Medical Endowment Scheme Annual Report 2018/2019

MEDICAL ENDOWMENT SCHEME ANNUAL REPORT 2018/2019

MEDICAL ENDOWMENT FUND ANNUAL REPORT FOR THE FINANCIAL YEAR 1 APRIL 2018 TO 31 MARCH 2019

CONTENTS PAGE 1. Introduction 1 2. Overview of Medical Endowment Fund 1 3. Financial Status of Medical Endowment Fund 2 4. MediFund and MediFund Silver Grants Disbursed 3 5. MediFund and MediFund Silver Usage 3 6. Auditor's Reports 6 7. Conclusion 7

EXHIBITS Exhibit 1: Financial Status of Medical Endowment Fund 2 Exhibit 2: MediFund and MediFund Silver Grants to MFIs 3 Exhibit 3: Number of Admissions/Attendances/Bed Months Approved 3 for MediFund and MediFund Silver Assistance Exhibit 4: Utilisation of MediFund and MediFund Silver by MFIs 4 Exhibit 5: MediFund and MediFund Silver Assistance Disbursed to 5 Patients Exhibit 6: Average FY18 Assistance According to where Patients 6 received Treatment in PHIs Exhibit 7: Percentage of Admissions/Attendances/Bed Months which 6 received Full Assistance from MediFund and MediFund Silver in FY18

CHARTS Chart 1a: Distribution of MediFund and MediFund Silver Grant to 8 MediFund Committees of Public Hospitals and Institutions in FY18 Chart 1b: Distribution of MediFund and MediFund Silver Grant to 9 MediFund Committees of ILTC Facilities in FY18 Chart 2a: Total Number of Admissions/Attendances Approved for 10 MediFund and MediFund Silver Assistance by Public Hospitals and Institutions in FY17 and FY18 Chart 2b: Total Number of Admissions/Attendances/Bed Months 10 Approved for MediFund and MediFund Silver Assistance by MediFund Committees of ILTC Facilities in FY17 and FY18 Chart 3a: Total Amount of MediFund and MediFund Silver 11 Assistance Approved by MediFund Committees of Public Hospitals and Institutions in FY17 and FY18 Chart 3b: Total Amount of MediFund and MediFund Silver 11 Assistance Approved by ILTC Facilities in FY17 and FY18 Chart 4a: Breakdown of Number of Admissions/Attendances 12 Approved for MediFund and MediFund Silver Assistance by MediFund Committees of Public Hospitals and Institutions in FY18 Chart 4b: Breakdown of Number of Admissions/Attendances/Bed 13 Months Approved for MediFund and MediFund Silver Assistance by MediFund Committees of ILTC Facilities in FY18: Non-Residential Services Chart 4c: Breakdown of Number of Admissions/Attendances/Bed 13 Months Approved for MediFund and MediFund Silver Assistance by MediFund Committees of ILTC Facilities in FY18: Intermediate Term Residential Services Chart 4d: Breakdown of Number of Admissions/Attendances/Bed 14 Months Approved for MediFund and MediFund Silver Assistance by MediFund Committees of ILTC Facilities in FY18: Long Term Residential Services Chart 5a: Breakdown of Amount of MediFund and MediFund Silver 15 Assistance Approved by MediFund Committees of Public Hospitals and Institutions in FY18 Chart 5b: Breakdown of Amount of MediFund and MediFund Silver 16 Assistance Approved by MediFund Committees of ILTC Facilities in FY18

ANNEXES Annex A: List of MediFund Committees and MediFund Approved 17 Institutions in FY18 Annex B: MediFund Advisory Council in FY18 24 Annex C: Auditor’s Report on MediFund Accounts 25

MEDICAL ENDOWMENT FUND ANNUAL REPORT FOR THE FINANCIAL YEAR 1 APRIL 2018 TO 31 MARCH 2019

1. INTRODUCTION

1.1. The Medical Endowment Fund (MediFund) is governed by the Medical and Elderly Care Endowment Schemes Act (Chapter 173A). As required under the Act, this Report gives an account of the administration of MediFund for the Financial Year 2018 (FY18), i.e. for the period 1 April 2018 to 31 March 2019.

2. OVERVIEW OF MEDICAL ENDOWMENT FUND

Objective

2.1 MediFund was created by the Government on 1 April 1993. Its objective is to assist needy Singapore Citizens who are unable to afford their medical bills, after government subsidies and having made use of their MediShield Life and MediSave.

2.2 Needy Singaporeans who receive subsidised treatment and have difficulties paying their medical bills can apply for MediFund assistance. The quantum of assistance given is tailored to the individual’s circumstances.

2.3 Over the years, MediFund has been enhanced to ensure that needy Singapore Citizens receive appropriate and adequate help. For example, MediFund Silver and MediFund Junior were introduced in 2007 and 2013 to better target assistance for the elderly and children respectively from needy families. MediFund has also been extended to cover more healthcare services1.

2.4 To strengthen our social safety net, the Government injects significant sums into MediFund when the budget permits. As at end FY18, the respective capital sums for MediFund and MediFund Silver stood at $3.13 billion and $1.37 billion.

MediFund Committees

2.5 Every MediFund-approved institution (MFI) has a MediFund Committee to evaluate and approve applications from eligible patients. In FY18, there were 48 MediFund Committees administering MediFund for 148 MFIs, an increase of 9 institutions from FY17. The MFIs include Public Hospitals, National Speciality Centres and Polyclinics (collectively referred as Public Healthcare Institutions, PHIs) and various intermediate and long term care (ILTC) Facilities (including PHI- affiliated Community Hospitals) (Annex A)2.

1 For example, the use of MediFund was extended in 2013 to primary care at the polyclinics, dental services, and antenatal and delivery services. 2 A MediFund Committee may administer MediFund for more than one institution. For instance, in FY18, the Agency for Integrated Care (AIC) MediFund Committee administered MediFund for patients from 55 institutions, including private nursing homes with beds subsidised by MOH and selected non-residential ILTC facilities. 1

2.6 The MediFund Committees approve applications from patients at their respective institutions and decide on the quantum of MediFund assistance to be provided. MediFund Committee members are nominated by the respective institutions and come from diverse backgrounds. They are appointed by the Permanent Secretary (Health).

MediFund Advisory Council

2.7 The MediFund Advisory Council is appointed by the Minister for Health to advise him on all matters relating to the use of the interest income of MediFund. The Council also recommends directives and guidelines on the approval of applications from eligible patients and on the administration of the MediFund Accounts of MediFund Committees. The ninth Council was appointed in April 2017 for a 3-year term till 31 March 2020 (see Annex B for the composition of the Council).

3. FINANCIAL STATUS OF MEDICAL ENDOWMENT FUND

3.1 Exhibit 1 provides the financial status of the Medical Endowment Fund in FY17 and FY18.

Exhibit 1: Financial status of Medical Endowment Fund1

FY17 ($ million) FY18 ($ million) MediFund MediFund Total MediFund MediFund Total Silver Silver Balance at 1 Apr of FY 2,896.5 1,227.5 4,124.0 3,269.6 1,379.7 4,649.3 Capital Injection 350.0 150.0 500.0 0.0 0.0 0.0

Total Income in the FY 134.2 49.1 183.3 130.8 55.2 186.0 Total Expenditure in the (111.1) (46.9) (158.0)3 (134.1) (48.7) (182.9)3 FY Balance at end of FY 3,269.6 1,379.7 4,649.3 3,266.3 1,386.1 4,652.4 Comprising: Capital Sum 3,130.0 1,370.0 4,500.0 3,130.0 1,370.0 4,500.0 Protected Reserves2 113.1 6.2 119.3 113.1 6.2 119.3 Accumulated Income2 26.5 3.5 30.0 23.1 9.9 33.1 Notes: 1. The figures in this and subsequent tables may not add up due to rounding. 2. The protected reserves comprise accumulated unutilised interest monies that were locked-up at the change-over of Government in December 2001, May 2006, May 2011 and 30 Sep 2015. 3. Total expenditure includes $138,501 payment for auditor’s fees and printing of the annual report in FY18 ($135,826 for FY17).

4. MEDIFUND AND MEDIFUND SILVER GRANTS DISBURSED

4.1. The Ministry of Health (MOH) provides the MFIs with grants from income generated from MediFund each year. The amount provided takes into account various factors such as the MFI’s projected needs for the year and savings from the previous year. The MediFund Committees of the MFIs then approve payments of MediFund and MediFund Silver assistance for patients’ bills from their Institution’s MediFund Account based on the grant and savings.

4.2. In FY18, MOH distributed $182.7 million in MediFund and MediFund Silver grants to the institutions (see Exhibit 2). The grants to the MFIs are shown in Chart 1a and Chart 1b respectively.

Exhibit 2: MediFund and MediFund Silver grants to MFIs

MFIs FY17 ($ million) FY18 ($ million) % Change PHIs 125.1 143.6 14.8% ILTCs 32.7 39.2 19.8% Total 157.8 182.7 15.8% Notes: 1. Figures may not tally due to rounding.

5. MEDIFUND AND MEDIFUND SILVER USAGE

Number of Admissions/Attendances/Bed Months Approved for MediFund Assistance

5.1 In FY18, 99.9% of the MediFund applications received were approved. 1,239,578 admissions, attendances and bed months were approved for MediFund and MediFund Silver assistance, an increase of 5.1% from FY17 (see Exhibit 3). The breakdown of MediFund workload by PHIs and ILTC facilities is shown in Charts 4a to 4d. Approved applications for MediFund assistance at ILTCs grew by 16.1%, due to new MediFund-approved ILTC facilities, ramping up of existing facilities to cater to rising healthcare needs, and higher patient volume.

Exhibit 3: Number of Admissions/Attendances/Bed Months approved for MediFund and MediFund Silver Assistance

FY17 FY18 MediFund % Total MediFund Total Silver Change PHIs 1,042,929 792,635 288,570 1,081,205 + 3.7% ILTCs 136,596 74,005 84,368 158,373 + 16.1% Overall 1,179,525 866,640 372,938 1,239,578 + 5.1% Notes: 1. Admissions/attendances/bed months are not equivalent to unique patients. A patient may be assisted for more than one hospitalisation admission or a stretch of outpatient attendances. 2. In the ILTC sector, visits to Non-Residential Services (e.g. Dementia Day Care) are counted as attendances, a continuous period of stay with an Intermediate Term Residential Service (e.g. Community Hospital) is counted as one admission, and for a Long Term Residential Service (e.g. Nursing Home), and each 30-day period is counted as one bed month. 3. Figures may not add up due to rounding.

Utilisation of Allocation

5.2 A total assistance of $156.5 million was given by MediFund Committees to patients in FY18. In aggregate, MediFund Committees utilised about 85.6% of the amount of MediFund allocated in FY18 (see Exhibit 4).

Exhibit 4: Utilisation of MediFund and MediFund Silver by MFIs

FY17 FY18 Quantum of Quantum of Assistance to Utilisation of Assistance to Utilisation of

Patients Allocation Patients Allocation ($ million) ($ million) MediFund 104.5 94.2% 107.7 80.4% MediFund 45.3 96.5% 48.8 100.2% Silver Overall 149.8 94.9% 156.5 85.6% Notes: 1. Utilisation can exceed yearly allocation when MFIs carry over surpluses from past years’ MediFund allocation. 2. Figures may not add up due to rounding. 3. Utilisation of more than 100% indicates that MediFund committees have tapped on past years’ savings.

Assistance disbursed to Patients

5.3 The amount of MediFund assistance disbursed for care in PHIs totalled to $124.2 million in FY18, while that in ILTC was $32.3 million (see Exhibit 5). Assistance for patients in the ILTC facilities increased by 8.2% compared to FY17, due to higher capacity and number of approved applications.

Exhibit 5: MediFund and MediFund Silver Assistance disbursed to Patients

FY17 ($) FY18 ($) % Change To all patients PHIs 119,924,869 124,220,634 + 3.6% ILTCs 29,844,097 32,299,733 + 8.2% Overall 149,768,966 156,520,367 + 4.5% To patients aged 65 and above PHIs 27,202,559 30,286,326 + 11.3% ILTCs 19,600,256 21,609,356 + 10.6% Overall 46,802,816 51,895,682 + 11.0% To patients aged 18 and below PHIs 11,844,512 11,561,253 - 2.4% ILTCs 29,784 37,868 + 27.1% Overall 11,874,296 11,599,121 - 2.3% Note: 1. Assistance given to patients aged 65 and above includes both MediFund and MediFund Silver assistance. 2. Figures may not add up due to rounding.

Average Assistance per Admission/Attendance

5.4 Similar to previous years, bills for outpatient treatment formed the majority of applications approved for MediFund and MediFund Silver assistance among the PHIs. In FY18, outpatient applications made up 96.7% of the approved MediFund applications in PHIs. 73.5% of the total MediFund and MediFund Silver assistance disbursed in PHIs were for outpatient treatments.

5.5 The quantum of MediFund and MediFund Silver assistance received by patients varied depending on their actual bills incurred in the various settings (see Exhibit 6). For inpatient admissions, the average assistance per admission was $917. For outpatient attendances, the average assistance per attendance was $87.

Exhibit 6: Average FY18 Assistance According to where Patients received Treatment in PHIs

Assistance Average assistance Number disbursed ($ disbursed ($) mil) Class B2 4,148 3.68 887 Class C 26,994 26.76 991 Inpatient admissions Day Surgery 4,737 2.45 518 Overall 35,879 32.89 917 Outpatient attendances 1,045,326 91.33 87 Note: Figures may not tally due to rounding.

5.6 MediFund and MediFund Silver paid fully for the outstanding subsidised bills of 90.9% of the MediFund-assisted workload in FY18, similar to the percentage in FY17 (see Exhibit 7).

Exhibit 7: Percentage of MediFund-assisted Admissions/Attendances/Bed Months which received Full Assistance from MediFund and MediFund Silver in FY18

% of MediFund-assisted MFIs Admissions/Attendances/Bed Months with Full Assistance Inpatient 88.0% PHIs Outpatient 92.9% Overall 92.8% Non-residential 74.7% (attendances) Intermediate term ILTC 88.0% residential (admissions) Long term residential (bed 86.0% months) Overall 90.9% Notes: 1. Full assistance means that MediFund and MediFund Silver paid for 100% of the outstanding subsidised bills which the patient could not afford after drawing on all other means of payment. 2. Besides MediFund, patients may also receive charity assistance.

6. AUDITOR’S REPORTS

6.1. In accordance with Section 13 of the Act, every MediFund Committee will submit the annual financial statements of its Institution’s MediFund Account to the auditor appointed by MOH.

6.2. Kong Lim & Partners LLP was appointed the auditor for the FY18 accounts. The audited financial statements of the main MediFund account administered by MOH and the various Institutions’ MediFund Accounts are at Annex C.

7. CONCLUSION

7.1. MOH will continue to work closely with MediFund Committees to manage the MediFund budget, to ensure that sufficient funds are available to assist needy Singapore Citizens with their medical bills.

Chart 1a Distribution of MediFund Grant to MediFund Committees of Public Hospitals and Institutions in FY18

MediFund Allocation ($) 0 20,000,000

Singapore General Hospital $29,313,300

Tan Tock Seng Hospital $24,458,100

National University Hospital $23,335,800

Institute of Mental Health $16,298,600 KK Women's and Children's $13,139,700 Hospital Changi General Hospital $7,661,600

Khoo Teck Puat Hospital $6,362,200 Ng Teng Fong General $4,856,600 MediFund Hospital MediFund Silver Singhealth Polyclinics $3,601,800

National Heart Centre $3,498,500 National Healthcare Group $2,968,800 Polyclinics National Cancer Centre $2,026,800

National Dental Centre $1,922,600 National Neuroscience $1,629,000 Institute Singapore National Eye $1,288,500 Centre Sengkang General Hospital $786,600

National Skin Centre $416,600

Chart 1b Distribution of MediFund Grant to MediFund Committees of ILTC Facilities in FY18

MediFund Allocation ($) $0 $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $6,000,000 $7,000,000 Ren Ci Community Hospital $6,750,900 Agency for Integrated Care $4,090,500 Singhealth Community Hospitals $3,512,100 Apex Harmony Lodge $2,322,500 Singapore Anglican Community Services $1,884,400 Ju Eng Home for Senior Citizens $1,717,900 The Salvation Army, Peacehaven Nursing Home $1,674,800 All Saints Home $1,599,000 Sunshine Welfare Action Welfare Mission Home $1,397,300 Vanguard Healthcare $1,307,000 St Andrew's Community Hospital $1,302,100 Jamiyah Nursing Home $1,242,400 NTUC Health Nursing Home $1,201,600 Catholic Welfare Services Nursing Home $1,118,000 Lions Home for the Elders $958,000 Bright Hill Evergreen Home $907,000 MediFund Ang Mo Kio - Thye Hua Kwan Hospital $802,400 Grace Lodge $724,300 MediFund Silver Methodist Welfare Services $672,200 Ling Kwang Home for Senior Citizens $660,900 Singapore Christian Home for the Aged $512,500 Society for the Aged Sick $489,400 XiSer CareServe $340,700 Man Fut Tong Nursing Home $324,300 Kwong Wai Shiu Hospital and Nursing Home $294,900 Sree Narayana Mission (Singapore) $279,600 Dover Park Hospice $247,900 Yishun Community Hospital $233,100 Home Nursing Foundation $223,900 Jurong Community Hospital $220,400 St Luke's Hospital for the Elderly $79,500 AWWA $62,100 St Luke's Eldercare $29,100 Assisi Hospice $-

Chart 2a Total Number of Admissions/Attendances Approved for MediFund and MediFund Silver Assistance by Public Hospitals and Institutions in FY17 and FY18

1,081,205 1,045,326 1,042,927 1,007,323

FY17 FY18

35,606 35,879

Inpatient Outpatient Total

Chart 2b Total Number of Admissions/Attendances/Bed Months Approved for MediFund and MediFund Silver Assistance by ILTC Facilities in FY17 and FY18

158,373

136,597

112,767 95,726

FY17 FY18 44,841 40,083

787 765

Non-Residential Intermediate Term Long Term Total Services Residential Residential Services Services

Chart 3a Total Amount of MediFund and MediFund Silver Assistance Approved by Medifund Committees of Public Hospitals and Institutions in FY17 and FY18

$124,220,634 $119,924,869

$91,332,612 $85,990,902

FY17 FY18

$33,933,967 $32,888,022

Inpatient Outpatient Total

Chart 3b Total Amount of MediFund and MediFund Silver Assistance Approved by ILTC Facilities in FY17 and FY18

$29,844,097 $32,299,733 $29,644,507 $27,168,799

FY17 FY18

$1,444,821 $1,759,686 $1,230,477 $895,540

Non-Residential Intermediate Term Long Term Total Services Residential Residential Services Services

Chart 4a Breakdown of Number of Admissions/Attendances Approved for MediFund and MediFund Silver Assistance by MediFund Committees of Public Hospitals and Institutions in FY18

Number of Approved MediFund applications 0 50,000 100,000 150,000 200,000

Singapore General Hospital 160,993

National University Hospital 159,951

Tan Tock Seng Hospital 137,481

Singhealth Polyclinics 86,667

Institute of Mental Health 85,941

National Healthcare Group 80,762 Polyclinics

Ng Teng Fong General 79,606 Hospital

Changi General Hospital 70,918 MediFund MediFund Silver KK Women's and Children's 70,521 Hospital

Khoo Teck Puat Hospital 47,196

National Heart Centre 26,774

National Cancer Centre 24,845

Singapore National Eye 19,802 Centre

National Dental Centre 12,505

National Skin Centre 6,861

National Neuroscience 5,337 Institute

Sengkang General Hospital 5,045

Chart 4b Breakdown of Number of Admissions/Attendances/Bed Months Approved for MediFund and MediFund Silver Assistance by ILTC Facilities in FY18: Non-Residential Services

Number of Approved MediFund applications

0 5,000 10,000 15,000 20,000 25,000

Singapore Anglican Community Services 23,269 Sunshine Welfare Action Welfare Mission Home 21,299 Peacehaven Nursing Home for the Aged 19,141 Home Nursing Foundation 16,658 AWWA 11,976 Agency for Integrated Care 5,429 Jamiyah Nursing Home 3,293 St Andrew's Community Hospital 2,931 MediFund Ling Kwang Home for Senior Citizens 2,847 Ren Ci Community Hospital 2,523 Sree Narayana Mission (Singapore) 1,159 MediFund Silver Methodist Welfare Services 945 Yishun Community Hospital 395 Assisi Hospice 273 Kwong Wai Shiu Hospital and Nursing Home 244 Jurong Community Hospital 163 Vanguard Healthcare 105 Dover Park Hospice 58 SingHealth Community Hospitals 32 St. Luke's Eldercare 22 Ang Mo Kio - Thye Hua Kwan Hospital 5

Chart 4c Breakdown of Number of Admissions/Attendances/Bed Months Approved for MediFund and MediFund Silver Assistance by ILTC Facilities in FY18: Intermediate Term Residential Services

Number of Approved MediFund Applications 0 200 400 600

Yishun Community Hospital 576 Ang Mo Kio - Thye Hua Kwan Hospital 103 SingHealth Community Hospitals 101 St Andrew's Community Hospital 97 Jurong Community Hospital 95

St Luke's Hospital for the Elderly 61 MediFund Ren Ci Community Hospital 55 Dover Park Hospice 46 MediFund Silver Assisi Hospice 21

Chart 4d Breakdown of Number of Admissions/Attendances/Bed Months Approved for MediFund and MediFund Silver Assistance by ILTC Facilities in FY18: Long Term Residential Services

Number of Approved MediFund Applications 0 1,000 2,000 3,000 4,000 5,000

Agency for Integrated Care 5,450 St Andrew's Community Hospital 4,605 NTUC Health Nursing Home 3,846 Ju Eng Home for Senior Citizens 2,550 Peacehaven Nursing Home for the Aged 2,390 Bright Hill Evergreen Home 2,123 Vanguard Healthcare 2,009 Catholic Welfare Services Nursing Home 1,959 Grace Lodge 1,888 Society for the Aged Sick 1,833 Ling Kwang Home for Senior Citizens 1,711 Singapore Anglican Community Services 1,666 Lions Home for the Elders 1,574 Ang Mo Kio - Thye Hua Kwan Hospital 1,567 Singapore Christian Home for the Aged 1,347 Kwong Wai Shiu Hospital and Nursing Home 1,339 MediFund Sunshine Welfare Action Welfare Mission Home 1,232 MediFund Silver Sree Narayana Mission (Singapore) 1,166 Man Fut Tong Nursing Home 1,163 XiSer CareServe 1,094 Jamiyah Nursing Home 1,031 SingHealth Community Hospitals 549 Methodist Welfare Services 511 Ren Ci Community Hospital 137 St Luke's Hospital for the Elderly 88 All Saints Home 12 Apex Harmony Lodge 1

Note: 1. The Agency for Integrated Care MediFund Committee administers MediFund for 55 different institutions, as shown in Annex A. 2. Figures may not tally due to rounding.

Chart 5a Breakdown of Amount of MediFund and MediFund Silver Assistance Approved by MediFund Committees of Public Hospitals and Institutions in FY18

Amount of MediFund Help ($) $0 $10,000,000 $20,000,000 $30,000,000

Singapore General Hospital $24,328,655

Tan Tock Seng Hospital $22,624,397

National University Hospital $18,612,147

Institute of Mental Health $12,970,748

KK Women's and Children's Hospital $10,810,449

Changi General Hospital $8,119,522

Khoo Teck Puat Hospital $5,703,433 MediFund Ng Teng Fong General Hospital $4,687,539 MediFund Silver National Heart Centre $4,359,905

Singhealth Polyclinics $2,678,878

National Healthcare Group Polyclinics $2,139,542

National Cancer Centre $1,930,944

Singapore National Eye Centre $1,341,223

National Neuroscience Institute $1,251,567

National Dental Centre $1,124,725

Sengkang General Hospital $991,909

National Skin Centre $545,051

Chart 5b Breakdown of Amount of MediFund and MediFund Silver Assistance Approved by MediFund Committees of ILTC Facilities in FY18 Amount of MediFund help ($) 0 1,000,0002,000,0003,000,0004,000,0005,000,000 Ren Ci Community Hospital 3,914,250 Agency for Integrated Care 3,119,598 St Andrew's Community Hospital 2,435,901 Singhealth Community Hospitals 1,901,485 Ju Eng Home for Senior Citizens 1,438,691 NTUC Health Nursing Home 1,425,417 All Saints Home 1,328,387 Singapore Anglican Community Services 1,265,991 The Salvation Army, Peacehaven Nursing Home 1,264,541 Catholic Welfare Services Nursing Home 1,222,511 Bright Hill Evergreen Home 1,056,331 Vanguard Healthcare 987,713 Ang Mo Kio - Thye Hua Kwan Hospital 986,158 Ling Kwang Home for Senior Citizens 843,989 Jamiyah Nursing Home 832,654 Grace Lodge 809,715 Lions Home for the Elders 807,164 MediFund Sunshine Welfare Action Welfare Mission Home 803,994 MediFund Silver Singapore Christian Home for the Aged 768,095 Society for the Aged Sick 759,012 Sree Narayana Mission (Singapore) 588,130 Kwong Wai Shiu Hospital and Nursing Home 585,148 Methodist Welfare Services 559,716 Apex Harmony Lodge 538,129 XiSer CareServe 510,967 Man Fut Tong Nursing Home 431,494 Home Nursing Foundation 345,287 St Luke's Hospital for the Elderly 178,954 Yishun Community Hospital 159,464 Jurong Community Hospital 140,248 Dover Park Hospice 124,687 AWWA 114,407 Assisi Hospice 47,183 St Luke's Eldercare 4,323

ANNEX A

LIST OF MEDIFUND COMMITTEES AND MEDIFUND APPROVED INSTITUTIONS IN FY18

Name of MediFund Approved Institutions Committee 1. Agency for (1) Adventist Nursing and Rehabilitation Integrated Care Centre MediFund (2) Agency for Integrated Care Pte Ltd Committee (3) Alzheimer’s Disease Association —New Horizon Centre (Tampines) (4) Apex Day Rehabilitation Centre for Elderly (5) Econ Medicare Centre (Braddell Road) (6) Econ Medicare Centre (Chai Chee) (7) Econ Medicare Centre (Choa Chu Kang) (8) Econ Medicare Centre (Recreation Road) (9) Econ Medicare Centre (Upper East Coast) (10) Econ Medicare Centre — Yio Chu Kang (11) Econ Nursing Home (Buangkok) (12) Green Avenue Home for the Elderly (13) Lee Ah Mooi Old Age Home (14) Marine Parade— Aspiration Elderly Lodge (15) Orange Valley Nursing Home (16) Orange Valley Nursing Home (Clementi) (17) Orange Valley Nursing Home (Marsiling) (18) Orange Valley Nursing Home (Simei) (19) Orange Valley Nursing Home (Sims Avenue) (20) Our Lady of Lourdes Nursing Home Pte Ltd (21) Pacific Healthcare Nursing Home (Bukit Merah) (22) Pacific Healthcare Nursing Home II (23) SASCO Integrated Eldercare Centre (24) Silver Circle (Serangoon Central) (25) Silver Circle (Toa Payoh) (26) Society for the Physically Disabled – SPD Ability Centre (27) Society for the Physically Disabled – Community Rehabilitation Centre (28) SPD@Toa Payoh (29) St Hilda’s Community Services Centre (Ageing in Place)

Name of MediFund Approved Institutions Committee (30) Sunlove Abode for Intellectually Infirmed Ltd (Sunlove Rehab Centre @ Ang Mo Kio) (31) Sunlove Home (32) Sunlove Home@IMH (33) Sunlove Home@SILRA (34) SunnyVille Home (35) Tembusu Eldercare Centre (SPICE) (36) Tembusu Rehab and Day Care Centre (37) The Lentor Residence (38) Thian Leng Old Folks Home (39) TOUCH Community Services Ltd—TOUCH Home Care (Jurong) (40) TOUCH Community Services Ltd — TOUCH Home Care (Toa Payoh) (41) TP Healthcare Ltd (42) Tsao Foundation (43) United Medicare Centre (44) United Medicare (Elizabeth Drive) Pte Ltd (45) Yong-En Care Centre (46) United Medicare Centre (Queensway) (47) SATA CommHealth Home Care Services (48) Lee Ah Mooi Old Age Home (Silat) (49) SASCO@Jurong West (50) SASCO Day Activity Centre (Telok Blangah Rise) (51) SASCO Hong Kah North Day Care Centre (52) ComSA Whampoa Centre (53) Orange Valley Care Centre (Balestier) (54) Active Global Ghim Moh Active Ageing Hub (55) Active Global Telok Blangah Active Ageing Hub 2. All Saints Home (1) All Saints Home MediFund (2) All Saints Home (Hougang) Committee (3) All Saints Home (Yishun) (4) All Saints Home (Jurong East) 3. Ang Mo Kio — Thye (1) Ang Mo Kio — Thye Hua Kwan Hospital Hua Kwan Hospital (2) Thye Hua Kwan Moral Charities Ltd MediFund (3) THK Nursing Home @ Hougang Committee

Name of MediFund Approved Institutions Committee (4) THK Senior Care Centre @ Kaki Bukit (Bedok North) 4. Apex Harmony Apex Harmony Lodge Lodge MediFund Committee 5. Assisi Hospice Assisi Hospice MediFund Committee 6. AWWA MediFund (1) AWWA Rehab & Day Care Centre Committee (formerly known as AWWA Readycare Centre) (2) AWWA Dementia Day Care Centre (3) AWWA Dementia Day Care Centre (Yishun) 7. Methodist Welfare (1) MWS Bethany Nursing Home – Choa Chu Services (MWS) Kang MediFund (2) MWS Home Care Committee (3) MWS Nursing Home (Yew Tee) (Previously “Bethany Methodist Nursing Home MediFund Committee”) 8. Bright Hill Bright Hill Evergreen Home Evergreen Home MediFund Committee 9. SingHealth (1) Bright Vision Hospital Community (2) Sengkang Community Hospital Hospitals MediFund Committee (Previously “Bright Vision Hospital MediFund Committee”) 10. Catholic Welfare (1) St Joseph’s Home Services Nursing (2) St Theresa’s Home Home MediFund (3) Villa Francis Home for the Aged Committee 11. Changi General Changi General Hospital Hospital MediFund Committee

Name of MediFund Approved Institutions Committee 12. Dover Park Hospice (1) Dover Park Hospice MediFund (2) Dover Park Day Care Committee 13. Grace Lodge Grace Lodge MediFund Committee 14. Home Nursing Home Nursing Foundation Foundation MediFund Committee 15. Jamiyah Nursing Jamiyah Nursing Home (Darul Syifaa) )(Previously Home MediFund “Jamiyah Nursing Home”) Committee 16. Ju Eng Home for Ju Eng Home for Senior Citizens Senior Citizens MediFund Committee 17. Ng Teng Fong (1) Jurong Community Hospital General Hospital (2) Jurong Medical Centre MediFund (3) Ng Teng Fong General Hospital Committee (Previously “Jurong (4) National University Polyclinics Health Services MediFund Committee”) 18. Khoo Teck Puat (1) Khoo Teck Puat Hospital Hospital MediFund (2) Yishun Community Hospital Committee (3) Admiralty Medical Centre 19. KK Women’s and KK Women’s and Children's Hospital Children’s Hospital MediFund Committee 20. Kwong Wai Shiu (1) Kwong Wai Shiu Hospital & Nursing Home Hospital & Nursing (2) Kwong Wai Shiu Care @McNair Home MediFund (3) Kwong Wai Shiu Care @Jalan Besar Committee

21. Ling Kwang Home Ling Kwang Home for Senior Citizens for Senior Citizens MediFund Committee

Name of MediFund Approved Institutions Committee 22. Lions Home for the (1) Lions Home for the Elders Elders MediFund (2) Lions Home for the Elders (Bishan) Committee 23. Man Fut Tong (1) Man Fut Tong Nursing Home Nursing Home (2) Man Fut Tong Ho Yuen Hoe Senior Care MediFund Centre Committee 24. National Cancer (1) National Cancer Centre Centre MediFund (2) National Dental Centre Committee 25. National Healthcare National Healthcare Group Polyclinics Group Polyclinics MediFund Committee 26. National Heart National Heart Centre Centre MediFund Committee 27. National National Neuroscience Institute Neuroscience Institute MediFund Committee 28. National Skin National Skin Centre Centre MediFund Committee 29. National University (1) National University Hospital Hospital MediFund (2) Alexandra Hospital (from 1 Jun 2018) Committee 30. The Salvation Army, (1) The Salvation Army, Peacehaven Nursing Peacehaven Home Nursing Home (2) The Salvation Army, Peacehaven Bedok MediFund Day Centre Committee 31. Ren Ci Community (1) Ren Ci Hospital Hospital MediFund (2) Ren Ci Community Hospital Committee (3) Ren Ci @ Bukit Batok Street 52 (Nursing Home) (4) Ren Ci @ Ang Mo Kio (Nursing Home) 32. Sengkang General (1) Alexandra Hospital (from 1 Jul 2015 to Hospital MediFund before 1 Jun 2018) Committee (2) Sengkang General Hospital

Name of MediFund Approved Institutions Committee 33. Singapore Christian Singapore Christian Home Home MediFund Committee 34. Singapore General Singapore General Hospital Hospital MediFund Committee 35. Singapore National Singapore National Eye Centre Eye Centre MediFund Committee 36. SingHealth SingHealth Polyclinics Polyclinics MediFund Committee 37. Society for the Aged Society for the Aged Sick Sick MediFund Committee 38. Sree Narayana (1) Sree Narayana Mission Nursing Home Mission (Singapore) (Previously “Sree Narayana Mission Home MediFund for the Aged Sick”) Committee (2) Sree Narayana Mission Senior Care (Previously “Sree Centre (Woodlands) (Previously “Sree Narayana Mission Narayana Mission, Multi-Service Centre @ Home for the Aged Woodlands”) Sick MediFund Committee”) 39. St. Andrew’s (1) St. Andrew’s Community Hospital Community Hospital (2) St. Andrew’s Nursing Home MediFund (3) St. Andrew’s Senior Care Joy Connect Committee (4) St. Andrew’s Nursing Home (Henderson) (5) St. Andrew’s Nursing Home (Queenstown) (6) St. Andrew’s Senior Care (Tampines) 40. St Luke’s Hospital St. Luke’s Hospital for the Elderly for the Elderly MediFund Committee 41. Sunshine Welfare Sunshine Welfare Action Mission (SWAMI) Home Action Mission (SWAMI) Home MediFund Committee

Name of MediFund Approved Institutions Committee 42. XiSer CareServe XiSer CareServe MediFund (Previously “Tai Pei Social Service (TPSS)”) Committee (Previously “Tai Pei Social Service (TPSS) MediFund Committee”) 43. Tan Tock Seng Tan Tock Seng Hospital Hospital MediFund Committee 44. Woodbridge Woodbridge Hospital/Institute of Mental Health Hospital/Institute of Mental Health MediFund Committee 45. NTUC Health (1) NTUC Health Nursing Home (Jurong West) Nursing Home (2) NTUC Health Nursing Home (Chai Chee) MediFund (3) NTUC Health Nursing Home (Geylang Committee East) 46. Vanguard (1) Pearl’s Hill Care Home Healthcare (2) Woodlands Care Home MediFund (3) Tampines Care Home Committee 47. Singapore Anglican (1) Anglican Care Centre (Hougang) Community (2) Anglican Care Centre (Simei) Services MediFund (3) Anglican Care Centre (Bukit Batok) Committee (4) Anglican Care Centre (Pasir Ris) (5) Anglican Care Centre (Yishun) (6) Anglican Care Centre (Farrer Park) (7) Anglican Senior Centre (Hillview) (8) St. Andrew’s Nursing Home (Taman Jurong)

(The above Anglican Care Centres except Anglican Care Centre (Farrer Park), which is set up in FY17, were previously known as Singapore Anglican Community Services, and managed under St. Andrew’s Community Hospital MediFund Committee) 48. St. Luke’s Eldercare St. Luke’s Eldercare Ltd MediFund Committee

ANNEX B

NINTH MEDIFUND ADVISORY COUNCIL

Chairman

Mr Benedict Cheong CEO Temasek Foundation International

Members

Mrs Mui-Kok Kah Wei Retired (Former Senior Director of NTUC Fairprice)

Mr Christopher Woo Yin Loong Director Quahe Woo & Palmer LLC

Mr Shaik Aziz Shaik Mohideen Company Director Management Synergy Pte Ltd

Ms Lim Hsiu Mei Director M & M Link

Mr Sim Gim Guan CEO National Council of Social Service

Mr T K Udairam COO Sheares Healthcare Management Pte Ltd

Ms Wee Wan Joo Retired (Former GM of St Luke’s Eldercare and Director of Corporate Development of St Luke’s Hospital) Mr Kenneth Au Yong Partner Ramdas & Wong

Mr Mohd Ismail Bin Hussein Partner RI Education LLP

Ms Khoo Kim Geok Jacqueline Director JC Trust Limited

Mr Louis Lim Partner William Poh & Louis Lim

ANNEX C

AUDITOR’S REPORT ON MEDIFUND ACCOUNTS