SCRIPPS HEALTH: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: SCRIPPS HEALTH (EIN 95-1684089)
Tax period: 2010-10-01 to 2011-09-30
Filed: 2012-08-07
IRS object ID: 201212209349301351
Schema version: 2010v3.7
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-08-07T18:05:47-05:00	Timestamp
Tax Period End Date	2011-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	4370 LA JOLLA VILLAGE DR SUITE 500	AddressLine1
City	SAN DIEGO	City
State	CA	State
ZIP Code	92122	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	951684089	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SCRIPPS HEALTH	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SCRI	NameControl
Phone	8586787226	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4275 CAMPUS POINT COURT	AddressLine1
City	SAN DIEGO	City
State	CA	State
ZIP Code	92121	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RICHARD ROTHBERGER	Name
Title	EVP/CFO	Title
Date Signed	2012-08-06	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	8585357200	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	CHRISTOPHER VAN GORDER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	4275 CAMPUS POINT COURT	AddressLine1
City	SAN DIEGO	City
State	CA	State
ZIP Code	92121	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	2972936548	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.SCRIPPSHEALTH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1924	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. (CONTINUED IN SCHEDULE O)	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	14503	TotalNbrEmployees
Total Nbr Volunteers	2017	TotalNbrVolunteers
Total Gross UBI	1570062	TotalGrossUBI
Net Unrelated Business Txbl Income	116296	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	32675457	ContributionsGrantsPriorYear
Contributions Grants Current Year	29783755	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	2168904416	ProgramServiceRevenuePriorYear
Program Service Revenue CY	2330470088	ProgramServiceRevenueCY
Investment Income Prior Year	43151540	InvestmentIncomePriorYear
Investment Income Current Year	52825764	InvestmentIncomeCurrentYear
Other Revenue Prior Year	21717638	OtherRevenuePriorYear
Other Revenue Current Year	23264824	OtherRevenueCurrentYear
Total Revenue Prior Year	2266449051	TotalRevenuePriorYear
Total Revenue Current Year	2436344431	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	248745	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	1807000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1007336617	SalariesEtcPriorYear
Salaries Etc Current Year	1055666424	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	9260455	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1069409188	OtherExpensePriorYear
Other Expenses Current Year	1100823614	OtherExpensesCurrentYear
Total Expenses Prior Year	2076994550	TotalExpensesPriorYear
Total Expenses Current Year	2158297038	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	189454501	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	278047393	RevenuesLessExpensesCY
Total Assets BOY	2593861709	TotalAssetsBOY
Total Assets EOY	2852085000	TotalAssetsEOY
Total Liabilities BOY	1028635427	TotalLiabilitiesBOY
Total Liabilities EOY	1067338141	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1565226282	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1784746859	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. (CONTINUED IN SCHEDULE O)	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	1946297403	Expense
Grants	1807000	Grants
Revenue	2351857161	Revenue
Description	SEE SCHEDULE O	Description
Total Program Service Expense	1946297403	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	true	ForeignOffice
Foreign Activities	true	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	true	DeductibleNonCashContributions
Deductible Contributions Of Art	true	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	1333	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	14503	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	true	ForeignFinancialAccount
Name Of Foreign Country	CJ	NameOfForeignCountry
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form1098 C Filed	false	Form1098CFiled
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	RICHARD ROTHBERGER	NamePerson
Telephone Number	8586786828	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	4275 CAMPUS POINT COURT	AddressLine1
City	SAN DIEGO	City
State	CA	State
ZIP Code	92121	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (42 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
MARY JO ANDERSON CHS
TRUSTEE	5.0	X	0	0	0
RICHARD BIGELOW
TRUSTEE	5.0	X	0	0	0
DOUGLAS A BINGHAM ESQ
TRUSTEE	5.0	X	0	0	0
JEFF BOWMAN
TRUSTEE (PART-YEAR)	5.0	X	0	0	0
JUDY CHURCHILL PHD
TRUSTEE	5.0	X	0	0	0
GORDON R CLARK
TRUSTEE	5.0	X	0	0	0
MARTIN C DICKINSON
TRUSTEE	5.0	X	0	0	0
VIRGINIA GILLIS RSM EDD
TRUSTEE	5.0	X	0	0	0
RICHARD L HALL MD
TRUSTEE (PART-YEAR)	5.0	X	0	0	0
KATHERINE A LAUER
TRUSTEE	5.0	X	0	0	0
MARTY J LEVIN
TRUSTEE	5.0	X	0	0	0
ERNEST S RADY
TRUSTEE (PART-YEAR)	5.0	X	0	0	0
MAUREEN STAPLETON
TRUSTEE	5.0	X	0	0	0
ROBERT TJOSVOLD
TRUSTEE	5.0	X	0	0	0
CHRISTOPHER VAN GORDER
PRESIDENT AND CEO	40.0	X	1453121	0	1213781	X
RICHARD VORTMANN
TRUSTEE (PART-YEAR)	5.0	X	0	0	0
ABBY SILVERMAN WEISS
TRUSTEE	5.0	X	0	0	0
RICHARD ROTHBERGER
EXEC VP/CFO	40.0		883519	0	143644	X
RICHARD SHERIDAN
CORP SR VP, GENERAL COUNSEL	40.0		574758	0	609240	X
GALE KEEL
ASST SEC TO SCRIPPS BOARD	40.0		87477	0	12840	X
VIRGINIA LEARY
EXEC SECRETARY TO CEO	40.0		92733	0	21097	X
ARNOLD BRENT EASTMAN MD
CORP SR VP, CHIEF MED OFFICER	40.0		728589	0	528983		X
VICTOR V BUZACHERO
CORP SR VP INNOVAT/HR/PERF MGT	40.0		642395	0	156738		X
JUNE KOMAR
CORP EXEC VP, STRATEGY & ADMIN	40.0		626504	0	605371		X
LARRY HARRISON
CHIEF EXECUTIVE, SR VP	40.0		658470	0	109493		X
THOMAS GAMMIERE
CHIEF EXECUTIVE, SR VP	40.0		615525	0	117086		X
GARY FYBEL
CHIEF EXECUTIVE, SR VP	40.0		678579	0	101184		X
ROBIN BROWN
CHIEF EXECUTIVE, SR VP	40.0		550038	0	287858		X
CARL ETTER
CHIEF EXECUTIVE, SR VP	40.0		538731	0	84454		X
JOHN ENGLE
CHIEF EXECUTIVE, SR VP	40.0		485831	0	83220		X
MARY L CARRAHER
CHIEF EXECUTIVE, SR VP	40.0		319325	0	32808		X
BARBARA PRICE
CORP SR VP BUS & SERV LINE DEV	40.0		527886	0	90853		X
DAVID M COHN
CORP VP, REVENUE CYCLE	40.0		406208	0	71465		X
MARC A REYNOLDS
CORP SR VP, PAYER RELATIONS	40.0		410780	0	78073		X
JOHN E ARMSTRONG
CORP SR VP, SPLY CHAIN/FACIL	40.0		374876	0	78002		X
PATRIC THOMAS
CORP VP, INFORMATION SVCS	40.0		407156	0	32287		X
GLEN MUELLER
CORP VP, AUDIT AND COMPLIANCE	40.0		382260	0	68436		X
BRIAN ISSELL MD
CORP VP, CLINICAL RESEARCH	40.0		727876	0	100981			X
CATHY GUIBAL
VP FINANCE/CFO SCRIPPS MED FDN	40.0		324067	0	63099			X
EDWARD NAZARRO
COE CLINIC	40.0		325751	0	81600			X
ROBERT T HOFF
CORP VP, CLINICAL ANC OPS	40.0		424450	0	58564			X
DANA LAUNER
DIRECTOR OF MEDICAL AFFAIRS	40.0		431182	0	30313			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	13678087	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	4861470	TotalOtherCompensation
Number Individuals GT100 K	1560	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
SCRIPPS CLINIC MEDICAL GROUP
10666 N TORREY PINES RD MS129	LA JOLLA	CA	92037	PHYSICIAN SERVICES	138859184
SCRIPPS COASTAL MEDICAL GROUP
501 WASHINGTON AVE 601	SAN DIEGO	CA	92103	PHYSICIAN SERVICES	50782851
MCCARTHY BUILDING COMPANIES
20401 SW BIRCH ST STE 300	NEWPORT BEACH	CA	92006	CONSTRUCTION	37446929
KILROY REALTY LP
12200 W OLYMPIC BLVD 200	LOS ANGELES	CA	90064	LEASE SERVICES	12805269
EMERGENCY ACUTE CARE MED CORP
440 STEVENS AVE STE 150	SOLANA BEACH	CA	92075	PHYSICIAN SERVICES	11656980

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	149	NumberOfContractorsGT100K
Fundraising Events	507593	FundraisingEvents
All Other Contributions	29276162	AllOtherContributions
Noncash Contributions	7487759	NoncashContributions
Total Contributions	29783755	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
HEALTHCARE DELIVERY REVENUE	622110	2218890952	2217846874	1044078
CAPITATION PREMIUM	622110	71502171	71502171
RESEARCH REVENUE	541700	7266993	6919286	347707
JOINT VENTURE - CHILDRENS HOSPITAL	622110	5819085	5819085
RENTAL INCOME - MEDICAL OFFICE BUILDING	531120	10653195	10653195

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	16337692	TotalRevenueColumn
Related Or Exempt Function Income	16337692	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	2330470088	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	21788066	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	44970	UnrelatedBusinessRevenue
Exclusion	$21,743,096	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	566987787	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	535950089	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	31037698	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	31037698	TotalRevenueColumn
Exclusion	$31,037,698	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	1069898	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	507593	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	642028	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	427870	TotalRevenueColumn
Exclusion	$427,870	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA	722310	5802643	5802643
PARKING	812930	2677282	2543975	133307
GIFT SHOP	453220	1544447	1544447

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	12812582	TotalRevenueColumn
Related Or Exempt Function Income	11496008	RelatedOrExemptFunctionIncome
Exclusion	$1,316,574	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	22836954	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2436344431	TotalRevenueColumn
Related Or Exempt Function Income	2350465376	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1570062	UnrelatedBusinessRevenue
Exclusion	$54,525,238	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	1807000	Total
Program Services	1807000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	18257609	Total
Management And General	18257609	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	815322824	Total
Program Services	731334533	ProgramServices
Management And General	78759831	ManagementAndGeneral
Fundraising	5228460	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	30164000	Total
Program Services	26533049	ProgramServices
Management And General	3500861	ManagementAndGeneral
Fundraising	130090	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	132913091	Total
Program Services	118253363	ProgramServices
Management And General	14009177	ManagementAndGeneral
Fundraising	650551	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	59008900	Total
Program Services	52445552	ProgramServices
Management And General	6274277	ManagementAndGeneral
Fundraising	289071	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	6036853	Total
Program Services	646231	ProgramServices
Management And General	5367652	ManagementAndGeneral
Fundraising	22970	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	527996	Total
Program Services	13652	ProgramServices
Management And General	514344	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	489897	Total
Program Services	0	ProgramServices
Management And General	489897	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	3139800	Total
Management And General	3139800	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	372627186	Total
Program Services	347864478	ProgramServices
Management And General	24166184	ManagementAndGeneral
Fundraising	596524	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3556981	Total
Program Services	324183	ProgramServices
Management And General	3220948	ManagementAndGeneral
Fundraising	11850	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	398548889	Total
Program Services	388733946	ProgramServices
Management And General	8888875	ManagementAndGeneral
Fundraising	926068	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	71152319	Total
Program Services	63297462	ProgramServices
Management And General	7655179	ManagementAndGeneral
Fundraising	199678	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	0	Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	13538240	Total
Program Services	11938676	ProgramServices
Management And General	1599564	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	91970689	Total
Program Services	88295970	ProgramServices
Management And General	3674719	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	6523167	Total
Program Services	6509772	ProgramServices
Management And General	13395	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
HOSPITAL FEE PROGRAM	79451766	79451766
REPAIRS & MAINTENANCE	44600184	23493268	21060689	46227
LOSS ON IMPAIRMENT	1961780	1961780
PROFESSIONAL CLAIMS EXPENSES	906250	906250
BAD DEBT	89492	89492

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	5702125	Total
Program Services	2396980	ProgramServices
Management And General	2146179	ManagementAndGeneral
Fundraising	1158966	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	2158297038	Total
Program Services	1946297403	ProgramServices
Management And General	202739180	ManagementAndGeneral
Fundraising	9260455	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	506688259	BOY
EOY	624787001	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	26952656	BOY
EOY	25264516	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	250792672	BOY
EOY	250516944	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	515667	BOY
EOY	687129	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	30659540	BOY
EOY	29961850	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	13822671	BOY
EOY	41364501	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	1836549514	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	987553299	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	781990459	BOY
EOY	848996215	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	525186264	BOY
EOY	440203894	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	343111000	BOY
EOY	485217000	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	9233008	BOY
EOY	9314963	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	33914773	BOY
EOY	33953343	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	70994740	BOY
EOY	61817644	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	2593861709	BOY
EOY	2852085000	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	303777923	BOY
EOY	337402887	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	11302644	BOY
EOY	13078381	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	619641282	BOY
EOY	608828692	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	8446438	BOY
EOY	5460073	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	85467140	BOY
EOY	102568108	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1028635427	BOY
EOY	1067338141	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1376703739	BOY
EOY	1605255443	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	119066984	BOY
EOY	107716333	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	69455559	BOY
EOY	71775083	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1565226282	BOY
EOY	1784746859	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2593861709	BOY
EOY	2852085000	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	278047393	ReconcilationRevenueExpenses
Reconcilation Other Changes	-58526816	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	true	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	true	DirectContactLegislators
Direct Contact Legislators	$287,345	DirectContactLegislatorsAmount
Rallies Demonstrations	true	RalliesDemonstrations
Rallies Demonstrations	$37,312	RalliesDemonstrationsAmount
Other Activities	true	OtherActivities
Other Activities	$165,240	OtherActivitiesAmount
Total Lobbying Expenditures IIB	489897	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	PUBLIC AFFAIRS EDUCATION AND INFORMATION	Identifier
Return Reference	SCHEDULE C, PART II-B, LINE 1I	ReturnReference
Explanation	SCRIPPS HEALTH IS AS MEMBER OF SEVERAL HOSPITAL ASSOCIATIONS AND HEALTH CARE ORGANIZATIONS AND HAS PARTICIPATED IN PUBLIC AFFAIRS AND ADVOCACY ACTIVITIES ORGANIZED BY THESE ORGANIZATIONS. THIS ACTIVITY HAS INCLUDED BRIEFING OF LEGISLATORS AND LEGISLATIVE STAFF MEMBERS (FEDERAL, STATE AND LOCAL) ON MATTERS AFFECTING HEALTH CARE AND HEALTH CARE OPERATIONS. ACTIVITY IS ON FEDERAL, STATE AND LOCAL LEVELS AND LOCATIONS. SUCH MATTERS INCLUDE: ACCOUNTABLE CARE ACT (HEALTH REFORM); BUDGET IMPACTS; REIMBURSEMENT; PROVIDER FEES; DATA MANAGEMENT AND REPORTING; QUALITY AND PATIENT SAFETY, HEALTH INFORMATION TECHNOLOGY, EMERGENCY DEPARTMENT OPERATIONS AND IMPACTS; UNINSURED, COST SHIFT IMPACTS AND OTHER SAFETY NET ISSUES; COMMUNITY BENEFIT PROGRAMS; GRADUATE MEDICAL EDUCATION; VALUE-BASED PURCHASING; BUNDLED PAYMENTS; ACCOUNTABLE CARE ORGANIZATIONS. THE ORGANIZATION STAFFS A GOVERNMENT RELATIONS DEPARTMENT THAT COORDINATES INFORMATION AND EDUCATION PROGRAMS ON PUBLIC POLICY AND ADVOCACY MATTERS. ALL WORK IS FOCUSED ON ISSUES AND NOT ON PARTISAN MATTERS, CANDIDATES OR POLITICAL ACTIVITIES. NO CORPORATE ACTIVITY ADDRESSED PARTISAN CAMPAIGNS. A PORTION OF ANNUAL MEMBERSHIP DUES SCRIPPS HEALTH PAYS TO CALIFORNIA HOSPITAL ASSOCIATION (CHA) AND ITS SUBSIDIARY THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD & IC), AMERICAN HOSPITAL ASSOCIATION (AHA), THE ALLIANCE OF CATHOLIC HEALTH CARE AND PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS (PEACH) IS DIRECTED BY THESE ORGANIZATIONS TO DIRECT LOBBYING SERVICES.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	87057000	BeginningOfYearBalance
Contributions	2316000	Contributions
Investment Earnings Or Losses	657000	InvestmentEarningsOrLosses
Grants Or Scholarships	703000	GrantsOrScholarships
Other Expenditures	1930000	OtherExpenditures
Administrative Expenses	807000	AdministrativeExpenses
End Of Year Balance	86590000	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	81098000	BeginningOfYearBalance
Contributions	685000	Contributions
Investment Earnings Or Losses	7714000	InvestmentEarningsOrLosses
Grants Or Scholarships	36000	GrantsOrScholarships
Other Expenditures	1636000	OtherExpenditures
Administrative Expenses	768000	AdministrativeExpenses
End Of Year Balance	87057000	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	69740000	BeginningOfYearBalance
Contributions	7288000	Contributions
Investment Earnings Or Losses	5902000	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	1372000	OtherExpenditures
Administrative Expenses	460000	AdministrativeExpenses
End Of Year Balance	81098000	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.00000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.00000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	true	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	26592333	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	65153697	OtherCostOrOtherBasis
Book Value	91746030	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	799283316	OtherCostOrOtherBasis
Depreciation	409684769	Depreciation
Book Value	389598547	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	75183248	OtherCostOrOtherBasis
Depreciation	34429643	Depreciation
Book Value	40753605	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	699998315	OtherCostOrOtherBasis
Depreciation	543438887	Depreciation
Book Value	156559428	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	170338605	OtherCostOrOtherBasis
Book Value	170338605	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	848996215	TotalOfBookValueLandBuildings
Financial Derivatives		FinancialDerivatives
Closely Held Equity Interests		CloselyHeldEquityInterests

Other Securities OtherSecurities (5 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
PRIVATE EQUITY INVESTMENTS	7760107	F
HEDGE FUND INVESTMENTS	121189431	F
FGN EQUITY COMMINGLED FUNDS	43088739	F
DOM FXD INC COMMINGLED FUNDS	216677968	F
FGN FXD INC COMMINGLED FUNDS	96500755	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	485217000	TotalOfBookValueSecurities
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescription	AmountAmount
ANNUITY AND UNITRUSTS	$9,716,854
DEFERRED RETIREMENT LIABILITY	$16,804,341
DEPOSITS & CONTINGENCIES	$83,957
SELF INSURED MALPRACTICE LIABILITY	$17,064,900
SELF INSURED WORKERS COMP LIABILITY	$45,055,660
ASSET RETIREMENT OBLIGATION	$13,813,293
AGENCY ENDOWMENT LIABILITY	$830,244
ARBITRAGE REBATE LIABILITY	$419,180
INTERCOMPANY LIABILITIES	-$1,220,321

Field	Value	IRS element (for citing)
Total Of Amounts	102568108	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
INTENDED USES OF ORGANIZATIONS ENDOWMENT FUNDS	SCHEDULE D, PART V, QUESTION 4	CONTRIBUTIONS RECEIVED FOR CAPITAL PROJECTS USE INCLUDING BUILDING PROJECTS, MAJOR RENOVATIONS, AND EQUIPMENT PURCHASES. $1,086,131 CONTRIBUTIONS RECEIVED TO FUND GRADUATE MEDICAL EDUCATION PROGRAMS, FELLOWS, AND LECTURE SERIES. $14,782,529 CONTRIBUTIONS RECEIVED FOR USE IN SPECIFIC DEPARTMENTS OR DIVISIONS IN THE HOSPITALS AND/OR CLINICS. $24,979,944 CONTRIBUTIONS RECEIVED TO COVER COSTS OF HEALTHCARE PROVIDED TO INDIVIDUALS WITHOUT INSURANCE OR THE MEANS FOR PAYING FOR THEIR CARE. $12,820,850 CONTRIBUTIONS RECEIVED TO FUND RESEARCH PROJECTS IN SPECIFIC AREAS OR DIVISIONS. $14,683,156 TOTAL - $68,352,610
UNCERTAIN TAX POSITIONS UNDER ASC 740 (FKA FIN 48)	SCHEDULE D, PART X, LINE 2	SCRIPPS HEALTH IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, SCRIPPS HEALTH IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSE FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS TAKEN AS A WHOLE. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT SEPTEMBER 30, 2011 OR 2010.

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	true	GrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable (6 entries)

RegionRegion	Number Of EmployeesNumberOfEmployees	Type Of Activities ConductedTypeOfActivitiesConducted	Specific Services ProvidedSpecificServicesProvided	Total ExpendituresTotalExpenditures
North America	25	Program Services	Reconstructive Surgery	173358
East Asia and the Pacific	14	Program Services	Medical Care & Trainin	43537
Central America and the Caribbean	0	Investments		95876806
East Asia and the Pacific	0	Fundraising		0
Central America and the Caribbean	0	Fundraising		0
North America	0	Fundraising		0

Field	Value	IRS element (for citing)
Subtotal Number Of Offices	0	SubtotalNumberOfOffices
Subtotal Number Of Employees	39	SubtotalNumberOfEmployees
Total Number Of Offices	0	TotalNumberOfOffices
Total Number Of Employees	39	TotalNumberOfEmployees
Subtotal Amount Spent	96093701	SubtotalAmountSpent
Total Amount Spent	96093701	TotalAmountSpent
Transfer To Foreign Corp	true	TransferToForeignCorp
Interest In Foreign Trust	false	InterestInForeignTrust
Own Foreign Corp	false	OwnForeignCorp
Passive Foreign Invest Co	false	PassiveForeignInvestCo
Foreign Partnership	false	ForeignPartnership
Boycott Countries	false	BoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

Field	Value	IRS element (for citing)
Identifier	ACCOUNTING METHOD	Identifier
Return Reference	SCHEDULE F, PART I, LINE 3, COLUMN F	ReturnReference
Explanation	THE ACCRUAL METHOD OF ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS IN COLUMN F.	Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	SPINOFF 2011	NameOfEvent1
Gross Receipts Event1	485484	GrossReceiptsEvent1
Charitable Contributions Event1	150855	CharitableContributionsEvent1
Gross Revenue Event1	334629	GrossRevenueEvent1
Rent Facility Costs Event1	77069	RentFacilityCostsEvent1
Food And Beverage Event1	60	FoodAndBeverageEvent1
Entertainment Event1	200	EntertainmentEvent1
Other Direct Expenses Event1	33943	OtherDirectExpensesEvent1
Name Of Event2	MERCY BALL '11	NameOfEvent2
Gross Receipts Event2	310890	GrossReceiptsEvent2
Charitable Contributions Event2	90930	CharitableContributionsEvent2
Gross Revenue Event2	219960	GrossRevenueEvent2
Rent Facility Costs Event2	57830	RentFacilityCostsEvent2
Food And Beverage Event2	3537	FoodAndBeverageEvent2
Entertainment Event2	15700	EntertainmentEvent2
Other Direct Expenses Event2	34814	OtherDirectExpensesEvent2
Total Number Of Other Events	4	TotalNumberOfOtherEvents
Gross Receipts Other Events	781117	GrossReceiptsOtherEvents
Charitable Contrib Other Events	265808	CharitableContribOtherEvents
Gross Revenue Other Events	515309	GrossRevenueOtherEvents
Rent Facility Costs Other Events	222980	RentFacilityCostsOtherEvents
Entertainment Other Events	46499	EntertainmentOtherEvents
Other Direct Expenses Other Events	149396	OtherDirectExpensesOtherEvents
Gross Receipts Total	1577491	GrossReceiptsTotal
Charitable Contributions Total	507593	CharitableContributionsTotal
Gross Revenue Total Events	1069898	GrossRevenueTotalEvents
Rent Facility Costs Total Events	357879	RentFacilityCostsTotalEvents
Food And Beverage Total Events	3597	FoodAndBeverageTotalEvents
Entertainment Total Events	62399	EntertainmentTotalEvents
Other Direct Expenses Total Events	218153	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	642028	DirectExpenseSummaryEvents
Net Income Summary	427870	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	41216024	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	41216024	NetCommunityBenefitExpense
Percent Of Total Expense	0.01910	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	141543730	TotalCommunityBenefitExpense
Direct Offsetting Revenue	124971888	DirectOffsettingRevenue
Net Community Benefit Expense	16571842	NetCommunityBenefitExpense
Percent Of Total Expense	0.00770	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	39022213	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17405159	DirectOffsettingRevenue
Net Community Benefit Expense	21617054	NetCommunityBenefitExpense
Percent Of Total Expense	0.01000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	221781967	TotalCommunityBenefitExpense
Direct Offsetting Revenue	142377047	DirectOffsettingRevenue
Net Community Benefit Expense	79404920	NetCommunityBenefitExpense
Percent Of Total Expense	0.03680	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6292954	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1024381	DirectOffsettingRevenue
Net Community Benefit Expense	5268573	NetCommunityBenefitExpense
Percent Of Total Expense	0.00240	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	23535692	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5591590	DirectOffsettingRevenue
Net Community Benefit Expense	17944102	NetCommunityBenefitExpense
Percent Of Total Expense	0.00830	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	21831463	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12712847	DirectOffsettingRevenue
Net Community Benefit Expense	9118616	NetCommunityBenefitExpense
Percent Of Total Expense	0.00420	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	22943384	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6383325	DirectOffsettingRevenue
Net Community Benefit Expense	16560059	NetCommunityBenefitExpense
Percent Of Total Expense	0.00770	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2025702	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11278	DirectOffsettingRevenue
Net Community Benefit Expense	2014424	NetCommunityBenefitExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	76629195	TotalCommunityBenefitExpense
Direct Offsetting Revenue	25723421	DirectOffsettingRevenue
Net Community Benefit Expense	50905774	NetCommunityBenefitExpense
Percent Of Total Expense	0.02360	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	298411162	TotalCommunityBenefitExpense
Direct Offsetting Revenue	168100468	DirectOffsettingRevenue
Net Community Benefit Expense	130310694	NetCommunityBenefitExpense
Percent Of Total Expense	0.06040	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	51676	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	51676	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	5	NumberOfActivitiesOrPrograms
Persons Served	4616	PersonsServed
Total Community Building Expense	346063	TotalCommunityBuildingExpense
Direct Offsetting Revenue	11345	DirectOffsettingRevenue
Net Community Building Expense	334718	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	2734	PersonsServed
Total Community Building Expense	110999	TotalCommunityBuildingExpense
Direct Offsetting Revenue	49133	DirectOffsettingRevenue
Net Community Building Expense	61866	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	2212	PersonsServed
Total Community Building Expense	163483	TotalCommunityBuildingExpense
Direct Offsetting Revenue	72935	DirectOffsettingRevenue
Net Community Building Expense	90548	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	5	NumberOfActivitiesOrPrograms
Persons Served	20	PersonsServed
Total Community Building Expense	332307	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	332207	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	18	NumberOfActivitiesOrPrograms
Persons Served	9582	PersonsServed
Total Community Building Expense	1004528	TotalCommunityBuildingExpense
Direct Offsetting Revenue	133413	DirectOffsettingRevenue
Net Community Building Expense	871015	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$16,602,587	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	343069577	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	405590777	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-62521200	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
SCRIPPS ENCINITAS
AMBULATORY SURGERY CENTER	0.55500	0.00000	0.25000
Surgery Center

SCRIPPS MEMORIAL
MEDICAL OFFICE BUILDING	0.15300	0.00000	0.77200
XIMED MEDICAL

SCRIPPS MERCY ASC
AMBULATORY SURGERY CENTER	0.73500	0.00000	0.26500

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	5	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (5 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Teaching HospitalTeachingHospital	Critical Access HospitalCriticalAccessHospital	Research FacilityResearchFacility	Er24 HoursEr24Hours	Er OtherErOther
Scripps Memorial Hospital La Jolla
1	9888 Genesee Avenue	La Jolla	CA	92037	X	X	X	X	X	X	X
Scripps Mercy Hospital
2	4077 5th Avenue	San Diego	CA	92103	X	X	X	X	X	X	X
Scripps Green Hospital
3	10666 N Torrey Pines Road	La Jolla	CA	92037	X	X	X	X	X
Scripps Memorial Hospital Encinitas
4	354 Santa Fe Drive	Encinitas	CA	92024	X	X	X	X	X	X	X
Scripps Mercy Hospital Chula Vista
5	435 H Streeet	Chula Vista	CA	91910	X	X	X	X	X	X	X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (5 entries)

Hospital Facility NumberHospitalFacilityNumber
Scripps Memorial Hospital La Jolla
1
Scripps Mercy Hospital
2
Scripps Green Hospital
3
Scripps Memorial Hospital Encinitas
4
Scripps Mercy Hospital Chula Vista
5

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	29	NumberOfOtherFacilities

Other Facilities OtherFacilities (29 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
Scripps Clinic - Torrey Pines
10666 N Torrey Pines Rd	La Jolla	CA	92037	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Rancho Bernardo
15004 Innovation Dr	San Diego	CA	92128	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Carmel Valley
3811 Valley Centre Dr	San Diego	CA	92130	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Cedar
130 Cedar Rd	Vista	CA	92083	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic- Encinitas
310 Santa Fe Dr	Encinitas	CA	92024	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Mission Valley
7565 Mission Valley Road	San Diego	CA	92108	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Mission Valley
7425 Mission Valley Road	San Diego	CA	92108	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Carlsbad
2176 Salk Ave	Carlsbad	CA	92008	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Hillcrest
501 Washington St 525 600	San Diego	CA	92103	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Rancho San Diego
10862 Calle Verde	La Mesa	CA	91941	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Rancho San Diego
3835 Avocado	La Mesa	CA	91941	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Escondido
488 E Valley Pkwy 411	Escondido	CA	92025	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMNET
SCMC- Eastlake
971 Lane Avenue	Chula Vista	CA	91914	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Mission
2201 Mission	Oceanside	CA	92058	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Del Mar
12395 El Camino Real Ste 317 112	Del Mar	CA	92130	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Encinitas
477 N El Camino Real A208B305	Encinitas	CA	92024	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Del Mar
1335 Camino Del Mar	Del Mar	CA	92014	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Santee
278 Town Center Pkwy Ste 105	Santee	CA	92071	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- OBGYN Encinitas
332 Santa Fe Dr Ste 115	Encinitas	CA	92024	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic- La Jolla OBGYN
Genesee Ave 170	San Diego	CA	92121	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic- La Jolla Memorial Campus
XIMED Bldg Ste 600	San Diego	CA	92121	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic- La Jolla Memorial Campus
XIMED Bldg Ste 510	San Diego	CA	92121	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Sycamore
2120 Thibido	Vista	CA	92084	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- OBGYN Vista
2067 W Vista Way	Vista	CA	92083	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC- Oncology at Mercy
501 Washington St 525 600	San Diego	CA	92103	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Coronado
1317 A Ynez Pl	Coronado	CA	92118	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Clinic - Mental Health
15004 Innovation Dr	San Diego	CA	92128	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
Scripps Home Health Services
9619 Chesapeake Dr Suite 300	San Diego	CA	92123	HOME HEALTH SERVICES
Scripps Cardio & Thoracic Surgery Center
9850 Genesee Avenue 560	La Jolla	CA	92037	PRIMARY CARE AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
SCHEDULE H, PART I, LINE 3C	FPG ARE USED TO DETERMINE CHARITY CARE ELIGIBILITY.
SCHEDULE H, PART I, LINE 6A	SCRIPPS HEALTH COMMUNITY BENEFIT REPORT IS PREPARED FOR THE HEALTH SYSTEM AS A WHOLE AND CAN BE FOUND AT WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE- COMMUNITY.
SCHEDULE H, PART I, LINE 7G	SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN EVEN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDI-CAL SHORTFALLS. SCRIPPS PROVIDES SUCH SERVICES BECAUSE THEY MEET AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, THEY WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION TO PROVIDE. SUBSIDIZED SERVICES DO NOT INCLUDE SUCH ANCILLARY SERVICES AS LAB WORK AND RADIOLOGY. IF THESE SERVICES ARE PROVIDED TO LOW-INCOME PERSONS, THEY ARE REPORTED AS CHARITY CARE/FINANCIAL ASSISTANCE. SCRIPPS' TOTAL NET COST FOR SUBSIDIZED HEALTH SERVICES FOR FY11 WAS $9,118,616. THIS INCLUDES SCRIPPS INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES, MERCY CLINIC AND SCRIPPS IN-LIEU OF FUNDS, WHICH ARE USED FOR UNFUNDED OR UNDERFUNDED PATIENTS AND THEIR POST-DISCHARGE NEEDS INCLUDING BOARD AND CARE, SKILLED NURSING FACILITIES, LONG-TERM ACUTE CARE AND HOME HEALTH. IN ADDITION, THE FUNDS MAY BE USED FOR MEDICATIONS, EQUIPMENT AND TRANSPORTATION SERVICES. MERCY CLINIC OF SCRIPPS MERCY HOSPITAL SAN DIEGO FOUNDED IN 1930 AND ADOPTED BY THE SISTERS OF MERCY IN 1961, MERCY CLINIC OF SCRIPPS MERCY HOSPITAL IS A PRIMARY CARE CLINIC THAT TREATS MORE THAN 1,000 PATIENTS EACH MONTH. TOTAL PATIENT VISITS FOR PRIMARY AND SUBSPECIALTY CARE AT THE CLINIC IN FY11 WERE 12,715. A FULL TIME CLINIC STAFF OF NURSES AND OTHER PERSONNEL WORK HAND-IN-HAND WITH PHYSICIANS FROM SCRIPPS MERCY HOSPITAL. AS AN INTEGRAL PART OF TREATING ITS PATIENTS, MERCY CLINIC SERVES AS A TRAINING GROUND FOR MORE THAN 50 RESIDENTS EACH YEAR FROM THE SCRIPPS MERCY HOSPITAL GRADUATE MEDICAL EDUCATION PROGRAM. ESTABLISHED WITH THE INTENT OF CARING FOR THE POOR, MERCY CLINIC HAS BECOME A CRITICAL SOURCE OF MEDICAL CARE FOR SAN DIEGO'S "WORKING AND DISABLED POOR". EACH YEAR, 90 PERCENT OF PATIENT VISITS ARE PAID THROUGH MEDI-CAL, MEDICARE OR SOME OTHER INSURANCE PLAN. THE REMAINING 10 PERCENT PAY WHAT, AND IF, THEY CAN. THOUSANDS OF PEOPLE IN THE REGION RELY ON MERCY CLINIC; MOST ARE LOW-INCOME, MEDICALLY UNDERSERVED ADULTS AND SENIORS WHO OTHERWISE WOULD HAVE NO ACCESS TO HEALTH CARE. THE TOTAL SUBSIDIZED NET COST FOR MERCY CLINIC FOR FY11 WAS $2.3 MILLION (EXCLUDES MEDI-CAL, BAD DEBT AND CHARITY CARE).
SCHEDULE H, PART I, LINE 7, COLUMN F	$89,492 IS THE AMOUNT OF BAD DEBT INCLUDED IN PART IX, LINE 25 BUT ADDED BACK FOR THE PURPOSE OF CALCULATING THE PERCENTAGES IN SCHEDULE H, PART I, LINE 7, COLUMN (F).
SCHEDULE H, PART I, LINE 7	FINANCIAL SUPPORT REFLECTS THE COST (LABOR, SUPPLIES, OVERHEAD, ETC) ASSOCIATED WITH THE PROGRAMS/SERVICE LESS DIRECT REVENUE. THE FIGURE DOES NOT INCLUDE A CALCULATION FOR PHYSICIAN AND STAFF VOLUNTEER LABOR HOURS. IN SOME INSTANCES, AN ENTIRE COMMUNITY BENEFIT PROGRAM COST CENTER HAS BEEN DIVIDED BETWEEN SEVERAL INITIATIVES. SCRIPPS EMPLOYEES TRACK COMMUNITY BENEFIT PROGRAMS/ACTIVITIES VIA AN ACCESS COMMUNITY BENEFIT DATABASE. THE ACCESS COMMUNITY BENEFIT DATABASE HAS BEEN ALIGNED TO THE SCHEDULE H 990 CATEGORIES AND REPORTING CRITERIA. THE DATABASE IS USED TO RECORD INFORMATION FOR EACH ACTIVITY (SERVICE OR PROGRAM) WHICH PROVIDES COMMUNITY BENEFIT. THIS DATABASE IS USED TO RECORD ACTUAL EXPENSES AND FUNDING/OFFSETTING REVENUE FOR SINGLE OR MULTIPLE OCCURRENCES OF AN "ACTIVITY". ALL COMMUNITY BENEFIT PROGRAMS/ACTIVITIES ARE THEN ENTERED INTO THE "COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY" (CBISA) DATABASE. CBISA SERVES AS THE ROLL UP AND OR END PRODUCT OF COMMUNITY BENEFIT TRACKING. IT IS ALIGNED WITH THE NEW SCHEDULE H REQUIREMENTS AND HOUSES THE SCHEDULE H WORKSHEETS THAT CAN BE USED FOR AUDIT PURPOSES. FINANCE WORKS TO RECONCILE UNCOMPENSATED CARE NUMBERS ACCORDING TO THE SCHEDULE H METHODOLOGY. FINANCIAL PLANNING EXCEL WORKSHEETS ARE USED TO RECONCILE COMMUNITY BENEFIT NUMBERS INCLUDING UNCOMPENSATED CARE NUMBERS. SCRIPPS UNCOMPENSATED CARE FY2011 METHODOLOGY SCRIPPS CONTINUES TO CONTRIBUTE RESOURCES TO PROVIDE LOW- AND NO-COST HEALTH CARE SERVICES TO POPULATIONS IN NEED. CALCULATIONS FOR BAD DEBT AND CHARITY CARE IS ESTIMATED BY EXTRACTING THE GROSS WRITE-OFFS OF BAD DEBT AND CHARITY CARE CHARGES AND APPLYING THE HOSPITAL RATIO OF COST TO CHARGES (RCC) TO ESTIMATE THE COST OF CARE. CALCULATIONS FOR MEDI-CAL AND OTHER MEANS- TESTED GOVERNMENT PROGRAMS AND MEDICARE SHORTFALL ARE DERIVED USING THE PAYOR-BASED COST ALLOCATION METHODOLOGY. PROVIDER TAX PROGRAM (REFLECTED IN PART I, LINE 7B) IN JANUARY 2010, THE STATE OF CALIFORNIA ENACTED LEGISLATION THAT PROVIDED FOR SUPPLEMENTAL MEDI-CAL PAYMENTS TO CERTAIN HOSPITALS FUNDED BY A QUALITY ASSURANCE FEE PAID BY PARTICIPATING HOSPITALS AND MATCHING FEDERAL FUNDS ("THE 2010 HOSPITAL FEE PROGRAM"). THE LEGISLATION COVERED THE PERIOD OF APRIL 1, 2009 THROUGH DECEMBER 31, 2010 (21 MONTHS). THE CENTERS FOR MEDICARE & MEDICAID SERVICES ("CMS") APPROVED THE 2010 HOSPITAL FEE PROGRAM IN ITS ENTIRETY IN DECEMBER 2010, AND, THEREFORE, ALL ACTIVITY OF THE PROGRAM WAS RECOGNIZED DURING THE YEAR ENDED SEPTEMBER 30, 2011, RESULTING IN NET ADDITIONAL INCOME OF $22,620,000. THE SUPPLEMENTAL PAYMENTS RECEIVED DURING THE YEAR ENDED SEPTEMBER 30, 2011 ENCOMPASSED FEE-FOR-SERVICE PAYMENTS TO THE ORGANIZATION DIRECTLY FROM THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES AS WELL AS PAYMENTS ROUTED THROUGH MANAGED CARE PLANS, AMOUNTING IN TOTAL TO APPROXIMATELY $102,072,000. THESE PAYMENTS WERE RECORDED IN NET PATIENT REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. QUALITY ASSURANCE FEES ASSESSED TO AND PAID BY THE ORGANIZATION RELATED TO THE 2010 HOSPITAL FEE PROGRAM DURING THE YEAR ENDED SEPTEMBER 30, 2011, WERE $77,850,000 AND WERE RECORDED AS PROVIDER TAX FEES IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE CALIFORNIA HOSPITAL ASSOCIATION CREATED A PRIVATE PROGRAM, THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT), ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA (TOGETHER WITH THE SUPPLEMENTAL PAYMENTS AND THE QUALITY ASSURANCE FEE DISCUSSED ABOVE, THE 2010 PROVIDER FEE PROGRAM). DURING THE YEAR ENDED SEPTEMBER 30, 2011, THE ORGANIZATION MADE CHARITABLE CONTRIBUTIONS OF $1,602,000 RELATED TO THE 2010 PROVIDER FEE PROGRAM TO CHFT, WHICH WERE RECORDED AS PROVIDER TAX FEES IN THE CONSOLIDATED STATEMENTS OF OPERATIONS.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES. ECONOMIC DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 2 EXECUTIVE LEADERSHIP, SPONSORED BY THE OFFICE OF THE PRESIDENT, DONATES TIME ON NOT-FOR PROFIT BOARDS REPRESENTING SCRIPPS HEALTH, INCLUDING THE FOLLOWING ORGANIZATIONS AND BOARDS: SAN DIEGO REGIONAL CHAMBER OF COMMERCE (CHAMBER BOARD, CHAMBER CEO ROUNDTABLE AND POLICY COMMITTEE ASSIGNMENTS); SAN DIEGO COUNTY TAXPAYERS ASSOCIATION (SDCTA BOARD, EXECUTIVE COMMITTEE AND HEALTH COMMITTEE WORK ASSIGNMENTS); SAN DIEGO REGIONAL ECONOMIC DEVELOPMENT CORPORATION (EDC BOARD AND POLICY COMMITTEE ASSIGNMENTS); AND THE DOWNTOWN SAN DIEGO PARTNERSHIP (DSDP BOARD AND WORKING COMMITTEE ASSIGNMENTS). COMMUNITY SUPPORT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 3. THE CITY HEIGHTS WELLNESS CENTER (CHWC) IS A UNIQUE RESOURCE, AS THERE IS NO OTHER COMMUNITY-BASED FACILITY PROMOTING HEALTH AND WELLNESS IN CENTRAL SAN DIEGO. THE OVERALL GOAL OF CHWC IS TO PREVENT DISEASE AND PROMOTE HEALTH, STRENGTHEN COMMUNITY PARTNERSHIPS AND PROVIDE OPPORTUNITIES TO RESIDENTS TO BECOME SELF-EMPOWERED AND BECOME MORE INVOLVED IN MANAGING THEIR OWN HEALTH. IN FY11, THE CENTER PROVIDED COMMUNITY MEETINGS FOCUSED ON ACCESS TO HEALTH CARE SERVICES, CREATING A SAFER COMMUNITY ENVIRONMENT AND COMMUNITY-WIDE COMMUNICATION AND COMMUNITY BUILDING STRATEGIES. THE CENTER IS OPERATED JOINTLY BY SCRIPPS MERCY HOSPITAL AND CHILDREN'S HOSPITAL. HOLIDAY CARDS TO OVERSEAS MILITARY HOLIDAYS CARDS SEND ENCOURAGEMENT TO OVERSEE MILITARY PERSONNEL. THE CARDS WERE SIGNED AND THE ENVELOPES WERE LEFT OPEN FOR FINAL INSPECTION BY PITNEY BOWES. SCRIPPS GATHERED THE CARDS AND MAILED TO PITNEY BOWES SO THEY WOULD RECEIVE THE CARDS ON TIME. IN ADDITION, SCRIPPS COLLECTED DONATED GIFTS MAILED TO A NAVY SHIP AT SEA ON ACTIVE DUTY FOR ONE YEAR. EAT LIKE A MARINE FUNDRAISER SCRIPPS HEALTH AND MEDASSETS WORKED TOGETHER WITH THEIR VENDORS TO RAISE MORE THAN $155,000 TO SPONSOR A MAKE-UP HOMECOMING BALL FOR THE MARINES FROM THE DARK HORSE BATTALION. MARINES AND THEIR FAMILY MEMBERS TRAVELED FROM AROUND THE COUNTRY TO LAS VEGAS TO ATTEND THEIR SPECIAL HOMECOMING BALL. SCRIPPS HEALTH AND MEDASSETS THANKED THOSE VENDORS WHO HELPED FUND THE ENTIRE HOMECOMING BALL BY INVITING THEM TO "EAT LIKE A MARINE". THIS THANK YOU RECEPTION PROVIDED A CHANCE FOR ALL WHO CONTRIBUTED TO MEET SOME OF OUR COUNTRY'S BRAVEST MARINES FROM THE DARK HORSE BATTALION. THEY WERE ON HAND TO SHARE THEIR STORIES AND TEACH GUESTS HOW TO PREPARE MEALS READY TO EAT (MRE'S). DISASTER PREPAREDNESS - COMMUNITY OUTREACH AND EDUCATION HAVING THE ABILITY TO PROVIDE EMERGENCY SERVICES TO THOSE INJURED IN A LOCAL DISASTER WHILE CONTINUING TO CARE FOR HOSPITALIZED PATIENTS IS A CRITICAL COMMUNITY NEED. SCRIPPS DELEGATES PARTICIPATION IN SD COUNTY AND STATE OF CA ADVISORY GROUPS TO PLAN, IMPLEMENT AND EVALUATE KEY DISASTER PREPAREDNESS RESPONSE PLANS AND FUNDING. EFFORTS LED BY THE DISASTER PREPAREDNESS PROGRAM UNDER THE DIRECTION OF THE CHIEF MEDICAL OFFICER. AMERICAN HEART ASSOCIATION HEART WALK AMERICAN HEART WALK -SCRIPPS ALLOCATED $29,010 IN OPERATIONAL FUNDS TO SUPPORT THE AMERICAN HEART ASSOCIATION'S EFFORTS TO FIGHT HEART DISEASE AND STROKE. IN ADDITION, THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER PROGRAM COORDINATED WALKER PARTICIPATION AND FUND RAISING EFFORTS. THE SAN DIEGO HEART WALK RAISED MORE THAN $1.2 MILLION. IN 2011, MORE THAN 2,000 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES AND FRIENDS - WALKED TO HELP RAISE MORE THAN $138,000. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT BY PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION MATERIALS, AND MORE. FOOD STAMP ASSISTANCE THE CITY HEIGHTS WELLNESS CENTER (CHWC) HOSTS ELIGIBILITY WORKERS FROM THE SAN DIEGO HUNGER COALITION WHO ARE AVAILABLE TO COUNSEL PEOPLE AND HELP FILL OUT APPLICATIONS FOR FOOD STAMP ASSISTANCE. CHWC NOT ONLY PROVIDES THE NEEDED SPACE FOR THIS ACTIVITY, BUT ALSO ACTIVELY PARTICIPATES BY DEVELOPING OUTREACH FLYERS, SCHEDULING COMMUNITY RESIDENTS, AND OVERALL COORDINATION FOR THE CLASS. MID-CITY CAN, SAN DIEGO CITY HEIGHTS WELLNESS CENTER HOSTS AND PARTICIPATES IN MONTHLY NETWORKING MEETINGS FOR MID-CITY CAN (COMMUNITY ADVOCACY NETWORK). THESE MEETINGS PROVIDE AN OPPORTUNITY FOR COMMUNITY RESIDENTS AND REPRESENTATIVES FROM PRIVATE AND PUBLIC ORGANIZATIONS, FAITH COMMUNITIES, SCHOOLS AND BUSINESSES TO COME TOGETHER FOR ACTION ON AREAS OF COMMON INTEREST. IN ASSOCIATION WITH THESE MEETINGS, SELF-DIRECTED MOMENTUM TEAMS HAVE BEEN DEVELOPED TO PROVIDE DIRECTION AND LEADERSHIP AS NEEDS AND ISSUES ARISE WITHIN THE COMMUNITY. SAN DIEGO CAREGIVER ACTION NETWORK (SANDI-CAN) THE CITY HEIGHTS WELLNESS CENTER HOSTS MONTHLY MEETINGS FOR SANDI-CAN, A COMMUNITY PARTNERSHIP OF 200 CONSUMERS, VOLUNTEERS, CAREGIVERS, AND SERVICE PROVIDERS DEDICATED TO WORKING TOGETHER ON PROJECTS THAT ENHANCE THE LIVES OF OLDER ADULTS AND ADULTS WITH DISABILITIES LIVING IN THE CITY OF SAN DIEGO. LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS -- THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 5. CITY HEIGHTS WELLNESS CENTER - HEALTH ADVOCACY PROJECT THE CITY HEIGHTS WELLNESS CENTER HEALTH ADVOCACY PROJECT IS SUPPORTED BY A GRANT FROM THE CALIFORNIA ENDOWMENT FOUNDATION AND IS DESIGNED TO STRENGTHEN THE CAPACITY TO DELIVER CULTURALLY AND RELIGIOUSLY COMPETENT HEALTH PROMOTION SERVICES TO SOMALI AND EAST AFRICAN WOMEN AND THEIR FAMILIES. THIS PROGRAM ADDRESSES UNMET NEEDS LIKE PRENATAL OUTREACH AND EDUCATION, CULTURALLY ADAPTED NUTRITION AND FITNESS EDUCATION, BREASTFEEDING EDUCATION, EARLY CHILDHOOD HEALTH, AND NUTRITION AND SAFETY CLASSES. THE PROJECT IS SPONSORED BY SCRIPPS MERCY SAN DIEGO COMMUNITY BENEFIT SERVICES. LEAD SAN DIEGO VISIONARY AWARDS THROUGH THE OFFICE OF THE PRESIDENT, SCRIPPS SPONSORED THE LEAD SAN DIEGO VISIONARY AWARD. LEAD SAN DIEGO MEMBERS AND INVESTORS PLAY A VITAL ROLE IN DEVELOPING DIVERSE LEADERS. THE VISIONARY AWARDS STRIVE TO INSPIRE INNOVATIONS AND SHARE SUCCESSES IN COMMUNITY LEADERSHIP. LEARNING FOR LIFE SAN DIEGO - IMPERIAL COUNCIL BOY SCOUTS OF AMERICA SCRIPPS SPONSORSHIP, PROVIDED BY SCRIPPS OFFICE OF THE PRESIDENT, SUPPORTED THE DISTINGUISHED CITIZEN'S DINNER. THE EVENT RAISED FUNDS FOR OUTREACH PROGRAMS DELIVERED BOTH IN SCHOOL AND AFTER SCHOOL TO SUPPORT YOUTH IN HIGH-RISK AREAS OF SAN DIEGO COUNTY, AFFORDING THEM THE OPPORTUNITY TO BUILD LEADERSHIP SKILLS, DEVELOP CHARACTER AND LEARN JOB SKILLS. FOUNDATION OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES DONATION MADE TO THE FOUNDATION OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES, FUND FOR INNOVATION IN HEALTHCARE LEADERSHIP. THIS DONATION WILL HELP FUND THE IMPLEMENTATION AND APPLICATION OF HEALTH SERVICES RESEARCH AND TO HELP DEVELOP FUTURE LEADERSHIP. SPONSORED BY SCRIPPS OFFICE OF THE PRESIDENT. COALITION BUILDING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 6. CALIFORNIA ENDOWMENT MEETING THE CITY HEIGHTS WELLNESS CENTER (CHWC) HOSTS MEETINGS OF THE CALIFORNIA ENDOWMENT (A PRIVATE, STATEWIDE HEALTH FOUNDATION) FOR ITS 10-YEAR BUILDING HEALTHY COMMUNITIES INITIATIVE, WHICH AIMS TO SUPPORT THE DEVELOPMENT OF COMMUNITIES WHERE YOUTH ARE HEALTHY, SAFE AND READY TO LEARN. THE CHWC HAS BEEN INVOLVED, PARTICIPATORY AND SUPPORTIVE OF THE ENDOWMENT AND THEIR EFFORTS IN THIS INITIATIVE. CALIFORNIA PARTNERSHIP LATINOS Y LATINAS EN ACCIN (LLEA), A PROJECT OF MID-CITY CAN (COMMUNITY ADVOCACY NETWORK), SUPPORTS LATINOS IN USING THEIR COLLECTIVE VOICE EFFECTIVELY AND INCREASING LATINO INVOLVEMENT IN ALL LEVELS OF COMMUNITY DECISION MAKING AND CIVIC PARTICIPATION. LLEA HAS BEEN IN EXISTENCE SINCE 2002, AS A GRASSROOTS EFFORT LEAD BY CONCERNED PARENTS, RESIDENTS AND TEACHERS OF THE CITY HEIGHTS COMMUNITY. MOVILIZANDO EL VOTO INMIGRANTE IS A CAMPAIGN IN WHICH LLEA COLLABORATED WITH CALIFORNIA PARTNERSHIP, A COALITION OF COMMUNITY GRASSROOTS ORGANIZATIONS THROUGHOUT THE STATE OF CALIFORNIA. OVER THE LAST THREE YEARS LLEA MEMBERS HAVE WALKED PRECINCTS IN CITY HEIGHTS BEFORE, DURING AND AFTER ELECTORAL CAMPAIGNS WITH THE GOAL OF IDENTIFYING POTENTIAL IMMIGRANT VOTERS AND ENGAGING THEM IN DIALOGUE ABOUT ISSUES FACING THE LATINO COMMUNITY IN CITY HEIGHTS. DURING THE NOVEMBER PRESIDENTIAL ELECTIONS RETURNED OUT MORE THAN 2,500 CITY HEIGHTS VOTERS WHO WERE KEY IN A HISTORIC SUCCESS FOR PEOPLE OF COLOR IN THIS COUNTRY. SPONSORED BY SCRIPPS CITY HEIGHTS WELLNESS CENTER. FOOD JUSTICE MOMENTUM TEAM THE CITY HEIGHTS WELLNESS CENTER HOSTS AND CO-CHAIRS MONTHLY MEETINGS OF THE FOOD JUSTICE MOMENTUM TEAM. THE MISSION OF THIS TEAM IS TO GATHER A DIVERSE COMMUNITY WORKING TOGETHER TOWARDS CREATING AN ECOLOGICALLY SOUND, ECONOMICALLY VIABLE AND SOCIALLY JUST FOOD SYSTEM FOR ALL. ACCESS TO HEALTH CARE THE CITY HEIGHTS WELLNESS CENTER HOSTS AND PARTICIPATES IN MONTHLY MEETINGS OF THE ACCESS TO HEALTH CARE MOMENTUM TEAM.
SCHEDULE H, PART III, LINE 4	FOOTNOTE FOR PART III, LINE 4 - BAD DEBT FOOTNOTE: The Organization adopted the accounting standard addressing the presentation of the provision for bad debts as of the current reporting period and as such, net patient service revenues are reported net of the provision for bad debts on the statements of operations. The Organization records its provision for doubtful accounts based upon historical experience, as well as collection trends for major payor types. The provision for bad debts for fiscal year 2010 was reclassified as a reduction of net patient service revenues. BAD DEBT METHODOLOGY UNCOMPENSATED COST IS ESTIMATED BY APPLYING RATIO-COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS BAD-DEBT ADJUSTMENTS, LESS RECOVERIES. THE FOLLOWING COSTS ARE EXCLUDED: BAD DEBT ADJUSTMENTS AT COST FOR MEDI-CAL AND CMS PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. THE AMOUNT ON PART III, LINE 2 REPRESENTS PATIENT CARE CHARGES WRITTEN OFF TO BAD DEBT WHERE THE PATIENT HAD THE ABILITY TO PAY. WHERE A PATIENT QUALIFIED FOR PARTIAL OR FULL CHARITY CARE, THE UNPAID AMOUNT IS NOT CONSIDERED BAD DEBT. WE BELIEVE THAT BAD DEBT PERTAINING TO PATIENT CARE CHARGES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THESE PATIENTS RECEIVE TREATMENT REGARDLESS OF WHETHER WE COLLECT PAYMENT FOR THE SERVICES PERFORMED. DESCRIBE HOW THE ORGANIZATION HAS ACCOUNTED FOR DISCOUNTS IN DETERMINING BAD DEBT EXPENSE (E.G. SELF-PAY DISCOUNTS): A PROMPT-PAY DISCOUNT OF 50 PERCENT IS AVAILABLE. BAD DEBT DOES NOT INCLUDE ANY AMOUNTS RELATED TO DISCOUNTS.
SCHEDULE H, PART III, LINE 8	MEDICARE AND MEDICARE HMO: HOSPITALS MEDICARE ALLOWABLE COSTS ARE DETERMINED USING A COST TO CHARGE RATIO. THE FOLLOWING COSTS ARE EXCLUDED: CHARITY AND BAD DEBT ADJUSTMENTS AT COST FOR MEDICARE AND MEDICARE SENIOR PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, SUBSIDIZED HEALTH SERVICES PROVIDED TO MEDICARE PATIENTS AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. DESCRIBE THE ORGANIZATION'S RATIONALE FOR THE POSITION THAT MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS A NOT-FOR-PROFIT, COMMUNITY BENEFIT 501(C)(3) ORGANIZATION, SCRIPPS HEALTH'S PURPOSE IS TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES SERVED. MEDICARE COVERS A SIGNIFICANT PROPORTION OF THE SAN DIEGO COMMUNITY PATIENT POPULATION, INPATIENT AND OUTPATIENT. THE LEVEL OF QUALITY AND ACCESS TO CARE IS THE SAME, REGARDLESS OF PAYER. HOSPITALS DO NOT DETERMINE THE LEVEL OF PAYMENT FOR MEDICARE; RATHER, IT IS SUBJECT TO GOVERNMENT REIMBURSEMENT POLICY. THERE IS A WELL-DOCUMENTED MEDICARE REIMBURSEMENT SHORTFALL OF PAYMENT FOR CARE NOT MEETING THE COST OF DELIVERING CARE. THAT SHORTFALL IS AN UNREIMBURSED AMOUNT THAT MUST BE ACCOUNTED FOR IN THE HOSPITAL'S FINANCIAL STATEMENTS. IT IS REAL AND SUBSTANTIAL. IT SHOULD BE ACCEPTED AS A SHORTFALL IN IRS REPORTING STANDARDS. SCRIPPS MUST ACCEPT THE PATIENTS REGARDLESS OF REIMBURSEMENT RATES FROM MEDICARE AND IF PATIENTS ARE NOT CARED FOR BY SCRIPPS IT IS LIKELY THAT ANOTHER COMMUNITY OR GOVERNMENT AGENCY WOULD HAVE TO COVER THE CARE OF THE PATIENT.
SCHEDULE H, PART III, LINE 9B	COLLECTION POLICY ALL PATIENT FINANCIAL RESOURCES ARE EXPLORED PRIOR TO USING A COLLECTION AGENCY OR OTHER MEANS TO COLLECT ON ACCOUNTS. THE ORGANIZATION ALSO SCREENS PATIENTS WHO CANNOT AFFORD TO PAY CO-INSURANCE AND DEDUCTIBLES TO SEE WHETHER THEY QUALIFY FOR FINANCIAL ASSISTANCE OR CHARITY CARE PROGRAM. IF THE PATIENT DOES NOT QUALIFY, OR IF THERE IS A LACK OF INFORMATION AVAILABLE TO MAKE A DETERMINATION AND NO CONTACT IS ESTABLISHED WITH THE PATIENT, THEN THE ORGANIZATION MAY USE A COLLECTION AGENCY OR INTERNAL STAFF TO COLLECT THE ACCOUNT. WHEN A COLLECTION AGENCY OR THE ORGANIZATION STAFF DETERMINES THAT A PATIENT CANNOT PAY ON THE ACCOUNT, THE ORGANIZATION WRITES THE ACCOUNT OFF AS CHARITY. SHOULD A PATIENT MAKE A PAYMENT ON AN ACCOUNT THAT HAS BEEN WRITTEN OFF TO BAD-DEBT EXPENSE, BAD-DEBT EXPENSE IS REDUCED TO THE EXTENT OF THE PAYMENT.
NEEDS ASSESSMENT	DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. CALIFORNIA SENATE BILL 697 (CHAPTERED IN 1994) REQUIRES AN UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. IDENTIFYING SAN DIEGO COUNTY'S HEALTH PRIORITIES IS A COMPLEX PROCESS. THE WORKING GROUP KNOWN AS THE SAN DIEGO COUNTY SB697 COALITION WAS INITIALLY ATTENDED BY REPRESENTATIVES FROM OVER 25 HEALTH CARE-RELATED ORGANIZATIONS WITH THE GOAL OF PRODUCING ONE NEEDS ASSESSMENT TO MAXIMIZE RESOURCES AND DEVELOP A MORE COMPREHENSIVE REPORT FOR THE COUNTY OF SAN DIEGO. THE COALITION, RENAMED COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) SHORTLY AFTER THE COMPLETION OF THE FIRST ASSESSMENT, FORMALIZED ITS ROLE TO PROVIDE OVERSIGHT AND DIRECTION TO THE PERIODIC NEEDS-ASSESSMENT PROCESS. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, THE ORGANIZATION IS BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. COMMUNITY HEALTH IMPROVEMENT PARTNERS SCRIPPS IS AN OFFICIAL PARTNER AND AN ACTIVE PARTICIPANT IN COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP). THROUGH CHIP, MORE THAN 25 COMMUNITY HEALTH-RELATED ORGANIZATIONS COME TOGETHER TO JOINTLY ADDRESS THE COUNTY'S HEALTH NEEDS. SCRIPPS WORKS WITH CHIP AND OTHER HEALTH CARE SYSTEMS AND PARTNERS TO DEVELOP A COMPREHENSIVE COUNTY HEALTH NEEDS ASSESSMENT, UPDATED EVERY THREE YEARS, INCLUDING COUNTY, STATE AND NATIONAL HEALTH STATISTIC COMPARISONS. THE COLLABORATIVE ASSESSMENT PROCESS IS ONE OF THE MOST RESPECTED IN CALIFORNIA. CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY "CHARTING THE COURSE VI," CHIP'S 2010 HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY, BUILDS ON THE WORK DONE IN THE FIVE PREVIOUS ASSESSMENTS IN 1995, 1998, 2001, 2004 AND 2007. THE CHIP HEALTH NEEDS ASSESSMENTS MONITOR CHANGES AND TRENDS IN HEALTH STATUS AMONG SAN DIEGO COUNTY RESIDENTS. THIS INFORMATION PROVIDES THE BASIS UPON WHICH PROGRAMS AND INTERVENTIONS CAN BE TARGETED, DEVELOPED AND EVALUATED, WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY AND ITS MEMBERS. IN ADDITION TO FULFILLING LEGISLATIVE REQUIREMENTS, "CHARTING THE COURSE VI" PROVIDES A RESOURCE FOR INDIVIDUALS, AGENCIES AND INSTITUTIONS TO IDENTIFY COMMUNITY HEALTH NEEDS AND CONCERNS. IT IS AVAILABLE VIA THE CHIP WEBSITE (WWW.SDCHIP.ORG).	SCHEDULE H, PART VI, LINE 2
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	DESCRIBE HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S CHARITY CARE POLICY. HOSPITAL CARE CAN BE EXPENSIVE AND IS OFTEN UNEXPECTED. TO HELP MEET THE NEEDS OF LOW-INCOME UNINSURED AND UNDERINSURED PATIENTS WHO USE SCRIPPS HOSPITALS, SCRIPPS HAS A PATIENT FINANCIAL ASSISTANCE POLICY CONSISTENT WITH CALIFORNIA AB774 "FAIR PRICING POLICY" LEGISLATION, CHAPTERED IN 2006. FOLLOWING PRINCIPLES AND GUIDELINES SET BY THE AMERICAN HOSPITAL ASSOCIATION AND THE CALIFORNIA HOSPITAL ASSOCIATION, THE POLICY ESTABLISHES STANDARDS FOR CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES AND LOW-INCOME PATIENT ASSISTANCE THROUGH DISCOUNTED HOSPITAL CHARGES. SCRIPPS ACTIVELY SCREENS, MONITORS AND IDENTIFIES PATIENT ACCOUNTS THAT MAY BENEFIT FROM FINANCIAL ASSISTANCE, PROVIDES COUNSELING, INFORMATION AND LANGUAGE INTERPRETATION AND MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING FINANCIAL OBLIGATIONS. WHEN NECESSARY, SCRIPPS ALSO HELPS PATIENTS UNDERSTAND AND PARTICIPATE IN FINANCIAL ASSISTANCE OPTIONS. THIS INCLUDES BILLING STATEMENTS THAT ALERT PATIENTS TO THE AVAILABILITY OF ASSISTANCE AS WELL AS LIMITS ON ACCOUNT COLLECTION ACTIVITIES. (SCRIPPS DOES NOT, FOR EXAMPLE, APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS.) ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON AN EVALUATION OF INCOME AND EXPENSE INFORMATION. FOR LOW-INCOME, UNINSURED PATIENTS EARNING LESS THAN 200 PERCENT OF THE FEDERAL POVERTY GUIDELINES (FPG), SCRIPPS FULLY FORGIVES THE ENTIRE BILL. FOR INDIVIDUALS WHO EARN BETWEEN 201-400 PERCENT OF THE FPG, FINANCIAL ASSISTANCE IS BASED ON A SCHEDULE WITH SHARE-OF-COST DISCOUNTS. SCRIPPS POSTS A SUMMARY OF ITS CHARITY CARE POLICY ON THE SCRIPPS WEB SITE AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE FINANCIAL ASSISTANCE POLICY IS IN WRITTEN FORM TO GUIDE AND DIRECT STAFF AND EFFECTIVELY COMMUNICATES HOW OUR COMMITMENT WILL BE APPLIED CONSISTENTLY TO ALL PATIENTS. THE POLICY INITIALLY ESTABLISHED IN 2001 WAS REVISED TO BE CONSISTENT WITH AB774 "FAIR PRICING POLICY" LEGISLATION. THE PRACTICES ESTABLISHED IN THE POLICY REFLECT SCRIPPS' CONTINUING COMMITMENT TO ASSISTING LOW-INCOME UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES. POLICY HIGHLIGHTS INCLUDE: - SCRIPPS HEALTH WILL RESPECT THE DIGNITY OF EACH PATIENT, ACT ETHICALLY IN ALL PATIENT FINANCIAL MATTERS AND COMMUNICATE EFFECTIVELY TO ASSIST PATIENTS IN RESOLVING THEIR FINANCIAL OBLIGATIONS. EVERY REASONABLE EFFORT IS MADE TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES. SCRIPPS FINANCIAL ASSISTANCE IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD PARTY COVERAGE INCLUDING MEDICARE. - FINANCIAL ASSISTANCE INFORMATION IS POSTED IN CONSPICUOUS REGISTRATION AREAS INCLUDING THE EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION, AND ANCILLARY SERVICE LOCATIONS. PATIENT ACCOUNTS THAT MAY BENEFIT FROM FINANCIAL ASSISTANCE ARE ACTIVELY SCREENED, MONITORED AND IDENTIFIED AS SOON AS POSSIBLE. EVALUATION FOR FINANCIAL ASSISTANCE ELIGIBILITY IS BASED ON THE EVALUATION OF INCOME AND EXPENSE INFORMATION PROVIDED BY THE PATIENT. - SCRIPPS HEALTH WILL WORK TO ASSIST ANY PATIENT UNABLE TO PAY FOR SERVICES, WHO COOPERATIVELY PROVIDES INFORMATION ABOUT HIS/HER ABILITY TO PAY. FAILURE BY THE PATIENT TO COOPERATE MAY RESULT IN THE INABILITY OF THE HOSPITAL TO PROVIDE FINANCIAL ASSISTANCE DETERMINATION. - PATIENTS ARE PROVIDED WITH COUNSELING AND WRITTEN INFORMATION REGARDING FINANCIAL ASSISTANCE. LANGUAGE INTERPRETIVE SERVICES ARE UTILIZED FREE OF CHARGE WHENEVER NECESSARY TO FACILITATE THE PATIENTS UNDERSTANDING AND PARTICIPATION IN FINANCIAL ASSISTANCE OPTIONS. - FINANCIAL ASSISTANCE APPLIES TO INDIVIDUALS WHOSE FAMILY INCOME LEVEL IS 400 PERCENT OF THE FEDERAL POVERTY GUIDELINES OR BELOW. DETERMINATION IS MADE ON AN ALL OR PARTIAL BASIS USING THE APPROVED DISCOUNT SCHEDULE.	SCHEDULE H, PART VI LINE 3
COMMUNITY INFORMATION	DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES. (E.G., URBAN, SUBURBAN, RURAL), THE COMMUNITY OR COMMUNITIES (E.G., POPULATION, AVERAGE INCOME, PERCENTAGES OF COMMUNITY RESIDENTS WITH INCOMES BELOW THE FEDERAL POVERTY GUIDELINE, PERCENTAGE OF THE HOSPITAL'S AND COMMUNITY'S PATIENTS WHO ARE UNINSURED OR MEDICAID RECIPIENTS), THE NUMBER OF OTHER HOSPITALS SERVING THE COMMUNITY OR COMMUNITIES, AND WHETHER ONE OR MORE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE COMMUNITY. MEETING THE CHALLENGES OF A DIVERSE BORDER COMMUNITY SAN DIEGO COUNTY IS AN INTERNATIONAL BORDER COMMUNITY COMPRISED OF 3.2 MILLION PEOPLE. GEOGRAPHICALLY DISPERSED OVER 4,300 SQUARE MILES, THE POPULATION REPRESENTS MULTIPLE ETHNIC GROUPS. THE SAN DIEGO ASSOCIATION OF GOVERNMENT'S (SANDAG) POPULATION GROWTH PROJECTIONS ARE JUST OVER 1 PERCENT PER YEAR, EXTENDING OUT 25 YEARS TO THE YEAR 2030. THE SANDAG 2050 SUB-REGIONAL GROWTH FORECAST PROJECTS POPULATION GROWTH TO 4.4 MILLION BY 2050. THIS IS A 40.0% INCREASE IN POPULATION GROWTH. DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE BASED ON SANDAG 2010 ESTIMATES AND ARE AVAILABLE AT THE ZIP CODE LEVEL AT HTTP://DATAWAREHOUSE.SANDAG.ORG. A BREAKDOWN OF THE REGIONAL DEMOGRAPHICS CAN BE FOUND IN THE REGIONAL FORUM SECTIONS OF THE CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY (APPENDIX SECTION) HTTP://WWW.SDCHIP.ORG. SCRIPPS SERVES A QUARTER OF THE TOTAL COUNTY POPULATION, CONCENTRATING SERVICES IN THE NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTH REGIONS OF SAN DIEGO COUNTY WHERE SCRIPPS FACILITIES ARE LOCATED. SCRIPPS MERCY HOSPITAL (INCLUDING SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 67 PERCENT OF THE CHARITY CARE WITHIN THE SCRIPPS SYSTEM. SCRIPPS MERCY'S SERVICE AREA HAS A MORE ECONOMICALLY DISADVANTAGED POPULATION COMPARED TO THE COUNTY AS A WHOLE, WITH THE LOWEST NUMBERS OF INSURED ADULTS IN THE COUNTY AND A MUCH HIGHER PERCENTAGE OF ETHNIC MINORITIES, PRIMARILY HISPANIC AND ASIAN. AS A DISPROPORTIONATE-SHARE HOSPITAL, SCRIPPS MERCY SAN DIEGO AND CHULA VISTA CAMPUSES PLAY IMPORTANT HEALTH CARE SERVICE ROLES IN THE CENTRAL/SOUTHERN SAN DIEGO COUNTY SERVICE AREA (RANGING FROM INTERSTATE 8 TO THE UNITED STATES-MEXICO BORDER). MORE THAN HALF OF SCRIPPS MERCY SAN DIEGO AND CHULA VISTA PATIENTS ARE GOVERNMENT INSURED-MEDICARE AND MEDI-CAL. SCRIPPS HOSPITALS HOUSE 26.0 PERCENT OF THE COUNTY'S GENERAL ACUTE-CARE LICENSED BEDS. SCRIPPS PROVIDES SIGNIFICANT AND GROWING VOLUMES OF EMERGENCY, OUTPATIENT AND PRIMARY CARE. IN FY11, SCRIPPS PROVIDED 2.1 MILLION OUTPATIENT VISITS. ALMOST HALF (43.7 PERCENT) OF SAN DIEGO SAFETY NET DISCHARGES ARE FROM CENTRAL AND SOUTH SUBURBAN REGIONS. SAFETY NET DISCHARGES INCLUDE COUNTY INDIGENT PROGRAMS, MEDI-CAL AND SELF PAY. COUNTY SAFETY NET DISCHARGES CY10: - CENTRAL DISCHARGES - 17,493 - SOUTH SUBURBAN DISCHARGES - 13,404 SCRIPPS OSHPD SAFETY NET DISCHARGES CY10: - SCRIPPS CENTRAL DISCHARGES - 5,359 - SCRIPPS SOUTH SUBURBAN DISCHARGES - 4,252 COUNTY OVERVIEW ACCESS TO MEDICAL CARE IS CRUCIAL TO THE WELL-BEING OF INDIVIDUALS AND THE SAN DIEGO COMMUNITY AS A WHOLE. THERE ARE MANY BARRIERS TO CARE FOR THE SAFETY NET POPULATION THAT PREVENT THEM FROM OBTAINING MUCH NEEDED MEDICAL SERVICES. LACK OF INSURANCE IS A PRIMARY BARRIER, AS EVIDENCED BY THE 17.2 PERCENT OF ADULTS AGE 19-64 (EXCLUDING MEDICARE AND MILITARY) WHO LACK HEALTH INSURANCE IN SAN DIEGO COUNTY. THE CALIFORNIA HEALTHCARE FOUNDATION (CHCF) REPORTED ESTIMATES THAT 21% OF STATE RESIDENTS HAD NO INSURANCE IN 2010, THE SAME PERCENTAGES OF 2009 BUT UP FROM 19.3% IN 2000. CALIFORNIA HAD THE HIGHEST NUMBER OF UNINSURED RESIDENTS IN THE NATION AT 6.9 MILLION - A FUNCTION OF IT BEING THE MOST POPULOUS STATE IN THE U.S.- AND THE EIGHTH HIGHEST PERCENTAGE AMONG STATES. CALIFORNIA'S HIGH RATE OF UNINSURED RESIDENTS IS ATTRIBUTABLE TO SEVERAL FACTORS, INCLUDING A STEADY DECLINE IN EMPLOYER-BASED HEALTH COVERAGE. THE CHCF REPORT NOTED THAT "THE PERCENTAGE OF CALIFORNIANS WHO OBTAIN THEIR INSURANCE THROUGH THEIR JOB HAS CONTINUED TO FALL," DECLINING FROM 61.9% IN 2000 TO 53% IN 2010. DURING THE SAME TIME PERIOD, THE PERCENTAGE OF STATE RESIDENTS COVERED BY MEDI-CAL INCREASED FROM 13.3% IN 2000 TO 19.3% IN 2010. INCOME WAS ALSO A FACTOR, WITH 35.1% OF STATE RESIDENTS WITH ANNUAL INCOMES UNDER $25,000 LACKING INSURANCE. BUT EVEN MORE AFFLUENT RESIDENTS WERE NOT IMMUNE, WITH 18.3% OF RESIDENTS WITH HOUSEHOLD INCOMES BETWEEN $50,000 AND $75,000 GOING WITHOUT HEALTH INSURANCE IN 2010. THE RATES OF UNINSURED RESIDENTS IN THE STATE COULD DECLINE IN 2011 AS MORE ADULTS WITHOUT INSURANCE FIND COVERAGE THROUGH THE STATE'S BRIDGE TO REFORM PROGRAM. SINCE THE START OF 2011, A DOZEN COUNTIES HAVE LAUNCHED LOW-INCOME HEALTH PLANS TO COVER UNINSURED ADULTS WHO DO NOT QUALIFY FOR MEDI-CAL, PROVIDING COVERAGE FOR MORE THAN 200,000 RESIDENTS (CALIFORNIA HEALTHCARE FOUNDATION. CALIFORNIA HEALTH CARE ALMANAC, DECEMBER 2011). ACCORDING TO A 2006 SAN DIEGO COUNTY HEALTH CARE SAFETY NET STUDY, NEARLY ONE-THIRD OF SAN DIEGO COUNTY'S POPULATION (909,661) IS UNINSURED OR UNDERINSURED, WITH THE HIGHEST CONCENTRATION - HALF OF THE TOTAL - SOUTH OF INTERSTATE 8. THE HOSPITALS AND COMMUNITY CLINICS THAT PROVIDE HEALTH CARE TO THIS POPULATION COMPRISE THE SAFETY NET. SINCE SAN DIEGO COUNTY DOES NOT OPERATE A PUBLIC HOSPITAL, THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO PROVIDE CARE TO UNINSURED AND MEDICALLY UNDERSERVED POPULATIONS. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE CURRENT SAFETY NET IS A CRITICAL POLICY CHALLENGE. THE SAN DIEGO COUNTY HEALTH CARE SAFETY NET STUDY FOUND THAT THE CENTRAL AND SOUTH REGIONS HAVE THE LARGEST PROPORTION OF UNINSURED. NORTH CENTRAL HAS THE LEAST NUMBER OF UNINSURED. THE COUNTY HAS 14.3 PERCENT OF ITS POPULATION ON MEDI-CAL (434,936). CENTRAL AND SOUTH REGIONS HAVE THE LARGEST NUMBER OF MEDI-CAL BENEFICIARIES (22.3 AND 19.4 PERCENT, RESPECTIVELY). COMBINED, THE SAFETY NET CONSUMER COMPRISES 29.5 PERCENT OF THE POPULATION (907,661). WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ARE LEFT TO ABSORB THE COST INVOLVED IN CARING FOR UNINSURED PATIENTS INTO THEIR OPERATING BUDGETS. THE FINANCIAL BURDEN PLACED ON HOSPITALS AND PHYSICIANS CARING FOR UNINSURED PATIENTS IS SIGNIFICANT. SAN DIEGO MEDI-CAL REIMBURSEMENT IS AMONG THE LOWEST IN CALIFORNIA, ALREADY THE STATE WITH THE NATION'S LOWEST MEDICAID REIMBURSEMENT RATE.	SCHEDULE H, PART VI, LINE 4
PROMOTION OF COMMUNITY HEALTH	PROVIDE ANY OTHER IMPORTANT INFORMATION TO DESCRIBING HOW THE ORGANIZATION'S HOSPITALS OR HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (E.G., OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS ETC). FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE, NOT-FOR-PROFIT COMMUNITY HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS A HALF-MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF MORE THAN 2,563 AFFILIATED PHYSICIANS AND 13,323 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIAN OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. SCRIPPS IS A RECOGNIZED LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE AND IS AT THE FOREFRONT OF CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. AS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, SCRIPPS TAKES PRIDE IN ITS SERVICE TO THE COMMUNITY. THE SCRIPPS SYSTEM IS GOVERNED BY A 14-MEMBER VOLUNTEER BOARD OF TRUSTEES. THIS SINGLE POINT OF AUTHORITY FOR ORGANIZATIONAL POLICY ENSURES A UNIFIED APPROACH TO SERVING PATIENTS ACROSS THE REGION. THE BOARD IS RESPONSIBLE FOR PROMOTING CORPORATE PURSUIT OF ITS MISSION, APPROVAL OF THE BUDGET AND ASSURING THROUGH OVERSIGHT THE EFFECTIVE FUNCTIONING OF THE CORPORATION. ITS PURPOSE IS TO ESTABLISH AND MAINTAIN A NONPROFIT PUBLIC BENEFIT CORPORATION ORGANIZED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES, WHOSE ACTIVITIES ARE CONDUCTED IN SUCH A MANNER THAT NO PART OF ITS NET EARNINGS WILL BENEFIT OF ANY TRUSTEE, OFFICER OR OTHER INDIVIDUAL. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL SYSTEM IN THEIR OVERSIGHT ROLE, PARTICIPATION IN VARIOUS BOARD COMMITTEES AND GENERAL STEWARDSHIP. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES HAVE AN OPEN MEDICAL STAFF FOR ALL QUALIFIED PHYSICIANS. THE BOARD OF TRUSTEES HAS AUTHORITY TO APPROVE BYLAWS, RULES AND REGULATIONS FOR THE MEDICAL STAFF OF EACH HOSPITAL, SURGERY CENTER OR SIMILAR FACILITY, AND TO APPOINT, SUSPEND OR REMOVE ANY PHYSICIAN FROM THE MEDICAL STAFF. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES PARTICIPATE IN MEDI-CAL AND MEDICARE CONTRACTS. SCRIPPS SURPLUS FUNDS ARE REINVESTED BACK INTO THE SAN DIEGO COMMUNITY. SURPLUS FUNDS ARE UTILIZED FOR NEW FACILITIES, EQUIPMENT, SEISMIC RETROFITTING, PROFESSIONAL EDUCATION AND HEALTH RESEARCH, ACCESS TO PATIENT CARE AND COMMUNITY BENEFIT PROGRAMS. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH AND MEDICAL EDUCATION PROGRAMS. DURING FY11 (OCTOBER 2010 TO SEPTEMBER 2011), SCRIPPS INVESTED $35,486,538 IN PROFESSIONAL TRAINING PROGRAMS AND HEALTH RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES FOR SAN DIEGO COUNTY. QUALITY HEALTH CARE DEPENDS ON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WOULD BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH THROUGH THE DEVELOPMENT OF NEW AND INNOVATIVE TREATMENT OPTIONS. PROFESSIONAL EDUCATION AND HEALTH RESEARCH REFLECTS CLINICAL RESEARCH, AS WELL AS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. RESEARCH TAKES PLACE PRIMARILY AT SCRIPPS CLINICAL RESEARCH SERVICES, SCRIPPS WHITTIER DIABETES INSTITUTE, SCRIPPS GENOMIC MEDICINE AND SCRIPPS TRANSLATIONAL SCIENCE INSTITUTE. CALCULATIONS ARE BASED ON TOTAL PROGRAM EXPENSES LESS APPLICABLE DIRECT-OFFSETTING REVENUE. EXPENSES ARE NOT OFFSET BY GRANT REVENUE OR RESTRICTED FUNDS ACCORDING TO THE SCHEDULE H 990 IRS GUIDELINES. A LACK OF HEALTH INSURANCE AND ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS ARE TWO OF THE PRIMARY BARRIERS TO HEALTH CARE ON BOTH A LOCAL AND NATIONAL LEVEL. WITHOUT ACCESS TO BASIC HEALTH CARE SERVICES, INDIVIDUALS SUFFER FROM MORE ACUTE EPISODES OF ILLNESS, INJURY AND MORTALITY. LACK OF INSURANCE ALSO INCREASES THE BURDEN ON HOSPITALS AND HEALTH PROVIDERS. IN AN EFFORT TO PROVIDE FOR POPULATIONS IN NEED, SCRIPPS ASSISTED IN FY11 WITH THE FOLLOWING HEALTH CARE PROGRAMS AND PROJECTS. MERCY OUTREACH SURGICAL TEAM (MOST) REACHING OUT TO THOSE WHO HAVE LIMITED ACCESS TO HEALTH CARE, THE MERCY OUTREACH SURGICAL TEAM (MOST) PROVIDES MEDICAL AND SURGICAL CARE TO UNDERPRIVILEGED CHILDREN AND ADULTS FROM OTHER COUNTRIES. THE VOLUNTEER GROUP OF PHYSICIANS, NURSES, TECHNICIANS AND OTHERS PERFORM LIFE-CHANGING SURGERIES TO CORRECT CLEFT LIPS, CLEFT PALATES, BURN SCARS, CROSSED EYES, HERNIAS AND A VARIETY OF OTHER CONDITIONS. DURING FY11, THE MOST TEAM SERVED 233 INDIVIDUALS. GRADUATE MEDICAL EDUCATION STAFF SUPPORT TO ST. VINCENT DE PAUL VILLAGE MEDICAL CENTER AND MID-CITY COMMUNITY CLINICS THE GRADUATE MEDICAL EDUCATION (GME) PROGRAM AT SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC FOCUSES ON PHYSICIAN TRAINING AND CLINICAL RESEARCH, WITH 28 RESIDENTS AND 37 FELLOWS. THE PROGRAM ALSO GIVES BACK TO THE COMMUNITY BY STAFFING EVENING CLINICS AT ST. VINCENT DE PAUL VILLAGE AND THE MID-CITY COMMUNITY CLINIC, WHERE SCRIPPS RESIDENTS AND STAFF PROVIDED MEDICAL CARE TO APPROXIMATELY 295 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS DURING FY11. SCRIPPS HEALTH COMMUNITY BENEFIT GRANTING IN 2011, SCRIPPS AWARDED A TOTAL OF $215,000 IN SEVEN COMMUNITY GRANTS TO PROGRAMS BASED THROUGHOUT SAN DIEGO, RANGING FROM $10,000 TO $120,000 EACH. THE PROJECTS THAT RECEIVED FUNDING ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH-PRIORITY HEALTH NEEDS WITH THE GOAL OF IMPROVING ACCESS TO VITAL HEALTH CARE SERVICES FOR A VARIETY OF AT-RISK POPULATIONS, INCLUDING PEOPLE WHO ARE HOMELESS, ECONOMICALLY DISADVANTAGED, AND MENTALLY ILL. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $2.2 MILLION DOLLARS.	SCHEDULE H, PART VI, LINE 5
AFFILIATED HEALTH CARE SYSTEM	IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. SCRIPPS HEALTH IS AN INTEGRATED HEALTH SYSTEM, OPERATING FIVE ACUTE CARE HOSPITALS AND TWENTY-TWO OUT PATIENT CLINICS IN SAN DIEGO COUNTY. IN ADDITION, SCRIPPS HEALTH IS THE PARENT ORGANIZATION OF THE WHITTIER INSTITUTE OF DIABETES WHICH OFFERS IMPROVED QUALITY OF LIFE FOR INDIVIDUALS WITH DIABETES THROUGH INNOVATIVE EDUCATION PROGRAMS, CLINICAL CARE, RESEARCH AND COLLABORATION THAT PURSUES PREVENTION AND A CURE.	SCHEDULE H, PART VI, LINE 6
STATE FILING OF COMMUNITY BENEFIT REPORT	California. Scripps Health Community Benefit Report can be found at: http://www.scripps.org/about-us__scripps-in-the-community	SCHEDULE H, PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
Infoline of San Diego County
PO Box 881307	SAN DIEGO	CA	92018	331029843	501(c)(3)	15000	PROGRAM SUPPORT
Partnership for Smoke Free Families
3020 Childrens Way	SAN DIEGO	CA	92123	953545901	501(c)(3)	15000	PROGRAM SUPPORT
Legal Aid Society of San Diego
1764 SD Ave Ste 200	SAN DIEGO	CA	92110	981869806	501(c)(3)	120000	PROGRAM SUPPORT
Catholic Charities
349 Cedar Street	SAN DIEGO	CA	92101	237334012	501(c)(3)	55000	PROGRAM SUPPORT
California Health Foundation & Trust (CHFT)
1215 K ST STE 800	SACRAMENTO	CA	95814	941498697	501(c)(3)	1602000	CA HOSP FEE PROGRAM

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	5	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Description of Organization's Procedures for Monitoring the Use of Grants	Identifier
Return Reference	FORM 990, SCHEDULE I, LINE 2	ReturnReference
Explanation	A SEMI-ANNUAL REPORT AND A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT TO DATE IS REQUIRED. THIS SEMI-ANNUAL REPORT SHALL INCLUDE PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN THE GRANT APPLICATION. A FINAL REPORT IS DUE WITHIN THIRTY (30) DAYS FOLLOWING THE EXPIRATION DATE OF THE GRANT. IN ADDITION TO THE PROGRESS MADE TOWARD MEETING THE OBJECTIVES OUTLINED IN THE GRANT APPLICATION, THE FINAL REPORT SHALL INCLUDE QUANTITATIVE AND QUALITATIVE RESULTS OF THE PROGRAM AGAINST ITS STATED GOALS AND OBJECTIVES. A FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT AGAINST THE BUDGET MUST BE INCLUDED AS PART OF THIS FINAL REPORT.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Discretionary Spending Account	X	DiscretionarySpendingAccount
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (24 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHRISTOPHER VAN GORDER
1001043	0	420899	0	31179	0	1170401	0	43380	0	2666902	0	0	0
RICHARD ROTHBERGER
612723	0	220562	0	50234	0	114532	0	29112	0	1027163	0	0	0
RICHARD SHERIDAN
425277	0	123229	0	26252	0	585282	0	23958	0	1183998	0	0	0
ARNOLD BRENT EASTMAN MD
523762	0	160174	0	44653	0	475886	0	53097	0	1257572	0	0	0
VICTOR V BUZACHERO
468464	0	154349	0	19582	0	125674	0	31064	0	799133	0	0	0
JUNE KOMAR
464064	0	133286	0	29154	0	583479	0	21892	0	1231875	0	0	0
LARRY HARRISON
446327	0	120512	0	91631	0	68144	0	41349	0	767963	0	57497	0
THOMAS GAMMIERE
487924	0	114285	0	13316	0	88684	0	28402	0	732611	0	0	0
GARY FYBEL
471874	0	109081	0	97624	0	66319	0	34865	0	779763	0	58483	0
ROBIN BROWN
415853	0	106654	0	27531	0	254642	0	33216	0	837896	0	0	0
CARL ETTER
379595	0	88312	0	70824	0	55687	0	28767	0	623185	0	41489	0
JOHN ENGLE
314744	0	97635	0	73452	0	60284	0	22936	0	569051	0	48189	0
MARY L CARRAHER
224256	0	55609	0	39460	0	17937	0	14871	0	352133	0	8137	0
BRIAN ISSELL MD
427224	0	77530	0	223122	0	84111	0	16870	0	828857	0	180838	0
BARBARA PRICE
371756	0	86540	0	69590	0	62218	0	28635	0	618739	0	45811	0
CATHY GUIBAL
299034	0	14750	0	10283	0	43950	0	19149	0	387166	0	0	0
DAVID M COHN
282078	0	67479	0	56651	0	47037	0	24428	0	477673	0	35555	0
MARC A REYNOLDS
307634	0	91627	0	11519	0	62669	0	15404	0	488853	0	0	0
EDWARD NAZARRO
299845	0	15613	0	10293	0	51358	0	30242	0	407351	0	0	0
JOHN E ARMSTRONG
290347	0	65988	0	18541	0	39952	0	38050	0	452878	0	0	0
PATRIC THOMAS
315605	0	68191	0	23360	0	23068	0	9219	0	439443	0	13141	0
ROBERT T HOFF
310469	0	73553	0	40428	0	33736	0	24828	0	483014	0	18361	0
GLEN MUELLER
285523	0	68196	0	28541	0	5399	0	63037	0	450696	0	0	0
DANA LAUNER
377319	0	51417	0	2446	0	7350	0	22963	0	461495	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Supplemental Compensation Information	Schedule J, Part I, Line 1	Scripps Health incurs the cost of a membership for a business networking club in San Diego for the Chief Executive Officer. This membership is used 100% for business purposes and accordingly, no part of this benefit is included within the Chief Executive Officer's taxable compensation. The membership fee is $94 per month. CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR W-2.
SEVERANCE PAYMENT	Schedule J, Part I, Line 4A	THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAY IN CALENDAR YEAR 2010: BRIAN ISSELL, MD - $35,807
SERP	Schedule J, Part I, Line 4B	SCRIPPS HEALTH SUPPLEMENTAL RETIREMENT PLAN (SERP) PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN KEY EMPLOYEES. IT HAS BEEN CLOSED TO NEW PARTICPANTS SINCE 2001. THE PLAN PROVIDES A BENEFIT DETERMINED BY A FORMULA DRIVEN BY THE EXECUTIVE'S AVERAGE OF THE FIVE HIGHEST YEARS OF PAY AND TAKES INTO CONSIDERATION TENURE AT SCRIPPS HEALTH, AGE AND LIFE EXPECTANCY AND ASSUMES MAXIMUM PARTICIPATION IN OTHER RETIREMENT PROGRAMS. SCRIPPS HEALTH EXECUTIVE BENEFITS PROGRAM PROVIDES A 457F PLAN WITH A FLEXIBLE BENEFIT ALLOWANCE THAT CAN BE USED TO PURCHASE ADDITIONAL INSURANCE COVERAGE FOR CERTAIN EXECUTIVE LEVEL EMPLOYEES. ANY REMAINING BENEFIT ALLOWANCE CAN BE DEPOSITED INTO THE SUPPLEMENTAL ACCUMULATION RETIREMENT ACCOUNT (SARA) WITH A FUTURE VESTING DATE. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE SARA PLAN IN CALENDAR YEAR 2010: MARY L. CARRAHER - $ 8,137 DAVID M. COHN - $ 35,555 JOHN ENGLE - $ 48,189 CARL ETTER - $ 41,489 GARY FYBEL - $ 58,483 LARRY HARRISON - $ 57,497 ROBERT T. HOFF - $ 18,361 BRIAN ISSELL, MD - $180,838 BARBARA PRICE - $ 45,811 PATRIC THOMAS - $ 13,141

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
CA STATEWIDE COMMUNITIES DEVELOPMENT AGENCY
680164610	1309116Y1	2007-03-02	49995000	SEE PART V	false	false	true
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
521643828	13033F5A4	2008-08-14	99830304	SEE PART V	false	false	false
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
521643828	13033F5L0	2008-08-14	221230000	SEE PART V	false	false	false
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
521643828	13033FWK2	2005-06-02	40975000	SEE PART V	false	false	false

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Other Spent ProceedsOtherSpentProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
0	49995000	0	146070	0	49848930	2005	true	false	true	true
2010000	99830304	9904407	0	0	89925897		true	false	true	true
32160000	221230000	0	0	5544	221224456		true	false	true	true
0	40975000	0	280659	918283	39776058		false	true	true	true

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
false	false	true	false	true	true
false	false	true	false	true	true
false	false	true	false	true	true
false	false	true	false	true	true

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated
(no name)
false	true	false	false	true	false
(no name)
false	false	false	false	false	false
CITIBANK NA
false	true	true	false	false	false	23.1	false	false
CITIBANK NA
false	true	true	false	false	false	14.3	false	false

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Identifier	SEE SCHEDULE O	Identifier

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
HG FENTON COMPANY INC
SEE PART V	2435550	SEE PART V	false
MATTHEW BALOGH
SEE PART V	50289	SEE PART V	false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	BUSINESS TRANSACTIONS WITH INTERESTED PERSONS	Identifier
Return Reference	SCHEDULE L, PART IV	ReturnReference
Explanation	MARTIN DICKINSON IS ON THE BOARD OF H.G. FENTON COMPANY, INC., A REAL ESTATE COMPANY, FROM WHICH THE ORGANIZATION LEASES LAND AND BUILDINGS AND HAS ENTERED INTO A DEVELOPMENT AGREEMENT. MATTHEW BALOGH, SON-IN-LAW OF BOARD MEMBER GORDON R. CLARK, IS EMPLOYED BY SCRIPPS HEALTH.	Explanation

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	4	NumberOfContributions
Noncash Contribs Rptd F990	149840	NoncashContribsRptdF990
Method Of Determining Revenues	OPINIONS OF EXPERTS	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Art Historical Treasures		ArtHistoricalTreasures
Art Fractional Interest		ArtFractionalInterest
Books And Publications		BooksAndPublications
Clothing And Household Goods		ClothingAndHouseholdGoods

Cars And Other Vehicles CarsAndOtherVehicles

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	1	NumberOfContributions
Noncash Contribs Rptd F990	14560	NoncashContribsRptdF990
Method Of Determining Revenues	COST/SELLING PRICE	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Boats And Planes		BoatsAndPlanes
Intellectual Property		IntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	42	NumberOfContributions
Noncash Contribs Rptd F990	6738322	NoncashContribsRptdF990
Method Of Determining Revenues	COST/SELLING PRICE	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStock
Securities Prtnrshp Trust Intrsts		SecuritiesPrtnrshpTrustIntrsts
Securities Miscellaneous		SecuritiesMiscellaneous
Qualified Contrib Hist Struct		QualifiedContribHistStruct
Qualified Contrib Other		QualifiedContribOther

Real Estate Residential RealEstateResidential

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	7	NumberOfContributions
Noncash Contribs Rptd F990	574037	NoncashContribsRptdF990
Method Of Determining Revenues	COST/SELLING PRICE	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Real Estate Commercial		RealEstateCommercial
Real Estate Other		RealEstateOther

Collectibles Collectibles

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Number Of Contributions	3	NumberOfContributions
Noncash Contribs Rptd F990	11000	NoncashContribsRptdF990
Method Of Determining Revenues	OPINIONS OF EXPERTS	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Food Inventory		FoodInventory
Drugs And Medical Supplies		DrugsAndMedicalSupplies
Taxidermy		Taxidermy
Historical Artifacts		HistoricalArtifacts
Scientific Specimens		ScientificSpecimens
Archaeological Artifacts		ArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Description	EVENT INVENTORY	Description
Number Of Contributions	651	NumberOfContributions
Noncash Contribs Rptd F990	0	NoncashContribsRptdF990
Method Of Determining Revenues	0	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Number Of8283 Received	0	NumberOf8283Received
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	true	ReviewProcessUnusualNCGifts
Third Parties Used	true	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
CONTRIBUTIONS REPORTED	SCHEDULE M, PART I, COLUMN B	THE NUMBER OF TRANSACTIONS, WHICH MOST CLOSELY APPROXIMATES THE NUMBER OF ITEMS CONTRIBUTED IS BEING REPORTED IN COLUMN B. HOWEVER, CONTRIBUTIONS OF EQUIPMENT AND EVENT GIFTS IN KIND INCLUDE MULTIPLE COMPONENTS.
THIRD PARTIES ENGAGED TO SOLICIT, PROCESS AND SELL NON-CASH CONTRIBUTIONS	SCHEDULE M, PART I, ITEM 32B	SCRIPPS HEALTH USES A NUMBER OF BROKERS AND VENDORS IN THE COURSE OF SOLICITING, PROCESSING AND LIQUIDATING DONATED NON-CASH ASSETS: REAL ESTATE BROKERS: LOCATE BUYER AND NEGOTIATE/CLOSE SALE THROUGH ESCROW; SECURITIES BROKER: RECEIVE DONATED SECURITIES INTO SCRIPPS ACCOUNTS, SELL ASSETS ON SECURITIES MARKET, AND REMIT NET PROCEEDS TO SCRIPPS; TRANSACTION SERVICES PROVIDER: PROVIDE HOSTED WEB SITE SUPPORTING EVENT REGISTRATION, ON-LINE AUCTIONS, AND/OR EVENT ON-SITE AUTOMATED PROCESSING SYSTEM FOR SPECIAL EVENTS; CONSIGNMENT AUCTION HOUSE: ACCEPT GOODS FOR SALE THROUGH AUCTIONS, LOCATE BUYERS, SETTLE PAYMENT WITH BUYERS, AND REMIT NET PROCEEDS TO SCRIPPS HEALTH; DIRECT MAIL SERVICES PROVIDER: PLAN AND SCHEDULE MAILINGS, DESIGN AND PRODUCE COLLATERAL MATERIALS, DELIVER MAIL LIST WITH MATERIALS TO COMMERCIAL MAIL HOUSE, ANALYZE RESULTS, AND PROVIDE GUIDANCE ON FUTURE STRATEGIES.
NON-CASH GIFTS - REVENUE RECOGNITION	SCHEDULE M, PART I, ITEM 33	IT IS SCRIPPS HEALTH'S POLICY TO ONLY RECORD CONTRIBUTION REVENUE FOR NON-CASH ITEMS IF THE FAIR MARKET VALUE IS OVER $10,000. GIFTS OF SECURITIES ARE AN EXCEPTION TO THIS POLICY AND ARE RECORDED AS CONTRIBUTION REVENUE ONCE THE SECURITY IS SOLD.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (25 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES	FORM 990, PART I AND PART III, LINE 1	FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,563 AFFILIATED PHYSICIANS AND 13,323 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY.
FY11 PROGRAM SERVICES ACCOMPLISHMENTS	FORM 990, PART III, LINE 4A	FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $320,673,826 TO COMMUNITY BENEFIT PROGRAMS AND SERVICES IN THE AREAS OF UNCOMPENSATED CARE, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND HEALTH RESEARCH. OUR PROGRAMS EMPHASIZE COMMUNITY-BASED PREVENTION EFFORTS AND USE INNOVATIVE APPROACHES TO REACH RESIDENTS AT GREATEST RISK FOR HEALTH PROBLEMS. WE MAKE COMMITMENTS TO IMPROVE THE HEALTH OF OUR PATIENTS AND OUR SAN DIEGO COMMUNITIES. AS A LONG-STANDING MEMBER OF THESE COMMUNITIES, AND AS A NOT-FOR-PROFIT COMMUNITY RESOURCE, OUR GOAL AND RESPONSIBILITY ARE TO PROVIDE HELP AND ASSISTANCE FOR ALL WHO COME TO US FOR CARE, AND TO REACH OUT ESPECIALLY TO THOSE WHO FIND THEMSELVES VULNERABLE AND WITHOUT SUPPORT. THIS RESPONSIBILITY IS AN INTRINSIC PART OF OUR MISSION. THROUGH OUR CONTINUED ACTIONS AND COMMUNITY PARTNERSHIPS, WE STRIVE TO RAISE THE QUALITY OF LIFE IN THE COMMUNITY AS A WHOLE. ASSESSING COMMUNITY NEED CALIFORNIA SENATE BILL 697 REQUIRES THE UPDATING OF A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. IDENTIFYING SAN DIEGO COUNTY'S HEALTH PRIORITIES IS A COMPLEX PROCESS OUTLINED IN THE FOLLOWING PAGES. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, WE ARE BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. THE REPORT IS THE SIXTH EDITION OF THE TRIENNIAL NEEDS ASSESSMENT. THE PROJECT WAS INITIALLY UNDERTAKEN BY THE HOSPITAL COUNCIL OF SAN DIEGO AND IMPERIAL COUNTIES IN 1995 TO ASSIST PRIVATE NOT-FOR-PROFIT HOSPITALS TO COMPLY WITH STATE COMMUNITY BENEFIT LEGISLATION SENATE BILL 697 (SB697), WHICH REQUIRED THEM TO CONDUCT A PERIODIC ASSESSMENT OF THE HEALTH NEEDS OF THOSE LIVING IN THEIR SERVICE AREA IN ORDER TO BETTER RESPOND TO THE COMMUNITY'S HEALTH NEEDS. THE GROUP WAS INITIALLY KNOWN AS THE SAN DIEGO COUNTY SB697 COALITION AND ATTENDED BY REPRESENTATIVES FROM OVER 25 HEALTH CARE-RELATED ORGANIZATIONS. THE GOAL OF THE COALITION WAS TO COLLABORATE AND PRODUCE ONE NEEDS ASSESSMENT IN ORDER TO MAXIMIZE RESOURCES AND DEVELOP A MORE COMPREHENSIVE REPORT FOR THE COUNTY OF SAN DIEGO. DURING THE FIVE SUBSEQUENT NEEDS ASSESSMENTS, THE COALITION, RENAMED COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), SHORTLY AFTER THE COMPLETION OF THE FIRST ASSESSMENT, FORMALIZED ITS ROLE TO PROVIDE OVERSIGHT AND DIRECTION TO THE PERIODIC NEEDS ASSESSMENT PROCESS. COMMUNITY HEALTH IMPROVEMENT PARTNERS SCRIPPS IS AN OFFICIAL PARTNER AND AN ACTIVE PARTICIPANT IN COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP). THROUGH CHIP, MORE THAN 25 COMMUNITY HEALTH-RELATED ORGANIZATIONS COME TOGETHER TO JOINTLY ADDRESS THE COUNTY'S HEALTH NEEDS. SCRIPPS WORKS WITH CHIP AND OTHER HEALTH CARE SYSTEMS AND PARTNERS TO DEVELOP A COMPREHENSIVE COUNTY HEALTH NEEDS ASSESSMENT WHICH IS UPDATED EVERY THREE YEARS, INCLUDING COUNTY, STATE AND NATIONAL HEALTH STATISTIC COMPARISONS. THE COLLABORATIVE ASSESSMENT PROCESS IS ONE OF THE MOST RESPECTED IN CALIFORNIA. CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY CHARTING THE COURSE VI IS INTENDED TO HELP FULFILL LEGISLATIVE REQUIREMENTS OF SB 697 AND TO PROVIDE A RESOURCE FOR INDIVIDUALS, AGENCIES AND INSTITUTIONS TO IDENTIFY COMMUNITY HEALTH NEEDS AND CONCERNS. READERS ARE ENCOURAGED TO EXPLORE CHARTING THE COURSE VI TO LEARN MORE ABOUT THE CRITICAL HEALTH ISSUES IMPACTING SAN DIEGO COUNTY RESIDENTS. THIS DOCUMENT PRESENTS A WEALTH OF INFORMATION RELATING THE HEALTH ISSUES TO RACE/ETHNICITY, GENDER, AGE CATEGORY AND GEOGRAPHIC REGION. THE REPORT ALSO MONITORS CHANGES AND TRENDS IN HEALTH STATUS AMONG SAN DIEGO COUNTY RESIDENTS. THIS INFORMATION PROVIDES THE BASIS UPON WHICH COMMUNITY HEALTH PROGRAMS AND INTERVENTIONS CAN BE TARGETED, DEVELOPED AND EVALUATED, WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY AND ITS MEMBERS. TO GAIN A FULL UNDERSTANDING OF SCRIPPS' HEALTH ASSESSMENT AND ANALYSIS OF COMMUNITY NEED IN SAN DIEGO, WE RECOMMEND REVIEWING THE CHIP 2010 "CHARTING THE COURSE VI" SAN DIEGO COUNTY HEALTH NEEDS ASSESSMENT AT HTTP://WWW.SDCHIP.ORG. 2010 PRIORITY SETTING PROCESS ONE OF THE MAJOR FEATURES OF EACH NEEDS ASSESSMENT IS THE REVIEW OF HEALTH ISSUES FELT TO BE IMPACTING THE SAN DIEGO REGION. THESE HEALTH ISSUES ARE EXAMINED FROM A LOCAL (SAN DIEGO COUNTY), STATE AND NATIONAL PERSPECTIVE. THE STARTING POINT FOR THIS PROCESS WAS A REVIEW OF THE 38 HEALTHY PEOPLE 2020 FOCUS AREAS. BECAUSE OF THE LARGE NUMBER AND THE DIVERSITY OF HEALTH ISSUES, THE NEEDS ASSESSMENT COMMITTEE SELECTED 17 OF THESE HEALTH ISSUES FOR ADDITIONAL STUDY AND POSSIBLE INCLUSION IN THIS YEAR'S NEEDS ASSESSMENT. THESE ISSUES WERE SELECTED BASED ON AN EXTENSIVE REVIEW OF THE ISSUES AND A RANKING OF THEIR PERCEIVED IMPORTANCE BY THE NEEDS ASSESSMENT COMMITTEE. THE GOAL OF THE PRIORITY-SETTING PROCESS FOR CHARTING THE COURSE VI WAS TO PROVIDE AN ORGANIZED, OBJECTIVE METHOD OF REVIEWING AND PRIORITIZING THE HEALTH ISSUES FACING SAN DIEGO COUNTY. BECAUSE OF THE LARGE NUMBER AND THE DIVERSITY OF HEALTH ISSUES, THE NEEDS ASSESSMENT COMMITTEE SELECTED 17 OF THESE HEALTH ISSUES FOR ADDITIONAL STUDY AND POSSIBLE INCLUSION IN THIS YEAR'S NEEDS ASSESSMENT. THESE ISSUES WERE DIVIDED INTO THREE CATEGORIES: - OVERARCHING ISSUES (4 ISSUES) - CONSIDERED OVERARCHING BECAUSE THEY POTENTIALLY IMPACT ALL OF THE OTHER ISSUES IN THIS REPORT. THESE INCLUDED: O ACCESS TO HEALTH SERVICES O HEALTH COMMUNICATIONS AND HEALTH INFORMATION TECHNOLOGY O PUBLIC HEALTH INFRASTRUCTURE O SOCIAL DETERMINANTS OF HEALTH - HEALTH-RELATED BEHAVIORS (7 ISSUES) - BEHAVIORS THAT ARE IMPORTANT COMPONENTS IN LONG-TERM HEALTH, SUCH AS: O IMMUNIZATION O SMOKING CESSATION O IMPROVING NUTRITION O INCREASING PHYSICAL ACTIVITY O ACHIEVING A HEALTHY WEIGHT STATUS O ORAL HEALTH O VIOLENCE AND INJURY PREVENTION - HEALTH OUTCOMES (7 ISSUES) - LOOKS AT THE CHANGE IN THE HEALTH STATUS OF THE POPULATION AND VARIOUS DEMOGRAPHIC GROUPS OVER TIME RELATED TO: O CANCER O DIABETES O HEART DISEASE AND STROKE O INFECTIOUS DISEASES O MATERNAL, INFANT AND CHILD HEALTH O MENTAL HEALTH O RESPIRATORY DISEASES TO HELP NARROW THE NUMBER OF HEALTH ISSUES, 379 COMMUNITY LEADERS FROM THROUGHOUT SAN DIEGO COUNTY WERE INVITED TO PRIORITIZE EACH ISSUE BASED ON THE FOLLOWING FOUR CRITERIA: 1. WHAT IS THE SIZE OF THE HEALTH ISSUE IN SAN DIEGO COUNTY? 2. WHAT IS THE SERIOUSNESS OF THE HEALTH ISSUE IN SAN DIEGO COUNTY? 3. WHAT COMMUNITY RESOURCES ARE CURRENTLY AVAILABLE TO ADDRESS THE HEALTH ISSUE? 4. HOW MUCH DATA OR INFORMATION DO WE HAVE TO EVALUATE THE HEALTH ISSUE'S OUTCOME? PARTICIPANTS IN THIS PRIORITY-SETTING PROCESS WERE ASKED TO REVIEW THE INFORMATION FOR EACH HEALTH ISSUE COVERED IN A BRIEFING DOCUMENT, PROVIDE THEIR RATINGS FROM THEIR PERSPECTIVE AND WEIGH EACH ISSUE USING THE INFORMATION PROVIDED ALONG WITH THEIR KNOWLEDGE OF THE HEALTH ISSUE. OVERALL, 72 COMMUNITY LEADERS PARTICIPATED IN THE PRIORITY SETTING PROCESS. BASED ON INPUT FROM THIS PRIORITY-SETTING PROCESS, THE NEEDS ASSESSMENT COMMITTEE SELECTED FIVE HEALTH ISSUES FOR THE FOCUS OF CHARTING THE COURSE IV. - ACCESS TO HEALTH SERVICES - SOCIAL DETERMINANTS OF HEALTH - WEIGHT STATUS AND PHYSICAL ACTIVITY - INJURY AND VIOLENCE - MENTAL HEALTH CHARTING THE COURSE VI CONTAINS AN IN-DEPTH REVIEW OF THESE FIVE HEALTH ISSUES ABOVE ALONG WITH THE PRIORITY-SETTING PROCESS USED TO SELECT THESE ISSUES AND THE BACKGROUND INFORMATION RELATED TO 17 ADDITIONAL ISSUES REVIEWED AS PART OF THE PRIORITY-SETTING PROCESS. IN ADDITION, INFORMATION IS PRESENTED RELATED TO THE COMMUNITY FORUMS HELD IN EACH OF THE SIX REGIONS OF SAN DIEGO COUNTY TO GAIN INSIGHTS INTO THE HEALTH ISSUES OF WEIGHT STATUS, MENTAL HEALTH, AND INJURY AND VIOLENCE, AND TO BEGIN THE PROCESS OF IDENTIFYING SOME OF THE ROOT CAUSES RELATED TO THESE ISSUES.
MEETING THE CHALLENGES OF A DIVERSE BORDER COMMUNITY		SAN DIEGO COUNTY IS AN INTERNATIONAL BORDER COMMUNITY COMPRISED OF 3.2 MILLION PEOPLE. GEOGRAPHICALLY DISPERSED OVER 4,300 SQUARE MILES, THE POPULATION REPRESENTS MULTIPLE ETHNIC GROUPS. THE SAN DIEGO ASSOCIATION OF GOVERNMENT'S (SANDAG) POPULATION GROWTH PROJECTIONS ARE JUST OVER 1 PERCENT PER YEAR, EXTENDING OUT 25 YEARS TO THE YEAR 2030. THE SANDAG 2050 SUB-REGIONAL GROWTH FORECAST PROJECTS POPULATION GROWTH TO 4.4 MILLION BY 2050. THIS IS A 40.0% INCREASE IN POPULATION GROWTH. DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE BASED ON SANDAG 2010 ESTIMATES AND ARE AVAILABLE AT THE ZIP CODE LEVEL AT HTTP://DATAWAREHOUSE.SANDAG.ORG. A BREAKDOWN OF THE REGIONAL DEMOGRAPHICS CAN BE FOUND IN THE REGIONAL FORUM SECTIONS OF THE CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY (APPENDIX SECTION) HTTP://WWW.SDCHIP.ORG. SCRIPPS SERVES A QUARTER OF THE TOTAL COUNTY POPULATION, CONCENTRATING SERVICES IN THE NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTH REGIONS OF SAN DIEGO COUNTY WHERE SCRIPPS FACILITIES ARE LOCATED. COUNTY OVERVIEW ACCORDING TO A 2006 SAN DIEGO COUNTY HEALTHCARE SAFETY NET STUDY, NEARLY ONE-THIRD OF SAN DIEGO COUNTY'S POPULATION (909,661) IS UNINSURED OR UNDERINSURED, WITH THE HIGHEST CONCENTRATION - HALF OF THE TOTAL - SOUTH OF INTERSTATE 8. THE HOSPITALS AND COMMUNITY CLINICS THAT PROVIDE HEALTH CARE TO THIS POPULATION ARE THE SAFETY NET. THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO PROVIDE CARE TO UNINSURED AND MEDICALLY UNDERSERVED POPULATIONS. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE CURRENT SAFETY NET IS A CRITICAL POLICY CHALLENGE. WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ARE LEFT TO ABSORB THE COST INVOLVED IN CARING FOR THE UNINSURED IN THEIR OPERATING BUDGETS. THE FINANCIAL BURDEN PLACED ON HOSPITALS AND PHYSICIANS TO CARE FOR UNINSURED PATIENTS IS SIGNIFICANT. SAN DIEGO HAS EXPERIENCED A BRIEF IMPROVEMENT IN THE NUMBER OF INSURED RESIDENTS FROM 2003 TO 2009. AT THAT TIME, 17.2 PERCENT OF THE ADULT (19 TO 64 & NON-MILITARY) POPULATION IN SAN DIEGO COUNTY LACKS HEALTH INSURANCE COVERAGE. THE CALIFORNIA HEALTHCARE FOUNDATION (CHCF) REPORTED ESTIMATES OF 21% OF STATE RESIDENTS HAD NO INSURANCE IN 2010, THE SAME PERCENTAGES OF 2009 BUT UP FROM 19.3% IN 2000. CALIFORNIA HAD THE HIGHEST NUMBER OF UNINSURED RESIDENTS IN THE NATION AT 6.9 MILLION - A FUNCTION OF IT BEING THE MOST POPULOUS STATE IN THE U.S.- AND THE EIGHTH HIGHEST PERCENTAGE AMONG STATES. CALIFORNIA'S HIGH RATE OF UNINSURED RESIDENTS IS ATTRIBUTABLE TO SEVERAL FACTORS, INCLUDING A STEADY DECLINE IN EMPLOYER-BASED HEALTH COVERAGE. THE CHCF REPORT NOTED THAT "THE PERCENTAGE OF CALIFORNIANS WHO OBTAIN THEIR INSURANCE THROUGH THEIR JOB HAS CONTINUED TO FALL," DECLINING FROM 61.9% IN 2000 TO 53% IN 2010. DURING THE SAME TIME PERIOD, THE PERCENTAGE OF STATE RESIDENTS COVERED BY MEDI-CAL INCREASED FROM 13.3% IN 2000 TO 19.3% IN 2010. INCOME WAS ALSO A FACTOR, WITH 35.1% OF STATE RESIDENTS WITH ANNUAL INCOMES UNDER $25,000 LACKING INSURANCE. BUT EVEN MORE AFFLUENT RESIDENTS WERE NOT IMMUNE, WITH 18.3% OF RESIDENTS WITH HOUSEHOLD INCOMES BETWEEN $50,000 AND $75,000 GOING WITHOUT HEALTH INSURANCE IN 2010. THE RATES OF UNINSURED RESIDENTS IN THE STATE COULD DECLINE IN 2011 AS MORE ADULTS WITHOUT INSURANCE FIND COVERAGE THROUGH THE STATE'S BRIDGE TO REFORM PROGRAM. SINCE THE START OF 2011, A DOZEN COUNTIES HAVE LAUNCHED LOW-INCOME HEALTH PLANS TO COVER UNINSURED ADULTS WHO DON'T QUALIFY FOR MEDI-CAL, PROVIDING COVERAGE FOR MORE THAN 200,000 RESIDENTS. LAST YEAR CALIFORNIA HOSPITALS PROVIDED MORE THAN $12.5 BILLION IN UNCOMPENSATED CARE IN 2010 ACCORDING TO THE CALIFORNIA HOSPITAL ASSOCIATION. OF THAT AMOUNT, MEDICARE AND MEDI-CAL PAYMENTS WERE $8.3 BILLION LESS THAN THE ACTUAL COST OF PROVIDING NECESSARY HEALTH CARE SERVICES, WHILE CHARITY CARE AND BAD DEBTS TOTALED MORE THAN $4 BILLION. THE AVERAGE CALIFORNIA HOSPITAL RECEIVES 68 PERCENT OF ITS REVENUE FROM MEDICARE AND MEDI-CAL; FOR CERTAIN HOSPITALS, THAT NUMBER EXCEEDS 95 PERCENT. FINANCIAL ASSISTANCE ASSISTING LOW-INCOME, UNINSURED PATIENTS THE SCRIPPS FINANCIAL ASSISTANCE POLICY IS CONSISTENT WITH THE AB774 "FAIR PRICING POLICY" LEGISLATION. THE PRACTICES ESTABLISHED REFLECT OUR COMMITMENT WITH RESPECT TO ASSISTING LOW-INCOME, UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES. OUR PROGRAM IS PROVIDED WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION OR NATIONAL ORIGIN. SCRIPPS PROVIDES FULL FINANCIAL ASSISTANCE TO LOW-INCOME AND UNINSURED PATIENTS EARNING LESS THAN 200 PERCENT OF THE FEDERAL POVERTY LEVEL GUIDELINES. FOR INDIVIDUALS WHO QUALIFY BETWEEN 201-400 PERCENT OF THE POVERTY LEVEL, FINANCIAL ASSISTANCE IS BASED ON A DISCOUNT SCHEDULE. FOR 2011, HEALTH AND HUMAN SERVICES DEFINED THE 200 PERCENT FEDERAL POVERTY LEVEL OF A FAMILY OF FOUR AS $44,700. COMMUNITY HEALTH SERVICES COMMUNITY HEALTH SERVICES INCLUDE PREVENTION AND WELLNESS PROGRAMS SUCH AS SCREENINGS, HEALTH EDUCATION, SUPPORT GROUPS AND HEALTH FAIRS, WHICH ARE SUPPORTED BY OPERATIONAL FUNDS, GRANTS, IN-KIND DONATIONS, AND PHILANTHROPY. THESE PROGRAMS ARE DESIGNED TO RAISE PUBLIC AWARENESS, UNDERSTANDING OF AND ACCESS TO IDENTIFIED COMMUNITY HEALTH NEEDS. SCRIPPS CATEGORIZES COMMUNITY HEALTH SERVICES ACCORDING TO THE SCHEDULE H 990 CATEGORIES MANDATED BY THE IRS. IT IS CATEGORIZED INTO FIVE MAIN AREAS: o COMMUNITY HEALTH IMPROVEMENT SERVICES o COMMUNITY BENEFIT OPERATIONS o CASH AND IN-KIND CONTRIBUTIONS o SUBSIDIZED HEALTH SERVICES o COMMUNITY BUILDING ACTIVITIES DURING THIS FISCAL YEAR, SCRIPPS INVESTED $17,272,628 IN COMMUNITY HEALTH SERVICES (INCLUDES SUBSIDIZED HEALTH). THIS FIGURE REFLECTS THE COST ASSOCIATED WITH PROVIDING SUCH ACTIVITIES, INCLUDING SALARIES, MATERIALS AND SUPPLIES, MINUS REVENUE. FOLLOWING ARE HIGHLIGHTS OF JUST SOME OF THE ACTIVITIES CONDUCTED BY SCRIPPS DURING THIS FISCAL YEAR.
ACCESS TO CARE		A LACK OF HEALTH INSURANCE AND ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS ARE TWO OF THE PRIMARY BARRIERS TO HEALTH CARE ON BOTH A LOCAL AND NATIONAL LEVEL. WITHOUT ACCESS TO BASIC HEALTH CARE SERVICES, INDIVIDUALS SUFFER FROM MORE ACUTE EPISODES OF ILLNESS, INJURY AND MORTALITY. IT IS ALSO AN INCREASED BURDEN ON HOSPITALS AND HEALTH PROVIDERS RESULTING FROM PROVIDING UNCOMPENSATED CARE TO THE UNINSURED. RISING RATES OF UNINSURED MAY BE REFLECTED IN HIGHER USE OF EMERGENCY DEPARTMENTS, WHICH BY LAW MUST PROVIDE AT LEAST STABILIZING CARE TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. REVIEW OF THE SAN DIEGO COUNTY ED DISCHARGES BY SOURCE OF PAYMENT BETWEEN 2006 AND 2008 FOUND THE DEMAND OF ED SERVICES INCREASED BY 11.9%, 582,129 AND 651,595 RESPECTIVELY. IN ADDITION, SEVERAL SHIFTS IN PAYOR SOURCES WERE NOTED INCLUDING A DECLINE IN PRIVATE HMO AND WORKER COMPENSATION ED DISCHARGES AND INCREASES IN BOTH SELF PAY AND MEDI-CAL ED DISCHARGES. THE DECLINE IN PRIVATE HMP COVERAGE WAS OFFSET BY A SLIGHT INCREASE IN OTHER PRIVATE INSURANCE. THE INCREASE IN SELF-PAY AND MEDI-CAL DISCHARGES SUGGESTS MORE PATIENTS ARE RELYING ON ED CARE DUE TO LACK OF INSURANCE COVERAGE. IN AN EFFORT TO PROVIDE FOR POPULATIONS IN NEED, SCRIPPS ASSISTED IN FY11 WITH THE FOLLOWING EXAMPLES OF HEALTH CARE PROGRAMS AND PROJECTS. MERCY OUTREACH SURGICAL TEAM (MOST) - THE MERCY OUTREACH SURGICAL TEAM (MOST) WORKS TO MITIGATE THE EFFECTS PHYSICAL DEFORMITIES HAVE ON CHILDREN BY PROVIDING RECONSTRUCTIVE SURGERIES AT NO COST TO CHILDREN IN NEED. THROUGH VOLUNTEERISM, MOST PROVIDES RECONSTRUCTIVE SURGERIES TO MORE THAN 400 CHILDREN (UNDER 18 YEARS OF AGE) WITH PHYSICAL DEFORMITIES CAUSED BY BIRTH DEFECTS OR ACCIDENTS IN MEXICO. IN SPECIAL CIRCUMSTANCES, SURGERIES ALSO ARE PROVIDED FOR ADULTS. DURING FY11, THE MOST TEAM PROVIDED RECONSTRUCTIVE SURGERIES FOR MORE THAN 353 CHILDREN. (SPONSORED BY SCRIPPS MERCY HOSPITAL SAN DIEGO AND AFFILIATED PHYSICIANS). GRADUATE MEDICAL EDUCATION STAFF SUPPORT TO ST. VINCENT DE PAUL VILLAGE MEDICAL CENTER AND MID-CITY COMMUNITY CLINICS - WEEKLY COMMUNITY CLINICS WERE HELD AT THE ST. VINCENT DE PAUL AND MID-CITY COMMUNITY CLINICS. STAFFED BY THE SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC INTERNAL MEDICINE RESIDENTS, THESE CLINICS PROVIDED MEDICAL CARE TO APPROXIMATELY 294 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS DURING FY11. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) FIJI ALLIANCE PROJECT - IN PARTNERSHIP WITH THE INTERNATIONAL RELIEF TEAMS OF SAN DIEGO, THE LOLOMA FOUNDATION, SCRIPPS EMPLOYEES, SCRIPPS CLINIC PHYSICIANS AND OTHER SCRIPPS AFFILIATED PHYSICIANS PROVIDED MEDICAL AND SURGICAL SERVICES IN FIJI TO PERSONS IN NEED. RESIDENTS FROM SCRIPPS CLINIC AND SCRIPPS GREEN HOSPITAL HAVE AN OPPORTUNITY TO PARTICIPATE IN THE MEDICAL MISSIONS AS ONE OF THEIR ROTATIONS. EXAMPLES OF PROCEDURES INCLUDE CLEFT LIP AND PALATE REPAIRS, REPAIRS OF DEFORMITIES OF EYELIDS, FACE AND FEET, BURN SCAR REVISION, BREAST MASSES, DIABETES MANAGEMENT AND HERNIA REPAIRS. ALL SURGICAL SUPPLIES WERE DONATED BY PROFESSIONAL HOSPITAL SUPPLY CORP. (PHS), THE SUPPLIER FOR SCRIPPS HEALTH SYSTEM. THE SUPPLIES INCLUDED SURGICAL GOWNS, GLOVES, DRAPES, DRESSINGS, BANDAGES, SUTURES, ETC. CARDINAL HEALTH SYSTEMS, WHICH PROVIDES PHARMACEUTICALS AND OTHER SUPPLIES TO SCRIPPS HEALTH, DONATED ALL THE MEDICATIONS NECESSARY. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND - IN 2011, SCRIPPS AWARDED A TOTAL OF $215,000 IN COMMUNITY GRANTS TO PROGRAMS BASED THROUGHOUT SAN DIEGO. SCRIPPS AWARDED SIX GRANTS RANGING FROM $10,000 TO $120,000 EACH. THE PROJECTS THAT RECEIVED FUNDING ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH-PRIORITY HEALTH NEEDS WITH THE GOAL OF IMPROVING ACCESS TO VITAL HEALTH CARE SERVICES FOR A VARIETY OF AT-RISK POPULATIONS, INCLUDING THE HOMELESS, ECONOMICALLY DISADVANTAGED, MENTALLY ILL AND OTHERS. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $2.2 MILLION DOLLARS. PROGRAMS FUNDED DURING FY11 INCLUDE: O CB FUND - CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA). FUNDING PROVIDES LOW INCOME UNINSURED MERCY CLINIC PATIENTS' AND BEHAVIORAL HEALTH PATIENTS WHO NEED ASSISTANCE IN OBTAINING HEALTHCARE BENEFITS, SSI AND RELATED SERVICES, WHILE SIMULTANEOUSLY REDUCING UNCOMPENSATED CARE EXPENSES FOR MERCY. THIS PROJECT PROVIDES ADVOCACY SERVICES FOR THE TIME-INTENSIVE GOVERNMENT BENEFIT CASES. (SPONSORED BY SCRIPPS MERCY HOSPITAL ADMINISTRATION). O CB FUND - CATHOLIC CHARITIES - FUNDING AWARDED TO PROVIDE SHORT-TERM EMERGENCY SHELTER TO MEDICALLY FRAGILE HOMELESS PATIENTS BEING DISCHARGED FROM SCRIPPS MERCY HOSPITAL SAN DIEGO AND TO EXPAND TO SCRIPPS MERCY CHULA VISTA. CASE MANAGEMENT AND SHELTER IS PROVIDED FOR PREVIOUSLY HOMELESS PATIENTS DISCHARGED FROM SCRIPPS MERCY HOSPITAL WHO NO LONGER REQUIRE HOSPITAL CARE BUT DO NEED A SHORT-TERM SUPPORTIVE RECUPERATIVE ENVIRONMENT. PATIENTS DEMONSTRATING A READINESS FOR CHANGE ARE ASSISTED WITH ONE WEEK IN A HOTEL ALONG WITH FOOD AND BUS FARE TO PURSUE CASE PLAN. THE FOCUS OF THE CASE MANAGEMENT IS TO STABILIZE THE CLIENT BY HELPING THEM CONNECT TO MORE PERMANENT SOURCES OF INCOME, HOUSING AND ONGOING SUPPORTS FOR EFFORTS TOWARD SELF-RELIANCE. THE GOAL OF THIS PARTNERSHIP IS TO REDUCE THE INCIDENCE OF ER RECIDIVISM IN THIS POPULATION AND IMPROVE THE QUALITY OF LIFE FOR THE PATIENT. O CB FUND - 2-1-1 NEW ACCESS SYSTEM - FUNDING WAS AWARDED FOR 2-1-1 HEALTHCARE NAVIGATION PROGRAM. THERE IS AN OVERWHELMING NEED FOR A DEPENDABLE SERVICE TO ASSIST PEOPLE IN NAVIGATING TODAY'S COMPLEX HEALTHCARE SYSTEM. SINCE THE INCEPTION OF THE HEALTHCARE NAVIGATION PROGRAM, 2-1-1 HAS RESPONDED TO OVER 6,000 CALLS FROM CLIENTS SPECIFICALLY SEEKING HEALTH-RELATED RESOURCES AND 5,726 SELF SELECTED "HEALTH" AS THEIR NEED. 2-1-1 SAN DIEGO IS THE DIALING CODE FOR INFORMATION ABOUT COMMUNITY, HEALTH AND DISASTER SERVICES. IT CONNECTS PEOPLE WITH RESOURCES OVER THE PHONE, ONLINE AND IN PRINT. LOCALLY, 2-1-1 SAN DIEGO WAS LAUNCHED IN JUNE 2005 AS A MULTILINGUAL AND CONFIDENTIAL SERVICE COMMITTED TO PROVIDING ACCESS 24/7. O CB FUND - AMERICAN HEART ASSOCIATION - FUNDING AWARDED FOR THE 2011 HEART WALK CORPORATE SPONSORSHIP. HEART DISEASE AND STROKE ARE THE NUMBER ONE AND NUMBER THREE CAUSES OF DEATH IN THE NATION FOR MEN AND WOMEN. HEART DISEASE IS THE NATION'S LEADING CAUSE OF DEATH, CLAIMING MORE THAN 950,000 AMERICAN LIVES EACH YEAR. SCRIPPS PARTNERS WITH THE AMERICAN HEART ASSOCIATION ON THEIR ANNUAL HEART WALK, TO RAISE FUNDS FOR RESEARCH, PROFESSIONAL AND PUBLIC EDUCATION AND ADVOCACY. O CB FUND - PARTNERSHIP FOR SMOKE-FREE FAMILIES - THE PARTNERSHIP FOR SMOKE-FREE FAMILIES PROGRAM (PSF) IS A COMPREHENSIVE TOBACCO CONTROL PROGRAM TO REDUCE TOBACCO SMOKE EXPOSURE AMONG PREGNANT WOMEN AND SMALL CHILDREN BY SYSTEMATICALLY SCREENING PREGNANT WOMEN AND NEW PARENTS FOR TOBACCO USE IN THEIR OBSTETRICIAN'S AND PEDIATRICIAN'S OFFICE AND LINKING THEM WITH TAILORED INTERVENTIONS. PSF HAS BECOME A STANDARD OF CARE IN SAN DIEGO COUNTY AND A NATIONALLY RECOGNIZED MODEL. PSF PROVIDES A VALUABLE RESOURCE FOR PHYSICIANS AND SMOKING CESSATION SERVICES SPECIFICALLY FOR PREGNANT WOMEN AND NEW PARENTS THAT WAS PREVIOUSLY NON-EXISTENT IN SAN DIEGO. CANCER/ONCOLOGY CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE U.S. EXCEEDED ONLY BY HEART DISEASE AND ACCOUNTS FOR ALMOST ONE QUARTER OF ALL DEATHS IN SAN DIEGO COUNTY. ACCORDING TO NATIONAL CANCER INSTITUTE (NCI) ESTIMATES, IN 2009 THERE WILL BE 1,479,350 NEW CASES OF CANCER DIAGNOSED AND AN ESTIMATED 562,540 DEATHS RELATED TO CANCER. CURRENTLY LUNG, BREAST, COLORECTAL AND PROSTATE CANCERS ACCOUNTED FOR 53% OF ALL NEW CASES OF CANCER AND 50% OF ALL CANCER DEATHS. IN SAN DIEGO COUNTY DURING 2007, PERSONS AGE 55 AND OVER ACCOUNTED FOR ALMOST 88% OF CANCER DEATHS WITH MORTALITY RATES PER 100,000 POPULATION RANGING FROM 267.7 AMONG THOSE IN THE 55 - 64 AGE CATEGORY TO 1,533.5 AMONG THOSE AGE 85 AND OVER. TRENDS BETWEEN 2000 AND 2007, SAN DIEGO COUNTY'S AGE-ADJUSTED MORTALITY RATE FOR CANCER HAS DECLINED FROM 189.1 TO 162.6 PER 100,000 POPULATION. IN RESPONSE TO THIS SERIOUS HEALTH CONCERN, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS DESIGNED TO EDUCATE PEOPLE ON THE IMPORTANCE OF EARLY DETECTION AND TREATMENT FOR SOME OF THE MOST COMMON FORMS OF CANCER. THE FOLLOWING ARE SOME EXAMPLES OF CANCER PROGRAMS AND ACTIVITIES IN WHICH SCRIPPS ENGAGED IN DURING FY11.
SCRIPPS GREEN CANCER CENTER SUPPORT GROUPS		SCRIPPS GREEN CANCER CENTER SUPPORT GROUPS OFFER CANCER PATIENTS THE OPPORTUNITY TO EXPRESS THE EMOTIONS THAT COME WITH A CANCER DIAGNOSIS AND HELP THEM COPE MORE EFFECTIVELY WITH THEIR TREATMENT REGIMEN BY NURTURING THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL WELL BEING. CLASSES AT SCRIPPS GREEN HOSPITAL SUCH AS THE FREE CANCER WRITING WORKSHOP, WHEN WORDS HEAL, ARE DESIGNED TO USE EXPRESSIVE WRITING TO HELP PATIENTS NAVIGATE THEIR JOURNEY WITH CANCER. IN 2011, 16 CANCER PATIENTS ATTENDED A SUPPORT GROUP AT SCRIPPS GREEN AT A COST OF $1,818 TO PROVIDE THESE FREE SERVICES TO THE COMMUNITY. (SPONSORED BY SCRIPPS GREEN HOSPITAL) SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFIT SERVICES BREAST HEALTH CLINICAL SERVICES A TOTAL OF 4,968 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES IN THE COMMUNITY AND SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY SERVICES. A TOTAL OF 6,859 SERVICES WERE PROVIDED INCLUDING TELEPHONE REMINDERS, OUTREACH AND EDUCATION, CASE MANAGEMENT AND A VARIETY OF PRESENTATIONS. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS). SCRIPPS MERCY HOSPITAL CHULA VISTA, RADIOLOGY LOSS TO FOLLOW-UP SERVICES A TOTAL OF 36 PATIENTS HAVE BEEN PROVIDED SUPPORT. OF THESE PATIENTS, A TOTAL OF 77 SERVICES WERE PROVIDED. SERVICES INCLUDE ENCOURAGEMENT FOR PATIENTS TO REPEAT EXAM, ASSIST PATIENTS TO GET HEALTH INSURANCE APPROVAL TO REPEAT EXAM, SOCIAL/ EMOTIONAL SUPPORT, AND EDUCATION ABOUT HOW TO PREVENT BREAST CANCER. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS). SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY POSITIVE BREAST CANCER PATIENT SUPPORT A TOTAL OF 14 PATIENTS WERE SUPPORT. A TOTAL OF 61 SERVICES WERE PROVIDED THAT INCLUDE PHONE CALLS, HOME VISITS, GIVE A PACKAGE WITH A CALENDAR, A PEN AND EDUCATIONAL MATERIALS, SOCIAL AND EMOTIONAL SUPPORT. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS). SCRIPPS POLSTER BREAST CARE CENTER MUSIC AS MEDICINE PROGRAM PATIENTS AND THEIR SUPPORT PERSON PARTICIPATE IN THE MUSIC AS MEDICINE THERAPY CLASS FACILITATED BY A MUSIC THERAPIST. THE MUSIC THERAPIST ASKS QUESTIONS AND TAILORS THE THERAPY TO THE PARTICIPANTS' EMOTIONAL AND PHYSICAL NEEDS. SESSIONS INVOLVE LISTENING TO MUSIC, WRITING SONGS, DISCUSSING WHAT LYRICS MEAN TO THE PARTICIPANTS, USE OF SINGING BOWLS, VOCALIZATION, AND DRUMMING. RESEARCH HAS SHOWN MUSIC'S ABILITY TO BOOST THE IMMUNE FUNCTION, TO BLOCK INCOMING PAIN STIMULI, LOWER BLOOD PRESSURE AND INFLUENCE EMOTIONAL WELL BEING. (SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER). SCRIPPS POLSTER BREAST CARE CENTER SUPPORT GROUPS SCRIPPS POLSTER BREAST CARE CENTER SUPPORT GROUPS PROVIDE A VENUE FOR WOMEN TO COME TOGETHER, DISCUSS ISSUES RELATING TO DIAGNOSES, AND RECEIVE SUPPORT. THE SUPPORT GROUPS ARE OFFERED TO WOMEN IN THE SAN DIEGO COMMUNITY. (SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER). CANCER CENTER AWARENESS AND EDUCATIONAL EVENTS A SERIES OF EDUCATIONAL EVENTS, COORDINATED WITH AMERICAN CANCER SOCIETY AWARENESS MONTHS, ON VARIOUS TYPES OF CANCER, SUCH AS BREAST CANCER, LUNG CANCER, CERVICAL CANCER, COLORECTAL CANCER, SKIN CANCER, OVARIAN/GYNECOLOGICAL CANCER, AND PROSTATE CANCER. AN RN CLINICIAN ANSWERS QUESTIONS AND PROVIDES WRITTEN EDUCATIONAL MATERIAL. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA CANCER CENTER). HEALTH EDUCATION AND SUPPORT GROUPS EDUCATION AND SUPPORT GROUPS PROVIDED TO SAN DIEGO COUNTY RESIDENTS REGARDING A WIDE VARIETY OF HEALTH CONCERNS AND DISEASES. EDUCATION AND SUPPORT GROUP TOPICS INCLUDE: FAMILIES WHO HAVE EXPERIENCED THE LOSS OF A CHILD, CHILDREN WHO HAVE LOST A PARENT TO CANCER, INFERTILITY, PARENTING TWINS, IMPROVING CHILDREN'S READING ABILITIES, HUNTINGTON'S DISEASE, PARKINSON'S DISEASE, MENTAL ILLNESS, OSTOMY, POSTPARTUM, GYNECOLOGICAL CANCER, CHRONIC PAIN, AND MULTIPLE SCLEROSIS. (SPONSORED BY SCRIPPS LA JOLLA COMMUNITY BENEFIT SERVICES.) CARDIOVASCULAR DISEASE CORONARY HEART DISEASE AND STROKE ARE THE NUMBER ONE AND NUMBER THREE CAUSES OF DEATH IN THE NATION FOR BOTH MEN AND WOMEN. HEART DISEASE IS OUR NATION'S LEADING CAUSE OF DEATH, CLAIMING MORE THAN 950,000 AMERICAN LIVES EVERY YEAR. STROKE IS AMERICA'S THIRD KILLER AND IS A LEADING CAUSE OF SERIOUS, LONG-TERM DISABILITY. ACCORDING TO THE AMERICAN HEART ASSOCIATION, AN ESTIMATED 80,000,000 AMERICAN ADULTS HAVE ONE OR MORE TYPES OF CARDIOVASCULAR DISEASE (CVD). IT IS ESTIMATED THAT FEWER THAN HALF OF THESE, 38,100,000, ARE AGE 60 OR OLDER. HIGH BLOOD PRESSURE, CORONARY HEART DISEASE (CHD) AND STROKE ARE THE MOST COMMON FORMS OF CVD. CHD WAS THE LARGEST SINGLE KILLER OF AMERICANS IN 2006, RESULTING IN 445,687 DEATHS. THE PREVALENCE OF CHD AMONG U.S. ADULTS AGE 20 AND OLDER WAS 16,800,000 AND AN ESTIMATED 785,000 PERSONS IN THE U.S. HAD A NEW CORONARY ATTACK AND ANOTHER 470,000 HAD A RECURRENT ATTACK DURING 2006. AN ESTIMATED ADDITIONAL 195,000 PERSONS HAD A SILENT ATTACK DURING THIS SAME PERIOD. STROKE KILLED 137,119 PEOPLE IN 2006. IT'S THE THIRD LARGEST CAUSE OF DEATH, RANKING BEHIND "DISEASES OF THE HEART" AND ALL FORMS OF CANCER. STROKE IS A LEADING CAUSE OF SERIOUS, LONG-TERM DISABILITY IN THE UNITED STATES. THERE ARE NINE POTENTIALLY MODIFIABLE RISK FACTORS FOR CVD THAT HAVE BEEN IDENTIFIED AS CONSISTENT IN MEN AND WOMEN ACROSS ETHNIC GROUPS AND REGIONS. THEY INCLUDE CIGARETTE SMOKING, ABNORMAL BLOOD LIPID LEVELS, HYPERTENSION, DIABETES, ABDOMINAL OBESITY, A LACK OF PHYSICAL ACTIVITY, LOW DAILY FRUIT AND VEGETABLE CONSUMPTION, ALCOHOL OVERCONSUMPTION, AND PSYCHOSOCIAL INDEX. DURING 2007, DISEASES OF THE HEART WERE THE SECOND LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 4,743 DEATHS DURING THIS PERIOD. BETWEEN 2003 AND 2007, THE NUMBER OF HEART DISEASE DEATHS DROPPED 12 PERCENT FROM 5,404 IN 2003. THE AGE-ADJUSTED RATE OF DEATH RELATED TO HEART DISEASE DURING 2007 WAS 151 PER 100,000 POPULATION. DURING 2007, THE SAN DIEGO COUNTY DEATH RATE PER 100,000 ATTRIBUTED TO CHD WAS 112.5. THOSE MOST IMPACTED WERE MALES 148.3, WHITES 118.8, AFRICAN AMERICANS 179.0 AND PERSONS AGES 65 AND OLDER, ACCOUNTING FOR 82% OF CHD DEATHS. THE SAN DIEGO DEATH RATE FOR STROKE WAS 36.1 PER 100,000 POPULATION. HISPANICS AND AFRICAN AMERICANS HAVE THE HIGHEST RATE OF STROKE, 43.1 AND 41.0, RESPECTIVELY. WOMEN, WITH A RATE OF 36.1 ACCOUNTED FOR 59.1% OF SAN DIEGO COUNTY STROKE DEATHS. DURING FY11, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. AMERICAN HEART WALK SCRIPPS ALLOCATED $10,000 IN OPERATIONAL FUNDS AND $30,000 IN IN-KIND DONATIONS TO SUPPORT THE AMERICAN HEART ASSOCIATION'S EFFORTS TO FIGHT HEART DISEASE AND STROKE. IN ADDITION, THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER PROGRAM COORDINATED WALKER PARTICIPATION AND FUND RAISING EFFORTS. THE SAN DIEGO HEART WALK EXCEEDED ITS GOAL BY RAISING MORE THAN $1 MILLION. IN 2011, MORE THAN 2,000 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES AND FRIENDS - WALKED TO HELP RAISE MORE THAN $138,000. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT BY PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION MATERIALS AND MORE. (SPONSORED BY SCRIPPS COMMUNITY BENEFIT SERVICES) COMMUNITY HEALTH EDUCATION PROGRAMS THE COMMUNITY HEALTH EDUCATION PROGRAMS COVER A WIDE VARIETY OF HEALTH RELATED TOPICS ON DISEASE MANAGEMENT, HEALTH CARE UPDATES, AND PREVENTION. THE TOPICS INCLUDE: ALTERNATIVES TO HYSTERECTOMY, STROKE, STRESS, VARICOSE VEINS, INFERTILITY, CARDIAC, DEPRESSION, MACULAR DEGENERATION, MEMORY, BRAIN, ORTHOPEDIC CARE, ROBOTIC SURGERY, SKIN CARE, BACK CARE, MIGRAINES, KNEE PAIN, PELVIC FLOOR INCONTINENCE, SAFETY AND FALL PREVENTION, BLADDER HEALTH, HEALTHY DINING, EXERCISE, VOICE, FLU PREVENTION, SLEEP DISORDERS, NUTRITION, HYPERTENSION, FOOT CARE, SPINE SURGERY, JOINT REPLACEMENT, BREATHING, PAIN MANAGEMENT, AND MEDICATION MATTERS. (SPONSORED BY SCRIPPS LA JOLLA COMMUNITY BENEFIT SERVICES) CPR CLASSES FOR PATIENTS AND FAMILIES OF THE CARDIAC TREATMENT CENTER CPR CLASSES OFFERED TO CARDIAC TREATMENT CENTER PATIENTS AND THEIR FAMILIES. CPR CERTIFICATION CLASSES (FRIENDS AND FAMILIES) OFFERED 4 TIMES YEAR TO PATIENTS AND FAMILY MEMBERS. DESIGNED TO IMPROVE COMMUNITY HEALTH THROUGH INCREASED KNOWLEDGE OF CARDIOPULMONARY RESUSCITATION PRACTICES. (SPONSORED BY CARDIAC TREATMENT CENTER AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA)
CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS		CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS INCLUDE: TAI CHI- TWICE WEEKLY. DESIGNED TO DECREASE STRESS & IMPROVE BALANCE; RESTORATIVE YOGA- THREE TIMES A WEEK. DESIGNED TO DECREASE STRESS, IMPROVE STRENGTH & FLEXIBILITY; FITBALL- TWICE WEEKLY. DESIGNED TO IMPROVE STRENGTH, POSTURE, CORE STABILITY & BALANCE; YOGA FOR CANCER RECOVERY- WEEKLY. DESIGNED TO DECREASE STRESS, IMPROVE CIRCULATORY FLOW, EASE TENSION DURING HEALING; BALANCE- WEEKLY. DESIGNED TO BUILD BALANCE, POSTURE & COORDINATION; POWER YOGA- TWICE WEEKLY. DESIGNED TO IMPROVE STRENGTH & FLEXIBILITY; PILATES-WEEKLY. DESIGNED TO IMPROVE STRENGTH, BALANCE & FLEXIBILITY. YOGA FOR MS-WEEKLY. DESIGNED TO PROMOTE HEALING & IMPROVE STRENGTH & FLEXIBILITY. MEDITATION-WEEKLY. (SPONSORED BY THE CARDIAC TREATMENT CENTER, SCRIPPS MEMORIAL HOSPITAL LA JOLLA) STROKE CARE PROGRAMS A WIDE VARIETY OF COMMUNITY EDUCATION AND AWARENESS WAS PROVIDED ON STROKE RELATED ISSUES. (SPONSORED BY SCRIPPS MERCY SAN DIEGO AND CHULA VISTA STROKE PROGRAM) HEART HEALTH - SCRIPPS HOME HEALTH SERVICES SCRIPPS HOME HEALTH PROVIDED COMMUNITY EDUCATION TO PROMOTE INDEPENDENT MANAGEMENT OF CONGESTIVE HEART FAILURE (CHF) IN ORDER TO PREVENT EXACERBATIONS AND HOSPITALIZATIONS. EDUCATION INCLUDES WHAT IS CHF, MEDICATIONS, DIET, WEIGHT AND EXERCISE. IN FY11, 20 SAN DIEGO COUNTY RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) PREVENTION OF CARDIOVASCULAR DISEASE - SCRIPPS HOME HEALTH SERVICES COMMUNITY EDUCATION TO PROMOTE A HEART HEALTHY DIET AND HEALTHY EATING. IN FY11, 40 SAN DIEGO COUNTY RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES). THE ERIC PAREDES SAVE A LIFE FOUNDATION. THE ERIC PAREDES SAVE A LIFE FOUNDATION IS COMMITTED TO PREVENTING SUDDEN CARDIAC ARREST/DEATH IN MIDDLE AND HIGH SCHOOL AGED CHILDREN THROUGH AWARENESS, EDUCATION AND ACTION. A $15,000 DONATION WAS MADE TO PURCHASE SCREENING EQUIPMENT (EKG MACHINES). THE DONATION GIVEN, HELPED THE FOUNDATION TO PROVIDE HEALTH SCREENINGS, INVOLVING ELECTROCARDIOGRAMS (ECGS) AND ECHOCARDIOGRAMS TO CHILDREN BEFORE THEY CAN PARTICIPATE IN ORGANIZED SPORTS AND ACTIVITIES, ALONG WITH EQUIPPING SCHOOLS WITH AUTOMATED EXTERNAL DEFIBRILLATORS (AEDS). DIABETES DATA FROM THE 2007 NATIONAL DIABETES FACT SHEET (THE MOST RECENT YEAR FOR WHICH DATA IS AVAILABLE) ESTIMATED A TOTAL OF 23.6 MILLION CHILDREN AND ADULTS IN THE US, 7.8% OF THE POPULATION, HAVE DIABETES. THESE INCLUDED 17.9 MILLION PEOPLE WHO HAVE BEEN DIAGNOSED WITH DIABETES AND ANOTHER 5.7 MILLION PEOPLE WITH UNDIAGNOSED DIABETES. ADDITIONALLY, THERE WERE 57 MILLION PEOPLE WITH PRE-DIABETES. EACH YEAR 1.6 MILLION NEW CASES OF DIABETES ARE DIAGNOSED IN PEOPLE AGED 20 YEARS AND OLDER. THERE ARE THREE MAJOR TYPES OF DIABETES: TYPE 1 DIABETES, TYPE 2 DIABETES, AND GESTATIONAL DIABETES. ALL THREE TYPES OF DIABETES SHARE THE SAME BASIC CHARACTERISTIC -- THE BODY'S INABILITY EITHER TO MAKE OR TO USE INSULIN. WITHOUT ENOUGH INSULIN, GLUCOSE STAYS IN THE BLOOD, CREATING HIGH LEVELS OF BLOOD SUGAR. OVER TIME, THIS BUILDUP CAUSES DAMAGE TO KIDNEYS, HEART, NERVES, EYES, AND OTHER ORGANS. TYPE 1 DIABETES MOST OFTEN OCCURS DURING CHILDHOOD OR ADOLESCENCE, ACCOUNTING FOR 5% TO 10% OF ALL DIAGNOSED CASES OF DIABETES. TYPE 2 DIABETES TYPICALLY OCCURS LATER IN LIFE, FREQUENTLY AS THE RESULT OF OBESITY, PHYSICAL INACTIVITY AND OTHER RISK FACTORS. TYPE 2 DIABETES ACCOUNTS FOR 90% TO 95% OF DIABETES CASES. HOWEVER, DUE TO THE CURRENT OBESITY EPIDEMIC, IT IS ESTIMATED THAT 39% OF THE GIRLS AND 33% OF THE BOYS WHO ARE NOW HEALTHY 2 TO 3 YEAR OLDS ARE LIKELY TO DEVELOP DIABETES. MORE THAN 90 MILLION AMERICANS (33 PERCENT) LIVE WITH A CHRONIC DISEASE. WHILE THERE ARE MANY DISABLING CHRONIC DISEASES, DIABETES HAS BEEN IDENTIFIED AS ONE OF THE PRIMARY CHRONIC CONDITIONS IN SAN DIEGO COUNTY. AS THE SEVENTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY DURING 2007, DIABETES WAS RESPONSIBLE FOR 2.7% (520) OF DEATHS DURING THIS PERIOD. IN SAN DIEGO COUNTY, THE AGE-ADJUSTED ESTIMATE OF ADULTS DIAGNOSED WITH DIABETES IN 2007 WAS 6.7%. NATIONALLY, DIABETES WAS THE SIXTH LEADING CAUSE OF DEATH DURING 2006, ACCOUNTING FOR 72,449 DEATHS DURING THIS PERIOD. HEALTH CONSEQUENCES THE COMPLICATIONS ASSOCIATED WITH DIABETES ARE SIGNIFICANT AND WELL ESTABLISHED. THE CDC REPORTS COMPLICATIONS INCLUDING HEART DISEASE, STROKE, HYPERTENSION, BLINDNESS, KIDNEY DISEASE, PREGNANCY COMPLICATIONS, LOWER-LIMB AMPUTATIONS, PERIODONTAL DISEASE AND NERVOUS SYSTEM DISEASE. - THE AGE-ADJUSTED RATE OF HOSPITALIZATION FOR PERSONS WITH DIABETES AMONG SAN DIEGO COUNTY RESIDENTS IN 2008 WAS 128.5 PER 100,000 POPULATION, AN 18.9% INCREASE SINCE 2001. - IN 2008, HISPANICS AND AFRICAN AMERICANS LIVING IN SAN DIEGO COUNTY HAD DIABETES-RELATED HOSPITALIZATION RATES 1.8 AND 2.6 TIMES HIGHER THAN THAT OF THE OVERALL POPULATION. - IN SAN DIEGO COUNTY, THE AGE-ADJUSTED DIABETES-RELATED MORTALITY RATES DECREASED FROM 21.4 PER 100,000 POPULATION IN 2005 TO 17.5 IN 2007, AN 18.2% DECREASE. - IN 2007, DIABETES WAS THE SEVENTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 520 DEATHS. - IN 2007, DIABETES WAS THE SEVENTH LEADING CAUSE OF DEATH IN THE U.S. WITH AN AGE-ADJUSTED DEATH RATE FOR DIABETES AT 23.5 PER 100,000 POPULATION. AMONG THOSE 65 AND OVER, DIABETES WAS THE SIXTH LEADING CAUSE OF DEATH WITH A DEATH RATE OF 135.6 PER 100,000 POPULATION. OVER SIX MILLION AMERICANS ARE UNAWARE THEY HAVE DIABETES. THE COMPLICATIONS RELATED TO DIABETES ARE SERIOUS AND CAN BE REDUCED WITH PREVENTIVE PRACTICES. LEADING TO SCHOOL AND WORK ABSENTEEISM, AN ELEVATED RATE OF HOSPITALIZATION, FREQUENT EMERGENCY ROOM VISITS, PERMANENT PHYSICAL DISABILITIES AND SOMETIMES DEATH, DIABETES IS A SERIOUS COMMUNITY HEALTH PROBLEM. DURING FY11, SCRIPPS ENGAGED IN THE FOLLOWING DIABETES MANAGEMENT INITIATIVES. PROJECT DULCE - FORMED THROUGH COLLABORATION BETWEEN THE SCRIPPS WHITTIER DIABETES INSTITUTE, THE COUNCIL OF COMMUNITY CLINICS, AND COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) PROJECT DULCE IS A COMPREHENSIVE, CULTURALLY COMPETENT DIABETES MANAGEMENT PROGRAM FOR UNDERSERVED AND UNINSURED POPULATIONS IN SAN DIEGO COUNTY. PROJECT DULCE INCORPORATES THE CHRONIC CARE MODEL IN ITS TEAM-BASED APPROACH TO CARE. PROJECT DULCE HAS BEEN WORKING IN COMMUNITIES ACROSS SAN DIEGO FOR THE PAST 10 YEARS BY PROVIDING DIABETES CARE AND SELF MANAGEMENT EDUCATION. NURSE-LED TEAMS FOCUS ON ACHIEVING MEASURABLE IMPROVEMENTS IN THE HEALTH OF THEIR PATIENTS; NURSE EDUCATORS LEAD MULTIDISCIPLINARY TEAMS THAT PROVIDE CLINICAL MANAGEMENT; AND PEER EDUCATORS FROM EACH CULTURAL GROUP, KNOWN AS PROMOTORAS, PROVIDE PUBLIC AND PATIENT EDUCATION TO THEIR PERSPECTIVE COMMUNITIES. THIS INNOVATIVE PROGRAM COMBINES THE STATE-OF-THE-ART IN CLINICAL DIABETES MANAGEMENT WITH PROVEN EDUCATIONAL AND BEHAVIORAL INTERVENTIONS. PROJECT DULCE PROVIDED 6,036 DIABETES CARE AND EDUCATION VISITS FOR LOW-INCOME AND UNDERSERVED INDIVIDUALS THROUGHOUT SAN DIEGO IN FY11 AND ENROLLED MORE THAN 812 NEW PATIENTS IN PROJECT DULCE. THE PROGRAM ALSO INITIATED FOUR NEW PROGRAMS: 1) DIABETES PREVENTION FOR WOMEN WITH A HISTORY OF GESTATIONAL DIABETES; 2) REPLICATING PROJECT DULCE IN TIJUANA; 3) DIABETES PEER CARE COORDINATION PROJECT AT SCRIPPS MERCY CHULA VISTA HOSPITAL AND 4) DIABETES GENEBANK PROGRAM. SCRIPPS WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION AND TRAINING THE SCRIPPS WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION TEAMS PROVIDE STATE-OF-THE-ART EDUCATION AND TRAINING FOR PEOPLE WHO WISH TO INCREASE THEIR DIABETES MANAGEMENT KNOWLEDGE AND SKILLS. WITH THE RISE IN THE NUMBER OF PEOPLE WITH DIABETES, MEDICATION UPGRADES, NUTRITION CHANGES AND CHANGES IN DIABETES RELATED DEVICES, THERE IS A GREAT NEED TO EQUIP HEALTH CARE PROFESSIONALS WITH THE LATEST INFORMATION AND CLINICAL PRACTICE SKILLS. THE WHITTIER'S PROFESSIONAL EDUCATION PROGRAM IS LED BY A TEAM OF EXPERTS THAT INCLUDE ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS, AND OTHER DIABETES SPECIALISTS, THESE INDIVIDUALS TRAIN PRACTICING PROFESSIONALS TO DELIVER THE BEST CARE POSSIBLE FOR THEIR PATIENTS WITH DIABETES. COURSES ARE DESIGNED TO RESPOND TO THE NEEDS OF ALLIED HEALTH PROFESSIONALS SEEKING AN UNDERSTANDING OF THE NEW AND COMPLEX CLINICAL TREATMENT OPTIONS FOR TYPE 1, TYPE 2 AND GESTATIONAL DIABETES. PROVIDED PROFESSIONAL EDUCATION TO 2,126 INDIVIDUALS ON DIABETES TOPICS, INCLUDING INSULIN MANAGEMENT, INCRETIN THERAPY, THE DIABETES DIET, THE BASICS OF DIABETES, HOME HEALTH EDUCATION AND 5-DAY COMPREHENSIVE TRAINING FOR DIABETES CARE PROFESSIONALS. INDIVIDUALS CAME FROM THROUGHOUT THE UNITED STATES, AS WELL AS FROM LOCAL HEALTH INSTITUTIONS, TO LEARN FROM THE WHITTIER INSTITUTE'S MOST EXPERIENCED DIABETES EXPERTS, INCLUDING ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS AND COMMUNITY EDUCATORS. OVER THE LAST YEAR, THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION DEPARTMENT PROVIDED 23 SEPARATE PROGRAMS TO PHYSICIANS, NURSES, PHARMACISTS, SOCIAL WORKERS, DIETITIANS, MID-LEVEL PROVIDERS AND SOCIAL WORKERS.
HEALTH RELATED BEHAVIORS		HEALTH-RELATED BEHAVIOR IS ONE OF THE MOST IMPORTANT ELEMENTS IN PEOPLE'S HEALTH AND WELL-BEING. ITS IMPORTANCE HAS GROWN AS SANITATION HAS IMPROVED AND MEDICINE HAS ADVANCED. DISEASES THAT WERE ONCE INCURABLE OR FATAL CAN NOW BE PREVENTED OR SUCCESSFULLY TREATED. HEALTH-RELATED BEHAVIORS SUCH AS IMMUNIZATION, SMOKING CESSATION, IMPROVED NUTRITION, INCREASED PHYSICAL ACTIVITY, ORAL HEALTH, AND INJURY PREVENTION HAVE BECOME IMPORTANT COMPONENTS OF LONG-TERM HEALTH. UNDERSTANDING THAT PERSONAL BEHAVIORS PLAY A SIGNIFICANT ROLE IN AN INDIVIDUAL'S OVERALL HEALTH STATUS, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS THAT HELP PEOPLE TAKE CHARGE OF THEIR OWN HEALTH AND THAT OF THEIR FAMILIES. DURING FY11, SCRIPPS PARTICIPATED IN A NUMBER OF HEALTH BEHAVIOR MODIFICATION EFFORTS. FLU VACCINATION CAMPAIGN ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), AN AVERAGE OF 50,000 ADULTS DIE ANNUALLY IN THE UNITED STATES FROM DISEASES THAT ARE PREVENTABLE THROUGH VACCINATION. APPROXIMATELY 36,000 ADULTS DIE FROM INFLUENZA, OVER 6,000 FROM INVASIVE PNEUMOCOCCAL DISEASE, AND 5,000 FROM HEPATITIS B. IN SAN DIEGO COUNTY, INFLUENZA AND PNEUMONIA WERE THE TENTH LEADING CAUSE OF DEATH IN 2007, WITH 1,111 DEATHS RECORDED BETWEEN 2005 AND 2007. BASED ON 2007 CHIS DATA, ONLY 34.6% OF SAN DIEGO COUNTY RESIDENTS REPORTED RECEIVING AN INFLUENZA VACCINATION DURING THE PAST 12 MONTHS. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR 2008 REPORTED ONLY 26.5% OF ADULTS AGED 65 AND OVER HAD BEEN VACCINATED FOR INFLUENZA DURING THE PAST 12 MONTHS. VACCINATIONS MAY NOT BE RECEIVED DUE TO COST AND LOCAL AVAILABILITY ISSUES OR A LACK OF EDUCATION ABOUT TIMING AND EFFECTIVENESS. MISUNDERSTANDING, MISINFORMATION, OR SKEPTICISM RELATED TO THE BENEFITS AND POSSIBLE RISKS ASSOCIATED WITH VACCINES MAY ALSO REDUCE VACCINATION RATES. MATERNAL CHILD HEALTH THE HEALTH OF MOTHERS, INFANTS, AND CHILDREN IS A REFLECTION OF THE CURRENT HEALTH STATUS OF A LARGE SEGMENT OF THE US POPULATION AND A HEALTH PREDICTOR FOR THE NEXT GENERATION. THE FOCUS OF THE INFORMATION IN THIS TOPIC INCLUDES INDICATORS OF MATERNAL ILLNESS AND DEATH AND THOSE THAT AFFECT INFANT HEALTH AND SURVIVAL. AMONG THESE ARE INFORMATION RELATED TO INFANT MORTALITY RATES, ACCESS TO PREVENTIVE CARE, AND FETAL, PERINATAL, AND OTHER INFANT DEATHS. THERE ARE NUMEROUS RISK FACTORS ASSOCIATED WITH MATERNAL AND INFANT HEALTH INCLUDING: - ALCOHOL, TOBACCO, AND ILLEGAL SUBSTANCES DURING PREGNANCY - A MAJOR RISK FACTOR FOR LOW BIRTH WEIGHT AND OTHER POOR INFANT OUTCOMES - VERY LOW BIRTH WEIGHT - ASSOCIATED WITH PRETERM BIRTH, SPONTANEOUS ABORTION, LOW PRE-PREGNANCY WEIGHT, AND CIGARETTE SMOKING - INFANT DEATH - RATES ARE HIGHEST AMONG INFANTS BORN TO YOUNG TEENAGERS AND MOTHERS AGED 44 YEARS AND OLDER BEING PREGNANT OR TRYING TO BECOME PREGNANT ACCOUNTS FOR A SMALL PORTION OF A WOMAN'S LIFE. AN UNINTENDED PREGNANCY IS A PREGNANCY THAT IS EITHER MISTIMED OR UNWANTED AT THE TIME OF CONCEPTION. UNINTENDED PREGNANCY ACCOUNTS FOR AN ESTIMATED 49% OF ALL PREGNANCIES IN THE U.S. AND IS ASSOCIATED WITH INCREASED MORBIDITY AND WITH BEHAVIORS DURING PREGNANCY THAT ARE LINKED WITH ADVERSE HEALTH EFFECTS. WOMEN WHO CAN PLAN THE NUMBER AND TIMING OF THE BIRTHS OF THEIR CHILDREN ENJOY IMPROVED HEALTH, EXPERIENCE FEWER UNPLANNED PREGNANCIES AND BIRTHS, AND HAVE LOWER RATES OF ABORTION. WHO IS MOST IMPACTED DURING 2008, SAN DIEGO COUNTY'S CRUDE BIRTH RATE PER 1,000 POPULATION WAS 14.9, ACCOUNTING FOR 46,742 LIVE BIRTHS. CRUDE BIRTH RATES RANGED FROM 9.2 AMONG WHITE WOMEN TO 22.3 AMONG HISPANIC WOMEN. DURING 2008, HISPANICS ACCOUNTED FOR 44.7% OF ALL LIVE BIRTHS FOLLOWED BY 30.9% FOR WHITES. WOMEN BETWEEN THE AGES OF 20 AND 34 ACCOUNTED FOR 74.2% OF BIRTHS. SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION OFFERINGS FOR LOW-INCOME WOMEN IN SAN DIEGO COUNTY IN FY11. THE FOLLOWING ARE EXAMPLES OF PROGRAMS: SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFIT SERVICES o OFFERED A TOTAL OF OVER 700 MATERNAL CHILD HEALTH CLASSES THROUGHOUT SAN DIEGO COUNTY DESIGNED TO ENHANCE THE PARENTING SKILLS. LOW-INCOME WOMEN IN THE COUNTY OF SAN DIEGO WERE ELIGIBLE TO ALL ATTEND CLASSES AT NO CHARGE OR ON A SLIDING FEE SCHEDULE. o MAINTAINED THE EXISTING PRENATAL EDUCATION SERVICES IN ALL REGIONS OF THE COUNTY ENSURING THAT PROGRAMS CONTINUED TO DEMONSTRATE A MORE THAN 90 PERCENT SATISFACTION RATING o PROVIDED AND SUPPORTED WEEKLY BREASTFEEDING SUPPORT GROUPS THROUGHOUT SAN DIEGO COUNTY. THIS INCLUDES TWO WITH BILINGUAL SERVICES. o OFFERED A MATERNAL CHILD HEALTH EDUCATION SERIES COVERING ISSUES SUCH AS DOGS AND BABIES: SAFETY, GRANDPARENTING AND BABY SITTER SAFETY IN THE NORTH COUNTY. o OFFERED THE FOLLOWING MATERNAL CHILD HEALTH CLASSES AT THE MENDE WELL BEING CENTER: BASIC TRAINING FOR DADS, GETTING READY FOR THE BABY, THE INFANT CPR AND SAFETY PROGRAM, PARENT CONNECTION PROGRAMS, AND REDIRECTING CHILDREN'S BEHAVIOR. o OFFERED DOGS & BABIES PROGRAM QUARTERLY WITH MORE THAN 40 ATTENDEES. o OFFERED WEEKLY MOMMY & ME YOGA PROGRAMS TO NEW PARENTS. o OFFERED A PRENATAL YOGA PROGRAM FOR EXPECTANT WOMEN IN SAN DIEGO COUNTY. o OFFERED A PREGNANCY NUTRITION PROGRAM QUARTERLY AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. o OFFERED "PELVIC FLOOR AND PREGNANCY CHANGES" FOR EXPECTANT FAMILIES AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFIT SERVICES) FIRST 5 MORE THAN 1,285 SERVICES WERE RECEIVED FOR FIRST TIME MOTHERS INCLUDING: HOME VISITS, REFERRALS RECEIVED, DATA ENTRY, FOLLOW UP PHONE CALLS, PARENTING CLASSES AND OTHER SUPPORT SERVICES. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA, COMMUNITY BENEFITS) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE-FUNDED WIC PROGRAM, SERVING 6 LOCATIONS THAT ARE CONVENIENTLY SITUATED EITHER IN OR NEXT TO COMMUNITY CLINICS AND/OR HOSPITALS IN THE CENTRAL SAN DIEGO AREA OF SAN DIEGO COUNTY. WIC'S TARGET POPULATION IS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO FIVE). ON AN ANNUAL BASIS, SCRIPPS MERCY WIC SERVES APPROXIMATELY 9,000 WOMEN AND CHILDREN WITH 44% IN THE CITY HEIGHTS COMMUNITY. THE CLIENT BASE IN CITY HEIGHTS IS 91% HISPANIC AND MADE UP OF PREGNANT AND POSTPARTUM WOMEN (24%), INFANTS (20%) AND CHILDREN (56%). IN FY11, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS TO 119,003 WOMEN AND CHILDREN IN THE SOUTH AND CENTRAL REGIONS OF SAN DIEGO. SCRIPPS MERCY WIC PROGRAM PLAYS A KEY ROLE IN MATERNITY CARE BY REACHING LOW-INCOME WOMEN DURING PREGNANCY TO PROMOTE PRENATAL CARE, GOOD NUTRITION AND BREASTFEEDING. NUTRITION-TRAINED STAFF BEGIN EDUCATING WOMEN ABOUT THE IMPORTANCE OF BREASTFEEDING DURING PREGNANCY; OFFER LACTATION SUPPORT (ONE ON ONE AND GROUP) AS WELL AS SUPPLIES - PUMPS, BREAST PADS - DURING THE POSTPARTUM PERIOD. (SPONSORED BY SCRIPPS MERCY SAN DIEGO) SUBSTANCE ABUSE AND TOBACCO USE SUBSTANCE ABUSE HAS A MAJOR IMPACT ON INDIVIDUALS, THEIR FAMILIES, AND THEIR COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL AND PUBLIC HEALTH PROBLEMS. THESE PROBLEMS INCLUDE TEENAGE PREGNANCY, HIV/AIDS, OTHER SEXUALLY TRANSMITTED DISEASES (STDS), DOMESTIC VIOLENCE, CHILD ABUSE, MOTOR VEHICLE CRASHES, PHYSICAL FIGHTS, CRIME, HOMICIDE AND SUICIDE. ACCORDING TO THE NATIONAL INSTITUTE ON DRUG ABUSE, THE TOTAL ESTIMATED ANNUAL COSTS ASSOCIATED WITH SUBSTANCE ABUSE EXCEED HALF A TRILLION DOLLARS. THIS INCLUDES APPROXIMATELY $181 BILLION FOR ILLICIT DRUGS, $168 BILLION FOR TOBACCO AND $185 BILLION FOR ALCOHOL. DURING 2009, CALIFORNIA'S ESTIMATED HEALTHCARE COSTS DIRECTLY CAUSED BY SMOKING WERE $9.14 BILLION. TOBACCO USE - DURING 2007, BASED ON THE YOUTH RISK BEHAVIOR SURVEILLANCE SURVEY (YRBSS), 43.6% OF STUDENTS IN GRADES 9-12 WITHIN THE SAN DIEGO UNIFIED SCHOOL DISTRICT REPORTED THEY HAD EVER TRIED CIGARETTE SMOKING. - DURING THIS SAME TIME PERIOD, 11.0% OF STUDENTS IN GRADES 9-12 REPORTED CURRENT CIGARETTE USE AND 7.0% REPORTED THEY SMOKED MORE THAN 10 CIGARETTES PER DAY. - OF THOSE STUDENTS WHO REPORTED THEY CURRENTLY SMOKE, 41.4% REPORTED THEY HAVE TRIED TO QUIT SMOKING AT LEAST ONCE DURING THE PAST 12 MONTHS. - DURING 2008, BASED ON BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA FOR SAN DIEGO COUNTY, 14.5% OF ADULTS, AGED 18 OR OLDER, CURRENTLY SMOKE. MOREOVER, 23% ARE FORMER SMOKERS AND 62.5 HAVE NEVER SMOKED.
ALCOHOL USE		- DURING 2007, BASED ON THE YRBSS, 72.0% OF STUDENTS IN GRADES 9-12 WITHIN THE SAN DIEGO UNIFIED SCHOOL DISTRICT REPORTED THEY HAD AT LEAST ONE DRINK OF ALCOHOL ON AT LEAST 1 DAY DURING THEIR LIFE. - DURING THIS SAME TIME PERIOD, 36.7% OF STUDENTS IN GRADES 9-12 REPORTED THEY HAD AT LEAST ONE DRINK OF ALCOHOL ON AT LEAST 1 DAY DURING THE 30 DAYS PRIOR TO THE SURVEY. - EPISODIC HEAVY DRINKING, HAVING FIVE OR MORE DRINKS OF ALCOHOLIC IN A ROW WITHIN A COUPLE OF HOURS ON AT LEAST ONE DAY DURING THE 30 DAYS PRIOR TO THE SURVEY, WAS REPORTED BY 21.8% OF STUDENTS. - DURING 2008, BASED ON BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA FOR SAN DIEGO COUNTY, 55.1% OF ADULTS, AGED 18 OR OLDER, HAVE HAD AT LEAST ONE DRINK DURING THE PAST 30 DAYS. IN AN EFFORT TO ENCOURAGE MORE PEOPLE TO TAKE STEPS TO PREVENT SUBSTANCE ABUSE, SCRIPPS ENGAGED IN THE FOLLOWING ACTIVITIES: INTERVENTION WORKSHOPS AIM TO IMPROVE COMMUNITY HEALTH THE INTERVENTION PROGRAM AT SCRIPPS DRUG AND ALCOHOL TREATMENT PROGRAM OFFERS FREE WORKSHOPS FOR PARENTS TO HELP THEM BETTER UNDERSTAND ADOLESCENT ALCOHOL AND SUBSTANCE ABUSE AND THE WIDESPREAD PROBLEM OF TEEN ADDICTION. OTHER INTERVENTION WORKSHOPS ADDRESS THE WARNING SIGNS OF ADULT ADDICTION FOR FAMILIES AND EMPLOYERS, PROVIDING AGE-SPECIFIC INFORMATION ON HOW TO HELP LOVED-ONES RECOGNIZE THE SIGNS OF ADDICTION AND HOW TO GET AN ADDICTED INDIVIDUAL TO SEEK TREATMENT. MORE THAN 11,000 PEOPLE ATTENDED THE WORKSHOPS ON THE SCRIPPS MEMORIAL HOSPITAL LA JOLLA CAMPUS IN 2011. EVERY 15 MINUTES THE EVERY 15 MINUTES PROGRAM IS A TWO-DAY EVENT THAT EXPOSES HIGH SCHOOL STUDENTS TO THE CONSEQUENCES OF DRINKING AND DRIVING THROUGH A DRAMATIC REENACTMENT OF AN ALCOHOL-RELATED TRAFFIC ACCIDENT. THE "INJURED" STUDENTS ARE TAKEN TO SCRIPPS MERCY TRAUMA CENTER. THIS PROGRAM IS SPONSORED JOINTLY BY LOCAL HIGH SCHOOLS, COUNTY POLICE, SHERIFFS, CHP, EMERGENCY DEPARTMENTS AND AMBULANCE SERVICES. DURING FY11, SCRIPPS MERCY HOSPITAL PARTICIPATED IN FOUR (4) EVERY 15 MINUTES PROGRAMS, REACHING OVER 3,000 HIGH SCHOOL STUDENTS THROUGHOUT SAN DIEGO COUNTY. SCRIPPS MEMORIAL HOSPITAL LA JOLLA PARTICIPATED IN ONE EVERY 15 MINUTES PROGRAM, REACHING 250 HIGH SCHOOL STUDENTS IN LA JOLLA. (SPONSORED BY SCRIPPS MERCY TRAUMA AND ED; SCRIPPS LA JOLLA TRAUMA DEPARTMENT) PARTNERSHIP FOR SMOKE-FREE FAMILIES PROGRAM CIGARETTE SMOKING HAS BEEN IDENTIFIED AS THE MOST IMPORTANT SOURCE OF PREVENTABLE MORBIDITY AND PREMATURE MORTALITY WORLDWIDE. CIGARETTE SMOKING CAUSES HEART DISEASE, SEVERAL KINDS OF CANCER (LUNG, LARYNX, ESOPHAGUS, PHARYNX, MOUTH AND BLADDER AND CHRONIC LUNG DISEASE. APPROXIMATELY 11% OF PREGNANT WOMEN SMOKE. AN ESTIMATED 25-60% OF ALL FEMALE SMOKERS QUIT SHORTLY AFTER LEARNING THEY ARE PREGNANT (RECENT QUITTERS). AMONG THOSE WHO QUIT ON THEIR OWN, 20% TO 40% WILL GO BACK TO SMOKING DURING PREGNANCY. IN THE US, 25% OF CHILDREN UNDER THE AGE OF SIX YEARS LIVE IN A HOUSE WHERE SOMEONE SMOKES INSIDE AT LEAST FOUR DAYS PER WEEK. PRENATAL RISKS SMOKING DURING PREGNANCY HAS BEEN SHOWN TO CAUSE ADVERSE OUTCOMES INCLUDING MISCARRIAGE, PLACENTAL ABRUPTION AND SEPARATION AND INCREASED PERINATAL MORTALITY. IT ACCOUNTS FOR 20% OF LOW BIRTH WEIGHT DELIVERIES, EIGHT PERCENT OF PRETERM BIRTHS, AND 5 PERCENT OF ALL PRENATAL DEATHS. INFANT/CHILD RISKS THE EFFECTS OF MATERNAL SMOKING ARE NOT LIMITED TO THE PRENATAL PERIOD. MORE INFANTS DIE OF SUDDEN INFANT DEATH SYNDROME WHETHER THE MOTHER SMOKED DURING PREGNANCY OR AFTER THE BIRTH. CHILDREN OF SMOKERS HAVE MORE RESPIRATORY PROBLEMS, EAR INFECTIONS, ASTHMA, AND DOCTOR VISITS. CHILDREN WHOSE PARENTS SMOKE ARE MORE LIKELY TO HAVE BEHAVIOR PROBLEMS AND TROUBLE WITH SCHOOLWORK. LAUNCHED IN 1998 BY THE CEOS OF RADY CHILDREN'S HOSPITAL, SCRIPPS AND SHARP HEALTHCARE, PSF HAS THE GOAL OF REDUCING TOBACCO SMOKE EXPOSURE AMONG PREGNANT WOMEN AND YOUNG CHILDREN. THE PROGRAM WORKS DIRECTLY WITH OBSTETRICIANS AND PEDIATRICIANS ACROSS SAN DIEGO COUNTY TO IMPLEMENT "BEST PRACTICES" AS OUTLINED IN THE USDHHS TREATING TOBACCO USE AND DEPENDENCE CLINICAL PRACTICE GUIDELINE. PSF HAS BECOME A STANDARD OF CARE IN SAN DIEGO COUNTY, AND IS RECOGNIZED NATIONALLY. AS OF NOVEMBER 30, 2010 NEARLY 300,000 PREGNANT WOMEN AND PARENTS OF SMALL CHILDREN HAVE BEEN SCREENED FOR TOBACCO USE/EXPOSURE AND MORE THAN 55,000 PROACTIVELY LINKED WITH TARGETED INTERVENTIONS. (SPONSORED BY SCRIPPS HEALTH SYSTEM, COMMUNITY BENEFIT SERVICES) HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 84 PARTICIPANTS WERE INCLUDED IN THE STAY QUIT STUDY. THIS STUDY IS A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. A TOTAL OF 507 PEOPLE HAVE BEEN SCREENED. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA) YOUTHFUL DRINKING AND DRIVING PROGRAM CONSIDERING THAT AT LEAST 74.3 PERCENT OF HIGH SCHOOL STUDENTS IN THE U.S. REPORT DRINKING ALCOHOL, IT IS IMPERATIVE THAT STUDENTS UNDERSTAND THE RISKS ASSOCIATED WITH ALCOHOL ABUSE. IN AN EFFORT TO EDUCATE AT-RISK STUDENTS ABOUT THE DANGERS ASSOCIATED WITH DRINKING AND DRIVING, SCRIPPS MERCY HOSPITAL'S EMERGENCY DEPARTMENT AND TRAUMA CENTER PARTICIPATED IN THE CORRECTIVE BEHAVIOR INSTITUTE'S YOUTHFUL DRINKING AND DRIVING PROGRAM, PROVIDING TEENS WITH A TRAUMA CENTER VISITATION EXPERIENCE. THIS FOUR-HOUR SUPERVISED TRAUMA VISITATION PROGRAM FOR YOUNG DRIVERS AGES 14 AND OVER TO SHOW THEM THE REALISTIC CONSEQUENCES OF DRIVING UNDER THE INFLUENCE. OVER 44 HIGH SCHOOL STUDENTS WERE SERVES WITH THIS PROGRAM. PARTICIPANTS VISIT THE TRAUMA ROOM, ER, ICU, CAT SCAN AND OTHER HOSPITAL AREAS. (SPONSORED BY SCRIPPS MERCY HOSPITAL'S EMERGENCY DEPARTMENT AND TRAUMA CENTER) SAN DIEGO COUNTY POLICY PANEL ON YOUTH ACCESS TO ALCOHOL SCRIPPS PARTICIPATES ON A PANEL WHICH WORKS TO SHAPE LOCAL, STATE AND NATIONAL POLICIES THAT AFFECT UNDERAGE DRINKING. IT IS THE LEAD ORGANIZATION FOR THE REGION'S COMBATING UNDERAGE DRINKING INITIATIVE, AND PROVIDES STRUCTURE TO SUPPORT THE PROJECT'S STRATEGIES THROUGH MEDIA ADVOCACY, DATA COLLECTION, AND RESPONSIBLE BEVERAGE SERVICE TRAINING AND YOUTH PARTICIPATION. (SPONSORED BY SCRIPPS MERCY HOSPITAL, TRAUMA SERVICES) SAN DIEGO COUNTY METHAMPHETAMINE STRIKE FORCE (MSF) CONVENED IN 1996 BY THE COUNTY BOARD OF SUPERVISORS, THIS MULTIAGENCY GROUP IS TASKED WITH THE DEVELOPMENT OF A REGIONAL PREVENTION AND TREATMENT STRATEGY TO ADDRESS METHAMPHETAMINE ABUSE. SCRIPPS MERCY HOSPITAL TRAUMA SERVICES IS ON THE COORDINATING COMMITTEE. THE STRIKE FORCE TRACKS ITS PROGRESS WITH AN ANNUAL REPORT CARD OF TEN INDICATORS. THE STRIKE FORCE PROGRAMS HAVE BEEN DUPLICATED IN SEVERAL OTHER PARTS OF THE UNITED STATES. (SPONSORED BY SCRIPPS MERCY HOSPITAL, TRAUMA SERVICES) UNINTENTIONAL INJURY AND VIOLENCE IN CALIFORNIA, INJURY, INCLUDING BOTH UNINTENTIONAL AND INTENTIONAL, IS THE NUMBER ONE KILLER AND DISABLER OF PERSONS AGED 1 TO 44 (CDPH, 2010). THE NUMBERS OF DEATHS ASSOCIATED WITH UNINTENTIONAL INJURY ARE SIGNIFICANT, YET PRESENT ONLY A SMALL PART OF A MUCH LARGER AND SERIOUS PUBLIC HEALTH PROBLEM. HOSPITALIZATION DATA IS MORE INDICATIVE OF THE EXTENT OF THE INJURY PROBLEM THAN DEATH DATA ALONE. IN SAN DIEGO COUNTY DURING 2008 THERE WERE OVER 930 DEATHS, MORE THAN 20,800 SAN DIEGANS WERE HOSPITALIZED AND NEARLY 150,000 WERE TREATED ANNUALLY IN EMERGENCY DEPARTMENTS FOR UNINTENTIONAL INJURIES. THE NUMBER OF UNINTENTIONAL INJURIES TREATED IN PHYSICIANS' OFFICES AND CLINICS RELATED TO UNINTENTIONAL INJURY, WHILE UNKNOWN, IS LIKELY MUCH HIGHER THAN THE NUMBER OF EMERGENCY DEPARTMENT VISITS. UNINTENTIONAL INJURIES ARE ONE OF THE LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY RESIDENTS OF ALL AGES, REGARDLESS OF GENDER, RACE, OR REGION. DURING 2008, UNINTENTIONAL INJURY WAS THE LEADING CAUSE OF DEATH FOR PERSONS AGES 1 TO 4 YEARS AND 15 TO 34 YEARS AND THE SIXTH LEADING CAUSE OF DEATH OVERALL. OVER 930 SAN DIEGANS DIED IN 2008 AS A RESULT OF UNINTENTIONAL INJURIES. DURING 2008, THERE WERE 149,900 UNINTENTIONAL INJURY DISCHARGES FROM SAN DIEGO COUNTY EDS, ACCOUNTING FOR ALMOST ONE IN FOUR (24.2%) OF ALL ED DISCHARGES DURING THIS PERIOD. THE RATE OF ED DISCHARGES RELATED TO UNINTENTIONAL INJURY WAS 4,735 PER 100,000 AND REPRESENTED THE LOWEST RATE DURING THE PAST THREE YEARS. UNINTENTIONAL INJURIES CAN OCCUR AT HOME, AT WORK, WHILE PARTICIPATING IN SPORTS AND RECREATION, ON THE STREETS, AND AT SCHOOL. CAUSES OF UNINTENTIONAL INJURIES INCLUDE MOTOR VEHICLE ACCIDENTS, FALLS, FIREARMS, FIRE/BURNS, DROWNING, POISONING (INCLUDING DRUGS AND CAUSTIC SUBSTANCES) AND ALCOHOL, GAS, CLEANERS AND INJURIES AT WORK. THE FOLLOWING ARE SOME OF SCRIPPS HEALTH PROGRAMS THAT ADDRESS UNINTENTIONAL INJURIES AND VIOLENCE FOR FY11.
HEALTH AND SAFETY FAIR - SCRIPPS HOME HEALTH SERVICES		PROVIDED EDUCATION FOR SENIORS ON FALL PREVENTION (PRIMARY CAUSES OF FALLS AND FRACTURES) AND FIRE SAFETY. HOME HEALTH NURSES PROVIDE INFORMATION TO SENIORS AND THEIR FAMILIES ON CONTINUUM OF CARE OPTIONS. IN FY11, 735 SAN DIEGO RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) FALL PREVENTION - SCRIPPS MEMORIAL HOSPITAL LA JOLLA AND THE LAWRENCE FAMILY JEWISH COMMUNITY CENTER PARTNERED TO OFFER A CLASS TAUGHT BY TRAUMA CARE EXPERTS TO LEARN WAYS TO REDUCE FALL RISK, IMPROVE SAFETY AWARENESS AND UTILIZE AVAILABLE RESOURCES TO PROMOTE INDEPENDENCE AND OVERALL SAFETY. 3,500 PARTICIPANTS FROM THE COMMUNITY ATTENDED THIS CLASS. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, TRAUMA SERVICES) SPORTS CONCUSSION PROGRAM - REHABILITATION CENTER AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS EVERY YEAR IN THE U.S., ALMOST 300,000 SPORTS-RELATED CONCUSSIONS OCCUR PER YEAR - 100,000 IN FOOTBALL ALONE, AND APPROXIMATELY 130,000 HIGH SCHOOL ATHLETES SUFFER A CONCUSSION. A RECENT REPORT SHOWED THAT CLOSE TO 40 PERCENT OF HIGH SCHOOL ATHLETES WHO SUSTAIN A CONCUSSION RETURN TO PLAY TOO SOON. THE REHABILITATION CENTER AT SCRIPPS ENCINITAS HAS DEVELOPED A PUBLIC EDUCATION AND COMMUNITY OUTREACH PROGRAM DESIGNED TO BRING AWARENESS TO CONCUSSION, SIGNS AND SYMPTOMS OF CONCUSSION, HOW TO AVOID THEM, TREAT THEM AND UNDERSTAND THEIR CONSEQUENCES. 194 STUDENTS HAVE BEEN SERVED BY THIS PROGRAM. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL ENCINITAS) SAN DIEGO FALL PREVENTION TASK FORCE THIS COUNTY HHSA- AGING AND INDEPENDENCE SERVICE-SUPPORTED TASK FORCE SEEKS TO REDUCE FALLS AND THEIR DEVASTATING CONSEQUENCES IN SAN DIEGO COUNTY. GOALS AND STRATEGIES INCLUDE: (1) INCREASE CONNECTIONS BETWEEN PHYSICIANS AND OTHER COMMUNITY SERVICE PROVIDERS THAT PROVIDE FALL PREVENTION SERVICES; (2) INCREASE AWARENESS AMONG OLDER ADULTS AND SERVICE. SCRIPPS MERCY HOSPITAL TRAUMA DEPARTMENT PARTICIPATES IN THIS TASK FORCE. WEIGHT STATUS, NUTRITION, ACTIVITY AND FITNESS THE NUMBERS SPEAK FOR THEMSELVES - 63% OF AMERICAN ADULTS ARE EITHER OVERWEIGHT OR OBESE. NATIONALLY, THE PREVALENCE OF OBESE ADULTS (THOSE WITH A BODY MASS INDEX [BMI] OF 30 OR MORE) HAS INCREASED BY 68% SINCE 1995, FROM 16% TO ALMOST 27%. DURING THIS SAME PERIOD, THE PREVALENCE OF OVERWEIGHT ADULTS HAS INCREASED BY ONLY TWO PERCENT, 35.5% TO 36.2%. 2009 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR SAN DIEGO COUNTY INDICATES THAT ALMOST 59% OF THE ADULT POPULATION IS CONSIDERED EITHER OVERWEIGHT OR OBESE. SINCE 2005, THE FIRST YEAR BRFSS DATA WAS REPORTED FOR SAN DIEGO COUNTY, THE PREVALENCE OF OBESE ADULTS HAS RANGED FROM 20% IN 2005 TO 26.7% IN 2006, WITH THE MOST CURRENT MEASURE AT 21.6% SINCE 2006. THE PREVALENCE OF OVERWEIGHT ADULTS IN SAN DIEGO COUNTY HAS INCREASED SLIGHTLY FROM 36.5% TO 37.7%. REVIEW OF ADULT OVERWEIGHT AND OBESITY PREVALENCE DATA BY ETHNICITY, RACE AND GENDER INDICATES THE PREVALENCE RATES OF OBESITY AMONG LATINOS AND AFRICAN AMERICANS ARE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITES AT THE NATIONAL, STATE AND COUNTY LEVELS. OBESITY RATES BY GENDER ALSO VARIED SIGNIFICANTLY IN THE 2007 CHIS, THE MOST RECENT COUNTY LEVEL DATA AVAILABLE BY GENDER, WITH 25.4% OF MALES AND 18.1% OF FEMALES HAVING A BMI OF 30.0 OR HIGHER. MOREOVER, MALES WERE SIGNIFICANTLY MORE LIKELY TO BE OVERWEIGHT (BMI BETWEEN 25.0 AND 29.99) THAN FEMALES, 40.5% AND 25.8%, RESPECTIVELY. CAUSES OF OBESITY MANY FACTORS PLAY A ROLE IN OVERWEIGHT AND OBESITY, MAKING IT A COMPLEX HEALTH ISSUE TO ADDRESS. SOME OF THE FACTORS THAT ARE MAJOR CONTRIBUTORS TO THE OBESITY EPIDEMIC INCLUDE (DH&HS, 2010): - GENETIC PREDISPOSITION - ENVIRONMENTAL INFLUENCES - BEHAVIOR (DIETARY PATTERNS AND PHYSICAL ACTIVITY) - CULTURAL INFLUENCES - SOCIOECONOMIC STATUS IN THE CONTEXT OF PREVENTION, IT IS IMPORTANT TO UNDERSTAND THE AFFECT EACH OF THESE FACTORS HAS ON OBESITY AND WHICH CAN BE CHANGED AS A MEANS OF REDUCING THE PREVALENCE OF OBESITY. THE FOLLOWING ARE SOME EXAMPLES OF SCRIPPS PROGRAMS THAT ADDRESS THE HEALTH ISSUES DESCRIBED ABOVE. NUTRITION SERVICES AND PHYSICAL ACTIVITY ACCORDING TO THE 2009 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR SAN DIEGO COUNTY, MORE THAN 59 PERCENT OF THE ADULT POPULATION IS CONSIDERED EITHER OVERWEIGHT OR OBESE. OBESITY INCREASES THE HEALTH RISK FOR CHRONIC DISEASES, SUCH AS HEART DISEASE, TYPE 2 DIABETES, HIGH BLOOD PRESSURE, STROKE AND SOME FORMS OF CANCER. AT EVEN GREATER RISK ARE THE NATION'S LOW-INCOME MINORITY POPULATIONS. IN AN EFFORT TO ADDRESS THIS CRITICAL HEALTH CONCERN, STAFF MEMBERS BASED AT THE CITY HEIGHTS WELLNESS CENTER HAVE ESTABLISHED A VARIETY OF NUTRITION EDUCATION AND SERVICES, DESIGNED SPECIFICALLY TO MEET THE NEEDS OF LOW-INCOME MINORITY POPULATIONS. THE CENTER USES A COMBINATION OF APPROACHES TO ADDRESS A BROAD ARRAY OF COMMUNITY HEALTH PRIORITIES, INCLUDING NUTRITION, ACCESS TO SERVICES AND COMMUNITY ENGAGEMENT. THE "HUB" OF THE WELLNESS CENTER IS A TEACHING KITCHEN; A HANDS-ON INTERACTIVE SETTING FOR COOKING DEMONSTRATIONS, WEIGHT MANAGEMENT AND MEAL PREPARATION CLASSES, NUTRITION EDUCATION AND COUNSELING. DURING FY11, MORE THAN 6,000 VISITS ACCESSED NUTRITION EDUCATION AND COUNSELING SERVICES AT THE CITY HEIGHTS WELLNESS CENTER. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE-FUNDED WIC PROGRAM, SERVING 6 LOCATIONS THAT ARE CONVENIENTLY SITUATED EITHER IN OR NEXT TO COMMUNITY CLINICS AND/OR HOSPITALS IN THE CENTRAL SAN DIEGO AREA OF SAN DIEGO COUNTY. WIC'S TARGET POPULATION IS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO FIVE). ON AN ANNUAL BASIS, SCRIPPS MERCY WIC SERVES APPROXIMATELY 9,000 WOMEN AND CHILDREN WITH 44% IN THE CITY HEIGHTS COMMUNITY. THE CLIENT BASE IN CITY HEIGHTS IS 91% HISPANIC AND MADE UP OF PREGNANT AND POSTPARTUM WOMEN (24%), INFANTS (20%) AND CHILDREN (56%). IN FY11, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS TO 119,003 WOMEN AND CHILDREN IN THE SOUTH AND CENTRAL REGIONS OF SAN DIEGO. (SPONSORED BY SCRIPPS MERCY SAN DIEGO) HEALTHY LIVE HEALTHY - FAMILY NUTRITION PROGRAM USING THE COOPERATIVE EXTENSION'S RESEARCH-BASED CURRICULUMS AND BILINGUAL STAFF, A REGISTERED DIETITIAN SUPERVISED THE IMPLEMENTATION OF WEEKLY NUTRITION EDUCATION CLASSES IN SPANISH. PROGRAM TARGETS THE LOW-INCOME, FOOD STAMP POPULATION. IT CONSISTS OF A SERIES OF EIGHT WEEKLY CLASSES AND THE PRIMARY GOAL IS TO INCREASE KNOWLEDGE, SKILLS AND MOTIVATIONAL LEVEL OF AREA RESIDENTS TO PRACTICE HEALTHY EATING AND RELATED BEHAVIORS. CLASS TOPICS FOCUS ON NUTRITION, PHYSICAL FITNESS, FOOD SAFETY, MEAL PLANNING AND FOOD SHOPPING. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) COLLABORATE FOR HEALTHY WEIGHT. THIS ADVISORY GROUP MEETS MONTHLY. COLLABORATE FOR HEALTHY WEIGHT IS A PROGRAM OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AND THE NATIONAL INITIATIVE FOR CHILDREN'S HEALTHCARE QUALITY (NICHQ). THE SHARED VISION IS TO CREATE PARTNERSHIPS BETWEEN PRIMARY CARE, PUBLIC HEALTH, AND COMMUNITY ORGANIZATIONS TO DISCOVER SUSTAINABLE WAYS TO PROMOTE HEALTHY WEIGHT AND ELIMINATE HEALTH DISPARITIES IN COMMUNITIES ACROSS THE UNITED STATES. ALL THREE SECTORS MUST COLLABORATE, USING EVIDENCE-BASED APPROACHES, TO REVERSE THE OBESITY EPIDEMIC AND IMPROVE THE HEALTH OF OUR COMMUNITIES. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA, VISTA, COMMUNITY BENEFIT SERVICES) MENTAL HEALTH AND MENTAL DISORDERS ACCORDING TO THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH), ANNUALLY, AN ESTIMATED 13 MILLION AMERICAN ADULTS (APPROXIMATELY 1 IN 17) HAVE A SERIOUSLY DEBILITATING MENTAL ILLNESS (NIMH, 2008). FURTHERMORE, MENTAL HEALTH DISORDERS ARE THE LEADING CAUSE OF DISABILITY IN THE U.S., ACCOUNTING FOR 25% OF ALL YEARS OF LIFE LOST TO DISABILITY AND PREMATURE MORTALITY (WHO, 2004). MOREOVER, IN 2007, SUICIDE WAS THE 11TH LEADING CAUSE OF DEATH IN THE U.S., ACCOUNTING FOR OVER 34,500 DEATHS (NVSS, 2010). SAN DIEGO COUNTY - PREVALENCE OF SERIOUS MENTAL ILLNESS THERE ARE 141,420 PERSONS IN SAN DIEGO COUNTY WITH SERIOUS MENTAL ILLNESS, REPRESENTING 4.9% OF THE HOUSEHOLD POPULATION IN SAN DIEGO COUNTY (DMH, 2007). THE MOST IMPACTED BY SERIOUS MENTAL ILLNESS IN SAN DIEGO ARE PERSONS UNDER AGE 18 AND THOSE LIVING IN HOUSEHOLDS UNDER 200% OF THE FEDERAL POVERTY LEVEL, 7.4% AND 8.8% RESPECTIVELY. EMERGENCY DEPARTMENT DISCHARGES DURING 2008, THERE WERE 25,468 DISCHARGES FROM SAN DIEGO COUNTY HOSPITAL EMERGENCY DEPARTMENTS WITH A PRIMARY DIAGNOSIS OF MENTAL DISORDER, ACCOUNTING FOR 4.1% OF ALL ED DISCHARGES. (NOTE, THE PRIMARY DIAGNOSIS OF MENTAL DISORDER INCLUDES A WIDE RANGE OF DIAGNOSES INCLUDING ALCOHOLIC AND DRUG PSYCHOSES, DEPENDENCE AND ABUSE.) THE OVERALL RATE OF ED DISCHARGES WITH A DIAGNOSIS OF MENTAL DISORDER WAS 809.5 PER 100,000 POPULATION.
HOSPITALIZATIONS		DURING 2008, THERE WERE 22,971 HOSPITALIZATIONS IN SAN DIEGO COUNTY HOSPITALS WITH A PRINCIPAL DIAGNOSIS CODE OF MENTAL DISORDERS (ICD-9-CD CODE 290 - 319), ACCOUNTING FOR 7.4% OF ALL HOSPITALIZATIONS. THESE HOSPITALIZATIONS INCLUDED 17,556 WITH A PRINCIPAL DIAGNOSIS OF PSYCHOSES, ACCOUNTING FOR 59% OF ALL MENTAL HEALTH HOSPITALIZATIONS. THERE WERE 6,210 WITH A PRINCIPAL DIAGNOSIS OF SCHIZOPHRENIC DISORDERS AND 4,583 WITH A PRINCIPAL DIAGNOSIS OF MAJOR DEPRESSIVE DISORDER, ACCOUNT FOR 27% AND 20% OF ALL MENTAL HEALTH HOSPITALIZATIONS, RESPECTIVELY (COSDEPI, 20010). SUICIDE AND SUICIDE ATTEMPTS (SELF-INFLECTED INJURY) SUICIDE OCCURS WHEN A PERSON ENDS HIS OR HER LIFE AND IS A MAJOR COMPLICATION OF DEPRESSION. IN 2008, IT WAS THE EIGHTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 369 DEATHS WITH AN OVERALL RATE OF 11.3 SUICIDE DEATHS PER 100,000 PEOPLE (SDEPI, 2010). SUICIDE DEATHS ARE ONLY PART OF THE PROBLEM, MORE PEOPLE SURVIVE SUICIDE ATTEMPTS THAN ACTUALLY DIE. THOSE WHO ATTEMPT SUICIDE ARE OFTEN SERIOUSLY INJURED AND REQUIRE MEDICAL AND PSYCHIATRIC CARE. BETWEEN 2000 AND 2008, 2,896 SAN DIEGANS HAVE DIED AS A RESULT OF SUICIDE. SCRIPPS OFFERS BOTH INPATIENT AND OUTPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT THE SCRIPPS MERCY HOSPITAL SAN DIEGO CAMPUS. SCRIPPS MERCY'S BEHAVIORAL HEALTH PROGRAM ALSO ACTIVELY SUPPORTS COMMUNITY PROGRAMS DESIGNED TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. SCRIPPS HEALTH BEHAVIORAL HEALTH INPATIENT PROGRAMS INDIVIDUALS SUFFERING FROM ACUTE PSYCHIATRIC DISORDERS ARE SOMETIMES UNABLE TO LIVE INDEPENDENTLY OR MAY EVEN POSE A DANGER TO THEMSELVES OR OTHERS. IN SUCH CASES, HOSPITALIZATION MAY BE THE MOST APPROPRIATE ALTERNATIVE. SCRIPPS MERCY HOSPITAL'S BEHAVIORAL HEALTH INPATIENT PROGRAM HELPS PATIENTS AND THEIR LOVED ONES WORK THROUGH SHORT-TERM CRISES, MANAGE MENTAL ILLNESS AND RESUME THEIR DAILY LIVES. CHALLENGES * LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. * IN 2011, SCRIPPS MERCY'S BEHAVIORAL HEALTH PROGRAM LOST $5.2 MILLION. * IN 2011, 25 PERCENT OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED. SCRIPPS HEALTH BEHAVIORAL HEALTH OUTPATIENT PROGRAMS SCRIPPS MERCY PROVIDES COMMUNITY-BASED ADULT PSYCHIATRIC TREATMENT AT SCRIPPS MERCY SAN DIEGO. THE OUTPATIENT PROGRAM IS AN INTENSIVE DAY PROGRAM DESIGNED TO HELP INDIVIDUALS REDUCE THEIR SYMPTOMS WHILE THEY CONTINUE TO LIVE IN THE COMMUNITY. THE PROGRAM PROVIDES TWO LEVELS OF CARE: * THE OUTPATIENT PROGRAM OFFERS PATIENTS ONE TO FOUR TREATMENT DAYS PER WEEK * THE PARTIAL HOSPITALIZATION PROGRAM PROVIDES MORE INTENSIVE TREATMENT FIVE TO SIX DAYS PER WEEK. MENTAL HEALTH OUTREACH SERVICES A-VISIONS SERVICE PROGRAM BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL ESTABLISHED THE A-VISIONS VOCATIONAL TRAINING PROGRAM, IN PARTNERSHIP WITH THE SAN DIEGO MENTAL HEALTH ASSOCIATION TO HELP DECREASE THE STIGMA OF MENTAL ILLNESS. THE PROGRAM HELPS PEOPLE RECEIVING MENTAL HEALTH TREATMENT BY PROVIDING VOCATIONAL TRAINING, POTENTIALLY LEADING TO A GREATER LEVEL OF INDEPENDENCE. THIS YEAR, BEHAVIORAL HEALTH CONTINUED PARTICIPATION IN THE A-VISIONS PROGRAM (SOCIAL REHABILITATION AND PREVOCATIONAL SERVICES FOR PEOPLE LIVING WITH MENTAL ILLNESS). IN FY11, 32 CLIENTS WERE SERVED. CURRENTLY 21 PEOPLE ARE VOLUNTEERING AND 20 PEOPLE ARE PARTICIPATING IN SUPPORTIVE EMPLOYMENT. THE TOTAL EXPENSE FOR THE A-VISIONS PROGRAM FOR FY11 WAS $174,037. INCREASE AWARENESS OF MENTAL HEALTH AND GERIATRIC PSYCHIATRIC ISSUES IN FY11, SCRIPPS BEHAVIORAL HEALTH DEPARTMENT IMPROVED AWARENESS OF MENTAL HEALTH AND GERIATRIC ISSUES BY PROVIDING INFORMATION AND SUPPORTIVE SERVICES TO MORE THAN 1,000 PEOPLE AT COMMUNITY EVENTS. MENTAL HEALTH EMERGING ISSUES HEALTHY PEOPLE 2020 HAS IDENTIFIED SEVERAL MENTAL HEALTH ISSUES THAT HAVE EMERGED AMONG SOME SPECIAL POPULATIONS; THESE INCLUDE: POST-TRAUMATIC STRESS DISORDER (PTSD) AMONG VETERANS AND OTHERS WHO HAVE EXPERIENCED SOME TYPE OF TRAUMATIC EVENT. THESE TRAUMATIC EVENTS MAY INCLUDE: WAR, RAPE, NATURAL DISASTERS, A CAR OR PLANE CRASH, KIDNAPPING, VIOLENT ASSAULT, SEXUAL OR PHYSICAL ABUSE AND MEDICAL PROCEDURES (ESPECIALLY IN KIDS). SCRIPPS MEMORIAL HOSPITAL AT ENCINITAS OFFERS A TWO DAY COURSE CALLED "BRAIN INJURY REHABILITATION CONFERENCE: BEYOND THE HOSPITAL, INTO THE COMMUNITY". THIS TWO DAY COURSE ON PTSD AND STRESS DISORDER IS DESIGNED TO PROVIDE STRATEGIES AND A FRAMEWORK FOR THE MANAGEMENT OF BRAIN INJURED PATIENTS BOTH WITHIN AND OUTSIDE THE CLINICAL SETTING. TREATMENTS ARE FOCUSED ON THE TOTAL CARE CONTINUUM-PHYSICAL, COGNITIVE, PERCEPTUAL, EMOTIONAL AND SOCIAL-IN A MULTIDISCIPLINARY FORMAT. THIS CONFERENCE ALSO PROVIDES THE PARTICIPANT WITH THEORETICAL, PRACTICAL, AND ADVANCED APPLICATIONS IN BRAIN INJURY REHABILITATION. THE COURSE IS TAUGHT BY AN INTERDISCIPLINARY TEAM OF SPECIALISTS IN BRAIN INJURY REHABILITATION AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS. INFECTIOUS DISEASE SEXUALLY TRANSMITTED DISEASES AND HIV/AIDS SEXUALLY TRANSMITTED DISEASES (STDS) HAVE BEEN REFERRED TO BY THE INSTITUTE OF MEDICINE AS A "HIDDEN EPIDEMIC OF ENORMOUS HEALTH AND ECONOMIC CONSEQUENCE IN THE U.S. THEY ARE HIDDEN BECAUSE MANY AMERICANS ARE RELUCTANT TO ADDRESS SEXUAL HEALTH ISSUES IN AN OPEN WAY AND BECAUSE OF THE BIOLOGICAL AND SOCIAL CHARACTERISTICS OF THESE DISEASES". STDS ENCOMPASS MORE THAN 25 INFECTIOUS ORGANISMS TRANSMITTED PRIMARILY THROUGH SEXUAL ACTIVITY. LOCAL, STATE AND NATIONAL HEALTH AGENCIES ARE RESPONSIBLE FOR SURVEILLANCE AND MONITORING OF STDS. TUBERCULOSIS TUBERCULOSIS (TB) IS AN AIRBORNE INFECTIOUS DISEASE CAUSED BY THE BACTERIUM MYCOBACTERIUM TUBERCULOSIS THAT USUALLY AFFECTS THE LUNGS, ALTHOUGH OTHER ORGANS AND TISSUES SUCH AS THE KIDNEY, SPINE, AND BRAIN CAN BE AFFECTED AS WELL. TB CAN BE SPREAD BY COUGHING, SNEEZING, LAUGHING OR SINGING. AS OF DECEMBER 31, 2008, 13,820 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) CASES HAVE BEEN REPORTED IN SAN DIEGO COUNTY SINCE 1981. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH AIDS IN SAN DIEGO COUNTY ARE WHITE, MALE, AGED 30 TO 39 YEARS AND HAVE MALE SEX PARTNERS. DURING THIS PERIOD, 3,847 HUMAN IMMUNODEFICIENCY VIRUS (HIV) CASES HAVE BEEN REPORTED. BECAUSE OF A CHANGE IN THE HIV REPORTING SYSTEM, ALL HIV REPORTING DATA CURRENTLY AVAILABLE COVERS THE PERIOD APRIL 17, 2006 THROUGH DECEMBER 2008. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH HIV ARE WHITE, MALE AND AGED 30 TO 39. DURING 2009, THERE WERE 264 TUBERCULOSIS CASES. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH TB ARE HISPANIC (52.3%) OR ASIAN/PACIFIC ISLANDER (31.1%), MALE (62.5%) AND BETWEEN THE AGES OF 25 AND 64 YEARS . SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER SENIOR PREVENTION AND WELLNESS SENIOR HEALTH CHATS WERE IMPLEMENTED TO PROVIDE HEALTH EDUCATION TO THE OLDER ADULT COMMUNITY IN SOUTH BAY. APPROXIMATELY 25-20 SENIORS ATTENDED THESE MONTHLY THROUGHOUT THE YEAR. THESE PRESENTATIONS INCLUDED A VARIETY OF HEALTH AND AGE RELATED PREVENTION AND WELLNESS. ONE OF THE TOPICS WAS ABOUT TUBERCULOSIS AND HOW TO PREVENT AND TREAT. IN ADDITION, INFORMATION WAS PRESENTED ABOUT SIGNS AND SYMPTOMS. THE PRESENTATIONS ARE FACILITATED BY VARIOUS SCRIPPS MERCY HEALTH CARE PROFESSIONALS, PHYSICIANS AND FAMILY MEDICINE RESIDENTS. TOPICS ARE ALL CHOSEN BY THE SENIORS THEMSELVES SO AS TO MEET THEIR LOCAL NEEDS. ALSO, THE HEALTH CHATS PROVIDE AN INTERCHANGE BETWEEN THE COMMUNITY MEMBERS AND MEDICAL RESIDENTS AND OTHER HEALTH CARE PROFESSIONALS TO FOSTER HEALTHY LIFESTYLES AND HEALTH PREVENTION. SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER STAFF PREPARE AND CONDUCT THESE SESSIONS WITH THE SENIORS TO FOSTER HEALTH PREVENTION, AWARENESS AND DIALOGUE BETWEEN THE SENIORS. MANY QUESTIONS ARE ASKED ABOUT CHRONIC HEALTH ISSUES AND OTHER GERIATRIC RELATED HEALTH CONCERNS.
SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER		YOUTH PREVENTION AND WELLNESS SCRIPPS MERCY HOSPITAL HEALTH CARE PROFESSIONALS, FAMILY MEDICAL RESIDENTS, DIETICIANS, NURSES AND DOCTORS, ENLIGHTEN STUDENTS IN THE CLASSROOM OF TEN LOCAL SOUTH BAY HIGH SCHOOLS ON HEALTH RELATED TOPICS. SOME OF THE TOPICS INCLUDED SEXUALLY TRANSMITTED ILLNESSES AND TUBERCULOSIS 101. STUDENTS RECEIVED HEALTH CAREER TOOLS/BROCHURES THAT INCLUDED INFORMATION ON PREVENTION AND DETECTION AS WELL AS TREATMENT, SIGNS AND SYMPTOMS. 2,527 PEOPLE WERE SERVED. SCRIPPS MERCY HOSPITAL FAMILY MEDICINE RESIDENCY RUN TWO HEALTH CLINICS ESTABLISHED AT PALOMAR AND SOUTHWEST HIGH SCHOOL FOR FAMILY MEDICINE RESIDENTS TO GAIN ADDITIONAL SKILLS IN ADOLESCENT MEDICINE AND FOR YOUTH TO GAIN THE KNOWLEDGE, ATTITUDES, AND SKILLS NECESSARY TO PURSUE HEALTH CAREERS. FAMILY MEDICINE RESIDENTS AND FACULTY INTERACT TWICE PER WEEK AT THE CLINIC PROVIDING ADOLESCENT MEDICINE. SOME TEACHING AND EDUCATION TAKES PLACE ONE-ON-ONE WITH STUDENTS REGARDING SEXUALLY TRANSMITTED ILLNESSES PREVENTION, SIGNS, SYMPTOMS AND TREATMENT. ALSO, INFORMATION IS PRESENTED ON TUBERCULOSIS PREVENTION, SIGNS, SYMPTOMS AND TREATMENT. RESPIRATORY DISEASE RESPIRATORY DISEASES SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE A SIGNIFICANT PUBLIC HEALTH BURDEN IN THE UNITED STATES. ASTHMA AND COPD ARE AMONG THE 10 LEADING CHRONIC CONDITIONS CAUSING RESTRICTED ACTIVITY. AFTER CHRONIC SINUSITIS, ASTHMA IS THE MOST COMMON CAUSE OF CHRONIC ILLNESS IN CHILDREN. COPD, WHICH INVOLVES EMPHYSEMA AND CHRONIC BRONCHITIS, IS THE FOURTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY AND THE US. IN 2007, COPD ACCOUNTED FOR 1,023 DEATHS IN SAN DIEGO COUNTY AND 123,311 DEATHS NATIONALLY FOR AN AGE-ADJUSTED MORTALITY RATE PER 100,000 POPULATION OF 34.1 AND 40.5, RESPECTIVELY. HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 507 PARTICIPANTS WERE INCLUDED IN THE PILOT RANDOMIZED CONTROL TRIAL TO ASSESS HOW BEST TO ASSIST HOSPITALIZED SMOKERS QUIT SMOKING. THIS STUDY IS A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. THE SMOKING CESSATION PILOT AND EXPANDED STUDY ARE PREVENTION PROGRAMS RELATED TO RESPIRATORY DISEASE CONSIDERING THE RESPIRATORY THERAPISTS ARE CORE TO THE PILOT AS WELL AS THE LARGER NIH STUDY. MANY OF THE HOSPITALIZED SMOKERS ARE ADMITTED FOR PULMONARY AND RESPIRATORY DISEASE THAT IS OF COURSE LINKED TO SMOKING. (SPONSORED BY SCRIPPS MERCY HOSPITAL CHULA VISTA). PARTNERSHIP FOR SMOKE-FREE FAMILIES PROGRAM SECOND-HAND SMOKE IS CLEARLY A COMMUNITY HEALTH RISK ATTRIBUTING TO LOW BIRTH WEIGHT IN NEWBORNS, SUDDEN INFANT DEATH SYNDROME (SIDS), RESPIRATORY INFECTIONS, ASTHMA AND MIDDLE-EAR DISEASE IN INFANTS AND CHILDREN. THE PARTNERSHIP FOR SMOKE-FREE FAMILIES (PSF) IS A COLLABORATIVE EFFORT SUPPORTED BY SCRIPPS, SHARP HEALTHCARE AND CHILDREN'S HOSPITAL FOCUSED ON IMPROVING THE HEALTH AND WELL BEING OF CHILDREN BY REDUCING THEIR EXPOSURE TO SECOND-HAND SMOKE. (SPONSORED BY SCRIPPS HEALTH COMMUNITY BENEFITS) CITY HEIGHTS WELLNESS CENTER, "HEALTHY HOMES AND ASTHMA TRIGGER NIGHT FORUM" THE CITY HEIGHTS WELLNESS CENTER PARTNERED WITH THE COMMUNITY ASTHMA TASK FORCE (CAT FORCE). FAMILIES WITH ASTHMATIC CHILDREN OFTEN FACE A NUMBER OF CHALLENGES THAT CAN LEAD TO ANXIETY, FEAR OR CONFLICT. THE FORUM PRESENTED WAYS FOR PARENTS TO LEARN TO OVERCOME OBSTACLES AND CHALLENGES PRESENTED BY THEIR CHILD'S CONDITION AND FIND WAYS TO WORK WITH THEM TO MAINTAIN A HEALTHY AND POSITIVE LIVING ENVIRONMENT. SOME OF THE TOPICS THAT WERE PRESENTED INCLUDED: LEARNING HOW TO GET AN ASTHMA ACTION PLAN COMPLETED BY A DOCTOR; LEARNING HOW TO HAVE A SCHOOL NURSE AND THE CLASSROOM TEACHER FOLLOW THE ASTHMA ACTION PLAN; LEARNING HOW TO RID HOMES OF MOLD, ALLERGENS AND OTHER ASTHMA TRIGGERS; AND LEARNING WHAT CAN BE DONE IN HOMES TO HELP CHILDREN FROM HAVING ASTHMA ATTACKS AND LEARNING ABOUT QUALIFYING TO HAVE HOMES OR APARTMENTS RENOVATED AT NO COST. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) ORAL HEALTH ORAL HEALTH IN AMERICA: A REPORT OF THE SURGEON GENERAL, DECLARES THAT "ORAL HEALTH IS ESSENTIAL TO THE GENERAL HEALTH AND WELL-BEING OF ALL AMERICANS." THE REPORT IDENTIFIES HUGE DISPARITIES IN THE ORAL HEALTH STATUS OF CERTAIN POPULATIONS IN THE UNITED STATES, INCLUDING LOW-INCOME FAMILIES, THOSE LIVING IN RURAL COMMUNITIES, RACIAL OR ETHNIC MINORITIES, CHILDREN, THE ELDERLY AND THE DEVELOPMENTALLY DISABLED. THE 2005 CALIFORNIA ORAL HEALTH NEEDS ASSESSMENT REPORTED 54% OF KINDERGARTENERS AND 71% OF THIRD GRADERS HAVE A HISTORY OF TOOTH DECAY AND MORE THAN 25% OF ELEMENTARY SCHOOL CHILDREN HAVE UNTREATED DECAY. A REPORT CARD ISSUED IN 2010 BY CHILDREN NOW GAVE CALIFORNIA A D+ FOR HEALTH COVERAGE AND A D+ FOR ORAL HEALTH. THOSE WHO SUFFER THE WORST ORAL HEALTH ARE FOUND AMONG THE POOR OF ALL AGES, WITH POOR CHILDREN AND POOR OLDER AMERICANS PARTICULARLY VULNERABLE. IDENTIFIED BARRIERS TO CARE INCLUDE: NO PERCEIVED NEED FOR ORAL CARE AND/OR THE PUBLIC AND POLICYMAKERS PLACING A LOW PRIORITY ON ORAL HEALTH AND PREVENTION STRATEGIES; LACK OF ACCESS TO DENTISTS; LOW SOCIO-ECONOMIC STATUS AND/OR LACK OF FINANCIAL RESOURCES TO PAY FOR CARE; INADEQUATE REIMBURSEMENT BY GOVERNMENT INSURANCE PROGRAMS AND EXCESSIVE PAPERWORK REQUIRED FOR REIMBURSEMENT; LACK OF PROVIDERS TRAINED TO CARE FOR DIVERSE POPULATIONS, VERY YOUNG CHILDREN AND PEOPLE WITH SPECIAL NEEDS; AND MEDI-CAL BENEFICIARIES BEING UNAWARE THAT DENTAL BENEFITS ARE INCLUDED AS PART OF THEIR INSURANCE PLAN. PROJECT DULCE PROJECT DULCE ADDRESSES ORAL HEALTH ISSUES WITH PATIENTS DURING COUNSELING VISITS. FOSTERING VOLUNTEERISM SCRIPPS BELIEVES THAT HEALTH IMPROVEMENT BEGINS WHEN COMMUNITY MEMBERS TAKE AN ACTIVE ROLE IN MAKING A POSITIVE IMPACT ON THEIR COMMUNITY. FOR THIS REASON, SCRIPPS SUPPORTS VOLUNTEER PROGRAMS FOR SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS WHO WANT TO HELP MAKE EVEN MORE OF A DIFFERENCE IN THE HEALTH OF THEIR COMMUNITY. THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER CLUB IS ONE AVENUE THROUGH WHICH SCRIPPS MATCHES THE TALENTS AND INTERESTS OF EMPLOYEES AND PHYSICIANS WITH COMMUNITY NEEDS. THIS INCLUDES, BUT IS NOT LIMITED TO, MENTORING PARTNERSHIPS WITH LOCAL SCHOOLS AND EFFORTS TO PROVIDE FREE MEDICAL AND SURGICAL CARE TO PATIENTS IN NEED. IN ADDITION TO THE FINANCIAL COMMUNITY BENEFIT CONTRIBUTIONS MADE DURING FY11, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS CONTRIBUTED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS-SPONSORED COMMUNITY BENEFIT PROGRAMS AND SERVICES. WITH CLOSE TO 21,302 HOURS OF VOLUNTEER TIME, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $906,229.90. PROFESSIONAL EDUCATION & HEALTH RESEARCH QUALITY HEALTH CARE IS HIGHLY DEPENDENT UPON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WOULD BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH THROUGH THE DEVELOPMENT OF NEW AND INNOVATIVE TREATMENT OPTIONS. REFLECTS CLINICAL RESEARCH AS WELL AS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES, INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. RESEARCH TAKES PLACE PRIMARILY AT SCRIPPS CLINICAL RESEARCH SERVICES, SCRIPPS WHITTIER DIABETES INSTITUTE, SCRIPPS GENOMIC MEDICINE AND SCRIPPS TRANSLATIONAL SCIENCE INSTITUTE. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO THE ADVANCEMENT OF HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH AND MEDICAL EDUCATION PROGRAMS. DURING THIS FISCAL YEAR, SCRIPPS INVESTED $34,504,162 IN PROFESSIONAL TRAINING PROGRAMS AND CLINICAL RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES FOR SAN DIEGO COUNTY. HEALTH PROFESSIONS TRAINING INTERNSHIPS SCRIPPS' COMMITMENT TO ONGOING LEARNING AND HEALTH CARE EXCELLENCE EXTENDS BEYOND OUR ORGANIZATION. OUR INTERNSHIP PROGRAMS HELP PROMOTE HEALTH CARE CAREERS TO A NEW GENERATION, SHAPE THE FUTURE WORKFORCE, AND DEVELOP FUTURE LEADERS IN OUR COMMUNITY. INTERACTING WITH HEALTH CARE PROFESSIONALS IN THE FIELD PROVIDES A LEARNING EXPERIENCE THAT EXPANDS EDUCATION OUTSIDE OF THE CLASSROOM. SCRIPPS STAFF PLAYS AN IMPORTANT ROLE AS PRECEPTORS BY INVESTING THEIR TIME TO CREATE A VALUABLE EXPERIENCE FOR THE COMMUNITY. IN FISCAL YEAR 2011 SCRIPPS HOSTED 1,903 INTERNS WITHIN OUR SYSTEM AND PROVIDED A COMBINED TOTAL OF 192,609 DEVELOPMENT HOURS SPANNING ACROSS NURSING AND ANCILLARY SETTINGS. TABLE 1 PROVIDES A BREAKDOWN OF INTERNS BY SCRIPPS FACILITY.
COLLEGE AND UNIVERSITY AFFILIATIONS		SCRIPPS COLLABORATES WITH LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO ENABLE STUDENTS TO EXPLORE ROLES IN HEALTH CARE AND GAIN FIRST-HAND EXPERIENCE AS THEY WORK WITH SCRIPPS PROFESSIONALS. SCRIPPS IS AFFILIATED WITH OVER 90 DIFFERENT SCHOOLS AND PROGRAMS RANGING FROM CLINICAL TO NON-CLINICAL PARTNERSHIPS. LOCAL SCHOOLS INCLUDE, BUT ARE NOT LIMITED TO, POINT LOMA NAZARENE UNIVERSITY (PLNU), UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD), CAL STATE UNIVERSITY SAN MARCOS (CSUSM), SAN DIEGO STATE UNIVERSITY (SDSU), UNIVERSITY OF SAN DIEGO (USD), MESA COLLEGE, SAN DIEGO CITY COLLEGE, GROSSMONT COLLEGE AND MIRA COSTA COLLEGE. SCRIPPS IS REGULARLY ACCEPTING NEW PARTNERSHIPS BASED ON COMMUNITY AND WORKFORCE NEEDS. SCRIPPS ESTABLISHED AN AFFILIATION AGREEMENT COMMITTEE TO REVIEW ALL REQUESTS AND PROVIDE A SYSTEMWIDE APPROACH TO SECURING NEW STUDENT PLACEMENTS. THIS COMMITTEE IS INTERDISCIPLINARY AND REPRESENTS LEARNING AND DEPARTMENT LEADERSHIP ACROSS THE SCRIPPS SYSTEM, ENSURING A PROACTIVE APPROACH TO BUILDING A CAREER PIPELINE FOR TOP TALENT. RESEARCH STUDENTS SCRIPPS SUPPORTS GRADUATE LEVEL RESEARCH AT ITS FACILITIES FOR MASTER AND DOCTORAL LEVEL STUDENTS STUDYING AT A UNIVERSITY WHICH HAS AN AFFILIATION AGREEMENT WITH SCRIPPS. SCRIPPS CENTER FOR LEARNING & INNOVATION OVERSEES THE STUDENT PLACEMENT PROCESS. NON-PHYSICIAN STUDENTS WHO HAVE PARTICIPATED IN RESEARCH AT SCRIPPS REPRESENT A VARIETY OF HEALTHCARE DISCIPLINES INCLUDING PUBLIC HEALTH, PHYSICAL THERAPY, PHARMACY AND NURSING. IN FY11, STUDENT RESEARCH CONDUCTED AT SCRIPPS REPRESENTED STUDENTS FROM THE USD, SDSU, PLNU, POST-DOCTORAL PHARMACY RESIDENCY PROGRAMS AND PGY1 PHARMACY RESIDENCY PROGRAM. COLLEGE COLLABORATIONS SCRIPPS PARTNERED WITH POINT LOMA NAZARENE UNIVERSITY TO CREATE HEALTHCARE FOCUS COURSES INCLUDING HEALTHCARE FINANCE AND HEALTHCARE OPERATIONS. PLNU STUDENTS (NON-SCRIPPS EMPLOYEES) MAY ELECT TO TAKE THESE COURSES TOWARDS MBA COMPLETION. HIGH SCHOOL PROGRAMS SCRIPPS IS DEDICATED TO PROMOTING HEALTH CARE AS A REWARDING CAREER TO TOMORROW'S WORKFORCE. SCRIPPS COLLABORATES WITH PARTICIPATING HIGH SCHOOLS TO OFFER STUDENTS AN OPPORTUNITY TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRST-HAND EXPERIENCE AS THEY WORK WITH SCRIPPS HEALTH CARE PROFESSIONALS. FOLLOWING IS A SUMMARY OF THE HIGH SCHOOL PROGRAMS MADE AVAILABLE TO THE COMMUNITY THIS PAST YEAR: SCRIPPS HIGH SCHOOL EXPLORATION PROGRAM AND REGIONAL ALLIED HEALTH AND SCIENCE INITIATIVE (RASHI) THIS PROGRAM IS DESIGNED TO REACH OUT TO SAN DIEGO HIGH SCHOOL YOUTH INTERESTED IN EXPLORING A CAREER IN HEALTH CARE. IN FY11 SCRIPPS HIRED 35 STUDENTS TO PARTICIPATE IN THE PROGRAM. DURING THEIR PAID FIVE WEEK ROTATION, THE STUDENTS ROTATE THROUGH DEPARTMENTS, EXPLORING CAREER OPTIONS AND LEARNING VALUABLE LIFE LESSONS ABOUT HEALTH AND HEALING. UC HIGH SCHOOL COLLABORATION UC HIGH SCHOOL AND SCRIPPS PARTNERED THIS YEAR TO PROVIDE A REAL-LIFE CONTEXT TO HEALTHCARE ESSENTIALS COURSE TAUGHT AT UC HIGH SCHOOL. FOR FY11, 10 STUDENTS WERE INTERVIEWED AND SELECTED TO ROTATE THROUGH THREE DIFFERENT SCRIPPS CLINIC LOCATIONS DURING THE FALL AND SPRING SEMESTER TO INCREASE THEIR AWARENESS OF HEALTHCARE CAREERS. UC HIGH STUDENTS VISITED SCRIPPS CLINIC TORREY PINES, DEL MAR, AND CARMEL VALLEY SHADOWING HEALTHCARE PROFESSIONALS IN VARIOUS DEPARTMENTS INCLUDING INTERNAL MEDICINE, RADIOLOGY, ASC, INTEGRATIVE MEDICINE, URGENT CARE, CARDIOLOGY, AND PEDIATRICS. YOUNG LEADERS IN HEALTH CARE AN OUTREACH PROGRAM AT SCRIPPS HOSPITAL ENCINITAS, YOUNG LEADERS IN HEALTH CARE TARGETS LOCAL HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING CAREERS IN HEALTH CARE. STUDENTS FROM GRADES 9-12 PARTICIPATE IN THE PROGRAM. THIS PROGRAM IS DESIGNED TO PROVIDE A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS BREADTH OF CAREER OPPORTUNITIES. IT IS A COMBINED EXPERIENCE INCLUDING WEEKLY MEETINGS AT LOCAL SCHOOLS FACILITATED BY TEACHERS AND ADVISORS, AS WELL AS MONTHLY MEETINGS AT SCRIPPS HOSPITAL ENCINITAS. THE PROGRAM MENTORS STUDENTS ABOUT LEADERSHIP AND PROVIDES TOOLS DAILY LIFE CHALLENGES. YOUNG LEADERS IN HEALTH CARE ALSO INCLUDES A SERVICE PROJECT TO MEET HIGH SCHOOL REQUIREMENTS AND ALSO MAKE A POSITIVE IMPACT ON THE COMMUNITY. THE PROGRAM CLOSES THE YEAR WITH A PRESENTATION THAT IS ALIGNED WITH THE YEARLY FOCUS. MORE THAN 60 STUDENTS, COMMUNITY MEMBERS AND HEALTH CARE SPECIALISTS ATTENDED THE YOUNG LEADER IN HEALTH CARE FINAL MEETING OF THE SCHOOL YEAR CULMINATING IN STUDENT PRESENTATIONS ON SPORTS INJURIES AND PREVENTION. WORKABILITY SCRIPPS PARTNERS WITH THE SAN DIEGUITO ACADEMY WORKABILITY PROGRAM WHICH EDUCATES STUDENTS AND THE COMMUNITY REGARDING HEALTH CARE CAREER OPPORTUNITIES. SCRIPPS PROVIDES FIRST-HAND TOURS OF HOSPITAL FACILITIES AND EDUCATES PARTICIPANTS ABOUT THE COMPLEXITIES OF HOSPITAL OPERATIONS. THE PROGRAM IS DESIGNED TO PROVIDE PRE-EMPLOYMENT SKILLS DEVELOPMENT, WORKSITE TRAINING AND FOLLOW-UP SERVICES FOR YOUTH (AGES 12-22) WITH SPECIAL NEEDS WHO ARE MAKING THE TRANSITION FROM SCHOOL TO WORK. WHILE STUDENTS GET CLASSROOM TRAINING, SCRIPPS HAS PARTNERED WITH THE PROGRAM TO PROVIDE ONSITE CAREER TRAINING FOR THE STUDENTS. IN FY11, 5 STUDENTS PARTICIPATED IN THE PROGRAM AT GREEN AND ENCINITAS. NEW GRAD RESIDENCY PROGRAM DESIGNED FOR THE NEWLY GRADUATED REGISTERED NURSE (RN), THIS INNOVATIVE PROGRAM AIMS TO IMPROVE PATIENT CARE QUALITY AND SAFETY DURING THE FIRST YEAR ON THE JOB. BY TRAINING NEW NURSES AND BUILDING CONFIDENCE AT THE BEDSIDE, THE PROGRAM HELPS MAKE THE INITIAL YEAR OF A NURSE'S CAREER A LAUNCH PAD TO SUCCESS. 990 PART V, LINE 7H THE DONATED VEHICLE WAS PLACED IN SERVICE FOR THE ORGANIZATION, THEREFORE, FORM 1098-C IS NOT APPLICABLE.
990 REVIEW PROCESS WITH GOVERNING BODY	FORM 990, PART VI, LINE 11B	THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS.
COMPLIANCE POLICY MONITORING	FORM 990, PART VI, LINE 12C	WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT ARE REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN	FORM 990, PART VI, LINE 15A & 15B	PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN SAN DIEGO, CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: -FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. -SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. -TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. -BENEFITS ARE POSITIONED AT THE 65TH PERCENTILE OF THE PEER GROUP. -ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 14, 2011. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES.
JOINT VENTURES	FORM 990, PART VI, LINE 16	SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS.
AVAILABILITY OF DOCUMENTS TO THE GENERAL PUBLIC	FORM 990, PART VI, LINE 19	FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
HOURS DEVOTED TO RELATED ORGANIZATIONS	FORM 990, PART VII	THE TRUSTEES OF SCRIPPS HEALTH ALSO SERVE AS TRUSTEES OF THE WHITTIER INSTITUTE WHERE THEY DEVOTE 5 HOURS PER WEEK. CHRISTOPHER VAN GORDER IS ALSO THE PRESIDENT AND CEO OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK. RICHARD ROTHBERGER IS ALSO THE CFO AND CORPORATE EXECUTIVE VP OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK. RICHARD SHERIDAN IS ALSO THE CORPORATE SENIOR VP AND GENERAL COUNSEL OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK. GALE KEEL IS ALSO THE ASSISTANT SECRETARY TO THE BOARD OF DIRECTORS OF THE WHITTIER INSTITUTE WHERE SHE DEVOTES 5 HOURS PER WEEK. VIRGINIA LEARY IS ALSO THE EXECUTIVE SECRETARY TO THE CEO OF THE WHITTIER INSTITUTE WHERE SHE DEVOTES 5 HOURS PER WEEK. ARNOLD BRENT EASTMAN IS ALSO THE CORPORATE SENIOR VP AND CHIEF MEDICAL OFFICER OF THE WHITTIER INSTITUTE WHERE HE DEVOTES 5 HOURS PER WEEK.
OTHER CHANGES TO NET ASSETS/FUND BALANCES	FORM 990, PART XI, LINE 5	UNREALIZED GAIN/LOSS ON INVESTMENTS $(62,209,559) CHANGE IN VALUE OF DEFERRED GIFTS $ (852,534) OTHER CHANGES IN NET ASSETS $ 1,322,181 JOINT VENTURES-NONCONTROLLING INTERESTS $ 3,212,000 OTHER CHANGES $ 1,096 --------------- TOTAL $(58,526,816)
TAX EXEMPT BONDS	SCHEDULE K, PART I, ISSUE PRICE	BOND ISSUE A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON THE 8038 TAX FORM AS THE $49,995,000 AMOUNT REPRESENTS ONLY SCRIPPS HEALTH'S PORTION IN A POOL BOND LOAN PROGRAM.
SCHEDULE K, PART I, CUSIP NUMBER	BOND ISSUE D (2005A/2008G):	THE SERIES 2005A BONDS, CUSIP 13033FWK2, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G, CUSIP 13033F5M8 (SCRIPPS HEALTH), ON AUGUST 14, 2008.
SCHEDULE K, PART I, DESCRIPTION OF PURPOSE	BOND ISSUE A (2007A):	POOL BOND. PROCEEDS USED FOR EQUIPMENT PURPOSES. BOND ISSUE B (2008A): REFUNDING OF PRIOR ISSUES 07/07/2005 BOND ISSUE C (2008B-F): THE $221,230,000 (2008B - F) REFUNDED THE 2005B - F BONDS. THE ISSUE DATE FOR THE 2005 B - F WAS 6/17/2005. BOND ISSUE D (2005A/2008G): THE $40,975,000 (2008G) EXCHANGED THE 2005A BOND. THE ISSUE DATE FOR THE 2005A WAS 6/2/2005. THE PROCEEDS OF THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2005A (SCRIPPS HEALTH), WERE ISSUED FOR THE PURPOSE, TOGETHER WITH OTHER AVAILABLE FUNDS, OF ADVANCE REFUNDING THE ORGANIZATION'S SERIES 1998C BONDS. THE SERIES 2005A BONDS, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G (SCRIPPS HEALTH), ON AUGUST 14, 2008. BASED ON THE ADVICE OF BOND COUNSEL, THE ORGANIZATION IS TREATING THE SERIES 2008G BONDS AS THE SAME ISSUE AS THE SERIES 2005A BONDS FOR FEDERAL INCOME TAX PURPOSES. FURTHER INFORMATION REGARDING THE SERIES 2008G BONDS: ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY; ISSUER EIN: 52-1643828; CUSIP #: 13033F5M8; DATE EXCHANGED: 8/14/2008; ISSUE PRICE: N/A; DESCRIPTION OF PURPOSE: EXCHANGE FOR SERIES 2005A BONDS (SAME ISSUE). BOND ISSUE A-2 (2010A): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE B-2 (2010B & C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT.
SCHEDULE K, PART II, QUESTION 8	BOND ISSUE B (2008B-F):	SUBSTANTIALLY COMPLETE PRIOR TO ISSUANCE BOND ISSUE D (2005A/2008G): SUBSTANTIALLY COMPLETE PRIOR TO ISSUANCE
SCHEDULE K, PART III, QUESTION 3C		THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY.
SCHEDULE K, PART IV, ARBITRAGE, QUESTION 5	BOND ISSUE A (2007A):	AN AMOUNT IN THE COSTS OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008. BOND ISSUE D (2005A/2008G): THE COST OF ISSUANCE WAS NOT EXPENDED UNTIL 1/4/2006. PER THE TAX CERTIFICATE IT WAS EXPECTED TO BE EXPENDED WITHIN 180 DAYS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1
SCRIPPS CARDIO&THORACIC SURGERY BILLING
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	270602996	HLTHCR ADMIN	CA	4764135	0	NA
SCRIPPS CLINIC BILLING LLC
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	870737749	HLTHCR ADMIN	CA	360005626	0	NA
SCRIPPS MERCY BILLING LLC
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	870737748	HLTHCR ADMIN	CA	55032815	0	NA

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1
THE WHITTIER INSTITUTE
9894 GENESEE AVENUE	LA JOLLA	CA	92037	953621314	RSRCH & EDU	CA	501(C)(3)	4	SCRIPPS
SCRIPPS CLINICAL SCIENCE CENTER
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	264479543	RESEARCH	CA	501(C)(3)	4	SCRIPPS
MERCY HOSPITAL FOUNDATION
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	942958094	FUNDRAISING	CA	501(C)(3)	11, I	SCRIPPS

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
SCRIPPS MERCY AMBULATORY SURGERY CENTER
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	450503246	AMBUL SURGERY CTR	CA	NA	RELATED	2568078	3845311	false	$0	true	0.73500
SCRIPPS ENCINITAS SURGERY CENTER LLC
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	205942958	HOSPITAL	CA	NA	RELATED	1467685	95939	false	$0	false	0.55500
SCRIPPS IDN MGMT LLC
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	454557426	HEALTHCARE SVCS	CA	NA	RELATED	0	0	false	$0	true	0.50000

Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
SC PHYSICIANS ORGANIZATION INC
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	330796247	HOLDING COMPANY	CA	NA	C CORP	0	420432	1.00000
SCRIPPS HEALTH & HEALING
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	205156965	PATIENT EDUCATION	CA	NA	C CORP	0	0	1.00000
SCRIPPS HEALTH PLAN SERVICES (SHPS)
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92191	330782099	HLTHCARE SVC PLAN	CA	NA	C CORP	236291742	39250328	1.00000
CHARITABLE REMAINDER TRUSTS (66)
					HOSPITAL SUPPORT	CA	NA	TRUST
CHARITABLE LEAD TRUSTS (2)
					HOSPITAL SUPPORT	CA	NA	TRUST
SCRIPPSCARE
4275 CAMPUS POINT COURT	SAN DIEGO	CA	92121	452870638	HEALTHCARE SVCS	CA	NA	C CORP	0	0	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	true	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved
Scripps Health Plan Services (SHPS)
K	78139020
Scripps Health Plan Services (SHPS)
L	9715236
Whittier Institute for Diabetes
P	2961475
Scripps Mercy Ambulatory Surgery Center
A(IV)	741913
Scripps Encinitas Surgery Center LLC
A(IV)	339169
Scripps Clinical Science Center
	0
Mercy Hospital Foundation
	0
Scripps IDN Management LLC
	0
SC Physicians Organizations INC
	0
Scripps Health & Healing
	0
Charitable Remainder Trusts (66)
	0
Charitable Lead Trusts (2)
	0
ScrippsCare
	0

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	RELATED ORGANIZATIONS TAXABLE AS PARTNERSHIPS	Identifier
Return Reference	SCHEDULE R, PART III	ReturnReference
Explanation	SCRIPPS MERCY AMBULATORY SURGERY CENTER EIN: 45-0503246 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121 SCRIPPS ENCINITAS SURGERY CENTER EIN: 20-5942958 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121 SCRIPPS IDN MANAGEMENT LLC EIN: 45-4557426 4275 CAMPUS POINT COURT, SAN DIEGO, CA 92121	Explanation