2024-11-15T10:27:57+00:00 2023-12-31 346565596 ERNST & YOUNG US LLP 2323 VICTORY AVENUE DALLAS TX 75219 990 2023-01-01 840166760 Children's Hospital Colorado CHIL 7207771234 13123 EAST 16TH AVENUE AURORA CO 80045 JENA HAUSMANN PRESIDENT AND CEO 2024-11-15 true true Patrick Shields P01508556 2149698000 2024-11-14 2023 2024-10-15 13:58:12Z JENA HAUSMANN 13123 EAST 16TH AVENUE AURORA CO 80045 1884261865 false X WWW.CHILDRENSCOLORADO.ORG X 1908 CO TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. 28 27 10924 2355 7886445 435077 23107575 10835364 1759565719 1848731304 9721449 22912634 29519645 1782563 1821914388 1884261865 595550 725550 0 0 919405180 1021647273 0 0 0 803274656 873552686 1723275386 1895925509 98639002 -11663644 2309224154 2330877583 1073506162 1042953407 1235717992 1287924176 TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. false false 1610020140 725550 1848731304 ROUTINE INPATIENT SERVICES; ANCILLARY INPATIENT SERVICES SUCH AS LAB, RADIOLOGY, OPERATING ROOM, RECOVERY ROOM, CENTRAL SUPPLIES, ETC.; OUTPATIENT SERVICES SUCH AS EMERGENCY ROOM, MULTI-SPECIALTY AMBULATORY SERVICES INCLUDING ORTHO CLINIC, ONCOLOGY CLINIC, ETC. 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53372712 6486957 582885 117107 59159677 48474391 5882427 883405 100701 53372712 41279296 8349894 1059492 95307 48474391 0.0 1.0 0.0 true false 38023300 38023300 1315612149 435341175 880270974 46114052 17117239 28996813 618375845 416532313 201843532 86206346 5184222 81022124 1230156743 OPERATING LEASES 66017948 TAMMEN TRUST 57523912 MISC. RECEIVABLES 54979869 INTERCOMPANY OTHER AFFILIATES 14181042 OTHER NON CURRENT ASSETS 21128603 FINANCIAL SWAP-ASSET 12126756 457 ASSETS 10237338 MISC. NOTE RECEIVABLES 10169915 SELF INSURANCE TRUST LT REC. 4475237 250840620 LEASE LIABILITY LT-OPERATING 79789970 CURRENT PORTION LT DEBT 16985477 SELF INSURANCE TRUST LIABILITY 17530410 VALUE OF INTEREST RATE SWAP 10913052 457 LIABILITIES 10237338 135456247 X Schedule D, Part V, Line 4 Intended uses of endowment funds THE HOSPITAL IS THE INCOME BENEFICIARY OF THE H.H. TAMMEN TRUST, A PERPETUAL TRUST UNDER WHICH THE HOSPITAL HAS THE IRREVOCABLE RIGHT TO RECEIVE THE INCOME EARNED ON THE TRUST ASSETS IN PERPETUITY. FUNDS ARE USED TO SUPPORT HOSPITAL ACTIVITIES. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. true true X true X 250 true X true true true false true true 2686639 580342 2106297 0.0011 854164976 492156270 362008706 0.1909 36722326 34445304 2277022 0.0012 0 0 893573941 527181916 366392025 0.1933 27868879 5561090 22307789 0.0118 42156669 10802522 31354147 0.0165 37801519 26431942 11369577 0.0060 40134902 12389676 27745226 0.0146 564525 564525 0.0003 0 0 148526494 55185230 93341264 0.0492 0 0 1042100435 582367146 459733289 0.2425 0 0.0 20987 20987 0.0000 29087 29087 0.0000 81044 17167 63877 0.0000 0 0.0 43777 43777 0.0000 0 0.0 1305358 284648 1020710 0.0005 0 0.0 0 0 1480253 301815 1178438 0.0006 true 9734935 1460240 2568698 3571538 -1002840 X true true 4 1 CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS 13123 EAST 16TH AVENUE AURORA CO 80045 WWW.CHILDRENSCOLORADO.ORG 010417 X X X X X A 2 CHCO - SOUTH CAMPUS 1811 PLAZA DRIVE HIGHLANDS RANCH CO 80129 WWW.CHILDRENSCOLORADO.ORG 01F105 X X X X X A 3 CHCO - COLORADO SPRINGS 4090 BRIARGATE PKWY COLORADO SPRINGS CO 80920 WWW.CHILDRENSCOLORADO.ORG 01b436 X X X X X 4 CHCO - NORTH CAMPUS 469 STATE HIGHWAY 7 BROOMFIELD CO 80023 WWW.CHILDRENSCOLORADO.ORG 017MU3 X X X X X A 2 false false true X X X X X X X X X 21 true true false true X https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ X X true 22 true https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ false true X 250.0 400.0 X X X true true X X X X true X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X X X X X X true X false X X X X true X false false CHCO - COLORADO SPRINGS 1 false false true X X X X X X X X X 21 true false false true X https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ X X true 22 true https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ false true X 250.0 400.0 X X X true true X X X X true X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X X X X X X true X false X X X X true X false false CHCO - NORTH CAMPUS 1 false false true X X X X X X X X X 22 true false false true X https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ X true 23 true https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ false true X 250.0 400.0 X X X true true X X X X true X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E A single Schedule H, Part V, Section B was completed for facility reporting group A. The following hospital facilities are included in facility reporting Group A: (1) Children's Hospital Colorado (CHCO) - Anschutz (2) CHCO - South Campus In 2021, Children's Hospital Colorado conducted a Community Health Needs Assessments (CHNA's). A joint assessment was conducted for licensed hospital facilities in the Denver Metro area, which included CHCO -Anschutz Medial Campus, CHCO - South Campus. The CHNA was approved by the Children's Hospital Colorado Board of Directors on December 16, 2021. Children's Hospital Colorado included in the CHNA report a prioritized list and description of the community's significant health needs identified through the CHNA process. The Anschutz CHNA' child mental health emerged as the top community concern through every method of data collection included in the assessments. Children's Hospital Colorado will address this community driven priority through a commitment of resources with specific programs and services as outlined in the corresponding implementation plans. "2021 CHNA's: https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/" Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 5 APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. Facility reporting group A, facilities 1 (Anschutz/Aurora) and 2 (South Campus/Highlands Ranch), for our 2021 Community Health Needs Assessment (CHNA) we collected input from persons who represent the broad interest of the community by engaging in community outreach to assess the interests and concerns of caregivers with children in the home who live in the 4-county area (counties of Arapahoe, Adams, Denver, and Douglas). Through our primary data collection approaches, which included surveys, interviews, and community meetings, we were able to gain the input of 408 respondents to our caregiver survey, 22 stakeholder interviews with community-based organization leaders, 94 respondents to a healthcare workers survey, more than 30 data sources queried, and 6 community meetings were held to prioritize findings. We also sought expertise from partners with special knowledge and expertise in public health, including the Center for Health Progress who facilitated four meetings with community members, one meeting with leaders of community-based organizations, and one internal meeting with the CHCO Team Member Resource Groups to discuss the assessment findings and identify priority needs from the community's perspective. To promote language justice, translation services were made available so that community members were able to participate in their preferred spoken language. Another organization we partnered with who are experts in public health is the Colorado School of Public Health, who facilitated meetings with groups of students enrolled in a Community Health Assessment course to assist with stakeholder interviews with organizations focused on food insecurity and to research existing and new, more holistic methods to screen for and measure food insecurity in a household. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 6a APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. Facility reporting group A, the CHNA for facilities (1) and (2) were conducted together as they share the same definition of community. Schedule H, Part V, Section B, Line 7 Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 7D APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. The CHNA is posted on the hospital's external facing website and is made available upon request either digitally or written format. As part of the CHNA communication plan, results of the CHNA and the subsequent implementation plan are shared at various stakeholder meetings and community forums with the goal of identifying opportunities to engage in collaborative efforts to address areas of need. A dedicated community benefit email also provides an opportunity for input and questions. In 2019, the State of Colorado enacted HB19-1320, Hospital Community Benefit Accountability. A pivotal requirement of the legislation is an annual community benefit public meeting. The purpose of the public meeting is to inform the community of the hospital's community benefit expenditures, provide an opportunity for the community to learn about the most recent CHNA and the strategies that address the identified priority needs. The community is also provided the opportunity to advise on health and social service needs that continue to be of concern for the community. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. Facility reporting group A, facilities 1 (Anschutz/Aurora) and 2 (South Campus/Highlands Ranch) for our 2021 Community Health Needs Assessment (CHNA) we took a holistic approach to addressing child mental health, which is our primary priority need identified in our CHNA. Our approach will focus on four areas: 1. Direct services and supports to prevent or address mental health conditions, 2. Advocating for improved systems of care for mental health, 3. Reducing stressors that may impact mental health, and 4. Engaging community to inform and shape our priorities. These strategies occur at various levels: individual child or youth, caregiver, healthcare provider, school, community, or at the system and policy level. Together, these areas will comprehensively work to address mental health needs among children and youth. CHCO recognizes that the public health needs of the community are extensive, and many needs are not explicitly addressed through our priority and goals. Access to health care, including mental health services, and several social determinants of health were identified as top needs by the community and within the data, such as food insecurity, housing, access to benefits, mother and infant health, and economic issues. While mental health will be our primary focus for the next several years, many strategies in this plan are connected to priorities identified in our needs assessment. Specifically, this plan includes strategies to improve access to health care and mental health services and address social determinants of health, both of which can improve mental health for children and youth. GOAL 1: Improve mental health awareness and reduce the risk of suicide. ACTIVITY: Provide training and implementation support to meet mental health needs of students (e.g., dialectical behavior therapy (DBT), suicide intervention and postvention protocols). OUTCOME: In 2023, we partnered with a subject matter expert to update the DBT series, now with three different focuses - elementary, middle and high school. We also created 19 short videos to support the learning experience. In 2023, we trained 345 school professionals through our DBT series. ACTIVITY: Provide training and implementation support to help clinics implement youth suicide prevention care pathways using evidence-based approaches (i.e., Ask Suicide-Screening Questions (ASQ) Suicide Screening, Brief Suicide Safety Assessment, and PracticeWISE MAP). OUTCOME: We offered Zero Suicide training to 232 medical professionals working in community primary care clinics (1,088 contact hours). We also provide more than 20 hours of content in partnership with Colorado ECHO. ACTIVITY: Provide suicide prevention training and education with community members (e.g., Question Persuade Refer (QPR), Applied Suicide Intervention Skills Training, Youth Mental Health First Aid). OUTCOME: 68 community members attending QPR training in 2023; all participants demonstrated an increase in knowledge across all measures. About 4% of participants were from rural or frontier communities. ACTIVITY: Expand Existing suicide ideation and depression screening to other clinical settings for patients aged 12 years and older. OUTCOME: In August 2023, universal suicide and depression screening has been implemented across all in-patient units and a few outpatient settings, with an overall screening rate of 73%. ACTIVITY: Host educational presentations by physicians, nurses, and other health care experts for community organizations and schools. OUTCOME: In 2023, we provided mental health educational and access information at 31 community-based events, in 331 media stories, and our mental health educational webpage reached 45,416 users. GOAL 2: Improve systems of care and access to mental health services. ACTIVITY: Strengthen the youth mental health system by, 1. Fighting for kids to get their fair share in the annual state budget, and 2. Strengthening the accountability and unity of the mental health system for kids with the new Behavioral Health Administration and the next phase of Colorado. OUTCOME: At the state level in 2023, Children's Hospital Colorado coordinated testimony from 28 experts on pending legislation at committee hearings, and actively tracked 176 bills. We activated our grassroots network on multiple child health policy topics, generating hundreds of messages to state and federal lawmakers on youth mental health. Top priority bills relevant to community benefit included advocating for youth mental health. We established a new Children, Youth and Families Mental Health Coalition in January 2022 and as of December 2023, we had 80 individuals and organizational representatives of diverse interests represented including schools, treatment providers, child abuse prevention advocates, mental health policy experts and more. Major community health priorities included a bill to increase access to mental health services for children under age 21 who are insured by Medicaid without the requirement for a mental health diagnosis. This expands access to integrated care and provides care to children and youth in need who may otherwise have barriers to access. We worked on two proposals this year to establish eating disorder prevention programs at the Colorado Department of Public Health and Environment and a bill to increase access to treatment for individuals with disordered eating by prohibiting health plans and Medicaid from utilizing body mass index to determine access to treatment. Additionally, we led an effort to support additional investments in community-based residential treatment capacity for children and youth with complex mental health needs and to require hospitals and counties to report to the state the number of patients with mental health conditions who were boarding or staying for extended periods of time beyond clinical need due to lack of intensive community-based treatment options. ACTIVITY: Support policies that address social determinants of health, including supporting funding and policy decisions that prioritize housing, economic security, and food security to reduce risk factors and promote the health and well-being of kids and families. OUTCOME: In 2023, we led a coalition to expand access to community health workers, where research has shown that access to community health workers can improve patient health outcomes, address health disparities and reduce healthcare costs while also expanding and diversifying the healthcare workforce. The legislation will enable community health workers to be paid for their care by Colorado Medicaid. We also worked on a number of proposals related to housing stability and nutrition, two of the most commonly identified needs among our patient population when we use our psychosocial screener. ACTIVITY: Advocate for healthcare financing models that provide better care for individuals with mental health conditions, including the integration of physical and mental health. OUTCOME: We work to expand the number of underinsured and uninsured children who can be served by Children's Hospital Colorado and other pediatric providers in Colorado and improve access to care and equity between private and public coverage. Serving as a bridge between patients, advocacy, providers, and the State, we engage deeply with behavioral health reform, as well as Medicaid, indigent care programs, and the Children's Health Insurance Program, among others. GOAL 3: Promote protective factors and reduce risk factors for mental health conditions. ACTIVITY: Address social needs of identified patients through the social needs screener and increase health navigation referrals. OUTCOME: Our health navigation teams play a critical role addressing needs such as housing, food, benefits, transportation, etc. Universal social needs screening has been occurring in our primary care settings since 2016 and was launched for inpatient units in August 2023. In 2023, our health navigators served more than 8,300 unique patients in inpatient and specialty clinic settings and 5,360 unique patients in primary care outpatient settings. ACTIVITY: Resource Connect and its partner organizations will increase families' access to health-related social supports. Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL FACILITIES INCLUDED IN GROUP (CONT.). OUTCOME: Resource Connect is a physical suite of offices in the Children's Colorado Health Pavilion where we host community-based organizations who help us respond to the social needs of our patient families and provide wraparound care and support. In 2023 our partners were: Denver Human Services (Public Benefits Technician); Arapahoe County Women, Infant and Children program; Energy Outreach Colorado; Spectrum Advocacy; Adams County Workforce; A Precious Child; and internal partner programs: Colorado Medical-Legal Partnership; Healthy Roots Food Clinic; and Injury Prevention (car seats and infant cribs education and distribution). The services provided in Resource Connect promote equitable access to the resources that all families, including families of color and families with low-income, need to improve their comprehensive picture of health and well-being. In 2023, Children's Colorado providers and other team members referred 2,077 families to Resource Connect; of those referrals, 681 were for the Healthy Roots Food Clinic, 357 were for assistance with public benefits, 232 were for legal services, 77 for WIC, 166 for housing navigation, and 165 for energy assistance. ACTIVITY: The Food as Medicine (FAM) team, who lead the Health Roots Food Clinic (HRFC), will increase families' access to healthy food and provides education to families about health eating, food preparation, and behavior change to encourage children to eat more fruits and vegetables. OUTCOME: In 2023, the Healthy Roots Food Clinic received 681 referrals from primary care clinics in our Health Pavilion and served 4,248 people (2,165 children and 2,083 adults). Most of these referrals came from social needs screening within our Health Pavilion's primary care clinics which provides comprehensive, team-based, family-centered primary care in a medical home model to more than 12,000 children annually from birth to 18 years, regardless of their ability to pay. Additionally, our Healthy Roots Garden produced over 1,230 pounds of fresh produce that was distributed in our food clinic. ACTIVITY: The Injury Prevention team will promote safe sleep through the distribution of portable infant cribs, in collaboration with the Community Health Navigation team, show families how to use them as a safe sleep option. OUTCOME: In 2023, we provided more than 100 portable infant cribs to families in need and provided them safe sleep education. ACTIVITY: The Injury Prevention team will provide child car seats and education on proper car seat installation. OUTCOME: In 2023, our Injury Prevention completed 550 car seat and booster seat checks, providing 406 child restraints to families in need. We provided car seat education with the support of in-person and virtual interpreters in 13 languages this year. We provided training and certification for 31 Child Passenger Safety Technicians (CPST) from Children's Hospital Colorado and surrounding community partners including law enforcement, healthcare, fire rescue, DHS workers, and more. In October, we trained 11 CPST's in our community to work with adaptive car seats for children with medical needs. ACTIVITY: Improve health outcomes for African American and Black mothers by addressing social isolation, health and community resources, anxiety and depression to improve perinatal health outcomes and decrease infant and maternal mortality through Kindred Mamas mentorship model. OUTCOME: In 2023, we supported 16 new mentors and paired them with 9 new mentees. ACTIVITY: Provide cultural responsiveness training for healthcare providers in partnership with community-based advocates and organizations through the Center for Advancing Professional Excellence (CAPE) simulation education training. OUTCOME: In 2023, we trained 53 providers (MD's, PhD's, PA's, APN's, MSW's, and medical residents), and 63 community advocates (BS, BA, RN, MSN, MS, MPH). ACTIVITY: Engage team members in the Experience Difference programming to practice and model inclusive behaviors, promote the tenants of health equity, and help create an organization that intentionally values difference. OUTCOME: In 2023, our Diversity, Health Equity, and Inclusion team launched the seventh cohort of the Captains of Inclusion program, training a total of 50 new Captains. ACTIVITY: Increase workforce diversity to be reflective of the community we serve. OUTCOME: Our Human Resources department is leading efforts to increase the diversity of leadership within our system; this work is ongoing. For this measure our definition of diversity is a "person of color", and our definition of leadership are roles who have direct supervisory responsibilities. In 2022, our benchmark was set at 17.02% of our leadership team identifying as a person of color, and that increased to 17.8% in 2023. ACTIVITY: The Team Member Resource Groups (TMRG) will support hospital-wide diversity and inclusion efforts, serve as a source of educational and professional development opportunities, and maintain an open forum for the exchange of ideas. OUTCOME: In 2023, the TMRG's consulted on 66 hospital policies and conducted 76 educational events within the organization. ACTIVITY: AsthmaCOMP (Colorado Comprehensive School-Centered Asthma Program) works with students, families, and school staff to improve school-based asthma care and pediatric asthma outcomes. Health navigators assess caregiver mental health using the Patient Health Questionnaire-4 (PHQ-4) and work to connect caregivers to community mental health services as necessary. OUTCOME: In the 2023 school year, this team completed 295 visits with students in 20 elementary schools. ACTIVITY: Just Keep Breathing (JKB) provides home visits to patients with high-risk asthma, improving outcomes through asthma education, environmental assessments and remediation, care coordination, and patient navigation. Health navigators assess caregiver mental health using the Patient Health Questionnaire-4 (PHQ-4) and work to connect caregivers to community mental health services as necessary. OUTCOME: In 2023, 325 eligible patients were approached, 71 patients were active in the program, and the team completed 143 home visits either virtually or in-person. ACTIVITY: Disparities Elimination through Coordinated Interventions to Prevent and Control Health and Lung Disease Risk (DECIPHeR) is expanding school-based asthma care into communities across Colorado with a focus on local adaptation led by cross-sector Community Advisory Boards. OUTCOME: In 2023, we conducted 11 community advisory board meetings. ACTIVITY: An inpatient asthma navigator for asthma patients and families transitioning from the inpatient setting to home, ensuring they are connected to follow up care and providing resources for identified psychosocial needs. OUTCOME: In 2023, our inpatient asthma navigator served 104 patients. ACTIVITY: The School Health team will develop a strategic plan that will implement systematic training, professional development for nurses, education to students and families, and support for school nurses and childcare health consultants around behavioral health and how to access additional resources for students with 504, individualized education programs, individual family service plan, or care plans. OUTCOME: In 2023, Children's Colorado's team of 33 School Nurse Consultants (SNCs) served over 250 school and childcare sites touching 62,000 children's lives in the Denver Metro area. Also in 2023, our School Health team created an online resource hub for any school in Colorado to access and download student care plan templates for 16 different health conditions: https://www.childrenscolorado.org/community/community-health/school-health/school-nurse-resources/ ACTIVITY: PMHI is partnering with schools to train school personnel how to lead Unstuck and On Target, a community-based curriculum for students, focused on cognitive behavioral techniques to promote executive functioning and students' success, including making goals and plans, balancing others' needs, and regulating emotions. This program will expand to the schools who receive training to lead the curriculum in their schools and classrooms. OUTCOME: In 2023, there were 27,525 visits to the website; 36,542 people received executive functioning resources; and 1,255 people enrolled in the program. ACTIVITY: The School-Based Dental Clinic team will provide dental hygiene services in schools in order to prevent caries and increase access to dental services. Schedule H, Part V, Section B, Line 11 Facility A, 3 Facility A, 3 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL FACILITIES INCLUDED IN GROUP (CONT.). OUTCOME: In 2023, our oral health outreach program provided preventive oral health services to children in various school settings outside of a traditional dental clinic. Through collaborative efforts with Aurora Public Schools, 15 school dental screening events occurred, with a focus on schools in north Aurora. Over 700 students (preschool to 3rd grade) received a dental screening and 235 students were identified as having dental needs, of which approximately 20% were urgent (rampant decay, pain, systemic infection). Every student screened was provided with an oral hygiene kit (i.e., toothbrush, toothpaste, floss, etc.) and those with dental needs were referred for care. GOAL 4: Promote community voices and engagement to inform, advise, and shape mental health priorities and systems of care. ACTIVITY: Children's Colorado's Government Affairs, Medicaid Strategy, and Partners for Children's Mental Health (PCMH) teams will lead and participate in community coalitions and continue to cultivate a statewide network of child health advocates and encourage Coloradans to voice their views on the importance of child and youth mental health in public policy. The PCMH Youth Council, led by 14 youth from across Colorado, will shape how PCMH plans, develops, and executes initiatives. The PMHI Youth Action Board (YAB), a program with up to 18 youth from 30 schools in the Denver metro area, will continue to promote ways to reduce stigma and raise awareness about mental health issues. OUTCOME: In 2023, 251 Child Health Champions trained and 232 community resident training on child advocacy. PCMH's youth engagement work was revamped to create the Youth Council on Mental Health (YCMH). The new structure was built for youth, by youth. Over 43 Colorado youth applied to participate in the YCMH. The council holds 22 Colorado youth and two boards: Community Action Team and the Program Innovation Team. These boards meet monthly to discuss mental health initiatives in schools and youth-led resource development (social media guide for teens). ACTIVITY: Engage and collaborate with community-focused public organizations in order to offer guidance, support, and/or feedback on shared strategies and goals aimed at mental health and/or contributing factors. OUTCOME: We participate with and/or lead more than 30 community-focused organizations/coalitions. Some key efforts include leading the Colorado Alliance for School Health, leading Safe Kids Colorado, and we activity participate in the Colorado Blueprint to End Hunger, Metro Denver Partnership for Health, the Aurora Health Alliance, Future of Charitable Food, Resident Leadership Council, Child Fatality Review Boards (Adams, Arapahoe and Douglas), Colorado Department of Education, Aurora Public School District, Colorado Association of School Nurses, Colorado Department of Public Health and Environment, Colorado Perinatal Care Quality Collaborative (CPCQC), Families Forward Resource Center, Food Bank of the Rockies, Hunger Free Colorado, and more. ACTIVITY: Provide a defined avenue for families, youth, and community through Family Advisory Councils (FAC) and Resource Connect Governance Council to advocate, engage, and educate Children's Hospital Colorado to improve the system of care and health outcomes for children and families receiving care. OUTCOME: There are 13 Family Advisory Councils representing a variety of affinity groups, such as the Hispanic FAC and the African American FAC, in addition to may FAC's specific to a medical condition (i.e., mental health, cancer, prematurity, etc.). These groups each meet 11-12 times per year, and they consulted on more than 100 hospital policies in 2023. Schedule H, Part V, Section B, Line 3E In 2021, CHNA was conducted for the CHCO - Colorado Springs hospital, licensed in 2019. This meets the requirement that newly licensed hospital facilities complete a CHNA by the last day of the second taxable year. The CHNA was approved by the Children's Hospital Colorado Board of Directors on December 16, 2021. CHCO - Colorado Springs CHNA prioritized a list and description of the community's significant health needs identified through the CHNA process. Colorado Springs CHNA reported child mental health as the top community concern through every method of data collection included in the assessments. CHCO - Colorado Springs will address this community driven priority through a commitment of resources with specific programs and services as outlined in the corresponding implementation plans. "2021 CHNA's: https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/" Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - CHCO - COLORADO SPRINGS. We engaged in community outreach process to assess the interests and concerns of caregivers in the neighborhoods and counties that the hospital serves. Through our primary data collection approaches, which included surveys, interviews, and community meetings, we were able to gain the input of hundreds of people. There were 90 respondents to our caregiver survey, 32 stakeholder interviews with community-based organization leaders, more than 30 data sources queried, and 1 community meeting was held to prioritize findings. We also sought expertise from partners with special knowledge and expertise in public health, including the Healthy Community Collaborative (HCC), who is a community stakeholder group formed in 2011 to address the health and social needs of El Paso County residents. The HCC consists of over 60 representatives from schools, hospitals and health systems, non-profit organizations, city and county government agencies, public health, medical providers, and interested citizens. We collaborated with the HCC in two ways: first, to provide feedback on our secondary data collection process and second, to prioritize the health needs of the children and youth in the El Paso County community. We partnered with UC Health system to prepare and collect stakeholder interviews. Our teams met weekly to strategize our stakeholder interview approach and outreach to shared stakeholders in El Paso County. We co-created data one-pagers for stakeholders to review prior to the interview. Another organization we partnered with who are experts in public health is the Colorado School of Public Health, who facilitated meetings with groups of students enrolled in a Community Health Assessment course to assist with stakeholder interviews with organizations focused on food insecurity and to research existing and new, more holistic methods to screen for and measure food insecurity in a household. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - CHCO - Colorado Springs. The CHNA is posted on the hospital's external facing website and is made available upon request either digitally or written format. As part of the CHNA communication plan, results of the CHNA and the subsequent implementation plan are shared at various stakeholder meetings and community forums with the goal of identifying opportunities to engage in collaborative efforts to address areas of need. A dedicated community benefit email also provides an opportunity for input and questions. In 2019, the State of Colorado enacted HB19-1320, Hospital Community Benefit Accountability. A pivotal requirement of the legislation is an annual community benefit public meeting. The purpose of the public meeting is to inform the community of the hospital's community benefit expenditures, provide an opportunity for the community to learn about the most recent CHNA and the strategies that address the identified priority needs. The community is also provided the opportunity to advise on health and social service needs that continue to be of concern for the community. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - CHCO - Colorado Springs. For our 2021 Community Health Needs Assessment (CHNA) we took a holistic approach to addressing child mental health, which is our primary priority need identified in our CHNA. Our approach will focus on four areas: 1. Direct services and supports to prevent or address mental health conditions, 2. Advocating for improved systems of care for mental health, 3. Reducing stressors that may impact mental health, and 4. Engaging community to inform and shape our priorities. These strategies occur at various levels: individual child or youth, caregiver, healthcare provider, school, community, or at the system and policy level. Together, these areas will comprehensively work to address mental health needs among children and youth. CHCO recognizes that the public health needs of the community are extensive, and many needs are not explicitly addressed through our priority and goals. Access to health care, including mental health services, and several social determinants of health were identified as top needs by the community and within the data, such as food insecurity, housing, access to benefits, mother and infant health, and economic issues. While mental health will be our primary focus for the next several years, many strategies in this plan are connected to priorities identified in our needs assessment. Specifically, this plan includes strategies to improve access to health care and mental health services and address social determinants of health, both of which can improve mental health for children and youth. Many of our goals and activities are intended to serve communities within and beyond the primary service area of the specific facility location; for example, much of our community work is conducted at the systems-level or statewide. Unless a specific geography is noted in the activities and outcomes below (i.e., Colorado Springs) the activities were carried out in a way that was inclusive of all our facility communities and/or statewide. GOAL 1: Improve mental health awareness and reduce the risk of suicide. ACTIVITY: In Colorado Springs, provide 1:1 coaching for youth with an assigned health coach who assists the students in identifying areas to build resilience, utilizes motivational and strength-based techniques, and provides support where needed. Offer and provide peer coaching to give students the ability to strengthen their own resilience with their peers. Lead, engage, and participate in community collaboratives that aim to decrease youth suicide, decrease utilization of crisis services, and promote preventative services. OUTCOME: During the 2022-2023 school year there were approximately 2,700 individual student coaching sessions were conducted within 24 middle schools in Colorado Springs. ACTIVITY: Provide training and implementation support to meet mental health needs of students (e.g., dialectical behavior therapy (DBT), suicide intervention and postvention protocols). OUTCOME: In 2023, we partnered with a subject matter expert to update the DBT series, now with three different focuses - elementary, middle and high school. We also created 19 short videos to support the learning experience. In 2023, we trained 345 school professionals through our DBT series. ACTIVITY: Provide training and implementation support to help clinics implement youth suicide prevention care pathways using evidence-based approaches (i.e., Ask Suicide-Screening Questions (ASQ) Suicide Screening, Brief Suicide Safety Assessment, and PracticeWISE MAP). OUTCOME: We offered Zero Suicide training to 232 medical professionals working in community primary care clinics (1,088 contact hours). We also provide more than 20 hours of content in partnership with Colorado ECHO. ACTIVITY: Provide suicide prevention training and education with community members (e.g., Question Persuade Refer (QPR), Applied Suicide Intervention Skills Training, Youth Mental Health First Aid). OUTCOME: 68 community members attending QPR training in 2023; all participants demonstrated an increase in knowledge across all measures. About 4% of participants were from rural or frontier communities. ACTIVITY: Expand Existing suicide ideation and depression screening to other clinical settings for patients aged 12 years and older. OUTCOME: In August 2023, universal suicide and depression screening was implemented within all the inpatient units of the Children's Colorado system; in 2023, we screened 4,271 patients for suicide and depression in Colorado Springs. ACTIVITY: Host educational presentations by physicians, nurses, and other health care experts for community organizations and schools. OUTCOME: In 2023, we provided mental health educational and access information at 31 community-based events, in 331 media stories, and our mental health educational webpage reached 45,416 users. GOAL 2: Improve systems of care and access to mental health services. ACTIVITY: Strengthen the youth mental health system by, 1. Fighting for kids to get their fair share in the annual state budget, and 2. Strengthening the accountability and unity of the mental health system for kids with the new Behavioral Health Administration and the next phase of Colorado. OUTCOME: At the state level in 2023, Children's Hospital Colorado coordinated testimony from 28 experts on pending legislation at committee hearings, and actively tracked 176 bills. We activated our grassroots network on multiple child health policy topics, generating hundreds of messages to state and federal lawmakers on youth mental health. Top priority bills relevant to community benefit included advocating for youth mental health. We established a new Children, Youth and Families Mental Health Coalition in January 2022 and as of December 2023, we had 80 individuals and organizational representatives of diverse interests represented including schools, treatment providers, child abuse prevention advocates, mental health policy experts and more. Major community health priorities included a bill to increase access to mental health services for children under age 21 who are insured by Medicaid without the requirement for a mental health diagnosis. This expands access to integrated care and provides care to children and youth in need who may otherwise have barriers to access. We worked on two proposals this year to establish eating disorder prevention programs at the Colorado Department of Public Health and Environment and a bill to increase access to treatment for individuals with disordered eating by prohibiting health plans and Medicaid from utilizing body mass index to determine access to treatment. Additionally, we led an effort to support additional investments in community-based residential treatment capacity for children and youth with complex mental health needs and to require hospitals and counties to report to the state the number of patients with mental health conditions who were boarding or staying for extended periods of time beyond clinical need due to lack of intensive community-based treatment options. ACTIVITY: Support policies that address social determinants of health, including supporting funding and policy decisions that prioritize housing, economic security, and food security to reduce risk factors and promote the health and well-being of kids and families. OUTCOME: In 2023, we led a coalition to expand access to community health workers, where research has shown that access to community health, we led a coalition to expand access to community health workers, where research has shown that access to community health workers can improve patient health outcomes, address health disparities and reduce healthcare costs while also expanding and diversifying the healthcare workforce. The legislation will enable community health workers to be paid for their care by Colorado Medicaid. We also worked on a number of proposals related to housing stability and nutrition, two of the most commonly identified needs among our patient population when we use our psychosocial screener. ACTIVITY: Advocate for healthcare financing models that provide better care for individuals with mental health conditions, including the integration of physical and mental health. OUTCOME: We work to expand the number of underinsured and uninsured children who can be served by Children's Hospital Colorado and other pediatric providers in Colorado and improve access to care and equity between private and public coverage. Serving as a bridge between patients, advocacy, providers, and the State, we engage deeply with behavioral health reform, as well as Medicaid, indigent care programs, and the Children's Health Insurance Program, among others. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 CONTINUE. GOAL 3: Promote protective factors and reduce risk factors for mental health conditions. ACTIVITY: Address social needs of identified patients through the social needs screener and increase health navigation referrals. OUTCOME: Our health navigation teams play a critical role addressing needs such as housing, food, benefits, transportation, etc. In 2023, our health navigators in Colorado Springs completed screening for 3,398 inpatients among 1,981 unique patients. ACTIVITY: Health Navigation will help families to navigate systems and connect them to community resources to meet families' social needs. OUTCOME: Health Navigators in Colorado Springs made 1,530 referrals to community resources. ACTIVITY: The Injury Prevention team will educate families/caregivers on appropriate steps to take when an infant is crying, calming techniques, and coping mechanisms to manage stress to prevent Shaken Baby Syndrome (SBS) through virtual classes and provided resources. OUTCOME: In Colorado Springs, we continued our free 1-hour virtual education class, 'Crying Happens. What's Your Plan?', in partnership with UCHealth Memorial Hospital, a main birthing hospital in the area. The class teaches about Shaken Baby Syndrome (SBS) prevention and has interactive questions for participants on frequency, causes, and how to make a plan. The course reached 33 caregivers and each participant who completed the post-survey reported having learned something new about SBS. ACTIVITY: The Injury Prevention team will provide car seats and education on proper car seat installation. OUTCOME: In 2023, we expanded our community outreach in Colorado Springs to increase injury prevention efforts with an equity lens. We continued providing 1-on-1 car seat checks by appointment and also partnered with the Colorado Springs Fire Department, Fountain Fire, and Colorado Springs Police Department to hold 11 monthly car seat check events in the community. Through these seat checks and car seat educational classes at the local Lutheran Family Services Refugee and Asylee program, we educated 238 caregivers on proper child restraint use, checked 206 car seats and boosters and corrected over an 80% misuse rate, while also providing 82 reduced-cost car seats and booster seats to families in need. We continued conducting appointments in English and Spanish while utilizing interpreters for families who spoke Dari, Arabic, and Swahili. We conducted 8 total in-person car seat safety presentations for expecting families at Peterson Space Force Base and the United States Air Force Academy, reaching 54 military parents and caregivers. We continued our child passenger safety program in the hospital, providing 43 free car seats to patient families in need along with printed materials on southern Colorado inspection stations and handouts with installation videos, Colorado law and best practices. Additionally, we created a program to be responsive to disparities in motor vehicle collisions (MVC) for Hispanic and Latino individuals, who have a 50% higher rate of death compared to non-Hispanic white adults in El Paso County. Also in Colorado over a 4-year period, a higher percentage of Hispanic and Latino children who died in MVCs were improperly restrained compared to non-Hispanic white children (72.3% vs. 46.2%). In wanting to intentionally address this, we identified the need to bring child passenger safety education to the part of our community with higher percentages of Hispanic or Latino families and reduce the geographic barrier of driving to our hospital location. We also partnered with Peak Vista Community Health Center's First Visitor program, which serves over 800 families yearly, 73% of which are Spanish speaking. As a result, in 2023, we held 6 Child Passenger Safety classes in Spanish at Peak Vista's location, reaching 21 caregivers and providing 31 reduced-cost car seats and boosters, each which is checked for proper installation after each class. We also held two Child Passenger Safety Technician (CPST) certification courses, training over 35 Children's Hospital Colorado and community members as CPSTs, and held one Safe Travel for All Children (STAC) adaptive child restraint course, training 11 Children's Hospital Colorado and community members. ACTIVITY: Provide cultural responsiveness training for healthcare providers in partnership with community-based advocates and organizations through the Center for Advancing Professional Excellence (CAPE) simulation education training. OUTCOME: In 2023, we trained 53 providers (MD's, PhD's, PA's, APN's, MSW's, and medical residents), and 63 community advocates (BS, BA, RN, MSN, MS, MPH). ACTIVITY: Engage team members in the Experience Difference programming to practice and model inclusive behaviors, promote the tenants of health equity, and help create an organization that intentionally values difference. OUTCOME: In 2023, our Diversity, Health Equity, and Inclusion team launched the seventh cohort of the Captains of Inclusion program, training a total of 50 new Captains; 10 of which are based in our Colorado Springs locations. ACTIVITY: Increase workforce diversity to be reflective of the community we serve. OUTCOME: Our Human Resources department is leading efforts to increase the diversity of leadership within our system; this work is ongoing. For this measure our definition of diversity is a "person of color", and our definition of leadership are roles who have direct supervisory responsibilities. In 2022, our benchmark for the system was set at 17.02% of our leadership team identifying as a person of color; in 2023, our Colorado Springs performance was 19.6%. ACTIVITY: The Team Member Resource Groups (TMRG) will support hospital-wide diversity and inclusion efforts, serve as a source of educational and professional development opportunities, and maintain an open forum for the exchange of ideas. OUTCOME: In 2023, the TMRG's consulted on 66 hospital policies and conducted 76 educational events within the organization. ACTIVITY: The School Health team will develop a strategic plan that will implement systematic training, professional development for nurses, education to students and families, and support for school nurses and childcare health consultants around behavioral health and how to access additional resources for students with 504, individualized education programs, individual family service plan, or care plans. OUTCOME: In 2023, our School Health team created an online resource hub for any school in Colorado to access and download student care plan templates for 16 different health conditions: https://www.childrenscolorado.org/community/community-health/school-health/school-nurse-resources/ ACTIVITY: PMHI is partnering with schools to train school personnel how to lead Unstuck and On Target, a community-based curriculum for students, focused on cognitive behavioral techniques to promote executive functioning and students' success, including making goals and plans, balancing others' needs, and regulating emotions. This program will expand to the schools who receive training to lead the curriculum in their schools and classrooms. OUTCOME: In 2023, there were 27,525 visits to the website; 36,542 people received executive functioning resources; and 1,255 people enrolled in the program. ACTIVITY: Behavioral Health Navigators, as part of the Building Resiliency for Healthy Kids program (in several Colorado Springs school districts) will support school health coaches, provide 1:1 behavioral health services when additional care is needed for students, and connect families to community resources when appropriate. OUTCOME: In Colorado Springs schools, behavioral health providers (licensed clinicians) delivered therapeutic services to 354 students in their school settings. GOAL 4: Promote community voices and engagement to inform, advise, and shape mental health priorities and systems of care. ACTIVITY: Children's Colorado's Government Affairs, Medicaid Strategy, and Partners for Children's Mental Health (PCMH) teams will lead and participate in community coalitions and continue to cultivate a statewide network of child health advocates and encourage Coloradans to voice their views on the importance of child and youth mental health in public policy. The PCMH Youth Council, led by 14 youth from across Colorado, will shape how PCMH plans, develops, and executes initiatives. The PMHI Youth Action Board (YAB), a program with up to 18 youth from 30 schools in the Denver metro area, will continue to promote ways to reduce stigma and raise awareness about mental health issues. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 CONTINUE. OUTCOME: In 2023, 251 Child Health Champions trained and 232 community residents training on child advocacy. PCMH's youth engagement work was revamped to create the Youth Council on Mental Health (YCMH). The new structure was built for youth, by youth. Over 43 Colorado youth applied to participate in the YCMH. The council holds 22 Colorado youth and two boards: Community Action Team and the Program Innovation Team. These boards meet monthly to discuss mental health initiatives in schools and youth-led resource development (social media guide for teens). ACTIVITY: Engage and collaborate with community-focused public organizations in order to offer guidance, support, and/or feedback on shared strategies and goals aimed at mental health and/or contributing factors. OUTCOME: We participate with and/or lead more than 30 community-focused organizations/coalitions. Some key efforts include leading the Colorado Alliance for School Health, leading Safe Kids Colorado, leading Safe Kids Colorado Springs, and we activity participate in the El Paso County Public Health Healthy Communities Collaborative, El Paso County Public Health Tobacco Free Alliance, El Paso County Public Health Youth Suicide Prevention Workgroup, Colorado Blueprint to End Hunger, Colorado Department of Education, Colorado Association of School Nurses, Colorado Department of Public Health and Environment, Colorado Perinatal Care Quality Collaborative (CPCQC), and more. ACTIVITY: Provide a defined avenue for families, youth, and community through Family Advisory Councils (FAC) and Resource Connect Governance Council to advocate, engage, and educate Children's Hospital Colorado to improve the system of care and health outcomes for children and families receiving care. OUTCOME: There are 13 Family Advisory Councils representing a variety of affinity groups, such as the Hispanic FAC and the African American FAC, in addition to may FAC's specific to a medical condition (i.e., mental health, cancer, prematurity, etc.). There is also a FAC specific to Colorado Springs. These groups each meet 11-12 times per year, and they consulted on more than 100 hospital policies in 2023. Schedule H, Part V, Section B, Line 3E Facility reporting; CHCO - NORTH CAMPUS IN 2022, CHILDREN'S HOSPITAL COLORADO CONDUCTED THE FIRST COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR FACILITY (4). THIS MEETS THE REQUIREMENT THAT NEWLY LICENSED HOSPITAL FACILITIES COMPLETE A CHNA BY THE LAST DAY OF THE SECOND TAXABLE YEAR. THE CHNA WAS APPROVED BY THE CHILDREN'S HOSPITAL COLORADO BOARD OF DIRECTORS ON DECEMBER 15, 2022. CHILDREN'S HOSPITAL COLORADO INCLUDED IN THE CHNA REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH INCLUDE CHILD MENTAL HEALTH AS THE TOP COMMUNITY CONCERN THROUGH EVERY METHOD OF DATA COLLECTION INCLUDED IN THE ASSESSMENTS, FOLLOWED BY ACCESS TO CARE AND FOOD INSECURITY. CHILDREN'S HOSPITAL COLORADO WILL ADDRESS THIS COMMUNITY DRIVEN PRIORITY THROUGH A COMMITMENT OF RESOURCES WITH SPECIFIC PROGRAMS AND SERVICES AS OUTLINED IN THE CORRESPONDING IMPLEMENTATION PLANS. 2022 CHNA: https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Schedule H, Part V, Section B, Line 5. Facility 4 (North/Broomfield) we engaged in community outreach process to assess the interests and concerns of caregivers in the neighborhoods and counties that the hospital serves. Through our primary data collection approaches, which included surveys, interviews, and community meetings, we were able to gain the input of hundreds of people. There were 314 respondents to our caregiver survey, 33 stakeholder interviews with community-based organization leaders, more than 30 data sources queried, and 2 community meetings were held to prioritize findings. We also sought expertise from partners with special knowledge and expertise in public health, including the Adams County Health Alliance who we partnered with to present findings and have a community prioritization meeting with members of the alliance; Broomfield Public Health and Environment, who we partnered with to join the Broomfield Community Services Network for a community meeting and to identify community partners to engage in stakeholder interviews and assist with distributing the caregiver survey; Broomfield Community Services Network, who partnered with University of Colorado Health (UCHealth) and Centura Health System to have a joint community prioritization meeting with; and, the Colorado School of Public Health provided a graduate intern who helped to conduct, transcribe and synthesize findings from key stakeholder interviews. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - CHCO - NORTH CAMPUS. Facility 4 (North/Broomfield) for our 2022 Community Health Needs Assessment (CHNA) we will take a holistic approach to addressing child mental health, which is our primary priority need identified in our CHNA, along with access to care and food insecurity. CHCO recognizes that the public health needs of the community are extensive, and many needs are not explicitly addressed through our priority and goals. Several health and social needs were identified as top needs by the community and within the data, such as maternal and infant health, child abuse and neglect, oral health, and affordable housing. Children's Colorado realizes the health and social needs for children and youth in our communities are vast. We aim to meaningfully advance child health and achieve more impact by focusing on our top three priority areas, rather than extending too far across domains and limiting our ability to improve health in any one area. Mental health, access to care, and food insecurity will be our primary areas of focus for the next several years for Broomfield and Adams counties. To impact mental health, our approach will focus on four areas: 1. Direct services and supports to prevent or address mental health conditions, 2. Advocating for improved systems of care for mental health, 3. Reducing stressors that may impact mental health, and 4. Engaging community to inform and shape our priorities. These strategies occur at various levels: individual child or youth, caregiver, healthcare provider, school, community, or at the system and policy level. Together, these areas will comprehensively work to address mental health needs among children and youth. To impact food security, our approach will focus on three areas: 1. Strengthen supports for families experiencing food insecurity by promoting our Food As Medicine (FAM) program by increasing access to healthy foods, health education and behavior change to promote healthy lifestyles and improve access to food supports; 2. Raise awareness of the health impacts of food insecurity by promoting food assistance and education programs in schools, primary care, and communities to increase enrollment in food-related benefits and access to food; and, 3. Promote community partnerships in support of food security. Many of our goals and activities are intended to serve communities within and beyond the primary service area of the specific facility location; for example, much of our community work is conducted at the systems-level or statewide. Unless a specific geography is noted in the activities and outcomes below (i.e., Broomfield or Adams County) the activities were carried out in a way that was inclusive of all the communities of our Denver Metro facilities, and/or statewide. MENTAL HEALTH GOAL 1: Improve mental health awareness and reduce the risk of suicide. ACTIVITY: Provide training and implementation support to meet mental health needs of students (e.g., dialectical behavior therapy (DBT), suicide intervention and postvention protocols). OUTCOME: In 2023, we partnered with a subject matter expert to update the DBT series, now with three different focuses - elementary, middle and high school. We also created 19 short videos to support the learning experience. In 2023, we trained 345 school professionals through our DBT series. ACTIVITY: Provide training and implementation support to help clinics implement youth suicide prevention care pathways using evidence-based approaches (i.e., Ask Suicide-Screening Questions (ASQ) Suicide Screening, Brief Suicide Safety Assessment, and PracticeWISE MAP). OUTCOME: We offered Zero Suicide training to 232 medical professionals working in community primary care clinics (1,088 contact hours). We also provide more than 20 hours of content in partnership with Colorado ECHO. ACTIVITY: Provide suicide prevention training and education with community members (e.g., Question Persuade Refer (QPR), Applied Suicide Intervention Skills Training, Youth Mental Health First Aid). OUTCOME: 68 community members attending QPR training in 2023; all participants demonstrated an increase in knowledge across all measures. About 4% of participants were from rural or frontier communities. ACTIVITY: Expand Existing suicide ideation and depression screening to other clinical settings for patients aged 12 years and older. OUTCOME: In August 2023, universal suicide and depression screening was implemented across all in-patient units and a few outpatient settings in the Children's Colorado System. At our North Campus in Broomfield, we screened 4,567 patients for suicide and depression in 2023. ACTIVITY: Host educational presentations by physicians, nurses, and other health care experts for community organizations and schools. OUTCOME: In 2023, we provided mental health educational and access information at 31 community-based events, in 331 media stories, and our mental health educational webpage reached 45,416 users. MENTAL HEALTH GOAL 2: Improve systems of care and access to mental health services. ACTIVITY: Strengthen the youth mental health system by fighting for kids to get their fair share in the annual state budget, and strengthening the accountability and unity of the mental health system for kids with the new Behavioral Health Administration and the next phase of Colorado. OUTCOME: At the state level in 2023, Children's Hospital Colorado coordinated testimony from 28 experts on pending legislation at committee hearings, and actively tracked 176 bills. We activated our grassroots network on multiple child health policy topics, generating hundreds of messages to state and federal lawmakers on youth mental health. Top priority bills relevant to community benefit included advocating for youth mental health. We established a new Children, Youth and Families Mental Health Coalition in January 2022 and as of December 2023, we had 80 individuals and organizational representatives of diverse interests represented including schools, treatment providers, child abuse prevention advocates, mental health policy experts and more. Major community health priorities included a bill to increase access to mental health services for children under age 21 who are insured by Medicaid without the requirement for a mental health diagnosis. This expands access to integrated care and provides care to children and youth in need who may otherwise have barriers to access. We worked on two proposals this year to establish eating disorder prevention programs at the Colorado Department of Public Health and Environment and a bill to increase access to treatment for individuals with disordered eating by prohibiting health plans and Medicaid from utilizing body mass index to determine access to treatment. Additionally, we led an effort to support additional investments in community-based residential treatment capacity for children and youth with complex mental health needs and to require hospitals and counties to report to the state the number of patients with mental health conditions who were boarding or staying for extended periods of time beyond clinical need due to lack of intensive community-based treatment options. ACTIVITY: Support policies that address social determinants of health, including supporting funding and policy decisions that prioritize housing, economic security, and food security to reduce risk factors and promote the health and well-being of kids and families. OUTCOME: In 2023, we led a coalition to expand access to community health workers, where research has shown that access to community health workers can improve patient health outcomes, address health disparities and reduce healthcare costs while also expanding and diversifying the healthcare workforce. The legislation will enable community health workers to be paid for their care by Colorado Medicaid. We also worked on a number of proposals related to housing stability and nutrition, two of the most commonly identified needs among our patient population when we use our psychosocial screener. ACTIVITY: Advocate for healthcare financing models that provide better care for individuals with mental health conditions, including the integration of physical and mental health. OUTCOME: We work to expand the number of underinsured and uninsured children who can be served by Children's Hospital Colorado and other pediatric providers in Colorado and improve access to care and equity between private and public coverage. Serving as a bridge between patients, advocacy, providers, and the State, we engage deeply with behavioral health reform, as well as Medicaid, indigent care programs, and the Children's Health Insurance Program, among others. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - CHCO - NORTH CMAPUS. MENTAL HEALTH GOAL 3: Promote protective factors and reduce risk factors for mental health conditions. ACTIVITY: Provide cultural responsiveness training for healthcare providers in partnership with community-based advocates and organizations through the Center for Advancing Professional Excellence (CAPE) simulation education training. OUTCOME: In 2023, we trained 53 providers (MD's, PhD's, PA's, APN's, MSW's, and medical residents), and 63 community advocates (BS, BA, RN, MSN, MS, MPH). ACTIVITY: Engage team members in the Experience Difference programming to practice and model inclusive behaviors, promote the tenants of health equity, and help create an organization that intentionally values difference. OUTCOME: In 2023, our Diversity, Health Equity, and Inclusion team launched the seventh cohort of the Captains of Inclusion program, training a total of 50 new Captains. ACTIVITY: Increase workforce diversity to be reflective of the community we serve. OUTCOME: Our Human Resources department is leading efforts to increase the diversity of leadership within our system; this work is ongoing. For this measure our definition of diversity is a "person of color", and our definition of leadership are roles who have direct supervisory responsibilities. In 2022, our benchmark was set at 17.02% of our leadership team in the Denver Metro area identifying as a person of color, and that increased to 17.8% in 2023. ACTIVITY: The Team Member Resource Groups (TMRG) will support hospital-wide diversity and inclusion efforts, serve as a source of educational and professional development opportunities, and maintain an open forum for the exchange of ideas. OUTCOME: In 2023, the TMRG's consulted on 66 hospital policies and conducted 76 educational events within the organization. MENTAL HEALTH GOAL 4: Promote community voices and engagement to inform, advise, and shape mental health priorities and systems of care. ACTIVITY: Children's Colorado's Government Affairs, Medicaid Strategy, and Partners for Children's Mental Health (PCMH) teams will lead and participate in community coalitions and continue to cultivate a statewide network of child health advocates and encourage Coloradans to voice their views on the importance of child and youth mental health in public policy. The PCMH Youth Council, led by 14 youth from across Colorado, will shape how PCMH plans, develops, and executes initiatives. The PMHI Youth Action Board (YAB), a program with up to 18 youth from 30 schools in the Denver metro area, will continue to promote ways to reduce stigma and raise awareness about mental health issues. OUTCOME: In 2023, 251 Child Health Champions trained and 232 community residents training on child advocacy. PCMH's youth engagement work was revamped to create the Youth Council on Mental Health (YCMH). The new structure was built for youth, by youth. Over 43 Colorado youth applied to participate in the YCMH. The council holds 22 Colorado youth and two boards: Community Action Team and the Program Innovation Team. These boards meet monthly to discuss mental health initiatives in schools and youth-led resource development (social media guide for teens). ACTIVITY: Engage and collaborate with community-focused public organizations in order to offer guidance, support, and/or feedback on shared strategies and goals aimed at mental health and/or contributing factors. OUTCOME: We participate with and/or lead more than 30 community-focused organizations/coalitions. Some key efforts include leading the Colorado Alliance for School Health, leading Safe Kids Colorado, and we activity participate in the Colorado Blueprint to End Hunger, Metro Denver Partnership for Health, the Aurora Health Alliance, Future of Charitable Food, Resident Leadership Council, Child Fatality Review Boards (Adams, Arapahoe and Douglas), Colorado Department of Education, Aurora Public School District, Adams 14 School District, Kids First Healthcare, Colorado Association of School Nurses, Colorado Department of Public Health and Environment, Colorado Perinatal Care Quality Collaborative (CPCQC), Families Forward Resource Center, Food Bank of the Rockies, Hunger Free Colorado, and more. ACTIVITY: Provide a defined avenue for families, youth, and community through Family Advisory Councils (FAC) and Resource Connect Governance Council to advocate, engage, and educate Children's Hospital Colorado to improve the system of care and health outcomes for children and families receiving care. OUTCOME: There are 13 Family Advisory Councils representing a variety of affinity groups, such as the Hispanic FAC and the African American FAC, in addition to may FAC's specific to a medical condition (i.e., mental health, cancer, prematurity, etc.). These groups each meet 11-12 times per year, and they consulted on more than 100 hospital policies in 2023. ACCESS TO CARE. To impact access to care, our approach will focus on three areas: 1. Improve systems of care and access to healthcare services by partnering with primary care practices, payers, and lawmakers to identify opportunities to improve access to healthcare services for children and families; 2. Promote navigation supports to increase access to social services and supports that affect access to care; and, 3. Promote community partnerships in support of access to care. ACCESS TO CARE GOAL 1: Improve systems of care and access to healthcare services ACTIVITY: Advocate for policies that improve insurance coverage and quality, build and strengthen provider networks, and improve health care financing, particularly for health-related social needs. OUTCOME: We work to expand the number of underinsured and uninsured children who can be served by Children's Hospital Colorado and other pediatric providers in Colorado and improve access to care and equity between private and public coverage. Serving as a bridge between patients, advocacy, providers, and the State, we engage deeply with behavioral health reform, as well as Medicaid, indigent care programs, and the Children's Health Insurance Program, among others. ACCESS TO CARE GOAL 2: Promote navigation support to increase access to social services and supports that affect access to care. ACTIVITY: Address social needs of identified patients through social needs screening and increase health navigation referrals. Health navigation will help families to navigate systems and connect them to community resources to meet families' resource needs. Explore health navigation expansion at North Campus to provide resource referrals. OUTCOME: Our health navigation teams play a critical role addressing needs such as housing, food, benefits, transportation, etc. Universal social needs screening was implemented at all inpatient units in the Children's Colorado system in August of 2023. At our North Campus facility in Broomfield, we screened 675 inpatients in 2023 and 88.9% of people who wanted help, got help (referrals). ACCESS TO CARE GOAL 3: Promote community partnership in support of access to care ACTIVITY: AsthmaCOMP (Colorado Comprehensive School-Centered Asthma Program) works with students, families, and school staff to improve school-based asthma care and pediatric asthma outcomes. Health navigators assess caregiver mental health using the Patient Health Questionnaire-4 (PHQ-4) and work to connect caregivers to community mental health services as necessary. OUTCOME: In the 2023 school year, this team completed 295 visits with students in 20 elementary schools. ACTIVITY: Just Keep Breathing (JKB) provides home visits to patients with high-risk asthma, improving outcomes through asthma education, environmental assessments and remediation, care coordination, and patient navigation. Health navigators assess caregiver mental health using the Patient Health Questionnaire-4 (PHQ-4) and work to connect caregivers to community mental health services as necessary. OUTCOME: In 2023, 325 eligible patients were approached, 71 patients were active in the program, and the team completed 143 home visits either virtually or in-person. ACTIVITY: An inpatient asthma navigator for asthma patients and families transitioning from the inpatient setting to home, ensuring they are connected to follow up care and providing resources for identified psychosocial needs. OUTCOME: In 2023, our inpatient asthma navigator served 104 patients. Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - CHCO - NORTH CAMPUS. ACTIVITY: The School Health team will develop a strategic plan that will implement systematic training, professional development for nurses, education to students and families, and support for school nurses and childcare health consultants around behavioral health and how to access additional resources for students with 504, individualized education programs, individual family service plan, or care plans. OUTCOME: In 2023, Children's Colorado's team of 33 School Nurse Consultants (SNCs) served over 250 school and childcare sites touching 62,000 children's lives in the Denver Metro area. Also in 2023, our School Health team created an online resource hub for any school in Colorado to access and download student care plan templates for 16 different health conditions: https://www.childrenscolorado.org/community/community-health/school-health/school-nurse-resources/ ACTIVITY: PMHI is partnering with schools to train school personnel how to lead Unstuck and On Target, a community-based curriculum for students, focused on cognitive behavioral techniques to promote executive functioning and students' success, including making goals and plans, balancing others' needs, and regulating emotions. This program will expand to the schools who receive training to lead the curriculum in their schools and classrooms. OUTCOME: In 2023, there were 27,525 visits to the website; 36,542 people received executive functioning resources; and 1,255 people enrolled in the program. ACTIVITY: The School-Based Dental Clinic team will provide dental hygiene services in schools in order to prevent caries and increase access to dental services. OUTCOME: In 2023, our oral health outreach program provided preventive oral health services to children in various school settings outside of a traditional dental clinic. Through collaborative efforts with Aurora Public Schools (which covers portions of both Adams and Arapahoe counties), 15 school dental screening events occurred, with a focus on schools in north Aurora. Over 700 students (preschool to 3rd grade) received a dental screening and 235 students were identified as having dental needs, of which approximately 20% were urgent (rampant decay, pain, systemic infection). Every student screened was provided with an oral hygiene kit (i.e., toothbrush, toothpaste, floss, etc.) and those with dental needs were referred for care. FOOD INSECURITY GOAL 1: Strengthen supports for families experiencing food insecurity. ACTIVITY: Screen for food insecurity in the inpatient setting. Explore expanding community health navigation to North Campus to provide resource referral for benefits. OUTCOME: We have a dedicated health navigator at our North Campus in Broomfield who responds to identified social needs. In 2023 social needs screening was implemented and 670 patients were screened for food needs; of those who were screened, 88.9% of those who identified a food need and wanted help, got help. FOOD INSECURITY GOAL 2: Raise awareness of the health impacts of food insecurity. ACTIVITY: Partner with schools and community-based organizations to identify opportunities to promote access to high-quality nutritious food and education. OUTCOME: Our Food As Medicine Team is actively partnering with the Adams 12 School District's 5 Star Education Foundation to coordinate efforts. Our partnership will transform their existing food pantries into food clinics by adopting Food as Medicine principles. Children's Colorado will provide the technical assistance to do this, and we are actively partnering on grant funding proposals. FOOD INSECURITY GOAL 3: Promote community partnerships in support of food security. ACTIVITY: Coordinate with partners on existing strategies and opportunities to promote food security. Participate in Metro Denver Health Beverage Coalition, Blueprint to End Hunger Coalition and national-level efforts to promote food security. OUTCOME: Our Food As Medicine team is actively collaborating with the Blueprint to End Hunger on strategies to address the food pantry desert in Adams County. We are also advocating on behalf of the Adams county area for Food Bank of the Rockies to increase access to charitable food in the area. 9 CHILDREN'S HOSPITAL CO OP SPECIALTY CARE 4125 BRIARGATE PKWY COLORADO SPRINGS CO 80920 SPECIALTY CARE, ONCOLOGY CLINICS, URGENT CARE CHILDREN'S CO HEALTH PAVILION 860 NORTH POTOMAC CIRCLE AURORA CO 80011 OT/PT, SPEECH & AUDIOLOGY, MULTI-SPECIALTY CLINICS,DENTAL CLINCIS, SPECIALTY PHARMACY CHILDREN'S HOSPITAL CO - THERAPY CARE 9139 SOUTH RIDGELINE BLVD 100 HIGHLANDS RANCH CO 80129 REHABILITATION & THERAPY SERVICES CHILDREN'S HOSPITAL CO - THERAPY CARE 8401 ARISTA PLACE BROOMFIELD CO 80021 OT/PT, SPEECH & AUDIOLOGY SERVICES KIDSTREET 860 N POTOMAC CIR AURORA CO 80011 REHABILITATION & THERAPY SERVICES CHILDREN'S HOSPITAL CO - UPTOWN 1830 FRANKLIN ST DENVER CO 80218 EMERGENCY CARE, UC, OP SPCLTY, DIAGNOSTIC, OBSERVATION LICENSEDC CMTY CLINIC 18M127 CHILDREN'S HOSPITAL CO - ORTHOPEDIC CARE 9094 E MINERAL AVE SUITE 110 CENTENNIAL CO 80112 ORTHOPEDIC CARE, RADIOLOGY SERVICES, SPORTS MEDDICINE CHILDREN'S HOSPITAL CO - UC & OP CARE 3455 LUTHERAN PKWY WHEATRIDGE CO 80033 URGENT CARE, SPECIALIST CARE SPORTS MEDICINE CHILDREN'S HOSPITAL CO - THERAPY CARE 2375 TELSTAR DR SUITE 160 COLORADO SPRINGS CO 80920 OT/PT, SPEECH THERAPY, THERAPY SERVICES Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT CHILDREN'S COLORADO PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT. THE 2023 REPORT WILL BE PUBLISHED AFTER THE FINALIZATION OF THE 2023 SCHEDULE H 990 REPORTING. THE 2021 REPORT CAN BE FOUND AT HTTPS://WWW.CHILDRENSCOLORADO.ORG/COMMUNITY/COMMUNITY-HEALTH/. PRIOR TO THE COMPLETION OF THE REPORT A DISTRIBUTION LIST OF COMMUNITY MEMBERS, PARTNERS AND STATE AND LOCAL OFFICIALS IS DEVELOPED, AND THE REPORT IS DISTRIBUTED UPON COMPLETION. COINCIDING WITH THE PHYSICAL DISTRIBUTION THE REPORT IS THEN PUBLISHED ON THE CHCO WEBSITE. Schedule H, Part I, Line 7 COMMUNITY BENEFITS IN 2023, CHILDREN'S HOSPITAL COLORADO PROVIDED $459,733,289 IN BENEFIT TO THE COMMUNITY. MEDICAID AT CHILDREN'S HOSPITAL COLORADO ACCOUNTED FOR $362,008,706 OF NET COMMUNITY BENEFIT EXPENSE WITH $2,106,297 IN FINANCIAL ASSISTANCE AND $2,277,022 IN MEANS TESTED PROGRAMS. OTHER BENEFITS ACCOUNTED FOR $ 93,341,264 IN NET COMMUNITY BENEFIT EXPENSE. OF THAT $22,307,789 IN COMMUNITY HEALTH IMPROVEMENT, $31,354,147 IN HEALTH PROFESSION EDUCATION, $11,369,577 IN SUBSIDIZED HEALTH SERVICES, $27,745,266 IN RESEARCH AND $564,524 IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT. INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THOSE WHICH CHILDREN'S HOSPITAL COLORADO PROVIDES TO ITS PATIENT POPULATION AT A LOSS. THE NUMBER REFLECTED IN SUBSIDIZED HEALTH SERVICES EXCLUDES BAD DEBT, MEDICAID AND OTHER MEANS TESTED PROGRAMS SHORTFALLS AND FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO IS COMMITTED TO SERVING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. Schedule H, Part VI, Line 7 State filing of community benefit report IN 2019, COLORADO LAWMAKERS PASSED HB19-1320, HOSPITAL COMMUNITY BENEFIT ACCOUNTABILITY, REQUIRING NONPROFIT HOSPITALS TO SUBMIT AN ANNUAL COMMUNITY BENEFIT REPORT. Schedule H, Part II, Line 10 COMMUNITY BUILDING ACTIVITIES IN 2023, CHILDREN'S HOSPITAL COLORADO PROVIDED $1,178,438 IN COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE DESIGNED TO PROMOTE THE HEALTH OF THE BROADER COMMUNITY. WE CONTINUE TO BUILD ON OUR LONG AND STRONG RECORD OF COLLABORATION WITH COMMUNITY GROUPS, BUSINESSES, ACADEMIC INSTITUTIONS AND GOVERNMENTAL AND NON-GOVERNMENTAL ORGANIZATIONS, WITH THE GOAL OF IMPROVING HEALTH OUTCOMES AND REDUCING HEALTH DISPARITIES FOR CHILDREN AND THEIR FAMILIES. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUED) WORKFORCE DEVELOPMENT: THE MEDICAL CAREER COLLABORATIVE (MC2) program propels high school students towards careers in healthcare through hands on experiences and professional development opportunities. Applicants are selected in the spring of their sophomore high school year by a committee with great emphasis placed on selecting a diverse group of students from a range of backgrounds and high schools in the Denver metro area. Increasing diversity and providing opportunity to underrepresented populations in the health professions has become identified as paramount to the nation's need to eliminate inequities in the quality and availability of health care for underserved populations. In the 2022-2023 academic year, MC2 served 130 high school students (68 juniors and 62 seniors) from 49 high schools. 94% of graduates plan to attend a 2- or 4-year college and 91% of graduates declared a health or pre-health major. Ninety-seven percent of MC2 participants are students of color; 42% Hispanic/Latino, 23% Black/African American, 15% Asian/Pacific Islander, 14% multi-racial, 3% Middle Eastern, 3% White/Caucasian, and 0% American Indian/Alaskan Native. WORKFORCE DEVELOPMENT: PROJECT SEARCH is a school-to transition work program for students with significant disabilities. The program provides employment and education opportunities which span a full academic year. Students complete 4-day work weeks for 15 weeks, and rotate worksites throughout the hospital. The goal of Project Search is that the participants leave the program employment ready and gain successful employment at the host site's business or elsewhere in the community. In 2023, we supported 8 students. MEDICAL FACULTY PROFILE. Our open medical staff arrangement allows community practitioners to hold privileges at our hospitals, and more than half of our approximately 2,700 medical staff of providers and advanced practice nurses are community-based. Among the thousands of referring providers throughout our seven-state region, these community staff members are frontline partners not only in establishing a seamless continuum of care for our young patients, but in providing training opportunities in primary care for the medical students and residents who will become tomorrow's pediatric professionals. Through our affiliation with family medicine residency programs in Colorado and Wyoming, we're able to provide pediatric rotation at our hospitals, which offers significant benefit to a region with a large rural population and a shortage of rural care providers. These affiliations also ensure that a primary care perspective is central to our strategies for providing the region's children with the broadest spectrum of care. RESEARCH. 2023 marked another year of impressive growth and accomplishments for child health research teams. Our child health researchers earned a top spot as national leaders in NIH research funding in 2023, published by Blue Ridge Institute for Medical Research. The rankings place the University of Colorado's Department of Pediatrics as the second highest NIH-funded pediatric department in the country. In addition, overall funding for all CU and Children's Hospital Colorado's child health research teams increased nearly $7.8 million from the previous fiscal year, coming in at more than $156.8 million in 2023. Here's a look at some of the highlights: $156.8M+ in funding to Children's Colorado and University of Colorado in FY2023; 521 unique child health principal investigators with externally sponsored funding; and #2 NIH-funded pediatrics department (Source: Blue Ridge Institute for Medical Research). BOARD OF DIRECTORS. At the time of filing this form 990, Children's Hospital Colorado's Board of Directors is made up of twenty-six volunteers and the associated executive leaders from the hospital and affiliated institutions. Board service is a commitment to help further the hospital's mission of improving the health of children through the provision of high quality, coordinated programs of patient care, education, research, and advocacy. KIDS ARE OUR BOTTOM-LINE. As a non-profit organization, surplus funds are invested back into providing health care services and resources to the community, including but not limited to new patient care locations and equipment, expanded programs and services, community health promotion, research, and training of physicians, nurses, and other allied health professionals. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE ORGANIZATION RECOGNIZES NET PATIENT SERVICE REVENUE IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 606, REVENUE FROM CONTRACTS WITH CUSTOMERS. THE ADOPTION OF ASC 606 RESULTED IN CHANGES TO THE PRESENTATION FOR NET PATIENT SERVICES REVENUE RELATED TO UNINSURED OR UNDERINSURED PATIENTS. UNDER ASC 606, THE ESTIMATED UNCOLLECTABLE AMOUNTS DUE FROM THESE PATIENTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE, RATHER THAN AS A PROVISION FOR BAD DEBTS, AND ARE BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE. OTHER THAN THESE CHANGES IN PRESENTATION, THE ADOPTION OF ASC 606 DID NOT HAVE A MATERIAL IMPACT ON THE OVERALL FINANCIAL STATEMENTS OF THE ORGANIZATION. EXPANDED DISCLOSURES REQUIRED BY ASC 606 ARE INCLUDED WITHIN NOTE 4, NET PATIENT SERVICES REVENUE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology CHILDREN'S HOSPITAL INACTIVATES AR BALANCES BETWEEN 150-175 DAYS AFTER THE FIRST BILLING CYCLE. ACCOUNTS ARE REFERRED TO COLLECTION AGENCIES FOR RECOVERY. THE HOSPITAL DOES NOT REPORT ANY BAD DEBT AMOUNT IN COMMUNITY BENEFIT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION RECOGNIZES NET PATIENT SERVICE REVENUE IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 606, REVENUE FROM CONTRACTS WITH CUSTOMERS. THE ADOPTION OF ASC 606 RESULTED IN CHANGES TO THE PRESENTATION FOR NET PATIENT SER VICES REVENUE RELATED TO UNINSURED OR UNDERINSURED PATIENTS. UNDER ASC 606, THE ESTIMATED UNCOLLECTABLE AMOUNTS DUE FROM THESE PATIENTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE, RATHER THAN AS A PROVISION FOR BAD DEBTS, AND ARE BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE. OTHER THAN THESE CHANGES IN PRESENTATION, THE ADOPTION OF ASC 606 DID NOT HAVE A MATERIAL IMPACT ON THE OVERALL FINANCIAL STATEMENTS OF THE ORGANIZATION. EXPANDEDDISCLOSURES REQUIRED BY ASC 606 ARE INCLUDED WITHIN NOTE 4, NET PATIENT SERVICES REVENUE. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE SHORTFALL REPORTED IN LINE 7 REPRESENTS MEDICARE SHORTFALLS FOR HIGH NEED PEDIATRIC PATIENTS SERVED BY CHILDREN'S HOSPITAL COLORADO. IF CHILDREN'S HOSPITAL COLORADO DID NOT SUBSIDIZE THE HIGHLY SPECIALIZED CARE, ACCESS FOR THIS POPULATION WOULD BE LIMITED, THUS WE VIEW THIS CARE AS COMMUNITY BENEFIT. THE HOSPITAL UTILIZED COST TO CHARGE RATIO METHODOLOGY TO ARRIVE AT THIS NUMBER. THE AMOUNT INCLUDES ALL COSTS LESS ALL PAYMENTS RECEIVED. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance YES, THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. PRIOR TO DEBT REFERRALS, ACCOUNTS ARE REVIEWED FOR ALL THIRD-PARTY PAYER ELIGBILITY PRIOR TO QUALIFYING FOR ANY CHARITY CARE OR FINANCIAL ASSISTANCE. ONCE THE PATIENT'S RESPONSIBILITY IS VALIDATED, THE HOSPITAL PROVIDES SLIDING SCALE DISCOUNTS BASED ON INCOME AND/OR EXPENSES. PARENTS WHOSE CHILDREN DO NOT QUALIFY FOR MEDICAID CAN ALSO APPLY FOR THIS DISCOUNT PLAN. THE HOSPITAL HAS A DEDICATED FINANCIAL COUNSELING/SERVICES DEPARTMENT WHO WORK CLOSELY WITH PARENTS TO ESTABLISH PAYMENT PLANS. Schedule H, Part V, Section B, Line 16a FAP website A - CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS: Line 16a URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - COLORADO SPRINGS: Line 16a URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - NORTH CAMPUS: Line 16a URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; Schedule H, Part V, Section B, Line 16b FAP Application website A - CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS: Line 16b URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - COLORADO SPRINGS: Line 16b URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - NORTH CAMPUS: Line 16b URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS: Line 16c URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - COLORADO SPRINGS: Line 16c URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - NORTH CAMPUS: Line 16c URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE CHNA, CHILDREN'S HOSPITAL COLORADO REGULARLY ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE. ACROSS THE HOSPITAL, NUMEROUS INTERNAL AND EXTERNAL DATA SOURCES ARE REGULARLY MONITORED AND UTILIZED TO IDENTIFY TRENDS AND OPPORTUNITIES TO IMPACT CHILD HEALTH. ADDITIONALLY, HOSPITAL STAFF DEDICATES SIGNIFICANT TIME TO SERVING ON COMMUNITY BOARDS AND OTHER COMMUNITY GROUPS THAT ASSESS HEALTH NEEDS OF THE COMMUNITY AND PROACTIVELY PARTICIPATES IN THE HEALTH IMPROVEMENT EFFORTS LED BY THESE PARTNERS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance CHILDREN'S HOSPITAL COLORADO HAS A PROCESS FOR INFORMING AND EDUCATING FAMILIES ABOUT HOW THEY MAY BE BILLED FOR PATIENT CARE AND THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO'S FULL TIME PATIENT FINANCIAL COUNSELORS ARE DEDICATED TO WORKING WITH FAMILIES TO PROVIDE GUIDANCE REGARDING AVAILABLE FINANCIAL ASSISTANCE WHICH ENSURES THAT ITS PATIENT POPULATION RECEIVES THE CRITICAL CARE IT NEEDS. ADDITIONALLY, CHILDREN'S HOSPITAL COLORADO PROVIDES PATIENT ASSISTANCE TO HELP IDENTIFY COMMUNITY-BASED RESOURCES, FACILITATE SERVICES AND PROVIDE APPROPRIATE REFERRAL ASSISTANCE TO HELP WITH CONTINUITY OF CARE. INPATIENT PROCESS: THIS PROCESS APPLIES TO PATIENTS WHO ARE BEING ADMITTED FOR OBSERVATION, SURGERY OR OTHER INPATIENT SERVICES. IF THE PATIENT IS PRE-SCHEDULED, CHILDREN'S HOSPITAL COLORADO PATIENT ACCESS WORKS TO CONTACT THE FAMILY PRIOR TO ADMISSION TO ARRANGE FOR A FINANCIAL SCREENING APPOINTMENT. REGARDLESS OF WHETHER AN APPOINTMENT IS SET PRIOR TO ADMISSION, THE PATIENT FINANCIAL COUNSELING TEAM WORKS WITH THE FAMILY TO DETERMINE THEIR SELF-PAY STATUS (EITHER NON-COMMERCIAL OR GOVERNMENT INSURANCE) AND SUBSEQUENTLY WORKS WITH THEM TO SCREEN FOR FINANCIAL ASSISTANCE OPTIONS. OUTPATIENT PROCESS: WHEN A PATIENT SCHEDULES A NON-EMERGENT OR URGENT OUTPATIENT CLINIC VISIT, THEY WILL IDENTIFY THEMSELVES AS SELF-PAY IF THEY DO NOT HAVE EITHER COMMERCIAL OR GOVERNMENT INSURANCE. AT THIS POINT, THEY ARE GIVEN TWO OPTIONS: (1) PAY A $200 DEPOSIT AT THE TIME OF APPOINTMENT AND BE BILLED ANY REMAINING BALANCE OR (2) SCHEDULE TIME WITH PATIENT FINANCIAL COUNSELING FOR ASSISTANCE. IF THE PATIENT WAS SEEN IN THE EMERGENCY DEPARTMENT OR URGENT CARE WITHOUT THE PRE-SCREEN, THEY STILL CAN APPLY FOR FINANCIAL ASSISTANCE WITH THE PATIENT FINANCIAL COUNSELING OFFICE. ALL SELF-PAY FAMILIES ARE AUTOMATICALLY GIVEN A 35 PERCENT DISCOUNT. CHILDREN'S HOSPITAL COLORADO HAS A FORMAL POLICY REGARDING ELIGIBILITY CRITERIA FOR CHARITY CARE. THE DECISION TO PROVIDE CHARITY CARE WILL BE, IN ALL CASES, BASED ON A REVIEW OF THE INCOME, ASSETS AND LIABILITIES OF THE FAMILY AT THE TIME OF ADMISSION TO THE HOSPITAL OR CLINIC. THE LEVELS OF CHARITY CARE AND FINANCIAL ASSISTANCE PROVIDED BY CHILDREN'S HOSPITAL COLORADO WILL BE DETERMINED BASED ON FEDERAL POVERTY GUIDELINES WHICH MAY BE ADJUSTED UP TO 200 PERCENT AND REVISED FROM TIME TO TIME. FAMILIES WITH ADJUSTED GROSS INCOME BETWEEN 200 PERCENT AND 400 PERCENT OF FEDERAL POVERTY GUIDELINES MAY ALSO BE CONSIDERED FOR CHARITY CARE WITH A CAP FOR OUT-OF-POCKET RESPONSIBILITY. DETERMINATION OF ELIGIBILITY WILL BE EFFECTIVE FOR SIX MONTHS AND APPLY TO ALL PATIENTS REGARDLESS OF IMMIGRATION STATUS. CHILDREN'S COLORADO WORKS TO PROVIDE NECESSARY HOSPITAL-RELATED SERVICES CONSISTENT WITH ITS MISSION, ITS STATUS AS A NONPROFIT HOSPITAL AND ITS STEWARDSHIP RESPONSIBILITY TO ITS DONORS. CHILDREN'S HOSPITAL COLORADO'S FINANCIAL ASSISTANCE PUBLIC POLICY AND PLAIN LANGUAGE SUMMARY ARE available at www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/. Schedule H, Part VI, Line 4 Community information Children's Hospital Colorado serves infants, toddlers, adolescents, teens and young adults, primarily from newborns through age 21. Children's Hospital Colorado also treats individuals over the age of 21 with special needs or congenital disorders that require continued care. Children, newborn to age 2, represent the largest proportion of the population served by Children's Colorado. In the state of Colorado, there are approximately one million children and adolescents; 70 percent reside within Denver's seven county metropolitan area. Children's Hospital Colorado is the largest provider of health care services for low-income children in Colorado, with 50.2% of patients covered by Medicaid, 40.7% commercial insurance, 5.3% TRICARE, 2.0% CHP+, and 1.8% all other (including Medicare, cash-pay, uninsured, indigent care, etc.). Demographically, children served have diverse cultural and ethnic backgrounds -- Children's Hospital Colorado translates medical care and education instructions into 65 languages (including sign language) to deliver culturally sensitive, high quality pediatric healthcare. Most of its patients speak English, followed by significant numbers of families who speak Spanish, then Arabic, Vietnamese, French, Chinese, Nepali, Russian, Somali, Amharic, and then Burmese. Additionally, Children's Hospital Colorado works to deliver our mission not only in the Denver metro area and the state of Colorado, but also throughout the surrounding seven-state region. The region is geographically diverse and is comprised of seven states located in the western High Plains and Rocky Mountains regions. Children's Hospital Colorado is the only free-standing Children's Hospital in the region. In response to the unique characteristics of the region, Children's Hospital Colorado delivered high quality care in 21 sites, by 13 specialties and held 1,287 outreach clinics outside its primary service area in 2023. CHCO is dedicated to designing innovative approaches to providing medical education opportunities with the goal of strengthening the workforce to meet the needs of our rural communities, presently an underserved population in the U.S. Schedule H, Part VI, Line 5 Promotion of community health To address the depth and breadth of community health, Children's Colorado continues to build on our long and strong record of collaborating with community-based organizations, K-12, academic institutions, and governmental and non-governmental organizations, with the goal of improving health outcomes and reducing health disparities for children and their families. Additionally, significant resources were allocated in 2023 to support efforts to engage community members advocating for access to healthcare as well as providing educational sessions for both policymakers and advocates on child health issues of importance. DISEASE AND CONDITION SPECIFIC COMMUNITY HEALTH EDUCATION. Children's Colorado plays an important role in creating content on various health topics accessible to the general public. The Children's Colorado digital content team developed and/or promoted health education for parents and the community-at-large via www.childrenscolorado.org and on our social media channels throughout 2022. Just Ask Children's is a collection of free programs and tools that improve access to health care services and educate parents on the fundamentals of keeping children safe and well. This is offered through a free monthly email newsletter delivered to 21,523 subscribers, web content, social media and paid media offering parenting tips and advice on key health topics. Examples of 2023 topics included: Internet safety, fitness and nutrition, safe sleep, neurodivergency, mental health resources, body positivity, loneliness, head injuries, germs, and respiratory illnesses. In 2023, there were more than 14.4 million people reached through this medium. AFTER HOURS TELEPHONE CARE PROGRAM was developed in 1988 based on pediatrician-identified need to provide health care information and care advice when the office is closed as well as supporting the physician to promote a better work/life balance. Families in the community receive significant benefits from this program through access to timely, helpful advice concerning their child's illness or injury. In 2023, we answered 59,945 calls to our After-Hours Telephone Care program. CHILDREN'S COLORADO PARENT SMART HOTLINE provides parents and caregivers 24/7 access to experienced pediatric nurse who can provide telephone triage and in-depth information on what may be ailing their child. In 2023, we answered 34,590 calls to our ParentSmart hotline. FAMILY AID serves to reduce barriers to health care utilization by addressing social determinants of health. Examples of areas of support are food/groceries, gas cards, bus passes, hotel, etc. TRANSPORATION ASSISTANCE is provided to families following a financial needs assessment that determines they are not eligible for transportation assistance through any other program, like Medicaid-funded transportation or insurance reimbursement. Transportation provided is to accommodate access to care, barriers to discharge and the safety of the child. In 2023, we provided 2,890 rides. THE BUG WATCH 2.0 publication, led by the Department of Epidemiology, provides vital information to community providers to visualize and assess what organisms are prevalent in the community and to help make better clinical decisions when treating patients. Data within the Bug Watch 2.0 dashboard is updated weekly during the respiratory season (usually October-April) and every two weeks during the non-respiratory months. In 2023, there were 859 community providers who received the weekly or biweekly distribution. MOTHER's MILK BANK. We are a milk donation and outreach center in collaboration with the Mothers' Milk Bank, a program of Rocky Mountain Children's Health Foundation. The donation and outreach center collects donated human milk as a community service, provide human milk to babies whose own mothers cannot supply the milk to meet their baby's needs. In 2023, there were 27 donations serving 23 mothers/infants. BURN CAMP is a medical specialty rehabilitative camp program for burn survivors 8-18 and their families. Supported by a licensed medical and psychosocial staff, campers reprocess the traumatic pathways caused by a burn injury in an outdoor setting. The program addresses social skill development, body image, challenging negative/limiting beliefs, appropriate risk-taking, and overcoming challenges in a supportive community. Campers are encouraged to translate these experiences into life-long formative skills and build bridges to future successes. In 2023, we served 121 campers across three camp programs: Winter Burn Camp, Family Burn Camp, and Summer Burn Camp. The Children's Hospital Colorado Burn Camps Program is an American Camp Association accredited suite of programs structured to meet the rehabilitative and psychosocial needs of children who have sustained a burn injury. Our Burn Camps Program is made available free of charge to any child who sustains a burn injury. Summer Burn Camp is offered to all children who received their care at Children's Colorado, as well as one of four referring burn units. HEALTH PROFESSIONS EDUCATION. Annually, approximately 14,000 pediatric residents are trained in Children's Hospitals Graduate Medical Education (CHGME) across the United States, accounting for 50% of the total number of pediatric residents trained. Children's Hospital Colorado is currently home to more than 286 pediatric medical residents and 16 pediatric dental residents. Federal CHGME funding falls far below our institutional financial support and we backfill the needs at triple the amount currently funded by the federal government. From 2016-2024, 64% of our pediatric medical residents continued practicing in Colorado after program completion. Upon completion of training, many of these providers care for children throughout the broader Rocky Mountain region as well, where there are no other pediatric training programs. We provided clinical experiences and internships for 817 nursing students (programs that lead to a registered nurse license) in 2023. We also provided clinical experiences and internships for 332 advanced practice nursing students (graduate level: NP, DPT). In 2023, we hosted 72 Certified Nursing Assistant students for clinical rotations. In addition to training physicians and nurses, we also provide internships and preceptorships for the following health professions: certified nurse assistant (CNA), emergency medical technicians (EMT), physical therapists, occupational therapists, speech therapists, pharmacists, respiratory therapists, social workers, and other allied health professionals. Some health colleges and universities we partnered with in 2023 includes Pickens Technical College, Pima Medical Institute, Pueblo Community College, Regis University, University of Colorado, Metropolitan State College of Denver, American Public University, Erikson, Mills College, Washington University, University of Utah, Edgewood and College of Charleston, and St Louis University. EMERGENCY MEDICAL SERVICES COMMUNITY EDUCATION. As a Level One Trauma Center, we also have an emphasis on education and outreach. The Children's Colorado Emergency Medical Services (EMS) Outreach Education team provides education to first responders, hospital providers, and other medical facilities across a seven-state region. Across the region many of the first responders they train live in rural communities. The team uses evidence-based research and guidelines from the hospital, oftentimes changing the way EMS teams respond to situations to achieve improved pediatric outcomes. In 2023, the team conducted 46 educational events covering all four quadrants of the state and reached 2,640 EMS providers. CLINICAL OUTREACH & EDUCATION FOR COMMUNITY-BASED HEALTHCARE PROVIDERS. We provided 6,322 community-based medical professionals with more than 7,700 hours of training during 211 classes/events. Schedule H, Part VI, Line 7 State filing of community benefit report CO true BUFFALO SPORTS PROPERTIES LLC PO Box 843038 Kansas City MO 641843038 900776492 501(C)(3) 112500 General Program Support CHEYENNE FRONTIER DAYS INC PO Box 2477 Cheyenne WY 82003 830297781 501(C)(3) 18300 General Program Support CHEYENNE MTN ZOOLOGICAL SOCIETY 4250 Chey Mtn Zoo Rd Co Springs CO 80906 840407039 501(C)(3) 89000 General Program Support CHILDRENS MUSEUM OF DENVER INC 2121 Ch Museum Drive Denver CO 80211 840658142 501(C)(3) 35000 General Program Suppport COLORADO COLLEGE 14 E Cache La Poudre Co Springs CO 80903 840402510 501(C)(3) 22500 General Program Support COLORADO RUSH SOCCER 8101 S Shaffer Pkwy Littleton CO 80127 841411827 501(C)(3) 7500 General Program Support CO SPRINGS PHILHARMONIC ORCHESTRA PO Box 1266 Co Springs CO 809011266 743091110 501(C)(3) 10000 General Program Support CO SPRINGS YOUTH SPORTS 2212 Executive Cir Co Springs CO 80906 841350101 501(C)(3) 10000 General Program Support CONQUERING CHD 8383 Greenway Blvd Middlton WI 53562 463576700 501(C)(3) 10000 General Program Support DENVER BOTANIC GARDENS 909 York Street Denver CO 80206 840440359 501(C)(3) 7500 General Program Support DENVER MUSEUM OF NATURE & SCIENCE 2001 Colorado Blvd Denver CO 802055798 840518447 501(C)(3) 15000 General Program Support FOOTHILLS PARK & RECREATION DISTRICT 6612 South Ward Street Littleton CO 80127 846013730 501(C)(3) 10000 General Program Support GOLD CROWN FOUNDATION INC 1743 Wazee Street Ste 300 Denver CO 80202 742422126 501(C)(3) 45000 General Program Support PEDIATRIC HEART TRANSPLANT SOCIETY PO Box 55904 Birmingham AL 352555904 274436351 501(C)(3) 10000 General Program Support PIKES PEAK LIBRARY DISTRICT FOUNDATION 1175 Chapel Hills Drive Colorado Springs CO 80920 113690724 501(C)(3) 14500 General Program Support PIKES PEAK OR BUST RODEO 104 S Cascade Ave 200B Colorado Springs CO 80903 841589318 501(C)(3) 7000 General Program Support PRIDE SOCCER CLUB 5955 Lehmen Dr Ste 100 Colorado Springs CO 80918 841271042 501(C)(3) 10000 General Program Support REAL COLORADO 8200 South Akron St Ste 122 Centennial CO 80112 742392779 501(C)(3) 25250 General Program Support ROCKY MOUNTAIN VIBES 4385 Tutt Blvd Colorado Springs CO 80922 874234058 501(C)(3) 6000 General Program Support RONALD MCDONALD HOUSE CHARITIES 4223 Royal Pine Drive Colorado Springs CO 80920 841013843 501(C)(3) 14000 General Program Support ROUGHRIDER SPORTS CLUB LLC 1 Superior Dr Superior CO 80027 263040721 501(C)(3) 7500 General Program Support Papua New Guinea Tribal Foundation 121 South Nevada Ave Montrose CO 81401 271334147 501(C)(3) 60000 General Program Support ST ANTHONY HOSPITAL 11600 West 2nd Place Lakewood CO 80228 840902211 501(C)(3) 6000 General Program Support SWITCHBACKS FC 234 N Tejon St Colorado Springs CO 80903 464110067 501(C)(3) 75000 General Program Support TEALL PROPERTIES GROUP LLC PO Box 31384 Charlotte NC 28231 832060347 501(C)(3) 40000 General Program Support WOW CHILDRENS MUSEUM WORLD OF WONDER LTD 110 N Harrison Ave Lafayette CO 80026 841421537 501(C)(3) 10000 General Program Support YMCA OF METROPOLITAN DENVER 2625 S Colorado Blvd Denver CO 80222 840402696 501(C)(3) 15000 General Program Support YMCA OF NORTHERN COLORADO & BOULDER VALL 2800 Dagny Way Lafayette CO 80026 840459944 501(C)(3) 12000 General Program Support YMCA OF THE PIKES PEAK REGION 316 North Tejon St Colorado Springs CO 80903 840404266 501(C)(3) 11000 General Program Support YOUNG AMERICANS CENTER FOR FINANCIAL 3550 E First Ave Denver CO 80206 841564926 501(C)(3) 10000 General Program Support 30 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. CHILDREN'S HOSPITAL COLORADO RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT EXEMPT ORGANIZATIONS TO MONITOR THE USE OF FUNDS AS INTENDED. X X X X true true false false false false false true false Jena Hausmann President and CEO 1653306 0 671440 0 260618 0 382193 0 28462 0 2996019 0 257030 0 Jeffrey Harrington SVP and CFO 870706 0 259129 0 125449 0 182049 0 16337 0 1453670 0 114648 0 Michelle Lucero Chief Legal Officer, General Counsel/Secretary 544969 0 163027 0 518572 0 151325 0 18305 0 1396198 0 506564 0 David Biggerstaff Former EVP and COO 0 0 168506 0 428848 0 0 0 0 0 597354 0 0 0 Amy Feaster SVP Chief Digital info Officer 365029 0 106168 0 61471 0 114580 0 7913 0 655161 0 53820 0 Patricia Givens SVP Chief Nursing Executive 481990 0 138696 0 100078 0 121870 0 23 0 842657 0 80441 0 Suzanne Jaeger SVP Experience and Access 488389 0 121211 0 399728 0 130346 0 19962 0 1159636 0 390591 0 Gregory Raymond SVP Colorado Springs President 520715 0 128772 0 51995 0 137801 0 25400 0 864683 0 49698 0 Dana Moore SVP and CIO 601507 0 156410 0 110352 0 165586 0 22367 0 1056222 0 97742 0 Elizabeth Rodriguez SVP Chief HR Officer 459207 0 126238 0 94979 0 135743 0 22368 0 838535 0 76125 0 Raphe Schwartz SVP and Chief Strategy Officer 546519 0 158349 0 83938 0 141267 0 25401 0 955474 0 79846 0 Jerrod Milton SVP Chief Clinical Officer 412956 0 100917 0 52181 0 108652 0 22117 0 696823 0 47069 0 Christopher Martin VP Ambulatory Services 345426 0 72445 0 39284 0 86739 0 23 0 543917 0 37061 0 Charlotte Isoline VP Marketing & Communications 327321 0 79586 0 62355 0 107462 0 22368 0 599092 0 48834 0 Kathleen Seerup SVP Chief Nursing Ops Officer 322984 0 92440 0 154683 0 112983 0 19962 0 703052 0 147989 0 Megan Zatz VP Deputy General Counsel 351909 0 52119 0 1002 0 70647 0 22 0 475699 0 0 0 Elizabeth Nowak VP Payer Strategy & Network Development 316487 0 76811 0 178911 0 92725 0 10180 0 675114 0 172287 0 Schedule J, Part I, Line 4a Severance or change-of-control payment THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAY DURING 2023: David Biggerstaff $428,848 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INDIVIDUALS RECEIVED PAYOUTS FROM A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: SUZANNE JAEGER $390,591 AMY FEASTER $53,820 GREGORY RAYMOND $49,698 JEFFREY HARRINGTON $114,648 JENA HAUSMANN $257,030 PATRICIA GIVENS $80,441 MICHELLE LUCERO $506,564 ELIZABETH RODRIGUEZ $76,125 JERROD MILTON $47,069 CHARLOTTE ISOLINE $48,834 DANA MOORE $97,742 RAPHAEL SCHWARTZ $79,846 ELIZABETH NOWAK $172,287 KATHLEEN SEERUP $147,989 CHRISTOPHER MARTIN $37,061 Schedule J, Part I, Line 7 Non-fixed payments CERTAIN INDIVIDUALS ARE ELIGIBLE TO PARTICIPATE IN THE INCENTIVE PLAN FOR CHILDREN'S COLORADO, THE COMPONENTS OF WHICH INCLUDE ACHIEVEMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE GOALS. BECAUSE THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS RESERVES THE RIGHT TO CHANGE, AMEND OR TERMINATE THIS PLAN AT ANY TIME, FOR ANY REASON, AT ITS SOLE DISCRETION AND BECAUSE OF CERTAIN OTHER CONDITIONS OF THE PLAN, LINE 7 REGARDING "NON-FIXED PAYMENTS" IS ANSWERED YES. NOTE THAT PRIOR TO THE PAYMENT OF ANY AMOUNTS TO AN INDIVIDUAL WHO IS CONSIDERED A DISQUALIFIED PERSON, THE COMPENSATION COMMITTEE SHALL CERTIFY IN WRITING THE EXTENT TO WHICH THE PERFORMANCE FACTORS ESTABLISHED BY THE COMPENSATION COMMITTEE HAVE BEEN SATISFIED AND SHALL APPROVE THE PAYMENT OF SUCH BONUSES TO SUCH INDIVIDUALS. SEE PART VI, LINES 15A AND 15B FOR ADDITIONAL INFORMATION ON EXECUTIVE COMPENSATION. A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648A7J8 2016-05-24 200724807 SERIES 2016A & 2016C - SEE PART VI false false false B COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648A8D0 2016-05-24 70300000 SERIES 2016B - SEE PART VI false false false C COLORADO HEALTH FACILITIES AUTHORITY 840752932 000000000 2019-03-27 20000000 SERIES 2019A - SEE PART VI false false false D COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648FMY7 2019-11-04 235360000 SERIES 2019BCD - SEE PART VI false false false A 46980000 200724807 1519986 80000000 119204821 2019 false true true true B 0 70300000 300000 70000000 2019 false false true true C 12949994 20000000 58500 19941500 2019 false false true true D 0 235360000 408677 234951323 2019 true false true true A false false false false 0.0 false false true B false false false false 0.0 false false true C false false false false 0.0 false false true D false false false false 0.0 false false true A false false false true false false false false true B false false false true true false false false true C false true false false false false false false true D false true false false true false false false true A true B true C true D true Schedule K, Part I, Column (f) Description of purpose BOND A - HOSPITAL REVENUE BONDS SERIES 2016A & 2016C THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2004C AND 2004D BONDS. BOND B - HOSPITAL REVENUE BONDS SERIES 2016B THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS. BOND C - HOSPITAL REVENUE BONDS SERIES 2019A THE PURPOSE OF THIS BOND ISSUE WAS TO PURCHASE EQUIPMENT. BOND D - HOSPITAL REVENUE BONDS SERIES 2019BCD THE PURPOSE OF THIS BOND ISSUE WAS TO REFUND SERIES 2013B, 2013C1 AND 2013C2. BOND E - HOSPITAL REVENUE BONDS SERIES 2020A-B THE PURPOSE OF THIS BOND ISSUE IS TO REFUND SERIES 2008A & 2010A BONDS. BOND F - HOSPITAL REVENUE BONDS SERIES 2021A THE PURPOSE OF THIS BOND ISSUE IS TO FINANCE CAPITAL EQUIPMENT. BOND G - HOSPITAL REVENUE BONDS SERIES 2022A THE PURPOSE OF THIS BOND ISSUE IS TO FINANCE CAPTIAL EQUIPMENT. BOND H - HOSPITAL REVENUE BONDS SERIES 2023A - THE PURPOSE OF THIS BOND ISSUE IS TO REFUND SERIES 2013A. Schedule K, Part IV, Line 2c Date of rebate computation Bond A (SERIES 2016A & 2016C): November 9, 2021 Bond B (SERIES 2016B): November 17, 2021 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648FPT5 2020-07-01 105685000 SERIES 2020A-B - SEE PART VI false false false B COLORADO HEALTH FACILITIES AUTHORITY 840752932 000000000 2021-07-29 20000000 SERIES 2021a - SEE PART VI false false false C COLORADO HEALTH FACILITIES AUTHORITY 840752932 000000000 2022-03-29 20000000 SERIES 2022A - SEE PART VI false false false D Colorado Health Facilities Authority 840752932 000000000 2023-12-01 72815000 Series 2023A - see part VI false false false A 3410000 105685000 844996 104840004 2020 true false true true B 6457228 20000000 34500 19965500 2021 false false true true C 5504848 20000000 34500 19965500 2022 false false true true D 72815000 174166 72640834 true false true true A false false false false 0.0 false false true B false false false false 0.0 false false true C false false false false 0.0 false false true D false false false false 0.0 false false true A false true false false true false false false true B false true false false false false false false true C false true false false false false false false true D false true false false false false false false true A true B true C true D true Form 990, Part I, Line 6 NUMBER OF VOLUNTEERS FROM TEENAGERS TO GREAT GRANDPARENTS, FROM HOMEMAKERS TO PROFESSIONAL ATHLETES, CHILDREN'S HOSPITAL COLORADO VOLUNTEERS ENCOMPASS ALL WALKS OF LIFE AND ALL INCOME LEVELS, EACH VOLUNTEER WITH SOMETHING UNIQUE TO OFFER. OUR DIVERSE GROUP OF VOLUNTEERS HAS ONE THING IN COMMON, HOWEVER, THE DESIRE TO HELP SICK CHILDREN AND THEIR FAMILIES. CHILDREN'S HOSPITAL COLORADO IS FORTUNATE TO HAVE THOUSANDS OF DEDICATED VOLUNTEERS WHO WORK REGULARLY, FROM SEVERAL HOURS A YEAR TO SEVERAL HOURS A WEEK, TO PROVIDE BETTER CARE FOR THE CHILDREN OF CHILDREN'S HOSPITAL COLORADO. THE ASSOCIATION OF VOLUNTEERS THE VOLUNTEERS AT CHILDREN'S HOSPITAL COLORADO ARE ALL PART OF A GROUP CALLED CHILDREN'S HOSPITAL COLORADO ASSOCIATION OF VOLUNTEERS (AOV). THE AOV COORDINATES PLACEMENTS FOR VOLUNTEERS AND ENSURES THAT COMPLETE ORIENTATION AND TRAINING IS PROVIDED TO ALL VOLUNTEERS. OUR VOLUNTEER'S SKILLS AND INTERESTS ARE ALL SO APPRECIATED AND WE TRY TO PLACE EVERYONE IN A ROLE THAT SUITS THEM AND OUR NEEDS. THE EXAMPLES BELOW ARE JUST SOME OF THE WAYS THAT OUR VOLUNTEERS CONTRIBUTE: - VOLUNTEERS ARE ACTIVE ACROSS THE SYSTEM OF CARE INCLUDING AT THE ANSCHUTZ MEDICAL CAMPUS, THE SOUTH CAMPUS, THE NORTH CAMPUS, COLORADO SPRINGS HOSPITAL CAMPUS . - VOLUNTEERS SPEND TIME WITH OUR PATIENTS BY HOLDING, COMFORTING, PLAYING WITH THEM AND MAKING THEM LAUGH. - VOLUNTEERS BRING SPECIALLY SCREENED DOGS TO PROVIDE ANIMAL-ASSISTED THERAPY FOR THE PRESCRIPTION PET PROGRAM. - SPECIALLY TRAINED VOLUNTEERS SERVE AS AMBASSADORS WITH THE WELCOME PROGRAM. VOLUNTEERS GREET NEWLY ADMITTED PATIENT FAMILIES UPON THEIR ARRIVAL AND INTRODUCE THEM TO THE HOSPITAL'S MANY AMENITIES. THE GOAL IS TO PROVIDE A WARM AND WELCOMING ENVIRONMENT AND TO ANSWER ANY NON-MEDICAL QUESTIONS. - THE WINE EVENT IS THE ASSOCIATION OF VOLUNTEERS' SIGNATURE EVENT. THE SPECIAL EVENING FEATURES A SILENT AND LIVE AUCTION OF FINE WINES AND EXPERIENCES WITH ALL PROCEEDS BENEFITING THE HOSPITAL AND ITS PROGRAMS. - MANY GROUPS OF VOLUNTEERS DO NOT SPEND TIME DIRECTLY WITH OUR PATIENTS, BUT PERFORM MORE ADMINISTRATIVE DUTIES, WHICH CAN BE JUST AS IMPORTANT TO THE DAY-TO-DAY OPERATIONS OF CHILDREN'S HOSPITAL COLORADO. - TEENAGERS BETWEEN 13 AND 18 YEARS OF AGE PARTICIPATE IN THE JUNIOR VOLUNTEER PROGRAM. THEY SUPPORT THE HOSPITAL BY WORKING IN SEVERAL DEPARTMENTS AS WELL AS SUPPORTING FUNDRAISING ACTIVITIES. - VOLUNTEERS ALSO ASSIST IN STAFFING CHILDREN'S HOSPITAL COLORADO GIFT SHOP AND LA CACHE. - CHAPTER VOLUNTEERS IN THE COMMUNITY ARE VERY ACTIVE IN FUNDRAISING EVENTS THROUGHOUT THE YEAR THAT HELP TO FUND SPECIAL EQUIPMENT, FACILITIES AND PROGRAMS FOR THE PATIENTS OF CHILDREN'S HOSPITAL COLORADO. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS - CONTINUATION (3) Multidisciplinary Asthma Clinic (MAC) MAC clinic is a clinic designed for children and adolescents who have poorly controlled asthma despite guidelines-based therapy, multiple co-morbidities directly contributing to poor asthma control, consideration for biologic treatment AND/OR require coordination of multidisciplinary services (allergy, pulmonary, social work, nutrition, speech the respiratory therapy, nursing). In the past three years there has been over 140 referrals to this clinic, with 28% of those patients completing the program and returning to primary care and specialist (allergy or pulmonary) managing their asthma control long term; and 46% of the patients remain under the care of the MAC team with the goal of transitioning them back to primary and specialty care in the future. Home Visit Program - Just Keep Breathing Asthma home visits provides an opportunity for a nurse and community health workers to educate, review medication plans, and help families identify environmental factors in their homes that may contribute poorly controlled asthma. Evidence shows reducing environmental triggers in the home can significantly improve the health outcomes of children with asthma and reduce unplanned emergency department visits and hospitalizations. The home visit program has provided support to 78 patients and currently have 36 families enrolled in the program. High Risk Asthma Children with two or more emergency department visits, 1 hospitalization and/or 1 ICU admission in the past year for asthma is high risk of having future asthma exacerbations and healthcare utilization. Studies have shown children who were seen by an asthma specialist have improved asthma control, reduced exacerbations and decrease in oral steroid prescriptions. The High-Risk Asthma program is designed to identify these children, notify the primary doctor of the risk of future healthcare utilization and work with caregivers and primary doctor to determine if the patient qualifies to be seen by an asthma specialist. In the past year 720 number of children admitted to one of the locations within the Children's Hospital Colorado system were identified as high risk, 72% were contacted to encourage follow up with an asthma specialist, and of 66% those children were seen by an asthma specialist at Children's Hospital. Asthma Population Dashboard Philanthropic funds were provided to the Asthma program to develop a population-based dashboard. A population-based dashboard provides insights into a population's demographics, health, and other characteristics, including the impact various interventions may have on overall health outcomes. The development of this dashboard to track health outcomes of children seen by the MAC team and/or home visit program. Over time the plan is to continue to expand this dashboard to look at other interventions and sub-populations who have a greater risk of morbidity and mortality. Asthma Reinforcement Program There is a strong link to asthma morbidity, social determinants, and neighborhood conditions. The Child Opportunity Index (COI) is a publicly available resource for measuring neighborhood conditions where higher scores reflect higher "opportunity". Children living in neighborhoods with a very low or low score are at higher risk for asthma morbidity and may benefit from care coordination and health navigation to address barriers affecting health outcomes. A QI pilot was initiated this past year to identify children who are high risk, seen in Pulmonary and Child Health Clinic who live in lower socioeconomic neighborhoods. Children's caregivers were contacted monthly by the multidisciplinary team to identify and address any clinical or social barriers potentially preventing the child from following their asthma action plan. A total of 9 children were initially identified and supported during this pilot. As a result of this pilot 33% familied identified at least one social barrier and 66% had at least one clinical barrier. As a result of this pilot, we were able to reduce subsequent hospitalization or ED visit within 6 months in 88% of the patients. We are not rolling out phase two of this pilot with the hopes of having similar positive outcomes. Reach the Peak Annual Asthma and Allergy Conference This is an annual two-day hybrid (in-person and virtual) conference for advanced practice providers, registered nurses, respiratory therapists, pharmacists, clinical social workers, certified health educators and other asthma care professionals. Who are interested in learning more about pathophysiology and contributing factors of asthma diagnosis, treatment and management of asthma, patient and family assessment, and program development to improve patient outcomes. In 2023, there were 73 attendees with 4.65 excellence score from participants. Vent Care Program Initiatives The Ventilator Care Program (VCP) is a multidisciplinary team of nurses, respiratory therapists, nurse practitioners, providers, developmental therapists, social workers, and care coordinators dedicated to providing excellent, evidenced-based care to all families and children with tracheostomy tubes with or without chronic ventilation. Below are some of the initiatives occurring in the VCP in 2023. Caring for a Student with a Tracheostomy/G Tube in the School Setting Conference This one-day conference is held annually to provide education and hands on skills practice to school nurses and other clinicians in the community to better prepare them for caring for children with tracheostomy tubes, chronic ventilation, and G tubes. Topics taught include routine and emergency tracheostomy care, ventilation concepts, and routine and emergency G tube care. Education is provided through didactic lectures, case studies, and hands on skills practice in small groups. The conference is planned and taught by a multidisciplinary team, including nurses, nurse practitioners, and respiratory therapists. Community and School Health Conference This two-day conference is offered annually to provide education to school nurses on the care of children with chronic medical conditions. One day of the conference is dedicated to tracheostomy and ventilator care. Similar to the Caring for a Student with a Tracheostomy/G Tube in the School Setting Conference education is provided through didactic lectures, case studies, and hands on skills practice. This conference is also planned and taught by a multidisciplinary team which includes respiratory therapists. GATROENTEROLOGY, HEPATOLOGY AND NUTIRITION Digestive Health Institute Community Benefit Report 2024 Children's Hospital Colorado's (CHCO) Digestive Health Institute (DHI) remains the top pediatric Gastroenterology, Hepatology and Nutrition program in the Rocky Mountain region and amongst the top programs in the United States. DHI has consistently ranked in the top five program in the country as ranked by US News and World Report. In 2023 DHI received a #3 ranking. The Gastroenterology team includes 31 Pediatric Gastroenterologist, 9 Hepatologists, 8 Advanced Practice Providers, and 21 outpatient nurses. The multidisciplinary care team also includes social workers, registered dieticians, occupational and speech therapists, child life specialists, and psychologists. The DHI provides care at 4 inpatient facilities, 7 outpatient clinic locations, and 4 regional outreach clinics. The DHI cares for patients across the entire digestive health spectrum including: General Gastroenterology, Hepatology (Liver), Inflammatory Bowel Disease (IBD), Celiac Disease, Pancreas, Gastrointestinal Eosinophilic Disease (GEDP), Neurogastro Motility (NGM), Intestinal Rehabilitation, Aerodigestive and more. In 2023, the DHI had 33,122 outpatient visits, 5,017 surgical visits, and 2,708 inpatients discharges with 14,886 patient days. Of these visits approximately 94% of patients were from Colorado while the remaining almost 6% were from the 7-state region or beyond. The DHI has been extensive users of telehealth, performing 7,489 telehealth visits in 2023. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS - CONTINUATION (4) National/Regional Presence: - The DHI continues to be a national leader in pediatric living donor liver transplant; of our 15 liver transplants in 2023, 6 were from living donors and 5 of those were from non-directed donors, all with 100% patient survival. Because of our robust living donor program, patients wait on average only 1.6 months to receive a transplant at CHCO. - The DHI are national leaders in developing and operationalizing innovative procedures, often enabling new diagnostic, less invasive, and/or therapeutic options for patients and families. In 2023 we: - Completed implementation of EvoEndo disposable Transnasal Endoscopy (TNE) scopes with the first cases taking place in early January 2024. With this new technology, we have been able to diagnose and treat a wider range of digestive health issues without the added monetary and time commitments required for anesthesia. - Completed implementation of IB Stim device and therapy within our Neurogastro and Motility (NGM) program. IB-STIM is a non-surgical device that safely and effectively treats functional abdominal pain in adolescents who have been unresponsive to traditional therapies. The first IB Stim devices at CHCO were placed in early January 2024. - Performed 40 esophageal string tests, a procedure invented by faculty in the DHI. The String test allows doctors to measure eosinophil counts to both diagnose and monitor EoE and eliminates the need to go under anesthesia for an endoscopy. - Performed several advanced endoscopies techniques including (1) transnasal endoscopies (TNE), an upper endoscopy method performed through the nose which requires no fasting, less preparation and allows patients to return to regular activities almost immediately, and (2) Endoscopic Retrograde Cholangiopancreatography (ERCP), a specialized type of endoscopic procedure used to visualize the bile ducts, gallbladder and the pancreas. Currently, there are fewer than 20 pediatric gastroenterologists in the U.S. who perform this procedure. - DHI has faculty with medical licenses in additional states around the region including NM, MT, and WY to ensure we can provide care to patients closer to home via telehealth or through one of our in-person regional outreach clinics. In 2023 we served >300 patients out of state via telehealth and completed 559 visits at one of our four outreach clinics located on the CO Western Slope (Grand Junction & Durango), Wyoming, and Montana. Investing in providers who can serve patients across our vastly rural 7-state region brings sub-specialty expertise to many patients who would otherwise have to travel long distances to the Denver metro area. Quality Improvement: The DHI is committed to developing quality improvement as a core clinical strategy by continually advancing the effectiveness, efficiency, safety, experience, and coordination of the care it provides to its patients. The Clinical Effectiveness Collaborative (CEC) is broadly representative, multidisciplinary and guides the range of activities and initiatives through which the DHI is pursuing its clinical, operational, value-driven, and financial improvement goals. The DHI had several active Quality & Process Improvement initiatives underway in 2023 including: - Reducing 30-day readmission rates and improving caregiver confidence managing patients on home parenteral nutrition (PN) with Central Venous Catheters (CVC). This initiative has implemented several innovative education offerings for families to gain confidence including using our simulation lab to practice home care activities. - Improving our pre-procedural instruction for colonoscopies to improve the quality of procedures and decrease procedural cancelations due to lack of complete pre-procedural preparation. - Development of standardized nursing telephone triage guidelines to improve the ability for RNs to accurately triage patients and reduce unnecessary ED and hospitalization usage. - Ongoing participation in ImproveCareNow, where we maintain a >80% prednisone-free remission rate. Research Through basic, translational, and clinical research, the DHI is committed to advancing knowledge and clinical care to improve the digestive health of our patients. In 2023 significant advancements include: - Improving outcomes for patients with Alagille Syndrome and cholestatic pruiritis which found that prolonged maralixibat (MRX) treatment shows promising results in improved survival and clinical outcomes. - Advances in neurogastroenterology, including the first evidence showing intestinal glial cells can change into nerve cells, constituting a new potential strategy for treating motility disorders and the role for the microbiome in understanding the mind-gut connection. - Nonalcoholic fatty liver disease (NAFLD), a common and progressive disease, is on track to become the leading cause of liver transplants among adults. A study from our researchers illuminates how both the severity of nonalcoholic fatty liver disease - and its reversal - depend on sugar. - The safety of live vaccines from pediatric transplant patients. Data from participating centers showed that both vaccines resulted in immune protection in most patients who'd received a transplant without making them sick. Results from this study are already inspiring action- the 18 institutions involved are moving forward with giving vaccines to transplant patients, and more centers have joined the consortium since the paper was published. Form 990, Part VI, Line 1a Delegate broad authority to a committee CHILDREN'S HOSPITAL COLORADO'S EXECUTIVE COMMITTEE CONSISTS OF THE BOARD CHAIR, CHAIR ELECT, CHIEF EXECUTIVE OFFICER, SECRETARY, BOARD TREASURER, CORPORATE TREASURER, IMMEDIATE PAST CHAIR, THE CHAIR OF THE CHILDREN'S HOSPITAL COLORADO FOUNDATION, THE CHANCELLOR (OR DESIGNEE) AND UP TO TWO (2) ADDITIONAL SEATS TO BE FILLED BY THE BOARD CHAIR. THE EXECUTIVE COMMITTEE HAS ALL THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT AS LIMITED BY LAW, DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL COLORADO. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE WRITTEN CONSENT OF CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS REQUIRED TO APPROVE THE BOARD OF DIRECTORS OF CHILDREN'S HOSPITAL COLORADO. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM AS THE SOLE MEMBER HAS CERTAIN APPROVAL POWERS AS DESCRIBED IN THE AMENDED AND RESTATED BYLAWS DATED SEPTEMBER 22, 2011 AND AMENDED MOST RECENTLY IN FEBRUARY 2017. Form 990, Part VI, Line 11b Review of form 990 by governing body CHILDREN'S HOSPITAL COLORADO'S FINANCE DEPARTMENT WORKS CLOSELY WITH HUMAN RESOURCES, CORPORATE COMPLIANCE, LEGAL AND PUBLIC RELATIONS TO GATHER ALL THE DATA REQUIRED TO COMPLETE THE FORM 990. THE VICE PRESIDENT FINANCE & REPORTING CONDUCTS A REVIEW WITH THE CFO PRIOR TO THE DRAFT BEING DISTRIBUTED TO THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE MADE, THE FORM IS SIGNED BY THE CFO, REVIEWED BY THE AUDIT COMMITTEE, AND A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS VIA A SECURED WEBSITE. Form 990, Part VI, Line 12c Conflict of interest policy BOARD MEMBERS ARE REQUIRED TO DISCLOSE, ON AN ANNUAL BASIS, POTENTIAL CONFLICTS OF INTEREST PURSUANT TO THE WRITTEN POLICIES OF CHILDREN'S HOSPITAL COLORADO (CHCO) AND CHILDREN'S HOSPITAL COLORADO FOUNDATION (CHCF). ALL EMPLOYEES AND BOARD MEMBERS MUST PROMPTLY PROVIDE A WRITTEN DESCRIPTION OF MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO CORPORATE COMPLIANCE AND/OR GENERAL COUNSEL ON THE APPROPRIATE DISCLOSURE FORM. SUCH DISCLOSURE WILL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF THE CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. POLICIES AND PROCEDURES FOR DISCLOSING CONFLICTS OF INTEREST ARE TO BE FOLLOWED ACCORDING TO THE INDIVIDUAL'S FUNCTION, IN COMPLIANCE WITH STATE AND FEDERAL REGULATIONS. COMPLETED DISCLOSURE FORMS ARE SUBJECT TO AUDIT REVIEW BY LEGAL, THE CORPORATE COMPLIANCE PROGRAM, AND THE COMPLIANCE AND BUSINESS ETHICS COMMITTEE OF THE BOARD OF DIRECTORS. FAILURE TO COMPLY WITH CONFLICT OF INTEREST POLICIES MAY LEAD TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR WORKING RELATIONSHIP WITH THE CHILDREN'S HOSPITAL COLORADO. ONCE THE COMPLIANCE AND BUSINESS ETHICS (CABE) COMMITTEE HAS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO AN AGREEMENT/CONTRACT THEN: 1. THE (CABE) COMMITTEE WILL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER CHILDREN'S HOSPITAL COULD OBTAIN A MORE ADVANTAGEOUS AGREEMENT/CONTRACT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES AND, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT. 2. IN CONSIDERING WHETHER TO ENTER THE PROPOSED AGREEMENT/CONTRACT, THE CABE COMMITTEE MAY APPROVE SUCH CONTRACT, TRANSACTION OR ARRANGEMENT ONLY IF THE DISINTERESTED PERSON OR COMMITTEE DETERMINE BY A MAJORITY VOTE THAT: - THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT IS IN CHILDREN'S COLORADO'S BEST INTERESTS AND FOR COLORADO CHILDREN'S OWN BENEFIT; AND - THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO CHILDREN'S HOSPITAL COLORADO (CHCO), CONSIDERING, AMONG OTHER RELEVANT FACTORS, WHETHER CHCO COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. Form 990, Part VI, Line 15a Process to establish compensation of top management official CHILDREN'S HOSPITAL COLORADO HAS AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS AND APPROVES ANY PROPOSED INCREASES RELATED TO ANY OFFICERS AND KEY EMPLOYEES OF THE COMPANY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE ALONG WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EACH YEAR. ONCE A CHANGE IN COMPENSATION IS APPROVED, FORMAL DOCUMENTS ARE COMPLETED AND MINUTES OF THE MEETING ARE PREPARED, REVIEWED AND APPROVED. EXECUTIVE COMPENSATION PROGRAMS FOR CHILDREN'S HOSPITAL COLORADO (CHCO) ARE DESIGNED TO ATTRACT AND RETAIN TOP EXECUTIVE TALENT. PROGRAM OBJECTIVES INCLUDE: - MAINTAIN EXECUTIVE PAY RANGES THAT REFLECT MARKET AND INTERNAL ALIGNMENT - ESTABLISH PAY FOR INDIVIDUAL EXECUTIVES BASED ON SKILLS, EXPERIENCE AND/OR PERFORMANCE HISTORY - PROVIDE ANNUAL PAY INCREASE TO REWARD INDIVIDUAL PERFORMANCE AND MAINTAIN MARKET COMPETITIVENESS - UTILIZE INCENTIVE PAY TO REWARD THE EXECUTIVE'S ABILITY TO ALIGN DIVISIONAL PERFORMANCE TO ORGANIZATIONAL PERFORMANCE - PROMOTE THE HEALTH AND WELLNESS OF EXECUTIVES AND THEIR FAMILIES, WHILE PROVIDING FAMILY FRIENDLY PROGRAM OPTIONS CONSISTENT WITH CHCO MISSION - MAINTAIN OVERALL PROGRAM AFFORDABILITY AND SUSTAINABILITY FOR THE ORGANIZATION THE EXECUTIVE COMPENSATION PACKAGE CONSISTS OF BASE PAY, INCENTIVE PAY, AND BENEFITS (MEDICAL, DENTAL, VISION, LIFE, DISABILITY, RETIREMENT, AND VOLUNTARY BENEFIT PROGRAMS). CHCO DEFINES MARKET COMPETITIVENESS BASED ON COMPARISONS WITH A PEER GROUP CONSISTING OF NATIONAL PEDIATRIC AND REGIONAL HEALTH SYSTEMS THAT ARE SIMILAR IN SIZE AND COMPLEXITY. IN DETERMINING MARKET COMPETITIVENESS, CHCO PARTNERS WITH AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT TO GATHER AND ASSESS MARKET DATA FROM INDEPENDENT COMPENSATION AND BENEFIT SURVEYS THAT REFLECT FUNCTIONALLY COMPARABLE POSITIONS IN THE PEER GROUP. AS NEEDED, THE EXTERNAL EXECUTIVE COMPENSATION CONSULTANT WILL PROVIDE RECOMMENDATIONS TO HELP RESOLVE DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES OR ENSURE CRITICAL BUSINESS OR STRATEGIC ISSUES ARE ADDRESSED. 2023 CUSTOM PEER GROUP - TEXAS CHILDREN'S HOSPITAL (HOUSTON, TX) - THE CHILDREN'S HOSPITAL OF PHILADELPHIA (PHILADELPHIA, PA) - NATIONWIDE CHILDREN'S HOSPITAL (COLUMBUS, OH) - BOSTON CHILDREN'S HOSPITAL (BOSTON, MA) - COOK CHILDREN'S HEALTH CARE SYSTEM (FORT WORTH, TX) - CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (CINCINNATI, OH) - CHILDREN'S HEALTHCARE OF ATLANTA (ATLANTA, GA) - CHILDREN'S MERCY KANSAS CITY (KANSAS CITY, MO) - CHILDREN'S HEALTH SYSTEM OF TEXAS (DALLAS, TX) - CHILDREN'S NATIONAL HEALTH SYSTEM (WASHINGTON, DC) - CHILDREN'S WISCONSIN (MILWAUKEE, WI) - SEATTLE CHILDREN'S (SEATTLE, WA) - CHILDREN'S HOSPITAL LOS ANGELES (LOS ANGELES, CA) - DRISCOLL HEALTH SYSTEM (CORPUS CHRISTI, TX) - THE NEMOURS FOUNDATION (ORLANDO, FL) - RADY CHILDREN'S HOSPITAL - SAN DIEGO (SAN DIEGO, CA) - PHOENIX CHILDREN'S HOSPITAL (PHOENIX, AZ) - ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (CHICAGO, IL) - CHILDREN'S HOSPITALS AND CLINICAL OF MINNESOTA (MINNEAPOLIS, MN) - CHOC CHILDREN'S (ORANGE, CA) - ARKANSAS CHILDREN'S HOSPITAL (LITTLE ROCK, AR) - VALLEY CHILDREN'S HEALTHCARE (FRESNO, CA) - NICKLAUS CHILDREN'S HEALTH SYSTEM (MIAMI, FL) - UCHEALTH (AURORA, CO) - CENTURA HEALTH (CENTENNIAL, CO) - SCL HEALTH (BROOMFIELD, CO) - ST. LUKE'S HEALTH SYSTEM (BOISE, ID) THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2023. Form 990, Part VI, Line 15b Process to establish compensation of other employees SEE FORM 990, PART VI, LINE 15A NARRATIVE ABOVE. Form 990, Part VI, Line 19 Required documents available to the public THESE DOCUMENTS ARE MADE AVAILABLE UPON REASONABLE REQUEST. Form 990, Part VIII, Line 2f Other Program Service Revenue All other program service revenue - Total Revenue: 94070273, Related or Exempt Function Revenue: 92451461, Unrelated Business Revenue: 1618812, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees PHYSICIAN SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 28911154, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 89878395, Program Service Expense: 76038044, Management and General Expenses: 13840351, Fundraising Expenses: ; CONSULTING FEES - Total Expense: 12258728, Program Service Expense: 10371010, Management and General Expenses: 1887718, Fundraising Expenses: ; OTHER - Total Expense: 7760555, Program Service Expense: 6565509, Management and General Expenses: 1195046, Fundraising Expenses: ; FREIGHT & Delivery - Total Expense: 1872564, Program Service Expense: 1584208, Management and General Expenses: 288356, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances EQUITY TRANSFER FROM FOUNDATION - 44694785; CHANGE IN PERPETUAL TRUST - 7478154; OTHER CHANGES IN NET ASSETS - 5883924; PARTNERSHIP INCOME/LOSS - -341221; FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS - CONTINUATION (1) CHILDREN'S HOSPITAL COLORADO (CHCO) works collaboratively with its affiliates as an academic medical center to fulfill a joint mission to provide excellent services and the best health outcomes for children, through teaching, research, clinical care and community support services. CHCO is committed TO INCLUSION AND BELONGING IN OUR WORKFORCE AND IN OUR COMMUNITY. WE STRIVE FOR EVERYONE TO FEEL VALUED. The following section describes CHCO's program service accomplishments for each of the three largest program services, as measured by expense. NEONATAL CARE For more than 50 years, the Neonatal Intensive Care Unit (NICU) at Children's Hospital Colorado (CHCO) has been a nationally recognized leader in the treatment of critically ill infants. The leading-edge Level IV NICU (the highest distinction by the American Academy of Pediatrics), at Children's Hospital Colorado, provides 82 critical care beds specifically for this patient population. The NICU provides excellence in care for infants throughout Colorado and the mountain state region. Named one of the country's top centers by U.S. News & World Report, our Level IV Neonatal Intensive Care Unit offers the highest level of care to more than 1,200 newborns every year -one of the largest centers in the region. We care for any condition affecting a newborn, no matter how rare or critical that condition may be. Therapies include extra corporeal membrane oxygenation (ECMO), continuous renal replacement (CRRT), genetic testing, and neonatal surgery. Volumes matter. Children's Colorado's NICU is among the highest volume centers in the U.S. for high-complexity patients, meaning we see more and treat more neonates with complex congenital conditions and severe complications of prematurity than most other centers. The NICU cares for both premature and term infants with a variety of conditions, including hypoxic respiratory failure, infections, hematological, neurological, cardiovascular, and metabolic disorders. Infants with single major or multiple anomalies requiring diagnostic evaluation or surgical intervention are often treated in the NICU. Our survival rates rank among the best in the nation. Our high volumes not only allow for the development of highly specialized teams and standardized approaches to care, they also build our surgical and medical sub-specialists' experience and expertise. The Neonatology team has pioneered many critical developments in neonatal clinical care including surfactant replacement for premature infants, inhaled nitric oxide therapy for pulmonary hypotension, therapeutic hypothermia for perinatal brain injury, optimal nutrition for low-birth-weight infants and innovative care following fetal surgery. Collectively, the neonatologists and PhD research faculty published 80 articles in 2023. Throughout a visit, a baby and their family stay together in an environment we specifically designed to feel as much like home as possible. Families are integral to the care delivered. Key areas of focus include developmentally supportive care of the newborn, primary nursing and a family centered care approach. Parents are encouraged to participate in daily rounds and in all aspects of care. There is a Family Advisory Council to support current families and provide perspective on the patient experience. The clinical care team in the NICU is comprised of Neonatologists, Neonatal Nurse Practitioners, specialty trained nurses, respiratory therapists, pharmacists, physical, speech and occupational therapists, lactation specialists, neonatal nutrition, social work, chaplains, and case managers. Specialty consultants include neurology, pulmonology, genetics, gastroenterology, nutrition, metabolic, endocrinology, hematology, cardiology and cardiovascular surgery, general pediatric surgery, renal, ophthalmology, orthopedics and ear, nose and throat specialists. Children's Hospital Colorado neonatologists have diverse expertise caring for an array of complex conditions. The Section of Neonatology provides full clinical support for infants and their families at multiple hospitals in the Denver metropolitan area including Children's Hospital Colorado, University of Colorado Hospital and Denver Health Medical Center. The 35 board-certified neonatologists are nationally and internationally recognized leaders in neonatal care as well as clinical and scientific research. With advances in technology, the NICU team can provide teleconferencing for referring providers and/or parents who may not be present. They can also provide tele-NICU services to hospitals in rural areas to ensure those infants are properly treated in their home community and transferred only when appropriate. The NICU team continuously reviews quality and patient safety data focusing on excellence in patient outcomes. The NICU leadership team meets for Quality Rounds, promoting engagement of front-line staff and a multi-disciplinary approach to care. The NICU team promotes the safest environment possible with key communication in safety huddles each shift to review details of our safety and quality improvement work. Optimal communication with a large multidisciplinary team is one of our key strategies to promote the highest quality care possible. 2023 NICU Quality and Process Improvement Initiatives: - Family experience scores are consistently 80% or greater. Parents are invited to rounds with the NICU team daily. Our goal is to partner with parents in their child's plan of care. The CHCO NICU is involved in a regional quality collaborative to improve family engagement and satisfaction within NICU's. There is a strong foundation of Primary nursing as the model of care. - There is major focus on infection prevention practices and hand washing compliance among the large multidisciplinary team in the NICU. - A significant focus on the prevention of central line associated blood stream infections (CLABSI's). Our goal is to sustain a CLABSI rate of 1/1000-line days or less in 2023. The rate for 2023 was 0.93/1000 line days. There is frequent auditing of compliance to the CLABSI bundle regarding the care of the central lines and prevention measures. Line days totaled 5388 in 2023, demonstrating the complex, high acuity NICU patient population that is cared for. - Ongoing key quality initiatives include focusing on a sustained decrease in unplanned extubations, patient identification events, pressure injuries, adverse medication events and peripheral intravenous catheter extravasations. - The Lactation program has sustained the goal of 82% or greater of NICU infants receiving breast milk while hospitalized and upon discharge. In addition, there are several other quality projects with a nutrition focus lead by Clinician Nutrition, the Lactation Specialty Team rand the broader multi-disciplinary team. - Clinical outcomes of infants delivered in the Labor and Delivery Care Unit at CHCO and admitted to the NICU are followed closely. - Team debriefs are held after infant resuscitations to strengthen team dynamics and clinical practices. The NICU team also participates in high fidelity, multi-disciplinary code simulations. - A standardized, evidenced based approach to caring for infants in the Small Baby Unit within the NICU. Key clinical outcomes are tracked and reviewed. - Close follow up of infants treated with surgical interventions, hypothermic therapy for neonatal encephalopathy, unique ventilation strategies, Supporting Preemie Respiratory Outcomes (SPROUT) Transitional Team, extracorporeal membrane oxygenation (ECMO), inhaled nitric oxide (iNO), continuous renal replacement therapy (CRRT) and peritoneal dialysis. RESPIRATORY SERVICES Breathing Institute -Respiratory Care The physicians and care teams of the Breathing Institute at Children's Hospital Colorado provide comprehensive clinical care and consultation for children with common and complex breathing disorders. Our world-class team of pediatric pulmonologists is always available to care for children with shortness of breath, wheezing, cough, noisy breathing, oxygen dependency, recurrent pneumonia and other general lung disorders. Special areas of expertise include asthma, cystic fibrosis, airway anomalies and disease, pulmonary hypertension, apnea, aspiration, ventilator dependency, chronic lung disease of infancy, sleep-disordered breathing and other high acuity breathing disorders. At Children's Hospital Colorado, Respiratory Care is part of the Breathing Institute service line. This department cares for a diverse patient population from around the United States, ranging in age from birth to early adulthood. Providing care at 4 inpatient facilities, 4 emergency departments/urgent care, 5 outpatient clinic locations, and 6 regional outreach clinics in including our recently developed telemedicine outreach. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS - CONTINUATION (2) The Respiratory Care team includes 26 Pediatric Pulmonologists, 7 Pediatric Sleep Medicine Physicians (includes 4 sleep/pulmonary providers and one ENT provider), 2 Allergists, 18 Advanced Practice Providers, and 28 outpatient nurses. The multidisciplinary care team also includes respiratory therapists, social workers, health navigators, community health workers registered dieticians, physical, occupational and speech therapists, and psychologists. In 2023, the Breathing Institute had 18,244 outpatient visits 5,452 inpatient discharges, performed 661 bronchoscopies (1.2% decrease from 2019), and completed 3,473 sleep studies - all values are increased from 2022. Breathing Institute - Respiratory Care Quality Initiatives Breath Better Annual Conference Healthcare is constantly changing, making it a challenge for health professionals to stay current on the latest education and learning. The Breathing Institute at Children's Hospital Colorado hosts an annual conference called Breathe Better: Promoting Healthy Lungs Together for a Lifetime. This 4-hour 2023 educational event brought together 66 multidisciplinary group of physicians, included community-based clinicians, advanced practice providers, nurses, respiratory therapists, community health workers, and researchers to discuss the latest developments in lung health. Virtual Webinars The Breathing Institute hosts 2-3 annual virtual webinars where clinical experts are reviewing current literature and standards of care in evaluating, treating, and managing of pediatric patients with asthma, sleep, and chronic lung disease disorders. As a result of this activity in 2023, 63 learners will be able to expand upon their current knowledge and potentially apply lessons learned within their own community practices to assist in improving patient outcomes. TRACK (Transitional Respiratory and Airway Center for Kids) - Pilot In August 2023, a new patient care model was launched on the inpatient Level 9 unit. This pilot program addresses the needs of a subset of our long-term patients with tracheostomies and are ventilator dependent. These patients are medically ready for discharge but cannot leave the hospital due to external barriers, such as home nursing shortages, and the lack of long-term care facilities. The goal of TRACK is to provide more developmentally appropriate care, while we advocate for longer-term solutions, such as getting patients out of their rooms routinely, implementing standardized schedules for medical services and other care, providing uninterrupted nap time, therapy, and a designated bedtime. Asthma Program with the Breathing Institute -Quality Initiatives Inpatient Asthma Navigator (IAN) Asthma is the most common chronic illness in children and the most common chronic diagnosis leading to hospitalization for children. Children hospitalized with an asthma exacerbation have a 30% risk of readmission after the first hospitalization. Children who see their primary care provider (PCP) after admission for asthma and those seen by an asthma specialist are less likely to be readmitted for asthma. Pediatric readmissions for asthma are more common in children who report significant barriers to health such as economic and psychosocial factors. The inpatient health navigator role (non-clinical) has been in existence for two years to assist in improving the transition of care from hospital back to the community providers, identify and assist with social barriers to following plan of care, and increase access to an asthma specialist. In 2023, the IAN was able to maintain scheduled PCP appointments around 80%, decrease CHCO specialty no-show rate for asthma to an average of 6.7% and identifying/assisting 20% of families who have reported at least one or more social barriers preventing them from following their home plan of care. Inpatient Asthma Care Coordination Children who are admitted to the ICU or who have known poor medication adherence resulting in asthma exacerbation are at greater risk of having poorer health outcomes, quality of life and greater unplanned healthcare utilization. Annually 20% of children treated in the Emergency Department are admitted to the PICU for an asthma exacerbation. The inpatient asthma care coordinator meets with the patient and caregiver(s) to identify any clinical or social barriers to care, assesses medication adherence, emphasizes current asthma education being provided by the bedside team, and partners with patient, caregivers, and medical team to come up with the best discharge plan for the family. The inpatient asthma care coordinator supports transitions of care from hospital to home in partnership with the asthma navigator and coordinates care back to community partners (primary care, schools, daycare, preschool, other specialists, etc.) to improve collaborative support and communication to improve health outcomes for the child. The care coordinator also provides ongoing educational support through follow up telephone, outreach, and telehealth visits. Through this work we have been able address barriers to medication adherence and facilitate specialty follow-up post discharge decreased health care utilization, particularly for high healthcare utilizers. This program has been in existence for nearly 6 years and the inpatient asthma care coordinator has supported over 2,000 patients. Hospital Transformation Program The goal of Children's Hospital Colorado's comprehensive asthma care is to give patients and families tools they can use to control asthma and improve the quality of life for their child with asthma. The National Asthma Education and Prevention Program (NAEPP) and Global Initiative for Asthma (GINA) guidelines, and Joint Commission Children's Asthma Care (CAC) measures recommend that written asthma action plans (AAPs) be included in asthma education as an integral part of care. The AAP provides a clear, step by step plan for the caregiver to follow in the case of an asthma attack. The development of individualized written AAP is an ideal situation for fostering shared decision-making and partnership between the family and providers in asthma care. In 2023, 94% of all asthma patients discharged from the hospital had a current asthma action plan. Potential Avoidable Cost/Access Health Connections Discharging pediatric patients is a complex process of communication that may place patients at risk for adverse outcomes if done poorly. Poor communication at discharge is linked to adverse events after discharge including medication errors, poor follow up, and worsening health. Data indicate that interventions for improving pediatric hospital-to-home transitions for asthma should include partnerships with the medical home to ensure patients and families continue to have access to medications, continue to be medically managed and continue to support clinical and social barriers. From the 2023 work, Children's in partnership with four other primary care organizations (Stride, Every Child Pediatrics, Kaiser, and Doctors Care) continues to optimize using EMR tools to communicate social barriers and social resources provided, expand lessons learned into other patient populations, and learning how to optimize visibility of information across HER's. Asthma Newsletter In an ever-changing climate of healthcare, it is difficult for primary care practices and community providers to remain current in topics impacting the care of children with asthma. To increase awareness and knowledge around asthma management and treatment, the asthma program sends out a twice a year asthma newsletter to hundreds of community partners on current topics impacting the care of children with asthma. Asthma Education Standardization National and Global guidelines recommend asthma education for all affected individuals as an integral part of disease management. Standardized patient education can help healthcare providers improve patient outcomes by providing a consistent learning experience for patients and their caregivers. The Asthma Team continues to ensure our 35+ asthma specific patient education handouts align with standards of care and evidence-based practice. This includes creating and incorporating educational videos that can be accessible to patients, their caregivers, and health care providers on YouTube and Children's Colorado website. QR codes have also been created to allow for quick access to those educational that can be embedded within educational handouts and shared through MyChart. National and Global guidelines recommend asthma education for all affected individuals as an integral part of disease management. Standardized patient education across the system can help healthcare providers improve patient outcomes by providing a consistent learning experience for patients and their caregivers. 5314 INSURANCE COMPANY LLC 677 ALA MOANA BLVD SUITE 316 HONOLULU HI 96813 843975618 CAPTIVE INS. HI 5146893 32753419 CH-COLORADO CHILDREN'S HOSPITAL COLORADO HLTH SYSTEM 13123 EAST 16TH AVE AURORA CO 80045 454182666 HEALTHCARE CO 501(c)(3) Type III-FI NA false The Children's Hospital Colorado Foundation 13123 EAST 16TH AVE AURORA CO 80045 840813462 FOUNDATION CO 501(c)(3) 7 CHCHS true PEDIATRIC CARE NETWORK CHCH LLC 13123 EAST 16TH AVE AURORA CO 80045 813554450 HEALTHCARE CO CH-COLORADO C Corporation 4568082 4618808 1 true PERPETUAL TRUST HOSPITAL SUPPORT CO CH-COLORADO true true true true true false false false false false false true true true true true false false false false CHILDRENS HOSPITAL COLORADO FOUNDATION C 87369 ACCRUAL