2024-11-13T10:07:16-06:00 2023-12-31 346565596 ERNST & YOUNG US LLP 370 17TH STREET SUITE 4800 DENVER CO 80202 990 2023-01-01 814791043 ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC STJO 7075255300 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 PATTI PILGRIM CFO 7075255300 2024-11-01 1 1 ANDREW JAMESON P01894820 7209314000 2024-10-28 2023 2024-10-15 13:58:12Z LAUREEN DRISCOLL 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 1504197558 0 X PROVIDENCE.ORG/ABOUT/NORTHERN-CALIFORNIA X 2016 CA SEE SCHEDULE O 13 12 5406 78 342105 11787 7191874 13329974 1286812037 1454736280 -16263525 26075773 11061684 10055531 1288802070 1504197558 5939230 13258946 0 0 511844106 527941247 0 0 2945397 943187369 991218372 1460970705 1532418565 -172168635 -28221007 1241817376 1393234313 537328384 665214964 704488992 728019349 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 1473981200 13258946 1464791811 SEE SCHEDULE O 1473981200 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 376 0 1 5406 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 CA X JIM MARTIN 4255253985 1801 LIND AVE SW RENTON WA 98057 KEVIN MANEMANN DIV. 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ADDITIONALLY, A PORTION OF THE DUES PAID TO ALLIANCE OF CATHOLIC HEALTH CARE, AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION FOR LOBBYING SERVICES. 9665056 470015 241984 10377055 10861840 -1134967 61817 9665056 9300091 533646 1054452 26349 10861840 10385095 7500 928391 2000000 20895 9300091 1446786 8019532 955593 36816 10385095 0.00000 0.95290 0.04710 0 0 22254253 22254253 802451507 379659024 422792483 141020444 107571678 33448766 482347131 432149912 50197219 81258120 81258120 609950841 HOSPITAL FEE/PROVIDER TAX RECEIVABLE 172388673 RIGHT OF USE OPERATING LEASES 21223967 DUE FROM THIRD PARTY 39090769 OTHER ASSETS 525924 CHARITABLE GIFT ANNUITIES 314452 233543785 I/C - TAX-EXEMPT BOND LIABILITIES 248712487 DUE TO AFFILIATES 136978797 HOSPITAL FEE/PROVIDER TAX LIABILITY 82123593 DUE TO THIRD PARTY 64596359 LONG-TERM LINE OF CREDIT 42809561 CAPITAL LEASE OBLIGATIONS 10124940 ACCRUED RETIREMENT COMPENSATION 6111185 CHARITABLE GIFT ANNUITIES/TRUST FUND OBLIGATIONS 132167 OTHER CURRENT AND LT LIABILITIES -20881784 570707305 PART V, LINE 4: INTENDED USE OF ENDOWMENT FUNDS THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDES SCHOLARSHIPS FOR EMPLOYEES WHO WISH TO RETURN TO SCHOOL TO BECOME NURSES AND MEET THE CRITICAL NEEDS OF THE HOSPITAL, AS WELL AS THE COMMUNITY'S NEEDIEST INDIVIDUALS. 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 8219222 8219222 0.00540 388184733 278410786 109773947 0.07160 396403955 278410786 117993169 0.07700 16082906 2211134 13871772 0.00910 3561933 1261954 2299979 0.00150 5024764 3183005 1841759 0.00120 6453179 6453179 0.00420 31122782 6656093 24466689 0.01600 427526737 285066879 142459858 0.09300 0 561795854 702092566 -140296712 X 1 0 1 CENTER FOR MATERNAL NEWBORN AND CHILD HEALTH LLC CLINICAL HOSPITAL SERVICES 0.50000 0.00000 0.50000 4 1 SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DRIVE SANTA ROSA CA 95405 WWW.PROVIDENCE.ORG 6933475 X X X DESIGNATED TRAUMA CENTER, LEVEL II A 2 QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA CA 94558 WWW.PROVIDENCE.ORG 110000060 X X X DESIGNATED TRAUMA CENTER, LEVEL III 3 REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA CA 95540 WWW.PROVIDENCE.ORG D-0295172 X X X X A 4 ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA CA 95501 WWW.PROVIDENCE.ORG D-0189726 X X X A SJHNC LLC (GROUP A - 1 3 & 4) 0 0 1 X X X X X X X X X 23 1 1 1 1 X SEE PART V, SECTION C X 1 23 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 1 QUEEN OF THE VALLEY MEDICAL CENTER (2) 2 0 0 1 X X X X X X X X X 23 1 0 1 1 X SEE PART V, SECTION C X 1 23 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 1 QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 3J: PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS AN IMPORTANT TOOL WE USE TO BETTER UNDERSTAND HEALTH DISPARITIES AND INEQUITIES WITHIN THE COMMUNITIES WE SERVE, AS WELL AS THE COMMUNITY STRENGTHS AND ASSETS.THE EQUITY FRAMEWORK IS FOUNDATIONAL TO OUR OVERALL CHNA FRAMEWORK, A MODIFIED VERSION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO). THE MODIFIED MAPP FRAMEWORK TAKES A MIXED-METHODS APPROACH TO PRIORITIZE HEALTH NEEDS, CONSIDERING POPULATION HEALTH DATA, COMMUNITY INPUT, INTERNAL UTILIZATION DATA, COMMUNITY STRENGTHS AND ASSETS, AND A PRIORITIZATION PROTOCOL.IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY THE PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER AND NAPA COUNTY HEALTH AND HUMAN SERVICES AGENCY, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. IN ADDITION, WE RECOGNIZE THAT THERE ARE OFTEN GEOGRAPHIC AREAS WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE POORER THAN NEARBY AREAS. WHENEVER POSSIBLE AND RELIABLE, DATA ARE REPORTED AT CENSUS TRACT LEVEL. THESE SMALLER GEOGRAPHIC AREAS ALLOW US TO BETTER UNDERSTAND THE NEIGHBORHOOD LEVEL NEEDS OF OUR COMMUNITIES AND BETTER ADDRESS INEQUITIES WITHIN AND ACROSS COMMUNITIES.COMMUNITY INPUT:THROUGH A MIXED-METHODS APPROACH, USING QUANTITATIVE AND QUALITATIVE DATA, WE COLLECTED INFORMATION FROM THE FOLLOWING SOURCES: AMERICAN COMMUNITY SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, LOCAL PUBLIC HEALTH DATA, CALIFORNIA HEALTHY KIDS SURVEY, FEEDING AMERICA, U.S. CENSUS BUREAU, AND THE LIVE HEALTHY NAPA COUNTY LANGUAGE INCLUSION SURVEY. TO ACTIVELY ENGAGE THE COMMUNITY, WE CONDUCTED 15 LISTENING SESSIONS WITH PEOPLE WHO HAVE CHRONIC CONDITIONS, ARE FROM DIVERSE COMMUNITIES, HAVE LOW-INCOMES, AND/OR ARE MEDICALLY UNDERSERVED. WE ALSO CONDUCTED 4 CAREGIVER LISTENING SESSIONS, 12 KEY INFORMANT INTERVIEWS, AND 7 ADDITIONAL PRELIMINARY DATA FEEDBACK SESSIONS WITH 13 REPRESENTATIVES FROM ORGANIZATIONS THAT SERVE THESE POPULATIONS, SPECIFICALLY SEEKING TO GAIN DEEPER UNDERSTANDING OF COMMUNITY STRENGTHS AND OPPORTUNITIES. ALL COMMUNITY INPUT WAS COLLECTED FROM MARCH 2023-MAY 2023.KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH:- ALISSA ABDO, EXECUTIVE DIRECTOR FOR ON THE MOVE (EDUCATION)- LIZ ALESSIO, CITY COUNCILMEMBER FOR NAPA CITY COUNCIL (ELECTED OFFICIAL)- JESUS ROSAS, DIRECTOR FOR COMMUNITY HEALTH INITIATIVE (HEALTH INSURANCE/ACCESS)- MICHELE GRUPE, EXECUTIVE DIRECTOR FOR COPE FAMILY (FAMILY RESOURCE CENTERS)- ROB WEISS, EXECUTIVE DIRECTOR FOR MENTIS (MENTAL HEALTH)- JENNY OCON, EXECUTIVE DIRECTOR FOR UPVALLEY FAMILY CENTERS (FAMILY RESOURCE CENTERS)- ALICIA HARDY, CEO FOR OLE HEALTH (FQHC)- SOLICIA AGUILAR, PROGRAM DIRECTOR FOR LGBTQIA+ CONNECTION (EDUCATION, SOCIAL JUSTICE)- ESMERALDA GIL, DIRECTOR FOR PUERTAS ABIERTAS (FAMILY RESOURCE CENTERS)- JOELLE GALLAGHER, DISTRICT SUPERVISOR FOR NAPA COUNTY BOARD OF SUPERVISORS (ELECTED OFFICIAL)- TRACY LAMB, EXECUTIVE DIRECTOR FOR NEWS (SOCIAL SERVICES)- CHARLIE TOLEDO, EXECUTIVE DIRECTOR FOR SUSCOL INTERTRIBAL COUNCIL (NATIVE AMERICAN)MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS BEING REPRESENTED BY ORGANIZATIONS OR INDIVIDUALS THAT PROVIDED INPUT:- YOUTH, FOSTER YOUTH- LGBTQIA+ INDIVIDUALS- OLDER ADULTS- AGRICULTURAL WORKERS- INDIVIDUALS ACCESSING NAPA COUNTY MENTAL HEALTH SERVICES- INDIVIDUALS EXPERIENCING HOMELESSNESSNONPROFIT AND GOVERNMENT STAKEHOLDER INTERVIEWS:A TOTAL OF 12 KEY INFORMANT INTERVIEWS WERE COMPLETED BY REPRESENTATIVES FROM QVMC. KEY INFORMANTS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO ARE ECONOMICALLY POOR AND VULNERABLE. QVMC AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A PUBLIC HEALTH OFFICER FROM NAPA COUNTY PUBLIC HEALTH.DATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR, INCLUDING THE FOLLOWING:- NOT ALL DESIRED DATA WERE READILY AVAILABLE, SO SOMETIMES WE HAD TO RELY ON TANGENTIAL OR PROXY MEASURES OR NOT HAVE ANY DATA AT ALL. FOR EXAMPLE, THERE IS LITTLE COMMUNITY-LEVEL QUANTITATIVE DATA ON BARRIERS TO ACCESSING TRANSPORTATION.- WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS PERCENTAGE OF PEOPLE UNINSURED) AND THE MOST RECENT DATA AVAILABLE ARE NOT A GOOD REFLECTION OF THE CURRENT STATE.- REPORTING DATA AT THE COUNTY LEVEL CAN MASK INEQUITIES WITHIN COMMUNITIES. THIS CAN ALSO BE TRUE WHEN REPORTING DATA BY RACE, WHICH CAN MASK WHAT IS HAPPENING WITHIN RACIAL AND ETHNIC SUBGROUPS. THEREFORE, WHEN APPROPRIATE AND AVAILABLE, WE DISAGGREGATED THE DATA BY GEOGRAPHY AND RACE.- DATA THAT ARE GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION.- THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS. QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 6B: QUEEN OF THE VALLEY MEDICAL CENTER COLLABORATED WITH MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS:- ABODE- ALDEA- CITY OF NAPA- CALIFORNIA GROWER'S ASSOCIATION- COMMUNITY ACTION NAPA VALLEY- COMMUNITY ACTIVE NAPA VALLEY- COMMUNITY ORGANIZATION ACTIVE IN DISASTER- COMMUNICARE+OLE- COMMUNITY HEALTH INITIATIVE- COMMUNITY RESOURCES FOR CHILDREN- COPE FAMILY CENTER- FEEDING IT FORWARD- FIRST 5 NAPA COUNTY- GIRLS ON THE RUN- KAISER PERMANENTE- LGBTQIA+ CONNECTION- MENTIS- MOLLY'S ANGELS- NAPA CITY COUNCIL- NAPA CO OFFICE OF EDUCATION- NAPA COUNTY BOARD OF SUPERVISORS- NAPA COUNTY HHSA- NAPA FARMERS MARKET- NAPA VALLEY UNIFIED SCHOOL DISTRICT- NAPA VALLEY VINE TRAIL COALITION- NURTURING EMPOWERMENT WORTH SAFETY (NEWS)- ON THE MOVE- PARTNERSHIP HEALTH PLAN- PUERTAS ABIERTAS- SUSCOL INTERTRIBAL COUNCIL- UP VALLEY FAMILY CENTERS QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 11: THE 2023 COMMUNITY HEALTH NEEDS PRIORITIZED NEEDS ARE LISTED BELOW:1) HOUSING2) BEHAVIORAL HEALTH3) ACCESS TO HEALTH SERVICES4) RACIAL EQUITY & LGBTQIA+ INCLUSION5) ECONOMIC STABILITY HOUSINGLIMITED HOUSING STOCK PUSHES PRICES SO HIGH AS TO BE OUT OF REACH FOR MANY AND CREATES AN ESPECIALLY DIFFICULT SITUATION FOR PEOPLE WITH LOW INCOMES. COST OF LIVING IS VERY HIGH, AND MANY WORKERS ARE NOT PAID A LIVING WAGE. HOUSING STABILITY CREATES A FOUNDATION FOR FURTHER STABILITY. FEAR OF, AND DISRESPECT TO, UNHOUSED INDIVIDUALS CAN RESULT IN FEELINGS OF ISOLATION. PAPERWORK AND HOUSING SUPPORT SYSTEMS ARE CUMBERSOME. DEMAND FOR LOW-COST OPTIONS MAY LEAD TO UNFAIR HOUSING PRACTICES FROM LANDLORDS.STRATEGIES TO ADDRESS HOUSING AND HOMELESSNESS INCLUDE- SUPPORT THE DEVELOPMENT OF AFFORDABLE HOUSING STOCK, INCLUDING PERMANENT SUPPORTIVE HOUSING UNITS- SUPPORT THE LAUNCH OF A HOUSING ADVOCACY ORGANIZATION TO PROMOTE AN INCREASE IN SUPPLY, AFFORDABILITY AND DIVERSITY OF HOMES- INVEST IN RESPITE SHELTER SERVICES SUPPORTED WITH CARE NETWORK COMPLEX CARE MANAGEMENT- ADMINISTER COMMUNITY GRANTS TO EXPAND SUPPORTIVE SERVICES FOR THOSE EXPERIENCING OR AT RISK OF HOMELESSNESS- ENHANCE CARE NETWORK OUTREACH AT THE SOUTH NAPA SHELTER AND ENHANCE CARE NETWORK CARE MANAGEMENT SERVICES AT SUPPORTIVE HOUSING LOCATIONSBEHAVIORAL HEALTHTHE SCALE OF THE MENTAL HEALTH CRISIS APPEARS TO HAVE OVERWHELMED THE CARE SYSTEM. MENTAL HEALTH IS OFTEN AN UNADDRESSED, UNDERLYING ISSUE. THERE ARE VALUABLE SOURCES OF MENTAL HEALTH SUPPORT OUTSIDE THE FORMAL CARE SYSTEM AND PARTICIPANTS REPORT RELYING ON FRIENDS AND FAMILY FOR COMFORT OR STRENGTH. THE TASK OF PROVIDING MENTAL HEALTH SUPPORT CAN BE A HEAVY WEIGHT TO BEAR. MENTAL HEALTH PROVIDERS OFTEN EXPERIENCE COMPASSION FATIGUE AND OPPORTUNITIES FOR SELF-CARE CAN BE DIFFICULT TO ACCESS WITH BUSY CASELOADS. SUBSTANCES SUCH AS ALCOHOL, TOBACCO, AND DRUGS MAY BE USED AS A FORM OF SELF-MEDICATION. THERE ARE COMMON MISCONCEPTIONS ABOUT SUBSTANCE USE (ACROSS ALL DEMOGRAPHICS), LEADING PEOPLE TO UNDER-ESTIMATE THE HARM DONE.STRATEGIES TO ADDRESS BEHAVIORAL HEALTH INCLUDE- INCREASE LOCAL CAPACITY TO PROVIDE CULTURALLY APPROPRIATE MENTAL HEALTH SERVICES- INCREASE SUPPORT TO EMERGENCY DEPARTMENT PATIENTS WITH SUBSTANCE USE DISODERS- CARE NETWORK TO ENHANCE THE CONTINUUM OF CARE INCREASING IDENTIFICATION, SCREENING, AND ACCESS TO MENTAL HEALTH AND SDOH SERVICES FOR EMERGENCY ROOM LATINE PATIENTS- CARE NETWORK TO INCREASE PERCENTAGE OF ENROLLED ECM CLIENTS WHO ARE SCREENED WITH THE PHQ-9- ADMINISTER COMMUNITY GRANTS TO ENHANCE RESOURCES TO EXPAND PREVENTION, EDUCATION, AND INTERVENTION OF BEHAVIORAL HEALTH SERVICESACCESS TO HEALTH SERVICESPARTICIPANTS NAMED COST AND DIFFICULTY NAVIGATING COMPLEX SYSTEMS AS BARRIERS TO ACCESSING HEALTHCARE. BECAUSE MANY PEOPLE HAVE NO STABLE RELATIONSHIP WITH A PRIMARY CARE PROVIDER AND WAIT TIMES FOR APPOINTMENTS CAN BE MONTHS, THE EMERGENCY ROOM OFTEN BECOMES THE FIRST ACCESS POINT FOR CARE. IT IS DIFFICULT TO ACCESS TRANSGENDER CARE IN NAPA COUNTY. THERE IS CONCERN AROUND LACK OF ACCESS TO HEALTH INSURANCE FOR MIXED STATUS FAMILIES (FAMILIES WITH A VARIETY OF DOCUMENTATION STATUSES, INCLUDING UNDOCUMENTED STATUS), AS WELL AS PEOPLE LOSING THEIR INSURANCE DUE TO JOB LOSS DURING THE PANDEMIC. CAREGIVERS AND COMMUNITY MEMBERS SHARED THAT ACCESSING DENTAL CARE CAN BE VERY DIFFICULT FOR ALL AGES BECAUSE THERE ARE FEW DENTAL APPOINTMENTS AVAILABLE LOCALLY.STRATEGIES TO ADDRESS ACCESS TO HEALTH SERVICES INCLUDE- BUILD A NETWORK OF BILINGUAL BICULTURAL BIRTH DOULAS IN NAPA COUNTY- IDENTIFY TRANSGENDER CARE SERVICE GAPS, AND SPECIFIC SERVICE NEEDS, TO INCREASE ACCESS TO LOCAL TRANSGENDER CARE- PROVIDE EARLY ORAL HEALTH SCREENING, PREVENTION, TREATMENT, AND EDUCATION TO LOW-INCOME CHILDREN; COMPLETE DENTAL CARE DELIVERY, INCLUDING CHECKUP, TREATMENT, AND ORAL HEALTH EDUCATION FOR PATIENT/PARENT- INCREASE ACCESS TO SPECIALTY CARE INCLUDING HIV CARE, DIAGNOSTIC SCREENINGS, AND PROCEDURES- MAINTAIN NUMBER OF CARE NETWORK CLIENTS ENROLLED IN ENHANCED CARE MANAGEMENT (ECMRACIAL EQUITY & LGBTQIA+ INCLUSIONRACISM IS OFTEN SEEN AS A BARRIER TO HEALTH BY NAPA COUNTY RESIDENTS OF COLOR. IT IS FELT DURING SYSTEM NAVIGATION, IN A LACK OF REPRESENTATION IN LEADERSHIP POSITIONS, AND IN DAY-TO-DAY INTERPERSONAL INTERACTIONS WITH LAW ENFORCEMENT AND OTHER COMMUNITY MEMBERS. MARGINALIZED GROUPS OFTEN EXPERIENCE PREJUDICE AND HATE SPEECH THAT MAKE THEM ISOLATED AND FEARFUL. MANY FEEL THAT CULTURAL COMMUNITY EVENTS ARE INAUTHENTIC AND CREATED FOR TOURISTS. COMMUNITY MEMBERS SEEKING TO BE ALLIES ARE CONCERNED ABOUT "DOING IT WRONG."RACIAL EQUITY AND LGBTQIA+ INCLUSION WAS IDENTIFIED AS A CHIP PRIORITY AND AS A CROSSCUTTING THEME AND ROOT CAUSE AMONG ALL PRIORITIZED NEED AREAS. BECAUSE PROMOTING RACIAL EQUITY AND LGBTQIA+ INCLUSION IS FOUNDATIONAL TO ADDRESSING THE OTHER NEEDS, THE RELATED STRATEGIES WILL BE INCORPORATED INTO OTHER PRIORITY COMMUNITY NEED AREAS.ECONOMIC STABILITYMANY PARTICIPANTS SPOKE TO THE NEED FOR LIVING WAGE JOBS AND INCREASED WAGES TO MEET THE HIGH COST OF LIVING IN NAPA COUNTY. THEY SHARED THAT FAMILIES WITH LOW INCOMES OFTEN EXPERIENCE HOUSING INSTABILITY AND USE MOST OF THEIR INCOME TO MEET BASIC NEEDS, OFTEN BEING FORCED TO MAKE SPENDING TRADEOFFS. A LARGE PROPORTION OF EMPLOYMENT OPPORTUNITIES CENTER AROUND AGRICULTURE AND HOSPITALITY, WHICH OFTEN COME WITH LOW WAGES AND CAN SOMETIMES HAVE POOR WORKING CONDITIONS. MANY PEOPLE THAT WORK IN NAPA, INCLUDING TEACHERS, LIBRARIANS AND OTHERS WHO SERVE THE COMMUNITY, CANNOT AFFORD TO LIVE HERE. YOUTH ARE HIGHLY AWARE OF THE FINANCIAL STRESS OF THEIR FAMILIES AND FEAR FOR THEIR OWN FINANCIAL FUTURE.STRATEGIES TO ADDRESS ECONOMIC STABILITY INCLUDE- ADMINISTER COMMUNITY GRANTS TO SUPPORT AND BUILD CAPACITY TO FRESH, NUTRITIOUS, CULTURALLY, AND/OR MEDICALLY APPROPRIATE FOOD- ADMINISTER COMMUNITY GRANTS TO SUPPORT AND BUILD CAPACITY TO ACCESSIBLE AND AFFORDABLE TRANSPORTATION- ADMINISTER COMMUNITY GRANTS TO SUPPORT AND BUILD CAPACITY OF LOCAL EMERGENCY FUNDS FOR BASIC NEEDSFULL DETAIL OF STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS CAN FOUND IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) HERE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN FULLY ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WHILE QUEEN OF THE VALLEY MEDICAL CENTER WILL EMPLOY STRATEGIES TO ADDRESS EACH OF THE FOUR SIGNIFICANT HEALTH NEEDS THAT WERE PRIORITIZED DURING THE CHNA PROCESS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT AGENCIES ARE CRITICAL FOR ACHIEVING THE ESTABLISHED GOALS.QUEEN OF THE VALLEY MEDICAL CENTER WILL COLLABORATE WITH NAPA COUNTY, THE CITY OF NAPA, OLE HEALTH, ADVENTIST HEALTH, MENTIS, ABODE, AND A VARIETY OF LOCAL FAMILY RESOURCE CENTERS THAT ADDRESS THE COMMUNITY NEEDS TO COORDINATE CARE AND REFERRALS TO ADDRESS UNMET NEEDS.FURTHERMORE, ST. JOSEPH HEALTH QUEEN OF THE VALLEY WILL ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT QUEEN OF THE VALLEY SERVICE AREAS. QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 13H: QUEEN OF THE VALLEY MEDICAL CENTER:THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 24: IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE. QUEEN OF THE VALLEY MEDICAL CENTER (2) PART V, SECTION B, LINE 11 (CONTINUED):THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED WITH THE FOLLOWING EXPLANATION: QUEEN OF THE VALLEY DOES NOT DIRECTLY ADDRESS IMMIGRATION STATUS. HOWEVER, COMMUNITY BENEFIT SERVICES ARE PROVIDED WITHOUT CONSIDERATION OF IMMIGRATION STATUS AND THE MEDICAL CENTER PROVIDES CHARITY MEDICAL CARE. IN ADDITION, QUEEN OF THE VALLEY MEDICAL CENTER AND COMMUNITY BENEFIT PROGRAMS PARTNER WITH MULTIPLE COMMUNITYBASED ORGANIZATIONS TO ADDRESS THE NEEDS OF THE UNDOCUMENTED. WHILE CANCER, HEART DISEASE, DIABETES AND ASTHMA ARE NOT A PRIMARY FOCUS OF THE PLAN, THE SERVICE AREA INCLUDES QUEEN OF THE VALLEY MEDICAL CENTER, ST. HELENA HOSPITAL, KAISER CLINIC AND OLE HEALTH THAT PROVIDE MEDICAL SERVICES TO INDIVIDUALS WITH THESE CONDITIONS. ALSO, QUEEN OF THE VALLEY'S CARE NETWORK PROVIDES CARE COORDINATION AND CARE MANAGEMENT FOR LOW INCOME PERSONS WITH COMPLEX MEDICAL CONDITIONS INCLUDING CHRONIC DISEASES SUCH AS THESE. QUEEN OF THE VALLEY DOES NOT DIRECTLY ADDRESS ISSUES OF TRANSPORTATION AND TRAFFIC. AS A PARTNER IN LIVE HEALTHY NAPA COUNTY, QUEEN OF THE VALLEY PARTNERS WITH THE COMMUNITY TO IMPROVE CONDITIONS THROUGH ADVOCACY AND PARTNERSHIPS. IN ADDITION, TRANSPORTATION SUPPORT IS PROVIDED TO QUEEN OF THE VALLEY CARE NETWORK CLIENTS. WHILE ACCESS TO FOOD IS NOT A PRIMARY FOCUS OF THE CB IMPLEMENTATION STRATEGY, QUEEN OF THE VALLEY COMMUNITY BENEFIT PROVIDES FUNDING SUPPORT TO LOCAL FOOD SAFETY NET ORGANIZATIONS, WORKS DIRECTLY WITH COMMUNITY PARTNERS SUCH AS THE NAPA VALLEY FARMER'S MARKET AND LIVE HEALTHY NAPA COUNTY TO EXPAND ACCESS, AND DIRECTLY ASSISTS LOWINCOME CHRONICALLY ILL CARE NETWORK CLIENTS WITH FOOD ACCESS. IN ADDITION, QUEEN OF THE VALLEY WILL COLLABORATE WITH PUBLIC AGENCIES AND COMMUNITYBASED ORGANIZATIONS THAT ADDRESS LANGUAGE BARRIERS AND AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: SANTA ROSA MEMORIAL HOSPITAL, - FACILITY 3: REDWOOD MEMORIAL HOSPITAL, - FACILITY 4: ST. JOSEPH HOSPITAL OF EUREKA SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 3J: PART V, SECTION B, LINE 3ESANTA ROSA MEMORIAL HOSPITAL (1), REDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4)THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 5: SANTA ROSA MEMORIAL HOSPITAL (1) THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS AN IMPORTANT TOOL WE USE TO BETTER UNDERSTAND HEALTH DISPARITIES AND INEQUITIES WITHIN THE COMMUNITIES WE SERVE, AS WELL AS THE COMMUNITY STRENGTHS AND ASSETS.THE EQUITY FRAMEWORK IS FOUNDATIONAL TO OUR OVERALL CHNA FRAMEWORK, A MODIFIED VERSION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO). THE MODIFIED MAPP FRAMEWORK TAKES A MIXED-METHODS APPROACH TO PRIORITIZE HEALTH NEEDS, CONSIDERING POPULATION HEALTH DATA, COMMUNITY INPUT, INTERNAL UTILIZATION DATA, COMMUNITY STRENGTHS AND ASSETS, AND A PRIORITIZATION PROTOCOL.IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY THE HOSPITAL, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. IN ADDITION, WE RECOGNIZE THAT THERE ARE OFTEN GEOGRAPHIC AREAS WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE POORER THAN NEARBY AREAS. WHENEVER POSSIBLE AND RELIABLE, DATA ARE REPORTED AT CENSUS TRACT LEVEL. THESE SMALLER GEOGRAPHIC AREAS ALLOW US TO BETTER UNDERSTAND THE NEIGHBORHOOD LEVEL NEEDS OF OUR COMMUNITIES AND BETTER ADDRESS INEQUITIES WITHIN AND ACROSS COMMUNITIES.COMMUNITY INPUT:TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, REPRESENTATIVES FROM SANTA ROSA MEMORIAL HOSPITAL CONDUCTED 14 KEY INFORMANT INTERVIEWS WITH REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS AND IN PARTNERSHIP WITH ON THE MARGINS, LLC, CONDUCTED 3 LISTENING SESSIONS WITH COMMUNITY MEMBERS. ADDITIONALLY, REPRESENTATIVES FROM COMMUNITY HEALTH INVESTMENT CONDUCTED ONE PROVIDENCE CAREGIVER LISTENING SESSION. DURING THESE INTERVIEWS AND LISTENING SESSIONS, COMMUNITY MEMBERS AND NONPROFIT AND GOVERNMENT KEY INFORMANTS DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA. BELOW IS A HIGH-LEVEL SUMMARY OF THE FINDINGS OF THESE SESSIONS.NONPROFIT AND GOVERNMENT STAKEHOLDER INTERVIEWS:A TOTAL OF 14 KEY INFORMANT INTERVIEWS WERE COMPLETED BY REPRESENTATIVES FROM SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS. KEY INFORMANTS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A REPRESENTATIVE FROM THE SONOMA COUNTY HUMAN SERVICES DEPARTMENT.KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH:- KT SWAN, PROGRAM DIRECTOR FOR BUCKELEW PROGRAMS (BEHAVIORAL HEALTH)- STEPHANIE MERRIDA-GRANT, ASSISTANT DIRECTOR OF OUTREACH AND ENGAGEMENT FOR CATHOLIC CHARITIES OF SANTA ROSA (SOCIAL SERVICES, HOMELESS SERVICES)- CHRIS CABRAL, CHIEF EXECUTIVE OFFICER FOR COMMITTEE ON THE SHELTERLESS (SOCIAL SERVICES)- KISMET BALDWIN SANTANA MD, INTERIM HEALTH OFFICER FOR COUNTY OF SONOMA PUBLIC HEALTH (PUBLIC HEALTH)- JEN KLOSE, EXECUTIVE DIRECTOR FOR GENERATION HOUSING (AFFORDABLE HOUSING)- KIMBERLY BENDER, EXECUTIVE DIRECTOR FOR HEALTHCARE FOUNDATION OF NORTHERN SONOMA COUNTY (PHILANTHROPY, HEALTHCARE)- STEPHANIE MANIERI, EXECUTIVE DIRECTOR FOR LATINO SERVICE PROVIDERS (SOCIAL SERVICES)- TASHA BOLLINGER, MEDICAL PARTNERSHIP ATTORNEY FOR LEGAL AID OF SONOMA COUNTY (SOCIAL SERVICES)- ESTHER LEMUS, SUPERIVISING ATTORNEY FOR LEGAL AID OF SONOMA COUNTY (SOCIAL SERVICES)- MICHELINE WHITE, EXECUTIVE DIRECTOR FOR MENDONOMA HEALTH ALLIANCE (HEALTHCARE, SOCIAL SERVICES)- ANNIE NICOL, DIRECTOR OF HEALTH SERVICES FOR PETALUMA HEALTH CENTER (HEALTHCARE)- RAMONA FAITH, CHIEF EXECUTIVE OFFICER FOR PETALUMA HEALTHCARE DISTRICT (SOCIAL SERVICES)- ELECE HEMPEL, SECRETARY FOR PETALUMA HEALTHCARE DISTRICT (SOCIAL SERVICES)- TROY GIDEON, CHIEF ADMINISTRATIVE OFFICER FOR PROVIDENCE PETALUMA VALLEY AND HEALDSBURG HOSPITAL- CHUCK KASSIS, CHIEF EXECUTIVE FOR PROVIDENCE SANTA ROSA MEMORIAL HOSPITAL- MARGARET SLUYK, CHIEF EXECUTIVE OFFICER FOR REACH FOR HOME (SOCIAL SERVICES)MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS BEING REPRESENTED BY ORGANIZATIONS OR INDIVIDUALS THAT PROVIDED INPUT:- LATINX- INDIGENOUS/NATIVE AMERICAN- BBIPOC- INDIVIDUALS EXPERIENCING HOMELESSNESS (OR AT-RISK)- INDIVIDUALS EXPERIENCING BEHAVIORAL HEALTH ISSUES- OLDER ADULTSDATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR, INCLUDING THE FOLLOWING:- NOT ALL DESIRED DATA WERE READILY AVAILABLE, SO SOMETIMES WE HAD TO RELY ON TANGENTIAL OR PROXY MEASURES OR NOT HAVE ANY DATA AT ALL. FOR EXAMPLE, THERE IS LITTLE COMMUNITY-LEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH OR SUBSTANCE USE.- WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS PERCENTAGE OF PEOPLE UNINSURED) AND THE MOST RECENT DATA AVAILABLE ARE NOT A GOOD REFLECTION OF THE CURRENT STATE.- REPORTING DATA AT THE COUNTY LEVEL CAN MASK INEQUITIES WITHIN COMMUNITIES. THIS CAN ALSO BE TRUE WHEN REPORTING DATA BY RACE, WHICH CAN MASK WHAT IS HAPPENING WITHIN RACIAL AND ETHNIC SUBGROUPS. THEREFORE, WHEN APPROPRIATE AND AVAILABLE, WE DISAGGREGATED THE DATA BY GEOGRAPHY AND RACE.- DATA GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION AS A WHOLE.- THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS.REDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4)THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS AN IMPORTANT TOOL WE USE TO BETTER UNDERSTAND HEALTH DISPARITIES AND INEQUITIES WITHIN THE COMMUNITIES WE SERVE, AS WELL AS THE COMMUNITY STRENGTHS AND ASSETS.THE EQUITY FRAMEWORK IS FOUNDATIONAL TO OUR OVERALL CHNA FRAMEWORK, A MODIFIED VERSION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO). THE MODIFIED MAPP FRAMEWORK TAKES A MIXED-METHODS APPROACH TO PRIORITIZE HEALTH NEEDS, CONSIDERING POPULATION HEALTH DATA, COMMUNITY INPUT, INTERNAL UTILIZATION DATA, COMMUNITY STRENGTHS AND ASSETS, AND A PRIORITIZATION PROTOCOL.IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY THE HOSPITAL, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. IN ADDITION, WE RECOGNIZE THAT THERE ARE OFTEN GEOGRAPHIC AREAS WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE POORER THAN NEARBY AREAS. WHENEVER POSSIBLE AND RELIABLE, DATA ARE REPORTED AT CENSUS TRACT LEVEL. THESE SMALLER GEOGRAPHIC AREAS ALLOW US TO BETTER UNDERSTAND THE NEIGHBORHOOD LEVEL NEEDS OF OUR COMMUNITIES AND BETTER ADDRESS INEQUITIES WITHIN AND ACROSS COMMUNITIES.COMMUNITY INPUT:TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, REPRESENTATIVES FROM ST. JOSEPH AND REDWOOD MEMORIAL HOSPITALS CONDUCTED 13 KEY INFORMANT INTERVIEWS WITH REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, 7 LISTENING SESSIONS WITH COMMUNITY MEMBERS, AND 3 LISTENING SESSIONS WITH PROVIDENCE CAREGIVERS WHO WORK DIRECTLY WITH UNDERSERVED POPULATIONS IN THE COMMUNITY. ALL COMMUNITY INPUT WAS COLLECTED BETWEEN MARCH AND MAY 2023.NONPROFIT AND GOVERNMENT STAKEHOLDER INTERVIEWS:A TOTAL OF 10 KEY INFORMANT INTERVIEWS WERE COMPLETED BY REPRESENTATIVES FROM ST. JOSEPH AND REDWOOD MEMORIAL HOSPITALS. KEY INFORMANTS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. ST. JOSEPH AND REDWOOD MEMORIAL HOSPITALS AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A REPRESENTATIVE FROM THE HUMBOLDT COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES. SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 6A: SANTA ROSA MEMORIAL HOSPITAL (1)MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE HOSPITAL FACILITIES:- SUTTER HEALTH- KAISER PERMANENTE- SONOMA WEST MEDICAL CENTERREDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4)ST. JOSEPH HOSPITAL EUREKA CONDUCTED THE CHNA IN PARTNERSHIP WITH REDWOOD MEMORIAL HOSPITAL. SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 6B: SANTA ROSA MEMORIAL HOSPITAL (1)MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:- SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES- SONOMA COUNTY DEPARTMENT OF PUBLIC HEALTH- BURBANK HOUSING- BUCKELEW PROGRAMS- PETALUMA PEOPLE SERVICES CENTER- WEST COUNTY HEALTH CENTERS- HEALTHY PETALUMA- PETALUMA HEALTH CENTER- ALLIANCE MEDICAL CENTER- LATINO SERVICE PROVIDERS- CATHOLIC CHARITIES OF THE DIOCESE OF SANTA ROSA- COMMITTEE ON THE SHELTERLESS- GENERATION HOUSING- LEGAL AID OF SONOMA COUNTY- MENDONOMA HEALTH ALLIANCE- REACH FOR HOME- ON THE MARGINSREDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4)SEVERAL PEOPLE AND ENTITIES COLLABORATED TO MAKE THIS CHNA POSSIBLE. THE DATA ANALYTICS TEAM FROM PROVIDENCE ORGANIZED DATA AND CREATED THE HUMBOLDT COUNTY DATA HUB THAT ALLOWED VISUALIZATION OF DATA ON CENSUS-TRACT MAPS.THE PROVIDENCE COMMUNITY RESOURCE CENTERS HELD COMMUNITY LISTENING SESSIONS WITH THE COMMUNITY MEMBERS THEY SERVE, AND WE ARE GRATEFUL FOR THE LEADERSHIP OF THE COORDINATORS AT THESE CENTERS WHO MADE THESE LISTENING SESSIONS HAPPEN. THE PASO A PASO PROGRAM HOSTED A COMMUNITY LISTENING SESSION AT THE LOLETA COMMUNITY RESOURCE CENTER THAT WAS WELL ATTENDED AND LIVELY. BEING A TRUSTED PROGRAM WITH DECADES OF EXPERIENCE SERVING THE HISPANIC/LATINO COMMUNITY IN HUMBOLDT COUNTY, PASO A PASO WAS ABLE TO LEAN ON RELATIONSHIPS TO CREATE A SAFE SPACE FOR A ROBUST AND LIVELY CONVERSATION ON HEALTH, WELLBEING, AND COMMUNITY NEEDS.WE CONTINUE TO PARTNER CLOSELY WITH THE COUNTY OF HUMBOLDT PUBLIC HEALTH DEPARTMENT AND ALIGN WITH LIVE WELL HUMBOLDT, WHICH IS A NETWORK OF COMMUNITY HEALTH IMPROVEMENT COLLABORATORS COMMITTED TO TAKING ACTIONS TO IMPROVE HEALTH AND WELLBEING.THERE WERE SEVERAL KEY INFORMANTS REPRESENTING MULTIPLE LOCAL NON-PROFIT ORGANIZATIONS, EDUCATIONAL INSTITUTIONS, OR GOVERNMENT AGENCIES, THAT WERE GENEROUS WITH THEIR TIME AND ALLOWED OUR COMMUNITY HEALTH NEEDS ASSESSMENT TEAM TO INTERVIEW THEM. THANK YOU TO ALL THOSE WHO CONTRIBUTED THEIR TIME AND EXPERTISE. A COMPLETE LIST OF KEY INFORMANTS CAN BE FOUND IN THE APPENDIX.HEARTFELT GRATITUDE IS EXTENDED TO THE CAREGIVERS THAT WORK IN THE COMMUNITY HEALTH INVESTMENT DIVISION OF PROVIDENCE ST. JOSEPH AND REDWOOD MEMORIAL HOSPITALS. THESE CAREGIVERS SHARED THEIR EXPERIENCES AND EXPERTISE BUILT FROM YEARS OF WORKING WITH UNDERSERVED COMMUNITIES. THEIR INSIGHTS INTO THE STRENGTHS OF THE COMMUNITIES THEY SERVE AND THEIR IDENTIFICATION OF UNMET NEEDS, IS VALUABLE.AND FINALLY, THIS CHNA WOULD NOT BE POSSIBLE WITHOUT THE GENEROUS, HONEST, AND INSIGHTFUL CONTRIBUTIONS OF THE COMMUNITY MEMBERS THAT PARTICIPATED IN LISTENING SESSIONS. WE ARE FOREVER GRATEFUL FOR THE CANDID CONVERSATIONS AND SHARING THE THINGS THAT HAVE MOST IMPACTED HEALTH AND WELLBEING IN YOUR LIVES AND THE LIVES OF FAMILIES, FRIENDS, AND NEIGHBORS. SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 11: SANTA ROSA MEMORIAL HOSPITAL (1)THE 2023 COMMUNITY HEALTH NEEDS PRIORITIZED NEEDS ARE LISTED BELOW:1) BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER2) HOMELESSNESS AND HOUSING INSTABILITY3) ACCESS TO HEALTH CARE AND DENTAL SERVICES4) AGING ISSUESBEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERPUBLICLY AVAILABLE DATA ALONG WITH PROVIDENCE HOSPITALIZATION DATA SHOW WORSENING TRENDS OF INDIVIDUALS EXPERIENCING A BEHAVIORAL HEALTH CRISIS, MANY OF WHOM ARE UTILIZING EMERGENCY ROOMS FOR CARE. SUBSTANCE USE DISORDER WAS IDENTIFIED AS THE LEADING BEHAVIORAL HEALTH DIAGNOSIS BEING TREATED AT SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS. KEY INFORMANTS, COMMUNITY MEMBERS AND CAREGIVERS ALL SHARED THAT LACK OF BEHAVIORAL HEALTH AND SUBSTANCE USE SERVICES WAS A MAJOR BARRIER IN SONOMA COUNTY. THE LACK OF BILINGUAL/BICULTURAL PROVIDERS AND THE ABSENCE OF MEDICAL DETOX WAS ALSO A COMMONLY VOICED NEED. DATA SHOWED PARTICULAR CONCERN FOR YOUTH.STRATEGIES TO ADDRESS BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER INCLUDE:- LEVERAGE PARTNERSHIPS BETWEEN THE MOBILE HEALTH CLINIC AND BEHAVIORAL HEALTH COMMUNITY-BASED ORGANIZATIONS- CONNECT PATIENTS TO MEDICATION-ASSISTED TREATMENT PROGRAMS THROUGH SUBSTANCE USE NAVIGATION- PROVIDE COMPREHENSIVE CASE MANAGEMENT TO HIGH-RISK AND SEVERE AND PERSISTENT MENTAL ILLNESS POPULATION THROUGH ENHANCED CARE MANAGEMENT (ECM)- ADMINISTER COUNTY-WIDE COMMUNITY GRANTS TO COMMUNITY BASED ORGANIZATIONS ADDRESSING BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERHOMELESS AND HOUSING INSTABILITYOVER 25% OF SONOMA COUNTY IS EXPERIENCING SEVERE HOUSE COST BURDEN, SPENDING 50% OR MORE OF THEIR HOUSEHOLD INCOME ON HOUSING. ADDITIONALLY, OVER 2800 INDIVIDUALS WERE FOUND TO BE EXPERIENCING HOMELESSNESS IN 2022. MOST KEY INFORMANTS IDENTIFIED THE NEED FOR ADDITIONAL PERMANENT SUPPORTIVE HOUSING, HOUSING ACCEPTING HOUSING VOUCHERS, AFFORDABLE HOUSING, AND SHELTER BEDS. OLDER ADULTS AND BBIPOC POPULATION EXPERIENCE ADDITIONAL BARRIERS TO HOUSING IN SONOMA COUNTY.STRATEGIES TO ADDRESS HOMELESSNESS AND HOUSING INSTABILITY INCLUDE:- INVEST IN THE MAINTENANCE AND EXPANSION OF EXISTING RECUPERATIVE BEDS AND SERVICES- PRIORITIZE FUNDING TOWARDS MAINTAINING OPERATIONAL EXPENSES AT ESTABLISHED PERMANENT SUPPORTIVE HOUSING (PSH) LOCATIONS FOR SUSTAINABILITY OF HOUSING UNITS- PROVIDE COMPREHENSIVE CASE MANAGEMENT TO UNHOUSED POPULATION THROUGH CARE NETWORK'S ENHANCED CARE MANAGEMENT PROGRAM- PROVIDE SUPPORT TO COMMUNITY BASED ORGANIZATIONS FOCUSED ON ADVOCATING FOR HOUSING INITIATIVES WITH THE GOAL OF INCREASING THE SUPPLY AND AFFORDABILITY OF HOMES IN SONOMA COUNTYACCESS TO HEALTH CARE AND DENTAL SERVICESFEWER PEOPLE SAW A PRIMARY CARE DOCTOR OR DENTIST OVER THE PAST YEAR IN 2022. THIS TREND COUPLED WITH QUALITATIVE DATA EXPRESSING LACK OF PRIMARY MEDICAL AND DENTAL PROVIDERS, HIGHLIGHTED LACK OF APPROPRIATE LEVEL OF HEALTH CARE ACCESS IN SONOMA COUNTY. EMERGENCY TRANSPORT TIMES WERE SOME OF THE LONGEST IN THE STATE OF CALIFORNIA IN NORTHERN SONOMA COUNTY. KEY INFORMANTS AND CAREGIVERS EXPRESSED THE NEED FOR EXTENDED HOURS, BILINGUAL/BICULTURAL PROVIDERS AND TRANSPORTATION OPTIONS TO BREAK DOWN ACCESS BARRIERS FOR OLDER ADULTS, PEOPLE EXPERIENCING HOMELESSNESS, AND AGRICULTURAL WORKERS. ACCESS WAS NOTED TO BE HIGHLY LINKED TO ECONOMIC INSECURITY.STRATEGIES TO ADDRESS ACCESS TO CARE INCLUDE:- ENGAGE HIGH-RISK INDIVIDUALS WITH CARE NETWORK'S COMPLEX CARE MANAGEMENT AND ENHANCED CARE MANAGEMENT TEAMS TO INCREASE ACCESS TO HEALTH CARE- PROVIDE COMMUNITY HEALTH WORKER SERVICES INCLUDING SCREENINGS, EDUCATION, NAVIGATION, AND ADVOCACY FOR BBIPOC AND VULNERABLE POPULATIONS- PROVIDE DENTAL CARE TO UN- AND UNDERINSURED PATIENTS THROUGH PROVIDENCE DENTAL CLINIC- PROVIDE PRIMARY CARE AND LINKAGES TO MEDICAL HOMES FOR UN- AND UNDERINSURED PATIENTS THROUGH PROVIDENCE MOBILE HEALTH CLINIC WITH THE GOAL OF REDUCING AVOIDABLE EMERGENCY DEPARTMENT VISITSAGING ISSUESTHERE IS A GROWING POPULATION OF OLDER ADULTS (OVER 60) IN SONOMA COUNTY WITHOUT ADEQUATE RESOURCES TO MEET THEIR NEEDS. OLDER ADULTS EXPERIENCING HOMELESSNESS AND HOUSING INSTABILITY AS WELL AS MENTAL HEALTH ISSUES DUE TO ISOLATION, IS ON THE RISE IN SONOMA COUNTY. A LACK OF PROVIDERS WITH EXPERIENCE SPECIFIC TO GERIATRIC CONDITIONS IS OF CONCERN.STRATEGIES TO ADDRESS AGING ISSUES INCLUDE:- SUPPORT COMMUNITY BASED ORGANIZATIONS THROUGH GRANTS AND PARTNERSHIPS TO INCREASE TRANSPORTATION ACCESS- SERVING SENIORS THROUGH DIRECT SERVICE PROGRAMS- PRIVATE DUTY CAREGIVING- ADMINISTER COMMUNITY GRANTS TO ADDRESS AGING ISSUESFULL DETAIL OF STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS CAN FOUND IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) HERE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO SINGLE HOSPITAL FACILITY CAN FULLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WHILE SANTA ROSA MEMORIAL EMPLOYS STRATEGIES TO ADDRESS EACH OF THE FOUR SIGNIFICANT HEALTH NEEDS THAT WERE PRIORITIZED DURING THE CHNA PROCESS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT AGENCIES ARE CRITICAL FOR ACHIEVING THE ESTABLISHED GOALS.SANTA ROSA MEMORIAL HOSPITAL COLLABORATED WITH COMMUNITY-BASED ORGANIZATIONS, FQHCS, AND A VARIETY OF LOCAL FAMILY RESOURCE CENTERS THAT ADDRESS THE COMMUNITY NEEDS TO COORDINATE CARE AND REFERRALS TO ADDRESS UNMET NEEDS. WE CONTINUED FUNDING OTHER LOCAL NONPROFIT ORGANIZATIONS THROUGH GRANTS FROM OUR CARE FOR THE POOR PROGRAM MANAGED BY THE SRMH COMMUNITY HEALTH INVESTMENT DEPARTMENT. SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 13H: SANTA ROSA MEMORIAL HOSPITAL (1), REDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4):THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. SJHNC, LLC (GROUP A - 1, 3 & 4) PART V, SECTION B, LINE 24: IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE. SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 7A: CHNA WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSUNDER NORTHERN CALIFORNIA. QUEEN OF THE VALLEY MEDICAL CENTER - PART V, SECTION B, LINE 7A: CHNA WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSUNDER NORTHERN CALIFORNIA.SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 9:SANTA ROSA MEMORIAL HOSPITAL (1)THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 16, 2024, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).REDWOOD MEMORIAL HOSPITAL (3) & ST. JOSEPH HOSPITAL OF EUREKA (4)THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 10, 2024, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).QUEEN OF THE VALLEY MEDICAL CENTER - PART V, SECTION B, LINE 9:THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 18, 2024, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1). SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSUNDER NORTHERN CALIFORNIA. QUEEN OF THE VALLEY MEDICAL CENTER - PART V, SECTION B, LINE 10A:IMPLEMENTATION STRATEGY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSUNDER NORTHERN CALIFORNIA. SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 5 (CONT): CAREGIVER LISTENING SESSIONS:A TOTAL OF 3 LISTENING SESSIONS WERE COMPLETED WITH INTERNAL CAREGIVERS WHO REPRESENT THE NEEDS AND CHALLENGES OF THE CLIENTS THEY SERVE.KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH:- SOFIA PEREIRA, PUBLIC HEALTH DIRECTOR FOR COUNTY OF HUMBOLDT DHHS (PUBLIC HEALTH)- CHERYL CHURCHILL, EXECUTIVE DIRECTOR FOR HOUSING AUTHORITIES OF THE CITY OF EUREKA & THE COUNTY OF HUMBOLDT (HOUSING)- EMI BOTZLER-RODGERS LMFT, BEHAVIORAL HEALTH DIRECTOR FOR COUNTY OF HUMBOLDT, DHHS (BEHAVIORAL HEALTH)- ANTOINEETE MARTINEZ MD, FAMILY MEDICINE AND OBSTETRICS PHYSICIAN FOR UNITED INDIAN HEALTH SERVICES (INDIGENOUSE HEALTH CARE)- JASMINE GUERRA, EXECUTIVE DIRECTOR FOR HUMBOLDT AREA CENTER FOR HARM REDUCTION (HARM REDUCTION)- JEREMY CAMPBELL, EXECUTIVE DIRECTOR FOR WATERFRONT RECOVERY SERVICES (BEHAVIORAL HEALTH)- ELIZABETH ROSE-MARINI, COMMUNITY ENGAGEMENT AND PARTNERSHIPS COORDINATOR FOR EUREKA VA CLINIC (VETERANS' HEALTH CARE)- LEONARD LA FRANCE, POLICE COMMANDER FOR EUREKA POLICE DEPARTMENT (LAW ENFORCEMENT AND HOMELESS OUTREACH)- ANDREW RIX, MANAGER FOR WORKFORCE AND ECONOMIC DEVELOPMENT CAL POLY HUMBOLDT (ECONOMIC DEVELOPMENT)- SEAN GARDNER, GRADUATE STUDENT FOR SCHOOL OF PSYCHOLOGY AT CAL POLY HUMBOLDT (EDUCATION AND MENTAL HEALTH)- TERESA GARCIA-RODRIGUEZ, ADRIANNA RODRIGUEZ-TORRES AND ANGEL MARTINEZ, LATINO HEALTH COORDINATORS FOR OPEN DOOR COMMUNITY HEALTH CENTERS (HEALTH CARE)- STEPHANIE BRITTAIN, HEALTH COORDINATOR FOR NORTH COAST CHILDREN'S SERVICES (CHILD DEVELOPMENT)- BRENDA PEREZ, EXECUTIVE DIRECTOR FOR CENTRO DEL PUEBLO (IMMIGRANT RIGHTS) MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS REPRESENTED BY ORGANIZATIONS OR INDIVIDUALS PROVIDING INPUT:- SENIORS, ELDERS- FAMILIES WITH CHILDREN- LATINX POPULATION- NATIVE AMERICAN/INDIGENOUS POPULATIONS- VETERANS- HOUSING SHELTER PARTICIPANTS- INDIVIDUALS EXPERIENCING HOMELESSNESS- INDIVIDUALS EXPERIENCING BEHAVIORAL HEALTH ISSUESDATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR, INCLUDING THE FOLLOWING:- NOT ALL DESIRED DATA WERE READILY AVAILABLE, SO SOMETIMES WE HAD TO RELY ON TANGENTIAL OR PROXY MEASURES OR NOT HAVE ANY DATA AT ALL. FOR EXAMPLE, THERE IS LITTLE COMMUNITY-LEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH OR SUBSTANCE USE.- WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS PERCENTAGE OF PEOPLE UNINSURED) AND THE MOST RECENT DATA AVAILABLE ARE NOT A GOOD REFLECTION OF THE CURRENT STATE.- REPORTING DATA AT THE COUNTY LEVEL CAN MASK INEQUITIES WITHIN COMMUNITIES. THIS CAN ALSO BE TRUE WHEN REPORTING DATA BY RACE, WHICH CAN MASK WHAT IS HAPPENING WITHIN RACIAL AND ETHNIC SUBGROUPS. THEREFORE, WHEN APPROPRIATE AND AVAILABLE, WE DISAGGREGATED THE DATA BY GEOGRAPHY AND RACE.- DATA THAT ARE GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION AS A WHOLE.- THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS. SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 11 (CONT): WITH RESPECT TO SOME OF THE OTHER NEEDS IDENTIFIED IN THE CHNA PROCESS THAT WERE NOT PRIORITIZED FOR ACTION THROUGH THIS PLAN, WE INTEND TO REMAIN ENGAGED IN ADDRESSING ORAL HEALTH NEEDS THROUGH OUR ONGOING COMMUNITY DENTAL CLINIC AND MOBILE DENTAL CLINIC. AND WHILE FOOD AND NUTRITION IS NOT TO BE DIRECTLY ADDRESSED BY OUR OWN PROGRAMMING, WE ANTICIPATE THAT OUR ONGOING SUPPORT OF LOCAL INITIATIVES AND ORGANIZATIONS INVOLVED IN MEDICALLY TAILORED AND HOME-DELIVERED MEALS FOR THE MOST VULNERABLE WILL INCLUDE A CONSIDERATION AND INCLUSION OF STRATEGIES TO ADDRESS THIS NEED. CHI CONTINUED TO SUPPORT A CONTRACT WITH A PRIVATE DUTY CARE GIVING AGENCY FOR PATIENTS WHO ARE AT-RISK OR UNABLE TO RECEIVE GOVERNMENT FUNDED CAREGIVING.REDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4)COMMUNITY HEALTH NEEDS PRIORITIZED:1) HOMELESSNESS & HOUSING INSTABILITY2) BEHAVIORAL HEALTH & ACCESS TO CARE3) ACCESS TO HEALTH CARE SERVICES4) FOOD INSECURITYHOMELESSNESS & HOUSING INSTABILITYKEY INFORMANTS, PROVIDENCE CAREGIVERS, AND COMMUNITY MEMBERS IDENTIFIED HOUSING AS A BASIC NEED AND NAMED IT AS THE NUMBER ONE SOCIAL DETERMINANT OF HEALTH. THEY IDENTIFIED A NEED FOR MORE AFFORDABLE HOUSING ACROSS THE SPECTRUM, INCLUDING SUPPORTIVE HOUSING AND TRANSITIONAL HOUSING. THERE IS ALSO A NEED FOR MORE SUPPORT FOR PEOPLE EXPERIENCING HOMELESSNESS. EQUITABLE AND INCLUSIVE HOUSING WAS EXPLICITLY PRIORITIZED.KEY INFORMANTS NOTED FINDING STABLE, AFFORDABLE HOUSING FOR THE FOLLOWING POPULATIONS CAN BE MORE DIFFICULT: FAMILIES WITH CHILDREN, PEOPLE WITH MENTAL HEALTH CHALLENGES, AND PEOPLE WITH A SUBSTANCE USE DISORDER. CAREGIVERS NOTED THAT MOLD AND SUB-STANDARD HOUSING CONDITIONS CONTRIBUTE TO UNHEALTHY AND UNSAFE LIVING CONDITIONS.STRATEGIES TO ADDRESS HOMELESSNESS AND HOUSING INSTABILTY INCLUDE:- MAINTAIN PERMANENT SUPPORTIVE HOUSING PROJECTS PREVIOUSLY ESTABLISHED; PROVIDE SUPPORTIVE SERVICES TO TENANTS- INVEST IN RESPITE AND RECUPERATIVE CARE BEDS COUPLED WITH COMPLEX CARE MANAGEMENT SERVICES- SUPPORT PROGRAMS AND INTERVENTIONS INTENDED TO SERVE THOSE WHO ARE HOMELESS AND PREVENT HOMELESSNESS AMONGST THOSE AT-RISK OF LOSING THEIR HOMES- SUPPORT LOCAL HOMELESS SERVICES PROVIDERS THORUGH GRANTS AND PARTNERSHIPSBEHAVIORAL HEALTH & ACCESS TO CAREMOST KEY INFORMANTS, CAREGIVERS, AND COMMUNITY MEMBERS SPOKE TO A LACK OF BEHAVIORAL HEALTH SERVICES TO MEET NEEDS ACROSS THE CONTINUUM OF CARE, CITING A NEED FOR LOCAL RESIDENTIAL TREATMENT CENTERS, CRISIS SERVICES, LOW-BARRIER SUBSTANCE USE DISORDER (SUD) TREATMENT PROGRAMS, AND MENTAL HEALTH SERVICES IN GENERAL. COMMUNITY MEMBERS AND CAREGIVERS SPOKE TO A NEED FOR MORE MENTAL HEALTH SERVICES AND SUPPORT GROUPS IN SPANISH SPECIFICALLY. EQUITABLE AND INCLUSIVE ACCESS TO BEHAVIORAL HEALTH CARE AND SERVICES WAS EXPLICITLY PRIORITIZED. ALL GROUPS WERE PARTICULARLY CONCERNED ABOUT INCREASED DEPRESSION AND ANXIETY FOR YOUNG PEOPLE, AND MANY SPOKE TO THE IMPORTANCE OF ADDRESSING ADVERSE CHILDHOOD EXPERIENCES (ACES). KEY INFORMANTS NOTED SEEING AN INCREASE IN ALCOHOL USE, SUD, DOMESTIC VIOLENCE, DEATH BY SUICIDE, ISOLATION, OVERDOSES, AND DISTRESS SINCE THE START OF THE PANDEMIC.STRATEGIES TO ADDRESS BEHAVIORAL HEALTH INCLUDE:- CULTURALLY AND LINGUISTICALLY APPROPRIATE PRIMARY PREVENTION CLASSES AND EVENTS AS WELL AS PSYCHOTHERAPY FOR MILD TO MODERATE BEHAVIORAL HEALTH NEEDS- INCREASE ACCESS TO MEDICATION ASSISTED TREATMENT FOR EMERGENCY ROOM PATIENTS VIA THE SUBSTANCE USE NAVIGATOR AND BEHAVIORAL HEALTH NAVIGATOR- PROVIDE COMPREHENSIVE, COMMUNITY BASED INTENSIVE, CASE MANAGEMENT FOR PRIORITY POPULATIONS- MAINTAIN SUPPORT FOR PLACE-BASED COMMUNITY RESOURCE CENTERS IN RURAL POCKETS OF HUMBOLDT COUNTY TO PREVENT SOCIAL ISOLATION AND PROMOTE FAMILY AND COMMUNITY STRENGHTENING- INCREASE LOCAL CAPACITY TO PROVIDE CULTURALLY APPROPRIATE MENTAL HEALTH AND SUD SERVICES WHEN NEEDED (FROM PREVENTION TO CRISIS INTERVENTION)ACCESS TO HEALTH CARE SERVICESCOMMUNITY MEMBERS, CAREGIVERS, AND KEY INFORMANTS EMPHASIZED ACCESSING PRIMARY CARE AND SPECIALTY CARE IS DIFFICULT IN HUMBOLDT COUNTY FOR MANY PEOPLE. LOCAL PRIMARY CARE CLINICS HAVE LIMITED AVAILABILITY AND MANY PATIENTS DRIVE OUT OF HUMBOLDT TO ACCESS PRIMARY AND SPECIALTY CARE. TRANSPORTATION IS A SIGNIFICANT AND PERSISTENT BARRIER TO CARE. MANY PEOPLE LACK SUFFICIENT FUNDS TO TRAVEL OUT OF THE COUNTY TO ACCESS CARE. TO ADDRESS BARRIERS TO CARE, CAREGIVERS SHARED A NEED FOR MORE CULTURALLY MATCHED PROVIDERS, CASE MANAGEMENT, MEDICATION MANAGEMENT, AND WARM HANDOFFS. MANY PROGRAMS THAT PROVIDE SUPPORT HAVE WAITLISTS. EQUITABLE AND INCLUSIVE ACCESS TO CARE WAS EXPLICITLY PRIORITIZED. THERE IS A NEED FOR MORE BILINGUAL, SPANISH-SPEAKING, HEALTH CARE PROVIDERS AND BLACK, BROWN, INDIGENOUS, AND PERSONS OF COLOR (BBIPOC) PROVIDERS. ADDITIONALLY, DENTAL CARE WAS HIGHLIGHTED AS A MAJOR AND FRUSTRATING CHALLENGE FOR MANY PEOPLE IN HUMBOLDT COUNTY, WITH FEW LOCAL DENTAL PROVIDERS AND DIFFICULTY AFFORDING AND ACCESSING SERVICES. THE COSTS AND TIME ASSOCIATED WITH TRAVEL OUT OF THE AREA IS BURDENSOME.STRATEGIES TO ADDRESS ACCESS TO CARE INCLUDE:- INCREASE ACCESS TO CANCER CARE AT ST. JOSEPH HOSPITAL BY PROVIDING TEMPORARY LODGING, TRANSPORTATION ASSISTANCE AND OTHER SUPPORTIVE SERVICES- IMPROVE ACCESS TO FOLLOW UP CARE AND SDOH SUPPORTS FOR PATIENTS RECENTLY DISCHARGED FROM THE HOSPITAL WITH CRHONIC HEALTH CONDITIONS- IMPROVE BIRTH EQUITY FOR PRIORITY POPULATIONS VIA MULTIPLE STRATEGIES INCLUDING INCREASE THE CAPACITY OF INDIGENOUS DOULAS- CONTINUE TO SUPPORT PROGRAMS THAT DEPLOY COMMUNITY HEALTH WORKERS, NAVIGATORS AND SOCIAL WORKERS TO PROVIDE ENROLLMENT, NAVIGATION, CARE COORDINATION SERVICES AND TRANSPORTATION- INCREASE ACCESS TO SPECIALTY CARE AND PROCEDURES FOR UNINSURED- CONTINUE TO SUPPORT ACCESS TO DENTAL CARE IN HUMBOLDT COUNTY; INCLUDES PREVENTIONFOOD INSECURITYKEY INFORMANTS HIGHLIGHTED FOOD INSECURITY AS A KEY NEED AND SIGNIFICANT IN MANY PARTS OF HUMBOLDT COUNTY. KEY INFORMANTS AND CAREGIVERS NOTED MORE RURAL OR ISOLATED PARTS OF THE COUNTY DO NOT HAVE ACCESS TO AFFORDABLE, HEALTHY FOOD OPTIONS. PEOPLE MAY HAVE TO USE THEIR CALFRESH BENEFITS TO BUY FOOD AT GAS STATIONS. COMMUNITY MEMBERS WOULD LIKE TO SEE MORE FOOD RESOURCES AND PANTRIES, PARTICULARLY IN COMMUNITIES BESIDES EUREKA. FOOD PROGRAMS FOR FAMILIES WITH CHILDREN OVER FIVE YEARS IS ALSO NEEDED. EQUITABLE AND INCLUSIVE ACCESS TO HIGH QUALITY FOOD WAS EXPLICITLY PRIORITIZED.STRATEGIES TO ADDRESS FOOD INSECURITY INCLUDE:- OPERATE FOOD PANTRIES AND FOOD PROGRAMS IN ISOLATED COMMUNITIES IN PARTNERSHIP WITH FOOD FOR PEOPLE- SUPPORT AND BUILD CAPACITY IN LOCAL FOOD SECURITY PROGRAMS- SUPPORT AND BUILD CAPACITY FOR LOCAL SCHOOL FARMS AND COMMUNITY GARDENS THAT EMPHASIZE FOOD SOVEREIGNTY AND CULTURALLY RELEVANT FOODSFULL DETAIL OF STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS CAN FOUND IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) HERE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN FULLY ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WHILE ST. JOSEPH HOSPITAL WILL EMPLOY STRATEGIES TO ADDRESS EACH OF THE FOUR SIGNIFICANT HEALTH NEEDS THAT WERE PRIORITIZED DURING THE CHNA PROCESS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT AGENCIES ARE CRITICAL FOR ACHIEVING THE ESTABLISHED GOALS.ST. JOSEPH HOSPITAL WILL COLLABORATE WITH OPEN DOOR COMMUNITY HEALTH CENTERS, THE PUBLIC HEALTH DEPARTMENT, HUMBOLDT STATE UNIVERSITY, THE HUMBOLDT NETWORK OF FAMILY RESOURCE CENTERS, LOCAL PHILANTHROPY, AND OTHERS TO ADDRESS THE COMMUNITY NEEDS AND COORDINATE CARE AND REFERRALS TO ADDRESS UNMET NEEDS.FURTHERMORE, REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL SERVICE AREAS. SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 11 (CONT): THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW:WHILE WE COULD NOT PRIORITIZE ALL OF THE NEEDS IDENTIFIED, WE WILL BE ABLE TO AFFECT MANY OF THE NEEDS BY WORKING ON ROOT CAUSE. FOR EXAMPLE, HEART DISEASE IS NOT A PRIORITY NEED, BUT WE WILL IMPACT THIS HEALTH OUTCOME BY FOCUSING OUR EFFORTS ON PROMOTING GOOD NUTRITION AND FOOD SECURITY. DENTAL CARE IS NOT A PRIORITIZED NEED BUT REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL IS COMMITTED TO WORKING WITH PARTNERS ON THE MULTI-YEAR DENTAL TRANSFORMATION GRANT OUR PUBLIC HEALTH DEPARTMENT RECEIVED FROM THE CA DEPARTMENT OF HEALTH CARE SERVICES. ADDITIONALLY, REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL DOES NOT HAVE A PROGRAM IN PLACE TO DIRECTLY PREVENT ASTHMA OCCURRENCE IN OUR SERVICE AREA; HOWEVER, WE PARTNER WITH SEVERAL ENTITIES, INCLUDING THE PUBLIC HEALTH DEPARTMENT THAT DO ADDRESS ASTHMA PREVENTION. FURTHERMORE, OUR EFFORTS TO IMPROVE THE QUALITY OF HOUSING IN OUR SERVICE HAS THE POTENTIAL TO IMPACT ASTHMA OCCURRENCE.IN ADDITION, REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL WILL COLLABORATE WITH LOCAL ORGANIZATION(S) THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS. SJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 16A: FINANCIAL ASSISTANCE POLICY HTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEQUEEN OF THE VALLEY MEDICAL CENTER - PART V, SECTION B, LINE 16A:FINANCIAL ASSISTANCE POLICY HTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCESJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 16B:FINANCIAL ASSISTANCE APPLICATION HTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEQUEEN OF THE VALLEY MEDICAL CENTER - PART V, SECTION B, LINE 16B:FINANCIAL ASSISTANCE APPLICATION HTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCESJHNC, LLC (GROUP A - 1, 3 & 4) - PART V, SECTION B, LINE 16C:PLAIN LANGUAGE SUMMARY HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCEQUEEN OF THE VALLEY MEDICAL CENTER - PART V, SECTION B, LINE 16C:PLAIN LANGUAGE SUMMARY:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE 4 1 - NKM - GASTROENTEROLOGY & RHEUMATOLOGY 2752 HARRISON AVE STE A2 EUREKA CA 95501 SPECIALTY CLINIC 2 - NQM - DENTAL 3488 VILLA LANE STE 102 NAPA CA 94558 SPECIALTY CLINIC 3 - NRM - ST JOSEPH HEALTH RURAL HEALTH CLIN 3302 RENNER DR FORTUNA CA 955407103 SPECIALTY CLINIC 4 - NSM - LAB 110 LYNCH CREEK WAY STE B PETALUMA CA 95401 SPECIALTY CLINIC PART I, LINE 3C: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. PART I, LINE 6A: SANTA ROSA MEMORIAL HOSPITALSANTA ROSA MEMORIAL HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT:HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/SANTA-ROSA-MEMORIAL-HOSPITAL/COMMUNITY-SUPPORTREDWOOD MEMORIAL HOSPITALREDWOOD MEMORIAL HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/REDWOOD-MEMORIAL/COMMUNITY-SUPPORTST. JOSEPH HOSPITAL OF EUREKAST. JOSEPH HOSPITAL OF EUREKA PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT:HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/ST-JOSEPH-HOSPITAL-EUREKA/COMMUNITY-SUPPORTQUEEN OF THE VALLEY MEDICAL CENTERQUEEN OF THE VALLEY MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE ATHTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/QUEEN-OF-THE-VALLEY/ABOUT-US/COMMUNITY-OUTREACH PART I, LINE 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING WORKSHEET 2, A COST-TO-CHARGE RATIO AND GENERAL LEDGER. PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. PART III, LINE 4: AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019. PART III, LINE 8: THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. PART III, LINE 9B: COLLECTION ACTIVITYOUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE AND WHILE PENDING A FINAL DETERMINATION FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: NEEDS ASSESSMENT:SANTA ROSA MEMORIAL HOSPITALTHROUGH A MIXED-METHODS APPROACH USING QUANTITATIVE AND QUALITATIVE DATA, OUR CHNA PROCESS USED SEVERAL SOURCES OF INFORMATION TO IDENTIFY COMMUNITY NEEDS. ACROSS SONOMA COUNTY, INFORMATION COLLECTED INCLUDES PUBLIC HEALTH DATA REGARDING HEALTH BEHAVIORS, MORBIDITY AND MORTALITY, AND HOSPITAL-LEVEL DATA. IN 2019, ST. JOSEPH HEALTH SONOMA PARTNERED WITH SUTTER HEALTH AND KAISER PERMANENTE TO GATHER DATA FROM LISTENING SESSIONS AND INTERVIEWS WITH DIVERSE, LOW-INCOME AND MEDICALLY UNDERSERVED COMMUNITIES IN SONOMA COUNTY. IN 2020, INDIVIDUAL STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM ORGANIZATIONS THAT SERVE THESE POPULATIONS TO BETTER UNDERSTAND THE IMPACTS OF COVID-19 IN OUR COMMUNITIES. IN ADDITION, STAKEHOLDER PARTICIPATION IN HEALTH ACTION SONOMA COUNTY, A MULTISECTOR COLLABORATIVE, ENSURES ONGOING ASSESSMENT TO ADDRESS SIGNIFICANT NEEDS AS THEY ARISE THROUGHOUT THE YEAR.REDWOOD MEMORIAL HOSPITALIN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, REDWOOD MEMORIAL HOSPITAL, FORTUNA COMMUNITY BENEFIT STAFF ARE CORE MEMBERS OF MULTIPLE CROSS-SECTOR COLLABORATIVES INCLUDING AN ACCOUNTABLE COMMUNITY FOR HEALTH, COAD AND LIVE WELL HUMBOLDT (LWH). HUMBOLDT COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LWH, AND THIS PUBLIC AND PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 20 AGENCIES. FRONTLINE CB CAREGIVERS ALSO PROVIDE ONGOING INFORMATION AND FEEDBACK ABOUT NEEDS THEIR CLIENTS FACE IN REAL TIME. THE ORGANIZATION ALSO PARTNERS WITH CAL POLY HUMBOLDT, COLLEGE OF THE REDWOODS AND OTHER NONPROFITS TO CONDUCT SURVEYS OF VULNERABLE POPULATIONS. IN ADDITION TO LWH, REDWOOD MEMORIAL HOSPITAL, FORTUNA STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS.ST. JOSEPH HOSPITAL OF EUREKAIN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, ST. JOSEPH HOSPITAL COMMUNITY BENEFIT STAFF ARE CORE MEMBERS OF MULTIPLE CROSS-SECTOR COLLABORATIVES INCLUDING AN ACCOUNTABLE COMMUNITY FOR HEALTH, COAD AND LIVE WELL HUMBOLDT (LWH). HUMBOLDT COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LWH, AND THIS PUBLIC AND PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 20 AGENCIES. FRONTLINE CB CAREGIVERS ALSO PROVIDE ONGOING INFORMATION AND FEEDBACK ABOUT NEEDS THEIR CLIENTS FACE IN REAL TIME. THE ORGANIZATION ALSO PARTNERS WITH CAL POLY HUMBOLDT, COLLEGE OF THE REDWOODS AND OTHER NONPROFITS TO CONDUCT SURVEYS OF VULNERABLE POPULATIONS. IN ADDITION TO LWH, ST. JOSEPH HOSPITAL STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS.QUEEN OF THE VALLEY MEDICAL CENTERIN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, QUEEN OF THE VALLEY COMMUNITY BENEFIT STAFF ARE CORE MEMBERS OF LIVE HEALTHY NAPA COUNTY (LHNC). NAPA COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LHNC, AND THIS PUBLIC AND PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 40 AGENCIES. LHNC MEETS REGULARLY, HAS A WEB SITE AND SENDS ELECTRONIC NEWSLETTERS AND UPDATES FOR ANY URGENT COMMUNITY NEEDS THAT ARISE BETWEEN MEETINGS. QUEEN OF THE VALLEY IS ALSO ACTIVE IN THE NAPA VALLEY COMMUNITY ORGANIZATIONS ACT DEVELOPS AND ENHANCES PARTNERSHIPS FOR COMMUNICATION, COORDINATION AND COLLABORATION AMONGST THE WHOLE COMMUNITY DURING ALL PHASES OF DISASTER. NAPA'S COMMUNITY LEADERS COALITION WORKS TO MOBILIZE COMMUNITY LEADERS TO COLLECTIVELY ADVOCATE FOR THE NEEDS OF VULNERABLE POPULATIONS THROUGHOUT NAPA COUNTY. QUEEN OF THE VALLEY STRATEGIC SERVICES CONTINUOUSLY CONDUCTS ANALYSIS AND REPORTS ON COMMUNITY NEEDS AND TRENDS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE.PROVIDENCE ENSURES THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES. TRAINING IS PROVIDED TO STAFF MEMBERS (I.E., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS.WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, PROVIDENCE ATTEMPTS TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.PROVIDENCE SHARES THEIR FINANCIAL ASSISTANCE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS. PART VI, LINE 4: SANTA ROSA MEMORIAL HOSPITALSANTA ROSA MEMORIAL HOSPITAL (SRMH), FOUNDED BY THE SISTERS OF ST. JOSEPH OF ORANGE, HAS BEEN SERVING THE HEALTHCARE NEEDS OF FAMILIES IN THE COMMUNITY FOR MORE THAN 60 YEARS. DURING THIS TIME, ITS MISSION HAS REMAINED THE SAME: TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES SERVED. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS PROVIDENCE ST. JOSEPH HEALTH (PSJH), SRMH IS PART OF A COUNTYWIDE DELIVERY NETWORK THAT INCLUDES THREE HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRY'S CORE FACILITIES ARE PETALUMA VALLEY HOSPITAL (PVH), AN 80-BED ACUTE CARE HOSPITAL, SANTA ROSA MEMORIAL HOSPITAL, A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER, AND HEALDSBURG HOSPITAL, A 43-BED CRITICAL ACCESS HOSPITAL AND CERTIFIED STROKE CENTER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY. SRMH PROVIDES SOUTHERN MENDOCINO, NORTHERN MARIN, AND SONOMA COUNTIES' COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM UKIAH IN THE NORTH, MARSHALL IN THE SOUTH, SONOMA VALLEY IN THE EAST AND BODEGA BAY IN THE WEST. SRMH'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF SANTA ROSA, PETALUMA, SEBASTOPOL, WINDSOR, HEALDSBURG, ROHNERT PARK, COTATI, SONOMA, CLOVERDALE, UKIAH, AND POINT ARENA.DEFINING THE COMMUNITY:SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION ESTIMATED TO BE NEARLY 171,000 IN 2012 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. AT LEAST PART OF SONOMA COUNTY, CALIFORNIA, IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). THE AREA IS 0.8 SQUARE MILES AND IS LOCATED NEAR DOWNTOWN SANTA ROSA. THE CLOVERDALE AREA IN SONOMA COUNTY IS A DESIGNATED PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (PC-HSPA). SRMH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL IS LOCATED IN DOWNTOWN SANTA ROSA, ABOUT 55 MILES NORTH OF SAN FRANCISCO JUST OFF THE HIGHWAY 101 CORRIDOR IN CENTRAL SONOMA COUNTY. SRMH'S PRIMARY SERVICE AREA IS LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE COUNTY, PLUS NORTHERN MARIN COUNTY AND SOUTHERN MENDOCINO COUNTY. THE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY.SRMH TOTAL SERVICE AREA:THE COMMUNITY SERVED BY SRMH IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF SRMH'S INPATIENTS. THE SRMH TOTAL SERVICE AREA IS COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWING CRITERIA:- PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS)- SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY)- INCLUDES ZIP CODES FOR CONTINUITY- NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.)- CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTH THE PSA IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF SRMH'S PATIENTS ORIGINATE. THE CITIES AND TOWNS IN THE SRMH PSA INCLUDE SANTA ROSA, SEBASTOPOL, WINDSOR, FORESTVILLE, ROHNERT PARK AND COTATI/PENNGROVE. THE SSA IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE SSA INCLUDES ALL OF SONOMA COUNTY, UKIAH TO THE NORTH IN MENDOCINO COUNTY, AND NORTHERN MARIN COUNTY TO THE SOUTH.OTHER HOSPITALS IN SERVICE AREATHE MINISTRY'S SERVICE AREA IS ALSO SERVED BY SUTTER SANTA ROSA REGIONAL HOSPITAL AND KAISER PERMANENTE SANTA ROSA MEDICAL CENTER AND MEDICAL OFFICES.REDWOOD MEMORIAL HOSPITALBASED ON THE AVAILABILITY OF DATA, GEOGRAPHIC ACCESS TO THE FACILITY, AND OTHER HOSPITALS IN NEIGHBORING COUNTIES, HUMBOLDT COUNTY SERVES AS THE BOUNDARY FOR THE HOSPITAL SERVICE AREA.ST. JOSEPH AND REDWOOD MEMORIAL HOSPITAL PROVIDE HUMBOLDT COUNTY COMMUNITIES WITH ACCESS TO ADVANCED AND COMPASSIONATE CARE. THE HOSPITAL'S COMMUNITY EXTENDS FROM THE HUMBOLDT-DEL NORTE COUNTY LINE IN THE NORTH, GARBERVILLE IN THE SOUTH, WILLOW CREEK, HOOPA, AND BRIDGEVILLE IN THE EAST AND IS BORDERED BY THE PACIFIC OCEAN IN THE WEST. THIS INCLUDES A POPULATION OF APPROXIMATELY 137,000 PEOPLE.TO FACILITATE IDENTIFYING HEALTH DISPARITIES AND SOCIAL INEQUITIES BY PLACE, WE DESIGNATED A "HIGH NEED" SERVICE AREA AND A "BROADER" SERVICE AREA, WHICH TOGETHER MAKE UP THE HUMBOLDT COUNTY SERVICE AREA. BASED ON WORK DONE BY THE PUBLIC HEALTH ALLIANCE OF SOUTHERN CALIFORNIA AND THEIR HEALTHY PLACES INDEX (HPI) TOOL, WE IDENTIFIED THE HIGH NEED SERVICE AREA BASED ON INCOME, EDUCATION, ENGLISH PROFICIENCY, AND LIFE EXPECTANCY.FOR THIS ANALYSIS, CENSUS TRACKS WITH MORE PEOPLE BELOW 200% FEDERAL POVERTY LEVEL (FPL), MORE PEOPLE WITHOUT A HIGH SCHOOL DIPLOMA, MORE LIMITED ENGLISH HOUSEHOLDS, AND A LOWER LIFE EXPECTANCY AT BIRTH WERE IDENTIFIED AS "HIGH NEED." THE MEAN VALUE OF NEAREST NEIGHBORS WAS USED TO INSERT MISSING DATA FOR VARIABLES BY WAY OF THE NEIGHBORHOOD SUMMARY STATISTICS GEOPROCESSING TOOL IN ARCGIS PRO 3.1. ALL VARIABLES WERE WEIGHTED EQUALLY. THE CENSUS TRACTS WERE ASSIGNED A SCORE BETWEEN 0 AND 100 WHERE 0 REPRESENTS THE CENSUS TRACT WITH THE LOWEST NEED AND 100 REPRESENTS THE HIGHEST NEED, ACCORDING TO THE CRITERIA. CENSUS TRACTS THAT SCORED HIGHER THAN THE AVERAGE WERE CLASSIFIED AS A HIGH NEED SERVICE AREA AND ARE DEPICTED IN GREEN. IN THE HUMBOLDT SERVICE AREA, 20 OF 35 CENSUS TRACTS (57%) SCORED ABOVE THE AVERAGE OF 62.5 ON THE PROVIDENCE NEED INDEX (PNI), INDICATING A HIGH NEED.MORE OF THE POPULATION THAT IDENTIFIES AS HISPANIC IS IN THE HIGH NEED SERVICE AREA (14.5%) COMPARED TO THE OVERALL POPULATION OF HISPANIC PEOPLE LIVING IN HUMBOLDT COUNTY (12.3%), INDICATING A DISPARITY. SIMILARLY, THE FOLLOWING RACIAL GROUPS ARE OVERREPRESENTED IN THE HIGH NEED SERVICE AREA COMPARED TO THE OVERALL POPULATION LIVING IN HUMBOLDT COUNTY: AMERICAN INDIAN, ASIAN, BLACK OR AFRICAN AMERICAN, NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER, OTHER OR TWO OR MORE RACES.A SIGNIFICANT DISPARITY IN MEDIAN INCOME EXISTS IN HUMBOLDT COUNTY BETWEEN HOUSEHOLDS IN THE HIGH NEED SERVICE AREA VERSUS THOSE IN THE BROADER SERVICE AREA (A DIFFERENCE OF $18,263). BUT AN EVEN GREATER DISPARITY IN MEDIAN INCOME EXISTS BETWEEN HOUSEHOLDS IN HUMBOLDT COUNTY VERSUS THE STATE OF CALIFORNIA (A DIFFERENCE OF $29,855).HUMBOLDT COUNTY AS A WHOLE (32.6%) AND THE HIGH NEED SERVICE AREA (34.6%) ALSO HAVE A GREATER PERCENTAGE OF RENTER HOUSEHOLDS SPENDING MORE THAN 50% OF INCOME ON HOUSING COSTS THAN THE STATE OF CALIFORNIA (26.3%). THIS INDICATES A SEVERE HOUSING COST BURDEN. COUNTY HEALTH RANKINGS AND ROADMAPS EXPLAINS THE LINK BETWEEN HEALTH AND HOUSING IN THE FOLLOWING WAY: "THERE IS A STRONG AND GROWING EVIDENCE BASE LINKING STABLE AND AFFORDABLE HOUSING TO HEALTH. AS HOUSING COSTS HAVE OUTPACED LOCAL INCOMES, HOUSEHOLDS NOT ONLY STRUGGLE TO ACQUIRE AND MAINTAIN ADEQUATE SHELTER, BUT ALSO FACE DIFFICULT TRADE-OFFS IN MEETING OTHER BASIC NEEDS. WHEN THE MAJORITY OF A PAYCHECK GOES TOWARD THE RENT OR MORTGAGE, IT MAKES IT HARD TO AFFORD DOCTOR VISITS, HEALTHY FOODS, UTILITY BILLS, AND RELIABLE TRANSPORTATION TO WORK OR SCHOOL. THIS CAN, IN TURN, LEAD TO INCREASED STRESS LEVELS AND EMOTIONAL STRAIN."HEALTH PROFESSIONS SHORTAGE AREA:HUMBOLDT COUNTY IS A HEALTH PROFESSIONAL SHORTAGE AREA IN THE AREAS OF PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. IT IS RURAL AND A MEDICALLY UNDERSERVED AREA. REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL ARE LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA), WITH HUMBOLDT COUNTY HAVING FOUR DESIGNATED HIGH NEED HPSAS FOR PRIMARY CARE.A MAJORITY OF THE COUNTY IS DESIGNATED AS A DENTAL HEALTH HPSA, AND ALL OF THE COUNTY IS DESIGNATED AS A MENTAL HEALTH HPSA. ADDITIONALLY, THE FOLLOWING FACILITIES ARE ALL DESIGNATED HPSA FOR PRIMARY CARE, DENTAL HEALTH, AND MENTAL HEALTH: KARUK TRIBE OF CALIFORNIA CLINIC-ORLEANS, K'IMA W MEDICAL CENTER, OPEN DOOR COMMUNITY HEALTH CENTERS, POTAWOT HEALTH VILLAGE, SOUTHERN TRINITY HEALTH SERVICES, EUREKA HEALTH CENTER, AND REDWOODS RURAL HEALTH CENTER, INCORPORATED. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:SANTA ROSA MEMORIAL HOSPITAL (1), QUEEN OF THE VALLEY MEDICAL CENTER (2), REDWOOD MEMORIAL HOSPITAL (3) AND ST. JOSEPH HOSPITAL OF EUREKA (4)THE HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. THE HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. PART VI, LINE 6: AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA AS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND ADVANCING OUR WASTE OPTIMIZATION WORK ACROSS ALL HOSPITALS AND CLINICS.THE FOLLOWING ARE KEY EXAMPLES OF HOW WE ARE INVESTING IN ADVANCING THE HEALTH OF OUR COMMUNITIES: ST. JOSEPH FUND:ST. JOSEPH FUND (SJF) IS PROVIDENCE'S GRANTMAKING FOUNDATION. IT INVESTS IN AND FOSTERS LONG-TERM PARTNERSHIPS, ROOTED IN LOVE, WITH COMMUNITIES TO ENSURE THEY ARE LIVELY, HOPEFUL, HEALTHY, AND JUST.ITS PARTNERSHIPS ARE TAILORED TO PROVIDE EACH GROUP WITH CAPACITY-BUILDING SUPPORT SPECIFIC TO THEIR NEEDS. TOGETHER, THEY BUILD RELATIONSHIPS AND FOSTER ONGOING DIALOGUES BEYOND A GRANT TERM. EACH PARTNERSHIP ENCOURAGES THE ACCESSIBILITY OF STAFF TO GENERATE IDEAS AND INNOVATIONS.SJF INVESTS IN REGIONAL NONPROFITS AND COLLABORATIVES ACROSS ALASKA, CALIFORNIA, MONTANA, OREGON, AND WASHINGTON TO STRENGTHEN AND BUILD THE POWER OF COMMUNITIES, FOCUSING ON BUILDING COMMUNITY IN FOUR KEY AREAS:- DISASTER RESPONSE AND RESILIENCE- LIFELONG EDUCATION THAT OPENS DOORS- POSITIVE CHANGE THROUGH COMMUNITY POWER- COMMUNITY HEALING AND RESILIENCECAPACITY BUILDING IS AT THE CENTER OF SJF'S WORK. BY THAT, IT MEANS INFRASTRUCTURE DEVELOPMENT, INTERNAL ASSESSMENTS, RESEARCH, TRAINING, COHORT LEARNING, EXAMINING POLICIES AND PROCEDURES, AND MORE TO ENCOMPASS THE BUILDING BLOCKS FOR ORGANIZATIONAL POWER TO CARRY FORTH DIRECT COMMUNITY AND SOCIAL IMPACT. IT PARTNERS WITH COMMUNITY MEMBERS TO GO THE DISTANCE WITH THEM TOWARD WHOLENESS. THE SJF DOESN'T JUST FUND INITIATIVES IT REMAINS PARTNERS LONG AFTER THE GRANT FUNDS HAVE BEEN EXPENDED. SJF LEADERS AND THOSE AT THEIR NONPROFIT PARTNERS EACH HAVE LIVED EXPERIENCE AND UNDERSTAND THE NEEDS OF UNDERSERVED COMMUNITIES. THE SJF TEAM IS MOTIVATED BY COMPASSION, KINDNESS, AND THE DESIRE TO BENEFIT OTHERS AND BELIEVES THIS LEADS TO MORE POSITIVE OUTCOMES AND CREATES A SENSE OF FULFILLMENT AND SATISFACTION.ABOVE ALL, SJF BELIEVES IN THE POWER OF THE COMMUNITY.IT CELEBRATES AND CENTERS COMMUNITY EXPERTISE AND EXPERIENCE. IT LISTENS TO THEIR WISDOM. IT UNDERSTANDS THEIR NEEDS. AND IT INVESTS IN THEIR OPPORTUNITIES. SJF ENVISIONS WORKING AND LIVING TOGETHER IN LIVELY, HOPEFUL, HEALTHY, AND JUST COMMUNITIES. THE SJF INVESTS IN LONG-TERM PARTNERSHIPS ROOTED IN LOVE.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/INITIATIVES/ST-JOSEPH-FUNDINVESTING IN OUR COMMUNITIES IS AN ESSENTIAL WAY WE LIVE OUR MISSIONFOR GENERATIONS, THE PROVIDENCE FAMILY OF ORGANIZATIONS HAS SERVED AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. GUIDED BY COMMUNITY HEALTH NEEDS ASSESSMENTS, WE CONTINUE OUR LONGSTANDING COMMITMENT TO THOSE IN NEED THROUGH COMMUNITY BENEFIT AND OTHER HIGH-IMPACT INVESTMENTS.OUR INVESTMENTS GO BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS AND DEEP INTO COMMUNITIES TO SUPPORT ORGANIZATIONS AND CAUSES THAT SERVE THOSE IN NEED; ADDRESS GAPS IN SERVICES AND RESOURCES THAT CONTRIBUTE TO OVERALL HEALTH; AND ENHANCE CARE DELIVERY WITH INNOVATIVE SOLUTIONS TO HEALTH CARE'S BIGGEST CHALLENGES. THIS IS HOW WE INVEST IN HEALTH TODAY TO CREATE A BETTER FUTURE. BELOW WE HIGHLIGHT KEY EXAMPLES. PART VI, LINE 7, REPORTS FILED WITH STATES CA SCHEDULE H, PART VI, LINE 4 (CONTINUED): REDWOOD MEMORIAL HOSPITAL (CONTINUED)MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA:MEDICALLY UNDERSERVED AREAS (MUAS) AND MEDICALLY UNDERSERVED POPULATIONS (MUPS) ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATIONS THAT DEMONSTRATE A SHORTAGE OF HEALTH CARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING THE COMMUNITY HEALTH CENTER FUND TO THE AREAS OF GREATEST NEED. MUAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE." MUPS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MUAS AND MUPS ARE PERMANENTLY SET AND NO RENEWAL PROCESS IS NECESSARY. THERE ARE MUAS IN HUMBOLDT COUNTY, BUT NO MUPS.OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITALS IN HUMBOLDT COUNTY INCLUDE ST. JOSEPH HOSPITAL IN EUREKA, MAD RIVER COMMUNITY HOSPITAL IN ARCATA AND JEROLD PHELPS COMMUNITY HOSPITAL IN GARBERVILLE. SCHEDULE H, PART VI, LINE 4 (CONTINUED): ST. JOSEPH HOSPITAL OF EUREKACOMMUNITY INFORMATION:BASED ON THE AVAILABILITY OF DATA, GEOGRAPHIC ACCESS TO THE FACILITY, AND OTHER HOSPITALS IN NEIGHBORING COUNTIES, HUMBOLDT COUNTY SERVES AS THE BOUNDARY FOR THE HOSPITAL SERVICE AREA.ST. JOSEPH AND REDWOOD MEMORIAL HOSPITAL PROVIDE HUMBOLDT COUNTY COMMUNITIES WITH ACCESS TO ADVANCED AND COMPASSIONATE CARE. THE HOSPITAL'S COMMUNITY EXTENDS FROM THE HUMBOLDT-DEL NORTE COUNTY LINE IN THE NORTH, GARBERVILLE IN THE SOUTH, WILLOW CREEK, HOOPA, AND BRIDGEVILLE IN THE EAST AND IS BORDERED BY THE PACIFIC OCEAN IN THE WEST. THIS INCLUDES A POPULATION OF APPROXIMATELY 137,000 PEOPLE.TO FACILITATE IDENTIFYING HEALTH DISPARITIES AND SOCIAL INEQUITIES BY PLACE, WE DESIGNATED A "HIGH NEED" SERVICE AREA AND A "BROADER" SERVICE AREA, WHICH TOGETHER MAKE UP THE HUMBOLDT COUNTY SERVICE AREA. BASED ON WORK DONE BY THE PUBLIC HEALTH ALLIANCE OF SOUTHERN CALIFORNIA AND THEIR HEALTHY PLACES INDEX (HPI) TOOL, WE IDENTIFIED THE HIGH NEED SERVICE AREA BASED ON INCOME, EDUCATION, ENGLISH PROFICIENCY, AND LIFE EXPECTANCY.FOR THIS ANALYSIS, CENSUS TRACKS WITH MORE PEOPLE BELOW 200% FEDERAL POVERTY LEVEL (FPL), MORE PEOPLE WITHOUT A HIGH SCHOOL DIPLOMA, MORE LIMITED ENGLISH HOUSEHOLDS, AND A LOWER LIFE EXPECTANCY AT BIRTH WERE IDENTIFIED AS "HIGH NEED." THE MEAN VALUE OF NEAREST NEIGHBORS WAS USED TO INSERT MISSING DATA FOR VARIABLES BY WAY OF THE NEIGHBORHOOD SUMMARY STATISTICS GEOPROCESSING TOOL IN ARCGIS PRO 3.1. ALL VARIABLES WERE WEIGHTED EQUALLY. THE CENSUS TRACTS WERE ASSIGNED A SCORE BETWEEN 0 AND 100 WHERE 0 REPRESENTS THE CENSUS TRACT WITH THE LOWEST NEED AND 100 REPRESENTS THE HIGHEST NEED, ACCORDING TO THE CRITERIA. CENSUS TRACTS THAT SCORED HIGHER THAN THE AVERAGE WERE CLASSIFIED AS A HIGH NEED SERVICE AREA AND ARE DEPICTED IN GREEN. IN THE HUMBOLDT SERVICE AREA, 20 OF 35 CENSUS TRACTS (57%) SCORED ABOVE THE AVERAGE OF 62.5 ON THE PROVIDENCE NEED INDEX (PNI), INDICATING A HIGH NEED.MORE OF THE POPULATION THAT IDENTIFIES AS HISPANIC IS IN THE HIGH NEED SERVICE AREA (14.5%) COMPARED TO THE OVERALL POPULATION OF HISPANIC PEOPLE LIVING IN HUMBOLDT COUNTY (12.3%), INDICATING A DISPARITY. SIMILARLY, THE FOLLOWING RACIAL GROUPS ARE OVERREPRESENTED IN THE HIGH NEED SERVICE AREA COMPARED TO THE OVERALL POPULATION LIVING IN HUMBOLDT COUNTY: AMERICAN INDIAN, ASIAN, BLACK OR AFRICAN AMERICAN, NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER, OTHER OR TWO OR MORE RACES.A SIGNIFICANT DISPARITY IN MEDIAN INCOME EXISTS IN HUMBOLDT COUNTY BETWEEN HOUSEHOLDS IN THE HIGH NEED SERVICE AREA VERSUS THOSE IN THE BROADER SERVICE AREA (A DIFFERENCE OF $18,263). BUT AN EVEN GREATER DISPARITY IN MEDIAN INCOME EXISTS BETWEEN HOUSEHOLDS IN HUMBOLDT COUNTY VERSUS THE STATE OF CALIFORNIA (A DIFFERENCE OF $29,855).HUMBOLDT COUNTY AS A WHOLE (32.6%) AND THE HIGH NEED SERVICE AREA (34.6%) ALSO HAVE A GREATER PERCENTAGE OF RENTER HOUSEHOLDS SPENDING MORE THAN 50% OF INCOME ON HOUSING COSTS THAN THE STATE OF CALIFORNIA (26.3%). THIS INDICATES A SEVERE HOUSING COST BURDEN. COUNTY HEALTH RANKINGS AND ROADMAPS EXPLAINS THE LINK BETWEEN HEALTH AND HOUSING IN THE FOLLOWING WAY: "THERE IS A STRONG AND GROWING EVIDENCE BASE LINKING STABLE AND AFFORDABLE HOUSING TO HEALTH. AS HOUSING COSTS HAVE OUTPACED LOCAL INCOMES, HOUSEHOLDS NOT ONLY STRUGGLE TO ACQUIRE AND MAINTAIN ADEQUATE SHELTER, BUT ALSO FACE DIFFICULT TRADE-OFFS IN MEETING OTHER BASIC NEEDS. WHEN THE MAJORITY OF A PAYCHECK GOES TOWARD THE RENT OR MORTGAGE, IT MAKES IT HARD TO AFFORD DOCTOR VISITS, HEALTHY FOODS, UTILITY BILLS, AND RELIABLE TRANSPORTATION TO WORK OR SCHOOL. THIS CAN, IN TURN, LEAD TO INCREASED STRESS LEVELS AND EMOTIONAL STRAIN."THE FOLLOWING VARIABLES WERE USED FOR THE PNI ANALYSIS: POPULATION BELOW 200% THE FEDERAL POVERTY LEVEL (AMERICAN COMMUNITY SURVEY, 2021); PERCENT OF POPULATION WITH AT LEAST A HIGH SCHOOL EDUCATION (AMERICAN COMMUNITY SURVEY, 2021); PERCENT OF POPULATION, AGES 5 YEARS AND OLDER IN LIMITED ENGLISH HOUSEHOLDS (AMERICAN COMMUNITY SURVEY, 2021); LIFE EXPECTANCY AT BIRTH (ESTIMATES BASED ON CDC, 2010 - 2015 DATA)HEALTH PROFESSIONS SHORTAGE AREAHUMBOLDT COUNTY IS A HEALTH PROFESSIONAL SHORTAGE AREA IN THE AREAS OF PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. IT IS RURAL AND A MEDICALLY UNDERSERVED AREA. REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL ARE LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA), WITH HUMBOLDT COUNTY HAVING FOUR DESIGNATED HIGH NEED HPSAS FOR PRIMARY CARE. A MAJORITY OF THE COUNTY IS DESIGNATED AS A DENTAL HEALTH HPSA, AND ALL OF THE COUNTY IS DESIGNATED AS A MENTAL HEALTH HPSA. ADDITIONALLY, THE FOLLOWING FACILITIES ARE ALL DESIGNATED HPSA FOR PRIMARY CARE, DENTAL HEALTH, AND MENTAL HEALTH: KARUK TRIBE OF CALIFORNIA CLINIC-ORLEANS, K'IMA W MEDICAL CENTER, OPEN DOOR COMMUNITY HEALTH CENTERS, POTAWOT HEALTH VILLAGE, SOUTHERN TRINITY HEALTH SERVICES, EUREKA HEALTH CENTER, AND REDWOODS RURAL HEALTH CENTER, INCORPORATED.MEDICALLY UNDERSERVED AREAS (MUAS) AND MEDICALLY UNDERSERVED POPULATIONS (MUPS) ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATIONS THAT DEMONSTRATE A SHORTAGE OF HEALTH CARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING THE COMMUNITY HEALTH CENTER FUND TO THE AREAS OF GREATEST NEED. MUAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE." MUPS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MUAS AND MUPS ARE PERMANENTLY SET AND NO RENEWAL PROCESS IS NECESSARY. THERE ARE MUAS IN HUMBOLDT COUNTY, BUT NO MUPS.OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITALS IN HUMBOLDT COUNTY INCLUDE REDWOOD MEMORIAL IN FORTUNA AND MAD RIVER COMMUNITY HOSPITAL IN ARCATA. SCHEDULE H, PART VI, LINE 4 (CONTINUED): QUEEN OF THE VALLEY MEDICAL CENTERQUEEN OF THE VALLEY MEDICAL CENTER'S TOTAL HOSPITAL SERVICE AREA (TSA) INCLUDES APPROXIMATELY 138,000 PEOPLE AND PORTIONS OF NAPA AND SONOMA COUNTIES. THE PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES FOR THE CITIES OF NAPA AND YOUNTVILLE, AND THE SECONDARY SERVICE AREA CONSISTS OF THE CITIES OF AMERICAN CANYON, ST. HELENA, AND BOYES HOT SPRINGS IN SONOMA. OVER 75% OF THE POPULATION OF THE TSA IS IN NAPA COUNTY, AND APPROXIMATELY 90% OF NAPA COUNTY'S POPULATION IS WITHIN THE TSA.A PREMIUM WINE PRODUCING REGION, THERE IS A LARGE AGRICULTURE AND HOSPITALITY INDUSTRY. ALTHOUGH OFTEN VIEWED AS A COMMUNITY OF WEALTH, THE LARGE NUMBER OF LOW WAGE EARNERS IN THESE INDUSTRIES COMBINED WITH THE HIGH COST OF LIVING LEND TO POCKETS OF POVERTY AND INDIVIDUALS AND FAMILIES HAVING DIFFICULTY MEETING BASIC NEEDS.ETHNIC DIVERSITY OF THE TSA INCLUDE 34.7% LATINO, 51% NON-LATINO WHITE WITH JUST UNDER 8% ASIAN AND 2.0% BLACK. NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDERS, AMERICAN INDIAN AND ALASKA NATIVE, AND THOSE IDENTIFYING AS "SOME OTHER RACE" EACH MADE UP UNDER ONE PERCENT OF THE POPULATION.THE MEDIAN HOUSEHOLD INCOME IS $97,421. QUEEN OF THE VALLEY'S TSA HAS A HIGHER PERCENTAGE OF OLDER ADULTS (21.0%) THAN THE MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE". MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. QUEEN OF THE VALLEY, ALONG WITH THE MAJORITY OF THE TSA IS LOCATED IN A MEDICALLY UNDERSERVED POPULATIONS AREA, SIGNIFYING THE IMPORTANCE OF THE MEDICAL CENTER TO THE COMMUNITY IT SERVES STATE.HEALTH PROFESSIONS SHORTAGE AREATHE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. CLINICIANS IN HPSAS ARE WORKING IN AREAS WITH FEWER RESOURCES, HIGHER PATIENT LOADS, AND CHALLENGES WITH RECRUITMENT AND RETENTION. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). ALTHOUGH NAPA COUNTY IS NOT DESIGNATED AS AN HPSA FOR PRIMARY CARE, DENTAL HEALTH, OR MENTAL HEALTH, LARGE PORTIONS OF THE SERVICE AREA TO THE NORTH ARE DESIGNATED AS SHORTAGE AREAS. MOST OF THE GEOGRAPHY TO THE NORTH OF NAPA COUNTY IS CONSIDERED A MENTAL HEALTH HPSA.OTHER HOSPITALS IN SERVICE AREATHERE IS ONE OTHER HOSPITAL IN THE COMMUNITY: ST. HELENA HOSPITAL. SCHEDULE H, PART VI, LINE 6 (CONTINUED): HEALTH EQUITYCHANGE BEGINS WITH USAT PROVIDENCE, WE RECOGNIZE THAT INEQUITY PERSISTS IN NEARLY EVERY MAJOR FACET OF SOCIETY. THAT INCLUDES IN HEALTH CARE AND THE SOCIAL DETERMINANTS OF HEALTH. AND THE CONSEQUENCES ARE OFTEN DEADLY, LEADING TO HIGHER MORTALITY AND MORBIDITY RATES FOR COMMUNITIES OF COLOR AND MARGINALIZED POPULATIONS. TOWARD THAT END:- WE ARE INVESTING $50 MILLION OVER FIVE YEARS TO IMPROVE HEALTH EQUITY IN OUR COMMUNITIES. OUR HEALTH EQUITY STRATEGIC PLAN AND INTERVENTIONS ARE INFORMED BY ADVANCED DATA ANALYTICS AND THE HEALTH PRIORITIES IDENTIFIED WITH OUR LOCAL COMMUNITY PARTNERS AND CARE TEAMS.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/HEALTH-EQUITYADVOCACY AND SOCIAL RESPONSIBILITYIN PARTNERSHIP WITH COMMUNITIES, THE PROVIDENCE FAMILY OF ORGANIZATIONS ADVOCATES FOR RESPONSIBLE, SUSTAINABLE, AND EQUITABLE POLICIES AND PRACTICES. WE REACH BEYOND THE WALLS OF HOSPITALS AND CARE FACILITIES TO WORK WITH LOCAL, STATE AND NATIONAL PARTNERS TO ADVANCE POLICIES DESIGNED TO BETTER SERVE VULNERABLE POPULATIONS AND PROMOTE JUSTICE IN OUR COMMUNITIES. WE ALSO PARTNER TO PROMOTE PRACTICES AND INFRASTRUCTURE THAT WILL SUSTAIN THE PLANET FOR FUTURE GENERATIONS AND TRANSFORM OUR COMMUNITIES FOR A HEALTHIER, MORE EQUITABLE WORLD.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ADVOCACY-AND-SOCIAL-RESPONSIBILITYENVIRONMENTAL STEWARDSHIPTHE PROVIDENCE FAMILY OF ORGANIZATIONS HAS A VISION OF HEALTH FOR A BETTER WORLD. AS SUCH, WE ARE CALLED TO CARE WISELY FOR OUR COMMUNITIES, RESOURCES, AND EARTH. OUR ORGANIZATIONS STRIVE TO BECOME CARBON NEGATIVE BY 2030. THIS BOLD COMMITMENT GOES BEYOND ADDRESSING CARBON EMISSIONS. THE CLIMATE CRISIS CANNOT BE SOLVED WITHOUT ALSO RESPONDING TO SOCIAL AND RACIAL INEQUITIES.WE ARE COMMITTED TO HEALTH EQUITY, INCLUDING ENVIRONMENTAL EQUITY, AS CLIMATE CHANGE IMPACTS WORSEN, AND DISPARITIES AND INEQUITIES WIDEN DUE TO HISTORICAL AND STRUCTURAL CAUSES OF OPPRESSION.THE CURRENT CRISIS CALLS FOR US TO ACT BOLDLY, WITH COMPASSION. WE ARE DOING SO BY HELPING TO CARE FOR OUR COMMON HOME, ENSURING EQUITY TODAY, AND PASSING A HEALTHY PLANET TO THE GENERATIONS OF TOMORROW.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ADVOCACY-AND-SOCIAL-RESPONSIBILITY/ENVIRONMENTAL-STEWARDSHIPWELL BEING TRUSTPROVIDENCE'S WELL BEING TRUST IS A FOUNDATION DEDICATED TO ADVANCING THE MENTAL, SOCIAL, AND SPIRITUAL HEALTH FOR ALL. WITH A BOLD MISSION, VISION AND OVERARCHING GOAL, WELL BEING TRUST IS INVESTING IN APPROACHES THAT HAVE THE POTENTIAL TO MODEL THE WAY FORWARD AND ADVANCE CLINICAL, COMMUNITY AND CULTURAL CHANGETO TRANSFORM THE HEALTH OF THE NATION AND IMPROVE WELL-BEING FOR EVERYONE. FOR MORE INFORMATION GO TO: HTTPS://WELLBEINGTRUST.ORG/ABOUT/INSTITUTE FOR SYSTEMS BIOLOGY: ON OUR JOURNEY TO CREATE HEALTHIER COMMUNITIES, WE ARE TURNING TO THE SCIENCE OF GENOMICS TO HELP INDIVIDUALS MAP A PERSONAL PATH TO WELLNESS. IT'S A UNIQUE APPROACH TO PERSONALIZED MEDICINE THAT WE CALL SCIENTIFIC WELLNESS. THE INSTITUTE FOR SYSTEMS BIOLOGY IS A NOT-FOR-PROFIT BIOMEDICAL RESEARCH ORGANIZATION THAT IS PART OF THE PROVIDENCE FAMILY. THE SCIENTISTS AND ENGINEERS AT ISB ARE WORKING TO UNLOCK THE MYSTERY OF THE GENOME TO LEARN HOW WE CAN KEEP PEOPLE HEALTHY WELL INTO THEIR 90S.THIS IS A PROACTIVE APPROACH TO MEDICINE THAT WILL HELP US SHIFT FROM A DISEASE FOCUS TO A WELLNESS FOCUS. WITH ISB, WE ARE PURSUING RESEARCH IN THE AREAS OF BREAST CANCER SURVIVORSHIP, ALZHEIMER'S, GLIOBLASTOMA AND MARKERS TO HELP US IDENTIFY AND REVERSE DISEASE AT THE EARLIEST POSSIBLE STAGES. OUR PARTNERSHIP GIVES US THE OPPORTUNITY TO BRING THESE ADVANCES TO PEOPLE IN THE COMMUNITIES WE SERVE.FOR MORE INFORMATION GO TO: HTTPS://ISBSCIENCE.ORG/ 1 ABODE SERVICES 40849 FREMONT BLVD FREMONT CA 94538 943087060 501(C)(3) 13000 0 COMMUNITY BENEFIT RESTRICTED GRANT AGEWELL PACE 5789 STATE FARM DRIVE ROHNERT PARK CA 94928 873207747 501(C)(3) 200000 0 COMMUNITY BENEFIT RESTRICTED GRANT ALTERNATIVES FOR BETTER LIVING 701 SCHOOL STREET NAPA CA 94559 943306094 501(C)(3) 9280 0 COMMUNITY BENEFIT RESTRICTED GRANT AMBULATORY SURGERY ACCESS COALITION 353 KEARNY STREET SUITE 201 SAN FRANCISCO CA 94108 943180356 501(C)(3) 185000 0 COMMUNITY BENEFIT RESTRICTED GRANT ATHLETIC REHAB CLINIC 1255 N DUTTON AVE SANTA ROSA CA 95401 872108616 501(C)(3) 25000 0 SPONSORSHIP BUCKELEW PROGRAMS 201 ALAMEDA DEL PRADO SUITE 103 NOVATO CA 94949 237088977 501(C)(3) 349000 0 COMMUNITY BENEFIT RESTRICTED GRANT BURBANK HOUSING 1425 CORPORATE CNTR PKWY SANTA ROSA CA 95407 942837785 501(C)(3) 700000 0 COMMUNITY BENEFIT RESTRICTED GRANT CATHOLIC CHARITIES OF THE DIOCESE OF SANTA ROSA PO BOX 4900 SANTA ROSA CA 95402 942479393 501(C)(3) 747340 0 COMMUNITY BENEFIT RESTRICTED GRANT CERES COMMUNITY PROJECT PO BOX 1562 SEBASTOPOL CA 95473 262250997 501(C)(3) 75000 0 COMMUNITY BENEFIT RESTRICTED GRANT COMMITTEE ON THE SHELTERLESS PO BOX 2744 PETALUMA CA 94953 680176855 501(C)(3) 284486 0 COMMUNITY BENEFIT RESTRICTED GRANT COMMUNITY HEALTH INITIATIVE NAPA COUNTY INC 2140 JEFFERSON ST STE D NAPA CA 94559 251924934 501(C)(3) 15000 0 COMMUNITY BENEFIT RESTRICTED GRANT COMMUNITY RESOURCES FOR CHILDREN 3299 CLAREMONT WAY STE 1 NAPA CA 94558 942524785 501(C)(3) 10000 0 COMMUNITY BENEFIT RESTRICTED GRANT COPE FAMILY CENTER 707 RANDOLPH STREET NAPA CA 94559 942322399 501(C)(3) 99500 0 COMMUNITY BENEFIT RESTRICTED GRANT COPPERTOWER FAMILY MEDICAL CENTER INC 106 E 1ST STREET CLOVERDALE CA 95425 680345901 501(C)(3) 99500 0 COMMUNITY BENEFIT RESTRICTED GRANT GIRLS ON THE RUN NAPA VALLEY 3299 CLAREMONT WAY STE 6 NAPA CA 94558 550906534 501(C)(3) 10000 0 COMMUNITY BENEFIT RESTRICTED GRANT HUMANIDAD THERAPY AND EDUCATION SERVICES 1260 N DUTTON AVE SUITE 230 SANTA ROSA CA 95401 463725156 501(C)(3) 95000 0 COMMUNITY BENEFIT RESTRICTED GRANT JAMBOREE HOUSING CORPORATION 17701 COWAN STE 200 IRVINE CA 92614 330413518 501(C)(3) 500000 0 COMMUNITY BENEFIT RESTRICTED GRANT LEGAL AID OF SONOMA COUNTY 144 SOUTH E STREET SUITE 100 SANTA ROSA CA 95404 680008581 501(C)(3) 156093 0 COMMUNITY BENEFIT RESTRICTED GRANT MENDONOMA HEALTH ALLIANCE 39251 S HIGHWAY 1 GUALALA CA 95445 821813874 501(C)(3) 65000 0 COMMUNITY BENEFIT RESTRICTED GRANT MENTIS 709 FRANKLIN ST NAPA CA 94559 941236934 501(C)(3) 34727 0 OPERATIONAL SUPPORT MOLLYS ANGELS 433 SOSCOL AVE 100 NAPA CA 94559 311675725 501(C)(3) 12000 0 COMMUNITY BENEFIT RESTRICTED GRANT NAMI SONOMA COUNTY 182 FARMERS LN 202 SANTA ROSA CA 95404 680041644 501(C)(3) 65120 0 COMMUNITY BENEFIT RESTRICTED GRANT NAPA VALLEY COMMUNITY ORGANIZATIONS ACTIVE IN DISASTER 980 TRANCAS ST SUITE 9 NAPA CA 94558 920361721 501(C)(3) 14000 0 COMMUNITY BENEFIT RESTRICTED GRANT OLE HEALTH 1141 PEAR TREE LANE NAPA CA 94558 237221695 501(C)(3) 70000 0 COMMUNITY BENEFIT RESTRICTED GRANT ON THE MARGINS INC 132 MARINERO CIRCLE TIBURON CA 94920 922312966 501(C)(3) 250000 0 COMMUNITY BENEFIT RESTRICTED GRANT ON THE MOVE 780 LINCOLN AVE ATTN BRODIE AZEVEDO NAPA CA 94558 753149095 501(C)(3) 55000 0 COMMUNITY BENEFIT RESTRICTED GRANT PUERTAS ABIERTAS COMMUNITY RESOURCE CENT RESOURCE CENT 952 NAPA ST NAPA CA 94559 203126333 501(C)(3) 15000 0 COMMUNITY BENEFIT RESTRICTED GRANT SANTA ROSA COMMUNITY HEALTH 3569 ROUND BARN CIR SANTA ROSA CA 95403 680365296 501(C)(3) 275065 0 COMMUNITY BENEFIT RESTRICTED GRANT SANTA ROSA FIRE FOUNDATION PO BOX 1251 SANTA ROSA CA 95402 871382136 501(C)(3) 6500 0 OPERATIONAL SUPPORT SHARE THE CARE NAPA VALLEY 162 S COOMBS ST NAPA CA 94559 815288335 501(C)(3) 25000 0 COMMUNITY BENEFIT RESTRICTED GRANT ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DR SUITE 100 IRVINE CA 92612 330143024 501(C)(3) 7985399 0 OPERATIONAL SUPPORT THE LIVING ROOM CENTER INC 1207 CLEVELAND AVE SANTA ROSA CA 95401 582675876 501(C)(3) 400000 0 COMMUNITY BENEFIT RESTRICTED GRANT TIDES CENTER 427 MENDOCINO AVE SUITE 100 SANTA ROSA CA 95401 943213100 501(C)(3) 250000 0 COMMUNITY BENEFIT RESTRICTED GRANT UPVALLEY FAMILY RESOURCE CENTER 1500 CEDAR STREET CALISTOGA CA 94515 800023012 501(C)(3) 30000 0 COMMUNITY BENEFIT RESTRICTED GRANT VIA HEART PROJECT 1725 CLAY STREET SUITE 100 SAN FRANCISCO CA 94109 271530938 501(C)(3) 20000 0 COMMUNITY BENEFIT RESTRICTED GRANT 35 0 PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. 1 1 0 0 0 0 0 1 0 KEVIN MANEMANN DIV. CHIEF EXEC - SOUTH - THRU 2/23 0 115132 0 1717844 0 193414 0 9900 0 3387 0 2039677 0 170754 LAUREEN DRISCOLL RN PRESIDENT (PART YEAR) 0 865621 0 500000 0 361142 0 240719 0 34515 0 2001997 0 0 NATHAN HUSMANN CFO/TREASURER 0 525717 0 488588 0 81473 0 165017 0 33678 0 1294473 0 57263 TERRENCE WOOTEN CHIEF EXEC QVMC - THRU 11/23 0 359303 0 424891 0 128239 0 9900 0 24676 0 947009 0 4006 OLUYEMI ADEYANJU ESQ SECRETARY 0 388930 0 301838 0 48827 0 76133 0 13993 0 829721 0 47943 FRANK BEIRNE FRMR REGIONAL COO NORTHERN CA 0 0 0 409060 0 394791 0 0 0 0 0 803851 0 0 CHARLES KASSIS CHIEF EXEC - SONOMA - THRU 11/23 0 419683 0 203869 0 104625 0 14850 0 25227 0 768254 0 0 CHAD KRILICH FORMER CMO 0 0 0 0 522765 0 0 0 0 0 522765 0 55951 0 ROBERTA LUSKIN-HAWK MD FRMR CHIEF EXEC EUREKA 0 0 0 0 0 489091 0 0 0 0 0 489091 0 0 RUSS BRAUN CHIEF MEDICAL OFFICER HOSPITAL 381290 0 40948 0 36709 0 18359 0 6142 0 483448 0 0 0 PATTI PILGRIM REGIONAL CFO, TREASURER - THRU 4/23 0 138985 0 277043 0 37820 0 14850 0 13436 0 482134 0 13469 NAYDU LUCAS CHIEF NURSING OFFICER 303487 0 48802 0 70982 0 17527 0 31261 0 472059 0 0 0 STACIE MILLER CHIEF NURSING OFFICER 344458 0 32069 0 40931 0 17437 0 27922 0 462817 0 0 0 REBECCA ALTHOFF ACUTE CARE RN 393439 0 0 0 18486 0 34028 0 12001 0 457954 0 10735 0 TARINDER KHATKAR CHIEF NURSING OFFICER 239162 0 0 0 177718 0 4093 0 15071 0 436044 0 0 0 DARIAN HARRIS MHA CHIEF EXEC HUMBOLDT - THRU 7/23 0 203683 0 116801 0 34218 0 4950 0 16561 0 376213 0 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 266681 0 24827 0 1367 0 15474 0 15372 0 323721 0 0 KEVIN KLOCKENGA FRMR KE - REG CHIEF EXEC. - NO CA 0 0 0 0 0 281492 0 0 0 0 0 281492 0 0 PART I, LINE 1A PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS, FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES RELATED TO RELOCATION OF NEWLY HIRED EMPLOYEES AND CURRENT EMPLOYEES RELOCATING TO A NEW POSITION. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE ELIGIBLE EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES INCLUDE RENT (EXCLUDING AMOUNTS WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL TITLE CLEARS), NON-REFUNDABLE SECURITY DEPOSITS AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMOPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT IN 2023: TERRENCE WOOTEN - $32,558 FRANK BEIRNE - $394,790 CHARLES KASSIS - $37,626 CHAD KRILICH - $466,814 ROBERTA LUSKIN-HAWK, M.D. - $489,091 TARINDER KHATKAR - $106,400 KEVIN KLOCKENGA - $281,492 NON-QUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: KEVIN MANEMANN - $170,754 NATHAN HUSMANN - $57,263 TERRENCE WOOTEN - $4,006 OLUYEMI ADEYANJU, ESQ. - $47,943 CHAD KRILICH - $55,951 PATTI PILGRIM - $13,469 REBECCA ALTHOFF - $10,735 PART I, LINE 7 NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE - BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID - IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN AND LONG-TERM INCENTIVE PLAN, WHICH ARE PERFORMANCE-BASED ANNUAL INCENTIVE PLANS THAT AFFORD PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE - THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY. TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES: -PROVIDENCE ACROSS SEVEN WESTERN STATES -COVENANT HEALTH IN WEST TEXAS -PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA -KADLEC IN SOUTHEAST WASHINGTON -PACIFIC MEDICAL CENTERS IN SEATTLE, WA -SWEDISH HEALTH SERVICES IN SEATTLE, WA AS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND. THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES. WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDS PROVIDENCE CONTINUES TO EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND ADVANCING OUR WASTE OPTIMIZATION WORK ACROSS ALL HOSPITALS AND CLINICS. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC ON MARCH 31, 2018, ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, SANTA ROSA MEMORIAL HOSPITAL, AND QUEEN OF THE VALLEY MEDICAL CENTER, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OF THEIR NET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED 501(C) (3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WAS CREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THE OPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OF THE HOSPITALS REMAIN THE SAME. 2023 PROGRAM SERVICE ACCOMPLISHMENTS PROVIDENCE ST. JOSEPH HEALTH NORTHERN CALIFORNIA IS COMPRISED OF FOUR MAIN HOSPITAL FACILITIES: SANTA ROSA MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL EUREKA. EACH HOSPITAL FACILITY HAS ITS OWN SERVICE AREA, CONDUCTS ITS OWN CHNA, PREPARES ITS OWN IMPLEMENTATION STRATEGY AND SUBMITS ITS OWN ANNUAL REPORTS. THE THREE PROGRAM ACCOMPLISHMENTS FOR ST. JOSEPH NORCAL ARE HIGHLIGHTED BELOW: CARE NETWORK, PASO A PASO AND MOBILE HEALTH CLINIC. CARE NETWORK: CARE (CARE MANAGEMENT, ADVOCACY, RESOURCES AND EDUCATION) NETWORK IS A NATIONALLY RECOGNIZED, MISSION-DRIVEN, INTENSIVE, COMMUNITY-BASED MEDICAL AND PSYCHOSOCIAL CARE MANAGEMENT PROGRAM UTILIZING AN INTERDISCIPLINARY, RN, SOCIAL WORK, COMMUNITY HEALTH BEHAVIORAL AND SPIRITUAL APPROACH. SERVICES ARE PROVIDED TO PERSONS WITH COMPLEX HEALTH, BEHAVIORAL AND SOCIAL CHALLENGES. CLIENTS ARE SERVED IN THE COMMUNITY THEY RESIDE, INCLUDING ENCAMPMENTS, SHELTERS, HOME OR AS NEEDED IN A HEALTH PROVIDER OFFICE OR OTHER COMMUNITY SERVICE LOCATION. THE PROGRAM IS AIMED AT CARE COORDINATION AND IMPROVING DISEASE MANAGEMENT AND QUALITY OF LIFE WHILE REDUCING OVERALL GOVERNMENT BURDEN OF HEALTHCARE COST. IN SONOMA COUNTY, CARE NETWORK EXPANDED TO ADD AN ADDITIONAL COMMUNITY HEALTH WORKER TO THE HIGH-UTILIZER TEAM AND ONE ADDITIONAL SUBSTANCE USE NAVIGATOR, WORKING WITH CLIENTS WITH BEHAVIORAL HEALTH CHALLENGES, CO-OCCURRING SUBSTANCE USE DISORDERS, AS WELL AS COMPLEX MEDICAL CONDITIONS THAT REQUIRE CARE COORDINATION, CASE MANAGEMENT AND CONNECTION TO MENTAL HEALTH SERVICES. ADDITIONALLY, CARE NETWORK HAS ESTABLISHED A NARCAN DISTRIBUTION PROGRAM WITH THE LOCAL PROVIDENCE EMERGENCY DEPARTMENTS. CARE NETWORK REGION-WIDE HAS BEEN ACCEPTED AS ENHANCED CARE MANAGEMENT PROVIDERS THROUGH PARTNERSHIP HEALTH PLAN OF CALIFORNIA. CARE NETWORK PROGRAMS WERE SELECTED TO CONDUCT OUTREACH, ENROLLMENT AND ENHANCED SERVICES FOR POPULATIONS OF FOCUS INCLUDING THOSE EXPERIENCING HOMELESSNESS, HIGH UTILIZERS OF EMERGENCY DEPARTMENTS, AND ADULTS WITH SERIOUS MENTAL ILLNESS OR SUBSTANCE USE DISORDER. IN 2023, CARE NETWORK ENROLLED 255 INDIVIDUALS IN ECM SERVICES AND HELPED THEM ACCESS NEEDED HOUSING, FOOD, SKILLED NURSING, SUD AND MENTAL HEALTH SERVICES AND CRITICAL MEDICAL CARE. ACROSS ALL SERVICE AREAS, CARE NETWORK SERVED PATIENTS THROUGH 88,074 ENCOUNTERS. CY23 NET BENEFIT = $7,410,814. PASO A PASO: ST. JOSEPH HEALTH NORTHERN CALIFORNIA OFFERS A CONTINUUM OF COMMUNITY HEALTH IMPROVEMENT SERVICES TO ITS COMMUNITIES IN ORDER TO MEET IDENTIFIED NEEDS. THIS INCLUDES A PROGRAM CALLED PASO A PASO (STEP BY STEP) WHICH IS INTENDED TO PROVIDE PERINATAL AND PARENTING EDUCATION AND SUPPORT SERVICES AND COMMUNITY-BASED CASE MANAGEMENT SERVICES TO SPANISH SPEAKING PEOPLE, PRIMARILY LATINA BIRTHING PEOPLE AND THEIR FAMILY, IN THE HOSPITAL SERVICE AREA. THE PASO A PASO PROGRAM ALSO PROVIDES PRIMARY PREVENTION INTERVENTIONS INCLUDING HEALTH AND WELLBEING PROMOTION, CULTURAL CELEBRATIONS, NATIVE FOOD GARDENS, SUPPORT GROUPS, INCLUSIVE ACTIVITIES FOR FAMILIES WITH CHILDREN WITH SPECIAL NEEDS AND MORE. IN 2023, THE PASO A PASO PROGRAM HAD 18,283 ENCOUNTERS. INCLUDED IN THESE ENCOUNTER NUMBERS ARE ALSO LATINO OUTREACH FOR HEALTH INSURANCE ENROLLMENT, HEALTHCARE NAVIGATION AND SOCIAL SERVICES CONNECTIONS AND SUPPORT. THE PASO A PASO PROGRAM IS STAFFED WITH COMMUNITY HEALTH WORKERS THAT ARE BI-LINGUAL AND BI-CULTURAL AS WELL AS ONE MASTERS PREPARED SOCIAL WORKER THAT IS ALSO CULTURALLY MATCHED. CY23 NET BENEFIT = $733,508. MOBILE HEALTH CLINIC: OUR MOBILE HEALTH CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN 2023, IN OUR SERVICE AREA, THE CLINIC SERVED 1,678 PATIENTS OVER 3,767 ENCOUNTERS AT SEVERAL LOCATIONS, INCLUDING THE CITIES OF SONOMA/BOYES HOT SPRINGS, SANTA ROSA, CLOVERDALE, WINDSOR, ROHNERT PARK, PETALUMA, BODEGA BAY, AND SEBASTOPOL. THE MOBILE HEALTH TEAM ALSO SERVED SEVERAL LOCAL HOMELESS SHELTERS, ENCAMPMENTS AND RURAL COMMUNITIES, PROVIDING DIRECT PATIENT CARE. CY23 NET BENEFIT = $891,767. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/NORTHERN-CALIFORN IA FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATION'S SECTION 4960 TAX ANALYSIS AND REPORTING. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBER RESERVES THE RIGHT TO APPOINT THE ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, REVISED IN 2023, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY CORE LEADERS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS RECUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE A PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN JUNE 2024. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. FORM 990, PART IX, LINE 11G MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 101,649,358. MANAGEMENT AND GENERAL EXPENSES 4,690,446. FUNDRAISING EXPENSES 249,208. TOTAL EXPENSES 106,589,012. AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 44,237,138. MANAGEMENT AND GENERAL EXPENSES 2,041,252. FUNDRAISING EXPENSES 108,454. TOTAL EXPENSES 46,386,844. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 69,477,300. MANAGEMENT AND GENERAL EXPENSES 3,205,918. FUNDRAISING EXPENSES 170,333. TOTAL EXPENSES 72,853,551. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 21,761,012. MANAGEMENT AND GENERAL EXPENSES 1,004,127. FUNDRAISING EXPENSES 53,350. TOTAL EXPENSES 22,818,489. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 8,314,913. MANAGEMENT AND GENERAL EXPENSES 383,678. FUNDRAISING EXPENSES 20,385. TOTAL EXPENSES 8,718,976. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 510. MANAGEMENT AND GENERAL EXPENSES 24. FUNDRAISING EXPENSES 1. TOTAL EXPENSES 535. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 43,408,074. FAS 136 - RECIPIENT ORGANIZATION ADJUSTMENT 1,648,124. OTHER CHANGES IN NET ASSETS 540,301. COLLABRIA CARE 414 SOUTH JEFFERSON STREET NAPA CA 94559 680393144 HEALTHCARE CA 501(C)(3) 10 SJHCN 1 COVENANT ACO 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 611573313 HEALTHCARE TX 501(C)(3) 12, I CHS 1 COVENANT CHILDREN'S PHYSICIANS GROUP 3615 19TH STREET LUBBOCK TX 79410 881290850 HEALTHCARE TX 501(C)(3) PENDING CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 461259908 HEALTHCARE CA 501(C)(3) 12, III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 463516417 HEALTHCARE TX 501(C)(3) 12, I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS 1 COVENANT HOME AND COMMUNITY CARE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 920275096 HEALTHCARE TX 501(C)(3) 10 CHS 1 COVENANT HOSPITAL HOBBS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 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