2012-08-09T13:27:12-05:00 2011-09-30 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2010-10-01 910564748 SEATTLE CHILDREN'S HOSPITAL SEAT 2069874846 PO BOX 5371 MS RC-507 SEATTLE WA 981455005 KELLY A WALLACE 2069874846 2012-08-08 1 JANE M SEARING 4254544919 2010 2016-02-24 21:20:13Z THOMAS HANSEN MD PO BOX 5371 MS RC-507 SEATTLE WA 981455005 1032614625 0 X WWW.SEATTLECHILDRENS.ORG X 1907 WA AT SEATTLE CHILDREN'S HOSPITAL, WE WILL PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. 23 21 5309 851 2075272 552155 91110848 109050088 665004815 717569080 9760859 32753835 3415575 4554899 769292097 863927902 1951531 4468797 0 0 348135636 382749549 0 0 0 363344028 397743508 713431195 784961854 55860902 78966048 1511039931 1603702328 662376562 695794835 848663369 907907493 X AT SEATTLE CHILDREN'S HOSPITAL, WE BELIEVE ALL CHILDREN HAVE UNIQUE NEEDS AND SHOULD GROW UP WITHOUT ILLNESS OR INJURY. WITH THE SUPPORT OF THE COMMUNITY AND THROUGH OUR SPIRIT OF INQUIRY, WE WILL PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. (SEE THE COMMUNITY BENEFIT REPORT IN SCHEDULE O.) 0 0 617444998 4432797 711109760 PATIENT CARE: SEATTLE CHILDREN'S HOSPITAL PROVIDES SUPERIOR MEDICAL CARE TO CHILDREN FROM WASHINGTON, ALASKA, MONTANA AND IDAHO, SERVING THE LARGEST GEOGRAPHICAL AREA OF ANY CHILDREN'S HOSPITAL IN THE UNITED STATES. IN ADDITION, FAMILIES LIVING BEYOND OUR PRIMARY SERVICE REGION INCREASINGLY SEEK CARE FROM OUR WORLD-RENOWNED SPECIALISTS IN PROGRAMS SUCH AS CANCER, ORGAN TRANSPLANTS AND CRANIOFACIAL SPECIALTIES. IN FISCAL YEAR 2011, CHILDREN'S MEDICAL TEAM TREATED KIDS OF ALL AGES DURING 323,292 PATIENT VISITS, INCLUDING 14,118 ADMISSIONS TO THE HOSPITAL AND 36,200 VISITS TO OUR EMERGENCY ROOM. WE PERFORMED 12,714 DAY SURGERIES AND CARED FOR CHILDREN DURING 260,260 APPOINTMENTS IN OUTPATIENT CLINICS. 91221860 36000 4852991 RESEARCH: BECAUSE RESEARCH IS THE FOUNDATION OF SEATTLE CHILDREN'S MISSION TO PREVENT, TREAT, AND ELIMINATE PEDIATRIC DISEASE, SEATTLE CHILDREN'S HOSPITAL INVESTED $25.5 MILLION IN RESEARCH DURING FISCAL YEAR 2011. SEATTLE CHILDREN'S INVESTIGATORS ARE ADVANCING SCIENTIFIC UNDERSTANDING OF IMPORTANT BIOLOGICAL PROCESSES AND INFLUENCING THE PRACTICE OF PEDIATRICS AROUND THE WORLD. 21947577 1606329 EDUCATION: SEATTLE CHILDREN'S HOSPITAL IS THE MAJOR RESOURCE FOR PEDIATRIC GRADUATE MEDICAL EDUCATION PROGRAMS IN OUR REGION. RESIDENTS AND FELLOWS FROM 75 PROGRAMS ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) PLUS 3 PROGRAMS ACCREDITED BY THE AMERICAN DENTAL ASSOCIATION (ADA) HAD RESIDENTS OR FELLOWS AT SEATTLE CHILDREN'S HOSPITAL IN ACADEMIC YEAR 2011. SEATTLE CHILDREN'S HAS DEVELOPED CURRICULUM AND EVALUATION METHODS THAT ASSESS AND ASSURE RESIDENT COMPETENCY IN SIX MAIN AREAS: PATIENT CARE, MEDICAL KNOWLEDGE, PRACTICE-BASED LEARNING, INTERPERSONAL AND COMMUNICATIONS SKILLS, PROFESSIONALISM, AND SYSTEM-BASED PRACTICE. 730614435 1 1 0 1 1 0 0 0 1 1 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 1 533 0 1 5309 1 1 1 0 0 0 0 0 0 0 0 0 X 23 21 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X WARREN E HEWITT VP FINANCE 2069874846 4300 ROOSEVELT WAY NE 5TH FLOOR SEATTLE WA 981054718 X DEAN ALLEN 4.00 X 0 0 0 RHODA ALTOM 3.00 X X 0 0 0 LIBBY ARMINTROUT 1.00 X 0 0 0 ROBB BAKEMEIER 8.00 X 0 0 0 JOEL BENOLIEL 2.00 X 0 0 0 JANE BLAIR 2.50 X 0 0 0 ROSS BOGUE 1.00 X 0 0 0 PAT CHAR 3.00 X 0 0 0 NANCY DALY 2.00 X 0 0 0 MICHAEL DELMAN 4.00 X X 0 0 0 BOB FLOWERS 2.00 X X 0 0 0 MARY ANN FLYNN 6.00 X 0 0 0 GENIE HIGGINS 4.00 X 0 0 0 JUDY HOLDER 3.00 X 0 0 0 CYNTHIA HUFFMAN 4.00 X X 0 0 0 CILLA JOONDEPH 5.00 X 0 0 0 JIM LADD 5.00 X X 0 0 0 SANDRA MADRID 1.00 X 0 0 0 CINDY MASIN 3.00 X 0 0 0 SUSAN MASK 4.00 X 0 0 0 RESA MOORE 4.00 X 0 0 0 JEFF NITTA 5.00 X 0 0 0 GLORIA NORTHCROFT 2.00 X 0 0 0 LAURIE OKI 3.00 X 0 0 0 ROB ROSKIN MD 2.00 X 0 0 0 NANCY SENSENEY 5.00 X 0 0 0 PETE SHIMER 2.00 X 0 0 0 JAN SINEGAL 10.00 X X 0 0 0 MICHELE SMITH 2.00 X 0 0 0 CHARLES STEVENS 2.00 X 0 0 0 THOMAS HANSEN MD 27.50 X 569477 569476 224724 KELLY WALLACE 41.00 X 430470 143490 125090 PATRICK HAGAN 50.00 X 594413 66046 210140 DAVID FISHER MD 50.00 X 630665 70074 119347 DREXEL DEFORD 55.00 X 560986 0 95445 SANFORD MELZER MD 41.00 X 302399 221963 122555 JAMES HENDRICKS MD 55.00 X 418569 0 81991 LISA BRANDENBURG 55.00 X 480574 0 90263 JEFFREY SCONYERS 28.00 X 209729 209728 81629 EDWIN WRIGHT 55.00 X 406983 0 35742 SUSAN HEATH 55.00 X 359442 0 65453 SUZANNE PETERSEN 55.00 X 294216 0 40716 STEVEN HURWITZ 55.00 X 313576 0 33752 CARA BAILEY 55.00 X 298446 0 23897 ERIK LAUSUND 55.00 X 278049 0 28330 JENNIFER ABERMANIS 55.00 X 275109 0 39765 CINDY EVANS 55.00 X 322662 0 31833 DAVID PERRY 55.00 X 275506 0 34678 WARREN HEWITT 55.00 X 259595 0 30199 JUDITH DOUGHERTY 55.00 X 273352 0 31325 TODD JOHNSON 55.00 X 277446 0 28133 CHARLES HODGE 55.00 X 250974 0 32583 DAVID BRAUNER 55.00 X 499766 0 29393 DOUGLAS PICHA 5.50 X 41638 374734 76174 JOE RUTLEDGE 55.00 X 368257 0 28094 ANNE MANKTELOW 55.00 X 366662 0 15892 DONA BREKKE 55.00 X 352521 0 16852 9711482 1655511 1773995 476 0 1 0 CHILDREN'S UNIVERSITY MEDICAL GROUP PO BOX 50010 SEATTLE WA 98105 PHYSICIAN SERVICES 56266011 UNIVERSITY OF WASHINGTON PO BOX 358220 SEATTLE WA 98195 RESIDENTS & INTERNS 27132985 SELLEN CONSTRUCTION 227 WESTLAKE AVENUE NORTH SEATTLE WA 98109 CONSTRUCTION 23060515 PUGET SOUND BLOOD CENTER 921 TERRY AVENUE SEATTLE WA 98104 BLOOD PROCESSING 8498375 DENALI ADVANCED INTEGRATION 17735 NE 65TH STREET SUITE 130 REDMOND WA 98052 IT CONSULTING 5828187 188 41672323 64854712 2523053 382342 109050088 PATIENT SVC REVENUES 621500 707937443 707937443 OTHER HEALTHCARE SVCS 621500 8336196 4817265 2075272 1443659 INVESTMENT PROV CHILD 621500 654500 654500 WHALE GIFT SHOP 453220 640941 640941 717569080 28611737 28611737 169308481 3520340 165497353 3189370 3811128 330970 4142098 4142098 CAFETERIA 722212 2678257 2678257 PARKING 812930 1866300 1866300 MISCELLANEOUS 900099 10342 10342 4554899 863927902 713409208 2075272 39393334 4468797 4468797 9742032 9742032 295121188 276079640 19041548 14648660 13703512 945148 41980624 39271987 2708637 21257045 19885517 1371528 1972678 1845399 127279 305675 285953 19722 267015 267015 388994 363896 25098 64331912 60181145 4150767 2607749 2439494 168255 98677433 92310655 6366778 7721185 7223006 498179 17299393 16183217 1116176 2821978 2639901 182077 1736760 1624702 112058 23109066 21618043 1491023 55959769 52349182 3610587 2388113 2234029 154084 PHYSICIANS SERVICES 78968204 78968204 LICENSES & TAXES 27228756 25471926 1756830 MISCELLANEOUS 10128084 9474608 653476 BANK FEES 1644994 1538857 106137 UBI TAXES 185750 185750 784961854 730614435 54347419 0 98291775 185075395 4636194 4650912 117245201 107695722 62541 64752 8018233 8349144 8059537 7378119 1140207151 401038189 722548130 739168962 434225414 447000132 30215001 28369501 87737905 75949689 1511039931 1603702328 92082997 126024567 479128486 474772627 28331863 29856758 62833216 65140883 662376562 695794835 X 641866237 693079002 56086551 61713507 150710581 153114984 848663369 907907493 1511039931 1603702328 X 78966048 -19721924 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 267015 267015 783172722 783439737 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 301403 310524 247092 267015 1126034 250000 250000 250000 250000 1000000 1500000 3 31200 35580 748782 1 1 250467000 2576000 2474000 5541000 249976000 224924000 2946000 27782000 5185000 250467000 221932000 8002000 -179000 4831000 224924000 0.48300 0.47500 0.04200 0 1 1 163751776 163751776 581262323 178710804 402551519 10760012 4440879 6319133 317589947 214910338 102679609 66843093 2976168 63866925 739168962 SWAP MTM VALUE - SERIES 2006A & B 27971966 PAYABLE TO SCHS - STEWART PLACE 21021249 DEFERRED COMPENSATION PLAN PAYABLE 6087288 DEFERRED AND OTHER LIABILITIES 9278402 CAPITAL LEASE OBLIGATION 781978 65140883 863927902 784961854 78966048 -25807114 6085190 -19721924 59244124 836072605 -7017562 -7017562 843090167 388994 20448741 20837735 863927902 787554690 2981830 2981830 784572860 388994 388994 784961854 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) AND SEATTLE CHILDREN'S HOSPITAL (SCH) SHARE IN A UNIFIED ENDOWMENT FUND (UEF) THAT IS MANAGED BY SCHS. SEATTLE CHILDREN'S HOSPITAL'S TEMPORARILY AND PERMANENTLY RESTRICTED ASSETS REFLECT ENDOWMENTS WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN SCHS -672,399. RESTRICTED GRANTS AND DONATIONS 36,893,177. NET ASSETS RELEASED FROM RESTRICTION -30,135,588. PART XII, LINE 4B - OTHER ADJUSTMENTS: NET INVESTMENT INCOME 23,430,571. PROVISION FOR BAD DEBT -2,981,830. PART XIII, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 2,981,830. EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES ATTENDED LEADERSHIP TRAINING IN JAPAN ON CONTINUOUS PROCESS IMPROVEMENTS 132732 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TEACHING IN KENYA - PEDIATRIC RESIDENCY GLOBAL TRACK PROGRAM 59620 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES DEVELOPMENT OF GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH PROGRAM 327219 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES DEVELOPMENT OF GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH PROGRAM 38471 SOUTH ASIA 0 0 PROGRAM SERVICES DEVELOPMENT OF GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH PROGRAM 21621 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES DEVELOPMENT OF GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH PROGRAM 2892 NORTH AMERICA 0 0 PROGRAM SERVICES DEVELOPMENT OF GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH PROGRAM 814 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES INTERNATIONAL TRAVEL TO MEDICAL CONFERENCES 84249 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES INTERNATIONAL TRAVEL TO MEDICAL CONFERENCES 48028 NORTH AMERICA 0 0 PROGRAM SERVICES INTERNATIONAL TRAVEL TO MEDICAL CONFERENCES 27292 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES INTERNATIONAL TRAVEL TO MEDICAL CONFERENCES 19340 SOUTH AMERICA 0 0 PROGRAM SERVICES INTERNATIONAL TRAVEL TO MEDICAL CONFERENCES 9736 SOUTH ASIA 0 0 PROGRAM SERVICES INTERNATIONAL TRAVEL TO MEDICAL CONFERENCES 1599 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES MEDICAL SERVICES 14262 SOUTH AMERICA 0 0 PROGRAM SERVICES MEDICAL SERVICES 2438 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES MEDICAL SERVICES 615 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES EFFORTS FOR THE PREVENTION OF AIDS 22216 0 0 0 0 0 0 667618 145526 813144 1 0 0 0 0 0 METHOD USED TO ACCCOUNT FOR EXPENDITURES: SCHEDULE F, PART I, LINE 3: THE ACCRUAL METHOD WAS USED TO ACCOUNT FOR EXPENDITURES. OTHER INFORMATION SCHEDULE F, PART V SCHEDULE F, PART IV, LINE 1: FORM 926 IS NOT REQUIRED TO BE FILED BECAUSE THE TRANSFER TO A FOREIGN CORPORATION DOES NOT MEET THE REPORTING REQUIREMENTS IN I.R.C. SEC. 6038(A)(1)(A). 1 1 1 X 400.000000000000 1 X 1 1 1 0 1 1 1 20217 10679000 0 10679000 0.01360 8 123833 291941000 199229000 92712000 0.11810 9 144050 302620000 199229000 103391000 0.13170 93 10389042 735400 9653642 0.01230 78 21947577 3032805 18914772 0.02410 9 86610028 1545476 85064552 0.10840 6 1526932 0 1526932 0.00190 186 120473579 5313681 115159898 0.14670 195 144050 423093579 204542681 218550898 0.27840 10 572594 572594 0.00070 1 35182 35182 0.00000 4 49488 49488 0.00010 8 483973 483973 0.00060 9 343097 343097 0.00040 32 1484334 1484334 0.00180 1 1452500 0 3484864 5378967 -1894103 X 1 1 1 NA 1 1 SEATTLE CHILDREN'S HOSPITAL (SCH)

4800 SAND POINT WAY NE SEATTLE WA 98105

X X X X X X SEATTLE CHILDREN'S HOSPITAL (SCH) 1 1 X X X X X X X X X X 10 1 0 0 X X X X 0 1 1 400.000000000000 0 1 X X X 1 1 X X X X X 1 0 1 X 0 0 16 SEATTLE CHILDREN'S RESEARCH INSTITUTE

1100 OLIVE WAY SEATTLE WA 98101

PEDIATRIC RESEARCH SEATTLE CHILDREN'S RESEARCH INSTITUTE

307 WESTLAKE AVENUE SEATTLE WA 98101

PEDIATRIC RESEARCH BELLEVUE CLINIC & SURGERY CENTER

1500 116TH AVE NE BELLEVUE WA 98004

CLINIC, SUB SPECIALITY SERVICES, URGENT CARE AND SURGERY CENTER HOME CARE SERVICES

2525 220TH STREET SE BOTHELL WA 98201

PEDIATRIC HOME CARE SERVICES THAT SUPPORT SCH OVERLAKE MEDICAL TOWER

1135 116TH AVE NE SUITE 400 SEATTLE WA 98004

SUB SPECIALITY CARE ODESSA BROWN CLINIC

2101 E YESLER WAY SEATTLE WA 98122

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE ANCHORAGE CLINIC

3260 PROVIDENCE DRIVE ANCHORAGE AK 99508

CARDIOLOGY CLINIC SEATTLE CHILDREN'S DENTAL SURGERY CTR

6222 NE 74TH STREET SEATTLE WA 98115

PEDIATRIC DENTAL CARE LISA LI BUILDING

4909 25TH AVE NE SEATTLE WA 98105

AUTISM CLINIC FEDERAL WAY CLINIC

34503 9TH AVE S SUITE 300 FEDERAL WAY WA 98003

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE EVERETT CLINIC

900 PACIFIC AVE SUITE 100 EVERETT WA 98201

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE SOUTH SOUND CARDIOLOGY CEDAR MED CTR

1901 S CEDAR ST STE 103 TACOMA WA 98405

CARDIOLOGY CLINIC OLYMPIA CLINIC

615 LILLY ROAD MEDICAL BLDG STE 140 OLYMPIA WA 98506

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE MONTANA CARDIOLOGY PRACTICE

2835 FORT MISSOULA ROAD MISSOULA MT 59804

CARDIOLOGY CLINIC MADISON TOWER CLINIC

1101 MADISON STREET SUITE 550 SEATTLE WA 98104

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE TRI CITIES CLINIC

969 STEVENS DRIVE RICHLAND WA 99352

AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALITY CARE PART I, LINE 3C: SEATTLE CHILDREN'S HOSPITAL (SCH) USES 400% OF THE FEDERAL POVERTY GUIDELINES (FPG) AS ITS THRESHOLD FOR QUALIFYING PATIENTS WHO APPLY FOR CHARITY CARE. FURTHERMORE, SCH USES ADDITIONAL CRITERIA OTHER THAN FPG TO QUALIFY ADDITIONAL PATIENTS FOR CHARITY CARE. RESPONSIBLE PARTIES WHOSE INCOME EXCEEDS 400%, HAVE INCURRED CATASTROPHIC ACCOUNT BALANCES AND WHO ARE NOT ELIGIBLE FOR FUNDING FROM OTHER SOURCES ARE ALSO ELIGIBLE FOR CATASTROPHIC CHARITY CARE WHEREBY THEY ARE RESPONSIBLE FOR A PORTION OF THE OUTSTANDING BALANCE AND SCH'S CHARITY CARE FUNDS THE REMAINING BALANCE. FAMILIES WHO RECEIVE A DENIAL OF CHARITY CARE BASED ON THE FPG AND FAMILY SIZE INFORMATION ARE ALLOWED TO APPEAL THE DENIAL BY PROVIDING INFORMATION ABOUT ADDITIONAL CIRCUMSTANCES IMPACTING THEIR FINANCIAL SITUATION SUCH AS EXCESSIVE MEDICAL DEBT. THE SENIOR DIRECTOR OF REVENUE CYCLE OR CHIEF FINANCIAL OFFICER MAY ADMINISTRATIVELY APPROVE CHARITY CARE BASED ON THIS ADDITIONAL INFORMATION. DUE TO SOCIOECONOMIC OR OTHER FACTORS SUCH AS KNOWLEDGE THAT THE PATIENT IS HOMELESS, THE STANDARD APPLICATION PROCESS FOR CHARITY CARE IN RARE CASES MAY NOT BE COMPLETED. IN CASES WHERE A PATIENT CAN BE REASONABLY PRESUMED TO QUALIFY FOR CHARITY CARE IN THE ABSENCE OF RECEIVING ALL REQUIRED INFORMATION, THE SENIOR DIRECTOR OF REVENUE CYCLE OR THE CHIEF FINANCIAL OFFICER MAY ALSO APPROVE PATIENT ACCOUNT BALANCE WRITE-OFFS FOR CHARITY CARE. PART I, LINE 6: SCH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS AVAILABLE TO THE GENERAL PUBLIC. SCH APPLIES THE CATHOLIC HEALTH ASSOCIATION PRINCIPLES AND USES THE "LYONS" SOFTWARE TO ACCUMULATE THE INFORMATION INCLUDED IN ITS ANNUAL COMMUNITY BENEFIT REPORT. SEE SCHEDULE O FOR THE FULL 2011 COMMUNITY BENEFIT REPORT AND AT WWW.SEATTLECHILDRENS.ORG. PART I, LINE 7: SCH USES A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 TO CALCULATE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS (7A-7D) REPORTED IN THE TABLE. SCH USED ITS 2011 MEDICARE COST REPORT TO CALCULATE PROGRAM SPECIFIC COST-TO-CHARGE RATIOS FOR LINES 7E-7K.IN ACCORDANCE WITH ITS MISSION TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE, SCH COMMITS SIGNIFICANT RESOURCES TO PROMOTE THE HEALTH AND WELL-BEING OF CHILDREN. IN SUPPORT OF THIS ENDEAVOR, SCH RECOGNIZES THAT SOME OF ITS MOST FRAGILE CONSTITUENTS ARE CHILDREN WHOSE FAMILIES ARE FINANCIALLY OR MEDICALLY INDIGENT. TO THAT END, SCH PROVIDES MEDICAL TREATMENT TO CHILDREN WHOSE FAMILIES ARE UNABLE TO PAY FOR SUCH TREATMENT. SCH ENSURES THAT CHARITY CARE, EDUCATION, RESEARCH AND OTHER SPONSORED COMMUNITY PROGRAMS BENEFIT ALL CHILDREN, REGARDLESS OF ECONOMIC STATUS. THEREFORE, SCH MAINTAINS CHARITY AND COMMUNITY BENEFIT PROGRAMS, WITHIN LIMITS, THAT ARE AVAILABLE TO THE ENTIRE COMMUNITY, WITH EQUAL CONSIDERATION FOR THOSE THAT ARE POOR AND UNDERSERVED.THE CATEGORIES INCLUDED AS PROGRAMS AND SERVICES FOR THE POOR AND THE UNDERSERVED ARE AS FOLLOWS:CHARITY CARE - REPRESENTS THE ESTIMATED COST OF CARE PROVIDED TO CHILDREN WHO ARE UNINSURED OR UNDERINSURED AND WHOSE FAMILIES CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. SCH PROVIDES CHARITY CARE IN ACCORDANCE WITH ITS CHARITY CARE POLICY BASED ON FAMILY NEED AND MAINTAINS RECORDS TO IDENTIFY THE LEVEL OF CHARITY IT PROVIDES. THE DETERMINATION OF FAMILY NEED IS EVALUATED DURING A PATIENT'S COURSE OF CARE AND CAN BE UPDATED AFTER CARE IS COMPLETE. THE RATIO OF COST-TO-CHARGE WAS DETERMINED USING SUPPLEMENTARY WORKSHEET 2 OF SCHEDULE H.UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS - REPRESENTS THE ESTIMATED COST OF PROVIDING SERVICES TO PATIENTS COVERED UNDER MEDICAID AND INDIGENT CARE PROGRAMS, IN EXCESS OF PAYMENTS FROM ALL SOURCES. THE UNREIMBURSED COST FOR PROVIDING THESE SERVICES WAS DETERMINED USING SUPPLEMENTARY WORKSHEET 3 OF SCHEDULE H.OTHER BENEFITS - REPRESENTS COST OF PROVIDING SERVICES FOR THE BENEFIT OF THE ENTIRE COMMUNITY. THESE BENEFITS INCLUDE RESEARCH, EDUCATION AND VARIOUS OTHER COMMUNITY-BASED HEALTH CARE PROGRAMS. THE MAJORITY OF THESE BENEFITS ARE FOR PEDIATRIC RESEARCH AND GRADUATE MEDICAL EDUCATION. PART II: PROMOTING THE HEALTH OF THE COMMUNITY IS A CORE ASPECT OF OUR HOSPITAL MISSION, VISION AND COMMITMENT. OTHER ASPECTS OF OUR HOSPITALS COMMUNITY BENEFIT INCLUDE:- MOBILE PROGRAMS SUCH AS THE SMILEMOBILE, THE SCIENCE ADVENTURE LAB AND THE HEALTH AND SAFETY VAN TRAVEL THE STATE OFFERING DENTAL CARE, SCIENCE EDUCATION AND HEALTH AND SAFETY INFORMATION AND GEAR, RESPECTIVELY, TO CHILDREN WHO MIGHT NOT OTHERWISE RECEIVE THESE SERVICES.- COORDINATION WITH STATE AND LOCAL GOVERNMENT AGENCIES, HEALTHCARE PROVIDERS AND COMMUNITY ORGANIZATIONS TO BRING PREVENTION AND TREATMENT SERVICES RELATED TO SUBSTANCE ABUSE, DROWNING, MOTOR VEHICLE INJURIES, HEAD CONCUSSIONS, ABUSIVE HEAD TRAUMA, IMMUNIZATIONS, AND OBESITY, AMONG OTHERS.- CLASSES AND SUPPORT GROUPS TO CHILDREN, TEENS, PARENTS, CAREGIVERS AND HEALTHCARE PROVIDERS IN THE COMMUNITY ABOUT AUTISM, CPR, SAFE BABYSITTING, CHILD PASSENGER SAFETY AND GROWING UP.- FREE HEALTH AND SAFETY EDUCATION AND INFORMATION TO THE COMMUNITY THROUGH PRINTED MATERIALS, COMMUNITY OUTREACH EVENTS, MEDIA PARTNERSHIPS AND SOCIAL MEDIA VEHICLES.- OUR LONGSTANDING ROLE AS A TEACHING HOSPITAL WITH ONE OF THE TOP RATED RESIDENCY PROGRAMS. STUDENTS IN MANY OTHER HEALTH CARE PROFESSIONS INCLUDING NURSING, LAB, RADIOLOGY AND RESPIRATORY THERAPY RECEIVE TRAINING.- INTERNSHIPS AND JOB SHADOWING OFFERED FOR HIGH SCHOOL, UNDERGRADUATE AND GRADUATE STUDENTS, AS WELL AS OBSERVERSHIPS FOR HEALTHCARE PROFESSIONALS AND NURSING CAMP.- GRAND ROUNDS AND OTHER EDUCATIONAL SESSIONS OPEN TO COMMUNITY AND SCHOOL NURSES AS WELL AS DOCTORS THROUGHOUT THE REGION. HEALTHCARE PROFESSIONALS LEARN ABOUT SPECIALTY PEDIATRIC CARE AND DIFFERENT HEALTH CONDITIONS. STATEWIDE TELECONFERENCE IS BROADCASTED ACROSS THE STATE.- A COMMITMENT TO SPEND NEARLY $4 MILLION ON TRANSPORTATION OVER THE NEXT 20 YEARS TO IMPROVE NORTHEAST SEATTLE'S WALKABILITY, BIKEABILITY, AND DRIVABILITY AS PART OF THE HOSPITAL'S COMPREHENSIVE TRANSPORTATION PLAN. IMPROVEMENTS WILL POTENTIALLY INCLUDE "SMART" SIGNALS TO EASE TRAFFIC FLOW, BICYCLE BOULEVARDS, INCREASED ACCESS TO CITYWIDE BIKE TRAIL SYSTEMS, AND BETTER STREET CROSSINGS.- A SIGNIFICANT INVESTMENT IN RESEARCH FOCUSED ON BOTH PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND CHRONIC CONDITIONS.- A FAMILY ADVISORY COUNCIL AS WELL AS A NUMBER OF DEPARTMENT SPECIFIC ADVISORY COUNCILS WHERE FAMILIES PROVIDE EXPERT GUIDANCE. - LEADERSHIP IN THE HEALTH COALITION FOR CHILDREN AND YOUTH, ADVOCATING FOR HEALTHCARE COVERAGE FOR ALL CHILDREN, INCLUDING IMMIGRANT CHILDREN. - HOSPITAL FOUNDATION ACTIVITIES TO RAISE MONEY FOR UNCOMPENSATED CARE AND TO FUND HEALTH IMPROVEMENT PROGRAMS FOCUSED ON AT RISK AND UNDERSERVED CHILDREN AND FAMILIES.- THE LARGEST VOLUNTEER PROGRAM IN THE UNITED STATES WITH OVER 800 VOLUNTEERS A MONTH. PART III, LINE 4: SCH CHARACTERIZES SELF PAY AS BAD DEBT WHEN A FAMILY IS EITHER NOT ELIGIBLE OR HAS NOT APPLIED FOR FINANCIAL ASSISTANCE AND IS UNWILLING OR UNABLE TO PAY AN OUTSTANDING ACCOUNT BALANCE. THE MOST COMMON PATIENT BAD DEBT SCENARIOS INCLUDE UNPAID SELF PAY PORTIONS OF ACCOUNT BALANCES AFTER INSURANCE OR THIRD PARTY ASSISTANCE PAYMENTS OR UNPAID ACCOUNT BALANCES AFTER A BANKRUPTCY FILING. SCH IS SENSITIVE TO THE FINANCIAL HEALTH OF FAMILIES AND RECOGNIZES THAT FAMILY FINANCIAL CONCERNS MAY NOT ALWAYS BE EFFECTIVELY COMMUNICATED. SCH IS COMMITTED TO MANAGING COLLECTION EFFORTS INTERNALLY, IN A RESPECTFUL MANNER AND WITHOUT USING EXTERNAL COLLECTION OR CREDIT AGENCIES, EXCEPT IN LIMITED CIRCUMSTANCES SUCH AS INTERNATIONAL PATIENTS. SINCE ALL COLLECTIONS EFFORTS ARE MANAGED INTERNALLY, IN A RESPECTFUL MANNER, SCH DOES NOT DISCLOSE ITS COLLECTION PRACTICE IN THE FOOTNOTES OF THE FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE OBTAINED DIRECTLY FROM THE MEDICARE COST REPORT AND ARE DETERMINED IN ACCORDANCE WITH THE MEDICARE PRINCIPLES OF REIMBURSEMENT. SCH'S MEDICARE PATIENTS ARE CHILDREN WITH END STAGE RENAL DISEASE (ESRD) THAT INCLUDES DIALYSIS CARE AND OFTEN KIDNEY TRANSPLANT ALONG THE OTHER RELATED SERVICES. THE ESRD CARE OFTEN RESULTS IN LONGER LENGTH OF STAY AND HIGHER ACUITY. MEDICARE REIMBURSEMENT FOR THESE SERVICES IS SUBJECT TO TEFRA A LIMIT THAT OFTEN IS BELOW SCH'S COST. THE ACTUAL SHORTFALL IN COST REIMBURSEMENT SHOULD AT LEAST BE TREATED AS COMMUNITY BENEFIT. PART III, LINE 9B: SCH'S BUSINESS SERVICES DEPARTMENT USES A STANDARD, RESPECTFUL PROCEDURE FOR RESOLVING UNPAID PATIENT BALANCES. A. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES.B. SCH PROVIDES A STANDARD 25% DISCOUNT ON HEALTH CARE SERVICES TO PATIENTS WHO ARE UNINSURED IN ACCORDANCE WITH ORGANIZATIONAL POLICIES AND PROCEDURES. THIS DISCOUNT ALIGNS WITH OR IS LOWER THAN DISCOUNTS PROVIDED TO COMMERCIAL INSURERS.C. ADDITIONALLY, SCH ATTEMPTS TO ACCOMMODATE U.S. FAMILIES WHO DESIRE TO SET UP REASONABLE PAYMENT PLANS.D. IF A PATIENT ACCOUNT BALANCE REMAINS UNPAID AFTER STANDARD INTERNAL COLLECTION PROCEDURES HAVE BEEN FOLLOWED, AND IF THE FAMILY HAS NOT APPLIED FOR OR DOES NOT QUALIFY FOR SCH'S FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE WILL BE WRITTEN OFF AS BAD DEBT IN ACCORDANCE WITH STANDARD PROCEDURAL TIMELINES. - UPON RECEIPT OF A PERSONAL BANKRUPTCY NOTICE, SCH IDENTIFIES ANY OUTSTANDING ACCOUNT BALANCES FOR THE ASSOCIATED PATIENT AND WRITES OFF THESE BALANCES AS BAD DEBT. - SCH'S FINANCE DEPARTMENT MONITORS THE PORTION OF OUTSTANDING AR THAT IS CLASSIFIED AS BAD DEBT FOR SIGNIFICANT VARIANCES. - SCH'S STANDARD PRACTICE IS TO COLLECT ON OUTSTANDING PATIENT ACCOUNTS USING INTERNAL RESOURCES. 1. REPORTS ARE NOT SENT TO CREDIT AGENCIES. 2. COLLECTION AGENCIES WILL NOT BE USED TO COLLECT ANY OUTSTANDING PATIENT ACCOUNT EXCEPT AS SPECIFICALLY AUTHORIZED BY THE SENIOR DIRECTOR OF REVENUE CYCLE. 3. THE USE OF COLLECTION AGENCIES WILL ONLY BE PERMITTED IN VERY RARE SCENARIOS WHERE THE FAMILY RESIDES OUTSIDE OF SCH'S SERVICE AREA (E.G., INTERNATIONAL PATIENTS). 4. SCH WILL NOT FILE A LIEN AGAINST A PATIENT'S OR FAMILY'S PRIMARY RESIDENCE TO SECURE PAYMENT ON PATIENT ACCOUNT BALANCES. SEATTLE CHILDREN'S HOSPITAL (SCH) PART V, SECTION B, LINE 1J: IN 2011 SEATTLE CHILDREN'S CONTINUED OUR COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), INITIATED IN 2010 WITH PHASE ONE, AND WHICH FOCUSED ON DESCRIBING SOCIAL DETERMINANTS OF HEALTH AND ACCESS IN OUR SERVICE REGION (WASHINGTON, ALASKA, MONTANA AND IDAHO). PHASE TWO HAD THE PURPOSE OF A) IDENTIFYING ISSUES AND ASSETS THAT IMPACT AT RISK AND UNDERSERVED POPULATIONS, INCLUDING FAMILIES WHO HAVE A CHILD WITH SPECIAL HEALTH CARE NEEDS; B) IDENTIFYING KEY HEALTH AND SAFETY ISSUES USING EXISTING DATA AND FROM THE PERSPECTIVE OF COMMUNITY STAKEHOLDERS AND FAMILIES; AND C) PRIORITIZING TOPIC AREAS BASED ON COMMUNITY NEEDS AND WHERE SEATTLE CHILDREN'S HAS SIGNIFICANT EXPERTISE. THIS LAYS THE FOUNDATION FOR A COMMUNITY BENEFIT IMPLEMENTATION PLAN THAT ENGAGES STAKEHOLDERS, LINKS TO THE HOSPITAL'S STRATEGIC PLAN AND SUPPORTS PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS, OTHER HEALTHCARE PROVIDERS AND THE COMMUNITY. SEATTLE CHILDREN'S HOSPITAL (SCH) PART V, SECTION B, LINE 3: IN GATHERING QUALITATIVE AND QUANTITATIVE INFORMATION FOR PHASE TWO OF THE CHNA, WE USED A MULTI-PRONGED COMMUNITY PARTICIPATION APPROACH. LED BY THE EXTERNAL AFFAIRS AND GUEST SERVICES AND WITH SUPPORT FROM THE HOSPITAL'S ADVOCACY ADVISORY COMMITTEE, WE ELICITED AND INCORPORATED INPUT FROM 75 COMMUNITY LEADERS, FROM 57 ORGANIZATIONS, FAMILY REPRESENTATIVES FROM TWO FOCUS GROUPS, AND THE HOSPITAL'S FAMILY ADVISORY COUNCIL, AS WELL AS KEY INTERNAL STAKEHOLDERS. WE COMPILED AVAILABLE CHILD AND ADOLESCENT HEALTH DATA FROM VARIOUS SOURCES ON 24 KEY TOPIC AREAS, INTERVIEWED KEY MEMBERS OF OUR ORGANIZATION AND INTERNAL STAKEHOLDERS, QUERIED PUBLIC HEALTH EXPERTS AND COMMUNITY REPRESENTATIVES, CONDUCTED AN ONLINE SURVEY WITH COMMUNITY STAKEHOLDERS AND CONDUCTED TWO PARENT LISTENING GROUPS. AS A RESULT WE HAVE DRAFTED FIVE PROPOSED COMMUNITY BENEFIT PRIORITIES. IN THE LAST QUARTER OF 2011 AND FIRST QUARTER OF 2012, WE ARE ENTERING PHASE THREE, WHICH CONSISTS OF PRESENTING THE FINDINGS OF THE CHNA AND PROPOSING THE FIVE PRIORITY AREAS TO BE INCORPORATED IN THE HOSPITAL'S OPERATING AND STRATEGIC INITIATIVES. SEATTLE CHILDREN'S HOSPITAL (SCH) PART V, SECTION B, LINE 5C: PHASE FOUR OF THE CHNA, WHICH CONSISTS OF WRITING AND PUBLISHING THE CHNA REPORT IS SCHEDULED FOR THE SECOND HALF OF 2012 AFTER APPROVAL BY THE HOSPITAL'S BOARD OF TRUSTEES. THE CHNA WILL BE MADE WIDELY AVAILABLE THROUGH THE HOSPITAL'S WEBSITE, WWW.SEATTLECHILDRENS.ORG. SEATTLE CHILDREN'S HOSPITAL (SCH) PART V, SECTION B, LINE 7: SEATTLE CHILDREN'S HAS A HISTORY OF EXTENSIVE INVOLVEMENT IN COMMUNITY BENEFIT. WHILE WE ARE IDENTIFYING COMMUNITY BENEFIT PRIORITY AREAS AS A RESULT OF THIS COMPREHENSIVE CHNA PROCESS, THE HOSPITAL CONTINUES TO ENCOURAGE COMMUNITY BENEFIT PROGRAMS AT ALL LEVELS OF THE ORGANIZATION. EXECUTION OF IMPLEMENTATION STRATEGIES GENERALLY HAPPEN AT DEPARTMENTAL AND PROGRAM LEVELS. THE RESULTS OF THE CHNA WILL BOTH VALIDATE EXISTING WORK AND PROVIDE FOCUS FOR PRIORITY WORK IN KEY FOCUS AREAS AT AN ORGANIZATIONAL LEVEL. PHASE FIVE OF THE CHNA CONSISTS IN WRITING AND PUBLISHING THE COMMUNITY BENEFIT IMPLEMENTATION STRATEGY AND WILL INCLUDE A DEFINITION OF THE PRIORITY COMMUNITY BENEFIT AREAS, THE PLAN FOR ADDRESSING THEM, METRICS TO TRACK PROGRESS AND THE REASONING WHY THE HOSPITAL WILL NOT BE ADDRESSING OTHER IDENTIFIED NEEDS. THIS PHASE FIVE IS SCHEDULED TO BE COMPLETED BY END OF SEPTEMBER 2012. SEATTLE CHILDREN'S HOSPITAL (SCH) PART V, SECTION B, LINE 11H: DUE TO SOCIOECONOMIC OR OTHER FACTORS SUCH AS KNOWLEDGE THAT THE PATIENT IS HOMELESS, THE STANDARD APPLICATION PROCESS FOR CHARITY CARE IN RARE CASES MAY NOT BE COMPLETED. IN CASES WHERE A PATIENT CAN BE REASONABLY PRESUMED TO QUALIFY FOR CHARITY CARE IN THE ABSENCE OF RECEIVING ALL REQUIRED INFORMATION, THE SENIOR DIRECTOR OF REVENUE CYCLE OR THE CHIEF FINANCIAL OFFICER MAY ALSO APPROVE PATIENT ACCOUNT BALANCE WRITE-OFFS FOR CHARITY CARE. PART VI, LINE 2: AS PART OF CHILDREN'S STRATEGIC PLAN DEVELOPMENT, RESEARCH WAS DONE TO IDENTIFY SPECIALTY CARE, MENTAL HEALTH AND EMERGENCY CARE ACCESS AND SHORTAGE ISSUES; ASSESS THE ONGOING NEED FOR UNCOMPENSATED CARE SUPPORT; AND DETERMINE POTENTIAL PARTNERSHIPS TO BETTER ADDRESS THE HEALTH CARE NEEDS OF ALL CHILDREN IN THE PACIFIC NORTHWEST. ADDITIONALLY, NUMEROUS PROGRAMS AND DEPARTMENTS IN THE HOSPITAL CONDUCT NEEDS ASSESSMENTS TO IDENTIFY HEALTH PROMOTION, HEALTH CARE AND HEALTH DISPARITIES THAT IMPACT THE HEALTH OF CHILDREN AND FAMILIES. FOR EXAMPLE, THE CENTER FOR DIVERSITY AND HEALTH EQUITY HAS ASSESSED THE NEED FOR MORE CULTURAL NAVIGATORS; MEDICAL LEGAL PARTNERSHIP HAS ASSESSED HOW MANY PRIMARY CARE PRACTICES ARE ACCEPTING NEW MEDICAID CHILDREN IN KING COUNTY AND SAFE KIDS SOUTH KING IS ASSESSING INJURY RATES AND COMMUNITY ASSETS. PART VI, LINE 3: EVERY FAMILY THAT COMES TO SCH, WHETHER FOR AN INPATIENT STAY, CLINIC VISIT, SURGERY OR THROUGH THE EMERGENCY DEPARTMENT, IS PROVIDED WITH INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM. SIGNAGE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IS AVAILABLE IN OUR PRIMARY LANGUAGES: ENGLISH, SPANISH, RUSSIAN AND VIETNAMESE. APPLICATION FORMS ARE AVAILABLE IN ENGLISH AND SPANISH. IN PERSON INTERPRETERS AND THE HOSPITAL'S SPEAK LINE, WHICH ACCESSES TELEPHONE INTERPRETATION, HELP PROVIDE INFORMATION TO FAMILIES WITH LIMITED ENGLISH PROFICIENCY. INFORMATION ABOUT FINANCIAL ASSISTANCE AND AN APPLICATION FORM IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE. ALL REGISTRATION DESKS HAVE FINANCIAL ASSISTANCE INFORMATION VISIBLE AND AVAILABLE. EVERY INPATIENT AND EMERGENCY DEPARTMENT FAMILY IS OFFERED FINANCIAL ASSISTANCE INFORMATION, WHETHER OR NOT THEY HAVE INSURANCE. ALL HOSPITAL BILLS INCLUDE A STATEMENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IF HELP IS NEEDED IN PAYING A BILL, REGARDLESS OF INSURANCE STATUS. FINANCIAL COUNSELORS ARE AVAILABLE TO MEET INDIVIDUALLY WITH FAMILIES TO HELP DETERMINE WHAT ASSISTANCE THEY MAY QUALIFY FOR AND TO HELP THEM COMPLETE AND SUBMIT FORMS. THEY ARE LOCATED ON THE SEATTLE CHILDREN'S MAIN CAMPUS NEXT TO THE AMBULATORY CHECK IN AREA TO FACILITATE ACCESS. THE FINANCIAL COUNSELORS RECEIVE INFORMATION THROUGH THE SCHEDULING SYSTEM THAT IDENTIFIES UNINSURED OR UNDERINSURED FAMILIES. FINANCIAL COUNSELORS CONTACT FAMILIES TO CLARIFY ASSISTANCE AVAILABLE AND TO OFFER THEIR HELP WITH APPLYING FOR ASSISTANCE. THEY HELP FAMILIES DETERMINE IF THEY QUALIFY FOR OTHER SOURCES OF FUNDING, INCLUDING MEDICAID. SOCIAL WORKERS ALSO HELP SCREEN FAMILIES FOR FINANCIAL NEEDS AND REFER PATIENTS TO FINANCIAL COUNSELORS. PART VI, LINE 4: SCH PRIMARILY SERVES CHILDREN FROM WASHINGTON, ALASKA, MONTANA AND IDAHO, COMPRISING THE LARGEST GEOGRAPHICAL AREA OF ANY CHILDREN'S HOSPITAL IN THE UNITED STATES. SEATTLE CHILDREN'S ORIGINAL VISION - TO CARE FOR CHILDREN REGARDLESS OF RACE, RELIGION, GENDER OR A FAMILY'S ABILITY TO PAY - STILL GUIDES THE HOSPITAL TODAY. WHILE WE PRIMARILY SERVE CHILDREN FROM BIRTH TO 21 YEARS OLD, OUR SERVICES ARE EXPANDING TO SERVE HIGH RISK PREGNANT MOTHERS AND YOUNG ADULTS SUCH AS THOSE WHO NEED CANCER CARE AND WOULD BENEFIT FROM THE EFFECTIVENESS OF PEDIATRIC PROTOCOLS. OUR PRIMARY CARE CLINIC, ODESSA BROWN CHILDREN'S CLINIC, SERVES PRIMARILY LOW INCOME FAMILIES LIVING IN CENTRAL AND SOUTHEAST SEATTLE. APPROXIMATELY 15% OF CHILDREN UNDER AGE 18 IN WASHINGTON STATE LIVE BELOW THE FEDERAL POVERTY LEVEL WHILE OVER 45% OF OUR PATIENTS ARE ON MEDICAID, A SIMILAR LOW INCOME INSURANCE PROGRAM OR WHO ARE UNINSURED. PART VI, LINE 6: SCH IS GOVERNED BY A BOARD OF TRUSTEES, CONSISTING BETWEEN 20-30 VOTING TRUSTEES AND ARE MEMBERS OF THE LOCAL COMMUNITY. SCH FUNCTIONS THROUGH COMMITTEES THAT ARE STAFFED WITH TRUSTEES OF RESPECTIVE BOARDS WHO HAVE SIGNIFICANT EXPERIENCE AND SKILLS REQUIRED BY THAT COMMITTEE, AND IN SOME CASES INCLUDE OUTSIDE MEMBERS WHO ARE NOT TRUSTEES WHEN THEIR KNOWLEDGE OR EXPERIENCE WOULD CONTRIBUTE TO THE WORK OF THE COMMITTEE. SCH ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO CERTAIN QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OF ITS DEPARTMENTS. SCH ALSO HAS REGIONAL STRATEGIC AFFILIATIONS WITH THE FOLLOWING ENTITIES:- UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM)SCH HAS HAD A FORMAL AFFILIATION WITH THE UWSOM SINCE 1974. SCH PROVIDES THE PEDIATRIC COMPONENT OF THE UWSOM UNDERGRADUATE MEDICAL EDUCATION PROGRAM AS WELL AS THE HOSPITAL-BASED PEDIATRIC TRAINING EXPERIENCE FOR ALL POST-GRADUATE PROGRAMS.THE UWSOM, A REGIONAL RESOURCE FOR WASHINGTON, WYOMING, ALASKA, MONTANA, AND IDAHO, IS A NATIONALLY AND INTERNATIONALLY RECOGNIZED LEADER IN MEDICAL EDUCATION, PATIENT CARE, SCIENTIFIC RESEARCH AND COMMUNITY SERVICE. THE UWSOM HAS 30 DEPARTMENTS, MANY CENTERS AND NUMEROUS AFFILIATIONS THROUGHOUT THE FIVE-STATE REGION. THE UWSOM OFFERS EXTENSIVE TRAINING PROGRAMS IN THE BASIC MEDICAL SCIENCES, PRIMARY CARE AND THE SPECIALTIES OF CLINICAL MEDICINE. IT HAS A FULL-TIME REGULAR AND RESEARCH FACULTY OF APPROXIMATELY 2,400. IN ADDITION TO TRAINING FUTURE PHYSICIANS, THE FACULTY ALSO TEACHES GRADUATE AND UNDERGRADUATE STUDENTS IN MANY DISCIPLINES, AND 4,600 VOLUNTEER AND PART-TIME CLINICAL FACULTY MEMBERS TEACH STUDENTS IN TOWNS AND CITIES ACROSS THE REGION. THE UWSOM IS AFFILIATED WITH THE 450-BED UNIVERSITY OF WASHINGTON MEDICAL CENTER AND THE 413-BED HARBORVIEW MEDICAL CENTER, WITH WHICH SCH SHARES A DESIGNATION AS A PEDIATRIC LEVEL I TRAUMA CENTER.- CHILDREN'S UNIVERSITY MEDICAL GROUP (CUMG)CHILDREN'S PHYSICIANS AND THE UNIVERSITY OF WASHINGTON (THE "UW") JOINTLY CONTROL CUMG, A WASHINGTON NONPROFIT CORPORATION AND A 501(C)(3) ORGANIZATION. CUMG IS A PEDIATRIC PRACTICE PLAN THAT EMPLOYS AND MANAGES THE CLINICAL PRACTICES OF APPROXIMATELY 495 PROFESSIONAL MEMBERS WHO ARE BOTH MEMBERS OF SCH MEDICAL STAFF AND PEDIATRIC FACULTY MEMBERS OF THE UWSOM.- PROVIDENCE-CHILDREN'S NEONATAL SERVICES, LLCSCH PARTICIPATES IN A JOINT VENTURE WITH PROVIDENCE EVERETT MEDICAL CENTER (PEMC), AN UNRELATED COMMUNITY-BASED HOSPITAL LOCATED IN EVERETT, WASHINGTON. CHILDREN'S AND PEMC EACH OWN A 50% INTEREST IN PROVIDENCE-CHILDREN'S NEONATAL SERVICES, LLC (PCNS). PCNS MANAGES THE OPERATIONS OF THE NEONATAL INTENSIVE CARE UNIT AT PEMC AND PROVIDES NEONATAL NURSE PRACTITIONER SERVICES TO PEMC.- SEATTLE CANCER CARE ALLIANCETHE SEATTLE CANCER CARE ALLIANCE (SCCA), A WASHINGTON NONPROFIT CORPORATION AND 501(C)(3) ORGANIZATION, OFFERS A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES. ITS MEMBERS ARE SEATTLE CHILDREN'S HEALTHCARE SYSTEM, THE UW, AND THE FRED HUTCHINSON CANCER RESEARCH CENTER. SCCA OPERATES AN AMBULATORY CANCER CARE SERVICES FACILITY AND A 20-BED LICENSED HOSPITAL INSIDE UWMC. 1 ALASKA ARTS SOUTHEAST INC PO BOX 3086 SITKA AK 99835 237240278 501 (C) (3) 15000 SCHOLARSHIPS FOR CHILDREN WHO WISH TO PARTICIPATE IN THE SITKA FINE ARTS CAMP PROGRAM ALASKA NETWORK ON DOMESTIC VIOLENCE AND SEXUAL ASSAULT 130 SEWARD ST STE 209 JUNEAU AK 99801 920087216 501 (C) (3) 12000 PROGRAM PROMOTING LEADERSHIP AND PREVENTING DOMESTIC VIOLENCE ALASKA COUNCIL OF SCHOOL ADMINISTRATORS 326 4TH ST STE 404 JUNEAU AK 99801 920073478 501 (C) (6) 25682 JUNEAU UNITED MEDICAL PROVIDERS AND PARENTS (JUMPP) PROJECT AMERICAN HEART ASSOCIATION 710 SECOND AVE STE 900 SEATTLE WA 98104 135613797 501 (C) (3) 13200 SEATTLE HEART BALL SPONSORSHIP BARTLETT REGIONAL MEDICAL CENTER 3260 HOSPITAL DRIVE JUNEAU AK 99801 920118538 GOVERNMENT 15324 NEONATAL RESUSCITATION PROGRAM BETTY ELIASON CHILD CARE CENTER 607 LINCOLN ST SITKA AK 99835 920065572 501 (C) (3) 8939 PURCHASE OF A NEW SANITIZING DISHWASHER & REFRIGERATOR BLATCHLEY MIDDLE SCHOOL 601 HALIBUT POINT RD SITKA AK 99835 926000113 GOVERNMENT 20300 "DISCOVERING YOUR POTENTIAL" AND ANTI-BULLYING PROGRAM GRANT CAMP KOREY 28901 NE CARNATION FARM RD CARNATION WA 98014 203829742 501 (C) (3) 15000 ONGOING SUPPORT FOR CAMP PROGRAMS CATHOLIC COMMUNITY SERVICE INC 419 6TH STREET JUNEAU AK 99801 920042651 501 (C) (3) 15000 EDUCATIONAL & RECREATIONAL AFTER SCHOOL PROGRAM FOR STUDENTS AND FAMILIES CITY OF SAXMAN ROUTE 2 BOX 1 KETCHIKAN AK 99901 920041226 501 (C) (3) 22000 BRIDGE THE YOUTH CAPACITY BUILDING PROGRAM FUNDING GAP GREATER ISSAQUAH CHAMBER OF COMMERCE 155 NW GILMAN BLVD ISSAQUAH WA 98027 916056410 501 (C) (6) 5500 SALMON DAYS FESTIVAL SPONSORSHIP GROUP HEALTH FOUNDATION 320 WESTLAKE AVE N STE 100 SEATTLE WA 98109 911246278 501 (C) (3) 8750 GIFT OF HEALTH GALA SPONSORSHIP JDRF SEATTLE GUILD 1215 FOURTH AVE STE 1400 SEATTLE WA 98161 231907729 501 (C) (3) 25000 DREAM GALA AND SEATTLE SWEDEN DIABETES AWARENESS DAY SPONSORSHIPS KETCHIKAN WELLNESS COALITION PO BOX 23167 KETCHIKAN AK 99901 270897521 501 (C) (3) 7800 "BE THE CHANGE" CHALLENGE DAY FOLLOW-UP ACTIVITIES MARCH OF DIMES 1904 THIRD AVE STE 230 SEATTLE WA 98101 131846366 501 (C) (3) 10550 NURSE OF THE YEAR BREAKFAST SPONSORSHIP PACIFIC HIGH SCHOOL 509 LINCOLN STREET SITKA AK 99835 926000113 GOVERNMENT 24500 "HEALTHY LUNCH, HEALTHY LIVES" PROGRAM PACIFIC SCIENCE CENTER FOUNDATION 200 SECOND AVE N SEATTLE WA 981094895 910750867 501 (C) (3) 50000 SUPPORT FOR PROFESSOR WELLBODY'S HEALTH AND WELLNESS ACADEMY EXHIBIT PELICAN CITY SCHOOL DISTRICT PO BOX 90 PELICAN AK 99832 926000109 GOVERNMENT 6000 STUDENTS TO CAREER FAIR AND JOB SHADOWING PROVIDENCE HOSPICE & HOME CARE FOUNDATION SNOHOMISH COUNTY 2731 WETMORE AVE STE 500 EVERETT WA 98201 272552749 501 (C) (3) 6250 BRUNCH BY THE BAY AND PEDIATRIC LUNCHEON EVENT SPONSORSHIPS PUGET SOUND HEALTH ALLIANCE 2003 WESTERN AVE STE 600 SEATTLE WA 98121 470948895 501 (C) (3) 7777 COMMUNITY CHECKUP PARTICIPATION RONALD MCDONALD HOUSE CHARITIES OF WESTERN WASHINGTON & ALASKA 5130 40TH AVE NE SEATTLE WA 98105 911061043 501 (C) (3) 317475 ONGOING SUPPORT FOR HOUSING PROGRAMS SEATTLE CANCER CARE ALLIANCE 825 EASTLAKE AVE E SEATTLE WA 98109 911935159 501 (C) (3) 2461351 PROTON BEAM SEATTLE POLICE FOUNDATION PO BOX 456 SEATTLE WA 98111 912171529 501 (C) (3) 10000 AWARDS BANQUET SPONSORSHIP SEATTLE UNIVERSITY 901 12TH AVE / PO BOX 222000 SEATTLE WA 981221090 910565006 501 (C) (3) 18500 SEATTLE UNIVERSITY GALA SPONSORSHIP SITKA CONSERVATION SOCIETY PO BOX 6533 SITKA AK 99835 920096633 501 (C) (3) 10000 PROGRAM TO SERVE LOCALLY HARVESTED FISH IN SITKA'S SCHOOL LUNCHES SITKA SOUND SCIENCE CENTER 834 LINCOLN STREET SUITE 200 SITKA AK 99835 261253086 501 (C) (3) 18618 SCHOLARSHIPS FOR MAKING WAVES SCIENCE CAMP PROGRAM SOUTHEAST ALASKA INDEPENDENT LIVING 3225 HOSPITAL DRIVE SUITE 300 JUNEAU AK 99801 920144370 501 (C) (3) 25000 WHEELCHAIR ACCESSIBILITY UPGRADE TO CITY PLAYGROUND FOR CHILDREN UNIVERSITY OF WASHINGTON DENTAL FACILITY 1325 FOURTH AVENUE 2000 SEATTLE WA 98101 916001537 GOVERNMENT 1000000 GRANT FOR DEVELOPMENT OF A PEDIATRIC DENTAL FACILITY UNIVERSITY OF WASHINGTON FOUNDATION 407 GERBERDING HALL SEATTLE WA 98195 943079432 501 (C) (3) 76871 ORAL HEALTH DENTISTRY FUND, PROFESSORSHIP IN HEALTH POLICY, AND GALA SPONSORSHIP WITHIN REACH 11000 LAKE CITY WAY NE 301 SEATTLE WA 981256748 911443685 501 (C) (3) 15000 IMMUNIZATION SOCIAL MARKETING CAMPAIGN AND LUNCHEON SPONSORSHIP YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF SEATTLE-KING COUNTY-SNOHOMISH COUNTY 1118 FIFTH AVENUE SEATTLE WA 98101 910482890 501 (C) (3) 6000 COMMUNITY EVENT SPONSORSHIP 29 2 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: A SPONSORSHIP COMMITTEE WAS ESTABLISHED BY SEATTLE CHILDREN'S HOSPITAL TO MEET REGULARLY FOR THE PURPOSE OF EVALUATING DIFFERENT OPPORTUNITIES TO SUPPORT OTHER NONPROFIT ORGANIZATIONS THROUGH PROVIDING VOLUNTEERS, GRANTS, AND SPONSORSHIPS FOR FUNDRAISING AND EDUCATIONAL EVENTS. CRITERIA USED IN THE DETERMINATION OF ASSISTANCE INCLUDE: THE ORGANIZATION'S ALIGNMENT WITH THE HOSPITAL'S CORE MISSION AND VALUES, THE DIVERSITY AND LOCATION OF THE POPULATION SERVED, AS WELL AS DOCUMENTED COMMUNITY NEED ADDRESSED BY THE ORGANIZATION. X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 THOMAS HANSEN MD 369272 369271 200205 200205 0 0 97542 97541 14820 14821 681839 681838 0 0 KELLY WALLACE 303521 101173 126949 42317 0 0 73889 24629 19929 6643 524288 174762 0 0 PATRICK HAGAN 399016 44335 195397 21711 0 0 164823 18314 24303 2700 783539 87060 0 0 DAVID FISHER MD 427196 47466 203469 22608 0 0 82896 9211 24516 2724 738077 82009 0 0 DREXEL DEFORD 397322 0 163664 0 0 0 75455 0 19990 0 656431 0 0 0 SANFORD MELZER MD 189011 184167 113388 37796 0 0 61214 32600 18749 9992 382362 264555 0 0 JAMES HENDRICKS MD 307755 0 110814 0 0 0 56410 0 25581 0 500560 0 0 0 LISA BRANDENBURG 342091 0 138483 0 0 0 64413 0 25850 0 570837 0 0 0 JEFFREY SCONYERS 147873 147873 61856 61855 0 0 28090 28089 12725 12725 250544 250542 0 0 EDWIN WRIGHT 305596 0 101387 0 0 0 10261 0 25481 0 442725 0 0 0 SUSAN HEATH 249612 0 109830 0 0 0 47922 0 17531 0 424895 0 0 0 SUZANNE PETERSEN 224377 0 69839 0 0 0 15985 0 24731 0 334932 0 0 0 STEVEN HURWITZ 241513 0 72063 0 0 0 11125 0 22627 0 347328 0 0 0 CARA BAILEY 221772 0 76674 0 0 0 14254 0 9643 0 322343 0 0 0 ERIK LAUSUND 216156 0 61893 0 0 0 15579 0 12751 0 306379 0 0 0 JENNIFER ABERMANIS 204032 0 71077 0 0 0 15176 0 24589 0 314874 0 0 0 CINDY EVANS 228140 0 94522 0 0 0 14465 0 17368 0 354495 0 0 0 DAVID PERRY 205296 0 70210 0 0 0 10118 0 24560 0 310184 0 0 0 WARREN HEWITT 204326 0 55269 0 0 0 14758 0 15441 0 289794 0 0 0 JUDITH DOUGHERTY 207848 0 65504 0 0 0 14373 0 16952 0 304677 0 0 0 TODD JOHNSON 205721 0 71725 0 0 0 11397 0 16736 0 305579 0 0 0 CHARLES HODGE 182881 0 68093 0 0 0 10460 0 22123 0 283557 0 0 0 DAVID BRAUNER 349266 0 150500 0 0 0 9800 0 19593 0 529159 0 0 0 DOUGLAS PICHA 33608 302469 8030 72265 0 0 5061 45548 2556 23009 49255 443291 0 0 JOE RUTLEDGE 348394 0 19863 0 0 0 14799 0 13295 0 396351 0 0 0 ANNE MANKTELOW 361662 0 5000 0 0 0 6588 0 9304 0 382554 0 0 0 DONA BREKKE 250182 0 102339 0 0 0 10467 0 6385 0 369373 0 0 0 PART I, LINE 1A PART I, LINE 1A: BUSINESS OR FIRST CLASS TRAVEL IS PROVIDED IN THE EVENT OF MEDICAL NECESSITY OR ON CERTAIN INTERNATIONAL FLIGHTS OF LONG DURATION. THIS IS NOT TREATED AS COMPENSATION. THE CHIEF EXECUTIVE OFFICER IS PROVIDED MEMBERSHIP TO THE RAINIER CLUB. ANNUAL DUES ARE $2,285, WHICH IS REPORTED AS IMPUTED COMPENSATION. ADDITIONALLY, JAMES HENDRICKS, A KEY EMPLOYEE, AND DOUGLAS PICHA, A HIGHEST COMPENSATED EMPLOYEE, ARE PROVIDED ROTARY CLUB MEMBERSHIPS, FOR WHICH ANNUAL DUES ARE $560 EACH. PART I, LINE 4B THE FOLLOWING EMPLOYEES PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THOMAS HANSEN MD - $188,589 KELLY WALLACE - $87,493 PATRICK HAGAN - $172,112 JAMES HENDRICKS MD - $44,784 LISA BRANDENBURG - $57,023 DREXEL DEFORD - $68,105 DAVID FISHER MD - $84,757 SUSAN HEATH - $35,908 SANFORD MELZER MD - $70,345 JEFFREY SCONYERS - $44,669 DOUGLAS PICHA - $38,458 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HAA3 2010-09-02 77394750 SEE PART V SUPPLEMENTAL INFORMATION 0 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HAB1 2010-09-02 46669601 SEE PART V SUPPLEMENTAL INFORMATION 0 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978EK43 2008-04-16 148540000 SEE PART V SUPPLEMENTAL INFORMATION 0 0 0 WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978E586 2008-05-29 90800036 SEE PART V SUPPLEMENTAL INFORMATION 0 0 0 77394750 77394750 2010 0 0 1 1 46669601 568714 20887 2010 1 0 1 1 148540000 2265000 2008 1 0 1 1 90800036 800036 2009 0 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 GOLDMAN SACHSJP MORGAN 23.000000000000 0 0 0 0 1 0 0 0 0 0 1 ENTITY 1 - FIRST SCHEDULE: PART I, COLUMN F, DESCRIPTION OF PURPOSE: LINE A, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2010A (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2010A BONDS"), WERE ISSUED TO REIMBURSE SEATTLE CHILDREN'S ("CHILDREN'S") FOR THE COSTS OF ACQUIRING CERTAIN REAL PROPERTY (INCLUDING LAND) TO BE DEVELOPED AND USED AS HEALTH CARE FACILITIES OF CHILDREN'S. LINE B, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2010B (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2010B BONDS"), WERE ISSUED TO (I) REFUND, ON A CURRENT BASIS, AND DEFEASE ALL OF THE OUTSTANDING WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 1998 (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) (THE "SERIES 1998 BONDS"), AND (II) PAY COST OF ISSUANCE FOR THE SERIES 2010B. THE SERIES 1998 BONDS WERE DATED NOVEMBER 17, 1998 AND THE PROCEEDS USED TO PROVIDE A PORTION OF THE FUNDING FOR A COMPREHENSIVE FACILITY RENOVATION PROGRAM THAT INCLUDED EXTENSIVE CAPITAL IMPROVEMENTS TO THE HOSPITAL'S MAIN FACILITY. LINE C, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2008A/B (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) (THE "SERIES 2008A/B BONDS") WERE ISSUED TO REFUND, ON A CURRENT BASIS, AND REDEEM ALL OF THE OUTSTANDING WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2006A (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) AND SERIES 2006B (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER), EACH DATED FEBRUARY 16, 2006 (THE "SERIES 2006A/B BONDS") THE PROCEEDS OF WHICH WERE USED TO PROVIDE (I) A PORTION OF THE FUNDING TO ADVANCE REFUND AND DEFEASE $67 MILLION OF THE SERIES 1998 BONDS AND (II) ADVANCE REFUND AND DEFEASE $66 MILLION OF THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2001 (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) (THE "SERIES 2001 BONDS"), THE PROCEEDS OF WHICH WERE USED TO PROVIDE (I) A PORTION OF THE FUNDING FOR A $120 MILLION CAPITAL PROGRAM, (II) PAY FOR THE PREMIUM RELATING TO THE BOND INSURANCE POLICY AND (III) PAY CERTAIN COSTS OF ISSUANCE OF THE SERIES 2001 BONDS. THE CUSIP NUMBER IS FOR THE SERIES 2008B BONDS, WHICH HAVE THE LATER OF THE TWO MATURITIES OF THE TWO SERIES. LINE D, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2008C (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) (THE "SERIES 2008C BONDS") WERE ISSUED TO (I) REPAY AND RETIRE CHILDREN'S TAXABLE LINE OF CREDIT INDEBTEDNESS OWED TO WELLS FARGO BANK, N.A., WHICH INDEBTEDNESS WAS INCURRED TO REDEEM AND RETIRE THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2006C (CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER) (THE "SERIES 2006C BONDS") THE PROCEEDS OF WHICH WERE USED TO PROVIDE A PORTION OF THE FUNDS NECESSARY TO CONSTRUCT, REMODEL AND/OR ACQUIRE ADDITIONAL HEALTH CARE FACILITIES FOR CHILDREN'S AND (II) TO PAY CERTAIN COSTS OF ISSUANCE OF THE SERIES 2008C BONDS. PART II, PROCEEDS: COLUMN B: $46,080,000 WAS USED TO REFUND, ON A CURRENT BASIS, AND DEFEASE THE OUTSTANDING SERIES 1998 BONDS, WITHIN 90 DAYS OF THE CLOSING OF THE SERIES 2010B BONDS. COLUMN C: $146,275,000 WAS USED TO REFUND, ON A CURRENT BASIS AND REDEEM ALL OF THE OUTSTANDING SERIES 2006A AND SERIES 2006B BONDS WITHIN 90 DAYS OF THE CLOSING OF THE SERIES 2008A/B BONDS. COLUMN D: $90,000,000 WAS USED TO REPAY AND RETIRE A TAXABLE LINE OF CREDIT INDEBTEDNESS WITHIN 90 DAYS OF THE CLOSING OF THE SERIES 2008C BONDS. PART III, PRIVATE BUSINESS USE: LINES 4-6: THERE IS NO PRIVATE USE PROPERTY. PERCENTAGES = 0.00%. ENTITY 2 - SECOND SCHEDULE: PART I, COLUMN F, DESCRIPTION OF PURPOSE: LINE A, THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS, SERIES 2009 (SEATTLE CHILDREN'S HOSPITAL) (THE "SERIES 2009 BONDS") WERE ISSUED TO PROVIDE ALL OR A PORTION OF THE FUNDS NECESSARY TO (I) PAY THE COSTS (INCLUDING NEW CAPITAL COSTS, REIMBURSEMENT COSTS, AND REFINANCING COSTS) OF ACQUIRING THE LAND FOR CONSTRUCTING AND EQUIPPING A NEW OUTPATIENT CLINIC AND AMBULATORY SURGERY FACILITY IN BELLEVUE, WASHINGTON, RENOVATING AND REMODELING VARIOUS PORTIONS OF CHILDREN'S EXISTING FACILITIES AT ITS SEATTLE CAMPUS, AND ACQUIRING NEW AND REPLACEMENT EQUIPMENT TO BE USED INITIALLY IN CHILDREN'S EXISTING FACILITIES ON ITS MAIN CAMPUS AND (II) PAY ISSUANCE COSTS OF THE SERIES 2009 BONDS. PART II, PROCEEDS: COLUMN A: LINE 3 INCLUDES INVESTMENT EARNINGS OF $100,038. PART III, PRIVATE BUSINESS USE: LINES 4-6: THERE IS NO PRIVATE USE PROPERTY. PERCENTAGES = 0.00%. WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978E584 2009-08-19 113722874 SEE PART V SUPPLEMENTAL INFORMATION 0 0 0 113822912 1975466 107009910 4837536 2012 0 0 0 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 HOSPITAL CENTRAL SERVICES ASSOCIATION (HCSA) KELLY WALLACE, CFO, IS ON THE BOARD OF HCSA. 1723761 SERVICES 0 SEATTLE CHILDREN'S HEALTHCARE SYSTEM COMMON BOARD 923220 RENTAL REV/OP EXPS TRANSFERRED TO SCHS 0 KING 5 TV FAMILY MEMBER OF CYNTHIA HUFFMAN, TRUSTEE, IS CEO OF KING 5 TV. 525000 SERVICES 0 MCKINSTRY COMPANY DEAN ALLEN, TRUSTEE, IS CEO AND PART OWNER OF MCKINSTRY COMPANY. 126571 SERVICES 0 ELLEN FISCHER DR. ROB ROSKIN, TRUSTEE, IS THE SPOUSE OF ELLEN FISCHER. 111005 EMPLOYMENT 0 SARAH BOWDEN WARREN HEWITT, VP OF FINANCE, IS A FAMILY MEMBER OF SARAH BOWDEN. 49983 EMPLOYMENT 0 X 1 14800 MARKET VALUE X 37 267451 MARKET VALUE X 1 44091 MARKET VALUE X 1 20000 MARKET VALUE X MICROSCOPE 1 36000 MARKET VALUE 1 0 1 1 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): LINE 1 - 1 CONTRIBUTION OF AN OIL PAINTING; LINE 9 - 37 CONTRIBUTIONS OF VARIOUS AMOUNTS OF SECURITIES; LINE 11 - 1 CONTRIBUTION OF A RETURN OF LIFE INTEREST IN A CHARITABLE REMAINDER TRUST; LINE 17 - 1 CONTRIBUTION OF LAND; LINE 25 - 1 CONTRIBUTION OF AN EVOS FL DIGITAL FLUORESCENCE MICROSCOPE. THIRD PARTY USE: PART I, LINE 32B: SEATTLE CHILDREN'S HOSPITAL FOUNDATION AND SEATTLE CHILDREN'S HOSPITAL GUILD ASSOCIATION (RELATED ORGANIZATIONS) SOLICIT BOTH CASH AND NON-CASH GIFTS ON BEHALF OF SEATTLE CHILDREN'S HOSPITAL ("THE HOSPITAL"). FOR GIFTS OF REAL ESTATE, THE HOSPITAL HIRES REALTY COMPANIES TO SELL THE REAL ESTATE. FORM 990, PART I, LINE 6: SEATTLE CHILDREN'S HOSPITAL HAS A DEDICATED GROUP OF VOLUNTEERS WHO GENEROUSLY GIVE THEIR TIME AND ENERGY TO SUPPORTING THE MISSION OF THE HOSPITAL. IN FISCAL YEAR 2011, 821 VOLUNTEERS, AFTER COMPLETING A THOROUGH INTERVIEW AND TRAINING PROCESS, LOGGED 90,966 HOURS OF SERVICE IN ONE OF 80 DIFFERENT DEPARTMENTS, WITH DUTIES RANGING FROM WORKING IN THE HOSPITAL GIFT SHOP, TO ENTERTAINING PATIENTS IN THE PLAYROOM, TO HELPING WITH ADMINISTRATIVE TASKS AT A RECEPTION AREA. IN ADDITION, 30 TRUSTEES SERVED ON THE SEATTLE CHILDREN'S HOSPITAL BOARD DURING FISCAL YEAR 2011. IN ALL THAT THEY DO, OUR VOLUNTEERS ARE HIGHLY VALUED MEMBERS OF OUR HOSPITAL COMMUNITY. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE VOTING MEMBER OF SEATTLE CHILDREN'S HOSPITAL IS SEATTLE CHILDREN'S HEALTHCARE SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A SEATTLE CHILDREN'S HEALTHCARE SYSTEM, AS THE SOLE MEMBER OF SEATTLE CHILDREN'S HOSPITAL, ELECTS THE MEMBERS OF THE BOARD OF TRUSTEES (WHICH IS THE GOVERNING BODY) OF SEATTLE CHILDREN'S HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B SEATTLE CHILDREN'S HEALTHCARE SYSTEM, AS THE SOLE MEMBER OF SEATTLE CHILDREN'S HOSPITAL, HAS THE AUTHORITY TO MAKE, ALTER, AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS OF SEATTLE CHILDREN'S HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT AND INDEPENDENT TAX PROFESSIONALS PRESENT AND REVIEW THE FORM 990 WITH THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF TRUSTEES. THE ENTIRE BOARD OF TRUSTEES RECEIVES COPIES OF THE FORM 990 AFTER REVIEW BY THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE, PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF SEATTLE CHILDREN'S HOSPITAL REQUIRES AN ANNUAL SURVEY OF ALL BOARD MEMBERS OF SEATTLE CHILDREN'S HOSPITAL, MEMBERS OF THE MEDICAL LEADERSHIP, STAFF MEMBERS OCCUPYING ROLES WITH A DEGREE OF AUTHORITY, AS WELL AS ALL STAFF MEMBERS PARTICIPATING IN RESEARCH ACTIVITIES AND MEMBERS OF THE HOSPITAL'S PHARMACY AND THERAPEUTICS COMMITTEE. THE SENIOR VICE PRESIDENT AND GENERAL COUNSEL, ACTING UNDER THE OVERSIGHT OF THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF DIRECTORS, REVIEWS ALL DISCLOSURES AND ESTABLISHES AND OVERSEES ANY NECESSARY MANAGEMENT PLANS RELATED TO THEM. ANY COVERED PERSON OR OTHER EMPLOYEE WHO ENGAGES IN A VIOLATION OF THIS POLICY OR PURSUES A TRANSACTION OR EVENT FOLLOWING DISAPPROVAL BY THE BOARD OR THE CHIEF EXECUTIVE OFFICER MAY, IN THE DISCRETION OF THE BOARD OR THE CHIEF EXECUTIVE OFFICER IN ACCORDANCE WITH THEIR RESPECTIVE AUTHORITY, BE REMOVED IMMEDIATELY FROM HIS OR HER DUTIES WITH SEATTLE CHILDREN'S HOSPITAL AND/OR TERMINATED IN HIS OR HER EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION FALLS WITHIN THE PURVIEW OF THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE BOARD ENGAGES AN INDEPENDENT THIRD-PARTY EXPERT ANNUALLY TO REVIEW AND ASSESS THE EXECUTIVE COMPENSATION PROGRAM (BASE, INCENTIVE COMPENSATION, AND EMPLOYER-PAID BENEFITS) TO DETERMINE COMPETITIVENESS. THE BOARD RELIES ON THE EXPERT ANALYSIS TO DETERMINE THAT COMPENSATION IS REASONABLE AND WITHIN THE "BOUNDS OF COMPETITIVE PRACTICE" AND TO DECLARE A REBUTTABLE PRESUMPTION OF REASONABLENESS REGARDING EXECUTIVE COMPENSATION. THE COMPENSATION COMMITTEE REVIEWS THE SUMMARY DATA PROVIDED AND APPROVES BASE SALARY RECOMMENDATIONS FOR THE PRESIDENT, CHIEF EXECUTIVE OFFICER, AND OTHER "KEY" EXECUTIVES. THE FULL BOARD OF TRUSTEES REVIEWS AND FORMALLY APPROVES THE ACTIONS OF THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 SEATTLE CHILDREN'S HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 1B: TRUSTEE CYNTHIA HUFFMAN IS NOT INDEPENDENT BECAUSE OF HER FAMILY RELATIONSHIP TO RAY HEACOX, THE CHIEF EXECUTIVE OFFICER OF KING 5 TV. SEATTLE CHILDREN'S HOSPITAL ENGAGES WITH KING 5 TV FOR MARKETING AND COMMUNICATION SERVICES. TRUSTEE DEAN ALLEN IS THE CHIEF EXECUTIVE OFFICER AND PART OWNER OF MCKINSTRY CO. AND IS NOT INDEPENDENT BECAUSE SEATTLE CHILDREN'S HOSPITAL ENGAGES WITH MCKINSTRY CO. ON VARIOUS CONSTRUCTION PROJECTS. FORM 990, PART VII, SECTION A, COLUMN (B): HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: JIM LADD - 1 LAURIE OKI - 3 JAN SINEGAL - 1 THOMAS HANSEN - 28.5 KELLY WALLACE - 15 PATRICK HAGAN - 5 DAVID FISHER - 6 SANFORD MELZER - 14 JEFFREY SCONYERS - 27 DOUGLAS PICHA - 50.5 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -25,807,114. CHANGE IN BENEFICIAL INTEREST IN SCHS -672,399. RESTRICTED GRANTS AND DONATIONS 36,893,177. NET ASSETS RELEASED FROM RESTRICTION -30,135,588. TOTAL TO FORM 990, PART XI, LINE 5: -19,721,924. SEATTLE CHILDREN'S COMMUNITY BENEFIT REPORT 2011 LETTER FROM OUR CHIEF EXECUTIVE OFFICER AT SEATTLE CHILDREN'S, WE'RE ALWAYS THINKING OF THE HEALTH AND WELL-BEING OF EVERY CHILD AND FAMILY IN THE COMMUNITY. IT IS OUR MISSION AND OUR PASSION. OUR STAFF AND FACULTY MEMBERS REACH BEYOND OUR CAMPUS EVERY DAY TO PROVIDE PROGRAMS, SERVICES, EDUCATION AND RESEARCH TO MAKE CHILDREN AND FAMILIES SAFER AND HEALTHIER WHERE THEY LIVE. OUR 2011 COMMUNITY BENEFIT REPORT DESCRIBES SOME OF THE WAYS CHILDREN'S RESPONDS TO COMMUNITY NEEDS AS WE STRIVE TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. I'M PROUD TO REPORT THAT THE TOTAL VALUE OF OUR INVESTMENT IN THE COMMUNITY IN 2011 WAS $220,035,000 - WITH A LITTLE LESS THAN HALF GOING TO UNCOMPENSATED CARE. WITH HELP FROM FAMILIES AND LEADERS IN COMMUNITY ORGANIZATIONS AND PUBLIC HEALTH AGENCIES, WE'RE "TAKING THE TEMPERATURE" OF CHILDREN AND FAMILIES WITH A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT TO MAKE SURE OUR INVESTMENT IS MEETING THEIR MOST URGENT NEEDS. ONE OF THE TOP HEALTH CONCERNS THAT HAS SURFACED IN OUR COMMUNITY HEALTH ASSESSMENT IS OBESITY. OBESITY IS AN EPIDEMIC THAT IS SWEEPING THE COUNTRY. ABOUT 11% OF HIGH SCHOOL YOUTH IN WASHINGTON STATE ARE OBESE AND 14 TO 16% ARE OVERWEIGHT. ONE IN FIVE HIGH-SCHOOL YOUTHS IN KING COUNTY IS OVERWEIGHT. ON EACH SECTION OF OUR COMMUNITY BENEFIT REPORT WE HIGHLIGHT EXAMPLES OF HOW WE ARE ADDRESSING THIS SERIOUS HEALTH ISSUE IN PARTNERSHIP WITH PUBLIC HEALTH, COMMUNITY ORGANIZATIONS AND FAMILIES. BUILDING A SAFE AND HEALTHY FUTURE FOR CHILDREN AND FAMILIES IS A BIG JOB. WE COULDN'T DO THIS WORK WITHOUT YOUR SUPPORT. THANK YOU. TOTAL 2011 VALUE TO THE COMMUNITY: $220,035,000 OUR COMMUNITY BENEFIT INVESTMENT IN PATIENT CARE AND RESEARCH, IN EDUCATING HEALTHCARE PROFESSIONALS AND IN COMMUNITY PROGRAMS AND SERVICES REFLECTS CHILDREN'S COMMITMENT TO PREVENTING, TREATING AND ELIMINATING PEDIATRIC DISEASE. LEARN MORE ABOUT THE WAYS WE BENEFIT OUR COMMUNITY AT WWW.SEATTLECHILDRENS.ORG/ABOUT/COMMUNITY-BENEFIT/. UNCOMPENSATED CARE OUR FINANCIAL ASSISTANCE PROGRAM HONORS OUR FOUNDING PROMISE TO CARE FOR EVERY CHILD WHO NEEDS US REGARDLESS OF A FAMILY'S ABILITY TO PAY. IN 2011, CHILDREN'S PROVIDED $103 MILLION IN UNCOMPENSATED CARE TO CHILDREN IN WASHINGTON, ALASKA, MONTANA AND IDAHO, ENSURING ALL OF OUR REGION'S SICK AND INJURED CHILDREN HAVE ACCESS TO THE BEST MEDICAL CARE AVAILABLE. WHEN A CHILD IS BATTLING A SERIOUS MEDICAL CONDITION, FAMILIES HAVE ENOUGH TO WORRY ABOUT WITHOUT STRESSING OVER HOW TO PAY THE HOSPITAL BILL. CHILDREN'S UNCOMPENSATED CARE PROGRAM HELPS FAMILIES FOCUS ON HEALING, NOT COST, REGARDLESS OF THEIR INSURANCE COVERAGE OR FINANCIAL CIRCUMSTANCES. CHILDREN'S UNCOMPENSATED CARE PROGRAM BRIDGES THE GROWING GAP BETWEEN MEDICAID REIMBURSEMENTS AND THE REAL COST OF TREATMENT. MEDICAID IS THE GOVERNMENT PROGRAM THAT PROVIDES MEDICAL COVERAGE AT NO OR LOW COST TO LOW-INCOME FAMILIES. NEARLY HALF OF OUR PATIENTS RECEIVED COVERAGE THROUGH MEDICAID IN 2011, AND ONLY 71% OF THE COST WAS REIMBURSED FOR THE CARE PROVIDED. OUR UNCOMPENSATED CARE PROGRAM MADE UP FOR THE SHORTFALL WHICH AMOUNTED TO $92.3 MILLION IN 2011. ANOTHER $10.7 MILLION WENT TO SUPPORT FAMILIES WITH NO ABILITY TO PAY FOR THEIR CHILD'S CARE. FEATURE: A BOY AND HIS FAMILY FIND CARE AND COMPASSION AT CHILDREN'S A BOY'S LIFE HAS BEEN FILLED WITH DOCTORS, HOSPITAL STAYS AND MEDICAL EQUIPMENT. BORN IN 2009, HE WAS DIAGNOSED PRENATALLY WITH LARGE CYSTS ON HIS CHEEK AND NECK - KNOWN AS LYMPHATIC MALFORMATIONS - AND HAS REQUIRED EXTRAORDINARY CARE FOR THE MOST BASIC THINGS, LIKE EATING AND BREATHING. BY THE END OF 2009, THE MEDICAL BILLS FOR HIS CARE OVERWHELMED HIS FAMILY. THEY APPLIED TO CHILDREN'S UNCOMPENSATED CARE PROGRAM AND WERE GRANTED FINANCIAL SUPPORT. "WE HUMBLY ACCEPTED THE HELP AND FELL TO OUR KNEES IN GRATITUDE," SAYS HIS MOTHER. "IT FEELS SO SAFE AND SECURE TO KNOW A CO-PAY WILL NEVER STAND IN THE WAY OF OUR SON'S CARE." NOW, THE FAMILY WANTS TO GIVE BACK. THEY'RE FORMING A GUILD TO SUPPORT RESEARCH FOR VASCULAR ANOMALIES. "WE FEEL DRIVEN TO HELP OTHER FAMILIES THE WAY WE'VE BEEN HELPED," SAYS HIS MOTHER. FOCUS ON OBESITY: FIGHTING FOR POLICIES THAT FIGHT OBESITY CHILDREN'S PLAYS A LEADING ROLE IN THE STATEWIDE CHILDHOOD OBESITY PREVENTION COALITION. THE COALITION'S 43 MEMBERS ADVOCATE FOR POLICIES TO BUILD A HEALTHIER GENERATION. IN 2011, THE COALITION HELPED PASS LEGISLATION TO MAKE STREETS SAFER FOR PEDESTRIANS AND BICYCLISTS, LAUNCHED A SODA FREE SUNDAYS CAMPAIGN TO RAISE AWARENESS ABOUT THE RISKS OF SUGARY DRINKS, AND HELD AN OBESITY PREVENTION SUMMIT CO-HOSTED BY CHILDREN'S AND THE AMERICAN HEART ASSOCIATION. RESEARCH RESEARCH IS ESSENTIAL IN FULFILLING CHILDREN'S MISSION TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE. WE'RE COMMITTED TO TRANSLATING OUR RESEARCH INTO NEW AND BETTER THERAPIES SO THAT ALL OF OUR PATIENTS - AND CHILDREN AROUND THE WORLD - BENEFIT FROM OUR DISCOVERIES. THE SEATTLE CHILDREN'S RESEARCH INSTITUTE HAS BECOME THE LARGEST PEDIATRIC RESEARCH CENTER WEST OF THE MISSISSIPPI, AND ONE OF THE TOP FIVE IN THE NATION BASED ON FUNDING RECEIVED FROM THE NATIONAL INSTITUTES OF HEALTH (NIH). GRANTS FROM THE NIH INCREASED FROM $13 MILLION IN 2006 TO MORE THAN $52 MILLION IN FISCAL YEAR 2011. TOTAL EXTRAMURAL FUNDING GREW TO $69 MILLION IN 2011. DISCOVERY CENTRAL SEATTLE CHILDREN'S RESEARCH INSTITUTE COMPRISES NINE INTERDISCIPLINARY CENTERS AND FOUR PROGRAMS ENCOMPASSING AREAS CENTRAL TO PEDIATRIC HEALTH: CENTERS: - BEN TOWNE CENTER FOR CHILDHOOD CANCER RESEARCH - CENTER FOR CHILD HEALTH, BEHAVIOR AND DEVELOPMENT - CENTER FOR CHILDHOOD INFECTIONS AND PREMATURITY RESEARCH - CENTER FOR CLINICAL AND TRANSLATIONAL RESEARCH - CENTER FOR DEVELOPMENTAL THERAPEUTICS - CENTER FOR GENETICS AND DEVELOPMENT - CENTER FOR IMMUNITY AND IMMUNOTHERAPIES - CENTER FOR INTEGRATIVE BRAIN RESEARCH - CENTER FOR TISSUE AND CELL SCIENCES PROGRAMS: - GLOBAL ALLIANCE TO PREVENT PREMATURITY AND STILLBIRTH - NORTHWEST GENOME ENGINEERING CONSORTIUM - SCIENCE ADVENTURE LAB - TREUMAN KATZ CENTER FOR PEDIATRIC BIOETHICS PREVENTING ILLNESSES AND INJURIES ADDRESSING TEEN SUICIDE RISK TEEN SUICIDE IS A DEADLY PROBLEM IN THE UNITED STATES. ACCORDING TO THE WASHINGTON STATE DEPARTMENT OF HEALTH, SUICIDE IS THE SECOND LEADING CAUSE OF DEATH FOR YOUTH 10 TO 24 YEARS OLD IN OUR STATE. IDENTIFYING TEENS WITH SUICIDAL THOUGHTS IS CRITICAL TO PREVENTING SUICIDE, BUT A STUDY LED BY DR. CAROLYN MCCARTY SUGGESTS SUICIDAL TEENS AREN'T GETTING THE MENTAL HEALTH SERVICES THEY NEED. MCCARTY AND HER CO-INVESTIGATORS FROM THE UNIVERSITY OF WASHINGTON (UW) AND GROUP HEALTH RESEARCH INSTITUTE FOUND THAT ONLY 13% OF TEENS AGES 13 TO 18 WITH SUICIDAL THOUGHTS VISITED A MENTAL HEALTH PROFESSIONAL THROUGH THEIR HEALTH CARE NETWORK AND ONLY 16% RECEIVED SERVICES THE YEAR AFTER. THE LOW RATES ARE A STRIKING CALL TO ACTION, SAYS MCCARTY. "THESE FINDINGS UNDERSCORE THE NEED FOR PRIMARY CARE PHYSICIANS TO SCREEN FOR DEPRESSION AND SUICIDAL THOUGHTS." ESTABLISHING HIGH BLOOD PRESSURE RISK HIGH BLOOD PRESSURE AMONG CHILDREN IN THE UNITED STATES HAS INCREASED FIVE-FOLD OVER THE LAST 30 YEARS. RESEARCH LED BY DR. JOSEPH FLYNN AND A TEAM FROM JOHN HOPKINS CENTER FOUND THAT HIGH BLOOD PRESSURE MAY LEAD TO WORSE HEART TROUBLE FOR BLACK CHILDREN UNDER THE AGE OF 13 THAN FOR OTHER CHILDREN OF THE SAME AGES. THE STUDY FOUND THEY WERE TWICE AS LIKELY TO DEVELOP A DANGEROUS THICKENING OF THE HEART MUSCLE THAT IS AN EARLY AND COMMON COMPLICATION OF HIGH BLOOD PRESSURE. THE STUDY ALSO FOUND THAT BLACK TEENS HAVE HIGHER BLOOD PRESSURE OVERALL AND THAT IT REMAINED IN THE DANGEROUS RANGE LONGER THAN OTHER TEENS. "THE STUDY EMPHASIZES THE NEED FOR EARLY DIAGNOSIS AND TREATMENT OF HIGH BLOOD PRESSURE IN ALL CHILDREN, BUT PEDIATRICIANS SHOULD BE AWARE THAT BLACK CHILDREN AND TEENS MAY DEVELOP MORE SEVERE COMPLICATIONS OR DEVELOP THEM MORE QUICKLY," FLYNN SAYS. IDENTIFYING THE BEST TREATMENTS HELPING FAMILIES COPE WITH FETAL ALCOHOL SYNDROME CHILDREN WITH FETAL ALCOHOL SPECTRUM DISORDERS (FASD) ARE BORN WITH A PAINFUL LEGACY OF LIFELONG NEUROLOGICAL ISSUES RANGING FROM LEARNING DEFICITS TO MEMORY LOSS. DR. HEATHER CARMICHAEL OLSON IS LEADING AN ONGOING RESEARCH EFFORT THAT IS IMPROVING THE LIVES OF CHILDREN AND FAMILIES COPING WITH FASD. CARMICHAEL OLSON DEVELOPED A STRATEGY THAT CONNECTS FAMILIES WITH TRAINED SPECIALISTS. THE SPECIALISTS TEACH PARENTS HOW TO RECOGNIZE THEIR CHILD'S NEURODEVELOPMENTAL DISABILITIES AND ADAPT THE HOME AND SCHOOL ENVIRONMENT TO LESSEN THE IMPACT AND IMPROVE THEIR CHILD'S DAY-TO-DAY FUNCTION. FOR EXAMPLE, WHEN A PARENT ASKS A CHILD WITH FASD TO GET DRESSED, THE CHILD MIGHT NOT BE ABLE TO REMEMBER LONG ENOUGH TO COMPLETE THE REQUEST, SO PARENTS LEARN WAYS TO ADDRESS THE MEMORY PROBLEM SUCH AS HANGING A POSTER ON THE BEDROOM WALL AS A VISUAL CLUE. COORDINATING CARE FOR CHRONICALLY ILL CHILDREN MANAGING THE HEALTH OF A CHILD WITH A LIFELONG CHRONIC ILLNESS SUCH AS CYSTIC FIBROSIS OR TYPE 1 DIABETES IS COMPLEX AND REQUIRES COORDINATION WITH MANY DIFFERENT HEALTHCARE PROVIDERS. THESE CHILDREN OFTEN END UP IN AND OUT OF THE HOSPITAL - IN PART BECAUSE HOSPITALS LACK A CONSISTENT METHOD TO IDENTIFY THEM AND EFFICIENTLY COORDINATE THEIR CARE ONCE THEY GO HOME. A STUDY LED BY DR. JOHN NEFF USED HOSPITAL DISCHARGE DATA FROM CHILDREN'S AND ODESSA BROWN CHILDREN'S CLINIC TO DEVELOP A UNIQUE WAY TO TRACK CHILDREN WITH LIFELONG CHRONIC CONDITIONS - THE FIRST STEP TOWARD IMPROVING THEIR QUALITY OF LIFE AND REDUCING COSTS BY DECREASING READMISSIONS. LINKING CAUSE AND EFFECT BRINGING PAIN MANAGEMENT HOME DR. TONYA PALERMO IS LEADING A NATIONWIDE TRIAL OF AN ONLINE TOOL TO HELP CHILDREN MANAGE CHRONIC PAIN AT HOME. THE WEB-BASED INTERVENTION SHE DEVELOPED TEACHES CHILDREN TO USE COGNITIVE BEHAVIORAL STRATEGIES, SUCH AS PROBLEM-SOLVING AND RELAXATION TECHNIQUES, AND TEACHES PARENTS HOW TO SUPPORT THEIR CHILDREN. UP TO 40% OF CHILDREN EXPERIENCE SOME DEGREE OF CHRONIC PAIN, USUALLY HEADACHES, BACKACHES OR ABDOMINAL PAIN. IN 5% TO 10% OF CASES, THE PAIN BECOMES DISABLING, CAUSING CHILDREN TO MISS SCHOOL, STOP EXERCISING AND WITHDRAW FROM FRIENDS. PALERMO'S TOOL PROVIDES AN OPTION FOR CHILDREN WHO LACK ACCESS TO PAIN MANAGEMENT PROGRAMS IN THEIR COMMUNITY AND COULD HELP ALL CHILDREN WITH CHRONIC PAIN ADDRESS THEIR PAIN SOONER. PEOPLE MAKING A DIFFERENCE: DR. DOUG DIEKEMA PHYSICIAN HELPS MAKE SENSE OF COMPLEX ETHICAL ISSUES CARING FOR CHILDREN WITH COMPLEX ILLNESSES AND INJURIES CREATES MANY MEDICAL CHALLENGES, BUT ALSO GENERATES MANY ETHICAL QUESTIONS. ADVANCES IN MEDICAL TECHNOLOGY, FINANCIAL CONSTRAINTS AND CHANGES IN THE HEALTHCARE SYSTEM ARE CONSTANTLY RAISING NEW ISSUES. AS A BIOETHICS CONSULTANT AT SEATTLE CHILDREN'S, DR. DOUG DIEKEMA GUIDES FAMILIES, PHYSICIANS, RESEARCHERS AND INSTITUTIONS THROUGH CHALLENGING DECISIONS, SUCH AS WHAT TO DO IF FAMILIES AND DOCTORS DISAGREE ABOUT TREATMENT OR WHETHER TO TELL CHILDREN THEY'RE CARRYING A GENE THAT COULD THREATEN THEIR LIFE AS AN ADULT. "MY JOB IS TO TAKE THESE COMPLEX AND PERPLEXING ISSUES AND PRESENT THEM IN A WAY THAT PEOPLE CAN UNDERSTAND AND ACT ON," DIEKEMA SAYS. IN 2011, THE CENTER PROVIDED 31 CLINICAL BIOETHICS CONSULTS. "THERE'S MORE TO MOST MEDICAL DECISIONS THAN THE MEDICAL FACTS," DIEKEMA SAYS. "OUR ROLE IN BIOETHICS IS TO SHINE A LIGHT ON THE DIFFERENT VALUES PEOPLE BRING TO THE TABLE WHEN THEY'RE MAKING DIFFICULT CHOICES." FEATURE: WASHINGTON GLOBAL HEALTH ALLIANCE MAPPING PROJECT IMPROVING THE HEALTH OF THE WORLD'S MOST VULNERABLE POPULATIONS SEATTLE IS HOME TO A STELLAR NETWORK OF WORLD LEADERS IN GLOBAL HEALTH RESEARCH. LOCAL INSTITUTIONS, BUSINESSES AND FOUNDATIONS ARE WORKING FROM UGANDA TO THE UKRAINE TO IMPROVE THE HEALTH OF THE WORLD'S MOST VULNERABLE POPULATIONS. CHILDREN'S IS PART OF THE WASHINGTON GLOBAL HEALTH ALLIANCE MAPPING PROJECT THAT TRACKS THE ACTIVITIES OF THE STATE'S GLOBAL HEALTH ORGANIZATIONS AND FOSTERS COLLABORATION BETWEEN THEM. IN 2011, CHILDREN'S COLLABORATED WITH 70 GLOBAL HEALTH INSTITUTIONS, INCLUDING 32 INTERNATIONAL COLLABORATORS. WE WORK IN PARTNERSHIP WITH 16 COUNTRIES SUCH AS EGYPT, PAKISTAN, INDIA, BRAZIL AND MALAYSIA. DR. LISA FRENKEL AND HER COLLABORATORS AT CHILDREN'S ARE WORKING WITH INVESTIGATORS IN AFRICA, ASIA AND LATIN AMERICA TO IMPROVE THE HEALTH OF HIV-INFECTED PERSONS AND TO PREVENT MOTHER-TO-INFANT TRANSMISSION OF HIV. THEIR GOALS INCLUDE DEVELOPING AN INEXPENSIVE TEST TO DETECT WHETHER HIV-INFECTED MOTHERS ARE RESISTANT TO A COMMON ANTIRETROVIRAL THERAPY. FOCUS ON OBESITY: DO NEIGHBORHOODS AFFECT FITNESS? CHILDREN'S AND THE UW ARE STUDYING THE LINK BETWEEN A PERSON'S ACTIVITY LEVEL AND WHERE THEY LIVE. PARTICIPANTS IN THE TRAVEL ASSESSMENT AND COMMUNITY (TRAC) PROJECT, LED BY DR. BRIAN SAELENS, WILL COMPLETE SURVEYS ABOUT NEIGHBORHOOD TRANSPORTATION OPTIONS (SIDEWALKS, BIKE PATHS, BUS SERVICE, ETC.), WEAR AN ACTIVITY METER AND RECORD THEIR MODES OF TRAVEL. THE INFORMATION WILL SHOW HOW NEIGHBORHOODS COULD BECOME HEALTHIER PLACES BY PROVIDING TRANSPORTATION CHOICES THAT HELP PEOPLE STAY ACTIVE. HEALTH PROFESSIONAL EDUCATION SEATTLE CHILDREN'S IS A PLACE WHERE HEALING AND TEACHING GO HAND-IN-HAND. AS HOME TO THE ONLY PEDIATRIC RESIDENCY PROGRAM IN A FIVE-STATE REGION, WE HELP YOUNG DOCTORS IN TRAINING FROM THE UNIVERSITY OF WASHINGTON GAIN INVALUABLE EXPERIENCE CARING FOR SERIOUSLY ILL CHILDREN WHILE WORKING BESIDE WORLD-CLASS SPECIALISTS. WITH PEDIATRIC SPECIALISTS IN SHORT SUPPLY NATIONWIDE, CHILDREN'S IS A VITAL TRAINING GROUND FOR BOTH THE PEDIATRICIANS AND THE SPECIALISTS NEEDED BY FUTURE GENERATIONS OF CHILDREN. WE'RE ALSO AN IMPORTANT RESOURCE FOR THE COMMUNITY. ALL OF OUR RESIDENTS SPEND TIME WORKING IN RURAL COMMUNITIES WHERE ACCESS TO CARE CAN BE LIMITED. IN ADDITION, WE PROVIDE CONTINUING MEDICAL EDUCATION FOR COMMUNITY CLINICIANS AND OFFER PROGRAMS THAT TEACH PARENTS HOW TO BE PARTNERS IN THEIR CHILD'S HEALTH CARE. TRAINING THE NEXT GENERATION EDUCATING THE NEW CLINICIANS CHILDREN'S TRAINS TOP-NOTCH PEDIATRICIANS. WE RAISE THE LEVEL OF CARE FOR CHILDREN EVERYWHERE AND ESPECIALLY IN OUR COMMUNITY. MORE THAN HALF OF ALL GRADUATES OF THE UW PEDIATRIC RESIDENCY PROGRAM, WHICH IS BASED AT CHILDREN'S, CHOOSE TO STAY IN THE PACIFIC NORTHWEST TO PRACTICE AS PRIMARY CARE AND SUB-SPECIALTY PEDIATRICIANS. THE UW PROGRAM IS THE ONLY PEDIATRIC RESIDENCY PROGRAM IN WASHINGTON, WYOMING, ALASKA, MONTANA AND IDAHO (WWAMI REGION). IN 2011, 776 RESIDENTS FROM TRAINING PROGRAMS THROUGHOUT THE NORTHWEST ROTATED AT CHILDREN'S. BECAUSE WE OFFER FELLOWSHIPS IN MORE THAN 30 SPECIALTY AREAS, MANY RESIDENTS CONTINUE THEIR EDUCATION AT CHILDREN'S. IN JUNE 2011, 27 PHYSICIANS COMPLETED PEDIATRIC RESIDENCY (AND 1 COMPLETED PRELIMINARY TRAINING) BEFORE ENTERING INTO SUB-SPECIALTY FELLOWSHIPS AT CHILDREN'S. IN ADDITION, CHILDREN'S WAS A TRAINING SITE FOR 787 MEDICAL STUDENTS. SUPPORTING NURSING EDUCATION CHILDREN'S SUPPORTS THE EDUCATION OF NURSES AT ALL STAGES. WE HOST A FREE NURSING CAMP EVERY SUMMER WHERE HIGH SCHOOL STUDENTS SHADOW FOUR DIFFERENT NURSES OVER THREE DAYS. IN 2011, 27 STUDENTS INTERACTED WITH PATIENTS, WATCHED SURGERIES AND PARTICIPATED IN PANEL DISCUSSIONS AS THEY EXPLORED WHETHER A NURSING CAREER IS RIGHT FOR THEM. NURSES-IN-TRAINING COME TO CHILDREN'S FOR CLINICAL ROTATIONS WHERE THEY WORK ALONGSIDE OUR HIGHLY EXPERIENCED NURSING STAFF TO LEARN MORE ABOUT CARING FOR PEDIATRIC PATIENTS. WE OFFER CLINICAL PRECEPTORSHIPS TO NURSING STUDENTS AT ALL LEVELS, FROM BACCALAUREATE TO DOCTORAL PROGRAMS. CHILDREN'S NURSES SERVE AS INVITED LECTURERS AT NURSING PROGRAMS ACROSS THE REGION. WE ALSO HELP EDUCATE STUDENT NURSES AT OTHER HOSPITALS THROUGH OUR OUTREACH PROGRAMS. PEDIATRIC NURSING GROUND ROUNDS PROVIDE COMMUNITY NURSES THROUGHOUT THE REGION WITH THE LATEST INFORMATION ABOUT PEDIATRIC NURSING AND DIFFERENT HEALTH CONDITIONS. THE PRESENTATIONS TAKE PLACE NINE TIMES A YEAR AT CHILDREN'S AND ARE BROADCAST TO 47 SITES AROUND THE REGION AND ARCHIVED ONLINE. IN ADDITION, CHILDREN'S COLLABORATES WITH THE STATE DEPARTMENT OF HEALTH AND OFFICE OF SUPERINTENDENT OF PUBLIC INSTRUCTION TO SPONSOR AN ANNUAL TELECONFERENCE BROADCAST TO SCHOOL DISTRICTS AND PUBLIC HEALTH NURSES ACROSS THE STATE. IN 2011, THE TELECONFERENCE FOCUSED ON PEDIATRIC NEUROLOGICAL CASE REVIEWS. EDUCATING HEALTHCARE PROFESSIONALS HELPING RESEARCHERS COMMUNICATE CLEARLY PATIENTS MUST GIVE THEIR INFORMED CONSENT BEFORE PARTICIPATING IN RESEARCH. BUT THAT CAN BE DIFFICULT SINCE MANY CONSENT FORMS ARE FULL OF MEDICAL JARGON AND EXCEED THE READING LEVEL OF MANY ADULTS. A NEW ONLINE COURSE, FREE AND AVAILABLE TO ANY RESEARCHER, SHOWS HOW TO USE PLAIN LANGUAGE IN INFORMED CONSENT FORMS AND OTHER COMMUNICATIONS SO THAT STUDY PARTICIPANTS CAN UNDERSTAND THESE DOCUMENTS. THE COURSE USES CONCRETE EXAMPLES TO HELP RESEARCHERS TRANSITION FROM WRITING FOR ACADEMIC JOURNALS TO WRITING FOR THE PATIENTS AND FAMILIES. THE COURSE WAS DEVELOPED BY THE GROUP HEALTH RESEARCH INSTITUTE AND THE INSTITUTE FOR TRANSLATIONAL HEALTH SCIENCES, A PARTNERSHIP INVOLVING CHILDREN'S, THE UW, FRED HUTCHINSON CANCER RESEARCH CENTER AND OTHERS. PROVIDING A WAY TO TEST FOR TEEN DEPRESSION DEPRESSION IS COMMON IN TEENAGERS, BUT PRIMARY CARE DOCTORS HAVE LACKED A RELIABLE WAY TO SCREEN FOR IT - UNTIL NOW. DR. LAURA RICHARDSON AND COLLEAGUES AT CHILDREN'S, THE UW AND GROUP HEALTH RESEARCH INSTITUTE DETERMINED THAT A QUESTIONNAIRE COMMONLY USED TO SCREEN ADULTS FOR DEPRESSION ALSO WORKS WELL WITH TEENS. THE FINDINGS WERE BASED ON A STUDY OF 442 TEENS 13 TO 17 YEARS OLD. THE SCREENING TOOL - KNOWN AS THE PHQ-9 - IS EASY TO SCORE AND INTERPRET AND FREELY AVAILABLE ONLINE. SHARING EXPERTISE ABOUT KIDS WITH SPECIAL NEEDS HELPING CHILDREN WITH DEVELOPMENTAL DISABILITIES GROW UP TO REACH THEIR FULL POTENTIAL IS A TEAM EFFORT THAT INVOLVES THEIR FAMILIES AND NUMEROUS MEDICAL SPECIALISTS. SINCE 1977, CHILDREN'S HAS HOSTED THE ANNUAL DUNCAN SEMINAR, AN INTERDISCIPLINARY CONFERENCE WHERE HOSPITAL STAFF AND FACULTY, COMMUNITY HEALTHCARE PROVIDERS AND FAMILIES COME TO LEARN NEW SKILLS AND SHARE EXPERIENCES. "WE'RE ALL WORKING TOGETHER TO DEVELOP HAPPY, PRODUCTIVE ADULTS, AND OUR GOAL IS FOR NO ONE TO FALL SHORT, WHILE BEING REALISTIC ABOUT EACH INDIVIDUAL'S CIRCUMSTANCE," SAYS DR. JOHN MCLAUGHLIN, WHO OVERSEES THE DUNCAN SEMINAR. IN 2011, THE EVENT (ATTENDED BY 126 PEOPLE) FOCUSED ON THE UNIQUE COMMUNICATIONS CHALLENGES FACED BY CHILDREN WITH DEVELOPMENTAL DISABILITIES, WHO OFTEN MUST USE ADAPTIVE STRATEGIES AND EQUIPMENT TO EXPRESS THEMSELVES. PEOPLE MAKING A DIFFERENCE: DR. KYLE YASUDA PASSION FOR ADVOCACY DRIVES PEDIATRICIAN DR. KYLE YASUDA HAS ANSWERED COUNTLESS QUESTIONS FROM RESIDENTS DURING HIS MANY YEARS AS A TEACHING PHYSICIAN, BUT WHEN THEY ASK WHY HE BECAME A PEDIATRICIAN, "IT'S BEEN TOO LONG. I CAN'T REMEMBER," HE LAUGHS. YASUDA IS CERTAIN, THOUGH, THAT HE MADE THE RIGHT CHOICE. "I LOVE BEING AN ADVOCATE AND WORKING WITH KIDS, DOCTORS AND THE COMMUNITY TO IMPROVE CHILD HEALTH." YASUDA, WHO COMPLETED HIS OWN RESIDENCY AT CHILDREN'S IN 1983, WORKS WITH CHILDREN'S RESIDENTS AS A STAFF PEDIATRICIAN AT HARBORVIEW MEDICAL CENTER AND IN THE RESIDENCY'S COMMUNITY PEDIATRICS AND ADVOCACY PATHWAY. A HIGH POINT OF HIS CAREER CAME IN 2011 WHEN HE WAS ELECTED TO THE BOARD OF THE AMERICAN ACADEMY OF PEDIATRICS. IT'S ONE OF MANY LEADERSHIP ROLES HE'S PLAYED AT THE LOCAL, STATE AND NATIONAL LEVELS TO ADDRESS IMPORTANT PEDIATRIC HEALTH ISSUES - OFTEN IN COLLABORATION WITH CHILDREN'S. YASUDA'S ONGOING ADVOCACY AND HIS YEARS AS A PRACTICING PEDIATRICIAN MAKE HIM A COMPELLING ROLE MODEL. "THERE'S MORE TO MEDICINE THAN THE XS AND OS," HE SAYS. "I TRY TO SHARE WHAT THE HEART AND SOUL OF MEDICINE IS ALL ABOUT - UNDERSTANDING THE COMMUNITY'S NEEDS AND BUILDING GENUINE RELATIONSHIPS WITH PATIENTS AND FAMILIES." FEATURE: BROADENING THE HORIZONS OF PEDIATRIC RESIDENCY PROGRAM OFFERS DIVERSE EXPERIENCES THE RESIDENCY PROGRAM AT CHILDREN'S IS ONE OF THE MOST COMPETITIVE IN THE NATION. IN 2011, ALMOST HALF OF THE MEDICAL STUDENTS IN THE COUNTRY PLANNING TO ENTER PEDIATRICS APPLIED FOR ONE OF THE 34 SPOTS IN CHILDREN'S PROGRAM. OUR NEW ALASKA TRACK, ANNOUNCED LAST YEAR, ADDS FOUR SPOTS FOR RESIDENTS INTERESTED IN PRIMARY CARE STARTING IN 2012. RESIDENTS ON THE ALASKA TRACK WILL SPEND EIGHT MONTHS IN SEATTLE AND FOUR MONTHS IN ALASKA DURING ALL THREE YEARS OF THEIR RESIDENCY. IN ALASKA, THEY'LL PROVIDE PRIMARY CARE TO THE GENERAL POPULATION AND AT SITES SERVING THE ALASKA NATIVE POPULATION. THE ALASKA TRACK JOINS EXISTING TRAINING PATHWAYS FOR RESIDENTS INTERESTED IN COMMUNITY HEALTH, GLOBAL HEALTH AND RESEARCH. ALL OF OUR RESIDENTS SPEND TWO MONTHS WORKING WITH PRIMARY CARE PROVIDERS IN RURAL COMMUNITIES ACROSS THE WWAMI REGION, INCLUDING BELLINGHAM, PORT ANGELES AND YAKIMA, WASH. AND SANDPOINT AND POCATELLO, IDAHO. RESIDENTS WHO GO TO YAKIMA, WASH., SPEND PART OF THEIR ROTATION AT THE YAKIMA VALLEY FARM WORKERS CLINIC IN NEARBY TOPPENISH. THE WWAMI ROTATION AND ALASKA TRACK GIVE RESIDENTS UNIQUE EXPERIENCES, PROVIDE ISOLATED COMMUNITIES BETTER ACCESS TO CARE AND POTENTIALLY LEAD YOUNG DOCTORS TO ESTABLISH PRACTICES WHERE THEY'RE NEEDED MOST. FOCUS ON OBESITY: TRAINING RESIDENTS TO BUILD HEALTHY HABITS CHILDREN'S IS COLLABORATING WITH A GROUP OF CHILD CARE SITES AND PEDIATRIC CLINICS TO PROMOTE PHYSICAL ACTIVITY AND OBESITY PREVENTION FOR CHILDREN FROM BIRTH TO AGE 5. WE'RE TRAINING RESIDENTS WORKING IN CLINICS SO THEY CAN EDUCATE PARENTS AND CHILD CARE PROVIDERS ABOUT KEEPING KIDS ACTIVE AND HEALTHY. WE'RE ALSO DEVELOPING MATERIALS THAT WILL GIVE PARENTS TIPS ON HELPING THEIR CHILDREN PLAY AND INFORMATION ABOUT LOW-COST ACTIVITIES IN THEIR COMMUNITY. COMMUNITY PROGRAMS AND SERVICES CHILDREN'S WORKS IN AND WITH THE COMMUNITY TO ADDRESS THE HEALTH AND SAFETY NEEDS OF CHILDREN AND FAMILIES. WE TACKLE THE ROOT CAUSES OF ILLNESS AND INJURY, PROVIDE A VOICE FOR FAMILIES WHO ARE NOT ALWAYS HEARD, AND PROMOTE CHANGES THAT WILL LEAD TO HEALTHIER COMMUNITIES. TOGETHER WITH OUR PARTNERS, WE STRIVE TO IMPROVE ACCESS TO HEALTHCARE, PROMOTE HEALTHY CHILD DEVELOPMENT AND MEET THE SPECIAL NEEDS OF CHILDREN WITH CHRONIC CONDITIONS WHERE THEY LIVE. ADDRESSING PUBLIC HEALTH ISSUES COMMUNICATING WITH VACCINE-HESITANT PARENTS MORE THAN 6% OF WASHINGTON PARENTS OPT OUT OF REQUIRED KINDERGARTEN VACCINATIONS FOR THEIR CHILDREN - THE HIGHEST RATE OF ANY STATE IN THE COUNTRY. WHEN SOME PARENTS SKIP OR DELAY ROUTINE VACCINATIONS, IT PUTS THE COMMUNITY AT RISK OF OUTBREAKS. TO HELP VACCINE-HESITANT PARENTS MAKE AN INFORMED DECISION, CHILDREN'S JOINED GROUP HEALTH, WASHINGTON STATE DEPARTMENT OF HEALTH, WITHIN REACH AND THE COMMUNITY PEDIATRIC FOUNDATION OF WASHINGTON IN 2011 TO LAUNCH VAX NORTHWEST. VAX NORTHWEST WORKS WITH PARENTS OF VACCINATED CHILDREN TO SHARE INFORMATION ON IMMUNIZATION WITH OTHER PARENTS WHO MAY BE HESITANT TO VACCINATE THEIR CHILD. IT ALSO HAS DEVELOPED TOOLS TO HELP VACCINE PROVIDERS HAVE PRODUCTIVE CONVERSATIONS WITH PARENTS WHO ARE HESITANT ABOUT IMMUNIZATION. THIS COMES ON THE HEELS OF A NEW STATE LAW WHICH MANDATES THAT PARENTS WHO WANT TO OPT OUT MUST HAVE A VACCINE PROVIDER SIGN THE EXEMPTION FORM TO CONFIRM THEY'VE RECEIVED VACCINE BENEFIT AND RISK INFORMATION. VAX NORTHWEST IS STUDYING ITS TWO-PRONGED APPROACH OF WORKING WITH BOTH PARENTS AND PROVIDERS AND WILL SHARE WHAT IT LEARNS THROUGHOUT THE STATE AND BEYOND. DELIVERING DENTAL CARE TO CHILDREN STATEWIDE CHILDREN SHOULD BE SEEN BY A DENTIST AS SOON AS THEY HAVE TEETH, BUT THE NUMBER OF CHILDREN IN OUR STATE WHO GROW UP WITHOUT DENTAL CARE IS HEARTBREAKING. WHEN THE SMILEMOBILE ROLLS INTO A COMMUNITY, IT CAN BE THE FIRST TIME MANY CHILDREN SEE A DENTIST - AND SOMETIMES THEY ARE 18 YEARS OLD. THE SMILEMOBILE IS A 38-FOOT DENTAL CLINIC ON WHEELS SPONSORED BY CHILDREN'S AND THE WASHINGTON DENTAL SERVICE FOUNDATION THAT TRAVELS THROUGHOUT WASHINGTON PROVIDING DENTAL CARE TO CHILDREN FROM FAMILIES WITH LIMITED INCOMES. THE SMILEMOBILE HELPED 2,000 CHILDREN IN 2011 AND MORE THAN 25,000 CHILDREN SINCE HITTING THE ROAD IN 1995. THE MOBILE CLINIC PROVIDES EXAMS, PREVENTIVE CARE, FILLINGS AND MINOR ORAL SURGERY ON A SLIDING-FEE BASIS. THE SMILEMOBILE ADDRESSES A PRESSING NEED. TWO-YEAR-OLDS IN WASHINGTON ARE MORE THAN TWICE AS LIKELY AS CHILDREN ELSEWHERE IN THE NATION TO HAVE DENTAL DECAY, ACCORDING TO THE DENTAL ASSOCIATION FOUNDATION. PREVENTING DRUG AND ALCOHOL ABUSE MORE THAN 10% OF TEENS IN WASHINGTON USE PRESCRIPTION MEDICINE TO GET HIGH, AND MORE THAN THREE OUT OF FIVE TEENS SAY PAIN RELIEVERS ARE EASY TO GET FROM A PARENT'S OR GRANDPARENT'S MEDICINE CABINET, ACCORDING TO THE WASHINGTON STATE DEPARTMENT OF HEALTH. CHILDREN'S WORKS ON MANY FRONTS TO PREVENT ADOLESCENT SUBSTANCE ABUSE - INCLUDING IN THE NEIGHBORHOOD AROUND US. OUR ADOLESCENT MEDICINE DEPARTMENT OFFERS SUBSTANCE ABUSE PREVENTION AND MENTAL HEALTH SERVICES AT ECKSTEIN MIDDLE SCHOOL. WE'RE ALSO PART OF PREVENTION WORKS IN SEATTLE (WINS), A COMMUNITY COALITION FOCUSED ON FIGHTING ADOLESCENT DRUG AND ALCOHOL ABUSE IN THE NORTHEAST SEATTLE COMMUNITY. SINCE 2006, PREVENTION WINS CONDUCTS PROGRAMS SERVING FAMILIES AT ECKSTEIN - INCLUDING MAILING A SERIES OF INFORMATIONAL POSTCARDS WITH A SPECIAL FOCUS ON THE GROWING DANGER OF PRESCRIPTION DRUG ABUSE. THESE AND OTHER EFFORTS SEEM TO BE PAYING OFF. ACCORDING TO THE WASHINGTON STATE HEALTHY YOUTH SURVEY, ALCOHOL USE RATES FOR 10TH AND 12TH GRADERS IN NATHAN HALE AND ROOSEVELT HIGH SCHOOLS (WHERE ECKSTEIN STUDENTS GO TO) DROPPED BY MORE THAN 10% FROM 2006 TO 2010. REACHING OUT TO FAMILIES OF CHILDREN WITH AUTISM LEARNING THEIR CHILD HAS AUTISM IS AN EMOTIONALLY DISTRESSING PIECE OF NEWS FOR PARENTS TO RECEIVE. THEY'RE TOLD THEIR CHILD HAS A NEURODEVELOPMENTAL DISORDER WITH AN UNKNOWN CAUSE, NO KNOWN CURE AND AN UNCERTAIN TREATMENT PATH. OUR AUTISM CENTER HELPS FAMILIES COPE BY OFFERING CLASSES AND SUPPORT GROUPS. IN 2011, WE ADDED AN AUTISM BLOG. THE BLOG ENABLES AUTISM EXPERTS TO ANSWER QUESTIONS, SHARE THE LATEST NEWS AND OFFER PERSPECTIVE ON HOW TO RAISE A CHILD WITH AUTISM - EVERYTHING FROM HOW TO CHOOSE A SUMMER CAMP TO MAKING THE TRANSITION FROM PRESCHOOL TO KINDERGARTEN. ONE OUT OF EVERY 110 CHILDREN IS DIAGNOSED WITH AUTISM, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND THERE'S A LONG LIST OF FAMILIES WAITING TO BE SEEN AT THE AUTISM CENTER. THE BLOG LETS US REACH MORE FAMILIES AND PROVIDE THE SUPPORT AND INFORMATION THEY NEED. PROTECTING INFANTS FROM ABUSIVE HEAD TRAUMA IN A TRAGIC PARALLEL TO THE ECONOMIC DOWNTURN, HOSPITALS HAVE BEEN TREATING A RISING NUMBER OF INFANTS FOR ABUSIVE HEAD TRAUMA, ACCORDING TO A MULTI-SITE STUDY THAT INCLUDED CHILDREN'S. THE STUDY SHOWED THE NUMBER OF CASES OF ABUSIVE HEAD TRAUMA - ALSO KNOWN AS SHAKEN BABY SYNDROME - DOUBLED BETWEEN 2007 AND 2009. FRUSTRATION OVER A CRYING BABY IS THE MOST COMMON TRIGGER FOR CAREGIVERS INFLICTING ABUSIVE HEAD INJURIES IN INFANTS. THIS ALARMING TREND LED CHILDREN'S TO FORM THE ABUSIVE HEAD TRAUMA PREVENTION TASK FORCE, A STATEWIDE NETWORK OF PROFESSIONALS AND PARENTS OF VICTIMS WORKING TO PREVENT SHAKEN BABY SYNDROME. THE TASK FORCE HAS BEEN INSTRUMENTAL IN PROVIDING EDUCATIONAL MATERIALS TO 35,000 NEW FAMILIES TO RAISE AWARENESS THAT CRYING IS NORMAL AND CAREGIVERS SHOULD DEVELOP A PLAN TO COPE WITH THE POTENTIAL FRUSTRATION. THE EDUCATIONAL MATERIALS ARE BASED ON THE PERIOD OF PURPLE CRYING EVIDENCE-BASED PROGRAM, DEVELOPED BY THE NATIONAL CENTER ON SHAKEN BABY SYNDROME. THE ACRONYM PURPLE DESCRIBES THE SPECIFIC CHARACTERISTICS OF AN INFANT'S CRYING AND REASSURES THEM THIS PERIOD WILL END. EDUCATING THE PUBLIC ABOUT DWARFISM CHILDREN'S, THE PUGET SOUND CHAPTER OF LITTLE PEOPLE OF AMERICA (LPA) AND CAFFE LADRO ESPRESSO BAR AND BAKERY KICKED OFF NATIONAL DWARFISM MONTH WITH A "STAND TALL FOR LITTLE PEOPLE" CAMPAIGN. THROUGHOUT OCTOBER, CAFFE LADRO'S 13 LOCATIONS USED CUPS THAT SHRANK THE SIZE OF THEIR SIGNATURE "TALL MAN" LOGO, ADDED THE PHRASE "STAND TALL FOR LITTLE PEOPLE" AND DIRECTED COFFEE DRINKERS TO THE PUGET SOUND CHAPTER OF LPA WEBSITE - ALL TO RAISE AWARENESS ABOUT ISSUES SURROUNDING DWARFISM OR SKELETAL DYSPLASIA. CHILDREN'S HAS ONE OF THE LARGEST SKELETAL DYSPLASIA CLINICS IN THE REGION AND CARES FOR PEOPLE OF ALL AGES WITH SKELETAL DYSPLASIA AND OTHER RARE BONE CONDITIONS. "WE HAVE A RESPONSIBILITY TO PROVIDE EXPERTISE AND COMPREHENSIVE CARE TO PATIENTS, AND TO ALSO SUPPORT THE BROADER DWARFISM COMMUNITY BY EDUCATING THE GENERAL PUBLIC," SAYS DR. MICHAEL GOLDBERG, WHO LEADS THE SKELETAL DYSPLASIA CLINIC. EDUCATING COMMUNITY MEMBERS SHARING INFORMATION THROUGH THE MEDIA CHILDREN'S IS A TRUSTED SOURCE OF INFORMATION ABOUT THE HEALTH AND SAFETY OF CHILDREN AND FAMILIES. WE USE ALL FORMS OF MEDIA TO EDUCATE THE COMMUNITY AND RESPOND TO QUESTIONS AND CONCERNS. IN 2011, WE COLLABORATED WITH KUNS/UNIVISION TV TO PRODUCE A HALF-HOUR PROGRAM IN SPANISH ABOUT DIABETES. THE PROGRAM TOLD THE STORIES OF THREE LATINO PATIENTS AND EMPHASIZED THAT IT TAKES A TEAM - INCLUDING THE FAMILY - TO PROVIDE THE CARE AND SUPPORT NEEDED BY DIABETES PATIENTS. WE WORKED WITH KING-TV TO AIR 30 SHORT HEALTHLINK SEGMENTS ABOUT TYPICAL CHILDHOOD AND PARENTING CONCERNS, AS WELL AS TWO HOUR-LONG SPECIALS - ONE ABOUT TEEN HEALTH ISSUES AND ANOTHER ABOUT HOW STAFF, PATIENTS AND VOLUNTEERS SUPPORT THE HOSPITAL. WE PRODUCED FOUR ISSUES OF GOOD GROWING NEWSLETTER - DISTRIBUTED ONLINE AND THROUGH PARENTMAP MAGAZINE -AND SIX ISSUES OF MY GOOD GROWING, AN EMAIL NEWSLETTER PROVIDING CHILD HEALTH AND SAFETY INFORMATION. WE ALSO CONTINUED TO EXPAND OUR USE OF SOCIAL MEDIA TO INTERACT WITH THE COMMUNITY - AND HELP FAMILIES SHARE EXPERIENCES WITH OTHER FAMILIES - THROUGH BLOGS (TEENOLOGY 101, SEATTLE MAMA DOC, AUTISM), FACEBOOK, TWITTER AND YOUTUBE (WHERE WE'VE POSTED MORE THAN 300 VIDEOS). SUPPORTING TEENS AND YOUNG ADULTS WITH CANCER WITH THE MANY LIFE CHANGES TEENS AND YOUNG ADULTS GO THROUGH, SUPPORT FROM PEERS IS ALWAYS IMPORTANT, BUT IT'S EVEN MORE IMPORTANT FOR YOUNG PEOPLE FIGHTING CANCER. TO HELP MEET THEIR UNIQUE NEEDS, CHILDREN'S RELEASED A NEW VIDEO SERIES ON YOU TUBE CALLED "GOOD TIMES AND BALD TIMES." THE VIDEOS FEATURE SEVEN CANCER SURVIVALS FROM THE ADOLESCENT AND YOUNG ADULT (AYA) ONCOLOGY PROGRAM TALKING ABOUT THEIR CANCER EXPERIENCES IN CANDID GROUP DISCUSSIONS KNOWN AS TEEN TALKING CIRCLES (TTC). "USING THE TTC APPROACH FOR TEENS WITH CANCER IS NEW," SAYS LEAH KROON, A NURSE WITH THE AYA TEAM, "BUT IT'S A SAFE WAY FOR THEM TO TALK ABOUT THEIR EXPERIENCES AND A GREAT PLATFORM FOR REACHING OTHER TEENS WITH CANCER." THE 12 VIDEOS ADDRESS TOPICS RANGING FROM DEALING WITH SCHOOL TO FERTILITY ISSUES SUCH AS SPERM BANKING AND EGG PRESERVATION. "IT'S SO IMPORTANT THAT TEENS AND YOUNG ADULTS WITH CANCER KNOW THERE ARE PEERS OUT THERE WHO KNOW WHAT THEY'RE GOING THROUGH," SAYS DR. REBECCA JOHNSON, WHO LEADS THE AYA ONCOLOGY PROGRAM. PEOPLE MAKING A DIFFERENCE: REGIONAL CARE COORDINATORS FINDING HEALING IN A BOWL OF MOOSE SOUP MEDICINE COMES IN MANY FORMS. AN ALASKA NATIVE BOY FOUND HEALING IN A BOWL OF MOOSE SOUP, THANKS TO KATHY SALMONSON, A REGIONAL CARE COORDINATOR FROM CHILDREN'S. THE BOY - WHO NEEDED A LIVER TRANSPLANT - CAME TO CHILDREN'S FROM A SMALL VILLAGE IN ALASKA. AS THE 12-YEAR-OLD RECUPERATED FROM SURGERY, HE WASN'T EATING MUCH. FOOD HERE WAS JUST TOO DIFFERENT FROM WHAT HE WAS USED TO BACK HOME. THE ONLY FOOD HE WANTED WAS MOOSE SOUP. WHEN SALMONSON LEARNED OF HIS REQUEST, SHE USED HER CONTACTS HERE AND IN ALASKA TO OBTAIN NATIVE INGREDIENTS FOR THE DISH. LOCAL ALASKA NATIVE COMMUNITY MEMBERS COOKED AND PREPARED FOOD TO BRING TO HIM AND HIS FAMILY. HE STARTED EATING AGAIN AFTER RECEIVING FOODS FROM HOME. CHILDREN'S IS THE PEDIATRIC REFERRAL CENTER FOR A FOURSTATE REGION, SO WE CARE FOR MANY CHILDREN LIKE THIS PATIENT WHO COME FROM SMALL AND DISTANT COMMUNITIES. OUR REGIONAL NURSE CARE COORDINATORS, SALMONSON WITH ALASKA AND MONTANA AND CATE FAIRHEAD WITH CENTRAL WASHINGTON, SERVE AS A LINK BETWEEN HOME AND HOSPITAL. THEIR MAIN JOB IS TO SUPPORT COMMUNICATION, SYSTEM NAVIGATION, CARE COORDINATION AND DISCHARGE PLANNING BETWEEN CHILDREN'S AND CARE PROVIDERS IN THEIR RESPECTIVE REGION. AS PART OF COORDINATING FOLLOWUP CARE FOR DISCHARGED PATIENTS, SALMONSON AND FAIRHEAD PROVIDE SUPPORT TO FAMILIES DURING THEIR STAY HERE. "IT'S REALLY IMPORTANT TO TAKE THE TIME TO LISTEN AND BE AWARE OF HOW FAR FROM HOME SOME FAMILIES ARE AND HOW SCARY THIS ALL IS," SALMONSON SAYS. "WE TRY OUR BEST TO MAKE A DIFFERENCE FOR FAMILIES DURING A DIFFICULT TIME IN THEIR LIVES." FEATURE: FAMILIES FIND STRENGTH IN SUPPORT GROUPS WHEN LYNN VIGO JOINED CHILDREN'S FIVE YEARS AGO, SHE KNEW FROM EXPERIENCE THAT PARENTS OF CHILDREN WITH AUTISM LACKED OPPORTUNITIES TO LEAN ON AND LEARN FROM EACH OTHER - BECAUSE HER DAUGHTER HAS AUTISM. "RAISING A CHILD WITH AUTISM CAN BE ISOLATING," VIGO SAYS. "PARENTS NEED A PLACE TO SHARE CHALLENGES AND SUCCESSES AND KNOW THEY'RE NOT ALONE, BUT THE DEMAND WASN'T BEING MET." NOW A FAMILY ADVOCATE WITH CHILDREN'S AUTISM CENTER, VIGO STARTED AUTISM LIVING LIFE & YOU (ALLY), A MONTHLY SUPPORT GROUP FOR PARENTS OF CHILDREN SIGNIFICANTLY AFFECTED BY AUTISM. ALLY IS NOW UP TO FOUR DIFFERENT GROUPS. CHILDREN'S ALSO SPONSORS SUPPORT GROUPS FOR PARENTS OF CHILDREN WITH ARTHROGRYPOSIS (A DEBILITATING CONTRACTION OF THE MUSCLES); PARENTS OF INFANTS, TODDLERS AND PRESCHOOLERS WITH DIABETES; SIBLINGS OF CHILDREN WITH SPECIAL NEEDS; AND FAMILIES WHO HAVE EXPERIENCED A CHILD'S DEATH. IN ADDITION, WE PROVIDE SPACE FOR NUMEROUS INDEPENDENT SUPPORT GROUPS TO MEET. FOCUS ON OBESITY: EVERYONE SWIMS SWIMMING IS A GOOD WAY TO GET THE EXERCISE NEEDED TO FIGHT OBESITY, AND KNOWING HOW TO SWIM HELPS PROTECT CHILDREN FROM DROWNING. IN 2011, CHILDREN'S WORKED WITH POOLS, COMMUNITY HEALTH CLINICS AND MANY OTHER ORGANIZATIONS ON EVERYONE SWIMS, A PROGRAM TO INCREASE ACCESS TO SWIMMING AND WATER RECREATION FOR LOW-INCOME AND CULTURALLY DIVERSE FAMILIES. WE'RE WORKING WITH PARTNERS LIKE SEATTLE PARKS AND RECREATION TO INCREASE THE NUMBER OF SCHOLARSHIPS FOR SWIMMING LESSONS AND MAKE PEOPLE AWARE OF SWIMMING OPPORTUNITIES IN THEIR COMMUNITIES. IN SEATTLE'S CENTRAL DISTRICT, FOR EXAMPLE, ODESSA BROWN CHILDREN'S CLINIC AND MEDGAR EVERS POOL WORK TOGETHER TO OFFER SWIM LESSONS FOR OBCC PATIENTS. SEATTLE CHILDREN'S RESEARCH HOLDINGS LLC PO BOX 5371 MS RC-507 SEATTLE WA 981455005 910564748 PROPERTY DEVELOPMENT AND OPERATION WA 1590519 28201299 N/A SEATTLE CHILDREN'S HEALTHCARE SYSTEM PO BOX 5371 MS RC-507 SEATTLE WA 981455005 911250116 HEALTH CARE WA 501(C) (3) 7 N/A 0 SEATTLE CHILDREN'S HOSPITAL FOUNDATION PO BOX 5371 MS RC-507 SEATTLE WA 981455005 911156519 FUNDRAISING WA 501(C) (3) 7 SEATTLE CHILDREN'S HEALTHCARE SYSTEM 0 SEATTLE CHILDREN'S HOSPITAL GUILD ASSN PO BOX 5371 MS RC-507 SEATTLE WA 981455005 911394056 FUNDRAISING, CHILD ADVOCACY, AND PEDIATRIC HEALTH AWARENESS WA 501(C) (3) 7 SEATTLE CHILDREN'S HEALTHCARE SYSTEM 0 CHILDREN'S RETAIL PO BOX 5371 MS RC-507 SEATTLE WA 981455005 911998909 THRIFT STORES WA 501(C) (3) LINE 11 - TYPE I SEATTLE CHILDREN'S HEALTHCARE SYSTEM 0 CHILDREN'S PHYSICIANS PO BOX 5371 MS RC-507 SEATTLE WA 981455005 911348125 MEDICAL PRACTICE WA 501(C) (3) 7 SEATTLE CHILDREN'S HEALTHCARE SYSTEM 0 CHILDREN'S UNIVERSITY MEDICAL GROUP PO BOX 50010 SEATTLE WA 98105 911336707 MEDICAL PRACTICE WA 501(C) (3) LINE 11, TYPE I N/A 0 CHILDREN'S HEALTH NETWORK PO BOX 5371 MS RC-507 SEATTLE WA 981455005 911226716 PEDIATRIC HEALTHCARE SERVICES WA 501(C) (3) LINE 11, TYPE I SEATTLE CHILDREN'S HEALTHCARE SYSTEM 0 SEATTLE CHILDRENS'S RESEARCH INVESTORS LLC PO BOX 5371 MS RC-507 SEATTLE WA 981455005 263852796 RESEARCH FACILITY DEVELOPMENT WA SEATTLE CHILDREN'S HEALTHCARE SYSTEM RELATED 4462 235399 0 0 0.01000 0 0 1 0 0 0 0 0 1 1 0 1 0 0 0 1 0 0