2020-08-14T13:30:54-05:00 2019-09-30 350921680 CROWE LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2018-10-01 741100555 TEXAS CHILDREN'S HOSPITAL TEXA 8328242982 6621 FANNIN ST HOUSTON TX 77030 WELDON GAGE Executive VP / CFO 2020-08-14 false Rachel Spurlock P00520729 2147775200 2018 2020-09-23 17:36:50Z WELDON GAGE 6621 FANNIN ST HOUSTON TX 77030 2610550389 false X WWW.TEXASCHILDRENS.ORG X 1950 TX TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH. 13 1 12738 1768 333333 23515 131328683 72219363 2263329456 2494889730 15831813 15037016 16601350 19253563 2427091302 2601399672 8548133 9310916 0 1040582971 1127345855 675626 481822 11038955 1172900708 1282454583 2222707438 2419593176 204383864 181806496 5395940841 5647281033 1252437049 1375024631 4143503792 4272256402 TEXAS CHILDREN'S HOSPITAL, LOCATED IN HOUSTON, TEXAS, IS A NOT-FOR-PROFIT ORGANIZATION WHOSE MISSION IS TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH. WE ARE PROUD TO BE CONSISTENTLY RANKED AMONG THE TOP CHILDREN'S HOSPITALS IN THE NATION. WE ARE PROUD TO BE CONSISTENTLY RANKED AMONG THE TOP CHILDREN'S HOSPITALS IN THE NATION. false false 2116413736 8664149 2457847852 PATIENT CARE: TEXAS CHILDREN'S HOSPITAL IS AN INTERNATIONALLY RECOGNIZED FULL-CARE PEDIATRIC HOSPITAL OPERATING TWO CAMPUSES IN THE HOUSTON AREA, THE LARGEST OF WHICH IS LOCATED IN THE TEXAS MEDICAL CENTER. ONE OF THE LARGEST PEDIATRIC HOSPITALS IN THE UNITED STATES, THE HOSPITAL IS CONSISTENTLY RANKED AS THE BEST CHILDREN'S HOSPITAL IN TEXAS, AND AMONG THE TOP IN THE NATION. TEXAS CHILDREN'S HAS GARNERED WIDESPREAD RECOGNITION FOR ITS EXPERTISE AND BREAKTHROUGHS IN PEDIATRIC AND WOMEN'S HEALTH. THE HOSPITAL INCLUDES TEXAS CHILDREN'S HOSPITAL; THE JAN AND DAN DUNCAN NEUROLOGICAL RESEARCH INSTITUTE; THE FEIGIN CENTER FOR PEDIATRIC RESEARCH; TEXAS CHILDREN'S PAVILION FOR WOMEN, A COMPREHENSIVE OBSTETRICS/GYNECOLOGY HOSPITAL FOCUSING ON HIGH-RISK BIRTHS; TEXAS CHILDREN'S HOSPITAL WEST CAMPUS, A COMMUNITY HOSPITAL IN SUBURBAN WEST HOUSTON; TEXAS CHILDREN'S HOSPITAL THE WOODLANDS, THE FIRST HOSPITAL DEVOTED TO CHILDREN'S CARE FOR COMMUNITIES NORTH OF HOUSTON, a second community hospital that opened April 2017. THE ORGANIZATION ALSO CREATED TEXAS CHILDREN'S HEALTH PLAN, THE NATIONS' FIRST HMO FOR CHILDREN; TEXAS CHILDREN'S PEDIATRICS, THE LARGEST PEDIATRIC PRIMARY CARE NETWORK IN THE COUNTRY; TEXAS CHILDREN'S URGENT CARE CLINICS THAT SPECIALIZE IN AFTER-HOURS CARE TAILORED SPECIFICALLY FOR CHILDREN; AND A GLOBAL HEALTH PROGRAM THAT'S CHANNELING CARE TO CHILDREN AND WOMEN ALL OVER THE WORLD. TEXAS CHILDREN'S HOSPITAL IS AFFILIATED WITH BAYLOR COLLEGE OF MEDICINE. TEXAS CHILDREN'S PAVILION FOR WOMEN OFFERS A FULL SPECTRUM GYNECOLOGICAL AND MATERNAL AND FETAL MEDICINE SERVICES, INCLUDING AN ARRAY OF FETAL DIAGNOSTIC PROCEDURES AND HIGHLY SPECIALIZED FETAL SURGERIES, THREE PRIVATE OB/GYN PRACTICES, THE FAMILY FERTILITY CENTER, THE MENOPAUSE CENTER AND THE WOMEN'S PLACE - CENTER FOR REPRODUCTIVE PSYCHIATRY. DURING THE YEAR THE HOSPITAL OVERALL OPERATED 795 INPATIENT BEDS AND MORE THAN 125 AMBULATORY SPECIALTY CLINICS, SUPPORTED BY AN AWARD-WINNING MEDICAL STAFF CONSISTING OF MORE THAN 1,797 BOARD-CERTIFIED PEDIATRIC SUBSPECIALISTS, OBSTETRICIANS AND GYNECOLOGISTS, ADULT SUBSPECIALISTS AND DENTISTS AND A DEDICATED AND HIGHLY SKILLED NURSING AND SUPPORT STAFF OF MORE THAN 10,181. IN 2019, THE PAVILION PERFORMED APPROXIMATELY 6,205 DELIVERIES AND THE HOSPITAL SYSTEM EXCEEDED 199,080 OUTPATIENT CLINIC VISITS. 107289887 439222 25333625 RESEARCH: TEXAS CHILDREN'S/BAYLOR RESEARCHERS AT THE FEIGIN CENTER, THE JAN AND DAN DUNCAN NEUROLOGICAL RESEARCH INSTITUTE AND THE CHILDREN'S NUTRITION RESEARCH CENTER ARE CONDUCTING SOME OF THE MOST INNOVATIVE ONGOING RESEARCH IN A VARIETY OF AREAS FROM PEDIATRIC CARDIOLOGY TO INFECTIOUS DISEASES, NUTRITION, VACCINES AND PEDIATRIC NEUROLOGY AND NEUROGENETICS. DURING 2019, TEXAS CHILDREN'S INVESTED IN MORE THAN $109 MILLION IN OVER 2,132 CLINICAL, BASIC AND TRANSLATIONAL RESEARCH PROJECTS, EXPLORING A WIDE RANGE OF CHILDREN'S AND WOMEN'S HEALTH ISSUES. IN ADDITION, THE HOSPITAL CONTINUED ITS STRATEGIC FOCUS ON THE GROWTH AND SUCCESS OF ALL TEXAS CHILDREN'S RESEARCH ENDEAVORS THROUGH ENHANCED INFRASTRUCTURE, SUCH AS THE EXPANSION OF THE JAN AND DAN DUNCAN NEUROLOGICAL RESEARCH INSTITUTE WHERE INVESTIGATORS CAN ACCESS CUTTING EDGE IMAGING MODALITIES, SUCH AS TWO-PHOTON MICROSCOPY, AND STATE-OF-THE-ART NEUROPHYSIOLOGY AND BEHAVIORAL SCIENCE CORE RESOURCES. 50697592 207545 11708253 EDUCATION: THE HOSPITAL SERVES AS THE PRIMARY PEDIATRIC TEACHING FACILITY FOR BAYLOR COLLEGE OF MEDICINE (THEIR LONG-TERM ACADEMIC PARTNER). IN ADDITION, THE TEXAS CHILDREN'S PAVILION FOR WOMEN IS ONE OF THE PREMIER PRIVATE TRAINING HOSPITALS FOR BAYLOR COLLEGE OF MEDICINE'S DEPARTMENT OF OBSTETRICS AND GYNECOLOGY. THE CLOSE AFFILIATION BETWEEN THE INSTITUTIONS EXTENDS THROUGHOUT TEXAS CHILDREN'S OPERATIONS, BAYLOR FACULTY INCLUDING SERVICE CHIEFS, MEDICAL DIRECTORS AND STAFF PHYSICIANS ACROSS THE HOSPITAL'S 65 SUB-SPECIALTY CARE OFFERINGS. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, THE HOSPITAL INVESTED MORE THAN $55 MILLION IN THE TRAINING OF OVER 1,229 TRAINEES IN 89 TRAINING PROGRAMS ROTATING AT TEXAS CHILDREN'S. BAYLOR AND TEXAS CHILDREN'S HAVE A PROVEN TRACK RECORD RECRUITING TRANSFORMATIVE PHYSICIAN-SCIENTISTS AND ONE OF THE STRONGEST PEDIATRIC RESIDENCY PROGRAMS IN THE COUNTRY. BAYLOR'S PEDIATRIC RESIDENCY PROGRAM IS THE LARGEST TRAINING GROUND FOR PEDIATRICS AND ONE OF THE MOST COMPETITIVE IN THE COUNTRY. MORE THAN 2,000 STUDENTS APPLY EACH YEAR FROM THE TOP MEDICAL SCHOOLS AROUND THE COUNTRY. 2274401215 true true false true false false false false true true false false true true true false true false false true false false true true false true true true true true true false false false false false false false false false false true false false false false true true true false false true 911 0 true 12738 true true true false false false false true true false false false false true false X 13 1 false false false false true true true true false false false true true true true true true true true false CO FL GA AL HI IL KS KY MD MA MN MS NJ NM NY NC ND OH OR SC TN UT WA WI X JENNIFER LITTLE 8328242972 1919 BRAESWOOD BLVD HOUSTON TX 77030 Dan DiPrisco SCHEDULE O 38.0 2.0 X X 1006907 0 124006 Weldon Gage SCHEDULE O 38.0 2.0 X X 1492417 0 187027 Mark Mullarkey SCHEDULE O 34.0 6.0 X X 1344041 0 162895 Michelle Riley-Brown SCHEDULE O 39.0 1.0 X X 1388536 0 189426 Mark A Wallace Schedule O 36.0 4.0 X X 6781279 0 657376 Mary Jo Andre Schedule O 20.0 20.0 X 1241079 0 125332 Dean B Andropoulos MD BOARD MEMBER 1.0 1.0 X 92800 0 0 Michael A Belfort MD PhD BOARD MEMBER 1.0 3.0 X 123600 0 0 Mark W Kline MD BOARD MEMBER 1.0 4.0 X 136600 0 0 James Versalovic MD PhD BOARD MEMBER 1.0 1.0 X 100000 0 0 Eric Williams MD BOARD MEMBER 37.0 3.0 X 0 0 0 Thierry Huisman MD BOARD MEMBER 1.0 39.0 X 0 323031 16636 Larry Hollier MD BOARD MEMBER 1.0 1.0 X 130600 0 0 Aisha Jamal Assistant Secretary 38.0 2.0 X 172898 0 27216 Tabitha Rice Senior Vice President 40.0 0.0 X 845957 0 115117 Ivett Shah VICE PRESIDENT 40.0 0 X 363592 0 64593 Matthew Girotto Senior Vice President 39.0 1.0 X 739201 0 106034 Linda Aldred Senior Vice President 40.0 0.0 X 1119190 0 151234 MYRA L DAVIS SENIOR VICE PRESIDENT 40.0 0 X 1192269 0 149765 Stanley Spinner MD Vice President 38.0 2.0 X 777336 0 62697 Kay Tittle Vice President 6.0 34.0 X 1706393 0 50533 Lance Lightfoot SENIOR VICE PRESIDENT 38.0 2.0 X 1205235 0 151265 Angelo P Giardino MD PHD FORMER BOARD MEMBER 0 X 388215 0 30619 Charles D Fraser Jr MD FORMER BOARD MEMBER 0 X 525000 0 0 Mallory Caldwell SENIOR VICE PRESIDENT 0 X 288782 0 97909 George Bisset III MD FORMER BOARD MEMBER 0 X 0 347808 15247 23161927 670839 2484927 2172 true true false BAYLOR COLLEGE OF MEDICINE 1 BAYLOR PLAZA HOUSTON TX 77030 PHYSCN & FACULTY SVC 87865481 ACCUDATA SYSTEMS INC 10713 W SAM HOUSTON PARKWAY N STE 600 HOUSTON TX 77064 NETWORK SERVICES 8829430 BRIGGS & CALDWELL LP 9801 WESTHEIMER ROAD STE 701 HOUSTON TX 77042 ADVERTISING 7698234 BAYLOR MIRACA GENETICS LABORATORIES LLC PO BOX 847228 DALLAS TX 752847228 LAB SERVICES 7364046 EPIC SYSTEMS CORPORATION 1979 Milky Way Verona WI 53593 IT SERVICES 6746776 278 X 2707760 13624561 55887042 2190687 72219363 NET PATIENT SERVICE REVENUE 622310 2140250018 2140250018 1115 WAIVER UNCOMPENSATED CARE POOL 622310 123557412 123557412 PHARMACY REVENUE 622310 107811575 107811575 MANAGEMENT SERVICES 541611 72338730 72005397 333333 RENTAL INCOME 900099 17452945 17452945 33479050 33479050 0 0 2494889730 14768642 14768642 393548 69637 323911 0 323911 323911 6176671 247937 6156234 20437 247937 268374 268374 490981 2707760 1147315 -656334 -656334 3183030 1777531 1405499 1405499 PARKING GARAGE REVENUE 812930 18180487 18180487 0 0 0 0 18180487 2601399672 2494556397 333333 34290579 X 8767916 8767916 543000 543000 16740571 583600 16156971 525000 525000 885875039 845639863 37126246 3108930 39294287 37263463 1862824 168000 118885121 108538006 9973999 373116 66025837 59651071 6160530 214236 5050567 5050567 177000 177000 522958 522958 481822 481822 447822963 427181954 19607885 1033124 15547971 7427644 4009302 4111025 59316642 55999590 3196058 120994 51694303 42955880 8686759 51664 63125794 59382507 3523347 219940 4877096 4628051 237909 11136 2699351 2480062 211609 7680 29117600 23386229 5596833 134538 184007524 175427707 7726209 853608 4645843 4219121 390410 36312 PHARMACEUTICAL SUPPLIES 176350551 176350551 MEDICAL/SURGICAL SUPPLIES 121202029 121202029 ENHANCED MISSION SUPPORT 44304529 44304529 LOCAL PROVIDER FUNDS TAX 8102275 8102275 63889587 59318209 4458548 112830 2419593176 2274401215 134153006 11038955 19051408 56008663 139544622 130994022 356709163 394408001 0 0 0 21493964 25426595 42847250 61834854 3757521757 1557367631 2254354106 2200154126 350305832 384523926 249851 36329 135268259 195426548 2076116386 2198467969 5395940841 5647281033 253114828 317728654 12808582 8763174 919924627 903910230 0 3866034 944062 62722978 143678511 1252437049 1375024631 X 3731684755 3876046184 226818324 210222355 185000713 185987863 4143503792 4272256402 5395940841 5647281033 X 181806496 1590685 4798707 -59443278 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false false false true 464177 false false true 139252 603429 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY TEXAS CHILDREN'S HOSPITAL (TCH) MAINTAINS A GOVERNMENT RELATIONS DEPARTMENT THAT ADVOCATES FOR PUBLIC POLICY AT THE LOCAL, STATE, AND FEDERAL LEVEL. TCH SUPPORTS POLICIES THAT PROMOTE THE HEALTH OF CHILDREN AND WOMEN, BUILD HIGH QUALITY PEDIATRIC AND WOMEN'S HEALTHCARE SYSTEMS, AND ADVOCATE FOR HEALTH COVERAGE FOR CHILDREN AND WOMEN. IN ADDITION TO ADVOCACY, THE GOVERNMENT RELATIONS DEPARTMENT PROVIDES EDUCATION ON THE UNIQUE NEEDS OF PEDIATRIC AND WOMEN'S HEALTHCARE PATIENTS AND FAMILIES. TEXAS CHILDREN'S HOSPITAL PAID DUES TO THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH) AND TEXAS HOSPITAL ASSOCIATION (THA), OF WHICH A PORTION WAS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 185000713 6077225 2446808 7536883 185987863 160839511 13640542 17439098 6918438 185000713 139937336 15943722 11439594 6481141 160839511 131831471 3651064 10445580 5990779 139937336 132134564 7810864 -2104397 6009560 131831471 0.07 0.93 0.0 false true true 129955335 129955335 1629904084 376676679 1253227405 47051852 32914602 14137250 1873008001 1061208391 811799610 77602485 86567959 -8965474 2200154126 INVESTMENT IN TEXAS CHILDREN'S HOSPITAL FOUNDATION 2019624558 TCH INSURANCE COMPANY REBATE RECEIVABLE 55203766 MISC RECEIVABLES 17066249 Prepaid Mission Support 6283096 DUE FROM AFFILIATES 26670279 DISPROPORTIONATE RECEIVABLE 59318289 WAIVER RECEIVABLE 14301732 2198467969 INTEREST RATE SWAP 47971246 DEFERRED COMPENSATION 4216019 RETIREMENT PLAN LIABILITY 91491246 OTHER LONG-TERM LIABILITY 143678511 X Schedule D, Part V, Line 4 Intended uses of endowment funds TEXAS CHILDREN'S HOSPITAL ENDOWMENT FUNDS ARE PERMANENTLY RESTRICTED FUNDS IN WHICH THE PRINCIPAL IS HELD IN PERPETUITY AND INVESTED FOR GROWTH AND THE INCOME GENERATED IS CONSUMED IN THE FURTHERANCE OF TEXAS CHILDREN'S EXEMPT PURPOSE. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AS OF SEPTEMBER 30, 2019 OR 2018. Sub-Saharan Africa Program Services Health care services 2429098 Central America and the Caribbean Program Services SELF- INSURANCE 48969 0 0 0 0 0 0 2478067 0 2478067 false false false false false false X X X X X X X true INFOGROUP INC 200 Pemberwick Road GREENWICH CT 06830 DIRECT MAIL false 372642 -372642 270 STRATEGIES 626 WEST JACKSON BLVD SUITE 600 CHICAGO IL 60661 ANALYTIC SERVICES false 30500 -30500 TARRYN LANKFORD 9713 PINE LAKE DRIVE HOUSTON TX 77055 EVENT COORDINATION false 78680 -78680 0 481822 -481822 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Spirit of the Woods 770029 534656 235373 430703 Mainstreet America 541256 496229 45027 111217 6 1887455 1676874 210581 605395 3198740 2707759 490981 1147315 1147315 -656334 true true X true X true X true true true false true true 26269159 2933523 23335636 0.0096 1068383701 903514758 164868943 0.0681 68901958 56766671 12135287 0.0050 0 0 1163554818 963214952 200339866 0.0828 7200652 3949831 3250821 0.0013 50697592 3480171 47217421 0.0195 21562773 10809756 10753017 0.0044 108921276 27160608 81760668 0.0338 8125868 93912 8031956 0.0033 0 0 196508161 45494278 151013883 0.0624 0 0 1360062979 1008709230 351353749 0.1452 0 0 0 0.0 0 0 0 0.0 105495 0 105495 0.0000 5000 0 5000 0.0000 122780 0 122780 0.0001 50300 0 50300 0.0000 7500 0 7500 0.0000 0 0 0 0.0 41220 0 41220 0.0000 0 0 332295 0 332295 0.0001 true 0 0 8035214 9422252 -1387038 X true true 1 1 TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON TX 77030 WWW.TEXASCHILDRENS.ORG 000117 X X X X X X TEXAS CHILDREN'S HOSPITAL 1 false false true X X X X X X X X X 18 true true true true X https://www.texaschildrens.org/about-us/community-benefit-efforts/reports-community-health-needs X true 19 true https://www.texaschildrens.org/about-us/community-benefit-efforts/reports-community-health-needs false true X 200.0 400.0 X X X X true true X X X true X See Part VI X See Part VI X See Part VI X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Prioritized Community Health Needs Through an extensive process including but not limited to key informant interviews, focus groups, and ongoing participation in community health efforts in the region, Texas Children's identified six key health needs that pertain to our patient population. The findings were brought before the Hospital's Community Benefits Workgroup for guidance on prioritizing them from the perspective of the Hospital's Network of Care. Their guidance is shaped by the institution's mission to create a healthier future for the children and women throughout our global community by leading in patient care, education and research. It is also shaped by the four core values of Texas Children's: to embrace freedom, lead tirelessly, live compassionately, and amplify unity. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Texas Children's Hospital. Shared Initiative - Key Informant Interviews In fulfillment of its 2018-2022 Strategic Plan to take a systems-focused approach to community health, the Episcopal Health Foundation coordinated an interview initiative in 2018 to support four Greater Houston hospital systems in preparing their 2019 community health needs assessments. The collaborating hospitals include CHI St. Luke's, Houston Methodist Hospital, Memorial Hermann Health System, and Texas Children's Hospital. The goal of the CHNA Shared Initiative was to collect qualitative data from a group of stakeholders representing diverse populations in Greater Houston. Through this collaborative effort, the four hospitals sought to minimize burden to respondents who may receive multiple requests for interviews by the participating hospitals for their respective CHNAs. The Foundation hired Health Resources in Action (HRiA), a nonprofit public health institute, to conduct interviews with respondents identified by the four hospitals and to analyze those interviews for prominent themes. Though the Texas Children's service area, Greater Houston, is only nine counties, respondents are distributed across ten counties. Interviews were conducted with stakeholders, community leaders, providers, and staff from a wide range of organizations across sectors, including public health, health care, education, housing, transportation, immigrant services, the faith-based community, local government, early childhood, and social services. The University of Texas School of Public Health - Focus Groups In the spring of 2019, Texas Children's formed a partnership with the University of Texas Health Science Center at Houston, School of Public Health (UTSPH) to afford public health graduate students the opportunity to gain real-world public health experience, by helping Texas Children's complete its 2019 Community Health Needs Assessment. Nine graduate students enrolled in the PH 1112 Community Needs Assessment class conducted focus groups with Texas Children's social workers, financial assistance program workers, and health care providers. Through a focus group discussion guide the team gathered information on community and systemic health factors and suggestions for improving community health. At each focus group, two students led the focus group questioning while one student took notes and recorded the session. Other students listened to the recordings, highlighted key themes, and presented key findings. Ongoing Participation in Local Community Health Initiatives Texas Children's Department of Government Relations and Community Benefits participates in several community health initiatives, workgroups, and councils throughout Greater Houston providing ongoing insight into the health needs of the communities we serve. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Texas Children's Hospital. In fulfillment of its 2018-2022 Strategic Plan to take a systems-focused approach to community health, the Episcopal Health Foundation coordinated an interview initiative in 2018 to support four Greater Houston hospital systems in preparing their 2019 community health needs assessments. The collaborating hospitals include CHI St. Luke's, Houston Methodist Hospital, Memorial Hermann Health System, and Texas Children's Hospital. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Texas Children's Hospital. The CHNA was conducted with the Episcopal Health Foundation Shared Initiative and The University of Texas School of Public Health. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Texas Children's Hospital. HOW TEXAS CHILDREN'S IS ADDRESSEING NEEDS IDENTIFIED IN ITS 2019 CHNA Texas Children's 2019 Community Health Needs Assessment identified five healthcare topics needing specific Hospital expertise and resources, prioritized in the following order: * Mental and Behavioral Health * Access to Care * Social Determinants of Health * Maternal Health * Obesity & Chronic Disease (Tie) * Environmental Health (Tie) Texas Children's is addressing these needs by employing the strategies outlined in the Texas Children's 2020-2022 Community Benefit Implementation Plan. This plan, developed by the Hospital's Community Benefit Workgroup (CBW) and reviewed and endorsed by the Board of Trustees, presents current actions Texas Children's is taking to address these needs in addition to proposed actions and strategies. Mental and Behavioral Health Current actions to address this issue: Action 1 - Support school-based efforts aimed at prevention and early intervention in mental health. Mental Health America, the nation's leading community-based non-profit dedicated to mental illness, points out that schools provide an important opportunity for addressing the mental health and well-being of children. This is because they can provide students with the tools they need to be mentally well, while also identifying early signs that a child might need extra support. * In February of 2020, Texas Children's executed a multiyear gift agreement with the Girl Scouts of San Jacinto Council to promote their Girl Scouting in the School Day (GSSD) program. GSSD is a free leadership development program held during the school day, that provides an authentic Girl Scout experience to middle school girls in underserved communities where a lack of volunteers, transportation, and financial resources are often barriers to joining traditional Girl Scout troops. Preliminary analysis of pre and post surveys on the GSSD program in Dallas suggest that girls who participate see a 78% improvement in academic engagement, 84% improvement in stronger sense of self, 80% improvement in practical life skills, and 96% improvement in increased understanding of STEM. * Texas Children's Departments of Psychiatry, Psychology, and the Texas Children's Trauma and Grief Center, support various initiatives aimed at prevention and early intervention in mental health in schools. * Texas Children's Department of Government Relations and Community Benefits, furthermore, is actively involved in the implementation of Texas Senate Bill 11, which was signed into law in June, 2019. The bill provides an additional $110 million over the next two years for school security and better access to mental health resources. It also requires that districts create multi-hazard emergency plans, use trauma-informed practices, and provide more training to staff. Action 2 - Explore the logistics of forming an on-site crisis response team based out of the Texas Children's Trauma and Grief (TAG) Center. According the National Alliance on Mental Illness (NAMI), mental health crisis response services are a vital part of any mental health service system. A well-designed crisis response system can provide backup to community providers, perform outreach by connecting first-time users to appropriate services and improve community relations by providing reassurance that the person's needs are met in a mental health crisis. While the Harris Center for Mental Health and Intellectual or Developmental Disabilities (IDD) currently operates a mobile crisis outreach team for children and adults of Harris County, an additional crisis response team, based out of Texas Children's TAG Center, could potentially reach more people in other parts of the Hospital's community benefits service area. TAG is often called upon to provide mental health crisis outreach, including in the aftermath of Hurricane Harvey, the Santa Fe School shooting, Sutherland Springs Church shooting, and more. With a dedicated on-site crisis response team, TAG may be able to respond to more crises without significantly disrupting its operations. * The Texas Children's Trauma and Grief Center and the Department of Community Benefits are currently pursuing funding opportunities to support an on-site crisis response team. Action 3 - Encourage collaborations between law enforcement agencies and mental health providers to decriminalize mental health crises. Individuals with mental illness are often detained and transported by law enforcement during instances of mental crisis. The National Alliance on Mental Illness (NAMI) estimates that over 2 million people with mental illness, most of which are non-violent offenders, are booked into the jail system annually instead of diverted into medical care to assess their mental health. The continued jailing of individuals committing non-violent crime who suffer from mental illness induces unnecessary stress, increases state and local law enforcement spending, and creates unwarranted burden on law enforcement. * Texas Children's Trauma and Grief (TAG) Center is currently piloting the "Handle with Care" initiative, which puts systems in place for police to alert schools when a child experiences a potentially traumatic event so that the teacher is made aware and the child receives immediate support in the classroom, if needed. * Texas Children's Section of Public Health Pediatrics seeks to expand its collaboration with the Harris County Sheriff's Office and the University of Texas Medical Branch to study the needs of children with incarcerated parents. Access to Care Current actions to address this issue: Action 1 - Partner with community-based organizations to improve health insurance coverage and health literacy in vulnerable communities. Extensive research indicates that health insurance coverage improves children's access to preventive checkups and medications, and to a medical home, where caregivers can meet health issues and developmental needs. Medicaid, which serves over half of Texas newborns and two out of five Texas kids, is also linked to better educational outcomes and better health and economic well-being over time. The Center for Public Policy Priorities (CPPP) estimates that of the 835,000 uninsured Texas children in 2017, at least 350,000 were eligible for Medicaid or CHIP. * For decades, Texas Children's has advocated for improving health insurance coverage policies, including efforts to expand Medicaid coverage for postnatal women for 12 months, and removal of income checks after 6 months of eligibility for children on Medicaid. Texas Children's Department of Government Relations and Community Benefits is currently coordinating a system-wide health literacy and health insurance enrollment campaign targeting YMCA locations, Boys and Girls Club locations, and schools in areas with high uninsured rates. Key personnel at community-based sites will be trained on how to identify and approach uninsured families and navigate them to staff that can provide application assistance. Action 2 - Continue to explore telehealth strategies to increase access to healthcare in vulnerable communities. The Health Resources and Services Administration (HRSA) defines telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. * Established in 1993, the Texas Children's Center for TeleHealth was the first pediatric-based telemedicine program to go live.The Center for TeleHealth continues to facilitate timely diagnoses and treatments, link researchers and patient populations at a variety of sites throughout the world and promote networking among physicians, health care providers and institutions. Action 3 - Explore the use of ride-share services to help underserved communities access care. Lack of transportation, specifically for lower income residents, was identified by respondents in the 2019 CHNA as a top barrier to accessing health care. They noted that the large footprint of the city-and its sprawling nature-makes it difficult to get anywhere except by car. While there is a public bus system, respondents reported that using the system can be cumbersome and expensive. * Texas Children's Trauma and Grief Center, which is a subsidized health service primarily supported by grant funding, partners with Lyft to help patients get to appointments. Texas Children's Department of Government Relations and Community Benefits will explore mechanisms to expand this model to other areas of the Texas Children's Hospital System, especially in underserved communities. (See continuation of Part V, Line 11) Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Texas Children's Hospital. Social Determinants of Health Current actions to address this issue: Action 1 - Advocate for evidence based programs and policies that improve the quality of life and health outcomes for children and families living in poverty. In "Poverty and Child Health in the United States," the American Academy of Pediatrics points out that almost half of young children in the United States live in poverty or near poverty. They further advise that poverty and related social determinants of health are linked to adverse health outcomes in childhood and adulthood, negatively affecting physical health, socioemotional development, and educational achievement. The American Academy of Pediatrics suggests that pediatricians and other pediatric health practitioners are uniquely equipped to assess the financial stability of families, link families to resources, and coordinate care with community partners. Facilitating pediatric health practitioners' capacity to provide this type of support and information to families served is vital to combatting poverty and related adverse health outcomes. * Texas Children's is a charter member of the Greater Houston Coalition for Social Determinants of Health, whose stated mission is to establish a sustainable, data-driven, human-centered ecosystem of care that equitably addresses the social determinants of health among Greater Houston's communities. * In February of 2020, Texas Children's executed a multiyear gift agreement with the Houston Food Bank to support their Food for Change initiative (FFC). Food for Change includes several programs aimed at creating economic and healthcare partnerships to address root causes and downstream effects of food insecurity. FFC's health programs include Food Rx, FIRST Link, and Core Connections Network. Action 2 - Support efforts to increase access to quality early childhood education programs in economically disadvantaged communities. According to the Institute of Education Sciences, a branch of the US Department of Education, early childhood education is a broad term used to describe any type of educational program that serves children from birth through third grade. Early childhood education may consist of any number of activities and experiences designed to aid in the cognitive and social development of young children in their early formative years. * Through partnerships with child-serving organizations, local governments, places of worship, school districts, public housing communities, WIC centers, public libraries, and safety net providers, Texas Children's Department of Public Health Pediatrics is focused on expanding the upWORDS program, a 14-week early language development program for low-resourced families with children aged 0-2 years. From 2016-2019 the upWORDS program served over 500 families. * Texas Children's will continue partnerships with The City of Houston Health Department and the Children's Museum to expand the Houston Basics Program, a free program empowering parents with skills and tools to support improved brain development in children for the first three years of life. Mental Health Current actions to address this issue: Action 1 - Advocate for policies that increase access to health services during the year after pregnancy. In "It's Past Time to Provide Continuous Medicaid Coverage for One Year Postpartum," Emily Eckert argues that medical and behavioral health conditions must be managed and treated before the point of progressive severity to help curb maternal deaths in the postpartum period. Extending Medicaid coverage for pregnant women from 60 days to 12 months postpartum, for example, would help women access the care they need to address health concerns after their pregnancy ends. Current coverage does not allow ample time for women to access care for chronic conditions, treatment for substance use disorders, and behavioral or other mental health services, and this is a more critical barrier for mothers at lower socioeconomic status. The American College of Obstetricians and Gynecologists (ACOG) supports the suggestion to extend coverage, and at its June 2019 meeting, the American Medical Association's House of Delegates adopted a resolution supporting the extension of Medicaid coverage for women in the postpartum period. * Dr. Lisa Hollier, CMO at Texas Children's Health Plan, and Division Director in Obstetrics and Gynecology at Baylor College of Medicine, currently chairs the governor-appointed Texas Maternal Mortality and Morbidity Taskforce. * Dr. Hollier and Dr. Chris Greeley, Section Head of Public Health Pediatrics, are also on the Harris County Maternal Mortality Taskforce, which shares a similar mission as the state taskforce, but for Harris County. * Leaders at Texas Children's comprise a large part of the Texas Collaborative for Healthy Mothers and Babies (TCHMB) Executive Committee. The TCHMB is a multidisciplinary network of health professionals throughout the state whose mission is to advance health care quality and patient safety for all Texas mothers and babies, through the collaboration of health and community stakeholders in the development of joint quality improvement (QI) initiatives, the advancement of data-driven best practices, and the promotion of education and training. Action 2 - Support community-based care models to improve maternal health outcomes and promote postpartum wellness among vulnerable populations. Community-based care is an important component of providing a continuum of care for low-resource communities. The health and well-being of women, newborns, and children, furthermore, are inherently linked - when mothers are malnourished, ill, or receive insufficient care, their newborns are at increased risk of disease, morbidity, and premature death. * Texas Children's Section of Public Health Pediatrics was funded by the Texas Medical Center to work with Dr. Lucy Puryear, Medical Director of The Women's Place - Center for Reproductive Psychiatry, to pilot a home visitation program for women with postpartum depression. This pilot is aimed at narrowing the disparity gap in receiving mental health services. Obesity & Chronic Disease Current actions to address this issue: Action 1 - Support community-based interventions that focus on diet and physical activity in families. Research suggests that community-based programs represent a feasible approach to assist individuals, families, and communities in developing healthy behaviors that promote and maintain weight loss. * Texas Children's partners extensively with the YMCA of Greater Houston, providing financial support for initiatives like the Diabetes Prevention Program and the Healthy Weight and Your Child Program. In addition, providers at Texas Children's Hospital and Baylor College of Medicine helped develop the YMCA's Kamp K'aana, nutritional summer camp for overweight children. * In the past, Texas Children's has supported an array of YMCA initiatives, including the construction of an adaptive sports complex for children with physical limitations, and the YMCA's Safety Around Water Initiative. In February of 2020, Texas Children's executed a multiyear gift agreement with the Houston Food Bank to support their Food for Change initiative (FFC). Food for Change includes several programs aimed at creating economic and healthcare partnerships to address root causes and downstream effects of food insecurity. FFC's health programs include Food Rx, FIRST Link, and Core Connections Network. Action 2 - Advocate for programs and policies that improve the nutritional quality of school lunches and breakfasts. Researchers and advocates argue that schools play a unique role in influencing children's eating habits and lifelong behavior through the food and drink choices offered in cafeterias, hallway vending machines, and elsewhere on campus. * The Children's Nutrition Research Center (CNRC) is a unique cooperative venture between Baylor College of Medicine, Texas Children's Hospital and the U.S. Department of Agriculture/Agricultural Research Service (USDA/ARS) that has 50 faculty members conducting nutrition-related research. Research goals include establishment of evidence-based guidelines promoting health, growth and development through optimal nutrition for use by physicians, parents and others responsible for the care and feeding of children. * The Texas Children's Center for Childhood Obesity provides comprehensive help to the community and providers in caring for patients with weight management challenges, obesity and associated co-morbidities. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - Texas Children's Hospital. Environmental Health Current actions to address this issue: Action 1 - Support evidence-based strategies to reduce the effects of mobile and industrial sources of pollution on health in Greater Houston. Mobile sources of pollution include cars, trucks, ships, planes, and trains. A wealth of research suggests that people who are disproportionality exposed to pollution from mobile sources suffer higher rates of asthma, cardiovascular disease, impaired lung development in children, pre-term and low-birthweight infants, childhood leukemia, and premature death. Industrial pollution sources include chemical plants, oil refineries, and other "small area" sources that represent 90 percent of the worst urban toxic pollutants for human health. The American Public Health Association (APHA) recommends increasing EPA funding for ambient and community-scale air toxics programs, focusing more resources on environmental justice issues, developing and validating advanced monitoring and data analysis technologies, and promoting clean power programs to mitigate mobile sources of pollution. * Texas Children's Department of Government Relations and Community Benefits works closely with Air Alliance Houston, a local non-profit advocacy organization working to reduce the public health impacts of air pollution and advance environmental justice. In addition to partnering on research and advocacy efforts, representatives from Texas Children's sit on Air Alliance Houston's Policy Advisory Committee for the health impact assessment of the proposed I-45 highway expansion. Action 2 - Explore strategies to improve access to green space for children and families in underserved communities. A wealth of evidence suggests a positive relationship between mental and physical well-being and access to green space, particularly in children. In fact, studies show that children with a green space nearby spend less time on the computer, watching television, or playing video games than children who have to walk more than 20 minutes to a green space. * Texas Children's is working with The Episcopal Health Foundation, the City of Houston Parks Department, and the Memorial Hermann Community Benefit Corporation on an effort to improve park space in the Alief area of Houston, an economically disadvantaged community that is part of the Mayor's Complete Communities initiative. The effort is aimed at utilizing community benefit resources and foundation support to enhance programming and equipment at a park in Alief, and track utilization and health outcomes over time. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Texas Children's Hospital. The Hospital annually places a notice of its financial assistance policy in the legal section of a widely read local paper, The Houston Chronicle, as well as in the Spanish version of this paper, La Voz. Additionally, a notice of the financial assistance policy is posted in the Hospital's emergency rooms, waiting rooms and admissions offices. Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - Texas Children's Hospital. Line 20A is not checked because the Hospital does not perform any Extraordinary Collection Actions. 5 Vannie Cook Children's Cancer and Hematology Clinic 101 W Expressway 83 McAllen TX 78503 Community Based Outpatient / Diagnostic Clinic SuperKids and Ronald McDonald Care Mobile Clinics 8080 N Stadium Drive Houston TX 77054 Community Based Mobile Clinics Texas Children's Pavilion for Women - Obstetrics & Gynecology Pearland 9003 Broadway St Pearland TX 77584 Community Based Outpatient / Diagnostic Clinic Primary Care Practice at Palm Center 5400 Griggs Road Suite 101 Houston TX 77021 Community Based Outpatient / Diagnostic Clinic Texas Children's Specialty Care - Upper Kirby 3023 Kirby Dr Suite 201 Houston TX 77098 Community Based Outpatient / Diagnostic Clinic Schedule H, Part VI, Line 7 State filing of community benefit report Additional information: The Hospital files the Annual Statement of Community Benefits Standard (ASCBS), the State of Texas' community benefit reporting for not-for-profit hospitals. For the fiscal year ended September 30, 2019, the Hospital reported approximately $377,506,018 as the total annual charity and community benefit in its ASCBS. Differences between Schedule H and the ASCBS are stated below. The resulting difference of $(26,152) between the ASCBS and the amounts recorded in Part I line 7 are due primarily to varying reporting requirements as outlined below (in $1000's): ASCBS includes bad debt expense in the patient care RCC. Additionally, the ASCBS RCC is calculated using 2019 financial information. (12,767) ASCBS includes financial assistance provided to community by related organizations. (7,190) ASCBS includes the unreimbursed cost of community building activities. (332) ASCBS includes the unreimbursed cost of Medicare and Champus. (5,863) Total variance between Part I line 7 and ASCBS. (26,152) Schedule H, Part VI, Line 5 Promotion of Community Health (continued) c. Texas Children's Hospital West Campus serves one of the fastest growing pediatric populations in the country. As the population grows, so has this community hospital. To meet the needs of these diverse neighborhoods, the Hospital continues to look at its patients and engage community-based organizations and leaders to determine what programs, services and initiatives may make the most impact in west Houston. In 2019, Texas Children's Hospital provided pediatric care with over 464,000 visits at the West Campus, and this number has continued to grow annually each year since opening its doors in 2010. The campus provides subspecialty outpatient care including physician visits, therapy services, and a full complement of diagnostic services. The Hospital has 86 inpatient beds, which includes a 22 bed pediatric intensive care unit and remains the only 24/7 dedicated pediatric emergency center in the west Houston area. The hospital continues to operate a state of the art Special Isolation Unit to care for those patients with highly contagious diseases such as Ebola. In addition, a 28,500 square foot, state-of-the-art sports medicine clinic continues to serve the Greater Houston area with physicians specialized in Orthopedics and Sports Medicine, and with dedicated physical therapists focusing on the unique needs of a pediatric athlete. In an effort to focus on our most vulnerable patients, West Campus continues to utilized its Complex Care Clinic to support patients with complex medical needs including care coordination needs, medical fragility, technology dependence, and increased health care utilization. To meet the need for providing increased access to diagnostic services, West Campus operates an Interventional Radiology Suite providing a wide range of image-guided minimally invasive procedures such as Needle Biopsies, and the placement of central lines, feeding and drainage tubes for abscess or other abnormal collections of pus/fluid in the body. The patients most commonly served by this department include those with Hypersalivation, Varicocele, deep Vein thrombosis, Cystic Fibrosis, foreign body removal and Venous system related diseases. d. Texas Children's Health Plan operates two Centers for Children and Women, family-centered medical homes for TCHP members located within two of Houston's most underserved areas, Greenspoint and Sharpstown. The facilities offer primary pediatric and obstetric care, pediatric optometry and dentistry and onsite imaging, speech therapy, lab and pharmacy. In November 2016, TCHP launched STAR Kids, a Medicaid-managed care plan for children and young adults up to 21 years old with disabilities. The STAR Kids program offers the same benefits as Medicaid plus many extra services, including long-term support, service coordination through the STAR Kids health plan, and help in the home to optimize the environment for the child with disabilities, among other benefits. e. The Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children's Hospital is the world's first comprehensive pediatric neurological research center devoted to collaborative efforts to understand neurological conditions like autism, cerebral palsy and epilepsy - a class of disorders that together are expected to exceed more than a half-trillion dollars annually in healthcare costs. The NRI includes more than 400,000 square feet of advanced research and office space, including a new laboratory floor, a customized nuclear MRI suite and additional vivarium space. f. At Texas Children's, we believe in providing women, mothers and babies quality health care at every important stage of their lives. We call this model "family-centered care." Texas Children's Pavilion for Women brings together obstetricians, gynecologists, oncologists, surgeons, geneticists and nurses from the Hospital and Baylor College of Medicine, to accomplish this purpose. With high-risk births on the rise nationally, our renowned experts and specialists focus on furthering obstetrical research. We also provide advanced treatment, including level IV neonatal intensive care units to give premature and sick babies more extensive support and care. The Hospital was the first hospital to receive designation from the State of Texas as a level IV NICU, one of only a few verified under the new regulations. g. The Feigin Tower is the Hospital's central hub for pediatric research. The Hospital is an internationally recognized leader in pediatric research and continues to be a leading recipient of pediatric grant funding through the National Institutes of Health (NIH). With total external and internal funding of more than $186 million annually, researchers conduct more than 1,400 clinical, basic science and translational research projects to identify groundbreaking treatments and cures for childhood diseases. Schedule H, Part V, Section B, Line 16 FAP WEBSITE The website for Schedule H, Part V, Lines 16a-c is: https://www.texaschildrens.org/patients-and-visitors/insurance-and-billing-assistance/financial-arrangements Schedule H, Part I, Line 7g Organizational Subsidized Health Services Continued from prior response on schedule H, Part I, Line 7g Texas Children's Hospital Primary Care Practice at Palm Center provides comprehensive routine and preventive health care, including well child check-ups, sick visits, sports physicals, immunizations and management of chronic pediatric medical conditions. Texas Children's Hospital Primary Care Practice at Palm Center serves as the largest Texas Children's Hospital and Baylor College of Medicine practice that provides primary care experience for pediatric medical students and residents. This clinic's location in the Palm Center neighborhood in Houston's Third Ward offers a great opportunity to serve the community while modeling best practices to the next generation of pediatricians. Third Ward is a historically African American community with a rich history and cultural legacy along with a renewed sense of purpose and commitment. The clinic's location offers free parking and is conveniently located at the Palm Center Station on the MetroRail's Purple Line. Schedule H, Part I, Line 7g Subsidized Health Services The Hospital has included five hospital-based outpatient clinical services (The Developmental Pediatrics and Autism Center, Renal Outpatient Services, Special Needs Primary Care Clinic, The Center for Childhood Obesity and Mental Health Services- includes pediatric and maternal services) and four stand-alone clinics (the Mobile Clinic Outreach Program, Pediatric Dentistry, the Primary Care practice at Palm Center, and the Vannie E. Cook Jr. Children's Cancer and Hematology Clinic) as subsidized health services in Part I, Line 7g. Gross expenses of $21,562,773, offsetting revenue of $10,809,756 and net expenses of $10,753,017 are included in that line. The stand-alone clinics include gross expenses of $9,638,381, offsetting revenue of $7,583,032 and net expenses of $2,055,349 in line 7g. These clinics qualify as subsidized health services because they provide care and services to vulnerable, low income populations whose communities lack primary care services and programs. The Texas Children's Autism Center and Meyer Center for Developmental Pediatrics provide diagnostic services for children suspected of having an Autism Spectrum Disorder, Developmental Delay, Intellectual Disabilities, Learning problems, etc. These multidisciplinary centers are comprised of developmental pediatricians, neurologists, psychologists and psychiatrists who work collaboratively to provide a comprehensive diagnostic evaluation. They also have a social work team to help families obtain resources in the community and school not provided at the Hospital. The Autism Center and The Meyer Center for Developmental Pediatrics are housed in the same location and have over 4,600 patient visits annually. Renal Outpatient Services - Services started in 1980 in response to community needs for chronic hemodialysis for children. Approximately 60 chronic patients are seen annually by pediatric nephrologists and undergo dialysis treatment at the hospital or at home in order to improve their health outcomes while maintaining a child's normalcy of school and activities with friends. In addition to chronic end stage renal dialysis patients, approximately 3,900 patients are treated in pheresis and renal clinics. The Special Needs Primary Care Clinic provides a medical home, case management and social services for children with very complex underlying medical conditions. These patients have difficulty finding a general pediatrician to oversee their care and tend to utilize emergency rooms and subspecialists for routine care. The Center for Childhood Obesity was developed to provide comprehensive help to the community and providers in caring for patients with weight management challenges, obesity (children with a body mass index above the 95th percentile) and associated co-morbidities. Programs include: * The Program for Healthy Bodies: a comprehensive evaluation of medical and psychosocial issues as well as an assessment of lifestyle leads to an individualized plan for each patient. This plan may include subspecialty care. The goal for every family is additional weight management services close to home between visits to the Center. Over 80% of the children seen are severely obese. * On the Weigh: a 10-week group program for elementary school age children and their parents that is offered at the CyFair Health Center in the late afternoon. * The Weigh of Life Program: a 15-week program that serves individual children and addresses behavior change for weight control as well as emotions and self-esteem. * Kamp K'aana: a two-week residential camp program for children 10 to 14 years of age who are struggling with obesity, supported in part through fundraising efforts of volunteers from the Hospital. Sites expanded through community partners from Camp Cho-yeh and YMCA Camp Cullen. * The Saturday Wellness Program: quarterly sessions offered on Saturday mornings to teach children six to 16 years of age about healthy lifestyles and nutrition. Supported by the Texas Department of State Health Services. The Psychiatry Service serves patients with a wide variety of psychiatric conditions often which are comorbid. Services include diagnostic assessments and treatment of complex anxiety and mood disorders, Tourette's syndrome, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, medication management for children with Autism Spectrum Disorders, among other conditions. The Service also has a consult liaison service to the inpatient units of the Hospital. The Service has over 13,800 patient visits annually. The Psychology Service serves patients with varying degrees of assessment and treatment needs. Services include neuropsychological testing, cognitive assessments, treatment in the areas of pre-school and school age disruptive behavior, anxiety and mood disorders, complex ADHD, and the Trauma and Grief Center (TAG). TAG services patients from 7-17 who are in need of therapy for trauma related incidents or grief counseling. The TAG team also helps train community partners including numerous school districts in trauma and grief protocols, etc. The Psychology Service works closely with other services within Texas Children's Hospital, both inpatient and outpatient, in helping patients adjust to and manage complicated or serious medical diagnoses. The Service has nearly 7,900 patient visits annually. Mobile Clinic Outreach Program -The Hospital's mobile clinics partner with underserved schools in the city and travel to low-income neighborhoods to provide free health care to children and adolescents from birth to age 18 who do not have insurance. As part of its goal to build a community of healthy children, the Hospital operates mobile clinics to provide trusted, high-quality medical services to children who normally might not have the opportunity to receive health care. In 2019, mobile clinics visited over 30 locations in Greater Houston, with over 11,000 patients, 12,000 procedures and 11,000 vaccines administered. Services include sick visits, well-child check-ups, vision and hearing screenings and free immunizations to all Texas Vaccines for Children-eligible patients. Additionally, our community health workers can help families apply for public health insurance, such as Medicaid, CHIP and the Harris Health Eligibility Card. We also provide referrals for social services and affordable permanent medical homes. Pediatric Dentistry Services - Community based dentists are generally not equipped to treat dental patients with special needs that often require treatment in the operating room or heavy sedation. The Pediatric Dental Clinic at Texas Children's Hospital (Dental Clinic) was developed to care for these children. The Dental Clinic is primarily focused on patients with cardiac issues, cancer, neurologic disorders and other medical issues. Approximately 77% of the patients seen in the Dental Clinic are insured through Medicaid. In 2019, the Dental Clinic had over 3,800 patient visits which included about 1,400 operating room cases. Additionally, the Pediatric Orthodontic Clinic at Texas Children's Hospital (Orthodontic Clinic) treats children who have congenital anomalies and/or cleft palates in conjunction with the Plastic Surgery department. In 2019, the Orthodontic Clinic had over 3,600 patient visits with about 66% insured through Medicaid. The Vannie E. Cook Jr. Children's Cancer and Hematology Clinic (Vannie Cook Clinic) is located in McAllen, Texas and is a joint effort between the Vannie E. Cook Jr. Cancer Foundation, Baylor College of Medicine and Texas Children's Cancer and Hematology Centers. The Vannie Cook Clinic offers treatment to children along the Mexico border in South Texas who suffer from cancer and blood disorders. It is the only comprehensive pediatric cancer treatment facility in South Texas. Many of these patients previously would have traveled to San Antonio or Houston for their treatment, a hardship physically, emotionally and financially for them and their families. It is a comprehensive care facility offering diagnostic and cancer treatment services, cancer genetic counseling and a long-term survivorship program which follows childhood cancer survivors through adulthood. Most of the patients (73%) are from low-income, uninsured or underinsured families. Every year, the clinic staff sees approximately 1,300 patients and of these patients, approximately 600 are newly diagnosed. (See continuation of Part I, Line 7G) Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 0 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance For Part 1, Line 7, Texas Children's Hospital (Hospital) applied the ratio of patient care costs (RCC) to charges derived from Worksheet 2 to the charges the Hospital forgave pursuant to the financial assistance policy (line 7a), Medicaid charges (line 7b), other means-tested charges (line 7c) and research patient care charges (line 7h). Worksheets 1, 2, 3, 4, 5, 6, 7 & 8 and the corresponding instructions have been used as the primary basis for completing Part 1, Line 7. For each subsidized health service, the Hospital used the RCC for cost report line 90.00 Outpatient Clinics where the subsidized health service cost centers reside and applied it to the respective gross patient charges to calculate community benefit expense. The exception to the above is Renal Outpatient Services. Costs incurred for Renal Outpatient Services reside in multiple cost centers and multiple cost report lines. The RCC for the related cost report line where the actual gross patient charges were recorded was used to calculate community benefit expense for Renal Outpatient Services. For each subsidized stand-alone clinic, the Hospital calculated a specific ratio of patient care costs to charges using the same method prescribed in worksheet 2 and applied it to the respective clinics' gross patient charges to calculate community benefit expenses. For Part 1, Line 7, the Hospital applied indirect cost ratios from the 2019 Medicaid cost report to direct program expense to determine total community benefit expense related to community health improvement services and community benefit operations (line 7e), non-GME health professional education programs (line 7f) and in-kind contributions (line 7i). The indirect cost ratios computed from the 2019 Medicaid cost report are both comprehensive and a good proxy of the associated overhead costs. For Part 1, Line 7f, the Hospital included the direct and indirect expense from the 2019 Medicaid cost report for state accredited and nationally accredited Graduate Medical Education (GME) programs. For Part 1, Line 7h, the Hospital included the direct and indirect expense from the 2019 Medicaid cost report for research. No industry-sponsored research activities are included in line 7h. Schedule H, Part II Community Building Activities The Hospital's community building activities promote the health of the communities served and support organizations focused on the root causes of health problems (e.g., poverty and homelessness) and vulnerable populations (e.g., children with special healthcare needs). Community Support Activities (Line 3) Net Community Building Expense GIRL SCOUTS $ 27,500 RONALD MCDONALD HOUSE Houston $ 15,000 THE BALLARD HOUSE $ 15,000 Candlelighters Childhood Cancer Family Alliance $ 10,000 GiGi's Playhouse $ 10,000 Be An Angel $ 5,000 FAITH Fighting Cancer $ 5,000 LIFELINE CHAPLAINCY $ 5,000 The Stacey and Bo Porter SELF Foundation $ 5,000 YES to YOUTH - Montgomery County Youth Services $ 3,000 Boys & Girls Club of Greater Houston $ 2,500 Autoimmune Encephalitis Alliance $ 1,495 Houston Texans Foundation $ 1,000 TOTAL $ 105,495 Environmental Improvement Activities (Line 4) Net Community Building Expense Air Alliance Houston $ 5,000 TOTAL $ 5,000 Leadership Development and Training for Community Member Activities (Line 5) Net Community Building Expense JUNIOR LEAGUE OF HOUSTON $ 115,000 TEACH - To Educate All Children $ 5,000 Center for Houston's Future $ 2,750 American Leadership Forum $ 30 TOTAL $ 122,780 Coalition Building Activities (Line 6) Net Community Building Expense Leaping Butterfly Ministry $ 25,000 State of Black Women $ 25,000 Jewish Family Services Houston $ 300 TOTAL $ 50,300 Community Health Improvement Advocacy Activities (Line 7) Net Community Building Expense Children's Defense Fund $ 5,000 Interfaith of The Woodlands $ 2,500 TOTAL $ 7,500 Other (Line 9) Net Community Benefit Expenses The Health Museum $ 20,000 Houston Children's Charity $ 10,170 The Woodforest Charitable Foundation $ 5,250 Summerhouse Houston $ 3,000 INSPIRATION RANCH $ 2,800 TOTAL $ 41,220 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount In accordance with HFMA Statement 15 and ASU 2014-09, Topic 606, Bad debt expense represents the difference between the standard rates (or explicit contracted rates) and the amounts expected to be collected from a third-party payor after all reasonable collection efforts have been exhausted. Also in accordance with HFMA Statement 15 and ASU 2014-09, Topic 606, Bad debt expense is calculated as the charges written off (at full established rate), less any indirect funds received to offset charges written off. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Bad debt attributable to patients eligible under financial assistance policy: The Hospital does not contend that any of its bad debt expense is attributable to the organization's financial assistance policy (FAP) or should be considered a community benefit. Robust screening processes are used in determining FAP-eligibility and financial assistance amounts are not expected to result in cash flows. All uncollected charges attributable to patients eligible under the organization's FAP are included in line 7a (at cost). Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Footnote describing accounts receivables (page 14) of audited financial statements: Patient accounts receivable include reductions for explicit contractual agreements, discounts provided to uninsured and underinsured patients, implicit price concessions, and charity adjustments and are recorded on an accrual basis at net realizable value in the consolidated balance sheets. The estimate of patient accounts receivable is based primarily on Texas Children's historical collection and write-off experience and the aging of patient accounts receivables. Changes in business and economic conditions, trends in federal, state and private employer health care coverage, and other collection indicators are also taken into consideration when estimating price concessions each quarter. Footnote describing revenue recognition, implicit price concessions and bad debt expense (page 18) of audited financial statements: In May 2014, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2014-09, Revenue from Contracts with Customers which provides for a single comprehensive principles-based standard for the recognition of revenue across all industries through the application of a five-step framework. The core principle of 2014-09 is that an entity recognizes revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. In addition, the standard requires expanded disclosures in regards to the nature, amount, timing and uncertainty of revenue, as well as the certain additional quantitative and qualitative disclosures. Texas Children's has adopted ASU 2014-09 by applying the full retrospective method. As of September 30, 2019, the primary impact of adopting ASU 2016-09 is $74,333 previously classified as the provision for doubtful accounts is now reflected as an implicit price concession within net patient service revenue. These amounts are no longer separately stated as a reduction to net patient service revenue in the consolidated statements of operations and changes in net assets. Texas Children's will consider certain changes in the financial status of a third-party payor not assessed at the date of service, for example, a bankruptcy, as bad debt expense within general and administrative expenses. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The sources used to determine the amount reported as Medicare Allowable Costs on Part III, line 6 was the Hospital's 2019 Medicare Cost Report and supporting workpapers. Substantial shortfalls typically arise from payments that are less than the cost to provide the care or services and do not include any amounts relating to inefficient or poor management. The Hospital accepts Medicare patients seeking pediatric or women's health services, as reflected on the year-end Medicare Cost Report, with the knowledge that there may be shortfalls. IRS Revenue Ruling 69-545, which established the community benefit standards for nonprofit hospitals, implies that treating Medicare patients is a community benefit and states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Patients who have qualified for financial assistance, if the discount is less than 100%, will be responsible for payment of any applicable hospital charges at a reduced rate. If the patient does not pay the amount and fails to renegotiate a payment plan (if applicable), the uncollected balance will be considered an implicit price concession. Provisions for estimated retroactive adjustments under such programs are provided in the period the related services are rendered, adjusted in future periods as final settlements are determined, and are included in current assets. The Hospital may use reasonable efforts to collect outstanding patient receivables which include but are not limited to: telephone calls, email and couriered written correspondence. The Hospital does not engage in extraordinary actions to force collections on patient accounts. Schedule H, Part V, Section B, Line 16a FAP website - TEXAS CHILDREN'S HOSPITAL: Line 16a URL: See Part VI; Schedule H, Part V, Section B, Line 16b FAP Application website - TEXAS CHILDREN'S HOSPITAL: Line 16b URL: See Part VI; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - TEXAS CHILDREN'S HOSPITAL: Line 16c URL: See Part VI; Schedule H, Part VI, Line 2 Needs assessment In addition to the CHNA, Texas Children's Hospital has a Community Benefits department whose structure and purpose includes engaging with internal and external partners in the development of community partnerships, identifying new programs and funding opportunities and reporting community benefit programs' progress, outcomes and evaluation. To accomplish this, Community Benefits employs the ICARE framework: * Identify community health needs as they arise. * Collect data. * Align the Texas Children's community-related efforts with identified needs. * Recognize components of Texas Children's that provide quality community-related services * Enhance community-related health efforts across the entire system. A Community Benefits Workgroup, comprised of physician and administrative leaders from across Texas Children's, works in collaboration with the Community Benefits department. The workgroup is charged with determining how best to address identified community needs. Members/Leaders in the Hospital's supported programs created to address existing community health needs provide critical guidance to the Community Benefits department on how best to measure program success and continued support, or expansion of these efforts to other areas of the community. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance All patients who receive services at the Hospital or their families are notified of their rights and responsibilities and the availability of government or hospital sponsored programs if financial assistance is needed. * Information is provided during inpatient and outpatient registration where materials are always available in both English and Spanish. * Notices of the Hospital's financial assistance program are posted in public waiting and registration areas, including Admissions, Emergency Center, outpatient clinics and other prominent areas. A variety of language services are available upon request. * The Hospital's Financial Assistance Policy, Financial Assistance Application and a plain language summary of the Financial Assistance Policy are posted on Texas Children's Hospital's public website in both English and Spanish. The site directs patient families to contact admissions counselors and financial counselors in the Admissions department for more information about available financial options and resources. * The Hospital annually publishes a summary of its financial assistance policy in the local major newspapers. * Financial counselors are available to determine eligibility for government and/or hospital-sponsored financial assistance. Financial counselors receive training on eligibility requirements for financial assistance and government programs. * State Out-stationed Eligibility Workers (OEW) are on-site to support the government-sponsored assistance program application process. * Referrals for charity consideration may originate with the scheduling, pre-service, customer service departments, hospital social workers and clinicians, external providers and through self-referral. These referrals are directed to the appropriate department's financial counselors who discuss options, including charity assistance. * Financial counselors also contact patients arriving via the Emergency Center after appropriate medical screenings to discuss eligibility for government programs like Medicaid, CHIP, CSHCN and charity assistance. Schedule H, Part VI, Line 4 Community information Given the services provided to patients from around the world, the Hospital defines its community as local, national and international. In regards to the CHNA, the Hospital focuses on addressing local needs. For community benefit reporting purposes, Texas Children's defines the community it serves as the Houston-The Woodlands-Sugar Land Metropolitan Statistical Area (MSA), also known as "Greater Houston." An MSA - defined by the U.S. Office of Management and Budget (OMB) and used by the Census Bureau and other federal government agencies for statistical purposes - is a geographical region with a relatively high population density at its core and close economic ties throughout the area. While the Texas Children's Hospital Network of Care treats patients from around the globe, the majority of our patients (90.9% in fiscal year 2019) come from Greater Houston. In terms of land area, Greater Houston is approximately 9,350 square miles, making it as large or larger than the states of New Hampshire (9,350 sqmi), New Jersey (8,721 sqmi), Connecticut (5,543 sqmi), Delaware (2,489 sqmi), or Rhode Island (1,545 sqmi). For more in depth information on each county in the Hospital's community benefits service area, including demographic profiles, please refer to the Hospital's CHNA online: https://www.texaschildrens.org/about-us/community-benefit-efforts/reports-community-health-needs In general, Texas Children's focuses community benefit efforts in neighborhoods with high concentrations of poverty because poverty is linked to many other social determinants of health. Several research institutions have developed indexes to better understand neighborhood-level factors beyond poverty that can affect health outcomes. These indexes include the CDC's Social Vulnerability Index (SVI), Ohio State University's Childhood Opportunity Index (COI), and HRSA/The University of Wisconsin's Area Deprivation Index (ADI). These indexes often score neighborhoods based on a variety of factors related to socioeconomic status to paint a more comprehensive picture of the disadvantages faced by neighborhood residents. Texas Children's uses the Area Deprivation Index to identify the most vulnerable neighborhoods in our service area because it is based on the most current data of all of the indexes. Additionally, it provides data at a higher spatial resolution, the census block group, compared to other indexes that oftentimes use census tracts or zip codes. The ADI was developed by HRSA over twenty years ago for county-level use, but has since been adapted and validated to the census block group level by researchers at the University of Wisconsin-Madison. The ADI ranks each census block group in each state from 1 to 10 based socioeconomic factors, such as income, education, employment, and housing quality. Census block groups that receive a score of 1 are the lowest on the ADI, and are the least disadvantaged neighborhoods, while census block groups that receive a score of 10 are the highest on the ADI and are the most disadvantaged neighborhoods. Schedule H, Part VI, Line 5 Promotion of community health As a leader in pediatrics and women's health, the Hospital continues its mission to serve the community through preeminent research, education and patient care. This ongoing commitment ensures the health and well-being of the youngest and most vulnerable members of the community, whether they reside in nearby neighborhoods or on the other side of the world. In addition to the information supplied in other sections of this document, the following are examples of the Hospital's ongoing commitment to the community it serves: 1) Texas Children's Board of Trustees is composed of representatives who reside in the greater Houston community and are not employees of the hospital. Many Trustees are business and civic leaders who are active in other local charitable organizations. 2) The Hospital extends medical staff privileges to all qualified non-hospital-based physicians from the community. Privileges are granted in accordance with medical staff bylaws. 3) Emphasizing its world-class expertise in highly specialized fields, the Hospital operates Centers of Excellence in oncology, cardiology and neonatology. Ranked third among all children's hospitals nationally by U.S. News & World Report, Texas Children's Hospital is the only children's hospital in Texas to receive the prestigious Honor Roll designation. In the 2020 U.S. News survey - which uses data from 2019 - the Hospital ranked in the top ten in nine subspecialties and #1 in the nation in cardiology/heart surgery for the fourth year in a row. As a national leader among pediatric institutions, the Hospital has multidisciplinary expertise in some of the most complex medical challenges facing children today. 4) As part of its responsiveness to the community, the Hospital operates and supports several advisory committees, comprised of community members and patient families. These groups consult with Hospital representatives on a wide range of topics designed to increase the quality of care and services provided. 5) The Hospital invests its operating margin in capital projects and programmatic initiatives focused on improving patient care, medical education and research. 6) The Hospital served as a training center for nursing students, supporting approximately 1700 candidates in 2019. Although these trainees are not obligated to remain at the Hospital upon certification, they gain valuable knowledge for their careers in pediatrics. 7) Texas Children's Medical Legal Partnership (MLP) promotes the health of vulnerable, low-income populations by addressing legal needs that affect patient health. In fiscal year 2019, there were a total of 306 consultations. The MLP brings together lawyers, doctors and social workers when a legal situation is required. A staff attorney and volunteers provide free legal advice to patients and families on a variety of legal matters including improving housing conditions, obtaining guardianships for adult children or unrelated caregivers and securing public school accommodations for children with disabilities. 8) The Simulation Center at Texas Children's Hospital provides Pediatric Simulation Training for Emergency Pre-hospital Providers (Pedi-STEPPs) to members of the Houston Fire Department (HFD). This program originally started with a grant from the Cullen Trust for Healthcare, as well as a commitment from the Hospital, allowed this innovative training to be offered free of charge to the City. The initial grant was for two years. Although there is no longer a grant, the hospital continues to see great need for this program and is continuing its commitment to train firefighters. In fiscal year 2019, 258 individuals participated in this training. The training course incorporates multimedia, technical skills training and communication/team skills training through participation in high-fidelity simulation scenarios. February 26, 2016, marked the first day of implementing newly revised scenarios with the continuation of each high-fidelity simulation followed by a facilitated video-reviewed debriefing session where participants reflect on and learn from their performance. 9) The Hospital's 24/7 transport service, the Kangaroo Crew, comprises a fixed-wing aircraft and ground ambulance medical service providing coordinated patient assessment, necessary intervention and safe, rapid transport of critically ill or injured patients. All transport service personnel are specially trained in pediatric/neonatal transport medicine and safety in accordance with Federal Aviation Administration (FAA) and Texas Department of State Health Services guidelines. 10) The transport service team is a member of the Pediatric Disaster Coalition (Coalition), a planning group that consists of subject matter experts from freestanding children's hospitals, facilities with dedicated pediatric/neonatal units, pediatric specialty transport organizations, local and state public health and federal partners. The Coalition shares recommendations and technical guidance with other healthcare facilities throughout the state, as well as federal agencies and other national organizations including Child Health Care Association (CHCA), Children's Hospital Association (CHA), Association of Air Medical Services (AAMS) and American Academy of Pediatrics (AAP) Section on Transport Medicine. 11) At Texas Children's Hospital, we are committed not only to providing the best possible care, but also to expanding that care-reaching out to more children and families and providing more specialized services where they are most needed. The Hospital is committed to creating a healthier future for children and women throughout our global community by leading in patient care, education and research: a. This region has embraced Texas Children's Hospital The Woodlands since we opened the doors in 2017. We have brought world class pediatric care closer to home for the North Region's patient and families. This pediatric hospital campus increases access to pediatric subspecialty care within the following services: adolescent medicine and physical rehabilitation, allergy and immunology, cardiology, cancer and hematology, dermatology, developmental pediatrics, diabetes and endocrinology, gastroenterology, hepatology and nutrition, genetics, infectious disease, neurology, neurosurgery, ophthalmology, orthopedics, otolaryngology, pediatric and adolescent gynecology, pediatric surgery, plastic surgery, psychiatry, psychology, pulmonology, rheumatology, sports medicine and urology. Hospital facilities include 25 emergency center rooms, 74 outpatient rooms, five radiology rooms, four operating rooms and 46 acute care beds, 14 pediatric intensive care and 14 neonatal intensive care beds with plans allowing for expansion up to 200 beds. Additional hospital services include: radiology, pathology, sleep center, infusion center, helipad access, audiology, cardiac stress tests, echosonography, pulmonary diagnostics, developmental physical, occupational and speech therapy and sports physical therapy as well as motion gait analysis and fetal medicine testing. Along with serving families throughout The Woodlands area, the Hospital serves families throughout Greater North Houston and north of Houston including Montgomery, Angelina, Walker, Brazos, Grimes, Madison, Liberty, Harris, Polk, San Jacinto, Trinity and Hardin counties. b. In 2019, our $350 million expansion, the Lester and Sue Smith Legacy Tower, completed its first full year operation. The Hospital's new home for surgery, critical care and Texas Children's Heart Center was designed to help meet the increasing demand for the highly-specialized, critical and medically-complex pediatric care that few centers in the country can provide. It enhances patient care by giving caregivers and families in critical and progressive care areas much-needed additional space. The tower houses a 130-bed intensive care unit, new operating rooms with the latest technology and a cardiovascular intensive care unit. (SEE CONTINUATION OF PART VI, LINE 5) Schedule H, Part VI, Line 6 Affiliated health care system The Hospital is affiliated with Texas Children's Pediatrics (TCP, EIN 76-0460242) in promoting health care in the community served. TCP is one of the nation's largest pediatric primary care networks. With 51 practices in the Greater Houston area, 7 in Austin, and 1 in College station, TCP pediatricians serve approximately 25 percent of Houston's children, helping treat and prevent infectious illnesses. Seven TCP practices, identified as the Community Cares Program, are located in medically underserved neighborhoods and provide consistent care for little or no cost to more than 36,000 children who otherwise would seek services from emergency rooms or go without care. In addition to providing high quality, affordable primary care, each Community Cares practice is uniquely designed to meet the needs of the diverse communities they serve. Using the medical home model of care, we provide: wrap-around services that eliminate logistical, cultural and social barriers to access care; counseling and educational services with emphasis on risk behaviors; on-site social workers and specialists who provide assistance signing up for Medicaid/CHIP or other Affordable Care Act providers; partnerships with local dentists, pharmacies and other services to ensure comprehensive affordable health care is provided; extra support and guidance for parents to promote total health and well-being of children. In addition to providing care to children in our community during normal business hours, TCP through its subsidiary, Texas Children's Urgent Care (TCUC, EIN 47-2029489), provides urgent care when kids get sick at night or on the weekends. As of the end of 2019, there were eleven TCUC sites around the greater Houston area and one location in South Austin. These sites provide families with convenient access to care when it is needed most, and saves them time and money from seeking out inappropriate use of emergency center care. Two of our busiest locations are located adjacent to our Medical Center EC and West Camps EC. These locations have helped redirect patients to seeking care in a more appropriate setting, as well as reducing the cost of care from the patient side. The impact has been tremendous on reducing the low acuity visits being treated in our Emergency Center. Texas Children's Health Plan (TCHP, EIN 76-048264) is the largest and most frequently selected provider of Children's Medicaid/CHIP coverage in the region. TCHP was founded in 1996 by Texas Children's Hospital making it the nation's first health maintenance organization (HMO) created just for children. Through a contractor role with the Texas Health and Human Services Commission (HHSC), Texas Children's Health Plan provides STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens and children in Houston and surrounding areas. Starting in November 2016, Texas Children's Health Plan also provides STAR Kids to children and young adults under the age of 21 with disabilities. As of September 2019, the Health Plan has over 425,000 members. The staff and network of over 4,300 primary care physicians, 6,800 specialists and 118 hospitals that provide acute care and inpatient and outpatient behavioral health and substance abuse treatment are committed to providing excellent service and patient care to TCHP members. The Hospital is Baylor College of Medicine's primary pediatric training hospital, with one of the largest pediatric residency programs in the country. The hospital's medical staff consists of more than 1,700 board-certified, primary care physicians, pediatric subspecialists and pediatric-surgical subspecialists. Together, the Hospital and Baylor College of Medicine represent one of the most active and best funded pediatric research programs in the country. Baylor College of Medicine investigators at the Hospital are conducting innovative research in nearly every pediatric subspecialty with the goal of quickly translating discoveries into breakthrough treatments for children everywhere. Schedule H, Part VI, Line 7 State filing of community benefit report TX true AADE - American Association of Drilling Engineers Houston Chapter P O Box 107 Houston TX 77001 760485105 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG ACHA - Adult Congenital Heart Association 280 North Providence Rd Ste 6 Media PA 19063 043447959 501(C)(3) 12500 SUPPORT NON-PROFIT HEALTHCARE ORG AIDS FOUNDATION HOUSTON 3202 WESLAYAN ANNEX HOUSTON TX 77027 760073661 501(C)(3) 25000 SUPPORT NON-PROFIT HEALTHCARE ORG Air Alliance Houston 3914 Leeland St Houston TX 77003 760461030 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG American Heart Association 10060 Buffalo Speedway Houston TX 770541302 135613797 501(C)(3) 18100 SUPPORT NON-PROFIT HEALTHCARE ORG Astros Golf Foundation 501 Crawford St Ste 500 Houston TX 77002 831791157 501(C)(3) 115000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Be An Angel 2003 Aldine Bender Houston TX 77032 760262730 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Big Love Cancer Care P O Box 90818 Austin TX 78709 208516221 501(C)(3) 15000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Brookwood Community 1752 FM 1489 Brookshire TX 77423 741587672 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Candlelighters Childhood Cancer Family Alliance 12919 Southwest Freeway Ste 100 Stafford TX 77477 760367440 501(C)(3) 11200 SUPPORT NON-PROFIT PHILANTHROPIC ORG Center for Public Policy Priorities 7020 Easy Wind Drive Ste 200 Austin TX 78752 742898197 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Championship Hearts Foundation 8310 Shoregrove Dr Humble TX 77346 811986712 501(C)(3) 5000 SUPPORT NON-PROFIT HEALTHCARE ORG Chance For Hope Foundation P O Box 842044 Pearland TX 77584 465359628 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Children At Risk 2900 Weslayan Ste 400 Houston TX 77027 760360533 501(C)(3) 30000 SUPPORT NON-PROFIT PHILANTHROPIC ORG CHILDRENS ASSESSMENT CENTER FOUNDATION 2500 Bolsover Houston TX 77005 760458780 501(C)(3) 52500 SUPPORT NON-PROFIT PHILANTHROPIC ORG Children's Defense Fund 840 First St NE Suite 300 Washington DC 20002 520895622 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG CHILDRENS MUSEUM INC 950 Trout Brook Drive West Hartford CT 06119 060896043 501(C)(3) 75000 SUPPORT NON-PROFIT PHILANTHROPIC ORG DePelchin's Children Center 4950 Memorial Drive Houston TX 77007 760318867 501(C)(3) 7500 SUPPORT NON-PROFIT PHILANTHROPIC ORG Easter Seals Greater Houston 4500 BISSONNET SUITE 340 Bellaire TX 774013006 741238418 501(C)(3) 5000 SUPPORT NON-PROFIT HEALTHCARE ORG Epilepsy Foundation 2401 Fountainview Suite 900 Houston TX 77057 742141084 501(C)(3) 8500 SUPPORT NON-PROFIT PHILANTHROPIC ORG FAITH Fighting Cancer P O Box 445 Conroe TX 77305 272274753 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Fore The Cure 9568 Doliver Dr Houston TX 770631011 472874715 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG GiGi's Playhouse 2350 W Higgins Rd Hoffman Est IL 60169 462014837 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Girl Scouts 12012 Park Thirty-Five Circle Austin TX 78753 741109644 501(C)(3) 27500 SUPPORT NON-PROFIT PHILANTHROPIC ORG Good Samaritan Foundation 3355 W ALABAMA STREET SUITE 1025 HOUSTON TX 77098 741235398 501(C)(3) 5131 SUPPORT NON-PROFIT PHILANTHROPIC ORG Harrison's Heroes 10921 Roaring Brook Ln Houston TX 770246837 474958602 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Heart Heroes 610 S Pinckney St Elk Point SD 57025 834138370 501(C)(3) 15000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Houston Alumnae Chapter of Kappa Alpha Theta 5868 A-1 Westheimer Rd 302 Houston TX 770575641 501(C)(6) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Houston Children's Charity 230 Westcott St Houston TX 77007 760135741 501(C)(3) 10170 SUPPORT NON-PROFIT PHILANTHROPIC ORG HOUSTON DEFENDER NEWSPAPER INC 12401 South Post Oak Houston TX 77045 760238885 25000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Houston Pi Beta Phi 9668 Westheimer Rd Ste 200 95 Houston TX 77063 760438662 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Humble ISD Education Foundation P O Box 2000 Humble TX 77347 760608461 501(C)(3) 15000 SUPPORT NON-PROFIT EDUCATIONAL ORG IMMUNIZATION PARTNERSHIP P O Box 5168 Katy TX 77491 760695612 501(C)(3) 40000 SUPPORT NON-PROFIT PHILANTHROPIC ORG TCH Pediatric Associates Inc P O Box 300630 Houston TX 772300630 760460242 501(C)(3) 6999998 SUPPORT NON-PROFIT PHILANTHROPIC ORG INSTITUTE FOR SPIRITUALITY AND HEALTH 8100 Greenbriar Houston TX 77054 741246255 501(C)(3) 100000 SUPPORT NON-PROFIT EDUCATIONAL ORG JUNIOR LEAGUE OF HOUSTON 1811 Briar Oaks Lane HOUSTON TX 77027 741185659 501(C)(3) 115000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Kinder Institute 2479 Aloma Avenue Winter Park FL 32792 262620015 501(C)(3) 10000 SUPPORT NON-PROFIT EDUCATIONAL ORG Leaping Butterfly Ministry 30 Kingscote Way The Woodlands TX 77382 455343705 501(C)(3) 25000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Lifeline Chaplaincy 1415 Southmore Blvd Houston TX 77004 760504483 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG MAKE A WISH FOUNDATION OF THE TEXAS GULF 12625 SOUTHWEST FREEWAY STAFFORD TX 77477 760116615 501(C)(3) 25000 SUPPORT NON-PROFIT PHILANTHROPIC ORG MARCH OF DIMES 3000 WESLAYAN SUITE 100 HOUSTON TX 77027 131846366 501(C)(3) 55000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Mental Health America of Greater Houston 2211 Norfolk Houston TX 77098 741272394 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Moebius Syndrome Foundation P O Box 147 Pilot Grove MO 65276 133753992 501(C)(3) 12000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Mothers Against Cancer P O Box 5103 Kingwood TX 77325 760324101 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG National Hemophilia Foundation - Lone Star Chapter of the National Hemophil ia Foundation 5600 Northwest Central Road Ste 140 Houston TX 77092 760661966 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG National Multiple Sclerosis Society 733 THIRD AVENUE 3RD FLOOR NEW YORK NY 10017 135661935 501(C)(3) 15000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Rise School 5618 H MarkCrosswell Jr St Houston TX 77021 760606866 501(C)(3) 10000 SUPPORT NON-PROFIT EDUCATIONAL ORG Ronald McDonald House Houston 1907 HOLCOMBE BLVD HOUSTON TX 77030 741984499 501(C)(3) 65000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Rotary International in the Woodlands P O Box 7353 The Woodlands TX 77387 510136532 501(C)(3) 25000 SUPPORT NON-PROFIT PHILANTHROPIC ORG SEARCH - Houston without Homeless 2015 Congress Avenue Houston TX 77002 760260403 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Shlenker School 5524 Dayna Court New Orleans LA 70124 760686559 501(C)(3) 10000 SUPPORT NON-PROFIT EDUCATIONAL ORG Sky High 9800 Richmond Ave Ste 335 Houston TX 77042 260465972 501(C)(3) 20000 SUPPORT NON-PROFIT PHILANTHROPIC ORG Social Motion 10694 Haddington Ste G Houston TX 77043 474785251 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG TEACH - To Educate All Children 2900 Weslayan Ste 375 Houston TX 77027 202425139 501(C)(3) 5000 SUPPORT NON-PROFIT EDUCATIONAL ORG Texans Care for Children 1106 Clayton Lane Austn TX 78723 752687008 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG TEXAS A & M RESEARCH FOUNDATION 400 HARVEY MITCHELL PKWAY NO 300 COLLEGE STATION TX 77845 741238434 501(C)(3) 10000 SUPPORT NON-PROFIT EDUCATIONAL ORG Texas Southern Foundation 3100 Cleburne St Hannah Hall Houston TX 77004 741620415 501(C)(3) 10000 SUPPORT NON-PROFIT EDUCATIONAL ORG THE BALLARD HOUSE 1420 7th Avenue North Birmingham AL 35203 453971768 501(C)(3) 15000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Cure Starts Now 10280 Chester Road Cincinnati OH 45215 260269131 501(C)(3) 15000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Greater Houston Partnership 701 Avenida De Las America Ste 9 Houston TX 77010 208179135 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Health Museum 1515 Hermann Dr Houston TX 77004 746106357 501(C)(3) 20000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Living Bank 4545 Post Oak Pl Dr 340 Houston TX 77027 741607315 501(C)(3) 10000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Periwinkle Foundation 3000 Richmond Ave Suite 340 Houston TX 77098 760093914 501(C)(3) 25000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Rose 12700 N Featherwood Ste 260 Houston TX 77034 760193812 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG The Stacey and Bo Porter Self Foundation P O Box 16751 Sugarland TX 77496 455619988 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG UNITED STATES FUND FOR UNICEF 125 MAIDEN LANE NEW YORK NY 10038 131760110 501(C)(3) 5000 SUPPORT NON-PROFIT PHILANTHROPIC ORG University of Texas Health Science Center at Houston (UTHealth) 7000 FANNIN STREET SUITE 1200 HOUSTON TX 77226 741761309 GOVT 55000 SUPPORT NON-PROFIT MEDICAL SCHOOL West Houston Leadership Institute 10370 Richmond Ave Suite 125 Houston TX 77042 204314065 501(C)(3) 5010 SUPPORT NON-PROFIT EDUCATIONAL ORG YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE GREATER HOUSTON AREA 2600 North Loop West Houston TX 77092 741109737 501(C)(3) 75000 SUPPORT NON-PROFIT PHILANTHROPIC ORG 69 2 FELLOWSHIPS 5 525000 SCHOLARSHIPS 6 18000 Schedule I, Part I, Line 1 DESCRIPTION OF GRANT SELECTION CRITERIA TEXAS CHILDREN'S HOSPITAL REQUIRES ALL REQUESTS TO BE IN WRITING AND BE SUBMITTED TO THE OFFICE OF DEVELOPMENT FOR EVALUATION. THE DIRECTOR OF DEVELOPMENT MAKES A RECOMMENDATION FOR RECOGNITION OF EACH CONTRIBUTION TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF TEXAS CHILDREN'S HOSPITAL FOR FINAL APPROVAL. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. AFTER THE SPONSORSHIP/DONATION IS MADE, WE RECEIVE AN ACKNOWLEDGMENT LETTER WITH A RECEIPT OF THE GIFT. TYPICALLY THIS LETTER TELLS US HOW THE MONEY WILL BE USED AT THEIR PARTICULAR ORGANIZATION. X X X X false true false false false false false false false Dan DiPrisco SCHEDULE O 478183 0 519500 0 9224 0 105355 0 18651 0 1130913 0 0 0 Weldon Gage SCHEDULE O 723323 0 744500 0 24594 0 159130 0 27897 0 1679444 0 0 0 Mark Mullarkey SCHEDULE O 555930 0 670300 0 117811 0 125407 0 37488 0 1506936 0 114407 0 Michelle Riley-Brown SCHEDULE O 631681 0 715000 0 41855 0 143622 0 45804 0 1577962 0 37123 0 Mark A Wallace Schedule O 1824913 0 4606723 0 349643 0 623980 0 33396 0 7438655 0 2080523 0 Charles D Fraser Jr MD FORMER BOARD MEMBER 525000 0 0 0 0 0 0 0 0 0 525000 0 0 0 George Bisset III MD FORMER BOARD MEMBER 0 247196 0 0 0 100612 0 7798 0 7449 0 363055 0 0 Mary Jo Andre Schedule O 416085 0 441600 0 383394 0 93412 0 31920 0 1366411 0 358552 0 Thierry Huisman MD BOARD MEMBER 0 198653 0 100000 0 24378 0 7072 0 9564 0 339667 0 0 Angelo P Giardino MD PHD FORMER BOARD MEMBER 222308 0 0 0 165907 0 24547 0 6072 0 418834 0 133017 0 Aisha Jamal Assistant Secretary 157564 0 14300 0 1034 0 14274 0 12942 0 200114 0 0 0 Mallory Caldwell SENIOR VICE PRESIDENT 117446 0 0 0 171336 0 87444 0 10465 0 386691 0 0 0 Tabitha Rice Senior Vice President 397046 0 380800 0 68111 0 80601 0 34516 0 961074 0 64942 0 Ivett Shah VICE PRESIDENT 297767 0 54800 0 11025 0 57664 0 6929 0 428185 0 0 0 Matthew Girotto Senior Vice President 329358 0 355400 0 54443 0 68700 0 37334 0 845235 0 33771 0 Linda Aldred Senior Vice President 507210 0 514400 0 97580 0 113592 0 37642 0 1270424 0 69502 0 MYRA L DAVIS SENIOR VICE PRESIDENT 574921 0 543400 0 73948 0 120812 0 28953 0 1342034 0 50302 0 Stanley Spinner MD Vice President 338471 0 362700 0 76165 0 32986 0 29711 0 840033 0 0 0 Kay Tittle Vice President 599274 0 574400 0 532719 0 33268 0 17265 0 1756926 0 74339 0 Lance Lightfoot SENIOR VICE PRESIDENT 559496 0 554400 0 91339 0 118622 0 32643 0 1356500 0 68776 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 457(F) PLAN: PAID/DEFERRED DAN DIPRISCO 519,500 / 80,388 WELDON GAGE 744,500 / 137,500 MARK MULLARKEY 784,707 / 98,780 MICHELLE RILEY-BROWN 752,123 / 115,500 MARK A. WALLACE 4,638,133 / 0 MARY JO ANDRE 800,152 / 61,630 TABITHA RICE 445,742 /52,500 IVETT SHAH 54,800 / 34.300 MATTHEW GIROTTO 389,171 / 42,500 LINDA ALDRED 583,902 / 80,200 MYRA L. DAVIS 593,702 / 93,760 KAY TITTLE 1,072,401 / 0 STANLEY SPINNER 408,549 / 0 LANCE LIGHTFOOT 623,176 / 90,900 ANGELO P. GIARDINO 133,017 / 0 THIERRY HUISMAN, M.D. 0 / 1,412 GEORGE BISSETT, III M.D. 4,125 / 0 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED AISHA JAMAL 14,300 / 0 457(F): THE 457(F) PLAN IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO RECEIVE SUPPLEMENTAL EXECUTIVE RETIREMENT INCOME. FUNDS MAY BE CREDITED INTO THIS ACCOUNT FROM AN EMPLOYER CONTRIBUTION, CALCULATED BASED ON AN INDIVIDUAL'S TITLE AND BASE SALARY AS OF JANUARY 1. THESE EMPLOYER FUNDED CONTRIBUTIONS VEST THE EARLIER OF FIVE YEARS, OR THE ATTAINMENT OF AGE 60 AND 75-POINTS DETERMINED AS OF THEIR AGE AND YEARS OF SERVICE. THE 457(F) PLAN ALSO CONTAINS RESIDUAL LONG-TERM INCENTIVE PLAN CONTRIBUTIONS AND CAPITAL ACCUMULATION CONTRIBUTIONS FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THE LONG-TERM INCENTIVE CONTRIBUTIONS VEST AFTER THREE YEARS AND THE CAPITAL ACCUMULATION CONTRIBUTIONS VEST AFTER 5 YEARS IN THE PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND/OR YEAR. A HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO 760337885 414009DY3 2010-01-15 80078929 REFUND PRIOR ISSUES (1999B-2 SERIES ISSUED 07/20/99). true false false B HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO 760337885 414009CG3 2009-06-17 198965284 BUILD HEALTH CARE FACILITIES true false false C HARRIS COUNTY HEALTH FACILITIES DEVELOPMENT CO 521284201 414152RW0 2008-04-30 300000000 REFUND PRIOR ISSUES (2007 SERIES ISSUED 06/27/07) false false false D HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO 760337885 414009JX9 2015-06-30 225732600 REFUND AND REDEEM PRIOR ISSUES (1999B-1 SERIES ISSUED 07/20/99) AND BUILD HEALTH CARE FACILITIES false false false A 26540000 51670000 80078929 0 0 0 1278929 0 0 0 78800000 0 2010 true false true true B 77230000 122770000 199780590 0 0 0 3311550 0 0 196469040 0 0 2011 false false true true C 108550000 0 300000000 0 0 0 0 0 0 0 300000000 0 2011 true false true true D 20310000 0 225843941 0 3839429 0 1825784 0 0 97078729 123100000 0 2018 true false true true A 0.0 0.0 0.0 B false false true true false 0.009 0.0 0.009 false false true C false true true true false 0.005 0.0 0.005 false false true D false false false false 0.0 0.0 0.0 false false true A false false true false false false false false true B false false true false false false false false true C false false true false true false false false true D false true false false false false false false true A true B true C true D true Schedule K, Part VI Explanation for variance THE VARIANCE BETWEEN PART I, COLUMN (E) AND PART II, LINE 3 FOR ALL ISSUES INCLUDE INVESTMENT EARNINGS. A HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO 760337885 414009KB5 2015-06-03 50000000 BUILD HEALTH CARE FACILITIES false false false B HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO 760337885 NONEAVAIL 2015-07-16 100000000 BUILD HEALTH CARE FACILITIES false false false C Harris County Cultural Education Facilities FIN CO 760337885 414009KC3 2015-06-03 110000000 BUILD HEALTH CARE FACILITIES false false false D HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO 760337885 414009LJ7 2019-07-10 179636388 DEFEASANCE AND SUBSEQUENT REFUNDING OF PRIOR ISSUES (2009 & 2010 SERIES) false false false A 0 0 50158367 0 369684 0 436586 0 0 49352097 0 0 2018 false false true true B 2575000 0 100911324 0 1779231 0 63000 0 0 99069093 0 0 2018 false false true true C 0 0 110637440 0 666579 0 783455 0 0 109187406 0 0 2018 false false true true D 179636388 178136681 1499707 2019 true false true true A false false true false false 0.0 0.0 0.0 false false true B false false true false false 0.0 0.0 0.0 false false true C false false true false false 0.0 0.0 0.0 false false true D false false false false 0.0 0.0 0.0 false false true A false true false false true false false false true B false true false false true false false false true C false true false false true false false false true D false false false false false false false false true A true B true C true D true A HARRIS COUNTY CULTURAL FACILITIES FIN CO 760337885 414009MAS 2019-07-10 92175560 REFUND PRIOR ISSUE (2008-3 SERIES ISSUED 4/30/2008) false false false A 92175560 675560 91500000 2019 true false true true A false false false false 0.0 0.0 0.0 false false true A false false false false false false true A true X 1 2500 Market value X 134451 Market value X 14 1346882 Other X 15 80276 Cost X EQUIPMENT 19 166350 Cost X TICKETS AND CERTIFICATES 24 148738 Cost X TOYS 6 311490 NONE 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Securities - Publicly traded - COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Food inventory - COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Other - EQUIPMENT - COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Other - TICKETS AND CERTIFICATES - COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Form 990, Part VI, Line 1a Texas Children's is the parent entity of Texas Children's Hospital. Texas Children's board of directors retains significant reserved authorities (detailed in Part VI, Line 7b below) that allow it to provide strategic oversight and direction to Texas Children's Hospital and its affiliated entities. Texas Children's board is representative of the community served and is composed of 35 individuals, 34 of which are independent. Form 990, Part VI, Line 6 Classes of members or stockholders Texas Children's is the sole corporate member of Texas Children's Hospital. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Texas Children's annually appoints the Organization's board of directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PER THE ORGANIZATION'S BYLAWS THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER, APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER, OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIC FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION OF THE OFFICERS, PHYSICIAN EMPLOYEES AND INDEPENDENT CONTRACTOR PHYSICIANS OF THE CORPORATION. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL OR STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS. -DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBERS. -TAKE ANY ACTION WHICH WOULD BE INCONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body No such committees exist. Form 990, Part VI, Line 11b Review of form 990 by governing body Per a resolution approved by the member's board of directors, the member board's audit and compliance committee has Delegated authority to review the organization's completed Form 990 prior to filing. Following the committee's Review, the completed Form 990 is distributed to the members of the organization's board of directors prior to filing with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS - PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION ( RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC. ) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS/KEY EMPLOYEES - PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE ANNUAL PROCESS FOR DETERMINING COMPENSATION INCLUDES: - REVIEW AND APPROVAL BY GOVERNING BODY AND COMPENSATION COMMITTEE, PROVIDED THAT PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE WERE NOT INVOLVED. - COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. - CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION AGREEMENT. Form 990, Part VI, Line 15b Process to establish compensation of other employees Please refer to process described in Part VI, Line 15a. Form 990, Part VI, Line 19 Required documents available to the public ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VII, Section A TITLES DAN DIPRISCO: EXECUTIVE VICE PRESIDENT AND BOARD MEMBER WELDON GAGE: CFO, EXECUTIVE VICE PRESIDENT, AND BOARD TREASURER MARK MULLARKEY: EXECUTIVE VICE PRESIDENT AND BOARD MEMBER MICHELLE RILEY-BROWN: EXECUTIVE VICE PRESIDENT AND BOARD MEMBER MARK A WALLACE: CEO, PRESIDENT AND BOARD CHAIRMAN MARY JO ANDRE: SENIOR VICE PRESIDENT, CNO AND BOARD MEMBER Form 990, Part VII, Section A INCENTIVE COMPENSATION DRS. ANDROPOULOS, BELFORT, KLINE, VERSALOVIC, FRASER, AND HOLLIER WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVE(D) AS IN-CHIEFS DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO THEIR SENIOR LEADERSHIP ROLES, THEY ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THEIR CONTRIBUTIONS TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN THEIR CAPACITY AS PHYSICIAN LEADERS. Form 990, Part VIII, Line 2f Other Program Service Revenue SETTLEMENT - Total Revenue: 15149628, Related or Exempt Function Revenue: 15149628, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; INDIRECT AFFILIATE REVENUE - Total Revenue: 10761314, Related or Exempt Function Revenue: 10761314, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; OTHER - Total Revenue: 7568108, Related or Exempt Function Revenue: 7568108, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees HEALTHCARE PROFESSIONAL SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: , Fundraising Expenses: ; OTHER NON-HEALTHCARE PROFESSIONAL SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: 82424765, Management and General Expenses: 19607885, Fundraising Expenses: 1033124; Form 990, Part XI, Line 9 Other changes in net assets or fund balances ACTUARIAL LOSS ON PENSION - -75932605; CHANGE IN BENEFICIAL INTEREST IN FOUNDATION - 41605155; CHANGE IN BENEFICIAL INTEREST IN AFFILIATES - 8630; CHANGE IN CHARITABLE GIFT ANNUITY - -38755; CHANGE IN SWAP VALUATION - -29377294; CHANGE IN TECO VALUATION - -25270; TRANSFER FROM FOUNDATION - 11798342; TRANSFER TO TCH PEDIATRIC ASSOCIATES - -1662215; Loss on Bond Defeasance - -4667226; DUE TO TEXAS CHILDREN'S HOSPITAL FROM CAIN FOUNDATION - -3342796; DESIGNATED ASSETS RELEASED FOR EQUIPMENT - 2190756; SCHEDULE O FORM 5471 DISCLOSURE STATEMENT UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN: 20-2380599 6621 FANNIN ST HOUSTON, TX 77030 TEXAS CHILDREN'S WOMEN'S SPECIALISTS PO BOX 300630 HOUSTON TX 77230 261482195 HEALTH CARE TX 501(c)(3) Type II TEXAS CHILDREN'S true TEXAS CHILDREN'S 1919 S BRAESWOOD 4TH FL HOUSTON TX 77030 760461578 PARENT TX 501(c)(3) Type II NA false TEXAS CHILDREN'S PHYSICIAN GROUP 6621 FANNIN STREET HOUSTON TX 77030 260834681 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S true TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON TX 77230 760460242 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S true TEXAS CHILDREN'S HEALTH PLAN 6330 WEST LOOP SOUTH SUITE 800 8TH FLOOR BELLAIRE TX 77401 760486264 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON TX 77030 202380599 SUPPORTING ORG TX 501(c)(3) Type II TEXAS CHILDREN'S true TEXAS CHILDREN'S HEALTH PLAN - THE CENTER 6621 FANNIN STREET HOUSTON TX 77030 461392824 HEALTH CARE TX 501(c)(3) Type I TEXAS CHILDREN'S HEALTH PLAN INC true TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 472029489 HEALTH CARE TX 501(c)(3) 10 TCH PEDIATRIC ASSOCIATES INC true THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON TX 77046 760246858 SUPPORTING ORG TX 501(c)(3) Type I TEXAS CHILDREN'S HOSPITAL true CORDILLERA PRIMARY WAVE CO-INVESTMENT FUND LP 3000 SAND HILL ROAD BLDG 3 STE 100 MENLO PARK CA 94025 821568240 INVESTMENT CA NA N/A TCH INSURANCE COMPANY LTD 23 LIME TREE BAY AVENUE GRAND CAYMAN CJ KY11102 980176652 INSURANCE CJ NA C Corporation true CVI GVF HOLDINGS 3 LTD UGLAND HOUSE SOUTH CHURCH STREET GEORGE TOWN CJ KY11104 981078282 INVESTMENT CJ NA C Corporation true false true true false false false false false false false false true true true true false true true true TEXAS CHILDREN'S HEALTH PLAN L 8603043 COST TEXAS CHILDREN'S HEALTH PLAN N 31534704 COST TEXAS CHILDREN'S HEALTH PLAN Q 1230533 COST TEXAS CHILDREN'S HEALTH PLAN L 436327760 COST TEXAS CHILDREN'S HEALTH PLAN R 60000000 COST TEXAS CHILDREN'S WOMEN'S SPECIALISTS L 702115 COST TCH PEDIATRIC ASSOCIATES INC L 3099996 COST TCH PEDIATRIC ASSOCIATES INC B 6999998 COST TCH PEDIATRIC ASSOCIATES INC R 120896 COST TCH PEDIATRIC ASSOCIATES INC Q 30000000 COST TEXAS CHILDREN'S PHYSICIAN GROUP Q 1177902 COST TEXAS CHILDREN'S PHYSICIAN GROUP R 230566588 COST TEXAS CHILDREN'S HOSPITAL FOUNDATION S 11798342 COST TCH INSURANCE COMPANY LTD S 8000000 COST TCH INSURANCE COMPANY LTD Q 6694534 COST TEXAS CHILDREN'S URGENT CARE B 89910 COST THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION C 1380911 COST