2021-07-13T11:52:06-05:00 2020-08-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2019-09-01 770440090 LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH LUCI 6504978365 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 KATHRYN COULBOURN CFO 6504978365 2021-07-06 1 KATHRYN J OKIMOTO P00746598 4254544919 2021-07-06 2019 2022-09-23 18:48:47Z CYNTHIA BRANDT 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 123661557 0 X WWW.LPFCH.ORG X 1996 CA THE LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH WORKS IN ALIGNMENT WITH LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD AND THE CHILD HEALTH PROGRAMS OF STANFORD UNIVERSITY. OUR MISSION IS TO ELEVATE THE PRIORITY OF CHILDREN'S HEALTH AND INCREASE THE QUALITY AND ACCESSIBILITY OF CHILDREN'S HEALTH CARE THROUGH LEADERSHIP AND DIRECT INVESTMENT. 25 23 116 335 0 159431 140831261 85001090 19354087 20106980 482480 334781 -622717 -2968 160045111 105439883 116821422 112291658 0 0 15620231 16287042 90559 21784 17792634 6506201 7314073 139038413 135914557 21006698 -30474674 331716034 325810216 27106702 42536941 304609332 283273275 X THE LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH WORKS IN ALIGNMENT WITH LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD AND THE CHILD HEALTH PROGRAMS OF STANFORD UNIVERSITY.OUR MISSION IS TO ELEVATE THE PRIORITY OF CHILDREN'S HEALTH AND INCREASE THE QUALITY AND ACCESSIBILITY OF CHILDREN'S HEALTH CARE THROUGH LEADERSHIP AND DIRECT INVESTMENT. 0 0 2244092 2244092 CHILD HEALTH RESEARCH GRANTS: THE FOUNDATION PROVIDES GRANTS TO THE PEDIATRIC PROGRAMS AT THE STANFORD SCHOOL OF MEDICINE AND THE LUCILE PACKARD CHILDREN'S HOSPITAL TO FUND CLINICAL PROGRAMS, RESEARCH, EDUCATION, AND TRAINING. THE GRANTS ARE FUNDED BY A GRANT RECEIVED FROM THE DAVID AND LUCILE PACKARD FOUNDATION BETWEEN 2000 AND 2004. THE FOUNDATION MADE THE FINAL GRANT PAYMENT IN FISCAL YEAR 2020. 108366514 108366514 20106980 DEVELOPMENT: THE FOUNDATION RAISES MONEY TO SUPPORT THE LUCILE PACKARD CHILDREN'S HOSPITAL AND THE PEDIATRIC AND OBSTETRIC PROGRAMS AT THE STANFORD SCHOOL OF MEDICINE. ONE HUNDRED PERCENT OF FUNDS RAISED ARE TRANSFERRED TO THE HOSPITAL AND SCHOOL OF MEDICINE ON A MONTHLY BASIS. THE FOUNDATION COMPLETED ITS LAST CAMPAIGN AT THE END OF 2012, RAISING A TOTAL OF $548M AGAINST A CAMPAIGN GOAL OF $500M. THE FOUNDATION HAS ENTERED A NEW CAMPAIGN AND IS CURRENTLY DEVELOPING THE CASE STATEMENT AND SOLICITING LEAD GIFTS. 4229065 1681052 FOUNDATION PROGRAMS: THROUGH ITS PROGRAMS AND PARTNERSHIPS WORK, THE FOUNDATION SEEKS TO BUILD AWARENESS ABOUT ISSUES AFFECTING CHILDREN'S HEALTH BY INVESTING IN PROGRAMS TO ENHANCE THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES AND THROUGH THE PROVISION OF DATA ON THE HEALTH AND WELL BEING OF CHILDREN IN CALIFORNIA. DURING THE FISCAL YEAR ENDED AUGUST 31, 2020, THE FOUNDATION INVESTED APPROXIMATELY $4.2 MILLION IN THIS AREA. 114839671 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 1 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 77 0 1 116 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 25 23 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 AL AR CA FL GA HI IL KS KY MD MA MI MN MS NH NJ NM NY NC OR PA RI SC TN UT VA WV WI X KATHRYN COULBOURN 6504978365 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 PAUL KING DIRECTOR 0.30 50.00 X 0 1277410 0 CYNTHIA BRANDT PRESIDENT & CEO 40.00 0.00 X X 668755 0 122021 BRIAN PERRONNE SVP FOR DEVELOPMENT ADMIN, COO 40.00 0.00 X 527857 0 159355 EDWARD SCHOR FORMER KEY EMPLOYEE 40.00 0.00 X 453665 0 49972 KATHRYN COULBOURN CFO 40.00 0.00 X 323515 0 72267 GREG MUNIZ ASSOCIATE VP PRINCIPAL GIFTS 40.00 0.00 X 282621 0 55015 RACHEL GLEBOV ASSOCIATE VP MAJOR GIFTS 40.00 0.00 X 281495 0 49179 SARAH COLLINS VP PRINCIPAL GIFTS 40.00 0.00 X 274233 0 30298 JAMES DEASY ASSOC VP & DEPUTY OPS 40.00 0.00 X 251188 0 47997 EILEEN WALSH FORMER KEY EMPLOYEE 26.00 0.00 X 133630 0 31142 JEAN GORMAN DIRECTOR OF GIFT PLANNING 40.00 0.00 X 236609 0 40773 KIRK BOSTROM DIRECTOR 0.30 0.00 X 0 0 0 C BRYAN CAMERON DIRECTOR 0.30 0.00 X 0 0 0 JEFF CHAMBERS DIRECTOR 0.30 0.00 X 0 0 0 KATE DACHS DIRECTOR 0.30 0.00 X 0 0 0 SUSAN FORD DORSEY DIRECTOR 0.30 0.00 X 0 0 0 ELIZABETH DUNLEVIE CHAIR 0.30 0.00 X X 0 0 0 JANE DUNLEVIE DIRECTOR 0.30 0.00 X 0 0 0 PAUL FISHER DIRECTOR 0.30 0.00 X 0 0 0 NANCY LARSSON DIRECTOR 0.30 0.00 X 0 0 0 MARY B LEONARD DIRECTOR 0.30 0.00 X 0 0 0 ESTHER LEVY DIRECTOR 0.30 0.00 X 0 0 0 JOHN LILLIE DIRECTOR 0.30 0.00 X 0 0 0 LLOYD MINOR DIRECTOR 0.30 0.00 X 0 0 0 KATHERINE ORR DIRECTOR 0.30 0.00 X 0 0 0 SUSAN P ORR DIRECTOR 0.30 0.00 X 0 0 0 MINDY ROGERS VICE CHAIR 0.30 0.00 X X 0 0 0 MICHELLE SANDBERG DIRECTOR 0.30 0.00 X 0 0 0 CHRIS SCHAEPE LEAVE OF ABSENCE DIRECTOR 0.30 0.00 X 0 0 0 BILL C SONNEBORN DIRECTOR 0.30 0.00 X 0 0 0 DAVID K STEVENSON DIRECTOR 0.30 0.00 X 0 0 0 GEORGE F TIDMARSH DIRECTOR 0.30 0.00 X 0 0 0 HILARY VALENTINE DIRECTOR 0.30 0.00 X 0 0 0 CHARLOTTE WAXMAN DIRECTOR 0.30 0.00 X 0 0 0 MICHAEL T LONGAKER DIRECTOR 0.30 0.00 X 0 0 0 STEVE MULLANEY DIRECTOR 0.30 0.00 X 0 0 0 ELAINE CHAMBERS PAST CHAIR 0.30 0.00 X 0 0 0 3433568 1277410 658019 39 1 1 0 SCHULTZ & WILLIAMS INC ONE PENN CTR 1617 JFK BLVD SUITE PHILADELPHIA PA 19103 PRINTING/CONSULTING 500950 POPULATION REFERENCE BUREAU 1875 CONNECTICUT AVE NW STE 520 WASHINGTON DC 200095728 CONSULTING/DATA COLLECTION 272849 CAMBRIDGE ASSOCIATES LLC P O BOX 412015 BOSTON MA 022412015 INVESTMENT ADVISOR 226724 STONE PUBLISHING INC DBA ALMADEN 2549 SCOTT BLVD SANTA CLARA CA 95050 PRINTING/CONSULTING 168171 BLUEPRINT STUDIOS 352 SHAW ROAD S SAN FRANCISCO CA 94080 EVENT DESIGN/CONSULTING 165573 16 3817 94390 97000 84805883 27823890 85001090 DEVELOPMENT FEES REIMB 900099 20106980 20106980 20106980 497152 497152 18049525 18211896 -162371 -162371 -162371 6810 94390 9778 -2968 -2968 105439883 20106980 0 331813 112291658 112291658 2267738 126212 333973 1807553 331365 331365 10195271 635322 920891 8639058 921445 43971 101307 776167 1799899 154564 697559 947776 771324 75904 76070 619350 32 32 170004 170004 21784 21784 192371 192371 2102843 286127 324852 1491864 260372 38361 222011 603182 24774 69279 509129 645017 212484 108812 323721 1305497 130270 109943 1065284 69691 11015 2791 55885 50091 4625 14573 30893 191528 18039 25080 148409 118204 3558 50184 64462 PRINTING 436413 2978 743 432692 PROGRAM CONTRACTS 383769 383769 GIFTS IN-KIND 374638 374638 UBI TAXES 59474 59474 350947 64675 24346 261926 135914557 114839671 3282252 17792634 221861 304704 48973859 62863115 144164937 109333333 44222 1927446 124693 2318 490579 607752 2722728 2213835 486236 508893 31222492 23760284 105851677 110647652 135478 15854719 331716034 325810216 2988208 3060157 1447348 1143364 11022510 8938032 11648636 29395388 27106702 42536941 X 114030179 118465472 190579153 164807803 304609332 283273275 331716034 325810216 X -30474674 8901978 236639 X 0 1 X 1 0 X 147489092 152037713 74363774 140831261 85001090 599722930 147489092 152037713 74363774 140831261 85001090 599722930 158254933 441467997 310792 533741 590922 592472 497152 2525079 602248009 89206881 0.73300 0.70540 X SCHEDULE A, PART II: SUPPORT SCHEDULE LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH CHANGED ITS FISCAL YEAR END FROM DECEMBER 31 TO AUGUST 31 DURING 2016. AS A RESULT, A SHORT PERIOD TAX RETURN WAS FILED TO CAPTURE EIGHT MONTHS OF ACTIVITY FROM JANUARY 1, 2016 - AUGUST 31, 2016. THE IRS REQUIRES THAT THE YEARS DISPLAYED IN PART II, COLUMNS (A) - (E) REFLECT SHORT YEAR RETURNS THAT WERE FILED. THE CORRECT YEARS ARE AS FOLLOWS: COLUMN (A) 2015 - SHORT YEAR JANUARY 1, 2016 - AUGUST 31, 2016 COLUMN (B) 2016 - FISCAL YEAR SEPTEMBER 1, 2016 - AUGUST 31, 2017 COLUMN (C) 2017 - FISCAL YEAR SEPTEMBER 1, 2017 - AUGUST 31, 2018 COLUMN (D) 2018 - FISCAL YEAR SEPTEMBER 1, 2018 - AUGUST 31, 2019 COLUMN (E) 2019 - FISCAL YEAR SEPTEMBER 1, 2019 - AUGUST 31, 2020 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 116637637 9154414 1681052 7099088 -1871477 118883388 118241165 489705 2094558 2814728 -2816053 116637637 113411531 8999933 3590488 2810823 -2231012 118241165 112452618 11767062 1220808 8701992 885349 113411531 111085968 5037607 807259 2097675 766023 112452618 1.00000 0 0 313792 285476 28316 1403682 987280 416402 1005254 941079 64175 508893 HEDGE FUNDS 21055210 F INTERNATIONAL EQUITY TRUSTS 44805562 F REAL ASSET FUNDS 13457567 F VENTURE CAPITAL/PRIVATE EQUITY 26388736 F DEBT SECURITIES 4940577 F 110647652 FUNDS TO BE TRANSFERRED TO LPCH AND SOM 6156968 FUNDS TO BE TRANSFERRED TO OTHERS 507608 PAYMENTS FOR TRUST BENEFICIARY 6876813 LEASE LIABILITY - REAL ESTATE 15853999 29395388 X 114021269 8901978 44268 8946246 105075023 364860 364860 105439883 135357326 9778 9778 135347548 192371 374638 567009 135914557 PART V, LINE 4: THE FOUNDATION USES ITS ENDOWMENT TO FUND ACTIVITIES TO SUPPORT ITS PROGRAMMATIC OBJECTIVES IN CHILDREN'S HEALTH AND RELATED ADMINISTRATIVE COSTS. PROGRAMMATIC OBJECTIVES INCLUDE BUILDING AWARENESS AT THE COMMUNITY AND STATE LEVEL ABOUT ISSUES AFFECTING CHILDREN'S HEALTH AND ENHANCING THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES. PART X, LINE 2: THE FOUNDATION FOLLOWS THE PROVISION OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX PROVISION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN AND PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. MANAGEMENT BELIEVES THAT NO SUCH UNCERTAIN TAX POSITIONS EXIST REQUIRING ACCRUAL OR DISCLOSURE AS OF AUGUST 31, 2020 OR 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSES -192,371. CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST 236,639. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES -9,778. DONATED GIFTS IN KIND 374,638. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 9,778. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATED GIFTS IN KIND 374,638. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 20378273 0 0 0 0 0 0 20378273 0 20378273 1 0 0 0 1 0 PART III ACCOUNTING METHOD: SCHEDULE F, PART I THE FOUNDATION'S DISCLOSURE IN PART 1, LINE 3(1) REFLECTS THE DOMICILE OF CERTAIN INVESTMENT ENTITIES WHICH SERVE MERELY AS THE VEHICLE FOR SUBSEQUENT INVESTING OF FUNDS AND IS NOT REPRESENTATIVE OF THE UNDERLYING GEOGRAPHICAL STRATEGY OF THOSE INVESTMENTS. THE FOUNDATION'S INVESTMENTS ARE FULLY DIVERSIFIED ACROSS ASSET CLASSES, STRATEGIES AND GEOGRAPHICAL REGIONS. IT ADHERES TO AN APPROVED STATEMENT OF INVESTMENT OBJECTIVES AND POLICIES AND HAS IN PLACE A STRATEGIC ASSET ALLOCATION POLICY WHICH ALLOWS IT TO ACHIEVE ITS SHORT TERM FINANCIAL AND LONG TERM INVESTMENT OBJECTIVES. X X X X X X X 1 DECATHLON 4801 WOODWAY DRIVE SUITE 140W HOUSTON TX 77056 PROFESSIONAL FUNDRAISING THROUGH EVENTS 0 87297 21784 65513 87297 21784 65513 AL AK AR CA CO CT FL GA HI IL KS KY LA ME MD MA MI MN MS MO NV NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI NH LUNCH AND LEARN 101200 94390 6810 9778 101200 94390 6810 9778 9778 -2968 1 CHILDREN'S HOSPITAL OF LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 90027 951690977 501C(3) 296596 CALIFORNIA-BASED NURSE-LED DISCHARGE LEARNING (CANDLE) COLLABORATIVE - PHASE II NATIONAL HEALTH LAW PROGRAM 3701 WILSHIRE BLVD SUIT 750 LOS ANGELES CA 90010 953080947 501C(3) 102500 IMPROVING ACCESS TO DURABLE MEDICAL EQUIPMENT AND SUPPLIES THROUGH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM - PHASE II UNIVERSITY OF COLORADO DENVER 13001 E 17TH PLACE AURORA CO 80045 840404231 501C(3) 98762 PUBLISHING AND DISSEMINATING A NATIONAL RESEARCH AGENDA FOR CYSHCN INSTITUTE FOR PATIENT AND FAMILY 6917 ARLINGTON ROAD SUITE 309 BETHESDA MD 20814 521777133 501C(3) 249848 A NATIONAL STUDY OF PATIENT AND FAMILY ADVISORY COUNCILS IN U.S. CHILDREN'S HOSPITALS CHOC FOUNDATION 1201 WEST LA VETA ORANGE CA 92868 956097416 501C(3) 77332 OCC3 FOR KIDS: ACCESS TO CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501C(3) 62959 CRISS ACTIVITIES ADDRESSING CCS WHOLE CHILD MODEL IMPLEMENTATION ANN & ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO 225 E CHICAGO AVE BOX 205 CHICAGO IL 60611 362170833 501C(3) 196832 ADVANCING A FAMILY-CENTERED EVIDENCE-BASE FOR PEDIATRIC HOME HEALTH CARE STANFORD UNIVERSITY SCHOOL OF MEDICINE 1265 WELCH ROAD MAIL BOX 240 STANFIRD CA 94305 941156365 501C(3) 50000 COMMUNITY-LEVEL COVID RELIEF: ADDRESSING EMERGENT NEEDS AND GROWING ECONOMIC INEQUITIES FOR LOW-INCOME LPCH PATIENTS AND FAMILIES IN OUTPATIENT AND COMMUNITY SETTINGS CALIFORNIA HEALTH REPORT (TIDES CENTER) 610 16TH ST M24 OAKLAND CA 94612 943213100 501C(3) 30000 MEDIA COVERAGE ON THE IMPACTS OF COVID-19 AND CHILDREN WITH SPECICAL HEALTH CARE NEEDS STANFORD CHILDREN'S HEALTH 180 EL CAMINO REAL M384 PALO ALTO CA 94304 770003859 501C(3) 50000 COVID-19 FOOD SUPPORT SERVICES AT LPCH INSTITUTE FOR PATIENT AND FAMILY CENTERED CARE 6917 ARLINGTON ROAD SUITE 309 BETHESDA MD 20814 521777133 501C(3) 50000 PATIENT AND FAMILY-CENTERED CARE AND PARTNERSHIPS DURING COVID-19 CHILDREN NOW 1404 FRANKLIN ST SUITE 700 OAKLAND CA 94612 943059243 501C(3) 40000 BOOSTING FAMILY ENGAGEMENT IN CALIFORNIA CHILDRENS POLICYMAKING THE REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO 3333 CALIFORNIA STREET SAN FRANCISCO CA 94118 946036493 501C(3) 55699 FROM ASSESSING NEEDS TO TAKING ACTION: UNDERSTANDING WHAT WAS AND WAS NOT ACCOMPLISHED IN CALIFORNIA AFTER PREVIOUS TITLE V CCS NEEDS ASSESSMENTS AND IDENTIFYING STRATEGIES AND BEST PRACTICES TO ENSURE PROGRESS CENTER FOR HEALTH POLICY DEVELOPMENT (NASHP) 2 MONUMENT SQUARE SUITE 910 PORTLAND ME 04101 521576801 501C(3) 262601 ADVANCING NATIONAL STANDARDS FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS HEALTH LEADS PO BOX 961630 BOSTON MA 02196 450484533 501C(3) 21500 VIRTUAL PLANNING SESSIONS FOR CAREGIVER SUMMIT LUCILE PACKARD CHILDREN'S HOSPITAL & STANFORD SCHOOL OF MEDICINE 725 WELCH ROAD PALO ALTO CA 94304 941156365 501C(3) 2244092 CHILDREN'S HEALTH INITIATIVE LUCILE PACKARD CHILDREN'S HOSPITAL & STANFORD SCHOOL OF MEDICINE 725 WELCH ROAD PALO ALTO CA 94304 941156365 501C(3) 108366514 CHILDREN'S HEALTH LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501C(3) 23458 CHILDREN'S HEALTH 14 0 PART I, LINE 2: GRANTS ARE AWARDED TO ORGANIZATIONS BASED ON THEIR ABILITY TO SUPPORT THE FOUNDATION'S CHARITABLE PROGRAM OBJECTIVES, SPECIFICALLY IN RESPECT OF THE FOUNDATION'S WORK TO ENHANCE THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES. APPLICANT ORGANIZATIONS SUBMIT PROPOSALS BASED ON MUTUALLY AGREED UPON OBJECTIVES, MILESTONES AND DELIVERABLES. FOUNDATION PROGRAM STAFF ANALYZE THE APPLICANT'S EXPERTISE, PROJECT GOALS, AND COSTS BEFORE AWARDING A GRANT. GRANTS OVER $50,000 AND UP TO $250,000 MAY BE APPROVED BY THE CEO UPON REVIEW AND FORMAL RECOMMENDATION OF A MAJORITY OF THE MEMBERS OF THE PROGRAMS AND PARTNERSHIPS COMMITTEE. GRANTS OVER $250,000 MUST BE APPROVED BY THE BOARD. X X X X X 0 1 0 0 0 0 0 1 0 PAUL KING DIRECTOR 0 895226 0 300319 0 81865 0 0 0 0 0 1277410 0 0 CYNTHIA BRANDT PRESIDENT & CEO 534945 0 133000 0 810 0 114212 0 7809 0 790776 0 0 0 BRIAN PERRONNE SVP FOR DEVELOPMENT ADMIN, COO 374643 0 126351 0 26863 0 131523 0 27832 0 687212 0 17748 0 EDWARD SCHOR FORMER KEY EMPLOYEE 182081 0 0 0 271584 0 26741 0 23231 0 503637 0 0 0 KATHRYN COULBOURN CFO 279546 0 42818 0 1151 0 52064 0 20203 0 395782 0 0 0 GREG MUNIZ ASSOCIATE VP PRINCIPAL GIFTS 246468 0 34610 0 1543 0 28000 0 27015 0 337636 0 0 0 RACHEL GLEBOV ASSOCIATE VP MAJOR GIFTS 238888 0 42162 0 445 0 28000 0 21179 0 330674 0 0 0 SARAH COLLINS VP PRINCIPAL GIFTS 240238 0 29245 0 4750 0 27406 0 2892 0 304531 0 0 0 JAMES DEASY ASSOC VP & DEPUTY OPS 226337 0 17786 0 7065 0 25775 0 22222 0 299185 0 0 0 EILEEN WALSH FORMER KEY EMPLOYEE 125675 0 6348 0 1607 0 13458 0 17684 0 164772 0 0 0 JEAN GORMAN DIRECTOR OF GIFT PLANNING 215378 0 17695 0 3536 0 23631 0 17142 0 277382 0 0 0 PART I, LINE 4B THE FOUNDATION OFFERS A 457 (F) PLAN FOR SELECT MEMBERS OF EXECUTIVE MANAGEMENT. DURING THE CALENDAR YEAR 2019, THE CEO, CFO, AND COO WERE ELIGIBLE TO RECEIVE CONTRIBUTIONS FROM THE PLAN. THE TOTAL AMOUNT CONTRIBUTED TO THE PLAN BUT NOT PAID OUT WAS $164,594.89. THE TOTAL AMOUNTS DISTRIBUTED OUT UNDER THE PLAN WAS $17,748.14 TO BRIAN PERRONNE (SVP FOR DEVELOPMENT ADMIN & COO). VESTED AMOUNTS PAID DIRECT IN 2019 WAS $16,044.58 TO EDWARD SCHOR (FORMER SVP PROGRAMS & PARTNERSHIPS). PART I, LINE 7 THE CEO, CFO, AND COO RECEIVE AN INCENTIVE COMPENSATION PAYMENT EQUAL TO A PERCENTAGE OF TOTAL BASE COMPENSATION. THE PERCENTAGE IS DETERMINED BASED ON THE ACHIEVEMENT OF SPECIFIC GOALS BUT IS LIMITED TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN THE FOUNDATION'S POLICY RANGE OF THE 75TH TO 90TH PERCENTILE OF COMPENSATION AS PER SPECIFIC COMPENSATION SURVEYS. THE PERCENTAGE MAY VARY YEAR TO YEAR AS A RESULT OF THIS PROCESS. INCENTIVE COMPENSATION FOR THE CEO IS DETERMINED AND APPROVED BY THE COMPENSATION COMMITTEE. THE INCENTIVE COMPENSATION FOR THE CFO AND COO IS PROPOSED BY THE CEO AND APPROVED BY THE COMPENSATION COMMITTEE. X 135 27352502 AVERAGE MARKET VALUE X 3 96750 AVERAGE MARKET VALUE X SUPPLIES 8 374638 RETAIL VALUE 0 0 1 1 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BASED ON THE NUMBER OF ITEMS OR DONORS WHO MADE CONTRIBUTIONS. PART I, LINE 32B: THE FOUNDATION ENGAGES A BROKER TO RECEIVE AND LIQUIDATE GIFTS OF MARKETABLE SECURITIES. FORM 990, PART I, LINE 6: VOLUNTEERS INCLUDE THE FOUNDATION'S BOARD OF DIRECTORS AS WELL AS VOLUNTEERS WHO SUPPORT VARIOUS FOUNDATION FUNDRAISING EVENTS. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE BOARD BETWEEN BOARD MEETINGS WITH THE EXCEPTION OF CERTAIN SPECIFIC POWERS, AS SPECIFIED IN THE BYLAWS. THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIRMAN OF THE BOARD, THE PRESIDENT/CEO OF THE FOUNDATION, AND THE CHAIRS OF ALL OTHER STANDING COMMITTEES. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 JEFF CHAMBERS, ELIZABETH DUNLEVIE, PAUL KING, MARY LEONARD, LLOYD MINOR, SUSAN ORR, MINDY ROGERS, AND CYNTHIA BRANDT HAVE A BUSINESS RELATIONSHIP. KATHERINE ORR AND SUSAN ORR HAVE A FAMILY RELATIONSHIP. ELIZABETH DUNLEVIE AND JANE DUNLEVIE HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD IS THE SOLE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE FOUNDATION, THE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE FOUNDATION, THE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS OF THE FOUNDATION. REVISIONS TO THE FOUNDATION'S BYLAWS MUST BE APPROVED BY THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT MAKES THE REDACTED FORM 990 AVAILABLE TO THE FULL BOARD AND ANY NON-DIRECTOR MEMBERS OF THE AUDIT COMMITTEE PRIOR TO THE AUDIT COMMITTEE MEETING AT WHICH THE FORM WILL BE REVIEWED. THE BOARD AND AUDIT COMMITTEE ARE ASKED TO PROVIDE FEEDBACK AND/OR QUESTIONS FOR DISCUSSION AT THE AUDIT COMMITTEE MEETING. UPON REVIEW OF THE FORM 990 AND AFTER ALL FEEDBACK AND QUESTIONS HAVE BEEN ADDRESSED, THE AUDIT COMMITTEE WILL VOTE WHETHER TO APPROVE A RECOMMENDATION TO THE FULL BOARD TO APPROVE THE FORM 990. THE PUBLIC DISCLOSURE COPY OF THE FORM 990 IS THEN PRESENTED TO THE FULL BOARD FOR FINAL APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS, AND KEY EMPLOYEES ("KEY PERSONS") ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS AND TO DISCLOSE ALL REAL AND POTENTIAL CONFLICTS OF INTEREST. KEY PERSONS ARE REQUIRED TO CONFIRM THAT THEY HAVE REVIEWED THE POLICY BY SIGNING THAT THEY HAVE DONE SO, EVEN IF NO CONFLICTS ARE DISCLOSED. IN ADDITION, KEY PERSONS ARE REQUIRED TO DISCLOSE REAL OR APPARENT CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE DURING DISCUSSIONS OF THE BOARD, BOARD COMMITTEES, OR STAFF. KEY PERSONS WITH CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM RELATED DISCUSSIONS AND DECISIONS. THE FOUNDATION'S CEO IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION HAS A COMPENSATION COMMITTEE COMPRISED ENTIRELY OF INDEPENDENT DIRECTORS, NONE OF WHOM HAVE A CONFLICT OF INTEREST WITH THE CEO, CFO OR ANY OF THE KEY EMPLOYEES. THE COMPENSATION COMMITTEE ESTABLISHES THE COMPENSATION PHILOSOPHY FOR THE ORGANIZATION AND MEETS ANNUALLY TO SET THE SALARY FOR THE CEO AND CFO AND REVIEW AND DISCUSS SALARIES FOR KEY EMPLOYEES. THE COMMITTEE HAS ENGAGED A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT TO ATTEND ITS ANNUAL MEETING THE LAST OF WHICH WAS HELD ON NOVEMBER 8, 2020. IN DETERMINING COMPENSATION LEVELS, THE COMMITTEE USES TWO INDEPENDENT THIRD PARTY SALARY SURVEYS, ONE PUBLISHED BY WOODMARK AND ONE PUBLISHED BY LASNIK BROIDA. KEY DELIBERATIONS OF THE COMPENSATION COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING. THE LAST COMPENSATION REVIEW WAS DONE ON NOVEMBER 8, 2020. FORM 990, PART VI, SECTION C, LINE 19 WHILE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST 236,639. LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD 725 WELCH ROAD PALO ALTO CA 94304 770003859 HEALTHCARE/HOSPITAL CA 501(C)(3) LINE 3 N/A 0 CHARITABLE REMAINDER TRUST (12) INVESTMENT CA N/A T 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1