The recipient entity's physical address:
           210 State Street
New Orleans, LA 70118

The recipient entity's mailing address (if different):
           200 Henry Clay Ave
New Orleans, LA 70118

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          

The last four digits of the entity's taxpayer ID number:  0

What is the dollar amount of the request?  $15,148,073

What type of request is this?  Capital Outlay Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           CHILDREN'S HOSPITAL BOARD MEMBERSHIP LIST
Children’s Board of Trustees
Elwood F. Cahill, Jr., Chairman
Kyle France, Vice Chairman
Anthony Recasner, Ph.D., Secretary- Treasurer
Allan Bissinger
Ralph O. Brennan
Katie Andry Crosby
Stephen Hales, M.D.
A. Whitfield Huguley, IV
Mrs. Francis Lauricella (Betty)
William L. Mimeles
Mrs. Norman C. Sullivan, Jr. (Betty)
Mrs. George Villere (Fran)
Mrs. Julie Livaudais George
John Heaton, MD
Greg Feirn
Richard Baumgartner, MD


Emeritus Board Members
Kenneth Beer
Philip Claverie
Susan Johnson
John Pearce
Elliot Roberts

CEO:
John Nickens
200 Henry Clay Ave
New Orleans, LA 70114

Provide a summary of the project or program:
           CHNOLA has provided inpatient
behavioral healthcare to adolescents since 2009, and proposes to construct a 50-bed, $12.9 million facility at
210 State Street, which is adjacent to the main hospital at 200 Henry Clay Avenue in uptown New Orleans.
The facility will feature private rooms, private restrooms, common area space for group therapy, meals and
family interaction, as well as office space for private treatment sessions. The facility will be fully equipped to
provide 24/7 care, including all life safety and ancillary services provided in any other hospital. The facility will
focus on children ages 7-18 with complex behavioral health needs, will be staffed by LSU pediatric
psychiatrists and operated by CHNOLA. Although CHNOLA cares for patients across the state and region, a
majority of patients for this behavioral health hospital will be from the greater New Orleans area.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          CHNOLA has provided inpatient
behavioral healthcare to adolescents since 2009, and proposes to construct a 50-bed, $12.9 million facility at
210 State Street, which is adjacent to the main hospital at 200 Henry Clay Avenue in uptown New Orleans.
The facility will feature private rooms, private restrooms, common area space for group therapy, meals and
family interaction, as well as office space for private treatment sessions. The facility will be fully equipped to
provide 24/7 care, including all life safety and ancillary services provided in any other hospital. The facility will
focus on children ages 7-18 with complex behavioral health needs, will be staffed by LSU pediatric
psychiatrists and operated by CHNOLA. Although CHNOLA cares for patients across the state and region, a
majority of patients for this behavioral health hospital will be from the greater New Orleans area.

What are the goals and objectives for achieving such purpose?
          CHNOLA has provided inpatient
behavioral healthcare to adolescents since 2009, and proposes to construct a 50-bed, $12.9 million facility at
210 State Street, which is adjacent to the main hospital at 200 Henry Clay Avenue in uptown New Orleans.
The facility will feature private rooms, private restrooms, common area space for group therapy, meals and
family interaction, as well as office space for private treatment sessions. The facility will be fully equipped to
provide 24/7 care, including all life safety and ancillary services provided in any other hospital. The facility will
focus on children ages 7-18 with complex behavioral health needs, will be staffed by LSU pediatric
psychiatrists and operated by CHNOLA. Although CHNOLA cares for patients across the state and region, a
majority of patients for this behavioral health hospital will be from the greater New Orleans area.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           1 year

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                 

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
              

          Provide the name, address, and office of the official to whom the person is related:
               

          What is the nature of the relationship? 

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               


Contact Information
name:  ayame dinkler 
                                       address:  200 Henry Clay
New Orleans, LA 70118
                                       phone:  2027443590
                                       fax: 
                                       e-mail:  ayame.dinkler@gmail.com
                                       relationship to entity:  Chief Administrative Officer