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Home My WebLink AboutCOM 0122.030 2000-2002 Stephen K Yamashtro Dtxte Kaetsu tfat•or Dvector Frank Manalili Depun COUNTY Of Ii~llll~kI'I DEPARTMENT OF FINANCE 25 4upunt Street Room I I8 Hdo, Haweu 96720-4252 (808)961-8234 Fex(808)961-8248 HAWAII COUNTY NONPROFIT GRANTS (FY 2001-02) HUMAN SERVICES NONPROFIT GRANTS REVIEW COMMITTEE FISCAL YEAR ENDING June 30, 2002 DATE OF APPLICATION January I 1 , 2 0 0 I GRANT APPLICATION FOR West Hawaii Counseling and Supportive Living Protect IPrognm 77ae) Legal Name ofOrgantzation KaP~lani Medical Center for Wtmeri aM Children (ltapwlani Child Protection Cents Mailing Address 55 Merchant St., 22rd Floor, Honolulu, Ilaiaii 96813 Facili[yiSiteAddress 74-5605 Alapa St., B 5 b 6 Mez., Kailua-Kona, HI 96740 DirectoriSite Manager Mary Jo Westmoreland Organization President Frances A. Hallonquist Contact Person (Grant Writer) Mary Jo destmoreland Amount of Request for County Funds $ 20 , 000.00 Total Annual Budget of Organization $ 615,610.00 Has the applicant applied for any other funds from the County of Hawaii this fiscal year Yes SourceiDepartment Numan Services for Sex Abuse Resources ? No and Advocacy Services Agency/Program(s) 0 Social Services ? Youth Programs ? Elderly Programs Check Categories ? Culture and Arts ~ Education ? Other Briefly, define the program for which funding is being requested: Title IVB, West Hawaii Counseling and Supportive Living Protect - CA/N Diversion Services. Program provides cr~n• _-e, suooortive Living and suvnortive services for families where there rs a risk of child abuse or neglectL.,,,,,,,, N,~ (2 2.30 File 2Io. L3 V D Ref. To: ~Mh~ l+s ~v ~ F B6 2 0 2001 1. OtiALIFYING STANDARDS FOR APPLICANTS Check all that accurately describe your organization: [VOTE 4n applicant must meet all of the following standards] Be chattered or otherwise authorized to do business m the State for cfiaritable purposes and exempted from the federal income tax by the Internal Revenue Service 0 Have a governing board whose members serve without compensation and have no conFlict of interest between their regular occupations and the services provided © Have bylaws or policies which describe the manner in which business is conducted, including management audit fiscal policies and procedures policies on nepotism, and policies on management of potential conflict of interest 0 Have at least one yeaz's experience with the service or activity for which the appropriation is sought or can otherwise demonstrate to the satisfaction of the County sufficient expertise to successfully cam out the service or acnnry Be licensed and accredited in accordance with applicable requirements of Federal, State and County laws II. GRANT CONDITIONS The applicant agrees to comply with the following terms and conditions prior to receiving a grant award A Comply with applicable Federal and State laws prohibiting discrimination against any person on the basis of race. color, national origin, religion, creed, sex, age, or handicap B Agree not to use any public funds for purposes of entertainment or perquisites C Comply with such other requirements as the Director of Finance may prescribe to ensure adherence by the nonprofit organization with Federal, State, and County laws, and established standards for fiscal and program management D 411ow the Director of Finance, the committees of the council and their staffs, and the Legislative Auditor access to records, reports, files, and other related documents in order that the program, management and fiscal practices of the nonprofit organization may be monitored and evaluated to assure the proper and effective expenditure of public funds III. RECORDS AND REPORTS A The applicant shall follow generally accepted accounting procedures and practices and shall maintain books records, documents and other evidence which sufficiently and properly account for the expenditure of County funds The books. records and documents shall be subJect at all reasonable times to inspection reviews or audits by the County expending agency the Director of Finance, and the Legislative Auditor or by their representatives B The County expending agency, Director of Finance, or County Council may request periodic written reports on [he use of County funds C The nonprofit organization shall submu a final written report to the Legislative Auditor within sixty (601 davs after June 30 of the fiscal year The report shall include an explanation of the public benefits derived from the awarding of the grant, a listing of other funding sources and amounts obtained during the .:rani period and a complete accounting of all expenditures supported by Counrv of Hawaii grant funds ;per Chapter? Article ?5 Section 2-142(d) Hawaii Counn• Code amended August 1999} [V. QUARTERLY ALLOCATION Under no circumstances shall grant funds be disbursed in a lump sum payment Grant funds will be disbursed to Grantees only through a quarterly allocation process The disbursement of grant funds can be formulated on an equal quarterly apportionment basis V, GRIEVANCE PROCEDURE The applicant will adopt and maintain a grievance procedure to assure proper accounting for any concerns and complaints about its programs or services that may arise from its members, employees, clients or from other members of the public VI. DISCLOSURE OF INFORMATION All information, data, or any other material provided to the County 6y vtmie of this application shall be subiect to the Untfoim Information Practices Act (UIPA), ch 92F, Hawatt Revised Statutes All such material is deemed government record and shall be open to the publtc and may be provided to other public and/or private funding sources VII. CONTINUED ELIGIBILITY Any applicant or rcetptent who withholds or omits any material facts or deliberately misrepresents such facts to the County of Hawaii shall. I) [mmedtately be disqualified from consiueration for Nonprofit Giant funding, OR 2) be in violation of the terms of the Giant Agreement of County funds in which case a grant agreement can be terminated by the County and the recipient or provider may be liable to reimburse all or a portion of any funds received therein. VIII. ACIQYOWLEDGMENT Itaoi'olani Medical Center for Waaert and Children (Legal Name ut Urganiutionl :.dpi'olani Child Protection Center hereby agrees to administer the West I~la+aii Counseling b Supportive Living Project (Program Title) in accordance with the regulations, policies and procedures prescribed by the Hawaii County Finance - Department. Distribution of grant funds is limited to grantees, which are in compliance with County regulaziom, policies and procedures. The County reserves the tight to withhold grant distributions at anv time the grange is not in compiirrice It is the policy of the County of Hawatt and for those who do business with the County to provide equal employment opportunities to all persons regardless of race, physical disabilities, color, religion, sex, age, or national origin as mandated by the Federal Civil Rignts Acu, as amended, and any other federal or state laws relating to equal employment opportunities IX. AMENDMENTS TO THE APPLICATION/EVALUATION The applicant assures that it will suomit to the HSNPGRC for prior review and approval, a written request and ~ustificanon for any changes. additions, or deletions to any portion(s) of the grant application or a duly executed Grant Agreement of County Funds. The applicant will cooperate and assts[ in any effon undertaken by the HSNPGRC to evaluate, inspect or otherwise monitor the effectiveness, feasibility, and/or cost efficiency of any and all prnettces. policies and procedures or activities pursuant to this appltcatton or any giant designation or allocation received as a result of this application. 3 X. 4UTHORITY AND CAPACITY OF 4PPLICANT The applicant certifies tha[ it has the authority and capacity to develop and submit this application, and t fully administer the program(s) pursuant to this application UNSIGNED PROPOSALS WILL YOT BE ACCEPTED! gna[ureof Executive Vice Pry ident and CE Date e I ` / Stgna ~ of Executive DirectoriManager Dace 4 HAWAII COUNTY HUMAN SERVICES NON-PROFIT GRANT PROPOSAL 1tAPl'OLANI CH1LD PROTECTION CENTER -HAWAII ISLAND A. Overview 1) Describe the program for which funding is being requested. Funding is being requested to support the West Hawatt Cotmselmg and Supportive Ltvmg Project Thts protect is primarily funded through a Federal Title lV-B Subpart 2 Faintly Preservation and Support Grtint, admittutered by the State Deptvtrnrnt of Human Services The Federal grant rcqutres a 25% funding match. The State Depattairnt of Hitmm Services contributes I S% of the matching funds and the provider f 0% We are requesting twenty thoitsand dollar (520,1100) from Hawaii County as part of our 10% match, to assist with operational support for the p%tect 'Phis protect has been designed to assist individuals and famtltes in providing a safe and nuriurtng home for children A primary focus of this proles is to prowde services for percnu who are addicted to substance and need support and assurance to recover from then addtcttons so that they may appropriately care for then children. This protect offer services to temtlies who are acuvely involved with Child Welfare Servtces because of child abuse and neglect or the threat of harm, and to Camilla who need xrvtces az a diverstan from stave CWS involvement. Servtces are also available to famtiia who have not been reported to DHS-CWS, but where a risk of child abiise and neglet has been identified. 2) What unique or sigoifleant services will be provided? This project is unique in that it offers servtca armed at improving outwmes for long-term substance abuse recovery and safety of children in famtbes at risk of child abux. A flexible array of servtt:es is available to each cliem, with individual smites being accessed based on the specific needs of the indmdiral and family. Sernca inclitde eomprahemive rmtce needs assessment, referral to and linkage with other cotnmunity smtce provtder. Several types of ataasmertb era provided, including mental health assessment, medical needs asxssmrnt, parenting and anger management assestmetit Individual, wuple, faintly and group comseling xrvices arc provided The protect also offer medical care coordination, Gfe skills eduction acrd specialized parenting classes for addicted parents in recovery Anger maitagemrnt camxling and education, subatattc abiise counxling and education, adult and child peer mrntoring, and other wrap around supportrve Servtces ate atom available. Paymem of Therapeutic Living Services for substance abusing prcgnmt women and mother who have entered outpatient substmc abuse treatment is also orovided. A staff team of professionals provtder mmy of the arise[ services to clients, with linkage and referral [Wade w other agencies or private practitioner, as appropriate. ICapi'olmi Ch tId Proiz~,.on Center (KCPC) staff inchida two Smttx Coordinator, two ~Itmal Social Workers, a Cluucal Nure Specialist, two Clinical Care Coordinator, two Administrative Secretaries and the Branch Administrator KCPC has established either Memormditms of Agreement or contracts for payment with a nitmber of agencies and professionals throughout the West I-Ewer[ Area, so that the widest possible choice of serrates u avaLble to cliena. Servtces arc free to chrnb, although at tomes a client maybe asked to share in the cost e! pert of their individualized xrvtce plan 3) What specific outcomes arc to be aehkved? 90% of famiha referred wtli be fully assessed to determhte child safety asks and service needs 90% of famthes that establish a service phin Suitt complete the service plan. 90% of families that complete a assures plan will have established and impkmemed a child safety pim m tax cinsttra. 90% of families that complete a service plan will have lied no new report of child abitx or neglect during p: ~~;t-srn Servtces 90% of families that complete a xrvice plm will have no new reptxt of child abiix or neglect a< 3 month follow-up. 90% of families that complete a xrvice plm will have no new report of child abttx or neglect at 6 matith follow-up 4) How will the proposed program empower parttctpaotalelienb to become xlf-miflcieot and facilitate positive social change? Of most tmportaace to this protect is the willingness and ebihty of climb to voluntarily partictpttte in and complete Servtces. To this end, chrnis are informed at intake that they will be expected to psmctpate in the development of their service plm and writ be asked to develop and tmplemeM a child safety plan Addmonally, citznb arc informed that thry will be dismissed from the prolt:ct tf thry repeatedly fail to keep service appointments, stn mavailable for tracking or roflbe m pttrticiptua m agreed upon seines. Clients are rcqutred to develop m individualized service plm, tdenufytng with project steffspectfic behavioral objectives to be met Clirnb arc then helped to Ieam to take the inmanve in meeting their own ongoing needs. Throughout their time in the protect. clients are assisted in developing a clean and sober lifestyle and Itfe s1uIIS that will serve them once their involvement in the protect has cndzd Delivered service are targeted to achieve the idrnnfied posmve behavioral oblectva that will reduce the risks of child abuse and neglect. Kapi olant Chdd Protection Czmer -West Nawau Page 2 B. Prablem/Need 1) What is the problem/need the proposed program is dutgned to meet? Many children m West Hawau are at nsk of abuse and neglect and the detenoratton of quality of Itfe due to the effects of physical, mental and behavioral health problems which impair pnmazy caregivers' ability to maintain an adequate, safe, secure and nttrtunng faintly home Drug and alcohol abuse, domestic violence and emotional inrtabtltty arc the pnmery nsk factors for child abuse in West Hawau Emotional and psychological problems, low self-esteem, lack ofself-control and anti-social behavior arc contnbuting nsk factors Economic hazdship, poor parrnting and Itfe sktlls and limited social supports compound thue nsks. Families with multiple problems need comprehensive servtces that focus on counseling end educational activities to improve overall functioning, commiinications sktlls, parenting sktlls, anger management sktlls, and life sktlls. Assistance in the development of a positive support system and Itrtkage with community rcsotirces is also needed. Many ctregivers have never had good role models to teach them how care for themselves or theu children. They need mentors to help them learn to establish and maintain a dtvg fredviolence free lifestyle where children are nttrttired and safe The West Hawaii Counseling and Supportive Living Protect is deigned to address the problem of child safety by providing accessible and affordable services targeted to individual faintly nsks and needs The evatlability of a wide array of services from Protect staff, contracted providers and through coordination effotu with other community resources give families the opportunity to team new behaviors that will promote child safety and well being 2) Who are the target population and what arc the specific needs? The pnmery target group for this protect is familia in West Hawaii who arc at ruk of child ebux and neglect because of substance abuse by one or more of the primary caregivers. Most of these families are actively involved with CPS. Most servtces are provided to the caregivers in the family although services am provided to children as well. Caregivers of children n risk, usually the parents, need cottmeling service to address mrntal health issue and improve thetr individual functioning. They need family violence intervrntion xrvtces, especially anger management counselmg and education. They also need life alrilla education and mentonng to prepare them for Irving a clean and sober lifestyle. They need specialized parenting education to help them understand then children's needs and accept parenting responstbditru. These caregivers need to learn how the abtrx of drugs/alcohol harms their children, and how substance abuse harms thetr relaaottship with their chtldrrn. Most of these caregiver need treatrnent for additttons and some need Therapeutic Living Servtcu in a safe restdrntial envirottmrnt to begin their treatment Mort of those caregivers also need long term supportive semen to help them maintain a lifutyle that ensures the safety end well being of their childrrn A second target population is familiu who have barn invuagated by CPS, found to be at nsk, and diverted to the protect for intensive xrvtces but without stave CPS involvement A third target group is famthu who are in crisis and, who have acknowledged a need for assistance and have asked for help on thetr own. Thex familiu often need only short-term counseling, support or linkage with other agencies to resolve the cnsis and reduce the nsk of harm to their rluldren. A foiudi target group is fimtliu who are preparing to or have adopted a child who was abused or neglected by then biological parrnp These chtklrrn and the adoptive parents need transition cowxling as they move through the adoptive prceess and sometimes cnsis intervrntron alter the adoption has been completed 3) What is the geognphial area(s) to be served, facility and hours of opentlon. The geographic area to be served covers the entire Wut Hawaii rcgton, which includes the distncts of North end South Kohala, North and South Kona, and Kau to Foliate. Staff provided, or conttacted, semcu arc avatleble throughout the rcgton The Kapr'olani Child Protection Center office in Wut Hawaii is currently located at 743605 Alape Street B-3816 Mez, Karlua-Kona, HI 96740 KCPC-West Hawaii is cutxntiy in the process of securing a new office location in Keilua-Kona, The planned office will include, >u a minimum, s conference room to be used for tax conf'erencu, faintly conferences, group courixling and parenting ciassu In addition, two pnvate counxling rooms arc planned, to be treed for asxssmrnts as well as for indindual and couple counselmg. Addiaonel private rooms will be included rf the budget allows. Work cubicles equipped with computers will be provided for all staff, with a pnvate office space for the Burtch Admintstmtor. The office will include sufficient area for file storage, reception and krtchrn factlttiu There will be bathrooms on site. Kapi'olmi Child Protection Center -West Hawaui Page 3 Regular office hours arc Monday through Fnday from 8 00 a m to 4.30 p m.. However, staff provided sconces are available dating the early mommg hours, and duumg the evrnmg and on weekends, as needed, to accommodate the chant's schedule Many of the services provided by the proJed arc delivered to client m locations other that the KCPC office. Intakes and assessments may be compleud at the chant's home or mother location agreeable to the client. Outide services paid for with protect funds are obtmed by the client at the provider's location (e g. Bndge House, ACCESS, BISAC, FCSI, private practitioners, etc.) C. Collabontion/Coordination 1) What spaific masures will be taken to mllabontdceordinate with other community raourcn to achieve ma:imam program etflcieney and cwt eRecriveaess? Thu protect wen specifically designed m a collaborative coil aordtnated endeavor. Regioml Plammg Committees were established m 1994 to assns commumity needs. Members of the Regional Planning Committee included rcprcsentnves fittm most humor xrvice agencies in the region, m well m representahvm from the busnas community, state agencies, coil the grneral public From the RPC needs assessment, the West Hawaii Cougxling coil Supportive Living Protect wen developed. Over the part four years, m Faders! funding became available, Memormduins of Agrutement and Service Contracts were developed between KCPC coil other agencies. Thex include DHS, DOH, Public Health Nursing, Probation, Bndge Houx, DASH, BISAC, ACCESS, FCSI, FSS WH, QLCC, coil CFS. 'Ibex dttcumenb outline specific serviem available to project clients from each agency or provider, rcfirtal mechmirtns, payment opdons coil levels of pantcipanon in the project Several cmtracb have alto barn developed with private cotmseling practidonen throughout the region. Additionally, a drub baby protocol hen been developed with Kona Hospital and North Hawaii Hwpitl. One of the primary tasks of the Project Service Coordinators is to continually further collaboration coil coordination with other community resources. An additional task is to mrtire that services for clients ate obtained efficiently and Bost effectively. A comprchenrtve intake is completed with each client requesting ~ervtces. Dunng the intake proeem, climb idmrify other agencies they may currently be involved with coil previous services thev may have received. The Coordinate works with clime throughout the tune they are involved with the project, holding case conferences, m needed, wtth the client and other provider, n order to enhance service delivery. To facilitte coordination, a confidential rcleax of infemarion form hen been develooed that allows then[ information to be shared between agencies. All climb participating in the project must voluntarily sift this rclatax before being accepted imo the program. Ducrction us used in boih obtaimn; .,rid ditaeminsting sensitive client information. As stated above, connect agreement have been established with many agmcia coil private pracnriooers. Reasoiiable fees for servuces have been negotiated with thex pronders coil cost are monitored closely. An extensive compute databex hen been developed to track clirnt services, involvement with other agmam coil achievement of ouuomes. N 1999, the Neighborhood Place of Kons wen opened. The NPK is a plea where families can go to receive help from community agencies when a nslt of child abttx a neglect hen taco identified. The NPK is one of two pilot sits m the state. Numerous public coil private agencies m well m private practiritiners have made a commimtmt to deliver services directly et the Neighborhood Place md/or to be linked with fsmilim through the Neighborhood Place KCPC staffmemben have been involved in Neighborhood Place pletiiung from the stn Since ib opening, KCPC staff have been working cloxly with NPK staff, sharing service tasks on femdia served jointly and cross rcfemng m appropnate. Since September 1999 KCPC staff have been providing a parenting class for subrtmce abusers in recovery at the Neighborhood Place. C. CollaboratioNCoordinarioa fContiouedl 2) How will these measuro reduce or eliminate any exustung duplkarioo otxrvkn to your daigoated target Broup? Reduction or elimination of duplicanen of serviceu a primary goal of this protect All of the above memttrcs ~acditte this goal. Client service needs arc established and prionti~sd during the intake procem. Current coil fonder provider are then reviewed coil additional appropnate provider(s) identified to meet curtest xrvice needs . Although there may u times be some overlap of service component, duplicate services arc effectively elimuiated fireugh tracking of client puirricipatiai and progress coil frequent communication between the niwerom agencies coil pnvam prncutionera involved in the project, diem needs are met without duplication of services. Joint xrvice planning between the KCPC Title IV-B Project, the NPK, FSSWH, CFS coil other pnvate providers rnsures coordintued xrvice delivery and prevent duplica[ion of services Kapt'olant Child Pro[ect+on Center - West liawau D. Goals and Obieetives Page 4 1) What are the major goalslbeachmarks of the proposed program? • Promote and parttctpate in a collaborative communtry continuum of care to support the treatment of addtatons, promote long- term recovery and prevent moral and subsequent inctdenb of child abuse and neglect • Promote and participate in a collaborative communtry continuwn of care to unprove the functtoamg of at nsk caregivers and prevent initial and subsequent mcidenb of child abuse and neglect. • Promou and pan+cipate in a collabotatwe community continuum of care to unprove the delivery and coordination of xmces for families at nsk for child abuse and neglect 2) What specific objectiveslactioa steps are planged for each goal? • Enhance effesivenas of treatment of drag and alcohol addtsions by providing access to counseling aad supportive services for long term recovery of child caregivers. • Enhance access to and effectiveness of therapeutic support and education for at risk families learoing to develop and maintain healthy family relationships. • Enhance access to and effesrvrness of mrntal health srnices for faintly members expenencing problems that interfere with family well being • Enhance access to and effi;ctivrness of service delivery for at risk families through the development of individualized service plans and collaborative service coordimnon. 3) What b time tlmelioe (start aad end data) for each action step. This proles began in October 1995 with the provision of mrnW health avessmrnt aad coiraaeliag semt:es for u ruk families. Services were limned to individual wutixling with contracted pnvate practrtionm. Ice October 1996, faintly aad group counseling services were added through the addition of a staff clinical social worker aad a contracnul agtrumeat with ACCESS Eaurprises. This component of the program b ongoing. In Jmuary 1998, group-coutueling services were started for womrn completing formal substanw abiise treatment end tiansmoning from Supportive Living. MrnW haahh services are added or augmented when indicated by clirnt needs, when other service programs arc esnbhshed, and when providers rntenag the area introduce ae+v options. Tn October 1996, the Supportive Living compotieat was added to the protect when Bndge Hoax begin scceptrag women into their residence. )n January 1997 an in-hoax txaiaseling/parenting group was started at Bndge Hoge by the project clitiii:al social worker Access through the project to eager msaagaarnt classes, parenting classes, childcare wistaaee, medical are coord'mwoa and faintly home visiting began in October 1996. '[Lae wmponeab arc ongoing. Service Coordination begin oa a limited bads is October 1995 and has barn expanded over the past four years. Ice July 1999 two Cfiniral Care Coordinators were hired in addition to the Sesvtce Ciiordininor. Thex staff members are cottaseliag professionals who provide the long-term support, case managemrnt and life skills education needed by clieab. We arc currently in the process of hirmg another Clinical Social Worker with substance abux expertix, to expand our caputry to provide is-hoax assessment and counseling services. 3) What b time tlmellae (start and cod data) for each aetioo step. (Coatioaed) la Apnl 1999 we began Joint sernce plarmiag with the Neighborhood Place. We also bcgen integration of outreach xrvices into the program with the use of ilia NPK oiitreseh worker, In July, 1999 we were awarded a four yar conaact with DHS-C WS to provide short arm social services to families reported to CPS but assessed to be at low to moderate ruk. These families arc referred to the Diversion Program We have integrated this program with the Title !V-B project administratively to provide a eoatinuum of care for families. Thox families needing longer than three weeks intervrnnon (maximum service time allowed by the Drvers+on Contras) can now be automatically transidoiied into the Title IV-B protect or to the Neighborhood Place. >n July 1999 we began developmen[ of the Adoptive Semces component of the protect. Working with DHS, CFS cad QLCC we developed a referral protocol and identified needed services These are• transittorml counseling for children moving from foster care Kapt'olant Child Protection Center -West Hawau Page 5 to adoption and for faster parenu becoming adoptive parrnu, pre and post adoptive rnsis intervrntion, longteria post adoptive support In September 1999 we started the first in a xnes of parenting clazxs for carcgrven in substance abuse recovery Thex classes arc held at the NPK and have been very successful. We arc beguining our third xnes of classes in this time and are fully booked, as we were wish the fast two sessions. Thex parenting clazxs arc the only ones in West Hawaii specifically deigned to address the unique needs of substance abusers in recovery in October 1999 protect evaluation waz expanded to include both a three-month and asix-month follow-up of families who completed a service plan and were successfully discharged. The reulu of these follow-up contacu should provide us wish good information on the long-term safety of the children involved In the 1999-2000 focal year, refenals to the protect increased to the point when KCPC was noble to give all the families referred the attention they needed. Therefore, in November 2000, DHS awarded the Ported a substmtial increase in funding for fiscal year 2000- 2001. The increase waz given to ensure adequate staffing and avetlability of services for all the families referred. To date, we have hued one new Master's level Clinical Care Coordinator and arc in the process of recroiang for another Bachelor's level Service Coordinator and an eddthonal Administrative Secretary. Another increax in funding u planned by DHS for July, 2001. That inersase is earmarked to establish both m adult and child peer- mentoringcomponent within the protect At this tune the action steps planned ere 1) Rernut, hue and train new Servtce Coordinator and new Admintstrsdve Secretary' 2) Relocate the KCPC office, preferably co-locatwn with the Neighborhood Phtce of Kona 3) Continuoio upgrading of the project databax 4) Ongoing planning between the Regional Planning Committer:, DHS, NPK and KCPC to develop serviea, insure seamless and timely referrals, and prevent duplication 5) Development of recruiaarnt, screening, and training pukage for aduh and peer mmtoring. To be completed by 7/1101 Development will involve direct planing with DHS, ACCESS Capabilities, Family Support Services of Wet Hawaii and KCPC Oshu Branch. 6) Augmrnting existing direct service - Omgoiag 'f] Working with the state leguiature to securing addmonal funding for long term family tres®mt of substance abuse - =001 8) 7/1/01 Initiation of adult peer mentoruig, followed by evaluation and acpension of eompoomt 9) 10/1/Ol Inmedon of child peer mrntoiing, followed by evaliiation tend expamsica of component 4) What sigoitfeant client centered onteome(s) will the program ae6leve? KCPC staffmemben worst with each client to develop m indmdualimd service plan that tdmafia targeted personal behavioral obtectiva to be met One of the behavioral objecava for all churn u to complete the aervia plan that they have esnblished. When that has been done, we mtictpete the achievement of the following client centered outcomes. a) 90Ye of famthe that complete a xmce plan wi116ave established and implemented a child safety plan at cage closure b) 90Ye of families that complete a service plm will have had no new report of child abtue or neglect during program service. c) 90% of families that complete a Servtce pin will have no new report of child abtix or neglect at 3 month follow-up. d) 90% of families that complete s service plm will have no new report of child abtix or neglect ar 6 month follow-up. 4) How many partlelpann/cl'uan will attain at least one perinea/ program oateome or show meuunbk progress towards program goab? We anticipate being able to serve 200 Emilie with avarlable finding. We ettmste that 90X or 180 familie will engage in at least the assessment component of the protect, with only 10`h (20 familie) refusing savica or othawue being unsvaslable to pantcipate in xrvices. (i.e. we cannot cmtact them) Of these 180 familie who initislly engage, we estunate that 30°.G (54 families) will receive assessment service Doty m asxssmem and litikage with other resources. Swttt plans wiN be established wM 126 familie with 90% of them or 113 familie completing their plans. Of these ~ompletmg their service phw we mtieipem that 90X or 102 familie will attain the above personal program outcome. W ithin the 200 fsmtlia referred we anticipate that than wilt be at least 350 adulu and 400 children We mactpate that approxunetely 230 adult aaregrven will achieve nix or non spxtfic behavioral objectives se[ out in the service plan with approximately 200 children achieving behavioral objectives. Kapt'olant Chtld Protection Center-West Hawatt Page 6 E. Servtce Delivery As described above, Servtce delivery will be accomplished through a combination of staff delivered servtces, payment to contracted Servtce provtders and linkage with other agenctn. servtces will be delivered in clients' homes, the KCPC office, the NPK, and other community provtders' locations Methodologies will include any and all sacral Servtce intervennons tdenttfied as appropriate to meet faintly member needs F. Evaluation 1) Client evaluation soil progress measurement. 90% of families referred will be fully assessed to determine child safety risks and Servtce needs When a KCPC ptro~ea staff person meets with the family the fast time, a Child Safety Assessment form rs completed for each child in the faintly, a written narrative assessment written on faintly member and a Servtce Needs Assessment forth completed Whm these arc finished, a chakbox is marked in the famrlin comptter case file that the faintly has been assessed. On a gttarterly buts, a Service Coordinator or the Branch Administrator tuns a computer report that shows the number and percentage of fiuntlies that were assessed. 90% of families that establish a Servtce plm will complete the Servtce plan. When a Semce Plan is developed and mgned, a "Servtce Plan Fstablivhed" checkbox is marked in the rnmputer cave record by an Admmtstraave Secretary or Servtce Coordinainr At discharge, a "Servtce Plm Completed" checkbox u marked when a family has completed then Servtce plan. A Servtce Caordtttator or the Hawaii Branch Administrator tuns a quarterly computer report thtu shows the ntunber and percentage of fundid completing a Semce plan. 90% of families that complete a Servtce plan will have established anti implemented a child safety plan at case closure. An initial Cluld Safety Plan will be developed with families es part of the asspsmmt procesv When semen (rave been completed, the Clmtcal Therapist, Clinual Nurser Spectahst and Clinical Can Coordiaatots will mat with faintly members to review, discuss and revise the written Child Safety Plan. The revised Child Safety Phin will dacinetu the safety measures clients have implemented in then family 6fe during the service period Once the Plan v revised, u tvtll be checked o[i m the client's computer record es having been deveoped end tmplemetrted On a quarterly basis, a Service Coordinator or the Branch Administrator trots a comptrter report that shows the ntrmber and percentage of famiin who have developed and implemented a Child Safety Plan. 90% of famthes that complete a Servtce plan will have had no new report of child abuse or neglect druiag program servtces 90% of femtlies that complete a Servtce plan will have no new report of child abuse or neglect at 3 month follow-up. 90% of families that complete a service plan will have no new report of child abase m neglect at 6 month foNow-»p. On a monthly basis, a Servtce Coordinator prepares a hat of all famthes that were closed om of Title IV-BJ2 servtces dirrmg the prior month, and all Camiha due for three and six month follow-up evdnation. This livt is fatted to the DHS~WS intake Unit Social Services Aide. The Attie reviews DHS~CWS raordv, noting the date of any new CPS tepixts far any 7"rtle fV-B2 cltent on the list The list a faxed back to the KCPC office and any inforinanon on new repom enared into the chmt's computer record. A Smite Coordinator or the Hawau Brmch Administrator runs gtratterly computer otncoine rcporb that show the number and percentage of clients who did or did not have a new CPS report ditrmg the Semce period, the (bier-month follow-up period and the six-month follow-up period. G. Proanm Fen 1) Does your orgaaizatioe charge a membenhlp fa for service partieipaob? No 2) Don the proposed program charge participants a f« for aervlce(s) provided by your organhationl No, all service are free to the cltent with one exception. If it is determined, during the individualized service planing proceu, that tt would be bmefictal for the cltent to shah in the tort of servtces (such as W show then comtntttnent to services or because services are Court mandated) a client may be asked to pay a contracted provider a portion of the Semce fa. If it is determined that s client's health insurance will cover the cost of a Servtce, that cltmt's health insurtince will be billed. Kapt'olant Chtld Protection Center -West Hawatt H. Viabili Page 7 1) W hat u your Justrficatioo or rationale for the e:penditnre of public funds for the propaaed program? Our main rationale for the expenditure of publtc funds is that we feel the community has a responstbtltty to promote the safety and adequate care of children Abuse of drags and alcohol hay become epidemic in West Haweti, resulting in great harm both to children and then parents Intensive and long-term services arc needed to help these families recover from substance abuse Most of these parents are not able to provide appropnau care for their children without life skills and parenMg education, counseling and other supportive assistance Many of these parenu do not have the finmcial meets to obtain the help they need. Use of publtc funds is therefore appropnate, especially if it saves even one child from abuse or neglect 2) What ere your financial and programmatic plans to sustain the proposed program beyond the upeomrng fiscal year. Our ciirrent contract with DHS for Project funding expires on June 30, 2001. We have applied to the DHS for Project funding for fiscal years 2001-2003 with mtomattc renewal for 20042005. We mncipate that our proposal will be approved and a new contract awarded. I. Bud¢et Please see attached. ORGANIZATION/AGENCY INFORMATION A. Board of Directors 1) Has the organiratbn's Board of Direetors received formal trainlag within the past two (2) (Meal yon? Yes However, there is no specific Board traiaitig certifictumn. a) What plans do you have to provde formal tniniog to your current Bard of Dlreeton? Board education is m ongoing function of Board leadcr•,~ The Board of Directors of ICMCWC meets with all Executive ^•embers a, well as Board Chairpersoru on a regular bests. They .;rc provided with "7tie Hoard Book" which is a comprehensive mangy .t contouring KMC WC orgmi>attoital itiformahoti and iuforttiation on Board members' roles and rapomibdities. 'ihe mmual and iu Appendices are rcgulsrly updated to keep Board members apposed of the moat current orgmiatiotral information. b) When will the nest Board training be completed? As stated above, Board education u m ongoing fmrnon of Board leadership. The Board Book to updated annually, and all Board members receive ongoing eduuhon et each Board meeting through presentations oo current issues and trends m our industry, including issues affecting our parent populations, emerging health care needs, and new technology and service development Educational sessions are documented m the minutes of the Board meetings. Sptxisl sesstam for eduatiao and strategic plmmg arc also held es needed, such as the amual reheat of the medical staff and Btrsrd leadership to rtwiew performance :rprovemem pnoriries, quality mittetrves and growth opportmities. ORGANIZATION/AGENCY INFORMATION A. Board of Directors (Continued) c) How will you provide formal tninrng to newly arrrvtng board members or bard members whu mused scheduled tniniog? New Board members arc provided eduction as to the histo~• Mission and ptupose of Kapi olam Medical Center For Women and Children, its services, programs, and tumor iswes, a~ we i I ~ rndt in heath care and the care of women and children m particular. A Board education mmwl is used to asset the new members i~ their leammg. One on one eduratiaoai session ate even by the Kepi olmi Health Prcmdmt/CEO and the Exaeuuve Vice-Presidenr/CEO of KMCWC. The Board Chan of KMCWC ss well as the Chan of the Kapiolant Health holding company Board also a~citmate new Board members t~ t,:e orgmi7anon and their role as Board Kapi olani Child Protection Center -West i-!ewers Page 8 members New Board members meet with each Executive member and venous Board Chain and arc provided with `"Ilia Board Book" and "The Board Book, Appendixes" 2) What are the primary roles soil raponsibilitia of your organiz'atioo'a Executive Director. The pnmary roles and responsibilities of Kapi'olani Medtcal Center for Women and Children's Executive Vice President 8t CEO is to provide leadership, direction, and administration of all aspects of hospitaUmulti-hospital activities and other corporate entities to rnsure compliance with established oblecaves and the realvatwn of quality, economical health care services, and other related Imes of business The KMCWC Executive Vice President functions u a member of the Kapi olani Health executive management team to fulfill the mission of the medical center within the context of a comprehensive health care system. The pnmery roles and responsibilities of the Kapi'olam Child Protection Center's Hawaii Island Branch Administrator include hwig, supervision, evaluation, and termination of staff for both the East Hawaii and West Hawaii offices; program development and accountability; budget preparation and accountabihry, groat wntiag; aetwarking with other community agencies; provision of direct consultation and coordination services and other activities to ensiue that quality services are effectively delivered. 3) What are the primary roles and responsibilities of your orgeniution's Board of Direeton? (Clarify role of executive ofticen vs. General membership) The Kapi olani Child Protection Center is pan of Kapi olani Medical Center For Women and Children soil is governed by the fiduciary Board of Trustees of KMC WC, which administers KMC WC as a 501 c3 corporation The Board of Triutees u an eleven member Board, comprised of physician, business leaders and community representsuves. The prnident and CEO of Kapi olani Health and the Executive Vice President of KMCWC have been delegated authonty by the Board to administer the services and programs of the medical center, including the Kapi olani Child Protection Center. The role of the Board overall is to set policy and determine strategic planning for the medical !eater and is programs. The executive kedenhip of the medical cwter appoints the Hawaii Branch Admmistrrotor of the KCPC and dekgata to that individual the rcsponsrbility for the day to day operation of the SATC to include service development and care advocacy. The KCPC West Hawaii Counseling and Suppomve Living Project u advised by the West Hawaii Title N-B2 Regional Planning Commmee and the Title IV-B/2 Statewide Plenmg Committee. The roles end responmbtlities of the West Heweti RPC are to determine community needs related to child abuse and neglect, plan for services m meet those needs, end adviu KCPC program staff on service development and serve delivery. The roles and responbilihes of the Statewide Regiouel Planing Commtaee ere to review statewide service needs, plan programs and set budgetary allocation to men those needs and review service delivery of Ttle IV-82 progrenis statewide B. Past Pertormaace 1) How eReeHve 6ae your orpniatiodageory been in ac6leviog program goals is the put Mo (2) !!seal yan? !Delude the following ia[orsatfoa: a) Quatittttva da4 oa numbsn served; sad b) Quallhthe data showing anmber and •.L of partkipeats aehkvlag mwanbN oateoma. Please see information listed below. Kapi'olani Child Protection Center - West Hawaii & Past Performance (Continued) Page 9 TITLE IVB COUNSELING & SUPPORTIVE LIVING PRO tF'CI' FY 1998-99 (7/1/98-0!!0/99) FV 1999-00 (7/1/99-6f30/00) Clienn Served # Families Referted 107 173 CPS Diversion 24 22 4% 33 19 OY° Athve CPS 35 32.7% 79 45 7% Non-CPS 48 44 9% 61 35 3% # Aduln Referred 169 302 # Children Refemd 239 q42 # Families Who Received Direct Services 104 169 # Aduln Who Recervad Din:ct Services 124 226 # Cbildrca Who Received Direct Services 34 236 # Families Who Refiised Services or No Contact esnbhshed 7 q Aehkvement of Proposed Outcome (Clwed C n..t v FY 199&99 FY 1999.00 Number Percept Num r Pe ant Toni Families Closed 98 l36 Families Assessed For Semce Needs 81 82.7% 132 97.1 Ye Families Who Established a Savice Plan 72 73.5% 85 62 5% Families Who Completed s Service Plsn 56 77.8% 64 75.3% Families who had no new report of child abusa/neglect at case clostue 95 %.9Yo l l8 86 BYe Tarteted Outcomes Chepn who mamteiped Substaax Abtix Recovery 26/35 74.3% 39/44 88 6Ye Clienn who unproved indtvtdtial funehonmg 41/S I 80.4°h 43/48 89 6% Clienn who improved problem solving skills 31/38 81.6% 41/47 87.2% Clienn who improved family rclauomhips 26/32 81.3Ye 30/37 31 Clienn who improved parrntmg skills 13/)4 92.9°/. 2227 81.5% Clienn who improved family support 9/I 1 81.8% 11/12 91.7% Targeted outcome data is collected on mdtvidwl family members who complete s service plan only. C. Financial 1) Have your otgaatraHea'a currept program operations remained the same as last year? What mgor program or fiasnelal ehaaga gill be incurred nest year? The DHS Child Abiue and Neglect Diversion Program received a funding ipcretue Gan 560,000 to 585,083 this fiscal year to accotnmodate the large number of rcferraLs That contract has been mcreued from 560,000 to S 120,000 for both fiscal years O I-02 and 02-03. The Multtdisctplitutry Team Services Progtam in Kona received a finding increase from 5126,299 to SI. i,300 epd the MDT m Hilo received a funding mcrease from 531,978 to 580,000. Aldrwgh not reflected in the attached budget because not yet committed, DHS has indicated to us that there will be a 5150 000 increase next yar to be sprcnd across all MDT programs. We anucipate that the greatest share of these funds will go to me Hilo Team, with a small ptavon to the Kom Team. The West Haweti Title N-13R p%1eM funding increased from S 180,51 B to 5270,085 this fiscal year. An additional increase to 5300,000 is anticipated for next fiscal year, followed by an mcrcase to 5330,000 in fiscal yar 02-03. Kapi'olani Child Protection Center- West Hawaii Page IO 2) What is the status of all of your orgaeiration's major contracts or agreements for the coming year (employment agreements, otflee leases, primary gnat reveaue/suppller, etc.)? Our current Title IV-B Counseling and Supportive Living Protect contract with DHS will expire on June 30, 2001. We have applied to DHS to continue the program and anticipate that our proposal will be accepted and a new 2 year contras awarded with a 2 year automatic extension Our Multidisciplinary Team contact with DHS expires on June 30, 2001 We have applted to continue the program and anticipate that ottr proposal will be accepted and a new 4 year contras awarded. Our DHS CA/N Diversion contract was awarded on July I, 1999 and expires June 30, 2003 Employment agreements with staff arc ongoing and expire only when an employee resigns or is terminated for cause. Conaacu with other agencies and private practitioners expire on June 30, 2001 with sutomahc rrnewal for one year if smite are effestvely delivered Our current lease with Xerox for a copier expires was extrnded for five years on 1/1/01 Our current office lease expired on 12/31/00 We entered into a month to month extension agreement with the landlord and are currently seeking new office space to rent 3) How don the proposed program flt Into your organizatloe's long Hoge fieaecial plan? The West Hawaii Counseling and Suppontve Livmg Prates ciirrently reprnenu about one half of the rcvrnue in the KCPC West Hawari office. As with other DNS contracts, the viability of thu program is always subjes to the avalability of governmrnt funds. Federal Funding of the Protect will likely be renewed for another four years on July 1, 2001. At this time, Kapi'olani Medical Crnter for Womrn and Childrrn cannot coininit to long range funding of this program without government support It is therefore not included in KMCWC's long renge financial plan. D. Monttortntt 1) During the past two (2) yeah, what floaocial and/or admleutntWe monitoring hu your oigaevatlon received from any and all fu~dhrg source? Monitoring has been provided by the State of Hawaii Department of Human Services. Monitoring has included site visits and review of quarterly financial and program reports. The DHS progrtun monitor for the Title IV-B Coutseling and Supportive Living Projes u Colleen O'Sullivan (phone - 974-4000-6-5669 or I{808) 586-5669). Monitoring has been provided by the Hawau Island United Way. Monitoring has included a site visit by the allocaaoru coitueittee poor to determination of funding approval and review of gtiarterly finaacul and program reporu Information on HIUW program monitory may be obtained from Carol Feldmm, Vice President (phone 326-7400) The County of Hawaii has also provided mortaonng. Monttonng has include a site visit by County Council member poor W determination of funding approval end review of semi-annual sad aoatiaY reports to the County Council. Information on County of Hawaii program monitoring may be obtained from Helen Matsui (phone 961-8259). E. Alcohol. Tobacco end Divi[-Free Workelaee Policies tied Information 1) How does your orgaeiatNoo addriea alrnho4 tobacco and other drug prevention foformatioe dlssemioatroo u part of your workplace and/or program eoviroemeet? Kepi olmi Health has established "House Rules" and a "Drug Free Worltplace Policy" These doctimrnu arc provided to all employees of KCPC as part of orientation. The Wen Hawaii Counseling end Suppomve Livmg prates hu u one of its mom ptitposes the reducnoa w eliminatioe of alcohol and drug above. Substance abuse information is disseminated to chenn in venous ways; through counseling, literature and medical consultation Clirnts arc not provided service while tinder the influrnce of drugs or alcohol. AGENCY/ORGANIZATION Keni olam Chdd Protanon Crnter PRO]ECT NAME Tide IV-B Cowselm¢ & Suo°omve Lrvme Project ATTACHMENT 1 TABLE 3 Budeet Item #1 Professional Fees a. Administrative Fees: Indirect costs are those costs commonly referred to as "overhead", or costs incurred by the institution that cannot be directly identified or readily allocable to a specific project. Examples include facilities, utilities, general administration, purchasing, payroll and accounting expenses. KMCWC typically allocates indirect costs as an estalished percentage of direct costs. Acttral FY Ol calculated indirect costs for off-site (non- medical center located programs) is 25.53%. Because of state imposed budget constraints, all state and city and county off-site projects are allocated a reduced indirect cost percentage of 15%. The program administrative fee in this application includes both the 10% fee on the Title IV-B contract and 15% fee charged on the County Grant. The Administrative fee is not charged on any fiinds expended for purchase of equipment. The Administrative Fee includes: Bookkeeping & Accounting Legal Services Audit Services All Insurance Administrative Grant Management b. Other Professional Fees: Kapi'olani Child Protection Center -West Hawati subcontracts with a number of professionals for program services. These include: Multidisciplinary Team: Physicians Psychologists Social Workers & Child Abuse Specialists Title IV-B Counseling & SuppotUve Lrving Project Private counselors Non-profit agencies (ACCESS Capablities, FCSI-ATV, FSSWH, Bridge House) Computer specialists (database development) TABLE 6 Fundine From Private Foundations Atherton Family Fund: $3,000 to purchase new computers for Hilo office CO~JNT~ OF HRILI~'~ HUII~AN SERVICES NONPROFIT GRANTS (FY2001-02) Staff Information Sheet Mary Jo Westmoreland BA-Httmaatdes X X X X HI Branch Administrator Barbara Eldridge X X X X Branch Secretary To Be Hired X X X X Administrative Secretary Dame Masutomi BA-Psychology X X X Service Coordinator To Be Hind BA X X X Service Coordinator Carat Dinmon BS Nursing-PNP X X X Clinical Nurse Specnahst Frances O'Leary Dmtz MSW-Social Work X X X Clinical Therepat Tomte Bernhardson MSW-Social Work X X X Clinical Can Coordinator Rebecca Traatue MEd.-Comseling X X X Clinical Can Coordinator Deborah Chavez MA-Human Devel. 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Hewtui %720252 (808) %1-8234 • Fex(BOB) %1-8248 HAWAII COUNTY NONPROFIT GRANTS (FY 2001-02) FINANCIAL QUESTIONNAIRE Please include as an attachment an explaaanon for all "NO" answers to gttethom #1 thru #11 below: Yes No ? 1. Has the agency opasted cottGnuowly for the pest three (3) years? ? ? 2. Hera the agency operated with a positive cash flow fa the part three (3) years? Excluding transfers to the parent ?x ? 3. Does your Board of Directors approve a detailed cash flow budget before the beginning of each fiscal yeafl ? ? 4. Do your Board mating minutes show that quarterly financiei atatemeots are approved? Financial Statements are reported b reviewed at each Board meeting. ? S. Is your equrty balance at lean 20% of your Total Liability bsLace? ? ? 6 Is your Total Cunmt Asset balance large than your Total Current Liability balance? ® ? 7. Are baalc recoaeliaaons and accouanng performed by aomeoae other than the check signuory? R? ? 8. Are you fully insured far the agency's vehicle(s) and btulding(a)7 ? ® 9. Is your Worltas' Compensauon at least 2%ofpayroll? Kapi'olani Medical Center for Women and Children is self insured for worker's compensation. © ? 10. Are you current (non~dmquent) on all payroll and payroll tax paymmta? ? n 11. Ia the agency free of any penatng Ittigadon, lien or judgments? for medical malpractice litigation ? ? 12. Within the pert 12 months. has the agency applied for veada or bank credit and was denied credit? If yd, please explain. At the gmnr appltcanR I etrnfy that the agenev her saru,•"ccronly ruponded to each ojth abawr rryanons and eaplawd as needed I hereby cernfy that this tnfonnatton tr true and correct to the bent ojmy btowledge. Kapi'olani Medical Center Agency' for Women and Children Phone: (808) 983-5000 Preps^edby' Donna Masuda-Kam, Director of Accounting ~2L[„• C~le:a-~ ~ Pent Nemdl itle Srpre~e J.n Frances A. Hallonquist G„~_,~/ ~ Cemfiedby: Executive Vice President s ('EO v ~ Pnnt Nerve of Fss~me Dinemr S,~eoee v: i ~ / COMBINED FINANCIAL STATEMENTS Kapi'olatu Health Yeats ended June 30, 2000 and 1999 Kapi`olani Health Combined Financial Statements Years ended June 30, 2000 and 1999 Contents Report of Independent Auditors l Financial Statements Combined Balance Sheeta ..................................................................................................2 Combined Statements of Unratricted Revenue, Expenses and C+ther Changes in Net Assets ....................................................................4 Combined Statements of Caah Flows ................................................................................6 Notes to Combined Financial Statements ..........................................................................8 ERNST & YOUNG • Errot 6 Young ur • Phone IB081 531-203' 2400 Pauahi Tower www ev com 1001 Bnhop Street Honolulu, Hawau 96813-3429 Report of Independent Auditors Board of Trustees Kapi`olani Health We have sudite~ the accompanying wmbined balance sheets of Kapi`olaai Health as of June 30, 2000 and 1999, and the related combined statemrnts of unrestricted revenue, expenses and other changes in net assets and cash flows for the yeas they ended. These financial statemrnts are the responsibility of the Company's manageme~. Our responsrbility is to express an opinion on these financial statemrnts based on our audits. We conducted our audits in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstateme~. An audit includes examining, on a test basis, evidrnce supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statemrnt prarntation. We believe that our audits provide a reasonable basis for our opinion. in our opinion, the financial statements referred to above present fairly, in all material respects, the combined financial position of Kapi'olani Health at June 30, 2000 and 1999, and the combined results of its operations and changes in net assets, and its cash flows for the years then rnded, in conformity with grnerally accepted accounting principles. October 12, 2000 Emst ~ Young w b a merrbex of Emet d Yourrg Intamauonal, Led 1 Kapi`olani Health Combined Balance Sheets Juoe 30 2000 1999 AsseU Current assets: Cash and cash equivalents S 17,618,237 S 22,982,137 Net patient accounts receivable, less allowance for uncollectible accounts (2000- S 16,508,000; 1999 - 514,603,000) 34,253,762 43,395,316 Other receivables 1,488,095 2,058,635 Inventories 2,426,804 1,659,892 Funds held by trustee under bond indenture agreement (Notts 1 arrd S) 8,563,346 8,448,618 prepaid expenses and other current assets 1,993,280 1,673,013 Total current assets 66,343,524 80,217,611 Assets whose use is limited or restricted: Designated by Board for expansion: Cash and cash equivalents 34,946,524 5,084,272 Accrued interest receivable 504,760 700,050 Inves~tenta (Note 1) 108,240,399 116,426,434 Rend pr,op~, 497,430 497,430 144,189,113 122,708,186 Project funds held by trustee under bond indenture agreement (Notes 1 and S) - 105,959 Restricted by donor or grantor. Cash and cash equivalents 1,148,407 1,624,913 Grants and other receivables 1,514,705 1,366,585 Rend p~perty 906,786 959,276 Investrnents (Note 1) 4,768,760 4,464,844 8,338,658 8,415,618 Total assets whose use is limited or restricted 152,527,771 131,229,763 property and equipment, net (Notes 3, S and 7) 152,846,600 163,723,954 Other assets: Investrnent in joint venture pertrrershipa (Note 8) 3,387,755 , 1,797,226 Deposits and other noncurrent assets 7,685,617 7,656,636 Net assets from discontinued operations (Note 9) - 2,079,41 S 11,07372 11,533,277 Total assets S 382,791,267 S 386.704,605 2 June 30 2000 1999 Liabilities and net assets Ctirrrent liabilities: Accounts payable S 14,687,252 S 19,942,213 Payroll and related liabilities 6,890,825 10,338,107 Accrued expenses 10,736,084 10,216,092 Due to governmental agencies 6,897,532 2,919,174 Agency funds held for others 404,824 81,962 Current portion of long-tertn debt (Note S) 3,844,936 3,620,794 Total current liabilities 43,461,453 47,118,342 Accrued beneSt cost (Note 4) 3,784,325 2,841,316 Long-term debt, less current portion (Note S) 154,634,346 158,454,287 Unearned income (Note 7) 1,604,885 1,604,885 Other long-term liabilities 4,404,001 4,780,671 Allowance for disposal of discontinued operations (Note 9) 1,106,636 - Net assets: Unrestricted 163,515,353 160,488,483 Temporarily restricted: SpeciSc purposes 6,011,049 6,909,321 Plant replacement end expansion 132,844 656,258 6,143,893 7,565,579 p~~~Uy acted 4,136,375 3,851,042 173,795,621 171,905,104 Total liabilities and net assets S 382,791,267 S 386,704,605 See aeconrpetrying notes. 3 Kapi`olani Health Combined Statements of Unrestricted Revenue, Expenses and Other Changes in Net Assets Year ended June 30 2000 1999 Unrestricted revenue Net patient service revenue S 185,821,553 S 184,452,555 Other revenues (including net assets released from restrictions for grant expenses: 2000 - 58,034,331; 1999 - 58,179,740) 50,308,711 34,488,415 Total unrestricted revenue 236,]30,264 218,940,970 Expenaa Nursing services 49,29],251 48,708,020 Other professional services 57,105,104 56,288,204 Cienp'81 spyj~ 17,915,960 18,304,941 Fiscal services 10,933,592 10,697,828 Administrative services 42,338,868 41,942,536 Provision for uncollectible accounts 8,213,599 11,836,839 Grant expenses 8,034,331 8,179,740 Depreciation and amortization 16,090,347 16,015,204 Interest eXpense l0,OS3,733 10,369,780 Total expenses 2]9,976,785 222,343,092 Operating income (loss) 16,153,479 (3,402,122) Nouoperating gains (losses) Unrestricted donations and contnbutions 51,816 264,683 Joint venture investment income (loss) 1,841,195 (278,860) Other nonoperating gains 1,500 650 Income (loss) on disposals (975,497) 151,173 Net nonoperating gains 919,014 137,646 Excess (deficiency) of revenues and gains over expenses and losses from continuing operations 17,072,493 (3,264,476) Change in net unrealized gains and losses on other than trading securities (Note 1J (3,150,422) 811,271 Change in unrestricted net assets before effects of discontinued operations 13,922,071 (2,453,205) See aecompaxying notes. 4 Kapi`olani Health Combined Statements of Unrestricted Revenue, Expenses and Other Changes in Net Assets (continued) Year ended June 30 2000 1999 (Loss) income from discontinued operations (Note 9) S (411,250) S 1,451,920 Estimated loss on disposal of discontinued operations (Note 9) (]0,483,951) - Increase (decrease) in unrestricted net assets 3,026,870 (1,001,285) Temporarily restricted net aaseb SpeciSc purpose: Restricted grants and contnbutions 7,136,059 9,024,615 Net assets released from restrictions (8,034,331) (8,179,740) (Decrease) increase in specific purpose (898,272) 844,875 Plant, replacement and expansion: Other changes in plant, replacement and ~p~;~ net (523,414) 5,035 (Decrease) increase in temporarily restricted net assets (1,421,686) 849,910 Permanently restrkted net assns Net realized and unrealized gains on investments 285,333 461,693 increase in permanently restricted net assets 285,333 461,693 Increase ~ net 1,890,517 310,318 Net assets at beginning of year 171,905,104 171,594,786 Net assets at end of year S 173,795,621 S 171,903,104 See accompanying notts. S Kapt`olani Health Combined Statements of Cash Flows Year ended June 30 2000 1999 Operatlng activitles Change in net assets S 1,890,517 $ 310,318 Adjustments to reconcile the change in net assets to net cash provided by operating activities: Depreciation and amortization 16,090,347 16,015,204 Loss (income) on disposal of equipment 975,497 (151,173) Joint venture inveatrnent (income) lose (1,841,195) 278,860 Net unrealized losses (gains) on investments, other than trading securities 3,150,422 (811,271) Decrease in restricted rental property 52,490 125,459 Restricted im~esmrmt income (285,333) (461,693) Changes in operating assets and liabilities: Decrease in patient accouata receivable 9,141,554 10,604,121 Decrease (increase) in other receivables 570,540 (1,344,049) Increase in inventories and other asseu (1,116,160) (2,324,102) Increase in funds held by trustee uader bond indenture agreement (114,728) (882,895) Decrease (increase) in net assets from discontinued operations 2,0')9,415 (3,608,001) (Decrease) increase in accounts payable and accrued expenses (8,223,]29) 2,389,370 Increase (decrease) in net amounts due to third- PartYPBY'~ 3,978,358 (1,047,853) (Decrease) increase in liability for estimated malpractice costa 40,878 27,489 Increase (decrease) in agency funds held for others 322,862 (834,987) (Decrease) increase in other long-term liabilities (376,670) 2,217,387 Increase in allowaace for disposal of discontinued operations 1,106,636 - Net cash provided by operating activities 27,442,301 20,502,184 Investing actlvitla Purchase ofproperty and equipment (6,156,703) (19,182,216) Proceeds from sak of assets 45,]42 34,805 Sale of joist venture partnership 250,666 325,264 Assets whose rase is limited: Net (increase) decrease in cash and cash equivalents (29,385,746) 1,654,132 Increase in Qarrb and older receivables (148,120) (540,174) Net sales of investment securities 5,212,320 6,619,303 Decrease in project funds held by trustee 105,959 10,630,683 Net cash used in investing activities (30,076,482) (458,003) 6 Kapi`olani Health Combined Statements of Cash Flows (continued) Year ended June 30 2000 1999 ]'financing scdvitia Paymrnt of long-term debt and note payable to bank S (2,729,719) S (10,501,693) Proceeds from note payable to bank - 5,000,000 Net cash used in financing activities (2,729,719) (5,501,693) (Decrease) increase in cash and cash equivalrnts (5,363,900) 14,542,488 Cash aad cash equivalents at beginning of year 22,982,137 8,439,649 Cash and cash equivalents at rnd of year S 17,618,237 S 22,982,137 Ste accompanying notes. 7 Kapi`olant Health Notes to Combined Financial Statements June 30, 2000 1.Organization and Summary of Accounting Policies I{api`olani Health ("KH'~ controls ICapi'olani Medical Center for Womm and Childrsrr ("ICMCWC'~, ICapi'olani Medical Center at Pali Momi ("KMCPM'~, ICapi`olani Health Foundation and other health care related rntities located in Hawaii. I{H has also organized other corporations and health care related rntities to accomplish its objectives. It controls all subsidiaries through stock ownership (taxable corpoationa) and affiliates through board membership and management (nontaxable corporatiom). All interorganizational transactions and balances have been eliminated in combination. KH is snot-for-profit support organization as described in sections SOl(cx3) and 509(ax3) of the Internal Revrnue Code ("1RC'~. I{.H and all other significant combined affiliates are not-for-profit corporations exempt from federal and state taxes on related income pursuant to IRC Section SOl(a) and the related Hawaii Revised Statutes, respectively. The accounting principles followed by I{Ii, its subsidiaries and affiliates, and the methods of applying those principles comply with grnerally accepted accounting principles and grneral practice within the health taro industry. The significant policies are summarized below. Inventories Inventories are valued at the lower of cost (first-in, first-out method) or market. Property and Equipment Property and equipment acquisitions are recorded at cost. Depreciation is computed using the straight-line method over the estimated useful lives of the asseh, ranging from 5 to 40 years for buildings and improvements and 3 to 20 years for equipmerrt. Equipmmt under capital lease obligations is amortized on the straight-line method over the shorter period of the lease tmn or the estimated useful life of the equipmmt. Such amortization is included in depreciation and amortization in the financial atatmtmts. Interest coat incurred on borrowed funds during the period of construction of capita assets is capitalized as a component of the cost of acquiring those assets. 8 Kapi`olani Health Notes to Combined Financial Statements (continued) 1.Organization and Summary of Accounting Policies (continued) Property sad Eqnipmeat (contianed) Gifts of long-lived assets such as land, buildings, or equipment are reported as unrestricted support, and are excluded from the excess of revenues over expenses, unless explicit donor stipulations specify how the donated assets must be used. Gifts of long- lived assets with explicit restrictions that specify how the assets are to be used and gifts of cash or other assets that must be used to acquire long-lived assets are reported es restricted support. Absent explicit donor stipulations about how long those long-lived assets must be maintained, expirations of donor restrictions are reported when the donated or acquired long-lived assets are placed in service. Investments Investrnents in equity securities with readily determinable fair values and all investments in debt securities are measured at fair value in the balance sheet Investment income or loss (including realized gains and losses on investments, interest and dividends) is included in the excess of revenues and gains over expenses and losses and reported as other revenues unless the income or loss is restricted by donor or law. Unrealized gains and losses on investments are excluded from the excess of revenues and gains over expenses and losses unless the investments are trading securities. Income on investments ofdonor-restricted funds and endowment funds is recorded as an increase in unrestricted net assets, unless restricted by the donor. Realized gains and losses are computed using the specific identification method. ICH utilizes several investment managers to diversify the investment portfolios. Investments in joint venture partnerships which are 50'/0 or less owned are reported on the equity method of accounting which approximates KH's equity in their underlying net book values. Board-Designated A»eb Board-designated assets consist of unrestricted donations and accumulated income which have been designated by the Board of Trustees for expansion. The Board can redesignate these assets at its discretion. 9 Kapi`olani Health Notes to Combined Financial Statements (continued) 1.Organization and Summary of Accounting Policies (continued) Pledges Pledges (unconditional promises to give), less an allowance for uncollectible amounts, are recorded as receivables in the year made. Restricted pledges are reported as additions to the appropriate temporarily or permanently restricted net asset balance. Temporarily and Permanently Restrlcted Net Assefs Restricted net assets consist of donations and other funds where restriction have been unposed as to their use by the donor for specific operating purposes. Temporarily restricted net assets consist of those net assets whose use by KH has been limited by donors to a specific purpose or time period. Permanently restricted net easels consist of the principal amount of net assets whose use by donor; has been restricted is perpetuity, Deferred FYnancing Coat Costs of issuing long-term debt have been capitalized and are being amortized over the terms of the obligation using an interest method. The amortization is included in depreciation and amortization expene. Statement of Cash F7owa Highly ligwd investments with a maturity of three months or leas when purchased are conidered cash equivalents. Net Patient Service Revepue and Accounts Receivable Net patirnt service revenue is reported at the estimated net realizable amounts lion patirnts, third-Party payors, and others for services rrndered, including estimated retroactive adjustments under reimbursement agreements with third-Party pyora. Significant concentration of gross patirnt accounts receivable include the Hawaii Medical Service Association - 23%, State of Hawaii's QUEST pmgrtrm - 16%. Medicaid • 19°/a ~ Medicare - 19% as of June 30, 2000. 10 Kapi`olani Health Notes to Combined Financial Statements (continued) 1.Organization sod Summary of Accounting Policies (continued) Government Reimbursement Programs KH rrndets services to patirnts under a contractual arrangement with the Medicare and Medicard programs based primarily on a Prospective Payment System (PPS). The percentage of patient service revenue applicable to the Medicare and Medicaid programs, respectively, approximated 18% and 9% in fiscal year 2000 and 17% and 8% in fiscal year 1999. PPS payment rates for Medicare acute inpatient services are based on clinical, diagnostic, and other factors; and for Medicaid are based upon a per diem rate for routine services and a per discharge rate for ancillary services. ]npatient nonacute services, outpatient sernces and defined capital costa related to Medicare and Medicaid brneficiaries are paid based upon fee schedules or a cost reimbursement method. KH is reimbursed tot these reimbursable items at an interim rate; final settlement is determined after annual cost reports submitted by KH are audited by the fiscal intermediary. Normal estimation differences betwern final settlemrnts and amounts accrued in previous years are reported as current year deductions firm revenues. Laws and regulations govcming the Medicare and Medicaid programs are complex and subject to interpretation. Other than the matter discussed in the last paragraph of Note 7, KH believes that it is in compliance wrth all applicable laws and regulations and is not aware of any pending or threatrned investigation involving allegations of potential wrongdoing that would have a material impact in its financial position on June 30, 2000. While no such regulatory inquiries have barn made, compliance with such laws and regulations can be subject to future govemmrnt review and interpretation as well as srgmficant regulatory action including fines, penalties, and exclusion fiom the Medicare and Medicaid programs. In 1995, ISH entered into several agreements with prepaid health plant to provide hospital services to plan members who are eligible to participate in the State of Hawaii's QUEST program. The plans committed to share any favorable or unfavorable experiences with KH under terms agreed upon by KH and the plans. Management don not expect a material impact to the combined financial statements as a result of the risk abating provisions of the agreemrnts. The percrntage of patient service revrnue applicable to the QUEST program approximated 20% and 22% in fisca12000 and 1999, respectively. 11 Kapi`olani Health Notes to Combined Financial Statements (continued) 1.Organization and Summsry of Accounting Policies (continued) Charity Care ICH will treat paUrnts regardless of the>r ability to pay. An established charity cats policy sets guidelines to determine which patients qualify for cats gives at no charge. Since KH does not pursue collection from qualified charity taro patirnta, they are not reported es revenue. Recorded charity care provided in both 2000 and 1999 comprised leas thaw 1% of total revenue. Revenues I{Ii's purpose is to provide diversified health taro services primarily in the State of Hawaii and secondarily in t}te Pacific Basin. Hrnce, operating tsvmues include those grnerated from direct patient taro, rrntala from medical office buildings, grants, fundraising activities, investing activities, and other tsvrnues, all of which aro either directly related to or used in support of the operation of KH's facilities. Convetaely, unrestricted donations and disposal of equipment are reported as nonoperating gains and losses. Fair Value of Financial Instrument: The carrying amounts reported in the balance sheet for cash and cash equivalents, receivables, accounts payable and accrued expenses approximate fair value due to the short-term natttro of these instruments. Fair values for long-term debt arc estimated using quoted market prices of similar types of borrowings. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying note. Actual tssults could differ from those estimates. 12 Kapi`olanl Health Notes to Combined Financial Statements (continued) 1.Organization and Summary of Accounting Policies (continued) Reclasslllcations Certain 1999 balances have been reclassified to conform with 2000 presentation. Functional Classiflcatlon ofE:penaes The functional classification of expenses by major classes of program services and supporting activities are summarized as follows: 2000 1999 Amite hospital care S 144,728,542 S 147,124,086 Management and general 75,241,243 73,219,006 S 219,976,785 S 222,343,092 2. Investment lnvestments stated at fair value as of June 30 are as follows: 2000 1999 Des~ated by Board for expansion: F_quity securities S 78337,032 S 67,845,913 U.S. Tteasuryand agency obligabans 6,600,60E 10,676,239 Iamited parmenhip 2,948330 - Real estate 5,467,801 - Cotponte debt securities ] 4,857,940 37,904,262 108,240,999 116,426,434 Project funds held by twtee under band indenture egreemeot: Ca>b and short_t~ imKSbrcnn 8363,346 399,130 U.S. Tteasttry and sgenay obhgabons - 7,933,447 8,563346 8,334,377 Restricted by donor ar grantor. Cash 1,333 676 i;ytuty secimties 3,440,605 2,808,721 I.i®ted partaerahip 29,612 - Real estate 61,810 53,178 U.S. Treasury and agency obligations 892,242 1,181,779 Corptnate debt seeinitia 315,158 420,487 4,761,760 4,464,814 Less current portion of proleet funds held by trustee under bawd iodedine agreement 8,563346 8.448,618 S 113,009.15! S 120.997,237 13 Kapi`olani Health Notes to Combtned Financial Statements (continued) 2. Investments (continued) Investment income and gains for assets limited as to use, cash equivalents, and other mvestmrnts are comprised of the following for the years rnded June 30, 2000 and 1999: 2000 1999 Other revrnuea: Interest income 5 5,214,509 S 6,215,919 Realized gains on sales of securities 21,094,065 6,812,579 S 26,308,574 S 13,028,498 Other changes in unrestricted net assets: Unrealized (losses) gains on other than trading securities S (3,150,422) S 811,271 3. Property and Egalpment Property and equipment is summarized as follows: 2000 ]999 Land S 14,940,026 S 15,900,255 Land improvements ],]83,852 1,183,852 Buildings and improvemrnts 166,207,436 164,557,660 Fixed equipment 10,4]4,566 10,272,632 Major movable equipment 93,953,635 88,622,638 Minor equipment 2,029,363 1,940,448 Capitalized leases 2,988,956 2,988,956 Corutruction in progress 3,514,191 4,851,657 295,232,025 290,318,098 Less accumulated depreciation and amortization 142 8S 42 126 594 144 Property and equipment, net S 152,846,600 S 163,72 ,954 14 Kapi`olani Health Notes to Combined Financial Statements (continued) 4. Peasioa Plaaa Eligible employees of KH are covered under its noncontributory, defined-brnefit pension plan. I{H's plans were combined into one plea effective July 1, 1995. I{Ii's plan cover; substantially all employees of KH and affiliates meeting minimum eligibility requirements. Brnefits are based on years of service and a percentage of the employee's comprnsation. ICH's policy is to accrue actuarially determined net periodic prnsion costs and to annually contribute an amount within regulatory guidelines. The plan's funded status and amounts recognized in KH's balance sheets at June 30 are as follows: Juae 30 2000 1999 Benefit obligation S 42,830,000 S 40,800,000 Fair value of plan assets (primarily marketable equity securities) 47,288,000 41,971,000 Funded status S 4,458,000 S 1,171,000 Accrued brnefit cost recognized in the Combined Balanced Sheets S 3,784,325 S 2,841,316 Weighted Average Assumptions: Discount rate 7.75% 7.50'/e Expected rehun oa plan assets 8.00% 8.00'/e Rate of compensation increase 5.00% 5.00% Benefit cost S 2,569,000 S 1,988,000 Employs contributions S 1,626,000 S 1,778,000 Benefits paid S 1,358,000 S 1,315,000 15 Kapi`olani Health Notes to Combined Financial Statements (continued) 5. Long-Term Debt and Note Payable to Bank 2000 1999 Sines 1996 Special Purpose Revenue Bonds (face value of 554,195,000 leas unanrornud diacormt of S376,583 based on effective mterat rates ranging from approximately 4.75% to 5.60%), ntcest payable semi- annually at rates ranging from 4.95% to 6.25%, principal payments n varying annual amounts ranging from 5840,000 to 52,475,000 due July 2000 through 2019; 511,780,000 due July 2020, 512,520,000 due July 2021 S 53,818,417 5 54,605,269 Sines 1993 Special Purpose Revenue Bonds (face value of 5101,925,000 leas unarmrtixed dracornt of 51,768,516 based on effective i>rter+est rata ranging from approximately 4.OOX to 7.00X), interest payable Berm-annually at rates ranging from 5.40% to 6.4096, principal payments n varyng annual amormb ranging from 51,860,000 to 53,300,000 due July 2000 through 2003; 519,780,000 due July 2004 through 2008; 526,890,000 due July 2009 through 2013; and 545,015,000 due July 2014 through 2019 100,156,184 101,831,264 Sines 1991 Special Propose Revenue Bonds, interest payable senu-annually at rtes ranging from 6.90Yo to 7.00%, principal paymenu in varying annual amounts ranging from 5925,000 to 5990,000 due July 2000 through 2001 1,915,000 2,775,000 Carry forward 155,689,901 159,211,533 16 Kapi`olani Health Notes to Combined Financial Statements (continued) 5. Long-Term Debt and Note Payable to Bank (continued) 2000 1999 Carry forward S 155,889,901 S 159,211,533 Nou payable wrth interest at 12%; pnnctpsl and intercat payable in monthly installments rurgmg from 534,367 to 555,612 through July 2003 end the balance due on August 1, 2003 cvtth the ophan to exund the tnatunty daze to August 1, 2006; collateralized by all leasehold rmprovemrnts, fumitutt, futures and equipment of I{H's corporau offices with a carrying value of approxrrnauly 56,096,431 1,766,297 1,990,130 l~t}rer 823,084 873,418 158,479,282 162,075,081 Less ciarent pornon (3,844,936) (3,620.794) S 154,63446 S 158.454,287 The 1996, 1993, and 1991 Series Special Purpose Revrnue Bonds are secured by a security interest in the gross receipts and pledged assets of the Obligated Group (KH - patent company only. ICMCWC, and I{MCPIvn as defined in the Master Indenture. The 1993 Bonds are subject to redemption on or after July 1, 2003, at redemption prices ranging from 100% to 102% of the principal amount of the bonds being redeemed. Series 1993 term bonds have mandatory sinking fund requirements effective July 1, 2004, payable in annual amounts ranging from 53,490,000 to 58,635,000. In January 1993, the Obligated Group made an advance refunding of 565,365,000 of the Series 1991 Special Purpose Revenue Bonds, by issuing Series 1993 Special Purpose Revenue Bonds and purchasing Government Obligations deposited with an escrow agent under an Escrow Agreement. The principal and interest on such Government Obligations provides suf5cimt funds to pay the principal end interest on the Series 1991 refunded Bonds. The outstanding principal balance on the refunded Bonds which were not included in the accompanying financial atatemrnts amounted to 565,665,000 as of both Jtme 30, 2000 and 1999. ' 17 Kapi`olani Health Notes to Combined Financial Statements (conttnued) 5. Long-Term Debt and Note Payable to Bank (conNnoed) Approximately 515,800,000 of the Series 1993 bonds (net of discount and issuance coats) were issued to finance renovation of and construction at KMCWC and purchase additional equipmrnt (the "1993 ItMCWC Project's as described in the Indrnture. KMCWC completed this project in August 1995. In April 1996, the Series 1996 Special Purpose Revrnue Bonds of 555,000,000 were issued to assist the Obligated Group in fmancing or refinancing, or both, new construction and renovation and equipment purchases (the "1996 ICapi'olani Pmject'~ as described in the Indrnture and Loan Agreement. KH completed this project in Apri11999. As of June 30, 1999 the Obligated Group had an outstanding irrevocable standby letter of credit in the pnncipal amount of 51,059,300, expiring July 1, 2001, to fund its Bond Reserve Fund. An annual commitment fee is payable ranging from $8,000 to 518,600 based upon the Obligated Group's long-term debt service coverage ratio. In addition, 58,563,346, included in current assets, is held by the Bond Trustee to fiord cunsnt principal maturities and accrued interest payable. Long-term debt maturities for the years succeeding June 30, 1999 are: 2001 S 3,844,936 2002 3,925,336 2003 4,273,399 2004 4,536,548 2005 4,819,930 Thereafter 137,079,133 S 158,479,282 Interest paid during the years rnded June 30, 2000 and 1999 was approxtmately 510,039,901 and S10,232,738, respectively. The fair value of long-tens debt as of June 30, 2000 and 1999 was approximately 5158,774,034 and 5171,775,070, respecdvely. 18 Kapi`olant Health Notes to Combined Financial Statements (continued) 5. Long-Term Debt and Note Payable to Bank (continued) I{H also has available a $10,000,000 unsecured revolving line of credit, expiring April 16, 2001. The interest rate on the line is a floating,rate based on the bank's base rate. I{li also has available a $2,000,000 irrevocable standby letter of credit to support the obligations of ICHIi as a State of Hawaii QUEST provider. The letter of credit is automatically renewable annually at the discretion of the bank. 6. Leases Leases on various types of office and storage space, office equipment and furniture are classi5ed as operating leases. Future minimum lease payments under noncancelable operating leases are as follows: Year ending June 30 2001 S 1,660,589 2002 1,752,046 2003 1,824.247 2004 979,287 2005 949,307 Thereafter 1,090,656 Total minimum lease payments $ 8,256,132 Rental expense paid during the years ended June 30, 2000 and 1999 was approximately $1,951,000 and 51,728,000, rsapectively. 7. Commitmenb and Contingencies Unemployment Claims KH is self-insured for substantially all of its unemployment claims. Claims for unemployment are insigni5cant and expensed when incurred. 19 Kapi`olatti Health Notes to Combined Financial Statements (continued) 7. Commitments and Contingencfea (contlnued) Workers' Compensation Clalma KH is self-insured for workers' compensation claims (effective March 1994, I{MCPM began self-insuring its workers compensation claims ands KH's pmgram). Ia lieu of a bond, the System has an outstanding letter of credit in favor of the State of Hawaii in the principal amount of $1,000,000, as required by self-insurance regulations of the State. The letter of credit is automatically renewable annually, but not beyond February 1, 2004. Claims administration is performed by a claims adjusting company. The claims adjusting company provides KH with estimated claims paymenffi which KH accrues ao iffi workers' compensation expense. In the opinion of management, adequate acavals have bem provided for known and incurred but not reported workers' compensation claims. Medical Malpnctlce Insurance ICIi is insured for medical malpractice claims. ceneratly, medical malpractice insurance policies have included a shared deductible provision, which is currently SOX of the indemnity loan, up to a $25,000 maximum deductible per claim. Primary coverage is $1,000,000 (occurrence basis) with excess coverage of 519,000,000 for KMCWC and $9,000,000 for KMCPM (claims-made basis, with a seven year prepaid discovery period). I{MS' primary coverage is $1,000,000 (occurrence basis) with excess coverage of $2,000,000 with a combined deductible of SS0,000. Medical malpractice expeoae, including estimated accruals for amounts below the deductible provisions, totaled $2,394,000 and $2,263,000 for the years ended June 30, 2000 and 1999, respectively. Construction-In-Progreso Commitrnenffi to complete operating room renovations for KMCWC totaled approximately 51,750,000 as of June 30, 2000. Estimated completion date of the renovations is December 2000. 20 Kapi`olani Health Notes to Combined Financial Statements (continued) 7. Commitments and Contingencies (continued) Debt Service Forward Delivery Agreement KH has executed a debt sernce forward delivery agreemrnt with a financial institution related to the semi-annual payments on the Series 1993 Special Purpose Revenue Bonds in which it received payment in exchange for the potential interest earnings on the serai- annual paymrnts placed in escrow prior to payment to the bond holden. The agreement represents a put option premium which is measured at fav value. If KH terminates the agreement, it will be obligated to reimburse the financial institution for its economic losses incurred as the result of the termination. Losses, if any, will be determined at the date of termination. The financial institution has the right to terminate the agreement commrncing in 2004. If it elects to do so, KH would be obligated to reimburse up to a maximum of $2,650,000. Management has no present intention to terminate the agreement. Health Systems Affliatlon Agreemwt In March 1996, KH, Wilcox Health System ("Wilcox' and The Queen's Health Systems ("QHS' rntered into a Health Systems Affiliation Agreement ("Agnement'~ where KH and QHS agreed to make grants of 55,750,000 to Wilcox (53,500,000 firom KH and 52,250,000 from QHS) over the next four years provided that Wilcox satisfy certain financial and operational conditions. In November 1997, the agreement was amended where KH and QHS agreed to make additional grants of 51,000,000 to Wilcox (5500,000 from KH and 5500,000 from QHS) in equal installments over the next four years beginning January 10, 1998 provided that Wilcox continues to satisfy the certain financial and operational conditions. The agreement was further amended in February 1999 to provide for a change in the timing of cash payments, but not the total amount to Wilcox. Under the amendments, KH will pay 563,079 per month through February 2002, provided that Wilcox satisfies certain financial and operational conditions. Ia consideration of the grant payments described above, KH received a 50% interest in the land under the Kauai Medical Group facilities from Wilcox. KH and QHS were each allowed to appoint one member to Wilcox's Board of Directors and one member to the Wilcox physician group's board of directors. 21 Kapi `olani Health Notes to Combined Financial Statements (continued) 7. Commitments and Contingencies (continued) Other During 1998, management became aware that cerlsin billing errors had occurred in the Kapiolani Home Health Services and Kapiolani Extended Care subsidiaries. Settlement of approxunately 54 million was paid in August 1999 and has been accrued as a charge in the accompanying Combined Statements of Unrestricted Revenue, Expenses and Other Changes in Net Assets for the year ended June 30, 1999. 8. Related Party Traosactlous A joint vrnture investmrnt of KH provides laundry services to KH. Payments for services totaled 5994,000 and 5964,000 in 2000 aad 1999, respectively. KH paid approximately 56,314,000 and 56,634,000 for laboratory services provided by a joint vrnture in 2000 aad 1999, respectively. Payments made to Parhurs Health Hawaii for managemrnt fees totaled 5115,000 and 5709,000 in 2000 and 1999, respectively. Notes receivable from an affiliate totaled 5375,000 as of June 30, 1999. The notes receivable from an affiliate was zero as of ]une 30, 2000. 9. Diacootlnued Operations Tn October 1999, the Board of Directors approved management's decision to discontinue its health insurance plan business and, KH and KHH entered into a Reorganization Agreement with Hawaii Medical Services Association, ("1~IIvJSA'~. Under the Agreement, effective November 1, 1999 substantially all of KHH'a commercial healUr insurance contracts were assigned to HMSA. The assigned contracts expire at various dates through January 2001. KHH also assigned its State Health Fund contract to HMSA on July 1, 2000 which expires on June 30, 2001. KH and KHH remain contingently liable for aggrcgete losses on the assigned contracts. No consideration was exchanged in connection with the assignment. 22 Kapi`olani Health Notes to Combined Financial Statements (continued) 9. Discontinued Operations (continued) ICHFi will retain its Medicaid (QUEST) business until the QUEST contract between ICHIi and the State of Hawaii expires on June 30, 2002. HMSA operates the QUEST business solely for admmistrative purposes under a third party administration agreement. ICHIi continues to assume full financial responsibility for the QUEST contract. In accordance with the Reorganization Agreement, KH executed a guarantee to HMSA that KHH will maintain adequate capital levels to meet its net worth requirsmrnts pursuant to the HMO Act and to reimburse HMSA for any aggregate losses on the assigned commercial contracts and assume full fmancial risk for any losses incurred in relation to its QUEST contract. Accordingly, the 2000 and 1999 operating results of KHH have been segregated from contmuing operations and reported as discontinued operations in the Combined Statements of Unrestricted Revrnue, Expenses and Other Changes in Net Assets. Operating results 5om discontinued operations (July 1 to October 31, 1999), exclusive of intercompany revenue and exprnse transactions which are eliminated upon consolidation of ICIi, are as follows: 2000 1999 Premium revenue $ 26,457,512 S 63,697,381 Other operating revenue - ],799,389 Medical claims expense (22,996,672) (52,971,174) General utd administrative expense (3,872,090) (11,073,6717 Operating (loos) income $ (411,250) S 1,451,920 Operating loss from discontinued operations for the period November 1 through June 30, 2000 is 57,983.951. 23 Kapi`olani Health Notes to Combined Financial Statements (continued) 9. Discontinued Operatlona (continued) The net assets of I{FII3 included in the accompanying combined balance sheets consisted of the following: 2000 1999 Cash and cash equivalents S 9,293,553 S 17,852,577 Receivables 1,590,963 1,431,909 Due from affiliate (net) 1,106,636 - Othercurrent assets 58,525 89,734 property and equipment, net 974,269 2,032,730 Other net assets - 50,000 Total assets of discontinued operations 13,023,946 21,456,950 Accounts payable 592,841 541,583 Accrued liabilities 7,664,983 8,625,537 Medical claims payable 4,581,122 9,886,514 Other current liabilities - 323,901 Other long-tens liabilities 185,000 - Total liabilities of discontinued operations 13,023,946 19,377,535 Net assets of discontinued operations 5 - S 2,079,415 The cost of health care services provided or contracted for is accrued in the period in which tt is provided to a member based in part on estimates, including an accrual for medical services Provided but not reported to We HMO. Reinsurance premiums are included in health care costa, and reinsurance recoveries are reported as a reduction of related health care costa. The estimated loss on disposal of discontinued operations of S 10,483,951 is comprised of 57,983,951 in operating losses from November 1 through June 30, 2000, approximately 52,275,000 for operational losses during the phase out period (net of estimated reinsurance recoveries) and severance pay of approximately 5225,000. 24 Combined Financial Statements itapi`olani Health Years ended June 30, 1999 and 1998 Kapi`olani Hea':h Combtned Ftnanctal _..::.:ments Years ended June 30, 1999 and 1998 Contents Keport of Independent Auditots l Financial Statements Combined Balance Sheets ..................................................................................................2 Combined Statemrnts of Apetanons .................................................................................4 Combined Statemrnts of Changes in Net Assets ...............................................................5 Combined Statements of Caah Flows ................................................................................6 Notes to Combined Financial Statements ........................................................................8 ERNST&YOUNG LLP ..,:_,=,_a- mae s 7none 9,~.>;--?~_~_- ~ - Inonol~i., Na~4aii 9681134?? Report of Independent Auditors Board of Trustees Kapi'olam Health We have audited the accompanying combined balance sheets of Kapi`olani Health as of June 30, 1999 and 1998, and the related combined statements of operations, changes m net assets and cash flows for the years thrn ended. These financtal statements are the responsibility of the Company's management. Our responsibility is to express an opuuon on these financial statements based on our audits. We conducted our audits in accordance with grnerally accepted auditing standards. Those standards requue that we plan and perform the audit to obtain reasonable assurance about whether the financtal statemrnts are free of material misstatement. An audit includes examuung, on a test bests, evidence supporting the amounts and disclosures m the financ~a] statements. An audit also includes assessing the accounting principles used and srgmficant estimates made by management, as well as evaluating the overall financial statement presentation We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statemrnts referred to above presrnt fairly, in all material respects, the combined financial position of Kepi `olani Health at June 30, 1999 and 1998, and the combined results of its operations and changes in net assets, and its cash flows for the years thrn rnded, m conformity with generally accepted accounting principles. f October 7, 1999 except for Note ] 0, as to which the date is October 18, 1999 Ernst & Young ur is a member of Ernst & Young International Ltd 1 Kapi`olatti Health Combined Balance Si~eets June 30 1999 1998 Assets Cutrrnt assets: Cash and cash equivalents S 40,834,714 $ 15,489,629 Net patient accounts receivable, less allowance for doubtful accounts (1999- $14,603,000; 1998 - $11,888,000) 43,395,316 53,999,437 Other receivables 3,490,544 5,762,048 Inventories 1,659,892 1,662,519 Funds held by trustee under bond indenture agreemrnt (Ivores :and S) 8,448,618 7,565,723 Prepaid expenses and other current assets 1,762,747 1,823,253 Total current assets 99,591,831 86,302,609 Assets whose use is limited or restricted. Designated by Board for expansion: Cash and cash equivalents 5,084,272 6,424,938 Accrued interest receivable 700,050 598,078 Investments (Note 2) 116,426,434 123,043,302 Rrntal property 497,430 497,430 122,708,186 130,563,748 Project funds held by trustee under bond indenture agrecmrnt (Notes 2 and S) 105,959 10,736,642 Restncted by donor or grantor: Cash and cash equivalents 1,624,913 1,938,379 Grants and other receivables 1,366,585 826,411 Rrntal property 959,276 1,084,735 Investmrnts (Note 2) 4,464,844 3,296,487 8,415,618 7,146,012 Total assets whose users limited or restncted 131,229,763 148,446,402 Property and equipment, net (Notes 3, S and 7) 165,756,684 162,228,215 Other assets: Investment in joint venture parinershrps (Note 8) 1,797,226 2,606,747 Deposits and other noncurrent assets 7,706,636 5,361,452 9,503,862 7,968,199 Total assets 5406,082,]40 $404,945,425 2 June 30 1999 1998 Liabilities and net assets Cuaent habilitres• Accounts payable $ 20,483,796 $ 20,394,752 Payroll and related Irabilitres 10,643,866 11,612,453 Accrued expenses 15,837,430 12,012,813 Medical claims payable 9,886,5]4 10,815,807 Due to governmental agencres 5,617,6]4 3,967,027 Agency funds held for others 405,863 38,457 Note payable to bank - 3,000,000 Current portion of long-term debt (Note S) 3,620,794 2,652,740 Total current liabilities 66,495,877 64,494,049 Accrued benefit cost (Note 4) 2,841,316 2,631,847 Long-term debt, less current portron (Note S) 158,454,287 162,056,574 Unearned income 1,604,885 1,535,107 Other long-term liabilities 4,780,671 2,633,062 Net assets: Unrestricted 160,488,483 161,489,768 Temporarily restricted: Specrfic purposes 6,909,32] 6,064,446 Plant replacement and expansron 656,258 651,223 7,565,579 6,715,669 Permanently restncted 3,851,042 3,389,349 171,905,]04 171,594,786 Total liabilities and net assets 5406,082,]40 5404,945,425 See accompanyrng notes 3 Kapt`olani Health Combined Statements of Cash Flows Yesr ended June 30 1999 1998 Operating activities Change in net assets S 310,318 $ 11,625,703 Adjustments to reconcile the change in net assets to net cash provided by operating activities: Depreciation 16,403,011 14,583,586 Amortization of bond discount 76,929 113,368 (Income) loss on disposal of equipment (149,277) 1,894,701 Ioint venture investment loss 278,860 440,309 Net unrealized gains on investments, other than trading securities (513,271) (3,558,285) Decrease in restricted rental property 125,459 131,834 Restricted investment income (461,693) (443,647) Changes in operating assets and liabilities: Decrease (increase) in patient accounts receivable ] 0,604,121 (15,601,203) Decrease (increase) in other receivables 2,271,504 (1,881,421) Increase in inventories and other assets (2,282,051) (3,309,038) Increase in funds held by trustee under bond indenture agreement (882,895) (805,484) Increase in accounts payable and accrued expenses 2,917,585 9,542,746 (Decrease) increase in medical claims payable (929,293) 9,036,897 Increase (decrease) in net amounts due to third- partypayors 1,650,587 (241,921) Increase (decrease) in liability for estimated malpractice costs 27,489 (77,047) Increase (decrease) in agency funds held for others 367,406 (31,010) Increase in other long-term liabilities 2,217,387 2,633,062 Net cash provided by operating activities 31,734,176 24,053,150 6 Kapt`olant Health Notes to Combtned Ftnanctal Statements June 30, 1999 1. Organization and Summary of Accounting Policies Kapi`olam Health ("KFi") convols Kap~`olam Medical Center for Womrn and Children ("KMCWC"), Kapi`olam Medical Center at Pah Mono ("KMCPM'~, Kapi`olani HealthHawai'~ ("KHH'~, Kapi`olani Health Foundation and other health care related entities located m Hawaii. KH has also organized other corporations and health care related entntnes to accomplish its objectives. It controls all subsidiaries through stock owners}up (taxable corporations) and affiliates through board membership and managemrnt (nontaxable corporations). All interorgamzational transactions and balances have been eliminated in combination. KH is snot-for-profit support organization as described in sections 501(c)(3) and 509(a)(3) of the Internal Revrnue Code ("IItC'~. KH and all other significant combined affiliates are not-for-profit corporations exempt from federal and state taxes on related income pursuant to IRC Section 501(a) and the related Hawaii Revised Statutes, respectively. The accounting pnnciples followed by KH, its subsidiaries and affiliates, and the methods of applying those pnnciples comply with grnerally accepted accounting pnnciples and grneral practice within the health care industry. The significant policies are summanzed below. Inventories Inventones are valued at the lower of cost (first-in, first-out method) or market Property and Equipment Property and equipmrnt acquisitions are recorded at cost. Depreciation is computed using the straight-line method over the estimated useful lives of the assets, ranging from 5 to 40 years for buildings and impirovemrnts and 3 to 20 years for equipment. Equipment under capital lease obligations is amortized on the straight-line method over the shorter period of the lease term or the estimated useful life of the equipmrnt. Such amortization is included in depreciation and amortization in the financial statetnrnts. Interest cost incurred on borrowed funds during the period of construction of capital assets is capitalized as a component of the cost of acquiring those assets. Kapi`olant Health Notes to Combined Financial Statements (continued) I. Organization and Summary of Accounting Policies (continued) Property and Equipment (contlnued) Gifts of long-Irved assets such as land, buildings, or equipmrnt are reported as unrestricted support, and are excluded fium the excess of revenues over expenses, unless explicit donor stipulations specify how the donated assets must be used. Gifts of long- ]rved assets with explicit restrictions that specify how the assets are to be used and gifts of cash or other assets that must be used to acqurre long-lived assets are reported as resmcted support. Absrnt explicit donor stipulations about how long those long-lived assets must be maintained, expirations of donor restrictions are reported whrn the donated or acquired long-lived assets are placed in service. Investments Investments m equity securities with readily determinable fair values and all investments rn debt securities are measured at fair value in the balance sheet. Investment income or loss (including realized gains and losses on investments, interest and dividends) is included in the excess of revenues over expenses and reported as other revenues unless the income or loss is restricted by donor or law Unrealized gains and losses on investments are excluded from fire excess of revenues over expenses unless the investments are trading securities. Income on invesunrnts of donor-restricted funds and rndowmrnt funds is recorded as an increase m unresmcted net assets, unless resmcted by the donor. Realized gains and losses are computed using the specific identification method. KH utilizes several investmrnt managers to diversify the rnvestmrnt portfolios. Investmrnts in joint venture partnerships which arc 50% or less owned are reported on the equity method of accounting which approxrmates I{H's equity in their underlyrng net book values. Board-Designated Assets Board-designated assets consist of assets held by trustees under indrnture agreements and unresmcted donations and accumulated income which have been designated by the Board of Trustees for expansion. The Board can redesignate these assets at its dtscreuon. 9 Kapi`olant Health Notes to Combined Financial Statements (continued) 1.Organization and Summary of Accounting Policies (continued) Pledges Pledges (unconditional promises to give), less an allowance for uncollectible amounts, aze recorded as receivables in the year made. Restricted pledges are reported as additions to the appropriate temporarily or periiianrntly restricted net asset balance. Temporarily and Permanently Restricted Net Asaet: Restricted net assets consist of donations and other funds where restrictions have been imposed as to their use by the donor for specific operating purposes. Temporarily restricted net assets consist of those net assets whosc use by KH has been limited by donors to a specific purpose or time pcnod. Permanrntly restricted net assets consist of the principal amount of net assets whose use by donors has bern restricted in perpetwty. Deferred Financing Costs Costs of issuing long-term debt have been capitalized and are being amortized over the terms of the obligations using an interest method. The amortization is included in depreciation and amortization expense. Statement of Cssh Flows Highly liquid investments with a maturity of three months or less when purchased are considered cash equivalents. Net Patient Service Revenue and Accounts Receivable Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others for services rendered. Retroactive adJustmrnts are accrued on an estimated basis m the period the related services are rrndered and adjusted m future periods as final settlements are deteimmed. Significant concrnvations of gross patient accounts receivable include the Hawaii Medical Service Association - 17%, State of Hawaii's QUEST program - 17%, Medicaid - 25%, and Medicare - 13% as of June 30, 1999. 10 Kapi`olani Health Notes to Combined Financial Statements (continued) 1.Organization and Summary of Accounting Policies (continued) Charity Care KH will treat padrnts regardless of their ability to pay. An established chanty care policy sets guidehnes to determine which patients qualifi~ for care given at no charge. Since KH does not pursue collection brorri qualified chanty care patients, they are not reported as revrnue. Recorded charity care provided m both 1999 and 1998 comprised less than 1% of total revrnue. Revenues ICIi's purpose is to provide diversified health care services primarily in the State of Hawaii and secondarily is the Pacific Basin. Hence, operating revenues include those generated from direct patient care, rentals from medical office buildings, grants, fundraising activities, investing activities, and other revrnues, all of which are either directly related to or used in support of the operation of KH's facilities. Conversely, unrestncted donations and disposal of equipment are reported as nonaperatmg gains and losses. HMO Premium Revenge Premiums arc billed in advance of the respective coverage period and are recorded as revenue in the month services are provided. Group contracts are grnerally twelve months in duration, subject to cancellation, and are subject to rating, brnefit and other changes negotiated on an annual basis. HMO Medical Claims E:pease ICffi-I contracts with various health care providers for the provision of certain medical care services to its members. The cost ofhealth care services provided or contracted for is accrued in the penod m which it is provided to a member based in part on estimates, including an accrual for medical services provided but not reported to the HMO. Reinsurance premitmis are included in health care costs, and reinsurance recovenes are reported as a reduction of related health care costs. 12 Kapt`olant Health Notes to Combtned Ftnanctal Statements (continued) 1.Organization and Summary of Accounting Policies (continued) Fair Value of Financial Instruments The carrying amounts reported m the balance sheet for cash and cash equivalents, receivables, accounts payable and accrued expenses approximate fair value due to the short-term nature of these instruments. Fair values for ]ong-teen debt are estimated using quoted market pnces of similar types of borrowings. Use of Estimates The prcpazatron of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the amounts reported m the financial statements and accompanying notes. Actual results could differ from those estimates. Pension Disclosures In February 1998, the Financial Accounting Standards Board issued Statement of Financial Accounting Standards No. 132, "Employers' Disclosure about Pensions and Other Postretiremrnt Benefits" (SFAS 132). SFAS 132 revises the disclosure requirements of Statements of Financial Accounting Standards No. 87, "Employers' Accounung for Prnsions", No. 88, "Accounting for Settlements and Curtailments of Defined Brnefit Prnsrons Plans and for Termination Benefits" and No. 106, "Et»ployets' Accounting for Postretinemrnt Benefits Other Than Pensions." SFAS 132 does not change the recognition or measurement of pension or postretirement benefit plans, but standazdizes disclosure requiremrnts for pensions and other postretiremrnt benefits. ICH adopted the provisions of SFAS 132 effective July 1, 1998. Reclassifications Certazn 1998 balances have been reclassified to conform with 1999 presentation. 13 Kapt`olani Health Notes to Combined Ftnanctal Statements (continued) 1.Orgsnizatioa and Summary of Accounting Policies (continued) Functional Classification of Expenses The funcuona] classiScation of expenses by maJor classes of program services and supporting activities are summarized as follows: 1999 1998 Acute hospital Dane S 147,124,083 S 144,722,390 Managed care 55,371,761 29,835,324 Other healffi care related activities - 2,374,327 Management and general 83,890,202 82,862,577 S 286386,046 $ 259,794,618 2. lovestments Investments stated at fau• value as of June 30 are as follows: 1999 1998 Designated by Board for expansion: Equity securities S 67,845,913 S 82,859,192 U.S. Treasury and agency obligations 10,676,259 17,336,123 Corporate debt securities 37,904,262 22,847,987 l 16,426,434 123,043,302 14 Kapt`olant Health Notes to Combtned Ftnanctal Statements (conttnued) 2. Investments (continued) 1999 1998 Project funds held by trustee under bond indenture agreement: Cash and short-term investments S 599,130 $ 30,607 U.S. Trcasury and agency obligations 7,955,447 18,271,758 8,554,577 18,302,365 Restncted by donor or grantor: Cash 676 1,019 Equtty secunties 2,808,724 1,764,163 Real estate 53,178 53,178 U.S. Treasury and agency obligations 1,]81,779 1,258,053 Corporate debt secunties 420,487 220,074 4,464,844 3,296,487 Less current portion of project funds held by trustee under bond indenture agreement 8,448,618 7,565,723 S 120,997,237 $ ]37,076,431 Investment income and gazns for assets lirrttted as to use, cash equivalents, and other investments are compnsed of the following for the years ended )tine 30, 1999 and 1998: 1999 1998 Income: Interest income S 6,215,919 $ 6,774,307 Realt2ed gains on sales of securities 6,812,579 7,227,649 S 13,028,498 $ 14,001,956 Other changes rn unrestncted net assets. Unreahzed gazns on other than trading secttnttes S 811,27] $ 3,558,285 15 Kapt`olani Health Notes to Combined Financial Statements (continued) 3. Property and Equipment Property and equipmrnt is summarized as follows: 1999 1998 Land S 15,900,255 S 15,900,255 Land improvements 1,183,852 1,166,424 Buildings and improvements 164,577,657 154,070,505 Fixed equipment 10,272,632 9,927,156 Mayor movable equipment 91,329,311 82,480,478 Minor equipment 1,954,860 1,825,434 Capitalized leases 2,988,956 2,988,956 Construction in progress 4.877,616 5,386,087 293,085,139 273,745,295 Less accumulated depreciation and amortization (127,328,455) (111,517,080) Property and equipment, net S ] 65,756,684 S 162,228,215 4. Pension Plaua Jane 30 1999 1998 Benefit obligation S 40,800,000 S 36,438,000 Fair value of plan assets (primarily marketable equity securities) 41,971,000 39,468,000 Funded status S 1,171,000 $ 3,030,000 Accrued benefit cost recogmzed in the Combined Balanced Sheets S 2,841,316 $ 2,631,847 Weighted Average Assumptions: Discount rate 7.50% 7.50% Expected rerun on plan assets 8.00% 8.00% Rate of compensation increase 5.00% 5.00% Benefit cost S 1,988,000 $ 2,207,000 Employer contributions S 1,778,000 $ 2,665,000 Benefits paid S 1,315,000 $ 2,259,000 16 Kapl `olani Health Notes to Combined Financlal Statements (continued) 5. Long-Term Debt and Note Payable to Bank 1999 1998 Srnes 1996 Spectal Purpose Revrnue Bonds (face value of $55,000,000 less wamomzed discount of 5394,731 based on effective interest rates ranging from approximately 4.75% to 5.60%), interest payable semt- annually at rates ranging from 4.95% to 6.25%, pnnctpal payments in varying armua] amounts ranging from $805,000 to 52,475,000 due July 1999 through 2019; $11,780,000 due July 2020, 512,520,000 due July 2021 S 54,605,269 S 54,587,120 Srnes 1993 Specta] Purpose Revrnue Bonds (face value of 5103,695,000 less unamorhzed discount of $1,863,736 based on effective interest rates ranging from approximately 400% to 7.00%), interest payable semi-annually at rates ranging from 5.20% to 6 40%, pnncipal payments m varying annual amounts ranging from 51,770,000 to 53,300,000 due July 1999 through 2003, $19,780,000 due July 2008; 526,890,000 due July 2013, and $45,015,000 due July 2019 101,831,264 103,421,045 Senes 1991 Special Purpose Revrnue Bonds, interest payable semo-annually at rates ranging from 6.80% to 7 00%, pnnctpal payments to varying annual amounts ranging from $860,000 to $990,000 due July 1999 through 2001 2,775,000 3,585,000 Carry forward 159,211,533 161,593,165 17 Kapi`olani Health Notes to Combined Financial S~ai~^ents (continued) 5. Long-Term Debt and Note Payable to Bank (continued) 1999 1998 Carry forwazd S 159,211,533 S 161,593,165 Note payable with interest at 12%; principal and interest payable in montlily ttutallinenta ranging from 534,36; to 555,612 through July 2003 and the balance due on August 1, 2003 with the option to extend the inatunty date to August 1, 2006; eollateralrud by all leasehold improvemrnta, furniture, factures and eginpment of ICI3's corporate offices wiUi a carrying value of approximately 54,294,000 1,990,130 2,188,982 Other 873,418 927,167 162,075,081 164,709,314 Less current portion (3,620,794) (2,652,740) S 138,454,287 S 162.056,574 The 1996, 1993, and 1991 Series Special Purpose Revenue Bonds are secured by a seciu?ry interest in the gross receipts and pledged assets of Uie Obligated Group (KH - parent company only, I{MCWC, and I{MCPM) as defined in the Master Indenture. The 1993 Bonds are subject to redemption on or after July 1, 2003, at redemption prices ranging from 100% to 102% of the principal amount of the bonds being redeemed. Series 1993 teen bonds have mandatory sinking fund requirements effective July 1, 2004, payable m annual amounts ranging from 53,490,000 to $8,635,000. In January 1993, the Obligated Group made an advance refunding of $65,665,000 of the Series 1991 Special Purpose Revenue Bonds, by issuing Series 1993 Special Purpose Revenue Bonds and purchasing Government Obligations deposited with an escrow agrnt under an Escrow Agreement. The principal and interest on such Government Obligations provides sufficient funds to pay the principal and interest on the Serves 199] refunded Bonds. The outstanding principal balance on the refunded Bonds which were not included in the accompanying financial statements amounted to $65,665,000 as of both June 30, 1999 and 1998. 18 Kapi`olant Health Notes to Combtned Financial Statements (continued) 5. Long-Term Debt snd Note Payable to Bank (continued) Approximately $15,800,000 of the Senes 1993 bonds (net of discount and issuance costs) were rssued to finance renovation of and constructron at KMCWC and purchase addrtronal equipmrnt (the "1993 I{MCWC ProJect'~ as described in the Indenture. KMCWC completed this protect m August 1995. In April 1996, the Series 1996 Special Purpose Revenue Bonds of $55,000,000 were issued to assist the Obligated Group in financing or refinancing, or both, new construction and renovation and equipment purchases (the "1996 Kapi`olani Project's as described in the Indenture and Loan Agreemrnt. KH completed this project in April 1999 As of June 30, 1999 the Obligated Group had an outstanding irrevocable standby letter of credit to the principal amount of $1,059,300, expiring July 1, 2001, to fund its Bond Reserve Fund. An annual commitment fee is payable ranging from $8,000 to $18,600 based upon the Obligated Group's long-term debt semce coverage ratio. Tn addition, $8,448,618, included rn cun-rnt assets, is held by the Bond Trustee to fund current pnncrpal matunhes and accrued interest payable. Long-term debt matuntres for the years succeeding June 30, 1999 are: 2000 $ 3,620,794 200] 3,824,735 2002 3,925,336 2003 4,273,399 2004 4,536,548 Thereafter 141,894,269 $162,075,08 ] Interest paid doting the years ended June 30, 1999 and 1998 was approxtmately $10,232,738 and $12,877,902, respectively. The fatr value of long-term debt as of June 30, 1999 and 1998 was approximately $171,775,070 and $181,891,332, respectively. 19 Kapt`olani Health Notes to Combtned Financial Sta:~ments (conttnued) 5. Long-Term Debt and Note Payable to Bank (continued) KH also has available a $10,000,000 unsecured revolving line of credit, expinng April 17, _'U00 The tnterest rate on the Ime is a floating rate based on the bank's base rate. KH also has available a $1,000,000 irrevocable standby letter of credit to support the obligations of I{HIi as a State of Hawaii QUEST provider. The letter of crndrt is automatically renewable annually at the discretion of rue bank. 6. Leases Leases on various types of office and storage space, office equipmrnt and fiuniture are classified as operating leases. Future minimum lease paymrnts under noncancelable operatrng leases are as follows: Year ending June 30 2000 $ 1,806,332 2001 1,389,621 2002 1,399,966 2003 1,501,779 2004 948, l 65 Thereafter 2,025,507 Total mintmum lease payments $ 9,071,370 Rental expense paid during the years rnded June 30, 1999 and ] 998 was approxrmately $1,728,000 and 51,939,000, respxtively. 7. Commitments and Contingencies Unemployment Claims ICH is self-insured for substantially all of its unemployment claims. Claims for unemployment are insignificant and expensed when incurred. 20 Kapi`olant Health Notes to Combined Ftnanctal Statements (continued) 7. Commitments and Contingencies (continued) Workers' Compensation Claims ICFi rs self-insured for workers' compensatton claims (effective March 1994, KMCPM began self-insuring its workers compensation cla~ars under KH's program). In lieu of a bond, the System has an outstanding letter of credit in favor of the State of Hawaii in the principal amount of SI,000,000, as required by self-insurance regulatioffi of the State. The letter of credit is automatically renewable annually, but not beyond February 1, 2000. Claims administration is performed by a claims adjusting company. The claims adjusting company provides KH with estimated claims payments which KH accrues ea its workers' compensation expense. 1n the opinion of management, adequate accruals have been provided for known and incurred but not reported workers' compensation claims. Medical Malpractice Insurance KFi rs insured for medical malpractice claims. Generally, medical malpracUCe inenrnnce policies have included a shared deductible provision, which is currently 50% of the mdemrury loss, up to a $25,000 maximum deductible per claim. Primary coverage is $1,000,000 (occurrence basis) with excess coverage of 519,000,000 for ICMCWC and $9,000,000 for KMCPM (claims-made basis, with a scum year prepaid discovery penod). Medtcal malpractice expense, including estimated accruals for amounts below the deductible provisions, totaled $2,263,000 and $2,056,000 for the years ended June 30, 1999 and 1998, respectively. Debt Service Forward Delivery Agreement I{H has executed a debt sernce forward delivery agreement with a financial institution related to the semi-annual payments on the Series 1993 Special Purpose Revenue Bonds rn which rt received a payment of $1,727,000 ]n exchange for the potential interest earnings on the semi-annual payments placed rn escrow prior to payment to the bond holders. If KH terminates the agreement, it will be obligated to reimburse the financial rnstrtuhon for its economic losses incurred as the result of the temunation. Such losses will be determined at the date of tem?inatton. The financial institution has the tight to terminate the agreement commenctng in 2004. If it elects to do so, KH would be obligated to reimburse rt up to a maxunum of 52,650,000. Management has ao present mtenhon to terminate the agreement. 21 Kapr`olani Health Notes to Combined Financial Statements (continued) 7. Commttments and Contingencies (continued) Health Systems Aflllistion Agreement In Mazch 1996, KH, Wilcox Health System ("Wilcox' and The Queen's Health Systems ("QHS' entered into a Health Systems Affiliation Agreement ("Agreement's where KH and QHS agreed to make grants of 55,750,000 to Wilcox (53,500,000 from KH and $2,250,000 from QHS) over the next four years provided that Wilcox satisfy certain financial and operational conditions. In November 1997, the agreement was amended where l:F: ~ d QHS agreed to make additional grants of 51,000,000 to Wilcox (5500,000 from KH and 5500,000 from QHS) in equal instalhnenta over the next four years beginning January 10, 1998 provided that Wilcox continues to satiafy the certain financial and operational condinons. The agreement was further amended in February 1999 to provide for a change in the timing of cash payments, but not the total amount to Wilcox. Under the amendments, KH will pay 563,079 per month through February 2002, provided that Wilcox satisfies certain financial and operational conditions. As of June 30, 1999, KH recorded an accrual of 5949,000 for its obligation under the Agreement. Additionally, KH and QHS purchased the land under the Kauai Medical Group facilities from Wilcox for 51,085,000, which rs included In the grant payments and split equally between KH and QHS. KH and QHS were each allowed to appoint one member to Wilcox's Boazd of Duectors and one member to the Wilcox physician group's board of directors. Other Daring 1998, mazngement became aware that certain billing errors had occurred in the Kapiolani Home Health Services and Kapiolani Extended Care subsidiaries. Settlement of approximately 54 million was made in August 1999 and has been accrued as a charge in the accompanying statement of operations. An affiliate of KH filed an initial application for tax exemption which was denied. As of June 30, 1999, the denial was on appeal. In July 1999, the tax exemption was granted by the lntemal Revenue Service subject to agreed upon changes which include the closure of Partner's Health Hawaii in which one of Kap`iolani Health's affiliates is a partner. Kapi`olant Health Notes to Combined Ftnanctal Sta[ements (continued) 8. Related Party Transactions A ~oynt vrnture ynvestmrnt of I{H provides laundry services to I{H. Charges for sernces totaled $964,000 and $944,000 in 1999 and 1998, respectively. Premiums paid to Pacific Health Can, a 20% owned affiliate totaled $349,000 in 1998. No premyums were paid to Pacific Health Can; in 1999. KH paid approxymately $6,634,000 and $6,422,000 for laboratory services provided by a point vrnture in 1999 and 1998, respectively. Payments made to Partners Health Hawaii for management fees totaled $709,000 aad $829,000 in 1999 sad 1998, respectively. Notes receyvable from an affiliate totaled $375,000 as of June 30, 1999 and 1998. 9. Restructuring Charges In vyew of cun-ent operating trends and future projections, ICFi has decided to focus on its pnmazy lines of business, operating hospytals and operating a health plan. Accordingly, management decided to dispose of or discontinue certain operations which yt deemed outsyde of the focus of operating 1{MCWC, KMCPM and ICHFi. Management ymplemrnted a plan to exit the Home Health/Extended Care businesses, the physicians' practice managemrnt busyness and the development of a new physycian's office and clinic site m Leewazd Oahu. This plan was approved by management and the Board of Directors yn the fourth quarter of the year ended ]tine 30, 1998. In add»ton, a program to increase operating efficyrncy and reduce expenses was approved yn the fourth quarter of the year ended June 30, 1998. Costs for tenrytnatyon brnefits, lease oblygatyons and fixed assets related to the restructunng amounted to approximately $3,000,000 in 1998. Kapi`olani Health Notes to Combined Financial Staiements (continued) 10. Subsequent Event -Reorganization of Health Insurance Business In October 1999, KH and KliI3 rntered into a Reorgamzauon Agreemrnt with Hawaii Medical Sen ices Association, ("FIIVISA'~. Under the Agreement, effective November 1, 1999 suos,anually all of KHH's commercial health insurance contracts will be assigned to HMSA. The assigned contracts expiry at venous dates through January 2001, the majority expiring in mid-2000. 1{Ii and KHH remain contingrntly liable for aggregate losses on the assigned contracts. No consideration will be exchanged in connection with the assignment. KHH will retain its Medicaid (QUEST) business, which will be operated under a third party administration agreemrnt with HMSA. The QUEST contract betwern KHH and the State of Hawaii expires June 30, 2002. KHH will continue to operate the State Health Fund contract, which expires in June 2001. Management's assessmrnt of the costa of the reorganvadon through January 2001 is approximately $2.4 million, which will be accrued as a charge in the Sscal year rndmg June 30, 2000. 11. Impact of Year 2000 (Unaudited) General Description of the Year 2000 Issue and Uie Nature and Effects of the Year 2000 on lnformatlon Technology (IT) and Non-IT Systems The Year 2000 Issue is the result of computer programs being writtrn using two digits rather than four to define the applicable year. In any of I{Ii's computer programs, date- srnsitive software or embedded chips may recognize a date using "00" as the year 1900 rather than the year 2000. This could result m a system failure or miscalculations causing disruptions of operations, including, among other things, a temporary inability to process transactions, bill for services, provide patient care, or rngage in similar normal activities. I{H determined that it will be required to modify or replace significant portions of its software and certain hardware so that those systems will properly utilize dates beyond December 31, 1999. KH presently believes that with modifications or replacemrnts of existing software and certain hardware, the Year 2000 Issue has been mitigated. 24 Kapt`olani Health Notes to Combined Financial Statements (continued) 11. Impact of Year 2000 (Unaudited) (continued) General Description of the Year 2000 Issue and the Nature and Effects of the Year 2000 on Information Technology (IT) snd Non-IT Systems (continued) I{H's plan to resolve the Year 2000 Issue involves the following four phases: assessment, remediaUOn, testing, and implcairntation. To date, KH has fully completed its asaesamrnt of all systems that could be significantly affected by the Year 2000. The completed assessment indicated that most of I{H's significant information technology systems could be affected, including the general ledger, patient accounting, clinical, medical records, and internal communication systems. That assessmrnt also indicated that software and hazdware (embedded claps) used in medical equipmrnt also are at tisk. In additioa, I{Ii has gathered information about the Yar 2000 compliance status of its significant suppliers and subcontractors and continues to monitor their compliance. Status of Progress in Becoming Year 2000 Compliant Overall, ICIi is approximately 92% complete with all activities to remediate, test and implemrnt compliant versions of its IT deprndrnt systems, including the preparation and testing of contingrncy plans. Nature and Level of Importance of Third Parties and their Exposure to the Year 2000 KH is 100% complete with the idrntification of non-IT deprndrnt business partners. KH has identified approximately 60 mission critical business partners whose Yar 2000 compliance or non-compliance could materially impact ICIi's ability to operate. These range from patirnt care affecting clinical partners to public utilities, insurance payers, financial institutions, and providers of govemmrntal services. KH is monitoring the efforts of these partners to achieve Year 2000 compliance which in nearly all cases, appear to be substantial. In cases where certain partners do not appear to be making substantial progress, ICH has developed contingency plans so that the other parry's failure to comply will not dtsrupt ICH's operations. The process of completing and testing the contingency plans will continue through the remainder of 1999. 25 ICapi`olant Health Notes to Combtned Financta: ~.3:~ments (continued) ]].Impact of Year 2000 (Unaudited) (continued) Costs of the Year 2000 Effort KH is uuirz~ng both internal and external resources to reprogram, or replace, test, and implement the software and operating equipment for Year 2000 modifications and to work with mission critical business partners to assess and if necessary mitigate their compliance. The total coat of the Year 2000 proiect rs estrmated at 56,500,000 and is being funded through operating cash flows. To date, ICFi has incurred approximately S5,_SO,000 (54,900,000 expensed and 5350,000 capitalized for new systems and egmpment), related to all phases of the Year 2000 project. Of the total remaining project costs, virtually all will be expeosod, approxtmately half the ,,...,.;~,,.g amount being budgeted for retention incenave to be esmed in the fiscal yar ending June 30, 2000. 26 1998 INCOME TAX RETURNS KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHII.DREN ERNST & YOUNG LLP 2400 Pau~hl Tower phone 808 531 2037 1001 el~hop Btn~t Honolulu, Haw~ll 98813 C~OG°~~ Instructions for tiling KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN Form 990 with Sch. A - Exempt Under 5011c113) for the period ended Juns 30, 1999 Signsturs... Ths original return should bs dated end signed by an officer of the organization. Filing... Ths signed return should be filed on or before May 16, 2000 with... Internal Revenue Service Ogden, UT 84201-0027 Payment of tax... No payment of tax Is rsqulrsd. To document the tlmaly filing of your tax raturnlsl, we suggest that you obtain and retain proof of mailing. Proof of mailing can ba accomplished by sending the tax return(s) by registered or certified mall Imstered by the U.S. Postal Ssrvlcel or through the use o1 an IRS approved delivery method provided by en IRS designated private delivery service. ~o» i aoo Form 990 Return of Organization Exempt From Income Tax ' Under seetlon 601~e1 of th! Internal Rlve 1t+ q~l~exclmt bleek I~rrrg b!nlAt Depenment am. rl..euy trust or prlvat! to Adetlon) or slctlon 4i~7`a~(1) n nlxlinpt char bph trwt n IR Oxar. veer A For the 9 cblend! x e I I 1996 and end OB / 30 t• 99 B CterA! t>7eeee C Neme of orpentrsllm D t~rgeyr Iderellketlert number el"ne. ts.ttu KAP I ' OLAN I MEDICAL CENTER FOR WOMEN AND i°°"~ rbN « I^~ CHILDR 99-0177360 retun prln a Flee ryp•, Number end Nrwl (or P O box M nMI Y na delwrW m ebsN addrew) RooMSUIe [ TYepherte numbs retun !ee ?"'""1010 56 ERCHANT STREET 24TH FLOOR 808 536-7366 stun _ :imeia !q~ CIry or town, stela or country, end ZJP + 4 F ara ? e eumptkn .•rY reperetp) G Typa or orpenlatbn ~ Exempt under sMbn 507(e) (3 ) ~ (Irx~erl number) OR ? sedlon 4947(e)(1) nonexempt cherkabM trot Nob: eMlon 601 c 7 exam en@ end 4M7 ¦ 7 n•nexem cherb Weh MUlT • cpn heduN A N Is this ¦proup rstum filed for e}Nteles4, , , , , , Yes X No I It ekMr box In H le eMelad Mw; enter Iotrdpl proup axemptlon number (GEN)? (b) I}'Yee; enter the number or aMMatw fa vrlrkh Ode Tatum b Glad ? J AeeouMlnp method? OlM X Aoerwl C 4lnb • r rreb rwm Tree ~ mwred • YM X NO OtnM ? K Check hen ? It the oryenlxetlon's prow reeNpb en normNly nol moo then 125,000. TM orpentrNlon need not Ole • neon vrln Ole IR8, but II O recaWSd a Form 890 Pecke9e In the mel, O ehoub fIe • Teton wtftad Orartael Ale Som! steles rlquk! ¦ compllb rebm. Nob: Form ls0.EZ ms be ed b eeaw wRh bw Men 1100 000 end hdl/ swab brp Men S2d0 000 et end d Revenu! Ex ensp and Chan !s In N!t Asslb q FuM B!1lrq!! B!! 8 ac1Oc InstrucOOnt trrt 1a 1 ContrlDtrtlone, plb, prenb, end ebrrler emolyds nealvld. STMT i ¦ DlreaPubllesuppart, , , , , , , , , , , , , , , , , , , , , , , 1¦ 641 043. b IndlrMpuDllesupptrt,,,,,,,,,, 1b 3 558 676. e GwemmerdeomrlbldMS(lrenA) , , , , , , , , , , , , , , , , , 1e 4 634 708. d Tobl (edd Ilnes to through te) (ebeh aeheduN d eordrlhtlws) (ceens 8.834.424. noneeens ) , , , , , , , , , , , 1d 8 834 424. 2 Propnm service revenue Ineludlnp povemmerd few end cerdreeb (from Pere VII, Irre 03) , , , , , , , , 2 134 7 84 a Membenhlp duw erd eeeewmerlb . 7 4 IntarM on wvlnpe erW tamparlry nah brreebrterlle 4 9 6 Dhbends end IMereN mom sectellw , , , , , , , , , , , , , , , , , • 4 0 6 . Grow rerrta a. .1. . b Law• rerwl 1 b 8 e NN renNl Income M (bee) (eubtrla Irre m hlRt Inc , , , , 6a . a 7 Other Invwtmem Income (dssub ? S A 3 7 s a Grow enrourd from eeN d eeeeh o[nr A Bee Otlrr loco lnwmory,,,,,,, 04 9 9 se 8 00 b Lew. cost or otMr hest end wNs experrw • 0 s b 4 o Glln ar (low) (etterh erJrsAA) , , , , , , , 13 64 so - 3 3 d NN peen or (loss) (eonrbM Inc se, cdklrw (/q erd (B)) s • Speelel events end eelNOlw (ebdr eareAA) [ Grow rawnw foal krehritp s d eontrlbutlons reporlW on Irre 1!), , , , , , , 0¦ b Lese. dlrM axpenew direr Orrl furtdrlbkrp experraw , , , , , , • b O NN Income or (bes) mom epee4l event (et[tr!a Inc 9b trom Inc 9!) 1a 0¦ Groes eslw d Irrverdvy, Isw ratum..nd rowwro.. oe 99 d b Lws eoN d poode sold o e Gross proM tx (low) hom wlee of Inwrday (enerlt earedtds) (etddrM Irre 1lb frorrr Nrre 14) , , , 11 OlMr revenue (mom Pere VII, Inc 100) 71 12 Totll revenue add Ilnee td 2 3 4 S !k 7 ird Oe 10e end 11 12 1 13 Proprem eervkes (mom Ilne M, eohxm . 1 a 9 9 14 Menapament end penenl (hom Irre M, cokxm (C)) , 14 ~i 16 Fundnbinp (hom Irr 44, cobrrm (D)) 1 s W is P.ymenbeo.rnllelr(.batearedtsy 5~~. STA7~MENT. 4, , , is 17 Totll ex en!!s add Ilnw 10 erq 41 cebnrn 17 1 5 1 • Excess or (dencO) far tM yeer (subtrea tir 17 hom Inc 72) 1 s - 6 ~ 10 NN assets or rund bahnew N Daplndnp d year (fiom Inc 7a, saloon (I~) , , , 1 • 1 20 Other changes In nN assets or rural beYner (etch sxplerretlon) STMT, $TMT, - x 1 NN easels or rund belencw et end d nd ~ For Paperwork Rlduetbn Act Notlel, se! pay! 1 of tll! slpersb UntrvdlierM. • • . Fam[[0 It!!s) +a+o~oraeo FOF14F 701A 06/10/4000 tl•30~L6 V8. 07.01 70078381 4 Form 9B0 t Statement o All orpenlietlon. mu.t complNe column (A) casxrvw (91, (Q, ena (°1 n ragired for s~olbn en1(ox3) .nd arpereeells¦ Functional Ex erases ene xMan X9.7 . ~ nonexem onehteDb trawls e+r cafes e.6 ~ on ~ Do nor Indrde emounh rsported an brr proplen Iel Mansawtre de 06 D6 f0e d /d d PeR I IAl tO~ wMOr FlMeYYtp Y2 Grants end slloa0ons (attach schedub) ~~778.573.,w~ ~Z2 7 834 277. 7 834 277. 23 speameumunno.rouwwidu.rt.s+~n.cn.dur) 13 Z4 Senates peld to ar br mettles (seam e:nWUN) Z 4 26 Compense4on of officers, directors, etc 16 NON 2i Othsrselartesendwa0es , , , , 26 48 776 459. 28 777 621. 19 897 938. 27 Pension planconutbutlons , , , , , , 17 1 231 863. 728 793. 506 080. 2e Other employee benefits , , 1i 4 727 463. 2 789 197. 1 93 268 . 2i Peyrolltaxss , , , , , , , , , , 2a 3 876 048. 2 288 277. 1 688 789. 30 Profesalonal fundralsin0 tees , , , , , 30 31 Accountin0 fees , , , , , , , , , , , , 37 32 LeOelTesc 32 16 042. 16 042. 33 SupDlles,,,,,,,,,,,,,,,, 33 12 736 980. 11 811 711. 1 1 2 9. 34 Telephone . . . . . . . 34 399 520. 236 717. 183 803. 3i PosteOe end ehlppep , , , 76 36 Occupartq 30 1 239 184. 731 119. 50 066. 37 Equipment rental and melntanencs, , 37 848 916. 38 508. 28 809 . 3l Printin0 end publKaboM 31 39 Travel,,,,,,,,,,,,,,,,, 30 202 486. 119 488. B 019, 40 Confaranees, eonverdlorr, end mMlttge 40 41 Interest,,,,,,,,,,,,,,,,, 41 4 263 289. 2 609 429, 1 74 84 4t apr.~i.u.n,d.pruon,.te.pn.d,.a.a~q, , 42 7 796 980. 4 699 828. 3 19 36 17 Olheraigwws(t.min) ±STMT_ 8 _ 3a 48 991 944. 36 89 076. 13 299 889. b 3b e d-------------------------- 3 e-------------------------- 44 Twtrmewti aynw(W ww.altiwy~al °thair ra~h4 a iri 1s9j°~:r•!~B•t}((•°~j• • ~ • . 14 2 7 6 9 8 1 Reportlrp o/ JoIM Cab. - Dld you report In column (B) (Program ssrvkss) arty Jobtt cosh from • rombbtad educts0onal eempalOn end }undra)sln0 sollala0on7 , , , , , , , , , , , , , , , , ? ~ V. ®Ne II Mee,' areer m the e0prepete amount of these )obd coats i , (i) Me etnoum e0opted to ProOram esrvtor i M eiot7tW to M anent and navel i • and tM emourd eioeeted to F tatamsnt r ram erv ea ccom is mants ee a net Ions txt s wn.tl.tn.o<D.n~~.pm.rr~r.mptpr.pa.~ ?_7Q_eFoY1Q~.H~!?LJJiSrI?A~---------------- tee.. M or0enbetlorts muM deserau thek exempt purpaw sehlewtnwtb In a dear end eortt:W tnervlar Stele the number (Rapubee to iMk)te)snd 01 olNnb awed, putdleetlons Maud, ale Qwew eohlewnvanb ihd an not tmesueNw (Beetles SOt(e)(3) end (4) (al des , sid eMpxt) orOmixetlau end 4W 7(e)(1) nonexempt eharkabN trus4 mtul eMo enter Ote etnara d perlb end eAoesOons b a0ten.) ~ °FS°r ~ ¦ ROUTINE HOSP I TA,~_ SERV I CEPS _STATEM€NT_ZA_____________________________ Granh end a0ocabari 4 9 4 68 b ANCILLARY SERVICES-STATEMENT 7A GraMe and alloca0ansi 42 618 878 . e KAPI'OLANI_MEDICAL CENTER FOR WOMEIj_~ CHILDREN AWARQS______-__ VARIOUS GRANS TO ORGANIZATIONS I N THE _C_OMMU~ I_T_Y_T_0_ PROVIDE HEALTHCARE_ SOCIAL SERVICES _AND _EDUCAT I ONr4_eA_OGRAMS~,___________ Grants and allocationsi 7 834 277. 7 834 277. d Gratrts and e0txetlorls i • Other ro ram servkea eluch schethda Grants and dloeatltms i ~f Total of ProOrem aervke Expenap (should equal Itne 41, column (B). Protuam servteea)• • ? 88.296.718 . aefa7a 1010 60F12E 1018 08/10/2000 14:30:46 V8.07.01 10078381 6 vo,mesonasei 99-0177350 P.os9 Balance Sheets (See Specific Instructions on page 20.) Nob: Wharo rcgwred, attached schedules end amounts wrttun fha dsscnpbon (A) (B) column should be for endof- er amounts onl t3eginnmg of yer End of year 46 Cash - noMnterest-beannp 46 40 Sanngsandtampararyeashinvestments , , , , , , , , , , , , , , , 1 336 929. 4• 4 940 891 . 47a Accounts recenrabls , , , , , , , , , , , , , , , , 47a 41 443 468 . b Less allowance for doubtful accounts , , , , , , 47b 8 856 945. 38 650 702. 47e 32 787 513 . 43¦ Pledpsa reservable , , , , , , , , , , , , , , , Its b Less allowance for doubtful eaountc , , , , , , 43b 43e 43 Grarttsrecefvabla . 828 411. 43 1 281 685. 60 ReceHables from otfcen, directors, bueteee, and key empkryan (attach scheduk) !i0 61a Other notes and loam receHabla (eltch scheduk) 31¦ i b Less allowancsfordoubtfulaaounts , , , , , 61b its 63 Invsntoneaforsakoruse . . . . . . . . 1 289 206. 62 1 221 13 69 Prepaid expenses and deferred charges 1 927 083. bi 2 198 002 . a4 Irnastmena-sscurkias(attachschadula)SEE. STATEMENT. 8.....107 488 878. 34 91 797 465. 68a Investment -land, buNdkigs, and equlpment•baw,,,,,,,,,,,,,,,,,, 66¦ 63 178, b Lsss aaumulated daprada6on (attach scheduk) . . . . . . . . 36b 63 178. 8fa 63 178 . ti{ Irnestmsnts -other (athch scheduk) 6• 07¦ Land, buildings, and equipment bass $Tp1T, ,1 Q 37a 143 248 896 . b Leu sccumulatad dspreua0on (attach scheduk) . . . . . 67b B4 213 372. 73 011 224. 670 79 038 623. ae Other asset(desabe?SEE STATEMENT 11 ) 21 089 918, ii 21 442 084. tli Too assets sdd II es 45 throw h 58 must a ua h s 74 • • 0 30 Accourds payable and accrued expense , , , , , , , , , , , , , , , , , , , 18 9 1 381. {e 17 098 719 . •1 Grsribpayabk 11 {i Deferred rswnw S7M7..12.. 1 69 1 si NO {i Loans from ofOcen, dirsdon, tnntaas, and key employees (attach • • scheduk) , {i 34a Tax-exempt bondllabilitlea(attachscheduk) STMJ..13... 28 833 085. e4a 28 3 8 048. b Mortgages and other note payable (attach acheduN) , , , , , , , , , , , , , t4b e6 Other Iiabilltles (desabs ? SEE STATEMENT 14 ) 8 9 96 {s Tota111sbI1Mlaa add Ilnss 80 throw h 85 67 314 487. 57 431 82 Organizations that follow BFAe 117, cheek hen ? X and complete Iirisa 87 through 8g and Onas 79 and 74 s7 Unrastrktad 181 238 944. {7 189 26 49 33 7amporariyrestrktad,••••••••••••••.••„••.•••••• 3 728 748. •i 4 1 00 Parmanentyrestrlebd. 3 389 349. N 3 851 04 4 Organlzatlons that do not follow eFAi 117, cheek hare ? ? and 3 complete Iinsa 70 through 74. ~ 70 Capdal stock, tent pnnelpal, or cement Amds , , , , , , , , , , , , , , 70 L 71 Paid-In or capdal surplus, or land, building, and equlpmantfind , , , , , , , , 71 ~ 73 Retained earnings, endowment, accumulated income, or other funds , , , , , 7Z i 73 Tobl net asset or fund Wtaneas (sdd Ilnea 87 through 8g OR Imes 70 through 72, column (A) must equal Iina 1g and column (8) must equallina2l)„ „ 188 357 039. 73 177 3 3 640. 74 Totsl Ilabllltles and net aasetsffund balances add Imes 88 and 73 45 871 528. 74 34 755 18 Form 000 is avallabk }or pubke inspectlon and, for come ppeopple, serves as the primary or cola souru o1 informatlon about a par4cular orpsnaebor~ How the publk parceWas an organiza8on In such peas may ba determined by Na Informat)on prsaantad on fts return ThereMra, please make cure the return Is complete and accurate end fuly deecrbas, In Pct III, the organlza0ottti programs and sccompishmarib rE~0a1 t OEe Gnc~~c tntA nRrtnr~nnn ta•9n•aR VR 07 01 10078381 8 Form eeo race 3 Reconciliation of Revenue per Audited Reconciliation tN Expenses per Audited Financial Statements with Revenue per Financial Statemenb with Expenses per Return (See SpecMc Instructions, age 22. Return a Total revenue, pains, and other support • Total expernes aIW losaes per _ per audited finanael statemertb , , ? • audited flnanclal stetemenb , , ? ¦ b Amounts Included on Itns a but not on b Amountc included on line a Dut not :r: Ilne 12, Form 990 on Ilna 17, Form 990 (1) Net unreelltW %ItK (t) Donated earvkee on Investmanb t end uee of btllNlp t (2) Donated eerncee (2) Prlor yeer ed)ustmartb and use of bcllales s reported on Ilne 20, (7) Racovanes of prbr Form 9a0 ,i yeer pnnb , , i (t) Loesae reponed on (1) Other (spaeyJ _ _ _ _ Ilna 20, Form BBO t __STMT 16__t 2ea.9oa. (e) otnertep.dM_ _ _ Add amounts on Imes (1) through (4) ? b _ STMT_ 17 _ t 2a a .000 . Atld emounb on Ilnee (7) through (4) , , ? b c Llne a minus hna b , , , , , , , , , ? e e Llns • minus line b , , , ? a d Amounts Included on Ilne 12, d Amounts Included on Ilna 17, Form 890 but not on Ilns Form 990 but not on Ilne a: (1) Inveetmenl experr~ (1) Inveelment~M nd Included on Ikte not Included on IM ab, Form 9a0 t Bb, Form Ba0 ,t (2) aver (speoryl _ _ _ _ (2) Omer (epeelly) _ _ _ __STNIT ts__t 972.241. _ sjMT 18 _t 21.767.70. Add ¦mourtb on Imes (1) end (2) ? d Add emounb on Imes (7) and , ? d • Total revenue par Ilne 12, Form 990 • Total expensse per Ilna 17, Form 990 line a lus Ilna d e Ilne c lut Ilna d • List M Offlurs, Directors, Trustees, and Key Employees (Lest each one even H not eompernebd, sae Specific Instrucllorn on • • 22. hl title end evenae (C) cornperreaon (0) alleaw. r IN Nm w etlee~ noun pe •eell M rest IrM, enlrr •~Msws eerr rrir a eeopount end ~ dented t0 er.rree ellowrlo• S STATE NON NON 76 Dk any oflka, dlreelor, trustee, a key employee reealve epprepele tanpertptlert d rrtdn etch 5100,000 ham yt•e oram¢aflon end eN rebtetl orambetlotn, of whkh mwe then 510,000 wee provked by 1M nMW orpertlretlone9 ? ®Yes ~ No 11'Yee; edeehseheduN-w8peeakbtetrueUareonpepezz SEE STATEMENT 28 JM 0elON 1000 50F12E 1018 06/10/2000 14:30:46 VB.07.01 10078381 7 arm B90 t96e 9 - 0 0 6 Other Information See S ecific Instructlons on e e 23 Yas No DId the orpanlxatlon engage In sny edMly not provlousry reponotl to the IRS? I}'Ye," attenh • delslled descnptlon of eeeh ocevty , , , Tt 7 Wara any chenpas made In the orpanlxlnp or governing doeumarda but rat reponed W iM IRS7 » X II'Yn; snaeh o eonlortrrd ropy of ere ohertpas 8 a DId the organization have unrelated business gross rncoms of 51,000 a more durnp the year covered by this rehart7' , 70• X b If "Yes; has rt fiW ¦ to Mum on Form tt0•T for ede yaaff 7th X t Was there • Iiquidatlon, diasolullon, terminstlon, or aubstsntlal contnetlon durlnp tM yaaR II Yes,' atheh • tlatamord , 7t x i0 ¦ la the orpamzahon related (other thin by nsoelatlon with • shtewltls or nationwide arpanWtbn) erouph comnan membership, governing bodies, trustees, ofircers, etc , to any other exempt or nonexempt orpanlaa0on7 e0• b 11 'Yes; enter the name olMe orpanlxebat ? STMT 27 and check whether N Y exempt OR nonexempt 11 • Enter the amount of polkical expendlturas, direct or Indlrsd, u daserlbW M the Instrudlons for nrra el 81• NONE b DId the orpanrzatkfn flM Ferm 7710iOL for thb yeeYl - . - , t1 b X 11 a DId the orpenlzatlon reserve donated servlcao or the use of matadaM, equlpnwd, a helNtles al ra ehrpo or at subetentle0y Ma lhn htr rental vakw9 , , , , , , t1• b II'Yeo; you may indicate the value of theca Nems lien Do rat hteWde Urle amoud u revenue In Pan 1 or as sn expense h Part II (Sae krtrucllarra for rapodYq N Part Ill) t1b N/A t1• DId the orpenlzatron comply with the public Inspection raqulrements for retumo and s»mptlon applkyWrw9 , tta X b Dld the orpenlxatlon campy wNh the dloeloeuro roqulremonb reletlnp to quid pro quo eorttr0utlorts7 - , - , , , , , , , , , ttb )Ia DId the orpanlzatlon so1kN any contributlone or pMe that wsn rrat to deducible?, t+a b II "Yea; did the orpan¢etlon Include weh every sollcNatlon an exprw steNrneM Ural such eaddWMorr or pet wan not tax dadtrctl6M9 t/b 1f 501 fc!(+), (sl. or (6) opNz.fMn. wer• .ubstantl.ly .ll dues roMeduc161e by mamben4 tta b DId the orpanlxetlon make only In-house lobbylrp sxpandlturas of {2,000 a less 1 , - ttb If 'Yes' was answaretl to eltMr 85e a BSb, do not complete BSe through eSh Mknv unleee the orpanlxetlon received • welwr for proxy tax owed fa era pile year. e Dup, assesamerda, and aknter amount harm merrrbars ........................tie d Seetlon 182(e) lobbying and polNk:al experMtuso , ,Bid • Apprepata nondetluNlble amount of eeetlon 0033(ex7xA) duw rWkoo, ,tie f TaxaDM amount o1 lobbying and polltlnl expandeureo (Aire BSd lew Bee) , ref p pop era orpenlxellan el•et to pay the sMbn e033(o) tax on Ute amoud ti ten ei h II section 6033(e)(1)(A) dues notleu ware sent, does the orpanlsatbn ayee to add tlr amour h e51 to b raucrragp estimate o} dues allocable to nondadualbN lobbying and polNkal axpondNurp (or ere fo/oah%tax yeah - , , , , , , , , , tih t• 501(e!(~! ary.nrssbona-EMr a InNlatlon lean and caged eontrlbulbns hrdudad en Ilrra 72 ................................................eta N/ b Gras receipts, Included on Ilne 72, for puMe are of club faellees ttb N / n 5o11e111~1 ~~-Erb ¦ Gras Ineonre front rrwrr6era or aharMalden t7 • b Grow Income from other sources. (Da naf net anauds dw or pek fo serer sources epalrot amount due a ncelvad can ewe) t7b / A t• At any time durlnp tM ynr, dltl ere apanlxNkn own • SO% a praetor YdsroM h a tosbM oaporalbrt a' pertnorshlp9 II'Yoo; txartpNM Pan DC tt t• •501/01!31 otyarrttatlorx-EMOr: Maud M tea Imposed on eta txponlxolbrt durYtp ere year utdr. eoetlon +ett ? NONE ,section +e72 ? NONE ,sectbn 4656 ? b 50f/c)/31 snd 50f(c!(I) ayenhe5ara-DId Mo orpenlxatbn enpego In airy sMbn 4e5e etuen bortolt tranaeNlon durlnp tM yaeff II'Yao; attach • abderrterd expYYtYtp eatit bartsactlon , - , , , ttb e Enter Amount of tax Imposed on tM orponlxotbn menopon or dMgtrlead parrots draYtp er year agar sedbns +e72, +B55, end +65e . . . . . . . NONE d Enlar Amount of tax In 86e, chow, relmbused by ere orpanlxallat , , , , , , , , , , , , , , , , ? NON E t0 a Ltst the steles with which a copy of CtN reban k Ited ? N / A b Number of employeae employed In tM pay period that Includes Mordt 12, tree (ew lttobudfora), , , , , , , , , , , , , , , , , ,I toe 17 387 tt Tn.Dooksenlnonof ? KAPI'OLANI HEALTH TeMphonro.?808-636-7366 Loeeted at? 56 MERCHANT ST. 24TH FL. HONOLULU HAWAII ZIP~+ ? t1 SeeNon +te7(aJ(1) nonexempt cherbbN busts IYYg Form Da0 bleu a/ Form 7041-Check ttan - , - , , , , , , , , , , , , , , , , ? and enter the amount of tex-exempt Interest reeelvatl a aeen»d durlra tM hx veer ? I t1 I NON E ~.a serer r too Gnctoc to+a nF/7nf~nnn 7d•~0•dR VR 07 07 70078381 8 Form ffo Iffe 99-0177360 g Anal sis of Income-Producin Adivkies See S ecMc Instructions on a e 27. EM4r proEE tunouMa unlaas otharwfa4 UnrelEted buElnsEa InaorttE ExcludEd b aeetlon 317 513 «514 lEl IndlatEtl (A) Is) tl l (p) RNEIEd « B"~"••• Amount E%O Amount exempt luneeon f ~ Proprsm serNee mronw eooa eodE Ineom4 SEE STATEMENT 28 1 077 010. 133 887 803. b e d / MetltcererMedlcsltl PaYmrtb . . . . p Fete antl connat.4 ham por^E^•M apttrtd. f4 Mambershlp dun End Eit4faf114rME . f 6 i•an.t en .MeE rxt ttn•pnry a.n nt..hiw 14 9 8 0 f6 DHldsnds End Intaraal from EEeurfNE _ 14 4 031 81 f7 NEt rentEl Income «(losa) Iron real nMa a tlaDt•finane4d propErly . b red daDt-financed DropErly 18 1 8 3 041 f f N•t nnbl hrn~. a Otrl Irotn pNES.I pRFMl/ . •s aharinvastmantlrtcanr 309 9 9 too GEMa(la.)ha•.rs•..s eewr u.n nwnbrr 18 4 098 162. 107 NM IneomE or (logy hom apEeW avarea . 702 Grwa prom «(Iwa) hom aalr d I 03 1 9 702 gharrawxrw E bPARKING 03 33 eCAFETERIA 03 86 0 dREIMBURSEMENTS 30 0 .OTHER SERVICES 0 6 44 104 subtodl (add cohnxr (D), antl (E)). • 0 0 0. 7 3 0 4 3 3 8 10f To1E1(atld Arta 111/, aowm. (o), Erld (E)) ? 146.626 .28 B . Not.: L/na f03 e1. id PER I ahouM do Emounr an eEr /2 PER I. Reletio shl o ctivkies to the e I M of Fite Pu sas Ses S e Llna No. ExplEtn how neh aetlvlly 1« whkh IneomE k r4poMtl In column (E) of PER VII eontrlbutad InpeArfy M mE EooartpfMnrrt ? of the or EnlxEtlon's exam u oaea dMr than Mtda /4r each SEE STATEMENT 29 Information R s din axeble Subs fes Com a is Part k "Yes' ed NErna~ Eddraw, End Empbyttr Idarfekallpt PEreEnbpE d NEtun d To1E1 Erd•dyor numbs d wrpontlon «partrrr4t4 IM~rEEt Dualnaaa EctlrMIEE Ineonta EaaEb UnGr EI or papury, I tare that I hne earnlrlEd mY letuln, inthp~rto ELiwdYYa wW an0 b iM bwl a IvtwlEtlpE Please • ~ h Irw, mru , ~o E.,DEC r PnpEnr (oCw min Y m Y lrMOmrllen of wfi~ pnp(r h.a En/ 1~.Ya0E. Sign J c~eiittiss sr~ ' O ' trot t crD Here 11w TypE «pdR rrrr .td Ida pr~Ky' Dala C/ttlcf Paid •bni0i N aaf• Preparers Fhm'. rxtm.la Eq - UseOny vouna•.E+ntpor.tll' 400 PAUA TOW 1001 ISHO ST. rEh in0id°~ HO O ULU ZIP.4? 98 aEt 3 50F12E 1018 06/10/2000 14:30:46 V8.07.01 10078381 9 SCHEDULER Organization Exempt Under Section 501(c)(3) ow l+a ,s,e-0o.~ (FOrm 990) (Except Pmate Foundation) and 8eetlon 501(e), SOt(fj, 501(k), 5o1(n), or Seg PPlime ~1nNhon~axam Charltabh Tnst o Q oep.nmam dltr Tlawuy Saa aeparate fnstrtwilar ~~~Y inl.lni aw.nu. Seller ? Must be com leted b the above or anizellorla and attached to lhak Form 980 or BBO-EZ Neme of the oraantratwn KAPI'OLAN1 MEDICAL CENTER FOR WOMEN AND a+TbYer laeaaaoaoe eumaer CHILDREN 99-0177360 Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees See instructlons on a e 1 List each o e. If th r ere o s sr'None p) name ana eadreu of eeoh empbyee peio rtiale PI TIIN ena avenge tel Contnaulow m p) pperae loan 350 000 noun per re~a k) Cpllperleepan mployee OerletY plra L exeunt entl ally Beveled le eeerYn w......w ...~.......~.rv.. 11 Tod number d o1Mr ampbyaae pakl over sao.ooo . . ? 7 8 Compensation of the Five Highest Peid Independent Contrectots far PrOfeesbnel IlervkM lal Planle ane earner a Been ~ eueaetr Pala mae ern eS0,00D Ia1~YPa of eenlw p conw.rd, MORTENSOr~'-~ ~d------------------------------ 1089 ALAKEA S /1680 HONOLU U H 98819 TRACTING E 400 0 SAP 1 ~4~~~l1_ I NFOSEgV I CES 66 MERCHANT STR T HONOLULU 908 9 ATA PROCESSING 8 8 0 HAWAII_RESIQEN~Y PROGRAM_C/0_PKF_HAWA,(I_ 1100 ALAKEA ST (2100 HONOLULU HI 9681 HYSICIAN SERVIC 8 2 81 d UNIVERSITY_OF_HAWAIj_ _ JABSOM_____________ 1980 EA T WES RD. HONOLULU HI 968 HYSICIAN SERVICES 2 070 80 EMERGENCY_PHYSICIANS'_MEDICAL_GROU~ MO GOME 1390 S N FRA CA 9 10 S V TaW number d ethem reeeMnr o`w iao,ooo w d«.la.l w~+o.. . ? Fer hpernora Reduelbn Ael Ndke, see peps 1 el 1M Inebudblr b Farm aM end Faem eea~ tafeade A M aa1)1ua eavv ~ w ene: ene- ene• neren/Bonn ~I.gn.aR V• A7 117 7rIn7R9A1 10 6cheduMA Fomspo lppe 98-0777350 2 Statements About Activities Yes No 7 Durlnp tM year, has the organisation akamptsd to iniluenea national, dda, a beat hphhlbn, Includrp arty attempt to InOuance public opinion on • Ieplslatlve rtaakar a rclerendum7 . . 1 x If Yea,' enter the total expenses paid or incurred In connectlan vdth tM kabtrylnp aetlvkha ' Orpanla:atlons that made an election under sechon 501(h) by OOrp Fom 5786 moat eomphh Pert VI-A. OIfNr organizations checking Yn; mutt complete Part VI-B AND attach • stalemam pNbap • delalkd deecnptlon of the lobbying aetlvkles Z During the year, has the organization, either doeclly or indirectly, engaged N arty d iM IdknNnp acts Mdka arty of ka trustees, dlrettors, ofOcen, creators, key employees, or members of Nair fiml8as, a wl8a any taaubh orpanlxstlon wkh which any such person Is affiliated as sn offlesr, dkeclor, trratsa, maJorky owrw, a pmelpal bern04ary a Sala, exchange, a hnlrap d Pr~f? • b Lendlnp of money or other eadembn d aadk7 . . . . . 2 b e Fumlehlnp d pootls, sarvkes, a faclMhs7 . . . . . . . e X d Paynaem of compenaatlon (or payment or relmbunermm d sxparnes 8 mqa Utah 17,000)7 , , , • Transfer d airy peR d b iroorrre a araah7 . . . . . . . . . II the Newer to any quntlon h Yes,` attach a dehllsd statemsrd exphWrap tlr tnrtsaetlorr. 7 Does the organ@dlon make puma fa seMhnMpa, felowehlpa, duderd kxsrts, sh.9 . 4a Do you MW s section 403(b) areadty phn la your empkayeea9 . b Atheh • shtamem to exphln how the orpan¢atlon ddarminea that IndWldtah a aputbatlar reeeNFp prams or loans 1r m k In furtherance of ks cherltabk ro rams uall to r clue 8 ktshuekona Reason for Non-Private Foundation Status (See instructions on popes 2 through 4.) The or enlzatlon h not • prNah Iourds8at beuuee k h (Plwe eMok only ONE applkabN boat) 6 A church, convention of churches, or assoehtldn d ehureftss Secllora 170(b)(7)(A)(I). • A school. Section 17IXb)(1)(A)(gj, (Aho comphh Parl V, psp 4 ) 7 X A Mepkal or ¦ eoopenllw hwpkd servke oryeNatlon 8eotlon 170(b)(1)(A)(E). g A Federal, state, or local government or povemnaerahl unit. Seethrt 170(b)(t)(A)(v). 6 A medical research orpanlxallon operetM In eonJunctlon wkh • hoaplW. Section 170(bx1)(dA)(E). Emer Yre heapkara name, eky, end stab 16 ? An orpanlzakon operated for the bmefk of • eolhpe or unlwrsky owned a operated by • povsrmwaW uri eeslhn 170(b)(t)(1lxlar). (Also eomplde tlts iuPport ielaadrA h PM N,A) 11 a ? An orpanlxatbn mat normaly ratelwe • subsfimlal paA of ka support Iron • povsrterrerdY uri a from Qle garret pubic. Bedhn 770(b)(1)(A)(vp (Aho eorraDlsts Uta 6upporl IieMduls h Part N-A.) 7 7 b ? A communky trod. Seetbn 770(b)(1)(A)(vq (Alw eonyaMe kte aupperl aehedrda h PM N,A) 77 An orpanlzakon the nomry reeelves• (1) more than 77 7h% of ks suppoA from eomrlbullorr, rnnrbardt?1aw, snd proN racelph from Mlvkhs rahhd to ks eMrkabh, ate , fune8oras - eubiecl h eerhln asapthrr, and (i) ne more lMn u 7q% d ks suppoA from gross InwebmM Income and umehted bwlnaw hnbh ktoorrte (has seetlen S77 IsoQ flOltl btslbrssw eegltbsd by the orpanlxdhn after June 30, 7 D75 See saetkara 50ap)(~, (Aho eonaplde t1w iupperl seMAM to Parl Nat) 17 ? M apenlzstion that N not controlhd by any drsqua110ad persona (dMr than lourrdaaon martaptrs) arq euppah orysrdtatlarr deaerlMd h (1) Ilnes 5 through 12 above, a (Z) section 501(e)(1), (5), a (6), k IMr mad tlae lad d esotlon BOa(a)(~ ls« section 50p(U(3).) Provide the followln Inlormatlon aboN the su oned or anlzekorw. a krAuelleras on d p) Nama(a) d wDP~d orpanbstlorr(s) (b) Lim ntertbsr from above 74 I I An aoanltetaon oraenlzed and ooeratW to ted la oublle solely Section 30WeN41. (bee InrArucitons on oaos •.1 snfA'1 ~ncr~e ~n+a nR/tn/7nOn 1a•3o•a6 V8. 07.01 10078381 17 ;cn u A F rm t 9- 350 7 Support Scheduh (Complete only It you checkatl a boa on Nna 10,11, or 12) Use cash msMod deaeaurltlrp, NOT AP P L I CAB L E N • You ma use the worksheet in fha insfrueoona /ar convemn ham fhs emusl fo the sash method d ¦ :slender ear or Nseal eerb Innl h e 1997 b 199M a 1993 1991 • Tohl 16 Glfls, pools, and eordrlbAlorr recelvad (Do not melude unusual nob Sea nm 2M Ie Membersh tap rceehvd I7 Grass reeslpb tram admNelom, merehsndlw sold or urvlwe partomled, or furnlshirlp of facllkMs In any edlvky that k not ¦ bwlnsu unrelated to the orpenlzatlan's eherlte to Gn>ts Income Iram Interest, dlvldends, smounh rseeWed from paynwds on eeeurMMa loans (saetbn 312(axfi)), rerNS, roysMss, and unrelated buslrlaes lnabN Income (less scatters 311 tune) from hulnaasss aequlrad b the or enlzatlon after June 1973 I N Net Income from unnhlsd bushlese sethklas nd Included In Ilm 1l1 t0 Tu revenues levlad tar tM orpaMZadonY Danafk and ekher paid to k a a:?endW on ke Whop 11 TM valve d servkr or faellltYs fumMlyd to the orpanWNon by • povemmen4l unk wlthod eMrpe Do nd heluda tM vahw of eervkes or IaellkNs penanny fumYMtl to tM ublk wNMU eMr t1 Otlw Ineortla Atheh • eeheduM. Do nd Include peln or (loos) hom cent d npol eessb [i Total 1 t4 Llm 9 m to Mer 1 to OrpenWtAm deserlbed h INr. 19 or 11: ¦ Enter 2% of amount h eollrm (e), rte 21 rIQT, APF~.I ~A9L~. ? 1 b Attach • Ilat (whkh Y nd open to publk Impadlon) showlrq tM norm d and amount aonlrlbutW by eardl _ person (dMr tlrn • povemmeMsl unk or publley supported orpsnlzstlon) whose aaW pNl• for 1994 throual 1 B97 cascaded tM amount shown h the 2tL Eller tM curs d aN Mleea sacess amaab , , , , , , , , , , , , , , ? 1e e Tdel support far seetlon 309(ax1) test Enter Irr 24, aoksral (e) ? 2ee d Add Amounb kom eoMam (s) fa Irlee: 10 19 • 22 2qb ? • Publk support Phe 26e minw Nrle Zed tohq ? f Publk su rt areenta a II ¦ 1ee numerator dMded Nne lee denoml , ? % t7 Orpenlzalbm hserNrad on IYr 11: • Far amounts Included In Ilrlas 16, 10, end 17 that wen reeaMd from a 'dhgtwNlMd parsers,' stleeh • IM to show tM mrrr d, end todl amoures reeelved In each y..r tram, neh'dYqusNMd psraen• t:rrsr tM sun d such amount far each yer. NOT APPLICABLE (1~~ (199Q) (1tt93) (1994) b For any amount Included In Nm 17 that was reeelved from • nondlsquellfNd parson, etlatJt s YM b allow dla rwrls d, ell angtee neaMd far each year,lMt wss moo thm lM lerper d (1) the amount on IIm ZS for tM yer a (1) 13,000 (Include h Ule Mat orpanlzatlom dsscrlMd In Ilnn S Ihrouph 11, ss weN as IndNlduak.) After eompudrlp dls dMhranos between tlls anlolee reoNvad end the Isrpsr smouM daserlbed h 11) ar (1~ abler 1M sum of these dMaande (du aacw amourb) Ia sash y..r. 11097) ------'----'°--(1~ (1993) -------------_____-(1994)--_____------_- e Add Amounts from eohsm (e) for Irw: 13 18 17 20 21 ? Ifs d Add' Llm 27e toW end IIm 27b foul , ? 17d a PubNe support (IIm 27e trial mhw Ikr 27d ~ ? • f Tdel support for settlers S119(s)(2) teat Erer amount on Irr 23, eohmn (e)........... ? 171 y Publk support parcentapa (Ilm 17a Inumareter) dfvWsd br Nm 1711denorwlrreter)) ? 7 % h InveslmeM Income arcenta IIm 11 eelumn a numerates dNlded Nrre 171 demmlml 7 to Unusual Orares: For en orpenlzallon deeerlbW h IIm 10, 11, or 12 thN recanted arty unuausl pnnb durtny 1994 through 1997, attach • Ibt (whkh b not open to puWk Inspaetlon) for each year showlrp the name of tM eorerbllor, IM dsla and snwrre d the rent end • brNt desert Ion of Ora nature d the rant De not Include these h Nrra 16. Sae Yreatedlerle on 1. ScheeuN A (Porto aaD)1aa8 Page 4 Private School Questionnaire (See instructlons on page 4.) (To be completed ONLY by schools that checked the box on line 6 in Part fV) NOT APPL I CABL E Yes No 26 Does the orgernzation have a recialty nondiscriminatory polcy toward students by statement m As charter, bylaws, other governing instrument, or m a rasoluhon of Its povaminp body? . . . . . . . . . . . 2f SO Doas the organizWOn mcluda a statement of rte recialty nondiscnmmatory poky toward students h Y ks brochures, catalogues, and other written communications wM the public deelinp with student edmiesioru, proprems, and scholarshps7 , 30 . J1 Hae the orpen~zeLon public¢ed its racially nondiscriminatory policy through newspaper or broadcast mad4 dump the period of solicitation for students, or dunng the repistratlon penod d rt has no solicitation program, h a way that makes the poky known to all parts of the psnsnl commuMy k servss7 J~ It "Yes," please describe, H "No," please expl•~n (H you need more space, attach a separate statement) 32 Does the orpanltsbon malnhin the follovnnp. a Records mdica4np the racial composition of the student body, faculty, end admhatratne staR1 J2a b Records dacumenbnp that seholarshipe and other financld asststancs ere ewerded on • recMy natdananhatory basis? J2b . e Copies of all cetalopuss, brochures, snnouncementa, and other written commurocebons to the pubic dealnp with student edmucbro, propnms, and scholarWps7 , Jt2e . d Copies o} all metsnal used by the arpantzetion or on ds behsM to soNdt contnbubom7 3 d If you encwered "NO" to soy of the above, please expleh (H you need mare specs, altech a separate shtement) JJ Does the orpen¢abon dwcnmmete by race m any way with recpsdto • Students' rights or prhAspea7 . . . . . JJe b Admissions poidp7 Jab e Employment of facuHy or edminbtratlve staff? ~ . JJe d Scholarships or other fharrJal aeektanee7 e Edueattonal poAda7 T Use offecBltlw7 J p Athle4epropnms7 h Other extrecumcular ectlvltles7 . . If you encwered "Yes" to srry o} the above, please e~lah. (H you need more specs, attach • separate aMement) J4a Does the orpenlzabon rscena any financial eld or easattarrce from a povemmenW egarwyl b Hes the orpenl2eUOn's right to such eld ever been revoked or suepended7 If you encwered "Yes" to either 34a or b, please explain uahp an attached sta4msrR Je Does the orpanaebon cerlHy that H ha complied wHh the epplKebls requwemants of saoflone 4.01 tlrouph 4 lM of Rev Proe 75-50 1675.2 C B Se7 covenn reeid nondisenmmetion7 H"No"attach en • uuae . em - SeheduN A Form 980 1988 9 - 3 Pe 6 Lobbyelg Expendkures by Electing Publk Charities (See Instructions on page 8.) o be com leted ONLY b en eli able or enizatbn that filed Form 5788 N Check here ? s d the organ¢aton belongs to an affillatsd group Check here ? b ff ou checked 9" above end'llmked control' rovisions a Limits on Lobbying Expenditures AIrIII.t(ee prow To a Domple4d totak for ALL ebDlklg (The term "expenditures" means amounts pakl or hlcllrred) organixatbrls J6 Total lobbylnp expendlturss to influence public opinion (gnseroots lobbying) , , , Js J7 Total lobbylnp expenditures to Influence a legislative body (direct lobbyng) , , J7 J8 Total lobbylnp expenditures (add lines 36 and 37) J/ J9 Other exempt purpose expendihuss , , , , , , , , , , , , , , , , , , , , , , , , , J8 10 Total exempt purpose axpenddurec (add Ilnec 38 and 39) , , , , , , , , , , , , , 40 41 Lobbying nontaxable amount Enter the amount hom the following table - r e 1} the amount on Ilne 4e {s - TM lobbylnp nonUxsbN amount b - Nol Dyer 3300,000 20% M the .moot an Illy 10 . Over 5500,000 Dut rM over 51,000 000 , 3100,000 plw 15% W the exeeee ow 5500,000 Over (1,000,000 Dui na over (1,500,000 , 3773,000 glue 10% of the eKCew Dyer s1,000,000 } 11 Over 31,500,000 DN not over 317 000,000 5225,000 plus S% d the excwe war 51,500,000 Over 517.000.000 . . . . . . . . . .31,000.000 . . . . . . 4Z Grassroots nontaxable amount (enter 25% of 8ne 41) . , . , , , , , IZ 4J Subtract 8ne 42 hom line J8. Eller -0- H has 42 k more than Ilea 38 , , , , , 43 14 SubVad line 41 from Ilne 38 Enter -0- K Ilne 41 k more than Ilne 9t1 . , . , , . 44 Cautbn: 1/ rhsro ra sn amount on either line ~3 or Ims must IrN Form 17P0 4-Year Averaging Period Under3eetion 601~h) (Some organizebons that made a section 501(h) electlon do not have to complete ell of the Ms columns below. See the Instructions for Iinss 45 thro h 50 on e 7 Lobbying Expenditures Durhrg 4-Yaar Averaging Period CaNndsr year (ar 11sea1 le) (b) (e) (d) (e) ear Inn in ? 1900 1997 169e 1 gg5 ToW LobtllArip nordaxabN .moon! Lobbyin8 eNlirq .mount 150% or aria ~5 • 7 al Onarods nncaeDM Oneeroeb aearlp emaxt of • Onseroob bbbyhq Lobbying Activity by Norrelaetirrp Public Charitles For re ortln on o enizetions >hM did not com lets Pert VI-A See instructions on s 8. Durlrp the yar, dM the oraanhatbn eaempl to InlWenee ratlorlM, ante a bat Isglrlslbn, eiDM7dkV enr snempt to Influence puWk opinbn on . kpblstM meaer or rehrerldlen, evou8h tM uee or Yes No Amount a Volunteers . . . . . . b Paid stair or management (Include compensation in expenses repoAed on Rnss c through h) , , e Msdlasdvsrtieemetlb„ d Mailings to members, legislators, or tM puWc, , , , , , , , , , , , , , , , , , , , • Publications, or pubfishsd or broadcpt sMSmeri4 , , , , , , , , , , , , , , , , X f Grerlb to other orpanlrations for lobbykp purposes , , , , , , , , . . g Direct contact wdh legislators, thek staffs, government offkiala, Ix • kpklaeve body , , , , . h Ralllas, demonstrations, seminars, conventions, speeches, lecitras, or arty other maw , , , , , 1 Total lobbying expenditurss (add rives c through h) . . . . . . . . . . . . K "Yes" to am of the above, also sttsch • statement afvine a detailed descrbtlon of tt1a lobbvina aotlrltles. rat Schedule A Form l190 169E 9 - 3 6 Information Regarding Transfers To and Transactions and Relationships With NoneharkabM Exempt Organizations 67 Did the repoNng orgenizahon directly or indueclly engage in any of the following with any other organaatlon descnbed in section 501(c) of the Code (other than section 501(c)(3) organizettone) or in section 527, rela4ng to political orgenaebons7 a Transfers from the reportmp orgamzabon to a noncharrtabls exempt orpen¢eikn of Yes No (I) Caah 61s1 (II) Other assets • X b Other VansetUons Sales of assets to a noncherRable exempt organhatlon , , , , , , , , , , , , , , , , , , , , , , , , , , , , b X (11) Purchases of assets from a nonchardeble exempt orgenaahon , , , , , , , , , , , , , , , , , , , , , , , , b X (III Renbl of fealrbes or equipment , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , b II (W) Reimbursement arrangements . . . . . . . . . . b X (v) Loene or loan guarantees b v . (vl) Performance o1 services or membership or fundrskmp soidtetloro , , , , , , , , , , , , , , , , , , , , , , e Sharing a(facilihes, equipment, mailing lists, other essab, or geld employees , , , , , , , , , , , , , , , , , , , , o X d If the snswsr to any of the above Is'Yes; oomplNe the following scheduN Column (b) steak sAvaps slaw iM feY rtrrkM vsNrs N iM goods, Nhsr sssNS, or services given by the reporting organ@atlon If tM orpsntrsrbn rseeNsd Iw tlrn IeF merkM vMU h any ns e r • rs enl sh win tot mn d r. N IU ro) k) 1a1 LIM ro Amount InvoNSd N~m~ of noneherMebM en Dewrl Ion W tnrNw, aM 1 V 5 343 P10 A A U C O V 61 V 3 106. A 10 AN A I 0 lifts Is the organizatlon directly or Indirectly affllieted vvitlt, or related to, one or more tax-sxsmpt orgert~etlaw described In section 501(0) of the Code (other than sscbon 501(c)(3)) or h sactlon 5274 , , , , , , , , , , ?®Yss ~ No 0 K "Yes 'Dom lab the folowln echedtM: ' U) (b) le) Name of or snbetlon T of or mltMlen Dose of n A I IC HEALT H 01 C 4 o w ' KA 10 ANI H A TH MO 601 C 4 1 0 SU FO O ' HEA PL N PART S 50 1 O E K O A A w 'S PAR rw etlKtAO _ _ _ _ _ _ _ _ _ _ KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART 1 - OTHER INVESTMENT INCOME cccccamccc~cascscsmccmmmmssmsassssmsssscss DESCRIPTION AMOUNT ENDOWMENT FUND 309,979. TOTAL 309,979 asssssssssss STATEMENT 3 ~r~teo .n.e nei.n iennn ~~.~n.~e vo n7 n1 1nn7AAA1 1B KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART I - PAYMENTS TO AFFILIATES aasaasasaa=aaseaaaaaaaaasssaaaaaaasasssaa DESCRIPTION AMOUNT NET EQUITY TRANSFERS TO KAPI'OLANI HEALTH (PARENT) 21,581,410. TOTAL 21,681,410. ssaaaaaaaaaa STATEMENT 4 60F72E 7018 06/10/2000 1L:30:L6 V8.07.01 10076387 18 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART I - OTHER INCREASES IN FUND BALANCES CiCC6i6CS C C S C ~ S QCQiiIC i C~OiCiiii DESCRIPTION AMOUNT UNREALIZED GAIN ON RESTRICTED INVESTMENT 161,714. TOTAL ----161,714 6i6 Q Qi STATEMENT 6 60F12E 1018 06/10/2000 14:30:48 Va.e7_e7 ~ee~aaa~ KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART I - OTHER DECREASES IN FUND BALANCES amaaaaaasaaasaaaaaaasaaaaaaaaaaaaaaaasssasaaaaaaaaa DESCRIPTION AMOUNT NET UNREALIZED LOSS ON INVESTMENTS 2,137,705. TOTAL 2,137,706. asaaaasasaaa STATEMENT 0 ~~?~io ene~~~ •n~e nei+niennn ~I.9A•AR \/p A7 Al 7AA7R9A1 21 e M V R A ~ ~ ~ Z l ~ ~ W 0 W ? f ~ 6 6 0 0 5 i W W C i J C ~ O M < ~ ~ F M e 4 Q e ~ W W W ~ ~ i t O J t i ~!r ~ ~ a o w f W i y ~ Z W p? t i ~ s w i t a J ~ ~ O oi< M_ f • ~ ~ ~ tpYt FF FF _ C i t i ~ ~ < « ~ c C t } C e ~ t & • ~ ~ ~c i t! • ~ ~ ( ~ ~ ~ C KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN SUMMARY OF CONTRACT AND GRANT ACCOUNTB FOR THE FISCAL YEAR: 071// • O81// GRANT NAME AWARD AMT REHAB • UAP 71.000 I CI C ~ R J AT CLI 7, C H Y H • . M ICETAERAPY EAM - MIBC M U "i61;~ TOTAL AWARDED T~~/d7/ ' SSAiIl~! 7 F.~i'olr 71tlid Caen fr Wame t ma6~ For9r ffa M D, lir 7; G+as t AOarmm~ OM19r Oarb~ FYE 1~ 70. 7000 Kabb Saaea Prm9a9 Fa 71W ofDm9 W96 A®fa 1999 f 19,7M 70717rt1 & aW 399 TSSib 14a~ w s6771 xlxs (w4 u.+em.ar9 t caw sY9oou Ia00 7676 Kam Mgr Hmbiti b 96916 7A9Ri dIHr 1,761 9a s. lcra s9.. s.a.310 xml.ww fau aem 4M Fn.9m CaHlm IAa st alr x...l~ Is n!0 n.af..l af99t f31~ xmel.l~w 9au IWr Fa H®Sarf~ 1x00 !If a.9u Y x.obl~w a9n a.a a r a.. Fr SpraJ~ daa~ 1[a Pa~r1199y 7aaO CeD RNC Wm~Y Crlr w..a ae a7r r Cw (ail a..i 1f07 s e..r. af.r 76.OIdtiw fa76 aarar.l. x.flr 7,aa 376N IC~W aO.r x~bl.w San Ar7~ Cyr 69d~0' 3.000 77700 N~ Aw IlmblS lO fa17 Hw~Y MYeb Asdrl~ y0pp ¦.~.r r arr. f.9 nlf rr.?. s a.7a xo..rk w 9x39 x...a 99W W Arrld~ I,Oa lag a a.wr. a9.r Sr as xssli~ w 9x39 os~onl a.19.r 1e.9 1,000 I7Y7rtt94dHwdl OOgYN 171f IWaf aOiM, M fbf 71mY4 M 9f97f H9'is g11w9Y l,000 9a IOW 4 N~k10 fY17 YMCA d09r 1.000 IOW atrial Hsobl9, le faU Mr7bsa aeioeY EdsriY 1,000 1737 Dek 9Yr1 Hmbk M 90(37 Sa A79w T~e~ C~9r 7A00 xvOr4w fan Ilwi 6W~Y d9r F~9d~ Ia00 Hweb4 Fbwi au.6.rle..91,000 7,7ss 9 s7,7a SLT~r 7 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN FEDERAL I.D. NO. 89-0177350 JUNE 30,1998 PART III - Statement of Proprem Accomplishments Kapi'olanl Medical Center for Women and Children (KMCWC) provides healthcare regardless of race, creed, sex, natbnel origin, handkap, age or ebilNy to pay. KMCWC Is a 232 bed/90 bassinet non-profit hosptlal which has been desfpnated the level III, Tertiary Cara and Perinetel Center of the Pacific Basin by the State of Hawall. Its activflfea as a apeclaHy medical center Inducts provldMp for medfcst, health end social services for the care of the women end children of HawaB. KapPolenl also serves as the mafor obsteV<cal, gynecological end psdiatr~ teaching facdiry for the University of Hawaii John A. Bums Scholl of Medicine. During the fiscal year ended June 30, 1999 KMCWC engaged In the following activities which were m the furtherance of its charitable purposes: • Provided hospHel aervkes l017,003 patbMs and provided h excess of 125,600 outpatient services. Inpatbnt services inducted labor and delNery, neorretal ICU, pediatric ICU admissions, end patients trensported to the NICU end PICU from other pens of Oahu, neighbor islands and the PacMc Basin. • ObstetricalGynecolopy Fetal Diagnostk Center Genetlc counseling services GYN oncology services 24 hour emaryerwy servioss • Pedlatrbs Pediatric Open Heart Proprem Pediatric Outpe9ent Clinb Pediatric Immundopy Program Surgical, medical, oncology services • Outreach Proprems Sex Abuse Treatment Centx Child ProtecOve Services Team Teen Intervention Proprem Healthy Mothers HeaMhy Babies FemBy Planning Services Moblk Servlcs Therepy Team Bereavement Proprem • Other Proprems Kapl'oleni Center for Women's HealCr Hawaii Poison Center STATEMENT7? m r z w W J 1 I A F.. Fa I on V on1~loMm < m W I p N < z¢ I p W n/gPlbnmb m rb l m ~ W W I ~O OmN~.-rh N pm 1 m y W W I pP Ombm<17m r' m< I p A I p 0 P m m O b I"` O m m ~ I N 2O I ~p VIOm W W W i ~ < Z 1 111 ~ ~ I A < . . . . I y l ~ W ~ W b N O P9 ~ p m ~ 0 W O ~ I b Z W 1 m<017h1"PbbNO<O~-IMP I P /q ¢<C1 I 1~ V P1p~ONp<~f ppppm/7 1 0 /y > I ~ n b m N m N P H m m b m ~ I p ¢ I m O< m P H {O < b ~ N ~ b N I m ¢ W 1 <pP b~ p m b <O~ fib 1 IO d y l I I W 1~ mPPN 1 . . . . I ~O~Pbp/017 ~f bmbOpm~f I < J I b m m 0 0 0 N N W m 0 0 0 N I< < 1 p<170m 1+1<~p~pNp p mN I p F I O< 1 ~ O I m N b p O ~ m N O m< m m b W m l p r F- I mPdhl7hP W ~<bpN~<W l p ap N•'I"~bmmr~pPm~ Imp 1 p p ~ ~ I I< m h h N ~ ~ I n O O r _ ~ O n O m b r y O W W y Z < W 2 ~ d O X o W f O f<f1 O W Oy y W N = J W W W d O O ~C1 Z F Z ~ I W¢ W O O yW yW2 ~ F- Z y W y W J W d m d 0 U p Z O < ¢ W¢ O H X W > Z- Z `Z` V U W y ~ ~ t W< Wy! Oy W d Z I Z Z y y y ~ ¢ V Z N _O I Ott WG W F y WWW I y Z W X 2 y¢ d LL O F- I F•~1-< <V< W py X O p 6 1 < d m-¢ Z F ~ Y Z¢ J W W b Q+ O¢ C- b C y V Z¢ J 2 I,i I dW y<<O WGpWZy--W W < ¢ y I ¢x0>Hdy28»W@1Cds F ; LL ~ O I VOmdO¢ Od Jp¢=WO F- KAPI'OIANI MEDICAL CENTER FOR WOMEN AND 99-0177360 FORM 990, PART IV - INVESTMENTS - SECURITIES ~Ci6SCC-iiCiCCiiC3~CT ~~~CiiiiS~CC~iiiiiiiiiii BEGINNING ENDING DESCRIPTION BOOK VALUE BOOK VALUE CORPORATE STOCKS 53,022,384. 33,416,088. CORPORATE BONDS 22,656,381. 37,748,284. GOVERNMENT AGENCIES 12,718,545. NONE US GOVERNMENT OBLIGATIONS 5,275,831. 8,707,731. PREFERRED STOCKS 5,013,874. 4,180,843. US TREASURY BILLS 2,963,079. 6,879,344. FOREIGN BONDS, NOTES S DEBENT. 612,700. NONE MONEY MARKET FUNDS 1,020, 878 INVESTMENT CASH 5,434,602. 3,891,601. TOTALS 107,488,878. 81,797,466. iiiiiiiiiiiiiii iiiiiiiiiiiiiii STATEMENT 8 60P12E 1018 06/10/2000 14:30:46 V8.07.01 10078381 24 ' ~ d ~ ~ R ~ ~ ~ ~ - M tlQ ~ r ~ `y ~ _ ~ E iE ~ . ~ ~ ~ g ~ - e 8 s ~ ~ 9 ~ a ~ R M c~ n C M a ~ a ~ ~ ~ 6 ~ ~ ~ ~ ~ a M M ~ # ~ ~ ~ s ~ € ~ ~ $ ~ ~ = = g M ~ ~ C C ~~A~ ~ _ 0 w C ~ „ i ~ ~ ~ F i R 9 Z ~ ~ KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177360 FORM 990, PART IV - OTHER ASSETS ____a Sa a a BEGINNING ENDING DESCRIPTION BOOK VALUE BOOK VALUE DUE FROM AFFILIATES 19,499,430. 19,397,683. OTHER RECEIVABLES 831,893. 1,183,334. ACCRUED INTEREST RECEIVABLE 592,478. 896,060. ARTWORK 188,117. 188,117. TOTALS 21,089,918. 21,442,084. aaisaaaaaaasaaa afaaaaaaaaaafaf STATEMENT 11 ~~1100 anct~c rota naiteiseee ta:90:t6 V8.07.07 70078381 28 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART IV - DEFERRED REVENUE ee~seeeaasssc=~ee..sax ev~aaceeeeaaxt BEGINNING ENDING DESCRIPTION BOOK VALUE BOOK VALUE DEFERRED INCOME 1,536,107. NONE TOTALS 1,536,107. NONE ea=eessaaoveeas ssassassnsnesaa STATEMENT 12 "m 60F12E 1018 06/10/2000 14:30:46 V8.07.01 10078381 27 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART IV - TAX-EXEMPT BOND LIABILITIES =ace~~cs=c-.x..c.e.coee=seeeseeae=easaxxe=eassx BEGINNING ENDING DESCRIPTION BOOK VALUE BOOK VALUE BONDS PAYABLE 30,170,000. 28,646,000. UNAMORTIZED DISCOUNT -338,936. -318,966. TOTALS 29,833,066. 28,328,046. xxsC=axaeesass~ iOiitxsi~~6ixxi STATEMENT 19 ~ 1°' 50F12E 1018 06/10/2000 14:30:46 V8.07.01 10078381 28 ~a~ ~ Boo ~ ~ ~ N N ~r~~ ~ ~ e ~F R ~ ~ ~ ~ ~ = g b ~ l~~ ~ ~ ~ ~ ~F ~ ~ ~ ~ ~ - M 4g~ ~ N N y~ m z ~ ~ ~ ~ ~ ~m ~ ~ ~ ~ ~ ~i z ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~F ~ ~ KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART IV - OTHER LIABILITIES C C CCOC6CCC!'3 Ri DESCRIPTION BEGINNING ENDING BOOK VALUE BOOK VALUE DUE TO AFFILIATES 4,548,567. 6,912,749. DEFERRED PENSION CREDIT 2,478,571. 2,374,863. DUE TO GOVERMENT AGENCIES 1,818,737, 1,887,211 DEBT SERVICE FORWARD AGREEMENT NONE 1,804,886. LEASE LOSS RESERVE 191,988. 193,428. AGENCY FUNDS HELD FOR OTHERS -80,877. 36,934. TOTALS 8,974,964. 12,008,868. eas==laasasxias siiiiiisiiisiii STATEMENT 14 .w~ ~ em bOF12E 1018 06/10/2000 14:30:46 V8.07.01 10076381 2g KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177360 FORM 990, PART IV-A - OTHER REVENUE ON BOOKS BUT NOT ON RETURN aeaasaeeaoeeemeeaeseeeea=acme=eeeaeaaeeaxseaeenaxaeeaeaaeaeeoa DESCRIPTION AMOUNT RENTAL EXPENSES REPORTED NET 80,729. LOSS ON ASSET DISPOSAL 38,393. COST OF INVENTORY SOLD 179,878. TOTAL 299,000. ssassssaaaaaaaa STATEMENT 16 gy'm' 60F12E 1018 06/10/2000 14:30:46 V8.07.01 10078381 80 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177360 FORM 990, PART IV-A - OTHER REVENUE ON RETURN BUT NOT ON BOOKS saa~¢¢¢sessss¢easesssease=s¢eoessasssassxsaaaasaaassssssssaaaa DESCRIPTION AMOUNT CONTRIBUTION INCOME-RECORDED 170,000, AS EXPENSE RECOVERY ON BOOKS TRANSFERS FROM RESTRICTED FUND 482,282. ENDOWMENT FUND INCOME RECORDED 308,979. ON BOOKS IN RESTRICTED FUND TOTAL 972,241. ¢aasaaaaaaaaaaa STATEMENT 10 " 50F12E 7018 06/10/2000 14:30:46 Vrl.07.01 1007E3t1 31 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177360 FORM 990, PART IV-B - OTHER EXPENSES ON BOOKS BUT NOT ON RETURN a a a66C6CamCai6iaCCSCS p a DESCRIPTION AMOUNT RENTAL EXPENSES REPORTED NET 80,729. LOSS ON ASSET DISPOSALS 38,393. COST OF INVENTORY SOLD 179,878. TOTAL 288,000, asaassaaaasaaaa STATEMENT 17 ~sww~m' 60F12E 1018 06/10/2000 14:30:46 V8.07.01 10078381 32 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART IV-B - OTHER EXPENSES ON RETURN BUT NOT ON BOOKS C i i C C CCYiiiiiiiiiiCiiiiSiii DESCRIPTION AMOUNT CONTRIBUTION INCOME REPORTED 170,000. AS EXPENSE RECOVERY ON BOOKS NET EQUITY TRANSFER REPORTED 21,581,410. AS PAYMENT TO AFFILIATE TOTAL 21,761,410. iiiiiiiiiiiiiii STATEMENT 18 60F12E 7018 06/10/2000 14:30:46 V8.07.01 10078381 33 i (U•) ~ INj1 1 W W W W W W W W w < W V 1 Z Z Z Z Z Z Z Z ~ 22 I O O O O O O O O W F< I Z Z Z Z Z Z Z Z NO~I F z 1 z W O J I W d Z J 1 W < < 1 ~ < 2 W Z ~ N F O W < 1 J 1 W W W W W W W W F O d 1 Z Z Z Z Z Z Z Z I 7J I O O O O O O O O mdF~• 1 Z Z Z Z Z Z Z Z Q W LL 1 F• W 1 20=1 V~m s m 1 W W W W W W W W < 1 O O O O O O O O N I 2 Z Z Z Z Z Z Z Z I W I I N 1 W U 1 W y Y I W N V ~ O i N W aC X m ~ 1 ~ H ~ W W W O 1 2 HO 1 ~ ~ V d d N O O WOI U- W- - O- O- - W_- H J W 1 H O H H F W H LL f H H H n I V FF• 1 O O V V ~ ~ S o W -O 1 ¢H NF GH ~H H H UF• K F>1 WC WG d¢ dS Z¢ iC ~Q N W 1 O < Q < X < > < > < W < W < d < > C O O 1 an d d d W d W d W d N LL N d > d ( b • < W W ) V b ~ O O 1 - W w W w < n d w w W w - O w ~ > N I c)F•- z- dw O - d-_ S- O-_ SW- w N 1 aCN- W- = JW- Op H- WC)- O F W 1 ~ < FN- JN< WO< fp< S« Q K 1 SOS « ~O- ~J; ~ NZ; ()J; < p l U Z< < 2< S K< N < O< W<< 7 d< W d p l - S S < S N< S - Z S m S N >>L~ !L7 1 F Y J S J W ~ J J J Y J J J QQi W 1 Z (((W~~~ O O J Z< O Q< O N o*Q Z N O W O O I IL ~ ~ UO~ SOY I~LN~ ~NS ~ W ~ ~N~ i U NI I U¢ W I W W W W W W W W_ O <xZ I O O O p O O O N W f< I Z Z Z Z 2 Z Z Z Z O G ~ F ¦ W O J I Z d 2 J ~ W X < < I Z W W F (/1 Vl I Z W Z I N OW<~ - Y J I W W W W W W W W H O d I Z Z Z Z Z Z Z Z 1 OJ I O O O O O O O O m d F I Z Z Z Z Z Z Z Z - ~ - I ¢ W LL 1 H W I Z O Z I O f- w I U m I ~ tl r7 ~ OI - I W W W W W W W W < I O O O O O O O O m N I Z Z Z 2 Z Z Z 2 j 2 I J WI al 1 N I W U I W ~ OI U ¢ 1 ~ :~I y W tl p tll I J f F F H H ¢ n Z H O I W Z Z Z Z Z U O < Od i Z O O O O_ O W ~ 1 y tF I ~W ¢W WW iqW t/JW yW fIJW . FW ~ ¢ I U~ W= W~ W~ W ~ W W= Z 'J O O WO 1 - 1- JW I ZF OF dF- dF- dF dH dF- c U 1 W fA 1 1 1 I 1 W -O I OF « WI- WH WF- WF WF~ F- ¢ 1 ~ ¢ W ¢ U ¢ U ¢ U ¢ U ¢ U ¢ fq ¢ tl W 1 d< < < fq< > 2 O O I >d F-d >d >d >d >d >d <d < tl - ~ N ¢ O W Pl O U { - J 01 0 LL ~ O O~ o N 1~A 1 tl a MM N N tl W n tl ~ w - 1 N tl N N O tl W ~ N ~ u J I tl n F-tl tl ~ ¢tl tl tl N tl Ftl Wtl tl N wn Htl Ftl O ~ 1 W W W W OI Ol W n tl N A W O II W ¢ W Utl Oat W m > 1 N I F-- U- J<a < 1 fA I Z - f- tl- WJ O- W OI•-- O f~ F 0 W I ~7 < U1 < < J < m d ~ ¢ - W < ¢ b < ~ J ¢1 ¢I ~o; ; <; Zd; O Ste; ; d 1 O I tlx Wxx x f<x ; FY< •xx tllOx N -1 I LL QJ - UF- Udx Z< IL o n o I x~ o - < rnx - r~~ <o~ o m II Z 1 dOJ Z~Z W-J <J OZ - W ZJ YJJ to 1 1 J J O J J J < Y~ x N J T Y J ~ II W 1 J • O J am- J tl 0 J tl 0 2 J F W W W 1 0 C` O q ¢ II Z I O 2 ¢ I J ~ ~C J O U O- ¢ 1 Z m N H l9 ~ J O M < 1 x •O <tl- <'~f0 <O< Ols Wn~ LL II Z 1 ddx W W= (7~S ;NS ¢~Y ~tlY ¢tl a00x = I U y I m W I W W W W W W W W ~ < W V I Z Z = Z Z Z 2 2 N SZ I O O O O O O O O W H< I Z Z Z Z Z Z Z Z NO~ I F- I Z X < < I W W F Z W 2 1 W P O W < I - y J I W W W W W W W W 1 HQd I 2 Z Z Z Z Z Z Z OJ I O O O O O O O O m d F I Z Z Z Z Z Z Z Z - ~ - 1 ~WIL 1 H W I Z O 2 OHWI m 1 a o N O I W W W W W W W W I ~ Z O I {~1 Q i ~ I f \ i ~ ~ ~ ~ _ _ ~ O O W D I W~ W~ W- W~ W- W- W~ W- H JW I W1~ W1•- WH WF• WF WF WH W~" h V HF' I F H H H H f F H O W O I fAf NF" mH mf- NH tAF- fIDH aDH s H> I O K O K O r O K O a O O Q. o W I Q < 6: < at < 6: < at a < of c < > 0 o I d H 6, F a. f 6. f 6. f- n, ~ d H o. ~o N K O W N V LL ~ LL O O ~ O W O O O N F m < O O fA N b 1~ O m J ~ ~ O O b ~ y~ r ~ b JfN rYN ~ ~ ~ J F- O m O m W W m m 4 m b W O W O G O ; W O f 0 O O O O 1 W m >a1 O <O WmO Wa Ol d1 U > b i GN- G- p< S- bJ- C6:- W- F- Q ¢ i ! < ; ; S J S H Z ; < Y ; ~ w ; N ~ ; - K ; - Q Z 'f7 fp ~ I S- Jf0 f S < - H< IL o p I C/N0 FO •D7 ;JO mZ0 C1Y0 00 O p = I ~J ``J m 2 J •<J ~J -J •JJ 10 p YO 26.0 Z<~ Y00 I O J J W J 2 J J O J ~ 6. J Y J ; W I Hw0 <00 Q~7ac <w0 •WO fo0 > O Z O ~ 6 I Z N j ¢O N 7O < J ~O Qi fA W J ~ J O H• r V N I N < W V I z z 1 Sz I O i O~ N W H< I z I 1 F 2 O ~ I ~ 1 1 = W O J I W W t i~ i j i i F N fq I < 2 W 2 i ~ OW<I H J I W I W F O d I 2 ~ z 7J I O I O mdFl z Ix - ~ - 1 I Q W LL 1 1 F W I i 2 0 z t i O ~ W 1 1 V m I 1 n z I OI - I W I W F 1 2 I z I O _ 4 D O i H d ~ io tp ~ Q o W V A W W O p LL p O O N v~1 0 J A ~p J O p I J W W ' ~ i ; W - m ~ W 1 < < 6 ~ I ~ < Z W t I J J .N.. O 2 I fA~J p A < I Y ~ A 2 W ~ =tl0 ~ g ~ ; ~ I V yl < W V I N O < O N W F< I n p O O I W Q~ i m t7 N O W W ` < I H 2 W 2 I y OW<1 -YJI ~ J d I O P P P m~ f i O O W N ~ W d 1 O W OI l0 F W I O < W N U ~ m l b O O _ W OI - I I I p a W I < 1 10 ~ N ~ y I O < O Q W 1 1~ p ' O I O O f 1 O OJ l7 N W O I W- O• m HH I OH ?F fW.~~ V ~ c O I yF VF- ~F- ~F p I W S W S d S d C O W W I K < X < > < > < > = O O I d d W d W 6 W d < 10 O p~ o d W O ~ ~ ` o 0 y o C = N O ~*Fj W ~y r b N N ~ U o U~ ~ o 0 0 > y 1 F zp H da F O w f do-, ao y l J W- J S J J W- J O Q O F W 1 < < HHl- < Jy< < W8< ~ K Q I W W O- W W H J; < pQ I S < S ~2< S SS< S V1 < W d OI <S y<¦ S <S N < 1 -W W J -{7 y< -N < -N O ~ z 1 SO 7< - 2O S 20 <O ZO <J - d O O 1 <N ¢SO <{7 ;W <19 JO <l9 -O O p Z I J O O<J J O H J O y-J J O ySJ b w < I Oi ~[O Oaf Y-< Or WJ~ Oi W-7 I - N Q J - N W ~ N J N J J ~ W 1 - O W O O - O J - O 2 i O - O K< O 1 d l < d 1 R d l <10 d l <r2 i ~w Ya sow Ya ~ai.twv~ Yp c=i~~ F V N I 1 < W V I Z b Z O N tl1 0 < I Z Z F W G J I N Z S Z J I W X « I Z W W H < P y HI H Z W Z I W ~ } J H O d I b b N b ' myH I O 1? P 1~p i I C W LL I < r O b 202 ~ N W N OFWI O m I ~ p Z I - - p OI 1 f- I O O r 1 ~ W'j - O m F F I O~ O~ S~ W~ p O f> 1 Z K Z C ~ K ~ C O W W I W W< d< d< > O OI Nd Nd >d >d ` O ~ o o. a' z o < o tl1 0 Z N W ~ N 1~ ~ O b ~ Y N ~ N N ~ J V F- O > O C b b O 1 W wl - w) A O > N I F C- F O- H C W- F r M 1 J F- J J W V- J Z O f W I < N< < < S<< < QQ•!< ~ C C I W ~ W fA 2~ W V J s W Q q; d < I -l7 d~ -17 CZ -W mi -P! •N ~ • I ZO ZO LL ZO }J ZO LL - LL O O I «l J J O <~7 LL~ O <w4 COO ~ O p Z I J O J< J J O W< J J O "j J J O d O J b a <I Or -YO O~ BYO O~ iY~ O~ -m7 I N Y J N J N J - N J J j W I - O N O - O 2 N 0 - O W O O - O J_ O ~ 1 d l Z O Z d l O 2 d l fp l7 d l O 1 ~ ~ 1 <O <PO <O ~f,90 <A 00~ <O S LL Z I Yp -NS Yo W S Yw CN SSSSSS Yw dG SSS V yl < W V 1 2 N z W 10 O N WF-< 1 z ~ z Z F W O J I O Z a 2 J 1 W X6<1 ~ W W H < y y 1 F z W Z l y ~ > J i HOd l O 10 m N 7 J I O ? N 10 m d H 1 < < O O - ~ - 1 - - S WIL 1 ~ m p O F- W I zOZI V~ml 0 zl ~ OI - 1 1 ~ p to 0 < 1 p p w to y l O O! O O 2 Z 1 O W I W O m W d l ~ IA O W F ~ 1 r r r r < 1 N_ V 1 z i < zl O OI W H 1 ~ g ' Z - I O I W F O I z Z 2 O < G~i O O_ D W < F I 6 W y W N W y W r 1 K 1 W~ W•~ W~ W~ O Wp l K- K- p- Q- m w~ d~ d~ d~ o -O 1 « Wf• WF WH W ~ W ~ C< U< V~ 4 D OI Hd >d >d >d > b > < O ac o d w F- o < o y o 2 10 N W O ~ 4 NI N N ~ ~ H m ~ < 10 FO WO O el O I S W w S Kw 2 W w S (~O O > y l H F- F-- F- V- H J<w y l J 1-- J y- J J WJ O F W 1 < fp< < < < J< < md- K ¢ I W ~ W W z d~ W O - d ~ ~ w ii= w x°~z w o~c~= w a~i 1 zO J - ZO V H - z0 20 C1dS IL O O 1 <{q <17 SV~ <<7 S7 <Pi < O p Z I J O z ~ Z J O W- J J O < J J O O 2 10 a < 1 O< Of J» Or ~YO O< aC« 1 - N OJ N J - N J - N <Y~ g W 1 -O J ~ -O JID O - O J O O -O S J 4 1 d l I J d l - ~ d l J O 6 1 W- 1 <s <•o <a ~ <w z 1 YO WOOf~ Y4 (9~ Yp ;~72 Yw C•'Y .a 1 VFW 1 W W 1 1 O '41 <Si I O O I to N_ W F< I 2 2 I 01 1 I W O J 1 I N Z W d 2 J 1 I ~ W<< 1 i 1 W H f N N I N 2 W 2 I O W < I -YJ I I Y f O d l ~ t7 I W O J I r- n 1~ m d F l Y o 1 0 - ~ - I I Q W LL I OI < I N H W I ~ N 1 0 2 0 Z I 1 l q OF-W I I V m I 1 < 2 I OI 1 1 ?-I ~ n In d >d b < O t o d ~ z + o f o < o y o = N W ~ d O O r W ~ ~ U Q O O • P } O O I = tp = ao O } y I J O~ J W~ O SI N 0 0~ o A z l J O W J O 2 J O O < 1 ~ N S N~ ~ N Q< J W i 60 t19= ~O ~mmOWpNO i KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990, PART VI - NAMES OF RELATED ORGANIZATIONS CSSSCSCCCSaCZCSCii'J iCSCCCiSYCOYtiiiiiiiiii6C6SiifY EXEMPT: KAPI'OLANI HEALTH KAPI'OLANI MEDICAL CENTER AT PALI MOMI KAPI'OLANI HEALTH FOUNDATION KAPI'OLANI HOME HEALTH SERVICES KAPI'OLANI EXTENDED CARE KAPI'OLANI MEDICAL SPECIALISTS HEALTH PLAN PARTNERS NON-EXEMPT: KAPI'OLANI SERVICE CORPORATION AND SUBSIDIARIES STATEMENT 27 "'a"10m cnct~c torn nR/tn/9nnf1 1a~30:a6 Vfl.07.07 70076381 ~2 m N F- ~ W I Z I I W O 1 m m m n~ m I P! l y W 2 1 < 10 N V 019 I O ~ i _ I f- ~ 1 m W ~ m N m 1 n y 02 ~ •-mn~In 1 m OI nNa~ im W~ 1 nO1 e! I o! <Z 1 m' aD I r J ~ I W LL I K 1 N I r 1 1 Z I I 1 I I I 1 I < 1 I 1 1 O r Iq W 1 m 7 G I J O I o U V I n X ~ W O I O I O _ ~ r I ~ O W H 1 O I O Z ~ 1 n I n O W I n I n I O 1 0 m W ~ r I ~ 1 b W I r v o > w W W W I ~ r W 2G1 s O 1 O O < ~ ~ I M O m O N ~ O d ~ 1 10 O - uay>o m > y-~WV- - F uQyCl=u~ O a W N LL Q 0 ~ 6 i 2J«< F to EC 1 -J <C1~ ~ ~ ~ I ~ ~ O W W LL D I pC~VWjS KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177360 FORM 990, PART VIII - ACCOMPLISHMENT OF EXEMPT PURPOSES vsecemsxseamsmexsmsxveeveasnxxseasxesssss+eaa=ssassmsss EXPLANATION OF HOW EACH ACTIVITY FOR WHICH INCOME LINE IS REPORTED IN COLUMN IE) OF PART VII CONTRIBUTED NO. IMPORTANTLY TO THE ACCOMPLISHMENT OF EXEMPT PURPOSES 93AS ROUTINE AND ANCILLARY SERVICES COMPRISE PATIENT SERVICE B,C REVENUES AND ARE USED TO PAY COSTS INCURRED IN PROVIDING HOSPITAL AND SUPPORTING HEALTH SERVICES TO THE PUBLIC. THESE REVENUES ARE PARTIALLY OFFSET BY A CONTRACTUAL ADJUSTMENT NEGOTIATED WITH THIRD PARTY PAYORS. AN ESTABLISHED CHARITY CARE POLICY SETS GUIDELINES TO DETERMINE WHICH PATIENTS QUALIFY FOR CARE GIVEN AT NO CHARGE. SERVICES PROVIDED FOR QUALIFIED CHARITY CARE PATIENTS ARE NOT REPORTED AS REVENUE. 93E MEDICAL RESIDENCY PROGRAM - REVENUES RECEIVED FROM UNIVERSITIES HELP SUPPORT THE COST OF PROVIDING RESIDENCY TRAINING TO PHYSICIANS. 93D~ EDUCATION COURSES & PROGRAMS - VARIOUS HEALTH EDUCATION F CLASSES AND DIETARY COUNSELING SERVICES TO ITS PATIENTS AS PART OF THE PATIENT'S HEALTH CARE REGIMEN. 103C MISCELLANEOUS REIMBURSEMENTS - COVERS COST OF ADMINISTRATIVE SERVICES RENDERED IE.G. PROVIDING COPIES AND HOSPITAL RECORDS, ETC.1, PURCHASE DISCOUNTS, ETC. STATEMENT 29 60F12E 1018 06/10/2000 14:90:46 VB.07.01 1007E981 44 ERNST & YOUNG LLP ~ 2100 P~u~hl Tower phorM 80e 531 2oa7 1001 Dlshop Stroll Honolulu, H~wdi 9887 C~Op~I Instructions for filing KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN Form 9907 - Exempt Orpanizstlon Businsee Return for th• period ended June 30, 1999 •......~e~~..¦.¦~.~~....• Signature... The or(pinel return should bs dated end eipnsd by •n officer of th• organization. Fllinp... Th• signed return should b• filed on or bsfor• Mey 16, 2000 with... Internal Revanu• Service Ogden, UT 84201-0027 Overpayment of tax... Th• return shows •n overpayment of 511,800. of which =11,600. should be refunded to you and :NONE hae been applied to your 1899 Estimated Tax. To document the timely filing of your tax returnlel, w• suggest that you obtain and retain proof of mailing. Proot of mailing can b• eccompllehed by sending the tax returnlel by repletered or certified mail (metered by the U,S. Poetel Service) or through the ue• of en IRS spproved delivery method provided by en IRS deaipnated private delivery •ervlce. ......•.••.••e~~.•....... 1cN0f0 1000 990-T Exempt Organization Business Income Tax Return OMB NO ,sae-0ee7 Form (and proxy tax under section 6033(e)) o.wmnenr d er 7n.w.r For ceNnGr yea t.M or om.r r•x ywr bplnnkq _ Q Z L D~_ t•K •N Mtlkq 0 6 / 3 0_ _ , u 9 9_ _ ~ C~ 98 ImemM bwaae Emkt ? see fA na hr6buucllera A Check bax r Neme d orpanuatlan O ¦+nParr ItlenlMCMbn nomber ~tl^6'a"'"pi° API'OLANI MEDICAL CENTER FOR WOMEN AND (Employew'blrtawlneauaaurex Blxk D on peps e ) • Examq antler aactlon Plewe H I LDREN X 501(C)(3 ) PriN ar Number, etren, ens room a aulle ro (II ¦ P O boc aw Pepe e d Ir.truolbrw) 9 9 - 0 7 7 6 0 6oep) sole) Type ¦ unr.ktewlw.kr....ewkycow 6oeA ao(a) 55 MERCHANT STREET 24TH FLOOR Imwdln.ar eloolrE on p.p.e) e~9 Ciry or laver, Hale, eM 21P oo0e c ook~e ¦ aw ONOLULU HI 9681 448110 at entl d yar F Grou exem tlon number eee InNnxtlorr far Bbek F on 2 3 4 7 6 618 2 . o cMek or enl:.tbn X so, a ca restore so, a treat cot . Iruet an.r tn,et H Deserlbetheor nizetion'e rime unreMNbwklewe SEE STATEMENT 1 1 During the tex yea, vns tM eorpontbn s eubsldlery In en aflleslN group a. psmtaubsWfery eorreoeed prolp7 ? Yes X No If 'Yn' enter the name end Idenlihlnp number d ele parent cerporetlon ? .I Th boob en M an d ' OL A N I EA T Tele hone number ? 8 - 3 Unrelated Trade or Business Incorrle A Income c Nd , a Grave reeepe ar eYr 1 0 7 7 010 . b lesser eae.re„er~ a Barrx:e , e 1 077 010 . 1 coee of goods cad (sall.mr h err , s 7 6 9 44 8 , 3 GrweprofN(subeeetirlfromerrle), , , , , , , , , , 3 323 68 323 68 CepNN pain nN income (eVeoh SaMduM D) , , , , 4• b Mel peln (low) (Farm 1707, PeR II, er. te) pew farm A7•>) e b a capeN ios. deauabn fa trlwb ea 6 Income (low) from peNrNxPa end b tarpnelldA (ertaan wrlernarp 6 f Rerd Irleonr (Salydlde C) • 7 Unrelated debt-Rnsrxsd Yrcorrr (Schedlde E), , , , , 7 f INmN, ennuela, royseles, end nrde from earoMd orpenlxNlons (eee Pepe 7 d krtnrelbn) • InwetmeN Income d • sedlal'S01(e)(7), (f), v (17) orpenlxNlon (tidlsdli O) f , 0 ExpbRed exempt edNey Income (adrdlde q , 0 1, Adverthkq kteoms (.SahedlM -0 11 11 Other Irxzme pee peps ! d dr eleeuatlorr - elledr adrdler . , • 7oTAL combine Imes 3 th , 6 6 3 6 Deductions Not Taken Elsewhere (See pays 8 of the irlstructlorls for IlmNetlons on deductlofr.) Exce for contributions deductlorls must be dire connected with the unrelett3d btninea infwme. , 4 Compenatlon or oflleels, dlsebon, and tnretese (eahedlA q ,t ,f s.l.N...nd,neo.e 1 fie 707 . 1f Repelw .red nrMderrroe 1f 8 619 ,7 Beddebb ,7 ,t IreereN (seedl edfeAY) 1t ,f Ta«.rwea.rr.. .f 12 fifio. . :o ChsrltebN contrbutbns (see peps 10 d tfr Irlstrlratlorr kr 6neetlon ndr) . NONE 1, Depreelstlon (eNeeh Fam 1, NO 11 Less deprecletlon eINmN on SetrduN A end eYewlrre on rehan 1te 11b NONE 13 Deplellon 2s 1e contNbutbn. to aer.rr.d eomPerreearl pleb . 1s tf EmPbYee benefl DmYrefra 1f 1f Exeeee exampl e~erres (ShcedM Q . . . Ze 17 Excess nsdsnMP cosh (Shcedl~e -0 27 1s Other aedua,bns (atteah eelre4de) S,E,~ ST/~T,EJI(E,N,T, R . sf 141 363 . 1f Totel Deduetbro (edd erlse 11 through 1q , , , , , , , , , , , , , , , , , , , , , f 928 438 . . 3o UnreYtN Dwinees texsbM Income DN«e nN operetinp loss dNUdkn pubtnd Irle 2p hom ens 1~ , , , , , , 3f - 6 8 7 7 . 31 NN OpereNnp bw dedlxdlsn f1 98 839. . 31 Unreletad Dwlnees texebN Income Mfore speeNk deduNlon (wbeeet err 31 from ens 30) , , , , , , , , , , , 3 - 44 718 . speeNk dNualon 33 1 000 . 31 Unrelated buslmes uxabN klcoma (subtract err 33 from•ene 31). If Ilse 33 Y preNer ern err 32, II .wl For Peperwerk RedueNen Aa Netise. eee krtrueVOrr. Form ff0-T pffs) IEt6fa 6000 FnF19F 7078 08/10/2000 71:30.46 V8.07.01 70078381 48 Form 9e0•T (tees 99-0177360 t ax om utat(on ]6 Orpanizatlena Taxable u Gorpers8ons (sea Instructions for tax com ulebon on Wps 11) Controlled group mamWn (aee0ona 1581 and 1563) - cheek !tars ~ See Inatruetlona sttd a Enter your share of the 550,000, 525,000, and 1p,925,tK)0 taxable Income brackets (in Est order) (1)~ NONE ~ (2)~ NONE ~ (3) NONE b Enter orpani:etlon'a ahere of: (1) addltlorrl S% lax (rat more Stan 171,750), , , , , , (2) addltlonal 3% tax (not more than 1100,000) , , - , e Income tax on the amount on tits 3< , , , , , , , , , , , , , , , , , , , , , , , , , , , ? ]ea NON E ]e Trusts Taxable at Trual Retela-(s-aIe Instructlona for tea com utatlon on papa 12) Income tax on the amount on Ilne 34 from ~J Tent me schedule a ~ Schedule D (Form 1047) . ? ]7 Proxy lea fees page 13 d ktr4nrcilors) ? 17 ]e Tetel add Ilne 37 to Iins 36e or 38 whiohever a le. , . , , , , , , , NONE Tax and Ps manta ]e• Foreign tax cradle (corporatlors shah Form 1118, tnrels atledt Farm 1116). b Other creetls (ace pep. 13 d iM ksbuc6orrs) ]eb e General buskrw cradle - Chadt tl ham Form 3600 ar ~ Form (sparJfy)? Ue d Cradtl for prior year minlmum tax (athdr Fam 6601 a 8827) ]ed • Total (add Ilnee ape Mrotrph 39Q , , , See 4o Subtnd Ilna ape Irom lrr ]6... 40 NON E 41 Recapture base. Chatlt tl ham. ~ Form 4266 ~ Form 8811 , , , , , , , , , , , , 41 I7 AaamstM minimum 1st 4 4] Toth tax (add Iinaa 40, 41, and 42) 4] NON 44 Paymarda• a tpp7 owrpaymem croe8ad to 1pp6 , 44a b 1pp8 aatlmatad tax psyrnenb 44b 1 1 800 . e Tax depoatlad with Farm 7061 or Form 2756 , , , , , , 440 d Forelpn orpan@atlerr -Tax geld or wlhhald sl wura (ace Inatrucibrr), 44d • Backup w6hhoWlrp (sae kaatrctlarr) 44e f Other eredile and paymsras (ass ktatruetlarrs) , , , , 411 46 Total payments (add Ilnas 44a through 44Q 4a 1 1 8 0 0 . 4a Eatlmatad tax panetly face Pape 4 d iM Nrbudlana) Check ? ~ If Form 2220 le t4ladtad . 4T Tax dw - If Ilne 46 Is NM than the total of Ilnss ~ artd b, antler amwd owed , , ? NON 4e Ov.rpaymera - if urea 4s le I.rpar then Ina total d Ilna 43 end 4!, araar amotnl owrp.le ? 11 8 00 . 4e Enter IM amourd of Ilrw 48 wart Cradhad tot/// ea8matad tax Re ? 1 ~ 800 , Statements Re ardin CeRain Activities •nd Other Information Sse irlatructlons on a e 14. 1 At any Dma during the 1996 calendar year, did the orpenita6on hew an Irttareet In or / sipnalun a o1Mr etfthorlly Yea Ne over • financrN account in • forelpn caurdry (ctxdl es • bank aeeoutlt, sectwHlse eccotalt, or oeter flnattdal aeeatlp? X H 'Yee," the orpanizatlon may haw to TAe Form 7D F 90-22 1. H "Yee," abler tM name of the forelpn country hers 7 Dudnp tM tax year, dW 1M orpmit:atlon recent • dleMbution hom, or wee ! Uta granter d, ar trarsfaror b, a loratpn trurl9 X 11 -Ya; see paps 14 d Ste IrrtnMlons for dfw farms tlr arpardte9on mry Ireva b Ile ] Enhr the amount of hx•exem Interest rseelwd ar sotawd 6s 1st SCHEDULER-COST F GOODS SOLD Sse insWdions on a e 15. Method d Inwrrto wluaaan ? 1 Imamory at bepinnirq d year , 1 NON a Inventory H end d yar , , , , , , , , , e NON E : Ptrcftaass, , , , , , , , : 7 ti 3 448. 7 ca.l of peods geld seMnet hra e 1 Cast d Isbar, , , , , , , , . , 1 from Ilna S. (Erur hen and an Irra 4. Aeetllon.l asatim 2e3A raw 2, tyre I.) y 7 6 3 448 . (aMaeh selydtA) , , , , 4• t Do tM Nlw of ssetlon 263A (with raaparib Ya Me 0 OtMr costs (a6aeh eeMdtae). , 4 b properly produced or acqulrad for ruW) apply b s Tohl-wed trees 1 Inrau 4b s 763 448. area or arttratlort7 X und.r penam 1 Par ~}T, r daelere t rtA Aare etamkrq UtY raaaRteprdYrp aCrAar sra atarsrrer.t, erN to tle bat[ a rry aowdp. PAW and W a trw, d, and w k D~n on preps r (Wr 8rr ~ 6wa an Y Hunrlbn dMaen praparar Ir ry aaNe~a Npiei S EvP ~ Cho 6lpratura a Debar u tldtstsy Gale ' TMle Prepren Dre Chadr a u/- Prstxeren aotlY eaeely ranear Pafd a, ' ~ em 220-82-0047 Preparers am r.me(aryan, ERNST a YOUNG LLP (74 ? 34-8688698 Use Only tlwa.npsy.d) ' 2400 PAUAH I TOWER 1001 B 1 ZPasaa ? 98818 +M HONOLULU, HI ensaoese~OF19F 1018 013/70/2000 74.30.46 V8 07.07 70076381 48 Form 9e0•T lteeal 9 -0177360 aw s SCHEDULE C -RENT INCOME (FROM REAL PROPERTY AND PERSONAL PROPERTY LEASED WITH REAL PROPERTY) (See Instructions on page 15.) 7 Description of property (t) (2) (3) 4 2 Rent reeeWed a ettrued p) From penonei property (f ere peraniepa at real (b) From rnl entl pereonel goperry (Nine percereepe a Detluetbro tllreciy eonneaW ,rat, tlu Yenrne h for pareonel PropeM ¦ more iMn 10% bai IKn M rent rot penonel progrty exceeds SU% a Y Iti cdumna zp) eM 7tD) (eW W, eoheole) more Nen 50% rent k Deeed on a Intdra 1 2 4 TaN ToW TohldaducUoes.Ertbr Total Income (Add totak of columns 2(e) and 2(b). Enter hero hers end on Ina B, column end on Ilns 8 column A Pert l eat ? B Part I 1 SCHEDULE E -UNRELATED DEBT -FINANCED INCOME See Instructions on a 10. a DwuRlar tlYeery axxraetl eN a ebabM b 7 Deeenptbn a oegJMirxwf property : Grose xroenr nom a tl eeoeeDN ro tlebl•Innnoetl UI 61nIpM IM Oepedeaa, M Otl,er tlea,ollaa Fr°O~M erred, 1 t Amount M ewepe i Avenpe egrretl beet ri t ecquwtlan tlebl on a or etoeebY b Cohn I 7 Grove Incas apa0eble t AllopbN 64rdlaa NkoebM ro tleadYnneetl tleDlalnenoetl prepary tlMtlW by (COIWM 6 x total a aateoa r cress ants cWUmn 3 leolumn Z x Cann e) 3h) ana J(D)) 7 4 stet here end on Ins 7, Entar hats end on Ina 7, olumn (A), PeR I, papa 1 column (B), PeR I, Pape 1 Totals Total dlvidends•reeaNW ineludad M olum B SCHEDULE F -INTEREST, ANNUITIES, ROYALTIES, AND RENT8 FROM CONTROLLED OROANQATIONS Ses Mttthucporn txt 17. e 0.euNnre d amearie ~ Exe oord,aaet 1 Nerve end atldnee d aoreoYd apreaetlaip) ! Grave Ytoarr eryenlteeer+tiaP M) Unretre0 PI TeaehY Mart aorrprd kI has axarWletl wnneetee ww meeee 7 r tl,aryl M scampi a,tler astern (a) oryerrtreaerrpe) anma lewr.drar) Ineonr~r sea tSOn(y, a fr amaet h AMtltl W x x x 4 % Norrxenpt wNOYtl orpenlreaoa M TarMe stoats, a k)Cone,n pap a Grove Iromr nperubY 7 AaowbM tletluoaoa p? Excer maple nroer,r amount h aonrm (y, tlWitletl W Icewmn z x eaurnn e(e) a (eolre,n 7 x canem ye) a column 6(e)) cohxnn 6(ap 7 Enter here end Nxluda tm Erdar here end Yteklda on Ilna ll, column (A), PeR I, Ise e, column (B), PsR I, ToUle ? a a 1 • 1 .,ee ee,ss, ao 60F12E 1018 06/10/2000 14:90:46 V8.07.01 10078981 47 99-0177350 Form eeo-T (tired) 1'.0.4 SCHEDULE G -INVESTMENT INCOME OF A SECTION 501(c)(7), (9), OR (17) ORGANIZATION See Instructions on a e 17. i DWUaUara f Tohl htlu0lpre 7 De.cnptlon d •rpMr 3 Amount d rrrmnN tliredlr pplYledetl (nedl entl M.ooltloo (opt a 1 1 Enter here entl on Yrle p, - -'4c-~ Eller free end trn column (A), pert I, pogo 1 Ilno p, eokpnn (8), TNele ? Perl 1, ptrq 1 SCHEDULE I -EXPLORED EXEMPT ACTIVITY INCOME, OTHER THAN ADVERTISING INCOME See insWClions on a e 17. ~ NN Irmrre 7 E1grIMO (loco) tbn 7 Eton erarrgl a tllredlr unnlNW Doh eyer~ee 1 Doscnptbn d unreMOtl eonneetetl wer ar braYrer• a Gras tw~arr a ~M (column a mku orbloOW ecWay bu.Yre kroorrMl protlucllon d (column a rtiFrr~ horrr eRh7ly Irrt etlrlbNebb b Colnlrer 6. but b hom tnh ar unrN.htl column a>_ N e h not rrneYtotl ool,ere, a mph M bulrieee burrw kwvrr pMn, aanPee btnlrren Yroprrr adrnm Q coo 6 eoagh 7 1 1 Enter ban end on Enbr bon and on Mfr Ilne 10, col (A), Ilne 10, ccl on Ilno ?d, PM II, Port I, WOf 1 Pert I, pope 1. pope 1 Colum toh ? SCHEDULE J -ADVERTISING INCOME Ses instruelbna on a 18. kteome From Perlodleals Re rbd orl • Conaolldaited Basb ~ AtlvalYlp 1 Nerve d a Gron a Bred pole or (lpo.) (oot a Clmrlaan • R..er.erq r. E..I~iq ope p.noalrr odor a minuo pat a} r tneon~ (aohem d mlru Yworrie t~ s r00~T _ eplumn 6, brt npt mat that eduner ¢ T 1 uM iN.Y (cry to Port I ? ktcorrle From Periodleab Reported en • Seperab Basb ( or each psriotilcal Ibtted In Pert 11,1111 columns 2 thro h 7 on a Ilne- Nne beat. t 4 TN,Y beer M 1 Entor bore ord m Enter Iles end rn Mr Isere IIM 1 T, col (A), IIM 11, cal IM Ilrle 27, Pat II, Column totob, Pal I, pope 7. Pert I, pope 7. pope 1 Perlll.. SCHEDULE K-COMPENSATION OF OFFICERS DIRECTORS AND TRUS E S ee in on 18. s erpordM carrperreuatretaeoab 7 Wme a Teb tlme tla0bd b b unYbtl arreYrao TNN - Erda hen end an Irr 1~ Port 11 1 .et..et 60F12E 7018 06/10/2000 14:30:46 VB.07.01 10078381 48 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0777350 )RGANIZATION'S PRIMARY UNRELATED BUSINESS ACTIVITY. .~SSSiCiiiC6iC3i~iiCl.CC~~~~~i~~CT.iiCiiiiiiiiiiiiiiii 'HARMACV SALES TO THE GENERAL PUBLIC . STATEMENT 1 60F12E 1078 06/10/2000 71:10:14 V8.07.01 70076387 49 KAPI'OLANI MEDICAL CENTER FOR WOMEN AND 99-0177350 FORM 990T - PART II - LINE 28 - TOTAL OTHER DEDUCTIONS ~piQQiQiiiCCCSSYi'Li6000CQC~CpCCC~QCplQiiiii66iiiQiiiY OVERHEAD ALLOCATION 139,800. SUPPLIES 1,282 SUBSCRIPTIONS 269. OTHER EXPENSE 12 PART II - LINE 28 - OTHER DEDUCTIONS 141,363 iiiiiiiiii STATEMENT 2 ~~10~ 60F72E 7018 06/10/2000 74:30:46 Ve.07.01 10078381 60 Kapi'olani Medical Center for Women and Children EIN: 99-0177350 FYE. lone 30, 1999 Form 990-T, Part II, Line 20 -Charitable Contributions Carryforward from 6/96 S 6,496,420 Carryforward from 6/97 6,567,899 Carryforward from 6/98 7,271,390 Correa[ Year contributions 7,834,277 Total Contributions available 28,169,986 Deduction allowed (10% of AGI = 5-5,877) 0 Carryforward to 6/30/00 S 28,169,986 Form 990-T, Part II, Line 31 -Net OpentinQ Loss Deduction FYE 06/30/981oss (subject to carryback) S 38,839 Total Carryforward NOL 38,839 Loss utilized 6/30/99 0 Carryforward to 6/30/00 S 38,839 Form 4626, Line 6 -Alternative Minimum Taz Net Operating Loss Deduction FYE 06/30/981oes (subject to carryback) S 38,839 Total Carryforward NOL 38,839 Loss utilized 6/30/99 0 Carryforward to H/30/00 S Statement 3 CONTROLLED GROUP ELECTION STATEMENTS ELECTION TO ALLOCATES 18,000 BUSINESS ASSET EXPENSE The undenrgned corporation, component members of a controlled group of corporation, as defined in Internal Revewe Code § 179(dx7), hereby consent to the apporoonment plan fisted below wath respect to the taxable yeu of uch corporation which includes ]une 30, 1999. ELECTION TO ALLOCATE 540,000 ALTERNATIVE MIIQIMUM TAX EXEMP11ON The undenrgned corporation, component members of a controlled group of corporation (within the meamng of Internal Revenue Code §1563(x)), hereby consem under IRC ¢ 1.58-1(cx3) to the apportionment plan listed below with respect 1o the rouble yeu of each corporation which includes Jtme 30, 1999. ELECTION TO ALLOCATE 5150,000 ALTERNATIVE MIIQASUM TAX I:XEMP71ON The undenrgoed corporation, component member of a controlled group of corporation (within the meaning of Internal Revenue Code ¢1563(a)~ hereby consent under IRC ¢1.58-1(ex3) to the apportionment plm lisped below with respect ro the tuable yeu of each corptastiam which includes June 30, 1999. ELECTION TO ALLOCATE TAXABLE INCOME BRACKETS The undenigoed corporation, component members of a controlled group of carpondon (within the meartmg of Internal Revewe Code ¢ 1563(x)), hereby consent under IRC ¢ 1.58-1(ex3) to the apportionment phm listed below with respect to the taxable yeu of each corpontiam which include ]tine 30, 1999. I:LECIION TO ALLOCATE ACCUMULATED EAItNINOS CREDIT The uadenigmd corporsdoq component member of a controlled group of corpontiom (within the meaning of Internal Revenue Code ¢1563(x)), hereby consent under IRC ¢1.535-3 to the apportionment plan listed below wilh respect so the taxable yeu of each corporation which mchrda June 30, 1999. ' Company Employer Apport of Depr. Apport. of 540,000 Apport of Nnmba Bwinas Asset Alt Min 1'a 5150,000 Alt Min. Expense Exemptiam Tax Ertemptiam 1 99-0318588 None 540,000 SIS0,000 2 99-0177350 518,000 None Nam 3 99-0274038 Nom None None STATI3~C OF TAX BRACKET A1.LOCA77ON The amamb in each taxable inca~me bracket in the tax table in 1RC ¢11(b) have been alloated to the following easpaadams ptasuant to ¢ 1.1563-3(a) Company Employer Fint 550,000 Taxabk Taxabk Twbk Taxabk Number of Taxable income over income over income eve income over ]ncome 550,000 but 575,000 but 5100,000 bat 5335,000 brat not over not ova not ova not ova 575,000 5100,000 5335,000 SI0,000,000 1 99-0318588 Nam Name Nom Name Nom 2 99.0177350 550,000 523,000 523,000 5235,000 59,663,000 3 99-0274038 Nom Nom Nom Nom Nom CONTROLLED GROUP ELECTION STATEMENT IDENTIFICATION AND SIGNATURES: Ca~mpany Employs Name and Addrea Taxable Si~agae and Title of Office Nwabs Yea End 1 99-0318588 Kapiobuu Service Corp. k 06!30/99 Subwdiaria SS Merehaat Street. 24~ Floor Hanohiln,Hl 96813 / ~j~ 2 99-0177350 Kapiohmi Medial Cents fa 06/30/99 Gr~C~~i~ti'Fn ~?Pe(~ Women sad G3ildrea SS Merchant Sheet, 24~ Floor Honoluht, HI 96813 3 99-02474038 Kapiohnu Medical Ceats at 06!30/99 ~P A~ Pali Momi SS Merchant Street, 24a Floor Honohilu, HI 96813 _ Atla•e:s acv reD", ° . o~.:~5: e. :i 9J?:: _ _ _ L 1.A•eu:~a 3.2~ internal Revenue Service cn• ,•a~• ~e J . Jones FEB 1 7 1978 L-178, code EZZEO:-z:~:: Determination Section (213) 683-4553 D Aapiolani-fh ildren's Med.ra! Cancer 1315 Funahou Scree[ Honolulu, Rawaii 96826 Purpose: Charitable Accounting Period Ending: June 30 Based on information supplied. sad assuming your operations will be as stated in your application for recognition of exemption, ws have determined you are except from Federal income tax under section SOl(c?13) of the Internal Revenue Code. Re have further determined you are not a private foundataoa within the meaning of section 3091a) of the Code, bec use yea n e ~~s:: crganization described ia,ssetion 170(b)(1)(A)~iii) and ~09(a)(1). You are not liable Tor social security (FICA) taxsa unless you file a waiver of exemption certificate as provided an the Federal Insurance Contributions Act. You are not laabls for the taxes imposed under the Federal Unemployment Tax Act (FUTA). Since you are noL a private foundation, you are not subject to • the ezeisa Lazes under Chapter 42 of the Cods. However, you ere not automatically exempt from other Federal exeasa taxes. If you have any questions about excise, employment. or other Federal taxes, please let ua know. Donors may deduct contributions to you as provided in sactior. 17U of the Code. Bequests. legacasa, devises, transfers, or gaffs to ;:ou or for your uas are deductible for Federal estate and gaff tax purposes if they meet the applicable provisions of sections 2055. 2106, and 2522 of the Code. If your purposes, character, or method of operation is changed, please let us know ao we eaa consadar the etfoct of the change on ^ocr except status Also, yoe should inform us of all changes in your naxe or address. iOr•r~ Form L-178 (Rev r%3) laoo~ - yo__ E:ess re:sz::: sat.. yea: a norca:'_g ::cre to=~ _ t:e :equ: rec :e f:ie ' _ - 99:.. ne o: G: gar._za:ion =:ces: income Tax. es the 15 day of the fiftc monts• after the en2 c`wycu: anrusi accouaL:n~ period. The :ar imposes a penalty of £10 a ca)•, up to t ¢ar.L-a¢ o= £S.000, for :allure to file a return oa Lice. Fou a:e no: :eeu:red to file Federal income tax rar_rns unless yo. a:e suo~ec: the tzr. on unrelated business income under sectio: 5__ of the Code If you are subject to•this tax, you must file an In~a.e :a: return on Forr_ 990-T. Ir. thas letter re are not deterelnia` rhethe: nay of yoar present or proposed activitiea are unrelated trade or business as defined in section 513 of the Coda. You need ar. emoloye: identification number ever. if you have no a^loyees. If an eaploysr identification numbs: ras not entered on yo::: applicatio:.. a number rill be assigned to you and yoc gill be advised of it. Please use that number on all returns you fil• and ir. all correspondence rith the Internal Revenue Service. Please keep this determination letter in your permanent records Sincerely yours, . (30-,...,-~.~ District Director ec: William A. McDonald el • Form 1-178 (R~v a-73~ CERTIFICATE OF INSURANCE IMYed DY• Treok InWferwe Caohenee. L,oe Anpelee. CA Natrwd Kaplolenl Medbal Lerner for Warren end ChlWren Ineraed Addnaa 110 Ounshou Street Honolulu, Howell pes:e 1170.1000 um Tbla nrtifh:ato or vwMkatlon of Ineerate:a le Trot an Inaurallae palby and daM net arrsnd. extend. or eher tha covaapo afkrded ry tha pdby nhmd to above. Nolwithafsl~np any rgebeasnb tarrll ar rusld7tlon W eny eontraot a other doounsM wrfh rNNat to whleh thle oeAlsoale a wABodlon of Ylarlrallae mtly be leewd or may wrfaln. tN Inwnnoe aNordad by tM poNcy N whJeot b NI the terns, eaohreione, and aandllbne o1 each pollry. Inarrlee hoe • SInpN LImN ae hMkaled below. SINOL.C LJMIT SS mipbn tech Ooeunenw • CanpreMnatw NaeMese Proheabnel WIIIrtY, Oeaeret UiOY~y, BodNy InJury i HePaftY t?awepe UIeYMty • Ctalma Made 'MadNled Oaoemrse n •Oaeurtenn DlSCgIPT10N OP OPFRATIONi1VEHICI.ESAPCCIAL ITCMSIItlMARKS: ErMNnea d tleepheere Oaewl aM P'reN WenM UablNly Nvwge for pant rMeYnp q Kapleled Child Wdstlon CerAer -Went Hawall Branch alld tM County of Hawall. Notla of nanoepalbn of the cevwape eWanWnly terminaMe eeveraBe. A1M aalroMlatlen tMS aerMllaate 6aaoma void eatl wnheu! efetaf. A bnMrdown of fhe Ilrnpe wIN ba pnvlder open derrtenr. EMeoWs Oobber 1,1001 CwrtMuoue ulltll canoebd Dale Plan tae AnpeNe, CA County of Hawap Interest M ~ flnanoe 76 Aupunl Street, SYMe 11p Hlb, HerrNi 0{720~tp1 /~A',/-~ January Z0. 111pe CSI-srf~.e/ / / DATE TvPEO AueheNree Reoreeen•~twe T FARMt.R6 INSURANCE Gi7C::P t]t' COMPANIES - ICAPTOLANI MEDICAL CENTER FOR WOMEN AND CHII.DREN CERTIFICATE OF RESOLUTION I, Betty Kaneshiro, Assistant Secretary of ICAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN, a nonprofit corporation duly orgeniad and existing under and by virtue of the taws of the State of Hawaii, do hereby certify that the following is a full, true and wrrect wpy of a certain resolution adopted by the Board of Tnz,tas of said corporation, at a meeting duly called and held at the o>$cw of the Corporation, I319 P~mahou Street, Honolulu, Hawaii, on the 2nd day of April, 1987, at which meeting a quorum was present and acting - throughout; and that said resolution has not been modified, amended or rescinded and continues is full force sad aliext; RESOLVED that s~ individual at the time holding the position of Chairman of the Board, Via Chairman of the Board, 1'resideat, Executive Vta President, Seaetery air Treaa~aa, be, and each of tluan hemby is, audrori~d to execrme on behalf of the Corporation any bid, proposal or pct for the sale or rental of the products of the Caspeaatie®, and to execute nay bond required by any such bid, proposal or connect with the United Ststes Oovermnaot or the State of Hawaii as the City and Courty of Honolulu, or any Comity or Municipal Ooverament of said State, or arry department or nub-dividon of a~ of them. IN WITNESS WFIEREOF, I have hereunto set my lewd and affixed the corporate seal of said I{.API'OLAM MEDICAL CENTER FOR WOMEN AND CHII.DREN this 17` day of August 2000. c.~i~ arty ' ~ , Assrsiaat Secretary KAPI`OLANI MEDICAL CENTER fur Womtn b CJt~ldrrn CHARTER OF INCORPORATION ARTICLE I Colporste Name The name of the Corporation is ICAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHII,DREN. ARTICLE II Location of the Coroontlon The location of the Corporation and the address of its initial office is 1319 Punahou Street, Honolulu, Hawaii 96826. ARTICLE III C~ponte Poro~ Section 3.1 pin Qoag. The corporation is organtzed exclusively to operate and mazntain a hospital and medical curter primarily to provide comprehenive health care servtces and resources to women and children and to operate exclusively for charitable, educational and scientific purposes, within the meaning of Section 501(cx3) of the Internal Revenue Code, including for such purposes, the malting of distribution to organization that qualify as tax-exempt organization under Section 501(cx3) of the Internal Revenue Code of 1954 (or any future wrneponding provision). Sectlon 3.2 RnMctlons. No part of the assets or earnings of the Corporation shall more to the benefit of any individual. The Corporation shall not participate in or intervene (including the publication or distribution of statements) in say political campaign on behalf of any candidate for public office. Notwithstanding any other provision of this Charter, the Corporation shall not carry on any activities not permitted to be carried on: Aa Adopted May 18, 1976 and amended throu8h luly 7, 1993. (i) By a corporation exempt from Federal Income Tax under Section 501(c)(3) of the Internal Revenue Code of 1954 (or the corresponding provi- sion of any future Umted States Internal Revenue Law); or (ii) By a corporation, contributions to which are deductible under Section 170(c)(2) of the Internal Revenue Code of 1954 (or the corresponding provision of any future United States Internal Revenue Law). ARTICLE rv Cornonte Powers The Corporation shall have and possess all the powers permitted to nonprofit corpora- tions under the laws of the State of Iiawaii. ARTICLE V Coroonte Llfe The duration of the Corpotation shall be perpetual. ARTICLE VI Trartees sad Oflleen Sectloa 6.1 @q¦rd of Trastees. There shall be a Board of Trustees elected as provided in the Bylaws who shall number 20 at the formation of the Corporation and within three years thereafter shall be reduced to a number not leas than eleven nor more than seven- teen persons. The Board of Trustees shall have sad may exercise all the powers of the Corpo- ration except as otherwise provided by law, this Charter or the Bylaws. Sectioa 6.2 Qj$~ The officers of the Corporation shall be a chairman of the board, a president, a secretary sad a treasurer. The Corporation may have such additional officers as determined in aocotdaace with Ure Bylaws. The officers shall have the powers, perform the duties and be appointed in the manner set forth in the Bylaws. Any person may hold two or more o~xa of the Corporation unless such practice is prohibited by the Bylaws. ARTICLE VII LlabWty sad Iademal~wtloa otOfllcers, Dlreeton. Emoloven sad Aaeab Sectloa 7.1 No Lia611tty to Coroontioa. No trustee, offices, employs or other agent of the Corporation and m person serving st the request of the Corporation as a trustee, officer, employee or other agent of mother corporation, partnership, joint veatiae, trust or rtrrcwc ~v or teo~yomm other mterpnse and no lieu', or personal representative of any such person shall be liable to the Corporation for any loss or damage suffered by it on account of an action or omission by such person as a trustee, officer, employee or other agent if helahe acted in good faith and in a manner reasonably believed to be in or not opposed to the best interests of this Corporation, unless with respect to an action or suit by or in the right of the Corporation to procure a ~udgmmt in its favor such person shall have been adjudged to be liable for negligence or misconduct m the performance of his/her duty to this Corporation. Section 7.2 Indem°itv. (1) The Corporation shall indemnify any person who was or is a party or is threatened to be made a party to any threatened, pending or completed action, suit or proceeding, whether civil, criminal, administrative or investigative (other than an action by or in the right of the Corporation) by reason of the fact that helahe is or was a frusta, officer, employe or other agent of the Corporation or is or was nerving at the request of the Corporation as a tnista, officer, employs or other agent of another corporation, partnership, joint venttae, trust or other enterprise, against expenses (including attorneys' fees), ~udgmmta, fires and amounts paid in settlement actually and reasonably incurred by him/her in comtection with such action, suit or proceeding if hdshe acted is good faith and is a meaner he/nhe reasonably believed to be in or not opposed to the best interests of the Corporation, or, with respect to any criminal action or proceeding. had no maaonable cause to believe his/her conduct was unlawful. The termiaatiaa of a~ action, suit or proceeding by judgment, order, settlement, conviction, or upon a play of nolo contmdere or its equivalent, shall not, of ifsel~ create a presumptior that the person did not act in good faith sad in a meaner which he/she reasonably believed to be in or not apposed to the best interests of thin Corporation or, with respect to any criminal action or proceeding, had reasonable cause to believe that his/her conduct was unlawful. (2) The Corporation shall indemnify each person who was or is a party or is threatened to be made a party to any threatened, pending or completed action or suit by or is the right of the Corporation to procure a judgment in its favor by reason of the fact that such person is or was a frusta, officer, employs or agent of the Corporation or is or was serving at the request of the Corporation as a treats, officer, employs or agent of another corporation, partnership, joint venture, trust or other entity, against expenses (including attomeya' fees) actually and reasonably inmrsed by him/her in connection with the defetiae or settlement of such action or suit if hdshe acted in good faith and in a meaner he/she reasonably believed to be in or not opposed to the best interests of this Corporation, except that no tndmuiification shall be made in respell of any claim, issue or matter as to which such person shall have ben adjudged to be liable for negligence or misconduct in the performance of hia/har duty to this Corporation unless and xwcwc m.,Q or ieoorporrfoe p+s ~ only to the extent that the court m which such action or scut was brought shall detennme upon application that, despite the adiudtcation of ]iabrliry but in view of all the ciretunstances of the case, such person is fairly and reasonably rnntled to indetnmty for such expenses which such court shall deem proper. (3) To the extent that a trustee, officer, employee or other agnt of the Corporation or of any division of the Corporation, or a person serving at the request of the Corporation as a trustee, officer, employee or agnt of another corpotadon, partnership, Joist vrnture, trust or other entity, has bern successful on the merits or otherwise m defense of any action, sun or p-~:~edtng referred to m paragraphs (1) and (2) of this sxtion, or in defense of .uiy claim, issue or matter therein, he/she shall be indemnified against expenses (including attorneys' fees) actually and reasonably incurred by him/her in connection therewith. (4) Any indemnification under paragraphs (1) and (2) of this section (unless ordered by a court) shall be made by the Corporation only if authorized in the specific case upon a determination that indemnification of the trustee, officer, employee or agent is proper in the ciroumstuices because he/she has met the applicable standard of conduct set forth in paragraphs (1) and (2). Such detenvination may be tnade• (i) by the Board of Tnistees by a majority vote of a quonim consisting of directors who were not parties to such action, suit or proceedings; (ii) if such a Quorum is not obtainable, or, evm if obtainable and a quorum of disinterested directors so directs, by independent legal counsel in a written opinion to the Corporation; (iii) if a quorum of disinterested tnrstees so directs, by a majonty vote of the members; or (iv) by the court in which such proceeding is or was pending upon application mule by the Corporation or the agent or the attorney or other person rendering services in comecdon with the defense, whether of not such application by the agent, attorney or other person is opposed by the Corporation. (5) Expenses intoned in defending a civil or criminal action, suit or proceeding may be paid by the Corporation in advance of the final disposition of such action, suit or proceeding as authorized by the Board of Tnistees in a particular case upon receipt of an undertaldag by or on behalf of the tnittee, officer, employee or agent to repay such amount unless it shall ultimately be xMCac ~>a or iooorpaerfa. determined that he/she is rntitled to be indemnified by the Corporation as authonzed in this article, (6) The indemnification provided by ttus article shall not be deemed exclusive of any other tights to which those indemnified may be rntitled and shall continue as to a person who has ceased to be a tnrstee, officer, employee or agent and shall inure to the benefit of the heirs and personal representatives of any such person. (7) The Corporation shall have the power to purchase and maintain insurance on behalf of any person who is or was a tnistee, officer, employee or other agrnt of the Corporation or is or was serving at the request of the Corporation as a trustee, officer, employee or other agrnt of another corporation, partnership, joint venture, trust or other enterprise, against any liability asserted against him/her and incurred by him/her in any such capacity or ansing out of his/her status as such, whether or not the Corporation would have the power to indemnify him/her against such liability under the provisions of this Article. ARTICLE VIII Membenhio The sole voting member of the Corporation shall be I{api`olani Health [formerly (mown as Kapiolani Health Care System], a Hawaii noapmfit corporation. The sole voting member of the Corporation shall have such rights and powers as are provided in the Charter of Incorporation, the Bylaws snd the laws of the State of Hawaii including, without limitation of the grnerality of the foregoing, the exclusive power. (a) to elect the trustees of the Corporation and to remove any of the trustees of the Corporation from otHce; and (b) to vote on all matters where the vote of members with voting rights is required under the Charter of Incorporation, the Bylaws, or the laws of the State of Hawaii. The Corporation may provide in the Bylaws for one or more classes of supporting, life, honorary, or other non-voting members, who shall have Uie rights set forth in the Bylaws but who shall not be entitled to vote or to have any voice in the management of corporate affairs. ioecwc mnc a iowraonooo rse s ARTICLE ix Divisions The Corporation may provide m the Bylaws for special articles of governance for erne or more drv~sioas. such as the Auxiliary and the Medical Staff; and the Bylaws may authonze such drvts~on..:o adopt their own. bylaws, rules and regulations, subject to approval of the Board of Trustees. ARTICLE X on-Profit The Corporation is not organized for profit and it will not issue any stock, and no part of its assets, income, or earnings shall be distributed to tts trustees or ofScers, except for semces actually rendered to the Corporation, except that the Corporation snail be empowered to make payments and distn'butions in furtherance of the exempt purposes for which it was formed ARTICLE XI Co~onte Liability The property of the Corporation shall alone be liable in law for the payment of the debts and liabilities ofthe Corporation. ARTICLE XII Coroonte Dissolatioa If the Corporation shall cease to exist or shall be dissolved, all property and assets of the Corporation of every kind, after payment of its just debts, shall be distributed to I{api`olani Health [formerly known sa 1{apiolaoi Health Cars System], ICapi`olani Health Foundation [formerly known as I{apiolaai Medical Center Foundation for Women and Children) or either of them, or to any other health care organization which is then affiliated with either of them, provided the recipient is then a tmr-exmtpt organization described in Section 501(c)(3) of the Internal Revenue Code of 1954 (or the corresponding provision of a~ future United States Internal Revenue law), but if ICapi`olani Health [formerly known as ICapiolaai Health Can System] or ICapi'olaoi Health Foundation [formerly known as Kapiolani Medical Center Foundation for Womm and Children] at that torte is no longer such atax-exempt organization, then the remaining assets shall be dishibuted, for the specific purposes of prenatal and postnatal health care for Womm and childrsn, only to one or mon public agencies, arganizuiom, corporations, trusts or foundations organized and operated exclusively for charitable, scientific, educational or literary purposes, no part of whose assets, income or earnings may be used for dividends or otherwise withdrawn or distributed to or nnun to the benefit of aay private shareholder or individual and the activities of which do not xracwe arr~ of toeoipaneoe P~{e 6 Include partlcipatlon or mtervrnnon (including the publication or distribunon of statements) In any pollticai campazgn on behalf of any candidate for public office. In no event shall any distribution be made to any orgaaizahoa unless it qualifies as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code of 1954 (or the corresponding provision of any future Umted States Internal Revrnue Law) with purposes similar or related to those of the Corporation. To the extrnt economically and socially feasible, any such drstnbutions shall be allocated equally betwern medical care fur women and medical care for children; and to the extent that any restncted funds art distributed for one of such purposes, an equrvalrnt amount of unrestricted funds ahsll be distributed for the other purposes, so that the total distribution shall be approximately egtiivalrnt. ARTICLE XIII Bvlaws The power to adopt, alter, amend or repeal the Bylaws or adopt new Bylaws shall be vested in the Board of Trustees subject to repeal or change by the action of the members. ARTICLE XIV Charter of Iecorpontion This Charter shall be subject to amendment from time to time in the manner set forth by law, and the Corporation shall be subject to aII general lawn now in force or hereafter enacted with regard to corporations of this naturie. NNN NIVN r~tcrvc br ItAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN Certification of Assistant Secretary I, Betty I{aneshiro, Assistant Secretary of 1{API' OLAM MEDICAL CENTER FOR WOMEN AND CHILDREN, a nonprofit corporation duly organized and existing under and by vtttue of the laws of the State of Hawaii, do hereby certify that the Bylaws attached hereto are a fiill, true and correct copy of the Bylaws as amended through October 15, 1997, aad that since that date said Bylaws have not been modified, amended or rescinded and continue in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal of said ICAPI' OLAM MEDICAL CENTER FOR WOMEN AND CHII.DREN this 7• day of January, 2000. ~G't:~ B Kaoeshiro Assistant Secretary KAPI'OLANI MEDICAL cErrrEr. . for women b C/a7drcn BYLAWS ARTICLE I Activit;es The activities of I{api`olani Medical Center for Women and Children (the "Corporation") shall be those necessary and appropriate to accomplish the purposes of the Corporation as stated in the Charter of Incorporation of the Corporation (the "Charter"). ARTICLE II Membenhio and Votlea Seetloe 2.1 Votlntr Member. The sole voting member of the Corporation shall be ICapi`olani Health [formerly ]mown as I{apiolani Health Care System], a Hawaii nonprofit corporation. Sectloe 2.2 Sunnortleg. Life aed Honorary Member. Any individual or corporation may be a supporting, life or honorary member of the Corporation by vote of the Trustees at any regular, special or annual meeting, and who pays such fees and dues as maybe prescribed by the Board of Trustees, Supporting, life and honorary members shall be entitled to the pnvileges prescribed by the Board of Trustees but shall not be entitled to vote or to have any vorce in the maasgement of corporate affairs. ARTICLE III Meetleg of Members Sectlon 3.1 epppgj,~pg. The annual meeting of the member: shall be held each year at such time and place es the Board of Trustees determines for the purposes of electing trustees and transacting such other b++~++s?< as may come before the meeting. The voting members may dispense with the annual mating by unanimous written consent. Section 3.2 Snecid Meetleas. Special meetings of the members for any purpose or purposes may be held at any time upon the call of the President or any three trustees or upon the written request of the majority of the voting power of the membership of the Corporation, Aa Adopted Msy 18, 1976 and smeoded through October 15, 1997. Section 3.3 Place of Meetin¢, The Boazd of Trustees may designate any place for any annual or special meetmg of the members. If no designation is made, the place of meeting shall be the principal office of the Corporation. Section 3.4 Notice of Meetintta. Notice of all meetings, annual or special, stating the place, day and hour of the meeting and whether it is annual or special, and in case of a special meetmg staling the purpose or purposes thereof, shall be givrn personally or by mail. If by mail, such notice shall be postage prepazd to each member at his address as it appears on the membership roll of the Corporation at least trn days before the meeting. Section 3.5 Adjourned Meetlnes and Notice Thereof. Any meeting of the members, annual or special, whether or not a quorum is present, may be adjourned from time to time by the vote of a majority of the voting members present, but in the absence of a quorum no other business may be transacted at any such meeting. Whrn any members' meeting, either annual or special, is adjourned for thirty days or more, notice of the adjourned meeting shall be givrn as in the case of an original meeting; otherwise it shall not be necessary to give any nonce of an ad~ouined meeting other than by announcement at the meeting at which the adjoununrnt is takrn. Section 3.6 Voti°¢. At all meetings of members, every voting member rntitled to vote shall have the right to vote m person or by writtrn proxy, Section 3.7 QgQp~. A majority of the voting members constitutes a quorum for the transaction of business and any decision of a majority of the quorum of voting member; shall be valid and binding except as otherwise specifically provided with respect to particular matters by the Charter, these Bylaws or by applicable provisions of law. ARTICLE IV Board of Trustees Section 4.1 Number and Oualitication of Trustees. There shall be not less than elevrn nor more than seventeen trustees. The number of trustees for any following year shall be determined by the voting membership at the annual meeting. The President of the Corporation and the Chief of Staff shall be trustees. The remaining trustees shall be elected by the membership at the annual meeting to hold of5ce for the term elected and thereafter until their successors are duly elected aad qualified, provided that additional trustees may be elected at any special mating of the membership called for that purpose during the year to fill any unfilled positrons. Section 4.2 Term of Membership. The initial term of each Trustee shall be for a period of one year and thereafter the time shalt be three years, except that shorter terms may be set so that terms of approximately ono-third of the total number constituting the Board shall expire each year. The term of each President and Chief of Staff as Trustees shall continue so long as each occupies that position. Any member of the Board may be removed ¢uccwc ayi... P•s z from office upon the affirmative vote of not less than three-fourths of the Boazd No trustee may serve for more than three consecutive terms Section 4.3. Schedule and Notlce of Meetings. (a) Organization Meeting of Board. A meeting of the Boazd elected at an annual meeting of the members shall be held at the place of such annual meeting and immediately thereafter and no nonce thereof shall be necessary. In the event that such meeting of the Board shall not be held, a special meeting shall be called to be held as soon as practicable thereafter. The purpose of this meeting is to elect officers of the Corporation for the wining yeaz. (b) $~]gt,~pgg. Regular meetings of the Board may be held at least quarter annually at the place and tune established by the trustees and when any such meeting or meetings is established no further notice thereof shall be necessary. At regular meetings, the Board, subject to any requirements of law aad of the Charter sad these Bylaws, may transact any general business brought before the meeting and take any corporate action. (c) Special Meetings. Special meetings of the Board may be called at any time by the Chairman of the Boazd, the President or by any three trustees. (d) Notice of Meetings of the Board. Except as otherwise provided herein, the Secretary shall give notice of each meeting of the Board, either orally or in writing by mail or delivery not leas than one day before the meeting unless otherwise prescribed by the Board. The failure of the Secretary to give notice or the non-receipt of notice by any trustee shall not invalidate the proceedings of any meeting of the Board at which a quorum of the trustees is ptesmt. Sectloa 4.4 Oaoram for the Board. A majority of the Board constitutes a quorum for transaction of business. Sectioa 4.5 Vacancies oa the Board. Should a vacancy occur on the Board, the remaining members of the Board may, by a majority vote, elect a successor to fill the vacancy to serve for the unexpired term. Sectloa 4.6 Atteadaace at Meetlegs of the Board. If any member of the Board is absent from thrroe consecutive meetings or four or more meetings per annum, without leave of the Board for due cause, his office may be declared vacaat and his removal from the Board and from his office shall be completed whoa ouch fact is noted is the minutes of the Board by order of the Trustees. Tn any such case or procedure, the Board shall fill such vacancy until the next annual meeting. xMCwc syt.~ 3 Section 4.7 Powers of the Board All powers and authority of the Corporation shall be vested in and be exercised by the Boazd except as limited by law, the Charter or these Bylaws: such powers including the following: (a) To acquire and dispose of property; (b) To elect officer; and appoint agents or employees of the Corporation and to confer upon and to delegate to them by power of attorney or othtrwise such power and authority as it determines; (c) To determine all matters affecting finances; to fix the salaries or compensation of the agents and employees of the Corporation, and in its discretion require secunty of any of them for the faithful performance of any of their duties; (d) To make rules and regulations not inconsistent with law or the Charter of Incorporation or these Bylaws for the operation of the medical center; (e) To create coaunittees of the Board and to designate as members such persons as it determines and to confer upon such committees such powers and authority as by resolution set forth for carrying on or exercising the powers of the Corporation; (f) To remove or suspend any officers. Any officer elected by the Trustees may be rmoved with or without cause by the vote of a majority of the Trustees. (g) To incur indebtedness as necessary, and as security for the payment of obligations of the Corporation, to assign, set over, transfer, mortgage, pledge or hypothecate any and all of its real, personal, or other property, and to execute or endorse in the name and on behalf of the Corporation such note or notes or other obligations as the Board deems advisable. (h) Generally, to do any lawful act necessary or proper to cant' into effect the powers and purposes of the Corporation. ARTICLE V omeer: Section 5.1 Prine pal Offlcen. The principal officers of the Corporation shall be a Chairman of the Board, a Vico-Chairman, a President, a Secretary and a Treasurer. The officers shall be elected annually by the Board at the organization meeting or the first meeting thereof after the annual or special meetings of the members at which the Board is elected, and iuwcac syi... >+n 4 shall hold office for one year and thereafter until their successors are duly elected and qualified. The offices of the Secretary and Treasurer may be held by the same person The Treasurer may be a corporation. The Chartman of the Board and any Vice Charman or Vice Chazrmen, rf elected, and the President shall be Trustees. No other officer need be a Trustee Section 5.2 Chairman of the Board. The Chairman of the Board shall have general suprnrsron over the Corporation's busuress and affairs and see to the proper observance and enforcement of the Charter and these Bylaws and the rules and regulations, actions and orders of the Board. The Chairman shall call such meetings of the members of the Corporation and of the Board as are herein provided for and such other meetings as shall seem proper to the Chairman. Sectlon 5.3 Vice Chairman of the Bosrd. The Board at any meeting, may elect one or more Vice Chairmen of the Board. In the absence or disability of the Chairman of the Boatel, the Vice Chairmen in order of their rank as fixed by the Board, shall preside at any meeting of the members or the Board. Section 5.4 President. The President shall have such duties and responsibilities as the Board shall prescribe from time to time. Section 5.5 Vice Prsident. The Board at any meeting, may elect one or more Vice Presidents. In the absence or disability of the Prestdent, the Vice Presidents, in order of their rank as fixed by the Board, or if not ranked, the Vice President designated by the Board of Directors, shall perform all duties of the President, and when ao acting shall have all power of, and be subject to all restrictions upon, the President; the Vice Presidents shall have such other powers and perform such other duties from time to time prescribed for them respectively by the Board or the Bylaws. Section 5.6 ,~~y. The Secretary shall give the notices of all meetings of the members of the Corporation and the Board and shall keep the minutes of such meetings. The Secretary shall furnish the Treasurer with the frames of all persons elected to membership in the Corporation, keep the membership roll of the Corporation. The Secretary shall perform all other duties assigned by the Board. Section 5.7 Treasurer and Aaaiatant Trcnurcr. The treasurer shall review the financial status of the Corporation and recommend fiscal policies to the President, chairman of the board and the Board of Trustees. The treasurer may be a corporation. The treasurer shall perform all other duties assigned by the chairman of the board or the Board of Trustees. The assistant treasurer or assistant heasiners, if elected, shall, in the order designated by the chairman of the board of the Board of Trustees, perform all the duties and exercise all the powers of the treasurer during the absence or disability of the treasurer or whenever the office is vacant and shall perform all the duties assigned by the chairman of the board or the Board of Trustees. Sectlon 5.8 Subordinate tJflicers. The Boatel may appoint subordinate officers who shall hold their positions at the pleasure of the Board, and who shall have the powers and - KMCWC Sylaw~ Paje 3 duties detennrned by the Boazd The number and title of subordinate officers may be changed from time to time and subordinate officers may be appointed from tune to nine at any meeting or meetings of the Board The authonty to fix the powers and dunes of subordinate officers may be delegated by the Board to any officer or officers of the Corporation. Any officer of the Corporation may also be a subordinate officer. Subordinate officers need not be Trustees. ARTICLE VI Chief Executive Officer The Board shall appoint a Chief Executive Officer, who need not be an officer of the Corporation, and who shall have such duties and responsibilities as the Board shall prescribe from trine to time. ARTICLE VII Ezecation of Instruments All checks and other orders for payment of money, drafts, notes, bonds, acceptances, contracts, and all other instruments shall be signed by such person or persons designated by general or special resolution of the Board, and, in the absence of any such general or special resolution applicable to any such instrument, then the mstnunent shall be signed by the Chairman of the Board, any Vice Chairman or the President and by the Treasurer or the Secretary. ARTICLE VIII Committees of the Board Section 8.1 Staodine Committee. The Corporation shall have the following standing committees: Executive, Finance, Nominating and Corporate Bylaws, and such other standing committees as the Board may authorize. The Chairman and members of the standing committees of the Board shall be appointed by the Charnnan of the Board and shall serve for at least aone-year term, which may be extended by the Chairman of the Board. There shall be such special committees as may be appointed by the Cti.irrr~n~ of the Board fivm time to time. At a committee meeting, a quorum shall be a majority of committee members. Activities of the committees may be recorded in minutes. Section 8.2 Fzecutive Committee. The Executive Committee shall consist of the Chairman, the President, and at least one additional tn~atee appointed by the Board. The Executive Committee shall have the power to transact all regular business of the Corporation dunng the penod between the meetings of the Board, subject to any limitations imposed by the Board. Section 8.3 Finance Committee. The Finance Committer shall consist of at least three Trustees, The duties of the committee include the following: tcMCwc arr.. rye6 (a) Responsibility for supemsing the management of all endowment and trust funds of the medical center; (b) Review of and approval of the capital and annual operating budgets of the Corporation. (c) Review of the 6narcial feasibility of corporate projects, acts and undertalungs referred to rt by the Board and malting recommendations thereon; (d) Review and evaluate the findings and final reports of the auditors and based thereon making recommendations to the Board concerning financial operation of, and services required by and provided to the Corporation; (e) Performing such other duties related to fiscal matters as maybe assigned to it by the Board or the Chairman. Sectlon 8.4 Nominating Committee. The Nominating Committee shall be appointed each year by the Chairman of the Board. This committee shall be composed of at least three members of the Board. The Nominating Committee shall have the duty of nominating at the annual meeting of the Corporation, sad at other meetings whrn vacancies are to be filled, candidates to be elected officers and member; of the Board. Sectlon 8.5 Corporate Bvlaws Committee. The Corporate Bylaws Committee shall be appointed each year by the Chairman of the Board. The Committee shall review annually the Bylaws, organization and general policies of the Corporation and shall submit to the Board a report based on its review, including any recommrndations for changes. ARTICLE IX AYatWa There shall be an auxiliary of the Corporation, to be known as the Kepi`olsni Medical Center for Women and Children Auxiliary. The purpose of the auxiliary shall be to assist the medical center by voluntary services, promotion of projects and solicitation of donations and funds for the benefit of the medical center. The Auxiliary shall adopt bylaws to govern its activities and such bylaws shall be submitted to the Board for approval. ARTICLE X Ms~ltiLLSttff Sectlon 10.1 ~anLratlop asd Bvlawa. There shall be an organized medical staff that has overall responsibility for the quality of all medical care provided to patirnts, and for the ethical conduct and professional practices of its members as well as for accounting - KMCWC Bylaws Page 7 therefor to the Board The medical staff shall develop and adopt bylaws, rules and regulations to establish a framework for self-government and a means of accountabihry to the Boazd. These bylaws, rules and regulations shall be submitted to the Board for approval and shall contazn procedures for satisfying the requirements of due process in conducting heanngs and appeals Section 10.2 Medical Executive Committee. (a) The Medical Executive Committee shall be the executive committee of the medical staff. The chairman of the Medical Executive Committee is the Chief of Staff and is an ex-officio member of the Board. (b) The Medical Executive Committee shall act in an advisory capacity to the Board when called upon, approve or disapprove the character of medical work done in the medical center, and if necessary, limit the activities of the members of the active and visiting staff, provided no such member's actinties shall be ]united unless and until said member has had the pnvilege of appearing before and being heard by the Medical Executive Committee. (c) The Medics[ Executive Committee shall advise the Board and make such rewmmendations with respect to all grievances, wmplaints, suggestions and criticisms rogarding medical practice and ethics that are brought to its attention. Section 10.3 ~poointmeots. (a) The Board shall approve, upon the advice of the Chief of Staff of the Medical Executive Committee of the medical staff, the persons entitled to Medical or Dental Staff membership as evidenced by their individual qualifications and licensed by the State of Hawaii subsequently to engage in medical practice within the medical center and the conditions and standards under which such practice shall be conducted. (b) All initial appointments to the medical stafl'shall be for a period of one year pursuant to formal reapplication procedures. Reappointments shall be for two years each. (c) When an appointment is not to be renewed, or when privileges have been or are proposed to be reduced, altered, suspended, or terminated, the staff member shall be afforded the opportunity of due process as outlined in the medical staffbylaws. nrcac ayr.. gra Section 10.4 Phvsicians and Dentists Emoloved by the Medical Center. (a) Physicians and dentists employed by the Corporation in a purely administrative capacity with no climcal dunes arc subject to the regular personnel pohcres of the hospital and their contract or other terms of employment, and need not be members of the medical staff: (b) Physicians and dentists employed by the Corporation, either full or part-time, whose dunes are medico-admuustrative in nature and include clinical responsibilities or funcnons with the medical staff involving their professional capability as physicians or dentists, must be members of the medical staff, achieving this status by the same procedure provided for other medical staff members. Medical staff membership and clinical privileges may or may not be made connngent on continued employment (c) Termination of employment of a physician or dentist in a medico-adrttinistrative position :hall be subject to review, and a hearing, if requested, by a joint conference of Board members and representatives elected by the voting members of the medical staff. (d) When the reason for the action is determined to involve the individual's medical competence, which includes competence to supervise the professional activities of practitioners under his or her direction, the medical staff shall provide for a review of the decision, including the right to a hearing if requested by the individual, and a recommendation to the Board on the action proposed. (e) When the reason for the action is determined by the joint conference to be purely admiaistrative in nature and does not involve the rndividual's medical competence, the Board shall follow its usual personnel policies, or the terms of the contract, if them be one. Section 10.5 Resoonslbilitia of the Medical Stiff. The medical staff shall have the authority and responsibility to establish and maintain the following: (a) To be a member of the medical staff a doctor shall qualify for the medical privileges, and exercise the privileges granted, consistrnt with the requirements of these bylaws and the bylaws, rules and regulation of the medical staff. (b) The medical staff shall be organized to provide a framework for effective performance by the member of their duties aad functions. The organization shall be in categories set forth in the medical ataffbylawa, which shall provide for the election of offioeas, executive committee and service chiefs. The service chiefs may serve for a period of two yeas and may be te- elected subject to the dir~eetives of the medical staff and its bylaws. KMCWC Bylaws base 9 (c) The medical staff shall stnve to create and mazntazn an optimal level of professional performance by its members through the appointment procedure, delineation of medical staff pnvileges and the continual review and evaluation of each member's clinical activities (d) The medical staff shall provide procedures by committee or otherwise for regular review, evaluation and monitoring of practices and functions of members for the purpose of maintazning high professional standards of care; (e) There shall be regular medical staff and departrncntal meetings to review the clinical work of members and to complete medical staff administrative duties; (f) The medical staff shall provide a continuing program of medical education; and the members shall submit or give evidence of participation in the program or comparable programs to the medical stall: ARTICLE XI Contiict of Interest (a) Trustees, oflcers and employees shall exercise utmost good faith in all transactions involving the Corporation and its property, and they shall comply with the strictest rules of honesty and fair dealing. They shall not use their positions or information gained from such positions in any way to create or participate in a conflict between their interest and the interest of the Corporation. (b) No trustee, officer or employee shall act in any manna which affects the Corporation adversely. (c) No trustee, officer or employee of the corporation shall accept any favor which might influence his actions concerning the Corporation. (d) All trustees, officers and employees of the Corporation shall use their best efforts to avoid any new employment, activity, investment or other interest which would wmpete with or be in conflict with the interest of the Corporation and in the event any such activity, investinent or other interest becomes apparent, the trustee, officer or employee shall disclose the same to the Board of Trustees of the Corporation. (e) If any trustee, oflcer or employee prepares to undertake any transaction for which there can be any doubt about the existence of a conflict of interest, the trustee, officer or employee shall file a written disclosure with xMCwc ayr., eye 10 the Executive Committee of the Corporation before consummating the transaction. (f) The President of the Corporation shall prepare an appropnate questionnaire to ascertain if any trustee, officer or employee [s involved in any trars~cuon which may be deemed a conflict of interest with that of the Corporation. Each trustee, officer and selected employee who receives a copy of the questionnaire shall complete and return [t to the President. The President shall report to the Executive Committee all transactions about which there appears to be any question of a conflict of mterest. The questionnaire procedure shall be performed at least annually. ARTICLE XII Auditor The Auditor shall be elected anmially by the Board. The Auditor shall audit the books and accounts of the Corporation and shall certify its findings grid report thereon, in writing, to the members at least annually; and shall make other audits and reports as the Board shall determine from time to time. The Auditor may be a person, copartnership, or a corporation. No member, trustee of a corporate member, or trustee shall be eligible to nerve as Auditor of the Corporation. The Auditor may be removed from of5ce either with or without cause at any time at any meeting of the Board. ARTICLE 7KIII AO1CYdmt;II$ These Bylaws may be altered, amended or repealed at any meeting of the Board provided that written notice of the meeting shall be given in accordance with section 4.3(d) of these Bylaws, which notice shall state that one of the purposes of the meeting is the consideration of the amendment of these Bylaws and shall set forth the proposed amendments. I~VNN v t~t. YjVMa ~~i tt ICAPI'OLANI Human Resources Policy and Procedure: HEALTH EMPLOYMENT OF RELATIVES Number 6.6 Reviewed Effective Date. 11/1/85 Approval Revision Date• 5/1/97 I. Purpose Kapi'olani Health recognizes that relatives of employees may be a valuable source of reciuitmrnt for Iob vacancies. However, n also recognizes employment of relatives in the same organizational entity may cause potential conflicts and create issues of favontism and employee morale. II. Relatives Defined Relatives are defined as spouses, domestic partners, parents, stepparrnts, parents-tn-law, siblings, stepsiblings, brothers-rn law, sisters-rn-law, children, stepchildren, children-in-law, gtandparrnts, grandpazrnts-in-Iaw, aunts, uncles, nieces, nephews, first cousins, and legal guardians III. Procedure A. Conditions prohibiting employmrnt. 1 Relatives shall not be employed where the applicant would: a Directly or indirectly supernse or be supervised by a relative. b Be employed to work in the same entity, subsidiary, or dtvision as a relative. c When a conflict of interest or the perception of a conflict of interest could occur by the applicant working in such areas as administration, finance, matenais management, purchasing, or secunty. 2 Relatives or members of the Leadershup Team and other key members of managemrnt may not be employed with Kapi'olani Health. B Employee relationships occurring after employment. 1 Whrn either a mamage or domestic partnership betwern two employees occurs in one of the areas listed in A above, changes in employment will not be required. However, a mutually suitable solution shall be sought to avoid continued employment of both employees working rn these aeeas The two employees who become so involved (maznage or domestic partnership) shall suggest the suitable solutions to the appropnate members) of the Executive Team, and rn consultation with the Vrce Presrdrnt of Human Resotut;es, the solution will be documented and implemented. 2. If a direct or indirect supervisory relationhhup occurs as a result of mamage or domestic partnership, the employees so involved will determine a plan to resolve the srtuanon within the soonest possible time frame. This solution shall be presented to the appropnate Employment of Relatives Page 2 member(s) of the Executive Team and the Vice President of Human Resources, and, if approved, will be implemented as soon as practical. Should the solution not be acceptable to management, the group will work together until a solution is found that resolves the situation. Depending on the closeness of the supernsory relationship, management reserves the right to require that the two affected employees determitie which one of them will remove themselves from the work environment, either by transfer, demotion, or resignation. This is clearly the least optimal solution, and if it becomes necessary to implement such a solution, an appropriate separation package wtll be offered, consistent with separation packages given in layoff situations. H Policv M~nu~l 2000Vtelanve dac