2025-08-14T19:30:42-05:00 2024-09-30 390859910 BAKER TILLY ADVISORY GROUP LP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2023-10-01 941294954 VALLEY CHILDREN'S HOSPITAL VALL 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 936368762 TINA MYCROFT SVP AND CFO 5593533000 2025-08-14 1 1 WENDY CAMPOS P00448102 2099556100 2025-08-14 2023 2025-03-06 01:10:19Z TODD SUNTRAPAK 9300 VALLEY CHILDRENS PLACE MADERA CA 936368762 1681162578 0 X WWW.VALLEYCHILDRENS.ORG X 1949 CA PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN 15 14 4075 310 -3051050 208970 9460031 27531096 748650351 833543744 50512885 91361125 12944813 13981763 821568080 966417728 1218901 1893633 0 0 369980125 409076984 0 0 0 404558073 460026664 775757099 870997281 45810981 95420447 2141940535 2326989096 370211936 360805090 1771728599 1966184006 TO PROVIDE HIGH QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. 0 0 668507956 1893633 833543744 VALLEY CHILDREN'S HOSPITAL IS CENTRAL CALIFORNIA'S ONLY PEDIATRIC HOSPITAL, FEATURING THE REGION'S ONLY LEVEL IV NICU, A RENOWNED PEDIATRIC CANCER AND BLOOD DISEASES CENTER AND A PIONEERING HEART CENTER. WE WERE THE FIRST CHILDREN'S HOSPITAL WEST OF THE ROCKIES TO EARN THE MAGNET NURSING DESIGNATION - THE HIGHEST NURSING BENCHMARK - AND U.S. NEWS & WORLD REPORT RANKS US ONE OF THE NATION'S TOP CHILDREN'S HOSPITALS IN THREE SPECIALTIES. OUR TEAM OF APPROXIMATELY 670 PHYSICIANS AND APPROXIMATELY 3,500 STAFF MEMBERS PROVIDES HIGH-QUALITY CARE TO MORE THAN 1.3 MILLION CHILDREN IN THE REGION. SEE OUR COMPLETE COMMUNITY BENEFIT REPORT ON OUR WEBSITE AT WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY BENEFIT. 668507956 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 356 0 1 4075 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 15 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 CA X X TINA MYCROFT SVP & CFO 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 TODD SUNTRAPAK CEO 20.50 39.50 X X 3203684 0 66483 BEVERLY HAYDEN-PUGH FORMER CNO, SVP/ADVR TO CEO (AS OF 3/23) 24.00 36.00 X 1555213 0 134615 MICHELE WALDRON FORMER CFOEVP & PRINC. CNSLT TO CEO (AS OF 10/23) 22.20 37.80 X 1405362 0 47171 DAVID CHRISTENSEN MD SVP, CPE & PRESIDENT VCMG 24.00 36.00 X 1245480 0 62371 NATALE PONTICELLO JR FORMER CPO,SVP/ADVR TO SVP&CPO (AS OF 3/23) 43.00 17.00 X 1035059 0 100431 JOLIE LIMON MD VP ACAD AFFAIRS, DIO & CHI (THRU 10/23) 50.00 10.00 X 966773 0 116590 JOEL BROWNELL MD VP, CHIEF MED INFO OFF. (THRU 9/23) 40.00 20.00 X 890134 0 100105 DAVID HODGE JR VP, MEDICAL GROUP & ANCILLARY OP 35.00 25.00 X 758642 0 135046 DANIELLE BARRY SVP, COO 30.00 30.00 X 770415 0 116567 JANE WILLSON SVP, CHIEF STRATEGY OFFICER 18.00 42.00 X 744502 0 111071 MICHAEL GOLDRING SVP STRATEGIC PARTNERSHIPS 12.00 48.00 X 768985 0 41352 WILLIAM CHALTRAW JR SVP, CHIEF LEGAL OFFICER 12.00 48.00 X 734725 0 56128 KAREN DAHL MD VP, MED AFFAIRS & PHYS DEV 40.00 20.00 X 678467 0 107096 LYNNE ASHBECK SVP, CHIEF COMMUNITY IMPACT OFFICER 18.00 42.00 X 679973 0 94904 KEVIN SHIMAMOTO FORMER CIO VP AND ADVISOR TO CIO (THRU 9/24) 10.00 50.00 X 648571 0 106657 STEPHANIE VANCE VP, FINANCE (THRU 11/23) 30.00 30.00 X 579841 0 117222 JOSEPH EGAN VP & CIO 50.00 10.00 X 580598 0 108047 KELLY BEALL SVPCHIEF PEOPLE OFFICER (AS OF 3/23) 43.00 17.00 X 539749 0 90664 VICKY TILTON VP PATIENT CARE SVCS/CNO (AS OF 3/23) 50.00 10.00 X 473529 0 81548 TINA MYCROFT SVP & CFO (AS OF 10/23) 22.20 37.80 X 409219 0 11082 KELLIE DYER VP SUPPLY CONSTR & FAC. (AS OF 1/23) 35.00 15.00 X 353626 0 30672 JESSIE HUDGINS VP, FACILITIES & SUPPORT (THRU 1/23) 45.00 15.00 X 261912 0 72753 FAISAL RAZZAQI MD CHIEF OF STAFF/BOARD MEMBER (THRU 2/24) 0.50 0.50 X 75000 0 0 DAN ADAMS BOARD TREASURER 0.50 1.80 X X 0 10000 0 JOSE ELGORRIAGA BOARD CHAIR 0.60 1.40 X X 0 0 0 MICHAEL HANSON BOARD VICE CHAIR 0.50 1.80 X X 0 0 0 DANIELLE PARNAGIAN BOARD SECRETARY 0.50 0.50 X X 0 0 0 CHRISTINE ALMON MD CHIEF OF STAFF (AS OF 3/24) 0.50 0.50 X 0 0 0 SUSAN BYERS BOARD MEMBER 0.50 0.50 X 0 0 0 LUZ GONZALEZ MD BOARD MEMBER 0.50 0.50 X 0 0 0 ALLISON KARAHADIAN BOARD MEMBER 0.50 0.50 X 0 0 0 MENDY LAVAL BOARD MEMBER 0.50 0.50 X 0 0 0 JARROD MARTINEZ BOARD MEMBER 0.50 0.50 X 0 0 0 THOMAS PAGE MD BOARD MEMBER 0.50 0.50 X 0 0 0 LISA SMITTCAMP BOARD MEMBER 0.50 0.50 X 0 0 0 VALERIE VUICICH BOARD MEMBER 0.50 0.50 X 0 0 0 SISSY DALENA WOOD BOARD MEMBER 0.50 0.50 X 0 0 0 DAN KOONTZ BOARD MEMBER (THRU 8/24) 0.50 0.50 X 0 0 0 BILL SMITTCAMP BOARD MEMBER (THRU 12/23) 0.50 1.80 X 0 0 0 RILEY WALTER BOARD MEMBER (THRU 12/23) 0.50 0.50 X 0 0 0 19359459 10000 1908575 1059 1 1 0 VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 SUBSPEC PHYSICIAN SERVICES 62500000 QUIRING GENERAL LLC 5118 E CLINTON WAY FRESNO CA 93727 CONSTRUCTION SERVICES 17547904 PEDIATRIC ANESTHESIA ASSOCIATES 6235 N FRESNO ST STE 103 FRESNO CA 93710 ANESTHESIA/CRITICAL CARE 15138436 SODEXO INC& ASSOCIATES PO BOX 360170 PITTSBURGH PA 152516170 HOUSEKEEPING SERVICES 6077211 KRUGER CONSTRUCTION INC 1205 BARSTOW AVENUE CLOVIS CA 93612 CONSTRUCTION SERVICES 4786998 135 22819221 4166489 545386 12055 27531096 PATIENT SERVICES 900099 814945222 814945222 HOME CARE 340B PROGRAM 900099 11911286 11911286 SUPPORT SERVICES 541610 6607365 6607365 LAB SERVICES 900099 79871 79871 833543744 42428988 -3051050 45480038 991791 991791 1128900 684982 443918 443918 443918 761518412 212002 713629476 160592 47888936 51410 47940346 47940346 416820 269800 147020 147020 CAFETERIA REVENUE 900099 2727849 2727849 10662976 10662976 13390825 966417728 833543744 -3051050 108393938 X 1511774 1511774 381859 381859 13756808 13756808 302248035 229173201 73074834 17696373 13594426 4101947 52877143 37036546 15840597 22498625 16443407 6055218 4872384 4872384 4272541 4272541 286324 286324 127500 127500 6067999 6067999 117575314 117311708 263606 2010232 50508 1959724 146265126 137021921 9243205 8833093 6523527 2309566 8734950 6674658 2060292 1009291 297690 711601 379862 31979 347883 10785604 8252595 2533009 39890357 22049014 17841343 8065453 8065453 HOSPITAL FEE PROGRAM 42926883 42926883 PURCHASED SERVICES 29466811 13608119 15858692 BAD DEBT 13481552 13481552 UBI TAXES 976377 976377 13999011 1160212 12838799 870997281 668507956 202489325 0 812358 840653 488908207 561470620 968363 766903 103018092 137465776 58150923 58823805 14738794 17617644 11904486 13365224 922643854 473608098 445055720 449035756 536982420 557599978 251771950 374492887 44683956 41233162 184945266 114276688 2141940535 2326989096 90954979 93309225 246977204 238789518 32279753 28706347 370211936 360805090 X 1744021434 1931011467 27707165 35172539 1771728599 1966184006 2141940535 2326989096 X 95420447 95822692 3212268 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 16602 0 1 325147 341749 0 PART II-B, LINE 1 VALLEY CHILDREN'S HOSPITAL HAS HAD DIRECT CONTACT WITH LOCAL, STATE, AND FEDERAL ELECTED OFFICIALS REGARDING HEALTHCARE POLICY THAT IMPACTS CHILDREN, INCLUDING GENERAL COMMUNICATION WITH AND EDUCATION OF BOTH THE LEGISLATORS AND THEIR STAFF MEMBERS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. VALLEY CHILDREN'S HOSPITAL HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $16,602 BROWNSTEIN HYATT FARBER SCHRECK $127,500 ASSOCIATION DUES RELATED TO LOBBYING NACH 43,798 AMERICAN SOCIETY HEALTHCARE ENGINEERING 41 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 314 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 80,551 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 27,214 CHILDREN'S SPECIALTY CARE COALITION 3,591 FRESNO CHAMBER OF COMMERCE 267 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA 41,751 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $341,749 91520402 91520402 408358925 181191123 227167802 3554557 3554216 341 359856806 257872227 101984579 59353164 30990532 28362632 449035756 LIMITED PARTNERSHIPS 157176882 F HEDGE FUNDS 108968953 F PRIVATE CAPITAL FUNDS 108347052 F 374492887 MALPRACTICE RESERVE 8188588 ACCRUED PENSION LIABILITY 431999 457 LIABILITY 5957023 1732 LIABILITY 456342 WORKERS COMP 4410215 INS LIABILITY 1843785 DC SERP LIABILITY 984262 457F RT LIABILITY 297 OPERATING LEASE - LONG TERM PORTION 5771766 LAND DEVELOPMENT OBLIGATION 115000 RETIREE HEALTH LIABILITY 300000 OTHER 247070 28706347 PART VII, LINE 3: THE OVERALL FINANCIAL OBJECTIVES OF THE HOSPITAL'S INVESTMENT PORTFOLIO ARE TO 1) PRESERVE PRINCIPAL AND MAINTAIN PURCHASING POWER FOR A PORTION OF PORTFOLIO ASSETS IN ORDER TO PROVIDE A SOURCE OF FUNDING FOR STRATEGIC INVESTMENT AND ANNUAL ENDOWMENT DISTRIBUTIONS, AND 2) GROW A PORTION OF PORTFOLIO ASSETS TO IMPROVE THE FINANCIAL WELL-BEING OF VALLEY CHILDREN'S HEALTHCARE AND ITS SUBSIDIARIES. TO ACHIEVE THESE GOALS, THE PORTFOLIO IS INVESTED IN A VARIETY OF INVESTMENT VEHICLES INCLUDING, BUT NOT LIMITED TO, MUTUAL FUNDS, EXCHANGE TRADED FUNDS, SEPARATELY MANAGED ACCOUNTS, COMMINGLED FUNDS, US TREASURY NOTES, LIMITED PARTNERSHIPS, HEDGE FUNDS, PRIVATE CAPITAL FUNDS AND PRIVATE DEBT. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 174335391 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 14618454 0 0 0 0 0 0 188953845 0 188953845 1 0 1 1 1 0 PART I, LINE 3: THE AMOUNT IN COLUMN F IS BASED ON FAIR MARKET VALUE. 1 1 1 X 1 X 1 0 1 1 117077 117077 0.00010 587139150 511285638 75853512 0.08850 260347 116757 143590 0.00020 587516574 511402395 76114179 0.08880 2578768 0 2578768 0.00300 16766168 1362441 15403727 0.01800 1574471 542856 1031615 0.00120 701536 0 701536 0.00080 21620943 1905297 19715646 0.02300 609137517 513307692 95829825 0.11180 1 4433297 270550 310834 -40284 X 1 1 1 1 VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 WWW.VALLEYCHILDRENS.ORG 040000160 X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 22 1 1 1 1 X WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFIT X 1 23 1 WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFIT 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X 1 X 0 0 PART V, SECTION B, LINE 5: FACILITY REPORTING GROUP AIN ACCORDANCE WITH STATE REGULATIONS, A CHNA IS PERFORMED EVERY THREE YEARS. IN CONDUCTING THE MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. A VARIETY OF PRIMARY DATA COLLECTION METHODS WERE USED TO OBTAIN COMMUNITY INPUT INCLUDING FOCUS GROUPS, INTERVIEWS, AND SURVEYS. THE COLLECTED DATA WAS USED TO IDENTIFY SIGNIFICANT COMMUNITY NEEDS.FRESNO, KINGS, MADERA, AND TULARE COUNTIESPRIMARY DATA WERE COLLECTED THROUGH SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. THE SURVEY INCLUDED QUESTIONS TO DESCRIBE THE COMMUNITY, THE SOCIAL DETERMINANTS OF HEALTH AND HEALTH STATUS AND WAS AVAILABLE IN ENGLISH AND SPANISH. COMMUNITY ORGANIZATIONS DISTRIBUTED THE SURVEYS ONLINE AND IN PAPER FORMAT. 4,856 USABLE SURVEYS WERE RECEIVED. COMMUNITY-BASED ORGANIZATIONS AND OTHER GROUPS LED THE FOCUS GROUPS AND INTERVIEWS. COMMUNITY MEMBERS ATTENDED IN-PERSON OR VIRTUALLY ON ZOOM. FIFTY-NINE (59) FOCUS GROUPS ENGAGED 473 PERSONS FROM OCTOBER TO DECEMBER 2021. TARGET POPULATIONS FOR THE FOCUS GROUPS WERE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY. KEY INFORMANTS WERE CHOSEN FOR INTERVIEWS BASED ON THEIR KNOWLEDGE OF COMMUNITY HEALTH ISSUES. FIFTY (50) KEY INFORMANT INTERVIEWS WERE COMPLETED FROM OCTOBER TO DECEMBER 2021.KERN COUNTYPRIMARY DATA WERE COLLECTED THROUGH INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND SURVEYS WITH COMMUNITY RESIDENTS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THIRTY (30) TELEPHONE INTERVIEWS WERE CONDUCTED FROM OCTOBER TO DECEMBER 2021. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN KERN COUNTY WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. SURVEYS WERE DISTRIBUTED TO ENGAGE COMMUNITY RESIDENTS AND OBTAIN INPUT ON HEALTH AND SOCIAL NEEDS. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT AND IN A PAPER COPY FORMAT. THE ELECTRONIC AND PAPER SURVEYS WERE AVAILABLE IN ENGLISH AND SPANISH. THE SURVEYS WERE AVAILABLE FROM SEPTEMBER 13 TO NOVEMBER 15, 2021. DURING THIS TIME, 255 USABLE SURVEYS WERE COLLECTED. THE SURVEYS WERE DISTRIBUTED THROUGH HOSPITAL CHANNELS INCLUDING SOCIAL MEDIA. THE SURVEY WAS ALSO DISTRIBUTED TO COMMUNITY PARTNERS WHO MADE THEM AVAILABLE TO THEIR CLIENTS.MERCED COUNTYTHE ASSESSMENT INCORPORATED PRIMARY RESEARCH THROUGH A COMMUNITY HEALTH SURVEY AND AN ONLINE KEY INFORMANT SURVEY. THE SURVEYS WERE CONDUCTED VIA TELEPHONE (LANDLINE AND CELL PHONE) AND THROUGH ONLINE QUESTIONNAIRES. THE SAMPLE DESIGN USED FOR THIS EFFORT CONSISTED OF A RANDOM SAMPLE OF 300 INDIVIDUALS, AGES 18 AND OLDER, IN MERCED COUNTY. WHEN THE INTERVIEWS WERE COMPLETED, THEY WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION TO APPROPRIATELY REPRESENT MERCED COUNTY AS A WHOLE.AN ONLINE KEY INFORMANT SURVEY SOLICITED INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY VALLEY CHILDREN'S HOSPITAL AND MERCY MEDICAL CENTER MERCED. THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. IN ALL, 69 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.PARTICIPATION INCLUDED REPRESENTATIVES OF THE FOLLOWING ORGANIZATIONS:- ACE OVERCOMERS- ALL DADS MATTER- BEHAVIORAL HEALTH- CASTLE FAMILY HEALTH CENTERS- CENTRAL CALIFORNIA ALLIANCE FOR HEALTH- CENTRAL OPPORTUNITY CENTER CVOC- COURT APPOINTED SPECIAL ADVOCATES MERCED COUNTY- FAMILY RESOURCE COUNCIL- FIRST 5 MERCED COUNTY- HEAD START PROGRAM MERCED COUNTY OFFICE OF EDUCATION- MERCED CITY SCHOOL DISTRICT- MERCED COUNTY COMMUNITY ACTION AGENCY WIC- MERCED COUNTY DEPARTMENT OF PUBLIC HEALTH- MERCED COUNTY HUMAN SERVICES AGENCY, ALL MOMS MATTER- MERCED COUNTY HUMAN SERVICES AGENCY, EMPLOYMENT AND TRAINING BRANCH- MERCED COUNTY MENTAL HEALTH DEPT.- MERCED COUNTY OFFICE OF EDUCATION, CARING KIDS- MERCED COUNTY OFFICE OF EDUCATION, GROW PROGRAM- MERCED COUNTY OFFICE OF EDUCATION, MIGRANT EDUCATION- MERCED RESCUE MISSION- PEOPLE'S PROMISE- SIERRA VISTA CHILDREN AND FAMILY SERVICES- ST. VINCENT DE PAUL SOCIETY PLANADA- UNIVERSITY OF CALIFORNIA MERCED- VALLEY CRISIS CENTERSTANISLAUS COUNTYTWELVE (12) INTERVIEWS WERE CONDUCTED DURING JANUARY AND FEBRUARY 2022. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH THE HEALTH AND WELLBEING IN STANISLAUS COUNTY, WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITY. ORGANIZATIONS WERE IDENTIFIED BASED ON THE ROLE THEY PLAYED IN THE COMMUNITY. INDIVIDUALS REPRESENTING ORGANIZATIONS THAT DELIVERED HEALTH AND RELATED SOCIAL SERVICES TO THE COMMUNITY AT-LARGE WERE SOLICITED FOR INVOLVEMENT. SOCIAL SERVICE/COMMUNITY SERVING ORGANIZATIONS, INCLUDING HEALTH CARE PROVIDERS (FQHCS), AND THE INDIVIDUALS REPRESENTING THEM, WERE ALSO RECRUITED FOR PARTICIPATION. THE LOCAL PUBLIC HEALTH AGENCY WAS RECRUITED FOR PARTICIPATION AND REPRESENTATIVES FROM THE HOSPITAL WERE INCLUDED.FOCUS GROUP PARTICIPANTS WERE IDENTIFIED FROM THE ORGANIZATIONS SERVING THE COMMUNITY'S MOST VULNERABLE POPULATIONS. IN SOME INSTANCES, WHERE A FOCUS GROUP WAS DIFFICULT TO CONVENE (DUE TO THE PANDEMIC), REPRESENTATIVES THAT WORKED DIRECTLY WITH VULNERABLE POPULATIONS WERE SOLICITED FOR INVOLVEMENT. THREE (3) FOCUS GROUPS ENGAGED 17 PEOPLE AND WERE HELD VIA ZOOM IN MARCH 2022. FOCUS GROUP PARTICIPANTS REPRESENTED COMMUNITY HEALTH WORKERS, STUDENTS, VOLUNTEERS AND OUTREACH WORKERS. KEY INFORMANTS WERE CHOSEN FOR INTERVIEWS BASED ON THEIR KNOWLEDGE OF COMMUNITY HEALTH ISSUES. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: VALLEY CHILDREN'S HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: VALLEY CHILDREN'S HOSPITAL COLLABORATED WITH THE FOLLOWING HOSPITAL FACILITIES TO COMPLETE THE CHNA:FRESNO, KINGS, MADERA AND TULARE COUNTIES- SAINT AGNES MEDICAL CENTER AND COMMUNITY REGIONAL MEDICAL CENTER.KERN COUNTY- DIGNITY HEALTH (MERCY AND MEMORIAL HOSPITALS), ADVENTIST HEALTH (BAKERSFIELD, DELANO AND TEHACHAPI VALLEY), KERN MEDICAL, AND KAISER PERMANENTE.MERCED COUNTY- MERCY MEDICAL CENTER MERCED.STANISLAUS COUNTY- SUTTER HEALTH MEMORIAL MEDICAL CENTER. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: VALLEY CHILDREN'S HOSPITAL COLLABORATED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA TO COMPLETE THE CHNA. PART V, LINE 7A, HOSPITAL FACILITY'S WEBSITE: WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFIT PART V, SECTION B, LINE 11 THE 2022 CHNA PROCESS INCLUDED COLLECTION AND ANALYSIS OF DATA SOURCES FOR THE HOSPITAL SERVICE AREA. SECONDARY DATA WERE COLLECTED FROM COUNTY AND STATE SOURCES TO PRESENT COMMUNITY DEMOGRAPHICS, SOCIAL DETERMINANTS OF HEALTH, ACCESS TO HEALTH CARE, BIRTH CHARACTERISTICS, ACUTE AND CHRONIC CONDITIONS, HEALTH BEHAVIORS, MENTAL HEALTH, AND SUBSTANCE USE. IN ADDITION, VALLEY CHILDREN'S CONDUCTED INTERVIEWS, FOCUS GROUPS AND SURVEYS WITH COMMUNITY STAKEHOLDERS AND RESIDENTS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THE COLLECTED DATA WERE USED TO IDENTIFY SIGNIFICANT COMMUNITY NEEDS. GIVEN THE COMMUNITY INPUT SPECIFIC TO CHILD HEALTH, THE MAJOR NEEDS IDENTIFIED FOR CHILDREN THROUGHOUT THE SERVICE AREA INCLUDED THE FOLLOWING:- ACCESS TO HEALTH CARE INCLUDES ACCESS TO PRIMARY CARE, SPECIALTY CARE, PREVENTIVE CARE, AND TRANSPORTATION.- CHRONIC DISEASES INCLUDE PREVENTION, MANAGEMENT, AND TREATMENT OF CHRONIC DISEASES (DIABETES, ASTHMA, CANCER), CAREGIVER SUPPORT FOR CHILDREN EXPERIENCING CHRONIC DISEASES.- ECONOMIC INSECURITY INCLUDES POVERTY, BASIC NEEDS SERVICES, AND FOOD INSECURITY.- HOUSING AND HOMELESSNESS INCLUDE ACCESS TO SAFE AND AFFORDABLE HOUSING, AND ISSUES RELATED TO PERSONS WHO ARE EXPERIENCING HOMELESSNESS, INCLUDING HOUSING AVAILABILITY, SOCIAL SERVICES AND TRANSITIONAL CARE.- MATERNAL AND INFANT HEALTH INCLUDE TEEN PREGNANCY, PRENATAL CARE, LOW-BIRTH WEIGHT BIRTHS,PREMATURE BIRTHS, INFANT MORTALITY, AND BREASTFEEDING.- MENTAL HEALTH INCLUDES ANXIETY AND DEPRESSION, SEVERE MENTAL ILLNESS, ACCESS TO MENTAL HEALTHCARE AND SUPPORTIVE SERVICES, REDUCTION IN STIGMA AND AVAILABILITY OF MENTAL HEALTH CARE BEDS.- OBESITY/NUTRITION/PHYSICAL ACTIVITY INCLUDE ACCESS TO HEALTHY, AFFORDABLE FOOD, INCREASED ACCESS TO OUTDOOR ACTIVITIES.- PREVENTIVE CARE INCLUDES VACCINES, TESTING AND SCREENINGS.- SUBSTANCE USE AND MISUSE INCLUDE TOBACCO USE, VAPING, DRUG MISUSE AND ALCOHOL USE.- VIOLENCE AND INJURY PREVENTION INCLUDE ACCIDENTAL INJURIES, NEIGHBORHOOD SAFETY, REDUCTION IN CRIME, AND CHILD ABUSE.THE CHNA SERVED AS A RESOURCE DOCUMENT FOR THE REVIEW OF HEALTH NEEDS AS IT PROVIDED DATA ON THE SCOPE AND SEVERITY OF ISSUES AND INCLUDED COMMUNITY INPUT ON THE HEALTH NEEDS. THE COMMUNITY PRIORITIZATION OF NEEDS WAS ALSO TAKEN INTO CONSIDERATION. VALLEY CHILDREN'S IS ADDRESSING THE FOLLOWING NEEDS:- ACCESS TO HEALTH CARE (INCLUDING PREVENTIVE CARE)- CHRONIC DISEASES (INCLUDING OBESITY, NUTRITION, AND PHYSICAL ACTIVITY)- MATERNAL AND INFANT HEALTH- MENTAL HEALTH- VIOLENCE AND INJURY PREVENTIONACCESS TO CAREACCESS TO PRIMARY AND PREVENTIVE CARE FOR AT-RISK CHILDRENPEDIATRIC PHYSICIAN RESIDENTS PARTICIPATING IN VALLEY CHILDREN'S PEDIATRIC RESIDENCY PROGRAM PROVIDED PRIMARY AND PREVENTIVE HEALTHCARE SERVICES TO AT-RISK CHILDREN IN FRESNO COUNTY AS PART OF THE FRESNO COUNTY SUPERINTENDENT OF SCHOOLS' MOBILE HEALTH UNIT (MHU). DESIGNED TO HELP ENSURE THAT CHILDREN ARE ABLE TO START SCHOOL ON TIME AND ACCESS THEIR EDUCATION, THE MHU HELD 43 CLINICS IN 2024, INCLUDING MANY LOCATED IN RURAL AND LOW-INCOME COMMUNITIES. AS A PART OF THOSE CLINICS, 1,014 CHILDHOOD VACCINATIONS WERE ADMINISTERED, AND 256 SPORTS PHYSICALS WERE PERFORMED.ADAPTIVE SPORTS PROGRAMVALLEY CHILDREN'S ADAPTIVE SPORTS PROGRAM PROVIDES FREE RECREATIONAL AND ATHLETIC EXPERIENCES FOR CHILDREN, ADOLESCENTS AND YOUNG ADULTS WITH DISABILITIES, REGARDLESS OF WHETHER THEY HAVE BEEN OR ARE CURRENTLY PATIENTS AT VALLEY CHILDREN'S. THE PROGRAM, THE ONLY ONE OF ITS KIND IN CENTRAL CALIFORNIA, IS DESIGNED FOR INDIVIDUALS WITH PHYSICAL IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY, SPINAL CORD INJURIES AND AMPUTATIONS. DISABLED YOUTH, UP TO AGE 21, ARE ESPECIALLY ENCOURAGED TO ATTEND. IN 2024, ABOUT 70 CHILDREN PARTICIPATED IN A VARIETY OF ACTIVITIES INCLUDING WHEELCHAIR BASKETBALL, WHEELCHAIR TENNIS, WHEELCHAIR SOCCER, CANOEING/KAYAKING, ROCK CLIMBING, TRACK AND FIELD, AND SNOW AND WATER SKIING.ENROLLMENT IN HEALTH INSURANCEVALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM OR VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED THE FAMILIES WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES.EXPANDED ACCESS TO PEDIATRIC PRIMARY AND SPECIALTY CAREVALLEY CHILDREN'S MADE CASH CONTRIBUTIONS FOR THE PURCHASE OF CAPITAL-RELATED ITEMS TO BE USED TO INCREASE ACCESS TO HEALTHCARE SERVICES FOR CHILDREN THROUGHOUT THE REGION.TRANSPORTATIONGIVEN THE CENTRAL VALLEY'S LARGELY RURAL LANDSCAPE AND HIGH CONCENTRATION OF POVERTY, TRANSPORTATION HAS LONG BEEN A CHALLENGE FOR MANY FAMILIES. VALLEY CHILDREN'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING GAS CARDS, TAXI VOUCHERS, AND FUNDING TRANSPORTATION/RIDE SHARING EXPENSES, AMTRAK TICKETS AND BUS TOKENS. VALLEY CHILDREN'S ALSO SUBSIDIZED BUS AND OTHER PUBLIC TRANSIT SERVICES FROM THE CITY OF FRESNO AND KINGS COUNTY.VISION SCREENINGSTHROUGH A PARTNERSHIP WITH THE TZU CHI MEDICAL FOUNDATION AND ITS SEE 2 SUCCEED INITIATIVE, VALLEY CHILDREN'S HELPED MAKE POSSIBLE VISION SCREENINGS FOR 14,409 SCHOOL AGED CHILDREN IN FRESNO COUNTY ACROSS 18 SCHOOL DISTRICTS AND 51 SCHOOL SITES. AS A RESULT OF THE SCREENINGS, 1,353 FULL EYE EXAMS WERE CONDUCTED, AND 1,167 PAIRS OF GLASSES WERE PROVIDED TO CHILDREN.CHRONIC DISEASE PREVENTIONBLUE ZONES PROJECT BAKERSFIELDBLUE ZONES BAKERSFIELD SUPPORTS INTERVENTIONS AND INITIATIVES THAT EMPOWER PEOPLE, INCENTIVIZES DIFFERENT ORGANIZATIONS AND BUSINESSES TO ENHANCE THE WAYS THEY PROMOTE HEALTH AND WELLNESS, AND IMPLEMENTS POLICIES THAT TRANSFORM THE ENVIRONMENT. IN 2024, VALLEY CHILDREN'S PROVIDED FINANCIAL SUPPORT FOR BLUE ZONES PROJECT BAKERSFIELD, SUPPORTED ITS ADVOCACY EFFORTS, AND PARTICIPATED ON THE INITIATIVE'S STEERING COMMITTEE AND SCHOOL WELLNESS COMMITTEE. WITH THE HELP OF VALLEY CHILDREN'S, A TOTAL OF 20 SCHOOLS HAD BECOME CERTIFIED AS BLUE ZONE PROJECT APPROVED SCHOOLS AT THE END OF 2024. TO BECOME AN APPROVED SITE, SCHOOLS SIGN A PLEDGE COMMITTING TO PURSUE SPECIFIC POLICIES AND PROGRAMS THAT SUPPORT STUDENT HEALTH AND WELLBEING. VALLEY CHILDREN'S SUPPORT ALSO HELPED MAKE POSSIBLE "WELLNESS WALKS TO SCHOOL AND A BOOK VENDING MACHINE AT MCKINLEY ELEMENTARY SCHOOL IN BAKERSFIELD.FOOD FOR FAMILIESVALLEY CHILDREN'S DIETARY DEPARTMENT PROVIDED MEAL COUPONS TO BREASTFEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WHO WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL WITH MEAL COUPONS WHEN THE NEED WAS DETERMINED. THE SOCIAL WORK TEAM ALSO WORKED CLOSELY WITH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM TO PROVIDE FOOD FOR ELIGIBLE FAMILIES.FOOD SECURITY - CENTRAL CALIFORNIA FOOD BANK PARTNERSHIPIN MARCH 2022, VALLEY CHILDREN'S ENTERED A THREE-YEAR PARTNERSHIP WITH THE CENTRAL CALIFORNIA FOOD BANK TO SUPPORT ACCESS TO HEALTHY AND NUTRITIOUS FOOD FOR CHILDREN AND FAMILIES ACROSS OUR SERVICE AREA. THROUGH THIS PARTNERSHIP, VALLEY CHILDREN'S HOME CARE STAFF, AS PART OF THEIR REGULAR HOME VISITS, ARE BRINGING QUALIFYING FAMILIES A SPECIALLY ASSEMBLED FOOD BOX EVERY MONTH THAT ALIGNS WITH THE FAMILY'S CULTURAL PREFERENCES. IN THE PARTNERSHIP'S FIRST TWO YEARS, VALLEY CHILDREN'S DISTRIBUTED 19,512 POUNDS OF FOOD (THE EQUIVALENT OF 16,259 MEALS) TO 83 FAMILIES, INCLUDING 197 CHILDREN. ANOTHER COMPONENT OF OUR PARTNERSHIP INCLUDES SUPPORT FOR FOOD DISTRIBUTION AT WEST FRESNO ELEMENTARY SCHOOL WHERE OVER 90% OF THE STUDENTS DURING THE 2023 2024 SCHOOL YEAR QUALIFIED FOR FREE AND REDUCED PRICED MEALS. DURING THE PARTNERSHIP'S FIRST TWO YEARS, 94,900 POUNDS OF FOOD WERE DISTRIBUTED (THE EQUIVALENT OF 79,083 MEALS) TO 1,293 FAMILIES INCLUDING 4,388 CHILDREN.A THIRD FEATURE OF THE PARTNERSHIP INCLUDES VALLEY CHILDREN'S SUPPORT FOR THE FIRST FRUITS MARKET THAT OPENED IN FRESNO IN SEPTEMBER 2023. INSIDE THE FRESNO RESCUE MISSION'S CITY CENTER, A FULL SERVICE 'HUB' FOR KIDS, FAMILIES, RUNAWAY YOUTH, AND UNHOUSED ADULTS, THE MARKET PROVIDES A VARIETY OF FRESH PRODUCE, PROTEIN, CULTURALLY APPROPRIATE FOOD AND SHELF-STABLE FOOD ITEMS TO ANYONE IN NEED OF FOOD ASSISTANCE IN AN ENVIRONMENT DESIGNED JUST LIKE ANY GROCERY STORE WHERE 'CUSTOMERS' CAN CHOOSE ITEMS MOST USEFUL AND MOST CULTURALLY APPROPRIATE FOR THEM. THROUGH JANUARY 2024, THE MARKET DISTRIBUTED CLOSE TO 500,000 POUNDS OF FOOD TO OVER 11,000 HOUSEHOLDS. PART V, SECTION B, LINE 11 (CONTINUED) FOOD SECURITY - MERCED PARTNERSHIPIN MERCED COUNTY, VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS PRACTICE CONTINUED ITS PARTNERSHIP WITH COMMUNITY INITIATIVES FOR COLLECTIVE IMPACT AND THE MERCED COUNTY FOOD BANK TO HELP NEEDY FAMILIES ACCESS FOOD AT LOCAL GROCERY STORES. THROUGH THE PARTNERSHIP, VALLEY CHILDREN'S PROVIDERS SCREEN ALL CHILDREN ENROLLED IN MEDI-CAL AND THEIR FAMILIES FOR FOOD INSECURITY. IF A FAMILY SCREENS POSITIVE FOR FOOD INSECURITY, THE PROVIDERS GIVE THE FAMILY A COUPON THAT CAN BE USED AT ANY GROCERY STORE THAT ACCEPTS FOOD COUPONS TO HELP WITH THE PURCHASE OF STAPLES SUCH AS FRUITS, VEGETABLES AND DAIRY PRODUCTS. IN 2024, 23% OF FAMILIES SCREENED POSITIVE FOR FOOD INSECURITY. NEARLY 14% OF THOSE WHO SCREENED POSITIVE HAD PRIVATE HEALTH INSURANCE, AND 73% OF IDENTIFIED AS HISPANIC AND LATINO INDIVIDUALS.FOOD SECURITY - FOODLINK FOR TULARE COUNTY PARTNERSHIPIN 2024, VALLEY CHILDREN'S CONTINUED ITS PARTNERSHIP WITH FOODLINK FOR TULARE COUNTY IN SUPPORT OF THE ORGANIZATION'S SMART PACK PROGRAM. THROUGH THE SMART PACK PROGRAM, FOODLINK PROVIDES FOOD INSECURE STUDENTS AND THEIR FAMILIES WITH A BACKPACK OF HEALTHY FOOD EACH FRIDAY DURING THE SCHOOL YEAR SO THAT CHILDREN HAVE FOOD OVER THE WEEKENDS WHEN THEY ARE NOT ABLE TO ACCESS FREE OR REDUCED-PRICE SCHOOL BREAKFASTS AND LUNCHES. WITH VALLEY CHILDREN'S FINANCIAL SUPPORT, FOODLINK PROVIDED 1,184 BACKPACKS TO 51 FAMILIES FOR THE SCHOOL YEAR ENDING JUNE 2024.EPILEPSY SUPPORT PROGRAMVALLEY CHILDREN'S EPILEPSY PROGRAM CONTINUED ITS COMMUNITY-BASED OUTREACH WORK IN 2024 BY PROVIDING THE FOLLOWING EDUCATION AND TRAINING TO KEY STAKEHOLDERS.1. SCHOOL HEALTH AND WELLNESS - PROVIDED SEIZURE SAFE TRAINING TO MORE THAN 600 STAFF ACROSS 15 SCHOOL DISTRICTS.2. COMMUNITY RESOURCES - HOSTED 36 SUPPORT GROUPS. - FILMED AND MADE AVAILABLE 10 EDUCATIONAL VIDEOS ON ADMINISTERING SEIZURE RESCUE MEDICATIONS WITH MORE THAN 174,000 VIEWS. - DISTRIBUTED 100 COMFORT CARE BACKPACKS TO SCHOOL NURSES.3. COMMUNITY EVENTS - HOSTED ART FOR EPILEPSY, SUMMER SAFETY WATER SPLASH DAY, AND EPILEPSY AWARENESS ACTIVITIES, REACHING MORE THAN 1,000 INDIVIDUALS.4. LEGISLATIVE ADVOCACY - CONTINUED TO SUPPORT THE WORK OF THE CONGRESSIONAL EPILEPSY CAUCUS, ADVOCATING FOR EPILEPSY AWARENESS AND RESEARCH FUNDING.MATERNAL AND INFANT HEALTHCLINICAL PARTNERSHIP PROGRAMVALLEY CHILDREN'S CLINICAL PARTNERSHIP PROGRAM BRINGS TOGETHER INSTITUTIONS FOCUSED ON ENHANCING NEONATAL AND PEDIATRIC CARE, REGARDLESS OF WHETHER THE ILL OR INJURED CHILD BECOMES A VALLEY CHILDREN'S PATIENT. THROUGH THE PROGRAM, VALLEY CHILDREN'S PHYSICIANS AND STAFF PROVIDE EDUCATION AND OTHER RESOURCES FOR PARTNERING HEALTHCARE FACILITIES. THIS SUPPORT HELPS MINIMIZE CHILDREN BEING TRANSFERRED OR REFERRED UNNECESSARILY TO VALLEY CHILDREN'S AND HELPS TO QUICKLY IDENTIFY WHEN A CHILD NEEDS ADVANCED PEDIATRIC CARE. ADDITIONALLY, WITH IMPROVED COMMUNICATION AND TOOLS, THE PROGRAM DECREASES STRESS FOR PATIENTS AND FAMILIES, INCREASES PROVIDER CONFIDENCE, AND ENHANCES PERFORMANCE AT VALLEY CHILDREN'S AND THE PARTNERING PROVIDER.IN 2024, VALLEY CHILDREN'S SUPPORTED 18 INPATIENT AND FOUR OUTPATIENT CLINICAL PARTNERS AND, AS A PART OF THAT SUPPORT, CONVENED MORE THAN 30 TRAINING AND EDUCATION EVENTS THAT DREW MORE THAN 750 ATTENDEES. THE AVERAGE INVESTMENT OF TIME FOR EACH HEALTHCARE PARTNER WAS MORE THAN 200 HOURS ANNUALLY.MEETING FAMILIES' BASIC NEEDS: DIAPERSACCORDING TO RESEARCH RESULTS RELEASED BY THE NATIONAL DIAPER BANK NETWORK IN JUNE 2023, NEARLY HALF (47%) OF U.S. FAMILIES WITH YOUNG CHILDREN STRUGGLE TO AFFORD DIAPERS. BASED ON THAT SAME RESEARCH, A LACK OF ADEQUATE DIAPERS "IS ASSOCIATED WITH PHYSICAL, EMOTIONAL, AND ECONOMIC HARDSHIP TO CHILDREN AND FAMILIES." ACROSS OUR SERVICE AREA, WHERE UP TO 30% OF CHILDREN ARE LIVING IN POVERTY, THERE IS A CLEAR LINK BETWEEN FAMILY INCOME AND A FAMILY'S INABILITY TO COVER BASIC NEEDS FOR THEIR CHILDREN, INCLUDING PURCHASING DIAPERS. IN RECOGNITION OF THIS REALITY, VALLEY CHILDREN'S DONATED 49,312 DIAPERS TO COMMUNITY-BASED ORGANIZATIONS TO DISTRIBUTE TO FAMILIES IN NEED. ORGANIZATIONS RECEIVING DIAPERS INCLUDED FIRST 5 MADERA COUNTY, SAINT REST BAPTIST CHURCH AND WEST FRESNO FAMILY RESOURCE CENTER.SAFE SLEEP FOR INFANTSTHE GUILDS CENTER FOR COMMUNITY HEALTH CONTINUED TO SUPPORT THE CENTRAL VALLEY SAFE SLEEP COALITION THAT REPRESENTS MORE THAN 50 MEMBERS IN NINE COUNTIES ACROSS THE CENTRAL VALLEY. THE COALITION, CO-CHAIRED BY VALLEY CHILDREN'S AND FIRST 5 FRESNO COUNTY, HAS A VISION THAT EVERY PARENT AND CAREGIVER OF AN INFANT WILL HAVE ACCESS TO CULTURALLY APPROPRIATE RISK REDUCTION EDUCATION AND RESOURCES ON INFANT SLEEP, KEEPING ALL CENTRAL VALLEY INFANTS SAFE FROM PREVENTABLE CAUSES OF DEATH. COALITION MEMBERS INCLUDE REPRESENTATIVES FROM LOCAL PUBLIC HEALTH DEPARTMENTS, COUNTY FIRST 5 OFFICES, THE CALIFORNIA HEALTH COLLABORATIVE, COUNTY OFFICES OF EDUCATION, COUNTY COMMUNITY ACTION PARTNERSHIPS, THE BLACK WELLNESS AND PROSPERITY CENTER AND CULTURAL BROKERS, INC. IN 2024, THE COALITION HOSTED ITS SECOND-ANNUAL SAFE SLEEP CONFERENCE THAT FOCUSED ON EDUCATORS AND INCLUDED A PANEL OF COMMUNITY HEALTH WORKERS (CHW) AND PARENTS WHO LOST A CHILD TO SUDDEN INFANT DEATH SYNDROME TO TELL THEIR STORIES. ALSO, THE COALITION DISTRIBUTED 66 CRIBETTES INCLUDING 35 THROUGH OUR COMMUNITY PARTNERS TO INFANTS IDENTIFIED AS HAVING NO SAFE SLEEP ENVIRONMENTS AND CONDUCTED VIRTUAL TRAININGS ON SAFE SLEEP BASICS TO NEARLY 300 CHILDCARE PROVIDERS, HEALTHCARE STAFF AND COMMUNITY MEMBERS. THE COALITION CONTINUES TO WORK WITH FRESNO HOPE AND THEIR CHW NETWORK TO PROVIDE CULTURALLY APPROPRIATE SAFE SLEEP EDUCATION AND RESOURCES TO PARENTS IN NEED.MENTAL HEALTHMENTAL HEALTH IS ONE OF THE MOST PRESSING NEEDS FACING CHILDREN IN CALIFORNIA. CHILDREN LIVING IN VALLEY CHILDREN'S SERVICE AREA ARE PARTICULARLY UNDERSERVED DUE TO THE GEOGRAPHY, PROVIDER SHORTAGES AND LIMITED COMMUNITY-BASED SERVICES. IN 2024, VALLEY CHILDREN'S DEMONSTRATED ITS COMMITMENT TO MEETING THE MENTAL HEALTH NEEDS OF CHILDREN IN A NUMBER OF WAYS, INCLUDING THOSE LISTED BELOW.ADVERSE CHILDHOOD EXPERIENCES (ACES)IN SPRING 2024, VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS PRACTICE IN MERCED CONCLUDED WORK ON A $622,000 GRANT FROM THE CALIFORNIA'S ACES AWARE INITIATIVE TO ADDRESS ACES THROUGH INCREASED COMMUNITY PARTNERSHIPS, EXPANDED EDUCATION AND BROADENED SCREENING AND REFERRALS.THROUGH THE GRANT, VALLEY CHILDREN'S HELPED TO IDENTIFY PATIENTS AND FAMILIES AT RISK FOR POOR HEALTH OUTCOMES BECAUSE OF ACES AND TOXIC STRESS; EDUCATED PROVIDERS, STAFF AND COMMUNITY MEMBERS AROUND ACES AND TOXIC STRESS AND HOW TO INTERVENE; CONNECTED FAMILIES TO NEEDED RESOURCES; AND BUILT RESILIENCE TO BREAK THE CYCLE.SCREENING AND REFERRALS FOR ACES HAS EXPANDED BEYOND OUR MERCED PRACTICE AND IS NOW BEING IMPLEMENTED ACROSS OUR PRIMARY CARE SITES FROM MERCED TO BAKERSFIELD. IN 2024, VALLEY CHILDREN'S PRIMARY CARE PRACTICES SCREENED MORE THAN 2,600 CHILDREN FOR ACES, WITH NEARLY 11% SCREENING POSITIVE FOR HIGH RISK OF TOXIC STRESS.YOUTH HEALTH AMBASSADORSIN MAY 2023, THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) ANNOUNCED THE CHILD AND YOUTH RESILIENCE CHALLENGE, LOOKING FOR INNOVATIVE, COMMUNITY-LED INITIATIVES TO PROMOTE RESILIENCE IN CHILDREN AND ADOLESCENTS. VALLEY CHILDREN'S SUBMITTED A PROPOSAL IN CONJUNCTION WITH THE FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP YOUTH LEADERSHIP COUNCIL AND WAS AWARDED FUNDING TO SUPPORT THE WORK OF THE PARTNERSHIP. WITH THE FUNDING, VALLEY CHILDREN'S FACILITATED THE DEVELOPMENT OF A NOVEL, YOUTH-DRIVEN CURRICULUM TITLED, "YOUTH HEALTH AMBASSADORS" THAT COMBINES AN EVIDENCE-BASED APPROACH TO COMBAT TOXIC STRESS, WITH YOUTH LED COMMUNITY EDUCATION AND SERVICE. THE PROGRAM WAS SELECTED AS ONE OF 14 FINALISTS FROM MORE THAN 500 APPLICATIONS FROM ACROSS THE U.S. AND CULMINATED IN EIGHT VALLEY YOUTH FROM UNDERSERVED AND UNDER-RESOURCED COMMUNITIES PRESENTING THEIR WORK TO HHS IN WASHINGTON, D.C. THE PROGRAM IS NOW A TWO-YEAR, LONGITUDINAL CURRICULUM FOCUSED ON LEADERSHIP DEVELOPMENT SKILLS AND TRAINING.COMMUNITY-BASED COLLABORATION AND EDUCATIONIN 2024, VALLEY CHILDREN'S CONTINUED ITS PARTICIPATION IN THE ZERO SUICIDE INITIATIVE, A NATIONAL COLLABORATIVE AIMED AT PREVENTING YOUTH SUICIDE THROUGH IMPROVED HOSPITAL SCREENING, INTERNAL SYSTEMS OF CARE AND REGIONAL COMMUNITY COLLABORATIONS. REGIONAL COLLABORATIVES, IN WHICH VALLEY CHILDREN'S PARTICIPATED, INCLUDED THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND THE MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE. THEY ADDRESSED ISSUES OF MENTAL HEALTH, HOMELESSNESS AND THE IMPACT ON FAMILIES. PART V, SECTION B, LINE 11 (CONTINUED) ADDITIONALLY, VALLEY CHILDREN'S CONTINUED ITS COLLABORATION WITH CALIFORNIA STATE UNIVERSITY FRESNO IN SUPPORT OF HEALTHY KIDS. HEALTHY FUTURES. FOCUSING ON THE HEALTH AND WELL-BEING OF KIDS IN THE CENTRAL VALLEY. HEALTHY KIDS. HEALTHY FUTURES. PROVIDES RESOURCES TO STUDENTS AND FAMILIES ON HEALTHY EATING TIPS, BACK TO SCHOOL ADVICE FOR PARENTS, AND OTHER USEFUL RESOURCES.VIOLENCE AND INJURY PREVENTIONCHILD ABUSE PREVENTIONVALLEY CHILDREN'S GUILDS CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN, DEPENDENT ADULTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, TRAUMA-INFORMED PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF VICTIMS WITH ABUSE CONSIDERATIONS.THE CENTER IS RECOGNIZED IN CENTRAL CALIFORNIA AND AROUND THE STATE AS A LEADER IN ADVOCACY, INJURY PREVENTION AND ACADEMIC TRAINING. THE CENTER PRIDES ITSELF ON WORKING COLLABORATIVELY WITH PREVENTION AND INTERVENTION GROUPS THROUGHOUT THE STATE TO ENSURE THEY ARE ADDRESSING CHILD MALTREATMENT TO THE BEST OF THEIR ABILITY. THE CENTER IS CURRENTLY A MEMBER OF THE CHILD ADVOCACY CENTERS OF CALIFORNIA, CENTRAL CALIFORNIA COALITION OF CHILD ABUSE PREVENTION COUNCILS AND THE RAY E. HELFER SOCIETY FOR CHILD ABUSE PEDIATRICS.THE GUILDS CHILD ABUSE PREVENTION AND TREATMENT CENTER INCLUDES THE CHILD ADVOCACY CLINIC, WHICH OPERATES FIVE DAYS A WEEK AND SEES APPROXIMATELY 800 CHILDREN EACH YEAR. THE CENTER'S PROVIDERS ARE ALSO AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES AN ADDITIONAL 100 CHILDREN ANNUALLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE AND PEDIATRIC INTENSIVE CARE UNITS. IN ADDITION TO THE MEDICAL SERVICES OFFERED, THE CENTER HAS A TEAM OF SOCIAL WORKERS AND A LICENSED MENTAL HEALTH CLINICIAN THAT PROVIDE PSYCHO-SOCIAL ASSESSMENT, LINKAGES TO COMMUNITY SERVICES AND TRAUMA THERAPY.IN 2024, THE CENTER WORKED CLOSELY WITH LAW ENFORCEMENT, CHILD PROTECTIVE SERVICES AND DISTRICT ATTORNEYS' OFFICES IN THEIR INVESTIGATIVE EFFORTS OF CHILD MALTREATMENT. COLLABORATIVE EFFORTS INCLUDED CASE CONSULTATION AND MONTHLY SUSPECT CHILD ABUSE AND NEGLECT MEETINGS FACILITATED BY OUR CHILD ADVOCACY CLINIC IN AN EFFORT TO TRACK, MONITOR AND ADVOCATE FOR THE HEALTH AND SAFETY OF AT-RISK CHILDREN THROUGHOUT THE VALLEY.FOR PREVENTION EDUCATION, THE CENTER CONTINUED TO COLLABORATE WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTHCARE PERSONNEL, TEACHERS AND MANDATED REPORTERS. THESE PARTNERS INCLUDED RAPE COUNSELING SERVICES (RCS) OF FRESNO, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, CHILD PROTECTIVE SERVICES, DISTRICT ATTORNEY'S OFFICES, LOCAL LAW ENFORCEMENT AGENCIES, SEXUAL ASSAULT RESPONSE TEAMS (SART), VICTIM ADVOCACY GROUPS, SCHOOL DISTRICTS THROUGHOUT THE CENTRAL VALLEY AND COUNTY PUBLIC HEALTH DEPARTMENTS. IN ADDITION, THE CENTER HOSTED ITS FOURTH ANNUAL CHILD ABUSE PREVENTION CONFERENCE IN APRIL 2024 BRINGING EXPERTS IN THE FIELD OF CHILD ABUSE TO PROVIDE EDUCATION AND INFORMATION ON BEST PRACTICES TO CHILDPROTECTION PROFESSIONALS THROUGHOUT THE CENTRAL VALLEY.INJURY PREVENTION PROGRAMUNINTENTIONAL INJURY IS THE NUMBER ONE KILLER OF CHILDREN ACROSS THE UNITED STATES AND AROUND THE WORLD. SAFE KIDS CENTRAL CALIFORNIA IS ONE OF 400 COALITIONS THAT ARE PART OF SAFE KIDS WORLDWIDE, AN EXTENSIVE NETWORK OF COALITIONS AND PARTNERS IN THE UNITED STATES AND AROUND THE WORLD DEDICATED TO REDUCING INJURIES FROM MOTOR VEHICLES, SPORTS, DROWNINGS, FALLS, BURNS, POISONINGS AND MORE. AS THE LEAD AGENCY FOR SAFE KIDS CENTRAL CALIFORNIA, VALLEY CHILDREN'S IS A LEADER IN SUPPORTING PEDIATRIC INJURY PREVENTION EFFORTS THROUGHOUT CENTRAL CALIFORNIA AND IS COMMITTED TO PROVIDING RESOURCES TOWARD THESE EFFORTS. SAFE KIDS CENTRAL CALIFORNIA IS A COALITION OF 30 AGENCIES MADE UP OF HEALTHCARE, LAW ENFORCEMENT, SOCIAL SERVICES, EDUCATION, MEDIA AND OTHER ORGANIZATIONS THAT ARE DEDICATED TO PREVENTING UNINTENTIONAL INJURY IN CHILDREN.IN 2024, VALLEY CHILDREN'S INJURY PREVENTION PROGRAM RECORDED 6,177 CONTACTS WITH COMMUNITY MEMBERS DURING 15 COMMUNITY-BASED TEACHING EVENTS ON THE FOLLOWING TOPICS: ATV SAFETY, CARBON MONOXIDE POISONING PREVENTION, CHILD PASSENGER SAFETY, CONCUSSIONS, GUN STORAGE SAFETY, HALLOWEEN SAFETY, HOME SAFETY, POISON PREVENTION, RAILROAD SAFETY, SAFE INFANT SLEEP, TEEN DRIVING, TOY SAFETY, VEHICLE SAFETY, VEHICULAR HEAT STROKE PREVENTION AND WATER SAFETY.TO ENSURE THAT CHILDREN WERE SAFE AT HOME, VALLEY CHILDREN'S DISTRIBUTED SAFETY EQUIPMENT, INCLUDING THE FOLLOWING, TO FAMILIES IN NEED. - 2,235 REFLECTOR FLASHLIGHTS - 296 INFANT SAFE SLEEP SACKS - 284 BICYCLE HELMETS - 76 CAR SEATS - 62 GUN SAFETY LOCKSDISASTER PREPAREDNESSVALLEY CHILDREN'S DONATED SPACE TO THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH TO STORE PHARMACEUTICALS TO BE USED IN REGIONAL DISASTERS OR MEDICAL EMERGENCIES.POISON CONTROLTHE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE VALLEY CHILDREN'S CAMPUS AND RECEIVED A DONATION OF OFFICE SPACE IN 2024 FROM VALLEY CHILDREN'S. THE CENTER ANSWERS CALLS 24 HOURS A DAY, SEVEN DAYS A WEEK AND PROVIDES EXPERT ADVICE AND INFORMATION REGARDING EXPOSURE TO POTENTIALLY HARMFUL SUBSTANCES.SIGNIFICANT NEEDS VALLEY CHILDREN'S DOES NOT INTEND TO ADDRESSKNOWING THAT THERE ARE NOT SUFFICIENT RESOURCES TO ADDRESS ALL THE COMMUNITY HEALTH NEEDS, VALLEY CHILDREN'S CHOOSES TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. VALLEY CHILDREN'S WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING ECONOMIC INSECURITY, HOUSING AND HOMELESSNESS, AND SUBSTANCE USE. ALSO, AS POINTED OUT EARLIER, THIS REPORT IS NOT EXHAUSTIVE OF EVERYTHING VALLEY CHILDREN'S DOES TO ENHANCE THE HEALTH AND WELLBEING OF THE COMMUNITIES WE SERVE. VALLEY CHILDREN'S WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS WHERE IT CAN APPROPRIATELY CONTRIBUTE TO ADDRESSING THOSE NEEDS, EITHER DIRECTLY OR IN COLLABORATION WITH OTHERS. PART V, SECTION B, LINE 13H: FACILITY REPORTING GROUP - A200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-400% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.400% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 400% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES. FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.PROMPT PAY DISCOUNT: VALLEY CHILDREN'S WILL EXTEND A 45% PROMPT PAY DISCOUNT TO THOSE SELF-PAY PATIENTS WHO WISH TO PAY THEIR ENTIRE OUTSTANDING BALANCE IMMEDIATELY. INSURED PATIENTS WITH NON-COVERED SERVICES WHICH ARE DEEMED MEDICALLY NECESSARY AND WISH TO PAY THEIR OUTSTANDING BALANCE IMMEDIATELY WILL BE ELIGIBLE FOR A 45% DISCOUNT UPON REQUEST. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.VALLEYCHILDRENS.ORG/PATIENTS-AND-FAMILIES/RECORDS-BILLING/FINANCIAL-AID PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.VALLEYCHILDRENS.ORG/PATIENTS-AND-FAMILIES/RECORDS-BILLING/FINANCIAL-AID PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.VALLEYCHILDRENS.ORG/PATIENTS-AND-FAMILIES/RECORDS-BILLING/FINANCIAL-AID PART V, LINE 16J, FAP OTHER INFORMATION: ADDITIONALLY THE POLICY IS SENT BY US POSTAL SERVICE TO COMMUNITY AGENCIES TO BE DISTRIBUTED.VALLEY CHILDREN'S MAINTAINS A LIST OF PROVIDERS IN A DOCUMENT SEPARATE FROM THE FINANCIAL ASSISTANCE POLICY. MEMBERS OF THE PUBLIC MAY READILY OBTAIN A COPY FREE OF CHARGE, BOTH ONLINE AND ON PAPER, AS REQUIRED BY IRS NOTICE 2015-46. THE LINK TO THE WEBSITE IS:HTTPS://WWW.VALLEYCHILDRENS.ORG/FIND-A-DOCTOR/FIND-A-DOCTOR PART I, LINE 3C: N/A PART I, LINE 6A: N/A PART I, LINE 7: CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.). PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 13,481,552. PART III, LINE 2: COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF. PART III, LINE 4: FOOTNOTE DESCRIBING BAD DEBT EXPENSE: SEE PAGE 15-16 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2024 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI-CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION. PART III, LINE 9B: COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE. PART VI, LINE 2: IN ADDITION TO PERFORMING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE FACILITY HAS MADE ITS MOST RECENT FY2022 CHNA AVAILABLE ON ITS PUBLIC WEBSITE AND ASKS FOR PUBLIC COMMENTS TO SOLICIT ADDITIONAL INFORMATION AND INPUT ON COMMUNITY HEALTH NEEDS. FACILITY STAFF ACTIVELY PARTICIPATE IN LOCAL COLLABORATIVE GROUPS THAT CONVENE TO IDENTIFY AND ADDRESS COMMUNITY HEALTH AND WELFARE NEEDS. MEMBERS OF FACILITY STAFF SERVE ON COMMUNITY ORGANIZATION GOVERNING BOARDS AND ADVISORY BODIES TO PUBLIC HEALTH AGENCIES, AND INFORMATION OBTAINED FROM THIS ACTIVE COMMUNITY INVOLVEMENT FACTORS INTO IDENTIFICATION OF COMMUNITY HEALTH NEEDS. PART VI, LINE 3: ENROLLMENT IN HEALTH INSURANCEVALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM OR VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED THE FAMILIES WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. PART VI, LINE 4: VALLEY CHILDREN'S HEALTHCARE IS CENTRAL CALIFORNIA'S ONLY HIGH-QUALITY, COMPREHENSIVE HEALTHCARE NETWORK DEDICATED TO CHILDREN, FROM BEFORE BIRTH TO YOUNG ADULTHOOD, AS WELL AS TO HIGH-RISK PREGNANT WOMEN, OFFERING HIGHLY SPECIALIZED MEDICAL AND SURGICAL SERVICES TO CARE FOR CONDITIONS RANGING FROM COMMON TO THE HIGHLY COMPLEX.VALLEY CHILDREN'S SERVICE AREA IS FOCUSED ON THE SEVEN COUNTIES THAT COLLECTIVELY ACCOUNT FOR MORE THAN 90% OF VALLEY CHILDREN'S INPATIENT AND OUTPATIENT VOLUME. THOSE COUNTIES ARE FRESNO, KERN, KINGS, MADERA, MERCED, STANISLAUS AND TULARE.THE TOTAL POPULATION OF VALLEY CHILDREN'S HOSPITAL'S SEVEN-COUNTY SERVICE AREA COUNTIES IS 3,454,760. DENSITIES RANGED FROM 72.74 PERSONS PER SQUARE MILE IN MADERA COUNTY TO 363.09 PERSONS PER SQUARE MILE IN STANISLAUS COUNTY. THE PERCENTAGE OF CHILDREN AND TEENS, AGES 0 TO 17, RANGED FROM 27.2% IN KINGS COUNTY AND STANISLAUS COUNTY TO 31.0% IN TULARE COUNTY, AS COMPARED TO CALIFORNIA AT 23.0%. THE PERCENTAGE OF ADULTS, AGES 18 TO 64, RANGED FROM 57.9% IN TULARE COUNTY TO 62.8% IN KINGS COUNTY. THE PERCENTAGE OF ADULTS, AGES 65 AND OLDER, RANGED FROM 10.0% IN KINGS COUNTY TO 13.8% IN MADERA COUNTY.AMONG SERVICE AREA COUNTIES, THE HISPANIC OR LATINO POPULATIONS RANGED FROM 46.3% IN STANISLAUS COUNTY TO 64.6% IN TULARE COUNTY. WHITE POPULATIONS RANGED FROM 27.6% IN MERCED COUNTY TO 41.9% IN STANISLAUS COUNTY. ASIAN POPULATIONS RANGED FROM 1.9% IN MADERA COUNTY TO 10.1% IN FRESNO COUNTY. BLACK OR AFRICAN AMERICAN POPULATIONS RANGED FROM 1.3% IN TULARE COUNTY TO 5.8% IN KINGS COUNTY.THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ANNUALLY UPDATES OFFICIAL POVERTY LEVELS. IN 2019, THE FEDERAL POVERTY LEVEL (FPL) WAS AN ANNUAL INCOME OF $12,490 FOR ONE PERSON AND $25,750 FOR A FAMILY OF FOUR. AMONG RESIDENTS OF THE SERVICE AREA COUNTIES, POVERTY RATES RANGED FROM 15.1% IN STANISLAUS COUNTY TO 23.8% IN TULARE COUNTY. LOW-INCOME RATES (200% OF FPL OR BELOW) IN THE SERVICE AREA RANGED FROM 37.9% IN STANISLAUS COUNTY TO 50.1% IN TULARE COUNTY. ADULTS, BELOW 200% FPL, RECEIVING FOOD STAMPS, RANGED FROM 11.0% IN KINGS COUNTY TO 32.0% IN FRESNO COUNTY. PARENTS OR GUARDIANS OF ELIGIBLE CHILDREN WHO PARTICIPATED IN THE WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM RANGED FROM 44.5% IN MADERA COUNTY TO 82.6% IN MERCED COUNTY.THE HEALTHY PEOPLE 2030 OBJECTIVE FOR HEALTH INSURANCE COVERAGE FOR ALL POPULATION GROUPS IS 92.1%. HEALTH INSURANCE COVERAGE FOR ALL POPULATIONS RANGED FROM 91.7% IN FRESNO, MADERA, AND MERCED COUNTIES TO 94.3% IN STANISLAUS COUNTY. HEALTH INSURANCE COVERAGE FOR CHILDREN AND YOUTH, AGES 0 TO 18, RANGED FROM 96.1% IN MADERA COUNTY TO 97.8% IN STANISLAUS COUNTY. CHILDREN AND YOUTH, AGES 0 TO 18, WHO HAD MEDICAID (MEDI-CAL) HEALTH INSURANCE COVERAGE RANGED FROM 43.2% IN STANISLAUS COUNTY TO 70.4% IN TULARE COUNTY. IN 2024, 75.7% OF VALLEY CHILDREN'S INPATIENT AND 72% OF OUTPATIENT VISITS WERE COVERED BY MEDICAID.ALL SERVICE AREA COUNTIES HAVE ONE OR MORE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE GOVERNING BOARD OF VALLEY CHILDREN'S HOSPITAL IS PRIMARILY COMPRISED OF MEMBERS OF THE COMMUNITY WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. THE HOSPITAL FACILITY MAINTAINS AN OPEN MEDICAL STAFF EXCEPT IN RARE INSTANCES WHEN A CLINICAL DEPARTMENT IS "CLOSED" IN ACCORDANCE WITH CALIFORNIA LAW FOR HOSPITAL-BASED SERVICES. AS A NONPROFIT ORGANIZATION, ANY SURPLUS FUNDS ARE INVESTED BACK INTO PROVIDING HEALTH CARE SERVICES AND RESOURCES TO THE COMMUNITY, INCLUDING BUT NOT LIMITED TO NEW PATIENT CARE LOCATIONS AND EQUIPMENT, EXPANDED PROGRAMS AND SERVICES, AND THE TRAINING OF PHYSICIANS, NURSES, AND OTHER HEALTH PROFESSIONALS. VALLEY CHILDREN'S PEDIATRIC RESIDENCY PROGRAM IS AFFILIATED WITH THE STANFORD UNIVERSITY SCHOOL OF MEDICINE AND PROVIDES GENERAL AND ADVANCED CLINICAL PEDIATRIC TRAINING. THE PROGRAM PLAYS A CRITICAL ROLE IN MEETING THE PEDIATRIC PHYSICIAN NEEDS OF THE CENTRAL VALLEY.THE RESEARCH PROGRAM AT VALLEY CHILDREN'S HOSPITAL CONSISTS OF NATIONAL MULTI-CENTER CLINICAL TRIALS AND LOCALLY GENERATED, PHYSICIAN-INITIATED RESEARCH STUDIES. OUR FOCUS IS TO PARTICIPATE IN STUDIES THAT ARE TAILORED TO MEET THE VARYING NEEDS OF OUR PATIENT POPULATION. VALLEY CHILDREN'S ONCOLOGY RESEARCH PROGRAM IS A MEMBER OF THE CHILDREN'S ONCOLOGY GROUP, AN INTERNATIONAL NETWORK OF CLINICAL TRIALS, WHICH IS FEDERALLY FUNDED BY THE NATIONAL CANCER INSTITUTE. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 BUDDHIST TZU CHI FOUNDATION 3898 N ANN AVE FRESNO CA 93727 942952782 501(C)(3) 10000 0 SPONSORSHIP CHILDREN'S MOVEMENT OF FRESNO 4949 E KINGS CANYON RD STE 202 FRESNO CA 93706 946003272 501(C)(3) 8500 0 SPONSORSHIP CULTURAL BROKERS INC 2025 E DAKOTA AVE 223 FRESNO CA 93706 455495386 501(C)(3) 20000 0 DONATION FOODLINK TULARE COUNTY 611 2ND ST EXETER CA 93221 942558802 501(C)(3) 13037 0 SPONSORSHIP MAKE A WISH 351 W CROMWELL AVE STE 112-A FRESNO CA 93711 680027351 501(C)(3) 7500 0 SPONSORSHIP MARJAREE MASON CENTER 1600 M STREET FRESNO CA 93721 941156639 501(C)(3) 65000 0 SPONSORSHIP AND DONATION POVERELLO HOUSE 412 F ST FRESNO CA 93706 770007985 501(C)(3) 20000 0 DONATION SAN JOAQUIN RIVER PARKWAY 11605 OLD FRIANT RD FRESNO CA 93730 770196692 501(C)(3) 30000 0 SPONSORSHIP AND DONATION THE BOYS & GIRLS CLUBS OF FRESNO COUNTY 540 N AUGUSTA AVE FRESNO CA 93701 941149171 501(C)(3) 5500 0 DONATION THE FOUNDATION FCOE 1111 VAN NESS 3RD FLR FRESNO CA 93706 800381096 501(C)(3) 12500 0 SPONSORSHIP UNITED WAY OF STANISLAUS COUNTY 422 MCHENRY AVE MODESTO CA 95354 941212129 501(C)(3) 7500 0 DONATION VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 464158433 501(C)(3) 975000 0 CONTRIBUTION WEST FRESNO FAMILY RESOURCE CENTER 1802 E CALIFORNIA AVE FRESNO CA 93706 770577093 501(C)(3) 10700 0 SPONSORSHIP CENTRAL VALLEY COMMUNITY FOUNDATION 1260 FULTON STREET STE 200 FRESNO CA 93706 770478025 501(C)(3) 25000 0 SPONSORSHIP THE DOLLYWOOD FOUNDATION 111 E MAIN ST 2ND FLR SEVLERVILLE TN 37764 621348105 501(C)(3) 30000 0 DONATION BREAK THE BARRIERS INTERNATIONAL 8555 N CEDAR AVE FRESNO CA 93720 770106437 501(C)(3) 50000 0 DONATION ADVENTIST HEALTH DELANO FOUNDATION 1401 GARCES HWY DELANO CA 93215 770258013 501(C)(3) 50000 0 DONATION CENTRAL CALIFORNIA FOOD BANK 4010 E AMENDOLA DR FRESNO CA 93720 770320851 501(C)(3) 58360 0 DONATION 18 0 NURSING SCHOLARSHIP 9 22500 EDUCATION SCHOLARSHIP - RESPIRATORY FOCUS 2 1500 CAFETERIA MEALS 17767 109267 FMV MEAL COUPONS FOR PATIENT FAMILIES TAXI, BUS AND TRANSIT SERVICES 15235 200592 BOOK SUBSIDIZATION OF BUS AND TRANSIT SERVICES CANCER SURVIVORSHIP SCHOLARSHIP 48 48000 PART I, LINE 2: NURSING SCHOLARSHIPS ARE DESIGNED TO HELP EMPLOYEES MEET FINANCIAL NEEDS THAT ARE NOT COVERED BY OTHER TUITION REIMBURSEMENT PROGRAMS. A SCHOLARSHIP COMMITTEE REVIEWS APPLICATIONS BI-ANNUALLY BASED ON CERTAIN CRITERIA. RECIPIENTS ARE CHOSEN BY THE COMMITTEE AND THE CHIEF NURSING OFFICER APPROVES THE SELECTIONS. ALL RECIPIENTS ARE EMPLOYEES OF THE HOSPITAL AND THE HOSPITAL IS MADE AWARE WHEN THE RECIPIENT COMPLETES THEIR EDUCATION. CANCER SURVIVORSHIP SCHOLARSHIPS ARE DESIGNED TO HELP HOSPITAL PEDIATRIC CANCER SURVIVORS WITH THEIR COLLEGE/VOCATIONAL EDUCATION EXPENSES. A COMMITTEE REVIEWS APPLICATIONS ON AN ANNUAL BASIS AND APPROVES THE SCHOLARSHIP. ALL RECIPIENTS ARE CURRENT OR FORMER PATIENTS OF THE HOSPITAL'S CANCER AND BLOOD DISORDER CENTER. OTHER SERVICES ARE PURCHASED FROM VARIOUS VENDORS AND ARE SUPPLIED TO PATIENTS AND THEIR FAMILIES. THE RECORDS FOR THESE PURCHASED SERVICES ARE MAINTAINED BY THE HOSPITAL. 1 X X X X 1 1 0 0 0 0 0 1 0 TODD SUNTRAPAK CEO 1696750 0 598969 0 907965 0 30180 0 36303 0 3270167 0 0 0 BEVERLY HAYDEN-PUGH FORMER CNO, SVP/ADVR TO CEO (AS OF 3/23) 564061 0 272568 0 718584 0 116917 0 17698 0 1689828 0 577609 0 MICHELE WALDRON FORMER CFOEVP & PRINC. CNSLT TO CEO (AS OF 10/23) 506380 0 476624 0 422358 0 30180 0 16991 0 1452533 0 0 0 DAVID CHRISTENSEN MD SVP, CPE & PRESIDENT VCMG 854764 0 177845 0 212871 0 30180 0 32191 0 1307851 0 0 0 NATALE PONTICELLO JR FORMER CPO,SVP/ADVR TO SVP&CPO (AS OF 3/23) 323995 0 87384 0 623680 0 99238 0 1193 0 1135490 0 559747 0 JOLIE LIMON MD VP ACAD AFFAIRS, DIO & CHI (THRU 10/23) 327354 0 0 0 639419 0 90401 0 26189 0 1083363 0 167863 0 JOEL BROWNELL MD VP, CHIEF MED INFO OFF. (THRU 9/23) 278414 0 0 0 611720 0 80457 0 19648 0 990239 0 164011 0 DAVID HODGE JR VP, MEDICAL GROUP & ANCILLARY OP 492048 0 88507 0 178087 0 102855 0 32191 0 893688 0 70399 0 DANIELLE BARRY SVP, COO 519848 0 106973 0 143594 0 82241 0 34326 0 886982 0 49185 0 JANE WILLSON SVP, CHIEF STRATEGY OFFICER 465532 0 98760 0 180210 0 102649 0 8422 0 855573 0 72388 0 MICHAEL GOLDRING SVP STRATEGIC PARTNERSHIPS 523554 0 106425 0 139006 0 30180 0 11172 0 810337 0 0 0 WILLIAM CHALTRAW JR SVP, CHIEF LEGAL OFFICER 490239 0 104438 0 140048 0 23537 0 32591 0 790853 0 0 0 KAREN DAHL MD VP, MED AFFAIRS & PHYS DEV 465126 0 87730 0 125611 0 95315 0 11781 0 785563 0 65617 0 LYNNE ASHBECK SVP, CHIEF COMMUNITY IMPACT OFFICER 432744 0 87241 0 159988 0 94904 0 0 0 774877 0 64741 0 KEVIN SHIMAMOTO FORMER CIO VP AND ADVISOR TO CIO (THRU 9/24) 429112 0 80717 0 138742 0 98235 0 8422 0 755228 0 68057 0 STEPHANIE VANCE VP, FINANCE (THRU 11/23) 357128 0 108920 0 113793 0 85031 0 32191 0 697063 0 50747 0 JOSEPH EGAN VP & CIO 398320 0 72171 0 110107 0 67034 0 41013 0 688645 0 0 0 KELLY BEALL SVPCHIEF PEOPLE OFFICER (AS OF 3/23) 391964 0 79996 0 67789 0 51651 0 39013 0 630413 0 0 0 VICKY TILTON VP PATIENT CARE SVCS/CNO (AS OF 3/23) 378998 0 69699 0 24832 0 49543 0 32005 0 555077 0 0 0 TINA MYCROFT SVP & CFO (AS OF 10/23) 267848 0 99658 0 41713 0 0 0 11082 0 420301 0 0 0 KELLIE DYER VP SUPPLY CONSTR & FAC. (AS OF 1/23) 264051 0 44133 0 45442 0 20725 0 9947 0 384298 0 0 0 JESSIE HUDGINS VP, FACILITIES & SUPPORT (THRU 1/23) 12009 0 0 0 249903 0 72062 0 691 0 334665 0 55415 0 PART I, LINE 3 VALLEY CHILDREN'S HOSPITAL RELIED ON A RELATED ORGANIZATION, VALLEY CHILDREN'S HEALTHCARE, TO ESTABLISH THE COMPENSATION AND BENEFITS USING ALL OF THE METHODS INCLUDED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS AND "WRITTEN EMPLOYMENT CONTRACT." PART I, LINES 4A-B SEVERANCE PAYMENTS TOTALING $393,078 AND $419,557 WERE MADE TO JOEL BROWNELL AND JOLIE LIMON, RESPECTIVELY DURING THE CALENDAR YEAR AND ARE INCLUDED IN PART II, COLUMN B(III). THE SEVERANCE PAYMENTS ARE SUBJECT TO A CONFIDENTIALITY CLAUSE; TERMS AND CONDITIONS OF THE AGREEMENTS WILL BE PROVIDED TO THE IRS UPON REQUEST. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE 1) A NONCONTRIBUTORY, NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (DCSERP), 2) A SPLIT DOLLAR LIFE INSURANCE PROGRAM USED AS A RETENTION TOOL FOR CERTAIN KEY EXECUTIVES. PARTICIPANTS OF THIS PROGRAM FORFEIT ELIGIBILITY FOR THE DCSERP (SEE SCHEDULE L PART V FOR A BROADER DESCRIPTION) AND 3) AN ADDITIONAL DEFERRED COMPENSATION PLAN BENEFITTING CERTAIN KEY EXECUTIVES (457F RT). $1,088,761 WAS PAID OUT OF THE DCSERP PLAN DURING THE YEAR. DCSERP PAYOUT AND EMPLOYER ACCRUAL TO THE DCSERP FOR CALENDAR YEAR 2023 ARE AS FOLLOWS: BEVERLY HAYDEN-PUGH - DCSERP PAYOUT $86,760; ACCRUAL $86,737 JESSIE HUDGINS - DCSERP PAYOUT $55,415; ACCRUAL $51,311 JANE WILLSON - DCSERP PAYOUT $72,388; ACCRUAL $72,369 STEPHANIE VANCE - DCSERP PAYOUT $50,747; ACCRUAL $54,851 NATALE PONTICELLO - DCSERP PAYOUT $105,414; ACCRUAL $70,014 KAREN DAHL - DCSERP PAYOUT $65,617; ACCRUAL $70,948 KEVIN SHIMAMOTO - DCSERP PAYOUT $68,057; ACCRUAL $67,982 DANIELLE BARRY - DCSERP PAYOUT $49,185; ACCRUAL $70,041 JOEL BROWNELL - DCSERP PAYOUT $164,011; ACCRUAL $56,377 DAVID HODGE JR - DCSERP PAYOUT $70,399; ACCRUAL $72,675 LYNNE ASHBECK - DCSERP PAYOUT $64,741; ACCRUAL $64,724 JOLIE LIMON - DCSERP PAYOUT $167,863; ACCRUAL $60,221 VICKY TILTON - DCSERP ACCRUAL $37,343 KELLY BEALL - DCSERP ACCRUAL $29,006 JOSEPH EGAN - DCSERP ACCRUAL $36,854 MICHAEL GOLDRING, WILLIAM CHALTRAW, JR, DAVID CHRISTENSEN, TODD SUNTRAPAK, MICHELE WALDRON, DANIELLE BARRY, KELLY BEALL, AND VICKY TILTON PARTICIPATE IN THE SPLIT-DOLLAR LIFE INSURANCE PROGRAM IN LIEU OF THE DCSERP. THE EFFECTIVE DATE OF PARTICIPATION FOR DANIELLE BARRY, VICKY TILTON AND KELLY BEALL WAS MAY 2023, AND THE DC SERP CONTRIBUTIONS WERE SUBSEQUENTLY FORFEITED. BEVERLY HAYDEN-PUGH AND NATALE PONTICELLO PARTICIPATE IN A 457F RT DEFERRED COMPENSATION PLAN. THE FOLLOWING AMOUNTS PAID DURING THE 2023 CALENDAR YEAR: BEVERLY HAYDEN-PUGH - $490,849 NATALE PONTICELLO - $454,332 PART I, LINE 7 AN INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON NETWORK WIDE GOALS TO QUALIFYING INDIVIDUALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND ITS RELATED ENTITIES. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE VALLEY CHILDREN'S HEALTHCARE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS AND APPROVES THE PLAN GOALS AT THE BEGINNING OF THE PLAN YEAR AND ACHIEVEMENT OF THESE GOALS, AND FORECASTED PAYOUTS, AT THE END OF EACH YEAR. TODD SUNTRAPAK OFFICER SPLIT INTEREST INSURANCE X 11109107 11594071 0 1 1 MICHELE WALDRON FORMER OFFICER SPLIT INTEREST INSURANCE X 9721634 10150122 0 1 1 DAVID CHRISTENSEN KEY EMPLOYEE SPLIT INTEREST INSURANCE X 5282545 5513152 0 1 1 WILLIAM CHALTRAW KEY EMPLOYEE SPLIT INTEREST INSURANCE X 2122641 2215304 0 1 1 MICHAEL GOLDRING HIGHEST COMPENSATED EMPLOYEE SPLIT INTEREST INSURANCE X 5498581 5738619 0 1 1 TODD SUNTRAPAK OFFICER SEE BELOW STATEMENT 2 X 5000000 4330703 0 1 1 DANIELLE BARRY KEY EMPLOYEE SPLIT INTEREST INSURANCE X 5061842 5317642 0 1 1 KELLY BEALL KEY EMPLOYEE SPLIT INTEREST INSURANCE X 5657652 5943562 0 1 1 VICKY TILTON KEY EMPLOYEE SPLIT INTEREST INSURANCE X 4494584 4721719 0 1 1 WILLIAM CHALTRAW KEY EMPLOYEE SPLIT INTEREST INSURANCE X 3140219 3298911 0 1 1 58823805 PART II, COLUMN C: STATEMENT 1: THE HOSPITAL HAS ENTERED INTO LIFE INSURANCE-BASED ARRANGEMENTS WITH CERTAIN KEY EXECUTIVES WHO FORFEITED THEIR PARTICIPATION IN THE DC SERP PLAN. THE PURPOSE OF THESE ARRANGEMENTS IS TO RETAIN THE EXECUTIVES FOR A SPECIFIED PERIOD OF TIME AND THEREFORE ACCESS TO THIS BENEFIT IS SUBJECT TO EXTENDED VESTING REQUIREMENTS. THE HOSPITAL FULLY FUNDED THE PREMIUMS ON THE ASSOCIATED LIFE INSURANCE POLICIES AT IMPLEMENTATION AND THERE ARE NO ADDITIONAL FUNDING REQUIREMENTS. UNDER THE ARRANGEMENTS, THE HOSPITAL WILL ACCRUE INVESTMENT RETURNS AND INTEREST ON THE PREMIUMS PAID FOR THE LIFE INSURANCE POLICIES. UPON THE DEATH OF A COVERED EXECUTIVE, THE HOSPITAL WILL BE REPAID THE INVESTMENT AND ACCRUED RETURNS, THE EXECUTIVES' BENEFICIARIES WILL RECEIVE AS A DEATH BENEFIT AN AMOUNT EQUAL TO THE MOST RECENT PROJECTION OF THE TOTAL VESTED LIFETIME AMOUNT AVAILABLE, LESS ANY AMOUNTS BORROWED BY THE EXECUTIVE AFTER THE DATE OF THE PROJECTION, AND ANY REMAINING EXCESS PROCEEDS WILL BE DONATED TO THE HOSPITAL TO BE USED TO SERVE THE COMMUNITY AND OTHERWISE FULFILL THE MISSION. THE VALUE OF THE DONATION (THE ESTIMATED EXCESS PROCEEDS THAT WOULD REMAIN) AS OF 9/30/24 IS ESTIMATED TO BE IN EXCESS OF $78.6M IN THE AGGREGATE WITH RESPECT TO THESE KEY EXECUTIVES.STATEMENT 2: LOAN FOR RESIDENCE AS A RETENTION INCENTIVE IN LIEU OF OTHER COMPENSATION. ANNUAL LOAN REDUCTION REPRESENTS TAXABLE INCOME REPORTED IN SCHEDULE J PART II B (III) AS OTHER REPORTABLE COMPENSATION. FORM 990, PART VI, SECTION A, LINE 2 LISA SMITTCAMP AND BILL SMITTCAMP HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE AMENDED AND RESTATED BYLAWS OF VALLEY CHILDREN'S HOSPITAL, EFFECTIVE 10/17/13, ESTABLISHED VALLEY CHILDREN'S HEALTHCARE AS THE SOLE MEMBER OF THE CORPORATION. CERTAIN MEMBER RIGHTS, INCLUDING THE RIGHT TO APPROVE, FIX THE NUMBER, ELECT, AND REMOVE ELECTED TRUSTEES, ARE INCLUDED IN THESE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A SEE ANSWER FOR LINE 6 ABOVE FORM 990, PART VI, SECTION A, LINE 7B SEE ANSWER FOR LINE 6 ABOVE FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. IN ADDITION, A MEETING IS HELD TO REVIEW THE FORM 990 AND PROVIDE FOR ADDITIONAL TIME TO ANSWER QUESTIONS. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS. FORM 990, PART VI, SECTION B, LINE 15 AS PROVIDED BY THE VALLEY CHILDREN'S HEALTHCARE BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE NETWORK AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE FORM 990, PART VI, SECTION C, LINE 19 A COPY OF VALLEY CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF VALLEY CHILDREN'S HOSPITAL IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE ANNUAL FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION B, LINE 16B: THE ORGANIZATION'S BOARD OF DIRECTOR'S ADOPTED A WRITTEN POLICY IN 2025 GOVERNING JOINT VENTURE PARTICIPATION. HOWEVER, THIS POLICY WAS NOT OPERATIVE DURING THE APPLICABLE TAX YEAR. HOWEVER, AS A MATTER OF PRACTICE, ANY JOINT VENTURE OR OTHER ARRANGEMENT WOULD BE REVIEWED BY BOTH INTERNAL AND EXTERNAL LEGAL COUNSEL, AS WELL AS OTHER QUALIFIED ADVISORS, TO CONSIDER THE IMPACTS OF THE JOINT VENTURE OR SIMILAR ARRANGEMENT ON THE TAX-EXEMPT STATUS OF THE ORGANIZATION. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 93,890,656. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,890,656. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 23,421,052. MANAGEMENT AND GENERAL EXPENSES 142,985. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,564,037. CONSULTING & SERVICE FEES - ON PARENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 120,621. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120,621. FORM 990, PART XI, LINE 9: GAIN ON SALE OF ASSETS 161,218. PASS-THROUGH INVESTMENT LOSS 3,051,050. HERNDON TEMPERANCE LLC 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 812808671 REAL PROPERTY CA 721800 5828158 VALLEY CHILDREN'S HOSPITAL VALLEY CHILDREN'S HEALTHCARE FOUNDATION 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 942797447 PHILANTHROPY/FUNDRAISING FOR VALLEY CHILDREN'S HEALTHCARE & RELATED ENTITIES CA 501(C)(3) LINE 7 VALLEY CHILDREN'S HEALTHCARE 0 VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 464150987 HEALTH CARE CA 501(C)(3) LINE 10 VALLEY CHILDREN'S HEALTHCARE 1 VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 464158433 HEALTH CARE CA 501(C)(3) LINE 12C, III-FI N/A 0 FOWLER BUSINESS & PROFESSIONAL PARK LLC 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 471813772 REAL ESTATE INVESTMENT CA N/A RELATED 400722 16779198 1 1 0.50000 COMPASS HEALTH ADMINISTRATORS LLC 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 822891309 BENEFIT ADMIN CA N/A 0 0 VALLEY CHILDREN'S HOLDINGS I LLC 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 371872422 HEALTHCARE CA N/A C 0 FOWLER BUSINESS & PROFESSIONAL PARK PROPERTY OWNERS ASSOCIATION 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 301030354 PROPERTY OWNERS ASSOCIATION CA FOWLER BUSINESS & PROFESSIONAL PARK LLC C 8086 0.50000 0 0 1 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 VALLEY CHILDREN'S MEDICAL GROUP M 68105284 COST