From: Redacted
To: "Mason Stoppers"
From: Redacted
To: Redacted

Subject: April 2009 Reps info

(... )

March 28, 2009

To all Representatives both Iowa and Colorado. This has gone out to all the Reps prior to me sending this to you. I first wanted to notify the Hospitals and then the Representatives and now want to make sure that you can begin to understand the Financial issue that Shriners Hospitals for Children faces. We will be sending more information out as each week progress. This is what we hope will be a beginning of a “Plan for Financial Stability”.

Regarding: March Joint Board Meeting.

Hi I want to give you an update from the board meeting held in Tampa this past week. I must say that this was the most “Emotional” meeting that I have attended since being elected to the boards. Over the past few years in my State of the Hospital Report, I have made reference on many occasions that we were worried about our hospital budget growing much to fast. In 2005, you ordered the boards to bring the endowment fund up to 12 Billion Dollars by the year 2014. Well, it is now well into 2009 and we have gone in round figures from 8 billion to 5 billion dollars. We have said time and time again that we can’t afford to run 22 hospitals as we have in the past. In fact, the Representatives have been approving a deficit budget since the year 2001. With the endowment fund decreasing, the cost of healthcare increasing, we are put into a situation that is not financial stable for Shriners Hospitals for Children for the long term.

The boards have wrestled with this situation and have really had a very hard and emotional week. I must say that Staff is equally concerned and the one thing that we all came to agree on was this: We all want to continue to care for Children. The question is if we do not address this situation, “For How Long”. Given what we have for income, and even with the possibility that the Representatives will approve the request to begin the process of utilizing 3rd party pay, which will take up to 4 years to get the paper work completed, and that is with a vendor to do the collections for us, that is not enough of a fix to bring our income where it is equal to the expense.

For this reason, the boards will make available to you the voting Representatives, up to 4 budgets that you can adopt. Each of these will be explained over the next few months so that you have a clear understanding of the issues we face. I believe that everyone agrees that the system must change. But when it comes down to the details, few of us are willing to tolerate provisions that might harm them, to sacrifice some hospitals for the greater good. We need to look at the broad picture, instead of each stakeholder focused on his own area and then dig in for the battle. I have been reading a book by Senator Tom Daschle and the government is in the same situation as we are. No money.

I include with this email, the same document that is given to the Imperial Officers and Trustees as well as the hospitals so that we are all looking as the same paper. Again, I reiterate, we all want to continue to care for the children we have as well as those children that will need our help in the future. If we do nothing, adopt a budget that sees us continue to withdraw the funds from the endowment fund, in as few as 5 years, we could close 22 hospitals, and in effect, have a small fraternity with no philanthropy to represent. A summary of the options are to look at some alternatives that all include 3rd party pay. Getting all the necessary things in place at all hospitals, should the Representatives agree to taking insurance, will take almost 4 years to initiate. Why you may ask, because with 20 hospitals in 20 states dealing with different health care facilities and providers in each state as well as the many different providers with each family, all require contracts and that in itself will take a long time to execute. You will see in the document below the hospitals that will be suggested to be closed. The alternative that the board recommends is one will be for a 5 year solution that will keep Shriners Hospitals for Children open for what we hope will be forever, but is does suspend the operations at 6 hospitals. The others would be a huge decrease in the present budget with huge cuts in future budgets that in affect will curtail the services we perform.

Here is the document that I spoke of. Please contact me if you have any questions. We are all exhausted in dealing with this situation, and we hope that you will all help in finding a cure that can keep Shriners Hospitals for Children taking care of children into the future. Those Children that are In the hospitals that are on the closure list, they will all be taken care of in our other hospitals. This information has been given to all the hospital Administrators, Chief of Staffs, Directors of Patient Care Services, and the Chair and Vice Chairman in a Teleconference on Thursday afternoon. I feel that it was necessary that they be informed first, as the media will be on this immediately after, and that they were. I also felt that each of you be informed and a copy of the talking point be given to each of the representatives, so that you can offer your thoughts and we may have the chance to answer them before we get to San Antonio. Remember, you will be given the opportunity to vote on a budget and we the Boards will do our best to make it work. This will be an effort to have each of you help in this dramatic and emotional situation we find the finances in.

SHRINERS HOSPITALS FOR CHILDREN

Talking Points

At the meeting of the Boards of Directors and Trustees on March 23-25, several actions were taken to address the future direction of Shriners Hospitals for Children (SHC). The deliberations by the members of the Boards focused on meeting the growing shortfall in cash flows necessary to operate the hospital system. This shortfall, at a minimum currently stands at $200 million.

Financial viability is deemed dependent upon both revenue enhancements and cost reduction measures throughout the system. The success of each will require the cooperation of the Nobility, leadership and staff.

The revenue enhancement initiatives include:

- Continuing prudent management of the endowment

-Exploring third party pay

a. pursuit third party pay for eligible patients, 3-4 year implementation

-Increasing Philanthropic/Development efforts

a. increase number of development directors

b. create corporate giving partners

c. develop a planned giving and major gifts program

d. create a nationwide signature event

The cost reduction efforts include:

-Across the board reduction to the operating expense budget

a. immediate reductions of 5% to 7% in hospital’s operating budget for 2009

This would not apply to hospitals affected by consolidations

b. Modify employee benefit offerings (i.e., suspend employer match to defined contribution plan, freeze defined benefit pension plan to existing participants, reconfigure investment strategy for pension plans, and consolidate to single HMO offering)

c. 8% reduction to Headquarters in 2009 operating budget

d. Consolidate into four major research centers in the U.S. (Northern California, Boston, Philadelphia and Portland; continuing the research in Canada)

e Actions for 2010: reduce nine hospitals by additional 3% operating expense and Headquarters by additional 5%, implement third party pay

-Assessing the inpatient versus outpatient models of care

a. identify hospitals to transition from inpatient hospitals to ambulatory centers providing day surgeries only

-Taking action to address excess capacity across the system

Reconfigure the hospital system:

a. Possible closure of 5 hospitals (Erie, Spokane, Springfield, Shreveport, and Greenville)

b. Uphold the suspension of the Galveston Hospital

c. Transition patients to other SHC hospitals Year 2011 the financial stability is regained

2011- Resume modest growth

2012- Assume favorable results from third party pay; budget would grow by 3.2%

2013-continue on the path of previous year projection of $35M from third party pay continued implementation of third party pay has a financial projection of net revenue of approximately $70M

The Planning committee recommended a multi year plan offering a potential path to financial stability. As adopted by the Boards, the options outlined in this plan will be presented to the Imperial Council in July 2009 in San Antonio, Texas. As implemented, these options would allow Shriners to fulfill their philanthropic mission of Shriners Hospitals for Children.

Information will continue to be updated regularly through several means of communication.

So, below here is some good news as far as donations is concerned;

The International House of Pancakes (IHOP) raised $448,000 for Shriners Hospitals for Children during the month of February.

IHOP celebrated National Pancake Day by giving out a free stack of buttermilk pancakes to customers on Feb. 24 at more than 250 locations in 7 western states: Arkansas, Colorado, Louisiana, New Mexico, Oklahoma, Texas and Wyoming. In return, guests were encouraged to donate what they would have paid for their pancakes, or more, to Shriners Hospitals for Children.

Prior to the big day, IHOP introduced a four-week point-of-purchase fundraising campaign at the participating locations. When guests paid for their meals, they were given an option to add between $1 and $5 to their bill, with proceeds benefiting Shriners Hospitals for Children. This component of the campaign raised $176,000.

The health care system has been the beneficiary of National Pancake Day at select IHOP stores since 2006. Imperial Donor Relations Director Tom Smith as worked with IHOP for many years and we thank him for his help in making this year’s event such a success.

Shriners Hospitals for Children — Houston kicked off the event locally on Feb. 19 with a Pancake Pandemonium Party for kids at the hospital. Houston City Council Member Wanda Adams visited and presented a City Proclamation to kick off National Pancake Day. In addition, Houston Texans player Eric Winston was a celebrity “pancake flipper” at an area IHOP on Feb. 24. Watch a video from the Houston event on our Web site at

http://www.shrinershq.org/Hospitals/Houston/News/news03050901.aspx

Jet Foods/David Ragan

On March 1, our fundraising program with Jet Foods and David Ragan kicked-off.

From March 1 through April 30, 2009, customers at 53 Jet Food Stores in Georgia will be given the option to add a donation to Shriners Hospitals for Children to each purchase they make. A special mobile is provided for donors to write their name for display in the store.

For more details and a list of participating Jet Food stores, visit our Web site at http://www.shrinershq.org/Shrine/News/news01300901.aspx

I again ask you for your thoughts. This is a time in the history of our philanthropy that we all need to be businessmen with business minds to think of how we can make Shriners Hospitals for Children something that Donors will want to donate funds to, without seeing the Red in the balance sheets.

My best to your Lady Judith C..

Fraternally Yours,

Ralph W. Semb, President and Chief Executive Officer, Shriners Hospitals for Children


Additional Resources

The Shriners - Krafty Klowns and eyeballs pierced with three sided blades

The Royal Order of Jesters - The Shriners Secret Society Secret Society

Daughters of Isis, Prince Hall Freemasonry