4A (Expenses $ 801589022 including grants of $ 2500759) (Revenue $ 1043101201)
CLINICAL CARE:A DISTINGUISHING FEATURE OF FRED HUTCH CLINICAL CARE IS THE INTEGRATION OF OUR TREATMENT PROGRAMS AND RESEARCH, WHICH WAS STRENGTHENED BY THE APRIL 2022 MERGER OF A RESPECTED CLINICAL CANCER CARE ORGANIZATION (SEATTLE CANCER CARE ALLIANCE) AND A RENOWNED RESEARCH ORGANIZATION (FRED HUTCHINSON CANCER RESEARCH CENTER), CREATING FRED HUTCHINSON CANCER CENTER. THIS UNIFICATION SUPPORTS OUR FOCUS OF SPEEDING THE TRANSFER OF NEW DIAGNOSTIC AND TREATMENT TECHNIQUES FROM THE RESEARCH SETTING TO PATIENT CARE. THE HIGHLY INTEGRATED APPROACH SUPPORTS THE FLOW OF SCIENTIFIC INFORMATION AMONG RESEARCHERS, CLINICIANS, AND PATIENTS, THEREBY ACCELERATING THE DEVELOPMENT OF NEW KNOWLEDGE AND TREATMENT OF VARIOUS CANCERS.THE 2022 MERGER WAS ALSO ACCOMPANIED BY A RESTRUCTURING OF A LONG-STANDING RELATIONSHIP WITH THE UW MEDICINE HEALTH SYSTEM. UNDER THIS RESTRUCTURING AGREEMENT, FRED HUTCH, AN INDEPENDENT, NONPROFIT ORGANIZATION, NOW SERVES AS THE CANCER PROGRAM FOR UW MEDICINE. THIS UNIQUE RELATIONSHIP BETWEEN TWO SEPARATE ORGANIZATIONS ALLOWS FOR ENHANCED CARE COORDINATION BETWEEN A TOP-RANKED CANCER CENTER AND ONE OF THE WORLD'S LEADING INTEGRATED HEALTH SYSTEMS.AS PART OF FRED HUTCH'S COMMITMENT TO ADVANCING THE STANDARD OF CANCER CARE, IT OFFERS MANY EDUCATIONAL OPPORTUNITIES FOR HEALTH CARE PROFESSIONALS OF ALL KINDS SEEKING THE SPECIALIZED KNOWLEDGE IN ONCOLOGY SETTINGS TO EARN CONTINUING EDUCATION CREDITS. FRED HUTCH IS DESIGNATED AS AN INSTRUCTIONAL SITE FOR BACHELOR AND ADVANCED DEGREE CANDIDATES FROM SEVERAL INSTITUTIONS AROUND THE PUGET SOUND AREA. FRED HUTCH OPERATES A HOUSING PROGRAM INCLUDING BOTH SOUTH LAKE UNION HOUSE AND PETE GROSS HOUSE AND RELATED TRANSPORTATION TO THE CLINIC.

4B (Expenses $ 174279546 including grants of $ 32237673) (Revenue $ 3340728)
RESEARCH PROGRAM: FRED HUTCH RESEARCH PROGRAMS INTEGRATE THE LATEST IN COMPUTATIONAL, LABORATORY AND PATIENT-ORIENTED CLINICAL RESEARCH METHODS TO BETTER UNDERSTAND THE MECHANISMS THAT DRIVE CANCER AND OTHER HUMAN DISEASES. OUR RESEARCHERS ARE CONTINUALLY DEVELOPING NEW THERAPEUTIC APPROACHES AND THEY DEVELOP AND LEAD CLINICAL TRIALS THAT HELP MOVE LABORATORY DISCOVERIES INTO NEW TREATMENT OPTIONS FOR PATIENTS. OUR DISCOVERIES, WHICH INCLUDE PROVING BONE MARROW TRANSPLANTATION COULD CURE LEUKEMIAS AND OTHER BLOOD CANCERS, HAVE SAVED HUNDREDS OF THOUSANDS OF LIVES. FRED HUTCH RESEARCHERS PARTNER WITH SCIENTISTS AT LABORATORY, CLINICAL AND FIELD SITES IN THE AMERICAS, AFRICA, ASIA AND EUROPE. OUR RESEARCHERS TAKE PRIDE IN THEIR COLLABORATIVE EFFORTS TO PREDICT, DETECT, TREAT, AND PREVENT INFECTIOUS DISEASES IN HUMANS, INCLUDING KNOWN AND EMERGING INFECTIONS OF MAJOR GLOBAL HEALTH IMPORTANCE, SUCH AS CORONAVIRUS, HIV AND CANCER-RELATED INFECTIOUS DISEASES.

FRED HUTCHINSON CANCER CENTER
PART V, SECTION B, LINE 5: FOR THE 2022 CHNA, FRED HUTCH INTERVIEWED A VARIETY OF CONSTITUENTS FROM ACROSS KING, PIERCE, AND SNOHOMISH COUNTIES. THEY REPRESENTED FEDERALLY QUALIFIED HEALTH CENTERS, RESEARCH CENTERS, LOCAL PUBLIC HEALTH AGENCIES, NATIVE TRIBES AND COMMUNITY-BASED ORGANIZATIONS WORKING ALONGSIDE PEOPLE FROM A WIDE RANGE OF RACES AND ETHNICITIES, FAMILIES AND INDIVIDUALS WITH LOW INCOME, SENIORS, RECENT IMMIGRANTS AND REFUGEES, AND OTHER GROUPS WHO FACE SIGNIFICANT BARRIERS TO ACCESSING CANCER SERVICES DUE TO CURRENT AND HISTORICAL STRUCTURAL AND SYSTEMIC RACISM AND DISCRIMINATION. WE DESIGNED A SEMI-STRUCTURED INTERVIEW PROTOCOL AND INCLUDED QUESTIONS ABOUT THE INTERVIEWEE'S ORGANIZATION AND THE SERVICES THEY PROVIDE, THEIR EXPERIENCE WORKING WITH MEDICALLY UNDERSERVED POPULATIONS, UNMET HEALTH AND CANCER-RELATED NEEDS IN THE COMMUNITY, SOCIOECONOMIC FACTORS THAT CONTRIBUTE TO HEALTH DISPARITIES, AND EXISTING RESOURCES IN THE COMMUNITY. BETWEEN SEPTEMBER AND DECEMBER 2021, THE FOLLOWING ORGANIZATIONS KINDLY AGREED TO SHARE THEIR EXPERIENCE AND EXPERTISE IN INTERVIEWS: AFRICAN AMERICANS REACH & TEACH HEALTH MINISTRY (AARTH), CIERRA SISTERS, COMMUNITIES OF COLOR COALITION, INTERNATIONAL COMMUNITY HEALTH SERVICES (ICHS), KOREAN WOMEN'S ASSOCIATION, MERCY HOUSING, MUCKLESHOOT FOOD SOVEREIGNTY PROJECT, PUBLIC HEALTH SEATTLE & KING COUNTY, SEA MAR COMMUNITY HEALTH CENTERS, SEATTLE INDIAN HEALTH BOARD, STILLY VALLEY HEALTH CONNECTIONS, AND URBAN INDIAN HEALTH INSTITUTE.

FRED HUTCHINSON CANCER CENTER
PART V, SECTION B, LINE 11: FRED HUTCH IDENTIFIED THE FOLLOWING CANCER-RELATED COMMUNITY HEALTH NEEDS THROUGH ITS CHNA: ACCESS TO AFFORDABLE AND ATTAINABLE COMPREHENSIVE CARE; CULTURALLY ATTUNED PREVENTION, EDUCATION AND SCREENING; ENVIRONMENTAL HEALTH AND CLIMATE CHANGE; HEALTH EQUITY; MENTAL HEALTH SUPPORT FOR PATIENTS, FAMILIES AND COMMUNITY; POLICY AND SYSTEMS CHANGE WHILE INCREASING CAPACITY OF COMMUNITY-BASED ORGANIZATIONS AND COMMUNITY CLINICS; TRUST AND RELATIONSHIP-BUILDING. FRED HUTCH HAS COMBINED MOST OF THE NEEDS IDENTIFIED THROUGH THE CHNA INTO THREE PRIORITY AREAS IN ITS IMPLEMENTATION STRATEGY: 1. ADVANCING HEALTH EQUITY 2. PROVIDING CULTURALLY ATTUNED PREVENTION, EDUCATION AND SCREENING 3. DELIVERING ACCESS TO AFFORDABLE AND ATTAINABLE COMPREHENSIVE CARE, INCLUDING MENTAL HEALTH CARE. WE WILL CONTINUE TO STRENGTHEN OUR TRUST AND RELATIONSHIP-BUILDING WITHIN FRED HUTCH AND WITH COMMUNITY PARTNERS. OUR COMMITMENT TO HEALTH EQUITY AND BECOMING AN ANTIRACIST ORGANIZATION ENCOMPASSES SUPPORTING POLICY AND SYSTEMS CHANGE WHILE INCREASING CAPACITY OF LOCAL TRIBAL AND COMMUNITY-BASED ORGANIZATIONS AND COMMUNITY CLINICS.THE FOLLOWING OBJECTIVES OUTLINE HOW FRED HUTCH IS ADDRESSING EACH PRIORITY AREA. ADVANCING HEALTH EQUITY: FRED HUTCH IS ADDRESSING OUR ORGANIZATION'S ENTRENCHED SOCIAL INEQUITIES ASSOCIATED WITH RACE, ETHNICITY, LANGUAGE, CULTURAL NORMS AND EDUCATION TO MOVE TO A SYSTEM WHERE EVERY PERSON HAS THE OPPORTUNITY TO ATTAIN THEIR FULL HEALTH POTENTIAL. WE WILL IMPROVE LANGUAGE ACCESS AND CULTURALLY RELEVANT RESOURCES TO BETTER SERVE COMMUNITY MEMBERS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH OR PREFER VISUAL COMMUNICATION. WE WILL BUILD CULTURAL RESPONSIVENESS AND INTERNAL CAPACITY IN EQUITY, DIVERSITY, INCLUSION AND ANTI-RACISM SO THAT EVERY PATIENT WHO IDENTIFIES AS BLACK, INDIGENOUS OR ANOTHER PERSON OF COLOR RECEIVES SUPPORT ACCORDING TO THEIR PREFERENCES. FRED HUTCH IS INCREASING THE OFFERING OF DIVERSITY, EQUITY, INCLUSION, BELONGING AND BIAS AWARENESS EDUCATION TO FRED HUTCH PROVIDERS AND RESEARCH STAFF. WE ARE PARTICIPATING IN THE NATIONAL COMPREHENSIVE CANCER NETWORK (NCCN) HEALTH EQUITY REPORT CARD PILOT PROJECT. WE ARE INCREASING REPRESENTATION OF BLACK, INDIGENOUS, AND OTHER PEOPLE OF COLOR IN COMMITTEES, ADVISORY GROUPS, AND OVERALL DECISION-MAKING. TO STRENGTHEN COMMUNITY-BASED ORGANIZATIONS WHO ARE TRUSTED BY OUR COMMUNITIES, FRED HUTCH PROVIDES GRANTS TO SUPPORT CANCER AND SOCIAL DETERMINANTS OF HEALTH-RELATED AWARENESS, PREVENTION, AND CARE SERVICES. FRED HUTCH WILL BE DEVELOPING, ENHANCING, OR TRANSLATING EDUCATION MATERIALS BASED ON COMMUNITY PARTNER NEEDS TO IMPROVE LANGUAGE ACCESS AND CULTURALLY RELEVANT RESOURCES. WE WILL BE IMPROVING ACCESS TO CLINICAL TRIALS FOR UNDERREPRESENTED MINORITY PATIENTS AS WELL AS IMPROVING COLLECTION OF RACE AND ETHNICITY DATA OF NEW PATIENTS TO BETTER UNDERSTAND THE BURDEN OF CANCER. PROVIDING CULTURALLY ATTUNED PREVENTION, EDUCATION AND SCREENING: FRED HUTCH PROMOTES KNOWLEDGE OF HEALTHY LIFESTYLES AND REGULAR CANCER SCREENINGS TO DECREASE THE PREVALENCE AND SEVERITY OF CANCER WITH A FOCUS ON MARGINALIZED AND BIPOC COMMUNITIES. WE PROVIDE EDUCATION AND RECOMMENDED SCREENING AND TREATMENT OPTIONS TO MEMBERS OF OUR COMMUNITY THROUGH COMMUNITY HEALTH EVENTS THAT REACH PRIORITY POPULATIONS. THE FRED HUTCH MOBILE MAMMOGRAM VAN DELIVERS THOUSANDS OF MAMMOGRAPHY SCREENINGS TO THE COMMUNITY EACH YEAR IN VARIOUS SETTINGS. WITH A FOCUS ON BLACK AND AFRICAN AMERICAN WOMEN, WE ARE ALSO PARTNERING WITH COMMUNITY ORGANIZATIONS TO SUPPORT THEIR ESTABLISHED EVENTS AS WELL AS LAUNCHING OUTREACH CAMPAIGNS WITH OUTSIDE REFERRING PROVIDERS TO REACH DUE/OVERDUE PATIENTS. FRED HUTCH ESTABLISHED THE HELI?IL PROGRAM TO IDENTIFY BARRIERS TO LUNG CANCER SCREENING IN INDIGENOUS COMMUNITIES AND TO PARTNER WITH TRIBAL AND COMMUNITY LEADERS TO REDUCE THE RATE OF NON-CEREMONIAL TOBACCO USE IN OUR COMMUNITIES. WE ARE ALSO INCREASING AWARENESS ABOUT PROSTATE CANCER EQUITY AND SCREENINGS AMONG BLACK AND AFRICAN AMERICAN MEN THROUGH COMMUNITY-BASED RESEARCH AND ADVOCACY. DELIVERING ACCESS TO AFFORDABLE AND ATTAINABLE COMPREHENSIVE CARE, INCLUDING MENTAL HEALTH CARE: FRED HUTCH IS IMPROVING ACCESS TO HIGH-QUALITY CANCER CARE ALONG THE CANCER CARE CONTINUUM AND TO WRAPAROUND SERVICES THAT BOLSTER HEALTH. WE WORK TO CONNECT INDIVIDUALS NEEDING CARE TO HEALTH INSURANCE COVERAGE AND OTHER SUPPORT PROGRAMS. FRED HUTCH PROVIDES INTERNAL COUNSELING TO PATIENTS ABOUT INSURANCE COVERAGE AS WELL AS ACCESS TO STAFF WHO CAN HELP PATIENTS AND COMMUNITY MEMBERS LOOK FOR COVERAGE THROUGH THE WASHINGTON STATE HEALTH BENEFIT EXCHANGE. FRED HUTCH HAS A FINANCIAL ASSISTANCE, OR CHARITY CARE, PROGRAM. WE HAVE AN ADDITIONAL ASSISTANCE FUND TO SUPPORT PATIENTS IN NEED WITH TRANSPORTATION, HOUSING, GROCERIES, AND OTHER NEEDS RELATED TO THEIR BUILT ENVIRONMENT OR LIVING SITUATION. WE ARE ALSO PILOTING A SOCIAL DETERMINANTS OF HEALTH (SDOH) PATIENT SCREENING TOOL TO ASSESS PATIENTS' SOCIAL BARRIERS AND REFER THEM TO COMMUNITY RESOURCES. FRED HUTCH CONTINUES TO INTEGRATE A POPULATION-BASED NAVIGATION MODEL INTO OUR SERVICE STRUCTURE TO SERVE MORE PATIENTS EXPERIENCING SOCIO-ECONOMIC BARRIERS, AS WELL AS THOSE WHO NEED HELP NAVIGATING THROUGH FRED HUTCH OR REQUIRE COMMUNITY RESOURCES. FRED HUTCH ALSO ACTIVELY PARTICIPATES IN THE KING COUNTY BREAST, CERVICAL AND COLON HEALTH PROGRAM (BCCHP) AS WELL AS ADVOCATES ON STATE AND FEDERAL POLICIES TO IMPROVE PATIENT ACCESS TO HEALTH SERVICES. WE ARE ENHANCING ACCESS TO MENTAL HEALTH CARE FOR CANCER PATIENTS, FAMILIES, AND THE COMMUNITY BY DEEPENING RELATIONSHIPS WITH COMMUNITY-BASED MENTAL HEALTH PROVIDERS TO CREATE EASY AND FOCUSED REFERRAL DESTINATIONS WHEN PATIENTS END THEIR ACTIVE ONCOLOGY TREATMENT. WE ARE ALSO IMPLEMENTING AN INSTITUTION-WIDE SUICIDAL IDEATION ASSESSMENT. FRED HUTCH IS NOT DIRECTLY ADDRESSING ENVIRONMENTAL HEALTH AND CLIMATE CHANGE WITHIN THE COMMUNITY BENEFIT IMPLEMENTATION STRATEGY; HOWEVER, WE ARE COMMITTED TO ENVIRONMENTAL SUSTAINABILITY. ENERGY CONSERVATION, RECYCLING AND COMPOSTING, WATER CONSERVATION AND SUSTAINABLE TRANSPORTATION ARE EMBEDDED IN EVERYTHING WE DO. WE AIM TO SUPPORT ENVIRONMENTAL POLICIES, SYSTEMS AND RESEARCH THAT PROMOTE SUSTAINABLE AND CLIMATE-RESILIENT OPERATIONS AT FRED HUTCH FACILITIES AND MITIGATE THE OVERALL IMPACTS OF CLIMATE CHANGE. WE PLAN TO ENGAGE IN EXISTING AND UPCOMING CLIMATE RESILIENCE HEALTHCARE ANALYSES AND STRATEGIC FRAMEWORKS INTENDED TO MITIGATE OUR CONTRIBUTIONS TO CLIMATE CHANGE AND SECURE BUSINESS RESILIENCE IN THE FACE OF CLIMATE CHANGE, IN ALIGNMENT WITH THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' INITIATIVE TO HALVE U.S. CARBON EMISSIONS BY 2030.

FRED HUTCHINSON CANCER CENTER
PART V, SECTION B, LINE 13B: APPLICANTS WHOSE INCOME EXCEEDS 300% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE BUT WHO HAVE INCURRED CATASTROPHIC ACCOUNT BALANCES AFTER ALL SOURCES OF THIRD PARTY COVERAGE AND SPONSORSHIP WILL BE CONSIDERED FOR HARDSHIP WRITE-OFFS ON A CASE BY CASE BASIS.

FRED HUTCHINSON CANCER CENTER
PART V, SECTION B, LINE 13H: THE FOLLOWING PATIENTS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY EVEN THOUGH THE PATIENTS ARE NOT RESIDENTS OF THE STATE OF WASHINGTON: 1) PATIENTS WHO HAVE AN EMERGENCY MEDICAL CONDITION; 2) PATIENTS WHO ARE REFUGEES, ASYLEES OR SEEKING ASYLUM AND PROVIDE APPROPRIATE INS DOCUMENTATION. IF THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS APPARENT, FRED HUTCH MAY, IN ITS SOLE DISCRETION, CHOOSE TO WAIVE SOME OR ALL OF THE DOCUMENTATION AND VERIFICATION REQUIREMENTS. EXAMPLES OF CIRCUMSTANCES IN WHICH THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE MAY BE APPARENT INCLUDE THE FOLLOWING:1) A PATIENT OR GUARANTOR WHO HAS DECLARED BANKRUPTCY AND HAS INCLUDED THE FRED HUTCH DEBT IN THE BANKRUPTCY;2) A PATIENT OR GUARANTOR WHO DIES WITHOUT MATERIAL ASSETS;3) A PATIENT OR GUARANTOR WHO IS DETERMINED TO BE HOMELESS; OR4) ACCOUNTS RETURNED BY THE COLLECTION AGENCY AS UNCOLLECTIBLE DUE TO ANY OF THE ABOVE REASONS. FRED HUTCH STAFF DISCRETION WILL BE EXERCISED IN SITUATIONS WHERE FACTORS SUCH AS SOCIAL OR HEALTH ISSUES EXIST. SUCH ISSUES WILL BE DOCUMENTED TO SUPPORT FINANCIAL ASSISTANCE CONSIDERATION.

FRED HUTCHINSON CANCER CENTER
PART V, SECTION B, LINE 20E: FRED HUTCH CONTACTED PATIENTS AND HELPED THEM COMPLETE PAPERWORK TO APPLY FOR FINANCIAL ASSISTANCE FOR MEDICARE, MEDICAID, OR ANY OTHER POSSIBLE SOURCE OF COVERAGE.

PART V, SECTION B, LINE 3E:
FRED HUTCH IS DEDICATED TO ENSURING THAT OUR PURPOSE, WHICH UNITES THE DRIVE TO IMPROVE CANCER CARE AND OUTCOMES WITH THE POWER OF CLINICAL RESEARCH, IS MEETING OUR COMMUNITY'S HEALTH NEEDS. THE NEEDS IDENTIFIED BY DATA AVAILABLE TO US, COMMUNITY STAKEHOLDER INPUT, AND FEEDBACK ON OUR PREVIOUS HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES HAVE LED US TO PRIORITIZE CULTURALLY AND LINGUISTICALLY APPROPRIATE COMMUNITY HEALTH IMPROVEMENT EFFORTS AS WELL AS CANCER-RELATED HEALTH NEEDS THAT ARE CLEARLY IDENTIFIED IN THE COMMUNITY AND FOR WHICH AN EVIDENCE-BASED INTERVENTION EXISTS THAT CAN IMPROVE CANCER CARE AND OUTCOMES FOR OUR COMMUNITY.FRED HUTCH ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY FOR THE CHNA VIA QUANTITATIVE AND QUALITATIVE DATA ANALYSIS. WHEN POSSIBLE, WE ACCESSED DATA ON INDICATORS ABOUT INDIVIDUALS IN KING, PIERCE, AND SNOHOMISH COUNTIES DIRECTLY FROM PUBLICLY AVAILABLE DATASETS, MOST OF WHICH ARE MAINTAINED BY NATIONAL, STATE AND COUNTY GOVERNMENT AGENCIES. IN OTHER INSTANCES, WE QUERIED DATA FOR EACH COUNTY SEPARATELY AND COMBINED THEM INTO A WEIGHTED AVERAGE. IN MOST CASES, WE BENCHMARKED THE THREE-COUNTY REGION NUMBERS AGAINST WASHINGTON STATE DATA OR HEALTHY PEOPLE 2030. THIS DATA WAS THEN ANALYZED AND INTERPRETED TO UNDERSTAND THE COMMUNITY AND ITS CANCER BURDEN OVERALL, AS WELL AS THE DISPARITIES OF CERTAIN POPULATIONS WITHIN THE COMMUNITY. WITH ASSISTANCE FROM PUBLIC HEALTH SEATTLE & KING COUNTY, WE QUERIED THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE WASHINGTON STATE CENTER FOR HEALTH STATISTICS (WASHINGTON VITAL RECORDS) AND WASHINGTON STATE CANCER REGISTRY DATASETS FOR CANCER-RELATED INCIDENCE AND MORTALITY DATA ACROSS RACIAL AND ETHNIC POPULATIONS, AS WELL AS SOME OF THE BEHAVIORS THAT HAVE BEEN LINKED WITH CERTAIN TYPES OF CANCER AND THE UPTAKE OF RECOMMENDED CANCER SCREENINGS. WE INCORPORATED RELEVANT INFORMATION FROM THE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT FRED HUTCH PUBLISHES TOGETHER WITH THE KING COUNTY HOSPITALS FOR A HEALTHIER COMMUNITY (KCHHC) COLLABORATIVE. THROUGH THIS EFFORT, 10 HOSPITALS AND HEALTH SYSTEMS IN KING COUNTY IDENTIFY SIGNIFICANT HEALTH NEEDS AND ASSETS IN THE COMMUNITIES WE SERVE. WE ALSO REVIEWED COMMUNITY HEALTH ASSESSMENTS AND REPORTS IN PIERCE AND SNOHOMISH COUNTIES PUBLISHED IN THE LAST THREE YEARS AND MADE AVAILABLE TO THE PUBLIC, WITH THE PURPOSE OF AVOIDING DUPLICATION AND TO HONOR THE EFFORTS OF HOSPITALS, LOCAL HEALTH DEPARTMENTS AND COMMUNITY LEADERS WHO SUMMARIZE THE NEEDS AND STRENGTHS OF THE COMMUNITIES THEY KNOW BEST. WE GATHERED DATA PRIOR TO THE ONSET OF THE COVID-19 PANDEMIC AND SOME COMPILED IN THE MIDST OF IT. DATA ARE PRESENTED FOR THE MOST RECENT YEARS WE HAVE DATA AVAILABLE IN MOST CASES AS EARLY AS 2019. WHERE APPLICABLE, WE HAVE ALSO INTEGRATED RECENT DATA COLLECTED DURING 2020 AS WELL AS SOME OF THE KNOWN IMPACTS OF THE PANDEMIC. AFTER GATHERING AND ANALYZING THE SECONDARY DATA, WE DESIGNED SEMI-STRUCTURED INTERVIEW AND LISTENING SESSION PROTOCOLS TO SOLICIT COMMUNITY INPUT. THE PROTOCOL INCLUDED QUESTIONS ABOUT THE INTERVIEWEE'S ORGANIZATION AND THE SERVICES THEY PROVIDE; THEIR PERSPECTIVES ABOUT THE MOST PRESSING HEALTH ISSUES FACING OUR COMMUNITIES; THE ROOT CAUSES AND DETERMINING FACTORS FOR THESE ISSUES, GAPS OR CONCERNS SPECIFIC TO CANCER PREVENTION AND CARE; AND THE CURRENT STRENGTHS AND ASSETS OF THE COMMUNITY SERVED. WE ALSO ASKED INTERVIEW AND LISTENING SESSION PARTICIPANTS HOW FRED HUTCH CAN BE INVOLVED IN ADDRESSING THE ISSUES OR BUILDING ON THE STRENGTHS THAT THEY IDENTIFIED. WE INTERVIEWED A VARIETY OF CONSTITUENTS FROM ACROSS THE THREE-COUNTY AREA. THEY REPRESENTED FEDERALLY QUALIFIED HEALTH CENTERS, RESEARCH CENTERS, LOCAL PUBLIC HEALTH AGENCIES, NATIVE TRIBES AND COMMUNITY-BASED ORGANIZATIONS WORKING ALONGSIDE PEOPLE FROM A WIDE RANGE OF RACES AND ETHNICITIES, FAMILIES AND INDIVIDUALS WITH LOW INCOME, SENIORS, RECENT IMMIGRANTS AND REFUGEES, AND OTHER GROUPS WHO FACE SIGNIFICANT BARRIERS TO ACCESSING CANCER SERVICES DUE TO CURRENT AND HISTORICAL STRUCTURAL AND SYSTEMIC RACISM AND DISCRIMINATION. WE CONDUCTED A LISTENING SESSION WITH FRED HUTCH'S PATIENT AND FAMILY ADVISORY COUNCIL TO HEAR THEIR FIRSTHAND PERSPECTIVES AROUND SEEKING TREATMENT, BARRIERS TO CARE AND OPPORTUNITIES FOR EDUCATION AND INFORMATION OFFERINGS ABOUT HEALTHY BEHAVIORS AND RECOMMENDED SCREENINGS. WE ALSO MET WITH A GROUP OF FRED HUTCH LEADERS AND STAFF TO SPECIFICALLY TALK ABOUT SOCIAL DETERMINANTS OF HEALTH. IN ALL, 30+ INDIVIDUALS PARTICIPATED IN THE INTERVIEW AND LISTENING SESSION PROCESS. THE INSIGHT OF THESE COMMUNITY CONSTITUENTS HELPED US UNDERSTAND THE CONTEXT SURROUNDING CANCER-RELATED HEALTH ISSUES IDENTIFIED IN THE QUALITATIVE DATA AND ALLOWED US TO OVERCOME SOME OF THE LIMITATIONS IN THE QUANTITATIVE DATA. AFTER WE COMPLETED THE CHNA, WE FACILITATED A PRIORITIZATION EXERCISE WITH FRED HUTCH LEADERS AND STAFF REPRESENTING A RANGE OF FUNCTIONS ACROSS THE ORGANIZATION, BOTH CLINICAL AND ADMINISTRATIVE, INCLUDING DEPARTMENTS ENGAGED IN CONDUCTING COMMUNITY BENEFIT ACTIVITIES ON A DAY-TO-DAY BASIS. THIS GROUP REVIEWED THE QUALITATIVE AND QUANTITATIVE DATA FROM THE CHNA AND DISCUSSED THE IDENTIFIED THEMES, WHICH OUTLINED CANCER-RELATED HEALTH NEEDS AND ASSETS IN OUR COMMUNITY. FINALLY, WE REACHED CONSENSUS ON WHICH HEALTH ISSUES WERE PRIORITIES FOR FRED HUTCH. CRITERIA FOR PRIORITIZATION INCLUDED SEVERITY OF NEED, MAGNITUDE/SCALE OF THE NEED, PRESENCE OF CLEAR DISPARITIES OR INEQUITIES, EXISTING ATTENTION AND RESOURCES DEDICATED TO THE ISSUE, POTENTIAL FOR PARTNERING AND COLLABORATING WITH LOCAL ORGANIZATIONS, AND OPPORTUNITY FOR FRED HUTCH TO MAKE A MEANINGFUL CONTRIBUTION.THROUGH OUR NEEDS ASSESSMENT PROCESS FRED HUTCH GROUPED THE HEALTH NEEDS INTO 3 PRIORITY AREAS: ADVANCING HEALTH EQUITY, PROVIDING CULTURALLY ATTUNED PREVENTION, EDUCATION, AND SCREENING, AND DELIVERING ACCESS TO AFFORDABLE AND ATTAINABLE COMPREHENSIVE CARE.

PART I, LINE 3C:
IN ACCORDANCE WITH WAC 246-453-040, THE APPLICANTS FAMILY SIZE AND INCOME WILL BE REVIEWED AND WILL DETERMINE PERCENTAGE OF FEDERAL POVERTY LINE, THIS PERCENTAGE WILL DETERMINE THE LEVEL OF FINANCIAL ASSISTANCE TO BE AWARDED. IF THE APPLICANT HAS A FAMILY INCOME AT OR BELOW 300% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE, THE PATIENT WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE IN THE AMOUNT EQUAL TO THE UNPAID BALANCE REMAINING AFTER ALL SOURCES OF THIRD PARTY COVERAGE AND SPONSORSHIP HAVE BEEN EXHAUSTED. APPLICANTS WHOSE INCOME EXCEEDS 300% OF THE FEDERAL POVERTY STANDARD AS ADJUSTED FOR FAMILY SIZE BUT WHO HAVE INCURRED CATASTROPHIC ACCOUNT BALANCES AFTER ALL SOURCES OF THIRD PARTY COVERAGE AND SPONSORSHIP WILL BE CONSIDERED FOR HARDSHIP WRITE-OFFS ON A CASE BY CASE BASIS.

PART I, LINE 7:
FRED HUTCH UTILIZED WORKSHEET 2 TO ARRIVE AT A COST TO CHARGE RATIO FOR COMPLETING LINE 7.

PART I, LINE 7G:
THERE ARE NO PHYSICIAN CLINIC EXPENSES INCLUDED.

PART I, LN 7 COL(F):
"BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX IS $529,385. THIS AMOUNT DOES NOT RELATE TO ANY PATIENT SERVICE RELATED ACTIVITY AND IS DERIVED SOLELY FROM THE RESEARCH SIDE OF THE ORGANIZATION. EFFECTIVE JULY 1, 2018, FRED HUTCH ADOPTED ASU 2014-09 ""REVENUE FROM CONTRACTS WITH CUSTOMERS (ASC TOPIC 606)."" ASC 606 INTRODUCED A NEW TERM, (IMPLICIT) PRICE CONCESSION, AND REDEFINED BAD DEBT EXPENSE TO MORE CLOSELY REFLECT IMPAIRMENT. AN IMPAIRMENT LOSS OCCURS WHEN PATIENTS FRED HUTCH ORIGINALLY EXPECTED TO COLLECT FROM, UNEXPECTEDLY EXPERIENCE ADVERSE EVENTS (SUCH AS A JOB LOSS OR BANKRUPTCY) THAT LEAD TO AN INABILITY TO PAY. BECAUSE FRED HUTCH HAD ORIGINALLY EXPECTED TO COLLECT THESE AMOUNTS, THESE AMOUNTS ARE NOW CONSIDERED UNCOLLECTIBLE AND MUST BE WRITTEN OFF AS AN IMPAIRMENT LOSS. UNDER ASC 606, WHAT FRED HUTCH PREVIOUSLY DEFINED AS BAD DEBT EXPENSE IS NOW CONSIDERED AN IMPLICIT PRICE CONCESSION AND INCLUDED IN NET PATIENT SERVICE REVENUE."

PART III, LINE 2:
"BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX RELATED TO PATIENT CARE SERVICES IS $0. EFFECTIVE JULY 1, 2018, FRED HUTCH ADOPTED ASU 2014-09 ""REVENUE FROM CONTRACTS WITH CUSTOMERS (ASC TOPIC 606)."" ASC 606 INTRODUCED A NEW TERM, (IMPLICIT) PRICE CONCESSION, AND REDEFINED BAD DEBT EXPENSE TO MORE CLOSELY REFLECT IMPAIRMENT. AN IMPAIRMENT LOSS OCCURS WHEN PATIENTS FRED HUTCH ORIGINALLY EXPECTED TO COLLECT FROM, UNEXPECTEDLY EXPERIENCE ADVERSE EVENTS (SUCH AS A JOB LOSS OR BANKRUPTCY) THAT LEAD TO AN INABILITY TO PAY. BECAUSE FRED HUTCH HAD ORIGINALLY EXPECTED TO COLLECT THESE AMOUNTS, THESE AMOUNTS ARE NOW CONSIDERED UNCOLLECTIBLE AND MUST BE WRITTEN OFF AS AN IMPAIRMENT LOSS. UNDER ASC 606, WHAT FRED HUTCH PREVIOUSLY DEFINED AS BAD DEBT EXPENSE IS NOW CONSIDERED AN IMPLICIT PRICE CONCESSION AND INCLUDED IN NET PATIENT SERVICE REVENUE."

PART III, LINE 4:
REFER TO PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS.

PART III, LINE 8:
FRED HUTCH COMPLETED PART III, LINE 6 USING THE ALLOWABLE COSTS FROM THE AS-FILED MEDICARE COST REPORT FOR FY22. THE METHODOLOGY USED TO COMPLETE THE MEDICARE COST REPORT WAS BASED ON THE CMS PROVIDER REIMBURSEMENT MANUAL PUB 15.IN ADDITION TO MEDICARE AMOUNTS REPORTED ON THE MEDICARE COST REPORT, FRED HUTCH HAS A NON-MEDICARE COST REPORT FEE SCHEDULE AND MEDICARE MANAGED CARE. THE NON-MEDICARE COST REPORT FEE SCHEDULE AND THE MANAGED CARE REVENUES ARE BASED ON THE REIMBURSEMENT RECEIVED FROM MEDICARE. THE COSTS ARE DERIVED USING THE RATIO OF COST TO CHARGES FROM THE AS FILED MEDICARE COST REPORT. THE TABLE BELOW REFLECTS TOTAL REVENUES AND EXPENSES ATTRIBUTABLE TO ALL OF FRED HUTCH'S MEDICARE PROGRAMS: PART III, NON-COST REPORT TOTAL SECTION B FEE SCHED. MANAGED CARE MEDICAREMEDICARE REVENUE $204,072,512 $1,370,231 $31,794,377 $237,237,120MEDICARE EXPENSE $225,758,369 $2,742,501 $70,320,209 $298,821,079SHORTFALL ($21,685,857) ($1,372,269) ($38,525,832) ($61,583,959)FRED HUTCH CONSIDERS THE SHORTFALL ON MEDICARE SERVICES TO BE 100% COMMUNITY BENEFIT. HAD FRED HUTCH NOT DELIVERED THE SERVICES, THE SERVICES AND FINANCIAL LOSS WOULD FALL TO ANOTHER COMMUNITY HOSPITAL.

PART III, LINE 9B:
PATIENTS WHO HAVE BEEN APPROVED FOR 100% FINANCIAL ASSISTANCE ARE REMOVED FROM THE COLLECTIONS WORKFLOW SO THEIR ACCOUNTS WILL NOT BE SENT TO COLLECTIONS.

PART VI, LINE 2:
IN ADDITION TO OUR CHNA ASSESSMENT PROCESS, FRED HUTCH WORKS TOGETHER WITH SEATTLE CHILDREN'S HOSPITAL AND THE UNIVERSITY OF WASHINGTON TO FOCUS ON DEVELOPING AND DELIVERING THE BEST CANCER PREVENTION AND TREATMENTS AVAILABLE. FRED HUTCH COLLABORATES WITH THESE OTHER INSTITUTIONS AS PART OF THE CANCER CONSORTIUM TO ASSESS THE OCCURRENCE OF CANCER IN THE COMMUNITIES WE SERVE AND EVALUATE THE DIVERSITY OF PARTICIPANTS IN OUR RESEARCH COMPARED TO OUR COMMUNITIES. WE THEN MAKE STRATEGIC INVESTMENTS IN RESEARCH TO ADDRESS AREAS OF CANCER-RELATED HEALTH NEEDS IN OUR COMMUNITIES. FURTHERMORE, FRED HUTCH IS A MEMBER INSTITUTION OF THE KING COUNTY HOSPITALS FOR A HEALTH COMMUNITY COLLABORATIVE, WHICH JOINS TOGETHER 10 HOSPITALS AND THE PUBLIC HEALTH SEATTLE & KING COUNTY TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE COUNTY AND IDENTIFY OPPORTUNITIES FOR THE DEVELOPMENT OF COLLECTIVE, DATA-DRIVEN STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS.

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PATIENTS REQUESTING INFORMATION ABOUT FINANCIAL ASSISTANCE ARE GIVEN A BROCHURE DESCRIBING THE FINANCIAL PROGRAMS AVAILABLE ALONG WITH CONTACT INFORMATION FOR FRED HUTCH RESOURCES. A FINANCIAL COUNSELOR IS AVAILABLE FREE OF CHARGE TO HELP PATIENTS REVIEW THEIR INFORMATION AND TO HELP COMPLETE THE NECESSARY PAPERWORK TO APPLY FOR ASSISTANCE. INTERPRETER SERVICES ARE AVAILABLE IF NEEDED TO HELP.FRED HUTCH'S WEBSITE HAS A LIST OF OUTSIDE RESOURCES AVAILABLE TO PATIENTS IN NEED OF ASSISTANCE. FRED HUTCH'S WEBSITE HAS ITS FINANCIAL ASSISTANCE POLICY AVAILABLE IN ENGLISH, AND 5 OTHER LANGUAGES. THE FRED HUTCH FINANCIAL ASSISTANCE POLICY IS ALSO PROVIDED IN A PLAIN LANGUAGE SUMMARY IN ENGLISH AND 5 OTHER LANGUAGES ON THE WEBSITE, AND IS AVAILABLE THROUGHOUT THE CLINIC.

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FRED HUTCH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

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WASHINGTON STATE REQUIRES HOSPITALS TO MAKE THEIR CHNA WIDELY AVAILABLE TO THE PUBLIC AND TO ADOPT A COMMUNITY BENEFIT IMPLEMENTATION STRATEGY, WHICH IS ALSO MADE AVAILABLE TO THE PUBLIC. FRED HUTCH COMPLIES WITH BOTH REQUIREMENTS AND POSTS ITS CHNA AND IMPLEMENTATION STRATEGY ON ITS PUBLIC WEBSITE.

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FRED HUTCH'S REACH EXTENDS FAR AND WIDE, WITH PATIENTS FROM ACROSS THE PUGET SOUND REGION, WASHINGTON STATE, AND THE WORLD. CONSISTENT WITH OUR PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS, WE DEFINE OUR COMMUNITY AS EVERYONE IN KING, PIERCE AND SNOHOMISH COUNTIES. THE TOTAL POPULATION IN OUR COMMUNITY IS 3.98 MILLION PEOPLE, WHICH ACCOUNTS FOR MORE THAN HALF OF THE STATE'S POPULATION. KING COUNTY AND SEATTLE ARE THE MOST POPULOUS COUNTY AND CITY IN WASHINGTON STATE, RESPECTIVELY. FURTHER, OVER HALF THE AREA'S POPULATION AND 58 PERCENT OF FRED HUTCH'S PATIENTS RESIDE IN THE COUNTY. PIERCE AND SNOHOMISH HAVE LESS THAN ONE MILLION RESIDENTS EACH, AND ABOUT 14 PERCENT AND 6 PERCENT OF FRED HUTCH PATIENTS COME FROM THESE COUNTIES, RESPECTIVELY. THE ADULT POPULATION IN THE FRED HUTCH COMMUNITY IS SLIGHTLY LOWER THAN IN THE STATE: 14 PERCENT OF PEOPLE ARE 65 AND OLDER AND 62 PERCENT ARE BETWEEN 18 AND 64 YEARS OLD, COMPARED TO 16 PERCENT AND 62 PERCENT OF WASHINGTONIANS WHO FALL WITHIN THOSE AGE RANGES, RESPECTIVELY. PIERCE COUNTY HAS THE LARGEST PERCENTAGE OF YOUTH IN THE FRED HUTCH COMMUNITY AREA; THIS IS ALSO HIGHER THAN THE AVERAGE YOUTH POPULATION IN THE STATE. A GROWING DEMOGRAPHIC DIVERSITY CONTINUES TO SHAPE AND ENRICH THE LANDSCAPE OF OUR REGION. A LARGER PROPORTION OF OUR COMMUNITY'S POPULATION IDENTIFY AS ASIAN, BLACK, HISPANIC/LATINO OR RACIALLY MIXED. INCREASING RACIAL AND ETHNIC DIVERSITY AMONG CHILDREN IS A CONTINUING DEMOGRAPHIC TREND. THE POPULATION OF CHILDREN UNDER AGE 18 IS NOW 53 PERCENT PEOPLE OF COLOR. OUR REGION HAS A WIDE RANGE OF CULTURAL AND LINGUISTIC DIVERSITY. ABOUT ONE IN FIVE INDIVIDUALS (ONE IN THREE IN KING COUNTY) LIVE IN A HOUSEHOLD WHERE A LANGUAGE OTHER THAN ENGLISH IS SPOKEN. THE MOST SPOKEN LANGUAGES OUTSIDE OF ENGLISH ARE SPANISH, CHINESE AND VIETNAMESE. IN THE FRED HUTCH COMMUNITY, THE MEDIAN HOUSEHOLD INCOME IN 2019 WAS ESTIMATED AT $95,850 ABOVE THE WASHINGTON ESTIMATE OF $78,700. DATA SHOW DISPARITIES IN INCOME BY RACE AND ETHNICITY, WITH BLACK/AFRICAN AMERICAN AND HISPANIC/LATINO HOUSEHOLDS AVERAGING $34,600 AND $22,705 BELOW THE FRED HUTCH COMMUNITY AVERAGE, RESPECTIVELY. AMERICAN INDIAN AND ALASKA NATIVES IN KING COUNTY HAVE THE LOWEST HOUSEHOLD INCOMES OF ALL RACES AND ETHNICITIES IN THE THREE-COUNTY AREA ($40,306).

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FRED HUTCH CONTRIBUTES TO COMMUNITY HEALTH PROMOTION THROUGH A VARIETY OF PROGRAMS AND ACTIVITIES, EXAMPLES OF WHICH ARE OUTLINED BELOW. TRAINING HEALTH PROFESSIONALS:OUR CONTRIBUTION IS BROAD BECAUSE WE HAVE UNPARALLELED RESOURCES TO SHARE WHAT WE KNOW THROUGH THE EDUCATION OF DOCTORS, NURSES, AND SCIENTISTS, PUBLICATIONS IN LEADING MEDICAL JOURNALS, AND SPECIALIZED TRAINING AND SYMPOSIA FOR MEDICAL PROFESSIONALS. WE ARE PROUD TO BE A HUB FOR CONTINUING MEDICAL EDUCATION (CME) IN OUR REGION. FRED HUTCH PARTICIPATES IN MULTIPLE EDUCATION AND TRAINING PROGRAMS FOR PHYSICIANS, NURSES AND OTHER ALLIED HEALTH PROFESSIONALS. THIS INCLUDES RESIDENCY, ROTATIONS, SHADOWING AND OTHER PROGRAMS TO ALLOW HEALTH PROFESSIONAL TRAINEES TO DEVELOP EXPERTISE IN SPECIALIZED ONCOLOGY SKILLSETS, THEREBY IMPROVING THE LOCAL HEALTHCARE WORKFORCE'S OVERALL CAPACITY TO ADDRESS THE COMMUNITY'S HEALTH NEEDS RELATED TO CANCER. CLINICAL RESEARCH: FRED HUTCH HAS HUNDREDS OF CLINICAL TRIALS OPEN AT ANY GIVEN TIME. THIS PROVIDES OUR COMMUNITY AND THE COMMUNITIES SERVED BY OUR NETWORK AFFILIATES WITH ACCESS TO GROUNDBREAKING TREATMENT OPTIONS. AS THE ONLY NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER IN A FIVE-STATE AREA (WA, WY, AK, MT, ID), THE ACCESS TO CLINICAL TRIAL PARTICIPATION IS A VALUABLE RESOURCE TO PATIENTS ACROSS THE REGION. FRED HUTCH ALSO HAS DEDICATED STAFF TO REPORT PATIENT-LEVEL DATA TO STATE AND NATIONAL CANCER REGISTRIES FOR SOLID TUMOR AND BONE MARROW TRANSPLANT POPULATIONS TO HELP ADVANCE THE CLINICAL EVIDENCE BASE. NETWORK AFFILIATE PROGRAM:FRED HUTCH PARTNERS WITH EIGHT COMMUNITY PROVIDERS ACROSS AK, HI, ID, AND WA TO COORDINATE CARE AND IMPROVE REGIONAL AND RURAL ACCESS TO THE LATEST CANCER TREATMENTS AND CLINICAL TRIALS. THROUGH THE AFFILIATION WITH LOCAL COMMUNITY CANCER CENTERS. FRED HUTCH IS ABLE TO PROVIDE ACCESS TO RESOURCES AND THERAPIES TO ALL OF THE NETWORK MEMBER PATIENT POPULATIONS. ALL OF OUR NETWORK MEMBERS HAVE DESIGNATED MEDICALLY UNDERSERVED AREAS (MUA) WITHIN THEIR OPERATING LOCALITY. MEMBERS OF THE AFFILIATE NETWORK ALSO RECEIVE CONTINUING MEDICAL EDUCATION (CME) PRESENTATION AND RESOURCES FROM FRED HUTCH ON THE LATEST BREAKTHROUGHS IN CANCER CARE. A NUMBER OF THESE CME OFFERINGS ARE OPEN TO THE PUBLIC FOR BROADER EDUCATION FOR COMMUNITY PROVIDERS AND COMMUNITY MEMBERS. COMMUNITY HEALTH SERVICES:FRED HUTCH HAS RELATIONSHIPS WITH FEDERALLY QUALIFIED HEALTH CENTERS LOCATED WITHIN THE MEDICALLY UNDERSERVED AREAS IN KING, SNOHOMISH AND PIERCE COUNTIES. FRED HUTCH HAS SPECIFIC CONTRACTS WITH PUBLIC HEALTH SEATTLE & KING COUNTY AND SEA MAR COMMUNITY HEALTH CENTERS TO PROVIDE PREVENTIVE HEALTH SCREENINGS TO THE LOCAL UNDERSERVED COMMUNITIES. FRED HUTCH IS ALSO PART OF THE BREAST, CERVICAL, AND COLON HEALTH PROGRAM (BCCHP). THE PURPOSE OF THE BCCHP IS TO REDUCE MORBIDITY AND MORTALITY FROM BREAST, CERVICAL AND COLON CANCERS BY THE EARLY DETECTION OF CANCER THROUGH FREE SCREENINGS. FRED HUTCH PROVIDES BREAST CANCER SCREENING THROUGH REGULAR MAMMOGRAMS. FRED HUTCH ACCEPTS REFERRALS OF PATIENTS WHO HAVE A FINDING ON THEIR MAMMOGRAM AND PERFORMS DIAGNOSTICS AND TREATS PATIENTS WHO ARE DEEMED TO HAVE CANCER. SINCE 2014, FRED HUTCH HAS PARTICIPATED IN THE ANNUAL SEATTLE-KING COUNTY FREE CLINIC TO PROVIDE UNDERSERVED INDIVIDUALS WITH NECESSARY HEALTH CARE, INCLUDING CANCER SCREENINGS AND OTHER MEDICAL SERVICES. FRED HUTCH PROVIDES BREAST CANCER SCREENINGS THROUGH ITS MAMMOGRAM VAN AND FRED HUTCH STAFF VOLUNTEER AT THE EVENT. COMMUNITY HEALTH EDUCATION:FRED HUTCH PROVIDES COMMUNITY EDUCATION PROGRAMMING FOR CANCER SURVIVORS, INCLUDING MEDICAL NUTRITION EDUCATION TO COMMUNITY CANCER SUPPORT GROUPS, WELLNESS CONFERENCES AND CANCER SURVIVORSHIP CONFERENCES. FRED HUTCH ALSO PROVIDES MONTHLY SURVIVORSHIP EDUCATION. FURTHERMORE, FRED HUTCH ATTENDS LOCAL COMMUNITY HEALTH FAIRS AND EVENTS TO PROVIDE CANCER SCREENING INFORMATION AND TOBACCO CESSATION EDUCATION AND COUNSELING. HEALTH POLICY ADVOCACY:FRED HUTCH INVESTS RESOURCES IN ADVOCATING FOR POLICIES THAT IMPROVE THE HEALTH OF OUR COMMUNITY, LOWER THE BURDEN OF CANCER-RELATED DISEASE, AND INCREASE ACCESS TO HIGH-QUALITY, INNOVATIVE, AND AFFORDABLE CANCER CARE. FOR EXAMPLE, FRED HUTCH RESEARCHERS AND CLINICIANS SUPPORTED THE RAPID ADAPTION OF CLINICAL TRIAL RESEARCH TO THE CIRCUMSTANCES OF ENROLLING AND TREATING PATIENTS ON PROTOCOLS DURING THE COVID-19 PANDEMIC. COVID-19 VACCINE DISTRIBUTION: FRED HUTCH WAS AMONG THE FIRST WASHINGTON HEALTHCARE PROVIDERS TO RECEIVE THE COVID-19 VACCINE AND DISTRIBUTE DOSES TO PATIENTS, FAMILIES AND THE BROADER COMMUNITY. WE PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS, PUBLIC SCHOOLS, FAITH-BASED ORGANIZATIONS, LOW INCOME/HIGH DENSITY HOUSING GROUPS, AND PRODUCTION AND MANUFACTURING FACILITIES TO HOST MOBILE CLINICS AND REACH MARGINALIZED COMMUNITIES. INSTITUTIONAL SERVICE TO THE COMMUNITY:FRED HUTCH HAS A LONG AND PROUD REPUTATION OF COLLABORATION WITH OTHER HEALTHCARE, GOVERNMENTAL, AND NONPROFIT ORGANIZATIONS IN THE DEVELOPMENT AND DEPLOYMENT OF COMMUNITY EDUCATION PROGRAMS, WELLNESS INITIATIVES, AND AWARENESS CAMPAIGNS. WE ARE ALSO COMMUNITY SERVANTS IN THAT FRED HUTCH IS GOVERNED BY A 13-MEMBER BOARD OF DIRECTORS, INCLUDING NINE COMMUNITY DIRECTORS AND FOUR EX OFFICIO POSITIONS. THE COMMUNITY DIRECTORS BRING A DIVERSE RANGE OF EXPERTISE AND PERSPECTIVES FROM ACROSS HEALTH CARE, TECHNOLOGY AND PROFESSIONAL SERVICES SECTORS.