2014-08-12T16:54:56-05:00 2013-09-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2012-10-01 911250116 SEATTLE CHILDREN'S HEALTHCARE SYSTEM SEAT 2069874846 PO BOX 5371 MS RC-507 SEATTLE WA 981455005 KELLY A WALLACE 2069874846 2014-08-12 1 JANE M SEARING P00000565 4254544919 2014-07-28 2012 2015-11-30 17:44:51Z KELLY A WALLACE PO BOX 5371 MS RC-507 SEATTLE WA 981455005 591424002 0 X WWW.SEATTLECHILDRENS.ORG X 1984 WA THE PROVISION OF QUALITY HEALTH CARE SERVICES TO INFANTS, CHILDREN AND ADOLESCENTS. 26 24 12 28 187829 0 6058912 2161183 10901203 3184313 12652102 7258998 471763 155895 30083980 12760389 0 0 0 0 3295041 2816200 0 0 0 2079597 2106939 5374638 4923139 24709342 7837250 570594098 611136103 8796083 8187124 561798015 602948979 X SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) IS ENGAGED IN ACTIVITIES RELATING TO THE PROVISION OF HEALTH CARE SERVICES TO INFANTS, CHILDREN, AND ADOLESCENTS, DELIVERING AND IMPROVING THE DELIVERY AND THE QUALITY OF THOSE SERVICES THROUGH RESEARCH, EDUCATION, AND CONTRIBUTIONS TO OR FOR THE BENEFIT OF TAX-EXEMPT ORGANIZATIONS WHICH PROVIDE HEALTH CARE SERVICES, PRIMARILY SEATTLE CHILDREN'S HOSPITAL. 0 0 1588559 3184313 SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S PROGRAM OPERATING COSTS ARE RELATED TO ACTIVITIES INCURRED TO PROVIDE, DIRECTLY OR INDIRECTLY, HEALTHCARE OR HEALTH RELATED SERVICES APPROPRIATE FOR THE SPECIAL NEEDS OF INFANTS, CHILDREN AND ADOLESCENTS, DELIVERING AND IMPROVING THE DELIVERY OF THOSE SERVICES AND/OR THE QUALITY OF THOSE SERVICES THROUGH RESEARCH, EDUCATION, AND CHILD ADVOCACY. PROGRAM REVENUE IS PRIMARILY RELATED TO SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S PROGRAM RELATED JOINT VENTURE WITH SEATTLE CANCER CARE ALLIANCE (SCCA), A NOT-FOR-PROFIT CORPORATION FORMED IN 1998 BY SEATTLE CHILDREN'S HEALTHCARE SYSTEM, THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, AND FRED HUTCHINSON CANCER RESEARCH CENTER FOR THE PURPOSE OF OFFERING A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES. 1588559 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 3 0 1 12 1 1 1 0 0 0 0 0 0 0 0 0 X 26 24 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X WARREN E HEWITT VP FINANCE 2069874846 4300 ROOSEVELT WAY NE 5TH FLOOR SEATTLE WA 981054718 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 DAVID FISHER MD 5.00 51.00 X 0 685381 125909 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 2137798 548931 238410 KELLY WALLACE 14.00 42.00 X 2372583 432031 152677 JEFFREY SCONYERS 27.50 27.50 X 198825 203960 81484 SANFORD MELZER MD 14.00 41.00 X 143890 289702 84445 JODI LONG 22.00 23.00 X 123856 123856 33576 DONNA REINHART 20.00 20.00 X 86900 86901 28079 PATRICK HAGAN 0.00 55.00 X 3366467 764355 133511 8430319 3135117 878091 6 1 1 0 WELLINGTON TRUST COMPANY NA PO BOX 13766 NEWARK NJ 071880766 INVESTMENT MANAGEMENT 597303 MONTICELLO ASSOCIATES INC 1800 LARIMER STREET STE 2100 DENVER CO 80202 INVESTMENT CONSULTING 250000 BNY MELLON NA PO BOX 223230 PITTSBURGH PA 152512230 INVESTMENT SERVICES 151063 CAPITAL GUARDIAN TRUST COMPANY PO BOX 659518 SAN ANTONIO TX 782659088 INVESTMENT MANAGEMENT 138661 4 2161183 51486 2161183 SERVICES THROUGH SCCA 900099 2779333 2779333 MEDICAL CLINIC RENTAL 900099 404980 404980 3184313 3277869 187829 3090040 482458 326563 155895 155895 155895 579903910 2414269 575102266 3234784 4801644 -820515 3981129 3981129 12760389 3184313 187829 7227064 X 1515092 1515092 682885 682885 395518 395518 100071 100071 122634 70667 51967 128420 128420 530516 530516 52046 52046 1006302 1006302 1560 1560 69786 69786 LICENSES AND TAXES 313449 313449 4860 2800 2060 4923139 1588559 3334580 0 388745 383772 0 181962 174689 224810 43568872 301499 46586316 43267373 184681511 175774975 212390488 255670890 115282589 122454286 11089760 13178035 570594098 611136103 433595 676926 38442 38442 8324046 7471756 8796083 8187124 X 467069079 501686992 19901943 24496393 74826993 76765594 561798015 602948979 570594098 611136103 X 7837250 28813714 4500000 X 0 1 X 1 0 X 8543940 4426584 6249116 6058912 2161183 27439735 8543940 4426584 6249116 6058912 2161183 27439735 27439735 7813686 5361362 5752273 4735326 3572498 27235145 146620 187829 334449 346144 346144 55355473 42362042 0.49570 0.53960 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: PENSION FORFEITURE - 2011 AMOUNT: $ 346,144. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 278449000 492000 34591000 3058000 310474000 243536000 408000 37409000 2904000 278449000 243212000 1204000 1848000 2728000 243536000 221667000 667000 23571000 2693000 243212000 221109000 650000 2392000 2484000 221667000 0.82970 0.13710 0.03320 0 0 41984292 41984292 1319730 301499 1018231 264850 264850 43267373 POOLED INVESTMENTS 214081185 C CHARITABLE REMAINDER UNITRUSTS 894626 C PERPETUAL & TESTAMENTARY TRUSTS 33941151 C GIFT ANNUITIES 3774150 C DEFERRED COMPENSATION PLANS 2484522 C OTHER ALTERNATIVE INVESTMENTS 495256 C 255670890 INVESTMENT IN SCCA 96497333 C INVESTMENT IN SCRI, LLC 21901672 C INVESTMENT IN SYZYGY LLC 3946730 C ACCRUED INTEREST 108551 F 122454286 ANNUITIES AND TRUSTS PAYABLE 2956350 DEFERRED COMPENSATION PAYABLE 2834521 PAYABLE TO AFFILIATES 1571992 OTHER PAYABLES 108893 7471756 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) AND SEATTLE CHILDREN'S HOSPITAL (SCH) SHARE IN A UNIFIED ENDOWMENT FUND (UEF) THAT IS MANAGED BY SCHS. SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S TEMPORARILY AND PERMANENTLY RESTRICTED ASSETS REFLECT ENDOWMENTS WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ACCOUNTING STANDARDS CERTIFICATION (ASC) TOPIC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT THE COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. DURING THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, SCHS DID NOT RECORD ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. CENTRAL AMERICA AND THE CARIBBEAN - INVESTMENTS 192260307 0 0 0 0 0 0 192260307 0 192260307 1 0 1 1 1 0 METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: THE ACCRUAL METHOD WAS USED TO ACCOUNT FOR INVESTMENTS. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 DAVID FISHER MD 0 501843 0 173406 0 10132 87505 15000 0 23404 87505 723785 0 0 THOMAS HANSEN MD 382654 382655 144593 144595 1610551 21681 205005 7500 12952 12953 2355755 569384 1609194 0 KELLY WALLACE 107613 322838 33196 99588 2231774 9605 118675 11250 5688 17064 2496946 460345 2231394 0 JEFFREY SCONYERS 153314 153314 44972 45574 539 5072 52484 7500 10750 10750 262059 222210 0 0 SANFORD MELZER MD 66744 200231 27297 81892 49849 7579 52070 11250 5281 15844 201241 316796 49849 0 JODI LONG 112406 112405 10420 10420 1030 1031 8555 8554 8233 8234 140644 140644 0 0 DONNA REINHART 80319 80320 6356 6357 225 224 5819 5818 8221 8221 100940 100940 0 0 PATRICK HAGAN 0 53539 0 154928 3366467 555888 114624 15000 0 3887 3481091 783242 3366467 0 PART I, LINE 1A THE CHIEF EXECUTIVE OFFICER IS PROVIDED MEMBERSHIP TO THE RAINIER CLUB. ANNUAL DUES ARE REPORTED AS TAXABLE COMPENSATION. PART I, LINE 4B THE FOLLOWING EMPLOYEES PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DAVID FISHER MD - $87,505 DEFERRED COMPENSATION. THOMAS HANSEN MD - $197,505 DEFERRED COMPENSATION, $1,609,194 REPORTABLE PAYMENT. KELLY WALLACE - $114,925 DEFERRED COMPENSATION, $2,231,394 REPORTABLE PAYMENT. JEFFREY SCONYERS - $44,984 DEFERRED COMPENSATION. SANFORD MELZER MD - $48,320 DEFERRED COMPENSATION, $49,849 REPORTABLE PAYMENT. PATRICK HAGAN - $114,624 DEFERRED COMPENSATION, $3,366,467 REPORTABLE PAYMENT. 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 SANFORD MELZER MD - $49,849 PATRICK HAGAN - $3,366,467 X 13 51486 MARKET VALUE 0 0 1 1 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): LINE 9 - 13 CONTRIBUTIONS OF VARIOUS AMOUNTS OF SECURITIES. 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 HEALTHCARE SYSTEM (SCHS). FORM 990, PART I, LINE 6: 28 MEMBERS OF THE BOARD OF TRUSTEES PERFORM THEIR DUTIES UNCOMPENSATED. FORM 990, PART VI, SECTION A, LINE 2 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. JEFFREY SCONYERS 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, 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. 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 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 HEALTHCARE SYSTEM REQUIRES AN ANNUAL SURVEY OF ALL BOARD MEMBERS OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM, MEMBERS OF THE MEDICAL LEADERSHIP, STAFF MEMBERS OCCUPYING ROLES WITH A DEGREE OF AUTHORITY AND MEMBERS OF SEATTLE CHILDREN'S HOSPITAL'S PHARMACY AND THERAPEUTICS COMMITTEE. THE SENIOR VICE PRESIDENT 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 HEALTHCARE SYSTEM AND/OR TERMINATED IN HIS OR HER EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION FALLS WITHIN THE PURVIEW OF THE MANAGEMENT DEVELOPMENT AND COMPENSATION COMMITTEE ("MDCC") OF THE BOARD OF TRUSTEES. PURSUANT TO THE BOARD-APPROVED MDCC CHARTER, THE MDCC ENGAGES AN INDEPENDENT THIRD-PARTY CONSULTANT EXPERT IN THE COMPENSATION OF EXECUTIVES AND OTHER TOP MANAGERS OF NONPROFIT HOSPITALS AND HEALTH CARE SYSTEMS. WITH APPROPRIATE COMPARABILITY DATA PROVIDED BY ITS CONSULTANT (COMPRISING MARKET DATA REGARDING COMPENSATION PAID FOR COMPARABLE SERVICES IN COMPARABLE ORGANIZATIONS), THE MDCC ENGAGES IN AN ANNUAL REVIEW AND ASSESSMENT OF THE SEATTLE CHILDREN'S HEALTHCARE SYSTEM EXECUTIVE COMPENSATION PROGRAM (BASE, INCENTIVE COMPENSATION, AND EMPLOYER-PAID BENEFITS) TO DETERMINE COMPETITIVENESS. BASED ON THIS EXPERT ANALYSIS AND ON RELEVANT PERFORMANCE INFORMATION FOR THE EXECUTIVES IN QUESTION AND THE ORGANIZATION AS A WHOLE, THE MDCC PRESENTS A RECOMMENDATION TO THE BOARD REGARDING THE TOTAL COMPENSATION PACKAGE FOR EACH OF THE EFFECTED EXECUTIVES, INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND KEY EMPLOYEES. THE FULL BOARD REVIEWS THE RECOMMENDATIONS AS WELL AS ALL RELEVANT COMPARABILITY DATA AND THE GOALS OF THE ORGANIZATION IN MAKING ITS FINAL DECISION. IN DOING SO IT RELIES ON THE EXPERT ANALYSIS TO DETERMINE THAT COMPENSATION IS REASONABLE AND WITHIN THE "BOUNDS OF COMPETITIVE PRACTICE". ALL DELIBERATIONS AND DECISIONS OF THE MDCC AND FULL BOARD ARE DOCUMENTED IN THE BOOKS AND RECORDS IN ACCORDANCE WITH GENERAL ADMINISTRATIVE PROVISIONS AND PROCEDURES WITHIN THE BYLAWS. THE PROCESS FOLLOWED BY THE MDCC AND THE FULL BOARD SATISFIES BEST GOVERNANCE PRACTICES AND ALSO MEETS THE REGULATORY REQUIREMENTS NECESSARY TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO THE BOARD'S DECISION. FORM 990, PART VI, SECTION C, LINE 19 SEATTLE CHILDREN'S HEALTHCARE SYSTEM MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, COLUMN (D): ALTHOUGH SEATTLE CHILDREN'S HEALTHCARE SYSTEM HAS SUBSTANTIAL CONTRIBUTION REVENUE, IT DOES NOT INCUR FUNDRAISING EXPENSES. ALL FUNDRAISING ACTIVITIES AND CONTRIBUTIONS TO SEATTLE CHILDREN'S HEALTHCARE SYSTEM ARE CONDUCTED BY RELATED ORGANIZATIONS. SEE ADDITIONAL DESCRIPTION FOR SCHEDULE M, LINE 32. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: SHARE OF LOSS FROM INVESTMENT IN SCCA RELATED TO PROCURE SEATTLE HOLDINGS 4,500,000. 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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