Catholic Health Initiatives

“Catholic health initiatives (chi) has not formally adopted a written policy or written procedure regarding joint ventures. However chi's system-wide joint venture model operating agreement incorporates controls over the venture sufficient to ensure that (1) the exempt organization at all times retains control over the venture sufficient to ensure that the partnership furthers the exempt purpose of the organization; (2) in any partnership in which the exempt organization is a partner, achievement of exempt purposes is prioritized over maximization of profits for the partners; (3) the partnership does not engage in any activities that would jeopardize the exempt organization's exemption; and (4) returns of capital, allocations, and distributions must be made in proportion to the partners' respective ownership interests. Any joint venture agreements that do not conform to the model agreement are generally reviewed by counsel.”

“c. Board Evaluation of Non-Transactional Conflicts i. The Board carefully reviews and scrutinizes any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI Entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). ii. In such circumstances, by a majority vote of the disinterested Trustees, the Board takes whatever action is deemed appropriate with respect to the Trustee or Corporate Officer under the circumstances (including possible disciplinary or corrective action) to best protect the interests of CHI or the CHI Entity. The Board is encouraged to consult with the General Counsel of CHI or his or her designee when considering disciplinary or corrective action. iii. The conflicted Trustee or Corporate Officer is not permitted to use his or her personal influence with respect to the conflict matter. However, if requested, such Trustee or Corporate Officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from Trustees, as his or her knowledge may be relevant. The Trustee or Corporate Officer is excused from the meeting during discussion and vote on the conflict of interest. d. Record of Proceedings: With respect to Board member and Officer conflicts of interest, minutes of the Board are expected to reflect the identity of the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the Board, and that the interested Trustee or Corporate Officer was excused during the discussion, and that the interested Trustee abstained from voting. D. Conflicts Reporting: All conflicts of interest are reported by CHI as required by law, regulations, and CHI policy.”

“Catholic Health Initiatives' BOARD OF STEWARDSHIP TRUSTEES DOES HAVE AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE IS COMPRISED OF THE BOARD CHAIRPERSON, THE CHAIRPERSON-ELECT, VICE-CHAIRPERSON, AND UP TO THREE ADDITIONAL TRUSTEES APPOINTED BY THE BOARD OF STEWARDSHIP TRUSTEES. EXCEPT AS OTHERWISE PROVIDED BY LAW, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF STEWARDSHIP TRUSTEES. ADDITIONALLY, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE ITS POWERS TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF STEWARDSHIP TRUSTEES, PROVIDED THAT SUCH ACTIONS TAKEN ARE CONSISTENT WITH AND NOT CONFLICT WITH ANY ACTIONS OR POLICIES OF THE BOARD OF STEWARDSHIP TRUSTEES, THE BYLAWS, OR APPLICABLE LAW. THE EXECUTIVE COMMITTEE KEEPS REGULAR MINUTES OF ITS PROCEEDINGS AND REPORTS THE SAME TO THE BOARD OF STEWARDSHIP TRUSTEES ITS NEXT REGULAR OR ANNUAL MEETING.”

“Form 990 instructions define a "member" as any person who, pursuant to a provision of the organization's governing documents or applicable state law, has the right to... "approve significant decisions of the governing body" or to... "receive a share of the organization's profits or excess dues or a share of the organization's net assets upon the organization's dissolution". The corporation was founded by religious institutes of the roman catholic church. Those religious institutes of the roman catholic church that agree to accept the mission and vision of the organization and meet certain other requirements established by the board of stewardship trustees, and who are approved by a 2/3 vote of the board of stewardship trustees, have "participating congregation" rights and duties under the bylaws of the organization. Participating congregations have the right to approve substantial changes to the mission and philosophical direction of the organization, approve amendments to the articles and bylaws affecting any provision governing the qualifications, rights or responsibilities of the participating congregations, select and remove a person who represents that participating congregation in exercising its rights and duties, participate in the distribution of assets upon the dissolution of the organization, participate in organizational advocacy efforts, encourage members of the participating congregations to participate in the ministries sponsored by the organization, and participate through their representatives in meetings held at least once a year with the board of stewardship trustees. (section 3.1.1 of the bylaws of catholic health initiatives.)”

“Form 990 instructions indicate that an organization must answer "yes" if at any time during the organization's tax year, there were one or more persons who had the right to approve or ratify decisions of the organization's governing body such as approval of the governing body's decision to dissolve the organization. The corporation was founded by religious institutes of the roman catholic church. Those religious institutes of the roman catholic church that agree to accept the mission and vision of the organization and meet certain other requirements established by the board of stewardship trustees, and who are approved by a 2/3 vote of the board of stewardship trustees have participating congregation rights and duties under the bylaws of the organization. Participating congregations have the right to approve substantial changes to the mission and philosophical direction of the organization, approve amendments to the articles and bylaws affecting any provision governing the qualifications, rights or responsibilities of the participating congregations, select and remove a person who represents that participating congregation in exercising its rights and duties, participate in the distribution of assets upon the dissolution of the organization, participate in organizational advocacy efforts, encourage members of the participating congregations to participate in the ministries sponsored by the organization, participate through their representatives in meetings held at least once a year with the board of stewardship trustees. (section 3.1.1 of the bylaws of catholic health initiatives).”

“THE CATHOLIC HEALTH INITIATIVES FORM 990 IS REVIEWED BY THE (CHI) VICE PRESIDENT, LEGAL - TRANSACTIONS AND TAX, AND RELEVANT SECTIONS OF THE RETURN ARE ALSO REVIEWED BY VARIOUS INDIVIDUALS INCLUDING THE CHI NATIONAL Vice President Human Resources, AND CHI National Director Executive Compensation. AFTER INCORPORATING ANY CHANGES RESULTING FROM THESE REVIEWS, THE FORM 990 IS PROVIDED TO THE CHI BOARD OF STEWARDSHIP TRUSTEES THROUGH THE ELECTRONIC BOARD PACKET PRIOR TO FILING THE RETURN. UPON RECIPT OF APPROVAL AND SIGNATURE FROM THE SENIOR EXECUTIVE VICE PRESIDENT CORPORATE AFFAIRS AND CHIEF LEGAL OFFICER, THE VICE PRESIDENT, LEGAL - TRANSACTIONS AND TAX FILES THE FINAL FORM 990 AS PROVIDED TO THE BOARD, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.”

“Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy (the "Policy") in place to maintain the integrity of its activities. The Policy applies to the following Persons: members of the CHI Board of Stewardship Trustees and its committees; members of any CHI direct affiliate or subsidiary (each a CHI Entity) board and their committees; employees of CHI Entities, and all CHI Researchers (as defined in the policy). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. A. Disclosure Obligations: 1. Ongoing: Each Person is required to promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The Person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation in which the person is in doubt it is expected that full disclosure be made to permit an impartial and objective determination as to the existence of a conflict. 2. Periodic Written - In addition to the ongoing disclosure obligation, periodic written conflict of interest disclosure Forms must be completed as follows: A) Initially: 1) Upon Hiring (Employees), 2) Appointment (Board / Committee members), 3) Upon consideration of affiliation with research sponsor (Researchers) B) Annually: 1) Board / committee members 2) Employees at the level vice president or above 3) Researchers 4) Supply Chain Employees at the level of vice president and above and those employees involved in contracting regardless of employment level 5) Other employees as determined by CHI leadership. 3. Failure to Disclose - An individual who fails to disclose a perceived, potential, or actual conflict of interest, or all material facts surrounding an actual or potential conflict or fails to abide by the final decision regarding the conflict may be subject to disciplinary or corrective actions such as termination of employment, removal from a board or committee, loss or restriction of clinical privileges, or restrictions on research activities in accordance with applicable laws, regulations, rules, contracts, and bylaws, etc. B. Conflicts Review: 1. No disclosed Conflicts - In the absence of perceived, potential or actual conflicts of interest, no follow-up conflicts review is required or performed. 2. Disclosure of perceived, potential or actual conflicts - a. Are initially reviewed by national or regional legal or corporate responsibility team members (depending upon the role of the individual disclosing the actual or potential conflict) to determine whether an actual or potential for a conflict may exist. b. If it is determined that a potential or actual conflict may exist, i. In the case of Board or Committee Members or Officers, issues are elevated to the Executive Committee of the Board or Board Chair. ii. In the case of other Persons, conflicts issues are elevated to the Conflicts of Interest Review Committee ("C-CIRC"). C. Conflicts Determination and Management: 1. Matters elevated to C-CIRC - a. The C-CIRC determines whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a COI exists, and adequate controls are not in place to mitigate the conflict, the C-CIRC facilitates development of a COI management plan designed to mitigate the conflict. Designated CHI Entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. Notwithstanding the foregoing, at its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential conflict of interest. b. Appeal - If a Person does not agree with a determination made by the C-CIRC, its interpretation of the COI Policy, still seeks an exemption or exception”

“Catholic Health Initiatives (CHI) has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Korn Ferry Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Korn Ferry Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by the Korn Ferry Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board. The last review was September 11, 2017. In addition, Korn Ferry Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable.”

“See narrative for form 990, part vi, section b, line 15a.”

“Catholic health initiatives' articles of incorporation are available on the colorado secretary of state website. Catholic health initiatives' consolidated audited financial statements are available on the chi website at www.catholichealthinitiatives.org. Catholic health initiatives' bylaws and conflict of interest policy are not publicly available.”

“AN ORGANIZATION IS NOT REQUIRED TO REPORT COMPENSATION FROM A RELATED ORGANIZATION TO A PERSON LISTED ON FORM 990, PART VII, SECTION A IF THE ORGANIZATION IS UNABLE TO SECURE THE INFORMATION ON COMPENSATION PAID BY A RELATED ORGANIZATION AFTER MAKING A REASONABLE EFFORT TO OBTAIN IT. IN THAT CASE, THE ORGANIZATION SHALL REPORT THE EFFORTS UNDERTAKEN ON SCHEDULE O. CATHOLIC HEALTH INITIATIVES (CHI) BELIEVES THAT IT HAS FULLY DISCLOSED ALL COMPENSATION PAID BY RELATED ORGANIZATIONS TO THE INDIVIDUALS LISTED ON SCHEDULE J. HOWEVER, IN THE EVENT THAT ANY RELATED PARTY COMPENSATION HAS BEEN INADVERTENTLY EXCLUDED, CHI OFFERS THE FOLLOWING INFORMATION CONCERNING REASONABLE EFFORTS: CHI PERFORMED A COMPREHENSIVE REVIEW OF THE COMPENSATION PAID BY EACH ORGANIZATION WITHIN THE CHI FAMILY AS FOLLOWS: EACH CHI LEGAL ENTITY PROVIDED A LIST OF ITS OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND ESTIMATED TOP TEN HIGHEST PAID EMPLOYEES. THIS INFORMATION WAS PROVIDED TO VARIOUS DEPARTMENTS INCLUDING, CHI'S CENTRALIZED ACCOUNTS PAYABLE SERVICE CENTER, CENTRALIZED PAYROLL CENTER AND BENEFITS COORDINATOR. EACH DEPARTMENT PROVIDED A REPORT REFLECTING THE AMOUNT PAID TO EACH REPORTABLE INDIVIDUAL BY PAYOR-ENTITY. EACH REPORTABLE INDIVIDUAL RECEIVED A REPORT REFLECTING that individual's COMPENSATION AS IT WILL BE REPORTED ON THE FORM 990 (INCLUDING COMPENSATION PAID BY RELATED ORGANIZATIONS) AND WERE ASKED TO VERIFY THE ACCURACY OF THE INFORMATION.”

“Other Miscellaneous Revenue - Total Revenue: 658750, Related or Exempt Function Revenue: , Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 658750;”

“Amended Return Reasons: 1) Form 990 Part VII Section B Independent Contractors: The taxpayer inadvertently reported incorrect compensation for certain independent contractors. Therefore, the taxpayer is amending the compensation reported on Part VII, Section B, Line 1, column (C) for the following independent contractors: Deloitte Consulting LLP WIPRO Limited In addition, Performance Interiors replaced McKinsey & Company, Inc. and Cerner Corporation replaced Ernst & Young, LLP. The taxpayer also inadvertently reported an incorrect number of independent contractors who received more than $100,000 in compensation from the organization. Therefore, the taxpayer is amending Part VII, Section B, Line 2. 2) Form 990 Part VIII Statement of Revenue: Form 990-T for the tax year ended June 30, 2018 was amended due to the repeal of qualified transportation fringe benefit income under Section 512(a)(7) and revisions of other unrelated business income activities. Therefore, Part VIII, Statement of Revenue, is being amended due to the Form 990-T amendments.”

“The mission of the corporation is to nurture the healing ministry of the church, supported by education and research. Fidelity to the gospel urges the corporation to emphasize human dignity and social justice as it creates healthier communities. The corporation, sponsored by a lay-religious partnership, calls other catholic sponsors and systems to unite to ensure the future of catholic health care. To fulfill this mission, the corporation, as a values-based organization, will assure the integrity of the ministry in both current and developing organizations and activities; research and develop new ministries that integrate health, education, pastoral, and social services; promote leadership development and formation for ministry throughout the entire organization; advocate for systemic changes with specific concern for persons who are poor, alienated, and underserved; and steward resources by general oversight of the entire organization.”

“THE FOLLOWING EXAMPLES OF COMMUNITY BENEFIT ACTIVITIES IN FISCAL YEAR 2018 REPRESENT ONLY A SMALL FRACTION OF THOSE TAKING PLACE ON A DAILY BASIS AT THESE FACILITIES AND THROUGHOUT THE CATHOLIC HEALTH INITIATIVES HEALTH CARE SYSTEM. ST. FRANCIS MEDICAL CENTER, Breckenridge, Minnesota: Community outreach for the low income included A Prescription Drug Program - St. Francis Medical Center provides prescription medications to persons who have no means to procure those medications. Provision of these medications helps the recipients to recover more quickly from their illnesses, better manage chronic conditions, and avoid costly hospitalizations and interventions. In fiscal year 2018, prescription drugs (valued at $2,300) were provided to 15 low-income, elderly, and/or uninsured individuals. Community Outreach for the Broader Community included Subsidized Health Services - St. Francis is the sole provider for several needed health services in our community. Milnor Clinic is a rural health clinic located in Southeast North Dakota, 40 miles west of Breckenridge. Clinic services are provided to a medically underserved community through a Nurse Practitioner. Approximately 465 patient visits were conducted during fiscal year 2018 at a net cost of $194,869. The Hope Unit provides outpatient psychiatric, psychological, and substance use disorder treatment services to help address the behavioral health needs of the community. Wilkin County has been designated as a mental health provider shortage area, and the Hope Unit staffs the only psychiatrist in the community. Despite these unmet mental health needs, the Hope Unit conducted 3,612 patient encounters during fiscal year 2018 at a net cost of $104,974. St. Francis has also contracted to provide e-psychiatry services in the acute care area for emergency consults. Total Financial Assistance Provided for the Year ended June 30, 2018: $296,443 Total Medicaid Provided for the Year ended June 30, 2018: $919,691 CHI St. Joseph's Children, Albuquerque, New Mexico: Community outreach for the low income included: Home Visiting: This program is the flagship program of SJC providing home visits by trained professionals to expectant moms and families with first born children. SJC utilizes outcomes-based models (First Born, Partners for a Healthy Baby) that have proven results in improving child and family outcomes. The benefits of early intervention and health promotion in maternal and child health are well-documented and have a lifetime Effect. The net benefit provided to the community by this program during fiscal year 2018 was $3,068,672 and included 10,206 contacts. Enhanced Referral: This program operates in conjunction with the Home Visiting program (see above). The Enhanced Referral program provides services to address housing, legal aid, transportation, medical care, access to food, child care, employment, dental care, school re-entry and special needs services. Addressing these underlying social-environmental factors has been shown to impact physical health, emotional/social development, family capacity and functioning. In fiscal year 2018 the enhanced referral program provided a net benefit of $399,106 to the community and resulted in 6,847 community contacts. Miscellaneous Programs: This category covers events sponsored by SJC throughout the year including the SJC Celebration of Babies Event. The net benefit provided to the community by these programs was $28,549 and yielded 900 community contacts. CHI Lakewood Health, Baudette, Minnesota: Community Outreach for the Broader Community included THE FOLLOWING: Lakewood Health sponsors and provides support for development and maintaining an Alzheimer's support group in Lake of the Woods County and surrounding area. Volunteers have come forward to lead the support group and monthly meetings have been established. The meetings are held at Lakewood and refreshments are provided by Lakewood dietary department. An Alzheimer's Association Support Gro”

“To fulfill its mission, catholic health initiatives (chi), as a values-driven organization, assures the integrity of the ministry by fostering research and development of new ministries that integrate health, education, pastoral and social services; promoting leadership development and formation for the ministry throughout the organization; advocating for systemic changes with specific concern for persons who are poor, alienated and underserved; and stewarding resources by providing coordinated management and strategic planning services along with centralized shared services (payroll, h/r, a/p and purchasing) for the chi national healthcare ministry. Catholic health initiatives (chi) is a national nonprofit health organization headquartered in denver. Chi's exempt purpose is to operate exclusively for the benefit of, to perform the functions of, and/or to carry out the religious, charitable, scientific, and educational purposes, within the meaning of section 501(c)(3) of the code, of catholic health care federation, a public juridic person within the meaning of the code of canon law for the roman catholic church, including by supporting such other charitable organizations, the purposes of which are to embody the mission of the healing ministry of jesus in the church through ownership, management, or governance of health ministries, or the supporting of charitable and religious programs or services consistent with such purposes, in keeping with the gospel imperative. Chi serves as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or mbos. An mbo is a direct provider of care or services within a defined market area. To further its exempt purpose, chi provides strategic planning and management services as well as centralized "shared services" for the mbos. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain - provides economies of scale and purchasing power to the mbos. The cost savings achieved through chi's centralization enables mbos to dedicate additional resources to delivery of high-quality health care and community outreach services to the most vulnerable members of our society. The chi mission and ministry fund provided $5.2 million in grants (plus $4.1 million to support the recipients of multi-year funding) during fiscal year 2018 to build healthy communities in the united states and internationally. During the past 22 years 525 grants have been awarded for more than $84 million. Since 2009 the mission and ministry fund allocated $22.4 million ($2.9 million in fiscal year 2018) in grants to reduce violence in the communities chi serves. Chi directly invests in the communities it serves through chi's direct community investment program which has provided $54.2 million in low interest loans to organizations that give disadvantaged populations access to jobs, housing, education and health care. Reporting across the system: the chi faith-based system operates in 18 states and comprises 100 hospitals, including two academic health centers, major teaching hospitals as well as 29 critical-access facilities; community health-services organizations; accredited nursing colleges; home-health agencies; senior living communities; and other facilities and services that span the inpatient and outpatient continuum of care. In fiscal year 2018, chi provided more than $1.1 billion in financial assistance and community benefit for programs and services for the poor, free clinics, education and research. Financial assistance and community benefit totaled more than $2.0 billion with the inclusion of the unpaid costs of medicare. The health system, which generated operating revenues of $14.98 billion in fiscal year 2018, has total assets of approximately $20.6 billion. Chi healthcare facilities provided 10.9 million physician and practice clinician visits, 464,717 acute c”

“Purchased Services - Total Expense: XXX-XX-XXXX, Program Service Expense: 76723070, Management and General Expenses: XXX-XX-XXXX, Fundraising Expenses: ;”

“Capital Resource Pool Contributions - 87418594; Equity Transfers to/from affiliates - -XXX-XX-XXXX; Pension Adjustment - 95815740; Returned Grants - 2025604; Dissolution of CHI PSO, LLC - 39406;”

“CHI St. Alexius Health Devil's Lake Hospital, Devils Lake, North Dakota: Community Outreach for the Poor included: medical eligibility and counseling services to provide dedicated person to assist uninsured and underinsured patient's with links to health care services and government programs. Other programs included a variety of education programs FOR the community at large for reduced or no charge to the recipient. Programs include: prepared childbirth, grief issues, unsafe lifestyle choices, advance directives, women's health, suicide prevention, strength training, and participation in many community health fairs. Cardiac recovery for the post cardiac patient is a goal of Mercy Hospital's cardiac exercise program maintained by the Cardiac Rehab Department. All cardiac patients under the care of Mercy Hospital's medical staff are eligible for our exercise program for a nominal monthly fee. Other patients with specific disease states are also eligible for this service and routinely participate. The incidence of pediatric admissions, particularly for newborns, has been reduced by the home breast feeding instruction program originally funded by the Sisters of Mercy of Omaha. The "Baby and I" program provides in-house instruction to mothers on the benefits of and proper techniques for breast-feeding. Follow up visits at home with the mother are conducted to provide assurance and continuity of care to the mother and infant. A support group also meets weekly to provide further support and enhance the benefits of breast-feeding. Total Financial Assistance Provided for the Year ended June 30, 2018: $497,994 CHI Franciscan Health St Elizabeth Hospital, Enumclaw, Washington: CHI Franciscan opens our facilities and hosts numerous groups and classes with donated space and classes open to all in our communities. CHI Franciscan sponsors support groups around grief, heart failure, stroke, cancer, substance use recovery, and more. CHI Franciscan provides significant financial contributions to non-profit organizations in our community that promote the health and well-being of our communities. This includes major participation and sponsorship in the American Heart Association, Bras for a Cause at St Elizabeth Hospital, Relay for Life and more. All CHI Franciscan facilities participate in and contribute to our local United Way affiliates to achieve their goal of supporting residents. Total Financial Assistance Provided for the Year ended June 30, 2018: $476,883 CHI St. Gabriel's Health, Little Falls, Minnesota: Community Outreach for the Poor included: Translation Services - One area that has shown continued growth as the community has become more diverse, has seen the increased need for translation services. In 2010, the amount spent for providing translation services was approximately $8,500, which has increased to approximately $28,387 in 2013 (an increase of over 300%) and was $30,629 (nearly 400% since 2010) in FY 2014 and slightly decreased to $24,473 in FY2015. In FY2017, the amount was $35,265. In FY2018, the amount was $29,389. Other programs included: Community Financial Application Assistance - UNITY FAMILY HEALTHCARE financial assistance counselors assist individuals in filling out the paperwork to acquire financial assistance in paying for their medical bills. In 2018 the total number of individuals who received this assistance was 870 and the dollar value of this assistance was $81,563. The amount of assistance has been increasing due to a number of factors influencing their ability to pay their medical bills. Total Financial Assistance Provided for the Year ended June 30, 2018: $733,086 Total Medicaid Provided for the Year ended June 30, 2018: $489,266 CHI St. Vincent Morrilton, Morrilton, Arkansas: Community outreach for the poor included: Vincent Morrilton provides free medications to patients in need at discharge. St. Vincent Morrilton also donated food packets and meals for those who could not afford TO PURCHASE FOOD. St. Vin”

“CHI St. Joseph's Health, Park Rapids, Minnesota: Community Outreach for the Poor included: Our Community Dental Clinic provides dental care to the publicly funded populations throughout north central Minnesota. This past year, they provided 6,091 dental visits. The "Give Kids a Smile" day provided oral screening, fluoride varnish, and dental education to 65 children. Other programs included: * Our Family Home Visiting Program (ebhv) addresses the needs of at-risk mothers, children, and families living in our county. The program includes prenatal education, parenting education and support. The Temporary Assistance for Needy Families and Evidence Based Home Visiting Grants provide support for this programming, and CHI St. Joseph's Health provides the oversight of the grants and the additional funding for this program. CHI St. Joseph's Health has worked to expand the number of families served through the TANF and EBHV program which focuses on parenting, family violence prevention and child abuse prevention, using an evidence-based curriculum. Weekly home visits are made to at-risk families by a trained family home visitor to provide parenting education. Families are visited until the child reaches three years of age. * Annual flu shot clinics are provided to area businesses, and we provide free flu immunizations to qualifying children at area schools. Through Child and Teen Checkup outreach, we provide referrals for families in need of low or no-cost childhood immunizations. * CHI St. Joseph's Health provides outreach to uninsured individuals in our service area. We assist them in the enrollment to Minnesota Care or make referrals for other insurance services. CHI St. Joseph's Health has been certified as an MNCAA agent (Minnesota Community Application Agent) since 2010 to help assist eligible patients with their Medical Assistance applications. * CHI St. Joseph's Health will pay the cost of transportation home from the emergency department or the hospital to individuals that have no options for a ride home. * CHI St. Joseph's Health provides mammograms at no cost to eligible women enrolled in the Sage Program through the Minnesota Department of Health. Total Financial Assistance Provided for the Year ended June 30, 2018: $293,178 Total Medicaid Provided for the Year ended June 30, 2018: $223,433 CHI St. Anthony Hospital, Pendleton, Oregon: Community Outreach for the Poor included: * Care Rides: SAH collaborates with the City of Pendleton by paying for one quarter of the cost of transportation for low-income patients in the community. This is to help ensure that this population has easy access to health care. Without it over three thousand rides would not have been provided, and many may have hesitated to address their needs in a timely manner, increasing the cost of care for all. * Salvation Army Meals: SAH partners with the Salvation Army and other faith community members to provide meals for the poor at the Salvation Army facility. Approximately 23 thousand meals are served at this site annually. Although the economy continues to improve, and the number of meals needed have slowly dissipated over the years the need is still great. For many households the noon sALVATION aRMY meal that is provided is the only real substance that they get throughout the day. * Pioneer Relief Nursery (prn). SAH provides supplies, utilities and free space for Pioneer Relief Nursery. The nursery provides respite childcare and training to parents who have challenges with childcare (which is a chronic unmet need). Its goal is to prevent child abuse and neglect in Umatilla County through intensive family support. They address the cycle of child abuse and neglect by providing therapeutic early childhood classrooms, parenting education, planned respite and comprehensive family support. PRN utilizes research-based strategies to help families build skills to cope with the stresses of raising children in families with risk factors such as poverty, substance”