4A (Expenses $ 550417217 including grants of $ 25940258) (Revenue $ 788748302)
"INPATIENT SERVICES: CHILDREN'S HOSPITAL OF WISCONSIN, INC. (""CHW OR ""THE HOSPITAL"") OPERATES A 298-BED HOSPITAL AT ITS MILWAUKEE CAMPUS, WHICH INCLUDES AN EMERGENCY ROOM OPEN ON A 24/7 BASIS. IT IS A FREESTANDING WISCONSIN HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN AND IS ONE OF THE LEADING CENTERS FOR PEDIATRIC HEALTH CARE IN THE UNITED STATES. THE HOSPITAL SERVES CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE, TO CHILDREN FROM WISCONSIN AND BEYOND. IN 2021, 9,130 CHILDREN WERE ADMITTED TO THE MILWAUKEE HOSPITAL, WHICH INCLUDES A NEONATAL INTENSIVE CARE UNIT (NICU), PEDIATRIC INTENSIVE CARE UNIT (PICU), A CANCER AND BLOOD DISORDERS CENTER, MEDICAL/SURGICAL UNITS AND A DAY SURGERY AND SHORT-STAY UNIT. IN ADDITION, THERE WERE 4,334 OBSERVATION PATIENTS IN 2021. THE HOSPITAL ALSO OPERATES A SEPARATELY LICENSED 42-BED PEDIATRIC HOSPITAL, WHICH INCLUDES A NICU AND A PEDIATRIC MEDICAL/SURGICAL UNIT, LOCATED AT THEDACARE REGIONAL MEDICAL CENTER-NEENAH, THROUGH WHICH IT PROVIDES PEDIATRIC EXPERTISE TO THE GREATER FOX VALLEY AND GREEN BAY AREAS. IN 2021, 527 CHILDREN WERE ADMITTED TO THE FOX VALLEY HOSPITAL. IN ADDITION, THERE WERE 336 OBSERVATION PATIENTS IN 2021.OUTPATIENT AND AMBULATORY SERVICES: THE HOSPITAL PROVIDES A FULL ARRAY OF OUTPATIENT AMBULATORY, DIAGNOSTIC, TREATMENT AND SURGICAL SERVICES. PROVIDERS IN MORE THAN 70 SUBSPECIALTY AREAS DIAGNOSE AND TREAT A WIDE VARIETY OF PEDIATRIC DISORDERS. THE HOSPITAL IS A CERTIFIED LEVEL 1 PEDIATRIC TRAUMA CENTER, AND HANDLED 62,837 VISITS TO THE EMERGENCY DEPARTMENT IN 2021. OUTPATIENT SERVICES ARE OFFERED AT ACCESSIBLE LOCATIONS THROUGHOUT SOUTHEASTERN WISCONSIN, AND IN THE FOX VALLEY AND GREEN BAY MARKETS. THE HOSPITAL'S NATIONALLY KNOWN AND RECOGNIZED SPECIALTY PROGRAMS INCLUDE THOSE FOR TREATING CHILDREN WITH AIRWAY, DIGESTIVE AND VOICE CONDITIONS; BURNS; CANCER AND BLOOD DISORDERS; CONGENITAL AND ACQUIRED HEART DEFECTS AND DISEASES; CRANIOFACIAL DISORDERS; DERMATOLOGY, BIRTHMARKS AND VASCULAR ANOMALIES; DIABETES; GASTROINTESTINAL PROBLEMS; GENETIC DISORDERS; HIV; NEUROLOGICAL DISORDERS; ORTHOPEDIC CONDITIONS (INCLUDING SPINE, SPORTS MEDICINE, CONCUSSION); IMMUNODEFICIENCIES AND IMMUNE DYSREGULATION SYNDROMES; PSYCHIATRY; SLEEP DISORDERS; SOLID ORGAN TRANSPLANTATION; SPEECH AND HEARING DISORDERS; AND SPASTICITY AND OTHER TONE AND MOBILITY CONDITIONS. THROUGH ITS AFFILIATES, THE HOSPITAL PROVIDES PRIMARY CARE, DENTAL CARE, MENTAL AND BEHAVIORAL HEALTH SERVICES AND CHILD PROTECTIVE SERVICES TO UNDERSERVED CHILDREN AT SEVERAL CLINICS IN CENTRAL CITY MILWAUKEE NEIGHBORHOODS. THE HOSPITAL ALSO OFFERS CASE MANAGEMENT SERVICES AND A FULL RANGE OF MEDICAL, PSYCHOLOGICAL, NURSING AND SOCIAL SERVICES FOR CHILDREN WITH DEVELOPMENTAL, BEHAVIORAL AND LEARNING PROBLEMS. IN 2021, THERE WERE A TOTAL OF 319,625 OUTPATIENT VISITS.RESEARCH: THE HOSPITAL AND CHILDREN'S RESEARCH INSTITUTE PARTICIPATE IN AN ARRAY OF RESEARCH INITIATIVES SEEKING TO IMPROVE THE DIAGNOSIS AND TREATMENT OF CONGENITAL AND ACQUIRED PEDIATRIC HEALTH CONDITIONS. THESE RESEARCH INITIATIVES INCLUDE BEHAVIORAL HEALTH; EPILEPSY AND OTHER NEUROLOGICAL CONDITIONS; HEART DEFECTS; ORGAN TRANSPLANTATION; BIRTH DEFECTS AND FETAL ANOMALIES; IMMUNOLOGICAL CONDITIONS, BLOOD DISORDERS AND VARIOUS CHILDHOOD CANCERS; AND ENVIRONMENTAL HEALTH CONDITIONS. ADDITIONAL RESEARCH IS CONDUCTED IN COLLABORATION WITH ACADEMIC INVESTIGATORS AT THE MEDICAL COLLEGE OF WISCONSIN, MARQUETTE UNIVERSITY, UNIVERSITY OF WISCONSIN-MADISON AND OTHER INSTITUTIONS. NURSING RESEARCH INCLUDES STUDIES REGARDING PAIN MANAGEMENT, QUALITY OF LIFE, COPING SKILLS, FAMILY READINESS AND SEDATION PROTOCOLS. EDUCATION: THE HOSPITAL IS A MAJOR TEACHING AFFILIATE OF THE MEDICAL COLLEGE OF WISCONSIN, WITH THIRD- AND FOURTH-YEAR MEDICAL STUDENTS ROTATING THROUGH THE HOSPITAL FOR REQUIRED AND ELECTIVE ROTATIONS. THE HOSPITAL ALSO MAINTAINS A THREE-YEAR PEDIATRIC RESIDENCY PROGRAM, A TWO-YEAR DENTAL TRAINING PROGRAM AND AN ACADEMIC FELLOWSHIP PROGRAM IN AN ARRAY OF SPECIALTIES. THE HOSPITAL HAS RELATIONSHIPS WITH MORE THAN TWO DOZEN UNIVERSITIES FOR THE CLINICAL EDUCATION OF PEDIATRIC NURSES AND OTHER HEALTH CARE PROFESSIONAL STUDENTS, AS WELL AS HEALTH CARE ADMINISTRATION AND VARIOUS OTHER DISCIPLINES. THE HOSPITAL'S PEDIATRIC SPECIALISTS ALSO PROVIDE EDUCATION AND TRAINING TO HEALTH CARE PROFESSIONALS AT COMMUNITY HOSPITALS, PRIMARY CARE CLINICS AND SCHOOLS THROUGHOUT WISCONSIN IN CONNECTION WITH THE IDENTIFICATION, DIAGNOSIS AND TREATMENT OF PEDIATRIC HEALTH AND WELFARE CONDITIONS.COMMUNITY EDUCATION AND OUTREACH: THE HOSPITAL OFFERS A WIDE VARIETY OF COMMUNITY EDUCATION, OUTREACH AND CHILD HEALTH ADVOCACY PROGRAMS. THROUGH COMMUNITY EDUCATION PROGRAMS ON TOPICS SUCH AS CHILD HEALTH, INJURY PREVENTION, PARENTING, MANAGEMENT OF CHRONIC DISEASES, AND PREVENTIVE HEALTH, THE HOSPITAL REACHES THOUSANDS OF FAMILIES. ALONG WITH THE MEDICAL COLLEGE, THE HOSPITAL SPONSORS THE CENTER FOR THE ADVANCEMENT OF UNDERSERVED CHILDREN, WHICH SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN IN WISCONSIN. THE HOSPITAL PARTICIPATES IN AND STAFFS CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, THROUGH WHICH PROVIDERS AROUND THE STATE WORK COLLABORATIVELY TO RAISE AWARENESS OF CHILDREN'S HEALTH ISSUES, INCREASE ACCESS TO PEDIATRIC CARE, AND PROMOTE BEST PRACTICES. OTHER COMMUNITY OUTREACH AND ADVOCACY INITIATIVE EXAMPLES INCLUDE CAR SEAT CLINICS, THE DANIEL M. SOREF FAMILY RESOURCE CENTER, SERVICES PROVIDED AT SOJOURNER FAMILY PEACE CENTER (SERVICES FOR ADULTS AND CHILDREN WHO HAVE EXPERIENCED DOMESTIC VIOLENCE), AND PROJECT ADAM (EDUCATION AND PREVENTION INITIATIVES IN THE AREA OF PEDIATRIC SUDDEN CARDIAC DEATH)."

CHILDREN'S HOSPITAL OF WI-MILWAUKEE
PART V, SECTION B, LINE 5: CHW IS A MEMBER OF THE MILWAUKEE HEALTH CARE PARTNERSHIP, WHICH BRINGS TOGETHER MILWAUKEE'S HEALTH SYSTEMS, HOSPITALS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL AND STATE PUBLIC HEALTH DEPARTMENTS, ALL COMMITTED TO WORKING TOGETHER TO CREATE A HEALTHIER MILWAUKEE. TO GET A HOLISTIC PICTURE OF HEALTH IN MILWAUKEE, EVERY THREE YEARS THE PARTICIPATING HEALTH SYSTEMS COMMISSION A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN COLLABORATION WITH THE MILWAUKEE HEALTH DEPARTMENT AND OTHER MUNICIPAL HEALTH DEPARTMENTS. THE ASSESSMENTS SERVE AS THE FOUNDATION FROM WHICH HOSPITALS AND LOCAL HEALTH DEPARTMENTS DEVELOP THEIR RESPECTIVE COMMUNITY HEALTH IMPROVEMENT STRATEGIES. THE ASSESSMENT FOR MILWAUKEE COUNTY INCLUDES THREE PRIMARY DATA SOURCES: - MILWAUKEE COUNTY COMMUNITY HEALTH SURVEY: THIS PHONE-BASED SURVEY OF NEARLY 1,312 MILWAUKEE COUNTY RESIDENTS ASSESSES ADULT AND CHILD HEALTH AND RELATED BEHAVIORS, AS WELL AS PERCEPTIONS OF TOP HEALTH ISSUES FOR THE COMMUNITY. - KEY INFORMANT INTERVIEW REPORT: THIS REPORT OF LOCAL PUBLIC HEALTH PRIORITIES IS MADE UP OF INPUT FROM 80 INDIVIDUALS, REPRESENTING 40 KEY INFORMANTS AND FOUR FOCUS GROUPS. - HEALTH COMPASS MILWAUKEE: A COMPILATION OF NUMEROUS PUBLICLY REPORTED DATA AND OTHER SOURCES ON ONE WEBSITE (HEALTHCOMPASSMILWAUKEE.ORG)WHILE THESE REPORTS PROVIDE RICH DATA, THEY PRIMARILY FOCUS ON THE ADULT POPULATION ACROSS THE ENTIRE COUNTY. TO ENSURE CHILDREN'S HOSPITAL'S HIGHEST PRIORITY CHILDREN ARE WELL REPRESENTED, WE CONSULTED ADDITIONAL PUBLIC SOURCES WITH THE CITY OF MILWAUKEE AS OUR SCOPE: - KIDS COUNT. FUNDED BY THE ANNIE E. CASEY FOUNDATION, THIS NATIONAL AND STATE-BY-STATE EFFORT TRACKS WELL-BEING INDICATORS FOR CHILDREN IN THE U.S. - U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY. IN ADDITION TO ITS DECENNIAL CENSUS, THE BUREAU COLLECTS AND DISSEMINATES DATA ACROSS A VARIETY OF TOPICS. - YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM (YRBS). THE DEPARTMENT OF PUBLIC INSTRUCTION CONDUCTS THIS SURVEY REGULARLY IN SCHOOLS ACROSS THE STATE. YRBS IS CURRENTLY UNDERGOING MAJOR MODIFICATIONS, SO COUNTY-LEVEL DATA WAS UNAVAILABLE AT THE TIME OF THIS REPORT. WE USED MILWAUKEE PUBLIC SCHOOL DISTRICT YRBS DATA IN LIEU OF COUNTY DATA BECAUSE MPS IS THE LARGEST DISTRICT IN THE COUNTY. - OTHER PUBLIC AND GOVERNMENT SOURCES. ADDITIONAL SOURCES INCLUDE WISCONSIN INTERACTIVE STATISTICS ON HEALTH AND THE MILWAUKEE HOMICIDE REVIEW COMMISSION ANNUAL REPORT.

CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 5: THE FOX VALLEY COMMUNITY HEALTH IMPROVEMENT COALITION (FVCHIC) IS COMPRISED OF FIVE PUBLIC HEALTH DEPARTMENTS AND FIVE HEALTH CARE SYSTEMS IN THE TRI-COUNTY SERVICE AREA OF CALUMET, OUTAGAMIE AND WINNEBAGO COUNTIES. THE FVCHIC CONTRACTS WITH JKV RESEARCH, LLC TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY FEW YEARS. JKV RESEARCH USED FOUR PRIMARY DATA SOURCES FOR FVCHIC'S ASSESSMENT: - RANDOM TELEPHONE SURVEY OF 1,500 ADULT RESIDENTS - A SURVEY-SUBSET WITHIN THE ADULT TELEPHONE SURVEY ABOUT A RANDOMLY SELECTED YOUTH IN THE HOUSEHOLD - MORE THAN 100 KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS AND STAKEHOLDERS FROM DIVERSE BACKGROUNDS AND SECTORS - YOUTH RISK BEHAVIOR SURVEYS CONDUCTED BY FOX VALLEY PARTICIPATING SCHOOL DISTRICTS, WITH A TOTAL OF 11,662 COMPLETED HIGH SCHOOL SURVEYSWHILE THESE SOURCES PROVIDE RICH DATA, THEY PRIMARILY FOCUS ON THE ADULT POPULATION ACROSS THE TRI-COUNTY AREA. TO ENSURE CHILDREN ARE WELL REPRESENTED, WE CONSULTED ADDITIONAL DATA SOURCES: - KIDS COUNT: FACILITATED BY THE ANNIE E. CASEY FOUNDATION, THIS NATIONAL AND STATE-BY-STATE EFFORT TRACKS WELL-BEING INDICATORS FOR CHILDREN IN THE U.S. - U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY: IN ADDITION TO ITS DECENNIAL CENSUS, THE BUREAU COLLECTS AND DISSEMINATES DATA ACROSS A VARIETY OF TOPICS. - OTHER PUBLIC AND GOVERNMENT SOURCES: ADDITIONAL SOURCES INCLUDE WISCONSIN INTERACTIVE STATISTICS ON HEALTH FROM THE WISCONSIN DEPARTMENT OF HEALTH SERVICES AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE'S COUNTY HEALTH RANKINGS.

CHILDREN'S HOSPITAL OF WI-MILWAUKEE
PART V, SECTION B, LINE 6A: THE FOLLOWING HOSPITAL FACILITIES WERE INTEGRAL TO THE COMPLETION OF THE MILWAUKEE HEALTH CARE PARTNERSHIP'S COMMUNITY HEALTH NEEDS ASSESSMENT: ADVOCATE AURORA HEALTH, COLUMBIA ST. MARY'S HEALTH SYSTEM, FROEDTERT HEALTH, AND WHEATON FRANCISCAN HEALTHCARE.

CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 6A: THE FOLLOWING HOSPITAL FACILITIES WERE INTEGRAL TO THE COMPLETION OF THE TRI-COUNTY AREA'S COMMUNITY HEALTH NEEDS ASSESSMENT: ASCENSION, ADVOCATE AURORA HEALTH, AND THEDACARE.

CHILDREN'S HOSPITAL OF WI-MILWAUKEE
PART V, SECTION B, LINE 6B: IN ADDITION TO THE HOSPITAL FACILITIES NAMED IN LINE 6A, CHW-MILWAUKEE CONDUCTED ITS CHNA WITH PUBLIC HEALTH OFFICIALS IN THE CITY OF MILWAUKEE AND OTHER MILWAUKEE COUNTY MUNICIPALITIES. THE CENTER FOR URBAN POPULATION HEALTH CONDUCTED THE ASSESSMENT FOR THE MILWAUKEE HEALTH CARE PARTNERSHIP. CHILDREN'S PROVIDED ADDITIONAL LEADERSHIP, RESEARCH AND ANALYSIS TO DEVELOP THE ASSESSMENT UNIQUE TO CHILDREN IN MILWAUKEE.

CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 6B: IN ADDITION TO THE HOSPITAL FACILITIES NAMED IN LINE 6A, CHW-FOX VALLEY CONDUCTED ITS CHNA WITH THE HEALTH DEPARTMENTS OF APPLETON, MENASHA AND OUTAGAMIE, CALUMET AND WINNEBAGO COUNTIES. JKV RESEARCH ADMINISTERED AND REPORTED ON THE YOUTH RISK BEHAVIOR SURVEY AND COMMUNITY MEMBER AND STAKEHOLDER SURVEY. CHILDREN'S PROVIDED ADDITIONAL LEADERSHIP, RESEARCH AND ANALYSIS TO DEVELOP THE ASSESSMENT UNIQUE TO CHILDREN IN THE FOX VALLEY.

CHILDREN'S HOSPITAL OF WI-MILWAUKEE
PART V, SECTION B, LINE 11: WE RECOGNIZE THAT CHILDREN'S HOSPITAL CANNOT COMPLETELY ELIMINATE EVERY CHALLENGE TO CHILDREN'S HEALTH. THESE ISSUES ARE LARGE AND COMPLEX, AND THERE ARE SOCIAL, ENVIRONMENTAL, GENETIC AND BEHAVIORAL FACTORS BEYOND OUR CONTROL. NOR CAN WE SOLVE THESE PROBLEMS ALONE. HOWEVER, AS A LEADER IN PEDIATRIC HEALTH CARE, WE ARE COMMITTED TO WORKING WITH OUR COMMUNITY PARTNERS TO MAKE A DIFFERENCE FOR THE KIDS WHO NEED US MOST. THROUGH PROGRAMMING, COLLABORATION AND EDUCATION, WE CAN LEVERAGE ALL AVAILABLE RESOURCES TO ENSURE THE BEST CARE FOR KIDS IN OUR COMMUNITY. AS THE FOLLOWING SECTIONS DEMONSTRATE, WE ARE ALREADY USING A VARIETY OF STRATEGIES TO MAKE STRIDES TOWARD THESE GOALS AND ARE ACTIVELY WORKING ON INITIATIVES THAT IMPACT ALL SIGNIFICANT NEEDS IDENTIFIED IN THE ASSESSMENT. PRIORITY #1: CHRONIC DISEASE MANAGEMENT - ASTHMA & ORAL HEALTHASTHMA IS A PREVALENT CHRONIC DISEASE FOR CHILDREN IN MILWAUKEE, MUCH MORE THAN MANY OTHER WISCONSIN COUNTIES, PUTTING CHILDREN AND YOUTH IN MILWAUKEE COUNTY AT GREATER RISK FOR HOSPITALIZATION AND MISSED SCHOOL DAYS IF THEIR CONDITION IS NOT MANAGED CORRECTLY. OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE ASTHMA PRIORITY FOLLOW.WISCONSIN ASTHMA COALITIONSINCE 2001, CHILDREN'S HOSPITAL HAS SUPPORTED THIS DIVERSE, STATEWIDE COALITION THAT WORKS TO TAKE CONTROL OF ASTHMA THROUGH IMPLEMENTATION OF THE WISCONSIN ASTHMA PLAN. THE WISCONSIN ASTHMA PLAN IS A BLUEPRINT FOR MANAGING ASTHMA ACROSS THE STATE, AND INCLUDES THE FOLLOWING ACTIVITIES:SCHOOL AND CHILDCARE WALKTHROUGH PROGRAM - THIS PROGRAM PROVIDES AN ENVIRONMENTAL ASSESSMENT OF SCHOOLS AND CHILDCARE CENTERS FOR ENVIRONMENTAL ASTHMA TRIGGERS AND OFFERS LOW- AND NO-COST REMEDIATION STRATEGIES. IMPROVING OUTCOMES IN PRACTICAL ASTHMA MANAGEMENT THIS INITIATIVE OFFERS IN-PERSON EDUCATION FOR PRIMARY CARE PROVIDER TEAMS ON HOW TO IMPLEMENT THE NATIONAL ASTHMA GUIDELINES WITHIN THEIR CLINICAL PRACTICE. ASTHMA MEDICATION ASSISTANCE - AT CHAWISCONSIN.ORG/MEDS, THE COALITION HAS COMPILED AN ONLINE RESOURCE OF ALL PRESCRIPTION ASSISTANCE PROGRAMS AND COUPONS AVAILABLE FOR ASTHMA MEDICATIONS.SCHOOL-BASED ASTHMA MANAGEMENT PROGRAM - THIS IS A NATIONAL INITIATIVE OF THE AMERICAN ACADEMY OF ALLERGY, ASTHMA AND IMMUNOLOGY AND THE NATIONAL ASSOCIATION OF SCHOOL NURSES. IT INVOLVES A FOUR-STEP PROCESS TO IMPROVE THE SYSTEM OF CARE AND COMMUNICATION BETWEEN FAMILIES, CLINICIANS AND SCHOOLS.COMMUNITY HEALTH ASTHMA MANAGEMENT PROGRAM LAUNCHED IN 2015 AT NINE MILWAUKEE PUBLIC SCHOOLS, CHILDREN'S COMMUNITY HEALTH ASTHMA MANAGEMENT PROGRAM (CHAMP; FORMERLY ASTHMA CARE AND ENVIRONMENTAL SERVICES) PROVIDES SELF-MANAGEMENT EDUCATION BY A TRAINED ASTHMA EDUCATOR, ASTHMA ACTION PLAN REVIEW, TWO IN-HOME SESSIONS WITH A WALKTHROUGH, FOLLOW-UP CALLS AND RECOMMENDED ACTIONS FOR REDUCING ASTHMA TRIGGERS.ANTICIPATED IMPACT: EDUCATION, ASTHMA CONTROL. WE EXPECT THIS PROGRAM TO IMPROVE ASTHMA CONTROL, ENHANCE ASTHMA KNOWLEDGE, DECREASE THE PERCENTAGE OF EMERGENCY DEPARTMENT VISITS AND HOSPITALIZATIONS DUE TO ASTHMA EXACERBATION, DECREASE THE PERCENTAGE OF STUDENTS WITH ASTHMA WHO ARE CHRONICALLY ABSENT (MISSING AT LEAST ONE DAY OF SCHOOL PER WEEK AVERAGED OVER A MINIMUM OF THREE MONTHS), AND INCREASE THE NUMBER OF ENVIRONMENTAL RECOMMENDATIONS IMPLEMENTED TO REDUCE ASTHMA EXACERBATION.ASTHMA AND ORAL HEALTH ADVOCACYIN ADDITION TO SUPPORTING A STRONG MEDICAID/CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) PROGRAM AT THE STATE AND FEDERAL LEVELS, WHICH HELPS ENSURE KIDS HAVE ACCESS TO THE MEDICAL CARE THEY NEED, CHILDREN'S HAS SUPPORTED EFFORTS TO REDUCE YOUTH ACCESS AND USE OF TOBACCO-RELATED PRODUCTS. THIS INCLUDES ADVOCATING FOR LEGISLATION TO RESTRICT FLAVORED TOBACCO AND E-CIGARETTE PRODUCTS, RESTRICTING VAPING/E-CIGARETTE USE IN PUBLIC PLACES, PROHIBITING THE SALE OF VAPOR PRODUCTS TO MINORS AND RAISING THE AGE OF PURCHASE OF TOBACCO PRODUCTS TO 21. CHILDREN'S HAS ALSO SUPPORTED EFFORTS TO IMPROVE SCHOOL CONSTRUCTION NOTIFICATION ALERTS SO THAT STUDENTS WITH ASTHMA, ALONG WITH STUDENTS WITH OTHER HEALTH CONDITIONS, ARE WELL INFORMED AND BETTER ABLE TO MANAGE THEIR CARE.CHILDREN'S WISCONSIN HAS ADVOCATED FOR A NUMBER OF INITIATIVES TO HELP KIDS ORAL HEALTH, INCLUDING: SUPPORTING A STRONG MEDICAID/CHIP PROGRAM AT THE STATE AND FEDERAL LEVELS, WHICH HELPS ENSURE KIDS HAVE COVERAGE FOR THE ORAL HEALTH CARE THEY NEED; EFFORTS TO INCREASE DENTAL AND ORAL HEALTH CARE ACCESS, INCLUDING LEGISLATION TO EXPAND THE SETTINGS WHERE DENTAL HYGIENISTS CAN PROVIDE IMPORTANT PREVENTIVE CARE, AS WELL AS ADVOCATING FOR THE LICENSURE OF DENTAL THERAPIST; IMPROVING ORAL HEALTH CARE FOR KIDS IN OUT-OF-HOME CARE; INCREASING FUNDING TO HELP CARE FOR DENTAL PATIENTS WITH COMPLEX HEALTH CARE NEEDS; FUNDING FOR THE SCHOOL-BASED SEAL-A- SMILE PROGRAM TO ENSURE KIDS RECEIVE SEALANTS TO HELP PREVENT CAVITIES; EFFORTS TO LIMIT YOUTH VAPING, WHICH CAN HAVE ORAL HEALTH CONSEQUENCES.WISCONSIN SEAL-A-SMILEWISCONSIN SEAL-A-SMILE PROVIDES SCHOOL-BASED ORAL HEALTH PREVENTION SERVICES TO NEARLY 80,000 CHILDREN ACROSS THE STATE. THE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN LEADS AND MANAGES THIS PROJECT IN COLLABORATION WITH THE WISCONSIN DEPARTMENT OF HEALTH SERVICES AND DELTA DENTAL OF WISCONSIN. APPROXIMATELY $1.10 MILLION IS MANAGED BY THE ALLIANCE AND AWARDED TO LOCAL PROGRAMS TO PROVIDE THESE SERVICES.ANTICIPATED IMPACT: ACCESS TO CARE, EARLY INTERVENTION. THE SEAL-A-SMILE PROGRAM WILL IMPACT ORAL HEALTH BY INCREASING THE NUMBER OF CHILDREN RECEIVING DENTAL SEALANTS AND ORAL HEALTH ASSESSMENTS IN SCHOOL. WE EXPECT TO SEE AN INCREASE IN THE PERCENTAGE OF CHILDREN IN ELIGIBLE SCHOOLS PARTICIPATING AND IN THE PERCENT OF THIRD GRADERS WHO HAVE DENTAL SEALANTS.WISCONSIN ORAL HEALTH COALITIONTHE WISCONSIN ORAL HEALTH COALITION LED BY CHILDREN'S HEALTH ALLIANCE OF WISCONSIN IS A DEDICATED GROUP OF MORE THAN 200 INDIVIDUALS, ORGANIZATIONS AND AGENCIES ADDRESSING ORAL HEALTH ACCESS ISSUES AND WORKING TO IMPROVE ORAL HEALTH FOR ALL RESIDENTS STATEWIDE. WE WORK TO CREATE MEANINGFUL CHANGE TO IMPROVE ORAL HEALTH AND ACCESS TO CARE THROUGH DIVERSE PUBLIC AND PRIVATE PARTNERSHIPS. ADDITIONALLY WE MANAGE AND SUPPORT EIGHT LOCAL ORAL HEALTH COALITIONS ACROSS WISCONSIN.ANTICIPATED IMPACT: ACCESS TO CARE. THIS COALITION WILL INCREASE ACCESS TO DENTAL SERVICES AND MOBILIZE PARTNERS AT THE GRASSROOTS LEVEL TO ENGAGE IN ADVOCACY AND PROGRAM DEVELOPMENT.WISCONSIN MEDICAL DENTAL INTEGRATION PROJECTTHE WISCONSIN MEDICAL DENTAL INTEGRATION PROJECT FOCUSES ON ENGAGING HEALTH SYSTEMS IN THE INTEGRATION OF DENTAL HYGIENE SERVICES IN THE PRIMARY CARE MEDICAL HOME. PARTICIPANTS WORK AS PART OF A LEARNING COLLABORATIVE TO IMPLEMENT QUALITY IMPROVEMENT TECHNIQUES AND IDENTIFY, DOCUMENT AND SPREAD BEST PRACTICES. THIS INTEGRATION PROJECT REACHES STATEWIDE INCLUDING ACROSS MILWAUKEE COUNTY. ANTICIPATED IMPACT: ACCESS TO CARE, EARLY INTERVENTION. WE EXPECT TO SEE AN INCREASED NUMBER OF PATIENTS RECEIVING DENTAL SERVICES AT A WELL VISIT AND AN INCREASE IN THE PERCENTAGE OF CHILDREN AGES 0-5 THAT REMAIN CARIES FREE AFTER RECEIVE DENTAL SERVICES AT A WELL VISIT.PRIORITY #2: INFANT MORTALITYINFANT MORTALITY WAS IDENTIFIED AS AN EMERGING TREND FOR THE MILWAUKEE HEALTH CARE PARTNERSHIP'S COMMUNITY HEALTH NEEDS ASSESSMENT; HOWEVER, CHILDREN'S LEADERSHIP AND COMMUNITY PARTNERS SEE IT AS A PROMINENT AREA OF FOCUS FOR CHILDREN'S. ESSENTIAL DRIVERS INFLUENCING RATES OF INFANT MORTALITY INCLUDE PRENATAL AND PERINATAL CARE, AND UNINTENTIONAL INJURIES.HEALTHY STARTHEALTHY START IS A PROGRAM THROUGH THE HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNED TO IMPROVE ACCESS TO QUALITY HEALTH CARE AND SERVICES FOR WOMEN, INFANTS, CHILDREN AND MALE PARTNERS THROUGH OUTREACH, CARE COORDINATION, HEALTH EDUCATION AND CONNECTIONS TO HEALTH INSURANCE. HEALTHY START AIMS TO STRENGTHEN THE HEALTH WORKFORCE, SPECIFICALLY FOR THOSE INDIVIDUALS RESPONSIBLE FOR PROVIDING DIRECT SERVICES; BUILD HEALTHY COMMUNITIES; ENSURE ONGOING, COORDINATED, COMPREHENSIVE SERVICES ARE PROVIDED IN THE MOST EFFICIENT MANNER THROUGH EFFECTIVE SERVICE DELIVERY; AND PROMOTE AND IMPROVE HEALTH EQUITY BY CONNECTING FAMILIES WITH APPROPRIATE ORGANIZATIONS.ANTICIPATED IMPACT: AWARENESS AND ACCESS. HEALTHY START WORKS TO IMPROVE HEALTH OUTCOMES BEFORE, DURING AND AFTER PREGNANCY, AND REDUCE RACIAL/ETHNIC DIFFERENCES IN RATES OF INFANT DEATH AND ADVERSE PERINATAL OUTCOMES. (CONTINUED ON PAGE 66)

CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 11: WE RECOGNIZE THAT CHILDREN'S HOSPITAL CANNOT COMPLETELY ELIMINATE EVERY CHALLENGE TO CHILDREN'S HEALTH. THESE ISSUES ARE LARGE AND COMPLEX, AND THERE ARE SOCIAL, ENVIRONMENTAL, GENETIC AND BEHAVIORAL FACTORS BEYOND OUR CONTROL. NOR CAN WE SOLVE THESE PROBLEMS ALONE. HOWEVER, AS A LEADER IN PEDIATRIC HEALTH CARE, WE ARE COMMITTED TO WORKING WITH OUR COMMUNITY PARTNERS TO MAKE A DIFFERENCE FOR THE KIDS WHO NEED US MOST. THROUGH PROGRAMMING, COLLABORATION AND EDUCATION, WE CAN LEVERAGE ALL AVAILABLE RESOURCES TO ENSURE THE BEST CARE FOR KIDS IN OUR COMMUNITY. AS THE FOLLOWING SECTIONS DEMONSTRATE, WE ARE ALREADY USING A VARIETY OF STRATEGIES TO MAKE STRIDES TOWARD THESE GOALS AND ARE ACTIVELY WORKING ON INITIATIVES THAT IMPACT ALL SIGNIFICANT NEEDS IDENTIFIED IN THE ASSESSMENT. PRIORITY #1: CHRONIC DISEASE ORAL HEALTHORAL HEALTH IS AN INTEGRAL PART OF OVERALL HEALTH AND IS KEY TO CHILDREN'S GROWTH AND DEVELOPMENT. AND YET OUR ASSESSMENT NOTES THAT ONE IN THREE WISCONSIN CHILDREN ARE LIVING WITH UNTREATED DENTAL DECAY. PRIMARY ISSUES LEADING TO ADVERSE OUTCOMES IN PEDIATRIC ORAL HEALTH INCLUDE EARLY TOOTH DECAY AND ACCESS TO DENTAL CARE.WISCONSIN SEAL-A-SMILEWISCONSIN SEAL-A-SMILE PROVIDES SCHOOL-BASED ORAL HEALTH PREVENTION SERVICES TO NEARLY 80,000 CHILDREN ACROSS THE STATE. THE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN LEADS AND MANAGES THIS PROJECT IN COLLABORATION WITH THE WISCONSIN DEPARTMENT OF HEALTH SERVICES AND DELTA DENTAL OF WISCONSIN. THE ALLIANCE MANAGES AND AWARDS APPROXIMATELY 1.10 MILLION TO LOCAL PROGRAMS TO PROVIDE THESE SERVICES.ANTICIPATED IMPACT: ACCESS TO CARE, EARLY INTERVENTION. THE SEAL-A-SMILE PROGRAM WILL IMPACT ORAL HEALTH BY INCREASING THE NUMBER OF CHILDREN RECEIVING DENTAL SEALANTS AND ORAL HEALTH ASSESSMENTS IN SCHOOL. WE EXPECT TO SEE AN INCREASE IN THE PERCENTAGE OF CHILDREN IN ELIGIBLE SCHOOLS PARTICIPATING AND IN THE PERCENT OF THIRD GRADERS WHO HAVE DENTAL SEALANTS.WISCONSIN ORAL HEALTH COALITIONTHE WISCONSIN ORAL HEALTH COALITION, LED BY CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, IS A DEDICATED GROUP OF MORE THAN 200 INDIVIDUALS, ORGANIZATIONS AND AGENCIES ADDRESSING ORAL HEALTH ACCESS ISSUES AND WORKING TO IMPROVE ORAL HEALTH FOR ALL RESIDENTS STATEWIDE. WE WORK TO CREATE MEANINGFUL CHANGE TO IMPROVE ORAL HEALTH AND ACCESS TO CARE THROUGH DIVERSE PUBLIC AND PRIVATE PARTNERSHIPS. ADDITIONALLY, WE MANAGE AND SUPPORT EIGHT LOCAL ORAL HEALTH COALITIONS ACROSS WISCONSIN.ANTICIPATED IMPACT: ACCESS TO CARE. THIS COALITION INCREASES ACCESS TO DENTAL SERVICES AND MOBILIZES PARTNERS AT THE GRASSROOTS LEVEL TO ENGAGE IN ADVOCACY AND PROGRAM DEVELOPMENT.WISCONSIN MEDICAL DENTAL INTEGRATION PROJECTTHE WISCONSIN MEDICAL DENTAL INTEGRATION PROJECT FOCUSES ON ENGAGING HEALTH SYSTEMS IN THE INTEGRATION OF DENTAL HYGIENE SERVICES IN THE PRIMARY CARE MEDICAL HOME. PARTICIPANTS WORK AS PART OF A LEARNING COLLABORATIVE TO IMPLEMENT QUALITY IMPROVEMENT TECHNIQUES AND IDENTIFY, DOCUMENT AND SPREAD BEST PRACTICES. THIS WORK TAKES PLACE ACROSS WISCONSIN, INCLUDING IN THE FOX VALLEY REGION.ANTICIPATED IMPACT: ACCESS TO CARE, EARLY INTERVENTION. WE EXPECT TO SEE AN INCREASED NUMBER OF PATIENTS RECEIVING DENTAL SERVICES AT A WELL VISIT AND AN INCREASE IN THE PERCENTAGE OF CHILDREN AGES 0 5 THAT REMAIN CARIES FREE AFTER RECEIVE DENTAL SERVICES AT A WELL VISIT.ORAL HEALTH ADVOCACYCHILDREN'S WISCONSIN HAS ADVOCATED FOR A NUMBER OF INITIATIVES TO HELP KIDS ORAL HEALTH, INCLUDING: SUPPORTING A STRONG MEDICAID/CHIP PROGRAM AT THE STATE AND FEDERAL LEVELS, WHICH HELPS ENSURE KIDS HAVE COVERAGE FOR THE ORAL HEALTH CARE THEY NEED; EFFORTS TO INCREASE DENTAL AND ORAL HEALTH CARE ACCESS, INCLUDING LEGISLATION TO EXPAND THE SETTINGS WHERE DENTAL HYGIENISTS CAN PROVIDE IMPORTANT PREVENTIVE CARE, AS WELL AS ADVOCATING FOR THE LICENSURE OF DENTAL THERAPIST; IMPROVING ORAL HEALTH CARE FOR KIDS IN OUT-OF-HOME CARE; INCREASING FUNDING TO HELP CARE FOR DENTAL PATIENTS WITH COMPLEX HEALTH CARE NEEDS; FUNDING FOR THE SCHOOL-BASED SEAL-A- SMILE PROGRAM TO ENSURE KIDS RECEIVE SEALANTS TO HELP PREVENT CAVITIES; EFFORTS TO LIMIT YOUTH VAPING, WHICH CAN HAVE ORAL HEALTH CONSEQUENCESPRIORITY #2: MENTAL AND BEHAVIORAL HEALTHBEHAVIORAL HEALTH ENCOMPASSES BOTH MENTAL HEALTH AND SUBSTANCE ABUSE, AND CONTINUES TO BE NOTED AS ONE OF THE GREATEST HEALTH PROBLEMS FOR FOX VALLEY RESIDENTS. WHILE THERE ARE MANY FACTORS IMPACTING A CHILD'S MENTAL AND BEHAVIORAL HEALTH, NOTABLE ISSUES FOR THE TRI-COUNTY AREA'S PEDIATRIC POPULATION INCLUDE BULLYING, ACCESS TO BEHAVIORAL HEALTH SERVICES AND SUICIDE.TO ACHIEVE OUR OBJECTIVES, CHILDREN'S WILL CONTINUE TO IMPLEMENT THE FOLLOWING STRATEGIES IN ALIGNMENT AND PARTNERSHIP WITH OUR COMMUNITY:CATALPA HEALTHIN COLLABORATION WITH TWO OTHER HEALTH SYSTEMS, THEDA CARE AND ASCENSION, CHILDREN'S PROVIDES STRATEGIC INVESTMENT AND ENGAGED LEADERSHIP TO IMPROVE ACCESS TO MENTAL HEALTH ACCESS AND SERVICES AS WELL AS CONNECTIONS TO COMMUNITY-BASED ORGANIZATIONS, RESOURCES AND ASSETS ACROSS THE FOX VALLEY REGION.ANTICIPATED IMPACT: CARE ACCESS AND QUALITY. CATALPA HEALTH IMPROVES CHILDREN AND FAMILIES' MENTAL HEALTH AND WELLNESS BY PROVIDING THE RIGHT CARE AT THE RIGHT TIME AND CLOSE TO HOME. CATALPA REDUCES WAIT TIMES FOR MENTAL HEALTH EVALUATIONS, INCREASES THE NUMBER OF MENTAL HEALTH PROVIDERS AND DECREASES NO- SHOW RATES FOR CLIENTS (WHEN LEAVING INPATIENT CARE).CHILD PSYCHIATRY CONSULTATION PROGRAM (CPCP)THERE IS A CRITICAL SHORTAGE OF CHILD PSYCHIATRISTS IN WISCONSIN AND NATIONWIDE. TO HELP FILL THE PROVIDER GAP THE MEDICAL COLLEGE OF WISCONSIN, IN PARTNERSHIP WITH CHILDREN'S AND THE STATE OF WISCONSIN OFFERS CPCP, AN ON-CALL MENTAL AND BEHAVIORAL HEALTH CONSULTATION SERVICE FOR ENROLLED PRIMARY CARE PROVIDERS. CHILD PSYCHIATRISTS, A PSYCHOLOGIST AND RESOURCE COORDINATORS PROVIDE ONGOING EDUCATION AND CONSULTATION TO PRIMARY CARE PROVIDERS ON BEHAVIORAL HEALTH ISSUES. THIS HELPS PRIMARY CARE PROVIDERS TREAT KIDS WITH MENTAL HEALTH ISSUES IN THEIR MEDICAL HOMES SO THAT KIDS CAN MORE QUICKLY GET THE TREATMENT THEY NEED.ANTICIPATED IMPACT: EARLY DETECTION, ACCESS TO CARE. WE WILL CONTINUE TO EXPAND THE NUMBER OF ENROLLED PROVIDERS AND CLINICS USING CPCP TO IMPROVE CHILD ACCESS TO HIGH QUALITY BEHAVIORAL HEALTH CARE SERVICES.SCHOOL AND FAMILY E-LEARNING COURSES AND RESOURCES: HEALTHY MINDS, ACT NOW! IT'S UR CHOICECHILDREN'S FUN AND ENGAGING E-LEARNING PROGRAMS INSPIRE STUDENTS AND THEIR FAMILIES TO LEAD HEALTHIER LIVES, BOTH PHYSICALLY AND EMOTIONALLY. OFFERED AT NO COST TO SCHOOLS ACROSS WISCONSIN, THESE PROGRAMS MEET NATIONAL HEALTH EDUCATION STANDARDS AND WERE DEVELOPED USING EVIDENCE- BASED RESEARCH AND COMMUNITY INPUT. TOPICS INCLUDE BULLYING PREVENTION, SUBSTANCE USE AND MINDFULNESS. RESOURCES ARE DESIGNED TO SERVE CHILDREN IN GRADES K3 8, OFFERING INTERACTIVE AND EDUCATIONAL MATERIALS FOR TEACHERS, COUNSELORS, STUDENTS AND FAMILIES, AND TRULY IMPACTING THE CULTURE OF HEALTH ACROSS SCHOOL COMMUNITIES.ANTICIPATED IMPACT: PREVENTION, REDUCED STIGMA. THESE E-LEARNING RESOURCES CAN IMPROVE STUDENT AND STAFF KNOWLEDGE, EMPOWER STUDENTS AND FAMILIES, IMPROVE SCHOOL CLIMATE, REDUCE BEHAVIORAL DIFFICULTIES AND STRESSORS, INCREASE POSITIVE BEHAVIORS, AND REDUCE OFFICE REFERRALS AND SCHOOL SUSPENSION, ALL OF WHICH CAN POSITIVELY INFLUENCE ATTENDANCE AND ACADEMIC PERFORMANCE.THE CONNECTION: N.E.W. MENTAL HEALTH THE CONNECTION IS A BACKBONE AGENCY LEADING A COLLABORATION OF COMMUNITY STAKEHOLDERS TO CREATE AND CONTINUOUSLY IMPROVE MENTAL HEALTH CARE FOR OUTAGAMIE, CALUMET AND WINNEBAGO COUNTIES. WITHIN THIS COLLECTIVE IMPACT MODEL, CHILDREN'S STAFF SIT ON THE BOARD OF DIRECTORS, AS WELL AS THE STEERING COMMITTEE FOR THE QUALITATIVE STUDY ON TEEN SUICIDE RELATED BEHAVIORS.ANTICIPATED IMPACT: SCREENING, ACCESS TO CARE. THIS PROGRAM AIMS TO INCREASE THE NUMBER OF ADOLESCENTS SCREENED FOR DEPRESSION, REDUCE THE RATE OF DEPRESSION IN YOUTH AGES 12 - 18, AND REDUCE THE NUMBER OF HIGH SCHOOL STUDENTS ATTEMPTING SUICIDE. (CONTINUED ON PAGE 63)

CHILDREN'S HOSPITAL OF WI-MILWAUKEE
PART V, SECTION B, LINE 16J: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING STATEMENTS, MYCHART AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO CHILDREN'S HOSPITAL. THE FULL WRITTEN POLICY IS AVAILABLE ON OUR WEBSITE AND UPON REQUEST. A PLAIN LANGUAGE SUMMARY IS AVAILABLE IN WAITING AREAS.

CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 16J: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING STATEMENTS, MYCHART AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO CHILDREN'S HOSPITAL. THE FULL WRITTEN POLICY IS AVAILABLE ON OUR WEBSITE AND UPON REQUEST. A PLAIN LANGUAGE SUMMARY IS AVAILABLE IN WAITING AREAS.

CHILDREN'S HOSPITAL OF WI-MILWAUKEE
"PART V, SECTION B, LINE 20E: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING STATEMENTS, MYCHART AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO THE HOSPITAL. PRIOR TO REFERRING AN ACCOUNT TO A COLLECTION AGENCY OR UNDERTAKING ANY EXTRAORDINARY COLLECTION ACTIONS, CHILDREN'S HOSPITAL WILL MAKE EFFORTS TO COLLECT AMOUNTS DUE, INCLUDING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. AS OUTLINED IN CHILDREN'S WISCONSIN POLICY ""BILLING AND COLLECTIONS FOR SELF-PAY AMOUNTS"", AT LEAST 3 BILLING STATEMENTS ARE SENT OVER A PERIOD OF 120 DAYS. CHILDREN'S HOSPITAL MAKES EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED."

CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 20E: CHILDREN'S HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE FAP VIA ITS WEBSITE, BILLING STATEMENTS, MYCHART AND AT VARIOUS LOCATIONS THROUGHOUT CHILDREN'S HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE GIVEN A PLAIN LANGUAGE SUMMARY UPON ADMISSION TO THE HOSPITAL. PRIOR TO REFERRING AN ACCOUNT TO A COLLECTION AGENCY OR UNDERTAKING ANY EXTRAORDINARY COLLECTION ACTIONS, CHILDREN'S HOSPITAL WILL MAKE EFFORTS TO COLLECT AMOUNTS DUE, INCLUDING REASONABLE EFFORTS TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FAP. AT LEAST 3 BILLING STATEMENTS ARE SENT OVER A PERIOD OF 120 DAYS. CHILDREN'S HOSPITAL MAKES EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED.

PART V, SECTION B, LINE 11 (CONTINUED):
MENTAL AND BEHAVIORAL HEALTH ADVOCACYCHILDREN'S IS COMMITTED TO ENSURING CHILDREN GET THE MENTAL AND BEHAVIORAL HEALTH CARE THEY NEED AND WORKS WITH POLICYMAKERS TO IMPROVE ACCESS, COVERAGE AND CARE. THE ISSUES WE HAVE SUPPORTED INCLUDE THE FOLLOWING: IMPROVING ACCESS TO SCHOOL-BASED MENTAL HEALTH CARE ACROSS THE STATE BY REDUCING BARRIERS AND INCREASING FUNDING; FUNDING FOR BULLYING PREVENTION PROGRAMMING TO HELP STUDENTS DEVELOP SKILLS TO COMBAT BULLYING AND BUILD INTERPERSONAL COMMUNICATION SKILLS; FUNDING TO SUPPORT THE CHILD PSYCHIATRY CONSULTATION PROGRAM (CPCP), WHICH HELPS CONNECT PROVIDERS ACROSS THE STATE TO PEDIATRIC MENTAL AND BEHAVIORAL HEALTH EXPERTS TO PROVIDE ENHANCED CARE AND RESOURCES TO THEIR PATIENTS;EFFORTS TO RECOGNIZE THE IMPORTANCE AND EFFECTIVENESS OF TRAUMA-INFORMED CARE FOR CHILDREN AND FAMILIES; INITIATIVES TO IMPROVE MENTAL AND BEHAVIORAL HEALTH CARE FOR KIDS IN OUT-OF-HOME CARE, AS WELL AS POLICIES TO OFFER ALTERNATIVE FAMILY TREATMENT COURTS FOR PARENTS WITH ISSUES RELATED TO MENTAL ILLNESS OR SUBSTANCE ABUSE; FEDERAL EFFORTS TO EXPAND FUNDING FOR BEHAVIORAL TELEHEALTH CARE, LIKE THE CPCP; FUNDING TO INCREASE THE PEDIATRIC MENTAL AND BEHAVIORAL HEALTH CARE WORKFORCE TO ENSURE WE HAVE ADEQUATE PROVIDERS SPECIALLY TRAINED TO CARE FOR KIDS.PRIORITY #3: OVERWEIGHT AND OBESITYPHYSICAL ACTIVITY PLAYS AN IMPORTANT ROLE IN CHILDREN'S HEALTH AND WELLNESS, FROM PREVENTING OBESITY AND CHRONIC DISEASES TO SETTING THE STAGE FOR LIFELONG HEALTHY HABITS. TWENTY KEY INFORMANTS NEARLY ONE THIRD RANKED PHYSICAL ACTIVITY AS A TOP-FIVE HEALTH PRIORITY FOR THE FOX VALLEY. NOTABLE ISSUES TO ADDRESS OVERWEIGHT AND OBESITY IN THE FOX VALLEY INCLUDE MAKING SURE CHILDREN ARE REGULARLY ACTIVE, REDUCING EXCESS SCREEN TIME, AND CONSUMING VEGETABLES MORE REGULARLY.MISSION: HEALTHY KIDS (SCHOOL AND FAMILY E-LEARNING COURSES AND RESOURCES)MISSION: HEALTHY KIDS, A PARTNERSHIP OF KOHL'S CARES AND CHILDREN'S WISCONSIN, RAISES AWARENESS ABOUT THE IMPACT OF NUTRITION AND PHYSICAL ACTIVITY ON CHILDREN'S PHYSICAL DEVELOPMENT, ABILITY TO LEARN AND EMOTIONAL WELL-BEING.ANTICIPATED IMPACT: EDUCATION, SCHOOL CULTURE. SCHOOL ENGAGEMENT IN HEALTHY SCHOOLS CHALLENGES, FAMILY ENGAGEMENT IN HEALTHY FAMILIES CHALLENGES, SCHOOL APPLICATIONS FOR WISCONSIN SCHOOL HEALTH AWARD.BEWELL FOX VALLEYBEWELL FOX VALLEY (BWFV) IS A COMMUNITY HEALTH INITIATIVE WITH A MISSION OF PARTNERING TO ADVANCE A CULTURE OF HEALTH AND WELL-BEING FOR ALL IN THE FOX VALLEY. BWFV IS THE RESULT OF A ONE-YEAR RE-VISIONING PROCESS FOR WEIGHT OF THE FOX VALLEY IN 2018-19. BWFV HAS A GREATER FOCUS ON OVERALL WELL-BEING AND A MORE CONCENTRATED FOCUS ON CHANGING POLICY, SYSTEMS AND THE ENVIRONMENT, AS WELL AS SHIFTING CULTURE TO SUPPORT HEALTH. CONTINUING WITH A POPULATION-WIDE APPROACH, WHILE ALSO INCORPORATING SPECIAL EMPHASIS ON CHILDREN, FAMILIES AND OUR MOST VULNERABLE POPULATIONS, WILL HELP TO ENSURE THAT ALL COMMUNITY MEMBERS HAVE THE OPPORTUNITY TO LIVE LONGER, BETTER, HEALTHIER AND HAPPIER LIVES SINCE ITS TRANSITION TO BWFV, THE GROUP CONTINUES TO FOCUS ON HEALTH EATING, PHYSICAL ACTIVITY AND FOOD SECURITY.ANTICIPATED IMPACT: PREVENTION, COMMUNITY CULTURE. LOCAL GOVERNMENTS, THE PRIVATE SECTOR, NONPROFIT LEADERS AND COMMUNITY MEMBERS WORKING TOGETHER WILL IMPROVE INDIVIDUAL HEALTH AND WELL-BEING, ENHANCE PRODUCTIVITY, REDUCE HEALTH CARE COSTS, AND RECOGNIZE THE FOX VALLEY AS A DESIRABLE PLACE TO LIVE.OVERWEIGHT AND OBESITY ADVOCACYCHILDREN'S SUPPORTS POLICY EFFORTS AIMED AT ADDRESSING DETERMINANTS OF HEALTH, INCLUDING IMPROVING ACCESS TO HEALTHY AND AFFORDABLE FOOD AND SAFE AND SUPPORTIVE ENVIRONMENTS FOR OUTDOOR PHYSICAL ACTIVITY. WE HAVE SUPPORTED THE FARM-TO-SCHOOL PROGRAM, WHICH BRINGS LOCAL FOODS TO SCHOOLS AND ENCOURAGES HANDS-ON LEARNING ACTIVITIES WITH NUTRITIOUS, FRESH FOODS, AS WELL AS EFFORTS TO ENHANCE NUTRITION AND PHYSICAL EDUCATION REQUIREMENTS IN WISCONSIN SCHOOLS. WE HAVE ALSO ADVOCATED FOR EFFORTS TO IMPROVE ACCESS TO HEALTHY AND AFFORDABLE FOOD OPTIONS, PARTICULARLY FOR HOUSEHOLDS WITH LOWER INCOMES OR THOSE LIVING IN FOOD DESERTS. CHILDREN'S RECOGNIZES THE IMPORTANCE OF THE SNAP/FOODSHARE PROGRAM FOR WISCONSIN KIDS AND FAMILIES TO ENSURE ACCESS TO HEALTHY FOODS.

PART V, SECTION B, LINE 11 (CONTINUED):
"FAMILY CASE MANAGEMENTCHILDREN'S HAS A CONTRACT WITH THE WISCONSIN DEPARTMENT OF CHILDREN AND FAMILIES, THROUGH THE DIVISION OF MILWAUKEE CHILD PROTECTIVE SERVICES, TO PROVIDE ONGOING CASE MANAGEMENT SERVICES FOR FAMILIES WHOSE CHILDREN HAVE BEEN DETERMINED TO BE UNSAFE AND SUBSEQUENTLY REMOVED WHILE PARENTS WORK ON ENHANCING THEIR ABILITY TO PARENT SAFELY. ONE OF THE SERVICES OUR CASE MANAGERS PROVIDE IS A NEWBORN SAFETY BUNDLE, WHICH INCLUDES EDUCATION AND SCREENING FOR SAFE SLEEP ENVIRONMENTS. IF FAMILIES DO NOT HAVE A SAFE SPACE FOR A BABY TO SLEEP, FAMILY CASE MANAGERS PROVIDE RESOURCES (E.G., PACK 'N PLAY, NEWBORN NEST, ETC.).ANTICIPATED IMPACT: EDUCATION, SCREENING. FAMILY CASE MANAGERS ASSESS SLEEP ENVIRONMENTS, PROVIDE EDUCATION, AND IF NECESSARY, RESPOND WITH APPROPRIATE INTERVENTION.HOME VISITINGTHROUGH OUR HOME VISITING PROGRAMS, PARENT EDUCATORS TRAINED IN VARIOUS MODELS PROVIDE IN- HOME PARENT EDUCATION, SUPPORT, COMMUNITY RESOURCES AND CHILD DEVELOPMENT SERVICES TO PREGNANT AND PARENTING FAMILIES. HOME VISITING USES AN EVIDENCE-BASED MODEL THAT IS FAMILY- CENTERED, CULTURALLY SENSITIVE, STRENGTH-BASED, AND PROMOTING OF POSITIVE CHILD DEVELOPMENT AND EARLY SCHOOL READINESS. ONE PARTICULAR CURRICULA USED IS SLEEP BABY SAFE, PROVIDED BY CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, WHICH PROMOTES A CONSISTENT AND CLEAR SAFE SLEEP MESSAGE AND OTHER RESOURCES FOR PROFESSIONALS WORKING WITH FAMILIES.ANTICIPATED IMPACT: PARENT KNOWLEDGE OF CHILD DEVELOPMENT. HOME VISITS IMPROVE CHILD HEALTH (E.G., CHILDREN WILL HAVE A PRIMARY CARE PROVIDER), CHILD DEVELOPMENT AND SCHOOL READINESS (E.G., DEVELOPMENTAL SCREENING AND FOLLOW-UP), MATERNAL HEALTH (E.G., POSTPARTUM DEPRESSION SCREENING AND FOLLOW-UP), AND POSITIVE PARENTING PRACTICES (E.G., HOME SAFETY ASSESSMENT).COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORSCHILDREN'S IS ACTIVELY PARTNERED WITH FIVE NEIGHBORHOODS ACROSS MILWAUKEE, ALIGNING CHILDREN'S RESOURCES WITH COMMUNITY NEEDS. AS CERTIFIED COMMUNITY HEALTH WORKERS, COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS SUPPORT FAMILIES TO MEET BASIC NEEDS AND SUPPORT THEM AS THEY WORK TOWARD SELF-SUFFICIENCY FOCUSING ON HOUSING, SAFETY, FINANCIAL MANAGEMENT, EDUCATION, SOCIAL SUPPORT, PARENTING AND HEALTH.ANTICIPATED IMPACT: EMPOWERMENT. COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS WORK WITH FAMILIES TO IMPROVE HEALTH OUTCOMES, INCREASE ACCESS TO AND UTILIZATION OF COMMUNITY RESOURCES, AND INCREASE SELF-SUFFICIENCY.INFANT MORTALITY ADVOCACYCHILDREN'S HAS ADVOCATED FOR A VARIETY OF INITIATIVES IN THIS AREA, INCLUDING SUPPORTING A STRONG MEDICAID/CHIP PROGRAM, WHICH HELPS ENSURE KIDS HAVE ACCESS TO THE MEDICAL CARE THEY NEED; INCREASED FUNDING FOR STATE AND FEDERAL HOME VISITING PROGRAMS TO PROVIDE PARENT EDUCATION AND RESOURCES ON TOPICS LIKE PREGNANCY AND PRENATAL CARE, CHILD DEVELOPMENT AND BEHAVIORS, WHICH HELP STRENGTHEN FAMILY FUNCTIONING AND REDUCE THE LIKELIHOOD OF CHILD MALTREATMENT; EFFORTS TO ENABLE MORE ACCURATE REPORTING FOR THE STATE'S BIRTH DEFECTS REGISTRY, WHICH WILL HELP CONNECT FAMILIES WITH RESOURCES THEY NEED; INCREASED FUNDING TO PROMOTE SAFE SLEEP PRACTICES AND IMPROVE INFANT AND CHILD DEATH REVIEW PROGRAMS TO BETTER UNDERSTAND RISK FACTORS AND CIRCUMSTANCES SURROUNDING CHILD DEATH AND TO DRIVE PREVENTION PROGRAMMINGPRIORITY #3: MENTAL AND BEHAVIORAL HEALTHBEHAVIORAL HEALTH ENCOMPASSES BOTH MENTAL HEALTH AND SUBSTANCE ABUSE, NOTED BY THE MHCP'S ASSESSMENT TO BE AMONG MILWAUKEE COUNTY'S GREATEST HEALTH PROBLEMS. NOTABLE ISSUES IN THE PEDIATRIC POPULATION INCLUDE ACCESS TO CARE, BULLYING AND SUICIDE. AT THE TURN OF 2020, THERE WAS A SIGNIFICANT INCREASE IN MENTAL BEHAVIORAL HEALTH DEMANDS IN WHICH CHILDREN'S RESPONDED IN MANY WAYS TO INCREASE ACCESS, SERVICES AND PARTNERSHIPS. A SAMPLING OF CHILDREN'S COMMITMENT TO AND INVESTMENT IN MENTAL BEHAVIORAL HEALTH IS FOLLOWING.CHILD PSYCHIATRY CONSULTATION PROGRAM (CPCP)THERE IS A CRITICAL SHORTAGE OF CHILD PSYCHIATRISTS IN WISCONSIN AND NATIONWIDE. TO HELP FILL THE PROVIDER GAP THE MEDICAL COLLEGE OF WISCONSIN, IN CONJUNCTION WITH CHILDREN'S AND THE STATE OF WISCONSIN, OFFERS CPCP, AN ON-CALL MENTAL AND BEHAVIORAL HEALTH CONSULTATION SERVICE TO ENROLLED PRIMARY CARE PROVIDERS. CHILD PSYCHIATRISTS, A PSYCHOLOGIST AND RESOURCE COORDINATORS PROVIDE ONGOING EDUCATION AND CONSULTATION TO PRIMARY CARE PROVIDERS ON BEHAVIORAL HEALTH ISSUES. THIS HELPS PRIMARY CARE PROVIDERS TREAT KIDS WITH MENTAL AND BEHAVIORAL HEALTH ISSUES IN THEIR MEDICAL HOMES SO THAT KIDS CAN MORE QUICKLY GET THE TREATMENT THEY NEED.ANTICIPATED IMPACT: EARLY DETECTION, ACCESS TO CARE. WE WILL CONTINUE TO EXPAND THE NUMBER OF ENROLLED PROVIDERS AND CLINICS USING CPCP TO IMPROVE CHILD ACCESS TO HIGH QUALITY BEHAVIORAL HEALTH CARE SERVICES.INTEGRATED MENTAL AND BEHAVIORAL HEALTH CAREA PSYCHOLOGIST OR PSYCHOTHERAPIST IS PART OF THE MEDICAL TEAM AT SOME CHILDREN'S WISCONSIN PRIMARY CARE SITES, MAKING IT EASY FOR PRIMARY CARE PROVIDERS (PCPS) TO CONSULT ON PATIENTS' BEHAVIORAL HEALTH CONCERNS, PROVIDE SAME-DAY BEHAVIORAL HEALTH SERVICES, AND MAKE AN IMMEDIATE AND IN-PERSON REFERRAL FOR PATIENTS WHO NEED MENTAL HEALTH INTERVENTION. THE PSYCHOLOGIST OR PSYCHOTHERAPIST OFFERS SAME-DAY BEHAVIORAL HEALTH SERVICES TO PATIENTS WHILE THEY ARE IN THE CLINIC TO SEE THEIR PCP, INCLUDING BEHAVIORAL HEALTH SCREENING, HEALTH AND BEHAVIOR CONSULTATION RELATED TO BEHAVIORAL MANAGEMENT OF PHYSICAL HEALTH CONDITIONS, INFORMAL CONSULTATION TO THE PCPS, AND ""WARM HAND-OFFS."" A WARM HAND-OFF ALLOWS THE PATIENT TO MEET THE BEHAVIORAL HEALTH PROVIDER IN PERSON AND FACILITATES THE DEVELOPMENT OF RAPPORT AND SUCCESSFUL REFERRAL TO A SEPARATE, CO-LOCATED BEHAVIORAL HEALTH VISIT. DURING THOSE VISITS, THE BEHAVIORAL HEALTH PROVIDER COMPLETES DIAGNOSTIC EVALUATIONS AND PROVIDES BRIEF PSYCHOTHERAPY, WITH CLOSE COORDINATION WITH THE PCP.ANTICIPATED IMPACT: ACCESS TO CARE. WHEN BEHAVIORAL HEALTH PROVIDERS ARE INVOLVED AS A FUNCTIONAL TEAM MEMBER DURING PRIMARY CARE VISITS (SAME-DAY BEHAVIORAL HEALTH VISITS), WE CAN IMPROVE FAMILY ENGAGEMENT IN PRIMARY CARE AND GREATLY REDUCE THE TIME TO ACCESS BEHAVIORAL HEALTH CARE.TRIPLE PTRIPLE P IS A UNIVERSAL ACCESS, EVIDENCE-BASED PROGRAM FOR CAREGIVERS OF CHILDREN AGES 0-12. IT AIMS TO INCREASE PARENTS AND CAREGIVERS' KNOWLEDGE OF POSITIVE PARENTING TECHNIQUES. PARENTS AND CAREGIVERS ARE REACHED THROUGH FIVE CHILDREN'S PRIMARY CARE CLINICS AND COMMUNITY SERVICES LOCATIONS IN MILWAUKEE AND RACINE.ANTICIPATED IMPACT: PREVENTION. WE TRACK THE NUMBER OF REFERRALS RECEIVED AND THE NUMBER OF FAMILIES ACTIVELY PARTICIPATING IN EDUCATION AND APPLYING ATTAINED SKILLS.SCHOOL-BASED MENTAL HEALTHSCHOOL-BASED MENTAL HEALTH SERVICES ARE PROVIDED TO STUDENTS WITH MENTAL AND BEHAVIORAL HEALTH CONCERNS IN THE CHILD'S OWN SCHOOL. THERAPISTS SPEND ONE TO FIVE DAYS PER WEEK IN NEARLY 50 PARTNER SCHOOLS, WHERE THEY PROVIDE ASSESSMENT AND PSYCHOTHERAPY TO CHILDREN WHO ARE REFERRED TO THE PROGRAM. THERAPISTS ALSO PROVIDE ONGOING PROFESSIONAL EDUCATION, SUPPORT AND CONSULTATION TO TEACHERS, PARENTS AND SCHOOL PERSONNEL.ANTICIPATED IMPACT: EARLY DETECTION, ACCESS TO CARE, REDUCED STIGMA. SERVICES INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE FOR CHILDREN AND FAMILIES WHO MIGHT OTHERWISE HAVE BARRIERS TO SERVICE. BY INCREASING ACCESS, WE AIM TO REDUCE DISTRESSING SYMPTOMS AND BEHAVIORAL DIFFICULTIES, SUPPORT POSITIVE BEHAVIORS AND REDUCE DISCIPLINARY ACTION ALL OF WHICH POSITIVELY INFLUENCE KIDS' SCHOOL ATTENDANCE AND ACADEMIC PERFORMANCE.SCHOOL AND FAMILY E-LEARNING COURSES AND RESOURCES: HEALTHY MINDS, ACT NOW!, IT'S UR CHOICECHILDREN'S FUN AND ENGAGING E-LEARNING PROGRAMS INSPIRE STUDENTS AND THEIR FAMILIES TO LEAD HEALTHIER LIVES, BOTH PHYSICALLY AND EMOTIONALLY. OFFERED AT NO COST TO SCHOOLS ACROSS WISCONSIN, THESE PROGRAMS MEET NATIONAL HEALTH EDUCATION STANDARDS AND WERE DEVELOPED USING EVIDENCE- BASED RESEARCH AND COMMUNITY INPUT. TOPICS INCLUDE BULLYING PREVENTION, SUBSTANCE USE AND MINDFULNESS. RESOURCES ARE DESIGNED TO SERVE CHILDREN IN GRADES K3 - 8, OFFERING INTERACTIVE AND EDUCATIONAL MATERIALS FOR TEACHERS, COUNSELORS, STUDENTS AND FAMILIES, AND TRULY IMPACTING THE CULTURE OF HEALTH ACROSS SCHOOL COMMUNITIES.ANTICIPATED IMPACT: PREVENTION, REDUCED STIGMA. THESE E-LEARNING RESOURCES CAN IMPROVE STUDENT AND STAFF KNOWLEDGE, EMPOWER STUDENTS AND FAMILIES, IMPROVE SCHOOL CLIMATE, REDUCE BEHAVIORAL DIFFICULTIES AND STRESSORS, INCREASE POSITIVE BEHAVIORS, AND REDUCE OFFICE REFERRALS AND SCHOOL SUSPENSION, IN TURN POSITIVELY INFLUENCING ATTENDANCE AND ACADEMIC PERFORMANCE. (CONTINUED ON PAGE 72)"

PART V, SECTION B, LINE 11 (CONTINUED):
MENTAL AND BEHAVIORAL HEALTH ADVOCACYCHILDREN'S IS COMMITTED TO ENSURING CHILDREN GET THE MENTAL AND BEHAVIORAL HEALTH CARE THEY NEED AND WORKS WITH POLICYMAKERS TO IMPROVE ACCESS, COVERAGE AND CARE. THE ISSUES WE HAVE SUPPORTED INCLUDE THE FOLLOWING: IMPROVING ACCESS TO SCHOOL-BASED MENTAL HEALTH CARE ACROSS THE STATE BY REDUCING BARRIERS AND INCREASING FUNDING; FUNDING FOR BULLYING PREVENTION PROGRAMMING TO HELP STUDENTS DEVELOP SKILLS TO COMBAT BULLYING AND BUILD INTERPERSONAL COMMUNICATION SKILLS; FUNDING TO SUPPORT THE CHILD PSYCHIATRY CONSULTATION PROGRAM (CPCP), WHICH HELPS CONNECT PROVIDERS ACROSS THE STATE TO PEDIATRIC MENTAL AND BEHAVIORAL HEALTH EXPERTS TO PROVIDE ENHANCED CARE AND RESOURCES TO THEIR PATIENTS; EFFORTS TO RECOGNIZE THE IMPORTANCE AND EFFECTIVENESS OF TRAUMA-INFORMED CARE FOR CHILDREN AND FAMILIES; INITIATIVES TO IMPROVE MENTAL AND BEHAVIORAL HEALTH CARE FOR KIDS IN OUT-OF-HOME CARE, AS WELL AS POLICIES TO OFFER ALTERNATIVE FAMILY TREATMENT COURTS FOR PARENTS WITH ISSUES RELATED TO MENTAL ILLNESS OR SUBSTANCE ABUSE; FEDERAL EFFORTS TO EXPAND FUNDING FOR BEHAVIORAL TELEHEALTH CARE, LIKE THE CPCP; FUNDING TO INCREASE THE PEDIATRIC MENTAL AND BEHAVIORAL HEALTH CARE WORKFORCE TO ENSURE WE HAVE ADEQUATE PROVIDERS SPECIALLY TRAINED TO CARE FOR KIDS.PRIORITY #4: VIOLENCETHE MILWAUKEE HEALTH CARE PARTNERSHIP COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED VIOLENCE AS MAJOR AREA OF CONCERN FOR BOTH COMMUNITY LEADERS AND COMMUNITY MEMBERS. OUR ASSESSMENT OF YOUTH IN MILWAUKEE COUNTY EMPHASIZED THEIR EXPOSURE TO AND EXPERIENCE OF VIOLENCE IN THREE AREAS: COMMUNITY VIOLENCE (INCLUDING GUNS, GANGS AND BULLYING), HUMAN TRAFFICKING AND CHILD MALTREATMENT (INCLUDING ABUSE AND NEGLECT). OUR PROGRAMS AND INITIATIVES THAT ADDRESS THE VIOLENCE PRIORITY FOLLOW:PROJECT UJIMAPROJECT UJIMA WORKS TO STOP THE CYCLE OF VIOLENT CRIMES BY REDUCING THE NUMBER OF REPEAT VICTIMS OF VIOLENCE THROUGH INDIVIDUAL, FAMILY AND COMMUNITY INTERVENTIONS AND PREVENTION STRATEGIES. THE PROGRAM'S KEY ELEMENTS INCLUDE HOSPITAL-BASED SERVICES (MEDICAL CARE, PEER SUPPORT, CRISIS INTERVENTION AND SOCIAL AND EMOTIONAL ASSESSMENT), HOME-BASED SERVICES (MEDICAL FOLLOW-UP OF INJURIES, EVALUATION OF PRIMARY HEALTH CARE NEEDS, PSYCHOLOGICAL SCREENING AND COUNSELING), COMMUNITY-BASED SERVICES (MENTORING, YOUTH DEVELOPMENT, FAMILY AND YOUTH SUPPORT GROUPS, GANG INTERVENTIONS, JOB PREPAREDNESS AND ADVOCACY TO ADDRESS LEGAL, EDUCATION AND HOUSING ISSUES), AND COMMUNITY AND PROFESSIONAL EDUCATION ABOUT YOUTH VIOLENCE. IN THE PAST TWO YEARS, THE PROGRAM HAS EXPANDED ITS SERVICES TO REDUCE AGE QUALIFIERS AND SERVE ALL CHILDREN AND HAS ESTABLISHED NEW MENTAL BEHAVIORAL HEALTH AND SOCIAL NEEDS ASSESSMENTS FOR BOTH THE FAMILY.ANTICIPATED IMPACT: PREVENTION. WE EXPECT TO MAINTAIN OUR CURRENT RECIDIVISM RATE OF LESS THAN 5 PERCENT FOR PROGRAM PARTICIPANTS.MILWAUKEE CHILD ADVOCACY CENTERCHILDREN'S CHILD ADVOCACY CENTERS (CAC) BRING TOGETHER MULTIDISCIPLINARY PARTNERS IN CHILD MALTREATMENT INVESTIGATIONS TO PROVIDE COMPREHENSIVE, ON-SITE MEDICAL, FORENSIC INTERVIEW AND ADVOCACY SERVICES FOR CHILDREN AND FAMILIES IN MILWAUKEE COUNTY. BY BRINGING TOGETHER PROFESSIONALS FROM LAW ENFORCEMENT, CRIMINAL JUSTICE, CHILD PROTECTIVE SERVICES, VICTIM ADVOCACY AGENCIES AND THE MEDICAL AND MENTAL HEALTH COMMUNITIES, CACS PROVIDE COMPREHENSIVE SERVICES FOR CHILD VICTIMS AND THEIR FAMILIES.ANTICIPATED IMPACT: PREVENTION, ACCESS TO CARE. THE CACS POSITIVELY IMPACT THE NUMBER OF CHILDREN AND FAMILIES BENEFITTING FROM A COMPREHENSIVE REVIEW, WHICH MINIMIZES TRAUMA AND HELPS TO BREAK THE CYCLE OF ABUSE AS WELL AS INCREASE PROSECUTION RATES FOR PERPETRATORS.PERIOD OF PURPLE CRYINGA PILOT PROJECT LAUNCHED IN 2016, PERIOD OF PURPLE CRYING IS AN EVIDENCE-BASED INFANT ABUSE PREVENTION PROGRAM THAT EDUCATES PARENTS AND CAREGIVERS ABOUT NORMAL INFANT CRYING AND THE DANGERS OF SHAKING AN INFANT. PARENTS AND CAREGIVERS ARE REACHED THROUGH CHILDREN'S WISCONSIN NEONATAL INTENSIVE CARE UNIT AND EMERGENCY ROOM, PRIMARY CARE CLINICS AND URGENT CARE LOCATIONS.ANTICIPATED IMPACT: PREVENTION. PERIOD OF PURPLE CRYING WILL INCREASE THE NUMBER OF FAMILIES THAT BENEFIT FROM ENHANCED KNOWLEDGE AND AWARENESS OF NORMAL INFANT CRYING, WHICH COULD REDUCE THE RATE OF INJURY FOR INFANTS.AWARENESS TO ACTIONTHIS STATEWIDE PROGRAM WILL BEGIN WORKING ACROSS MILWAUKEE COUNTY OVER THE NEXT THREE YEARS.AWARENESS TO ACTION EDUCATES AND ADVOCATES FOR ADULTS TO TAKE ACTION TO PREVENT CHILD SEXUAL ABUSE. EDUCATION INCLUDES RESOURCES FOR ADULTS ON HEALTHY SEXUAL DEVELOPMENT AND HOW TO DISCUSS SEXUAL DEVELOPMENT WITH CHILDREN.SCHOOL AND FAMILY E-LEARNING COURSES AND RESOURCES: ACT NOW!CHILDREN'S FUN AND ENGAGING E-LEARNING PROGRAMS INSPIRE STUDENTS AND THEIR FAMILIES TO LEAD HEALTHIER LIVES, BOTH PHYSICALLY AND EMOTIONALLY. OFFERED AT NO COST TO ALL SCHOOLS ACROSS WISCONSIN, THESE PROGRAMS MEET NATIONAL HEALTH EDUCATION STANDARDS AND WERE DEVELOPED USING EVIDENCE-BASED RESEARCH AND COMMUNITY INPUT. TOPICS INCLUDE BULLYING PREVENTION, SUBSTANCE USE AND MINDFULNESS. RESOURCES ARE DESIGNED TO SERVE CHILDREN IN GRADES K3 8, OFFERING INTERACTIVE AND EDUCATIONAL MATERIALS FOR TEACHERS, COUNSELORS, STUDENTS AND FAMILIES, AND TRULY IMPACTING THE CULTURE OF HEALTH ACROSS SCHOOL COMMUNITIES.ANTICIPATED IMPACT: PREVENTION, EMPOWERMENT. THESE E-LEARNING RESOURCES AND SERVICES CAN IMPROVE STUDENT AND STAFF KNOWLEDGE, EMPOWER STUDENTS AND FAMILIES, IMPROVE SCHOOL CLIMATE, REDUCE BEHAVIORAL DIFFICULTIES AND STRESSORS, INCREASE POSITIVE BEHAVIORS, AND REDUCE OFFICE REFERRALS AND SCHOOL SUSPENSION, IN TURN POSITIVELY INFLUENCING ATTENDANCE AND ACADEMIC PERFORMANCE.VIOLENCE PREVENTION ADVOCACYCHILDREN'S RECOGNIZES VIOLENCE AS A PUBLIC HEALTH EPIDEMIC WITH A DEVASTATING EFFECT ON THE CHILDREN AND FAMILIES OF WISCONSIN. CHILDREN'S ADVOCATES FOR A VARIETY OF LAWS, POLICIES AND FUNDING FOCUSED ON VIOLENCE PREVENTION, INCLUDING: FUNDING FOR BULLYING PREVENTION PROGRAMMING, HOME VISITING AND PARENT EDUCATION PROGRAMS, AND CHILD ABUSE AND NEGLECT PREVENTION, INVESTIGATION AND TREATMENT SERVICES; LEGISLATION TO FURTHER PROTECT CHILD VICTIMS OF SEXUAL ABUSE, TRAFFICKING AND DATING VIOLENCE; FUNDING FOR THE CHILD ABUSE PREVENTION AND TREATMENT ACT, AS WELL AS FOR ADDITIONAL FUNDING TO PROVIDE RESOURCES TO CARE PROVIDERS TO HELP IDENTIFY POTENTIAL PHYSICAL ABUSE IN INFANTS; POLICIES TO REDUCE CHILD AND YOUTH ACCESS FIREARMS, INCLUDING EFFORTS TO IMPROVE BACKGROUND CHECKS AND PROMOTE SAFE FIREARM STORAGE, AND USE OF OTHER SAFETY MECHANISMS TO BETTER PROTECT CHILDREN; ADDITIONAL FUNDING FOR U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION RESEARCH ON FIREARM-RELATED INJURIES AND FATALITIES.

PART I, LINE 3C:
"CHILDREN'S HOSPITAL OF WISCONSIN, INC. (""CHILDREN'S HOSPITAL"") USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY AT BOTH OF ITS HOSPITAL SITES. CHILDREN'S HOSPITAL IS DEDICATED TO ENSURING THAT PATIENTS RECEIVE ALL MEDICALLY NECESSARY CARE. IN FURTHERANCE OF THAT OBJECTIVE, CHILDREN'S HOSPITAL MAINTAINS A FINANCIAL ASSISTANCE POLICY (""FAP""), PURSUANT TO WHICH CHILDREN'S HOSPITAL PROVIDES DISCOUNTED OR FREE CARE TO PATIENTS WHO ARE UNINSURED OR OTHERWISE UNABLE TO PAY ALL OR A PORTION OF THEIR BILLED CHARGES. THE POLICY GENERALLY PROVIDES THAT ELIGIBILITY IS DETERMINED BASED ON HOUSEHOLD INCOME AND FAMILY SIZE, AND SPECIFICALLY INCORPORATES CRITERIA SET FORTH UNDER THE FEDERAL POVERTY GUIDELINES."

PART I, LINE 6A:
"CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (""CHHS""), THE SOLE CORPORATE MEMBER OF CHILDREN'S HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF BOTH OF THE HOSPITALS AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON CHILDREN'S HOSPITAL'S WEBSITE OR UPON REQUEST."

PART I, LINE 7:
CHILDREN'S HOSPITAL USED A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, TO CALCULATE THE AMOUNTS REPORTED IN LINES 7A AND 7B FOR CHARITY CARE AT COST AND UNREIMBURSED MEDICAID. FOR LINES 7E, 7F, 7G, 7H, AND 7I, THE HOSPITAL USED COSTS FROM ITS ACCOUNTING SYSTEM. FOR LINE 7G, THE COSTS FROM THE ACCOUNTING SYSTEM WERE ADJUSTED FOR MEDICAID AND CHARITY CARE PATIENTS, AS THE COST RELATED TO THESE PATIENTS WAS TAKEN INTO ACCOUNT IN LINES 7A AND 7B. THE WISCONSIN MEDICAID PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED OR UNDERINSURED. HOSPITAL REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND THE AVAILABILITY OF STATE AID AND TO ASSIST THEM IN ENROLLING IN THE PROGRAM THAT PROVIDES THE PATIENT WITH THE GREATEST BENEFIT. FOR THAT REASON, THE AMOUNT OF CHARITY CARE RENDERED BY THE HOSPITAL IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION.

PART I, LINE 7G:
"CHILDREN'S HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7G $9,208,133 PAID TO CHILDREN'S MEDICAL GROUP, INC. (""CMG""), WHICH IS A SECTION 501(C)(3) ORGANIZATION AND AN AFFILIATE OF THE HOSPITAL THAT PROVIDES PRIMARY CARE PHYSICIAN SERVICES IN SOUTHEASTERN WISCONSIN. THE PAYMENTS WERE MADE TO SUBSIDIZE CMG CLINICS WITHIN MILWAUKEE COUNTY THAT PROVIDE PRIMARY CARE PRIMARILY TO CHILDREN ENROLLED IN THE WISCONSIN MEDICAID PROGRAM OR WHO ARE UNINSURED."

PART II, COMMUNITY BUILDING ACTIVITIES:
CHILDREN'S HOSPITAL'S COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS FOR CHILDREN, SUCH AS POVERTY AND ENVIRONMENTAL ISSUES. THESE COMMUNITY-BUILDING ACTIVITIES INCLUDE STAFF PARTICIPATION ON COMMUNITY BOARDS, COALITIONS AND/OR COMMITTEES THAT ASSIST IN IMPROVING THE HEALTH OF THE COMMUNITY. CHILDREN'S HOSPITAL'S PARENT ORGANIZATION, CHHS, ALSO PERFORMS COMMUNITY-BUILDING ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT ADVOCACY, WHICH ARE FURTHER DISCUSSED IN SCHEDULE H PART VI, LINE 6.

PART III, LINE 2:
THE AMOUNT REPORTED IN PART III, SECTION A, LINE 2 IS CHILDREN'S HOSPITAL'S BAD DEBT EXPENSE INCLUDED AS A REDUCTION OF PATIENT REVENUE, AND IS THE SUM OF ALL OF THE UNCOLLECTED PATIENT ACCOUNT BALANCES SENT TO THIRD PARTY COLLECTIONS, REDUCED BY ACTUAL RECOVERIES, REDUCED BY ANY ACCOUNTS RETURNED TO THE HOSPITAL BY THE THIRD PARTY COLLECTION AGENCY, AND INCREASED BY AN ESTIMATE FOR UNCOLLECTIBLE ACCOUNTS WHEN APPLICABLE. THE AMOUNT DOES NOT INCLUDE DISCOUNTS PROVIDED UNDER THE HOSPITAL'S FAP, INCLUDING DISCOUNTS PROVIDED TO SELF-PAY ACCOUNTS, WHICH ARE ALSO REPORTED AS A REDUCTION OF PATIENT REVENUE.

PART III, LINE 4:
CHILDREN'S HOSPITAL'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. SEE PAGES 26-28 OF THE ATTACHED FINANCIAL STATEMENTS.

PART III, LINE 8:
CHILDREN'S HOSPITAL USED ITS FILED MEDICARE COST REPORT TO OBTAIN THE MEDICARE ALLOWABLE COST REPORTED ON PART III, SECTION B. THE YEARLY INTERIM RATE ADJUSTMENTS WERE MORE THAN ADEQUATE FOR THE FISCAL YEAR.

PART III, LINE 9B:
AT ALL LOCATIONS, CHILDREN'S HOSPITAL UNDERTAKES EXTENSIVE MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, CHILDREN'S HOSPITAL AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE MEDICAID PROGRAM. IN CASES WHERE MEDICAID COVERAGE IS NOT AVAILABLE, CHILDREN'S HOSPITAL SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER CHILDREN'S HOSPITAL'S FAP. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, HOSPITAL PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES; SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNTS DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS' ELIGIBILITY FOR FINANCIAL ASSISTANCE CANNOT BE DETERMINED DUE TO THE INACCESSIBILITY OF THE FAMILY, OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION. IN SUCH CASES, CHILDREN'S HOSPITAL FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS IN AN EFFORT TO REACH THE FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ACCOUNTS ARE SENT TO COLLECTIONS ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN WITHOUT SUCCESS.

PART VI, LINE 4:
CHILDREN'S HOSPITAL PROVIDES CARE TO CHILDREN FROM URBAN, RURAL, AND SUBURBAN AREAS, REGARDLESS OF RACE, GENDER, SEXUAL ORIENTATION, ETHNICITY, INCOME, DISABILITY OR COUNTRY OF ORIGIN. CHILDREN'S HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE PRIMARILY TO CHILDREN FROM SOUTHEASTERN WISCONSIN, BUT TREATS PATIENTS FROM THE ENTIRE STATE OF WISCONSIN AND THROUGHOUT THE UNITED STATES. APPROXIMATELY HALF OF CHILDREN'S HOSPITAL'S PATIENTS ARE MEDICAID BENEFICIARIES, AND IN 2021 APPROXIMATELY HALF OF GROSS CHARGES WERE FROM PATIENTS ENROLLED IN MEDICAID.

PART VI, LINE 5:
CHILDREN'S HOSPITAL PROMOTES THE HEALTH AND SAFETY OF CHILDREN LOCATED THROUGHOUT ITS SERVICE AREA. CHILDREN'S HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. CHILDREN'S HOSPITAL'S BOARD OF DIRECTORS CONSISTS OF INDIVIDUALS REPRESENTING THE COMMUNITY. CHILDREN'S HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AT BOTH HOSPITAL SITES, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTH CARE PROFESSIONALS, AS SET FORTH IN THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS. CHILDREN'S HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. IN THESE AND OTHER RESPECTS, CHILDREN'S HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). CHILDREN'S HOSPITAL OFFERS SPECIALTY CLINICS THAT ARE COMFORTABLE AND ACCESSIBLE TO FAMILIES. IN MILWAUKEE, CHILDREN'S HOSPITAL OFFERS CLINICS THROUGHOUT THE METROPOLITAN AREA. FAMILIES MAY ALSO ACCESS SERVICES IN THE FOX VALLEY, GREEN BAY, NEW BERLIN, MEQUON, DELAFIELD AND KENOSHA AREAS. IN RESPONSE TO FEEDBACK FROM THE COMMUNITY GAINED THROUGH LISTENING SESSIONS, CHILDREN'S HOSPITAL, THROUGH ITS AFFILIATE, CHILDREN'S MEDICAL GROUP, HAS ADDED CLINICS IN AREAS OF MILWAUKEE PREVIOUSLY LACKING PEDIATRIC PRIMARY CARE PROVIDERS.DURING THE COVID-19 PANDEMIC, CHILDREN'S PIVOTED TO PROVIDE THE CARE KIDS AND FAMILIES NEED AS SAFELY AS POSSIBLE. THIS INCLUDED A SIGNIFICANT INCREASE IN USE OF TELEHEALTH (INCLUDING FOR MENTAL AND BEHAVIORAL HEALTH NEEDS) AND SUPPORTING OUR COMMUNITY THROUGH TESTING, VACCINATION AND PEDIATRIC HEALTH AND SAFETY ADVICE AND RECOMMENDATIONS.CHILDREN'S SCHOOL NURSE PROGRAM PROVIDES HEALTH CARE SERVICES IN 11 K-8 MILWAUKEE PUBLIC SCHOOLS AT NO COST TO MPS OR TO STUDENTS AND FAMILIES. IN THE 2021-22 SCHOOL YEAR, THE SCHOOL NURSE PROGRAM COMPLETED OVER 8,078 HEALTH ROOM VISITS. THE NURSES ADVOCATE FOR A COLLABORATIVE AND HOLISTIC APPROACH TO ADDRESS THE PHYSICAL, MENTAL, AND SOCIAL-EMOTIONAL WELL-BEING NEEDS OF STUDENTS. THE SCHOOL NURSES ALSO WORK CLOSELY WITH CHILDREN'S COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS ON POPULATION-BASED CARE, OUTREACH, AND ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH. THEY BRING PROVIDERS, FAMILIES, AND SCHOOL SUPPORT STAFF TOGETHER TO ADDRESS AND IMPROVE THE HEALTH AND WELLNESS OF THE STUDENTS THEY CARE FOR ON A DAILY BASIS. THE SCHOOL NURSES' ROLE ENCOMPASSES DELIVERING PREVENTIVE AND SCREENING SERVICES; ESTABLISHING MEDICAL AND DENTAL HOMES; BEHAVIORAL ASSESSMENT; DISEASE SURVEILLANCE AND REPORTING; CHRONIC DISEASE MANAGEMENT; SCHOOL SAFETY AND EMERGENCY PREPAREDNESS; PROVIDING HEALTH EDUCATION; AND DAILY CARE COORDINATION INCLUDING MEDICATION ADMINISTRATION, G-TUBE FEEDINGS AND OTHER COMPLEX HEALTH PROCEDURES ONLY A HEALTH CARE PROVIDER CAN ADMINISTER. AN INCREASING NUMBER OF STUDENTS ARE ENTERING SCHOOLS EACH YEAR WITH SPECIAL NEEDS AND COMPLEX HEALTH CONDITIONS (ATTENTION-DEFICIT/ HYPERACTIVITY DISORDER, DIABETES, LIFE-THREATENING ALLERGIES, ASTHMA, AND SEIZURES) THAT REQUIRE EXTENSIVE INTERVENTION AND COORDINATION THROUGHOUT THE SCHOOL DAY TO KEEP KIDS HEALTHY AND IN THE CLASSROOM LEARNING. FOR CHRONIC ILLNESSES SUCH AS ASTHMA, DIABETES, SEIZURES OR SICKLE CELL ANEMIA, THE SCHOOL NURSES WORK WITH PARENTS AND FAMILIES TO CREATE CARE PLANS HELPING GUIDE THE STUDENTS TO SELF-MANAGEMENT BY THE TIME THEY REACH HIGH SCHOOL, WITH A GOAL OF DECREASED URGENT CARE AND EMERGENCY DEPARTMENT VISITS AND INCREASED UTILIZATION OF PRIMARY CARE PROVIDERS. ADDITIONALLY, THE NURSES HELP FAMILIES' ACCESS COMMUNITY RESOURCES AND COORDINATE CARE WITH SOCIAL WORKERS AND SPECIALTY SERVICE PROVIDERS, INCLUDING BEHAVIORAL HEALTH, FOR FAMILIES WITH IDENTIFIED NEEDS AND EDUCATE STUDENTS AND FAMILIES REGARDING THE IMPORTANCE OF PREVENTIVE CARE AND A HOST OF OTHER HEALTH TOPICS, SUCH AS ANGER MANAGEMENT, DRUGS AND ALCOHOL, HUMAN GROWTH AND DEVELOPMENT, HYGIENE, NUTRITION, AND STRESS. DURING THE 2021-22 SCHOOL YEAR, CHILDREN'S SCHOOL NURSE PROGRAM CARED FOR MORE THAN 4,195 STUDENTS WHO MIGHT OTHERWISE NOT HAVE ACCESS TO HEALTH CARE.CHILDREN'S HOSPITAL OFFERS MANY OPTIONS FOR FAMILIES WHO NEED ACCESS TO MENTAL HEALTH PROVIDERS. THE HOSPITAL OFFERS PSYCHIATRISTS, PSYCHOLOGISTS, NEUROPSYCHOLOGISTS, PSYCHOTHERAPISTS AND NURSE PRACTITIONERS WHO PROVIDE MENTAL HEALTH DIAGNOSIS AND TREATMENT FOR A VARIETY OF DISORDERS. COUNSELORS WORK WITH CHILDREN AND FAMILIES TO ADDRESS SOCIAL AND EMOTIONAL DIFFICULTIES AND STRENGTHEN FAMILY TIES. CHILDREN'S ALSO PROVIDES SCHOOL-BASED MENTAL AND BEHAVIORAL HEALTH SERVICES IN MORE THAN 67 SCHOOLS THROUGHOUT THE STATE, PLACING CHILD AND FAMILY THERAPISTS IN THE SCHOOL SETTING TO HELP REDUCE BARRIERS TO CARE. TO HELP FURTHER ADDRESS THE INCREASING NEED FOR MENTAL HEALTH SERVICES FOR KIDS AND TEENS IN WISCONSIN, CHILDREN'S HAS LAUNCHED SHINE THROUGH, A FIVE-YEAR AWARENESS CAMPAIGN TO HELP ADDRESS THE MENTAL AND BEHAVIORAL HEALTH CHALLENGES OF KIDS. THE PRIMARY GOALS OF THE AWARENESS CAMPAIGN ARE (1) TO DETECT MENTAL HEALTH NEEDS SOONER, (2) IMPROVE ACCESS TO SERVICES AND (3) REDUCE THE STIGMA AROUND THE ILLNESS. A MENTAL HEALTH WALK-IN CLINIC OPENED IN MARCH 2022 THAT PROVIDES SAME-DAY CARE FOR CHILDREN AND TEENS (AGES 5-18) WHO ARE EXPERIENCING URGENT MENTAL HEALTH ISSUES. THE CLINIC IS DESIGNED TO OFFER AN ALTERNATIVE TO TRADITIONAL URGENT CARE AND EMERGENCY ROOM SERVICES.CHILDREN'S HOSPITAL ALSO OFFERS PROGRAMS TO EDUCATE CHILDREN AND FAMILIES REGARDING A WIDE RANGE OF ISSUES IMPACTING THE HEALTH AND SAFETY OF CHILDREN. RESOURCES AND PROGRAMS ARE AVAILABLE FOR CHILDREN, PARENTS, TEACHERS AND CAREGIVERS TO HELP KEEP WISCONSIN'S CHILDREN HEALTHY AND SAFE. ONLINE LEARNING PROGRAMS ARE A RESOURCE FOR TEACHERS TO USE IN THEIR CLASSROOMS TO DELIVER AN OUTCOMES-BASED HEALTH CURRICULUM TO STUDENTS IN GRADE K5-8. THE INJURY PREVENTION TEAM OFFERS COMMUNITY-BASED EDUCATIONAL EVENTS INCLUDING BIKE HELMET FITTINGS AND CAR SEAT CHECKS. THEY ALSO DELIVER IMPORTANT FIRE PROTECTION AND PEDESTRIAN SAFETY EDUCATION THROUGHOUT WISCONSIN. CHILDREN'S ALSO DEVELOPED CROSSROADS, A TEEN DRIVING PROGRAM DESIGNED TO IMPROVE SAFETY FOR TEENS ON WISCONSIN'S ROADS.IN 2021, CHILDREN'S HOSPITAL CONTINUED ITS PARTNERSHIP WITH KOHL'S CORPORATION TO OFFER MISSION: HEALTHY KIDS. THIS PROGRAM PROVIDES FREE RESOURCES TO FAMILIES AND EDUCATORS TO HELP RAISE AWARENESS ABOUT THE IMPACT OF NUTRITION AND PHYSICAL ACTIVITY ON CHILDREN'S DEVELOPMENT AND WELL-BEING. CHILDREN'S HOSPITAL'S CAR SEAT CLINIC IS A COLLABORATION BETWEEN CHILDREN'S HOSPITAL, ITS INJURY PREVENTION PROGRAM, SAFE KIDS WISCONSIN COALITION AND SAFE KIDS SOUTHEAST WISCONSIN COALITION. IT OFFERS CAR SEAT CLINICS WHERE TRAINED CHILD PASSENGER SAFETY TECHNICIANS ENSURE THAT INFANT AND TODDLER CAR SEATS AND BOOSTER SEATS ARE INSTALLED CORRECTLY AND ARE APPROPRIATE FOR THE AGE AND SIZE OF THE CHILDREN USING THEM. THE PROGRAM ALSO PROVIDES LOW-COST OR FREE CAR OR BOOSTER SEATS FOR FAMILIES IN NEED. DUE TO THE COVID-19 PANDEMIC, THE TEAM TRANSITIONED TO OFFERING VIRTUAL CAR EAT VISITS. THESE VIDEO MEETINGS ALLOW CAREGIVERS TO GET ONE-ON-ONE INSTALLATION SUPPORT THROUGH ZOOM WHILE STAYING SAFE IN THE COMFORT OF THEIR HOME. THE WISCONSIN POISON CENTER, WHICH IS STAFFED BY REGISTERED NURSES SUPPORTED BY PHYSICIAN TOXICOLOGISTS 24 HOURS A DAY, 365 DAYS A YEAR, PROVIDES IMMEDIATE AND AUTHORITATIVE PHONE CONSULTATION IN CASES OF ACCIDENTAL OR INTENTIONAL POISONING IN ADULTS AND CHILDREN FOR PATIENTS AND HOSPITALS ACROSS WISCONSIN. THE CENTER ALSO HAS A VARIETY OF PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS ALERTING PEOPLE TO SPECIFIC TOXIC DANGERS. THESE INCLUDE HOSPITAL GRAND ROUNDS LECTURES FOR PHYSICIANS, TRAINING FOR EMERGENCY MEDICAL TECHNICIANS, BABY-SITTER WORKSHOPS, AND PRESCHOOL POISON PREVENTION EDUCATION. THE POISON CENTER ALSO TRIAGES CALLS FOR MPOWER, AN ALCOHOL AND DRUG CRISIS LINE FOR TEENS. PROJECT ADAM (AUTOMATIC DEFIBRILLATORS IN ADAM'S MEMORY) IS A PROGRAM COMMITTED TO MAKING AUTOMATED EXTERNAL DEFIBRILLATORS UNIVERSALLY AVAILABLE TO ALL CHILDREN AND ADOLESCENTS BY BEING A NATIONAL RESOURCE FOR IMPLEMENTING PEDIATRIC PUBLIC ACCESS DEFIBRILLATION PROGRAMS IN SCHOOLS. IT IS ALSO WORKING TOWARD ERADICATING SUDDEN CARDIAC DEATH IN CHILDREN THROUGH EDUCATION AND PREVENTION INITIATIVES. SINCE THE PROGRAM BEGAN, THE HOSPITAL HAS CELEBRATED MORE THAN 200 LIVES SAVED THROUGH PROJECT ADAM. (CONTINUED ON PAGE 95)

PART VI, LINE 6:
CHILDREN'S HOSPITAL IS PART OF AN AFFILIATED GROUP OF ORGANIZATIONS UNDER THE CONTROL OF CHHS, WHICH PROVIDES VARIOUS CENTRALIZED ADMINISTRATIVE AND SUPPORTING SERVICES FOR THE HOSPITAL AND ITS AFFILIATES. AMONG THE AFFILIATED ENTITIES, THE HOSPITAL AND CERTAIN OTHER ENTITIES (INCLUDING CHILDREN'S MEDICAL GROUP, INC.) DIRECTLY PROVIDE PROFESSIONAL PEDIATRIC HEALTH CARE SERVICES IN A VARIETY OF ACCESSIBLE LOCATIONS THROUGHOUT WISCONSIN.CHILDREN'S HOSPITAL OPERATES A LARGE CLINIC IN NORTHWEST MILWAUKEE. THE MIDTOWN CLINIC IS LOCATED IN A NEIGHBORHOOD WITH FEW PEDIATRIC HEALTH CARE OPTIONS AND A LARGE POPULATION OF CHILDREN. THE CLINIC OFFERS PEDIATRIC AND ADOLESCENT PRIMARY CARE, BEHAVIORAL MEDICINE AND DENTAL CARE IN AN ENGAGING SPACE WITH STATE-OF-THE-ART TECHNOLOGY AND AMENITIES DESIGNED SPECIFICALLY FOR PEDIATRIC PATIENTS AND THEIR FAMILIES. BY OFFERING MULTIPLE SERVICES UNDER ONE ROOF IN A PATIENT-CENTERED MEDICAL HOME MODEL, CARE IS MORE EFFICIENT, COORDINATED AND ACCESSIBLE. THIS CLINIC HAD 16,531 PRIMARY CARE VISITS AND 6,839 DENTAL VISITS IN 2021 AND 92 PERCENT OF THE CHILDREN SEEN WERE INSURED BY MEDICAID.CHILDREN'S HOSPITAL ALSO HAS PARTNERED WITH LOCAL AGENCIES TO OPEN COMMUNITY CLINICS IN OTHER UNDERSERVED MILWAUKEE NEIGHBORHOODS. THESE CLINICS SERVE PEDIATRIC PATIENTS FROM BIRTH TO 19 YEARS OF AGE. THE CLINICS ARE STAFFED BY NURSE PRACTITIONERS AND ARE LOCATED IN AREAS THAT HISTORICALLY HAVE LARGE HEALTH CARE DISPARITIES AND FEW HEALTH CARE OPTIONS. THE CLINICS PROVIDE EASIER ACCESS TO HEALTH CARE FOR PATIENTS IN THESE NEIGHBORHOODS, ENSURING ALL CHILDREN HAVE THE NECESSARY SERVICES TO BE HEALTHY AND SAFE. THE CLINICS HAD 76 VISITS IN 2021 AND 85 PERCENT OF THE CHILDREN SEEN WERE INSURED BY MEDICAID. ANOTHER CLINIC IS LOCATED ON THE NEXT DOOR FOUNDATION CAMPUS IN MILWAUKEE'S CENTRAL CITY. IT PROVIDES PRIMARY CARE, DENTAL CARE AND MENTAL HEALTH CARE IN AN AREA THAT PREVIOUSLY DID NOT HAVE PEDIATRIC PRACTICES AVAILABLE TO ATTEND TO THE COMMUNITY'S NEEDS. THIS CLINIC HAD 3,089 PRIMARY CARE VISITS AND 3,530 DENTAL VISITS IN 2021. IN JUNE 2022, CHILDREN'S OPENED A NEW CLINIC ON MILWAUKEE'S SOUTH SIDE. THE FOREST HOME CLINIC PROVIDES A VARIETY OF PRIMARY AND SPECIALTY CARE, DENTAL CARE, MENTAL HEALTH CARE, IMAGING AND URGENT CARE SERVICES.ANOTHER AFFILIATE OF CHILDREN'S HOSPITAL IS CHILDREN'S SERVICE SOCIETY OF WISCONSIN, DOING BUSINESS AS CHILDREN'S HOSPITAL OF WISCONSIN COMMUNITY SERVICES (CHW COMMUNITY SERVICES). THIS SOCIAL SERVICE ORGANIZATION ADDRESSES THE CHALLENGES FACED BY CHILDREN, WHICH OFTEN DIRECTLY IMPACT THEIR PHYSICAL AND MENTAL HEALTH AND WELL-BEING. CHILDREN'S COMMUNITY SERVICES OFFERS CHILD WELL-BEING SERVICES IN FOUR CORE AREAS (PUBLIC CHILD WELFARE, CHILD AND FAMILY COUNSELING, OUT-OF-HOME CARE AND PREVENTION SERVICES) FROM LOCATIONS THROUGHOUT WISCONSIN. SERVICES INCLUDE: FINDING LOVING, STABLE HOMES FOR CHILDREN IN NEED OF A FAMILY THROUGH FOSTER CARE AND ADOPTION; REDUCING STRESS AND CONFLICT, ENHANCING PARENTING SKILLS AND STRENGTHENING FAMILY TIES THROUGH TRAUMA-INFORMED MENTAL HEALTH SERVICES COUNSELING; PROVIDING SERVICES TO CHILDREN IN OUT-OF-HOME CARE, ADVOCATING FOR THEIR SAFETY, WELL-BEING AND TIMELY REUNIFICATION WITH BIRTHPARENTS WHENEVER POSSIBLE; PROVIDING FOSTER PARENTS WHO ARE CARING FOR CHILDREN WITH SPECIAL MEDICAL OR EMOTIONAL NEEDS WITH A MUCH NEEDED BREAK THROUGH A RESPITE CARE PROGRAM; OFFERING FREE, CONFIDENTIAL AND SUPPORTIVE GUIDANCE TO HELP PARENTS DEALING WITH AN UNPLANNED PREGNANCY; PROVIDING INTENSIVE IN-HOME THERAPY TO KEEP CHILDREN SAFE IN THEIR HOMES AND PREVENT OUT-OF-HOME PLACEMENT; ASSISTING YOUNG ADULTS TRANSITIONING OUT OF FOSTER CARE BY GIVING THEM THE SKILLS, TRAINING, GUIDANCE AND SUPPORT ENABLING THEM TO MAKE IT ON THEIR OWN; PROVIDING PARENTS WITH SUPPORT AND GUIDANCE TO HELP THEM BE THE BEST PARENTS THEY CAN BE; AND PROVIDING CHILDREN WHO HAVE BEEN HARMED OR HURT A SAFE PLACE TO GO TO BE INTERVIEWED AND PROVIDING THEM RESOURCES TO HELP THEM HEAL.COMMUNITY SERVICES ALSO RUNS PROJECT UJIMA, A PROGRAM THAT PROVIDES CASE MANAGEMENT, EMOTIONAL SUPPORT AND RESOURCES TO FAMILIES WHOSE CHILDREN HAVE EXPERIENCED INTERPERSONAL COMMUNITY-BASED VIOLENCE OR WHO HAVE LOST A FAMILY MEMBER (OF ANY AGE) TO HOMICIDE IN MILWAUKEE COUNTY.CHHS ENGAGES IN COMMUNITY HEALTH IMPROVEMENT ADVOCACY ON BEHALF OF CHILDREN'S WISCONSIN AND ITS AFFILIATES AT THE LOCAL, STATE AND FEDERAL LEVELS OF GOVERNMENT. IN 2021, ADVOCACY AND POLICY WORK ACROSS THE LOCAL, STATE AND FEDERAL SPECTRUMS CONTINUED TO FOCUS ON THE COVID-19 PANDEMIC AND ITS MANY EFFECTS, ALONG WITH OTHER CHILD AND FAMILY HEALTH AND WELL-BEING ISSUES.ON THE FEDERAL LEVEL IN 2021, CHILDREN'S ADVOCATED FOR COVID-19 PROVIDER RELIEF, MEDICAID AND CHILD HEALTH PRIORITIES IN THE BUILD BACK BETTER LEGISLATION, THE CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION PROGRAM, WHICH SUPPORTS THE TRAINING OF THE MAJORITY OF U.S. PEDIATRIC PRIMARY AND SPECIALTY PHYSICIANS AND VIOLENCE PREVENTION FUNDING. A KEY PRIORITY HAS BEEN INCREASING ACCESS TO KIDS' MENTAL AND BEHAVIORAL HEALTH CARE THROUGH VARIOUS LEGISLATION, NATIONAL AWARENESS CAMPAIGNS AND MORE. CHILDREN'S CONTINUES TO PARTICIPATE IN THE COALITION FOR PEDIATRIC MEDICAL RESEARCH WHICH WORKED ON LEGISLATION TO PROVIDE GRANTS TO SUPPORT EARLY-CAREER PEDIATRIC RESEARCHERS AT THE NIH. CHILDREN'S WORKED TO SECURE COMMUNITY-DIRECTED FUNDING DIRECTLY TO CHILDREN'S INCLUDING TWO SCHOOL-BASED MENTAL HEALTH PROGRAMS, THE VIOLENCE INTERVENTION PROGRAM PROJECT UJIMA, AND CHILDREN'S RESEARCH INSTITUTE FOR EQUIPMENT. CHILDREN'S ALSO SUPPORTED PARTNER ORGANIZATIONS IN THEIR REQUEST FOR FUNDING FOR THE MENTAL HEALTH EMERGENCY CENTER AND SOJOURNER FAMILY PEACE CENTER. IN ADDITION, CHILDREN'S CONTINUED TO ADVOCATE FOR PROPOSALS TO INCREASE ACCESS TO VACCINES, EXTEND POSTPARTUM MEDICAID COVERAGE, IMPLEMENT MORE COMPREHENSIVE BACKGROUND CHECKS FOR FIREARM SALES, ADDRESS CHILD POVERTY AND MORE. ON THE REGULATORY SIDE, CHILDREN'S ENGAGED ON EFFORTS RELATED TO BILLING, TELEHEALTH AND MEDICAID. ON THE STATE LEVEL, CHILDREN'S ADVOCATED FOR STATE FUNDING IN THE BIENNIAL STATE BUDGET TO SUPPORT THE MEDICAID AND DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAMS, INCREASING ACCESS TO YOUTH MENTAL AND BEHAVIORAL HEALTH THROUGH SCHOOL-BASED GRANTS AND WORKFORCE INITIATIVES, SUPPORT FOR CHILDREN'S CHILD-FOCUSED ADOPTION SERVICES, HOME VISITING PROGRAMS, EXTENDING POSTPARTUM MEDICAID COVERAGE AND REIMBURSEMENT INCREASES FOR FOSTER/KINSHIP CARE, MENTAL HEALTH AND DENTAL PROVIDERS, AMONG OTHER ISSUES. CHILDREN'S CONTINUED TO ADVOCATE WITH THE STATE ON COVID-19 RELIEF AND RESPONSE EFFORTS, INCLUDING ON VACCINATIONS, AMERICAN RESCUE PLAN ACT FUNDING AND MORE. WE ALSO ADVOCATED WITH PARTNER ORGANIZATIONS FOR STATE LEGISLATION IN SUPPORT OF INCREASING THE AGE TO PURCHASE TOBACCO AND VAPING PRODUCTS FROM 18 TO 21, PROVIDING INFORMATION TO STUDENT ATHLETES ABOUT SUDDEN CARDIAC ARREST AND ADDRESSING INSURANCE-MANDATED PROCESSES FOR CLINICIAN-ADMINISTERED DRUGS, AMONG OTHERS. CHILDREN'S ALSO WORKED CLOSELY WITH PARTNERS ON GENERAL VACCINE MESSAGING. AT THE LOCAL LEVEL, CHILDREN'S ADVOCATED FOR USE OF AMERICAN RESCUE PLAN ACT FUNDING ON CHILD HEALTH AND WELL-BEING ISSUES INCLUDING LEAD POISONING PREVENTION, VIOLENCE PREVENTION, SOJOURNER FAMILY PEACE CENTER CRISIS SUPPORT, FOOD INSECURITY AND BACK-TO-SCHOOL SUPPORT. CHILDREN'S CONTINUED TO PARTNER WITH THE CITY OF MILWAUKEE HEALTH DEPARTMENT TO PROVIDE FLU AND COVID-19 VACCINES THROUGHOUT 2021. ALONG WITH PARTNERS, CHILDREN'S SUPPORTED A REQUEST OF CITY AND COUNTY OFFICIALS TO INVEST IN THE MILWAUKEE MARKET MATCH PROGRAM WHICH PROVIDES FRUIT AND VEGETABLE INCENTIVES FOR THOSE USING SNAP AT FARMER'S MARKETS. CHILDREN'S CONTINUES TO ENGAGE WITH THE MILWAUKEE HEALTH CARE PARTNERSHIP ON OUR SHARED HEALTH SYSTEM PRIORITIES.CHILDREN'S OFFERS OPPORTUNITIES TO TAKE GRASSROOTS ACTION THROUGH CHILDREN'S ADVOCACY NETWORK (CAN). CAN ADVOCATES TAKE ACTION ON IMPORTANT HEALTH AND WELL-BEING TOPICS TO HELP RAISE COLLECTIVE VOICES ON BEHALF OF THE KIDS AND FAMILIES CHILDREN'S SERVES. CHILDREN'S PROVIDED VIRTUAL ADVOCACY TRAINING AND RESOURCES TO PEDIATRIC RESIDENTS AND HELD VIRTUAL MEETINGS WITH SEVERAL LAWMAKERS TO LEARN ABOUT OUR CARE AND SERVICES, INCLUDING AN IN-PERSON VISIT FROM THE FIRST LADY, SECOND GENTLEMAN AND THE U.S. SURGEON GENERAL. ADDITIONALLY, CHILDREN'S PARTICIPATED IN TWO VIRTUAL LOBBY DAYS ONE WITH THE WISCONSIN HOSPITAL ASSOCIATION AND ONE WITH THE CHILDREN'S HOSPITAL ASSOCIATION WHICH FEATURED THREE CHILDREN'S PATIENT FAMILIES WHO ADVOCATED ON THE IMPORTANCE OF KIDS' MENTAL AND BEHAVIORAL HEALTH. THESE EVENTS OFFER OUR PATIENT FAMILIES, LEADERS, STAFF, BOARD MEMBERS, PROVIDERS AND COMMUNITY MEMBERS WITH OPPORTUNITIES TO STAY INFORMED AND ENGAGE IN IMPORTANT CHILD HEALTH POLICY CONVERSATIONS. (CONTINUED ON PAGE 93)

PART VI, LINE 2:
IN MILWAUKEE AND THE FOX VALLEY COMMUNITIES, THE HOSPITALS, IN COLLABORATION WITH A TEAM OF OTHER HOSPITAL SYSTEMS, HEALTH CARE PROVIDERS, COMMUNITY AGENCIES, LOCAL PUBLIC HEALTH DEPARTMENTS, COMMUNITY STAKEHOLDERS OR OTHER HEALTH PROFESSIONALS, HAS DEVELOPED A COMMUNITY NEEDS ASSESSMENT SURVEY TO ASSESS THE NEEDS OF THE COMMUNITY. THE ASSESSMENTS ARE REFLECTIVE OF INPUT GATHERED IN SURVEYS, BOTH INDIVIDUAL INTERVIEWS AND SMALL FOCUS GROUPS, AS WELL AS PRIMARY AND SECONDARY DATA ANALYSIS. IN ADDITION, CHW-MILWAUKEE CONDUCTED A THOROUGH REVIEW OF ADDITIONAL SECONDARY DATA SUCH AS THE WISCONSIN FAMILY HEALTH SURVEY, COUNTY HEALTH RANKING REPORT AND THE WISCONSIN HEALTHIEST PEOPLE 2020 TO ASSESS THE NEEDS OF THE COMMUNITY. THE SECONDARY DATA ALLOWED FOR CHILDREN'S TO GAIN A DEEPER UNDERSTANDING OF THE IDENTIFIED COMMUNITY HEALTH ISSUES SPECIFICALLY RELATED TO A PEDIATRIC POPULATION.

PART VI, LINE 3:
AS INDICATED ABOVE, CHILDREN'S HOSPITAL WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF WISCONSIN, AND WHERE APPROPRIATE, FEDERAL PROGRAMS. WHEN SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER CHILDREN'S HOSPITAL'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON CHILDREN'S HOSPITAL'S WEBSITE, MYCHART AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENTS' FAMILIES. A PLAIN LANGUAGE SUMMARY IS AVAILABLE IN WAITING AREAS AND PROVIDED TO ANY PATIENT WITH A SCHEDULED ADMISSION. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND CHILDREN'S HOSPITAL'S TRAINED FINANCIAL SERVICES COUNSELORS AND SOCIAL WORKERS. CHILDREN'S HOSPITAL MAKES EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED.

PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM (CONTINUED)
IN ADDITION TO ADVOCACY, THE CHILDREN'S COMMUNITY SERVICES DIVISION HAS INITIATED A COMMUNITY-BASED EFFORT TO IMPROVE CHILD HEALTH THAT ACKNOWLEDGES THE INFLUENCE OF SOCIAL, CULTURAL AND ENVIRONMENTAL FACTORS ON HEALTH AND RECOGNIZES THAT SUCH INFLUENCES MAY HAVE PARTICULARLY HARMFUL EFFECTS WHEN THEY OCCUR DURING CRITICAL PERIODS OVER ONE'S LIFE COURSE. CHILDREN'S HOSPITAL IS BRINGING THE FULL SPECTRUM OF THE SYSTEM'S RESOURCES TO BEAR IN THE COMMUNITY ENGAGEMENT EFFORT. BY CONNECTING OUR VAST CLINICAL AND COMMUNITY-BASED RESOURCES SCHOOL NURSES, COMMUNITY PEDIATRICIANS, SOCIAL WORKERS, HEALTH EDUCATORS, FOSTER CARE PARENTS, HOSPITALISTS, EMERGENCY DEPARTMENT STAFF, RESEARCHERS AND POLICY MAKERS CHILDREN'S HOSPITAL IS FACILITATING COMMUNITY HEALTH IMPROVEMENT BOTH DIRECTLY (E.G., EXPANDING MENTAL HEALTH AND DENTAL CARE IN UNDERSERVED AREAS), AND INDIRECTLY (E.G., BRINGING LAW ENFORCEMENT TO THE COMMUNITY CONVERSATION RELATED TO CRIME REDUCTION; SUPPORTING POLICY CHANGES AT THE LOCAL, STATE AND NATIONAL LEVELS THAT HAVE AN IMPACT ON CHILD HEALTH). CHILDREN'S HOSPITAL HAS SELECTED FIVE NEIGHBORHOODS FOR ENGAGEMENT EFFORTS. THESE NEIGHBORHOODS WERE IDENTIFIED BECAUSE THEY HAD A HIGH CONCENTRATION OF PEDIATRIC-AGED RESIDENTS; THERE WERE SIGNIFICANT, BUT MODIFIABLE, CHALLENGES TO CHILD HEALTH OUTCOMES; AND THEY HAD EXISTING TRUSTED COMMUNITY RESOURCES THAT WERE WILLING TO PARTNER WITH CHILDREN'S HOSPITAL TO ENGAGE THE COMMUNITY IN NEW WAYS TO IMPROVE CHILD HEALTH OUTCOMES. AS A PARTNER AND FACILITATOR, CHILDREN'S HOSPITAL'S STAFF HAS ENCOURAGED LEADERS FROM THE PRIORITY NEIGHBORHOODS TO IDENTIFY KEY AREAS FOR STRATEGIC INTERVENTION. ONE STRATEGY THAT HAS BEEN IMPLEMENTED IS USING COMMUNITY NAVIGATORS TRUSTED LOCAL RESIDENTS WHO EDUCATE NEIGHBORS ABOUT A SPECIFIC BEHAVIOR CHANGE OR RESOURCE UTILIZATION THAT WILL RESULT IN IMPROVED HEALTH OUTCOMES. CHHS'S FOCUS IS TO HAVE RELEVANT, ACCURATE, RESIDENT-LEVEL INFORMATION REGARDING TRUSTED SOURCES OF INFORMATION AND DIRECT INFLUENCES ON RESIDENT'S BEHAVIORS. CHILDREN'S HOSPITAL AND THE UNIVERSITY OF WISCONSIN-MILWAUKEE HELEN BADER SCHOOL OF SOCIAL WELFARE HAVE ESTABLISHED THE INSTITUTE FOR CHILD AND FAMILY WELL-BEING, AN ACADEMIC-COMMUNITY PARTNERSHIP TO IMPROVE THE LIVES OF CHILDREN AND FAMILIES FACING COMPLEX CHALLENGES SUCH AS VIOLENCE, INCARCERATION OR EXTREME POVERTY. THE INSTITUTE COMPRISES THREE CORE SERVICE AREAS: DESIGNING AND IMPLEMENTING EFFECTIVE PROGRAMS, CONDUCTING CUTTING-EDGE RESEARCH AND EVALUATION, AND PROMOTING CHANGE THROUGH POLICY AND ADVOCACY. THIS WORK IS CRITICAL BECAUSE NEARLY ONE THIRD OF CHILDREN IN MILWAUKEE (30.5 PERCENT) HAVE HAD AT LEAST TWO ADVERSE CHILDHOOD EXPERIENCES SUCH AS MALTREATMENT, NEGLECT, VIOLENCE OR EXTREME POVERTY WHICH IS SIGNIFICANTLY HIGHER THAN THE NATIONAL AVERAGE OF 22.6 PERCENT (DATA RESOURCE CENTER FOR CHILD & ADOLESCENT HEALTH). RESEARCH HAS PROVEN THAT CHILDHOOD ADVERSITY ACTUALLY INTERRUPTS CHILDREN'S BRAIN DEVELOPMENT, CAUSING INCREASED LIKELIHOOD OF MENTAL HEALTH PROBLEMS, SUBSTANCE ABUSE, JUVENILE DELINQUENCY AND TEEN PREGNANCY, IN ADDITION TO POOR LONG-TERM HEALTH OUTCOMES AND DECREASED ACADEMIC ACHIEVEMENT, WHICH CAN LEAD TO LONG-TERM EMPLOYABILITY ISSUES.THESE AFFILIATED PROGRAMS AND ACTIVITIES SEEK TO ENSURE THAT CHILDREN HAVE ACCESS TO HIGH-QUALITY HEALTH AND SOCIAL SERVICES.PART VI, LINE 7: CHHS, THE SOLE CORPORATE MEMBER OF CHILDREN'S HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF BOTH OF THE HOSPITALS AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON CHILDREN'S HOSPITAL'S WEBSITE OR UPON REQUEST.

PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH (CONTINUED)
"ADDITIONALLY, CHILDREN'S HOSPITAL OPERATES CHILD ADVOCACY CENTERS IN MILWAUKEE, RACINE, KENOSHA, WALWORTH COUNTY, NORTH CENTRAL WISCONSIN (WAUSAU), THE FOX VALLEY, AND CHIPPEWA VALLEY (EAU CLAIRE). EACH CENTER IS A SAFE PLACE FOR KIDS WHO MAY HAVE BEEN ABUSED OR NEGLECTED. THE CENTERS BRING TOGETHER A TEAM OF SPECIALLY TRAINED PROFESSIONALS WHO EVALUATE AND INVESTIGATE CASES OF CHILD ABUSE, PROVIDE MEDICAL CARE AND HELP CHILDREN AND THEIR FAMILIES HEAL. THE CENTERS ARE A COLLABORATION OF CHILDREN'S HOSPITAL AND DOZENS OF AREA LAW ENFORCEMENT, JUDICIAL AND SOCIAL SERVICE ORGANIZATIONS.CHILDREN'S HOSPITAL IS A FOUNDING AND ONGOING PARTNER IN THE SOJOURNER FAMILY PEACE CENTER, WHICH PROVIDES A SINGLE LOCATION FOR SERVICES FOR MILWAUKEE WOMEN, MEN AND CHILDREN IMPACTED BY FAMILY VIOLENCE. THE CENTER ALSO PROVIDES SPACE FOR THE DISTRICT ATTORNEY AND MILWAUKEE POLICE DEPARTMENT SENSITIVE CRIMES UNITS TO HELP SUPPORT AND PROTECT THIS VULNERABLE POPULATION.CHILDREN'S HOSPITAL'S SPECIAL NEEDS PROGRAM OFFERS COMPREHENSIVE CARE COORDINATION FOR CHILDREN WITH MULTIPLE MEDICAL NEEDS. THE GOAL IS TO ENSURE FAMILIES HAVE THE BEST POSSIBLE CARE IN AND OUT OF THE HOSPITAL. CHILDREN'S HOSPITAL PARTNERS WITH PATIENTS, FAMILIES, PRIMARY CARE AND OTHER HEALTH CARE PROVIDERS TO IMPROVE CARE COORDINATION. STAFF ALSO WORK WITH FAMILIES TO DEVELOP WRITTEN TRANSITION PLANS BASED ON NEEDS OR ISSUES THAT SHOULD BE ADDRESSED BEFORE A YOUTH IS READY TO TRANSITION TO ADULT CARE.FIGHT ASTHMA MILWAUKEE ALLIES, WHICH IS SUPPORTED BY MEDICAL STAFF AT CHILDREN'S HOSPITAL, IS A COALITION THAT WORKS TO REDUCE AND ELIMINATE DISPARITIES IN ASTHMA CARE AND DEVELOP A SUSTAINABLE STRATEGY FOR ASTHMA CONTROL IN THE COMMUNITY. THE COALITION PROVIDES COMMUNITY-WIDE ASTHMA EDUCATION FOR PARENTS, CAREGIVERS, HEALTH CARE PROFESSIONALS AND SCHOOL STAFF.THE INFANT DEATH CENTER (IDC) IS A STATEWIDE PROGRAM ADMINISTERED THROUGH CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, A HOSPITAL-LED AND STAFFED COALITION. THE CENTER PROVIDES INFORMATION AND SUPPORT TO WISCONSIN FAMILIES AND OTHERS AFFECTED BY THE SUDDEN AND UNEXPECTED DEATH OF AN INFANT. THE IDC STRIVES TO INCREASE HEALTHY BIRTH OUTCOMES AND REDUCE INFANT DEATHS. THE CENTER WORKS TOGETHER WITH OTHER PROFESSIONALS IN OUTREACH, EDUCATION AND INFANT MORTALITY REVIEW PROGRAMS. IN PARTNERSHIP WITH PUBLIC HEALTH SYSTEMS AND NATIONAL INFANT MORTALITY PROGRAMS, THE IDC MAINTAINS INFORMATION THAT ASSISTS IN THE STUDY AND UNDERSTANDING OF THE CAUSES OF INFANT DEATHS. THE INFORMATION IS USED FOR STATISTICAL REPORTING.THE DANIEL M. SOREF FAMILY RESOURCE CENTER, LOCATED ON THE FIRST FLOOR OF CHILDREN'S MILWAUKEE HOSPITAL CAMPUS, OFFERS PARENT-TO-PARENT SUPPORT, INFORMATION, REFERRALS AND HELP CONNECTING TO HOSPITAL AND COMMUNITY RESOURCES. THE RESOURCE CENTER OFFERS SPIRITUAL CARE, PATIENT RELATIONS, INTERPRETERS AND FAMILY ACCOMMODATIONS AND HOUSES THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. STAFF MEMBERS ARE TRAINED TO HELP CHILDREN, YOUNG ADULTS AND THEIR FAMILIES FIND ANSWERS TO QUESTIONS ABOUT LOCAL RESOURCES, SUPPORT GROUPS, FUNDING OPTIONS AND MORE. THE RESOURCE CENTER HAS COMPUTERS, A CONSULT ROOM, BUSINESS CENTER AND OTHER RESOURCES FOR FAMILIES. THE RESOURCE CENTER ALSO HAS A LENDING LIBRARY WITH BOOKS, VIDEOS AND ARTICLES ON A VARIETY OF HEALTH CONDITIONS AND TOPICS. IN 2021, THE FAMILY RESOURCE CENTER SERVED MORE THAN 5,767 VISITORS. CHILDREN'S HOSPITAL OPERATES A FREE GUARDIANSHIP CLINIC, WHICH PROVIDES PARENTS IN NEED WITH PRO BONO LEGAL SERVICES TO SECURE GUARDIANSHIP WHEN THEIR SPECIAL NEEDS CHILD TURNS 18.CHILDREN'S HOSPITAL SUPPORTS WORKFORCE DEVELOPMENT THROUGH JOB SHADOWING, WHICH MOSTLY OCCURS AT THE MILWAUKEE HOSPITAL CAMPUS. ADDITIONALLY, THROUGH A PARTNERSHIP WITH CREATIVE EMPLOYMENT OPPORTUNITIES/TRANSCEN, CHILDREN'S HOSPITAL OFFERS A PROGRAM CALLED PROJECT SEARCH, AN INNOVATIVE WORKFORCE AND CAREER DEVELOPMENT MODEL FOR YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. THROUGH PROJECT SEARCH, YOUNG ADULTS WITH DISABILITIES RECEIVE INTERNSHIPS WITHIN THE HOSPITAL TO GAIN ON-THE-JOB TRAINING AND OTHER CAREER DEVELOPMENT SKILLS TO SECURE COMPETITIVE EMPLOYMENT. CHILDREN'S HOSPITAL STAFFS CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, A STATEWIDE COALITION THAT WORKS TO IMPROVE THE HEALTH OF WISCONSIN CHILDREN AND REDUCE DISPARITIES IN AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE SERVICES. THE ALLIANCE IS GUIDED BY A STATEWIDE ADVISORY BOARD AND PARTNERS WITH HUNDREDS OF ORGANIZATIONS AND INDIVIDUALS TO RAISE AWARENESS OF CHILD HEALTH CONCERNS, MOBILIZE LEADERS, IMPACT PUBLIC HEALTH, AND IMPLEMENT PROGRAMS PROVEN TO WORK. THE ALLIANCE IS PARTIALLY FUNDED THROUGH A WISCONSIN DEPARTMENT OF HEALTH SERVICES MATERNAL CHILD HEALTH GRANT, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND OTHER PUBLIC AND PRIVATE FUNDING. THE ALLIANCE IS FINANCIALLY SUPPORTED BY CHILDREN'S HOSPITAL THROUGH STAFF AND OTHER RESOURCES TO CARRY ON THE ALLIANCE'S PROGRAMS. THE ALLIANCE'S KEY INITIATIVES ARE: ASTHMA, EARLY LITERACY, EMERGENCY CARE, GRIEF AND BEREAVEMENT, INJURY PREVENTION AND CHILD DEATH REVIEW, MEDICAL HOMES AND ORAL HEALTH. THE ALLIANCE LEADS AND MANAGES THE INFANT DEATH CENTER, REACH OUT AND READ WISCONSIN COALITION, WISCONSIN ASTHMA COALITION, AND THE WISCONSIN ORAL HEALTH COALITION. CHILDREN'S HOSPITAL ALSO SUPPORTS THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. IT IS ONE OF FIVE REGIONAL CENTERS DEDICATED TO SUPPORTING FAMILIES WITH CHILDREN WHO HAVE SPECIAL HEALTH CARE NEEDS AND THE PROVIDERS WHO CARE FOR THEM. IT IS FUNDED THROUGH A TITLE 5 MATERNAL AND CHILD HEALTH BLOCK GRANT, AND EXPENDITURES INCURRED BY CHILDREN'S HOSPITAL TO MATCH THE BLOCK GRANT INCLUDE STAFF AND OTHER PROGRAM EXPENSES. FAMILIES AND PROVIDERS CAN CALL THE CENTER FOR INFORMATION, REFERRAL AND PROBLEM-SOLVING RELATED TO COMMUNITY AND STATE SERVICES, HEALTH BENEFITS ASSISTANCE, TRANSITION PLANNING, AND EMOTIONAL SUPPORT. EACH YEAR THE STAFF OFFERS TRAINING SUCH AS ""CARE IN THE COMMUNITY AND OTHER SESSIONS THAT FOCUS ON YOUTH TRANSITIONS. STAFF ALSO PARTICIPATE IN NUMEROUS COMMUNITY INITIATIVES AND PARTNER WITH AREA PEDIATRICIANS AND OTHER HEALTH CARE PROVIDERS TO INCORPORATE EARLY IDENTIFICATION AND SCREENING METHODS INTO THEIR PRACTICES. EACH YEAR, STAFF SHARE THEIR EXPERTISE, LEADERSHIP AND TECHNICAL ASSISTANCE WITH VARIOUS COMMUNITY AGENCIES AND COMMITTEES. THE CENTER SERVES EIGHT COUNTIES. IN THE FOX VALLEY, CHILDREN'S HOSPITAL ALSO SUPPORTS THE NORTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, WHICH PROVIDES SIMILAR SERVICES TO THE SOUTHEAST CENTER DESCRIBED ABOVE WITH A FOCUS ON COUNTIES IN WISCONSIN'S FOX VALLEY. ADDITIONALLY, ONE OF THE NEEDS IDENTIFIED AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN THE FOX VALLEY WAS ACCESS TO MENTAL HEALTH CARE SERVICES. THEREFORE, CHILDREN'S HOSPITAL, ALONG WITH ASCENSION WISCONSIN AND THEDACARE, CREATED AN ORGANIZATION CALLED CATALPA HEALTH TO PROVIDE OUTPATIENT CHILD AND ADOLESCENT MENTAL HEALTH SERVICES IN THE FOX VALLEY."