4A (Expenses $ 722947424 including grants of $ 686385) (Revenue $ 729148561)
"SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2021 WAS MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTMISSION HOSPITAL2021 PROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - DECEMBER 31, 2021)IN 2021, PROVIDENCE MISSION HOSPITAL MEDICAL CENTER CONTINUED ITS TRADITION OF COMPASSION AND DEDICATION TO OUR COMMUNITIES BY INVESTING TO ADDRESS COMMUNITY NEED. IN 2021, WE FOCUSED ON ADDRESSING MENTAL HEALTH & SUBSTANCE USE, HOMELESSNESS AND EQUITY AND RACIAL DISPARITIES.PRIORITY 1: MENTAL HEALTH & SUBSTANCE USECOVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. SUBSTANCE USE PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY. MENTAL HEALTH CHALLENGES CAN IMPEDE PEOPLE'S ABILITIES TO REALIZE THEIR POTENTIAL, COPE WITH STRESSES, WORK PRODUCTIVELY AND FRUITFULLY, AND MAKE CONTRIBUTIONS TO THEIR COMMUNITIES. WE WILL BE FOCUSING ON INCREASING SERVICES TO SOUTH ORANGE COUNTY RESIDENTS AND REDUCING THE RATES OF SUBSTANCE USE AMONG YOUTH IN OUR COASTAL COMMUNITIES. PROVIDENCE MISSION HOSPITAL MISSION VIEJO AND PROVIDENCE MISSION HOSPITAL LAGUNA BEACH (WHICH WILL BE ADDRESSED SIMPLY AS ""MISSION HOSPITAL"") WILL WORK ON INCREASING AWARENESS AND SERVICES ADDRESSING MENTAL HEALTH ALONG WITH SUBSTANCE USE.IN 2021, THIS NEED WAS ADDRESSED BY:1. THERAPEUTIC SERVICES, INCLUDING SUPPORT GROUPS, INDIVIDUAL THERAPY AND PSYCHOEDUCATIONAL GROUPS IN AN IN-HOUSE PROGRAM.2. EACH MIND MATTERS CAMPAIGN - REDUCES STIGMA AND INCREASES AWARENESS OF MENTAL HEALTH THROUGH ""PROMISES TO TALK"" CAMPAIGN A REGIONAL EFFORT BY THE THREE ORANGE COUNTY HOSPITALS FORMING PART OF THE PROVIDENCE ST. JOSEPH HEALTH SYSTEM.3. YOUTH SUBSTANCE USE EFFORTS, INCLUDING A COMMUNITY-WIDE SOCIAL MEDIA CAMPAIGN FOR PARENTS CALLED RAISING HEALTHY TEENS AND ONE FOR YOUTH CALLED STRENGTH IN NUMBERS.4. OUR INVOLVEMENT IN COUNTY-WIDE EFFORTS TO ADDRESS STIGMA, AS PART OF BEWELLOC. MISSION HOSPITAL ACTED AS A LEAD AGENCY FOR THE EFFORTS AROUND STIGMA, HELPING TO COORDINATE EFFORTS ACROSS THE COUNTY AND ITS AGENCIES.PRIORITY 2: HOUSING & HOMELESSNESSPRIMARILY FOCUSED ON SUPPORTING EFFORTS TOWARD AFFORDABLE HOUSING AND THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. HOMELESSNESS AND AFFORDABLE HOUSING ARE SIGNIFICANT NEEDS IN OUR COMMUNITIES. HOMELESSNESS HAS A RIPPLE EFFECT THROUGHOUT THE COMMUNITY; IT IMPACTS THE AVAILABILITY OF HEALTHCARE RESOURCES, CRIME AND SAFETY, THE WORKFORCE, AND THE USE OF TAX DOLLARS. AFFORDABLE HOUSING BENEFITS OUR COMMUNITIES AND CREATES STRONGER OUTCOMES - IN EMPLOYMENT, HEALTH AND EDUCATION. WE WILL BE WORKING TO REDUCE CHRONIC HOMELESSNESS, SUPPORT THE NUMBER OF PERSONS ENTERING BRIDGE AND SUPPORTIVE HOUSING AND STRENGTHEN AFFORDABLE HOUSING POLICIES IN THE 2021-2028 HOUSING ELEMENT PLANS. SOCIAL DETERMINANTS OF HEALTH, LIKE HOUSING, HAVE A SUBSTANTIAL IMPACT ON HEALTH BEHAVIORS AND HEALTH OUTCOMES. ADDRESSING HOUSING INSTABILITY, HOUSING AFFORDABILITY, AND PREVENTING HOMELESSNESS WILL IMPROVE HEALTH AND THE COMMUNITIES WE SERVE.IN 2021, THIS NEED WAS ADDRESSED BY:1. FAMILY RESOURCE CENTERS PROVIDE HEALTH AND SOCIAL SERVICES TO THE LOW-INCOME RESIDENTS IN SOUTH ORANGE COUNTY AND ARE LOCATED IN LAKE FOREST AND SAN JUAN CAPISTRANO. SERVICES INCLUDE CONNECTING RESIDENTS TO HOUSING RESOURCES. SPONSORED BY MISSION HOSPITAL AND CONTRACTED THROUGH ORANGE COUNTY SOCIAL SERVICE AGENCY FAMILIES AND COMMUNITIES TOGETHER FUNDING, IN COLLABORATION WITH COMMUNITY NON-PROFIT AGENCIES, THE CENTERS ARE FULL-SERVICE WRAP-AROUND RESOURCE CENTERS FOR OUR COMMUNITIES IN NEED.2. HOSPITAL PATIENTS REQUIRING HOUSING AND RECUPERATIVE CARE ARE CONNECTED TO RECUPERATIVE CARE SERVICES. RECUPERATIVE CARE PROVIDERS OFFER CASE MANAGEMENT AND CONNECTS PEOPLE EXPERIENCING HOMELESSNESS WITH HOUSING, MEDICAL CARE, MENTAL HEALTH AND WORKFORCE SERVICES.PRIORITY 3: EQUITY & RACIAL DISPARITIESEVERYONE SHOULD HAVE A FAIR AND JUST OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL AND THAT NO ONE SHOULD BE DISADVANTAGED, EXCLUDED, OR DISMISSED FROM ACHIEVING THAT POTENTIAL BASED ON INHERENT CHARACTERISTICS SUCH AS RACE, ETHNICITY OR GENDER IDENTITY. WE WILL BE WORKING ON STRATEGIES THAT INCREASE INCLUSION, DIVERSITY AND MULTICULTURALISM, BOTH WITHIN OUR ORGANIZATION AS WELL AS THE BROADER COMMUNITIES OF SOUTH ORANGE COUNTY.IN 2021, THIS NEED WAS ADDRESSED BY:1. SERVICES TO PROMOTE INCLUSION, DIVERSION AND MULTICULTURALISM, AN IN-HOUSE PROGRAM RUN BY THE HOSPITAL.2. FAMILY RESOURCE CENTERS OFFERED SERVICES TO THE LOCAL COMMUNITY TO INCREASE INCLUSION AND BELONGING AMONGST RESIDENTS IN SOUTH ORANGE COUNTY. SERVICES INCLUDED CENSUS EFFORTS, VOTING REGISTRATION & EDUCATION, AND VIRTUAL DISCUSSIONS ABOUT INCLUSION & BELONGING AND EQUITY. MULTIPLE COMMUNITY STAKEHOLDERS, RESIDENTS AND FAITH COMMUNITY LEADERS PARTICIPATED IN THESE EVENTS TO SUPPORT LOCAL RESIDENTS WHO FEEL MARGINALIZED AND ISOLATED.3. PROVIDING YEAR-ROUND GRANT FUNDS TO FRIENDSHIP SHELTER AND FAMILY ASSISTANCE MINISTRIES. FRIENDSHIP SHELTER OPERATES THE CITY OF LAGUNA BEACH'S ALTERNATIVE SLEEPING LOCATION EMERGENCY SHELTER AND SEVERAL ADDITIONAL LOCATIONS IN SOUTH COUNTY PROVIDING MEALS, SHOWERS, LAUNDRY AND RESOURCES TO CONNECT GUESTS TO HOUSING, HEALTH AND MENTAL CARE. FAMILY ASSISTANCE MINISTRIES HAS PARTNERED WITH MISSION HOSPITAL'S CARE NAVIGATOR PROGRAM TO SUPPORT HOMELESS PATIENTS WHO HAVE BEEN DISCHARGED AND NEED SHORT TERM MOTEL SUPPORT WHILE THE TWO TEAMS SUPPORT RESIDENTS AND HELP THEM OBTAIN LONGER-TERM HOUSING SOLUTIONS.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/MISSION-HOSPITAL-MISSION-VIEJO"

SCHEDULE H, PART V, SECTION B, LINE 3E:
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

SCHEDULE H, PART V, SECTION B, LINE 5:
IN CONDUCTING THE 2021 CHNA TO IDENTIFY NEEDS, THE HOSPITAL LEVERAGED PREVIOUSLY COLLECTED INFORMATION FROM LOCAL PARTNERS IN ORANGE COUNTY. IT WAS DECIDED THAT THE FOCUS GROUPS CONDUCTED BY KAISER PERMANENTE AND THE ORANGE COUNTY HEALTH IMPROVEMENT PARTNERSHIP IN 2019, AS WELL AS THE CALOPTIMA MEMBER SURVEY WOULD BE UTILIZED IN PLACE OF PLANNED FOCUS GROUPS THAT WERE CANCELLED DUE TO THE COVID-19 PANDEMIC.KAISER CONDUCTED A SURVEY WITH 271 RESPONDENTS WHICH CONCLUDED IN JANUARY 30, 2019. REPRESENTATION IN THE SURVEY WERE MINORITY, MEDICALLY UNDERSERVED AND LOW-INCOME INDIVIDUALS.KAISER ORGANIZED ELEVEN (11) FOCUS GROUPS IN THE CITIES OF ANAHEIM AND MIDWAY CITY, IN NEIGHBORHOODS WHERE HEALTH, PHYSICAL ENVIRONMENT AND SOCIO-ECONOMIC MATTERS ARE OF GREAT CONCERN. BOTH THESE CITIES WERE TARGETED BECAUSE OF THE GREAT NEED IDENTIFIED THROUGH ORANGE COUNTY INDICATORS. CONSIDER THIS IN SANTA ANA 58% OF PEOPLE 25 YEARS AND OLDER HAVE A HIGH SCHOOL DEGREE COMPARED TO 98% IN COTO DE CAZA. MEDIAN HOUSEHOLD INCOME IN MIDWAY CITY IS $41,897 COMPARED TO $182,401 IN COTO DE CAZA.IN ALL ELEVEN (11) FOCUS GROUPS THERE WAS REPRESENTATION OF MINORITY, MEDICALLY UNDERSERVED AND LOW-INCOME INDIVIDUALS. FOCUS GROUP WITH SENIORS INCLUDED STROKE SURVIVORS AND SENIOR RESIDENTS. THREE (3) YOUTH MENTAL HEALTH FOCUS GROUPS WERE HELD WITH BOTH STUDENTS AND SCHOOL STAFF PARTICIPATION. THREE (3) PERMANENT SUPPORTIVE HOUSING GROUPS WITH RESIDENTS WERE HELD, ONE (1) MENTAL HEALTH (SUICIDE) FOCUS GROUP, A COMMUNITY RESIDENTS FOCUS GROUP AND ANOTHER HELD AT THE CENTER FOR HEALTHY NEIGHBORHOODS WITH LOW INCOME LATINO RESIDENTS IN FULLERTON.ALL ELEVEN (11) FOCUS GROUPS FOLLOWED THE SAME PROTOCOL, AND THE SAME TEN (10) STRATEGIC LEARNING QUESTIONS WERE ASKED. IN TOTAL YOU HAD 131 FOCUS GROUP PARTICIPANTS; WITH SOME FOCUS GROUPS REACHING AS HIGH AS EIGHTEEN (18) PARTICIPANTS, AND THE LOWEST PARTICIPATION LEVEL OF SEVEN (7).ADDITIONALLY, KAISER ALSO HELD A KEY COMMUNITY STAKEHOLDERS FOCUS GROUP. THE EIGHTEEN (18) PARTICIPANTS SPANNED THE FOLLOWING SECTORS: AFFORDABLE HOUSING, COMMUNITY-BASED ORGANIZATION, EDUCATION, HOUSING AND PUBLIC HEALTH. THE PARTICIPATING AGENCIES ARE AS FOLLOWS:1. 211 ORANGE COUNTY2. ALZHEIMER'S OC3. AMERICAN FOUNDATION OF SUICIDE PREVENTION4. COUNCIL ON AGING5. HEALTHY SMILES FOR KIDS OC6. HOME AND CARE SERVICES, SENIORSERV7. ILLUMINATION FOUNDATION8. KENNEDY COMMISSION9. ORANGE COUNTY CONGREGATION COMMUNITY ORGANIZATION10. ORANGE COUNTY FAIR HOUSING COUNCIL11. ORANGE COUNTY FOOD ACCESS COALITION12. OC HEALTH CARE AGENCY13. REGIONAL ASTHMA MANAGEMENT AND PREVENTION14. SAN CLEMENTE WELLNESS AND PREVENTION CENTER15. STROKE BOOT CAMP16. STUDENT MENTAL HEALTH, OC DEPARTMENT OF EDUCATION17. UCI INSTITUTE FOR CLINICAL AND TRANSLATIONAL SCIENCE18. WESTERN YOUTH SERVICESTHE SAME TEN (10) STRATEGIC LEARNING QUESTIONS WERE ASKED AS IN THE RESIDENT FOCUS GROUPS.THE TOP PRIORITIES IDENTIFIED THROUGH KAISER'S WORK WERE ACCESS TO HEALTH CARE, ECONOMIC, HOUSING AND FOOD INSECURITIES, MENTAL HEALTH AND SUBSTANCE USE INCLUDING SUICIDE AND STROKE.THE ORANGE COUNTY HEALTH IMPROVEMENT PARTNERSHIP, ON WHICH PROVIDENCE ST. JUDE MEDICAL CENTER PARTICIPATES, ALSO CONDUCTED FOCUS GROUPS. IN TOTAL SIX (6) FOCUS GROUPS WERE CONDUCTED WITH REPRESENTATION FROM UNDERREPRESENTED COMMUNITIES, INCLUDING VIETNAMESE OLDER ADULTS, SPANISH-SPEAKING ADULTS AND MOTHERS, ADOLESCENTS AND SERVICE PROVIDERS. ALL SIX (6) FOCUS GROUPS WERE ASKED FIVE (5) STRATEGIC LEARNING QUESTIONS. THE TOP PRIORITIES IDENTIFIED WERE HOMELESSNESS AND HOUSING, ENVIRONMENT, SAFETY, MENTAL HEALTH WITH SUBSTANCE USE, ACCESS TO CARE, NUTRITION, EARLY CHILD DEVELOPMENT AND AGING POPULATION.CALOPTIMA IS THE COUNTY ORGANIZED HEALTH SYSTEM THAT ADMINISTERS HEALTH INSURANCE PROGRAMS FOR LOW-INCOME CHILDREN, ADULTS, SENIORS AND PEOPLE WITH DISABILITIES. CALOPTIMA DID NOT CONDUCT FOCUS GROUPS, BUT RATHER EMBEDDED SEVEN (7) SOCIAL DETERMINANTS OF HEALTH QUESTIONS IN A COMPREHENSIVE MEMBER SURVEY. THE IDENTIFIED NEEDS FROM THE SURVEY WERE ACCESS BARRIERS TO HEALTH CARE, NEGATIVE SOCIAL AND ENVIRONMENTAL IMPACTS AND LACK OF AWARENESS OF BENEFITS AND RESOURCES.

SCHEDULE H, PART V, SECTION B, LINE 6A:
ST. JUDE MEDICAL CENTER AND ST. JOSEPH HOSPITAL ORANGE

SCHEDULE H, PART V, SECTION B, LINE 6B:
INPUT FROM THE ORANGE COUNTY HEALTH IMPROVEMENT PARTNERSHIP AND THE CALOPTIMA MEMBER SURVEY

SCHEDULE H, PART V, SECTION B, LINE 7A:
"THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE ""SOUTHERN CALIFORNIA"" TAB.SCHEDULE H, PART V, SECTION B, 10ATHE IMPLEMENTATION STRATEGY IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE ""SOUTHERN CALIFORNIA"" TAB."

SCHEDULE H, PART V, SECTION B, LINE 11:
"FOR CALENDAR YEARS 2021 - 2023 THE HOSPITAL IDENTIFIED THE FOLLOWING THREE (3) PRIORITIES:PRIORITY 1: MENTAL HEALTH & SUBSTANCE USECOVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. SUBSTANCE USE PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY. MENTAL HEALTH CHALLENGES CAN IMPEDE PEOPLE'S ABILITIES TO REALIZE THEIR POTENTIAL, COPE WITH STRESSES, WORK PRODUCTIVELY AND FRUITFULLY, AND MAKE CONTRIBUTIONS TO THEIR COMMUNITIES. WE WILL BE FOCUSING ON INCREASING SERVICES TO SOUTH ORANGE COUNTY RESIDENTS AND REDUCING THE RATES OF SUBSTANCE USE AMONG YOUTH IN OUR COASTAL COMMUNITIES. PROVIDENCE MISSION HOSPITAL MISSION VIEJO AND PROVIDENCE MISSION HOSPITAL LAGUNA BEACH (WHICH WILL BE ADDRESSED SIMPLY AS ""MISSION HOSPITAL"") WILL WORK ON INCREASING AWARENESS AND SERVICES ADDRESSING MENTAL HEALTH ALONG WITH SUBSTANCE USE.IN 2021, THIS NEED WAS ADDRESSED BY:1. THERAPEUTIC SERVICES, INCLUDING SUPPORT GROUPS, INDIVIDUAL THERAPY AND PSYCHOEDUCATIONAL GROUPS IN AN IN-HOUSE PROGRAM.2. EACH MIND MATTERS CAMPAIGN - REDUCES STIGMA AND INCREASES AWARENESS OF MENTAL HEALTH THROUGH ""PROMISES TO TALK"" CAMPAIGN A REGIONAL EFFORT BY THE THREE ORANGE COUNTY HOSPITALS FORMING PART OF THE PROVIDENCE ST. JOSEPH HEALTH SYSTEM.3. YOUTH SUBSTANCE USE EFFORTS, INCLUDING A COMMUNITY-WIDE SOCIAL MEDIA CAMPAIGN FOR PARENTS CALLED RAISING HEALTHY TEENS AND ONE FOR YOUTH CALLED STRENGTH IN NUMBERS.4. OUR INVOLVEMENT IN COUNTY-WIDE EFFORTS TO ADDRESS STIGMA, AS PART OF BEWELLOC. MISSION HOSPITAL ACTED AS A LEAD AGENCY FOR THE EFFORTS AROUND STIGMA, HELPING TO COORDINATE EFFORTS ACROSS THE COUNTY AND ITS AGENCIES.PRIORITY 2: HOUSING & HOMELESSNESSPRIMARILY FOCUSED ON SUPPORTING EFFORTS TOWARD AFFORDABLE HOUSING AND THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. HOMELESSNESS AND AFFORDABLE HOUSING ARE SIGNIFICANT NEEDS IN OUR COMMUNITIES. HOMELESSNESS HAS A RIPPLE EFFECT THROUGHOUT THE COMMUNITY; IT IMPACTS THE AVAILABILITY OF HEALTHCARE RESOURCES, CRIME AND SAFETY, THE WORKFORCE, AND THE USE OF TAX DOLLARS. AFFORDABLE HOUSING BENEFITS OUR COMMUNITIES AND CREATES STRONGER OUTCOMES - IN EMPLOYMENT, HEALTH AND EDUCATION. WE WILL BE WORKING TO REDUCE CHRONIC HOMELESSNESS, SUPPORT THE NUMBER OF PERSONS ENTERING BRIDGE AND SUPPORTIVE HOUSING AND STRENGTHEN AFFORDABLE HOUSING POLICIES IN THE 2021-2028 HOUSING ELEMENT PLANS. SOCIAL DETERMINANTS OF HEALTH, LIKE HOUSING, HAVE A SUBSTANTIAL IMPACT ON HEALTH BEHAVIORS AND HEALTH OUTCOMES. ADDRESSING HOUSING INSTABILITY, HOUSING AFFORDABILITY, AND PREVENTING HOMELESSNESS WILL IMPROVE HEALTH AND THE COMMUNITIES WE SERVE.IN 2021, THIS NEED WAS ADDRESSED BY:1. FAMILY RESOURCE CENTERS PROVIDE HEALTH AND SOCIAL SERVICES TO THE LOW-INCOME RESIDENTS IN SAN JUAN CAPISTRANO & LAKE FOREST. SERVICES INCLUDE CONNECTING RESIDENTS TO HOUSING RESOURCES. SPONSORED BY MISSION HOSPITAL IN COLLABORATION WITH COMMUNITY NON-PROFIT AGENCIES, THE CENTERS ARE FULL-SERVICE WRAP-AROUND RESOURCE CENTERS FOR OUR COMMUNITIES IN NEED.2. PROVIDING YEAR ROUND GRANT FUNDS TO FRIENDSHIP SHELTER AND FAMILY ASSISTANCE MINISTRIES. FRIENDSHIP SHELTER OPERATES THE CITY OF LAGUNA BEACH'S (ALTERNATIVE SLEEPING LOCATIONS) ASL EMERGENCY SHELTER PROVIDING MEALS, SHOWERS, LAUNDRY AND RESOURCES TO CONNECT GUESTS TO HOUSING, HEALTH AND MENTAL CARE. FAMILY ASSISTANCE MINISTRIES PARTNERED WITH MISSION HOSPITAL TO PROVIDE SHORT-TERM MOTEL ACCOMMODATIONS FOR HOMELESS PATIENTS DISCHARGED FROM THE HOSPITAL. BOTH COLLABORATIONS ALLOW MISSION HOSPITAL TO SERVE THE NEEDS OF ITS VULNERABLE COMMUNITIES AND GET THESE RESIDENTS THE WRAP-AROUND SUPPORT NEEDED TO DEVELOP LONGER-TERM HOUSING SOLUTIONS.3. HOSPITAL PATIENTS REQUIRING HOUSING AND RECUPERATIVE CARE ARE CONNECTED TO RECUPERATIVE CARE SERVICES. RECUPERATIVE CARE PROVIDERS OFFER CASE MANAGEMENT AND CONNECTS PEOPLE EXPERIENCING HOMELESSNESS WITH HOUSING, MEDICAL CARE, MENTAL HEALTH AND WORKFORCE SERVICES.PRIORITY 3: EQUITY & RACIAL DISPARITIESEVERYONE SHOULD HAVE A FAIR AND JUST OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL AND THAT NO ONE SHOULD BE DISADVANTAGED, EXCLUDED, OR DISMISSED FROM ACHIEVING THAT POTENTIAL BASED ON INHERENT CHARACTERISTICS SUCH AS RACE, ETHNICITY OR GENDER IDENTITY. WE WILL BE WORKING ON STRATEGIES THAT INCREASE INCLUSION, DIVERSITY AND MULTICULTURALISM, BOTH WITHIN OUR ORGANIZATION AS WELL AS THE BROADER COMMUNITIES OF SOUTH ORANGE COUNTY.IN 2021, THIS NEED WAS ADDRESSED BY:1. SERVICES TO PROMOTE INCLUSION, DIVERSION AND MULTICULTURALISM, AN IN-HOUSE PROGRAM RUN BY THE HOSPITAL.2. FAMILY RESOURCE CENTERS OFFERED SERVICES TO THE LOCAL COMMUNITY TO INCREASE INCLUSION AND BELONGING AMONGST RESIDENTS IN SOUTH ORANGE COUNTY. SERVICES INCLUDED CENSUS EFFORTS, VOTING REGISTRATION & EDUCATION, AND VIRTUAL DISCUSSIONS ABOUT INCLUSION & BELONGING AND EQUITY. MULTIPLE COMMUNITY STAKEHOLDERS, RESIDENTS AND FAITH COMMUNITY LEADERS PARTICIPATED IN THESE EVENTS TO SUPPORT LOCAL RESIDENTS WHO FEEL MARGINALIZED AND ISOLATED."

SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED):
"NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. OUR MISSION, ""AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE"", IS BEST LIVED BY PARTNERING WITH LIKE-MINDED ORGANIZATIONS THAT COUNT WITH THE CAPACITY AND EXPERTISE TO ADDRESS THE NEEDS OF ORANGE COUNTY RESIDENTS. WE ARE COMMITTED TO LIVING OUT OUR MISSION THROUGH OUR OWN COMMUNITY BENEFIT PROGRAMS, BY PARTNERSHIP WITH LIKE-MINDED PARTNERS AND BY FUNDING OTHER NON-PROFITS.FURTHERMORE, MISSION HOSPITAL WILL ENDORSE LOCAL NON-PROFIT ORGANIZATIONS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT MISSION'S SERVICE AREAS.THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE HOSPITAL'S 2019 CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW:CANCER:GIVEN OTHER PRIORITIES, THIS ISSUE WAS NOT SELECTED.DIABETES:SPECIFICALLY FOCUSED ON THE HEALTH CONDITION OF DIABETES, AND AWARENESS AND PREVENTION OF IT. LOCAL FEDERALLY QUALIFIED HEALTH CENTERS PROVIDE PRIMARY MEDICAL CARE TO RESIDENTS WITH LOW INCOMES WHO HAVE DIABETES. MISSION HOSPITAL PROVIDES YEARLY GRANT FUNDS TO CAMINO HEALTH CENTER FEDERALLY QUALIFIED HEALTH CENTER (FQHC) ENSURING THE DOOR REMAINS OPEN FOR MANY FAMILIES AND RESIDENTS WITH LOW-INCOMES NEEDING DIABETES SERVICES. IN ADDITION, LAGUNA BEACH COMMUNITY CLINIC ALSO PROVIDES DIABETES SERVICES.EARLY CHILDHOOD EDUCATION:GIVEN OTHER PRIORITIES, RESOURCE CONSTRAINTS, AND LACK OF EXPERTISE TO OFFER THIS PROGRAM, THIS ISSUE WAS NOT SELECTED.ECONOMIC MOBILITY:IDENTIFIED AS A ROOT CAUSE OF OTHER HEALTH ISSUES, THIS ISSUE COVERS THE EFFECTS OF POVERTY AND ECONOMIC CONCERNS AS WELL AS DIFFICULTIES AROUND FINDING JOBS THAT PAY LIVABLE SALARIES. GIVEN OTHER PRIORITIES, RESOURCE CONSTRAINTS AND LACK OF EXPERTISE TO OFFER THIS PROGRAM, THIS ISSUE WAS NOT SELECTED. OUR FAMILY RESOURCE CENTERS ADDRESS THIS NEED, AS WELL AS OTHER COMMUNITY-BASED ORGANIZATIONS: FAMILIES FORWARD, FAMILY ASSISTANCE MINISTRY, AND SOUTH COUNTY OUTREACH.ENVIRONMENT/CLIMATE:PROVIDENCE ST. JOSEPH HEALTH HAS COMMITTED TO BEING CARBON NEGATIVE BY 2030. THIS EFFORT WILL INVOLVE ALL HOSPITAL STAFF. THE REGIONAL DIRECTOR, COMMUNITY HEALTH INVESTMENT HAS BEEN APPOINTED TO THE SYSTEM ENVIRONMENTAL JUSTICE WORK GROUP.FOOD INSECURITY:CONCERNS ABOUT HEALTHY EATING HABITS, NUTRITION KNOWLEDGE, AND CHALLENGES OF COST AND AVAILABILITY OF HEALTHY OPTIONS. GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT CHNA, THIS NEED BECAME A LOWER PRIORITY COMPARED TO OTHERS WHEN REVIEWING THE IMPACT MISSION HOSPITAL COULD HAVE TO RESOLVE THIS ISSUE. THE FAMILY RESOURCE CENTERS ADDRESS THIS NEED THROUGH MONTHLY FOOD DISTRIBUTIONS, AS WELL AS OTHER COMMUNITY-BASED ORGANIZATIONS: FAMILIES FORWARD, FAMILY ASSISTANCE MINISTRY, FATHER SERRA'S FOOD PANTRY, MISSION BASILICA, HELPING HANDS WORLDWIDE, LAGUNA FOOD PANTRY, SECOND HARVEST FOOD BANK, SOUTH COUNTY OUTREACH, AND WOMEN, INFANT & CHILDREN'S CLINIC (WIC).HEALTH CARE ACCESS:LOCAL FEDERALLY QUALIFIED HEALTH CENTERS PROVIDE PRIMARY CARE SERVICES TO RESIDENTS OF SOUTH ORANGE COUNTY WITH LOW INCOMES. WE WILL MAINTAIN MANY OF THE PROGRAMS CURRENTLY IN PLACE THROUGH COMMUNITY HEALTH INVESTMENT TO CONTINUE SUPPORTING ACCESS TO CARE SUCH AS HEALTH INSURANCE ENROLLMENT, CARE NAVIGATION AND MEDICAL TRANSPORTATION SERVICES.OBESITY:GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT CHNA, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS.SAFETY:ENCOMPASSES THE INCIDENCE OF CRIME AND VIOLENCE AS WELL AS THE FEAR OF IT, WHICH PREVENTS PEOPLE FROM USING OPEN SPACE OR ENJOYING THEIR COMMUNITY. GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT CHNA, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS.SENIOR HEALTH:GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT CHNA, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS.IN ADDITION, MISSION HOSPITAL WILL COLLABORATE, WHEN FEASIBLE, WITH ORGANIZATIONS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL TO ADDRESS THESE UNMET NEEDS."

SCHEDULE H, PART V, SECTION B, LINE 13A:
1/1/2021 5/14/2021 MISSION HOSPITAL 100% DISCOUNT WAS UP TO 200% FPL AND 75% DISCOUNT BETWEEN 201% TO 500% FPL. EFFECTIVE 5/15/21 THROUGH 12/31/2021, MISSION HOSPITAL 100% DISCOUNT WAS UP TO 300% FPL AND 75% DISCOUNT BETWEEN 301% TO 350% FPL. SCHEDULE H, PART V, SECTION B, LINE 13HTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.

SCHEDULE H, PART V, SECTION B, LINE 16A:
FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT/FINANCIAL-ASSISTANCE

SCHEDULE H, PART V, SECTION B, LINE 16B:
FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT/FINANCIAL-ASSISTANCE#TABCONTENT-1-PANE-3

SCHEDULE H, PART V, SECTION B, LINE 16C:
FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT/FINANCIAL-ASSISTANCE#TABCONTENT-1-PANE-2

SCHEDULE H PART V, SECTION B, LINES 22B AND 22D:
PRIOR TO 5/15/2021 MISSION HOSPITAL REGIONAL MEDICAL CENTER USED THE PROSPECTIVE MEDICARE OR MEDICAID AGB METHOD. EFFECTIVE 5/15/2021 MISSION HOSPITAL REGIONAL MEDICAL CENTER WENT LIVE ON EPIC AND MOVED TO THE LOOK BACK METHOD BASED ON CLAIMS ALLOWED BY MEDICARE FEE FOR SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE HOSPITAL FACILITY DURING A PRIOR 12 MONTH PERIOD.

PART I, LINE 3C:
IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.

PART I, LINE 6A:
MISSION HOSPITAL REGIONAL MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/MISSION-HOSPITAL-MISSION-VIEJO/ABOUT-US/COMMUNITY-BENEFIT

PART I, LINE 7:
THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO AND GENERAL LEDGER.

PART I, LINE 7G:
NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.

PART II, COMMUNITY BUILDING ACTIVITIES:
FOSTERING A PREPARED AND PRODUCTIVE WORKFORCE IS THE PRIMARY FOCUS OF OUR COMMUNITY BUILDING AT MISSION. WE COMPLETE THIS EFFORT THROUGH CONTINUED COLLABORATION WITH CAPISTRANO UNIFIED SCHOOL DISTRICT ADULT TRANSITION PROGRAM. SINCE 2006, MISSION HOSPITAL HOSTS YOUNG ADULTS WITH DISABILITIES EACH FALL TO PROVIDE WORK EXPERIENCE IN A HOSPITAL SETTING.THESE STUDENT INTERNS ARE PLACED IN HOSPITAL DEPARTMENTS SUCH AS NUTRITIONAL CARE SERVICES, ENVIRONMENTAL SERVICES AND CENTRAL SUPPLY TO LEARN JOB SKILLS THAT WILL HELP THEM ATTAIN LONG-TERM EMPLOYMENT EITHER AT THE HOSPITAL OR A LOCAL ORGANIZATION. MANY OF THESE STUDENTS WOULD BE HIGHLY CHALLENGED TO FIND PERMANENT, ON-GOING WORK BECAUSE OF THEIR DISABILITIES. IN 2021, 5 INTERNS RECEIVED MENTORING/JOB COACHING SUPPORT.LEADERSHIP DEVELOPMENT: MISSION HOSPITAL HAS PARTNERED WITH THE SISTERS OF ST. JOSEPH TO FOSTER LEADERSHIP DEVELOPMENT AS PART OF THEIR ST. JOSEPH WORKER PROGRAM. THIS PROGRAM SUPPORTS WOMEN FOR A 10 MONTH FORMATION PROGRAM WITH THE SISTERS WHILE THEY WORK WITH LOCAL COMMUNITIES AND DEVELOP PUBLIC HEALTH AND ADVOCACY SKILLS.

PART III, LINE 4:
AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019.

PART III, LINE 8:
THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.

PART III, LINE 9B:
OUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY.

PART VI, LINE 2:
NEEDS ASSESSMENTAN ANNUAL MARKET ASSESSMENT IS COMPLETED FOR OUR LOCAL MARKET THAT PROVIDES INFORMATION ON DEMOGRAPHICS, COUNTY HEALTH RANKINGS, PHYSICIAN LANDSCAPE, ACUTE CARE UTILIZATION RATES, MARKET SHARE, OUTMIGRATION TO OTHER MEDICAL FACILITIES FOR TREATMENT, EMERGENCY DEPARTMENT AND ANCILLARY UTILIZATION, AS WELL AS SERVICE LINE FORECASTS. IN ADDITION, OUR COMMUNITY HEALTH INVESTMENT TEAM WORKS CLOSELY WITH NON-PROFITS AND RESIDENTS THROUGH OUR OUTREACH PROGRAMS AND FAMILY RESOURCE CENTERS. THROUGH THIS CLOSE CONTACT THE TEAM CONSISTENTLY ASSESSES NEEDS AND MAY CREATE ADDITIONAL OPPORTUNITIES FOR UNIQUE SERVICES AS IDENTIFIED THROUGHOUT THE YEAR.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE.

PART VI, LINE 5:
"PROMOTION OF COMMUNITY HEALTHMISSION HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. MISSION HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY HEALTH COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND ISA SUBCOMMITTEE OF THE BOARD OF TRUSTEES.2) OPEN MEDICAL STAFF.3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.LOCAL COMMUNITY HEALTH COMMITTEE:THE ROLE OF THE MISSION HOSPITAL'S COMMUNITY HEALTH (CH) COMMITTEE IS TO SUPPORT THE LOCAL MINISTRY BOARD IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE CH COMMITTEE ACTS IN ACCORDANCE WITH A BOARD APPROVED CHARTER. THE CH COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS ""IDENTIFIED SIGNIFICANT NEEDS"" IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES.THE CH COMMITTEE HAS A MINIMUM OF EIGHT (8) MEMBERS INCLUDING THREE (3) MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES FIVE (5) MEMBERS OF THE BOARD OF TRUSTEES AND EIGHT (8) COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE CH COMMITTEE GENERALLY MEETS SIX TIMES PER YEAR."

PART VI, LINE 7, REPORTS FILED WITH STATES
CA

PART VI, LINE 4:
"COMMUNITY INFORMATIONMISSION HOSPITAL PROVIDES SOUTH ORANGE COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM THE JUNCTION OF THE 405 AND 5 FREEWAYS IN THE NORTH, TO CAMP PENDLETON IN THE SOUTH, SANTA ANA MOUNTAINS IN THE EAST AND THE PACIFIC OCEAN IN THE WEST. OUR HOSPITAL TOTAL SERVICE AREA INCLUDES THE CITIES OF ALISO VIEJO, CAPISTRANO BEACH, DANA POINT, FOOTHILL RANCH, LADERA RANCH, LAGUNA BEACH, LAGUNA HILLS, LAGUNA NIGUEL, LAGUNA WOODS, LAKE FOREST, MISSION VIEJO, RANCHO SANTA MARGARITA, SAN CLEMENTE, SAN JUAN CAPISTRANO, AND TRABUCO CANYON.TOTAL SERVICE AREA:THE TOTAL SERVICE AREA FOR MISSION HOSPITAL WAS DEFINED USING CENSUS TRACTS INSIDE SOUTH ORANGE COUNTY. IN TOTAL, THERE ARE 109 CENSUS TRACTS WITHIN THE TOTAL SERVICE AREA OF MISSION HOSPITAL. THE TOTAL SERVICE AREA WAS LATER DIVIDED INTO THE ""BROADER SERVICE AREA AND ""HIGH NEED SERVICE AREA"" (TOTAL SERVICE AREA = BROADER SERVICE AREA + HIGH NEED SERVICE AREA). OF THE OVER 590,000 PERMANENT RESIDENTS IN THE TOTAL SERVICE AREA, ROUGHLY 42% LIVE IN THE HIGH NEED AREA, DEFINED BY LOWER LIFE EXPECTANCY AT BIRTH, LOWER HIGH SCHOOL GRADUATION RATES, AND MORE HOUSEHOLDS AT OR BELOW 200% FEDERAL POVERTY LEVEL (FPL) COMPARED TO CENSUS TRACTS IN THE TOTAL SERVICE AREA. FOR REFERENCE, 200% FPL IS EQUIVALENT TO AN ANNUAL HOUSEHOLD INCOME OF $51,500 OR LESS FOR A FAMILY OF 4. THESE HOUSEHOLDS ARE MORE LIKELY TO REGULARLY MAKE SPENDING TRADEOFFS REGARDING UTILITIES, RENT, GROCERIES, MEDICINE, AND OTHER BASIC EXPENSES.POPULATION AND AGE DEMOGRAPHICS:THE POPULATION IN MISSION HOSPITAL'S TOTAL SERVICE AREA MAKES UP 18% OF ORANGE COUNTY. THE MALE-TO FEMALE DISTRIBUTION IS ROUGHLY EQUAL ACROSS THE GEOGRAPHIES. THE HIGH NEED SERVICE AREA HAS A HIGHER PERCENTAGE OF PEOPLE OVER THE AGE OF 65 AND BETWEEN AGES 18 AND 34. PEOPLE AGES 35 TO 54 AND UNDER THE AGE OF 18 ARE LESS LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS.POPULATION BY RACE AND ETHNICITY:INDIVIDUALS WHO IDENTIFY AS HISPANIC AND ""OTHER"" RACE ARE MORE LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS. PEOPLE IDENTIFYING AS WHITE ARE LESS LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS.SOCIOECONOMIC INDICATORS:THE MEDIAN INCOME FOR THE TOTAL SERVICE AREA FOR MISSION HOSPITAL IS ABOUT $20,000 HIGHER THAN ORANGE COUNTY OVERALL. THERE IS OVER A $40,000 DIFFERENCE IN MEDIAN INCOME BETWEEN THE BROADER AND HIGH NEED SERVICE AREA.HOUSING COST BURDEN:SEVERE HOUSING COST BURDEN IS DEFINED AS HOUSEHOLDS THAT SPEND 50% OR MORE OF THEIR INCOME ON HOUSING COSTS. THE TOTAL SERVICE AREA AND ORANGE COUNTY HAVE ROUGHLY THE SAME PERCENTAGE OF RENTER HOUSEHOLDS THAT ARE SEVERELY HOUSING COST BURDENED (28%). IN THE HIGH NEED SERVICE AREA, 30% OF RENTER HOUSEHOLDS ARE SEVERELY HOUSING COST BURDENED. WITHIN THE TOTAL SERVICE AREA THERE ARE CENSUS TRACTS IN WHICH OVER 50% OF HOUSEHOLDS ARE EXPERIENCING SEVERE HOUSING COST BURDEN.HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND MEDICALLY UNDERSERVED AREAS (MUA) & MEDICALLY UNDERSERVED POPULATIONS (MUP):THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA) DEMOGRAPHICS (I.E., LOW-INCOME POPULATION) OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). MISSION HOSPITAL IS NOT LOCATED IN A SHORTAGE AREA.MEDICALLY UNDERSERVED AREAS (MUA) AND MEDICALLY UNDERSERVED POPULATIONS (MUP) ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MUA ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL ""UNDER SERVICE."" MUP ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MUA AND MUP ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. MISSION HOSPITAL VIEJO AND MISSION HOSPITAL LAGUNA BEACH ARE NOT LOCATED IN MEDICALLY UNDERSERVED AREAS. HOWEVER, COASTAL COMMUNITIES WITHIN THEIR TOTAL SERVICE AREA, STRETCHING BETWEEN DANA POINT AND SAN CLEMENTE, ARE DESIGNATED AS MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATION AREAS, SIGNIFYING THE IMPORTANCE OF MISSION HOSPITAL TO THE COMMUNITY IT SERVES.OTHER HOSPITALS IN SERVICE AREAOTHER HOSPITAL IN THE COMMUNITY INCLUDE: SADDLEBACK HOSPITAL."

PART VI, LINE 6:
AFFILIATED HEALTH CARE SYSTEMAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIALSERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:- PROVIDENCE ACROSS SEVEN WESTERN STATES- COVENANT HEALTH IN WEST TEXAS- PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA- HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA- KADLEC IN SOUTHEAST WASHINGTON- PACIFIC MEDICAL CENTERS IN SEATTLE, WA- SWEDISH HEALTH SERVICES IN SEATTLE, WA2021 WAS A YEAR MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT