4A (Expenses $ 24131114 including grants of $ 0) (Revenue $ 24566152)
IU HEALTH BLACKFORD HOSPITAL IS A 15-BED CRITICAL ACCESS HOSPITAL THAT OFFERS A BROAD RANGE OF SERVICES TO CARE FOR ITS PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IU HEALTH BLACKFORD HOSPITAL FEATURES ALL PRIVATE ROOMS, A SPECIALTY CLINIC, CARDIAC AND PULMONARY REHABILITATION, OUTPATIENT SURGICAL SERVICES AND DIAGNOSTIC IMAGING. IN ADDITION TO PROVIDING 24 HOUR EMERGENCY SERVICES, THE HOSPITAL HOSTS A PARAMEDIC-LEVEL AMBULANCE SERVICE.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 4280702)
As of December 31, 2021, Indiana University Health Blackford Hospital, Inc. received stimulus funds from the Provider Relief Fund under the provisions of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) and Paycheck Protection Program and Health Care Enhancement Act. Indiana University Health Blackford Hospital recognized $4,280,702 as other program service revenue. Indiana University Health Blackford Hospital, Inc. will continue to monitor compliance with the terms and conditions of the Provider Relief Fund.

4C (Expenses $ 122225 including grants of $ 0) (Revenue $ 124428)
INDIANA UNIVERSITY HEALTH BLACKFORD HOSPITAL, INC. LEASES PHYSICIAN AND CLINIC SPACE TO RELATED TAX-EXEMPT ORGANIZATIONS. IU HEALTH BLACKFORD RECEIVES REVENUE FROM A RELATED 501(C)(3) ENTITY FOR SHARED SERVICES.

Schedule H, Part V, Section B, Line 3E
IU Health Blackford Hospital's 2021 Community Health Needs Assessment (CHNA) report includes a prioritized description of significant health needs in the community. The CHNA report identified the following needs as priorities for IU Blackford Hospital: 1. Access to Healthcare Services 2. Aging Population and Needs of Seniors 3. Behavioral Health 4. Chronic Disease and Chronic Disease Management 5. Smoking, Tobacco Use and Exposure to Secondhand Smoke 6. Social Determinants of Health

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - IU HEALTH BLACKFORD HOSPITAL. In conducting each its most recent CHNA, IU Health Blackford took into account input from persons who represent the broad interests of the communities it serves by hosting two community focus groups and an interview. These events engaged public health officials and community-based organizations that provide services and/or reflect community members who are medically underserved, low-income, or of a minority subpopulation to discuss the health needs of the service area and what role IU Health could play in addressing the identified needs. IU Health Blackford The defined community per the most recent CHNA is Blackford County, Indiana, where the hospital resides. Blackford County - Community Meetings and Interview Two community meetings were held in 2021 to receive input from stakeholders regarding the health needs in Blackford County - one on April 23 and another on May 13. Secondary data and a preliminary list of community health need priorities was presented at both meetings. Each group was then asked questions about the preliminary list, including their reactions, additions to the proposed needs, thoughts regarding the causes, impacts of the COVID-19 pandemic and others. After these discussions, participants were given the opportunity to make additional comments before being asked to vote on the significant needs in the county. Participants were asked to choose three to five significant health needs in a poll during the meeting. Participants focused discussion on access to mental health services, health insurance barriers, substance abuse and addiction, tobacco use (including during pregnancy and among youth with vaping), a lack of health education, maternal and infant health, childcare, the disconnect between good education rates but lack of jobs, transportation barriers, a lack of knowledge of available resources and others. From this process, participants from the April 23 community meeting identified the following needs as most significant for Blackford County: * Access to mental health providers * Health literacy and education * Substance abuse (including opioids, alcohol and methamphetamines) * Obesity and associated conditions (diabetes, cardiovascular issues) Participants from the May 13 community meeting identified the following needs as most significant for Blackford County: * Substance abuse and addiction (including tobacco usage) * Access to healthcare services * Access to mental health services * Maternal, infant and child health and wellbeing In discussing the impacts of the COVID-19 pandemic on health, participants focused on isolation and its impacts on mental health, increase in substance abuse, impacts on child learning, increase in domestic violence and abuse, increasing physical inactivity and growing community conflict and negative attitudes (including towards frontline workers). An additional community survey was issued to stakeholders unable to attend community meetings, asking them to identify priority needs. Among two responses, the following issues were identified as the most significant by both respondents: * Substance abuse and addiction * Mental health and suicide * Poverty and lack of resources for low-income population * Lack of providers (specialists and mental health) The survey also asked about the impacts of the COVID-19 pandemic. Issues selected as significant impacts by both respondents include: * Social isolation and loneliness * Learning and development impacts among children An additional interview was conducted with a representative of a local public health department to obtain subject-matter expertise into the health needs in Blackford County. The following issues were discussed as significant: * Substance abuse and addiction is a significant issue * Mental health and access to mental health care are significant issues, amplified by the COVID-19 pandemic * Maternal and infant health issues exist, particularly around teen births and smoking during pregnancy * Smoking and obesity are two issues that have long been identified as issues in Blackford and continue to persist despite local work * Transportation is a large barrier to accessing services, particularly a lack of public transportation options * More community focus on health lifestyle is needed, including nutrition, physical activity, tobacco-free residents and accessible areas to exercise (health education plays a role here) Community meeting and survey participants Individuals from a wide variety of organizations and communities participated in the interview process, community meetings and surveys. Participants included representatives from the following organizations: * Blackford County Community Corrections * Blackford County Community Foundation * Blackford County Economic Development Corporation * Blackford County Health Department * Blackford County Schools * Blackford County Sheriff's Office * Citizens State Bank * Indy Container Board * IU Health * IU Health Ball * IU Health Blackford * LifeStream Services * Purdue Extension * Second Harvest Food Bank * Smith Insurance Services

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - IU HEALTH BLACKFORD HOSPITAL. In conjunction with the CHNA, IU Health Blackford Hospital's Board adopted an implementation strategy in April 2022 related to the 2021 CHNA. IU Health Blackford Hospital prioritized and determined which of the community health needs identified in its most recently conducted CHNA were most critical for it to address. IU Health Blackford Hospital will address the following community health needs between 2022 and 2024: - Access to Healthcare Services - Aging Population and Needs of Seniors - Behavioral Health* - Chronic Disease and Chronic Disease Management* - Smoking, Tobacco Use and Exposure to Secondhand Smoke - Social Determinants of Health* *IU Health uses the term Behavioral Health to refer to mental health and drug and substance abuse (including opioids and alcohol) *Chronic Disease and Chronic Disease Management includes needs such as obesity, diabetes, and physical inactivity *Social Determinants of Health includes needs such as food insecurity and healthy eating IU Health Blackford Hospital will address all community health needs based on their 2021 Community Health Needs Assessment. There were no identified needs that will not be addressed. In addition, during 2021 IU Health Blackford Hospital continued to address the needs identified in the 2018 CHNA, through the implementation strategy adopted in April 2019 related to the 2018 CHNA. IU Health Blackford will address the following community health needs in between 2019 and 2021: - Access to Healthcare Services - Aging Population and Needs of Seniors - Drug and Substance Abuse (including Opioids and Alcohol) - Maternal and Infant Health and Child Wellbeing - Mental Health - Obesity and Diabetes - Smoking and Tobacco Usage - Social Determinants of Health IU Health uses the term ""Behavioral Health"" to refer to Mental Health and Drug and Substance Abuse (including Opioids and Alcohol). Access to Healthcare Services IU Health Blackford's implementation strategy to address the identified need of Access to Healthcare includes the following: Five-Year Physician Plan - Recruit new primary care, obstetric and mental health medical doctors to practice in East Central Region. In 2021, a new two-physician primary care clinic was established in Upland and also includes a FNP-BC to provide additional primary care support. A partnership with Taylor University began providing a student health center at this practice starting in the fall. The IU Health Blackford clinic received a Rural Health Clinic (RHC) certification in November of 2020 and began practicing as a RHC on 1/1/2021. A new Nurse Practitioner joined the Blackford practice in May of 2021. Jay Family First Health added a new physician in the fall of 2021. A new clinic was opened in Muncie in the second half of 2021 with a newly recruited Family Medicine/OB physician. Another newly recruited Family Medicine Physician started in Portland in September. Three new APPs for Family Medicine have been recruited to join clinic opening in Albany late 2021. The capability for any primary care clinic to do acute behavioral health consults virtually was added in 2021. Aging Population and Needs of Seniors IU Health Blackford's implementation strategy to address the identified need of Aging Population and Needs of Seniors include the following: East Central Indiana Food Council The East Central Indiana Food Council is a volunteer-run organization led by local activists interested in addressing community issues around new food policy, food waste reduction, healthy eating and food access. It receives support from the IU Health-driven Healthy Community Alliance initiative. The group has strategically grown from a Delaware County focus to include participants from Blackford and Jay Counties. The Council is composed of multiple community collaborators representing Ball State University, The Muncie Food Hub, IU Health, Purdue Extension, Second Harvest Food Bank, Grace Baptist Church, the Soup Kitchen of Muncie, Blood-n-Fire Ministries, Community and Family Services Food Pantries in Hartford City, Montpelier and Portland and the Children's Bureau; as well as local farmers and farmers market organizers. The Healthy Community Alliance Nutrition Workgroup was combined into the Food Council in June 2021 and this has brought additional partners into the collaborative discussions as well as integrating a more defined focus on healthy eating. The group organized educational activities and field trip in July 2021 to tour an aquaculture facility which has long term potential to bring fresh produce to underserved areas. Families at the Farmers Market The Families at the Farmers Market in Muncie and Hartford City are offered in IU Health's East Central Region each year. In 2021, the program's in-person sessions were eliminated due to COVID-19 precautions. 68 families in Muncie and 29 families in Hartford City received a healthy lifestyle packet with coupons redeemable at local farmers markets and farm stands. Tobacco cessation information was also included. Head Start joined the collaboration and facilitated connections with families in Blackford County. 67% of survey participants stated they utilize fresh fruits/vegetables at ""most meals"" after completing the program; 100% of respondents stated they ""Learned a Lot""; and reported they used the Farmers Market ""2 or more times."" Coupon redemption rates were slightly more than 50%. Several new farmers market locations were added to extend the footprint of the program. In 2021, area markets processed more than $2,800 worth of produce from area families primarily from underserved areas of the community. Collaborators - Minnetrista, Whitely Comm. Council, Ross Center, Minority Health Coalition, Ivy Tech, Boys/Girls Club, Buley Center, Open Door Health Services, Salvation Army, YWCA of ECI, YMCA/Appletree, Youth Opportunity Center, Hillcroft, Spangler Farms, Northern Tropics Greenhouse and IU Health Blackford Hospital Hospital. Blackford County: Children and Family Services of Blackford County /WIC, Grace United Methodist Church, Growers and Makers Market, Common Grounds Coffee Shop, Blackford County Public Library, Purdue Extension, and IU Health Blackford. Healthy Community Alliance of East Central Indiana (HCA) The Healthy Community Alliance of East Central Indiana (HCA) engaged 149 collaborating organizations in 3 ECR counties- Delaware, Blackford and Jay during 2021. HCA makes multiple resources available to collaborators, including facilitated workgroup sessions in each county, materials such as Tobacco Cessation Toolkits and Healthy Lifestyle toolkits; and online resources such a e-newsletter, media messaging and access to community health data for each of the three counties. These resources are provided to all collaborating organizations free of charge. A majority of HCA Partner organizations are currently utilizing at least one of these provided resources to influence change amongst their audiences. To adapt to COVID-19 restrictions, in 2021 the HCA retooled its virtual workgroup process to focus on specific partner initiatives for obesity prevention and tobacco cessation and ways other partners can become engaged. One new partner was added in 2021."

Schedule H, Part V, Section B, Line 11 Facility , 2
"Facility , 2 - IU HEALTH BLACKFORD HOSPITAL (CONTINUED). Blackford Community Partnership Plan IU Health Blackford established a hospital advisory council to engage community partners in discussions around community healthcare topics such as the Community Heath Needs Assessment, EMS and County 911 operations, Hospital Quality Outcomes, COVID-19 Response, IU Health Foundation, Medical Staff business, Physician recruitment, Team Member Engagement, and Hospital Finances. Participating organizations include Blackford County Council, 3M, New Indy, Purdue Extension Office, Smith Insurance Agency, Blackford Community Foundation, and the Blackford County Health Department. The group meets for discussion on a bi-monthly basis. In 2021, the group participated in the IU Health Community Health Needs Assessment focus group process. Behavioral Health (includes Drug & Substance Abuse and Mental Health) IU Health Blackford's implementation strategy to address the identified need of Behavioral Health includes the following: IU Health Blackford Hospital Hospital Addiction Treatment and Recovery Center-Adult Intensive Outpatient Program (IOP) - Provide structured therapeutic recovery program. The IU Health Blackford Hospital Addiction Treatment and Recovery Center opened in 2019 and now offers an Intensive Outpatient Program (IOP) - which includes Group therapy Recreation therapy and individual and family counseling services and peer recovery coaching. Medication Assisted Treatment (MAT) is also offered as well as an Individual outpatient Program and IOP Aftercare Program. During 2021, the Center assessed nearly 150 patients, and enrolled more than 150 in the IOP or individual track. Patients who have completed the IOP demonstrate a 35% increase in sobriety and pregnant women have demonstrated a 100% sobriety rate. IU Health Blackford Virtual Care Behavioral Health Hub In 2021, approximately 70 patients were admitted into the IU Health Blackford and Jay Emergency Rooms with an SUD diagnosis. Patients are identified by administering an UNCOPE screening; or the patient reports previous Substance use/treatment; or bedside staff identifies substance misuse is the cause for ED visit. In 2021, approximately 75 episodes of treatment were provided for 60 patients. The Hub employees a total of seven coaches. There is always a coach available 24/7. Average response time, once a consult is requested is approx. 5 mins. The Hub receives a call from ECR every 8-10 days. Collaborators include SCS/Virtual Care, BHC, ED management and staff. Funding is through FSSA and ISDH. New in 2021- PRC support for IU Health Blackford Hospital when in person coaches are not available, approximately seven patients seen in 2021. Drug Take Back Program - Provide prescription medication disposal kiosks at IU Health East Central Region facilities. Drug take-back kiosks have been installed at four East Central Indiana locations: Pavilion Pharmacy at IU Health Blackford Hospital Memorial Hospital in Muncie; IU Health Yorktown Pharmacy, Yorktown; IU Health Blackford Pharmacy, Hartford City; and IU Health Jay Hospital, Portland. The kiosks are open to the public and available during business hours. IU Health has installed drug take-back kiosks at four east central Indiana pharmacy locations: the kiosks are open to the public and available during business hours. In 2021, over 1,400 pounds of prescription medications were recovered. Blackford Community Partnership Plan *See Initiative Update under Aging Population and Needs of Seniors. Maternal and Infant Health and Child Well-being IU Health Blackford's implementation strategy to address the identified need of Maternal and Infant Health and Child Wellbeing include the following: Obstetric Clinic - Provide two family medicine directors and a resident rotation at a subsidized rate to local federally qualified health center. IU Health Blackford Hospital provided two family Medicine Directors plus a resident rotation at a subsidized rate to Open Door health Services (which services several counties including Blackford County). This has allowed Open Door to expand its obstetric capability to service low-income residents of East Central Indiana. The two physicians provided more than 9,000 patient encounters in 2021. Other OB Services are offered at IU Health Blackford Hospital Memorial Hospital through its Family Medicine Program, Perinatal Center and physician practice facilities. Several other private practices offer OB Services to the community as well. Obesity and Diabetes IU Health Blackford's implementation strategy to address the identified need of Obesity and Diabetes include the following: East Central Indiana Food Council *See Initiative Update under Aging Population and Needs of Seniors. Healthy Community Alliance of East Central Indiana (HCA) *See Initiative Update under Aging Population and Needs of Seniors. Families of the Farmers Market *See Initiative Update under Aging Population and Needs of Seniors. Smoking and Tobacco Usage IU Health Blackford's implementation strategy to address the identified need of Smoking and Tobacco Usage include the following: 1-800-QUIT-NOW: Indiana Tobacco Quitline - Educate staff regarding ""Ask, Advise, Refer"" process to refer patients and family members to the Indiana Tobacco Quitline. In 2021, after declining during the COVID-19 pandemic, the Indiana Tobacco Quit Line received a total of 114 referrals from the East Central Region; 76 from Delaware County, 20 from Blackford County and 18 from Jay County. IU Health East Central Region Perinatal Coordinator - Enhance efforts to decrease infant mortality in the IU Health East Central Region. In 2021 the IU Health ECR Perinatal Coordinator implemented a Tobacco Treatment Pilot Program in 5 ECR physician office settings designed to provide client consultations and referrals to 1-800 Quit Now, Baby and Me Tobacco Free program, and pharmacotherapy options. In 2021, the Indiana Department of Health (IDOH) awarded two years of funding for the implementation of a HIPAA compliant text messaging and remote monitoring virtual platform to all obstetrical practices in the ECR providing prenatal care and offering delivery services at IU Health Blackford Hospital. Healthy Community Alliance of East Central Indiana (HCA) *See Initiative Update under Aging Population and Needs of Seniors. Families of the Farmers Market *See Initiative Update under Aging Population and Needs of Seniors. Social Determinants of Health IU Health Blackford's implementation strategy to address the identified need of Social Determinants of Health include the following: Blackford Community Partnership *See Initiative Update under Behavioral Health. IU Health East Central Regional Perinatal Coordinator *See Initiative Update under Smoking and Tobacco. IU Health Blackford addressed all community health needs based on their 2018 Community Health Needs Assessment. There were no identified needs that will not be addressed."

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - IU HEALTH BLACKFORD HOSPITAL. IN ADDITION TO FPG, IU HEALTH BLACKFORD HOSPITAL MAY TAKE INTO CONSIDERATION A PATIENT'S INCOME AND/OR ABILITY TO PAY IN CALCULATION OF A FINANCIAL ASSISTANCE AWARD.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - IU HEALTH BLACKFORD HOSPITAL. IU Health Blackford Hospital takes into consideration several other factors in determining patient eligibility for financial assistance. These factors include the following: 1. Eligibility for Financial Assistance due to Financial or Personal Hardship In order to be eligible for Financial Assistance due to Financial or Personal Hardship under this Policy, a patient or guarantor must: - Submit a completed Financial Assistance Application with all supporting documentation and be approved in accordance with this Policy; - Be an Indiana Resident as defined in this Policy; and - If Uninsured, consult with a member of IU Health's Individual Solutions department to determine if health care coverage may be obtained from a government insurance or assistance product, the Health Insurance Marketplace, or from any other source of coverage. Financial Assistance due to Financial Hardship is only available for encounters where care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility. 2. Financial Assistance due to Financial Hardship The FPL income threshold under this section is as follows: - If one or more adults and zero dependents are in the household, the FPL Income Threshold is 200%. - If two or more adults and one or more dependents are in the household, the FPL Income Threshold is 250%. - If one adult and one or more dependents are in the household, the FPL Income Threshold is 300%. In some instances, an adult will also qualify as a dependent. When this occurs, IU Health will treat the adult as a dependent for purposes of the FPL calculation. IU Health will utilize the most recent FPL data available and will apply the FPL data to a patient or guarantor's account balance based upon the calendar date a completed Financial Assistance Application was received, not a patient's date of service. An Uninsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Gross Charges if approved. An Underinsured Patient or their guarantor whose household income is less than or equal to the FPL income threshold may be eligible for full Financial Assistance up to 100% of Patient Responsibility if approved. 3. Financial Assistance due to Personal Hardship An Uninsured or Underinsured patient or their guarantor whose household income is above the FPL income threshold may be eligible for Financial Assistance if the patient's outstanding Patient Responsibility exceeds 20% of the patient's or their guarantor's annual household income. - If approved, the patient's balance will be reduced to 20% of the patient or guarantor's annual household income or the Amounts Generally Billed, whichever is less. - IU Health will work with the patient or guarantor to identify a reasonable payment plan on the remainder of the balance. 4. Eligibility Period If approved for financial assistance by IU Health, the patient will be guaranteed financial assistance for treatment related to the underlying condition, for which the patient was originally screened and approved, through the remainder of the calendar year. As a condition of extending the on-going Financial Assistance, the patient must comply with requests from IU Health to verify that the patient continues to meet the conditions for qualification. 5. Appeals and Assistance Granted By the Financial Assistance Committee The Financial Assistance Committee will review and make determinations on all requests for appeals related to Financial Assistance. If a patient or guarantor seeks to appeal a Financial Assistance Determination, a written request must be submitted, along with the supporting documentation. The Financial Assistance Committee will review requests for and may grant additional Financial Assistance, including but not limited to, the following: - Assistance to patients who are seeking treatment that can only be provided in Indiana by IU Health or who would benefit from continued medical services from IU Health for continuity of care; - Care approved by the IU Health Chief Medical Officer (CMO) or the Chief Executive Officer (CEO) or CMO of an IU Health facility or region, including medically necessary non-elective services for which no payment source can be identified; - Care provided when it is known no payment source exists; - International humanitarian aid; and - Other care identified by the Financial Assistance Committee that fulfills the IU Health Mission. All decisions of the Financial Assistance Committee are final. 6. Presumptive Eligibility No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: - Medicaid (any state) - Indiana Children's Special Health Care Services - Healthy Indiana Plan - Patients who are awarded Hospital Presumptive Eligibility (HPE) - A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: - If the patient or their guarantor is found to have filed a petition for bankruptcy. - If the patient is deceased and found to have no estate. - If the patient is deceased and was under 21 years of age at the time of death. 7. Exhaustion of Alternate Sources of Assistance Patients must exhaust all other state and federal assistance programs prior to receiving Financial Assistance due to Financial or Personal Hardship under this Policy including, but not limited to, Medicaid. Patients who may be eligible for coverage under an applicable health insurance policy must exhaust all insurance benefits. - This includes patients covered under their own policy and those who may be entitled to benefits from a third-party policy. - IU Health may request patients show proof that such a claim was properly submitted to the appropriate insurance provider before awarding Financial Assistance. Eligible patients who receive medical care from an IU Health facility as a result of an injury proximately caused by a third party, and later receive a monetary settlement or award from said third party, may receive Financial Assistance for any outstanding balance not covered by the settlement or award. In the event Financial Assistance has already been granted in the above circumstances, IU Health reserves the right to reverse the Financial Assistance Determination in an amount equal to the amount IU Health would be entitled to receive had no Financial Assistance been awarded. 8. Patient Assets There are situations where a patient or their guarantor may have significant income or assets available to pay for healthcare services such as a legal settlement. The Financial Assistance Committee may evaluate the income or assets in determining Financial Hardship. IU Health may require a list of all property owned by the patient or guarantor and adjust a Financial Assistance Determination as a result.

Schedule H, Part V, Section B, Line 16 Facility , 1
Facility , 1 - IU HEALTH BLACKFORD HOSPITAL. IU Health Blackford Hospital takes several other measures to publicize its FAP within the community. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program.

Schedule H, Part I, Line 6a C.B. REPORT PREPARED BY A RELATED ORG.
"IU HEALTH BLACKFORD HOSPITAL'S COMMUNITY BENEFIT AND OTHER INVESTMENTS, ENCOMPASSING ITS TOTAL COMMUNITY INVESTMENT, ARE INCLUDED IN THE IU HEALTH COMMUNITY BENEFIT REPORT WHICH IS PREPARED ON BEHALF OF AND INCLUDES IU HEALTH AND ITS RELATED HOSPITAL ENTITIES IN THE STATE OF INDIANA (""IU HEALTH STATEWIDE SYSTEM""). THE IU HEALTH COMMUNITY BENEFIT REPORT IS MADE AVAILABLE TO THE PUBLIC ON IU HEALTH'S WEBSITE AT HTTPS://IUHEALTH.ORG/IN-THE-COMMUNITY/COMMUNITY BENEFIT THE IU HEALTH COMMUNITY BENEFIT REPORT IS ALSO DISTRIBUTED TO NUMEROUS KEY ORGANIZATIONS THROUGHOUT THE STATE OF INDIANA IN ORDER TO BROADLY SHARE THE IU HEALTH STATEWIDE SYSTEM'S COMMUNITY BENEFIT EFFORTS. IT IS ALSO AVAILABLE BY REQUEST THROUGH THE INDIANA STATE DEPARTMENT OF HEALTH OR IU HEALTH."

Schedule H, Part I, Line 7f BAD DEBT EXPENSE
THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IS $1,447,547. BAD DEBT EXPENSE IS REPORTED AT COST BASED ON THE COST-TO-CHARGE RATIO. DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO-CHARGES.

Schedule H, Part I, Line 7 TOTAL COMMUNITY BENEFIT EXPENSE
SCHEDULE H, PART I, LINE 7, COLUMN (F), PERCENT OF TOTAL EXPENSE, IS BASED ON COLUMN (E) NET COMMUNITY BENEFIT EXPENSE. THE PERCENT OF TOTAL EXPENSE BASED ON COLUMN (C) TOTAL COMMUNITY BENEFIT EXPENSE, WHICH DOES NOT INCLUDE DIRECT OFFSETTING REVENUE, IS 25.81%.

Schedule H, Part II PROMOTION OF HEALTH IN COMMUNITIES SERVED
"IU Health Blackford is a subsidiary of IU Health. IU Health participates in a variety of community-building activities that address the social determinants of health in the communities it serves. IU Health and its related hospital entities across the State of Indiana (""IU Health Statewide System"") investments include economic development efforts across the state, collaborate with like-minded organizations through coalitions that address key issues, and advocate for improvements in the health status of vulnerable populations. This includes making contributions to community-building activities by providing investments and resources to local community initiatives that addressed economic development, community support and workforce development, several examples include IU Health's support of numerous organizations and initiatives that focus on some of the root causes of the health issues, such as lack of education, employment and poverty. IU Health Blackford is a supporting member of a three-county health coalition focused on obesity prevention and tobacco cessation as a means to reduce the impact of chronic disease including cancer and heart disease. More than 150 organizations are partners in the ""Healthy Community Alliance of East Central Indiana"" coalition and each pledge to influence audiences to make positive choices regarding improved nutrition, increased physical activity or tobacco cessation. Coalition partners report a collective total audience size of more than 50,000 people. In 2019 IU Health Blackford Hospital established a hospital advisory council to engage community partners in discussions around community healthcare topics such as the Community Heath Needs Assessment, EMS and County 911 operations, Hospital Quality Outcomes, COVID-19 Response, IU Health Foundation, Medical Staff business, Physician recruitment, Team Member Engagement, and Hospital Finances. Participating organizations include Blackford County Council, 3M, New Indy, Purdue Extension Office, Smith Insurance Agency, Blackford Community Foundation, and the Blackford County Health Department. The group meets for discussion on a bi-monthly basis. IU Health Blackford is part of the Consortium for Opioids Response Engagement which was created to build sustainable consortium of stakeholders to combat the opioid crisis. Early intervention of children, adolescents and families with a focus on the individual, interpersonal, community, and societal influences that produce health disparities, stigma and bias, and cultural insensitivities. Embed evidence-based prevention, treatment and recovery services into a seamless community-based system of care for both counties through process design and improvement. Increase access to medication-assisted treatment (MAT) for opioid addiction. Participating organizations include: Purdue University, Jay County Drug Prevention Coalition, Blackford County Community Corrections, Hester Hollis Concern Center, A Better Life Brianna's Hope."

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
Indiana University Health, Inc.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
1447547

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE BAD DEBT EXPENSE OF $546,210 REPORTED ON SCHEDULE H, PART III, LINE 2 IS REPORTED AT COST, AS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY.

Schedule H, Part V, Section B, Line 16a FAP website
- IU HEALTH BLACKFORD HOSPITAL: Line 16a URL: https://iuhealth.org/pay-a-bill/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- IU HEALTH BLACKFORD HOSPITAL: Line 16b URL: https://iuhealth.org/pay-a-bill/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- IU HEALTH BLACKFORD HOSPITAL: Line 16c URL: https://iuhealth.org/pay-a-bill/financial-assistance;

Schedule H, Part VI, Line 7 State filing of community benefit report
IN

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
IU Health will deem patients or their guarantors presumptively eligible for Financial Assistance if they are found to be eligible for one of the following programs and care was initiated via an eligible facility's emergency department, direct admission from a physician's office, or transfer from another hospital facility: 1. Medicaid (any state) 2. Indiana Children's Special Health Care Services 3. Healthy Indiana Plan 4. Patients who are awarded Hospital Presumptive Eligibility (HPE) 5. A state and/or federal program that verifies the patient or guarantor's gross household income meets the FPL income threshold. No Financial Assistance Application is required to receive Financial Assistance under this Presumptive Eligibility section. IU Health will conduct a quarterly review of all accounts placed with a collection agency partner for at least one hundred and twenty (120) days after the account is eligible for an ECA as set forth in this Policy. If the patient or guarantor's individual scoring criteria demonstrates the patient has a low likelihood and/or propensity to pay or no credit, the patient or guarantor may be deemed presumptively eligible for Financial Assistance. Financial Assistance may additionally be granted in the following circumstances: a) If the patient or their guarantor is found to have filed a petition for bankruptcy. b) If the patient is deceased and found to have no estate. c) If the patient is deceased and was under 21 years of age at the time of death. Due to this comprehensive methodology, IU Health does not believe any amount of bad debt is attributable to patients who may be eligible under the financial assistance policy and no portion of bad debt is included as community benefit.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
IU Health's consolidated financial statements, Footnote 5, addresses bad debt expense as follows: The Indiana University Health System does not require collateral or other security from its patients, substantially all of whom are residents of the State, for the delivery of health care services. However, consistent with industry practice, the Indiana University Health System routinely obtains assignment of (or is otherwise entitled to receive) patients' benefits payable under their health insurance programs, plans, or policies (e.g., Medicare, Medicaid, managed care payers, and commercial insurance policies). The Indiana University Health System uses a portfolio approach to account for categories of patient contracts as a collective group, rather than recognizing revenue on an individual contract basis. The portfolios consist of major payer classes for inpatient revenue and outpatient revenue. Based on the historical collection trends and other analysis, the Indiana University Health System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. In support of its mission, the Indiana University Health System provides care to uninsured and underinsured patients. The Indiana University Health System provides charity care to patients who lack financial resources and are deemed to be medically indigent. Financial assistance is available to qualifying uninsured and underinsured patients receiving care at an Indiana University Health System hospital location. Under its financial assistance policy, the Indiana University Health System provides medically necessary care to uninsured patients. Financial assistance up to the full amount of patient financial responsibility is available for uninsured and underinsured patients receiving care via the emergency department, direct admission from a physician's office, or transfer from another hospital. The federal poverty level (FPL) thresholds for this type of financial assistance are based on household makeup. Households without dependents are eligible for assistance if household income is less than or equal to 200% FPL, two adults and at least one dependent are eligible if household income is less than or equal to 250% FPL, and households with one adult and at least one dependent are eligible if household income is less than or equal to 300% FPL. Individuals with medical bills totaling more than 20% of annual household income, regardless of FPL, qualify for catastrophic assistance and are eligible for a reduction in patient financial responsibility to 20% of annual household income. Since the Indiana University Health System does not pursue collection of these amounts, the discounted amounts are not reported as patient service revenue. The Indiana University Health System uses presumptive eligibility screening procedures for some forms of financial assistance and recognizes net patient service revenue on services provided to self-pay patients at the discounted rate at the time services are rendered. The estimated cost of charity care, using the consolidated cost to charge ratio, was $133,584,000 and $90,358,000 in 2021 and 2020, respectively.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
"IU Health Blackford Hospital did not have a Medicare shortfall for 2021. IU Health Blackford Hospital's Medicare reimbursements, however, are normally less than the cost of providing patient care and services to Medicare beneficiaries and do not include any amounts that result from inefficiencies or poor management. IU Health Blackford Hospital accepts all Medicare patients knowing that there may be shortfalls; therefore it has taken the position that any shortfall should be counted as part of its community benefit. Additionally, it is implied in Internal Revenue Service Revenue Ruling 69-545 that treating Medicare patients is a community benefit. Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. The amount reported on Schedule H, Part III, Line 6 is calculated, in accordance with the Form 990 instructions, using ""allowable costs"" from the IU Health Medicare Cost Report. ""Allowable costs"" for Medicare Cost Report purposes, however, are not reflective of all costs associated with IU Health's participation in Medicare programs. For example, the Medicare Cost Report excludes certain costs such as billed physician services, the costs of Medicare Parts C and D, fee schedule reimbursed services, and durable medical equipment services. Inclusion of all costs associated with IU Health Blackford Hospital's participation in Medicare programs would significantly reduce the Medicare surplus reported on Schedule H, Part III, Line 7."

Schedule H, Part VI, Line 2 Needs assessment
Each IU Health hospital is dedicated to the community it serves. Each hospital conducts a CHNA to understand current community health needs and to inform strategies designed to improve community health, including initiatives designed to address social determinants of health. The CHNAs are conducted using widely accepted methodologies to identify the significant needs of a specific community. The assessments also are conducted to comply with federal laws and regulatory requirements that apply to tax-exempt hospitals. IU Health Blackford Hospital assesses the health care needs of the communities it serves by conducting a Community Health Needs Assessment (CHNA) for its hospital location. For the 2021 CHNA, IU Health Blackford Hospital obtained community input through focus groups of community stakeholders, additional surveys issued to stakeholders who were unable to attend community meetings, a survey issued to internal providers from IU Health Blackford Hospital and key informant interviews with those possessing public health expertise. After completion of the CHNA, IU Health Blackford Hospital reviewed secondary data, findings from other community health assessments of areas served by the hospital, input obtained from individuals who participated in community meetings, and input obtained from key stakeholders. The top health needs of the IU Health communities are those that are supported by multiple data sources. Additionally, the effectiveness of an intervention for each need and IU Health's ability to impact positive change was evaluated. IU Health believes its CHNA process is comprehensive and additional assessments are not required.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
IU Health Blackford Hospital is committed to serving the healthcare needs of all of its patients regardless of their ability to pay for such services. To assist in meeting those needs, IU Health Blackford Hospital has established a FAP to provide Financial Assistance to Uninsured Patients. IU Health Blackford Hospital is committed to ensuring its patients are compliant with all provisions of the Patient Protection & Affordable Care Act. To that end, IU Health Blackford Hospital will make a good faith effort to locate and obtain health insurance coverage for patients prior to considering patients for coverage under the FAP. IU Health Blackford Hospital takes several measures to inform its patients of the FAP and FAP-eligibility. These measures include the following: 1. Post this Policy, a Plain Language Summary of this Policy, and the Financial Assistance Application on its website. 2. Provide patients with a Plain Language Summary of this Policy during registration and/or discharge. 3. Post conspicuous displays in appropriate acute care settings such as emergency departments and registration areas describing the available assistance and directing eligible patients to the Financial Assistance Application. 4. Include a conspicuous written notice on all patient post-discharge billing statements notifying the patient about this Policy and the telephone number of the Customer Service Department which can assist patients with questions regarding this Policy. 5. Make available Customer Service representatives via telephone during normal business hours. 6. Mail copies of this Policy, a Plain Language Summary of this Policy, and a Financial Assistance Application to patients or their guarantor free of charge upon request. 7. Broadly communicate this Policy as a part of its general outreach efforts. 8. Educate patient-facing team members on this Policy and the process for referring patients to the program.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
IU Health Blackford Hospital's FAP and Written Debt Collection Policy describe the collection practices applicable to patients, including those who may qualify for financial assistance. 1. Financial Assistance Application Financial Assistance Applications must include the following documentation: - All sources of Income for the last three (3) months. - Most recent three (3) months of pay stubs or Supplemental Security Income via Social Security. - Most recent three (3) statements from checking and savings accounts, certificates of deposit, stocks, bonds and money market accounts. - Most recent state and Federal Income Tax forms including Schedules C, D, E, and F. In the event the patient or guarantor's income does not warrant the filing of a federal tax statement, the individual may submit a notarized affidavit attesting to the foregoing. - Most recent W-2 statement. - For patients or members of the Household who are currently unemployed, Wage Inquiry from WorkOne. - If applicable, divorce/dissolution decrees and child custody order. Patients or their guarantors wishing to apply for Financial Assistance due to Financial Hardship are encouraged to submit an Application within ninety (90) days of discharge. Patients or their guarantors may submit an Application up to two-hundred and forty (240) days from the date of their initial post-discharge billing statement from IU Health, however, accounts may be subject to Extraordinary Collection Actions (ECA) as soon as one-hundred and twenty (120) days after receipt of the initial post-discharge billing statement. Patients or their guarantors submitting an incomplete Financial Assistance Application will receive written notification of the Application's deficiency upon discovery by IU Health. The Application will be pended for a period of forty-five (45) days from the date the notification is mailed. IU Health will suspend any ECA until the Application is complete or the expiration of the forty-five (45) day period. Patients with limited English proficiency may request a copy of this Policy, a Financial Assistance Application, and a Plain Language Summary in one of the below languages: - Arabic; - Burmese; - Burmese - Falam; - Burmese - Hakha Chin; - Mandarin/Chinese; or - Spanish The patient, and/or their representative, such as the patient's physician, family members, legal counsel, community or religious groups, social services or hospital personnel may request a Financial Assistance Application be mailed to a patient's primary mailing address free of charge. IU Health maintains the confidentiality of all Financial Assistance Applications and supporting documentation. IU Health will deny or revoke Financial Assistance for any patient or guarantor who falsifies any portion of a Financial Assistance Application. 2. Financial Assistance Determinations IU Health will inform patients or guarantors of the results of their Application by providing the patient or guarantor with a Financial Assistance Determination within ninety (90) days of receiving a completed Application and all requested documentation. A patient's Financial Assistance Application and Financial Assistance Determination are specific to each date(s) of service and approved related encounters. If a patient or guarantor is granted less than full charity assistance and the patient or guarantor provides additional information for reconsideration, Revenue Cycle Services may amend a prior Financial Assistance Determination. 3. Extraordinary Collection Actions IU Health may refer delinquent patient accounts to a third-party collection agency after utilizing reasonable efforts to determine a patient's eligibility for assistance under this Policy. Reasonable efforts include the following: - IU Health will notify the patient of this Policy at least thirty (30) days prior to initiating an ECA. - IU Health will not initiate an ECA for at least one-hundred and twenty (120) days after the patient's initial post-discharge billing statement. - IU Health will review all Financial Assistance Applications received up to and including two-hundred and forty (240) days after the patient's initial post-discharge billing statement. IU Health will cease any ECAs it has initiated upon receipt of a Financial Assistance Application until a Financial Assistance Determination is made under this policy. - If an Application is Approved, IU Health will issue a revised statement, issue refunds, and make reasonable efforts to reverse ECAs as necessary. IU Health and its third-party collection agencies may initiate an ECA against a patient or their guarantor in accordance with this Policy and 26 C.F.R.  1.501(r). ECAs may include the following: - Selling a patient or their guarantor's outstanding financial responsibility to a third party. - Reporting adverse information about the patient or their guarantor to consumer credit reporting agencies or credit bureaus. - Deferring or denying, or requiring a payment before providing, medically necessary care because of a patient or their guarantor's nonpayment of one or more bills for previously provided care covered under this Policy. - Actions requiring a legal or judicial process, including but not limited to placing a lien on a patient's or their guarantor's property, foreclosing on a patient's or their guarantor's real property, attaching or seizing a patient's or their guarantor's bank account or other personal property, commencing a civil action against a patient or their guarantor, causing a patient or guarantor's arrest, causing a patient and/or guarantor to be subject to a writ of body attachment, and garnishing a patient or guarantor's wages When it is necessary to engage in such action, IU Health and its third party collection agencies, will engage in fair, respectful and transparent collections activities. 4. Refunds Patients eligible for Financial Assistance under this Policy who remitted payment to IU Health in excess of their Patient Responsibility will be alerted to the overpayment as promptly after discovery as is reasonable given the nature of the overpayment. Patients with an outstanding account balance due on a separate account will have their refund applied to the outstanding balance. Patients without an outstanding account balance described above will be issued a refund check for their overpayment as soon as technically feasible.

Schedule H, Part VI, Line 4 Community information
IU Health Blackford Hospital is located in Blackford County, Indiana, a county located in east-central Indiana. Its service areas include Blackford, Grant, Delaware, Jay, and Wells counties. Blackford County includes ZIP codes within the towns of Hartford City and Montpelier. Based on the most recent Census Bureau (2021) statistics, Blackford County's population is 12,091 persons with approximately 50.6% being female and 49.4% male. The county's population estimates by race are 94.8% White, 1.9% Hispanic or Latino, 0.9% Black, 0.6% Asian, 0.3% American Indian or Alaska Native, and 1.7% persons reporting two or more races. Blackford County has relatively low levels of educational attainment. The level of education most of the population has achieved is a high school degree (91.1%). As of 2021, 13.7% of the population had a bachelor's degree or higher.

Schedule H, Part VI, Line 5 Promotion of community health
"IU Health Blackford is a subsidiary of Indiana University Health, Inc., a tax-exempt healthcare organization, whose Board of Directors is composed of members of which substantially all are independent community members. IU Health Blackford extends medical staff privileges to all qualified physicians in its community for some or all its departments and specialties. IU Health does not deny appointments based on gender, race, creed or national origin. IU Health, in conjunction with the IU School of Medicine, trains the next generation of physicians in an exceptional environment. Blending breakthrough research and treatments with the highest quality of patient care. IU Health Blackford participates in other initiatives and collaborations throughout the year to promote health and wellness in the community. Some of these include: - IU Health Blackford team member annual campaign to raise donations for the local United Way. - Nutrition counseling available to diabetics in the community. - Education for students in the healthcare field such as nursing, pharmacy and radiology. Students job shadowed nurses at IU Health Blackford to learn and experience the healthcare field. - In 2021, IU Health Blackford held COVID-19 vaccine clinics at the hospital which were open to the community. Clinics were also held at the local high school for students over the age of 16. More than 2,500 vaccines were administered. - Additionally, team members at IU Health Blackford Hospital participated in the IU Health Statewide System's team member community benefit service program, ""IU Health Serves"", team members across the state make a difference in the lives of thousands of Hoosiers every year."

Schedule H, Part VI, Line 6 Affiliated health care system
"Indiana University Health Blackford is part of Indiana University Health (""IU Health"" or ""the healthcare system""), which is Indiana's most comprehensive healthcare system. A unique partnership with the Indiana University School of Medicine (""IU School of Medicine""), one of the nation's leading medical schools, gives patients access to innovative treatments and therapies. The healthcare system is comprised of hospitals, physicians and allied services dedicated to providing preeminent care throughout Indiana and beyond. IU Health's affiliate hospitals are divided into five regions that serve communities in Northwest, Northeast, Central and Southern Indiana. The 16 hospitals in the healthcare system include IU Health Inc. (i.e., the IU Health Academic Health Center consists of IU Health Methodist Hospital, IU Health University Hospital, Riley Hospital for Children at IU Health and IU Health Saxony Hospital); IU Health Arnett; IU Health Ball; IU Health Bedford Hospital; IU Health Blackford Hospital; IU Health Bloomington Hospital; IU Health Frankfort; IU Health Jay; IU Health North Hospital; IU Health Paoli Hospital; IU Health Tipton Hospital; IU Health West Hospital; and IU Health White Memorial Hospital. Each affiliate hospital in the healthcare system conducts and adopts its own community health needs assessment (CHNA) and implementation strategy. IU Health considers the sum of these CHNAs and the implementation strategies part of a system wide goal of making Indiana one of the healthiest states in the nation. The affiliate hospitals are guided by a system wide mission to improve the health of our patients and community through innovation, and excellence in care, education, research, and service. The healthcare system is keenly aware of the positive impact it can have on improving the health of communities throughout the state of Indiana by aligning resources in a system-level and strategic way. The healthcare system includes an Academic Health Center (i.e., IU Health Inc.), a regional academic health center (i.e., IU Health Bloomington Hospital) and several affiliate hospitals that work in partnership with the IU School of Medicine to train physicians, blending breakthrough research and treatments with the highest quality of patient care throughout IU Health. Each year, more than 1,000 residents and fellows receive training in affiliate hospitals. Research conducted by IU School of Medicine faculty gives IU Health physicians and patients access to the most leading-edge and comprehensive treatment options. To further promote the health of the communities served by IU Health, the system-level Community Health Division team partners with state and local community-based organizations, community coalitions and governmental agencies to focus on clinical care, community investment and advocacy strategy that seeks to improve the health of communities. All affiliate hospitals in the healthcare system identifies and addresses significant health needs unique to the community they serve. Some of these health needs are common in communities served by multiple affiliate hospitals in the healthcare system and align with system priority areas, warranting a system level strategy. The Community Health Division plans and provides technical assistance for system-level strategies that address these common health needs including health inequities, tobacco, behavioral health access, infant and maternal health and social needs. Each affiliate hospital works collaboratively with the Community Health Division team to operationalize system-level strategies through the implementation of specific activities that align and activate local resources too. This benefits the community each affiliate hospital serves and works towards a statewide impact (system-level) on health outcomes. As part of the Community Health Division, IU Health Serves, a system-level team member volunteer program, seeks to positively impact the health of communities IU Health affiliate hospitals serve and foster a culture of engagement and social responsibility. IU Health Blackford coordinates the different initiatives of the program, including Days of Service. This is the largest volunteer event of the year, consisting of projects designed to engage IU Health Blackford team members in activities that address local, identified community health priorities. The Community Impact and Investment (CII) Fund is a $100 million board designated fund that is managed by the IU Health Foundation to financially support high impact community investing designed to address social determinants of health in communities IU Health serves. Each affiliate hospital has a significant impact on and is deeply invested in their local communities. Through the grants provided by this CII Fund, IU Health can strategically and intentionally address the social, economic, and environmental factors that impact the health of their surrounding communities. Each IU Health affiliate hospital and its team members are eligible to pursue this grant opportunity with a community organization or agency."