4A (Expenses $ 81965603 including grants of $ 0) (Revenue $ 83200322)
SEE SCHEDULE O1. HEMATOLOGY/ONCOLOGY - HEMATOLOGY/ONCOLOGY SERVICES AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND (DBA UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND) PROVIDES COMPREHENSIVE EVALUATION AND TREATMENT OF ALL PEDIATRIC BLOOD DISORDERS AND CANCER. OUR GOAL IS TO PROVIDE STATE-OF-THE-ART CARE IN A WARM AND SUPPORTIVE ENVIRONMENT THAT INCLUDES ONGOING DIRECT COMMUNICATION WITH THE PRIMARY CARE PHYSICIAN. OUR COMPREHENSIVE SERVICES INCLUDE PROGRAMS FOR HEMOPHILIA, THALASSEMIA, AND SICKLE CELL DISEASE. OUR SICKLE CELL PROGRAM IS THE LARGEST IN THE WESTERN UNITED STATES AND INCLUDES ADULT PATIENTS. WE ARE THE LEAD AGENCY FOR THE NORTHERN CALIFORNIA COMPREHENSIVE SICKLE CELL CENTER (NCCSCC). THROUGH NCCSCC, A MULTIDISCIPLINARY TEAM CONSISTING OF PHYSICIANS, NURSE PRACTITIONERS, PSYCHOLOGISTS, AND SOCIAL WORKERS PROVIDE COMPREHENSIVE CARE IN A MEDICAL HOME MODEL. MEDICAL THERAPY INCLUDES HYDROXYUREA, TRANSFUSIONS, APHERESIS, CHELATION, PAIN MANAGEMENT, AND BONE MARROW TRANSPLANTATION. NCCSCC ALSO DEVELOPED AND COORDINATES THE NORTHERN CALIFORNIA NETWORK OF CARE FOR SICKLE CELL DISEASE, A PARTNERSHIP AMONG LOCAL HOSPITALS, CLINICS, AND COMMUNITY AGENCIES TO HELP IMPROVE THE ACCESS TO HEALTHCARE SERVICES FOR PEOPLE WITH SICKLE CELL DISEASE. WE ALSO HAVE PROGRAMS IN NEURO-ONCOLOGY, THROMBOPHILIA, STEM CELL TRANSPLANTATION, AND BONE MARROW TRANSPLANTATION. THE HEMATOLOGY/ONCOLOGY HAS ITS OWN 25-BED INPATIENT UNIT WITH PRIVATE, AIR-FILTERED ISOLATION ROOMS. A 20-BED DAY-USE TRANSFUSION AND CHEMOTHERAPY UNIT IN OUR OUTPATIENT CENTER INCLUDES AN APHERESIS PROGRAM AND A BONE MARROW TRANSPLANTATION UNIT. CHILDREN'S HAS DEVELOPED A NUMBER OF INNOVATIVE TREATMENTS FOR BLOOD DISORDERS AND REMAINS A MAJOR CENTER FOR HEMATOLOGICAL AND ONCOLOGICAL CLINICAL RESEARCH, ATTRACTING PATIENTS AND RESEARCH PARTICIPANTS FROM OTHER STATES AND COUNTRIES.

4B (Expenses $ 76848939 including grants of $ 0) (Revenue $ 94220749)
SEE SCHEDULE O2. NEONATOLOGY - NEONATOLOGY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES HIGHLY-SPECIALIZED INTENSIVE CARE TO CRITICALLY ILL AND PREMATURE NEWBORNS IN OUR LEVEL 4 NEONATAL INTENSIVE CARE UNIT (NICU). OUR INTENSIVE MULTIDISCIPLINARY AND SPECIALIST CARE TREATMENT TEAM IS PERHAPS THE BIGGEST REASON FOR OUR SUCCESS. EACH NICU PATIENT AND FAMILY RECEIVES THE FULL ATTENTION OF THE NICU TEAM OF PEDIATRIC MEDICAL AND SURGICAL EXPERTS, INCLUDING NEONATOLOGISTS, NEONATAL NURSE PRACTITIONERS, NURSES, RESPIRATORY THERAPISTS, SOCIAL WORKERS, AND DEVELOPMENTAL SPECIALISTS. THEIR COLLABORATION ENSURES COMPREHENSIVE CARE AND MONITORING OR SUPPORT OF VITAL FUNCTIONS BEYOND THOSE AVAILABLE IN THE GENERAL PEDIATRIC UNIT OR COMMUNITY HOSPITAL. THE NEWBORN INTENSIVE CARE NURSERY AT CHILDREN'S IS A 44-BED, FAMILY-CENTERED, REGIONAL REFERRAL CENTER FOR NEONATAL INTENSIVE CARE. BOARD CERTIFIED NEONATOLOGISTS ARE IN THE HOSPITAL 24 HOURS A DAY, 7 DAYS A WEEK. PARENTS ARE WELCOME TO VISIT ANY TIME. THIS MULTIDISCIPLINARY MEDICAL TEAM WORKS CLOSELY WITH THE ENTIRE RANGE OF CHILDREN'S PEDIATRIC SUB-SPECIALTY SERVICES.

4C (Expenses $ 47628217 including grants of $ 0) (Revenue $ 65262873)
SEE SCHEDULE O3. GASTROENTEROLOGY/HEPATOLOGY - GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES CARE FOR CHILDREN FROM BIRTH TO AGE 18 WHO HAVE SYMPTOMS AND DISEASES OF THE STOMACH, INTESTINES, LIVER AND PANCREAS. GASTROENTEROLOGY REFERS TO THE STOMACH, INTESTINES AND ASSOCIATED ORGANS. COMMON CONDITIONS INCLUDE FEEDING DISORDERS, PANCREATITIS, CONSTIPATION, CELIAC DISEASE AND INFLAMMATORY BOWEL DISEASE. HEPATOLOGY REFERS TO THE LIVER. COMMON LIVER CONDITIONS TREATED INCLUDE HEPATITIS AND OTHER INFECTIONS; METABOLIC LIVER DISEASE, GLYCOGEN STORAGE DISEASE, GALLSTONES AND GALL BLADDER DISORDERS, AND LIVER TRANSPLANT COORDINATION. CONGENITAL ANOMALIES OF THE GI TRACT ARE AMONG THE MOST COMMON SURGICAL PROBLEMS IN NEWBORN INFANTS. CARE OF THESE COMPLEX INFANTS IS ONE OF OUR CORE AREAS OF EXPERTISE. THE GI-NICU PROGRAM AT CHILDREN'S IS AN INTEGRATED MULTIDISCIPLINARY, FAMILY-CENTERED PROGRAM DESIGNED TO PROVIDE THE HIGHEST LEVEL OF CARE TO INFANTS WITH SURGICAL AND/OR MEDICAL GI PROBLEMS. BASED IN OUR LEVEL IIID NICU, OUR PROGRAM EXTENDS FROM PRENATAL DIAGNOSIS AND PLANNING, THROUGH THE NEONATAL PERIOD, AND TRANSITIONS TO LONG-TERM OUTPATIENT AND INPATIENT FOLLOW-UP.

4D (Expenses $ 267199489 including grants of $ 0) (Revenue $ 441062118)
15. PRIMARY CARE - PRIMARY CARE PROVIDES THE BASIC HEALTHCARE SUPERVISION OF CHILDREN FROM BIRTH TO AGE 19, INCLUDING ROUTINE PREVENTATIVE CARE, CHRONIC DISEASE MANAGEMENT, AND IMMUNIZATIONS. IN ADDITION, THE PRIMARY CARE CLINIC PROVIDES HEALTH EDUCATION, PARTICIPATES IN TRANSLATIONAL RESEARCH, OFFERS SOCIAL AND MENTAL HEALTH SERVICES, AND PLAYS A KEY ROLE IN TRAINING THE NEXT GENERATION OF PEDIATRICIANS. THE PRIMARY CARE CLINIC IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), A SPECIAL DESIGNATION FOR HEALTH CENTERS THAT SERVE A LARGE PERCENTAGE OF LOW-INCOME FAMILIES, AND MORE SPECIFICALLY CARES FOR FOSTER AND HOMELESS YOUTH. THE CLINIC AT CHILDREN'S IS THE ONLY FQHC IN THE COUNTRY ASSOCIATED WITH A CHILDREN'S HOSPITAL. THE PRIMARY CARE CLINIC CONDUCTS SEVERAL SPECIALIZED CLINICS INCLUDING AN INTERNATIONAL CLINIC, WHICH PROVIDES CARE FOR NON-ENGLISH SPEAKERS, ENCORE MEDICAL CLINIC, WHICH SPECIALIZES IN THE UNIQUE NEEDS OF CHILDREN WHO ARE HOMELESS OR IN FOSTER CARE, AND AN ASTHMA CLINIC, WHICH PROVIDES SPECIALIZED MEDICAL CARE AND ASTHMA MANAGEMENT EDUCATION FOR FAMILIES WHO HAVE CHILDREN WITH PARTICULARLY COMPLEX CASES OF ASTHMA.16. ENDOCRINOLOGY - ENDOCRINOLOGY AND DIABETES AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND TREATS CHILDREN FROM BIRTH TO AGE 18 WHO HAVE ALL TYPES OF ENDOCRINE DISORDERS. ENDOCRINE DISORDERS INCLUDE DIABETES, HYPERTHYROIDISM AND HYPOTHYROIDISM, AND OTHER DISORDERS OF THE ENDOCRINE GLANDS. THE DIVISION CARES FOR MORE THAN 1000 CHILDREN WITH DIABETES, BOTH TYPE 1 AND TYPE 2. WEIGHT MANAGEMENT AND GENERAL FITNESS ARE EMPLOYED FOR CHILDREN MANAGING DIABETES AND OTHER ENDOCRINE DISORDERS.17. RADIOLOGY - RADIOLOGY AND DIAGNOSTIC IMAGING AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES A FULL RANGE OF DIAGNOSTIC IMAGING SERVICES IN SUPPORT OF PRIMARY CARE AND SPECIALTY CARE PATIENTS IN BOTH INPATIENT AND OUTPATIENT SETTINGS. IN ADDITION, THE DIVISION PROVIDES INTERVENTIONAL RADIOLOGY SERVICES FOR TREATMENT OF A BROAD RANGE OF PEDIATRIC CONDITIONS.18. PLASTIC SURGERY - PLASTIC SURGERY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND EVALUATES AND TREATS A WIDE RANGE OF PLASTIC SURGERY PROBLEMS IN CHILDREN FROM BIRTH TO 18 YEARS, INCLUDING CONGENITAL ANOMALIES, ACUTE TRAUMATIC INJURIES, AND RECONSTRUCTION FOLLOWING BURNS AND OTHER TRAUMATIC INJURIES. SERVICES INCLUDE DIAGNOSIS AND TREATMENT OF ALL CONGENITAL AND ACQUIRED RECONSTRUCTIVE PROBLEMS, CRANIOMAXILLOFACIAL SURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, AND HAND/MICROSURGERY.19. NEPHROLOGY - NEPHROLOGY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND DEALS WITH THE FUNCTION AND DISEASES OF THE KIDNEYS. NEPHROLOGISTS AT CHILDREN'S HOSPITAL & RESEARCH CENTER OAKLAND PROVIDE CARE FOR CHILDREN FROM BIRTH THROUGH AGE 18 WHO HAVE RENAL DISEASE. LONG-TERM PATIENTS ARE SEEN UP TO AGE 21 YEARS.20. RHEUMATOLOGY - PEDIATRIC RHEUMATOLOGY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDE DIAGNOSIS AND TREATMENT OF RHEUMATOLOGIC DISORDERS AND MULTI-SYSTEM INFLAMMATORY DISEASES THAT AFFECT MUSCLES, JOINTS AND CONNECTIVE TISSUES. THIS INCLUDES THE EVALUATION OF PATIENTS WITH A WIDE VARIETY OF SYMPTOMS INCLUDING MUSCULOSKELETAL COMPLAINTS, BONE AND JOINT PAIN, UNEXPLAINED RASH, AND FEVERS OF UNKNOWN ORIGIN. DIAGNOSES TREATED INCLUDE JUVENILE IDIOPATHIC ARTHRITIS (JIA), SYSTEMIC LUPUS ERYTHEMATOSUS (SLE), JUVENILE DERMATOMYOSITIS (JDM), VASCULITIS, SCLERODERMA, AND PERIODIC FEVER/INFLAMMATORY SYNDROMES.21. ADOLESCENT MEDICINE - THE ADOLESCENT MEDICINE PROGRAM AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES SPECIALIZED SERVICES FOR CHILDREN AGES 11-24. THE DIVISION PARTICIPATES IN THE CARE OF PATIENTS AT OUR HIGH VOLUME TEEN CLINIC, TWO SCHOOL-BASED HEALTH CENTERS, AND THE MEDICAL CLINIC AT THE ALAMEDA COUNTY JUVENILE JUSTICE CENTER, THE LOCATION FOR ALL JUVENILE DETAINEES IN THE COUNTY. OUR INTERDISCIPLINARY TEAM OF ADOLESCENT PROVIDERS HELP PROVIDE A WIDE RANGE OF PRIMARY CARE AND PSYCHOLOGICAL SERVICES INCLUDING WELL VISITS, CHRONIC AND ACUTE DISEASES, URGENT CARE, STDS, FAMILY PLANNING AND REPRODUCTIVE SERVICES, SPORTS EXAMINATIONS, MENTAL HEALTH CONDITIONS, PHYSICAL AND SEXUAL ASSAULT, HEALTH EDUCATION, AND PROFESSIONAL TRAINING. OUR ADOLESCENT MEDICINE PROVIDERS LOOK AT ALL ASPECTS OF AN ADOLESCENT'S LIFE TO HELP ADDRESS THE MANY MEDICAL AND MENTAL HEALTH ISSUES THAT THEY FACE.22. AUDIOLOGY - AUDIOLOGY SERVICES AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND WORKS WITH CHILDREN FROM BIRTH TO 21 YEARS TO DIAGNOSE AND TREAT HEARING LOSS OR IMPAIRMENT. WE HAVE A SPECIALLY TRAINED TEAM OF AUDIOLOGISTS AND SPEECH PATHOLOGISTS THAT OFFER CUTTING-EDGE TECHNOLOGY TO HELP CHILDREN IMPROVE HEARING, SPEECH AND LANGUAGE.23. UROLOGY - THE DIVISION OF UROLOGIC SERVICES AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES COMPREHENSIVE MEDICAL SERVICES IN THE DIAGNOSIS AND TREATMENT OF CHILDREN BIRTH TO AGE 18 WHO HAVE PROBLEMS WITH THE KIDNEYS, BLADDER AND GENITALIA. OUR COMPASSIONATE PROFESSIONALS SPECIALIZE IN TREATING DEFECTS OF THE URINARY TRACT, SUCH AS HYPOSPADIAS AND EPISPADIAS (BIRTH DEFECTS IN BOYS IN WHICH THE URINARY TRACT OPENING IS NOT AT THE TIP OF THE PENIS), BLADDER EXSTROPHY, AMBIGUOUS GENITALIA AND OBSTRUCTIVE UROPATHY (BLOCKED URINE FLOW) CAUSED BY URETHRAL ABNORMALITIES.24. OPHTHALMOLOGY - OPHTHALMOLOGY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND EVALUATES AND TREATS EYE PROBLEMS IN CHILDREN FROM INFANCY THROUGH ADOLESCENCE. OUR SERVICES INCLUDE BOTH OUTPATIENT AND INPATIENT DIAGNOSIS AND MANAGEMENT OF ALL PEDIATRIC EYE CONDITIONS.25. DENTISTRY - DENTISTRY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES THE EXPERTISE NECESSARY TO MEET THE PEDIATRIC DENTISTRY NEEDS OF CHILDREN WITH COMPLEX MEDICAL CONDITIONS, PARTICULARLY THOSE PATIENTS WHO REQUIRE SEDATION TO ALLOW ADEQUATE EVALUATION AND TREATMENT OF THEIR DENTAL NEEDS.26. BEHAVIORAL HEALTH - PSYCHIATRY AND BEHAVIORAL HEALTH AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND OFFERS A FULL RANGE OF OUTPATIENT PSYCHIATRIC AND PSYCHOLOGICAL SERVICES FOR CHILDREN UP TO AGE 18 AND THEIR FAMILIES, AS WELL AS CONSULTATION/LIAISON AND SUPPORTING CLINICAL SERVICES TO INPATIENTS AND STAFF. CHILDREN'S MULTIDISCIPLINARY TEAM OF PSYCHIATRISTS, PSYCHOLOGISTS AND SOCIAL WORKERS TREAT CHILDREN FROM MANY BACKGROUNDS AND WITH A WIDE VARIETY OF CONDITIONS, INCLUDING ADJUSTMENT DISORDERS, AFFECTIVE DISORDERS, DEVELOPMENTAL DELAYS, DEPRESSION AND LEARNING DISABILITIES.27. DERMATOLOGY - DERMATOLOGY AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND CONSISTS OF A TEAM OF BOARD CERTIFIED PEDIATRIC DERMATOLOGISTS AND EXPERIENCED CLINICIANS WHO ARE SPECIALLY TRAINED AND CERTIFIED TO CARE FOR CHILDREN. PEDIATRIC DERMATOLOGISTS OFFER UNIQUE EXPERTISE IN DIAGNOSES AND TREATMENT OF COMMON SKIN CONDITIONS AS WELL AS RARE AND CHALLENGING SKIN DISORDERS IN INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS. CHILDREN'S DERMATOLOGISTS ARE SPECIALISTS IN TREATING PEDIATRIC SKIN, HAIR, AND NAIL DISORDERS AND EXPERTS ON HOW DIFFERENT PROCEDURES AFFECT YOUR CHILD'S HEALTH, APPEARANCE, AND SKIN HEALING.28. MEDICAL GENETICS - MEDICAL GENETICS AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PROVIDES CONSULTATION SERVICES FOR CHILDREN FROM BIRTH TO 18 YEARS. WORKING IN COLLABORATION WITH THE CRANIOFACIAL CENTER, THE FETAL TREATMENT CENTER AND THE BEHAVIORAL AND DEVELOPMENTAL PEDIATRIC PROGRAM, THIS DIVISION EVALUATES CHILDREN WHO ARE AT RISK FOR OR HAVE EVIDENCE OF GENETIC DISORDERS. ADULTS WITH SOME TYPES OF GENETIC CONDITIONS MAY ALSO BE EVALUATED. RESEARCH IS ALSO AN EXTREMELY IMPORTANT PART OF OUR MISSION. THE CHILDREN'S HOSPITAL OAKLAND RESEARCH INSTITUTE (CHORI) WAS FOUNDED IN 1959 AS THE RESEARCH ARM OF THE HOSPITAL. AT THAT TIME, IT WAS THE ONLY FACILITY IN NORTHERN CALIFORNIA DEDICATED EXCLUSIVELY TO RESEARCH ON CHILDREN'S DISEASES. IN RECENT YEARS WE HAVE PARTNERED WITH THE UNIVERSITY OF CALIFORNIA TO EXECUTE ON THE RESEARCH MISSION. WORLD-CLASS INVESTIGATORS HAVE MADE SIGNIFICANT PROGRESS IN SUCH AREAS AS SICKLE CELL DISEASE, DIET AND NUTRITION, GASTROINTESTINAL CONDITIONS, PEDIATRIC CANCERS, CRITICAL CARE MEDICINE, GENETICS, IMMUNOBIOLOGY, AND HEALTH EQUITY, TO NAME A FEW KEY AREAS OF RESEARCH.

CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS VIA KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. INDIVIDUALS WITH THE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH AND OTHER PUBLIC AGENCIES, COMMUNITY ORGANIZATIONS, LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND RACIAL/ETHNIC POPULATIONS. FOR A COMPLETE LIST OF INDIVIDUALS WHO PROVIDED INPUT, SEE APPENDIX A IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT.

CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
PART V, SECTION B, LINE 6A: CHRCO WAS PART OF THE ALAMEDA & CONTRA COSTA COUNTIES HOSPITAL CHNA GROUP THAT WORKED WITH THE FOLLOWING PARTNERS: ALAMEDA & CONTRA COSTA COUNTIES HOSPITAL CHNA GROUP INCLUDED JOHN MUIR HEALTH, SUTTER HEALTH, ST. ROSE HOSPITAL, STANFORD HEALTH CARE VALLEYCARE, UCSF BENIOFF CHILDREN'S HOSPITALS.

CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
PART V, SECTION B, LINE 11: THE CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND IDENTIFIED ITS PRIORITIZED HEALTH NEEDS THROUGH ITS COMMUNITY HEALTH NEEDS ASSESSMENT. THROUGH A COMPREHENSIVE PROCESS, A COMMITTEE OF 14 REPRESENTATIVES IDENTIFIED AND RANKED THE TOP PRIORITY HEALTH NEEDS PER THE PRIORITIZATION PROCESS. DETAILED PROFILES FOR EACH HEALTH NEED ARE FOUND IN APPENDIX G OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH INCLUDES: BEHAVIORAL HEALTH; HOUSING & HOMELESSNESS; HEALTHCARE ACCESS & DELIVERY; COMMUNITY AND FAMILY SAFETY; ECONOMIC SECURITY; STRUCTURAL RACISM, FOOD SECURITY; AND TRANSPORTATION. THE PRIORITIES WERE REORGANIZED BY NAMING STRUCTURAL RACISM AS AN OVERARCHING FRAMEWORK AND CONSOLIDATING HOUSING, FOOD SECURITY, TRANSPORTATION, AND INCOME/EMPLOYMENT UNDER THE BROAD TOPIC OF ECONOMIC SECURITY. WITHIN EACH KEY AREA, WE IDENTIFIED STRATEGIES AND COMMUNITY COLLABORATORS SUMMARIZED IN THE COMMUNITY BENEFIT IMPLEMENTATION PLAN 2022-2024 FOUND ON THE HOSPITAL'S WEBSITE. THERE ARE TOO MANY PROGRAMS, INITIATIVES, AND EFFORTS TO LIST FOR THIS REPORT THAT CHRCO IS WORKING ON TO ADDRESS THE IDENTIFIED PRIORITIES. WHAT WE HAVE HIGHLIGHTED IN THE IMPLEMENTATION PLAN IS THE WORK THAT BEST ALIGNS WITH THE NEEDS ARTICULATED BY THE COMMUNITY IN THE CHNA. EACH STRATEGY COLLABORATES WITH NUMEROUS PARTNERS. THE COLLABORATORS LISTED ARE NOT EXHAUSTIVE AND ARE MEANT TO ILLUSTRATE THE TYPES OF PARTNERSHIPS.

PART I, LINE 7:
COSTING METHOD: AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND, OPERATING EXPENSES ARE EITHER A DIRECT OR AN INDIRECT EXPENSE. DIRECT EXPENSES ARE ATTRIBUTED TO DIRECT PATIENT CARE SERVICES AND INCLUDES SALARIES, SUPPLIES, ETC. INDIRECT EXPENSES, ALSO KNOWN AS OVERHEAD INCLUDE EXPENSES ASSOCIATED WITH SUPPORT DEPARTMENTS SUCH AS HUMAN RESOURCES, FINANCE, INFORMATION SYSTEMS, ADMINISTRATION, FACILITIES, MAINTENANCE, LEGAL, ETC. INDIRECT EXPENSES USE COST DRIVERS AS A CRITERIA TO ALLOCATE THE COST OF EACH NON-PATIENT CARE AREA (OVERHEAD). THE COST DRIVER REFLECTS THE EXTENT TO WHICH THE INDIRECT DEPARTMENT IS USED BY THE DIRECT DEPARTMENT. AN EXAMPLE OF A COST DRIVER IS SQUARE FOOTAGE, FTES, ETC. FOR EXAMPLE, A DEPARTMENT THAT CONTAINS TWICE AS MANY FTES IS ALLOCATED TWICE THE COST OF HR EXPENSES. ALL INDIRECT EXPENSE IS ALLOCATED TO REVENUE PRODUCING DEPARTMENTS AND IS BASED ON COST REPORT LOGIC; USING SIMILAR COST DRIVERS AS THOSE FOUND IN THE COST REPORT.SOURCE SYSTEMS LIKE THE GENERAL LEDGER, PAYROLL, PATIENT ACCOUNTING AND MEDICAL RECORDS FEED INTO OUR COST ACCOUNTING APPLICATION EPSI. THE DATA, BASED ON DISCHARGED PATIENT RECORDS MERGES WITH FINANCIAL DATA FROM THE GENERAL LEDGER AND PAYROLL. EPSI PROVIDES PATIENT LEVEL TOTAL COST ASSOCIATED WITH THE DELIVERY OF PATIENT CARE. EPSI RECEIVES PATIENT DATA NIGHTLY AND GENERAL LEDGER INFORMATION MONTHLY. EACH MONTH THE DATABASE IS RE-CALCULATED AND RECONCILED TO REFLECT THE MOST CURRENT ACTUAL EXPENSE REPORTED IN THE GENERAL LEDGER. THE DATA REFLECTS REVENUES AND EXPENSES ASSOCIATED FOR A SPECIFIC PATIENT POPULATION.

PART I, LINE 6A
THE 2021 COMMUNITY BENEFIT REPORT WAS FILED ON 8/12/22 UPON AN HCAI (DEPARTMENT OF HEALTH CARE AND INFORMATION) APPROVED EXTENSION. CHRCO WAS NOT ABLE TO MEET THE ORIGINAL FILING DEADLINE IN TAX YEAR 2022 OF 11/27/21 DUE TO TURN OVER OF PERSONNEL IN THE DEPARTMENT WHO PREPARE THE COMMUNITY BENEFIT REPORT.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIES:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PARTICIPATES IN A MYRIAD OF COMMUNITY-BUILDING ACTIVITIES AS DETAILED IN ITS ANNUAL COMMUNITY BENEFIT REPORT FOUND ON THE HOSPITAL'S WEBSITE. COMMUNITY BUILDING PRIMARILY INCLUDES LEADING COMMUNITY COALITIONS TO ADDRESS VARIOUS HEALTH INEQUITIES IN CHILDREN INCLUDING ASTHMA, SICKLE CELL, INJURIES, AND DIABETES; COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY ACROSS A RANGE OF TOPICS; AND EXTENSIVE WORKFORCE DEVELOPMENT PROGRAMS FOR HIGH SCHOOL, COLLEGE, AND PROFESSIONAL STUDENTS.ONE LONGSTANDING WORKFORCE DEVELOPMENT PROGRAM IS CHAMPS (COMMUNITY HEALTH AND ADOLESCENT MENTORING PROGRAM FOR SUCCESS). CHAMPS PROVIDES INTENSIVE SUPPORT, MENTORING, AND ON-SITE EXTERNSHIPS TO LOCAL HIGH SCHOOL STUDENTS FROM POPULATIONS UNDERREPRESENTED IN HEALTH.THE CENTER FOR CHILD AND COMMUNITY HEALTH IS A DEPARTMENT AT CHRCO WHOSE GOALS INCLUDE WORKING WITH COMMUNITY ORGANIZATIONS AND DEVELOPING NEW PROGRAMS THAT DEMONSTRATE HOW CHRCO CAN REACH BEYOND THE TRADITIONAL MEDICAL MODEL TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. THE CENTER BRIDGES CHILDREN'S HEALTH CARE WITH COMMUNITY NEEDS AND EXISTING COMMUNITY BENEFIT PROGRAMS AND SERVES AS A HUB FOR COLLABORATIONS WITH COMMUNITY STAKEHOLDERS.

PART III, LINE 2:
ACCOUNTS MAY BE ADJUSTED FOR A VARIETY OF REASONS, INCLUDING DISSATISFACTION WITH SERVICE OR OTHER SUBSTANTIAL PATIENT CONCERNS THAT THE HOSPITAL DETERMINES IS BEST ADDRESSED FINANCIALLY. IF ALL COLLECTION EFFORTS FAIL, AN ACCOUNT MAY BE ASSIGNED TO BAD DEBT, AND THE OUTSTANDING BALANCE MAY BE WRITTEN OFF.

PART III, LINE 4:
NO SEPARATE FOOTNOTE IS PUBLISHED FOR CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND. BAD DEBT EXPENSE IS REPORTED AS PART OF NET PATIENT REVENUE IN THE FINANCIAL STATEMENTS.

PART III, LINE 8:
THE HOSPITAL BELIEVES THAT 100% OF THE COST OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. WHILE THE LEVEL OF QUALITY AND ACCESS TO CARE IS THE SAME REGARDLESS OF THE SOURCE OF PAYOR, THE LEVEL OF PAYMENT FOR MEDICARE IS DETERMINED BY GOVERNMENT REIMBURSEMENT POLICY. THE MEDICARE SHORTFALL IS AN UNREIMBURSED AMOUNT THAT MUST BE ACCOUNTED FOR IN THE HOSPITAL'S FINANCIAL STATEMENTS. SINCE GENERALLY ACCEPTED ACCOUNTING STANDARDS IDENTIFY THIS SHORTFALL, IT SHOULD BE ACCEPTED AS A SHORTFALL IN IRS REPORTING STANDARDS FOR PURPOSES OF MEASURING THE HOSPITAL'S LEVEL OF COMMUNITY BENEFIT.

PART III, LINE 9B:
COLLECTION PRACTICES: DIRECT CHARITY CARE IS THE PROVISION OF HEALTHCARE GOODS AND SERVICES WITHOUT CHARGE OR AT SUBSTANTIALLY REDUCED RATES TO MEMBERS OF THE COMMUNITY WHO DEMONSTRATE AN INABILITY TO PAY FOR NECESSARY HEALTHCARE SERVICES EITHER ENTIRELY OR IN PART. THIS IS DISTINGUISHED FROM BAD DEBT WHICH RESULTS FROM AN UNWILLINGNESS TO PAY AND FROM CONTRACTUAL DISCOUNT WHICH RESULTS FROM PREDETERMINED AGREEMENTS TO ACCEPT SOME REDUCTION FROM BILLED CHARGES. COLLECTION ACTIVITY IS NOT INITIATED ON CHARITY CARE PATIENTS BECAUSE THE CHARGES WERE NEVER EXPECTED TO BE PAID, AND ARE THUS NOT BAD DEBT.

PART VI, LINE 4:
COMMUNITY INFORMATION:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND IS GEOGRAPHICALLY LOCATED IN THE CITY OF OAKLAND IN ALAMEDA COUNTY, BUT DRAWS PATIENTS FROM THROUGHOUT NORTHERN CALIFORNIA. WITH A POPULATION OF 1,648,556 ALAMEDA COUNTY IS ONE OF THE 10 LARGEST IN CALIFORNIA. AROUND 56% OF PATIENTS AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND COME FROM THERE. CHILDREN AND ADOLESCENTS FROM 0-18 CONSTITUTE ABOUT 20% OF ALAMEDA COUNTY'S POPULATION. OVERALL, THE COUNTY IS VERY DIVERSE, WITH 31% NON-HISPANIC WHITE, 10% AFRICAN AMERICAN, 33% ASIAN, AND 22% LATINO. AMONG PATIENTS WHO COME TO CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND, 67.6% USE MEDI-CAL.

PART VI, LINE 7, REPORTS FILED WITH STATES
CA

PART VI, LINE 2:
NEEDS ASSESSMENT:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND CONDUCTS A COMPREHENSIVE, FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS, MOST RECENTLY IN 2022. THE CHNA (A) IDENTIFIED HEALTH NEEDS ASSESSMENT FOR ALAMEDA COUNTY; (B) CONDUCTED STRUCTURED 43 KEY INFORMANT INTERVIEWS WITH AN INFORMED GROUP OF STAKEHOLDERS; (C) CONDUCTED 10 COMMUNITY RESIDENT FOCUS GROUPS WITHIN NORTHERN AND CENTRAL ALAMEDA COUNTY AND THE TRI VALLEY AREA; (D) REVIEWED SECONDARY DATA FROM NATIONAL, STATEWIDE, AND LOCAL SOURCES; (E) TRIANGULATED ANALYZED QUANTITATIVE AND QUALITATIVE DATA, AN APPROACH USING MULTIPLE SOURCES OF DATA TO ENHANCE THE CREDIBILITY OF THE OUTCOMES (F) APPLIED A MULTI-STEP PROCESS TO RANK HEALTH NEEDS; (E) SELECTED HIGHEST PRIORITY NEEDS FOR CHRCO TO ADDRESS THROUGH A VOTING PROCESS. IN ADDITION TO THE FORMAL CHNA, CHRCO MAINTAINS BOTH A COMMUNITY ADVISORY BOARD AND A FAMILY ADVISORY BOARD COMPRISED OF COMMUNITY MEMBERS THAT ADVISE THE HOSPITAL ON HOW BEST TO SERVE THE COMMUNITY.

PART VI, LINE 3:
"PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:INFORMATION ABOUT FINANCIAL ASSISTANCE THAT IS AVAILABLE AT CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND (THE ""HOSPITAL"") IS DISSEMINATED THROUGH A VARIETY OF MECHANISMS, INCLUDING THE POSTING OF NOTICES IN THE EMERGENCY DEPARTMENT, CLINICS, PATIENT REGISTRATION AREAS, OTHER PUBLIC PLACES IN THE HOSPITAL, OUTPATIENT SETTINGS, AND INCLUDING SUCH INFORMATION ON THE PATIENT'S/GUARANTOR'S BILL. EVERY INDIVIDUAL THAT IS ADMITTED AND RECEIVES CARE AT THE HOSPITAL RECEIVES INFORMATION, EITHER ORALLY OR IN WRITING, REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AS PART OF THE INTAKE OR DISCHARGE PROCESS. THIS INFORMATION IS PROVIDED IN ENGLISH AND SPANISH, AND IS TRANSLATED FOR PATIENTS/GUARANTORS WHO SPEAK OTHER LANGUAGES.INTERNALLY, THE HOSPITAL USES A VARIETY OF FORUMS, SOCIAL WORKER MEETINGS, AMBULATORY MEETINGS, RESIDENT IN SERVICE REVENUE CYCLE MEETINGS, AND FINANCIAL COUNSELING MEETINGS AND ""HUDDLES"" TO SHARE WITH MANAGERS BOTH THE EMAIL DISTRIBUTION GROUPS AND SPECTRA LINK NUMBERS TO PHONE FOR FINANCIAL SCREENING AND/OR ASSISTANCE, AS WELL AS TO MAKE APPOINTMENTS FOR SCREENING FAMILIES FOR ALL FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT THE HOSPITAL. FAMILIES CHECKING IN FOR APPOINTMENTS ARE REFERRED IN REAL TIME AND ARE PROVIDED WITH FINANCIAL COUNSELING SERVICES AT NO COST."

PART VI, LINE 5:
PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND HAS NUMEROUS ADDITIONAL ACTIVITIES AND COMMUNITY BENEFITS PROGRAMS. EXAMPLES OF THESE PROGRAMS INCLUDE: (A) CHRCO RUNS A MULTI-SITE FEDERALLY QUALIFIED HEALTH CENTER (FQHC) TO PROVIDE PRIMARY CARE TO LOW-INCOME FAMILIES. OVER 90% OF FAMILIES WHO VISIT THE FQHC CLINICS UTILIZE MEDICAID AS THEIR INSURANCE. TWO OF THE SITES ARE BASED AT HIGH SCHOOLS--THE YOUTH UPRISING/CASTLEMONT HIGH SCHOOL CLINIC IS LOCATED IN A VERY HIGH RISK AREA OF EAST OAKLAND AND THE MCCLYMONDS HIGH SCHOOL CLINIC IS LOCATED IN A HIGH RISK AREA OF WEST OAKLAND; (B) CHRCO STAFF PARTICIPATE IN THE PLANNING AND EXECUTION OF A SICKLE CELL CAMP FOR PATIENTS AND NON-PATIENTS ALIKE; (C) CHRCO MAINTAINS BOTH A COMMUNITY ADVISORY BOARD AND A FAMILY ADVISORY BOARD COMPRISED OF COMMUNITY MEMBERS. AMONG OTHER THINGS, THESE BOARDS ADVISE THE HOSPITAL ON HOW BEST TO SERVE THE COMMUNITY; (D) CHRCO IS THE SOLE PROVIDER OF MEDICAL CARE AT THE ALAMEDA COUNTY JUVENILE JUSTICE CENTER CLINIC; (E) CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND D/B/A UCSF BENIOFF CHLDREN'S HOSPITAL OAKLAND RUNS AN INJURY PREVENTION PROGRAM, ADMINISTERED BY TRAUMA SERVICES, WHICH AIMS TO REDUCE THE NUMBER OF UNINTENTIONAL INJURIES AND FATALITIES IN CHILDREN YOUNGER THAN 18 PRIMARILY THROUGH PUBLIC SERVICE ANNOUNCEMENTS, COMMUNITY EVENTS, PARTNERSHIPS, AND COALITION EFFORTS.