2024 Employee Giving Campaign Form

Y UR PASSION OUR PURPOSE

Employee #:

Name: Address:

Choose where you want your donation to go:

Passion Category: Staff Support

Nursing Education & Technology

Employee Crisis Fund: UnityPoint Health – Des Moines

Employee Crisis Fund: UnityPoint Clinic

Employee Crisis Fund: UnityPoint at Home

Diversity, Equity & Inclusion Education Fund

Passion Category: Blank Children’s

Child Life

STAR Center

Pediatric Therapy

Passion Category: Mental Health

Mental Health - ILH Inpatient/Outpatient

Eyerly Ball

Passion Category: Cancer Care

Oncology Navigators

Charlie Cutler Healing & Wellness Program

Adolescent & Young Adult (AYA) Cancer Program

Passion Category: Hospice Care

Patient Assistance Fund

Taylor House

Passion Category: Patient Support

Younker Rehabilitation - Equipment & Technology

LGBTQ Fund

Compassion Fund: Blank Children’s Hospital

Compassion Fund: Methodist, Lutheran & Methodist West

Compassion Fund: John Stoddard Cancer Center

Compassion Fund: Eyerly Ball

Other Giving Options

Other UPH–DM Foundation Fund:

I’d like my donation designated to the following:

United Way of Central Iowa

Variety – the Children’s Charity

Passion Category: Events

2025 Rally Against Cancer ($225/person)

#________ Tickets | $___________

2025 A Night of Blue & White ($175/person)

2024 Hops for Hospice ($125/person)

Frequently Asked Questions

Is this form online?

Yes! You can complete this form using QR code or online at https://bit.ly/2024YPOP

To whom do I make my check?

Make checks payable to UnityPoint Health – Des Moines Foundation. Support for United Way and Variety should be made payable to them.

When is a one-time payroll deduction taken out of my paycheck?

One-time payroll deduction will be deducted January 5, 2024.

How are PTO (Paid Time Off) hours deducted?

PTO hours will be deducted November 10, 2023 and February 2, 2024. NOTE: PTO is taxed at 30% and will be deducted from your donation; please contact the Foundation with any questions.

Where can I find a list of UPH-DM Foundation Funds?

A full list of funds and descriptions can be found on our website at: https://bit. ly/2024YPOP.

Who do I contact if I have a question about the Employee Giving Campaign?

Contact the UnityPoint Health – Des Moines Foundation at 515-241-6304 or e-mail unitypointfoundation@unitypoint.org.

How do payroll deductions work?

Your gift per paycheck can add up to a lot each year. Payroll deductions are made over 26 pay periods starting in 2024. Let’s do some number crunching. The chart to the right can assist you in determining annual gift totals.

Wear your passion on your sleeve: GIVE 5 CHALLENGE

Make a gift of $5/per pay period, join the 1-Hour Club or make a one-time gift of $130+ and receive a campaign t-shirt. Imagine if every UnityPoint Health - Des Moines employee joined the Give 5 Challenge - together we can raise more than $1,000,000 to impact the lives of our patients and employees. Go ahead. Wear your passion on your sleeve. To receive your t-shirt, the deadline to submit paper or online forms is September 27.

If you qualify, list your size here:

Passion Categories and Their Impact

Passion Category: Staff Support

• Nursing Education & Technology: To provide advanced education and technology for nurses to remain at the forefront of care. Impact: 2,000 nurses each year.

• Employee Crisis Fund: Helps meet the immediate emergency needs of employees who have been impacted by personal crisis such as prolonged illness, death, or weather event. Impact: Hundreds of UnityPoint Health employees.

• Diversity, Equity & Inclusion Education Fund: Provide qualified, underrepresented employee applicants the opportunity to further their leadership education, knowledge and skills to advance within UnityPoint Health. Impact: 12 scholarships given to team members last year.

Passion Category: Blank Children’s

• Child Life: Help children find positive ways to cope with the fear and anxiety that often accompany a trip to the doctor, a medical procedure or a hospital stay. Impact: 34,000 interactions per year.

• STAR Center: A special center that is child and adolescent friendly and trauma sensitive to help children thrive regardless of circumstance. Impact: 3,440 services to 1,657 patients.

• Pediatric Therapy: Provides full range of therapy services for inpatient and outpatient care for infants, children and teens. Impact: 4,300 patients served per year.

Passion Category: Mental Health

• Mental Health - ILH Inpatient/Outpatient: Offers an extensive spectrum of care covering all age groups and types of programs to meet the needs of our community. Impact: 100,000 patients served through inpatient and outpatient visits.

• Eyerly Ball: Committed to providing comprehensive community mental health services. Impact: 5,000 individuals served every year.

Passion Category: Cancer Care

• Oncology Navigators: Specially trained nurses and social workers help connect patients and families with resources within the Cancer Center and in the community. Impact: Added a financial navigator to navigate patients through financial barriers of care.

• Charlie Cutler Healing & Wellness Program: Provides evidence-based complementary therapies that support mind, body and spirit. Impact: 378 hours of massage therapy, 6,200 Meals that Matter provided, 56 music therapy hours.

• Adolescent & Young Adult (AYA) Cancer Program: Provides programs and services to cancer patients, ages 15-39. Impact: 435 patients served since 2013.

Passion Category: Hospice Care

• Patient Assistance Fund: Provides comfort, dignity and compassion to all patients and families ensuring no patient is turned away. Impact: 85 patients are provided assistance per year.

• Taylor House: Provides care and comfort to terminally ill patients and their families in home-like setting. Impact: 422 patients served.

Passion Category: Patient Support

• Compassion Funds: Provides additional support to patients and families based on financial need.

• Methodist, Lutheran & Methodist West – Impact: Help more than 250 patients each year with medication and transportation.

• John Stoddard Cancer Center – Impact: 350 gas cards given to patients per year.

• Blank Children’s Hospital – Impact: 1,050 patients with a variety of needs per year.

• LGBTQ Fund: Supports education and training for staff as well as special needs for patients. Impact: 200+ appointments per year.

• Younker Rehabilitation: To provide state-of-the-art rehabilition equipment and technology to help patients achieve their goals. Impact: 800+ patients served per year.