2019-04-12T13:09:17-05:00 2018-06-30 861065772 DELOITTE TAX LLP 1033 DEMONBREUN SUITE 400 NASHVILLE TN 37203 990 2017-07-01 620646012 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC STJU 9015953903 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 PAT KEEL SVP AND CFO 9015953903 2019-04-12 1 FRANCIS J BEDARD P00752421 6152591800 167.219.88.229 2019-04-12 12:59:26 ED P 81DE22CF9F7F0862406D1A466D95956A5FFF36F5 7976E27EA537A2528AFD4534CEC7185AB37FE28A 2017 2019-02-21 02:37:17Z JAMES R DOWNING 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 988538801 0 X WWW.STJUDE.ORG X 1959 TN THE MISSION OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S ABILITY TO PAY. 43 41 5185 3950 0 138854 753145680 851803301 124099314 117420862 -1169284 -7463705 24726224 18895861 900801934 980656319 4956619 4312073 0 0 462005025 505567014 0 0 0 390060200 440836545 857021844 950715632 43780090 29940687 4787635534 5434170902 127718358 131298150 4659917176 5302872752 X THE MISSION OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S ABILITY TO PAY. 0 0 457825537 4160447 113179305 PATIENT CARE: THE HOSPITAL PROVIDED 19,202 INPATIENT DAYS OF CARE DURING THE YEAR. OUR BONE MARROW TRANSPLANTATION PROGRAM ACCOUNTED FOR 4,407 OR 23% OF THOSE INPATIENT DAYS. PATIENTS MADE 79,024 CLINIC VISITS DURING THE YEAR. 410716516 146126 RESEARCH: THE CURRENT BASIC SCIENCE AND CLINICAL RESEARCH AT THE HOSPITAL INCLUDES WORK IN GENE THERAPY, CHEMOTHERAPY, THE BIOCHEMISTRY OF NORMAL AND CANCEROUS CELLS, RADIATION TREATMENT, BLOOD DISEASES, RESISTANCE TO THERAPY, VIRUSES, HEREDITARY DISEASES, INFLUENZA, PEDIATRIC AIDS AND PHYSIOLOGICAL EFFECTS OF CATASTROPHIC ILLNESSES. 21767276 5500 EDUCATION AND TRAINING: AS PART OF ITS MISSION, THE HOSPITAL HAS DEVELOPED A GLOBAL INITIATIVE (ST. JUDE GLOBAL) TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE GLOBAL ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, HELPING TO IMPLEMENT NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND DEVELOPING REGIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THIS MISSION WILL BE ACHIEVED BY FOCUSING ON THREE OVERRIDING GOALS: (1) TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION, (2) TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES, AND (3) TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE. THESE INITIATIVES ARE SPEARHEADED BY ST. JUDE EXPERTS WHO WORK CLOSELY WITH HEALTHCARE PROFESSIONALS AT OUR PARTNER SITES. IN ADDITION, A GRADUATE PROGRAM IS OFFERED THROUGH A WHOLLY-OWNED SUBSIDIARY, ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, LLC, TO EDUCATE AND TRAIN FUTURE GENERATIONS OF SCIENTISTS SEEKING TO UNDERSTAND THE MOLECULAR BASIS OF HUMAN DISEASE AND DEVELOP NOVEL THERAPIES BASED ON THAT UNDERSTANDING. 890309329 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 0 1 1394 0 1 5185 1 1 1 0 0 0 0 0 0 0 0 0 X 43 41 1 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 TN X X SHARON HENDRIX 9015953903 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 JOYCE ABOUSSIE VOTING DIRECTOR 4.00 4.00 X 0 0 0 SUSAN MACK AGUILLARD MD VOTING DIRECTOR 8.00 4.00 X 0 0 0 MAHIR AWDEH MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 JOSEPH S AYOUB JR ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL J AYOUB ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 FREDERICK M AZAR MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 JAMES B BARKATE VOTING DIRECTOR 4.00 8.00 X 0 0 0 MARTHA PERINE BEARD VOTING DIRECTOR 4.00 8.00 X 0 0 0 SHERYL BOURISK VOTING DIRECTOR 4.00 4.00 X 0 0 0 ROBERT A BREIT MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 TERRY BURMAN VOTING DIRECTOR 4.00 4.00 X 0 0 0 ANN M DANNER VOTING DIRECTOR 4.00 4.00 X 0 0 0 JOSEPH M DEVIVO VOTING DIRECTOR 4.00 4.00 X 0 0 0 FRED P GATTAS III PHARMD VOTING DIRECTOR 4.00 4.00 X 0 0 0 RUTH GAVIRIA VOTING DIRECTOR 4.00 4.00 X 0 0 0 CHRISTOPHER GEORGE MD VOTING DIRECTOR 8.00 4.00 X 0 0 0 JUDY HABIB VOTING DIRECTOR 4.00 8.00 X 0 0 0 GABRIEL GABY HADDAD MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL K HAJAR VOTING DIRECTOR 4.00 4.00 X 0 0 0 CHUCK HAJJAR VOTING DIRECTOR 4.00 4.00 X 0 0 0 FOUAD HAJJAR MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 FREDERICK R HARRIS JR MD VOTING DIRECTOR 4.00 4.00 X 0 0 0 BRUCE B HOPKINS VOTING DIRECTOR 4.00 4.00 X 0 0 0 J DAVID KARAM II VOTING DIRECTOR 4.00 4.00 X 0 0 0 SHARON L MCCOLLAM VOTING DIRECTOR 4.00 4.00 X 0 0 0 MICHAEL D MCCOY VOTING DIRECTOR 4.00 4.00 X 0 0 0 ROBERT T MOLINET ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 RAMZI NUWAYHID VOTING DIRECTOR 4.00 4.00 X 0 0 0 THOMAS PENN III VOTING DIRECTOR 4.00 4.00 X 0 0 0 CHRISTINA M RASHID VOTING DIRECTOR 4.00 4.00 X 0 0 0 CAMILLE F SARROUF JR ESQ VOTING DIRECTOR 8.00 4.00 X 0 0 0 JOSEPH C SHAKER VOTING DIRECTOR 4.00 4.00 X 0 0 0 JOSEPH G SHAKER VOTING DIRECTOR 4.00 4.00 X 0 0 0 GEORGE A SIMON II VOTING DIRECTOR 4.00 4.00 X 0 0 0 MICHAEL SIMON VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL J SIMON VOTING DIRECTOR 4.00 4.00 X 0 0 0 TONY THOMAS VOTING DIRECTOR 4.00 4.00 X 0 0 0 RICHARD M UNES VOTING DIRECTOR 4.00 4.00 X 0 0 0 PAUL H WEIN ESQ VOTING DIRECTOR 4.00 4.00 X 0 0 0 THOMAS WERTZ VOTING DIRECTOR 4.00 4.00 X 0 0 0 TAMA ZAYDON VOTING DIRECTOR 4.00 4.00 X 0 0 0 RICHARD SHADYAC JR EX-OFFICIO DIRECTOR 1.00 55.00 X 0 794032 99557 JAMES R DOWNING PRESIDENT/CEO 55.00 1.00 X X 1058448 0 144500 PATRICIA A KEEL SVP/CFO 55.00 0.00 X 633157 0 84957 JAMES I MORGAN EVP/SCIENTIFIC DIRECTOR 55.00 0.00 X 540847 0 57000 ELLIS NEUFELD EVP/CLINICAL DIRECTOR 55.00 0.00 X 811492 0 117999 MARY ANNA QUINN EVP/CHIEF ADMIN OFFICER 55.00 0.00 X 445639 0 399741 CHARLES M ROBERTS EVP/DIRECTOR CANCER CENTER 55.00 0.00 X 780623 0 163941 CARLOS RODRIGUEZ-GALINDO EVP/CHAIR 55.00 0.00 X 602659 0 146198 ANDREW DAVIDOFF CHAIR 55.00 0.00 X 1304122 0 61557 CHARALAMPOS KALODIMOS CHAIR 55.00 0.00 X 862969 0 21036 THOMAS E MERCHANT CHAIR 55.00 0.00 X 822323 0 67616 RAUL C RIBEIRO FACULTY 55.00 0.00 X 974588 0 42061 STEPHEN W WHITE CHAIR 55.00 0.00 X 809046 0 103615 WILLIAM E EVANS FACULTY/FORMER PRESIDENT/CEO 55.00 0.00 X 681292 0 41198 10327205 794032 1550976 887 1 1 0 FLINTCO LLC 2179 HILLSHIRE CIRCLE MEMPHIS TN 38133 CONSTRUCTION CONTRACTOR 16730625 BELZ CONSTRUCTION SERVICES 100 PEABODY PLACE SUITE 1400 MEMPHIS TN 38103 CONSTRUCTION COTRACTOR 12946531 THE CRUMP FIRM INC 81 MONROE AVE SUITE 100 MEMPHIS TN 38103 ARCHITECT 10091203 CERNER CORP 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 SOFTWARE SUPPORT 8346513 METHODIST HEALTHCARE MEMPHIS 1265 UNION AVE MEMPHIS TN 38104 MEDICAL SERVICES 8045433 244 757401831 82755154 11646316 2017179 851803301 PATIENT CARE 621110 117420862 117420862 117420862 11469 11469 11297052 11297052 369380 37928 292260 7590222 77120 -7552294 -7475174 -7552294 77120 CAFETERIA/VENDING 722514 4288072 4288072 CHGME/CHCA 900099 2351842 2351842 HHMI 900099 327751 327751 631144 631144 7598809 980656319 113179305 0 15673713 4311573 4311573 500 500 6085991 3217948 2868043 799828 722828 77000 387908704 358975889 28932815 23815628 22039300 1776328 60458204 55948828 4509376 26498659 24522213 1976446 24129726 22548266 1581460 2499010 2335225 163785 320997 299959 21038 82616 82616 92493428 81585900 10907528 729512 681700 47812 2541058 2495428 45630 32959451 30799292 2160159 35929278 30447214 5482064 12417773 11675859 741914 2204122 1680718 523404 86661284 77373949 9287335 1926949 1409067 517882 PHARMACEUTICAL SUPPLIES 52287399 51348474 938925 LABORATORY SUPPLIES 49243057 48358799 884258 TELEPHONE 1453871 1246308 207563 ALLOCATION ADJUSTMENTS 0 18503310 -18503310 42957014 37780782 5176232 950715632 890309329 60406303 0 21110 1110291 20889800 22491694 19183301 21703486 7505346 7732327 16177850 13941837 1520270198 851159790 638878938 669110408 2045240 2222796 4082933949 4695858063 4787635534 5434170902 113161164 112276799 11299828 15399715 3257366 3621636 127718358 131298150 X 3620941222 4201630278 73722532 76544144 965253422 1024698330 4659917176 5302872752 4787635534 5434170902 X 29940687 90775 612924114 X 0 1 X 1 1 1 X 611432510 674808276 895523715 753145680 851803301 3786713482 611432510 674808276 895523715 753145680 851803301 3786713482 3786713482 24413935 7579828 11681881 4641541 11308521 59625706 8697307 7390478 6775862 20138461 7598809 50600917 3896940105 558989512 0.97170 0.97190 X PART II, SECTION B, LINE 10: EXPLANATION FOR OTHER INCOME: 2013 $ 3,314,275 - CAFETERIA/VENDING $ 1,955,292 - CHGME/CHCA $ 3,427,740 - OTHER REVENUE $ 8,697,307 - TOTAL OTHER INCOME 2014 $ 3,534,638 - CAFETERIA/VENDING $ 1,454,365 - CHGME/CHCA $ 2,401,475 - OTHER REVENUE $ 7,390,478 - TOTAL OTHER INCOME 2015 $ 3,709,328 - CAFETERIA/VENDING $ 1,683,327 - CHGME/CHCA $ 1,383,207 - OTHER REVENUE $ 6,775,862 - TOTAL OTHER INCOME 2016 $ 8,152,422 - BOND DEFEASANCE GAIN $ 4,086,280 - CAFETERIA/VENDING $ 2,058,124 - CHGME/CHCA $ 5,841,635 - OTHER REVENUE $ 20,136,461 - TOTAL OTHER INCOME 2017 $ 4,288,072 - CAFETERIA/VENDING $ 2,351,842 - CHGME/CHCA $ 327,751 - HHMI $ 631,144 - OTHER REVENUE $ 7,598,809 - TOTAL OTHER INCOME 0 1 0 0 0 0 1 20605 0 1 62011 82616 0 PART II-B, LINE 1: LINE 1B) ST. JUDE EMPLOYS A DIRECTOR OF GOVERNMENT AFFAIRS; LINE 1G) AMOUNT LISTED IS PRORATED SALARY OF DIRECTOR OF GOVERNMENT AFFAIRS PLUS TRAVEL EXPENSES; LINE 1I) AMOUNT LISTED IS RELATED TO PRORATED RETAINER FEES FOR DIRECT AND STATE LEGISLATIVE CONTACTS AS WELL AS PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING FOR THE CHGME PROGRAM. 965253422 21281957 92690065 54527114 1024698330 873056599 12552432 103475245 23830854 965253422 873885134 2341719 -72118 3098136 873056599 915104075 2970640 8222632 52412213 873885134 843843273 1097137 121617552 51453887 915104075 1.00000 1 1 1 1072930987 551379204 521551783 435519226 293417281 142101945 11819985 6363305 5456680 669110408 INTEREST IN NET ASSETS OF AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC 4695858063 4695858063 SELF INSURANCE LIABILITY 2433543 WORKERS COMPENSATION 1188093 3621636 X 774002857 90775 550657594 550748369 223254488 757401831 757401831 980656319 950715632 0 950715632 0 950715632 PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC., A RELATED ORGANIZATION, AND ARE USED TO SUPPORT THE FUTURE NEEDS OF ST. JUDE. PART X, LINE 2: AS OF JUNE 30, 2018, THE ORGANIZATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS COMBINED FINANCIAL STATEMENTS. IN THE EVENT THE ORGANIZATION WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AS A GENERAL EXPENSE. GENERALLY, TAX YEARS ENDING IN 2015 THROUGH 2018 ARE OPEN TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES, RESPECTIVELY. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN UNRESTRICTED NET ASSETS OF ALSAC 550,657,594. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION - SUPPORT RECEIVED FROM ALSAC 755,384,652. NET ASSETS TRANSFERRED FROM ALSAC 2,017,179. CENTRAL AMERICA & THE CARIBBEAN 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 2059852 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 3880595 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 480768 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 4294023 NORTH AMERICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 562337 RUSSIA AND NEIGHBORING STATES 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 18889 SOUTH AMERICA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 1185385 SOUTH ASIA 0 0 PROGRAM SERVICES RESEARCH / EDUCATION AND TRAINING 1612 0 0 0 0 0 0 12483461 0 12483461 0 0 0 0 0 0 PART I, LINE 3: EXPENDITURES ARE RECORDED ON AN ACCRUAL BASIS. PAYMENTS ARE ISSUED BASED ON CONTRACTUAL OBLIGATIONS UPON RECEIPT OF SUPPORTING DOCUMENTATION. 1 1 0 0 1 1 1 0 0 82232400 437689 81794711 0.08600 142079478 31173380 110906098 0.11670 11276642 2524151 8752491 0.00920 235588520 34135220 201453300 0.21190 20383627 20383627 0.02140 12659463 273821 12385642 0.01300 28089119 28089119 0.02950 374887708 82891685 291996023 0.30710 2142358 2142358 0.00230 438162275 83165506 354996769 0.37330 673750795 117300726 556450069 0.58520 77361 77361 0.00010 6334 6334 0.00000 22855 22855 0.00000 106550 106550 0.00010 0 773000 0 0 465779 -465779 X 1 1 1 1 ST JUDE CHILDREN'S RESEARCH HOSPITAL 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 WWW.STJUDE.ORG TN STATE LICENSE NUMBER 0000000113 X X X ST JUDE CHILDREN'S RESEARCH HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X SEE PART V, SECTION C X 1 15 1 SEE PART V, SECTION C 0 1 X 1 1 X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X 1 X 0 0 ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 5: ST. JUDE'S 2016 CHNA BUILDS UPON THE 2013 CHNA AND REFLECTS THE ACTIVITIES IDENTIFIED IN ST. JUDE'S 2013 COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE 2016 CHNA WAS LED BY AN INTERNAL TEAM OF ST. JUDE STAFF MEMBERS. THE LEADERSHIP OF THIS TEAM ENGAGED HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH CONSULTANCY ORGANIZATION, TO CONDUCT THE CHNA. IN AN EFFORT TO DEVELOP A SOCIAL, ECONOMIC, AND HEALTH PORTRAIT OF THE COMMUNITY SERVED BY ST. JUDE FOR THE GREATER MEMPHIS AREA AND NATIONALLY, HRIA REVIEWED EXISTING DATA DRAWN FROM LOCAL, STATE, AND NATIONAL SOURCES. HRIA CONDUCTED QUALITATIVE RESEARCH WITH INTERNAL AND EXTERNAL ST. JUDE STAKEHOLDERS AS WELL AS PATIENTS AND FAMILY MEMBERS SERVED IN ORDER TO SUPPLEMENT QUANTITATIVE FINDINGS WITH PERCEPTIONS OF COMMUNITY STRENGTHS AND ASSETS, THEIR PRIORITY HEALTH CONCERNS, AND SUGGESTIONS FOR FUTURE PROGRAMMING AND SERVICES.FOCUS GROUPS FOCUS GROUPS WERE CONDUCTED WITH CURRENT AND FORMER ST. JUDE PATIENTS, PATIENT CAREGIVERS, AND ST. JUDE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF. DIFFERENT TOPIC AREAS WERE EXPLORED BASED ON THE UNIQUE EXPERIENCES OF EACH OF THE GROUPS. THE PATIENT AND CAREGIVER FOCUS GROUPS, CONDUCTED WITH CURRENT PATIENTS AND REPRESENTATIVES OF THE FAMILY ADVISORY AND QUALITY OF LIFE/PALLIATIVE CARE STEERING COUNCILS, EXPLORED THE EXTENT TO WHICH ST. JUDE IS MEETING THE NEEDS OF CHILDREN WITH CATASTROPHIC ILLNESSES AND OPPORTUNITIES TO BRIDGE PATIENT NEEDS IN THE FUTURE. THE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF FOCUS GROUP EXPLORED THESE TOPICS AS WELL AS SPECIFIC ISSUES RELATED TO THE GREATER MEMPHIS COMMUNITY. A SEMI-STRUCTURED MODERATOR'S GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. WHILE SIMILAR, SEPARATE GUIDES WERE USED FOR THE CAREGIVER AND PATIENT FOCUS GROUPS SO THAT THEY WERE AGE AND DEVELOPMENTALLY APPROPRIATE. EACH FOCUS GROUP WAS FACILITATED BY AN EXPERIENCED HRIA STAFF MEMBER, WHILE A NOTE-TAKER TOOK DETAILED NOTES DURING THE DISCUSSION. ON AVERAGE, FOCUS GROUPS LASTED 30-90 MINUTES. BEFORE THE START OF THE GROUPS, HRIA EXPLAINED THE PURPOSE OF THE STUDY TO PARTICIPANTS AND PARTICIPANTS HAD AN OPPORTUNITY TO ASK QUESTIONS. THEY WERE ALSO NOTIFIED VERBALLY THAT GROUP DISCUSSIONS WOULD REMAIN CONFIDENTIAL, AND NO RESPONSES WOULD BE CONNECTED TO THEM PERSONALLY. PATIENT FOCUS GROUP PARTICIPANTS RECEIVED A $30 GIFT CERTIFICATE AS WELL AS FOOD AND BEVERAGES IN APPRECIATION FOR THEIR TIME. PARTICIPANTS WERE RECRUITED BY ST. JUDE STAFF, WHO ARRANGED ALL LOGISTICS FOR THE ONSITE FOCUS GROUPS.MEDICAL EXECUTIVE COMMITTEE/CLINICAL COUNCIL (INTERNAL) - EMILY BROWNE, DIRECTOR, PROFESSIONAL DEVELOPMENT AND APP - ANDREW M. DAVIDOFF, MD, CHAIR, SURGERY DEPARTMENT - PAM DOTSON, SVP, PATIENT CARE SERVICES/CNO - JANICE ENGLISH, DIRECTOR, NURSING - PATRICIA FLYNN, MD, MEMBER, SVP, MEDICAL DIRECTOR QUALITY AND PATIENT CARE - WILLIAM L. GREENE, PHARM D, CHIEF PHARMACEUTICAL OFFICER - LIZA JOHNSON, MD, STAFF PHYSICIAN, HOSPITALIST - PAT KEEL, SVP, CHIEF FINANCIAL OFFICER - CINDY LEKHY, VP, CLINICAL OPERATIONS - MONIKA METZGER, MD, REGIONAL DIRECTOR, CENTRAL AND SOUTH AMERICA REGIONS, INTERNATIONAL OUTREACH PROGRAM - SEAN PHIPPS, PHD, CHAIR, PSYCHOLOGY DEPARTMENT - ULRIKE REISS, MD, DIRECTOR, CLINICAL HEMATOLOGY DIVISION - GILES W. ROBINSON, MD, ASSISTANT MEMBER, ONCOLOGY DEPARTMENT - VICTOR SANTANA, MD, MEMBER, VP, CLINICAL TRIALS ADMINISTRATION - RON SMITH, VP, SCIENTIFIC OPERATIONS - ELAINE TUOMANEN, MD, CHAIR, DEPARTMENT OF INFECTIOUS DISEASES FAMILY ADVISORY COUNCIL AND QUALITY OF LIFE/PALLIATIVE CARE STEERING COUNCIL (INTERNAL AND EXTERNAL, SOME FAMILY MEMBERS AND FORMER PATIENTS ARE ALSO ST. JUDE EMPLOYEES), N=5ADOLESCENT PATIENTS, N=4 KEY INFORMANT INTERVIEWS HRIA CONDUCTED 16 INTERVIEWS; 6 WERE INTERNAL TO THE ST. JUDE HOSPITAL AND 10 WERE EXTERNAL REPRESENTATIVES. INTERVIEWEES REPRESENT A RANGE OF SECTORS, INCLUDING LEADERS IN HEALTH CARE AND HEALTH RESEARCH, GOVERNMENT, AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS. SIMILAR TO THE FOCUS GROUPS, A SEMI-STRUCTURED INTERVIEW GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. INTERVIEWS WERE APPROXIMATELY 30 MINUTES IN LENGTH. INTERNAL KEY INFORMANT INTERVIEWS - CAROLYN RUSSO, MD, MEDICAL DIRECTOR AFFILIATE PROGRAM - JUSTIN BAKER, CHIEF, DIVISION OF QUALITY OF LIFE AND PALLIATIVE CARE - MARTHA PERINE BEARD, CHAIR, ST. JUDE BOARD OF GOVERNORS - FRAN GREESON, DIRECTOR OF SOCIAL WORK AND JANA KING, DIRECTOR OF DOMICILIARY SERVICES - MICHAEL LINK, MD, CHAIR, ST. JUDE SCIENTIFIC ADVISORY BOARD- ALICIA HUETTEL, DIRECTOR OF FAMILY CENTERED CARE EXTERNAL KEY INFORMANT INTERVIEWS - DR. JOHNATHAN MCCULLERS, CHAIR, DEPARTMENT OF PEDIATRICS, UTHSC/LE BONHEUR CHILDREN'S HOSPITAL - JENNIFER MARSHALL PEPPER, HIV/RYAN WHITE, SHELBY COUNTY - DR. DAVID STERN, DEAN UTHSC COLLEGE OF MEDICINE - DR. BARRY GOLDSPIEL, ACTING CHIEF, PHARMACY DEPARTMENT, CHIEF, CLINICAL PHARMACY SPECIALIST SECTION, NIH - DRS. NADA ELMAGBOUL AND ROBIN WOMEODU, SICKLE CELL DISEASE PROGRAM METHODIST LE BONHEUR HEALTHCARE - VALERIE NAGOSHINER, DEPUTY COMMISSIONER, TN DEPARTMENT OF HEALTH - ANGELA MOORE, PH COORDINATOR, COMMUNITY HEALTH PLANNING, SHELBY COUNTY HEALTH DEPARTMENT - JENNIFER MYRICK, HEALTH SYSTEMS MANAGER, AMERICAN CANCER SOCIETY MID-SOUTH - DEE WIMBERLY, CAROL WEIDENHOFFER, HUGH JONES, ZACHARY HIDINGER, ANDREA TUTOR, METHODIST LE BONHEUR HEALTHCARE CHNA TEAM - DR. MARTIN WHITSIDE, TENNESSEE CANCER COALITION ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 13H: SEE NARRATIVE FOR PART I, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 15E: SEE NARRATIVE FOR PART I, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. ST. JUDE CHILDREN'S RESEARCH HOSPITAL PART V, SECTION B, LINE 20E: ST. JUDE DOES NOT TAKE ANY OF THE COLLECTION ACTIONS DESCRIBED IN PART V, SECTION B, LINE 19 BECAUSE ST. JUDE COVERS ALL TREATMENTS, COPAYS, DEDUCTIBLES, COINSURANCE AND ANY OTHER COST SHARING OBLIGATIONS THAT ARE NOT COVERED BY INSURANCE. ST. JUDE TAKES NO ACTION TO COLLECT FROM PATIENTS OR THEIR FAMILIES AND DOES NOT REPORT TO CREDIT AGENCIES. ST. JUDE CHILDREN'S RESEARCH HOSPITAL: PART V, SECTION B, LINE 11: ST. JUDE CHILDREN'S RESEARCH HOSPITALCOMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN UPDATE (06/30/18) ST. JUDE: PATIENT POPULATION AND CLINICAL FOCUSTHE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST. JUDE IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CANCER AND BLOOD DISORDERS, AND CHILDREN AND ADOLESCENTS WITH HIV INFECTION. IT SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. ST. JUDE TREATS CHILDREN AND YOUNG ADULTS WITH NEWLY DIAGNOSED OR SUSPECTED PEDIATRIC CANCER, HIV INFECTIONS, OR CERTAIN HEMATOLOGIC OR GENETIC DISEASES. WE ACCEPT MOST PATIENTS OUTSIDE OUR PRIMARY MARKET ON THE BASIS OF A REFERRAL FROM THEIR PHYSICIAN OR AN AFFILIATE CLINIC, THEIR AGE, AND THEIR ABILITY TO ENROLL IN AN OPEN CLINICAL TRIAL. IN ADDITION TO BEING TREATED AT ST. JUDE, PATIENTS MAY HAVE THE OPTION TO RECEIVE CARE AT ONE OF OUR EIGHT REGIONAL AFFILIATE CLINICS.ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. MORE SPECIFICALLY, APPROXIMATELY 7,800 PATIENTS ARE SEEN AT ST. JUDE ANNUALLY FOR ACTIVE THERAPY, TREATMENT-COMPLETION MONITORING, SURVIVORSHIP SUPPORT, OR PARTICIPATION IN RESEARCH PROGRAMS. THE HOSPITAL IS LICENSED FOR 80 INPATIENT BEDS AND CURRENTLY STAFFS 69 BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS WHO MAY HAVE BEEN ADMITTED AS INPATIENTS AT MOST HOSPITALS TO BE TREATED AS OUTPATIENTS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES, DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA AIR FILTRATION, INFECTION-RESISTANT SURFACES, AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES.THE ST. JUDE AFFILIATE PROGRAM MAKES TREATMENTS DEVELOPED AS CLINICAL TRIALS AT ST. JUDE CHILDREN'S RESEARCH HOSPITAL AVAILABLE TO MORE CHILDREN BY OFFERING MUCH OF THE CARE CLOSE TO HOME. THE ST. JUDE AFFILIATE PROGRAM IS A NETWORK OF PEDIATRIC HEMATOLOGY-ONCOLOGY CLINICS, HOSPITALS, AND IN SOME CASES, UNIVERSITIES UNITED TO EXTEND THE MISSION OF ST. JUDE. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF OF ST. JUDE TO DELIVER STATE-OF-THE-ART CARE AND INNOVATIVE CLINICAL TRIALS TO CHILDREN WITH CANCER AND BLOOD DISORDERS. ST. JUDE ALSO OPERATES ST. JUDE GLOBAL. ITS MISSION IS TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE THROUGH THE SHARING OF KNOWLEDGE, TECHNOLOGY, AND ORGANIZATIONAL SKILLS. THERE ARE 3 OVERRIDING GOALS:- TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION- TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES- TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE.ST. JUDE IS A RESEARCH ORGANIZATION, AND THERE ARE TIMES WHEN BASIC RESEARCH DISCOVERIES PERTAIN TO DISEASES THAT ARE BEYOND THE SCOPE OF DISEASES TREATED AS A PRIMARY DIAGNOSIS AT ST. JUDE.FOR THE PURPOSES OF THIS REPORT, THE FOCUS IS SOLELY ON THOSE DISEASES FOR WHICH CHILDREN ARE ADMITTED TO ST. JUDE FOR TREATMENT.CONSISTENT WITH ST. JUDE'S PREVIOUS CHNA, THE FINDINGS IN 2016 HIGHLIGHTED THE ISSUES OF ACCESS TO CARE, CHILDHOOD CANCER, SICKLE CELL DISEASE AND HEMATOLOGY PATIENTS, LIVING WITH HIV AND AIDS, NEEDS OF THE PATIENTS' FAMILIES AND CAREGIVERS, POST TREATMENT AND CARE TRANSITION, HEALTH STATUS OF THE MEMPHIS COMMUNITY, AND ADDITIONAL GAPS FOR THE GENERAL PEDIATRIC POPULATION. ST. JUDE HAS CHOSEN TO ADDRESS THESE NEEDS IN THREE GENERAL FOCUS AREAS: IMPROVING ACCESS TO CARE, ENHANCING COORDINATION OF CARE, AND IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDREN. THESE INITIATIVES, WHICH OFTEN ADDRESS MULTIPLE ISSUES IDENTIFIED IN THE CHNA, WERE CHOSEN BECAUSE THEY ARE ALIGNED WITH OUR MISSION AND OUR CAPABILITIES. BELOW ARE THE THREE FOCUS AREAS, INITIATIVES, AND CORRESPONDING ISSUES FOR THE NEXT YEAR.AIM #1 IMPROVING ACCESS TO CAREPEDIATRIC HEATH NEED:ACCESS TO AFFORDABLE HEALTH INSURANCE COVERAGEHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MANAGED CARE DEPARTMENTANTICIPATED OUTCOME:ASSIST UNINSURED PATIENTS WITH ENROLLING IN FUNDING FOR WHICH THEY QUALIFY.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. RENEW CONTRACT WITH VENDOR TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO ASSIST PATIENT FAMILIES APPLYING FOR HEALTH INSURANCE COVERAGE THROUGH THE FEDERALLY FACILITATED MARKETPLACE.2. CONDUCT AN AUDIT OF THE SCREENING PROCESS TO VALIDATE COMPLIANCE. MAKE PROCESS ADJUSTMENTS AS NEEDED.SELECTED ACCOMPLISHMENTS:- THE AGREEMENT WITH FIRSTSOURCE SOLUTIONS USA, LLC (DBA MEDASSIST) IS RENEWED ANNUALLY. MEDASSIST IS THE VENDOR USED TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO UNINSURED PATIENTS. - AN AUDIT OF THE SCREENING PROCESS IS CONDUCTED MONTHLY TO ENSURE THAT ALL FAMILIES ARE GIVEN ASSISTANCE WITH THE SCREENING AND ENROLLMENT PROCESS. IN FY18, 87% OF UNINSURED PATIENTS WERE OFFERED ASSISTANCE, AND FOURTEEN UNINSURED PATIENTS WERE ENROLLED IN HEALTH PLANS. THE REMAINING 13% WERE NOT CONTACTED BECAUSE THEY WERE IN THE AFTER COMPLETION OF THERAPY PROGRAM AND WERE NOT HERE LONG.PEDIATRIC HEALTH NEED:PALLIATIVE CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF ONCOLOGY, DIVISION OF QUALITY OF LIFE AND PALLIATIVE CAREANTICIPATED OUTCOME:INCREASE THE NUMBER OF CLINICIANS TRAINED IN PALLIATIVE CARE MEDICINE (PCM) AND EDUCATIONAL OPPORTUNITIES FOR PCM.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. RECRUIT AND TRAIN TWO PHYSICIAN FELLOWS IN THE PALLIATIVE CARE TRAINING PROGRAM.2. PROVIDE TRAINING IN PALLIATIVE CARE FOR ADVANCED PRACTICE HEALTHCARE PERSONNEL THROUGH TARGETED CONFERENCES AND OTHER EDUCATIONAL OPPORTUNITIES, INCLUDING THE END-OF-LIFE NURSING EDUCATION CONSORTIUM (ELNEC) CONFERENCE, AN INSTITUTION-DEVELOPED QUALITY OF LIFE SEMINAR (QOLA), AND A 2-DAY PEDIATRIC ONCOLOGY PALLIATIVE CARE CONFERENCE.3. EDUCATE COMMUNITY PROVIDERS ABOUT PCM THROUGH COMMUNITY-BASED BRIDGING PROGRAMS FOR HOME HEALTH AND HOSPICE CARE THROUGH THE QUALITY OF LIFE FOR ALL KIDS PROGRAM VIA A THREE-HOUR DIDACTIC CURRICULUM.4. ENHANCE TRAINING OPPORTUNITIES WITH ST. JUDE AFFILIATES.SELECTED ACCOMPLISHMENTS:- IN COMBINATION WITH THE UTHSC PALLIATIVE CARE FELLOWSHIP, WE ARE TRAINING THREE PEDIATRIC PALLIATIVE CARE PHYSICIAN FELLOWS IN ACADEMIC YEAR 2018-2019.- ENROLLMENT: FY16 FY17 FY18ELNEC 32 78 38QOLA 37 29 25PPOS 325 300+ *PPOS - PEDIATRIC PALLIATIVE ONCOLOGY CARE CONFERENCE- BEDSIDE NURSES ARE REQUIRED TO COMPLETE ELNEC WITHIN THREE YEARS. INPATIENT AND OUTPATIENT NURSES ARE REQUIRED AND SUPPORTED TO COMPLETE BOTH SEMINARS, A TOTAL OF 24.5 CEUS IN PCM.- A THREE-HOUR DIDACTIC CURRICULUM HAS BEEN HELD TWICE MONTHLY THROUGH OUR COMBINED FELLOWSHIP PROGRAM. AN AVERAGE OF 10 ATTENDEES, INCLUDING GRADUATE STUDENTS, MEDICAL STUDENTS, ADVANCED CLINICIANS, AND OTHERS, ARE PRESENT FOR EACH SESSION.- THE DIVISION OF QUALITY OF LIFE AND PALLIATIVE CARE FACULTY HOSTED A TOTAL OF 5 POE STUDENTS THROUGHOUT THE SUMMER, INVOLVING THEM IN ONGOING EDUCATIONAL EFFORTS. IN ADDITION, WE HOSTED APPROXIMATELY 8 GRADUATE STUDENTS FOR PALLIATIVE CARE ROTATIONS. - THE SJ AFFILIATE STAFF ARE INVITED TO PARTICIPATE IN ELNEC, THE QOL SEMINAR, AND THE PEDIATRIC PALLIATIVE ONCOLOGY SYMPOSIUM AT NO COST AND ARE INCLUDED IN THE NUMBERS CITED ABOVE.PEDIATRIC HEALTH NEED:HEALTHCARE OF CHILDHOOD CANCER SURVIVORSHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF ONCOLOGY, DIVISION OF CANCER SURVIVORSHIPANTICIPATED OUTCOME:PROVIDE CANCER SURVIVORSHIP INFORMATION TO BOTH CAREGIVERS AND SURVIVORS VIA SURVIVORS' DAY CONFERENCE AND ST. JUDE LIFE ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. PROVIDE WORKSHOPS AND SPEAKERS THAT OFFER INFORMATION ABOUT AVAILABLE RESOURCES.2. GIVE SURVIVORS AND THEIR FAMILIES THE OPPORTUNITY TO LEARN FROM OTHER SURVIVORS.3. ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH POST TREATMENT HEALTHCARE.4. OFFER AN ONLINE RESOURCE FOLLOWING THE CONFERENCE FOR A CONTINUOUSFLOW OF SURVIVORSHIP INFORMATION.5. ASSESS LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS.6. USE INFORMATION FROM THESE STUDIES TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTIONS.SELECTED ACCOMPLISHMENTS:1. PROVIDE WORKSHOPS AND SPEAKERS THAT OFFER INFORMATION ABOUT AVAILABLE RESOURCES:THE ST. JUDE FACULTY PROVIDE LECTURES AND PARTICIPATE IN WORKSHOPS RELATED TO A VARIETY OF SURVIVORSHIP ISSUES. AUDIENCES INCLUDE SURVIVORS' HEALTHCARE PROVIDERS, SURVIVORS, AND SURVIVORS' FAMILIES.LECTURES/WORKSHOPS PROVIDED BY MELISSA M. HUDSON:- YOU ARE THE KEY TO HPV CANCER PREVENTION. SHELBY COUNTY SCHOOL SYSTEM HEALTH ADVISORY COUNCIL MEETING, JANUARY 18, 2018- CANCER OUTCOMES AND SURVIVORSHIP (ICOS) AND THE CENTER FOR OUTCOMES AND EFFECTIVENESS RESEARCH AND EDUCATION (COERE), "THE ROLE OF SURVIVORSHIP RESEARCH IN ADVANCING CHILDHOOD CANCER CARE AND QUALITY OF SURVIVAL," UNIVERSITY OF ALABAMA, BIRMINGHAM, BIRMINGHAM, ALABAMA, FEBRUARY 19, 2018 - ST. JUDE PEDIATRIC HEMATOLOGY-ONCOLOGY FELLOWS' ROUNDS, "THE ROLE OF SURVIVORSHIP RESEARCH IN ADVANCING CHILDHOOD CANCER CARE AND QUALITY OF SURVIVAL," MEMPHIS, TENNESSEE, APRIL 2, 2018LECTURES/WORKSHOPS PROVIDED BY DANIEL MULROONEY:- CARDIOVASCULAR SEQUELAE OF CHILDHOOD CANCER THERAPY AND IMPLICATIONS FOR ADULT HEALTH, RADIATION RESEARCH SOCIETY, CANCUN, MEXICO, OCTOBER 16, 2017 - THE PAST, PRESENT, AND FUTURE OF CANCER SURVIVORSHIP, AFFILIATE PHYSICIANS' CONFERENCE, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MEMPHIS, TENNESSEE, APRIL 7, 2018 - CARING FOR AND LEARNING FROM SURVIVORS OF CHILDHOOD CANCER, MINNESOTA CHILDHOOD CANCER SURVIVORSHIP SYMPOSIUM, UNIVERSITY OF MINNESOTA, MINNEAPOLIS, MINNESOTA, APRIL 27, 2018 2. GIVE SURVIVORS AND THEIR FAMILIES THE OPPORTUNITY TO LEARN FROM OTHER SURVIVORS:ST. JUDE HOSTS PERIODIC CELEBRATIONS OF SURVIVORSHIP ATTENDED BY SURVIVORS, FAMILIES, AND FRIENDS. THE EVENT PROVIDES A FORUM TO CELEBRATE SURVIVORSHIP, EDUCATE ATTENDEES ABOUT HEALTH EFFECTS OF CHILDHOOD CANCER AND RESEARCH PROGRESS IN THIS AREA, AND SHARE INFORMATION ABOUT HEALTH RESOURCES. ST. JUDE SURVIVOR DAY ACTIVITIES, SEPTEMBER 9, 2017: INSPIRATIONAL CANCER SURVIVOR DR. WENDY HARPHAM SHARED HER SURVIVORSHIP EXPERIENCES IN THE KEYNOTE ADDRESS ENTITLED "HAPPINESS IN A STORM." SURVIVORSHIP STAFF AND DR. HARPHAM LED WORKSHOPS FOCUSING ON HOPE AND RESILIENCY IN OVERCOMING THE OBSTACLES ASSOCIATED WITH THE CANCER EXPERIENCE AND ITS AFTERMATH.3. ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH HEALTHCARE POST TREATMENT:SURVIVORS AND THEIR FAMILIES ATTENDING THE AFTER COMPLETION OF THERAPY AND ST. JUDE LIFETIME COHORT CLINICS ROUTINELY RECEIVE COUNSELING ABOUT THEIR HEALTH HISTORY, CANCER-RELATED HEALTH RISKS, HEALTH SCREENING RECOMMENDED FOR THEIR SPECIFIC CANCER TREATMENT EXPOSURES, AND METHODS OF RISK REDUCTION. A SURVIVORSHIP CARE PLAN IS PROVIDED AT THE FIRST EVALUATION THAT DETAILS THE CANCER DIAGNOSIS, TREATMENT, MAJOR HEALTH EVENTS THAT HAVE OCCURRED DURING AND AFTER THERAPY, CANCER-RELATED HEALTH RISKS, AND RECOMMENDED HEALTH SCREENING. THE SURVIVORSHIP CARE PLAN IS UPDATED AFTER EVERY HEALTH EVALUATION. FOR SURVIVORS WHO DO NOT WISH TO PARTICIPATE IN THE ACT OR ST. JUDE LIFETIME COHORT PROGRAMS, THESE SAME SERVICES ARE AVAILABLE THROUGH THE ST. JUDE ALUMNUS PROGRAM OFFICE.SURVIVORSHIP STAFF HAVE BEEN INVOLVED IN MULTIDISCIPLINARY EFFORTS TO INTRODUCE AND CONSISTENTLY ADDRESS SURVIVORSHIP TRANSITION ISSUES, PARTICULARLY PSYCHOSOCIAL AND REHABILITATION NEEDS, AT EARLIER TIME POINTS AFTER DIAGNOSIS. THEIR EFFORTS ARE REFLECTED IN THE NEWLY DEVELOPED TRANSITION ONCOLOGY PROGRAM.4. OFFER AN ONLINE RESOURCE FOLLOWING THE CONFERENCE FOR A CONTINUOUS FLOW OF SURVIVORSHIP INFORMATION:PERIODIC BRIEF PUBLICATIONS FEATURE SURVIVOR STORIES AND EDUCATIONAL TOPICS:- LONG-TERM FOLLOW-UP NEWSLETTERS AND BRIEFS (AVAILABLE AT HTTPS://LTFU.STJUDE.ORG/) ARE PUBLISHED ON A QUARTERLY BASIS.- LIFELINE NEWSLETTERS (AVAILABLE AT HTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/PARTICIPATE-IN-ST-JUDE-LIFE-STUDY/LIFELINE-NEWSLETTER.HTML) ARE PUBLISHED SEMIANNUALLY.- OTHER SURVIVORSHIP RESOURCES ARE AVAILABLE AT: HTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/PARTICIPATE-IN-ST-JUDE-LIFE-STUDY/HANDOUTS.HTMLHTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/LIFE-AFTER-CANCER.HTML MORTON LM, SAMPSON JN, ARMSTRONG GT, CHEN TH, HUDSON MM, KARLINS E, DAGNALL CL, LI SA, WILSON CL, SRIVASTAVA DK, LIU W, KANG G, OEFFINGER KC, HENDERSON TO, MOSKOWITZ CS, GIBSON TM, MERINO DM, WONG JR, HAMMOND S, NEGLIA JP, TURCOTTE LM, MILLER J, BOWEN L, WHEELER WA, LEISENRING WM, WHITTON JA, BURDETTE L, CHUNG C, HICKS BD, JONES K, MACHIELA MJ, VOGT A, WANG Z, YEAGER M, NEALE G, LEAR M, STRONG LC, YASUI Y, STOVALL M, WEATHERS RE, SMITH SA, HOWELL R, DAVIES SM, RADLOFF GA, ONEL K, BERRINGTON DE GONZALEZ A, INSKIP PD, RAJARAMAN P, FRAUMENI JF, BHATIA S, CHANOCK SJ, TUCKER MA, ROBISON LL. GENOME-WIDE ASSOCIATION STUDY TO IDENTIFY SUSCEPTIBILITY LOCI THAT MODIFY RADIATION-RELATED RISK FOR BREAST CANCER AFTER CHILDHOOD CANCER. J NATL CANCER INST. 2017 NOV 1;109(11).CHEUNG YT, BRINKMAN TM, MULROONEY DA, MZAYEK Y, LIU W, BANERJEE P, PANOSKALTSIS-MORTARI A, SRIVASTAVA DK, PUI CH, ROBISON LL, HUDSON MM, KRULL KR. IMPACT OF SLEEP, FATIGUE AND SYSTEMIC INFLAMMATION ON NEUROCOGNITIVE AND BEHAVIORAL OUTCOMES IN LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA. CANCER. 2017 SEP 1;123(17):3410-3419.CHEMAITILLY W, LI Z, KRASIN MJ, BROOKE RJ, WILSON CL, GREEN DM, KLOSKY JL, BARNES N, CLARK KL, FARR JB, FERNANDEZ-PINEDA I, BISHOP MW, METZGER M, PUI CH, KASTE SC, NESS KK, SRIVASTAVA DK, ROBISON LL, HUDSON MM, YASUI Y, SKLAR CA. PREMATURE OVARIAN INSUFFICIENCY IN CHILDHOOD CANCER SURVIVORS: A REPORT FROM THE ST. JUDE LIFETIME COHORT. J CLIN ENDOCRINOL METAB. 2017 JUL 1;102(7):2242-2250.MULROONEY DA, SOLIMAN EZ, LU L, EHRHARDT MJ, DUPREZ DA, LUEPKER RV, ARMSTRONG GT, JOSHI VM, GREEN DM, SRIVASTAVA DK, KRASIN MJ, MORRIS GS, ROBISON LL, HUDSON MM, NESS KK. ELECTROCARDIOGRAPHIC ABNORMALITIES IN ADULT SURVIVORS OF CHILDHOOD CANCER: A CROSS-SECTIONAL STUDY FROM THE ST. JUDE LIFETIME COHORT. AM HEART J. 2017 JUL;189:19-27VUOTTO SC, OJHA RP, LI C, KIMBERG C, KLOSKY JL, KRULL KR, SRIVASTAVA DK, ROBISON LL, HUDSON MM, BRINKMAN TM. THE ROLE OF BODY IMAGE DISSATISFACTION IN THE ASSOCIATION BETWEEN TREATMENT-RELATED SCARRING OR DISFIGUREMENT AND PSYCHOLOGICAL DISTRESS IN ADULT SURVIVORS OF CHILDHOOD CANCER. PSYCHO-ONCOLOGY. 2018 JAN;27(1):216-222ARMSTRONG GT, TOLE JJ, PIANA R, SANTUCCI A, LEATHERS J, NESS KK, MULROONEY DA, GREEN DM, JOSHI, VM, ROBISON LL, HUDSON MM, LENIHAN D. EXERCISE RIGHT HEART CATHETERIZATION FOR PULMONARY HYPERTENSION IDENTIFIED ON SCREENING ECHOCARDIOGRAPHY IN ADULT SURVIVORS OF CHILDHOOD CANCER: A REPORT FROM THE ST. JUDE LIFETIME COHORT. PEDIATR BLOOD CANCER. 2018 JAN;65(1).STUDAWAY A, OJHA RP, BRINKMAN TM, ZHANG N, BAASSIRI M, BANERJEE P, EHRHARDT MJ, SRIVASTAVA D, ROBISON LL, HUDSON MM, KRULL KR. CHRONIC HEPATITIS C VIRUS INFECTION AND NEUROCOGNITIVE FUNCTION IN ADULT SURVIVORS OF CHILDHOOD CANCER. CANCER. 2017 NOV 15;123(22):4498-4505.INTERIANO RB, KASTE SC, LI C, SRIVASTAVA DK, RAO BN, WARNER WC JR, GREEN DM, KRASIN MJ, ROBISON LL, DAVIDOFF AM, HUDSON MM, FERNANDEZ-PINEDA I, NESS KK. ASSOCIATIONS BETWEEN TREATMENT, SCOLIOSIS, PULMONARY FUNCTION, AND PHYSICAL PERFORMANCE IN LONG-TERM SURVIVORS OF SARCOMA. J CANCER SURVIV. 2017 OCT;11(5):553-561.EHRHARDT MJ, MULROONEY DA, LI C, BAASSIRI MJ, BJORNARD K, SANDLUND JT, BRINKMAN TM, HUANG IC, SRIVASTAVA DK, NESS KK, ROBISON LL, HUDSON MM, KRULL KR. NEUROCOGNITIVE, PSYCHOSOCIAL, AND QUALITY-OF-LIFE OUTCOMES IN ADULT SURVIVORS OF CHILDHOOD NON-HODGKIN LYMPHOMA. CANCER. 2018 JAN 15;124(2):417-425.BHAKTA N, LIU Q, NESS KK, BAASSIRI M, EISSA H, YEO F, CHEMAITILLY W, EHRHARDT MJ, BASS J, BISHOP MW, SHELTON K, LU L, HUANG S, LI Z, CARON E, LANCTOT J, HOWELL C, FOLSE T, JOSHI V, GREEN DM, MULROONEY DA, ARMSTRONG GT, KRULL KR, BRINKMAN TM, KHAN RB, SRIVASTAVA DK, HUDSON MM, YASUI Y, ROBISON LL. THE CUMULATIVE BURDEN OF SURVIVING CHILDHOOD CANCER: AN INITIAL REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY (SJLIFE). LANCET. 2017 DEC 9;390(10112):2569-2582EISSA HM, LU L, BAASSIRI M, BHAKTA N, EHRHARDT MJ, TRIPLETT BM, GREEN DM, MULROONEY DA, ROBISON LL, HUDSON MM, NESS KK. CHRONIC DISEASE BURDEN AND FRAILTY IN SURVIVORS OF CHILDHOOD HSCT: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. BLOOD ADV. 2017 NOV 7;1(24):2243-2246. LIU W, CHEUNG YT, BRINKMAN TM, BANERJEE P, SRIVASTAVA D, NOLAN VG, ZHANG H, GURNEY JG, PUI CH, ROBISON LL, HUDSON MM, KRULL KR. BEHAVIORAL SYMPTOMS AND PSYCHIATRIC DISORDERS IN CHILD AND ADOLESCENT LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH CHEMOTHERAPY ONLY. PSYCHO-ONCOLOGY. 2018 JUN;27(6):1597-1607.LIU W, CHEUNG YT, CONKLIN HM, JACOLA LM, SRIVASTAVA D, NOLAN VG, ZHANG H, GURNEY JG, HUANG IC, ROBISON LL, PUI CH, HUDSON MM, KRULL KR. EVOLUTION OF NEUROCOGNITIVE FUNCTION IN LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH CHEMOTHERAPY ONLY. J CANCER SURVIV. 2018 JUN;12(3):398-406.IM C, NESS KK, KASTE SC, CHEMAITILLY W, MOON W, SAPKOTA Y, BROOKE RJ, HUDSON MM, ROBISON LL, YASUI Y, WILSON CL. GENOME-WIDE SEARCH FOR HIGHER ORDER EPISTASIS AS MODIFIERS OF TREATMENT EFFECTS ON BONE MINERAL DENSITY IN CHILDHOOD CANCER SURVIVORS. EUR J HUM GENET. 2018 FEB;26(2):275-286.HOWELL CR, WILSON CL, EHRHARDT MJ, PARTIN RE, KASTE SC, LANCTOT JQ, PUI CH, ROBISON LL, HUDSON MM, NESS KK. CLINICAL IMPACT OF SEDENTARY BEHAVIORS IN ADULT SURVIVORS OF ACUTE LYMPHOBLASTIC LEUKEMIA: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. CANCER. 2018 MAR 1;124(5):1036-1043GIBSON TM, LI Z, GREEN DM, ARMSTRONG GT, MULROONEY DA, SRIVASTAVA D, BHAKTA N, NESS KK, HUDSON MM, ROBISON LL. BLOOD PRESSURE STATUS IN ADULT SURVIVORS OF CHILDHOOD CANCER: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. CANCER EPIDEMIOL BIOMARKERS PREV. 2017 DEC;26(12):1705-1713.ALLEN J, WILLARD VW, KLOSKY JL, LI C, SRIVASTAVA DK, ROBISON LL, HUDSON MM, PHIPPS S. POSTTRAUMATIC STRESS-RELATED PSYCHOLOGICAL FUNCTIONING IN ADULT SURVIVORS OF CHILDHOOD CANCER. J CANCER SURVIV. 2018 APR;12(2):216-223.CHOW EJ, CHEN Y, HUDSON MM, FEIJEN EAM, KREMER LC, BORDER WL, GREEN DM, MEACHAM LR, MULROONEY DA, NESS KK, OEFFINGER KC, RONCKERS CM, SKLAR CA, STOVALL M, VAN DER PAL HJ, VAN DIJK IWEM, VAN LEEUWEN FE, WEATHERS RE, ROBISON LL, ARMSTRONG GT, YASUI Y. PREDICTION OF ISCHEMIC HEART DISEASE AND STROKE IN SURVIVORS OF CHILDHOOD CANCER. J CLIN ONCOL. 2018 JAN 1;36(1):44-52.FELLAH S, CHEUNG YT, SCOGGINS MA, ZOU P, SABIN ND, PUI CH, ROBISON LL, HUDSON MM, OGG RJ, KRULL KR. BRAIN ACTIVITY ASSOCIATED WITH ATTENTION DEFICITS FOLLOWING CHEMOTHERAPY FOR CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA. J NATL CANCER INST. 2018 MAY 21. [EPUB AHEAD OF PRINT].HUANG IC, KLOSKY JL, YOUNG CM, MURPHY SE, KRULL KR, SRIVASTAVA DK, HUDSON MM, ROBISON LL. MISCLASSIFICATION OF SELF-REPORTED SMOKING. PEDIATR BLOOD CANCER. 2018; E27240.FERNANDEZ-PINEDA I, DAVIDOFF AM, LU L, RAO BN, WILSON CL, SRIVASTAVA DK, KLOSKY JL, METZGER ML, KRASIN MJ, NESS KK, PUI CH, ROBISON LL, HUDSON MM, SKLAR CA, GREEN DM, CHEMAITILLY W. IMPACT OF OVARIAN TRANSPOSITION BEFORE PELVIC IRRADIATION ON OVARIAN FUNCTION AMONG LONG-TERM SURVIVORS OF CHILDHOOD HODGKIN LYMPHOMA: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. PEDIATRI BLOOD CANCER. 2018 MAY 11: E27232.HUANG IC, BRINKMAN TM, MULLINS L, PUI CH, ROBISON LL, HUDSON MM, KRULL KR. CHILD SYMPTOMS, PARENT BEHAVIORS, AND FAMILY STRAIN IN LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA. PSYCHO-ONCOLOGY 2018;27(8):2031-8.MONAHAN K, LENIHAN D, BRITTAIN EL, SALIBA L, PIANA RN, ROBISON LL, HUDSON MM, ARMSTRONG GT. THE RELATIONSHIP BETWEEN PULMONARY ARTERY WEDGE PRESSURE AND PULMONARY BLOOD VOLUME DERIVED FROM CONTRAST ECHOCARDIOGRAPHY: A PROOF-OF-CONCEPT STUDY. ECHOCARDIOGRAPHY. 2018 MAY 14. [EPUB AHEAD OF PRINT].5 & 6. AS OF SEPTEMBER 30, 2018, 5,657 SURVIVORS HAVE BEEN ENROLLED ON THE ST. JUDE LIFETIME COHORT STUDY. AMONG 3,866 ENROLLED 10+ YEAR SURVIVORS 18+ YEARS OF AGE, 3,489 SURVIVORS HAVE COMPLETED ONE OR MORE COMPREHENSIVE EVALUATION WITH PARTICIPATION RATES REMAINING HIGH (92% OF THOSE CONTACTED AND 85% OF TOTAL ELIGIBLE). AMONG 5-YEAR SURVIVORS IN THE EXPANDED ELIGIBLE COHORT, 1,791 PARTICIPANTS HAVE BEEN RECRUITED (AVERAGING 29 SURVIVOR REGISTRATIONS PER MONTH IN LAST YEAR). IN ADDITION, 652 CONTROL SUBJECTS HAVE BEEN RECRUITED, OF WHOM 600 HAVE COMPLETED COMPREHENSIVE EVALUATIONS.PEDIATRIC HEALTH NEED:COMMUNITY EDUCATIONHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, COMMUNICATIONS & PUBLIC RELATIONS DEPARTMENTANTICIPATED OUTCOME:IMPROVED HEALTH OUTCOMES AND COMMUNITY UNDERSTANDING OF HEALTH CARE RESOURCES AND HEALTH CARE CAREERSACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. ST. JUDE PROFESSIONALS WILL PROVIDE INFORMATION AND RESOURCES ABOUT SICKLE CELL DISEASE, HIV, CANCER, FLU, AND OTHER PEDIATRIC LIFE-THREATENING DISEASES.2. INVENTORY EDUCATIONAL OPPORTUNITIES ABOUT HEALTHCARE CAREERS ALREADY AVAILABLE FROM ST. JUDE TO DETERMINE AREAS OF FOCUS.SELECTED ACCOMPLISHMENTS:ST. JUDE PROFESSIONALS PROVIDING INFORMATION AND RESOURCES:- ST. JUDE CONDUCTED MORE THAN 75 30-SECOND EDUCATIONAL RADIO SPOTS IN FY18. TOPICS INCLUDED THE HIV VOICES PROJECT, AIDS SUPPORT, SICKLE CELL TRANSITION E-LEARNING PROGRAM (STEP), BLOOD DONOR CENTER, AND THE HPV VACCINE FOR CANCER PREVENTION. - IN ADDITION, ST. JUDE DISTRIBUTED PUBLIC SERVICE ANNOUNCEMENT SCRIPTS TO INCREASE AWARENESS ABOUT THE HPV VACCINE TO LOCAL MEMPHIS AND REGIONAL RADIO STATIONS IN FY18.- ALSO, ST. JUDE SUBMITTED A PUBLIC SERVICE ANNOUNCEMENT IN MAY 2018 TO INVITE THE COMMUNITY TO A SYMPOSIUM ABOUT SICKLE CELL DISEASE. - MEDIA RELATIONS EFFORTS RESULTED IN A NUMBER OF ST. JUDE PROFESSIONALS BEING INTERVIEWED THIS YEAR ON COMMUNITY SUBJECTS, INCLUDING FLU AWARENESS AND REMINDERS TO GET THE FLU VACCINE. INFORMATION FROM DR. RICHARD WEBBY AND HIS TEAM ABOUT THE FLU VACCINE APPEARED IN MORE THAN 1,000 NEWS PIECES, INCLUDING 13 LOCAL MEMPHIS STORIES. - "PROMISE" MAGAZINE IS ONE VEHICLE USED BY THE ST. JUDE COMMUNICATIONS AND PUBLIC RELATIONS DEPARTMENT TO EDUCATE THE PUBLIC ABOUT SICKLE CELL DISEASE, HIV, CANCER AND OTHER DISEASES. EACH QUARTER, "PROMISE" IS MAILED TO BETWEEN 250,000 AND 300,000 READERS, INCLUDING DONORS, EMPLOYEES, PEER INSTITUTIONS, CEOS OF FORTUNE 500 COMPANIES, SELECT MEDIA, AND INDIVIDUALS WHO SUBSCRIBE THROUGH OUR ONLINE SUBSCRIPTION FORM. ALL THE ARTICLES APPEAR ONLINE, WHERE THEY HAVE AN EVEN WIDER READERSHIP. AN E-NEWSLETTER VERSION OF "PROMISE" IS ALSO SENT TO NEARLY 10,000 SUBSCRIBERS QUARTERLY.A FEW OF THE EDUCATIONAL ARTICLES IN "PROMISE" MAGAZINE ARE LISTED:- THE SUMMER 2018 "PROMISE" INCLUDED A STORY ON HOW ST. JUDE PARTNERS WITH THE COMMUNITY TO BRING CUTTING-EDGE HIV PREVENTION AND EDUCATION TO AT-RISK YOUTH.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SUMMER-2018/PARTNERS-FOR-HIV-PREVENTION.HTML- THE SPRING 2018 "PROMISE" FEATURED AN ARTICLE ON OUR SCHOOL LIAISON SERVICES THAT HELP PATIENTS MAKE A SEAMLESS TRANSITION BACK TO THE CLASSROOM. THE ARTICLE FEATURED A LOCAL BOY WHO HAD COMPLETED TREATMENT AND RETURNED TO HIS MEMPHIS CLASSROOM.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SPRING-2018/SCHOOL-LIAISON-SERVICES-HELP-KIDS-GO-BACK-TO-SCHOOL.HTML- THE SPRING 2018 ISSUE ALSO INCLUDED AN ARTICLE ABOUT USING VIRTUAL REALITY FOR RELIEF OF PAIN FROM SICKLE CELL DISEASE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SPRING-2018/VIRTUAL-REALITY-A-DISTRACTION-FROM-SICKLE-CELL-PAIN.HTML- THE WINTER 2018 ISSUE FEATURED AN ARTICLE ABOUT HYDROXYUREA TREATMENT FOR KIDS WITH SICKLE CELL DISEASE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/WINTER-2018/HYDROXYUREA-WHEN-MORE-IS-BETTER.HTML- THE AUTUMN 2017 "PROMISE" INCLUDED A FEATURE ON FLU SURVEILLANCE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/AUTUMN-2017/KEEPING-FLU-AT-BAY.HTML- ST. JUDE HAS A PRESENCE ON SOCIAL MEDIA AS @STJUDERESEARCH ACROSS EIGHT PLATFORMS, WITH A TOTAL OF MORE THAN 38,000 FOLLOWERS. THE GOAL FOR SOCIAL MEDIA IS TO INCREASE THE RECOGNITION AND UNDERSTANDING OF ST. JUDE SCIENCE, MEDICINE, AND TRANSLATIONAL RESEARCH BY HIGHLIGHTING SCIENTIFIC AND MEDICAL STUDIES, SUCCESSES, PROJECTS, AND PROGRAMS. THE PLATFORMS ALSO FEATURE CAREER OPPORTUNITIES FOR RESEARCH AND CLINICAL CARE STAFF. THE AUDIENCE IS CURRENT AND POTENTIAL PHYSICIANS, SCIENTISTS, CLINICIANS, POSTDOCS, REFERRING PHYSICIANS, AND PATIENTS AND THEIR FAMILIES. WITHIN THE LAST YEAR, FEATURED TOPICS HAVE RANGED FROM CHILDHOOD CANCER FACTS TO PALLIATIVE CARE AWARENESS TO OPENINGS FOR SPECIALTY CANCER CLINICS.EDUCATIONAL OPPORTUNITIES ABOUT HEALTH CARE CAREERS:- THE SUMMER 2018 EDITION OF "PROMISE" INCLUDED AN UPDATE ON THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, THE FIRST DEGREE-GRANTING PROGRAM EVER ESTABLISHED ON THE ST. JUDE CAMPUS.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SUMMER-2018/FROM-STUDENT-TO-SCIENTIST-ST-JUDE-GRADUATE-SCHOOL.HTML- THE SPRING 2018 ISSUE OF "PROMISE" INCLUDED AN ARTICLE ON ST. JUDE AS AN EMPLOYER AND WHY EMPLOYEES ENJOY THEIR CAREERS IN HEALTH CARE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SPRING-2018/ST-JUDE-EMPLOYEES-THE-HEARTBEAT-OF-THE-HOSPITAL.HTML - APPROXIMATELY 120 LOCAL HIGH SCHOOL STUDENTS AND TEACHERS VISITED ST. JUDE IN MARCH 2018 FOR THE THIRD ANNUAL SCIENCE SCHOLARS OF TOMORROW SYMPOSIUM. THE DAY-LONG EVENT FEATURED SCIENTIFIC PRESENTATIONS AND TOURS OF LABORATORIES, CLINICS, AND CORE FACILITIES, ENABLING STUDENTS TO INTERACT WITH SCIENTISTS AND CLINICIANS.- MORE THAN 300 CANCER SURVIVORS, INCLUDING LOCAL MEMPHIS RESIDENTS, ATTENDED SURVIVORS DAY IN SEPTEMBER 2017, WHERE THEY RECEIVED INFORMATION ABOUT CANCER SURVIVORSHIP, SOCIAL WORK, EDUCATION, AND MORE.PEDIATRIC HEALTH NEED:ST. JUDE AFFILIATE NETWORKHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, AFFILIATE PROGRAM OFFICEANTICIPATED OUTCOME:THE ST. JUDE AFFILIATE NETWORK SHOULD BE MAINTAINED TO EXPAND OPPORTUNITIES FOR SERVICES TO A LARGER NUMBER OF CHILDREN.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. EVALUATE OPPORTUNITIES TO EXPAND TO ADDITIONAL LOCATIONS.2. ENHANCE OPERATIONS AND INCREASE PATIENT VISITS AT ALL CLINICS.3. INCREASE ACCRUALS ON ST. JUDE CLINICAL TRIALS.4. ENHANCE THE PATIENT EXPERIENCE AND ENSURE HIGH-QUALITY CARE.SELECTED ACCOMPLISHMENTS:- THE NUMBER OF PATIENTS ENROLLED IN ST. JUDE PRIMARY THERAPEUTIC PROTOCOLS FROM THE AFFILIATE CLINICS HAS INCREASED EACH YEAR:FY15 62 FY16 69 (+11%)FY17 106 (+54%)FY18 107 (+.01%)- THE SICKLE CELL CLINICAL RESEARCH AND INTERVENTION PROGRAM HAS BEEN ACTIVELY ENROLLING AT THE BATON ROUGE, CHARLOTTE, AND PEORIA AFFILIATE CLINICS, WITH ~20% OF ACCRUALS FROM THE AFFILIATE AREAS.- THE REDUCTION IN TIME-TO-ANTIBIOTICS IN IMMUNOCOMPROMISED CHILDREN QUALITY IMPROVEMENT PROJECT WAS SUCCESSFULLY COMPLETED.- AN AMBULATORY IMPLANTED CATHETER CARE BUNDLE WAS INSTITUTED AT ALL EIGHT AFFILIATES, WITH REDUCTIONS IN CENTRAL LINE INFECTIONS.- A PATIENT NAVIGATOR POSITION WAS ESTABLISHED TO IMPROVE THE PATIENT EXPERIENCE.AIM #2 ENHANCING COORDINATION OF CAREPEDIATRIC HEALTH NEED:PHYSICIAN COORDINATION OF CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITALST. JUDE AFFILIATE INSTITUTIONSALL DOMESTIC AND INTERNATIONAL REFERRING CLINICIANS AND CENTERSANTICIPATED OUTCOME:IMPROVE CONTINUITY OF CARE BY ENHANCING COMMUNICATION TOOLS AND EFFORTS TO PROVIDE PHYSICIANS WITH UNPARALLELED ACCESS TO PATIENT INFORMATION.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO IMPROVE THE CLINICIAN PORTAL TO PERMIT REFERRING AND AFFILIATED PHYSICIANS' CONVENIENT ACCESS TO PATIENT INFORMATION, IN ACCORDANCE WITH APPLICABLE LAW. SELECTED ACCOMPLISHMENTS:- PROVIDERS IN THE AFFILIATE PROGRAM NOW HAVE FULL ACCESS TO THE ST. JUDE ELECTRONIC MEDICAL RECORD. - CLINICIAN PORTAL WORK IS ONGOING. A VENDOR HAS BEEN SELECTED TO BEGIN DEVELOPMENT OF PATIENTSAFE. PROCESSES ARE UNDERWAY TO INVITE PHYSICIANS TO HAVE ACCOUNTS AND ASSIGN THEM USERNAMES AND PASSWORDS. THERE IS AN ON-GOING REVIEW PROCESS TO FINALIZE THAT PHYSICIANS CONTINUE TO HAVE ACTIVE PATIENT CARE RELATIONSHIPS WITH ST. JUDE PATIENTS.- DESIGNED AND TESTED A WEB PORTAL TO BE USED BY REFERRING AND AFFILIATED PHYSICIANS TO ACCESS PATIENT RECORDS AND IMPROVE COMMUNICATION. POLICIES AND PROCEDURES ARE BEING DRAFTED, AND AN IMPLEMENTATION COMMITTEE HAS BEEN FORMED.- METRICS TO QUALIFY TIMELY ENTRY AND CLINICIAN USAGE ARE ALSO BEING DEFINED. A REFERRING PHYSICIAN TASK FORCE (COMPRISED OF CLINICAL DIRECTOR, CLINICAL SERVICE LEADERS, FACULTY MEMBERS, AND CLINICAL AND ADMINISTRATIVE PROCESS LEADERS [INFORMATION SCIENCES, HEALTH INFORMATION MANAGEMENT, PHYSICIAN/PATIENT REFERRAL OFFICE]) IS CURRENTLY REVIEWING COMMUNICATION PROCESSES BY CLINICAL SERVICES TO ENSURE COMPLIANCE WITH THE COMMUNICATION POLICY FOR EXTERNAL CLINICIANS. THERE HAS ALSO BEEN AN EFFORT TO EXTEND AN INVITATION TO THE AFFILIATE PHYSICIANS TO PARTICIPATE REMOTELY IN WEEKLY MULTIDISCIPLINARY CONFERENCES TO AID IN COMMUNICATION AND SERVE AS AN OPPORTUNITY FOR TRAINING. PEDIATRIC HEALTH NEED:TRANSITION OF PATIENTS FROM PEDIATRIC TO ADULT HEALTHCARE SERVICESHEALTH FACILITIES INVOLVED:SICKLE CELL DISEASE PROGRAM - ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF HEMATOLOGY, CLINICAL HEMATOLOGY DIVISIONDIGGS-KRAUS SICKLE CELL CENTER AT REGIONAL ONE HEALTHMETHODIST HEALTHCARE COMPREHENSIVE SICKLE CELL CENTER (MCSCC)ANTICIPATED OUTCOME:INCREASE THE NUMBER OF PATIENTS WITH SICKLE CELL DISEASE WHO ESTABLISH SUSTAINED ADULT CARE AFTER LEAVING PEDIATRIC CARE AT ST. JUDE.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1.CONTINUE TO WORK WITH ADULT SICKLE CELL CENTERS IN THE COMMUNITY TO ENHANCE A SEAMLESS TRANSITION FROM PEDIATRIC CARE.2. ENHANCE ADOLESCENT AND YOUNG ADULTS (AYA) TRANSITION CLINICS WITH CO-LOCATION OF PEDIATRIC AND ADULT HEMATOLOGY PROVIDERS.3. AUGMENT FORMAL PROGRAMMING AND PLANNING PROCESSES FOR ADOLESCENTS WITH HEMATOLOGIC AND ONCOLOGIC DISEASES BY DEVELOPING DISEASE EDUCATIONAL CURRICULUM AND TRAINING MODULES TO FOSTER INCREASED ADOLESCENT AUTONOMY AND MEDICAL LITERACY.SELECTED ACCOMPLISHMENTS:- FY18 - 59 PATIENTS TRANSITIONED TO ADULT CARE.1. CONTINUE TO WORK WITH ADULT SICKLE CELL CENTERS IN THE COMMUNITY TO ENHANCE A SEAMLESS TRANSITION FROM PEDIATRIC CARE. WE CONTINUE TO PROVIDE THE QUARTERLY TEEN TRANSITION TOUR TO THE ADULT PROVIDERS IN MEMPHIS. LAST YEAR, 27 PATIENTS WITH SICKLE CELL DISEASE PARTICIPATED.A MONTHLY TRANSITION SKILLS LAB WAS IMPLEMENTED TO EQUIP YOUNG ADULTS WITH LIFE SKILLS THAT ARE NECESSARY AS THEY MOVE INTO THE ADULT REALM. LAST YEAR, 15 PATIENTS WITH SICKLE CELL DISEASE PARTICIPATED.DURING SKILLS LAB - THE TEENAGERS LEARN:A. HOW TO SCHEDULE A DOCTOR'S APPOINTMENTB. HOW TO ORDER MEDICATION REFILLC. HOW TO ACCESS INSURANCE BENEFITS D. WHAT A CO-PAY IS2. ENHANCE ADOLESCENT AND YOUNG ADULTS (AYA) TRANSITION CLINICS WITH CO-LOCATION OF PEDIATRIC AND ADULT HEMATOLOGY PROVIDERS. WE CONTINUE TO PROVIDE CO-LOCATION OF CARE FOR RECENTLY TRANSITIONED PATIENTS WITH SICKLE CELL DISEASE WHO CHOOSE TO CONTINUE CARE AT THE METHODIST COMPREHENSIVE SICKLE CELL CENTER. 3. AUGMENT FORMAL PROGRAMMING AND PLANNING PROCESSES FOR ADOLESCENTS WITH HEMATOLOGIC AND ONCOLOGIC DISEASES BY DEVELOPING DISEASE EDUCATIONAL CURRICULUM AND TRAINING MODULES TO FOSTER INCREASED ADOLESCENT AUTONOMY AND MEDICAL LITERACY.SINCE 2017, EDUCATION HAS BEEN DEVELOPED ON VARIOUS TOPICS, WITH THE GOAL OF INCREASING THE MEDICAL LITERACY AMONG PATIENTS WITH SICKLE CELL DISEASE.THE FOLLOWING TOPICS ARE PROVIDED TO ALL TRANSITIONING PATIENTS: A. COMPLICATIONS OF SICKLE CELL DISEASE AND HOW TO MANAGE THEM.B. WHAT ARE BLOOD COUNTS?C. WHAT IS BONE MARROW TRANSPLANT?AIM #3 IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDRENPEDIATRIC HEALTH NEED:CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY, AND PHYSICAL ACTIVITYHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, GLOBAL PEDIATRIC MEDICINEANTICIPATED OUTCOME:INCREASE THE NUMBER OF STUDENTS AND TEACHERS PARTICIPATING IN ST. JUDE CANCER AND HEALTHY LIVING EDUCATION PROGRAM.INCREASE THE KNOWLEDGE THAT CHILDREN HAVE ON CANCER AND HEALTHY LIVING TOPICS (NUTRITION, EXERCISE, SUN PROTECTION, AVOIDING TOBACCO)WITH PRE AND POST QUIZZES. IMPROVE ATTITUDES OF CHILDREN TOWARD HEALTHY LIVING PRACTICES (AVOIDING SMOKING, BETTER NUTRITION HABITS, MORE EXERCISE, AVOIDING EXCESSIVE SUN) USING SURVEY INSTRUMENTS. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. EVALUATE THE EFFECTIVENESS OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN CURRICULUM AT INCREASING CHILDREN'S KNOWLEDGE OF CANCER AND HEALTHY LIVING TOPICS (NUTRITION, EXERCISE, SUN PROTECTION, AVOIDING TOBACCO). 2. EVALUATE THE EFFECTIVENESS OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN CURRICULUM AT IMPROVING CHILDREN'S ATTITUDES TOWARDS HEALTHY LIVING PRACTICES (AVOIDING SMOKING, BETTER NUTRITION HABITS, MORE EXERCISE, AVOIDING EXCESSIVE SUN).3. PARTNER WITH LOCAL EDUCATION AGENCIES TO DISSEMINATE CANCER AND HEALTHY LIVING EDUCATIONAL PROGRAMS.SELECTED ACCOMPLISHMENTS:1. DEVELOP A FORMAL PROFESSIONAL DEVELOPMENT TRAINING SERIES FOR K-12 EDUCATORS INTERESTED IN INCORPORATING CANCER EDUCATION CONCEPTS INTO THEIR CLASSROOM CURRICULUM. THE ST. JUDE CANCER EDUCATORS CLASSROOM (SJCEC) IS A YEAR-LONG WORKSHOP SERIES THAT AIMS TO PROVIDE K-12 LEADERS AND EDUCATORS WITH VARIOUS FRAMEWORKS AND STRATEGIES FOR IMPROVING SCIENCE EDUCATION PEDAGOGY AND REDUCING STEREOTYPE THREATS THAT PREVENT INDIVIDUALS FROM UNDERREPRESENTED BACKGROUNDS FROM PURSUING CAREERS IN BIOMEDICAL RESEARCH. IN THIS INNOVATIVE APPROACH TO PROFESSIONAL DEVELOPMENT, PARTICIPANTS EXPLORED WAYS TO WEAVE TOGETHER SOCIAL AND EMOTIONAL LEARNING WITH SCIENCE EDUCATION IN A WAY THAT ENCOURAGES STUDENTS TO THINK CRITICALLY AND CREATIVELY, FOSTERS A FEARLESSNESS TO TACKLE WHAT ARE OFTEN BELIEVED TO BE UNSOLVABLE PROBLEMS, AND PROMOTES POSITIVE SELF-IDENTITIES THAT ENCOURAGE STUDENTS FROM UNDERREPRESENTED BACKGROUNDS TO PURSUE CAREERS IN BIOMEDICAL RESEARCH.THE SJCEC PILOT PROGRAM TOOK PLACE DURING THE 2017-2018 ACADEMIC YEAR WITH A GROUP OF 15 K-12 EDUCATORS AND 2 PROFESSIONAL LEARNING COACHES (PLCS) FROM 7 SCHOOLS THAT PREDOMINANTLY SERVE STUDENTS FROM LOW SOCIOECONOMIC BACKGROUNDS AND STUDENTS OF COLOR. ALL PARTICIPANTS WERE EMPLOYEES IN THE SHELBY COUNTY SCHOOL DISTRICT. LEARNING IN THIS PILOT PROGRAM TOOK PLACE THROUGH FOUR ONE-DAY INTERACTIVE WORKSHOPS AND A WEEK-LONG SUMMER COLLABORATIVE WORKSHOP.WORKSHOP 1: ENSURING A HIGH-QUALITY SCIENCE EDUCATION FOR ALL STUDENTS THIS WORKSHOP INTRODUCED TEACHERS TO PRACTICES AND METHODS THAT MAKE SCIENCE CONCEPTS RELEVANT TO ALL STUDENTS. PARTICIPANTS CONSIDERED SOME OF THE CHALLENGES AND BARRIERS TO STUDENT LEARNING IN RACIALLY IDENTIFIABLE SCHOOLS AND HIGH-POVERTY SCHOOLS AND BRAINSTORMED METHODS FOR OVERCOMING THESE BARRIERS.WORKSHOP 2: FOSTERING THINKING IN THE SCIENCE CLASSROOMTHIS WORKSHOP INTRODUCED EDUCATORS TO METHODS FOR FOSTERING THINKING IN THE SCIENCE CLASSROOM. PARTICIPANTS WERE ASKED TO REFLECT ON THEIR OWN CLASSROOM ENVIRONMENT AND TO IDENTIFY AREAS OF STRENGTH AND WEAKNESS.WORKSHOP 3: 3-DIMENSIONAL LESSON PLANNINGTHIS WORKSHOP GUIDED TEACHERS THROUGH THE NATIONAL ACADEMIES OF SCIENCES' A FRAMEWORK FOR K-12 SCIENCE EDUCATION TO EXPLORE CURRENT SHIFTS IN SCIENCE EDUCATION. PARTICIPANTS WORKED IN GRADE-LEVEL TEAMS TO IDENTIFY 3-DIMENSIONAL LESSONS WITHIN CANCER RESEARCH THEMES.WORKSHOP 4: CURRICULUM MAPPING AND ASSESSMENT PLANNINGTHIS WORKSHOP GUIDED TEACHERS THROUGH THE PROCESS OF CURRICULUM MAPPING AND ASSESSMENT PLANNING. PARTICIPANTS MODIFIED EXISTING CURRICULUM MAPS TO INCORPORATE 3-DIMENSIONAL LESSONS WITHIN CANCER RESEARCH THEMES AND CONNECT THEM TO TENNESSEE STATE SCIENCE STANDARDS.SUMMER COLLABORATIVE:THE SUMMER COLLABORATIVE WAS AN INTENSIVE, WEEK-LONG CURRICULUM DEVELOPMENT WORKSHOP. PARTICIPANTS WORKED IN SCHOOL TEAMS TO DESIGN 3-DIMENSIONAL LESSON PLANS FOCUSED ON CANCER EDUCATION THEMES. LESSONS INTEGRATED CONCEPTS FROM THE CULTURE OF THINKING (COT) PEDAGOGY WITH THE SCIENCE SCHOLARS OF TOMORROW (SSOT) CURRICULAR ITEMS. SEVERAL THEMES EMERGED THROUGHOUT THESE WORKSHOPS THAT DIRECTLY TIE TO NEGATIVE SELF-STEREOTYPES THAT CAN INHIBIT STUDENTS FROM UNDERREPRESENTED POPULATIONS FROM PURSUING CAREERS IN SCIENCE. THESE INCLUDE:- STUDENTS' FEELINGS OF HOPELESSNESS - FIXED MINDSETS (AND HOPELESSNESS) FORMED AS A RESULT OF LOW INCOME MOBILITY RATES IN MEMPHIS AND GENERATIONAL POVERTY- STUDENTS FEEL AS THOUGH THE SCHOOL IS PREPARING THEM FOR PRISON (THE SCHOOL-TO-PRISON PIPELINE WAS MENTIONED)- THE INVENTION OF COUNTER-CULTURES THAT PROVIDE A SPACE WHERE STUDENTS FEEL THAT THEY CAN SUCCEED (COUNTER-CULTURES ARE SUBCULTURES WHOSE VALUES AND NORMS OF BEHAVIOR ARE SUBSTANTIALLY DIFFERENT FROM THOSE OF MAINSTREAM SOCIETY, OFTEN IN OPPOSITION TO MAINSTREAM CULTURAL MORES)- STUDENTS OFTEN FAIL TO SEE HOW SCIENCE IS RELATED TO SOCIAL CHANGE AND WILL OFTEN WORK HARDER IN SOCIAL STUDIES AND HISTORY CLASSES THAN MATH AND SCIENCE CLASSES AS A RESULT. (THIS TIES TO A LACK OF UNDERSTANDING OF HOW SCIENCE IS RELEVANT TO THEM AND THEIR COMMUNITY, WHICH HAS SEVERAL IMPLICATIONS FOR CHALLENGES IN MINORITY INCLUSION ON CLINICAL TRIALS AS WELL.)PARTICIPANTS ALSO BRAINSTORMED PROGRAMMATIC EFFORTS TO REDUCE STEREOTYPE THREAT IN THEIR CLASSROOMS. THROUGH THESE CONVERSATIONS, FOUR ESSENTIAL COMPONENTS TO PROGRAMMATIC EFFORTS WERE IDENTIFIED:- PROVIDE COUNTER-STEREOTYPES: STUDENTS NEED TO SEE EXAMPLES OF UNDER REPRESENTED MINORITIES (URMS) PARTICIPATING IN SCIENTIFIC RESEARCH.- SUSTAIN INTERACTION: WHETHER THROUGH ONLINE/VIRTUAL INTERACTIONS, SCIENTIST VISITS TO THE CLASSROOM, OR FIELD TRIPS, STUDENTS NEED SUSTAINED INTERACTION WITH ST. JUDE/SCIENCE IN ORDER TO VIEW IT AS A POSSIBLE CAREER OPTION.- START YOUNG: STEREOTYPE THREAT BEGINS EARLY. MOST STUDENTS HAVE DECIDED WHETHER OR NOT THEY ARE GOOD AT/LIKE SOMETHING BY MIDDLE SCHOOL. WE NEED TO ENGAGE STUDENTS THROUGHOUT THE K-12 SPECTRUM WITH SUSTAINED EFFORTS THAT COUNTER STEREOTYPE THREATS.- ENGAGE ALL SCHOOL STAKEHOLDERS: SCHOOL ADMINISTRATORS NEED EDUCATION ON WHY SCIENCE AND STEM SHOULD BE AN IMPORTANT FOCUS IN K-5 CLASSROOMS IN ADDITION TO NUMERACY AND LITERACY. PARENTS NEED EDUCATION ON HOW TO SUPPORT A CHILD INTERESTED IN STEM CAREERS AS WELL AS COUNTER-STEREOTYPES THAT DEMONSTRATE THAT URM CHILDREN CAN HAVE SUCCESSFUL CAREERS IN SCIENCE. TEACHERS NEED GRADE-LEVEL PROFESSIONAL DEVELOPMENT RELATED TO HIGH-LEVEL SCIENCE CONCEPTS AND RESOURCES FOR TEACHING STUDENTS HIGH-LEVEL SCIENCE.THE SUMMER COLLABORATIVE YIELDED A VARIETY OF IDEAS AND STRATEGIES FOR IMPLEMENTING 3-DIMENSIONAL SCIENCE LESSONS IN THE CLASSROOM. THESE VARIED BASED ON GRADE-LEVEL AND SUBJECT TAUGHT, BUT ALL INVOLVED THE INCORPORATION OF CASE-BASED/PROBLEM-BASED LESSONS THAT CENTER AROUND A REAL-WORLD SCENARIO. THE ST. JUDE CANCER EDUCATION AND OUTREACH TEAM WILL CONTINUE TO WORK WITH THESE EDUCATORS FOR AT LEAST 3 YEARS FOLLOWING THE WORKSHOP SERIES TO CONTINUE TO HELP GROW AND FOSTER A CULTURE OF THINKING IN THE CLASSROOM, PROVIDE NECESSARY RESOURCES TO PROMOTE HIGH-QUALITY SCIENCE IN THE CLASSROOM THROUGH THE CANCER EDUCATION IN THE CLASSROOM LOAN KIT PROGRAM, AND COORDINATE SCIENTIST VISITS TO THE CLASSROOM THROUGH THE ST. JUDE SCIENCE AMBASSADORS PROGRAM. 2. PARTNER WITH LOCAL EDUCATION AGENCIES TO DISSEMINATE CANCER AND HEALTHY LIVING EDUCATIONAL PROGRAMS.THE ST. JUDE CANCER EDUCATION AND OUTREACH PROGRAM IS A SCHOOL-BASED OUTREACH PROGRAM THAT USES EDUCATION AND POSITIVE REINFORCEMENT TO HELP PROMOTE HEALTHY LIFESTYLE CHOICES AND TO REDUCE A CHILD'S LIFETIME RISK OF DEVELOPING CANCER. THE PROGRAM'S EDUCATIONAL OBJECTIVES ARE TO (A) EDUCATE ELEMENTARY SCHOOL CHILDREN ABOUT CANCER AND DISPEL COMMON MISCONCEPTIONS, (B) EDUCATE ABOUT AND PROMOTE HEALTHY LIFESTYLE CHOICES THAT CAN HELP CHILDREN REDUCE THEIR RISK OF CANCER IN ADULTHOOD, AND (C) INSPIRE AN INTEREST IN SCIENCE AND SCIENTIFIC CAREERS. IT SPECIFICALLY ADDRESSES OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. DURING THE 2017-2018 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM PARTNERED WITH 19 SCHOOLS TO DELIVER EDUCATIONAL CONTENT TO OVER 5,000 K-12 STUDENTS IN THE MEMPHIS AREA. ST. JUDE CHILDREN'S RESEARCH HOSPITAL: PART V, SECTION B, LINE 7A: THE CHNA REPORT WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 10A: THE HOSPTIAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 14: ST. JUDE CURRENTLY DOES NOT BILL NOR PURSUE PAYMENT FOR ANY ST. JUDE PATIENT; THEREFORE, ST. JUDE DOES NOT HAVE A BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS.ST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16A: THE FAP WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16B: BASED ON THE FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY(HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML), ST. JUDE DOES NOT HAVE AN APPLICATION FORM.ST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML PART I, LINE 3C: NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. WE DO NOT NEED TO DETERMINE ELIGIBILITY FOR THIS ASSISTANCE. BY DEFAULT, ALL PATIENTS ARE ELIGIBLE TO RECEIVE MEDICAL CARE AND SUPPORT SERVICES AT NO COST. ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. BILLING INSURANCE FOR THE COSTS THAT WOULD BE DUE AT ANY OTHER HOSPITAL ALLOWS ST. JUDE TO CONTINUE DOING SOME OF THE MOST ADVANCED RESEARCH IN THE WORLD. IT ALSO ALLOWS ST. JUDE TO PAY FOR TREATMENTS, COPAYMENTS, DEDUCTIBLES, COINSURANCE, AND ANY OTHER COSTS INSURANCE DOES NOT COVER.TO ENSURE FAMILIES ARE MAKING USE OF ALL RESOURCES FOR WHICH THEY ARE ELIGIBLE, WE HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. DOING SO ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE ALSO CONTRACT WITH A VENDOR TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO ASSIST FAMILIES APPLYING FOR HEALTH INSURANCE COVERAGE THROUGH FEDERAL OR STATE FACILITATED MARKETPLACES. PART I, LINE 7: COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. COST-TO-CHARGE RATIO USED FOR LINE 7A FINANCIAL ASSISTANCE AT COST, LINE 7B MEDICAID, AND LINE 7C COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS.SOME CHIPS VOLUME IS INCLUDED IN MEDICAID IN PART I, LINE 7B BECAUSE IN MANY STATES THE CHIPS PROGRAMS ARE MANAGED BY THE SAME THIRD PARTY ADMINISTRATORS, AND IT IS DIFFICULT TO DISTINGUISH BETWEEN CHIPS AND MEDICAID COVERAGE. PART I, LINE 7G: ST. JUDE CHILDREN'S RESEARCH HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES SUPPORT FOR EIGHT AFFILIATE CLINICS TOTALING APPROXIMATELY $10.8 MILLION. PART II, COMMUNITY BUILDING ACTIVITIES: THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL CEO IS A MEMBER OF MEMPHIS TOMORROW. MEMPHIS TOMORROW IS AN ASSOCIATION OF CHIEF EXECUTIVE OFFICERS OF MEMPHIS' LARGEST ENTERPRISES. THE PURPOSE IS TO BRING TOP BUSINESS LEADERS TOGETHER WITH GOVERNMENT AND CIVIC LEADERS TO FOSTER ECONOMIC PROSPERITY FOR ALL WHO LIVE IN OUR COMMUNITY. THEIR INITIATIVES ARE FOCUSED IN THOSE AREAS WHICH DIRECTLY IMPACT ECONOMIC GROWTH AND OPPORTUNITY, INCLUDING: HUMAN CAPITAL DEVELOPMENT, INDUSTRY DEVELOPMENT, AND PUBLIC SAFETY. ST. JUDE ALSO PARTICIPATES WITH MEMPHIS FAST FORWARD WHOSE STRATEGIES ARE BASED ON THE COMMON SENSE PREMISE THAT ECONOMIC GROWTH AND PROSPERITY, AND IMPROVED QUALITY OF LIFE, WILL FOLLOW ONCE MEMPHIS AND SHELBY COUNTY SUCCESSFULLY ADDRESS THE BASICS: GOOD JOBS, QUALITY EDUCATION, SAFE STREETS AND EFFICIENT GOVERNMENT. THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL CEO IS A MEMBER OF THE CHAIRMAN'S CIRCLE. THE CHAIRMAN'S CIRCLE ENGAGES MEMPHIS BUSINESS LEADERS ON ISSUES THAT AFFECT MEMPHIS AND THE MID-SOUTH. THE CHAIRMAN'S CIRCLE'S 100+ MEMBERS REPRESENT MORE THAN 100,000+ EMPLOYEES IN THE MEMPHIS BUSINESS COMMUNITY. ITS MISSION IS TO MAKE MEMPHIS GREAT BY USING OUR COLLECTIVE STRENGTHS AS COMMUNITY AND BUSINESS LEADERS TO CREATE A CLEAR PATH TO POSITIVE CHANGE IN MEMPHIS AND THE MID-SOUTH. ST. JUDE IS A MEMBER OF THE ASPIRING FOR PURCHASING EXCELLENCE (APEX) ASSOCIATION OF MEMPHIS. APEX IS AN ASSOCIATION OF PURCHASING AND PROCUREMENT PROFESSIONALS FROM MEMPHIS ORGANIZATIONS WHOSE PURPOSE IS TO PROMOTE BEST PRACTICES IN SUPPLIER DIVERSITY. ADDITIONALLY, ST. JUDE IS SILVER SPONSOR FOR THE MID-SOUTH MINORITY BUSINESS COUNCIL (MMBC) ECONOMIC DEVELOPMENT FAIR. THE MMBC SERVES AS THE MID-SOUTH'S FOREMOST MINORITY BUSINESS DEVELOPMENT ORGANIZATION. THE MMBC HELPS TO DEVELOP A STRONG MINORITY AND WOMEN BUSINESS COMMUNITY IN AN EFFORT TO IMPACT ECONOMICALLY THE ENTIRE MID-SOUTH REGION. THE PEDIATRIC ONCOLOGY EDUCATION PROGRAM BRINGS FIFTY TO SIXTY STUDENTS EACH SUMMER FOR INTERNSHIPS IN BASIC SCIENCE OR CLINICAL RESEARCH. ADDITIONALLY, EXPERIENTIAL LEARNING INTERNSHIPS ARE STRUCTURED BY AND MANAGED BY ACADEMIC PROGRAMS IN MANY AREAS FROM SCIENCE TO ACCOUNTING. THERE ARE ANOTHER 150 STUDENTS INVOLVED IN THESE INTERNSHIPS. THESE PROGRAMS SUPPORT INCREASING THE AWARENESS OF CAREERS IN RESEARCH SCIENCE, HEALTHCARE, OR HEALTHCARE MANAGEMENT AND CONTRIBUTE TO PREPARING STUDENTS TO ENTER THESE CAREERS. THE CLINICAL EDUCATION AND TRAINING OFFICE HOSTS FORTY TO FIFTY STUDENTS ANNUALLY AS PATIENT CARE OBSERVERS. THESE STUDENTS ARE AT DIFFERENT STAGES OF TRAINING AND ARE FROM UNDERGRADUATE COLLEGES OR PROFESSIONAL HEALTHCARE SCHOOLS INCLUDING MEDICAL SCHOOLS. THE OBSERVERS ARE DECIDING ON OR CONFIRMING A DESIRE TO PURSUE A CAREER IN HEALTHCARE. THE FAMILY, GUEST, AND VOLUNTEER SERVICES DEPARTMENT PROVIDES SUMMER PROGRAMS FOR HIGH SCHOOL AND COLLEGE STUDENTS THAT DRIVE ENTRY INTO HEALTH CAREERS.THE OFFICE OF LEGAL SERVICES OFFERS LEGAL INTERNSHIPS TO LOCAL (UNIVERSITY OF MEMPHIS, OLE MISS) LAW STUDENTS DURING THE ACADEMIC YEAR AND TO NATIONAL LAW SCHOOLS DURING THE SUMMER. INTERNS PERFORM LEGAL RESEARCH; DRAFT MEMORANDA, LETTERS, AND OTHER DOCUMENTS; DRAFT AND REVIEW CONTRACTUAL AGREEMENTS; PREPARE PRESENTATIONS TO ST. JUDE PERSONNEL; AND ASSIST WITH DRAFTING POLICIES. INTERNS ALSO LEARN THROUGH OBSERVATION OF AND PARTICIPATION IN DAY-TO-DAY LAW PRACTICE ACTIVITIES, INCLUDING LEGAL PROCEEDINGS, NEGOTIATIONS, MEETINGS, TRAININGS, AND COUNSELING SESSIONS. WHEN POSSIBLE, INTERNS WORK WITH CLIENT DEPARTMENTS AND DEPARTMENTAL STAFF TO GATHER INFORMATION AND TO GAIN INSIGHT INTO AND UNDERSTANDING OF RESEARCH, CLINICAL, BUSINESS, AND HEALTH CARE OPERATIONS.IN ADDITION, MEMBERS OF THE OFFICE OF LEGAL SERVICES ENGAGED IN THE FOLLOWING ACTIVITIES WITHIN THE MEMPHIS AND LARGER TENNESSEE COMMUNITIES:- FIVE LAWYERS VOLUNTEERED AT A SATURDAY LEGAL CLINIC ORGANIZED BY MEMPHIS AREA LEGAL SERVICES.- CO-PRESENTED ON "PEDIATRIC BIOETHICS AND THE LAW," AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW, FEBRUARY 2018. - PRESENTED ON FUNDAMENTALS OF PROTECTION OF HUMAN SUBJECTS IN RESEARCH AT A PROGRAM BY THE HEALTH LAW SOCIETY AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW IN NOVEMBER 2017. - PRESENTED AT THE TENNESSEE BAR ASSOCIATION ANNUAL HEALTH LAW PRIMER IN OCTOBER 2017. - PRESENTED A WEBINAR FOR THE TENNESSEE BAR ASSOCIATION ON "CONTROLLED SUBSTANCE PRESCRIBING: EVOLVING STANDARDS DURING THE OPIOID EPIDEMIC" IN SEPTEMBER 2017. - SERVED AS A PANELIST AT THE SOCIETY FOR HUMAN RESOURCE MANAGEMENT - MEMPHIS MEETING IN MARCH 2018. - PLANNED A HEALTH LAW NETWORKING EVENT AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW.- SERVED ON THE TENNESSEE BAR ASSOCIATION HEALTH LAW SECTION EXECUTIVE COUNCIL.FINALLY, THE CHIEF GOVERNMENT AFFAIRS OFFICER WORKED IN COLLABORATION WITH LEGAL STAFF AND OUTSIDE ADVOCACY GROUPS TO SUPPORT EFFORTS TO CREATE A STATE PALLIATIVE CARE/QUALITY OF LIFE ADVISORY COUNCIL.THE ST. JUDE CHIEF GOVERNMENT AFFAIRS OFFICER CONTINUES TO SERVE ON THE BOARD OF DIRECTORS OF THE MEMPHIS RIVER PARKS PARTNERSHIP (MRPP), FORMERLY KNOWN AS THE RIVERFRONT DEVELOPMENT CORPORATION (RDC). THE MRPP IS A NON-PROFIT ORGANIZATION THAT, UNDER A LONG-TERM CONTRACT WITH THE CITY OF MEMPHIS, MANAGES ALL THE PARKS ALONG A 5-MILE STRETCH OF THE MEMPHIS RIVERFRONT INCLUDING ALONG DOWNTOWN MEMPHIS AND MUD ISLAND RIVER PARK. ELEMENTS ALONG THE RIVER FOSTER HEALTHY LIFESTYLES INCLUDING RIVERFIT, A SERIES OF PHYSICAL FITNESS CHALLENGES, AND A PLAYGROUND DESIGNED SPECIFICALLY FOR CHILDREN AT BEALE ST. LANDING, THE ONLY CHILD-DESIGNATED PLAYGROUND ON THE MEMPHIS RIVERFRONT. THE MRPP IS ALSO WORKING WITH THE CITY OF MEMPHIS TO IMPLEMENT A SERIES OF IMPROVEMENTS DESIGNED TO TIE THE RIVERFRONT CLOSER TO WORKERS AND RESIDENTS OF DOWNTOWN MEMPHIS TO MAKE ACCESS TO RIVERFRONT AMENITIES EASIER FOR ALL CITIZENS OF MEMPHIS AND TOURISTS VISITING THE CITY.THIS PAST YEAR THE CHIEF GOVERNMENT AFFAIRS OFFICER WAS ALSO APPOINTED TO SERVE ON THE BOARD OF COMMISSIONERS OF THE MEMPHIS AREA TRANSIT AUTHORITY (MATA) BY MEMPHIS MAYOR JIM STRICKLAND. IN THIS CAPACITY, HE HELPS TO PROMOTE THE HEALTH OF THE COMMUNITY BY ADVOCATING FOR POLICIES THAT ENABLE ENHANCED MOBILITY FOR A LARGER PERCENTAGE OF THE POPULATION OF MEMPHIS AND SHELBY COUNTY.THE CHIEF LEGAL OFFICER PARTICIPATES ON COMMITTEES OF THE MEMPHIS CHILD ADVOCACY CENTER, WHICH HELPS LOCAL CHILDREN FIND SAFETY AND HEALING (INCLUDING ACCESS TO A MENTAL HEALTH PROFESSIONAL) AFTER A REPORT OF SEXUAL OR OTHER SEVERE ABUSE, AND OFFERS ABUSE PREVENTION TRAINING TO COMMUNITY VOLUNTEERS AND PARENTS. THE CHIEF LEGAL OFFICER SERVES AS CHAIR OF THE ADVISORY BOARD OF THE INSTITUTE FOR HEALTH LAW & POLICY OF THE CECIL C. HUMPHREYS UNIVERSITY OF MEMPHIS SCHOOL OF LAW, WHICH ENDEAVORS TO ADDRESS UNMET HEALTH LAW NEEDS OF THE LOCAL COMMUNITY AND WORK WITH COMMUNITY LEADERS TO PROACTIVELY ADDRESS HEALTH POLICY NEEDS.THE SENIOR ASSOCIATE COUNSEL IS THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION'S ELECTED REPRESENTATIVE TO THE BOARD OF THE MEMPHIS BAR ASSOCIATION. THE ASSOCIATE COUNSEL SERVES ON THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION BOARD. THE ASSOCIATE COUNSEL CHAIRS THE COMMUNITY AFFAIRS COMMITTEE OF THAT SECTION AND THE CHIEF LEGAL OFFICER IS AN ACTIVE MEMBER OF THE COMMITTEE, WHICH ANNUALLY SPONSORS A SATURDAY LEGAL CLINIC PROVIDING UNREPRESENTED MEMBERS OF THE COMMUNITY AN OPPORTUNITY TO MEET WITH A VOLUNTEER ATTORNEY AND DISCUSS LEGAL ISSUES, INCLUDING THOSE THAT HAVE AN IMPACT ON PERSONAL HEALTH.THE MANAGER OF THE CANCER EDUCATION PROGRAM IN THE DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE (GPM) DEDICATES 80% OF HER TIME, AND THE COORDINATOR FOR CANCER EDUCATION DEDICATES 100% OF HER TIME TO CANCER EDUCATION OUTREACH, INCLUDING ACTIVITIES SUCH AS K-12 CURRICULUM DEVELOPMENT, SCHOOL VISITS FOR CANCER AND HEALTHY LIVING EDUCATION, CAREER TALKS, TEACHER TRAINING WORKSHOPS AND PUBLIC-ACCESS WEBSITE DEVELOPMENT. PART III, LINE 2: BAD DEBT EXPENSE IS EQUAL TO CHARGES ON ACCOUNTS DETERMINED TO BE UNCOLLECTIBLE. SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: BAD DEBT EXPENSE EXPLANATION IN FINANCIAL STATEMENTS FOOTNOTES IS AS FOLLOWS:NET PATIENT SERVICE REVENUES AND RECEIVABLES - NO FAMILY EVER PAYS THE HOSPITAL FOR THE CARE THEIR CHILD RECEIVES. ACCORDINGLY, NET PATIENT SERVICE REVENUE CONSISTS ONLY OF ESTIMATED NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS (IF NECESSARY) DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED AS AMOUNTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PATIENT SERVICE REVENUE HAS BEEN REDUCED BY ADJUSTMENTS FOR UNCOLLECTIBLE ACCOUNTS TOTALING APPROXIMATELY $773,000 AND $512,000 IN 2018 AND 2017, RESPECTIVELY.ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER BAD DEBT EXPENSE A COMMUNITY BENEFIT. PART III, LINE 8: ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER THE MEDICARE SHORTFALL A COMMUNITY BENEFIT. THE COST TO CHARGE RATIO WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE. PART III, LINE 9B: ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. THIS IS SET FORTH IN OUR FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/ LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML). PART VI, LINE 2: ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. CANCERPEDIATRIC CANCERS ARE RARE COMPARED TO ADULT CANCERS. ONLY 10,590 NEW CASES ARE EXPECTED TO OCCUR AMONG CHILDREN 14 YEARS OF AGE AND YOUNGER IN 2018; HOWEVER, CANCER IS THE LEADING CAUSE OF DISEASE-RELATED DEATH IN U.S. CHILDREN (FOOTNOTE 1). THE PRINCIPAL FOCUS OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS CANCER. SEVENTY-FIVE PERCENT OF ALL RESOURCES AT ST. JUDE ARE INVESTED IN ELUCIDATING BASIC BIOLOGICAL MECHANISMS OF PEDIATRIC CANCERS, AND TRANSLATING THIS KNOWLEDGE INTO IMPROVED DIAGNOSTIC TOOLS AND CURATIVE THERAPIES, WHILE MINIMIZING LONG-TERM SIDE EFFECTS. AS THE FIRST AND ONLY NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER FOCUSED EXCLUSIVELY ON CHILDREN, ST. JUDE SERVES AS A NATIONAL RESOURCE FOR RESEARCH AND TREATMENT OF PEDIATRIC CANCERS. OUR INITIATIVES ARE DESIGNED TO IMPACT PEDIATRIC CANCER TREATMENT ON A LOCAL, REGIONAL, NATIONAL AND GLOBAL SCALE. OUR CANCER PATIENTS COME FROM ALL OVER THE UNITED STATES AND ABROAD; HOWEVER, 66% OF THE NEW CANCER PATIENTS WE REGISTER RESIDE IN THE ST. JUDE CATCHMENT AREA, WHICH INCLUDES A 180-MILE RADIUS AROUND ST. JUDE LOCATED IN MEMPHIS, TN AND A 100-MILE RADIUS AROUND EACH OF OUR EIGHT AFFILIATES. THESE EIGHT AFFILIATES ARE LOCATED IN HUNTSVILLE, AL, CHARLOTTE, NC, JOHNSON CITY, TN, BATON ROUGE, LA, SHREVEPORT, LA, TULSA, OK, SPRINGFIELD, MO, AND PEORIA, IL. THE CATCHMENT POPULATION IS GENERALLY CHARACTERIZED BY A HIGHER PROPORTION OF NON-HISPANIC BLACK/AFRICAN-AMERICAN RACE, LOWER PROPORTION OF HISPANIC ETHNICITY, LOWER HOUSEHOLD INCOMES AND HOME VALUES, AND LOWER PROPORTION WITH AN EDUCATION BEYOND HIGH SCHOOL. APPROXIMATELY 4.9% OF THE POPULATION LIVE IN RURAL AREAS (BY RUCA CODE 10). TAKEN TOGETHER, THIS DIVERSE POPULATION INCLUDES MANY WITH LIMITED RESOURCES WHO ARE MEDICALLY UNDERSERVED. THROUGH ST. JUDE'S FOUNDING POLICY--THAT NO PATIENT BE DENIED TREATMENT BASED ON RACE, ETHNICITY, RELIGION, OR A FAMILY'S INABILITY TO PAY--AND WITH THE PROVISION OF RESOURCES TO OFFSET THE COSTS OF TRANSPORTATION AND HOUSING DURING CLINIC VISITS AND TREATMENT, WE REMOVE BARRIERS IN ACCESS TO OUR CUTTING-EDGE CLINICAL RESEARCH TRIALS AND EXCEPTIONAL CLINICAL CARE. ALL PEDIATRIC PATIENTS IN OUR CATCHMENT AREA ARE ACCEPTED TO ST. JUDE FOR TREATMENT OF THEIR CANCER.THE DEMOGRAPHICS OF THE PEDIATRIC CANCER POPULATION TREATED AT ST. JUDE CLOSELY MATCH THOSE OF OUR CATCHMENT AREA (BASED ON 2010 DATA FROM THE US CENSUS BUREAU) AND ALIGN WITH THE ESTIMATED INCIDENCE OF PEDIATRIC CANCER IN REPRESENTED RACIAL AND ETHNIC GROUPS (BASED ON SURVEILLANCE EPIDEMIOLOGY AND END RESULTS [SEER] 2009 DATA), CONFIRMING THAT ST. JUDE IS CLOSELY ALIGNED WITH THE NEEDS OF THE POPULATION IT SERVES. DEMOGRAPHICS FROM THE ST. JUDE PEDIATRIC CANCER COHORT ARE COMPARED WITH THE DEMOGRAPHICS OF THE CATCHMENT AREA ANNUALLY TO MONITOR DEMOGRAPHIC REPRESENTATION OF OUR CANCER PATIENTS IN RELATION TO THE AREA THAT WE SERVE. THERE ARE NO KNOWN DIFFERENCES IN PEDIATRIC CANCER INCIDENCE BY GEOGRAPHIC REGION IN THE U.S. CONSEQUENTLY, IT IS NOT POSSIBLE TO CATER OUR CLINICAL TRIALS TO TARGET PEDIATRIC CANCERS SPECIFICALLY PREVALENT IN OUR CATCHMENT AREA. WHILE NUMEROUS ADULT CANCERS HAVE BEEN SHOWN TO HAVE HIGH VARIATION IN INCIDENCE RATES ACROSS RACES AND ETHNICITIES, THE SITUATION IS LESS CLEAR IN PEDIATRIC CANCER, WHERE FEWER DISCREPANCIES HAVE BEEN IDENTIFIED. ALTHOUGH OUR CATCHMENT AREA HAS A HIGHER PROPORTION OF AFRICAN-AMERICAN PATIENTS THAN THE GENERAL U.S. POPULATION, THERE ARE VERY FEW EXAMPLES OF PEDIATRIC CANCERS IN WHICH THE INCIDENCE IS HIGHER IN RACIAL AND/OR ETHNIC MINORITIES (FOOTNOTES 2 AND 3). CONSEQUENTLY OUR RESEARCH AND CLINICAL TRIALS ADDRESS THE MOST PRESSING PROBLEMS IN PEDIATRIC CANCER. ST. JUDE OFFERS THERAPEUTIC TRIALS FOR THE TOP PEDIATRIC CANCERS (FOOTNOTE 1) INCLUDING ACUTE LYMPHOBLASTIC LEUKEMIA, MEDULLOBLASTOMA, NEUROBLASTOMA, HODGKIN LYMPHOMA, RETINOBLASTOMA, RHABDOMYOSARCOMA AND OTHERS. MANY OF THESE TRIALS ARE INSTITUTIONALLY SPONSORED; HOWEVER, ST. JUDE ALSO PARTICIPATES IN A NUMBER OF CLINICAL TRIALS CONSORTIA PROVIDING OUR CANCER PATIENTS ACCESS TO A VARIETY OF THERAPEUTIC STUDIES. PEDIATRIC CANCER PATIENTS MAY EXPERIENCE TREATMENT-RELATED SIDE EFFECTS MANY YEARS AFTER DIAGNOSIS. THE CHILDHOOD CANCER SURVIVOR STUDY AND ST. JUDE LIFE ARE TWO STUDIES, ACTIVE AT ST. JUDE, ASSESSING LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS. INFORMATION FROM THESE STUDIES WILL BE USED TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTIONS.WHEN CONSIDERING HEALTH-RELATED FACTORS, OUR CATCHMENT POPULATION IS CHARACTERIZED AS HAVING HIGH RATES OF TOBACCO USE, HIGH PREVALENCE OF OVERWEIGHT/OBESITY, AND LOW PHYSICAL ACTIVITY LEVEL. ALTHOUGH THESE FEATURES ARE NOT KNOWN TO AFFECT THE INCIDENCE OF ANY TYPE OF PEDIATRIC CANCER, THEY ARE IMPORTANT FOR HEALTH OUTCOMES.ANOTHER KEY AREA THAT ST. JUDE IS PROMOTING IN OUR CATCHMENT AREA AND BEYOND IS PREVENTION OF HPV-RELATED CANCERS. THE AMERICAN CANCER SOCIETY AND OTHER ORGANIZATIONS HAVE PUT FORTH THE GOAL TO ERADICATE HPV-RELATED CANCERS THROUGH VACCINATION AND SCREENING. NEARLY 80 MILLION INDIVIDUALS IN THE U.S. - 1 OUT OF EVERY 4 PEOPLE - ARE INFECTED WITH HUMAN PAPILLOMAVIRUS (HPV). APPROXIMATELY 31,500 CANCERS ATTRIBUTABLE TO HPV OCCUR EACH YEAR (FOOTNOTE 4). U.S. VACCINATION RATES REMAIN SIGNIFICANTLY LOWER FOR HPV THAN FOR OTHER RECOMMENDED ADOLESCENT VACCINES. IN 2017, TENNESSEE'S COMBINED HPV VACCINATION COVERAGE FOR MALES AND FEMALES AGES 13-17 IS ONLY 56%, WHICH RANKS 46TH IN THE NATION. BY GENDER, FEWER THAN 50% OF GIRLS AND APPROXIMATELY 30% OF BOYS AGES 13-17 ARE UP-TO-DATE ON THE HPV VACCINE SERIES (FOOTNOTE 5). RESIDENTS OF TENNESSEE AND THE MID-SOUTH HAVE AMONG THE HIGHEST INCIDENCES OF HPV-RELATED CANCERS IN THE COUNTRY (FOOTNOTE 6). AS THE ONLY NCI-DESIGNATED CANCER CENTER DEVOTED SOLELY TO CHILDREN, ST. JUDE IS COMMITTED TO TAKING ON A NEW LEADERSHIP ROLE IN PROTECTING YOUNG PEOPLE FROM PREVENTABLE HPV-ASSOCIATED CANCERS LATER IN LIFE. RECENTLY, ST. JUDE LAUNCHED HPV AWARENESS EFFORTS INCLUDING EDUCATION AT LOCAL SCHOOLS, OUTREACH TO NEWS MEDIA, DEVELOPMENT OF WEB CONTENT, AND PARTNERING WITH OTHER NCI-DESIGNATED CANCER CENTERS TO ENDORSE A GOAL OF ELIMINATING HPV-ASSOCIATED CANCERS IN THE UNITED STATES. OVER THE NEXT 5 YEARS, OUR PLAN IS TO SIGNIFICANTLY EXPAND OUR EFFORTS TO HAVE A GREATER IMPACT IN THE PROMOTION OF HPV VACCINATION IN OUR LOCAL CATCHMENT AREA, IN THE STATE OF TENNESSEE, AND NATIONALLY.ACCORDING TO THE AMERICAN CANCER SOCIETY, INDIVIDUALS WITH LOWER SOCIOECONOMIC STATUS HAVE HIGHER CANCER INCIDENCE RATES DUE TO ENGAGING IN LIFESTYLE BEHAVIORS THAT INCREASE CANCER RISK (FOOTNOTE 1). THE ST. JUDE CANCER EDUCATION FOR CHILDREN PROGRAM IS A LOCAL COMMUNITY EFFORT THAT USES EDUCATION AND POSITIVE REINFORCEMENT TO PROMOTE HEALTHY LIFESTYLE CHOICES THAT CAN HELP CHILDREN REDUCE THEIR RISK OF CANCER IN ADULTHOOD. EDUCATIONAL COMPONENTS OF THE PROGRAM SPECIFICALLY ADDRESS OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. THE PROGRAM DEVELOPMENT IS OVERSEEN BY A MULTIDISCIPLINARY TEAM COMPOSED OF ST. JUDE FACULTY AND STAFF, LOCAL EDUCATORS, AND LOCAL HEALTH EXPERTS WHO WORK TOGETHER TO ENSURE THAT THE CONTENT ACHIEVES THE GOALS OF THE PROGRAM WHILE ALIGNING TO STATE AND NATIONAL EDUCATION STANDARDS. DURING THE 2017-2018 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM WORKED WITH THE SHELBY COUNTY SCHOOL DISTRICT TO DELIVER CANCER AND HEALTHY LIVING EDUCATION PROGRAMS TO OVER 5,000 K-12 STUDENTS.(NOTE: THIS NARRATIVE FOR PART VI, LINE 2 IS CONTINUED BELOW.) - SEE PAGE 109/116 PART VI, LINE 3: AS NOTED IN PART I, LINE 3C, NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. IN ADDITION, ST. JUDE PROVIDES AN UNPARALLELED LEVEL OF SUPPORT SERVICES AT NO COST TO FAMILIES. WE ALSO HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. FAMILIES ALSO HAVE ACCESS TO AN ONLINE EDUCATIONAL RESOURCE TITLED "YOU AND THE AFFORDABLE CARE ACT" (HTTPS://WWW.STJUDE.ORG/TREATMENT/PATIENT-RESOURCES/CAREGIVER-RESOURCES/PATIENT-FAMILY-EDUCATION-SHEETS/LEGAL-FINANCIAL/YOU-AND-THE-AFFORDABLE-CARE-ACT.HTML). THIS ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE UTILIZE AN OUTSIDE CONTRACTOR TO PROVIDE APPLICATION ASSISTANCE. THE HOSPITAL'S FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML) ARE POSTED ON THE HOSPITAL'S WEBSITE AND AVAILABLE AT REGISTRATION. THE DOCUMENTS ARE AVAILABLE IN ENGLISH AND SPANISH. FOR FAMILIES SPEAKING OTHER LANGUAGES, WE UTILIZE ONSITE INTERPRETER SERVICES AND/OR PROFESSIONAL CONTRACTED INTERPRETATION AND TRANSLATION SERVICES. PART VI, LINE 4: ST. JUDE CHILDREN'S RESEARCH HOSPITAL IN MEMPHIS, TN, IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CATASTROPHIC DISEASES WITH A FOCUS ON CANCER AND BLOOD DISORDERS. PATIENTS AT ST. JUDE ARE REFERRED BY A PHYSICIAN, DIAGNOSED WITH A DISEASE CURRENTLY UNDER STUDY, AND ELIGIBLE FOR A RESEARCH PROTOCOL. ST. JUDE IS THE ONLY PEDIATRIC RESEARCH CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, INCLUDING CANCER AND BLOOD DISORDERS, WHERE FAMILIES NEVER PAY FOR TREATMENT NOT COVERED BY INSURANCE. IN FACT, NO FAMILY EVER PAYS ST. JUDE FOR ANYTHING. TRANSPORTATION, HOUSING AND FOOD ARE AMONG THE NO-COST SERVICES PROVIDED TO ENSURE FAMILIES COMING TO ST. JUDE CAN FOCUS ON THEIR CHILD. NO CHILD IS EVER DENIED TREATMENT DUE TO RACE, SEX, NATIONALITY, ETHNICITY, RELIGION, OR THE FAMILY'S ABILITY TO PAY. THE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST. JUDE SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, SUCH AS CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. IT DOES NOT ADMIT CHILDREN FOR ANY DIAGNOSTIC GROUPS OUTSIDE OF THESE SERVICES AND DOES NOT OFFER MEDICAL SERVICES BEYOND THOSE NECESSARY TO CARE FOR CHILDREN WITH THESE DISEASES. ST. JUDE DOES NOT HAVE AN EMERGENCY ROOM (ER). A REFERRAL FROM A MEDICAL PROFESSIONAL EXTERNAL TO ST. JUDE, TYPICALLY THE CHILD'S PEDIATRICIAN OR A PEDIATRIC SUBSPECIALIST, IS NECESSARY PRIOR TO ACCEPTING A PATIENT FOR TREATMENT TO ST. JUDE. ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS. SPECIFICALLY, MORE THAN 7,800 PATIENTS ARE SEEN AT ST. JUDE YEARLY, MOST OF WHO ARE ENROLLED ON CLINICAL TRIALS FOR NEW TREATMENTS DEVELOPED BY ST. JUDE, AND WHO ARE TREATED ON A CONTINUOUS OUTPATIENT BASIS. THE HOSPITAL HAS 69 OPERATIONAL BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS TO BE TREATED AS OUTPATIENTS WHO WOULD BE ADMITTED INTO INPATIENT UNITS AT MOST HOSPITALS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA FILTRATION, INFECTION-RESISTANT SURFACES AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES. ST. JUDE HAS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE TO EXTEND CARE AND BENEFITS TO MORE CHILDREN AND INCREASE THE NUMBER OF CHILDREN ABLE TO BE TREATED ON ST. JUDE CLINICAL TRIAL.ST. JUDE ALSO OPERATES AN INTERNATIONAL OUTREACH PROGRAM IN GLOBAL PEDIATRIC MEDICINE (GPM), AIMED AT IMPROVING SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, IMPLEMENTING NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND GENERATING INTERNATIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THERE ARE AN ESTIMATED 175,000 NEWLY DIAGNOSED CASES OF CHILDHOOD CANCER WORLDWIDE EACH YEAR, AND 84% OCCUR IN LOW- AND MIDDLE-INCOME COUNTRIES. CANCER IS EMERGING AS A MAJOR CAUSE OF CHILDHOOD DEATH IN ALL DEVELOPING COUNTRIES, REPLACING OTHER CAUSES OF CHILDHOOD MORTALITY (E.G. HIV, MALNUTRITION, INFECTIONS). DESPITE VAST IMPROVEMENTS IN THERAPY AND SURVIVAL IN HIGH-INCOME COUNTRIES OVER THE PAST 30 YEARS, AN ESTIMATED 60% DO NOT HAVE ACCESS TO ADEQUATE DIAGNOSIS AND MODERN CARE. ST. JUDE STRIVES TO ADDRESS THE NEEDS OF THOSE CHILDREN IN COUNTRIES THAT LACK SUFFICIENT RESOURCES AND HELP THEM MANAGE THEIR OWN BURDEN OF CASES EFFECTIVELY. WHILE SICK CHILDREN FROM AROUND THE WORLD HAVE TRAVELED TO OUR HOSPITAL IN MEMPHIS, RECEIVING TREATMENT IN THEIR OWN COUNTRIES IS MORE EFFICIENT AND LESS DISRUPTIVE FOR THEM AND THEIR FAMILIES. AS A RESULT OF OUR INTERNATIONAL EFFORTS, WE ARE ABLE TO REACH FAR MORE CHILDREN THAN WOULD EVER BE ABLE TO COME TO MEMPHIS. A BASIC HEALTHCARE INFRASTRUCTURE IS NEEDED TO SUPPORT PEDIATRIC ONCOLOGY PROGRAMS, WHICH IN TURN FURTHER IMPROVES THE DEVELOPMENT OF BASIC HEALTHCARE. AT THE LOCAL LEVEL, GPM DEVELOPS PARTNERSHIPS WITH MEDICAL INSTITUTIONS AND FUND-RAISING ORGANIZATIONS AND FACILITATES THE INVOLVEMENT OF OTHER AND GOVERNMENT ORGANIZATIONS TO SUPPORT KEY PROGRAMS AND THE EDUCATION OF LOCAL PERSONNEL. AT THE REGIONAL LEVEL, GPM DEVELOPS PROGRAMS THROUGH THE USE OF TECHNOLOGY AND FOSTERS REGIONAL AND INTERNATIONAL COLLABORATIONS WITH OTHER PEDIATRIC MEDICAL INSTITUTIONS. THE PRIMARY GOAL IS TO DEVELOP LOCAL AND REGIONAL SELF-SUFFICIENCY. THIS MODEL RESULTS IN SIGNIFICANT OVERALL IMPROVEMENT IN HEALTHCARE FACILITIES, THE LEVEL OF PRACTICE, THE CONFIDENCE OF HEALTHCARE PROVIDERS, AND LOCAL COMMUNITY INVOLVEMENT. ST. JUDE EMPHASIZES THE BUILDING OF REGIONAL EXPERTISE AND DIAGNOSTIC CAPABILITIES, WHICH PROVIDE A CRITICAL MASS OF PROFESSIONALS WHO CONTINUALLY LEARN FROM AND ASSIST EACH OTHER. COST EFFICIENCY IS ALSO REALIZED BECAUSE OF SHARED RESOURCES.ST. JUDE HAS PARTNERSHIPS WITH 28 MEDICAL INSTITUTIONS ACROSS 17 DIFFERENT COUNTRIES - BRAZIL, CHILE, CHINA, COSTA RICA, DOMINICAN REPUBLIC, ECUADOR, EL SALVADOR, GUATEMALA, HAITI, HONDURAS, JORDAN, LEBANON, MEXICO, NICARAGUA, PHILIPPINES, URUGUAY AND VENEZUELA. ST. JUDE WORKS WITH ITS PARTNERS TO DEVELOP EVIDENCED-BASED TREATMENT PROTOCOLS TAILORED TO REGIONAL NEEDS AND RESOURCES. ADDITIONALLY, ST. JUDE PHYSICIANS AND NURSES SERVE AS MENTORS TO CLINICAL PERSONNEL AT PARTNER SITES, PROVIDE LOCAL AND ONLINE TRAINING FOR ONCOLOGY CARE, DIAGNOSIS, AND SUPPORTIVE CARE, AND PARTICIPATE IN ONLINE MEETINGS TO DISCUSS CLINICAL CARE BEST PRACTICES. THE MAJORITY OF ONLINE MEETINGS AND TRAINING ARE PROVIDED VIA ST. JUDE'S WEB-BASED PLATFORM, ST. JUDE CURE4KIDSTM (C4K), A FREE RESOURCE FOR PEDIATRIC ONCOLOGY PROFESSIONALS, SCIENTISTS AND RESEARCHERS, REGARDLESS OF THEIR AFFILIATION WITH ST. JUDE OR ITS PARTNERS. IN ADDITION TO CONTENT THAT INCLUDES MORE THAN 1,600 ONLINE SEMINARS, 18 SELF-PACED COURSES, AND 40 INSTRUCTOR-LED COURSES, C4K PROVIDES ONLINE MEETING AND CONFERENCE SPACE. IN FY18, C4K HAD 45,585 CONTENT VIEWS WITH 7,640 UNIQUE REGISTERED USERS, AND HOSTED 2,274 MEETINGS WITH 2,104 UNIQUE PARTICIPANTS FROM 150 DIFFERENT COUNTRIES; THERE ARE 64 NCI CENTERS THAT PARTICIPATE IN C4K. FINALLY, ST. JUDE PARTNERS WITH LOCAL FUNDRAISING ORGANIZATIONS THAT SUPPORT THE MEDICAL PROGRAMS. THIS MODEL HAS PROVEN TO BE HIGHLY EFFECTIVE IN PROVIDING POOR CHILDREN IN DEVELOPING COUNTRIES ACCESS TO MODERN TREATMENT AND CARE.ST. JUDE IS ALSO A RESEARCH ORGANIZATION, WITH RESEARCH COVERING A BROADER SCOPE OF HEALTH ISSUES THAN THE DISEASES TREATED AS A PRIMARY DIAGNOSIS. THE HOSPITAL'S OUTREACH INCLUDES THE LOCAL MARKET, AFFILIATE INSTITUTIONS, OTHER AREAS OF THE UNITED STATES/U.S. TERRITORIES, AND THE INTERNATIONAL COMMUNITY. THE LOCAL MARKET ENCOMPASSES MEMPHIS, TENNESSEE AND THE SURROUNDING GEOGRAPHIC AREA WITH APPROXIMATELY 25% OF NEW ONCOLOGY PATIENTS RESIDING WITHIN THIS AREA. FY18 NEW CANCER PATIENTSPATIENT ORIGIN % OF TOTALMEMPHIS, TN AND SURROUNDING AREA 25%AFFILIATE REFERRAL 39%NATIONAL REFERRAL (OTHER AREAS OF U.S.) 28%INTERNATIONAL REFERRAL 8%GRAND TOTAL 100%THE ST. JUDE AFFILIATE PROGRAM (AP) IS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE TO EXTEND CARE AND BENEFITS TO MORE CHILDREN AND INCREASE THE NUMBER OF CHILDREN ABLE TO BE TREATED ON ST. JUDE CLINICAL TRIALS CLOSER TO HOME. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF AT ST. JUDE TO DELIVER PROTOCOL RELATED CARE OR EVIDENCE BASED TREATMENT WHEN NOT PARTICIPATING IN A TRIAL TO PEDIATRIC HEMATOLOGY-ONCOLOGY PATIENTS, SO THAT PATIENTS CAN RECEIVE CARE CLOSER TO HOME. AFFILIATES ARE CURRENTLY LOCATED IN BATON ROUGE, LA, CHARLOTTE, NC, HUNTSVILLE, AL, JOHNSON CITY, TN, PEORIA, IL, SHREVEPORT, LA, SPRINGFIELD, MO, AND TULSA, OK. THE AFFILIATES' ENROLLMENT OF PATIENTS ON ST. JUDE CLINICAL TRIALS HELPS ST. JUDE FIND CURES FASTER AND SAVE MORE CHILDREN. (NOTE: THIS NARRATIVE FOR PART VI, LINE 4 IS CONTINUED BELOW.) - SEE PAGE 115/116 PART VI, LINE 5: ST. JUDE CHILDREN'S RESEARCH HOSPITAL WAS OPENED IN 1962. OUR MISSION IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER, DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S INABILITY TO PAY. OUR VISION IS TO BE THE WORLD LEADER IN ADVANCING THE TREATMENT AND PREVENTION OF CATASTROPHIC DISEASES IN CHILDREN. THIS VISION IS PURSUED BY PROVIDING OUTSTANDING PATIENT CARE; BY CONDUCTING BASIC, TRANSLATIONAL AND CLINICAL RESEARCH DESIGNED TO ELUCIDATE BIOLOGICAL MECHANISMS, UNDERSTAND DISEASE PATHOGENESIS, IMPROVE DIAGNOSIS, ENHANCE TREATMENT OUTCOME, PREVENT DISEASES AND MINIMIZE ADVERSE CONSEQUENCES OF TREATMENT; AND BY EDUCATING HEALTH CARE AND SCIENTIFIC RESEARCH PROFESSIONALS. THROUGH THESE EFFORTS, WE SEEK TO CURE AND ENHANCE THE QUALITY OF LIFE FOR AN INCREASING NUMBER OF CHILDREN WHO COME TO US FOR TREATMENT BY EXPANDING AND SHARING KNOWLEDGE TO ADVANCE TREATMENT OF CHILDREN WITH CATASTROPHIC DISEASES WORLDWIDE, WHILE DEVELOPING STRATEGIES TO PREVENT CATASTROPHIC DISEASES IN CHILDREN.ST. JUDE COMBINES LABORATORY AND CLINICAL RESEARCH TO ADVANCE THE CARE OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES. THE FOCUS IS ON PROVIDING OUTSTANDING PATIENT CARE RESULTS AND ON RESEARCH FINDINGS THAT TRANSLATE INTO IMPROVED PATIENT OUTCOMES. ST. JUDE HAS AN ACADEMIC FACULTY ENGAGED IN A BROAD SPECTRUM OF RESEARCH, INCLUDING THERAPEUTIC TRIALS, INVESTIGATION OF DISEASE PATHOGENESIS AND DISCOVERY-ORIENTED BASIC RESEARCH.HOSPITAL OPERATIONS ARE OVERSEEN BY A BOARD OF GOVERNORS, MOST OF WHICH ARE NEITHER EMPLOYEES, INDEPENDENT CONTRACTORS, OR THEIR FAMILY MEMBERS. RESEARCH ACTIVITIES ARE REVIEWED ANNUALLY BY A SCIENTIFIC ADVISORY BOARD COMPOSED OF INTERNATIONALLY PROMINENT PHYSICIANS AND SCIENTISTS.ST. JUDE CONTRIBUTED TO THE BUILDING OF A STATE-OF-THE ART NEUROSURGICAL FACILITY FOR TREATING LOCAL PEDIATRIC PATIENTS AND ST. JUDE BRAIN TUMOR PATIENTS. THE FACILITY IS EQUIPPED WITH INTRA-OPERATIVE IMAGING EQUIPMENT (IMRI). WHEN PURCHASED, ONLY TWO NEUROSURGICAL FACILITIES IN THE UNITED STATES PROVIDED PATIENTS WITH THIS LEVEL OF TREATMENT, WHICH ALLOWS IMAGING TO TAKE PLACE DURING SURGICAL PROCEDURES. IMRI EQUIPMENT ALLOWS SURGEONS TO MAKE INFORMED DECISIONS DURING THE SURGERY. LIVE WEB CASTS ALLOW OTHERS TO VIEW PROCEDURES. OUR ASSISTANCE WITH THIS FACILITY HELPS ASSURE THAT CHILDREN IN THE AREA HAVE ACCESS TO THE BEST NEUROSURGICAL TREATMENT AVAILABLE.ST. JUDE COMPLETED THE FIRST PHASE OF THE PEDIATRIC CANCER GENOME PROJECT (PCGP) IN JANUARY 2013 - A COLLABORATION WITH WASHINGTON UNIVERSITY TO FIND CLUES TO THE CAUSES OF CHILDHOOD CANCER AND POTENTIAL NEW TREATMENTS AND CURES. THE PROJECT HAS RESULTED IN GROUNDBREAKING DISCOVERIES IN A NUMBER OF CHILDHOOD CANCERS INCLUDING RETINOBLASTOMA, MEDULLOBLASTOMA, NEUROBLASTOMA, DIFFUSE INTRINSIC PONTINE GLIOMA, TWO AGGRESSIVE FORMS OF LEUKEMIA AND LOW-GRADE GLIOMAS. IN DECEMBER 2012, THE PCGP WAS RECOGNIZED AS ONE OF TIME MAGAZINE'S TOP 10 MEDICAL BREAKTHROUGHS AND, IN 2013, AS ONE OF TIME MAGAZINE'S TOP 100 NEW SCIENTIFIC DISCOVERIES. THE SECOND PHASE OF PCGP EXAMINED THE CANCER SAMPLES FROM 300 CHILDREN AND FOCUSED ON DEFINING MUTATIONS THAT CONTRIBUTE TO TUMOR FORMATION, CHARACTERIZING THE STATE OF THE CANCER CELL'S EPIGENOME AND DESCRIBING HOW IT DIFFERED FROM WHAT IS SEEN IN THE NORMAL CELLS. THE SECOND PHASE ALSO INCLUDED A CLINICAL GENOMICS PROJECT CALLED GENOMES FOR KIDS THAT INVOLVED NEXT-GENERATION SEQUENCING FOR CHILDREN WITH CANCER. WHEN PHASE 2 IS COMPLETE, ST. JUDE HOPES TO HAVE A MODEL FOR HOW TO EXTEND GENOME SEQUENCING TO EVERY CHILDHOOD CANCER PATIENT IN THE UNITED STATES. FROM ITS BEGINNINGS IN 2010, THE PCGP IS THE LARGEST, BROADEST, PRIVATELY FUNDED SEQUENCING PROJECT FOR CHILDREN WITH CANCER AND HAS SEQUENCED MORE THAN 800 MATCHED PAIRS OF TUMOR AND HEALTHY GENOMES FROM YOUNG PATIENTS. THE PCGP HAS PROVIDED NEW DETAILS ABOUT THE MUTATIONS THAT UNDERLIE THE DEVELOPMENT AND GROWTH OF A RANGE OF CHILDHOOD CANCERS, AND HAS LAID THE FOUNDATION FOR IMPROVED DIAGNOSTIC TESTING AND THE NEXT GENERATION OF MORE EFFECTIVE, LESS-TOXIC THERAPIES. THE PROJECT HAS LED TO NEW DIRECTIONS IN RESEARCH INVOLVING HIGH-RISK LEUKEMIA, BRAIN AND SOLID TUMORS AS WELL AS NEW COMPUTATIONAL METHODS THAT HAVE BEEN SHARED FOR FREE WITH THE GLOBAL SCIENTIFIC COMMUNITY.THE CYCLOTRON (PARTICLE ACCELERATOR) AT ST. JUDE ENABLES RESEARCHERS TO TRACK THE GROWTH OF CANCER CELLS, PINPOINT THE PRODUCTION OF NEW DNA BY TUMOR CELLS AND STUDY THE HEARTS OF ADULT CHILDHOOD CANCER SURVIVORS RETURNING TO ST. JUDE FOR LIFETIME FOLLOW-UP. THE CYCLOTRON HELPS RESEARCHERS BETTER UNDERSTAND CHILDHOOD CANCER BY ENABLING THEM TO PRODUCE NEW, VERY SHORT-ACTING TRACERS.ST. JUDE USES THE SERVICES OF CHILDREN'S GMP, LLC (OF WHICH ST. JUDE IS THE SOLE MEMBER). CHILDREN'S GMP, LLC, MANAGES AND OPERATES A GOOD MANUFACTURING PRACTICE (GMP) FACILITY THAT ENGAGES IN THE PRODUCTION OF BIOLOGICS AND DRUGS FOR RESEARCH. THE GMP OFFERS RESOURCES TO STUDY RARE DISEASES OVERLOOKED BY PHARMACEUTICAL COMPANIES BECAUSE THERE IS LITTLE PROFIT IN MANUFACTURING DRUGS FOR LESSER-KNOWN DISEASES. THE FACILITY, OPERATING ACCORDING TO APPROVED FDA STANDARDS, ALLOWS DOCTORS TO TAILOR TREATMENTS SPECIFICALLY FOR AN INDIVIDUAL CHILD.THE CELL AND TISSUE IMAGING CENTER INCLUDES ELECTRON MICROSCOPY AND LIGHT MICROSCOPY. THE FACILITY PROVIDES INVESTIGATORS ACCESS TO TRANSMISSION ELECTRON MICROSCOPY, CONFOCAL LASER SCANNING MICROSCOPY, MULTIPHOTON MICROSCOPY, IMAGE ANALYSIS, CELL MICROINJECTION AND LIVE CELL IMAGING. THE FEI TECNAI 20 200KV FEG ELECTRON MICROSCOPE, WHICH CAN MAGNIFY AN OBJECT 700,000 TIMES, IS AT THE HEART OF THIS PROGRAM. THIS TECHNOLOGY ALLOWS RESEARCHERS TO GET A CLOSER LOOK AT CANCER TO BETTER UNDERSTAND HOW IT GROWS AND SPREADS AND RESPONDS TO THERAPY. USING THE ELECTRON MICROSCOPE, RESEARCHERS LEARN HOW CANCER CELLS BREAK AWAY FROM THE TUMOR AND SPREAD THROUGHOUT THE BODY.ST. JUDE IS HOME TO THE ONLY PROTON BEAM RADIATION THERAPY CENTER DEVOTED SOLELY TO TREATING CHILDREN WITH BRAIN TUMORS AND SEVERAL OTHER CHILDHOOD CANCERS. PROTON THERAPY IS LESS DAMAGING TO SURROUNDING HEALTHY TISSUE THAN OTHER CURRENT RADIATION THERAPIES. THIS EQUIPMENT ENABLES ST. JUDE TO PROVIDE THIS THERAPY IN A MORE INTEGRATED MANNER TO OUTPATIENTS AND ALLOW OUR RADIATION ONCOLOGISTS TO LEAD THE DEVELOPMENT OF NEW TREATMENTS WITH PROTONS. TO FURTHER PALLIATIVE SERVICES IN THE COMMUNITY, ST. JUDE PARTICIPATED WITH LE BONHEUR CHILDREN'S HOSPITAL IN DEVELOPING THE QUALITY OF LIFE FOR ALL KIDS PALLIATIVE PROGRAM FOR SERIOUSLY ILL CHILDREN. HOSPICE STAFF, BOTH IN THE HOME AND IN THE HOSPICE RESIDENCE, PROVIDES INTERDISCIPLINARY CARE TO CHILDREN THROUGHOUT THE ILLNESS TRAJECTORY AND CONCURRENT THERAPIES.ST. JUDE ADMINISTRATIVE LEADERS AND FACULTY MEMBERS OF THE DEPARTMENT OF PHARMACEUTICAL SCIENCES HAVE BEEN AT THE FOREFRONT OF BRINGING NATIONAL ATTENTION TO THE PEDIATRIC CANCER DRUG SHORTAGE TOPIC, ACTIVELY ENGAGING REGULATORY AND LEGISLATIVE BODIES TO UNDERSTAND THE IMPACT THESE DRUG SHORTAGES HAVE ON PEDIATRIC CARE AND RESEARCH. PRESENTATIONS OR WRITTEN TESTIMONY HAVE BEEN PROVIDED TO THE FDA CENTER FOR DRUG EVALUATION AND RESEARCH WORKSHOP, TWO SENATE HEARINGS, AND HEALTH SUBCOMMITTEE OF THE HOUSE COMMITTEE ON ENERGY AND COMMERCE. ST. JUDE FOCUSES ON EDUCATING AND TRAINING THE NEXT GENERATION OF DOCTORS, NURSES, RESEARCHERS AND ACADEMIC LEADERS. FROM PROGRAMS FOR HIGH SCHOOL STUDENTS TO THE POSTDOCTORAL LEVEL, THE HOSPITAL PLAYS A MAJOR ROLE IN PREPARING FUTURE LEADERS OF SCIENCE AND MEDICINE. IN ADDITION TO ONSITE EDUCATION, THE ST. JUDE GLOBAL PROVIDES AN EDUCATION AND COLLABORATION WEB SITE, CURE4KIDS(TM) (WWW.CURE4KIDS.ORG). VIA THE CONNECT2PROTECT PROGRAM, ST. JUDE COLLABORATES WITH CHURCHES, OTHER HEALTH CARE ORGANIZATIONS AND CIVIC GROUPS TO RAISE AWARENESS ABOUT PREVENTING THE SPREAD OF HIV/AIDS. THE PRIMARY TARGET IS THE AFRICAN-AMERICAN COMMUNITY, ALTHOUGH OTHER ETHNIC GROUPS ARE ALSO SERVED INCLUDING ASIAN, CAUCASIAN AND HISPANIC.THE FUNDRAISING SOURCE FOR ST. JUDE IS ALSAC, WHICH RAISES FUNDS SOLELY FOR THE HOSPITAL. BECAUSE OF THE HOSPITAL'S MISSION, PEOPLE NATIONWIDE CONTRIBUTE VIA TENS OF THOUSANDS OF FUNDRAISING EFFORTS. ALSAC CONTRIBUTED $755 MILLION IN FY18 TO SUPPORT ST. JUDE.VOLUNTEERS ENHANCE THE QUALITY OF PATIENT CARE BY PARTNERING WITH CLINICAL STAFF TO PROVIDE AN ADDITIONAL PERSONAL TOUCH. VOLUNTEERS ALSO HELP ENSURE A SAFE ENVIRONMENT. THEY LEND ASSISTANCE AND PROVIDE COMPASSIONATE CONCERN BY OFFERING A LISTENING EAR TO FAMILIES AT A TIME WHEN THEY NEED IT MOST. THEY ARE VITAL AMBASSADORS FOR THE HOSPITAL AND COMMUNITY. PART VI, LINE 2 (CONTINUATION FROM 98/116): HEMATOLOGYTHE GEOGRAPHIC CATCHMENT AREA FOR ST. JUDE ENCOMPASSES 21 COUNTIES IN WESTERN TENNESSEE INCLUDING MEMPHIS, AND AREAS IN EAST ARKANSAS, NORTH MISSISSIPPI, AND A FEW COUNTIES IN MISSOURI. MORE THAN 70,000 PEOPLE IN THE UNITED STATES HAVE SICKLE CELL DISEASE (SCD), AND IT IS ESTIMATED THAT MORE THAN 1 MILLION PEOPLE WORLDWIDE SUFFER FROM THE DISEASE. IT IS THE MOST FREQUENT GENETIC BLOOD DISORDER IN THE WORLD. ST. JUDE HAS ONE OF THE LARGEST PEDIATRIC SCD PROGRAMS IN THE COUNTRY AND PROVIDES COMPREHENSIVE TREATMENT AND EDUCATION TO ABOUT 900 CHILDREN WITH SCD IN THE GEOGRAPHIC CATCHMENT AREA. SCD IS DIAGNOSED BY STATE-WIDE NEWBORN SCREENING IN ALL 50 STATES. ST. JUDE HAS A PARTNERSHIP WITH NEWBORN SCREENING PROGRAMS IN TN AND MS THAT ENSURES A STABLE RELATIONSHIP AMONG PARENTS, PATIENTS, PRIMARY CARE PROVIDERS. ABOUT 50 NEWBORNS WITH SCD ARE IDENTIFIED EACH YEAR IN OUR GEOGRAPHIC CATCHMENT AREA. OUR SCD INFANT TODDLER PROGRAM CONTACTS AND ACCEPTS ALL CHILDREN DIAGNOSED WITH THE DISEASE TO ITS COMPREHENSIVE CARE SERVICE. ADDITIONALLY, ST. JUDE PROVIDES TRAIT COUNSELING SERVICE TO INFANTS BORN WITH SICKLE CELL TRAIT TO 21 COUNTIES IN WESTERN TN. ST. JUDE PROVIDES CONFIRMATORY TESTING, EDUCATION AND COMPREHENSIVE CARE AND FOLLOW-UP THROUGHOUT CHILDHOOD FOR CHILDREN WITH SCD DISEASE. FROM BIRTH TO AGE 18 YEARS, PATIENTS ARE CLINICALLY EVALUATED AT LEAST EVERY 6 MONTHS, RECEIVE EDUCATION AND MULTI-DISCIPLINARY SERVICES ACCORDING TO STANDARDIZED TREATMENT AND EDUCATION GUIDELINES. SERVICES ALSO INCLUDE COMMUNITY OUTREACH AND EDUCATION OF THE LOCAL COMMUNITY. ST. JUDE HAS ESTABLISHED A FORMAL TRANSITION PROGRAM TO ADULT CARE FOR PATIENTS WITH SCD AND PROVIDES SUPPORT TO PATIENTS AND FAMILIES THROUGHOUT THE TRANSITION PROCESS BY WORKING CLOSELY WITH THE ADULT SCD PROGRAMS AT METHODIST UNIVERSITY HOSPITAL AND REGIONAL ONE HOSPITAL. IN THE PAST, THE SCD PROGRAM AT ST. JUDE HAS COLLABORATED WITH SEVERAL FEDERALLY QUALIFIED HEALTH CARE CENTERS, WITH COMMUNITY PRIMARY CARE PHYSICIANS, LATINO MEMPHIS (THE LARGEST HISPANIC SOCIAL AGENCY IN TENNESSEE), WITH THE SICKLE CELL FOUNDATION OF TENNESSEE (A COMMUNITY-BASED SCD ORGANIZATION), AND WITH REGIONAL SCD PROVIDERS TO ENSURE A MEDICAL HOME AND ADEQUATE SOCIAL SUPPORT FOR ALL SCD PATIENTS IN THE AREA. ST. JUDE ASSESSES PATIENT NEEDS THROUGH PARENT AND PATIENT SURVEYS, INTERACTIVE EDUCATION, MATERIALS REVIEW, AND THROUGH GROUP DISCUSSIONS WITH PARENTS AND PATIENTS.ST. JUDE ALSO PROVIDES CLINICAL SERVICES FOR APPROXIMATELY 800 CHILDREN PER YEAR WITH OTHER NON-MALIGNANT HEMATOLOGICAL DISORDERS THROUGH A STRONG RELATIONSHIP WITH LOCAL COMMUNITY PHYSICIANS. CHILDREN FROM THE GEOGRAPHIC CATCHMENT AREA OF ST. JUDE (AS OUTLINED ABOVE) WITH ILLNESSES SUCH AS HEMOPHILIA, APLASTIC ANEMIA, THROMBOSIS, THALASSEMIA, SPHEROCYTOSIS, AND IMMUNE THROMBOCYTOPENIC PURPURA AND OTHER NON-MALIGNANT HEMATOLOGIC DISORDERS ARE REFERRED TO AND RECEIVE STATE-OF THE-ART CARE FROM ST. JUDE PHYSICIANS AND MEDICAL STAFF. ST. JUDE IS ONE OF A SELECT GROUP OF FEDERALLY RECOGNIZED PEDIATRIC HEMOPHILIA TREATMENT CENTERS AND PROVIDES STATE-OF-THE-ART COMPREHENSIVE CARE TO APPROXIMATELY 300 CHILDREN WITH BLEEDING AND THROMBOSIS DISORDERS.IN ADDITION TO PROVIDING AND CONTINUOUSLY IMPROVING STANDARDIZED CARE TO THESE PATIENT POPULATIONS, ST. JUDE HEMATOLOGY DEDICATES A SIGNIFICANT AMOUNT OF RESOURCES TO CLINICAL, TRANSLATIONAL, AND BASIC RESEARCH TO IMPROVE SURVIVAL AND DECREASE MORBIDITY OF CHILDREN WITH NON-MALIGNANT CHRONIC BLOOD DISEASES. MOST PATIENTS PARTICIPATE IN RESEARCH STUDIES, WHICH HAVE RESULTED IN MAJOR IMPROVEMENTS IN CLINICAL CARE. FOR EXAMPLE, RECENT RESULTS FROM THE BABY HUG TRIAL SHOWED THAT DAILY ORAL HYDROXYUREA IS SAFE AND EFFECTIVE FOR INFANTS AND YOUNG CHILDREN WITH SCD, WHICH LED TO THE RECOMMENDATION OF ITS GENERAL USE IN THIS SUBPOPULATION. ALSO, IN A FIRST-IN-MAN TRIAL, ST. JUDE HEMATOLOGY SHOWED THE SAFETY AND EFFICACY OF A NOVEL GENE TRANSFER AGENT CARRYING THE FACTOR IX GENE FOR TREATMENT OF HEMOPHILIA B; ALL TEN ADULT PARTICIPANTS WITH SEVERE HEMOPHILIA B HAD NO SERIOUS UNEXPECTED SIDE EFFECTS AND ALL PARTICIPANTS SHOWED AN INCREASE IN FACTOR IX LEVELS LEADING TO A SUBSTANTIAL REDUCTION IN THEIR BLEEDING TENDENCY. ADDITIONALLY, ST. JUDE HAS DEVELOPED A VECTOR FOR GENE TRANSFER TO TREAT CHILDREN WITH X LINKED SEVERE COMBINED IMMUNODEFICIENCY (X LINKED SCID) DISEASE WHICH HAS SHOWN PROMISE AS A CURE FOR THE DISEASE. FUTURE EFFORTS WILL CONTINUE TO FOCUS ON FINDING VIABLE CURES AND/OR TREATMENTS TO PREVENT COMPLICATIONS IN CHILDREN WITH SCD AND OTHER NON-MALIGNANT, CHRONIC HEMATOLOGIC DISEASES.HIVIN 1987, ST. JUDE'S FOUNDING FATHER, DANNY THOMAS DECLARED AIDS A CATASTROPHIC ILLNESS. IT WAS THEN THAT THE COMPREHENSIVE HIV CARE AND PREVENTION PROGRAM FOR CHILDREN AND YOUTH WAS ESTABLISHED. THE PROGRAM, LOCATED IN THE MEMPHIS METROPOLITAN STATISTICAL AREA, IS IN A COMMUNITY WHERE DESPITE ADVANCES IN TREATMENT, AVAILABILITY OF RAPID HIV TESTING, AND THE INCREASE IN EVIDENCE-BASED PREVENTION INTERVENTIONS, NEW INFECTION RATES REMAIN HIGH FOR MINORITIES, MALES (79%), AND YOUNG ADULTS AGES 15-34 (63%). SINCE ITS BEGINNING, THE HIV CLINICAL AND RESEARCH PROGRAM HAS PROVIDED EXCEPTIONAL CARE TO PERINATALLY-INFECTED INFANTS AND CHILDREN AND AN EXCELLENT YOUTH-FOCUSED HIV PROGRAM FOR YOUTH AGES 13 TO 21. THE SERVICES INCLUDE A STANDALONE LABORATORY THAT SUPPORTS THE HIV/AIDS CLINICAL & RESEARCH PROGRAMS, COMPREHENSIVE MEDICAL CARE, CASE MANAGEMENT SERVICES, A FULL PHARMACY, PATIENT ADVOCACY, PSYCHOSOCIAL, AND SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES. OUR STRONG COMMUNITY INFRASTRUCTURE, FORMALLY ESTABLISHED 12 YEARS AGO, IS COMMITTED TO THE CAUSE OF HIV EDUCATION AND PREVENTION IN THE COMMUNITY. OUR COMMUNITY COALITION, CONNECT TO PROTECT (C2P), CONTINUES TO HAVE 23 CONSISTENT AND ACTIVE MEMBERS THAT REPRESENT AIDS SERVICE ORGANIZATIONS, LOCAL GOVERNMENT, FAITH-BASED AND SOCIAL SERVICE ORGANIZATIONS. QUARTERLY, THE COALITION MEMBERS CONTINUE TO IDENTIFY AT-RISK YOUTH AND CREATE A PROFILE OF AVAILABLE COMMUNITY RESOURCES BASED ON ELIMINATING BARRIERS TO BEING LINKED TO AND RETAINED IN CARE. IN ADDITION TO DEVELOPING A SOLID HIV PREVENTION PLAN, COALITION MEMBERS, ALONGSIDE OUR CLINICAL RESEARCH STAFF, HAVE CO-FACILITATED AND/OR PARTICIPATED IN APPROXIMATELY 95 OUTREACH EVENTS, TRAININGS, AND SPEAKING ENGAGEMENTS REACHING ABOUT 2,688 PEOPLE FOR THE YEAR OF 2018.WORKING TO ALIGN THE STRATEGIC PLAN WITH THE HIV CONTINUUM OF CARE THAT SPECIFICALLY ADDRESSES YOUTH BARRIERS TO TESTING, SURVEILLANCE REPORTING AND LINKAGE OF NEWLY DIAGNOSED HIV+ YOUTH TO MEDICAL CARE IN RESOURCE POOR COMMUNITIES HAS BEEN A STRONG ASSET TO OUR COMMUNITY INFRASTRUCTURE. FOR THIS CALENDAR YEAR, OUR STRATEGIC MULTISITE INITIATIVE FOR LINKAGE AND ENGAGEMENT (SMILE) INTO CARE EFFORTS RESULTED IN APPROXIMATELY 71% (88/124) OF NEWLY DIAGNOSED HIV+ YOUTH BEING ENGAGED IN MEDICAL CARE AND 92% (81/88) OF THEM BEING RETAINED IN CARE. THIS SUCCESS SPEAKS TO STRATEGIC COMMUNITY MOBILIZATION, PARTNER AGENCY PARTICIPATION AND IMPROVED ACCESS TO CARE FOR NEWLY DIAGNOSED HIV POSITIVE YOUTH. PARTICIPANTS IN THE SMILE PROGRAM RECEIVE ASSISTANCE WITH LINKAGE AND ENGAGEMENT IN CARE SERVICES, SPECIALIZED CASE MANAGEMENT, CRISIS INTERVENTION, AND INDIVIDUALIZED COMMUNITY SERVICE AND RESOURCE REFERRALS AS INDIVIDUAL BARRIERS ARE IDENTIFIED. THE SMILE PROGRAM DATA HAS BEEN USED TO FACILITATE CONTINUED DIALOGUE WITHIN THE C2P COALITION. THE INTEGRATION OF BOTH PROGRAMS HAS ENCOURAGED THE COALITION TO PRIORITIZE ALIGNMENT OF THE STRATEGIC PLAN WITH THE HIV CARE CONTINUUM THEREBY IMPROVING ENGAGEMENT AND RETENTION IN CARE OUTCOMES FOR INDIVIDUALS THAT PARTICIPATE IN THE SMILE PROGRAM.OUR COMMUNITY BASED PREVENTATIVE RESEARCH PROTOCOL, HIV PREVENTION TRIALS NETWORK (HPTN) 083, IMPLORES A COMMUNITY BASED PARTICIPATORY RESEARCH (CBPR) APPROACH TO HELP REACH ELIGIBLE AT-RISK YOUTH AND YOUNG ADULTS. WE RECEIVED BUY-IN AND SUPPORT FROM VARIOUS STAKEHOLDERS BY HOSTING COMMUNITY BASED HIV TESTING EVENTS THAT OFFER LINKAGE INTO CARE FOR NEWLY DIAGNOSED HIV+ YOUTH AND LINK TO PRE-EXPOSURE PROPHYLAXIS (PREP) FOR THOSE WHO PRESENT HIV NEGATIVE. THIS PAST YEAR, THE HIV PREVENTION TEAM, SUCCESSFULLY LED 25 STAKEHOLDER/GATEKEEPER MEETINGS THAT FOCUSED ON PLANNING AND COORDINATING SPECIFIC OUTREACH AND EDUCATIONAL STRATEGIES. THIS YIELDED EIGHT (6 SMALL AND 2 LARGE SCALE EVENTS (E.G., TRANS AWARENESS PANEL DISCUSSION AND GALA, MINI BALL EVENTS, A KARAOKE DAY PARTY, AND A COMMUNITY KICKBALL GAME) THAT REACHED OVER 599 YOUTH AND YOUNG ADULTS. AS A RESULT, THERE HAVE BEEN APPROXIMATELY 75 INDIVIDUALS APPROACHED AS ELIGIBLE STUDY PARTICIPANTS AND APPROXIMATELY 45 ENROLLED THIS CALENDAR YEAR. THIS BRINGS OUR TOTAL NUMBER OF HPTN STUDY PARTICIPANTS TO 86. LASTLY, WE HAVE STARTED A RETENTION IN CARE PROGRAM THAT WORKS SIMULTANEOUSLY WITH THE SOCIAL WORK TEAM TO FORMULATE A CARE PLAN IN PREPARATION FOR TRANSITIONING PATIENTS FROM ADOLESCENT CARE TO ADULT CARE. THE PRIMARY NURSE PRACTITIONER, ASSIGNED SOCIAL WORKER, AND RETENTION IN CARE COORDINATOR REVIEW BEHAVIORS, BARRIERS, AND AREAS IN NEED OF SPECIAL ATTENTION TO HELP PROMOTE AND ENCOURAGE SUCCESSFUL TRANSITION. THIS CALENDAR YEAR, THE COORDINATOR ASSISTED WITH AND IS CURRENTLY FOLLOWING APPROXIMATELY 32 PATIENTS WITH TRANSITION AND CURRENTLY WORKS WITH 120 PATIENTS TO SUCCESSFULLY ASSURE THEY ARE RETAINED IN MEDICAL CARE. 1. AMERICAN CANCER SOCIETY. CANCER FACTS & FIGURES 2018. ATLANTA: AMERICAN CANCER SOCIETY; 2018.2. LIU ET AL. J CLIN ONCOL 34(14):1634-43, 2016.3. BHATIA ET AL. CANCER 122(15):2426-2439, 2016.4. HOW MANY CANCERS ARE LINKED WITH HPV EACH YEAR? CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/CASES.HTM.5. TEENVAXVIEW: 2017 ADOLESCENT HUMAN PAPILLOMAVIRUS (HPV) VACCINATION COVERAGE REPORT. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/VACCINES/IMZ-MANAGERS/COVERAGE/TEENVAXVIEW/DATA-REPORTS/HPV/DASHBOARD/2017.HTML.6. HPV-ASSOCIATED CANCER RATES BY STATE. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/STATE/INDEX.HTM. PART VI, LINE 4 (CONTINUATION FROM 104/116): ST. JUDE PROVIDES FINANCIAL SUPPORT FOR CLINICAL OPERATIONS TO ENSURE EXCELLENT QUALITY OF CARE THAT MEETS ST. JUDE PROTOCOL GUIDELINES AND TO PROVIDE PATIENT ASSISTANCE. THE AP AND OTHER STAFF ASSIST THE AFFILIATES IN THE DEVELOPMENT OF NEW PEDIATRIC HEMATOLOGY-ONCOLOGY PROGRAMS; PROVIDE MONITORING AND CONSULTATION TO IMPROVE PATIENT CARE AND CLINICAL PROCESSES FOR THE AFFILIATE CLINIC AND CHILDREN'S HOSPITAL; AND PROVIDE NUMEROUS EDUCATIONAL OFFERINGS AND MENTORING FOR AFFILIATE STAFF. IN ADDITION, ST. JUDE HAS MANY PROCESSES TO ENSURE GOOD CONTINUITY OF CARE BETWEEN THE AFFILIATES AND ST. JUDE. THE AFFILIATES' CLINICAL RECORDS FOR SHARED PATIENTS ARE AVAILABLE IN ST. JUDE MEDICAL RECORDS AND EVERY AFFILIATE HAS ACCESS TO ST. JUDE ELECTRONIC MEDICAL RECORDS OF SHARED PATIENTS. THE AFFILIATES ALSO HAVE ACCESS TO ALL ELECTRONIC RESOURCES, E.G. PATIENT EDUCATION MATERIALS, RESEARCH PROTOCOLS, CLINICAL GUIDELINES AND RESOURCES; EVERYTHING ON THE ST. JUDE INTRANET. IN ADDITION TO ASSISTING THE AFFILIATES, ST. JUDE PROVIDES CONSULTATION SERVICES FOR MORE THAN 3,000 NATIONAL AND 900 INTERNATIONAL PHYSICIAN REQUESTS. FOR FY18 PATIENT CONSULTATIONS BY CONTINENT TOTALED 3,937 AS FOLLOWS:CONTINENT NUMBER OF PATIENT CONSULTATIONSNORTH AMERICA (INCL. CENTRALAMERICA AND CARIBBEAN) 3,234SOUTH AMERICA 134EUROPE 153AFRICA 29ASIA 320AUSTRALIA 55 UNKNOWN LOCATION 12TOTAL 3,937 0 UNIVERSITY OF TENNESSEE 50 NORTH DUNLAP MEMPHIS TN 38105 626001636 GOVERNMENT ENTITY 1144497 COLLABORATION AND SUPPORT AGREEMENT SAINT FRANCIS MEDICAL CENTER 530 NE GLEN OAK AVE PEORIA IL 61637 370662569 501(C)(3) 490909 OPERATION OF ST. JUDE CLINIC CHURCH HEALTH CENTER OF MEMPHIS 1350 CONCOURSE AVE SUITE 142 MEMPHIS TN 38104 581716113 501(C)(3) 100000 FINANCIAL SUPPORT NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 600 13TH STREET NW SUITE 500 WASHINGTON DC 20005 582176067 501(C)(6) 7800 CONTRIBUTION OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER 777 HENNESY BLVD BATON ROUGE LA 70808 720423651 501(C)(3) 2000000 FINANCIAL SUPPORT GORDON RESEARCH CONFERENCES 512 LIBERTY LANE WEST KINGSTON RI 028921502 260150662 501(C)(3) 6000 INTRINSICALLY DISORDERED PROTEINS AND DNA TOPOISOMERASES IN BIOLOGY AND MEDICINE CONFERENCES UNIVERSITY HEALTH SHREVEPORT 1505 KINGS HIGHWAY SHREVEPORT LA 71103 800944985 501(C)(3) 517464 COLLABORATION AND SUPPORT AGREEMENT BELMONT UNIVERSITY 1900 BELMONT BLVD NASHVILLE TN 37212 620465076 501(C)(3) 8950 TN HEALTH CARE HALL OF FAME CONFERENCE CENTER FOR MEDICAL TECHNOLOGY POLICY 401 E PRATT STREET SUITE 631 BALTIMORE MD 21202 271203017 501(C)(3) 10000 FINANCIAL SUPPORT 8 1 PART I, LINE 2: ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS ACTIVELY INVOLVED WITH THE DONEE. THROUGH THIS ACTIVE INVOLVEMENT, THE ORGANIZATIONS ARE MONITORED TO ENSURE THE SUPPORT IS USED APPROPRIATELY. X X X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 RICHARD SHADYAC JR EX-OFFICIO DIRECTOR 0 790468 0 0 0 3564 0 80445 0 19112 0 893589 0 0 JAMES R DOWNING PRESIDENT/CEO 978811 0 150 0 79487 0 119700 0 24800 0 1202948 0 0 0 PATRICIA A KEEL SVP/CFO 564121 0 50350 0 18686 0 57658 0 27299 0 718114 0 0 0 JAMES I MORGAN EVP/SCIENTIFIC DIRECTOR 531766 0 150 0 8931 0 29700 0 27300 0 597847 0 0 0 ELLIS NEUFELD EVP/CLINICAL DIRECTOR 582932 0 190150 0 38410 0 89583 0 28416 0 929491 0 0 0 MARY ANNA QUINN EVP/CHIEF ADMIN OFFICER 436558 0 150 0 8931 0 375000 0 24741 0 845380 0 0 0 CHARLES M ROBERTS EVP/DIRECTOR CANCER CENTER 736703 0 150 0 43770 0 141100 0 22841 0 944564 0 0 0 CARLOS RODRIGUEZ-GALINDO EVP/CHAIR 598887 0 150 0 3622 0 134700 0 11498 0 748857 0 0 0 ANDREW DAVIDOFF CHAIR 713319 0 17850 0 572953 0 29700 0 31857 0 1365679 0 189272 0 CHARALAMPOS KALODIMOS CHAIR 281458 0 540150 0 41361 0 2167 0 18869 0 884005 0 0 0 THOMAS E MERCHANT CHAIR 734883 0 17850 0 69590 0 29700 0 37916 0 889939 0 0 0 RAUL C RIBEIRO FACULTY 382851 0 17850 0 573887 0 29700 0 12361 0 1016649 0 0 0 STEPHEN W WHITE CHAIR 360041 0 27850 0 421155 0 29700 0 73915 0 912661 0 0 0 WILLIAM E EVANS FACULTY/FORMER PRESIDENT/CEO 654652 0 17850 0 8790 0 29700 0 11498 0 722490 0 0 0 PART I, LINE 1A FIRST-CLASS TRAVEL: ONE FORMER OFFICER PURCHASED ONE FIRST CLASS TICKET, THE ECONOMY PORTION WAS REIMBURSED BY THE HOST AND ONLY THE UPGRADE PORTION OF $598.67 WAS PAID WITH ST. JUDE FUNDS. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND NOT RECORDED AS COMPENSATION. TRAVEL FOR COMPANIONS: FAMILY MEMBER OF ONE FORMER OFFICER, TRAVELS ON HOSPITAL BUSINESS AS REQUIRED BY THE POSITION. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND NOT RECORDED AS COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: A PAYMENT WAS ISSUED FOR DEPENDENT TUITION FOR TWO OFFICERS. THE APPLICABLE EXPENSE WAS GROSSED-UP AND INCLUDED IN THE EMPLOYEE'S W-2 AS ADDITIONAL TAXABLE COMPENSATION. PART I, LINE 4B THE ORGANIZATION ESTABLISHED A NON-QUALIFIED DEFERRED COMPENSATION PLAN PURSUANT TO CODE SECTION 457(F) OF THE INTERNAL REVENUE CODE. THE PLAN AMOUNTS ARE SUBJECT TO SUBSTANTIAL FUTURE SERVICE REQUIREMENTS TO THE ORGANIZATION AND ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. PAYMENTS WERE MADE TO THE FOLLOWING LISTED PERSONS IN PART VII UNDER THE NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE YEAR: RAUL C. RIBEIRO - $565,425 STEPHEN W. WHITE - $412,456 SCHEDULE J, PART II: RICHARD C. SHADYAC, JR. SERVES AS AN EX-OFFICIO VOTING DIRECTOR OF THE BOARD OF ST. JUDE. MR. SHADYAC IS EMPLOYED AS AN OFFICER OF ALSAC, A RELATED ORGANIZATION TO ST. JUDE. THE COMPENSATION SHOWN IN COLUMNS (B), (C), (D) AND (E) WAS PAID TO MR. SHADYAC BY ALSAC FOR HIS DUTIES AS CEO OF ALSAC. MARY RELLING SEE PART V 528041 EMPLOYMENT 0 SUSANNA DOWNING SEE PART V 59348 EMPLOYMENT 0 DIANE ROBERTS SEE PART V 212895 EMPLOYMENT 0 JEREMY QUINN SEE PART V 73845 EMPLOYMENT 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: MARY RELLING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF FORMER OFFICER (PRESIDENT AND CEO), WILLIAM E. EVANS.(C) AMOUNT OF TRANSACTION: $528,041(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO(A) NAME OF INTERESTED PERSON: SUSANNA DOWNING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF PRESIDENT AND CEO, JAMES R. DOWNING.(C) AMOUNT OF TRANSACTION: $59,348(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO(A) NAME OF INTERESTED PERSON: DIANE ROBERTS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, CHARLES M. ROBERTS.(C) AMOUNT OF TRANSACTION: $212,895(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO(A) NAME OF INTERESTED PERSON: JEREMY QUINN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, MARY ANNA QUINN.(C) AMOUNT OF TRANSACTION: $73,845(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO X 1 2017179 COST OR SELLING PRICE 0 0 0 0 PART I, COLUMN (B): THE NUMBER IN COLUMN (B) REFERS TO THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 2 FAMILY RELATIONSHIP AMONG DIRECTORS: JOSEPH S. AYOUB, JR., ESQ. AND PAUL J. AYOUB, ESQ.; GEORGE A. SIMON, II AND PAUL J. SIMON; ROBERT A. BREIT, MD AND JOSEPH G. SHAKER; JOSEPH C. SHAKER AND JOSEPH G. SHAKER; PAUL J. SIMON AND MICHAEL SIMON. FORM 990, PART VI, SECTION A, LINE 4 ON JUNE 23, 2018, ST. JUDE CHILDREN'S RESEARCH HOSPITAL AMENDED ARTICLE IV, SECTION 3, PARAGRAPH 1 OF ITS BYLAWS TO REDUCE THE MAXIMUM NUMBER OF ELECTED BOARD MEMBERS FROM 55 TO 45 AS OF JULY 1, 2018. FORM 990, PART VI, SECTION B, LINE 11B IN FEBRUARY OF EACH YEAR, THE AUDIT COMMITTEE AND OFFICERS OF THE BOARD ARE PROVIDED WITH A DRAFT COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES. THE AUDIT COMMITTEE MEETS WITH ITS TAX PREPARER TO REVIEW THE DRAFT FORM 990 BEFORE IT IS FILED WITH THE IRS. ADDITIONALLY THE COMPENSATION COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE COMPENSATION SECTIONS OF THE FORM 990, AND THE CONFLICT OF INTEREST COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE CONFLICT-OF-INTEREST SECTIONS OF THE FORM 990 FOR REVIEW BEFORE THE FINALIZED DOCUMENT IS FILED WITH THE IRS. EACH VOTING MEMBER OF THE BOARD IS PROVIDED WITH A FINAL COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C NEW BOARD MEMBERS ARE GIVEN A COPY OF THE BOARD OF GOVERNOR'S CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. THERE IS A CONFLICT OF INTEREST COMMITTEE OF THE BOARD THAT REVIEWS THE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT ARE COMPLETED BY EACH BOARD MEMBER AND DISCUSSES AND RESOLVES CONFLICTS OF INTEREST, WITH OPPORTUNITY FOR APPEAL TO THE FULL BOARD. IN ADDITION, THE ORGANIZATION HAS A CHIEF COMPLIANCE OFFICER AND COMPLIANCE DEPARTMENT, WHICH ADMINISTER THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR ALL EMPLOYEES IN CLINICAL, RESEARCH, AND SELECT ADMINISTRATIVE DEPARTMENTS, AS WELL AS EMPLOYEES IDENTIFIED AS SUPERVISORS OR WHO HAVE PURCHASING AUTHORITY. ALL SUCH EMPLOYEES COMPLETE CONFLICT OF INTEREST TRAINING AND A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE COMPLIANCE OFFICER ENSURES EMPLOYEES MEET THESE REQUIREMENTS AND REVIEWS SUBMITTED DISCLOSURES. DISCLOSURES IDENTIFIED AS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARE ADDRESSED BY THE COMPLIANCE OFFICE WITH INVOLVEMENT OF THE INSTITUTIONAL CONFLICT OF INTEREST COMMITTEE AS APPROPRIATE. DEPENDING ON THE FACTS AND CIRCUMSTANCES, THE ACTIVITY MAY BE MANAGED PURSUANT TO A MANAGEMENT PLAN, OR PROHIBITED. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S COMPENSATION COMMITTEE COMMISSIONS ANNUAL THIRD PARTY SALARY SURVEYS TO DETERMINE COMPENSATION FOR THE FOLLOWING OFFICERS: CHIEF EXECUTIVE OFFICER, SCIENTIFIC DIRECTOR, CANCER CENTER DIRECTOR, CHIEF ADMINISTRATIVE OFFICER, CHIEF FINANCIAL OFFICER, CLINICAL DIRECTOR, CHIEF GOVERNANCE OFFICER/CORPORATE SECRETARY, CHIEF LEGAL OFFICER, AND CHAIR, DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE. IN ADDITION, FIVE EMPLOYEES ARE CONSIDERED "DISQUALIFIED" BECAUSE THEY ARE FORMER EXECUTIVES OR RELATIVES OF CURRENT OR FORMER EXECUTIVES, AND THEIR COMPENSATION THEREFORE FALLS WITHIN THE COMPENSATION COMMITTEE'S PURVIEW. ALL CHANGES TO OFFICERS' SALARIES ARE APPROVED BY THE COMPENSATION COMMITTEE AND REPORTED TO THE BOARD. THE LAST REVIEW WAS COMPLETED IN DECEMBER 2018. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE ONLY AS REQUIRED BY APPLICABLE STATE LAW. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN UNRESTRICTED NET ASSETS OF ALSAC 550,657,594. CHANGE IN INTEREST IN RESTRICTED NET ASSETS OF ALSAC 62,266,520. ADDITIONAL HEALTH NEEDS IDENTIFIED IN ADDITION TO THE HEALTH NEEDS OUTLINED IN ITS 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, ST. JUDE HAS ALSO CHOSEN TO ADDRESS THE FOLLOWING HEALTH NEEDS: PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #1 OF THE CHNA): TRANSITION ONCOLOGY PROGRAM HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ACT CLINIC, TRANSITION ONCOLOGY PROGRAM (TOP) ANTICIPATED OUTCOME: PROVIDE PROSPECTIVE, SYSTEMATIC, TRANSITION-RELATED SERVICES FOR ONCOLOGY PATIENTS ACROSS THE CONTINUUM OF CARE THAT WILL SUPPORT TRANSITIONS FROM ACTIVE THERAPY TO TREATMENT AND FROM TREATMENT COMPLETION TO ACT. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. IDENTIFY AND IMPLEMENT APPROPRIATE MANAGEMENT AND OPERATIONS STRUCTURE, AND BEGIN STAFFING THE PROGRAM. 2. CLOSELY MONITOR RESOURCES TO STAFF THE CLINIC TO ITS FULLEST FORM, AND COMPLETE AN ASSESSMENT AFTER THE FIRST 18 MONTHS OF OPERATION TO ENSURE THAT THE PROGRAM IS MEETING ITS PURPOSE. 3. EVALUATE IMPACT ON INTERPRETER SERVICES, CLINICAL INFORMATICS, REHABILITATION SERVICES, CLINIC SPACE, HOUSING, AND TRAVEL COSTS. 4. EVALUATE RESOURCES IN ACT IN ANTICIPATION OF AN INCREASE IN ACT PATIENT VOLUMES. PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #3 OF THE CHNA): PREVENTING VIRUS-ASSOCIATED CANCERS THROUGH INCREASED HPV VACCINATION (HEALTH STATUS OF THE MEMPHIS COMMUNITY) HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL ANTICIPATED OUTCOME: INCREASE THE VACCINATION RATES FOR HPV VACCINE LOCALLY AND STATE-WIDE ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. CREATE A TASK FORCE TO GATHER INFORMATION ABOUT CURRENT INITIATIVES AND PROGRAMS IN MEMPHIS, ACROSS TENNESSEE, AND NATIONALLY AND TO EVALUATE PUBLISHED STUDIES ON PROGRAM APPROACHES. 2. DEVELOP GOALS, STRATEGIES, AND ACTIONS FOR A HPV VACCINATION INITIATIVE. SELECTED ACCOMPLISHMENTS: 1. CREATE A TASK FORCE TO GATHER INFORMATION ABOUT CURRENT INITIATIVES AND PROGRAMS IN MEMPHIS, ACROSS TENNESSEE, AND NATIONALLY AND TO EVALUATE PUBLISHED STUDIES ON PROGRAM APPROACHES. OVER THE PAST YEAR, A TASK FORCE WAS CREATED BY THE CANCER CENTER AT ST. JUDE. LEADERSHIP INCLUDED MELISSA HUDSON, MD, AND MELISSA JONES. SEVERAL ACTIONS WERE COMPLETED TO GATHER INFORMATION AND LEARN ABOUT PROGRAMS IN PLACE AND THE IMPACT THESE PROGRAMS HAVE ON HPV VACCINATION RATES. INFORMATION WAS ALSO GATHERED TO UNDERSTAND POTENTIAL BARRIERS AS WELL AS LOCAL AND STATE-WIDE SUPPORT FOR A BROADER INITIATIVE. ACTIONS COMPLETED INCLUDE: - PARTICIPATED IN STATEWIDE HPV MEETING IN NASHVILLE - ENGAGED SHELBY COUNTY SCHOOLS, TNAAP, AND HPV CANCER FREE TENNESSEE (TN DEPT OF HEALTH) - HOSTED WEST TN CHAPTER MEETING - MET WITH AND LOBBIED SENATORS, HEALTH COMMISSIONER, AND GOVERNOR ON IMPORTANCE OF VACCINE - ATTENDED THE NCI CANCER CENTER HPV VACCINE MEETING IN JUNE - COMPLETED PUBLIC RELATIONS EFFORTS TO RAISE AWARENESS - COMPLETED A REVIEW OF THE LITERATURE - INTERVIEWED AND GATHERED INFORMATION ON NATIONAL PROGRAMS 2. DEVELOP GOALS, STRATEGIES, AND ACTIONS FOR A HPV VACCINATION INITIATIVE. THE TASK FORCE ALSO WORKED OVER THIS PAST YEAR TO DEVELOP A MORE COMPREHENSIVE PROGRAM AND STRATEGY. A LARGER CONCEPT HAS BEEN DEVELOPED THAT WILL BE REVIEWED AND EVALUATED FOR IMPLEMENTATION IN FY20. THE PROPOSAL IS FOCUSED ON ACHIEVING THE AMERICAN CANCER SOCIETY'S AND OTHER ORGANIZATIONS' GOAL OF ELIMINATING HPV-RELATED CANCERS THROUGH VACCINATION AND SCREENING. THIS GOAL AND VISION WAS ENDORSED BY ALL NCI-DESIGNATED CANCER CENTERS IN JUNE 2018. THE PROGRAM IS FOCUSED ON DEVELOPING AND DEPLOYING STRATEGICALLY ALIGNED INITIATIVES IN THREE CRITICAL AND INTERCONNECTED DOMAINS OF COMMUNITY, HEALTHCARE PROVIDERS AND SYSTEMS, AND PUBLIC POLICY. THERE ARE EIGHT GOALS OUTLINED IN THE PLAN. FURTHER REVIEW OF THE PLAN WILL OCCUR EARLY IN FY19, WITH ANTICIPATED INCLUSION IN THE FY20 BUDGET. CHILDREN'S GMP LLC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 474475625 VACCINE MANUFACTURER TN 433875 1312451 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC THANKS & GIVING LLC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 201310435 ROYALTY INCOME FROM RECORD SALES TN 0 10632 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC THE RIGHT WORDS LLC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 954878579 ROYALTY INCOME FROM BOOK SALES NY 0 0 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC ST JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 813240987 HIGHER EDUCATION TN 7319 827699 ST JUDE CHILDREN'S RESEARCH HOSPITAL INC AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES INC 501 ST JUDE PLACE MEMPHIS TN 38105 351044585 SOLICIT SUPPORT FOR OPERATION OF ST. JUDE IL 501(C)(3) 7 N/A 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 1