2019-06-20T12:17:04-05:00 2018-08-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2017-09-01 770440090 LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH LUCI 6504978365 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 KATHRYN COULBOURN CFO 6504978365 2019-06-17 1 KATHRYN J OKIMOTO P00746598 4254544919 2019-06-17 65.158.230.194 2019-06-17 15:22:57 PD P DE1D2BBAE0F1147E7A7EA18DABEA7E867F199504 A8F8671919AEAF184819608176B45343F82BD7C9 2017 2019-02-21 02:37:17Z CYNTHIA BRANDT 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 119506728 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. 27 25 113 1073 0 150709 152037714 74363774 17368869 21426191 730275 384750 -989892 -47597 169146966 96127118 125292421 88920099 0 0 13962236 16903408 96709 91237 19484053 6272815 7813170 145624181 113727914 23522785 -17600796 311981176 304208017 18489990 19897346 293491186 284310671 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 1300873 1300873 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. 84028738 84028738 21426191 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. 6401311 3590488 FOUNDATION PROGRAMS: THROUGH ITS PROGRAMS AND PARTNERSHIPS WORK, THE FOUNDATION SEEKS TO BUILD AWARENESS ABOUT ISSUES AFFECTING CHILDREN'S HEALTH AND INVESTS IN PROGRAMS TO ENHANCE THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES. DURING THE FISCAL YEAR ENDED AUGUST 31, 2018, THE FOUNDATION INVESTED APPROXIMATELY $6.4 MILLION IN THIS AREA. 91730922 1 1 0 1 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 0 0 0 1 76 0 1 113 1 1 1 0 0 0 0 1 1 0 0 0 0 X 27 25 1 0 1 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 X KATHRYN COULBOURN 6504978365 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 KIRK BOSTROM DIRECTOR 0.30 0.00 X 0 0 0 TIMOTHY BRACKNEY DIRECTOR 0.30 0.00 X 0 0 0 C BRYAN CAMERON DIRECTOR 0.30 0.00 X 0 0 0 ELAINE CHAMBERS CHAIR 0.30 0.00 X X 0 0 0 JEFF CHAMBERS DIRECTOR 0.30 0.00 X 0 0 0 CHRISTOPHER DAWES DIRECTOR 0.30 50.00 X 0 3707335 84357 ELIZABETH DUNLEVIE DIRECTOR 0.30 0.00 X 0 0 0 JANE DUNLEVIE DIRECTOR 0.30 0.00 X 0 0 0 KEN GOLDMAN DIRECTOR 0.30 0.00 X 0 0 0 ANNA HENDERSON DIRECTOR 0.30 0.00 X 0 0 0 MANUEL HENRIQUEZ VICE CHAIR 0.30 0.00 X X 0 0 0 LAURIE KRAUS LACOB DIRECTOR 0.30 0.00 X 0 0 0 NANCY LARSSON DIRECTOR 0.30 0.00 X 0 0 0 DAVID LEE DIRECTOR 0.30 0.00 X 0 0 0 MARY B LEONARD MD DIRECTOR 0.30 0.00 X 0 0 0 MICHAEL T LONGAKER MD DIRECTOR 0.30 0.00 X 0 0 0 DENNY LUND MD DIRECTOR 0.30 50.00 X 0 904008 54644 LLOYD MINOR MD DIRECTOR 0.30 0.00 X 0 0 0 STEVE MULLANEY DIRECTOR 0.30 0.00 X 0 0 0 DAVID ORR 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 BRIAN PERRONNE INTERIM CEO 40.00 0.30 X X 513692 0 106576 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 DIRECTOR 0.30 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 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 MATT WILSEY DIRECTOR 0.30 0.00 X 0 0 0 DAVID ALEXANDER PRESIDENT & CEO (THRU 3/2018) 40.00 0.30 X X 926300 0 66986 KATHRYN COULBOURN CFO 32.00 0.00 X 241439 0 65984 EDWARD SCHOR SVP PROGRAM & PARTNERSHIP 40.00 0.00 X 345237 0 66478 DONNA RICHARDSON SVP MAJ.&PRIN. GIFTS (THRU 12/2017) 40.00 0.00 X 699108 0 44030 GREG MUNIZ ASSOC VP PRINCPIAL GIFTS 40.00 0.00 X 239347 0 48682 JEAN GORMAN DIRECTOR GIFT PLANNING 40.00 0.00 X 223536 0 41742 ANDREW COPE DIRECTOR MAJOR GIFTS 40.00 0.00 X 205252 0 44049 JAMES DEASY SENIOR DIRECTOR MAJOR GIFTS 40.00 0.00 X 207470 0 42828 LINDSAY MYRBACK ASSOC VP DONOR ENGAGEMENT 40.00 0.00 X 198843 0 26742 EILEEN WALSH FORMER DIRECTOR PROG. & PARTNERSHIPS 24.00 0.00 X 127182 0 30870 3927406 4611343 723968 38 1 1 0 RHP INC DBA GOT LIGHT 211 INDUSTRIAL STREET SAN FRANCISCO CA 94124 EVENTS 430770 SCHULTZ & WILLIAMS INC ONE PENN CTR 1617 JFK BLVD 1700 PHILADELPHIA PA 19103 PRINTING/CONSULTING 317835 PAULA LEDUC FINE CATERING 1350 PARK AVENUE EMERYVILLE CA 94608 CATERING/EVENTS 279796 CAMBRIDGE ASSOCIATES LLC P O BOX 412015 BOSTON MA 022412015 INVESTMENT ADVISOR 279601 PATSONS PRESS INC 970 STEWART DRIVE SUNNYVALE CA 94085 CONSULTING 260914 14 3179 175214 74185381 7985078 74363774 DEVELOPMENT FEES REIMB 900099 21426191 21426191 21426191 590922 590922 23091578 23297750 -206172 -206172 -206172 20093 175214 70453 -50360 -50360 14170 11407 2763 2763 96127118 21426191 0 337153 88920099 88920099 4297761 885601 348825 3063335 8014632 612437 757724 6644471 794057 91958 79005 623094 3049766 85700 299397 2664669 747192 85380 64549 597263 4517 2952 1565 156770 154405 2365 91237 91237 230675 230675 3021107 479722 110755 2430630 259773 18216 54 241503 606772 19499 62259 525014 578872 172382 148720 257770 1274968 136957 110102 1027909 139290 28748 6792 103750 85057 13591 26208 45258 193341 49892 13647 129802 108997 7523 47903 53571 PRINTING 597552 2872 501 594179 PROGRAM CONTRACTS 104365 104365 MEMBERSHIPS 78596 10863 3592 64141 MEALS 27479 2626 1888 22965 345039 2491 42986 299562 113727914 91730922 2512939 19484053 197490 159505 14922221 16881278 162325393 146375660 577473 227453 600000 0 0 136564 550582 541218 2497314 1837990 503186 659324 27797426 30005427 104379341 109088738 128064 132850 311981176 304208017 2756356 3195875 1131087 795745 6632110 6523427 7970437 9382299 18489990 19897346 X 116872470 118936776 176618716 165373895 293491186 284310671 311981176 304208017 X -17600796 8868163 -447881 X X 0 1 X 1 0 X 89425660 139531063 147489092 152037713 74363774 602847302 89425660 139531063 147489092 152037713 74363774 602847302 226757168 376090134 2090422 877930 310792 533741 590922 4403807 607251109 77995219 0.61930 0.57060 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) 2013 - CALENDAR YEAR 2014 COLUMN (B) 2014 - CALENDAR YEAR 2015 COLUMN (C) 2015 - SHORT YEAR JANUARY 1, 2016 - AUGUST 31, 2016 COLUMN (D) 2016 - FISCAL YEAR SEPTEMBER 1, 2016 - AUGUST 31, 2017 COLUMN (E) 2017 - FISCAL YEAR SEPTEMBER 1, 2017 - AUGUST 31, 2018 0 0 0 0 0 0 113809775 113809775 0 1000000 0 250000 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 250000 250000 250000 250000 1000000 1500000 113411531 8999933 3590488 2810823 -2231012 118241165 112452618 11767062 1220808 8701992 885349 113411531 111085968 5037607 807259 2097675 766023 112452618 116338431 138310 1291038 2615555 1484180 111085968 112625884 5102796 1366057 2783257 -2759065 116338431 1.00000 0 0 313792 212601 101191 1226893 702204 524689 956629 923185 33444 659324 HEDGE FUNDS 22099865 F INTERNATIONAL EQUITY TRUSTS 42746813 F REAL ASSET FUNDS 17637046 F VENTURE CAPITAL/PRIVATE EQUITY 22247332 F DEBT SECURITIES 4357682 F 109088738 DEFERRED RENT 426019 FUNDS TO BE TRANSFERRED TO LPCH AND SOM 1686082 FUNDS TO BE TRANSFERRED TO OTHERS 7270198 9382299 X 104398585 8868163 -178328 8689835 95708750 418368 418368 96127118 113579100 81860 81860 113497240 230675 230675 113727915 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, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSES -230,675. CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST 52,347. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT, NET -81,860. GIFTS IN KIND 500,228. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT, NET 81,860. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 18422281 0 0 0 0 0 0 18422281 0 18422281 0 0 0 0 0 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 1 DECATHLON 4801 WOODWAY DRIVE SUITE 140W HOUSTON TX 77056 PROFESSIONAL FUNDRAISING THROUGH EVENTS 0 165786 41435 124351 RUFFALO NOEL LEVITZ 1025 KIRKWOOD PARKWAY SW CEDAR RAPIDS IA 52404 TELEPHONE FUNDRAISING 0 30311 49802 -19491 196097 91237 104860 AL AK AR CA CO CT FL GA HI IL KS KY LA ME MD MA MI MN MS MO NV NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI LUNCH AND LEARN 131807 114714 17093 1955 3806 20910 25118 8329 THE DINNER 63500 60500 3000 285 5898 4152 195307 175214 20093 2240 9704 20910 25118 12481 70453 -50360 14170 11040 367 0 14170 11040 367 11407 2763 CA 1 0 1 0 1.00000 S MCDONNELL 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 1 CHILDREN'S HOSPITAL OF LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 90027 951690977 501(C)(3) 244180 CALIFORNIA NURSES-LEAD HOSPITAL TRANSITIONS LEARNING COLLABORATIVE LURIE CHILDREN'S HOSPITAL 225 EAST CHICAGO AVE BOX 205 CHICAGO IL 60611 362170833 501(C)(3) 199768 DEVELOPMENT OF A PATIENT AND CAREGIVER REPORTED INSTRUMENT OF THE ACCESS TO AND QUALITY OF HOME HEALTH CARE FOR CHILDREN WITH MEDICAL COMPLEXITY CHILD TRENDS 7315 WISCONSIN AVE SUITE 1200W BETHESDA MD 20814 132982969 501(C)(3) 115201 CONCEPTUAL FRAMEWORK FOR STATE SUPPORT OF CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS SUPPORT FOR FAMILIES OF CHILDREN WITH DISABILITIES 1663 MISSION ST 7TH FL SAN FRANCISCO CA 94103 942819062 501(C)(3) 139327 FAMILY VOICES OF CALIFORNIA OUTREACH AND ENGAGEMENT WITH FAMILIES OF CYSHCN LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD M/C 5524 PALO ALTO CA 94705 770003859 501(C)(3) 49979 CHILDREN'S REGIONAL INTEGRATED SERVICE SYSTEM (CRISS) EXPANSION ACTIVITIES FAMILY VOICES (NATIONAL) PO BOX 37188 ALBUQUERQUE NM 87176 850430800 501(C)(3) 209802 ASSESSING FAMILY ENGAGEMENT JOHNS HOPKINS UNIVERSITY 1101 E 33RD ST BALTIMORE MD 21218 520595110 501(C)(3) 240987 ENGAGING FAMILIES TO IMPROVE THE QUALITY AND OUTCOMES OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS LEADING FOR KIDS 514 SANTA CLARA AVE REDWOOD CITY CA 94061 824081482 501(C)(3) 2000000 SEED GRANT FOR 'LEADING FOR KIDS' KERN COUNTY PUBLIC HEALTH SERVICES DEPT 1800 MT VERNON AVE BAKERSFIELD CA 93306 956000925 501(C)(3) 28210 IMPROVING THE READINESS OF TRANSITIONING CCS ADOLESCENTS: BUILDING A BEST PRACTICE MODEL CHILDREN'S HOSPITAL OF LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 90027 951690977 501(C)(3) 40000 CALIFORNIA NURSES-LEAD HOSPITAL TRANSITIONS LEARNING COLLABORATIVE PUBLIC COUNSEL 610 SOUTH ARDMORE AVE LOS ANGELES CA 90005 237105149 501(C)(3) 40000 ADVOCACY TO ADDRESS DISPARITIES IN ACCESS TO CARE AND SERVICES FOR LOW-INCOME AND MINORITY CHILDREN WITH DEVELOPMENTAL DISABILITIES THE CHILDREN'S PARTNERSHIP 811 WILSHIRE BLVD SUITE 1000 LOS ANGELES CA 90017 464106389 501(C)(3) 100000 ADVANCING TELEHEALTH UTILIZATION FOR CALIFORNIA'S VULNERABLE CHILDREN: PHASE 3 CALIFORNIA HEALTH REPORT (TIDES CENTER) 610 16TH ST M24 OAKLAND CA 94612 943213100 501(C)(3) 120000 MEDIA COVERAGE OF CHILDREN'S HEALTH ISSUES IN CALIFORNIA CHOC FOUNDATION 1201 W LA VETA AVENUE ORANGE CA 92868 956097416 501(C)(3) 18000 ORANGE COUNTY CARE COORDINATION COLLABORATIVE FOR KIDS (5C'S) FIRST 5 SAN JOAQUIN (FAMILY RESOURCE NETWORK) 5232 CLAREMONT AVE SUITE 148 STOCKTON CA 95207 680277688 501(C)(3) 17932 SAN JOAQUIN COUNTY 5CS PHASE IV STANFORD SOM & LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 941156365 501(C)(3) 1300873 CHILDREN'S HEALTH INITIATIVE STANFORD SOM & LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 941156365 501(C)(3) 84028738 CHILDREN'S HEALTH LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501(C)(3) 20771 CHILDREN'S HEALTH 15 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 CHRISTOPHER DAWES DIRECTOR 0 979769 0 2697696 0 29870 0 42300 0 42057 0 3791692 0 0 DENNY LUND MD DIRECTOR 0 389149 0 485163 0 29696 0 16902 0 37742 0 958652 0 0 BRIAN PERRONNE INTERIM CEO 396137 0 93956 0 23599 0 79971 0 26605 0 620268 0 14269 0 DAVID ALEXANDER PRESIDENT & CEO (THRU 3/2018) 549168 0 158750 0 218382 0 26500 0 40486 0 993286 0 93243 0 KATHRYN COULBOURN CFO 214018 0 26382 0 1039 0 39604 0 26380 0 307423 0 0 0 EDWARD SCHOR SVP PROGRAM & PARTNERSHIP 304690 0 10317 0 30230 0 26500 0 39978 0 411715 0 0 0 DONNA RICHARDSON SVP MAJ.&PRIN. GIFTS (THRU 12/2017) 306153 0 50444 0 342511 0 26500 0 17530 0 743138 0 42427 0 GREG MUNIZ ASSOC VP PRINCPIAL GIFTS 209577 0 29397 0 373 0 24290 0 24392 0 288029 0 0 0 JEAN GORMAN DIRECTOR GIFT PLANNING 203968 0 16398 0 3170 0 22274 0 19468 0 265278 0 0 0 ANDREW COPE DIRECTOR MAJOR GIFTS 189325 0 15349 0 578 0 20845 0 23204 0 249301 0 0 0 JAMES DEASY SENIOR DIRECTOR MAJOR GIFTS 185364 0 15127 0 6979 0 21053 0 21775 0 250298 0 0 0 LINDSAY MYRBACK ASSOC VP DONOR ENGAGEMENT 174695 0 22075 0 2073 0 18627 0 8115 0 225585 0 0 0 EILEEN WALSH FORMER DIRECTOR PROG. & PARTNERSHIPS 118420 0 5983 0 2779 0 12685 0 18185 0 158052 0 0 0 PART I, LINES 4A-B DONNA RICHARDSON WAS PAID $258,594. HER SEVERANCE AGREEMENT IS A TERM WITHOUT CAUSE WITH A STANDARD RELEASE OF LIABILITY FOR PAYMENT OF 9 MONTH'S SALARY, AS SPECIFIED IN HER EMPLOYMENT AGREEMENT. THE FOUNDATION OFFERS A 457(F) PLAN FOR SELECT MEMBERS OF EXECUTIVE MANAGEMENT. DURING CALENDAR YEAR 2017, 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 $68,323. THE TOTAL AMOUNTS DISTRIBUTED OUT UNDER THE PLAN WERE $191,444 TO DAVID ALEXANDER (CEO), $14,269 TO BRIAN PERRONNE (INTERIM CEO), $74,090 TO DONNA RICHARDSON (SVP MAJOR AND PRINCIPAL GIFTS), AND $24,668 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 144 7484850 AVERAGE MARKET VALUE X SUPPLIES 19 500228 RETAIL VALUE 0 0 1 1 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BASED ON THE NUMBER OF 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 CHRISTOPHER DAWES AND DENNY LUND HAVE A BUSINESS RELATIONSHIP WITH ELAINE CHAMBERS, JEFF CHAMBERS, MARY LEONARD, LLOYD MINOR, SUSAN ORR, BRIAN PERRONNE, MINDY ROGERS AND DAVID ALEXANDER. DAVID STEVENSON, MARY LEONARD, MICHAEL LONGAKER, AND LLOYD MINOR HAVE A BUSINESS RELATIONSHIP WITH MINDY ROGERS. DAVID ORR, 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 4 THE FOUNDATION'S BOARD APPROVED THE FOLLOWING SUBSTANTIVE CHANGES TO THE BYLAWS DURING THE FISCAL YEAR: 1) CHANGED THREE STANDING COMMITTEES (AUDIT, INVESTMENT AND FINANCE, AND NOMINATING AND GOVERNANCE) FROM BOARD COMMITTEES TO ADVISORY COMMITTEES. AS SUCH, THEY DO NOT HAVE THE POWER OF THE BOARD, BUT THEY MAY HAVE VOTING NON-DIRECTOR MEMBERS. 2) ADDED A PROVISION THAT THE CHAIRS OF THE 3 ADVISORY COMMITTEES MUST BE DIRECTORS. 3) REPLACED 'TREASURER' WITH 'CHIEF FINANCIAL OFFICER AND UPDATED THE RELATED DESCRIPTION. 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 NOVEMBER 20, 2017. 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 20, 2017. 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: GIFTS IN KIND -500,228. CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST 52,347. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE WAS CHANGED FROM A BOARD COMMITTEE TO AN ADVISORY COMMITTEE, IN THE FOUNDATION'S BYLAWS. AS SUCH, THE AUDIT COMMITTEE DOES NOT HAVE THE AUTHORITY OF THE BOARD. AS A RESULT, THE FOUNDATION'S ANNUAL AUDIT IS REVIEWED BY THE AUDIT COMMITTEE AND RECOMMENDED TO THE BOARD FOR FINAL ACCEPTANCE. PRIOR TO THIS CHANGE, THE ANNUAL AUDIT WAS REVIEWED AND ACCEPTED BY THE AUDIT COMMITTEE AND WAS NOT REQUIRED TO GO TO THE BOARD. 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