2025-11-12T16:02:03-06:00 2024-12-31 135565207 KPMG LLP 3975 FREEDOM CIRCLE SANTA CLARA CA 95054 990 2024-01-01 680249685 JOHN MUIR BEHAVIORAL HEALTH JOHN 9259393000 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 TED WANG CFO 9259393000 2025-11-07 1 0 CAREY MCKEE P01281067 2139724000 2025-11-07 2024 2025-03-06 01:10:19Z MICHAEL S THOMAS 1400 TREAT BLVD WALNUT CREEK CA 94597 54186756 0 X WWW.JOHNMUIRHEALTH.COM X 1991 CA 73 BED ACUTE PSYCHIATRIC HOSPITAL PROVIDING CARE TO CHILDREN, ADOLESCENTS AND ADULTS. 16 15 298 0 0 0 14421914 12059749 44667251 42127007 0 0 0 0 59089165 54186756 9391698 7257781 0 0 31463150 32030263 0 0 0 15871878 16822131 56726726 56110175 2362439 -1923419 19955745 17332987 6603633 5904294 13352112 11428693 JOHN MUIR BEHAVIORAL HEALTH PROVIDES PSYCHIATRIC AND SUBSTANCE ABUSE TREATMENT IN A 73-BED ACUTE PSYCHIATRIC HOSPITAL TO CHILDREN, ADOLESCENTS, AND ADULTS AND OFFERS ADOLESCENT AND ADULT TREATMENT IN A PARTIAL HOSPITAL AND INTENSIVE OUTPATIENT PROGRAM. 0 0 32721462 7257781 42127007 PATIENT CARE ACTIVITIES SUPPORT JOHN MUIR BEHAVIORAL HEALTH'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES WITH QUALITY AND COMPASSION BY PROVIDING SPECIALIZED PSYCHIATRIC AND SUBSTANCE ABUSE TREATMENT. JOHN MUIR BEHAVIORAL HEALTH OWNS AND OPERATES A FREESTANDING ACUTE PSYCHIATRIC HOSPITAL WITH 73 LICENSED BEDS TREATING CHILDREN, ADOLESCENT, AND ADULT PATIENTS AND A PARTIAL HOSPITAL AND INTENSE OUTPATIENT PROGRAM TREATING ADOLESCENT AND ADULT PATIENTS. 32721462 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 31 0 1 298 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JEFFREY SMITH 9259393000 1400 TREAT BLVD WALNUT CREEK CA 94597 MICHAEL S THOMAS CEO/DIRECTOR/PRESIDENT 5.00 70.00 X X 0 2125935 1676571 JAY HARRIS CHAIRMAN 5.00 10.00 X X 0 0 0 ROGER BAILEY VICE CHAIRMAN 5.00 10.00 X X 0 31250 0 JOHN SAYRES SECRETARY & TREASURER 5.00 10.00 X X 0 31250 0 FATIMA ANGELES DIRECTOR 5.00 10.00 X 0 31250 0 CHINNAVUTH DE MONTEIRO MD DIRECTOR 5.00 10.00 X 0 31250 0 ANNE GRODIN DIRECTOR 5.00 10.00 X 0 31250 0 STEVEN GREEN MD DIRECTOR 5.00 10.00 X 0 39500 0 CAROLYN LACEY MD DIRECTOR 5.00 10.00 X 0 31250 0 LAUREN MARKSTEIN DIRECTOR 5.00 10.00 X 0 25000 0 MARK MUSCO MD DIRECTOR 5.00 10.00 X 0 31250 0 KATHLEEN ODNE DIRECTOR 5.00 10.00 X 0 31250 0 JACK THOMPSON DIRECTOR 5.00 10.00 X 0 31250 0 PETER WILSON DIRECTOR 5.00 10.00 X 0 31250 0 VIVIAN WING MD DIRECTOR 5.00 10.00 X 0 31250 0 STEPHEN YOUNG MD DIRECTOR 5.00 10.00 X 0 25000 0 JANE WILLEMSEN CHIEF OPERATING OFFICER 6.00 66.00 X 0 1585728 607981 MELINDA ESTEP SENIOR VP/CFO (THRU 6/4/24) 5.00 70.00 X 0 717836 8033 TIM MAURICE INTERIM CFO (AS OF 6/4/24) 5.00 70.00 X 0 374400 0 JESSE TAMPLEN VICE PRESIDENT 40.00 0.00 X 507339 0 165778 KRISTIN PACE DIRECTOR OF NURSING 40.00 0.00 X 318455 0 73150 BOUALAY BALA MANAGER 40.00 0.00 X 281024 0 72727 KATIE JONES MANAGER 40.00 0.00 X 281024 0 70500 SONIA GOMEZ MANAGER 40.00 0.00 X 277110 0 59958 1664952 5237149 2734698 102 0 1 0 UNIVERSAL PROTECTION SERVICES LP PO BOX 31001-2374 PASADENA CA 91110 SECURITY SERVICES 602922 CROSS COUNTRY STAFFING LA LOCKBOX FILE 50941 LOS ANGELES CA 90074 TEMP STAFFING 258394 ARMAN DANIELYAN MD INC PO BOX 1326 LAFAYETTE CA 94549 MEDICAL 199100 ALEX SMIRNOFF MD INC PO BOX 30753 WALNUT CREEK CA 94598 MEDICAL 168075 CEP AMERICA - PSYCHIATRY 2100 POWELL STREET STE 900 EMERYVILLE CA 94608 MEDICAL 128700 6 12059749 12059749 NET PATIENT REVENUE 621400 41977576 41977576 OTHER OPERATING REVENU 621400 149431 149431 42127007 54186756 42127007 0 0 7257781 7257781 25934355 16689210 9245145 942546 704406 238140 3319706 2447420 872286 1833656 1210511 623145 1846493 1846493 62734 42000 20734 2707308 1722092 985216 930082 234092 695990 2329596 1622670 706926 14256 109 14147 951963 539259 412704 HEALTH ASSESSMENT 7538491 7538491 PHARMACEUTICALS 172721 169781 2940 MEDICAL SUPPLIES 93417 80122 13295 LICENSES & TAXES 22327 1052 21275 152743 957 151786 56110175 32721462 23388713 0 1309622 2124658 0 0 0 0 6224066 6931160 0 0 0 0 0 0 62145 61285 270475 245196 16011173 9479243 8138532 6531930 0 0 0 0 0 0 0 0 3950905 1438758 19955745 17332987 4282443 3865611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2321190 2038683 6603633 5904294 X 13352112 11428693 0 0 13352112 11428693 19955745 17332987 -1923419 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12935494 7410257 5525237 2968723 2068986 899737 106956 106956 6531930 OTHER RECEIVABLES 13875 RIGHT OF USE ASSETS 1277403 OTHER ASSETS 147480 1438758 LEASE LIABILITIES 1891203 OTHER LIABILITIES 147480 2038683 42241280 0 42241280 11945476 11945476 54186756 48852394 0 48852394 7257781 7257781 56110175 PART XI, LINE 4B - OTHER ADJUSTMENTS: GROSS-UP FOR REVENUE INCLUDED IN CHANGES IN NET ASSETS 11,945,476. PART XII, LINE 4B - OTHER ADJUSTMENTS: GROSS-UP FOR EXPENSES INCLUDED IN CHANGES IN NET ASSETS 7,257,781. 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 77252 77252 0.00140 11474616 10086925 1387691 0.02470 11551868 10086925 1464943 0.02610 3708 3708 0.00010 170407 170407 0.00300 5223419 5223419 0.09310 988 988 0.00000 5398522 5398522 0.09620 16950390 10086925 6863465 0.12230 0 1415379 14851353 17409236 -2557883 X 1 1 1 1 JOHN MUIR BEHAVIORAL HEALTH 2740 GRANT ST CONCORD CA 94520 WWW.JOHNMUIRHEALTH.COM 140000418 X JOHN MUIR BEHAVIORAL HEALTH 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 400.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 JOHN MUIR BEHAVIORAL HEALTH PART V, SECTION B, LINE 5: COMMUNITY INPUT PROCESSCOMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS VIA KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. INDIVIDUALS WITH THE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH AND OTHER PUBLIC AGENCIES, COMMUNITY ORGANIZATIONS, AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND RACIAL/ETHNIC POPULATIONS. KEY INFORMANT INTERVIEW METHODOLOGY:APPLIED SURVEY RESEARCH (ASR) CONDUCTED 32 KEY INFORMANT INTERVIEWS WITH REPRESENTATIVES FROM ORGANIZATIONS SERVING CONTRA COSTA COUNTY AND 43 KEY INFORMANT INTERVIEWS WITH INDIVIDUALS FROM ORGANIZATIONS SERVING ALAMEDA COUNTY. THOSE ORGANIZATIONS REPRESENT DIVERSE SECTORS. THE KEY INFORMANTS WERE IDENTIFIED COLLABORATIVELY BY KAISER PERMANENTE, THE PUBLIC HEALTH AGENCIES AND MEMBERS OF THE ALAMEDA AND CONTRA COSTA COUNTIES HOSPITAL CHNA GROUP. ALL INTERVIEWS WERE CONDUCTED IN ENGLISH AND FOLLOWED A STANDARD SET OF INTERVIEW QUESTIONS. CONFIDENTIALITY WAS ASSURED AT THE BEGINNING OF EACH INTERVIEW AND INTERVIEWERS TOOK DETAILED NOTES DURING THE CONVERSATION. INTERVIEW TOPICS: INTERVIEW QUESTIONS WERE DEVELOPED BY ASR AND ADDRESSED THE FOLLOWING TOPICS: - PRIORITY PLACED ON 2019 HEALTH NEEDS - OTHER PRIORITY HEALTH NEEDS - IMPACT OF COVID-19 ON PRIORITY HEALTH NEEDS - CHALLENGES TO ADDRESSING PRIORITY HEALTH NEEDS - SOURCES OF INFORMATION ON HEALTH NEEDS - STRATEGIES TO ADDRESS PRIORITY HEALTH NEEDS - HEALTH INEQUITIES AND DISPARITIES - STRATEGIES TO ADDRESS INEQUITIES/DISPARITIES - EXISTING COMMUNITY RESOURCES TO ADDRESS PRIORITY HEALTH NEEDSDATA ANALYSIS: ASR DELIVERED TO AD LUCEM CONSULTING A SPREADSHEET CONTAINING INDIVIDUAL INTERVIEWEE RESPONSES AND KEY THEMES. THE THEMES WERE FURTHER ORGANIZED BY AD LUCEM CONSULTING INTO THE HEALTH NEEDS DEFINED BY THE KAISER PERMANENTE COMMUNITY HEALTH DATA PLATFORM, THEN THE NUMBER OF MENTIONS FOR ALL THEMES RELATED TO A PARTICULAR HEALTH NEED WERE TALLIED TO DEVELOP AN INTERVIEW DATA SCORE. HEALTH NEEDS WERE ASSIGNED POINTS BASED ON THE FREQUENCY OF MENTIONS OF THE HEALTH NEED BY KEY INFORMANTS. POINTS FOR EACH HEALTH NEED WERE TALLIED ACROSS INTERVIEWEES TO DEVELOP INTERVIEW SCORES FOR HEALTH NEED PRIORITY, RACIAL/ETHNIC DISPARITIES, GEOGRAPHIC OR OTHER DISPARITIES AND IMPACT OF THE COVID-19 PANDEMIC ON THE HEALTH NEED.FOCUS GROUP METHODOLOGY: NINE COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED IN GEOGRAPHIC AREAS WITHIN EASTERN, CENTRAL, AND WESTERN COSTA COUNTY. SEVEN GROUPS WERE CONDUCTED IN ENGLISH, AND TWO WERE CONDUCTED IN SPANISH. PARTICIPANTS WERE BLACK/AFRICAN AMERICAN AND LATINX COMMUNITY MEMBERS, AND ADULTS OVER THE AGE OF 65 FROM UNDERSERVED, LOW-INCOME, AND DIVERSE RACIAL/ETHNIC COMMUNITIES. TEN COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED IN GEOGRAPHIC AREAS WITHIN NORTHERN AND CENTRAL ALAMEDA COUNTY AND THE TRI-VALLEY AREA. THREE GROUPS WERE CONDUCTED IN ENGLISH, FOUR WERE CONDUCTED IN SPANISH, ONE IN VIETNAMESE, ONE IN CANTONESE, AND ONE IN A COMBINATION OF ENGLISH AND SPANISH. PARTICIPANTS WERE FROM UNDERSERVED, LOW-INCOME, SENIOR, UNHOUSED, LGBTQIA+, AND DIVERSE RACIAL/ETHNIC COMMUNITIES (VIETNAMESE, CANTONESE, BLACK/AFRICAN AMERICAN, INDIGENOUS, AND LATINX). JOHN MUIR BEHAVIORAL HEALTH PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN CHNAALL JOHN MUIR HEALTH HOSPITAL FACILITIES (JOHN MUIR MEDICAL CENTER, WALNUT CREEK; JOHN MUIR MEDICAL CENTER, CONCORD; AND JOHN MUIR BEHAVIORAL HEALTH) COLLABORATED WITH SUTTER HEALTH, ST. ROSE HOSPITAL, STANFORD HEALTH CARE VALLEYCARE, UCSF BENIOFF CHILDREN'S HOSPITALS, KAISER PERMANENTE, ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT AND CONTRA COSTA HEALTH SERVICES ON THE COMMUNITY HEALTH NEEDS ASSESSMENT. JOHN MUIR BEHAVIORAL HEALTH PART V, SECTION B, LINE 6B: OTHER NON-HOSPITAL ORGANIZATIONS INCLUDED IN CHNAJOHN MUIR BEHAVIORAL HEALTH, IN CONNECTION WITH ITS ASSOCIATION WITH JOHN MUIR HEALTH (JMH) CONTRACTED WITH AD LUCEM CONSULTING, A PUBLIC HEALTH CONSULTING FIRM, TO CONDUCT THE CHNA. AD LUCEM CONSULTING SPECIALIZES IN INITIATIVE DESIGN, STRATEGIC PLANNING, GRANTS MANAGEMENT, AND PROGRAM EVALUATION, TAILORING METHODS AND STRATEGIES TO EACH PROJECT AND ADAPTING TO CLIENT NEEDS AND PRIORITIES, POSITIONING CLIENTS FOR SUCCESS. AD LUCEM CONSULTING WORKS IN CLOSE COLLABORATION WITH CLIENTS, SYNTHESIZING COMPLEX INFORMATION INTO EASY-TO-UNDERSTAND, USABLE FORMATS, BRINGING A HANDS-ON, DOWN-TO-EARTH APPROACH TO EACH PROJECT. AD LUCEM CONSULTING SUPPORTS CLIENTS THROUGH A VARIETY OF SERVICES THAT CAN BE APPLIED TO A RANGE OF ISSUES. AD LUCEM CONSULTING HAS DEVELOPED NUMEROUS CHNA REPORTS AND IMPLEMENTATION STRATEGIES FOR HOSPITALS INCLUDING SYNTHESIS OF SECONDARY AND PRIMARY DATA, NEEDS PRIORITIZATION, AND IDENTIFICATION OF ASSETS AND IMPLEMENTATION STRATEGIES.APPLIED SURVEY RESEARCH (ASR), WWW.APPLIEDSURVEYRESEARCH.ORG, CONDUCTED KEY INFORMANT INTERVIEWS FOR CHNAS COVERING ALAMEDA AND CONTRA COSTA COUNTIES. SECONDARY DATA CHARTS/TABLES AND INTERVIEW DATA WERE GENEROUSLY SHARED WITH MEMBERS OF THE ALAMEDA AND CONTRA COSTA COUNTIES HOSPITAL CHNA GROUP. ASR ALSO CONVENED COMMUNITY STAKEHOLDERS AND HOSPITAL REPRESENTATIVES TO REVIEW SERVICE AREA DATA AND PARTICIPATE IN A HEALTH NEED RANKING PROCESS. ASR IS A SOCIAL RESEARCH ORGANIZATION DEDICATED TO HELPING PEOPLE BUILD BETTER COMMUNITIES THROUGH MEASURING AND IMPROVING ORGANIZATIONAL IMPACT AND SERVICES AND QUALITY OF LIFE. ASR HAS A STRONG HISTORY OF WORKING WITH VULNERABLE POPULATIONS AND EXTENSIVE EXPERIENCE WORKING WITH PUBLIC AND PRIVATE AGENCIES, FEDERAL AND LOCAL GOVERNMENT, HEALTH AND HUMAN SERVICE ORGANIZATIONS, CITIES AND COUNTY OFFICES, SCHOOL DISTRICTS, INSTITUTIONS OF HIGHER LEARNING AND CHARITABLE FOUNDATIONS. PART V, SECTION B, LINE 7A CHNA REPORT MADE WIDELY AVAILABLE TO PUBLICTHE CHNA REPORT WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.JOHNMUIRHEALTH.COM/ABOUT-JOHN-MUIR-HEALTH/COMMUNITY-COMMITMENT.HTML PART V, SECTION B, LINE 10A WEBSITE FOR ADOPTED IMPLEMENTATION STRATEGYTHE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.JOHNMUIRHEALTH.COM/ABOUT-JOHN-MUIR-HEALTH/COMMUNITY-COMMITMENT.HTML PART V, SECTION B, LINE 11 SIGNIFICANT NEEDS ADDRESSED IN CHNATHE HEALTH SYSTEM IDENTIFIED NINE COMMUNITY HEALTH NEEDS:1. BEHAVIORAL HEALTH2. HOUSING AND HOMELESSNESS3. ECONOMIC SECURITY4. IMPROVEMENTS IN ACCESS5. HEALTHCARE ACCESS AND DELIVERY6. COMMUNITY AND FAMILY SAFETY7. FOOD SECURITY8. EDUCATION9. TRANSPORTATIONTHE 2022 CHNA FOR JOHN MUIR BEHAVIORAL HEALTH PLACED PARTICULAR EMPHASIS ON THE HEALTH ISSUES AND CONTRIBUTING FACTORS THAT IMPACT POPULATIONS WITH DISPROPORTIONATELY POOR HEALTH OUTCOMES. PRIORITY COMMUNITY PROFILES WERE DEVELOPED TO PRESENT LOCAL DATA AS A COMPLEMENT TO THE JOHN MUIR HEALTH SERVICE AREA DATA REPORTED ELSEWHERE IN THE CHNA. THE PROFILES INCLUDE DEMOGRAPHICS, DATA ON ROOT CAUSES OF HEALTH, AND ADDITIONAL STATISTICS.A. IDENTIFYING COMMUNITY HEALTH NEEDS I. DEFINITION OF "HEALTH NEED" FOR THE PURPOSES OF THE CHNA, HEALTH NEEDS ARE DEFINED AS INCLUDING THE ELEMENTS ESSENTIAL TO IMPROVING OR MAINTAINING HEALTH STATUS IN THE COMMUNITY AT LARGE AND IN PARTICULAR PARTS OF THE COMMUNITY, SUCH AS PARTICULAR GEOGRAPHIES OR POPULATIONS EXPERIENCING HEALTH INEQUITIES. ESSENTIAL ELEMENTS MAY INCLUDE ADDRESSING FINANCIAL AND OTHER BARRIERS TO CARE AS WELL AS PREVENTING ILLNESS, ENSURING ADEQUATE NUTRITION, OR ADDRESSING SOCIAL, BEHAVIORAL, AND ENVIRONMENTAL FACTORS THAT INFLUENCE HEALTH IN THE COMMUNITY. HEALTH NEEDS WERE IDENTIFIED BY THE COMPREHENSIVE IDENTIFICATION, INTERPRETATION, AND ANALYSIS OF A ROBUST SET OF PRIMARY AND SECONDARY DATA.II. CRITERIA AND ANALYTICAL METHODS USED TO IDENTIFY THE COMMUNITY HEALTH NEEDS THE FOLLOWING CRITERIA WERE EMPLOYED TO PRIORITIZE THE LIST OF HEALTH NEEDS FOR THE JOHN MUIR HEALTH SERVICE AREA: - SEVERITY: HOW SEVERE THE HEALTH NEEDS ARE (POTENTIAL TO CAUSE DEATH OR DISABILITY) - MAGNITUDE OF SCALE: THE NUMBER OF PEOPLE AFFECTED BY THE HEALTH NEED - CLEAR DISPARITIES OR INEQUITIES: DIFFERENCES IN HEALTH OUTCOMES BY SUBGROUPS (BASED ON GEOGRAPHY, LANGUAGES, ETHNICITY, CULTURE, CITIZENSHIPS STATUS, SEXUAL ORIENTATION, AGE, GENDER, OR OTHERS) - COMMUNITY PRIORITY: THE COMMUNITY PRIORITIZES THE ISSUE OVER OTHER ISSUES - MULTIPLE EFFECT: A SUCCESSFUL SOLUTION TO THE HEALTH NEED HAS THE POTENTIAL TO SOLVE MULTIPLE PROBLEMSB. CRITERIA AND PROCESS USED FOR PRIORITIZATION OF HEALTH NEEDSI. PRIORITIZATION CRITERIATHE FOLLOWING CRITERIA WERE EMPLOYED TO PRIORITIZE THE LIST OF HEALTH NEEDS FOR THE JOHN MUIR HEALTH SERVICE AREA:- SEVERITY: HOW SEVERE THE HEALTH NEED IS (POTENTIAL TO CAUSE DEATH OR DISABILITY)- MAGNITUDE OR SCALE: THE NUMBER OF PEOPLE AFFECTED BY THE HEALTH NEED- CLEAR DISPARITIES OR INEQUITIES: DIFFERENCES IN HEALTH OUTCOMES BY SUBGROUPS (BASED ON GEOGRAPHY, LANGUAGES, ETHNICITY, CULTURE, CITIZENSHIP STATUS, ECONOMIC STATUS, SEXUAL ORIENTATION, AGE, GENDER, OR OTHERS)- COMMUNITY PRIORITY: THE COMMUNITY PRIORITIZES THE ISSUE OVER OTHER ISSUES- MULTIPLIER EFFECT: A SUCCESSFUL SOLUTION TO THE HEALTH NEED HAS THE POTENTIAL TO SOLVE MULTIPLE PROBLEMSII. PRIORITIZATION PROCESSA PROCESS WAS CONDUCTED TO RANK THE HEALTH NEEDS AND IDENTIFY THE TOP FOUR PRIORITY HEALTH NEEDS DURING VIRTUAL MEETINGS. IN PARTNERSHIP WITH KAISER PERMANENTE, ASR CONTACTED COMMUNITY LEADERS INCLUDING COUNTY HEALTH, PARTNER HOSPITALS, AND COMMUNITY ORGANIZATION LEADERS TO ATTEND COUNTY-LEVEL GROUP MEETINGS TO RANK TOP HEALTH NEEDS FOR SERVICE AREAS WITHIN CONTRA COSTA AND ALAMEDA COUNTIES. THE MEETING FOR CONTRA COSTA COUNTY WAS ATTENDED BY 12 PARTICIPANTS SERVING DIVERSE LOW-INCOME POPULATIONS EXPERIENCING HEALTH INEQUITIES, INCLUDING: HOSPITAL REPRESENTATIVES, CONTRA COSTA COUNTY HEALTH SERVICES, THE COMMUNITY CLINIC CONSORTIUM OF CONTRA COSTA AND SOLANO COUNTIES, THE CONTRA COSTA COUNTY OFFICE OF EDUCATION AND THE CALIFORNIA ENDOWMENT (A HEALTH FUNDER). THE MEETING FOR ALAMEDA COUNTY WAS ATTENDED BY 14 PARTICIPANTS SERVING DIVERSE LOW-INCOME POPULATIONS EXPERIENCING HEALTH INEQUITIES, INCLUDING: HOSPITAL REPRESENTATIVES, ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT, COMMUNITY HEALTH CENTER NETWORK, ALAMEDA COUNTY OFFICE OF EDUCATION AND THE CALIFORNIA ENDOWMENT (A HEALTH FUNDER). ASR PRESENTED QUALITATIVE AND QUANTITATIVE FINDINGS FOR THE TOP SCORING EIGHT HEALTH NEEDS IDENTIFIED THROUGH THE SCORING PROCESS DESCRIBED ABOVE. ONE REPRESENTATIVE FROM EACH ORGANIZATION AFFILIATED WITH EACH SERVICE AREA RANKED THE HEALTH NEEDS ON A SCALE OF 0-4, WITH 0 BEING NOT A PRIORITY" TO 4 BEING A "VERY HIGH PRIORITY". VOTE VALUES (0-4) FROM EACH VOTING ATTENDEE WERE AVERAGED. CONTINUED... C. PRIORITIZED DESCRIPTION OF HEALTH NEEDS THE RESULTS OF THE PRIORITIZATION AND BRIEF DESCRIPTIONS OF THE TOP PRIORITY HEALTH NEEDS ACROSS JOHN MUIR HEALTH'S CONTRA COSTA AND ALAMEDA COUNTY SERVICE AREAS ARE PROVIDED BELOW. BEHAVIORAL HEALTH: BEHAVIORAL HEALTH WHICH INCLUDES MENTAL HEALTH, EMOTIONAL AND PSYCHOLOGICAL WELL-BEING, ALONG WITH THE ABILITY TO COPE WITH NORMAL, DAILY LIFE AFFECTS A PERSON'S PHYSICAL WELL-BEING, ABILITY TO WORK AND PERFORM WELL IN SCHOOL AND TO PARTICIPATE FULLY IN FAMILY AND COMMUNITY ACTIVITIES. BEHAVIORAL HEALTH ALSO COVERS SUBSTANCE ABUSE, WHICH IMPACTS MANY ASPECTS OF HEALTH. BEHAVIORAL HEALTH AND THE MAINTENANCE OF GOOD PHYSICAL HEALTH ARE CLOSELY RELATED; COMMON MENTAL HEALTH DISORDERS SUCH AS DEPRESSION AND ANXIETY CAN AFFECT ONE'S ABILITY FOR SELF-CARE WHILE CHRONIC DISEASES CAN LEAD TO NEGATIVE IMPACTS ON MENTAL HEALTH. AMONG CONTRA COSTA COUNTY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS IDENTIFYING BEHAVIORAL HEALTH AS A PRIORITY, MOST REPORTED THAT BEHAVIORAL HEALTH WAS OFTEN LINKED TO OTHER HEALTH NEEDS SUCH AS TRAUMA, COMMUNITY SAFETY (OVER-POLICING AND OVER-INCARCERATION IN COMMUNITIES OF COLOR), SUBSTANCE USE, ECONOMIC SECURITY CHALLENGES, AND HOMELESSNESS. MENTAL HEALTH PROVIDERS ARE LESS AVAILABLE IN CONTRA COSTA COUNTY WHEN COMPARED TO THE CA AVERAGE (339 VERSUS 352 PER 100,000 POPULATION). HOUSING AND HOMELESSNESS: THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT DEFINES HOUSING AS AFFORDABLE WHEN IT COSTS NO MORE THAN 30% OF A HOUSEHOLD'S INCOME. THE EXPENDITURE OF GREATER SUMS CAN RESULT IN THE HOUSEHOLD BEING UNABLE TO AFFORD OTHER NECESSITIES SUCH AS FOOD, CLOTHING, TRANSPORTATION, AND MEDICAL CARE. THE PHYSICAL CONDITION OF A HOME, ITS NEIGHBORHOOD, AND THE COST OF RENT OR MORTGAGE ARE STRONGLY ASSOCIATED WITH THE HEALTH, WELLBEING, EDUCATIONAL ACHIEVEMENT, AND ECONOMIC SUCCESS OF THOSE WHO LIVE INSIDE. HOMELESSNESS IS CORRELATED WITH POOR HEALTH: POOR HEALTH CAN LEAD TO HOMELESSNESS AND HOMELESSNESS IS ASSOCIATED WITH GREATER RATES OF PREVENTABLE DISEASES, LONGER HOSPITAL STAYS, AND GREATER RISK OF PREMATURE DEATH. CONTRA COSTA COUNTY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS WHO IDENTIFIED HOUSING AND HOMELESSNESS AS A PRIORITY HEALTH NEED DISCUSSED HOW HOUSING CHALLENGES INFLUENCE OTHER HEALTH NEEDS BY INCREASING ECONOMIC AND FOOD INSECURITY, AND UNHEALTHY BEHAVIORS THAT EXACERBATE CHRONIC DISEASE AND DISABILITY. ECONOMIC SECURITY: FACTORS CONTRIBUTING TO ECONOMIC SECURITY CHALLENGES IDENTIFIED IN CONTRA COSTA COUNTY KEY INFORMANT INTERVIEWS AND FOCUS GROUPS INCLUDED: INSUFFICIENT VOCATIONAL TRAINING, LIMITED LIVING WAGE JOBS, AND LACK OF CLEAR COMMUNICATION ON AVAILABILITY OF/REGISTRATION FOR EXISTING INCOME/EMPLOYMENT SUPPORTS. THEY REPORTED THAT THESE ECONOMIC SECURITY CHALLENGES EXACERBATE A VARIETY OF ISSUES FOR CONTRA COSTA COUNTY RESIDENTS, SUCH AS HOUSING, ACCESS TO HEALTHCARE, UNHEALTHY BEHAVIORS THAT PROMOTE CHRONIC DISEASE AND DISABILITY, FOOD INSECURITY, MENTAL HEALTH ISSUES AND SUBSTANCE USE. IMPROVEMENTS IN ACCESS: IMPROVEMENTS IN ACCESS WAS A MAJOR NEED IDENTIFIED BY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS IN CONTRA COSTA AND ALAMEDA COUNTIES. IN CONTRA COSTA COUNTY, SEVERAL KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS DESCRIBED HOW PEOPLE OF COLOR HAVE LIMITED HEALTHCARE ACCESS AND DELIVERY, WORSE QUALITY OF SERVICES RECEIVED, DECREASED SENSE OF COMMUNITY AND FAMILY SAFETY, AND HIGHER RATES OF TRAUMA AND MENTAL HEALTH DISORDERS FOR PEOPLE OF COLOR COMPARED TO WHITE RESIDENTS. HEALTHCARE ACCESS AND DELIVERY: ACCESS TO COMPREHENSIVE, QUALITY HEALTHCARE HAS A PROFOUND EFFECT ON HEALTH AND QUALITY OF LIFE. COMPONENTS OF ACCESS TO AND DELIVERY OF CARE INCLUDE: INSURANCE COVERAGE, ADEQUATE NUMBERS OF PRIMARY AND SPECIALTY CARE PROVIDERS, HEALTHCARE TIMELINESS, QUALITY AND TRANSPARENCY, MULTI-LINGUISTIC CAPACITY, AND CULTURAL COMPETENCE/CULTURAL HUMILITY. LIMITED ACCESS TO HEALTHCARE AND COMPROMISED HEALTHCARE DELIVERY NEGATIVELY AFFECTS HEALTH OUTCOMES AND QUALITY OF LIFE. COMMUNITY AND FAMILY SAFETY: SAFE COMMUNITIES PROMOTE COMMUNITY COHESION, ECONOMIC DEVELOPMENT, AND OPPORTUNITIES TO BE ACTIVE WHILE REDUCING UNTIMELY DEATHS AND SERIOUS INJURIES. CRIME, VIOLENCE, AND INTENTIONAL INJURY ARE RELATED TO POORER PHYSICAL AND MENTAL HEALTH OUTCOMES. CHILDREN AND ADOLESCENTS EXPOSED TO VIOLENCE ARE AT RISK FOR POORER LONG-TERM BEHAVIORAL AND MENTAL HEALTH OUTCOMES. TWO KEY MEASURES OF COMMUNITY SAFETY, VIOLENT CRIME AND INJURY DEATHS, WERE SUBSTANTIALLY HIGHER IN ALAMEDA COUNTY THAN THE CA AVERAGE. KEY INFORMANTS IN CONTRA COSTA AND ALAMEDA COUNTIES BELIEVES THAT IMPROVEMENT IN ACCESS WILL POSITIVELY IMPACT COMMUNITY SAFETY.FOOD SECURITY: FOOD INSECURITY IS THE LACK OF CONSISTENT ACCESS TO ENOUGH FOOD FOR AN ACTIVE, HEALTHY LIFE. FOOD INSECURITY ENCOMPASSES: ANXIETY ABOUT FOOD INSUFFICIENCY, HOUSEHOLD FOOD SHORTAGES, REDUCED QUALITY, VARIETY, OR DESIRABILITY OF FOOD, DIMINISHED NUTRIENT INTAKE, AND DISRUPTED EATING PATTERNS. SEVERAL CONTRA COSTA COUNTY FOCUS GROUP PARTICIPANTS STATED THAT ACCESSING FRESH PRODUCE AND HEALTHY FOOD OPTIONS IS DIFFICULT THROUGHOUT THE COUNTY, REPORTING THAT STORES STOCKING HEALTHY FOODS ARE NOT IN WALKING DISTANCE FOR MOST RESIDENTS AND REQUIRE A CAR OR PUBLIC TRANSPORTATION TO ACCESS. CONTINUED... EDUCATION: THE LINK BETWEEN EDUCATION AND HEALTH IS WELL-KNOWN. THOSE WITH HIGHER LEVELS OF EDUCATION ARE MORE LIKELY TO BE HEALTHIER AND LIVE LONGER. PRE-SCHOOL EDUCATION IS POSITIVELY ASSOCIATED WITH READINESS FOR AND SUCCESS IN SCHOOL, AS WELL AS LONG-TERM ECONOMIC BENEFITS FOR INDIVIDUALS AND SOCIETY, INCLUDING GREATER EDUCATIONAL ATTAINMENT, HIGHER INCOME, AND LOWER ENGAGEMENT IN DELINQUENCY AND CRIME. INDIVIDUALS WITH AT LEAST A HIGH SCHOOL DIPLOMA DO BETTER ON SEVERAL MEASURES THAN HIGH SCHOOL DROPOUTS: INCOME, HEALTH OUTCOMES, LIFE SATISFACTION, AND SELF-ESTEEM. WEALTH AMONG FAMILIES IN WHICH THE HEAD OF HOUSEHOLD HAS A HIGH SCHOOL DIPLOMA IS 10 TIMES HIGHER THAN THAT OF FAMILIES IN WHICH THE HEAD OF HOUSEHOLD DROPPED OUT OF HIGH SCHOOL. TRANSPORTATION: WITHOUT RELIABLE AND SAFE TRANSPORTATION, INDIVIDUALS STRUGGLE TO MEET BASIC NEEDS SUCH AS EARNING AN INCOME, ACCESSING HEALTHCARE, AND SECURING FOOD. TRANSPORTATION INFRASTRUCTURE FAVORS INDIVIDUAL CAR USE, WHICH IS ASSOCIATED WITH A NUMBER OF ADVERSE CONSEQUENCES, INCLUDING MOTOR VEHICLE INJURIES AND DEATHS, THE EXPENSES OF OWNING A VEHICLE, AND GREENHOUSE GAS EMISSIONS WHICH ARE A RISK FACTOR FOR HEART DISEASE, STROKE, ASTHMA, AND CANCER. FOR HOUSEHOLDS WITHOUT ACCESS TO A CAR, INCLUDING MANY LOW-INCOME INDIVIDUALS AND PEOPLE OF COLOR, WALKING, BIKING AND USING PUBLIC TRANSPORTATION PROVIDE CRITICAL LINKS TO JOBS AND ESSENTIAL SERVICES AND PROMOTE EXERCISE AND SOCIAL COHESION. CONTRA COSTA COUNTY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS IDENTIFYING TRANSPORTATION AS A HEALTH NEED DESCRIBED HOW INADEQUATE TRANSPORTATION PRESENTS BARRIERS TO ACCESSING HEALTHCARE AND A NUMBER OF HEALTH-RELATED ACTIVITIES OF DAILY LIVING, INCLUDING: ACCESS TO GROCERY STORES SELLING HEALTHY FOOD, ABILITY TO GET CHILDREN TO/FROM SCHOOL, ACCESS TO COMMUNITY EVENTS, AND ABILITY TO COMMUTE TO A LIVING WAGE JOB. HEALTH NEEDS JOHN MUIR BEHAVIORAL HEALTH IN COLLABORATION WITH JOHN MUIR HEALTH WILL ADDRESS ACROSS ITS SERVICE AREA DURING 2023-2025 ARE:1. IMPROVEMENTS IN ACCESS (AN OVERARCHING NEED THAT CUTS ACROSS ALL OTHER HEALTH NEEDS) 2. HEALTHCARE ACCESS AND DELIVERY 3. BEHAVIORAL HEALTH 4. HOUSING AND HOMELESSNESSD. JOHN MUIR HEALTH IMPLEMENTATION STRATEGIESJOHN MUIR HEALTH HAS IDENTIFIED EXPECTED IMPACTS, STRATEGIES, FOCUS AREAS, AND PARTNERS FOR EACH PRIORITY HEALTH NEED, AS DESCRIBED BELOW. STRATEGY IMPLEMENTATION WILL DRAW ON JOHN MUIR HEALTH'S ORGANIZATIONAL RESOURCES (GRANTMAKING, INTERNAL PROGRAMS, JOHN MUIR HEALTH STAFF, AND OTHER ASSETS) IN COMBINATION WITH AN ARRAY OF PARTNERSHIPS AND COLLABORATIONS WITH COMMUNITY ORGANIZATIONS, STAKEHOLDERS, AND LEADERS THROUGHOUT ITS SERVICE AREA. JOHN MUIR HEALTH HAS SELECTED THE FOLLOWING NEEDS TO ADDRESS, WITH IMPROVEMENTS IN ACCESS AS THE DRIVER THAT ADDRESSES ALL FOCUS AREAS. WITHIN EACH FOCUS AREA, JOHN MUIR HEALTH PLANS TO IMPLEMENT PROGRAMMING THAT ALIGNS WITH SPECIFIC PROGRAMMATIC CATEGORIES, PROMOTING HEALTH VIA MULTIFACETED APPROACHES: - WORKFORCE DEVELOPMENT - PROMOTION AND PREVENTION - DIRECT SERVICES AND TREATMENT - RESILIENCY AND SUPPORT SERVICESPRIORITY HEALTH NEED: IMPROVEMENTS IN ACCESSIMPROVEMENTS IN ACCESS IS A SELECTED PRIORITY NEED THAT WILL BE INFUSED INTO STRATEGIES IMPLEMENTED TO ADDRESS ALL SELECTED HEALTH NEEDS. STRATEGIES AIMED TO ACHIEVE IMPROVEMENTS IN ACCESS FOCUS ON SUPPORTING SYSTEMS CHANGE AMONG JOHN MUIR HEALTH GRANTEES AND PARTNERS (COMMUNITY-BASED NONPROFIT ORGANIZATIONS SERVING THE JOHN MUIR HEALTH SERVICE AREA) BY FINANCIALLY SUPPORTING INTERVENTIONS THAT GUIDE ADOPTION OF IMPROVEMENT IN ACCESS POLICIES, PRACTICES, SERVICES AND RESOURCES.IMPROVEMENTS IN ACCESS GOALS:LONG-TERM GOAL: IMPROVE ACCESS FOR ALL COMMUNITIES. INTERMEDIATE GOALS: - INCREASE FINANCIAL SUPPORT TO ALL JOHN MUIR HEALTH COMMUNITY BENEFIT PARTNER NONPROFIT ORGANIZATIONS TO SUPPORT ADOPTION OF NEW POLICIES, PRACTICES AND SERVICES THAT ADDRESS IMPROVEMENTS IN ACCESS. - INCREASE COMMUNITY-BASED NONPROFIT ORGANIZATION ACCESS TO TOOLS THAT ADDRESS IMPROVEMENTS IN ACCESS.TO PROMOTE IMPROVEMENTS IN ACCESS, CHANGE AT THE ORGANIZATIONAL LEVEL, JOHN MUIR HEALTH WILL AWARD ALL GRANTEES ADDITIONAL FUNDING TO BE RESTRICTED TOWARDS ADDRESSING IMPROVEMENTS IN ACCESS AND WILL ENGAGE EVALUATION METHODOLOGIES TO MEASURE IMPACT ACROSS THE SERVICE AREA. JOHN MUIR HEALTH WILL GUIDE, AND SUPPORT SYSTEMS CHANGE BY EXTERNALIZING INTERNAL RESOURCES AND EXPERTISE FROM THE OFFICE OF BELONGING, EXPERIENCE AND ENGAGEMENT, PROVIDING GRANTEE AND PARTNER ORGANIZATIONS WITH A MENU OF ISSUES/STRATEGIES TO ADDRESS/IMPLEMENT, INCLUDING: - REPRESENTATION IN BOARD OF DIRECTORS AND LEADERSHIP COMPOSITION - HIRING AND WORKFORCE DEVELOPMENT PRACTICES - DIVERSITY, ENSURING COMMUNITY NEEDS ARE MET, AND INCLUSION TRAININGS OR WORKSHOPS - EMPLOYEE ENGAGEMENT OPPORTUNITIES (I.E., EMPLOYEE RESOURCE GROUPS, CULTURAL CELEBRATIONS)PRIORITY HEALTH NEED: HEALTHCARE ACCESS AND DELIVERY LONG-TERM GOAL: THE ENTIRE COMMUNITY HAS ACCESS TO APPROPRIATE CULTURALLY AND LINGUISTICALLY ALIGNED HEALTHCARE AND HEALTHCARE SUPPORT SERVICES THAT ARE DELIVERED WITH QUALITY AND COMPASSION. INTERMEDIATE GOALS: - INCREASE ACCESS TO A DIVERSE, LINGUISTICALLY AND CULTURALLY ALIGNED HEALTHCARE WORKFORCE. - INCREASE ACCESS TO SUBSIDIZED CARE AND FINANCIAL ASSISTANCE FOR LOW-INCOME AND UNINSURED INDIVIDUALS. - INCREASE ACCESS TO COMPREHENSIVE PRIMARY CARE, SPECIALTY CARE SERVICES, SUPPORT SERVICES, AND PREVENTION PROGRAMMING FOR LOW-INCOME, VULNERABLE, AND UNINSURED INDIVIDUALS.EXPECTED IMPACT: - INCREASED OPPORTUNITIES FOR HEALTHCARE SECTOR CAREERS FOR POPULATIONS UNDERREPRESENTED IN THE HEALTHCARE WORKFORCE. - INCREASED ACCESS TO AND USE OF COMPREHENSIVE PRIMARY CARE AND SPECIALTY CARE FOR LOW-INCOME AND UNINSURED POPULATIONS. STRATEGY TO ACHIEVE THIS INCLUDES: - IMPROVED QUALITY OF CARE FOR CLIENTS OF SAFETY NET ORGANIZATIONS. - INCREASED ACCESS TO COMMUNITY-BASED HEALTH SCREENINGS AND HEALTHCARE SUPPORT SERVICESSTRATEGY TO ACHIEVE THESE GOALS INCLUDES:- PROVIDING WORKFORCE DEVELOPMENT PROGRAMMING TO HIGH SCHOOL, JUNIOR COLLEGE, AND MEDICAL SCHOOL STUDENTS UNDERREPRESENTED IN HEALTHCARE CAREERS TO INCLUDE YOUNG HEALERS AND CLIMB MENTORSHIP PROGRAMS.- PROVIDE SUPPORT TO THE VULNERABLE POPULATIONS CURRICULUM OF THE JOHN MUIR HEALTH FAMILY MEDICINE RESIDENCY TO ENGAGE MEDICAL RESIDENTS IN COMMUNITY-BASED SERVICES IN PARTNERSHIP WITH LOCAL NONPROFIT ORGANIZATIONS. - PROVIDE FINANCIAL ASSISTANCE, VIA THE JOHN MUIR HEALTH CHARITY CARE POLICY, TO SUPPORT LOW-INCOME PATIENTS BY SUBSIDIZING ALL OR A PORTION OF THEIR JOHN MUIR HEALTH MEDICAL EXPENSES. - PARTICIPATE IN THE GOVERNMENT-SPONSORED MEDI-CAL PROGRAM TO PROVIDE COMPREHENSIVE INPATIENT CARE TO MEDI-CAL ENROLLEES THAT GENERATE UNPAID COSTS AT JOHN MUIR MEDICAL CENTER-WALNUT CREEK, JOHN MUIR MEDICAL CENTER-CONCORD, JOHN MUIR PHYSICIAN NETWORK, AND BEHAVIORAL HEALTH CENTER. CONTINUED... PRIORITY HEALTH NEED: BEHAVIORAL HEALTH LONG-TERM GOAL: THE ENTIRE COMMUNITY HAS ACCESS TO BEHAVIORAL AND MENTAL HEALTH PROGRAMMING, SUPPORT AND DIRECT SERVICES TO PROMOTE WHOLE HEALTH AND EMOTIONAL WELLNESS. INTERMEDIATE GOALS: - INCREASE ACCESS TO ALTERNATIVE MENTAL HEALTH WORKFORCE TO INCLUDE COMMUNITY HEALTH WORKERS AND PROMOTORES TRAINING PROGRAMS. - INCREASE ACCESS TO BEHAVIORAL AND MENTAL HEALTH SERVICES THAT PROVIDE PREVENTION, DIRECT SERVICE AND SUPPORT FOR VULNERABLE INDIVIDUALS AND FAMILIES. -INCREASE VIOLENCE PREVENTION AND RESILIENCY PROGRAMMING FOR VULNERABLE COMMUNITIES.EXPECTED IMPACT - INCREASED ACCESS TO AND USE OF BEHAVIORAL AND MENTAL HEALTH SERVICES. - INCREASED ACCESS TO CULTURALLY AND LINGUISTICALLY ALIGNED BEHAVIORAL AND MENTAL HEALTH SERVICES. - IMPROVED YOUTH RESILIENCE. - INCREASED ACCESS TO SUPPORTIVE COMMUNITY-BASED SERVICES THAT PREVENT AND MITIGATE THE IMPACTS OF VIOLENCE AND TRAUMA.STRATEGY TO ACHIEVE THESE GOALS:- SUPPORT COMMUNITY HEALTH WORKER AND PROMOTORES PROGRAMS THAT OFFER TRAINING TO COMMUNITY MEMBERS TO PREVENT AND/OR REDUCE LEVELS OF STRESS, ANXIETY AND DEPRESSION IN VULNERABLE COMMUNITIES. - LEAD THE RESTORATIVE JUSTICE INITIATIVE ACROSS CONTRA COSTA COUNTY SCHOOLS TO PROMOTE VIOLENCE PREVENTION AND PROVIDE TRAINING TO SCHOOL STAFF AND ADMINISTRATION ON HOW TO RESOLVE HARM AND REDUCE CONFLICT AMONG THE SCHOOL COMMUNITY. - SUPPORT PROGRAMMING THAT FOCUSES ON SOCIAL CONNECTION AMONG OLDER ADULTS TO REDUCE ISOLATION AND PROMOTE WELL-BEING. - PROVIDE DIRECT MENTAL HEALTH THERAPY SERVICES TO YOUTH, ADULTS AND FAMILIES WHO ARE UNABLE TO ACCESS CARE DUE TO INADEQUATE INSURANCE COVERAGE, ACCESSIBILITY OF SERVICES, OR TIMELINESS OF APPOINTMENTS. PROGRAMS INCLUDE: JOHN MUIR HEALTH BEYOND VIOLENCE, JOHN MUIR HEALTH MOBILE HEALTH CLINIC, CANCER SUPPORT SERVICES, AND SCHOOL-BASED SERVICES. - LEAD THE BEYOND VIOLENCE PROGRAM AND ALL PARTNERS COLLABORATIVE TO PROVIDE HOSPITAL-BASED VIOLENCE INTERVENTION SERVICES TO INDIVIDUALS IMPACTED BY INTENTIONAL VIOLENCE AND PROMOTE RESILIENCY BY PROVIDING ROBUST COMMUNITY-BASED SUPPORT SERVICES TO INDIVIDUALS AND THEIR FAMILIES VIA PARTNERSHIPS WITH LOCAL NONPROFIT ORGANIZATIONS. - PROVIDE PEER-DELIVERED SERVICES, SUPPORT GROUPS AND CONNECTION TO RESOURCES FOR VULNERABLE ADULTS DIAGNOSED WITH MENTAL ILLNESS.PRIORITY HEALTH NEED: HOUSING AND HOMELESSNESS LONG-TERM GOAL: THE ENTIRE COMMUNITY HAS ACCESS TO SAFE, HEALTHY, AND AFFORDABLE HOUSING. INTERMEDIATE GOALS: - INCREASE SUPPORT OF THE HOUSING NAVIGATORS WORKFORCE AND EMPLOYMENT OPPORTUNITIES TO COMMUNITIES PRONE TO HOMELESSNESS. - INCREASE ACCESS TO HOMELESSNESS PREVENTION RESOURCES TO LOW-INCOME AND VULNERABLE COMMUNITIES. - INCREASE ACCESS TO HOUSING RESOURCES AND SUPPORT SERVICES TO PROVIDE UNSHELTERED INDIVIDUALS AND FAMILIES WITH ACCESS TO TRANSITIONAL SUPPORTIVE HOUSING, RESPITE CARE AND RECUPERATIVE HOUSING, PERMANENT SUPPORTIVE HOUSING, AND ULTIMATELY INDEPENDENT PERMANENT AFFORDABLE HOUSING. - INCREASE FOOD SECURITY AND DECREASE THE FOOD COST BURDEN FOR LOW-INCOME FAMILIES TO FREE UP FUNDS TO COVER HOUSING COSTS.EXPECTED IMPACT: - INCREASED NUMBER OF COMMUNITY MEMBERS WITH STABLE HOUSING. - INCREASED ACCESS TO HOUSING SERVICES FOR COMMUNITY MEMBERS WHO ARE UNHOUSED AND AT RISK OF BECOMING UNHOUSED. - INCREASED COMMUNITY OUTREACH AND AWARENESS OF HOUSING RESOURCES. - INCREASED CONSISTENT ACCESS TO HEALTHY FOOD FOR LOW- INCOME AND UNHOUSED INDIVIDUALS.STRATEGIES TO ACHIEVE THESE GOALS INCLUDE:- PROVIDE CONNECTIONS TO RESPITE CARE AND RECUPERATIVE HOUSING FOR HOMELESS PATIENTS DISCHARGED FROM LOCAL HOSPITALS, INCLUDING JOHN MUIR HEALTH. - PROVIDE CONNECTIONS TO TRANSITIONAL SUPPORTIVE HOUSING FOR INDIVIDUALS AND FAMILIES WHO ARE IN RECOVERY FROM ALCOHOL AND OTHER SUBSTANCES. - PROVIDE CONNECTIONS TO PERMANENT SUPPORTIVE AND AFFORDABLE HOUSING FOR HOMELESS INDIVIDUALS AND FAMILIES. JOHN MUIR HEALTH DEVELOPS COLLABORATIVE PARTNERSHIPS WITH LOCAL ORGANIZATIONS TO BE RESPONSIVE TO THE NEEDS OF THE MOST VULNERABLE AND UNDERSERVED POPULATIONS. THE FOLLOWING HIGHLIGHTS A FEW OF THE 2024-YEAR END RESULTS IN COLLABORATION WITH LOCAL ORGANIZATION BY EACH OF THE FOUR-COMMUNITY HEALTH NEEDS THAT JOHN MUIR HEALTH IS ADDRESSING.COMMUNITY HEALTH NEEDS: IMPROVEMENTS IN ACCESSHEALTH OUTCOMES ARE DIRECTLY IMPACTED BY PREJUDICE AND SOCIETAL INEQUITIES. AS PART OF JMH'S COMMUNITY BENEFIT FUNDING STRATEGY, JMH IS INVESTING IN EACH OF ITS 33 COMMUNITY PARTNER ORGANIZATIONS EXPLICITLY TO ADOPT INTERVENTIONS THAT ENSURES COMMUNITY NEEDS ARE MET WITHIN THEIR INDIVIDUAL ORGANIZATIONS, BOARDS, STAFF, AND THE COMMUNITY SERVED. EACH ORGANIZATION RECEIVES AN ADDITIONAL $5,000 PER YEAR, FOR THREE YEARS, TO SUPPORT FUNDAMENTAL AND LASTING CHANGES. CONTINUED... COMMUNITY HEALTH NEED: BEHAVIORAL HEALTH. THE FOLLOWING ARE SELECT HIGH-IMPACT PROGRAM OUTCOMES IN 2024:- JOHN MUIR BEHAVIORAL HEALTH THROUGH ITS AFFILIATION WITH JOHN MUIR HEALTH PARTNERS WITH FAMILY JUSTICE CENTERS OF CONTRA COSTA, FRED FINCH AND FAMILY SERVICES, MENTAL HEALTH CONNECTIONS, MENTES POSITIVAS EN ACCION (POSITICE MINDS IN ACTION) PROMOTORES PROGRAM, MONUMENT CIRIS CENTER, VILLAGE COMMUNITY RESOURCE CENTER AND WOMEN'S CANCER RESOURCE CENTER TO HELP ADDRESS THE BEHAVIORAL AND MENTAL HEALTH OF THE COMMUNITY IT SERVES.- IN 2024, THERE WAS A TOTAL CLIENT LOAD OF 58 INDIVIDUALS WHO CONSENTED TO RECEIVE BEYOND VIOLENCE SERVICES AT THE FOLLOWING PARTNER NONPROFIT ORGANIZATIONS: RYSE CENTER IN RICHMOND, ONE DAY AT A TIME IN BRENTWOOD, CENTER FOR HUMAN DEVELOPMENT IN CONCORD AND FAMILY JUSTICE CENTER IN ANTIOCH AND RICHMOND. A TOTAL OF 174 INDIVIDUALS WERE PROVIDED WITH MENTAL HEALTH COUNSELING SERVICES. A TOTAL OF 55 CLIENTS RECEIVED FREE THERAPY FORM VOLUNTEERS.E. JOHN MUIR HEALTH WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS:1. ECONOMIC SECURITY2. COMMUNITY AND FAMILY SAFETY3. FOOD SECURITY4. EDUCATION5. TRANSPORTATIONJMH RECOGNIZES THE IMPORTANCE OF EACH OF THE PRIORITIZED COMMUNITY HEALTH NEEDS. HOWEVER, JMH'S EXPERIENCE IS THAT OUR INVESTMENTS COULD HAVE THE MOST IMPACT ON COMMUNITY HEALTH BY FOCUSING RESOURCES ON THE SELECTED COMMUNITY HEALTH NEEDS. THEREFORE, THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE DECIDED TO ADDRESS THE COMMUNITY HEALTH NEEDS THAT ARE ALIGNED WITH OUR MISSION, LEVERAGE JMH'S EXPERTISE, AND HAVE FEASIBLE INTERVENTIONS AND PARTNERS FOR SCALABLE IMPACT.THE SELECTED HEALTH NEEDS DO NOT REPRESENT EVERYTHING JOHN MUIR HEALTH DOES TO IMPROVE COMMUNITY HEALTH. FOR THOSE NEEDS NOT SELECTED, GENERALLY, JOHN MUIR HEALTH DOES NOT HAVE THE EXPERTISE OR CAPACITY TO ADDRESS THE NEED; HOWEVER, THERE ARE AREAS OF OVERLAP WITH CURRENT COMMUNITY BENEFIT STRATEGIES. FOR EXAMPLE, WHILE FOOD SECURITY WAS NOT EXPLICITLY SELECTED AS A PRIORITIZED NEED, JOHN MUIR HEALTH CONTINUES TO SUPPORT AND DONATE TO LOCAL FOOD BANKS. IN ADDITION, WHILE TRANSPORTATION WAS NOT CHOSEN, JOHN MUIR HEALTH WILL SUPPORT TRANSPORTATION INITIATIVES THAT DECREASE ISOLATION AMONG VULNERABLE SENIORS AND INCREASE ACCESS TO HEALTH AND SUPPORT SERVICES AMONG VULNERABLE INDIVIDUALS.JOHN MUIR HEALTH REMAINS DEDICATED TO BEING A LEADER IN BUILDING A HEALTHIER COMMUNITY. BY LISTENING, ENGAGING AND COLLABORATING WITH SERVICE AREA COMMUNITIES, JOHN MUIR HEALTH IS COMMITTED TO CREATING A NETWORK OF HEALTH AND WELLNESS SERVICES AND SUPPORT. THIS 2023-2025 COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS ADOPTED BY JOHN MUIR HEALTH'S BOARD OF DIRECTORS ON DECEMBER 14, 2022. PART V, SECTION B, LINE 13B INCOME LEVEL OTHER THAN FPGOTHER CRITERIA USED IS BASED ON THE PATIENT'S ELIGIBILITY FOR LOW-INCOME PROGRAMS THAT HAVE THE SAME OR STRICTER (LOWER) INCOME CRITERIA AS THE JOHN MUIR HEALTH CHARITY CARE PROGRAM. THIS INCLUDES PATIENTS WHO ARE QUALIFIED WITH SIX MONTHS OF THE DATE OF SERVICE FOR THE CALIFORNIA MEDICAID (MEDI-CAL) PROGRAM, OR FOR THE COUNTRY'S MEDICALLY INDIGENT PROGRAM. ADDITIONALLY, THE ORGANIZATION USES ESTIMATED FEDERAL POVERTY GUIDELINES DEVELOPED BY A CONTRACTED THIRD PARTY. THE THIRD PARTY DEVELOPED AN ALGORITHM BASED ON ESTIMATED HOUSEHOLD INCOME, WHICH IS THEN TRANSLATED INTO FPG FOR THE HOUSEHOLD. PART V, SECTION B, LINE 16A THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.JOHNMUIRHEALTH.COM/PATIENTS-AND-VISITORS/PAYMENT-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM/PATIENT-FINANCIAL-ASSISTANCE.HTML PART V, SECTION B, LINE 16B THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.JOHNMUIRHEALTH.COM/PATIENTS-AND-VISITORS/PAYMENT-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM/PATIENT-FINANCIAL-ASSISTANCE.HTML PART V, SECTION B, LINE 16C A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.JOHNMUIRHEALTH.COM/PATIENTS-AND-VISITORS/PAYMENT-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM/PATIENT-FINANCIAL-ASSISTANCE.HTML PART I, LINE 3C: ELIGIBILITY CRITERIA USED FOR DETERMINING FREE OR DISCOUNTED CAREJMBH APPLIES THE SAME CHARITY CARE POLICY AND GUIDELINES AS JOHN MUIR HEALTH. THE MAJORITY OF CHARITY CARE IS GIVEN BASED EITHER IN THE FEDERAL POVERTY GUIDELINES ("FPG") AS CALCULATED FROM DOCUMENTATION AND STATEMENTS MADE ON THE INTERNAL JOHN MUIR HEALTH CHARITY CARE APPLICATION, OR ON THE FPG AS ESTIMATED BY A CONTRACTED THIRD PARTY. THE THIRD PARTY HAD DEVELOPED AN ALGORITHM BASED ON ESTIMATED HOUSEHOLD INCOME, WHICH IS THEN TRANSLATED INTO FPG FOR THE HOUSEHOLD. JOHN MUIR HEALTH HAS NO INPUT INTO THE CRITERIA USED FOR THE ALGORITHM, WHICH IS THE SAME CALCULATION USED BY THE CONTRACTED THIRD PARTY FOR ALL OF THEIR CLIENTS NATIONWIDE. OTHER CRITERIA USED IS BASED ON THE PATIENT'S ELIGIBILITY FOR LOW-INCOME PROGRAMS THAT HAVE THE SAME OR STRICTER (LOWER) INCOME CRITERIA AS THE JMBH CHARITY CARE PROGRAM. THIS INCLUDES PATIENTS WHO ARE QUALIFIED WITH SIX MONTHS OF THE DATE OF SERVICE FOR THE CALIFORNIA MEDICAID (MEDI-CAL) PROGRAM, OR FOR THE COUNTY'S MEDICALLY INDIGENT PROGRAM.PART I, LINE 4MEDICALLY INDIGENT CAREWE PROVIDE HEALTH CARE TO THE MOST VULNERABLE INDIVIDUALS OF OUR COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY THROUGH OUR MEDICAL CENTER IN CONCORD.JOHN MUIR BEHAVIORAL HEALTH HAS A NUMBER OF PROGRAMS TO HELP OUR PATIENTS WITH THEIR MEDICAL BILLS. THESE PROGRAMS INCLUDE A PATIENT ASSISTANCE PROGRAM TO ABSORB PART, OR ALL, OF THE BILL BASED ON INCOME AND OTHER PROGRAM GUIDELINES, ASSISTANCE ENROLLING IN A NUMBER OF INSURANCE PROGRAMS, AND EXTENDED PAYMENT PLANS.JMBH MAY ALSO ASSIGN ACCOUNTS TO PRESUMPTIVE CHARITY, WITHOUT A PATIENT ASSISTANCE APPLICATION SUBMITTED BY THE PATIENT, BASED ONPREDETERMINED CRITERIA COLLECTED FROM APPROVED SOURCES. THIS CRITERIA INCLUDES:- THE PATIENT HAVING DOCUMENTED IN HIS/HER MEDICAL RECORD AS BEING HOMELESS OR VERIFICATION RECEIVED THROUGH THE MEDICAL CENTER OR A FAMILY MEMBER THAT THE PATIENT IS CURRENTLY INCARCERATED.OR- THE PATIENT QUALIFIES FOR A GOVERNMENT PROGRAM WITH ELIGIBILITY REQUIREMENTS THAT REASONABLY MEET THE QUALIFICATIONS FOR THE JOHN MUIR HEALTH CHARITY CARE PROGRAM WITHIN SIX (6) MONTHS OF THE DATE THE PATIENT RECEIVED SERVICES AT THE MEDICAL CENTER.OR- AFTER NORMAL COLLECTION EFFORTS HAVE NOT PRODUCED ANY PAYMENT, AND JMBH HAS IDENTIFIED WITH REASONABLE EFFORT AND ASSURANCE THAT THE PATIENT'S ESTIMATED INCOME IS AT 250 PERCENT OR LESS OF HE FPL (FEDERAL POVERTY LEVEL). PART I, LINE 6A: COMMUNITY BENEFIT REPORTALL JOHN MUIR HEALTH ENTITIES (WALNUT CREEK CAMPUS, CONCORD CAMPUS AND BEHAVIORAL HEALTH) REPORT COMMUNITY BENEFIT INFORMATION AS PART OF THE JOHN MUIR HEALTH ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: FINANCIAL ASSISTANCE POLICYJOHN MUIR BEHAVIORAL HEALTH HAS ADOPTED THE GUIDELINES DEVELOPED BY THE CATHOLIC HEALTHCARE ASSOCIATION AND VHA INC. FOR REPORTING THE ECONOMIC VALUE OF ITS COMMUNITY BENEFIT CONTRIBUTIONS.PART I, LINE 7, COLUMN (F)FINANCIAL ASSISTANCE PERCENT OF TOTAL EXPENSETHE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,415,379.PART I, LINE 7ECOMMUNITY HEALTH IMPROVEMENT SERVICES:JOHN MUIR HEALTH'S COMMUNITY HEALTH IMPROVEMENT SERVICES ADDRESS SOCIOECONOMIC BARRIERS TO OPTIMAL PHYSICAL AND MENTAL HEALTH SUCH AS JOBS, EDUCATION, POVERTY, LANGUAGE, CULTURE, RACE, ETHNICITY, TRANSPORTATION, ETC. MANY OF OUR COMMUNITY HEALTH IMPROVEMENT SERVICES ALSO MEET THE DEFINITION OF COMMUNITY BENEFIT. IN 2024 JMBH PARTICIPATED IN THE FOLLOWING COMMUNITY HEALTH EDUCATION.- CAMPOLINDO WELLNESS FAIR- NORTHGATE HIGH SCHOOL WELLNESS DAY- LAS LOMAS HIGH SCHOOL WELLNESS FAIR- OVERDOSE AWARENESS DAY- REMIX RECOVERY RESOURCES FAIR RESOURCES PROVIDED- CONNECTIONS HOUSE HARVEST FESTIVAL RESOURCES PROVIDEDJMBH STAFF ALSO PROVIDED CLINICAL ROTATIONS FOR 100 NURSING STUDENTS IN THE FOLLOWING SCHOOLS:- SAMUEL MERRITT UNIVERSITY- LOS MEDANOS COLLEGE- UNIVERSITY OF SAN FRANCISCO- CALIFORNIA STATE UNIVERSITY, EAST BAY PART III, LINE 2: BAD DEBT EXPENSEBAD DEBT IS DETERMINED USING THE COST-TO-CHARGE METHODOLOGY. THE ORGANIZATION DOES NOT INCLUDE BAD DEBT IN COMMUNITY BENEFIT. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTETHE ORGANIZATION DOES NOT ISSUE SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN THE JOHN MUIR HEALTH AND SUBSIDIARIES CONSOLIDATED, INDEPENDENT AUDITED FINANCIAL STATEMENTS THAT DO NOT INCLUDE A DESCRIPTION OF BAD DEBT EXPENSE. PART III, LINE 8: SHORTFALL TREATED AS COMMUNITY BENEFITTHE ORGANIZATION DOES NOT TREAT MEDICARE SHORTFALL AS COMMUNITY BENEFIT. JMBH USES ITS COST ACCOUNTING SYSTEM TO CALCULATE MEDICARE SHORTFALL. PART III, LINE 9B: COLLECTION PRACTICESOTHER THAN SENDING STATEMENTS AND NOTIFICATIONS TO THE PATIENT, JMBH DOES NOT CONDUCT PATIENT-OWED COLLECTION INTERNALLY. THESE TYPES OF FUNCTIONS ARE OUTSOURCED TO AN OUTSIDE AGENCY. THE COLLECTION POLICY IS IN THE FORM OF, AND INCORPORATED INTO, THE CONTRACT AGREEMENT WITH THE OUTSIDE AGENCY AS A FULL ADDENDUM TO THE CONTRACT, WITH A SEPARATE SIGNATURE LINE FOR JMBH AND THE AGENCY AS PART OF THE ADDENDUM. IN ADDITION TO THE CUSTOMIZED JMBH COLLECTION GUIDELINES, THE ADDENDUM ALSO CONTAINS THE COLLECTION CRITERIA AND REQUIREMENTS FOUND IN CALIFORNIA LAW UNDER ASSEMBLY BILL 774. PART VI, LINE 2: NEEDS ASSESSMENTTHE 2022 HEALTH NEEDS ASSESSMENT INCLUDES A COMPREHENSIVE NEED ASSESSMENT OF THE COMMUNITY SERVED, WHICH HAS BEEN USED TO DEVELOP OUR ANNUAL AND TRIENNIAL COMMUNITY BENEFIT PLANS. FOR MORE INFORMATION, THE CHNA REPORT AND IMPLEMENTATION STRATEGY (A.K.A. COMMUNITY HEALTH IMPROVEMENT PLAN) CAN BE FOUND HERE:HTTPS://WWW.JOHNMUIRHEALTH.COM/ABOUT-JOHN-MUIR-HEALTH/COMMUNITY-COMMITMENTIN ADDITION TO THE CHNA, JMBH IS CONTINUALLY ASSESSING THE NEEDS OF THE COMMUNITY IN A VARIETY OF WAYS. JOHN MUIR HEALTH DEVELOPS COLLABORATIVE PARTNERSHIPS WITH LOCAL ORGANIZATIONS IN ORDER TO BE RESPONSIVE TO THE NEEDS OF THE MOST VULNERABLE AND UNDERSERVED POPULATIONS IN OUR COMMUNITY. JMBH KEPT ABREAST OF CURRENT HEALTH ISSUES OF IMPORTANCE TO THE COMMUNITY BY ACTIVE PARTICIPATION AND COMMUNICATION WITH A VARIETY OF COMMUNITY GROUPS. THESE SOURCES OF INFORMATION PROVIDE CURRENT INFORMATION REGARDING COMMUNITY HEALTH STATUS AND ALSO HELP IDENTIFY EMERGING NEEDS IN THE SERVICE AREA POPULATION. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEJMBH HAS SIGNAGE POSTED IN PATIENT ACCESS AREA/LOBBIES INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR THEIR HEALTH CARE BILLS AND ELIGIBILITY. ALL PATIENTS RECEIVE A "PATIENT ASSISTANCE" BROCHURE, WHICH IDENTIFIES VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO THE PATIENT, INCLUDING THE JMBH CHARITY CARE PROGRAM AS WELL AS PROGRAMS THROUGH GOVERNMENT AGENCIES (STATE, COUNTY, ETC). THE BROCHURE ALSO LISTS CONTACT INFORMATION FOR THESE PROGRAMS. NOTIFICATIONS THAT PROGRAMS, INCLUDING CHARITY CARE, ARE AVAILABLE IS ALSO PRINTED ON PATIENT BILLING STATEMENTS, ACCOMPANIED BY THE ABILITY FOR A PATIENT TO REQUEST THE VARIOUS PROGRAM MATERIALS BE SENT TO HIS/HER HOME. CONTACT INFORMATION IS ALSO LISTED IN THE PATIENT STATEMENT. INFORMATION IN THE HEALTH SYSTEM'S CHARITY CARE PROGRAM IS POSTED ON THE JOHN MUIR HEALTH INTERNET WEBSITE AS WELL.PATIENTS ADMITTED TO THE HOSPITAL, AND WHO HAVE NO THIRD-PARTY INSURANCE LISTED ARE INTERVIEWED BY TRAINED FINANCIAL COUNSELORS DURING THEIR HOSPITAL STAY TO INFORM THEM OF THE VARIOUS PROGRAMS WHICH ARE AVAILABLE, AND DETERMINE IF THE PATIENT WOULD LIKE ASSISTANCE TO OBTAIN ELIGIBILITY FOR THE STATE MEDICAID (MEDI-CAL) PROGRAM, STATE DISABILITY, CHARITY CARE OR OTHER AVAILABLE PROGRAMS IN THE COUNTY. THIS ELIGIBILITY ASSISTANCE, WHICH INCLUDES HELP IN FILLING OUT THE APPLICATION, GATHERING REQUIRED DOCUMENTS, AND TRANSPORTATION TO ELIGIBILITY APPOINTMENTS, IF NECESSARY, IS OFFERED AT NO CHARGE TO THE PATIENT. IN ADDITION, PATIENT ACCOUNTING REPRESENTATIVES MAY ALSO CONTACT PATIENTS AFTER DISCHARGE TO ASK ABOUT PAYMENT ARRANGEMENTS AND TO INFORM THEM OF THE CHARITY CARE PROGRAM IF THE PATIENT NEEDS ASSISTANCE IN PAYING FOR THEIR MEDICAL BILLS. PART VI, LINE 4: COMMUNITY INFORMATIONJOHN MUIR BEHAVIORAL HEALTH'S PRIMARY AND SECONDARY SERVICE AREA EXTENDS FROM SOUTHERN SOLANO COUNTY INTO EASTERN CONTRA COSTA COUNTY AND SOUTH TO SAN RAMON IN CONTRA COSTA COUNTY. JOHN MUIR BEHAVIORAL HEALTH'S COMMUNITY BENEFIT PROGRAMS AS OF THE 2022 CHNA STUDY PRIMARILY FOCUS ON THE NEEDS OF VULNERABLE POPULATIONS IN CONTRA COSTA COUNTY, THE TRI-VALLEY, AND NORTHERN ALAMEDA COUNTY. VULNERABLE POPULATIONS ARE DEFINED AS EXPERIENCING EVIDENCED-BASED DISPARITIES IN HEALTH OUTCOMES, SIGNIFICANT BARRIERS TO CARE AND ECONOMIC INEQUITIES.THE JOHN MUIR HEALTH SERVICE AREA HAS THE FOLLOWING DEMOGRAPHIC PROFILE:CONTRA COSTA COUNTYTOTAL POPULATION:% AGE 65+: 16%% UNDER AGE 19: 25%RACE:WHITE: 52%AFRICAN AMERICAN: 9%ASIAN: 18%OTHER: 14%MULTIRACIAL: 6%AMERICAN INDIAN/ALASKAN NATIVE: <1%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER: <1%ETHNICITY:HISPANIC: 26%NON-HISPANIC: 74%SOCIOECONOMIC DATE:LIVING IN POVERTY (<100% FEDERAL POVERTY LEVEL): 9%CHILDREN IN POVERTY: 12%SENIOR (>65) IN POVERTY: 6%UNEMPLOYMENT: 6%UNINSURED POPULATION: 6%ADULTS WITH NO HIGH SCHOOL DIPLOMA: 12% PART VI, LINE 5: COMMUNITY HEALTH PROMOTIONJMBH IS A NOT-FOR-PROFIT, COMMUNITY-BASED ORGANIZATION THAT IS GOVERNED BY THOSE WHO LIVE IN THE COMMUNITY WE SERVE. COMMUNITY RESIDENTS ARE ACTIVELY INVOLVED IN OUR VARIOUS BOARDS AND BOARD COMMUNITIES. THE BOARD OF JMBH CONSISTS PRIMARILY OF MEMBERS OF THE COMMUNITY AND AND OUR HOSPITAL MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO QUALIFIED PRACTITIONERS. OUR FOCUS REMAINS FIRMLY ON IMPROVING THE HEALTH OF THE PEOPLE OF CONTRA COSTA COUNTY AND SURROUNDING COMMUNITIES. AS A NOT-FOR-PROFIT ORGANIZATION, THERE ARE NO SHAREHOLDERS WHO BENEFIT FROM OUR FINANCIAL SURPLUSES. INSTEAD, WE REINVEST ANY SURPLUSES INTO THE COMMUNITY WITH NEW PROGRAM IMPLEMENTATION, ADVANCED TECHNOLOGY, COMMUNITY SERVICES AND BUILDING PROJECTS. JMBH ALSO CONTRIBUTES SIGNIFICANTLY TO THE ECONOMIC VITALITY OF CONTRA COSTA COUNTY BY EMPLOYING OVER 250 INDIVIDUALS IN 2024.AS A NOT-FOR-PROFIT, JMBH HAS AN OBLIGATION TO MAKE A CHARITABLE CONTRIBUTION TO THE COMMUNITY, BUT OUR COMMITMENT TO KEEPING THE COMMUNITIES WE SERVE GO FAR DEEPER THAN THAT. JMBH'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION ACCURATELY REFLECTS OUR COMMUNITY HEALTH EFFORTS AS A CORPORATE LEADER AND COMMUNITY PARTNER. SOME OF THE PROGRAMS INCLUDE TREATING PATIENTS REFERRED BY LOCAL COMMUNITY CLINICS FOR SPECIALTY CARE SERVICES, AND SUPPORTING DEPRESSION PREVENTION ACTIVITIES FOR LOW-INCOME INDIVIDUALS. JMBH SERVED OVER 3,201 RESIDENTS THROUGH COMMUNITY BENEFIT ACTIVITIES IN 2024.JMBH'S COMMITMENT TO THE LOCAL COMMUNITY IS EXPRESSED IN THE MANY INITIATIVES WE DELIVER. JMBH PROVIDES CHARITY CARE FOR MANY INDIVIDUALS AND FAMILIES WITH NO INSURANCE AND LIMITED MEANS. IN 2024, WE PROVIDED $77 THOUSAND IN CHARITY CARE AT COST. JMBH ALSO ABSORBED $1.4 MILLION, THE COST OF PROVIDING CARE TO INDIVIDUALS THAT EXCEEDS THE PAYMENT WE RECEIVED FROM MEDI-CAL.LASTLY, JOHN MUIR HEALTH CONTRIBUTES MANY NON-QUANTIFIABLE BENEFITS AT EACH OF OUR FACILITIES.NON-QUANTIFIABLE BENEFITS:JMBH CONTRIBUTES MANY NON-QUANTIFIABLE BENEFITS AT EACH OF OUR FACILITIES. THE HEALTH SYSTEM CONTINUALLY PROVIDES LEADERSHIP IN THE COMMUNITY, ASSISTS WITH LOCAL CAPACITY BUILDING AND PARTICIPATE IN COMMUNITY-WIDE HEALTH PLANNING. THE FOLLOWING ARE EXAMPLES OF NON-QUANTIFIABLE BENEFITS PROVIDED IN 2024:- JOHN MUIR HEALTH NURSES ARE DEEPLY INVOLVED IN THEIR COMMUNITY THROUGH VOLUNTEERING. JOHN MUIR HEALTH ENCOURAGES NURSING VOLUNTEERISM THROUGH MAGNET RECOGNITION STATUS WHERE NURSES BUILD PARTNERSHIPS WITH THE COMMUNITY. FOR EXAMPLE, OUR NURSES PARTICIPATE AS VOLUNTEERS IN OUR MOBILE HEALTH CLINIC, AND VOLUNTEERED DURING THE HABITAT FOR HUMANITY WOMEN'S LEADERSHIP BUILD.- JOHN MUIR HEALTH LEADERSHIP ACTIVELY PARTICIPATES IN GOVERNMENT AND CITY ADVISORY COUNCILS AND TASK FORCES, SOME OF WHICH INCLUDE CITY OF CONCORD, CITY OF WALNUT CREEK, WALNUT CREEK HOUSING TASK FORCE. - JOHN MUIR HEALTH'S COMMITMENT TO ENVIRONMENTAL SUSTAINABILITY IS EVIDENT THROUGH MANY INITIATIVES, SOME OF WHICH INCLUDE: - NURSING, EVS, MATERIALS PARTNERSHIP OF A MEDICAL SUPPLY DONATION PROGRAM THAT BENEFITS THIRD WORLD COUNTRIES - ELIMINATED ALL STYROFOAM PRODUCTS - PEN AND PENCIL RECYCLING PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMSJOHN MUIR HEALTH1400 TREAT BOULEVARD, WALNUT CREEK, CA 94597JOHN MUIR HEALTH IS A NATIONALLY RECOGNIZED, NOT-FOR-PROFIT HEALTH CARE ORGANIZATION LOCATED EAST OF SAN FRANCISCO, SERVING PATIENTS IN CONTRA COSTA, EASTERN ALAMEDA AND SOUTHERN SOLANO COUNTIES. IT INCLUDES A NETWORK OF OVER 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS, 6,600 EMPLOYEES, MEDICAL CENTERS IN CONCORD AND WALNUT CREEK, INCLUDING THE COUNTY'S ONLY TRAUMA CENTER, AND A BEHAVIORAL HEALTH CENTER. THE HEALTH SYSTEM ALSO OFFERS A FULL RANGE OF MEDICAL SERVICES, INCLUDING PRIMARY CARE, OUTPATIENT, LAB AND IMAGING SERVICES, AND IS WIDELY RECOGNIZED AS A LEADER IN MANY SPECIALTIES - NEUROSCIENCES, ORTHOPEDIC, CANCER, CARDIOVASCULAR, EMERGENCY AND HIGH-RISK OBSTETRICS CARE.JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND5003 COMMERCIAL CIRCLE, SUITE 275, CONCORD, CA 94520THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND IS ONE ARM OF GRANT-MAKING AT JOHN MUIR HEALTH SYSTEM. THE FUND'S GOAL IS TO FOSTER SYSTEMIC CHANGE THAT IMPROVES THE HEALTH OF PEOPLE IN CENTRAL AND EASTERN CONTRA COSTACOUNTY WHO ARE UN- OR UNDER-INSURED, HAVE LIMITED ACCESS TO HEALTH CARE, ARE MORE AT-RISK FOR POOR HEALTH, AND ARE MOST LIKELY TO EXPERIENCE HEALTH CARE DISPARITIES. TO ACCOMPLISH THIS GOAL, THE FUND DEVELOPED A FUNDING PROCESS THAT NURTURES LONG TERM PARTNERSHIP WITH AND AMONG THE COMMUNITY BASED ORGANIZATIONS. THIS LEADS TO VISIONARY HEALTH INITIATIVE THAT BUILD AND SUSTAIN THE CAPACITY TO DELIVER ON THE PROMISE OF GOOD HEALTH AND AFFORDABLE HEALTH CARE FOR ALL. FROM 1997, THE YEAR THE COMMUNITY HEALTH FUND WAS FORMED, THROUGH 2024, THE FUND HAS GRANTED OVER $34 MILLION JOHN MUIR HEALTH COMMUNITY BENEFIT DOLLARS INTO LOCAL COMMUNITY-BASED HEALTH PROJECTS. MORE DETAILED INFORMATION ABOUT THE FUNDS, ITS GOVERNANCE, GRANT PROGRAM AND COMMUNITY BENEFIT REPORTS CAN BE FOUND ON ITS WEBSITE: HTTPS://WWW.JOHNMUIRHEALTH.COM/ABOUT-JOHN-MUIR-HEALTH/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-FUND.HTMLJOHN MUIR PHYSICIAN NETWORK1400 TREAT BOULEVARD, WALNUT CREEK, CA 94597THE JOHN MUIR PHYSICIAN NETWORK IS A NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION, WHOSE SOLE CORPORATE MEMBER IS JOHN MUIR HEALTH. SINCE ITS INCEPTION IN 1996, IT HAS BECOME ONE OF THE LARGEST PROVIDERS OF PHYSICIAN AND ALLIED HEALTH SERVICES IN NORTHERN CALIFORNIA, WITH OVER 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS WHO DELIVER COORDINATED PATIENT CARE. PHYSICIANS ASSOCIATED WITH THE PHYSICIAN NETWORK BELONG TO EITHER JOHN MUIR MEDICAL GROUP (JMMG), JOHN MUIR SPECIALTY MEDICAL GROUP (JMSMG), JOHN MUIR CARDIOVASCULAR MEDICAL GROUP (JMCVMG) OR JOHN MUIR HEALTH CANCER MEDICAL GROUP(JMHCMG). THE PHYSICIAN NETWORK OWNS AND OPERATES PRIMARY CARE CENTERS STAFFED BY JMMG PHYSICIANS IN NUMEROUS LOCATIONS FROM BRENTWOOD TO PLEASANTON. JMMG ALSO PROVIDES HOSPITALIST (IN-PATIENT MEDICAL SERVICES)AT JOHN MUIR HEALTH'S HOSPITALS. THE PHYSICIAN NETWORK ALSO OWNS SPECIALTY CLINICS STAFFED BY JMSMG, JMCVG, AND JMHCMG. THE PHYSICIAN NETWORK IS ACTIVE IN COMMUNITY SERVICE, HEALTH EDUCATION AND CLINICAL RESEARCH. THE PHYSICIAN NETWORK CURRENTLY HOLDS CONTRACTS WITH SEVEN MAJOR HEALTH PLANS FOR MORE THAN 50,000 COMMERCIAL AND SENIOR HMO MEMBERS. THE PHYSICIAN NETWORK MANAGES HEALTH PLAN CONTRACTING FOR JOHN MUIR HEALTH AND ITS HOSPITALS AND ENGAGES PHYSICIAN RECRUITMENT TO MEET COMMUNITY NEEDS. THE PHYSICIAN NETWORK ALSO OPERATES THE JMH MEDICARE ACCOUNTABLE CARE ORGANIZATION (ACO) WHICH PROVIDES THE COORDINATION OF CARE FOR ITS MEDICARE ACO MEMBERS.JOHN MUIR HEALTH FOUNDATION1400 TREAT BOULEVARD, WALNUT CREEK, CA 94597THE JOHN MUIR HEALTH FOUNDATION RAISES FUNDS TO OFFSET THE COST OF CAPITAL AND OPERATING EXPENSES FOR THE JOHN MUIR HEALTH PROGRAMS, INCLUDING VARIOUS EDUCATIONAL PROGRAMS, OPERATIONS, BUILDINGS AND EQUIPMENT. IN THISWAY, THE FOUNDATION HELPS TO MITIGATE THE COST OF CARE PROVIDED AND ASSISTS JOHN MUIR HEALTH IN MAINTAINING STATE-OF-THE-ART FACILITIES, EQUIPMENT AND PROGRAMS FOR THE COMMUNITY. JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF THE JOHN MUIR HEALTH FOUNDATION. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 JOHN MUIR HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 941461843 501(C)(3) 7232155 0 N/A N/A GENERAL SUPPORT JOHN MUIR HEALTH PHYSICIAN NETWORK 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680360801 501(C)(3) 25626 0 N/A N/A GENERAL SUPPORT 2 0 PART I, LINE 2: GRANT MONITORING PROCESS JOHN MUIR HEALTH FINANCIAL MANAGEMENT MONITORS THE USE OF RESTRICTED FUNDS TO MEET THE INTENDED PURPOSES. X 1 1 1 1 0 0 0 0 0 0 0 MICHAEL S THOMAS CEO/DIRECTOR/PRESIDENT 0 1423500 0 676181 0 26254 0 1657032 0 19539 0 3802506 0 676181 JANE WILLEMSEN CHIEF OPERATING OFFICER 0 1096693 0 449639 0 39396 0 580463 0 27518 0 2193709 0 449639 MELINDA ESTEP SENIOR VP/CFO (THRU 6/4/24) 0 342539 0 61737 0 313560 0 0 0 8033 0 725869 0 61737 JESSE TAMPLEN VICE PRESIDENT 378794 0 123069 0 5476 0 142268 0 23510 0 673117 0 98069 0 KRISTIN PACE DIRECTOR OF NURSING 296053 0 22369 0 33 0 50569 0 22581 0 391605 0 22369 0 TIM MAURICE INTERIM CFO (AS OF 6/4/24) 0 374400 0 0 0 0 0 0 0 0 0 374400 0 0 BOUALAY BALA MANAGER 266859 0 14165 0 0 0 38399 0 34328 0 353751 0 14165 0 KATIE JONES MANAGER 266859 0 14165 0 0 0 48668 0 21832 0 351524 0 14165 0 SONIA GOMEZ MANAGER 262742 0 14008 0 360 0 43684 0 16274 0 337068 0 14008 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES JOHN MUIR HEALTH AND JOHN MUIR BEHAVIORAL HEALTH PAY UP TO 50% OF HEALTH CLUB DUES FOR EXECUTIVE DIRECTORS OF OPERATIONS, VICE PRESIDENTS AND ABOVE. THESE BENEFITS ARE TREATED AS TAXABLE INCOME TO THESE INDIVIDUALS. PART I, LINE 3 COMPENSATION OVERSIGHT JOHN MUIR HEALTH, A RELATED TAX-EXEMPT ORGANIZATION OF JOHN MUIR BEHAVIORAL HEALTH, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B SEVERANCE OR CHANGE OF CONTROL PAYMENT MELINDA ESTEP, SENIOR VP/CFO, RECEIVED A SEVERANCE PAYMENT OF FOUR MONTHS OF COMPENSATION TOTALING $224,615 WHICH IS INCLUDED IN PART II, COLUMN (B)(III). PART I, LINE 4B: NON-QUALIFIED RETIREMENT PLANS RETIREMENT RESTORATION PLAN EMPLOYEES ELIGIBLE FOR THE RETIREMENT RESTORATION PLAN ARE EITHER SENIOR VICE PRESIDENT OR VICE PRESIDENT LEVEL EMPLOYEES. EMPLOYER CONTRIBUTIONS ARE MADE TO THE PLAN ON BEHALF OF ELIGIBLE EMPLOYEES. THE ANNUAL INCREASE IN ACTUARIAL VALUE OF THE PLAN BENEFIT IS REPORTED IN PART II, COLUMN C. VESTING FOR THE RESTORATION PLAN IS AT THE EARLIEST OF THE FOLLOWING: REACHING AGE 65 WITH AT LEAST THREE YEARS OF SERVICE, BECOMING TOTALLY AND PERMANENTLY DISABLED, INVOLUNTARY TERMINATION FOR ANY REASON OTHER THAN CAUSE, CHANGE OF CONTROL OF JOHN MUIR HEALTH, OR DEATH. RESTORATION PLAN BENEFITS ARE PAYABLE AND TAXABLE UPON VESTING. THE FOLLOWING EXECUTIVE PARTICIPATED IN THE PLAN AND EARNED THE FOLLOWING BENEFIT: JESSE TAMPLEN $23,932. SUPPLEMENTAL EXECUTIVE PLAN EMPLOYEES ELIGIBLE FOR THE SUPPLEMENTAL EXECUTIVE PLAN ARE EITHER CEO OF EMPLOYEES THAT PREVIOUSLY HELD ONE OF THOSE POSITIONS. EMPLOYER WERE MADE DURING THE YEAR. SUPPLEMENTAL EXECUTIVE PLAN JOHN MUIR HEALTH, CEO OR CAO OF JOHN MUIR PHYSICIAN NETWORK, AND CURRENT CONTRIBUTIONS ARE MADE TO THE PLAN ON BEHALF OF ELIGIBLE EMPLOYEES. THE ANNUAL INCREASE IN ACTUARIAL VALUE OF THE PLAN BENEFIT IS REPORTED IN PART II, COLUMN C. VESTING FOR THE SUPPLEMENTAL EXECUTIVE PLAN IS AT THE EARLIEST OF THE FOLLOWING: REACHING AGE 65 WITH AT LEAST THREE YEARS OF SERVICE, BECOMING DISABLED, INVOLUNTARY TERMINATION FOR ANY REASON OTHER THAN CAUSE, TERMINATION UPON CHANGE OF CONTROL OF JOHN MUIR HEALTH, OR DEATH. BENEFITS ARE PAYABLE AND TAXABLE UPON VESTING. THE FOLLOWING EXECUTIVES PARTICIPATED IN THE PLAN AND EARNED THE FOLLOWING BENEFITS DURING THE TAX YEAR: MICHAEL THOMAS $887,895, AND JANE WILLEMSEN $39,543. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF JOHN MUIR BEHAVIORAL HEALTH. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS OF GOVERNING BODY THE BYLAWS OF JOHN MUIR BEHAVIORAL HEALTH PROVIDE THAT THE VOTING AND NON-VOTING MEMBERS OF THE BOARD OF DIRECTORS OF JOHN MUIR HEALTH, THE SOLE CORPORATE MEMBER OF JOHN MUIR BEHAVIORAL HEALTH, SHALL SERVE EX-OFFICIO AS THE VOTING AND NON-VOTING MEMBERS OF THE BOARD OF DIRECTORS OF JOHN MUIR BEHAVIORAL HEALTH. AS A RESULT, THE BOARD OF DIRECTORS OF JOHN MUIR HEALTH CONTROLS THE NUMBER, APPOINTMENT, TERM AND REMOVAL OF THE MEMBERS OF THE BOARD OF DIRECTORS OF JOHN MUIR BEHAVIORAL HEALTH. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS JOHN MUIR HEALTH, AS THE SOLE CORPORATE MEMBER OF JOHN MUIR BEHAVIORAL HEALTH, ALSO HAS THE RIGHT TO APPROVE CERTAIN ACTIONS IN ACCORDANCE WITH THE CALIFORNIA NONPROFIT PUBLIC CORPORATION LAW, INCLUDING THE VOLUNTARY DISSOLUTION OF JOHN MUIR BEHAVIORAL HEALTH, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF JOHN MUIR BEHAVIORAL HEALTH, AND THE MERGER OF JOHN MUIR BEHAVIORAL HEALTH WITH OR INTO ANY OTHER ENTITY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED AND CONSCIENTIOUS REVIEW BY ALL MEMBERS. AN OVERVIEW OF THE FORM 990, WITH SUFFICIENT DETAIL, IS PRESENTED TO THE BOARD WITH THE COMPLETED FORM 990. ALL QUESTIONS AND CONCERNS OF THE BOARD OF DIRECTORS WILL BE ADDRESSED BY THE CHIEF FINANCIAL OFFICER OR THEIR DESIGNEE AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. AFTER ALL OF THE INPUT FROM THE BOARD OF DIRECTORS HAS BEEN APPROPRIATELY ADDRESSED, SENIOR MANAGEMENT OF JOHN MUIR BEHAVIORAL HEALTH WILL FILE THE FINAL FORM 990 AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST MONITORING ANNUALLY, THE JOHN MUIR HEALTH (JMH) BOARD CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO BOARD MEMBERS, ALONG WITH A CONFLICT OF INTEREST DISCLOSURE FORM REQUIRED TO BE COMPLETED AND SIGNED. DISCLOSED CONFLICTS ARE COMPILED IN A DOCUMENT AND REVIEWED BY THE BOARD CHAIR, PRESIDENT/CEO, AND GENERAL COUNSEL. TOGETHER, THESE INDIVIDUALS MONITOR ANY POTENTIAL CONFLICTS AND THE GENERAL COUNSEL ATTEND BOARD MEETINGS TO ENSURE COMPLIANCE WITH THE POLICY. TRANSACTIONS INVOLVING A POTENTIAL CONFLICT ARE REVIEWED AND APPROVED IN ADVANCE BY THE GENERAL COUNSEL, GOVERNANCE COMMITTEE AND FOR CERTAIN TRANSACTIONS WITH THE CURRENT BOARD MEMBERS, THE BOARD. THE POLICY ALSO REQUIRES BOARD MEMBERS TO DISCLOSE CONFLICTS DURING THE YEAR AND RECUSE THEMSELVES FROM VOTING ON ANY MATTERS RELATED TO A CONFLICT. AS QUESTIONS ABOUT POTENTIAL CONFLICTS ARISE DURING THE YEAR, THE GENERAL COUNSEL REVIEWS THEM WITH THE AFFECTED BOARD MEMBER, THE PRESIDENT/CEO AND THE BOARD CHAIR. TO ENSURE THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, PERIODIC REVIEWS SHALL BE CONDUCTED, INCLUDING PERIODIC REVIEWS OF ITS TRANSACTIONS OR ARRANGEMENTS WITH ITS OFFICERS AND BOARD MEMBERS, AND ANY OTHER INDIVIDUAL OR ENTITIES THAT MAY HAVE A SUBSTANTIAL INFLUENCE OVER THE BUSINESS AND AFFAIRS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, OTHER OFFICERS AND KEY EMPLOYEES ARE ESTABLISHED ANNUALLY BY THE COMPENSATION COMMITTEE OF JOHN MUIR HEALTH. THE COMPENSATION COMMITTEE IS A STANDING COMMITTEE OF THE BOARD OF DIRECTORS COMPRISED OF NO LESS THAN 5 VOTING DIRECTORS, NONE OF WHICH HAS A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION TRANSACTIONS UNDER CONSIDERATION. THE COMPENSATION COMMITTEE UTILIZES AN OUTSIDE EXPERT COMPENSATION CONSULTANT. THE OUTSIDE CONSULTANT PROVIDES MARKET DATA OF SIMILARLY SITUATED ORGANIZATIONS FOR EACH INDIVIDUAL BASED UPON THEIR LEVEL OF RESPONSIBILITES. THAT DATA IS USED BY THE COMPENSATION COMMITTEE TO ESTABLISH THE ANNUAL COMPENSATION PACKAGE FOR EACH INDIVIDUAL. IT IS THE PHILOSOPHY OF THE ORGANIZATION TO ESTABLISH A COMPENSATION PACKAGE FOR EACH INDIVIDUAL THAT REFLECTS THE MEDIAN OF THE MARKET AS ESTABLISHED BY THE OUTSIDE CONSULTANT. THE COMMITTEE'S DELIBERATIONS AND DECISIONS REGARDING THESE COMPENSATION ARRANGEMENTS ARE DOCUMENTED IN THE COMMITTEE MINUTES THAT ARE REVIEWED AT ITS NEXT MEETING. THE DOCUMENTED MINUTES INCLUDE (1) TERMS OF THE COMPENSATION ARRANGEMENT, INCLUDING DATE IT WAS APPROVED; (2) A DESCRIPTION OF THE COMPARABLE DATA RELIED UPON BY THE COMMITTEE AND HOW IT WAS OBTAINED; 3) A LIST OF THE MEMBERS PRESENT DURING THE DELIBERATIONS AND HOW THE MEMBERS VOTED; 4) ANY ACTIONS TAKEN WITH RESPECT TO CONSIDERATION OF ANY MEMBER OF THE COMMITTEE WHO HAD A POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO THE TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FROM THE JOHN MUIR HEALTH LEGAL DEPARTMENT UPON REQUEST. 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