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LUKE'S MEDICAL CENTER. SCHEDULE D, PART X, LINE 2 ASC 740 (FIN48) FOOTNOTE FROM AUDIT: THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH, THE LEGAL ENTITY, AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)), AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. WITH RESPECT TO ITS TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD, UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2015 AND 2014, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 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X X true true X X X X true X 0 X 0 X X X X X X X true X false X X X X true X X false false NOVATO COMMUNITY HOSPITAL 6 false false true X X X X X X X X X 13 true true false true X See section C X See section C true 13 true See section C false false true X 400. 0. X X true true X X X X true X X X X X X true X false X X X X true X X false false SUTTER LAKESIDE HOSPITAL 7 false false true X X X X X X X X X 13 true true false true X See Section C X See Section C true 13 true See Section C false false true X 400. 0. X X true true X X X X true X X X X X X true X false X X X X true X X false false SUTTER SANTA ROSA REGIONAL HOSPITAL 8 false false true X X X X X X X X X 13 true true true true X See section C X See section C true 13 true See section C false false true X 400. 0. X X true true X X X X true X X X X X X true X false X X X X true X X false false REPORTING FACILITY: A, 1-5 SCHEDULE H, PART V, LINE 5 CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, FACILITIES 1-5): IN CONDUCTING ITS MOST RECENT CHNA, CALIFORNIA PACIFIC MEDICAL CENTER, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THE COMMUNITY BENEFIT PARTNERSHIP WORKED COLLECTIVELY TO IDENTIFY THE COMMUNITY'S HEALTH NEEDS AND TO DEVELOP THE CHNA REPORT. IN COLLABORATION WITH ACADEMIC PARTNERS, THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH AS WELL AS THE BROADER SAN FRANCISCO COMMUNITY, THE COMMUNITY BENEFIT PARTNERSHIP BUILT ON THE STRONG FOUNDATION OF YEARS WORKING ON THE PAST TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS. AN OUTGROWTH OF THE BUILDING A HEALTHIER SAN FRANCISCO (BHSF) NEEDS ASSESSMENT PROCESS AND THE CHARITY CARE PROJECT (CCP), THE COMMUNITY BENEFIT PARTNERSHIP SEEKS TO HARNESS THE COMBINED ENERGY AND RESOURCES OF SAN FRANCISCO'S PRIVATE NONPROFIT HOSPITALS, CITY DEPARTMENTS (PUBLIC HEALTH AND HUMAN SERVICES), COMMUNITY CLINICS, HEALTH PLANS, NONPROFIT PROVIDERS AND ADVOCACY GROUPS TO IMPROVE THE HEALTH STATUS OF SAN FRANCISCO RESIDENTS. THE COMMUNITY BENEFIT PARTNERSHIP WAS CONCEIVED IN 1999 TO COLLABORATIVELY IDENTIFY COMMUNITY HEALTH NEEDS AND SUPPORT COORDINATED DECISION-MAKING TO ADDRESS THE NEEDS. IT IS WITH THIS SAME DETERMINATION THAT THE PARTNERS UNDERTOOK A COMMUNITY ORIENTED PROCESS - IN ALIGNMENT WITH THE VALUES EXPRESSED BY THE NEIGHBORHOOD RESIDENTS - FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. DURING 2012, A NUMBER OF OTHER COMMUNITY-BASED NEEDS ASSESSMENTS WERE UNDERWAY AT THE SAME TIME AS THE CHNA. IN ORDER TO REDUCE DUPLICATION OF EFFORT, LEVERAGE RESOURCES, AND RESPECT COMMUNITY MEMBERS' TIME COMMITMENT TO THE PROCESS, THE CHNA PROCESS WAS COMBINED WITH THE DEPARTMENT OF PUBLIC HEALTH'S PROCESS TO COMPLETE A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND ITS COMMUNITY HEALTH ASSESSMENT (CHA). THIS COMBINATION OF EFFORTS BROUGHT TOGETHER A NUMBER OF ADDITIONAL PARTNERS THAT ENRICHED THE INPUT THROUGH A VARIETY OF PERSPECTIVES AND CONTRIBUTIONS TO THE PROCESS. SPECIFICALLY, THE COLLABORATING ORGANIZATIONS AND INDIVIDUALS INCLUDED: - HOSPITAL AND ACADEMIC PARTNERS, WHO CONTINUED TO PARTNER WITH SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH (SFDPH) ON SAN FRANCISCO'S CHA/CHIP LEADERSHIP COUNCIL, WHICH HAS GUIDED THE DEVELOPMENT AND WILL GUIDE THE IMPLEMENTATION OF SAN FRANCISCO'S CHIP. - COMMUNITY STAKEHOLDERS - INCLUDING REPRESENTATIVES FROM SAN FRANCISCO'S NONPROFIT HOSPITALS, ACADEMIC INSTITUTIONS, HEALTH PLANS, THE AFRICAN AMERICAN HEALTH DISPARITIES PROJECT, SAN FRANCISCO HUMAN SERVICES AGENCY, AND SFDPH. - COMMUNITY RESIDENTS AND MEMBERS OF THE LOCAL PUBLIC HEALTH SYSTEM - INCLUDING REPRESENTATIVES FROM K-12 EDUCATION, HIGHER EDUCATION, PHILANTHROPY, NONPROFIT AGENCIES, MINORITY HEALTH EQUITY COALITIONS, GOVERNMENT (INCLUDING THE SAN FRANCISCO MAYOR'S OFFICE AND HEALTH COMMISSION), HOSPITALS, AND MORE. - HEALTH CONTENT EXPERTS ENGAGED WITH SFDPH AS WELL AS ITS HOSPITAL AND ACADEMIC PARTNERS TO REFINE PRIORITY GOALS, OBJECTIVES, MEASURES, AND STRATEGIES THAT HAVE COME TO FORM THE CURRENT CHIP. A NUMBER OF CONSULTING FIRMS AND CONSULTANTS WERE INVOLVED THROUGHOUT THIS PROCESS, INCLUDING: 1) HEARTBEATS, FOR COMMUNITY ENGAGEMENT; 2) CIRCLE POINT, FOR ONGOING COMMUNICATION WITH STAKEHOLDERS; 3) HARDER+COMPANY, FOR DATA COLLECTION AND ANALYSIS; AND 4) NANCY SHEMICK, MPA, FOR MEETING FACILITATION AND REPORT-WRITING. FROM JULY 2011 UNTIL FEBRUARY 2013, THE PARTNERS ENGAGED A WIDE RANGE OF COMMUNITY RESIDENTS AND LOCAL PUBLIC HEALTH SYSTEM PARTNERS INCLUDING: - COMMUNITY RESIDENTS FROM EACH OF SAN FRANCISCOS 21 NEIGHBORHOOD AREAS. - SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH CONVENED A 42 MEMBER TASK FORCE THAT REPRESENTED HOSPITALS, CLINICS, K-12 EDUCATION, SMALL BUSINESS, URBAN PLANNING, CONSUMER GROUPS, NONPROFIT ORGANIZATIONS REPRESENTING DIFFERENT ETHNIC MINORITY GROUPS. THE TASK FORCE MET 10 TIME BETWEEN JULY 2011 AND MAY 2012 IN DIFFERENT SAN FRANCISCO NEIGHBORHOODS AND ENGAGED MORE THAN 100 COMMUNITY RESIDENTS. - THE CITY OF SAN FRANCISCO ENGAGE 224 COMMUNITY RESIDENTS IN FOCUS GROUPS AND INTERVIEWED 40 COMMUNITY STAKEHOLDERS TO DISCUSS DEFINITION OF HEALTH AND WELLNESS. - A 10-MEMBER DATA ADVISORY COMMITTEE COMPRISED OF LOCAL PUBLIC HEALTH SYSTEM PARTNERS, RESIDENTS, AND SFDPH STAFF OVERSAW THE SELECTION DATA INDICATORS. A COMPREHENSIVE LISTING OF THE MEETING ATTENDEES, INVITEES, ASSESSMENT PROCESS, TIMELINES, AND COMMUNITY INPUT ARE AVAILABLE IN CPMC'S CHNA AT: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A & 6B CHNA HOSPITAL COLLABORATORS: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, FACILITIES 1-5): A COMPLETE LISTING OF HOSPITALS AND PARTNERS WHO COLLABORATED ON THE CHNA IS AVAILABLE FOR DOWNLOAD AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, FACILITIES 1-5): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.CPMC.ORG/ABOUT/COMMUNITY/ - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, FACILITIES 1-5): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT CPMC INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: INCREASE ACCESS TO HIGH-QUALITY HEALTH CARE AND SERVICES - ACCESS TO COMPREHENSIVE, HIGH-QUALITY HEALTH CARE AND OTHER SERVICES IS ESSENTIAL IN PREVENTING ILLNESS, PROMOTING WELLNESS, AND FOSTERING VIBRANT COMMUNITIES. THIS PRIORITY STRIVES TO BRIDGE EXISTING GAPS IN HEALTH CARE ACCESS DUE TO: LOW INCOME; LANGUAGE/LITERACY BARRIERS OR LACK OF CULTURAL COMPETENCY OF SERVICE PROVIDERS; LACK OF INSURANCE OR PROVIDERS NOT ACCEPTING COVERAGE SUCH AS MEDI-CAL BECAUSE OF LOW REIMBURSEMENT RATES. INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY - SCIENCE LINKS HEALTH CONDITIONS SUCH AS HEART DISEASE, DIABETES, AND CANCER TO DAILY PRACTICES LIKE EATING A HEALTHY, BALANCED DIET AND GETTING REGULAR EXERCISE. THIS PRIORITY STRIVES TO DEMONSTRATE THE LINK BETWEEN DIET, INACTIVITY, AND CHRONIC DISEASE AND TO HELP SAN FRANCISCO CREATE ENVIRONMENTS THAT MAKE HEALTHY CHOICES EASIER. DISPARITIES EXIST DUE TO SOCIOECONOMIC AND ENVIRONMENTAL FACTORS SUCH AS AFFORDABILITY AND ACCESSIBILITY OF HEALTHY FOOD OPTIONS, AND NEIGHBORHOOD SAFETY WHEN ENGAGING IN EXERCISE. OBESITY RISK ALSO VARIES ACCORDING TO DIFFERENT RACIAL/ETHNIC GROUPS. ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS - THIS PRIORITY HIGHLIGHTS THE NEED FOR HEALTH AND WELLNESS-ORIENTED LAND USE PLANNING, MEANINGFUL OPPORTUNITIES FOR OUTDOOR RECREATION, AND A POSITIVE BUILT ENVIRONMENT FOR THE HEALTH OF ALL INDIVIDUALS AND COMMUNITIES. IT SEEKS TO ADDRESS DISPARITIES IN ACCESS TO PARKS, PUBLIC TRANSIT, GROCERY STORES WITH HEALTHIER FOOD CHOICES, AND OTHER RESOURCES THAT BENEFIT HEALTH AND WELLNESS. CERTAIN NEIGHBORHOODS AND RACIAL/ETHNIC GROUPS - OFTEN POOR COMMUNITIES OF COLOR - ARE MORE IMPACTED BY CRIME AND VIOLENCE, AND ARE CLOSER TO FAST FOOD AND ALCOHOL OUTLETS, FREEWAYS, INDUSTRIAL POLLUTANTS, AND OTHER FACTORS THAT CONTRIBUTE TO HIGH RATES OF DISEASE, DEATH, INJURY, AND VIOLENCE. DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. ALTHOUGH NO HOSPITAL CAN ADDRESS ALL ASPECTS OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY, CPMC PLANS TO ADDRESS ALL THREE OF THE PRIORITIES IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. AS A MEMBER OF SFHIP (SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP), CPMC WILL CONTINUE TO WORK IN COLLABORATION WITH OTHER LOCAL HOSPITALS AND HEALTH PLANS TO IDENTIFY GAPS IN SERVICE AND TO DETERMINE WHERE EFFORTS SHOULD BE COLLECTIVELY REDIRECTED IN ORDER TO MOST EFFECTIVELY IMPROVE THE HEALTH OF SAN FRANCISCO RESIDENTS. FOR MORE INFORMATION ABOUT SFHIP, PLEASE VISIT HTTP://WWW.SFHIP.ORG. CPMC IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. SCHEDULE H, PART V, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, FACILITIES 1-5): PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITYS FINANCIAL ASSISTANCE POLICY: CALIFORNIA PACIFIC MEDICAL CENTER (REPORTING GROUP A, FACILITIES 1-5): THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITALS SERVICE AREA. REPORTING FACILITY: #6, NOVATO COMMUNITY HOSPITAL SCHEDULE H, PART V, LINE 5 NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #6): IN CONDUCTING ITS MOST RECENT CHNA, NOVATO COMMUNITY HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA THE THREE MARIN COUNTY NOT-FOR-PROFIT HOSPITALS (MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL, AND KAISER PERMANENTE) WORKED TOGETHER WITH THE HEALTHY MARIN PARTNERSHIP (HMP) TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CONSULTANTS FOR THE 2013 CHNA INCLUDED: - HUMAN IMPACT PARTNERS - ROCHELLE EREMAN, MS, MPH, MARIN HEALTH AND HUMAN SERVICES DEPARTMENT EPIDEMIOLOGIST - ABINADER GROUP - CO HERNNDEZ, MFT - LYNN H. BASKETT, MBA - WESTED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN, PUBLIC HEALTH THAT PROVIDED INPUT INCLUDED: - LARRY MEREDITH, PHD, DIRECTOR, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT - ROCHELLE EREMAN, MS, MPH, COMMUNITY EPIDEMIOLOGY CHIEF, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT - JENNIFER REINKS, PHD, FACULTY, FAMILY HEALTH OUTCOMES PROJECT, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO - TOM PETERS, PHD, PRESIDENT, MARIN COMMUNITY FOUNDATION AND FORMER DIRECTOR, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT - MATTHEW WILLIS, MD, MPH, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, PUBLIC HEALTH OFFICER - D.J. PIERCE, MARIN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, CHIEF OF DIVISION OF ALCOHOL, TOBACCO & OTHER DRUGS THESE PUBLIC HEALTH EXPERTS PARTICIPATED IN KEY INFORMANT INTERVIEWS. LARRY MEREDITH, PHD, JENNIFER REINKS, PHD, AND MATTHEW WILLIS, MD ALSO PARTICIPATED IN THE HMP-COORDINATED COMMUNITY CONVENING AND MS. EREMAN WAS A CONSULTANT TO THE CHNA WORK GROUP AND PROCESS. FROM APRIL 23, 2012 TO JUNE 11, 2012 SELMA ABINADER OF ABINADER GROUP CONDUCTED 25 PHONE INTERVIEWS OF STAKEHOLDERS SELECTED BY HMP LEADERSHIP. STAKEHOLDERS WERE HMP LEADERSHIP AND REPRESENTATIVES FROM HOSPITAL AND HEALTH ORGANIZATIONS, PUBLIC HEALTH EXPERTS, FUNDING INSTITUTIONS, GOVERNMENT, BUSINESS, EDUCATION, AND COMMUNITY BASED AGENCIES. KEY INFORMANTS, COMMUNITY PHYSICIANS AND THOSE PARTICIPATING IN THE HMP-COORDINATED COMMUNITY CONVENING INCLUDED 44 MARIN COUNTY RESIDENTS AND LEADERS REPRESENTING KEY POPULATIONS (MEDICALLY-UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE). FOCUS GROUPS WERE CONDUCTED BETWEEN APRIL 16 AND MAY 9, 2012 BY THE COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES. THEY WERE HELD IN MARIN CITY, NOVATO, CANAL, SAN GERONIMO, WEST MARIN, WHISTLESTOP AND THE YOUTH LEADERSHIP INSTITUTE. A TOTAL OF 103 ENGLISH AND 50 SPANISH RESPONSES WERE OBTAINED. FOCUS GROUPS INCLUDED 144 COMMUNITY RESIDENTS REPRESENTING THE FOLLOWING GROUPS: LOCATION PARTICIPANTS MEDICALLY LOW MINORITY CHRONIC UNDERSERVED INCOME DISEASE PT. REYES/W. MARIN 13 X X X SAN GERONIMO 15 X X X X MARIN CITY 39 X X X X NOVATO 12 X X X X SAN RAFAEL/ CANAL 33 X X WHISTLESTOP 16 X X X X YOUTH LEADERSHIP INST. 16 X X X FOCUS GROUP PARTICIPANTS WERE SURVEYED ABOUT: - IMPORTANT HEALTH ISSUES THEY, THEIR FAMILIES, AND THEIR COMMUNITIES FACED - WHAT THEY SAW AS HEALTHY AND UNHEALTHY ABOUT THEIR COMMUNITIES - WHAT THEY WOULD CHANGE TO MAKE THEIR COMMUNITIES HEALTHIER. ADDITIONAL DETAILS ON KEY INFORMANTS, COLLABORATIVE PARTNERS AND FOCUS GROUPS CAN BE FOUND IN NOVATO COMMUNITY HOSPITAL'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #6): THE THREE MARIN COUNTY NOT-FOR-PROFIT HOSPITALS, MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL, AND KAISER PERMANENTE, WORKED TOGETHER WITH THE HEALTHY MARIN PARTNERSHIP TO COMPLETE THE CHNA. SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #6): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/COMMUNITY_BENEFITS.HTML - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #6): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT NOVATO COMMUNITY HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: ACCESS TO PRIMARY AND SPECIALTY CARE - ALTHOUGH ACCESS TO HEALTH CARE AS MEASURED BY HEALTH INSURANCE IS RELATIVELY HIGH IN MARIN, THERE ARE SIGNIFICANT GEOGRAPHIES WHERE RESIDENTS LACK INSURANCE AND OBTAINING TIMELY AND EFFECTIVE SCREENING AND TREATMENT IS LACKING. LIMITATIONS ON ACCESS AFFECT PARTICIPATION IN SCREENINGS AND TREATMENT OF EARLY DIAGNOSIS FOR CANCER, HEART DISEASE, ASTHMA, MENTAL HEALTH, SUBSTANCE ABUSE, AND DIABETES. HEALTHY EATING AND ACTIVE LIVING - EATING HEALTHY FOODS AND ENGAGING IN AN ACTIVE LIFESTYLE ARE DETERMINANTS OF HEALTH FOR DIABETES, CANCER, HEART DISEASE, AND MENTAL HEALTH. SOCIAL SUPPORTS (INCLUDING FAMILY AND COMMUNITY SUPPORT SYSTEMS) - THESE SYSTEMS AND SERVICES DIRECTLY AFFECT MENTAL HEALTH, SUBSTANCE ABUSE, ACCESS TO HEALTH CARE, AND FALLS. MENTAL HEALTH - A GREATER PERCENTAGE OF MARIN ADULTS REPORT POOR MENTAL HEALTH AND HIGHER SUICIDE RATES THAN CALIFORNIA AND HEALTHY PEOPLE 2020. DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH OTHER CRITICAL EFFORTS ON BEHALF OF NOVATO COMMUNITY HOSPITAL. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. NOVATO COMMUNITY HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THIS IMPLEMENTATION STRATEGY DOES NOT INCLUDE SPECIFIC PLANS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: - SUBSTANCE ABUSE (ALCOHOL AND OTHER DRUGS) - NCH DOES NOT HAVE SUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THIS NEED. THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS THIS NEED. OTHER FACILITIES AND ORGANIZATIONS IN THE COMMUNITY DO ADDRESS THIS NEED. (COMMUNITY ASSETS LISTED IN CHNA: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/NCH_2013CHNAREPORT.PDF) - SOCIOECONOMIC STATUS - NCH DOES NOT HAVE SUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THIS NEED. THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS THIS NEED. OTHER FACILITIES AND ORGANIZATIONS IN THE COMMUNITY DO ADDRESS THIS NEED. (COMMUNITY ASSETS LISTED IN CHNA: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/NCH_2013CHNAREPORT.PDF) - CANCER - NCH DOES NOT HAVE SUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THIS NEED. THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS THIS NEED. OTHER FACILITIES AND ORGANIZATIONS IN THE COMMUNITY DO ADDRESS THIS NEED. (COMMUNITY ASSETS LISTED IN CHNA: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/NCH_2013CHNAREPORT.PDF) - HEART DISEASE - NCH DOES NOT HAVE SUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THIS NEED. THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS THIS NEED. OTHER FACILITIES AND ORGANIZATIONS IN THE COMMUNITY DO ADDRESS THIS NEED. (COMMUNITY ASSETS LISTED IN CHNA: HTTP://WWW.NOVATOCOMMUNITY.ORG/ABOUT/NCH_2013CHNAREPORT.PDF) SCHEDULE H, PART V, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #6): PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITYS FINANCIAL ASSISTANCE POLICY: NOVATO COMMUNITY HOSPITAL (HOSPITAL FACILITY #6): THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITALS SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. ON AN ANNUAL BASIS SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE REPORTING FACILITY: #7, SUTTER LAKESIDE HOSPITAL SCHEDULE H, PART V, LINE 5 SUTTER LAKESIDE HOSPITAL (HOSPITAL FACILITY #7): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER LAKESIDE HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. THREE PRIMARY METHODS OF COLLECTING INPUT FROM THE COMMUNITY WERE USED IN THE ASSESSMENT - COMMUNITY SURVEY, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. KEY INFORMANT INTERVIEWS: TELEPHONE INTERVIEWS USING A STRUCTURED SET OF QUESTIONS (WITH ADDITIONAL, PERSONALIZED QUESTIONS TO OBTAIN MORE IN-DEPTH INFORMATION) WERE CONDUCTED WITH 16 INDIVIDUALS WHOSE PERCEPTIONS AND EXPERIENCE WERE INTENDED TO INFORM THE ASSESSMENT. THE INTERVIEWS PROVIDED AN INFORMED PERSPECTIVE FROM THOSE WORKING DIRECTLY WITH THE PUBLIC, INCREASED AWARENESS ABOUT AGENCIES AND SERVICES, OFFERED INPUT ABOUT GAPS AND POSSIBLE DUPLICATION IN SERVICES, AND SOLICITED IDEAS ABOUT RECOMMENDED STRATEGIES AND SOLUTIONS. THE INTERVIEWS ALSO FOCUSED THE NEEDS ASSESSMENT ON PARTICULAR ISSUES OF CONCERN WHERE INDIVIDUALS WITH CERTAIN EXPERTISE COULD CONFIRM OR DISPUTE PATTERNS IN THE DATA AND IDENTIFY DATA AND OTHER STUDIES THE COLLABORATIVE MIGHT NOT OTHERWISE BE AWARE OF. KEY INFORMANTS INTERVIEWED INCLUDE THE FOLLOWING: - DAVID SANTOS, VICE PRESIDENT OF OPERATIONS, ST. HELENA HOSPITAL CLEAR LAKE - DENISE RUSHING, SUPERVISOR, LAKE COUNTY BOARD OF SUPERVISORS - DENNIS FAY, EXECUTIVE DIRECTOR, COMMUNITY CARE MANAGEMENT CORPORATION - DIANE PEGE, MD, VICE PRESIDENT, MEDICAL AFFAIRS, SUTTER LAKESIDE HOSPITAL - KIMBERLY TANGERMANN, MANAGER, LIVE WELL & KONOCTI WELLNESS CENTER, ST. HELENA HOSPITAL CLEAR LAKE - LINDA MORRIS, DEPUTY DIRECTOR, CLINICAL SERVICES, LAKE COUNTY BEHAVIORAL HEALTH DEPARTMENT - LYN SCURI, HEALTH PLANNER, PARTNERSHIP HEALTH PLAN - MARK BUEHNERKEMPER, OPTOMETRIST, LAKE COUNTY RESIDENT - MERYL FEATHERSTONE, TRIBAL HEALTH - MONTE WINTERS, SPRING VALLEY RESIDENT - ROB BROWN, SUPERVISOR, LAKE COUNTY BOARD OF SUPERVISORS - ROBERT GARDNER, MD, MEDICAL DIRECTOR, LUCERNE COMMUNITY CLINIC - SIRI NELSON, CHIEF EXECUTIVE OFFICER, SUTTER LAKESIDE HOSPITAL - STEPHANIE LILLY, DIRECTOR OF PROGRAMS, LAKE FAMILY RESOURCE CENTER - TERESA CAMPBELL, CHIEF NURSING EXECUTIVE, SUTTER LAKESIDE HOSPITAL - WALLY HOLBROOK, SUPERINTENDENT OF SCHOOLS, LAKE COUNTY OFFICE OF EDUCATION - BOB PENNY, LAKE COUNTY VETERAN'S SERVICES - MARTA FULLER, DENTAL DISEASE PREVENTION, LAKE COUNTY PUBLIC HEALTH DEPARTMENT - SHERYLIN TAYLOR, LAKE COUNTY PUBLIC HEALTH DEPARTMENT A QUESTIONNAIRE WAS DEVELOPED IN ENGLISH AND SPANISH FOR THE GENERAL PUBLIC THAT SOLICITED PEOPLES OPINIONS ABOUT MOST-IMPORTANT HEALTH NEEDS, IDEAS FOR RESPONSIVE SOLUTIONS, AND HABITS THEY USED TO MAINTAIN THEIR OWN PERSONAL HEALTH. THE SURVEY WAS DISTRIBUTED IN HARD COPY BY MEMBERS OF THE COLLABORATIVE TO LOCATIONS WHERE THE GROUPS OF INTEREST WOULD BEST BE REACHED, SUCH AS AT CASINOS, A BOWLING ALLEY, BRANCHES OF PUBLIC LIBRARIES, AND FAMILY RESOURCE CENTERS THROUGHOUT THE COUNTY. IN ADDITION, THE SURVEY WAS AVAILABLE BY COMPUTER (ENGLISH ONLY) AND NOTICES ABOUT THE ONLINE VERSION WERE POSTED IN THE COUNTYS AND VARIOUS ORGANIZATIONS WEBSITES AND IN THEIR NEWSLETTER. FOUR LOCATIONS CLEARLAKE, MIDDLETOWN, LAKEPORT, AND KELSEYVILLE, ENSURED GEOGRAPHIC REPRESENTATION AND 8 COMMUNITY FOCUS GROUPS WERE CONDUCTED AT SITES INTENDED TO DRAW POPULATIONS THAT TYPICALLY GATHERED THERE. KEY COMMUNITY-BASED ORGANIZATIONS WERE IDENTIFIED BY THE COLLABORATIVE AND ASKED TO HOST A FOCUS GROUP. FOCUS GROUPS WERE CO-SCHEDULED AT THE SITES AMONG PARTICIPANTS WHO WERE ALREADY MEETING THERE FOR OTHER PURPOSES TO FACILITATE ACCESS AND PROMOTE ATTENDANCE. ALTHOUGH THE PARTICIPANTS CONSTITUTED A CONVENIENCE SAMPLE, THERE WAS THE EXPECTATION THAT IN THE AGGREGATE THE GROUPS WOULD BE DIVERSE AND INCLUDE POPULATIONS OF HIGH INTEREST. ONE OF THE GROUPS WAS FACILITATED IN SPANISH. THE FINDINGS FROM KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND SURVEY IN SUTTER LAKESIDE HOSPITAL'S CHNA ARE AVAILABLE AT: HTTP://WWW.SUTTERLAKESIDE.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML SCHEDULE H, PART V, LINE 6A SUTTER LAKESIDE HOSPITAL (HOSPITAL FACILITY #7): THE COLLABORATIVE INCLUDED THE TWO LAKE COUNTY HOSPITALS, ST. HELENA CLEAR LAKE AND SUTTER LAKESIDE. SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: SUTTER LAKESIDE HOSPITAL (HOSPITAL FACILITY #7): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.SUTTERLAKESIDE.ORG/ABOUT/ - OTHER WEBSITE: HTTP://WWW.SUTTERLAKESIDE.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML SCHEDULE H, PART V, LINE 11 SUTTER LAKESIDE HOSPITALS (HOSPITAL FACILITY #7): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT SUTTER LAKESIDE HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: - RISK FACTORS AND IMPLICATIONS FROM TOBACCO USE, HIGH BLOOD PRESSURE, PHYSICAL INACTIVITY AND OBESITY; - LACK OF ACCESS TO COMMUNITY-BASED MENTAL HEALTH SERVICES; AND - HIGH RATES OF ALCOHOL AND DRUG USE. DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH ADDITIONAL EFFORTS ON BEHALF OF SUTTER COAST HOSPITAL. ALTHOUGH NO HOSPITAL CAN ADDRESS ALL ASPECTS OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY, SUTTER LAKESIDE HOSPITAL PLANS TO ADDRESS ALL FOUR OF THE PRIORITIES IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. SUTTER LAKESIDE HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. SCHEDULE H, PART V, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: SUTTER LAKESIDE HOSPITALS (HOSPITAL FACILITY #7) PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINE 16I MEASURES USED TO PUBLICIZE THE FACILITYS FINANCIAL ASSISTANCE POLICY: SUTTER LAKESIDE HOSPITALS (HOSPITAL FACILITY #7) THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. ON AN ANNUAL BASIS SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART V, LINE 22D AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: SUTTER LAKESIDE HOSPITAL (HOSPITAL FACILITY #7): THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT. REPORTING FACILITY: #8, SUTTER SANTA ROSA REGIONAL HOSPITAL SCHEDULE H, PART V, LINE 5 SUTTER SANTA ROSA REGIONAL HOSPITAL (HOSPITAL FACILITY #8): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER SANTA ROSA REGIONAL HOSPITAL, A FACILITY OF SUTTER WEST BAY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. KEY INFORMANT INTERVIEWS ARE IN-DEPTH EXPLORATIONS OF ISSUES OR CONCERNS. THE PURPOSE OF KEY INFORMANT INTERVIEWS IS TO COLLECT INFORMATION FROM A RANGE OF LEADERS WHO HAVE FIRST-HAND KNOWLEDGE ABOUT THE COMMUNITY. THIS TECHNIQUE IS A QUALITATIVE PROCESS THAT CONCENTRATES ON REVEALING UNDERLYING REASONING. THESE COMMUNITY EXPERTS, WITH THEIR PARTICULAR KNOWLEDGE AND UNDERSTANDING, PROVIDE IMPORTANT INSIGHTS ON THE NATURE OF COMMUNITY HEALTH ISSUES. BABS KAVANAUGH AND BARBARA GRAVES, CONSULTANTS, CONDUCTED EIGHTEEN KEY INFORMANT INTERVIEWS WITH INDIVIDUALS SELECTED BECAUSE OF THEIR EXPERTISE AND LEADERSHIP IN HEALTH AND SOCIAL SERVICES IN SONOMA COUNTY. THE PURPOSE OF THE INTERVIEWS WAS TO EXPLORE ISSUES THAT ARE IMPACTING THE HEALTH OF RESIDENTS IN SONOMA COUNTY, TO IDENTIFY THOSE POPULATIONS MOST AFFECTED BY THESE ISSUES AND TO GATHER INPUT ABOUT SYSTEM CHANGES AND PREVENTION APPROACHES THAT COULD HAVE POSITIVE IMPACT ON THESE ISSUES. ALL PARTICIPANTS RECEIVED THE SAME SET OF QUESTIONS IN ADVANCE OF THE INTERVIEWS. IN AN EFFORT TO GATHER DIVERSE POINTS OF VIEW THOSE INTERVIEWED REPRESENTED THE FOLLOWING SECTORS, SERVICES, ORGANIZATIONS AND AGENCIES: - HEALTH AND HUMAN SERVICES (6) - HOSPITALS (3) - SONOMA COUNTY SCHOOLS (1) - ORAL HEALTH SERVICES (1) - COMMUNITY HEALTH CENTERS (4) - COMMUNITY BASED ORGANIZATIONS (1) - HEALTH INSURANCE PLANS (1) - ECONOMIC DEVELOPMENT (1) KEY INFORMANTS INTERVIEWED INCLUDE: - RITA SCARDACI, DIRECTOR, DEPARTMENT OF HEALTH SERVICES - ELIZABETH CHICOINE, DIRECTOR OF PUBLIC HEALTH NURSING, DEPT OF HEALTH SERVICES, PUBLIC HEALTH DIVISION - MARK NETHERDA, MD, SC DEPUTY PUBLIC HEALTH OFFICER AND LYNN SILVER OF THE DEPARTMENT OF HEALTH SERVICES - ELLEN BAUER, HEALTH ACTION PROGRAM MANAGER, DEPT OF HEALTH SERVICES, PUBLIC HEALTH DIVISION - MIKE KENNEDY, MH/AODS DIRECTOR, DEPT OF HEALTH SERVICES, MENTAL HEALTH DIVISION - DIANE KALJIAN, DIRECTOR, DEPT OF HUMAN SERVICES, ADULT AND AGING DIVISION - KIRK PAPPAS, MD, KAISER PERMANENTE MEDICAL CENTER, SANTA ROSA - BILL CARROLL, CHIEF MEDICAL OFFICER, SUTTER SANTA ROSA REGIONAL HOSPITAL - GARY GREENSWEIG, CHIEF MEDICAL OFFICER, ST JOSEPH HEALTH SYSTEM, SONOMA COUNTY - MARY MADDUX-GONZALEZ, MD, EXECUTIVE DIRECTOR, REDWOOD COMMUNITY HEALTH COALITION - MOLIN MALICAY, CHIEF EXECUTIVE OFFICER, SONOMA COUNTY INDIAN HEALTH PROJECT - FRANCISCO TRILLA, MD, CHIEF MEDICAL OFFICER, SANTA ROSA COMMUNITY HEALTH CENTER - KATHIE POWELL, EXECUTIVE DIRECTOR, PETALUMA HEALTH CENTER - MICHAEL SPEILMAN, DRUG ABUSE ALTERNATIVE CENTER - BOB MOORE, MEDICAL DIRECTOR, PARTNERSHIP HEALTH PLAN OF CALIFORNIA - LYNN GARRIC, SCOE - SAFE SCHOOL PROJECT DIRECTOR - SUSAN COOPER, DDS, SONOMA COUNTY ORAL HEALTH ACCESS COALITION - BEN STONE, ECONOMIC DEVELOPMENT BOARD DURING JUNE AND JULY 2012, ST. JOSEPH HEALTH SYSTEM CONDUCTED A SERIES OF TARGETED, COMMUNITY-BASED FOCUS GROUPS ON BEHALF OF THE PROJECT PARTNERS. THE GOAL OF THE FOCUS GROUP PROCESS WAS TO GATHER INFORMATION FROM RESIDENTS OF LOW-INCOME NEIGHBORHOODS ON THEIR HEALTH CONCERNS, THE CHALLENGES THEY FACE IN MAINTAINING HEALTH AND THEIR IDEAS ON HOW TO IMPROVE THEIR COMMUNITYS HEALTH AND WELLBEING. FOUR FOCUS GROUPS WERE HELD, AVERAGING 8 PARTICIPANTS PER GROUP. GROUPS WERE FACILITATED IN BOTH SPANISH AND ENGLISH, BASED ON GROUP MAKE-UP. THE GROUPS WERE CONDUCTED IN COMMUNITIES OF SONOMA VALLEY, ROHNERT PARK, SANTA ROSA, AND CLOVERDALE AND WERE FACILITATED BY ST. JOSEPH'S STAFF USING STANDARDIZED QUESTIONS APPROVED BY THE CHNA PARTNERSHIP. IN THE SPRING OF 2012, ST. JOSEPH HEALTH SYSTEM CONTACTED 1500 PEOPLE (839 COMPLETED THE SURVEY) USING A SURVEY TOOL INCORPORATING QUESTIONS FROM THE NATIONAL BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY. THE SURVEY PROVIDED VALUABLE INFORMATION ON LOCAL HEALTH STATUS, HEALTH BEHAVIORS, EXPERIENCE WITH THE LOCAL HEALTH SYSTEMS AND HIGHLIGHTED THE LINKS BETWEEN SOCIAL DETERMINANTS, PREDOMINANTLY INCOME AND EDUCATION ATTAINMENT, AND DISPARITIES IN HEALTH AND HEALTH CARE ACCESS. THE FINDINGS FROM KEY INFORMANT INTERVIEWS, SURVEY, AND FOCUS GROUPS IN SUTTER SANTA ROSA REGIONAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 6A SUTTER SANTA ROSA REGIONAL HOSPITAL (HOSPITAL FACILITY #8): SUTTER SANTA ROSA REGIONAL HOSPITAL, IN COLLABORATION WITH LOCAL PARTNERS KAISER PERMANENTE, ST. JOSEPH'S HEALTH SYSTEM AND THE SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2013. SCHEDULE H, PART V, LINE 7A, 7B, 10A CHNA AVAILABILITY ONLINE: SUTTER SANTA ROSA REGIONAL HOSPITAL (HOSPITAL FACILITY #8): - HOSPITAL FACILITY'S WEBSITE: HTTP://WWW.SUTTERSANTAROSA.ORG/RELATIONS/COMMUNITY_BENEFITS.HTML - OTHER WEBSITE: HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SCHEDULE H, PART V, LINE 11 SUTTER SANTA ROSA REGIONAL HOSPITAL (HOSPITAL FACILITY #8): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER SANTA ROSA REGIONAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: HEALTHY EATING AND PHYSICAL FITNESS - POOR NUTRITION AND LACK OF PHYSICAL ACTIVITY ARE DRIVING A NATIONAL AND LOCAL OBESITY EPIDEMIC AND ARE CONTRIBUTIONS TO INCREASING RATES OF CHRONIC DISEASE, DISABILITY AND PREMATURE MORTALITY IN SONOMA COUNTY. LOW-INCOME CHILDREN AND FAMILIES ARE ESPECIALLY AT RISK WHEN THEY RESIDE IN NEIGHBORHOODS THAT OFFER FEW OPTIONS TO OBTAIN HEALTHY, NUTRITIOUS FOOD OR ENGAGE SAFELY IN PHYSICAL ACTIVITY. EXPANSION OF CURRENT EFFORTS IN SCHOOLS AND COMMUNITIES TO IMPROVE NUTRITION AND FITNESS AMONG YOUTH AND ADULTS CAN HELP TO REDUCE THE GROWING BURDEN OF DISEASE. GAPS IN ACCESS TO PRIMARY CARE - STRONG PRIMARY CARE SYSTEMS ARE ASSOCIATED WITH IMPROVED HEALTH OUTCOMES AND REDUCED HEALTH CARE COSTS. WHILE MOST SONOMA COUNTY RESIDENTS HAVE A REGULAR SOURCE OF CARE AND CAN ACCESS HEALTH CARE WHEN THEY NEED IT, TOO MANY DO NOT. THOSE WHO ARE UNINSURED, LOW-INCOME, OR ARE MEMBERS OF RACIAL AND ETHNIC MINORITIES ARE LESS LIKELY TO HAVE AN ONGOING SOURCE OF CARE AND MORE LIKELY TO DEFER NEEDED CARE, MEDICINES AND DIAGNOSTICS, OFTEN AT THE COST OF UNNECESSARY SUFFERING AND POOR HEALTH OUTCOMES. INCREASING ACCESS TO AFFORDABLE, PREVENTION-FOCUSED PRIMARY CARE CAN HELP TO ELIMINATE HEALTH DISPARITIES AND PROMOTE HEALTH AND WELL-BEING. ACCESS TO SERVICES FOR SUBSTANCE USE DISORDERS - TREATMENT WORKS. EARLY SCREENING, INTERVENTION AND APPROPRIATE TREATMENT FOR HARMFUL SUBSTANCE USE AND ADDICTION BEHAVIORS ARE CRITICAL TO INTERVENING WITH TEENS, PREGNANT WOMEN AND OTHERS WHO CAN BENEFIT FROM TREATMENT. UNFORTUNATELY, DESPITE INCREASING LEVELS OF ADDICTION, ACCESS TO SUBSTANCE ABUSE TREATMENT IN SONOMA COUNTY IS SEVERELY LIMITED FOR LOW-INCOME INDIVIDUALS WITHOUT HEALTH CARE COVERAGE. INSURING TIMELY ACCESS TO CULTURALLY COMPETENT SUBSTANCE ABUSE TREATMENT, TAILORED TO THE SPECIFIC NEEDS OF THOSE SEEKING HELP, CAN BREAK THE CYCLE OF ADDICTION AND BENEFIT INDIVIDUALS, FAMILIES AND THE COMMUNITY. ACCESS TO MENTAL HEALTH SERVICES - MANY MENTAL HEALTH PROBLEMS CAN BE EFFECTIVELY TREATED AND MANAGED WITH ACCESS TO ASSESSMENT, EARLY DETECTION, AND LINKS TO ONGOING TREATMENT AND SUPPORTS. IN SONOMA COUNTY, HOWEVER, MANY LOW INCOME INDIVIDUALS WITH MENTAL HEALTH CONCERNS DO NOT HAVE ACCESS TO THE TREATMENT THEY NEED. INSUFFICIENT PRIVATE INSURANCE COVERAGE FOR MENTAL HEALTH SERVICES AND INSUFFICIENT AVAILABILITY OF PUBLICLY-FUNDED TREATMENT SERVICES ARE SIGNIFICANT BARRIERS FOR MANY. LIMITED INTEGRATION OF MENTAL HEALTH SERVICES WITHIN THE HEALTH CARE SYSTEM ALSO LEADS TO MISSED OPPORTUNITIES FOR EARLY PROBLEM IDENTIFICATION AND PREVENTION. CARDIOVASCULAR DISEASE - CARDIOVASCULAR DISEASE IS THE THIRD LEADING CAUSE OF DEATH FOR PEOPLE AGES 18 - 59 IN SONOMA COUNTY. FOR RESIDENTS, AGE 60 AND OLDER, CORONARY HEART DISEASE AND STROKE ARE THE SECOND AND THIRD MOST COMMON CAUSE OF DEATH, BEHIND CANCER. MAJOR BEHAVIORAL CONTRIBUTORS TO CARDIOVASCULAR DISEASE INCLUDE TOBACCO USE, PHYSICAL INACTIVITY, UNHEALTHY DIET AND HARMFUL USE OF ALCOHOL. EDUCATION AND PREVENTION EFFORTS TARGETING THESE "LIFESTYLE" CHOICES AND BEHAVIORS SHOULD BE EXPANDED ALONG WITH CONTINUED EMPHASIS ON EARLY DETECTION AND MANAGEMENT OF CHRONIC DISEASE. ACCESS TO HEALTH CARE COVERAGE - ENSURING ACCESS TO AFFORDABLE, QUALITY HEALTH CARE SERVICES IS IMPORTANT TO PROTECTING BOTH INDIVIDUAL AND POPULATION HEALTH, ELIMINATING HEALTH DISPARITIES AND PROMOTING OVERALL QUALITY OF LIFE IN THE COMMUNITY. FOR UNINSURED PEOPLE, THE COST OF BOTH ROUTINE AND EMERGENCY CARE CAN BE FINANCIALLY DEVASTATING. INDIVIDUALS WITHOUT HEALT 23 California Campus - Alzheimers Res Care 3773 Sacramento Street San Francisco CA 94118 Skilled Nursing Facility Sutter Lakeside Family Medical Clinic 5176 Hill Road East Lakeport CA 95453 Rural Health Clinic San Francisco Endoscopy Center 3468 California St San Francisco CA 94118 Outpatient Services California Pacific Medical Center 2100 Webster Street Suite 103 San Francisco CA 94115 RADIOLOGY/LABORATORY/ Ultrasound Services California Pacific Medical Center 3838 California Street Suite 106 San Francisco CA 94115 Outpatient Services - LABORATORY/IMAGING California Pacific Medical Center 2351 Clay Street 4th Floor San Francisco CA 94115 Chronic Dialysis California Pacific Medical Center 2340 Clay Street Suite 114A San Francisco CA 94115 Outpatient Services - HEART TRANSPLANT CLINIC California Pacific Medical Center 2340 Clay Street 4th Floor San Francisco CA 94115 Outpatient Services - LIVER, PANCREAS, KIDNEY TRANSPLANT CLINIC California Pacific Medical Center 2340 Clay Street 5th Floor San Francisco CA 94115 Outpatient Services - OPTHAMOLOGY CLINIC Physical Therapy & Sport Fitness 100 Rowland Way Novato CA 94945 Outpatient Services Diagnostic Center 165 Rowland Way Novato CA 94945 Outpatient Services Surgery Transfusion Services 180 Rowland Way Novato CA 94945 Outpatient Services California Pacific Medical Center 2351 Clay Street Suite 600 San Francisco CA 94115 Outpatient Services - IES California Pacific Medical Center 2360 Clay Street San Francisco CA 94115 Outpatient Services - PT, OT & CARDIAC REHAB Imaging Services 1375 Sutter Street San Francisco CA 94119 Outpatient Services California Pacific Medical Center 1580 Valencia Street Suite 440 San Francisco CA 94115 Outpatient Services - CHILD DEVELOPMENT California Pacific Medical Center 1625 Van Ness San Francisco CA 94115 Outpatient Services - CHILD DEVELOPMENT California Pacific Medical Center 101 North El Camino Suite 1 San Mateo CA 94402 Outpatient Services - HAND THERAPY Terra Linda Health Plaza 4000 Civic Center Drive San Rafael CA 94903 Outpatient Services Sutter Medical Center Santa Rosa Sports 4729 Hoen Avenue Suite A Santa Rosa CA 95405 Outpatient Services Presidio Surgery Center 1635 Divisadero Street Suite 200 San Francisco CA 94115 Outpatient Services California Pacific Advanced Imaging 504 Redwood Blvd 300 Novato CA 94949 Outpatient Services CALIFORNIA PACIFIC MEDICAL CENTER 2351 CLAY STREET SUITE 150 San Francisco CA 94115 OUTPATIENT SERVICES - ALS SCHEDULE H, PART I, LINE 3A & 3C FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENTS FAMILY INCOME. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY. SCHEDULE H, PART I, LINE 7G CALIFORNIA PACIFIC MEDICAL CENTER: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $16,438,043. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: CALIFORNIA PACIFIC MEDICAL CENTER: CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. BUILDING THE SAN FRANCISCO WORKFORCE, ESPECIALLY BY CREATING OPPORTUNITIES FOR YOUTH, IS A MAJOR FOCUS FOR CPMC. IN 2015, CPMC PROVIDED WORK-READINESS TRAINING AND CAREER EXPLORATION EXPERIENCES TO INDIVIDUALS THROUGH ITS COMMUNITY WORKFORCE PROGRAMS. THESE PARTNERSHIPS HELP EDUCATE AND INSPIRE UNDERSERVED YOUTH TO PURSUE HEALTH CAREERS. THEY INCLUDE: GALILEO HEALTH ACADEMY OFFERS TWO 12-WEEK SPEAKER SERIES THAT TAKE PLACE IN THE SPRING AND FALL OF THE ACADEMIC YEAR FOR HIGH SCHOOL JUNIORS. TWICE A WEEK, CPMC EMPLOYEES PROVIDE LECTURES, DEMONSTRATIONS, TOURS AND ACTIVITIES TO ENHANCE STUDENTS' UNDERSTANDING OF THE COMPLEXITIES AND OPPORTUNITIES IN A MODERN, COMPREHENSIVE ACUTE CARE MEDICAL CENTER. CPMC ALSO PROVIDES SIX-WEEK SUMMER INTERNSHIPS FOR GALILEO STUDENTS TO GAIN EXPERIENCE WORKING IN A HOSPITAL ENVIRONMENT. YEAR UP PLACES LOW-INCOME YOUNG ADULTS BETWEEN THE AGES OF 18 AND 24 INTO INFORMATION TECHNOLOGY INTERNSHIPS AT CPMC. ENABLING PATIENTS TO VOTE IS A PROGRAM THAT PROVIDES PATIENTS WITH THE OPPORTUNITY TO VOTE IN ELECTIONS. VOLUNTEERS ASSIST IN PROMOTING THIS PROGRAM THROUGHOUT CPMC OVER THE COURSE OF SEVERAL DAYS. VOLUNTEERS ALSO FAX BALLOT REQUESTS TO CITY HALL, PICK-UP ABSENTEE BALLOTS, DISTRIBUTE BALLOTS TO PATIENTS, COLLECT BALLOTS AT THE END OF THE DAY, AND DROP OFF BALLOTS AT POLLING SITES, AND CITY HALL, FOR TABULATION IN A TIMELY MANNER. PROJECT HOMELESS CONNECT IS SAN FRANCISCO'S SIGNATURE PROGRAM TO PROVIDE SERVICES TO ITS HOMELESS POPULATION. THE MISSION OF PROJECT HOMELESS CONNECT IS TO PROVIDE A SINGLE LOCATION WHERE NONPROFIT MEDICAL AND SOCIAL SERVICES PROVIDERS COLLABORATE TO SERVE THE HOMELESS OF SAN FRANCISCO WITH COMPREHENSIVE, HOLISTIC SERVICES. CPMC VOLUNTEERS HELP PROJECT HOMELESS CONNECT PROVIDE MEDICAL AND SOCIAL SERVICES TO SAN FRANCISCO'S MOST IMPOVERISHED RESIDENTS, INCLUDING PRIMARY MEDICAL CARE, EYE EXAMS, WHEELCHAIR REPAIR, DENTAL TREATMENT, SUBSTANCE ABUSE CONNECTIONS, AND EVEN ACUPUNCTURE AND MASSAGE. CPMC'S CHILD DEVELOPMENT CENTER IS PART OF THE FIRST 5 CALIFORNIA COALITIONS. FIRST 5 CALIFORNIA REPRESENTS AN IMPORTANT PART OF OUR STATE'S EFFORT TO NURTURE AND PROTECT OUR MOST PRECIOUS RESOURCE - OUR CHILDREN. FIRST 5 CALIFORNIA'S SERVICES AND SUPPORT ARE DESIGNED TO ENSURE THAT MORE CHILDREN ARE BORN HEALTHY AND REACH THEIR FULL POTENTIAL. AT RISK YOUTH INTERNSHIP PARTNERS CPMC WITH COMMUNITY AGENCIES TO PROVIDE INTERNSHIPS FOR AT-RISK YOUTH THROUGH THE VOLUNTEER SERVICES DEPARTMENT BOTH DURING THE SCHOOL YEAR AS WELL AS OFFERING SUMMER PROGRAMS. THE NATIONAL COUNCIL ON AGING SENIOR COMMUNITY SERVICE PROGRAM: CREATED IN 1965, SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM IS THE NATION'S OLDEST PROGRAM TO HELP LOW-INCOME, UNEMPLOYED INDIVIDUALS AGED 55+ FIND WORK. A CPMC EMPLOYEE SPENDS TIME SUPPORTING TWO PROGRAM PARTICIPANTS. MERITUS HELPS LOW-INCOME SAN FRANCISCO YOUTH COMPLETE A COLLEGE DEGREE AND PREPARE FOR POST-COLLEGE SUCCESS THROUGH A COMBINATION OF SCHOLARSHIPS, COACHING, AND CAREER MENTORSHIP. INTERNSHIPS AT CPMC EXPOSE STUDENTS TO A RANGE OF EXPERIENCES LEADING TO INFORMED DECISION-MAKING ABOUT POST COLLEGE OPPORTUNITIES. NOVATO COMMUNITY HOSPITAL: NOVATO COMMUNITY HOSPITAL (NCH) FUNDS THE FOLLOWING PROGRAM THAT HELPS ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. IN 1995, THE HEALTHY MARIN PARTNERSHIP WAS FORMED IN RESPONSE TO CALIFORNIA SENATE BILL 697, A LEGISLATIVE MANDATE REQUIRING NOT-FOR-PROFIT HOSPITALS TO COMPLETE A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. NCH PARTICIPATES IN THIS PARTNERSHIP, ALONG WITH OTHER KEY STAKEHOLDERS, TO PRODUCE THE COMMUNITY HEALTH NEEDS ASSESSMENT. NOVATO COMMUNITY HOSPITAL PARTNERS WITH THE FRIENDS OF STAFFORD LAKE BICYCLE PARK TO PROMOTE HEALTHY EATING AND ACTIVE LIVING BY BUILDING AND MAINTAINING AN OFF-ROAD CYCLING PARK ON COUNTY LAND TO PROVIDE A SAFE RIDING ENVIRONMENT FOR ALL AGES WITH A COMPONENT TO INVOLVE YOUNG CHILDREN IN LEARNING THE SPORT. NOVATO COMMUNITY HOSPITAL PARTNERS WITH THE CITY OF SAN RAFAEL DOWNTOWN STREETS TEAM TO HELP REDUCE HOMELESS RELATED ISSUES ON THE STREET, TO CHANGE PERCEPTIONS ABOUT PEOPLE WITHOUT SHELTER AND TO SUPPORT THE TEAM MEMBERS IN FINDING EMPLOYMENT AND/OR PARTICIPATE IN COUNTYWIDE EMPLOYMENT TRAINING PROGRAMS. SUTTER LAKESIDE HOSPITAL: SUTTER LAKESIDE HOSPITAL FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. SUTTER LAKESIDE HOSPITAL STAFF MEMBERS ARE ASSIGNED TO COMMUNITY BOARDS, PANELS, COMMITTEES, AND GROUPS. SUTTER LAKESIDE HOSPITAL HOSTED ITS INAUGURAL HEROES OF HEALTH AND SAFETY FAIR, WHICH SERVES AS AN OPPORTUNITY FOR THEIR COMMUNITY TO SEE ALL OF THE COUNTY'S HEALTH AND SAFETY RESOURCES IN ONE LOCATION. SUTTER SANTA ROSA REGIONAL HOSPITAL: SUTTER SANTA ROSA REGIONAL HOSPITAL FUNDS THE FOLLOWING PROGRAMS THAT HELP ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH AND WELL-BEING IN THE COMMUNITIES WE SERVE (ALSO KNOWN AS COMMUNITY-BUILDING ACTIVITIES). THESE PROGRAMS HELP SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF SUTTER HEALTH. SUTTER SANTA ROSA REGIONAL HOSPITAL EMPLOYEES PARTICIPATE ON THE HEALTH ACTION COMMITTEE. SONOMA COUNTY DEVELOPED THIS MULTI-PRONGED APPROACH TO BECOMING THE "HEALTHIEST COUNTY IN CALIFORNIA" BY 2020 THAT INVOLVES LEADERS FROM ACROSS HEALTHCARE, COMMUNITY-BASED ORGANIZATIONS AND INDUSTRY TO WORK TOGETHER TO IMPROVE HEALTH AND QUALITY OF LIFE FOR ALL. SCHEDULE H, PART III, LINE 2 METHODOLOGY FOR CALCULATING BAD DEBT (AT COST): THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 METHODOLOGY FOR DETERMINING THE AMOUNT OF BAD DEBT LIKELY ATTRIBUTABLE TO CHARITY CARE: AMOUNTS MAY BE INCLUDED IN BAD DEBT PENDING A CHARITY CARE DETERMINATION. UPON ELIGIBILITY THESE AMOUNTS WOULD BE RECLASSIFIED AS CHARITY CARE. SCHEDULE H, PART III, LINE 4 AUDIT FOOTNOTE THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. PROVISION FOR BAD DEBTS IS LISTED ON A SEPARATE LINE ITEM IN THE FINANCIAL STATEMENTS. THE AUDIT DOES INCLUDE A FOOTNOTE FOR PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS. PATIENT SERVICE REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS AND THIRD-PARTY PAYERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT PROGRAMS WITH THIRD-PARTY PAYERS. ESTIMATED SETTLEMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, PRIMARILY AS A RESULT OF FINAL COST REPORT SETTLEMENTS WITH GOVERNMENTAL AGENCIES. PATIENT SERVICE REVENUES LESS PROVISION FOR BAD DEBTS ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SUTTER'S SELF-PAY WRITE-OFFS WERE $192 MILLION AND $287 MILLION FOR 2015 AND 2014, RESPECTIVELY. SCHEDULE H, PART III, LINE 7 MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT. SCHEDULE H, PART III, LINE 9B DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL AND CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: CALIFORNIA PACIFIC MEDICAL CENTER DURING 2013, A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE CITY AND COUNTY OF SAN FRANCISCO WAS CONDUCTED BY CPMC, THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, LOCAL NONPROFIT HOSPITALS AND ACADEMIC PARTNERS, AND MORE THAN 500 COMMUNITY RESIDENTS. SERVING CALIFORNIA'S ONLY CONSOLIDATED CITY AND COUNTY AND A DIVERSE POPULATION OF 805,235 RESIDENTS, THE PARTNERS MADE EVERY EFFORT TO CREATE A COMMUNITY-ORIENTED PROCESS ALIGNED WITH THE FOLLOWING VALUES: - TO FACILITATE ALIGNMENT OF SAN FRANCISCO'S PRIORITIES, RESOURCES, AND ACTIONS TO IMPROVE HEALTH AND WELL-BEING. - TO ENSURE THAT HEALTH EQUITY IS ADDRESSED THROUGHOUT PROGRAM PLANNING AND SERVICE DELIVERY. - TO PROMOTE COMMUNITY CONNECTIONS THAT SUPPORT HEALTH AND WELL-BEING. THE MEMBERS OF THIS COMMUNITY BENEFIT PARTNERSHIP, WITH A LONG HISTORY OF SUCCESSFUL COLLABORATION, AGREED TO TACKLE A NEW REQUIREMENT UNDER THE AFFORDABLE CARE ACT: TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS. THIS EFFORT IS NOT UNFAMILIAR TO SAN FRANCISCO'S NONPROFIT HOSPITALS, AS THEY HAVE UNDERGONE A SIMILAR PROCESS EVERY THREE YEARS SINCE CALIFORNIA SENATE BILL 697 WAS PASSED IN 1994; FOR MORE THAN A DECADE THIS COLLABORATIVE HAS CONDUCTED COLLECTIVE COMMUNITY NEEDS ASSESSMENTS. HELPFUL TO THIS YEAR'S PROCESS WAS THE NUMBER OF SIMILAR EFFORTS BEING UNDERTAKEN TO ASSESS COMMUNITY HEALTH NEEDS AND IMPROVEMENT STRATEGIES, SUCH AS THE HEALTH CARE SERVICES MASTER PLAN AND ACCREDITATION FOR THE SAN FRANCISCO PUBLIC HEALTH DEPARTMENT (SFDPH). TO LEVERAGE RESOURCES REQUIRED FOR THESE ENDEAVORS, THE COMMUNITY BENEFIT PARTNERSHIP MADE USE OF A COMMUNITY-DRIVEN PROCESS THAT ENGAGED MORE THAN 500 COMMUNITY RESIDENTS AND LOCAL PUBLIC HEALTH SYSTEM PARTNERS WHO IDENTIFIED THE FOLLOWING KEY HEALTH PRIORITIES FOR ACTION: - ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS - INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY - INCREASE ACCESS TO HIGH-QUALITY HEALTH CARE AND SERVICES FROM JULY 2011 UNTIL FEBRUARY 2013, THE PARTNERS ENGAGED IN A PROCESS TO: A) AGREE ON DATA ELEMENTS AND INDICATORS TO BE COLLECTED B) DETERMINE THE PARTIES RESPONSIBLE TO COLLECT THOSE DATA C) AGREE ON METHODS TO SOLICIT AND INCORPORATE COMMUNITY INPUT D) SHARE FINDINGS E) IDENTIFY PRIORITIZATION CRITERIA TO BE USED F) CONDUCT THE PRIORITIZATION PROCESS G) GET COMMUNITY STAKEHOLDERS' INPUT ON STRATEGIES TO ADDRESS THE HEALTH NEEDS TO YIELD A REPRESENTATIVE AND TRANSPARENT ASSESSMENT PROCESS, THE COMMUNITY BENEFIT PARTNERSHIP SOUGHT TO ENGAGE A RANGE OF COMMUNITY RESIDENTS AND LOCAL PUBLIC HEALTH SYSTEM PARTNERS AT EACH STEP. SPECIFICALLY: - COMMUNITY RESIDENTS FROM EACH OF SAN FRANCISCO'S 21 NEIGHBORHOOD AREAS CAME TOGETHER FOR A DAY-LONG EVENT TO DISCUSS THEIR VIEWS OF HEALTH AND THEIR HOPES FOR SAN FRANCISCO'S HEALTH FUTURE. THIS RESULTED IN ELEMENTS OF A COMMUNITY-GUIDED HEALTH VISION FOR THE CITY AND COUNTY OF SAN FRANCISCO. - SFDPH CONVENED A 42-MEMBER TASK FORCE TO SUPPORT SAN FRANCISCO'S CHA AND A PARALLEL EFFORT, THE HEALTH CARE SERVICES MASTER PLAN (HCSMP). TASK FORCE MEMBERS REPRESENTED A RANGE OF COMMUNITY STAKEHOLDERS SUCH AS HOSPITALS/CLINICS, K-12 EDUCATION, SMALL BUSINESS, URBAN PLANNING, CONSUMER GROUPS, NONPROFITS REPRESENTING DIFFERENT ETHNIC MINORITY GROUPS, AND MORE. TO ENSURE COMMUNITY PARTICIPATION IN THE HCSMP AND CHA PROCESSES, THE TASK FORCE MET A TOTAL OF 10 TIMES BETWEEN JULY 2011 AND MAY 2012 - FOUR OF THOSE IN DIFFERENT SAN FRANCISCO NEIGHBORHOODS - AND ENGAGED MORE THAN 100 COMMUNITY RESIDENTS IN DIALOGUE TO BETTER DETERMINE HOW TO IMPROVE THE HEALTH OF ALL SAN FRANCISCANS WITH A PARTICULAR FOCUS ON THE CITY/COUNTY'S MOST VULNERABLE POPULATIONS. TO ENCOURAGE COMMUNITY DIALOGUE, TASK FORCE NEIGHBORHOOD MEETINGS TOOK PLACE IN THE EVENING, AND SFDPH PROVIDED INTERPRETATION SERVICES IN SPANISH AND CANTONESE. - SAN FRANCISCO ENGAGED 224 COMMUNITY RESIDENTS IN FOCUS GROUPS AND INTERVIEWED 40 COMMUNITY STAKEHOLDERS TO LEARN MORE ABOUT SAN FRANCISCANS' DEFINITIONS OF HEALTH AND WELLNESS AS WELL AS THEIR PERCEPTIONS OF SAN FRANCISCO'S STRENGTHS VERSUS AREAS FOR HEALTH IMPROVEMENT. FOCUS GROUPS TARGETED SAN FRANCISCO SUBPOPULATIONS (SENIORS AND PERSONS WITH DISABILITIES, TRANSGENDERED PEOPLE, MONOLINGUAL SPANISH SPEAKERS, AND TEENS) AND SPECIFIC NEIGHBORHOODS (BAYVIEW HUNTERS POINT, CHINATOWN, EXCELSIOR, MISSION, SUNSET/RICHMOND, AND TENDERLOIN). FOCUS GROUP PARTICIPANTS GREATLY INFORMED SAN FRANCISCO'S HEALTH VISION AS WELL AS THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT. - A 10-MEMBER DATA ADVISORY COMMITTEE COMPRISED OF LOCAL PUBLIC HEALTH SYSTEM PARTNERS, RESIDENTS, AND SFDPH STAFF OVERSAW THE SELECTION OF DATA INDICATORS FOR THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA). THIS BODY ALSO ENSURED THE INTEGRITY OF THE CHSA'S METHODOLOGY AND QUANTITATIVE DATA. - IN JUNE 2013, THE CHIP AND CHNA WERE PUBLICLY LAUNCHED AT THE MAYOR'S BREAKFAST ATTENDED BY 400 COMMUNITY PARTNERS. SECONDARY DATA WERE GATHERED WITH THE ASSISTANCE OF HARDER+COMPANY. THE REPORT "COMMUNITY HEALTH STATUS ASSESSMENT: CITY AND COUNTY OF SAN FRANCISCO" WAS COMPLETED IN JULY 2012. THE HEALTH INDICTORS, SELECTED BY MEMBERS OF THE LEADERSHIP GROUP WITHIN THE COALITION, AS WELL AS EACH INDICATOR'S DATA SOURCE, ARE ALSO INCLUDED IN THE REPORT. THE PARTNERS CONDUCTED FOUR HEALTH ASSESSMENTS TO IDENTIFY COMMUNITY HEALTH NEEDS AND INFORM HEALTH PRIORITY SELECTION: COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, FORCES OF CHANGE ASSESSMENT, AND A COMMISSIONED COMMUNITY HEALTH STATUS ASSESSMENT. ONCE COLLECTED, SFDPH STAFF GROUPED DATA BY COMMON THEMES GROUPING LIKE DATA POINTS. THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR CALIFORNIA PACIFIC MEDICAL CENTER IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML NOVATO COMMUNITY HOSPITAL: NOVATO COMMUNITY HOSPITAL (NCH) AND HEALTHY MARIN PARTNERSHIP (HMP) HAVE CONDUCTED COMMUNITY NEEDS ASSESSMENTS SINCE 1995 TO COMPLY WITH THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. THE 2013 CHNA RESULTED IN A RE- EXAMINATION OF OUR PROCESS AND ATTENTION TO COMMUNITY INPUT, TRANSPARENCY, SUBJECT MATTER EXPERTISE AND DATA COLLECTION. HMP CONDUCTED A COMMUNITY CONVENING OF MORE THAN 30 REPRESENTATIVES OF UNDERSERVED COMMUNITIES, PUBLIC HEALTH EXPERTS, AND COMMUNITY LEADERS. THEY PRESENTED THE GROUP WITH EXTENSIVE DATA, KEY INFORMANT INTERVIEWS AND COMMUNITY FOCUS GROUPS RESULTS. THE GROUP WAS ENGAGED IN A PROCESS TO EXAMINE AND DISCUSS THE INFORMATION. AS A FINAL STEP THEY IDENTIFIED THE FOLLOWING MARIN COUNTY HEALTH NEEDS IN PRIORITY ORDER: 1. MENTAL HEALTH 2. SUBSTANCE ABUSE 3. ACCESS TO HEALTH CARE/MEDICAL HOMES/HEALTH CARE COVERAGE 4. SOCIOECONOMIC STATUS (INCOME, EMPLOYMENT, EDUCATION LEVEL) 5. HEALTHY EATING AND ACTIVE LIVING (NUTRITION/HEALTHY FOOD/FOOD ACCESS/PHYSICAL ACTIVITY 6. SOCIAL SUPPORTS (FAMILY AND COMMUNITY SUPPORT SYSTEMS AND SERVICES; CONNECTEDNESS) 7. CANCER 8. HEART DISEASE THE NOVATO COMMUNITY HOSPITAL SERVICE AREA INCLUDES THE NORTHERN CALIFORNIA COUNTY OF MARIN AND PARTS OF SOUTHERN SONOMA COUNTY. FOR PURPOSES OF THIS CHNA, ACTIVITIES WERE RESTRICTED TO RESIDENTS WITHIN THE BORDERS OF MARIN COUNTY. THE COUNTY OF SONOMA IS ADDRESSED BY SUTTER SANTA ROSA REGIONAL HOSPITAL. MARIN'S THREE NOT-FOR-PROFIT HOSPITALS, MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL AND KAISER PERMANENTE COLLABORATED WITH HMP TO COMPLETE THE CHNA. THE PROCESS INCLUDED FOUR PRIMARY ACTIVITIES: 1. KEY INFORMANT INTERVIEWS (PUBLIC HEALTH EXPERTS AND COMMUNITY LEADERS) 2. FOCUS GROUPS (UNDERSERVED COMMUNITIES IN ENGLISH AND SPANISH, WITH ADDITIONAL TRANSLATION AVAILABLE) 3. THE HMP COMMUNITY CONVENING (EXPERTS, LEADERS, AND RESIDENTS) 4. A COMPREHENSIVE DATA REVIEW OF 153 HEALTH INDICATORS. FINDINGS WERE COMPARED TO STATE AND NATIONAL AVERAGES AND, WHEN POSSIBLE MAPPED BY CENSUS TRACTS TO SHOW VARIATIONS AMONG GEOGRAPHIC AREAS ACROSS THE COUNTY. THE ENTIRE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR NOVATO COMMUNITY HOSPITAL IS AVAILABLE AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SUTTER LAKESIDE HOSPITAL: A COMMUNITY HEALTH NEEDS ASSESSMENT BUILDS THE FOUNDATION FOR ALL COMMUNITY HEALTH PLANNING, AND PROVIDES APPROPRIATE INFORMATION ON WHICH POLICYMAKERS, PROVIDER GROUPS, AND COMMUNITY ADVOCATES CAN BASE IMPROVEMENT EFFORTS; IT CAN ALSO INFORM FUNDERS ABOUT DIRECTING GRANT DOLLARS MOST APPROPRIATELY. IN 2012-2013, A COLLABORATIVE THAT INCLUDED THE TWO LAKE COUNTY HOSPITALS, ST. HELENA CLEAR LAKE AND SUTTER LAKESIDE, JOINED BY PUBLIC HEALTH AND OTHER LOCAL ORGANIZATIONS, RETAINED BARBARA AVED ASSOCIATES (BAA) TO UPDATE THE COMMUNITY HEALTH NEEDS ASSESSMENT BAA CONDUCTED IN 2010. THE PURPOSE OF THE STUDY WAS TO EXAMINE RELEVANT COMMUNITY HEALTH INDICATORS, IDENTIFY THE HIGHEST UNMET NEEDS AND PRIORITIZE AREAS FOR IMPROVING COMMUNITY HEALTH. THE ASSESSMENT MEETS THE PROVISIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) FOR COMMUNIT SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER WEST BAY HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE CHARITY CARE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. FOR A MORE DETAILED LOOK AT OUR CHARITY CARE POLICIES BY REGION, PLEASE VISIT THE OFFICE OF STATEWIDE AND HEALTH PLANNING'S WEBSITE AT HTTP://SYFPHR.OSHPD.CA.GOV COMMUNICATIONS OF FINANCIAL ASSISTANCE AVAILABILITY A. INFORMATION PROVIDED TO PATIENTS: 1. PREADMISSION OR REGISTRATION: DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITAL AFFILIATES SHALL PROVIDE: - ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES (IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS) - PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED WITH A FINANCIAL ASSISTANCE APPLICATION SUBSTANTIALLY SIMILAR TO THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION, "STATEMENT OF FINANCIAL CONDITION" 2. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL PROVIDE THE ABOVE INFORMATION AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. 3. ALL OTHER TIMES: UPON REQUEST, HOSPITAL AFFILIATES SHALL PROVIDE PATIENTS WITH INFORMATION ABOUT THEIR RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES, THE SUTTER HEALTH STANDARDIZED FINANCIAL ASSISTANCE APPLICATION FORM, "STATEMENT OF FINANCIAL CONDITION". B. POSTINGS AND OTHER NOTICES: INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL ALSO BE PROVIDED AS FOLLOWS: 1. BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION, INCLUDING BUT NOT LIMITED TO THE EMERGENCY DEPARTMENT, BILLING OFFICES, ADMITTING OFFICE, AND OTHER HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. BY POSTING INFORMATION ABOUT FINANCIAL ASSISTANCE ON THE SUTTER HEALTH WEBSITE AND EACH HOSPITAL AFFILIATE WEBSITE, IF ANY. 3. BY INCLUDING INFORMATION ABOUT FINANCIAL ASSISTANCE IN BILLS THAT ARE SENT TO UNINSURED PATIENTS. 4. BY INCLUDING LANGUAGE ON BILLS SENT TO UNINSURED PATIENTS AS SPECIFICALLY SET FORTH IN THE MANAGEMENT OF PATIENT ACCOUNTS RECEIVABLE, COLLECTION PRACTICES, HOSPITAL AFFILIATE THIRD-PARTY LIENS, AND AFFILIATE DISPUTE INITIATION POLICY (FINANCE POLICY 14-227). C. APPLICATIONS PROVIDED AT DISCHARGE: IF NOT PREVIOUSLY PROVIDED, HOSPITAL AFFILIATES SHALL PROVIDE UNINSURED PATIENTS WITH APPLICATIONS FOR MEDI-CAL, HEALTHY FAMILIES, CALIFORNIA CHILDREN'S SERVICES, OR ANY OTHER POTENTIALLY APPLICABLE GOVERNMENT PROGRAM AT THE TIME OF DISCHARGE. D. LANGUAGES: ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF THE AFFILIATE'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. E. NOTIFICATIONS TO UNINSURED PATIENTS OF ESTIMATED FINANCIAL RESPONSIBILITY: BY LAW, UNINSURED PATIENTS ARE ENTITLED TO RECEIVE AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES. EXCEPT IN THE CASE OF EMERGENCY SERVICES, HOSPITAL AFFILIATES SHALL NOTIFY PATIENTS WHO THE HOSPITAL IDENTIFIES MAY BE UNINSURED PATIENTS THAT THEY MAY OBTAIN AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR HOSPITAL SERVICES, AND PROVIDE ESTIMATES TO THOSE PATIENTS UPON REQUEST. ESTIMATES SHALL BE WRITTEN, AND BE PROVIDED DURING NORMAL BUSINESS HOURS. ESTIMATES SHALL PROVIDE THE PATIENT WITH AN ESTIMATE OF THE AMOUNT THE HOSPITAL AFFILIATE WILL REQUIRE THE PATIENT TO PAY FOR THE HEALTH CARE SERVICES, PROCEDURES, AND SUPPLIES THAT ARE REASONABLY EXPECTED TO BE PROVIDED TO THE PATIENT BY THE HOSPITAL, BASED UPON THE AVERAGE LENGTH OF STAY AND SERVICES PROVIDED FOR THE PATIENT'S DIAGNOSIS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: CALIFORNIA PACIFIC MEDICAL FOUNDATION: THE HOSPITAL SERVICE AREA FOR CALIFORNIA PACIFIC MEDICAL CENTER INCLUDES ALL POPULATIONS RESIDING IN THE CITY AND COUNTY OF SAN FRANCISCO. THERE ARE 12 HOSPITALS SERVING THE COMMUNITY. THE TOTAL POPULATION OF CPMC'S HOSPITAL SERVICE AREA IS 805,235. 48.5% OF THE POPULATION IS WHITE. 15.1% IS LATINO. 6.1% IS AFRICAN AMERICAN. 33.7% IS ASIAN AND PACIFIC ISLANDER. 0.5% IS NATIVE AMERICAN. MEDIAN AGE IS 38.2 YEARS. AVERAGE HOUSEHOLD INCOME IS $73,127. 11.86% OF THE POPULATION IS LIVING IN POVERTY. 15% OF CHILDREN ARE LIVING IN POVERTY. 9.5% OF THE POPULATION IS UNEMPLOYED. 11.53% OF THE POPULATION IS UNINSURED. 27.59% IS LIVING UNDER 200% POVERTY LEVEL. 24.78% IS LINGUISTICALLY ISOLATED. AND 14.29% OF THE POPULATION HAS NO HIGH SCHOOL DIPLOMA. (SOURCES: HTTP://WWW.COUNTYHEALTHRANKINGS.ORG; HTTP://WWW.CHNA.ORG/KP; HTTP://WWW.SFDPH.ORG/DPH/FILES/REPORTS/POLICYPROCOFC/CHSA_10162012.PDF) AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE CALIFORNIA PACIFIC MEDICAL CENTER CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML NOVATO COMMUNITY HOSPITAL: THE NOVATO COMMUNITY HOSPITAL SERVICE AREA INCLUDES THE NORTHERN CALIFORNIA COUNTY OF MARIN AND PARTS OF SOUTHERN SONOMA COUNTY. FOR PURPOSES OF THIS STUDY, ACTIVITIES WERE RESTRICTED TO RESIDENTS WITHIN THE BORDERS OF MARIN COUNTY. SUTTER SANTA ROSA REGIONAL HOSPITAL ADDRESSES THE COUNTY OF SONOMA. THERE ARE THREE HOSPITALS SERVING THE COMMUNITY. THE NOVATO COMMUNITY HOSPITAL SERVICE AREA COMPRISES MARIN COUNTY UNINCORPORATED AREAS AND CITIES INCLUDING BELVEDERE, CORTE MADERA, FAIRFAX, LARKSPUR, MILL VALLEY, NOVATO, ROSS, SAN ANSELMO, SAN RAFAEL, SAUSALITO, AND TIBURON AND THE COASTAL TOWNS OF STINSON BEACH, BOLINAS, POINT REYES, INVERNESS, MARSHALL, AND TAMALES. THE TOTAL POPULATION IN MARIN COUNTY IS 352,544. WHITES MAKE UP 81.94% OF MARIN COUNTY'S POPULATION. 16.68% ARE LATINO. 2.38% ARE AFRICAN AMERICAN. 5.33% ARE ASIAN AND PACIFIC ISLANDER. 0.36% ARE NATIVE AMERICAN. (DATA SOURCE: US CENSUS BUREAU, 2006-2010 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATE. KFH-SAN RAFAEL SERVICE AREA DATA) MEDIAN AGE IS 44 YEARS, WITH 15.47% OF THE POPULATION OVER THE AGE OF 65. 91.68% OF THE POPULATION GRADUATED ON TIME FROM HIGH SCHOOL. 9.22% OF CHILDREN LIVE IN POVERTY. THE MEDIAN HOUSEHOLD INCOME IS $89,268. 9.36% OF THE POPULATION HAVE NO HIGH SCHOOL DIPLOMA. 8.6% OF THE POPULATION ARE MEDI-CAL/MEDI-CAID RECIPIENTS. THE UNEMPLOYMENT RATE IS 6.16%. 10.0% ARE UNINSURED, AND 11.33% LACK A SOURCE OF CONSISTENT PRIMARY CARE. MARIN COUNTY IS A HEALTHY AND AFFLUENT COUNTY COMPARED TO CALIFORNIA, AND THE NATION, AS A WHOLE. HOWEVER, A SUB-COUNTY GEOGRAPHIC QUANTITATIVE AND QUALITATIVE DATA ANALYSIS IDENTIFIES DISPARITIES IN SOCIOECONOMIC STATUS THAT LIMIT ACCESS TO HEALTH CARE AND THE CAPACITY OF SOME RESIDENTS TO MAKE CHOICES THAT CONTRIBUTE TO A HEALTHY LIFESTYLE. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS OF THE SERVICE AREA IS AVAILABLE IN THE NOVATO COMMUNITY HOSPITAL'S CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SUTTER LAKESIDE HOSPITALS: SUTTER LAKESIDE HOSPITAL'S HOSPITAL SERVICE AREA IS DEFINED AS LAKE COUNTY. THERE ARE TWO HOSPITALS SERVING THE COMMUNITY. LAKE COUNTY IS LOCATED IN NORTHERN CALIFORNIA JUST TWO HOURS BY CAR FROM THE SAN FRANCISCO BAY AREA, THE SACRAMENTO VALLEY, OR THE PACIFIC COAST. THE COUNTY'S ECONOMY IS BASED LARGELY ON TOURISM AND RECREATION, DUE TO THE ACCESSIBILITY AND POPULARITY OF ITS SEVERAL LAKES AND ACCOMPANYING RECREATIONAL AREAS. IT IS PREDOMINANTLY RURAL, ABOUT 100 MILES LONG BY ABOUT 50 MILES WIDE, AND INCLUDES THE LARGEST NATURAL LAKE ENTIRELY WITHIN CALIFORNIA BORDERS. LAKE COUNTY IS MOSTLY AGRICULTURAL, WITH TOURIST FACILITIES AND SOME LIGHT INDUSTRY. MAJOR CROPS INCLUDE PEARS, WALNUTS AND, INCREASINGLY, WINE GRAPES. DOTTED WITH VINEYARDS AND WINERIES, ORCHARDS AND FARM STANDS, AND SMALL TOWNS, THE COUNTY IS HOME TO CLEAR LAKE, CALIFORNIA'S LARGEST NATURAL FRESHWATER LAKE, KNOWN AS "THE BASS CAPITAL OF THE WEST,MT. KONOCTI, WHICH TOWERS OVER CLEAR LAKE. WITHIN LAKE COUNTY THERE ARE TWO INCORPORATED CITIES, THE COUNTY SEAT OF LAKEPORT AND THE CITY OF CLEARLAKE, THE LARGEST CITY, AND THE COMMUNITIES OF BLUE LAKES, CLEARLAKE OAKS, COBB, FINLEY, GLENHAVEN, HIDDEN VALLEY LAKE, KELSEYVILLE, LOCH LOMOND, LOWER LAKE, LUCERNE, NICE, MIDDLETOWN, SPRING VALLEY, ANDERSON SPRINGS, UPPER LAKE, AND WITTER SPRINGS. LAKE COUNTY IS BORDERED BY MENDOCINO AND SONOMA COUNTIES ON THE WEST; GLENN, COLUSA AND YOLO COUNTIES ON THE EAST; AND NAPA COUNTY ON THE SOUTH. THE TWO MAIN TRANSPORTATION CORRIDORS THROUGH THE COUNTY ARE STATE ROUTES 29 AND 20. STATE ROUTE 29 CONNECTS NAPA COUNTY WITH LAKEPORT AND STATE ROUTE 20 TRAVERSES CALIFORNIA AND PROVIDES CONNECTIONS TO HIGHWAY 101 AND INTERSTATE 5. ACCORDING TO CALIFORNIA LABOR MARKET DATA ABOUT COUNTY-TO-COUNTY COMMUTE PATTERNS (WHICH HAVE NOT BEEN UPDATED SINCE 2000), THE TOTAL NUMBER OF WORKERS THAT LIVE AND WORK IN LAKE IS 15,566 PERSONS: THE TOTAL FOR WORKERS COMMUTING IN WAS 1,046, AND 4,320 WORKERS COMMUTED OUT. ABOUT 67% OF PEOPLE WHO LIVE IN LAKE COUNTY ALSO WORK WITHIN THE COUNTY. WHILE THE POPULATION SIZE OF LAKE COUNTY WAS ESTIMATED AT 64,394 RESIDENTS IN JULY 2012, THE POPULATION CAN SWELL WITH DAYTIME WORK COMMUTERS AND SEASONAL TOURISTS. DEMOGRAPHICS: - POPULATION CHANGE IS MOSTLY STATIC. ESTIMATES OF ANNUAL PERCENT CHANGE BETWEEN JANUARY 2011 AND JANUARY 2012 SHOW ZERO GROWTH FOR THE COUNTY OVERALL. - WITH 21% OF RESIDENTS OVER THE AGE OF 65, THE COUNTY HAS NEARLY TWICE THE PROPORTION OF OLDER RESIDENTS THAN CALIFORNIA AS A WHOLE. THE OVER-AGE-60 GROUP IS ESTIMATED TO INCREASE 59% FROM 2010 TO 2030. THE ANTICIPATED SIGNIFICANT GROWTH IN THIS AGE GROUP WILL PUT A LARGER BURDEN ON THE HEALTH CARE SYSTEM AND LOCAL ECONOMY, WHICH MAY NOT HAVE SUFFICIENT COMMUNITY SERVICES OR TAX BASE TO SUPPORT IT. - LAKE COUNTY'S POPULATION IS PROJECTED TO BECOME INCREASINGLY CULTURALLY DIVERSE IN COMING YEARS. FOR EXAMPLE, THE HISPANIC POPULATION IS PROJECTED TO INCREASE SLIGHTLY MORE THAN 3-FOLD AND PERSONS IDENTIFYING AS MULTI-RACE BY ABOUT 2-FOLD FROM 2010 TO 2050. SOCIOECONOMIC FACTORS: - RECOVERY FROM THE RECESSION HAS BEEN SLOW; 21.4% (UP FROM 17.9% IN 2008) OF LAKE COUNTY RESIDENTS, ONE-THIRD HIGHER THAN THE STATE AVERAGE, LIVED BELOW THE FEDERAL POVERTY LEVEL IN 2011. - ONE-THIRD OF THE POPULATION WAS REPORTED TO BE "FOOD INSECURE. IN 2011, 61% OF STUDENTS ACROSS THE COUNTY WERE RECEIVING FREE-REDUCED PRICE LUNCHES. THESE FINDINGS, HOWEVER, SHOWED SLIGHT IMPROVEMENT FROM THE PRIOR ASSESSMENT PERIOD. - THE PROPORTION OF THE NON ELDERLY POPULATION (AGES 0-64) WHO WERE UNINSURED ALL OR PART OF THE YEAR IN LAKE COUNTY IS VERY SIMILAR TO THE STATEWIDE AVERAGE. - THERE WERE FEWER UNINSURED CHILDREN IN LAKE COUNTY THAN IN CALIFORNIA IN 2009, BUT THE PERCENTAGE COVERED BY EMPLOYMENT-BASED INSURANCE, 44.5%, WAS LOWER THAN THE STATE AVERAGE. - LAKE COUNTY HAS THE HIGHEST PERCENTAGE OF SENIORS COVERED BY A COMBINATION OF MEDICARE AND MEDI-CAL IN THE NORTHERN AND SIERRA COUNTIES REGION. IT HAS THE SECOND LOWEST PERCENTAGE OF SENIORS THAT HAVE PRIVATE SUPPLEMENTAL COVERAGE IN ADDITION TO MEDICARE. - MORE PEOPLE IN LAKE COUNTY, 86.3%, COMPARED TO CALIFORNIA, 80.7%, HAVE COMPLETED HIGH SCHOOL OR HIGHER. - LAKE COUNTY'S OVERALL HIGH SCHOOL DROPOUT RATE IN 2011-12, 2.8%, WAS MORE FAVORABLE THAN THE STATEWIDE RATE OF 4.0%, BUT SLIGHTLY HIGHER THAN THE PRIOR SCHOOL YEAR. NATIVE AMERICAN AND AFRICAN AMERICAN STUDENTS DROP OUT OF SCHOOL AT HIGHER RATES THAN THE OVERALL COUNTY AVERAGE. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE HOSPITAL CHNA AT HTTP://WWW.SUTTERHEALTH.ORG/COMMUNITYBENEFIT/COMMUNITY-NEEDS-ASSESSMENT.HT ML SUTTER SANTA ROSA REGIONAL HOSPITAL: SUTTER SANTA ROSA REGIONAL HOSPITAL'S HOSPITAL SERVICE AREA IS DEFINED AS SONOMA COUNTY. THERE ARE THREE HOSPITALS SERVING THE COMMUNITY. DEMOGRAPHIC OVERVIEW: SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. THE COUNTY'S TOTAL POPULATION IS CURRENTLY ESTIMATED AT 487,011. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%). GEOGRAPHIC DISTRIBUTION OF POPULATION: SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION OF 168,841 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. SONOMA COUNTY'S UNINCORPORATED AREAS ARE HOME TO 146,739 RESIDENTS, 30.1% OF THE TOTAL POPULATION. A SIGNIFICANT NUM SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO "ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES." SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC): THE 2013 - 2015 IMPLEMENTATION STRATEGY FOR CALIFORNIA PACIFIC MEDICAL CENTER DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: CPMC'S ST. LUKE'S HEALTH CARE CENTER (SLHCC) PROVIDES A FULL RANGE OF OBSTETRIC AND GYNECOLOGICAL CARE AT ITS WOMEN'S CENTER; WELL-BABY CARE, WELL-CHILD CARE, AND CARE FOR ILL OR INJURED CHILDREN AT ITS PEDIATRIC CLINIC; AND PRIMARY, ACUTE AND CHRONIC CARE AT ITS ADULT INTERNAL MEDICINE CLINIC FOR TEENAGERS AND ADULTS. SLHCC'S CLINICIANS AND STAFF ARE BILINGUAL IN ENGLISH AND SPANISH, ENSURING CULTURALLY COMPETENT AND SENSITIVE CARE. SLHCC IS ANTICIPATED TO IMPROVE ACCESS TO CARE FOR UNINSURED AND UNDERINSURED PATIENTS RESIDING IN COMMUNITIES SOUTH OF MARKET STREET IN SAN FRANCISCO. IN 2015, OVER 12,800 UNIQUE PATIENTS WERE SEEN AT ST. LUKES HEALTH CARE CENTER, WITH NEARLY 41,000 PATIENT VISITS. HEALTHFIRST, SLHCCS AFFILIATED CENTER FOR HEALTH EDUCATION AND DISEASE PREVENTION, HAD OVER 2,300 PATIENT VISITS, SERVING NEARLY 750 PATIENTS IN CHRONIC DISEASE MANAGEMENT. CPMC MAINTAINS SLHCC AT ITS ST. LUKES CAMPUS IN ORDER TO PROVIDE SUBSIDIZED PRIMARY CARE AND PREVENTIVE SERVICES TO UNDERSERVED RESIDENTS OF THE MISSION, AS WELL AS BAYVIEW, DOWNTOWN/CIVIC CENTER, VISITACION VALLEY AND EXCELSIOR SOME OF THE SAN FRANCISCO NEIGHBORHOODS IDENTIFIED AS HAVING THE HIGHEST DISPARITIES RELATED TO IMPORTANT SOCIO-ECONOMIC DETERMINANTS OF HEALTH. BY PROVIDING SERVICES SUCH AS THESE, CPMC CONTRIBUTES TO IMPROVED ACCESS TO CARE AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR TRACKING THE NUMBER OF SAN FRANCISCANS WITH A USUAL SOURCE OF HEALTH CARE (FROM 86.8% IN 2009 TO 87.3% IN 2014) (WWW.SFHIP.ORG). BY ENSURING THAT SERVICES ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE, CPMC HELPS TO BRIDGE GAPS IN ACCESSIBILITY DUE TO LANGUAGE AND CULTURAL BARRIERS FOR NON-NATIVE-ENGLISH SPEAKERS, AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR MEASURING SAN FRANCISCOS PERCENTAGE OF ADULTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME WHO HAVE DIFFICULTY UNDERSTANDING THEIR DOCTORS (FROM 2.1% IN 2009 TO 1.7% IN 2011-2012) (WWW.SFHIP.ORG). THESE SERVICES ALSO COUNTER LIMITED ACCESS THAT MAY BE CAUSED BY PRIMARY CARE PROVIDERS BEING LESS LIKELY TO SERVE MEDI-CAL BENEFICIARIES DUE TO LOW GOVERNMENT REIMBURSEMENT RATES. CPMC'S KALMANOVITZ CHILD DEVELOPMENT CENTER (KCDC) PROVIDES DIAGNOSIS, EVALUATION, TREATMENT AND COUNSELING FOR CHILDREN AND ADOLESCENTS WITH LEARNING DISABILITIES AND DEVELOPMENTAL OR BEHAVIORAL PROBLEMS CAUSED BY PREMATURITY, AUTISM SPECTRUM DISORDER, EPILEPSY, DOWN SYNDROME, ATTENTION DEFICIT DISORDER, OR CEREBRAL PALSY. ITS COMPREHENSIVE ASSESSMENTS AND ONGOING THERAPY PROGRAMS INCLUDE THE FOLLOWING DISCIPLINES: DEVELOPMENTAL/BEHAVIORAL PEDIATRICS; PSYCHOLOGY AND PSYCHIATRY; SPEECH/LANGUAGE AND AUDITORY PROCESSING; OCCUPATIONAL THERAPY; BEHAVIOR MANAGEMENT CONSULTATIONS; EARLY INTERVENTION/ PARENT-INFANT PROGRAM; SOCIAL SKILLS GROUPS; FEEDING ASSESSMENT AND THERAPY; ASSESSMENT AND THERAPY FOR THE NEONATAL INTENSIVE CARE UNIT AND ASSESSMENT FOR THE FOLLOW-UP CLINIC; EDUCATIONAL ASSESSMENT, THERAPY AND TREATMENT. BESIDES OPERATING ITS OWN CLINICS, KCDC ALSO EXTENDS ITS SERVICES TO A LARGE NUMBER OF AT-RISK CHILDREN BY PARTNERING WITH LOCAL SCHOOLS AND OTHER COMMUNITY ORGANIZATIONS, SUCH AS DE MARILLAC ACADEMY, IMMACULATE CONCEPTION ACADEMY, AND FIRST 5 SAN FRANCISCO. KCDC IS ANTICIPATED TO IMPROVE ACCESS TO CARE FOR UNINSURED AND UNDERINSURED PATIENTS RESIDING IN SAN FRANCISCO. IN 2015, KCDCS TWO SAN FRANCISCO LOCATIONS HAD OVER 16,700 PATIENT VISITS, SERVING 1,450 UNIQUE PATIENTS WHO OTHERWISE MAY NOT HAVE BEEN ABLE TO RECEIVE CHILD DEVELOPMENTAL SERVICES. THESE SERVICES PROVIDED AT REDUCED OR NO COST TO FAMILIES ARE PARTICULARLY IMPORTANT SINCE CHILDREN FROM LOW-INCOME FAMILIES HAVE A 50% HIGHER RISK OF DEVELOPMENTAL DISABILITIES; EARLY IDENTIFICATION AND TREATMENT CAN CHANGE THE COURSE OF THESE CHILDRENS LIVES. KCDC PROVIDED ADDITIONAL SERVICES THROUGH CPMC'S "JOINT VENTURE HEALTH" WITH UC BERKELEY'S SCHOOL OF PUBLIC HEALTH AND NORTH EAST MEDICAL SERVICES (NEMS); IN THIS PARTNERSHIP, KCDC DONATED THE LABOR TIME OF A DEDICATED CHILD DEVELOPMENT SPECIALIST STATIONED AT NEMS SO THAT KIDS WITH DEVELOPMENTAL DISABILITIES COULD RECEIVE DEVELOPMENTAL SERVICES AT AN INTEGRATED MEDICAL HOME WHERE THEY ALSO RECEIVE PRIMARY CARE. THROUGH THIS PROGRAM IN 2015, NEARLY 3,000 KIDS UNDER AGE 11 WERE SCREENED, OF WHOM 14 PERCENT WERE AT MODERATE OR HIGH RISK FOR DEVELOPMENTAL AND SOCIAL/EMOTIONAL DELAYS. ALL WERE CONNECTED TO APPROPRIATE RESOURCES FOR EARLY INTERVENTION. BAYVIEW CHILD HEALTH CENTER (BCHC) OFFERS ROUTINE PREVENTATIVE AND URGENT PEDIATRIC CARE IN ONE OF SAN FRANCISCO'S MOST MEDICALLY UNDERSERVED NEIGHBORHOODS, AND ADDRESSES PREVALENT COMMUNITY HEALTH ISSUES SUCH AS WEIGHT CONTROL AND ASTHMA MANAGEMENT. THE CENTER IS PARTICULARLY ATTUNED TO THE IMPACT OF COMMUNITY VIOLENCE AND CHILDHOOD TRAUMA ON CHILDREN'S MENTAL AND PHYSICAL HEALTH. THE CLINIC ALSO OFFERS PSYCHOLOGICAL AND CASE MANAGEMENT SERVICES TO FAMILIES THROUGH A PARTNERSHIP WITH THE CENTER FOR YOUTH WELLNESS. DENTAL SERVICES ARE PROVIDED ON SITE THROUGH A PARTNERSHIP WITH THE NATIVE AMERICAN HEALTH CENTER. THE CLINIC IS A COLLABORATION BETWEEN CPMC, SUTTER PACIFIC MEDICAL FOUNDATION, AND CPMC FOUNDATION. IN 2015, THE CLINIC SERVED AN ESTIMATED 700 UNIQUE PATIENTS, WITH AN ESTIMATED 1,700 TOTAL PATIENT VISITS. CPMC AND ITS PARTNERS OPENED BCHC IN ORDER TO PROVIDE SUBSIDIZED PRIMARY CARE TO CHILDREN IN ONE OF THE MOST VULNERABLE, UNDERSERVED NEIGHBORHOODS IN SAN FRANCISCO. THROUGH SERVICES SUCH AS THESE, CPMC HAS CONTRIBUTED TO IMPROVED ACCESS TO CARE AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR TRACKING THE NUMBER OF SAN FRANCISCANS WITH A USUAL SOURCE OF HEALTH CARE (FROM 86.8% IN 2009 TO 87.3% IN 2014) (WWW.SFHIP.ORG). BY ENSURING THAT SERVICES ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE, CPMC HELPS TO BRIDGE GAPS IN ACCESSIBILITY DUE TO LANGUAGE AND CULTURAL BARRIERS FOR NON-NATIVE-ENGLISH SPEAKERS, AS MEASURED BY A SHIFT IN THE NEEDS ASSESSMENT INDICATOR MEASURING SAN FRANCISCOS PERCENTAGE OF ADULTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME WHO HAVE DIFFICULTY UNDERSTANDING THEIR DOCTORS (FROM 2.1% IN 2009 TO 1.7% IN 2011-2012) (WWW.SFHIP.ORG). THESE SERVICES ALSO COUNTER LIMITED ACCESS THAT MAY BE CAUSED BY PRIMARY CARE PROVIDERS BEING LESS LIKELY TO SERVE MEDI-CAL BENEFICIARIES DUE TO LOW GOVERNMENT REIMBURSEMENT RATES. CPMC'S AFRICAN AMERICAN BREAST HEALTH (AABH) AND SISTER TO SISTER PROGRAMS OFFER WOMEN MAMMOGRAPHY SCREENING AND ALL THE SUBSEQUENT BREAST HEALTH DIAGNOSTIC TESTING AND TREATMENT THEY MAY NEED AT NO COST. PARTNERSHIP ORGANIZATIONS, SUCH AS BAYVIEW HUNTERS POINT SENIOR CENTER, CALVARY HILL COMMUNITY CHURCH, GLIDE HEALTH SERVICES, SAN FRANCISCO FREE CLINIC, AND CLINIC BY THE BAY, REFER UNINSURED, UNDERINSURED, DISADVANTAGED AND AT-RISK WOMEN FOR MAMMOGRAPHY SERVICES. CPMC'S BREAST CENTER AT THE ST. LUKE'S CAMPUS PROMOTES BREAST HEALTH IN UNDERSERVED COMMUNITIES BY PARTNERING WITH NEIGHBORHOOD CLINICS AND COMMUNITY AGENCIES, INCLUDING SOUTHEAST HEALTH CENTER, MISSION NEIGHBORHOOD HEALTH CENTER, AND LATINA BREAST CANCER AGENCY. IN 2015, CPMCS AFRICAN AMERICAN AND SISTER TO SISTER BREAST HEALTH PROGRAMS PROVIDED 142 SCREENINGS, WITH 175 TOTAL PATIENT VISITS AND 11 FIRST-TIME MAMMOGRAMS. CPMCS GRANT TO LATINA BREAST CANCER AGENCY PROVIDED ASSISTANCE FOR LOW-INCOME PATIENTS TO RECEIVE 325 MAMMOGRAMS AT CPMCS ST. LUKES CAMPUS. CPMCS LATE-2014 GRANT TO SHANTI PROJECT'S MARGOT MURPHY BREAST CANCER PROGRAM HELPED TO PROVIDE CARE NAVIGATION SERVICES TO 417 SHANTI PATIENTS RECEIVING FREE BREAST CANCER TREATMENT, PRIORITIZING WOMEN WHO FACED PARTICULAR CHALLENGES IN COMPLETING TREATMENT DUE TO BEING LOW-INCOME, UNINSURED/UNDERINSURED, WITH LIMITED ENGLISH PROFICIENCY, AND/OR FROM IMMIGRANT POPULATIONS. IN ADDITION, 65 WELLNESS WORKSHOPS EMPOWERED CLIENTS WITH SELF-MANAGEMENT AND HEALTH PROMOTION RESOURCES. CPMC'S COMING HOME H SCHEDULE H, PART VI, LINE 5 (CONTINUED) PROMOTION OF COMMUNITY HEALTH (CONTINUED) NOVATO COMMUNITY HOSPITAL: THE 2013-2015 IMPLEMENTATION STRATEGY FOR NOVATO COMMUNITY HOSPITAL (NCH) DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: THE ROTOCARE CLINIC IS OPERATED BY LOCAL ROTARY CLUBS AND DEPENDS ON DONATIONS AND IN-KIND SERVICES FROM HEALTH CARE PROVIDERS TO OFFER CARE TO UNINSURED AND UNDOCUMENTED INDIVIDUALS PRIMARILY MALES AGES 22 TO 44. NCH PROVIDES A CASH GRANT AND FREE OUTPATIENT LABORATORY EXAMS FOR THE CLINICS PATIENTS. IN 2015, NCH PROVIDED FREE OUTPATIENT LABORATORY SERVICES FOR APPROXIMATELY 200 ROTACARE PATIENTS AT A COST TO THE HOSPITAL OF AN ESTIMATED $100,000. HOMEWARD BOUND OF MARIN PROVIDES SERVICES TO THE COUNTYS HOMELESS POPULATION, INCLUDING THE TRANSITION TO WELLNESS PROGRAM PROVIDING BEDS FOR HOMELESS PATIENTS DISCHARGED FROM THE THREE MARIN ACUTE CARE HOSPITALS WHO NEED TEMPORARY CARE. NCH PROVIDES AN ANNUAL GRANT TO SUPPORT THIS PROGRAM. IN FY 2014-2015 HOMEWARD BOUND TRANSITION TO WELLNESS ADMITTED 6 OF 12 NCH REFERRALS TO THE PROGRAM, RESULTING IN SAVING 24 HOSPITAL DAYS FOR A COST OF $15,500 OR APPROXIMATELY $625 PER DAY COMPARED TO 24 HOSPITAL DAYS AT $3,000= $72,000. UPON DISCHARGE FROM TRANSITION TO WELLNESS, THESE PATIENTS ENTERED THE HOMEWARD BOUND SHELTER, TRAINING PROGRAM, TEMPORARY RESIDENCES AND ULTIMATELY TO INDEPENDENT LIVING. NCH SUPPORTS WHISTLESTOP, A COMMUNITY-BASED ORGANIZATION THAT PROVIDES SERVICES TO SENIORS AND DISABLED ADULTS IN THE COUNTY THROUGH A PROGRAM CALLED HEALTH EXPRESS. IN 2015, 103 RIDES TO MEDICAL APPOINTMENTS WERE PROVIDED TO LOW INCOME SENIORS AND DISABLED PERSONS. NCH PROVIDES A GRANT TO NOVATO UNIFIED SCHOOL DISTRICT TO COVER THE COST OF MEDICAL CARE FOR UNDERSERVED STUDENTS. IN 2015, 35 STUDENTS RECEIVED ONE-ON-ONE NURSING CARE FOR ACUTE CONDITIONS SUCH AS TYPE 1 DIABETES AND SPINA BIFIDA. THE ANNUAL INFLUENZA SEASON FROM OCTOBER THROUGH MARCH AFFECTS ALL MEMBERS OF THE COMMUNITY AND IT IS IN THE BEST INTEREST OF PUBLIC HEALTH TO IMMUNIZE AS MANY INDIVIDUALS AS POSSIBLE. NCH HOSTS FREE IMMUNIZATION CLINICS FOR THE COMMUNITY AND IN 2015, 180 VACCINES WERE ADMINISTERED. OPERATION ACCESS IS A NON-PROFIT ORGANIZATION THAT RECRUITS PHYSICIAN VOLUNTEERS AND HOSPITALS TO PROVIDE AMBULATORY SURGERIES FOR INDIVIDUALS WHO REQUIRE PROCEDURES NOT COVERED BY INSURANCE. NCH PROVIDES OPERATING ROOM PROCEDURES AND RADIOLOGY SERVICES, AND SPECIALIST EVALUATIONS IN 2015, 11 OR PROCEDURES, 2 MINOR AND RADIOLOGY SERVICES AND 8 SPECIALIST EVALUATIONS WERE PROVIDED FREE OF CHARGE. A LEADING CAUSE OF STROKE IS AN UNHEALTHY LIFESTYLE AND IN RESPONSE TO THIS HEALTH NEED, NCH PROVIDES A FREE EDUCATION PROGRAM TAUGHT BY A REGISTERED NURSE FOR THE COMMUNITY. CLASSES ARE HELD AT SENIOR CENTERS AND OTHER COMMUNITY GATHERING PLACES. THE CLASSES DISCUSS HOW UNHEALTHY EATING AND LACK OF EXERCISE CAN LEAD TO HIGH BLOOD PRESSURE, DIABETES, HEART DISEASE AND STROKE. PARTICIPANTS RECEIVE SAMPLE DIETS, EXERCISES, AND LEARN HOW TO RECOGNIZE THE SYMPTOMS OF A STROKE. 1040 PEOPLE RECEIVED INFORMATION FROM AN RN ABOUT STROKE PREVENTION IN 2015. NCH SUBSIDIZES THE KALMANOVITZ CHILD DEVELOPMENT CENTER IN MARIN COUNTY TO SERVE INFANTS THROUGH ADOLESCENTS AND THEIR FAMILIES WITH MENTAL HEALTH COUNSELING, SPEECH THERAPY, DEVELOPMENTAL AND EDUCATIONAL ASSESSMENT AND TREATMENT ON A SLIDING FEE SCALE. IN 2015, 449 CHILDREN AGES 1 THROUGH 21 RECEIVED EDUCATIONAL EVALUATIONS, PSYCHIATRIC COUNSELING, OCCUPATIONAL AND PHYSICAL THERAPY AT THE CLINIC. SUTTER LAKESIDE HOSPITAL: THE 2013-2015 IMPLEMENTATION STRATEGY FOR SUTTER LAKESIDE HOSPITAL (SLH) DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: SLH PROVIDES A FOOD BANK DONATION SITE LOCATED IN THE HOSPITAL'S FRONT LOBBY. COLLECTIONS ARE DELIVERED TO LOCAL FOOD BANK. 1030 POUNDS OF FOOD WAS DONATED IN 2015. SLH HAS A STROKE SUPPORT GROUP THAT HELPS IMPROVE THE EMOTIONAL HEALTH AND WELL-BEING OF STROKE PATIENTS. IN 2015, SLH HOSTED MONTHLY CHRONIC ILLNESS & STROKE SUPPORT GROUP MEETINGS THAT ENGAGED MEMBERS OF THE LAKE COUNTY COMMUNITY. THE GROUPS RANGED BETWEEN 1-9 MEMBERS. THE GROUP ALLOWS STROKE SURVIVORS AND THEIR FAMILIES TO NETWORK WITH OTHER INDIVIDUALS IN THE COMMUNITY AND BUILD UPON SHARED EXPERIENCES, DISCUSS DIFFICULTIES AND PROBLEM-SOLVE AS WELL AS REDUCE EMOTIONAL STRESS. PATIENTS ATTENDED THE GROUP 45 TIMES IN 2015. SLH MATCHES SUTTER HEALTHS ANNUAL DONATION TO OUR LOCAL FOOD BANK, AND DONATES MONEY AND MEAT TO FEED THE NEEDY. THE FOOD BANK DONATION EXPANDED THE CAPACITY OF LOCAL FOOD BANKS TO SERVE HUNGRY FAMILIES. BECAUSE OF SLHS DONATION, THE TASK FORCE FED 45 NEEDY FAMILIES. SLHS PHYSICAL THERAPY DEPARTMENT PROVICES A FREE ARTHRITIS FOUNDATION SPONSORED EXERCISE CLASS TO IMPROVE MOBILITY AND FUNCTION. IN 2015, 100 PERSONS PARTICIPATED IN THE PROGRAM. SUTTER SANTA ROSA REGIONAL HOSPITAL: THE 2013-2015 IMPLEMENTATION STRATEGY FOR SUTTER SANTA ROSA REGIONAL HOSPITAL DEFINES A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY IT SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW: A SURVEY OF THE PATIENTS AT VISTA CLINIC, THE LOCAL COMMUNITY HEALTH CENTER, REVEALED THAT MORE THAN 60% OF THEIR PATIENTS EXPERIENCE REGULAR FOOD INSECURITY AND OFTEN NEED TO MAKE UNHEALTHY FOOD CHOICES BASED ON AFFORDABILITY, OR DON'T EAT AT ALL. IN RESPONSE TO THIS HEALTH NEED, SUTTER SANTA ROSA REGIONAL HOSPITAL ENTERED INTO A PARTNERSHIP WITH THE REDWOOD EMPIRE FOOD BANK TO BE A FOOD DROP-OFF LOCATION. EACH MONDAY, PATIENTS OF THE VISTA CLINIC ARE INVITED TO COME AND PICK UP ONE BOX OF HEALTHY, FRESH FOOD FOR THEIR FAMILIES. PATIENTS ARE ALSO EDUCATED ABOUT OTHER FOOD PROGRAMS AND FOOD STAMP EXCHANGES AT FARMERS MARKETS. IN 2015, 120 FAMILIES RECEIVE ANYWHERE FROM 2000-4000 LBS OF HEALTHY FOOD. SUTTER SANTA ROSA REGIONAL HOSPITAL SPONSORS A THREE-YEAR TRAINING PROGRAM FOR MEDICAL SCHOOL GRADUATES DESIRING TO BE PRIMARY CARE DOCTORS. THE TRAINING IS PROVIDED BY SUTTER PHYSICIANS WHO ARE ALSO ADJUNCT PROFESSORS WITH OUR PARTNER, THE UCSF MEDICAL SCHOOL. RESIDENTS ARE TRAINED IN THE HOSPITAL AND IN THE CLINIC SETTING BY CARING FOR PATIENTS UNDER THE CLINICAL SUPERVISION OF FACULTY. SUTTER HAS BEEN SPONSORING THE PROGRAM SINCE 1996, BUT IT HAS EXISTED IN OUR COMMUNITY FOR MORE THAN 40 YEARS. FUELING THE PRIMARY CARE PIPELINE IN SONOMA COUNTY IS VITAL TO THE HEALTH AND WELL-BEING OF OUR COMMUNITY. THE COST OF LIVING IS QUITE HIGH AND WITHOUT THIS PROGRAM, IT WOULD BE VERY DIFFICULT TO RECRUIT FAMILY PHYSICIANS TO THE AREA. THE IMPACT OF THE SANTA ROSA FAMILY MEDICINE PROGRAM CAN BE MEASURED IN MANY WAYS. IN TERMS OF INCREASING ACCESS TO PRIMARY CARE IN OUR COMMUNITY, THE TWO BIGGEST WAYS OF MEASURING IMPACT ARE IN THE NUMBERS OF PATIENTS SEEN BY THE RESIDENTS (PRIMARILY LOW-INCOME) AND IN THE NUMBER OF GRADUATES WHO STAY AND PRACTICE IN SONOMA COUNTY FOLLOWING GRADUATION. IN 2015, 4 OUT OF 12 GRADUATES ARE PRACTICING IN SONOMA COUNTY. ADDITIONALLY, 5 OUT OF 12 GRADUATES ARE PRACTICING EXCLUSIVELY AT LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHC). THE SANTA ROSA FAMILY MEDICINE RESIDENCY PROGRAM PARTNERS WITH REDWOOD COALITION FOR HEALTH CARE, TO STAFF THEIR SANTA ROSA COMMUNITY HEALTH CENTER VISTA CLINIC WITH 36 FAMILY MEDICINE RESIDENTS, SUPERVISED BY FACULTY PHYSICIANS. THIS PARTNERSHIP ESSENTIALLY OFFERS FREE PHYSICIAN STAFFING TO A CLINIC THAT WOULD OTHERWISE HAVE TO HIRE STAFF PHYSICIANS, PROVIDING A SIGNIFICANTLY INCREASED CAPACITY THAT THE CLINIC WOULD NOT BE ABLE TO SUSTAIN ON ITS OWN. 24,763 PATIENT VISITS OCCURRED IN 2015 THROUGH THIS PARTNERSHIP, INCLUDING AN APPROXIMATE $1.6 MILLION SAVING TO THE FQHC IN PHYSICIAN SALARIES. THE HOMELESS YOUTH MOBILE VAN IS A PARTNERSHIP BETWEEN THE SANTA ROSA FAMILY MEDICINE RESIDENCY, SANTA ROSA COMMUNITY HEALTH CENTERS AND SOCIAL ADVOCATES FOR YOUTH (SAY). ONCE PER MONTH, TWO TO THREE RESIDENT PHYSICIANS, A VOLUNTEER COMMUNITY PRECEPTOR, A MEDICAL ASSISTANT AND AN HIV TESTING AND OUTREACH WORKER GO TO THE SHELTER RUN BY SAY IN A VAN EQUIPPED WITH TWO TREATMENT ROOMS AND MEDICAL SUPPLIES. WE OFFER BASIC URGENT CARE SERVICES, SUCH AS TREATMENT OF SKIN INFECTIONS AND RASHES, ASSESSMENTS OF WOUNDS AND ABRASIONS, GENERAL HEALTH SCREENING, HIV TESTING, REFERRALS FOR FULL STD TESTING, FAMILY PLANNING SERVICES, TESTING AND TREATMENT OF URINARY TRACT INFECTIONS, SCREENING FOR DIABETES, ETC. WHEN WE CANNOT TREAT PATIENTS AT THE VAN WE REFER THEM TO BROOKWOOD HEALTH CENTER FOR MORE COMPREHENSIVE CARE. WE ALSO OFFER INITIAL MENTAL HEALTH CONSULTATIONS AND HAVE EVEN SEEN PATIENTS FOR PRENATAL AND POSTPARTUM VISITS. IN ADDITION TO THESE SERVICES, WE SPEND TIME HAN SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE ORGANIZATION IS AFFILIATED WITH SUTTER HEALTH, A NOT-FOR-PROFIT NETWORK OF HOSPITALS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS WHO CARE FOR PEOPLE WHO LIVE IN MORE THAN 100 NORTHERN CALIFORNIA TOWNS AND CITIES. TOGETHER, WE'RE CREATING A MORE INTEGRATED, SEAMLESS AND AFFORDABLE APPROACH TO CARING FOR PATIENTS. THE HOSPITAL'S MISSION IS TO ENHANCE THE WELL-BEING OF THE PEOPLE IN OUR COMMUNITIES THROUGH COMPASSION, EXCELLENCE AND INNOVATION IN HEALTH CARE SERVICES, RESEARCH AND EDUCATION. OVER THE PAST FIVE YEARS, SUTTER HEALTH HAS COMMITTED NEARLY $4 BILLION TO CARE FOR PATIENTS WHO COULDN'T AFFORD TO PAY, AND TO SUPPORT PROGRAMS THAT IMPROVE COMMUNITY HEALTH. OUR 2015 COMMITMENT OF $843 MILLION INCLUDES UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS, TRADITIONAL CHARITY CARE AND INVESTMENTS IN HEALTH EDUCATION AND PUBLIC BENEFIT PROGRAMS. FOR EXAMPLE: - TO PROVIDE CARE TO MEDI-CAL PATIENTS IN 2015, SUTTER HEALTH INVESTED $712 MILLION MORE THAN THE STATE PAID. SUTTER HEALTH HOSPITALS PROUDLY SERVE MORE MEDI-CAL PATIENTS IN OUR NORTHERN CALIFORNIA SERVICE AREA THAN ANY OTHER HEALTH CARE PROVIDER. - IN 2015, SUTTER HEALTH'S COMMITMENT TO DELIVERING CHARITY CARE TO PATIENTS WAS $52 MILLION. - THROUGHOUT OUR HEALTH CARE SYSTEM, WE PARTNER WITH AND SUPPORT COMMUNITY HEALTH CENTERS TO ENSURE THAT THOSE IN NEED HAVE ACCESS TO PRIMARY AND SPECIALTY CARE. WE ALSO SUPPORT CHILDREN'S HEALTH CENTERS, FOOD BANKS, YOUTH EDUCATION, JOB TRAINING PROGRAMS AND SERVICES THAT PROVIDE COUNSELING TO DOMESTIC VIOLENCE VICTIMS. EVERY THREE YEARS, SUTTER HEALTH HOSPITALS PARTICIPATE IN A COMPREHENSIVE AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IDENTIFIES LOCAL HEALTH CARE PRIORITIES AND GUIDES OUR COMMUNITY BENEFIT STRATEGIES. THE ASSESSMENTS HELP ENSURE THAT WE INVEST OUR COMMUNITY BENEFIT DOLLARS IN A WAY THAT TARGETS AND ADDRESSES REAL COMMUNITY NEEDS. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: CALIFORNIA true SAN FRANCISCO GENERAL HOSPITAL FOUNDATION 2789 25TH ST STE 2028 SAN FRANCISCO CA 94110 943189424 501(C)(3) 2005000 GENERAL SUPPORT PATIENT ASSISTANCE FOUNDATION 2100 WEBSTER ST 100 SAN FRANCISCO CA 94115 942944137 501(C)(3) 507995 GENERAL SUPPORT HEALTHRIGHT360 1735 MISSION ST STE 2001 SAN FRANCISCO CA 94103 946129071 501(C)(3) 250000 GENERAL SUPPORT SAN FRANCISCO MEDICAL CENTER 229 7TH ST SAN FRANCISCO CA 94103 237304921 501(C)(3) 250000 GENERAL SUPPORT NORTH EAST MEDICAL SERVICES 1520 STOCKTON ST SAN FRANCISCO CA 94133 941722562 501(C)(3) 205000 GENERAL SUPPORT CENTER FOR YOUTH WELLNESS 3450 THIRD ST STE 2A SAN FRANCISCO CA 94124 452527627 501(C)(3) 200000 GENERAL SUPPORT REGENTS OF THE UNIV OF CA UC BERKELEY CPHP 50 UNIVERSITY HALL MC7360 BERKELEY CA 94720 946002123 GOVERNMENT 169936 GENERAL SUPPORT NORTHERN CALIFORNIA CENTER FOR WELL BEING 101 BROOKWOOD AVE STE A SANTA ROSA CA 95404 931144835 501(C)(3) 152609 GENERAL SUPPORT MISSION NEIGHBORHOOD CENTER 240 SHOTWELL ST SAN FRANCISCO CA 94110 941408150 501(C)(3) 50000 GENERAL SUPPORT MARCH OF DIMES FULFILLMENT CENTER PO BOX 1657 WILKESBARRE PA 18703 131846366 501(C)(3) 37500 GENERAL SUPPORT SAN FRANCISCO CHILD ABUSE PREVENTION CENTER 1757 WALLER ST SAN FRANCISCO CA 94117 942455072 501(C)(3) 30000 GENERAL SUPPORT TIDES CENTER BODY POSITIVE 2417 PROSPECT ST STE A BERKELEY CA 94704 943213100 501(C)(3) 28000 GENERAL SUPPORT COMPASS FAMILY SERVICES 49 POWELL ST 3RD FL SAN FRANCISCO CA 94102 941156622 501(C)(3) 27500 GENERAL SUPPORT GRANT FOUNDATION 2840 LIBERTY AVE STE PITTSBURGH PA 15222 251017587 501(C)(3) 25987 GENERAL SUPPORT AMBULATORY SURGERY ACCESS COALITION 1119 MARKET ST STE 400 SAN FRANCISCO CA 94103 943180356 501(C)(3) 25000 GENERAL SUPPORT APA FAMILY SUPPORT SERVICES 10 NOTTINGHAM PL SAN FRANCISCO CA 94133 943164091 501(C)(3) 25000 GENERAL SUPPORT ASIAN AND PACIFIC ISLANDER WELLNESS CENTER 730 POLK ST 4TH FLR SAN FRANCISCO CA 94109 943096109 501(C)(3) 25000 GENERAL SUPPORT COMMUNITY CENTER PROJECT OF SF 1800 MARKET ST SAN FRANCISCO CA 94102 943236718 501(C)(3) 25000 GENERAL SUPPORT KIMOCHI INC 1715 BUCHANAN ST SAN FRANCISCO CA 94115 237117402 501(C)(3) 25000 GENERAL SUPPORT LATINA BREAST CANCER AGENCY 4271 MISSION ST 2ND FLR SAN FRANCISCO CA 94112 010628124 501(C)(3) 25000 GENERAL SUPPORT MAITRI COMPASSIONATE CARE 401 DUBOCE AVE SAN FRANCISCO CA 94117 943189198 501(C)(3) 25000 GENERAL SUPPORT SAN FRANCISCO COMMUNITY CLINIC CORP 1550 BRYANT ST STE 450 SAN FRANCISCO CA 94103 942897258 501(C)(3) 24400 GENERAL SUPPORT CURRY SENIOR CENTER 333 TURK ST SAN FRANCISCO CA 94102 237362588 501(C)(3) 20000 GENERAL SUPPORT LARKIN STREET YOUTH SERVICES 134 GOLDEN GATE AVE SAN FRANCISCO CA 94102 942917999 501(C)(3) 20000 GENERAL SUPPORT YEAR UP INC 93 SUMMER ST BOSTON MA 02110 043534407 501(C)(3) 19953 GENERAL SUPPORT SAN FRANCISCO HEARING SPEECH 1234 DIVISADERO ST SAN FRANCISCO CA 94115 941322198 501(C)(3) 18373 GENERAL SUPPORT LUTHER BURBANK MEMORIAL FOUNDATION 50 MARK W SPRINGS RD SANTA ROSA CA 95403 942581084 501(C)(3) 18162 GENERAL SUPPORT SAN FRANCISCO FOOD BANK 900 PENNSYLVANIA AVE SAN FRANCISCO CA 94107 943041517 501(C)(3) 17500 GENERAL SUPPORT SAN FRANCISCO PLANNING & URBAN RSRCH ASSOC 654 MISSION ST SAN FRANCISCO CA 94105 941498232 501(C)(3) 16000 GENERAL SUPPORT HOMEWARD BOUND OF MARIN 1385 NO HAMILTON PKWY NOVATO CA 94949 680011405 501(C)(3) 15385 GENERAL SUPPORT EPISCOPAL COMMUNITY SERVICES 165 8TH ST 3RD FL SAN FRANCISCO CA 94103 943096716 501(C)(3) 15000 GENERAL SUPPORT FRIENDS OF STAFFORD LAKE BIKE PARK PO BOX 875 KENTFIELD CA 94914 463245759 501(C)(3) 15000 GENERAL SUPPORT GLIDE FOUNDATION 330 ELLIS ST SAN FRANCISCO CA 94102 941156481 501(C)(3) 15000 GENERAL SUPPORT INSTITUTE ON AGING 3575 GEARY BLVD SAN FRANCISCO CA 94118 942978977 501(C)(3) 15000 GENERAL SUPPORT MARIN COMMUNITY FOUNDATION DBA CHILDRENS HLTH INITIATIVE 10 NO SAN RAFAEL CA 94903 943007979 501(C)(3) 12500 GENERAL SUPPORT ON LOK INC SENIOR HEALTH SERVICES 1333 BUSH ST SAN FRANCISCO CA 94109 943101464 501(C)(3) 11000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 426 17TH ST STE 300 OAKLAND CA 94612 135613797 501(C)(3) 11000 GENERAL SUPPORT CONARD HOUSE INC 1385 MISSION ST STE 200 SAN FRANCISCO CA 94103 941489356 501(C)(3) 10000 GENERAL SUPPORT JEWISH VOCATIONAL AND CAREER COUNSELING SVS 17 GEARY ST STE 401 SAN FRANCISCO CA 94108 942213100 501(C)(3) 10000 GENERAL SUPPORT MARIN COMMUNITY CLINIC PO BOX 1868 NOVATO CA 94948 942237120 501(C)(3) 10000 GENERAL SUPPORT HUCKLEBERRY YOUTH PROGRAMS INC 3310 GEARY BLVD SAN FRANCISCO CA 94118 941687559 501(C)(3) 8800 GENERAL SUPPORT COMMUNITY ACTION PARTNERSHIP OF SONOMA CTY 1300 NO DUTTON AVE SANTA ROSA CA 95401 941648949 501(C)(3) 8640 GENERAL SUPPORT GREATER BAY AREA MAKE A WISH FOUNDATION INC 55 HAWTHORNE ST STE 800 SAN FRANCISCO CA 94105 942958481 501(C)(3) 7500 GENERAL SUPPORT GUM MOON RESIDENCE HALL 940 WASHINGTON ST SAN FRANCISCO CA 94108 941156357 501(C)(3) 7500 GENERAL SUPPORT MISSION HIRING HALL INC 1048 FOLSOM ST SAN FRANCISCO CA 94103 941750329 501(C)(3) 7500 GENERAL SUPPORT MARIN SENIOR COORDINATING COUNCIL INC 930 TAMALPAIS AVE SAN RAFAEL CA 94901 941422463 501(C)(3) 6338 GENERAL SUPPORT YOUNG MENS CHRISTIAN ASSN OF RICHMOND DISTR 360 18TH AVE SAN FRANCISCO CA 94121 940997140 501(C)(3) 6250 GENERAL SUPPORT MERITUS COLLEGE FUND PO BOX 29024 SAN FRANCISCO CA 94129 943257076 501(C)(3) 5625 GENERAL SUPPORT LAKE COUNTY HUNGER TASK FORCE PO BOX 1463 KELSEYVILLE CA 95451 320400955 501(C)(3) 5050 GENERAL SUPPORT 49 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: IN ORDER TO CLOSELY MONITOR EFFICIENCY AND EFFECTIVENESS, THE COMMUNITY BENEFIT FUNCTION OUTLINES MEASURABLE REPORTING (QUARTERLY, SIX-MONTH AND/OR YEAR-END), PROGRAM AND FUNDING REQUIREMENTS IN A MEMORANDUM OF UNDERSTANDING (MOU), BUSINESS SERVICES AGREEMENT (BSA), OR JOINT VENTURE AGREEMENT FOR EACH INVESTMENT MADE WITH A COMMUNITY PARTNER. WHERE IT IS DETERMINED NECESSARY, ADDITIONAL EFFORTS ARE MADE TO MONITOR EFFECTIVENESS AND EFFICIENCY OF INVESTMENTS, WHICH COULD INCLUDE: - QUARTERLY MEETINGS WITH COMMUNITY PARTNERS - E-MAIL AND TELEPHONIC COMMUNICATIONS WITH COMMUNITY PARTNERS - CONTINUED DIALOGUE WITH INVOLVED HOSPITAL STAFF AND COMMUNITY PARTNERS THROUGHOUT DURATION OF PROGRAM - SITE VISITS WITH COMMUNITY PARTNERS - BI-ANNUAL "OUTCOMES" SURVEY (6-MONTH AND YEAR-END OUTCOMES) - REVIEW OF HOSPITAL USAGE AND PATIENT LEVEL DATA - COLLECTION OF PATIENT STORIES AND NARRATIVES - COLLABORATIVE DISCUSSIONS AROUND AD-HOC SUCCESSES AND CHALLENGES THAT ARISE - REPORTING TO INCLUDE YEAR-END FINANCIAL SUMMARY THAT COMPARES ACTUAL EXPENDITURES TO THE FUNDED PROJECTS BUDGET, INDICATING ANY UNUSED AMOUNT OF GRANT FUNDS. AT THE END OF EACH YEAR/REPORTING PERIOD, COMMUNITY BENEFIT ANALYZES FULL-YEAR DATA TO ENSURE COMMUNITY PARTNERS MET THE OBJECTIVES OUTLINED IN THE MOU OR BSA. IF THE COMMUNITY PARTNERS DID NOT REACH THE ANTICIPATED OUTCOMES, COMMUNITY BENEFIT WORKS TO UNDERSTAND WHAT CIRCUMSTANCES PREVENTED THE ORGANIZATION FROM NOT MEETING THE GOALS TO HELP IDENTIFY WAYS TO IMPROVE OR PERHAPS RE-EVALUATE WHAT SUCCESS OF THIS PROGRAM LOOKS LIKE, AND MAKES THE DETERMINATION TO CONTINUE OR TERMINATE FUNDING. X true true X X X X false true false false false false false true false MICHAEL COHILL PT-YR REG PRES, WEST BAY (PT YR) 0 730128 0 1294826 0 191091 0 323092 0 24450 0 2563587 0 555196 JEFF GERARD PRESIDENT, SH BAY AREA 0 763104 0 627231 0 113133 0 394192 0 20626 0 1918286 0 406467 SARAH KREVANS PRES & COO SH, ASST SEC. SWBH 0 1045572 0 888993 0 143129 0 470092 0 26048 0 2573834 0 559293 MICHAEL DUNCHEON VP, REG COUNSEL WB (PART YEAR) 0 374593 0 237367 0 34845 0 94842 0 13387 0 755034 0 109244 JOHN GATES CFO SUTTER HEALTH BAY AREA 0 633354 0 285096 0 49516 0 163042 0 20100 0 1151108 0 135078 KAREN HALL PT-YR CHIEF LEGAL OFFICER, BAY AREA 0 357431 0 206850 0 24477 0 99242 0 17185 0 705185 0 107824 WARREN BROWNER MD CEO, SAN FRANCISCO HOSPITALS 0 577330 0 384556 0 76588 0 194692 0 19010 0 1252176 0 185528 GRANT DAVIES EXECUTIVE VP WEST BAY 0 599540 0 438655 0 87177 0 193992 0 22481 0 1341845 0 281949 ANNE BARR REGIONAL CIO, WEST BAY 0 334372 0 199851 0 704 0 87742 0 16805 0 639474 0 91701 HON-WAI LAM REGIONAL VP & CMO, WEST BAY 0 473272 0 242494 0 38896 0 113992 0 8963 0 877617 0 109244 MICHAEL L PURVIS CAO, SMCSR 0 349374 0 223703 0 38636 0 104442 0 15100 0 731255 0 140450 CHRISTOPHER WILLRICH REG VP, STRATEGY WEST BAY 0 148939 0 206683 0 319770 0 56457 0 7758 0 739607 0 105617 MARTIN BROTMAN MD SVP SH (FORMER OFFICER) 0 14892 0 440765 0 1543273 0 57487 0 1299 0 2057716 0 475122 PAT FRY PRES & CEO, SH (FRMR OFFICER) 0 1562833 0 1913420 0 365492 0 3592743 0 35166 0 7469654 0 1281022 MAYNARD JENKINS VP, HR BAY AREA 0 350068 0 177062 0 14924 0 79692 0 12285 0 634031 0 78012 SCHEDULE J, PART I, LINE 1A RELEVANT INFORMATION REGARDING COMPENSATION ITEMS: TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY. SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION: THE CEO OF THIS ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTERS EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATIONS OVERALL MISSION. SEE SCHEDULE O NARRATIVE FOR PART VI, LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS COMPLETED BY SUTTER HEALTH. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTHS OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTERS PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR ELIGIBLE EARNINGS BEYOND THE IRS DEFINITION OF INCLUDIBLE COMPENSATION ("PENSION PAY CAP"), THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F)) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTHS QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTERS NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT. THE FOLLOWING INDIVIDUALS RECEIVED 457(F) NON-QUALIFIED PAYMENTS DURING THE YEAR: CHRISTOPHER WILLRICH - $51,099 MARTIN BROTMAN - $405,115 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% TO 10% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD UP TO 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTERS LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTHS OVERALL MISSION, VISION, AND VALUES, SUTTERS LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE. A CHFFA 2007A 521643828 13033FQ37 2007-05-01 790998316 Construct & Equip Facility false false false B CHFFA 2008A 521643828 13033FEL3 2008-05-14 329041638 Refunding 5/1/07, 04 & 02 false false false C CHFFA 2011D 521643828 13033LVW4 2011-12-22 331759643 Construct & Refunding false false false D CHFFA 2013A 521643828 13033LW52 2013-04-24 187683000 Construct & Equip Facility false false false A 0 0 858694930 0 55398317 0 0 0 0 783091871 20204742 0 2011 false false true true B 104255000 0 329041638 0 0 0 0 0 0 0 329041638 0 true false true true C 0 0 334684174 0 0 65070000 0 0 0 145589174 124025000 0 2014 true false true true D 0 0 496712142 0 0 0 0 0 0 473882520 0 22829622 2014 false false true true A false true true true true true 0.00480 0.00000 0.00480 false false false true B false true true true true true 0.01010 0.00060 0.01070 false false false true C false false true true true true 0 false false false true D false true true true true true 0.00250 0.00000 0.00250 false false false true A true false false 0 false 0 false true B false true false false false false 0 false 0 false true C false true false false false false 0 false 0 false true D false true false false false false 0 false 0 false true A true B true C true D true SCHEDULE K THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO CERTAIN SUBSIDIARY ORGANIZATIONS, INCLUDING THE ORGANIZATION. THE OUTSTANDING BOND LIABILITY ALLOCATED TO THIS ORGANIZATION IS REPORTED ON FORM 990, PART X, BALANCE SHEET AND PART VI HEREIN. WITH THE EXCEPTION OF THIS PORTION OF PART VI, THE SCHEDULE K FOR THIS ORGANIZATION IS REPORTING INFORMATION FOR THE ENTIRE BOND ISSUE. SCHEDULE K, PART I, COLUMN (E): THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNTS OF: $151,538,114 FROM THE 2007A ISSUE, $55,943,275 FROM THE 2008A ISSUE, $47,569,739 FROM THE 2011D ISSUE AND $187,683,000 FROM THE 2013A ISSUE. SCHEDULE K, PART I, LINE B, COLUMN (F)(CHFFA 2008A): THE REFUNDING OCCURRED VIA THE REPAYMENT OF A DRAW ON A TAXABLE LINE OF CREDIT, DRAWN IN SEVERAL INSTALLMENTS BETWEEN APRIL 7 AND APRIL 11, 2008, USED TO REFUND THE 2007 ISSUE. THE REFUNDED BONDS ISSUED IN 2007 WERE USED TO REFUND BONDS ISSUED IN 1996 THAT WERE USED TO REFUND BONDS ISSUED IN 1985, 1989, 1990, AND 1991. SCHEDULE K, PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. ANDREE S HEST SEE PART V 212564 SEE PART V false ANTHONY WAGNER SEE PART V 74634 SEE PART V false SCHEDULE L, PART IV DESCRIPTION OF BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: DEBORAH WYATT, TRUSTEE, AND ANTHONY WAGNER, TRUSTEE, OF SUTTER WEST BAY HOSPITALS (SWBH) EACH HAVE A FAMILY MEMBER WHO WORKS FOR SWBH. X 2 8458 FMV X 1 50000 X SF 49ER TICKETS 1 812 FMV X GIFT CERTIFICATE 1 500 FMV false true false PART I, COLUMN (B) COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 1 AND PART III, LINE 1 MISSION STATEMENT: WE ENHANCE THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE THROUGH OUR COMMITMENT TO COMPASSION, EXCELLENCE, INNOVATION AND A FULL CONTINUUM OF HEALTH CARE SERVICES. FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS: GENERAL DESCRIPTION SUTTER WEST BAY HOSPITALS WAS FORMED IN JANUARY 1, 2010. IT CONSISTS OF FOUR HOSPITALS: CALIFORNIA PACIFIC MEDICAL CENTER, NOVATO COMMUNITY HOSPITAL, SUTTER SANTA ROSA REGIONAL HOSPITAL, AND SUTTER LAKESIDE HOSPITAL. THERE WERE A TOTAL OF 225,007 PATIENT DAYS FOR 2015. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) IS ONE OF THE LARGEST PRIVATE, COMMUNITY BASED, NOT-FOR-PROFIT, TEACHING MEDICAL CENTERS IN CALIFORNIA. CPMC IS A TERTIARY REFERRAL CENTER PROVIDING ACCESS TO LEADING EDGE MEDICINE WHILE DELIVERING THE BEST POSSIBLE PERSONALIZED CARE. IT PROVIDES A WIDE VARIETY OF SERVICES, INCLUDING ACUTE, POST-ACUTE AND OUTPATIENT HOSPITAL CARE; HOSPICE SERVICES; PREVENTIVE AND COMPLEMENTARY CARE; AND HEALTH EDUCATION. CPMC COMPRISES OF FOUR OF THE OLDEST HOSPITALS IN SAN FRANCISCO. THE DAVIES CAMPUS, FORMERLY DAVIES MEDICAL CENTER, WAS FOUNDED IN 1854 TO HELP SAN FRANCISCOS GERMAN-SPEAKING IMMIGRANTS FIND WORK, SHELTER, FOOD, CLOTHING AND HEALTH CARE. THE PACIFIC CAMPUS WAS FOUNDED IN 1857 AND WAS THE FIRST MEDICAL SCHOOL IN THE AMERICAN WEST. THE CALIFORNIA CAMPUS WAS FOUNDED IN 1875 AS THE PACIFIC DISPENSARY FOR WOMEN AND CHILDREN, A HOSPITAL RUN BY WOMEN, FOR WOMEN. FINALLY, THE ST. LUKE'S CAMPUS FORMED IN THE 1870S HAS BEEN PROVIDING QUALITY HEALTH SERVICES TO ALL SAN FRANCISCANS FOR OVER 140 YEARS. TOGETHER THE DAVIES, CALIFORNIA, PACIFIC AND ST. LUKES CAMPUSES COMPRISE CPMCS 1,154 LICENSED BEDS. NOVATO COMMUNITY HOSPITAL (NOVATO) HAS SERVED THE NORTHERN MARIN AND SOUTHERN SONOMA COMMUNITIES SINCE 1961. IN 1985, THE HOSPITAL BECAME A SUTTER HEALTH AFFILIATE. THE NOVATO FACILITY IS A 47-BED ACUTE CARE HOSPITAL LOCATED AT 180 ROWLAND WAY AND IS NOTED FOR ITS ORTHOPEDIC SURGERY PROGRAM. SUTTER SANTA ROSA REGIONAL HOSPITAL (SSRRH), FORMERLY SUTTER MEDICAL CENTER SANTA ROSA, HAS A LONG HISTORY IN SONOMA COUNTY DATING BACK TO 1866 WHEN THE FIRST HOSPITAL OPENED. IN 1996, SSRRH BECAME AN AFFILIATE OF SUTTER HEALTH. A NEW STATE-OF-THE ART MEDICAL FACILITY OPENED WITH A NEW NAME IN OCTOBER 2014 WITH A FULL RANGE OF FIVE-STAR PERSONALIZED CARE SERVICES. THE HOSPITAL WAS RELOCATED TO 30 MARK WEST SPRINGS ROAD, SANTA ROSA, CA. SUTTER LAKESIDE HOSPITAL (LAKESIDE) IS A 25-BED CRITICAL ACCESS HOSPITAL AND IS ONE OF ONLY TWO HOSPITALS THAT SERVE THE 64,000 RESIDENTS OF LAKE COUNTY. IN 1992, THE HOSPITAL AFFILIATED WITH SUTTER HEALTH. SUTTER LAKESIDE PROVIDES A WIDE VARIETY OF SERVICES, INCLUDING ACUTE, POST-ACUTE AND OUTPATIENT HOSPITAL CARE; SURGICAL SERVICES; FAMILY BIRTH SERVICES; PREVENTIVE CARE; PRIMARY CARE THROUGH OUR CLINICS AND HEALTH EDUCATION. SWBH CARED FOR NEARLY 661 ADULT & PEDIATRIC INPATIENTS A DAY; ITS SEVEN EMERGENCY ROOMS ATTRACTED 405 VISITS A DAY; AND AT LEAST 73 SURGERIES A DAY WERE PERFORMED IN ITS FACILITIES. SEE ADDITIONAL DETAIL BELOW ON PATIENT ACTIVITY BY LOCATION. SWBH 2015 PATIENT ACTIVITY TOTAL ER VISITS 147,828 ACUTE DISCHARGES (INCL. PSYCH, REHAB) 38,229 SNF/ALZHEIMER/SUB ACUTE DISCHARGES 1,096 TOTAL DISCHARGES 39,235 DELIVERIES 7,568 TRANSPLANTS 305 SWBH CLINICAL PROGRAMS INCLUDE: - ASTHMA EDUCATION PROGRAM - BREAST FEEDING CENTERS - BREAST HEALTH CENTERS - CALIFORNIA PACIFIC MEDICAL CENTER RESEARCH INSTITUTE - CANCER RECOVERY PROGRAMS - COMING HOME HOSPICE - COMMUNITY BENEFITS PROGRAMS (DETAILED BELOW) - COMMUNITY HEALTH RESOURCE CENTER - COMPREHENSIVE STROKE CENTER - DIABETES EDUCATION PROGRAM - END-STAGE ORGAN FAILURE/TRANSPLANTATION PROGRAMS (HEART, KIDNEY, LIVER, PANCREAS) - FORBES NORRIS MDA/ALDS CENTER - HAND CLINIC - HOSPITALIST PROGRAM - INSTITUTE FOR HEALTH AND HEALING - IRENE SWINDELLS ALZHEIMER'S RESIDENTIAL CARE CENTER - LIONS EYE CLINIC - LOW VISION REHABILITATION CENTER - MUSCULAR DYSTROPHY ASSOCIATION NEUROMUSCULAR CLINIC - PACIFIC VISION FOUNDATION - PALLIATIVE CARE PROGRAM - PEDIATRIC SPECIALTY SERVICES - REHABILITATION SERVICES (ACUTE AND OUTPATIENT) - SIBLING CENTER - SMITH KETTLEWELL EYE RESEARCH INSTITUTE (THEY ARE INDEPENDENT OF CPMC.) - SUB-ACUTE CARE PROGRAM - TELEMEDICINE SERVICE (STROKE) - VISITING NURSES AND HOSPICE OF SAN FRANCISCO - WHITNEY NEWBORN ICU FOLLOW-UP CLINIC - WOMEN'S HEALTH RESOURCE CENTER - WOMEN'S SERVICES CLINICAL SERVICE OFFERINGS INCLUDE: - AIDS & HIV SERVICES - ALZHEIMER'S - ARTHRITIS - BARIATRIC SURGERY SERVICES - CANCER SERVICES - CARDIOVASCULAR SERVICES - CLINICAL LABORATORY - COMPLEMENTARY MEDICINE - COMPREHENSIVE STROKE SERVICES - CRITICAL CARE SERVICES - DIABETES SERVICES (ADULT & PEDIATRIC) - DIAGNOSTIC SERVICES/LABORATORIES - DIALYSIS SERVICES - EMERGENCY SERVICES - EPILEPSY - GASTROENTEROLOGY DISEASE SERVICES - HOME HEALTH & HOSPICE - INTERVENTIONAL ENDOSCOPY SERVICES - KALMONOVITZ CHILD DEVELOPMENT CENTERS - MEDICAL TRANSPORT SERVICES - MICROSURGERY AND LIMB SALVAGE SERVICES - NEONATAL INTENSIVE CARE - NEUROLOGY - NEURO-ONCOLOGY SURGERY - NUCLEAR MEDICINE - NUTRITION AND WEIGHT MANAGEMENT - OBSTETRICS & GYNECOLOGY - OCCUPATIONAL HEALTH - OPHTHALMOLOGY - ORGAN TRANSPLANTATION - ORTHOPEDICS - OTOLARYNGOLOGY - OUTPATIENT CLINICS & SERVICES - PATHOLOGY - PEDIATRIC EMERGENCY DEPARTMENT - PEDIATRIC SERVICES/PROGRAMS - PERIOPERATIVE SERVICES (OR AND POST-ANESTHESIA RECOVERY UNIT) - PHARMACY - PHYSICAL MEDICINE & REHABILITATION SERVICES - PSYCHIATRY - RADIOLOGY & DIAGNOSTIC IMAGING - RESPIRATORY CARE - RESIDENCY TRAINING AND FELLOWSHIP PROGRAMS - SURGICAL SERVICES/AMBULATORY SURGERY - URGENT CARE CENTER - VENTRICULAR ASSIST DEVICE (VAD) PROGRAM - WOMEN'S HEALTH PROGRAMS - WOUND CARE NON-CLINICAL SERVICES INCLUDE: - ADMINISTRATIVE SERVICES - CHAPLAINCY SERVICES - CHARITY CARE PROGRAM - COMMUNITY HEALTH RESOURCE CENTER - CONTINUING MEDICAL EDUCATION - INTERPRETER SERVICES - PATIENT SERVICES - RESEARCH INSTITUTE - SURGICAL TRAINING CENTER - VOLUNTEER SERVICES - WEB NURSERY - CALIFORNIA PACIFIC MEDICAL CENTER FOUNDATION - NOVATO COMMUNITY HOSPITAL DEVELOPMENT OFFICE - SUTTER LAKESIDE FOUNDATION FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS CONTINUED: COMMUNITY BENEFITS THE FOUR MEDICAL CENTERS IN SUTTER WEST BAY HOSPITALS (SWBH) PLAY INTEGRAL ROLES IN PROVIDING DIRECT HEALTH CARE SERVICES AS WELL AS MONETARY GRANTS OR SPONSORSHIPS TO NON-PROFIT ORGANIZATIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS OF VULNERABLE, UNDERINSURED, AND UNINSURED POPULATIONS IN THEIR COMMUNITIES. THE HOSPITALS COMMUNITY BENEFIT REPRESENTATIVES WORK COLLABORATIVELY AND IN PARTNERSHIPS WITH A BROAD AND DIVERSE NETWORK OF COMMUNITY-BASED NON-PROFITS, CITY AND COUNTY AGENCIES, PHYSICIANS, AND NEIGHBORHOOD GROUPS TO IDENTIFY LOCAL NEEDS, FORMULATE COMMUNITY BENEFIT PLANS, AND TAKE APPROPRIATE FUNDING ACTIONS. WHILE SUTTER WEST BAY REGIONAL MANAGEMENT SETS OVERALL GOALS FOR COMMUNITY BENEFITS, EACH OF THE AFFILIATES MEDICAL CENTER ADMINISTRATORS ARE RESPONSIBLE FOR IDENTIFYING HOW LOCAL NEEDS ARE TO BE ADDRESSED. IN FISCAL YEAR 2015, SUTTER WEST BAY HOSPITALS PROVIDED A REGIONAL TOTAL OF $144 MILLION IN COST OF SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED: $11.7 MILLION IN TRADITIONAL CHARITY CARE, $108 MILLION IN THE UNPAID COSTS OF MEDICAID, $6.2 MILLION IN COSTS FOR OTHER MEANS-TESTED PROGRAMS, AND $18.1 MILLION IN OTHER BENEFITS FOR THE POOR AND UNDERSERVED. IN ADDITION, SUTTER WEST BAY HOSPITALS PROVIDED AN ADDITIONAL $56.6 MILLION IN BENEFITS FOR THE BROADER COMMUNITY, FOR A TOTAL OF $200.6 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS. IN ADDITION, THE FOLLOWING ARE HIGHLIGHTS BY HOSPITAL OF QUANTIFIABLE COMMUNITY BENEFITS. CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) IN 2015, CPMC PROVIDED $129.8 MILLION IN COST OF SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED AND $40.7 MILLION IN BENEFITS TO THE BROADER COMMUNITY, FOR A TOTAL OF $170.5 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS. CPMC SUSTAINS ROBUST MEDICAL, NURSING, AND ALLIED HEALTH PROFESSIONS RESIDENCY PROGRAMS AS WELL AS A RESEARCH INSTITUTE THAT PROVIDES SIGNIFICANT COMMUNITY BENEFIT. CPMC SERVED 38,000 UNDUPLICATED MEDI-CAL AND CHARITY CARE PATIENTS IN 2015. CPMC IS A MEMBER OF THE SAN FRANCISCO CHARITY CARE PARTNERSHIP AND SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP (SFHIP) CONSORTIUMS LED BY THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH. THESE CONSORTIUMS CONSIST OF REPRESENTATIVES FROM ALL OF THE CITYS HOSPITALS AND OTHER HEALTHCARE-RELATED NON-PROFIT STAKEHOLDERS. CONSORTIUM MEMBERS CONDUCT A TRI-ANNUAL COMMUNITY NEEDS ASSESSMENT AS REQUIRED BY THE STATE AND FEDERAL GOVERNMENTS, AND COORDINATE EFFORTS TO ADDRESS THE CITYS HEALTH DISPARITIES IN SPECIFIC AT-RISK NEIGHBORHOODS OR VULNERABLE POPULATIONS. THE 2013-2015 COMMUNITY NEEDS ASSESSMENT IDENTIFIED THREE COMMUNITY HEALTH PRIORITIES; THESE PRIORITIES GUIDE CPMC'S COMMUNITY BENEFITS STRATEGY: 1. INCREASE ACCESS TO HIGH-QUALITY HEALTH CARE AND SERVICES CPMC MANAGES OR FUNDS MANY PROGRAMS FOCUSED ON IMPROVING ACCESS TO CARE, INCLUDING THE FOLLOWING: - ST. LUKES HEALTH CARE CENTER (ADULT, PEDIATRIC, AND WOMENS CLINICS) - KALMANOVITZ CHILD DEVELOPMENT CENTER (COMPREHENSIVE DEVELOPMENTAL ASSESSMENT AND TREATMENT PROGRAMS FOR INFANTS, PRESCHOOLERS, SCHOOL-AGE CHILDREN, AND FAMILIES) - BAYVIEW CHILD HEALTH CENTER (PRIMARY CARE FOR LOW-INCOME CHILDREN) - AFRICAN AMERICAN AND SISTER TO SISTER BREAST HEALTH PROGRAMS, AND ST. LUKES BREAST HEALTH PARTNERSHIPS (CANCER SCREENING AND PREVENTION) - COMING HOME HOSPICE (24-HOUR CARE FOR TERMINALLY ILL CLIENTS AND THEIR FAMILIES REGARDLESS OF ABILITY TO PAY) - JOINT VENTURE HEALTH (DEVELOPMENTAL SERVICES FOR CHILDREN AT THE CLINICS WHERE THEY RECEIVE PRIMARY CARE, SUCH AS NORTH EAST MEDICAL SERVICES) - MANAGED MEDI-CAL PARTNERSHIP WITH NORTH EAST MEDICAL SERVICES (PROVIDE AND TAKE RISK FOR INPATIENT AND SELECT OUTPATIENT SERVICES FOR ALMOST 32,000 MEDI-CAL AND HEALTHY KIDS MEMBERS) - HEALTHY SAN FRANCISCO (PROVIDE FREE HOSPITALIZATION AND SELECT SPECIALTY CARE TO HSF PARTICIPANTS WHO ARE ENROLLED IN NORTH EAST MEDICAL SERVICES OR BROWN & TOLAND AS THEIR MEDICAL HOME) - LIONS EYE CLINIC (OUTPATIENT COMPLEX EYE SERVICES FOR LOW-INCOME INDIVIDUALS) - OPERATION ACCESS (FREE DIAGNOSTIC SCREENINGS, SPECIALTY PROCEDURES, AND SURGICAL CARE TO LOW-INCOME UNINSURED) - PROJECT HOMELESS CONNECT (MEDICAL AND SOCIAL SERVICES TO THE HOMELESS) - SAN FRANCISCO GENERAL HOSPITAL DIAGNOSTICS (FREE ECHOCARDIOGRAMS AND OTHER DIAGNOSTIC SCREENINGS PROVIDED TO LOW-INCOME OR UNINSURED SFGH PATIENTS) 2. INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY CPMC MANAGES OR FUNDS PROGRAMS THAT AIM TO INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY AMONG LOW-INCOME POPULATIONS, INCLUDING THE FOLLOWING: - HEALTHFIRST: A CENTER FOR PREVENTION AND EDUCATION (MANAGEMENT OF CHRONIC DISEASES SUCH AS DIABETES THROUGH NUTRITION EDUCATION AND LIFESTYLE CHANGES) - COMMUNITY-BASED SERVICES FOR YOUTH THAT FOCUS ON HEALTHY LIFESTYLES, SUCH AS BAYVIEW CHILD HEALTH CENTERS NUTRITION SERVICES, WILLIAM MCKINLEY ELEMENTARY SCHOOLS NOON HOUR WELLNESS PROGRAM, AND DE MARILLAC ACADEMYS HEALTH CHAMPIONS PROGRAM 3. ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS CPMCS COMMUNITY HEALTH GRANTS AND SPONSORSHIPS PROGRAM SUPPORT ORGANIZATIONS THAT PROMOTE SAFE AND HEALTHY LIVING ENVIRONMENTS, INCLUDING THE FOLLOWING: - APA FAMILY SUPPORT SERVICES (SUPPORT SERVICES TO ASIAN/PACIFIC ISLANDER CHILDREN AND FAMILIES TO PREVENT CHILD ABUSE AND DOMESTIC VIOLENCE) - THE CENTER FOR YOUTH WELLNESS (TRAUMA-INFORMED PEDIATRIC CARE THAT ADDRESSES THE ROOT CAUSES OF POOR HEALTH OUTCOMES FOR CHILDREN AND YOUTH IN HIGH-RISK COMMUNITIES) - CHINATOWN COMMUNITY DEVELOPMENT CENTER (NEIGHBORHOOD ADVOCATES, COMMUNITY ORGANIZERS, PLANNERS, DEVELOPERS, AND MANAGERS OF AFFORDABLE HOUSING) - SAN FRANCISCO CHILD ABUSE PREVENTION CENTER AND THE CHILD ADVOCACY CENTER (SUPPORTIVE SERVICES TO CHILDREN AND FAMILIES; EDUCATION FOR CHILDREN, CAREGIVERS AND SERVICE PROVIDERS; AND ADVOCACY FOR SYSTEMS IMPROVEMENT AND COORDINATION) - KIMOCHI (JAPANESE LANGUAGE-BASED SERVICES FOR SENIORS, INCLUDING IN-HOME SUPPORT SERVICES, TRANSPORTATION, SOCIAL SERVICES, RESIDENTIAL/RESPITE CARE, ADULT SOCIAL DAY CARE, AND MEALS PROGRAM) SUTTER SANTA ROSA REGIONAL HOSPITAL (SSRRH) SSRRH SERVES SONOMA COUNTY, AS WELL AS OTHER COUNTIES IN THE NORTH BAY. IN 2015, SSRRH PROVIDED $10.2 MILLION IN COST OF SERVICES AND BENEFITS FOR THE POOR AND UNDERSERVED AND $11.3 MILLION IN BENEFITS FOR THE BROADER COMMUNITY, FOR A TOTAL OF $21.5 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS. COMMUNITY COLLABORATION SSRRH IS AN ACTIVE PARTNER IN MANY INNOVATIVE AND IMPORTANT COMMUNITY COLLABORATIONS THAT SEEK TO DEVELOP ACTIONABLE STRATEGIES IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY, PARTICULARLY AROUND ACCESS TO HEALTH AND DENTAL CARE. BELOW IS A PARTIAL LIST OF WORKGROUPS AND PROGRAMS: - COVERED SONOMA - SONOMA HEALTH ALLIANCE - HEALTH ACTION - FLUORIDE ADVISORY COUNCIL - DENTAL HEALTH NETWORK - HEALTHCARE WORKFORCE DEVELOPMENT ROUNDTABLE - DRUG FREE BABIES - SONOMA COUNTY FLU CONSORTIUM - HEALTHCARE FOR THE HOMELESS TASKFORCE - NORTHERN CALIFORNIA CENTER FOR WELL BEING - AMERICAN HEART ASSOCIATION - MARCH OF DIMES - OPERATION ACCESS - ELSIE ALLEN HIGH SCHOOL COMPACT FOR SUCCESS COMMUNITY BENEFIT IMPLEMENTATION PLAN UPDATES THE 2014-2016 IMPLEMENTATION PLANS (UNDER THE NEW FEDERAL GUIDELINES OF THE AFFORDABLE CARE ACT) WAS COMPLETED IN DECEMBER OF 2013. THE PLAN AND 2015 UPDATES CAN BE FOUND AT WWW.SUTTERSANTAROSA.ORG/COMMUNITY NOVATO COMMUNITY HOSPITAL (NOVATO) NOVATO COMMUNITY HOSPITAL SERVES MARIN COUNTY, AS WELL AS PORTIONS OF SOUTHERN SONOMA COUNTY. IN 2015, NOVATO PROVIDED A TOTAL OF $6.2 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS. NOVATO IS A MEMBER OF THE HEALTHY MARIN PARTNERSHIP A COLLABORATION OF THE THREE MARIN HOSPITALS KAISER PERMANENTE SAN RAFAEL, MARIN GENERAL HOSPITAL, AND NOVATO COMMUNITY HOSPITAL. THE GROUP WAS INITIALLY FORMED 16 YEARS AGO TO RESPOND TO CALIFORNIA SB697, WHICH REQUIRES ALL NOT-FOR-PROFIT HOSPITALS TO CONDUCT A TRI-ANNUAL COMMUNITY NEEDS ASSESSMENT. 2012 WAS THE FIRST YEAR OF AN ACCOUNTABLE CARE ACT FEDERAL MANDATE THAT 501(C)(3) HOSPITALS CONDUCT A TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENT. NCH AGAIN WORKED WITH ITS HOSPITAL PARTNERS AND HMP TO COMPLETE THIS MORE PRESCRIPTIVE FEDERAL REQUIREMENT. THIS REPORT AND AN IMPLEMENTATION PLAN ARE FILED WITH THE IRS IN TAX YEAR 2014. THE HOSPITALS HAVE AGREED TO CONTINUE THIS RELATIONSHIP TO MAKE THE BEST USE OF THEIR COMMUNITY BENEFIT RESOURCES. NCH WILL FILE ANNUAL PROGRESS REPORTS ON THE 2014 PLAN IN 2015 AND 2016. FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS CONTINUED: SUTTER LAKESIDE HOSPITAL (LAKESIDE) IN 2015, LAKESIDE PROVIDED A TOTAL OF NEARLY $2.5 MILLION IN QUANTIFIABLE COMMUNITY BENEFITS. THE POPULATION SERVED INCLUDES A HIGH PERCENTAGE OF FAMILIES WHOSE LOW INCOME AFFECTS THEIR ACCESS TO HEALTH CARE. SUTTER LAKESIDE'S COMMUNITY BENEFITS STRATEGY INCLUDES PREVENTIVE CARE, CLINICAL EDUCATION, AND SUBSIDIZING HEALTH SERVICES. LAKESIDE PREVENTIVE CARE INCLUDES THE SPONSORING AND FUNDING OF PROGRAMS THAT PROVIDE FREE OR LOW-COST PREVENTIVE CARE SCREENINGS AND TESTS, SUCH AS MAMMOGRAMS AND SEASONAL FLU VACCINATIONS. LAKESIDES ROLE IN CLINICAL EDUCATION IS TO PROVIDE OPPORTUNITIES FOR STUDENTS FROM MULTIPLE CLINICAL PROGRAMS TO APPLY THEIR LEARNING UNDER THE GUIDANCE AND SUPERVISION OF LAKESIDES STAFF. FINALLY, LAKESIDE SUBSIDIZES THE OPERATING COSTS OF HEALTH SERVICES THAT ARE CRUCIAL TO THE HEALTH AND WELL-BEING OF THE COMMUNITY, INCLUDING; EMERGENCY DEPARTMENT, FAMILY MEDICINE CLINIC, SUTTER LAKESIDE COMMUNITY CLINIC, MOBILE HEALTH CLINIC, AND BIRTH CENTER. MAY 15, 2015, THE MOBILE HEALTH CLINIC WAS CLOSED AND THE VAN WAS DONATED TO CENTRAL VALLEY CHARITY, CHILDRENS CRISIS CENTER OF STANISLAUS COUNTY. CPMC RESEARCH INSTITUTE FOSTERING CLOSE COLLABORATIONS AMONG SCIENTISTS WITHIN THE SUTTER HEALTH SYSTEM AND AT PARTNERING INSTITUTIONS, THE CPMC RESEARCH INSTITUTE (CPMCRI) IS A UNIQUE CENTER FOR TRANSLATIONAL RESEARCH. OUR INVESTIGATORS TAKE A CROSS-DISCIPLINARY APPROACH TO DISCOVERY RESEARCH IN COMMON HUMAN ILLNESSES-TRANSFORMING LABORATORY FINDINGS INTO NEW DIAGNOSTICS, PERSONALIZED THERAPIES, AND SUCCESSFUL CLINICAL STUDIES. OVER 80 CLINICAL INVESTIGATORS AT CPMC AND ACROSS THE SUTTER WEST BAY AREA LEAD INNOVATIVE RESEARCH INTO COMMON, CHRONIC ILLNESSES THAT IMPACT MILLIONS OF AMERICANS. OUR INVESTIGATORS MERGE RESEARCH INSTITUTE INTERESTS WITH THE NEEDS OF OUR MEDICAL CENTERS, MAKING RESEARCH AN INTEGRAL FOUNDATION FOR IMPROVED PATIENT CARE. RESEARCH IS CONDUCTED IN BOTH BASIC SCIENCE AND THE CLINICAL SETTING, INCLUDING MOLECULAR BIOLOGISTS, IMMUNOLOGISTS, PHARMACOLOGISTS, BIOCHEMISTS, PHYSICISTS, EPIDEMIOLOGISTS, BEHAVIORAL SCIENTISTS, BIOSTATISTICIANS, PHYSICIANS AND COMPUTER SCIENTISTS WORK WITHIN THE RESEARCH INSTITUTE AND THE MEDICAL CENTER. INNOVATIVE BIOMEDICAL RESEARCH IS CONDUCTED IN SUCH DIVERSE AREAS AS AGING, ARTHRITIS, EPILEPSY, DIABETES, NEUROBIOLOGY OF PAIN, CARDIOVASCULAR DISEASE, OSTEOPOROSIS, ORGAN TRANSPLANTATION, NEURODEGENERATIVE DISEASES (E.G. AMYOTROPHIC LATERAL SCLEROSIS), CANCER, AIDS, HEPATITIS AND OTHER INFECTIOUS DISEASES. SOME OF THESE SCIENTISTS ARE ENGAGED IN RESEARCH THAT WILL HELP US UNDERSTAND THE FUNCTION OF CERTAIN HUMAN CELLS, GENES, PROTEINS AND OTHER FUNDAMENTAL STRUCTURES WITHIN OUR BODIES. LARGE MULTI-CENTER STUDIES IN WOMEN'S HEALTH, AGING, COGNITIVE FUNCTION, CARDIOVASCULAR DISEASE, BREAST CANCER PREVENTION, OSTEOPOROSIS, AND ARTHRITIS INITIATED AT CPMCRI IN PARTNERSHIP WITH THE SAN FRANCISCO COORDINATING CENTER HAVE SIGNIFICANTLY ADVANCED RESEARCH INTO COMMON, CHRONIC ILLNESSES. OUR STUDIES ON LONGEVITY HAVE ACCUMULATED THE LARGEST, RICHEST DATASETS ABOUT AGING IN THE U.S. LARGE-COHORT STUDIES IN OSTEOPOROSIS AND BREAST CANCER HAVE YIELDED SOME OF THE MOST POWERFUL DATASETS IN THE U.S. TO HELP IMPROVE THE TREATMENT OF THESE ILLNESSES. OVER 200 CLINICAL TRIALS, SPONSORED BY PHARMACEUTICAL, BIOTECHNOLOGY AND THE NATIONAL CANCER INSTITUTE, ARE CURRENTLY CONDUCTED AT THE MEDICAL CENTER AND AFFILIATED SUTTER PACIFIC MEDICAL FOUNDATION CLINICS THROUGH THE CPMCRI OFFICE OF CLINICAL RESEARCH. OUR SCIENTISTS RECEIVED MORE THAN $16 MILLION IN RESEARCH FUNDING IN 2015. ONE OF OUR KEY PRIORITIES LIES IN TRAINING THE NEXT GENERATION OF CLINICIAN-SCIENTISTS. CPMCRI OFFERS RESOURCES FOR RESIDENTS AND FELLOWS AT CPMC WHO ARE MOTIVATED TO GAIN RESEARCH EXPERIENCE AND TRAINING, INCLUDING OPPORTUNITIES TO DESIGN AND CONDUCT THEIR OWN RESEARCH PROJECTS WITH CPMCRI CLINICAL AND BASIC SCIENCE RESEARCH FACULTY. OUR BASIC SCIENCE DISCOVERY LABS ALSO OFFER POST-DOCTORAL FELLOWSHIP TRAINING, AND CAN PROVIDE A MENTORED RESEARCH EXPERIENCE FOR VOLUNTEERS WHO WISH TO PURSUE A CAREER IN BASIC SCIENCE. HEALTH EDUCATION AND TRAINING TWO OF THE FOUR SUTTER WEST BAY HOSPITALS HAVE FORMAL HEALTH EDUCATION AND TRAINING PROGRAMS. SUTTER SANTA ROSA REGIONAL HOSPITAL ESTABLISHED ITS FAMILY MEDICINE TRAINING PROGRAM IN 1938. THE SANTA ROSA FAMILY MEDICINE RESIDENCY IS A CRITICAL STRATEGIC HEALTHCARE ASSET THAT ADDRESSES THE GROWING PHYSICIAN SHORTAGE IN SONOMA COUNTY. THE RESIDENCY HAS BEEN THE LARGEST SINGLE SOURCE OF FAMILY PHYSICIANS TO SONOMA COUNTY FOR OVER 80 YEARS; RESIDENCY GRADUATES COMPRISE NEARLY HALF OF FAMILY PHYSICIANS IN SONOMA COUNTY. RESIDENCY GRADUATES FILL POSITIONS IN PRIVATE PRACTICES, COMMUNITY CLINICS, AND LARGE MEDICAL GROUPS SUCH AS SUTTER MEDICAL GROUP OF THE REDWOODS, THE PERMANENTE MEDICAL GROUP, LOCAL COMMUNITY HEALTH CENTERS, AND SONOMA COUNTY HEALTH SERVICES AND LEADERSHIP POSITIONS THROUGHOUT THE MEDICAL COMMUNITY. THE THREE-YEAR PROGRAM IS AFFILIATED WITH THE UCSF DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE. CALIFORNIA PACIFIC MEDICAL CENTER PROVIDES A MODEL OF SPECIALTY CARE BY BLENDING EXCELLENCE IN ACADEMICS AND RESEARCH WITH A FOCUS ON PATIENT-CENTERED CARE. CPMC IS A MAJOR TEACHING AFFILIATE OF THE GEISEL SCHOOL OF MEDICINE AT DARTMOUTH (FORMERLY DARTMOUTH MEDICAL SCHOOL), PROVIDING CORE CLERKSHIPS IN INTERNAL MEDICINE, PSYCHIATRY, NEUROLOGY, FAMILY MEDICINE, PEDIATRICS AND OBSTETRICS-GYNECOLOGY. ADDITIONAL CORE CLERKSHIPS IN SURGERY AND OBSTETRICS-GYNECOLOGY ARE PROVIDED FOR MEDICAL STUDENTS FROM UCSF. MEDICAL STUDENTS FROM OTHER PRESTIGIOUS SCHOOLS ARE GRANTED A RANGE OF FINAL-YEAR ELECTIVES AND SUB-INTERNSHIPS IN DEPARTMENTS WHICH SPONSOR RESIDENCIES HERE. THE GRADUATE MEDICAL EDUCATION TRAINING PROGRAMS OFFERED AT CPMC ARE OF THE HIGHEST CALIBER WITH CPMCS PHYSICIANS EMBRACING THE ROLE OF EDUCATORS AS WELL AS CLINICIANS. RESIDENCIES AND FELLOWSHIPS EDUCATE PHYSICIANS IN SPECIFIC SPECIALTIES. CPMC HAS INDEPENDENT RESIDENCY AND FELLOWSHIP PROGRAMS IN INTERNAL MEDICINE, PSYCHIATRY, RADIATION ONCOLOGY, OPHTHALMOLOGY, CARDIOVASCULAR DISEASES, GASTROENTEROLOGY, PULMONARY/CRITICAL CARE MEDICINE, HEPATOLOGY/TRANSPLANT, ENDOCRINOLOGY, HAND SURGERY, KIDNEY TRANSPLANT, NEUROCRITICAL CARE, MRI, RETINA, OCULOPLASTIC SURGERY, MELANOMA SURGERY, AND SHOULDER SURGERY. CPMC ALSO OFFERS TRAINING IN SURGERY, ORTHOPEDIC SURGERY, AND PLASTIC SURGERY TO UCSF RESIDENTS. IN ADDITION, CPMC IS A TRAINING SITE FOR OPERATING ROOM NURSING STUDENTS, PHYSICIAN ASSISTANT STUDENTS, OCCUPATIONAL THERAPISTS, PHYSICAL THERAPISTS AND SURGICAL TECHNOLOGISTS. IN ADDITION TO THE AFOREMENTIONED EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS (UNDERGRADUATE MEDICAL EDUCATION) AND RESIDENTS/FELLOWS (GRADUATE MEDICAL EDUCATION), CPMC PROVIDES AN EXTENSIVE SELECTION OF CONTINUING MEDICAL EDUCATION THROUGH ITS NUMEROUS CONFERENCES FOR PHYSICIANS IN PRACTICE. CPMCS PHYSICIANS ALSO PROVIDE OUTREACH PROGRAMS IN CONTINUING MEDICAL EDUCATION LOCALLY, REGIONALLY, AND NATIONALLY. FORM 990, PART VI, LINE 1A THE AFFAIRS AND MANAGEMENT OF SUTTER WEST BAY HOSPITALS (SWBH) ARE SUPERVISED BY THE EXECUTIVE COMMITTEE WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF SWBH DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE CONSISTS OF SWBH'S CHAIR WHO SERVES AS CHAIR OF THE COMMITTEE, THE VICE CHAIR, THE CHAIR OF THE FINANCE AND PLANNING COMMITTEE, THE PRESIDENT OF SWBH AND UP TO NINE ADDITIONAL DIRECTORS. AT LEAST ONE COMMITTEE MEMBER IS A PHYSICIAN DIRECTOR. FORM 990, PART VI, LINE 4 BOARD COMPOSITION CHANGES FORMER: THE BOARD OF DIRECTORS SHALL CONSIST OF BETWEEN 5 AND 20 DIRECTORS. REVISED: THE BOARD OF DIRECTORS SHALL CONSIST OF BETWEEN 17 AND 25 DIRECTORS. FORMER: AT LEAST 3 PHYSICIANS SHALL BE MEMBERS OF THE BOARD. REVISED: BETWEEN 3 AND 8 PHYSICIANS SHALL BE MEMBERS OF THE BOARD. FORMER: A MAJORITY OF THE MEMBERS OF THE BOARD SHALL BE BROADLY REPRESENTATIVE OF THE AREAS SERVED BY THE CORPORATION. REVISED: BETWEEN 11 AND 14 INDIVIDUALS FROM THE COMMUNITY SHALL BE NOMINATED BY THE BOARD OF THE CORPORATION AND APPOINTED BY THE GENERAL MEMBER. THESE INDIVIDUALS SHOULD TOGETHER REFLECT A BREADTH OF DIVERSITY AND BE CHOSEN FOR THEIR WILLINGNESS AND ABILITY TO EFFECTIVELY CONTRIBUTE TO AND SUPPORT THE OBJECTIVES OF THE CORPORATION AND THE GENERAL MEMBER. FORMER: NO APPOINTED DIRECTOR MAY SERVE FOR MORE THAN NINE (9) CONSECUTIVE YEARS. REVISED: NO APPOINTED DIRECTOR MAY SERVE FOR MORE THAN TEN (10) CONSECUTIVE YEARS. FORM 990, PART VI, LINES 6 & 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS: THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B DESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS: SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: A. MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; B. AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; C. ADOPTION OF OPERATING BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY, INCLUDING CONSOLIDATED OR COMBINED BUDGETS OF THE CORPORATION AND ALL SUBSIDIARY ORGANIZATIONS OF THE CORPORATION; D. ADOPTION OF CAPITAL BUDGETS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; E. AGGREGATE OPERATING OR CAPITAL EXPENDITURES ON AN ANNUAL BASIS THAT EXCEED APPROVED OPERATING OR CAPITAL BUDGETS BY A SPECIFIED DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE GENERAL MEMBER; F. LONG-TERM OR MATERIAL AGREEMENTS INCLUDING, BUT NOT LIMITED TO, BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS; AND PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A FAIR MARKET VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE DETERMINED FROM TIME TO TIME BY THE DIRECTORS OF THE GENERAL MEMBER, WHICH SHALL NOT BE LESS THAN 10% OF THE TOTAL ANNUAL CAPITAL BUDGET OF THE CORPORATION; G. APPOINTMENT OF AN INDEPENDENT AUDITOR AND HIRING OF INDEPENDENT COUNSEL EXCEPT IN CONFLICT SITUATIONS BETWEEN THE GENERAL MEMBER AND THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; H. THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE ENTITY; I. CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL OR SUBSTANTIALLY ALL OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; J. APPROVAL OF MAJOR NEW PROGRAMS AND CLINICAL SERVICES OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. THE GENERAL MEMBER SHALL FROM TIME TO TIME DEFINE THE TERM "MAJOR" IN THIS CONTEXT; K. APPROVAL OF STRATEGIC PLANS OF THE CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY; L. ADOPTION OF QUALITY ASSURANCE POLICIES NOT IN CONFORMITY WITH POLICIES ESTABLISHED BY THE GENERAL MEMBER; M. ANY TRANSACTION BETWEEN THE CORPORATION, A SUBSIDIARY OR AFFILIATE AND A DIRECTOR OF THE CORPORATION OR AN AFFILIATE OF SUCH DIRECTOR. IN ADDITION, THE GENERAL MEMBER SHALL HAVE THE AUTHORITY (BY A VOTE OF NOT LESS THAN TWO-THIRDS (2/3) OF ITS BOARD), TO DECLARE A MAJOR ACTIVITY REQUIRING APPROVAL. FORM 990, PART VI, LINE 11B DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW FORM 990: SUTTER HEALTH, A RELATED TAX-EXEMPT ORGANIZATION, HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. FORM 990, PART VI, LINE 12 DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST: EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION. FORM 990, PART VI, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY LEADERS OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES. THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN DECEMBER OF 2015. FORM 990, PART VI, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO GENERAL PUBLIC: THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART XI, LINE 9 OTHER CHANGES IN FUND BALANCE: EQUITY TRANSFERS (NET) 160,000,127 PARTNERSHIP INCOME BOOKED ON RETURN 13,558,631 K-1 ORDINARY INCOME (12,961,403) K-1 INTEREST INCOME (19,498) K-1 ORDINARY DIVIDENDS (29,342) K-1 SHORT TERM CAPITAL GAIN (6,851) K-1 LONG TERM CAPITAL GAIN (254,398) K-1 SECTION 1231 GAIN (10,208) K-1 RENTAL INCOME (128,468) K-1 1250 GAIN (38) K-1 ROYALTY INCOME (6,035) K-1 OTHER INCOME (3,309) PRIOR PERIOD ADJ 7,981 OTHER ADJ TO BEG BALANCE 39,652 ------------ 160,186,868 CATHEDRAL HEIGHTS LLC PO BOX 7999 SAN FRANCISCO CA 94120 200511266 RENTAL PROP. CA 0 716321 N/A ADOLESCENT TREATMENT CENTERS INC C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 680088443 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true BETTER HEALTH EAST BAY FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 510160184 FUNDRAISING CA 501(C)(3) 7 SUTTER EBH true CALIFORNIA PACIFIC MEDICAL CTR FOUND C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942728423 FUNDRAISING CA 501(C)(3) 7 SUTTER WBH true EAST BAY PERINATAL CENTER 3012 SUMMIT STREET 3RD FLOOR OAKLAND CA 94609 510172285 HEALTHCARE CA 501(C)(3) 3 SUTTER EBH true EDEN MEDICAL CENTER C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942948100 HEALTHCARE CA 501(C)(3) 9 SUTTER HLTH true MEMORIAL HOSPITAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942290244 FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH true MILLS-PENINSULA HEALTH SERVICES C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 941156265 HOSPITAL CA 501(C)(3) 3 PAMF true MILLS-PENINSULA HOSPITAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 237288765 FUNDRAISING CA 501(C)(3) 7 MPHS true PALO ALTO MEDICAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 941156581 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SAMUEL MERRITT UNIVERSITY 450 30TH STEET SUITE 2820 OAKLAND CA 94609 942992642 UNIVERSITY CA 501(C)(3) 2 SUTTER EBH true SUTTER AUBURN FAITH HOSPITAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942594966 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER CENTRAL VALLEY HOSPITALS C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 941080917 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER COAST HOSPITAL C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942988520 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER DAVIS HOSPITAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 680217870 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER EAST BAY HOSPITALS C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 941196176 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER EAST BAY MEDICAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942690415 HEALTHCARE CA 501(C)(3) 11B-II SUTTER HLTH true SUTTER GOULD MEDICAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 941682256 HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH true SUTTER HEALTH C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942788907 SUPPORTING OR CA 501(C)(3) 11c III-FI NA false SUTTER HEALTH PACIFIC 91-2301 FORT WEAVER ROAD EWA BEACH HI 96706 990298651 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER HEALTH PLAN C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 461183948 HEALTH PLAN CA PENDING PENDING SUTTER HLTH true SUTTER HEALTH SACRAMENTO SIERRA REGION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 941156621 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER INSURANCE SERVICES CORPORATION 745 FORT STREET SUITE 1100 HONOLULU HI 96813 990289310 INSURANCE SVS HI 501(C)(3) 11C III-FI SUTTER HLTH true SUTTER MEDICAL CENTER FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 942788906 FUNDRAISING CA 501(C)(3) 7 SUTTER SSR true SUTTER MEDICAL CENTER CASTRO VALLEY C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 770146047 HOSPITAL CA 501(C)(3) 3 SUTTER HLTH true SUTTER VALLEY MEDICAL FOUNDATION C/O SH Tax 2200 River Plaza Drive SACRAMENTO CA 95833 680273974 HEALTHCARE CA 501(C)(3) 11b - 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