2020-07-15T14:03:35-05:00 2019-06-30 420714325 RSM US LLP 6 S PATTERSON BLVD DAYTON OH 45402 990 2018-07-01 310672132 DAYTON CHILDREN'S HOSPITAL DAYT 9376413000 ONE CHILDRENS PLAZA DAYTON OH 454041815 CHRIS BERGMAN VP FINANCE AND CFO 9376413000 2020-07-14 1 KAREN O CRIM P00368385 9372980201 2020-07-14 66.98.98.6 2020-07-14 18:46:09 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 562A18F8DC23C297E42EF16009230818801A988B 2018 2021-01-29 14:40:06Z DEBORAH FELDMAN ONE CHILDRENS PLAZA DAYTON OH 454041815 555464309 0 X WWW.CHILDRENSDAYTON.ORG X 1967 OH THE RELENTLESS PURSUIT OF OPTIMAL HEALTH FOR EVERY CHILD WITHIN OUR REACH. 18 16 3851 883 0 0 12341969 5993620 324875357 336893920 24607256 21831466 2828364 11491744 364652946 376210750 445628 96500 0 0 207982427 230299515 0 0 3027610 162676776 168001006 371104831 398397021 -6451885 -22186271 941142295 921744349 212323946 230554948 728818349 691189401 X TO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH SERVICE, EDUCATION, RESEARCH AND ADVOCACY. 0 0 322123404 96500 338330377 DAYTON CHILDREN'S HOSPITAL IS A PEDIATRIC HOSPITAL LOCATED IN DOWNTOWN DAYTON, OHIO. THE HOSPITAL AND ITS STAFF ARE COMMITTED TO SERVING AS AN ADVOCATE FOR THE CHILDREN AND THEIR FAMILIES IN THE MIAMI VALLEY THROUGH A VARIETY OF DIFFERENT PROGRAMS. IT OFFERS INPATIENT, OUTPATIENT AND ANCILLARY SERVICES TO THE CHILDREN IN THE SURROUNDING 20 COUNTIES. SERVICES ARE PROVIDED TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. FOR THE FISCAL YEAR ENDING JUNE 30, 2019, THE HOSPITAL'S MIX OF PATIENTS WAS 54.8% MEDICAID, 38.2% COMMERCIAL, 4.1% OTHER GOVERNMENT PROGRAMS AND 2.8% SELF PAY. THE HOSPITAL PROVIDES A LEVEL III NEONATAL NURSERY FOR PREMATURE NEWBORNS AS WELL AS CRITICAL CARE AND GENERAL PEDIATRIC INPATIENT BEDS. A 24 HOUR EMERGENCY DEPARTMENT IS AVAILABLE TO ALL CHILDREN IN THE AREA. SOME OF THE SPECIALTIES OFFERED AT THE HOSPITAL ARE NEUROSURGERY, HEMATOLOGY/ONCOLOGY, PULMONARY, GASTROENTEROLOGY, NEUROLOGY, UROLOGY, DEVELOPMENTAL DISORDERS, PSYCHOLOGY, PSYCHIATRY, ENDOCRINOLOGY, GENETICS, CARDIOLOGY, ORTHOPEDICS AND GENERAL SURGERY. WITHOUT DAYTON CHILDREN'S HOSPITAL, MANY CHILDREN IN THE AREA WOULD HAVE TO TRAVEL A GOOD DISTANCE TO RECEIVE THESE SERVICES. THE HOSPITAL ALSO OFFERS A PEDIATRIC RESIDENCY PROGRAM THAT TRAINS NEW PEDIATRICIANS WHO WILL CARE FOR THE NEXT GENERATION OF CHILDREN. DAYTON CHILDREN'S ALSO SPONSORS MANY COMMUNITY EVENTS WHERE CHILDREN'S HEALTH AND SAFETY ARE PROMOTED. SOME STATISTICS FOR THE FISCAL YEAR ENDING JUNE 30, 2019 ARE AS FOLLOWS # OF BEDS 181, INPATIENT DAYS 27,358, ADMISSIONS 5,148. AVERAGE LENGTH OF STAY 5.35 DAYS. AVERAGE DAILY CENSUS 101.2, OCCUPANCY RATE 60%, SURGERIES PERFORMED 12,768, X-RAY STUDIES 48,198, LAB TEST 605,834, RESPIRATORY THERAPY PROCEDURES 94,441, PHARMACY DOSES DISPENSED 760,817, CARDIOLOGY PROCEDURES 20,307, NEUROLOGY PROCEDURES 3,822, URGENT CARE VISITS 23,163, EMERGENCY DEPARTMENT VISITS 96,817, OUTPATIENT CLINICS 216,581. 322123404 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 484 0 1 3851 1 0 1 BD 0 0 0 1 1 0 0 0 0 0 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X CHRIS BERGMAN 9376415819 ONE CHILDRENS PLAZA DAYTON OH 45404 LAURENCE KLABEN CHAIRMAN 1.00 X X 0 0 0 VIPUL PATEL MD BEG 102018 CHAIR ELECT 1.00 X X 0 0 0 MATTHEW HARDWICK MD CHIAR ELECT 1.00 X X 0 0 0 LINDA BLACK-KUREK VICE CHAIR 1.00 X X 0 0 0 JAMES WHALEN SECRETARY/TREASURER 1.00 X X 0 0 0 MICHAEL MCQUISTON ASST SECRETY/TREASURER 1.00 X X 0 0 0 MAMLE ANIM MD BEG 2018 TRUSTEE 1.00 X 0 0 0 CLINTON BROWN TRUSTEE 1.00 X 0 0 0 MARK CHILSON TRUSTEE 1.00 X 0 0 0 JOHN DUBY MD TRUSTEE 1.00 X 0 0 0 GREGORY EBERHART MD END 102018 TRUSTEE 1.00 X 0 0 0 JACQUELINE GAMBLIN TRUSTEE 1.00 X 0 0 0 TIFFANY KELLNER TRUSTEE 1.00 X 0 0 0 THOMAS KRZMARZICK MD TRUSTEE 1.00 X 0 0 0 JAMIE MCGREGOR TRUSTEE 1.00 X 0 0 0 TIMOTHY PEPPER END 519 TRUSTEE 1.00 X 0 0 0 TODD PLEIMAN BEG 2018 TRUSTEE 1.00 X 0 0 0 MICHAEL SHANE END 419 TRUSTEE 1.00 X 0 0 0 BEVERLY SHILLITO END 102018 TRUSTEE 1.00 X 0 0 0 CHRISTINE SOWARD TRUSTEE 1.00 X 0 0 0 ADAM MEZOFF MD CMO 40.00 X 635391 0 33705 DEBORAH FELDMAN CEO 40.00 X X 812913 0 713717 CHRIS BERGMAN CFO 40.00 X 476691 0 24226 BENJAMIN GOODSTEIN VP AND CHIEF AMBULATORY OFFICER 40.00 X 271472 0 23476 JAYNE GMEINER VP AND CHIEF NURSING OFFICER 40.00 X 288858 0 20027 MATTHEW GRAYBILL VP HR AND CHIEF ADMINISTRA 40.00 X 340725 0 208051 KELLY KAVANAUGH VP AND CHIEF STRATEGY OFFI 40.00 X 267994 0 72546 NANCY SEVERT MANAGER - IMPATIENT PHARMACY 40.00 X 314840 0 15937 DAVID MILLER FORMER CFO (END 1/16) 0.00 X 294997 0 0 3703881 0 1111685 9 1 1 0 SHOOK CONSTRUCTION 4977 NORTHCUTT PL DAYTON OH 45414 CONSTRUCTION SERVICES 6171588 RSM US LLP 6 S PATTERSON BLVD DAYTON OH 45402 CONSULTING AND TAX SERVICES 1308237 CHILDREN'S EMERGENCY SERV 1 CHILDRENS PLAZA DAYTON OH 45404 PHYSICIAN SERVICES 1243411 STRATA DECISIONS TECHNOLOGY LLC 200 E RANDOLPH STREET 49TH FLOOR CHICAGO IL 60601 CONSULTING SERVICES AND SUPPORT FOR IT P 1042293 BIOFIRE DIAGNOSTICS LLC 515 COLOROW WAY SALT LAKE CITY UT 84108 MEDICAL SUPPLIES 906535 47 2458220 3535400 5993620 PATIENT SERVICE REVENUE 624100 199100962 199100962 MEDICARE/MEDICAID 624100 137792958 137792958 336893920 10122728 10122728 461890 471552 -9662 -9662 -9662 189895449 15350 178202061 0 11693388 15350 11708738 15350 11693388 638476 579946 58530 58530 REBATES 900099 6158418 6158418 CAFETERIA/KIDS CARE 900099 2332145 2332145 CHILD CARE CENTER 812930 910440 910440 2041873 1421107 620766 11442876 376210750 338330377 0 31886753 96500 96500 1993657 1993657 180073757 151906528 26649506 1517723 13262985 11065868 2086556 110561 21409485 17862837 3368177 178471 13559631 11313372 2133225 113034 1011765 1011765 350955 350955 178930 178930 1316281 1316281 26667617 16550052 9759095 358470 740859 740859 9916155 6141585 3476345 298225 11174331 8808092 2186018 180221 6131951 3373857 2739040 19054 1226611 704991 464147 57473 3875750 3875750 35701604 34812222 708652 180730 1931931 1931931 MEDICAL SUPPLIES AND DR 44187993 42094419 2083782 9792 BAD DEBT EXPENSE 15655122 15655122 STATE HOSPITAL ASSESSME 6274856 0 6274856 0 REPAIRS AND MAINTENANCE 1658295 1559029 95410 3856 398397021 322123404 73246007 3027610 77513 16156504 10002651 298581 221375 298888 78494029 75129446 5653234 6185058 4110591 4203711 567109671 161778994 358860156 405330677 324737595 263704040 130675127 124864759 26540462 23948088 1769562 1624597 941142295 921744349 17270830 16056262 151894138 151937717 10415000 10415000 32743978 52145969 212323946 230554948 X 727527945 689981054 1290404 1208347 728818349 691189401 941142295 921744349 X -22186271 -2281349 -13161328 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 105061 1 21890 1 51979 0 178930 0 PART II-B, LINE 1: LINE 1F: OHIO HOSPITAL ASSOCIATION $3,478 OHIO CHILDREN'S HOSPITAL ASSOCIATION $42,245 CHILDREN'S HOSPITAL ASSOCIATION $46,711 DAYTON DEV COALITION $12,300 DAYTON AREA CHAMBER OF COMMERCE $327 TOTAL $105,061 LINE 1G: MANAGEMENT TIME $21,890 DAYTON CHILDREN'S SPENDS TIME TRACKING SPECIFIC LEGISLATION THAT IS OF INTEREST TO PEDIATRIC HEALTH ISSUES. THEY PROVIDE SUGGESTIONS AND FEEDBACK TO LOCAL, STATE AND FEDERAL LEGISLATURES. THEIR MAIN FOCUS CONCERNS MEDICAID, CHILDREN'S SPECIFIC HEALTH ISSUES AND MEDICAL EDUCATION FUNDING. LINE 1H: CONSULTING EXPENSE $51,979 TOTAL LINE 1J : $178,930 1601373 21 80760 1520634 183912987 760296 640717 3340064 180372563 1601373 167616099 106014 22473043 6271797 10372 183912987 168335550 9088944 -3634804 6153591 20000 167616099 172836657 3053446 -1954780 5599773 168335550 1.00000 0 1 1 23234081 23234081 169079439 40378005 128701434 312003561 102134087 209869474 62792590 19266902 43525688 405330677 HEDGE FUNDS 65627519 F LIMITED PARTNERSHIP 35260690 F PRIVATE EQUITY 23976550 F 124864759 DEFERRED COMP PAYABLE 13794787 PENSION LIABILITIES 34374907 OTHER RECEIVABLES 3976275 52145969 X PART X, LINE 2: ALL SUBSIDIARIES OF THE HOSPITAL, EXCEPT DAYTON CHILDREN'S SPECIALTY PEDIATRICS, AND SELECTED JOINT VENTURE ENTITIES, ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE WHOLLY OWNED FOR-PROFIT SUBSIDIARIES DAYTON CHILDREN'S SPECIALTY PEDIATRICS HAD NO TAXABLE INCOME IN 2019 OR 2018. THE PROVISION FOR INCOME TAXES FOR THE JOINT VENTURE ENTITIES IS NOT SIGNIFICANT TO THE HOSPITAL. THE HOSPITAL COMPLETED AN ANALYSIS OF ITS UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2019 OR 2018. THE TAX CUTS AND JOBS ACT (THE ACT) WAS ENACTED ON DECEMBER 22, 2017. THE PRIMARY IMPACT IN 2018 ON THE HOSPITAL WAS THE ACT REDUCED THE U.S. FEDERAL CORPORATE TAX RATE FROM 35% TO 21% WHICH REQUIRED A REMEASUREMENT OF THE HOSPITAL'S DEFERRED TAXES. FOR TAX-EXEMPT ENTITIES, EFFECTIVE BEGINNING IN THE 2018 TAX YEAR, THE ACT ALSO REQUIRES ORGANIZATIONS TO CATEGORIZE CERTAIN FRINGE BENEFIT EXPENSES AS A SOURCE OF UNRELATED BUSINESS INCOME, PAY AN EXCISE TAX ON REMUNERATION ABOVE CERTAIN THRESHOLDS THAT IS PAID TO EXECUTIVES BY THE ORGANIZATION, AND REPORT INCOME OR LOSS FROM UNRELATED BUSINESS ACTIVITIES ON AN ACTIVITY-BY-ACTIVITY BASIS, AMONG OTHER PROVISIONS. AT JUNE 30, 2018, THE HOSPITAL HAS MADE A REASONABLE ESTIMATE OF THE TAX EFFECTS OF THE ENACTMENT OF THE ACT AND REMEASURED ITS DEFERRED TAX BALANCES, WHICH DID NOT HAVE A MATERIAL IMPACT ON THE HOSPITAL AS ALL DEFERRED TAX BALANCES ARE OFFSET BY A FULL VALUATION ALLOWANCE. THE HOSPITAL DID NOT RECORD ANY MATERIAL CHANGES TO ITS JUNE 30, 2018, ESTIMATES IN 2019. ADDITIONALLY, THE HOSPITAL DID NOT RECORD ANY MATERIAL AMOUNTS DURING THE YEAR ENDED JUNE 30, 2019, RELATED TO THE NEW REQUIREMENTS UNDER THE ACT. SUPPLEMENTAL INFORMATION THE ENDOWMENTS ARE HELD BY DAYTON CHILDREN'S HOSPITAL FOUNDATION, A SUBSIDIARY OF DAYTON CHILDREN'S HOSPITAL. THE FUNDS ARE USED EXCLUSIVELY TO SUPPORT DAYTON CHILDREN'S HOSPITAL AND ITS SUBSIDIARIES. THE INTENDED USE OF THE FUNDS IS TO SUPPORT MEDICAL RESEARCH, THE CHILD LIFE PROGRAM AND THE MEDICAL CHAIRS OF SPECIFIC HOSPITAL DEPARTMENTS. CENTRAL AMERICA/CARIBBEAN 1 2 INVESTMENTS.LIST 59 _ 3E059932 - 03/24/19 13:26 PM WORKSHEET SCHEDULE F - STATEMENT OF ACTIVITIES OU 104447210 CENTRAL AMERICA/CARIBBEAN 1 2 PROGRAM SERVICE SELF INSURANCE 2216263 EAST ASIA AND THE PACIFIC - AUSTRALIA, BRUNEI, BURMA, CAMBODIA, 0 0 INVESTMENTS 406783 NORTH AMERICA - CANADA AND MEXICO, BUT NOT THE UNITED STATES 0 0 INVESTMENTS 920261 SOUTH AMERICA - ARGENTINA, BOLIVIA, BRAZIL, CHILE, COLUMBIA, ECUADOR, 0 0 INVESTMENTS 5175 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 0 INVESTMENTS 2498554 MIDDLE EAST AND NORTH AFRICA - ALGERIA, BAHRAIN, DJIBOUTI, EGYPT, 0 0 INVESTMENTS 66846 2 4 0 0 2 4 110561092 0 110561092 1 0 1 0 0 0 1 1 X 1 X 1 X 1 1 1 0 1 1 537783 537783 0.00140 175733899 130719483 45014416 0.11760 176271682 130719483 45552199 0.11900 1492424 1492424 0.00390 2743947 1429905 1314042 0.00340 46192716 13324677 32868039 0.08590 194603 194603 0.00050 50623690 14754582 35869108 0.09370 226895372 145474065 81421307 0.21270 336280 336280 0.00090 17738 17738 0.00000 3483 3483 0.00000 357501 357501 0.00090 0 7356760 642871 642871 X 1 1 1 1 DAYTON CHILDREN'S HOSPITAL 1 CHILDRENS PLAZA DAYTON OH 454041815 WWW.CHILDRENSDAYTON.ORG 020035650 X X X X X DAYTON CHILDREN'S HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE PART V, SECTION C X 1 16 1 SEE PART V, SECTION C 0 1 X 100.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X 1 X 0 0 DAYTON CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5: PURSUING THE OPTIMAL HEALTH OF ALL CHILDREN IS THE MISSION OF DAYTON CHILDREN'S HOSPITAL. TO HELP DEVELOP MEANINGFUL AND IMPACTFUL COMMUNITY ENGAGEMENT AND CHILD HEALTH PROGRAMS, DAYTON CHILDREN'S EVALUATES THE STATUS OF OUR REGION'S PEDIATRIC HEALTH EVERY THREE YEARS THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). DAYTON CHILDREN'S CHNA INCLUDES FEEDBACK FROM THE GROUPS CONVENED BY THE HOSPITAL INCLUDING COMMUNITY MEMBERS, EXPERTS IN PUBLIC HEALTH AND CLINICAL PRACTITIONERS, AND INCLUDES DATA REGARDING THE HEALTH NEEDS OF VULNERABLE PEDIATRIC POPULATIONS, THOSE WITH CHRONIC ILLNESSES, AS WELL AS HEALTH DISPARITIES AMONG MINORITIES, LOW-INCOME AND MEDICALLY-UNDERSERVED POPULATIONS. OUR MOST CURRENT ASSESSMENT WAS COMPLETED IN JUNE 2017.FUNDED BY THE DAYTON CHILDREN'S FOUNDATION BOARD, GUIDED BY THE DAYTON CHILDREN'S BOARD OF TRUSTEES COMMUNITY BENEFIT COMMITTEE, AND ADOPTED BY THE DAYTON CHILDREN'S BOARD OF TRUSTEES, THE NEEDS ASSESSMENT UNCOVERS THE HIGHEST PRIORITY CHILD HEALTH AND SAFETY ISSUES. AS THE REGIONAL LEADER IN CHILDREN'S HEALTH, DAYTON CHILDREN'S CONDUCTS THE ASSESSMENT TO PROVIDE COMMUNITY HEALTH ADVOCATES INSIGHTS INTO THE HEALTH AND WELL-BEING OF OUR REGION'S CHILDREN AND TO SET A ROBUST AGENDA TO IMPROVE CHILDREN'S HEALTH. THE ASSESSMENT OFFERS A PATH TO WORK TOGETHER TO DEVELOP OR REFINE PROGRAMS TO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH COMMUNITY BENEFIT INVESTMENTS.TO CONDUCT THE 2017 CHNA AND CRAFT THE IMPLEMENTATION PLAN, DAYTON CHILDREN'S CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO COLLECT THE DATA, GUIDE THE HEALTH ASSESSMENT PROCESS, AND INTEGRATE SOURCES OF PRIMARY AND SECONDARY DATA INTO THE FINAL REPORT. THIS COMMUNITY HEALTH ASSESSMENT WAS CROSSSECTIONAL IN NATURE AND INCLUDED A WRITTEN SURVEY OF PARENTS WITHIN THE GREATER DAYTON AREA. FROM THE BEGINNING, COMMUNITY LEADERS AND PUBLIC HEALTH PARTNERS WERE ACTIVELY ENGAGED IN THE PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE STUDY. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID NEEDS ASSESSMENT. THE DAYTON CHILDREN'S CHNA MULTIDISCIPLINARY TEAM REVIEWED THE DATA AND THEN RATED THE NEEDS AGAINST CRITERIA INCLUDING PREVALENCE, SERIOUSNESS (HOSPITALIZATION AND/OR DEATH), IMPACT ON OTHER HEALTH ISSUES, URGENCY, PREVENTION, ECONOMICS/FEASIBILITY, ACCEPTABILITY AND RESOURCES. AFTER GROUP RANKING AND DISCUSSION, THE PRIORITIES OUTLINED IN THE IMPLEMENTATION PLAN WERE ADOPTED. THE HOSPITAL FACILITY ALSO CONSULTED WITH THE FOLLOWING COMMUNITY PARTNERS:CLARK COUNTY COMBINED HEALTH DISTRICTECHO (EMPOWERING CHILDREN WITH HOPE AND OPPORTUNITY) AT THE UNIVERSITY OF DAYTONGREENE COUNTY PUBLIC HEALTHCOMMUNITY HEALTH CENTERS OF GREATER DAYTONHEALTHY COMMUNITIES CONSULTING, LLCLEARN TO EARN DAYTONMIAMI COUNTY PUBLIC HEALTHMIAMI VALLEY CHILD DEVELOPMENT CENTERSMIAMI VALLEY REGIONAL PLANNING COMMISSIONMONTGOMERY COUNTY ADAMHS BOARDMONTGOMERY COUNTY HEALTH AND HUMAN SERVICESMONTGOMERY COUNTY JOB AND FAMILY SERVICES - CHILDREN SERVICE DIVISIONPUBLIC HEALTH - DAYTON & MONTGOMERY COUNTYSINCLAIR COMMUNITY COLLEGE, DIVISION OF HEALTH SCIENCESUNITED WAY OF GREATER DAYTONWARREN COUNTY HEALTH DISTRICTWRIGHT STATE UNIVERSITY DEPARTMENT OF PEDIATRICSWRIGHT STATE UNIVERSITY DEPARTMENT OF POPULATION & PUBLIC HEALTH SCIENCES DAYTON CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11: THE 2017 CHNA POINTED TO KEY AREAS WHERE THE DAYTON COMMUNITY CAN WORK TO IMPROVE THE HEALTH OF CHILDREN.1. MENTAL HEALTH AND ADDICTION (INCLUDES EMOTIONAL WELLBEING, MENTAL ILLNESS CONDITIONS, AND SUBSTANCE ABUSE DISORDERS) 9% OF CHILDREN EXPERIENCED 2 OR MORE ADVERSE CHILDHOOD EXPERIENCES. 19% OF MOTHERS AND 11% OF FATHERS OF 0 TO 5 YEAR OLDS RATED THEIR MENTAL AND EMOTIONAL HEALTH AS LESS THAN GOOD. 2. CHRONIC DISEASE (INCLUDES CONDITIONS SUCH AS HEART DISEASE, DIABETES, ASTHMA, AND RELATED CLINICAL RISK FACTORS SUCH AS OBESITY, HYPERTENSION, AND HIGH CHOLESTEROL, AS WELL AS BEHAVIORS CLOSELY ASSOCIATED WITH THESE CONDITIONS AND RISK FACTORS INCLUDING NUTRITION, PHYSICAL ACTIVITY, AND TOBACCO USE) 50% OF CHILDREN AGES 0 TO 11 WERE CLASSIFIED AS OVERWEIGHT (14%) OR OBESE (36%) BY BODY MASS INDEX (BMI) CALCULATIONS. 9% OF PARENTS WERE TOLD BY A DOCTOR THAT THEIR CHILD HAD ASTHMA. 6% OF PARENTS REPORTED THEIR CHILD WAS EXPOSED TO SECONDHAND SMOKE OR VAPING PRODUCTS AT HOME. 13% OF PARENTS REPORTED EXPERIENCING FOOD INSECURITY, INCREASING TO 19% OF PARENTS WITH A CHILD AGE 0 TO 5 AND 60% OF PARENTS WITH INCOMES LESS THAN $25,000. 3. MATERNAL AND INFANT HEALTH (INCLUDES INFANT AND MATERNAL MORTALITY, BIRTH OUTCOMES, AND RELATED RISK AND PROTECTIVE FACTORS IMPACTING PRECONCEPTION, PREGNANCY, AND INFANCY, INCLUDING FAMILY AND COMMUNITY CONTEXTS) 11% OF PARENTS REPORTED THEIR CHILD WAS BORN PREMATURE, INCREASING TO 21% OF AFRICAN AMERICAN PARENTS. 30% OF PARENTS OF 0 TO 5 YEAR OLDS REPORTED THEIR CHILD WAS NEVER BREASTFED. 41% OF PARENTS OF 0 TO 5 YEAR OLDS REPORTED THEIR CHILD SLEPT IN BED WITH A PARENT OR ANOTHER PERSON AS AN INFANT.THE IMPLEMENTATION PLAN INCLUDES A ROBUST SET OF PRIORITY ACTIONS TO IMPROVE HEALTH OUTCOMES IN THE THREE KEY PEDIATRIC HEALTH ISSUES AS WELL AS STRATEGIES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH TO WORK AT THE ROOT CAUSES OF POOR HEALTH FOR CHILDREN. TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES, DAYTON CHILDREN'S WILL EXECUTE STRATEGIES TO CREATE A PSYCHIATRY UNIT IN DAYTON CHILDREN'S HOSPITAL AND PROMOTE TRAUMA-INFORMED HEALTH CARE. TO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, DAYTON CHILDREN'S WILL IMPLEMENT NUTRITION POLICY IN SCHOOLS, IMPLEMENT SAFE ROUTES TO SCHOOL, AND ENHANCE THE DAYTON ASTHMA ALLIANCE. TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH, DAYTON CHILDREN'S WILL INCREASE THE USE OF SAFE SLEEP PRACTICES.TO ADDRESS MOST PRIORITY AREAS, THE FOLLOWING CROSS-CUTTING STRATEGIES ARE RECOMMENDED: 1. INCREASE BREASTFEEDING2. EXPLORE AND IMPLEMENT SCREENINGS TO ADDRESS SOCIAL AND BEHAVIORAL NEEDS3. INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICES4. PROMOTE A REGIONAL CHILDHOOD VACCINATION CAMPAIGN5. IMPLEMENT A FOOD INSECURITY SCREENING AND REFERRAL PROGRAM6. IMPLEMENT A FOOD PHARMACY PROGRAMTHE 2017-2020 DAYTON CHILDREN'S IMPLEMENTATION STRATEGY PRIORITIES ALIGN WITH REGIONAL, STATE AND NATIONAL PRIORITIES. DAYTON CHILDREN'S WILL BE ADDRESSING THE FOLLOWING PRIORITIES TO REACH THE CHILD POPULATION IN THE GREATER DAYTON AREA (MONTGOMERY, CLARK, GREENE, MIAMI, AND WARREN COUNTIES): MENTAL HEALTH AND ADDICTION, CHRONIC DISEASE, AND MATERNAL AND INFANT HEALTH. PUBLIC HEALTH OFFICIALS FROM THESE COUNTIES WERE PART OF THE PLANNING PROCESS TO ENSURE ALIGNMENT. IN ADDITION, AS IMPLEMENTATION STRATEGIES WERE DEVELOPED, THE OHIO STATE HEALTH IMPROVEMENT PLAN (SHIP) WAS CONSULTED. THE 2017-2019 SHIP SERVES AS A STRATEGIC MENU OF PRIORITIES, OBJECTIVES, AND EVIDENCE-BASED STRATEGIES TO BE IMPLEMENTED BY STATE AGENCIES, LOCAL HEALTH DEPARTMENTS, HOSPITALS, AND OTHER COMMUNITY PARTNERS AND SECTORS BEYOND HEALTH INCLUDING EDUCATION, HOUSING, EMPLOYERS, AND REGIONAL PLANNING. THE ASSESSMENT AND IMPLEMENTATION PLAN WAS ADOPTED BY THE HOSPITAL BOARD OF TRUSTEES AND POSTED ON THE HOSPITAL WEBSITE IN JUNE 2017. DATA IS AVAILABLE TO PUBLIC HEALTH AND OTHER CHILD-SERVING ENTITIES TO ASSIST IN THEIR INDIVIDUAL NEEDS ASSESSMENTS AS WELL. WE CONTINUOUSLY WORK TO ALIGN OUR IMPLEMENTATION STRATEGIES WITH OTHER LOCAL AND STATE HEALTH DEPARTMENTS AND OTHER HEALTH ENTITIES TO ENSURE THE GREATEST IMPACT ON HEALTH ISSUES.TIED DIRECTLY TO THE COMMUNITY NEEDS IDENTIFIED THROUGH OUR CHNA, DAYTON CHILDREN'S PARTICIPATES IN COMMUNITY OUTREACH INITIATIVES TO ADDRESS THE LEADING HEALTH ISSUES AFFECTING CHILDREN IN THE COMMUNITY. BELOW IS AN UPDATE ON THE INITIATIVES OUTLINED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION STRATEGY. TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES, THE FOLLOWING STRATEGIES WERE IDENTIFIED AND EXECUTED:STRATEGY: EXECUTE PLAN TO CREATE A PSYCHIATRY UNIT IN DAYTON CHILDREN'S HOSPITALDAYTON CHILDREN'S RENOVATED AN AREA ADJACENT TO THE EMERGENCY DEPARTMENT TO HOUSE A BEHAVIORAL CRISIS CENTER. IN THE CRISIS CENTER, TRAINED BEHAVIORAL HEALTH CLINICIANS WILL PROVIDE AN ASSESSMENT AND CONNECT THESE CHILDREN TO THE APPROPRIATE SERVICES. THIS ALLOWS THE EXPERTS AT MENTAL AND BEHAVIORAL HEALTH TO GET A CHILD HELP QUICKER, WHILE ALLOWING THE EXPERTS IN THE EMERGENCY DEPARTMENT TO FOCUS ON THE MEDICAL NEEDS OF CHILDREN. THE CRISIS CENTER OPENED IN JULY 2018. THE HOSPITAL EVALUATED APPROXIMATELY 1,600 CHILDREN THIS YEAR AT RISK FOR SELF-HARM.IN ADDITION, SCREENING FOR SUICIDE RISK WAS INITIATED FOR ALL PATIENTS TEN YEARS OF AGE AND OLDER WHO PRESENTED TO THE HOSPITAL'S EMERGENCY DEPARMTENT OR PERIOPERATIVE SERVICES, ALLOWING THE HOSPITAL TO IDENTIFY HIGH-RISK CHILDREN BEFORE THEY ATTEMPT TO HURT THEMSELVES.PLANS FOR A NEW A 24-BED INPATIENT MENTAL HEALTH UNIT TO PROVIDE NEEDED STABILIZATION CARE TO CHILDREN AND THEN CONNECT THEM TO THE APPROPRIATE FOLLOW UP CARE ALSO WAS A FOCUS THIS FISCAL YEAR. THE NEW INPATIENT UNIT OPENED IN JULY 2019. IN ADDITION TO THE NEW SERVICES BEING OFFERED TO ADDRESS CRITICAL COMMUNITY NEEDS AROUND MENTAL AND BEHAVIORAL HEALTH, THE CENTER FOR PEDIATRIC MENTAL HEALTH RESOURCES ESTABLISHED IN 2014 CONTINUES TO EVOLVE AND GROW. THE HOSPITAL PARTNERS WITH 22 AGENCIES IN ESTABLISHING THE MENTAL HEALTH ADVISORY ALLIANCE TO IMPROVE COMMUNICATION AND COORDINATION OF SERVICES. WITH SUPPORT FROM MONTGOMERY COUNTY ALCOHOL, DRUG ADDICTION AND MENTAL HEALTH SERVICES AS WELL AS DEVELOPMENTAL DISABILITIES SERVICES, WE HAVE ENHANCED PROGRAMS TO BETTER SERVE CHILDREN AND FAMILIES. THE PSYCHOLOGY DEPARTMENT PROVIDED OVER 70 PRESENTATIONS TO SCHOOLS, COMMUNITY AGENCIES, MEDICAL STUDENTS AND THE MEDIA ON VARIOUS TOPICS INCLUDING BULLYING, CHILDHOOD TRAUMA, ADHD AND OTHER LEARNING DISABILITIES, SUICIDE PREVENTION, SCHOOL VIOLENCE, BEHAVIOR MANAGEMENT AND OTHERS. STRATEGY: PROMOTE TRAUMA-INFORMED HEALTH CARE IN 2018, THE DAYTON CHILDREN'S SENIOR LEADERSHIP IDENTIFIED A MULTI-DISCIPLINARY TEAM OF REPRESENTATIVES TO MEET MONTHLY AND SUPPORT THE HOSPITAL'S EFFORTS TO PROMOTE TRAUMA-INFORMED CARE. THIS GROUP COMPLETED A SURVEY/NEEDS ASSESSMENT AND IDENTIFIED AREAS OF STRENGTH AND AREAS OF OPPORTUNITY RELATED TO TRAUMA-INFORMED CARE IN THE HOSPITAL. CLEAR STRENGTHS INCLUDE STAFF PROMOTING ACTIVE PARTICIPATION OF CAREGIVERS IN TREATMENT PROCESS, FAMILY-CENTERED CARE, STAFF ACCEPTANCE FOR PERSONAL RELIGIOUS OR CULTURAL PRACTICES, AND INCENTIVIZATION OF EMPLOYEE WELLNESS BY HOSPITAL LEADERSHIP. KEY AREAS OF OPPORTUNITY INCLUDE ASSESSMENT OF CAREGIVER HISTORY OF TRAUMA AND UNDERSTANDING AND ASSESSMENT OF SECONDARY TRAUMATIC STRESS IN HEALTH CARE WORKERS. THE KEY AREA OF FOCUS FOR FY2018-2019 HAS BEEN SUPPORTING CAREGIVERS OF CHILDREN HOSPITALIZED IN THE INTENSIVE CARE UNIT. THE GROUP BEGAN PILOTING A "STRESS THERMOMETER" ASSESSMENT FOR THIS TARGET POPULATION. DAYTON CHILDREN'S IS ALSO SUPPORTING TRAUMA-INFORMED CARE IN THE COMMUNITY. THE HOSPITAL PARTNERED WITH WESTWOOD NEIGHBORHOOD SCHOOLS CENTER (ZIP CODE 45417) TO PROVIDE A TRAUMA-INFORMED EDUCATION PROGRAM. DR. NORA VISH CONDUCTED SEVERAL WORKSHOPS FOR TEACHERS AND SCHOOL LEADERSHIP TO BUILD TRAUMA-INFORMED SKILLS. TO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, THE FOLLOWING STRATEGIES WERE IDENTIFIED AND EXECUTED:STRATEGY: IMPLEMENT NUTRITION POLICY IN SCHOOLSDAYTON CHILDREN'S IS COLLABORATING WITH LOCAL GROUPS TO SUPPORT LOCAL CHILD CARE CENTERS WORKING TO OBTAIN CERTIFICATION IN THE OHIO HEALTHY PROGRAM. IN ADDITION TO THIS WORK IN CHILD CARE CENTERS, DAYTON CHILDREN'S IS WORKING TO IMPROVE FOOD ACCESS IN THE SCHOOL/COMMUNITY SETTING. DAYTON CHILDREN'S HOSTED A WEB SITE FOR CONSUMERS TO FIND SUMMER FOOD SERVICE PROGRAM OPTIONS IN MONTGOMERY COUNTY AND PARTNERED ON A COMMUNICATIONS CAMPAIGN TO PROMOTE THE EXISITING SUMMER FOOD SITES. DAYTON CHILDREN'S ALSO SPONSORED THE YMCA'S Y ON THE FLY PROGRAM WHICH DELIVERED ACTIVITIES AND FOOD THROUGHOUT THE COMMUNITY WHERE THESE RESOURCES ARE LIMITED, INCLUDING CONTINUING TO PROVIDE A STOP IN THE OLD NORTH DAYTON NEIGHBORHOOD. PART V, SECTION B, LINE 7A: THE CHNA REPORT IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINES 16A-16C: THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/PATIENTS-VISITORS/AFTER-YOUR-VISIT/ BILLING/FINANCIAL-ASSISTANCE PART V, SECTION B LINE 10A: THE IMPLEMENTATION STRATEGY IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT CONTINUATION OF PART V, SECTION B, LINE 11: THE COLLABORATIVE HEALTHY WAY PROGRAM CONTINUES IN PARTNERSHIP WITH THE KROC CENTER WITH ONGOING PROGRAMMING THROUGHOUT THE YEAR. STRATEGY: IMPLEMENT SAFE ROUTES TO SCHOOLDAYTON CHILDREN'S, THROUGH OUR SAFE KIDS GREATER DAYTON COALITION, COLLABORATES WITH SEVERAL LOCAL ORGANIZATIONS TO IMPROVE WALKING AND BIKING INFRASTRUTURE TO ENSURE CHILDREN IN OUR COMMUNITY ARE SAFE AND HAVE ACCESS TO ACTIVITIES TO KEEP THEM HEALTHY. THE SAFE ROUTES TO SCHOOLS LARGE DISTRICT TRAVEL PLAN WAS PASSED IN JULY 2018 BY THE DAYTON CITY COMMISSION. AFTER THE TRAVEL PLAN WAS BOARDED, THE CITY OF DAYTON RECEIVED INFRASTRUCTURE FUNDS FROM THE STATE TO COMPLETE VARIOUS PROJECTS LISTED IN THE PLAN. DAYTON CHILDREN'S WORKED WITH DAYTON PUBLIC SCHOOLS TO ACCOMPLISH VARIOUS EDUCATIONAL PROGRAMS TO IMPROVE THE UTILIZATION OF THE INFRASTRUCTURE IMPROVEMENTS. THE GIRLS IN GEAR PROGRAM WAS IMPLEMENTED AT FOUR DAYTON PUBLIC SCHOOLS. THIS PROGRAM IS FOR GIRLS GRADES 4 TO 6 AND TEACHES THEM EMPOWERMENT THROUGH BUILDING BIKES. EACH GIRL RECEIVES A BIKE AND HELMET AT THE END OF EACH SESSION.DAYTON CHILDREN'S HELPS SUPPORT GIRLS IN GEAR PROGRAMMING BY TEACHING AT LEAST ONE HEALTH AND WELLNESS LESSON AND PROVIDING HELMETS FOR THE GIRLS IN GEAR GRADUATION. SAFE KIDS GREATER DAYTON SUPPORTED EIGHT WALK TO SCHOOL DAY AND FOUR BIKE TO SCHOOL DAY EVENTS IN BELLBROOK, KETTERING AND DAYTON. SAFE KIDS WORLDWIDE HELPED TO FUND THESE PROGRAMS.STRATEGY: ENHANCE THE DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, FOCUSING ON THE MOST AT-RISK POPULATIONS. USING THE COLLECTIVE IMPACT FRAMEWORK, THE ALLIANCE ENGAGES LOCAL PARTNER ORGANIZATIONS TO COLLABORATIVELY IMPLEMENT A VARIETY OF STRATEGIC ACTIONS TO IMPROVE OUTCOMES FOR CHILDREN WITH ASTHMA. TO HAVE THE GREATEST IMPACT AND TO ENSURE ALL CHILDREN WITH ASTHMA HAVE OPTIMAL HEALTH OUTCOMES, THE ALLIANCE IDENTIFIED THREE STRATEGIC FOCUS AREAS FOR THEIR WORK 1) ENSURE ASTHMA-FRIENDLY ENVIRONMENTS; 2) ENHANCE ACCESS TO HIGH QUALITY HEALTHCARE AND SUPPORTIVE SOCIAL SERVICES THROUGH CLINICAL-COMMUNITY LINKAGES; AND 3) EDUCATE AND EQUIP CHILDREN, FAMILIES AND THE COMMUNITY FOR ASTHMA WELLNESS. TO SUPPORT WORK IN THESE AREAS, DAYTON CHILDREN'S SERVES AS THE BACKBONE ORGANIZATION CONVENING THE GROUP OF COMMITTED STAKEHOLDERS AND SUPPORTING THE ALLIANCE WITH STAFF AND RESOURCES. THE ALLIANCE IS GOVERNED BY ENTITIES WITH A COMMON PURPOSE TO IMPROVE HEALTH OUTCOMES FOR CHILDREN WITH ASTHMA IN THE DAYTON REGION. THE ALLIANCE CONSULTS WITH ADDITIONAL ORGANIZATIONS TO GATHER DATA AND RESEARCH, ASCERTAIN BEST PRACTICES, AND TO IDENTIFY COMMUNITY RESOURCES TO SUPPORT CHILDREN WITH ASTHMA AND TO INFORM THE STRATEGIC FOCUS AREAS. ULTIMATELY, THE ALLIANCE AIMS TO REDUCE HOSPITAL ADMISSION RATES AND EMERGENCY DEPARTMENT VISITS TRIGGERED BY UNCONTROLLED ASTHMA AS REPORTED BY THE OHIO HOSPITAL ASSOCIATION AND DAYTON CHILDREN'S. THE ALLIANCE ALSO AIMS TO REDUCE SCHOOL ABSENCES RELATED TO ASTHMA. TO MEET THESE GOALS THE ALLIANCE IS IMPLEMENTING MULTIPLE PROJECTS FOCUSING ON IMPROVED EDUCATION OF CHILDREN AND FAMILIES AROUND ASTHMA TRIGGERS AND MANAGEMENT, ENHANCED EDUCATION OF SCHOOL PERSONNEL AROUND ASTHMA TRIGGERS AND MANAGEMENT, GREATER COMMUNITY RESOURCES PROVIDED TO CHILDREN AND FAMILIES TO HELP MANAGE ASTHMA, IMPROVED PRIMARY HEALTH CARE OF CHILDREN, AND DECREASED ENVIRONMENTAL TRIGGERS. THIS WORK COULD NOT BE DONE WITHOUT ALIGNMENT WITH A VARIETY OF COMMUNITY STAKEHOLDERS. IN ADDITION TO STAFF AND PERSONNEL FROM DAYTON CHILDREN'S CENTER FOR CHILD HEALTH AND WELLNESS AND DAYTON CHILDREN'S PULMONARY CLINIC, PARTNERS IN THE DAYTON ASTHMA ALLIANCE INCLUDE COMMUNITY PRIMARY CARE PHYSICIANS, COMMUNITY ALLERGISTS, CARESOURCE, COMMUNITY HEALTH CENTERS OF GREATER DAYTON, DAYTON PUBLIC SCHOOLS, GREATER DAYTON PREMIER MANAGEMENT, LEGAL AID OF WESTERN OHIO (MEDICAL-LEGAL PARTNERSHIP), PUBLIC HEALTH DAYTON & MONTGOMERY COUNTY, MIAMI VALLEY CHILD DEVELOPMENT CENTERS, THINK TV, WRIGHT STATE UNIVERSITY CENTER FOR HEALTHY COMMUNITIES AND SCHOOL OF NURSING. ADDITIONAL PARTNERS AND COLLABORATORS ARE CONTINUALLY INVITED TO JOIN THE ALLIANCE AS THE NEEDS OR INTEREST ARISE. IN FY2018-2019, DAYTON CHILDREN'S HIRED A DEDICATED COMMUNITY HEALTH WORKER TO CONDUCT HOME VISITS FOR CHILDREN/FAMILIES IN THE PULMONARY CLINIC AND THOSE ASSOCIATED WITH THE DAYTON ASTHMA ALLIANCE TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH ASSOCIATED WITH ASTHMA.THE DAYTON ASTHMA ALLIANCE ENGAGED WITH SEVERAL DAYTON PUBLIC SCHOOLS AND HUBER HEIGHTS SCHOOLS TO RUN THE OPEN AIRWAYS SELF-MANAGEMENT PROGRAM.THE DAYTON ASTHMA ALLIANCE IS ALIGNING WITH DAYTON CHILDREN'S HEALTH PARTNERS, THE HOSPITAL'S CLINICALLY INTEGRATED NETWORK, AROUND PRIMARY CARE QUALITY METRICS RELATED TO ASTHMA.DAYTON CHILDREN'S PULMONARY CLINIC HELD A COMMUNITY EVENT FOR FAMILIES ON APRIL 6, 2019, TO LEARN MORE ABOUT ASTHMA AND OBTAIN RESOURCES TO HELP MANAGE ASTHMA. IN ADDITION TO THE STRATEGIES LISTED ABOVE, THE HOSPITAL WORKED ON THE FOLLOWING PROGRAMS TO ADDRESS CHRONIC DISEASE PREVENTION AND SUPPORT HEALTHY LIFESTYLES.DAYTON CHILDREN'S PEDATRICS PHYSICIANS AND STAFF PARTNER WITH FIVE RIVERS METROPARKS AND WIC TO HOST A ONE MILE STROLLER FRIENDLY WALK THROUGH DOWNTOWN DAYTON AS PART OF THE WALK WITH A DOC PROGRAM. THIS PROGRAM WAS ATTENDED BY APPROXIMATELY 15 PEOPLE PER MONTH DURING FY 2018-2019. THERE WERE A TOTAL OF 5 WALK WITH A DOC EVENTS IN 2018-2019. THE HEALTHY WAY COLLABORATIVE SERVES AS A FORUM TO DISCUSS AND OFFER SOLUTIONS TO HEALTH AND SAFETY ISSUES IN THE GREATER OLD NORTH DAYTON NEIGHBORHOOD. TOGETHER WITH OVER 10 NEIGHBORHOOD PARTNERS, THE HOSPITAL FINDS WAYS TO ADDRESS HEALTH NEEDS, INCLUDING OBESITY, IN THE COMMUNITY. ONE WAY THE COLLABORATIVE ADDRESSES THIS NEED IS THROUGH THE HEALTHY WAY PROGRAM, WHICH REACHED 38 ADULTS AND 21 YOUTH IN FY 2018-2019 WITH NUTRITION EDUCATION, HEALTHY MEALS AND HEALTHY LIFESTYLE LESSONS. THIS PROGRAM IS A COLLABORATION BETWEEN THE OHIO STATE EXTENSION SERVICE, THE SALVATION ARMY KROC CENTER, AND NEIGHBORHOOD LEADERS. DAYTON CHILDREN'S DIETITIANS ALSO WORK TO TRAIN STUDENTS IN THE FIELD WITH OVER 2,000 HOURS DEDICATED TO THE OVERSIGHT OF STUDENT INTERNS AND VOLUNTEERS. THE CLINICAL NUTRITION STAFF ALSO REACHED 9 DIFFERENT SCHOOLS AND COMMUNITY AGENCIES WITH HEALTHY LIFESTYLE MESSAGING IN FY 2018-2019. TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH, THE FOLLOWING STRATEGIES WERE IDENTIFIED AND EXECUTED:STRATEGY: INCREASE THE USE OF SAFE SLEEP PRACTICESDAYTON CHILDREN'S IS A DESIGNATED CRIBS FOR KIDS SITE. THROUGH THIS PROGRAM, PARENTS/CAREGIVERS NEEDING A SAFE PLACE FOR THEIR BABY TO SLEEP ATTEND A ONE HOUR SAFE-SLEEP CLASS GIVEN BY TRAINED STAFF. AT THE END OF THE CLASS, PARENTS/CAREGIVERS ARE PROVIDED WITH A PORTABLE CRIB. THE HOSPITAL ALSO OFFERS A COMPLETE 'SAFE SLEEP SURVIVAL KIT,' WHICH CONTAINS A HALO SLEEP SACK (WEARABLE BLANKET), A PACK N PLAY CRIB SHEET, AND A PACIFIER APPROVED BY THE AMERICAN ACADEMY OF PEDIATRICS. IN FY 2018-2019, DAYTON CHILDREN'S DISTRIBUTED OVER 203 PACK N PLAYS THROUGH THIS PROGRAM, PARTIALLY FUNDED BY THE OHIO DEPARTMENT OF HEALTH. IN ADDITION, THE HOSPITAL'S INFANT MORTALITY PREVENTION AND AWARENESS COMMITTEE, OFFERS COMMUNITY BASED EDUCATION ON SAFE SLEEP IN A VARIETY OF SETTINGS. THE COMMITTEE ALSO WORKS TO PROVIDE SAFE SLEEP EDUCATION TO INTERNAL STAFF AND PATIENT FAMILIES. TO ADDRESS MOST PRIORITY AREAS, THE FOLLOWING CROSS-CUTTING STRATEGIES THAT HAVE THE ABILITY TO IMPACT ONE OR MORE OF THE PRIORITY ISSUES WERE IDENTIFIED AND EXECUTED: STRATEGY: INCREASE BREASTFEEDINGAS PART OF THE HOSPITAL'S INFANT MORTALITY AWARENESS AND PREVENTION COMMITTEE, A HOSPITAL PHYSICIAN WORKED TO INCREASE MEDICAL RESIDENT'S KNOWLEDGE, CONFIDENCE AND ATTITUDES OF BREASTFEEDING IN ORDER TO FURTHER BREASTFEEDING ADOPTION WITHIN THE COMMUNITY. THE GOAL OF THE PROJECT WAS TO IMPROVE MEDICAL RESIDENT'S KNOWLEDGE BY PROVIDING FOUR LECTURES ABOUT BREASTFEEDING AND SURVEYING THE RESIDENTS BEFORE AND AFTER THE EDUCATION. THE RESULTS SHOWED THAT THE EDUCATION IMPROVED KNOWLEDGE AND CONFIDENCE. STRATEGY: EXPLORE AND IMPLEMENT SCREENINGS TO ADDRESS SOCIAL AND BEHAVIORAL NEEDSTHE FAMILY RESOURCE CONNECTION USES A PATIENT'S VISIT TO THE DOCTOR AS AN OPPORTUNITY TO ADDRESS THE NON-MEDICAL ISSUES THAT HAVE AN IMPACT ON HEALTH. THIS PROGRAM SCREENS PATIENT FAMILIES FOR SOCIAL NEEDS. IDENTIFIED FAMILIES THEN ARE REFERRED TO AN ADVOCATE WORKING IN THE DAYTON CHILDREN'S HOSPITAL FAMILY RESOURCE CONNECTION FOR RESOURCE CONNECTION AND FOLLOW-UP. THE FAMILY RESOURCE CONNECTION IS MODELED AFTER THE WELL-KNOWN AND RESPECTED HEALTH LEADS PROGRAM. 10 1 - SPRINGBORO SOUTH URGENT CARE & OP CARE C 3333 WEST TECH ROAD MIAMISBURG OH 45342 URGENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER 2 - HUBER HEIGHTS OUTPATIENT TESTING CENTER 8501 OLD TROY PIKE HUBER HEIGHTS OH 45424 OUTPATIENT DIAGNOSTIC CENTER 3 - SPRINGFIELD SPECIALTY CARE CENTER 30 W MCCREIGHT AVENUE SPRINGFIELD OH 45504 OUTPATIENT DIAGNOSTIC CENTER 4 - BEAVERCREEK OUTPATIENT TESTING CENTER 3224 DAYTON-XENIA ROAD BEAVERCREEK OH 45431 OUTPATIENT DIAGNOSTIC CENTER 5 - VANDALIA OUTPATIENT TESTING CENTER 810 FALLS CREEK DRIVE SUITE A VANDALIA OH 45377 OUTPATIENT DIAGNOSTIC CENTER 6 - WARREN COUNTY SPECIALTY CARE CENTER 100 CAMPUS LOOP ROAD SUITE A FRANKLIN OH 45005 OUTPATIENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER 7 - KETTERING OUTPATIENT TESTING CENTER 4475 FAR HILLS AVENUE KETTERING OH 45429 OUTPATIENT DIAGNOSTIC CENTER 8 - KIDS EXPRESS SPRINGBORO 662 N MAIN STREET SPRINGBORO OH 45066 EXPRESS CARE 9 - TROY OUTPATIENT TESTING CENTER 865 W MARKET STREET TROY OH 45373 OUTPATIENT DIAGNOSTIC CENTER 10 - CHILD HEALTH PAVILION 1010 VALLEY STREET DAYTON OH 45404 PEDIATRIC CARE CLINICS AND COMMUNITY CONNECTIONS PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS AND RESIDENCY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: THE FOLLOWING COSTING METHODOLOGIES WERE USED IN PREPARATION OF SCHEDULE H, PART I, LINE 7:- CHARITY CARE AT COST WAS CALCULATED USING THE COST TO CHARGE RATIO. - UNREIMBURSED MEDICAID WAS CALCULATED USING THE COST TO CHARGE RATIO. - COMMUNITY HEALTH IMPROVEMENT SERVICES WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. - HEALTH PROFESSIONS EDUCATION COSTS WERE DETERMINED USING THE FACILITY'S MEDICARE COST REPORTED, SUPPLEMENTED BY THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. - SUBSIDIZED HEALTH SERVICES COSTS WERE DETERMINED USING THE FACILITY'S INTERNAL COST ACCOUNTING SYSTEM. THE COST OF THESE SERVICES INCLUDES DIRECT COSTS ATTRIBUTABLE TO HEALTH SERVICES OPERATIONS, TOGETHER WITH AN ALLOCATION OF FACILITY DIRECT AND INDIRECT OVERHEAD USING A COST FINDING METHODOLOGY PATTERNED AFTER THE MEDICARE COST REPORT. - CASH AND IN KIND CONTRIBUTIONS WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. PART I, LINE 7G: DAYTON CHILDREN'S INCLUDED $46,192,716 OF PHYSICIAN CLINIC COSTS IN THE SUBSIDIZED HEALTH SERVICES CATEGORY. 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 $ 15,655,122. PART II, COMMUNITY BUILDING ACTIVITIES: AS THE ONLY CHILDREN'S HOSPITAL IN THE REGION, WE TAKE OUR PEDIATRIC EXPERTISE INTO THE COMMUNITY TO SOLVE PROBLEMS AND CREATE A HEALTHY COMMUNITY FOR OUR CHILDREN. OUR COMMUNITY RELATIONSHIPS DEMONSTRATE OUR COMMITMENT TO DAYTON AND THE SURROUNDING COMMUNITY - A COMMUNITY WE HAVE CALLED HOME FOR NEARLY 50 YEARS. DAYTON CHILDREN'S IS COMMITTED TO WORKING WITH OUR MANY VALUED PARTNERS TO HELP ENSURE DAYTON REMAINS A GREAT CITY FOR CHILDREN TO LIVE, LEARN, GROW AND PLAY.SENSORY PROGRAMSDAYTON CHILDREN'S PARTNERED WITH THE BOONSHOFT MUSEUM OF DISCOVERY, THE DAYTON BALLET AND THE VICTORIA THEATRE ASSOCIATION TO PROVIDE THE SUPPORTS NEEDED TO BRING SENSORY FRIENDLY PROGRAMMING TO LIFE. EACH OF THESE ORGANIZATIONS DECIDED TO GO ABOVE AND BEYOND FOR THE CHILDREN IN THE GREATER DAYTON AREA BY PROVIDING SENSORY FRIENDLY OPPORTUNITIES TO FAMILIES. SENSORY-FRIENDLY DAYS PROVIDE A REDUCTION OF LOUD OR JARRING SOUNDS, THE ABSENCE OF FLASHING OR STROBE LIGHTING OR LOUD EQUIPMENT, AND JUDGMENT-FREE ENVIRONMENT WHERE ALL PATRONS ARE FREE TO VOCALIZE OR MOVE AROUND. ON THESE DAYS NO ONE WILL BE ASKED TO LEAVE DUE TO SOUND, MOVEMENT OR BEHAVIORS RELATED TO COGNITIVE/DEVELOPMENTAL ABILITIES. THE BOONSHOFT MUSEUM OF DISCOVERY WITH THE SUPPORT AND EXPERTISE OF DAYTON CHILDREN'S STAFF HOSTED 3 SENSORY SUNDAY EVENTS, OPENING THE MUSEUM TO FAMILIES OUTSIDE THEIR NORMAL BUSINESS HOURS WITH LOWER LIGHTING, LOWER VOLUME AND PLENTY OF VOLUNTEERS TO SUPPORT FAMILIES. BOTH THE DAYTON BALLET AND THE VICTORIA THEATRE ASSOCIATION OFFERED SENSORY FRIENDLY PERFORMANCES OF THE NUTCRACKER, SLEEPING BEAUTY, THE VERY HUNGRY CATERPILLAR & OTHER ERIC CARLE FAVOURITES, HOW TO SURVIVE MIDDLE SCHOOL AND THE MAGIC SCHOOL BUS: LOST IN THE SOLAR SYSTEM. BEFORE CHILDREN ATTENDED THE MUSEUM AND THE THEATER, DAYTON CHILDREN'S STAFF ENSURED ALL POTENTIAL OVERSTIMULATING ELEMENTS WERE ADDRESSED AND PLANNED FOR BY STAFF AND VOLUNTEERS. THE DAVINCI PROJECTTHE DAVINCI PROJECT IS A COMPREHENSIVE STRATEGY FOR NEIGHBORHOOD REVITALIZATION SUPPORTED IN THE OLD NORTH DAYTON AND MCCOOK FIELD NEIGHBORHOODS AND THE BUSINESS COMMUNITY AROUND IT INCLUDING DAYTON CHILDREN'S. DAYTON CHILDREN'S LEADS THIS EFFORT AND IS JOINED BY PARTNERS INCLUDING THE CITY OF DAYTON, GREATER OLD NORTH DAYTON BUSINESS ASSOCIATION, THE SALVATION ARMY KROC CENTER, THE UNIVERSITY OF DAYTON FITZ CENTER OF LEADERSHIP IN COMMUNITY, ST. MARY'S COMMUNITY DEVELOPMENT CORP. AND CITYWIDE DEVELOPMENT. THE DAVINCI PROJECT IS WORKING ON EFFORTS TO DEMOLISH NUISANCE BUILDINGS, REALIGN STREETS, BUILD A CHILDREN'S GARDEN, REVITALIZE BUS STOPS, IMPROVE WAYFINDING, AND BEAUTIFY THE NEIGHBORHOOD SO IT CONTINUES TO BE ATTRACTIVE TO FAMILIES AND BUSINESSES. THIS PROJECT IS IMPORTANT TO DAYTON CHILDREN'S, NOT ONLY BECAUSE WE WANT TO BE AN ACTIVE PARTICIPANT IN OUR COMMUNITY, WE WANT PATIENTS, STAFF, VOLUNTEERS AND VISITORS TO FEEL WELCOME WHEN THEY ENTER THE OLD NORTH DAYTON A NEIGHBORHOOD THAT WE ARE PROUD TO CALL HOME.COMMUNITY LEADERSHIPBEYOND PARTICIPATION IN ORGANIZATIONS THAT DIRECTLY IMPACT CHILDREN AND CHILDREN'S HEALTH, DAYTON CHILDREN'S STAFF AND LEADERSHIP SERVE ON VARIOUS COALITIONS TO IMPROVE THE ECONOMIC AND SOCIAL HEALTH OF OUR COMMUNITY INCLUDING THE PRESCHOOL PROMISE, UNITED WAY, THE FAMILY AND CHILDREN FIRST COUNCIL, A SPECIAL WISH, DAYTON DEVELOPMENT CORPORATION, HOPE CENTER, CITYWIDE, THE BREAST CANCER FOUNDATION, THE YWCA, AND THE MARCH OF DIMES. THROUGH THESE ACTIVITIES, DAYTON CHILDREN'S STRIVES TO CREATE A COMMUNITY THAT IS A PLACE WHERE ALL CHILDREN AND FAMILIES GROW AND THRIVE. DAYTON CHILDREN'S IS AN INDISPENSABLE RESOURCE TO OUR COMMUNITY BECAUSE WE: -SERVE AS THE COMMUNITY'S SAFETY NET HOSPITAL BY CARING FOR ALL CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, WHILE PROVIDING AND SUBSIDIZING HOSPITAL AND COMMUNITY-BASED SERVICES THAT ARE EITHER LIMITED OR UNAVAILABLE ELSEWHERE IN OUR COMMUNITY.-SERVE AS A VOICE FOR CHILDREN THROUGH PUBLIC POLICY ADVOCACY TO CHANGE LAWS, POLICIES, OR SYSTEMS LEADING TO THE IMPROVEMENT OF HEALTH AND SAFETY FOR CHILDREN AND FAMILIES.-JOIN WITH COMMUNITY PARTNERS AND LEND SUPPORT THROUGHOUT OUR REGION TO IMPROVE THE LIVES OF CHILDREN AND THEIR FAMILIES.-TRAIN FUTURE DOCTORS AND HEALTH CARE PROVIDERS TO BECOME THE NEXT GENERATION OF HIGH QUALITY, PROFESSIONAL PEDIATRIC EXPERTS, OFTEN AT A FINANCIAL LOSS TO THE HOSPITAL.AS A TEACHING HOSPITAL, DAYTON CHILDREN'S IS DEDICATED TO TRAINING THE NEXT GENERATION OF PEDIATRICIANS AND PEDIATRIC SPECIALISTS. EACH YEAR, DAYTON CHILDREN'S HOSTS MEDICAL RESIDENTS FROM THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE. IN ADDITION, DAYTON CHILDREN'S HOUSES THIS COUNTRY'S ONLY CIVILIAN/MILITARY INTEGRATED PEDIATRIC RESIDENCY PROGRAM WITH WRIGHT-PATTERSON AIR FORCE BASE. PHYSICIANS TRAINED AT DAYTON CHILDREN'S ARE CARING FOR CHILDREN IN OUR REGION AND THROUGHOUT THE WORLD. IN ADDITION, WE WORK WITH NUMEROUS COLLEGES AND UNIVERSITIES TO HELP TRAIN STUDENTS IN MULTIPLE DISCIPLINES INCLUDING NURSING, PUBLIC HEALTH, SOCIAL WORK, AND MANY MORE AREAS REQUIRED BY MODERN HEALTHCARE. TRAINING INVOLVES SIGNIFICANT COSTS FAR BEYOND THOSE USUALLY ASSOCIATED WITH PATIENT CARE. HOWEVER, WE RECOGNIZE TRAINING THE NEXT GENERATION OF HEALTH CARE WORKERS IS ESSENTIAL TO THE OVERALL HEALTH OF OUR COMMUNITY. DAYTON CHILDREN'S JOINS WITH OTHER CHILDREN'S HOSPITALS ACROSS THE COUNTRY TO ADDRESS ISSUES UNIQUE TO THE POPULATION WE SERVE. WE WORK WITH THE CHILDREN'S HOSPITAL ASSOCIATION, THE OHIO CHILDREN'S HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION TO ENSURE CHILDREN HAVE A VOICE IN POLICY MATTERS. DAYTON CHILDREN'S FURTHER SUPPORTS COMMUNITY EFFORTS TO IMPROVE THE HEALTH AND SAFETY OF CHILDREN THROUGHOUT THE REGION THROUGH DONATIONS AND SPONSORSHIPS MADE TO PROGRAMS THAT SUPPORT, HELP AND IMPROVE THE HEALTH STATUS OF CHILDREN AND IMPROVE THE QUALITY OF LIFE FOR CHILDREN AND THEIR FAMILIES. DAYTON CHILDREN'S HAS ASSISTED MANY ORGANIZATIONS INCLUDING: A SPECIAL WISH, BIG BROTHERS AND BIG SISTERS, CLOTHES THAT WORK, EQUITAS HEALTH, GIRLS ON THE RUN, HOMEFULL, JUVENILE DIABETES RESEARCH FOUNDATION, MARCH OF DIMES, AND THE UNITED WAY OF GREATER DAYTON. IN ADDITION, WE HAVE SUPPORT MANY COMMUNITY YOUTH SPORTS TEAMS TO ENSURE LOCAL CHILDREN HAVE ACCESS TO HEALTHY ACTIVITIES. AT DAYTON CHILDREN'S, WE BELIEVE THAT ALL CHILDREN IN OUR REGION DESERVE A GREAT CHILDREN'S HOSPITAL CLOSE TO HOME. WE ARE DEDICATED TO ADDRESSING THE HEALTH AND WELLNESS NEEDS OF CHILDREN BOTH THROUGH CLINICAL PRACTICE AS WELL AS OUR COMMUNITY BENEFIT ACTIVITIES. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE OF SELF-PAY ACCOUNTS RECEIVABLE INCLUDING THOSE BALANCES AFTER INSURANCE PAYMENTS AND NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR BAD DEBTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENTS THEMSELVES HAVE BEEN EXHAUSTED, THE HOSPITAL MAY PLACE CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE HOSPITAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. PART III, LINE 4: THE COSTING METHODOLOGY USED IN PREPARATION OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS IS THE COST TO CHARGE RATIO, RATIO OF PATIENT COST-TO-CHARGE. THE DAYTON CHILDREN'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE. A PROVISION FOR BAD DEBT EXPENSE IS SHOWN ON THE PROFIT AND LOSS STATEMENT. THE CALCULATION FOR BAD DEBT EXPENSE IS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRING MANAGEMENT TO MAKE ESTIMATES AND ASSUMPTIONS BASED ON HISTORICAL DATA THAT AFFECT THE REPORTED AMOUNTS OF REVENUE AND EXPENSES DURING THE REPORTED PERIOD. LIKEWISE, AN ALLOWANCE FOR BAD DEBT IS SHOWN ON THE BALANCE SHEET UNDER THE SAME PRINCIPLE AFFECTING THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES DURING THE REPORTED PERIOD. PART III, LINE 8: THE COSTS REPORTED FOR SERVICES PROVIDED TO MEDICARE PATIENTS COME FROM SCHEDULE E OF THE FACILITY'S COST REPORT AS FILED. SINCE DAYTON CHILDREN'S IS REIMBURSED FOR MEDICARE SERVICES UNDER A TEFRA METHODOLOGY, THERE IS NORMALLY NO SHORTFALL, AS ALLOWED COSTS AND PAYMENTS DUE ARE EQUAL. PART III, LINE 9B: THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE IN OUR FINANCIAL ASSISTANCE POLICY POSTED UNDER PATIENTS & VISITORS > AFTER YOU VISIT > BILLING > FINANCIAL ASSISTANCE. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT AND OTHER FINANCIAL ASSISTANCE PROGRAMS UP FRONT BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS. EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSITANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL ASSISTANCE COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE PROGRAMS IF DESIRED. PART VI, LINE 2: IN ADDITION TO OUR CHNA, DAYTON CHILDREN'S ASSESSES THE NEEDS OF OUR COMMUNITY IN A VARIETY OF WAYS. WE SERVE AS A KEY COMMUNITY PARTNER ON MANY LOCAL INITIATIVES WHICH ALLOWS US TO BETTER UNDERSTAND COMMUNITY NEEDS AND TRENDS. WE ALSO HAVE SEVERAL OTHER COMMUNITY BASED PROGRAMS WHICH ALLOW FOR FEEDBACK ABOUT THE COMMUNITY. CENTER FOR COMMUNITY HEALTH AND ADVOCACYIN FALL 2017, DAYTON CHILDREN'S CREATED THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY TO REALIGN AND ELEVATE CLINICAL PROGRAMS PROVIDING A GREATER FOCUS ON PRIMARY AND PREVENTATIVE CARE AND COMMUNITY ENGAGEMENT PROGRAMS AIMED AT IMPROVING THE HEALTH OF CHILDREN BEYOND THE WALLS OF THE HOSPTIAL. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY INTEGRATED OUR PRIMARY CARE CLINIC, DAYTON CHILDREN'S PEDIATRICS, FOSTER/KINSHIP CARE PROGRAMS, COMPLEX CARE CLINIC AND HEALTHY ME CLINIC WITH PROGRAMS ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH INCLUDING THE FAMILY RESOURCE CONNECTION, THE DAYTON ASTHMA ALLIANCE, INJURY PREVENTION PROGRAMS AND OTHER COMMUNITY BASED PROGRAMS TO ENSURE CHILDREN HAVE HEALTHY AND SAFE PLACES FOR ALL CHILDREN TO LIVE, LEARN AND PLAY. THE WORK OF THE CENTER IS DIRECTLY TIED TO THE NEEDS IDENTIFIED THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT. IN SPRING 2019, THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY FOUND A NEW HOME IN THE NEWLY BUILT CHILD HEALTH PAVILION. TO ENSURE THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY CONTINOUSLY OBTAINS FEEDBACK FROM THE COMMUNITY, A COMMUNITY ADVISORY BOARD OF COMMUNITY LEADERS REPRESENTING KEY CHILD SERVING AGENCIES WAS ASSEMBLED IN SPRING 2019DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, FOCUSING ON THE MOST AT-RISK POPULATIONS. USING THE COLLECTIVE IMPACT FRAMEWORK, THE ALLIANCE ENGAGES LOCAL PARTNER ORGANIZATIONS TO COLLABORATIVELY IMPLEMENT A VARIETY OF STRATEGIC ACTIONS TO IMPROVE OUTCOMES FOR CHILDREN WITH ASTHMA. TO HAVE THE GREATEST IMPACT AND TO ENSURE ALL CHILDREN WITH ASTHMA HAVE OPTIMAL HEALTH OUTCOMES, THE ALLIANCE IDENTIFIED THREE STRATEGIC FOCUS AREAS FOR THEIR WORK 1) ENSURE ASTHMA-FRIENDLY ENVIRONMENTS; 2) ENHANCE ACCESS TO HIGH QUALITY HEALTHCARE AND SUPPORTIVE SOCIAL SERVICES THROUGH CLINICAL-COMMUNITY LINKAGES; AND 3) EDUCATE AND EQUIP CHILDREN, FAMILIES AND THE COMMUNITY FOR ASTHMA WELLNESS. TO SUPPORT WORK IN THESE AREAS, DAYTON CHILDREN'S SERVES AS THE BACKBONE ORGANIZATION CONVENING THE GROUP OF COMMITTED STAKEHOLDERS AND SUPPORTING THE ALLIANCE WITH STAFF AND RESOURCES. THE ALLIANCE IS GOVERNED BY ENTITIES WITH A COMMON PURPOSE TO IMPROVE HEALTH OUTCOMES FOR CHILDREN WITH ASTHMA IN THE DAYTON REGION. THE ALLIANCE CONSULTS WITH ADDITIONAL ORGANIZATIONS TO GATHER DATA AND RESEARCH, ASCERTAIN BEST PRACTICES, AND TO IDENTIFY COMMUNITY RESOURCES TO SUPPORT CHILDREN WITH ASTHMA AND TO INFORM THE STRATEGIC FOCUS AREAS. THIS WORK COULD NOT BE DONE WITHOUT ALIGNMENT WITH A VARIETY OF COMMUNITY STAKEHOLDERS. IN ADDITION TO STAFF AND PERSONNEL FROM DAYTON CHILDREN'S CENTER FOR CHILD HEALTH AND WELLNESS AND DAYTON CHILDREN'S PULMONARY CLINIC, PARTNERS IN THE DAYTON ASTHMA ALLIANCE INCLUDE COMMUNITY PRIMARY CARE PHYSICIANS, COMMUNITY ALLERGISTS, CARESOURCE, COMMUNITY HEALTH CENTERS OF GREATER DAYTON, DAYTON PUBLIC SCHOOLS, GREATER DAYTON PREMIER MANAGEMENT, LEGAL AID OF WESTERN OHIO (MEDICAL-LEGAL PARTNERSHIP), PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY, MIAMI VALLEY CHILD DEVELOPMENT CENTERS, AND THINK TV. ADDITIONAL PARTNERS AND COLLABORATORS ARE CONTINUALLY INVITED TO JOIN THE ALLIANCE AS THE NEEDS OR INTEREST ARISE. FAMILY RESOURCE CONNECTIONTHE FAMILY RESOURCE CONNECTION USES A PATIENT'S VISIT TO THE DOCTOR AS AN OPPORTUNITY TO ADDRESS THE NON-MEDICAL ISSUES THAT HAVE AN IMPACT ON HEALTH. THIS PROGRAM SCREENS PATIENT FAMILIES FOR SOCIAL NEEDS. IDENTIFIED FAMILIES THEN ARE REFERRED TO AN ADVOCATE WORKING IN THE DAYTON CHILDREN'S HOSPITAL FAMILY RESOURCE CONNECTION FOR RESOURCE CONNECTION AND FOLLOW-UP. THE FAMILY RESOURCE CONNECTION IS MODELED AFTER THE WELL-KNOWN AND RESPECTED HEALTH LEADS PROGRAM.HEALTH LEADS (HEALTHLEADSUSA.ORG) IS A NATIONAL MOVEMENT THAT ENVISIONS A HEALTHCARE SYSTEM THAT ADDRESSES ALL PATIENTS' BASIC RESOURCE NEEDS AS A STANDARD PART OF QUALITY CARE. HEALTH LEADS' MISSION IS TO CATALYZE THIS HEALTHCARE SYSTEM BY CONNECTING PATIENTS WITH THE BASIC RESOURCES THEY NEED TO BE HEALTHY, AND IN DOING SO, BUILD LEADERS WITH THE CONVICTION AND ABILITY TO CHAMPION QUALITY CARE FOR ALL PATIENTS. HEALTH LEADS HAS OVER 19 YEARS OF EXPERIENCE BUILDING SOCIAL NEEDS PROGRAMS IN HOSPITAL AND CLINIC SETTINGS.IN FY 2017-2018, THE FAMILY RESOURCE CONNECTION HAS PROVEN OUTCOMES IN CONNECTING PATIENT FAMILIES TO RESOURCES. IN ITS FIRST YEAR, 838 FAMILIES ENGAGED IN THE PROGRAM AND OVER 612 RESOURCE CONNECTIONS WERE MADE. THE GREATEST NEEDS IDENTIFIED IN THE FAMILY RESOURCE CONNECTION ARE COMMODITIES INCLUDING DIAPERS, CRIBS AND BEDS, SCHOOL SUPPLIES AND CLOTHING.IN ADDITION TO PROVIDING POSITIVE OUTCOMES FOR FAMILIES, THE FAMILY RESOURCE CONNECTION HELPS TO TRAIN THE NEXT GENERATION OF THE HEALTH CARE WORKFORCE. OVER THE LAST YEAR, 28 STUDENT ADVOCATES FROM MULTIPLE COLLEGES AND UNIVERSITIES IN A VARIETY OF PROGRAMS AND MAJORS ENGAGED WITH THE PROGRAM. THE STUDENTS HAVE RANGED FROM CERTIFICATE PROGRAMS, ASSOCIATE, BACHELOR TO MASTERS DEGREES WITH A VARIETY OF PROGRAMS AND MAJORS WHICH HAVE INCLUDED PRE-MEDICAL, SOCIAL WORK, HEALTH CARE ADMINISTRATION, PUBLIC HEALTH, SOCIAL SERVICES AND HEALTH CARE NAVIGATORKISER NEIGHBORHOOD SCHOOLS CENTERDAYTON CHILDREN'S IS THE NONPROFIT COMMUNITY PARTNER TO KISER NEIGHBORHOOD SCHOOLS CENTER, AS PART OF THE DAYTON PUBLIC SCHOOL'S NEIGHBORHOOD SCHOOL CENTER PROGRAM. NEIGHBORHOOD SCHOOL CENTERS ARE DAYTON PUBLIC SCHOOLS THAT ARE CENTERED ON THEIR NEIGHBORHOODS, SERVING AS HEALTHY PLACES OF LEARNING FOR CHILDREN AND FAMILIES. THEY SEEK TO IMPROVE STUDENT PERFORMANCE, REALIGN COMMUNITY RESOURCES TO SUPPORT YOUTH ACHIEVEMENT AND IMPROVE QUALITY OF LIFE IN THE NEIGHBORHOOD. FOCUSED ON COMMUNITY LEADERSHIP, NEIGHBORHOOD SCHOOL CENTERS BRING TOGETHER PARTNERS TO OFFER A RANGE OF OPPORTUNITIES TO CHILDREN, FAMILIES, AND COMMUNITIES. TO AID IN THIS PARTNERSHIP, A GRANT-FUNDED DAYTON CHILDREN'S STAFF MEMBER SERVES AS SITE COORDINATOR IN THE SCHOOL. IN ADDITION TO MANAGING THE DUTIES OF THE SITE COORDINATOR, DAYTON CHILDREN'S OFFERS VARIOUS SERVICES AND RESOURCES TO CHILDREN AT KISER INCLUDING TUTORS. THIS IS A KEY PARTNERSHIP AS KISER NEIGHBORHOOD SCHOOLS CENTER IS IN OUR BACKYARD, THE GREATER OLD NORTH DAYTON. PART VI, LINE 3: THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE HTTPS://WWW.CHILDRENSDAYTON.ORG/PATIENTS-VISITORS/AFTER-YOUR-VISIT/BILLING/FINANCIAL-ASSISTANCE. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT, AND OTHER FINANCIAL ASSISTANCE PROGRAMS BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: DAYTON CHILDREN'S HOSPITAL IS LOCATED IN OLD NORTH DAYTON, NORTHEAST OF DOWNTOWN DAYTON AND THE URBAN CORE, IN MONTGOMERY COUNTY IN SOUTHWESTERN OHIO. THE HOSPITAL'S ROOTS CAN BE TRACED BACK TO 1919, WHEN PHILANTHROPIST AND ACTIVIST ANNA BARNEY GORMAN PLANNED A NORTH DAYTON COMMUNITY CENTER TO OFFER HEALTH SERVICES, EDUCATION AND RECREATION. THE BARNEY COMMUNITY CENTER LATER DEVELOPED INTO THE BARNEY CONVALESCENT HOSPITAL, WHICH CARED FOR POLIO VICTIMS. IN 1967 A FULL-SERVICE CHILDREN'S HOSPITAL, THE BARNEY CHILDREN'S MEDICAL CENTER, OPENED. THE NAME WAS CHANGED IN 1970 TO THE CHILDREN'S MEDICAL CENTER OF DAYTON. IN SPRING 2013, THE HOSPITAL CHANGED ITS NAME ONCE AGAIN TO DAYTON CHILDREN'S HOSPITAL. THE HOSPITAL CELEBRATED ITS 50-YEAR ANNIVERSARY IN 2017. DAYTON CHILDREN'S NOW SERVES INFANTS, CHILDREN AND TEENS FROM 20 OHIO COUNTIES, WITH 75 PERCENT OF PATIENTS COMING FROM MONTGOMERY, GREENE, CLARK, MIAMI AND NORTHERN WARREN COUNTIES. THE SERVICE AREA SPANS 9,000 SQUARE MILES WITH A 2.1 MILLION PEDIATRIC POPULATION THAT INCLUDES POOR URBAN AND RURAL AREAS. DAYTON CHILDREN'S IS THE ONLY PEDIATRIC HEALTH CARE PROVIDER AND THE LARGEST PROVIDER OF MEDICAL CARE TO LOW-INCOME CHILDREN IN THE REGION. CURRENTLY, THE HOSPITAL SERVES A DISPROPORTIONATE SHARE OF CHILDREN FROM LOW-INCOME FAMILIES. OVER 55 PERCENT OF THE PATIENTS AT DAYTON CHILDREN'S ARE COVERED BY MEDICAID. IN ADDITION, DAYTON CHILDREN'S SERVES AS THE PEDIATRIC RESOURCE FOR MILITARY FAMILIES STATIONED AT NEARBY WRIGHT-PATTERSON AIR FORCE BASE. DAYTON CHILDREN'S HAS ALWAYS BELIEVED THAT INFANTS, CHILDREN AND TEENS NEED TO BE CARED FOR BY PEDIATRIC SPECIALISTS. WITH IMPROVED ACCESS TO PEDIATRIC SPECIALTY SERVICES, THE HOSPITAL PROVIDES EXPERT CARE TO NEARLY 320,000 CHILDREN IN ITS 20-COUNTY REGION. OUTPATIENT AND ALTERNATIVE SERVICES INCLUDE PEDIATRIC LABORATORY AND IMAGING WHICH COMPLEMENT THE HOSPITAL'S INPATIENT SERVICES. MANY PROGRAMS HAVE RECEIVED CERTIFICATIONS AND ACCREDITATIONS FROM ORGANIZATIONS SETTING THE STANDARDS OF QUALITY CARE; THE HOSPITAL'S SCORES FROM THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS ARE CONSISTENTLY AMONG THE HIGHEST IN THE NATION. IN SUMMER 2018, DAYTON CHILDREN'S RECEIVED MAGNET DESIGNATION FOR THESECOND TIME, RECOGNIZING THE HOSPITAL AS PROVIDING THE GOLD STANDARD INPATIENT CARE AND THE PROFESSIONAL PRACTICE OF NURSING BY THE AMERICANNURSES CREDENTIALING CENTER (ANCC). IN JUNE, 2019, DAYTON CHILDREN'S RANKED IN THE TOP 50CHILDREN'S HOSPITALS IN THE COUNTRY FOR CARE IN PULMONOLOGY IN U.S. NEWSAND WORLD REPORT. PART VI, LINE 5: IN AN EFFORT TO BETTER ALIGN AND FOCUS ON OUR COMMUNITY ENGAGEMENT AND COMMUNITY HEALTH EFFORTS, IN FALL 2017, DAYTON CHILDREN'S FORMALLY ESTABLISHED THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY REALIGNS AND ELEVATES CLINICAL PROGRAMS PROVIDING A GREATER FOCUS ON PRIMARY AND PREVENTATIVE CARE AND COMMUNITY ENGAGEMENT PROGRAMS AIMED AT IMPROVING THE HEALTH OF CHILDREN BEYOND THE WALLS OF THE HOSPITAL. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY PUTS OUR CHILDREN'S HEALTH AGENDA IN FOCUS EMPHASIZING OUR COMMITMENT TO IMPROVING THE HEALTH STATUS OF ALL CHILDREN AND UNDERSCORING OUR COMMITMENT TO MOST VULNERABLE POPULATIONS AND HEALTH DISPARITIES.HAVE YOU HEARD THE PHRASE "A PERSON'S HEALTH IS DETERMINED MORE BY ZIP CODE THAN GENETIC CODE?" THAT PHRASE HAS BECOME POPULAR BECAUSE WE NOW KNOW THAT AT THE MAJORITY OF WHAT CONTRIBUTES TO A CHILD'S WELLNESS IS RELATED TO THE FAMILY WITH WHOM THEY LIVE AND THE ENVIRONMENT IN WHICH THEY ARE RAISED. CONSIDER A CHILD WITH ASTHMA WHO MAY RECEIVE MEDICATION AND EDUCATION FROM A PEDIATRICIAN HOWEVER LIVES IN A HOME WITH MOLD, PESTS AND SECONDHAND SMOKE WHICH CAUSE HIS OR HER ASTHMA TO BE UNCONTROLLED. THERE EXIST SOCIAL DETERMINANTS OF HEALTH SUCH AS POVERTY, LACK OF QUALITY AFFORDABLE HOUSING, EXPOSURE TO VIOLENCE AND NEGLECT, AND FOOD INSECURITY THAT ARE CRITICAL TO DETRACTING FROM A CHILD'S HEALTH AND WELLBEING. WE KNOW CHILDREN LIVE IN THE CONTEXT OF THEIR FAMILY AND COMMUNITY AND CLINICAL-COMMUNITY LINKAGES ARE ESSENTIAL TO IMPROVE CHILDREN'S HEALTH.AT DAYTON CHILDREN'S WE ARE PART OF THE TRANSFORMATION OF HEALTH CARE. JUST AS WE HAVE STATE-OF-THE-ART SERVICES FOR CHILDREN WHO ARE UNWELL DUE TO MEDICAL ISSUES, SO TOO DO WE NEED A STATE-OF-THE-ART RESPONSE FOR CHILDREN THAT ARE UNWELL BECAUSE OF THE ENVIRONMENT IN WHICH THEY ARE RAISED AND THE SOCIAL DETERMINANTS OF HEALTH WHICH THEY EXPERIENCE. DAYTON CHILDREN'S CENTER FOR COMMUNITY HEALTH AND ADVOCACY IS THE FIRST STEP IN THAT RESPONSE AND WILL WORK TO INTEGRATE CLINICAL SERVICES AND COMMUNITY-BASED PROGRAMS TO SUPPORT CHILDREN AND THEIR FAMILIES. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY IS RESPONSIBLE FOR THE PLANNING AND EXECUTION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ALONG WITH MANY OTHER COMMUNITY BENEFIT PROGRAMS. PROGRAMS AND SERVICES ALIGNED UNDER THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY-DAYTON CHILDREN'S PEDIATRICS IS A PRIMARY CARE PATIENT-CENTERED MEDICAL HOME PROVIDING COMPREHENSIVE WELL-CHILD SERVICES, TREATMENT FOR ILLNESSES AND MEDICAL CONDITIONS, AND REFERRALS FOR SPECIALTY CARE. DAYTON CHILDREN'S PEDIATRICS IS ALSO THE HOME OF PRIMARY CARE TRAINING FOR MANY OF THE PEDIATRIC MEDICINE RESIDENTS AT THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE.-A SPECIALTY MEDICAL HOME TO SUPPORT CHILDREN WITH DISPARATE MEDICAL AND BEHAVIORAL HEALTH CARE NEEDS, INCLUDING CHILDREN IN FOSTER/KINSHIP CARE AND CHILDREN WITH MEDICAL COMPLEXITIES. PATIENTS IN THESE PROGRAMS BENEFIT FROM DEDICATED CARE COORDINATION, SOCIAL WORK, AND COMMUNITY HEALTH WORKER SUPPORT.-THE DIVISION OF CHILD ADVOCACY INCLUDING THREE CHILD ADVOCACY CENTERS: CARE HOUSE, MICHAEL'S HOUSE, AND THE WARREN COUNTY CHILD ADVOCACY CENTER. THE DIVISION PROVIDES COMPREHENSIVE ASSESSMENTS FOR CHILDREN WHO ARE SUSPECTED VICTIMS OF ALL FORMS OF CHILD MALTREATMENT, INCLUDING PHYSICAL AND SEXUAL ABUSE. -A CONSULTATIVE SERVICE TO SUPPORT CHILDREN DEALING WITH ISSUES RELATED TO WEIGHT MANAGEMENT AND HEALTHY LIFESTYLES. THIS PROGRAM PROVIDES MULTIDISCIPLINARY SUPPORT INCLUDING RECOMMENDATIONS ON HEALTHY EATING, EXERCISE, AND DIAGNOSIS AND MANAGEMENT OF COMPLICATIONS RELATED TO OBESITY. -A COMMUNITY HEALTH WORKER PROGRAM WHEREBY NAVIGATORS INTEGRATE INTO CLINICS WHILE PROVIDING COMMUNITY SUPPORTS FOR CHILDREN AND FAMILIES.-COMMUNITY ENGAGEMENT PROGRAMS OUTLINED WITHIN THE CHNA IMPLEMENTATION PLAN INCLUDING THE FAMILY RESOURCE CONNECTION, THE DAYTON ASTHMA ALLIANCE, AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, THE SAFE KIDS GREATER DAYTON COALITION AND OTHER INJURY PREVENTION PROGRAMMING. WHILE THE CENTER EXTENDS WELL BEYOND THE WALLS OF THE HOSPITAL AND OUR CAMPUS ON VALLEY STREET, THE NEW HOME OF THE CENTER'S ADMINISTRATION WILL BE AT OUR NEW CHILD HEALTH PAVILION ON THE CORNER OF VALLEY AND STANLEY STREETS. CONSTRUCTION FOR THE CHILD HEALTH PAVILION BEGAN IN FY 2017-2018 WITH A OPENING IN MAY 2019. INJURY PREVENTIONDAYTON CHILDREN'S CONTINUES OUR WORK TO PREVENT CHILDHOOD INJURIES AS UNINTENTIONAL INJURY IS A LEADING CAUSE OF DEATH AND DISABILITY FOR CHILDREN ACROSS THE COUNTY AND REGIONALLY. DAYTON CHILDREN'S WORKS WITH PARTNERS SUCH AS THE OHIO INJURY PREVENTION PARTNERSHIP, OHIO OCCUPANT PROTECTION REGIONAL COORDINATOR PROGRAM, AND THE MONTGOMERY COUNTY CHILD FATALITY REVIEW BOARD TO ADDRESS SOME OF THE KEY UNINTENTIONAL INJURIES TO CHILDREN IN OUR COMMUNITY, SUCH AS MOTOR VEHICLE ACCIDENTS, PEDESTRIAN ACCIDENTS, AND UNSAFE SLEEP PRACTICES. DAYTON CHILDREN'S IS THE LEAD AGENCY OF SAFE KIDS GREATER DAYTON, WHICH IS OUR REGION'S LEADER IN CHILDHOOD INJURY PREVENTION PROGRAMMING. THE SAFE KIDS GREATER DAYTON COALITION ADDRESSES KEY PEDIATRIC SAFETY ISSUES WITH COMMUNITY PROGRAMMING INCLUDING CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, HOME/FIRE SAFETY, MEDICATION POISONING PREVENTION, WATER SAFETY AND BICYCLE HELMET EDUCATION. IN OCTOBER 2018, SAFE KIDS GREATER DAYTON PARTNERED WITH AREA SAFE ROUTES TO SCHOOLS PROGRAMS TO HOST INTERNATIONAL WALK TO SCHOOL DAY AT WESTWOOD NEIGHBORHOOD SCHOOLS CENTER, HORACE MANN ELEMENTARY, RIVER'S EDGE MONTESSORI IN DAYTON PUBLIC SCHOOLS AS WELL AS THREE ELEMENTARY SCHOOLS IN KETTERING, OHIO TO TEACH CHILDREN ABOUT WALKING TO SCHOOL SAFELY. WESTWOOD AND OTHER LOCAL ELEMENTARY SCHOOLS WERE PROVIDED COPIES OF CLIFFORD TAKES A WALK TO READ WITH THEIR STUDENTS TO LEARN PEDESTRIAN SAFETY HABITS. LATER IN OCTOBER, SAFE KIDS WORKED TO PROMOTE "BE SAFE, BE SEEN ON HALLOWEEN" AT SCHOOLS THROUGHOUT THE DAYTON REGION. BIKE TO SCHOOL DAY WAS HELD AT EDISON NEIGHBORHOOD SCHOOLS CENTER, KEMP ELEMENTARY SCHOOL AND BELLEHAVEN ELEMENTARY SCHOOL IN DAYTON, OHIO. ALL STUDENTS IN NEED OF A HELMET WERE GIVEN ONE, AND STUDENTS HAD A CHANCE TO ENTER A RAFFLE FOR ONE OF 20 NEW BIKES PROVIDED BY HUFFY. SAFE KIDS GREATER DAYTON ALSO SUPPORTED A BIKE TO SCHOOL DAY EVENT IN SUGARCREEK TOWNSHIP AT BELL CREEK INTERMEDIATE SCHOOL. STUDENTS IN THIRD, FOURTH AND FIFTH GRADE PARTICIPATED IN WALKING AND BIKING EVENTS AND HAD A CHANCE TO WIN ONE OF 20 NEW BIKES AND SCOOTERS. OVER 600 CHILDREN PARTICIPATED IN BIKE TO SCHOOL DAY EVENTS. BEYOND SAFE KIDS GREATER DAYTON, DAYTON CHILDREN'S HOSPITAL HAS OTHER OUTREACH PROGRAMS TO PREVENT INJURY BY EDUCATING PROFESSIONALS TO UNDERSTAND THE UNIQUE PHYSIOLOGY OF CHILDREN. THESE PROGRAMS INCLUDE EMS OUTREACH AND EDUCATION, THE NURSING LIAISON PROGRAM AND SPORTS MEDICINE. DAYTON CHILDREN'S EMS OUTREACH COORDINATORS TRAINED THE STAFF AT 39 FIRE DEPARTMENTS ON SPECIFIC PEDIATRIC TRAUMA CASES AS WELL AS CHILDREN WITH SPECIFIC HEALTH CARE NEEDS. BY COVERING TOPICS RANGING FROM SEIZURES TO RESPIRATORY, TO HIDDEN HAZARDS (POISON), THE EMS OUTREACH COORDINATORS ENSURE EMTS ARE EDUCATED IN VARIOUS PEDIATRIC HEALTH ISSUES. THE EMS OUTREACH COORDINATORS ENSURE ALL FIRE DEPARTMENTS HAD ACCESS TO TRAINING AS NEEDED IN THE GREATER DAYTON AREA. DAYTON CHILDREN'S NURSE LIAISONS PROVIDE CONTINUING EDUCATION TO COMMUNITY AND SCHOOL NURSES IN MONTGOMERY AND CLARK COUNTIES. COMMUNITY AND SCHOOL NURSES RECEIVED TRAINING ON SEIZURES, SCHOOL AVOIDANCE, USE OF NAR CAN, AND OTHER PERTINENT TOPICS. NURSE LIAISONS ALSO PROVIDED SUPPORT TO TWO LOCAL SUMMER CAMP PROGRAMS AT THE KROC CENTER AND BOONSHOFT MUSEUM OF DISCOVERY TO ENSURE THOSE SUMMER CAMPS WERE ABLE TO INCLUDE CHILDREN WHO NEEDED ACCESS TO MEDICAL CARE DURING CAMP HOURS. DISASTER RELIEF ON MEMORIAL DAY 2019, DAYTON AND SURROUNDING COMMUNITIES WERE HIT WITH DEVASTATING TORNADOS. THE GREATER OLD NORTH DAYTON NEIGHBORHOOD WAS HIT BADLY BY THE TORNADO REQUIRING AN IMMEDIATE RESPONSE FROM THE HOSPITAL. THE HOSPITAL THANKFULLY WAS SPARED. IN THE INITIAL DAYS AFTER THE STORM, AS AN EMERGENCY RESPONSE, THE HOSPITAL UNDERTOOK SEVERAL INITIATIVES TO HELP OUR NEIGHBORS. PART VI, LINE 7, REPORTS FILED WITH STATES OH CONTINUATION OF PART V, SECTION B, LINE 11: HEALTH LEADS (HEALTHLEADSUSA.ORG) IS A NATIONAL MOVEMENT THAT ENVISIONS A HEALTHCARE SYSTEM THAT ADDRESSES ALL PATIENTS' BASIC RESOURCE NEEDS AS A STANDARD PART OF QUALITY CARE. HEALTH LEADS' MISSION IS TO CATALYZE THIS HEALTHCARE SYSTEM BY CONNECTING PATIENTS WITH THE BASIC RESOURCES THEY NEED TO BE HEALTHY, AND IN DOING SO, BUILD LEADERS WITH THE CONVICTION AND ABILITY TO CHAMPION QUALITY CARE FOR ALL PATIENTS. HEALTH LEADS HAS OVER 20 YEARS OF EXPERIENCE BUILDING SOCIAL NEEDS PROGRAMS IN HOSPITAL AND CLINIC SETTINGS.IN FY 2018-2019, THE FAMILY RESOURCE CONNECTION HAS PROVEN OUTCOMES IN CONNECTING PATIENT FAMILIES TO RESOURCES. IN THE PAST YEAR, 1,646 FAMILIES ENGAGED IN THE PROGRAM AND OVER 405 RESOURCE CONNECTIONS WERE MADE. THE GREATEST NEEDS IDENTIFIED IN THE FAMILY RESOURCE CONNECTION ARE FOOD AND COMMODITIES INCLUDING DIAPERS, CRIBS AND BEDS, SCHOOL SUPPLIES AND CLOTHING.IN ADDITION TO PROVIDING POSITIVE OUTCOMES FOR FAMILIES, THE FAMILY RESOURCE CONNECTION HELPS TO TRAIN THE NEXT GENERATION OF THE HEALTH CARE WORKFORCE. OVER THE LAST YEAR, 28 STUDENT ADVOCATES FROM MULTIPLE COLLEGES AND UNIVERSITIES IN A VARIETY OF PROGRAMS AND MAJORS ENGAGED WITH THE PROGRAM. THE STUDENTS HAVE RANGED FROM CERTIFICATE PROGRAMS, ASSOCIATE, BACHELOR TO MASTERS DEGREES WITH A VARIETY OF PROGRAMS AND MAJORS WHICH HAVE INCLUDED PRE-MEDICAL, SOCIAL WORK, HEALTH CARE ADMINISTRATION, PUBLIC HEALTH, SOCIAL SERVICES AND HEALTH CARE NAVIGATOR.DAYTON CHILDREN'S IS PARTICIPATING IN A NATIONAL COLLABORATIVE TO ADVANCE SOCIAL HEALTH INGETRATION (CASHI) THROUGH THE HEALTH LEADS ORGANIZATION. DAYTON CHILDREN'S FAMILY RESOURCE CONNECTION IS SHARING AND LEARNING BEST PRACTICES IN IMPLEMENTING SOCIAL NEEDS PROGRAMS WITHIN A CLINIC SETTING.STRATEGY: INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICESRECOGNIZING THAT A SIGNIFICANT PORTION OF A CHILD'S HEALTH IS DETERMINED BY NON-CLINICAL FACTORS, DAYTON CHILDREN'S BEGIN EMPLOYING COMMUNITY HEALTH WORKERS TO SUPPORT SOME OF OUR MOST VULNERABLE POPULATIONS. THROUGH A GRANT FROM THE OHIO DEPARTMENT OF JOB AND FAMILY SERVICES AND MONTGOMERY COUNTY, DAYTON CHILDREN'S EMPLOYS TWO KINSHIP NAVIGATORS WHO KINSHIP FAMILIES BY HELPING THEM NAVIGATE SAFETY NET SYSTEMS, CONNECT TO RESOURCES AND COMPLETE BENEFIT FORMS FOR COUNTY, STATE, AND LOCAL AGENCIES. ANY KINSHIP CAREGIVER IN OUR COMMUNITY CAN ACCESS THE KINSHIP NAVIGATORS HOWEVER THE NAVIGATORS WORK CLOSELY WITH OUR NEW FOSTER/KINSHIP CLINIC AS WELL. IN ADDITION TO THE KINSHIP NAVIGATORS, DAYTON CHILDREN'S HIRED A COMMUNITY HEALTH WORKER ASSIGNED TO THE DAYTON ASTHMA ALLIANCE AND THE PULMONARY CLINIC. THIS COMMUNITY HEALTH WORKER WORKS DIRECTLY WITH FAMILIES IMPACTED BY ASTHMA TO IDENTIFY THE NON-MEDICAL BARRIERS TO OPTIMAL HEALTH INCLUDING HOUSING, FOOD INSECURITY AND EDUCATIONAL SUPPORT. THE COMMUNITY HEALTH WORKER OFTEN CONDUCTS HOME VISITS TO IDENTIFY ASTHMA TRIGGERS AND OFFERS REMEDIATION AND OTHER SOCIAL SUPPORT.WITH ADDITIONAL FUNDING FROM THE HEALTH PATH FOUNDATION, THE HOSPITAL HIRED A FOURTH COMMUNITY HEALTH WORKER TO SERVE FAMILIES OF CHILDREN WITH MEDICAL COMPLEXITIES WHO OFTEN NEED ADDITIONAL SUPPORT. THIS COMMUNITY HEALTH WORKER SERVES THE CHILDREN WITH COMPLEX MEDICAL NEEDS IN THE DAYTON CHILDREN'S PEDIATRICS CLINIC. STRATEGY: PROMOTE A REGIONAL CHILDHOOD VACCINATION CAMPAIGNTHIS STRATEGY BEGAN WITH WORK AROUND IDENTIFYING HOW MANY CHILDREN IN OUR COMMUNITY MIGHT NOT BE VACCINATED. THE HOSPITAL BEGAN OFFERING THE FLU SHOT TO CAREGIVERS OF OUR INPATIENT CHILDREN IN 2017 AND SUCCESSFULLY VACCINATED SEVERAL HUNDRED ADULTS. WE WANTED TO EXTEND THE PROGRAM TO OUR OUTPATIENT CHILDREN AND CAREGIVERS BUT NEEDED TO PLAN FOR HOW MANY EXTRA SHOTS WE WOULD NEED TO ORDER. WE ASKED EVERY FAMILY WHO CAME TO US THROUGH THE EMERGENCY DEPARTMENT OR FOR AN OUTPATIENT VISIT IF THEIR CHILD HAD RECEIVED THE FLU VACCINE. THE NUMBERS WERE STAGGERING. LESS THAN 30 PERCENT OF CHILDREN WHO CAME TO DAYTON CHILDREN'S FOR ANY REASON WERE VACCINATED AGAINST THE FLU. A TEAM WITH MEMBERS FROM INFECTIOUS DISEASE, PHARMACY, VALUE IMPROVEMENT, MARKETING AND COMMUNITY HEALTH ALL CAME TOGETHER TO FIND HOW TO BETTER SERVE OUR CHILDREN IN SUBSEQUENT FLU SEASONS.DURING THE FY2018-2019 FLU SEASON, THE HOSPITAL BEGAN OFFERING WALK UP FLU SHOTS AT OUR MAIN AND SOUTH CAMPUS PHARMACIES AND 816 FLU SHOTS WERE GIVEN. DAYTON CHILDREN'S IS CLOSELY WATCHING STATE LEGISLATION THAT COULD LESSON SOME OF THE PROGRESS MADE TO HAVE MORE CHILDREN IMMUNIZED. STRATEGY: IMPLEMENT A FOOD INSECURITY SCREENING AND REFERRAL PROGRAMIN FY 2018-2019, DAYTON CHILDREN'S LEVERAGED OUR FAMILY RESOURCE CONNECTION PROGRAM WITHIN DAYTON CHILDREN'S PEDIATRICS TO SCREEN FAMILIES FOR FOOD INSECURITY AND CONNECT THEM TO COMMUNITY RESOURCES. SCREENING ALSO SPREAD INTO THE HOSPITAL'S NUTRITION CLINIC. PLANS BEGAN FOR HOW THIS PROGRAM WILL BE INTEGRATED IN TO THE FOOD PHARMACY PROGRAM. STRATEGY: IMPLEMENT A FOOD PHARMACY PROGRAMTHE FOOD SCRIPTS PROJECT WAS INITIATED IN PARTNERSHIP WITH THE DAYTON FOOD BANK TO PURCHASE AND BUILD FOOD BOXES FOR PATIENT FAMILIES IDENTIFIED AS FOOD INSECURE BY THE FAMILY RESOURCE CONNECTION. THESE FAMILIES WERE REFFERED TO THE FOOD BANK AND PROVIDED AN ELECTRONIC VOUCHER TO PICK UP A FOOD BOX. THE FOOD SCRIPTS PROGRAM RAN THIS WAY UNTIL THE OPENING OF THE CHILD HEALTH PAVILLION, WHERE THE BOXES ARE MADE AVAILABLE IN THE SAME LOCATION AS THE FAMILY RESOURCE CONNECTION FOR FAMILIES IDENTIFIED AS FOOD INSECURE. WHILE OPERATING OUT OF THE DAYTON FOOD BANK AN AVERAGE OF 9 FAMILIES WERE SERVED EACH MONTH. IN APRIL 2019, THE FOOD SCRIPTS PROGRAM OFFICIALLY OPENED IN THE CHILD HEALTH PAVILION. IN PREPARATION FOR THE OPENING AND NEW PROGRAMMING, A COMMUNITY FOOD EQUITY MANAGER WAS HIRED IN JANUARY 2019 TO MANAGE THIS PROGRAM AND THE NEW DEMONSTRATION KITCHEN THAT IS PART OF THE HOSPITAL'S EFFORTS TO IMPROVE ACCESS TO HEALTHY FOOD IN THE REGION. THIS NEW LOCATION FOR THE PROGRAM GAVE FAMILIES BETTER ACCESS TO THE FOOD SCRIPTS PROGRAM AND IN MAY AND JUNE AN AVERAGE OF 64 FAMILIES WERE SERVED EACH MONTH.IN THE COMMUNITY TEACHING KITCHEN, NUTRITION CLASSES COVERING DIFFERENT NUTRITION REALTED TOPICS WERE DEVELOPED AND OFFERED TO THE COMMUNITY FREE OF CHARGE 2-3 TIMES PER WEEK. IN ADDITION TO THIS, SUMMER CAMPS, SCHOOL GROUPS, AND DIFFERENT COMMUNITY ORGANIZATIONS CAN COME TO TAKE A CLASS AS WELL. IN THE FIRST TWO MONTHS SINCE OPENING THE TEACHING KITCHEN HAS ENAGED A TOTAL OF 114 PEOPLE. 1 ADVOCATES FOR BASIC LEGAL EQUALITY INC 515 JEFFERSON AVENUE STE 300 TOLEDO OH 43604 237376131 501 (C) (3) 10000 PROGRAM DONATION BALWIN WALLACE UNIVERSITY 275 EASTLAND ROAD BEREA OH 44017 340714629 501 (C) (3) 12000 PROGRAM DONATION CULTURE WORKS 110 N MAIN STREET STE 165 DAYTON OH 45402 237412338 501 (C) (3) 6500 PROGRAM DONATION DAYTON PERFORMING ARTS ALLIANCE 126 NORTH MAIN ST STE 120 DAYTON OH 45402 316000101 501 (C) (3) 5000 PROGRAM DONATION DAYTON SOCIETY OF NATURAL HISTORY 2600 DEWEESE PKWY DAYTON OH 45414 310585917 501 (C) (3) 7500 PROGRAM DONATION DOWNTOWN DAYTON PARNERHSIP 1792 W SECOND ST SUITE 611 DAYTON OH 45402 341722175 501 (C) (3) 5000 PROGRAM DONATION FIRST FOUR EVENTS PO BOX 340488 DAYTON OH 45434 454231032 501 (C) (3) 5000 PROGRAM DONATION MARCH OF DIMES 3131 S DIXIE DRIVE STE 416 DAYTON OH 45439 131846366 501 (C) (3) 5500 PROGRAM DONATION SOUTHESTERN OHIO COUNCIL FOR HIGHER EDUCATION 3155 RESEARCH BLVD DAYTON OH 45420 237109141 501 (C) (3) 5000 PROGRAM DONATION UNITED WAY OF THE GREATER DAYTON AREA 33 W FIRST STREET STE 500 DAYTON OH 45402 310536658 501 (C) (3) 25000 CORPORATE PLEDGE VICTORIA THEATRE ASSOCIATION 138 N MAIN STREET DAYTON OH 45402 310897638 501 (C) (3) 5000 PROGRAM DONATION YMCA WOMEN OF INFLUENCE AWARDS 141 W THIRD STREET DAYTON OH 45402 310537168 501 (C) (3) 5000 PROGRAM DONATION 12 PART I, LINE 2: THE FINANCE COMMITTEE AND COMMUNITY RELATIONS MANAGER APPROVE ALL GRANTS AND CHARITABLE DONATIONS. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ADAM MEZOFF MD CMO 619982 0 0 0 15409 0 12507 0 21198 0 669096 0 7345 0 DEBORAH FELDMAN CEO 774467 0 0 0 38446 0 713717 0 0 0 1526630 0 21382 0 CHRIS BERGMAN CFO 468627 0 0 0 8064 0 10091 0 14135 0 500917 0 0 0 BENJAMIN GOODSTEIN VP AND CHIEF AMBULATORY OFFICER 268514 0 0 0 2958 0 10206 0 13270 0 294948 0 1538 0 JAYNE GMEINER VP AND CHIEF NURSING OFFICER 284314 0 0 0 4544 0 9585 0 10442 0 308885 0 0 0 MATTHEW GRAYBILL VP HR AND CHIEF ADMINISTRA 322349 0 0 0 18376 0 183489 0 24562 0 548776 0 10328 0 KELLY KAVANAUGH VP AND CHIEF STRATEGY OFFI 263672 0 0 0 4322 0 50393 0 22153 0 340540 0 0 0 NANCY SEVERT MANAGER - IMPATIENT PHARMACY 145674 0 10321 0 158845 0 2559 0 13378 0 330777 0 0 0 DAVID MILLER FORMER CFO (END 1/16) 0 0 0 0 294997 0 0 0 0 0 294997 0 294997 0 PART I, LINE 4B PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND THE INCREASE IN ACTUARIAL VALUE: DEBORAH FELDMAN 702,986 MATTHEW GRAYBILL 92,365 RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DAVID MILLER 273,166 A COUNTY OF MONTGOMERY 316000172 000000000 2016-10-13 30000000 HOSPITAL RENOVATION 0 0 0 B COUNTY OF MONTGOMERY 316000172 000000000 2015-11-20 12675000 HOSPITAL RENOVATION 0 0 0 C COUNTY OF MONTGOMERY 316000172 000000000 2014-08-19 117055000 HOSPITAL RENOVATION 0 0 0 A 30000000 30000000 2017 0 0 0 1 B 12675000 40000 12635000 2017 0 0 0 1 C 117055000 400070 116654930 2017 0 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 1 0 0 1 0 0 0 0 B 0 1 0 0 1 0 0 0 0 C 0 1 0 0 1 0 0 0 0 A 0 B 0 C 0 SARA GUERRERO-DUBY SPOUSE OF BOARD MEMBER 135655 EMPLOYED 0 FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWS KEY DISCLOSURES WITH APPROPRIATE COMMITTEES OF THE BOARD OF TRUSTEES. THEN PRIOR TO FILING, THE FORM 990 IS ELECTRONICALLY LOADED TO A SECURE WEBSITE FOR THE ENTIRE BOARD OF TRUSTEES TO REVIEW. AN EMAIL IS SENT TO ALL MEMBERS NOTIFYING THEM THAT THE FORM IS AVAILABLE FOR THEIR REVIEW AND THAT IT WILL BE FILED ON OR BEFORE THE EXTENDED DUE DATE. FORM 990, PART VI, SECTION B, LINE 12C AT THE BEGINNING OF EACH MEETING, THE CHAIRMAN OF THE BOARD ASKS EACH MEMBER TO IDENTIFY AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST BASED ON THE AGENDA OR ANY CHANGES IN THEIR BUSINESS PRACTICE THAT MIGHT BE RELEVANT. IF THERE ARE ANY CONFLICTS, THE MEMBER(S) RECUSE THEMSELVES AND DO NOT PARTICIPATE IN THE DISCUSSION AND DO NOT VOTE ON THE ITEM. THIS THEN IS NOTED IN THE MINUTES OF THAT MEETING. BOARD MEMBERS ANNUALLY AGREE TO ABIDE BY WRITTEN CONFLICT OF INTEREST AND CONFIDENTIALITY POLICIES. BOARD MEMBERS ALSO WORK TO REPRESENT AND BALANCE THE INTERESTS OF DAYTON CHILDREN'S HOSPITAL'S MANY CONSTITUENTS. THE BOARD ANNUALLY EVALUATES ITS OWN PERFORMANCE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE HOSPITAL'S CHIEF EXECUTIVE OFFICER (CEO) IS SET BY AN EXECUTIVE COMPENSATION COMMITTEE (THE COMMITTEE) MADE UP OF THREE INDEPENDENT TRUSTEES WHO ARE ALSO OFFICERS OF THE BOARD. THIS COMMITTEE ALSO APPROVES COMPENSATION LEVELS AND EXECUTIVE BENEFITS FOR EACH EXECUTIVE EMPLOYED BY THE HOSPITAL. THE COMMITTEE OPERATES UNDER A FORMAL CHARTER AND KEEPS CONTEMPORANEOUS MINUTES OF ITS PROCEEDINGS. THE COMMITTEE USED A TOTAL COMPENSATION PHILOSOPHY TO GUIDE ALL DECISIONS RELATED TO EXECUTIVE COMPENSATION AT DAYTON CHILDREN'S HOSPITAL (DCH), AND AS SUCH DETERMINES AND APPROVES ALL ASPECTS OF THE CEO'S TOTAL COMPENSATION PACKAGE, INCLUDING BENEFITS AND EXPENSE ALLOWANCES. THESE ARE DETAILED IN A WRITTEN EMPLOYMENT AGREEMENT FOR THE CEO. THE COMMITTEE USES AN OUTSIDE CONSULTANT TO CONDUCT PERIODIC REVIEWS OF THE EXECUTIVE COMPENSATION LEVELS OF THE ORGANIZATION VERSUS THOSE OF SIMILARLY SIZED AND SITUATED ORGANIZATIONS USING PUBLISHED SURVEYS. THESE SURVEY RESULTS ARE USED BY THE COMMITTEE IN SETTING EXECUTIVE LEVELS AND THE CEO'S COMPENSATION IN PARTICULAR. THE COMMITTEE FOLLOWS A FORMAL CALENDAR OF MEETINGS AND THE CHAIRMAN OF THE COMMITTEE REPORTS TO THE BOARD OF TRUSTEES AT LEAST ANNUALLY ON THE COMMITTEE'S ACTIVITIES AND ON DETAILS OF THE CEO'S COMPENSATION AND BENEFITS PACKAGE. THE COMMITTEE ALSO REVIEWS AND APPROVES DISCLOSURES RELATED TO EXECUTIVE COMPENSATION MADE AS PART OF IRS FORM 990. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS, ORGANIZING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE GENERAL PUBLIC UPON WRITTEN OR VERBAL REQUEST TO DAYTON CHILDREN'S HOSPITAL, FOR THE SAME PERIOD OF TIME AS SET FORTH IN THE INTERNAL REVENUE CODE SECTION 6104(D). FORM 990, PART XI, LINE 9: TRANSFER TO DAYTON CHILDREN'S HOSPITAL FOUNDATION 85,672. CHANGE IN PENSION BENEFIT OBLIGATION -13,247,000. CENTER FOR COMMUNITY HEALTH AND ADVOCACY ONE CHILDRENS PLAZA DAYTON OH 45404 824391789 NEW MARKETS TAX CREDIT OH -144751 9871677 DAYTON CHILDREN'S HOSPITAL CHILDREN'S HOME CARE OF DAYTON ONE CHILDRENS PLAZA DAYTON OH 45404 311356037 HOME CARE OH 501(C)(3) LINE 10 DAYTON CHILDREN'S HOSPITAL 1 DAYTON CHILDREN'S HOSPITAL FOUNDATION ONE CHILDRENS PLAZA DAYTON OH 45404 311045247 SUPPORT OH 501(C)(3) LINE 12A, I DAYTON CHILDREN'S HOSPITAL 1 PEDIATRIC ASSURANCE COMPANY LTD BUTTERFIELD BANK BLDG 6TH FLOOR HAMILTON BERMUDA HM BERMUDA BD 980478183 SELF-INSURANCE BD DAYTON CHILDREN'S HOSPITAL -242776 15881885 1.00000 1 DAYTON CHILDREN'S SPECIALTY PEDIATRICS ONE CHILDRENS PLAZA DAYTON OH 45404 311411364 SPEC PHYS GRO OH DAYTON CHILDREN'S HOSPITAL C -25025402 29661926 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 DAYTON CHILDREN'S SPECIALTY PEDIATRICS O 511368 CASH DAYTON CHILDREN'S SPECIALTY PEDIATRICS S 48575415 CASH DAYTON CHILDREN'S SPECIALTY PEDIATRICS Q 740623 CASH CHILDREN'S HOME CARE OF DAYTON B 79137 CASH CHILDREN'S HOME CARE OF DAYTON O 83960 CASH CHILDREN'S HOME CARE OF DAYTON P 14459806 CASH DAYTON CHILDREN'S HOSPITAL FOUNDATION O 151641 CASH DAYTON CHILDREN'S HOSPITAL FOUNDATION S 2377460 CASH PEDIATRIC ASSURANCE COMPANY R 3961800 CASH PEDIATRIC ASSURANCE COMPANY Q 1774253 CASH