2018-11-14T10:45:23-06:00 2017-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2017-01-01 390812532 CHILDREN'S HOSPITAL OF WISCONSIN INC CHIL 4142665420 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 MARC A CADIEUX TREASURER 4142665420 2018-11-13 1 BRYAN L PAUTSCH CPA P00034913 2627549400 2018-11-02 209.170.231.5 2018-11-13 16:46:20 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 934FC65FEE8495E85B690041CFEAE27130F8D972 2017 2019-02-21 02:37:17Z MARGARET TROY PO BOX 1997 MS 900 MILWAUKEE WI 532011997 816855193 0 X WWW.CHW.ORG X 1894 WI PEDIATRIC HEALTH CARE SERVICES 25 21 3863 572 164524 0 25924494 29584746 609866831 656973528 7123273 9096853 13257474 13700659 656172072 709355786 68637635 76818148 0 0 227913499 240900854 0 0 0 344856037 359760916 641407171 677479918 14764901 31875868 1456845160 1692269144 379386176 498844298 1077458984 1193424846 X CHILDREN'S HOSPITAL OF WISCONSIN, INC. PROVIDES A COMPREHENSIVE AND INTEGRATED PEDIATRIC HEALTH CARE MODEL THAT DELIVERS SUPERIOR QUALITY AND VALUE BY OFFERING THE BEST SOLUTION FOR THE TOTAL HEALTH CARE NEEDS OF CHILDREN WITHIN OUR COMMUNITY, STATE AND REGION. OUR VISION IS TO HAVE WISCONSIN CHILDREN BE THE HEALTHIEST CHILDREN IN THE COUNTRY. AS A PREMIER AND STANDARD-SETTING LEADER IN DELIVERY OF PEDIATRIC CARE, CHILDREN'S HOSPITAL BRINGS A COMMITMENT TO EXCELLENCE TO OUR PATIENTS AND FAMILIES, MEDICAL STAFF, EMPLOYEES AND COMMUNITIES IN ADDRESSING THE HEALTH AND WELL-BEING OF CHILDREN.OUR MISSION IS TO SERVE OUR CHILDREN THROUGH:CAREGIVING - OFFERING HIGH-QUALITY, COMPREHENSIVE MEDICAL CAREADVOCACY - SPEAKING UP AND PROTECTING CHILDRENRESEARCH - FINDING CURES TO THE ILLNESSES THAT AFFECT CHILDRENEDUCATION - SHARING WHAT WE LEARN AND TEACHING OTHERS TO CARE FOR KIDS 0 0 512164358 76818148 666126546 INPATIENT SERVICES: CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW OR "THE HOSPITAL") OPERATES A 298-BED HOSPITAL AT ITS MILWAUKEE CAMPUS, WHICH INCLUDES AN EMERGENCY ROOM OPEN ON A 24/7 BASIS. IT IS A FREESTANDING WISCONSIN HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN AND IS ONE OF THE LEADING CENTERS FOR PEDIATRIC HEALTH CARE IN THE U.S. THE HOSPITAL SERVES CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE, TO CHILDREN FROM WISCONSIN AND BEYOND. IN 2017, 9,305 CHILDREN WERE ADMITTED TO THE MILWAUKEE HOSPITAL, WHICH INCLUDES A NEONATAL INTENSIVE CARE UNIT (NICU), PEDIATRIC INTENSIVE CARE UNIT (PICU), A CANCER AND BLOOD DISORDERS CENTER, MEDICAL/SURGICAL UNITS AND A DAY SURGERY AND SHORT-STAY UNIT. IN ADDITION, THERE WERE 2,810 OBSERVATION PATIENTS IN 2017. THE HOSPITAL ALSO OPERATES A SEPARATELY LICENSED 42-BED PEDIATRIC HOSPITAL, WHICH INCLUDES A NICU AND A PEDIATRIC MEDICAL/SURGICAL UNIT, LOCATED AT THEDACARE REGIONAL MEDICAL CENTER-NEENAH, THROUGH WHICH IT PROVIDES PEDIATRIC EXPERTISE TO THE GREATER FOX VALLEY AND GREEN BAY AREAS. IN 2017, 551 CHILDREN WERE ADMITTED TO THE FOX VALLEY CAMPUS. IN ADDITION, THERE WERE 305 OBSERVATION PATIENTS IN 2017.OUTPATIENT AND AMBULATORY SERVICES: THE HOSPITAL PROVIDES A FULL ARRAY OF OUTPATIENT AMBULATORY, DIAGNOSTIC, TREATMENT AND SURGICAL SERVICES. PROVIDERS AT MORE THAN 70 SUBSPECIALTY CLINICS DIAGNOSE AND TREAT A WIDE VARIETY OF PEDIATRIC DISORDERS. THE HOSPITAL IS A CERTIFIED LEVEL 1 PEDIATRIC TRAUMA CENTER, AND HANDLED 70,424 VISITS TO THE EMERGENCY DEPARTMENT IN 2017. OUTPATIENT SERVICES ARE OFFERED AT ACCESSIBLE LOCATIONS THROUGHOUT SOUTHEASTERN WISCONSIN, AND IN THE FOX VALLEY AND GREEN BAY MARKETS. THE HOSPITAL'S NATIONALLY KNOWN AND RECOGNIZED SPECIALTY PROGRAMS INCLUDE THOSE FOR TREATING CHILDREN WITH AIRWAY, DIGESTIVE AND VOICE CONDITIONS; BURNS; CANCER AND BLOOD DISORDERS; CONGENITAL AND ACQUIRED HEART DEFECTS AND DISEASES; CRANIOFACIAL DISORDERS; DERMATOLOGY, BIRTHMARKS AND VASCULAR ANOMALIES; DIABETES; GASTROINTESTINAL PROBLEMS; GENETIC DISORDERS; HIV; NEUROLOGICAL DISORDERS; ORTHOPEDIC CONDITIONS (INCLUDING SPINE, SPORTS MEDICINE, CONCUSSION); IMMUNODEFICIENCIES AND IMMUNE DYSREGULATION SYNDROMES; PSYCHIATRY; SLEEP DISORDERS; SOLID ORGAN TRANSPLANTATION; SPEECH AND HEARING DISORDERS; AND SPASTICITY AND OTHER TONE AND MOBILITY CONDITIONS. THROUGH ITS AFFILIATES, THE HOSPITAL PROVIDES PRIMARY CARE, DENTAL CARE, BEHAVIORAL HEALTH SERVICES AND CHILD PROTECTIVE SERVICES TO UNDERSERVED CHILDREN AT SEVERAL CLINICS IN CENTRAL CITY MILWAUKEE NEIGHBORHOODS. THE HOSPITAL ALSO OFFERS CASE MANAGEMENT SERVICES AND A FULL RANGE OF MEDICAL, PSYCHOLOGICAL, NURSING AND SOCIAL SERVICES FOR CHILDREN WITH DEVELOPMENTAL, BEHAVIORAL AND LEARNING PROBLEMS. IN 2017, THERE WERE A TOTAL OF 309,207 OUTPATIENT VISITS.RESEARCH: THE HOSPITAL AND CHILDREN'S RESEARCH INSTITUTE PARTICIPATE IN AN ARRAY OF RESEARCH INITIATIVES SEEKING TO IMPROVE THE DIAGNOSIS AND TREATMENT OF CONGENITAL AND ACQUIRED PEDIATRIC HEALTH CONDITIONS. THESE RESEARCH INITIATIVES INCLUDE BEHAVIORAL HEALTH; EPILEPSY AND OTHER NEUROLOGICAL CONDITIONS; HEART DEFECTS; ORGAN TRANSPLANTATION; BIRTH DEFECTS AND FETAL ANOMALIES; IMMUNOLOGICAL CONDITIONS, BLOOD DISORDERS AND VARIOUS CHILDHOOD CANCERS; AND ENVIRONMENTAL HEALTH CONDITIONS. ADDITIONAL RESEARCH IS CONDUCTED IN COLLABORATION WITH ACADEMIC INVESTIGATORS AT THE MEDICAL COLLEGE OF WISCONSIN, MARQUETTE UNIVERSITY, UNIVERSITY OF WISCONSIN-MADISON AND OTHER INSTITUTIONS. NURSING RESEARCH INCLUDES STUDIES REGARDING PAIN MANAGEMENT, QUALITY OF LIFE, COPING SKILLS, FAMILY READINESS AND SEDATION PROTOCOLS. EDUCATION: THE HOSPITAL IS A MAJOR TEACHING AFFILIATE OF THE MEDICAL COLLEGE OF WISCONSIN, WITH THIRD- AND FOURTH-YEAR MEDICAL STUDENTS ROTATING THROUGH THE HOSPITAL FOR REQUIRED AND ELECTIVE ROTATIONS. THE HOSPITAL ALSO MAINTAINS A THREE-YEAR PEDIATRIC RESIDENCY PROGRAM, A TWO-YEAR DENTAL TRAINING PROGRAM AND AN ACADEMIC FELLOWSHIP PROGRAM IN AN ARRAY OF SPECIALTIES. THE HOSPITAL HAS RELATIONSHIPS WITH MORE THAN TWO DOZEN UNIVERSITIES FOR THE CLINICAL EDUCATION OF PEDIATRIC NURSES AND OTHER HEALTH CARE PROFESSIONAL STUDENTS, AS WELL AS HEALTH CARE ADMINISTRATION AND VARIOUS OTHER DISCIPLINES. THE HOSPITAL'S PEDIATRIC SPECIALISTS ALSO PROVIDE EDUCATION AND TRAINING TO HEALTH CARE PROFESSIONALS AT COMMUNITY HOSPITALS, PRIMARY CARE CLINICS AND SCHOOLS THROUGHOUT WISCONSIN IN CONNECTION WITH THE IDENTIFICATION, DIAGNOSIS AND TREATMENT OF PEDIATRIC HEALTH AND WELFARE CONDITIONS.COMMUNITY EDUCATION AND OUTREACH: THE HOSPITAL OFFERS A WIDE VARIETY OF COMMUNITY EDUCATION, OUTREACH AND CHILD HEALTH ADVOCACY PROGRAMS. THROUGH COMMUNITY EDUCATION PROGRAMS ON TOPICS SUCH AS CHILD HEALTH, INJURY PREVENTION, PARENTING, MANAGEMENT OF CHRONIC DISEASES, AND PREVENTIVE HEALTH, THE HOSPITAL REACHES THOUSANDS OF FAMILIES. ALONG WITH THE MEDICAL COLLEGE, THE HOSPITAL SPONSORS THE CENTER FOR THE ADVANCEMENT OF UNDERSERVED CHILDREN, WHICH SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN IN WISCONSIN. THE HOSPITAL PARTICIPATES IN AND STAFFS CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, THROUGH WHICH PROVIDERS AROUND THE STATE WORK COLLABORATIVELY TO RAISE AWARENESS OF CHILDREN'S HEALTH ISSUES, INCREASE ACCESS TO PEDIATRIC CARE, AND PROMOTE BEST PRACTICES. OTHER COMMUNITY OUTREACH AND ADVOCACY INITIATIVE EXAMPLES INCLUDE CAR SEAT CLINICS, THE DANIEL M. SOREF FAMILY RESOURCE CENTER AND PROJECT ADAM (EDUCATION AND PREVENTION INITIATIVES IN THE AREA OF PEDIATRIC SUDDEN CARDIAC DEATH). 512164358 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 736 0 3863 1 1 1 0 0 0 0 0 0 0 0 0 X 25 21 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MS SARAH KAFKA 4142661887 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 TODD ADAMS DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL W ALTSCHAEFL DIRECTOR 1.00 1.00 X 0 0 0 THOMAS ARENBERG DIRECTOR 1.00 1.00 X 0 0 0 ELIZABETH BRENNER DIRECTOR/VICE CHAIR 1.00 1.00 X X 0 0 0 MATT D'ATTILIO DIRECTOR 1.00 1.00 X 0 0 0 DAVID J DRURY DIRECTOR 1.00 1.00 X 0 0 0 JOE GEHRKE DIRECTOR 1.00 1.00 X 0 0 0 PATRICK HAMMES DIRECTOR 1.00 1.00 X 0 0 0 CHRIS KALTENBACH DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH KERSCHNER MD DIRECTOR 1.00 1.00 X 0 0 0 PAUL KNOEBEL DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL LOVELL DIRECTOR 1.00 1.00 X 0 0 0 KEVIN MANSELL DIRECTOR 1.00 1.00 X 0 0 0 LINDA T MELLOWES DIRECTOR 1.00 1.00 X 0 0 0 BEN MELSON DIRECTOR 1.00 1.00 X 0 0 0 JAMES POPP DIRECTOR 1.00 1.00 X 0 0 0 TOM PRECIA DIRECTOR 1.00 1.00 X 0 0 0 J JOEL QUADRACCI DIRECTOR 1.00 1.00 X 0 0 0 JAY O ROTHMAN DIRECTOR/CHAIR 1.00 1.00 X X 0 0 0 JOHN E SCHLIFSKE DIRECTOR 1.00 1.00 X 0 0 0 PETER M SOMMERHAUSER DIRECTOR 1.00 1.00 X 0 0 0 PAUL W SWEENEY DIRECTOR 1.00 1.00 X 0 0 0 PHOEBE W WILLIAMS DIRECTOR 1.00 1.00 X 0 0 0 MARK C WITT DIRECTOR 1.00 1.00 X 0 0 0 MARGARET TROY DIRECTOR/PRESIDENT & CEO CHHS 0.00 40.00 X X 0 1524413 287590 MARC CADIEUX TREASURER/CFO 0.00 40.00 X 0 621560 94262 MARC GORELICK MD COO & EXECUTIVE VP CHHS 40.00 0.00 X 327965 0 7755 MICHELLE METTNER SECRETARY 0.00 40.00 X 0 474174 78555 MICHAEL GUTZEIT MD CHIEF MEDICAL OFFICER/VP, CHW 40.00 0.00 X 605741 0 93804 JULIET KERSTEN VICE PRESIDENT, CHW 40.00 0.00 X 347839 0 37947 NANCY KOROM CHIEF NURSING OFFICER/VP, CHW 40.00 0.00 X 461461 0 90795 THOMAS MILLER VICE PRESIDENT, CHW 40.00 0.00 X 250326 0 29347 LISA JENTSCH VICE PRESIDENT, CHW 40.00 0.00 X 227859 0 46695 ANDREW SCHMITT MD HOSPITALIST 40.00 0.00 X 261308 0 41002 LORI BARBEAU DDS MEDICAL DIR, DENTAL PROGRAM 40.00 0.00 X 285447 0 52491 MARYLYN RANTA MD DIR, CHW PHYSICIAN AFFAIRS 40.00 0.00 X 279082 0 50788 THOMAS NICHOLS MD MEDICAL DIRECTOR/HOSPITALIST 40.00 0.00 X 277838 0 49426 CHRISTOPHER SPAHR CHIEF QUALITY OFFICER 40.00 0.00 X 292733 0 42378 SHEILA REYNOLDS FORMER SECRETARY 0.00 0.00 X 0 241525 21470 3617599 2861672 1024305 172 1 1 0 MEDICAL COLLEGE OF WISCONSIN INC 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 HEALTHCARE PROF/ACADEMIC/ADMIN 27650767 MEDICAL COLLEGE OF WISCONSIN AFFILIATED 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 RESIDENT SERVICES 14978520 THEDA CARE 122 E COLLEGE AVE APPLETON WI 54912 ANCILLARY SERV/OTHER SERV 6512271 BLOOD CENTER OF WISCONSIN INC 638 N 18TH ST MILWAUKEE WI 53233 LAB SERVICES 4402574 SODEXO INC & AFFILIATES 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 NUTRITION SERVICES 2931664 49 10231266 16713648 2639832 29584746 NET PATIENT SERVICE REVENUE 621990 647694974 647694974 RENTAL INCOME 531120 4925489 4925489 OUTSIDE SALARY SUPPORT 541900 4353065 4353065 656973528 8120333 8120333 108446140 29787 106827127 672280 1619013 -642493 976520 976520 340B CONTRACTS 722210 4943529 4943529 PHARMACY SALES TO EMPLOYEES 446110 2991951 2991951 FOX VALLEY SCHOOL THERAPY 900099 1015032 1015032 4750147 3194457 164524 1391166 13700659 709355786 666126546 164524 13479970 X 76818148 76818148 2527533 2527533 186887083 152731355 34155728 10349276 8385051 1964225 27677908 22059116 5618792 13459054 13366889 92165 82342000 3150000 79192000 44925 44925 988050 988050 84303708 69535769 14767939 108580 12190 96390 244178 67283 176895 415891 144040 271851 22707855 5865917 16841938 761609 363787 397822 448374 237041 211333 13258871 13258871 54435513 54435513 3318358 3318358 MEDICAL SUPPLIES 69779596 69779596 HOSPITAL ASSESSMENT TAX 10762417 10762417 15840991 7873017 7967974 677479918 512164358 165315560 0 140443623 99749698 3000507 3132603 79797757 92506526 490960 588167 7276894 8315980 3751373 3386608 818749977 420317839 412130570 398432138 215966201 374274394 593987275 711883030 1456845160 1692269144 74063010 77267872 763861 816640 252643936 365665769 51915369 55094017 379386176 498844298 X 870390872 957669803 56137091 53235220 150931021 182519823 1077458984 1193424846 1456845160 1692269144 X 31875868 -1982946 86072940 X 0 1 X 1 1 1 X 1 472577 347450 348953 471074 0 454920324 128971940 68331942 17189947 1686210 633348049 425930887 36643557 11123959 17129596 1648483 454920324 432441515 13587207 -2058549 16494796 1544490 425930887 368901399 70262985 8725963 14003006 1445826 432441515 337517064 20430025 20149400 8024840 1170250 368901399 0.62800 0.28800 0.08400 0 1 1 546809136 269232449 277576687 13004146 5136531 7867615 234910157 141763852 93146305 24026538 4185007 19841531 398432138 DUE FROM AFFILIATES 75813361 BENEFICIAL INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL OF WI FOUNDATION 633348049 457 PLAN ASSETS 1831566 INVESTMENT IN CATALPA AND OTHER 890054 711883030 457 PLAN LIABILITY 1831566 CAPITAL AND OTHER LEASE OBLIGATIONS 1648856 ESTIMATED THIRD PARTY PAYER SETTLEMENTS 1534328 RESERVE FOR MEDICAL EDUCATION GRANT SETTLEMENTS 2797316 LT PENSION LIABILITY 31055285 LT STRATEGIC FUNDING RESERVE 14190620 LT CONTRACT INCENTIVE PAYABLE 1886046 OTHER LIABILITIES 150000 55094017 X PART IV, LINE 1B: CERTAIN EMPLOYEES OF THE ORGANIZATION HAVE SIGNING AUTHORITY FOR THE CHILDREN'S HOSPITAL OF WISCONSIN MEDICAL STAFF FUNDS MONEY MARKET AND CHECKING ACCOUNT. AN EMPLOYEE OF THE ORGANIZATION ALSO PROVIDES ALL MONTHLY ACCOUNTING FUNCTIONS. PART V, LINE 4: CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC., A RELATED ENTITY, HOLDS ENDOWMENT FUNDS ON BEHALF OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. INTENDED USES OF THE FUNDS INCLUDE VARIOUS HEALTH-RELATED SERVICES, CAPITAL PROJECTS AND RESEARCH. PART X, LINE 2: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016. 1 1 X 1 X 1 X 1 1 0 1 1 722480 722480 0.00110 308830464 222817465 86012999 0.12700 309552944 222817465 86735479 0.12810 8959448 5547590 3411858 0.00500 25860580 7065217 18795363 0.02770 16455414 6315818 10139596 0.01500 6206995 6206995 0.00920 577305 577305 0.00090 58059742 18928625 39131117 0.05780 367612686 241746090 125866596 0.18590 63497 63497 0.00010 38886 38886 0.00010 1472 1472 0.00000 28423 28423 0.00000 19152 19152 0.00000 9813 9813 0.00000 161243 161243 0.00020 0 4533857 1373001 1614759 -241758 X 1 1 2 1 CHILDREN'S HOSPITAL OF WI-MILWAUKEE 9000 W WISCONSIN AVE MILWAUKEE WI 53201 CHW.ORG 135 X X X X X X 2 CHILDREN'S HOSPITAL OF WI-FOX VALLEY 130 S 2ND STREET NEENAH WI 54956 CHW.ORG 1005 X X X CHILDREN'S HOSPITAL OF WI-MILWAUKEE 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.CHW.ORG 1 16 1 WWW.CHW.ORG 0 1 X 200.000000000000 350.000000000000 X 1 1 X X X 1 X CHW.ORG X CHW.ORG X CHW.ORG X X X X X X X 1 X 0 X X X 1 X 0 0 CHILDREN'S HOSPITAL OF WI-FOX VALLEY 2 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.CHW.ORG 1 16 1 WWW.CHW.ORG 0 1 X 200.000000000000 350.000000000000 X 1 1 X X X 1 X CHW.ORG X CHW.ORG X CHW.ORG X X X X X X X 1 X 0 X X X 1 X 0 0 CHILDREN'S HOSPITAL OF WI-MILWAUKEE PART V, SECTION B, LINE 5: CHW IS A MEMBER OF THE MILWAUKEE HEALTH CARE PARTNERSHIP, WHICH BRINGS TOGETHER MILWAUKEE'S HEALTH SYSTEMS, HOSPITALS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL AND STATE PUBLIC HEALTH DEPARTMENTS, ALL COMMITTED TO WORKING TOGETHER TO CREATE A HEALTHIER MILWAUKEE. TO GET A HOLISTIC PICTURE OF HEALTH IN MILWAUKEE, EVERY THREE YEARS THE PARTICIPATING HEALTH SYSTEMS COMMISSION A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH THE MILWAUKEE HEALTH DEPARTMENT AND OTHER MUNICIPAL HEALTH DEPARTMENTS. THE ASSESSMENTS SERVE AS THE FOUNDATION FROM WHICH HOSPITALS AND LOCAL HEALTH DEPARTMENTS DEVELOP THEIR RESPECTIVE COMMUNITY HEALTH IMPROVEMENT STRATEGIES. THE ASSESSMENT FOR MILWAUKEE COUNTY INCLUDES THREE PRIMARY DATA SOURCES:- MILWAUKEE COUNTY COMMUNITY HEALTH SURVEY: THIS PHONE-BASED SURVEY OF NEARLY 2,000 MILWAUKEE COUNTY RESIDENTS ASSESSES ADULT AND CHILD HEALTH AND RELATED BEHAVIORS, AS WELL AS PERCEPTIONS OF TOP HEALTH ISSUES FOR THE COMMUNITY. - KEY INFORMANT INTERVIEW REPORT: THIS REPORT OF LOCAL PUBLIC HEALTH PRIORITIES IS BASED ON INTERVIEWS WITH 41 INDIVIDUAL KEY INFORMANTS AND 22 FOCUS GROUP PARTICIPANTS.- SECONDARY DATA REPORT: THIS REPORT SUMMARIZES THE DISTRIBUTION OF HEALTH INDICATORS AMONG SOCIOECONOMIC GROUPS WITHIN THE CITY AND COUNTY, USING PUBLICLY AVAILABLE DATA SOURCES FROM LOCAL, STATE AND NATIONAL LEVELS. WHILE THESE REPORTS PROVIDE RICH DATA, THEY PRIMARILY FOCUS ON THE ADULT POPULATION ACROSS THE ENTIRE COUNTY. TO ENSURE CHILDREN'S HOSPITAL'S HIGHEST PRIORITY CHILDREN ARE WELL REPRESENTED, WE CONSULTED ADDITIONAL PUBLIC SOURCES WITH THE CITY OF MILWAUKEE AS OUR SCOPE:- KIDS COUNT: FUNDED BY THE ANNIE E. CASEY FOUNDATION, THIS NATIONAL AND STATE-BY-STATE EFFORT TRACKS WELL-BEING INDICATORS FOR CHILDREN IN THE U.S. - U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY: IN ADDITION TO ITS DECENNIAL CENSUS, THE BUREAU COLLECTS AND DISSEMINATES DATA ACROSS A VARIETY OF TOPICS. - YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM (YRBS): THE CENTERS FOR DISEASE CONTROL AND PREVENTION SURVEYS HIGH SCHOOL STUDENTS ON RISKY BEHAVIORS FOR MAJOR CITIES ACROSS THE COUNTRY. THIS SURVEY IS CONDUCTED EVERY FEW YEARS, WITH THE MOST RECENT DATA AVAILABLE FROM THE 2013 SURVEY.- OTHER PUBLIC AND GOVERNMENT SOURCES: ADDITIONAL SOURCES INCLUDE THOSE SUCH AS THE WISCONSIN INTERACTIVE STATISTICS ON HEALTH AND THE MILWAUKEE HOMICIDE REVIEW COMMISSION ANNUAL REPORT. CHILDREN'S HOSPITAL OF WI-FOX VALLEY PART V, SECTION B, LINE 5: THE FOX VALLEY HEALTH IMPROVEMENT COALITION INCLUDES CHILDREN'S HOSPITAL OF WISCONSIN-FOX VALLEY, AFFINITY HEALTH SYSTEM, AURORA HEALTH CARE, THEDACARE; THE HEALTH DEPARTMENTS OF APPLETON, MENASHA AND OUTAGAMIE, CALUMET AND WINNEBAGO COUNTIES; AND REPRESENTATIVES FROM THE STATE DEPARTMENT OF HEALTH SERVICES. TO GET A HOLISTIC PICTURE OF HEALTH IN THE FOX VALLEY, OUR COALITION COMMISSIONS A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. THE CHNAS SERVE AS THE FOUNDATION FROM WHICH HOSPITALS AND LOCAL HEALTH DEPARTMENTS DEVELOP THEIR RESPECTIVE COMMUNITY HEALTH IMPROVEMENT STRATEGIES. THE CHNA FOR THE FOX VALLEY INCLUDES A FEW PRIMARY DATA SOURCES:- FOX VALLEY KEY INFORMANT INTERVIEWS: CONDUCTED BY THE CENTER FOR URBAN POPULATION HEALTH, THIS REPORT OF LOCAL PUBLIC HEALTH PRIORITIES IS BASED ON INTERVIEWS WITH 58 KEY INFORMANTS IN 2015. - FOX VALLEY REGIONAL BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM STUDY: THIS STUDY, CONDUCTED BY THE ST. NORBERT COLLEGE STRATEGIC RESEARCH INSTITUTE IN 2015, GATHERED INPUT FROM 1,758 TELEPHONE INTERVIEWS WITH RESIDENTS. OF THE OVERALL SAMPLE, 250 HOUSEHOLDS HAD CHILDREN UNDER AGE 12 AND WERE INCLUDED IN FURTHER ANALYSIS SPECIFIC TO CHILD HEALTH PRACTICES.- FOX CITIES COMMUNITY MENTAL HEALTH NEEDS ASSESSMENT: CARRIED OUT BY ST. NORBERT COLLEGE STRATEGIC RESEARCH INSTITUTE IN 2015, THIS PROJECT IDENTIFIED LEVELS OF KNOWLEDGE AND PERCEPTIONS OF MENTAL HEALTH IN THE FOX CITIES AREA OF OUTAGAMIE, NORTHERN WINNEBAGO AND NORTHERN CALUMET COUNTIES. IT DRAWS DATA FROM SECONDARY RESEARCH AND FOCUS GROUPS, AS WELL AS SURVEYS FROM THE GENERAL PUBLIC, PROVIDERS, REFERRAL AGENTS, AND CONSUMERS. TO ENSURE THE MOST COMPREHENSIVE REPORT, CHILDREN'S HOSPITAL CONSULTED ADDITIONAL SOURCES:- YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM (YRBS): THIS SURVEY BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION COLLECTS DATA FROM HIGH SCHOOL STUDENTS ON RISKY BEHAVIORS, PROVIDING STATE AND NATIONAL COMPARISONS TO LOCAL OUTCOMES.- LOCAL YOUTH RISK BEHAVIOR SURVEYS: CALUMET COUNTY HIGH SCHOOL YRBS BY INCLUDED INPUT FROM 1,010 STUDENTS. OUTAGAMIE COUNTY HIGH SCHOOL YRBS INCLUDED 3,425 STUDENTS. WINNEBAGO COUNTY HIGH SCHOOL YRBS INCLUDED 5,290 STUDENTS FROM MENASHA, NEENAH, OMRO, OSHKOSH AND WINNECONNE SCHOOL DISTRICTS.- KIDS COUNT: FACILITATED BY THE ANNIE E. CASEY FOUNDATION, THIS NATIONAL AND STATE-BY-STATE EFFORT TRACKS WELL-BEING INDICATORS FOR CHILDREN IN THE U.S. - U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY: IN ADDITION TO ITS DECENNIAL CENSUS, THE BUREAU COLLECTS AND DISSEMINATES DATA ACROSS A VARIETY OF TOPICS. - OTHER PUBLIC AND GOVERNMENT SOURCES: ADDITIONAL SOURCES INCLUDE THOSE SUCH AS WISCONSIN INTERACTIVE STATISTICS ON HEALTH FROM WISCONSIN DEPARTMENT OF HEALTH SERVICES AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE'S COUNTY HEALTH RANKINGS. CHILDREN'S HOSPITAL OF WI-MILWAUKEE PART V, SECTION B, LINE 6A: THE FOLLOWING HOSPITAL FACILITIES WERE INTEGRAL TO THE COMPLETION OF THE MILWAUKEE HEALTH CARE PARTNERSHIP'S COMMUNITY HEALTH NEEDS ASSESSMENT: AURORA HEALTH CARE, COLUMBIA ST. MARY'S HEALTH SYSTEM, FROEDTERT HEALTH, AND WHEATON FRANCISCAN HEALTHCARE. CHILDREN'S HOSPITAL OF WI-FOX VALLEY PART V, SECTION B, LINE 6A: THE FOLLOWING HOSPITAL FACILITIES WERE INTEGRAL TO THE COMPLETION OF THE TRI-COUNTY AREA'S COMMUNITY HEALTH NEEDS ASSESSMENT: AFFINITY HEALTH SYSTEM, AURORA HEALTH CARE, AND THEDACARE. CHILDREN'S HOSPITAL OF WI-MILWAUKEE PART V, SECTION B, LINE 6B: IN ADDITION TO THE HOSPITAL FACILITIES NAMED IN LINE 6A, CHW-MILWAUKEE CONDUCTED ITS CHNA WITH PUBLIC HEALTH OFFICIALS IN THE CITY OF MILWAUKEE AND OTHER MILWAUKEE COUNTY MUNICIPALITIES. THE CENTER FOR URBAN POPULATION HEALTH PREPARED THE PARTNERSHIP'S DATA. CHILDREN'S HOSPITAL'S COMMUNITY HEALTH TEAM PROVIDED ADDITIONAL RESEARCH AND ANALYSIS. CHILDREN'S HOSPITAL OF WI-FOX VALLEY PART V, SECTION B, LINE 6B: IN ADDITION TO THE HOSPITAL FACILITIES NAMED IN LINE 6A, CHW-FOX VALLEY CONDUCTED ITS CHNA WITH THE HEALTH DEPARTMENTS OF APPLETON, MENASHA AND OUTAGAMIE, CALUMET AND WINNEBAGO COUNTIES. THE CENTER FOR URBAN POPULATION HEALTH PREPARED THE KEY INFORMANT REPORT, AND THE ST. NORBERT COLLEGE STRATEGIC RESEARCH INSTITUTE, JKV RESEARCH AND CESA 6 ADMINISTERED THE OTHER TRI-COUNTY SURVEYS. CHILDREN'S HOSPITAL'S COMMUNITY HEALTH TEAM PROVIDED ADDITIONAL RESEARCH AND ANALYSIS. CHILDREN'S HOSPITAL OF WI-MILWAUKEE PART V, SECTION B, LINE 11: WE RECOGNIZE THAT CHILDREN'S HOSPITAL CANNOT COMPLETELY ELIMINATE EVERY CHALLENGE TO CHILDREN'S HEALTH. THESE ISSUES ARE LARGE AND COMPLEX, AND THERE ARE SOCIAL, ENVIRONMENTAL, GENETIC AND BEHAVIORAL FACTORS BEYOND OUR CONTROL. NOR CAN WE SOLVE THESE PROBLEMS ALONE. HOWEVER, AS A LEADER IN PEDIATRIC HEALTH CARE, WE ARE COMMITTED TO WORKING WITH OUR COMMUNITY PARTNERS TO MAKE A DIFFERENCE FOR THE KIDS WHO NEED US MOST. THROUGH PROGRAMMING, COLLABORATION AND EDUCATION, WE CAN LEVERAGE ALL AVAILABLE RESOURCES TO ENSURE THE BEST CARE FOR KIDS IN OUR COMMUNITY. AS THE FOLLOWING SECTIONS DEMONSTRATE, WE ARE ALREADY USING A VARIETY OF STRATEGIES TO MAKE STRIDES TOWARD THESE GOALS AND ARE ACTIVELY WORKING ON INITIATIVES THAT IMPACT ALL SIGNIFICANT NEEDS IDENTIFIED IN THE ASSESSMENT. PRIORITY #1: BEHAVIORAL HEALTHBEHAVIORAL HEALTH ENCOMPASSES BOTH MENTAL HEALTH AND SUBSTANCE ABUSE IT IS NOTED BY THE MILWAUKEE HEALTH CARE PARTNERSHIP'S ASSESSMENT TO BE AMONG MILWAUKEE COUNTY'S GREATEST HEALTH PROBLEMS. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE BEHAVIORAL HEALTH PRIORITY FOLLOW.CHILD PSYCHIATRY CONSULTATION PROGRAMTHERE IS A CRITICAL SHORTAGE OF CHILD PSYCHIATRISTS IN WISCONSIN AND NATIONWIDE. TO HELP FILL THE PROVIDER GAP, THE CHARLES E. KUBLY CHILD PSYCHIATRY CONSULTATION PROGRAM OFFERS ON-CALL CHILD PSYCHIATRISTS, A PSYCHOLOGIST AND RESOURCE COORDINATORS WHO PROVIDE ONGOING EDUCATION AND CONSULTATION TO PRIMARY CARE PROVIDERS ON BEHAVIORAL HEALTH ISSUES. THIS HELPS PRIMARY CARE PROVIDERS TREAT KIDS WITH MENTAL HEALTH ISSUES IN THEIR MEDICAL HOMES SO THAT KIDS CAN MORE QUICKLY GET THE TREATMENT THEY NEED. SINCE THE PROGRAM BEGAN IN 2012, IT HAS ENROLLED PRIMARY CARE PROVIDERS IN CLINICS ACROSS SOUTHEASTERN AND NORTH-CENTRAL WISCONSIN, INCLUDING MILWAUKEE. THE GOAL IS TO EXPAND THE PROGRAM STATEWIDE BY 2018. THIS PROGRAM IS IN THE PROCESS OF EXPANDING ITS REACH TO THE NORTHEAST REGION OF THE STATE IN 2018.SCHOOL-BASED MENTAL HEALTHSCHOOL-BASED MENTAL HEALTH SERVICES ARE A VITAL TOOL FOR MEETING THE NEEDS OF CHILDREN WITH BEHAVIORAL HEALTH ISSUES. THERAPISTS SPEND BETWEEN A HALF DAY A WEEK TO FULL-TIME HOURS DEDICATED TO A PARTICULAR SCHOOL, WHERE THEY PROVIDE ASSESSMENT AND PSYCHOTHERAPY TO CHILDREN WHO REQUIRE IMMEDIATE MENTAL HEALTH INTERVENTION. THE THERAPISTS ALSO OFFER CONSULTATION AND EDUCATION ABOUT MENTAL HEALTH TO EDUCATORS TO SUPPORT POSITIVE CLASSROOM INTERVENTIONS FOR KIDS AND ADOLESCENTS WHO ARE STRUGGLING WITH MENTAL AND BEHAVIORAL CHALLENGES. THIS STATEWIDE INITIATIVE LAUNCHED IN 2012 AND NOW INCLUDES SCHOOLS BETWEEN ALTOONA AND RACINE, PLUS GROUP THERAPIES IN MADISON-AREA SCHOOL DISTRICTS. THE FIVE MILWAUKEE SITES GREATER HOLY TEMPLE CHRISTIAN ACADEMY, PIERCE ELEMENTARY, AUER AVENUE (K-8), MILWAUKEE SCHOOL OF LANGUAGES, AND JAMES MADISON ACADEMIC CAMPUS HAVE THERAPISTS PROVIDING THERAPY SESSIONS TO STUDENTS, AS WELL AS OFFERING CONSULTS TO TEACHERS AND PARENTS. INTEGRATED BEHAVIORAL HEALTHTHIS PILOT PROJECT, FIRST LAUNCHED IN NOVEMBER 2015, USES AN INTEGRATIVE CARE MODEL TO REACH UNDERSERVED POPULATIONS IN THREE CENTRAL-CITY MEDICAL PRACTICES IN MILWAUKEE: NEXT DOOR PEDIATRICS, COA GOLDIN CENTER AND THE NORTHSIDE YMCA. A PSYCHOLOGIST OR PSYCHOTHERAPIST IS PART OF THE MEDICAL TEAM AT EACH SITE, MAKING IT EASY FOR PRIMARY CARE PROVIDERS TO MAKE AN IMMEDIATE AND IN-PERSON REFERRAL FOR PATIENTS WHO NEED MENTAL HEALTH INTERVENTION. THE PSYCHOLOGIST OR PSYCHOTHERAPIST OFFERS MENTAL HEALTH SCREENING; CONSULTATION TO PATIENTS, FAMILIES AND THE MEDICAL TEAM; BRIEF INTERVENTIONS; AND ONGOING PSYCHOTHERAPY. OUTPATIENT CLINICS CHILDREN'S HOSPITAL OFFERS OUTPATIENT MENTAL HEALTH SERVICES AT OVER 20 CLINICS STATEWIDE, INCLUDING THREE OUTPATIENT CLINICS IN MILWAUKEE: THE PSYCHIATRY AND BEHAVIORAL MEDICINE CENTER AT CHILDREN'S HOSPITAL OF WISCONSIN MILWAUKEE CAMPUS, CHILD AND FAMILY COUNSELING MILWAUKEE LOCATED ON 76TH STREET, AND SOJOURNER FAMILY PEACE CENTER AS WELL AS MANY OF OUR CHILDREN'S MEDICAL GROUP PRIMARY CARE CLINICS ACROSS SOUTHEASTERN WISCONSIN. SERVICES INCLUDE INDIVIDUAL, GROUP AND FAMILY THERAPY; TRAUMA-FOCUSED THERAPY; AND (AT SOME LOCATIONS) MEDICATION MANAGEMENT/PSYCHIATRIC SERVICES AND PSYCHOLOGICAL TESTING.IT'S UR CHOICECHILDREN'S HOSPITAL DEVELOPED AND DELIVERS FUN AND ENGAGING E-LEARNING PROGRAMS WHICH ARE OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN, DESIGNED TO INSPIRE STUDENTS TO LEAD HEALTHIER LIVES. USING ONLINE AND CLASSROOM LESSONS, IT'S UR CHOICE HELPS STUDENTS IN GRADES 4 THROUGH 8 MAKE INFORMED, POSITIVE CHOICES WHEN FACED WITH THE PRESSURES OF USING AND ABUSING ALCOHOL, TOBACCO AND OTHER DRUGS. IT MEETS NATIONAL HEALTH EDUCATION STANDARDS AND WAS DEVELOPED USING EVIDENCE-BASED OR INFORMED RESEARCH.TAKE 5 MINDFULNESSCHILDREN'S HOSPITAL DEVELOPED MINDFULNESS RESOURCES THAT ARE AVAILABLE AT NO COST TO SCHOOLS ACROSS WISCONSIN. TAKE 5 PRACTICES ARE AIMED AT INCREASING SELF-AWARENESS DURING MINDFUL PERIODS, AND ARE DESIGNED TO HELP STUDENTS, KINDERGARTEN THROUGH 12TH GRADE, FIND HEALTHY WAYS TO SELF-REGULATE. STUDENTS WHO HAVE EXPERIENCED TOXIC STRESS OR TRAUMA MAY NOT BE ABLE TO SIT QUIETLY WITH THEIR THOUGHTS DURING THESE PRACTICES. MINDFULNESS EXERCISES CAN BE INTEGRATED INTO THE SCHOOL DAY TO INCREASE PERSONAL WELLNESS AND POSITIVE FEELINGS, REDUCE REACTIVITY AND NEGATIVITY, AND IMPROVE OVERALL CLASSROOM CULTURE. ALCOHOL AND OTHER DRUG USE ADVOCACYCHILDREN'S SUPPORTS EFFORTS AND POLICIES THAT AIM TO REDUCE SUBSTANCE ABUSE. CHILDREN'S HAS BEEN A LONG-TIME LEADER IN ADVOCATING FOR STRONGER DUI LAWS, INCLUDING ENHANCED PENALTIES FOR DUI WITH A CHILD IN THE CAR. IN ADDITION, ALONG WITH THE WISCONSIN HOSPITAL ASSOCIATION AND OTHER PARTNERS, CHILDREN'S SUPPORTED A SERIES OF POLICY INITIATIVES COLLECTIVELY KNOWN AS THE HOPE LEGISLATION. THE HOPE AGENDA (HEROIN, OPIATE, PREVENTION, AND EDUCATION) IS A LEGISLATIVE PACKAGE THAT HAS RECEIVED UNANIMOUS BIPARTISAN SUPPORT, AIMED AT COMBATING OUR STATE'S HEROIN EPIDEMIC. CHILDREN'S WILL CONTINUE TO ADVOCATE FOR POLICIES THAT ADDRESS ACCESS TO AND TREATMENT FOR DRUG USE AND ABUSE.PRIORITY #2: PHYSICAL ACTIVITY, NUTRITION, OBESITY AND WEIGHT MANAGEMENT.PHYSICAL ACTIVITY, NUTRITION, OBESITY AND WEIGHT MANAGEMENT ARE CORNERSTONES OF GOOD HEALTH. AS DISCOVERED IN MILWAUKEE HEALTH CARE PARTNERSHIP AND CHILDREN'S COMMUNITY HEALTH NEEDS ASSESSMENTS, THEY ARE ALSO AREAS OF IMPROVEMENT FOR MILWAUKEE YOUTH. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE PHYSICAL ACTIVITY, NUTRITION, OBESITY AND WEIGHT MANAGEMENT PRIORITY FOLLOW.CLINICAL NUTRITION COMMUNITY OUTREACHCHILDREN'S HOSPITAL OFFERS A VARIETY OF NUTRITION EDUCATION PROGRAMS THROUGHOUT THE COMMUNITY. AT THE COA GOLDIN CENTER IN MILWAUKEE, WE'VE PROVIDED HEALTHY SNACKS AT COMMUNITY FUN NIGHTS EVERY OTHER MONTH AND OFFERED THE WHAT'S ON YOUR PLATE PROGRAM, WHICH INTRODUCES FAMILIES TO A HEALTHY LIFESTYLE CURRICULUM ON NUTRITION, COOKING AND PHYSICAL ACTIVITY. OUR CLINICAL NUTRITION STAFF FREQUENTLY PRESENT ON NUTRITION EDUCATION TO GROUPS STATEWIDE, FROM EDUCATING FAMILIES AFFECTED BY CYSTIC FIBROSIS AND PHENYLALANINE KETONURIA (PKU), TO TALKING WITH 1ST THROUGH 4TH GRADERS AT STARMS HEALTH FAIR, TO SHOWING FOSTER CARE YOUTH HOW TO COOK AND GROCERY SHOP AS THEY PREPARE TO LIVE ON THEIR OWN.BLUELOOP APPTHE BLUELOOP APP, WHICH WAS INITIALLY CONCEIVED BY A CHILDREN'S PATIENT FAMILY AND FURTHER DEVELOPED BY OUR DIGITAL TEAM, ALLOWS CHILDREN WITH DIABETES TO RECORD BLOOD SUGAR LEVELS, FOOD INTAKE, INSULIN INJECTIONS AND MORE RIGHT ON THEIR SMART PHONE. THIS INFORMATION IS ALL AVAILABLE TO THE CHILD'S CARE TEAM, HELPING DOCTORS AND THEIR PATIENTS STAY MORE CONNECTED, REDUCE ERRORS AND MAKE APPOINTMENTS MORE EFFICIENT. WHAT STARTED WITH A SINGLE CHILDREN'S FAMILY IS NOW USED BY MORE THAN HALF OF CHILDREN'S PATIENTS WITH DIABETES, AS WELL AS BY CLINICS ACROSS THE COUNTRY. THE BLUELOOP APP IS AVAILABLE ON IOS AND ANDROID.MISSION: HEALTHCHILDREN'S HOSPITAL DEVELOPED AND DELIVERS FUN AND ENGAGING E-LEARNING PROGRAMS, OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN, DESIGNED TO INSPIRE STUDENTS TO LEAD HEALTHIER LIVES. USING ONLINE AND CLASSROOM LESSONS MISSION:HEALTH HELPS STUDENTS IN GRADES K5 THROUGH 8 ESTABLISH HEALTHY HABITS, INCREASE PHYSICAL ACTIVITY AND AVOID CHILDHOOD OBESITY. IT MEETS NATIONAL HEALTH EDUCATION STANDARDS AND WAS DEVELOPED USING EVIDENCE-BASED OR INFORMED RESEARCH. (CONTINUED ON PAGE 63) CHILDREN'S HOSPITAL OF WI-FOX VALLEY PART V, SECTION B, LINE 11: WE RECOGNIZE THAT CHILDREN'S HOSPITAL CANNOT COMPLETELY ELIMINATE EVERY CHALLENGE TO CHILDREN'S HEALTH. THESE ISSUES ARE LARGE AND COMPLEX, AND THERE ARE SOCIAL, ENVIRONMENTAL, GENETIC AND BEHAVIORAL FACTORS BEYOND OUR CONTROL. NOR CAN WE SOLVE THESE PROBLEMS ALONE. HOWEVER, AS A LEADER IN PEDIATRIC HEALTH CARE, WE ARE COMMITTED TO WORKING WITH OUR COMMUNITY PARTNERS TO MAKE A DIFFERENCE FOR THE KIDS WHO NEED US MOST. THROUGH PROGRAMMING, COLLABORATION AND EDUCATION, WE CAN LEVERAGE ALL AVAILABLE RESOURCES TO ENSURE THE BEST CARE FOR KIDS IN OUR COMMUNITY. AS THE FOLLOWING SECTIONS DEMONSTRATE, WE ARE ALREADY USING A VARIETY OF STRATEGIES TO MAKE STRIDES TOWARD THESE GOALS AND ARE ACTIVELY WORKING ON INITIATIVES THAT IMPACT ALL SIGNIFICANT NEEDS IDENTIFIED IN THE ASSESSMENT. PRIORITY #1: MENTAL HEALTHMENTAL HEALTH WAS THE MOST FREQUENTLY RANKED ISSUE IN THE KEY INFORMANT REPORT, WITH MORE RESPONDENTS RANKING IT AS THEIR NUMBER ONE ISSUE THAN ANY OTHER ISSUE. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE MENTAL HEALTH PRIORITY FOLLOW.CATALPA HEALTHCATALPA HEALTH IS A STANDALONE NONPROFIT ORGANIZATION DEDICATED TO PROVIDING COMPREHENSIVE PEDIATRIC MENTAL HEALTH SERVICES IN THE FOX VALLEY. AFTER THE LAST COMMUNITY HEALTH NEEDS ASSESSMENT DEMONSTRATED A CRITICAL NEED FOR PEDIATRIC MENTAL HEALTH SERVICES CLOSE TO HOME, CATALPA HEALTH WAS FORMED AND CONTINUES TO BE SUPPORTED THROUGH A COLLABORATION AMONG CHILDREN'S HOSPITAL, AFFINITY HEALTH SYSTEM, AND THEDACARE. THE ORGANIZATION OPERATES FOUR FACILITIES THROUGHOUT THE FOX VALLEY, INCLUDING THREE OUTPATIENT TREATMENT CENTERS, AN ACCESS CENTER, AND A DAY TREATMENT CENTER. CATALPA PROVIDES ASSESSMENTS FOR A VARIETY OF EMOTIONAL AND MENTAL HEALTH CONCERNS; PSYCHOLOGICAL, NEUROPSYCHOLOGICAL, PSYCHIATRIC AND CONCUSSION EVALUATIONS; MEDICATION MANAGEMENT; INDIVIDUAL, FAMILY AND GROUP THERAPY; AND SCHOOL-BASED MENTAL HEALTH SERVICES. N.E.W. MENTAL HEALTH CONNECTIONN.E.W. MENTAL HEALTH CONNECTION IS A BACKBONE AGENCY LEADING THE COLLABORATION OF COMMUNITY STAKEHOLDERS TO CREATE AND CONTINUOUSLY IMPROVE AN EXCEPTIONAL MENTAL HEALTH SYSTEM OF CARE FOR OUTAGAMIE, CALUMET, AND WINNEBAGO COUNTIES. WITHIN THIS COLLECTIVE IMPACT MODEL, CHILDREN'S HOSPITAL STAFF SIT ON THE BOARD OF DIRECTORS AND CHAIR ONE OF THE ORGANIZATION'S SIX INITIATIVES THE CHILDREN'S MENTAL HEALTH INITIATIVE. THIS INITIATIVE PROVIDES RESOURCES FOR AND COORDINATION OF EDUCATION AND TRAINING REGARDING MENTAL WELLNESS AND MENTAL ILLNESS, APPROPRIATE AND TIMELY MENTAL HEALTH SCREENING, AND ACCESS TO SERVICES FOR CHILDREN, YOUTH AND FAMILIES.ACT NOW!CHILDREN'S HOSPITAL DEVELOPED AND DELIVERS FUN AND ENGAGING E-LEARNING PROGRAMS WHICH ARE OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN AND ARE DESIGNED TO INSPIRE STUDENTS TO LEAD HEALTHIER LIVES. USING ONLINE AND CLASSROOM LESSONS, ACT NOW! HELPS COUNSELORS AND TEACHERS, STUDENTS, PARENTS AND CAREGIVERS INCREASE AWARENESS ABOUT BULLYING AND HAS GIVEN STUDENTS AGE-APPROPRIATE SKILLS NEEDED TO PREVENT AND STOP BULLYING. ACT NOW! IS A COMPREHENSIVE E-LEARNING RESOURCE THAT FOCUSES ON IMPROVING SCHOOL CULTURE ACROSS THE SCHOOL COMMUNITY THROUGH AWARENESS, EDUCATION AND SKILL DEVELOPMENT FOR TEACHERS, COUNSELOR, STUDENTS AND PARENTS. IT MEETS NATIONAL HEALTH EDUCATION STANDARDS AND WAS DEVELOPED USING EVIDENCE-BASED OR INFORMED RESEARCH.TAKE 5 MINDFULNESSCHILDREN'S HOSPITAL DEVELOPED MINDFULNESS RESOURCES THAT ARE AVAILABLE AT NO COST TO SCHOOLS ACROSS WISCONSIN. TAKE 5 PRACTICES ARE AIMED AT INCREASING SELF-AWARENESS DURING MINDFUL PERIODS, AND ARE DESIGNED TO HELP STUDENTS, KINDERGARTEN THROUGH 12TH GRADE, FIND HEALTHY WAYS TO SELF-REGULATE. STUDENTS WHO HAVE EXPERIENCED TOXIC STRESS OR TRAUMA MAY NOT BE ABLE TO SIT QUIETLY WITH THEIR THOUGHTS DURING THESE PRACTICES. MINDFULNESS EXERCISES CAN BE INTEGRATED INTO THE SCHOOL DAY TO INCREASE PERSONAL WELLNESS AND POSITIVE FEELINGS, REDUCE REACTIVITY AND NEGATIVITY, AND IMPROVE OVERALL CLASSROOM CULTURE. MENTAL HEALTH ADVOCACYPOLICY MAKERS HAVE IDENTIFIED BEHAVIORAL HEALTH AS A MAJOR PRIORITY AREA TO IMPROVE OUTCOMES FOR CHILDREN, YOUTH AND ADULTS ALIKE. CHILDREN'S HAS WORKED WITH ELECTED OFFICIALS TO SUPPORT POLICIES THAT INCREASE MENTAL HEALTH ACCESS IN SCHOOL SETTINGS AND ALSO ON POLICY THAT ADDRESSES BUREAUCRATIC HURDLES THAT MAKE PROVIDING CARE DIFFICULT. CHILDREN'S ALSO SUPPORTED THE CREATION OF THE CHILD PSYCHIATRY CONSULTATION PROGRAM TO ASSIST FRONTLINE PROVIDERS IN PROVIDING ENHANCED CARE TO CHILDREN AND ADOLESCENTS WITH MILD OR MODERATE MENTAL HEALTH CARE NEEDS AND IS CURRENTLY ADVOCATING FOR INCREASED FUNDING FOR THIS PROGRAM. CHILDREN'S WILL CONTINUE TO ADVOCATE FOR BETTER ACCESS AND FUNDING FOR BEHAVIORAL HEALTH CARE COORDINATION AND COLLABORATION ACROSS PROVIDERS.PRIORITY #2: ALCOHOL AND OTHER DRUG USEALMOST HALF OF ALL KEY INFORMANTS RANKED ALCOHOL AND DRUG USE AMONG THE REGION'S TOP FIVE HEALTH ISSUES. THEY MENTIONED CULTURAL NORMS AROUND EXCESSIVE DRINKING AND ABUSE OF PRESCRIPTION MEDICATIONS AND OTHER DRUGS. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE ALCOHOL AND OTHER DRUG USE PRIORITY FOLLOW.IT'S UR CHOICECHILDREN'S HOSPITAL HAS CREATED FUN AND ENGAGING E-LEARNING PROGRAMS WHICH ARE OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN, DESIGNED TO INSPIRE STUDENTS TO LEAD HEALTHIER LIVES. USING ONLINE AND CLASSROOM LESSONS, IT'S UR CHOICE HELPS STUDENTS IN GRADES 4 THROUGH 8 MAKE SMART CHOICES WHEN FACED WITH THE PRESSURES OF USING AND ABUSING ALCOHOL, TOBACCO AND OTHER DRUGS. THE E-LEARNING COURSES MEET NATIONAL HEALTH EDUCATION STANDARDS AND WERE DEVELOPED USING EVIDENCE-BASED OR INFORMED RESEARCH.ALCOHOL AND OTHER DRUG USE ADVOCACYCHILDREN'S SUPPORTS EFFORTS AND POLICIES THAT AIM TO REDUCE SUBSTANCE ABUSE. CHILDREN'S HAS BEEN A LONG-TIME LEADER IN ADVOCATING FOR STRONGER DUI LAWS, INCLUDING ENHANCED PENALTIES FOR DUI WITH A CHILD IN THE CAR. IN ADDITION, ALONG WITH THE WISCONSIN HOSPITAL ASSOCIATION AND OTHER PARTNERS, CHILDREN'S SUPPORTED A SERIES OF POLICY INITIATIVES COLLECTIVELY KNOWN AS THE HOPE LEGISLATION. THE HOPE AGENDA (HEROIN, OPIATE, PREVENTION, AND EDUCATION) IS A LEGISLATIVE PACKAGE THAT HAS RECEIVED UNANIMOUS BIPARTISAN SUPPORT, AIMED AT COMBATING OUR STATE'S HEROIN EPIDEMIC. CHILDREN'S WILL CONTINUE TO ADVOCATE FOR POLICIES THAT ADDRESS ACCESS TO AND TREATMENT FOR DRUG USE AND ABUSE.PRIORITY #3: PHYSICAL ACTIVITY AND PRIORITY #4 NUTRITIONALMOST A THIRD OF ALL KEY INFORMANTS RANKED PHYSICAL ACTIVITY AS A TOP FIVE HEALTH ISSUE FOR THE FOX VALLEY REGION, WHILE MORE THAN A QUARTER RANKED NUTRITION AS A TOP FIVE HEALTH ISSUE. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE PHYSICAL ACTIVITY AND NUTRITION PRIORITIES FOLLOW.MISSION:HEALTHCHILDREN'S HOSPITAL DEVELOPED AND DELIVERS FUN AND ENGAGING E-LEARNING PROGRAMS WHICH ARE OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN, DESIGNED TO INSPIRE STUDENTS TO LEAD HEALTHIER LIVES. USING ONLINE AND CLASSROOM LESSONS MISSION:HEALTH HELPS STUDENTS IN GRADES K5 THROUGH 8 ESTABLISH HEALTHY HABITS, INCREASE PHYSICAL ACTIVITY AND AVOID CHILDHOOD OBESITY. THE E-LEARNING COURSES MEET NATIONAL HEALTH EDUCATION STANDARDS AND WERE DEVELOPED USING EVIDENCE-BASED OR INFORMED RESEARCH.CLINICAL NUTRITION CHILDREN'S HOSPITAL OFFERS A VARIETY OF NUTRITION EDUCATION PROGRAMS THROUGHOUT THE COMMUNITY. OUR CLINICAL NUTRITION STAFF FREQUENTLY PRESENT ON NUTRITION EDUCATION TO GROUPS STATEWIDE, INCLUDING SCHOOLS, COMMUNITY ORGANIZATIONS AND FOSTER CARE FAMILIES. BLUELOOP APPTHE BLUELOOP APP, WHICH WAS INITIALLY CONCEIVED BY A CHILDREN'S PATIENT FAMILY AND FURTHER DEVELOPED BY OUR DIGITAL TEAM, ALLOWS CHILDREN WITH DIABETES TO RECORD BLOOD SUGAR LEVELS, FOOD INTAKE, INSULIN INJECTIONS AND MORE RIGHT ON THEIR SMART PHONE. THIS INFORMATION IS ALL AVAILABLE TO THE CHILD'S CARE TEAM, HELPING DOCTORS AND THEIR PATIENTS STAY MORE CONNECTED, REDUCE ERRORS AND MAKE APPOINTMENTS MORE EFFICIENT. WHAT STARTED WITH A SINGLE CHILDREN'S FAMILY IS NOW USED BY MORE THAN HALF OF CHILDREN'S PATIENTS WITH DIABETES, AS WELL AS BY CLINICS ACROSS THE COUNTRY. THE BLUELOOP APP IS AVAILABLE ON IOS AND ANDROID.WEIGHT OF THE FOX VALLEYWEIGHT OF THE FOX VALLEY IS A COMMUNITY HEALTH INITIATIVE DESIGNED TO ADDRESS ACTIVE LIFESTYLES AND HEALTHY HABITS AMONG FOX VALLEY RESIDENTS TO REACH AND MAINTAIN A HEALTHY WEIGHT. CHILDREN'S HOSPITAL PARTICIPATES ON THE LEADERSHIP TEAM PROVIDING DIRECTION AND GUIDANCE, IN ADDITION TO ESTABLISHED ACTION TEAMS THAT ADDRESS ACTIVE COMMUNITIES, EARLY CHILDHOOD, FOOD SYSTEMS, HEALTHCARE, SCHOOLS AND WORKSITE. THROUGH THIS COLLECTIVE IMPACT MODEL, CHILDREN'S HOSPITAL PARTICIPATES PRIMARILY ON THE FOLLOWING INITIATIVES: (CONTINUED ON PAGE 74) CHILDREN'S HOSPITAL OF WI-MILWAUKEE PART V, SECTION B, LINE 16J: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING INVOICES, AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO CHILDREN'S HOSPITAL. THE FULL WRITTEN POLICY IS AVAILABLE ON OUR WEBSITE AND UPON REQUEST. A PLAIN LANGUAGE SUMMARY IS AVAILABLE IN WAITING AREAS. CHILDREN'S HOSPITAL OF WI-FOX VALLEY PART V, SECTION B, LINE 16J: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING INVOICES, AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES HAVE ACCESS TO THE FAP IN THE PATIENT HANDBOOK UPON ADMISSION. THE FULL WRITTEN POLICY IS AVAILABLE ON OUR WEBSITE AND UPON REQUEST. A PLAIN LANGUAGE SUMMARY IS AVAILABLE IN WAITING AREAS. CHILDREN'S HOSPITAL OF WI-MILWAUKEE PART V, SECTION B, LINE 20E: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING INVOICES, AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO THE HOSPITAL. PRIOR TO REFERRING AN ACCOUNT TO A COLLECTION AGENCY OR UNDERTAKING ANY EXTRAORDINARY COLLECTION ACTIONS, CHILDREN'S HOSPITAL WILL MAKE EFFORTS TO COLLECT AMOUNTS DUE, INCLUDING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. AT LEAST 3 BILLING STATEMENTS ARE SENT OVER A PERIOD OF 120 DAYS. CHILDREN'S HOSPITAL MAKES EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED. CHILDREN'S HOSPITAL OF WI-FOX VALLEY PART V, SECTION B, LINE 20E: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING INVOICES, AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO THE HOSPITAL. PRIOR TO REFERRING AN ACCOUNT TO A COLLECTION AGENCY OR UNDERTAKING ANY EXTRAORDINARY COLLECTION ACTIONS, CHILDREN'S HOSPITAL WILL MAKE EFFORTS TO COLLECT AMOUNTS DUE, INCLUDING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. AT LEAST 3 BILLING STATEMENTS ARE SENT OVER A PERIOD OF 120 DAYS. CHILDREN'S HOSPITAL MAKES EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED. PART V, SECTION B, LINE 11 (CONTINUED): PHYSICAL ACTIVITY AND NUTRITION ADVOCACYIN COLLABORATION WITH AMERICAN HEART ASSOCIATION, CHILDREN'S SUPPORTED LEGISLATION THAT REQUIRES DAILY 30 MINUTES OF PHYSICAL EDUCATION IN ELEMENTARY SCHOOLS TO ENSURE THAT CHILDREN HAVE A SAFE AND SUPPORTIVE ENVIRONMENT TO EXERCISE AND BUILD TEAM SKILLS. THIS LEGISLATION HAS NOT BECOME LAW, AND WE WILL CONTINUE TO FOCUS RESOURCES ON ADVOCATING FOR THIS POLICY. ALONG WITH OTHER MEDICAL PARTNERS, CHILDREN'S OPPOSED LEGISLATION THAT WOULD ALLOW UNPASTEURIZED "RAW MILK" TO BE SOLD TO CONSUMERS. CHILDREN'S WILL CONTINUE TO LOOK FOR WAYS TO SUPPORT ACCESS TO HEALTHY FOODS AND INCREASED PHYSICAL ACTIVITY IN OUR COMMUNITIES.PRIORITY #3: CHRONIC DISEASE MANAGEMENT (WE FOCUSED SPECIFICALLY ON ASTHMA)ASTHMA IS A PREVALENT CHRONIC DISEASE FOR CHILDREN IN MILWAUKEE, PUTTING THEM AT GREATER RISK FOR HOSPITALIZATION AND MISSED DAYS IN SCHOOL. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE ASTHMA PRIORITY FOLLOW.WISCONSIN ASTHMA COALITIONSINCE 2001, CHILDREN'S HOSPITAL HAS SUPPORTED THIS DIVERSE, STATEWIDE COALITION THAT WORKS TO TAKE CONTROL OF ASTHMA THROUGH IMPLEMENTATION OF THE WISCONSIN ASTHMA PLAN. THE WISCONSIN ASTHMA PLAN IS A BLUEPRINT FOR MANAGING ASTHMA ACROSS THE STATE, AND INCLUDES THE FOLLOWING ACTIVITIES:- SCHOOL AND CHILDCARE WALKTHROUGH PROGRAM THIS PROGRAM PROVIDES AN ENVIRONMENTAL ASSESSMENT OF SCHOOLS AND CHILDCARE CENTERS FOR ENVIRONMENTAL ASTHMA TRIGGERS AND OFFERS LOW- AND NO-COST REMEDIATION STRATEGIES.- IMPROVING OUTCOMES IN PRACTICAL ASTHMA MANAGEMENT THIS INITIATIVE OFFERS IN-PERSON EDUCATION FOR PRIMARY CARE PROVIDER TEAMS ON HOW TO IMPLEMENT THE NATIONAL ASTHMA GUIDELINES WITHIN THEIR CLINICAL PRACTICE.- ASTHMA MEDICATION ASSISTANCE AT CHAWISCONSIN.ORG/MEDS, THE COALITION HAS COMPILED AN ONLINE RESOURCE OF ALL PRESCRIPTION ASSISTANCE PROGRAMS AND COUPONS AVAILABLE FOR ASTHMA MEDICATIONS.- SCHOOL-BASED ASTHMA MANAGEMENT PROGRAM THIS IS A NATIONAL INITIATIVE OF THE AMERICAN ACADEMY OF ALLERGY, ASTHMA AND IMMUNOLOGY AND THE NATIONAL ASSOCIATION OF SCHOOL NURSES. IT INVOLVES A FOUR-STEP PROCESS TO IMPROVE THE SYSTEM OF CARE AND COMMUNICATION BETWEEN FAMILIES, CLINICIANS AND SCHOOLS.ASTHMA CARE AND ENVIRONMENTAL SERVICESLAUNCHED IN 2015, CHILDREN'S HOSPITAL'S ASTHMA CARE AND ENVIRONMENTAL SERVICES PROGRAM PROVIDES INTENSIVE SELF-MANAGEMENT EDUCATION TO SCHOOL-AGED CHILDREN AND THEIR FAMILIES, ALONG WITH AN ENVIRONMENTAL ASSESSMENT. SERVICE IS PROVIDED AT NO COST TO SCHOOLS ACROSS MILWAUKEE COUNTY.FIGHT ASTHMA MILWAUKEE ALLIESFIGHT ASTHMA MILWAUKEE ALLIES, WHICH IS SUPPORTED BY MEDICAL STAFF AT CHILDREN'S HOSPITAL, IS A COALITION THAT WORKS TO REDUCE AND ELIMINATE DISPARITIES IN ASTHMA CARE AND DEVELOP A SUSTAINABLE STRATEGY FOR ASTHMA CONTROL IN THE COMMUNITY. THE COALITION PROVIDES COMMUNITY-WIDE ASTHMA EDUCATION FOR PARENTS, CAREGIVERS, HEALTH CARE PROFESSIONALS AND SCHOOL STAFF.ASTHMA ADVOCACYCHILDREN'S SUPPORTED LEGISLATION TO INCLUDE E-CIGARETTES ON THE STATEWIDE SMOKING BAN LIST AND SUPPORTED LIMITING E-CIGARETTE USE ON SCHOOL PROPERTY.PRIORITY #4: VIOLENCEWHILE INJURY AND VIOLENCE WERE AMONG THE THREE TOP CONCERNS FOR KEY INFORMANTS ACROSS THE COUNTY, THOSE IN THE CITY OF MILWAUKEE EMPHASIZED VIOLENCE AS THEIR MAJOR CONCERN (INCLUDING YOUTH VIOLENCE, DOMESTIC AND INTIMATE PARTNER VIOLENCE AND CHILDHOOD TRAUMA). OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE VIOLENCE PRIORITY FOLLOW:ACT NOW!CHILDREN'S HOSPITAL HAS CREATED FUN AND ENGAGING E-LEARNING PROGRAMS, OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN, DESIGNED TO INSPIRE STUDENTS TO LEAD HEALTHIER LIVES. USING ONLINE AND CLASSROOM LESSONS ACT NOW! HELPS COUNSELORS AND TEACHERS, STUDENTS, PARENTS AND CAREGIVERS INCREASE AWARENESS ABOUT BULLYING AND HAS GIVEN STUDENTS AGE-APPROPRIATE SKILLS NEEDED TO PREVENT AND STOP BULLYING. ACTNOW! IS A COMPREHENSIVE E-LEARNING RESOURCE THAT FOCUSES ON IMPROVING SCHOOL CULTURE ACROSS THE SCHOOL COMMUNITY THROUGH AWARENESS, EDUCATION AND SKILL DEVELOPMENT FOR TEACHERS, COUNSELORS, STUDENTS AND PARENTS. IT MEETS NATIONAL HEALTH EDUCATION STANDARDS AND WAS DEVELOPED USING EVIDENCE-BASED OR INFORMED RESEARCH.MILWAUKEE CHILD ADVOCACY CENTERTHE MILWAUKEE CHILD ADVOCACY CENTER BRINGS TOGETHER MULTIDISCIPLINARY PARTNERS IN CHILD MALTREATMENT INVESTIGATIONS. IT PROVIDES COMPREHENSIVE MEDICAL, FORENSIC INTERVIEW AND ADVOCACY SERVICES FOR CHILDREN AND FAMILIES IN MILWAUKEE COUNTY. THE POSITIVE PARENTING PROGRAM (TRIPLE P)AS A PILOT PROJECT IN 2016, TRIPLE P IS A UNIVERSAL ACCESS, EVIDENCE-BASED PROGRAM FOR CAREGIVERS OF CHILDREN AGES 0-12. IT AIMS TO INCREASE PARENTS AND CAREGIVERS' KNOWLEDGE OF POSITIVE PARENTING TECHNIQUES. PARENTS AND CAREGIVERS ARE REACHED THROUGH FIVE CHILDREN'S HOSPITAL PRIMARY CARE CLINICS, COMMUNITY HEALTH NAVIGATORS IN FOUR PARTNER NEIGHBORHOODS AND SCHOOL NURSES IN 10 MILWAUKEE PUBLIC SCHOOLS.AWARENESS TO ACTIONA STATEWIDE PROGRAM FIRST LAUNCHED BY CHILDREN'S HOSPITAL IN 2006, AWARENESS TO ACTION EDUCATES AND ADVOCATES FOR ADULTS TO TAKE ACTION TO PREVENT CHILD SEXUAL ABUSE. EDUCATION INCLUDES RESOURCES FOR ADULTS ON HEALTHY SEXUAL DEVELOPMENT AND HOW TO DISCUSS SEXUAL DEVELOPMENT WITH CHILDREN. PERIOD OF PURPLE CRYINGA NEWLY LAUNCHED (2016) PILOT PROJECT, PERIOD OF PURPLE CRYING IS AN EVIDENCE-BASED INFANT ABUSE PREVENTION PROGRAM THAT EDUCATES PARENTS AND CAREGIVERS ABOUT NORMAL INFANT CRYING AND THE DANGERS OF SHAKING AN INFANT. PARENTS AND CAREGIVERS ARE REACHED THROUGH CHILDREN'S HOSPITAL'S NEONATAL INTENSIVE CARE UNIT AND EMERGENCY ROOM, FIVE OF THE CHILDREN'S HOSPITAL PRIMARY CARE CLINICS AND ONE URGENT CARE LOCATION.PREVENT CHILD ABUSE WISCONSINTHIS LONGSTANDING PROGRAM AIMS TO BUILD COMMUNITY RESOURCES, PROVIDE TRAINING AND PUBLIC AWARENESS, AND CARRY OUT ADVOCACY ACTIVITIES IN ORDER TO STRENGTHEN CHILD ABUSE PREVENTION EFFORTS. RECENT PROJECTS FACILITATED IN PART BY PREVENT CHILD ABUSE WISCONSIN INCLUDE THE "SAY SOMETHING, DO SOMETHING AND PINWHEELS FOR PREVENTION CAMPAIGNS TO ENCOURAGE ADULTS STATEWIDE TO TAKE ACTION TO ASSURE CHILDREN GROW UP IN SAFE, STABLE AND NURTURING ENVIRONMENTS. PROJECT UJIMATHE MISSION OF THIS COMMUNITY PROJECT IS TO STOP THE CYCLE OF VIOLENT CRIMES BY REDUCING THE NUMBER OF REPEAT VICTIMS OF VIOLENCE THROUGH INDIVIDUAL, FAMILY AND COMMUNITY INTERVENTIONS AND PREVENTION STRATEGIES. THE PROGRAM'S KEY ELEMENTS INCLUDE HOSPITAL-BASED SERVICES (MEDICAL CARE, PEER SUPPORT, CRISIS INTERVENTION AND SOCIAL AND EMOTIONAL ASSESSMENT), HOME-BASED SERVICES (MEDICAL FOLLOW-UP OF INJURIES, EVALUATION OF PRIMARY HEALTH CARE NEEDS, PSYCHOLOGICAL SCREENING AND COUNSELING), COMMUNITY-BASED SERVICES (MENTORING, YOUTH DEVELOPMENT, FAMILY AND YOUTH SUPPORT GROUPS, GANG INTERVENTIONS, JOB PREPAREDNESS AND ADVOCACY TO ADDRESS LEGAL, EDUCATION AND HOUSING ISSUES), AND COMMUNITY AND PROFESSIONAL EDUCATION ABOUT YOUTH VIOLENCE. MOST OF THE PROGRAM'S REFERRALS COME THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT, IN ADDITION TO REFERRALS FROM IDENTIFIED COMMUNITY PARTNERS.PRIORITY #5: SEXUAL HEALTHTHE MILWAUKEE HEALTH CARE PARTNERSHIP DISCOVERED SEXUAL HEALTH AS A COMMUNITY HEALTH PRIORITY FOR MILWAUKEE COUNTY, NOTING TEEN PREGNANCY AND SEXUALLY TRANSMITTED INFECTIONS AS HIGH CONCERNS, AMONG OTHERS. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE SEXUAL HEALTH PRIORITY FOLLOW.SCHOOL NURSESCHILDREN'S HOSPITAL'S SCHOOL NURSES PLAY A VITAL ROLE BY LEADING SEXUAL HEALTH EDUCATION FOR MILWAUKEE PUBLIC SCHOOLS' HUMAN GROWTH AND DEVELOPMENT CURRICULUM. NURSES USE THE ALWAYS CHANGING PUBERTY EDUCATION PROGRAM, WHICH WAS REVIEWED BY THE AMERICAN ASSOCIATION FOR HEALTH EDUCATION, WITH FOURTH AND FIFTH GRADERS. SINCE 2011, SCHOOL NURSES HAVE BEEN FACILITATING THIS CURRICULUM AT NINE PARTNER SCHOOLS. AN ADDITIONAL SCHOOL WAS ADDED FOR THE 2016-17 SCHOOL YEAR. IN ADDITION TO IMPLEMENTING CLASSROOM EDUCATION, THE NURSES OFFER ADDITIONAL SUPPORT (SUCH AS SMALL-GROUP DISCUSSION) FOR SPECIFIC STUDENTS OR SPECIFIC TOPICS.PRIORITY #6: HEALTH LITERACYTHE MILWAUKEE HEALTH CARE PARTNERSHIP ASSESSMENT IDENTIFIED HEALTH LITERACY AS A COMMUNITY HEALTH NEED, NOTING CHALLENGES FOR COMMUNITY RESIDENTS TO ACCESS AND UNDERSTAND HEALTH INFORMATION. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE HEALTH LITERACY PRIORITY FOLLOW.LANGUAGE SERVICESTHIS PROGRAM PROVIDES FACE-TO-FACE, TELEPHONE AND VIDEO RELAY INTERPRETERS FOR PATIENT FAMILIES WHO DO NOT SPEAK ENGLISH OR WHO HAVE LIMITED SPEECH PROFICIENCY OR HEARING OR SPEECH ISSUES. IN ADDITION TO IN-PERSON INTERPRETERS, CHILDREN'S HOSPITAL CAN ALSO CONNECT FAMILIES VIA TELEPHONE TO INTERPRETERS IN 150 LANGUAGES. THIS SERVICE IS AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK, AT NO COST TO FAMILIES. (CONTINUED ON PAGE 69) PART V, SECTION B, LINE 11 (CONTINUED): PATIENT FAMILY EDUCATION COMMITTEEIN PARTNERSHIP WITH PATIENT FAMILIES, THE CHILDREN'S HOSPITAL EDUCATIONAL SERVICES DEPARTMENT AND PATIENT AND FAMILY EDUCATION COMMITTEE REVIEWS MATERIALS FOR PATIENTS AND FAMILIES TO ENSURE READABILITY SO THAT CAREGIVERS HAVE A CLEAR UNDERSTANDING OF HOW TO BEST CARE FOR THEIR CHILD. PATIENT HANDOUTS ARE USUALLY WRITTEN AT A 5TH THROUGH 7TH GRADE READING LEVEL AND ARE OFFERED IN ENGLISH AND SPANISH.COMMUNITY HEALTH NAVIGATORSFIRST LAUNCHED IN 2011, THIS PROGRAM FOCUSES ON FIVE PARTNER NEIGHBORHOODS IN MILWAUKEE: AMANI/FRANKLIN HEIGHTS, METCALFE PARK, NEAR WEST SIDE NEIGHBORHOODS, LINDSAY HEIGHTS, AND CLARKE SQUARE. COMMUNITY HEALTH NAVIGATORS INCREASE RESIDENTS' PUBLIC HEALTH KNOWLEDGE AND SELF-SUFFICIENCY THROUGH A RANGE OF ACTIVITIES, INCLUDING OUTREACH, COMMUNITY EDUCATION, INFORMAL COUNSELING, SOCIAL SUPPORT AND ADVOCACY. THEY ALSO COLLABORATE WITH INTERNAL AND EXTERNAL PARTNERS TO CONNECT FAMILIES TO NEEDED RESOURCES AND INFLUENCE THE MEDICAL AND SOCIAL DETERMINANTS OF HEALTH. SCHOOL NURSESIT'S NOT ALWAYS EASY FOR CHILDREN TO GET THE HEALTH CARE THEY NEED. SCHOOL NURSES CAN FILL A CRITICAL GAP BY MAKING SURE THAT KIDS GET VISION AND HEARING SCREENS, CARE FOR CHRONIC CONDITIONS SUCH AS DIABETES AND ASTHMA, AND HEALTH AND WELLNESS EDUCATION. THE NURSES, WHO WORK WITHIN TEN PARTNER SCHOOLS IN MILWAUKEE, ALSO HELP COORDINATE CARE WITH PHYSICIANS, SOCIAL WORKERS AND OTHER COMMUNITY RESOURCES. AS A TRUSTED MEMBER OF BOTH MEDICAL AND SCHOOL COMMUNITIES, THE SCHOOL NURSE SERVES AS A BRIDGE TO UNDERSTANDING CLINICAL DIAGNOSIS AND MEDICATION INSTRUCTIONS.STRATEGIES THAT CROSS MULTIPLE PRIORITIESSOME OF OUR STRATEGIES CUT ACROSS THE PRIORITY AREAS THAT HAVE BEEN IDENTIFIED. THESE PARTNERSHIPS AND COLLABORATIVE INITIATIVES ALSO PLAY AN IMPORTANT ROLE IN IMPROVING CHILDREN'S HEALTH.WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILDSINCE 2009, OUR SCHOOL NURSES AND COMMUNITY HEALTH NAVIGATORS HAVE WORKED WITH TEN K-8 SCHOOLS (TEN FOR THE 2016-17 SCHOOL YEAR) IN THE MILWAUKEE PUBLIC SCHOOLS DISTRICT TO IMPLEMENT THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND ASSOCIATION FOR SUPERVISION AND CURRICULUM DEVELOPMENT WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILD MODEL. STRATEGIES RANGE FROM EDUCATION FOR STUDENTS, STAFF AND FAMILIES TO HEALTHY MEAL NIGHTS TO CLASSROOM PHYSICAL ACTIVITY BREAKS. THIS COORDINATED APPROACH TO SCHOOL HEALTH IMPROVES STUDENTS' HEALTH AND THEIR CAPACITY TO LEARN THROUGH THE SUPPORT OF FAMILIES, COMMUNITIES AND SCHOOLS.POPULATION HEALTH MANAGEMENT AND PAYMENT INNOVATIONCHILDREN'S HOSPITAL HAS DEDICATED THIS DIVISION TO SERVE AS A CENTER FOR RESEARCH AND DEVELOPMENT OF BEST-PRACTICE PROGRAMS TO PREVENT ILLNESS, IMPROVE WELLNESS, AND MANAGE HEALTH NEEDS OF POPULATIONS. A TEAM DEDICATED TO THIS WORK DEVELOPS AND TESTS NEW PAYMENT MODELS TO SUPPORT BEST-PRACTICE PROGRAMS AND TRANSITION OUR HEALTH SYSTEM FROM BEING PAID TO TREAT SICK CHILDREN TO BEING PAID TO KEEP CHILDREN HEALTHY. ONCE TESTED AND PROVEN, THE WORK OF THIS TEAM IS INTEGRATED INTO CLINICAL AND CARE MODELS.WITHIN THIS RESEARCH CENTER EXISTS OUR CLINICAL NAVIGATION PROGRAM, WHICH HELPS MILWAUKEE FAMILIES NAVIGATE COMPLEX HEALTH CARE SYSTEMS SO THEY CAN GET THE SERVICES THEY NEED.CHILDREN'S COMMUNITY HEALTH PLANCREATED BY CHILDREN'S HOSPITAL, THIS INSURANCE PLAN SERVES CHILDREN AND ADULTS WHO ARE COVERED BY BADGERCARE PLUS OR WHO PARTICIPATE IN THE COMMERCIAL HEALTH EXCHANGE, ENSURING THAT MORE FAMILIES GET ACCESS TO HIGH-QUALITY HEALTH CARE. OUR HEALTH PLAN FACILITATES A VARIETY OF HEALTH PROMOTION INITIATIVES FOR ITS FAMILIES, INCLUDING A HEALTHY MOMS HEALTHY BABIES PRENATAL CARE PROGRAM, ASTHMA OUTREACH, OUT-OF-HOME CARE AND HEALTHY SHOPPING EDUCATION.CARE FOR KIDSTHE WISCONSIN DEPARTMENT OF HEALTH SERVICES AND THE WISCONSIN DEPARTMENT OF CHILDREN AND FAMILIES HAVE PARTNERED WITH CHILDREN'S HOSPITAL AND OUR HEALTH PLAN FOR LOW-INCOME FAMILIES (CHILDREN'S COMMUNITY HEALTH PLAN) TO ADMINISTER CARE4KIDS. THIS INNOVATIVE PROGRAM OFFERS COMPREHENSIVE AND COORDINATED HEALTH SERVICES FOR CHILDREN IN FOSTER CARE IN SIX SOUTHEASTERN WISCONSIN COUNTIES. THIS INCLUDES MILWAUKEE COUNTY, WHICH ACCOUNTS FOR APPROXIMATELY TWO THIRDS OF THE 3,000 CHILDREN ENROLLED IN THE PROGRAM. THROUGH CARE4KIDS, WE PARTNER WITH PRIMARY CARE PROVIDERS WHO RECOGNIZE THE UNIQUE NEEDS OF THESE CHILDREN. THE PROGRAM CREATES A "MEDICAL HOME" TEAM, CONSISTING OF THE CHILD WELFARE WORKER, FAMILY MEMBERS, FOSTER PARENTS AND OTHER HEALTH CARE PROVIDERS. THIS TEAM DEVELOPS A COMPREHENSIVE HEALTH CARE PLAN BASED ON THE SPECIFIC NEEDS OF THE CHILDREN TAKING INTO ACCOUNT THEIR PHYSICAL, BEHAVIORAL HEALTH, DENTAL AND VISION CARE NEEDS. INSTITUTE FOR CHILD AND FAMILY WELL-BEINGTHIS JOINT INITIATIVE BETWEEN CHILDREN'S HOSPITAL'S COMMUNITY SERVICES DIVISION AND THE UNIVERSITY OF WISCONSIN-MILWAUKEE'S HELEN BADER SCHOOL OF SOCIAL WELFARE AIMS TO IMPROVE THE LIVES OF CHILDREN AND FAMILIES BY DESIGNING AND IMPLEMENTING EFFECTIVE PROGRAMS, CONDUCTING CUTTING-EDGE RESEARCH AND EVALUATION, AND PROMOTING CHANGE THROUGH POLICY AND ADVOCACY. TO FULFILL THIS MISSION, THE INSTITUTE PROMOTES COMMUNITY COLLABORATION TO BRIDGE UNNECESSARY DIVIDES BETWEEN PRACTICE, RESEARCH AND POLICY. ADVOCACYCHILDREN'S IS COMMITTED TO ADVOCATING ON BEHALF OF CHILDREN AND FAMILIES THROUGHOUT WISCONSIN. THROUGH FEDERAL, STATE AND LOCAL LEVEL ADVOCACY EFFORTS, CHILDREN'S FOCUSES ON PUBLIC POLICY THAT IMPROVES THE HEALTH STATUS OF CHILDREN.ADVOCATING FOR POLICY HAS A SIGNIFICANT IMPACT ON OUR COMMUNITIES BEYOND JUST THOSE SERVED BY CHILDREN'S. ALONG WITH VALUABLE PARTNER ORGANIZATIONS, CHILDREN'S HAS SUCCESSFULLY ADVOCATED FOR SEVERAL PIECES OF POLICY RELATED TO THE IDENTIFIED PRIORITIES AND OTHER AREAS IMPORTANT TO THE HEALTH OF CHILDREN AND FAMILIES.CHILDREN'S RESEARCH INSTITUTECHILDREN'S IS COMMITTED TO RESEARCH THAT LEADS TO LIFE-SAVING DISCOVERIES AND CURES, NEW AND BETTER TREATMENTS, AND HEALTHIER AND HAPPIER CHILDREN AND FAMILIES. OUR RESEARCH INSTITUTE STAFF IS TAKING DISCOVERIES FROM THE LABORATORY AND CONVERTING THEM TO NEW THERAPIES AT PATIENTS' BEDSIDES. WE ALSO STUDY OTHER FACTORS THAT IMPACT HEALTH AND QUALITY OF LIFE. WE HAVE HUNDREDS OF INVESTIGATORS, RESEARCH TRAINEES AND TECHNICIANS WORKING ON MORE THAN 1,000 RESEARCH PROJECTS AND ACTIVE CLINICAL TRIALS. OUR RESEARCH IS RELATED TO SEVERAL OF THE IDENTIFIED PRIORITIES AND MANY OTHER AREAS THAT IMPACT CHILDREN AND FAMILIES.EDUCATION OF FUTURE HEALTH CARE PROFESSIONALSWE HELP PROVIDE THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS WITH THE TRAINING THEY NEED TO CARE FOR THE UNIQUE MEDICAL NEEDS OF CHILDREN. THIS INCLUDES PROVIDERS WHO WILL WORK IN SPECIALTY CARE, PRIMARY CARE AND OTHER COMMUNITY-BASED SETTINGS. EACH YEAR, OUR PROVIDERS AND STAFF TEACH HUNDREDS OF MEDICAL STUDENTS, RESIDENTS, FELLOWS, NURSING STUDENTS AND STUDENTS FROM OTHER MEDICAL PROFESSIONS, ENSURING THEY HAVE THE SPECIAL KNOWLEDGE, SKILLS AND EXPERIENCE THEY REQUIRE TO ENSURE THE BEST HEALTH OUTCOMES FOR CHILDREN. PART V, SECTION B, LINE 11 (CONTINUED): - NUTRITION AND PHYSICAL ACTIVITY LEADERSHIP GROUP THIS GROUP CONSISTS OF NUTRITION AND PHYSICAL ACTIVITY EXPERTS WITHIN THE FOX VALLEY REGION. THE GROUP IS PART OF AN "ASK THE EXPERT" PANEL THAT ANSWERS QUESTIONS FROM COUNTY CITIZENS RELATED TO NUTRITION AND EXERCISE SENT THROUGH THE WEBSITE. THE LEADERSHIP GROUP DESIGNS AND EXECUTES INITIATIVES RELATED TO HEALTHY EATING AND EXERCISE.- FOOD SYSTEM ACTION TEAM THIS TEAM PROMOTES HEALTHY EATING AND HEALTHY FOOD PROCUREMENT WITHIN THE SERVICE LOCATIONS. THE TEAM IS WORKING TO INCREASE THE NUMBER OF FRUITS AND VEGETABLES CONSUMED BY CHILDREN IN BEFORE- AND AFTER- SCHOOL PROGRAMS. PHYSICAL ACTIVITY AND NUTRITION ADVOCACYIN COLLABORATION WITH AMERICAN HEART ASSOCIATION, CHILDREN'S SUPPORTED LEGISLATION THAT REQUIRES DAILY 30 MINUTES OF PHYSICAL EDUCATION IN ELEMENTARY SCHOOLS TO ENSURE THAT CHILDREN HAVE A SAFE AND SUPPORTIVE ENVIRONMENT TO EXERCISE AND BUILD TEAM SKILLS. THIS LEGISLATION HAS NOT BECOME LAW, AND WE WILL CONTINUE TO FOCUS RESOURCES ON ADVOCATING FOR THIS POLICY. ALONG WITH OTHER MEDICAL PARTNERS, CHILDREN'S OPPOSED LEGISLATION THAT WOULD ALLOW UNPASTEURIZED "RAW MILK" TO BE SOLD TO CONSUMERS. CHILDREN'S WILL CONTINUE TO LOOK FOR WAYS TO SUPPORT ACCESS TO HEALTHY FOODS AND INCREASED PHYSICAL ACTIVITY IN OUR COMMUNITIES.PRIORITY #5: ASTHMAABOUT A QUARTER OF KEY INFORMANTS RANKED CHRONIC DISEASE AS A TOP HEALTH CONCERN, AND CHILDREN'S HOSPITAL FURTHER PRIORITIZED ASTHMA DUE TO ITS PREVALENCE AMONG CHILDREN AND YOUTH. OUR PROGRAMS AND INITIATIVES THAT ADDRESSES THE ASTHMA PRIORITY FOLLOW.WISCONSIN ASTHMA COALITIONSINCE 2001, CHILDREN'S HOSPITAL HAS SUPPORTED THIS DIVERSE, STATEWIDE COALITION THAT WORKS TO TAKE CONTROL OF ASTHMA THROUGH IMPLEMENTATION OF THE WISCONSIN ASTHMA PLAN. THE WISCONSIN ASTHMA PLAN IS A BLUEPRINT FOR MANAGING ASTHMA ACROSS THE STATE, AND INCLUDES THE FOLLOWING ACTIVITIES:- IMPROVING OUTCOMES IN PRACTICAL ASTHMA MANAGEMENT THIS INITIATIVE OFFERS IN-PERSON EDUCATION FOR PRIMARY CARE PROVIDER TEAMS ON HOW TO IMPLEMENT THE NATIONAL ASTHMA GUIDELINES WITHIN THEIR CLINICAL PRACTICE.- ASTHMA MEDICATION ASSISTANCE AT CHAWISCONSIN.ORG/MEDS, THE COALITION HAS COMPILED AN ONLINE RESOURCE OF ALL PRESCRIPTION ASSISTANCE PROGRAMS AND COUPONS AVAILABLE FOR ASTHMA MEDICATIONS.ASTHMA ADVOCACYCHILDREN'S SUPPORTED LEGISLATION TO INCLUDE E-CIGARETTES ON THE STATEWIDE SMOKING BAN LIST AND SUPPORTED LIMITING E-CIGARETTE USE ON SCHOOL PROPERTY.STRATEGIES THAT CROSS MULTIPLE PRIORITIESSOME OF OUR STRATEGIES CUT ACROSS THE PRIORITY AREAS. THESE PARTNERSHIPS AND COLLABORATIVE INITIATIVES ALSO PLAY AN IMPORTANT ROLE IN IMPROVING CHILDREN'S HEALTH.RE:TH!NKCHILDREN'S HOSPITAL PARTICIPATES IN WINNEBAGO COUNTY'S HEALTHY LIVING PARTNERSHIP, RE:TH!NK, FACILITATED BY THE WINNEBAGO COUNTY HEALTH DEPARTMENT. RE:TH!NK FOCUSES ON CREATING AN ENVIRONMENT WHERE EVERYONE HAS THE OPPORTUNITY TO LIVE THE HEALTHIEST LIFE POSSIBLE, IMPLEMENTING STRATEGIES WHICH IMPACT MENTAL HEALTH, SUBSTANCE ABUSE, NUTRITION, PHYSICAL ACTIVITY, AND MORE. CHILDREN'S COMMUNITY HEALTH PLANCREATED BY CHILDREN'S HOSPITAL, THIS INSURANCE PLAN SERVES MORE THAN 130,000 CHILDREN AND ADULTS WHO ARE COVERED BY BADGERCARE PLUS OR WHO PARTICIPATE IN THE COMMERCIAL HEALTH EXCHANGE, ENSURING THAT MORE FAMILIES GET ACCESS TO HIGH-QUALITY HEALTH CARE. OUR HEALTH PLAN FACILITATES A VARIETY OF HEALTH PROMOTION INITIATIVES FOR ITS FAMILIES, SUCH AS HEALTHY SHOPPING EDUCATION AND PRENATAL EDUCATION AND REFERRALS.INSTITUTE FOR CHILD AND FAMILY WELL-BEINGTHIS JOINT INITIATIVE BETWEEN THE CHILDREN'S HOSPITAL'S COMMUNITY SERVICES DIVISION AND UNIVERSITY OF WISCONSIN-MILWAUKEE'S HELEN BADER SCHOOL OF SOCIAL WELFARE AIMS TO IMPROVE THE LIVES OF CHILDREN AND FAMILIES BY DESIGNING AND IMPLEMENTING EFFECTIVE PROGRAMS, CONDUCTING CUTTING-EDGE RESEARCH AND EVALUATION, AND PROMOTING CHANGE THROUGH POLICY AND ADVOCACY. TO FULFILL THIS MISSION, THE INSTITUTE PROMOTES COMMUNITY COLLABORATION TO BRIDGE UNNECESSARY DIVIDES BETWEEN PRACTICE, RESEARCH AND POLICY. NORTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDSTHE NORTHEAST REGIONAL CENTER IS ONE OF FIVE REGIONAL CENTERS ACROSS THE STATE, FUNDED THROUGH THE WISCONSIN DEPARTMENT OF HEALTH SERVICES' TITLE V CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS PROGRAM AND MATERNAL CHILD HEALTH PROGRAM LOCATED IN THE DIVISION OF PUBLIC HEALTH. CHILDREN'S HOSPITAL FACILITATES THE GRANT FOR THE NORTHEAST CENTER, PRIORITIZING:1. MEDICAL HOMES - CHILDREN AND YOUTH RECEIVE COORDINATED, ONGOING, AND COMPREHENSIVE CARE.2. TRANSITION - YOUTH RECEIVE THE SERVICES NECESSARY TO MAKE TRANSITIONS TO ALL ASPECTS OF ADULT LIFE, INCLUDING ADULT HEALTH CARE, WORK, AND INDEPENDENCE.3. FAMILY LEADERSHIP - FAMILIES ARE PARTNERS IN SHARED DECISION-MAKING FOR THE CHILD'S OPTIMAL HEALTH.THE NORTHEAST REGIONAL CENTER WORKS TOWARD THESE PRIORITIES BY PROVIDING INFORMATION AND RESOURCES TO FAMILIES AND THE PROVIDERS SERVING THOSE FAMILIES, AND BY BUILDING SYSTEMS AT THE COMMUNITY, COUNTY, AND STATE LEVELS. WISCONSIN MEDICAL HOME INITIATIVETHE WISCONSIN MEDICAL HOME INITIATIVE PROMOTES CHILDREN'S HEALTH AND DEVELOPMENT THROUGH ITS DIRECT SUPPORT TO PRIMARY CARE CLINICIANS AND FAMILIES. TRAINING, TECHNICAL ASSISTANCE, AND RESOURCES ARE PROVIDED TO SUPPORT MEDICAL HOME IMPLEMENTATION WITH A FOCUS ON DEVELOPMENTAL SCREENING, BEHAVIORAL HEALTH INTEGRATION, AND FAMILY PARTNERSHIP. THIS PROGRAM IS AN INITIATIVE OF CHILDREN'S HEALTH ALLIANCE OF WISCONSIN AND IS SUPPORTED BY CHILDREN'S HOSPITAL. FUNDING IS PROVIDED THROUGH THE WISCONSIN DEPARTMENT OF HEALTH SERVICES' TITLE V CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS PROGRAM AND MATERNAL CHILD HEALTH PROGRAM LOCATED IN THE DIVISION OF PUBLIC HEALTH.ADVOCACYCHILDREN'S IS COMMITTED TO ADVOCATING ON BEHALF OF CHILDREN AND FAMILIES THROUGHOUT WISCONSIN. THROUGH FEDERAL, STATE AND LOCAL LEVEL ADVOCACY EFFORTS, CHILDREN'S FOCUSES ON PUBLIC POLICY THAT IMPROVES THE HEALTH STATUS OF CHILDREN.ADVOCATING FOR POLICY HAS A SIGNIFICANT IMPACT ON OUR COMMUNITIES BEYOND JUST THOSE SERVED BY CHILDREN'S. ALONG WITH VALUABLE PARTNER ORGANIZATIONS, CHILDREN'S HAS SUCCESSFULLY ADVOCATED FOR SEVERAL PIECES OF POLICY RELATED TO THE IDENTIFIED PRIORITIES AND OTHER AREAS IMPORTANT TO THE HEALTH OF CHILDREN AND FAMILIES.CHILDREN'S RESEARCH INSTITUTECHILDREN'S IS COMMITTED TO RESEARCH THAT LEADS TO LIFE-SAVING DISCOVERIES AND CURES, NEW AND BETTER TREATMENTS, AND HEALTHIER AND HAPPIER CHILDREN AND FAMILIES. OUR RESEARCH INSTITUTE STAFF IS TAKING DISCOVERIES FROM THE LABORATORY AND CONVERTING THEM TO NEW THERAPIES AT PATIENTS' BEDSIDES. WE ALSO STUDY OTHER FACTORS THAT IMPACT HEALTH AND QUALITY OF LIFE. WE HAVE HUNDREDS OF INVESTIGATORS, RESEARCH TRAINEES AND TECHNICIANS WORKING ON MORE THAN 1,000 RESEARCH PROJECTS AND ACTIVE CLINICAL TRIALS. OUR RESEARCH IS RELATED TO SEVERAL OF THE IDENTIFIED PRIORITIES AND MANY OTHER AREAS THAT IMPACT CHILDREN AND FAMILIES.EDUCATION OF FUTURE HEALTH CARE PROFESSIONALSWE HELP PROVIDE THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS WITH THE TRAINING THEY NEED TO CARE FOR THE UNIQUE MEDICAL NEEDS OF CHILDREN. THIS INCLUDES PROVIDERS WHO WILL WORK IN SPECIALTY CARE, PRIMARY CARE AND OTHER COMMUNITY-BASED SETTINGS. EACH YEAR, OUR PROVIDERS AND STAFF TEACH HUNDREDS OF MEDICAL STUDENTS, RESIDENTS, FELLOWS, NURSING STUDENTS AND STUDENTS FROM OTHER MEDICAL PROFESSIONS, ENSURING THEY HAVE THE SPECIAL KNOWLEDGE, SKILLS AND EXPERIENCE THEY REQUIRE TO ENSURE THE BEST HEALTH OUTCOMES FOR CHILDREN. 3 1 - CHILD ADVOCACY CENTER - FOX VALLEY 325 N COMMERCIAL ST SUITE 400 NEENAH WI 54956 PATIENT CARE SERVICES 2 - CHILD ADVOCACY CENTER - WAUKESHA 726 N EAST AVE WAUKESHA WI 53186 PATIENT CARE SERVICES 3 - CHILD ADVOCACY CENTER - GREEN BAY 503 S MONROE AVE GREEN BAY WI 54301 PATIENT CARE SERVICES PART I, LINE 3C: CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHILDREN'S HOSPITAL") USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY AT BOTH OF ITS HOSPITAL SITES. CHILDREN'S HOSPITAL IS DEDICATED TO ENSURING THAT PATIENTS RECEIVE ALL MEDICALLY NECESSARY CARE. IN FURTHERANCE OF THAT OBJECTIVE, CHILDREN'S HOSPITAL MAINTAINS A FINANCIAL ASSISTANCE POLICY ("FAP"), PURSUANT TO WHICH CHILDREN'S HOSPITAL PROVIDES DISCOUNTED OR FREE CARE TO PATIENTS WHO ARE UNINSURED OR OTHERWISE UNABLE TO PAY ALL OR A PORTION OF THEIR BILLED CHARGES. THE POLICY GENERALLY PROVIDES THAT ELIGIBILITY IS DETERMINED BASED ON HOUSEHOLD INCOME AND FAMILY SIZE, AND SPECIFICALLY INCORPORATES CRITERIA SET FORTH UNDER THE FEDERAL POVERTY GUIDELINES. PART I, LINE 6A: CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE SOLE CORPORATE MEMBER OF CHILDREN'S HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF BOTH OF THE HOSPITALS AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON CHILDREN'S HOSPITAL'S WEBSITE OR UPON REQUEST. PART I, LINE 7: CHILDREN'S HOSPITAL USED A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, TO CALCULATE THE AMOUNTS REPORTED IN LINES 7A AND 7B FOR CHARITY CARE AT COST AND UNREIMBURSED MEDICAID. FOR LINES 7E, 7F, 7G, 7H, AND 7I, THE HOSPITAL USED COSTS FROM ITS ACCOUNTING SYSTEM. FOR LINE 7G, THE COSTS FROM THE ACCOUNTING SYSTEM WERE ADJUSTED FOR MEDICAID AND CHARITY CARE PATIENTS, AS THE COST RELATED TO THESE PATIENTS WAS TAKEN INTO ACCOUNT IN LINES 7A AND 7B. THE WISCONSIN MEDICAID PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED OR UNDERINSURED. HOSPITAL REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND THE AVAILABILITY OF STATE AID AND TO ASSIST THEM IN ENROLLING IN THE PROGRAM THAT PROVIDES THE PATIENT WITH THE GREATEST BENEFIT. FOR THAT REASON, THE AMOUNT OF CHARITY CARE RENDERED BY THE HOSPITAL IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION. PART I, LINE 7G: CHILDREN'S HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7G $5,792,476 PAID TO CHILDREN'S MEDICAL GROUP, INC. ("CMG"), WHICH IS A SECTION 501(C)(3) ORGANIZATION AND AN AFFILIATE OF THE HOSPITAL THAT PROVIDES PRIMARY CARE PHYSICIAN SERVICES IN SOUTHEASTERN WISCONSIN. THE PAYMENTS WERE MADE TO SUBSIDIZE CMG CLINICS WITHIN MILWAUKEE COUNTY THAT PROVIDE PRIMARY CARE PRIMARILY TO CHILDREN ENROLLED IN THE WISCONSIN MEDICAID PROGRAM OR WHO ARE UNINSURED. PART II, COMMUNITY BUILDING ACTIVITIES: CHILDREN'S HOSPITAL'S COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS FOR CHILDREN, SUCH AS POVERTY AND ENVIRONMENTAL ISSUES. THESE COMMUNITY-BUILDING ACTIVITIES INCLUDE STAFF PARTICIPATION ON COMMUNITY BOARDS, COALITIONS AND/OR COMMITTEES THAT ASSIST IN IMPROVING THE HEALTH OF THE COMMUNITY. CHILDREN'S HOSPITAL'S PARENT ORGANIZATION, CHHS, ALSO PERFORMS COMMUNITY-BUILDING ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT ADVOCACY, WHICH ARE FURTHER DISCUSSED IN SCHEDULE H PART VI, LINE 6. PART III, LINE 2: THE AMOUNT REPORTED IN PART III, SECTION A, LINE 2 IS CHILDREN'S HOSPITAL'S BAD DEBT EXPENSE INCLUDED AS A REDUCTION OF PATIENT REVENUE, AND IS THE SUM OF ALL OF THE UNCOLLECTED PATIENT ACCOUNT BALANCES SENT TO THIRD PARTY COLLECTIONS, REDUCED BY ACTUAL RECOVERIES, REDUCED BY ANY ACCOUNTS RETURNED TO THE HOSPITAL BY THE THIRD PARTY COLLECTION AGENCY, AND INCREASED BY AN ESTIMATE FOR UNCOLLECTIBLE ACCOUNTS WHEN APPLICABLE. THE AMOUNT DOES NOT INCLUDE DISCOUNTS PROVIDED UNDER THE HOSPITAL'S FAP, INCLUDING DISCOUNTS PROVIDED TO SELF-PAY ACCOUNTS, WHICH ARE ALSO REPORTED AS A REDUCTION OF PATIENT REVENUE. PART III, LINE 4: CHILDREN'S HOSPITAL'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. SEE PAGES 26-27 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: CHILDREN'S HOSPITAL USED ITS FILED MEDICARE COST REPORT TO OBTAIN THE MEDICARE ALLOWABLE COST REPORTED ON PART III, SECTION B. AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE THESE MEDICALLY NECESSARY SERVICES TO THIS POPULATION. PART III, LINE 9B: AT ALL LOCATIONS, CHILDREN'S HOSPITAL UNDERTAKES EXTENSIVE MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, CHILDREN'S HOSPITAL AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE MEDICAID PROGRAM. IN CASES WHERE MEDICAID COVERAGE IS NOT AVAILABLE, CHILDREN'S HOSPITAL SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER CHILDREN'S HOSPITAL'S FAP. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, HOSPITAL PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES; SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNTS DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS' ELIGIBILITY FOR FINANCIAL ASSISTANCE CANNOT BE DETERMINED DUE TO THE INACCESSIBILITY OF THE FAMILY, OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION. IN SUCH CASES, CHILDREN'S HOSPITAL FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS IN AN EFFORT TO REACH THE FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ACCOUNTS ARE SENT TO COLLECTIONS ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN WITHOUT SUCCESS. PART VI, LINE 2: IN MILWAUKEE AND THE FOX VALLEY COMMUNITIES, THE HOSPITALS, IN COLLABORATION WITH A TEAM OF OTHER HOSPITAL SYSTEMS, HEALTH CARE PROVIDERS, COMMUNITY AGENCIES, LOCAL PUBLIC HEALTH DEPARTMENTS, COMMUNITY STAKEHOLDERS OR OTHER HEALTH PROFESSIONALS, HAS DEVELOPED A COMMUNITY NEEDS ASSESSMENT SURVEY TO ASSESS THE NEEDS OF THE COMMUNITY. THE ASSESSMENTS ARE REFLECTIVE OF INPUT GATHERED IN BOTH INDIVIDUAL INTERVIEWS AND SMALL FOCUS GROUPS, AS WELL AS PRIMARY AND SECONDARY DATA ANALYSIS. IN ADDITION, CHW-MILWAUKEE CONDUCTED A THOROUGH REVIEW OF ADDITIONAL SECONDARY DATA SUCH AS THE WISCONSIN FAMILY HEALTH SURVEY, COUNTY HEALTH RANKING REPORT AND THE WISCONSIN HEALTHIEST PEOPLE 2020 TO ASSESS THE NEEDS OF THE COMMUNITY. THE SECONDARY DATA ALLOWED FOR CHILDREN'S TO GAIN A DEEPER UNDERSTAND OF THE IDENTIFIED COMMUNITY HEALTH ISSUES RELATED TO A PEDIATRIC POPULATION. PART VI, LINE 3: CHILDREN'S HOSPITAL WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF WISCONSIN, AND WHERE APPROPRIATE, FEDERAL PROGRAMS. WHEN SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER CHILDREN'S HOSPITAL'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON CHILDREN'S HOSPITAL'S WEBSITE AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENTS' FAMILIES. A PLAIN LANGUAGE SUMMARY IS AVAILABLE IN WAITING AREAS. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND CHILDREN'S HOSPITAL'S TRAINED FINANCIAL SERVICES COUNSELORS AND SOCIAL WORKERS. CHILDREN'S HOSPITAL MAKES EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED. PART VI, LINE 4: CHILDREN'S HOSPITAL PROVIDES CARE TO CHILDREN FROM URBAN, RURAL, AND SUBURBAN AREAS, REGARDLESS OF RACE, GENDER, ETHNICITY, INCOME, DISABILITY, OR COUNTRY OF ORIGIN AT BOTH OF ITS HOSPITAL SITES. CHILDREN'S HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE PRIMARILY TO CHILDREN FROM SOUTHEASTERN WISCONSIN, BUT TREATS PATIENTS FROM THE ENTIRE STATE OF WISCONSIN AND THROUGHOUT THE UNITED STATES. APPROXIMATELY HALF OF CHILDREN'S HOSPITAL'S PATIENTS ARE MEDICAID BENEFICIARIES, AND IN 2017 APPROXIMATELY HALF OF GROSS CHARGES WERE FROM PATIENTS ENROLLED IN MEDICAID. PART VI, LINE 5: CHILDREN'S HOSPITAL PROMOTES THE HEALTH AND SAFETY OF CHILDREN LOCATED THROUGHOUT ITS SERVICE AREA. CHILDREN'S HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. CHILDREN'S HOSPITAL'S BOARD OF DIRECTORS CONSISTS OF INDIVIDUALS REPRESENTING THE COMMUNITY. CHILDREN'S HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AT BOTH HOSPITAL SITES, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTH CARE PROFESSIONALS, AS SET FORTH IN THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS. CHILDREN'S HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. IN THESE AND OTHER RESPECTS, CHILDREN'S HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). CHILDREN'S HOSPITAL OFFERS SPECIALTY CLINICS THAT ARE COMFORTABLE AND ACCESSIBLE TO FAMILIES. IN MILWAUKEE, CHILDREN'S HOSPITAL OFFERS CLINICS THROUGHOUT THE CITY. FAMILIES MAY ALSO ACCESS SERVICES IN THE FOX VALLEY, GREEN BAY, NEW BERLIN, MEQUON, DELAFIELD AND KENOSHA AREAS. IN RESPONSE TO FEEDBACK FROM THE COMMUNITY GAINED THROUGH LISTENING SESSIONS, CHILDREN'S HOSPITAL, THROUGH ITS AFFILIATE, CHILDREN'S MEDICAL GROUP, HAS ADDED CLINICS IN AREAS OF THE CENTRAL CITY PREVIOUSLY LACKING PEDIATRIC PRIMARY CARE PROVIDERS.CHILDREN'S HOSPITAL FUNDS FULL-TIME SCHOOL NURSES IN 10 PARTNER MILWAUKEE PUBLIC SCHOOLS AND PART-TIME NURSING SERVICES IN AN ADDITIONAL TWO MPS SCHOOLS AT NO COST TO THE STUDENTS, FAMILIES OR SCHOOLS. THE NURSES PROVIDE CHRONIC DISEASE MANAGEMENT, ACUTE CARE FOR MINOR ILLNESS AND INJURIES, HEALTH MAINTENANCE AND PROMOTION, PREVENTIVE CARE, RISK REDUCTION, SCREENINGS INCLUDING REFERRALS AND FOLLOW UP, TRAUMA INFORMED CARE, AND CARE COORDINATION IN AN AREA WITH HIGH-RISK POPULATIONS AND LIMITED SERVICES. IN 2017, THERE WERE 15,100 SCHOOL NURSE ENCOUNTERS WITH A 94% RETURN TO CLASS RATE. VISION SCREENINGS WERE COMPLETED ON 1,599 STUDENTS AND OVER 750 REFERRALS WERE MADE FOR ADDITIONAL CARE NEEDS DISCOVERED DURING A SCHOOL NURSE OFFICE VISIT. THE SCHOOL NURSES ALSO PROVIDE CLASSROOM EDUCATION TO STUDENTS AND FACULTY ON A VARIETY OF HEALTH RELATED TOPICS ACCORDING TO THE NEEDS OF THE SCHOOL, AND WORK CLOSELY WITH THE COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS ON POPULATION-BASED CARE, OUTREACH, AND ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH.CHILDREN'S HOSPITAL OFFERS MANY OPTIONS FOR FAMILIES WHO NEED ACCESS TO MENTAL HEALTH PROVIDERS. THE HOSPITAL OFFERS PSYCHIATRISTS, PSYCHOLOGISTS, NEUROPSYCHOLOGISTS, PSYCHOTHERAPISTS AND NURSE PRACTITIONERS WHO PROVIDE MENTAL HEALTH DIAGNOSIS AND TREATMENT FOR A VARIETY OF DISORDERS. HOSPITAL COUNSELORS WORK WITH CHILDREN AND FAMILIES TO ADDRESS SOCIAL AND EMOTIONAL DIFFICULTIES AND STRENGTHEN FAMILY TIES.CHILDREN'S HOSPITAL ALSO OFFERS PROGRAMS TO EDUCATE CHILDREN AND FAMILIES REGARDING A WIDE RANGE OF ISSUES IMPACTING THE HEALTH AND SAFETY OF CHILDREN. RESOURCES AND PROGRAMS ARE AVAILABLE FOR CHILDREN, PARENTS, TEACHERS, AND CAREGIVERS TO HELP KEEP WISCONSIN'S CHILDREN HEALTHY AND SAFE. ONLINE LEARNING PROGRAMS ARE A RESOURCE FOR TEACHERS TO USE IN THEIR CLASSROOMS TO DELIVER AN OUTCOMES-BASED HEALTH CURRICULUM TO STUDENTS IN GRADE K5-8. THE INJURY PREVENTION TEAM OFFERS COMMUNITY-BASED EDUCATIONAL EVENTS INCLUDING BIKE HELMET FITTINGS AND CAR SEAT CHECKS. THEY ALSO DELIVER IMPORTANT FIRE PROTECTION AND PEDESTRIAN SAFETY EDUCATION THROUGHOUT WISCONSIN. IN 2017, CHILDREN'S HOSPITAL CONTINUED ITS PARTNERSHIP WITH KOHL'S CORPORATION ON A WEBSITE/MOBILE APP/TOUR RELATED TO INJURY PREVENTION IN THE HOME CALLED KOHL'S CARES GROW SAFE AND HEALTHY PROGRAM. THE PROGRAM IS DESIGNED TO MAKE WISCONSIN KIDS AND FAMILIES AWARE OF SAFETY RISKS IN AND OUT OF THEIR HOMES, AND THE NECESSARY STEPS TO HELP AVOID INJURY. CHILDREN'S HOSPITAL'S CAR SEAT CLINIC IS A COLLABORATION BETWEEN CHILDREN'S HOSPITAL, ITS INJURY PREVENTION PROGRAM, SAFE KIDS WISCONSIN COALITION AND SAFE KIDS SOUTHEAST WISCONSIN COALITION. IT OFFERS CAR SEAT CLINICS IN TWO LOCATIONS NEAR THE MILWAUKEE HOSPITAL CAMPUS AND DOWNTOWN MILWAUKEE. TRAINED CHILD PASSENGER SAFETY TECHNICIANS MAKE CERTAIN THAT INFANT AND TODDLER CAR SEATS AND BOOSTER SEATS ARE INSTALLED CORRECTLY AND ARE APPROPRIATE FOR THE AGE AND SIZE OF THE CHILDREN USING THEM. THE PROGRAM ALSO PROVIDES LOW-COST OR FREE CAR OR BOOSTER SEATS FOR FAMILIES IN NEED.THE WISCONSIN POISON CENTER, WHICH IS STAFFED BY REGISTERED NURSES SUPPORTED BY PHYSICIAN TOXICOLOGISTS 24 HOURS A DAY, 365 DAYS A YEAR, PROVIDES IMMEDIATE AND AUTHORITATIVE PHONE CONSULTATION IN CASES OF ACCIDENTAL OR INTENTIONAL POISONING IN ADULTS AND CHILDREN FOR PATIENTS AND HOSPITALS ACROSS WISCONSIN. THE CENTER ALSO HAS A VARIETY OF PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS ALERTING PEOPLE TO SPECIFIC TOXIC DANGERS. THESE INCLUDE HOSPITAL GRAND ROUNDS LECTURES FOR PHYSICIANS, TRAINING FOR EMERGENCY MEDICAL TECHNICIANS, BABY SITTER WORKSHOPS, AND PRESCHOOL POISON PREVENTION EDUCATION. THE POISON CENTER ALSO TRIAGES CALLS FOR MPOWER, AN ALCOHOL AND DRUG CRISIS LINE FOR TEENS. PROJECT ADAM (AUTOMATIC DEFIBRILLATORS IN ADAM'S MEMORY) IS A PROGRAM COMMITTED TO MAKING AUTOMATED EXTERNAL DEFIBRILLATORS UNIVERSALLY AVAILABLE TO ALL CHILDREN AND ADOLESCENTS BY BEING A NATIONAL RESOURCE FOR IMPLEMENTING PEDIATRIC PUBLIC ACCESS DEFIBRILLATION PROGRAMS IN SCHOOLS. IT IS ALSO WORKING TOWARD ERADICATING SUDDEN CARDIAC DEATH IN CHILDREN THROUGH EDUCATION AND PREVENTION INITIATIVES. SINCE THE PROGRAM BEGAN, THE HOSPITAL HAS CELEBRATED MORE THAN 130 LIVES SAVED THROUGH PROJECT ADAM. ADDITIONALLY, CHILDREN'S HOSPITAL OPERATES CHILD ADVOCACY CENTERS IN MILWAUKEE, RACINE, KENOSHA, WALWORTH COUNTY, NORTH CENTRAL WISCONSIN (WAUSAU), THE FOX VALLEY, AND CHIPPEWA VALLEY (EAU CLAIRE). EACH CENTER IS A SAFE PLACE FOR KIDS WHO MAY HAVE BEEN ABUSED OR NEGLECTED. THE CENTERS BRING TOGETHER A TEAM OF SPECIALLY TRAINED PROFESSIONALS WHO EVALUATE AND INVESTIGATE CASES OF CHILD ABUSE, PROVIDE MEDICAL CARE AND HELP CHILDREN AND THEIR FAMILIES HEAL. THE CENTERS ARE A COLLABORATION OF CHILDREN'S HOSPITAL AND DOZENS OF AREA LAW ENFORCEMENT, JUDICIAL AND SOCIAL SERVICE ORGANIZATIONS.CHILDREN'S HOSPITAL IS A FOUNDING AND ONGOING PARTNER IN THE SOJOURNER FAMILY PEACE CENTER, WHICH PROVIDES A SINGLE LOCATION FOR SERVICES FOR MILWAUKEE WOMEN AND CHILDREN IMPACTED BY FAMILY VIOLENCE. THE CENTER ALSO PROVIDES SPACE FOR THE DISTRICT ATTORNEY AND MILWAUKEE POLICE DEPARTMENT SENSITIVE CRIMES UNITS TO HELP SUPPORT AND PROTECT THESE VULNERABLE WOMEN AND CHILDREN.CHILDREN'S HOSPITAL'S SPECIAL NEEDS PROGRAM OFFERS COMPREHENSIVE CARE COORDINATION FOR CHILDREN WITH MULTIPLE MEDICAL NEEDS. THE GOAL IS TO ENSURE FAMILIES HAVE THE BEST POSSIBLE CARE IN AND OUT OF THE HOSPITAL. CHILDREN'S HOSPITAL PARTNERS WITH PATIENTS, FAMILIES, PRIMARY CARE AND OTHER HEALTH CARE PROVIDERS TO IMPROVE CARE COORDINATION. STAFF ALSO WORK WITH FAMILIES TO DEVELOP WRITTEN TRANSITION PLANS BASED ON NEEDS OR ISSUES THAT SHOULD BE ADDRESSED BEFORE A YOUTH IS READY TO TRANSITION TO ADULT CARE.FIGHT ASTHMA MILWAUKEE ALLIES, WHICH IS SUPPORTED BY MEDICAL STAFF AT CHILDREN'S HOSPITAL, IS A COALITION THAT WORKS TO REDUCE AND ELIMINATE DISPARITIES IN ASTHMA CARE AND DEVELOP A SUSTAINABLE STRATEGY FOR ASTHMA CONTROL IN THE COMMUNITY. THE COALITION PROVIDES COMMUNITY-WIDE ASTHMA EDUCATION FOR PARENTS, CAREGIVERS, HEALTH CARE PROFESSIONALS AND SCHOOL STAFF.THE INFANT DEATH CENTER (IDC) IS A STATEWIDE PROGRAM ADMINISTERED THROUGH CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, A HOSPITAL-LED AND STAFFED COALITION. THE CENTER PROVIDES INFORMATION AND SUPPORT TO WISCONSIN FAMILIES AND OTHERS AFFECTED BY THE SUDDEN AND UNEXPECTED DEATH OF AN INFANT. THE IDC STRIVES TO INCREASE HEALTHY BIRTH OUTCOMES AND REDUCE INFANT DEATHS. THE CENTER WORKS TOGETHER WITH OTHER PROFESSIONALS IN OUTREACH, EDUCATION AND INFANT MORTALITY REVIEW PROGRAMS. IN PARTNERSHIP WITH PUBLIC HEALTH SYSTEMS AND NATIONAL INFANT MORTALITY PROGRAMS, THE IDC MAINTAINS INFORMATION THAT ASSISTS IN THE STUDY AND UNDERSTANDING OF THE CAUSES OF INFANT DEATHS. THE INFORMATION IS USED FOR STATISTICAL REPORTING. (CONTINUED ON PAGE 99) PART VI, LINE 6: CHILDREN'S HOSPITAL IS PART OF AN AFFILIATED GROUP OF ORGANIZATIONS UNDER THE CONTROL OF CHHS, WHICH PROVIDES VARIOUS CENTRALIZED ADMINISTRATIVE AND SUPPORTING SERVICES FOR THE HOSPITAL AND ITS AFFILIATES. AMONG THE AFFILIATED ENTITIES, THE HOSPITAL AND CERTAIN OTHER ENTITIES (INCLUDING CHILDREN'S MEDICAL GROUP, INC.) DIRECTLY PROVIDE PROFESSIONAL PEDIATRIC HEALTH CARE SERVICES IN A VARIETY OF ACCESSIBLE LOCATIONS THROUGHOUT WISCONSIN.CHILDREN'S HOSPITAL OPERATES A LARGE CLINIC IN NORTHWEST MILWAUKEE. THE MIDTOWN CLINIC IS LOCATED IN A NEIGHBORHOOD WITH FEW PEDIATRIC HEALTH CARE OPTIONS AND A LARGE POPULATION OF CHILDREN. THE CLINIC OFFERS PEDIATRIC AND ADOLESCENT PRIMARY CARE, BEHAVIORAL MEDICINE AND DENTAL CARE IN AN ENGAGING SPACE WITH STATE-OF-THE-ART TECHNOLOGY AND AMENITIES DESIGNED SPECIFICALLY FOR PEDIATRIC PATIENTS AND THEIR FAMILIES. BY OFFERING MULTIPLE SERVICES UNDER ONE ROOF IN A PATIENT-CENTERED MEDICAL HOME MODEL, CARE IS MORE EFFICIENT, COORDINATED AND ACCESSIBLE. THIS CLINIC HAD 12,082 PRIMARY CARE VISITS AND 5,961 DENTAL VISITS IN 2017 AND 92 PERCENT OF THE CHILDREN SEEN WERE INSURED BY MEDICAID.CHILDREN'S HOSPITAL ALSO HAS PARTNERED WITH LOCAL AGENCIES TO OPEN COMMUNITY CLINICS IN OTHER UNDERSERVED MILWAUKEE NEIGHBORHOODS. THESE CLINICS SERVE PEDIATRIC PATIENTS FROM BIRTH TO 19 YEARS OF AGE. THE CLINICS ARE STAFFED BY NURSE PRACTITIONERS AND ARE LOCATED IN AREAS THAT HISTORICALLY HAVE LARGE HEALTH CARE DISPARITIES AND FEW HEALTH CARE OPTIONS. THE CLINICS PROVIDE EASIER ACCESS TO HEALTH CARE FOR PATIENTS IN THESE NEIGHBORHOODS, ENSURING ALL CHILDREN HAVE THE NECESSARY SERVICES TO BE HEALTHY AND SAFE. THE CLINICS HAD 753 VISITS IN 2017 AND 89 PERCENT OF THE CHILDREN SEEN WERE INSURED BY MEDICAID. ANOTHER CLINIC IS LOCATED ON THE NEXT DOOR FOUNDATION CAMPUS IN MILWAUKEE'S CENTRAL CITY. IT PROVIDES BOTH PRIMARY CARE AND DENTAL CARE IN AN AREA THAT PREVIOUSLY DID NOT HAVE PEDIATRIC PRACTICES AVAILABLE TO ATTEND TO THE COMMUNITY'S NEEDS. THIS CLINIC HAD 2,848 PRIMARY CARE VISITS AND 3,844 DENTAL VISITS IN 2017.ANOTHER AFFILIATE OF CHILDREN'S HOSPITAL IS CHILDREN'S SERVICE SOCIETY OF WISCONSIN, DOING BUSINESS AS CHILDREN'S HOSPITAL OF WISCONSIN COMMUNITY SERVICES (CHW COMMUNITY SERVICES). THIS SOCIAL SERVICE ORGANIZATION ADDRESSES THE CHALLENGES FACED BY CHILDREN, WHICH OFTEN DIRECTLY IMPACT THEIR PHYSICAL AND MENTAL HEALTH AND WELL-BEING. CHW COMMUNITY SERVICES OFFERS CHILD WELL-BEING SERVICES IN FOUR CORE AREAS (PUBLIC CHILD WELFARE, CHILD AND FAMILY COUNSELING, OUT-OF-HOME CARE AND PREVENTION SERVICES) FROM LOCATIONS THROUGHOUT WISCONSIN. SERVICES INCLUDE: FINDING LOVING, STABLE HOMES FOR CHILDREN IN NEED OF A FAMILY THROUGH FOSTER CARE AND ADOPTION; REDUCING STRESS AND CONFLICT, ENHANCING PARENTING SKILLS AND STRENGTHENING FAMILY TIES THROUGH TRAUMA-INFORMED MENTAL HEALTH SERVICES COUNSELING; PROVIDING SERVICES TO CHILDREN IN OUT-OF-HOME CARE, ADVOCATING FOR THEIR SAFETY, WELL-BEING AND TIMELY REUNIFICATION WITH BIRTHPARENTS WHENEVER POSSIBLE; PROVIDING FOSTER PARENTS WHO ARE CARING FOR CHILDREN WITH SPECIAL MEDICAL OR EMOTIONAL NEEDS WITH A MUCH NEEDED BREAK THROUGH A RESPITE CARE PROGRAM; OFFERING FREE, CONFIDENTIAL AND SUPPORTIVE GUIDANCE TO HELP PARENTS DEALING WITH AN UNPLANNED PREGNANCY; PROVIDING INTENSIVE IN-HOME THERAPY TO KEEP CHILDREN SAFE IN THEIR HOMES AND PREVENT OUT-OF-HOME PLACEMENT; ASSISTING YOUNG ADULTS TRANSITIONING OUT OF FOSTER CARE BY GIVING THEM THE SKILLS, TRAINING, GUIDANCE AND SUPPORT ENABLING THEM TO MAKE IT ON THEIR OWN; PROVIDING PARENTS WITH SUPPORT AND GUIDANCE TO HELP THEM BE THE BEST PARENTS THEY CAN BE; AND PROVIDING CHILDREN WHO HAVE BEEN HARMED OR HURT A SAFE PLACE TO GO TO BE INTERVIEWED AND PROVIDING THEM RESOURCES TO HELP THEM HEAL.CHW COMMUNITY SERVICES ALSO RUNS PROJECT UJIMA, A PROGRAM THAT PROVIDES CASE MANAGEMENT, EMOTIONAL SUPPORT AND RESOURCES TO FAMILIES WHOSE CHILDREN HAVE EXPERIENCED INTERPERSONAL COMMUNITY-BASED VIOLENCE OR WHO HAVE LOST A FAMILY MEMBER (OF ANY AGE) TO HOMICIDE IN MILWAUKEE COUNTY.CHHS ENGAGES IN COMMUNITY HEALTH IMPROVEMENT ADVOCACY ON BEHALF OF CHILDREN'S HOSPITAL AND ITS AFFILIATES AT THE STATE AND FEDERAL LEVELS OF GOVERNMENT. IN 2017, ON THE STATE LEVEL, CHILDREN'S ADVOCATED ON THE 2017-19 WISCONSIN STATE BUDGET, SPECIFICALLY THE MEDICAID BUDGET, THE DISPROPORTIONATE SHARE HOSPITAL PROGRAM (DSH), INCREASED MENTAL HEALTH CARE ACCESS IN SCHOOLS AND BULLYING PREVENTION FUNDING AMONG OTHER TOPICS. IN ADDITION, CHILDREN'S SUCCESSFULLY ADVOCATED FOR SEVERAL PIECES OF PUBLIC POLICY WITH PARTNER ORGANIZATIONS, INCLUDING LEGISLATION WHICH WILL ALLOW WISCONSIN DENTAL HYGIENISTS TO PRACTICE PREVENTIVE ORAL HEALTH CARE IN MORE SETTINGS IN ORDER TO BETTER ACCOMMODATE PATIENTS' NEEDS, ENSURING A FAVORABLE CONTRACTING ENVIRONMENT FOR NONPROFIT SOCIAL SERVICE PROVIDERS AND HELPING FAMILIES REPLACE LEAD PIPES ON THEIR PROPERTY. WE WERE ALSO SUPPORTIVE OF A SET OF NEW LAWS AIMED TO PROTECT VULNERABLE CHILD VICTIMS OF SEX TRAFFICKING BY INCREASING OFFENDER PENALTIES. WITH THE OPIOID EPIDEMIC DRASTICALLY IMPACTING THE LIVES OF CHILDREN AND FAMILIES IN WISCONSIN, CHILDREN'S SUPPORTED A HOST OF NEW LAWS TO PREVENT AND COMBAT THE EFFECTS OF OPIOID ABUSE, INCLUDING EXPANSION OF FUNDING FOR FAMILY TREATMENT COURTS, INCREASED FUNDING FOR AN ADDICTION MEDICINE CONSULTATION LINE, ALLOWING SCHOOL PERSONNEL TO ADMINISTER NALOXONE AND FURTHER REGULATING THE SALES OF PRODUCTS WITH CODEINE AND PSEUDOEPHEDRINE. ON THE FEDERAL LEVEL IN 2017, CHILDREN'S ADVOCATED TO PROTECT MEDICAID FUNDING FOR CHILDREN AND EDUCATED LAWMAKERS ABOUT THE IMPORTANCE OF ACCESS TO HIGH QUALITY HEALTH CARE FOR CHILDREN AND FAMILIES. MEDICAID ADVOCACY AND EDUCATION WAS ONE OF OUR TOP PRIORITIES BECAUSE THERE WERE VARIOUS FEDERAL LEGISLATIVE PROPOSALS INTRODUCED THAT AIMED TO SIGNIFICANTLY REFORM THE PROGRAM WHICH THREATENED CHILDREN'S ACCESS TO COVERAGE AND BENEFITS. WE ALSO ADVOCATED FOR LEGISLATION TO REAUTHORIZE THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) AND CONTINUE FUNDING FOR 2018 AND BEYOND. WITH RESPECT TO THE VARIOUS PROPOSALS TO REPEAL AND REPLACE THE AFFORDABLE CARE ACT (ACA), CHILDREN'S ADVOCATED TO PROTECT CHILDREN'S ACCESS TO CARE BY MAINTAINING MANY OF ACA'S CRITICAL PRIVATE INSURANCE MARKET REFORMS, SUCH AS THE PROHIBITION ON DENYING COVERAGE OR CHARGING MORE BECAUSE OF A PRE-EXISTING CONDITION. CHILDREN'S ALSO ADVOCATED FOR POLICIES TO MAINTAIN STABILITY IN THE EXCHANGE MARKETPLACE, INCLUDING THE CONTINUATION OF ACA'S COST SHARING REDUCTION PAYMENTS. WE ALSO ADVOCATED ON THE PROVISIONS IN THE TAX BILL, H.R. 1, RELATED TO TAX-EXEMPT AND ADVANCED REFUNDING FOR NONPROFITS, THE STANDARD DEDUCTION, THE CHARITABLE DEDUCTION AND THE REPEAL OF THE INDIVIDUAL MANDATE OF THE ACA. ADDITIONALLY, CHILDREN'S SUPPORTED FUNDING FOR THE CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION (CHGME) PROGRAM AT THE AUTHORIZED LEVEL OF $300 MILLION. CHILDREN'S ALSO SUPPORTED LEGISLATION REAUTHORIZING FUNDING FOR THE MATERNAL, INFANT AND EARLY CHILDHOOD HOME VISITING (MIECHV) PROGRAM TO ENSURE CHILDREN AND FAMILIES HAVE ACCESS TO SUPPORTIVE PREVENTIVE SERVICES TO KEEP CHILDREN SAFELY AT HOME. CHILDREN'S CONTINUES TO PARTICIPATE IN THE COALITION FOR PEDIATRIC MEDICAL RESEARCH WHICH WORKS ON DEVELOPING LEGISLATION TO STRENGTHEN NIH INVESTMENTS IN PEDIATRIC AND CHILD HEALTH RESEARCH.IN ADDITION TO ADVOCACY, CHILDREN'S HOSPITAL'S COMMUNITY SERVICES DIVISION HAS INITIATED A COMMUNITY-BASED EFFORT TO IMPROVE CHILD HEALTH THAT ACKNOWLEDGES THE INFLUENCE OF SOCIAL, CULTURAL AND ENVIRONMENTAL FACTORS ON HEALTH AND RECOGNIZES THAT SUCH INFLUENCES MAY HAVE PARTICULARLY DELETERIOUS EFFECTS WHEN THEY OCCUR DURING CRITICAL PERIODS OVER ONE'S LIFE COURSE. CHILDREN'S HOSPITAL IS BRINGING THE FULL SPECTRUM OF THE SYSTEM'S RESOURCES TO BEAR IN THE COMMUNITY ENGAGEMENT EFFORT. BY CONNECTING OUR VAST CLINICAL AND COMMUNITY-BASED RESOURCES SCHOOL NURSES, COMMUNITY PEDIATRICIANS, SOCIAL WORKERS, HEALTH EDUCATORS, FOSTER CARE PARENTS, HOSPITALISTS, EMERGENCY DEPARTMENT STAFF, RESEARCHERS AND POLICY MAKERS CHILDREN'S HOSPITAL IS FACILITATING COMMUNITY HEALTH IMPROVEMENT BOTH DIRECTLY (E.G., EXPANDING MENTAL HEALTH AND DENTAL CARE IN UNDERSERVED AREAS), AND INDIRECTLY (E.G., BRINGING LAW ENFORCEMENT TO THE COMMUNITY CONVERSATION RELATED TO CRIME REDUCTION; SUPPORTING POLICY CHANGES AT THE LOCAL, STATE AND NATIONAL LEVELS THAT HAVE AN IMPACT ON CHILD HEALTH). CHILDREN'S HOSPITAL HAS SELECTED FIVE NEIGHBORHOODS FOR ENGAGEMENT EFFORTS. THESE NEIGHBORHOODS WERE IDENTIFIED BECAUSE THEY HAD A HIGH CONCENTRATION OF PEDIATRIC-AGED RESIDENTS; THERE WERE SIGNIFICANT, BUT MODIFIABLE, CHALLENGES TO CHILD HEALTH OUTCOMES; AND THEY HAD EXISTING TRUSTED COMMUNITY RESOURCES THAT WERE WILLING TO PARTNER WITH CHILDREN'S HOSPITAL TO ENGAGE THE COMMUNITY IN NEW WAYS TO IMPROVE CHILD HEALTH OUTCOMES. (CONTINUED ON PAGE 97) PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM (CONTINUED) AS A PARTNER AND FACILITATOR, CHILDREN'S HOPSITAL'S STAFF HAS ENCOURAGED LEADERS FROM THE PRIORITY NEIGHBORHOODS TO IDENTIFY KEY AREAS FOR STRATEGIC INTERVENTION. AS A RESULT OF SEVERAL FACILITATED LISTENING SESSIONS, TWO OF THE THREE NEIGHBORHOODS HAVE ARTICULATED HEALTH AS A KEY AREA FOR STRATEGIC INTERVENTION AND THE COMMUNITIES NOW ARE IDENTIFYING SPECIFIC CATEGORIES WITHIN THE LARGER RUBRIC OF "HEALTH" ON WHICH TO CONCENTRATE IMPROVEMENT EFFORTS. ONE STRATEGY THAT HAS BEEN IMPLEMENTED IS USING COMMUNITY NAVIGATORS TRUSTED LOCAL RESIDENTS WHO EDUCATE NEIGHBORS ABOUT A SPECIFIC BEHAVIOR CHANGE OR RESOURCE UTILIZATION THAT WILL RESULT IN IMPROVED HEALTH OUTCOMES. CHHS'S FOCUS IS TO HAVE RELEVANT, ACCURATE, RESIDENT-LEVEL INFORMATION REGARDING TRUSTED SOURCES OF INFORMATION AND DIRECT INFLUENCES ON RESIDENT'S BEHAVIORS. CHILDREN'S HOSPITAL IS PARTNERING WITH THE COMPREHENSIVE CENTER OF EXCELLENCE FOR HEALTH EQUITY IN WISCONSIN TO UTILIZE COMMUNITY-MAPPED "WAYS OF KNOWING" TO BEST UNDERSTAND DIRECT INFLUENCES ON HEALTH BEHAVIORS IN THE SELECTED COMMUNITIES. THE COMMUNITY NAVIGATORS ARE WORKING COLLABORATIVELY WITH THE CENTER'S COMMUNITY HEALTH EDUCATOR TO FOSTER KEY RELATIONSHIPS WITHIN THE COMMUNITY. CHILDREN'S HOSPITAL FACILITATED THE DEVELOPMENT OF CULTURALLY AND LINGUISTICALLY APPROPRIATE EDUCATIONAL MATERIALS FOR THE COMMUNITY NAVIGATORS AND LED THE TRAINING OF BOTH THE COMMUNITY NAVIGATORS AND THE CENTER'S COMMUNITY HEALTH EDUCATOR. THIS COORDINATED APPROACH WILL ALLOW CHILDREN'S HOSPITAL AND THE CENTER TO FACILITATE EFFECTIVE COMMUNITY TRANSFORMATION THAT IS RESPECTFUL OF THE LOCAL CULTURE. IN ADDITION, THE COLLABORATION ALLOWS FOR COMMUNITY-LED MEASUREMENT OF IDENTIFIED OUTCOMES FACILITATING COMMUNITY EMPOWERMENT AND CONTRIBUTING TO SUSTAINABLE CHANGES.CHILDREN'S HOSPITAL AND THE UNIVERSITY OF WISCONSIN-MILWAUKEE HELEN BADER SCHOOL OF SOCIAL WELFARE HAVE ESTABLISHED THE INSTITUTE FOR CHILD AND FAMILY WELL-BEING, AN ACADEMIC-COMMUNITY PARTNERSHIP TO IMPROVE THE LIVES OF CHILDREN AND FAMILIES FACING COMPLEX CHALLENGES SUCH AS VIOLENCE, INCARCERATION OR EXTREME POVERTY. THE INSTITUTE COMPRISES THREE CORE SERVICE AREAS: DESIGNING AND IMPLEMENTING EFFECTIVE PROGRAMS, CONDUCTING CUTTING-EDGE RESEARCH AND EVALUATION, AND PROMOTING CHANGE THROUGH POLICY AND ADVOCACY. THIS WORK IS CRITICAL BECAUSE NEARLY ONE THIRD OF CHILDREN IN MILWAUKEE (30.5%) HAVE HAD AT LEAST TWO ADVERSE CHILDHOOD EXPERIENCES SUCH AS MALTREATMENT, NEGLECT, VIOLENCE OR EXTREME POVERTY WHICH IS SIGNIFICANTLY HIGHER THAN THE NATIONAL AVERAGE OF 22.6 PERCENT (DATA RESOURCE CENTER FOR CHILD & ADOLESCENT HEALTH). RESEARCH HAS PROVEN THAT CHILDHOOD ADVERSITY ACTUALLY INTERRUPTS CHILDREN'S BRAIN DEVELOPMENT, CAUSING INCREASED LIKELIHOOD OF MENTAL HEALTH PROBLEMS, SUBSTANCE ABUSE, JUVENILE DELINQUENCY AND TEEN PREGNANCY, IN ADDITION TO POOR LONG-TERM HEALTH OUTCOMES AND DECREASED ACADEMIC ACHIEVEMENT, WHICH CAN LEAD TO LONG-TERM EMPLOYABILITY ISSUES.THESE AFFILIATED PROGRAMS AND ACTIVITIES SEEK TO ENSURE THAT CHILDREN HAVE ACCESS TO HIGH-QUALITY HEALTH AND SOCIAL SERVICES.PART VI, LINE 7: CHHS, THE SOLE CORPORATE MEMBER OF CHILDREN'S HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF BOTH OF THE HOSPITALS AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON CHILDREN'S HOSPITAL'S WEBSITE OR UPON REQUEST. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH (CONTINUED) THE DANIEL M. SOREF FAMILY RESOURCE CENTER LOCATED ON THE FIRST FLOOR OF CHILDREN'S HOSPITAL'S MILWAUKEE CAMPUS OFFERS PARENT-TO-PARENT SUPPORT, INFORMATION, REFERRALS AND HELP CONNECTING TO HOSPITAL AND COMMUNITY RESOURCES. THE RESOURCE CENTER OFFERS SPIRITUAL CARE, PATIENT RELATIONS, INTERPRETERS, FAMILY ACCOMMODATIONS AND THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. STAFF MEMBERS ARE TRAINED TO HELP CHILDREN, YOUNG ADULTS AND THEIR FAMILIES FIND ANSWERS TO QUESTIONS ABOUT LOCAL RESOURCES, SUPPORT GROUPS, FUNDING OPTIONS AND MORE. THE RESOURCE CENTER HAS COMPUTERS, A CONSULT ROOM, BUSINESS CENTER AND OTHER RESOURCES FOR FAMILIES. THE RESOURCE CENTER ALSO HAS A LENDING LIBRARY WITH BOOKS, VIDEOS AND ARTICLES ON A VARIETY OF HEALTH CONDITIONS AND TOPICS. IN 2017, THE FAMILY RESOURCE CENTER SERVED MORE THAN 19,000 VISITORS. CHILDREN'S HOSPITAL OPERATES A FREE GUARDIANSHIP CLINIC, WHICH PROVIDES PARENTS IN NEED WITH PRO BONO LEGAL SERVICES TO SECURE GUARDIANSHIP WHEN THEIR SPECIAL NEEDS CHILD TURNS 18.CHILDREN'S HOSPITAL SUPPORTS WORKFORCE DEVELOPMENT THROUGH JOB SHADOWING, WHICH MOSTLY OCCURS AT THE MILWAUKEE HOSPITAL CAMPUS. ADDITIONALLY, CHILDREN'S HOSPITAL CONTINUES TO PARTNER WITH EASTER SEALS ON A PROGRAM CALLED PROJECT SEARCH, AN INNOVATIVE WORKFORCE AND CAREER DEVELOPMENT MODEL FOR YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. THROUGH PROJECT SEARCH, YOUNG ADULTS WITH DISABILITIES RECEIVE INTERNSHIPS WITHIN THE HOSPITAL TO GAIN ON-THE-JOB TRAINING AND OTHER CAREER DEVELOPMENT SKILLS TO SECURE COMPETITIVE EMPLOYMENT. IN THE FOX VALLEY, CHILDREN'S HOSPITAL AND THEDACARE REGIONAL MEDICAL CENTER-NEENAH PARTNER WITH ROOSEVELT ELEMENTARY SCHOOL TO PROMOTE HEALTHY HABITS AND CIVIC RESPONSIBILITY TO STUDENTS.CHILDREN'S HOSPITAL STAFFS THE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, A STATEWIDE COALITION THAT WORKS TO IMPROVE THE HEALTH OF WISCONSIN CHILDREN AND REDUCE DISPARITIES IN AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE SERVICES. THE ALLIANCE IS GUIDED BY A STATEWIDE ADVISORY BOARD AND PARTNERS WITH HUNDREDS OF ORGANIZATIONS AND INDIVIDUALS TO RAISE AWARENESS OF CHILD HEALTH CONCERNS, MOBILIZE LEADERS, IMPACT PUBLIC HEALTH, AND IMPLEMENT PROGRAMS PROVEN TO WORK. THE ALLIANCE IS PARTIALLY FUNDED THROUGH A WISCONSIN DEPARTMENT OF HEALTH SERVICES MATERNAL CHILD HEALTH GRANT, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND OTHER PUBLIC AND PRIVATE FUNDING. THE ALLIANCE IS FINANCIALLY SUPPORTED BY CHILDREN'S HOSPITAL THROUGH STAFF AND OTHER RESOURCES TO CARRY ON THE ALLIANCE'S PROGRAMS. THE ALLIANCE'S KEY INITIATIVES ARE: ASTHMA, EARLY LITERACY, EMERGENCY CARE, GRIEF AND BEREAVEMENT, INJURY PREVENTION AND CHILD DEATH REVIEW, MEDICAL HOMES AND ORAL HEALTH. THE ALLIANCE LEADS AND MANAGES THE INFANT DEATH CENTER, REACH OUT AND READ WISCONSIN COALITION, WISCONSIN ASTHMA COALITION, AND THE WISCONSIN ORAL HEALTH COALITION. CHILDREN'S HOSPITAL ALSO SUPPORTS THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. IT IS 1 OF 5 REGIONAL CENTERS DEDICATED TO SUPPORTING FAMILIES WITH CHILDREN WHO HAVE SPECIAL HEALTH CARE NEEDS AND THE PROVIDERS WHO CARE FOR THEM. IT IS FUNDED THROUGH A TITLE 5 MATERNAL AND CHILD HEALTH BLOCK GRANT, AND EXPENDITURES INCURRED BY CHILDREN'S HOSPITAL TO MATCH THE BLOCK GRANT INCLUDE STAFF AND OTHER PROGRAM EXPENSES. FAMILIES AND PROVIDERS CAN CALL THE CENTER FOR INFORMATION, REFERRAL AND PROBLEM-SOLVING RELATED TO COMMUNITY AND STATE SERVICES, HEALTH BENEFITS ASSISTANCE, TRANSITION PLANNING, AND EMOTIONAL SUPPORT. EACH YEAR THE STAFF OFFERS TRAINING SUCH AS "CARE IN THE COMMUNITY AND OTHER SESSIONS THAT FOCUS ON YOUTH TRANSITIONS. STAFF ALSO PARTICIPATE IN NUMEROUS COMMUNITY INITIATIVES AND PARTNER WITH AREA PEDIATRICIANS AND OTHER HEALTH CARE PROVIDERS TO INCORPORATE EARLY IDENTIFICATION AND SCREENING METHODS INTO THEIR PRACTICES. EACH YEAR, STAFF SHARE THEIR EXPERTISE, LEADERSHIP AND TECHNICAL ASSISTANCE WITH VARIOUS COMMUNITY AGENCIES AND COMMITTEES. THE CENTER SERVES EIGHT COUNTIES. IN THE FOX VALLEY, CHILDREN'S HOSPITAL ALSO SUPPORTS THE NORTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, WHICH PROVIDES SIMILAR SERVICES TO THE SOUTHEAST CENTER DESCRIBED ABOVE WITH A FOCUS ON COUNTIES IN WISCONSIN'S FOX VALLEY. ADDITIONALLY, ONE OF THE NEEDS IDENTIFIED AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN THE FOX VALLEY WAS ACCESS TO MENTAL HEALTH CARE SERVICES. THEREFORE, CHILDREN'S HOSPITAL, ALONG WITH AFFINITY HEALTH SYSTEM AND THEDACARE, CREATED AN ORGANIZATION CALLED CATALPA HEALTH TO PROVIDE OUTPATIENT CHILD AND ADOLESCENT MENTAL HEALTH SERVICES IN THE FOX VALLEY. 1 BROWN COUNTY ORAL HLTH PARTNERSHIP 331 N BROADWAY GREEN BAY WI 54303 208969896 501 ( C ) (3) 17223 DENTAL SEALANT COLUMBIA ST MARY'S FOUNDATION 2320 N LAKE DRIVE MILWAUKEE WI 53211 391494981 501 ( C ) (3) 135400 DENTAL SEALANT LAKES COMMUNITY HEALTH DEPARTMENT NORTHLAKES COMMUNITY CLINIC 15910 W COMPANY LAKE ROAD HAYWAD WI 54843 352297925 501 ( C ) (3) 24336 DENTAL SEALANT MARQUETTE UNIVERSITY PO BOX 1881 MILWAUKEE WI 53201 390806251 501 ( C ) (3) 15000 DENTAL SEALANT MEDICAL COLLEGE OF WISCONSIN 1155 N MAYFAIR RD MILWAUKEE WI 53226 390806261 501 ( C ) (3) 14340 COOPERATIVE AGREEMENTS TO SUPPORT STATE-BASED SAFE MOTHERHOOD AND INFANT HEALTH INITIATIVE PROGRAMS MEDICAL COLLEGE OF WISCONSIN 1155 N MAYFAIR RD MILWAUKEE WI 53226 390806261 501 ( C ) (3) 18702 CONGENITAL DISORDERS PORTAGE COUNTY HEALTH AND HUMAN SERVICES 817 WHITING AVENUE STEVENS POINT WI 54481 396005731 GOVERNMENT 24000 DENTAL SEALANT PREFERRED DENTISTRY ASSOCIATION OF WISCONSIN LLC 1029 HOWARD ST EVANSTON IL 60202 272634563 19750 DENTAL SEALANT PRICE COUNTY HEALTH DEPARTMENT 104 S EYDER AVENUE PHILLIPS WI 54555 396005733 GOVERNMENT 11111 DENTAL SEALANT SAUK COUNTY 505 BROADWAY BARABOO WI 53913 396005740 GOVERNMENT 16805 DENTAL SEALANT SEALS ON WHEELS 1710 GOLDEN OAK LN MADISON WI 53711 388086637 58768 DENTAL SEALANT VILAS COUNTY PUBLIC HEALTH 330 COURT STREET EAGLE RIVER WI 54521 396005751 GOVERNMENT 25257 DENTAL SEALANT WALWORTH COUNTY PO BOX 1001 ELKHORN WI 53121 396002726 GOVERNMENT 9747 DENTAL SEALANT WOOD COUNTY 400 MARKET STREET WISCONSIN RAPIDS WI 54494 396005763 GOVERNMENT 34188 DENTAL SEALANT CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 501 ( C ) (3) 34291892 GRANTS TO AFFILIATE CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390806380 501 ( C ) (3) 3827143 GRANTS TO AFFILIATE CHILDREN'S MEDICAL GROUP INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391789197 501 ( C ) (3) 12237541 GRANTS TO AFFILIATE ACCESS COMMUNITY HEALTH CENTERS 2901 W BELTLINE HWY STE 120 MADISON WI 53713 391391134 501 ( C ) (3) 8114 DENTAL SEALANT CATALPA HEALTH PO BOX 8776 CAROL STREAM IL 60197 454681563 501 ( C ) (3) 86688 VOCA CITY OF WATERTOWN 106 JONES STREET WATERTOWN WI 530940477 396005640 CITY OF WATERTOWN 5216 DENTAL SEALANT CLARK COUNTY HEALTH DEPARTMENT 517 COURT STREET RM 105 NIELLSVILLE WI 54456 396005679 CLARK COUNTY 8973 DENTAL SEALANT COLUMBIA COUNTY HEALTH AND HUMAN SERVICES PO BOX 136 PORTAGE WI 53901 396005681 COLUMBIA COUNTY 23378 DENTAL SEALANT COMMUNITY HEALTH SYSTEMS INC 74 ELCIPSE CENTER BELOIT WI 53511 391919806 6415 DENTAL SEALANT DENTAMED HEALTHCARE LLC 5212 W DONGES LANE BROWN DEER WI 53223 815225234 70939 DENTAL SEALANT JEFFERSON COUNTY 503 N JACKSON AVENUE JEFFERSON WI 53549 396005705 JEFFERSON COUNTY 6473 DENTAL SEALANT JUST KIDS DENTAL PO BOX 146 TWO HARBORS WI 55616 272311353 501 ( C ) (3) 6395 DENTAL SEALANT PROFESSIONAL DENTAL HYGIENE EXPRESS 5388 STATE HWY 64 BLOOMER WI 54724 274969600 68500 DENTAL SEALANT LACROSSE COUNTY HEALTH DEPARTMENT 300 N 4TH STREET LACROSSE WI 54601 396005709 LACROSSE COUNTY 1709 DENTAL SEALANT TREMPELEAU COUNTY HUMAN SERVICES 36245 MAIN STREET WHITEHALL WI 54773 396005747 TREMPELEAU COUNTY 8500 DENTAL SEALANT WAUPACA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES 811 HARDING STREET WAUPACA WI 54981 396005758 WAUPACA COUNTY 10468 DENTAL SEALANT 25 5 PART I, LINE 2: MONITORING PROCEDURES - THE ORGANIZATION RECEIVES GRANT FUNDING FROM VARIOUS STATE AND FEDERAL AGENCIES. SOME OF THE GRANT AWARDS ARE SUB-AWARDED TO OTHER AGENCIES BASED ON THE REQUIREMENTS OF THE INDIVIDUAL GRANT AGREEMENTS. IN ORDER TO MONITOR THE USE OF THE FUNDS, THE ORGANIZATION ENTERS INTO SIGNED AGREEMENTS WITH THE SUB-GRANTEE AGENCIES TO OUTLINE THE TERMS OF THE ARRANGEMENTS INCLUDING THE PROPER USE OF FUNDS. THESE AGREEMENTS REQUIRE AGENCIES TO PROVIDE CERTIFICATIONS OF EXPENSES SUBMITTED FOR REIMBURSEMENT ALONG WITH DESCRIPTIONS OF THE ACTUAL EXPENSES INCURRED COMPARED TO THE BUDGETED AWARD TOTAL. EACH AWARD IS MONITORED BY A DESIGNATED EMPLOYEE OF THE ORGANIZATION WHO VERIFIES THAT ALL SERVICES ARE PROVIDED ACCORDING TO THE CONTRACT, APPROVES PAYMENTS TO THE AGENCY, AND ENSURES THAT THE AWARD OBJECTIVES ARE MET. IN SOME CASES, THE ORGANIZATION REQUIRES THE AGENCY TO SUBMIT A COPY OF ITS ANNUAL OMB 133 AUDIT ALONG WITH ANY RELEVANT AUDIT FINDINGS. ADDITIONALLY, CHW AWARDS GRANTS TO ITS TAX-EXEMPT AFFILIATES. GRANTS ARE AWARDED BASED ON THE STRATEGIC INITIATIVES OF THE HEALTH SYSTEM, THE NEEDS OF THE AFFILIATES, AND ANY PURPOSE RESTRICTIONS SET BY THE DONORS. THE NEEDS OF THE AFFILIATES ARE EVALUATED IN THE ANNUAL BUDGET PROCESS. FINAL BUDGETS REQUIRE APPROVAL FROM MANAGEMENT, THE ENTITY'S BOARD OF DIRECTORS AND THE CHHS BOARD OF DIRECTORS AND SENIOR MANAGEMENT. IN ADDITION, THE OPERATIONS OF ALL AFFILIATES ARE SUBJECT TO SYSTEM CONTROLS, POLICIES AND PROCEDURES, AND ARE REFLECTED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF CHHS AND ITS AFFILIATES. X X X X X X 1 1 0 0 0 0 0 1 0 MARGARET TROY DIRECTOR/PRESIDENT & CEO CHHS 0 862613 0 525000 0 136800 0 255100 0 32490 0 1812003 0 62628 MARC CADIEUX TREASURER/CFO 0 455161 0 144434 0 21965 0 68100 0 26162 0 715822 0 0 MARC GORELICK MD COO & EXECUTIVE VP CHHS 99880 0 171945 0 56140 0 0 0 7755 0 335720 0 0 0 MICHELLE METTNER SECRETARY 0 330369 0 97436 0 46369 0 53140 0 25415 0 552729 0 0 MICHAEL GUTZEIT MD CHIEF MEDICAL OFFICER/VP, CHW 377999 0 112445 0 115297 0 63699 0 30105 0 699545 0 38383 0 JULIET KERSTEN VICE PRESIDENT, CHW 268782 0 77790 0 1267 0 13723 0 24224 0 385786 0 0 0 NANCY KOROM CHIEF NURSING OFFICER/VP, CHW 303450 0 93659 0 64352 0 56163 0 34632 0 552256 0 30911 0 THOMAS MILLER VICE PRESIDENT, CHW 206404 0 43220 0 702 0 16626 0 12721 0 279673 0 0 0 LISA JENTSCH VICE PRESIDENT, CHW 226099 0 0 0 1760 0 20746 0 25949 0 274554 0 0 0 ANDREW SCHMITT MD HOSPITALIST 249039 0 0 0 12269 0 10783 0 30219 0 302310 0 0 0 LORI BARBEAU DDS MEDICAL DIR, DENTAL PROGRAM 280044 0 200 0 5203 0 22500 0 29991 0 337938 0 0 0 MARYLYN RANTA MD DIR, CHW PHYSICIAN AFFAIRS 260217 0 0 0 18865 0 22500 0 28288 0 329870 0 0 0 THOMAS NICHOLS MD MEDICAL DIRECTOR/HOSPITALIST 248805 0 650 0 28383 0 19800 0 29626 0 327264 0 0 0 CHRISTOPHER SPAHR CHIEF QUALITY OFFICER 240011 0 44244 0 8478 0 9000 0 33378 0 335111 0 0 0 SHEILA REYNOLDS FORMER SECRETARY 0 0 0 0 0 241525 0 0 0 21470 0 262995 0 0 PART I, LINE 3 CHW AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE CORPORATE MEMBER OF CHW, SHARE A BOARD OF DIRECTORS WHICH INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE. THIS COMMITTEE IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF CHW'S PRESIDENT, AND USED THE METHODS LISTED AND CHECKED IN SCHEDULE J LINE 3. PART I, LINES 4A-B PART I, LINE 4A: UNTIL JUNE 2016, SHEILA REYNOLDS SERVED AS CHHS CORPORATE VP & GENERAL COUNSEL. BY VIRTUE OF THAT ROLE, MS. REYNOLDS SERVED AS THE SECRETARY OF CHW. IN 2017, CHHS PAID $241,525 AS SEVERANCE TO MS. REYNOLDS PURSUANT TO A WRITTEN AGREEMENT. PART I, LINE 4B: IN 2017, THERE WAS A CHHS FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2017 WERE AS FOLLOWS: M. CADIEUX, $48,300; M. GUTZEIT, M.D., $41,199; N. KOROM, $33,663; AND M.METTNER, $36,040. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2017 WERE: M. GUTZEIT, M.D., $38,383; AND N. KOROM, $30,911. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT & CEO. THE AMOUNT SET ASIDE IN 2017 WAS $238,000 AND OF THAT, $62,628 WAS PAID AS A VESTED CONTRIBUTION UNDER THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN) MENTIONED ABOVE AND IS INCLUDED IN PART II, COLUMN (B)(III). PART I, LINE 7 CERTAIN EXECUTIVES PARTICIPATE IN AN ANNUAL BONUS PLAN THAT PROVIDES COMPENSATION BASED ON ACHIEVING SPECIFIC PRE-DEFINED GOALS. BONUS CRITERIA ARE COMPRISED OF BOTH SYSTEM LEVEL AND EXECUTIVE SPECIFIC COMPONENTS. SUCH CRITERIA PERTAIN TO MATTERS WITHIN THE EXECUTIVE'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF THE ORGANIZATION AND ITS AFFILIATES IN ALIGNMENT WITH SYSTEM-WIDE BALANCED MEASURES. FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: MARGARET TROY, PRESIDENT & CEO OF CHHS, MARC CADIEUX, TREASURER OF CHW AND TREASURER & CFO OF CHHS, AND MICHELLE METTNER, SECRETARY OF CHW AND CORP VP GOVT & LEGAL AFFAIRS - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY MS. TROY AS A MEMBER OF THE BOARD OF DIRECTORS OF CHW WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. A WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 97710BCS9 2008-07-29 152300000 SEE PART VI 1 0 0 B WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 97710BCC4 2008-06-25 100771610 SEE PART VI 1 0 0 C WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DE77 2017-12-14 331805198 SEE PART VI 0 0 0 A 5600000 146700000 152300953 1000301 2075652 149225000 2009 1 0 1 1 B 2025000 101615000 113903904 771611 13132293 100000000 2009 1 0 1 1 C 331954892 229332317 2580397 100042178 0 1 0 1 A 0 1 1 1 0 0.00400 0.00400 1 0 1 B 0 0 1 1 0 0.00400 0.00400 1 0 1 C 0 1 1 1 0 0.00380 0.00380 1 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 SCHEDULE K SUPPLENTAL INFORMATION SCHEDULE K, PART I, LINE A, COLUMN (F): THE SERIES 2008B BONDS WERE ISSUED TO REFUND SEVERAL SERIES OF PRIOR BONDS, INCLUDING: (1) THE ISSUER'S SERIES 2007-3 BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON NOVEMBER 20, 2007 TO REFUND A PORTION OF THE ISSUER'S SERIES 1998 BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON JUNE 2, 1998. (2) THE ISSUER'S SERIES 2004B BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON MAY 6, 2004 TO CONSTRUCT AND EQUIP CERTAIN HEALTH CARE FACILITIES (INCLUDING A MEDICAL OFFICE BUILDING/CHILDREN'S CORPORATE CENTER, PARKING STRUCTURE, TUNNEL, UTILITIES AND A NEW PATIENT TOWER) AND TO PAY COSTS OF ISSUANCE. THE SERIES 2008B BONDS ALSO FUNDED CONSTRUCTION, RENOVATION AND EQUIPPING OF CERTAIN HEALTH CARE FACILITIES (A NEW PATIENT TOWER) AND TO PAY COSTS OF ISSUANCE. SCHEDULE K, PART I, LINE B, COLUMN (F): THE SERIES 2008A BONDS WERE ISSUED TO REFUND THE ISSUER'S SERIES 2007-1 AND SERIES 2007-2 BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON NOVEMBER 20, 2007 FOR THE CONSTRUCTION, RENOVATION AND EQUIPPING OF CERTAIN HEALTH CARE FACILITIES (A NEW PATIENT TOWER) AND TO PAY COSTS OF ISSUANCE. SCHEDULE K, PART I, LINE C, COLUMN (F): THE SERIES 2017 BONDS, TOGETHER WITH THE PROCEEDS OF A SERIES OF TAXABLE BONDS, WERE ISSUED TO ADVANCE REFUND THE 2008A AND 2008B BONDS. THE SERIES 2017 BONDS WERE ALSO ISSUED TO FUND ALL OR A PORTION OF THE COSTS OF THE ACQUISITION, CONSTRUCTION, RENOVATION, AND EQUIPPING OF CERTAIN HOSPITAL AND HEALTH CARE FACILITIES, INCLUDING BUT NOT LIMITED TO EXPANSION AND RENOVATION TO THE BORROWERS SURGICAL PLATFORM, AMBULATORY FACILITIES AND EMERGENCY DEPARTMENT AND TO PAY COSTS OF ISSUANCE. SCHEDULE K, PART II, LINE 3, COLUMN (A): THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO INVESTMENT PROCEEDS OF $953. SCHEDULE K, PART II, LINE 3, COLUMN (B): THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO INVESTMENT PROCEEDS OF $48,153 AND TRANSFERRED PROCEEDS FROM THE SERIES 2007-1 AND SERIES 2007-2 BONDS OF $13,084,140. SCHEDULE K, PART II, LINE 3, COLUMN (C): THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO INVESTMENT PROCEEDS OF $149,694. SCHEDULE K, PART III, COLUMN B, LINE 3A: THE ORGANIZATION HAS DETERMINED BASED ON A LEGAL REVIEW THAT A MANAGEMENT CONTRACT WITH RESPECT TO THE PROPERTY FINANCED BY THE BOND ISSUE LISTED IN COLUMN B DOES NOT RESULT IN PRIVATE BUSINESS USE. PART III, LINE 7 THE ORGANIZATION MONITORS THE PRIVATE USE OF ITS BOND-FINANCED ASSETS AND ROUTINELY TAKES STEPS TO LIMIT PRIVATE USE. THE ORGANIZATION DOES NOT SEPARATELY TRACK PRIVATE PAYMENTS AND PRIVATE SECURITIES, RATHER IT ASSUMES SUCH TESTS WILL BE MET AND MANAGES COMPLIANCE THROUGH THIS PRIVATE USE MONITORING. BASED SOLEY ON THIS ASSUMPTION, THE ORGANIZATION HAS RESPONDED YES TO THIS QUESTION. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: BRENNER AND KERSCHNER, DRURY AND SCHLIFSKE, DRURY AND SOMMERHAUSER, WITT AND SOMMERHAUSER, BRENNER AND SWEENEY, ROTHMAN AND QUADRACCI, ADAMS AND TROY, MANSELL AND SCHLIFSKE, LOVELL AND ADAMS, AND TROY AND LOVELL. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SOLE CORPORATE MEMBER WHICH IS CHHS. FORM 990, PART VI, SECTION A, LINE 7A CHHS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER, CHHS, HAS CERTAIN RESERVE POWERS OVER THE CORPORATION, INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; APPROVAL OF MERGER, CONSOLIDATION OR THE CREATION OF ANY SUBSIDIARIES BY THE CORPORATION; APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT; AND SELECTION OF THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS/CHW BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CHW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE DIRECTOR OF CORPORATE COMPLIANCE. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S COO, TREASURER, SECRETARY, CHHS PRESIDENT, VP CHIEF MEDICAL OFFICER, AND VP CHIEF NURSING OFFICER WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF THE OTHER KEY EMPLOYEES WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CHHS ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE CHHS PUBLIC RELATIONS DEPARTMENT. FORM 990, PART IX, LINE 11G MEDICAL COLLEGE OF WISCONSIN FEES: PROGRAM SERVICE EXPENSES 29,781,855. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,781,855. RESIDENT STIPENDS AND BENEFITS: PROGRAM SERVICE EXPENSES 14,368,852. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,368,852. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 25,385,062. MANAGEMENT AND GENERAL EXPENSES 14,767,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,153,001. FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN NET ASSETS OF CHWF 102,120,746. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 13,028. LOSS ON REFINANCING OF DEBT -16,060,834. FORM 990, SCHEDULE R, PART V, LINE 1E: PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED DECEMBER 14, 2017, CHILDREN'S HOSPITAL OF WISCONSIN, INC. AND CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. ARE MEMBERS OF AN OBLIGATED GROUP WHICH JOINTLY AND SEVERALLY GUARANTEE CERTAIN DEBT ISSUED BY A MEMBER OF THE OBLIGATED GROUP THROUGH THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PAYMENT OF SCHEDULED PRINCIPAL AND INTEREST IS SECURED BY A PLEDGE OF THE HOSPITAL'S AND FOUNDATION'S GROSS UNRESTRICTED RECEIPTS. CHILDREN'S HOSPITAL & HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 AMBULATORY SURGERY CTR, URGENT CARE, & OPERATIONAL SPPT SVCS WI 501(C)(3) LINE 3 N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500075 FUND DEVELOPMENT WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S MEDICAL GROUP INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391789197 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S PHYSICIAN GROUP PC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 364303682 PEDIATRIC PHYSICIAN SERVICES IL 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390806380 CHILD WELL-BEING SERVICES WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S COMMUNITY HEALTH PLAN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 271494977 WISCONSIN MEDICAID HMO WI 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS INC 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 391341366 GRADUATE MEDICAL EDUCATION SUPPORT WI 501(C)(3) LINE 12A, I N/A 0 1 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 0 1 CHILDREN'S SERVICE SOCIETY OF WISCONSIN B 3837093 CASH PAID/RECEIVED CHILDREN'S MEDICAL GROUP INC B 12237541 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC C 10231266 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC E 365665769 NET BOOK VALUE CHILDREN'S COMMUNITY HEALTH PLAN INC - PATIENT REIMBURSEMENT L 29340563 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC S 26000000 CASH PAID/RECEIVED CHILDREN'S COMMUNITY HEALTH PLAN INC - ASSESSMENT PASS THROUGH PAYMENTS S 16433686 CASH PAID/RECEIVED CHILDREN'S MEDICAL GROUP INC Q 175759 CASH PAID/RECEIVED SCHEDULE R, PART V, LINE 1E PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED DECEMBER 14, 2017, CHILDREN'S HOSPITAL OF WISCONSIN, INC. AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION, INC. ARE MEMBERS OF AN OBLIGATED GROUP WHICH JOINTLY AND SEVERALLY GUARANTEE CERTAIN DEBT ISSUED BY A MEMBER OF THE OBLIGATED GROUP THROUGH THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PAYMENT OF SCHEDULED PRINCIPAL AND INTEREST IS SECURED BY A PLEDGE OF THE HOSPITAL'S AND FOUNDATION'S GROSS UNRESTRICTED RECEIPTS