Friday, November 9, 2012 MEETING AGENDA 10-11:30Am

Home , Curren Price

Chair: Alberto Mier y Terán Univision Communications, Inc. Vice Chair: Jim Herr, The Boeing Co. Vice Chair: Deane Leavenworth, Time Warner Cable

Friday, November 9, 2012 MEETING AGENDA 10-11:30am

1. Welcome and Self Introductions

2. Post Election Debrief

3. Introduction

4. Guest Speakers  California State Senator Curren Price, District 26  Ellen Zaman, Director of Community Affairs-Children’s Hospital Los Angeles  Angie Brough, Director of Client Services Bright Horizons Family Solutions  Jennifer Vena, Senior Consultant, Bright Horizons Family Solutions

5. Q& A

6. Informational Items 1. First 5 Economic Brief 2. Labor Day Survey 3. Save the Date for Access D.C.-March 11th-13th

Last meeting for the 2012 year

Angie Brough, Director of Client Services Bright Horizon Family Solutions

Angie Brough serves Bright Horizons as director of client services for Southern California, Utah and Arizona. Her primary focus is to assist employers in determining and implementing the appropriate solutions for dependent care and work/life programs within their organizations to meet the needs of their employees.

Prior to joining the Company, Angie has spent the past 25 years working in the consultancy, advertising, and human resource field in the U.S., UK, Middle and Far East. Experienced in developing and growing new business within a fast paced creative environment, she has worked with many large organizations such as The Walt Disney Company, Roussel Pharmaceutical Corporation, Turner International, and the Ministry of Defense and Aviation handling their advertising, recruitment, employee benefits, and incentive programs.

Angie received her undergraduate degree in Special Education at Chiswick Polytechnic in London.

Ellen Zaman, LCSW, FACHE Children’s Hospital Los Angeles

Ellen Zaman is the Director, Community Affairs at Children’s Hospital Los Angeles where she is responsible for local government, business and civic relations, public policy, advocacy and community benefit. During her long tenure at CHLA, a 317 bed tertiary care pediatric teaching hospital, Ms. Zaman has held various leadership roles with responsibilities for the operations, clinical, teaching, and research activities of numerous Hospital Departments, Her focus on equity, access, and sustainable programming has led to the implementation of numerous patient, family, hospital, and external programs. Her workforce development programs have included the CHLA Employee Child Care Center and the Employee Assistance Program, health profession shortages, youth and young adult employment, and others.

Actively working with many healthcare, business, government, professional and civic organizations, Ms. Zaman is involved in many city, county and regional initiatives. She serves on the Board of Governors of the East Hollywood Business Improvement District, working with area stakeholders on neighborhood development. Working with committees of the Los Angeles Area Chamber of Commerce, she is engaged in its advocacy efforts related to workforce development. In the past, she has chaired the Metro Hospital Collaborative, led the Board of the Los Angeles Roundtable for Children, and worked on various public- private partnership activities in efforts to expand access to healthcare service systems.

Most recently, after receiving an Innovation Grant from the American College of Health Care Executives, she launched a public policy education series for emerging health leaders in Southern California. Also a dedicated preceptor for graduate students in heath administration, Ms Zaman emphasizes the importance of understanding the patient experience as a core competency for those aspiring to healthcare leadership.

Ms. Zaman is a Board Member of the Hospital Association of Southern California and serves on the Board of Health Care Executives of Southern California of the American College of Healthcare Executives.

As a Fellow of the American College of Healthcare Executives, Ms. Zaman is Board Certified in health care management and was the 2011 recipient of the Southern California Regent’s Award for Senior Level- Health Care Leader. She is also a 2010 Fellow of the Southern California Leadership Network/Leadership Los Angeles She holds a Master of Public Administration from New York University, and a Master of Social Welfare from Fordham University, and is a Licensed Clinical Social Worker, State of California. She and her husband are the parents of one wonderful son.

Jennifer Vena, Senior Consultant Bright Horizon Family Solutions

Ms. Vena currently serves as a senior consultant within Horizons Workforce ConsultingTM. Ms. Vena has more than 20 years of experience conducting dependent care needs assessments and developing strategic work/life initiatives for clients.

Through her tenure with the company, she has been the project manager on multi-site comprehensive dependent care needs assessments for organizations such as the University of Southern California and America Online. She has also conducted child care center feasibility studies for a variety of companies including Abercrombie & Fitch, Applied Biosystems, Immunex, Ingram Micro, Lawrence Berkeley National Laboratory, PIMCO, and Shell Oil. Additional consulting engagements have included quantifying the demand for center expansion and assisting clients with the positioning and branding of their work/life offerings. Ms. Vena has also consulted on the design of several workplace child care centers in California including centers sponsored by Universal Studios and Pacific Gas & Electric.

Ms. Vena advises on Horizons Workforce Consulting’s research projects, which have included: an investment impact study that measured the affect work-site child care centers have had on eight organizations; a comprehensive investigation into the dependent care needs of nurses throughout the United States and their preferred dependent care supports; and a study in conjunction with Simmons School of Management regarding the new workforce reality and understanding the motivations and priorities of employees today and in the future.

Ms. Vena holds a Bachelor of Arts degree in sociology from UCLA.

Senator Curren Price California State Senator, District 26

After serving one full term in the California State Assembly (2006-2008), Curren Price won a special election in May 2009 to represent the 26th District in the State Senate, which includes the cities of Culver City and Los Angeles, including the communities of Beverlywood, Century City, West Los Angeles, Mid-Wilshire, Hollywood, Larchmont, Hancock Park, South Los Angeles, Baldwin Hills, Koreatown, Silver Lake and Los Feliz. He was re-elected by an overwhelming majority in November 2010.

As a leading champion for working families, Senator Price has fought to protect the rights of California workers. He has led efforts to support homecare workers, hotel workers, security guards and other workers that are vital to California’s economy, in order to organize for better wages and benefits.

Senator Price has worked to expand the quality and affordability of health care for all Californians and has authored legislation that would allow parents to add dependent children up to age 26 to their employer-based health plans. He has also authored legislation that was signed into law requiring hospitals to provide public notification prior to closing its doors or eliminating vital health services.

As a strong and consistent advocate for small business, Senator Price has continued to prove that he is among California’s most influential voices advocating for new opportunities for small business enterprises. He believes in policies that spark economic growth, encourage innovation, open the doors for diversity in public contracting, create jobs and stimulate our state’s economy. He authored legislation that would increase opportunities for small businesses to compete for state contracts and would offer incentives for creating new jobs. He has also carried bills expanding health care, increasing educational opportunities, promoting civic engagement and supporting the Arts.

In addition to his legislative responsibilities, Senator Price was chosen by Senate Leadership to serve on a range of important legislative committees that reflect his priorities and interests. Senator Price chairs the Business, Professions and Economic Development Committee, which has jurisdiction over legislation related to business and professional services, practices, and regulations, and international trade.

In 2006, Mr. Price established and chaired the Assembly Select Committee on Procurement. Mr. Price will continue to chair the Select Committee on Procurement, which ensures that small businesses fully participate in state contracting and procurement opportunities.

Senator Price also chairs the Joint Legislative Committee on the Arts, and he chairs the California Legislative Black Caucus, vowing to push for improvements in education, health and jobs.

Additionally, Senator Price currently serves on the following standing committees: Appropriations, Banking, Finance and Insurance, Education, and Public Safety. He previously served on Governmental Organizations and Local Government. He also serves on more than 10 Select Committees focusing on major issues and opportunities confronting California.

Born and raised in Los Angeles, California, Senator Price attended Morningside High School in Inglewood and earned a scholarship to Stanford University where he graduated with a Bachelor of Arts degree in political science. He studied law at Santa Clara University and graduated in 1976 with a Juris Doctor degree.

After receiving his law degree, Senator Price relocated to Washington D.C. in 1979, where he was active for ten years in the satellite communications industry. Mr. Price worked with an export management firm which sold industrial projects to clients in the Far East and Middle East. As an advocate for minority enterprise, he was a frequent speaker at conferences sponsored by the National Telecommunications and Information Administration of the U.S. Department of Commerce.

Senator Price returned to California in 1999, serving as a deputy to two members of the Los Angeles City Council. He later served as the Southern California Coordinator for a statewide association that provided training to assist community-based organizations develop commercial real estate projects. Senator Price has lifetime teaching credentials for Adult Education and the California Community Colleges.

Prior to serving in the California Legislature, Senator Price was a ten-year member of the Inglewood City Council. He has also been a business owner and consultant for domestic and international transactions.

Throughout his tenure as an elected official, Senator Price has been awarded numerous honors in recognition of his legislation and advocacy on behalf of students, working families, and small businesses, the arts and international trade. Since 2007, he has been recognized as “Legislator of the Year” by various groups and organizations including the University of California Student Association, the West Basin Municipal Water District, the Southern California Apartment Owners Association and most recently, the California Small Business Association

Dependent Care Solutions

Presented by: Angie Brough, Client Services Director Jennifer Vena, Senior Consultant

November 9, 2012 Who is Bright Horizons?

Partner of choice • More than 1,000 client-partners

– 127 of FORTUNE 500

– 80 of Working Mother “Top 100 Companies To Work For”

– More than 80 clients in California • Innovative, customized solutions across every industry to address key life stages • More than 770 child care locations in U.S., Puerto Rico, UK, Ireland, Canada, India, and the Netherlands • Back-up care services for 760 clients, with 4.8 million lives covered Provider of choice • Full range of services and support for children of all ages as well as adults/elders • Commitment to continuous quality improvement Employer of choice • 13th time FORTUNE magazine’s “100 Best Companies To Work For” • Comprehensive training programs, professional growth and succession opportunities

Customized child care and Back-up care support: young Educational counseling and Solutions to support Work/life consulting to early education centers at children, school-agers, and tools to facilitate children’s employees’ academic increase effectiveness of or near work sites adults/elders educational aspirations and career planning people strategies

. 25% of parents have considered leaving their employers

• Of these, 62% report a center would have a significant impact on their decision to stay (additional 28% report a moderate impact)

. 13% of respondents are uncertain or not planning to return from parental leave

• Of these, 86% would return with a work-site center

. 90% of respondents report that a center would positively impact their organizations

Source: Bright Horizons’ proprietary survey database

. Attracting talent

• 68% said important in decision to accept job offer

• 83% would recommend their employer as a great place to work

. “Sticky” benefit

• 80% said they would continue to work for their employer because of on-site child care

• 23% have turned down another job due to child care benefit

. The incoming workforce

• Generation Y results showed an even stronger recruitment and retention impact for this group

Source: Bright Horizons’ Lasting Impact of Full-Service Employer-Sponsored Child Care, 2008

45% reduction in voluntary turnover . Center users are 20% more likely among center users vs. non-center users to be top performers than non- center users

. Center users are 68% more likely 11% to have 5-9 years tenure than 12% non-center users 10%

8% 6%

0% Voluntary Turnover

Control Group Center Users

Source: Bright Horizons’ Investment Impact Database

Bright Horizons’ Back-Up Care Advantage Program provides direct child or adult/elder care to employees’ dependents, enabling your employees to get to work when their regular care arrangement is unavailable. The program can be accessed 24 hours per day, seven days per week, and can be used for both last-minute and anticipated care needs.

of survey respondents said the Back-Up Care Advantage Program enhances 89% their productivity1 Respondents reported that those who have used back-up care for their child within the 6 past six months saved an average of 6 work days2

Back-up care for children and adult/elder relatives enables 86% of employees to work 86% a day they otherwise would have missed2

Highly engaged employee companies enjoy 26% higher employee productivity, 26% lower turnover, higher talent attraction, and greater shareholder return3

Of organizations that offered emergency back-up child care, 51% report a moderate 51% to high impact on retention4 Employees without access to dependent care supports were nearly one-third more likely to report being down, depressed, or hopeless in the last month. Overall, 1/3 respondents that had used a dependent care support within the past six months were significantly less likely to report mental health issues5

12012 YTD Back-Up Quarterly Survey Results 2Bright Horizons “Lasting Impact of Employer-Sponsored Back-Up Care” study 3Taleo Research White Paper: Profitable Talent Management (2011) 4WorldatWork, November, 2007 5Bright Horizons’ Consulting/Dr. Jamie Ladge, North Eastern University: Enhanced Employee Health, Well-Being, and Engagement through Dependent Care Supports (2010) © 2012, Bright Horizons Family Solutions LLC 9 Dependent Care Supports Enhance Employee Health and Engagement

STUDY QUESTIONS:

. Do employees who feel their employer supports work/life balance experience better health outcomes? . Are these employees more engaged in their work?

STUDY ANSWERS: Compared to employees whose employer does NOT support work/life balance, employees with supportive employers are:

. Less stressed and report fewer minor and major mental and physical health issues

. Less likely to report lost work time and productivity due to stress

. Less likely to have considered looking for a new job

. More connected to their work and their co-workers

Source: Bright Horizons’ Consulting/Dr. Jamie Ladge, North Eastern University: Enhanced Employee Health, Well-Being, and Engagement through Dependent Care Supports (2010) © 2012, Bright Horizons Family Solutions LLC 10

Determining Need and Cost

Step 1: Project demand for options (limited employee contact)

• Demographic profile

• Geographic profile

• Leadership interviews

• Market analysis

• Demand projection

• Financial model and cost projections Step 2: Confirm demand (engages workforce)

• Employee focus groups

• Utilization survey

• Revise program recommendation and cost projections, if necessary

Community 2 011 Benefit Report

1 Table of Contents

To Our Community Partners and Friends...... 2

Investing in Our Communities...... 4

Understanding Key Indicators of Our Community’s Health...... 5

Research to Ensure the Health and Well–being of the Community-at-Large...... 6

Improving Access to Quality Health Care...... 7

Proactive Approach to Preventive Health ...... 9

Strategies to Improve Health Knowledge...... 12

Compassionate Support System for Families...... 17

Children with Special Needs ...... 20

Advancing the Health and Well-Being of Adolescents...... 21

Keeping Children Safe...... 23

Quality Health Care Beyond International Borders...... 24

Tomorrow’s Caregivers...... 25

Opportunities for Young Adults in Our Community...... 28

Neighborhood Initiatives ...... 29

Our Partners Help Us Achieve Quality Care for Those in Need in Our Community...... 30

1 To Our Community Partners and Friends: The past year has been like no other in the history of Children’s Hospital Los Angeles . With the completion of our new hospital building, the Marion and John E . Anderson Pavilion, we have recommitted ourselves to our core mission of creating hope and building healthier futures for the patients and communities we serve .

Designing a hospital specifically for children and their families with more dedicated beds for intensive and acute care was an expensive but much- needed investment on behalf of the children and young people we will treat long into the future . From its spacious new patient rooms, to the family lounges on each floor, to the universally accessible playground, the 317-bed hospital allows our incredible doctors and nurses to care for more children than ever before .

Despite the time and attention directed toward the opening of the Anderson Pavilion, I’m proud that staff also ensured that our community outreach initiatives and programs continued to flourish . Far too numerous to list here, a few examples of the collaborative efforts highlighted in this report include:

• Improving Access to Quality Health Care – In Fiscal Year (FY) 2011 the Office of Community Affairs assisted more than 200 families with access to available health insurance coverage for the first time while also raising awareness of insurance programs to more than 37,000 children and parents .

• Promoting Healthy Habits – Through community health fairs, schools and other health care organizations our clinical dieticians reached nearly 10,000 children and families, promoting healthy eating habits and educating them regarding eating disorders .

• Providing Health Education – For FY 2011, 115 Children’s Hospital nurses provided health education at a variety of venues in the community, connecting with 6,900 families .

• Proactive Approach to Preventive Health – Members of the Children’s Orthopaedic Center staff provided primary and secondary scoliosis screening in public and private schools—often seeing up to 600 students at each school for initial screening as well as rescreening 40-60 referred students .

Combined with the opening of the Anderson Pavilion, these programs, and the others contained in this report, highlight our continued commitment to advancing the health of children inside and outside our hospital walls . With our new facility successfully opened, we are already caring for more children on our campus . And with each additional patient we treat, we gain a greater understanding of what we can do to improve the quality of life for the diverse communities we so proudly serve .

Richard D . Cordova, FACHE President and Chief Executive Officer Children’s Hospital Los Angeles

2 Our Mission

We create hope and build healthier futures .

Our History

Founded in 1901, Children’s Hospital Los Angeles Children’s Hospital Los Angeles is a premier teaching is one of the nation’s leading children’s hospitals hospital and has been affiliated with the Keck School and is acknowledged worldwide for its leadership in of Medicine of USC since 1932 . pediatric and adolescent health . Children’s Hospital Los Angeles is one of only 11 children’s hospitals in the nation, and the only one in California, ranked in all 10 pediatric specialties in the U.S. News & World Report rankings and named to the magazine’s Honor Roll of children’s hospitals .

The Saban Research Institute of Children’s Hospital Los Angeles is one of the few freestanding research centers in the U .S . where scientific inquiry is combined with clinical care and is devoted exclusively to children . The Institute’s investigators hold faculty appointments at the Keck School of Medicine of the University of Southern California (USC) and the center is an academic member of the Los Angeles Basin Clinical and Translational Science Institute, an academic-clinical-community consortium .

The Marion and John E. Anderson Pavilion

Children’s Hospital Los Angeles provides inpatient care for children in the Marion and John E . Anderson Pavilion . Named for generous benefactor and hospital Board of Trustees Co-Chair, Marion Anderson, and her husband, John, this new building is a premier health care setting for the treatment of children . Opened in July 2011, this 317-bed building allows the hospital to transform the practice of pediatric medicine, benefiting our patients, families and caregivers for generations to come .

3 Investing in our Communities – Community Benefit Financial Highlights

Children’s Hospital Los Angeles’ commitment to patients and their families extends well beyond the walls of the hospital . Our community benefits and activities ensure we remain responsive to the needs of our community . This investment helps make a difference in the lives of children, adolescents and their families .

Community benefit is defined as clinical or non-clinical programs or activities that provide treatment and/or promote health as a response to identified community needs with the following objectives: • Improve access to health care services • Enhance public health of the community • Advance medical or health care knowledge that provides public benefit • Relieve or reduce the burden of government or other community efforts

Community Benefit: • Unreimbursed Costs for Medical Services of Government-Sponsored Programs1: $94.7 million • Charity Care at Cost2: $2.7 million • Subsidized Health Services: $5.1 million • Research Activities: $26.8 million • Health Professions Education: $26 million • Community Health Improvement Services and Other Community Benefits: $5.8 million

3 Grand Total: $161.1 million

1 The Medi-Cal program partially offsets these losses through the Disproportionate Share Hospital Program, designed to support “safety net” hospitals, such as Children’s Hospital Los Angeles . The hospital received $44 .7 million in Disproportionate Share Hospital Funding in FY 2011 . 2 Includes cost of care provided to underinsured and/or uninsured children . 3 In January 2010, the State of California enacted legislation that provides for supplemental payments to certain hospitals funded by a quality assurance fee paid by participating hospitals as well as matching federal funds, called the “Hospital Fee Program .” The payments and fees under the Hospital Fee Program are retroactive to April 1, 2009 . Supplemental payments and fees related to the Hospital Fee Program produced a net benefit of $114 .4 million to Children’s Hospital Los Angeles in the fiscal year end June 30, 2011 .

4 Understanding Key Indicators of Our Community’s Health

Los Angeles County is one of the largest counties in the United States with 4,752 square miles and, with a population of approximately 10 million people, it is the most populous county in the nation . Within its vast geography, LA County is filled with dense urban areas, suburban cities and rural neighborhoods encompassing many diverse and unique communities .

Children’s Hospital Los Angeles recognizes that the best way to serve its community is to understand its health care needs and the issues that affect children, adolescents, parents and families . Our Community Health Needs Assessment serves as the basis for planning programs and services to address the identified needs of our surrounding communities, including access-to-care issues, injury prevention and chronic disease management .

Children’s Hospital works collaboratively on the assessment with four other area hospitals: California Hospital Medical Center, Good Samaritan Hospital, Kaiser Permanente Los Angeles Medical Center and St . Vincent’s Medical Center .

Recent Key Findings: Based on the result of the 2010 Community Health Needs Assessment, the three most commonly identified needs were access to health care, childhood obesity and dental health services . Data was organized in the form of Service Planning Areas (SPAs)—which are used by county agencies for health planning Antelope Valley purposes . Los Angeles County is divided into eight SPAs; Children’s Hospital is located in SPA 4 . San Fernando Valley San Gabriel Valley Access to Care: SPA 4 (9.2 percent), SPA 6 (9.7 percent) and SPA 7 (8.9 percent) were found Metro to have the highest percentage of uninsured children Antelope Valley West within LA County1 . San Fernando Valley South Childhood Obesity: 23% of school-aged children ages San Gabriel ValleyAntelope ValleyEast 2 10-15 were found to be obese . Metro South Bay San Fernando Vincludesalley Catalina Island Dental Health: 11% of children 3 to 11 years old West 3 San Gabriel Valley have never been to a dentist . South Metro Conducting the Community Health Needs Assessment East is just one of the many ways that Children’s Hospital South Bay West Los Angeles strengthens its commitment to understand includes Catalina Island South the health needs of the communities it serves .

Source: East 1 2007 Los Angeles County Health Survey 2 2008 Los Angeles County Department of Public Health South Bay 3 2009 Community Health Interview Survey includes Catalina Island

5 Research to Ensure the Health and Well-Being of the Community-at-Large

Children’s Hospital Los Angeles was awarded funding from the National Institutes of Health to support research projects conducted by the Los Angeles Basin Clinical and Translational Science Institute (CTSI) at Children’s Hospital Los Angeles.

The CTSI is comprised of a multidisciplinary team including faculty from Children’s Hospital Los Angeles, eight schools from the University of Southern California, the Los Angeles Departments of Health Services and Mental Health, the Community Clinic Association of Los Angeles County and more than 30 community health organizations in the Greater Los Angeles Area .

Interdisciplinary projects will draw on the knowledge of experts in the fields of medicine, informatics, film, dentistry, education, law, engineering, pharmacy and “The objective of this award is to focus on improving social work . “We are working collaboratively with the health of a diverse, urban population,” explains others on campus and off, using LA as a real-world Michele Kipke, PhD, associate CTSI director for laboratory to address issues that are important to the Community Engagement and director of the Community, community here,” says Thomas A . Buchanan, MD, Health Outcomes and Intervention Research (CHOIR) principal investigator and director of the CTSI . Program at The Saban Research Institute of Children’s Hospital Los Angeles . “Because of our location we are in a unique position to do this kind of research . Drawing faculty from Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, we can gain knowledge about densely populated urban areas that will ultimately set the standard of care for areas like ours around the world .”

“Our focus on pediatrics and child health allows the clinicians and scientists of Children’s Hospital Los Angeles to make a unique contribution to the CTSI,” says D . Brent Polk, MD, director of The Saban Research Institute and member of the CTSI Board of Oversight . “The grant will allow us to continue the successful work at The Saban Research Institute ensuring our position as a leading pediatric academic center in the 21st century .”

6 Improving Access to Quality Health Care

We work to address barriers to quality health care “As I handed them my paperwork to complete a services and affordable health insurance coverage for Healthy Families Program application, I immediately children, adolescents and families in our community . felt like a weight had been lifted off my shoulders,” she adds . “There is nothing in the world that comes Health Insurance Program close to the hope and peace of mind you have when you know your child is in the best hands possible .” Application Assistance “My daughter was born with what was considered The Office of Community Affairs at Children’s Hospital a pre-existing condition, which made her ineligible helps families like Piscitelli’s access low-cost health for certain types of services under our family’s health insurance coverage by assisting with applications plan,” says Courtney Piscitelli, mother of Shelby for health programs and referrals to other community Madden . “Since her birth in September 2006, we health resources . have gone through many changes in her care .” In FY 2011, more than 200 children and families Shelby, 5, was born with a rare syndrome that were assisted iwith access to available new health affected her head and facial structure . Piscitelli learned insurance coverage . More than 37,000 children and early on that she would need to fully understand the families were reached through outreach campaigns to limitations of her insurance, the explanation of benefits provide awareness of available programs . and the insurance approval process to ensure the best coverage for her daughter’s care . Shelby is doing well under the care of a specialized team of doctors and nurses at Children’s Hospital, “This was another part-time job for me, along with who regularly monitor her growth and development . already working full-time and being a single parent,” she says . “Children’s Hospital has helped us with everything from Shelby’s essential health needs to addressing her The effects of economic stress on Piscitelli’s employer ongoing social needs, to our difficult financial and resulted in a reduction of health benefits and an scheduling needs,” Piscitelli says . “Above all, they increase in her family’s deductible, making Shelby’s offer hope to those who need it most ”. continued care unaffordable on her mother’s salary . “I remember the day I came into the hospital’s Community Affairs office while Shelby was having Bringing Child Health Issues to Lawmakers outpatient surgery,” Piscitelli says . “It was one of Every year, Children’s Hospital participates in Family four surgeries in her then-three years of life . I was Advocacy Day, an event sponsored by the National worried about her and consumed with the guilt of Association of Children’s Hospitals . Family Advocacy possibly not being able to afford the continued Day is an opportunity for patients and families to meet medical care she required, even though I held with members of Congress and share their stories to down a steady full-time job .” illustrate why all children need children’s hospitals .

7 Advocating for Children’s Health Issues Budget shortfalls in California have forced more and more cuts to health and human services programs, and many of these cuts affect children .

With new regulations, budget actions and comprehensive health reform on the horizon, children’s health insurance advocates must be diligent in preventing erosion of current programs and in finding opportunities to improve access to care for children .

To help achieve this goal, the Los Angeles Healthcare Provider Alliance for Children (LA-HPAC) gives general pediatric residents at Children’s Hospital Los Angeles the chance to collaborate with the American Academy of Pediatrics and First 5 California, also known as the California Children and Families “A strong Medicaid safety net and funding for children’s Commission, to advocate for children’s health . hospitals’ graduate medical education are essential for our hospital to continue to provide quality, specialized “The program prepares and mobilizes health care care for all children,” explains Gail Margolis, Esq ,. providers to be effective advocates toward achieving vice president of Government, Business and Community universal, affordable and meaningful health care Relations for Children’s Hospital . coverage for all children through 5 years,” says Susan Wu, MD, program director . “It utilizes in-person To ensure that our child health advocacy efforts make and online training modules to educate health care an impact, the hospital builds strong relationships providers on health insurance issues and help them between hospital leaders and local, state and national develop advocacy skills to respond to time-sensitive representatives . “There’s a serious and growing policy matters .” financial vulnerability at many of the state’s hospitals, and these key relationships help ensure that these LA-HPAC hosted several legislative advocacy trainings challenges are addressed,” Margolis says . in FY 2011 for pediatric residents at Children’s Hospital, Kaiser Permanente Los Angeles Medical This year, Max Page, also known as “Mini Darth Center, University of California, Los Angeles and the Vader,” and his family joined other families representing University of California, Davis . their children’s hospital at Family Advocacy Day in Washington, D .C ., to share his story with lawmakers During a local legislative visit to Sacramento, a group about how Children’s Hospital Los Angeles has made of pediatric residents and practicing physicians from an impact in his life . Children’s Hospital joined members of the American Academy of Pediatrics-California/California Medical “Family Advocacy Day is an exceptional opportunity Association and First 5 California in visiting to personalize these issues and show legislators just 11 policymakers . how deeply children’s hospitals nationwide affect real-life families,” Margolis says .

“You guided us when we felt lost, taught us so we felt competent and supported us so we didn’t fall down … We marvel at your abilities and the strength you have to do your critical jobs. We are thankful you were called to work in pediatrics and that you played a major role in our lives … Children’s Hospital is our second home; we would do anything to give back to our hospital.” –The Page Family

8 Proactive Approach to Preventive Health

We take a proactive approach to address the health “Since the initial program in 1999, we have provided needs of children through community-based health comprehensive cardiovascular screenings for hundreds promotion, screenings and disease prevention . of athletes and family members at the Chad Foundation annual volleyball tournament,” says Michael Silka, Community-Based Cardiac Screening MD, head of the Division of Cardiology at Children’s Hospital . “A number of individuals with previously for High School Athletes unrecognized heart disease have been identified, Recently there have been several occasions in our as well as many individuals who are given a clean local communities of young athletes fatally collapsing bill of health .” while participating in physical activities . According to HealthDay News, an estimated 76 young athletes In addition, hundreds of cardiac screenings for collapse and die from sudden cardiac arrest during a student athletes from various local high school practice or game every year in the U .S . teams are provided in conjunction with the Chad Foundation event . Researchers have found that the most common cause of sudden cardiac death among young athletes is a heart condition called hypertrophic cardiomyopathy . This occurs when the heart is thickened and enlarged, which makes it more difficult to pump blood .

At Children’s Hospital Los Angeles, the Division of Cardiology has collaborated with the Chad Foundation for Athletes and Artists to provide preventive cardiac screenings for high school athletes in our local communities . These include an exam, an electrocardiogram (which measures the heart’s electrical activity) and an echocardiogram (an ultrasound of the heart).

9 The Division’s cardiac screening services for high According to the National Institute of Arthritis, school athletes also have been extended to the Los Musculoskeletal and Skin Diseases, three to five out Angeles Unified School District (LAUSD). LAUSD is of every 1,000 children develop spinal curves that among the largest school districts in the United States, are considered large enough to require treatment . with an estimated 750,000 students . At Children’s Hospital Los Angeles, the Spine Center “For many of these students, the LAUSD physician in the Children’s Orthopaedic Center annually on-site is their closest access to health care,” Silka performs 250 spine surgeries and follows more than explains . “As medical professionals who are 1,000 children and adolescents with spine problems . responsive to the health needs of our community, “School-based scoliosis screenings are critical because we provide our services as a backup when needed ”. they provide early detection, which is crucial for successful treatment,” says David L . Skaggs, MD, In addition to providing specific training for one of director of the Children’s Orthopaedic Center at LAUSD’s staff physicians, the Division’s cardiologists Children’s Hospital . are available to consult with physicians concerned about possible heart disease in the students . State law requires that all girls in seventh grade, and all boys in eighth grade, be screened for scoliosis . In Pertussis Vaccine for Parents of Neonates addition, Children’s Hospital Los Angeles makes these screenings available to other students . Pertussis (whooping cough) continues to circulate widely, causing the hospitalization and death of Phyllis D’Ambra, RN, manager in the Children’s infants who are too young for routine immunization . Orthopaedic Center, has championed the Center’s various community benefit programs, including The California Department of Public Health (CDPH) school-based scoliosis screenings, for the past 31 reports that close contacts, most often parents, are the years . The program provides primary and secondary most common known source of pertussis in infants . screenings for students from various public and private As a result, the CDPH recommends that all parents of schools in our community at no charge . newborn infants receive the Tdap (tetanus-diphtheria- pertussis) vaccine before the infant leaves the hospital. To assist with this, the CDPH made the Tdap vaccines available to hospitals free of charge .

“Our Pharmacy obtained a supply of this vaccine and arranged to have it administered by Pharmacy staff to parents who needed it,” says Carol Taketomo, PharmD, director of Pharmacy at Children’s Hospital . “Our pharmacists vaccinated 49 of our Newborn and Infant Critical Care Unit parents and one Cardiothoracic Intensive Care Unit parent with the Tdap vaccine .”

This is just one example of how pharmacists at Children’s Hospital provide a full complement of pharmacy services to meet the health needs of our patients, staff and parents in the community .

School-Based Scoliosis Screening Program Scoliosis (a curve in the spine) is a serious orthopaedic problem confronting children in our community . Although only two to three percent of the population have scoliosis, it can severely affect children and lead to pain, limited activity, reduced respiratory function and diminished self-esteem .

10 “It is important to screen early and continue to screen Services for children and adolescents include often,” D’Ambra says . “I go to 10 schools on any complete physical examinations and laboratory given day in various school districts to rescreen 40 to tests, immunizations, diagnostic services, counseling, 60 students per site who are referred by the school developmental and behavioral assessments and nurse to an orthopaedic specialist .” intervention, hearing and vision screenings and education . These comprehensive services are In addition, the program also provides initial available in the evening and on the weekend . screenings to two to four schools a day, reaching 400 to 600 students at each school . The program also With more than 44,000 patient care visits annually, educates public and private school nurses on how to the AltaMed Community Health Clinic at Children’s screen for scoliosis . Hospital expands access to preventive and other medical services for children and adolescents in our By helping detect this progressive condition early, community . these screenings are making a real difference in the quality of life for children in our community . Oral Health Program Dental caries (tooth decay) is considered the most Comprehensive General Health Care common infectious and chronic disease of childhood . The AltaMed Community Health Clinic of the Division Most patients and families are not aware of the of General Pediatrics at Children’s Hospital Los Angeles potential health, psychosocial and economic impact serves as a preventive and primary medical care of dental disease in children . Among other complica- center for children and adolescents in our community . tions, tooth decay can lead to infections, recurrent As a federally Qualified Health Center (FQHC), the pain that influences school performance/attendance clinic’s comprehensive diagnostic and treatment and loss of teeth, which affects self-esteem . services begin at birth and continue throughout childhood and adolescence . Despite efforts to raise public awareness of this largely preventable disease, many children still do “Our clinicians have significant experience not see a dentist until much later than the currently serving children and families in our community with recommended one-year visit . This has been attributed special health needs and provide a wide range of to barriers to dental access, as well as cultural/ well-child care, acute care and specialty services in societal misconceptions about preventive dental care . a family-centered atmosphere,” says Robert Jacobs, MD, MHA, division chief of General Pediatrics at As a result, a significant number of children in the Children’s Hospital Los Angeles . community have high rates of dental decay—18 percent for 2- to 4-year-olds; 52 percent for kids 6 to 8; and 67 percent for those 12 to 17 . There also is a subpopulation of children with medical conditions and therapies that can predispose them to dental disease .

To help children in our community maintain good dental health, two of our pediatricians—Joseph Gantan, MD, and Fasha Liley, MD—developed the Oral Health Program in the AltaMed General Pediatrics Clinic at Children’s Hospital Los Angeles . The program’s goal is to promote oral health in patients 6 months to 5 years of age .

Since its inception three years ago, the program has averaged 350 new patient referrals annually, with many patients returning for periodic follow-up to continue their oral health education . Because several patients did not already have a dental home, we established partnerships with general and pediatric dental providers to streamline the referral process .

“As pediatricians, we understand the connection between the oral and medical health of children,” Gantan says . “Because of this, we are committed to maintaining these types of programs . However, we need to continue to work with our dental colleagues to ensure all children have established a dental home by 1 year of age .”

11 Infant-Toddler Hearing Screening Because of the program, at least nine children with Baby Sound Check is an innovative model program permanent sensorineural hearing loss have been for integrating infant-toddler hearing screening into identified . In addition, 200 children with significant routine well-baby care in pediatric medical offices . transient hearing loss due to ongoing middle ear The goal: early identification of hearing loss . disease have been diagnosed and guided to appropriate intervention and treatment services . The program was created in collaboration with local community health care clinics and the Division of Furthermore, Baby Sound Check has enabled primary General Pediatrics at Children’s Hospital Los Angeles care physicians to immediately rule out hearing loss as to meet the hearing health needs of underserved a contributing factor in more than 900 children with populations in our community . In the first three years developmental concerns . of the program, more than 6,000 children have received objective hearing screenings in 11 community health clinics in the Los Angeles area .

Strategies to Improve Health Knowledge

We develop health education and other systematic Visitors to the Center can: strategies to improve health knowledge and health • Learn about standard medical care, as well as behavior of children and families in our community . complementary and alternative medicine options .

Family Resource Center • Create connections with other individuals, including youth and parent coaches who can offer support . At Children’s Hospital Los Angeles, we’re committed to empowering all families to become more • Find experiences to enhance learning and healing knowledgeable in key areas that affect the health through special programs at our hospital, including of their children . Spiritual Care, Child Life, Social Work Services, Nutrition, Rehabilitation Medicine (physical, speech To expand our reach and capacity in this area, we and occupational), Interpreting and Translation opened the Helen and Bill Close Family Resource Services, Pharmacy, Bibliotherapy, Nursing, Center in the Marion and John E . Anderson Pavilion . Community Programs and Injury Prevention . Officially dedicated in September 2011, the Center is a warm and welcoming place for the whole family The Family Resource Center is just one more way to learn how to care for themselves or a loved one Children’s Hospital is working to strengthen the who is at home or in the hospital . network of patient and family education and community resources to empower families to take “The Family Resource Center is open to everyone charge of their health . in our community, not only patients,” says Lori C . Marshall, PhD, RN, administrator of Patient Family Education and Resources at Children’s Hospital . “It Parent University serves as a hub of health knowledge and community Knowledge is power, especially when it comes to resources for children and families, as well as one a child’s health . To better educate, inform and of the entry points into the hospital .” empower parents and families about issues affecting their health and health care choices, Parent University was developed at Children’s Hospital Los Angeles .

In FY 2011, Parent University classes covered an array of timely health topics, including well-child visits, vaccines, common illnesses, talking to your teen, nutrition, sleeping and infant and child safety .

The classes are free and are open to all parents and parents-to-be . Each session is offered in English and Spanish and is taught by our caring health professionals, including Board-Certified/Board- Eligible doctors, nurses, dietitians, pharmacists and other specialists .

Sixty-five parents and parents-to-be attended Parent University in FY 2011 .

12 Epilepsy Resources for Parents The Office of Community Affairs at Children’s Hospital Over a six year period, the USC University works closely with local schools, community-based Center for Excellence in Developmental Disabilities organizations, community leaders and civic groups on (UCEDD) at Children’s Hospital received federal various community health initiatives and participates in funding to improve access to services for children community outreach events in these diverse communities . with epilepsy in California and three other western states (Alaska, Nevada and Wyoming). Project Access “We utilize a variety of outreach strategies to developed 15 products to assist parents, agencies address various health care needs and effectively and professionals in supporting family access to and communicate and educate families on timely child knowledge of services . Products were translated into health issues,” says Olga Taylor, Children’s Hospital’s multiple languages . “Epilepsy and Seizure Disorders: outreach coordinator . “These issues include chronic A Resource Guide for Parents,” provides parents and conditions and the prevention of common diseases, caregivers with information and tools they can use to such as pertussis (whooping cough). Through better understand and manage their child’s condition . education, outreach, awareness and advocacy, New resources developed in FY 2011 included an the Office of Community Affairs promotes the information sheet on medication substitution, a list health and well-being of children and families .” of children’s books addressing epilepsy, a seizure description tool to enable parents to describe the As part of these outreach efforts, health education signs and symptoms that are observed when their information and tools are provided to the general child has a seizure and a guide for preschool and community in various languages . Resources and childcare centers . referrals to community-based organizations are offered through educational community booths . The Resource Guide provides teachers, school staff and parents with the tools necessary to comfortably The Office of Community Affairs reached more than care for a child with epilepsy . 53,000 children and families by participating in 35 community-organized events in FY 2011 . In addition, in collaboration with various departments at Children’s Hospital, our successful community initiatives reached more than 490,000 children and families in Los Angeles County through community outreach .

Kids in Our Community Learn About Blood “Do you want to learn about blood?” Aimée Williams, project coordinator at the Hemostasis and Thrombosis Center at Children’s Hospital Los Angeles, will often ask this question to children at community health fairs .

“I utilize a snack activity to teach about blood,” Williams explains . “The snack is made up of Cheerios, marshmallows, raisins and pretzels . Each part of the Community Outreach snack represents a part of a person’s blood: Cheerios Los Angeles is home to families that come from are the red blood cells, marshmallows the white blood more than 140 countries—and speak more than 86 cells, raisins are platelets and pretzels are fibrin . languages . It spans a diverse geographic region, When you mix all of the items together, you have a amidst one of the largest and most diverse multiethnic snack that represents the components of blood!” populations in the nation . While participants make the snack, Aimée explains Children’s Hospital Los Angeles serves children and what each part of the blood does in a person’s body . families from all Service Planning Areas (SPAs) in Los For example, marshmallows represent white blood Angeles County . The hospital is physically located cells, which fight germs . in the Metro area and the Central Health District of the city of Los Angeles—an area that is home to The goal of the snack activity is not only to have more than 1 .2 million families and 300,000 children fun while learning about blood, but also to teach and youth . This large population represents various community members about bleeding and clotting diverse communities with specific needs . disorders, particularly von Willebrand disease . Von Willebrand disease is the most common bleeding disorder; according to the World Hemophilia Foundation, it affects 1 percent of the world’s population . As many as nine out of 10 people with the disorder are undiagnosed .

13 “Bleeding disorders are not uncommon, and the symptoms that may lead to the diagnosis of a bleeding disorder are very common—nose bleeds, bruising,” says Guy Young, MD, director of the Hemostasis and Thrombosis Center . “It is very important to educate the community about the symptoms of bleeding disorders because these disorders can otherwise lead to serious medical consequences .”

The Hemostasis and Thrombosis Center at Children’s Hospital Los Angeles is the largest hemophilia treatment center in California and treats children and adults with bleeding and clotting disorders . The Center also serves as an international referral center for children with hemostasis and thrombosis disorders, providing excellent clinical care and research . Remember to Read Reading skills are important to children’s success in Through her outreach efforts, Williams has met a school and work, and are critical in their development handful of families in our community who believe of the use of language to communicate . In addition, that they or someone they know may have von reading becomes a fun and imaginative way to Willebrand disease . encourage children to learn visual recognition and to identify what he or she hears and feels . “My goal is to educate others about bleeding and clotting disorders so that they learn what they are “All children need to read to succeed,” explains and where to get treatment,” she says . “I also want Cindy Weaver, also known as Aunty Cindy . Cindy is them to have fun while they learn!” one of the team of volunteer storytellers provided by the Literally Healing™ program at Children’s Hospital Los Angeles—a multifaceted literacy program that supports families both on our campus and back in their communities when they go home .

Aunty Cindy has been reading to children at the hospital for more than five years in the Cheryl and Haim Saban Story Corner, a space dedicated for reading in the hospital’s lobby . She leads story times twice a week and gifts more than 160 books a week to our patients and their siblings .

“Literally Healing is committed to positioning children for success, despite their medical limitations,” says Claire Austin, founder of the Literally Healing program .

In addition to reading times, carefully screened books are placed in a Therapeutic Library in the hospital and are provided free-of-charge to patients and their siblings . Books in this library have been carefully reviewed by hospital staff for their ability to help hospitalized children better understand and master the issues they face on a daily basis . Those issues include depression, sibling jealousy or guilt, fear of disfigurement, living with a permanent disability and even death and grieving .

“Through reading these books, our patients and their siblings can build mastery, courage and hope during their hospitalization,” Austin says .

The program annually gives away books to children and families in our community as well . In FY 2011, the Literally Healing program gave more than 4,300 books to organizations and schools in our community .

14 Community Pediatrics and Advocacy One of the ways that our pediatric medical residents positively influence the health of children in our communities is through the Community Pediatrics and Advocacy Program .

Developed and launched by Children’s Hospital pediatric medical residents, the Community Pediatrics and Advocacy Program offers young physicians the opportunity to learn the most effective methods for child health advocacy by exposing them to advocacy and outreach opportunities at the individual, community and legislative levels .

Medical residents collaborated with nearby Los Feliz and Allesandro elementary schools to teach children about safety issues and injury prevention . Pediatric interns are assigned a topic, such as animal, pedestrian or Halloween safety . The interns then create a lesson plan for that topic RN Remedies Blog for Families and teach three to four sessions to approximately WeAreChildrens .org/rn-remedies/ 30 elementary students at one time . Experienced pediatric nurses at Children’s Hospital Los Angeles have created a dynamic online education In FY 2011, Children’s Hospital interns taught seven forum for parents: the RN Remedies blog . safety-related topics at each school, reaching more than 1,600 elementary students . Since its beginnings in November 2010, a group of eight nurses have posted more than two dozen Pediatric medical residents also provide voluntary blog topics, covering childhood obesity, flu home safety assessments to families in our community . symptoms, onset of puberty, teens and texting, Through the hospital’s Home Safe Home Project, car seat safety, doctor visit tips and symptoms residents perform a home safety visit to one of their of common childhood conditions . primary pediatric patients, along with a faculty mentor .

“Our nurses are a diverse and extraordinary group In addition, pediatric residents perform a neighborhood who are continuously teaching, exploring and walk to understand environmental health hazards that growing,” says Mary Dee Hacker, MBA, RN, NEA- affect their patients and families . Children and their BC, FAAN, vice president, Patient Care Services families are taught to identify home safety hazards as and chief nursing officer of Children’s Hospital Los well as how to prevent injury . Angeles . “Our pediatric nurse bloggers are taking our profession’s core commitment to education and In FY 2011, 90 Children’s Hospital residents were combining it with the Internet’s remarkable power to trained in home safety, and they conducted 120 reach families everywhere .” Home Safe Home assessments .

Children’s Hospital has leveraged social media tools such as Twitter and Facebook to direct fans to the RN Remedies blog feature each Monday morning . The blog has accumulated a steady core of followers and receives more than 4,000 hits each month . Readers are encouraged to email their questions and topic suggestions, creating an intimate connection between the nurse bloggers and readers .

“The blog allows us to get information out to parents regarding children of all ages, and we are excited to share our experiences and expertise with parents on a global level,” says Kelli Anderson, RN, one of RN Remedies’ creators . “It’s a whole new world, and I’m thrilled to be a part of making a difference in the community, one post at a time .”

15 More Family Education Highlights for FY 2011 • Clinical dietitians reached 9,500 children and their • The Center for Endocrinology, Diabetes and families at community health fairs, schools and Metabolism hosted College Night for eight families other health care organizations . Dietitians promoted of college students with diabetes . College students healthy eating habits and provided education on were given tips on how to manage their diabetes various eating disorders . during long hours of school, nighttime studying and other college activities . • Physicians and sonographers at Children’s Hospital hosted a local symposium, “Echocardiographic • The hospital’s Annual Diabetes Family Retreat gave Evaluation of Congenital Heart Disease .” The children and families a chance to learn the latest symposium taught community sonographers on diabetes research and meet with other children and sonography students the finer points of and families with diabetes . echocardiography in neonates, infants, children, adolescents and adults with congenital heart • More than 55 caring hospital staff members raised disease . More than 70 people attended . funds for the March of Dimes’ March for Babies campaign . At the event, the Office of Community • The Division of Pediatric Surgery hosted “Biliary Affairs provided education to 2,000 people Atresia Day: A Day of Education and Networking .” regarding various community benefit services The event convened 42 families who have a child at Children’s Hospital . with biliary atresia, and gave them a chance to meet, share experiences and attend educational seminars . • Our annual Congenital Adrenal Hyperplasia Family Day attracted 60 families who enjoyed • Children’s Hospital residents developed the a day of learning and meeting other families LATCH NOW program, which aims to improve dealing with the disorder . breastfeeding support among community providers and mothers . The program works with the Los • Our Bloodmobile, “The Maxmobile,” reached Angeles County Department of Public Health and more than 600 people per month, including local numerous Los Angeles hospitals, and reaches more high school students, educating them about the than 10,000 people in our community each year . need to donate blood for children in our community while collecting much needed blood for the hospi • In FY 2011, 115 Children’s Hospital nurses tal’s patient population . provided health education at various community venues, reaching 6,900 children and their families .

16 Compassionate Support System for Families

We provide a compassionate, caring support system The HOPE Program for our patients, their siblings, families and the The HOPE (Hematology-Oncology Psychosocial and broader community in their time of need . Education) Program provides compassionate psychosocial care and support for patients diagnosed and Spiritual Care Services treated in our Children’s Center for Cancer and Blood Whether you are a patient, family member, staff Diseases . In addition to offering a complete range of member or friend, when you walk into Children’s culturally sensitive services for young people with Hospital, you will find an environment that promotes cancer or blood diseases, the program helps them compassionate and caring service for all . From the with transition to school, college and vocational work . dragonfly sculptures in The Joyce and Stanley Black and Family Healing and Meditation Garden, which The following are highlights from HOPE initiatives in are used as a symbol for transformation and healing, FY 2011: to our Interfaith Meditation Room and Chapel, which • The STAR (School Transition and Re-entry) Program is open for reflection and prayer, we honor all assisted 131 children and their families with individual beliefs and religious traditions . school re-entry after cancer and blood disease treatment . It also provided school intervention services, including consultation with families and medical teams, and parent advocacy skills training .

• The LIFE (Long-term Information, Follow-up and Education) Program provided comprehensive health services to 100 new survivors of childhood cancer at Children’s Hospital, and served 250 returning survivors . The LIFE Clinic for Adult Survivors provided adult-focused diagnostic and therapeutic services to 30 patients .

• The Teen Impact Program assisted 200 adolescents and young adults with cancer and blood diseases, providing group interventions, retreats and recreational outings to improve their quality of life as cancer survivors .

Our Spiritual Care Services programs offer support • The HOPE Resource Center is accessible to patients and comfort to patients, families and staff of all faiths and families at the hospital and through a web and cultures in times of crisis, loss, injury or illness . portal . By centralizing electronic and print The programs include sacred literature from diverse information resources in various languages, traditions, a place for prayer requests and religious services and referrals information in one location, services and rituals . the HOPE Resource Center helps guide families, staff and community providers in searching for “Even under the worst, most difficult circumstance, additional information on pediatric cancer and families are able to find hope and healing at our blood diseases . In FY 2011, the web portal hospital, largely through the use of our chapel, and was accessed by 4,500 patients, families and through attending our spiritual ceremonies,” says providers in our community . the Rev . Dagmar Grefe, manager of Spiritual Care • The HOPE Neurocognitive Program provided Services at Children’s Hospital . comprehensive neuropsychological evaluations and screenings to 150 children and youth . In addition to interfaith services, our Spiritual Care Services program celebrates Roman Catholic Mass • The HOPE Psychology Program helped 120 every Sunday for patients and families at our hospital . children and their families cope with the “Approximately 70 percent of the patients at our psychological challenges associated with hospital are Roman Catholic,” Grefe says . “The surviving cancer and blood diseases . celebration of Roman Catholic Mass is important to them and is open to the community .” In FY 2011, • The Celebrate Life with HOPE event was attended more than 1,500 children and their families attended by 2,700 children, families, staff and community the celebration of Mass and other spiritual ceremonies . partners in June 2011 on the New York City backlot of Paramount Pictures . The annual event Chaplains at Children’s Hospital also collaborate brings together childhood cancer survivors and with various faith communities, religious leaders their families, health care providers, community and local faith-based organizations to support agencies, volunteers and various Children’s patients and families in our community with their Hospital departments and programs to celebrate spiritual care needs . life and share information on various health topics . 17 NICCU Family Support Program “Through the Children’s Hospital and March of Dimes One in every 10 babies born in the U .S . is admitted partnership, we have implemented a Family Staff to a neonatal intensive care unit because of premature Advisory Council (FSAC) as part of the NICCU birth or another medical condition . Family Support Program,” says Hoda Sapir, a clinical social worker in the NICCU . “The council is comprised of NICCU staff and graduate NICCU parents who work together to develop customized supportive educational programs to serve the specific needs of each NICCU family .”

As part of the program, each NICCU family receives a patient care kit that includes educational flyers, a keepsake journal, a guide/glossary and an information booklet .

Families also have 24-hour access to informational resources and online communities through the March of Dimes kiosk in the NICCU Parent Lounge . There, parents and families of NICCU babies can visit secure websites to research neonatal diseases and connect with other NICCU families .

Patients in our NICCU have direct access to a wide range of pediatric medical and surgical subspecialists and ancillary services that allow treatment across the full range of neonatal diseases .

At Children’s Hospital Los Angeles, we treat the most critically ill of these newborns, who often have complex neonatal diseases and conditions . Patients are transported for care to our Newborn and Infant Critical Care Unit (NICCU) from neonatal intensive care units throughout the greater Los Angeles metropolitan area, Southern California and other states such as Nevada, Arizona and Hawaii .

For many of these families, coping with a baby’s NICCU stay can be very difficult . The interdisciplinary team at Children’s Hospital cares for and addresses the needs of parents, siblings, grandparents and the extended family throughout the hospitalization of a baby in the NICCU, during the transition home and in the event of a newborn death . In collaboration with the March of Dimes, Children’s Hospital Los Angeles offers the NICCU Family Support Program .

The program includes a professional development component that provides NICCU staff with educational opportunities to help them support families on a daily basis .

18 The Mark Taper-Johnny Mercer Artists Program More Family Support Highlights for FY 2011 At Children’s Hospital, the latest medicines and • Clinical social workers provide counseling services treatments are not the only tools we use to help and link patients and families to necessary resources patients heal . We also use paint, clay, musical and support programs at our hospital and in our instruments and rhymes . In fact, research has community . In FY 2011, hundreds of families were increasingly shown that art and music provide assisted with funds for prescription expenses, meal many benefits for sick and hospitalized children . vouchers, bus tokens and other transportation services . • Child Life specialists help our patients and families The Mark Taper-Johnny Mercer Artists Program cope with illness and hospitalization through play, at Children’s Hospital brings a wide array of art preparation, education and self-expression activities . experiences to critically and chronically ill children Understanding that a child’s well-being depends and teens and their siblings and families . The program’s on the support of the family, Child Life specialists multidisciplinary team provides art, music and writing provide information, support and guidance, and activities, as well as dance, movement and other serve hundreds of parents, siblings and other creative and expressive experiences for patients family members in our hospital every year . and families in their time of healing . • In FY 2011, our Comfort and Palliative Care Team reached 60 community providers and collaborated “We collaborate with various community-based with local hospice agencies to teach about pediatric organizations and various professional artists palliative and end-of-life care and supportive care and performers from the Los Angeles area to to families . offer entertainment, diversion and educational workshops in both the inpatient and outpatient • Pharmacists at Children’s Hospital provide areas at Children’s Hospital,” says Alexandra educational services for patients and families . Field, Artists Program lead . They also participate in community benefit projects, including providing prescription In collaboration with several community artists and donations to assist families in our community . internal artists, volunteers, clinicians and students, • The Audrey Hepburn CARES Team at Children’s the Mark Taper-Johnny Mercer Artists Program Hospital provides comprehensive services to young reached 7,700 children and families in FY 2011 . victims of abuse and their families . The team provides compassionate support to children and families by creating a child-friendly, safe environment . • In FY 2011, 59 adolescents with Turner Syndrome and seven counselors with the condition attended the hospital’s annual Turner Syndrome Camp . • Our Foster Care HUB serves 800 children and youth annually, providing initial medical exams, mental health screenings and care coordination for children in foster care . • To serve our culturally and linguistically diverse patient population, the Diversity Services department secures interpreting services for an average of 30 different languages, serving hundreds of families each month . • In FY 2011, 370 families were provided with gifts through the Holidays From the Heart Program . The program links families with hospital departments and donors who provide gifts based on specific individual and family needs . • Staff, parents and children in the Child Development Center at Children’s Hospital collected items, wrote cards and drew pictures of appreciation to send to hundreds of our troops for Christmas . • Each year, more than 500 compassionate individuals from our community volunteer more than 82,000 hours in 55 different areas of our hospital and various community benefit initiatives . In FY 2011, Volunteer Resources also donated and distributed 400,000 toys to patients, siblings and families in our community .

19 Children with Special Needs

We care for children with special needs and provide an array of services to support their families .

Excellence in Developmental Disabilities More than 100 interdisciplinary faculty, staff and trainees in the USC University Center for Excellence in Developmental Disabilities (UCEDD) at Children’s Hospital Los Angeles partner with community programs and our families . UCEDD delivers education (pre-service and community), conducts research and provides services for children with disabilities and their families . The major program areas are community mental health, developmental disabilities advocacy, policy and statewide initiatives and the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) Training Program.

UCEDD Services for the Community The USC University Center for Excellence in Developmental Disabilities at Children’s Hospital provides a comprehensive, interdisciplinary range of clinical and community services including: • Clinical Services – Provided through various hospital-based interdisciplinary programs and community-based programs • Diagnosis and Evaluation – Diagnostic and UCEDD Highlights for FY 2011 treatment/intervention recommendations for In FY 2011 more than 33,451 visits and 1,309 developmental, behavioral and attention problems patients were seen through the USC UCEDD mental • Feeding Development – Comprehensive assessment health clinics at Children’s Hospital . The USC and treatment services for feeding, growth and UCEDD served more than 2,000 patients/clients nutrition problems through community-based services and provided • Behavioral Pediatrics – Developmental and psycho- care for approximately 200 patients with autism social issues from a family-centered perspective spectrum disorder . • Community Mental Health – Provides individual and group therapy to serve children with severe In addition, 9,653 individuals, including professionals/ emotional and behavioral issues, as well as at-risk para-professionals, parents and family members, children and families . Includes the HEALS program individuals with developmental disabilities and other for victims of violent crimes such as non-accidental community representatives, received training on trauma, sexual molestation and neglect special health care needs for children through 196 training events . • Learning Abilities Program – Assessment of the impact of learning strengths and disabilities on More than 2,500 hours of technical assistance school achievement and behavioral development; for community-based organizations were provided, recommendations for behavioral and special reaching more than 44,838 individuals . The USC education support and services UCEDD disseminated multi-lingual children’s health • Community-Based Programs – Diagnosis, information to over 670,000 individuals through evaluation and treatment for infants, children and its webpage, media contacts, conferences and adults at several sites throughout Los Angeles direct mail . County including school-based sites • Individual, Family and Community Capacity Together with patients, families and community Building – Promotes activities that help assure partners the USC UCEDD at Children’s Hospital is quality of life for children and adolescents with working to accomplish a shared vision that foresees a developmental disabilities and their families nation in which all individuals, including the youngest through active involvement in the home, systems children and individuals with disabilities, participate of training and service, community support and fully in their communities . policy-making • Prevention and Early Intervention – UCEDD physicians and other health care providers focus on proactive outreach, early identification of needs, enhancing individual/family resources, and linking quality community services . 20 Oral Health for Children with Special A great example of the Division’s community benefits Health Care Needs is the Nasoalveolar Molding (NAM) Program led by The Division of Dentistry and Orthodontics at Children’s John Groper, MD, and Simon Gamer, MD, serving Hospital Los Angeles provides routine and specialized approximately 20 infants free-of-charge each year at dental and orthodontic care for more than 4,000 Children’s Hospital Los Angeles . children and adolescents every year, including those with complicated conditions such as cancer and “Nasoalveolar molding is a pre-surgical treatment hemophilia, cleft lip and palate and other congenital that serves to align and reshape the oral structures disorders . The Division has a long-standing tradition of affected by craniofacial defects and is used in providing community benefit and caring for children preparation for surgical repair of cleft lip and with special health care needs . cleft palate,” says Jose Polido, DDS, division chief, Dentistry and Orthodontics at Children’s Hospital .

In addition, the Division participates in various community events to advocate for and provide oral health education and awareness to children and families in our community . It also provides screenings focused on children with special health care needs .

“It is very important that all children maintain good oral hygiene,” Polido says . “Our community benefit efforts are helping children and families in our community better their oral health and stay healthy and happy .”

Advancing the Health and Well-Being of Adolescents

We provide comprehensive, specialized, appropriate, Project NATEEN sensitive care to address the health needs of Project NATEEN is an Adolescent Family Life Program adolescents in our community . that provides culturally sensitive and comprehensive case management services to pregnant and Adolescent Medicine parenting teens . Leading our community efforts in the area of adolescent development is the Division of Adolescent Medicine “The program provides pregnant and parenting at Children’s Hospital Los Angeles . The Division’s teens in our community with a full spectrum of leadership is known nationally for developing new supportive services so that they may accomplish program models that represent state-of-the-art health personal, educational and effective parenting goals,” interventions for adolescents . explains Alejandra Barragan, case manager with Project NATEEN . “Our therapeutic approaches and community partnerships promote personal empowerment within One of the program’s clients is Katherine Espinoza, the context of healthy relationships, families and the 17-year-old parent of a 1-year-old . She received communities,” says Marvin Belzer, MD, chief of the services from the program including parenting Division of Adolescent Medicine at Children’s Hospital . classes, comprehensive case management and other resources enabling her to succeed as a teen parent . In response to the needs of adolescents and young She has graduated from high school and is now adults in our communities, the Division employs more attending Santa Monica College . than 100 interdisciplinary staff who work across six major program areas: Case managers like Barragan facilitate support • Adolescent physical and mental health groups at local high schools and community-based • Homeless youth organizations . In addition, the program hosts a • HIV/AIDS breastfeeding support group for pregnant and • Pregnancy and parenting parenting adolescents in our community . • Substance abuse • Youth violence and gang prevention In FY 2011, Project NATEEN served 1,610 adolescents . The program’s community benefit efforts “Our Division’s advocacy and community benefit are ensuring that adolescents in our community have efforts, including cutting-edge research and the support necessary for future planning interventions, help advance the health and well-being and independence . of adolescents and their families in our communities and worldwide,” Belzer says . 21 Gang Prevention and Youth Development More Adolescent Medicine Highlights Many young people in our community live in for FY 2011 neighborhoods where educational, recreational • The Teenage and Young Adult Health Center and employment opportunities are very limited . serves the community by providing adolescent At the same time, young people are exposed to primary and subspecialty care . The Center has alcohol, drugs and gang violence in their schools approximately 3,000 visits a year and provides and on the streets . comprehensive social developmental assessments and services . In response to the city’s need for a comprehensive, community-based strategy to reduce gang crime • The High Risk Youth Program (HRYP) provides and violence in Los Angeles’ most gang-plagued integrated health services for runaway and communities, the Division of Adolescent Medicine homeless youth in our community, ages 12 to launched a comprehensive multiagency gang 24 . The HRYP also has a Mobile Health Team that prevention program in 1996 . offers basic medical screening at drop-in centers and shelters to maximize access to care . In FY Children’s Hospital Los Angeles also is the lead 2011, the program served 1,634 young people . agency for the Cypress Park/Northeast Los Angeles • The Substance Abuse Prevention and Treatment Gang Reduction Youth Development (GRYD) zone, Services (SAPT) program specializes in non- which leads violence prevention efforts to improve residential prevention and treatment of substance- the well-being and safety of youths and their families related problems affecting adolescents in our in the Cypress Park, Glassell Park and Highland Park community . The program is offered free-of-charge neighborhoods . and served 448 youth in FY 2011 .

Established by the Office of Los Angeles Mayor • The Substance Abuse and HIV Intervention Project Antonio Villaragoisa in 2007, the GRYD program (SHIP)’s Project Legacy served 225 homeless youth aims to reduce gang-related crime and engage in our community in FY 2011 . Project Legacy at-risk youth in positive activities . is a nine-week group intervention designed to support youth in reducing their HIV risk and The story of one 12-year-old boy, Oscar Cartagena, substance abuse by engaging them in goal-setting illustrates the challenges these young people face . and future planning . • More than 430 young people in our community Oscar attends Irving Middle School, located in received individual, family and group mental an area of Northeast Los Angeles that is heavily health services in FY 2011 . These included impacted by gang violence . transgender health services and services for young people at risk of or living with HIV/AIDS . “When he first came to the GRYD program, Oscar faced many personal and family challenges and was at risk for gang involvement,” says Adrianna Rincon, case manager in the GRYD program .

The GRYD program provides youths like Oscar, and their families, with comprehensive case management services including individual and family counseling, mentoring, academic assistance and tutoring, community mobilization and parent leadership workshops, educational, cultural and recreational activities and lessons in various sports at local community centers .

“Since Oscar’s involvement in the GRYD program, he is doing well in school, and has high aspirations for the future,” Rincon says .

In FY 2011, the GRYD program served 830 young people in our community .

22 Keeping Children Safe

Our community-based injury prevention efforts in the Kohl’s Safety and Injury Prevention Program Los Angeles area help minimize preventable injuries In partnership with Kohl’s Cares for Kids, the Kohl’s and keep children in our communities safe . Safety and Injury Prevention Program at Children’s Hospital Los Angeles provides safety education Preventing Unintentional Injuries and equipment for children and families in our Every year, more than 8,000 injured children are local communities . seen in our Emergency Department, many of them requiring hospitalization . The Trauma Team at The program raises awareness of preventable injuries Children’s Hospital Los Angeles follows each of and includes an array of family safety activities and these patients—from the time they enter our hospital resources including free-of-charge bicycle helmets, through their discharge, and as patients of the child safety seats, child safety seat check events, hospital’s outpatient Trauma Clinic . child safety seat classes and educational materials for children and families in our community . As the only free standing Level 1 Pediatric Trauma Center in Los Angeles County accredited by the In FY 2011, the Kohl’s Safety and Injury Prevention Committee on Trauma of the American College of Program at Children’s Hospital was present at more Surgeons, the Trauma Program at Children’s Hospital than 100 community health and safety fairs reaching provides a complete continuum of pediatric trauma thousands of children and families . Through its bi- care, and offers an active program of injury- weekly child safety seat classes, the program prevention education, research and outreach for provided more than 400 free-of-charge child safety children and families in our community . seats and reached hundreds of children and families from various communities . Approximately 65 percent of all trauma patients treated at Children’s Hospital were injured from an Buckle Up for Life incident involving a vehicle—either as a passenger, A unique partnership between Children’s Hospital pedestrian, bicyclist or (rarely) as a young driver. Los Angeles, Children’s Hospital Cincinnati and Toyota, “Buckle Up for Life” is an injury prevention “Our innovative, interactive educational injury- initiative for families in faith-based organizations in prevention programs and activities are reaching our community . many families and helping reduce unintentional injuries in our local community,” says Helen The Children’s Hospital Trauma Team teaches Arbogast, MPH, CHES, CPST, injury prevention children, teens, parents and caregivers who are coordinator in the Trauma Program . “In many members of various church congregations in cases, these are injuries that are preventable .” predominantly Hispanic and African-American communities the importance of passenger safety . LA Street Smarts A health and safety fair and child-safety seat As pedestrians, children are at even greater risk of check event are held at each church following injury or death from traffic crashes due to their small the completion of training . Each event is open to size, inability to judge distances and speeds and lack all families in the church’s local community . of experience with traffic rules . The Buckle Up for Life program at Children’s Hospital To address the need to reduce child pedestrian Los Angeles provided 450 free-of-charge child safety injuries and deaths, the Children’s Hospital Trauma seats and taught more than 1,000 children and Program developed an innovative program called LA families from six different congregations the Street Smarts . This interactive educational set, which importance of seat belt use . replicates a small neighborhood, is taken to local schools, where our experts teach children how to properly cross streets, maneuver in and around cars and stay safe while walking in the community .

All children who complete the course are provided with injury prevention materials to take home to reinforce the safety concepts and lessons learned . LA Street Smarts visited more than 25 sites in our community and reached more than 7,000 children and their families .

23 More Child Safety Highlights for FY 2011 • In FY 2011, 81 health professionals attended the • A collaboration with the Los Angeles Dodgers 12th annual Trauma Conference, entitled “Sports resulted in more than 300 families in our Injuries and Concussions .” community receiving child safety seats and • More than 50 health professionals in our attending child passenger safety classes . community participated in the Trauma Program • The Children’s Hospital Trauma Program created Pediatric Disaster Training and received pediatric- its first class of Pediatric Injury Prevention Scholars specific disaster education and preparation in (PIPS) consisting of students from various universities FY 2011 . who worked alongside senior researchers to learn about injury prevention services and research . • More than 50 injury prevention coordinators, trauma coordinators and health education professionals attended the two-day comprehensive injury prevention training focused on injury prevention best practices, evaluation and research . • The Trauma Program’s Injury Prevention team developed a blog for families and community members as a means for education and engagement with the injury prevention team . (Visit www.WeAreChildrens.org and search for “injury prevention.”)

Quality Health Care Beyond International Borders

Our highly skilled specialists at Children’s Hospital The team performed five surgeries on patients with Los Angeles provide care and education beyond complex congenital heart disease and provided international borders to improve children’s health . teaching and instruction to the hospital’s medical faculty members . Zhejiang Children’s Hospital “We exchanged skills and ideas around cardiac In addition to our high-quality health care services evaluation, new cardiac surgery techniques, cardiac provided to patients at Children’s Hospital Los anesthetic management, intraoperative transesophageal Angeles, our caring staff members often take their echocardiography, postoperative cardiac care and expertise abroad to help children in need . cardiac critical care protocols,” Wong says . In April 2011, Pierre Wong, MD, a pediatric Following the educational seminars, the medical cardiologist with the Division of Cardiology at team participated in and led talks to physicians Children’s Hospital Los Angeles, joined a team of from many different regions of China as part of a 35 volunteers from various children’s hospitals on a large, two-day symposium sponsored by Zhejiang mission to the Zhejiang Children’s Hospital University Children’s Hospital . School of Medicine at Hangzhou in China . “This was an unforgettable and valuable experience not only for the team,” Wong says, “but also for the children we served and the medical professionals we interacted with in China .”

Other International Highlights Our physicians, nurses and other health care staff have also provided services, training or developed programs in Haiti, Peru, Ecuador, Russia, El Salva- dor, India, Armenia, Kenya, Mongolia, Brazil, China and other international sites .

24 Tomorrow’s Caregivers

Physicians of the Future “Our faculty mentor some of the most talented young At Children’s Hospital Los Angeles we believe deeply leaders of the profession,” says Robert Adler, MD, that education is among the greatest legacies we can MSEd, vice chair of the Department of Pediatrics leave for future generations, and this commitment and director of Medical Education . “We believe that is evident in our teaching and training of medical Children’s Hospital Los Angeles is truly unique . Not students, residents and fellows . only does our institution bring together world-class clinical care, excellent education and leading-edge During the past fiscal year, our faculty trained 575 bench-to-bedside research in perhaps the most medical students, 85 full-time residents, three chief diverse urban center in the nation, it does so residents and 107 fellows who collectively reflect the in an environment of collaboration, passion diversity not only of the patient population, but also and dedication .” of the Los Angeles region . For the past 12 years, 97 percent of our graduating residents at Children’s Our faculty share their expertise and unique perspective Hospital have passed the American Board of of collaboration with all those who come to our hospital Pediatrics exam on the first attempt, far above for education and training—and with all whom the national average . we reach through our community initiatives and professional programs .

25 Innovative Nursing Education Program “Those aspiring to become a nurse come to Children’s One of the many characteristics that makes Children’s Hospital Los Angeles from all over the country because Hospital Los Angeles such a special place is the they want to work with and learn from our expert compassion, knowledge and dedication of our nurses who are at the forefront of pediatric health nurses . They are at the heart of our mission and the care,” says Mary Dee Hacker, MBA, RN, NEA-BC, embodiment of our values . As a Magnet Hospital FAAN, vice president, Patient Care Services and chief our organization has been recognized for quality nursing officer at Children’s Hospital . “What makes inpatient care as well as excellence in nursing, which Children’s Hospital one of America’s premier pediatric proves the hospital upholds the tradition of professional teaching hospitals is the warmth and welcoming of the nursing practice . Our commitment to quality inpatient people here—physicians, nurses and other caregivers, care begins with our commitment to supporting who are committed to teach those caring for the ones our nurses’ career goals and the development of we love the most, our children .” future nurses . Hacker also serves as a board member of the During the past fiscal year, 70 nurses graduated from California Institute for Nursing and Health Care, the Versant RN Residency in Pediatrics at Children’s a nonprofit organization dedicated to developing Hospital—a 22-week program providing new nursing solutions to a critical nurse shortage and related school graduates with a comprehensive clinical and nursing issues that affect the health of all Californians . learning experience to prepare them for work in an She is also a board member of the DAISY Foundation . acute care environment . The program has become Children’s Hospital was the 27th hospital to partner a national model for new graduate nurse residency with this nonprofit foundation to provide monthly programs in other hospitals . DAISY Awards to exceptional nurses nominated by leadership and their peers for compassionate care “We provide new graduate nurses and nursing students at the bedside of sick and injured children . with the appropriate tools, clinical experience and support system necessary to care for acutely ill and injured children,” says Suzanne Taylor, RN, director of Clinical Education and Professional Development at Children’s Hospital .

In addition to the Versant program, Children’s Hospital Los Angeles served as a training site for more than 1,170 student nurses from more than 15 community colleges and universities within Southern California in FY 2011 . Through clinical rotations, supervised by their clinical instructor and alongside our expert nurses at Children’s Hospital, student nurses are able to apply theoretical nursing concepts learned in school such as assessments, documenting charts and administering medication .

Through presentations at local schools and job- shadow opportunities at the hospital, our nurses also provided learning experiences for more than 130 young adults in our community, sparking an interest in a future career in nursing .

26 More Professional Education Highlights for FY 2011 • The Children’s Center for Cancer and Blood Diseases hosted five practicum-level psychology externs and 10 hematology-oncology fellows . • The Echocardiography Laboratory served as a principal externship site for students on pediatric echocardiography and congenital heart disease . • The Division of Dentistry trains more than 25 residents yearly from the USC Ostrow School of Dentistry . It also hosts national and international residents and dental students who come to Children’s Hospital to learn about oral health care for children with special needs . • The Department of Pathology and Laboratory Medicine hosted training for five laboratory professionals and students, including clinical laboratory scientists . • Seventy-eight trainees representing 13 disciplines completed the CA-Leadership Education in Neurodevelopmental and Related Disabilities (LEND) Training Program of the USC UCEDD at Children’s Hospital . In addition, the program trained 10 interns in Child Clinical Psychology, 10 postdoctoral fellows in adolescent health, early childhood mental health, child and family mental • Through its accredited Clinical Pastoral Education health, pediatric psychology and trauma (CPE) program, Spiritual Care Services trained psychology and five pediatric interns in the USC 18 student interns and religious leaders in UCEDD Dietetic Internship Program . interfaith professional education and clinically • The Pharmacy served as an externship site for supervised experience with children and families . 14 USC School of Pharmacy students . • The Office of Strategic Business and Innovation • The Department of Rehabilitation Medicine served served as a training site for two Master of Health as a training site for 18 physical and occupational Administration residents and five Master of Public therapy students . Health/Master of Business Administration interns, and mentored 10 students . • The Office of Community Affairs provided training for two Master of Health Administration residents and three college students . The Office also coordinated programs encouraging advancement in health care management through the American College of Healthcare Executives (ACHE). • Our hospital offers many health profession internships in the areas of social work, adolescent medicine, child life, research and community benefit operations .

27 Opportunities for Young Adults in Our Community

As one of Hollywood’s largest employers, Children’s Hospital Los Angeles serves as an economic engine Latino & African-American High School for the local community, spurring growth, development Internship Program (LA-HIP) and employment opportunities . The Latino & African-American High School Internship Program (LA-HIP) is a biomedical summer research Summer Youth Employment Program (SYEP) and college preparatory program for Latino and In Los Angeles, 18 percent of young adults ages African-American high school students who live 20 to 24 are unemployed, and approximately 22 or attend school in south or east Los Angeles percent of 18- to 24-year-olds do not have a high communities . school degree or GED equivalent . This results in a large number of young adults in our community who In FY 2011, 100 high school juniors from these are in need of skill development . communities applied for 16 available summer internships with LA-HIP . The program provides a Individuals without at least a high school diploma six-week hands-on medical research lab experience struggle to compete in today’s highly skilled labor for students who are passionate about pursuing a pool . Many of these young adults do not have access to opportunities or mentorship by professionals .

To address this community need, the Office of Community Affairs at Children’s Hospital Los Angeles is a host site for the Hire LA’s Youth “Summer Youth Employment Program” and joins with the Office of Los Angeles Mayor Antonio Villaraigosa and the Los Angeles Area Chamber of Commerce and other local businesses to support community youth development .

“Through the program, young adults gain entry-level work experience, learn skills critical for employment and are encouraged to pursue higher education to prepare them for a future career in health . Meanwhile, the hospital gains an opportunity to build a future workforce that is reflective of the local community .” says Rolando Gomez, MBA, Project Leader Commu- nity Benefits, Office of Community Affairs . career in the sciences . In FY 2011, the hospital provided scholarships for summer employment opportunities for two students . Working under the direction of scientists at The Saban One of these students, Luis Morales, was then offered Research Institute of Children’s Hospital Los Angeles, a full-time position as the GetWellNetwork assistant these interns conduct research projects on diseases in the Helen and Bill Close Family Resource Center at such as cancer and tuberculosis . Others work on Children’s Hospital . investigative research projects .

“My experience as a student intern with the “The success rate of our LA-HIP students and alumni is Summer Youth Employment Program helped me build something to be proud of,” says Emil Bogenmann, PhD, confidence, communication and organizational skills, EdD, director of LA-HIP . “Graduates of the program are as well as other entry-level skills necessary to prepare now matriculating at and attending various prestigious me to be competitive in the job market,” Morales academic institutions across the region ”. says . “This program has made a positive impact on my life, and I am grateful to Children’s Hospital for LA-HIP organizes college campus visits and provides opening its doors to me .” interns with the opportunity to meet admissions officials, current students, LA-HIP alumni and faculty who teach in scientific and biology departments . Interns attend college-counseling workshops, receive financial aid counseling and are guided through the college application process .

“Doctorates earned by African-American and Latino students combined represent less than 5 percent of PhDs received across all the sciences,” explains Bogenmann . “It’s our job to provide experience and access to education so that the workforce in research and medicine will be as diverse as our patient population ”. 28 More Youth Development Highlights • The National Institute of Diabetes, Digestive and for FY 2011 Kidney Diseases (NIDDK) STEP-UP Program at • Camp CHLA, an innovative program from Patient Children’s Hospital provides short-term research Care Services team, provided 185 students in education for undergraduate students from our community with a firsthand look at the under-represented minorities or disadvantaged fascinating world of health care at Children’s backgrounds . Students perform 10 weeks of Hospital Los Angeles . Students observed and hands-on biomedical research during the summer in joined our registered nurses, respiratory care such areas as diabetes, digestion, endocrinology, practitioners and other health care professionals hematology, kidney, liver, metabolism, nutrition, to learn about health care . The five-day camp obesity and urology . In FY 2011, 25 undergraduate also provides students an opportunity to observe students performed their research at Children’s various medical procedures and participate in Hospital and presented their accomplishments mock emergency drills . at a Science Symposium . • As part of the USC UCEDD’s Minority Partnership grants with California State University, Los Angeles, 14 undergraduate students received training in working with children and youth with neurodevelopmental and related disabilities .

Neighborhood Initiatives

At Children’s Hospital Los Angeles, we recognize the Vermont Avenue, near the hospital, to increase importance of our involvement in local community pedestrian traffic and safety . Over the past several development initiatives . years, our local community has seen more than 70 new trees planted, 100 lampposts repainted, graffiti We collaborate with community stakeholders to removed from bus stops and benches and sidewalks address civic issues affecting children, families and power-washed and cleaned . residents in our neighborhoods . In addition, the Facilities department at Children’s Children’s Hospital is a member of our local Hospital Los Angeles works diligently to maintain Hollywood Chamber of Commerce, surrounding a clean and safe environment for patients, families, neighborhood councils and several local civic staff, business partners and community members who groups . In addition, the hospital collaborates on reside near the hospital . numerous community development projects through its support and leadership of the East Hollywood Business Improvement District (BID). The district recently was renewed for 10 years with overwhelming support from local property owners .

“Children live in the context of their neighborhoods, and therefore, it is important for Children’s Hospital to play an active role in local efforts to enhance our communities,” says Ellen Zaman, FACHE, director, Office of Community Affairs at Children’s Hospital . “We have been working on several neighborhood projects to help create and sustain a healthier, safer community for children and their families .”

These projects range from street cleaning and beautification to the planning for medians along

29 Community Partners

We are grateful to each of our partners, who help us Los Angeles County Department of Health Services achieve our Community Benefit efforts to serve those Los Angeles County Department of Mental Health most in need in our community . Los Angeles County Emergency Medical Services Agency 211 Info Line Los Angeles County Poison Prevention American Cancer Society Los Angeles Fire Department Armenian American Chamber of Commerce Los Angeles Police Department Asian Pacific Health Care Venture Los Angeles Unified School District Bill Cruz Early Education Program Los Angeles Urban League California Highway Patrol Head Start State Preschool Children’s Bureau of Southern California March of Dimes City of Los Angeles Department of Recreation Maternal and Child Health Access and Parks Mexican American Opportunity Foundation Community Redevelopment Agency New Economics for Women Consulado General de Mexico in Los Angeles Office of Los Angeles Mayor Antonio Villaraigosa East Hollywood Neighborhood Council Para Los Niños Family Voices Padres Contra El Cancer Glendale Community College Queen Anne Place Great Beginnings for Black Babies Ready for School Center Hollywood Homeless Youth Partnership Ronald McDonald House Jewish Family Service of Los Angeles SafetyBeltSafe U .S .A . Local legislative offices, universities, faith-based South Central Family Health Center organizations and neighborhood councils South Central Prevention Coalition Local YMCAs State of California Kids Plates Program Los Angeles Access to Health Coverage Coalition Thai Community Development Center Los Angeles City College United American Indian Involvement Los Angeles City Council Districts Young Nak Presbyterian Church Los Angeles County Department of Children . . and many more and Family Services

30 Building Healthier Futures

Credits: Richard D. Cordova, FACHE President and Chief Executive Officer Gail L. Margolis, Esq. Vice President, Business, Government and Community Relations Ellen Zaman, FACHE, Director, Community Affairs Rolando Gomez, MBA, Project Leader Jim Deeken, Director, Creative Services Matthew Pearson, Director, Publications Chandra Broadwater, Sr . Communications Specialist

Community 2 011 Benefit Report

Office of Community Affairs - 4650 Sunset Blvd ., #118, Los Angeles, CA 90027 | 323-361-2487 | CHLA .org

32 ECONOMIC IMPACT OF THE EARLY CARE AND EDUCATION INDUSTRY on Los Angeles County

1 It is well documented in the research and more widely Since these jobs cannot be moved offshore or out of state understood that quality early care and education has for cost savings, like manufacturing jobs, the payrolls are tremendous benefi ts in contributing to children’s abilities distributed to local residents. The impact of these jobs to grow up and reach their potential and become productive on the local economy is enhanced by the fact that much citizens. Research fi ndings show that the signifi cance of of the revenue they generate is spent locally by both the early care and education goes beyond early child outcomes: members of the workforce as well as their employers (for they extend to later school performance, which in turn has example, child care centers purchase food and supplies a signifi cant inﬂ uence on our national, state, and local for their businesses). 1 economies. The health of the economy is therefore impacted by investments in providing early care and education. DirecT eMpLoYMeNT

An often overlooked factor in discussion of policies Within Los Angeles County, the formal early care and pertaining to early care and education is the early care education industry provides jobs for more than 40,000 and education workforce, which has a tremendous effect employees (see Table 1). on Los Angeles’ and California’s economic well-being in the form of jobs, revenue, increased economic activity When counting all full-time equivalent jobs in the early and downstream savings. In the sections that follow, this care and education industry, including those employees outside the Child Care Worker and Preschool Teacher report describes the early care and education workforce classifi cation, the number climbs to over 60,000 workers.3 and its effect on the local economy. Moreover, since many people employed by the early care and education industry work part time, the total number of Early Care and Education - employees is higher.4 a Signiﬁ cant Workforce As stated in the Center for Community Economic Sector in Los Angeles County Development’s 2006 study, in terms of direct employment by industry in Los Angeles County, early care and education Early Care and Education is a job-creating and income- generating sector of the Los Angeles County economy. provides more jobs than many other industries, including construction, automotive repair, legal services, and hotels/ motels (see Figure 1).

Table 1: Number of Child Care Workers and Preschool Teachers in Los Angeles County 2

1. MacGillvary, J., and Lucia, L. (2011). Economic Impacts of Early Care and Education in California. Center for Labor Research and Education, University of California Berkeley. 2. California Education Development Department. Data accessed via: http://www.labormarketinfo.edd.ca.gov/aspdotnet/SupportPage/AllOccPrj. aspx?soccode=399011 http://www.labormarketinfo.edd.ca.gov/aspdotnet/SupportPage/AllOccPrj.aspx?soccode=252011 3. Brown, B., Ramos, M., and Traill, S. (2008). The Economic Impact of the Early Care and Education Industry in Los Angeles County. Insight Center for Community Economic Development. 4. Brown, B., Ramos, M., and Traill, S. (2008).

1 Figure 1: Direct Employment by Various Industries in Los Angeles County (2005) 5

Table 2: Estimated Value of Annual Gross Receipts for the Formal Early Care and Education Industry in Los Angeles County (in millions) 6

SUBSIDIZED LICENSE-EXEMPT CHILD CARE PROVIDER

The above estimates are likely understated due to Gross Receipts the fact that they do not include license-exempt child care centers [aside from those that receive vouchers] Gross receipts measure the size of an industry in terms of the or information on the informal sector of the industry – overall value of the goods and services produced over the i.e., relatives, friends, and neighbors who regularly course of a year. The gross receipts for the early child care and care for young children. education industry are significant, with estimates of $1.7 billion in Los Angeles County and $5.6 billion in California (see Table 2).

5. Industries listed as presented in Brown, B., Ramos, M., and Traill, S. (2008). 6. Brown, B., Ramos, M., and Traill, S. (2008).

2 Figure 2: Gross Receipts by Various Industries in Los Angeles County (2006) 7

THe “MULTipLier eFFecT”

As compared to other The total impact of the early care and education industry’s $1.7 billion of receipts is further increased by the “multiplier effect.” industries in Los Angeles The industry supports jobs and increased economic output by County, the early care and employing individuals directly, indirectly supporting jobs by allowing parents to participate in the labor force, and inducing education industry generates jobs at local businesses where those parents and members of more in gross receipts than the early care and education workforce shop. These factors combine to affect spending in other sectors (e.g., retail, soft drink manufacturers, transportation) of the local economy, resulting in purchasing women’s clothing stores, and power that adds to the gross receipts for other local industries. An analysis by the Center for Labor Research and Education spectator sports, to name a estimates that, through this multiplier effect, every $1 spent on few. (see Figure 2). the early care and education industry in California yields $2 in economic output. 8 In other words, money spent on the early care and education industry in Los Angeles County doubles the gross receipts of $1.7 billion to approximately $3.4 billion.

7. Industries listed as presented in Brown, B., Ramos, M., and Traill, S. (2008). 8. MacGillvary, J., and Lucia, L. (2011).

3 Early Care and to care for their children, or be distracted at work due to stress related to child care issues. All these factors Education Impacts Labor affect business productivity. Employee absences cost Force Productivity businesses a minimum of two times the absent worker’s wage, and the cost of employee turnover has been The early care and education industry provides support estimated to be between 75 percent and 250 percent to parents beyond care and education and allows parents of the annual salary of employees.12 Estimates by WFD to work or attend school. By enabling more parents to work Consulting show that every $1 investment by employers or attend school, the industry supports higher earnings for back-up child care (off-site child care provided to for families, allows more women to join the workforce, employees) results in $3 to $4 in productivity and turnover improvements.13 Additionally, work productivity issues and enhances worker productivity. Each of these benefits related to child care affects employees without children as the local economy. well.

• Higher household earnings: In two-parent households, • Increased salaries due to higher education: the availability of child care allows both parents to work, Approximately 16 percent of parents seeking child care often resulting in a substantially higher household income, are in school or training programs.14 Access to quality compared to one. Higher earnings translate to more money in child care allows these parents to become higher-skilled the local and state economy through higher purchasing power members of the workforce, resulting in higher incomes for and more taxes. An analysis by the Center for Labor Research the families (through higher paid jobs), higher revenues for and Education at the University of California, Berkeley businesses (through a higher skilled workforce), increased estimates that parents using paid early child care education tax revenues, and less reliance on public services, such services in California have purchasing power of approximately as unemployment or government subsidies. A national $26.4 billion per year, based on their earnings.9 study has found that 88 percent of government subsidies • More women in the workforce: The percentage of women in the recipients who earned a four-year college degree were workforce is growing, nearing 50 percent in 2009.10 For women able to move off of government subsidies after earning with young children, the availability of affordable child care their degree.15 Moreover, access to quality early care and allows them to work, providing more income for themselves education makes it more likely that parents attending and their households. Studies have shown that the high cost school will ultimately graduate. Research demonstrates of early child care and education is often a barrier for women that student-parents using on-campus child care services wishing to enter the workforce. David M. Blau, professor of have higher graduation rates, are more likely to remain in economics at UNC-Chapel Hill estimates that full government school, and graduate in fewer years than student- parents funding of early care and education would increase overall without such access. Student-parents indicate that the maternal employment by up to 10 percent.11 availability of child care is critical to their decision to enroll in college.16 • Enhanced productivity at work: Some experts argue that

parents who have access to reliable child care are less likely to be absent from work, stop working in order

9. MacGillvary, J., and Lucia, L. (2011). 10. Institute for a Competitive Workforce (2010). Why Business Should Support Early Childhood Education. US Chamber of Commerce, Washington, DC. 11. MacGillvary, J., and Lucia, L . (2011). 12. MacGillvary, J., and Lucia, L. (2011). 13. Elswick, J. (2003). More Employers Offer Back-Up Care. Employee Benefit News, 17. 14. California Child Care Resource & Referral Network (CCRRN), 2009 Child Care Portfolio. 15. Brown, B., Ramos, M., and Traill, S. (2008). 16. Brown, B., Ramos, M., and Traill, S. (2008).

4 Figure 3: Rate of Return on Investment in Young Children According to the Heckman Equation17

Moreover, a study by The fi nding that investments in early care and education yield benefi ts for the participants has the RAND Corporation been repeated and affi rmed in multiple studies. calculated the costs and Dr. James Heckman, a Nobel Laureate in Economics and a professor at the University benefi ts of a universal of Chicago, has developed a formula called the half-day preschool program Heckman Equation that shows that the earlier for all of California’s 4 year an intervention occurs, the greater the payoff; thus investments made for high-quality early care and olds regardless of family education yield higher returns than investments income, and determined that made at later stages in life.19 Figure 3 shows an illustration of the rate of return on investments in there would be a return on children based on the Heckman Equation. investment of $2.62 for every dollar spent.18

17. Schweinhart, L. (2005). The High/Scope Perry Preschool Study Through Age 40: Summary of Conclusions, and Frequently Asked Questions. High/Scope Educational Research Foundation, Ypsilanti, Michigan. 18. Karoly, L., and Bigelow, J. (2005). Labor and Population: The Economics of Investing in Universal Preschool Education in California. RAND Corporation, Santa Monica, CA. 19. Institute for a Competitive Workforce (2010).

5 Savings on Social Services: Early care and education Savings on Future Public Spending programs have also provided savings by ensuring that Investing in early care and education saves on future public children who participate in quality early education spending for criminal justice and social welfare programs. programs become less likely to need government subsidies. The economic return to society of the High/Scope Perry Preschool Project is $2,768 per participant from saving • • Savings on criminal justice: Investments in quality early care on social services.23 The social services savings from the and education have shown that they save taxpayer money in economic return from the Chicago Child-Parent Centers is the long-run by reducing the rate of crime among early care estimated at 1.6 percent and amounts to about $657 per and education program participants. Adults who participated participant in 1998 dollars.24 as children in the High/Scope Perry Preschool program had, by age 40, significantly fewer lifetime arrests than those Individuals not needing government subsidies and children who were not randomly assigned into the program without a criminal record are more likely to earn higher (36 percent vs. 55 percent arrested five or more times), and wages. Thus, in addition to savings from less public spending had significantly fewer arrests for violent crimes (32 percent on social services and criminal justice, high-quality early vs. 48 percent ever arrested) and drug crimes (14 percent vs. care and education programs reap the future benefit of 34 percent ever arrested). Of the public return on investment higher incomes and higher purchasing power for the program in the High/Scope Perry Preschool Project, 88 percent came participants, which translate into more money spent in the from crime savings.20 For California, economist Robert G. Lynch local economy. In short, maintaining a robust, professional estimates that the crime-related savings to individuals from early care and education workforce is an important a universal prekindergarten program would total about $17.9 component of our national, state and local economies and billion in the year 2050.21 will require continued support of, and increased investment in, the early care and education workforce.

Table 3: Return on Investment for Selected Early Childhood Interventions in 2002 Dollars22

20. National Education Association (2007). Fact Sheet: Enriching Children, Enriching the Nation. 21. Schweinhart, L. (2005). 22.Brown, B., Ramos, M., and Traill, S. (2008) and MacGillvary, J. and Lucia, L. (2011). 23. Schweinhart, L. (2005). The economic return is presented in constant 2000 dollars discounted at 3 percent. 24. Institute for a Competitive Workforce (2010).

6 proJecT spoNsoreD BY FirsT 5 LA

First 5 LA oversees the L.A. County allocation of funds from Proposition 10, which added a 50-cent tax on tobacco products sold in California. Funds raised help pay for health care, education and child development programs for children from the prenatal stage to age fi ve and their families. First5 LA’s mission is to increase the number of young children who are physically and emotionally healthy, safe, and ready to learn. For more information, please visit www.ﬁ rst5la.org.

iN pArTNersHip WiTH:

The Los Angeles Chamber of Commerce is the voice of business, helping its members grow and promoting collaboration, the Los Angeles Area Chamber of Commerce seeks full prosperity for the Los Angeles region. As a trustee for the current and future welfare of the region, the Los Angeles Area Chamber of Commerce champions economic prosperity and quality of life.

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1 The Lasting Impact of Employer-Sponsored Child Care, Bright Horizons, 2008 2 The Lasting Impact of Employer-Sponsored Back-Up Care, Bright Horizons, 2008 3 College Coach Investment Impact Data, 2011 4 Bundled Value: Working Learners’ Perceptions of Tuition Benefit Programs, Apollo Research Institute, 2011 ©2012, Bright Horizons Family Solutions LLC Be a Part of the L.A. REGIONAL STEM Hub

Join the Los Angeles Area Chamber of Commerce in an effort to create the L.A. region’s first-ever Science, Technology, Engineering and Math (STEM) Hub. The L.A. Regional STEM Hub will connect the region’s leading STEM professionals with educators in an effort to provide students with access to a high-quality STEM education and fulfilling careers.

Why a STEM Hub? L.A. REGIONAL STEM Hub In order for students to have access to high-quality Priorities STEM teaching and learning, it is critical to address gaps in our education system. Statewide, the California  Improve STEM professional development for teachers STEM Learning Network is building a network of  Ensure students have access to positive STEM educators, business leaders and other stakeholders experiences committed to establishing the world’s best STEM  Connect the region’s top STEM education providers to education system. Regional networks have already the local STEM Industry been established in the Central Coast, Sacramento, San  Identify best practices and other resources that make Diego, Orange County, San Bernardino, Silicon Valley up the rich network of informal education providers and the East Bay. The L.A. Regional STEM Hub will ensure a strong L.A. voice in this statewide network.  Better alignment of regional workforce development with employers needs and educational opportunities  Encourage greater diversity within STEM careers  Advance STEM policies that enhance educational practice  Connect STEM businesses, trade and professional associations and labor unions  Utilize existing partnerships and assets and identify new ones

For more information contact Gail Levy, 213.580.7594 or [email protected].

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