2020-07-06T14:39:15-05:00 2019-08-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2018-09-01 770440090 LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH LUCI 6504978365 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 KATHRYN COULBOURN CFO 6504978365 2020-06-16 1 KATHRYN J OKIMOTO P00746598 4254544919 2020-06-15 65.158.230.202 2020-07-06 09:18:45 PD P 9CA007D6FA4ECCBF5600246BD0FD47D8656BF948 C070BA3AF7F6D7D87E83B9D9DF9412DF7C2C6F3F 2018 2021-01-29 14:40:06Z CYNTHIA BRANDT 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 169771756 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. 23 22 112 530 0 226066 74363774 140831261 21426191 19354087 384750 482480 -47597 -622717 96127118 160045111 88920099 116821422 0 0 16903408 15620231 91237 90559 16513821 7813170 6506201 113727914 139038413 -17600796 21006698 304208017 331716034 19897346 27106702 284310671 304609332 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 1085588 1085588 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 OVERSEES THE DISBURSEMENT OF THE PACKARD FOUNDATION GRANT FUNDS THROUGH INDEPENDENT REVIEW OF THE RESEARCH PROGRAMS. ANY FOUNDATION OVERSIGHT EXPENSES ARE PAID FOR BY THE INVESTMENT EARNINGS ON THE ORIGINAL GRANT. 113641277 113641277 19354087 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 IS CURRENTLY WORKING WITH THE HOSPITAL AND SCHOOL OF MEDICINE TO ESTABLISH STRATEGIC PRIORITIES WHICH WILL FRAME THE NEXT CAMPAIGN. 4948556 2094557 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, 2019, THE FOUNDATION INVESTED APPROXIMATELY $4.9 MILLION IN THIS AREA. 119675421 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 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 65 0 1 112 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 23 22 1 0 0 0 1 1 1 1 1 0 0 1 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 AK CO CT LA ME NV ND OH OK WA X KATHRYN COULBOURN 6504978365 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 X BRIAN PERRONNE COO/INTERIM CEO (THRU 8/2018) 40.00 0.00 X X 639386 0 128645 CYNTHIA BRANDT PRESIDENT & CEO 40.00 0.00 X X 498138 0 33135 DENNY LUND MD THRU 122018 DIRECTOR 0.30 50.00 X 0 1242885 61256 KIRK BOSTROM DIRECTOR 0.30 0.00 X 0 0 0 C BRYAN CAMERON DIRECTOR 0.30 0.00 X 0 0 0 ELAINE CHAMBERS PAST CHAIR 0.30 0.00 X 0 0 0 JEFF CHAMBERS DIRECTOR 0.30 0.00 X 0 0 0 ELIZABETH DUNLEVIE DIRECTOR 0.30 0.00 X 0 0 0 JANE DUNLEVIE DIRECTOR 0.30 0.00 X 0 0 0 NANCY LARSSON DIRECTOR 0.30 0.00 X 0 0 0 MARY B LEONARD MD DIRECTOR 0.30 0.00 X 0 0 0 MICHAEL T LONGAAKER MD DIRECTOR 0.30 0.00 X 0 0 0 LLOYD MINOR MD DIRECTOR 0.30 0.00 X 0 0 0 STEVE MULLANEY DIRECTOR 0.30 0.00 X 0 0 0 KATHERINE ORR DIRECTOR 0.30 0.00 X 0 0 0 SUSAN P ORR CHAIR 0.30 0.00 X X 0 0 0 MINDY ROGERS SECRETARY 0.30 0.00 X X 0 0 0 MICHELLE SANDBERG MD DIRECTOR 0.30 0.00 X 0 0 0 CHRIS SCHAEPE LEAVE OF ABSENCE DIRECTOR 0.00 0.00 X 0 0 0 BILL C SONNEBORN DIRECTOR 0.30 0.00 X 0 0 0 DAVID K STEVENSON MD DIRECTOR 0.30 0.00 X 0 0 0 GEORGE F TIDMARSH MD PHD 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 MANUEL HENRIQUEZ RES 32019 VICE CHAIR 0.30 0.00 X X 0 0 0 KEN GOLDMAN DIRECTOR 0.30 0.00 X 0 0 0 LAURIE KRAUS LACOB DIRECTOR 0.30 0.00 X 0 0 0 DAVID LEE DIRECTOR 0.30 0.00 X 0 0 0 PAUL KING FROM 012019 DIRECTOR 0.30 50.00 X 0 0 0 KATHY COULBOURN CFO/INTERIM VP P&P 36.00 0.00 X 281696 0 94994 EDWARD SCHOR THRU 72019 VP PROGRAMS & PARTNERS 40.00 0.00 X 370363 0 68111 GREG MUNIZ ASSOC VP PRINCIPAL GIFTS 40.00 0.00 X 276157 0 54923 JAMES DEASY ASSOC VP DEV & OPS 40.00 0.00 X 235956 0 46918 JEAN GORMAN DIRECTOR GIFT PLANNING 40.00 0.00 X 232840 0 42353 RACHEL GLEBOV ASSOC VP MAJOR GIFTS 34.00 0.00 X 228911 0 45475 SARAH COLLINS VP PRINCIPAL GIFTS 30.00 0.00 X 234380 0 25002 DAVID ALEXANDER THRU 32018 FORMER CEO & OFFICER 0.00 0.00 X 2014748 0 65470 EILEEN WALSH FORMER KEY EMPLOYEE 24.00 0.00 X 132348 0 30826 5144923 1242885 697108 46 1 1 0 SCHULTZ & WILLIAMS INC ONE PENN CTR 1617 JFK BLVD SUITE PHILADELPHIA PA 19103 PRINTING/CONSULTING 616372 POPULATION REFERENCE BUREAU 1875 CONNECTICUT AVE NW STE 520 WASHINGTON DC 200095728 CONSULTING/DATA COLLECTION 372338 PATSONS PRESS INC 970 STEWART DRIVE SUNNYVALE CA 94085 PRINTING/CONSULTING 284987 CAMBRIDGE ASSOCIATES LLC PO BOX 412015 BOSTON MA 022412015 INVESTMENT ADVISOR 233151 RUSSELL REYNOLDS ASSOCIATES INC CHURCH STREET STATION - PO BOX 64 NEW YORK NY 102496427 PROFESSIONAL SRVS. - RECRUITMENT 223876 10 4340 3295630 137531291 7330431 140831261 DEVELOPMENT FEES REIMB 900099 19354087 19354087 19354087 592472 592472 8771518 8881510 -109992 -109992 -109992 190518 3295630 824717 -634199 -634199 31900 20418 11482 11482 160045111 19354087 0 -140237 116821422 116821422 2708510 851165 335094 1522251 10035070 542404 905125 8587541 890973 88009 90156 712808 1218030 67146 287376 863508 767648 81917 70723 615008 722 722 171968 171968 90559 90559 227802 227802 1895074 540801 251638 1102635 349077 18225 330852 493547 18222 54549 420776 631527 207747 159709 264071 1305569 146996 113160 1045413 118545 28471 6375 83699 87560 10527 25162 51871 184318 23094 15667 145557 103746 4326 50264 49156 PRINTING 605254 977 730 603547 PROGRAM CONTRACTS 122800 122800 MEMBERSHIPS 74254 8967 3928 61359 UBI TAXES 35500 35500 98938 92205 43523 -36790 139038413 119675421 2849171 16513821 159505 221861 16881278 48973859 146375660 144164937 227453 44222 136564 124693 541218 490579 2508543 2022307 659324 486236 30005427 31222492 109088738 105851677 132850 135478 304208017 331716034 3195875 2988208 795745 1447348 6523427 11022510 9382299 11648636 19897346 27106702 X 118936776 114030179 165373895 190579153 284310671 304609332 304208017 331716034 X 21006698 154113 -862150 X 0 1 X 1 0 X 139531063 147489092 152037713 74363774 140831261 654252903 139531063 147489092 152037713 74363774 140831261 654252903 190703585 463549318 877930 310792 533741 590922 592472 2905857 657158760 84638129 0.70540 0.61930 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) 2014 - CALENDAR YEAR 2015 COLUMN (B) 2015 - SHORT YEAR JANUARY 1, 2016 - AUGUST 31, 2016 COLUMN (C) 2016 - FISCAL YEAR SEPTEMBER 1, 2016 - AUGUST 31, 2017 COLUMN (D) 2017 - FISCAL YEAR SEPTEMBER 1, 2017 - AUGUST 31, 2018 COLUMN (E) 2018 - FISCAL YEAR SEPTEMBER 1, 2018 - AUGUST 31, 2019 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 118241165 489705 2094558 2814728 -2816053 116637637 113411531 8999933 3590488 2810823 -2231012 118241165 112452618 11767062 1220808 8701992 885349 113411531 111085968 5037607 807259 2097675 766023 112452618 116338431 138310 1291038 2615555 1484180 111085968 1.00000 0 0 313792 249039 64753 1238123 839939 398184 956628 933329 23299 486236 HEDGE FUNDS 18333301 F INTERNATIONAL EQUITY TRUSTS 41586689 F REAL ASSET FUNDS 16102122 F VENTURE CAPITAL/PRIVATE EQUITY 25143762 F DEBT SECURITIES 4685803 F 105851677 DEFERRED RENT 299833 FUNDS TO BE TRANSFERRED TO LPCH AND SOM 3658677 FUNDS TO BE TRANSFERRED TO OTHERS 489139 PAYMENTS FOR TRUST BENEFICIARY 7200987 11648636 X 159804625 154113 -1129221 -975108 160779733 -734622 -734622 160045111 139505964 739930 739930 138766034 227802 44577 272379 139038413 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, 2019 OR 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSES -227,802. CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST -901,419. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING AND GAMING EVENT EXPENSES -779,199. DONATED GIFTS IN KIND 44,577. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING AND GAMING EVENT EXPENSES 779,199. RETURNED GRANTS -39,269. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATED GIFTS IN KIND 44,577. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 19455651 NORTH AMERICA 0 0 FUNDRAISING 14336 0 0 0 0 0 0 19469987 0 19469987 1 0 0 0 1 0 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 209225 52306 156919 RUFFALO NOEL LEVITZ 1025 KIRKWOOD PARKWAY SW CEDAR RAPIDS IA 52404 TELEPHONE FUNDRAISING 0 19455 38253 -18798 228680 90559 138121 AL AK AR CA CO CT FL GA HI IL KS KY LA ME MD MA MI MN MS NV NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI LUNCH AND LEARN 135460 78630 56830 12901 25244 19000 4494 THE DINNER 3350688 3217000 133688 4207 428889 168194 75963 85826 3486148 3295630 190518 4207 441790 193438 94963 90320 824718 -634200 31900 17925 2493 0 31900 17925 2493 20418 11482 CA 1 0 1 0 1.00000 BIANCA BIGLIONE 400 HAMILTON AVE SUITE 340 PALO ALTO CA 94301 0 IRENE CHEN 0 OVERSEES AND MANAGES THE GAMING ACTIVITY. NO PART OF HER REGULAR SALARY IS ALLOCATED TOWARDS OVERSEEING OR MANAGING THE GAMING ACTIVITY. X 0 PART I, LINE 1 LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH SOLICITS GOVERNMENT GRANTS WHICH ARE PASSED ALONG TO LUCILE PACKARD CHILDREN'S HOSPITAL FOR SERVICE TO SUPPORT ITS OUTREACH TO THE COMMUNITY. 1 SUPPORT FOR FAMILIES OF CHILDREN WITH DISABILITIES 1663 MISSION ST 7TH FLOOR SAN FRANCISCO CA 94103 942819062 501(C)(3) 455174 PARENT LEADERSHIP COORDINATION AND EXPANSION CHILDREN NOW 1404 FRANKLIN ST SUITE 700 OAKLAND CA 94612 943059243 501(C)(3) 15000 ANALYSIS OF FAMILY ENGAGEMENT IN CALIFORNIA'S POLICYMAKING CENTER FOR HEALTH POLICY DEVELOPMENT (NASHP) 2 MONUMENT SQUARE SUITE 910 PORTLAND ME 04101 521576801 501(C)(3) 165338 NATIONAL STANDARDS FOR IMPROVING QUALITY SYSTEMS OF CARE FOR CHILDREN AND YOUTH WITH SPECIAL CARE NEEDS CENTER FOR HEALTH POLICY DEVELOPMENT (NASHP) 2 MONUMENT SQUARE SUITE 910 PORTLAND ME 04101 521576801 501(C)(3) 286759 NATIONAL CARE COORDINATION STANDARDS FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS NATIONAL HEALTH LAW PROGRAM 3701 WILSHIRE BLVD SUITE 750 LOS ANGELES CA 90010 953080947 501(C)(3) 30000 IMPROVING ACCESS TO DURABLE MEDICAL EQUIPMENT IN THE CALIFORNIA CHILDREN'S SERVICES PROGRAM STANFORD CHILDREN'S HEALTH 180 EL CAMINO REAL SUITE M384 PALO ALTO CA 94304 770003859 501(C)(3) 197026 CREATING PARENT MENTOR/SELF-MANAGEMENT TRAINING CENTER FOR PEDIATRIC HEALTH SETTINGS NATIONAL ALLIANCE TO ADVANCE ADOLESCENT HEALTH (NAAAH) 1615 M ST NW SUITE 290 WASHINGTON DC 20036 204145524 501(C)(3) 133572 PHASE 2: A STRATEGIC DISSEMINATION PLAN TO PROMOTE THE USE OF VALUE-BASED PAYMENT AND CARE DELIVERY RECOMMENDATIONS FOR PEDIATRIC-TO-ADULT TRANSITIONAL CARE PUBLIC COUNSEL 610 SOUTH ARDMORE AVE LOS ANGELES CA 90005 237105149 501(C)(3) 135000 EQUITABLE FUNDING FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES IN CALIFORNIA OREGON HEALTH AND SCIENCE UNIVERSITY FOUNDATION 1121 SW SALMON ST SUITE 100 PORTLAND OR 97205 237083114 501(C)(3) 166608 GUIDING AND INFORM POLICY, SYSTEM AND PRACTICE-LEVEL EFFORTS FOCUSED ON CHILDREN WITH HEALTH COMPLEXITY CHILDREN'S HOSPITAL OF LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 90027 951690977 501(C)(3) 158030 IMPROVING HOME-BASED PALLIATIVE CARE FOR CHILDREN WITH MEDICAL COMPLEXITY FAMILY VOICE NATIONAL PO BOX 37188 ALBUQUERQUE NM 87176 850430800 501(C)(3) 174334 THE FAMILY ENGAGEMENT IN SYSTEMS ASSESSMENT TOOL AND TOOLKIT: ENSURING MEANINGFUL USE THE ACHIEVABLE FOUNDATION 5840 UPLANDER WAY SUITE 101 CULVER CITY CA 90230 954552419 501(C)(3) 25000 IMPROVING HEALTHCARE FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES CENTER FOR HEALTH CARE STRATEGIES 200 AMERICAN METRO BLVD SUITE 119 HAMILTON NJ 08619 223375015 501(C)(3) 127135 FAMILY ENGAGEMENT IN MEDICAID: A 50-STATE SCAN OF EFFORTS TO MEANINGFULLY ENGAGE FAMILIES OF CSHCN IN MEDICAID POLICYMAKING LUCILE PACKARD CHILDREN'S HOSPITAL & STANFORD SCHOOL OF MEDICINE 725 WELCH ROAD PALO ALTO CA 94304 941156365 501(C)(3) 1085588 CHILDREN'S HEALTH INITIATIVE LUCILE PACKARD CHILDREN'S HOSPITAL & STANFORD SCHOOL OF MEDICINE 725 WELCH ROAD PALO ALTO CA 94304 941156365 501(C)(3) 113641277 CHILDREN'S HEALTH LUCILE PACKARD CHILDREN'S HOSPITAL & STANFORD SCHOOL OF MEDICINE 725 WELCH ROAD PALO ALTO CA 94304 770003859 501(C)(3) 24762 CHILDREN'S HEALTH 13 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 1 1 0 0 0 0 0 1 0 BRIAN PERRONNE COO/INTERIM CEO (THRU 8/2018) 488277 0 122338 0 28771 0 98746 0 29899 0 768031 0 20719 0 CYNTHIA BRANDT PRESIDENT & CEO 172935 0 250000 0 75203 0 30532 0 2603 0 531273 0 0 0 DENNY LUND MD THRU 122018 DIRECTOR 0 394948 0 820769 0 27168 0 19967 0 41289 0 1304141 0 0 KATHY COULBOURN CFO/INTERIM VP P&P 228547 0 50916 0 2233 0 73444 0 21550 0 376690 0 0 0 EDWARD SCHOR THRU 72019 VP PROGRAMS & PARTNERS 321996 0 15940 0 32427 0 27500 0 40611 0 438474 0 0 0 GREG MUNIZ ASSOC VP PRINCIPAL GIFTS 242406 0 33035 0 716 0 27500 0 27423 0 331080 0 0 0 JAMES DEASY ASSOC VP DEV & OPS 210079 0 16375 0 9502 0 23559 0 23359 0 282874 0 0 0 JEAN GORMAN DIRECTOR GIFT PLANNING 212588 0 16838 0 3414 0 22943 0 19410 0 275193 0 0 0 RACHEL GLEBOV ASSOC VP MAJOR GIFTS 205549 0 23068 0 294 0 22862 0 22613 0 274386 0 0 0 SARAH COLLINS VP PRINCIPAL GIFTS 181802 0 47969 0 4609 0 23409 0 1593 0 259382 0 0 0 DAVID ALEXANDER THRU 32018 FORMER CEO & OFFICER 101419 0 119817 0 1793512 0 27500 0 37970 0 2080218 0 0 0 EILEEN WALSH FORMER KEY EMPLOYEE 124493 0 6163 0 1692 0 13066 0 17760 0 163174 0 0 0 PART I, LINES 4A-B THE ORGANIZATION MADE A SEVERANCE PAYMENT IN MARCH 2018 TOTALING $1,588,009 TO DAVID ALEXANDER, THE FORMER CEO OF THE ORGANIZATION. THE PAYMENT WAS MADE IN ACCORDANCE WITH THE TERMS OF DR. ALEXANDER'S EMPLOYMENT AGREEMENT. THE FOUNDATION OFFERS A 457(F) PLAN FOR SELECT MEMBERS OF EXECUTIVE MANAGEMENT. DURING CALENDAR YEAR 2018, THE CEO, CFO AND SENIOR VPS WERE ELIGIBLE TO RECEIVE CONTRIBUTIONS FROM THE PLAN. THE TOTAL AMOUNT CONTRIBUTED TO THE PLAN BUT NOT PAID OUT WAS $134,472. THE TOTAL AMOUNTS DISTRIBUTED OUT UNDER THE PLAN WERE $28,322 TO DAVID ALEXANDER (FORMER CEO), $20,719 TO BRIAN PERRONNE (INTERIM CEO), AND $26,568 TO EDWARD SCHOR (SVP PROGRAMS & PARTNERSHIPS). PART I, LINE 7 THE CEO, CFO, COO, AND SENIOR VICE PRESIDENTS 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, COO AND SENIOR VPS IS PROPOSED BY THE CEO AND APPROVED BY THE COMPENSATION COMMITTEE. X 106 7219918 AVERAGE MARKET VALUE X SUPPLIES/AUCTION ITEMS 33 110513 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, DENNY LUND, 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 COMPLETED FORM 990 AVAILABLE TO THE FULL BOARD AND ANY NON-DIRECTOR MEMBERS OF THE AUDIT COMMITTEE NO LESS THAN TWO WEEKS 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 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 SEPTEMBER 25, 2019. 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 SEPTEMBER 25, 2019. 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. PART V, LINE 15 AND PART VII THIS IS THE FIRST TAX YEAR THE LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH, AS AN EMPLOYER, WOULD BE SUBJECT TO IRC SECTION 4960 TAX ON PAYMENT(S) OF MORE THAN $1,000,000. HOWEVER, PER IRS NOTICE 2019-09, Q39, REMUNERATION PAID BEFORE THE START OF THE FIRST TAX YEAR BEGINNING AFTER THE EFFECTIVE DATE OF THE NEW LAW IS NOT SUBJECT TO THE EXCISE TAX. REMUNERATION PAID TO DAVID ALEXANDER WAS PAID IN MARCH 2018 AND THEREFORE, THE ORGANIZATION IS NOT SUBJECT TO THE IRC 4960 TAX FOR THE YEAR ENDED AUGUST 31, 2019. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST -901,419. GRANTS CLOSED OUT SHORT, REFUND OF UNUSED GRANT AND YE DISCOUNT 39,269. 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