2018-05-15T16:49:57-05:00 2017-06-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-07-01 940382330 Children's Hospital & Research Center At Oakland CHIL 5104283138 747 52nd Street Oakland CA 94609 Robert Fries CFO 5104283138 2018-05-15 1 Richard Croghan P00089862 4159561500 2018-05-15 2016 2022-09-23 18:48:47Z UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND Robert Fries 747 52nd Street Oakland CA 94609 624823601 0 X www.childrenshospitaloakland.org X 1912 CA THE MISSION OF CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND IS TO PROTECT AND ADVANCE THE HEALTH AND WELL-BEING OF CHILDREN THROUGH CLINICAL CARE, TEACHING AND RESEARCH. 21 19 3127 400 0 0 29802720 25718213 480092257 597170605 1339995 1113186 631644 -593365 511866616 623408639 17000 0 0 0 311183063 327103439 0 0 0 241360638 259611044 552560701 586714483 -40694085 36694156 530463084 600453262 243762296 277058318 286700788 323394944 X THE MISSION OF CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND IS TO PROTECT AND ADVANCE THE HEALTH AND WELL-BEING OF CHILDREN THROUGH CLINICAL CARE, TEACHING AND RESEARCH. 0 0 77780657 67265948 See Schedule O1. Hematology/Oncology--The Division of Hematology/Oncology at Children's Hospital & Research Center Oakland (Children's) is at the forefront of treatment and research; developing and evaluating treatments that offer the best opportunities for survival and preservation of quality of life. We provide access to all diagnostic and treatment methods available, some of which were originally developed at Children's. Our goal is to provide state-of-the-art care in a warm and supportive environment that includes ongoing direct communication with the primary care physician. Our comprehensive services include programs for hemophilia, thalassemia, and sickle cell disease. Our sickle cell program is the largest in the western United States and includes adult patients. We are the lead agency for the Northern California Comprehensive Sickle Cell Center (NCCSCC). Through NCCSCC, a multidisciplinary team consisting of physicians, nurse practitioners, psychologists, and social workers provide comprehensive care in a medical home model. Medical therapy includes hydroxyurea, transfusions, apheresis, chelation, pain management, and bone marrow transplantation. NCCSCC also developed and coordinates the Northern California Network of Care for Sickle Cell Disease, a partnership among local hospitals, clinics, and community agencies to help improve the access to healthcare services for people with sickle cell disease. We also have programs in neuro-oncology, thrombophilia, stem cell transplantation, and bone marrow transplantation. The Hematology/Oncology Department has its own 25-bed inpatient unit with private, air-filtered isolation rooms. A 20-bed day-use transfusion and chemotherapy unit in our outpatient center includes a pheresis program and a bone marrow transplantation unit. Children's has developed a number of innovative treatments for blood disorders and remains a major center for hematological and oncological clinical research, attracting patients and research participants from other states and countries. 30743142 41815489 SEE SCHEDULE O2. Emergency Medicine - Children's Hospital & Research Center Oakland has the region's only Level 1 Pediatric Trauma Center. Its Emergency Department is the San Francisco Bay Area's busiest and also the only one completely dedicated to the care of children. It is staffed 24 hours a day 7 days a week with certified pediatric emergency medicine specialists. Children ages 0-18 are treated at Children's ED. The ED also functions as the gateway to medical care for many children in the region; about 60 to 70 percent of patients admitted to Children's are first seen in the ED. 33759540 60273051 SEE SCHEDULE O3. Surgery- The surgery team at Children's Hospital & Research Center Oakland works with pediatricians, family physicians, child life specialists and other medical specialists. Our programs are designed to minimize the stress and discomfort of surgery while providing the highest level of pediatric surgical expertise, from the tiniest newborns to adolescents. Our surgical practice encompasses the full spectrum of general pediatric surgery. Our surgeons have particular expertise in neonatal surgery, open heart surgery, oncology, urology, and thoracic surgery, including laparoscopic and endoscopic procedures. The surgeons are available around the clock for critical care situations involving traumatic injuries that require surgical intervention. 286764009 427816117 4. Neonatology--The Neonatology Newborn Intensive Care Unit (NICU) at Children's Hospital & Research Center Oakland provides highly-specialized intensive care to critically ill and premature newborns. Our intensive multidisciplinary and specialist care treatment team is perhaps the biggest reason for our success. Each NICU patient and family receives the full attention of the NICU team of pediatric medical and surgical experts, including neonatologists, neonatal nurse practitioners, nurses, respiratory therapists, social workers, and developmental specialists. Their collaboration ensures comprehensive care and monitoring or support of vital functions beyond those available in the general pediatric unit or community hospital. The newborn intensive care nursery at Children's is a 44-bed, family-centered, regional referral center for neonatal intensive care. Board certified neonatologists are in the hospital 24 hours a day, 7 days a week. Parents are welcome to visit any time. This multidisciplinary medical team works closely with the entire range of children's pediatric sub-specialty services.5. Neurosurgery- The Neurosurgery staff at Children's Hospital & Research Center Oakland provide a full range of inpatient and outpatient services for infants, children and adolescents with neurological disorders. Children with conditions such as brain tumors, spinal disorders, congenital anomalies, craniosynostosis, spasticity, and hydrocephalus are treated by our surgical team of experienced, pediatric neurosurgeons and our advanced-practice registered nurses trained specifically to treat children. Our neurosurgery program is equipped with a computer-guided stereotactic neurosurgery station and neuroendoscope for minimally invasive, state-of-the-art brain surgery. Our patients receive the finest post-operative care in the largest pediatric intensive care unit and neonatal intensive care unit in Northern California. Transport teams are available to receive patients 24 hours a day. Children's multidisciplinary neuro-oncology, spinal disorder, spasticity, and craniofacial programs ensure that neurosurgery patients at children's receive complete, integrated outpatient care.6. Cardiology--The Pediatric Cardiac Center at Children's Hospital & Research Center Oakland provides comprehensive diagnostic, therapeutic, interventional, surgical and follow-up services for children with all types of heart disease from before birth to age 18; long-term patients are followed up to age 21. Our surgeons perform successful open-heart surgeries on children of all ages, including babies with hearts as small as a walnut. Pediatric cardiologists and pediatric cardiac surgeons lead the center with support from a dedicated, specially trained team that helps children and their families cope with the social and emotional impact of congenital heart disease. A social worker, an outpatient cardiology nurse and a team of clinical nurse specialists provide counseling and information about caring for children with cardiac disorders. The center offers a pacemaker clinic, performs over 100 cardiac catheterizations each year, and implants atrial septal devices (ASD) via catheterizations to block small openings in a child's heart. Children's sees about 4,900 patient visits a year at our specialty care offices. 7. OrthopedicsThe Division of Orthopedics at Children's Hospital & Research Center Oakland works with children from birth to age 18 to prevent or correct injuries and disorders of the skeletal system, and their associated muscles, joints and ligaments. We are the busiest pediatric orthopedic department in the bay area, with more than 21,000 patient visits a year. When a child fractures a bone, suffers a sports injury, or has a congenital disorder such as scoliosis or a neurological disorder such as spina bifida, it is important for him or her to see a pediatric orthopedist. Pediatric orthopedists treat children only and address each child's future growth as part of the treatment plan. This is how we help the child achieve the best functionality, and experience the least disruption to his or her normal activities. At Children's, we treat children with all kinds of fractures, congenital and traumatic hand injuries, problems due to cerebral palsy and scoliosis, as well as legg-perthes disease, limb disorders, dislocated hips, and other conditions. Our Sports Medicine Center For Young Athletes specializes in getting kids back in the game through prevention, diagnosis, and treatment of sports-related injuries.8. Gastroenterology/Hepatology- The Division of Gastroenterology, Hepatology, and Nutrition at Children's Hospital & Research Center Oakland provides care for children from birth to age 18 who have symptoms and diseases of the stomach, intestines, liver and pancreas. Gastroenterology refers to the stomach, intestines and associated organs. Common conditions include feeding disorders, pancreatitis, constipation, celiac disease and inflammatory bowel disease. Hepatology refers to the liver. Common liver conditions treated include hepatitis A, B, C and other infections; metabolic liver disease, glycogen storage disease, gallstones and gall bladder disorders, and liver transplant coordination. Congenital anomalies of the GI tract are among the most common surgical problems in newborn infants. Care of these complex infants is one of our core areas of expertiseover 25% of the patients in our NICU have some GI anomaly or surgical condition. The GI-NICU Program at Children's is an integrated multidisciplinary, family-centered program designed to provide the highest level of care to infants with surgical and/or medical GI problems. Based in our level IIID NICU, our program extends from prenatal diagnosis and planning, through the neonatal period, and transitions to long-term outpatient and inpatient follow-up.9. Otolaryngology (ENT)- The Department of Otolaryngology provides comprehensive diagnostic treatment services for children from birth to 18 years of age with ear, nose, throat, and laryngotracheal problems. Services at Children's include all pediatric ENT services, and a cochlear implant program. A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. The implant is surgically placed under the skin behind the ear. We have safely and successfully implanted the device in more than one hundred and eighty children.10. Neurology- Neurology staff at Children's Hospital & Research Center Oakland evaluate and care for children from birth to age 18 who have disorders affecting the central nervous system, spinal cord, nerves, and muscles. We have a comprehensive epilepsy center tubersclerosis clinic, and work closely with the neurosurgery staff to evaluate and manage care of children with brain tumors.11. Plastic Surgery- Plastic surgeons at Children's Hospital & Research Center Oakland evaluate and treat a wide range of plastic surgery problems in children from birth to 18 years, including congenital anomalies, acute traumatic injuries, and reconstruction following burns and other traumatic injuries. Services include diagnosis and treatment of all congenital and acquired reconstructive problems, cranio-maxillofacial surgery, plastic and reconstructive surgery, and hand/microsurgery.12. Pediatric Rehabilitation- The pediatric rehabilitation team at Children's Hospital & Research Center Oakland provides a comprehensive, integrated approach to caring for children and adolescents who require hospitalization for medical reasons related to disability, or need intensive rehabilitation following an illness or accident that has caused a loss of function. Our collaborative team approach includes occupational therapists, physical therapists, speech and language pathologists, hand therapists, audiologists, physiatrists, orthopedic specialists, rehabilitation nurses and social workers. This comprehensive approach assures that children will return to their previous functional status as quickly as possible or will gain the ability to do things they were not able to learn on their own. 13. Primary Care- Children's Primary Care Department sees more childrenabout 37,000 visits each yearthan any other primary care provider in the region. It provides the basic healthcare needs of primarily lower income children from birth to age 19, including routine preventative care, chronic disease management, and immunizations. In addition, the Primary Care Clinic provides health education, participates in translational research, offers social and mental health services, and plays a key role in training the next generation of pediatricians. The Primary Care Clinic is a Federally Qualified Health Center (FQHC), a special designation for health centers that serve a large percentage of low income families. The clinic at Children's is the only FQHC in the country associated with a children's hospital. The Primary Care Clinic conducts several specialized clinics including an International Clinic, which provides care for non-English speakers, Encore Medical Clinic, which specializes in the unique needs of children who are homeless or in foster care, and an Asthma Clinic, which provides specialized medical care and asthma management education for families who have children with particularly complex cases of asthma. 14. Audiology- The Division of Audiology at Children's Hospital & Research Center Oakland works with children from birth to 21 years to diagnose and treat hearing loss or impairment. We have a specially trained team of audiologists and speech pathologists that offer cutting edge technology to help children improve hearing, speech and language.15. Endocrinology- The Division of Endocrinology and Diabetes at Children's Hospital & Research Center Oakland treats children from birth to age 18 who have all types of endocrine disorders. Endocrine disorders include diabetes, hyperthyroidism and hypothyroidism, and other disorders of the endocrine glands. The Division cares for more than 1000 children with diabetes, both Type 1 and Type 2. Weight management and general fitness are employed for children managing diabetes and other endocrine disorders. Healthy Eating Active Living (HEAL) program: Children with obesity and related health issues such as high cholesterol or pre-diabetes receive care and counseling over the course of a year. Patients have access to a multidisciplinary team of physicians, a pediatric nurse practitioner, a dietitian, an exercise specialist, a psychologist, and support staffall of whom work together to provide individualized family support for obesity and obesity-related conditions.16. Pulmonology- The physicians and staff at the Division of Pulmonary Medicine treat children from birth to age 21 with a broad range of breathing or respiratory health problems. Common problems include asthma, recurrent coughs, respiratory infections, allergies, dyspnea (shortness of breath) and other conditions. Children's is a nationally certified Cystic Fibrosis Treatment Center. Children's Pulmonary Function Laboratory provides advanced pulmonary function testing using minimally invasive procedures designed to ease the child's fears and discomforts.17. Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Mental Health Programs- EPSDT Mental Health Programs are designed for children with socialemotional delays or disturbances: CARE Early Childhood Mental Health ProgramCARE provides home-based therapeutic intervention for children under age 6 and their families. In Fiscal Year 2016 EPSDT programs had almost 28,000 visits. Therapeutic Guidance for Infants and Families (TGIF)Infants in the TGIF program are those that are involved with the child welfare system and their families including biological parents, relatives and foster caregivers. The TGIF program activities include therapeutic parentchild playgroups, parent education and support sessions, and dyadic therapy sessions. About 10 parentchild dyads are served at any given time. FIRST Perinatal Drug Treatment Support ProgramThe FIRST program provides group and individual infant and early childhood therapeutic intervention to children living with their mothers in residential perinatal drug treatment or with their mothers in outpatient drug treatment. Children of incarcerated parents are also served in this program. Fussy Baby ProgramThe Fussy Baby program provides intervention to parents whose infants have crying, sleeping, or feeding problems that are creating stress in the family. Referrals come from local pediatric providers and community-based agencies.18. Nephrology - Nephrology deals with the function and diseases of the kidneys. Nephrologists at Children's Hospital & Research Center Oakland provide care for children from birth through age 18 who have renal disease. Long-term patients are seen up to age 21 years. 19. Adolescent Medicine- The Division of Adolescent Medicine at Children's Hospital & Research Center Oakland provides comprehensive medical, psychosocial and psychobiological services for children ages 11-24. The clinic also treats females under age 11 who have reached physical maturity. The Division runs a high volume teen clinic, two school-based health centers, and the medical clinic at the Alameda County Juvenile Justice Center, the location for all juvenile detainees in the county. Our interdisciplinary team of adolescent specialists help provide wide range of primary care and psychological services including well visits, chronic and acute diseases, urgent care, STDs, family planning and reproductive services, sports examinations, mental health conditions, physical and sexual assault, health education, and professional training. Our adolescent medicine specialists look at all aspects of an adolescent's life to help address the many medical and mental health issues that they face. The Division also runs a program to provide experiences for at-risk high school students interested in the health care field.20. Urology- Children's urology team provides comprehensive consultations for the diagnosis and treatment of children birth to age 18 who have problems with the kidneys, bladder and genitalia. Our compassionate professionals specialize in treating defects of the urinary tract, such as hypospadias and epispadias (birth defects in boys in which the urinary tract opening is not at the tip of the penis), bladder exstrophy, ambiguous genitalia and obstructive uropathy (blocked urine flow) caused by urethral abnormalities.21. Ophthalmology- The Eye Clinic at Children's Hospital & Research Center Oakland evaluates and treats eye problems in children from infancy through adolescence. Our services include routine eye exams and treatment of all pediatric eye conditions.22. Infectious disease- The Division of Infectious Disease at Children's Hospital & Research Center Oakland provides treatment for a wide spectrum of bacterial, viral, fungal, and parasitic infections. They also oversee investigation and prevention of nosocomial infections, exposures, and outbreaks in the hospital. The Pediatric HIV Program provides comprehensive treatment and case management for HIV-infected and exposed children. The Pediatric Tuberculosis clinic sees patients referred for treatment from exposure to tuberculosis. The Division is also active with clinical research, including clinical trials. A three-year accredited pediatric infectious diseases fellowship program is also available for clinicians who want specialized training.23. Speech Pathology- Speech and language specialists at Children's Hospital & Research Center Oakland diagnose and treat children from infancy through age 18 who have communication disorders, hearing problems or speech impediments.24. Rheumatology- Pediatric rheumatologists at UCSF Benioff Children's Hospital Oakland diagnose and treat rheumatic disorders and multi-system inflammatory diseases that affect muscles, joints and connective tissues. We evaluate patients with a wide variety of symptoms including musculoskeletal complaints, bone and joint pain, unexplained rash, and fevers of unknown origin. Diagnoses treated include juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), juvenile dermatomyositis (JDM), vasculitis, scleroderma, and periodic fever/inflammatory syndromes. 25. Dermatology- Our team of board certified pediatric dermatologists and experienced clinicians are specially trained and certified to care for children. Pediatric dermatologists offer unique expertise in diagnoses and treatment of common skin conditions as well as rare and challenging skin disorders in infants, children, adolescents, and young adults. Children's dermatologists are specialists in treating pediatric skin, hair, and nail disorders and experts on how different procedures affect your child's health, appearance, and skin healing. 26. Development and Behavioral pediatrics- Staff with the Division of Development and Behavioral Pediatrics provide evaluation, diagnosis, treatment and referral services for children who have or who are at risk for developmental delay, developmental disabilities, behavior disorders and learning problems. An essential part of the services we offer is support and education for parents.27. Psychiatry- The Division of Psychiatry at Children's Hospital & Research Center Oakland offers a full range of outpatient psychiatric and psychological services for children up to age 18 and their families, as well as consultation/liaison and supporting clinical services to inpatients and staff. Children's multidisciplinary team of psychiatrists, psychologists and social workers treat children from many backgrounds and with a wide variety of conditions, including adjustment disorders, affective disorders, developmental delays, depression and learning disabilities.28. The Center for Child Protection at UCSF Benioff Children's Hospital Oakland offers a full range of medical and mental health services to children impacted by abuse and exposure to violence. Research shows that when healthcare providers ask about domestic violence, more victims disclose abuse and seek help, and a specially-trained healthcare provider can ease the way for a battered caregiver to receive services by offering encouragement and support. We take all these things into consideration when we provide routine care, and have become one of Northern California's leading resources for child protective services in a medical setting. 29. Medical Genetics- The Children's Hospital & Research Center's Division of Medical Genetics provides consultation services for children from birth to 18 years. Working in collaboration with the Craniofacial Center, the Department of Behavioral and Developmental Pediatrics and the Children's Hospital Oakland Research Institute, clinicians evaluate children who are at risk for or have evidence of genetic disorders. Adults with some types of genetic conditions may also be evaluated.30. Research- The research division, known as Childrens Hospital Oakland Research Institute or CHORI is the internationally renowned biomedical research institute. With over 350 world-class scientists and an annual budget of over $44 million, CHORI was most recently ranked 8th in the nation for National Institutes of Health pediatric research funding. Bridging basic science and clinical research in the treatment and prevention of human disease, CHORI is a leader in translational research. During the last 50 years, CHORI has provided cures for debilitating blood diseases and cancers, developed new vaccines for infectious diseases, and discovered new treatment protocols for previously fatal or debilitating conditions.Providing the highest standard of excellence and innovation, CHORI brings together a multidisciplinary collaborative of distinguished investigators in eight different Centers of Research: The Center for Cancer Research, The Center for Critical Care Medicine,The Center for Genetics, The Center for Immunobiology & Vaccine Development, The Jordan Family Center for Blood & Marrow Transplantation and Cellular Therapies Research, The Center for Nutrition & Metabolism, The Center for Prevention of Obesity, Cardiovascular Disease & Diabetes, and The Center for Sickle Cell Disease & Thalassemia.Among the leading biotech enterprises in the Bay Area, CHORI has had over 86 patents issued and over 200 inventions disclosed. In addition to providing world-class research, CHORI is also a teaching institute, offering unique educational opportunities to high school, college, doctoral and post-doctoral students. 286764009 427816117 429047348 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 429 0 1 3127 1 0 0 0 0 0 0 0 0 0 0 X 21 19 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Colleen Reid 5104283467 747 52ND STREET OAKLAND CA 94609 X Louis J Lavigne Jr Chairman 5.00 3.00 X X 0 0 0 Shahan Soghikian Vice Chairperson 1.00 3.00 X X 0 0 0 Edward Penhoet PhD Secretary 1.00 3.00 X X 0 0 0 Jeffrey Cheung TREASURER 1.00 3.00 X X 0 0 0 Aida Alvarez LOA board member 1.00 3.00 X 0 0 0 David Beier board member 1.00 3.00 X 0 0 0 Lynne Benioff board member 1.00 3.00 X 0 0 0 Thomas Bret board member 1.00 3.00 X 0 0 0 Farah Champsi board member 1.00 3.00 X 0 0 0 Charles Cole III board member 1.00 3.00 X 0 0 0 Timothy Kendall board member 1.00 3.00 X 0 0 0 Kelley Meade MD Board Member 1.00 3.00 X 0 0 0 Jason Moment board member 1.00 3.00 X 0 0 0 Elsa Stad board member 1.00 3.00 X 0 0 0 Robin Washington board member 1.00 3.00 X 0 0 0 Carrie Wheeler board member 1.00 3.00 X 0 0 0 Melissa williams board member 1.00 3.00 X 0 0 0 Talmadge King MD Board Member/ex officio 1.00 3.00 X 0 923659 51960 Mark Laret CEO/President UCSF 4.00 36.00 X X 0 1205185 149011 Michael Anderson MD CEO/President 19.00 21.00 X X 0 17720 0 Bertram Lubin MD CEO/President (THRU 12/16) 31.00 9.00 X X 0 854167 39848 Colleen Reid Controller 40.00 0.00 X 0 296418 37561 Richard DeCarlo COO (Thru 5/17) 19.00 21.00 X 0 665173 40061 Lisa Ozaeta VP Children's Strategy (Thru 5/17) 19.00 21.00 X 0 408972 9789 Robert Fries CFO 19.00 21.00 X 0 607357 39102 David Durand MD VP & CMO Pediatrics 38.00 2.00 X 0 487593 55153 Nancy Shibata SVP Ops & CNO 40.00 0.00 X 435494 0 163490 Douglas Nelson VP of Capital Construction 40.00 0.00 X 231892 0 38323 Phyllis Weiss VP OF Human Resources 40.00 0.00 X 305582 0 18226 Steven Yedlin CIO & CEO, CFMG 40.00 0.00 X 469380 0 61319 LENDA TOWNSEND-WILLIAMS COO, CFMG 40.00 0.00 X 428356 0 111296 Mimi Yan Lee RN 40.00 0.00 X 336898 0 52818 CAROLYN Dossa VP, INSTITUTIONAL QUALITY 40.00 0.00 X 321028 0 82709 JAMES Sullivan Cardiovascular techNICIAN 40.00 0.00 X 281662 0 143776 Kathleen Cain Former CFO (THRU 12/15) 40.00 0.00 X 0 489412 0 Charlotte Biern Former SVP/CHF DVLPMNT (THRU 12/15) 40.00 0.00 X 372196 0 0 Donald Livsey Former CIO (THRU 11/15) 40.00 0.00 X 325148 0 30993 PATRICIA TAGGART Former VP/AMB SVS & CAO (THRU 11/15) 40.00 0.00 X 318469 0 64181 RAJNESH Prasad Former VP/RESEARCH OPS. 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Resolved at least 1 unmet social need for intervention group in RCT. For intervention group, improved perception of child health outcomes. Across study high patient satisfaction rates. Increased clinical training opportunities to address the social Determinants of health.Objective: Expand infrastructure at Early Intervention Services (EIS) to enable evaluation at UCSF Benioff Oakland's EIS.Impact: Objective met. EIS has the infrastructure to conduct research. EIS has obtained $2,200,000 in grants. CHILDREN'S HOSPITAL & RESEARCH CENTER Part V, Section B, Line 5: Primary data collection included input from more than 166 members of the hospital service area (HSA), expert interviews with 31 key informants, and 23 focus group interviews with 290 community members. In addition, a community health assets assessment collected data on more than 600 assets within the hospital's service area. CHILDREN'S HOSPITAL & RESEARCH CENTER Part V, Section B, Line 11: In 2016, the hospital identified the greatest public health needs in our community through its CHNA. Through a structured process, a committee of 15 individuals then prioritized and organized these needs into four areas: mental health, economic security, maternal/child health, and health care access/delivery. Within each area, the committee identified new objectives and strategies for how the hospital will address them. The group summarized this plan in a document called CHNA Priorities, Objectives, and Strategies (2016-2019). In addition to these new activities, the hospital maintains numerous long-term programs that continue to address health needs. These programs are summarized in the annual Community Benefit Report. A few needs were identified that were not selected as a priority for the hospital because they were beyond the scope of what we can do effectively. For example, there is a critical housing shortage in our area which has had the effect of displacing lower income families in particular. Housing costs drain resources from families, which negatively affects mental and physical health. This is a problem for which our hospital has little knowledge and insufficient resources to address. Part V, Section B, Line 16 www.childrenshospital.orgLine 16(a) - During the tax year, the Billing and Payment section of the Hospital's website informed patients who were experiencing financial hardship or were otherwise unable to pay their medical bills that financial assistance was available. The Hospital's staff and outside counsel are currently developing updated versions of the Hospital's FAP and FAP plain language summary for the Board's approval. Once approved, the updated FAP and FAP plain language summary will be conspicuously posted on the Hospital's website along with the financial assistance application. During the tax year, the Hospital engaged in significant and effective efforts to widely publicize its FAP. Every individual that was admitted and received care at the Hospital received information, either orally or in writing, regarding the availability of financial assistance as part of the intake or discharge process. Patients receiving billing statements related to their care were aware of the availability of financial assistance. The Hospital also took measures to conspicuously display signage in its emergency room, patient registration areas, clinics, and other outpatient settings that notified and informed patients about the FAP, and provided related notices and brochures to its patients. To facilitate the financial assistance application process, the Hospital offered patients financial counseling services at no cost. Specifically, trained staff from the Patient Financial Services Department was responsible for contacting patients to inform them of their financial liability and to assist them in resolving potential financial problems as early as possible.Line 16(b) - Please see the response to Item 16(a), above, describing the numerous methods utilized by the Hospital to widely publicize its FAP and how it facilitated the financial assistance application process. Additionally, note that paper copies of the financial assistance application were made available to patients upon request and without charge, both by mail and in public locations, including the Hospital's emergency room and patient registration areas. Line 16(f) - Please see the response to Item 16(a), above, describing the numerous methods utilized by the Hospital to widely publicize its FAP and how it facilitated the financial assistance application process. The Billing and Payment section of the Hospital's website clearly notified patients that financial assistance was available under the FAP and provided the contact information for financial counselors which patients could utilize at no cost for purposes of applying for financial assistance under the FAP. Line 16(h) - The Billing and Payment section of the Hospital's website informs patients who are experiencing financial hardship or are otherwise unable to pay their medical bills that financial assistance is available. To facilitate the financial assistance application process, the Hospital offers patients financial counseling services at no cost. Specifically, as noted in the FAP , trained staff from the Patient Financial Services Department are responsible for contacting patients to inform them of their financial liability and to assist them in resolving potential financial problems as early as possible. Part V, Section B, Line 24 All Outpatients without known coverage are automatically discounted to the insured rate, inpatient gross charges could be billed at full rate until patient (guarantor) submits a completed application for financial assistance for the care received or a determination is made as to the patient's (guarantor's) eligibility for financial assistance. 1 1 - Alameda County Juvenile Justice Center 2500 Fairmont Drive san leandro CA 94578 Medical clinic at Juvenile detention facility Part I, Line 7: Costing method: The data source is from discharged patient records combining Billing, Medical Records and Admission data in Meditech which is interfaced on a monthly basis into the TRENDSTAR Decision Support system used by finance. On a monthly basis, the TRENDSTAR data is reconciled back to the General Ledger by Finance for Net Revenues and Expenses. Costs are categorized into "Direct and "Indirect" expense. Direct expense is the operating expense directly associated with a given department (salaries, supplies, purchased services, etc). "Indirect expense" are those expenses that are "allocated" to each department from non-patient care areas. All indirect costs are allocated to revenue producing departments based on cost report logic - i.e. depreciation, maintenance and housekeeping are allocated based on square feet. Part I, Line 7g: Subsidized Health Services: Children's Hospital has 4 major programs: Endocrinology, Juvenile Justice Adolescent Medicine Model of Integrated Networks (Juvenile Justice Center); Early and Periodic Screening, Diagnosis,and Treatment (EPSDT); and Primary Care. Part I, Ln 7 Col(f): ACCOUNTS MAY BE ADJUSTED FOR A VARIETY OF REASONS, Including DISSATISFACTION WITH SERVICE or POTENTIAL LEGAL ACTION. IF ALL COLLECTION EFFORTS FAIL, AN ACCOUNT MAY BE ASSIGNED TO BAD DEBT, AND THE OUTSTANDING BALANCE MAY BE WRITTEN OFF. Part II, Community Building Activities: UCSF Benioff Children's Hospital Oakland has served as a pillar of the community for over 100 years, and continues care for all children, from all backgrounds and all walks of life. The Department of Community Health and Engagement (DCHE) at Benioff Children's demonstrates how a children's hospital can reach beyond the traditional medical model to address the social determinants of health that contribute to the overall health and success of children. Community Health and Engagement bridges children's health care with community needs, our existing community benefit programs, and serves as a point of contact for external collaborators with shared values. Part III, Line 3: the methodology used in determining the amounts reported as bad debt expense above is the amount that the payer is expected to pay and does not pay. Part III, Line 4: the methodology used for accounting for discounts and payments on patient accounts in determining bad debt expense above:ACCOUNTS MAY BE ADJUSTED FOR A VARIETY OF REASONS, Including DISSATISFACTION WITH SERVICE or POTENTIAL LEGAL ACTION. IF ALL COLLECTION EFFORTS FAIL, AN ACCOUNT MAY BE ASSIGNED TO BAD DEBT, AND THE OUTSTANDING BALANCE MAY BE WRITTEN OFF.Management analyzed the locations with the most bad debt expense. An estimated 65% of those patients with bad debt expense would have been eligible had they completed the hospital's application. Most of the individuals who elect not to complete the process are undocumented and/or non-compliant and have received their services, cannot pay and simply ignore our collection efforts. Part III, Line 8: Cost-to-charge. Part III, Line 9b: Collection Practices: Direct Charity Care is the provision of healthcare goods and services without charge or at substantially reduced rates to members of the community who demonstrate an inability to pay for necessary healthcare services either entirely or in part. This is distinguished from bad debt which results from an unwillingness to pay and from contractual discount which results from predetermined agreements to accept some reduction from billed charges. Collection activity is not initiated on charity care patients because the charges were never expected to be paid, and are thus not bad debt. Part VI, Line 2: NEEDS ASSESSMENT:IDENTIFIED EXISTING NEEDS ASSESSMENTS AND EPIDEMIOLOGICAL REPORTS FOR BOTH ALAMEDA AND CONTRA COSTA COUNTIES; CONDUCTED STRUCTURED ONE-ON-ONE INTERVIEWS WITH AN INFORMED GROUP OF STAKEHOLDERS; USING INFORMATION FROM THE REPORTS AND INTERVIEWS, CREATED A LIST OF OVER 50 PUBLIC HEALTH ISSUES AND SOCIAL OR ECONOMIC CONDITIONS THAT AFFECT THE HEALTH OF CHILDREN IN BOTH COUNTIES; SELECTED TOP 20 DISEASES/CONDITIONS; CREATED GRAPHS ILLUSTRATING THE CONDITIONS AND COMPARED TO CALIFORNIA AND US DATA. Part VI, Line 3: Patient education of eligibility for assistance:Information about financial assistance available from Children's Hospital shall be disseminated through a variety of mechanisms, including posting notices in the Emergency Department, clinics, other public places in the hospital, outpatient settings, and including information on the patient's/guarantor's bill. This information shall be provided in English and Spanish, and will be translated for patients/guarantors who speak other languages. Part VI, Line 4: Community information:Alameda and Contra Costa counties are the primary service area. They are among the top ten largest counties by population in California. Children and young adults from birth to 24 years constitute about one-third of the population. Alameda County has more diversity, with a larger proportion of Blacks and nearly double the percentage of Asians compared to Contra Costa County, where Whites are the majority. Part VI, Line 5: Promotion of Community Health:Several programs promote health improvement. The following are a few examples. The Center for Asthma Education, Management, and Research (CAEMR), based in Children's Primary Care Clinic, offers expertise in the management of asthma in children and adolescents. The Kohl's Injury Prevention Program (IPP), administered by Trauma Services at Children's, aims to reduce the number of unintentional injuries and fatalities in children younger than 14, primarily through education and by providing equipment to promote safety. Early Intervention Services (EIS) provides therapeutic intervention, child development services, and family support services for infants and young children (ages 0-6) with emerging developmental, medical, and social-emotional delays. Children's Comprehensive Center for Hemoglobinopathies, one of the largest in the world, treats about 1,000 children and adults with sickle cell disease and thalassemia each year, provides education to families and other medical providers, serves as a local and international resource, and conducts research and advocacy to improve the survival and quality of life of people with these conditions. Part VI, Line 7, Reports Filed With States CA X X 1 1 X X X X 1 0 0 0 0 0 0 1 0 Talmadge King MD Board Member/ex officio 0 629369 0 280604 0 13686 0 35201 0 16759 0 975619 0 0 Mark Laret CEO/President UCSF 0 1004777 0 185156 0 15252 0 127073 0 21938 0 1354196 0 0 Bertram Lubin MD CEO/President (THRU 12/16) 0 703810 0 133470 0 16887 0 20271 0 19577 0 894015 0 0 Colleen Reid Controller 0 255683 0 40735 0 0 0 17984 0 19577 0 333979 0 0 Richard DeCarlo COO (Thru 5/17) 0 575089 0 90084 0 0 0 20484 0 19577 0 705234 0 0 Lisa Ozaeta VP Children's Strategy (Thru 5/17) 0 351803 0 57169 0 0 0 9789 0 0 0 418761 0 0 Robert Fries CFO 0 500897 0 43537 0 62923 0 16118 0 22984 0 646459 0 0 David Durand MD VP & CMO Pediatrics 0 407959 0 79634 0 0 0 47606 0 7547 0 542746 0 0 Nancy Shibata SVP Ops & CNO 351504 0 78660 0 5330 0 148934 0 14556 0 598984 0 0 0 Douglas Nelson VP of Capital Construction 230650 0 0 0 1242 0 25067 0 13256 0 270215 0 0 0 Phyllis Weiss VP OF Human Resources 262935 0 31350 0 11297 0 15900 0 2326 0 323808 0 0 0 Steven Yedlin CIO & CEO, CFMG 412558 0 52250 0 4572 0 47736 0 13583 0 530699 0 0 0 LENDA TOWNSEND-WILLIAMS COO, CFMG 409980 0 16000 0 2376 0 101668 0 9628 0 539652 0 0 0 Mimi Yan Lee RN 336898 0 0 0 0 0 39941 0 12877 0 389716 0 0 0 CAROLYN Dossa VP, INSTITUTIONAL QUALITY 259611 0 59095 0 2322 0 63859 0 18850 0 403737 0 0 0 JAMES Sullivan Cardiovascular techNICIAN 281662 0 0 0 0 0 134204 0 9572 0 425438 0 0 0 Kathleen Cain Former CFO (THRU 12/15) 0 17038 0 0 0 472374 0 0 0 0 0 489412 0 0 Charlotte Biern Former SVP/CHF DVLPMNT (THRU 12/15) 0 0 0 0 372196 0 0 0 0 0 372196 0 0 0 Donald Livsey Former CIO (THRU 11/15) 0 0 0 0 325148 0 30993 0 0 0 356141 0 0 0 PATRICIA TAGGART Former VP/AMB SVS & CAO (THRU 11/15) 0 0 0 0 318469 0 64181 0 0 0 382650 0 0 0 RAJNESH Prasad Former VP/RESEARCH OPS. (THRU 2/16) 57314 0 0 0 253845 0 7415 0 3305 0 321879 0 0 0 Part I, Line 1a All compensation is reported on the W-2. We gross up salaries for financial planning and gym membership. Part I, Line 4a The following individuals received a severance payment during the year: -Charlotte Biern - $330,741 -Donald Livsey - $283,920 -Patricia Taggart - $251,500 -Rajnesh Prasad - $244,323 -Kathleen Cain - $410,750 Part I, Line 7 THE PURPOSE OF THE EXECUTIVE VARIABLE COMPENSATION PROGRAM (EVCP) IS TO FOCUS EXECUTIVES ON SPECIFIC, ANNUAL GOALS THAT ARE CRITICAL TO THE SUCCESS OF THE HOSPITAL AND ITS SUSTAINABILITY FOR THE FUTURE. THE EVCP IS DESIGNED TO ALIGN THE INTERESTS OF ALL BOARD AND EXECUTIVE STAKEHOLDERS TOWARDS THE MISSION, VISION AND GOALS OF THE HOSPITAL. THE BOARD OF DIRECTORS APPROVED THIS PLAN. IN ORDER FOR ANY BONUSES TO BE PAID THROUGH THE EVCP, THE GOALS WHICH ARE BASED ON A COMBINATION OF OVERALL HOSPITAL-WIDE ORGANIZATIONAL PERFORMANCE, DEPARTMENTAL, AND INDIVIDUAL PERFORMANCE MUST BE MET. THE MIX OF THESE CATEGORIES IN THE CALCULATION MAY DIFFER BY EXECUTIVE POSITION, A MAXIMUM BONUS OF 30% OF SALARY PER YEAR MAY BE EARNED FOR ACCOMPLISHMENTS OF GOALS. THE PARTICIPANT MUST ALSO BE AN EMPLOYEE IN GOOD STANDING AT THE TIME THE AWARD IS PAID. UCSF Clinical Enterprise Management Recognition Plan The purpose of the Regental approved University of California Clinical Enterprise Management Recognition Plan (CEMRP or Plan) is to provide at-risk, variable incentive compensation opportunity to those employees responsible for achieving or exceeding key Clinical Enterprise objectives. Consistent with healthcare industry practices, UC Health Systems use performance-based incentive compensation programs to encourage and reward achievement of specific financial and/or nonfinancial objectives (e.g., quality of care or patient satisfaction and safety, budget performance) and strategic objectives which relate to the Clinical Enterprise's mission. Awards amounts will be reviewed and approved by the CEO, Chancellor and Administrative Oversight Committee (AOC). Form 990, Part VI, Section A, line 6 CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND HAS A CORPORATE MEMBER, REGENTS OF THE UNIVERSITY OF CALIFORNIA. Form 990, Part VI, Section A, line 7a Children's Hospital & Research Center At Oakland has a corporate member, Regents of University of California. New bylaws state that the member has the authority to appoint all the directors except the ex officios - so that would be all the independent directors. Form 990, Part VI, Section B, line 11b A draft of the Form 990 was reviewed by senior management. A draft was submitted to the Board of Directors for a last review and revisions prior to submission to the Internal Revenue Service. Form 990, Part VI, Section B, line 12c Children's Hospital & Research Center at Oakland requires all employees, independent contractors, consultants, advisors and volunteers of the Hospital to observe high standards of business and personal ethics in the conduct of their duties and responsibilities. A Conflicts of Interest Reporting and Certification form is used as requested for Board Members, Medical Staff and employees to disclose potential conflicts of interest. The Hospital Conflict of Interest Policy provides the scope, purpose and other information detailing the requirements of employees to adhere to the policy. Form 990, Part VI, Section B, line 15 Compensation recommendations for the CEO, COO, CFO and CMO are approved by the University of California as the member of the corporation utilizing market data from Sullivan Cotter to assist with development of salary recommendations. Sullivan Cutter consultants' have strong expertise and knowledge in the healthcare executive compensation. Compensation recommendations for the Senior Vice Presidents, Vice Presidents, and key employees employed by The Hospital are reviewed by an external independent consulting firm, FutureSense, Inc. FutureSense, Inc provides recommendations to the Chief Executive Officer who approves the final compensation for the leadership positions employed by the Hospital. FutureSense, Inc. specializes in healthcare compensation and has substantial expertise in executive compensation. The recommendations include comparisons to benchmark market compensation for comparable positions for base and total compensation. Form 990, Part VI, Section C, line 19 To obtain a copy of the audited financial statements and or conflict of interest policy, One must submit a written request to the RISK MANAGEMENT DEPARTMENT and a copy will be sent to the return address. California law requires that the corporation file its Articles of Incorporation (and any amendments or restatements with respect thereto) with the California Secretary of State. Children's has done so. Copies of the Articles can be obtained by members of the public through the office of the California Secretary of State. There is no legal requirement that the corporation provide copies of its governance documents directly to members of the public. The issue of whether the corporation should voluntarily make these documents available for review is being reviewed by the Governance Committee of the Children's Board of Directors. 990, Part VII, Section A & Part IX, Statement of Functional Expenses The officer's listed on Form 990 Part VII Section A--Officers, Directors, Trustees, Key Employees and Highest Compensated Employees--are employed and compensated by University of California San Francisco (UCSF). UCSF reports 100% of the individual's compensation on W-2s, which are issued by UCSF. The officers are assigned duties to the filing organization and other related organizations (See Schedule R for additional information regarding the related organizations). As a result of these assignments, wage and benefit costs are allocated from related organization to the filing organization. The wage and benefit costs allocated from UCSF are reported for each individual as being compensated directly from the filing organization and the balance of compensation is reported as compensation by the related organizations. Form 990, Part IX, line 11g other fees for services: Program service expenses 778,317. Management and general expenses 3,866,975. Fundraising expenses 0. Total expenses 4,645,292. Physician Fees: Program service expenses 48,520,156. Management and general expenses 6,627,608. Fundraising expenses 0. Total expenses 55,147,764. form 990, Part VIII, Line 1d Children's Hospital & Research Center at Oakland received contributions from Children's Hospital & Research Center Foundation in the amount of $18,946,737 for the year ended June 30, 2017. Only a portion of the funds received was recognized into income and has been appropriately reported in Part VIII of the 990. The remaining portion of the funds received was recorded to deferred revenue. When the remaining funds are recognized into income, they will be reported as income on Line 1d. In addition, Children's Hospital & Research Center at Oakland received contributions from UCSF Foundation in the amount of $12,000,000 for the year ended June 30, 2017. Only a portion of the funds received was recognized into income and has been appropriately reported in Part VIII of the 990. The remaining portion of the funds received was recorded to deferred revenue. When the remaining funds are recognized into income, they will be reported as income on Line 1d. CHILDREN'S HOSPITAL & RESEARCH CNTR FNDN 2201 Broadway Suite 600 Oakland CA 94612 941657474 charitable foundation CA 501(c)(3) Line 7 CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND 1 Children's Hospital Oakland Family House 5222 Dover St Oakland CA 94609 942909976 TEMPORARY LODGING FOR PATIENT FAMILIES CA 501(c)(3) Line 7 CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND 1 BayChildren's Physicians 6475 Christie Ave 300 Emeryville CA 94608 861175591 Medical foundation CA 501(c)(3) Line 10 The Regents of The University of California 0 Foundation for Children's Care DBA Family Legacy Fund 2201 Broadway Suite 600 Oakland CA 94612 912145422 Foundation Support CA 501(c)(3) Line 12a, I CHILDREN'S HOSPITAL & RESEARCH CNTR FNDN 1 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA 1111 FRANKLIN STREET Oakland CA 94607 946036493 PUBLIC EDUCATIONAL INSTITUTION CA 501(c)(3) Line 6 N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 Children's Hospital & Research Center Foundation C 18946737 Cash Receipts children's Hospital & Research Center Foundation Q 3408706 BOOK VALUE