House District(s) All THE TWENTY-NINTH LEGISLATURE Log

;\pplicant Blood Bank of HawaiiIII.FinancialBudgetI. The applicant shall submit a budget utilizing the enclosed budget forms as applicable,to detail the cost of the request.a.b.c.d.e.2.Budget request by source of funds - See attached.Personnel salaries and wages - Not applicable.Equipment and motor vehicles - Not applicable.Capital project details - See attached.Government contracts, grants, and grants in aid - See attached. The applicant shall provide its anticipated quarterly funding requests for the fiscalyear 2019.Quarter 2Quarter I 500,000 500,0003.Quarter 3 1,000,000Quarter 4 500.000Total Grant 2,500,000 The applicant shall provide a listing of all other sources of funding that they areseeking for fiscal year 2019.BBH will be approaching a variety offoundations and corporations for additionalfu11di11g i11 2019. These potentia/fu11ders include:The Harry a11d Jeanette Weinberg Foundation, Inc. Mcl11emy Foundation Atherton Family FoundationJames and Abigail Campbell Foundation Local Ba11ks4.0The applicant shall provide a listing of all state and federal tax credits it has beengranted within the prior three years. Additionally, the applicant shall provide a listing ofall state and federal tax credits they have applied for or anticipate applying for pertainingto any capital project. if applicable.Not applicable.5.0The applicant shall provide a listing of all federal. state, and county governmentcontracts, grants, and grants in aid it has been granted within the prior three years and willbe receiving for fiscal year 2019 for program funding.Not applicable.6. The applicant shall provide the balance of its unrestricted current assets as ofDecember 31. 2017.Rev I li2 l!l 75Application for Grants

,\pp!icant Blood Bank of JlawaiiBLOOD BANK OF HAWAIICONSOLIDATED STATEMENTS OF FINANCIAL POSITION - SUMMARYFOR THE 3RD MONTH ENDED DECEMBER 31, 2017Unrestricted Net AssetsUndesignated, available for general activitiesBoard Designated:Major repairs and replacement ofequipmentResources for continuouscommunity blood supplyForrest J, Pinkerton Fund foreducation & researchTotal Unrestricted Net ce and CapabilityI. Necessary Skills and ExperienceThe applicant shall demonstrate that it has the necessary skills. abilities. knowledge of,and experience relating to the request. State your experience and appropriateness forproviding the service proposed in this application. The applicant shall also provide alisting of verifiable experience of related projects or contracts for the most recent threeyears that are pertinent to the request./11 early January 2016, BBH completed a 1,500,000 re11ovatio11 project to open its newprimary donor center i11 Honolulu after its Dilli11gham locatio11 was closed due topla1111ed co11structio11 of the Honolulu rail transit project.The new facility 011 Yo1111g Street more than doubled the donor capacity. The buildingwas completely renovated to ensure that donor collections did not impact the bloodproduct supply for patie11ts i11 Hawaii. The new facility also enabled BBH to enhancethe donor e,xperience with personalized e11tertai11me11t 011 iPads for do11ors to watchNetjlix, do email, or read books.The 11ew center was completed 011 time and 011 budget.2. FacilitiesThe applicant shall provide a description of its facilities and demonstrate its adequacy inrelation to the request. If facilities are not presently available. describe plans to securefacilities.BBH has occupied the 2043 Dillingham Boulevard premises since 1979, with someexpa11sio11/re11ovatio11 in 2012.Revll!2l/J76Application for Grants

Applicant Blood Bank of HawaiiBecause the rail project is scheduled to take place within 8 incites of tlte current site,BBH must relocate to ensure regulatory complia11ce witlt 110 disruption of tlte bloodproduct supply for patients in Hawaii.Tlte reason for the move is tit at the rail project will: Sig11ifica11tly increase dust (airborne particles) a11d pests; Significantly increase noise; Significantly increase vibration which interferes witlt critical equipment; Significantly decreased access for large vehicles used i11 blood collectio11s. Inhibit ability for blood drive staging and receipt of regulated supplies. Reduce access for routine a11d STAT distribution of blood to hospitals and receiptofpatient samples for testing 2417/365 operations. Interfere i11 tlte delivery of services to BBH a11d tltef1mctions of BBH i11maintaining safe operations. Interrupt utilities and cause periodic road closures.All of tlte above ltazards could It ave severe consequences. Even a delay in tlteprovision of blood or STAT patient test results potentially endanger patient safety andlives. Tlte above will likely occur witlt a higlt frequency wit en transit constructionbegins, a11d altltouglt tlte hazards will be detectable, tltere is 110 practical mitigationthat could be expected to adequately compensate for the negative impact 011 the abilityof the BBH to operate i11 compliance witlt FDA GMP requirements.Because it is not acceptable to continue to operate when GMP requirements are notbeing met and it is predictable that GMP will not be met, the only viable alternative isfor BBH to relocate prior to tlte comme11ceme11t of a11y nearby co11structio11 work 011the rail project in the vicinity of 2043 Dilli11gltam Boulevard.V.Personnel: Project Organization and StaffingI. Proposed Staffing, Staff Qualifications, Supervision and TrainingThe applicant shall describe the proposed staffing pattern and proposed service capacityappropriate for the viability of the request. The applicant shall provide the qualificationsand experience of personnel for the request and shall describe its ability to supervise, trainand provide administrative direction relative to the request.Dr. Kim-Anh Nguyen has served as president a11d CEO of BBH since 20I3. Dr.Nguyen came from Sa11 Francisco, where she was medical director of the BloodCenters of the Pacific for eight years and co11curre11tly served as chief medical officerof the Western Region for United Blood Services.Nguyen has also served as an associate clinical professor for tlte Department ofLaboratory Medicine at University of California at San Francisco, a11d as tlte programdirector of Blood Centers oftlte Pacific!UCSF's Transfusion llfedicine Fellows/tip.Rev I 1/21/177Application for Grants

Applicant Blood Bank of HawaiiShe holds a bachelor's degree i11 biochemical scie11cesfrom Harvard University a11dreceived doctorate degrees ill medicine a11d immunology from tlze University ofPennsylvania.In addition, the BBH Board of Trustees is comprised of community leaders who It aveexperience ill management of a variety of capital improvement projects. Boardmembers include:Executive Committee Patrick D. Ching, Board Chair Kim-Anh Nguyen, /}ID, PhD, Board President Robert S. Harrison, Treasurer Joh11 T. Komeiji, Vice President/Secretary Timothy Cotrell, PhD, Vice President Jason Chang, Vice President Markus Staib, Vice President Jill F. Shimokawa Higa, Vice President Lori McCamey, Immediate Past ChairBoard Members Susan K. Eiclwr Patty Foley Elizabeth M. Ignacio, MD Veronica Kaneko John L. Knorek David Lassner, PhD Avi Mannis Kenric Murayama, MD David Oyadomori Kuuhaku Park Tyler !If. Tokioka Ray P. Vara, Jr. Joseph P. Viola James S. Wataru2.cg] Organization ChartThe applicant shall illustrate the position of each staff and line ofresponsibility/supervision. If the request is part of a large, multi-purposeorganization, include an organization chart that illustrates the placement of thisrequest.See attached.3.cg] CompensationRev 1 li2 !!178Application for Grants

;\ppli(;ant Blood Bank of Ha,vaiiThe applicant shall provide the annual salaries paid by the applicant to the threehighest paid officers, directors, or employees of the organization by position.President/CEO 300,000COO S200,000Medical Director 185,000VI.OtherI. LitigationThe applicant shall disclose any pending litigation to which they are a party, including thedisclosure of any outstanding judgement. If applicable, please explain. 2.Civil litigation naming Blood Ba11k of Hawaii as defe11da11t is being dismissed wit!tprejudice.EEOC pendi11g litigation naming BBH as Defe11da11t. Licensure or AccreditationThe applicant shall specify any special qualifications. including but not limited tolicensure or accreditation that the applicant possesses relevant to this request.Federally regulated, blood banking is co11sidered part oft!te healthcare industry. Ast!te 111a11ufacturer of blood products, blood cellfers are also regarded as p!tar111aceuticalcompanies. We pride ourselves 011 regulatory excelle11ce and co111pliance. With 76 yearsof serving Hawaii's community, BBH has consiste11tly 111et all criteria and 111aintai11edseamless lice11sure a11d accreditation wit!t the leading regulatory agencies andorganizations - U.S. Food and Drug Administration, AABB (American Association ofBlood Banks) and Clinical Laboratory Improvement A111endments.Federal Drug Administration (FDA)FDA licensure enables BBH to collect, test, manufacture, store, issue and ship bloodcomponents. Maintenance of licensure requires compliance wit!t all federalregulations and successful outcomes of routine unannounced inspections.AABB (American Association o{Blood Banks)AABB accreditation involves tlte most stri11ge11t industry standards among all clinicallaboratories, i11cluding regular u11a11110u11ced i11spectio11s. Alt!toug!t participation i11AABB accreditation inspections is voluntary, continuing accreditatio11 is t!te goldsta11dard i11 t!te blood banking industry.CLJA (Cli11ical Laboratories Improve111e11t Ame11d111e11ts) and Clinical LaboratoryLicensesIll addition to collecting and processing blood, BBH also pe,forms cli11ical diagnostictesting, w!tic!t require national and state lice11s11re. CL/A regulations e11sure qualityRev I J/21!179Application for Grants

i\pplicant Blood Bank of Hawaiilaboratory testing with Hawaii State Department of Health pe,formi11g periodic auditsto verify compliance.America's Blood Cellters (ABC)BBH is afou11di11g member ofABC, a network of more tlzan 600 independentcommunity blood centers that collects half of the nation's blood supply. Ourorganization combines the purchasing power of its members to negotiate and securebulk collfract rates for blood banking supplies and services. It serves as a valuableeducation and networking resource. ABC is also active 011 the political front,monitoring important legislative issues facing the transfusion medicine communityand responding to legislative initiatives that affect blood banking.AABBBBH is also a founding member ofAABB, supporting its mission to establish andpromote the highest standard of care for patients and donors in all aspects of bloodbanking.3.0Private Educational InstitutionsThe applicant shall specify whether the grant will be used to support or benefit a sectarianor non-sectarian private educational institution. Please see i1r:lK h lIL.L'"L !!!c for the relevance of this question.Not applicable.4.[2g Future Sustainability PlanThe applicant shall provide a plan for sustaining after fiscal year 2018-19 the activityfonded by the grant if the grant of this application is:(a)(b)Received by the applicant for fiscal year 2018-19. butNot received by the applicant thereafter.Tlzis is a one-time request to the legislature for Grants it1 Aid funding to ensure thatthe blood product supply ill Hawaii is not interrupted due to the rail project. Thispermanent facility will be able to serve as a place to test, store and distribute bloodproducts island-wide. No other funds will be requested for operations of tlzis facility.5.[2g Certificate of Good Standing (If the Applicant is an Organization)If the applicant is an organization, the applicant shall submit one ( l) copy of a certificateof good standing from the Director of Commerce and Consumer Affairs that is dated noearlier than December I. 2017.Rev 11/21/1710Application for Grants

Applicant Blood Bank of HawaiiSee attached.6.13] Declaration StatementThe applicant shall submit a declaration statement affirming its compliance with Section42F-l 03. Hawaii Revised Statutes.See attacl,ed.7.13] Public PurposeThe applicant shall specify whether the grant will be used for a public purpose pursuant toSection 42F-l 02. Hawaii Revised Statutes.\BBH will use t!,e 11ew facility to be11ejit the public pursua11t to Section 42F-102,Hawaii Revised Statues by ensuring tl,at blood and blood products are readily availableto hospitals 011 all isla11ds for life saving orga11 transplants, heart a11d traumasurgeries, neonatal a11d pediatric intensive care, and oncology treatments.Rev 11/21/1711Application for Grants

Applicant Blood Bank of HawaiiSECTION IIIAttachmentsIll. I .aIII. l .dlll. l.eRev l l/21/17Budget requests by source of fundsCapital project DetailsGovernment contracts. grants, and grants in aid12Application for Grants

BUDGET REQUEST BY SOURCE OF FUNDSPeriod: July 1, 2018 to June 30, 2019ApplicantBlood Bank of HawaiiBUDGETCATEGORIESA.Total StateTotal FederalTotal CountyFunds Requested Funds Requested Funds Requested(a)(b)(c)Total Private/OtherFunds Requested(d)PERSONNEL COST1. Salaries2. Payroll Taxes & Assessments3. Fringe BenefitsTOTAL PERSONNEL COSTB.OTHER CURRENT EXPENSES1 . Airfare, I nter-lsland2. Insurance3. Lease/Rental of Equipment4. Lease/Rental of Space5. Staff Training6. Supplies7. Telecommunication8. Utilities91011121314151617181920TOTAL OTHER CURRENT EXPENSESC.D.E.EQUIPMENT PURCHASESTOR VEHICLE PURCHASESCAPITAL2,500,0 013,500,000TOTAL (A B C D E)Budget Prepared By:SOURCES OF FUNDING(a) Total State Funds Requested(b) Total Federal Funds Requested{c) Total County Funds Requested(d) Total Private/Other Funds Requested2,500,0000013,500,000Kim-Anh N u en, MD. PhD(808) 848,4705Phone' / 1-:,,-/20{Signature of Authorized Official8'DatePresident & CEOTOTAL BUDGET16,000,000Name and Tille (Please type or print)5Application for Grants

BUDGET JUSTIFICATION· CAPITAL PROJECT DETAILSPeriod: July 1, 2018 to June 30, 2019Applicant: Blood Bank of HawaiiFUNDING AMOUNT REQUESTEDALL SOURCES OF FUNDSRECEIVED IN PRIOR YEARSTOTAL PROJECT COSTFY: 2016-2017FY: 2017-2018STATE FUNDSREQUESTEDOTHER SOURCES OFFUNDS REQUESTEDFY:2018-2019FY:2018-2019PLANS 1,500,000LAND ACQUISITION 2,500,000FUNDING REQUIRED INSUCCEEDING YEARSFY:2019-2020FY:2020-2021DESIGNCONSTRUCTION 1,488,000 2,500,000 2,000,000 6,012,000 1,488,000 2,500,000 6,000,000 6,012,000EQUIPMENTTOTAL:JUSTIFICATION/COMMENTS:For construction of a new facility to permanently relocate the Blood Bank of Hawaii's blood products donation andmanufacturing facility to ensure that the blood supply for Hawaii's patients (statewide) is not impacted due to thedisruption that will be caused due to the rail project.81\pplication for Grants

GOVERNMENT CONTRACTS, GRANTS, AND I OR GRANTS IN AIDApplicant:Rlood Rank of HawaiiCONTRACT DESCRIPTIONContracts TY (U.S. I State I Haw IHon I Kau I MautCONTRACTVALUE91011121314 .15 .1617181920212223282930 ··················9Applicntion for Grnnts

Applicant Blood Bank of HawaiiSECTIONVAttachmentsV.2Rev I J/21/17Organization Chart13Application for Grants

Blood Bank of HawaiiORGANIZATION STRUCTUREEXECUTIVE - SUPERVISORPresident & Chief Executive OfficerKim-Anh Nguyen, MD, PhDIIFinancialControllerJorge GutierrezHuman ResourcesDirectorMark FennIPublic RelationsDirectorMaura DolormenteIMedicalDirectorRandal Covin, MDQuality Assuranceand Process ImprovementDirectorLaurel AndersonChief Operating OfficerTodd LewisIIMarketing/Donor RecruitmentDirectorKarin KnudsenCollectionsSenior ManagerRedley DazaIInformationTechnologySupervisorRodger BertinIField RecruitmentSupervisorCindi BauerITelerecruttmentSupervisorHelen NahoopiiIIMobileManagerDoreen MatsudaIMobileSupervisorSlavomir RaeITechnical ServicesDirectorMarni WildIDonor CenterSupervisorDaniel HarrisonICollectionsCompliance & ProcessDevelopment ManagerLeonard FontanillaReference LabSupervisorNathan RothIManufacturing &Distribution ManagerNicholas e 1211812017

Applicant Blood Bank of HawaiiSECTION VIAttachmentsVl.5Vl.6Rev 11/21/17Certificate of Good StandingDeclaration Statement14Application for Grants

Department of Commerce and Consumer AffairsCERTIFICATE OF GOOD STANDINGI, the undersigned Director of Commerce and Consumer Affairsof the State of Hawaii, do hereby certify thatBLOOD BANK OF HAWAIIwas incorporated under the laws of Hawaii on 10/26/1943 ;that it is an existing nonprofit corporation; and that,as far as the records of this Department reveal, has compliedwith all of the provisions of the Hawaii Nonprofit CorporationsAct, regulating domestic nonprofit corporations.,i, flCEC,o"'A,iDco-1,IN WITNESS WHEREOF, I have hereunto setmy hand and affixed the seal of theDepartment of Commerce and ConsumerAffairs, at Honolulu, Hawaii.Dated: January 16, 20180 Director of Commerce and Consumer AffairsTo check the authenticity of this certificate, please visit http:/ /hbe. ehawaii. gov/ documents/authenticate. htmlAuthentication Code: 2 95009 COGS PDF- 3161D2

DECLARATION STATEMENT OFAPPLICANTS FOR GRANTS PURSUANT TOCHAPTER 42F, HAWAl'I REVISED STATUTESThe undersigned authorized representative of the applicant certifies the following:I) The applicant meets and will comply with all of the following standards for the award of grants pursuantto Section 42F-103, Hawai'i Revised Statutes:a)Is licensed or accredited, in accordance with federal, state, or county statutes, rules, or ordinances, toconduct the activities or provide the services for which a grant is awarded;b) Complies with all applicable federal and state laws prohibiting discrimination against any person onthe basis of race, color, national origin, religion, creed, sex, age, sexual orientation, or disability;Agrees not to use slate funds for entertainment or lobbying activities; andc)d) Allows the state agency to which fonds for the grant were appropriated for expenditure, legislativecommittees and their stan: and the auditor full access to their records, reports, files, and other relateddocuments and infonnalion for purposes of monitoring, measuring the effectiveness, and ensuring theproper expenditure of the grant.2) If the applicant is an organization, the applicant meets the following requirements pursuant to Section 42F103, J-lawai'i Revised Statutes:a)Is incorporated under the Jaws of the State; andb) 1--Ias bylaws or policies that describe the manner in which the activities or services for which a grant isawarded shall be conducted or provided.3) If the applicant is a non-profit organization, it meets the following requirements pursuant lo Section 42Fl 03, Hawai'i Revised Statutes:a) Is determined and designated lo be a non-profit orga

Below is a map of the geographic coverage uai Molokai Oahu 1. Castle Medical Center 2. Kahuku Medical Center 3. Kaiser Permanente Medical Center 4. Kapiolani Medical Center for Women and Children 5. Kuakini Medical Center 6. Pali Marni Medical Center 7. The Queen's Medical Center Hawaii . · 8. Straub