNATI CHILDREN'S HOSPITAL 3333 BURNET AVENUE CINCINNATI OH 452293039 310537130 501(C)(3) 250000 GAPPS SUBGRANT: PREVENTING PRETERM BIRTH INITIATIVE AWARD CITY OF DES MOINES 21630 11TH AVENUE SOUTH DES MOINES WA 98198 916016496 GOVERNMENT 6090 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT COMPREHENSIVE HEALTH EDUCATION FOUNDATION 159 S JACKSON ST SUITE 510 SEATTLE WA 98104 916186093 501(C)(3) 49495 CHILDHOOD OBESITY PREVENTION EVENT SPONS. & SUBAWARD FROM COMMUNITY TRANSFORMATION GRANT CROHN'S AND COLITIS FOUNDATION OF AMERICA NORTHWEST CHAPTER 9 LAKE BELLEVUE DRIVE SUITE 203 BELLEVUE WA 98005 136193105 501(C)(3) 7250 LUNCHEON SPONSORSHIP GIRLS ON THE RUN OF PUGET SOUND 1404 E YESLER WAY SUITE 201 SEATTLE WA 98122 841618574 501(C)(3) 5300 BUILDING HEALTHY HABITS IN PUGET SOUND & GIRLS ON THE RUN EVENT SPONSORSHIP GREATER ISSAQUAH CHAMBER OF COMMERCE 155 NW GILMAN BLVD ISSAQUAH WA 98027 916056410 501(C)(6) 6950 SALMON DAYS FESTIVAL SPONSORSHIP HEALTH CARE WITHOUT HARM 12355 SUNRISE VALLEY DR SUITE 680 RESTON VA 20191 522358837 501(C)(3) 10183 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT HIGHLINE PUBLIC SCHOOLS 15675 AMBAUM BLVD BURIEN WA 98166 916001631 GOVERNMENT 12431 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT HOPELINK 10675 WILLOWS RD NE SUITE 275 REDMOND WA 98052 910982116 501(C)(3) 6000 REACHING OUT LUNCHEON SPONSORSHIP JUVENILE DIABETES RESEARCH FOUNDATION SEATTLE GUILD 1215 FOURTH AVE SUITE 1400 SEATTLE WA 98161 231907729 501(C)(3) 12000 DREAM GALA AND SYMPOSIUM SPONSORSHIPS KETCHIKAN YOUTH INITIATIVES 724 BAYVIEW ST KETCHIKAN AK 99901 202549904 501(C)(3) 20000 CONSTRUCTION OF YOUTH COMMUNITY CENTER KLAWOCK PARENT TEACHER STUDENT ASSOCIATION PO BOX 295 KLAWOCK AK 99925 920151710 501(C)(3) 10000 KLAWOCK PLAYGROUND PROJECT MARCH OF DIMES 1904 THIRD AVE SUITE 230 SEATTLE WA 98101 131846366 501(C)(3) 11000 NURSE OF THE YEAR AWARDS AND SIGNATURE CHEFS DINNER AND AUCTION SPONSORSHIPS MT EDGECUMBE PRESCHOOL 129 SEWARD ST SITKA AK 99835 920059190 501(C)(3) 11000 PURCHASE OF PRESCHOOL MULTIFUNCTION ACTIVITY BUS NAVOS MENTAL HEALTH SOLUTIONS 2600 SW HOLDEN ST SEATTLE WA 98126 910848698 501(C)(3) 10000 ANNUAL BREAKFAST AND GALA SPONSORSHIPS NICK OF TIME FOUNDATION PO BOX 14178 MILL CREEK WA 980823178 204200756 501(C)(3) 10000 SPONSORSHIP OF SEATTLE SCHOOLS HEART SCREENINGS PUGET SOUND BIKE SHARE PO BOX 4362 SEATTLE WA 98194 454996411 501(C)(3) 480500 DONATION FOR BIKE HELMETS AT BIKE SHARE STATIONS PUGET SOUND REGIONAL COUNCIL 1011 WESTERN AVE SUITE 500 SEATTLE WA 98104 910662794 GOVERNMENT 11157 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT PROGRESS EARLY PARENT SUPPORT 4649 SUNNYSIDE AVE N SUITE 346 SEATTLE WA 98103 911212698 501(C)(3) 6000 ANNUAL SPONSORSHIP FOR PARENTING SUPPORT IN THE COMMUNITY REACH INC 213 THIRD ST JUNEAU AK 99801 920070127 501(C)(3) 12620 FOR PURCHASE OF HEARING SCREENER AND ACCESSORIES FOR HAINES INFANT LEARNING CENTER RONALD MCDONALD HOUSE CHARITIES OF WESTERN WASHINGTON & ALASKA 5130 40TH AVE NE SEATTLE WA 98105 911061043 501(C)(3) 319237 SUPPORT FOR HOUSING PROGRAMS SEATTLE KING COUNTY DEPARTMENT OF PUBLIC HEALTH 401 FIFTH AVE SUITE 1300 SEATTLE WA 98104 916001327 GOVERNMENT 191537 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT SEATTLE MARATHON ASSOCIATION PO BOX 31849 SEATTLE WA 98103 911215695 501(C)(3) 30000 SEATTLE KIDS MARATHON SPONSORSHIP SEATTLE PARKS FOUNDATION 105 SOUTH MAIN ST SUITE 235 SEATTLE WA 98104 911998597 501(C)(3) 5350 BURKE GILMAN PICNIC TABLE DONATION SEATTLE POLICE FOUNDATION PO BOX 456 SEATTLE WA 98111 912171529 501(C)(3) 8700 ANNUAL POLICE AWARDS BANQUET SPONSORSHIP AND GUN BUYBACK PROGRAM DONATION SEATTLE PUBLIC SCHOOLS MS 33-343 PO BOX 34165 SEATTLE WA 981241165 916001541 GOVERNMENT 7225 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT SITKA SOUND SCIENCE CENTER 834 LINCOLN ST SUITE 200 SITKA AK 99835 261253086 501(C)(3) 20000 BLACK AND WHITE PROJECT TO CREATE NEWBORN KILLER WHALE REPLICA SOLID GROUND WASHINGTON 1501 N 45TH ST SEATTLE WA 98103 237421892 501(C)(3) 10000 STATEWIDE POVERTY ACTION NETWORK COMMUNITY BENEFIT PROGRAM SUPPORT SOUTH EAST REGIONAL RESOURCE CENTER 210 FERRY WAY SUITE 200 JUNEAU AK 99801 920058572 501(C)(3) 15000 STEMS AND ROOTS PROGRAM FOR EDUCATIONAL ACTIVITIES AND NATIVE AMERICAN FOOD PREPARATION TAYLOR WHITE FOUNDATION PO BOX 35411 JUNEAU AK 99803 270324305 501(C)(3) 20000 FREE DEFENSIVE DRIVER'S TRAINING AND SAFETY EDUCATION FOR TEENS AND PARENTS THE MEMORIAL FOUNDATION 2701 TIETON DR YAKIMA WA 98902 911022358 501(C)(3) 100000 CHILDREN'S VILLAGE EXPANSION CAMPAIGN THE REGENTS OF THE UNIVERSITY OF MICHIGAN 3003 SOUTH STATE STREET ANN ARBOR MI 48109 386006309 501(C)(3) 211618 GAPPS SUBGRANT: PREVENTING PRETERM BIRTH INITIATIVE AWARD UNIVERSITY OF WASHINGTON 12455 COLLECTIONS DRIVE CHICAGO IL 60693 916001537 GOVERNMENT 396426 GAPPS SUBGRANT & SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT UNIVERSITY OF WASHINGTON FOUNDATION 407 GERBERDING HALL SEATTLE WA 98195 943079432 501(C)(3) 9250 SPONSORSHIPS FOR EPILEPSY SURGERY SYMPOSIUM, SUICIDE PREVENTION EVENT, AND OTHER EVENTS/FUNDS WASHINGTON DEPT OF AGRICULTURE PO BOX 42591 OLYMPIA WA 98504 916001062 GOVERNMENT 38964 SUBAWARD UNDER CDC COMMUNITY TRANSFORMATION GRANT WITHIN REACH 11000 LAKE CITY WAY NE SUITE 301 SEATTLE WA 981256748 911443685 501(C)(3) 14500 VAX NORTHWEST IMMUNIZATION SOCIAL MARKETING CAMPAIGN AND LUNCHEON SPONSORSHIP YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF SEATTLE-KING COUNTY-SNOHOMISH COUNTY 1118 FIFTH AVENUE SEATTLE WA 98101 910482890 501(C)(3) 9615 INSPIRE LUNCHEON AND GIRLSFIRST GALA SPONSORSHIPS 43 1 SUPPORT TO PATIENT FAMILIES OF MEDICALLY FRAGILE CHILDREN FOR EMERGENCY GENERATORS 2 2000 COLLEGE SCHOLARSHIPS FOR HOSPITAL VOLUNTEERS 4 6400 SUPPORT TO PATIENT FAMILIES FOR TEMPORARY HOUSING AND RENTAL ASSISTANCE 103 47221 ACTUAL COST PAYMENTS TO HOUSING AND RENTAL COMPANIES SUPPORT TO PATIENT FAMILIES FOR UTILITY PAYMENTS 25 14518 ACTUAL COST PAYMENTS TO UTILITY COMPANIES SUPPORT TO PATIENT FAMILIES FOR TRANSPORTATION TO APPOINTMENTS 191 9477 ACTUAL COST PAYMENTS TO TRANSPORTATION COMPANIES SUPPORT TO PATIENT FAMILIES FOR MEDICAL EQUIPMENT 58 6938 ACTUAL COST PAYMENTS TO MEDICAL EQUIPMENT PROVIDERS SUPPORT TO PATIENT FAMILIES FOR FUNERAL EXPENSES 9 1580 ACTUAL COST PAYMENTS TO FUNERAL HOMES SUPPORT TO PATIENT FAMILIES FOR VARIOUS NEEDS 10 295 SUPPORT TO PATIENT FAMILIES TO PURCHASE GROCERIES 307 18050 MARKET VALUE SAFEWAY GIFT CARDS SUPPORT TO PATIENT FAMILIES TO PURCHASE GAS FOR TRANSPORTATION TO APPOINTMENTS 411 17641 MARKET VALUE GAS CARDS SUPPORT TO PATIENT FAMILIES WHO LACK THE FINANCIAL RESOURCES TO PURCHASE FOOD 943 5060 MARKET VALUE MEAL VOUCHERS TO CAFETERIA SUPPORT TO PATIENT FAMILIES WHO LACK THE FINANCIAL RESOURCES TO PURCHASE FOOD 245 4023 MARKET VALUE FOOD BAGS SUPPORT TO PATIENTS AND FAMILIES WHO ARE ADMITTED ON AN EMERGENT / URGENT BASIS 63 870 MARKET VALUE CLOTHING SUPPORT TO PATIENT FAMILIES TO CONNECT WITH FAMILY AND FRIENDS DURING CHILD'S HOSPITALIZATION 4 12 MARKET VALUE PHONE CARDS PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: A SPONSORSHIP COMMITTEE WAS ESTABLISHED BY SEATTLE CHILDREN'S HOSPITAL TO MEET REGULARLY FOR THE PURPOSE OF EVALUATING DIFFERENT OPPORTUNITIES TO SUPPORT OTHER NONPROFIT ORGANIZATIONS THROUGH PROVIDING VOLUNTEERS, GRANTS, AND SPONSORSHIPS FOR FUNDRAISING AND EDUCATIONAL EVENTS. CRITERIA USED IN THE DETERMINATION OF ASSISTANCE INCLUDE: THE ORGANIZATION'S ALIGNMENT WITH THE HOSPITAL'S CORE MISSION AND VALUES, THE DIVERSITY AND LOCATION OF THE POPULATION SERVED, AS WELL AS DOCUMENTED COMMUNITY NEED ADDRESSED BY THE ORGANIZATION. THE PURPOSE OF GRANTS DISTRIBUTED FROM THE REUBEN CROSSET ENDOWMENT FUND IS TO IMPROVE THE HEALTH OF CHILDREN LIVING IN SOUTHEAST ALASKA. AN ADVISORY COMMITTEE OF SEATTLE CHILDREN'S REPRESENTATIVES REVIEWS APPLICATIONS AND VISITS THE CITIES OF KETCHIKAN, SITKA, AND JUNEAU ANNUALLY TO GAIN FEEDBACK ON THE NEEDS OF THE COMMUNITIES AND VISIT ORGANIZATIONS THAT HAVE APPLIED FOR FUNDING. GRANT RECIPIENTS ARE ASKED TO PROVIDE A REPORT ON HOW THEY WILL EVALUATE THE SUCCESS OF THEIR PROJECT AND RETURN ANY UNSPENT GRANT FUNDS TO THE ENDOWMENT. ORGANIZATIONS SELECTED AS SUBGRANTEES UNDER THE GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH (GAPPS) PROGRAM ARE REQUIRED TO PROVIDE WRITTEN AND FINANCIAL REPORTS. THESE REPORTS ARE PREPARED ON AN INTERIM BASIS AS WELL AS AT THE END OF THE FISCAL YEAR. ADDITIONALLY, PRINCIPAL INVESTIGATORS HAVE QUARTERLY CHECK-IN PHONE CALLS AND ATTEND AN ANNUAL INVESTIGATORS MEETING IN SEATTLE TO REPORT ON THEIR PROGRESS. ALL ORGANIZATIONS SELECTED AS SUBGRANTEES ISSUED UNDER THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) GRANT NUMBER H75DP004595 ENTITLED, 'TRANSFORMING THE HEALTH OF SOUTH KING COUNTY TO REDUCE HEALTH INEQUITIES,' ARE REQUIRED TO ADHERE TO ALL TERMS AND CONDITIONS AS STATED IN THE SEATTLE CHILDREN'S NOTICE OF AWARD AS WELL AS ALL FEDERAL GRANT AND CONTRACT POLICIES (AND OMB CIRCULARS). THE FOLLOWING PROGRESS REPORTS ARE REQUIRED PER AWARD GUIDELINES: MONTHLY PROGRESS PHONE CALLS, INTERIM PROGRESS REPORTS, ANNUAL AND FINAL PROGRESS. QUARTERLY PREVENTION AND PUBLIC HEALTH FUND (PPHF) REPORTING IS REQUIRED AS WELL AS A FINAL FINANCIAL REPORT. ADDITIONAL PROGRESS/FINANCIAL REPORTING IS REQUIRED DEPENDING ON EACH ORGANIZATION'S A-133 AUDIT FINDINGS OR AS NEEDED BASED ON THE DELIVERABLES AS SET FORTH IN THE AGREEMENT. X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 THOMAS HANSEN MD 382655 382654 144595 144593 21681 1610551 7500 205005 12953 12952 569384 2355755 0 1609194 KELLY WALLACE 322838 107613 99588 33196 9605 2231774 11250 118675 17064 5688 460345 2496946 0 2231394 PATRICK HAGAN 53539 0 154928 0 555888 3366467 15000 114624 3887 0 783242 3481091 0 3366467 DAVID FISHER MD 501843 0 173406 0 10132 0 15000 87505 23404 0 723785 87505 0 0 LISA BRANDENBURG 501797 0 115487 0 16126 0 10000 85205 23422 0 666832 85205 0 0 SANFORD MELZER MD 200231 186700 81892 27297 7579 49849 11250 64266 15844 9532 316796 337644 0 49849 JAMES HENDRICKS MD 326893 0 110465 0 4679 0 15000 51279 21697 0 478734 51279 0 0 EDWIN WRIGHT 345758 0 116994 0 2783 0 12854 25385 21869 0 500258 25385 0 0 JEFFREY SCONYERS 153314 153314 45574 44972 5072 539 7500 52484 10750 10750 222210 262059 0 0 STEVEN HURWITZ 335768 0 65593 0 2246 0 13131 0 21020 0 437758 0 0 0 SUSAN HEATH 262538 0 129567 0 6374 0 15000 0 9108 0 422587 0 0 0 DREXEL DEFORD 202050 0 118199 0 29507 0 10000 38141 9270 0 369026 38141 0 0 CINDY EVANS 291319 0 72659 0 3333 0 16933 0 17410 0 401654 0 0 0 SUZANNE PETERSEN 288291 0 58529 0 7682 0 16892 0 21316 0 392710 0 0 0 CARA BAILEY 243593 0 94112 0 2995 0 16978 0 8932 0 366610 0 0 0 ERIK LAUSUND 237082 0 62050 0 3837 0 17449 0 10728 0 331146 0 0 0 JENNIFER ABERMANIS 220577 0 59200 0 3234 0 16918 0 20711 0 320640 0 0 0 WARREN HEWITT 213725 0 58032 0 4117 0 17156 0 12593 0 305623 0 0 0 TODD JOHNSON 215512 0 44729 0 5455 0 14583 0 20605 0 300884 0 0 0 JUDY DOUGHERTY 221354 0 31649 0 4376 0 16711 0 12664 0 286754 0 0 0 RUTH BENFIELD 201068 0 48621 0 4795 0 16924 0 12480 0 283888 0 0 0 STEPHANIE AXELROD 210617 0 26 0 2101 0 14602 0 20511 0 247857 0 0 0 DOUGLAS PICHA 32281 290531 13574 122170 7468 563874 1500 64411 2168 19511 56991 1060497 0 562848 JOE RUTLEDGE 374769 0 40622 0 12778 0 16895 0 14102 0 459166 0 0 0 CRAIG RUBENS 324474 0 91867 0 2226 0 11908 0 13521 0 443996 0 0 0 DAVID BRAUNER 287636 0 108059 0 3689 0 12500 0 20220 0 432104 0 0 0 ANNE MANKTELOW 366470 0 0 0 2116 0 12500 0 7244 0 388330 0 0 0 PART I, LINE 1A BUSINESS OR FIRST CLASS TRAVEL IS PROVIDED TO EMPLOYEES IN THE EVENT OF MEDICAL NECESSITY OR ON CERTAIN INTERNATIONAL FLIGHTS OF LONG DURATION. THIS IS NOT TREATED AS COMPENSATION. THE CHIEF EXECUTIVE OFFICER IS PROVIDED MEMBERSHIP TO THE RAINIER CLUB. ANNUAL DUES ARE REPORTED AS IMPUTED COMPENSATION. JAMES HENDRICKS AND DOUGLAS PICHA ARE PROVIDED ROTARY CLUB MEMBERSHIPS, WHICH ARE NOT TREATED AS COMPENSATION. PART I, LINE 4B THE FOLLOWING EMPLOYEES PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THOMAS HANSEN MD - $197,505 DEFERRED COMPENSATION, $1,609,194 REPORTABLE PAYMENT. KELLY WALLACE - $114,925 DEFERRED COMPENSATION, $2,231,394 REPORTABLE PAYMENT. PATRICK HAGAN - $114,624 DEFERRED COMPENSATION, $3,366,467 REPORTABLE PAYMENT. DAVID FISHER MD - $87,505 DEFERRED COMPENSATION. LISA BRANDENBURG - $85,205 DEFERRED COMPENSATION. SANFORD MELZER MD - $48,320 DEFERRED COMPENSATION, $49,849 REPORTABLE PAYMENT. JAMES HENDRICKS MD - $51,279 DEFERRED COMPENSATION. EDWIN WRIGHT - $25,385 DEFERRED COMPENSATION. JEFFREY SCONYERS - $44,984 DEFERRED COMPENSATION. DOUGLAS PICHA - $50,911 DEFERRED COMPENSATION, $562,848 REPORTABLE PAYMENT. DREXEL DEFORD - $38,141 DEFERRED COMPENSATION. SUPPLEMENTAL INFORMATION PART III 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: THOMAS HANSEN MD - $1,609,194 KELLY WALLACE - $2,231,394 PATRICK HAGAN - $3,366,467 SANFORD MELZER MD - $49,849 DOUGLAS PICHA - $562,848 A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93987HDX0 2012-06-20 80423004 SEE PART VI 0 0 0 B WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HEZ4 2012-06-20 142165000 SEE PART VI 0 0 0 C WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HAA3 2010-09-02 77394750 SEE PART VI 0 0 0 D WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HAB1 2010-09-02 46669601 SEE PART VI 0 0 0 A 80423004 285 30419377 50003342 2013 0 1 0 1 B 142165000 2012 1 0 1 1 C 77394750 77394750 2010 0 0 1 1 D 46669601 20887 568714 2010 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 ENTITY 1 - FIRST SCHEDULE: PART I, COLUMN F, DESCRIPTION OF PURPOSE: LINE A, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2012A AND REFUNDING REVENUE BONDS, SERIES 2012B (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2012A/B BONDS"), WERE ISSUED TO (I) REIMBURSE SEATTLE CHILDREN'S HOSPITAL ("SEATTLE CHILDREN'S") FOR A PORTION OF THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING CERTAIN HEALTH CARE FACILITIES OF SEATTLE CHILDREN'S, AND (II) TO ADVANCE REFUND AND DEFEASE $27 MILLION OF THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2009 (SEATTLE CHILDREN'S HOSPITAL), DATED AUGUST 19, 2009 (THE "SERIES 2009 BONDS"). THE PROCEEDS OF THE SERIES 2009 BONDS WERE USED TO PROVIDE ALL OR A PORTION OF THE FUNDS NECESSARY TO (I) PAY THE COSTS (INCLUDING NEW CAPITAL COSTS, REIMBURSEMENT COSTS, AND REFINANCING COSTS) OF ACQUIRING THE LAND FOR CONSTRUCTING AND EQUIPPING A NEW OUTPATIENT CLINIC AND AMBULATORY SURGERY FACILITY IN BELLEVUE, WASHINGTON, RENOVATING AND REMODELING VARIOUS PORTIONS OF SEATTLE CHILDREN'S EXISTING FACILITIES AT ITS SEATTLE CAMPUS, AND ACQUIRING NEW AND REPLACEMENT EQUIPMENT TO BE USED INITIALLY IN SEATTLE CHILDREN'S EXISTING FACILITIES ON ITS MAIN CAMPUS AND (II) PAY ISSUANCE COSTS OF THE SERIES 2009 BONDS. THE CUSIP NUMBER IS FOR THE SERIES 2012A BONDS, WHICH HAVE THE LATER OF THE MATURITIES OF THE TWO SERIES. LINE B, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REFUNDING REVENUE BONDS, SERIES 2012C AND REFUNDING REVENUE BONDS, SERIES 2012D (SEATTLE CHILDREN'S HOSPITAL), (THE "SERIES 2012C/D" BONDS"), WERE ISSUED TO REFUND, ON A CURRENT BASIS, AND REDEEM ALL OF THE OUTSTANDING WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2008A AND SERIES 2008B (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER), DATED APRIL 16, 2008 (THE "SERIES 2008A/B BONDS"). THE PROCEEDS OF THE SERIES 2008A/B BONDS WERE ISSUED TO REFUND, ON A CURRENT BASIS, AND REDEEM ALL OF THE OUTSTANDING WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2006A AND SERIES 2006B (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER), EACH DATED FEBURARY 16, 2006 (THE "SERIES 2006A/B BONDS"). THE PROCEEDS OF THE SERIES 2006A/B BONDS WERE USED TO PROVIDE (I) A PORTION OF THE FUNDING TO ADVANCE REFUND AND DEFEASE $67 MILLION OF THE WASHINGTON HEALTH CARE FACILIITES AUTHORITY REVENUE BONDS, SERIES 1998 BONDS (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER), DATED NOVEMBER 17, 1998 (THE "SERIES 1998 BONDS"), AND (II) ADVANCE REFUND AND DEFEASE $66 MILLION OF THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2001 (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER), DATED NOVEMBER 15, 2001 (THE "SERIES 2001 BONDS"). THE PROCEEDS OF THE SERIES 1998 BONDS WERE USED TO PROVIDE A PORTION OF THE FUNDING FOR A COMPREHENSIVE FACILITY RENOVATION PROGRAM THAT INCLUDED EXTENSIVE CAPITAL IMPROVEMENTS TO THE HOSPITAL'S MAIN FACILITY. THE PROCEEDS OF THE SERIES 2001 BONDS WERE USED TO PROVIDE (I) A PORTION OF THE FUNDING FOR A $120 MILLION CAPITAL PROGRAM, (II) PAY FOR THE PREMIUM RELATING TO THE BOND INSURANCE POLICY AND (III) PAY CERTAIN COSTS OF ISSUANCE OF THE SERIES 2001 BONDS. THE CUSIP NUMBER IS FOR THE SERIES 2012D BONDS AND THERE IS NO CUSIP NUMBER FOR THE SERIES 2012C BONDS. LINE C, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2010A (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2010A BONDS"), WERE ISSUED TO REIMBURSE SEATTLE CHILDREN'S FOR THE COSTS OF ACQUIRING CERTAIN REAL PROPERTY (INCLUDING LAND) TO BE DEVELOPED AND USED AS HEALTH CARE FACILITIES OF SEATTLE CHILDREN'S. LINE D, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2010B (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2010B BONDS"), WERE ISSUED TO (I) REFUND, ON A CURRENT BASIS, AND DEFEASE ALL OF THE OUTSTANDING SERIES 1998 BONDS, AND (II) PAY COST OF ISSUANCE FOR THE SERIES 2010B BONDS. PART II, PROCEEDS: COLUMN A, LINES 5 AND 6: $30,419,377.00 OF TOTAL PROCEEDS FROM THE SERIES 2012B BONDS WAS DEPOSITED IN A REFUNDING ESCROW ACCOUNTS AND $285.00 OF TOTAL PROCEEDS WAS DEPOSITED IN THE SERIES 2012B PRINCIPAL AND INTEREST ACCOUNT AND USED TO PAY INTEREST DUE ON THE SERIES 2012B BONDS. COLUMN B: $142,165,000.00 WAS USED TO REFUND, ON A CURRENT BASIS AND REDEEM ALL OF THE OUTSTANDING SERIES 2008A AND SERIES 2008B BONDS WITHIN 90 DAYS OF THE CLOSING OF THE SERIES 2012C/D BONDS. COLUMN D: $46,080,000.00 WAS USED TO REFUND, ON A CURRENT BASIS, AND DEFEASE THE OUTSTANDING SERIES 1998 BONDS, WITHIN 90 DAYS OF THE CLOSING OF THE SERIES 2010B BONDS. $20,887.00 OF PROCEEDS WAS TRANSFERRED TO THE PRINCIPAL AND INTEREST ACCOUNT OF THE SERIES 2010B BONDS, AND USED TO PAY INTEREST DUE ON THE SERIES 2010B BONDS. PART III, PRIVATE BUSINESS USE: COLUMN A AND COLUMN C, LINES 4-6: THERE IS NO PRIVATE USE PROPERTY. PERCENTAGES = 0.00%. PART IV, ARBITRAGE: COLUMN A, LINE 2B: A PORTION OF THE SERIES 2012A/B BOND ISSUE MET THE 6-MONTH SPENDING EXCEPTION TO REBATE SET FORTH IN REGULATIONS 1.148-9(H) AND 1.148-7. COLUMN B, LINE 4A: SEATTLE CHILDREN'S DID NOT ENTER, NOR EXPECTS TO ENTER INTO, ANY INTEREST RATE HEDGE ARRANGEMENTS IN CONNECTION WITH THE SERIES 2012C/D BONDS. SEATTLE CHILDREN'S DID ENTER INTO QUALIFIED HEDGES WITH RESPECT TO THE SERIES 2008A/B BONDS, WHICH WERE REFUNDED BY THE SERIES 2012C/D BONDS. THE TERMINATION OR DEEMED TERMINATION PAYMENT, AS APPLICABLE, WITH RESPECT TO THE HEDGES WILL BE TAKEN INTO ACCOUNT IN THE CALCULATION OF THE YIELD ON THE SERIES 2012C/D BONDS. ENTITY 2 - SECOND SCHEDULE: PART I, COLUMN F, DESCRIPTION OF PURPOSE: LINE A, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2009 (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2009 BONDS") WERE ISSUED TO PROVIDE ALL OR A PORTION OF THE FUNDS NECESSARY TO (I) PAY THE COSTS (INCLUDING NEW CAPITAL COSTS, REIMBURSEMENT COSTS, AND REFINANCING COSTS) OF ACQUIRING THE LAND FOR CONSTRUCTING AND EQUIPPING A NEW OUTPATIENT CLINIC AND AMBULATORY SURGERY FACILITY IN BELLEVUE, WASHINGTON, RENOVATING AND REMODELING VARIOUS PORTIONS OF SEATTLE CHILDREN'S EXISTING FACILITIES AT ITS SEATTLE CAMPUS, AND ACQUIRING NEW AND REPLACEMENT EQUIPMENT TO BE USED INITIALLY IN SEATTLE CHILDREN'S EXISTING FACILITIES ON ITS MAIN CAMPUS AND (II) PAY ISSUANCE COSTS OF THE SERIES 2009 BONDS. LINE B, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2008C (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) (THE "SERIES 2008C BONDS") WERE ISSUED TO (I) REPAY AND RETIRE SEATTLE CHILDREN'S TAXABLE LINE OF CREDIT INDEBTEDNESS OWED TO WELLS FARGO BANK, N.A., WHICH INDEBTEDNESS WAS INCURRED TO REDEEM AND RETIRE THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2006C (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER), DATED FEBRUARY 16, 2006 (THE "SERIES 2006C BONDS"). THE PROCEEDS OF THE SERIES 2006C BONDS WERE USED TO PROVIDE A PORTION OF THE FUNDS NECESSARY TO CONSTRUCT, REMODEL AND/OR ACQUIRE ADDITIONAL HEALTH CARE FACILITIES FOR SEATTLE CHILDREN'S AND (II) TO PAY CERTAIN COSTS OF ISSUANCE OF THE SERIES 2008C BONDS. PART II, PROCEEDS: COLUMN A: LINE 3 INCLUDES INVESTMENT EARNINGS OF $100,396.00. COLUMN B: $90,000,000.00 WAS USED TO REPAY AND RETIRE A TAXABLE LINE OF CREDIT INDEBTEDNESS WITHIN 90 DAYS OF THE CLOSING OF THE SERIES 2008C BONDS. PART III, PRIVATE BUSINESS USE: COLUMN A AND COLUMN B, LINES 4-6: THERE IS NO PRIVATE USE PROPERTY. PERCENTAGES = 0.00%. PART IV, ARBITRAGE: COLUMN A, LINE 2C: THE LAST REBATE COMPUTATION WAS PERFORMED ON OCTOBER 11, 2012. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978E584 2009-08-19 113722874 SEE PART VI 1 0 0 B WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978ES86 2008-05-29 90800036 SEE PART VI 0 0 0 A 27295000 113824086 1975466 111848620 2012 0 0 1 1 B 90800036 800036 2009 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 A 1 B 1 HOSPITAL CENTRAL SERVICES ASSOCIATION (HCSA) KELLY WALLACE, CFO, IS ON THE BOARD OF HCSA. 1847759 SERVICES 0 KING 5 TV FAMILY MEMBER OF CYNTHIA HUFFMAN, TRUSTEE, IS CEO OF KING 5 TV. 517887 SERVICES 0 ELLEN FISCHER DR. ROB ROSKIN, TRUSTEE, IS THE SPOUSE OF ELLEN FISCHER. 103290 EMPLOYMENT 0 SARAH BOWDEN WARREN HEWITT, VP OF FINANCE, IS A FAMILY MEMBER OF SARAH BOWDEN. 38770 EMPLOYMENT 0 LILAH MELZER DR. SANFORD MELZER, KEY EMPLOYEE, IS A FAMILY MEMBER OF LILAH MELZER. 36353 EMPLOYMENT 0 X 42 8188228 MARKET VALUE X 1 1970000 MARKET VALUE X TABLETS 1 60969 MARKET VALUE 0 0 1 1 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): LINE 9 - 42 CONTRIBUTIONS OF VARIOUS AMOUNTS OF SECURITIES; LINE 16 - 1 CONTRIBUTION OF COMMERCIAL REAL ESTATE PROPERTY; LINE 25 - 1 CONTRIBUTION OF 130 MICROSOFT SURFACE TABLETS AND TOUCH COVERS. THIRD PARTY USE: 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 HOSPITAL. WHEN GIFTS OF REAL ESTATE ARE NOT HELD FOR OTHER PURPOSES, SEATTLE CHILDREN'S HIRES REALTY COMPANIES TO SELL THE REAL ESTATE. FORM 990, PART I, LINE 6: SEATTLE CHILDREN'S HOSPITAL HAS A DEDICATED GROUP OF VOLUNTEERS WHO GENEROUSLY GIVE THEIR TIME AND ENERGY TO SUPPORTING THE MISSION OF THE HOSPITAL. IN FISCAL YEAR 2013, 747 VOLUNTEERS, AFTER COMPLETING A THOROUGH INTERVIEW AND TRAINING PROCESS, LOGGED 78,518 HOURS OF SERVICE IN ONE OF THE 80 DIFFERENT DEPARTMENTS, WITH DUTIES RANGING FROM WORKING IN THE HOSPITAL GIFT SHOP, TO ENTERTAINING PATIENTS IN THE PLAYROOM, TO HELPING WITH ADMINISTRATIVE TASKS AT A RECEPTION AREA. IN ADDITION, 28 UNCOMPENSATED TRUSTEES SERVED ON THE SEATTLE CHILDREN'S HOSPITAL BOARD DURING FISCAL YEAR 2013. IN ALL THAT THEY DO, OUR VOLUNTEERS ARE HIGHLY VALUED MEMBERS OF OUR HOSPITAL COMMUNITY. FORM 990, PART VI, SECTION A, LINE 2 SANFORD MELZER AND JEFFREY SCONYERS EACH HAVE A BUSINESS RELATIONSHIP WITH DEAN ALLEN, LIBBY ARMINTROUT, ROBB BAKEMEIER, JOEL BENOLIEL, SUSAN BETCHER, ROSS BOGUE, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, ROBERT FLOWERS, MARY ANN FLYNN, THOMAS HANSEN, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, JIM LADD, MONA LEE LOCKE, PATRICIA LOERA, SANDRA MADRID, SUSAN MASK, JEFF NITTA, LAURIE OKI, JUDITH PIERCE, MICHAEL REEVES, ROB ROSKIN, NANCY SENSENEY, PETE SHIMER, MICHELE SMITH, CHARLES STEVENS, AND KELLY WALLACE. THOMAS HANSEN HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, LIBBY ARMINTROUT, ROBB BAKEMEIER, JOEL BENOLIEL, SUSAN BETCHER, ROSS BOGUE, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, ROBERT FLOWERS, MARY ANN FLYNN, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, JIM LADD, MONA LEE LOCKE, PATRICIA LOERA, SANDRA MADRID, SUSAN MASK, JEFF NITTA, LAURIE OKI, JUDITH PIERCE, MICHAEL REEVES, ROB ROSKIN, NANCY SENSENEY, PETE SHIMER, MICHELE SMITH, CHARLES STEVENS, AND KELLY WALLACE. KELLY WALLACE HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, LIBBY ARMINTROUT, ROBB BAKEMEIER, JOEL BENOLIEL, SUSAN BETCHER, ROSS BOGUE, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, ROBERT FLOWERS, MARY ANN FLYNN, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, JIM LADD, MONA LEE LOCKE, PATRICIA LOERA, SANDRA MADRID, SUSAN MASK, JEFF NITTA, LAURIE OKI, JUDITH PIERCE, MICHAEL REEVES, ROB ROSKIN, NANCY SENSENEY, PETE SHIMER, MICHELE SMITH, AND CHARLES STEVENS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE VOTING MEMBER OF SEATTLE CHILDREN'S HOSPITAL IS SEATTLE CHILDREN'S HEALTHCARE SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A SEATTLE CHILDREN'S HEALTHCARE SYSTEM, AS THE SOLE MEMBER OF SEATTLE CHILDREN'S HOSPITAL, ELECTS THE MEMBERS OF THE BOARD OF TRUSTEES (WHICH IS THE GOVERNING BODY) OF SEATTLE CHILDREN'S HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B SEATTLE CHILDREN'S HEALTHCARE SYSTEM, AS THE SOLE MEMBER OF SEATTLE CHILDREN'S HOSPITAL, HAS THE AUTHORITY TO MAKE, ALTER, AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF SEATTLE CHILDREN'S HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 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 HOSPITAL REQUIRES AN ANNUAL SURVEY OF ALL BOARD MEMBERS OF SEATTLE CHILDREN'S HOSPITAL, MEMBERS OF THE MEDICAL LEADERSHIP, STAFF MEMBERS OCCUPYING ROLES WITH A DEGREE OF AUTHORITY AND MEMBERS OF THE HOSPITAL'S PHARMACY AND THERAPEUTICS COMMITTEE. THE SENIOR VICE PRESIDENT AND GENERAL COUNSEL OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM, ACTING UNDER THE OVERSIGHT OF THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF DIRECTORS, REVIEWS ALL DISCLOSURES AND ESTABLISHES AND OVERSEES ANY NECESSARY MANAGEMENT PLANS RELATED TO THEM. IN GENERAL, WHEN A CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON 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 COVERED PERSON OR OTHER EMPLOYEE WHO ENGAGES IN A VIOLATION OF THIS 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 HOSPITAL 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 OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS), A RELATED ORGANIZATION THAT IS THE SOLE VOTING MEMBER OF SEATTLE CHILDREN'S HOSPITAL. 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 HOSPITAL 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 SCHS 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 HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUATION OF INTEREST RATE SWAP AGREEMENTS 11,352,766. CHANGE IN BENEFICIAL INTEREST IN SCHS 4,071,701. SEATTLE CHILDREN'S COMMUNITY BENEFIT REPORT 2013 LETTER FROM OUR CHIEF EXECUTIVE OFFICER: A PLAN IS JUST ANOTHER PIECE OF PAPER UNTIL YOU ACT ON IT. OUR COMMUNITY BENEFIT IMPLEMENTATION PLAN IS NOT JUST ANOTHER PIECE OF PAPER. THE PLAN, COMPLETED IN 2013, DRIVES THE WORK DESCRIBED IN THE PAGES OF THIS REPORT. BASED ON A COMMUNITY HEALTH NEEDS ASSESSMENT OF THE REGION WE SERVE - WASHINGTON, ALASKA, MONTANA AND IDAHO - THE PLAN ADDRESSES SOME OF THE MOST URGENT HEALTH NEEDS AND HIGHLIGHTS THE NUMEROUS STRENGTHS OUR COMMUNITIES HAVE. WE'RE FOCUSING ON FIVE AREAS: - INCREASING ACCESS TO QUALITY HEALTHCARE FOR ALL CHILDREN AND TEENS - IMPROVING COORDINATION OF CARE FOR CHILDREN WITH CHRONIC CONDITIONS - IMPROVING HEALTH EQUITY AND ACCESS IN SOUTH KING COUNTY - PREVENTING AND TREATING OBESITY - ENHANCING ACCESS TO MENTAL AND BEHAVIORAL HEALTH CHILDREN'S IS WORKING WITH OTHER HOSPITALS AND WITH PUBLIC HEALTH SEATTLE & KING COUNTY AND THE WASHINGTON STATE HOSPITAL ASSOCIATION TO ACHIEVE SOME OF THESE GOALS THROUGH KING COUNTY HOSPITALS FOR A HEALTHIER COMMUNITY. THIS IS THE FIRST TIME HOSPITALS IN WASHINGTON STATE HAVE JOINED TOGETHER FOR A COMMON COMMUNITY HEALTH CAUSE. OUR FIRST STEP WAS TO PLEDGE TO INCREASE HEALTHY FOOD AND BEVERAGE CHOICES IN OUR FACILITIES. WE'RE ALSO COLLABORATING TO CREATE A JOINT COMMUNITY HEALTH ASSESSMENT. CARING FOR THE COMMUNITY IS OUR PASSION, OUR DUTY AND OUR PRIVILEGE. IN PARTNERSHIP WITH FAMILIES, PUBLIC HEALTH, HEALTHCARE PROVIDERS AND COMMUNITY-BASED ORGANIZATIONS, WE ARE WORKING TO MAKE OUR COMMUNITIES HEALTHIER AND SAFER. SINCERELY, TOM HANSEN, MD CEO, SEATTLE CHILDREN'S WHAT IS COMMUNITY BENEFIT? A COMMUNITY BENEFIT IS A PROGRAM OR SERVICE THAT: - 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 TOTAL 2013 VALUE TO THE COMMUNITY: $246,616,000 UNCOMPENSATED CARE (INCLUDING MEDICAID SHORTFALL): $117,244,000 HEALTH PROFESSIONS EDUCATION: $22,017,000 RESEARCH: $91,743,000 COMMUNITY PROGRAMS AND SERVICES: $15,612,000 LEARN MORE ABOUT THE WAYS WE BENEFIT OUR COMMUNITY AT WWW.SEATTLECHILDRENS.ORG/COMMUNITYBENEFIT, WHERE YOU WILL ALSO FIND OUR 2013-2016 COMMUNITY HEALTH ASSESSMENT AND COMMUNITY BENEFIT IMPLEMENTATION PLAN. UNCOMPENSATED CARE NO CHILD SHOULD HAVE TO GROW UP WITH ILLNESS OR INJURY, SO WHEN A CHILD NEEDS SPECIALIZED MEDICAL CARE, OUR DOORS ARE ALWAYS OPEN, REGARDLESS OF A FAMILY'S FINANCIAL SITUATION. WITH THE SUPPORT OF THE COMMUNITY, CHILDREN'S PROVIDED $117.2 MILLION IN UNCOMPENSATED CARE TO CHILDREN IN WASHINGTON, ALASKA, MONTANA AND IDAHO IN 2013. ASSISTANCE AVERTS FINANCIAL HARDSHIP A YOUNG GIRL WAS BORN WITH A LIFE-THREATENING HEART CONDITION. TWO MAJOR VESSELS THAT CARRY BLOOD AWAY FROM HER HEART WERE TRANSPOSED, AND HER HEART WASN'T CIRCULATING OXYGENATED BLOOD TO HER BODY. THE CONDITION REQUIRED THREE SURGERIES AT CHILDREN'S AND LONG HOSPITAL STAYS HERE AND IN HER HOMETOWN OF HELENA, MONT. - CARE THAT COULD HAVE EXCEEDED THE $1 MILLION CAP ON THE FAMILY'S HEALTHCARE PLAN BY UP TO $500,000. A CHILDREN'S SOCIAL WORKER SUGGESTED THEY APPLY FOR FINANCIAL ASSISTANCE, BUT THE FAMILY WAS RELUCTANT. ULTIMATELY, THEY AGREED TO APPLY. "WE WERE BEYOND ELATED WHEN CHILDREN'S SENT US A LETTER SAYING WE QUALIFIED," SAYS THE PATIENT'S MOTHER. "WITHOUT IT, WE MIGHT HAVE LOST EVERYTHING WE HAD, AND OUR PARENTS AND GRANDPARENTS WOULD HAVE SOLD EVERYTHING THEY HAD TO HELP US." OVERCOMING LANGUAGE BARRIERS COMMUNICATION BETWEEN PARENTS AND PROVIDERS IS ESSENTIAL IN CARING FOR CHILDREN WITH CHRONIC AND COMPLEX ILLNESSES. FAMILIES NEED TO WORK WITH A SMALL ARMY OF CAREGIVERS INSIDE AND OUTSIDE THE HOSPITAL, A COMPLEX AND POTENTIALLY CONFUSING SITUATION UNDER THE BEST OF CIRCUMSTANCES AND ESPECIALLY SO FOR FAMILIES WHO SPEAK LIMITED ENGLISH. OUR PATIENT NAVIGATOR PROGRAM HELPS SPANISH AND SOMALI FAMILIES BECOME ACTIVE PARTNERS IN THEIR CHILD'S CARE. "FAMILIES PLAY A VITAL ROLE IN MAINTAINING CONTINUITY BETWEEN THE CARE THEIR CHILD RECEIVES AT CHILDREN'S AND THE CARE THEY RECEIVE IN THE COMMUNITY," SAYS SARAH RAFTON, WHO LEADS THE PATIENT NAVIGATOR PROGRAM. "WE TEACH THEM HOW TO UNDERSTAND ALL THE INFORMATION THEY RECEIVE FROM US AND OTHER PROVIDERS, HOW TO MAKE USE OF IT AND HOW TO MAKE SURE THEIR QUESTIONS AND CONCERNS ARE ADDRESSED." LAST YEAR, THE PATIENT NAVIGATOR PROGRAM ASSISTED 178 INDIVIDUALS. FEATURE: DELIVERING LEGAL REMEDIES WHEN AN ILL CHILD NEEDS HELP, SOME FAMILIES NEED MORE THAN A GOOD DOCTOR. THEY ALSO NEED A GOOD LAWYER. THE WASHINGTON MEDICAL-LEGAL ASSISTANCE PARTNERSHIP (MLP) CAN PROVIDE ONE. THE MLP, A COLLABORATION BETWEEN CHILDREN'S, THE NORTHWEST JUSTICE PROJECT, HARBORVIEW MEDICAL CENTER AND SEA MAR COMMUNITY HEALTH CENTERS, GOES TO BAT FOR LOW-INCOME FAMILIES WHO FACE LEGAL BARRIERS THAT COULD DENY THEIR CHILD ACCESS TO BETTER HEALTH. BASED AT CHILDREN'S, THE MLP SERVED 464 PEOPLE LAST YEAR. "MOST OF THE FAMILIES WE SERVE WOULD NOT HAVE ACCESS TO LEGAL SERVICES IF WE WEREN'T HERE," SAYS SCOTT CRAIN, ONE OF THREE LAWYERS WHO WORK IN THE PROGRAM. THE LAWYERS HAVE THE SKILL AND KNOWLEDGE TO FIGHT FOR ASSISTANCE THAT FAMILIES ARE LEGALLY ENTITLED TO RECEIVE, SUCH AS INSURANCE BENEFITS AND EDUCATIONAL ACCOMMODATIONS. THEY ALSO TRAIN MEDICAL PROVIDERS, SOCIAL WORKERS AND STAFF TO RECOGNIZE LEGAL NEEDS, INTERVENE AS ABLE AND REFER TO THE MLP ATTORNEY AS NEEDED. IN 2013, THE MLP TEAM CONDUCTED 32 TRAININGS, EDUCATING 589 PROVIDERS. "A LITTLE BIT OF LEGAL ADVOCACY CAN GO A LONG WAY," SAYS ANNETTE QUAYLE, WHO COORDINATES THE MLP. "SCOTT AND THE OTHER LAWYERS KNOW THE SYSTEM, THEY KNOW THE LEGAL REQUIREMENTS AND THEY KNOW OUR FAMILIES. THEIR INVOLVEMENT CAN MAKE A HUGE DIFFERENCE." FEATURE: ADVANCING CARE FOR MEDICALLY COMPLEX KIDS CHILDREN WITH MEDICALLY COMPLEX CONDITIONS REQUIRE CARE FROM MANY DIFFERENT PROVIDERS IN A VARIETY OF SETTINGS - OFTEN IN DIFFERENT STATES. MANY OF THE MEDICALLY COMPLEX CHILDREN IN OUR REGION ARE COVERED BY MEDICAID. ADDING TO THE LOGISTICAL COMPLEXITY OF CARING FOR CHILDREN WHO LIVE FAR FROM OUR HOSPITAL IS THE VARIATION IN MEDICAID REIMBURSEMENT RATES FROM STATE TO STATE. CHILDREN'S IS WORKING WITH THE CHILDREN'S HOSPITAL ASSOCIATION AND OTHER HOSPITALS AROUND THE COUNTRY ON A PROPOSAL TO CREATE NATIONAL PROVIDER NETWORKS FOR CHILDREN WITH COMPLEX MEDICAL CONDITIONS. EACH NETWORK WOULD BE ANCHORED BY A CHILDREN'S HOSPITAL. THE GOAL IS TO ENSURE ACCESS TO SPECIALIZED CARE, IMPROVE THE COORDINATION OF CARE AND COLLECT INFORMATION TO INCREASE QUALITY AND REDUCE COSTS. ESTABLISHING STANDARD MEDICAID REIMBURSEMENTS FOR THESE CHILDREN IS A KEY COMPONENT OF THIS PROPOSAL. CHILDREN'S STAFF HAVE EDUCATED U.S. REPRESENTATIVES AND SENATORS REPRESENTING WASHINGTON STATE ABOUT WHAT THE PROPOSAL MEANS TO PATIENTS AND FAMILIES. IN ADDITION TO THIS NATIONAL POLICY EFFORT, WE ARE STUDYING THE ABILITY OF A CASE MANAGEMENT PROGRAM TO IMPROVE RESULTS AND DECREASE COSTS FOR CHILDREN WITH COMPLEX NEEDS. RESEARCH RESEARCH AND HEALING GO HAND IN HAND AT CHILDREN'S. WE IDENTIFY PROBLEMS, FIND ANSWERS AND TRANSLATE OUR DISCOVERIES INTO NEW AND BETTER THERAPIES THAT BENEFIT CHILDREN EVERYWHERE. SEATTLE CHILDREN'S RESEARCH INSTITUTE IS THE LARGEST PEDIATRIC RESEARCH CENTER WEST OF THE MISSISSIPPI, AND ONE OF THE TOP FIVE IN THE NATION BASED ON FUNDING RECEIVED FROM THE NATIONAL INSTITUTES OF HEALTH (NIH). TOTAL EXTRAMURAL FUNDING GREW FROM $37 MILLION IN 2008 TO $76 MILLION IN 2013. USING T-CELLS TO FIGHT CANCER OUR FIRST CANCER IMMUNOTHERAPY CLINICAL TRIAL SHOWED PROMISING RESULTS IN 2013, AS THE FIRST TWO PATIENTS TO ENROLL EXPERIENCED COMPLETE REMISSION OF THEIR RELAPSED ACUTE LYMPHOBLASTIC LEUKEMIA (ALL). THEY THEN UNDERWENT SUCCESSFUL BONE MARROW TRANSPLANTS. CANCER IMMUNOTHERAPY INVOLVES DRAWING BLOOD FROM THE PATIENT, REPROGRAMMING THEIR OWN INFECTION-FIGHTING T-CELLS TO DESTROY THE CANCER CELLS AND THEN INFUSING THE BLOOD BACK INTO THEIR BODY. "LESS THAN 40% OF PATIENTS WITH RELAPSED ALL TYPICALLY SURVIVE, SO IT'S IMPERATIVE THAT WE FIND NEW PATHS TO A CURE," SAYS DR. REBECCA GARDNER, WHO LEADS THE TRIAL. "ULTIMATELY, WE HOPE TO APPLY THIS SAME TYPE OF THERAPY FOR PATIENTS WITH MANY TYPES OF CANCER." READ MORE AT SEATTLECHILDRENS.ORG/AAR. OVERCOMING PARENTAL HESITANCY TOWARD CHILDHOOD VACCINES ABOUT ONE IN 20 CHILDREN IN WASHINGTON STATE DID NOT COMPLY WITH RECOMMENDED CHILDHOOD VACCINE SCHEDULES DURING THE 2012-2013 SCHOOL YEAR - THE SEVENTH HIGHEST RATE IN THE COUNTRY, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION. DR. DOUG OPEL HELPED DEVELOP A SURVEY FOR PARENTS OF YOUNG CHILDREN THAT CAN PREDICT IF A FAMILY IS AT RISK OF FALLING BEHIND ON THEIR CHILD'S VACCINE SCHEDULE. THE SURVEY QUERIES PARENTS' ATTITUDES TOWARD CHILDHOOD VACCINES, SUCH AS HOW CONCERNED THEY ARE ABOUT VACCINE SIDE EFFECTS AND SAFETY AND WHETHER THEY BELIEVE IT'S BETTER TO LET CHILDREN DEVELOP IMMUNITY BY GETTING SICK INSTEAD OF GETTING SHOTS. "PARENT SCORES ON THE SURVEY ARE ASSOCIATED WITH THEIR CHILD'S IMMUNIZATION STATUS, SO THE SURVEY CAN SERVE AS A TOOL FOR DOCTORS TO IDENTIFY VACCINE-HESITANT PARENTS EARLY AND ADDRESS THEIR VACCINE CONCERNS BEFORE THEIR CHILD FALLS BEHIND ON THEIR VACCINATION SCHEDULE," OPEL SAYS. PIONEERING A NEW SURGICAL TREATMENT DR. RICHARD HOPPER HAS DEVELOPED A PIONEERING SURGICAL TREATMENT FOR APERT SYNDROME THAT HELPS CHILDREN WITH THIS CONDITION LEAD MORE NORMAL LIVES. APERT SYNDROME IS A RARE GENETIC DISORDER THAT PREVENTS THE SKULL FROM GROWING PROPERLY, RESTRICTING A CHILD'S BREATHING PASSAGES AND CAUSING SLEEP APNEA. TRADITIONAL SURGERY MOVES A CHILD'S FACIAL BONES IN A SINGLE BLOCK TO IMPROVE BREATHING, BUT IT DOES NOTHING TO REMEDY THE FACIAL DEFORMITIES CAUSED BY THE DISORDER. HOPPER'S TECHNIQUE MOVES FACIAL BONES INDIVIDUALLY, WHICH NOT ONLY TREATS SLEEP APNEA MORE EFFECTIVELY, BUT ALSO IMPROVES A CHILD'S APPEARANCE. "IT'S EXCITING THAT WE CAN NOW OFFER SOMETHING THAT MAKES IT EASIER FOR A CHILD TO INTERACT WITH THEIR PEERS, MEET NEW FRIENDS AND GROW AS ADULTS," HOPPER SAYS. "WE'RE EAGER TO SHARE WHAT WE'VE LEARNED AND HELP MANY MORE CHILDREN IN THE FUTURE." HIS RESEARCH HAS BEEN PRESENTED AT INTERNATIONAL CONFERENCES AND HAS RECEIVED THE MARCHAC AWARD AND KAWAMOTO AWARD FROM THE INTERNATIONAL AND THE AMERICAN SOCIETIES OF CRANIOFACIAL SURGERY, RESPECTIVELY. READ MORE AT SEATTLECHILDRENS.ORG/AAR. OMG! DEVICES POSE DANGEROUS DISTRACTION A STUDY CO-AUTHORED BY DR. BETH EBEL FOUND THAT ONE IN FOUR PEDESTRIANS WAS USING A CELL PHONE OR OTHER MOBILE DEVICE TO TALK, TEXT OR LISTEN TO MUSIC AS THEY CROSSED BUSY SEATTLE STREETS - A POTENTIALLY DANGEROUS DISTRACTION BECAUSE MANY IGNORED BASIC SAFETY RULES SUCH AS LOOKING BOTH WAYS, OBEYING THE LIGHTS AND STAYING IN THE CROSSWALK. TEXTERS WERE THE WORST OFFENDERS. THEY WERE FOUR TIMES LESS LIKELY THAN OTHER PEDESTRIANS TO FOLLOW ALL SAFETY RULES. WHILE MOST OF THE PEDESTRIANS OBSERVED IN THE STUDY WERE ADULTS, MANY CHILDREN USE CELL PHONES AND OTHER MOBILE DEVICES AT A YOUNG AGE. EBEL SAYS THE STUDY UNDERSCORES THE NEED FOR PARENTS TO TALK TO THEIR CHILDREN ABOUT PUTTING DOWN THE PHONE WHILE CROSSING THE STREET. SHE EMPHASIZES THE IMPORTANCE OF TRAFFIC CALMING AND GOOD ROAD DESIGN AROUND SCHOOLS AND WALKING ROUTES SO THAT KIDS AND THEIR PARENTS CAN WALK SAFELY. SOLVING THE MYSTERY OF SIDS DR. DANIEL RUBENS IS INVESTIGATING A POSSIBLE LINK BETWEEN AN INNER EAR DEFICIT AND SUDDEN INFANT DEATH SYNDROME (SIDS) - WORK THAT COULD SAVE THE LIVES OF MANY BABIES AT RISK FOR THIS MYSTERIOUS DISEASE. THE INNER EAR CONTAINS THE ORGANS OF HEARING AND BALANCE. IN A STUDY PUBLISHED LAST YEAR, RUBENS FOUND THAT IMPAIRMENT TO THE BALANCE PORTION OF THE INNER EAR PREVENTED MICE FROM AROUSING AND MOVING AWAY TO ACCESS FRESH AIR WHEN EXPOSED TO SUFFOCATING GASES. THAT FOLLOWS AN EARLIER STUDY IN WHICH RUBENS FOUND THAT SIDS INFANTS HAD A RIGHT-SIDED HEARING IMPAIRMENT AT BIRTH. THE TWO FINDINGS SUPPORT HIS THEORY THAT NEWBORNS WITH INNER EAR DYSFUNCTION, EVEN IF ONLY ON ONE SIDE, MAY LACK A MECHANISM FOR AWAKENING IF THEY MOVE INTO A SUFFOCATING POSITION WHILE SLEEPING. RUBENS PLANS TO CONTINUE HIS RESEARCH WITH A LARGE POPULATION-BASED STUDY OF NEWBORNS IN HOPES OF ULTIMATELY ESTABLISHING A METHOD TO IDENTIFY CHILDREN AT RISK FOR SIDS AND DEVELOPING WAYS TO PREVENT IT. ASSESSING PROBLEMATIC INTERNET USE EVERYONE KNOWS YOUNG PEOPLE SPEND LOTS OF TIME ON THE INTERNET, BUT WHEN DOES IT BECOME A PROBLEM? THE SOCIAL MEDIA AND ADOLESCENT HEALTH RESEARCH TEAM DEVELOPED A SCREENING TOOL THAT ASSESSES THE EFFECTS OF INTERNET USE ON THE HEALTH AND WELL-BEING OF TEENS AND HELPS IDENTIFY THOSE WHO MAY BE STRUGGLING WITH ISSUES CAUSED BY THEIR ONLINE ACTIVITIES. THE TOOL USES 18 QUESTIONS TO MEASURE AND ATTACH A SCORE TO INTERNET USE THAT IS DEEMED RISKY, EXCESSIVE AND IMPULSIVE AND THAT CREATES NEGATIVE CONSEQUENCES SUCH AS FAILING TO BUILD REAL-LIFE RELATIONSHIPS, PERFORMING POORLY IN SCHOOL OR NOT SLEEPING AT NIGHT. A STUDY OF 300 COLLEGE STUDENTS FOUND THAT THOSE SCORING HIGHEST FOR PROBLEMATIC INTERNET USE ALSO WERE MORE LIKELY TO REPORT BEING DEPRESSED, HAVING SOCIAL ANXIETY AND HAVING ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD). READ MORE AT SEATTLECHILDRENS.ORG/AAR. COLLABORATION FUELS DISCOVERY DR. ERIC TURNER AND DR. TIM COX COLLABORATED ON A STUDY AT OUR RESEARCH INSTITUTE THAT COULD EVENTUALLY HELP IDENTIFY THE GENETIC MUTATIONS THAT CAUSE CONGENITAL EAR MALFORMATIONS IN CHILDREN. TURNER, A NEUROSCIENTIST, AND COX, A CRANIOFACIAL EXPERT, DISCOVERED A COMMON MUTATION IN SO-CALLED DUMBO MICE AND RATS - NAMED AFTER THE DISNEY CHARACTER BECAUSE OF THEIR OUTSIZED EARS. THEIR LONG-TERM GOAL IS TO CONNECT INSIGHTS FROM THEIR RODENT RESEARCH TO HUMAN EAR MALFORMATIONS. THEIR WORK IS AN EXAMPLE OF THE INSTITUTE'S MULTIDISCIPLINARY ENVIRONMENT IN ACTION. "THE INSTITUTE PUTS INVESTIGATORS INTERESTED IN DIFFERENT KINDS OF PROBLEMS - IN THIS CASE, BRAIN DEVELOPMENT AND CRANIOFACIAL BIRTH DEFECTS - UNDER ONE ROOF WHERE THEY CAN INTERACT, COMPARE IDEAS AND PURSUE QUESTIONS THEY MAY NOT HAVE IMAGINED ALONE," TURNER SAYS. FEATURE: ANSWERING MENTAL AND BEHAVIORAL HEALTH QUESTIONS OUR MENTAL AND BEHAVIORAL HEALTH EXPERTS CARE FOR CHILDREN WITH ADDICTION, DEPRESSION AND OTHER PROBLEMS THAT AFFECT THEIR DEVELOPMENT, SAFETY AND WELL-BEING. THEY ALSO WORK TO UNDERSTAND THE CAUSES OF THOSE PROBLEMS AND FIND MORE EFFECTIVE WAYS TO TREAT AND PREVENT THEM. - DR. SUSAN FERGUSON CO-LEADS A TEAM STUDYING A PART OF THE BRAIN INVOLVED IN DECISION-MAKING. THE TEAM IDENTIFIED A SET OF NEURONS THAT COULD BE ALTERED OR USED AS A TARGET FOR MEDICATION TO HELP PATIENTS WITH ADDICTION AND OTHER IMPULSE-CONTROL PROBLEMS MAKE BETTER CHOICES. - 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. 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. - DR. LAURA RICHARDSON FOUND THAT MANY YOUNG PEOPLE WITH AN INITIAL POSITIVE SCREENING FOR DEPRESSION GET BETTER WITHOUT REQUIRING ANTIDEPRESSANTS OR PSYCHOTHERAPY AND THAT REGULAR VISITS WITH THEIR CLINICIAN AND POSITIVE SUPPORT FROM THEIR PARENTS ARE KEYS TO THEIR RECOVERY. - DR. MEGAN MORENO AND OUR SOCIAL MEDIA AND ADOLESCENT HEALTH RESEARCH TEAM EXPLORE HOW SOCIAL MEDIA SUCH AS FACEBOOK BOTH REVEALS AND INFLUENCES HEALTH RISKS AMONG YOUNG PEOPLE. THEY FOUND EVIDENCE SUGGESTING THAT CIGARETTES ARE A GATEWAY DRUG TO MARIJUANA AND THAT STUDENTS WHO ENTER COLLEGE INTENDING NOT TO DRINK TYPICALLY REFRAIN FROM HARMFUL LEVELS OF DRINKING. HEALTH PROFESSIONAL EDUCATION CHILDREN'S INVESTMENT IN TRAINING DOCTORS AND NURSES HELPS ENSURE THAT CHILDREN OF FUTURE GENERATIONS WILL HAVE ACCESS TO HIGHLY TRAINED PROFESSIONALS SPECIALIZING IN PEDIATRIC CARE. WE ARE THE ONLY PEDIATRIC RESIDENCY PROGRAM IN A FIVE-STATE REGION AND HELPED TRAIN 848 RESIDENTS AND FELLOWS IN 2013. WE ALSO PROVIDED CONTINUING MEDICAL EDUCATION TO HUNDREDS OF HEALTHCARE PROFESSIONALS ALREADY CARING FOR KIDS IN THE COMMUNITY. NURSING EDUCATION MAKES BROAD IMPACT THE AMERICAN NURSES ASSOCIATION RECOGNIZED THE RANGE AND CONTENT OF OUR PROFESSIONAL DEVELOPMENT PROGRAMS WHEN THEY RENEWED CHILDREN'S MAGNET HOSPITAL DESIGNATION IN 2013. THE MAGNET DESIGNATION RECOGNIZES SELECT HEALTHCARE ORGANIZATIONS FOR THEIR OVERALL NURSING EXCELLENCE - INCLUDING THE STRENGTH OF THEIR PROFESSIONAL DEVELOPMENT PROGRAMS INSIDE THE HOSPITAL AND IN THE COMMUNITY. OUR PARTNERSHIP WITH THE WASHINGTON STATE DEPARTMENT OF HEALTH AND THE STATE SUPERINTENDENT OF PUBLIC INSTRUCTION IS AN EXAMPLE OF OUR OUTREACH EFFORTS. WE COLLABORATE EVERY YEAR TO WEBCAST NINE REGIONAL PEDIATRIC AND NEONATAL NURSING GRAND ROUNDS TO 64 SITES IN ALASKA, MONTANA AND WASHINGTON AND A CONTINUING EDUCATION TELECONFERENCE TO SCHOOL DISTRICTS AND PUBLIC HEALTH NURSES, AND PROVIDE LINKS TO PREVIOUS TELECONFERENCES ARCHIVED ON OUR WEBSITE. LAST YEAR, THE GRAND ROUNDS WERE SHARED WITH 1,600 PROFESSIONALS AND THE TELECONFERENCE WAS BROADCAST TO 350 SCHOOL AND PUBLIC HEALTH NURSES. WE RECENTLY TEAMED UP TO START A NURSING NETWORK FORUM TO PROMOTE SHARED CARE COORDINATION FOR CHILDREN WITH COMPLEX MEDICAL CONDITIONS AS THEY MOVE BETWEEN THE HOSPITAL, SCHOOL AND THEIR PRIMARY CAREGIVER. ADVANCING PHYSICAL THERAPY FOR NEWBORNS CHILDREN'S CARES FOR MANY FRAGILE NEWBORNS WITH PHYSICAL CHALLENGES. THESE INFANTS OFTEN STRUGGLE TO BUILD STRENGTH, GAIN RANGE OF MOTION AND ACQUIRE FEEDING SKILLS. THEY NEED SPECIAL OCCUPATIONAL/PHYSICAL THERAPY (OT/PT) TO ASSIST THEIR DEVELOPMENT, BUT UNTIL RECENTLY, THERE WERE NO FORMAL TRAINING PROGRAMS IN NEONATOLOGY FOR THERAPISTS. CHILDREN'S IS HOME TO THE FIRST NEONATOLOGY PHYSICAL THERAPY FELLOWSHIP PROGRAM IN THE COUNTRY. EACH FELLOW TAKES ACADEMIC COURSES AT ROCKY MOUNTAIN UNIVERSITY OF HEALTH PROFESSIONS IN UTAH AND COMPLETES THEIR CLINICAL WORK AT CHILDREN'S, WHERE THEY RECEIVE ONE-ON-ONE TRAINING FROM MENTOR THERAPISTS. "WE WERE THE FIRST ACCREDITED PROGRAM, AND WE LOOK FORWARD TO MORE NEONATOLOGY FELLOWSHIPS IN PHYSICAL THERAPY, AS THIS FILLS A GREAT TRAINING NEED," SAYS GAYLE BONATO, FELLOWSHIP COORDINATOR. RESIDENTS PROVIDE PRIMARY CARE IN ALASKA TWELVE OF OUR PEDIATRIC RESIDENTS DEDICATE A PORTION OF THEIR TRAINING EACH YEAR TO PRIMARY CARE CLINICS IN ALASKA. EACH RESIDENT SPENDS EIGHT MONTHS IN SEATTLE AND FOUR MONTHS IN ALASKA THROUGHOUT THEIR THREE-YEAR RESIDENCY. IN ALASKA, THEY PROVIDE PRIMARY CARE IN FOUR DIFFERENT SETTINGS THAT SERVE BOTH THE GENERAL POPULATION AND THE ALASKA NATIVE POPULATION. THE ALASKA RESIDENCY TRACK GIVES NEW DOCTORS UNIQUE EXPERIENCES AND PROVIDES ISOLATED COMMUNITIES BETTER ACCESS TO CARE. THE ULTIMATE GOAL OF THE PROGRAM IS TO INTEREST NEW DOCTORS IN ESTABLISHING PRACTICES WHERE THEY'RE BADLY NEEDED. THE ALASKA TRACK IS THE FOURTH TRAINING PATHWAY OFFERED BY CHILDREN'S PEDIATRIC RESIDENCY. THE OTHERS ARE FOR RESIDENTS INTERESTED IN COMMUNITY HEALTH, GLOBAL HEALTH AND RESEARCH. FEATURE: SHARING RESOURCES TO FIGHT OBESITY CHILDHOOD OBESITY HAS TRIPLED IN THE UNITED STATES SINCE 1980, AND ONE IN FIVE YOUTH IN KING COUNTY ARE OBESE OR OVERWEIGHT. WHILE OBESITY CONTRIBUTES TO MANY CHRONIC DISEASES, HEALTHCARE PROVIDERS OFTEN LACK THE TRAINING AND SUPPORT TO EFFECTIVELY CARE FOR OVERWEIGHT KIDS. CHILDREN'S WORKS ON MANY LEVELS TO SHARE KNOWLEDGE AND RESOURCES WITH PROVIDERS SO THEY CAN BETTER FIGHT OBESITY IN OUR COMMUNITIES. OUR EFFORTS IN 2013 INCLUDED INVITING DR. STEVEN GORTMAKER, WHO LEADS THE HARVARD SCHOOL OF PUBLIC HEALTH RESEARCH CENTER, TO SPEAK AT OUR WEEKLY GRAND ROUNDS ABOUT COST-EFFECTIVE WAYS TO REDUCE CHILDHOOD OBESITY. WE ALSO HOSTED A TALK BY DAVID JUST FROM THE CORNELL CENTER FOR BEHAVIORAL ECONOMICS, WHO DISCUSSED HOW TO HELP PEOPLE MAKE HEALTHY FOOD DECISIONS BY CHANGING THE ENVIRONMENT AROUND THEM. MORE THAN 100 PEOPLE FROM HOSPITALS ACROSS THE STATE ATTENDED THE TALK. WE PRODUCED HANDOUTS FOR PRIMARY CARE PROVIDERS TO GIVE PARENTS THAT EXPLAIN IN SEVERAL LANGUAGES THE IMPORTANCE OF ACTIVE PLAY IN A CHILD'S DEVELOPMENT AND OFFER TIPS FOR PROVIDING PLAY TIME FOR KIDS FROM BIRTH TO AGE 5. IN ADDITION, WE WORKED WITH OTHER CHILDREN'S HOSPITALS AROUND THE COUNTRY TO IMPROVE PREVENTION AND MANAGEMENT OF CHILDHOOD OBESITY AND EXPAND HEALTHY HOSPITAL EFFORTS THROUGH THE FOCUS ON A FITTER FUTURE INITIATIVE OF THE CHILDREN'S HOSPITAL ASSOCIATION. COMMUNITY PROGRAMS AND SERVICES CHILDREN'S IS MORE THAN A PLACE WHERE FAMILIES RECEIVE EXPERT MEDICAL CARE. WE ARE A TRUSTED COMMUNITY PARTNER THAT WORKS BEYOND THE WALLS OF THE HOSPITAL TO PROMOTE SERVICES, PROGRAMS AND POLICIES THAT IMPROVE CHILDREN'S HEALTH, SAFETY AND ACCESS TO QUALITY HEALTHCARE. HELPING NEW PARENTS BEGIN THEIR JOURNEY THE PROGRAM FOR EARLY PARENT SUPPORT (PEPS) IS A SEATTLE NONPROFIT THAT HELPS NEW MOMS AND DADS BEGIN THEIR JOURNEY INTO PARENTHOOD. PEPS NEIGHBORHOOD GROUPS HELP PARENTS SHARE EXPERIENCES, LEARN IMPORTANT SKILLS AND DEVELOP CONFIDENCE IN THEIR PARENTING ABILITIES AT WEEKLY MEETINGS. CHILDREN'S SPEECH-LANGUAGE PATHOLOGISTS ATTEND PEPS MEETINGS TO TALK ABOUT HOW PLAYING, READING AND INTERACTING WITH BABIES CONTRIBUTE TO A CHILD'S LANGUAGE DEVELOPMENT. "THEY HAVE VISITED MORE PEPS GROUPS OVER THE LAST SEVEN-PLUS YEARS THAN ANY OTHER SPEAKERS AND HAVE INFORMED, ENGAGED AND REASSURED THOUSANDS OF NEW PARENTS," SAYS L.B. KUSSICK, EXECUTIVE DIRECTOR OF PEPS. LAST YEAR, 250 PARENTS RECEIVED THE INFORMATION. EXPANDING NEWBORN SCREENING ALL BABIES BORN IN WASHINGTON STATE WILL BE SCREENED FOR SEVERE COMBINED IMMUNODEFICIENCY (SCID) AFTER CHILDREN'S IMMUNOLOGISTS HELPED THE STATE DEPARTMENT OF HEALTH (DOH) GAIN LEGISLATIVE APPROVAL TO ADD SCID SCREENING TO THE STATE'S NEWBORN SCREENING PROGRAM. SCID, SOMETIMES CALLED BUBBLE BOY DISEASE, IS A RARE CONDITION THAT MAKES IT IMPOSSIBLE FOR A CHILD TO FIGHT INFECTIONS. DIAGNOSING AND TREATING SCID BEFORE AN INFECTION TAKES HOLD CAN PREVENT COMPLICATIONS AND SAVE LIVES. CHILDREN'S GAVE THE STATE LAB TECHNICAL SUPPORT TO DEVELOP THE SCREENING PROCESS AND EDUCATED LAWMAKERS AND OTHER STAKEHOLDERS ABOUT THE LIFE-THREATENING CONSEQUENCES OF SCID AND THE POWER OF SCREENING TO SAVE LIVES. WHILE THE TEST WILL ADD $8 PER BABY TO THE COST OF NEWBORN SCREENING, THE COST OF CARING FOR ONE BABY WITH SCID CAN RUN INTO THE MILLIONS IF THE CONDITION IS NOT DETECTED EARLY. PROVIDING HELMET SAFETY FOR CHILDREN AND TEENS HELMETS SAVE LIVES AND HELP PREVENT HEAD INJURIES, BUT MANY KIDS DON'T HAVE A HELMET OR DON'T WEAR ONE EVEN THOUGH MANY WASHINGTON CITIES REQUIRE THEM BY LAW. A PROPERLY FITTING BIKE HELMET CAN REDUCE THE RISK OF HEAD INJURY BY 85%. THE KOHL'S HELMET SAFETY PROGRAM AT SEATTLE CHILDREN'S ALLOWS US TO PROVIDE FREE BIKE AND SKI HELMETS TO KIDS AND TEENS IN WASHINGTON STATE. IN PARTNERSHIP WITH KOHL'S, WE HOST UP TO 12 COMMUNITY EVENTS EACH YEAR, WHERE WE DISTRIBUTE THE FREE HELMETS AND TEACH PARENTS AND KIDS PROPER FIT AND USE. WE EMPHASIZE THAT THE HELMET SHOULD BE ADJUSTED TO FIT EACH CHILD'S HEAD AND WORN EVERY TIME THEY BIKE, SKATEBOARD, SKI OR SNOWBOARD. THE PROGRAM DISTRIBUTED 4,257 HELMETS DURING THE LAST FISCAL YEAR. KEEPING KIDS SAFE IN CARS CAR CRASHES ARE THE LEADING CAUSE OF DEATH FOR CHILDREN FROM BIRTH TO AGE 12, ACCORDING TO THE U.S. DEPARTMENT OF TRANSPORTATION. A PROPERLY FIT CHILD SAFETY SEAT REDUCES THE RISK OF FATALITY BY 71%, BUT CHOOSING THE RIGHT CAR SEAT OR BOOSTER SEAT AND INSTALLING IT CORRECTLY ARE EASIER SAID THAN DONE. EVERY YEAR, CHILDREN'S HOSTS FREE CHILD CAR SEAT CHECKS WHERE PARENTS, GRANDPARENTS AND CAREGIVERS CAN GET EXPERT ADVICE AND ASSISTANCE INSTALLING THEIR CHILD'S CAR SEAT. IN 2013, 68 PARENTS WERE SERVED. CHILDREN'S HAS A LONG HISTORY OF PROMOTING CHILD PASSENGER SAFETY. THE HOSPITAL WAS A FOUNDER OF THE WASHINGTON STATE BOOSTER SEAT COALITION, WHICH HELPED PASS THE NATION'S FIRST BOOSTER SEAT LAW IN 2000. SEATTLE CHILDREN'S ALSO WORKS WITH HEAD START PROGRAMS AND OFFERS CLASSES TO NEW PARENTS. SERIES OFFERS IBD ADVICE GROWING UP WITH CROHN'S DISEASE OR ULCERATIVE COLITIS PRESENTS MANY PHYSICAL AND EMOTIONAL CHALLENGES. THE FREQUENT AND URGENT NEED TO GO TO THE BATHROOM AND INCREASED FATIGUE INTERFERE WITH SCHOOL AND ACTIVITIES AND CAUSE EMBARRASSMENT. TO HELP CHILDREN AND THEIR FAMILIES COPE, THE INFLAMMATORY BOWEL DISEASE (IBD) CENTER AT CHILDREN'S PRODUCED A VIDEO SERIES THAT IS AVAILABLE ON OUR WEBSITE AND ON YOUTUBE. THE EIGHT-PART SERIES EXPLAINS IBD, DESCRIBES VARIOUS TREATMENTS AND PROVIDES TIPS FOR DEALING WITH CROHN'S AND ULCERATIVE COLITIS, SUCH AS MAKING SURE CHILDREN CAN LEAVE THEIR CLASSROOM TO USE THE BATHROOM AT ANY TIME. READ ABOUT HOW CHILDREN'S RESEARCHERS ARE USING FECAL TRANSPLANT TO FIND CURES FOR IBD AT SEATTLECHILDRENS.ORG/AAR. BLOG OFFERS INSIGHT ON RAISING TEENS RAISING A TEENAGER IS NOT ALWAYS SMOOTH SAILING. OUR TEENOLOGY 101 BLOG IS A VALUABLE RESOURCE FOR PARENTS AND CAREGIVERS OF TEENS AS THEY NAVIGATE THIS TURBULENT PERIOD IN A CHILD'S LIFE. ADOLESCENT MEDICINE EXPERT DR. YOLANDA EVANS, NURSE JENNIE BROWN, AND OTHERS OFFER TIPS FOR KEEPING TEENS SAFE AND HEALTHY, EXPLORE RELEVANT SOCIAL/POLITICAL ISSUES AND INVITE READERS TO SHARE THEIR PERSONAL INSIGHTS. A RECENT SERIES OF POSTS DISCUSSED PREPARING TEENS FOR COLLEGE. "OUR GOAL IS TO GIVE PARENTS ENCOURAGEMENT, ANSWER LOOMING QUESTIONS AND PROVIDE A WINDOW INTO THE MINDS OF TEENS," EVANS SAYS. CARING FOR KIDS WHERE THEY ARE THE ODESSA BROWN CHILDREN'S CLINIC (OBCC) PROVIDES MEDICAL, DENTAL AND MENTAL HEALTH SERVICES TO LOW-INCOME AND CULTURALLY DIVERSE FAMILIES WHO OFTEN HAVE A DIFFICULT TIME ACCESSING HEALTH CARE. LOCATED IN THE CENTRAL DISTRICT, OBCC IS SEATTLE CHILDREN'S ONLY PRIMARY CARE CLINIC. IN 2013, INTERDISCIPLINARY TEAMS FROM THE CLINIC BEGAN TO OFFER NURSING, MENTAL HEALTH AND CASE MANAGEMENT SERVICES AT BEACON HILL INTERNATIONAL SCHOOL AND MADRONA K-8 SCHOOL. REACHING OUT TO CHILDREN AT SCHOOL INCREASES SOCIAL AND EMOTIONAL DEVELOPMENT, REDUCES ACTING-OUT BEHAVIOR, IMPROVES OVERALL SCHOOL PERFORMANCE AND RAISES STAFF MORALE. "ALL TOO OFTEN WE EXPECT FAMILIES TO COME TO US," SAYS MARK FADOOL, DIRECTOR OF MENTAL HEALTH SERVICES AT OBCC. "BY GOING TO SCHOOLS, WE ARE EXPANDING THE WALLS OF OUR MEDICAL HOME AND MAKING IT POSSIBLE FOR FAMILIES WITH THE MOST BARRIERS TO ACCESS QUALITY SERVICES." PREVENTING TEEN SUBSTANCE ABUSE SEATTLE CHILDREN'S IS AN ACTIVE PARTNER IN PREVENTION WORKS IN SEATTLE (WINS), A COMMUNITY COALITION FIGHTING ADOLESCENT DRUG AND ALCOHOL ABUSE IN NORTHEAST SEATTLE. IN 2013, DR. LESLIE WALKER OF CHILDREN'S AND DR. KEVIN HAGGERTY OF THE SOCIAL DEVELOPMENT RESEARCH GROUP AT THE UNIVERSITY OF WASHINGTON WROTE "A PARENT'S GUIDE TO PREVENTING UNDERAGE MARIJUANA USE," A BOOKLET PUBLISHED BY PREVENTION WINS TO HELP PARENTS DISCOURAGE THEIR CHILDREN FROM USING MARIJUANA - A MORE COMPLICATED JOB NOW THAT MARIJUANA IS LEGAL IN WASHINGTON. PREVENTION WINS ALSO RELEASED A VIDEO ABOUT ADOLESCENT ALCOHOL USE CALLED "A PARENT'S ROLE IN PREVENTION." CHILDREN'S HOSTED THE PREMIERE OF THE VIDEO. WALKER SPOKE AFTERWARD ABOUT WHAT PARENTS CAN DO TO STOP UNDERAGE DRINKING AND JOINED A PANEL DISCUSSION ABOUT THE ROLE OF PARENTS AND THE COMMUNITY. GRANT SUPPORTS BIKE-SHARE PROGRAM CHILDREN'S AWARDED A $500,000 GRANT IN 2013 TO MAKE BIKE HELMETS AVAILABLE AT A NETWORK OF BIKE-SHARE STATIONS IN THE SEATTLE AREA. THE NONPROFIT ORGANIZATION PUGET SOUND BIKE SHARE WILL OPEN THE FIRST 50 RENTAL SITES, INCLUDING ONE AT CHILDREN'S, IN 2014. THE STATION WILL OFFER CHILDREN'S AND OUR NEIGHBORS ACCESS TO A BRAND-NEW FORM OF TRANSPORTATION. THE GRANT IS PART OF CHILDREN'S COMMITMENT TO REDUCING RELIANCE ON SINGLE-OCCUPANCY VEHICLES, WHICH ALSO INCLUDES BUILDING A CYCLE TRACK IN FRONT OF THE HOSPITAL AND CREATING A NEW CONNECTION TO THE NEARBY BURKE-GILMAN TRAIL. CHILDREN'S EMPLOYEES WILL RECEIVE FREE MEMBERSHIPS IN THE BIKE-SHARE PROGRAM. "WE ARE DEDICATED TO SUPPORTING A HEALTHY WORKFORCE AND HELPING OUR EMPLOYEES FIND TRANSPORTATION ALTERNATIVES," SAID LISA BRANDENBURG, HOSPITAL PRESIDENT. "BIKE SHARING IS ALSO ANOTHER OF OUR CONTRIBUTIONS TO MAKE OUR CITY A HEALTHIER PLACE TO LIVE." PROTECTING INFANTS FROM HEAD INJURY THE ABUSIVE HEAD TRAUMA PREVENTION TASK FORCE WORKS TO PREVENT SHAKEN BABY SYNDROME. AS A FOUNDER OF THE STATEWIDE GROUP, CHILDREN'S HELPS INTRODUCE HOSPITALS TO THE PERIOD OF PURPLE CRYING, A TRAINING PROGRAM THAT HELPS PARENTS SAFELY COPE WITH THE POTENTIAL FRUSTRATION OF A BABY'S PROLONGED CRYING, WHICH PREDICTABLY OCCURS DURING THE FIRST SIX MONTHS OF LIFE. THE NATIONAL CENTER ON SHAKEN BABY SYNDROME DEVELOPED THE PROGRAM. THE ACRONYM PURPLE DESCRIBES SPECIFIC CHARACTERISTICS OF AN INFANT'S CRYING AND LETS CAREGIVERS KNOW IT WILL END. CHILDREN'S HELPED RAISE AWARENESS OF THE PROGRAM IN 2013 BY COLLECTING 3,600 HAND-KNIT PURPLE HATS OVER THE COURSE OF THE YEAR AND GIVING THEM TO BABIES BORN IN NOVEMBER AT HOSPITALS OFFERING PERIOD OF PURPLE CRYING TRAINING. FEATURE: CULTIVATING HEALTHY COMMUNITIES CHILDREN'S IS PLANTING SEEDS FOR HEALTHY LIVING AMONG NEARLY 500,000 PEOPLE IN SOUTH SEATTLE AND SOUTH KING COUNTY THROUGH A COMMUNITY-BASED PREVENTION INITIATIVE. TOGETHER WITH THE HEALTHY KING COUNTY COALITION AND PUBLIC HEALTH SEATTLE & KING COUNTY, WE'RE USING A FEDERAL COMMUNITY TRANSFORMATION GRANT (CTG) TO SUPPORT POLICIES AND PROJECTS THAT PROMOTE NUTRITIOUS EATING, PHYSICAL ACTIVITY AND TOBACCO-FREE ENVIRONMENTS IN NUMEROUS COMMUNITIES WHERE THESE PROGRAMS ARE NEEDED MOST. OVER THE LAST YEAR, WE HAVE PARTNERED WITH LOCAL GOVERNMENT, SCHOOLS, CHILDCARE, HOSPITALS AND COMMUNITY ORGANIZATIONS. FOR EXAMPLE, THE CTG HELPED A GROUP OF SEVEN SCHOOL DISTRICTS WORK TOGETHER TO MAKE HEALTHY SCHOOL LUNCHES MORE APPEALING TO STUDENTS, FUNDED A FARM TOUR SO SCHOOLS COULD LEARN ABOUT SOURCING FRESH FOOD DIRECTLY FROM FARMERS AND HELPED TWO SCHOOL DISTRICTS UPDATE THEIR PHYSICAL EDUCATION PROGRAMS. CHILDREN'S AND ITS CTG PARTNERS ALSO EDUCATED STAKEHOLDERS ON POLICIES LIKE INCREASING THE SUPPLY OF TOBACCO-FREE AFFORDABLE HOUSING AND ADDING SINGLE-GENDER SESSIONS AT PUBLIC POOLS TO ENABLE PEOPLE FROM ALL CULTURES TO SWIM FOR EXERCISE. RENTON PUBLIC HOUSING AND RENTON PARKS ARE NOW SMOKE FREE, AND TUKWILA OFFERS WEEKLY SWIMS FOR MEN AND WOMEN. CTG BUILDS ON A PREVIOUS FEDERAL GRANT CALLED COMMUNITIES PUTTING PREVENTION TO WORK, WHICH LED TO A 17% DECLINE IN YOUTH OBESITY IN KING COUNTY, ACCORDING TO A REPORT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. 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