4A (Expenses $ 544351000 including grants of $ 0) (Revenue $ 526913000)
SEE SCHEDULE O

4B (Expenses $ 405175000 including grants of $ 0) (Revenue $ 539843000)
SEE SCHEDULE O

4C (Expenses $ 267757000 including grants of $ 0) (Revenue $ 227921000)
SEE SCHEDULE O

PART V, SECTION B, LINE 5
"LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD (""LPCH'S"") VALUES And prioritizes input from persons who represent the broad interests of the community in our Community Health Needs Assessment (""CHNA"") process - as outlined below. In addition, in FY22 LPCH maintained close connections to community partners, grant recipients, local leaders and community stakeholders, in order to understand the issues that affect our surrounding communities and their effects on the Social Determinants of Health. Those efforts resulted in a deeper understanding of how the community's needs have changed or deepened over the past year. In fiscal year 2022, in collaboration with local area nonprofit hospital organizations and the San Mateo and Santa Clara County Departments of Public Health, we finalized a CHNA that included three strategies for collecting community input: key informant interviews with health experts and community service leaders, focus groups with residents, and focus groups with professionals who represent and/or serve the community or residents. Individuals representing high-need populations (low-income, marginalized communities, medically underserved, homeless, older adult and youth) were included. The members of the informal CHNA collaborative started planning the 2022 Community Health Needs Assessment in January 2021 and began collecting data in spring 2021. To ensure consistency across each interview and focus group, the study team generated research protocols. This CHNA sought to build on prior CHNAs by focusing the primary research on topics and subpopulations that are less well-understood by the statistical data. For example, the experiences of the Black population in San Mateo and Santa Clara counties are often obscured by statistics that represent an entire county's population rather than the Black population as a particular subgroup. The 2022 study team specifically convened a focus group of Black professionals to better understand through this primary qualitative research. The study team conducted the key informant interviews and focus groups for this assessment and recorded each interview and focus group. Recordings were transcribed and qualitative research software tools were used to analyze the transcripts for common themes. The study group also tabulated how many times health needs were prioritized by each of the focus groups or described as a priority in a key informant interview. The study team used this tabulation to help assess community health priorities. In all, the study teams solicited input from nearly 100 community members, community leaders, and representatives of various organizations and sectors. These representatives work either in the health field or in a community-based organization that focuses on improving health and quality of life conditions by serving those from high-need populations. In March and April 2021, the study team spoke with 15 experts from various organizations in San Mateo and Santa Clara counties. Interviews were conducted virtually via Zoom for approximately one hour. Prior to each interview, participants were asked to complete a short online survey in which they were asked to identify the health needs they felt were the most pressing among the people they served. Interviewees could choose up to three needs from the list of needs presented to them, which had been identified in one or both counties in 2019, or could write in needs that were not on the combined 2019 list. Also in the survey, participants were advised of how their interview data would be used and were asked to consent to be recorded. Finally, participants were offered the option of being listed in the report and were asked to provide some basic demographic information (also optional). The discussions centered around four questions for each health need that was prioritized by interviewees: 1. How do you see this need playing out in the community? 2. Which populations are experiencing inequities with respect to this need? 3. How has this need changed in the past few years; how were things going prior to the pandemic, and how are they going now? 4. What is needed (including models/best practices) to better address this need? Further data regarding this gathered community input is contained in the full CHNA available at https://www.stanfordchildrens.org/content-public/pdf/community-health-asse ssment-2022.pdf Although contact information for the manager of community benefits is included in the community benefits report and on the website, we have not received written comments to date. https://www.stanfordchildrens.org/en/about/government-community/benefits-r eports PART V, SECTION B LINE 6 Lucile Salter Packard Children's Hospital Stanford's most recent Community Health Needs Assessment (""CHNA"") was conducted in collaboration with the following hospital facilities and organizations: . El Camino Health . Sutter Health . Stanford Health Care . Samaritan House . Gardner Health Services . Bay Area Community Health Advisory Council"

PART V, SECTION B, LINE 11
"LPCH selected four health needs identified and prioritized by the community through the CHNA process. LPCH selected community health needs that were prioritized through community input and issue areas that reflect LPCH's mission and expertise. THE FOUR SELECTED HEALTH NEEDS ARE: - BEHAVIORAL HEALTH - ECONOMIC INSECURITY - HEALTH CARE ACCESS AND DELIVERY - MATERNAL AND INFANT HEALTH THE FOLLOWING OUTLINES LPCH'S GOALS, STRATEGIES AND THE ANTICIPATED IMPACT OF OUR EFFORTS AROUND THE SELECTED HEALTH NEEDS. 1. BEHAVIORAL HEALTH 1A. GOALS - PROVIDE HIGH-QUALITY MENTAL HEALTH SERVICES TO YOUTH 1A. STRATEGIES - EXPAND ACCESS TO PROGRAMS AND SERVICES THAT PREVENT POOR MENTAL HEALTH (E.G., MINDFULNESS-BASED STRESS REDUCTION) - EXPAND ACCESS TO PROGRAMS AND SERVICES (INCLUDING SCREENING AND COUNSELING/ THERAPY) THAT ADDRESS STRESS, DEPRESSION, AND SUICIDAL IDEATION,including increasing mental/behavioral health workforce - SUPPORT SCHOOL-BASED INTERVENTIONS, POLICIES, PROGRAMS, AND APPROACHES TO IMPROVE SCHOOL CLIMATE AND PREVENT OR REDUCE BULLYING - SUPPORT PROGRAMS AND POLICIES THAT PREVENT OR REDUCE DOMESTIC VIOLENCE AND INCREASE HEALTHY RELATIONSHIPS, BOTH BETWEEN ADULTS AND CHILDREN AND BETWEEN PEERS - PARTICIPATE IN COLLABORATIVES AND PARTNERSHIPS TO ADDRESS MENTAL HEALTH IN THE COMMUNITY 1A. ANTICIPATED IMPACT - REDUCED BULLYING - IMPROVED ACCESS TO SOCIAL/EMOTIONAL HEALTH PROGRAMS AND SERVICES - INCREASED KNOWLEDGE AMONG YOUTH ABOUT METHODS OF COPING WITH STRESS AND DEPRESSION - INCREASED PROPORTION OF YOUTH SERVED WITH EFFECTIVE SOCIAL/EMOTIONAL HEALTH SERVICES - IMPROVED SOCIAL/EMOTIONAL HEALTH AMONG THOSE SERVED - IMPROVED COPING SKILLS AMONG THOSE SERVED - HEALTHIER RELATIONSHIPS FOR THOSE SERVED - REDUCED DISCIPLINARY ACTIONS (SUSPENSIONS, EXPULSIONS) IN SCHOOLS SERVED - IMPROVED SCHOOL CLIMATE IN SCHOOLS SERVED 1B. GOALS - ADDRESS THE SYSTEMIC/INSTITUTIONAL BARRIERS TO MENTAL HEALTH 1B. STRATEGIES - SUPPORT COLLABORATION AND REFERRALS BETWEEN PRIMARY CARE PROVIDERS, EDUCATIONAL PROFESSIONALS, SOCIAL WORKERS, AND OTHERS, AND MENTAL HEALTH SPECIALISTS (AKA YOUTH MENTAL HEALTH CONTINUUM OF CARE) - SUPPORT COORDINATION OF BEHAVIORAL HEALTH CARE AND PHYSICAL HEALTH CARE, SUCH AS CO-LOCATION OF SERVICES, AND MENTAL/BEHAVIORAL HEALTH PROVIDERS TO SUPPORT CO-LOCATED SERVICES - ADVOCACY FOR MENTAL HEALTH PARITY LEGISLATION 1B. ANTICIPATED IMPACT - AMONG PROVIDERS/PROFESSIONALS, INCREASED KNOWLEDGE OF LOCAL RESOURCES AVAILABLE FOR TREATMENT OF DEPRESSION AND RELATED DISORDERS - GREATER COLLABORATION AND COORDINATION IN PROVIDING MENTAL HEALTH SERVICES TO YOUTH - IMPROVED ACCESS TO COORDINATED SOCIAL/EMOTIONAL HEALTH SERVICES 1C. GOALS - IMPROVE MEDIA LITERACY AMONG YOUTH IN LIGHT OF MENTAL HEALTH 1C. STRATEGIES - SUPPORT INITIATIVES, PROGRAMS, AND SERVICES FOR YOUTH TARGETING MEDIA LITERACY, CRITICAL THINKING, AND THE ROLE OF PEERS 1C. ANTICIPATED IMPACT - GREATER MEDIA LITERACY AMONG THOSE SERVED - INCREASED CRITICAL THINKING ABILITIES AMONG THOSE SERVED - HEALTHIER USE OF SOCIAL MEDIA BY THOSE SERVED - REDUCED IMPACT OF CYBERBULLYING AMONG THOSE SERVED 2. ECONOMIC STABILITY 2A. GOALS - Reduce housing instability among vulnerable community members to support better health outcomes 2A. STRATEGIES - Support efforts to improve equitable access to social services that address housing insecurity and financial instability - Support local homelessness prevention organizations and collaboratives that provide temporary financial assistance, legal support, case management and/or other needed services to low-income individuals and families at risk of losing their housing - Support integrated case management programs that link vulnerable individuals with housing 2A. ANTICIPATED IMPACT - Increased equitable access to social services to prevent homelessness - Increased utilization of social services - Reduced proportion of individuals who are housing insecure - Reduced racial/ethnic disparities in housing instability - Increased housing stability among those served - Increased financial stability among those served - Improved health outcomes among those served 2B. GOALS - Reduce food insecurity among vulnerable community members to support better health outcomes 2B. STRATEGIES - Support efforts to improve equitable access to social services that address food insecurity - Support efforts to increase enrollment in CalFresh/SNAP & WIC - Support efforts to increase equitable utilization of existing food banks and other food distribution sites, - Support improvements in social determinants of health screening and referral systems in hospitals and community clinics - Support healthy food access interventions in communities (e.g., community gardens, farmers markets) - Support opportunities for community health education about nutrition/healthy eating 2B. ANTICIPATED IMPACT - Increased equitable access to social services to reduce food insecurity - Increased utilization of social services - Reduced racial/ethnic disparities in food insecurity - Increased food security among those served - Improved health outcomes among those served 2C. GOALS - Reduce economic instability among vulnerable community members to support better health outcomes 2C. STRATEGIES - Support distribution of ""essential resources"" to vulnerable community members - Support efforts to increase workforce-related educational attainment and/or job training - Advocacy for Universal Basic Income pilots 2C. ANTICIPATED IMPACT - More families can meet their basic needs - Reduced unemployment rates - Reduced pay disparities - Reduced inequities in educational attainment - Reduced poverty rates 3. ACCESS TO CARE 3A. GOALS - INCREASE AVAILABILITY OF HEALTH CARE SERVICES FOR VULNERABLE CHILDREN, YOUTH, AND YOUNG ADULTS (AGES 0-24) 3A. STRATEGIES - SUPPORT HEALTH CARE CLINICS IN CLOSE GEOGRAPHIC PROXIMITY TO POPULATIONS OF LOW SOCIOECONOMIC STATUS neighborhoods and other neighborhoods where health care disparities exist) - SUPPORT SYSTEMS APPROACHES TO INCREASED ACCESS TO CARE, INCLUDING TELEMEDICINE, AFTER-HOURS AVAILABILITY, ETC. 3A. ANTICIPATED IMPACT - INCREASED NUMBER OF CHILDREN AND EXPECTANT MOTHERS SERVED - INCREASED ACCESS TO PREVENTATIVE MEDICINE - INCREASED EQUITABLE ACCESS TO HEALTH CARE SERVICES - IMPROVED PATIENT RELATIONSHIPS WITH PRIMARY CARE PHYSICIANS - REDUCED UNNECESSARY ED VISITS/HOSPITALIZATIONS - INCREASED VACCINATION RATES - DECREASED OUTBREAKS OF VACCINE PREVENTABLE DISEASES - REDUCED HEALTH INEQUITIES 3B. GOALS - DIRECT PROVISION OF CARE TO VULNERABLE PATIENTS 3B. STRATEGIES - CONTINUE TO PROVIDE UNCOMPENSATED MEDICAL CARE TO MEDICAL PATIENTS - CONTINUE TO PROVIDE CHARITY CARE TO LOW-INCOME PATIENTS 3B. ANTICIPATED IMPACT - INCREASED NUMBER OF CHILDREN AND EXPECTANT MOTHERS SERVED - Increased equitable access to health care services - Reduced health inequities 3C. GOALS - ENSURE FUTURE SUPPLY OF DIVERSE HEALTH CARE PROVIDERS 3C. STRATEGIES - PROVIDE TRAINING TO HEALTH CARE PROFESSIONALS - Support efforts to increase diversity of health care workforce 3C. ANTICIPATED IMPACT - INCREASED NUMBER OF QUALIFIED PROVIDERS IN THE COMMUNITY FOCUSED ON COMMUNITY-BASED PRACTICES - STANDARD OF CARE RAISED - Increased equitable access to health care services 3D. GOALS - ADDRESS SYSTEMIC/INSTITUTIONAL BARRIERS TO ACCESS 3D. STRATEGIES - ADVOCATE FOR HEALTH CARE POLICY CHANGE AT THE LOCAL, STATE, AND FEDERAL LEVELS THAT IMPROVE HEALTH CARE ACCESS FOR VULNERABLE CHILDREN AND FAMILIES 3D. ANTICIPATED IMPACT - SYSTEM-WIDE HEALTH CARE IMPROVEMENTS FOR CHILDREN AND FAMILIES - Increased equitable access to health care services - Reduced health inequities"

PART V, SECTION B, LINE 11 (CONTINUED)
4. MATERNAL AND INFANT HEALTH 4A. GOALS - REDUCE THE RATES OF TEEN BIRTHS AND IMPROVE THE LIVES OF TEEN MOTHERS AND THEIR CHILDREN 4A. STRATEGIES - Expand access to teen pregnancy prevention programs among populations with historically high rates of teen pregnancy - EXPAND ACCESS TO DEPRESSION SCREENING PROGRAMS FOR PREGNANT AND NEW TEEN MOTHERS, INDIVIDUAL OR GROUP-BASED PARENTING PROGRAMS, HOME VISITS, AND NURSE/FAMILY PARTNERSHIPS 4A. ANTICIPATED IMPACT - LOWER RATE OF TEEN BIRTHS - REDUCED DISPARITIES IN TEEN BIRTH RATES - IMPROVED MENTAL HEALTH OF PREGNANT TEENS AND TEEN PARENTS 4B. GOALS - INCREASE LEVELS OF ADEQUATE PRENATAL CARE 4B. STRATEGIES - Expand access to enhanced prenatal care programs among Black women and other populations with historical disparities in birth outcomes - Expand access to group prenatal care among Black women and other populations with historical disparities in birth outcomes - Expand community access to prenatal health education 4B. ANTICIPATED IMPACT Among Black women and women from other populations with historical disparities in birth outcomes: - Increased number of pregnant women who benefit from home visits - Improved access to prenatal health education - Higher enrollment in group prenatal care programs - Improved access to prenatal care - More favorable birth outcomes (fewer incidences of low or very low birthweight, preterm or very preterm birth, and infant mortality) 4C. GOALS - Reduce disparities in birth outcomes 4C. STRATEGIES - Expand access to enhanced prenatal care programs among Black women and other populations with historical disparities in birth outcomes - Expand access to group prenatal care among Black women and other populations with historical disparities in birth outcomes - Expand community access to prenatal health education 4C. ANTICIPATED IMPACT - GREATER EQUITY IN BIRTH OUTCOMES 4D. GOALS - REDUCE RISKS OF INJURY TO INFANTS 4D. STRATEGIES - SUPPORT PUBLIC CAMPAIGNS, ADVOCACY, EDUCATION, AND/OR PROGRAMS AIMED AT REDUCING UNINTENTIONAL INJURIES (E.G., SIDS, VEHICULAR ACCIDENTS, FALLS), INCLUDING INFANT CPR - SUPPORT PUBLIC CAMPAIGNS, ADVOCACY, EDUCATION, AND/OR PROGRAMS AIMED AT REDUCING CHILD ABUSE AND NEGLECT, INCLUDING HOME VISITS 4D. ANTICIPATED IMPACT - INCREASED AWARENESS OF INFANT SAFETY - REDUCED NUMBER OF INFANT INJURIES - REDUCED NUMBER OF INFANT DEATHS DUE TO UNINTENTIONAL INJURIES, ABUSE, OR NEGLECT LPCH is dedicated to investing in community-based organizations and programs/services that improve these health needs in the community. These health needs comprise the primary focus of our proactive community benefit work and the grantmaking program. LPCH's community investments will focus primarily on the four community health needs listed above by investing staff time and financial resources into local community-based organizations working on projects or offering services in areas that reflect a shared commitment to improving these community health needs. IN ADDITION, LPCH WILL CONTINUE TO LEVERAGE OUR RESOURCES AND EXPERTISE WHILE PARTNERING WITH OTHERS ON THE REMAINING IDENTIFIED COMMUNITY HEALTH NEEDS FOR THE LIFE OF THIS CHNA. MANY OF THE UNSELECTED SIGNIFICANT HEALTH NEEDS OVERLAP AND THUS WILL RECEIVE ATTENTION AS THE HOSPITAL CONDUCTS ITS WORK AROUND THE FOUR PRIORITY AREAS IDENTIFIED BELOW. ALL ELEVEN IDENTIFIED HEALTH NEEDS WILL RECEIVE ATTENTION AND RESOURCES EITHER DIRECTLY OR INDIRECTLY. HEALTH NEEDS NOT SELECTED BY LPCH'S IMPLEMENTATION STRATEGY: LPCH WILL ADDRESS THE FOUR HEALTH NEEDS THAT MET ALL OF THE PRIORITIZATION/SELECTION CRITERIA. LPCH'S WILL NOT ADDRESS THE FOLLOWING IDENTIFIED HEALTH NEEDS: The following health needs were not chosen because the need was not strongly prioritized by the community or because existing programs/resources are available: - Asthma - Climate/Natural Environment - Cancer - Community Safety - Diabetes and Obesity - Unintended Injuries - Sexually Transmitted Infections

PART V, SECTION B, LINE 16A, 16B & 16C
"LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD (""LPCH"") MAKES ITS FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY AVAILABLE TO THE PUBLIC AT HTTPS://WWW.STANFORDCHILDRENS.ORG/EN/PATIENT-FAMILY-RESOURCES/FINANCIAL-AS SISTANCE-ENGLISH. IT IS ALSO AVAILABLE ON THE STATEMENTS SENT TO PATIENTS."

PART V, SECTION B, LINE 20A
FINANCIAL ASSISTANCE DISCUSSION OCCURS AT THE TIME OF ADMISSION WHEN THE PATIENT SPEAKS WITH A FINANCIAL COUNSELOR. FINANCIAL ASSISTANCE INFORMATION IS ALSO INCLUDED IN THE ADMISSION PACKETS PROVIDED TO PATIENTS. LPCH WILL PURSUE PAYMENT FOR DEBTS OWED FOR HEALTH CARE SERVICES PROVIDED BY LPCH. ALL PATIENT ACCOUNT BALANCES THAT MEET LPCH CRITERIA FOR ASSIGNMENT TO BAD DEBT ACCORDING TO LPCH POLICY AND PROCEDURES ARE ELIGIBLE FOR PLACEMENT WITH A COLLECTION AGENCY. HOWEVER, LPCH DOES NOT CURRENTLY ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITY (ECA).

PART V, SECTION B, LINE 20B & 20C
FINANCIAL ASSISTANCE DISCUSSION MAY ALSO OCCUR AT THE TIME OF DISCHARGE WITH A FINANCIAL COUNSELOR IF THE PATIENT EXPRESSES CONCERN ABOUT FINANCIAL LIABILITY.

PART V, SECTION B, LINES 20D AND 20E
LPCH DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS IN FY22.

SCHEDULE H, PART I, LINE 3C
For Financial Assistance Program, LPCH considers US residency as the criteria for eligibility. For Charity Care, LPCH does not limit it to US residency; international patients could also be eligible. SCHEDULE H, PART I, LINE 6 THE ORGANIZATION PREPARED A COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2022 AND IT IS AVAILABLE TO THE PUBLIC AT HTTP://WWW.STANFORDCHILDRENS.ORG/EN/ABOUT/GOVERNMENT-COMMUNITY/BENEFITS- REPORTS. SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $18,372,358. SCHEDULE H, PART I, LINE 7 Some of the amounts in Line 7 were calculated based on a cost accounting system. These items include charity care at cost, unreimbursed Medicaid cost, and unreimbursed costs related to other means-tested government programs. The cost accounting system addresses all patient segments, but excludes research and some grant related costs. Other benefit costs are direct, separately identifiable costs incurred by the organization.

SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES
LPCH invests in various community building activities in order to improve the community's health through a focus on the root causes of health problems, such as poverty, environmental issues, etc. LPCH's community building activities include: support for community-based non-profits working to address the root causes of health issues for children and expectant mothers; support for community emergency management, advocacy for children's health issues, and support for organizations working on economic development in the community.

SCHEDULE H, PART III, LINE 2
The costing methodology used to determine the amount reported on Line 2 is based on a cost accounting system. The hospital applied the same system-wide cost to charge ratio from the cost accounting system to its provision for doubtful accounts based on charges as was applied to its charity care based on charges. The cost to charge ratio from the organization's cost accounting system addresses all patient segments and excludes research and some grant related costs.

SCHEDULE H, PART III, LINE 4
"THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A SPECIFIC FOOTNOTE THAT DESCRIBES PROVISION FOR DOUBTFUL ACCOUNTS. Effective September 1, 2018, LPCH adopted ASU 2014-09, ""Revenue from Contracts with Customers"" (FASB ASC 606) using a modified retrospective method of application to all contracts existing upon adoption. The most significant impact of adopting the new standard is in the presentation in the consolidated statement of operations and changes in net assets where historical provision for bad debts is now considered an implicit price concession in determining the consideration expected to be paid to LPCH, and is therefore recorded as a direct reduction of patient revenue and patient accounts receivable."

SCHEDULE H, PART III, LINE 8
THE MEDICARE SHORTFALL OF ($6,630,505) REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON A COST ACCOUNTING SYSTEM. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY THE HOSPITAL. ACCORDINGLY, THE HOSPITAL MUST SUBSIDIZE THE COST OF CARE PROVIDED TO MEDICARE BENEFICIARIES WITH OTHER REVENUES.

SCHEDULE H, PART III, LINE 9B
"LPCH has a debt collection policy, which provides information regarding the billing and collection of patient debt, including patients who qualify under financial assistance. This policy complies with California Health Safety Code and the Federal Patient Protection and Affordable Care Act. A. LPCH will pursue payment for debts owed for health care services provided by LPCH according to LPCH policy and procedures. The procedures for assignment to collections/bad debt will be applicable to all LPCH Guarantors. B. LPCH will comply with relevant federal and state laws and regulations in the assignment of bad debt. C. All patient account balances that meet the following criteria are eligible for placement with a collection agency: 1. LPCH has made attempts to collect payment using reasonable collection efforts. LPCH will attempt to mail four (4) Guarantor statements after the date of discharge from outpatient or inpatient care, with a final 10 day notice appearing on the fourth Guarantor statement, indicating the account may be placed with a collection agency. All billing statements include a notice about the LPCH Financial Assistance/Charity Care Policy. 2. Accounts with a ""Returned Mail"" status are eligible for collections assignment after all good faith efforts have been documented and exhausted. 3. If a patient currently has other accounts that are open or unresolved bad debt balances, LPCH reserves the right to send accounts to collections earlier. 4. LPCH will suspend any and all collection actions if a completed Financial Assistance Application, including all requisite supporting documentation, is received. Further, if LPCH determines the individual is eligible for financial assistance, it will promptly refund any overpaid amounts. D. As stated in LPCH's Financial Assistance/Charity Care Policy, a patient who qualifies for a Financial Hardship Discount, may negotiate an extended interest-free payment plan for any patient out-of-pocket fees. The payment plan shall take into account the patient's income, essential living expenses, assets, the amount owed, and any prior payments. E. If a Guarantor disagrees with the account balance, the Guarantor may request the account balance be researched and verified prior to account assignment to a collection agency."

SCHEDULE H, PART VI, LINE 7
"LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD (""LPCH"") FILES AN ANNUAL COMMUNITY BENEFIT REPORT AND IMPLEMENTATION PLAN WITH THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT AS REQUIRED BY STATE LAW, SB 697 (TORRES, 1994)."

SCHEDULE H, PART VI, LINE 2
"IN ADDITION TO CONDUCTING A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND AN ANNUAL IMPLEMENTATION STRATEGY REPORT, LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD (""LPCH"") PARTICIPATES IN NUMEROUS OTHER ENDEAVORS THAT SEEK TO INFORM OUR ASSESSMENT OF THE OVERALL HEALTH OF THE COMMUNITY WE SERVE. THOSE ENDEAVORS ARE LISTED BELOW: 1) LPCH IS A MEMBER OF TWO COLLABORATIVE GROUPS THAT SEEK TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS AS THEIR MAIN FUNCTION: HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY, AND SANTA CLARA COUNTY COMMUNITY BENEFIT COALITION. 2) LPCH HAS DEDICATED COMMUNITY BENEFIT STAFF THAT ACTIVELY ENGAGE WITH COMMUNITY NONPROFITS AND PUBLIC HEALTH DEPARTMENTS WORKING ON BOTH PUBLIC HEALTH AND SOCIAL DETERMINANTS OF HEALTH ISSUES. 3) LPCH IS A MEMBER OF MULTIPLE CHAMBERS OF COMMERCE, REGIONAL ECONOMIC DEVELOPMENT ASSOCIATIONS AND SERVICE CLUBS THAT SEEK TO SHARE KNOWLEDGE ABOUT THE OVERALL HEALTH OF OUR COMMUNITY AND TO ADVOCATE FOR CHANGE THAT SEEKS TO IMPROVE THE HEALTH OF OUR COMMUNITY. THE SILICON VALLEY COUNCIL OF NONPROFITS, A NONPROFIT ASSOCIATION THAT ADVOCATES FOR NONPROFIT SERVICES IS ONE EXAMPLE. 4) LPCH HAS DEDICATED ADVOCACY STAFF THAT WORKS WITH COMMUNITY LEADERS, ELECTED OFFICIALS, AND ADVOCACY ORGANIZATIONS IN ORDER TO INFORM OUR UNDERSTANDING OF THE HEALTH OF OUR COMMUNITY AS WELL AS LARGER NATIONWIDE ISSUES. 5) LPCH LEADERSHIP PLAYS PIVOTAL ROLES ON VARIOUS BOARDS AND COMMITTEES IN THE COMMUNITY AND ACROSS THE NATION THAT INFORMS OUR UNDERSTANDING OF THE HEALTH OF OUR COMMUNITY AS WELL AS NATIONWIDE ISSUES. 6) LPCH HAS A DEEP RELATIONSHIP WITH STANFORD UNIVERSITY SCHOOL OF MEDICINE THAT INFORMS OUR UNDERSTANDING OF THE HEALTH OF OUR COMMUNITY AND THE NATION VIA ACCESS TO WORLD-RENOWNED FACULTY AND RESEARCH. 7) LPCH routinely invests in process improvement, program improvement and strategic planning initiatives that seek to improve the quality and impact of the organization's community investments. LPCH partners with public health experts to evaluate our current efforts and to improve our data collection processes and reporting. These, and other efforts help LPCH better understand the impact of community health improvement efforts on the underserved members of our community. 8) LPCH OFFERS TECHNICAL SUPPORT ASSISTANCE TO ITS community investments grants program member organizations in order to help build organizational sustainability over the long term. 9) IN FY20, LPCH SURVEYED COMMUNITY PARTNERS, GRANTEES, LOCAL LEADERS AND COMMUNITY STAKEHOLDERS IN ORDER TO BETTER UNDERSTAND THE IMPACTS OF COVID-19 AND THE ACCOMPANYING ECONOMIC CHALLENGES. THAT COMMUNITY INPUT HELPED LPCH BUILD A COVID-19 COMMUNITY RESPONSE PLAN THAT FOCUSED ON PROVIDING ESSENTIAL NEEDS SUPPORT TO DISADVANTAGED FAMILIES AND CHILDREN IN OUR COMMUNITY. 10) LPCH MAINTAINs CLOSE RELATIONSHIPS TO COMMUNITY PARTNERS, GRANT RECIPIENTS, LOCAL LEADERS, AND COMMUNITY STAKEHOLDERS IN ORDER TO UNDERSTAND BETTER THE IMPACTS OF COVID-19 AND THE EFFECTS IT HAS HAD ON THE SOCIAL DETERMINANTS OF HEALTH IN OUR COMMUNITY. THOSE EFFORTS RESULTED IN A DEEPER UNDERSTANDING OF HOW THE COMMUNITY'S NEEDS HAVE CHANGED OR DEEPENED OVER THE PAST YEAR. 11) LPCH is focused on numerous health equity initiatives that seek to reduce health disparities in the community. The efforts are focused on adopting a health equity framework for grantmaking, cultural diversity and equity and inclusion training and strategic planning."

SCHEDULE H, PART VI, LINE 3
THE FINANCIAL COUNSELING DEPARTMENT WORKS DIRECTLY WITH ANY PATIENT WHO EXPRESSES QUESTIONS OR CONCERNS ABOUT THEIR ABILITY TO PAY FOR SERVICES. FURTHER, FINANCIAL ASSISTANCE POLICIES ARE POSTED AND AVAILABLE IN ALL PATIENT CHECK-IN AREAS, ONLINE, AND ON PATIENT BILLING CORRESPONDENCE. ALL PATIENT SCHEDULING, REGISTRATION, CHECK-IN, AND CUSTOMER SERVICE STAFF ARE EDUCATED ON POLICIES AND ARE TRAINED TO DIRECT PATIENTS TO THE FINANCIAL COUNSELING DEPARTMENT. A. PUBLIC NOTICE CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY IS GIVEN BY THE FOLLOWING MEANS: 1. NOTICES ARE POSTED IN VISIBLE LOCATIONS WHERE THERE ARE HIGH VOLUMES OF INPATIENT AND/OR OUTPATIENT ADMITTING/REGISTRATIONS, BILLING OFFICES, ADMITTING OFFICES AND HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. POSTED NOTICES EXPLAIN THAT LPCH HAS A VARIETY OF OPTIONS AVAILABLE INCLUDING FINANCIAL ASSISTANCE AND DISCOUNTS TO PATIENTS WHO ARE UNINSURED AND UNDERINSURED. 3. NOTICES INCLUDE A CONTACT TELEPHONE NUMBER. A PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND TO APPLY FOR FINANCIAL ASSISTANCE. B. THE LPCH WEBSITE INCLUDES AN EXPLANATION OF THE FINANCIAL ASSISTANCE/CHARITY CARE POLICY, THE DEBT COLLECTION POLICY, FINANCIAL ASSET APPLICATION, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY, THE UNINSURED PATIENT DISCOUNT POLICY, THE AVAILABILITY OF SUCH ASSISTANCE AND DISCOUNTS, AND A TELEPHONE NUMBER. C. LPCH BILLING STATEMENTS INFORM THE PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE BY CONTACTING THE LPCH CUSTOMER SERVICE CENTER.

SCHEDULE H, PART VI, LINE 4
Because of its international reputation for providing outstanding care to babies, children, adolescents, and expectant mothers, LPCH serves patients and their families around the entire San Francisco Bay Area. In the 13-county Northern California region LPCH ranks first for pediatrics, with 10.1 percent market share, and third for obstetrics, with 4.4 percent market share. However, LPCH's 2021 discharge data show that slightly less than half (46.7 percent) of its inpatient pediatric cases (excluding normal newborns) and 81.1 percent of obstetrics cases come from San Mateo and Santa Clara counties. So, for purposes of its community benefit initiatives, LPCH has identified these two counties as its target community. This hospital ranks first in market share (19.9 percent) for pediatrics and second for obstetrics (9.3 percent) in its primary service area. San Mateo County comprises 19 cities and more than two dozen unincorporated towns and areas. It is far less populous than Santa Clara County, with approximately 746,752 residents in 2019. Daly City is San Mateo County's largest city by population, with just over 106,000 people (14% of the total). The population of the county is substantially more dense than the state, with 9,206 people per square mile compared to 8,486 per square mile in California. The median age in San Mateo County is 40.3 years old. Over 20% of the county's residents are under the age of 18, and nearly 16% are 65 years or older. Santa Clara County comprises 18 cities and large areas of unincorporated rural land. In 2019, approximately 1.92 million people lived there, making it the sixth largest county in California by population. San Jose is its largest city, with over 1.02 million people (53% of the total). The population of the county is substantially more dense than the state, with 9,115 people per square mile compared to 8,486 per square mile in California. The median age in Santa Clara County is 38.1 years old. More than 22% of the county's residents are under the age of 18, and over 13% are 65 years or older. In both counties, residents aged 0-14 make up about one fifth of the population, which is similar to the state. The percentage of women aged 15-50 who have given birth is 5 percent in both counties and in California. The ethnic makeup of both counties is extremely diverse. In total, the non-white population of San Mateo County represents about 62% of its total population, while 70% of Santa Clara County's total population is non-white. RACE/ETHNICITY SANTA CLARA COUNTY SAN MATEO COUNTY TOTAL PERCENTAGE OF COUNTY TOTAL PERCENTAGE OF COUNTY AMERICAN INDIAN/ALASKAN NATIVE 0.2 0.1 ASIAN 38.5 30.1 BLACK 2.3 2.2 HISPANIC/LATINX 25.1 24.2 PACIFIC ISLANDER/NATIVE HAWAIIAN 0.3 1.3 WHITE 29.9 37.8 MULTIRACIAL 3.4 4.0 SOME OTHER RACE 0.2 0.4 More than 34% of residents in San Mateo County and more than 39% of residents in Santa Clara County are foreign-born. This percentage is higher than the foreign-born populations statewide (27%) and nationwide (14%). Our communities earn some of the highest annual median incomes in the U.S., but they also bear some of the highest costs of living. Median household incomes are $130,820 in San Mateo County and $129,210 in Santa Clara County, both far higher than California's median of $82,053. Yet the California Self-Sufficiency Standard, set by the Insight Center for Community Economic Development, suggests that many households in San Mateo and Santa Clara counties are unable to meet their basic needs. (The Standard in 2021 for a family with two children, the 2021 standard was $166,257 in San Mateo County and $144,135 in Santa Clara County.) Housing costs are high: In 2021, the median home price was $1.6 million and the median rent was $2,451 in San Mateo County; this compares to $1.4 million and $2,374 in Santa Clara County. In both counties, 26% of children are eligible for free or reduced-price lunch and close to one quarter of children live in single-parent households (22% of children in San Mateo County and 23% of children in Santa Clara County). About 4% of people in our communities are uninsured. The minimum wage in San Mateo County was $14-$15.90 per hour in 2021 and in Santa Clara County was $14-$16.30 per hour, where self-sufficiency requires an estimated $34-$39 per hour. California Self-Sufficiency Standard data show a 26% increase in the cost of living in San Mateo County and a 27% increase in Santa Clara County between 2018 and 2021, while the U.S. Bureau of Labor Statistics reports only a 5.4% per year average increase in wages in the San Jose-Sunnyvale-Santa Clara metropolitan area between 2018 and 2020. Judging by the Neighborhood Deprivation Index, a composite of 13 measures of social determinants of health such as poverty/wealth, education, employment, and housing conditions, both counties' populations overall are healthier than the national average. Although San Mateo and Santa Clara counties are quite diverse and have substantial resources, there is significant inequality in their populations' social determinants of health and health outcomes. For example, the Gini Index, a measure of income inequality, is higher in certain ZIP Codes compared to others. Certain areas also have poorer access to high-speed internet (e.g., ZIP Codes 95013, 94074), walkable neighborhoods (e.g., ZIP Codes 95002, 94060), or jobs (e.g., ZIP Codes 95020, 94044). In our assessment of the health needs in our community, we focus particularly on disparities and inequities within our community rather than simply in comparison to California or the nation as a whole.

SCHEDULE H, PART VI, LINE 5
"LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD (""LPCH"") MAKES ANNUAL COMMUNITY INVESTMENT GRANTS TO COMMUNITY NONPROFITS WORKING ON SIGNIFICANT HEALTH NEEDS AS DETERMINED BY THE MOST RECENT CHNA. IN ADDITION, THE HOSPITAL MAKES SIGNIFICANT INVESTMENTS THAT PROMOTE THE HEALTH OF THE COMMUNITY. THESE PROGRAMS ARE FULLY DESCRIBED IN THE FY2022 COMMUNITY BENEFIT REPORT AND FY2023 IMPLEMENTATION PLAN FILED FEBRUARY 2023 WITH THE STATE OF CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. A THOROUGH ACCOUNTING OF THE HOSPITAL'S EFFORTS TO PROMOTE COMMUNITY HEALTH CAN BE READ IN THE REPORT, WHICH IS AVAILABLE AT communitybenefit.stanfordchildrens.org BELOW IS A LISTING OF LPCH'S SERVICES AND ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITY WE SERVE: HEALTH PROFESSIONS EDUCATION THE HOSPITAL IS A MAJOR EMPLOYER IN THE COMMUNITY IT SERVES AND, AS AN ACADEMIC MEDICAL CENTER, INVESTS SIGNIFICANTLY IN TRAINING THE HEALTH-CARE PROFESSIONALS OF THE FUTURE. THE HOSPITAL IS A MAJOR PROVIDER OF TRAINING FOR RESIDENT PHYSICIANS, FELLOWS AND MEDICAL STUDENTS, NURSES, AND ALLIED HEALTH PROFESSIONS FROM AROUND THE REGION FROM VARIOUS ORGANIZATIONS. THE HOSPITAL PROVIDES ANNUAL FUNDING FOR PEDIATRIC RESIDENTS ADVOCACY AND COMMUNITY HEALTH TRAINING AND PARTICIPATES IN STATE AND NATIONAL COLLABORATIVE WORKING ON MATERNAL AND PEDIATRIC HEALTH. COMMUNITY HEALTH IMPROVEMENT THE HOSPITAL CONDUCTS MULTIPLE PROGRAMS THAT ARE OFFERED AT NO COST TO COMMUNITY MEMBERS AND SEEKS TO IMPROVE THE HEALTH AND HEALTH KNOWLEDGE OF THE COMMUNITY. THESE ACTIVITIES INCLUDE DIRECT MEDICAL SERVICES FOR IMPOVERISHED TEENS, CHILD SAFETY PROGRAMS, COMMUNITY HEALTH LECTURES AND SEMINARS, ONGOING RESEARCH IN THE AREAS OF CHILD AND MATERNAL HEALTH, ETC. COMMUNITY HEALTH IMPROVEMENT GRANTS AT LPCH WE BELIEVE THAT WE CAN IMPACT THE HEALTH OF OUR COMMUNITY ON AN EVEN DEEPER LEVEL WHEN WE PARTNER WITH EXISTING COMMUNITY-BASED ORGANIZATIONS THAT ARE WORKING ON SHARED HEALTH INITIATIVES. WE ARE DEDICATED TO INVESTING IN LOCAL NONPROFITS THROUGH OUR COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. ANNUALLY, WE FUND A WIDE ARRAY OF PROGRAMS AND PROJECTS SEEKING TO IMPROVE THE HEALTH OF OUR COMMUNITY. COMMUNITY BUILDING ACTIVITIES THE HOSPITAL PARTICIPATES IN A MYRIAD OF COMMUNITY BUILDING ACTIVITIES THAT SEEK TO IMPROVE THE COMMUNITY'S HEALTH AND SAFETY. THESE SERVICES AND ACTIVITIES ARE EITHER PROVIDED BY THE HOSPITAL ITSELF OR INVOLVE SUPPORT FOR COMMUNITY ORGANIZATIONS WORKING IN THE AREAS OF: POVERTY, HOMELESSNESS, ECONOMIC DEVELOPMENT, ETC. HOSPITAL LEADERSHIP ALSO VOLUNTEERS THEIR EXPERTISE ON MULTIPLE COMMUNITY NONPROFIT BOARDS WORKING TO IMPROVE THE HEALTH OF THE COMMUNITY. THE HOSPITAL ALSO SUPPORTS LOCAL EMERGENCY MANAGEMENT EFFORTS, SUPPORTS ECONOMIC DEVELOPMENT IN THE REGION THROUGH TRANSPORTATION AND HOUSING ADVOCACY, AND ADVOCATES FOR CHILDREN'S HEALTH ISSUES. ACADEMIC MEDICAL CENTER - RESEARCH LPCH IS PART OF STANFORD UNIVERSITY SCHOOL OF MEDICINE, THE WEST COAST'S OLDEST MEDICAL SCHOOL AND WORLDWIDE LEADER IN PATIENT CARE, EDUCATION, RESEARCH, AND INNOVATION. LPCH IS PROUD TO BE THE PRIMARY TEACHING HOSPITAL OF STANFORD UNIVERSITY SCHOOL OF MEDICINE-ONE OF THE TOP RANKED ACADEMIC MEDICAL INSTITUTIONS IN THE COUNTRY. THROUGHOUT HISTORY, STANFORD UNIVERSITY SCHOOL OF MEDICINE HAS BEEN HOME TO CUTTING-EDGE MEDICAL ADVANCES, INCLUDING THE FIRST SUCCESSFUL ADULT HUMAN HEART TRANSPLANT IN THE COUNTRY AND THE FIRST COMBINED HEART-LUNG TRANSPLANT IN THE WORLD. LPCH FUNDS ONGOING RESEARCH THROUGH STANFORD UNIVERSITY SCHOOL OF MEDICINE THAT SEEKS TO IMPROVE THE HEALTH OF OUR COMMUNITY."