2020-07-13T11:24:06-05:00 2019-06-30 861065772 DELOITTE TAX LLP 1033 DEMONBREUN SUITE 400 NASHVILLE TN 37203 990 2018-07-01 620646012 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC STJU 9015953903 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 PAT KEEL SVP, CAO AND CFO 9015953903 2020-07-10 1 FRANCIS J BEDARD P00752421 6152591800 99.169.247.132 2020-07-10 11:19:00 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9AB8036A84DA1635B8EE3280B58BE06A32D88B7B 2018 2020-09-22 18:59:49Z JAMES R DOWNING 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 1108891351 0 X WWW.STJUDE.ORG X 1959 TN THE MISSION OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S ABILITY TO PAY. 44 41 5440 4003 0 0 851803301 974758247 117420862 109172619 -7463705 -556846 18895861 24595111 980656319 1107969131 4312073 1538019 0 0 505567014 545749401 0 0 0 440836545 474154881 950715632 1021442301 29940687 86526830 5434170902 6214238431 131298150 154548735 5302872752 6059689696 X THE MISSION OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S ABILITY TO PAY. 0 0 490685639 1291319 113964801 PATIENT CARE: THE HOSPITAL PROVIDED 19,394 INPATIENT DAYS OF CARE DURING THE YEAR. OUR BONE MARROW TRANSPLANTATION PROGRAM ACCOUNTED FOR 3,968 OR 20% OF THOSE INPATIENT DAYS. PATIENTS MADE 81,759 CLINIC VISITS DURING THE YEAR. 436938714 246700 RESEARCH: THE CURRENT BASIC SCIENCE AND CLINICAL RESEARCH AT THE HOSPITAL INCLUDES WORK IN GENE THERAPY, CHEMOTHERAPY, THE BIOCHEMISTRY OF NORMAL AND CANCEROUS CELLS, RADIATION TREATMENT, BLOOD DISEASES, RESISTANCE TO THERAPY, VIRUSES, HEREDITARY DISEASES, INFLUENZA, PEDIATRIC AIDS AND PHYSIOLOGICAL EFFECTS OF CATASTROPHIC ILLNESSES. 29338061 EDUCATION AND TRAINING: AS PART OF ITS MISSION, THE HOSPITAL HAS DEVELOPED A GLOBAL INITIATIVE (ST. JUDE GLOBAL) TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE GLOBAL ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, HELPING TO IMPLEMENT NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND DEVELOPING REGIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THIS MISSION WILL BE ACHIEVED BY FOCUSING ON THREE OVERRIDING GOALS: (1) TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION, (2) TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES, AND (3) TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE. THESE INITIATIVES ARE SPEARHEADED BY ST. JUDE EXPERTS WHO WORK CLOSELY WITH HEALTHCARE PROFESSIONALS AT OUR PARTNER SITES. IN ADDITION, A GRADUATE PROGRAM IS OFFERED THROUGH A WHOLLY-OWNED SUBSIDIARY, ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, LLC, TO EDUCATE AND TRAIN FUTURE GENERATIONS OF SCIENTISTS SEEKING TO UNDERSTAND THE MOLECULAR BASIS OF HUMAN DISEASE AND DEVELOP NOVEL THERAPIES BASED ON THAT UNDERSTANDING. 956962414 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1352 0 1 5440 1 0 0 0 0 0 0 0 0 0 0 0 0 X 44 41 1 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 TN X X SHARON HENDRIX 9015953903 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 JOYCE ABOUSSIE VOTING DIRECTOR 4.00 4.00 X 0 0 0 SUSAN MACK AGUILLARD MD VOTING DIRECTOR 8.00 4.00 X 0 0 0 MAHIR AWDEH MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 JOSEPH S AYOUB JR ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL J AYOUB ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 FREDERICK M AZAR MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 JAMES B BARKATE VOTING DIRECTOR 4.00 8.00 X 0 0 0 MARTHA PERINE BEARD VOTING DIRECTOR 4.00 8.00 X 0 0 0 SHERYL BOURISK VOTING DIRECTOR 4.00 4.00 X 0 0 0 ROBERT A BREIT MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 TERRY BURMAN VOTING DIRECTOR 4.00 4.00 X 0 0 0 ANN M DANNER VOTING DIRECTOR 4.00 4.00 X 0 0 0 JOSEPH M DEVIVO VOTING DIRECTOR 4.00 4.00 X 0 0 0 FRED P GATTAS III PHARMD VOTING DIRECTOR 4.00 4.00 X 0 0 0 RUTH GAVIRIA VOTING DIRECTOR 4.00 4.00 X 0 0 0 CHRISTOPHER GEORGE MD VOTING DIRECTOR 8.00 4.00 X 0 0 0 JUDY HABIB VOTING DIRECTOR 4.00 8.00 X 0 0 0 GABRIEL GABY HADDAD MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL K HAJAR VOTING DIRECTOR 4.00 4.00 X 0 0 0 CHUCK HAJJAR VOTING DIRECTOR 4.00 4.00 X 0 0 0 FOUAD HAJJAR MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 FREDERICK R HARRIS JR MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 BRUCE B HOPKINS VOTING DIRECTOR 4.00 4.00 X 0 0 0 J DAVID KARAM II VOTING DIRECTOR 4.00 4.00 X 0 0 0 SHARON L MCCOLLAM VOTING DIRECTOR 4.00 4.00 X 0 0 0 MICHAEL D MCCOY VOTING DIRECTOR 4.00 4.00 X 0 0 0 ROBERT T MOLINET ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 RAMZI NUWAYHID VOTING DIRECTOR 4.00 4.00 X 0 0 0 THOMAS PENN III VOTING DIRECTOR 4.00 4.00 X 0 0 0 CHRISTINA M RASHID VOTING DIRECTOR 4.00 4.00 X 0 0 0 CAMILLE F SARROUF JR ESQ VOTING DIRECTOR 8.00 4.00 X 0 0 0 JOSEPH C SHAKER VOTING DIRECTOR 4.00 4.00 X 0 0 0 JOSEPH G SHAKER VOTING DIRECTOR 4.00 4.00 X 0 0 0 GEORGE A SIMON II VOTING DIRECTOR 4.00 4.00 X 0 0 0 MICHAEL SIMON VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL J SIMON VOTING DIRECTOR 4.00 4.00 X 0 0 0 TONY THOMAS VOTING DIRECTOR 4.00 4.00 X 0 0 0 RICHARD M UNES VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL H WEIN ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 THOMAS WERTZ VOTING DIRECTOR 4.00 4.00 X 0 0 0 SUSAN R WINDHAM-BANNISTER VOTING DIRECTOR 4.00 4.00 X 0 0 0 TAMA ZAYDON VOTING DIRECTOR 4.00 4.00 X 0 0 0 RICHARD C SHADYAC JR EX-OFFICIO DIRECTOR 1.00 55.00 X 0 840195 118691 JAMES R DOWNING PRESIDENT/CEO 55.00 1.00 X X 1134497 0 144053 PATRICIA A KEEL SVP/CFO 55.00 0.00 X 595248 0 85631 JAMES I MORGAN EVP/SCIENTIFIC DIRECTOR 55.00 0.00 X 717786 0 56554 ELLIS NEUFELD EVP/CLINICAL DIRECTOR 55.00 0.00 X 741883 0 163760 MARY ANNA QUINN EVP/CHIEF ADMIN. OFFICER 55.00 0.00 X 470968 0 53994 CHARLES M ROBERTS EVP/DIRECTOR CANCER CENTER 55.00 0.00 X 774908 0 155598 CARLOS RODRIGUEZ-GALINDO EVP/CHAIR 55.00 0.00 X 703187 0 71325 ANDREW DAVIDOFF CHAIR 55.00 0.00 X 833933 0 60767 DAVID ELLISON CHAIR 55.00 0.00 X 735746 0 109717 AMAR J GAJJAR CHAIR 55.00 0.00 X 707462 0 48386 THOMAS E MERCHANT CHAIR 55.00 0.00 X 889223 0 64327 CHING-HON PUI CHAIR 55.00 0.00 X 740117 0 37545 WILLIAM E EVANS FACULTY/FORMER PRESIDENT/CEO 55.00 0.00 X 681292 0 41325 9726250 840195 1211673 1006 1 1 0 FLINTCO LLC 2179 HILLSHIRE CIRCLE MEMPHIS TN 38133 CONSTRUCTION CONTRACTOR 93282711 CS3 INC 8634 LADURL DRIVE BARTLETT TN 38133 GENERAL CONTRACTOR 7676755 BELZ CONSTRUCTION SERVICES 100 PEABODY PLACE SUITE 1400 MEMPHIS TN 38103 CONSTRUCTION CONTRACTOR 7621080 METHODIST HEALTHCARE MEMPHIS 1265 UNION AVE MEMPHIS TN 38104 MEDICAL SERVICES 6601217 MICROSOFT CORPORATION ONE MICROSOFT WAY REDMOND WA 98052 SOFTWARE SUPPORT 6424547 270 865122365 93978570 15657312 974758247 PATIENT CARE 621110 109172619 109172619 109172619 11974 11974 14721431 14721431 298814 54586 240612 681608 58202 -627022 -568820 -627022 58202 CAFETERIA/VENDING 722514 4454476 4454476 CHGME/CHCA 900099 2344673 2344673 HHMI 900099 363869 363869 2710662 2710662 9873680 1107969131 113964801 0 19246083 1538019 1538019 5957031 3388304 2568727 705647 705647 417581913 386631522 30950391 25959964 24035860 1924104 66802869 61851565 4951304 28741977 26611675 2130302 28661610 26611090 2050520 1517331 1408778 108553 202470 187985 14485 84368 84368 99709207 86684812 13024395 906842 841964 64878 2629666 2588790 40876 36721571 34094423 2627148 34371101 29213940 5157161 14879075 14052143 826932 1588699 1171854 416845 90990394 80942881 10047513 1742428 1226920 515508 PHARMACEUTICAL SUPPLIES 60477062 59536996 940066 LABORATORY SUPPLIES 51359042 50560708 798334 UBI TAXES 93875 0 93875 ALLOCATION ADJUSTMENTS 0 20883545 -20883545 48220140 42192993 6027147 1021442301 956962414 64479887 0 1110291 4118944 22491694 29362954 21703486 21028537 7732327 9042686 13941837 19016975 1678400886 915173701 669110408 763227185 2222796 2370565 4695858063 5366070585 5434170902 6214238431 112276799 137164440 15399715 14186821 3621636 3197474 131298150 154548735 X 4201630278 4972521523 76544144 0 1024698330 1087168173 5302872752 6059689696 5434170902 6214238431 X 86526830 77592 670212522 X 0 1 X 1 1 1 X 674808276 895523715 753145680 851803301 974758247 4150039219 674808276 895523715 753145680 851803301 974758247 4150039219 4150039219 7579828 11681881 4641541 11308521 14733405 49945176 7390478 6775862 20138461 7598809 9873680 51777290 4251761685 0.97610 0.97170 X PART II, SECTION B, LINE 10: EXPLANATION FOR OTHER INCOME: 2014 $ 3,534,638 - CAFETERIA/VENDING $ 1,454,365 - CHGME/CHCA $ 2,401,475 - OTHER REVENUE $ 7,390,478 - TOTAL OTHER INCOME 2015 $ 3,709,328 - CAFETERIA/VENDING $ 1,683,327 - CHGME/CHCA $ 1,383,207 - OTHER REVENUE $ 6,775,862 - TOTAL OTHER INCOME 2016 $ 8,152,422 - BOND DEFEASANCE GAIN $ 4,086,280 - CAFETERIA/VENDING $ 2,058,124 - CHGME/CHCA $ 5,841,635 - OTHER REVENUE $ 20,136,461 - TOTAL OTHER INCOME 2017 $ 4,288,072 - CAFETERIA/VENDING $ 2,351,842 - CHGME/CHCA $ 327,751 - HHMI $ 631,144 - OTHER REVENUE $ 7,598,809 - TOTAL OTHER INCOME 2018 $ 4,454,476 - CAFETERIA/VENDING $ 2,344,673 - CHGME/CHCA $ 363,869 - HHMI $ 2,710,662 - OTHER REVENUE $ 9,873,680 - TOTAL OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 21139 0 1 63229 84368 0 PART II-B, LINE 1: LINE 1A) A ST. JUDE PATIENT/FAMILY TRAVELED TO DC ON BEHALF OF ST. JUDE TO ADVOCATE WITH CONGRESS FOR INCREASED NIH FUNDING; LINE 1B) ST. JUDE EMPLOYS A DIRECTOR OF GOVERNMENT AFFAIRS; LINE 1G) AMOUNT LISTED IS PRORATED SALARY OF DIRECTOR OF GOVERNMENT AFFAIRS PLUS TRAVEL EXPENSES; LINE 1I) AMOUNT LISTED IS RELATED TO PRORATED RETAINER FEES FOR DIRECT AND STATE LEGISLATIVE CONTACTS AS WELL AS PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING FOR THE CHGME PROGRAM. 1024698330 4864242 64664085 38875713 1055350944 965253422 21281957 92690065 54527114 1024698330 873056599 12552432 103475245 23830854 965253422 873885134 2341719 -72118 3098136 873056599 915104075 2970640 8222632 52412213 873885134 1.00000 1 1 1 1208060491 597826180 610234311 456298014 310124244 146173770 14042381 7223277 6819104 763227185 INTEREST IN NET ASSETS OF AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC 5366070585 5366070585 SELF INSURANCE LIABILITY 1792643 WORKERS COMPENSATION 1181465 OWNER CONTROLLED INSURANCE PROGRAM 223366 3197474 X 823030750 77592 580106392 580183984 242846766 865122365 865122365 1107969131 1021442301 0 1021442301 0 1021442301 PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC., A RELATED ORGANIZATION, AND ARE USED TO SUPPORT THE FUTURE NEEDS OF ST. JUDE. PART X, LINE 2: AS OF JUNE 30, 2019, THE ORGANIZATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS COMBINED FINANCIAL STATEMENTS. IN THE EVENT THE ORGANIZATION WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AS A GENERAL EXPENSE. GENERALLY, TAX YEARS ENDING 2016 THROUGH 2019 ARE OPEN TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES, RESPECTIVELY. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF ALSAC WITHOUT DONOR RESTRICTIONS 580,106,392. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION - SUPPORT RECEIVED FROM ALSAC 865,122,365. CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 1866373 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 5567836 EUROPE (INCLUDING ICELAND & GREENLAND) 0 1 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 1361828 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 3975072 NORTH AMERICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 847849 RUSSIA AND NEIGHBORING STATES 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 144889 SOUTH AMERICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 1353167 SOUTH ASIA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 41604 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 57716 0 1 0 0 0 1 15158618 57716 15216334 0 0 0 0 0 0 PART I, LINE 3: EXPENDITURES ARE RECORDED ON AN ACCRUAL BASIS. PAYMENTS ARE ISSUED BASED ON CONTRACTUAL OBLIGATIONS UPON RECEIPT OF SUPPORTING DOCUMENTATION. 1 1 0 0 1 1 1 0 0 88740793 1022538 87718255 0.08590 152707177 31541618 121165559 0.11860 8545802 1717417 6828385 0.00670 249993772 34281573 215712199 0.21120 25592681 0 25592681 0.02510 15603972 280344 15323628 0.01500 28429296 0 28429296 0.02780 387337440 96291900 291045540 0.28490 1840087 0 1840087 0.00180 458803476 96572244 362231232 0.35460 708797248 130853817 577943431 0.56580 100244 100244 0.00010 18014 18014 0.00000 20848 20848 0.00000 139106 139106 0.00010 0 1100000 0 0 819608 -819608 X 1 1 1 1 ST JUDE CHILDREN'S RESEARCH HOSPITAL 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 WWW.STJUDE.ORG TN STATE LICENSE NUMBER 0000000113 X X X ST JUDE CHILDREN'S RESEARCH HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE PART V, SECTION C X 1 18 1 SEE PART V, SECTION C 0 1 X 1 1 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 1 X 0 0 ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 5: THE ST. JUDE FISCAL YEAR 2019 CHNA BUILDS UPON THE FISCAL YEAR 2013 AND 2016 CHNAS AND REFLECTS THE ACTIVITIES IDENTIFIED IN THE ST. JUDE FISCAL YEAR 2016 COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE FISCAL YEAR 2019 CHNA WAS LED BY AN INTERNAL TEAM OF ST. JUDE STAFF MEMBERS. THE LEADERSHIP OF THIS TEAM ENGAGED HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH CONSULTANCY ORGANIZATION, TO CONDUCT THE CHNA. THE NEW CHNA IDENTIFIED THE IMPORTANCE OF PARTNERSHIPS AND COLLABORATION WITH OTHER ORGANIZATIONS TO MEET THE HEALTH NEED AND MEDICAL NEEDS OF CHILDREN, INCLUDING THE SHELBY COUNTY HEALTH DEPARTMENT, METHODIST LE BONHEUR HEALTHCARE, AND BAPTIST MEMORIAL HEALTH CARE AND REGIONAL ONE HEALTH. EACH INSTITUTION IS WORKING TO ALIGN ITS ASSESSMENT AND PLANNING PROCESSES, WHEN APPROPRIATE, AND TO COORDINATE ACTIVITIES RELATED TO DATA COLLECTION.TO DEVELOP A SOCIAL, ECONOMIC, AND HEALTH PORTRAIT OF THE COMMUNITY SERVED BY ST. JUDE FOR THE GREATER MEMPHIS AREA AND NATIONALLY, HRIA REVIEWED EXISTING DATA DRAWN FROM LOCAL, STATE, AND NATIONAL SOURCES. TO GAIN MORE LOCAL-LEVEL DATA, ST. JUDE WORKED WITH THE SHELBY COUNTY HEALTH DEPARTMENT TO OBTAIN DEMOGRAPHIC, ECONOMIC, AND HEALTH DATA FOR SHELBY COUNTY. HRIA CONDUCTED QUALITATIVE RESEARCH WITH INTERNAL AND EXTERNAL ST. JUDE STAKEHOLDERS AS WELL AS PATIENTS AND FAMILY MEMBERS SERVED IN ORDER TO SUPPLEMENT QUANTITATIVE FINDINGS WITH PERCEPTIONS OF COMMUNITY STRENGTHS AND ASSETS, THEIR PRIORITY HEALTH CONCERNS, AND SUGGESTIONS FOR FUTURE PROGRAMMING AND SERVICES.FOCUS GROUPS FOCUS GROUPS WERE CONDUCTED WITH CURRENT AND FORMER ST. JUDE PATIENTS, PATIENT CAREGIVERS, AND ST. JUDE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF. DIFFERENT TOPIC AREAS WERE EXPLORED BASED ON THE UNIQUE EXPERIENCES OF EACH OF THE GROUPS. THE PATIENT AND CAREGIVER FOCUS GROUPS, CONDUCTED WITH CURRENT PATIENTS AND REPRESENTATIVES OF THE PATIENT FAMILY ADVISORY COUNCIL, EXPLORED THE EXTENT TO WHICH ST. JUDE IS MEETING THE NEEDS OF CHILDREN WITH CATASTROPHIC ILLNESSES AND OPPORTUNITIES TO BRIDGE PATIENT NEEDS IN THE FUTURE. THE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF FOCUS GROUPS EXPLORED THESE TOPICS AS WELL AS SPECIFIC ISSUES RELATED TO THE GREATER MEMPHIS COMMUNITY. A SEMI-STRUCTURED MODERATOR'S GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. WHILE SIMILAR, SEPARATE GUIDES WERE USED FOR THE CAREGIVER AND PATIENT FOCUS GROUPS SO THAT THEY WERE AGE AND DEVELOPMENTALLY APPROPRIATE. EACH FOCUS GROUP WAS FACILITATED BY AN EXPERIENCED HRIA STAFF MEMBER, WHILE A NOTE-TAKER TOOK DETAILED NOTES DURING THE DISCUSSION. ON AVERAGE, FOCUS GROUPS LASTED 30-90 MINUTES. BEFORE THE START OF THE GROUPS, HRIA EXPLAINED THE PURPOSE OF THE STUDY TO PARTICIPANTS AND PARTICIPANTS HAD AN OPPORTUNITY TO ASK QUESTIONS. THEY WERE ALSO NOTIFIED VERBALLY THAT GROUP DISCUSSIONS WOULD REMAIN CONFIDENTIAL, AND NO RESPONSES WOULD BE CONNECTED TO THEM PERSONALLY. PARTICIPANTS WERE RECRUITED BY ST. JUDE STAFF, WHO ARRANGED ALL LOGISTICS FOR THE ONSITE FOCUS GROUPS.MEDICAL EXECUTIVE COMMITTEE - ELIZABETH ADDERSON, MD, INFECTIOUS DISEASES - DORALINA ANGHELESCU, MD, ANESTHESIOLOGY - MICHAEL BISHOP, MD, ONCOLOGY, SOLID TUMOR - ROBIN DIAZ, JD, CHIEF LEGAL COUNSEL - SARA FEDERICO, MD, ONCOLOGY, SOLID TUMOR - WILLIAM GREENE, PHARMD, VICE PRESIDENT, PHARMACEUTICAL SERVICES - RAY MORRISON, MD, ICU, CRITICAL CARE-PULMONARY MEDICINE - ROBIN MUTZ, RN, SVP, CHIEF NURSING EXECUTIVE - TRACY PARKS, DIRECTOR, QUALITY MANAGEMENT - RICHARD ROCHESTER, MANAGER BMT/CT CLINIC - JOHN SANDLUND, MD, ONCOLOGY, LEUKEMIA/LYMPHOMA - BRANDON TRIPLETT, MD, BONE MARROW TRANSPLANT AND CELL THERAPY - JOSHUA WOLF, MD, INFECTIOUS DISEASES NURSING - MIKE BURGESS, PEDIATRIC ONCOLOGY NURSE III WKD, INPATIENT, BONE MARROW TRANSPLANT - LORI CHRISTION, INPATIENT UNIT MANAGER - JASMIN ELIZARRARAS, PEDIATRIC ONCOLOGY NURSE I, INPATIENT - CAMILLE FILOROMO, BSN, MED, PHD, RN, NEA-BC, SENIOR DIRECTOR OF CLINICAL EXPERIENCE - ANGEL PARKER, INPATIENT UNIT COORDINATOR - BOB SCHROEDER, INTERIM UNIT MANAGER, ICU - NICOLE WRIGHT, NURSING PROFESSIONAL DEVELOPMENT EDUCATOR I ST. JUDE PATIENT FAMILY ADVISORY COUNCIL - TEN MEMBERS OF THE COUNCIL PARTICIPATED ADOLESCENT ST. JUDE PATIENTS - FIVE PATIENTS PARTICIPATED KEY INFORMANT INTERVIEWS HRIA CONDUCTED 26 INTERVIEWS; 11 WERE INTERNAL REPRESENTATIVES OF ST. JUDE HOSPITAL AND 15 WERE EXTERNAL REPRESENTATIVES. INTERVIEWEES REPRESENT A RANGE OF SECTORS, INCLUDING LEADERS IN HEALTH CARE AND HEALTH RESEARCH, GOVERNMENT, AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS. A SEMI-STRUCTURED INTERVIEW GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. INTERVIEWS WERE APPROXIMATELY 30 MINUTES IN LENGTH. INTERNAL KEY INFORMANT INTERVIEWS - ROBERT CLARK, MS, FACHE, CHIEF GOVERNMENT AFFAIRS OFFICER - JANICE ENGLISH, DIRECTOR, PATIENT AND FAMILY EXPERIENCE OFFICE - COLETTE HENDRICKS, VP-CLINICAL OPERATIONS - MELISSA M. HUDSON, MD, DIRECTOR, CANCER SURVIVORSHIP DIVISION - MELISSA JONES, DIRECTOR, CANCER CENTER OPERATION - PAT KEEL, SVP/CFO - ELLIS NEUFELD, MD, PHD, EVP/CLINICAL DIRECTOR - CAROLYN RUSSO, MD, ASSOCIATE MEMBER/MEDICAL DIRECTOR AFFILIATE PROGRAM - VICTOR SANTANA, MD, MEMBER/SVP CLINICAL TRIALS - DANA WALLACE, DIRECTOR, CANCER CENTER ADMINISTRATION - SHEILA ANDERSON, RN, TRANSITION NURSE CASE MANAGER, HEMATOLOGY EXTERNAL KEY INFORMANT INTERVIEWS - CARLA BAKER, RN, PROJECT DIRECTOR, MEMPHIS BREAST CANCER EQUITY CONSORTIUM, COMMON TABLE HEALTH ALLIANCE - AMY DANIELS, SENIOR VICE PRESIDENT OF INVESTOR RELATIONS, MEMPHIS CHAMBER OF COMMERCE - JOAN HAN, MD, DIRECTOR, PEDIATRIC OBESITY PROGRAM, LE BONHEUR CHILDREN'S HOSPITAL - ALISA HAUSHALTER, DNP, RN, PHNA-BC, DIRECTOR, SHELBY COUNTY HEALTH DEPARTMENT - MICHELLE HEIL, SENIOR MANAGER, HOSPITAL SYSTEMS, AMERICAN CANCER SOCIETY, NORTH CENTRAL REGION - ANITA LARKIN, MSN, RN, CLINICAL DIRECTOR, METHODIST LE BONHEUR - MARIAN LEVY, DRPH, RD, FAND, ASSOCIATE DEAN, UNIVERSITY OF MEMPHIS SCHOOL OF PUBLIC HEALTH - VALERIE NAGOSHINER, CHIEF OF STAFF, TENNESSEE DEPARTMENT OF HEALTH - GARY SHORB, EXECUTIVE DIRECTOR, THE URBAN CHILD INSTITUTE - ANDREANA SMITH, DIRECTOR OF CLINICAL ADMINISTRATION, CHURCH HEALTH CENTER - WEBB A. SMITH, PHD, CLINICAL EXERCISE PHYSIOLOGIST, HEALTHY LIFESTYLES CLINIC, LE BONHEUR CHILDREN'S HOSPITAL - JAMILA SMITH-YOUNG, DNP, MPH, CPNP-AC, NURSE PRACTITIONER, UT LE BONHEUR PEDIATRIC SPECIALISTS DIVISION OF PEDIATRIC ENDOCRINOLOGY - CHARLES SNYDER, PHD, MPH, DIRECTOR, HEALTH DISPARITIES EDUCATION AND COMMUNITY ENGAGEMENT, UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER - KATY SPURLOCK, DEPUTY DIRECTOR, THE URBAN CHILD INSTITUTE - ROBIN WOMEODU, MD, FACP, CHIEF MEDICAL OFFICER, METHODIST UNIVERSITY HOSPITAL ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 13H: SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY. ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 15E: SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY. ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 20E: ST. JUDE DOES NOT TAKE ANY OF THE COLLECTION ACTIONS DESCRIBED IN PART V, SECTION B, LINE 19 BECAUSE ST. JUDE COVERS ALL TREATMENTS, COPAYS, DEDUCTIBLES, COINSURANCE AND ANY OTHER COST SHARING OBLIGATIONS THAT ARE NOT COVERED BY INSURANCE. ST. JUDE TAKES NO ACTION TO COLLECT FROM PATIENTS OR THEIR FAMILIES AND DOES NOT REPORT TO CREDIT AGENCIES. ST. JUDE CHILDREN'S RESEARCH HOSPITAL: PART V, SECTION B, LINE 11: ST. JUDE CHILDREN'S RESEARCH HOSPITALCOMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN UPDATE (06/30/19)ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC. CONDUCTED AND ADOPTED ITS THIRD COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING FISCAL YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:IMPROVING ACCESS TO CARE- PALLIATIVE CARE- SERVICES AND RESOURCES FOR CAREGIVERSIMPROVING COORDINATION OF CARE- TRANSITION OF PATIENTS FROM PEDIATRIC TO ADULT HEALTHCARE- OUTPATIENT CARE EXPERIENCE TRANSITION OF CARE FROM SPECIALTY TO PRIMARY CARE PROVIDERS- OUTPATIENT CARE EXPERIENCE PHYSICIAN COORDINATION OF CAREIMPROVING CHILD HEALTH STATUS- COMMUNITY HEALTH EDUCATION- PREVENTING VIRUS-ASSOCIATED CANCERS THROUGH INCREASED HPV VACCINATION- HIV COLLABORATION WITH COMMUNITY COALITION- CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY AND PHYSICAL ACTIVITYNO ACTIONS WERE TAKEN DURING FISCAL YEAR 2019 TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC.'S MOST RECENTLY CONDUCTED CHNA IN FISCAL YEAR 2019. THE THIRD CHNA WAS CONDUCTED AND ADOPTED AT THE END OF FISCAL YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS.ALL SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC.'S MOST RECENTLY CONDUCTED CHNA ARE BEING ADDRESSED.ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC. DID TAKE THE FOLLOWING ACTIONS DURING FISCAL YEAR 2019 WITH RESPECT TO ITS PREVIOUSLY CONDUCTED CHNA IN FISCAL YEAR 2016:ST. JUDE: PATIENT POPULATION AND CLINICAL FOCUSTHE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST. JUDE IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CANCER AND BLOOD DISORDERS, AND CHILDREN AND ADOLESCENTS WITH HIV INFECTION. IT SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. ST. JUDE TREATS CHILDREN AND YOUNG ADULTS WITH NEWLY DIAGNOSED OR SUSPECTED PEDIATRIC CANCER, HIV INFECTIONS OR CERTAIN HEMATOLOGIC OR GENETIC DISEASES. WE ACCEPT MOST PATIENTS OUTSIDE OUR PRIMARY MARKET BASED ON A REFERRAL FROM THEIR PHYSICIAN OR AN AFFILIATE CLINIC, THEIR AGE, AND THEIR ABILITY TO ENROLL IN AN OPEN CLINICAL TRIAL. IN ADDITION TO BEING TREATED AT ST. JUDE, PATIENTS MAY HAVE THE OPTION TO RECEIVE CARE AT ONE OF OUR EIGHT REGIONAL AFFILIATE CLINICS.ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. MORE SPECIFICALLY, APPROXIMATELY 8,600 PATIENTS ARE SEEN AT ST. JUDE ANNUALLY FOR ACTIVE THERAPY, TREATMENT-COMPLETION MONITORING, SURVIVORSHIP SUPPORT, OR PARTICIPATION IN RESEARCH PROGRAMS. THE HOSPITAL IS LICENSED FOR 80 INPATIENT BEDS AND CURRENTLY STAFFS 73 BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS WHO MAY HAVE BEEN ADMITTED AS INPATIENTS AT MOST HOSPITALS TO BE TREATED AS OUTPATIENTS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES, DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA AIR FILTRATION, INFECTION-RESISTANT SURFACES, AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES.THE ST. JUDE AFFILIATE PROGRAM MAKES TREATMENTS DEVELOPED AS CLINICAL TRIALS AT ST. JUDE CHILDREN'S RESEARCH HOSPITAL AVAILABLE TO MORE CHILDREN BY OFFERING MUCH OF THE CARE CLOSE TO HOME. THE ST. JUDE AFFILIATE PROGRAM IS A NETWORK OF PEDIATRIC HEMATOLOGY-ONCOLOGY CLINICS, HOSPITALS, AND IN SOME CASES, UNIVERSITIES UNITED TO EXTEND THE MISSION OF ST. JUDE. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF OF ST. JUDE TO DELIVER STATE-OF-THE-ART CARE AND INNOVATIVE CLINICAL TRIALS TO CHILDREN WITH CANCER AND BLOOD DISORDERS.ST. JUDE ALSO OPERATES ST. JUDE GLOBAL. ITS MISSION IS TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE THROUGH THE SHARING OF KNOWLEDGE, TECHNOLOGY, AND ORGANIZATIONAL SKILLS. THERE ARE 3 OVERRIDING GOALS:- TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION- TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES- TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE.ST. JUDE IS A RESEARCH ORGANIZATION, AND THERE ARE TIMES WHEN BASIC RESEARCH DISCOVERIES PERTAIN TO DISEASES THAT ARE BEYOND THE SCOPE OF DISEASES TREATED AS A PRIMARY DIAGNOSIS AT ST. JUDE.FOR THE PURPOSES OF THIS REPORT, THE FOCUS IS SOLELY ON THOSE DISEASES FOR WHICH CHILDREN ARE ADMITTED TO ST. JUDE FOR TREATMENT.CONSISTENT WITH ST. JUDE'S PREVIOUS CHNA, THE FINDINGS IN 2016 HIGHLIGHTED THE ISSUES OF ACCESS TO CARE; CHILDHOOD CANCER; SICKLE CELL DISEASE AND HEMATOLOGY PATIENTS; LIVING WITH HIV AND AIDS; NEEDS OF THE PATIENTS' FAMILIES AND CAREGIVERS; POST TREATMENT AND CARE TRANSITION; HEALTH STATUS OF THE MEMPHIS COMMUNITY AND ADDITIONAL GAPS FOR THE GENERAL PEDIATRIC POPULATION. ST. JUDE HAS CHOSEN TO ADDRESS THESE NEEDS IN THREE GENERAL AIMS: IMPROVING ACCESS TO CARE, ENHANCING COORDINATION OF CARE AND IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDREN. THESE AIMS, WHICH OFTEN ADDRESS MULTIPLE ISSUES IDENTIFIED IN THE CHNA, WERE CHOSEN BECAUSE THEY ARE ALIGNED WITH OUR MISSION AND OUR CAPABILITIES. BELOW ARE THE THREE AIMS AND CORRESPONDING INITIATIVES DEVELOPED.AIM #1 IMPROVING ACCESS TO CAREPEDIATRIC HEALTH NEED:ACCESS TO AFFORDABLE HEALTH INSURANCE COVERAGEHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MANAGED CARE DEPARTMENTANTICIPATED OUTCOME:UNINSURED PATIENTS WILL BE OFFERED ASSISTANCE REGARDING ENROLLMENT IN GOVERNMENTAL OR OTHER PROGRAMS.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO PROVIDE ASSISTANCE TO FAMILIES WITH ENROLLMENT.2. PERIODIC REVIEW OF IDENTIFICATION AND SCREENING PROCESSES TO ENSURE ALL UNINSURED PATIENTS ARE OFFERED ASSISTANCE.3. WORK WITH PATIENTS TRANSITIONING TO CARE POST ST. JUDE.SELECTED ACCOMPLISHMENTS:THE AGREEMENT WITH FIRSTSOURCE SOLUTIONS USA, LLC DBA MEDASSIST IS RENEWED ANNUALLY. MEDASSIST IS THE VENDOR USED TO HELP UNINSURED PATIENTS OBTAIN MEDICAID OR OTHER INSURANCE.AN AUDIT OF THE SCREENING PROCESS HAS BEEN DEVELOPED AND WILL CONTINUE TO BE CONDUCTED ON A MONTHLY BASIS TO ENSURE THAT ALL FAMILIES ARE GIVEN ASSISTANCE WITH THE SCREENING AND ENROLLMENT PROCESS.FY19:- 99.66% OF ST. JUDE'S UNINSURED PATIENTS WERE OFFERED ASSISTANCE.- 153 UNINSURED PATIENTS WERE ENROLLED IN HEALTH PLANS.- LESS THAN 1% OF UNINSURED PATIENTS WERE NOT CONTACTED BECAUSE THEY WERE ONLY BRIEFLY AT ST. JUDE.PEDIATRIC HEALTH NEED:PALLIATIVE CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF ONCOLOGY, DIVISION OF QUALITY OF LIFE AND PALLIATIVE CAREANTICIPATED OUTCOME:CONTINUE TO TRAIN CLINICIANS IN PALLIATIVE CARE MEDICINE (PCM) AND OFFER EDUCATIONAL OPPORTUNITIES FOR PCM.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. RECRUIT AND TRAIN TWO PHYSICIAN FELLOWS IN THE PALLIATIVE CARE TRAINING PROGRAM.2. PROVIDE TRAINING IN PALLIATIVE CARE FOR ADVANCED PRACTICE HEALTHCARE PERSONNEL THROUGH TARGETED CONFERENCES AND OTHER EDUCATIONAL OPPORTUNITIES INCLUDING END-OF-LIFE NURSING EDUCATION CONSORTIUM (ELNEC) CONFERENCE, AN INSTITUTION-DEVELOPED QUALITY OF LIFE SEMINAR (QOL), AND A 2-DAY PEDIATRIC ONCOLOGY PALLIATIVE CARE CONFERENCE.3. EDUCATE COMMUNITY PROVIDERS ABOUT PCM THROUGH COMMUNITY-BASED BRIDGING PROGRAMS FOR HOME HEALTH AND HOSPICE CARE THROUGH THE QUALITY OF LIFE FOR ALL KIDS PROGRAM VIA A THREE-HOUR DIDACTIC CURRICULUM.4. ENHANCE TRAINING OPPORTUNITIES WITH ST. JUDE AFFILIATES.SELECTED ACCOMPLISHMENTS:- EACH YEAR THE PALLIATIVE CARE TRAINING PROGRAM HAS BEEN SUCCESSFUL IN RECRUITING AND TRAINING TWO PHYSICIAN FELLOWS.- PALLIATIVE CARE MEDICINE FELLOWSHIP NOW TRAINS 5 MD'S PER YEAR.- ENROLLMENT: FY16 FY17 FY18ELNEC 32 78 35QOLA 37 29 45PPOS 325 340*PPOS - PEDIATRIC PALLIATIVE ONCOLOGY SYMPOSIUM IN ADDITION, ALL BEDSIDE NURSES ARE REQUIRED TO COMPLETE ELNEC WITHIN THREE YEARS. ALSO, INPATIENT AND OUTPATIENT NURSES ARE REQUIRED AND SUPPORTED TO COMPLETE BOTH SEMINARS (A TOTAL OF 24.5 CEUS IN PCM).- COMMUNITY PROVIDER EDUCATION HAPPENS TWICE A MONTH THROUGH ST. JUDE'S COMBINED FELLOWSHIP PROGRAM BOARD REVIEW SERIES. EACH SESSION AVERAGES 10 ATTENDEES RANGING FROM GRADUATE STUDENTS TO MEDICAL STUDENTS TO ADVANCED CLINICIANS.- THE SJ AFFILIATE STAFF ARE INVITED TO PARTICIPATE IN ELNEC, THE QOL SEMINAR AND THE PEDIATRIC PALLIATIVE ONCOLOGY SYMPOSIUM AT NO COST, AND ARE INCLUDED IN THE NUMBERS CITED ABOVE.- REGULAR PRESENTER IN AFFILIATE NURSING CONFERENCE.- 2 RESEARCH ARTICLES RESULTED FROM THIS CHNA AND CAN BE FOUND IN EXHIBIT 1.PEDIATRIC HEALTH NEED:HEALTHCARE OF CHILDHOOD CANCER SURVIVORSHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ONCOLOGY DIVISION, CANCER SURVIVORSHIP DEPARTMENTANTICIPATED OUTCOME:PROVIDE CANCER SURVIVORSHIP INFORMATION TO BOTH CAREGIVERS AND SURVIVORS VIA SURVIVORS' DAY CONFERENCE AND ST. JUDE LIFE. THE ST. JUDE LIFE PROGRAM WILL INCREASE ENROLLMENT WITHIN A DEFINED COHORT UNTIL ALL ELIGIBLE SURVIVORS HAVE BEEN APPROACHED.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. PROVIDE WORKSHOPS AND SPEAKERS THAT OFFER INFORMATION ABOUT AVAILABLE RESOURCES.2. GIVE SURVIVORS AND THEIR FAMILIES THE OPPORTUNITY TO LEARN FROM OTHER SURVIVORS.3. ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH HEALTHCARE POST-TREATMENT.4. OFFER AN ONLINE RESOURCE FOLLOWING THE CONFERENCE FOR CONTINUOUS FLOW OF SURVIVORSHIP INFORMATION.5. ASSESS LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS.6. USE INFORMATION FROM THESE STUDIES TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTION.SELECTED ACCOMPLISHMENTS:THE ST. JUDE FACULTY PROVIDE LECTURES AND PARTICIPATE IN WORKSHOPS RELATED TO A VARIETY OF SURVIVORSHIP ISSUES. AUDIENCES INCLUDE HEALTH CARE PROVIDERS OF SURVIVORS, SURVIVORS AND THEIR FAMILIES.- 3 LECTURES/WORKSHOPS PROVIDED BY MELISSA M. HUDSON AND CAN BE FOUND IN EXHIBIT 1.- 1 LECTURE/WORKSHOP PROVIDED BY DANIEL MULROONEY AND CAN BE FOUND IN EXHIBIT 1.- 5 LECTURES/WORKSHOPS PROVIDED BY MATTHEW EHRHARDT AND CAN BE FOUND IN EXHIBIT 1.STORIES OF RESILIENT SURVIVORS AND RESOURCES AVAILABLE TO OVERCOME PHYSICAL AND PSYCHOSOCIAL CHALLENGES OF SURVIVORSHIP HAVE BEEN FEATURED IN THE ST. JUDE LIFETIME COHORT LIFELINE AND LONG-TERM FOLLOW-UP STUDY NEWSLETTERS.- ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH HEALTHCARE POST-TREATMENT.SURVIVORS AND THEIR FAMILIES ATTENDING THE AFTER COMPLETION OF THERAPY (ACT) AND ST. JUDE LIFETIME COHORT CLINICS ROUTINELY RECEIVE COUNSELING ABOUT THEIR HEALTH HISTORY, CANCER-RELATED HEALTH RISKS, HEALTH SCREENING RECOMMENDED FOR THEIR SPECIFIC CANCER TREATMENT EXPOSURES, AND METHODS OF RISK REDUCTION. A SURVIVORSHIP CARE PLAN IS PROVIDED AT THE FIRST EVALUATION THAT DETAILS THE CANCER DIAGNOSIS, TREATMENT, MAJOR HEALTH EVENTS THAT HAVE OCCURRED DURING AND AFTER THERAPY, CANCER-RELATED HEALTH RISKS, AND RECOMMENDED HEALTH SCREENING. THE SURVIVORSHIP CARE PLAN IS UPDATED AFTER EVERY HEALTH EVALUATION.- FOR SURVIVORS WHO DO NOT WISH TO PARTICIPATE IN THE ACT OR ST. JUDE LIFETIME COHORT PROGRAMS, THESE SAME SERVICES ARE AVAILABLE THROUGH THE ST. JUDE ALUMNUS PROGRAM OFFICE.- SURVIVORSHIP STAFF ARE INVOLVED IN MULTIDISCIPLINARY EFFORTS TO INTRODUCE AND CONSISTENTLY ADDRESS SURVIVORSHIP TRANSITION ISSUES, PARTICULARLY PSYCHOSOCIAL AND REHABILITATION NEEDS, AT EARLIER TIME POINTS AFTER DIAGNOSIS. THEIR EFFORTS ARE REFLECTED IN THE NEWLY DEVELOPED TRANSITION ONCOLOGY PROGRAM.PERIODIC BRIEF PUBLICATIONS FEATURE SURVIVOR STORIES AND EDUCATIONAL TOPICS:- LONG-TERM FOLLOW-UP NEWSLETTERS (AVAILABLE AT HTTPS://LTFU.STJUDE.ORG/) ARE PUBLISHED ON A QUARTERLY BASIS.- LIFELINE NEWSLETTERS (AVAILABLE AT HTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/PARTICIPATE-IN- ST-JUDE-LIFE-STUDY/LIFELINE-NEWSLETTER.HTML) ARE PUBLISHED SEMIANNUALLY.PEDIATRIC HEALTH NEED:COMMUNITY EDUCATIONHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, COMMUNICATIONS & PUBLIC RELATIONS DEPARTMENTANTICIPATED OUTCOME:INCREASE THE NUMBER OF RADIO EDUCATION SPOTS, ARTICLES AND SOCIAL MEDIA REGARDING HEALTHCARE RESOURCES AND HEALTHCARE CAREERS ANNUALLY.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. ST. JUDE PROFESSIONALS WILL PROVIDE INFORMATION AND RESOURCES ABOUT SICKLE CELL DISEASE, HIV, CANCER, FLU, AND OTHER PEDIATRIC LIFE-THREATENING DISEASES.2. OFFER EDUCATIONAL OPPORTUNITIES AND OTHER INFORMATION ABOUT HEALTHCARE CAREERS. SELECTED ACCOMPLISHMENTS:ST. JUDE PROFESSIONALS PROVIDING INFORMATION AND RESOURCES:- ST. JUDE CONDUCTED 30-SECOND EDUCATIONAL RADIO SPOTS IN FY19. TOPICS INCLUDED: HIV VOICES PROJECT, AIDS SUPPORT, SICKLE CELL STEP, BLOOD DONOR CENTER AND THE HPV VACCINE FOR CANCER PREVENTION.- ST. JUDE FOCUSED EDUCATION EFFORTS ON PROMOTING THE HPV VACCINE. EFFORTS INCLUDED CONCENTRATED MEDIA RELATIONS PITCHING, DEDICATED SOCIAL MEDIA POSTS, BLOGS AND A RADIO PSA.- MEDIA RELATIONS EFFORTS RESULTED IN A NUMBER OF ST. JUDE PROFESSIONALS BEING INTERVIEWED THIS YEAR ON COMMUNITY SUBJECTS INCLUDING HIV, HPV VACCINATION, SLEEP HEALTH, FLU AWARENESS AND REMINDERS TO GET THE FLU VACCINE. INFORMATION FROM DR. RICHARD WEBBY AND HIS TEAM ABOUT THE FLU VACCINE APPEARED IN MORE THAN 240 NEWS PIECES, INCLUDING TWO LOCAL MEMPHIS STORIES.- "PROMISE" MAGAZINE IS MAILED TO BETWEEN 250,000 AND 300,000 READERS EACH QUARTER, INCLUDING DONORS, EMPLOYEES, PATIENTS, PEER INSTITUTIONS, CEOS OF FORTUNE 500 COMPANIES, SELECT MEDIA AND INDIVIDUALS WHO SUBSCRIBE THROUGH OUR ONLINE SUBSCRIPTION FORM. ALL THE ARTICLES APPEAR ONLINE, WHERE THEY HAVE AN EVEN WIDER READERSHIP. AN E-NEWSLETTER VERSION OF "PROMISE" IS ALSO SENT TO NEARLY 10,000 SUBSCRIBERS QUARTERLY.- APPROXIMATELY 120 LOCAL HIGH SCHOOL STUDENTS AND TEACHERS VISITED ST. JUDE IN FEBRUARY 2019 FOR THE FOURTH ANNUAL SCIENCE SCHOLARS OF TOMORROW SYMPOSIUM. THE DAY-LONG EVENT FEATURED SCIENTIFIC PRESENTATIONS AND TOURS OF LABORATORIES, CLINICS AND CORE FACILITIES, ENABLING STUDENTS TO INTERACT WITH SCIENTISTS AND CLINICIANS.- MORE THAN 9,000 CANCER SURVIVORS, INCLUDING LOCAL MEMPHIS RESIDENTS, RECEIVED PACKAGES CELEBRATING CANCER SURVIVORSHIP, INCLUDING A PAMPHLET ABOUT BEING A SURVIVOR AND WHERE TO FIND IMPORTANT INFORMATION.- 6 ARTICLES RELATED TO COMMUNITY EDUCATION WERE PUBLISHED IN "PROMISE" MAGAZINE AND CAN BE FOUND IN EXHIBIT 1.PEDIATRIC HEALTH NEED:ST. JUDE AFFILIATE NETWORKHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, AFFILIATE PROGRAM OFFICEANTICIPATED OUTCOME:THE ST. JUDE AFFILIATE NETWORK SHOULD BE MAINTAINED TO EXPAND OPPORTUNITIES FOR SERVICES TO A LARGER NUMBER OF CHILDREN. THE NUMBER OF PATIENTS ENROLLED IN ST. JUDE PRIMARY THERAPEUTIC PROTOCOLS FROM THE AFFILIATE CLINICS WILL INCREASE.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO ENHANCE OPERATIONS AND INCREASE PATIENT VISITS AT ALL CLINICS.SELECTED ACCOMPLISHMENTS:- ESTABLISHED ST. JUDE CENTRAL INSTITUTIONAL REVIEW BOARD TO FACILITATE LOCAL ENROLLMENT IN PRIMARY THERAPEUTIC CLINICAL TRIALS.- COMPLETED SEVERAL QUALITY IMPROVEMENT INITIATIVES WHICH RESULTED IN MAINTENANCE OF CERTIFICATION CREDIT.- PROVIDED FORMAL QUALITY IMPROVEMENT TRAINING FOR AFFILIATE STAFF.- CREATED PATIENT NAVIGATOR POSITION TO IMPROVE PATIENT TRANSITION TO AFFILIATE SITES.- DEVELOPED QUARTERLY EDUCATIONAL WEBINAR SERIES. AIM #2 ENHANCING COORDINATION OF CARE PEDIATRIC HEALTH NEED:PHYSICIAN COORDINATION OF CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ST. JUDE AFFILIATE INSTITUTIONS, ALL DOMESTIC AND INTERNATIONAL REFERRING CLINICIANS AND CENTERSANTICIPATED OUTCOME:IMPROVE CONTINUITY OF CARE BY ENHANCING COMMUNICATION TOOLS AND EFFORTS TO PROVIDE PHYSICIANS WITH UNPARALLELED ACCESS TO PATIENT INFORMATION.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO IMPROVE THE CLINICIAN PORTAL TO PERMIT REFERRING AND AFFILIATED PHYSICIANS' CONVENIENT ACCESS TO PATIENT INFORMATION, IN ACCORDANCE WITH APPLICABLE LAW.SELECTED ACCOMPLISHMENTS:- CLINICIAN PORTAL WORK IS ONGOING. EXTERNAL PHYSICIAN TESTING HAS BEEN COMPLETED AND FEEDBACK HAS BEEN RECEIVED.- IN A LIMITED SCOPE, ST. JUDE PROVIDERS NOW HAVE THE ABILITY VIA DIRECT EMAIL (ENCRYPTED PROVIDER DIRECTORY DEVELOPED FOR SECURE DATA EXCHANGE) TO SEND AN ELECTRONIC SUMMARY OF CARE, ALONG WITH OTHER DOCUMENTS AS ATTACHMENTS, TO OUTSIDE PHYSICIANS TO WHOM WE ARE REFERRING OUR PATIENTS. WE WILL ALSO BE ABLE TO RECEIVE AN ELECTRONIC TRANSITION OF CARE DOCUMENT FROM OUTSIDE PROVIDERS AND AFFILIATES WHO ARE REFERRING A PATIENT TO ST. JUDE. THIS WILL BE ROLLING OUT IN A LIMITED AVAILABILITY THROUGH THE END OF THE YEAR SINCE IT REQUIRES OUTSIDE PROVIDERS TO HAVE A SPECIAL SECURE CONNECTION. - PROVIDERS IN THE AFFILIATE PROGRAM NOW HAVE ACCESS TO THEIR PATIENTS' ST. JUDE ELECTRONIC MEDICAL RECORD.PEDIATRIC HEALTH NEED:TRANSITION OF PATIENTS FROM PEDIATRIC TO ADULT HEALTHCARE SERVICEHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF HEMATOLOGY, CLINICAL HEMATOLOGY DIVISION, DIGGS-KRAUS SICKLE CELL CENTER AT REGIONAL ONE HEALTH, METHODIST HEALTHCARE COMPREHENSIVE SICKLE CELL CENTER (MCSCC)ANTICIPATED OUTCOME:INCREASE THE NUMBER OF PATIENTS WITH SICKLE CELL DISEASE WHO ESTABLISH SUSTAINED ADULT CARE AFTER LEAVING PEDIATRIC CARE AT ST. JUDE.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO WORK WITH ADULT SICKLE CELL CENTERS IN THE COMMUNITY TO ENHANCE A SEAMLESS TRANSITION FROM PEDIATRIC CARE.2. ENHANCE ADOLESCENT AND YOUNG ADULTS (AYA) TRANSITION CLINICS WITH CO-LOCATION OF PEDIATRIC AND ADULT HEMATOLOGY PROVIDERS.3. AUGMENT FORMAL PROGRAMMING AND PLANNING PROCESSES FOR ADOLESCENTS WITH HEMATOLOGIC AND ONCOLOGIC DISEASES, THROUGH DEVELOPMENT OF DISEASE EDUCATIONAL CURRICULUM AND TRAINING MODULES TO FOSTER INCREASED ADOLESCENT AUTONOMY AND MEDICAL LITERACY.SELECTED ACCOMPLISHMENTS:BELOW, 2017 AND 2018 ARE INCLUDED DUE TO A LAG IN DATA. 2017- 43 PATIENTS GRADUATED FROM ST. JUDE BY DECEMBER 2017.- 38 TRANSFERRED TO ADULT CENTERS, FOR A RATE OF ADULT CARE PLACEMENT OF 88% (5 NEVER ESTABLISHED CARE WITH ADULT PROVIDER).- 12-MONTH RETENTION IN ADULT CARE: 79%.- 1 EXPIRED: TRANSFERRED TO ADULT CARE 5/9/17, INITIAL ADULT APPOINTMENT 6/22/17, EXPIRED 2/7/18 (MCSCC).- 7 WERE LOST TO FOLLOW UP/DISCONTINUED ADULT CARE AFTER TRANSFERRING OUT OF ST. JUDE.- 24-MONTH RETENTION IN ADULT CARE: NEED TO WAIT UNTIL END OF 2019 TO CALCULATE FINAL RATE.2018- 33 PATIENTS GRADUATED FROM ST. JUDE BY DECEMBER 2018.- 31 TRANSFERRED TO ADULT CENTERS, FOR A RATE OF ADULT CARE PLACEMENT OF 94%. - NOT INCLUDED IS 4 THAT RECEIVED LETTERS AND 1 RELOCATED. 31 OF 33 ESTABLISHED CARE.- ADULT CARE RETENTION: AT THE END OF 2019 WE WILL HAVE THE 12-MONTH ADULT CARE RETENTION DATA FOR 2018, AND AT THE END OF 2020 WE WILL HAVE THE 24-MONTH ADULT CARE RETENTION DATA FOR 2018.AIM #3 IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDRENPEDIATRIC HEALTH NEED:CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY, AND PHYSICAL ACTIVITYHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, GLOBAL PEDIATRIC MEDICINEANTICIPATED OUTCOME:INCREASE THE NUMBER OF STUDENTS AND TEACHERS PARTICIPATING IN ST. JUDE CANCER AND HEALTHY LIVING EDUCATION PROGRAM.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. EVALUATE THE EFFECTIVENESS OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN CURRICULUM AT INCREASING CHILDREN'S KNOWLEDGE OF CANCER AND HEALTHY LIVING TOPICS (NUTRITION, EXERCISE, SUN PROTECTION, AVOIDING TOBACCO).2. PARTNER WITH LOCAL EDUCATION AGENCIES TO DISSEMINATE CANCER AND HEALTHY LIVING EDUCATIONAL PROGRAMS. SELECTED ACCOMPLISHMENTS:- OVER 2,000 MEMPHIS-AREA K-12 STUDENTS RECEIVED HEALTHY LIFESTYLES EDUCATION: THE ST. JUDE CANCER EDUCATION AND OUTREACH PROGRAM PROVIDES STUDENTS IN GRADES K-12 EDUCATION AND POSITIVE REINFORCEMENT TO HELP PROMOTE HEALTHY LIFESTYLE CHOICES AND TO REDUCE A CHILD'S LIFETIME RISK OF CANCER. THE PROGRAM SPECIFICALLY ADDRESSES OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. DURING THE 2018-2019 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM PARTNERED WITH 19 SCHOOLS TO DELIVER EDUCATIONAL CONTENT TO OVER 2,000 K-12 STUDENTS IN THE MEMPHIS AREA.- 1 RESEARCH ARTICLE RESULTED FROM THIS EVALUATION.EXHIBIT 1 LECTURES PROVIDED: HEALTHCARE OF CHILDHOOD CANCER SURVIVORS- AMERICAN ACADEMY OF PEDIATRICS, NATIONAL CONFERENCE & EXHIBITION, "AFTER THE CANCER CRISIS: LONG TERM ISSUES FOR CHILDHOOD CANCER SURVIVORS", ORLANDO, FLORIDA, NOVEMBER 5, 2018.- AMERICAN SOCIETY OF PEDIATRIC HEMATOLOGY ONCOLOGY ANNUAL MEETING, LUMINARY SPEAKER, "THE ROLE OF SURVIVORSHIP RESEARCH IN ADVANCING CHILDHOOD CANCER CARE AND QUALITY OF SURVIVAL", NEW ORLEANS, LOUISIANA, MAY 4, 2019.- ADOLESCENT AND YOUNG ADULT LYMPHOMA SCIENTIFIC WORKSHOP AND INAUGURAL AYA LYMPHOMA CONSORTIUM MEETING, HEALTH OUTCOMES AND SURVIVORSHIP RESEARCH OF AYA LYMPHOMA, CHICAGO, ILLINOIS, MAY 15, 2019.- STATE OF THE HEART: CARDIO-ONCOLOGY AT ST. JUDE, ST. JUDE GRAND ROUNDS, ST. JUDE CHILDREN'S RESEARCH HOSPITAL MEMPHIS, TN, FEBRUARY 14, 2019.- SURVIVING CHILDHOOD CANCER. ST. JUDE MIDWEST AFFILIATE PEDIATRIC CANCER SURVIVORSHIP CONFERENCE, PEORIA, IL, JANUARY 2019.- CANCER SURVIVORSHIP AND THE AFTER COMPLETION OF THERAPY CLINIC. ST. JUDE MIDWEST AFFILIATE ASSOCIATION OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSES (APHON), PEORIA, IL, JANUARY 2019.- CANCER SURVIVORSHIP: LATE HEALTH EFFECTS, RISK-BASED SCREENING, AND OPTIMIZING CARE DELIVERY. CHILDREN'S HOSPITAL OF ILLINOIS/UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE PEDIATRIC GRAND ROUNDS, PEORIA, IL, JANUARY 2019.- CANCER SURVIVORSHIP: LATE HEALTH EFFECTS, RISK-BASED SCREENING, AND OPTIMIZING CARE DELIVERY. SANFORD CHILDREN'S HOSPITAL PEDIATRIC GRAND ROUNDS, SIOUX FALLS, SD, MAY 2019.- OBESITY AND THE METABOLIC SYNDROME IN CHILDHOOD CANCER SURVIVORS. ST. JUDE CHILDREN'S RESEARCH HOSPITAL AFFILIATE PHYSICIANS' CONFERENCE, MEMPHIS, TN, MAY 2019."PROMISE" MAGAZINE ARTICLES PUBLISHED:COMMUNITY EDUCATION- FIELD OF GENES: HISPANIC CHILDREN AND ALL (SPRING 2019)- FLU FIGHTERS: HOW THE IMMUNE SYSTEM PROTECTS INFANTS FROM INFLUENZA (WINTER 2019)- LI-FRAUMENI: STRENGTH IN NUMBERS (AUTUMN 2018)- EXERCISE YOUR OPTIONS (AUTUMN 2018)- BRAIN BOOSTER (AUTUMN 2018)- PARTNERS FOR HIV PREVENTION (SUMMER 2018)RESEARCH ARTICLES PUBLISHED:PALLIATIVE CARE- KAYE, E., APPLEGARTH, J., GATTAS, M., KIEFER, A., REYNOLDS, J., ZALUD, K., & BAKER, J. (2019) HOSPICE NURSES REQUEST PEDIATRIC-SPECIFIC EDUCATIONAL RESOURCES AND TRAINING PROGRAMS TO IMPROVE CARE FOR CHILDREN AND FAMILIES IN THE COMMUNITY: QUALITATIVE DATA ANALYSIS FROM A POPULATION-LEVEL SURVEY. PALLIATIVE MEDICINE, DOI: 10.1177/0269216319866576- KAYE, E., GATTAS, M., KIEFER, A., REYNOLDS, J., ZALUD, K., LI, C., LU, Z., & BAKER, J. (2019) PROVISION OF PALLIATIVE AND HOSPICE CARE TO CHILDREN IN THE COMMUNITY: A POPULATION STUDY OF HOSPICE NURSES. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, DOI HTTPS://DOI.ORG/10.1016/J.JPAINSYMMAN.2018.10.509CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY, AND PHYSICAL ACTIVITY- AYERS, K., LI, Z., VILLALOBOS, A., & KLOSKY, J. (2019) EVALUATION OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN PROGRAM ON CANCER RISK AWARENESS, ATTITUDES, AND BEHAVIORAL INTENTIONS AMONG FOURTH-GRADE SCIENCE STUDENTS: COMPARISONS BETWEEN RACIALLY IDENTIFIABLE/HIGH-POVERTY SCHOOLS AND RACIALLY DIVERSE/AFFLUENT SCHOOLS. JOURNAL OF CANCER EDUCATION, DOI: 10.1007/S13187-019-1476-3. ST. JUDE CHILDREN'S RESEARCH HOSPITAL: PART V, SECTION B, LINE 7A: THE CHNA REPORT WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 10A: THE HOSPTIAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 14: ST. JUDE CURRENTLY DOES NOT BILL NOR PURSUE PAYMENT FOR ANY ST. JUDE PATIENT; THEREFORE, ST. JUDE DOES NOT HAVE A BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS.ST. JUDE CHILDREN'S RESEARCH HOSPITAL: PART V, SECTION B, LINE 16A: THE FAP WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16B: BASED ON THE FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL- ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML), ST. JUDE DOES NOT HAVE AN APPLICATION FORM.ST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML PART I, LINE 3C: NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. WE DO NOT NEED TO DETERMINE ELIGIBILITY FOR THIS ASSISTANCE. BY DEFAULT, ALL PATIENTS ARE ELIGIBLE TO RECEIVE MEDICAL CARE AND SUPPORT SERVICES AT NO COST. ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. BILLING INSURANCE FOR THE COSTS THAT WOULD BE DUE AT ANY OTHER HOSPITAL ALLOWS ST. JUDE TO CONTINUE DOING SOME OF THE MOST ADVANCED RESEARCH IN THE WORLD. IT ALSO ALLOWS ST. JUDE TO PAY FOR TREATMENTS, COPAYMENTS, DEDUCTIBLES, COINSURANCE, AND ANY OTHER COSTS INSURANCE DOES NOT COVER. TO ENSURE FAMILIES ARE MAKING USE OF ALL RESOURCES FOR WHICH THEY ARE ELIGIBLE, WE HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. DOING SO ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE ALSO CONTRACT WITH A VENDOR TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO ASSIST FAMILIES APPLYING FOR HEALTH INSURANCE COVERAGE THROUGH FEDERAL OR STATE FACILITATED MARKETPLACES. PART I, LINE 7: COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. COST-TO-CHARGE RATIO USED FOR LINE 7A FINANCIAL ASSISTANCE AT COST, LINE 7B MEDICAID, AND LINE 7C COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS. SOME CHIPS VOLUME IS INCLUDED IN MEDICAID IN PART I, LINE 7B BECAUSE IN MANY STATES THE CHIPS PROGRAMS ARE MANAGED BY THE SAME THIRD PARTY ADMINISTRATORS, AND IT IS DIFFICULT TO DISTINGUISH BETWEEN CHIPS AND MEDICAID COVERAGE. PART I, LINE 7G: ST. JUDE CHILDREN'S RESEARCH HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES SUPPORT FOR EIGHT AFFILIATE CLINICS TOTALING APPROXIMATELY $9.6 MILLION. PART II, COMMUNITY BUILDING ACTIVITIES: THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL PRESIDENT AND CEO IS A MEMBER OF MEMPHIS TOMORROW. MEMPHIS TOMORROW IS AN ASSOCIATION OF CHIEF EXECUTIVE OFFICERS OF MEMPHIS' LARGEST ENTERPRISES. THE PURPOSE IS TO BRING TOP BUSINESS LEADERS TOGETHER WITH GOVERNMENT AND CIVIC LEADERS TO FOSTER ECONOMIC PROSPERITY FOR ALL WHO LIVE IN OUR COMMUNITY. THEIR INITIATIVES ARE FOCUSED IN THOSE AREAS WHICH DIRECTLY IMPACT ECONOMIC GROWTH AND OPPORTUNITY, INCLUDING HUMAN CAPITAL DEVELOPMENT, INDUSTRY DEVELOPMENT, AND PUBLIC SAFETY. ST. JUDE ALSO PARTICIPATES WITH MEMPHIS FAST FORWARD WHOSE STRATEGIES ARE BASED ON THE PREMISE THAT ECONOMIC GROWTH AND PROSPERITY, AND IMPROVED QUALITY OF LIFE, WILL FOLLOW ONCE MEMPHIS AND SHELBY COUNTY SUCCESSFULLY ADDRESS THE BASICS: GOOD JOBS, QUALITY EDUCATION, SAFE STREETS AND EFFICIENT GOVERNMENT.ST. JUDE IS A MEMBER OF THE ASPIRING FOR PURCHASING EXCELLENCE (APEX) ASSOCIATION OF MEMPHIS. APEX IS AN ASSOCIATION OF PURCHASING AND PROCUREMENT PROFESSIONALS FROM MEMPHIS ORGANIZATIONS WHOSE PURPOSE IS TO PROMOTE BEST PRACTICES IN SUPPLIER DIVERSITY. ADDITIONALLY, ST. JUDE IS SILVER SPONSOR FOR THE MID-SOUTH MINORITY BUSINESS COUNCIL (MMBC) ECONOMIC DEVELOPMENT FAIR. THE MMBC SERVES AS THE MID-SOUTH'S FOREMOST MINORITY BUSINESS DEVELOPMENT ORGANIZATION. THE MMBC HELPS TO DEVELOP A STRONG MINORITY AND WOMEN BUSINESS COMMUNITY IN AN EFFORT TO IMPACT ECONOMICALLY THE ENTIRE MID-SOUTH REGION.THE PEDIATRIC ONCOLOGY EDUCATION PROGRAM BRINGS FIFTY TO SIXTY STUDENTS EACH SUMMER FOR INTERNSHIPS IN BASIC SCIENCE OR CLINICAL RESEARCH. ADDITIONALLY, EXPERIENTIAL LEARNING INTERNSHIPS ARE STRUCTURED BY AND MANAGED BY ACADEMIC PROGRAMS IN MANY AREAS FROM SCIENCE TO ACCOUNTING. THERE ARE ANOTHER 150 STUDENTS INVOLVED IN THESE INTERNSHIPS. THESE PROGRAMS SUPPORT INCREASING THE AWARENESS OF CAREERS IN RESEARCH SCIENCE, HEALTHCARE, OR HEALTHCARE MANAGEMENT AND CONTRIBUTE TO PREPARING STUDENTS TO ENTER THESE CAREERS.THE CLINICAL EDUCATION AND TRAINING OFFICE HOSTS FORTY TO FIFTY STUDENTS ANNUALLY AS PATIENT CARE OBSERVERS. THESE STUDENTS ARE AT DIFFERENT STAGES OF TRAINING AND ARE FROM UNDERGRADUATE COLLEGES OR PROFESSIONAL HEALTHCARE SCHOOLS INCLUDING MEDICAL SCHOOLS. THE OBSERVERS ARE DECIDING ON OR CONFIRMING A DESIRE TO PURSUE A CAREER IN HEALTHCARE.THE FAMILY, GUEST, AND VOLUNTEER SERVICES DEPARTMENT PROVIDES SUMMER PROGRAMS FOR HIGH SCHOOL STUDENTS AND YEAR-ROUND PROGRAMS FOR COLLEGE STUDENTS. BOTH OF THESE PROGRAMS DRIVE ENTRY INTO HEALTH CAREERS. THE DEPARTMENT ALSO ENGAGES TWELVE FULL-TIME INTERNS, 4 EACH SEMESTER, WHO ARE EMBEDDED ON THE TEAM AND PREPARED FOR CAREERS IN NON-PROFIT LEADERSHIP OR HEALTHCARE MANAGEMENT.THE OFFICE OF LEGAL SERVICES OFFERS LEGAL INTERNSHIPS TO LOCAL (UNIVERSITY OF MEMPHIS, OLE MISS) LAW STUDENTS DURING THE ACADEMIC YEAR AND TO NATIONAL LAW SCHOOLS DURING THE SUMMER. INTERNS PERFORM LEGAL RESEARCH; DRAFT MEMORANDA, LETTERS, AND OTHER DOCUMENTS; DRAFT AND REVIEW CONTRACTUAL AGREEMENTS; PREPARE PRESENTATIONS TO ST. JUDE PERSONNEL; AND ASSIST WITH DRAFTING POLICIES. INTERNS ALSO LEARN THROUGH OBSERVATION OF AND PARTICIPATION IN DAY-TO-DAY LAW PRACTICE ACTIVITIES, INCLUDING LEGAL PROCEEDINGS, NEGOTIATIONS, MEETINGS, TRAININGS, AND COUNSELING SESSIONS. WHEN POSSIBLE, INTERNS WORK WITH CLIENT DEPARTMENTS AND DEPARTMENTAL STAFF TO GATHER INFORMATION AND TO GAIN INSIGHT INTO AND UNDERSTANDING OF RESEARCH, CLINICAL, BUSINESS, AND HEALTH CARE OPERATIONS. IN ADDITION, MEMBERS OF THE OFFICE OF LEGAL SERVICES ENGAGED IN THE FOLLOWING ACTIVITIES WITHIN THE MEMPHIS AND LARGER TENNESSEE COMMUNITIES:- VOLUNTEERED AT A SATURDAY LEGAL CLINIC ORGANIZED BY MEMPHIS AREA LEGAL SERVICES.- SERVED AS CHAIR OF THE HEALTH LAW & POLICY ADVISORY BOARD OF THE CECIL C. HUMPHREYS SCHOOL OF LAW, UNIVERSITY OF MEMPHIS.- PRESENTED ON "LAW AND BIOETHICS" AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW IN MARCH 2019.- PRESENTED ON "PRESCRIBING CONTROLLED SUBSTANCES IN TN: UNDERSTANDING NEW STANDARDS AND LAWS AMIDST THE OPIOID EPIDEMIC" AT THE TENNESSEE ATTORNEYS MEMO LAW CONFERENCE IN NOVEMBER 2018.- PLANNED A HEALTH LAW NETWORKING EVENT AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW.- SERVED ON THE TENNESSEE BAR ASSOCIATION HEALTH LAW SECTION EXECUTIVE COUNCIL.- SERVED ON THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION BOARD.- PARTICIPATED IN AN ATTORNEY HEALTH LAW PANEL AT THE CECIL C. HUMPHREYS SCHOOL OF LAW, UNIVERSITY OF MEMPHIS.- HOSTED SESSIONS AT ST. JUDE FOR THE EMBARK PROGRAM, WHICH IS PART OF THE NEW MEMPHIS INSTITUTE. EMBARK IS A 3-MONTH ENGAGEMENT THAT EMPOWERS HIGH PERFORMING TWENTYSOMETHINGS (2-7 YEARS INTO THEIR CAREERS) TO GROW AS LEADERS AND TO BUILD RELATIONSHIPS AS THEY PREPARE TO MAKE A DIFFERENCE IN MEMPHIS.- PARTICIPATED IN A PROFESSIONAL SPEED NETWORKING EVENT FOR COLLEGE STUDENTS AND RECENT GRADUATES IN MEMPHIS THROUGH THE NEW MEMPHIS INSTITUTE.FINALLY, THE CHIEF GOVERNMENT AFFAIRS OFFICER WORKED IN COLLABORATION WITH LEGAL STAFF AND OUTSIDE ADVOCACY GROUPS TO SUPPORT EFFORTS TO CREATE A STATE PALLIATIVE CARE/QUALITY OF LIFE ADVISORY COUNCIL.THE ST. JUDE CHIEF GOVERNMENT AFFAIRS OFFICER CONTINUES TO SERVE ON THE BOARD OF DIRECTORS OF THE MEMPHIS RIVER PARKS PARTNERSHIP (MRPP). THE MRPP IS A NON-PROFIT ORGANIZATION THAT, UNDER A LONG-TERM CONTRACT WITH THE CITY OF MEMPHIS, MANAGES ALL THE PARKS ALONG A 5-MILE STRETCH OF THE MEMPHIS RIVERFRONT INCLUDING ALONG DOWNTOWN MEMPHIS AND MUD ISLAND RIVER PARK. ELEMENTS ALONG THE RIVER FOSTER HEALTHY LIFESTYLES INCLUDING RIVERFIT, A SERIES OF PHYSICAL FITNESS CHALLENGES, AND A PLAYGROUND DESIGNED SPECIFICALLY FOR CHILDREN AT BEALE ST. LANDING, THE ONLY CHILD-DESIGNATED PLAYGROUND ON THE MEMPHIS RIVERFRONT. THE MRPP IS ALSO WORKING WITH THE CITY OF MEMPHIS TO IMPLEMENT A SERIES OF IMPROVEMENTS DESIGNED TO TIE THE RIVERFRONT CLOSER TO WORKERS AND RESIDENTS OF DOWNTOWN MEMPHIS TO MAKE ACCESS TO RIVERFRONT AMENITIES EASIER FOR ALL CITIZENS OF MEMPHIS AND TOURISTS VISITING THE CITY. AS PART OF THESE ADVOCACY EFFORTS, MRPP WAS AWARDED $10M IN STATE FUNDING TO UPGRADE TOM LEE PARK ON THE MEMPHIS RIVER FRONT.THE ST. JUDE CHIEF GOVERNMENT AFFAIRS OFFICER CONTINUES TO SERVE ON THE BOARD OF COMMISSIONERS OF THE MEMPHIS AREA TRANSIT AUTHORITY (MATA). IN THIS CAPACITY, HE HELPS TO PROMOTE THE HEALTH OF THE COMMUNITY BY ADVOCATING FOR POLICIES THAT ENABLE ENHANCED MOBILITY FOR A LARGER PERCENTAGE OF THE POPULATION OF MEMPHIS AND SHELBY COUNTY.THE CHIEF LEGAL OFFICER PARTICIPATES ON COMMITTEES OF THE MEMPHIS CHILD ADVOCACY CENTER, WHICH HELPS LOCAL CHILDREN FIND SAFETY AND HEALING (INCLUDING ACCESS TO A MENTAL HEALTH PROFESSIONAL) AFTER A REPORT OF SEXUAL OR OTHER SEVERE ABUSE AND OFFERS ABUSE PREVENTION TRAINING TO COMMUNITY VOLUNTEERS AND PARENTS.THE CHIEF LEGAL OFFICER SERVES AS CHAIR OF THE ADVISORY BOARD OF THE INSTITUTE FOR HEALTH LAW & POLICY OF THE CECIL C. HUMPHREYS UNIVERSITY OF MEMPHIS SCHOOL OF LAW, WHICH ENDEAVORS TO ADDRESS UNMET HEALTH LAW NEEDS OF THE LOCAL COMMUNITY AND WORK WITH COMMUNITY LEADERS TO PROACTIVELY ADDRESS HEALTH POLICY NEEDS.THE SENIOR ASSOCIATE COUNSEL IS THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION'S ELECTED REPRESENTATIVE TO THE BOARD OF THE MEMPHIS BAR ASSOCIATION. THE ASSOCIATE COUNSEL SERVES ON THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION BOARD. THE ASSOCIATE COUNSEL CHAIRS THE COMMUNITY AFFAIRS COMMITTEE OF THAT SECTION AND THE CHIEF LEGAL OFFICER IS AN ACTIVE MEMBER OF THE COMMITTEE, WHICH ANNUALLY SPONSORS A SATURDAY LEGAL CLINIC PROVIDING UNREPRESENTED MEMBERS OF THE COMMUNITY AN OPPORTUNITY TO MEET WITH A VOLUNTEER ATTORNEY AND DISCUSS LEGAL ISSUES, INCLUDING THOSE THAT HAVE AN IMPACT ON PERSONAL HEALTH. THE MANAGER OF THE CANCER EDUCATION PROGRAM IN THE DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE (GPM) DEDICATES 80% OF HER TIME, AND THE COORDINATOR FOR CANCER EDUCATION DEDICATES 100% OF HER TIME TO CANCER EDUCATION OUTREACH, INCLUDING ACTIVITIES SUCH AS K-12 CURRICULUM DEVELOPMENT, SCHOOL VISITS FOR CANCER AND HEALTHY LIVING EDUCATION, CAREER TALKS, TEACHER TRAINING WORKSHOPS AND PUBLIC-ACCESS WEBSITE DEVELOPMENT. PART III, LINE 2: BAD DEBT EXPENSE IS EQUAL TO CHARGES ON ACCOUNTS DETERMINED TO BE UNCOLLECTIBLE. SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: BAD DEBT EXPENSE EXPLANATION IN FINANCIAL STATEMENTS FOOTNOTES IS AS FOLLOWS: NET PATIENT SERVICE REVENUES AND RECEIVABLES - NO FAMILY EVER PAYS THE HOSPITAL FOR THE CARE THEIR CHILD RECEIVES. ACCORDINGLY, NET PATIENT SERVICE REVENUE CONSISTS ONLY OF ESTIMATED NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS (IF NECESSARY) DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED AS AMOUNTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PATIENT SERVICE REVENUE HAS BEEN REDUCED BY ADJUSTMENTS FOR UNCOLLECTIBLE ACCOUNTS TOTALING APPROXIMATELY $1,100,000 AND $773,000 IN 2019 AND 2018, RESPECTIVELY. ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER BAD DEBT EXPENSE A COMMUNITY BENEFIT. PART III, LINE 8: ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER THE MEDICARE SHORTFALL A COMMUNITY BENEFIT. THE COST TO CHARGE RATIO WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE. PART III, LINE 9B: ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. THIS IS SET FORTH IN OUR FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/ LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML). PART VI, LINE 2: ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. CANCERPEDIATRIC CANCERS ARE RARE COMPARED TO ADULT CANCERS. ONLY 11,060 NEW CASES ARE EXPECTED TO OCCUR AMONG CHILDREN 14 YEARS OF AGE AND YOUNGER IN 2019; HOWEVER, CANCER IS THE LEADING CAUSE OF DISEASE-RELATED DEATH IN U.S. CHILDREN (FOOTNOTE 1). THE PRINCIPAL FOCUS OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS CANCER. SEVENTY-FIVE PERCENT OF ALL RESOURCES AT ST. JUDE ARE INVESTED IN ELUCIDATING BASIC BIOLOGICAL MECHANISMS OF PEDIATRIC CANCERS, AND TRANSLATING THIS KNOWLEDGE INTO IMPROVED DIAGNOSTIC TOOLS AND CURATIVE THERAPIES, WHILE MINIMIZING LONG-TERM SIDE EFFECTS. AS THE FIRST AND ONLY NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER FOCUSED EXCLUSIVELY ON CHILDREN, ST. JUDE SERVES AS A NATIONAL RESOURCE FOR RESEARCH AND TREATMENT OF PEDIATRIC CANCERS. OUR INITIATIVES ARE DESIGNED TO IMPACT PEDIATRIC CANCER TREATMENT ON A LOCAL, REGIONAL, NATIONAL AND GLOBAL SCALE.OUR CANCER PATIENTS COME FROM ALL OVER THE UNITED STATES AND ABROAD; HOWEVER, 66% OF THE NEW CANCER PATIENTS WE REGISTER RESIDE IN THE ST. JUDE CATCHMENT AREA, WHICH INCLUDES A 180-MILE RADIUS AROUND ST. JUDE LOCATED IN MEMPHIS, TN AND A 100-MILE RADIUS AROUND EACH OF OUR EIGHT AFFILIATES. THESE EIGHT AFFILIATES ARE LOCATED IN HUNTSVILLE, AL, CHARLOTTE, NC, JOHNSON CITY, TN, BATON ROUGE, LA, SHREVEPORT, LA, TULSA, OK, SPRINGFIELD, MO, AND PEORIA, IL. THE CATCHMENT POPULATION IS GENERALLY CHARACTERIZED BY A HIGHER PROPORTION OF NON-HISPANIC BLACK/AFRICAN-AMERICAN RACE, LOWER PROPORTION OF HISPANIC ETHNICITY, LOWER HOUSEHOLD INCOMES AND HOME VALUES, AND LOWER PROPORTION WITH AN EDUCATION BEYOND HIGH SCHOOL. APPROXIMATELY 4.9% OF THE POPULATION LIVE IN RURAL AREAS (BY RUCA CODE 10). TAKEN TOGETHER, THIS DIVERSE POPULATION INCLUDES MANY WITH LIMITED RESOURCES WHO ARE MEDICALLY UNDERSERVED. THROUGH ST. JUDE'S FOUNDING POLICY - THAT NO PATIENT BE DENIED TREATMENT BASED ON RACE, ETHNICITY, RELIGION, OR A FAMILY'S INABILITY TO PAY - AND WITH THE PROVISION OF RESOURCES TO OFFSET THE COSTS OF TRANSPORTATION AND HOUSING DURING CLINIC VISITS AND TREATMENT, WE REMOVE BARRIERS IN ACCESS TO OUR CUTTING-EDGE CLINICAL RESEARCH TRIALS AND EXCEPTIONAL CLINICAL CARE. ALL PEDIATRIC PATIENTS IN OUR CATCHMENT AREA ARE ACCEPTED TO ST. JUDE FOR TREATMENT OF THEIR CANCER.THE DEMOGRAPHICS OF THE PEDIATRIC CANCER POPULATION TREATED AT ST. JUDE CLOSELY MATCH THOSE OF OUR CATCHMENT AREA (BASED ON 2010 DATA FROM THE US CENSUS BUREAU) AND ALIGN WITH THE ESTIMATED INCIDENCE OF PEDIATRIC CANCER IN REPRESENTED RACIAL AND ETHNIC GROUPS (BASED ON SURVEILLANCE EPIDEMIOLOGY AND END RESULTS [SEER] 2009 DATA), CONFIRMING THAT ST. JUDE IS CLOSELY ALIGNED WITH THE NEEDS OF THE POPULATION IT SERVES. DEMOGRAPHICS FROM THE ST. JUDE PEDIATRIC CANCER COHORT ARE COMPARED WITH THE DEMOGRAPHICS OF THE CATCHMENT AREA ANNUALLY TO MONITOR DEMOGRAPHIC REPRESENTATION OF OUR CANCER PATIENTS IN RELATION TO THE AREA THAT WE SERVE.THERE ARE NO KNOWN DIFFERENCES IN PEDIATRIC CANCER INCIDENCE BY GEOGRAPHIC REGION IN THE U.S. CONSEQUENTLY, IT IS NOT POSSIBLE TO CATER OUR CLINICAL TRIALS TO TARGET PEDIATRIC CANCERS SPECIFICALLY PREVALENT IN OUR CATCHMENT AREA. WHILE NUMEROUS ADULT CANCERS HAVE BEEN SHOWN TO HAVE HIGH VARIATION IN INCIDENCE RATES ACROSS RACES AND ETHNICITIES, THE SITUATION IS LESS CLEAR IN PEDIATRIC CANCER, WHERE FEWER DISCREPANCIES HAVE BEEN IDENTIFIED. ALTHOUGH OUR CATCHMENT AREA HAS A HIGHER PROPORTION OF AFRICAN-AMERICAN PATIENTS THAN THE GENERAL U.S. POPULATION, THERE ARE VERY FEW EXAMPLES OF PEDIATRIC CANCERS IN WHICH THE INCIDENCE IS HIGHER IN RACIAL AND/OR ETHNIC MINORITIES (FOOTNOTES 2 AND 3). CONSEQUENTLY OUR RESEARCH AND CLINICAL TRIALS ADDRESS THE MOST PRESSING PROBLEMS IN PEDIATRIC CANCER. ST. JUDE OFFERS THERAPEUTIC TRIALS FOR THE TOP PEDIATRIC CANCERS (FOOTNOTE 1) INCLUDING ACUTE LYMPHOBLASTIC LEUKEMIA, MEDULLOBLASTOMA, NEUROBLASTOMA, HODGKIN LYMPHOMA, RETINOBLASTOMA, RHABDOMYOSARCOMA AND OTHERS. MANY OF THESE TRIALS ARE INSTITUTIONALLY SPONSORED; HOWEVER, ST. JUDE ALSO PARTICIPATES IN A NUMBER OF CLINICAL TRIALS CONSORTIA PROVIDING OUR CANCER PATIENTS ACCESS TO A VARIETY OF THERAPEUTIC STUDIES. PEDIATRIC CANCER PATIENTS MAY EXPERIENCE TREATMENT-RELATED SIDE EFFECTS MANY YEARS AFTER DIAGNOSIS. THE CHILDHOOD CANCER SURVIVOR STUDY AND ST. JUDE LIFE ARE TWO STUDIES, ACTIVE AT ST. JUDE, ASSESSING LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS. INFORMATION FROM THESE STUDIES WILL BE USED TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTIONS.A KEY AREA THAT ST. JUDE IS PROMOTING IN OUR CATCHMENT AREA AND BEYOND IS PREVENTION OF HPV-RELATED CANCERS. THE AMERICAN CANCER SOCIETY AND OTHER ORGANIZATIONS HAVE PUT FORTH THE GOAL TO ERADICATE HPV-RELATED CANCERS THROUGH VACCINATION AND SCREENING. NEARLY 80 MILLION INDIVIDUALS IN THE U.S. - 1 OUT OF EVERY 4 PEOPLE - ARE INFECTED WITH HUMAN PAPILLOMAVIRUS (HPV). APPROXIMATELY 34,800 CANCERS ATTRIBUTABLE TO HPV OCCUR EACH YEAR (FOOTNOTE 4). U.S. VACCINATION RATES REMAIN SIGNIFICANTLY LOWER FOR HPV THAN FOR OTHER RECOMMENDED ADOLESCENT VACCINES. IN 2017, TENNESSEE'S COMBINED HPV VACCINATION COVERAGE FOR MALES AND FEMALES AGES 13-17 IS ONLY 56%, WHICH RANKS 46TH IN THE NATION. BY GENDER, FEWER THAN 50% OF GIRLS AND APPROXIMATELY 30% OF BOYS AGES 13-17 ARE UP-TO-DATE ON THE HPV VACCINE SERIES (FOOTNOTE 5). RESIDENTS OF TENNESSEE AND THE MID-SOUTH HAVE AMONG THE HIGHEST INCIDENCES OF HPV-RELATED CANCERS IN THE COUNTRY (FOOTNOTE 6). AS THE ONLY NCI-DESIGNATED CANCER CENTER DEVOTED SOLELY TO CHILDREN, ST. JUDE IS COMMITTED TO TAKING ON A NEW LEADERSHIP ROLE IN PROTECTING YOUNG PEOPLE FROM PREVENTABLE HPV-ASSOCIATED CANCERS LATER IN LIFE. RECENTLY, ST. JUDE LAUNCHED HPV AWARENESS EFFORTS INCLUDING EDUCATION AT LOCAL SCHOOLS, OUTREACH TO NEWS MEDIA, DEVELOPMENT OF WEB CONTENT, AND PARTNERING WITH OTHER NCI-DESIGNATED CANCER CENTERS TO ENDORSE A GOAL OF ELIMINATING HPV-ASSOCIATED CANCERS IN THE UNITED STATES. OVER THE NEXT 5 YEARS, OUR PLAN IS TO SIGNIFICANTLY EXPAND OUR EFFORTS TO HAVE A GREATER IMPACT IN THE PROMOTION OF HPV VACCINATION IN OUR LOCAL CATCHMENT AREA, IN THE STATE OF TENNESSEE, AND NATIONALLY.ACCORDING TO THE AMERICAN CANCER SOCIETY, INDIVIDUALS WITH LOWER SOCIOECONOMIC STATUS HAVE HIGHER CANCER INCIDENCE RATES DUE TO ENGAGING IN LIFESTYLE BEHAVIORS THAT INCREASE CANCER RISK (FOOTNOTE 1). THE ST. JUDE CANCER EDUCATION FOR CHILDREN PROGRAM IS A LOCAL COMMUNITY EFFORT THAT USES EDUCATION AND POSITIVE REINFORCEMENT TO PROMOTE HEALTHY LIFESTYLE CHOICES THAT CAN HELP CHILDREN REDUCE THEIR RISK OF CANCER IN ADULTHOOD. EDUCATIONAL COMPONENTS OF THE PROGRAM SPECIFICALLY ADDRESS OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. THE PROGRAM DEVELOPMENT IS OVERSEEN BY A MULTIDISCIPLINARY TEAM COMPOSED OF ST. JUDE FACULTY AND STAFF, LOCAL EDUCATORS, AND LOCAL HEALTH EXPERTS WHO WORK TOGETHER TO ENSURE THAT THE CONTENT ACHIEVES THE GOALS OF THE PROGRAM WHILE ALIGNING TO STATE AND NATIONAL EDUCATION STANDARDS. DURING THE 2017-2018 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM WORKED WITH THE SHELBY COUNTY SCHOOL DISTRICT TO DELIVER CANCER AND HEALTHY LIVING EDUCATION PROGRAMS TO OVER 5,000 K-12 STUDENTS.(NOTE: THIS NARRATIVE FOR PART VI, LINE 2 IS CONTINUED BELOW.) - SEE PAGE 101/131 PART VI, LINE 3: AS NOTED IN PART I, LINE 3C, NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. IN ADDITION, ST. JUDE PROVIDES AN UNPARALLELED LEVEL OF SUPPORT SERVICES AT NO COST TO FAMILIES. WE ALSO HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. FAMILIES ALSO HAVE ACCESS TO AN ONLINE EDUCATIONAL RESOURCE TITLED "YOU AND THE AFFORDABLE CARE ACT" (HTTPS://WWW.STJUDE.ORG/TREATMENT/PATIENT-RESOURCES/CAREGIVER-RESOURCES/PATIENT-FAMILY-EDUCATION-SHEETS/LEGAL-FINANCIAL/YOU-AND-THE-AFFORDABLE-CARE-ACT.HTML). THIS ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE UTILIZE AN OUTSIDE CONTRACTOR TO PROVIDE APPLICATION ASSISTANCE. THE HOSPITAL'S FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML) ARE POSTED ON THE HOSPITAL'S WEBSITE AND AVAILABLE AT REGISTRATION. THE DOCUMENTS ARE AVAILABLE IN ENGLISH AND SPANISH. FOR FAMILIES SPEAKING OTHER LANGUAGES, WE UTILIZE ONSITE INTERPRETER SERVICES AND/OR PROFESSIONAL CONTRACTED INTERPRETATION AND TRANSLATION SERVICES. PART VI, LINE 4: ST. JUDE CHILDREN'S RESEARCH HOSPITAL IN MEMPHIS, TN, IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CATASTROPHIC DISEASES WITH A FOCUS ON CANCER AND BLOOD DISORDERS. PATIENTS AT ST. JUDE ARE REFERRED BY A PHYSICIAN, DIAGNOSED WITH A DISEASE CURRENTLY UNDER STUDY, AND ELIGIBLE FOR A RESEARCH PROTOCOL. ST. JUDE IS THE ONLY PEDIATRIC RESEARCH CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, INCLUDING CANCER AND BLOOD DISORDERS, WHERE FAMILIES NEVER PAY FOR TREATMENT NOT COVERED BY INSURANCE. IN FACT, NO FAMILY EVER PAYS ST. JUDE FOR ANYTHING. TRANSPORTATION, HOUSING AND FOOD ARE AMONG THE NO-COST SERVICES PROVIDED TO ENSURE FAMILIES COMING TO ST. JUDE CAN FOCUS ON THEIR CHILD. NO CHILD IS EVER DENIED TREATMENT DUE TO RACE, SEX, NATIONALITY, ETHNICITY, RELIGION, OR THE FAMILY'S ABILITY TO PAY.THE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST JUDE SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, SUCH AS CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. IT DOES NOT ADMIT CHILDREN FOR ANY DIAGNOSTIC GROUPS OUTSIDE OF THESE SERVICES AND DOES NOT OFFER MEDICAL SERVICES BEYOND THOSE NECESSARY TO CARE FOR CHILDREN WITH THESE DISEASES. ST. JUDE DOES NOT HAVE AN EMERGENCY ROOM (ER). A REFERRAL FROM A MEDICAL PROFESSIONAL EXTERNAL TO ST. JUDE, TYPICALLY THE CHILD'S PEDIATRICIAN OR A PEDIATRIC SUBSPECIALIST, IS NECESSARY PRIOR TO ACCEPTING A PATIENT FOR TREATMENT TO ST. JUDE.ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS. SPECIFICALLY, MORE THAN 8,600 PATIENTS ARE SEEN AT ST. JUDE YEARLY, MOST OF WHO ARE ENROLLED ON CLINICAL TRIALS FOR NEW TREATMENTS DEVELOPED BY ST. JUDE, AND WHO ARE TREATED ON A CONTINUOUS OUTPATIENT BASIS. THE HOSPITAL HAS 73 OPERATIONAL BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS TO BE TREATED AS OUTPATIENTS WHO WOULD BE ADMITTED INTO INPATIENT UNITS AT MOST HOSPITALS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA FILTRATION, INFECTION-RESISTANT SURFACES AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES.ST. JUDE HAS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE TO EXTEND CARE AND BENEFITS TO MORE CHILDREN AND INCREASE THE NUMBER OF CHILDREN ABLE TO BE TREATED ON ST. JUDE CLINICAL TRIALS.ST. JUDE ALSO OPERATES AN INTERNATIONAL OUTREACH PROGRAM IN GLOBAL PEDIATRIC MEDICINE (GPM), AIMED AT IMPROVING SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, IMPLEMENTING NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND GENERATING INTERNATIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THERE ARE AN ESTIMATED 175,000 NEWLY DIAGNOSED CASES OF CHILDHOOD CANCER WORLDWIDE EACH YEAR, AND 84% OCCUR IN LOW- AND MIDDLE-INCOME COUNTRIES. CANCER IS EMERGING AS A MAJOR CAUSE OF CHILDHOOD DEATH IN ALL DEVELOPING COUNTRIES, REPLACING OTHER CAUSES OF CHILDHOOD MORTALITY (E.G. HIV, MALNUTRITION, INFECTIONS). DESPITE VAST IMPROVEMENTS IN THERAPY AND SURVIVAL IN HIGH-INCOME COUNTRIES OVER THE PAST 30 YEARS, AN ESTIMATED 60% DO NOT HAVE ACCESS TO ADEQUATE DIAGNOSIS AND MODERN CARE. ST. JUDE STRIVES TO ADDRESS THE NEEDS OF THOSE CHILDREN IN COUNTRIES THAT LACK SUFFICIENT RESOURCES AND HELP THEM MANAGE THEIR OWN BURDEN OF CASES EFFECTIVELY.WHILE SICK CHILDREN FROM AROUND THE WORLD HAVE TRAVELED TO OUR HOSPITAL IN MEMPHIS, RECEIVING TREATMENT IN THEIR OWN COUNTRIES IS MORE EFFICIENT AND LESS DISRUPTIVE FOR THEM AND THEIR FAMILIES. AS A RESULT OF OUR INTERNATIONAL EFFORTS, WE ARE ABLE TO REACH FAR MORE CHILDREN THAN WOULD EVER BE ABLE TO COME TO MEMPHIS. A BASIC HEALTHCARE INFRASTRUCTURE IS NEEDED TO SUPPORT PEDIATRIC ONCOLOGY PROGRAMS, WHICH IN TURN FURTHER IMPROVES THE DEVELOPMENT OF BASIC HEALTHCARE. AT THE LOCAL LEVEL, GPM DEVELOPS PARTNERSHIPS WITH MEDICAL INSTITUTIONS AND FUND-RAISING ORGANIZATIONS AND FACILITATES THE INVOLVEMENT OF GOVERNMENT AND OTHER ORGANIZATIONS TO SUPPORT KEY PROGRAMS AND THE EDUCATION OF LOCAL PERSONNEL. AT THE REGIONAL LEVEL, GPM DEVELOPS PROGRAMS THROUGH THE USE OF TECHNOLOGY AND FOSTERS REGIONAL AND INTERNATIONAL COLLABORATIONS WITH OTHER PEDIATRIC MEDICAL INSTITUTIONS. THE PRIMARY GOAL IS TO DEVELOP LOCAL AND REGIONAL SELF-SUFFICIENCY. THIS MODEL RESULTS IN SIGNIFICANT OVERALL IMPROVEMENT IN HEALTHCARE FACILITIES, THE LEVEL OF PRACTICE, THE CONFIDENCE OF HEALTHCARE PROVIDERS, AND LOCAL COMMUNITY INVOLVEMENT. ST. JUDE EMPHASIZES THE BUILDING OF REGIONAL EXPERTISE AND DIAGNOSTIC CAPABILITIES, WHICH PROVIDE A CRITICAL MASS OF PROFESSIONALS WHO CONTINUALLY LEARN FROM AND ASSIST EACH OTHER. COST EFFICIENCY IS ALSO REALIZED BECAUSE OF SHARED RESOURCES.ST. JUDE HAS PARTNERSHIPS WITH 28 MEDICAL INSTITUTIONS ACROSS 17 DIFFERENT COUNTRIES - BRAZIL, CHILE, CHINA, COSTA RICA, DOMINICAN REPUBLIC, ECUADOR, EL SALVADOR, GUATEMALA, HAITI, HONDURAS, JORDAN, LEBANON, MEXICO, NICARAGUA, PHILIPPINES, URUGUAY AND VENEZUELA.ST. JUDE WORKS WITH ITS PARTNERS TO DEVELOP EVIDENCED-BASED TREATMENT PROTOCOLS TAILORED TO REGIONAL NEEDS AND RESOURCES. ADDITIONALLY, ST. JUDE PHYSICIANS AND NURSES SERVE AS MENTORS TO CLINICAL PERSONNEL AT PARTNER SITES, PROVIDE LOCAL AND ONLINE TRAINING FOR ONCOLOGY CARE, DIAGNOSIS, AND SUPPORTIVE CARE, AND PARTICIPATE IN ONLINE MEETINGS TO DISCUSS CLINICAL CARE BEST PRACTICES. THE MAJORITY OF ONLINE MEETINGS AND TRAINING ARE PROVIDED VIA ST. JUDE'S WEB-BASED PLATFORM, ST. JUDE CURE4KIDSTM (C4K), A FREE RESOURCE FOR PEDIATRIC ONCOLOGY PROFESSIONALS, SCIENTISTS AND RESEARCHERS, REGARDLESS OF THEIR AFFILIATION WITH ST. JUDE OR ITS PARTNERS. IN ADDITION TO CONTENT THAT INCLUDES MORE THAN 1,657 ONLINE SEMINARS, 19 SELF-PACED COURSES, AND 51 INSTRUCTOR-LED COURSES, C4K PROVIDES ONLINE MEETING AND CONFERENCE SPACE. IN FY19, C4K HAD 31,640 CONTENT VIEWS WITH 4,273 UNIQUE REGISTERED USERS, AND HOSTED 1,791 MEETINGS WITH 1,793 UNIQUE PARTICIPANTS FROM 148 DIFFERENT COUNTRIES; THERE ARE 64 NCI CENTERS THAT PARTICIPATE IN C4K. FINALLY, ST. JUDE PARTNERS WITH LOCAL FUNDRAISING ORGANIZATIONS THAT SUPPORT THE MEDICAL PROGRAMS. THIS MODEL HAS PROVEN TO BE HIGHLY EFFECTIVE IN PROVIDING POOR CHILDREN IN DEVELOPING COUNTRIES ACCESS TO MODERN TREATMENT AND CARE.ST. JUDE IS ALSO A RESEARCH ORGANIZATION, WITH RESEARCH COVERING A BROADER SCOPE OF HEALTH ISSUES THAN THE DISEASES TREATED AS A PRIMARY DIAGNOSIS.THE HOSPITAL'S OUTREACH INCLUDES THE LOCAL MARKET, AFFILIATE INSTITUTIONS, OTHER AREAS OF THE UNITED STATES/U.S. TERRITORIES, AND THE INTERNATIONAL COMMUNITY. THE LOCAL MARKET ENCOMPASSES MEMPHIS, TENNESSEE AND THE SURROUNDING GEOGRAPHIC AREA WITH APPROXIMATELY 24% OF NEW ONCOLOGY PATIENTS RESIDING WITHIN THIS AREA.FY19 NEW CANCER PATIENTSPATIENT ORIGIN % OF TOTALMEMPHIS, TN AND SURROUNDING AREA 24%AFFILIATE REFERRAL 36%NATIONAL REFERRAL (OTHER AREAS OF U.S.) 29%INTERNATIONAL REFERRAL 11%GRAND TOTAL 100%THE ST. JUDE AFFILIATE PROGRAM (AP) IS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE PATIENTS TO BE TREATED CLOSER TO HOME AND TO INCREASE ENROLLMENT ON ST. JUDE CLINICAL TRIALS. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF AT ST. JUDE TO DELIVER PROTOCOL RELATED CARE OR EVIDENCE BASED TREATMENT WHEN NOT PARTICIPATING IN A TRIAL TO PEDIATRIC HEMATOLOGY-ONCOLOGY PATIENTS, SO THAT PATIENTS CAN RECEIVE CARE CLOSER TO HOME. AFFILIATES ARE CURRENTLY LOCATED IN BATON ROUGE, LA, CHARLOTTE, NC, HUNTSVILLE, AL, JOHNSON CITY, TN, PEORIA, IL, SHREVEPORT, LA, SPRINGFIELD, MO, AND TULSA, OK. THE AFFILIATES' ENROLLMENT OF PATIENTS ON ST. JUDE CLINICAL TRIALS HELPS ST. JUDE FIND CURES FASTER AND SAVE MORE CHILDREN.(NOTE: THIS NARRATIVE FOR PART VI, LINE 4 IS CONTINUED BELOW.) - SEE PAGE 107/131 PART VI, LINE 5: ST. JUDE CHILDREN'S RESEARCH HOSPITAL WAS OPENED IN 1962. OUR MISSION IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER, DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S INABILITY TO PAY. OUR VISION IS TO BE THE WORLD LEADER IN ADVANCING THE TREATMENT AND PREVENTION OF CATASTROPHIC DISEASES IN CHILDREN. THIS VISION IS PURSUED BY PROVIDING OUTSTANDING PATIENT CARE; BY CONDUCTING BASIC, TRANSLATIONAL AND CLINICAL RESEARCH DESIGNED TO ELUCIDATE BIOLOGICAL MECHANISMS, UNDERSTAND DISEASE PATHOGENESIS, IMPROVE DIAGNOSIS, ENHANCE TREATMENT OUTCOME, PREVENT DISEASES AND MINIMIZE ADVERSE CONSEQUENCES OF TREATMENT; AND BY EDUCATING HEALTH CARE AND SCIENTIFIC RESEARCH PROFESSIONALS. THROUGH THESE EFFORTS, WE SEEK TO CURE AND ENHANCE THE QUALITY OF LIFE FOR AN INCREASING NUMBER OF CHILDREN WHO COME TO US FOR TREATMENT BY EXPANDING AND SHARING KNOWLEDGE TO ADVANCE TREATMENT OF CHILDREN WITH CATASTROPHIC DISEASES WORLDWIDE, WHILE DEVELOPING STRATEGIES TO PREVENT CATASTROPHIC DISEASES IN CHILDREN.ST. JUDE COMBINES LABORATORY AND CLINICAL RESEARCH TO ADVANCE THE CARE OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES. THE FOCUS IS ON PROVIDING OUTSTANDING PATIENT CARE RESULTS AND ON RESEARCH FINDINGS THAT TRANSLATE INTO IMPROVED PATIENT OUTCOMES. ST. JUDE HAS AN ACADEMIC FACULTY ENGAGED IN A BROAD SPECTRUM OF RESEARCH, INCLUDING THERAPEUTIC TRIALS, INVESTIGATION OF DISEASE PATHOGENESIS AND DISCOVERY-ORIENTED BASIC RESEARCH.HOSPITAL OPERATIONS ARE OVERSEEN BY A BOARD OF GOVERNORS, MOST OF WHICH ARE NEITHER EMPLOYEES, INDEPENDENT CONTRACTORS, OR THEIR FAMILY MEMBERS. RESEARCH ACTIVITIES ARE REVIEWED ANNUALLY BY A SCIENTIFIC ADVISORY BOARD COMPOSED OF INTERNATIONALLY PROMINENT PHYSICIANS AND SCIENTISTS.ST. JUDE CONTRIBUTED TO THE BUILDING OF A STATE-OF-THE ART NEUROSURGICAL FACILITY FOR TREATING LOCAL PEDIATRIC PATIENTS AND ST. JUDE BRAIN TUMOR PATIENTS. THE FACILITY IS EQUIPPED WITH INTRA-OPERATIVE IMAGING EQUIPMENT (IMRI). WHEN PURCHASED, ONLY TWO NEUROSURGICAL FACILITIES IN THE UNITED STATES PROVIDED PATIENTS WITH THIS LEVEL OF TREATMENT, WHICH ALLOWS IMAGING TO TAKE PLACE DURING SURGICAL PROCEDURES. IMRI EQUIPMENT ALLOWS SURGEONS TO MAKE INFORMED DECISIONS DURING THE SURGERY. LIVE WEB CASTS ALLOW OTHERS TO VIEW PROCEDURES. OUR ASSISTANCE WITH THIS FACILITY HELPS ASSURE THAT CHILDREN IN THE AREA HAVE ACCESS TO THE BEST NEUROSURGICAL TREATMENT AVAILABLE.ST. JUDE COMPLETED THE FIRST PHASE OF THE PEDIATRIC CANCER GENOME PROJECT (PCGP) IN JANUARY 2013 - A COLLABORATION WITH WASHINGTON UNIVERSITY TO FIND CLUES TO THE CAUSES OF CHILDHOOD CANCER AND POTENTIAL NEW TREATMENTS AND CURES. THE PROJECT HAS RESULTED IN GROUNDBREAKING DISCOVERIES IN A NUMBER OF CHILDHOOD CANCERS INCLUDING RETINOBLASTOMA, MEDULLOBLASTOMA, NEUROBLASTOMA, DIFFUSE INTRINSIC PONTINE GLIOMA, TWO AGGRESSIVE FORMS OF LEUKEMIA AND LOW-GRADE GLIOMAS. IN DECEMBER 2012, THE PCGP WAS RECOGNIZED AS ONE OF TIME MAGAZINE'S TOP 10 MEDICAL BREAKTHROUGHS AND, IN 2013, AS ONE OF TIME MAGAZINE'S TOP 100 NEW SCIENTIFIC DISCOVERIES. THE SECOND PHASE OF PCGP EXAMINED THE CANCER SAMPLES FROM 300 CHILDREN AND FOCUSED ON DEFINING MUTATIONS THAT CONTRIBUTE TO TUMOR FORMATION, CHARACTERIZING THE STATE OF THE CANCER CELL'S EPIGENOME AND DESCRIBING HOW IT DIFFERED FROM WHAT IS SEEN IN THE NORMAL CELLS. THE SECOND PHASE ALSO INCLUDED A CLINICAL GENOMICS PROJECT CALLED GENOMES FOR KIDS THAT INVOLVED NEXT-GENERATION SEQUENCING FOR CHILDREN WITH CANCER. WHEN PHASE 2 IS COMPLETE, ST. JUDE HOPES TO HAVE A MODEL FOR HOW TO EXTEND GENOME SEQUENCING TO EVERY CHILDHOOD CANCER PATIENT IN THE UNITED STATES. FROM ITS BEGINNINGS IN 2010, THE PCGP IS THE LARGEST, BROADEST, PRIVATELY FUNDED SEQUENCING PROJECT FOR CHILDREN WITH CANCER AND HAS SEQUENCED MORE THAN 800 MATCHED PAIRS OF TUMOR AND HEALTHY GENOMES FROM YOUNG PATIENTS. THE PCGP HAS PROVIDED NEW DETAILS ABOUT THE MUTATIONS THAT UNDERLIE THE DEVELOPMENT AND GROWTH OF A RANGE OF CHILDHOOD CANCERS, AND HAS LAID THE FOUNDATION FOR IMPROVED DIAGNOSTIC TESTING AND THE NEXT GENERATION OF MORE EFFECTIVE, LESS-TOXIC THERAPIES. THE PROJECT HAS LED TO NEW DIRECTIONS IN RESEARCH INVOLVING HIGH-RISK LEUKEMIA, BRAIN AND SOLID TUMORS AS WELL AS NEW COMPUTATIONAL METHODS THAT HAVE BEEN SHARED FOR FREE WITH THE GLOBAL SCIENTIFIC COMMUNITY.THE CYCLOTRON (PARTICLE ACCELERATOR) AT ST. JUDE ENABLES RESEARCHERS TO TRACK THE GROWTH OF CANCER CELLS, PINPOINT THE PRODUCTION OF NEW DNA BY TUMOR CELLS AND STUDY THE HEARTS OF ADULT CHILDHOOD CANCER SURVIVORS RETURNING TO ST. JUDE FOR LIFETIME FOLLOW-UP. THE CYCLOTRON HELPS RESEARCHERS BETTER UNDERSTAND CHILDHOOD CANCER BY ENABLING THEM TO PRODUCE NEW, VERY SHORT-ACTING TRACERS.ST. JUDE USES THE SERVICES OF CHILDREN'S GMP, LLC (OF WHICH ST. JUDE IS THE SOLE MEMBER). CHILDREN'S GMP, LLC, MANAGES AND OPERATES A GOOD MANUFACTURING PRACTICE (GMP) FACILITY THAT ENGAGES IN THE PRODUCTION OF BIOLOGICS AND DRUGS FOR RESEARCH. THE GMP OFFERS RESOURCES TO STUDY RARE DISEASES OVERLOOKED BY PHARMACEUTICAL COMPANIES BECAUSE THERE IS LITTLE PROFIT IN MANUFACTURING DRUGS FOR LESSER- KNOWN DISEASES. THE FACILITY, OPERATING ACCORDING TO APPROVED FDA STANDARDS, ALLOWS DOCTORS TO TAILOR TREATMENTS SPECIFICALLY FOR AN INDIVIDUAL CHILD.THE CELL AND TISSUE IMAGING CENTER INCLUDES ELECTRON MICROSCOPY AND LIGHT MICROSCOPY. THE FACILITY PROVIDES INVESTIGATORS ACCESS TO TRANSMISSION ELECTRON MICROSCOPY, CONFOCAL LASER SCANNING MICROSCOPY, MULTIPHOTON MICROSCOPY, IMAGE ANALYSIS, CELL MICROINJECTION AND LIVE CELL IMAGING. THE FEI TECNAI 20 200KV FEG ELECTRON MICROSCOPE, WHICH CAN MAGNIFY AN OBJECT 700,000 TIMES, IS AT THE HEART OF THIS PROGRAM. THIS TECHNOLOGY ALLOWS RESEARCHERS TO GET A CLOSER LOOK AT CANCER TO BETTER UNDERSTAND HOW IT GROWS AND SPREADS AND RESPONDS TO THERAPY. USING THE ELECTRON MICROSCOPE, RESEARCHERS LEARN HOW CANCER CELLS BREAK AWAY FROM THE TUMOR AND SPREAD THROUGHOUT THE BODY.ST. JUDE IS HOME TO THE ONLY PROTON BEAM RADIATION THERAPY CENTER DEVOTED SOLELY TO TREATING CHILDREN WITH BRAIN TUMORS AND SEVERAL OTHER CHILDHOOD CANCERS. PROTON THERAPY IS LESS DAMAGING TO SURROUNDING HEALTHY TISSUE THAN OTHER CURRENT RADIATION THERAPIES. THIS EQUIPMENT ENABLES ST. JUDE TO PROVIDE THIS THERAPY IN A MORE INTEGRATED MANNER TO OUTPATIENTS AND ALLOW OUR RADIATION ONCOLOGISTS TO LEAD THE DEVELOPMENT OF NEW TREATMENTS WITH PROTONS.TO FURTHER PALLIATIVE SERVICES IN THE COMMUNITY, ST. JUDE PARTICIPATED WITH LE BONHEUR CHILDREN'S HOSPITAL IN DEVELOPING THE QUALITY OF LIFE FOR ALL KIDS PALLIATIVE PROGRAM FOR SERIOUSLY ILL CHILDREN. HOSPICE STAFF, BOTH IN THE HOME AND IN THE HOSPICE RESIDENCE, PROVIDES INTERDISCIPLINARY CARE TO CHILDREN THROUGHOUT THE ILLNESS TRAJECTORY AND CONCURRENT THERAPIES.ST. JUDE ADMINISTRATIVE LEADERS AND FACULTY MEMBERS OF THE DEPARTMENT OF PHARMACEUTICAL SCIENCES HAVE BEEN AT THE FOREFRONT OF BRINGING NATIONAL ATTENTION TO THE PEDIATRIC CANCER DRUG SHORTAGE TOPIC, ACTIVELY ENGAGING REGULATORY AND LEGISLATIVE BODIES TO UNDERSTAND THE IMPACT THESE DRUG SHORTAGES HAVE ON PEDIATRIC CARE AND RESEARCH. PRESENTATIONS OR WRITTEN TESTIMONY HAVE BEEN PROVIDED TO THE FDA CENTER FOR DRUG EVALUATION AND RESEARCH WORKSHOP, TWO SENATE HEARINGS, AND HEALTH SUBCOMMITTEE OF THE HOUSE COMMITTEE ON ENERGY AND COMMERCE.ST. JUDE FOCUSES ON EDUCATING AND TRAINING THE NEXT GENERATION OF DOCTORS, NURSES, RESEARCHERS AND ACADEMIC LEADERS. FROM PROGRAMS FOR HIGH SCHOOL STUDENTS TO THE POSTDOCTORAL LEVEL, THE HOSPITAL PLAYS A MAJOR ROLE IN PREPARING FUTURE LEADERS OF SCIENCE AND MEDICINE. IN ADDITION TO ONSITE EDUCATION, THE ST. JUDE GLOBAL PROVIDES AN EDUCATION AND COLLABORATION WEB SITE, CURE4KIDS(TM) (WWW.CURE4KIDS.ORG).VIA THE CONNECT2PROTECT PROGRAM, ST. JUDE COLLABORATES WITH CHURCHES, OTHER HEALTH CARE ORGANIZATIONS AND CIVIC GROUPS TO RAISE AWARENESS ABOUT PREVENTING THE SPREAD OF HIV/AIDS. THE PRIMARY TARGET IS THE AFRICAN-AMERICAN COMMUNITY, ALTHOUGH OTHER ETHNIC GROUPS ARE ALSO SERVED INCLUDING ASIAN, CAUCASIAN AND HISPANIC.THE FUNDRAISING SOURCE FOR ST. JUDE IS ALSAC, WHICH RAISES FUNDS SOLELY FOR THE HOSPITAL. BECAUSE OF THE HOSPITAL'S MISSION, PEOPLE NATIONWIDE CONTRIBUTE VIA TENS OF THOUSANDS OF FUNDRAISING EFFORTS. ALSAC CONTRIBUTED $865 MILLION IN FY19 TO SUPPORT ST. JUDE. VOLUNTEERS ENHANCE THE QUALITY OF PATIENT CARE BY PARTNERING WITH CLINICAL STAFF TO PROVIDE AN ADDITIONAL PERSONAL TOUCH. VOLUNTEERS ALSO HELP ENSURE A SAFE ENVIRONMENT. THEY LEND ASSISTANCE AND PROVIDE COMPASSIONATE CONCERN BY OFFERING A LISTENING EAR TO FAMILIES AT A TIME WHEN THEY NEED IT MOST. THEY ARE VITAL AMBASSADORS FOR THE HOSPITAL AND COMMUNITY. PART VI, LINE 2 (CONTINUATION FROM 90/131): HEMATOLOGYTHE GEOGRAPHIC CATCHMENT AREA FOR ST. JUDE ENCOMPASSES 21 COUNTIES IN WESTERN TENNESSEE INCLUDING MEMPHIS, AND AREAS IN EAST ARKANSAS, NORTH MISSISSIPPI, AND A FEW COUNTIES IN MISSOURI.MORE THAN 70,000 PEOPLE IN THE UNITED STATES HAVE SICKLE CELL DISEASE (SCD), AND IT IS ESTIMATED THAT MORE THAN 1 MILLION PEOPLE WORLDWIDE SUFFER FROM THE DISEASE. IT IS THE MOST FREQUENT GENETIC BLOOD DISORDER IN THE WORLD. ST. JUDE HAS ONE OF THE LARGEST PEDIATRIC SCD PROGRAMS IN THE COUNTRY AND PROVIDES COMPREHENSIVE TREATMENT AND EDUCATION TO ABOUT 900 CHILDREN WITH SCD IN THE GEOGRAPHIC CATCHMENT AREA. SCD IS DIAGNOSED BY STATE-WIDE NEWBORN SCREENING IN ALL 50 STATES. ST. JUDE HAS A PARTNERSHIP WITH NEWBORN SCREENING PROGRAMS IN TN AND MS THAT ENSURES A STABLE RELATIONSHIP AMONG PARENTS, PATIENTS, PRIMARY CARE PROVIDERS. ABOUT 50 NEWBORNS WITH SCD ARE IDENTIFIED EACH YEAR IN OUR GEOGRAPHIC CATCHMENT AREA. OUR SCD INFANT TODDLER PROGRAM CONTACTS AND ACCEPTS ALL CHILDREN DIAGNOSED WITH THE DISEASE IN OUR CATCHMENT AREA TO ITS COMPREHENSIVE CARE SERVICE. ADDITIONALLY, ST. JUDE PROVIDES TRAIT COUNSELING SERVICE TO INFANTS BORN WITH SICKLE CELL TRAIT TO 21 COUNTIES IN WESTERN TN. ST. JUDE PROVIDES CONFIRMATORY TESTING, EDUCATION AND COMPREHENSIVE CARE AND FOLLOW-UP THROUGHOUT CHILDHOOD FOR CHILDREN WITH SCD DISEASE. FROM BIRTH TO AGE 18 YEARS, PATIENTS ARE CLINICALLY EVALUATED AT LEAST EVERY 6 MONTHS, RECEIVE EDUCATION AND MULTI-DISCIPLINARY SERVICES ACCORDING TO STANDARDIZED TREATMENT AND EDUCATION GUIDELINES. SERVICES ALSO INCLUDE COMMUNITY OUTREACH AND EDUCATION OF THE LOCAL COMMUNITY. ST. JUDE HAS ESTABLISHED A FORMAL TRANSITION PROGRAM TO ADULT CARE FOR PATIENTS WITH SCD AND PROVIDES SUPPORT TO PATIENTS AND FAMILIES THROUGHOUT THE TRANSITION PROCESS BY WORKING CLOSELY WITH THE ADULT SCD PROGRAMS AT METHODIST UNIVERSITY HOSPITAL AND REGIONAL ONE HOSPITAL. IN THE PAST, THE SCD PROGRAM AT ST. JUDE HAS COLLABORATED WITH SEVERAL FEDERALLY QUALIFIED HEALTH CARE CENTERS, WITH COMMUNITY PRIMARY CARE PHYSICIANS, LATINO MEMPHIS (THE LARGEST HISPANIC SOCIAL AGENCY IN TENNESSEE), WITH THE SICKLE CELL FOUNDATION OF TENNESSEE (A COMMUNITY-BASED SCD ORGANIZATION), AND WITH REGIONAL SCD PROVIDERS TO ENSURE A MEDICAL HOME AND ADEQUATE SOCIAL SUPPORT FOR ALL SCD PATIENTS IN THE AREA. ST. JUDE ASSESSES PATIENT NEEDS THROUGH PARENT AND PATIENT SURVEYS, INTERACTIVE EDUCATION, MATERIALS REVIEW, AND GROUP DISCUSSIONS WITH PARENTS AND PATIENTS. ST. JUDE HAS AN ANNUAL SICKLE CELL EDUCATION DAY FOR PATIENTS WITH SICKLE CELL DISEASE AND THEIR FAMILIES/CAREGIVERS. MORE THAN 250 ATTEND THIS EVENT EVERY YEAR. ADDITIONALLY, ST. JUDE COLLABORATES WITH NATIONAL ORGANIZATIONS TO PROVIDE EDUCATION TO HEALTHCARE PROVIDERS AND PEOPLE WITH SICKLE CELL DISEASE TO INCREASE SICKLE CELL AWARENESS. ST. JUDE PROVIDES FREE EDUCATIONAL BOOKLETS AND BROCHURES (HARD COPY REQUEST OR DOWNLOAD) ON THE HEMATOLOGY WEBSITE AS WELL AS INTERACTIVE EDUCATIONAL VIDEOS. PEOPLE FROM THROUGHOUT THE US AND OTHER COUNTRIES UTILIZE THE EDUCATIONAL WEBSITE. ST. JUDE PARTICIPATES IN NUMEROUS HEALTH FAIRS, SCHOOL PROGRAMS, AND OTHER COMMUNITY EVENTS TO INCREASE KNOWLEDGE AND AWARENESS OF HEMATOLOGICAL DISORDERS AND THEIR IMPACT ON THE PATIENTS AND THE COMMUNITY.ST. JUDE ALSO PROVIDES CLINICAL SERVICES FOR APPROXIMATELY 800 CHILDREN PER YEAR WITH OTHER NON-MALIGNANT HEMATOLOGICAL DISORDERS THROUGH A STRONG RELATIONSHIP WITH LOCAL COMMUNITY PHYSICIANS. CHILDREN FROM THE GEOGRAPHIC CATCHMENT AREA OF ST. JUDE (AS OUTLINED ABOVE) WITH ILLNESSES SUCH AS HEMOPHILIA, APLASTIC ANEMIA, THROMBOSIS, THALASSEMIA, SPHEROCYTOSIS, AND IMMUNE THROMBOCYTOPENIC PURPURA AND OTHER NON- MALIGNANT HEMATOLOGIC DISORDERS ARE REFERRED TO AND RECEIVE STATE-OF-THE-ART CARE FROM ST. JUDE PHYSICIANS AND MEDICAL STAFF. ST. JUDE IS ONE OF A SELECT GROUP OF FEDERALLY RECOGNIZED PEDIATRIC HEMOPHILIA TREATMENT CENTERS AND PROVIDES STATE-OF-THE-ART COMPREHENSIVE CARE TO APPROXIMATELY 300 CHILDREN WITH BLEEDING AND THROMBOSIS DISORDERS.IN ADDITION TO PROVIDING AND CONTINUOUSLY IMPROVING STANDARDIZED CARE TO THESE PATIENT POPULATIONS, ST. JUDE HEMATOLOGY DEDICATES A SIGNIFICANT AMOUNT OF RESOURCES TO CLINICAL, TRANSLATIONAL, AND BASIC RESEARCH TO IMPROVE SURVIVAL AND DECREASE MORBIDITY OF CHILDREN WITH NON-MALIGNANT CHRONIC BLOOD DISEASES. MOST PATIENTS PARTICIPATE IN RESEARCH STUDIES, WHICH HAVE RESULTED IN MAJOR IMPROVEMENTS IN CLINICAL CARE. FOR EXAMPLE, RECENT RESULTS FROM THE BABY HUG TRIAL SHOWED THAT DAILY ORAL HYDROXYUREA IS SAFE AND EFFECTIVE FOR INFANTS AND YOUNG CHILDREN WITH SCD, WHICH LED TO THE RECOMMENDATION OF ITS GENERAL USE IN THIS SUBPOPULATION. ALSO, IN A FIRST-IN-MAN TRIAL, ST. JUDE HEMATOLOGY SHOWED THE SAFETY AND EFFICACY OF A NOVEL GENE TRANSFER AGENT CARRYING THE FACTOR IX GENE FOR TREATMENT OF HEMOPHILIA B; ALL TEN ADULT PARTICIPANTS WITH SEVERE HEMOPHILIA B HAD NO SERIOUS UNEXPECTED SIDE EFFECTS AND ALL PARTICIPANTS SHOWED AN INCREASE IN FACTOR IX LEVELS LEADING TO A SUBSTANTIAL REDUCTION IN THEIR BLEEDING TENDENCY. ADDITIONALLY, ST. JUDE HAS DEVELOPED A VECTOR FOR GENE TRANSFER TO TREAT CHILDREN WITH X LINKED SEVERE COMBINED IMMUNODEFICIENCY (X LINKED SCID) DISEASE WHICH HAS SHOWN PROMISE AS A CURE FOR THE DISEASE. FUTURE EFFORTS WILL CONTINUE TO FOCUS ON FINDING VIABLE CURES AND/OR TREATMENTS TO PREVENT COMPLICATIONS IN CHILDREN WITH SCD AND OTHER NON-MALIGNANT, CHRONIC HEMATOLOGIC DISEASES.HIVTHE CONNECT TO PROTECT (C2P) COMMUNITY COALITION LED BY MEMBERS OF THE HOSPITAL'S COMPREHENSIVE HIV PREVENTION AND TREATMENT PROGRAM FOR CHILDREN AND YOUTH, HAS SIGNIFICANTLY CONTRIBUTED TO THE STRONG COMMUNITY TIES THAT ST. JUDE HAS ESTABLISHED AND STRENGTHENED. LAUNCHED IN 2008, C2P IS MADE UP OF 25 PARTNER AGENCIES REPRESENTING A DIVERSE MIX OF STAKEHOLDERS FROM VARIOUS SECTORS IN MEMPHIS. THIS INCLUDES THE HEALTH DEPARTMENT, FAITH- AND COMMUNITY-BASED ORGANIZATIONS, SCHOOLS, BUSINESSES, YOUTH AND HEALTH CARE ORGANIZATIONS; ALL ALIGNED WITH THE COMMON GOAL OF OPTIMIZING HIV PREVENTION AND TREATMENT. THE STRENGTH OF THIS COALITION HAS BEEN TO PROVIDE A NON-THREATENING, COLLABORATIVE ENVIRONMENT WHERE INDIVIDUALS AND AGENCIES WITH DIFFERENT BACKGROUNDS AND PRIORITIES HAVE BEEN ABLE TO COLLABORATIVELY IMPLEMENT OVER 70 NEW POLICIES, PRACTICES AND PROGRAMS THAT IMPACT HIV PREVENTION AND TREATMENT IN YOUTH. IN THIS COALITION WE HAVE LEARNED AND SHARED BEST PRACTICES, AND TOGETHER, IDENTIFIED AND DEVELOPED NEW STRUCTURAL CHANGE OBJECTIVES TO ADDRESS IMPEDIMENTS THAT PREVENT YOUTH FROM MOVING ALONG THE HIV PREVENTION AND TREATMENT CARE CONTINUUM.HAVING ACCESS TO, AND COMMITMENT FROM, SUCH A DIVERSE GROUP OF PEOPLE AND ORGANIZATIONS HAS ALLOWED FOR SHARED RESPONSIBILITY IN TRANSFORMING THE HEALTH TRAJECTORY OF THE CITY. THE COALITION DESIGNED A STRATEGIC PLAN THAT SPECIFICALLY ADDRESSES YOUTH BARRIERS TO TESTING, TRANSITIONING TO ADULT CARE, PRE-EXPOSURE PROPHYLAXIS AND LINKAGE OF NEWLY DIAGNOSED HIV+ YOUTH TO MEDICAL CARE. AS BARRIERS ARE IDENTIFIED, MEMBERS ENGAGE IN DIALOGUE AND DISCUSSIONS WITH KEY STAKEHOLDERS, AND STRATEGIZE FOR POLICY AND PRACTICE CHANGES RELATED TO COMMONLY IDENTIFIED OBSTACLES SUCH AS DISCLOSURE, TIMELINES OF CONFIRMATORY TEST, MEDICATION/APPOINTMENT, SOCIAL DETERMINANTS AND ADHERENCE. SINCE IMPLEMENTING THE STRATEGIC MULTISITE INITIATIVE FOR LINKAGE AND ENGAGEMENT (SMILE) LINKAGE TO CARE PROGRAM IN 2010, WE HAVE BEEN ABLE TO ASSIST APPROXIMATELY 800 YOUTH AND YOUNG ADULTS WITH GETTING INTO MEDICAL CARE. THIS SUCCESS HAS GARNERED NATIONAL ATTENTION AND HAS BEEN RECOGNIZED BY THE CENTERS FOR DISEASE CONTROL AS A BEST PRACTICE MODEL. AS A RESULT, WE HAVE BEEN WORKING COLLABORATIVELY WITH THE SHELBY COUNTY HEALTH DEPARTMENT AND OTHER ADULT SPECIALTY CARE CLINICS, ON WAYS TO REPLICATE AND EXPAND OUR MODEL OF LINKAGE TO CARE AND TREATMENT THAT WE HAVE BUILT FOR YOUTH. THE GOAL IS THAT ALL NEWLY DIAGNOSED ADULTS CAN RECEIVE THE SAME TYPE OF SERVICE AND SUPPORT THAT WILL ENABLE THEM TO SUCCESSFULLY MOVE ALONG THE HIV CARE CONTINUUM. IN AN EFFORT TO FURTHER SUPPORT THOSE PATIENTS THAT MATRICULATE ALONG THE HIV CARE CONTINUUM, WE INSTITUTED A RETENTION IN CARE (RIC) PROGRAM THAT PROVIDES SUPPORT TO YOUTH AND YOUNG ADULT PATIENTS WHO FIND MAINTAINING CONSISTENT MEDICAL TREATMENT AND CARE A CHALLENGE. SINCE 2016, THE RIC COORDINATOR HAS CAREFULLY AND TACTFULLY WORKED TO ASSURE THAT APPROXIMATELY 20 PATIENTS ARE AS SUCCESSFUL AS POSSIBLE WITH TRANSITIONING TO ADULT MEDICAL CARE WITHOUT ANY GAPS OR DELAYS.OUR ABILITY TO FORGE STRONG PARTNERSHIPS AND INROADS IN THE PUBLIC AND PRIVATE SECTORS HAS ALSO ASSISTED US WITH OUR NEWEST RESEARCH INITIATIVE, INJECTABLE PREP (PRE-EXPOSURE PROPHYLAXIS) OR HPTN (HIV PREVENTION TRIALS NETWORK) 083. SINCE 2017, WE HAVE BEEN ABLE TO RECRUIT 93 UNINFECTED HIGH-RISK YOUNG ADULT VOLUNTEERS TO DETERMINE THE EFFICACY OF USING BIOMEDICAL PREVENTION IN OUR COMMUNITY AND MET OUR TWO YEAR RECRUITMENT GOAL (64) IN THE FIRST YEAR.FOR OVER A YEAR, C2P MEMBERS ALONGSIDE ST. JUDE COORDINATING CENTER STAFF, HAS BEEN SYSTEMATICALLY WORKING ON AN ENDING THE HIV EPIDEMIC IN MEMPHIS IMPLEMENTATION PLAN. RECOGNIZING THE STRENGTH AND VALUE OF THE INFRASTRUCTURE, MEMBERS COMMITTED TO CONTINUE CROSS-AGENCY COLLABORATION TO BUILD OUT A COMMUNITY DRIVEN PLAN THAT WOULD SUFFICIENTLY ADDRESS COMMUNITY NEEDS. LASTLY, MEMBERS FROM THE COALITION HAVE CO-FACILITATED AND/OR PARTICIPATED IN APPROXIMATELY 30 COMMUNITY BASED EDUCATIONAL AND TESTING EVENTS, AND RADIO/TELEVISION INTERVIEWS THAT HAVE IMPACTED WELL OVER 5,000 INDIVIDUALS IN MEMPHIS AND SURROUNDING AREAS. OUR HIV PREVENTION AND TREATMENT PROGRAM HAS REALLY VALUED THE STRONG AND BI-DIRECTIONAL COLLABORATION WITH COLLEAGUES IN THE COMMUNITY. WITH A SHARED FOCUS, WHAT WE HAVE BEEN ABLE TO ACHIEVE WITH OUR LINKAGE TO CARE, RETENTION IN CARE AND PREP EFFORTS, WOULD NOT HAVE BEEN FEASIBLE WITHOUT THIS TYPE OF COMMUNITY AGENCY BUY-IN AND SUPPORT.1. AMERICAN CANCER SOCIETY. CANCER FACTS & FIGURES 2019. ATLANTA: AMERICAN CANCER SOCIETY; 2019. 2. LIU ET AL. J CLIN ONCOL 34(14):1634-43, 2016.3. BHATIA ET AL. CANCER 122(15):2426-2439, 2016.4. HOW MANY CANCERS ARE LINKED WITH HPV EACH YEAR? CENTERS FOR DISEASE CONTROL AND PREVENTION.[ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/CASES.HTM.5. TEENVAXVIEW: 2017 ADOLESCENT HUMAN PAPILLOMAVIRUS (HPV) VACCINATION COVERAGE REPORT. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/VACCINES/IMZ- MANAGERS/COVERAGE/TEENVAXVIEW/DATA-REPORTS/HPV/DASHBOARD/2017.HTML.6. HPV-ASSOCIATED CANCER RATES BY STATE. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/STATE/INDEX.HTM. 0 UNIVERSITY OF TENNESSEE 50 NORTH DUNLAP MEMPHIS TN 38105 626001636 GOVERNMENT ENTITY 787209 COLLABORATION AND SUPPORT AGREEMENT SAINT FRANCIS MEDICAL CENTER 530 NE GLEN OAK AVE PEORIA IL 61637 370662569 501(C)(3) 490909 OPERATION OF ST. JUDE CLINIC CHURCH HEALTH CENTER OF MEMPHIS 1350 CONCOURSE AVE SUITE 142 MEMPHIS TN 38104 581716113 501(C)(3) 200000 FINANCIAL SUPPORT FASEB SCIENCE RESEARCH 9650 ROCKVILLE PIKE BETHESDA MD 20814 520700497 501(C)(3) 15000 SUPPORT HEMATOLOGIC MALIGNANCIES CONFERENCE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 600 13TH STREET NW SUITE 500 WASHINGTON DC 20005 582176067 501(C)(6) 13900 CONTRIBUTION REGIONAL ONE HEALTHCARE FOUNDATION 877 JEFFERSON AVENUE MEMPHIS TN 38103 581737037 501(C)(3) 6500 SPONSORSHIP 5 1 PART I, LINE 2: ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS ACTIVELY INVOLVED WITH THE DONEE. THROUGH THIS ACTIVE INVOLVEMENT, THE ORGANIZATIONS ARE MONITORED TO ENSURE THE SUPPORT IS USED APPROPRIATELY. X X X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 RICHARD C SHADYAC JR EX-OFFICIO DIRECTOR 0 790449 0 0 0 49746 0 99580 0 19111 0 958886 0 46182 JAMES R DOWNING PRESIDENT/CEO 1054860 0 150 0 79487 0 120250 0 23803 0 1278550 0 0 0 PATRICIA A KEEL SVP/CFO 586894 0 150 0 8204 0 59327 0 26304 0 680879 0 0 0 JAMES I MORGAN EVP/SCIENTIFIC DIRECTOR 558621 0 150150 0 9015 0 30250 0 26304 0 774340 0 0 0 ELLIS NEUFELD EVP/CLINICAL DIRECTOR 736703 0 150 0 5030 0 141650 0 22110 0 905643 0 0 0 MARY ANNA QUINN EVP/CHIEF ADMIN. OFFICER 461803 0 150 0 9015 0 30250 0 23744 0 524962 0 0 0 CHARLES M ROBERTS EVP/DIRECTOR CANCER CENTER 773267 0 150 0 1491 0 143106 0 12492 0 930506 0 0 0 CARLOS RODRIGUEZ-GALINDO EVP/CHAIR 624364 0 150 0 78673 0 60250 0 11075 0 774512 0 0 0 ANDREW DAVIDOFF CHAIR 745756 0 18250 0 69927 0 30250 0 30517 0 894700 0 0 0 DAVID ELLISON CHAIR 712822 0 17850 0 5074 0 93501 0 16216 0 845463 0 0 0 AMAR J GAJJAR CHAIR 620681 0 28250 0 58531 0 30250 0 18136 0 755848 0 0 0 THOMAS E MERCHANT CHAIR 772181 0 18050 0 98992 0 30250 0 34077 0 953550 0 0 0 CHING-HON PUI CHAIR 703277 0 28050 0 8790 0 30250 0 7295 0 777662 0 0 0 WILLIAM E EVANS FACULTY/FORMER PRESIDENT/CEO 654652 0 17850 0 8790 0 30250 0 11075 0 722617 0 0 0 PART I, LINE 1A FIRST-CLASS TRAVEL: ONE FORMER OFFICER PURCHASED TWO FIRST CLASS TICKETS, TWO OFFICERS EACH PURCHASED ONE FIRST CLASS TICKET. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND ARE NOT RECORDED AS COMPENSATION. TRAVEL FOR COMPANIONS: FAMILY MEMBER OF ONE FORMER OFFICER, TRAVELS ON HOSPITAL BUSINESS AS REQUIRED BY THE POSITION. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND ARE NOT RECORDED AS COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: A PAYMENT WAS ISSUED FOR RELOCATION FOR ONE OFFICER. THE APPLICABLE EXPENSE WAS GROSSED-UP AND INCLUDED IN THE EMPLOYEE'S W-2 AS ADDITIONAL TAXABLE COMPENSATION. PART I, LINE 4B THE ORGANIZATION ESTABLISHED A NON-QUALIFIED DEFERRED COMPENSATION PLAN PURSUANT TO CODE SECTION 457(F) OF THE INTERNAL REVENUE CODE. THE PLAN AMOUNTS ARE SUBJECT TO SUBSTANTIAL FUTURE SERVICE REQUIREMENTS TO THE ORGANIZATION AND ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. NO NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. SCHEDULE J, PART II RICHARD C. SHADYAC, JR. SERVES AS AN EX-OFFICIO VOTING DIRECTOR OF THE BOARD OF ST. JUDE. MR. SHADYAC IS EMPLOYED AS AN OFFICER OF ALSAC, A RELATED ORGANIZATION TO ST. JUDE. THE COMPENSATION SHOWN IN COLUMNS (B), (C), (D) AND (E) WAS PAID TO MR. SHADYAC BY ALSAC FOR HIS DUTIES AS CEO OF ALSAC. MARY RELLING SEE PART V 529674 EMPLOYMENT 0 SUSANNA DOWNING SEE PART V 71398 EMPLOYMENT 0 DIANE ROBERTS SEE PART V 221400 EMPLOYMENT 0 JEREMY QUINN SEE PART V 87543 EMPLOYMENT 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: MARY RELLING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF FORMER OFFICER (PRESIDENT AND CEO), WILLIAM E. EVANS.(C) AMOUNT OF TRANSACTION: $529,674(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: SUSANNA DOWNING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF PRESIDENT AND CEO, JAMES R. DOWNING.(C) AMOUNT OF TRANSACTION: $71,398(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: DIANE ROBERTS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, CHARLES M. ROBERTS.(C) AMOUNT OF TRANSACTION: $221,400(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: JEREMY QUINN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, MARY ANNA QUINN.(C) AMOUNT OF TRANSACTION: $87,543(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO FORM 990, PART VI, SECTION A, LINE 2 FAMILY RELATIONSHIP AMONG DIRECTORS: JOSEPH S. AYOUB, JR., ESQ. AND PAUL J. AYOUB, ESQ.; GEORGE A. SIMON, II AND PAUL J. SIMON; ROBERT A. BREIT, MD AND JOSEPH G. SHAKER; JOSEPH C. SHAKER AND JOSEPH G. SHAKER; PAUL J. SIMON AND MICHAEL SIMON. FORM 990, PART VI, SECTION A, LINE 4 ON SEPTEMBER 14, 2018, ST. JUDE CHILDREN'S RESEARCH HOSPITAL MADE THE FOLLOWING AMENDMENTS TO ITS BYLAWS: ARTICLE IV, SECTION 3 OF THE ST. JUDE BYLAWS WAS AMENDED TO REQUIRE THAT A MINIMUM OF 70% OF THE INDIVIDUALS ELECTED BOARD MEMBERS BE INDEPENDENT AND REPRESENT THE COMMUNITY IN ACCORDANCE WITH APPLICABLE LAW AND GOVERNANCE POLICIES ADOPTED BY THE INDEPENDENT MEMBERS OF THE BOARD. IN RELATED AMENDMENTS TO ITS COI POLICY, THE BOARD STATED A BOARD MEMBER IS "INDEPENDENT" IF HE/SHE WOULD BE CONSIDERED INDEPENDENT UNDER THE IRS' SECTION 501(C)(3) COMMUNITY BENEFIT STANDARD, AND PROVIDED GUIDANCE FOR THAT CONSIDERATION. ARTICLE VI, SECTION 1 OF THE ST. JUDE BYLAWS WAS AMENDED TO REQUIRE THAT ALL MEMBERS OF THE AUDIT, COMPENSATION, AND CONFLICT OF INTEREST COMMITTEES, AND 70% OF ALL OTHER COMMITTEES, BE INDEPENDENT AS DETERMINED IN ACCORDANCE WITH APPLICABLE LAW AND GOVERNANCE POLICIES ADOPTED BY THE INDEPENDENT MEMBERS OF THE BOARD. ARTICLE XVI, SECTION 1 OF THE ST. JUDE BYLAWS WAS AMENDED TO REQUIRE THAT NO MORE THAN TWO FAMILY MEMBERS AS DEFINED IN THE BYLAWS SHALL SERVE AS VOTING MEMBERS OF ANY BOARD COMMITTEE AT THE SAME TIME; AND TO UPDATE THE BOARD'S DEFINITION OF FAMILY MEMBER. ON JUNE 21, 2019, ST. JUDE CHILDREN'S RESEARCH HOSPITAL MADE THE FOLLOWING AMENDMENTS TO ITS BYLAWS: ARTICLE VI, SECTION 1, PARAGRAPH 3 OF THE ST. JUDE BYLAWS WAS AMENDED TO REDEFINE NOMINATING COMMITTEE MEMBERSHIP TO INCLUDE THE FOUR (4) MOST RECENT ACTIVE AND ELIGIBLE FORMER CHAIRS OF THE ALSAC AND HOSPITAL BOARDS AND THREE (3) OTHER VOTING MEMBERS WHO ARE NOT FORMER BOARD CHAIRS, EACH OF WHOM SHALL HAVE BEEN A VOTING MEMBER IN GOOD STANDING FOR A MINIMUM OF FIVE (5) CONSECUTIVE YEARS. IF A VOTING MEMBER HAS SERVED AS CHAIR OF BOTH THE ALSAC AND HOSPITAL BOARDS, ONLY HIS OR HER MOST RECENT TERM SHALL BE CONSIDERED FOR NOMINATING COMMITTEE MEMBERSHIP. A FORMER CHAIR OF THE ALSAC OR HOSPITAL BOARDS SHALL BE DEEMED TO BE ACTIVE AND ELIGIBLE FOR NOMINATING COMMITTEE MEMBERSHIP IF THEY ARE A VOTING MEMBER OF THE BOARD DURING THE PRIOR FISCAL YEAR. THE CEOS AND THE CURRENT CHAIRS AND VICE CHAIRS OF THE ALSAC AND HOSPITAL BOARDS ARE NOT ELIGIBLE TO SERVE AS MEMBERS OF THE NOMINATING COMMITTEE. ARTICLE VII OF THE ST. JUDE BYLAWS WAS AMENDED TO CREATE ACTIVE AND INACTIVE EMERITUS STATUS. ARTICLE VI, SECTION 1 OF THE ST. JUDE BYLAWS WAS AMENDED TO MERGE THE AUDIT AND LEGAL & COMPLIANCE COMMITTEES INTO AN AUDIT & COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B IN FEBRUARY OF EACH YEAR, THE AUDIT COMMITTEE AND OFFICERS OF THE BOARD ARE PROVIDED WITH A DRAFT COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES. THE AUDIT COMMITTEE MEETS WITH ITS TAX PREPARER TO REVIEW THE DRAFT FORM 990 BEFORE IT IS FILED WITH THE IRS. ADDITIONALLY THE COMPENSATION COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE COMPENSATION SECTIONS OF THE FORM 990, AND THE CONFLICT OF INTEREST COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE CONFLICT-OF-INTEREST SECTIONS OF THE FORM 990 FOR REVIEW BEFORE THE FINALIZED DOCUMENT IS FILED WITH THE IRS. EACH VOTING MEMBER OF THE BOARD IS PROVIDED WITH A FINAL COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C NEW BOARD MEMBERS ARE GIVEN A COPY OF THE BOARD OF GOVERNOR'S CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. THERE IS A CONFLICT OF INTEREST COMMITTEE OF THE BOARD THAT REVIEWS THE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT ARE COMPLETED BY EACH BOARD MEMBER AND DISCUSSES AND RESOLVES CONFLICTS OF INTEREST, WITH OPPORTUNITY FOR APPEAL TO THE FULL BOARD. IN ADDITION, THE ORGANIZATION HAS A CHIEF COMPLIANCE OFFICER AND COMPLIANCE DEPARTMENT, WHICH ADMINISTER THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR ALL EMPLOYEES IN CLINICAL, RESEARCH, AND SELECT ADMINISTRATIVE DEPARTMENTS, AS WELL AS EMPLOYEES IDENTIFIED AS SUPERVISORS OR WHO HAVE PURCHASING AUTHORITY. ALL SUCH EMPLOYEES COMPLETE CONFLICT OF INTEREST TRAINING AND A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE COMPLIANCE OFFICER ENSURES EMPLOYEES MEET THESE REQUIREMENTS AND REVIEWS SUBMITTED DISCLOSURES. DISCLOSURES IDENTIFIED AS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARE ADDRESSED BY THE COMPLIANCE OFFICE WITH INVOLVEMENT OF THE INSTITUTIONAL CONFLICT OF INTEREST COMMITTEE AS APPROPRIATE. DEPENDING ON THE FACTS AND CIRCUMSTANCES, THE ACTIVITY MAY BE MANAGED PURSUANT TO A MANAGEMENT PLAN, OR PROHIBITED. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S COMPENSATION COMMITTEE COMMISSIONS ANNUAL THIRD PARTY SALARY SURVEYS TO DETERMINE COMPENSATION FOR THE FOLLOWING OFFICERS: CHIEF EXECUTIVE OFFICER, SCIENTIFIC DIRECTOR, CANCER CENTER DIRECTOR, CHIEF ADMINISTRATIVE OFFICER, CHIEF FINANCIAL OFFICER, CLINICAL DIRECTOR, CHIEF GOVERNANCE OFFICER/CORPORATE SECRETARY, CHIEF LEGAL OFFICER, AND CHAIR, DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE. IN ADDITION, FIVE EMPLOYEES ARE CONSIDERED "DISQUALIFIED" BECAUSE THEY ARE FORMER EXECUTIVES OR RELATIVES OF CURRENT OR FORMER EXECUTIVES, AND THEIR COMPENSATION THEREFORE FALLS WITHIN THE COMPENSATION COMMITTEE'S PURVIEW. ALL CHANGES TO OFFICERS' SALARIES ARE APPROVED BY THE COMPENSATION COMMITTEE AND REPORTED TO THE BOARD. THE LAST REVIEW WAS COMPLETED IN DECEMBER 2019. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE ONLY AS REQUIRED BY APPLICABLE STATE LAW. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF ALSAC WITHOUT DONOR RESTRICTIONS 580,106,392. CHANGE IN INTEREST IN NET ASSETS OF ALSAC WITH DONOR RESTRICTIONS 90,106,130. ADDITIONAL HEALTH NEEDS IDENTIFIED IN ADDITION TO THE ACTIONS OUTLINED WITH THE PREVIOUSLY CONDUCTED 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, ST. JUDE HAS ALSO CHOSEN TO ADDRESS THE FOLLOWING HEALTH NEEDS: PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #1 OF THE CHNA): TRANSITION ONCOLOGY PROGRAM HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ACT CLINIC, TRANSITION ONCOLOGY PROGRAM (TOP) ANTICIPATED OUTCOME: PROVIDE PROSPECTIVE, SYSTEMATIC, TRANSITION-RELATED SERVICES FOR ONCOLOGY PATIENTS ACROSS THE CONTINUUM OF CARE THAT WILL SUPPORT TRANSITIONS FROM ACTIVE THERAPY TO TREATMENT AND FROM TREATMENT COMPLETION TO ACT. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. IDENTIFY AND IMPLEMENT APPROPRIATE MANAGEMENT AND OPERATIONS STRUCTURE, AND BEGIN STAFFING THE PROGRAM. 2. CLOSELY MONITOR RESOURCES TO STAFF THE CLINIC TO ITS FULLEST FORM, AND COMPLETE AN ASSESSMENT AFTER THE FIRST 18 MONTHS OF OPERATION TO ENSURE THAT THE PROGRAM IS MEETING ITS PURPOSE. 3. EVALUATE IMPACT ON INTERPRETER SERVICES, CLINICAL INFORMATICS, REHABILITATION SERVICES, CLINIC SPACE, HOUSING, AND TRAVEL COSTS. 4. EVALUATE RESOURCES IN ACT IN ANTICIPATION OF AN INCREASE IN ACT PATIENT VOLUMES. SELECTED ACCOMPLISHMENTS: - PROGRAM IS FULLY OPERATIONAL (AS OF DECEMBER 1, 2018). IN THE FIRST 6 MONTHS, WE WORKED WITH 185 PATIENTS. - WE ARE NEARLY FULLY-STAFFED WITH THREE NURSE PRACTITIONERS, THREE SCHOOL LIAISONS, TWO SOCIAL WORKERS, AND A REHAB SERVICES COORDINATOR. OUR PSYCHOLOGIST WILL START SEPTEMBER 2019. - PRIOR TO THE END OF THERAPY, PATIENTS MEET THE NURSE PRACTITIONER NAVIGATOR FOR AN INTRODUCTION TO THE PROGRAM, HAVE INITIAL VISITS WITH PSYCHOLOGY, SCHOOL LIAISON (IF SCHOOL-AGE), REHAB COORDINATOR (IF APPLICABLE), AND NP NAVIGATOR. AT THE END OF THERAPY, PATIENTS MEET WITH SOCIAL WORKER AND NP NAVIGATOR. NP NAVIGATOR MAKES PHONE CONTACT WITH FAMILY TO PROSPECTIVELY ASSESS FOR CONCERNS BETWEEN APPOINTMENTS. SUBSEQUENT APPOINTMENTS WITH TOP TEAM MEMBERS ARE SCHEDULED AS NEEDED. PATIENTS WHO DO NOT RECEIVE PSYCHOLOGICAL TESTING AS PART OF THEIR TREATMENT PROGRAM ARE ELIGIBLE FOR ABBREVIATED TESTING TO SCREEN FOR COGNITIVE CONCERNS. - 18-MONTH ASSESSMENT PLANNED FOR JUNE 2020. - OUTCOMES AND MEASUREMENT STRATEGIES ARE STILL BEING DEFINED. PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #3 OF THE CHNA): PREVENTING VIRUS-ASSOCIATED CANCERS THROUGH INCREASED HPV VACCINATION (HEALTH STATUS OF THE MEMPHIS COMMUNITY) HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL ANTICIPATED OUTCOME: INCREASE THE VACCINATION RATES FOR HPV. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. IMPLEMENT GOALS, STRATEGIES, AND ACTIONS FOR AN HPV INITIATIVE. SELECTED ACCOMPLISHMENTS: THE ST. JUDE TEAM LOOKED FOR OPPORTUNITIES TO NETWORK WITH EXPERTS IN THE FIELD INCLUDING ATTENDING EUROGIN 2018 INTERNATIONAL MULTIDISCIPLINARY HPV CONGRESS IN DECEMBER 2018 AND BECAME INVOLVED IN THE HPV NATIONAL ROUNDTABLE AND TWO OF ITS SUBCOMMITTEES, STATE COALITIONS AND INTEGRATED DELIVERY SYSTEMS (IDS): - ST. JUDE SERVED AS THE HOST SITE FOR THE INAUGURAL MEETING OF THE INTEGRATED DELIVERY SYSTEMS (IDS) TASK GROUP FROM THE NATIONAL HPV ROUNDTABLE ON JANUARY 24, 2019. REPRESENTATIVES FROM THE CENTERS FOR DISEASE CONTROL, HEALTH AND HUMAN SERVICES, AMERICAN CANCER SOCIETY (ACS) AND HEALTH SYSTEMS ACROSS THE COUNTRY GATHERED AT ST. JUDE FOR A WORKING MEETING TO STRATEGIZE ON ENGAGEMENT OF IDSS TO INCREASE HPV VACCINE UPTAKE. - WE WERE ALSO INVITED TO PARTICIPATE IN THE HPV STATE COALITION LEADERS MEETING AT UNIVERSITY OF ALABAMA, BIRMINGHAM (UAB) ON MARCH 4-5, 2019. - VOLUNTEERED TO AUTHOR A JOINT HPV VACCINE SUPPORT STATEMENT TO BE USED AS AN EDUCATION AND PARTNERSHIP BUILDING TOOL WITH LAWMAKERS/POLICY MAKERS IN TENNESSEE ON BEHALF OF OUR STATE COALITION MEMBERS. THE DRAFT FOR THIS JOINT STATEMENT IS CURRENTLY WITH VANDERBILT INGRAM CANCER CENTER FOR REVIEW. - ST. JUDE WAS INVITED TO PARTICIPATE AS A PARTNER AT A CONGRESSIONAL BRIEFING TITLED "LET'S END HPV-RELATED CANCERS" IN WASHINGTON D.C. TO BE HELD ON JUNE 27TH. SPONSORS INCLUDE AACR, MOFFITT CANCER CENTER AND THE BIDEN CANCER INITIATIVE. THIS BRIEFING WILL BE FOLLOWED BY A TWO-HOUR STRATEGY SESSION HOSTED BY THE BIDEN CANCER INITIATIVE WHERE ST. JUDE WILL HAVE A SEAT AT THE TABLE. STRATEGY SUMMIT: THE ALL-DAY INTERACTIVE MEETING WAS HELD ON MAY 6TH AT ST. JUDE TO GUIDE STRATEGY AND IMPLEMENTATION OF THE HPV BLUE SKY INITIATIVE. A TOTAL OF MORE THAN 60 INDIVIDUALS, INCLUDING INTERNAL LEADERSHIP, EXTERNAL EXPERTS AND LOCAL STAKEHOLDERS, PARTICIPATED IN THE WORKSHOP. THE DAY FEATURED TALKS FROM INTERNATIONALLY RECOGNIZED EXPERTS IN HPV AS WELL AS IN-DEPTH FACILITATED SMALL GROUP DISCUSSIONS AMONG EXTERNAL, LOCAL AND INTERNAL STAKEHOLDERS. DR. MELISSA HUDSON WAS COMMISSIONED TO LEAD THE SEARCH COMMITTEE FOR THE FACULTY DIRECTOR OF THE INITIATIVE. THE SEARCH COMMITTEE WILL MEET IN EARLY JULY TO BEGIN SCHEDULING ONSITE INTERVIEWS. CHILDREN'S GMP LLC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 474475625 VACCINE MANUFACTURER TN 1446385 3090916 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC THANKS & GIVING LLC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 201310435 ROYALTY INCOME FROM RECORD SALES TN 0 10632 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC THE RIGHT WORDS LLC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 954878579 ROYALTY INCOME FROM BOOK SALES NY 0 0 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC ST JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 813240987 HIGHER EDUCATION TN 1534 731953 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES INC 501 ST JUDE PLACE MEMPHIS TN 381053678 351044585 SOLICIT SUPPORT FOR OPERATION OF ST. JUDE IL 501(C)(3) 7 N/A 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0