4A (Expenses $ 147977991 including grants of $ 163525) (Revenue $ 185833864)
LODI MEMORIAL HOSPITAL IS A NON-PROFIT, ACUTE CARE HOSPITAL PROVIDING HIGH QUALITY SERVICES THAT PROMOTE HEALTH AND REHABILITATION, PREVENT DISEASE, AND TREAT AND CARE FOR THE SICK AND INJURED. HOSPITAL STAFF, MEDICAL STAFF AND THE GOVERNING BOARD ARE DEDICATED TO TREATING ALL PATIENTS AND VISITORS AS INDIVIDUALS WITH EQUAL DIGNITY, RESPECT AND QUALITY OF CARE.LODI MEMORIAL HOSPITAL TREATS AND PROVIDES CARE TO ITS PATIENTS THROUGH INPATIENT AND OUTPATIENT SERVICES. INPATIENTS RECEIVE CARE THROUGH MEDICAL-SURGICAL, PERI-OPERATIVE, PERI-NATAL, PEDIATRIC, INTENSIVE CARE, AND ACUTE-PHYSICAL REHABILITATION SERVICES.OUTPATIENT CARE INCLUDES 24-HOUR EMERGENCY, DIAGNOSTIC SERVICES, SURGERY, REHABILITATION AND EDUCATION.LODI MEMORIAL HOSPITAL IDENTIFIES THE HEALTH-CARE AND HEALTH MAINTENANCE NEEDS AND PREFERENCES OF THE COMMUNITY IT SERVES. DIAGNOSTIC, REHABILITATIVE, EDUCATIONAL, TREATMENT AND PREVENTATIVE SERVICES ARE DEVELOPED AS APPROPRIATE FOR A HOSPITAL OF THIS SIZE AND ROLE.LODI MEMORIAL HOSPITAL, CONSISTENT WITH ITS NON-PROFIT STATUS, DEVELOPS FINANCIAL RESOURCES TO ADEQUATELY SUPPORT HEALTH MAINTENANCE AND PATIENT-CARE SERVICES; CHARITY CARE FOR THOSE UNABLE TO PAY, WORKING CAPITAL NEEDS; AND CAPITAL REQUIREMENTS OF PLANT, EQUIPMENT AND ENVOLVING TECHNOLOGY. EVERY EFFORT IS MADE TO KEEP COSTS AFFORDABLE FOR PATIENTS WHILE CONTINUOUSLY STRIVING TO IMPROVE THE QUALITY OF SERVICE.

4B (Expenses $ 8244953 including grants of $ 0) (Revenue $ 4793544)
LODI MEMORIAL COMMUNITY CLINICS ARE LICENSED UNDER THE DEPARTMENT OF PUBLIC HEALTH SERVICES REGULATIONS, AND ARE OWNED AND OPERATED BY THE LODI MEMORIAL HOSPITAL ASSOCIATION, INC., A NOT-FOR-PROFIT ENTITY AND WILL PROVIDE MEDICAL CARE TO ANY AGE. A COMMUNITY CLINIC UNIT OFFERS SERVICES DURING POSTED HOURS OF BUSINESS, WITH AT LEAST ONE PHYSICIAN EXPERIENCED IN THE COMMUNITY CLINIC PRACTICE. SPECIALTY CONSULTATION WILL BE AVAILABLE BY PHONE OR REFERRAL TO MEMBERS OF THE MEDICAL STAFF. IN 2012, THERE WERE FOUR (4) COMMUNITY CLINICS LICENSED AND OPERATIONAL.

PART I, LINE 7: COST IS ASSIGNED UTILIZING OUR INTERNAL COST ACCOUNTING SYSTEM (EPSI). COST IS ESTIMATED BY UTILIZING RELATIVE VALUE UNITS ASSIGNED TO EACH PRODUCT (I.E. CHARGEABLE TEST, SUPPLY, OR PROCEDURE). EACH PRODUCT'S RELATIVE VALUE IS ESTIMATED BY EACH DEPARTMENT DIRECTOR BASED ON RESOURCES EXPENDED FOR EACH DEPARTMENT PRODUCT. DEPARTMENT COSTS ARE ALLOCATED TO EACH PRODUCT BASED ON ACCUMULATED RELATIVE VALUES. EACH PATIENT ACCUMULATES PRODUCTS DURING THEIR VISIT. THE TOTAL COST FOR EACH PATIENT REPRESENTS THE SUM OF ALL THE PRODUCTS PROVIDED TO THEM DURING THEIR VISIT OR INPATIENT STAY. THE ABOVE IS THE CACULATION FOR HOSPITAL CHARGES. FOR COMMUNITY CLINICS, HOSPITAL BASED CLINICS, HOSPITAL BASED HOME HEALTH AGENCY AND TWO SURGERY CENTER JOINT VENTURES A COST TO CHARGE RATIO WAS CALCULATED BASED ON THE DIRECT COSTS OF THESE LINES OF BUSINESS.

PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 30581962.

SCHEDULE H, PART I EXPLANATION
"OVERVIEW:CHA: ""THE HOSPITAL PROVIDER FEE IS CRUCIAL TO THE PRESERVATION OF CALIFORNIA'S ENTIRE SAFETY NET, WHICH IS WHY CALIFORNIA'S SAFETY-NET HOSPITALS INITIATED PROVIDER FEE LEGISLATION, AND WHY ALL CALIFORNIA HOSPITALS SUPPORT IT. THE PROGRAM USES FEES ASSESSED BY THE STATE ON HOSPITALS TO DRAW DOWN FEDERAL MATCHING FUNDS, WHICH ARE THEN ISSUED AS SUPPLEMENTAL PAYMENTS TO HOSPITALS. THE HOSPITAL PROVIDER FEE IS AN INTEGRAL ELEMENT TO IMPROVING ACCESS TO HEALTH CARE FOR SOME OF CALIFORNIA'S MOST VULNERABLE RESIDENTS.""THE 30 MONTH HOSPITAL QA FEE / SUPPLEMENTAL MEDI-CAL FEE FOR SERVICE (FFS) REVENUE PROGRAM WAS APPROVED BY CMS IN JUNE 2012. THE MEDI-CAL MANAGED CARE PORTION WAS NOT APPROVED UNTIL JUNE 2013. PERIOD COVERED JULY 1, 2011 - DECEMBER 31, 2013, WHICH COMPRISE 10 CALENDAR QUARTERS.BENEFIT TO LMH:IN 2012 WE RECORDED ON A PRORATED BASIS 18 MONTHS (7/1/2011-12/31/2012) OF THE HOSPITAL QA FEE / SUPPLEMENTAL MEDI-CAL FEE FOR SERVICE (FFS) PROGRAM'S EXPENSES AND REVENUES. NONE OF THE MANAGED CARE PORTION WAS RECORDED IN 2012. - TOTAL REVENUES EARNED FROM THIS PROGRAM TOTALED $15,322,180.20 - TOTAL FEES EXPENSED FOR THIS PROGRAM TOTALED $10,778,490.58 - ADDITIONAL FEES EXPENSED FOR THE CALIFORNIA HEALTH FOUNDATION AND TRUST TOTALED $139,603.97INCOME EARNED WAS CREDITED TO THE MEDI-CAL PROGRAM AND GREATLY REDUCED THE UNREIMBURSED COST OF THE MEDI-CAL PROGRAM IN 2012 WHICH IN TURN REDUCED THE CHARITY CARE COSTS REPORTED ON SCHEDULE H COMPARED TO 2011."

PART II: THE HOSPITAL PROVIDES MANY COMMUNITY-BUILDING ACTIVITIES TO INCREASE ACCESS TO PRIMARY-CARE SERVICES AND REDUCE THE NUMBER OF PATIENTS WHO PRESENT THEMSELVES TO THE EMERGENCY DEPARTMENT SEEKING CARE FOR MEDICAL CONDITIONS OR INJURIES THAT COULD HAVE EASILY BEEN TREATED AT THE ONSET BY A PRIMARY-CARE PHYSICIAN. THE FOLLOWING WERE LAUNCHED AND ARE NOW SUSTAINED BY THE HOSPITAL TO ADDRESS THE NEED FOR ACCESS TO CARE: A FREE CLINIC; THREE HOSPITAL BASED PRIMARY-CARE CLINICS, AN OBSTETRIC CLINIC AND A PEDIATRIC CLINIC; TWO PRIMARY-CARE COMMUNITY CLINICS AND ONE SPECIALTY COMMUNITY CLINIC. THE CLINICS ALSO KEEP LOCAL PHYSICIANS PRACTICING MEDICINE IN THE AREA. MANY PHYSICIANS WOULD HAVE RETIRED OR MOVED OUT OF THE AREA TO PRACTICE IN A HEALTH SYSTEM IF THE HOSPITAL HAD NOT AGREED TO EMPLOY THEM OR MANAGE THEIR PRACTICES. SO THAT ADULTS CAN WORK WHILE THEIR CHILDREN AND PARENTS ARE SAFELY AND LOVINGLY CARED FOR DURING THE DAY, THE HOSPITAL OFFERS AN AFFORDABLE CHILD-CARE CENTER AND AN ADULT-DAY-CARE CENTER. ADDITIONALLY, THE HOSPITAL PROVIDES NURSE TRAINING, SALARIES AND SUPPORT FOR NINE PARISH-NURSE PROGRAMS SO THAT PEOPLE IN THEIR CHURCHES HAVE ACCESS TO HEALTH EDUCATION, PREVENTION AND OTHER SUPPORTIVE SERVICES. TO PREVENT DISEASE AND INJURY AND ENCOURAGE WELLNESS, HEALTH NEWSLETTERS ARE MAILED TO 85,000 SERVICE-AREA HOUSEHOLDS AND MADE AVAILABLE ON THE HOSPITAL WEB SITE THREE TIMES A YEAR. SAN JOAQUIN COUNTY IS AMONG THE MOST DIFFICULT COUNTIES IN THE STATE WHEN IT COMES TO RECRUITING PHYSICIANS TO PRACTICE MEDICINE, AND THE HOSPITAL DEVOTES SIGNIFICANT FINANCIAL AND HUMAN RESOURCES TO THAT EFFORT.

"PART III, LINE 4: FINANCIAL STATEMENT NOTE 18. ""UNCOMPENSATED CARE AND COMMUNITY BENEFIT COSTS: OUR POLICY IS TO PROVIDE SERVICE TO ALL WHO REQUIRE IT, REGARDLESS OF THEIR ABILITY TO PAY. AS SUCH, WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE. WHEN THIS CARE IS PROVIDED TO PATIENTS WHO LACK FINANCIAL RESOURCES AND THEREFORE ARE DEEMED MEDICALLY INDIGENT, IT IS CLASSIFIED AS CHARITY CARE. WHEN IT IS PROVIDED TO PATIENTS WHO HAVE THE MEANS TO PAY, BUT DECLINE TO DO SO, IT IS CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS. SOME UNDETERMINED PORTION OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS REPRESENTS CARE TO INDIGENT PATIENTS WHO WE HAVE BEEN UNABLE TO IDENTITY AS CHARITY. NEITHER CHARITY CARE NOR THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS REFLECTED IN NET PATIENT SERVICE REVENUES. IN ADDITION, WE PROVIDE SERVICES TO POOR AND UNDERSERVED PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED, INCLUDING PATIENTS INSURED UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS THAT ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND FREQUENTLY THE PAYMENTS ARE LESS THAN THE COSTS OF RENDERING THE SERVICES.""COSTING METHODOLOGY:UTILIZING THE PREVIOUS COSTING METHODOLOGY AS OUTLINED IN RESPONSE TO PART I LINE 7, ALL PATIENTS ARE ASSIGNED A PAYOR CLASS (I.E. CHARITY, SELF PAY, MEDICARE, MEDI-CAL, MANAGED CARE). THE COST BY PAYOR IS A SUMMATION OF ALL PATIENTS IN THE ASSIGNED PAYOR CLASS. COMMUNITY BENEFIT RATIONALE: IN ADDITION TO 4C: UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGIBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE. OFTEN THE INFORMATION GATHERED IN THE MEDICAID APPLICATION WILL MAKE THIS DETERMINATION ""AUTOMATIC"". IF ADDITIONAL INFORMATION IS REQUIRED WE ATTEMPT TO CONTACT THE PATIENT.THE AMOUNTS WRITTEN OFF AS BAD DEBT (ASSIGNED TO A COLLECTION AGENCY) ARE NET OF ANY APPLICABLE PAYMENTS OR DISCOUNTS. ANY PAYMENTS RECEIVED AFTER AN ACCOUNT IS ASSIGNED TO A COLLECTION AGENCY REDUCE THE BAD DEBT EXPENSE IN THE PERIOD RECEIVED.OF THE TOTAL UNINSURED PATIENTS SEEN IN 2012: 47% QUALIFIED FOR CHARITY CARE AND 51% WERE WRITTEN OFF TO BAD DEBTS. IT IS DIFFICULT TO ASCERTAIN HOW MANY UNINSURED WRITTEN OFF TO BAD DEBTS WOULD QUALIFY FOR CHARITY CARE. ALL BAD DEBT WRITE OFFS ARE SENT TO A COLLECTION AGENCY. IF AN ACCOUNT QUALIFIES FOR CHARITY CARE AFTER SENT TO AN AGENCY, NO FURTHER COLLECTION ACTIVITY IS PURSUED AND THE ""BAD DEBT"" ACCOUNT IS WRITTEN OFF IN FULL - WE HAVE NOT TRACKED THESE IN THE PAST AS PART OF OUR CHARITY CARE EXPENSE BUT ESTIMATE AT LEAST 35% OF OUR BAD DEBT COSTS REPRESENT CHARITY CARE."

PART III, LINE 8: THE COSTS OF PROVIDING CARE TO MEDICARE RECIPIENTS OFTEN EXCEED THE GOVERNMENT'S REIMBURSEMENT FOR THESE SERVICES. FOR COST ASSIGNED TO MEDICARE PATIENTS, PLEASE SEE RESPONSE IN PART III, LINE 4.FEE REIMBURSED CHARGES FOR LABORATORY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY WITH INCIDENTAL CHARGES FOR SUPPLIES AND DRUGS WERE OBTAINED FROM THE MEDICARE PS&R. COST TO CHARGE RATIOS (CCR) FROM THE FILED COST REPORT WERE UTILIZED TO CALCULATE MEDICARE COSTS. MEDICARE REVENUES FOR THESE SERVICES WERE $45,457,536; COSTS WERE $50,198,898.THE COST ACCOUNTING SYSTEM IS USED FOR HOSPITAL CHARGES - ALL INPATIENT, OUTPATIENT, EMERGENCY AND URGENT CARE - FOR ALL PAYORS. A COST TO CHARGE RATIO WAS USED FOR SEGMENTS THAT ARE NOT YET INCLUDED IN THE COST ACCOUNTING SYSTEM: PRIMARILY HOSPITAL BASED CLINICS, COMMUNITY CLINICS, HOME HEALTH AND OUR RURAL HEALTHCARE CLINIC. 96.3% OF OUR CONSOLIDATED GROSS REVENUES ARE CAPTURED IN THE COST ACCOUNTING SYSTEM.

PART III, LINE 9B: UNINSURED PATIENTS ARE SCREENED FOR MEDICAID LINKAGE, GIVEN ASSISTANCE IN APPLYING FOR MEDICAID AND IF INELIGBLE FOR MEDICAID ARE GIVEN INFORMATION REGARDING OUR CHARITY CARE (FINANCIAL ASSISTANCE)POLICY AND ENCOURAGED TO APPLY FOR CHARITY CARE (FINANCIAL ASSISTANCE).

LODI MEMORIAL HOSPITAL
PART V, SECTION B, LINE 20D: THE FINANCIAL ASSISTANCE (CHARITY CARE) POLICY CHARGES THE PATIENT 10% OF GROSS CHARGES IF THEIR POVERTY LEVEL IS BETWEEN 300% AND 350% OF THE FEDERAL GUIDELINES. THE 10% OF GROSS CHARGES APPROXIMATES THE HOSPITAL'S REIMBURSEMENT FROM MEDICARE AND IS THE MAXIMUM CHARGED TO INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE.

LODI MEMORIAL HOSPITAL - WEST
PART V, SECTION B, LINE 20D: THE FINANCIAL ASSISTANCE (CHARITY CARE) POLICY CHARGES THE PATIENT 10% OF GROSS CHARGES IF THEIR POVERTY LEVEL IS BETWEEN 300% AND 350% OF THE FEDERAL GUIDELINES. THE 10% OF GROSS CHARGES APPROXIMATES THE HOSPITAL'S REIMBURSEMENT FROM MEDICARE AND IS THE MAXIMUM CHARGED TO INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE.

SCHEDULE H, PART V, FACILITY INFORMATION:
SECTION B APPLIES TO BOTH LODI MEMORIAL HOSPITAL AND LODI MEMORIAL HOSPITAL - WEST.

PART VI, LINE 2: EVERY THREE YEARS LODI MEMORIAL HOSPITAL ASSESSES COMMUNITY HEALTH NEEDS BY 1)CONSULTING WITH REPRESENTATIVES FROM A VARIETY OF COMMUNITY CONSTITUENCIES TO REVIEW THE NEEDS OF EACH CONSTITUENCY; 2)REVIEWING SERVICE-AREA MORBIDITY AND MORTALITY HEALTH DATA PROVIDED BY THE CALIFORNIA DEPARTMENT OF HEALTH SERVICES; 3)COMPILING SOCIO-ECONOMIC DATA TO DETERMINE WHERE THE GREATEST NEEDS EXIST WITHIN THE HOSPITAL-SERVICE AREA; AND 4)ASKING AREA RESIDENTS TO COMPLETE A HEALTH SURVEY REGARDING THEIR PERSONAL HEALTH AND NOTIONS ABOUT GOOD HEALTH. ONCE THE DATA IS COLLECTED, IT IS REVIEWED AND ASSESSED BY THE HOSPITAL'S COMMUNITY ADVISORY BOARD, BOARD OF DIRECTORS AND HOSPITAL MANAGERS TO DETERMINE WHAT SERVICES AND GAP AREAS MAY NEED ENHANCING OR ADDRESSING TO IMPROVE HEALTH WITHIN THE REALM OF THE HOSPITAL'S RESOURCES TO DO SO.

PART VI, LINE 3: SIGNS ARE PROMINENTLY POSTED IN THE ADMISSIONS, EMERGENCY AND BILLING DEPARTMENTS OF THE HOSPITAL, IN ADDITION TO ALL THE HOSPITAL CLINICS, TO ADVISE PATIENTS AND VISITORS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND HOW TO WORK WITH HOSPITAL STAFF TO OBTAIN IT. THE SAME INFORMATION IS INCLUDED IN PATIENT-ADMISSION PACKETS AND POSTED ON THE HOSPITAL WEB SITE. HOSPITAL CASE MANAGERS ARE VIGILANT OF PATIENTS NEEDING FINANCIAL ASSISTANCE AND FOLLOW UP WITH THOSE IN NEED. FINANCIAL ASSISTANCE INCLUDES APPLYING FOR MEDICAID AS WELL AS CHARITY CARE.

PART VI, LINE 4: NEARLY ALL OF THE INDIVIDUALS SEEKING CARE FROM LODI MEMORIAL HOSPITAL RESIDE IN ONE OF FIVE COUNTIES: SAN JOAQUIN, SACRAMENTO, SOLANO, AMADOR, AND CALAVERAS. ABOUT HALF OF THE HOSPITAL'S PATIENTS RESIDE WITHIN A FIVE-MILE RADIUS OF THE HOSPITAL IN SAN JOAQUIN COUNTY. GEOGRAPHICALLY, THE HOSPITAL SITS AT THE NORTHERN END OF THE SAN JOAQUIN VALLEY WHERE THE RESIDENTS ARE AMONG THE POOREST AND LEAST EDUCATED OF ALL THE STATE'S COUNTIES. IN ADDITION, SAN JOAQUIN COUNTY HAS AMONG THE WORST UNEMPLOYMENT RATES IN THE STATE'S COUNTIES; NEARLY TWO IN 10 RESIDENTS ARE UNEMPLOYED. ALSO SAN JOAQUIN COUNTY IS GROUND-ZERO FOR THE MORTGAGE CRISIS IN THIS COUNTRY. THE COUNTY IS ALSO AMONG THE MOST VIOLENT IN WHICH TO LIVE IN THE COUNTRY DUE TO SIGNIFICANT GANG ACTIVITY AND POVERTY. HOSPITAL PATIENTS REPRESENT DIVERSITY: ABOUT 30 PERCENT ARE HISPANIC, WITH MANY OF THOSE PATIENTS BEING MONOLINGUAL SPANISH SPEAKERS. ANOTHER THREE PERCENT ARE PAKISTANI, MANY OF WHOM SPEAK ONLY URDU OR PASHTU. ADDITIONALLY THERE IS A SIGNIFICANT POPULATION OF HOSPITAL PATIENTS WHO ARE GREATER THAN 80 YEARS OF AGE. THE MAJOR HEALTH ISSUES OF THE COUNTY ARE HEART DISEASE, STROKE, CANCER, DIABETES AND OBESITY.

PART VI, LINE 5: THE HOSPITAL CONDUCTS MYRIAD ACTIVITIES TO PROMOTE COMMUNITY HEALTH. THOSE ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO HEALTH FAIRS WITH FREE MEDICAL SCREENINGS FOR HIGH CHOLESTEROL, HIGH-BLOOD PRESSURE, DIABETES AND LOW-OXYGEN SATURATION LEVELS; REFERRALS TO FREE CLINICS OR LOCAL PHYSICIANS FOR THOSE WITH HIGH VALUES; A VARIETY OF LINKED VIDEOS TO THE HOSPITAL WEB PAGE, FACEBOOK PAGE, YOUTUBE PAGE, AND TWITTER RELATED TO HEALTH EDUCATION AND PREVENTION; A WELLNESS PROGRAM FOR HOSPITAL EMPLOYEES THAT IS ROOTED IN EXERCISE AND NUTRITION SO THAT EMPLOYEES MAY LEAD BY EXAMPLE; A MONTHLY NUTRITION COLUMN IN THE LOCAL NEWSPAPER; HOSPITAL STAFF SERVING ON THE BOARDS OF REGIONAL NGOS; DONATIONS OF MATERIALS AND EQUIPMENT TO NGOS; EMPLOYEE DONATIONS OF FOOD AND CLOTHING TO THE NEEDY; AND THE HOSPITAL IS THE SECOND LARGEST YEAR-ROUND EMPLOYER IN LODI SO THAT EMPLOYEES MAY REINVEST THEIR EARNINGS IN THE LOCAL ECONOMY. THE HOSPITAL HAS ALSO ADOPTED THE MOST IMPOVERISHED, LARGEST AND MOST DIVERSE SCHOOL IN THE LOCAL SCHOOL DISTRICT TO HELP EDUCATE STUDENTS, PARENTS AND TEACHERS IN PREVENTION. IN THAT EFFORT THE HOSPITAL HOSTS AT THE SCHOOL HEALTH AND EDUCATION FAIRS; PARTICIPATES IN CLASSROOM TEACHING AND HEALTH DEMONSTRATIONS; AND PARTICIPATES IN CAREERS FAIRS AT THE SCHOOL. DUE TO HAND-WASHING EDUCATION ALONE, THE SCHOOLS ABSENTEE RATES HAVE DECLINED DRAMATICALLY. FOR STUDENTS TO LEARN, THEY MUST BE IN SCHOOL; AND FOR SCHOOLS TO RECEIVE STATE FUNDING, THEY MUST MAINTAIN THEIR ATTENDANCE.

PART VI, LINE 6: N/A

REPORTS FILED WITH STATES PART VI, LINE 7
CA