2019-08-15T15:11:45-05:00 2018-09-30 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2017-10-01 060646755 CONNECTICUT CHILDREN'S MEDICAL CENTER % SETH VAN ESSENDELFT CONN 8605459000 282 WASHINGTON STREET HARTFORD CT 061063322 JAMES SHMERLING PRESIDENT/CEO 8605459000 2019-08-15 true Scott J Mariani P00642486 9738989494 148.77.36.74 22006220192275000370 2019-08-15 P 0E7AA6D09474FC827FC900BEE833A570B2ABBB6B 082E2311302191F55D0415F63BDE2ABE529C36FD 2017 2019-02-21 02:37:17Z JAMES E SHMERLING DHA FACHE 282 WASHINGTON STREET HARTFORD CT 061063322 367329012 false X WWW.CONNECTICUTCHILDRENS.ORG X 1921 CT CONNECTICUT CHILDREN'S MEDICAL CENTER IS DEDICATED TO IMPROVING THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN THROUGH FAMILY-CENTERED CARE, RESEARCH, EDUCATION AND ADVOCACY. 19 17 2133 406 0 0 20651195 23044053 319837504 341889316 13342446 -131835 2051462 2186170 355882607 366987704 98922 185281 0 0 154154143 167892476 0 0 3331024 159510751 165277411 313763816 333355168 42118791 33632536 416884241 447316131 147541897 132927688 269342344 314388443 X MISSION ======= CONNECTICUT CHILDREN'S MEDICAL CENTER IS DEDICATED TO IMPROVING THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN THROUGH FAMILY-CENTERED CARE, RESEARCH, EDUCATION AND ADVOCACY. WE EMBRACE DISCOVERY, TEAMWORK, INTEGRITY AND EXCELLENCE IN ALL THAT WE DO. VISION ====== WE ARE MAKING CHILDREN IN CONNECTICUT THE HEALTHIEST IN THE COUNTRY. VALUES ====== FAMILY-CENTERED CARE -------------------- - WE PLACE OUR PATIENTS AND THEIR FAMILIES AT THE CENTER OF ALL WE DO. - WE PARTNER WITH FAMILIES AND EMBRACE THEIR INVOLVEMENT IN ALL ASPECTS OF SERVICE AND CARE. DISCOVERY --------- - WE LOOK FOR NEW WAYS OF DOING THINGS. - WE ASK QUESTIONS, INVEST IN RESEARCH, FIND ANSWERS AND SHARE NEW KNOWLEDGE WITH THE WORLD. INTEGRITY --------- - WE ARE OPEN, HONEST AND ETHICAL. - WE TAKE RESPONSIBILITY FOR OUR ACTIONS AND FULFILL OUR COMMITMENTS. - WE ADMIT OUR MISTAKES AND LEARN FROM THEM. TEAMWORK -------- - WE LIVE BY THE STATEMENT "I CARE IF YOU SUCCEED." - WE WORK TOGETHER TO ACHIEVE OUR GOAL false false 253343112 185281 341889316 EXPENSES INCURRED TO PROVIDE ACUTE CARE INPATIENT AND OUTPATIENT SERVICES TO CHILDREN FROM CONNECTICUT AND THE SURROUNDING AREA. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 253343112 true true false true false false false false false true true false true true true true false true false false true false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 352 0 true 2133 true false false false false false true true false false false false X 19 17 true false false false true true true true true false false true true true true true true true true false X SETH VAN ESSENDELFT 8605459000 282 WASHINGTON STREET HARTFORD CT 06106 X DAVID M ROTH ESQ CHAIRMAN - DIRECTOR 1.0 0.0 X X 0 0 0 JAMES W FANELLI CFP SECRETARY - DIRECTOR 1.0 0.0 X X 0 0 0 ANDREA BALOGH DIRECTOR 1.0 0.0 X 0 0 0 KEVIN COUNIHAN DIRECTOR 1.0 0.0 X 0 0 0 E CLAYTON GENGRAS III DIRECTOR 1.0 0.0 X 0 0 0 SUSAN V HERBST PHD DIRECTOR 1.0 0.0 X 0 0 0 JEFFREY HYAMS MD DIRECTOR - PRESIDENT MED STAFF 55.0 0.0 X 0 548572 106809 PRESTON KODAK III DIRECTOR 1.0 0.0 X 0 0 0 CATO LAURENCIN MD PHD DIRECTOR 1.0 0.0 X 0 0 0 DOROTHY LEVINE MD DIRECTOR 1.0 0.0 X 0 0 0 MEGAN MACKEY DIRECTOR 1.0 0.0 X 0 0 0 KATHERINE O NIXON DIRECTOR 1.0 0.0 X 0 0 0 KOLAWOLE A OLOFINBOBA MD DIRECTOR 1.0 0.0 X 0 0 0 TINA ST PIERRE DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM C POPIK MD DIRECTOR 1.0 0.0 X 0 0 0 JONATHAN RUBIN DIRECTOR 1.0 0.0 X 0 0 0 JAMES E SHMERLING DHA FACHE DIRECTOR - PRESIDENT/CEO 55.0 0.0 X X 1110384 0 490244 AIMEE MONROY SMITH DIRECTOR 1.0 0.0 X 0 0 0 TINA STEVENSON-BROWN DIRECTOR 1.0 0.0 X 0 0 0 GENO AURIEMMA DIRECTOR (TERM ENDED 12/17) 1.0 0.0 X 0 0 0 THOMAS O BARNES DIRECTOR (TERM ENDED 12/17) 1.0 0.0 X 0 0 0 JEFFREY S HOFFMAN DIRECTOR (TERM ENDED 12/17) 1.0 0.0 X 0 0 0 ROBERT S LE BLANC DIRECTOR (TERM ENDED 12/17) 1.0 0.0 X 0 0 0 EDWARD LEWIS DIRECTOR (TERM ENDED 12/17) 1.0 0.0 X 0 0 0 ROBERT J SHANFIELD DIRECTOR (TERM ENDED 12/17) 1.0 0.0 X 0 0 0 PATRICK J GARVEY CPA CHFP TREASURER-SVP/CFO (TERM 12/17) 55.0 0.0 X 420072 0 127958 SETH VAN ESSENDELFT TREASURER - SVP/CFO (EFF 5/18) 55.0 0.0 X 0 0 20417 GIL PERI PRESIDENT & COO 55.0 0.0 X 260887 0 85321 CHRISTINE FINCK MD FACS EVP, SURGEON IN CHIEF 55.0 0.0 X 0 878842 246610 PAUL H DWORKIN MD EVP, COMMUNITY CHILD HEALTH 55.0 0.0 X 883644 0 159971 JUAN SALAZAR MD MPH EVP, ACADEMIC AFFAIRS 55.0 0.0 X 613309 0 236056 ANN G TAYLOR JD EVP, CHIEF ADMIN. OFFICER 55.0 0.0 X 474583 0 159784 ANDREA L BENIN MD SVP, PATIENT SAFETY(TERM 6/18) 55.0 0.0 X 485289 0 144340 KELLY STYLES MBA SVP, CHIEF INFORMATION OFFICER 55.0 0.0 X 392185 0 120289 CHERYL HOEY RN BSN MBA SVP, CLINICAL SERVICES & CNO 55.0 0.0 X 355456 0 131593 LAWRENCE E MILAN MA SVP, HUMAN RESOURCES 55.0 0.0 X 330713 0 121009 BOBBY M VARGAS ESQ VP, GENERAL COUNSEL 55.0 0.0 X 352895 0 143943 WILLIAM AGOSTINUCCI MS RPH VP, CLINICAL & SUPPORT SVCS 55.0 0.0 X 226114 0 116993 TRISHA FARMER MSN RN CPHRM VP, REG PARTNERSHIPS & OPS 55.0 0.0 X 213393 0 107955 HEATHER TORY MD MPH CPPS INTERM EXEC PT SFTY (EFF 6/18) 55.0 0.0 X 0 158984 37313 SARAH MATNEY MSOL BSN RN VP, AMBULATORY OPS (EFF 5/18) 55.0 0.0 X 0 142166 73067 DEB PAPPAS MBA VP MRKT/COMM OFFICER(EFF 2/18) 55.0 0.0 X 0 0 20001 RICHELLE DEMAYO MD CHIEF MED INFORMATION OFFICER 55.0 0.0 X 354055 0 82471 GLENN FLORES CHIEF RESEARCH OFFICER 55.0 0.0 X 153926 0 48784 JUNG PARK SR DIR, INFORMATION SERVICES 55.0 0.0 X 225176 0 49987 MARLENE E FERRIS SR DIR, ORGANIZATIONAL EFFECT. 55.0 0.0 X 223014 0 64934 PETER BORLA SENIOR DIRECTOR FINANCE 55.0 0.0 X 200154 0 70784 SHANNON M GRAD SR DIR, FAMILY EXP & PROF PRAC 55.0 0.0 X 195735 0 40635 PHILIP B HOPKINS DIRECTOR TECHNICAL SERVICES 55.0 0.0 X 195546 0 33182 DEAN A RAPOZA FORMER OFFICER 0.0 0.0 X 0 351383 50240 AUDREY WISE MBA FORMER OFFICER 0.0 0.0 X 228588 0 38771 7895118 2079947 3129461 207 true true false UNIVERSITY OF CONNECTICUT HEALTH CE 263 FARMINGTON AVENUE FARMINGTON CT 06032 MEDICAL 38277064 HARTFORD HOSPITAL 80 SEYMOUR STREET PO BOX 5037 HARTFORD CT 061025037 MEDICAL 8783955 ARAMARK FACILITY SERVICES PO BOX 651009 CHARLOTTE NC 282651009 CAFETERIA/DIETARY 2656319 AMN HEALTHCARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 STAFFING 2194033 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 53288 IT 1629370 40 X 10219145 4562009 8262899 23044053 NET PATIENT SERVICE REVENUE 541900 338506874 338506874 OTHER HEALTHCARE RELATED REVENUE 541900 3382442 3382442 341889316 68165 68165 0 0 243043 141308 101735 0 101735 101735 0 200000 -200000 -200000 -200000 0 0 0 0 0 0 0 0 0 FOOD SERVICES 453000 1197337 1197337 CONSULTING 541900 814097 814097 OTHER INCOME 541900 73001 73001 2084435 366987704 341889316 0 2054335 X 185281 185281 0 0 0 9355564 0 9355564 0 0 133784006 106941166 25435719 1407121 6267603 6345802 -161696 83497 4360866 3576742 737062 47062 14124437 10734572 3248621 141244 0 533767 405663 122766 5338 210972 160338 48524 2110 402178 402178 0 67474 67474 45127871 34403582 10271610 452679 1003820 762903 230879 10038 5038032 3828904 1158748 50380 4871974 3702700 1120554 48720 0 13073307 9935713 3006861 130733 536680 407876 123437 5367 0 771559 586384 177459 7716 2445468 1858555 562458 24455 0 20290885 15421073 4666903 202909 2751417 2091077 632826 27514 MEDICAL SUPPLIES 39597533 30094125 9107433 395975 SPECIALITY GROUP SUPPORT 14271226 10846132 3282382 142712 GRANT EXPENDITURES 7824456 5946586 1799625 78245 REPAIRS & MAINTENANCE 5003951 3803003 1150909 50039 1454841 1304935 132736 17170 333355168 253343112 76681032 3331024 X 4834224 3092574 0 0 0 0 42169894 44677260 0 0 0 0 0 0 2885311 3107959 659808 982807 327870625 190769654 134801235 137100971 0 0 0 0 210661386 224181831 0 0 20872383 34172729 416884241 447316131 46357136 43852537 0 0 0 0 44100166 36736470 0 0 0 0 20250974 23515792 4713 0 36828908 28822889 147541897 132927688 X 132758918 168221729 27947554 32148611 108635872 114018103 269342344 314388443 416884241 447316131 X 33632536 11413563 X X false true X true true true X true true false false false false true 339048 false true 63130 402178 false SCHEDULE C, PART II-B, LINES 1G & 1I CONNECTICUT CHILDREN'S MEDICAL CENTER ADVOCATES FOR CHILD-FRIENDLY POLICIES AT THE CONNECTICUT GENERAL ASSEMBLY AND THE UNITED STATES CONGRESS. ADVOCACY CAN INCLUDE MESSAGING SENT TO LEGISLATORS VIA EMAIL, LETTERS AND SOCIAL MEDIA AND SOMETIMES THE PROVISION OF OPPORTUNITIES FOR MEDICAL CENTER EMPLOYEES, MEDICAL STAFF AND SUPPORTERS IN THE COMMUNITY TO REACH OUT TO THEIR SENATORS AND REPRESENTATIVES BY SHARING ACTION ALERTS THROUGH EMAIL. THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, CONNECTICUT HOSPITAL ASSOCIATION AND NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TOWARDS LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THIS ORGANIZATION. THIS ALLOCATION AMOUNTED TO $63,130 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2018, THE ORGANIZATION PAID TWO OUTSIDE INDEPENDENT CONSULTING FIRMS A TOTAL OF $140,000 TO LOBBY ON BEHALF OF THE MEDICAL CENTER FOR LEGISLATION AFFECTING CHILDREN'S HEALTH AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION HAS ALLOCATED TOWARD LOBBYING ACTIVITIES A PERCENTAGE OF COMPENSATION PAID TO TWO CONNECTICUT CHILDREN'S MEDICAL CENTER EMPLOYEES TO REPRESENT TIME SPENT LOBBYING ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $199,048 DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. VOLUNTEER PARTICIPATION IN LOBBYING ACTIVITIES INCLUDING PHONE CALLS, EMAILS AND LETTERS TO LEGISLATORS AND FEDERAL AND STATE POLICY MAKERS REGARDING VARIOUS CHILD-RELATED ISSUES. THERE WAS NO MONEY INVOLVED IN THESE VOLUNTEER TRANSACTIONS. 22333915 1611103 1154088 0 852572 0 24246534 22429597 100411 163306 0 359399 0 22333915 22267000 883341 263705 0 984449 0 22429597 21942979 498716 1211645 0 1386340 0 22267000 19645169 431168 2467087 0 600445 0 21942979 0.00000 0.86120 0.13880 false true true 123441760 64412858 59028902 34956489 13214824 21741665 141815923 112032838 29783085 27656453 1109134 26547319 137100971 501(C)(3) TAX-EXEMPT ORG. 130944518 F FUNDS HELD IN TRUST BY OTHERS 93137313 F SPECIALISTS, INC. INVESTMENT 100000 F 224181831 DUE FROM AFFILIATED ENTITIES 23349329 INSURANCE RECEIVABLE 4028489 GROUND LEASE 2240930 OTHER RECEIVABLES 2650556 OTHER ASSETS 1903425 34172729 0 DUE TO THIRD PARTIES 5631453 DUE TO AFFILIATED ENTITIES 848681 ACCRUED PENSION LIABILITY 6475931 LEASE INCENTIVE OBLIGATION 4770791 OTHER LONG-TERM LIABILITIES 11096033 28822889 X SCHEDULE D, PART V, QUESTION 4 THE ENDOWMENT FUNDS REPORTED IN SCHEDULE D, PART V, ARE HELD BY CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION FOR THE BENEFIT OF CONNECTICUT CHILDREN'S MEDICAL CENTER. INCOME FROM ENDOWMENT FUNDS IS CONSIDERED TEMPORARILY RESTRICTED UNTIL IT MEETS THE ORIGINAL DONOR'S TIME OR PURPOSE RESTRICTION OF THE DONATION. THESE FUNDS ARE COMMINGLED WITH OTHER TEMPORARILY RESTRICTED CONTRIBUTIONS FOR THE SAME PURPOSES AND INVESTED UNTIL SUCH TIME THAT THE FUNDS ARE UTILIZED. CONNECTICUT CHILDREN'S MEDICAL CENTER'S SPENDING POLICY IS THAT ANY EXPENDITURE ASSOCIATED WITH THE ENDOWMENT IS APPROPRIATED BASED ON THE DONOR'S INTENTION. RESTRICTED FUNDS ARE USED TO SUPPORT AND FURTHER THE MISSION OF CONNECTICUT CHILDREN'S MEDICAL CENTER BY PROVIDING FUNDS IN SUPPORT OF OPERATIONS AND CAPITAL PURCHASES OF CONNECTICUT CHILDREN'S MEDICAL CENTER. SCHEDULE D, PART X, QUESTION 2 AN INDEPENDENT FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CONNECTICUT CHILDREN'S MEDICAL CENTER AND SUBSIDIARIES FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2017; RESPECTIVELY. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE ORGANIZATION'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): "THE MEDICAL CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO MATERIAL TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2018 AND 2017." IN ADDITION, THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ISSUES AUDITED CONSOLIDATED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2017 THAT REPORTS THE SYSTEMS LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): "THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO MATERIAL TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2018 AND 2017." Central America and the Caribbean Program Services FINANCIAL VEHICLE 3023000 3023000 3023000 false false false false false false true true X true X 250. true X 500. false true true false true true 1160673 1160673 0.00350 163049420 102503201 60546219 0.18160 164210093 102503201 61706892 0.18510 8750224 4304228 4445996 0.01330 20553963 266001 20287962 0.06090 8250565 1965961 6284604 0.01890 185281 185281 0.00060 37740033 6536190 31203843 0.09370 201950126 109039391 92910735 0.27880 23238 23238 0.00010 3865805 1561337 2304468 0.00690 600 600 0.00000 264207 264207 0.00080 133056 93374 39682 0.00010 4286906 1654711 2632195 0.00790 true 2082672 583148 390921 295319 95602 X true true 4 1 CONNECTICUT CHILDREN'S MEDICAL CENTER 282 WASHINGTON STREET HARTFORD CT 06106 WWW.CONNECTICUTCHILDRENS.ORG 2-CH X X X X X X 1 2 CCMC - NICU JOHN DEMPSEY HOSPITAL 263 FARMINGTON AVENUE FARMINGTON CT 06030 WWW.CONNECTICUTCHILDRENS.ORG 2-CH X X X X X 1 3 CCMC - NICU HARTFORD HOSPITAL 80 SEYMOUR STREET HARTFORD CT 06102 WWW.CONNECTICUTCHILDRENS.ORG 2-CH X X X X X 1 4 CCMC - PEDIATRIC IP UNIT ST MARY'S 56 FRANKLIN STREET WATERBURY CT 06706 WWW.CONNECTICUTCHILDRENS.ORG 2-CH X X X X 1 CONNECTICUT CHILDREN'S MEDICAL CENTER 1 false false true X X X X X X X X X X 15 true false false true X WWWW.CONNECTICUTCHILDRENS.ORG X WWW.CT.GOV X X true 16 true WWW.CT.GOV false true X 250. 500. true true X X X true X WWWW.CONNECTICUTCHILDRENS.ORG X WWWW.CONNECTICUTCHILDRENS.ORG X WWW.CONNECTICUTCHILDRENS.ORG X X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, QUESTION 3J THE ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") TAKES A COMPREHENSIVE LOOK AT THE NEEDS OF CHILDREN AND FAMILIES IN THE GREATER HARTFORD AREA AND OUTLINES HOW CONNECTICUT CHILDRENS WILL CONTINUE TO WORK TO ADDRESS THOSE NEEDS. THIS COMMUNITY HEALTH IMPROVEMENT PLAN ("CHIP") SERVES AS OUR RESPONSE TO OUR NEW CHNA. BACKGROUND: IN 2013, CONNECTICUT CHILDRENS PARTICIPATED WITH HARTFORD HOSPITAL, ST. FRANCIS HOSPITAL, AND THE CITY OF HARTFORDS HEALTH AND HUMAN SERVICES DEPARTMENT TO CREATE THE FIRST CHNA THAT ADDRESSED REQUIREMENTS OF THE AFFORDABLE CARE ACT. THE CHNA IDENTIFIED CHILDHOOD OBESITY AND CHILDHOOD ASTHMA AS NEEDS, BUT ALSO IDENTIFIED A LACK OF COORDINATED EFFORTS TO ADDRESS MANY SOCIAL DETERMINANTS THAT AFFECT THE HEALTH OF ALL RESIDENTS. OUR EASY BREATHING PROGRAM CONTINUES ITS FOCUS ON ASTHMA PREVENTION AND CONTROL, AND MONITORS ITS IMPACT BY SEEING A REDUCTION IN USAGE OF OUR EMERGENCY DEPARTMENT FOR ASTHMA TREATMENT. IN THE AREA OF CHILDHOOD OBESITY, WE HAVE CLINICAL SERVICES THROUGH OUR ENDOCRINOLOGY AND CLINICAL NUTRITION DEPARTMENTS THAT CONTINUE TO FOCUS ON OBESITY, AND ARE WORKING WITH MANY COMMUNITY PARTNERS THROUGH OUR FORMATION OF THE HARTFORD CHILDHOOD WELLNESS ALLIANCE TO MAKE INROADS IN THE REDUCTION OF CHILDHOOD OBESITY IN THE CITY OF HARTFORD. IN RESPONSE TO THE SYSTEMATIC NEEDS IDENTIFIED, CONNECTICUT CHILDRENS LEADERSHIP AND BOARD OF DIRECTORS ENDORSED THE CREATION OF THE OFFICE FOR COMMUNITY CHILD HEALTH ("OCCH") AS ITS CHIP FOR THE NEXT THREE YEARS. AS A COORDINATING ENTITY FOR CONNECTICUT CHILDRENS COMMUNITY CHILD HEALTH EFFORTS, OCCH OVERSEES 15 COMMUNITY-ORIENTED PROGRAMS, INCLUDING THE HELP ME GROW AND EASY BREATHING NATIONAL CENTERS. OCCHS THREE MAJOR STRATEGIES INCLUDE: ENHANCING THE EFFECTIVENESS OF EXISTING COMMUNITY-ORIENTED INITIATIVES THROUGH TECHNICAL ASSISTANCE FOCUSED ON PROGRAM DESIGN AND PERFORMANCE AND OUTCOME MEASUREMENT; PROMOTING STRATEGIC SYNERGIES AMONG PROGRAMS; AND DEVELOPING, SUPPORTING, AND DISSEMINATING PROMISING INNOVATIONS TO ADDRESS CRITICAL CONTEMPORARY CHALLENGES TO CHILDRENS HEALTH. OCCHS MISSION IS TO ELEVATE THE EFFECTIVENESS AND STATUS OF CONNECTICUT CHILDRENS AS A CRITICAL COMMUNITY RESOURCE IN PROMOTING THE OPTIMAL HEALTHY DEVELOPMENT OF ALL CHILDREN. IN ADDITION TO CHAMPIONING A SHIFT IN CONNECTICUT CHILDRENS MISSION, VISION, AND PRIORITIES, OCCH ACHIEVED REMARKABLE SUCCESS IN EACH OF ITS THREE STRATEGIC FOCUS AREAS. OCCH DEVELOPED AND IMPLEMENTED RIGOROUS PERFORMANCE METRICS TO MONITOR ITS PROGRESS AND TO ASSESS THE IMPACT OF ITS WORK. OFFICE AND PROGRAM LEVEL PROCESS AND OUTCOME METRICS CONTINUE TO DRIVE OCCHS COMMITMENT TO DATA-DRIVEN CONTINUOUS QUALITY IMPROVEMENT. SECONDLY, OCCH HAS BUILT SYNERGIES AMONG PREVIOUSLY SILOED PROGRAMS TO INCREASE THEIR COLLECTIVE IMPACT ON CHILDREN AND FAMILIES. THIRDLY, OCCH HAS DEVELOPED EXTENSIVE EXPERTISE AND TOOLS TO OFFER TECHNICAL ASSISTANCE TO ENABLE THE REPLICATION AND DISSEMINATION OF INNOVATIONS THAT LAUNCHED IN THE GREATER HARTFORD AREA AND ARE NOW BEING REPLICATED ACROSS THE COUNTRY. FOR MORE INFORMATION ON OUR PROGRESS, PLEASE REFER TO OUR LATEST COMMUNITY BENEFIT REPORT ON OUR WEBSITE. OUR 2016 CHNA (2015 TAX YEAR): OUR APPROACH TO ASSESSING THE HEALTH NEEDS OF CHILDREN IN OUR COMMUNITY HAS EVOLVED. THOUGH WE HAVE SEEN IMPORTANT RESULTS WITH THE REDUCTION OF CHILDREN USING OUR EMERGENCY DEPARTMENT FOR ASTHMA TREATMENT, THE FUNDING FOR THE HARTFORD CHILDHOOD WELLNESS ALLIANCE RAN OUT BEFORE WE COULD DO A FOLLOW-UP STUDY OF ANY IMPACT THAT THE ALLIANCE MAY HAVE HAD ON THE REDUCTION OF CHILDHOOD OBESITY IN HARTFORD. WHILE WE WILL CONTINUE TO LOOK FOR ADDITIONAL FUNDING SOURCES TO SUPPORT THE ALLIANCES EFFORTS, RELIANCE ON THE MANY VARIABLES BEYOND OUR CONTROL REINFORCED OUR BELIEF THAT THE CREATION OF OCCH AND TAKING A MORE SYSTEMATIC APPROACH IN MAKING LONG-TERM STRIDES IN MAKING CHILDREN IN OUR COMMUNITY HEALTHIER HAS MERIT. OUR APPROACH TO OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT REFLECTS THAT THINKING. OUR MOST RECENT CHNA UTILIZED A NUMBER OF COMPONENTS THAT INCLUDED THE INPUT OF MANY PEOPLE WORKING WITH THE UNDERSERVED, REPRESENTING VOICES FROM BOTH A LOCAL AND STATE-WIDE LEVEL. TWO MAJOR COMPONENTS WERE: THE HARTFORD BLUEPRINT FOR WOMEN AND CHILDRENS HEALTH ("THE BLUEPRINT") AND SOUTHSIDE INSTITUTIONS NEIGHBORHOOD ALLIANCES ("SINA") ECONOMIC DEVELOPMENT PLAN. IT IS FROM THOSE SOURCES THAT CONNECTICUT CHILDRENS WILL PRIORITIZE ITS INITIAL ACTIONS FOR OUR CHIP. OTHER SOURCES OF INFORMATION THE STATEWIDE DATA HAVEN REPORT, THE SCHOOL NURSE SURVEY, AND UNITED WAY OF CONNECTICUTS 211 SYSTEM WILL ACT AS A REFERENCES AS WE DEVELOP FURTHER STRATEGIES. FOR MORE INFORMATION, PLEASE REFER TO OUR CHNA ON OUR WEBSITE. THE BLUEPRINT: THE BLUEPRINT RECOMMENDED SIX STEPS BE TAKEN IN ORDER TO BUILD AN EFFECTIVE HEALTH CARE SYSTEM THAT BENEFITS WOMEN AND CHILDREN OF HARTFORD. THEY ARE: 1) ESTABLISH A PUBLIC/PRIVATE LEADERSHIP TEAM THAT INCLUDES THE CITY, OCCH, THE CHILD HEALTH AND DEVELOPMENT INSTITUTE OF CONNECTICUT, KEY STAKEHOLDERS, AND RESIDENTS TO GUIDE AND OVERSEE BLUEPRINT IMPLEMENTATION. 2) ESTABLISH WITHIN THE CITY A COMPREHENSIVE WOMEN AND CHILDRENS HEALTH SYSTEM THAT ENSURES WOMEN OF CHILD-BEARING AGE, CHILDREN AND FAMILIES HAVE TIMELY ACCESS TO A SEAMLESS AND USER-FRIENDLY RANGE OF SERVICES AND SUPPORTS. 3) DEVELOP AND DISSEMINATE DATA ON THE HEALTH OF WOMEN, THE HEALTH AND DEVELOPMENTAL STATUS OF CHILDREN, AND THE STATUS OF PROGRAMS AND SERVICES TO PUBLIC OFFICIALS, PROVIDERS, COMMUNITY BASED ORGANIZATIONS, AND RESIDENTS TO INFORM PRIORITIZATION AND DECISION MAKING. 4) ENGAGE ALL CITY PROVIDERS IN THE CONTINUOUS MONITORING OF THE QUALITY OF THE WOMENS AND CHILDRENS HEALTH CARE SERVICES, INCLUDING DEVELOPMENTAL ASSESSMENT SERVICES, CARE COORDINATION, AND HOME VISITING PROGRAMS, AND ENCOURAGE THE TESTING OF CHANGES TO IMPROVE SERVICE EFFICACY AND OUTCOMES. 5) SUPPORT THE ONGOING PROFESSIONAL DEVELOPMENT OF WOMENS AND CHILDRENS HEALTH PROVIDERS, TRAINEES, AND STAFF THROUGH ACCESSIBLE, EFFICACIOUS, AND EFFICIENT TRAINING THAT ENABLES THEM TO PERFORM AT THE TOP OF THEIR PROFESSIONAL LICENSES AND IN COLLABORATION WITH FAMILIES AND ONE ANOTHER. 6) BUILD ON AND EXPAND CURRENT PREVENTION EFFORTS AND ACTIVITIES TO PROMOTE THE HEALTHY DEVELOPMENT OF HARTFORDS WOMEN AND CHILDREN. ACTIONS TO DATE: - OCCH HAS APPLIED FOR MAJOR GRANT FUNDING TO SUPPORT SOME, IF NOT ALL, OF THE RECOMMENDATIONS OF THE BLUEPRINT. - OCCH HAS ALLOWED COMMUNITY BASED PARTNERS TO UTILIZE THE DATA FROM THE BLUEPRINT TO APPLY FOR GRANT FUNDING FOR IMPLEMENTATION AND WILL OFFER SUPPORT SHOULD THOSE PARTNERS OBTAIN FUNDING. - ADDITIONALLY, ACTIVE CONVERSATIONS WITH HARTFORDS PROMISE ZONE LEADERSHIP AND THEIR COMMUNITY COLLABORATOR, COMMUNITY SOLUTIONS, HAVE BEEN HELD WITH THE PURPOSE OF IMPLEMENTING MANY OF THE BLUEPRINT RECOMMENDATIONS, USING THE DESIGNATED PROMISE ZONE AREA AS A PILOT FOR THE REST OF THE CITY. SINAS ECONOMIC DEVELOPMENT PLAN: IN KEEPING WITH SINAS MISSION TO MAXIMIZE THE POSITIVE IMPACT THAT THREE NEIGHBORING ANCHOR INSTITUTIONS (CONNECTICUT CHILDRENS, HARTFORD HOSPITAL, TRINITY COLLEGE) CAN HAVE ON AN IMPOVERISHED NEIGHBORHOOD, SINA HAS UNDERTAKEN STEPS TO DEVELOP A PLAN TO DEAL WITH A MAJOR SOCIAL DETERMINANT THAT AFFECTS THE HEALTH OF FAMILIES - THE ECONOMY. THIS IS IN ADDITION TO SINAS WORK WITH OTHER SOCIAL DETERMINANTS LIKE HOUSING AND PUBLIC SAFETY. SINAS HOUSING PROGRAM, WHICH DEALS WITH NEIGHBORHOOD BLIGHT, CONTINUES TO SUPPORT CITY EFFORTS TO INCREASE THE NUMBER OF OWNER OCCUPIED HOMES IN THE NEIGHBORHOOD. A RECENT STATE GRANT WILL ALLOW SINA TO BUILD 11 NEW HOMES IN A STRATEGIC GEOGRAPHIC PORTION OF THE NEIGHBORHOOD, ADDING TO THE 65 HOMES THAT SINA HAS COMPLETED DURING THE PAST SEVEN YEARS. NEIGHBORHOOD SAFETY AND SECURITY HAS BEEN ENHANCED THROUGH SINAS RELATIONSHIP WITH THE HARTFORD POLICE DEPARTMENT (HPD). SINA HAS CONVENED DIALOGUES WITH THE SINA MEMBER SECURITY FORCES AND THE POLICE, ENHANCED HPDS ABILITY TO USE CAMERAS IN THE NEIGHBORHOOD FOR SURVEILLANCE IN HIGH CRIME AREAS, AND DEVELOPED A NEIGHBORHOOD SAFETY TEAM THROUGH ITS COMMUNITY ENGAGEMENT STRATEGIES. THE PLAN LOOKS AT THE ROLE CONNECTICUT CHILDRENS AND THE TWO OTHER SINA PARTNERS CAN PLAY IN WORKING WITH EXISTING ASSETS, BOTH INTERNALLY AND EXTERNALLY, TO IMPROVE NEIGHBORHOOD CONDITIONS. WITH SOME INITIATIVES, THE PARTNERS WILL TAKE AN ACTIVE ROLE, WHILE IN OTHERS THE PARTNERS WILL ACT AS CONVENERS, COLLABORATORS, OR INFLUENCERS. THE FOUR AREAS OF FOCUS WILL BE: - CAREER PREPARATION, JOB TRAINING AND EMPLOYMENT - ENTREPRENEURSHIP AND SMALL BUSINESS DEVELOPMENT - PUBLIC REALM INVESTMENTS - CULTURAL DEVELOPMENT A COMPLETE OVERVIEW OF THE PLAN, DETAILING INITIATIVES AND OUTLINING THE ROLE OF THE PARTNERS CAN BE FOUND ON SINAS WEBSITE; WWW.SINAINC.ORG. SUMMARY: WE ARE EXCITED TO FORGE AHEAD TO ADDRESS THE NEEDS IDENTIFIED IN OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. WE RECOGNIZE THAT THIS WORK CANNOT BE UNDERTAKEN SOLELY B SCHEDULE H, PART V, SECTION B, QUESTION 5 WHILE CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") THE ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE ORGANIZATION DEVELOPED THE CHNA WITH STRONG GUIDANCE FROM THE CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH ("THE OFFICE"). ADDITIONALLY, THE ORGANIZATION PARTNERED WITH VARIOUS OUTSIDE ORGANIZATIONS AS WELL AS A VARIETY OF KEY COMMUNITY STAKEHOLDERS. THIS COLLABORATION ALLOWED THE ORGANIZATION TO PRESENT COMMUNITY HEALTH NEEDS ACROSS THE AGE SPAN AND SECTORS OF SERVICE AND WITHIN THE CONTEXT OF KEY COMMUNITY CONTRIBUTORS TO HEALTH. PRIMARY DATA COLLECTION EFFORTS ------------------------------- AS DESCRIBED IN THE ORGANIZATIONS CHNA, IN AN EFFORT TO TAKE INTO ACCOUNT INPUT FORM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED, THE ORGANIZATION USED A VARIETY OF METHODS TO COMPILE DATA. THESE METHODS ARE OUTLINED BELOW: (1) KEY INFORMANT INTERVIEWS: IN DEVELOPING THIS ASSESSMENT, PRIMARY DATA COLLECTION EFFORTS RELIED HEAVILY ON INFORMATION OBTAINED DURING INTERVIEWS WITH KEY INFORMANTS. THOSE INTERVIEWS INCLUDED CITY OFFICIALS SUCH AS: - THE DIRECTOR OF THE HARTFORD DEPARTMENT OF HEALTH AND HUMAN SERVICES; - LEADERS OF PRIVATE FOUNDATIONS; - LEADERS OF COMMUNITY-BASED NONPROFIT ORGANIZATIONS; AND - LEADERS OF STATE AGENCIES. IN ADDITION TO CONNECTICUT CHILDREN'S, VARIOUS OTHER AGENCIES PARTICIPATED IN THE KEY INFORMANT INTERVIEWS. THOSE AGENCIES INCLUDE THE FOLLOWING: - CITY OF HARTFORD DEPARTMENT OF HEALTH AND HUMAN SERVICES; - CITY OF HARTFORD FRESH FOOD INITIATIVE IN EARLY CARE AND EDUCATION; - COMADRONA; - COMMUNITY HEALTH NETWORK OF CONNECTICUT; - CONNECTICUT DENTAL HEALTH PARTNERSHIP; - CONNECTICUT DEPARTMENT OF EDUCATION; - HARTFORD CHILDHOOD WELLNESS ALLIANCE; - HARTFORD FOUNDATION FOR PUBLIC GIVING; - HEALTHY START; - HISPANIC HEALTH COUNCIL; - MATERNAL AND INFANT OUTREACH PROGRAM; - MINDING THE BABY HOME VISITING PROGRAM; - NORTHEAST NEIGHBORHOOD PARTNERSHIP; - NURTURING FAMILIES NETWORK; - SUCCESSFUL FATHERHOOD INITIATIVE; - UNITED WAY OF CONNECTICUT; AND - VILLAGE FOR FAMILIES AND CHILDREN. INTERVIEWEES WERE ASKED A VARIETY OF QUESTIONS THAT FOCUSED ON IDENTIFYING UNMET NEEDS WITHIN THE COMMUNITY. (2) HARTFORD BLUEPRINT FOR WOMENS AND CHILDRENS HEALTH: THE HARTFORD BLUEPRINT FOR WOMENS AND CHILDRENS HEALTH ("THE BLUEPRINT") PROVIDES A COMPREHENSIVE LOOK AT THE NEEDS OF THE CITYS WOMEN AND YOUNG CHILDREN. THE CITY OF HARTFORD COMMISSIONED THE OFFICE TO PREPARE THE BLUEPRINT AS TO ARTICULATE THE NEED FOR BUILDING A COMPREHENSIVE SYSTEM IN HARTFORD TO ENSURE STRONG FAMILIES AND LIFELONG OUTCOMES FOR CHILDREN. THE DOCUMENT PROVIDES A ROADMAP TO ADDRESS THE NEEDS IDENTIFIED FOR HARTFORDS WOMEN AND CHILDREN THROUGH SYSTEM BUILDING AND COLLECTIVE IMPACT. ADDITIONAL PRIMARY COLLECTION DATA EFFORTS INCLUDE THE FOLLOWING WITH RESPECT TO THE BLUEPRINT: - THE ORGANIZATION REVIEWED PRIOR REPORTS AND SURVEYS RELATED TO HEALTH, PRENATAL CARE, AND EARLY CARE AND EDUCATION; - FOCUS GROUPS WITH EARLY CARE AND EDUCATION PROVIDERS, COMMUNITY LEADERS, AND RESIDENTS WERE CONDUCTED; - VARIOUS MEETINGS WITH HEALTH AND HUMAN SERVICES AND EARLY CARE AND EDUCATION STEERING COMMITTEES AND COLLABORATIVES TOOK PLACE; - SURVEYS FROM MEDICAL, BEHAVIORAL HEALTH, AND DENTAL PROVIDERS IN HARTFORD WERE DISTRIBUTED; AND - LEADERSHIP DISCUSSIONS WITH THE CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH OFFICE TOOK PLACE. (3) SCHOOL NURSE SURVEYS: A SURVEY OF SCHOOL NURSES FROM ACROSS CONNECTICUT WAS CONDUCTED IN AUGUST 2014 AND PROVIDED CRITICAL INFORMATION ABOUT THE NEEDS OF HARTFORDS OLDER CHILDREN. THE SURVEY, WAS CONDUCTED BY THE ORGANIZATION AND LISTED A VARIETY OF PUBLIC HEALTH CONCERNS AND ASKED RESPONDENTS TO RATE THEM FROM ZERO, WHERE THE ISSUE IS PERCEIVED NOT TO BE A PROBLEM, TO FOUR, WHERE THE ISSUE IS PERCEIVED TO BE A MAJOR PROBLEM. THE SURVEY ALSO ASKED RESPONDENTS TO PROVIDE IDEAS ABOUT HOW TO IMPROVE THE HEALTH OF CHILDREN IN CONNECTICUT. THERE WERE A TOTAL OF 90 SURVEYS COLLECTED FROM SCHOOL NURSES DURING A CONFERENCE IN AUGUST 2015. ARRANGED BY COUNTY, THERE WERE 57 FROM HARTFORD COUNTY, EIGHT FROM TOLLAND COUNTY, SEVEN FROM NEW LONDON COUNTY, SIX FROM FAIRFIELD COUNTY, THREE FROM LITCHFIELD COUNTY, AND TWO EACH FROM NEW HAVEN, WINDHAM, AND MIDDLESEX COUNTIES. (4) SINA NEIGHBORHOOD ECONOMIC DEVELOPMENT PLAN: BEYOND HEALTH AND CHILD DEVELOPMENT, THE CHNA ALSO CONSIDERS COMMUNITY NEEDS AS IDENTIFIED BY THE 2015 SINA ECONOMIC DEVELOPMENT PLAN. SINA, WHICH IS A PARTNERSHIP BETWEEN CONNECTICUT CHILDRENS, HARTFORD HOSPITAL, AND TRINITY COLLEGE, CONDUCTED AN ANALYSIS OF NEIGHBORHOOD NEEDS, OPPORTUNITIES AND RESOURCES AND COMPILED THE RESULTS INTO THE SINA NEIGHBORHOOD ECONOMIC DEVELOPMENT STUDY. THE ORGANIZATION CONDUCTED INTERVIEWS WITH SENIOR MANAGERS OF RELEVANT DEPARTMENTS WITHIN SINA MEMBER INSTITUTIONS. ADDITIONALLY, FOCUS GROUPS WITH KEY COMMUNITY STAKEHOLDERS WERE HELD. SECONDARY DATA COLLECTION EFFORTS --------------------------------- IN ADDITION TO THE PRIMARY DATA COLLECTIONS DESCRIBED ABOVE, THE ORGANIZATION TOOK INTO ACCOUNT VARIOUS SECONDARY DATA SOURCES WHEN DEVELOPING ITS CHNA. THESE INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) HARTFORD FOUNDATION FOR PUBLIC GIVING EARLY DEVELOPMENT INSTRUMENT ("EDI"): THE EDI ATTEMPTS TO ANSWER THE QUESTION OF WHAT CAN BE DONE TO ENSURE CHILDREN ARE READY FOR SCHOOL. THE ORGANIZATION ANALYZED THE DATA TO HELP IDENTIFY COMMUNITY NEEDS IN THIS REPORT. THE EDI PROJECT WAS CONDUCTED AT SCHOOLS IN HARTFORD AND WEST HARTFORD AS A POPULATION MEASURE OF HOW YOUNG CHILDREN ARE DEVELOPING IN COMMUNITIES. IT MEASURES FIVE AREAS OF EARLY CHILDHOOD DEVELOPMENT: PHYSICAL HEALTH AND WELLBEING; SOCIAL COMPETENCE; EMOTIONAL MATURITY; LANGUAGE AND COGNITIVE DEVELOPMENT; AND COMMUNICATIONS SKILLS AND GENERAL KNOWLEDGE. THE WORK WAS GUIDED BY THE UCLA CENTER FOR HEALTHIER FAMILIES, CHILDREN AND COMMUNITIES. THE ORGANIZATION USED THE DATA TO FURTHER GATHER INFORMATION WITH RESPECT TO COMMUNITY NEEDS RELATED TO EARLY CHILDHOOD CARE AND EDUCATION. (2) DATAHAVEN COMMUNITY WELLBEING SURVEY: THE DATAHAVEN COMMUNITY WELLBEING SURVEY ALSO PROVIDED KEY INFORMATION FOR THE CHNA. THE NON-PROFIT GROUP DATAHAVEN, BASED IN NEW HAVEN, CONNECTICUT, IS DEDICATED TO IMPROVING THE QUALITY OF LIFE OF RESIDENTS BY COLLECTING, INTERPRETING, AND SHARING PUBLIC DATA TO ASSIST LEADERS WITH EFFECTIVE DECISION MAKING. THE ORGANIZATION HAS BEEN IN EXISTENCE SINCE 1992. THE SURVEY IS ITS LARGEST INITIATIVE AND PRODUCES INFORMATION ON THE QUALITY OF LIFE, PUBLIC HEALTH, ECONOMIC DEVELOPMENT AND CIVIC VITALITY FOR MORE THAN 100 STATE AND LOCAL GOVERNMENT, HEALTH CARE, ACADEMIC, AND COMMUNITY PARTNERS ACROSS CONNECTICUT. THE ORGANIZATION ANALYZED DATA CONTAINED IN THE 2015 DATAHAVEN COMMUNITY WELL-BEING SURVEY FOR HARTFORD, AND USED PERTINENT INFORMATION TO IDENTIFY COMMUNITY NEEDS. DATAHAVEN CONTRACTED WITH THE SIENA COLLEGE RESEARCH INSTITUTE TO CONDUCT A SURVEY OF 16,820 RESIDENTS ACROSS THE STATE OF CONNECTICUT, INCLUDING 750 RESIDENTS OF THE CITY OF HARTFORD. INTERVIEWS WERE CONDUCTED IN ENGLISH AND SPANISH. TO ENSURE THAT THE STATISTICS REPRESENTED THE TRUE DEMOGRAPHICS OF THE STATE, THE OVERALL STATEWIDE SAMPLE WAS WEIGHTED BY AGE, GENDER, REPORTED RACE, AND COUNTY. IT WAS ALSO WEIGHTED TO MATCH CURRENT PATTERNS OF TELEPHONE USAGE (LANDLINE ONLY, CELL PHONE ONLY, OR BOTH). LOCAL LEVEL SAMPLES, LIKE THOSE FOR HARTFORD, WERE WEIGHED USING THE SAME PARAMETERS AND APPLIED AT A LOCAL LEVEL (TOWN INSTEAD OF COUNTY). SURVEYS WERE CONDUCTED VIA LANDLINES AND CELL PHONES. (3) UNITED WAY OF CONNECTICUTS 211 PROGRAM: THE NONPROFIT UNITED WAY OF CONNECTICUT STRIVES TO MEET THE NEEDS OF STATE RESIDENTS BY PROVIDING THEM WITH INFORMATION, EDUCATION, AND CONNECTIONS TO SERVICES. IT MANAGES AND OPERATES THE CHILD DEVELOPMENT INFOLINE, WHICH IS ACCESSIBLE THROUGH 211, AND SERVES AS THE STATEWIDE CENTRALIZED TELEPHONE ACCESS POINT WHERE CARE COORDINATORS CONNECT FAMILIES IN NEED WITH SERVICES THAT CAN HELP THEM. IN THE 2014-2015 FISCAL YEAR, HARTFORD RESIDENTS CALLED 211 A TOTAL OF 54,695 TIMES WHICH RESULTED IN 70,501 REQUESTS FOR SERVICES. THE CHNA ANALYZED DATA PROVIDED BY THE UNITED WAY OF CONNECTICUTS 211 INFORMATION AND REFERRAL SERVICE, WHICH SHOWS THE ESTIMATED NUMBER OF CALLS FOR SERVICE COMING IN FROM HARTFORD DURING THE 2015-2016 FISCAL YEAR. DATA FROM THE UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT, THE REGION THAT INCLUDES HARTFORD, WAS ALSO USED. THE ORGANIZATION USED THIS DATA TO GATHER ADDITIONAL INFORMATION WITH RESPECT TO THE COMMUNITY NEEDS OF THE GREATER HARTFORD AREA. SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6B ALTHOUGH THE CHNA WAS CONDUCTED SOLELY BY CONNECTICUT CHILDRENS MEDICAL CENTER, HARTFORD HOSPITAL IS A SINA PARTNER AND CONTRIBUTED TO THE ECONOMIC DEVELOPMENT PORTION OF OUR CHNA. THE ORGANIZATION HAS MANY LONG STANDING AND ACTIVE PARTNERSHIPS WITH VARIOUS GOVERNMENT, SOCIAL AND CIVIC ORGANIZATIONS. THEREFORE, THE CHNA IS THE RESULT OF A COLLABORATIVE EFFORT WITH VARIOUS COMMUNITY PARTNERS WHO WORKED TOGETHER TO IDENTIFY THE UNMET NEEDS OF THE COMMUNITY SERVED. MANY OUTSIDE ORGANIZATIONS CONTRIBUTED TO OUR CHNA. A FEW OF THEM WERE: - THE CITY OF HARTFORDS HEALTH AND HUMAN SERVICES DEPARTMENT - CONNECTICUT DEPARTMENT OF PUBLIC HEALTH - HARTFORD HOSPITAL - TRINITY COLLEGE - THE UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT - DATA HAVEN - HARTFORD FOUNDATION FOR PUBLIC GIVING - SPANISH AMERICAN MERCHANTS ASSOCIATION SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FULL CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.CONNECTICUTCHILDRENS.ORG/COMMUNITY-CHILD-HEALTH ADDITIONALLY, THE ORGANIZATION'S CHNA IS ALSO MADE WIDELY AVAILABLE AT THE FOLLOWING CONNECTICUT GOVERNMENT WEBSITE: HTTP://PORTAL.CT.GOV/-/MEDIA/DEPARTMENTS-AND-AGENCIES/DPH/DPH/OHCA/COMMUNI TY_NEEDS_ASSESSMENT/CHNA/2016/2016CONNECTICUTCHILDRENSMEDICALCENTERPDF.PDF ?LA=EN SCHEDULE H, PART V, SECTION B, QUESTION 7D THE ORGANIZATION'S CHNA WAS REVIEWED AND APPROVED BY ITS BOARD OF DIRECTORS. ONCE APPROVED, THE CHNA WAS POSTED ON THE ORGANIZATION'S WEBSITE, NOTING THAT HARD COPIES WERE AVAILABLE ON REQUEST. HARD COPIES OF OUR CHNA WERE DISTRIBUTED TO LEGISLATORS, LOCAL GOVERNMENT OFFICIALS, OTHER HOSPITALS THROUGHOUT CONNECTICUT, OTHER CHILDRENS HOSPITALS THROUGH THE CHILDRENS HOSPITAL ASSOCIATION, THE UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT, AND AT OUR LOCAL NEIGHBORHOOD REVITALIZATION ZONE MEETING. SCHEDULE H, PART V, SECTION B, QUESTION 10 DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE GOVERNMENT. THE ORGANIZATION'S HOSPITAL IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE GOVERNMENT'S WEBSITE: HTTP://PORTAL.CT.GOV/-/MEDIA/DEPARTMENTS-AND-AGENCIES/DPH/DPH/OHCA/COMMUNI TY_NEEDS_ASSESSMENT/CHNA/2017/2017CCMCCOMMUNITYHEALTHIMPROVEMENTPLANPDF.PD F?LA=EN SCHEDULE H, PART V, SECTION B, QUESTION 11 IN CONDUCTING THE CHNA, THE CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH ("THE OFFICE") DEVELOPED A ROBUST STRATEGY FOR ADDRESSING THE IDENTIFIED NEEDS TO ENHANCE HEALTH CARE FOR HARTFORDS WOMEN AND CHILDREN AND TO PROMOTE THE OPTIMAL HEALTHY DEVELOPMENT OF THE CITYS YOUNGEST RESIDENTS. THROUGHOUT THE CHNA THE ORGANIZATION IDENTIFIED THE FOLLOWING UNMET COMMUNITY HEALTH NEEDS: 1) DEVELOPMENTAL SURVEILLANCE AND SCREENING ------------------------------------------- IDENTIFIED NEED: THERE IS A NEED TO BRING TO SCALE AN EXISTING ASSESSMENT SERVICE, MID-LEVEL DEVELOPMENTAL ASSESSMENT, AND HELP ME GROW OPPORTUNITIES FOR AT-RISK CHILDREN WHO ARE NOT ELIGIBLE FOR PUBLICLY FUNDED INTERVENTION PROGRAMS. AREA OF FOCUS: MANY CHILDREN WITH MILD-TO-MODERATE DEVELOPMENTAL OR BEHAVIORAL CONCERNS ARE ELUDING EARLY DETECTION AND ARE ARRIVING AT KINDERGARTEN WITHOUT THE DEVELOPMENTAL, SOCIO-EMOTIONAL, BEHAVIORAL AND/OR COGNITIVE SKILLS TO BEGIN SCHOOL. THESE CHILDREN WERE OFTEN INELIGIBLE FOR EARLY INTERVENTION OR PRESCHOOL SPECIAL EDUCATION SERVICES PRIOR TO SCHOOL ENTRY, AS BOTH OF THESE SERVICES HAVE STRICT ELIGIBILITY REQUIREMENTS. 2) CROSS-SECTOR CARE COORDINATION --------------------------------- IDENTIFIED NEED: THERE IS A NEED TO BRING EXISTING CARE COORDINATION PROGRAMS TO SCALE THROUGHOUT THE CITY AND TO EXPAND THE HARTFORD CARE COORDINATION COLLABORATIVE ("HCCC") TO INCLUDE CARE COORDINATION SERVICES FROM HEALTH, CHILD CARE, HOME VISITING AND OTHER CHILD AND FAMILY SERVICES. AREA OF FOCUS: CARE COORDINATION FROM A VARIETY OF SERVICE SECTORS IS AVAILABLE TO CHILDREN AND FAMILIES IN HARTFORD. THERE IS ALSO A PROGRAM, THE HCCC, WHICH BRINGS HARTFORD AREA CARE COORDINATORS FROM A VARIETY OF CHILD AND FAMILY SERVING SECTORS TOGETHER TO INCREASE THE EFFICIENCY OF SERVICES AND DECREASE THE DUPLICATION THAT CAN OCCUR WHEN FAMILIES WORK WITH MULTIPLE CARE COORDINATORS FROM DIFFERENT SECTORS. 3) CHRONIC HEALTH PROBLEMS -------------------------- IDENTIFIED NEED: THERE IS A NEED TO BRING EXISTING PROGRAMS THAT ADDRESS ASTHMA AND LEAD CONCERNS, SUCH AS EASY BREATHING AND THE CONNECTICUT CHILDRENS HEALTHY HOMES PROGRAM, TO SCALE THROUGHOUT THE CITY FOR MAXIMUM IMPACT. AREA OF FOCUS: CHRONIC HEALTH CONDITIONS SUCH AS ASTHMA AND LEAD TOXICITY DISPROPORTIONATELY IMPACT URBAN CHILDREN, ESPECIALLY THOSE WHO LIVE IN POVERTY. 4) CHILDHOOD OBESITY -------------------- IDENTIFIED NEED: THERE IS A NEED TO BRING TO SCALE EXISTING NUTRITION AND PHYSICAL ACTIVITY PROGRAMS IN PRESCHOOLS, CHILDCARE CENTERS, AND IN THE PRIMARY CARE SETTING. AREA OF FOCUS: OBESITY DISPROPORTIONATELY AFFECTS CHILDREN OF COLOR AND THOSE IN LOW-INCOME FAMILIES. MORE THAN ONE-THIRD OF HARTFORD PRESCHOOLERS ARE OVERWEIGHT OR OBESE, WITH RATES FAR ABOVE THE NATIONAL AVERAGE ACCORDING TO A UNIVERSITY OF CONNECTICUT STUDY. 5) HOME VISITING SERVICES ADDRESSING WOMENS AND CHILDRENS HEALTH ------------------------------------------------------------------ IDENTIFIED NEED: THE CHALLENGE IS TO REDUCE WAITING LISTS AND BRING THIS TYPE OF FAMILY SUPPORT TO SCALE FOR THE ENTIRE POPULATION. AREA OF FOCUS: A VARIETY OF HOME VISITING PROGRAMS, SUCH AS THE MATERNAL AND INFANT OUTREACH PROGRAM, EXIST FOR FAMILIES IN HARTFORD AND HAVE SHOWN SUCCESS IN IMPROVING BIRTH OUTCOMES, ENSURING THAT PREGNANT WOMEN ENTER PRENATAL CARE EARLY, AND ADDRESSING DEVELOPMENTAL AND BEHAVIORAL HEALTH NEEDS OF CHILDREN. INITIAL GOALS ------------- IN ORDER TO FULFILL THE NEEDS OUTLINED ABOVE THE ORGANIZATION ESTABLISHED INITIAL GOALS. THESE GOALS INCLUDE THE FOLLOWING AREAS OF FOCUS TO BE OVERSEEN AND IMPLEMENTED BY THE OFFICE: 1) ENGAGE KEY COMMUNITY STAKEHOLDERS IN SETTING IMPLEMENTATION PRIORITIES; 2) COORDINATE IMPLEMENTATION OF KEY RECOMMENDATIONS AND BRING TO SCALE EVIDENCE INFORMED INNOVATIONS; 3) BUILD THE CAPACITY OF HARTFORD FAMILIES AND SERVICE PROVIDERS ACROSS VARIOUS SETTINGS TO PROMOTE CHILDRENS OPTIMAL HEALTHY DEVELOPMENT; AND 4) ESTABLISHING A DATA-DRIVEN CONTINUOUS QUALITY IMPROVEMENT ("CQI") SYSTEM FOR MONITORING EARLY CHILDHOOD SERVICES AND OUTCOMES IN HARTFORD. IN FEBRUARY OF 2017, THE ORGANIZATION CREATED ITS COMMUNITY HEALTH IMPROVEMENT PLAN ("CHIP") WHICH OUTLINED HOW THE ORGANIZATION WILL CONTINUE TO WORK TO ADDRESS THE NEED IDENTIFIED WITHIN ITS MOST RECENTLY CONDUCTED CHNA. THE ORGANIZATIONS CHIP STATES THE FOLLOWING: "OUR MOST RECENT CHNA UTILIZED A NUMBER OF COMPONENTS THAT INCLUDED THE INPUT OF MANY PEOPLE WORKING WITH THE UNDERSERVED, REPRESENTING VOICES FROM BOTH A LOCAL AND STATE-WIDE LEVEL. TWO MAJOR COMPONENTS WERE: THE HARTFORD BLUEPRINT FOR WOMEN AND CHILDRENS HEALTH ("THE BLUEPRINT") AND SOUTHSIDE INSTITUTIONS NEIGHBORHOOD ALLIANCES ("SINA") ECONOMIC DEVELOPMENT PLAN. IT IS FROM THOSE SOURCES THAT CONNECTICUT CHILDRENS WILL PRIORITIZE ITS INITIAL ACTIONS FOR OUR CHIP." THE COMPONENT OF OUR CHNA THAT EXAMINED THE SYSTEM OF SUPPORT FOR HARTFORDS WOMEN AND CHILDREN MADE SIX KEY RECOMMENDATIONS FOR IMPROVEMENT. UNFORTUNATELY, THE CITY LEADERSHIP WAS NOT IN THE FINANCIAL POSITION TO SUPPORT MANY OF THE RECOMMENDED CHANGES. SHORTLY AFTER THE BLUEPRINT FOR WOMEN AND CHILDRENS HEALTH WAS COMPLETED, HARTFORD VOTED IN A NEW MAYOR, WHOS PRIORITY WAS KEEPING THE CITY FROM FILING BANKRUPTCY. WITHOUT LEADERSHIP AND FULL-FLEDGED ENDORSEMENT FROM THE CITY, APPLICATION OF THOSE THE RECOMMENDATIONS ARE BEING EXPLORED IN A SECTION OF HARTFORD, THE NORTH END, WHICH HAPPENS TO BE THE POOREST PART OF HARTFORD AND HAS A PROMISE ZONE DESIGNATION. THE CITY IS STILL PARTICIPATING, BUT THERE HAS ALSO BEEN A CHANGE IN LEADERSHIP OF THE CITYS HEALTH AND HUMAN SERVICES DEPARTMENT, WHICH DELAYED SOME OF THE DISCUSSIONS. OTHER GROUPS IN DISCUSSIONS ABOUT IMPLEMENTING MEASURES INCLUDE LOCAL GROUPS NAMED COMMUNITY SOLUTIONS, WELLVILLE, TRINITY HEALTH/ST FRANCIS HOSPITAL, AND THE HARTFORD FOUNDATION FOR PUBLIC GIVING. SINAS ECONOMIC DEVELOPMENT PLAN FOCUSING ON SOCIAL DETERMINANTS OF HEALTH HAS MADE SOME PROGRESS WITH ITS EMPLOYMENT PIECE. A SUCCESSFUL GRANT AWARD HAS LED TO A CAREER NAVIGATOR BEING HIRED BY SINA TO HELP BOLSTER EMPLOYMENT OPPORTUNITIES FOR NEIGHBORHOOD RESIDENTS. IN 2018, HARTFORD ALSO RECEIVED A GRANT IN THE BOSTON FEDERAL RESERVES WORKING CITIES CHALLENGE, WITH SINA PLAYING A MAJOR PART. THAT GRANT WILL ALSO FOCUS ON EMPLOYMENT, WITH THE TARGET AGE GROUP BEING 18-24 YEARS. SINA HAS ALSO MADE SOME PROGRESS WITH CONNECTING EMPLOYEES TO LOCAL RESTAURANTS, TRYING TO CAPITALIZE ON THE PURCHASE POWER OF EMPLOYEES OF CONNECTICUT CHILDRENS AND HARTFORD HOSPITAL. ADDITIONALLY, SINA HAS RECEIVED GRANTS FROM THE STATE DEPARTMENT OF HOUSING AND SOLD TAX CREDITS THROUGH A STATE FUNDED PROGRAM TO WORK ON HOUSING IMPROVEMENTS IN THE NEIGHBORHOOD. THIS IS AN EFFORT TO SHORE UP LOW INCOME HOUSING UNITS, AND HELP ELIMINATE SOME OF THE NEIGHBORHOODS BLIGHTED PROPERTIES. IT SHOULD BE MENTIONED THAT TWO AREAS IDENTIFIED IN OUR 2013 CHNA CONTINUE TO BE ADDRESSED BY OUR ORGANIZATIONS EFFORTS. CHILDHOOD OBESITY AND ASTHMA STILL BEING ADDRESSED. WE HAD BEEN LOOKING AT CHILDHOOD OBESITY THROUGH OUR WORK WITH THE HARTFORD CHILDHOOD WELLNESS ALLIANCE. LEADERSHIP CHANGES AND A LACK OF RESOURCES RESULTED IN THAT GROUP DISSOLVING IN 2016. IN LATE 2017 A GRANT WAS RECEIVED TO ADDRESS OBESITY IN YOUNG CHILDREN AND THE START CHILDHOOD OFF RIGHT (SCOR) WAS FORMED TO BUILD A COLLABORATE EFFORT IN HARTFORD. ASTHMA CONTINUES TO BE ADDRESSED THROUGH MANY OF THE PROGRAMS UNDER THE UMBRELLA OF OUR ORGANIZATIONS OFFICE OF COMMUNITY CHILD HEALTH. EASY BREATHING, EDUCATING PRACTICES IN THE COMMUNITY, HEALTHY HOMES, CENTER FOR CARE COORDINATION, AND PERSON-CENTERED MEDICAL HOME ALL WORK TO ADDRESS ASTHMA RELATED ISSUES. SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.CONNECTICUTCHILDRENS.ORG/BILLING-AND-FINANCES 10 CCMC SPECIALTY CENTER 505 FARMINGTON AVENUE FARMINGTON CT 06030 SPEECH THERAPY, AUDIOLOGY, SLEEP LAB, EEG, EMG, AMBULATORY SURGERY CENTER CCMC SPECIALTY CENTER 399 FARMINGTON AVENUE FARMINGTON CT 06032 OCCUPATIONAL & PHYSICAL THERAPY, RADIOLOGY, MOTION ANALYSIS CCMC SPECIALTY CENTER 310 WESTERN BOULEVARD GLASTONBURY CT 06033 OCCUPATIONAL, PHYSICAL & SPEECH THERAPY, AUDIOLOGY, RADIOLOGY, ECHO CCMC HARTFORD HOSP BONE & JOINT INST 31 SEYMOUR STREET HARTFORD CT 06106 RADIOLOGY CCMC SPECIALTY CENTER 676 HEBRON AVENUE GLASTONBURY CT 06033 SLEEP LAB CCMC 100 RETREAT 100 RETREAT AVENUE 4TH FLOOR HARTFORD CT 06016 SPEECH THERAPY CCMC 111 FOUNDERS 111 FOUNDERS PLAZA EAST HARTFORD CT 06108 CLINICAL NUTRITION CCMC HARTFORD HOSP MED OFFICE BLDG 85 SEYMOUR STREET HARTFORD CT 06106 PULMONARY FUNCTION LAB CCMC AVON FAMILY WELLNESS CENTER 100 SIMSBURY ROAD AVON CT 06001 PHYSICAL THERAPY, OCCUPATIONAL THERAPY CCMC SOLTERA ACADEMY 300 JOHN DOWNEY DRIVE NEW BRITAIN CT 06051 OCCUPATIONAL THERAPY SCHEDULE H, PART I; LINE 3C NOT APPLICABLE. SCHEDULE H, PART I; LINE 6A THE ORGANIZATION PREPARED A COMMUNITY BENEFIT REPORT WHICH REPORTS THE RESULTS OF ITS EFFORTS TO SERVICE THE COMMUNITY AND HAVE A MEASURABLE IMPACT ON CHILDREN AND FAMILIES ACROSS THE STATE OF CONNECTICUT AND BEYOND. THE ORGANIZATIONS COMMUNITY BENEFIT REPORT IS MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. ADDITIONALLY, HARD COPIES WERE DISTRIBUTED TO KEY COMMUNITY LEADERS AND WERE MADE AVAILABLE ON REQUEST THROUGH THE OFFICE OF COMMUNITY CHILD HEALTH. SCHEDULE H, PART I; LINE 7 LINES 7A AND 7B WERE DETERMINED USING A RATIO OF COST TO CHARGES. LINES 7E THROUGH 7I WERE ALL REPORTED AT TRUE COST, NOT USING A COST TO CHARGE RATIO. SCHEDULE H, PART I; QUESTION 7G THE SUBSIDIZED HEALTH SERVICE REPORTED ON LINE 7G ARE FOR SHARED PSYCHIATRIC SERVICES WITH THE INSTITUTE OF LIVING. SCHEDULE H, PART II CONNECTICUT CHILDRENS MEDICAL CENTERS ("CONNECTICUT CHILDRENS") CORE MISSION IS TO IMPROVE THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN ACROSS THE STATE OF CONNECTICUT. WE RECOGNIZE THAT CHILDREN DO NOT LIVE IN ISOLATION. THEY ARE PART OF FAMILIES AND COMMUNITIES. IN ORDER TO FULFILL OUR MISSION, WE PROVIDE LEADERSHIP, PARTICIPATE IN COMMUNITY BASED PROGRAMS THAT HELP BUILD HEALTHIER COMMUNITIES, AND STRENGTHEN SYSTEMS THAT SUPPORT FAMILIES. OUR OFFICE OF COMMUNITY CHILD HEALTH ("OCCH") WAS CREATED TO SERVE AS A COORDINATING ENTITY FOR OUR COMMUNITY-ORIENTED PROGRAMS AND PROVIDE US WITH A STRONGER ADVOCACY VOICE IN SUPPORTING IMPROVED SYSTEMS FOR SUPPORTING FAMILIES. IN 2017, THE FOLLOWING WERE COMMUNITY BASED PROGRAMS UNDER OCCHS UMBRELLA: - ADVANCING KIDS INNOVATION PROGRAM (AKIP) - CARE COORDINATION COLLABORATIVE MODEL - CENTER FOR CARE COORDINATION - CHILDRENS CENTER ON FAMILY VIOLENCE - CHILDRENS HOSPITAL LEARNING COLLABORATIVE - CO-MANAGEMENT - EASY BREATHING - EDUCATING PRACTICES IN THE COMMUNITY - HARTFORD YOUTH HIV IDENTIFICATION AND LINKAGE CONSORTIUM - HEALTH HOMES PROGRAM - HELP ME GROW NATIONAL CENTER - INJURY PREVENTION CENTER - MID-LEVEL DEVELOPMENTAL ASSESSMENT - PERSON-CENTERED MEDICAL HOME - PRACTICE QUALITY IMPROVEMENT - RESIDENT EDUCATION IN ADVOCACY AND COMMUNITY HEALTH ALL PROGRAMS HAVE ELEMENTS OF COMMUNITY BUILDING IN THEIR PURPOSE. SOME INVOLVE WORKING WITH LOCAL COMMUNITIES, SOME WITH STATE-WIDE COMMUNITIES, SOME WORK ON NATIONAL LEVELS, AND SOME PROVIDE OUR EXPERTISE TO CLINICIANS TO HELP THEM BETTER SERVE FAMILIES IN THEIR COMMUNITIES. OCCH FOCUSES ON PROMOTING OPTIMAL HEALTHY DEVELOPMENT ACROSS ALL SECTORS IMPACTING CHILDREN. WE PAY PARTICULAR ATTENTION TO ADDRESSING SOCIAL DETERMINANTS OF HEALTH THAT SERVE AS MAJOR RISK FACTORS FOR POORER OUTCOMES. NO ONE ENTITY ALONE CAN HAVE THE KIND OF IMPACT THAT WE DESIRE. TO THAT END, THE PROGRAMS LISTED ABOVE, WORK WITH MORE THAN 150 COMMUNITY PARTNERS. ADDITIONAL COMMUNITY BUILDING INCLUDES OUR WORK WITH THE NEIGHBORHOOD PARTNERSHIP KNOWN AS SOUTHSIDE INSTITUTIONS NEIGHBORHOOD ALLIANCE ("SINA"). SINA IS A NEIGHBORHOOD PARTNERSHIP BETWEEN CONNECTICUT CHILDRENS, HARTFORD HOSPITAL, AND TRINITY COLLEGE. WE PAY DUES TO SUPPORT SINAS ANNUAL OPERATIONS BUDGET. THREE EMPLOYEES FROM CONNECTICUT CHILDRENS ARE ON SINAS BOARD OF DIRECTORS, AND IN 2017, THERE WERE ABOUT 20 EMPLOYEES WHO PARTICIPATED IN SINA COORDINATED COMMUNITY ACTIVITIES THAT PROMOTED EDUCATION, IMPROVED HOUSING, AND PUBLIC SAFETY IN OUR NEIGHBORHOOD. TWO WAYS THAT WE SUPPORTED EDUCATION DURING THE YEAR INCLUDE THE SPONSORSHIP OF A LOCAL ELEMENTARY SCHOOLS SCIENCE FAIR. SINA PAID FOR THE MANY OF THE SCHOOL SUPPLIES, FOOD FOR THE DAY, AND RECRUITING AND COORDINATED THE JUDGES FOR THE DAY. MOST OF THE JUDGES WERE CONNECTICUT CHILDRENS EMPLOYEES. OUR ORGANIZATION ALSO COORDINATED A BOOK DRIVE TO SUPPORT THE SCHOOLS AFTER-SCHOOL PROGRAM AND GET BOOKS INTO THE HOMES OF MANY OF THE STUDENTS. SINA RECEIVED A MAJOR GRANT FROM THE STATE OF CONNECTICUT TO BUILD NEW OWNER OCCUPIED HOUSING, IN PLACE OF SOME OF THE NEIGHBORHOODS BLIGHTED PROPERTIES. TWELVE NEW HOMES WILL BE A PART OF THE PROJECT, COMPLETED IN 2019. TO DATE, SINA HAS BUILT MORE THAN 60 HOMES IN THE AREA, ADDING CLOSE TO $500,000 PER YEAR TO THE CITYS TAX BASE. IN 2017, HARTFORD WAS HAVING DISCUSSIONS WITH THE STATE REGARDING ITS LARGE OPERATING DEFICIT. CONTRIBUTING TO THE DEFICIT IS THE LOW RATE OF HOMEOWNERSHIP. ADDITIONALLY, OUR HEALTH HOMES PROGRAM BEGAN WORKING WITH SINA TO IDENTIFY WAYS THAT THE TWO COULD COMPLEMENT ONE ANOTHER. SINAS OUTREACH STAFF BEGAN TO LOOK AT OPPORTUNITIES TO IDENTIFY PROPERTY OWNERS IN THE NEIGHBORHOOD WHO COULD BENEFIT FROM THE HEALTHY HOMES INTERVENTIONS. FOR PUBLIC SAFETY, SINA DEVELOPED A NEIGHBORHOOD SAFETY TEAM IN 2017. MADE UP OF REPRESENTATIVES FROM RESIDENTS, THE POLICE, LOCAL BUSINESSES, AND THE SINA PARTNERS, THE GOALS OF THE TEAM ARE TO GET TO KNOW EACH OTHER, OPEN UP THE LINES OF COMMUNICATION, IDENTIFY PROBLEMS IN THE NEIGHBORHOOD, AND GET A QUICK RESPONSE TO THOSE PROBLEMS. ADDITIONALLY, STAFF AT CONNECTICUT CHILDRENS ATTEND AND PARTICIPATE WITH THE NEIGHBORHOOD REVITALIZATION ZONE MEETINGS HELD MONTHLY, WHERE THE FOCUS IS ON PUBLIC SAFETY AND OTHER QUALITY OF LIFE ISSUES. A COMPONENT OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS SINAS ECONOMIC DEVELOPMENT STUDY, IDENTIFYING THE POVERTY IN THE NEIGHBORHOOD AS A MAJOR SOCIAL DETERMINANT. A PORTION OF THE STUDY RECOMMENDED THAT SINA AND ITS INSTITUTIONAL PARTNERS DEVELOP AN EMPLOYMENT PROGRAM. IN 2017, SINA WAS AWARDED A GRANT FROM THE HARTFORD FOUNDATION FOR PUBLIC GIVING TO HIRE A CAREER NAVIGATOR, WHO COULD WORK WITH NEIGHBORHOOD RESIDENTS IN GETTING EMPLOYMENT. ONE OF CONNECTICUT CHILDRENS HUMAN RESOURCES STAFF HAS BEEN IDENTIFIED TO SUPPORT THESE EFFORTS BEGINNING IN 2018. SCHEDULE H, PART III, SECTION A; QUESTIONS 2, 3 & 4 BAD DEBT IS BASED UPON HISTORICAL COLLECTION PERCENTAGE ANALYSIS OF ACCOUNTS WRITTEN OFF. BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. CONNECTICUT CHILDREN'S MEDICAL CENTER ("CONNECTICUT CHILDREN'S") AND ITS SUBSIDIARIES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. CONNECTICUT CHILDREN'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL FACILITIES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF CONNECTICUT CHILDREN'S AND SUBSIDIARIES: PATIENT ACCOUNTS RECEIVABLE --------------------------- PATIENT ACCOUNTS RECEIVABLE AND REVENUES ARE RECORDED WHEN PATIENT SERVICES ARE PERFORMED. AMOUNTS RECEIVED FROM CERTAIN PAYORS ARE DIFFERENT FROM ESTABLISHED BILLING RATES OF THE MEDICAL CENTER, AND THE DIFFERENCE IS ACCOUNTED FOR AS ALLOWANCES. THE MEDICAL CENTER RECORDS ITS PROVISION FOR BAD DEBTS BASED UPON A REVIEW OF ALL OF ITS OUTSTANDING RECEIVABLES. WRITE-OFFS OF RECEIVABLE BALANCES ARE RELATED PRIMARILY TO ITS POPULATION OF UNDERINSURED PATIENTS. AN UNDERINSURED PATIENT IS ONE WHO HAS COMMERCIAL INSURANCE WHICH LEAVES A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S REIMBURSEMENT TO BE PAID BY THE PATIENT, EITHER THROUGH LARGE DEDUCTIBLES OR CO-PAY REQUIREMENTS. SELF-PAY PATIENTS ARE RARE IN THE PEDIATRIC ENVIRONMENT, AS MEDICAID IS READILY AVAILABLE TO CHILDREN. SELF-PAY NET REVENUE APPROXIMATED $3,436,490 AND $2,982,900 FOR THE YEARS ENDED SEPTEMBER 30, 2018 AND 2017, RESPECTIVELY. CHARITY CARE ------------ THE MEDICAL CENTER ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO THE ESTABLISHED POLICIES OF THE MEDICAL CENTER. ESSENTIALLY, THOSE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE MEDICAL CENTER UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY GUIDELINES. THE COSTS OF CHARITY CARE INCURRED WERE APPROXIMATELY $935,887 AND $865,319 FOR THE YEARS ENDED SEPTEMBER 30, 2018 AND 2017, RESPECTIVELY. THE COSTS OF CHARITY CARE ARE DERIVED FROM BOTH ESTIMATED AND ACTUAL DATA. THE ESTIMATED COST OF CHARITY CARE INCLUDES THE DIRECT AND INDIRECT COST OF PROVIDING SUCH SERVICES AND IS ESTIMATED UTILIZING THE MEDICAL CENTER'S RATIO OF COST TO GROSS CHARGES, WHICH IS THEN MULTIPLIED BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS SHOULD BE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITALS' BEST EFFORTS AN SCHEDULE H, PART III, SECTION B; QUESTION 9B CONNECTICUT CHILDREN'S MEDICAL CENTER ("CONNECTICUT CHILDREN'S") HAS A BILLING AND COLLECTION POLICY. THE PURPOSE OF THIS POLICY IS TO ENSURE THAT THE ORGANIZATIONS BILLING, CREDIT AND COLLECTION PRACTICES COMPLY WITH ALL FEDERAL AND STATE LAWS, REGULATIONS GUIDELINES AND POLICIES. CONNECTICUT CHILDREN'S IS COMMITTED TO PROVIDING THE AVAILABLE HEALTHCARE, ALONG WITH CONVENIENT BILLING SERVICES, PAYMENT OPTIONS AND FINANCIAL ASSISTANCE. CONNECTICUT CHILDREN'S WILL MAKE EVERY EFFORT TO COMMUNICATE THE PATIENT FINANCIAL ASSISTANCE, BILLING, CREDIT AND COLLECTION PROCESSES TO THE PATIENT AND/OR THEIR FAMILY. PATIENTS AND THEIR FAMILIES ARE RESPONSIBLE TO PROVIDE TIMELY AND ACCURATE INFORMATION SUCH AS, BUT NOT LIMITED TO, DEMOGRAPHIC, INSURANCE, AND INCOME TO CONNECTICUT CHILDREN'S TO FACILITATE THE PATIENT FINANCIAL ASSISTANCE, BILLING, CREDIT AND COLLECTION PROCESSES. IT IS THE RESPONSIBILITY OF THE PATIENTS AND THEIR FAMILIES TO KNOW, UNDERSTAND, AND COMPLY WITH THEIR INSURANCE COVERAGE, COINSURANCE, COPAYS, DEDUCTIBLES, AND BENEFIT/COVERAGE LIMITATIONS. WE ASK OUR PATIENTS FAMILIES TO REMEMBER THAT AN INSURANCE POLICY IS A CONTRACT BETWEEN THEM AND THE INSURANCE COMPANY, AND THAT THEY HAVE THE FINAL RESPONSIBILITY FOR PAYMENT OF THEIR HOSPITAL BILL. CONNECTICUT CHILDREN'S PROVIDES PATIENT FINANCIAL SERVICES TO HELP FAMILIES NAVIGATE THE PROCESS OF BILLING AND MEDICAL INSURANCE. IN ADDITION, CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO PROVIDE COPIES OF ITEMIZED PATIENT BILLS, EXPLAIN PARTICULAR BILLS, SET UP PAYMENT ARRANGEMENTS OR REVIEW WHAT COSTS INSURANCE HAS PAID AND WHAT PAYMENTS ARE DUE. AS A COURTESY TO ITS PATIENTS, CONNECTICUT CHILDREN'S SUBMITS BILLS TO THEIR INSURANCE COMPANIES AND MAKES EVERY EFFORT TO ADVANCE THEIR CLAIM. HOWEVER, IT MAY BECOME NECESSARY FOR A POLICY HOLDER TO CONTACT THEIR INSURANCE PROVIDER OR SUPPLY ADDITIONAL INFORMATION REQUIRED FOR CLAIMS PROCESSING PURPOSES OR TO EXPEDITE PAYMENT. THE ORGANIZATION REQUESTS BILLS BE PAID IN FULL WITHIN THIRTY (30) DAYS. THE GUARANTOR IS RESPONSIBLE TO OBTAIN THE NECESSARY FUNDS FROM ANY SOURCE, SUCH AS OBTAINING A LOAN THROUGH THEIR BANK AND/OR CREDIT UNION. IF THE GUARANTOR IS UNABLE TO PAY BY OBTAINING A LOAN OR USE OF A CREDIT CARD, PAYMENT ARRANGEMENTS MAY BE MADE WITH COUNSELORS. MONTHLY PAYMENTS ARE REQUIRED. REQUESTS FOR ESTABLISHING PAYMENT PLANS THAT EXTEND PAST THE ABOVE RECOMMENDED TERMS GREATER THAN 12 MONTHS MUST BE REVIEWED AND APPROVED BY MANAGEMENT. IN ADDITION, ANY REQUESTS FOR ESTABLISHING PAYMENT PLANS THAT EXTEND PAST A 60 MONTH TERM MUST BE REVIEWED AND APPROVED BY MANAGEMENT. CONNECTICUT CHILDREN'S WILL ONLY REFER THOSE ACCOUNTS TO COLLECTION AGENCIES WHEN IT HAS BEEN DETERMINED THAT THE PATIENT/GUARANTOR HAS THE MEANS TO PAY THE BALANCE AND HAS CHOSEN NOT TO APPLY FOR PATIENT FINANCIAL ASSISTANCE. SCHEDULE H, PART VI; QUESTION 2 IN ADDITION TO THE CHNA REPORTED IN SCHEDULE H, PART V, SECTION B, THE ORGANIZATION CONTINUALLY WORKS TO ASSESS THE HEALTH OF THE COMMUNITY IN A NUMBER OF WAYS. WE COLLECT DATA REGARDING HOSPITAL USAGE AND REPORT THAT INFORMATION TO THE CONNECTICUT HOSPITAL ASSOCIATION. THAT DATA IS ANALYZED TO LOOK AT TRENDS AND OFTEN SUPPORTS OUR RESEARCH OR APPLICATIONS FOR GRANTS. EACH OF THE GRANTS THAT WE APPLY FOR INCORPORATES THE USE OF DATA AND RESEARCH TO EITHER RESPOND TO A NEED IDENTIFIED BY AN OUTSIDE FUNDING SOURCE, OR RESPOND TO A NEED THAT OUR ORGANIZATION HAS IDENTIFIED. CONNECTICUT HOSPITAL ASSOCIATION HAS A NUMBER OF MEETING GROUPS THAT GATHER PEOPLE FROM HOSPITALS ACROSS THE STATE TO SHARE TRENDS THAT THEY ARE SEEING AND SHARE BEST PRACTICES. THERE IS A POPULATION HEALTH GROUP AND A COMMUNITY HEALTH GROUP. A RECENTLY FORMED SOCIAL DETERMINANTS OF HEALTH GROUP HAS REPLACED THE HEALTH EQUITY GROUP. CONNECTICUT CHILDRENS IS REPRESENTED ON ALL OF THESE. WE ARE ALSO REPRESENTED ON BOARDS OF DIRECTORS/ADVISORY BOARDS OF A NUMBER OF ENTITIES THAT HELP US UNDERSTAND THE NEEDS OF THE COMMUNITY. A FEW EXAMPLES INCLUDE: - THE CHILDRENS FUND/CHILD HEALTH AND DEVELOPMENT INSTITUTE - CONNECTICUT AREA HEALTH EDUCATION CENTER - SOUTHSIDE INSTITUTE NEIGHBORHOOD ALLIANCE - URBAN LEAGUE OF GREATER HARTFORD - UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT - STATE DEPARTMENT OF PUBLIC HEALTHS HEALTH IMPROVEMENT TASK FORCE - CITY OF HARTFORDS HEALTH DEPARTMENTS PUBLIC HEALTH ADVISORY COMMITTEE - NORTH HARTFORDS TRIPLE AIM CONNECTICUT CHILDRENS FORMED A COMMUNITY CHILD HEALTH LEARNING COLLABORATIVE, WITH THE FIRST COHORT CONSISTING OF NINE OTHER CHILDRENS HOSPITALS FROM AROUND THE COUNTRY. THE COLLABORATIVE EMPHASIZES PEER TO PEER LEARNING THROUGH SITE VISITS AND WEBINARS. THIS HELPS ALL PARTICIPANTS COMPARE TRENDS AND SHARE BEST PRACTICES. SCHEDULE H, PART VI; QUESTION 3 IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING VARIOUS DOCUMENTS. THESE DOCUMENTS ARE WIDELY PUBLICIZED IN THE FOLLOWING WAYS: 1) THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY ("FAP"), FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ("PLS") ARE ALL AVAILABLE ON-LINE AT THE FOLLOWING WEBSITE: WWW.CONNECTICUTCHILDRENS.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCES 2) PAPER COPIES OF THE FAP, APPLICATION AND THE PLS ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL AND ARE AVAILABLE WITHIN VARIOUS AREAS THROUGHOUT CT CHILDRENS FACILITIES. THIS INCLUDES, BUT IS NOT LIMITED TO, EMERGENCY ROOMS, PATIENT REGISTRATION CHECK-IN AREAS AND THE PATIENT ACCESS DEPARTMENT. 3) THE ORGANIZATIONS FAP, APPLICATION AND PLS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH ("LEP") THAT CONSTITUTES THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY SERVED WITHIN CT CHILDRENS PRIMARY SERVICE AREA. 4) ALL PATIENTS OF THE MEDICAL CENTER WILL BE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE/DISCHARGE PROCESS. COPIES OF THE PLS WILL BE MADE AVAILABLE AT ALL CONNECTICUT CHILDRENS SPECIALTY GROUP OFFICE LOCATIONS. 5) SIGNS OR DISPLAYS INFORMING PATIENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE WILL BE CONSPICUOUSLY POSTED IN PUBLIC LOCATIONS INCLUDING THE EMERGENCY DEPARTMENT, PATIENT REGISTRATION CHECK-IN AREAS AND THE PATIENT ACCESS DEPARTMENT. 6) CT CHILDRENS WILL ALSO MAKE REASONABLE EFFORTS TO INFORM MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART VI; QUESTION 4 CONNECTICUT CHILDREN'S MEDICAL CENTER IS LOCATED IN HARTFORD CONNECTICUT. WE SERVE CHILDREN AND FAMILIES FROM THE ENTIRE STATE, THOUGH THE HEAVIEST CONCENTRATION OF THOSE SERVED COME FROM THE HARTFORD/GREATER HARTFORD AREA. CONNECTICUT RANKS AS ONE OF THE WEALTHIER STATES IN THE U.S. BASED ON PER CAPITA INCOME. WHILE HARTFORD HAS A RICH HISTORY, IT IS NOW CONSISTENTLY RANKED AMONG THE POOREST CITIES OF ITS SIZE IN THE COUNTRY, WITH ONE RECENT STUDY PLACING IT AT SEVENTH POOREST. SOME STATISTICS THAT DESCRIBE OUR COMMUNITY SERVED INCLUDE: - THE U.S. CENSUS LISTS CT'S POPULATION AT 3.5 MILLION PEOPLE. 70% OF THE RESIDENTS ARE WHITE, 15% ARE HISPANIC OF LATINO, AND 11% ARE BLACK OR AFRICAN AMERICAN. ACCORDING TO NUMEROUS SOURCES, CONNECTICUT RANKS ANYWHERE FROM #1 - #3 OF THE RICHEST STATES IN PER CAPITA INCOME. - HARTFORDS POPULATION IS CLOSE TO 125,000. 43% OF THE RESIDENTS ARE HISPANIC OR LATINO, 38% ARE BLACK OR AFRICAN AMERICAN, AND 15% ARE IDENTIFIED AS WHITE. AN ESTIMATED 38% OF THE CITY'S RESIDENTS LIVE IN POVERTY, COMPARED TO 10.7% OF THE STATE'S OVERALL POPULATION. AN ESTIMATED 44% OF HARTFORD FAMILIES WITH CHILDREN BELOW AGE 18 LIVE IN POVERTY. MORE THAN 50,000 RESIDENTS (42%) PARTICIPATE IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM. AN ESTIMATED 77% OF HARTFORD STUDENTS WERE ELIGIBLE FOR FREE OR REDUCED PRICE SCHOOL MEALS DURING THE YEAR. MORE THAN 52% OF THE 70,501 REQUESTS FROM HARTFORD RESIDENTS TO THE UNITED WAY'S INFORMATION AND REFERRAL SERVICE, 2-1-1, WERE FOR ASSISTANCE FOR BASIC NEEDS SUCH AS HOUSING, FOOD AND UTILITIES (INFORMATION FROM THE BLUEPRINT ON WOMEN AND CHILDREN'S HEALTH). - ACCORDING TO SINA'S NEIGHBORHOOD ECONOMIC DEVELOPMENT STUDY, THE NEIGHBORHOODS AROUND CONNECTICUT CHILDREN'S MEDICAL CENTER CONSIST OF MORE THAN 60% LATINO RESIDENTS AND MORE THAN 20% OTHER MINORITIES, MAINLY AFRICAN AMERICAN. ALMOST 60% OF THE HOUSEHOLDS HAVE ANNUAL INCOMES OF LESS THAN $25,000, AND ABOUT 25% HAVE ANNUAL INCOMES OF LESS THAN $10,000. FEWER THAN 20% HAVE INCOMES GREATER THAN $50,000. THESE FIGURES ARE ALL LOWER THAN THE CITY AVERAGE. ADDITIONALLY, MORE THAN 50% OF THE HOUSEHOLDS RECEIVE CASH ASSISTANCE AND/OR FOOD STAMPS, FIGURES THAT ARE HIGHER THAN THE CITY AVERAGE. ABOUT 40% OF THE ADULTS AGE 25 AND OLDER DO NOT HAVE A HIGH SCHOOL DIPLOMA OR EQUIVALENT. LESS THAN 20% HAVE EARNED AN ASSOCIATE'S DEGREE OR HIGHER. SCHEDULE H, PART VI; QUESTION 5 CONNECTICUT CHILDREN'S MEDICAL CENTER HAS A VISION TO MAKE CONNECTICUTS CHILDREN THE HEALTHIEST IN THE NATION. WHILE THE ORGANIZATION PROVIDES LEADING MEDICAL CARE, TREATMENT, AND FOLLOW-UP SUPPORT WITHIN ITS FACILITIES, SOME OF THEIR BEST WORK IS PROMOTING CHILDREN'S HEALTH HAPPENS WITHIN CONNECTICUTS COMMUNITIES. THE OFFICE OF COMMUNITY CHILD HEALTH (OCCH) SERVES AS OUR ORGANIZATIONS KEY VEHICLE FOR PROMOTING CHILDRENS OPTIMAL HEALTHY DEVELOPMENT. WE PROMOTE COMMUNITY HEALTH ON A LOCAL, STATE-WIDE AND NATIONAL LEVEL. OCCH ADMINISTRATORS, PROGRAM LEADERS, AND STAFF ALL INTERFACE WITH DIFFERENT COMMUNITY LEADERS AND PARTNERS. OUR WORK IS SHARED, AND OUR EXPERTISE IS OFTEN WELCOMED IN THE NUMEROUS SETTINGS TO WHICH WE ARE INVOLVED. WE ARE CONTINUALLY DEVELOPING PARTNERSHIPS ON ALL LEVELS AS WE RECOGNIZE THAT AN "ALL SECTORS IN" APPROACH IS WHAT WILL LEAD TO POSITIVE CHANGE. WE BRING A LEVEL OF HEALTH PROMOTION EVIDENT WITH OUR MISSION STATEMENT TO ALL PARTNERSHIPS, WITH CONCEPT THAT WE ALL NEED EACH OTHERS HELP. SOME OF THE PROGRAMS UNDER OCCH (EASY BREATHING, EPIC, MAINTENANCE OF CERTIFICATION, CO-MANAGEMENT) WORK WITH HEALTH PROVIDERS ACROSS THE STATE TO IDENTIFY BETTER APPROACHES TO MANAGING CHILDRENS HEALTH ISSUES. WEEKLY GRAND ROUNDS ARE ALSO HELD FOR BOTH INTERNAL AND EXTERNAL PROVIDERS WITH TOPICS THAT OFTEN INCLUDE THE PROMOTION OF COMMUNITY HEALTH. PROGRAMS LIKE THOSE OF OUT INJURY PREVENTION CENTER FOCUS MUCH OF THEIR EFFORTS IN THE SHARING OF THEIR RESEARCH AND PROMOTING PREVENTION THROUGH THEIR ACTIVITIES. HEALTHY HOMES, EASY BREATHING, HYHIL, AND REACH ALL HAVE HEALTH PROMOTION OR PREVENTION AS COMMON THEMES WITH THEIR ACTIVITY. THE OFFICE OF GOVERNMENT RELATIONS USES INFORMATION GATHERED FROM THE PROGRAMS UNDER OCCH TO ALSO PROMOTE HEALTH TO KEY LEADERS OF OUR STATE LEGISLATORS AS WELL AS OUR REPRESENTATIVES AT THE FEDERAL LEVEL. AN EXAMPLE OF THEIR WORK CAN BE SEEN THROUGH THEIR EFFORTS IN HELPING STATE OFFICIALS INTERPRET CAR ACCIDENT STATISTICS GATHERED BY OUR INJURY PREVENTION CENTER, LEADING TO OUR STATE EXAMINING LAWS SURROUNDING NEW TEEN DRIVERS. CONNECTICUT IMPLEMENTED NEW DRIVER RESTRICTIONS FOR THAT AGE GROUP AS A RESULT. WE HAVE A REFERRING PROVIDER BOARD OF PEDIATRICIANS, REPRESENTING DIFFERENT GEOGRAPHIC PORTIONS OF CONNECTICUT, THAT HELP US UNDERSTAND WHAT THEY SEE AS KEY ISSUES IN THEIR COMMUNITIES, AND SUPPORT OUR MESSAGES ABOUT HEALTH PROMOTION. OUR TUESDAY MORNING GRAND ROUNDS IS OPEN TO COMMUNITY CLINICIANS AND WILL OFTEN DISCUSS NEW RESEARCH, NEW APPROACHES TO TREATMENT, AND HEALTH PROMOTION. SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE CCMC CORPORATION AND SUBSIDIARIES: NOT FOR-PROFIT ENTITIES: CCMC CORPORATION ---------------- CCMC CORPORATION IS THE TAX-EXEMPT PARENT OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. CCMC CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). AS THE PARENT ORGANIZATION, CCMC CORPORATION STRIVES TO CONTINUALLY DEVELOP AND OPERATE A HEALTHCARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE CHILDREN OF CONNECTICUT AND SURROUNDING COMMUNITIES. CCMC CORPORATION ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. NO CHILDREN ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. CCMC CORPORATION IS THE SOLE MEMBER OF CONNECTICUT CHILDREN'S MEDICAL CENTER WHICH OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. IT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. IT OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL CHILDREN; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. IT MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF THE HOSPITAL RESTS WITH ITS BOARD OF DIRECTORS AND THE BOARD OF DIRECTORS OF CCMC CORPORATION. BOTH BOARDS ARE COMPRISED OF A MAJORITY OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION, INC. ------------------------------------------------------ CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION SUPPORTS CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND ITS AFFILIATES IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO THE COMMUNITY IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CCMC AFFILIATES, INC. --------------------- CCMC AFFILIATES, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES SPECIALIZED EDUCATION AND CHILD DEVELOPMENT PROGRAMS TO CHILDREN OF CONNECTICUT AND THE SURROUNDING AREAS. CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC. -------------------------------------------- CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CHILDREN'S FUND OF CONNECTICUT, INC. ------------------------------------ CHILDREN'S FUND OF CONNECTICUT, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND ITS AFFILIATES IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CHILDREN'S HEALTH AND DEVELOPMENT INSTITUTE, INC. ------------------------------------------------- CHILDREN'S HEALTH AND DEVELOPMENT INSTITUTE, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CAPITAL AREA HEALTH CONSORTIUM, INC. ------------------------------------ CAPITAL AREA HEALTH CONSORTIUM, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND ITS AFFILIATES IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. FOR-PROFIT ENTITIES: CCMC VENTURES, INC. ------------------- A FOR-PROFIT ENTITY, WHOSE SOLE SHAREHOLDER IS CCMC CORPORATION. THE ORGANIZATION IS LOCATED IN HARTFORD, CONNECTICUT. THIS ENTITY IS CURRENTLY INACTIVE. NEW ENGLAND PEDIATRICS INDEMNITY, LTD. -------------------------------------- A FOR-PROFIT ENTITY, WHOSE SOLE SHAREHOLDER IS CCMC CORPORATION. THE ORGANIZATION IS A MEDICAL MALPRACTICE INSURANCE FOREIGN CAPTIVE ORGANIZATION LOCATED IN BERMUDA. SCHEDULE H, PART VI; QUESTION 7 THE STATE OF CONNECTICUT HAS AN OFFICE OF THE HEALTHCARE ADVOCATE. THEY SURVEY EACH HOSPITALS SCHEDULE H OF THE 990 FILING TO ENSURE THAT COMMUNITY BENEFITS HAVE BEEN REPORTED IN LIEU OF SEPARATE REPORTS FROM HOSPITALS. true LEA'S FOUNDATION FOR LEUKEMIA RESEARCH INC 522 COTTAGE GROVE ROAD BLOOMFIELD CT 06002 061520923 501(C)(3) 7500 PROGRAM SUPPORT CYSTIC FIBROSIS FOUNDATION 6931 ARLINGTON ROAD BETHESDA MD 20814 131930701 501(C)(3) 10000 PROGRAM SUPPORT CROHN'S & COLITIS FOUNDATION OF AMERICA 733 THIRD AVENUE NEW YORK NY 10017 136193105 501(C)(3) 10000 PROGRAM SUPPORT URBAN LEAGUE OF GREATER HARTFORD INC 140 WOODLAND STREET HARTFORD CT 06105 066066491 501(C)(3) 10000 PROGRAM SUPPORT HARTFORD HOSPITAL 80 SEYMOUR STREET HARTFORD CT 06102 060646668 501(C)(3) 13000 PROGRAM SUPPORT 5 0 SCHEDULE I, PART I, QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X true true false false false true true true false JEFFREY HYAMS MD DIRECTOR - PRESIDENT MED STAFF 0 424370 0 49617 0 74585 0 75269 0 31540 0 655381 0 31282 JAMES E SHMERLING DHA FACHE DIRECTOR - PRESIDENT/CEO 733556 0 338625 0 38203 0 465006 0 25238 0 1600628 0 301781 0 PATRICK J GARVEY CPA CHFP TREASURER-SVP/CFO (TERM 12/17) 306387 0 78175 0 35510 0 94546 0 33412 0 548030 0 78175 0 GIL PERI PRESIDENT & COO 127825 0 115000 0 18062 0 76927 0 8394 0 346208 0 0 0 CHRISTINE FINCK MD FACS EVP, SURGEON IN CHIEF 0 756183 0 96933 0 25726 0 217689 0 28921 0 1125452 0 96933 PAUL H DWORKIN MD EVP, COMMUNITY CHILD HEALTH 422197 0 419288 0 42159 0 155555 0 4416 0 1043615 0 95101 0 JUAN SALAZAR MD MPH EVP, ACADEMIC AFFAIRS 454455 0 116310 0 42544 0 203702 0 32354 0 849365 0 116310 0 ANN G TAYLOR JD EVP, CHIEF ADMIN. OFFICER 346597 0 89420 0 38566 0 139702 0 20082 0 634367 0 89420 0 ANDREA L BENIN MD SVP, PATIENT SAFETY(TERM 6/18) 365643 0 106310 0 13336 0 109009 0 35331 0 629629 0 89607 0 KELLY STYLES MBA SVP, CHIEF INFORMATION OFFICER 285783 0 75515 0 30887 0 113177 0 7112 0 512474 0 65908 0 CHERYL HOEY RN BSN MBA SVP, CLINICAL SERVICES & CNO 274171 0 70370 0 10915 0 102690 0 28903 0 487049 0 67548 0 LAWRENCE E MILAN MA SVP, HUMAN RESOURCES 256853 0 66000 0 7860 0 109690 0 11319 0 451722 0 64724 0 BOBBY M VARGAS ESQ VP, GENERAL COUNSEL 292708 0 54278 0 5909 0 110752 0 33191 0 496838 0 54278 0 WILLIAM AGOSTINUCCI MS RPH VP, CLINICAL & SUPPORT SVCS 188049 0 31349 0 6716 0 104162 0 12831 0 343107 0 31349 0 TRISHA FARMER MSN RN CPHRM VP, REG PARTNERSHIPS & OPS 185302 0 27150 0 941 0 77195 0 30760 0 321348 0 27150 0 HEATHER TORY MD MPH CPPS INTERM EXEC PT SFTY (EFF 6/18) 0 142950 0 15728 0 306 0 28234 0 9079 0 196297 0 0 SARAH MATNEY MSOL BSN RN VP, AMBULATORY OPS (EFF 5/18) 0 119096 0 22822 0 248 0 41219 0 31848 0 215233 0 0 RICHELLE DEMAYO MD CHIEF MED INFORMATION OFFICER 286764 0 59670 0 7621 0 70844 0 11627 0 436526 0 54744 0 GLENN FLORES CHIEF RESEARCH OFFICER 118319 0 30000 0 5607 0 39308 0 9476 0 202710 0 0 0 JUNG PARK SR DIR, INFORMATION SERVICES 196552 0 28211 0 413 0 47893 0 2094 0 275163 0 28211 0 MARLENE E FERRIS SR DIR, ORGANIZATIONAL EFFECT. 188983 0 31568 0 2463 0 45699 0 19235 0 287948 0 30506 0 PETER BORLA SENIOR DIRECTOR FINANCE 172930 0 26861 0 363 0 40246 0 30538 0 270938 0 0 0 SHANNON M GRAD SR DIR, FAMILY EXP & PROF PRAC 167644 0 27750 0 341 0 38815 0 1820 0 236370 0 0 0 PHILIP B HOPKINS DIRECTOR TECHNICAL SERVICES 177328 0 16675 0 1543 0 31364 0 1818 0 228728 0 16675 0 DEAN A RAPOZA FORMER OFFICER 0 78460 0 76125 0 196798 0 18750 0 31490 0 401623 0 0 AUDREY WISE MBA FORMER OFFICER 148936 0 0 0 79652 0 9415 0 29356 0 267359 0 0 0 CORE FORM, PART VII AND SCHEDULE J IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED IN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2017 FORMS W-2. SCHEDULE J, PART I; QUESTION 3 EACH YEAR, Arthur Gallagher Associates CONDUCTS A MARKET ANALYSIS OF CONNECTICUT CHILDREN'S MEDICAL CENTER'S ("CONNECTICUT CHILDREN'S") PRESIDENT/CHIEF EXECUTIVE OFFICER, OFFICERS AND OTHER KEY EMPLOYEES. TO AUGMENT THEIR PROPRIETARY AND OTHER DATA TO WHICH THEY HAVE ACCESS, CONNECTICUT CHILDREN'S PROVIDES THE DATA RESULTS FROM SALARY SURVEYS IN WHICH CONNECTICUT CHILDREN'S PARTICIPATES. THE ANALYSIS AND PRESENTATION OF THE DATA IS PRESENTED BY THE Arthur Gallagher Associates REPRESENTATIVE TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE MEMBERS OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ANNUALLY THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE BOARD OF DIRECTORS THEN REVIEW AND DISCUSS SALARY RECOMMENDATIONS FOR THE OFFICERS AND OTHER KEY EMPLOYEES AND SIGN OFF ON THE FINAL RECOMMENDATIONS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MEETS INDEPENDENTLY WITH THE PRESIDENT/CHIEF EXECUTIVE OFFICER TO DISCUSS HIS INDIVIDUAL PERFORMANCE. FOLLOWING THE PERFORMANCE EVALUATION, A SALARY RECOMMENDATION IS MADE AND COMMUNICATED TO THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES TO AUTHORIZE PROCESSING. SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2017 WHICH WAS INCLUDED IN EACH INDIVIDUAL'S 2017 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: PATRICK J. GARVEY, CPA, CHEP, $6,498; DEAN A. RAPOZA, $185,203 AND AUDREY WISE, MBA, $78,462. SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2018 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JEFFREY HYAMS, M.D., $11,393; JAMES E. SHMERLING, DHA, FACHE, $145,800; SETH VAN ESSENDELFT, $20,417; GIL PERI, $73,450; CHRISTINE FINCK, M.D., FACS, $76,786; PAUL H. DWORKIN, M.D., $40,379; JUAN SALAZAR, M.D., MPH, $46,973; ANN G. TAYLOR, JD, $28,895; KELLY STYLES, MBA, $29,844; CHERYL HOEY, RN, BSN, MBA, $28,517; LAWRENCE E. MILAN, MA, $26,216; BOBBY M. VARGAS, ESQ., $31,500; WILLIAM AGOSTINUCCI, MS, RPH, $22,922; TRISHA FARMER, MSN, RN, CPHRM, $21,250; HEATHER TORY, M.D., MPH, CPPS, $3,500; SARAH MATNEY, MSOL, BSN, RN, $18,250; DEB PAPPAS, MBA, $20,001 AND GLENN FLORES, $35,000. SCHEDULE J, PART I; QUESTIONS 6A & 6B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). ACCORDINGLY, THE ORGANIZATION'S COMMITTEE MAY ELECT TO MAKE INCENTIVE AWARDS IN ITS SOLE DISCRETION. IF THE COMMITTEE ELECTS TO MAKE SUCH INCENTIVE AWARDS, THE AMOUNT OF AN ELIGIBLE EMPLOYEES INCENTIVE AWARD IS BASED GENERALLY UPON THE FOLLOWING CRITERIA: - CCMC CORPORATION ACHIEVING THRESHOLD FOR THE FINANCIAL GOALS, OTHERWISE NO INCENTIVE WILL BE PAID; - INDIVIDUAL AND CORPORATION PERFORMANCE AND WHETHER THE LEVEL OF PERFORMANCE ACHIEVED IS AT THRESHOLD, TARGET, OR STRETCH; AND - THE PERCENTAGE OF THE AWARD COMPRISED OF CORPORATION VERSUS INDIVIDUAL PERFORMANCE. THE COMPENSATION FOR CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II OF THIS FORM 990 CONSIST OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK INCENTIVE COMPENSATION. SCHEDULE J, PART I; QUESTION 7 IF THE COMPENSATION COMMITTEE ELECTS TO MAKE INCENTIVE AWARDS, THESE AWARDS ARE TO BE PAID NO LATER THAN TWO AND ONE-HALF MONTHS AFTER THE END OF THE FISCAL OR CALENDAR YEAR, WHICHEVER IS LATER, AFTER WHICH THE AMOUNT OF SUCH AWARDS ARE DETERMINED. THEREFORE, IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS, RULES AND REGULATIONS, CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED INCENTIVE AWARDS DURING CALENDAR YEAR 2017 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2017 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. ADDITIONALLY, INCENTIVE AWARDS DETERMINED FOR THE ORGANIZATION'S CURRENT FISCAL YEAR TO BE PAID IN A FUTURE CALENDAR YEAR, ARE CURRENTLY INCLUDED IN SCHEDULE J, PART II, COLUMN C, AS OTHER DEFERRED COMPENSATION. SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED WITHIN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDE EMPLOYEE INCENTIVE AWARDS AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE PREVIOUSLY REPORTED WITHIN SCHEDULE J, PART II, COLUMN C AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR YEARS FORMS 990. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED IN EACH INDIVIDUALS 2017 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JEFFREY HYAMS, M.D., $31,282; JAMES E. SHMERLING, DHA, FACHE, $301,781; PATRICK J. GARVEY, CPA, CHFP, $78,175; CHRISTINE FINCK, M.D., FACS, $96,933; PAUL H. DWORKIN, M.D., $95,101; JUAN SALAZAR, M.D., MPH, $116,310; ANN G. TAYLOR, JD, $89,420; ANDREA L. BENIN, M.D., $89,607; KELLY STYLES, MBA, $65,908; CHERYL HOEY, RN, BSN, MBA, $67,548; LAWRENCE E. MILAN, MA, $64,724; BOBBY M. VARGAS, ESQ., $54,278; WILLIAM AGOSTINUCCI, MS, RPH, $31,349; TRISHA FARMER, MSN, RN, CPHRM, $27,150; RICHELLE DEMAYO, M.D., $54,744; JUNG PARK, $28,211; MARLENE E. FERRIS, $30,506 AND PHILIP B. HOPKINS, $16,675. A CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2011-06-30 41580000 REFI SER B&C BOND/LEASE FINANCINGS false false false B CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2007-10-12 8500000 LEASE FINANCE VARIOUS EQUIPMENT true false false C CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2012-09-28 8800000 ELECTRONIC MEDICAL RECORDS false false false D CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2011-10-18 11200000 ELECTRONIC MEDICAL RECORDS false false false A 9390375 0 41580000 0 0 10255050 779214 0 0 0 30545736 0 2011 true true true true B 0 8500000 8500000 0 0 0 34581 0 0 8465419 0 0 2010 false false true true C 7445937 0 8800000 0 0 0 31338 0 0 8768662 0 0 2015 false false true true D 11053116 0 11200000 0 0 0 56108 0 0 11143892 0 0 2014 false false true true A false true false true true 0.01540 0.01540 true false false true B false false false false 0 true false false true C false false false true true 0 true false false true D false false false true true 0 true false false true A false true true true BANK OF AMERICA 20.8 false false false 0 false true B false true false false 0 false 0 false true C false true false false 0 false 0 false true D false true false false 0 false 0 false true A true B true C true D true A CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2013-04-04 13500000 CONSTRUCT & EQUIP ASC false false false B CT HEALTH & EDUCATIONAL FACILITIES AUTHORITY 060806186 2014-09-11 3250865 FINANCING OF CAPITAL MEDICAL EQUIP false false false A 10828875 0 13500000 0 0 0 49245 0 0 13450755 0 0 2015 false false true true B 2606474 0 3250865 0 0 0 0 0 0 3250865 0 0 2014 false false true true A false false false true true 0 true false false true B false false false true true 0 true false false true A false true false false 0 false 0 false true B false true false false 0 false 0 false true A true B true CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== CONNECTICUT CHILDREN'S MEDICAL CENTER ("CONNECTICUT CHILDREN'S") IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE ("IRS") AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES CONNECTICUT CHILDREN'S PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CONNECTICUT CHILDREN'S OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. CONNECTICUT CHILDREN'S PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. CONNECTICUT CHILDREN'S OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL CHILDREN WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. CONNECTICUT CHILDREN'S MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF CONNECTICUT CHILDREN'S RESTS WITH ITS BOARD OF DIRECTORS. ITS BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF CONNECTICUT CHILDREN'S, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF CONNECTICUT CHILDREN'S IS FOR THE BENEFIT OF THE PUBLIC, AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL, NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. HISTORY ======= CONNECTICUT CHILDREN'S IS A NATIONALLY RECOGNIZED NOT-FOR-PROFIT WITH A MEDICAL STAFF OF MORE THAN 1,000 WHO PROVIDE COMPREHENSIVE, WORLD-CLASS HEALTHCARE IN MORE THAN 30 PEDIATRIC SPECIALTIES AND SUBSPECIALTIES. CONNECTICUT CHILDRENS IS THE PRIMARY PEDIATRIC TEACHING HOSPITAL FOR THE UCONN SCHOOL OF MEDICINE, HAS A TEACHING PARTNERSHIP WITH THE FRANK H. NETTER, M.D. SCHOOL OF MEDICINE AT QUINNIPIAC UNIVERSITY AND IS A RESEARCH PARTNER OF THE JACKSON LABORATORY. THE HISTORY OF CONNECTICUT CHILDREN'S SPANS MORE THAN 100 YEARS. FOUNDED AS A 10-BED HOSPITAL FOR CHILDREN WHO SUFFERED THEN INCURABLE CONDITIONS SUCH AS CEREBRAL PALSY, SPINA BIFIDA AND POLIO, CONNECTICUT CHILDREN'S IS NOW ONE OF ONLY TWO FREESTANDING CHILDREN'S HOSPITALS IN NEW ENGLAND AND IS THE ONLY FREESTANDING CHILDREN'S HOSPITAL IN CONNECTICUT. CONNECTICUT CHILDREN'S PROVIDES AN ARRAY OF PEDIATRIC SERVICES IN LOCATIONS ACROSS CONNECTICUT AND IN MASSACHUSETTS, INCLUDING AT HOSPITALS IN HARTFORD AND WATERBURY, NEONATAL INTENSIVE CARE UNITS IN HARTFORD AND FARMINGTON, AN AMBULATORY SURGERY CENTER IN FARMINGTON PRIMARY CARE CENTERS AND EAST HARTFORD AND WEST HARTFORD, FIVE SPECIALTY CARE CENTERS, AND 11 OTHER LOCATIONS. ITS LEVEL 1 PEDIATRIC TRAUMA CENTER IS THE BUSIEST BETWEEN BOSTON AND NEW YORK. MISSION ======= CONNECTICUT CHILDREN'S IS DEDICATED TO IMPROVING THE PHYSICAL AND EMOTIONAL HEALTH OF CHILDREN THROUGH FAMILY-CENTERED CARE, RESEARCH, EDUCATION AND ADVOCACY. CONNECTICUT CHILDREN'S EMBRACES DISCOVERY, TEAMWORK, INTEGRITY AND EXCELLENCE IN ALL THAT IT DOES. PROGRAMS OF EXCELLENCE ====================== CONNECTICUT CHILDREN'S OFFERS THE HIGHEST LEVEL OF CARE TO CHILDREN AND OUR PHYSICIANS AND PROGRAMS ARE CONSISTENTLY HONORED FOR THEIR EXCELLENCE. RECENT AWARDS INCLUDE THE 2018 WOMENS CHOICE AWARD FOR BEST CHILDRENS HOSPITALS AND THE 2018 U.S. NEWS & WORLD REPORT BEST CHILDRENS HOSPITAL. IN ADDITION, THERE ARE SEVERAL PROGRAMS OF EXCELLENCE AT THE MEDICAL CENTER THAT HAVE TIME AND AGAIN EARNED NATIONAL AND INTERNATIONAL HONORS AND ACCOLADES INCLUDING, BUT NOT LIMITED TO: - DIABETES & ENDOCRINOLOGY; - GASTROENTEROLOGY; - NEONATOLOGY; - ORTHOPAEDICS; - RECONSTRUCTIVE AND SOLID TUMOR SURGERY; - SURGERY; AND - UROLOGY. EACH OF OUR PROGRAMS OF EXCELLENCE OFFERS SUPERIOR PEDIATRIC CLINICAL CARE AND HAS DEMONSTRATED THE ABILITY TO: 1) EXPAND ACCESS TO SERVICES TO MEET THE GROWING NEEDS OF CHILDREN AND FAMILIES; 2) INTEGRATE VARIOUS DISCIPLINES OF CLINICAL PRACTICE TO PROVIDE EXPANDED ADVANCED CARE; 3) DEVELOP OPPORTUNITIES TO EXPAND BASIC AND CLINICAL RESEARCH; AND 4) CREATE OPPORTUNITIES TO BE AN INNOVATIVE LEADER IN EDUCATION AND TRAINING. OUTCOMES -------- NOTHING MATTERS MORE THAN THE OUTCOME. CONNECTICUT CHILDREN'S KEEPS KIDS HEALTHY, PROTECTS THEM FROM SURGICAL COMPLICATIONS AND IMPROVES THE QUALITY OF LIFE OF THOSE WITH CHRONIC CONDITIONS. PROCESS OF CARE --------------- SEVERAL ELEMENTS ARE CONSIDERED, INCLUDING HOSPITAL COMPLIANCE WITH BEST PRACTICES AND A COMMITMENT TO INFECTION CONTROL. RESEARCH ======== CONNECTICUT CHILDREN'S IS COMMITTED TO MAKING CHILDREN AND FAMILIES HEALTHIER. OUR TALENTED MEDICAL PROFESSIONALS ARE AT THE FOREFRONT OF RESEARCH AND CLINICAL TRIALS. SUCH SCIENTIFIC INQUIRIES CHANGE THE FUTURE OF CHILDREN'S HEALTHCARE. FROM FUNDAMENTAL MOLECULAR SCIENCE THAT HELPS US UNDERSTAND DISEASES AT THE MOST BASIC LEVEL, TO MOTION STUDIES DESIGNED TO DISCOVER NEW WAYS FOR YOUNG ATHLETES TO AVOID INJURIES AND CLINICAL TRIALS THAT ESTABLISH THE MOST EFFECTIVE AND EFFICIENT PROTOCOLS FOR TREATING CHILDREN, CONNECTICUT CHILDREN'S IS A RESEARCH LEADER. FOR EXAMPLE, CONNECTICUT CHILDREN'S DIVISION OF HEMATOLOGY & ONCOLOGY IS ENGAGED IN CONDUCTING MORE THAN 100 ACTIVE CLINICAL TRIALS AND RESEARCH STUDIES THROUGH THE CHILDREN'S ONCOLOGY GROUP, THE NEUROBLASTOMA AND MEDULLOBLASTOMA TREATMENT RESEARCH CONSORTIUM, THE PEDIATRIC CANCER FOUNDATION'S SUNSHINE PROJECT, THE SUNCOAST COMMUNITY CLINICAL ONCOLOGY PROGRAM AND PHARMACEUTIC COMPANY SPONSORS. THIS NUMBER OF OPEN PROTOCOLS DISTINGUISHES CONNECTICUT CHILDREN'S HEMATOLOGY & ONCOLOGY DIVISION AMONG THE TOP 20 PERCENT AMONG ITS PEERS. ADDITIONALLY, THE DIVISION IS IN THE TOP THIRD PERCENTILE FOR TOTAL PEDIATRIC CANCER PATIENTS ENROLLED IN TRIALS. THIS IS ESPECIALLY IMPRESSIVE GIVEN THAT CONNECTICUT CHILDREN'S IS CONSIDERED ONE OF THE SMALLER FREE-STANDING CHILDREN'S HOSPITALS IN THE COUNTRY. AWARDS AND RECOGNITION ====================== CONNECTICUT CHILDRENS HAS RECEIVED THE FOLLOWING AWARDS: - 2018 & 2017 WOMENS CHOICE AWARD FOR BEST CHILDRENS HOSPITALS; - 2018 & 2017 CHIME HEALTHCARES MOST WIRED AWARD; - 2018 & 2017 U.S. NEWS & WORLD REPORT BEST CHILDRENS HOSPITAL; - 2018 & 2017 LANTERN AWARD; - 2018 3M AWARD FOR EXCELLENCE IN SKIN SAFETY; - 2016 CHILDKIND HOSPITAL DESIGNATION; - 2016 PRESS GANEY SUCCESS STORY AWARD; - 2016 HARTFORD BUSINESS JOURNAL HEALTHCARE HERO (CHRISTINE FINCK, M.D.); - 2016 HARTFORD BUSINESS JOURNAL BEST IN BUSINESS, ONCOLOGY (CENTER FOR CANCER AND BLOOD DISORDERS); - 2016 TOP MASTERS IN HEALTHCARE ADMINISTRATION; - 2016 GET WITH THE GUIDELINES - RESUSCITATION SILVER AWARD; AND - 2015 TOP WORKPLACE IN CONNECTICUT, RANKED 10TH IN LARGE ORGANIZATION CATEGORY. OFFICE OF COMMUNITY CHILD HEALTH ("OCCH") ========================================= CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH ELEVATES THE EFFECTIVENESS AND STATUS OF THE MEDICAL CENTER AS A CRITICAL COMMUNITY RESOURCE BY DEVELOPING, PROMOTING, SUPPORTING, EVALUATING AND DISSEMINATING INNOVATIVE, EFFECTIVE COMMUNITY-ORIENTED PROGRAMS AND SERVICES TO ADDRESS CHILDRENS CRITICAL HEALTH NEEDS. WHAT WE DO ---------- OCCH ADDRESSES CRITICAL CONTEMPORARY ISSUES IN CHILDRENS LIVES THAT HAVE THE POTENTIAL TO ADVERSELY AFFECT THEIR HEALTH AND DEVELOPMENT. THE OFFICE NOT ONLY SERVES AS A CRITICAL COMMUNITY RESOURCE, BUT ALSO CULTIVATES INNOVATIVE AND COST-EFFECTIVE SOLUTIONS TO ADDRESS EXISTING GAPS IN OUR HEALTH CARE AND CHILD SERVICE SYSTEMS. THROUGH THE OFFICE, CONNECTICUT CHILDRENS MEDICAL CENTER ENSURES THAT FAMILIES HAVE ACCESS TO A COMPREHENSIVE SYSTEM OF COMMUNITY PROGRAMS AND SERVICES THAT SUPPORTS THEM IN PROMOTING THEIR CHILDRENS OPTIMAL HEALTHY DEVELOPMENT. OUR MODEL --------- THE OFFICE OVERSEES A VARIETY OF COMMUNITY-ORIENTED PROGRAMS THAT ADDRESS A WIDE RANGE OF FACTORS THAT INFLUENCE CHILDRENS HEALTHY DEVELOPMENT. THOSE PROGRAMS, AND THEIR COMMUNITY-BASED PARTNERS, NOT ONLY FOCUS ON THE TRADITIONAL AREAS OF CHILD HEALTH SERVICES, FAMILY SUPPORT, AND EARLY CARE AND EDUCATION, BUT ALSO TOUCH OTHER SECTORS INCLUDING FOOD AND NUTRITION, HOUSING, ECONOMIC DEVELOPMENT, CHILD WELFARE, AND TRANSPORTATION. THE OFFICE TAKES A THREE-PRONGED APPROACH TO PROMOTING CHILDRENS OPTIMAL HEALTHY DEVELOPMENT: 1. STRENGTHENING EXISTING COMMUNITY-ORIENTED PROGRAMS; 2. FACILITATING SYNERGIES AMONG THOSE PROGRAMS; AND 3. SERVING AS AN INNOVATION INCUBATOR FOR PROMISING APPROACHES THAT IMPROVE SHORT AND LONG-TERM HEALTH OUTCOMES FOR CHILDREN. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS THE OFFICE SERVES AS A NEW MODEL FOR OTHER CHILDRENS HOSPITALS TO FOLLOW IN TERMS OF DEMONSTRATING THEIR COMMUNITY BENEFIT TO MAINTAIN TAX EXEMPT STATUS. IN THE PAST, HOSPITALS HAVE TRADITIONALLY RELIED ON DOCUMENTING THE DISCOUNTED AND UNREIMBURSED CARE THAT THEY PROVIDE TO PATIENTS. NOW, UNDER THE AFFORDABLE CARE ACT, THERE HAS BEEN A SHARP REDUCTION IN THE NUMBER OF AMERICANS WHO ARE UNINSURED AND, THEREFORE, A REDUCTION IN THE NEED FOR DISCOUNTED OR UNREIMBURSED CARE. BECAUSE OF THAT, HOSPITALS ARE BEING ENCOURAGED TO FIND NEW WAYS TO DEMONSTRATE THE BENEFIT THEY OFFER TO THEIR COMMUNITIES. THE OFFICES MODEL OFFERS A STRATEGIC APPROACH THAT SHOWS HOW ITS PROGRAMS ARE LINKED TO CRITICAL COMMUNITY NEEDS AND HOW THEY ARE ADDRESSING THOSE NEEDS. ALSO, THE OFFICES FOCUS ON PREVENTIVE AND COST-EFFECTIVE MODELS OF CARE FOR CHILDREN IS TIMELY GIVEN THE SHIFT IN HEALTHCARE TOWARDS ACCOUNTABLE CARE THAT EMPHASIZES VALUE IN TERMS OF KEEPING POPULATIONS HEALTHY. THE OFFICE TAKES AN ACTIVE LEADERSHIP ROLE IN INFORMING POPULATION HEALTH EFFORTS AT THE LOCAL, STATE AND NATIONAL LEVELS. OUR IMPACT, AT A GLANCE ----------------------- THE OCCH HAS ESTABLISHED ITSELF AS A CRITICAL RESOURCE IN THE STATE AND ACROSS THE NATION AND IS: - PARTNERING WITH THE CONNECTICUT OFFICE FOR EARLY CHILDHOOD TO LEAD THE DEVELOPMENT OF A COMPREHENSIVE, STATEWIDE EARLY CHILDHOOD SYSTEM; AND - ENGAGED IN ONGOING DIALOGUE ON KEY PUBLIC POLICY CONCEPTS NECESSARY FOR SYSTEM-BUILDING WITH A WIDE ARRAY OF FEDERAL AGENCIES, INCLUDING THE MATERNAL AND CHILD HEALTH BUREAU, THE ADMINISTRATION FOR CHILDREN AND FAMILIES AND THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION. OCCH PROGRAMS ------------- CONNECTICUT CHILDREN'S OCCH OPERATES A TOTAL OF 15 PROGRAMS: INNOVATION: - THE HELP ME GROW NATIONAL CENTER; - CONNECTICUT CHILDRENS ADVANCING KIDS INNOVATION PROGRAM; - EASY BREATHING; - KOHLS START CHILDHOOD OFF RIGHT PROGRAM; AND - CARE COORDINATION COLLABORATIVE MODEL. DIRECT SERVICES: - CONNECTICUT CHILDRENS CENTER FOR CARE COORDINATION; - CONNECTICUT CHILDRENS HEALTHY HOMES PROGRAM; - HARTFORD YOUTH HIV IDENTIFICATION AND LINKAGE CONSORTIUM; AND - PERSON-CENTERED MEDICAL HOME. EDUCATION AND RESEARCH: - INJURY PREVENTION CENTER; - CO-MANAGEMENT; - CHILDRENS CENTER ON FAMILY VIOLENCE; - EDUCATING PRACTICES IN THE COMMUNITY; - PRACTICE QUALITY IMPROVEMENT PROGRAM; AND - RESIDENT EDUCATION IN ADVOCACY AND COMMUNITY HEALTH. DESCRIPTIONS OF THOSE PROGRAMS ARE LISTED BELOW: INNOVATION ---------- THE HELP ME GROW NATIONAL CENTER, INNOVATED IN HARTFORD AND BASED AT CONNECTICUT CHILDRENS MEDICAL CENTER, SERVES AS A NATIONAL RESOURCE FOR SUPPORTING THE REPLICATION OF HELP ME GROW SYSTEMS THROUGHOUT THE COUNTRY. TESTED AS A PILOT PROJECT IN HARTFORD IN 1997, THE PROGRAM EXPANDED STATEWIDE IN 2002 AND IS ALSO BEING REPLICATED AROUND THE COUNTRY. HELP ME GROW LINKS CHILDREN WHO ARE AT RISK FOR DEVELOPMENTAL OR BEHAVIORAL PROBLEMS TO HELPFUL COMMUNITY-BASED PROGRAMS AND SERVICES. CONNECTICUT CHILDRENS ADVANCING KIDS INNOVATION PROGRAM CONNECTICUT CHILDRENS ADVANCING KIDS INNOVATION PROGRAM ("AKIP") OFFERS INDIVIDUALS AND ORGANIZATIONS AN EXCITING OPPORTUNITY TO GET CRUCIAL GUIDANCE, ACCESS TO KEY STAKEHOLDERS, AND TECHNICAL ASSISTANCE NEEDED TO MAKE INNOVATIONS PROMOTING THE OPTIMAL HEALTHY DEVELOPMENT OF CHILDREN SUCCESSFUL ON A LOCAL, STATEWIDE, AND EVEN NATIONAL LEVEL. AKIP, WHICH IS PART OF CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH (THE OFFICE), SEEKS TO ESTABLISH A PIPELINE OF INNOVATIONS THAT FOCUS ON THE HEALTH OF CHILDREN, STRENGTHEN FAMILIES, AND SHOW HIGH POTENTIAL FOR BEING BOTH SUSTAINABLE AND REPLICABLE. AKIP SEEKS TO ENGAGE A BROAD RANGE OF POTENTIAL COMMUNITY HEALTH INNOVATORS ADDRESSING CRITICAL COMMUNITY HEALTH NEEDS, INCLUDING INDIVIDUAL ENTREPRENEURS, BUSINESSES, COMMUNITY-BASED ORGANIZATIONS; RESEARCHERS; BEHAVIORAL HEALTH PROVIDERS, OTHER HEALTHCARE PROVIDERS, HEALTHCARE PAYERS AND OTHERS COMMITTED TO IMPROVING CHILDRENS HEALTHY DEVELOPMENT. THE PROGRAM PLANS TO SUPPORT INNOVATIONS AS THEY MOVE TOWARDS MORE EVIDENCE-INFORMED, HIGHER IMPACT SOLUTIONS DESIGNED TO CLOSE EXISTING GAPS IN PROGRAMS AND SERVICES CURRENTLY OFFERED TO CHILDREN ACROSS A VARIETY OF SECTORS. EASY BREATHING IS A COMMUNITY-BASED ASTHMA MANAGEMENT PROGRAM INNOVATED AT CONNECTICUT CHILDRENS AND HOUSED IN OUR ASTHMA CENTER. IT ENSURES CHILDREN, FAMILIES AND PHYSICIANS WORK TOGETHER TO MANAGE ASTHMA SYMPTOMS USING NATIONAL ASTHMA GUIDELINES. THE PROGRAM IS AVAILABLE TO CHILDREN ACROSS CONNECTICUT AND IS ALSO BEING REPLICATED IN OTHER STATES. THE KOHLS START CHILDHOOD OFF RIGHT (SCOR) PROGRAM IS DEDICATED TO DECREASING OBESITY IN HARTFORD CHILDREN FROM BIRTH TO AGE 2 BY FIVE PERCENT. SCOR IS WORKING TO ACCOMPLISH THAT GOAL THROUGH THE FOLLOWING ACTIVITIES: 1) CONVENE A COLLABORATIVE OF COMMUNITY PARTNERS WHO ARE MOBILIZED TO COMBAT CHILDHOOD OBESITY; 2) EDUCATE PEDIATRIC PROVIDERS TO COUNSEL HARTFORD FAMILIES ON HEALTHY NUTRITION AND ACTIVITY AND PROVIDE REFERRALS TO COMMUNITY RESOURCES FOR AT RISK 0-2 YEAR OLDS; 3) TRAIN COMMUNITY OUTREACH WORKERS ON COUNSELING AND SUPPORTING FAMILIES WITH 0-2 YEAR OLDS TO UTILIZE CONSISTENT HEALTHY GROWTH MESSAGING; 4) CONNECT HARTFORD FAMILIES TO HEALTH PROMOTION ORGANIZATIONS DURING WELLNESS EVENTS AND SHARING HEALTHY EATING MESSAGES; AND 5) REFER AT RISK FAMILIES TO CHILD DEVELOPMENT INFOLINE TO CONNECT THEM TO COMMUNITY RESOURCES. THE CARE COORDINATION COLLABORATIVE MODEL IS THE SIGNATURE INNOVATION OF CONNECTICUT CHILDRENS CETNER FOR CARE COORDINATION. THE MODEL IMPROVES COLLABORATION AMONG CARE COORDINATORS FROM DIVERSE SECTORS INCLUDING CHILD HEALTH, EARLY CARE AND EDUCATION, AND FAMILY SUPPORT. IT ALSO PROVIDES CHILDREN AND FAMILIES WITH LINKS TO EFFECTIVE SERVICES. IT WORKS BY BRINGING TOGETHER CARE COORDINATORS FROM SEVERAL CHILD-SERVING SECTORS FOR PERIODIC MEETINGS TO LEARN ABOUT AVAILABLE SERVICES AND HOW TO HELP FAMILIES ACCESS THEM, TO REVIEW CHALLENGING CASES AND DEVELOP SOLUTIONS FOR FAMILIES, AND TO ADVOCATE FOR POLICY LEVEL SOLUTIONS TO HELP FAMILIES ADDRESS CHALLENGES THEY FACE CONNECTING TO SERVICES. INITIALLY LAUNCHED IN THE GREATER HARTFORD AREA, THE PROGRAM HAS EXPANDED ACROSS THE STATE OF CONNECTICUT AND INTO ADDITIONAL STATES. DIRECT SERVICES --------------- THE CONNECTICUT CHILDRENS CENTER FOR CARE COORDINATION (THE CENTER) EMPOWERS FAMILIES OF ALL CHILDREN, INCLUDING THOSE WITH SPECIAL NEEDS, BY HELPING THEM ADVOCATE FOR ACCESS TO APPROPRIATE MEDICAL, BEHAVIORAL, EDUCATIONAL, LEGAL, AND SOCIAL SERVICES. THE CENTER ALSO PROVIDES TRAINING AND TECHNICAL SUPPORT FOR COMMUNITY-BASED PRIMARY CARE PROVIDERS, SUPPORTING THEM TO BECOME MEDICAL HOMES FOR THE CHILDREN THEY SERVE. THE CONNECTICUT CHILDRENS HEALTHY HOMES PROGRAM IMPROVES THE LIVES OF CHILDREN BY MAKING THEIR HOMES HEALTHIER, SAFER AND MORE ENERGY EFFICIENT. THE PROGRAM PROVIDES QUALIFIED HOMEOWNERS AND TENANTS WITH INSPECTIONS AND PLANS FOR THE REMOVAL OF LEAD, ASTHMA TRIGGERS, AND SAFETY HAZARDS. IT ALSO PROVIDES FINANCIAL ASSISTANCE FOR REMEDIATION, RELOCATION ASSISTANCE DURING CONSTRUCTION, REFERRALS TO LOW-COST OR NO-COST WEATHERIZATION PROGRAMS TO INCREASE ENERGY EFFICIENCY, AND EDUCATION PERTAINING TO HEALTHY AND SAFE HOMES. THE HARTFORD YOUTH HIV IDENTIFICATION AND LINKAGE CONSORTIUM WORKS TO PREVENT THE SPREAD OF HIV AND OTHER SEXUALLY TRANSMITTED DISEASES AMONG YOUTH. THE PROGRAM PROVIDES INTERACTIVE PREVENTION EDUCATION, COMMUNITY ENGAGEMENT AND OUTREACH, AND YOUTH FRIENDLY HIV/STD SCREENINGS. THE CONSORTIUM ALSO LINKS YOUTH TO MEDICAL CARE SERVICES, EMPLOYMENT SERVICES AND OTHER COMMUNITY RESOURCES. THE CONNECTICUT CHILDREN'S PRIMARY CARE CENTER RECENTLY RECEIVED DESIGNATION AS A PERSON CENTERED MEDICAL HOME. IN ACHIEVING THAT RECOGNITION, THE CENTER MET RIGOROUS STANDARDS SET BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE AND WAS RECOGNIZED FOR COORDINATING PATIENT CARE, MAINTAINING A HIGH LEVEL OF QUALITY IN SERVICE DELIVERY, AND ENSURING THAT PATIENTS AND FAMILIES REMAIN AT THE CENTER OF ALL CARE. SEVERAL PROGRAMS OVERSEEN BY THE OFFICE FOR COMMUNITY CHILD HEALTH SUPPORT THE PRIMARY CARE CENTER IN ITS MEDICAL HOME STATUS. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS EDUCATION AND RESEARCH ---------------------- THE INJURY PREVENTION CENTER ENGAGES IN RESEARCH, COMMUNITY OUTREACH, EDUCATION, TRAINING, AND PUBLIC POLICY WORK TO REDUCE PREVENTABLE INJURIES AND VIOLENCE TO CHILDREN. ITS THREE PRIMARY FOCUS AREAS ARE TEEN DRIVING SAFETY, TEEN SUICIDE PREVENTION AND DOMESTIC VIOLENCE PREVENTION. ITS COMMUNITY PROGRAMS, INCLUDING SAFE KIDS CONNECTICUT AND THE INJURY FREE COALITION FOR KIDS OF HARTFORD, ADDRESS A WIDE RANGE OF CHILD SAFETY CONCERNS RANGING FROM CHILD PASSENGER SAFETY TO POISONING PREVENTION AND OTHER HOME SAFETY ISSUES. CO-MANAGEMENT EMPOWERS PRIMARY CARE PROVIDERS TO IMPROVE THE BREADTH AND QUALITY OF CARE THEY PROVIDE TO CHILDREN. PRIMARY CARE PROVIDERS PARTNER WITH SUBSPECIALISTS TO DESIGN PROTOCOLS FOR THE CARE OF CERTAIN HIGH PREVALENCE CONDITIONS THAT ARE TYPICALLY REFERRED TO SUBSPECIALISTS. BY DOING SO, THIS CARE MODEL ALLOWS CHILDREN TO RECEIVE SOME SUBSPECIALTY CARE WITHIN THEIR MEDICAL HOME AND ENSURES THAT THEY RECEIVE TIMELY ACCESS TO SUBSPECIALTY CARE WHEN NEEDED. THE MODEL FREES UP SUBSPECIALTY APPOINTMENTS FOR CHILDREN WHOSE CONDITIONS CANNOT BE MANAGED IN THE PRIMARY CARE SETTING. THE CHILDRENS CENTER ON FAMLIY VIOLENCE AIMS TO INCREASE UNDERSTANDING ABOUT THE IMPACT FAMILY VIOLENCE HAS ON CHILDREN AND TO INCREASE SUPPORT SERVICES FOR AFFECTED CHILDREN. THE CENTER IS A PARTNERSHIP BETWEEN THE CONNECTICUT CHILDRENS SUSPECTED CHILD ABUSE AND NEGLECT PROGRAM, THE CONNECTICUT CHILDRENS INJURY PREVENTION CENTER, AND THE CONNECTICUT COALITION AGAINST DOMESTIC VIOLENCE. THE CENTERS GOALS INCLUDE IMPROVING SERVICE SYSTEMS FOR AFFECTED FAMILIES, WHICH CURRENTLY OFTEN DO NOT UTILIZE BEST PRACTICES, AND ENHANCING RESEARCH EFFORTS FOR CHILD-FOCUSED INTERVENTIONS, WHERE THE EVIDENCE BASE IS CURRENTLY INADEQUATE. THE CENTER ALSO PLANS TO ESTABLISH A STATEWIDE FAMILY VIOLENCE INFORMATION SYSTEM TO GATHER DATA, IDENTIFY TRENDS, AND TRACK PROGRESS OVER TIME. THE EDUCATING PRACTICES IN THE COMMUNITY PROGRAM IS A SIGNATURE INNOVATION OF THE CHILD HEALTH AND DEVELOPMENT INSTITUTE OF CONNECTICUT AND IS SUPPORTED BY THE CONNECTICUT CHILDRENS OFFICE FOR COMMUNITY CHILD HEALTH. ITS DESIGNED TO BRING THE NEWEST DEVELOPMENTS IN PEDIATRIC PRIMARY CARE TO CONNECTICUTS CHILD HEALTH PROVIDERS THROUGH THE PROCESS OF ACADEMIC DETAILING AND WORKS TO ADVANCE SUSTAINABLE IMPROVEMENTS IN PRIMARY AND PREVENTIVE HEALTH AND MENTAL HEALTH CARE PRACTICES FOR ALL CONNECTICUT CHILDREN. THE PRACTICE QUALITY IMPROVEMENT PROGRAM HELPS PRIMARY CARE PHYSICIANS USE A DATA-DRIVEN, QUALITY IMPROVEMENT APPROACH TO ENHANCE THE SERVICES THEY PROVIDE TO CHILDREN. PROGRAM ACTIVITIES HELP PRACTICES IMPROVE THEIR SURVEILLANCE AND SCREENING FOR DEVELOPMENTAL RISKS, IMPROVE THEIR IDENTIFICATION OF BEHAVIORAL CONCERNS, AND CONNECT CHILDREN AND FAMILIES TO HELPFUL SERVICES. THE RESIDENT EDUCATION IN ADVOCACY AND COMMUNITY HEALTH PROGRAM HELPS TO FOSTER THE GROWTH OF FUTURE GENERATIONS OF PEDIATRICIANS WHO ARE COMMUNITY CHILD HEALTH ADVOCATES. THE PROGRAM NURTURES PEDIATRIC RESIDENTS TO BECOME FUTURE LEADERS BY PROVIDING THEM WITH UNIQUE OPPORTUNITIES TO DEVELOP KNOWLEDGE AND SKILLS IN THE AREAS OF ADVOCACY, COMMUNITY HEALTH AND PUBLIC POLICY. DURING THEIR TIME IN THE PROGRAM, PEDIATRIC RESIDENTS WORK CLOSELY WITH EXPERTS IN THE FIELDS OF POPULATION HEALTH, COMMUNITY RESEARCH, POLICY REFORM, AND SOCIAL INNOVATION ALL WITH THE GOAL OF PROMOTING CHILDRENS HEALTHY DEVELOPMENT. CORE FORM, PART VI, SECTION A, QUESTION 2 WILLIAM C. POPIK, M.D. & DAVID M. ROTH, ESQ. - BUSINESS RELATIONSHIP. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 CCMC CORPORATION IS THE SOLE MEMBER OF THIS ORGANIZATION. CCMC CORPORATION HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE ASSUMES THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE SYSTEM'S FINANCE PERSONNEL INCLUDING THE SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, CORPORATE CONTROLLER, ACCOUNTING MANAGER AND VARIOUS OTHER INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE SYSTEM'S INTERNAL WORKING GROUP FOR REVIEW. THE SYSTEM'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE SYSTEM'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. THE FORM 990 WAS THEN PROVIDED AND PRESENTED TO THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE AND SUBSEQUENTLY TO EACH VOTING MEMBER OF ITS GOVERNING BODY PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION AND SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE ORGANIZATION'S CORPORATE COMPLIANCE/CONFLICT OF INTEREST COMMITTEE ("COMMITTEE") HAS OVERSIGHT OVER THE MANAGEMENT OF IDENTIFIED OR REPORTED CASES OF CONFLICTS OF INTEREST. THE COMMITTEE IS ALSO RESPONSIBLE FOR DEVELOPING, APPROVING, AND IMPLEMENTING, AS APPROPRIATE, POLICIES AND EDUCATION RELATING TO VARIOUS TYPES OF CONFLICTS OF INTEREST. THE COMMITTEE HAS DELEGATED THE DAY TO DAY INVESTIGATION OF DISCLOSURES TO THE SYSTEM'S GENERAL COUNSEL AND DIRECTOR OF COMPLIANCE. COMPLETED QUESTIONNAIRES ARE RETURNED TO THE SYSTEM'S GENERAL COUNSEL, WHO PERFORMS AN INITIAL SCREENING OF THE CONFLICT OF INTEREST DISCLOSURES. IF POTENTIAL CONFLICTS OF INTERESTS ARE REPORTED, GENERAL COUNSEL COMPLETES FURTHER INVESTIGATION AND RECOMMENDS A MANAGEMENT PLAN OR OTHER CORRECTIVE ACTIONS TO THE COMMITTEE. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF CONNECTICUT CHILDREN'S SENIOR MANAGEMENT. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THESE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE, INCLUDING COMPLEXITY OF SERVICES. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S SENIOR VICE PRESIDENT OF HUMAN RESOURCES AND THE HUMAN RESOURCES DEPARTMENT, IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. PLEASE ALSO REFER TO OUR RESPONSE INCLUDED IN SCHEDULE J, PART III, QUESTION 3 FOR FURTHER INFORMATION ON HOW CONNECTICUT CHILDREN'S MEDICAL CENTER SATISFIES THE CRITERIA TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO EXECUTIVE COMPENSATION REVIEW AND APPROVAL. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S GOVERNING POLICIES AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.CONNECTICUTCHILDRENS.ORG, OR BY REQUEST. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR THE RELATED ORGANIZATION; NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF DIRECTORS. CORE FORM, PART VII AND SCHEDULE J PLEASE NOTE, SETH VAN ESSENDELFT BECAME THE ORGANIZATION'S TREASURER AND SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED WITHIN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2017 FORMS W-2. ACCORDINGLY, THIS INDIVIDUAL HAS NO W-2 COMPENSATION REPORTED ON THE CURRENT YEAR FEDERAL FORM 990, CORE FORM VII, COLUMN D. ADDITIONALLY, DEB PAPPAS, MBA BECAME THE ORGANIZATION'S VICE PRESIDENT/CHIEF MARKETING AND COMMUNICATION OFFICER DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED WITHIN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2017 FORMS W-2. ACCORDINGLY, THIS INDIVIDUAL HAS NO W-2 COMPENSATION REPORTED ON THE CURRENT YEAR FEDERAL FORM 990, CORE FORM VII, COLUMN D. ADDITIONALLY, HEATHER TORY AND SARAH MATNEY, BECAME OFFICERS OF THE ORGANIZATION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. HOWEVER, THEY WERE PREVIOUSLY EMPLOYED BY A RELATED ORGANIZATION IN A NON-OFFICER CAPACITY. THE COMPENSATION BEING REPORTED FOR THESE INDIVIDUALS ON THIS FORM 990 REFLECTS COMPENSATION EARNED IN A NON-OFFICER CAPACITY.ACCORDINGLY, THESE INDIVIDUALS HAVE NO COMPENSATION REPORTED ON THE CURRENT YEAR FEDERAL FORM 990. ADDITIONALLY, HEATHER TORY AND SARAH MATNEY, BECAME OFFICERS OF THE ORGANIZATION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. HOWEVER, THEY WERE PREVIOUSLY EMPLOYED BY A RELATED ORGANIZATION IN A NON-OFFICER CAPACITY. THE COMPENSATION BEING REPORTED FOR THESE INDIVIDUALS ON THIS FORM 990 REFLECTS COMPENSATION EARNED IN A NON-OFFICER CAPACITY. CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF DIRECTOR MEMBERS AND OFFICERS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS WITHIN THE SYSTEM, THEIR RESPECTIVE HOURS ARE APPROXIMATELY THE SAME AS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS INCLUDE: - CHANGE IN FAIR MARKET VALUE OF SWAP AGREEMENTS - $70,654; - CHANGE IN EQUITY INTEREST IN THE NET ASSETS OF CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $7,363,317; - TRANSFER TO CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - ($17,532,374); - TRANSFER FROM CCMC AFFILIATES, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $7,291,283; - CHANGE IN FUNDED STATUS OF PENSION AND POST-RETIREMENT PLANS - $8,660,997; - TEMPORARILY RESTRICTED CHANGE IN EQUITY INTEREST IN THE NET ASSETS OF CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $177,455; - PERMANENTLY RESTRICTED CHANGE IN FUNDS HELD IN TRUST BY OTHERS - $3,321,764; AND - PERMANENTLY RESTRICTED CHANGE IN EQUITY INTEREST IN THE NET ASSETS OF CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $2,060,467. CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CONNECTICUT CHILDREN'S MEDICAL CENTER AND SUBSIDIARIES, FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2017; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. IN ADDITION, CCMC CORPORATION AND SUBSIDIARIES ALSO RECEIVED AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2017; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:9206097 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:25480577 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:6721399 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:2251983 FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY FEES TOTAL FEES:275866 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:270737 FORM 990 PART IX LINE 11G DESCRIPTION:ACTUARIAL FEES TOTAL FEES:100000 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE FEES TOTAL FEES:130425 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:690787 CCMC CORPORATION 282 WASHINGTON STREET HARTFORD CT 06106 222619876 HLTHCARE SVCS CT 501(C)(3) 509(A)(3) NA false CONNECTICUT CHILDREN'S MEDICAL CTR FDN 282 WASHINGTON STREET HARTFORD CT 06106 222619869 FUNDRAISING CT 501(C)(3) 509(A)(1) CCMC CORP false CCMC AFFILIATES INC 282 WASHINGTON STREET HARTFORD CT 06106 222619870 HLTHCARE SVCS CT 501(C)(3) 509(A)(2) CCMC CORP false CONNECTICUT CHILDREN'S SPECIALTY GROUP 282 WASHINGTON STREET HARTFORD CT 06106 061446900 HLTHCARE SVCS CT 501(C)(3) 509(A)(2) CT CHILDRENS true CHILDREN'S FUND OF CONNECTICUT INC 270 FARMINGTON AVENUE FARMINGTON CT 06032 061364513 HLTHCARE SVCS CT 501(C)(3) 509(A)(3) CT CHILDRENS true CHILDREN'S HEALTH & DEVEL INSTITUTE INC 270 FARMINGTON AVENUE FARMINGTON CT 06032 061504725 HLTHCARE SVCS CT 501(C)(3) 509(A)(1) CFCT false CAPITAL AREA HEALTH CONSORTIUM INC 270 FARMINGTON AVENUE FARMINGTON CT 06032 510173264 SUPPORT SVCS CT 501(C)(3) 509(A)(3) CT CHILDRENS true CCMC VENTURES INC 282 WASHINGTON STREET HARTFORD CT 06106 222619873 INACTIVE CT NA C CORP. false NEW ENGLAND PEDIATRICS INDEMNITY LTD 50 CEDAR AVENUE HAMILTON BERMUDA BD HM 11 FINANCIAL VEHICLE BD NA FOREIGN CORP. false false false true true true false false false true false false false false true true true true true true CCMC CORPORATION O 114641 COST CCMC CORPORATION R 58834 COST CONNECTICUT CHILDREN'S SPECIALTY GROUP P 14271226 COST CONNECTICUT CHILDREN'S SPECIALTY GROUP R 17532374 COST SCHEDULE R, PART V THE ORGANIZATION IS AN AFFILIATE WITHIN CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). IN THE ORDINARY COURSE OF BUSINESS, THIS ORGANIZATION MAY PAY EXPENSES OR TRANSFER FUNDS AMONGST AND FOR VARIOUS AFFILIATES. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.