2022-07-13T10:20:51-05:00 2021-08-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2020-09-01 941156276 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER FRES 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 DEBORAH MOFFETT VP, FINANCE 5594596000 2022-07-08 1 DEBORAH MOFFETT 999009999 TRACY S PAGLIA P00366884 2099556100 2022-07-08 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SEE SCHEDULE O CRAIG S CASTRO 1560 E SHAW AVENUE FRESNO CA 93710 2848646966 0 X WWW.COMMUNITYMEDICAL.ORG X 1947 CA FCH&MC MEETS THE MEDICAL NEEDS OF ITS COMMUNITY THROUGH ITS ACUTE-CARE HOSPITALS AND FACILITIES. 14 10 7590 97 18722726 185154 18863970 6757250 1750632391 1866455109 23731476 35900342 5940909 4589644 1799168746 1913702345 16161305 585167 0 0 796465489 885963000 0 0 0 903944403 978971097 1716571197 1865519264 82597549 48183081 2521392526 2723343481 1000740111 1103621119 1520652415 1619722362 X FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER'S (FCH&MC'S) MISSION IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY AND TO PROMOTE MEDICAL EDUCATION. 0 0 1699648187 585167 1848022230 FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER OPERATES TWO ACUTE-CARE HOSPITALS AND NUMEROUS OUTPATIENT CENTERS, CLINICS AND OTHER SERVICES WHICH MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL DETAILS.- COMMUNITY REGIONAL MEDICAL CENTER. CRMC IS A TERTIARY ACUTE CARE FACILITY THAT PROVIDES THE PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA WITH THE FOLLOWING SERVICES: (I) THE CENTRAL VALLEY'S ONLY LEVEL I TRAUMA CENTER, (II) THE COMMUNITY REGIONAL BURN CENTER, (III) A LEVEL III NEONATAL INTENSIVE CARE UNIT, (IV) COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES, INCLUDING TECHNOLOGICALLY ADVANCED MEDICAL/SURGICAL SPECIALTIES SUCH AS CARDIOVASCULAR, NEUROSCIENCE, ORTHOPEDICS AND WOMEN'S AND CHILDREN'S SERVICES, (V) THE COMMUNITY FAMILY BIRTH CENTER, (VI) GENERAL AND SPECIALTY INTENSIVE CARE UNITS, (VII) THE LEON S. PETERS REHABILITATION CENTER, (VIII) INPATIENT AND OUTPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) DIALYSIS TREATMENT FACILITIES, (XI) DIAGNOSTIC RADIOLOGY SERVICES, (XII) SHORT STAY SURGERY SERVICES, (XIII) A CARDIOVASCULAR CARE UNIT, AND (XIV) 24 HOUR EMERGENCY SERVICES. CRMC IS ALSO A TEACHING HOSPITAL THAT IS AFFILIATED WITH UCSF. THE MAIN CAMPUS OF CRMC CONSISTS OF A HOSPITAL BUILDING WITH FIVE AND 10-STORY WINGS, CONNECTED TO A FIVE STORY TRAUMA AND CRITICAL CARE BUILDING. CRMC ALSO PROVIDES (I) BEHAVIORAL HEALTH SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC"), (II) SUBACUTE AND SKILLED NURSING SERVICES AT A FREESTANDING FACILITY IN NORTHERN FRESNO KNOWN AS THE COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER ("CSTCC"), AND (III) HIV AND OMFS SERVICES ARE OFFERED AT THE DERAN KOLIGIAN AMBULATORY CARE CENTER LOCATED ON THE CRMC MAIN CAMPUS (THE "FRESNO CAMPUS"). - CLOVIS COMMUNITY MEDICAL CENTER. CCMC IS LOCATED IN THE CITY OF CLOVIS (WHICH IS CONTIGUOUS TO THE CITY OF FRESNO), WHERE IT SERVES THE PRIMARY SERVICE AREA AND, TO A LESSER DEGREE, THE SECONDARY SERVICE AREA. THE CMC CAMPUS IN CLOVIS (THE "CLOVIS CAMPUS") INCLUDES THE MAIN FACILITY, WHICH CONSISTS OF AN ACUTE CARE HOSPITAL WITH A FIVE-STORY TOWER AND A THREE-STORY TOWER CONNECTED TO AN OUTPATIENT SURGERY/ENDOSCOPY/DIAGNOSTIC CENTER. THE FACILITY HAS ALL PRIVATE ROOMS. THE FACILITY PROVIDES: (I) COMPREHENSIVE MEDICAL AND SURGICAL CAPABILITIES, (II) 24-HOUR EMERGENCY CARE, (III) AN INTENSIVE CARE UNIT, (IV) THE COMMUNITY FAMILY BIRTH CENTER, (V) THE MARJORIE E. RADIN BREAST CARE CENTER (VI) SHORT STAY AND INPATIENT SURGICAL SERVICES, INCLUDING ROBOTICS AND ADVANCED MINIMALLY INVASIVE SURGERY, (VII) A LEVEL II NEONATAL INTENSIVE CARE UNIT, (VIII) INPATIENT CANCER TREATMENT, (IX) PATHOLOGY AND CLINICAL LABORATORY SERVICES, (X) ADVANCED DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, AND (XI) INVASIVE AND NON-INVASIVE CARDIAC SERVICES. OTHER FACILITIES AND SERVICES PROVIDED ON THE CLOVIS CAMPUS INCLUDE: (I) AN OUTPATIENT WOUND CARE CLINIC WITH TWO HYPERBARIC OXYGEN CHAMBERS, (II) AN OUTPATIENT PHYSICAL REHABILITATION CLINIC, INCLUDING LYMPHEDEMA THERAPY, (III) COMMUNITY CANCER INSTITUTE (CCI), A THREE-STORY BUILDING WHICH IS CENTRAL CALIFORNIA'S PREMIER COMPREHENSIVE CANCER CARE CENTER - AND THE ONLY ONE IN THE AREA WITH MANY OUTPATIENT SERVICES IN A SINGLE LOCATION, AND (IV) THE H. MARCUS RADIN CONFERENCE CENTER, WHICH OPENED IN 2012 AND PROVIDES A 214- SEAT AUDITORIUM THAT IS FULLY INTEGRATED FOR TRAINING IN CHS'S OPERATING ROOMS AND FOR BROADCASTING OTHER EVENTS, AND TWO STATE-OF-THE-ART COMPUTER TRAINING LABS.- FRESNO HEART AND SURGICAL HOSPITAL. HEART HOSPITAL IS AN ACUTE CARE FACILITY WITH ALL PRIVATE ROOMS LOCATED IN THE CITY OF FRESNO OVERLOOKING WOODWARD PARK IN NORTHEAST FRESNO. THE FACILITY OPENED IN OCTOBER 2003 AND PROVIDES THE PRIMARY AND SECONDARY SERVICE AREAS WITH (I) CARDIOLOGY AND CARDIAC SURGERY SERVICES, (II) VASCULAR SURGERY SERVICES, AND (III) BARIATRIC AND OTHER MINIMALLY INVASIVE SURGERY SERVICES. THE ORGANIZATION IS THE PRINCIPAL TEACHING HOSPITAL IN THE CENTRAL VALLEY THROUGH A GRADUATE MEDICAL EDUCATION PROGRAM AFFILIATED WITH THE UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO MEDICAL EDUCATION PROGRAM. CHS SUPPORTS A FULLY ACCREDITED EDUCATIONAL PROGRAM WITH CALIFORNIA STATE UNIVERSITY, FRESNO, BY PROVIDING CLINICAL EXPERIENCE TO ITS NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND DIETETIC STUDENTS. ADDITIONALLY, THE ORGANIZATION PROVIDES CLINICAL EXPERIENCE TO FRESNO CITY COLLEGE'S NURSING, SURGERY AND RADIOLOGY TECHNOLOGY STUDENTS. CHS ALSO PROVIDES CLINICAL EXPERIENCE TO STUDENTS IN THE SAN JOAQUIN VALLEY COLLEGE LVN TO RN PROGRAM, FRESNO ADULT SCHOOL AND CLOVIS ADULT SCHOOL LICENSED VOCATIONAL NURSE PROGRAMS, AS WELL AS STUDENTS IN MANY OTHER PROGRAMS AT AREA COMMUNITY COLLEGES. EACH OF THE THREE ACUTE HOSPITALS CONDUCTS EDUCATIONAL PROGRAMS FOR THE BENEFIT OF PHYSICIANS, NURSES, TECHNICIANS, MANAGEMENT PERSONNEL, EMPLOYEES, AND THE PUBLIC. IN ADDITION, CHS SPONSORS NUMEROUS HEALTH PROMOTION AND EDUCATION PROGRAMS FOR ITS EMPLOYEES AND MEMBERS OF THE COMMUNITY IN MANY AREAS, INCLUDING ASTHMA, DIABETES, NUTRITION AND WEIGHT CONTROL, STRESS MANAGEMENT, HEALTH AND WELLNESS, AND SMOKING CESSATION. THE ORGANIZATION IS AN ACTIVE PARTNER IN SEVERAL COMMUNITY SERVICE PROJECTS SUPPORTING EDUCATION IN HEALTH CAREERS FOR HIGH SCHOOLS AND OTHER COMMUNITY GROUPS. TO ADDRESS THE NATION-WIDE NURSING SHORTAGE, THE ORGANIZATION HAS IMPLEMENTED SEVERAL SYSTEM-WIDE INITIATIVES TO INCREASE RECRUITMENT AND RETENTION INCLUDING THE IMPLEMENTATION OF A NURSE RESIDENCY PROGRAM AND CLINICAL LADDER, BOTH DESIGNED TO EXPAND THE EDUCATION OF NEW NURSES AND PROMOTE RETENTION OF A HIGHER PERCENTAGE OF THESE NURSES. 1699648187 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 X 496 0 1 7590 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 CA X DEBORAH MOFFETT 5594596000 1560 E SHAW AVENUE FRESNO CA 93710 TIM JOSLIN - FORMER PRESIDENT CHIEF EXECUTIVE OFFICER THRU 07/20 55.00 5.00 X 0 4641443 22780 CRAIG CASTRO - PRESIDENT CHIEF EXECUTIVE OFFICER 55.00 5.00 X 0 1523181 916416 CRAIG WAGONER EVP, CHIEF OPERATING OFFICER 55.00 6.90 X 0 1359660 31510 THOMAS UTECHT SVP, CHIEF QUALITY OFFICER 50.00 5.00 X 937877 0 41473 JOSEPH NOWICKI SVP, CORPORATE CFO THRU 12/20 55.00 5.00 X 0 935322 35907 ALDO DE LA TORRE SVP, NETWORK DEVELOPMENT 50.00 6.90 X 0 872513 35447 CARLA MILTON SVP, HUMAN RESOURCES 50.00 6.90 X 0 668932 35326 CHRISTOPHER NEUMAN SVP, CHIEF OPERATING OFFICER 50.00 5.00 X 598389 0 35276 TRACY KIRITANI CHIEF FINANCIAL OFFICER 50.00 5.00 X 589177 0 30708 BRIANNE L MARRIOTT SVP, CHIEF LEGAL OFFICER 50.00 5.00 X 0 571100 32271 WANDA HOLDERMAN - SVP CHIEF CLINICAL INTGT OFFICER THRU 07/20 50.00 5.00 X 572211 0 24655 JEFFREY THOMAS - CHIEF MEDICAL & QUALITY OFFICER - CRMC 50.00 5.00 X 545818 0 32482 DEBORAH MOFFETT - VP FINANCE INTERIM CFO/VICE FINANCIAL OFFICER 50.00 5.00 X 0 411319 30425 PATRICK T RAMIREZ SVP, COMMUNITY PROVIDER NETWORK 0.00 60.00 X 0 375224 34641 JUANITA HERNANDEZ - VICE SECRETARY/DIRECTOR, CORP GOVERNANCE 50.00 5.00 X 0 236871 29477 ROBYNN L VAN PATTEN - FORMER SVP, CHIEF LEGAL OFFICER THRU 06/19 0.00 0.00 X 0 244526 10766 AJIT ARORA MD BOARD MEMBER THRU 07/21 1.40 0.50 X 0 117230 0 RONALD BIERMA MD BOARD MEMBER 1.40 0.50 X 0 3000 0 ROGER LARSEN SVP, CORPORATE CFO AS OF 06/21 55.00 5.00 X 0 0 0 FARID ASSEMI CHAIR 1.40 0.50 X X 0 0 0 LINZIE DANIEL PAST CHAIR 1.40 0.50 X X 0 0 0 ROGER STURDEVANT CHAIR ELECT 1.40 2.40 X X 0 0 0 SUSAN ABUNDIS SECRETARY 1.40 0.50 X X 0 0 0 KEITH BOONE MD BOARD MEMBER 1.40 0.50 X 0 0 0 TERRANCE BRADLEY EDD BOARD MEMBER 1.40 0.50 X 0 0 0 JERRY COOK BOARD MEMBER 1.40 0.50 X 0 0 0 GREG ESTEP BOARD MEMBER 1.40 0.50 X 0 0 0 WAGIH IBRAHIM MD BOARD MEMBER AS OF 01/20 1.40 0.50 X 0 0 0 REN IMAI MD BOARD MEMBER THRU 12/20 1.40 0.50 X 0 0 0 JOSEPH JONES PHD BOARD MEMBER 1.40 0.50 X 0 0 0 KAREN MCCAFFREY BOARD MEMBER 1.40 0.50 X 0 0 0 JOHN MCGREGOR BOARD MEMBER 1.40 0.50 X 0 0 0 RUTHIE QUINTO BOARD MEMBER 1.40 0.50 X 0 0 0 CHANDRASEKAR VENUGOPAL MD BOARD MEMBER 1.40 0.50 X 0 0 0 3243472 11960321 1379560 1582 1 1 0 CARDINAL HEALTH PO BOX 56412 LOS ANGELES CA 90074 MEDICAL 113961423 CLARK CONSTRUCTION 677 D N MEDICAL CENTER DR EAST CLOVIS CA 93611 CONSTRUCTION SERVICES 92113142 CCFMG 2625 EAST DIVISADERO FRESNO CA 93721 MEDICAL 53473814 MEDLINE INDUSTRIES INC DEPT LA 21588 PASADENA CA 91185 MEDICAL 52500297 COMMUNITY HOSPITALIST MED GRP 7370 N PALM AVE FRESNO CA 93711 MEDICAL 40294024 405 2937656 3819594 6757250 MEDICAL SERVICE 622110 1822098375 1822098375 GRANTS AND CONTRACTS 622110 24848102 24848102 PHARMACY SALES 446110 18458929 217377 18241552 INCOME FR PARTNERSHIPS 622110 1049703 858376 191327 1866455109 28350895 28350895 942120822 373246 934909867 34754 7210955 338492 7549447 7549447 HOSPITAL CAFETERIA REV 722320 4299797 4299797 PARKING AND SECURITY 812930 289847 289847 4589644 1913702345 1848022230 18722726 40200139 X 585167 585167 7755145 7755145 710906 710906 720668441 626981544 93686897 24338051 21174104 3163947 84629986 73628088 11001898 47860471 41638610 6221861 333211 333211 1784253 1784253 313708069 300992646 12715423 1249505 1249505 4440739 4440739 25412781 21346736 4066045 329253 276573 52680 64102 64102 14172158 11904612 2267546 73569575 61798443 11771132 11062767 9292724 1770043 MEDICAL SUPPLIES 366621263 366621263 MEDI-CAL PROVIDER FEE 108167617 108167617 MINOR EQUIPMENT 27578374 27578374 PROVISION FOR BAD DEBT 2557892 2557892 27919538 24328786 3590752 1865519264 1699648187 165871077 0 125671755 59151550 220449663 345942716 14537294 16296765 3192472 3628685 20566102 19558499 30674661 56287425 1855374875 704297593 1032147292 1151077282 804312854 922708420 28062783 28481456 241777650 120210683 2521392526 2723343481 311252050 502301772 514327643 502852541 5834203 8149333 169326215 90317473 1000740111 1103621119 X 1520652415 1619722362 1520652415 1619722362 2521392526 2723343481 48183081 50886866 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15917825 15265158 31182983 1013230553 335438301 677792252 6218953 4953798 1265155 457783989 360912206 96871783 346958397 2993288 343965109 1151077282 ASSET RETIREMENT OBLIGATION 5518637 GROUP HEALTH 2760112 MALPRACTICE - IBNR 4441000 WORKERS COMPENSATION RESERVE 33994000 PHYSICIAN GUARANTEE PAYABLE 1528750 LEASE LIABILITY 28982984 DEFERRED TAXES 13091990 90317473 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 6818716 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES CAPTIVE INSURANCE 28212971 0 0 0 0 0 0 35031687 0 35031687 1 0 1 0 0 0 PART I, LINE 3: ACCRUAL METHOD PART III ACCOUNTING METHOD: 1 1 X 1 X 350.000000000000 1 X 351.000000000000 1 1 0 1 1 10383561 10383561 0.00560 398662065 223703615 174958450 0.09390 409045626 223703615 185342011 0.09950 1869388 1869388 0.00100 50807785 7240207 43567578 0.02340 2 259 161650 161650 0.00010 2 25690 250732 250732 0.00010 4 25949 53089555 7240207 45849348 0.02460 4 25949 462135181 230943822 231191359 0.12410 3 2471 134150 134150 0.00010 1 1400 1400 0.00000 1 434 434 0.00000 1 12 6130 6130 0.00000 6 2483 142114 142114 0.00010 1 2557892 0 302460331 364079271 -61618940 X 1 1 1 CA IMAGING INSTITUTE LLC MEDICAL IMAGING 0.50000 0.00000 0.50000 2 AMI REALTY PARTNERS LP PROPERTY MANAGEMENT 0.50000 0.00000 0.50000 2 1 COMMUNITY REGIONAL MEDICAL CENTER 2823 FRESNO ST FRESNO CA 93721 WWW.COMMUNITYMEDICAL.ORG 040000096 X X X X X A 2 CLOVIS COMMUNITY MEDICAL CENTER 2755 HERNDON CLOVIS CA 93612 WWW.COMMUNITYMEDICAL.ORG 040000004 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 19 1 1 0 1 X SEE PART V X SEE PART V X 1 19 1 SEE PART V 0 1 X 350.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X X 1 X X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: COMMUNITY REGIONAL MEDICAL CENTER, - FACILITY 2: CLOVIS COMMUNITY MEDICAL CENTER FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONSISTS OF PRIMARY DATA FROM MORE THAN 1,000 PARTICIPANTS IN INDIVIDUAL INTERVIEWS, MULTI-LANGUAGE FOCUS GROUPS, AND ONLINE SURVEYS. PARTICIPANTS INCLUDED REPRESENTATIVES FROM AND USERS OF HEALTH IMPROVEMENT PROGRAMS AIMED AT LOW-INCOME, VULNERABLE POPULATIONS, AND SERVING CHILDREN, HOMELESS, LGBTQ+, VETERANS, SENIORS, TRIBAL COMMUNITIES, AS WELL AS AFRICAN AMERICAN, HMONG, LATINO AND SPANISH-SPEAKING POPULATIONS. SECONDARY DATA WAS COLLECTED USING GOVERNMENT AND OTHER RESOURCES, SUCH AS THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, HEALTH RESOURCES AND SERVICES ADMINISTRATION, AND THE ROBERT WOOD JOHNSON'S COUNTY HEALTH RANKINGS AND ROADMAPS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: FOURTEEN FACILITIES OVER FOUR CENTRAL VALLEY COUNTIES COLLABORATED ON THIS REPORT. THE PARTICIPATING HOSPITALS WERE: COMMUNITY REGIONAL MEDICAL CENTER, CLOVIS COMMUNITY MEDICAL CENTER, FRESNO HEART AND SURGICAL HOSPITAL, ADVENTIST HEALTH-CENTRAL VALLEY NETWORK (HANFORD, REEDLEY, AND SELMA), COALINGA MEDICAL CENTER (CLOSED), KAISER PERMANENTE-FRESNO SERVICE AREA, KAWEAH DELTA HEALTH CARE DISTRICT, MADERA COMMUNITY HOSPITAL, SAN JOAQUIN VALLEY REHABILITATION HOSPITAL, SAINT AGNES MEDICAL CENTER, SIERRA VIEW MEDICAL CENTER, AND VALLEY CHILDREN'S HEALTHCARE. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING THE HEALTH NEEDS IN THE REPORT THROUGH A DIRECT PROGRAM/SERVICE APPROACH AS WELL AS A LEADERSHIP AND PARTICIPATION IN BROAD MULTI-STAKEHOLDER COLLABORATIVES THAT INCLUDE PUBLIC HEALTH, COMMUNITY-BASED ORGANIZATIONS, SCHOOLS, BUSINESSES AND OTHERS. COLLABORATIVES PROVIDE COMMUNITY-WIDE, TARGETED APPROACHES TO ADDRESS THE REGION'S COMPLEX HEALTHCARE NEEDS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13B: FULL CHARITY CARE IS AVAILABLE WHEN FAMILY INCOME IS AT OR BELOW 350% OF THE MOST RECENT FEDERAL POVERTY LEVEL AND WHO ARE UNINSURED.PARTIAL CHARITY CARE IS AVAILABLE WHEN FAMILY INCOME IS BETWEEN 351-400% OF THE MOST RECENT FEDERAL POVERTY LEVEL AND WHO ARE UNINSURED. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: THE PATIENT'S, OR THE PATIENT'S FAMILY'S MEDICAL EXPENSES FOR COVERED SERVICES (INCURRED AT CHS OR OTHER PROVIDERS IN THE PAST TWELVE (12) MONTHS) EXCEEDS 10% OF THE PATIENT'S FAMILY INCOME. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16J: OSHPD HAS CREATED A WEB-BASED SYSTEM THAT WILL ALLOW USERS TO SEARCH, COMPARE, AND VIEW EACH HOSPITAL'S SUBMITTED CHARITY CARE POLICY, DISCOUNT PAYMENT POLICY, ELIGIBILITY PROCEDURES, REVIEW PROCESS, AND APPLICATION FORM. ACCESS OSHPD'S HOSPITAL FAIR PRICING SEARCH SYSTEM AT: HTTPS://SYFPHR.OSHPD.CA.GOV/#FRESNO-COUNTY PART V, SECTION B, LINES 7A AND 7B: THE HOSPITAL FACILITY'S WEBSITE WHERE THE CHNA REPORT IS AVAILABLE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFITOTHER WEBSITE WHERE THE CHNA REPORT IS AVAILABLE:HTTPS://WWW.HOSPITALCOUNCIL.ORG/WP-CONTENT/UPLOADS/SITES/2/2021/11/FINAL_CENTRAL_VALLEY_CHNA_3.18.PDF PART V, SECTION B, LINE 10: THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY:HTTPS://WWW.COMMUNITYMEDICAL.ORG/ABOUT-US/COMMUNITY-BENEFIT SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP A: PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CAREPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.COMMUNITYMEDICAL.ORG/FOR-PATIENTS-FAMILIES/BILLING-AND-INSURANCE/DISCOUNTS-CHARITY-CARE PART V, SECTION B, LINE 22D: UNDER CALIFORNIA LAW (AB 774), THE MAXIMUM THAT A FAP-ELIGIBLE PATIENT MAY BE CHARGED IS THE REIMBURSEMENT RATE OF ANY GOVERNMENT-SPONSORED HEALTH PROGRAMS IN WHICH THE HOSPITALPARTICIPATES. 5 1 - COMMUNITY CANCER INSTITUTE 785 NORTH MEDICAL CENTER DR W CLOVIS CA 93611 OUTPATIENT CANCER CENTER INCLUDED IN CCMC HOSPITAL LICENSE 2 - DERAN KOLIGIAN AMBULATORY CARE CENTER 290 N WAYTE LANE FRESNO CA 93701 CLINICS: OMFS SURGERY, HIV/AIDS INCLUDED IN CRMC HOSPITAL LICENSE 3 - COMMUNITY BEHAVIORAL HEALTH CENTER 7171 N CEDAR AVE FRESNO CA 93720 PSYCHIATRIC CARE FACILITY INCLUDED IN CRMC HOSPITAL LICENSE 4 - COMMUNITY SUBACUTE TRANSITIONAL CARE CEN 3003 N MARIPOSA ST FRESNO CA 93703 TRANSITIONAL CARE INCLUDED IN CRMC HOSPITAL LICENSE 5 - FRESNO HEART AND SURGICAL HOSPITAL 15 E AUDUBON FRESNO CA 93720 SPECIALTY SURGERY SERVICES INCLUDED IN CRMC HOSPITAL LICENSE PART I, LINE 3C: DISCOUNTED CARE IS CONSIDERED FOR UNINSURED INDIVIDUALS BETWEEN 351-400% OF FPL. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS ISSUED BY COMMUNITY HEALTH SYSTEM (CHS), A DBA USED BY THE TWO HOSPITALS THAT COMPRISE THE ORGANIZATION. PART I, LINE 7: COSTING METHODOLOGY: CHARITY CARE IS ESTIMATED BY CALCULATING THE RATIO OF COST PER ADJUSTED PATIENT DAY (EXCLUDING BAD DEBTS) AND THEN MULTIPLYING THAT RATIO BY THE ADJUSTED PATIENT DAYS ASSOCIATED WITH CHARITY CARE PATIENTS. CHS DOES NOT UTILIZE A COST ACCOUNTING SYSTEM TO ESTIMATE THE COST OF CHARITY CARE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,557,892. PART II, COMMUNITY BUILDING ACTIVITIES: CHS'S EFFORTS TO IMPROVE THE COMMUNITY'S HEALTH STATUS ARE VARIED AND WIDE-RANGING. FROM SOPHISTICATED MEDICAL RESEARCH THAT ADDRESSES THE VALLEY'S UNIQUE HEALTH NEEDS TO INVESTMENTS IN FOOD SHARING PROGRAMS TO COMBAT HUNGER, CHS STRIVES TO RESPOND TO THE MOST PRESSING HEALTH NEEDS IN OUR REGION. THE CHNA PROVIDES US WITH A "ROADMAP" FOR OUR COMMUNITY HEALTH IMPROVEMENT EFFORTS. BELOW IS A SNAPSHOT OF CHS'S SIGNATURE COMMUNITY BENEFIT PROGRAMS FOR FISCAL YEAR 2021. CHS'S 2019 IMPLEMENTATION PLAN IS ADDRESSED THROUGH THE COMMUNITY BENEFIT ACTIVITIES IN THIS REPORT. ACTIVITIES RELATED TO THESE TWO REPORTS ARE IN RESPONSE TO THE 2019 CHNA IDENTIFIED HEALTH NEEDS. IN GOOD FAITH, CHS STRIVES TO SERVE THE IDENTIFIED HEALTH NEEDS DIRECTLY OR AS A SUBJECT MATTER EXPERT. WHILE CHS PARTICIPATES IN LOCAL AND REGIONAL COLLABORATIVE EFFORTS AROUND ALL 13 IDENTIFIED HEALTH NEEDS, CHS'S IMPLEMENTATION PLAN PRIMARILY FOCUSES ON ADDRESSING THE TOP FIVE HEALTHCARE NEEDS IDENTIFIED. COVID-19 COMMUNITY BENEFIT IMPACT SINCE THE START OF THE COVID-19 PANDEMIC IN MARCH 2020 AND WITH THE RISE OF THE DELTA VARIANT IN 2021, HOSPITAL VISITOR RESTRICTIONS AND IN-PERSON COMMUNITY ACTIVITIES CONTINUED UNDER STRICT LIMITS. THESE PUBLIC HEALTH MANDATES LIMITING SOCIAL GATHERINGS IMPACTED SEVERAL COMMUNITY BENEFIT ACTIVITIES IN FISCAL YEAR 2021 INCLUDING: STUDENT NURSING IN-SERVICE EDUCATION, IN-FACILITY VOCATIONAL TRAININGS, FACILITY VOLUNTEER OPPORTUNITIES, IN-PERSON SUPPORT GROUPS AND OTHERS. COVID-19 RESTRICTIONS GAVE WAY TO INNOVATIVE PATIENT AND GENERAL PUBLIC OUTREACH EFFORTS WITH THE USE OF ONLINE MEETING PLATFORMS, SOCIAL MEDIA AND VIDEO MESSAGING. CHS CONTINUED COLLABORATIONS WITH A BROAD PARTNERSHIP OF COMMUNITY GROUPS AND AREA HOSPITALS TO HELP MEET THE IMMEDIATE NEEDS OF FAMILIES IMPACTED BY THE PANDEMIC. PART II: HEALTH NEED 1 - ACCESS TO CAREGRADUATE MEDICAL EDUCATIONCHS SHARES A STRONG PARTNERSHIP WITH THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO. UCSF FRESNO, ESTABLISHED IN 1975, HELPS ADDRESS THE REGION'S NEED FOR PHYSICIANS AND INCREASES ACCESS TO CARE AND SPECIALTIES. THROUGH THE PARTNERSHIP, CHS HAS MORE THAN 200 RESIDENTS TRAINING IN EIGHT SPECIALTIES, A DENTAL ORAL MAXILLOFACIAL SURGERY RESIDENT AND MORE THAN 50 FELLOWS TRAINING IN 18 SUBSPECIALTIES. IN ADDITION, MORE THAN 300 THIRD- AND FOURTH-YEAR MEDICAL STUDENTS ARE TRAINED ANNUALLY ON A ROTATING BASIS IN CHS HOSPITALS. ROTATING MEDICAL STUDENTS INCLUDE THOSE IN UCSF'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION (SJV PRIME), WHICH LAUNCHED IN 2019 WITH SIX MEDICAL STUDENTS. TWELVE MEDICAL STUDENTS WERE ENROLLED IN THE PROGRAM IN 2021. SJV PRIME TRAINS LOCAL STUDENTS TO PROVIDE CULTURALLY-COMPETENT, ACCESSIBLE CARE IN THE SAN JOAQUIN VALLEY. THROUGH ITS PARTNERSHIP WITH UCSF, DURING THE TAX YEAR CHS TRAINED 204 RESIDENTS / FELLOWS. MEDICARE REIMBURSED CHS THE EXPENSES OF 126 OF THOSE RESIDENTS / FELLOWS, WITH CHS THEREBY FULLY FUNDING 78.UCSF FRESNO PROVIDES TRAINING IN 19 FELLOWSHIPS: -ACUTE CARE SURGERY -ADVANCED CARDIOVASCULAR IMAGING-CARDIOVASCULAR DISEASE -COMMUNITY PEDIATRICS -EMERGENCY MEDICINE EDUCATION -EMERGENCY ULTRASOUND -GASTROENTEROLOGY -HEAD AND NECK ONCOLOGY AND MICROVASCULAR RECONSTRUCTION -HEMATOLOGY/ONCOLOGY-HIV -HOSPICE AND PALLIATIVE CARE -HOSPITAL MEDICINE -INFECTIOUS DISEASES -INTERVENTIONAL CARDIOLOGY -MATERNAL CHILD HEALTH -PULMONARY/CRITICAL CARE -SLEEP MEDICINE -SURGICAL CRITICAL CARE -WILDERNESS MEDICINE UCSF FRESNO HAS EIGHT MEDICAL RESIDENCY PROGRAMS:-EMERGENCY MEDICINE-FAMILY AND COMMUNITY MEDICINE -INTERNAL MEDICINE-OBSTETRICS/GYNECOLOGY -ORTHOPAEDIC SURGERY -PEDIATRICS -PSYCHIATRY -SURGERY UCSF FRESNO ALSO PROVIDES TRAINING IN THREE PHYSICIAN ASSISTANT RESIDENCY PROGRAMS, INCLUDING ACUTE CARE/TRAUMA SURGERY, EMERGENCY MEDICINE AND ORTHOPAEDIC SURGERY. NEARLY 50% OF GRADUATING RESIDENTS STAY IN THE CENTRAL VALLEY TO PRACTICE MEDICINE, MAKING THIS PROGRAM CRITICAL TO ADDRESSING THE REGION'S ACCESS TO CARE ISSUES DETAILED IN THIS REPORT. DURING THE LAST 10 YEARS, CHS HAS INVESTED NEARLY $540 MILLION IN TOTAL MEDICAL EDUCATION OPERATING EXPENSES. CHS INVESTS MORE THAN $40 MILLION ANNUALLY IN THE EDUCATION PROGRAM, OF WHICH ONLY ABOUT $14.6 MILLION IS REIMBURSED ANNUALLY THROUGH FEDERAL GRADUATE MEDICAL EDUCATION (GME) FUNDING.AS PART OF THE COMPREHENSIVE MEDICAL EDUCATION PROGRAM, 320 RESEARCH STUDIES WERE CONDUCTED AT CHS FACILITIES AND IN THE COMMUNITY DURING FISCAL YEAR 2021. STUDIES CONDUCTED BY CHS AND UCSF FRESNO RESEARCHERS ADDRESS SPECIFIC VALLEY ISSUES INCLUDING METHAMPHETAMINE EXPOSURE AND BIRTH OUTCOMES, ENVIRONMENTAL CHEMICALS AND PREGNANCY EFFECTS AND PRE-TERM BIRTH AMONG VULNERABLE POPULATIONS INCLUDING HMONG, LATINO AND AFRICAN AMERICAN. NURSING IN-SERVICE EDUCATIONTHROUGH PARTNERSHIPS WITH OVER 20 UNIVERSITIES, COLLEGES AND ADULT SCHOOLS, CHS CONTINUES AS A REGIONAL LEADER IN THE TRAINING OF FUTURE GENERATIONS OF HEALTH PROFESSIONALS. NURSING STAFF AT CHS ACUTE AND SUB-ACUTE CARE FACILITIES PROVIDE HANDS-ON TEACHING IN A WIDE VARIETY OF MEDICAL DISCIPLINES INCLUDING LABOR AND DELIVERY, ONCOLOGY, BURN, NEUROLOGY, DIALYSIS, EMERGENCY MEDICINE, BEHAVIORAL HEALTH, MEDICAL-SURGICAL CARE, INTENSIVE CARE AND MORE. ON AVERAGE, THERE ARE OVER 100 STUDENTS WORKING TOWARD PROFESSIONAL LICENSURE WHO ROUND ALONGSIDE OUR NURSES DAILY. THESE NURSING STUDENTS ARE ENROLLED IN PROGRAMS INCLUDING REGISTERED NURSE, ASSOCIATE, BACHELOR'S OR MASTER'S DEGREE IN NURSING, FAMILY NURSE PRACTITIONER AND CLINICAL NURSE SPECIALIST. STUDENTS COME FROM THE FOLLOWING HIGHER EDUCATION INSTITUTIONS:-ASPEN UNIVERSITY -BRANDMAN UNIVERSITY -CALIFORNIA STATE UNIVERSITY, FRESNO-CLOVIS ADULT SCHOOL-COLLEGE OF THE SEQUOIAS-FRESNO ADULT SCHOOL-FRESNO CITY COLLEGE-GRAND CANYON UNIVERSITY -GURNICK ACADEMY OF MEDICAL ARTS -MADERA COMMUNITY COLLEGE-SAMFORD UNIVERSITY-SAN JOAQUIN VALLEY COLLEGE-UNIVERSITY OF COLORADO, DENVER-UNIVERSITY OF MISSOURI SINCLAIR SCHOOL OF NURSING-UNIVERSITY OF PHOENIX -UNIVERSITY OF SOUTH ALABAMA -UNIVERSITY OF TEXAS-ARLINGTON -WEST COAST UNIVERSITY-WEST HILLS COMMUNITY COLLEGE -WESTERN GOVERNORS UNIVERSITY IN FISCAL YEAR 2021, CHS NURSES PROVIDED CLOSE TO 145,000 HOURS OF HANDS-ON, IN-SERVICE EDUCATION TO NURSING STUDENTS IN CHS FACILITIES. STUDENTS LEARN AND WORK ALONGSIDE OUR NURSES AS PART OF THEIR DEGREE AND/OR LICENSURE PROGRAM.DUE TO COVID-19 AND THE DELTA VARIANT, ADDITIONAL PERSONS ENTERING CHS FACILITIES WERE LIMITED AS OF MARCH 2021. CHS VISITOR RESTRICTIONS IMPACTED NURSING STUDENT INTERACTIONS THROUGHOUT FISCAL YEAR 2021. FRESNO MEDICAL RESPITE CENTERCHS IS A FOUNDING HOSPITAL PARTNER IN THE FRESNO MEDICAL RESPITE CENTER ESTABLISHED IN JULY 2011. THE CENTER PROVIDES EIGHT BEDS FOR HOMELESS MEN AND FOUR BEDS FOR HOMELESS WOMEN AT THE FRESNO RESCUE MISSION IN DOWNTOWN FRESNO. THE RESPITE CENTER OFFERS A SAFE DISCHARGE PLACE FOR HOMELESS PATIENTS TO CONTINUE THEIR RECOVERY. RESEARCH SHOWS HOMELESS PATIENTS STAY 4.5 DAYS LONGER IN HOSPITALS COMPARED TO PATIENTS WITH SOCIAL SUPPORT AFTER THEIR DISCHARGE. THE CENTER PROVIDES A SAFE DISCHARGE ALTERNATIVE, REDUCING A PATIENT'S LENGTH OF STAY IN THE HOSPITAL. RESPITE BEDS ARE AVAILABLE TO PATIENTS FROM ALL LOCAL AREA HOSPITALS.SINCE JUNE 2016, CRMC'S HOME HEALTH CLINICAL STAFF AND CASE MANAGERS PROVIDE RESPITE CENTER PATIENTS WITH COORDINATED HEALTHCARE AND LINKAGES TO SOCIAL AND COMMUNITY RESOURCES. IN FISCAL YEAR 2021, CRMC CONTRIBUTED $102,000 TO THE FRESNO MEDICAL RESPITE CENTER AND PROVIDED CARE TO NEARLY 150 PATIENTS SAVING 2,270 HOSPITAL INPATIENT DAYS. SINCE THE PROGRAM'S LAUNCH, CHS HAS CONTRIBUTED MORE THAN $730,000 IN FUNDING. HOMELESS PATIENT DISCHARGE (SB 1152) AS THE REGION'S SAFETY NET HOSPITAL SYSTEM, CHS HAS CONSISTENTLY SERVED HOMELESS PATIENTS WITH QUALITY CARE AND DIGNITY. IN COMPLIANCE WITH CALIFORNIA SENATE BILL 1152, AS OF JANUARY 2019, ALL CALIFORNIA HOSPITALS ARE TASKED WITH TRACKING THE NUMBER OF HOMELESS PEOPLE SERVED AND IMPLEMENTING A COMPREHENSIVE DISCHARGE PLAN. THE PLAN REQUIRES ALL DISCHARGED PATIENTS RECEIVE WEATHER-APPROPRIATE CLOTHING AND SHOES, TRANSPORTATION, MEDICATION AND CONNECTIONS TO A SAFE DESTINATION WITHIN 30 MILES OF THE HOSPITAL. IN FISCAL YEAR 2021, CHS SERVED MORE THAN 4,200 HOMELESS PATIENTS IN OVER 9,200 ENCOUNTERS, PROVIDING EACH ONE WITH A SAFE AND DIGNIFIED DISCHARGE. THROUGHOUT THE YEAR, CHS STAFF DONATED NEW SHOES AND GENTLY USED CLOTHING FOR HOMELESS PATIENTS WHO NEED WEATHER-APPROPRIATE ATTIRE BEFORE BEING DISCHARGED. HOSPITAL PRESUMPTIVE ELIGIBILITYIN PARTNERSHIP WITH FRESNO COUNTY'S DEPARTMENT OF SOCIAL SERVICES (DSS), CHS CONTINUES TO PROVIDE IN-HOSPITAL ENROLLMENT FOR UNINSURED PATIENTS WHO "PRESUMPTIVELY" QUALIFY FOR MEDI-CAL. THROUGH THE HOSPITAL PRESUMPTIVE ELIGIBILITY (HPE) PROGRAM, CRMC ADMITTING STAFF ENROLL PATIENTS IN MEDI-CAL COVERAGE WHO LIKELY QUALIFY FOR THE PROGRAM BASED ON THEIR CURRENT ENROLLMENT IN OTHER SOCIAL AND PUBLIC ASSISTANCE PROGRAMS.PRESUMPTIVE ELIGIBILITY ENROLLMENT PROVIDES UNINSURED PATIENTS "REAL TIME" COVERAGE FOR THEIR VISITS AND ANY CARE VISITS UP TO 90 DAYS PRIOR. ONCE A PATIENT IS ENROLLED VIA HPE, THE PATIENT HAS 60 DAYS TO PROVIDE QUALIFYING DOCUMENTATION TO FRESNO COUNTY DSS IN ORDER TO RECEIVE PERMANENT COVERAGE. IN FISCAL YEAR 2021, CRMC AND CCMC ADMITTING STAFF ENROLLED NEARLY 1,400 UNINSURED PERSONS IN MEDI-CAL THROUGH THE HPE PROGRAM. PART II: HEALTH NEED 2 - OBESITY/HEALTHY EATING ACTIVE LIVING/DIABETESCOMMUNITY DIABETES EDUCATION CHS'S COMMUNITY DIABETES EDUCATION (CDE) SERVES PATIENTS FROM FRESNO AND FIVE AREA COUNTIES AT ITS DOWNTOWN CRMC CAMPUS. THE CENTER IS THE ONLY AMERICAN DIABETES ASSOCIATION-RECOGNIZED EDUCATION PROGRAM IN FRESNO COUNTY. IT PROVIDES CARE TO A HIGH PERCENTAGE OF PATIENTS WHO ARE OTHERWISE UNABLE TO RECEIVE DIABETES SELF-MANAGEMENT EDUCATION, INCLUDING BILINGUAL SERVICES TO A HIGH CONCENTRATION OF SPANISH-SPEAKING PATIENTS. THE CDE IS ALSO ONE OF TWO CALIFORNIA PUBLIC HEALTH DEPARTMENT-ACCREDITED SWEET SUCCESS AFFILIATES IN FRESNO COUNTY. THE SWEET SUCCESS PROGRAM TARGETS WOMEN DIAGNOSED WITH DIABETES DURING PREGNANCY. THE PROGRAM IS STAFFED BY REGISTERED NURSES AND REGISTERED DIETITIANS ALL ARE DIABETES CARE AND EDUCATION SPECIALIST-CERTIFIED. CDE STAFF PROVIDE EDUCATION TO WOMEN AND THEIR FAMILIES ON HEALTHY EATING HABITS AND CONTROLLING DIABETES DURING PREGNANCY. IN FISCAL YEAR 2021, THE CDE PROVIDED DIABETES MANAGEMENT EDUCATION AND SERVICES TO MORE THAN 1,650 PATIENTS, WITH OVER 5,500 VISITS; 75% OF THESE PATIENTS WERE COVERED BY MEDI-CAL. COMMUNITY DIABETES EDUCATION STAFF PARTICIPATED IN:-MONTHLY TRAINING FOR THE CALIFORNIA DIABETES AND PREGNANCY PROGRAM SWEET SUCCESS PROGRAM -MONTHLY HANDS-ON TRAINING FOR UCSF FRESNO MEDICAL EDUCATION STUDENTS, FAMILY HEALTH AND INTERNAL MEDICINE INTERNS, RESIDENTS AND FACULTY -DIABETES MEDICATION MANAGEMENT CLINIC AT CRMC'S NORTH MEDICAL PLAZA, PROVIDING PATIENTS WITH MEDICATION AND SUPPORT TO IMPROVE BLOOD GLUCOSE LEVELS; SERVICES WERE RECENTLY EXPANDED TO SERVE RESIDENTS IN NORTH FRESNO AT FRESNO HEART & SURGICAL HOSPITAL -MEDICAL RESIDENT TEACHING-REGISTERED NURSE RESIDENCY TRAINING-FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP'S (FCHIP) DIABETES COLLABORATIVE MONTHLY MEETINGS AS SUBJECT MATTER EXPERTSBARIATRIC SUPPORT GROUPSTO SUPPORT PATIENTS AND FAMILIES OF INDIVIDUALS WHO HAVE UNDERGONE OR ARE CONSIDERING BARIATRIC SURGERY, CHS HOSTS A SERIES OF NO-COST, VIRTUAL SUPPORT GROUPS. TOPICS FOR CHS'S BARIATRIC SUPPORT GROUPS INCLUDE EXERCISE AND NUTRITION, WELL-BEING, CHAIR YOGA AND GENERAL SUPPORT. EACH INTERACTIVE SESSION IS HOSTED BY A REGISTERED DIETICIAN OR LICENSED CLINICAL SOCIAL WORKER. SESSIONS ARE OPEN TO THE PUBLIC, REGARDLESS OF WHERE THEY RECEIVE OR PLAN TO RECEIVE BARIATRIC TREATMENT. IN FISCAL YEAR 2021, CHS HOSTED 35 VIRTUAL SUPPORT GROUPS THAT WERE EITHER 30 MINUTES OR 1 HOUR IN DURATION.FRESNO DIABETES COLLABORATIVETHE FRESNO DIABETES COLLABORATIVE WORKS TO PROVIDE LOCAL RESOURCES AND AWARENESS ON DIABETES SELF-MANAGEMENT AND PREVENTION. CHS LED FCHIP'S MONTHLY DIABETES COLLABORATIVE WORKGROUP FROM 2016 TO DECEMBER 2020. THE COLLABORATIVE ENGAGES A BROAD GROUP OF COMMUNITY PARTNERS INCLUDING HEALTHCARE PROVIDERS, PUBLIC HEALTH, CLINICS, HEALTH EDUCATORS AND HEALTH PLANS. IN ADDITION TO CHS, VALLEY CHILDREN'S HEALTHCARE AND SAINT AGNES ARE ALSO ACTIVE FCHIP PARTICIPANTS.CHS HELPED WRITE A GRANT PROPOSAL THAT RESULTED IN A $75,000 AWARD IN 2020 TO HIRE EIGHT PROMOTORAS OR NEIGHBORHOOD-BASED COMMUNITY HEALTH WORKERS. THE GRANT, IN COLLABORATION WITH LOCAL NONPROFIT EVERY NEIGHBORHOOD PARTNERSHIP (ENP), EDUCATES TRUSTED NEIGHBORHOOD COMMUNITY LEADERS ON THE PROMOTORA HEALTH PROMOTION MODEL WITH A FOCUS ON ACCESS TO CARE AND CHRONIC DISEASE MANAGEMENT. PROMOTORAS ENGAGE LATINO, SOUTHEAST ASIAN AND AFRICAN AMERICAN FAMILIES AND INDIVIDUALS AT RISK OF DEVELOPING DIABETES AND CHRONIC DISEASE CONDITIONS IN SOUTHEAST AND SOUTHWEST METROPOLITAN FRESNO. DUE TO COVID-19 HEALTH RESTRICTIONS, HEALTH ACCESS AND CHRONIC DISEASE MANAGEMENT TRAININGS ARE CONDUCTED ONLINE.IN FISCAL YEAR 2021, ENP'S PROMOTORA PROGRAM TRAINED FOUR LEADERS ON DIABETES AND CHRONIC DISEASE SELF-MANAGEMENT EDUCATION, AND MANAGED MEDI-CAL COVERAGE, AS WELL AS CPR AND FIRST AID. THE PROGRAM HAS PROVIDED HEALTH EDUCATION AND COMMUNITY RESOURCE INFORMATION TO 3,400 LOW-INCOME FAMILIES FROM FRESNO'S NEEDIEST NEIGHBORHOODS. ENP PROMOTORAS ALSO CONDUCTED A HEALTH NEEDS SURVEY FOR SOCIO-DISADVANTAGED FRESNO CITY ZIP CODES. THROUGH THE INFORMATION GATHERED, PROMOTORAS LEARNED THAT A SIGNIFICANT NUMBER OF PARENTS LACKED DIGITAL LITERACY SKILLS, ESPECIALLY THE USE OF COMPUTERS. THIS BECAME AN URGENTLY NEEDED PROFICIENCY DURING THE PANDEMIC WHEN SCHOOLS MOVED TO DISTANCE LEARNING AND MOST APPOINTMENTS AND MEETINGS SWITCHED TO ONLINE. IN RESPONSE TO THE NEED, ENP PROMOTORAS DEVELOPED A DIGITAL LITERACY CLASS FOR THE GENERAL PUBLIC AND HOSTED 10 SPANISH-LANGUAGE TRAININGS FOR CLOSE TO 60 PARENTS. THE TEAM ALSO ASSISTED SEVERAL COMMUNITY GROUPS IN TRAINING AN ADDITIONAL 75 PARTICIPANTS. ENP'S HEALTH SURVEY SHOWED FAMILIES WERE FACING MENTAL HEALTH ISSUES INCLUDING DEPRESSION AND ANXIETY. MANY SURVEYED WERE MOTHERS OF SCHOOL-AGE CHILDREN WHO EXPRESSED WORRY AND STRESS OVER THE PANDEMIC'S TOLL ON HOME FINANCES, DISTANCE LEARNING AND SOCIAL ISOLATION. IN RESPONSE, SINCE NOVEMBER 2020, ENP PROMOTORAS HOLD A MONTHLY, ONLINE WOMEN'S SUPPORT GROUP. THE GROUP AIMS TO CULTIVATE TRUSTED RELATIONSHIPS AMONG SOCIALLY ISOLATED MOTHERS AND HAS AN AVERAGE OF 25 PARTICIPANTS PER SESSION. SINCE ITS LAUNCH, MORE THAN 600 WOMEN HAVE PARTICIPATED IN THE ONLINE SESSIONS. THE SESSIONS PROVIDE PARTICIPANTS WITH A SAFE SPACE TO SHARE THEIR INDIVIDUAL AND GROUP CONCERNS AS WELL AS RECEIVE INFORMATION AND CONNECTIONS TO COMMUNITY RESOURCES. AFTER TAKING PART IN THE ONLINE SESSIONS, PARTICIPANTS EXPRESS FEELING A SENSE OF POSITIVITY DUE TO THEIR INTERACTION WITH OTHER WOMEN FACING AND OVERCOMING SIMILAR CHALLENGES.THE DIABETES COLLABORATIVE'S RESOURCE WORKGROUP, IN PARTNERSHIP WITH TULARE COUNTY'S ALLIANCE FOR MANAGEMENT & EDUCATION OF DIABETES (TAME), HOSTED THE ANNUAL FRESNO/TULARE DIABETES SYMPOSIUM FOR THE SECOND YEAR IN A ROW. THE SYMPOSIUM PROVIDES CONTINUING MEDICAL EDUCATION FOR PHYSICIANS AND ALLIED MEDICAL PROVIDERS CARING FOR DIABETES PATIENTS. DUE TO COVID-19, THE EVENT FORMAT WAS AN ONLINE SEMINAR SERIES WITH TRAININGS HELD IN SEPTEMBER AND OCTOBER 2020. OVER 100 PHYSICIANS, NURSES, DIETICIANS AND ALLIED HEALTH PROFESSIONALS FROM FRESNO, TULARE AND KINGS COUNTIES PARTICIPATED IN THE TRAININGS. PARTICIPATING HEALTH PROVIDERS AND ALLIED HEALTH PROFESSIONALS RECEIVED CONTINUING MEDICAL EDUCATION CREDITS ON DIABETES-RELATED ISSUES. SEMINAR TOPICS INCLUDED MENTAL HEALTH AND ITS EFFECT ON DIABETES MANAGEMENT AND MEDICATION REGIMENS FOR NEWLY DIAGNOSED AND LONG-STANDING PATIENTS. NEIGHBORHOOD DANCE FITNESS CHS PROVIDED EVERY NEIGHBORHOOD PARTNERSHIP (ENP) $8,000 FOR ITS NEIGHBORHOOD DANCE FITNESS PROGRAM. THE PROGRAM WAS CREATED IN JULY 2018 AFTER A SERIES OF COMMUNITY MEETINGS WITH SOUTHEAST AND SOUTHWEST FRESNO NEIGHBORHOOD PARENTS, LOCAL NONPROFIT ORGANIZATIONS AND HEALTHCARE PROVIDERS. PARTICIPANTS EXPRESSED THE NEED TO EXERCISE IN SAFE SPACES WITH CONSISTENT CLASS SCHEDULES. THE GROUP SOUGHT FUNDING FOR A PROGRAM TO TRAIN LEADERS TO BECOME NEIGHBORHOOD DANCE CLASS INSTRUCTORS. PROGRAM FUNDING HELPED PAY FOR AN INSTRUCTOR TO TEACH NEIGHBORHOOD LEADERS LATIN DANCE FITNESS ROUTINES AND PURCHASE SOUND SYSTEMS FOR 12 SITES.IN FISCAL YEAR 2021, IN RESPONSE TO THE CONTINUING COVID-19 HEALTH EMERGENCY, INSTRUCTORS CONTINUED TO USE FACEBOOK LIVE TO HOST FREE, LIVE-STREAMED CLASSES. FROM SEPTEMBER 2020 TO JUNE 2021, ENP'S NEIGHBORHOOD DANCE FITNESS ONLINE GROUP GREW FROM 60 TO 625 GROUP MEMBERS. CLASSES ARE HOSTED BY 25 COMMUNITY LEADERS WHO ARE ENP-TRAINED AS CERTIFIED DANCE INSTRUCTORS. A TOTAL OF 1,440 LIVE, ONLINE DANCE FITNESS CLASSES WERE HOSTED BY ENP TRAINERS. ENP LAUNCHED OUTDOOR, IN-PERSON CLASSES IN JUNE 2021, ONCE PUBLIC HEALTH DIRECTIVES ALLOWED SAFE GATHERINGS WITH SOCIAL DISTANCING. CLOSE TO 1,200 COMMUNITY MEMBERS HAVE PARTICIPATED IN THE WEEKLY, IN-PERSON CLASSES. IN FISCAL YEAR 2021, ENP HAD CLOSE TO 1,700 COMMUNITY MEMBERS PARTICIPATE IN THE SOCIALLY DISTANCED CLASSES HOSTED BY THE ORGANIZATION'S TRAINED DANCE FITNESS INSTRUCTORS. SINCE THE PROGRAM'S LAUNCH, MORE THAN 75 NEIGHBORHOOD LEADERS HAVE BEEN TRAINED TO LEAD DANCE FITNESS CLASSES. CHS HELPED JUMPSTART THIS PROGRAM WITH AN $11,000 INITIAL INVESTMENT; TO DATE, CHS'S PROGRAM CONTRIBUTIONS TOTAL $37,500. THIS MULTI-YEAR INVESTMENT IS PART OF CHS'S COMMITMENT TO ENSURE THAT DIVERSE, LOW-INCOME COMMUNITIES RECEIVE THE TOOLS THEY NEED TO LEAD AN ACTIVE LIFESTYLE. YOKOMI ELEMENTARY PHYSICAL ACTIVITY EQUIPMENT CHS CONTRIBUTED $2,500 TO PROVIDE PHYSICAL ACTIVITY EQUIPMENT TO YOKOMI ELEMENTARY STUDENTS AND FAMILIES. IN ORDER TO OFFER ADDITIONAL OPPORTUNITIES FOR PHYSICAL FITNESS, BESIDES THE ON-CAMPUS ACTIVITIES, YOKOMI SCHOOL OFFICIALS OFFER FITNESS EQUIPMENT FOR STUDENTS TO EXERCISE AT HOME. THE EQUIPMENT INCLUDES SOCCER AND BASKETBALLS, JUMP ROPES, HULA HOOPS AND MORE. PART II: YOKOMI ELEMENTARY IS LOCATED ADJACENT TO CRMC'S CAMPUS, IN ONE OF METROPOLITAN FRESNO'S MOST SOCIALLY AND ECONOMICALLY DISADVANTAGED NEIGHBORHOODS. THIS INVESTMENT IS PART OF CHS'S COMMITMENT TO ENSURE THAT DIVERSE, LOW-INCOME NEIGHBORHOODS HAVE EQUITABLE ACCESS TO ACTIVE LIFESTYLE OPPORTUNITIES.HEALTH NEED 3 - MATERNAL AND INFANT HEALTHMOTHER'S RESOURCE CENTER CHS IS A CHAMPION OF BREASTFEEDING EDUCATION FOR MOTHERS-TO-BE AND PROVIDES SUPPORT SERVICES FOR NEW MOTHERS THROUGHOUT THE CENTRAL VALLEY. SERVICES RANGE FROM PRENATAL BREASTFEEDING EDUCATION TO OUTPATIENT CONSULTATIONS FOLLOWING DELIVERY. IN FISCAL YEAR 2021, THE MOTHER'S RESOURCE CENTER PROVIDED NEARLY 10,000 INPATIENT BREASTFEEDING CONSULTATIONS BY INTERNATIONAL BOARD-CERTIFIED LACTATION CONSULTANTS. THE CENTER'S 3M CLUB (MOMMIES MAKING MILK) HAD MORE THAN 700 PARTICIPANT MOMS WHOSE BABIES WERE IN THE NICU. PARTICIPATING IN THE IN-HOSPITAL 3M CLUB REMAINS A HUGE INFLUENCE ON THE HEALTH AND LONGEVITY OF BREASTFEEDING FOR THESE TINY PATIENTS. THE EXCLUSIVE INPATIENT BREASTFEEDING RATE (WITH NO FORMULA SUPPLEMENTATION) IS 23% IN CHS HOSPITALS.SINCE JUNE 2017, THE CENTER HAS HOSTED BREASTFEEDING CLASSES IN BOTH ENGLISH AND SPANISH. IN FISCAL YEAR 2021, THE CENTER OFFERED SUPPORT AND EDUCATION IN AN OUTPATIENT GROUP SETTING TO NEARLY 46 NEW PARENTS RETURNING TO WORK OR WHO HAD SPECIAL NEEDS BABIES. CHS'S TOTAL INVESTMENTS IN OUTREACH AND EDUCATION FOR NEW MOTHERS AND THEIR FAMILIES IN FISCAL YEAR 2021 WAS NEARLY $160,000. DUE TO COVID-19 RESTRICTIONS, THE MOTHER'S RESOURCE CENTER OFFERED IN-PERSON, PRIVATE EDUCATION SESSIONS UNTIL MARCH 2020. THE CENTER CONTINUES OFFERING BREASTFEEDING EDUCATION CLASSES OVER THE PHONE OR VIA SECURE VIDEO CHAT. ADDITIONAL SUPPORT FOR FAMILIES OF CHILDREN 0 TO 3 IN FISCAL YEAR 2021, CHS CONTRIBUTED $2,500 TO CATHOLIC CHARITIES' PROGRAM ASSISTING FAMILIES WITH YOUNG CHILDREN. CHS'S FUNDING HELPED AUGMENT AN EXISTING CATHOLIC CHARITIES DIAPER SUPPLY PROGRAM BY ALSO PROVIDING FOOD FOR THESE FAMILIES. BETWEEN OCTOBER AND DECEMBER 2020, IN ADDITION TO DIAPERS, THE FAMILIES OF NEARLY 300 CHILDREN AGES 0 TO 3 ALSO RECEIVED SHELF-STABLE AND FRESH FOOD ITEMS. AS PART OF TARGETED SUPPORT SERVING LOW-INCOME FAMILIES OF YOUNG CHILDREN, IN APRIL 2021, CHS CONTRIBUTED $2,500 TO THE CENTRAL CALIFORNIA FOOD BANK. THESE FUNDS PAID FOR FOOD ACCESS EFFORTS AIDING FAMILIES AFFECTED BY THE PANDEMIC. CHS'S CONTRIBUTION PROVIDED 17,500 MEALS TO FAMILIES IN NEED THROUGH THE ORGANIZATION'S COMPREHENSIVE FEEDING PROGRAM. THIS INVESTMENT IS PART OF CHS'S COMMITMENT TO ENSURING LOW-INCOME FAMILIES WITH YOUNG CHILDREN HAVE EQUITABLE FOOD ACCESS.HEALTH NEED 4 - MENTAL HEALTHINVOLUNTARY MENTAL HEALTH HOLDS MENTAL HEALTH CHALLENGES IN THE CENTRAL VALLEY ARE WELL DOCUMENTED. FRAGMENTED PUBLIC SERVICES, LIMITED PRIVATE SECTOR RESOURCES AND INCREASING DEMANDS FOR MENTAL HEALTHCARE HAVE PUT PRESSURE ON ALL PARTS OF THE CARE CONTINUUM. THIS IS VISIBLE AT CHS'S TWO EMERGENCY ROOMS. CRMC AND CCMC EMERGENCY DEPARTMENTS CONTINUE OFFERING CRISIS INTERVENTION AND PROVIDE 5150/1799 "INVOLUNTARY HOLD" PROTOCOLS IN CONJUNCTION WITH FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH. CASE MANAGERS COORDINATE PATIENT CARE WITH COMMUNITY BEHAVIORAL HEALTH CENTER (PART OF CRMC) AND FRESNO COUNTY'S BEHAVIORAL HEALTH SERVICES. CASE MANAGERS CONNECT PATIENTS TO SOCIAL AND COMMUNITY SUPPORT SERVICES. IN FISCAL YEAR 2021, CRMC'S EMERGENCY DEPARTMENT RECEIVED 4,210 PATIENTS PLACED UNDER INVOLUNTARY HOLDS REQUIRING CASE MANAGEMENT SERVICES; 417 OF THESE WERE PEDIATRIC PATIENTS. CCMC'S EMERGENCY DEPARTMENT RECEIVED 1,539 PATIENTS UNDER INVOLUNTARY MENTAL HEALTH HOLDS; 208 OF THESE WERE PEDIATRIC PATIENTS.MENTAL WELLNESS AND RESILIENCY PROGRAMS AT CLOVIS UNIFIED SCHOOL DISTRICT CHS HAS CONTRIBUTED OVER $200,000 SINCE 2018 TO THE FOUNDATION FOR CLOVIS SCHOOLS FOR MENTAL HEALTH PROGRAMS AIMED AT CLOVIS UNIFIED K-12 STUDENTS AND FAMILIES. EFFORTS TO ADDRESS SOCIAL AND EMOTIONAL ISSUES AMONG THE DISTRICT'S YOUTH ARE IN RESPONSE TO INCIDENTS OF SUICIDE, SUICIDE ATTEMPTS, ANXIETY OVER RACIAL ISSUES AND INCREASED INVOLUNTARY MENTAL HEALTH HOLDS AMONG THE AREA'S YOUTH. AS A RESULT OF CHS'S FUNDING, CUSD CREATED THE WEST WELLNESS CENTER AT CLOVIS WEST HIGH SCHOOL DURING THE START OF THE COVID-19 PANDEMIC. THE CENTER PROVIDES RESOURCES AND TOOLS TO HELP STUDENTS IDENTIFY AND MANAGE THEIR EMOTIONAL WELL-BEING WITH EVIDENCE-BASED CURRICULUM. SINCE THE CENTER'S OPENING, MORE THAN 70 STUDENTS RECEIVED DIRECT ASSISTANCE FROM THE CENTER. CHS'S FUNDING DIRECTLY SUPPORTED CUSD'S PROJECT SMART AT CLOVIS COMMUNITY DAY SCHOOL, A MENTORING PROGRAM FOR AT-RISK STUDENTS IN FOURTH TO EIGHTH GRADE. PROJECT SMART MENTORING HELPS STUDENTS WITH INTERPERSONAL SKILLS DEVELOPMENT, ACADEMIC TUTORING AND COUNSELING. THE PROGRAM HAS RESULTED IN REDUCED JUVENILE DELINQUENCY AND INCREASED ACADEMIC ACHIEVEMENT. IN AN EFFORT TO PREVENT STUDENT SELF-HARM, CUSD HAS FOCUSED EFFORTS PROVIDING TEACHERS AND ON-SCHOOL-SITE PERSONNEL WITH THE APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST). WITH THE COMPLETION OF THE ASIST TRAINING, CUSD STAFF ARE BETTER ABLE TO RECOGNIZE WHEN SOMEONE MAY BE THINKING ABOUT SUICIDE AND KNOW HOW TO CONNECT THE INDIVIDUAL TO HELP AND SUPPORT. IN FISCAL YEAR 2021, CUSD WAS ABLE TO TRAIN 25 STAFFERS AND SINCE 2020, THE DISTRICT HAS PROVIDED THE TRAINING TO 230 EMPLOYEES.SPIRITUAL AND MENTAL HEALTH RESILIENCY TARGETING HARD-TO-REACH POPULATIONS CHS PROVIDED $15,000 TO THE CLINICAL PASTORAL EDUCATION OF CENTRAL CALIFORNIA (CPECC) TO PROVIDE SPIRITUAL AND SOCIAL SUPPORT SERVICES TO RURAL ISOLATED GROUPS SUCH AS FARM AND CONSTRUCTION WORKERS THROUGHOUT THE CENTRAL VALLEY AND THE STATE. SPANISH-LANGUAGE ASSISTANCE IS PROVIDED TO WORKERS FROM MEXICO AND CENTRAL AMERICA.BETWEEN JANUARY AND AUGUST 2021, CPECC CHAPLAINS PROVIDED SPIRITUAL AND RESILIENCY SUPPORT TO 500 FARM LABOR SUPPORT STAFF AND NEARLY 3,500 TEMPORARY MIGRANT LABORERS EMPLOYED UNDER H-2A VISAS. FOREIGN H-2A WORKERS LABOR IN AGRICULTURAL AND FARMING OPERATIONS IN THE VALLEY AND THROUGHOUT THE STATE ARE OFTEN IN SOCIALLY AND GEOGRAPHICALLY ISOLATED SITUATIONS. DURING THE COVID-19 PUBLIC HEALTH EMERGENCY AND IN ORDER TO ENSURE CONNECTIONS TO ISOLATED WORKERS, CPECC HELD OPEN-AIR, SOCIALLY DISTANCED EVENTS AFTER HOURS AND ON WEEKENDS. THESE MONTHLY EVENTS PROVIDED INFORMATION ON A WIDE VARIETY OF TOPICS INCLUDING HEALTH, SAFETY, SUBSTANCE ABUSE, GRIEF AND MENTAL WELLNESS. IN FISCAL YEAR 2021, CPECC CHAPLAINS MADE OVER 5,000 IN-PERSON AND PHONE CONNECTIONS WITH FARMWORKERS STRUGGLING WITH ISOLATION AND DEPRESSION. CPECC'S CHAPLAINS ADJUSTED OUTREACH STRATEGIES TO ENSURE SAFE CONNECTIONS WITH WORKERS NEEDING MENTAL WELLNESS AND SPIRITUAL SUPPORT. CPECC CHAPLAINS ESTABLISHED PHONE CALLS AND TEXTING AS A PRIMARY CONTACT METHOD. FOR WORKERS WITH LINKS TO SOCIAL MEDIA, IN MARCH 2020 CPECC CHAPLAINS OPENED A PRIVATE FACEBOOK GROUP. THE GROUP PROVIDES SPANISH-LANGUAGE VIDEOS CONTAINING ENCOURAGING MESSAGES, HEALTH EDUCATION AND COMMUNITY RESOURCES. CURRENTLY, THE PRIVATE GROUP HAS 3,500 ACTIVE SPANISH-LANGUAGE FARMWORKERS. CHAPLAINS PROVIDE INFORMATION ON MENTAL HEALTH RESILIENCY, PRAYER AND MEDITATION AS WELL AS PUBLIC HEALTH INFORMATION ON COVID-19 PREVENTION AND VACCINES. THIS INVESTMENT IS PART OF CHS'S COMMITMENT TO ENSURE THAT LOW-INCOME WORKERS HAVE EQUITABLE ACCESS TO MENTAL HEALTH AND WELLNESS PROGRAMS PROMOTING HOLISTIC HEALTH. YOUTH MENTAL HEALTH AND RESILIENCY CONNECTIONS CHS PROVIDED $5,000 TO CARE FRESNO'S CHILDHOOD RESILIENCY EFFORTS. CARE FRESNO'S STAFF LIVE AND WORK IN SOCIO-DISADVANTAGED NEIGHBORHOODS AND APARTMENT COMPLEXES IN SOUTHWEST FRESNO. STAFF WORK CLOSELY WITH CHILDREN AND FAMILIES PROVIDING ACADEMIC, SOCIAL AND EMOTIONAL ASSISTANCE. DUE TO COVID-19 GATHERING RESTRICTIONS, CARE FRESNO CONTINUED MODIFIED OUTREACH TO CHILDREN, TEENS AND FAMILIES SERVED IN SOUTHEAST AND SOUTHWEST FRESNO. CARE FRESNO STAFF VISITED FAMILIES WITH SOCIAL DISTANCING, MASKING AND ALSO CONNECTED VIA PHONE. FROM JANUARY TO AUGUST 2021, CARE FRESNO STAFF CONTACTED FAMILIES FOR MENTAL HEALTH AND RESOURCE CONNECTIONS THROUGH PHONE, TEXT AND SOCIAL MEDIA. CARE FRESNO STAFF WERE IN CONSTANT COMMUNICATION WITH THE FAMILIES OF 340 CHILDREN, PROVIDING EMOTIONAL SUPPORT AND LINKAGES TO UTILITY AND FOOD ASSISTANCE. IN TOTAL, CARE FRESNO MADE OVER 1,400 CONNECTIONS WITH PARENTS AND CHILDREN. CARE FRESNO SERVES LATINO, AFRICAN AMERICAN AND SOUTHEAST ASIAN FAMILIES.COVID-19 SOCIAL DISTANCING AND ECONOMIC HARDSHIPS PROVED TO BE CHALLENGING FOR THE FAMILIES ASSISTED BY CARE FRESNO STAFF. THROUGH CARE FRESNO'S HOPE RESILIENCY MENTAL HEALTH SURVEY, THE ORGANIZATION LEARNED THAT NEARLY 50% OF STUDENTS AND FAMILIES WERE EXPERIENCING DECLINES IN THEIR BELIEFS ABOUT THEIR OWN STRENGTH AS WELL AS THEIR FUTURE. PART II: CHS FUNDING PROVIDES SUPPORT FOR CARE FRESNO'S MENTAL HEALTH AND RESOURCE SUPPORT PROGRAMS FOR FAMILIES LIVING IN THE FOLLOWING FRESNO NEIGHBORHOODS: COURTYARD AT CENTRAL PARK, KING'S PALACE APARTMENTS, SUMMERSET VILLAGE APARTMENTS, CEDAR COURTS AND SEQUOIA COURTS. SUPPORT FOR CAREGIVERS CHS PROVIDED $2,500 TO SUPPORT VALLEY CAREGIVER RESOURCE CENTER'S (VCRC) EFFORTS TO PROVIDE RESPITE TO LOW-INCOME CAREGIVERS WHO OTHERWISE WOULD BE UNABLE TO TAKE A BREAK. CAREGIVERS SERVED BY VCRC PROVIDE HEALTHCARE, GROOMING, MEDICATION ASSISTANCE AND FEEDINGS TO THEIR ADULT PATIENT LOVED ONES WHO HAVE SUFFERED TRAUMATIC BRAIN INJURIES. MANY TIMES, THE LIFE OF A CAREGIVER IS NOT ONLY PHYSICALLY BUT MENTALLY EXHAUSTING. THE FUNDING THAT CHS PROVIDED VCRC HELPED ALLEVIATE STRESS AND GRANTED A MENTAL HEALTH REPRIEVE TO FAMILIES AND LOVED ONES SUPPORTING MEDICALLY FRAGILE ADULTS. BIRNEY ELEMENTARY RESILIENCY AND READING PROGRAM IN FISCAL YEAR 2021, CHS CONTRIBUTED NEARLY $16,000 TO BIRNEY ELEMENTARY TO FUND THE SCHOOL'S MENTAL HEALTH, RESILIENCY AND READING PROGRAMS. THROUGH THE SCHOOL'S ACTIVITY AND RESOURCE CLASSROOM, STUDENTS CAN EARN MENTAL WELLNESS PRIZES AND BOOKS FOR POSITIVE CHARACTER, CITIZENSHIP OR ACADEMIC ACHIEVEMENTS. BIRNEY, A FRESNO UNIFIED ELEMENTARY SCHOOL IN CENTRAL FRESNO, HAS A MAJORITY OF LATINO AND SOUTHEAST ASIAN STUDENTS. NINETY PERCENT OF BIRNEY STUDENTS RECEIVE FREE OR REDUCED PRICES ON MEALS, AN INDICATION OF POVERTY.HEALTH NEED 5 - ECONOMIC SECURITYECONOMIC HARDSHIPS CAUSED BY JOB LOSS AND BUSINESS CLOSURES AS A RESULT OF THE COVID-19 PUBLIC HEALTH CRISIS AND THE DELTA VARIANT SURGE RESULTED IN INCREASED NEEDS, ESPECIALLY AMONG ALREADY VULNERABLE POPULATIONS. COMMUNITY NONPROFIT ORGANIZATIONS AND HOSPITALS PARTNERED TO ADDRESS RENTAL/HOUSING, UTILITY AND FOOD EMERGENCIES. CHS RECEIVED MULTIPLE URGENT REQUESTS FOR FOOD ACCESS AID BY THE CENTRAL CALIFORNIA FOOD BANK AND FRESNO METRO MINISTRY, WHO WERE SEEING A NEARLY 50% INCREASE IN NEED. FOOD ASSISTANCE ORGANIZATIONS REPORTED THAT CLOSE TO 25% OF THOSE SEEKING AID WERE REQUESTING IT FOR THE FIRST TIME. FRESNO METRO MINISTRY'S FOOD TO SHARE PROGRAM CHS CONTRIBUTED $100,000 TO FRESNO METRO MINISTRY'S FOOD TO SHARE PROGRAM. THE PROGRAM OPERATES A FLEET OF TRUCKS THAT COLLECT EXCESS FOOD FROM LOCAL FARMERS, GROCERS, FOOD PROCESSORS AND SCHOOL DISTRICTS. THE COLLECTED FOOD, INCLUDING FRESH PRODUCE AND PACKAGED FOOD ITEMS, IS REDISTRIBUTED TO LOW-INCOME NEIGHBORHOODS CLASSIFIED AS "FOOD DESERTS" DUE TO THE LACK OF ACCESSIBLE GROCERY STORES. CHS'S CONTRIBUTION TO FOOD TO SHARE HELPED THE REDISTRIBUTION OF A LITTLE OVER ONE MILLION POUNDS OF NUTRITIOUS FOOD FROM SCHOOLS, RETAIL STORES AND PRODUCE PACKERS TO NEEDY FAMILIES. THE FOOD REDISTRIBUTION WAS MADE AVAILABLE TO LOW-INCOME FAMILIES WITH YOUNG CHILDREN, SENIORS AND DISABLED ADULTS VIA A NETWORK OF NEARLY 30 ORGANIZATIONS THROUGHOUT URBAN AND RURAL FRESNO COUNTY. INDIVIDUALS AND FAMILIES FACING FOOD INSECURITY WERE ABLE TO PICK UP FRESH PRODUCE FROM FOOD DISTRIBUTIONS AND COMMUNITY PANTRIES. DURING FISCAL YEAR 2021, FOOD TO SHARE FOOD DISTRIBUTION EFFORTS REACHED OVER 22,100 RESIDENTS NEEDING FOOD ASSISTANCE. AS PART OF CHS'S FUNDING TO FRESNO METRO MINISTRY'S NUTRITION ACCESS PROGRAMS, THE ORGANIZATION EXPANDED THE COOKING MATTERS PROGRAM. COOKING MATTERS TEACHES AREA RESIDENTS TO COOK HEALTHY AND AFFORDABLE DISHES. COOKING MATTERS CLASSES ARE LED IN BOTH ENGLISH AND SPANISH AND TAUGHT BY FRESNO CITY COLLEGE AND FRESNO STATE DIETETICS STUDENTS AS WELL AS FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH AND FRESNO METRO MINISTRY STAFF. DUE TO COVID-19 SOCIAL DISTANCING RESTRICTIONS, CLASSES WERE HELD ONLINE VIA ZOOM AND MADE AVAILABLE TO 30 LOW-INCOME RESIDENTS. EACH CLASS CONSISTED OF SIX EDUCATIONAL MODULES AND WAS AVAILABLE TO PARTICIPANTS FREE OF CHARGE.FRESNO METRO MINISTRY LED EFFORTS TO ESTABLISH A FRESNO COUNTY-CENTERED FOOD POLICY COUNCIL. THE COUNCIL BRINGS 60 ACTIVE CROSS-SECTOR LEADERS IN SIX DIFFERENT WORKGROUPS. THE WORKGROUPS EXAMINE COMMUNITY NEEDS, POLICIES AND POTENTIAL SOLUTIONS AROUND HEALTHY FOOD ACCESS, TRANSPORTATION AND LAND USE, EMERGENCY HUNGER RELIEF AND WASTE PREVENTION. CHS'S INVESTMENT IN FRESNO METRO MINISTRY'S FOOD ACCESS PROGRAMS IS HELPING THE ORGANIZATION REACH ITS $4.5 MILLION FUNDRAISING GOAL TOWARDS THE EXPANSION OF THE ST. REST + FOOD TO SHARE HUB. THE HUB, THE FIRST OF ITS KIND TO BE BUILT IN SOUTHWEST FRESNO, AIMS TO PROVIDE HEALTH-EQUITABLE RESOURCES TO A NEIGHBORHOOD LACKING FRESH PRODUCE MARKETS. THE PROJECT WILL RENOVATE AND EXPAND THE ST. REST + FOOD TO SHARE HUB, WHICH WILL INCLUDE A WAREHOUSE RENOVATION THAT ALLOWS FOR INCREASED COLD STORAGE AND TRANSPORTATION OF FRESH PRODUCE. THE PROJECT WILL ALSO INCLUDE THE CONSTRUCTION OF A COMMUNITY KITCHEN THAT WILL HELP EQUIP RESIDENTS TO COOK HEALTHY MEALS. THE HUB WILL SERVE AS A VOCATIONAL TRAINING CENTER FOR FOOD VENDORS, FARMERS AND DISTRIBUTORS. INVESTMENTS IN DIVERSE COMMUNITIES IS AN INTEGRAL PART OF CHS'S COMMITMENT TO ENSURE EQUITABLE ACCESS TO HEALTHY FOODS IN AREAS DESIGNATED AS "FOOD DESERTS." PROJECT SEARCH SINCE SEPTEMBER 2017, CHS HAS SERVED AS A VOCATIONAL TRAINING SITE FOR DISABLED ADULTS THROUGH PROJECT SEARCH. THE PROGRAM IS A COLLABORATION WITH BEST BUDDIES, A NONPROFIT ORGANIZATION THAT HELPS ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. PROJECT SEARCH PARTICIPANTS RECEIVE THE EXPERIENCE NECESSARY TO FIND AND MAINTAIN EMPLOYMENT. THE PROGRAM ALLOWS PARTICIPANTS TO LEARN AND WORK ALONGSIDE CHS STAFF IN SEVERAL CLINICAL AND NON-CLINICAL AREAS INCLUDING: NICU, ANTEPARTUM, POSTPARTUM, ENVIRONMENTAL SERVICES, MATERIALS MANAGEMENT, KITCHEN AND PLANT OPERATIONS. IN FISCAL YEAR 2021, CHS HOSTED 12 PROJECT SEARCH PARTICIPANTS AND FIVE JOB COACHES. NINE BEST BUDDY PARTICIPANTS GAINED EMPLOYMENT AS A RESULT OF THEIR EXPERIENCE AT CHS AND SEVEN CURRENTLY WORK AT CHS FACILITIES. DUE TO COVID-19 HOSPITAL VISITOR RESTRICTIONS, PROJECT SEARCH PARTICIPANTS WERE ABLE TO TRAIN AT CHS FACILITIES UNTIL MID-MARCH 2020. THE PROGRAM RESUMED ACCEPTING PARTICIPANTS AT CHS FACILITIES IN AUGUST 2021. PATIENT FINANCIAL NAVIGATOR PROGRAM IN MAY 2019, COMMUNITY CANCER INSTITUTE (CCI) HIRED A FINANCIAL COUNSELOR TO HELP CANCER PATIENTS AND FAMILIES NEEDING SUPPORT TO NAVIGATE THE COSTS OF CARE. THE FINANCIAL COUNSELOR MEETS WITH PATIENTS, REVIEWS THEIR TREATMENT PLAN AND PROVIDES A GUIDE TO HELP PATIENTS ENSURE THEY CAN RECEIVE THE CARE THEY NEED WITHOUT WORRYING ABOUT FINANCES. THE COUNSELOR HELPS PATIENTS UNDERSTAND THEIR INSURANCE COVERAGE AND ALSO LINKS PATIENTS TO COMMUNITY FINANCIAL AND SOCIAL RESOURCES. IN FISCAL YEAR 2021, CCI'S FINANCIAL COUNSELOR PROVIDED ASSISTANCE TO MORE THAN 400 PATIENTS; CLOSE TO 50% OF THOSE RECEIVING AID WERE COVERED BY MEDI-CAL. FINANCIAL ASSISTANCE IS PROVIDED IN BOTH ENGLISH AND SPANISH.HEALTH NEED 6 - ORAL HEALTHUCSF FRESNO DENTAL RESIDENTS IN A SHARED PARTNERSHIP WITH THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO SCHOOL OF DENTISTRY, THE ORAL & MAXILLOFACIAL SURGERY (OMFS) RESIDENCY PROGRAM TRAINS 16 RESIDENTS (FOUR PER YEAR) UTILIZING THE CRMC AND CCMC LOCATIONS. THE CHS INVESTMENT FUNDS 14.2 OF THE 16 FULL TIME EMPLOYEES THROUGH A $2.8 MILLION-DOLLAR COMMITMENT. CHS IS THE SPONSOR OF THE GENERAL PRACTICE RESIDENCY IN DENTISTRY (GPR) PROGRAM THROUGH A CLINICAL PARTNERSHIP WITH THE FAMILY HEALTHCARE NETWORK, AND AN ACADEMIC AFFILIATION WITH THE UNIVERSITY OF PACIFIC SCHOOL OF DENTISTRY. THE GPR TRAINS 11 RESIDENTS A YEAR WITH A $1.1-MILLION-DOLLAR COMMITMENT. DURING THE 12-MONTH PROGRAM, RESIDENTS PARTICIPATE IN GENERAL DENTISTRY CLINIC, FULL MOUTH DENTAL REHABILITATION (FMDR) IN THE OPERATING ROOM, ORAL AND MAXILLOFACIAL SURGERY, DERMATOLOGY, INTERNAL MEDICINE AND ANESTHESIA ROTATIONS. ALSO, THE DENTAL RESIDENTS TAKE CARE OF THE CRMC EMERGENCY DEPARTMENT DENTAL VISITS, VETERANS ADMINISTRATION CENTRAL CALIFORNIA HEALTH CARE SYSTEM, AND SELECT SKILLED NURSING FACILITIES.HEALTH NEED 7 - SUBSTANCE ABUSE AND TOBACCOBRIDGE OPIOID TREATMENT PROGRAM CRMC IS ONE OF NEARLY 221 CLINICAL SITES IN THE STATE OF CALIFORNIA PARTICIPATING IN THE BRIDGE PROGRAM FOR OPIOID TREATMENT. THE MEDICATION FOR THE EVIDENCE-BASED ADDICTION TREATMENT IS ACCESSIBLE 24 HOURS A DAY, 7 DAYS A WEEK AT CRMC'S EMERGENCY DEPARTMENT. THE BRIDGE PROGRAM PROVIDES INDIVIDUALS WITH BUPRENORPHINE (THE ACTIVE COMPONENT OF SUBOXONE MEDICATION) TO SUPPRESS CRAVINGS AND WITHDRAWAL SYMPTOMS. THE TREATMENT PROVIDES PATIENTS WITH IMMEDIATE ATTENTION IN THE EMERGENCY ROOM SETTING, RATHER THAN BEING REFERRED TO A REHABILITATION CENTER, WHICH IN MANY CASES CAN TAKE WEEKS OR MONTHS. IN FISCAL YEAR 2021, THE PROGRAM PROVIDED TREATMENT TO 20 PATIENTS A MONTH. SINCE THE PROGRAM'S LAUNCH, MORE THAN 540 PATIENTS HAVE RECEIVED TREATMENT. PART II: IN JUNE 2021, CHS HELPED FUND THE "ASSESSING THE NEEDS OF OPIOID SEEKING PATIENTS," A SYMPOSIUM FOR PHYSICIANS AND ALLIED HEALTHCARE PROFESSIONALS. THE EDUCATIONAL SESSIONS ADDRESSED PHYSICIAN PREPAREDNESS AND BIASES, PATIENTS WITH HIGH HEALTHCARE UTILIZATION AND HOW TO TAKE EFFICIENT CONTROL OF A PATIENT VISIT. THE SYMPOSIUM, OPEN TO ALL CENTRAL VALLEY CLINICIANS, PROVIDED CONTINUING MEDICAL EDUCATION CREDITS TO NEARLY 250 PROFESSIONALS.HEALTH NEED 8 - VIOLENCE AND INJURY PREVENTIONTRAUMA PREVENTION PROGRAM AS THE ONLY LEVEL 1 TRAUMA CENTER AND COMPREHENSIVE BURN CENTER BETWEEN LOS ANGELES AND SACRAMENTO, CRMC'S SKILLED AND DEDICATED PHYSICIANS AND STAFF PROVIDE TRAUMA SERVICES TO PATIENTS WELL BEYOND THE HOSPITAL'S TYPICAL SERVICE AREA. SINCE 2015, CRMC HAS EMPLOYED A FULL-TIME INJURY PREVENTION SPECIALIST. THE PREVENTION SPECIALIST IDENTIFIES THE MOST COMMON CAUSES OF INJURY AND DEATH SEEN AT THE TRAUMA CENTER BY USING THE HOSPITAL'S TRAUMA REGISTRY. AND THEN THE INJURY SPECIALIST PROVIDES COMMUNITY-WIDE PREVENTION INFORMATION AND SUPPORT TO ADDRESS THOSE SPECIFIC CAUSES. THROUGH EDUCATION AND ENVIRONMENTAL MODIFICATION, THE SPECIALIST WORKS TO REDUCE THE INCIDENCE OF INJURY, DISABILITY AND DEATH DUE TO TRAUMA. IN FISCAL YEAR 2021, CRMC'S TRAUMA PROGRAM LED THE FOLLOWING OUTREACH AND EDUCATION PROGRAMS:- SCHOOL OUTREACH: CRMC'S TRAUMA AND INJURY PREVENTION PROGRAM SPECIALIST PARTNERS WITH LAW ENFORCEMENT AND OTHER COMMUNITY ENTITIES TO EDUCATE TEENS ON THE DANGERS OF DISTRACTED AND RECKLESS DRIVING, BICYCLE AND PEDESTRIAN SAFETY, CONCUSSION AWARENESS AND DROWNING PREVENTION. IN FISCAL YEAR 2021, AND THROUGH A PARTNERSHIP WITH SUNNYSIDE HIGH SCHOOL'S DOCTORS ACADEMY, CRMC'S TRAUMA PROVIDED ALL 11TH GRADE STUDENTS WITH EDUCATION ON PREVENTING DISTRACTED DRIVING AND DRIVING WHILE UNDER THE INFLUENCE OF DRUGS OR ALCOHOL. - CAR SEAT SAFETY CHECKS: CRMC PROVIDED GROUP AND INDIVIDUAL CAR SEAT SAFETY AND EDUCATION TRAININGS THROUGHOUT THE YEAR. THESE TRAININGS WERE PROVIDED TO PARENTS IN BOTH ENGLISH AND SPANISH. SAFETY EDUCATION TRAININGS INCLUDED PROPER CAR SEAT INSTALLATION AND CHILD PLACEMENT RELATED TO LEGAL AGE AND WEIGHT REQUIREMENTS. CRMC'S TRAUMA PREVENTION TEAM HELD A PUBLIC EVENT AND DISTRIBUTED NEARLY A DOZEN CAR SEATS TO LOW-INCOME FAMILIES. CHECKS WERE DONE ON A ONE-ON-ONE BASIS, WITH PROPER SOCIAL DISTANCING AND HEALTH PREVENTION MEASURES. - OLDER ADULT FALL PREVENTION DRIVE-THRU EVENT: IN RESPONSE TO INCREASED FALLS BY OLDER ADULTS, CRMC'S TRAUMA PREVENTION PARTICIPATED IN A DRIVE-THRU EVENT HELD BY SEVERAL SENIOR-SERVING ORGANIZATIONS. THE EVENT PROVIDED INFORMATIONAL MATERIALS ON PHYSICAL ACTIVITY, NUTRITION AND IN-HOME MEASURES TO PREVENT FALLS. THE NO-COST EVENT HELD IN MAY 2021 SERVED OVER 150 SENIORS. SEXUAL ASSAULT FORENSIC EXAMINERS PROGRAM THE CRMC EMERGENCY DEPARTMENT OPERATES THE SEXUAL ASSAULT FORENSIC EXAMINERS (SAFE) PROGRAM. SAFE PROVIDES ROUND-THE-CLOCK, IN-HOSPITAL TESTING AND EXAMINATIONS FOR SEXUAL ASSAULT AND RAPE VICTIMS. SPECIALLY TRAINED NURSES COLLECT, PRESERVE AND SECURELY STORE EVIDENCE OBTAINED FROM ADULT AND PEDIATRIC VICTIMS AND SUSPECTS. CRMC NURSES ALSO SERVE AS EXPERT COURT WITNESSES. IN CONJUNCTION WITH THE CHILDREN'S HEALTH CENTER LOCATED ON CRMC'S CAMPUS, SAFE STAFF PROVIDE COMPREHENSIVE FOLLOW-UP EVALUATIONS FOR CHILD VICTIMS OF SEXUAL ABUSE. PROGRAM NURSES ALSO ASSIST IN CONNECTING VICTIMS AND FAMILIES TO COUNSELING SERVICES. IN FISCAL YEAR 2021, CRMC SAFE NURSES PROVIDED ASSISTANCE TO 173 PATIENTS. MAINTENANCE INVESTMENT FOR A VIOLENCE VICTIM SAFE HOUSE IN MAY 2021, CHS PROVIDED A $5,000 INVESTMENT TO HELP FUND MAINTENANCE AND UPKEEP FOR MARJAREE MASON CENTER'S SAFE HOUSE. THE COMMUNITY REFUGE PROVIDES SAFE LODGING FOR ADULTS AND CHILDREN FLEEING DOMESTIC VIOLENCE. CHS'S FUNDING ALLOWED FOR THE REMODELING OF THE SAFE HOUSE'S ON-SITE MAINTENANCE CLOSET AS WELL AS REPAIRS TO THE HOME'S BOILER. CHS'S CONTRIBUTION ALSO HELPED PROVIDE EMERGENCY SHELTER TO 12 ADULTS AND CHILDREN FROM THREE SEPARATE HOUSEHOLDS. MARJAREE MASON CENTER WITNESSED A SUBSTANTIAL RISE IN CASES OF DOMESTIC VIOLENCE DURING "STAY-IN-PLACE ORDERS AS A RESULT OF THE COVID-19 PANDEMIC.HEALTH NEED 9 - CLIMATE AND HEALTHIN-HOSPITAL GREEN INITIATIVESCHS'S SUSTAINABILITY TEAM CONTINUOUSLY SEEKS INNOVATIVE WAYS TO REDUCE AND RECYCLE CLINICAL AND NON-CLINICAL WASTE INCLUDING PAPER, SHARPS, DISPOSABLE LEAD WIRES AND CLOTH TOWELS FROM OPERATING ROOMS. THE SUSTAINABILITY TEAM IS MADE UP OF CHS EMPLOYEES WHO VOLUNTEER THEIR TIME TO RESEARCH AND SET UP PROGRAMS TO MAKE THE HOSPITAL GREENER. PARTICIPATING MEMBERS COME FROM CLINICAL, QUALITY, MATERIALS MANAGEMENT, NUTRITION AND OTHER CHS DEPARTMENTS. IN FISCAL YEAR 2021, CHS'S GREEN EFFORTS DIVERTED NEARLY 450,000 POUNDS OF WASTE FROM LOCAL LANDFILLS THROUGH ITS RECYCLING PROGRAM. RECLAIMED WATER IS ALSO UTILIZED AT CCMC FOR ALL ITS LANDSCAPING IRRIGATION RECYCLING AN AVERAGE OF 36 MILLION GALLONS OF WATER A YEAR IN COLLABORATION WITH THE CITY OF CLOVIS. CHS HAS ALSO INCREASED THE NUMBER OF RECHARGEABLE CAR STATIONS AT ITS FACILITIES BY INSTALLING 59 NEW CHARGING STATIONS AT CRMC, CCMC AND ADMINISTRATIVE OFFICE BUILDING PARKING LOTS. IN TOTAL, CHS HAS 110 CLEAN VEHICLE CHARGING STATIONS AVAILABLE TO THE PUBLIC, EMPLOYEES AND PHYSICIANS, FREE OF CHARGE. CHS'S CLEAN ENERGY EFFORTS ARE IN RESPONSE TO CALIFORNIA'S 50% RENEWABLE ENERGY MANDATE BY 2045. HOSPITAL RECOGNIZED FOR ENERGY USE AND EMISSIONS REDUCTIONS IN JULY 2021, CRMC'S EFFORTS TO CONVERT EXTERIOR LIGHTING AND UPGRADE COOLING SYSTEMS FOR THE TRAUMA AND CRITICAL CARE BUILDING TO MORE ENERGY-EFFICIENT SYSTEMS WERE RECOGNIZED WITH A 2021 ENVIRONMENT + ENERGY LEADER AWARD. THE DISTINCTION HONORS EXEMPLARY WORK IN ENERGY AND ENVIRONMENTAL MANAGEMENT. ALL EXTERIOR LIGHTING AT CRMC WAS SWITCHED OUT TO LED LIGHTS ACROSS THE 58-ACRE CAMPUS. THE HOSPITAL COOLING SYSTEMS WERE ALSO CONVERTED FROM CONSTANT-FLOW TO VARIABLE-FLOW COOLING, INCREASING EFFICIENCY AND RESULTING IN A 10% REDUCTION IN ELECTRICITY USE. THIS EFFICIENCY IMPROVEMENT REDUCED CARBON EMISSIONS, WHICH CONTRIBUTE TO THE REGION'S BAD AIR QUALITY. (ACCORDING TO THE AMERICAN LUNG ASSOCIATION THE FRESNO METROPOLITAN AREA IS RATED F FOR AIR QUALITY WITH THE FOURTH WORST AIR POLLUTION IN THE COUNTRY.)HEALTH NEED 10 CARDIOVASCULAR DISEASE/STROKEBLOOD PRESSURE CUFFS FOR LOW-INCOME PATIENTS IN FISCAL YEAR 2021, CHS DONATED $10,000 TO THE AMERICAN HEART ASSOCIATION. CHS'S INVESTMENT ENSURED THE PURCHASE OF 200 BLOOD PRESSURE CUFFS TO ASSIST LOW-INCOME PATIENTS WITH CARDIAC CONDITIONS BEING SEEN AT FAMILY HEALTH CARE NETWORK. ALONG WITH LEARNING HOW TO USE BLOOD PRESSURE CUFFS AND TRACKING THEIR BLOOD PRESSURE, PATIENTS RECEIVED HEART HEALTH INFORMATION. THE PROGRAM WAS AVAILABLE TO PATIENTS WHO WOULD OTHERWISE BE UNABLE TO PURCHASE A BLOOD PRESSURE MONITORING DEVICE AND WHO COULD ALSO BENEFIT FROM ONGOING HEALTH PREVENTION INFORMATION. THIS INVESTMENT DEMONSTRATES CHS'S COMMITMENT TO PROVIDE EQUITABLE OPPORTUNITIES FOR AT-RISK, VULNERABLE COMMUNITIES TO ACHIEVE IMPROVED HEART HEALTH.HEALTH NEED 11 - ASTHMAPEDIATRIC ASTHMA PROGRAM CHS'S PULMONARY REHABILITATION PROGRAM PROVIDED DISEASE MANAGEMENT EDUCATION AND SUPPORT FOR PARENTS. A RESPIRATORY CARE PRACTITIONER ASSISTED PARENTS AT A SOUTHCENTRAL FRESNO CLINIC, ONE OF THE CITY'S MOST UNDERSERVED AREAS. PARENTS RECEIVED TWO, ONE-HOUR SESSIONS WITH ADDITIONAL EDUCATION AS NEEDED. PATIENTS RECEIVED AN INDIVIDUALIZED "ASTHMA ACTION PLAN," ADDRESSING LUNG PHYSIOLOGY, ASTHMA ATTACK SYMPTOMS AND TRIGGERS, EFFECTIVE MANAGEMENT STRATEGIES AND PROPER MEDICATION AND INHALER USE. IN FISCAL YEAR 2021, THE PROGRAM SERVED 139 PATIENTS AND PROVIDED SPANISH AND ENGLISH HEALTH EDUCATION. IN MARCH 2020, THE PROGRAM ADOPTED SOCIAL DISTANCING AND MASKING PROTOCOLS IN RESPONSE TO COVID-19. SINCE JULY 2020, THE PROGRAM HAS OFFERED TELEHEALTH VISITS TO PATIENTS AND FAMILIES.HEALTH NEED 12 - HIV/AIDS/SEXUALLY TRANSMITTED INFECTIONSSPECIAL SERVICES CLINIC CHS SERVES AS GRANT ADMINISTRATOR FOR THE FEDERAL RYAN WHITE HIV/AIDS PROGRAM PROVIDING LIFESAVING CARE FOR CENTRAL VALLEY HIV/AIDS PATIENTS. CHS PARTNERS WITH FAMILY HEALTH CARE NETWORK'S (FHCN) SPECIAL SERVICES CLINIC TO PROVIDE VITAL AND TIMELY HEALTHCARE AND CASE MANAGEMENT SERVICES FOR PATIENTS AND FAMILIES. FHCN'S CLINICAL STAFF AND PHYSICIANS PROVIDE PATIENTS WITH DIRECT MEDICAL CARE AND CASE MANAGEMENT WHILE CHS SERVES AS THE FISCAL AND REPORTING ENTITY. IN FISCAL YEAR 2021, THE SPECIAL SERVICES CLINIC PROVIDED CARE TO 1,460 PATIENTS UNDER THE FEDERAL RYAN WHITE GRANT.HEALTH NEED 13 - CANCERCANCER SUPPORT GROUPS CCI HOSTS SEVERAL SUPPORT GROUPS FOR CANCER SURVIVORS AND THEIR FAMILIES. THE SUPPORT GROUPS, HELD IN BOTH ENGLISH AND SPANISH, ARE OPEN TO ALL PERSONS TOUCHED BY CANCER, REGARDLESS OF WHERE THEY RECEIVE CANCER CARE. PART II: CCI SUPPORT GROUPS HOST COHORT CANCER AND WELL-BEING SUPPORT SESSIONS INCLUDING: WOMEN FOR UNITY, MINDFULNESS MEDITATION, PROSTATE CANCER, BRAIN TUMORS, BREAST CANCER, AND HEAD AND NECK CANCER. IN FISCAL YEAR 2021, AND DUE TO THE CONTINUING COVID-19 PUBLIC HEALTH EMERGENCY, CCI HELD 27 VIRTUAL SUPPORT GROUPS. EACH SUPPORT GROUP SESSION RUNS BETWEEN ONE AND TWO HOURS.COMMUNITY BUILDING ACTIVITIESCHS RECOGNIZES THAT HEALTH AND WELL-BEING CANNOT BE ACHIEVED BY ONE SOLE ENTITY. POSITIVE OUTCOMES IN THE REGION'S IDENTIFIED HEALTH NEEDS REQUIRE WIDE-REACHING COLLABORATION. CHS JOINED VALLEY CHILDREN'S HEALTHCARE, SAINT AGNES MEDICAL CENTER AND KAISER PERMANENTE, COMMUNITY CLINICS, HEALTH PLANS, THE PUBLIC HEALTH DEPARTMENT, LOCAL ORGANIZATIONS AND OTHERS TO ADDRESS PRESSING HEALTH ISSUES. CHS PARTICIPATED IN SEVERAL COMMUNITY-WIDE HEALTH INITIATIVES AND ACTIVITIES, INCLUDING: FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP CHS JOINED THE FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP) LEADERSHIP TEAM IN JANUARY 2017. THIS STEERING COMMITTEE PROVIDES GUIDANCE AND DIRECTION FOR FIVE WORKGROUPS THAT INCLUDE THE DIABETES COLLABORATIVE, FRESNO FOOD SECURITY NETWORK, FRESNO COUNTY TRAUMA-INFORMED NETWORK OF CARE, AND THE EQUITY, DIVERSITY AND INCLUSION INITIATIVE. IN JULY 2021, CHS CONTRIBUTED $5,000 TO SUPPORT THE COLLABORATIVE WORK THAT FCHIP LEADS IN FRESNO COUNTY, WITH PARTICULAR FOCUS ON THE AREA'S TOP IDENTIFIED HEALTH NEEDS. IN ADDRESSING THOSE NEEDS, FCHIP'S DIABETES COLLABORATIVE, FOOD SECURITY, AND TRAUMA AND RESILIENCE WORKGROUPS HAVE MADE MEANINGFUL ADVANCES TOWARD IMPROVING THE HEALTH OF VULNERABLE POPULATIONS IN THE COUNTY, WITH PARTICULAR EMPHASIS IN SOUTHEAST AND SOUTHWEST METROPOLITAN FRESNO. FCHIP TRAUMA AND RESILIENCE NETWORK FCHIP'S TRAUMA AND RESILIENCE NETWORK (TRN) WORKS TO CREATE A TRAUMA-INFORMED COMMUNITY TO SUPPORT VULNERABLE RESIDENTS WHO HAVE EXPERIENCED ADVERSE CHILDHOOD EXPERIENCES (ACES). ACCORDING TO THE CDC, ACES CAN HAVE NEGATIVE, LONG-TERM IMPACT ON HEALTH IN ADULTHOOD, INCLUDING OBESITY AND DETRIMENTAL HEALTH BEHAVIORS SUCH AS ALCOHOL AND DRUG ABUSE. NEW RESEARCH SHOWS THAT ADULTS WHO HAVE SUFFERED PAST TRAUMA CAN RESTORE THEIR BRAINS AND BODIES MANY YEARS AFTER SUFFERING CHILDHOOD TRAUMA AND EXTREME NEGLECT. TRN'S LEADERSHIP TEAM INCLUDES 16 MEMBERS FROM VARIOUS COMMUNITY-BASED ORGANIZATIONS, GOVERNMENT AND EDUCATION INSTITUTIONS. IN FISCAL YEAR 2021, TRN HOSTED A VIRTUAL CONFERENCE AND BI-MONTHLY MINI-CONFERENCES FOCUSED ON BEING "TRAUMA-INFORMED, OR RECOGNIZING THAT THE PREVALENCE OF ADVERSE CHILDHOOD EXPERIENCES INFLUENCES NEGATIVE BEHAVIORS AND EXPERIENCES. THESE CONFERENCES HAVE REACHED RESIDENTS FROM ALL OVER THE CENTRAL VALLEY.AS A RESULT OF COVID-19'S NEGATIVE IMPACTS ON MENTAL HEALTH, TRN LAUNCHED A "COVID MENTAL HEALTH" WORKGROUP. THE WORKGROUP ANALYZED SOCIAL AND EMOTIONAL IMPACT THAT THE PANDEMIC WAS HAVING ON THE MOST SOCIO-ECONOMICALLY DISADVANTAGED RESIDENTS. THE GROUP WAS INVITED TO NATIONAL TRAUMA AND COVID-19 CONVERSATIONS.FCHIP FRESNO COUNTY TRAUMA-INFORMED NETWORK OF CAREFCHIP'S FRESNO COUNTY TRAUMA-INFORMED NETWORK OF CARE, RECEIVED A $2.6 MILLION GRANT THAT ALLOWS 50 PARTNERS TO DEVELOP A SYSTEM THAT PREVENTS, TREATS AND HEALS TOXIC STRESS. THE GRANT, FUNDED BY THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES AND THE OFFICE OF THE CALIFORNIA SURGEON GENERAL, ALLOWS PHYSICIANS TO CONDUCT IN-OFFICE VISIT CLINICAL ACES SCREENINGS. SCREENINGS ASSESS A PATIENT FOR ADVERSITY, CLINICAL MANIFESTATIONS OF TOXIC STRESS AND ADDS A TREATMENT PLAN THAT INCLUDES CARE COORDINATION. THE GRANT ALSO CONTAINS FUNDING FOR THE DEVELOPMENT OF DATA INTEGRATION. CURRENTLY, THE NETWORK OF CARE INCLUDES 46 FRESNO COUNTY PARTNERING ORGANIZATIONS, 111 MEDICAL PROVIDERS PROVIDING ACES SCREENINGS AND 26 COMMUNITY-BASED ORGANIZATIONS LENDING RESOURCE SUPPORT. TO DATE, NEARLY 700 INDIVIDUALS HAVE PARTICIPATED IN THE NETWORK OF CARE TRAUMA-INFORMED TRAININGS. COLLABORATIVE EQUITY, DIVERSITY AND INCLUSION WORK CHS PARTICIPATED AS A LEAD PARTNER IN FCHIP'S COMMUNITY-WIDE WORKSHOPS ENSURING THAT THE GROUP'S CORE VALUES REFLECT EQUITY, DIVERSITY AND INCLUSION (EDI) PRACTICES. A CHS REPRESENTATIVE HELPED GUIDE, PLAN AND FACILITATE COMMUNITY-WIDE CONVERSATIONS WITH CROSS-SECTOR LEADERS. THE WORKSHOP'S GOALS WERE TO ESTABLISH THE GROUP'S COLLABORATIVE HEALTH EFFORTS TO REFLECT EQUITABLE OUTREACH, ENGAGEMENT AND SERVICE TO COMMUNITY MEMBERS. FRESNO MADERA CONTINUUM OF CARE THE FRESNO MADERA CONTINUUM OF CARE (FMCOC) IS A TWO-COUNTY, CROSS-SECTOR COLLABORATIVE THAT IDENTIFIES AND PETITIONS STATE AND FEDERAL FUNDING FOR HOUSING ASSISTANCE AND RESOURCES FOR HOMELESS INDIVIDUALS. CREATED IN 2002, CONTINUUM OF CARE PARTNERS MEET MONTHLY AND INCLUDE COUNTY SOCIAL SERVICE AGENCIES, NATIVE AMERICAN, VETERAN AND SENIOR-SERVING ORGANIZATIONS, HEALTHCARE PROVIDERS, THE HOSPITAL COUNCIL, CORRECTIONS AND MENTAL HEALTH SERVICE PROVIDERS. THE COLLABORATIVE EFFORT HAS OVERSEEN THE LOCAL DISTRIBUTION OF MILLIONS OF DOLLARS TO ASSIST IN EMERGENCY AND LONG-TERM HOUSING FOR VULNERABLE INDIVIDUALS, FAMILIES AND VETERANS.CHS PARTICIPATES AS AN FMCOC VOTING MEMBER, HELPING GUIDE PROGRAM FUNDING FOR RAPID REHOUSING EFFORTS, EMERGENCY SHELTERS AND THE ANNUAL POINT IN TIME COUNT A CENSUS OF HOMELESS INDIVIDUALS. DUE TO COVID-19, THE FMCOC WAS FORCED TO FORGO AN IN-PERSON POINT IN TIME COUNT. FMCOC PARTNERS SECURED $2.5 MILLION FROM THE CARES ACT EMERGENCY SOLUTIONS GRANT. THESE FUNDS WENT TO LOCAL AGENCIES SERVING HOMELESS INDIVIDUALS AND FAMILIES WITH RAPID REHOUSING, INFECTION PREVENTION AND MITIGATION EFFORTS, EMERGENCY SHELTER AND QUARANTINE LODGING ASSISTANCE. DURING FY21, CONTINUUM OF CARE PARTNERS ENSURED THAT HOMELESS POPULATIONS HAD ACCESS TO EMERGENCY HOUSING IF THEY WERE EXPOSED TO OR INFECTED WITH COVID-19. A WIDE CITY-COUNTY PARTNERSHIP ALSO FOCUSED ON THE SAFETY OF HOMELESS INDIVIDUALS LIVING ALONGSIDE FREEWAYS BY RELOCATING INDIVIDUALS TO STABLE HOUSING. THE COLLABORATIVE CONTINUES ITS EFFORTS TO SEEK AND ENSURE STATE AND FEDERAL FUNDING TO SERVE THE COMMUNITIES' MOST VULNERABLE RESIDENTS. SCHOLARSHIPS FOR FARMWORKER CHILDREN SEEKING MEDICAL CAREERS CHS PROVIDED A $5,000 CONTRIBUTION TO THE CALIFORNIA FARMWORKER FOUNDATION'S CENTRAL VALLEY DREAM SCHOLARSHIP PROGRAM. THIS INVESTMENT IS PART OF CHS'S COMMITMENT TO PROVIDE EQUITABLE OPPORTUNITIES FOR COMMUNITIES TO ACHIEVE THEIR FULL POTENTIAL. THIS PROGRAM AIMS TO PROVIDE SCHOLARSHIPS TO PROMISING STUDENTS, SONS AND DAUGHTERS OF FARMWORKER PARENTS, AND HELPS STUDENTS WITH A DEMONSTRATED FINANCIAL NEED FOR THOSE WITH ABOVE-AVERAGE GRADE POINT AVERAGES. CHS'S CONTRIBUTION FUNDED FIVE WORTHY STUDENTS FROM RURAL CENTRAL VALLEY TOWNS SEEKING NURSING AND MEDICAL CAREERS. STUDENT RECIPIENTS ARE CURRENTLY ENROLLED IN COLLEGES AND UNIVERSITIES THROUGHOUT THE STATE. SUPPORT FOR MEDICAL MISSIONS ABROAD OVER THE PAST SIX YEARS, CHS HAS PROUDLY PROVIDED MORE THAN $1 MILLION IN FINANCIAL AND IN-KIND MEDICAL SUPPORT TO ARMENIA, A COUNTRY THAT HAS SEEN SIGNIFICANT SOCIAL TURMOIL. CHS'S INVESTMENT SECURED DOCTORS, MEDICAL EQUIPMENT AND SUPPLIES TO MAINLY RURAL AREAS THAT EXPERIENCE SIGNIFICANT BARRIERS TO CARE. CHS'S CONTRIBUTIONS PROVIDED THE DEPLOYMENT OF PHYSICIANS, DENTISTS AND NURSES TO AID ARMENIAN PATIENTS. IN ADDITION TO MEDICAL PERSONNEL, CHS'S INVESTMENT FACILITATED THE DELIVERY OF IV PUMPS, BLOOD PRESSURE CUFFS, GLUCOSE MONITORS, SURGICAL SCALPELS, PEDIATRIC SCALES, PORTABLE ULTRASOUND MACHINES AND SMALL ELECTROCARDIOGRAM DEVICES.COMMUNITY HEALTH EDUCATION AND SUPPORTTHE FOLLOWING INVENTORY OF COMMUNITY BENEFIT ACTIVITIES INCLUDES EDUCATIONAL PROGRAMS AND SUPPORT PROVIDED BY PHYSICIANS, STAFF AND VOLUNTEERS OF CHS. CHRONIC KIDNEY DISEASE: DIALYSIS OPTIONS CHS IS AMONG THE LARGEST PROVIDERS OF DIALYSIS SERVICES IN THE CENTRAL VALLEY, ANNUALLY SERVING OVER 10,000 PATIENT VISITS. CHS OFFERS DIALYSIS SERVICES TO ALL AGE GROUPS AND ETHNIC BACKGROUNDS AND PROVIDES ENGLISH AND SPANISH EDUCATIONAL MATERIALS. CHS'S PRIME DIALYSIS EDUCATION PROGRAM, OPTIONS, A PATIENT-CENTERED INFORMATION AND SUPPORT SERVICE FOR INDIVIDUALS WITH CHRONIC KIDNEY DISEASE. CHS PARTICIPATES IN THE NATIONAL KIDNEY FOUNDATION'S KIDNEY EARLY EVALUATION PROGRAM OR KEEP HEALTHY COMMUNITY-BASED INITIATIVE TO EDUCATE THE PUBLIC ABOUT KIDNEY HEALTH, RISK FACTORS AND STEPS TO REDUCE RISK. HEALTHQUEST SERIES CHS'S IN-PERSON HEALTHQUEST SEMINARS FEATURE PHYSICIANS AND MEDICAL EXPERTS DISCUSSING PUBLIC INTEREST HEALTH TOPICS. HEALTHQUEST IN-PERSON LECTURES ARE HELD MONTHLY ON CCMC AND CRMC CAMPUSES AND ARE PROVIDED TO THE PUBLIC AT NO CHARGE. DUE TO COVID-19, CHS'S HEALTHQUEST SERIES MOVED TO AN ONLINE PLATFORM. IN FISCAL YEAR 2021, CHS HOSTED SIX HEALTHQUEST LECTURES ON TOPICS RELATED TO REGIONAL IDENTIFIED HEALTH NEEDS. PART II: THESE SEMINARS INCLUDED: COLORECTAL CANCER AWARENESS, HEALTHY DIET, HEART FAILURE, THE COVID-19 VACCINE, STROKE AWARENESS AND OBESITY PREVENTION. ON AVERAGE, HEALTHQUEST SEMINARS ARE ATTENDED BY 150 PARTICIPANTS. MEDWATCH TODAY TELEVISION SERIES IN AN EFFORT TO INCREASE PUBLIC AWARENESS OF TIMELY HEALTH TOPICS, CHS PRODUCES A WEEKLY TELEVISION SHOW, MEDWATCH TODAY. THE SERIES FEATURES TOPICS THAT INCLUDE MENTAL HEALTH, PEDIATRIC ASTHMA, HEART DISEASE, DIABETES PREVENTION AND MANAGEMENT, AND MANY OTHERS. THE SHOW AIRS SATURDAYS ON KSEE24, AN NBC AFFILIATE, AND SUNDAYS ON CBS47. IN FISCAL YEAR 2021, MEDWATCH TODAY PRODUCED AND BROADCAST 50 SEGMENTS THAT ADDRESSED NINE OF THE 13 REGIONAL IDENTIFIED HEALTH NEEDS. A TOTAL OF 5.5 MILLION HOUSEHOLDS VIEWED MEDWATCH TODAY CONTENT IN FISCAL YEAR 2021, WITH AN AVERAGE OF 4,496 HOUSEHOLDS TUNING IN PER EPISODE. ADDITIONALLY, CONSUMERS HAVE VIEWED MORE THAN 4,500 HOURS OF MEDWATCH TODAY CONTENT ONLINE AS AN ON-DEMAND VIDEO HEALTH EDUCATION RESOURCE.SPANISH HEALTH EDUCATION SEGMENTS CHS STRIVES TO PROVIDE TIMELY AND RELEVANT HEALTH INFORMATION TO SPANISH-SPEAKING AUDIENCES, INCLUDING EQUITABLE INFORMATION TO OUR LATINO PATIENT POPULATION. IN ORDER TO PROMOTE COVID-19 VACCINE AWARENESS AND CLARIFY MISINFORMATION, CHS PRODUCED A SPANISH-LANGUAGE VIDEO WITH A UCSF RESIDENT PHYSICIAN ANSWERING COMMON QUESTIONS AND FEARS AROUND THE VACCINES. THE CHS-PRODUCED VIDEO WAS DISTRIBUTED THROUGH FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP) AND THE CHILDREN'S MOVEMENT LIST SERVES. THE VIDEO WAS WIDELY DISTRIBUTED VIA THE SOCIAL MEDIA PAGES OF SEVERAL COMMUNITY-BASED ORGANIZATIONS. KERMAN HIGH MEDICAL ROP CHS CONTRIBUTED $7,500 WORTH OF HOSPITAL-GRADE MEDICAL EQUIPMENT TO KERMAN HIGH SCHOOL'S MEDICAL REGIONAL OCCUPATIONAL PROGRAM (ROP). MEDICAL EQUIPMENT PROVIDED INCLUDED: IV POLES AND PUMPS, A GURNEY, EKG AND ULTRASOUND MACHINES, SURGICAL EQUIPMENT, WHEELCHAIRS AND OTHER ITEMS. KERMAN HIGH MEDICAL PATHWAY INSTRUCTORS USE THE EQUIPMENT FOR HANDS-ON LESSONS THAT ACCOMPANY TEXTBOOK INSTRUCTION. SINCE THE ADDITION OF THE MEDICAL EQUIPMENT, INSTRUCTORS REPORT INCREASED STUDENT ENROLLMENT IN THE MEDICAL EDUCATION PATHWAY PROGRAM. DURING THE 2020-2021 SCHOOL YEAR, THE ROP MEDICAL PROGRAM INSTRUCTOR LED HANDS-ON ENTRY MEDICAL LESSONS USING CHS-DONATED EQUIPMENT TO MORE THAN 170 STUDENTS. CONTINUING MEDICAL EDUCATION ON LGBTQ+ EQUITABLE CARE CHS CONTRIBUTED FUNDING IN FISCAL YEAR 2021 TOWARD THE FIRST VIRTUAL HEALTH SYMPOSIUM IN THE FRESNO AREA FOCUSED ON LGBTQ+ (LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER, PLUS) NEEDS. THE CONTINUING EDUCATION EVENT FOR PHYSICIANS AND ALLIED HEALTHCARE PROVIDERS AIMED TO INCREASE AWARENESS ON LGBTQ+ HEALTHCARE ACCESS AND IMPROVE CULTURALLY SENSITIVE CARE. THE SYMPOSIUM, HELD IN NOVEMBER 2021, WAS LED BY LICENSED THERAPISTS, COMMUNITY MEMBERS, PHYSICIANS AND SURGEONS. CHS'S INVESTMENT IN QUALITY, COMPETENT CARE FOR LGBTQ+ PATIENTS IS PART OF THE SYSTEM'S AIM TO PROVIDE EQUITABLE CARE TO DIVERSE CENTRAL VALLEY COMMUNITIES. FRESNO AREA COLLEGE NIGHT COMMUNITY CARE HEALTH (CCH), A CHS SUBSIDIARY AND INSURANCE PLAN, FUNDED $2,500 FOR THE FRESNO COUNTY SUPERINTENDENT OF SCHOOLS' ANNUAL FRESNO AREA COLLEGE NIGHT FOR 5,000 HIGH SCHOOL STUDENTS AND PARENTS. GENERAL COLLEGE PLANNING INFORMATION WAS PROVIDED ON TOPICS THAT INCLUDED THE COLLEGE ADMISSIONS PROCESS, FINANCIAL AID AND SCHOLARSHIPS. EVENT BREAKOUT SESSIONS WERE AVAILABLE IN ENGLISH, SPANISH AND HMONG. THE FREE EVENT, HELD SEPTEMBER 2020, WAS OPEN TO HIGH SCHOOL STUDENTS, MANY OF WHOM ARE FIRST IN THEIR FAMILY TO ATTEND COLLEGE.CENTRAL UNIFIED SCHOLARSHIPS IN FISCAL YEAR 2021, CCH COMMITTED TO PROVIDING SCHOLARSHIP FUNDS FOR LOW-INCOME SENIORS FROM CENTRAL UNIFIED. CCH FUNDING OF $7,500, WITH THAT OF OTHER COMMUNITY PARTNERS, WILL ENABLE THE FOUNDATION FOR CENTRAL SCHOOLS TO PROVIDE SIX $2,500 SCHOLARSHIPS FOR LOW-INCOME STUDENTS. SCHOLARSHIPS WILL HELP STUDENTS PAY FOR COLLEGE, VOCATIONAL OR TRADE SCHOOL NEEDS. END-OF-THE-YEAR CONTRIBUTIONS CCH FUNDING OF $3,000 PROVIDED THANKSGIVING MEALS TO NEEDY FAMILIES IN PARTNERSHIP WITH CATHOLIC CHARITIES. AS PART OF CATHOLIC CHARITIES' 10TH ANNUAL TURKEY DRIVE, NEARLY 1,200 LOW-INCOME FAMILIES RECEIVED A TURKEY HOLIDAY MEAL BOX IN 2019. CCH ALSO FUNDED CATHOLIC CHARITIES' "ADOPT A FAMILY" HOLIDAY GIFT PROGRAM FOR LOW-INCOME CHILDREN AND FAMILIES. THE PROGRAM GIFTS CHILDREN JACKETS, BLANKETS AND OTHER WINTER WEATHER ITEMS DURING ITS END-OF-THE-YEAR FESTIVITIES.VOLUNTEER SERVICES VOLUNTEERS ARE AN ESSENTIAL PART OF CHS'S MISSION TO IMPROVE THE HEALTH OF THOSE WE SERVE AND OF OUR COMMUNITY. IN FISCAL YEAR 2021, 60 VOLUNTEERS PROVIDED NEARLY 2,000 HOURS OF SERVICE TO CRMC AND ITS PATIENTS. AT CCMC, NEARLY 22 VOLUNTEER CHAPLAINS, ADULTS, GUILD MEMBERS, YOUTH AND STUDENT VOLUNTEERS PROVIDED OVER 791 HOURS OF SERVICE. IN MARCH 2020, VOLUNTEER ACTIVITIES WERE SUSPENDED DUE TO COVID-19 VISITOR RESTRICTIONS AT ALL CHS FACILITIES. THOSE RESTRICTIONS WERE EXTENDED UNTIL JANUARY 2021, WHEN LIMITED VOLUNTEER OPPORTUNITIES WERE REINSTATED. COVID-19 PUBLIC EDUCATION CHS LED A MULTILINGUAL PUBLIC EDUCATION CAMPAIGN TO INFORM THE PUBLIC ON COVID-19 PREVENTION AND SYMPTOMS. IN COORDINATION WITH THE FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH, AND A WIDE COLLABORATIVE OF COMMUNITY-BASED ORGANIZATIONS SERVING IMMEDIATE AREA NEEDS AS A RESULT OF THE PANDEMIC, CHS PRODUCED MULTI-PLATFORM EDUCATIONAL MATERIALS. THESE MATERIALS INCLUDED EDUCATION VIDEOS, INFOGRAPHICS AND NEWS ARTICLES FEATURING SUBJECT MATTER EXPERTS IN BOTH ENGLISH AND SPANISH. TOPICS INCLUDED BASIC INFORMATION ON THE COVID-19 VACCINE, CLEARING UP MYTHS WITH SCIENTIFIC BACKING AND THE IMPORTANCE OF CONTINUING MITIGATION METHODS TO REDUCE VIRUS SPREAD. THE CHS-PRODUCED COVID-19 EDUCATIONAL GRAPHICS AND VIDEOS WERE DISTRIBUTED TO MORE THAN 1,000 COMMUNITY LEADERS FROM NONPROFIT ORGANIZATIONS, PUBLIC HEALTH AGENCIES, HEALTH PLANS AND LOCAL SCHOOL DISTRICTS VIA FCHIP'S LIST SERVE AND CENTRAL VALLEY COMMUNITY FOUNDATION'S WEEKLY COVID-19 INFORMATIONAL CALL FOR VALLEY NONPROFITS. ON-SITE BLOOD DRIVES DURING THE COVID-19 PUBLIC HEALTH EMERGENCY, THE CENTRAL VALLEY SAW SERIOUS DECLINES IN LOCAL BLOOD SUPPLIES. TO HELP INCREASE THE AVAILABILITY OF BLOOD RESOURCES IN OUR REGION, CHS PARTNERED WITH THE CENTRAL CALIFORNIA BLOOD CENTER TO HELP BLOOD COLLECTION EFFORTS. IN FISCAL YEAR 2021, CHS HOSTED AND ORGANIZED 23 EVENTS ON THE FOLLOWING HOSPITAL CAMPUSES AND ADMINISTRATIVE OFFICES: CCMC, CRMC, FHSH AND THE SHAW BUSINESS CENTER. MORE THAN 830 CHS EMPLOYEES PARTICIPATED IN THE VOLUNTEER BLOOD DRIVES, WHICH PRODUCED 740 BLOOD UNITS FOR DISTRIBUTION THROUGHOUT THE CENTRAL VALLEY REGION. PART III, LINE 2: ADJUSTMENT DUE TO THE PATIENT'S ABILITY TO PAY DUE TO A BANKRUPTCY ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 3: CHS DOES NOT RECOGNIZE ANY PORTION OF ITS BAD DEBT EXPENSE AS A COMMUNITY BENEFIT. PART III, LINE 4: FOOTNOTE FOR BAD DEBT EXPENSE: SEE AUDITED FINANCIAL STATEMENTS NOTE 3, PAGE 16.FOOTNOTE FOR ACCOUNTS RECEIVABLE: SEE AUDITED FINANCIAL STATEMENTS NOTE 2, PAGE 12. PART III, LINE 8: MEDICARE SHORTFALL: THE MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFIT BECAUSE: (1) NONNEGOTIABLE MEDICARE RATES ARE SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; AND (2) BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES.COSTING METHODOLOGY: INPATIENT CARE SERVICES, SKILLED NURSING SERVICES, REHABILITATION SERVICES, AND CERTAIN OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DIAGNOSIS. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. CERTAIN INPATIENT NONACUTE SERVICES AND MEDICAL EDUCATION COSTS RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST-BASED REIMBURSEMENT METHODOLOGY. PROFESSIONAL SERVICES ARE REIMBURSED BASED ON A FEE SCHEDULE. PART III, LINE 9B: THOSE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE GENERALLY SUBJECT TO THE NORMAL COLLECTION PROCEDURES FOR ALL PATIENTS. THE FOLLOWING SPECIAL CIRCUMSTANCES MAY APPLY: CHS MAY EMPLOY REASONABLE COLLECTION EFFORTS TO OBTAIN PAYMENT FROM PATIENTS. GENERAL COLLECTION ACTIVITIES MAY INCLUDE ISSUING PATIENT STATEMENTS, PHONE CALLS, AND FOLLOW UP LETTERS SENT TO THE PATIENT OR GUARANTOR. CHS SHALL NOT PURSUE COLLECTIONS AND EXTRAORDINARY COLLECTION ACTIONS WHEN: THE PATIENT IS A RYAN WHITE PATIENT, THE PATIENT IS HOMELESS, THE PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AND/OR GOVERNMENT SPONSORED COVERAGE AND THE APPLICATION IS PENDING, CHS IS AWARE THAT THE PATIENT IS ALREADY APPROVED FOR FINANCIAL ASSISTANCE, AND THE PATIENT IS REASONABLY COOPERATING WITH THE CHS IN AN EFFORT TO SETTLE AN OUTSTANDING BILL. CHS WILL MAKE REASONABLE EFFORTS TO NOTIFY THE PATIENT PRIOR TO ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTIONS. THESE ACTIONS WILL ONLY TAKE PLACE AFTER 150 DAYS FROM THE INITIAL PATIENT STATEMENT. ALL PATIENT STATEMENTS SHALL INCLUDE THE NOTICE OF RIGHTS, WHICH INCLUDES A SUMMARY OF FINANCIAL ASSISTANCE THAT IS AVAILABLE TO ELIGIBLE PATIENTS. ALL PATIENTS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNT AT ANY TIME. PART VI, LINE 2: AS PART OF THE AFFORDABLE CARE ACT, THE ORGANIZATION PARTNERED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA AND A DOZEN OTHER VALLEY HOSPITALS TO PUBLISH A COMMUNITY NEEDS ASSESSMENT IN 2019. ADDITIONALLY, EACH OF OUR THREE HOSPITALS DEVELOPED IMPLEMENTATION PLANS TO ADDRESS SOME OF THE KEY NEEDS IDENTIFIED IN THE REPORT. PART VI, LINE 3: COMMUNICATION OF FINANCIAL ASSISTANCE POLICIES WITH PATIENTS AND THE PUBLIC:1. CHS SHALL POST NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME, UNINSURED AND UNDER-INSURED PATIENTS. THESE NOTICES WILL BE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL, INCLUDING BUT NOT LIMITED TO:A. ADMITTING/REGISTRATION;B. CASHIER WINDOWS;C. EMERGENCY DEPARTMENT; ANDD. OTHER APPROPRIATE OUTPATIENT SETTINGS.2. THESE POSTED NOTICES REGARDING FINANCIAL ASSISTANCE POLICIES SHALL CONTAIN BRIEF INSTRUCTIONS ON HOW TO APPLY FOR CHARITY CARE OR A DISCOUNTED PAYMENT. THE NOTICES WILL ALSO INCLUDE A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION.3. CHS WILL ENSURE THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES INCLUDING THE RYAN WHITE PROGRAM. TRAINING WILL BE PROVIDED TO STAFF MEMBERS (E.G., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS.4. WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, EMPLOYEES WILL ATTEMPT TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.5. PATIENTS (ADMITTED PATIENTS, AS WELL AS THOSE WHO RECEIVE EMERGENCY OR OUTPATIENT CARE) WILL BE GIVEN WRITTEN NOTICE REGARDING FINANCIAL ASSISTANCE, INCLUDING ELIGIBILITY AND CONTACT INFORMATION THAT IS IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT, AS DETERMINED BY CALIFORNIA INSURANCE CODE SECTION 12693.30 (POPULATIONS OVER 5% SERVED BY THE HOSPITAL) AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.6. CHS WILL SHARE ITS POLICY WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS.7. THE RYAN WHITE SLIDING FEE SCALE IS UPDATED YEARLY ACCORDING TO THE FEDERAL POVERTY GUIDELINES.8. ALL PATIENTS WHO POTENTIALLY QUALIFY FOR DISCOUNTS FOR SERVICES UNDER RYAN WHITE WILL HAVE THEIR FINANCIAL ELIGIBILITY TESTED EVERY SIX MONTHS. THE FINANCIAL ASSISTANCE POLICY AND THE APPLICATION ARE ALSO PUBLISHED IN CHS'S WEBSITE. IN ADDITION, ALL CHS BILLING STATEMENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. PART VI, LINE 4: SERVICE AREA: COMMUNITY HEALTH SYSTEMS (CHS) IS HEADQUARTERED IN FRESNO, PROVIDING THE SAN JOAQUIN VALLEY WITH ACUTE CARE, OUTPATIENT CENTERS, CLINICS, HOME CARE, COMMUNITY EDUCATION, PHYSICIAN GROUPS AND A PHYSICIAN RESIDENCY PROGRAM IN CONJUNCTION WITH THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO (UCSF). WITH MORE THAN 8,900 EMPLOYEES, 1,875 AFFILIATED PHYSICIANS AND NEARLY 100 VOLUNTEERS, CHS HAS A 15,000-SQUARE-MILE PRIMARY SERVICE AREA. THAT INCLUDES FRESNO, MADERA, KINGS, TULARE AND MARIPOSA COUNTIES. THE AREA IS AS LARGE AS RHODE ISLAND, CONNECTICUT AND NEW JERSEY COMBINED. CHS ALSO OPERATES THE ONLY COMBINED BURN AND LEVEL 1 TRAUMA UNITS BETWEEN LOS ANGELES AND SACRAMENTO, PROVIDING CRITICAL CARE AND OTHER SPECIALTY SERVICES TO PATIENTS FROM WELL OUTSIDE THE PRIMARY SERVICE REGION. THOSE UNITS ARE LOCATED AT COMMUNITY REGIONAL MEDICAL CENTER (COMMUNITY REGIONAL), WHICH ALSO OPERATES ONE OF THE BUSIEST HOSPITAL EMERGENCY DEPARTMENTS IN THE NATION.BOARD OF TRUSTEES: CHS IS GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES COMPRISED OF LOCAL CIVIC LEADERS AND PHYSICIANS. THE TRUSTEES PROVIDE VISION AND POLICY DIRECTION. THIS PROCESS INCLUDES AN ANNUAL REVIEW OF THE PRIOR FISCAL YEAR AND A COMMUNITY-NEEDS EVALUATION TO PRIORITIZE OPERATIONAL ISSUES AND PROVIDE DIRECTION. THE CORPORATE BOARD IS ALSO ACTIVELY INVOLVED IN APPROVING FISCAL APPROPRIATIONS FOR COMMUNITY BENEFITS PROGRAMS, OUTREACH SERVICES AND EDUCATION, AS WELL AS TRADITIONAL CHARITY CARE AND UNPAID COSTS OF PUBLIC PROGRAMS FOR THE MEDICALLY UNDERSERVED. CORPORATE BOARD MEMBERS, PHYSICIANS AND COMMUNITY'S LEADERSHIP TEAM HAVE HELPED IDENTIFY AND FUND COMMUNITY BENEFITS PROGRAMS. PART VI, LINE 5: CHS'S COMMITMENT TO COMMUNITY BENEFIT IS DEMONSTRATED AT EVERY LEVEL OF THE ORGANIZATION. EVIDENCE OF OUR MISSION IS THE CONTINUAL INVESTMENT IN IMPROVING THE HEALTH OF THOSE WE SERVE AND IN THE COMMUNITY THAT OUR MORE THAN 10,000 EMPLOYEES, PHYSICIANS AND VOLUNTEERS. AN INTEGRAL PART OF OUR MISSION IS OUR PATIENT POPULATION THAT INCLUDES MORE THAN 54,700 ADMISSIONS, 204,458 OUTPATIENT VISITS AND 159,500 EMERGENCY DEPARTMENT VISITS EQUALING MORE THAN 418,000 PATIENTS TO WHOM WE PROVIDED QUALITY MEDICAL CARE. OVER THE PAST TWO DECADES, NO OTHER HOSPITAL ORGANIZATION IN THE SAN JOAQUIN VALLEY HAS INVESTED MORE TO ENSURE HEALTHCARE ACCESS TO ALL PEOPLE OF THIS GROWING REGION.THE BOARD OF TRUSTEES REVIEWS THE COMMUNITY NEEDS ASSESSMENT, THE ANNUAL COMMUNITY BENEFIT REPORT AND OUR IMPACT ON THE AREAS OF GREATEST NEED. SENIOR MANAGEMENT ENCOURAGES INITIATIVES TO EXPAND ACCESS TO HEALTHCARE SERVICES IN OUR COMMUNITY AND IS COMMITTED TO INVESTING IN AND PARTNERING WITH LOCAL, NON-PROFIT ORGANIZATIONS WORKING IN SOCIO-ECONOMICALLY DISADVANTAGED NEIGHBORHOODS AND RURAL POPULATIONS. A MULTI-STAKEHOLDER COMMITTEE ENSURES THE BOARD AND SENIOR MANAGEMENT DIRECTIVES ARE FULFILLED AND APPROVES FINANCIAL ALLOCATIONS TO COMMUNITY BENEFIT PROGRAMS, OUTREACH AND EDUCATION.MANY CHS LEADERS AND STAFF MEMBERS PARTICIPATE IN A WIDE ARRAY OF COMMUNITY-SERVICE ORIENTED GROUPS, EXTENDING OUR COMMUNITY BENEFIT OUTREACH FAR BEYOND DOLLARS INVESTED. COMMUNITY BENEFIT AND COMMUNITY SERVICE ARE AT THE HEART OF OUR HEALTHCARE SYSTEM. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 FAMILY HEALTHCARE NETWORK 305 W CENTER AVE VISALIA CA 93291 942525145 501(C)(3) 500000 TRANSITION GRANT FRESNO RESCUE MISSION INC PO BOX 1422 FRESNO CA 93716 941279785 501(C)(3) 85167 DONATION FOR HOMELESS RESPITE CARE 2 0 PART I, LINE 2: THE ORGANIZATION DOES NOT HAVE A GRANT PROCEDURE FOR MONITORING THE USE OF FUNDS. X 1 1 X X X X 1 1 0 1 1 1 1 0 0 TIM JOSLIN - FORMER PRESIDENT CHIEF EXECUTIVE OFFICER THRU 07/20 0 479023 0 0 0 4162420 0 12116 0 10664 0 4664223 0 2051436 CRAIG CASTRO - PRESIDENT CHIEF EXECUTIVE OFFICER 0 1127335 0 172000 0 223846 0 893747 0 22669 0 2439597 0 98870 CRAIG WAGONER EVP, CHIEF OPERATING OFFICER 0 846375 0 299561 0 213724 0 17100 0 14410 0 1391170 0 92490 THOMAS UTECHT SVP, CHIEF QUALITY OFFICER 630497 0 203199 0 104181 0 19950 0 21523 0 979350 0 63736 0 JOSEPH NOWICKI SVP, CORPORATE CFO THRU 12/20 0 628095 0 177361 0 129866 0 17100 0 18807 0 971229 0 67152 ALDO DE LA TORRE SVP, NETWORK DEVELOPMENT 0 533818 0 191521 0 147174 0 14250 0 21197 0 907960 0 63055 CARLA MILTON SVP, HUMAN RESOURCES 0 452929 0 153690 0 62313 0 17100 0 18226 0 704258 0 47160 CHRISTOPHER NEUMAN SVP, CHIEF OPERATING OFFICER 483160 0 112694 0 2535 0 14250 0 21026 0 633665 0 0 0 TRACY KIRITANI CHIEF FINANCIAL OFFICER 448784 0 83698 0 56695 0 22800 0 7908 0 619885 0 0 0 BRIANNE L MARRIOTT SVP, CHIEF LEGAL OFFICER 0 391878 0 150001 0 29221 0 14250 0 18021 0 603371 0 0 WANDA HOLDERMAN - SVP CHIEF CLINICAL INTGT OFFICER THRU 07/20 254235 0 0 0 317976 0 15404 0 9251 0 596866 0 53741 0 JEFFREY THOMAS - CHIEF MEDICAL & QUALITY OFFICER - CRMC 457329 0 86065 0 2424 0 14250 0 18232 0 578300 0 0 0 DEBORAH MOFFETT - VP FINANCE INTERIM CFO/VICE FINANCIAL OFFICER 0 331522 0 72572 0 7225 0 22800 0 7625 0 441744 0 0 PATRICK T RAMIREZ SVP, COMMUNITY PROVIDER NETWORK 0 290752 0 73823 0 10649 0 14250 0 20391 0 409865 0 0 JUANITA HERNANDEZ - VICE SECRETARY/DIRECTOR, CORP GOVERNANCE 0 182399 0 38264 0 16208 0 14226 0 15251 0 266348 0 0 ROBYNN L VAN PATTEN - FORMER SVP, CHIEF LEGAL OFFICER THRU 06/19 0 0 0 0 0 244526 0 0 0 10766 0 255292 0 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR THOMAS UTECHT. THIS IS INCLUDED IN TAXABLE COMPENSATION. PART I, LINES 4A-B LINE 4A: TIM JOSLIN AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, ENTERED INTO A SEVERANCE AGREEMENT WHEREBY MR. JOSLIN WILL RECEIVE 52 BIWEEKLY PAYMENTS FOR $34,616 BEGINNING 07/18/2020 AND ENDING 07/02/2022. WANDA HOLDERMAN AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, ENTERED INTO A SEVERANCE AGREEMENT WHEREBY MS. HOLDERMAN WILL RECEIVE 39 BIWEEKLY PAYMENTS OF $17,705 BEGINNING 08/01/2020 AND ENDING 01/15/2022. LINE 4B: DURING THE YEAR, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, MADE A CONTRIBUTION OF $873,797 TO A SERP PLAN FOR CRAIG CASTRO. LINE 4B: DURING THE YEAR, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION, MADE THE FOLLOWING DISTRIBUTIONS FROM THE SERP PLAN FOR THE FOLLOWING INDIVIDUALS: - CRAIG CASTRO $98,870 - ALDO DE LA TORRE $63,055 - WANDA HOLDERMAN $53,741 - TIM JOSLIN $2,051,436 - CARLA MILTON $47,160 - JOSEPH NOWICKI $67,152 - THOMAS UTECHT $63,736 - CRAIG WAGONER $92,490 LINE 4B: SELECT INDIVIDUALS AGREED TO PARTICIPATE IN A CAP-EX PLAN. SEE SCHEDULE L, PART V FOR A BROADER DESCRIPTION. PART I, LINE 5 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA, A RELATED ORGANIZATION'S EXECUTIVE INCENTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD KEY MEMBERS OF THE EXECUTIVE TEAM FOR MEETING SPECIFIC AND MEASURABLE GOALS AT THE HEALTH SYSTEM AND INDIVIDUAL LEVELS. THE MAIN OBJECTIVES ARE: - MOTIVATE EXECUTIVES AND REWARD THEM FOR IMPROVING CHS'S OPERATIONAL PERFORMANCE; - INCREASE COMMUNITY INVOLVEMENT AND EFFECTIVENESS; - INCREASE EXECUTIVE COMMITMENT TO CHS'S SHORT AND LONG TERM GOALS; - PROVIDE EXECUTIVES WITH COMPETITIVE BUT REASONABLE COMPENSATION; - AND ATTRACT AND RETAIN HIGHLY TALENTED EXECUTIVES THAT ARE CRITICALLY IMPORTANT TO THE SUCCESS OF THE ORGANIZATION. PART I, LINE 6 SEE RESPONSE FOR QUESTION 5. A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TVWO 2015-07-01 128617535 CONSTRUCTION & REFUNDING 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TS20 2017-02-01 429863267 CONSTRUCTION & REFUNDING 0 0 0 A 12467535 128617535 1793836 50000000 76823699 2015 0 1 1 1 B 66915457 430205457 2780950 50342190 377082317 2018 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, COLUMN F: ROW A: SERIES 2015 BONDS REFUNDED A PORTION OF THE SERIES 2007 BONDS OUTSTANDING WITH A PAR AMOUNT OF $74,025,000. ROW B: SERIES 2017 REFUNDED THE FOLLOWING: REFUNDED A PORTION OF THE SERIES 2007 BONDS OUTSTANDING WITH A PAR AMOUNT OF $213,100,000; SERIES BONDS 2009 PAR AMOUNT $182,365,000. SCHEDULE K, PART II, LINE 3: COLUMN B: TOTAL PROCEEDS OF ISSUE = ISSUE PRICE + PROJECT FUND EARNINGS OF $342,190. SCHEDULE K COMBINED SUPPLEMENTAL INFORMATION: THE ORGANIZATION AND COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA HAVE ESTABLISHED AN OBLIGATED GROUP TO ACCESS CAPITAL MARKETS. THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY LIABLE FOR LONG-TERM DEBT OUTSTANDING UNDER THE OBLIGATED GROUPS MASTER TRUST INDENTURE. THE ORGANIZATION IS THE PRIMARY BENEFICIARY OF THE TAX-EXEMPT BOND PROCEEDS AND FILES SCHEDULE K FOR THE BENEFIT OF ALL MEMBERS OF THE OBLIGATED GROUP. TIM JOSLIN FORMER OFFICER/KEY EMPLOYEE SPLIT INTEREST INSURANCE X 5789822 5988385 0 1 1 CRAIG CASTRO OFFICER SPLIT INTEREST INSURANCE X 2630651 2721102 0 1 1 JOSEPH NOWICKI OFFICER SPLIT INTEREST INSURANCE X 1382253 1429780 0 1 1 CRAIG WAGONER KEY EMPLOYEE SPLIT INTEREST INSURANCE X 986225 1020135 0 1 1 ALDO DE LA TORRE KEY EMPLOYEE SPLIT INTEREST INSURANCE X 1795318 1830961 0 1 1 CARLA MILTON KEY EMPLOYEE SPLIT INTEREST INSURANCE X 706907 731213 0 1 1 ROBYNN VAN PATTEN FORMER KEY EMPLOYEE SPLIT INTEREST INSURANCE X 690388 714126 0 1 1 BRIANNE L MARRIOTT KEY EMPLOYEE SPLIT INTEREST INSURANCE X 823753 833488 0 1 1 PATRICK RAMIREZ KEY EMPLOYEE SPLIT INTEREST INSURANCE X 1020019 1027575 0 1 1 16296765 MATTHEW JOSLIN FAMILY MEMBER OF T. JOSLIN, AN OFFICER OF FCH&MC. 251627 SALARIES AND WAGES 0 CHRIS-ANN VENUGOPAL FAMILY MEMBER OF C. VENUGOPAL, MD, A MEMBER OF FCH&MC'S BOARD OF TRUSTEES 182191 SALARIES AND WAGES 0 REBECCA HAMBALEK FAMILY MEMBER OF R. QUINTO, A MEMBER OF FCH&MC'S BOARD OF TRUSTEES 13913 SALARIES AND WAGES 0 ADVANCE LAPAROSCOPIC SURGERY ASSOCIATES 35% CONTROLLED ENTITY OF K. BOONE, A MEMBER OF FCH&MC'S BOARD OF TRUSTEES 716394 MEDICAL DIRECTORSHIP AND ON-CALL SERVICES 0 PART II: (C) PURPOSE OF LOAN:THE ORGANIZATION HAS ENTERED INTO COLLATERAL ASSIGNMENT SPLIT DOLLAR AGREEMENTS WITH THE PERSONS LISTED ON SCHEDULE L, PART II UNDER TREAS. REG. SECTION 1.7872-15(E)(5)(II). THE ORGANIZATION HAS INVESTED AMOUNTS LISTED IN COLUMN (E) INTO THE PLANS AND IS ENTITLED TO RECEIVE A RETURN OF THESE FUNDS, PLUS AN INTEREST RATE UPON THE DEATH OF THE NAMED PERSON. FORM 990, PART I, LINE 6: DUE TO THE COVID-19 PANDEMIC, THERE WERE FEWER VOLUNTEERS FOR FISCAL YEAR 2021 DUE TO RESTRICTIONS FOR ADDITIONAL NON-ESSENTIAL PERSONNEL IN THE HOSPITAL'S FACILITIES. HEADING, BOX C: OTHER DBAS USED: BOB SMITTCAMP FAMILY NEUROSCIENCE INSTITUTE CENTRAL CALIFORNIA HEART INSTITUTE CLOVIS COMMUNITY CENTER FOR WOUND HEALING CLOVIS COMMUNITY MEDICAL CENTER COMMUNITY BEHAVIORAL HEALTH CENTER COMMUNITY CANCER INSTIUTE COMMUNITY DIALYSIS CENTER - CLOVIS COMMUNITY DIALYSIS CENTER - FRESNO COMMUNITY HEALTH CENTER - SIERRA COMMUNITY HEALTH SYSTEM COMMUNITY HOME CARE COMMUNITY MEDICAL CENTERS COMMUNITY PROVIDER NETWORK COMMUNITY REGIONAL MEDICAL CENTER COMMUNITY SUBACUTE AND TRANSITIONAL CARE CENTER DERAN KOLIGIAN AMBULATORY CARE CENTER DIABETES CARE CENTER OF FRESNO FRESNO HEART AND SURGICAL HOSPITAL UNIVERSITY MEDICAL CENTER FORM 990, PART V, LINES 1 & 2: COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA IS THE COMMON PAYMASTER FOR THE ORGANIZATION, COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA FOUNDATION, COMMUNITY HEALTH PARTNERS, AND ITSELF. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY HOSPITALS OF CENTRAL CALIFORNIA (CHCC) IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A CHCC IS THE SOLE MEMBER OF FCH&MC. IT HAS THE SOLE AND EXCLUSIVE RIGHT TO APPOINT ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CHCC IS THE SOLE MEMBER OF THIS ENTITY. AS SUCH, IT HAS THE RIGHTS OF MEMBERS CONFERRED BY CHAPTER 3 OF THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW, SECTIONS 5310-5354, WHICH INCLUDES THE RIGHTS TO APPROVE AMENDMENTS TO THE ARTICLES, BYLAWS AND SALE OF ASSETS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE MOST RECENT AMENDED ARTICLES OF INCORPORATION PROVIDES THAT UPON DISSOLUTION ALL REMAINING ASSETS WILL BE DISTRIBUTED TO CHCC OR ITS SUCCESSOR. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF AN INITIAL REVIEW BY SENIOR MANAGEMENT, THE FORM IS REVIEWED AT A MEETING OF THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE FINALIZED FORM 990 THEN BECOMES A RECORD OF THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF COMMITTEE WITH BOARD DELEGATED POWERS SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER COMMITTEE WITH BOARD DELEGATED POWERS ALSO COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT PRIOR TO THE ASSIGNMENT OF THEIR DUTIES AND THEREAFTER ON AN ANNUAL BASIS. THE STATEMENT ASKS SPECIFIC QUESTIONS THAT WOULD DETERMINE IF THERE ARE CONFLICTS OF INTERESTS. CHS'S CHIEF ETHICS & COMPLIANCE OFFICER, AND CHIEF LEGAL OFFICER REVIEW THE RESPONSES AND DETERMINE WHETHER THERE IS A CONFLICT BASED ON POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE DIRECTOR, PRINCIPAL OFFICER, OR MEMBER COMMITTEE WITH BOARD DELEGATED POWERS WILL BE REMOVED FROM DECISION MAKING AS IT PERTAINS TO THAT CONFLICT. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. THE PERIODIC REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS-LENGTH BARGAINING; 2) WHETHER ARRANGEMENTS FOR PHYSICIAN AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; 3) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT; AND 4) WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15A: CHCC, THE SOLE MEMBER OF FCH&MC, ESTABLISHES COMPENSATION FOR THE CEO. FORM 990, PART VI, SECTION B, LINE 15 RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION RESTS WITH THE BOARD'S EXECUTIVE COMPENSATION SUBCOMMITTEE. THE COMMITTEE WILL "CONSIDER ALL MATTERS INVOLVING COMPENSATION AND BENEFITS OF (I) CORPORATE OFFICERS WHO ARE CLASSIFIED AS "DISQUALIFIED PERSONS" PURSUANT TO INTERNAL REVENUE CODE SECTION 4958; (II) ALL OTHER CORPORATE OFFICERS WHO ARE SENIOR VICE PRESIDENTS AND EXECUTIVE VICE PRESIDENTS AND (III) THE PRESIDENT/CHIEF EXECUTIVE OFFICER." THROUGH THE EXECUTIVE COMPENSATION SUBCOMMITTEE, THE BOARD HAS ENGAGED SULLIVAN, COTTER AND ASSOCIATES, INC. TO CONDUCT A TOTAL COMPENSATION REVIEW FOR THOSE INDIVIDUALS IDENTIFIED IN THEIR SCOPE OF RESPONSIBILITY WHICH INCLUDED THE USE OF COMPARABILITY DATA AND DOCUMENTATION OF THE FINDINGS REPORTED TO THE COMMITTEE. THIS PROCESS WAS MOST RECENTLY COMPLETED IN OCTOBER, 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 201,391,883. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 201,391,883. MD SUPERVISORY FEES: PROGRAM SERVICE EXPENSES 12,317,008. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,317,008. CONSULTING & MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 218,373. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 218,373. MEDICAL PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 14,641,207. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,641,207. LINEN SERVICES: PROGRAM SERVICE EXPENSES 3,366,674. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,366,674. AMBULANCE SERVICE: PROGRAM SERVICE EXPENSES 3,666,361. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,666,361. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 65,609,513. MANAGEMENT AND GENERAL EXPENSES 12,497,050. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,106,563. 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