2024-05-06T14:27:18-05:00 2023-06-30 135565207 KPMG LLP 301 MAIN ST ONE AMERICAN PL STE 2150 BATON ROUGE LA 708011705 990 2022-07-01 810817660 ARKANSAS CHILDREN'S NORTHWEST INC ARKA 4797256800 1 CHILDRENS WAY LITTLE ROCK AR 72202 MARCELLA DODERER PRESIDENT/CEO 5013648000 2024-05-06 1 MARCELLA DODERER 999009999 0 RYAN HOOKS P00746825 2253444000 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARCELLA DODERER 1 CHILDRENS WAY LITTLE ROCK AR 72202 128704242 0 X WWW.ARCHILDRENS.ORG X 2015 AR WE CHAMPION CHILDREN BY MAKING THEM BETTER TODAY AND HEALTHIER TOMORROW. 14 11 704 290 0 0 9565863 12480553 95777725 113475618 293957 1512248 752708 1235823 106390253 128704242 279200 8543095 0 0 40061463 49502235 0 0 0 51704599 59087862 92045262 117133192 14344991 11571050 225679663 232631693 85628703 80945201 140050960 151686492 X WE CHAMPION CHILDREN BY MAKING THEM BETTER TODAY AND HEALTHIER TOMORROW.CONTINUED ON SCHEDULE O.ARKANSAS CHILDREN'S WILL FUNDAMENTALLY TRANSFORM HEALTHCARE DELIVERY FOR THE CHILDREN OF ARKANSAS AND BEYOND. ARKANSAS CHILDREN'S CORE VALUES ARE THE ORGANIZATIONAL PRINCIPLES THAT HIGHLIGHT OUR REGARD FOR EACH OTHER AND THOSE WE SERVE:SAFETY: WE ARE VIGILANT ABOUT CREATING AN ERROR-FREE ENVIRONMENT FOR PATIENTS, FAMILIES, AND TEAM MEMBERS.TEAMWORK: WE DEMONSTRATE ACTIONABLE CARE AND CONCERN FOR PATIENTS, FAMILIES, AND TEAM MEMBERS.COMPASSION: WE COORDINATE, COMMUNICATE, COOPERATE, AND COLLABORATE TO ENSURE THE HIGHEST LEVEL OF SERVICE FOR OUR PATIENTS, FAMILIES, AND TEAM MEMBERS.EXCELLENCE: WE ACHIEVE THE HIGHEST OF STANDARDS AND SERVE WITH DISTINCTION IN ORDER TO BE THE BEST.SAFETY AND EXCELLENCE FRAME OUR WORK. TEAMWORK AND COMPASSION PLACE PEOPLE AT THE CENTER OF ALL WE DO. 0 0 99168064 8543095 113787168 ARKANSAS CHILDREN'S NORTHWEST (ACNW) IS A PEDIATRIC HOSPITAL LOCATED IN SPRINGDALE, ARKANSAS THAT OPENED ON FEBRUARY 27, 2018. THE HOSPITAL INCLUDES INPATIENT BEDS, EMERGENCY CARE, DIAGNOSTIC SERVICES AND CLINIC SPACE. THE 37-ACRE CAMPUS INCLUDES NATURE TRAILS AND GARDENS FOR PATIENTS AND THEIR FAMILIES. DURING THE YEAR ENDED JUNE 30, 2023, ACNW'S UTILIZATION WAS AS FOLLOWS: 4,035 ADMISSIONS WITH AN AVERAGE STAY OF 2.01 DAYS; 7,661 PATIENT DAYS; 21.0 AVERAGE DAILY CENSUS; 79,451 OUTPATIENT VISITS, EXCLUDING ER VISITS WHICH WERE 45,913; AND 5,285 SURGERIES. CONTINUED ON SCHEDULE O.ACNW, THE REGION'S FIRST AND ONLY PEDIATRIC HOSPITAL, IS A LEVEL IV PEDIATRIC TRAUMA CENTER. ACNW WILL ADVANCE PEDIATRIC HEALTHCARE IN THE NORTHWEST PORTION OF ARKANSAS AND PROVIDE CARE CLOSE TO HOME FOR MORE THAN 200,000 CHILDREN IN THE REGION BY PROVIDING THE FOLLOWING SERVICES:*24 INPATIENT BEDS TO CARE FOR CHILDREN REQUIRING OVERNIGHT STAYS*24-HOUR PEDIATRIC EMERGENCY DEPARTMENT*A 4-BED CLINICAL DECISION UNIT*AN OUTPATIENT CLINIC WITH 30 EXAM ROOMS SUPPORTING MORE THAN 20 SUBSPECIALTY AREAS AND A PRIMARY CARE CLINIC*PEDIATRIC SURGERY UNIT WITH 5 OPERATING ROOMS*A FULL RANGE OF ANCILLARY AND DIAGNOSTIC SERVICES*IMAGING CAPABILITIES (MRI, CT, ULTRASOUND, AND ROUTINE X-RAY)*DIAGNOSTIC SERVICES (INFUSION, PFT, EEG, ECHO, NEUROPHYSIOLOGY, AUDIOLOGY, AND REHABILITATION)*HELIPAD AND REFUELING STATION SUPPORTING THE HELICOPTER TRANSPORT TEAM, ONE OF THE NATION'S LEADING PEDIATRIC INTENSIVE CARE TRANSPORT SERVICES 99168064 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 63 0 1 704 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 11 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X GENA WINGFIELD 5013642555 1 CHILDRENS WAY LITTLE ROCK AR 72202 MARCELLA DODERER PRESIDENT/CEO 0.18 56.42 X X 0 2003751 270566 RON CLARK TRUSTEE/DIRECTOR 0.03 0.32 X 0 0 0 JON DYER TRUSTEE/DIRECTOR (PARTIAL YEAR) 0.17 0.03 X 0 0 0 HARRY C ERWIN TRUSTEE/DIRECTOR 0.10 0.68 X 0 0 0 GARY GEORGE TRUSTEE/DIRECTOR 0.12 0.23 X 0 0 0 AARON MARSHALL TRUSTEE/DIRECTOR 0.03 0.00 X 0 0 0 PAT MCCLELLAND TRUSTEE/DIRECTOR 0.21 0.42 X 0 0 0 JOHN NOLEN MD TRUSTEE/DIRECTOR (PARTIAL YEAR) 0.21 0.03 X 0 0 0 CHARLES REDFIELD TRUSTEE/DIRECTOR 0.10 0.00 X 0 0 0 JOHN ROBERTS BOARD TREASURER 0.10 0.00 X 0 0 0 MARSHALL SAVIERS TRUSTEE/DIRECTOR (PARTIAL YEAR) 0.07 0.00 X 0 0 0 ROBERT SAYLORS MD TRUSTEE/DIRECTOR-CHIEF OF MED STAFF 0.22 55.00 X 0 291075 57620 STEVE STAFFORD TRUSTEE/DIRECTOR 0.06 0.00 X 0 0 0 CELIA SWANSON TRUSTEE/DIRECTOR 0.06 0.59 X 0 0 0 KC TUCKER VICE CHAIR 0.26 0.04 X 0 0 0 BARBARA TYSON TRUSTEE/DIRECTOR 0.09 0.00 X 0 0 0 NOEL WHITE CHAIR OF THE BOARD 0.13 0.00 X 0 0 0 GENA WINGFIELD EVP AND CFO 0.00 48.06 X 0 819786 96771 FREDERICK BARR MD EVP-CHIEF CLINICAL & ACADEMIC OFCR 6.00 54.31 X 0 872402 96924 JAMIE WIGGINS EVP/COO 0.00 50.00 X 0 644204 71983 LE'KITA BROWN REVENUE CYCLE VP 0.00 50.00 X 0 309846 21964 CINDY HILL FINANCIAL SERVICES VP 0.00 55.00 X 0 336822 24096 SHANNON HENDRIX ACNW SVP/CHIEF ADMINISTRATOR 50.00 0.00 X 372794 0 62720 DIANA MCDANIEL OPERATIONS VP 50.00 0.00 X 256344 0 6717 MICHAEL HOWARD VP/CNO 50.00 0.00 X 249787 0 22018 JAMALEE HUNTLEY PHARMACY DIRECTOR 40.00 0.00 X 175551 0 17389 KEITH VEIT PATIENT CARE SVC DIR (PARTIAL YR) 50.00 0.00 X 158641 0 19639 MICAH KIGHT DIRECTOR OF OPERATIONS 50.00 0.00 X 153428 0 30414 JEFFREY WILLIAMS PHARMACY COORDINATOR 40.00 0.00 X 157654 0 25838 SARAH SMITH AMBULATORY SERVICES DIRECTOR 45.00 0.00 X 157631 0 5340 DAVID THIESSEN DIRECTOR OF OPERATIONS 50.00 0.00 X 155803 0 17266 DEMETRIS TATUM RRT IV 48.00 0.00 X 148401 0 11696 KAYLEIGH THOMPSON PHARMACY OPERATIONS MANAGER 50.00 0.00 X 146489 0 15507 2132523 5277886 874468 33 0 1 1 CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 30384 STAFFING SERVICES 5464918 QUALIVIS LLC PO BOX 123847 DALLAS TX 75312 TRAVEL NURSE SERVICES 3186929 COMPASS ONE PO BOX 102289 ATLANTA GA 30368 CAFETERIA SERVICES 2043457 CROTHALL HEALTHCARE 13028 COLLECTION CENTER DRIVE CHICAGO IL 60693 PATIENT TRANSPORT/EVS/LINEN SERVICES 1825386 ALLIED UNIVERSAL SECURITY SERVICE PO BOX 828854 PHILADELPHIA PA 19182 SECURITY SERVICES 1162201 19 12321831 158722 12480553 PMTS FOR MEDICAL SVCS 622110 113475618 113475618 113475618 1512248 1512248 NUTRITIONAL SERVICES 622110 690837 690837 GIFT SHOP 459420 233436 233436 311550 311550 1235823 128704242 113787168 0 2436521 X 8451011 8451011 92084 92084 1929458 976990 952468 40581852 37256001 3325851 6990925 6548242 442683 5361012 2355156 3005856 9150 9150 14075788 11970226 2105562 471615 33078 438537 1448715 1300371 148344 2960482 1230138 1730344 1518366 747091 771275 259523 137129 122394 65829 35237 30592 2658464 2658464 8813355 7172244 1641111 486952 224966 261986 MEDICAL SUPPLIES 18522833 18409189 113644 OTHER ADMIN EXPENSES 1861408 1843105 18303 MINOR EQUIPMENT 352949 284329 68620 DUES & SUBSCRIPTIONS 221421 101477 119944 117133192 99168064 17965128 0 37550475 49784748 11387344 12372725 1149952 1654013 1043288 1018661 162519354 48225242 115171149 114294112 1731262 1783168 57646193 51724266 225679663 232631693 7686255 6124480 71074724 68211163 6867724 6609558 85628703 80945201 X 130160615 134287997 9890345 17398495 140050960 151686492 225679663 232631693 11571050 64482 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6967104 1740548 963065 259550 9411167 6032250 1854372 -666773 252745 6967104 4895940 71460 1332000 267150 6032250 4944705 41476 52607 142848 4895940 3721746 1402615 179656 4944705 0.00000 0.51400 0.48600 0 1 1 7940000 7940000 125630848 27726515 97904333 27653535 20461784 7191751 1294971 36943 1258028 114294112 MEDICAID RECEIVABLE 42167029 OTHER RECEIVABLES 295773 OPERATING LEASES 6571140 DUE FROM AFFILIATES 2681022 GRANT RECEIVABLE 9302 51724266 OPERATING LEASE - NONCURRENT 6120726 OPERATING LEASE - CURRENT 450414 CAPITAL LEASE OBLIGATIONS 38418 6609558 X PART V, LINE 4: EARNINGS FROM ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS. THE FILING ORGANIZATION DOES NOT HOLD ANY ENDOWMENTS; ALL ENDOWMENTS ARE HELD BY ARKANSAS CHILDREN'S FOUNDATION, A RELATED ORGANIZATION. PART X, LINE 2: NOTE: THE AUDIT IS COMPRISED OF THE CONSOLIDATED FINANCIAL STATEMENTS OF ARKANSAS CHILDREN'S, INC., ARKANSAS CHILDREN'S HOSPITAL, ARKANSAS CHILDREN'S FOUNDATION, ARKANSAS CHILDREN'S RESEARCH INSTITUTE, ARKANSAS CHILDREN'S NORTHWEST, ARKANSAS CHILDREN'S CARE NETWORK, ARKANSAS CHILDREN'S MEDICAL GROUP, AND SACOVA INSURANCE COMPANY (COLLECTIVELY, ARKANSAS CHILDREN'S). FOOTNOTE: ARKANSAS CHILDREN'S APPLIES FASB ASC TOPIC 740 (TOPIC 740), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. TOPIC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AND PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY ARKANSAS CHILDREN'S AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 1 X 250.000000000000 1 X 0 1 0 0 2752055 2752055 0.02350 71770655 66543329 5227326 0.04460 74522710 66543329 7979381 0.06810 1208683 33078 1175605 0.01000 39224 39224 0.00030 11827357 4064818 7762539 0.06630 8449571 1560 8448011 0.07210 21524835 4099456 17425379 0.14870 96047545 70642785 25404760 0.21680 1000 1000 0.00000 2000 2000 0.00000 3000 3000 0.00000 1 902151 131963 142204 -10241 X 1 1 1 1 ARKANSAS CHILDREN'S NORTHWEST 2601 GENE GEORGE BLVD SPRINGDALE AR 72762 WWW.ARCHILDRENS.ORG AR5392 X X X X ARKANSAS CHILDREN'S NORTHWEST 1 0 0 1 X X X X X X X X X X 21 1 1 1 1 X WWW.ARCHILDRENS.ORG/RESOURCES/COMMUNITY-NEEDS-ASSESSMENT X X 1 22 1 WWW.ARCHILDRENS.ORG/RESOURCES/COMMUNITY-NEEDS-ASSESSMENT 0 1 X 250.000000000000 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 1 X 0 0 ARKANSAS CHILDREN'S NORTHWEST PART V, SECTION B, LINE 3J: ARKANSAS CHILDREN'S NORTHWEST (ACNW) IS A PRIVATE, NONPROFIT HOSPITAL WITHIN ARKANSAS CHILDREN'S, INC., WHICH IS THE ONLY HEALTHCARE SYSTEM IN THE STATE SOLELY DEDICATED TO CARING FOR THE CHILDREN OF ARKANSAS. ARKANSAS CHILDREN'S, INC. IS A PRIVATE, NON-PROFIT ORGANIZATION WHICH INCLUDES TWO PEDIATRIC HOSPITALS, A PEDIATRIC RESEARCH INSTITUTE AND USDA NUTRITION CENTER, A PHILANTHROPIC FOUNDATION, A NURSERY ALLIANCE, STATEWIDE CLINICS, AND MANY EDUCATION AND OUTREACH PROGRAMS. ACNW, THE FIRST AND ONLY PEDIATRIC HOSPITAL IN THE NORTHWEST ARKANSAS REGION, OPENED IN SPRINGDALE IN EARLY 2018. ACNW DEFINES THE COMMUNITY IT SERVES AS ALL CHILDREN FROM BIRTH TO AGE 18 IN THE 15-COUNTY NORTHWEST REGION OF ARKANSAS (BAXTER, BENTON, BOONE, CARROLL, CRAWFORD, FRANKLIN, JOHNSON, LOGAN, MADISON, MARION, NEWTON, POPE, SCOTT, SEBASTIAN, WASHINGTON). ACCORDING TO THE U.S. CENSUS BUREAU, THERE ARE MORE THAN 200,000 CHILDREN UNDER AGE 18 IN THIS REGION. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONTAINS INFORMATION ABOUT THE NATURAL WONDERS PARTNERSHIP COUNCIL, WHICH IS A DIVERSE COALITION OF CHILD HEALTH ORGANIZATIONS WHO WORK TOGETHER TO IMPROVE CHILD HEALTH. ARKANSAS CHILDREN'S CHNA'S INFORM THE GOALS AND ACTION PLANS OF THE NATURAL WONDERS PARTNERSHIP COUNCIL. IN LIMITED CASES, TO ASSIST IN DEVELOPING A CLEAR PICTURE OF PARTICULAR ISSUES, ADULT DATA WAS ACCESSED AND INCLUDED IN THE ACNW CHNA. THE REPORT ALSO CONTAINS "BIG IDEAS" FROM COMMUNITY STAKEHOLDERS TO HELP INSPIRE THE WORK THAT RESULTS FROM THE CHNA. ARKANSAS CHILDREN'S NORTHWEST PART V, SECTION B, LINE 5: THE FY22 ACNW CHNA WAS CONDUCTED BY ARKANSAS CHILDREN'S COMMUNITY ENGAGEMENT, ADVOCACY, AND HEALTH DIVISION. FOR PORTIONS OF THE CHNA, ARKANSAS CHILDREN'S CONTRACTED WITH BOYETTE STRATEGIC ADVISORS AND KLEIN & PARTNERS. THIS TEAM REVIEWED ALL IRS REQUIREMENTS FOR THE 2022 ASSESSMENT AND DEVELOPED A REVISED AND THOROUGH PROCESS FOR COLLECTING AND ANALYZING ALL PRIMARY AND SECONDARY DATA NEEDED TO MAKE INFORMED DECISIONS ABOUT THE CURRENT CHILDREN'S HEALTH NEEDS IN ARKANSAS. A WIDE VARIETY OF PUBLIC HEALTH AND CHILD HEALTH STAKEHOLDERS PROVIDED INPUT, REVIEWED AND VETTED THE METHODS, DATA, PRIORITIZATION PROCESS, AND FINDINGS OF THE ASSESSMENT.THE STAKEHOLDER ENGAGEMENT PROCESS, AS WELL AS PRIMARY AND SECONDARY DATA REVIEW, OCCURRED FROM JUNE 2021 THROUGH APRIL 2022. A TOTAL OF 808 STAKEHOLDERS IN ARKANSAS PROVIDED THEIR PERSPECTIVES ON THE MOST IMPORTANT CHILD HEALTH ISSUES. STAKEHOLDERS PROVIDED FEEDBACK THROUGH PARTICIPATION IN FOCUS GROUPS, KEY INFORMANT INTERVIEWS, OR A PARENT AND CAREGIVER DIGITAL SURVEY. FOCUS GROUP WERE HELD IN-PERSON AND VIA ZOOM TO SEEK INPUT FROM PARENTS/CAREGIVERS, EDUCATORS, MEDICAL PROVIDERS, AND COMMUNITY LEADERS. A TOTAL OF 19 FOCUS GROUPS ENGAGED 161 OF THESE STAKEHOLDERS, 40 OF WHICH WERE SPECIFICALLY FROM NORTHWEST ARKANSAS. OF THE 19 FOCUS GROUPS, FOUR WERE INTENTIONALLY HELD IN-PERSON, IN SPANISH, AND IN FOUR DIFFERENT REGIONS OF THE STATE: DEQUEEN (SOUTHWEST ARKANSAS), WARREN (SOUTHEAST ARKANSAS), LITTLE ROCK (CENTRAL ARKANSAS), AND SPRINGDALE (NORTHWEST ARKANSAS). EACH FOCUS GROUP CONVERSATION LASTED 60-MINUTES AND WAS RECORDED TO ENSURE THAT ALL COMMENTS WERE CAPTURED FOR ANALYSIS. TWO TEAM MEMBERS LED THE FOCUS GROUPS - ONE WHO FACILITATED THE DISCUSSION AND ONE WHO CAPTURED COMMENTS AND IDENTIFIED THEMES. A FOCUS GROUP GUIDE WAS DEVELOPED TO PROVIDE STRUCTURE FOR THE DISCUSSIONS. IT INCLUDED A FULL SCRIPT OF THE INTRODUCTORY INFORMATION TO BE PROVIDED TO EACH GROUP ABOUT WHY THEY HAD BEEN INVITED TO JOIN THE CONVERSATION AND HOW THE INFORMATION WOULD BE USED TO HELP IDENTIFY AND ADDRESS CHILDREN'S HEALTH NEEDS IN ARKANSAS. IT ALSO INCLUDED POLL QUESTIONS THAT WERE INSERTED INTO THE CONVERSATION INTERMITTENTLY. CONVERSATIONS OPENED WITH GENERAL QUESTIONS ABOUT THEIR THOUGHTS ABOUT THE STATUS OF CHILDREN IN ARKANSAS, FOLLOWED BY MORE SPECIFIC EXPLORATION AROUND SOCIAL DETERMINANTS OF HEALTH, ACCESS TO AND QUALITY OF CLINICAL CARE, PHYSICAL ENVIRONMENT, HEALTHY BEHAVIORS, AND SOCIAL AND ECONOMIC FACTORS IMPACTING HEALTH. EACH TOPIC PROVIDED OPPORTUNITIES FOR THE FACILITATOR TO PROBE DEEPER TO GET FULL PERSPECTIVES FROM PARTICIPANTS. EACH FOCUS GROUP CLOSED WITH PARTICIPANTS BEING GIVEN THE OPPORTUNITY TO SHARE IDEAS OF HOW THEY WOULD IMPROVE CHILDREN'S HEALTH IF UNLIMITED RESOURCES WERE AVAILABLE.A COMBINATION OF INDUCTIVE AND DEDUCTIVE ANALYSIS WAS USED ON THE VERBATIM NOTES AND RECORDINGS CAPTURED DURING THE FOCUS GROUP DISCUSSIONS. ADDITIONALLY, THEMES THAT EMERGED ACROSS MULTIPLE GROUPS, AS WELL AS ANY GROUP DYNAMICS THAT MAY HAVE INFLUENCED COMMENTS, WERE NOTED. USING INITIAL THEMES, COMMENTS AND RESPONSES WERE CODED INTO PRELIMINARY CATEGORIES. ADDITIONAL THEMES OR "SUB-THEMES" THAT SURFACED WERE THEN ADDED TO THE CATEGORIES. THE THEMES AND COMMENTS WERE ORGANIZED IN A SPREADSHEET FORMAT WITH MULTIPLE TABS FOR THEMES RELATED TO THE PARTICULAR AUDIENCE IN THE FOCUS GROUP. A SUMMARY OF HIGH-LEVEL FINDINGS WAS DEVELOPED, ALONG WITH A COMPLETE NARRATIVE REPORT OF THE FOCUS GROUP'S DATA. THE POLL QUESTIONS INSERTED INTO THE DISCUSSIONS ALSO PROVIDED A LIMITED AMOUNT OF QUANTITATIVE DATA FROM THE FOCUS GROUPS.KEY INFORMANT INTERVIEWS WERE CONDUCTED VIA ZOOM BY BOYETTE STRATEGIC ADVISORS IN JULY AND AUGUST 2021. A TOTAL OF 41 SUBJECT MATTER EXPERTS AND OTHER KEY STAKEHOLDERS WERE INTERVIEWED, INCLUDING MEDICAL PROVIDERS, EDUCATORS, POLICY OFFICIALS, ACNW SENIOR LEADERSHIP, AND COMMUNITY LEADERS. THESE INFORMANTS WERE INCLUSIVE OF LEADERS WHO REPRESENTED MINORITY AND IMMIGRANT COMMUNITIES. EIGHT OF THE INFORMANTS WERE FROM NORTHWEST ARKANSAS. QUESTIONS USED FOR THE INTERVIEWS WERE CENTERED ON THE CONDITIONS THAT IMPACT HEALTH OR SOCIAL DETERMINANTS OF HEALTH, BUT ALSO PROVIDED OPPORTUNITIES FOR THE INTERVIEWEES TO SHARE THEIR THOUGHTS ABOUT A VARIETY OF POTENTIAL NEEDS AND CONCERNS. INTERVIEWS ALSO INCLUDED AN OPPORTUNITY FOR KEY INFORMANTS TO SHARE THEIR THOUGHTS ON ANY COVID-19 IMPACT TO CHILDREN'S HEALTH THAT MAY SURFACE OVER THE NEXT THREE TO FIVE YEARS.BOYETTE COMPLETED AN INITIAL ANALYSIS OF THE INTERVIEWS BY IDENTIFYING KEY THEMES THAT EMERGED OVER THE COURSE OF ALL CONVERSATIONS. ALL INTERVIEW NOTES WERE ORGANIZED IN A SPREADSHEET FORMAT THAT ALLOWED FOR QUANTIFYING THE FREQUENCY AND DEPTH OF CONCERNS ABOUT EACH OF THE NEEDS. A SERIES OF INTERSECTING FACTORS ALSO SURFACED AS THE THEMES WERE ANALYZED. BOYETTE PROVIDED A SUMMARY OF FINDINGS FROM THE INTERVIEWS TO THE ARKANSAS CHILDREN'S TEAM, INCLUDING QUOTES FROM KEY INFORMANTS THAT ILLUSTRATED THE PERSPECTIVES THAT WERE COMMON ACROSS MOST OF THE INTERVIEWS.ARKANSAS CHILDREN'S CONTRACTED KLEIN & PARTNERS, A HEALTHCARE FOCUSED MARKET RESEARCH FIRM, TO DESIGN AND FIELD A DIGITAL PARENT AND CAREGIVER SURVEY TO GATHER PARENT/CAREGIVER PERSPECTIVES ON A VARIETY OF ISSUES THAT POTENTIALLY IMPACT CHILDREN'S HEALTH AND WELL-BEING. WHILE THE 2019 CHNA PARENT AND CAREGIVER SURVEY WAS CONDUCTED BY TELEPHONE, THIS SURVEY WAS FIELDED DIGITALLY IN ORDER TO AVOID EMERGING LIMITATIONS WITH THE TELEPHONE METHODOLOGY. THE ONLINE SURVEY WAS FIELDED BETWEEN AUGUST 26 AND SEPTEMBER 16, 2021, TO A TOTAL OF 606 RESPONDENTS ACROSS ARKANSAS, 206 OF WHOM WERE FROM NORTHWEST ARKANSAS. TO ENSURE A VALID AND REPRESENTATIVE SAMPLE, DATA WAS WEIGHTED BY COUNTY, INCOME, EDUCATION, AND ETHNICITY. THE SAMPLE INCLUDED PARENTS OR CAREGIVERS WHO ARE THE HEALTHCARE DECISION-MAKERS FOR THEIR CHILDREN AND DO NOT WORK IN HEALTHCARE.ALSO INCLUDED IN THE ACNW CHNA WAS INFORMATION FROM THE NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY, CONDUCTED BY THE NORTHWEST ARKANSAS COUNCIL IN 2021. CHILD HEALTH STAKEHOLDERS REVIEWED EACH COMPONENT OF THE CHNA, SUCH AS THE PARENT AND CAREGIVER SURVEY QUESTIONS AND FOCUS GROUP GUIDE. MANY OF THESE STAKEHOLDERS SUPPLIED INPUT THROUGH THEIR WORK AS PART OF THE NATURAL WONDERS PARTNERSHIP COUNCIL. ARKANSAS CHILDREN'S NORTHWEST PART V, SECTION B, LINE 6A: THE ARKANSAS CHILDREN'S NORTHWEST CHNA WAS CONDUCTED IN PARTNERSHIP WITH ARKANSAS CHILDREN'S HOSPITAL. BOTH HOSPITALS ARE PART OF THE ARKANSAS CHILDREN'S SYSTEM, AND NORTHWEST ARKANSAS IS A SHARED COMMUNITY OF BOTH HOSPITALS. ARKANSAS CHILDREN'S NORTHWEST PART V, SECTION B, LINE 6B: THE ACNW NEEDS ASSESSMENT ENGAGED INDIVIDUALS AND ORGANIZATIONS THAT REPRESENT THE COMMUNITIES SERVED. MANY REPRESENTATIVES OF ORGANIZATIONS ARE PART OF NATURAL WONDERS PARTNERSHIP COUNCIL. SCHOOLS, PARENTS, CAREGIVERS, AND A VARIETY OF ORGANIZATIONS WITH AN INTEREST IN THESE ISSUES WERE ENGAGED IN DEFINING THE NEEDS FOR THIS CHNA. THOSE ORGANIZATIONS INCLUDE:ARKANSAS DEPARTMENT OF HEALTHARKANSAS DEPARTMENT OF EDUCATION DIVISION OF PRIMARY AND SECONDARY EDUCATIONARKANSAS DEPARTMENT OF HUMAN SERVICESARKANSAS MINORITY HEALTH COMMISSIONTHE ARKANSAS FOOD BANKTHE NORTHWEST ARKANSAS FOOD BANKTHE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS)ARKANSAS HUNGER RELIEF ALLIANCEARKANSAS ADVOCATES FOR CHILDREN AND FAMILIESHEALTH POLICY ORGANIZATIONS INCLUDING THE ARKANSAS CENTER FOR HEALTH IMPROVEMENTHEALTH CARE PROVIDERS INCLUDING PEDIATRICIANS, FAMILY PRACTICES PHYSICIANS, NURSES, DENTISTS, AND PHARMACISTSSCHOOLS AND SCHOOL-BASED HEALTH CLINICSARKANSAS IMMUNIZATION ACTION COALITION (IMMUNIZEAR)THE ARKANSAS FOUNDATION FOR MEDICAL CARE (AFMC)NONPROFIT ORGANIZATIONS PROVIDING DIRECT SERVICES TO CHILDRENPRIVATE HEALTH INSURANCE COMPANIESFAITH COMMUNITY REPRESENTATIVESLOW-INCOME LEGAL SERVICES ORGANIZATIONSPRIVATE FOUNDATIONS LIKE THE ARKANSAS COMMUNITY FOUNDATIONTHE ARKANSAS CAMPAIGN FOR GRADE-LEVEL READINGPRIVATE INDUSTRIES RANGING FROM PHARMACEUTICAL COMPANIES TO CHAMBERS OF COMMERCE ARKANSAS CHILDREN'S NORTHWEST PART V, SECTION B, LINE 7D: PRESENTATIONS ON THE FINDINGS FROM THE FY22 ACNW CHNA HAVE BEEN PROVIDED TO THE NATURAL WONDERS PARTNERSHIP COUNCIL, ACNW STAFF, ACNW VOLUNTEERS, THE NORTHWEST ARKANSAS COUNCIL, NEWS MEDIA OUTLETS, AND OTHER PUBLIC ORGANIZATIONS. IT IS ALSO AVAILABLE FOR PUBLIC VIEW WITHOUT CHARGE ON THE ARKANSAS CHILDREN'S WEBSITE. ARKANSAS CHILDREN'S NORTHWEST PART V, SECTION B, LINE 11: COMMUNITY HEALTH IMPROVEMENT INTRODUCTION: FOR THE MOST RECENT, FY22 CHNA, ARKANSAS CHILDREN'S NORTHWEST USED A RATING AND WEIGHTING INDEX, DESCRIBED ON PAGES 16-17 OF THE CHNA, TO PRIORITIZE THE COMMUNITY HEALTH NEEDS WHICH WERE IDENTIFIED. THE RATING AND WEIGHTING TOOL WAS UNIQUELY DEVELOPED BY THE ARKANSAS CHILDREN'S COMMUNITY ENGAGEMENT, ADVOCACY AND HEALTH DIVISION AND BOYETTE STRATEGIC ADVISORS. USING THIS TOOL AND METHODOLOGY, THE IDENTIFIED NEEDS WERE SCORED. THE SCORING RESULTED IN THREE TIERS OF PRIORITIES (PRIMARY PRIORITIES, SECONDARY PRIORITIES, AND SUSTAINING ACTIVITIES), AND THE DETERMINATION THAT POVERTY AND FINANCES ARE AN INTERSECTING NEED. USING THESE SCORING RESULTS, ACNW WORKED TO ADDRESS THE FOLLOWING PRIORITIZED HEALTH NEEDS: PRIMARY PRIORITIES: BEHAVIORAL AND MENTAL HEALTH IMMUNIZATIONSFOOD INSECURITYSECONDARY PRIORITIES: INFANT HEALTHCHILD ABUSE AND NEGLECTACCESS TO CARESUSTAINING ACTIVITIES: OBESITYINJURY PREVENTIONINTERSECTING NEED:POVERTY AND FINANCES(1) PRIMARY PRIORITY: BEHAVIORAL AND MENTAL HEALTHTHE BEHAVIORAL AND MENTAL HEALTH OF ARKANSAS CHILDREN WAS ONE OF THE MOST SIGNIFICANT TOPICS IDENTIFIED IN THE 2022 CHNA, A PROBLEM NOT UNIQUE TO ARKANSAS, BUT FELT NATIONWIDE. ACCORDING TO THE 2022 UNITED HEALTH FOUNDATION "AMERICA'S HEALTH RANKINGS", THE NUMBER OF ARKANSAS CHILDREN THAT DIE BY SUICIDE IS 13.3 PER 100,000, RANKING ARKANSAS 32ND IN THE NATION. ARKANSAS ALSO EXPERIENCES A SEVERE SHORTAGE OF MENTAL HEALTH PROFESSIONALS AND CONTINUES TO HAVE A STIGMA AROUND MENTAL HEALTH, WHICH ARE BOTH BARRIERS TO TREATMENT. THE 2023-2025 ACNW IMPLEMENTATION STRATEGY OUTLINES ACTION STEPS TO ADDRESS THESE ISSUES, WITH THE FIRST BEING TO TEACH PARENTS, COMMUNITY MEMBERS, AND OTHER PROFESSIONALS TO BE ADVOCATES FOR CHILDREN'S BEHAVIORAL AND MENTAL HEALTH, THROUGH EDUCATION ABOUT TOPICS LIKE BULLYING, SELF-HARM, SUICIDE PREVENTION AND EVIDENCE-BASED TRAININGS SUCH AS SAFE TALK, MOTIVATIONAL INTERVIEWING AND APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST). ARKANSAS CHILDREN'S STAFF ARE TRAINED IN THESE THREE EVIDENCE-BASED PROGRAMS AND HAVE MADE THE TRAININGS AVAILABLE TO SCHOOLS, COMMUNITY MEMBERS, AND WORKPLACES AS NEEDED. IN FY23, STAFF HELD EIGHT ASIST TRAININGS WITH A TOTAL OF 85 PARTICIPANTS AND FIVE MOTIVATIONAL INTERVIEWING TRAININGS WITH 143 PARTICIPANTS. ARKANSAS CHILDREN'S, IN PARTNERSHIP WITH THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS), WAS AWARDED A HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) GRANT FOR OVER $2 MILLION FOR BEHAVIORAL HEALTH INTEGRATION INTO PEDIATRIC PRIMARY CARE BY SUPPORTING PEDIATRIC MENTAL HEALTH CARE TELEHEALTH ACCESS PROGRAMS. DURING FY23, THE PROGRAM, ARKANSAS MENTAL HEALTH ACCESS FOR PEDIATRIC PRIMARY CARE (ARMAPP), DEVELOPED A CURRICULUM ADDRESSING MENTAL AND BEHAVIORAL HEALTH EDUCATION USING THE IECHO PLATFORM AND ESTABLISHED A TELEHEALTH CONSULTATION PROCESS FOR PRIMARY CARE PROVIDERS ACROSS THE STATE. CONSULTATIONS AND MONTHLY EDUCATIONAL SESSIONS ARE PLANNED TO COMMENCE DURING FY24. THE ARKANSAS CHILDREN'S CENTER FOR GOOD MOURNING STRIVES TO PROVIDE, IMPROVE, AND INCREASE SUPPORT AND ASSISTANCE GIVEN TO BEREAVED CHILDREN AND FAMILIES IN ARKANSAS THROUGH EDUCATION, PROGRAM DEVELOPMENT, AND GRIEF SUPPORT PROGRAMS. FROM AN E-NEWSLETTER, THE MOURNING NEWS, TO GRIEF SUPPORT GROUPS AND GRIEF RESOURCES, THE GRIEF PROGRAMMING OFFERED IS FREE-OF-CHARGE FOR FAMILIES AND GROUPS ACROSS THE STATE. IN FY23, 172 PRESENTATIONS WERE GIVEN TO 2,384 COMMUNITY ATTENDEES THROUGH THIS PROGRAM.AN INTERSECTING NEED FOR THIS AREA IS THE USE OF TOBACCO, E-CIGARETTE, AND VAPING PRODUCTS, AS USAGE OF THESE HAVE A NEGATIVE ASSOCIATION WITH MENTAL HEALTH. IN ARKANSAS, 24.3% OF HIGH SCHOOL STUDENTS VAPE AND 9.7% SMOKE, ACCORDING TO CAMPAIGN FOR TOBACCO-FREE KIDS IN OCTOBER OF 2023. TO ADDRESS THIS ISSUE, ARKANSAS CHILDREN'S COORDINATES, AND THE ARKANSAS DEPARTMENT OF HEALTH FUNDS, PROJECT PREVENT, THE STATEWIDE YOUTH TOBACCO PREVENTION COALITION, WHICH WORKS WITH YOUNG PEOPLE ACROSS THE STATE TO ADDRESS THE HARMFUL EFFECTS OF SMOKING, DIPPING AND VAPING. IN FY23, 2,391 STUDENT MEMBERS IN 90 PROJECT PREVENT CHAPTERS ENGAGED THEIR COMMUNITIES IN EDUCATION AND PREVENTION OUTREACH. PROJECT PREVENT CHAPTERS CAN BE FOUND IN 11 OF THE 15 ACNW SERVICE AREA COUNTIES. ADDITIONALLY, PROJECT PREVENT HOSTS TWO ANNUAL CONFERENCES, AS WELL AS A FILM, AN ESSAY, AND AN ART CONTEST FOR YOUTH IN THE STATE EACH YEAR. IN FY23, THE TWO ANNUAL CONFERENCES COMBINED SAW PARTICIPATION FROM 959 YOUTH. EACH CONTEST HELD IN FY23 HAD A COMMON THEME OF "INFLUENCER", CHALLENGING YOUTH TO ENCOURAGE OTHERS TO AVOID TOBACCO PRODUCTS. THE FILM CONTEST, READY. SET. RECORD., SAW PARTICIPATION FROM 498 YOUTH IN 7TH-12TH GRADES, WHILE THE ESSAY CONTEST, MY REASON TO WRITE, SAW PARTICIPATION FROM 244 YOUTH IN 4TH-6TH GRADES, AND THE ART CONTEST, DRAWING FOR A DIFFERENCE, SAW PARTICIPATION FROM 275 YOUTH FROM KINDERGARTEN TO 3RD GRADE. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED (2) PRIMARY PRIORITY: IMMUNIZATIONSOVER THE YEARS, ARKANSAS HAS IMPROVED IN CHILDHOOD IMMUNIZATION RATES, HOWEVER, THE COVID-19 PANDEMIC NEGATIVELY AFFECTED IMMUNIZATION COVERAGE, AND WE CONTINUE TO SEE RISING RATES OF PHILOSOPHICAL EXEMPTIONS AND VACCINE HESITANCY. ARKANSAS ALSO EXPERIENCES A VACCINE ACCESS ISSUE, WHERE 12 COUNTIES IN THE STATE ONLY HAVE VACCINES FOR CHILDREN (VFC) PROVIDERS IN THE COUNTY LOCAL HEALTH UNITS (LHU'S). THESE FACTORS CAUSE IMMUNIZATIONS TO BE A CONTINUING HIGH-PRIORITY HEALTH NEED FOR THE CHILDREN OF ARKANSAS.DURING FY23, ARKANSAS CHILDREN'S CREATED A MOBILE VACCINE STRATEGY TO TARGET SEVEN ARKANSAS COUNTIES WITH LOW IMMUNIZATION RATES, HIGH EXEMPTION RATES, AND LOW VFC PROVIDER ACCESS. THESE COUNTIES INCLUDE CRAWFORD, FRANKLIN, SEBASTIAN, LOGAN, SCOTT, YELL, AND JEFFERSON (5 OF WHICH ARE IN THE ACNW SERVICE AREA). WE ACKNOWLEDGE THAT THIS WORK IS NOT WORK WE CAN DO ALONE, SO WE CONTINUE TO BUILD PARTNERSHIPS WITH ORGANIZATIONS ACROSS THE STATE WHICH CAN HELP CREATE GREATER IMPACT IN THIS EFFORT. THROUGH THE WORK OF THIS MOBILE VACCINE STRATEGY AND PARTNERSHIPS, 709 NEEDED IMMUNIZATIONS WERE PROVIDED IN THE SEVEN TARGET LOW ACCESS COUNTIES, PLUS TWO ADDITIONAL NORTHWEST ARKANSAS COUNTIES (CARROLL AND BOONE), SUCCESSFULLY REACHING CHILDREN WHERE THEY LIVE, LEARN AND PLAY. THIS PROGRAM ACHIEVED TARGET IMMUNIZATION RATE GOALS IN ALL SEVEN TARGET COUNTIES, IMPROVING IMMUNIZATION RATES IN COUNTIES BY AS MUCH AS 25% (YELL COUNTY).ONE LARGE PARTNER IN THIS WORK IS ARKANSAS IMMUNIZATION ACTION COALITION, ALSO KNOWN AS IMMUNIZEAR. IMMUNIZEAR, A LOCAL STATEWIDE COALITION FOCUSED ON INCREASING IMMUNIZATION RATES IN THE STATE, CO-LED THE NATURAL WONDERS PARTNERSHIP COUNCIL - INCREASING IMMUNIZATIONS WORKGROUP. THE WORKGROUP HAS CREATED GOALS TO RECRUIT PHARMACIES IN HIGH NEED AREAS TO BECOME VFC PROVIDERS; DEVELOP RECRUITMENT PLAN AND CAMPAIGN MESSAGES FOR PARTNER VACCINE ADVOCACY WORK; TO INCLUDE PARENTS AS IMPORTANT ADVOCATES; AND PROVIDE IMMUNIZATION EDUCATION MATERIAL FOR SCHOOL NURSES THROUGH THE ARKANSAS DEPARTMENT OF HEALTH COMMUNITY HEALTH PROMOTION SPECIALISTS AND COMMUNITY HEALTH NURSE SPECIALISTS. AS PLANNING COMMENCED FOR FY24, IT WAS DETERMINED THAT ARKANSAS CHILDREN'S WILL CONTINUE TO COLLABORATE WITH IMMUNIZEAR TO SUPPORT THEIR WORK IN INCREASING VFC PROVIDERS IN COUNTIES WITH ONLY ONE PROVIDER. FOR ACNW, THESE COUNTIES INCLUDE FRANKLIN, LOGAN, AND SCOTT.(3) PRIMARY PRIORITY: FOOD INSECURITYACNW IS FOLLOWING BEST PRACTICES TO HELP IMPROVE THE FOOD SECURITY OF CHILDREN AND THEIR FAMILIES AROUND THE STATE. THIS PROCESS BEGINS WITH A SOCIAL DETERMINANTS OF HEALTH SCREENING TO DETERMINE FOOD SECURITY NEEDS AT THE INDIVIDUAL AND FAMILY LEVEL. PATIENTS ARE SCREENED ANNUALLY, IF THEY ARE A NEW PATIENT, OR IF THEY SCREENED AS VULNERABLE AT A RECENT VISIT, AND STAFF ARE ABLE TO MAKE REFERRALS THROUGH ARKANSAS CHILDREN'S RESOURCE CONNECT TO CONNECT FAMILIES TO RESOURCES TO ADDRESS A VARIETY OF BASIC NEEDS, INCLUDING FOOD SECURITY. ARKANSAS CHILDREN'S RESOURCE CONNECT (POWERED BY FINDHELP.ORG) IS A CLOSED-LOOP REFERRAL SYSTEM, WHICH WAS LAUNCHED IN APRIL 2021 FOR USE BY PATIENTS, FAMILIES, AND STAFF AT ACH AND ARKANSAS CHILDREN'S NORTHWEST. ADDITIONALLY, THE SYSTEM WAS MADE PUBLICLY AVAILABLE AS A COMMUNITY RESOURCE AND HAS SEEN THE BULK OF USE COMING FROM EXTERNAL COMMUNITY MEMBERS AND COMMUNITY-BASED ORGANIZATIONS, OFTEN CALLED CBO'S. DURING FY23, 6,194 SEARCHES OCCURRED ON THE PLATFORM IN THE ACNW SERVICE REGION, MOST COMMONLY FOR HELP TO PAY FOR UTILITIES (566), FOOD PANTRIES (542), HELP TO PAY FOR INTERNET OR PHONE (177), AND HELP TO PAY FOR HOUSING (173). THE BENEFIT OF THIS CLOSED-LOOP REFERRAL SYSTEM IS THAT REFERRED CBO'S, ARE ABLE TO UPDATE THE STATUS OF THE REFERRAL, CONFIRMING IF THE REFERRED PARTY RECEIVED HELP, WAS REFERRED ELSEWHERE, WAS NOT ELIGIBLE, COULDN'T BE CONTACTED, WAS NO LONGER INTERESTED, OR COULD NOT BE HELPED DUE TO A LACK OF CAPACITY AT THE CBO. FOR ACNW, A TOTAL OF 105 REFERRALS TOOK PLACE IN FY23, WITH 31 BEING CLOSED LOOP. THIS DIGITAL SYSTEM IS GREATLY HELPING ARKANSAS CHILDREN'S REFER FAMILIES TO RESOURCES FOR A VARIETY OF NEEDS AND IS PROVIDING USEFUL INSIGHT INTO WHAT ADDITIONAL COMMUNITY NEEDS EXIST.IF APPLICABLE, FAMILIES IN NEED WERE ALSO PROVIDED IMMEDIATE RESOURCES, SUCH AS EMERGENCY FOOD, AND ASSISTED IN APPLYING FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) AND OTHER PUBLIC BENEFIT PROGRAMS. IN FY23, 67 BOXES OF NON-PERISHABLE GROCERIES WERE DISTRIBUTED TO PATIENT FAMILIES NEEDING EMERGENCY FOOD, THROUGH A PARTNERSHIP WITH THE NORTHWEST ARKANSAS FOOD BANK. TO FURTHER SUPPORT THE WORK OF AREA FOOD BANKS AND PANTRIES, IN JUNE OF 2023, ARKANSAS CHILDREN'S ORGANIZED THEIR ANNUAL FOOD DRIVE, AND A TREMENDOUS 15,249 NON-PERISHABLE FOOD ITEMS WERE COLLECTED. AT ACNW, 11 TEAMS COLLECTED 1,935 ITEMS FOR THE NORTHWEST ARKANSAS FOOD BANK.ADDITIONALLY, ACNW PARTICIPATES IN THE USDA MEAL PROGRAM, AND DURING FY23, APPROXIMATELY 2,000 FREE USDA MEALS WERE PROVIDED TO CHILDREN THANKS TO THE PROGRAM. IN FY23, ARKANSAS CHILDREN'S FINANCIALLY CONTRIBUTED TO A VARIETY OF NONPROFIT FOOD BANKS AND FOOD PANTRIES TO HELP STRENGTHEN THE FOOD SECURITY OF FAMILIES AND THEIR CHILDREN AROUND THE STATE. ORGANIZATIONS SUPPORTED INCLUDE FOOD BANKS SERVING LARGE REGIONS OF THE STATE, LIKE THE ARKANSAS FOOD BANK, ARKANSAS HUNGER RELIEF ALLIANCE, NORTHWEST ARKANSAS FOOD BANK, FOOD BANK OF NORTHEAST ARKANSAS, RIVER VALLEY REGIONAL FOOD BANK, AND FOOD BANK OF NORTH CENTRAL ARKANSAS, AS WELL AS SMALLER ORGANIZATIONS LIKE TRI-CYCLE FARMS, AND APPLE SEEDS. TRI-CYCLE FARMS WAS ABLE TO DISTRIBUTE 33,700 EGGS TO FAMILIES IN THE NORTHWEST ARKANSAS REGION THANKS TO THIS SUPPORT. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED (4) SECONDARY PRIORITY: INFANT HEALTHIDENTIFIED AS A SECONDARY PRIORITY IN THE 2022 CHNA, INFANT HEALTH ENCOMPASSES ARKANSAS'S POOR INFANT MORTALITY RATE AND HIGH TEEN BIRTH RATE. IN 2022, ARKANSAS HAD 272 INFANT DEATHS AND HAD THE THIRD HIGHEST INFANT MORTALITY RATE IN THE NATION AT A RATE OF 7.67 INFANT DEATHS PER 1,000 LIVE BIRTHS. WHEN LOOKING AT INFANT MORTALITY RATES BY AGE, ARKANSAS SEES THE HIGHEST RATES IN MOTHERS AGED 15-19 YEARS, AND BY RACE, THE HIGHEST RATES IN BLACK MOTHERS. RECOGNIZING THAT THIS ISSUE CANNOT BE SOLVED ALONE, ARKANSAS CHILDREN'S WORKS WITH PARTNERS ACROSS THE STATE, IN PART DUE TO THE WORK OF THE NATURAL WONDERS PARTNERSHIP COUNCIL FIRST 2100 DAYS OF LIFE AND HEALTHY RELATIONSHIPS WORKGROUPS. IN FY23, THESE GROUPS CONTINUED TO FOCUS ON THE RESOURCES AND SUPPORT THAT EXPECTING MOTHERS AND CHILDREN, ESPECIALLY THOSE FROM BIRTH TO FIVE YEARS OLD, NEED TO BE HEALTHY. THE ARKANSAS HOME VISITING NETWORK (AHVN), A PARTNERSHIP BETWEEN THE ARKANSAS DEPARTMENT OF HEALTH AND ARKANSAS CHILDREN'S, HAS IMPROVED MATERNAL-CHILD HEALTH OUTCOMES FOR CAREGIVERS AND CHILDREN IN THE PROGRAM. AHVN IS A THRIVING COALITION OF PROVIDERS AND STAKEHOLDERS THAT WORK TOGETHER TO HELP PARENTS AND CHILDREN. THE AHVN IMPLEMENTS SIX EVIDENCE-BASED HOME VISITING MODELS IN THE 15-COUNTY ACNW SERVICE AREA: EARLY HEAD START - HOME BASED MODEL, FOLLOWING BABY BACK HOME, HEALTHY FAMILIES AMERICA, HOME INSTRUCTION FOR PARENTS OF PRESCHOOL YOUNGSTERS (HIPPY), PARENTS AS TEACHERS, AND SAFECARE. IN FY23, STATEWIDE, THE AHVN SERVED 8,725 FAMILIES WITH CHILDREN FROM THE PRENATAL STAGE TO AGE FIVE ACROSS ALL 75 COUNTIES IN THE STATE AND COMPLETED 126,780 HOME VISITS.ARKANSAS CHILDREN'S LEADS THE SAFETY BABY SHOWER PROGRAM, WHICH PROVIDES SAFE SLEEP EDUCATION ACROSS THE STATE. SAFETY BABY SHOWER CLASSES ARE TAUGHT TO PARENTS AND OFFERED IN A TRAIN-THE-TRAINER MODEL TO EQUIP COMMUNITY MEMBERS TO LEAD THEIR OWN CLASSES. DURING FY23, 54 SAFETY BABY SHOWERS WERE HELD, REACHING A TOTAL OF 365 PARTICIPANTS ACROSS ARKANSAS, AND 152 COMMUNITY MEMBERS WERE TRAINED TO IMPLEMENT SAFETY BABY SHOWER CLASSES IN THEIR OWN COMMUNITIES. DURING APRIL OF 2023, A NORTHWEST ARKANSAS SPECIFIC SAFETY BABY SHOWER TRAIN THE TRAINER EVENT WAS HELD WITH 22 ATTENDEES, 10 FROM CHILD CARE AWARE AND 12 FROM UAMS. ATTENDEES FROM UAMS WERE PRIMARILY SEEKING TRAINING TO EMPOWER THEM TO BETTER REACH MARSHALLESE COMMUNITY MEMBERS IN NORTHWEST ARKANSAS.ARKANSAS CHILDREN'S IS CONTRACTED BY THE ARKANSAS DEPARTMENT OF HEALTH TO COORDINATE THE ARKANSAS INFANT AND CHILD DEATH REVIEW PROGRAM (ICDR). ESTABLISHED IN 2010, THE ICDR PROGRAM CONSISTS OF 11 REGIONAL TEAMS THAT REVIEW UNNATURAL UNEXPECTED DEATHS OF ARKANSAS CHILDREN UP TO AGE 17. THE TEAMS COVER ALL 75 ARKANSAS COUNTIES, GIVING THE ICDR PROGRAM THE POTENTIAL TO EVALUATE 100% OF UNNATURAL, REVIEWABLE PEDIATRIC DEATHS, AS REQUIRED BY ARKANSAS ACT 1818 OF 2005. INFANT AND CHILD DEATH REVIEWS FOCUS ON PREVENTION OF UNNATURAL DEATHS WITH EFFECTIVE RECOMMENDATIONS TO KEEP CHILDREN HEALTHY, SAFE, AND PROTECTED. IN FY23, ICDR TEAMS REVIEWED THE CASES OF 147 CHILDREN WHO DIED FROM INJURIES IN 2021. THE MAJORITY OF THESE DEATHS WERE DUE TO MOTOR VEHICLE CRASHES, SUICIDE AND UNDETERMINED/SUDDEN UNEXPECTED INFANT DEATH (SUID), WITH THE FOLLOWING KEY FINDINGS: FOR THE MAJORITY OF CHILD DEATHS DUE TO MOTOR VEHICLE CRASHES, CHILD SAFETY SEATS WERE EITHER NOT USED OR USED INCORRECTLY; MORE THAN HALF OF THE SUICIDE DEATHS WERE COMPLETED USING A FIREARM; AND UNSAFE SLEEP PRACTICES IN AN ADULT BED WAS THE TOP CONTRIBUTING FACTOR IN INFANT MORTALITY DEATHS. ARKANSAS CHILDREN'S CHILD PASSENGER SAFETY TEAM MEMBERS ALSO PROVIDE CAR SEAT INSPECTIONS TO PARENTS, WHICH EDUCATE ON THE PROPER INSTALLATION OF CAR SEATS AND OTHER CAR SAFETY TOPICS, LIKE HOT CAR DEATHS, UNSECURED PROJECTILES, AND WEARING WINTER COATS. PARENTS HAVE ACCESS TO THIS EDUCATION AT ARKANSAS CHILDREN'S CAMPUSES, AS WELL AS THROUGH 31 SATELLITE SITES AROUND THE STATE. DURING THIS INSPECTION, PARENTS MAY HAVE THEIR CHILD'S CAR SEAT REPLACED IF THEY DO NOT HAVE A PROPER CAR SEAT FOR THEIR CHILD OR IF THE CAR SEAT THEY HAVE IS EXPIRED OR DAMAGED. DURING FY23, 1,515 CAR SEATS WERE DONATED TO FAMILIES IN NEED THROUGH THE WORK OF THE CHILD PASSENGER SAFETY TEAM AND SATELLITE SITE PARTNERSHIPS. OF THESE, 1,065 WERE FUNDED THROUGH A GRANTEE PARTNERSHIP WITH THE ARKANSAS HIGHWAY SAFETY OFFICE, AND AN ADDITIONAL 450 WERE PURCHASED WITH ARKANSAS CHILDREN'S ORGANIZATIONAL DOLLARS AND SPECIFIED PURPOSE FUNDING. TO FURTHER EXPAND THIS RESOURCE, THE TEAM HOSTS CHILD PASSENGER SAFETY CERTIFICATION COURSES, TRAINING PROFESSIONALS TO PROPERLY INSTALL CAR SEATS. IN FY23, THREE CERTIFICATION CLASSES WERE HELD IN THE ACNW SERVICE AREA WITH 49 ADDITIONAL PROFESSIONALS CERTIFIED. PROFESSIONALS CAME FROM A WIDE VARIETY OF LOCATIONS, INCLUDING BENTON, BOONE, CONWAY, POLK, POPE, SEARCY, SEBASTIAN AND WASHINGTON COUNTIES, AND EVEN FROM SURROUNDING STATES OF OKLAHOMA AND MISSOURI.LOVE NOTES, AN EVIDENCE-BASED, INNOVATIVE AND COMPREHENSIVE HEALTHY RELATIONSHIP PROGRAM, CONSISTS OF 13 LESSONS AND IS GEARED TOWARD STUDENTS FROM 9TH-12TH GRADES. IT BUILDS SKILLS AND KNOWLEDGE FOR HEALTHY AND SUCCESSFUL RELATIONSHIPS. A FIVE-YEAR EVALUATION, BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF ADOLESCENT HEALTH, SHOWED THAT LOVE NOTES REDUCED TEEN PREGNANCY RATES BY 46% COMPARED TO THE CONTROL GROUP. THE STUDY ALSO FOUND THAT TEENS WHO WERE TAUGHT LOVE NOTES HAD LESS RECENT SEXUAL ACTIVITY, HAD LESS FREQUENT SEXUAL ACTIVITY OVERALL, WERE MORE LIKELY TO USE PROTECTION IF DECIDING TO STAY SEXUALLY ACTIVE, AND IF DECIDING TO REMAIN ABSTINENT, A HIGHER PERCENTAGE OF THOSE IN THE LOVE NOTES GROUP ACTUALLY REMAINED ABSTINENT.FY23 WAS THE FOURTH CONSECUTIVE SCHOOL YEAR THAT ARKANSAS CHILDREN'S HAS IMPLEMENTED THE LOVE NOTES PROGRAM, REACHING 26 SCHOOLS, THREE OF WHICH ARE IN THE ACNW COMMUNITY, AND IN TOTAL, HAVE REACHED 677 HIGH SCHOOL STUDENTS ACROSS THE STATE. THE PROGRAM IS WELL RECEIVED BY TEACHERS AND STUDENTS AND INTEREST IN THE PROGRAM CONTINUES TO GROW. AT THE END OF FY23, 25 SCHOOLS WERE ON THE EVER-GROWING WAITING LIST FOR A PARTNERSHIP OPPORTUNITY WITH THE PROGRAM. ARKANSAS CHILDREN'S CONTINUES TO EXPLORE FUNDING OPPORTUNITIES TO EXPAND THIS NEEDED PROGRAM TO THOSE ON THE WAITING LIST. PROGRAM POSTTEST EVALUATIONS DURING JUNE OF 2023 FOUND THAT 66% OF STUDENTS REPORTED THEY WERE ABLE TO RECOGNIZE THE WARNING SIGNS OF AN UNHEALTHY RELATIONSHIP AND KNOW HOW TO DEAL WITH IT, A 14% INCREASE FROM PRETEST, AND 70% OF THE STUDENTS REPORTED THEY HAVE A PLAN FOR THEIR OWN SEXUAL ACTIVITY, EITHER TO BE ABSTINENT OR HOW TO PACE SEXUAL INVOLVEMENT WITH A TRUSTED PARTNER, A 15% INCREASE FROM PRETEST. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED (5) SECONDARY PRIORITY: CHILD ABUSE AND NEGLECTCHILD ABUSE AND NEGLECT WAS IDENTIFIED AS A SECONDARY PRIORITY HEALTH NEED DURING THE 2022 ACNW CHNA. THE "2021 KIDS COUNT REPORT" SHOWS THAT ARKANSAS RANKS 47TH FOR CHILDREN SUBJECT TO INVESTIGATIVE REPORTING, WITH A STATE RATE OF 78 OUT OF EVERY 1,000 CHILDREN COMPARED TO THE U.S. RATE OF 47 IN EVERY 1,000 CHILDREN. THE REPORT ALSO SHOWS THAT 12 OF EVERY 1,000 ARKANSAS CHILDREN EXPERIENCE MALTREATMENT, COMPARED TO NINE OF EVERY 1,000 CHILDREN NATIONALLY. ARKANSAS CHILDREN'S TEAM MEMBERS PARTICIPATED IN THE GOVERNOR APPOINTED BLUE RIBBON TASK FORCE TO END CHILD ABUSE. THIS TASK FORCE CONCLUDED DURING FY23 AND WAS CREATED THROUGH THE PASSING OF ACT 920 OF THE ARKANSAS LEGISLATURE. THE PURPOSE OF THE TASKFORCE WAS TO DEVELOP A SYSTEMATIC AND HOLISTIC APPROACH TO ELIMINATE CHILD ABUSE IN ARKANSAS, IN ADDITION TO ADDRESSING PRIMARY AND SECONDARY PREVENTION EFFORTS, AND IMPROVING PREVENTION NETWORKS AND PARTNERSHIPS. FOLLOWING THIS, A SECONDARY TASK FORCE WAS DEVELOPED BY EXECUTIVE ORDER 23-18: TO PROTECT CHILDREN, SUPPORT FAMILIES, AND IMPROVE THE FOSTER CARE SYSTEM. ARKANSAS CHILDREN'S WAS ASKED TO PARTICIPATE IN THIS TASKFORCE AND TO MAKE RECOMMENDATIONS AROUND REDUCING THE NUMBER OF CHILDREN ENTERING THE FOSTER CARE SYSTEM.AS WE ARE STILL IN YEAR ONE OF THE 2023-2025 IMPLEMENTATION PERIOD FOLLOWING THE 2022 CHNA, ACNW CONTINUES TO PLAN AND BUILD PROGRAMMING IN RESPONSE TO THIS HEALTH NEED. WE ARE EXPLORING PARTNERSHIPS IN NATIONALLY KNOWN FORUMS, LIKE WORKING TO REINSTATE A STATE CHAPTER OF PREVENT CHILD ABUSE AMERICA, AS WELL AS EXPLORING PARTNERSHIPS WITHIN OUR STATE, BY WORKING WITH OUR NATURAL WONDERS PARTNERSHIP COUNCIL - HEALTHY RELATIONSHIPS WORKGROUP. THIS WORKGROUP BEGAN AN ENVIRONMENTAL SCAN IN APRIL OF 2023 TO DETERMINE WHAT RESOURCES ARE AVAILABLE IN THE STATE AND WHO MIGHT BE MISSING FROM THE WORKGROUP CONVERSATION. AS MENTIONED IN THE PREVIOUS INFANT HEALTH PRIORITY NEED, THE AHVN SERVED 8,725 FAMILIES WITH CHILDREN FROM THE PRENATAL STAGE TO AGE FIVE ACROSS THE STATE IN FY23. THE AHVN PROGRAMMING IMPACTS INFANT HEALTH, AS WELL AS CHILD ABUSE AND NEGLECT, WITH THEIR HEALTHY FAMILIES AMERICA, SAFE CARE, HIPPY, AND PARENTS AS TEACHERS PROGRAMS POSITIVELY IMPACTING PARENT-CHILD ENGAGEMENT, PARENTING PRACTICES, RATES OF CHILD MALTREATMENT FATALITIES, AND REDUCING PARTICIPANTS DEEMED AT-RISK FOR CHILD EMOTIONAL NEGLECT. ALL 15 COUNTIES IN THE ACNW SERVICE AREA ARE REACHED WITH AT LEAST ONE OF THESE PROGRAMS. THE ARKANSAS CHILDREN'S SAFETY BABY SHOWER PROGRAM HAS CONNECTIONS TO CHILD ABUSE AND NEGLECT AS WELL, AS IT EDUCATED 365 PARTICIPANTS ON THE PERIOD OF PURPLE CRYING, AN EVIDENCE-BASED SHAKEN BABY SYNDROME/ABUSIVE HEAD TRAUMA PREVENTION PROGRAM.ACNW ALSO SUPPORTS THE CHILDREN'S SAFETY CENTER OF WASHINGTON COUNTY, WHICH IS A NON-PROFIT ORGANIZATION BASED ON THE CHILDREN'S ADVOCACY CENTER (CAC) MODEL AND FACILITATES MORE EFFECTIVE PREVENTION, DETECTION, INVESTIGATION, AND TREATMENT OF CHILD ABUSE(6) SECONDARY PRIORITY: ACCESS TO CAREACCESS TO CARE WAS A CHILD HEALTH NEED MENTIONED BY VIRTUALLY EVERY STAKEHOLDER WHO PARTICIPATED IN THE 2022 ACNW CHNA PROCESS, EITHER FROM A GENERAL PERSPECTIVE, OR WITH FOCUS ON TELEHEALTH OR ORAL HEALTH. THIS NEED HAS BEEN MENTIONED AND PRIORITIZED IN CHNAS FOR SEVERAL YEARS, AND THEREFORE IS IDENTIFIED AS A SUSTAINING ACTIVITY. NORTHWEST ARKANSAS HAS A DIVERSE PATIENT POPULATION WITH MANY NON-ENGLISH SPEAKING CHILDREN AND FAMILIES. FOR PATIENTS OF ACNW, ENGLISH, SPANISH, AND MARSHALLESE LANGUAGES ARE THE COMMON PRIMARY LANGUAGES. TO ENSURE ALL PATIENTS ARE SERVED IN A CULTURALLY SENSITIVE MANNER, ACNW HAS 12 INTERPRETERS (SEVEN FULL-TIME AND FOUR PART-TIME, AND ONE PRN), AND IS CONTINUALLY EVOLVING AND CUSTOMIZING INTERPRETER SERVICES, BOTH IN PERSON AND VIRTUALLY, IN ORDER TO ENSURE COVERAGE AND BETTER SERVE OUR FAMILIES WHO SPEAK LIMITED ENGLISH. INSURANCE AND A FAMILY'S ABILITY TO PAY FOR HEALTH CARE IS AN IMPORTANT COMPONENT OF EQUITABLE ACCESS TO CARE. ACNW HAS AN ESTABLISHED TEAM OF FINANCIAL COUNSELORS WHOSE GOAL IS TO PROVIDE ALL FAMILIES WITH GUIDANCE AND SUPPORT TO ESTABLISH A HEALTHCARE PAYER SOURCE. ALL PATIENTS THAT IDENTIFY AS UNINSURED ARE SCREENED FOR MEDICAID. IF CRITERIA ARE MET, THEN ACNW FINANCIAL COUNSELING STAFF BEGIN THE APPLICATION PROCESS. FINANCIAL COUNSELING IS OFFERED BY BOTH SPANISH AND MARSHALLESE-SPEAKING STAFF, IN ADDITION TO ENGLISH, TO BEST SERVE THE NORTHWEST ARKANSAS COMMUNITY. DURING FY23, 2,187 TOTAL APPLICATIONS FOR MEDICAID (1,515), THE FINANCIAL ASSISTANCE PROGRAM (565), TEFRA (73), AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) (34) WERE COMPLETED FOR FAMILIES WITH ASSISTANCE BY FINANCIAL COUNSELORS. ARKANSAS CHILDREN'S SUPPORTED THE CONTINUATION AND EXPANSION OF THE MEDICAL LEGAL PARTNERSHIP (MLP), A PROGRAM IMPLEMENTED IN COLLABORATION WITH LEGAL AID OF ARKANSAS TO REDUCE HEALTH-HARMING LEGAL NEEDS. THE ARKANSAS CHILDREN'S MLP IS ONE OF THE REFERRALS POSSIBLE WITH ARKANSAS CHILDREN'S RESOURCE CONNECT, MENTIONED IN THE FOOD INSECURITY SECTION OF THIS REPORT. THESE LEGAL AID ATTORNEYS HELP ELIGIBLE FAMILIES WITH HEALTH-HARMING LEGAL NEEDS. DURING FY23, THE ATTORNEYS RECEIVED 688 REFERRALS, 85 OF WHICH OCCURRED AT ACNW, AND CLOSED 315 CASES, RANGING FROM BRIEF LEGAL ADVICE AND/OR SERVICES TO EXTENDED REPRESENTATION. THE MOST FREQUENT TYPES OF CASE REFERRALS WERE RELATED TO EDUCATION (105 CASES), HOUSING AND RENTING CONDITIONS (90 CASES), ADULT GUARDIANSHIP ISSUES (87 CASES), AND SUPPLEMENTAL SECURITY INCOME/SOCIAL SECURITY DISABILITY INSURANCE (SSDI) (75 CASES). FROM THIS WORK, THE MLP TEAM ASSISTED CLIENTS WITH RECOVERING BENEFITS AND AVOIDING UNWARRANTED COSTS FOR A TOTAL VALUE OF $157,033.ARKANSAS CHILDREN'S ALSO SUPPORTS SCHOOL NURSES STATEWIDE THROUGH THE SCHOOL NURSE ACADEMY, A PARTNERSHIP BETWEEN ARKANSAS CHILDREN'S, ARKANSAS DEPARTMENT OF EDUCATION, AND ARKANSAS DEPARTMENT OF HEALTH. THROUGH THE SCHOOL NURSE ACADEMY IN FY23, 48 SCHOOL NURSES RECEIVED VIRTUAL, ASYNCHRONOUS ASTHMA MANAGEMENT TRAINING AND 143 PARTICIPANTS ATTENDED AN IN-PERSON MOTIVATIONAL INTERVIEWING TRAINING. THIS IN-PERSON TRAINING WAS HELD FIVE TIMES IN DIFFERENT REGIONS OF THE STATE AND REACHED NURSES IN 47 SCHOOL DISTRICTS. TO ADDITIONALLY SUPPORT THE INCREDIBLE WORK THAT SCHOOL NURSES DO, ARKANSAS CHILDREN'S CONTINUED TO SUPPORT A SCHOOL NURSE EDUCATIONAL RESOURCES WEBPAGE ON THEIR WEBSITE. THIS WEBPAGE MAKES AVAILABLE A VARIETY OF HEALTH RESOURCES TO KEEP SCHOOL NURSES INFORMED, SUCCESSFUL, AND CONFIDENT IN THEIR WORK TO CARE FOR STUDENTS. ONE RESOURCE AVAILABLE IS A VIRTUAL BROADCAST. IN FY23, EIGHT BROADCASTS REACHED 746 PARTICIPANTS IN 9 STATES (ARKANSAS, KENTUCKY, MARYLAND, MISSOURI, NEW YORK, OHIO, SOUTH CAROLINA, TENNESSEE, AND TEXAS) AND 70 OF 75 ARKANSAS COUNTIES. BROADCASTED TOPICS INCLUDE DIABETES: BACK-TO-SCHOOL, ALLERGIC REACTIONS, SCHOOL AGE RESPIRATORY EMERGENCIES, DEPRESSION AND ANXIETY: TOLERATING DISTRESS IS A SKILL WE ALL NEED TO LEARN, PROJECT ADAM: HEART SAFE SCHOOLS IN ARKANSAS, SEIZURES, CHILDHOOD IMMUNIZATIONS/MENINGITIS, AND HUMAN PAPILLOMA VIRUS (HPV). ACCESS TO CARE ISSUES CONTINUE TO EXIST IN ARKANSAS, WITH 15 COUNTIES IN ARKANSAS SCORING IN THE HIGHEST TIER OF RATING FOR DENTAL HEALTH PROFESSIONALS SHORTAGE AREAS (HPSA), TWO OF WHICH ARE IN THE ACNW REGION. DURING FY23, THE ARKANSAS CHILDREN'S DENTAL SEALANT PROGRAM OFFERED ORAL HEALTH SCREENINGS, FLUORIDE APPLICATIONS, AND DENTAL SEALANTS AT 34 SCHOOLS IN 18 COUNTIES OF THE STATE, THREE OF WHICH ARE IN THE ACNW SERVICE AREA (BENTON, WASHINGTON, AND POPE.) THEY SAW 2,910 CHILDREN, IN WHICH 919 (32%) WERE IDENTIFIED TO HAVE OBVIOUS DECAY. NOTES WERE SENT HOME WITH THESE STUDENTS TO INFORM THEIR PARENTS THAT THEY NEED TO SEEK DENTAL CARE. THE PROGRAM RECEIVED POSITIVE FEEDBACK FROM SCHOOL NURSES, WHO SAID THIS PROCESS HELPED AFFIRM THE MESSAGE THEY HAD BEEN TRYING TO GET ACROSS TO PARENTS, AS WELL AS MOTIVATING PARENTS TO GET THE NEEDED DENTAL CARE FOR THEIR CHILDREN.STUDENTS WERE ALSO SERVED BY MOBILE DENTAL CLINICS, WHERE 271 PATIENTS WERE SERVED ACROSS 696 VISITS. IN FY23, THE MOBILE DENTAL OUTREACH PROGRAM PROVIDED PREVENTATIVE WORK, INCLUDING 599 SEALANTS AND 256 CLEANINGS, AND RESTORATIVE WORK, INCLUDING 36 ROOT CANALS, 137 CROWNS, 560 FILLINGS, 140 EXTRACTIONS, AND 1,453 OTHER PROCEDURES, SUCH AS ORAL EXAMS, X-RAYS, FLUORIDE APPLICATIONS, NITROUS ADMINISTRATION, AND PLACING SPACE MAINTAINERS. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED (7) SUSTAINING ACTIVITY: OBESITYCHILDHOOD OBESITY AND FOOD SECURITY ARE INTERCONNECTED NEEDS, WITH PROGRESS NEEDED IN BOTH AREAS FOR EITHER TO IMPROVE. MUCH OF THE WORK REPORTED UNDER THE FOOD INSECURITY SECTION OF THIS REPORT HAS COMPONENTS OF OBESITY PREVENTION AS WELL. TO ADDRESS OBESITY, AND THE INTERSECTING NEED OF FOOD SECURITY, AT A COMMUNITY LEVEL, ARKANSAS CHILDREN'S HEALTH EDUCATORS UTILIZED THE COOKING MATTERS CURRICULUM, PROVIDING FAMILIES AND THEIR CHILDREN WITH SPECIFIC SKILLS TO COOK HEALTHY, LOW-COST MEALS. ARKANSAS CHILDREN'S SUPPORTED COOKING MATTERS PROGRAMS INCLUDE COOKING MATTERS, COOKING MATTERS AT THE STORE, AND POP-UP COOKING MATTERS, AN INTERACTIVE CURRICULUM FOR HIGH SCHOOL STUDENTS. IN FY23, 74 POP-UP COOKING MATTERS PRESENTATIONS WERE GIVEN TO 1,629 JUNIOR HIGH AND HIGH SCHOOL STUDENTS THROUGHOUT THE STATE. AFTER COMPLETING POP-UP COOKING MATTERS, STUDENTS ARE SURVEYED TO DETERMINE INTENT TO CHANGE BEHAVIOR AROUND TOPICS LIKE COMPARING FOOD LABELS TO MAKE HEALTHY CHOICES, READING INGREDIENT LISTS TO FIND WHOLE GRAINS, AND CHOOSING FRUITS AND VEGETABLES IN EVERY FORM (FRESH, FROZEN, OR CANNED). ANOTHER FINANCIAL CONTRIBUTION WAS MADE TO APPLE SEEDS INC., A NORTHWEST ARKANSAS BASED NON-PROFIT WHOSE MISSION IS TO INSPIRE HEALTHY LIVING THROUGH GARDEN-BASED EDUCATION. THEY CREATE PROGRAMS THAT EDUCATE AND EXCITE YOUNG STUDENTS ABOUT HEALTHY FOOD WHILE INCREASING THEIR ACCESS TO THOSE HEALTHY FOODS. OUR SUPPORT ASSISTED THEM IN EXPANDING THEIR GROWING MY PLATE PROGRAMMING ACROSS THE STATE, PROVIDING EDUCATION TO OVER 60 SCHOOLS AND TRAINING 68 TEACHERS IN 2022. GROWING MY PLATE PROGRAM EVALUATIONS ALSO SHOWED THAT 100% OF PARENTS REPORTED AN IMPROVEMENT IN THEIR CHILD IN A LEAST ONE BEHAVIOR AFTER IMPLEMENTATION (EITHER CHILD TALKING ABOUT NUTRITION, HEALTHY EATING, PARTICIPATION IN GROCERY SHOPPING, TRYING A NEW MEAL, AND FAMILY CONSUMPTION OF HEALTHY FOODS.)(8) SUSTAINING ACTIVITY: INJURY PREVENTION IMPROVEMENTS HAVE BEEN MADE OVER THE PAST 10 YEARS IN REGARDS TO INJURY PREVENTION; HOWEVER, THE 2022 CHNA FOUND THAT ARKANSAS STILL RANKS 42ND IN THE NATION FOR CHILD AND TEEN DEATH RATE AND STILL RANKS NEGATIVELY COMPARED WITH NATIONAL AVERAGES IN MOST INJURY MECHANISMS.BECAUSE OF THIS, ARKANSAS CHILDREN'S CONTINUED TO WORK TO REDUCE CHILD INJURIES AND DEATHS THROUGH PROGRAMMING FOCUSED ON THE ISSUES OF MOTOR VEHICLE SAFETY, SAFE SLEEP/INFANT MORTALITY, INTENTIONAL INJURIES, RECREATIONAL SAFETY, AND BURN/FIRE PREVENTION DURING FY23, UTILIZING A COMPREHENSIVE PUBLIC HEALTH APPROACH THAT INCLUDES EDUCATION, AWARENESS, AND ADVOCACY. AS PREVIOUSLY MENTIONED UNDER THE INFANT HEALTH SECONDARY PRIORITY, ARKANSAS CHILDREN'S LEADS THE SAFETY BABY SHOWER PROGRAM, WHICH PROVIDES SAFE SLEEP EDUCATION ACROSS THE STATE. SAFETY BABY SHOWER CLASSES ARE TAUGHT TO PARENTS AND OFFERED IN A TRAIN-THE-TRAINER MODEL TO EQUIP COMMUNITY MEMBERS TO LEAD THEIR OWN CLASSES. DURING FY23, 54 SAFETY BABY SHOWERS WERE HELD, TO REACH A TOTAL OF 365 PARTICIPANTS ACROSS ARKANSAS, AND 152 COMMUNITY MEMBERS WERE TRAINED TO IMPLEMENT SAFETY BABY SHOWER CLASSES IN THEIR OWN COMMUNITIES. IN APRIL OF 2023, A NORTHWEST ARKANSAS SPECIFIC SAFETY BABY SHOWER TRAIN THE TRAINER EVENT WAS HELD WITH 22 ATTENDEES, 10 FROM CHILD CARE AWARE AND 12 FROM UAMS. ATTENDEES FROM UAMS WERE PRIMARILY SEEKING TRAINING TO EMPOWER THEM TO BETTER REACH MARSHALLESE COMMUNITY MEMBERS IN NORTHWEST ARKANSAS.MOTOR VEHICLE SAFETY EFFORTS WERE FOCUSED AROUND CHILD PASSENGER SAFETY AND TEEN DRIVING SAFETY DURING THE FY23 TIMEFRAME. CHILD PASSENGER SAFETY EFFORTS WERE PREVIOUSLY DISCUSSED UNDER THE INFANT HEALTH SECONDARY PRIORITY, AND INCLUDED 11 CHILD PASSENGER SAFETY CERTIFICATION COURSES, WHICH TRAINED 133 PROFESSIONALS TO PROPERLY INSTALL CAR SEATS. CLASSES AND CORRESPONDING COMMUNITY SEAT CHECK EVENTS WERE HELD IN BENTON, BOONE, CRAIGHEAD, GARLAND, MISSISSIPPI, OUACHITA, PHILLIPS, PULASKI, AND SEBASTIAN COUNTIES. FAMILIES ALSO HAVE ACCESS TO CHILD PASSENGER SAFETY EDUCATION AT ARKANSAS CHILDREN'S LOCATIONS, AS WELL AS 31 SATELLITE SITES AROUND THE STATE, WHERE 1,065 CAR SEATS WERE DONATED TO FAMILIES IN NEED THROUGH AN ARKANSAS HIGHWAY SAFETY OFFICE GRANT AND ANOTHER 450 WERE DONATED THROUGH ARKANSAS CHILDREN'S ORGANIZATIONAL DOLLARS AND SPECIFIED PURPOSE FUNDING IN FY23. TEEN DRIVING SAFETY EFFORTS WERE CONDUCTED THROUGH THE YOUTH ACCIDENT PREVENTION PROGRAM (YAPP), WHICH REACHED 2,271 STUDENTS DURING FY23, AND A PEER LED ARKANSAS DRIVE SMART CHALLENGE, WITH 13 SCHOOLS AND 342 STUDENT LEADERS TRAINED. ARKANSAS CHILDREN'S CONTINUED TO OFFER BABYSITTING 101 CLASSES IN FY23. DURING BABYSITTING 101, STUDENTS RECEIVE TRAINING IN SAFETY SKILLS, CHILD CARE SKILLS, FIRST AID AND RESCUE SKILLS, AND LIFE AND BUSINESS SKILLS. SIX CLASSES TOOK PLACE THIS YEAR (FOUR IN LITTLE ROCK, ONE IN SPRINGDALE, AND ONE IN JONESBORO), AND 72 STUDENTS WERE TRAINED FROM 10 COUNTIES TO BE SAFE BABYSITTERS. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED INTERSECTING NEED: POVERTY AND FINANCES AS STATED IN THE 2022 ACH CHNA, BY MOST MEASURES, ARKANSAS CONSISTENTLY RANKS AS ONE OF THE POOREST STATES IN THE NATION, AND LACK OF INCOME AND/OR MONETARY RESOURCES AFFECTS THE HEALTH OUTCOMES OF ARKANSAS CHILDREN, PERHAPS MORE SO THAN ANY OTHER SINGLE TOPIC AREA REVIEWED. VIRTUALLY EVERY STAKEHOLDER WHO PROVIDED INPUT INTO THE CHNA CONNECTED THE DOTS BETWEEN POVERTY AND CHILDREN'S HEALTH. AS MENTIONED IN PRIOR SECTIONS OF THIS NARRATIVE, ARKANSAS CHILDREN'S RESOURCE CONNECT (POWERED BY FINDHELP.ORG) AND THE ARKANSAS CHILDREN'S MEDICAL LEGAL PARTNERSHIP HAVE BOTH PROVEN TO PROVIDE GREAT RESOURCES AND ASSISTANCE TO FAMILIES EXPERIENCING POVERTY. IN FY23, ARKANSAS CHILDREN'S SUPPORTED THE ALICE IN THE CROSSCURRENTS: COVID AND FINANCIAL HARDSHIP IN ARKANSAS 2023 REPORT, WITH TEAM MEMBERS SITTING ON THE STATE RESEARCH ADVISORY COMMITTEE. THIS ALICE (ASSET LIMITED, INCOME CONSTRAINED, EMPLOYED) REPORT PROVIDES THE FIRST LOOK AT THE EXTENT OF FINANCIAL HARDSHIP IN ARKANSAS USING ALICE METRICS SINCE THE COVID-19 PANDEMIC BEGAN. WHILE ARKANSAS CHILDREN'S IS NOT POSITIONED TO HAVE A SIGNIFICANT IMPACT ON INCREASING FAMILY INCOME AND DECREASING POVERTY RATES, THE SYSTEM WILL CONTINUE TO SEEK AND PARTICIPATE IN ACTIVITIES WHICH MAY CONTRIBUTE TO IMPROVING THIS NEED. SCHEDULE H, PART V, SECTION B, LINE 16A - FAP WEBSITE WWW.ARCHILDRENS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16B - FAP APPLICATION WWW.ARCHILDRENS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16C - FAP PLAIN LANGUAGE SUMMARY WWW.ARCHILDRENS.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 20 SCHEDULE H, PART V, QUESTION 20A-20E ARE NOT CHECKED BECAUSE ARKANSAS CHILDREN'S NORTHWEST DOES NOT PERFORM EXTRAORDINARY COLLECTION ACTIONS (ECA'S) OF ANY KIND. AS SUCH, NONE OF THE BOX 20 QUESTIONS OCCURRED "BEFORE INITIATING THE LISTED ACTIONS" BECAUSE THE LISTED ACTIONS WERE NEVER INITIATED. PLEASE REFER TO DESCRIPTION AT SCHEDULE H, PART III, SECTION C, QUESTION 9B FOR A COMPLETE DESCRIPTION OF ARKANSAS CHILDREN'S COLLECTION PRACTICES. 1 1 - HARVEY PEDIATRICS OPER BY AR CHILDRENS 900 SOUTH 52ND STREET 200 ROGERS AR 72758 OUTPATIENT HOSPITAL CLINIC PART I, LINE 3C: ACNW USES FEDERAL POVERTY GUIDELINES TO DETERMINE FREE OR DISCOUNTED CARE.PART I, LINE 4:ACNW DOES NOT HAVE A SPECIFIC FINANCIAL ASSISTANCE PROGRAM FOR THE "MEDICALLY INDIGENT" AS DEFINED BY AR CODE SECTION 6-64-503(A), BUT IT DOES PROVIDE FREE CARE FOR INDIVIDUALS WITH HOUSEHOLD INCOMES UP TO 250% OF POVERTY AND DISCOUNTED CARE FOR INDIVIDUALS WITH HOUSEHOLD INCOMES UP TO 400% OF POVERTY. AS PART OF THE APPLICATION PROCESS, ACNW REQUESTS THAT PERSONS WITH NO INCOME WHO ARE ALSO INELIGIBLE FOR MEDICAID, MEDICARE, OR MARKETPLACE SUBSIDIES PROVIDE A WRITTEN SIGNED STATEMENT DESCRIBING HOW THEY ARE MEETING THEIR DAY TO DAY BASIC LIVING NEEDS. THE APPLICATION SPECIFIES SUCH REQUIREMENTS FOR APPLICANTS WITH "NO INCOME IN THE HOME". ACNW ALSO ASSISTS FAMILIES IN APPLYING FOR MEDICAID (INCLUDING THE TEFRA PROGRAM FOR DISABLED CHILDREN THAT ONLY CONSIDERS THE CHILD'S INCOME), SSI, CHILDREN'S MEDICAL SERVICES, AS WELL AS ACH'S OWN FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO ALLOWS INTEREST FREE PAYMENTS TO BE MADE UNTIL THE OUTSTANDING BALANCE IS PAID WITHOUT TIME CONSTRAINTS. ACNW DOES NOT REPORT TO COLLECTION AGENCIES OR TAKE OTHER EXTRAORDINARY COLLECTION EFFORTS. PART I, LINE 7: COSTING METHOD - ARKANSAS CHILDREN'S NORTHWEST (ACNW) USES A COST ACCOUNTING (CA) SYSTEM AS THE BASIS FOR DETERMINING COST FOR ITS PATIENTS. ALL PATIENT ENCOUNTERS (INPATIENT, OUTPATIENT, ED, AMBULATORY SURGERY) ARE CAPTURED IN THE COST ACCOUNTING SYSTEM FOR ALL PATIENTS (MEDICAID, INSURANCE, UNINSURED) WITH NO DIFFERENTIATION FOR TYPE OF INSURANCE, IF ANY. A BRIEF DESCRIPTION OF THE COST ACCOUNTING SYSTEM IS BELOW.THE COST ACCOUNTING SYSTEM AT ACNW IS A DETAILED PROCEDURE SYSTEM. ALL SERVICES PERFORMED BY PATIENT CARE STAFF HAVE BEEN EVALUATED AS TO THE RESOURCES UTILIZED TO PROVIDE THE SERVICES INCLUDING LABOR, DIRECT MATERIALS AND EQUIPMENT. IN ADDITION, OVERHEAD TYPE COSTS (BUILDING, UTILITIES, PAYROLL, ETC.) HAVE ALSO BEEN ALLOCATED TO THESE SERVICES. THE TWO COMPONENTS, DIRECT AND INDIRECT COSTS, ARE COMBINED AND REPRESENT THE TOTAL COST TO PROVIDE EACH SERVICE. THIS IS DONE ON A PROCEDURE LEVEL BASIS. AS A PATIENT IS ADMITTED AND INCURS SERVICES (X-RAYS, ROOM & BOARD, LAB, ETC.), THE APPLICABLE PROCEDURE COSTS ARE ASSIGNED TO EACH PARTICULAR PATIENT. UPON DISCHARGE, THE COSTS FROM THE INDIVIDUAL PROCEDURES THAT WERE PROVIDED TO EACH PATIENT ARE ADDED UP FOR A TOTAL COST OF PROVIDING CARE FOR EACH INDIVIDUAL PATIENT.THE COST ACCOUNTING SYSTEM IS UPDATED ANNUALLY TO REFLECT THE CURRENT YEAR'S EXPENSES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES - ACNW PROVIDES MANY PEDIATRIC SPECIALIZED SERVICES TO THE COMMUNITY THAT ARE EITHER NOT AVAILABLE OR ARE BEYOND THE CAPACITY OF THE COMMUNITY TO PROVIDE. MANY OF THESE SERVICES ARE PROVIDED BY ACNW AT A LOSS. THESE LOSSES WERE OBTAINED FROM THE COST ACCOUNTING SYSTEM.ACNW SUBSIDIZED HEALTH SERVICES INCLUDES ONE STANDALONE CLINIC. THE NET LOSS OF $748,583 INCLUDED FROM THIS CLINIC REPRESENTS THE FACILITY PORTION OF THE CLINIC WHICH INCLUDES THE CLINIC VISIT, VACCINE ADMINISTRATION AND POINT OF CARE TESTING. PART II, COMMUNITY BUILDING ACTIVITIES: ACNW CONTRIBUTES TO THE COMMUNITY IT SERVES BOTH AT A LOCAL AND A REGIONAL LEVEL. ACNW TEAM MEMBERS PARTICIPATE IN AREA CHAMBER OF COMMERCE MEETINGS, WITH A TEAM MEMBER EVEN SERVING AS THE CHAIR FOR THE SPRINGDALE CHAMBER OF COMMERCE BOARD OF DIRECTORS. ACNW TEAM MEMBERS ALSO PARTICIPATE IN AND CO-CHAIR THE NORTHWEST ARKANSAS COUNCIL EXECUTIVE COMMITTEE. THE NORTHWEST ARKANSAS COUNCIL IS A PRIVATE, NONPROFIT ORGANIZATION WORKING TO ADVANCE JOB OPPORTUNITIES, TALENT RECRUITMENT, PHYSICAL INFRASTRUCTURE, HEALTH CARE AND QUALITY OF LIFE IN THE ACNW SERVICE AREA AND WAS ESTABLISHED 30 YEARS AGO BY SAM WALTON, DON TYSON, J.B. HUNT AND OTHER BUSINESS LEADERS.AS PREVIOUSLY DETAILED IN THE FOOD SECURITY SECTION, ACNW AND THE ARKANSAS CHILDREN'S SYSTEM MAKE FINANCIAL CONTRIBUTIONS TO NWA FOOD PANTRIES AND FOOD BANKS. OTHER ORGANIZATIONS ACNW SUPPORTED THIS FISCAL YEAR INCLUDE, THE ANNUAL NORTHWEST ARKANSAS FUNDRAISER OF ARKANSAS ADVOCATES FOR CHILDREN AND FAMILIES. ARKANSAS ADVOCATES FOR CHILDREN AND FAMILIES WORKS TO ENSURE THAT ALL CHILDREN AND THEIR FAMILIES HAVE THE RESOURCES AND OPPORTUNITIES TO LEAD HEALTHY AND PRODUCTIVE LIVES. THEY WORK TO ACHIEVE THIS GOAL THROUGH POLICY ADVOCACY, SHARING DATA TO SUPPORT PUBLIC POLICY, AND ORGANIZING COALITIONS OF DIVERSE GROUPS TO DRIVE CHANGE. ACNW HAS ALSO CONTRIBUTED TO THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, FAYETTEVILLE CHAMBER OF COMMERCE, DOWN'S SYNDROME CONNECTION OF NWA, NWA PRIDE EQUALITY, AND MORE.ARKANSAS CHILDREN'S CONTINUES TO CLOSELY PARTNER WITH SCHOOLS AND HAS FORMAL PARTNERSHIPS WITH SPRINGDALE HIGH SCHOOL - MEDICAL ACADEMY, LOCATED NEAR ARKANSAS CHILDREN'S NORTHWEST. GOALS FOR THESE PARTNERSHIPS INCLUDE PROMOTING HEALTH EDUCATION, PROMOTING EXPLORATION AND DISCOVERY OF HEALTHCARE CAREERS, AND FOSTERING A CLIMATE OF INVOLVEMENT, INTERACTION AND MUTUAL COOPERATION BETWEEN EACH PARTY. PART III, LINE 2: BAD DEBT EXPENSE REPORTED ON LINE 2 REPRESENTS UNCOLLECTIBLE PATIENT ACCOUNTS AND IS CALCULATED ON A COST BASIS. PART III, LINE 4: UNCOLLECTIBLE UNCOMPENSATED CARE GENERALLY REPRESENTS STANDARD CHARGES THAT ARE UNREALIZED DUE TO AN UNWILLINGNESS TO PAY BY THOSE RESPONSIBLE FOR PAYMENT, THEREFORE BAD DEBT. UNCOLLECTIBLE UNCOMPENSATED CARE IS REPORTED AS A DEDUCTION FROM GROSS PATIENT REVENUE.FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, ACNW RECOGNIZES REVENUE BASED ON ESTABLISHED RATES, SUBJECT TO CERTAIN DISCOUNTS AS DETERMINED BY ACNW. AN ESTIMATED PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED THAT RESULTS IN NET PATIENT SERVICE REVENUE BEING REPORTED AT THE NET AMOUNT EXPECTED TO BE RECEIVED. IT HAS BEEN DETERMINED, BASED ON AN ASSESSMENT AT THE CONSOLIDATED ENTITY LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR UNCOLLECTIBLE ACCOUNTS RELATED TO PATIENT REVENUE IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS.PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES.FOR PATIENT RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS, INCLUDING PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES FOR WHICH THIRD PARTY COVERAGE PROVIDES FOR A PORTION OF THE SERVICES PROVIDED, ACNW RECORDS AN ESTIMATED PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE YEAR OF SERVICE. PART III, LINE 8: THE ACNW MEDICARE POPULATION IS PRIMARILY RENAL PEDIATRIC PATIENTS. THEREFORE, THE MEDICARE SHORTFALL, IF ANY, SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIATED AND SERVICES CANNOT BE PROVIDED ELSEWHERE. PART III, LINE 9B: ARKANSAS CHILDREN'S USES ITS BEST EFFORTS TO ASSIST PATIENTS/GUARANTORS IN MEETING THEIR FINANCIAL RESPONSIBILITY FOR SERVICES PROVIDED AT ACNW. OUR POLICY IS TO ACT WITH INTEGRITY IN ALL ENDEAVORS; TREATING ALL PATIENTS AND THEIR FAMILIES WITH DIGNITY, RESPECT, AND COMPASSION. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES. NOTICES REGARDING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED IN ENGLISH AND SPANISH IN ALL REGISTRATION AREAS. IN ADDITION TO OFFERING FINANCIAL ASSISTANCE BROCHURES UPON ADMISSION, THEY ARE ALSO MADE AVAILABLE TO FAMILIES UPON REQUEST. THE GUARANTOR STATEMENTS AND THE ARKANSAS CHILDREN'S WEBSITE CONTAIN INFORMATION ABOUT THIS PROGRAM. THERE ARE FINANCIAL COUNSELORS AVAILABLE TO ALL REGISTRATION AREAS OF THE HOSPITAL TO ASSIST IN COMPLETING MEDICAID, CMS, SSI INTENTS, AND FINANCIAL ASSISTANCE APPLICATIONS. ACNW BILLING AND COLLECTIONS IS A SERVICE PROVIDED BY ARKANSAS CHILDREN'S HOSPITAL (ACH), WHICH IS AN AFFILIATED NON-PROFIT HOSPITAL. ACH TAKES NO EXTRAORDINARY COLLECTION EFFORTS. ACH DOES NOT REPORT TO CREDIT BUREAUS OR CHARGE INTEREST OR FILE LIENS AGAINST A PATIENT'S OR FAMILY'S RESIDENCE TO SECURE PAYMENT ON PATIENT ACCOUNT BALANCES. UPON RECEIPT OF A PERSONAL BANKRUPTCY NOTICE, ANY OUTSTANDING SELF-PAY BALANCES FOR THE ASSOCIATED PATIENT ARE WRITTEN OFF ONCE ALL OTHER PAYMENTS HAVE BEEN RECEIVED. ALL SELF-PAY COLLECTION ACTIVITY IS STOPPED UPON NOTIFICATION OF THE BANKRUPTCY.UPFRONT DISCOUNTS ON SERVICES FOR THE UNINSURED ARE OFFERED. THE FAMILY CAN ALSO REQUEST A PROMPT PAY DISCOUNT. ADDITIONALLY, ACH ATTEMPTS TO ACCOMMODATE U.S. FAMILIES WHO DESIRE TO SET UP REASONABLE PAYMENT PLANS. INTEREST IS NOT CHARGED. THE HOSPITAL'S GUARANTOR STATEMENTS ARE DESIGNED TO KEEP THE GUARANTOR UPDATED AS TO WHETHER THE ACCOUNT IS STILL PENDING RESOLUTION BY INSURANCE OR DUE FROM THE GUARANTOR. SELF-PAY COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: ARKANSAS CHILDREN'S NORTHWEST CONDUCTED ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DURING FISCAL YEAR 2019 AND EARLY FISCAL YEAR 2020, AND HAS CONTINUED ASSESSMENT WITH THEIR MOST RECENT CHNA AND IMPLEMENTATION STRATEGY ISSUED IN 2022.ACNW'S CHNA IS COMPREHENSIVE AND FOCUSES ON THE HOSPITAL'S 15 COUNTY SERVICE AREA. HOWEVER, CLINICAL ASSESSMENT OF NEEDS HAS DRIVEN ADDITIONAL EFFORTS TO IMPROVE ACCESS TO APPROPRIATE HEALTH CARE FOR CHILDREN AND TO EDUCATE A VARIETY OF STAKEHOLDERS IN ARKANSAS. FOR EXAMPLE, SCHOOL NURSES IDENTIFIED CERTAIN AREAS, SUCH AS TRACHEOSTOMY CARE, IN WHICH THEY FELT THEY NEEDED ADDITIONAL EDUCATION, AND ARKANSAS CHILDREN'S PARTNERED WITH THE AR DEPARTMENT OF HEALTH TO MEET THOSE NEEDS THROUGH THE SCHOOL NURSE ACADEMY. ACNW'S FAMILY ADVISORY BOARD HELPS GUIDE THE HOSPITAL STAFF AND BOARD REGARDING ISSUES RELATED TO ITS SERVICES AND IN CREATING A FAMILY-FRIENDLY, FAMILY-CENTERED PLACE OF CARE. PART VI, LINE 3: PLEASE SEE PART III, LINE 9B DESCRIPTION. PART VI, LINE 4: AS THE REGION'S FIRST AND ONLY PEDIATRIC HOSPITAL, ACNW DEFINES THE COMMUNITY IT SERVES AS THE MORE THAN 200,000 CHILDREN LOCATED IN THE 15-COUNTY NORTHWEST ARKANSAS REGION. THOUGH THE HOSPITAL SERVES OUT-OF-STATE PATIENTS AS WELL, ACNW DREW APPROXIMATELY 80.4% OF ITS OUTPATIENTS AND 72.7% OF ITS INPATIENTS FROM WASHINGTON AND BENTON COUNTIES FOR THE FISCAL YEAR ENDING JUNE 30, 2023, WITH THE MAJORITY OF THE PATIENTS COMING FROM WASHINGTON COUNTY. ACCORDING TO U.S. CENSUS BUREAU 2020 CENSUS DATA, POPULATION TOTALS AT THAT TIME WERE 3,011,524 FOR THE STATE OF ARKANSAS AND 530,204 FOR WASHINGTON AND BENTON COUNTIES COMBINED. ESTIMATED 2023 CENSUS DATA INDICATED POPULATION TOTALS TO BE 3,067,732 FOR ARKANSAS. ALSO ACCORDING TO ESTIMATED 2023 CENSUS DATA, APPROXIMATELY 22.9% OF THE ARKANSAS POPULATION WAS UNDER 18 YEARS OF AGE AND 5.9% WAS UNDER THE AGE OF 5. THE UNEMPLOYMENT RATE FOR THE STATE OF ARKANSAS FOR CALENDAR YEAR 2022 WAS 3.3%, A DECREASE FROM THE PREVIOUS YEAR. THE PER CAPITA PERSONAL INCOME FOR THE STATE OF ARKANSAS FOR 2021 WAS $31,380. THE PERCENT OF ALL PEOPLE IN POVERTY IN ARKANSAS ROSE SLIGHTLY TO 16.8% AND THE PERCENT OF CHILDREN 18 OR YOUNGER IN POVERTY WAS 22.1%, INDICATING A SLIGHT DECREASE FOR CHILDREN FROM THE PRIOR YEAR.THE ESTIMATED 694,298 ARKANSAS CHILDREN UNDER AGE 18 REPRESENTED 22.9% OF THE STATE'S TOTAL POPULATION FOR 2022. THE HISPANIC CHILD POPULATION GREW FROM 12.2% AS ESTIMATED IN THE 2020 CENSUS TO 12.9% FOR 2022. HOWEVER, THE NUMBER OF AFRICAN AMERICAN CHILDREN UNDER AGE 18 DROPPED SLIGHTLY FROM 17.1% TO 16.0%. WITH A PRIMARILY RURAL POPULATION LIVING IN MANY SMALL AND MEDIUM-SIZED COMMUNITIES, ACCESS TO HEALTH CARE SERVICES PRESENTS A VERY REAL CHALLENGE. ARKANSAS HAS SEEN A LARGE DECLINE IN UNINSURED CHILDREN SINCE 1990, WITH 5.9% OF CHILDREN LACKING COVERAGE AS OF 2021. ARKANSAS' "ARKIDS FIRST" HEALTH INSURANCE PROGRAM HAS BEEN A MAJOR FACTOR IN PROVIDING HEALTH INSURANCE FOR CHILDREN WHO MAY HAVE OTHERWISE GONE WITHOUT. ARKIDS FIRST WAS DESIGNED BY THE STATE OF ARKANSAS TO PROVIDE INSURANCE FOR CHILDREN OF WORKING FAMILIES WHO EARNED TOO MUCH FOR PUBLIC ASSISTANCE BUT COULD STILL NOT AFFORD TO PURCHASE HEALTH INSURANCE. PART VI, LINE 5: ARKANSAS CHILDREN'S VOLUNTEER ENGAGEMENT PROVIDES SYSTEM-WIDE VOLUNTEER SUPPORT TO ELEVATE THE PATIENT EXPERIENCE BY PROVIDING HELP TO CAREGIVERS, POSITIVE DISTRACTIONS FOR PATIENTS, AND SUPPORT TO HARDWORKING TEAMS. THE SYSTEM-WIDE TEAM LEADS MANY STRATEGIC HOSPITAL VOLUNTEER PROGRAMS IN ADDITION TO ENGAGING MORE THAN 250 WEEKLY ADULT VOLUNTEERS SERVING AT TWO HOSPITAL CAMPUSES. IN FY23 ON THE ACNW CAMPUS, 216 ADULT AND SPECIAL EVENT VOLUNTEERS SERVED A TOTAL OF 10,955 HOURS. THERE WERE ALSO AN ADDITIONAL 74 VOLUNTEERS WHO PROVIDED UNIQUE HANDMADE NEEDLEWORK ITEMS FOR THE HOSPITAL'S PATIENTS AND PATIENT FAMILIES. THE VOLUNTEER ENGAGEMENT SYSTEM TEAM SOLICITS, ACCEPTS, STEWARDS, AND DISTRIBUTES TOYS, CONVENIENCE ITEMS AND OTHER IN-KIND DONATIONS VALUED AT APPROXIMATELY $1,000,000 ANNUALLY. VOLUNTEER ENGAGEMENT ALSO PROVIDES STRATEGIC LEADERSHIP AND OPERATIONAL OVERSIGHT TO HOSPITAL GIFT SHOPS AND THE ACH FAMILY RESOURCE CENTER. DURING THE SUMMER, JUNE THROUGH AUGUST 2023, THE VOLUNTEER ENGAGEMENT TEAM WAS THRILLED TO WELCOME 13 HIGH SCHOOL STUDENTS WHO SERVED 12 WEEKS ON CAMPUS, A TOTAL OF 518 HOURS IN VARIOUS POSITIONS, PROVIDING VALUABLE SERVICE FOR OUR PATIENTS, FAMILIES AND STAFF, INCLUDING PILOTING A NEW VOLUNTEER PLACEMENT - A BILINGUAL WAYFINDER AT THE FRONT ENTRANCE. MANY ARKANSAS CHILDREN'S TEAM MEMBERS PARTICIPATED BY LEADING SESSIONS COVERING BROAD TOPICS OF OPERATIONS AND AVENUES TO CHAMPION CHILDREN THROUGH OUR HEALTHCARE SYSTEM. PARTICIPANTS WERE INTRODUCED TO DIVERSE CAREER OPPORTUNITIES AND GOT TO MEANINGFULLY ENGAGE WITH LEADERS THROUGHOUT THE ORGANIZATION DURING THE SUMMER LONG PROGRAM. HIGHLIGHTS INCLUDED A Q&A WITH THE ACNW CHIEF MEDICAL OFFICER; TOURS OF THE LAB, EMERGENCY DEPARTMENT AND RADIOLOGY; AND A DEEP DIVE INTO NUTRITION WITH DIETICIAN AND NUTRITIONAL SERVICES STAFF. THE ARKANSAS CHILDREN'S PATIENT AND FAMILY ADVISOR PROGRAM ENGAGES PARENTS AND CAREGIVERS IN A VARIETY OF WAYS TO CONTINUE ADVANCING OUR COMMITMENT TO PATIENT AND FAMILY-CENTERED CARE. THE HOSPITAL BEGAN WITH ONE FAMILY ADVISORY BOARD, AND THIS HAS GROWN TO TEN FAMILY ADVISORY BOARDS AND ONE YOUTH ADVISORY COUNCIL ACROSS THE ARKANSAS CHILDREN'S SYSTEM. THESE GROUPS HAVE BROUGHT ABOUT MANY MEANINGFUL CHANGES TO THE HOSPITAL INCLUDING: VIDEO STREAMING, CO-DESIGNED PATIENT SAFETY INFORMATION, A MEAL ASSISTANCE PROGRAM, THE DEVELOPMENT OF PATIENT AND FAMILY HEALTH INFORMATION. PATIENT AND FAMILY ADVISORS ARE ENGAGED IN OTHER CAPACITIES, INCLUDING HOSPITAL COMMITTEES, A MENTOR PROGRAM, AND OUR E-COUNCIL. THE ADVISORS ARE A MAJOR ASSET IN THE COMMITMENT TO PATIENT SAFETY AND TO THE HOSPITAL MISSION.ARKANSAS CHILDREN'S CARE NETWORK (ACCN), WITHIN THE ARKANSAS CHILDREN'S SYSTEM, IS A COLLABORATOR WITH ARKANSAS CHILDREN'S. ACCN SEEKS TO FUNDAMENTALLY AND POSITIVELY TRANSFORM HEALTH FOR THE CHILDREN OF ARKANSAS THROUGH A CLINICALLY INTEGRATED NETWORK (CIN) COMPRISED OF HEALTH CARE PROFESSIONALS WHO PROVIDE COORDINATED AND ACCOUNTABLE PEDIATRIC CARE. ACCN WILL ACHIEVE THIS BY IMPROVING QUALITY, ACCESS, AND PATIENT/FAMILY EXPERIENCE, WHILE IMPACTING THE AFFORDABILITY OF HEALTH CARE AND INCREASING PHYSICIAN ENGAGEMENT AND SATISFACTION. PART VI, LINE 6: ACNW IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, FOR WHICH ARKANSAS CHILDRENS, INC., INCORPORATED IN DECEMBER 2015, SERVES AS THE PARENT CORPORATION. THE ARKANSAS CHILDREN'S HEALTH SYSTEM CONSISTS OF ARKANSAS CHILDREN'S, INC., ARKANSAS CHILDREN'S HOSPITAL (ACH), ARKANSAS CHILDREN'S NORTHWEST (ACNW), ARKANSAS CHILDREN'S FOUNDATION (ACF), ARKANSAS CHILDREN'S RESEARCH INSTITUTE (ACRI), ARKANSAS CHILDREN'S CARE NETWORK (ACCN), ARKANSAS CHILDREN'S MEDICAL GROUP (ACMG), AND SACOVA INSURANCE COMPANY. ACH IS A NOT-FOR-PROFIT PEDIATRIC HOSPITAL LOCATED IN LITTLE ROCK, ARKANSAS AND SERVES AS THE ONLY QUATERNARY HEALTH CARE FACILITY FOR CHILDREN IN THE STATE OF ARKANSAS. ACNW IS A NOT-FOR-PROFIT PEDIATRIC HOSPITAL LOCATED IN SPRINGDALE, ARKANSAS, THAT OPENED IN FEBRUARY 2018. ACNW SERVES AS THE ONLY EXCLUSIVELY PEDIATRIC HEALTH CARE FACILITY FOR CHILDREN IN THE NORTHWEST REGION OF THE STATE. ACF IS A NOT-FOR-PROFIT ORGANIZATION THAT EXISTS AS THE FUNDRAISING BRANCH OF ARKANSAS CHILDREN'S. ACRI OPERATES TO SUPPORT, THROUGH CHARITABLE, SCIENTIFIC, AND EDUCATIONAL MEANS, THE MISSION OF ARKANSAS CHILDREN'S. ACCN IS A NOT-FOR-PROFIT PEDIATRIC STATEWIDE CLINICALLY INTEGRATED NETWORK. ACMG WAS FORMED TO PROVIDE PHYSICIAN SERVICES TO ACH AND ACNW. SACOVA IS A SINGLE PARENT CAPTIVE INSURANCE COMPANY PROVIDING PROFESSIONAL AND GENERAL LIABILITY AND WORKER'S COMPENSATION COVERAGE.ALTHOUGH NOT CORPORATE AFFILIATES, ACNW AND THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) ARE INVOLVED IN AN AGREEMENT IN THE PURSUIT OF PROFESSIONAL EDUCATION, RESEARCH, AND CLINICAL CARE FOR CHILDREN. ALL PEDIATRIC SUB-SPECIALTY WORK IS CONDUCTED ON THE ACNW CAMPUS WITH ACNW PROVIDING SPACE, SUPPORTING STAFF AND SERVICES AND FUNDING FOR MAJOR EDUCATIONAL AND CLINICAL EXPERTISE. 1 NORTHWEST ARKANSAS COUNCIL - HEALTHCARE TRANSFORMATION DIVISION 4100 CORPORATE CENTER DRIVE SUITE 205 SPRINGDALE AR 72762 710693739 501(C)(3) 60000 0 GENERAL SUPPORT ARKANSAS CHILDREN'S MEDICAL GROUP 1 CHILDRENS WAY LITTLE ROCK AR 72202 820771462 501(C)(3) 8369321 0 GENERAL SUPPORT 2 0 MEALS 1692 59006 COST MEALS FOR PATIENT FAMILIES/CAREGIVERS TRANSPORTATION COSTS (BUS TOKENS, CAB FARE, GAS CARDS) 159 3910 COST RENT, MORTGAGE, UTILITIES, LODGING 1 40 COST CLOTHING, GROCERY GIFT CARDS AND OTHER MISC. FAMILY ASSISTANCE 609 25432 COST FUNERAL EXPENSES 2 3695 COST PART I, LINE 2: THE HOSPITAL CONSIDERS REQUESTS FROM NON-PROFIT OR GOVERNMENTAL ENTITIES FOR PROGRAMS OR ACTIVITIES THAT ALIGN WITH ITS PLAN TO ADDRESS NEEDS AS IDENTIFIED IN THE CHNA OR THAT OTHERWISE SUPPORT THE HOSPITAL'S MISSION. THE HOSPITAL ANTICIPATES THAT THESE NON-PROFIT OR GOVERNMENTAL ENTITIES WILL MONITOR THE USE OF FUNDS IN ACCORDANCE WITH NON-PROFIT OR GOVERNMENTAL REQUIREMENTS. THE HOSPITAL PROVIDES SOME ASSISTANCE TO INDIGENT FAMILIES. THE HOSPITAL'S SOCIAL WORK DEPARTMENT EVALUATES THE NEED ON A CASE BY CASE BASIS AND PROVIDES THE APPROPRIATE ASSISTANCE, WHICH IS TYPICALLY FOOD, CLOTHING, SHELTER, OR TRAVEL VOUCHERS. CASH OR CASH EQUIVALENT ASSISTANCE IS SOMETIMES PROVIDED. THE ASSISTANCE PROVIDED IS DOCUMENTED BY THE HOSPITAL'S SOCIAL WORK DEPARTMENT. X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 MARCELLA DODERER PRESIDENT/CEO 0 1187391 0 600000 0 216360 0 258803 0 11763 0 2274317 0 200000 FREDERICK BARR MD EVP-CHIEF CLINICAL & ACADEMIC OFCR 0 667364 0 200096 0 4942 0 85600 0 11324 0 969326 0 0 GENA WINGFIELD EVP AND CFO 0 568077 0 184957 0 66752 0 85609 0 11162 0 916557 0 59202 JAMIE WIGGINS EVP/COO 0 502611 0 140764 0 829 0 60926 0 11057 0 716187 0 0 SHANNON HENDRIX ACNW SVP/CHIEF ADMINISTRATOR 310403 0 61901 0 490 0 47530 0 15190 0 435514 0 0 0 CINDY HILL FINANCIAL SERVICES VP 0 276450 0 58519 0 1853 0 13934 0 10162 0 360918 0 0 ROBERT SAYLORS MD TRUSTEE/DIRECTOR-CHIEF OF MED STAFF 0 287781 0 3294 0 0 0 0 0 57620 0 348695 0 0 LE'KITA BROWN REVENUE CYCLE VP 0 256804 0 52647 0 395 0 16050 0 5914 0 331810 0 0 MICHAEL HOWARD VP/CNO 215454 0 33849 0 484 0 12191 0 9827 0 271805 0 0 0 DIANA MCDANIEL OPERATIONS VP 218492 0 37648 0 204 0 4787 0 1930 0 263061 0 0 0 JAMALEE HUNTLEY PHARMACY DIRECTOR 163141 0 12271 0 139 0 12091 0 5298 0 192940 0 0 0 MICAH KIGHT DIRECTOR OF OPERATIONS 132883 0 20435 0 110 0 11044 0 19370 0 183842 0 0 0 JEFFREY WILLIAMS PHARMACY COORDINATOR 153470 0 4000 0 184 0 11415 0 14423 0 183492 0 0 0 KEITH VEIT PATIENT CARE SVC DIR (PARTIAL YR) 147334 0 10476 0 831 0 10217 0 9422 0 178280 0 0 0 DAVID THIESSEN DIRECTOR OF OPERATIONS 145154 0 10365 0 284 0 3028 0 14238 0 173069 0 0 0 SARAH SMITH AMBULATORY SERVICES DIRECTOR 147363 0 10090 0 178 0 3815 0 1525 0 162971 0 0 0 KAYLEIGH THOMPSON PHARMACY OPERATIONS MANAGER 141388 0 5000 0 101 0 6152 0 9355 0 161996 0 0 0 DEMETRIS TATUM RRT IV 140378 0 7992 0 31 0 2761 0 8935 0 160097 0 0 0 PART I, LINE 1A CHARTER TRAVEL IS USED BY ARKANSAS CHILDREN'S AND AFFILIATED ENTITIES' BOARD MEMBERS AND STAFF (AND OCCASIONALLY ACCOMPANYING SPOUSES/COMPANIONS) WHEN IT IS DEEMED THE MOST EFFICIENT METHOD OF TRAVEL TO DISTANT AREAS WITHIN THE STATE OR TO SURROUNDING STATES FOR PURPOSES RELATED TO ARKANSAS CHILDREN'S BUSINESS. SEPARATE (NON-CHARTER) TRAVEL FOR COMPANIONS IS REIMBURSED BY THE EMPLOYEE IF SUCH TRAVEL IS ON AN INDIVIDUAL BASIS; THUS, SUCH TRAVEL IS NOT CONSIDERED TAXABLE COMPENSATION TO THE EMPLOYEE. FOUR OFFICERS/EMPLOYEES USED CHARTER TRAVEL DURING THE CALENDAR YEAR. BECAUSE THE CHARTER TRAVEL WAS USED FOR ARKANSAS CHILDREN'S BUSINESS PURPOSES, IT WAS NOT CONSIDERED AS TAXABLE WAGES. PART I, LINE 3 COMPENSATION FOR ANY ACNW EXECUTIVE OR SENIOR OFFICER (PRESIDENT; EXECUTIVE VICE PRESIDENT; SENIOR VICE PRESIDENT) WHO IS NOT A CONTRACTED UAMS EMPLOYEE IS REVIEWED BY THE ARKANSAS CHILDREN'S HUMAN RESOURCES AND COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S, INC. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE HAS THE FULL AUTHORITY AND SPECIFIC RESPONSIBILITY FOR REVIEWING AND APPROVING COMPENSATION POLICIES, BASE SALARY AND INCENTIVE COMPENSATION LEVELS, EXECUTIVE RETIREMENT AND OTHER EXECUTIVE BENEFIT PLANS FOR HEALTH SYSTEM SENIOR MANAGEMENT, INCLUDING OFFICERS OF THE CORPORATION AND AFFILIATES WHO ARE "DISQUALIFIED PERSONS" UNDER SECTION 4958 OF THE CODE. THE POLICIES AND PROGRAMS REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL BE DESIGNED TO ENSURE THAT THE CORPORATION AND ITS AFFILIATES REMAIN COMPETITIVE AND REASONABLE RELATIVE TO THE COMPENSATION AND BENEFITS PRACTICES OF SIMILARLY SITUATED HEALTH SYSTEMS LOCALLY AND NATIONALLY, AND TO PERMIT THE CORPORATION AND SUCH AFFILIATES TO ATTRACT AND RETAIN SUPERIOR SENIOR MANAGEMENT, IN FURTHERANCE OF THE CORPORATION'S AND AFFILIATES PURPOSES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL HAVE, TO THE FULLEST EXTENT OF THE LAW, THE AUTHORITY TO APPROVE THE COMPENSATION PACKAGES FOR SENIOR MANAGEMENT OF THE CORPORATION AND THE AFFILIATES. IN ITS PROCESS, THE COMMITTEE SHALL OBTAIN AND MUST RELY UPON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENTS OF DISQUALIFIED PERSONS. APPROPRIATE DATA INCLUDES, BUT IS NOT LIMITED TO, COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR FUNCTIONALLY COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA OF THE CORPORATION, CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE DISQUALIFIED PERSON. THE COMMITTEE MAY RELY UPON OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. CONTEMPORANEOUSLY WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENT OF THE CEO AND DISQUALIFIED PERSONS, THE COMMITTEE SHALL DOCUMENT IN ITS MINUTES THE BASIS FOR ITS DECISIONS. A VERBAL REPORT IS PROVIDED TO THE BOARD BY THE CHAIR OF THE COMMITTEE. MINUTES ARE AVAILABLE FOR REVIEW UPON BOARD MEMBER REQUEST TO THE BOARD CHAIR. PART I, LINE 4B THE ARKANSAS CHILDREN'S DEFERRED COMPENSATION PLAN (DCP), WAS INSTITUTED ON 6/30/2014. THE DCP IS A 457(F) NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN, PROVIDING ANNUAL CONTRIBUTIONS TO CERTAIN EXECUTIVES AT A PERCENTAGE OF THEIR BASE SALARY IN EFFECT ON JUNE 30 OF THE PLAN YEAR. THE SUPPLEMENTAL COMPENSATION SERVES TO ENCOURAGE CONTINUED EMPLOYMENT WITH ARKANSAS CHILDREN'S AND ITS AFFILIATES. THE PLAN PROVIDES THAT DEFERRED AMOUNTS ARE PAID AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER BEING VESTED. IT IS INTENDED THAT SUCH PAYMENTS QUALIFY FOR THE "SHORT-TERM DEFERRAL" EXEMPTION FROM IRC SECTION 409A, AND FOR TAX DEFERRAL UNDER IRC SECTION 457(F). PER THE PLAN DOCUMENT, EACH DCP CONTRIBUTION FOR A PLAN YEAR AND ITS ASSOCIATED EARNINGS VEST AS FOLLOWS, ON THE EARLIER OF: - (SUBACCOUNT); THE FIRST DAY OF THE PLAN YEAR FOLLOWING THREE (3) CONTINUOUS PLAN YEARS OF EMPLOYMENT BY THE PARTICIPANT WITH ARKANSAS CHILDREN'S OR AFFILIATE, WHICH BEGINS ON THE FIRST DAY OF THE PLAN YEAR FOR WHICH THE CONTRIBUTION IS CREDITED. - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - ATTAINMENT OF AGE 65 AND AT LEAST 3 YEARS OF SERVICE AS A DCP PARTICIPANT - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - DEATH OR PERMANENT DISABILITY - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - INVOLUNTARY TERMINATION (OTHER THAN FOR CAUSE) - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - PLAN TERMINATION FOR TAX YEAR 2022 (FISCAL YEAR 2023), FIVE REPORTABLE EMPLOYEES WERE ELIGIBLE AND PARTICIPATING IN THE DEFERRED COMPENSATION PLAN. SOME OF THESE EMPLOYEES RECEIVED DISTRIBUTIONS PER THE PLAN DOCUMENT. SUCH AMOUNTS ARE NOTED BELOW. - MARCELLA DODERER: AC/ACH/ACNW PRESIDENT/CEO - $211,458 - GENA WINGFIELD: AC EVP AND CFO - $62,593 PER THE PLAN DOCUMENT, UPON BECOMING VESTED IN A PLAN YEAR SUBACCOUNT AND AS SOON AS ADMINISTRATIVELY PRACTICABLE AFTER SUCH VESTING DATE, BUT NO LATER THAN THE END OF THE CALENDAR YEAR IN WHICH SUCH VESTING DATE OCCURRED, INDIVIDUAL PARTICIPANTS WILL BE PAID A LUMP SUM PAYMENT EQUAL TO THE PLAN YEAR SUBACCOUNT BALANCE AS OF THE JUNE 30 IMMEDIATELY PRECEDING SUCH VESTING DATE. FORM 990, SCHEDULE J, PART I, LINES 5-7 THE INCENTIVE PLANS FOR ALL ENTITIES HAVE SPECIFIC RULES AND CALCULATIONS FOR BONUSES. NONE ARE CONTINGENT ON REVENUES OR NET EARNINGS OF THE ORGANIZATIONS (ANY), AND SINCE THEY ARE CALCULATED BASED ON A SPECIFIC FORMULA, THEY ARE NOT "NON-FIXED". FORM 990, PART VII, SECTION A, LINE 5: DIRECTOR AND CHIEF OF STAFF, ROBERT SAYLORS, M.D. WAS COMPENSATED BY UAMS AS AN EMPLOYEE FOR SERVICES RENDERED TO ARKANSAS CHILDREN'S HOSPITAL (ACH) AND ARKANSAS CHILDREN'S NORTHWEST (ACNW) FOR WHICH ACH REMITTED PAYMENT LISTED AS "REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS" IN PART VII. THE AMOUNT NOTED AS COMPENSATION IN SCHEDULE J FOR THE PHYSICIAN NOTED ABOVE WAS THE DESIGNATED AMOUNT PER THE RELATED CONTRACT WITH UAMS. A CITY OF SPRINGDALE AR PUBLIC FACILITIES BOARD 830465683 82025WAW1 2016-06-09 84999875 SEE SCHEDULE K, PART VI. 0 0 0 A 13695000 85258623 742725 84515898 2018 0 0 1 1 A 0 0 1 0 0 0.00070 0.00000 0.00070 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K SUPPLENTAL INFORMATION PART I, LINE A - DESCRIPTION OF PURPOSE. PROCEEDS USED TO (I) FINANCE THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF A PEDIATRIC HOSPITAL FACILITY TO BE LOCATED IN THE CITY OF SPRINGDALE, AR, AND (II) PAY CERTAIN EXPENSES IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2016 BONDS. PART II, LINE 3, BOND A - TOTAL PROCEEDS DIFFER FROM ISSUE PRICE DUE TO CUMULATIVE INVESTMENT EARNINGS. CCHWI LLC SEE PART V. ENTITY MORE-THAN-35%-OWNED BY BOARD MEMBER 500812 SEE PART V. LEASE OF REAL ESTATE FROM INTERESTED PERSON. LEASE EXPENSE WAS REASONABLE AND AT FMV RATE. 0 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING BOARD MEMBERS HAD A BUSINESS RELATIONSHIP DURING THE FISCAL YEAR: HARRY C. ERWIN, BARBARA TYSON, AND NOEL WHITE. THE FOLLOWING BOARD MEMBERS ALSO HAD A BUSINESS RELATIONSHIP DURING THE FISCAL YEAR: GARY GEORGE, STEVE STAFFORD, AND JOHN ROBERTS. THE FOLLOWING OFFICERS HAD A BUSINESS RELATIONSHIP DURING THE FISCAL YEAR: MARCELLA DODERER AND GENA WINGFIELD. BOTH SERVED ON THE BOARDS OF THE CHILDREN'S HEALTHCARE SYSTEM AND SACOVA INSURANCE COMPANY, LTD., WHICH ARE AFFILIATED COMPANIES. FORM 990, PART VI, SECTION A, LINE 3 ACNW'S CHIEF OF MEDICAL STAFF (CMS) POSITION IS HELD BY ROBERT SAYLORS, M.D., WHO HOLDS A FACULTY APPOINTMENT IN THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES, COLLEGE OF MEDICINE. ALTHOUGH DR. SAYLORS IS AN EMPLOYEE OF UAMS, AS CMS, HE IS ALSO A DESIGNATED MEMBER OF THE ACNW BOARD OF DIRECTORS. AS A UAMS EMPLOYEE, THE HOSPITAL SYSTEM REIMBURSES UAMS FOR HIS ROLE AND SERVICES RENDERED TO BOTH ACNW AND ACH. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF ACNW IS ARKANSAS CHILDREN'S, INC., AN ARKANSAS NONPROFIT PUBLIC BENEFIT CORPORATION (THE "SOLE MEMBER"). FORM 990, PART VI, SECTION A, LINE 7A ARKANSAS CHILDREN'S, INC., ACNW'S SOLE MEMBER, HAS THE RESERVED POWER TO FIX THE SIZE OF THE BOARD OF DIRECTORS, AND THE GOVERNING BOARD OF ANY AFFILIATE CONTROLLED BY THE CORPORATION, AND APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION, AND MEMBERS OF THE GOVERNING BOARD OF ANY AFFILIATE CONTROLLED BY THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B ACNW'S ARTICLES OF INCORPORATION MAY BE AMENDED, AND THE BYLAWS MAY BE ALTERED, AMENDED, OR REPEALED AND NEW BYLAWS MAY BE ADOPTED: (I) UPON THE APPROVAL OF BOTH THE BOARD AND THE SOLE MEMBER, IF THE AMENDMENT DOES NOT RELATE TO THE NUMBER OF DIRECTORS, THE COMPOSITION OF THE BOARD, THE TERM OF OFFICE OF DIRECTORS, OR THE METHOD OR WAY IN WHICH DIRECTORS ARE ELECTED OR SELECTED; OR (II) BY THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT FORM 990, WHICH IS RECONCILED TO THE ARKANSAS CHILDREN'S NORTHWEST (ACNW) INTERNAL FINANCIAL STATEMENTS AND THE ARKANSAS CHILDREN'S, INC. CONSOLIDATED AUDIT REPORT, IS INITIALLY REVIEWED IN DETAIL WITH THE EVP/CHIEF OPERATING OFFICER OF ARKANSAS CHILDREN'S, INC. THE DRAFT IS ALSO REVIEWED IN DETAIL WITH THE VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S, INC. IF THE REVIEW BY ACNW'S MANAGEMENT RESULTS IN REVISIONS TO THE DRAFT FORM 990, THOSE REVISIONS ARE MADE, AND THE FORM 990 TO BE FILED IS PROVIDED TO THE ACNW BOARD OF DIRECTORS PRIOR TO THE RETURN BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C ARKANSAS CHILDREN'S, INC. (THE PARENT) HAS A BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY THAT IS ISSUED TO AND REVIEWED WITH ALL NEW BOARD MEMBERS DURING THEIR BOARD ORIENTATION. IN ADDITION, THE INTERNAL GENERAL COUNSEL OR THE SYSTEM COMPLIANCE OFFICER WILL PERIODICALLY REVIEW THE POLICY WITH THE FULL BOARD DURING A REGULAR BOARD MEETING. A DIRECTOR SHALL DISCLOSE IN WRITING TO THE BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST WHEN THE SITUATION DEVELOPS, INCLUDING THE FACTS THAT MAKE IT AN ACTUAL OR POTENTIAL CONFLICT. EACH DIRECTOR SHALL SIGN AN INITIAL CONFLICT OF INTEREST DISCLOSURE STATEMENT UPON ELECTION TO THE BOARD OF DIRECTORS. EACH DIRECTOR ALSO SHALL SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST DEVELOPS AFTER THE DIRECTOR'S INITIAL AND ANNUAL STATEMENTS ARE SIGNED, THE DIRECTOR SHALL IMMEDIATELY SIGN A NEW DISCLOSURE STATEMENT TO ADDRESS THE NEW SITUATION OR TRANSACTION. CONFLICT OF INTEREST DISCLOSURE STATEMENTS OR DECLARED CONFLICTS WILL BE REVIEWED BY THE DIRECTOR BOARD OFFICERS. REVIEW WILL RESULT IN ONE OF THE FOLLOWING ACTIONS BY MAJORITY VOTE: (1) DETERMINED NOT TO BE A CONFLICT; (2) CONFLICT IS ACCEPTED; OR (3) CONFLICT IS NOT ACCEPTED AND THE DIRECTOR WILL NEED TO ABSTAIN FROM PARTICIPATION IN CERTAIN VOTES. CONFLICT DISCLOSURES, FACTS AND ACTIONS WILL BE DOCUMENTED IN THE APPROPRIATE COMMITTEE OR BOARD MINUTES. A DIRECTOR WITH A CONFLICT OF INTEREST WILL NOT PARTICIPATE IN DELIBERATIONS OR VOTE BY THE BOARD OF DIRECTORS, OR COMMITTEE THEREOF, ON THE MATTER GIVING RISE TO THE CONFLICT. HE OR SHE MAY PRESENT RELEVANT INFORMATION ABOUT THE MATTER AND ALSO MAY RESPOND TO REQUESTS FOR FACTS NEEDED BY THE BOARD TO REACH AN INFORMED DECISION. AFTER ANY DISCUSSION, THE INTERESTED DIRECTOR SHALL EITHER ABSTAIN FROM VOTE OR RECUSE COMPLETELY AND BE ABSENT DURING FURTHER DELIBERATIONS AND ACTION ON THE MATTER, AS DETERMINED BY THE DIRECTOR BOARD OFFICERS OF THE ENTITY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR ANY ACNW EXECUTIVE OR SENIOR OFFICER (PRESIDENT; EXECUTIVE VICE PRESIDENT; SENIOR VICE PRESIDENT) WHO IS NOT A CONTRACTED UAMS EMPLOYEE IS REVIEWED BY THE ARKANSAS CHILDREN'S HUMAN RESOURCES AND COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S, INC. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE HAS THE FULL AUTHORITY AND SPECIFIC RESPONSIBILITY FOR REVIEWING AND APPROVING COMPENSATION POLICIES, BASE SALARY AND INCENTIVE COMPENSATION LEVELS, EXECUTIVE RETIREMENT AND OTHER EXECUTIVE BENEFIT PLANS FOR HEALTH SYSTEM SENIOR MANAGEMENT, INCLUDING OFFICERS OF THE CORPORATION AND AFFILIATES WHO ARE "DISQUALIFIED PERSONS" UNDER SECTION 4958 OF THE CODE. THE POLICIES AND PROGRAMS REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL BE DESIGNED TO ENSURE THAT THE CORPORATION AND ITS AFFILIATES REMAIN COMPETITIVE AND REASONABLE RELATIVE TO THE COMPENSATION AND BENEFITS PRACTICES OF SIMILARLY SITUATED HEALTH SYSTEMS LOCALLY AND NATIONALLY, AND TO PERMIT THE CORPORATION AND SUCH AFFILIATES TO ATTRACT AND RETAIN SUPERIOR SENIOR MANAGEMENT, IN FURTHERANCE OF THE CORPORATION'S AND AFFILIATES PURPOSES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL HAVE, TO THE FULLEST EXTENT OF THE LAW, THE AUTHORITY TO APPROVE THE COMPENSATION PACKAGES FOR SENIOR MANAGEMENT OF THE CORPORATION AND THE AFFILIATES. IN ITS PROCESS, THE COMMITTEE SHALL OBTAIN AND MUST RELY UPON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENTS OF DISQUALIFIED PERSONS. APPROPRIATE DATA INCLUDES, BUT IS NOT LIMITED TO, COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR FUNCTIONALLY COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA OF THE CORPORATION, CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE DISQUALIFIED PERSON. THE COMMITTEE MAY RELY UPON OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. CONTEMPORANEOUSLY WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENT OF THE CEO AND DISQUALIFIED PERSONS, THE COMMITTEE SHALL DOCUMENT IN ITS MINUTES THE BASIS FOR ITS DECISIONS. A VERBAL REPORT IS PROVIDED TO THE BOARD BY THE CHAIR OF THE COMMITTEE. MINUTES ARE AVAILABLE FOR REVIEW UPON BOARD MEMBER REQUEST TO THE BOARD CHAIR. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 FOR ARKANSAS CHILDREN'S NORTHWEST IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 ARKANSAS CHILDREN'S NORTHWEST'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AS REQUIRED. FORM 990, PART IX, LINE 11G PHYSICIAN REMUNERATION: PROGRAM SERVICE EXPENSES 9,737,686. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,737,686. REFERRED TESTING: PROGRAM SERVICE EXPENSES 1,035,751. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,035,751. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 882,314. MANAGEMENT AND GENERAL EXPENSES 372,597. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,254,911. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 314,475. MANAGEMENT AND GENERAL EXPENSES 1,732,965. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,047,440. FORM 990, PART XII, LINE 2C IT IS PART OF THE RESERVED POWERS OF ARKANSAS CHILDREN'S, INC. TO RETAIN, OVERSEE AND TERMINATE INDEPENDENT EXTERNAL AUDITORS TO AUDIT THE FINANCIAL STATEMENTS OF ACH OR OF ANY AFFILIATE. ONE OF THE STANDING COMMITTEES OF ARKANSAS CHILDREN'S, THE FINANCIAL PLANNING AND OVERSIGHT COMMITTEE, SHALL UNDERTAKE THE FOLLOWING DUTIES IN THE AREAS OF FINANCE AND AUDITS: (I) CAUSING TO BE PREPARED, AND SUBMIT TO THE BOARD OF DIRECTORS AT ITS LAST MEETING BEFORE THE END OF THE FISCAL YEAR, THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION, AS WELL AS THE CAPITAL AND OPERATING BUDGETS OF AFFILIATES; (II) EXAMINING THE MONTHLY FINANCIAL REPORTS OF THE HEALTH SYSTEM; (III) REVIEWING THE INTERNAL AUDITING FUNCTIONS OF THE HEALTH SYSTEM; (IV) ENGAGING AN EXTERNAL AUDIT FIRM, SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS; (V) REVIEWING WITH THE INDEPENDENT AUDITOR THE SCOPE AND PLANNING OF THE AUDIT PRIOR TO THE COMMENCEMENT OF THE AUDIT, AS WELL AS UPON COMPLETION OF THE AUDIT, REVIEWING AND DISCUSSING WITH THE INDEPENDENT AUDITOR ANY MATERIAL RISKS OR WEAKNESSES IN INTERNAL CONTROLS IDENTIFIED BY THE AUDITOR, ANY RESTRICTIONS ON THE SCOPE OF THE AUDITOR'S ACTIVITIES OR ACCESS TO REQUESTED INFORMATION, ANY SIGNIFICANT DISAGREEMENTS BETWEEN THE AUDITOR AND MANAGEMENT, AND THE ADEQUACY OF THE HEALTH SYSTEM'S ACCOUNTING AND FINANCIAL REPORTING PROCESSES; (VI) ANNUALLY CONSIDERING THE PERFORMANCE AND INDEPENDENCE OF THE INDEPENDENT AUDITOR; (VII) REVIEWING AND REPORTING TO THE BOARD ON THE ANNUAL AUDITED FINANCIAL STATEMENT OF THE HEALTH SYSTEM CERTIFIED BY THE CORPORATION'S CERTIFIED PUBLIC ACCOUNTANTS, TOGETHER WITH SUCH CERTIFIED PUBLIC ACCOUNTANTS' MANAGEMENT LETTER TO THE CORPORATION WHICH THE COMMITTEE SHALL REVIEW AND REPORT ON TO THE BOARD OF DIRECTORS; (VIII) SUGGESTING MEANS TO IMPROVE FISCAL ACCOUNTABILITY AND INTERNAL AUDIT PROCEDURES FOR THOSE AREAS IDENTIFIED AS REQUIRING IMPROVEMENT; (IX) PROVIDING OVERSIGHT FOR THE HEALTH SYSTEM'S CORPORATE COMPLIANCE PROGRAM, INCLUDING CORPORATE ETHICS AND COMPLIANCE WITH LEGAL AND REGULATORY REQUIREMENTS; AND (X) REPORTING ON THE FINANCIAL PLANNING AND OVERSIGHT COMMITTEE'S ACTIVITIES TO THE FULL BOARD. 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