2018-07-03T14:38:18-05:00 2017-08-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2016-09-01 770440090 LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH LUCI 6504978365 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 KATHRYN COULBOURN CFO 6504978365 2018-07-03 1 KATHRYN J OKIMOTO P00746598 4254544919 2018-06-19 2016 2022-09-23 18:48:47Z DAVID ALEXANDER 400 HAMILTON AVENUE NO 340 PALO ALTO CA 94301 198566590 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 21 100 496 0 56557 147489092 152037714 10950754 17368869 317682 730275 -89431 -989892 158668097 169146966 150331099 125292421 0 0 8746669 13962236 0 96709 14813554 4301438 6272815 163379206 145624181 -4711109 23522785 277916306 311981176 158392800 18489990 119523506 293491186 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 2353909 2353909 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. 121717704 121717704 17368869 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. 4163366 1220808 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, 2017, THE FOUNDATION INVESTED APPROXIMATELY $4.2 MILLION IN THIS AREA. 128234979 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 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 86 0 1 100 1 1 1 0 0 0 0 1 1 0 0 0 0 X 23 21 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AR CA CT 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 TREASURER 0.30 0.00 X X 0 0 0 ELAINE CHAMBERS CHAIR 0.30 0.00 X X 0 0 0 JEFF CHAMBERS DIRECTOR 0.30 0.30 X 0 0 0 CHRISTOPHER DAWES DIRECTOR 0.30 40.00 X 0 1367557 373771 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 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 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 SUSAN P ORR DIRECTOR 0.30 0.00 X 0 0 0 MINDY ROGERS SECRETARY 0.30 3.00 X X 0 0 0 MICHELLE SANDBERG MD 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 MATT WILSEY DIRECTOR 0.30 0.00 X 0 0 0 DAVID ALEXANDER MD PRESIDENT & CEO 40.00 0.30 X X 955299 0 53504 J TAYLOR CRANDALL DIRECTOR 0.30 0.00 X 0 0 0 GARY DILLABOUGH DIRECTOR 0.30 0.00 X 0 0 0 KEITH FOX DIRECTOR 0.30 0.00 X 0 0 0 JOHN KRIEWALL DIRECTOR 0.30 0.00 X 0 0 0 GEORGE PHIPPS DIRECTOR 0.30 0.00 X 0 0 0 CHRIS SCHAEPE DIRECTOR 0.30 0.00 X 0 0 0 KATHRYN COULBOURN CFO 32.00 0.00 X 236833 0 55388 BRIAN PERRONNE SR. VP DEVELOPEMENT & ADMIN 40.00 0.00 X 467966 0 77272 DONNA RICHARDSON SR. VP MAJOR & PRINCIPAL GIFTS 40.00 0.00 X 454618 0 36430 EDWARD SCHOR SR. VP/DIRECTOR PROGRAMS & PRTNSHIP 40.00 0.00 X 341098 0 53504 GREG MUNIZ DIRECTOR, PRINCIPAL GIFTS 40.00 0.00 X 223167 0 46795 JEAN GORMAN DIRECTOR, GIFT PLANNING 40.00 0.00 X 216946 0 31113 JAMES DEASY DIRECTOR, MAJOR GIFTS 40.00 0.00 X 197308 0 47130 ANDREW COPE DIRECTOR OF MAJOR GIFTS 40.00 0.00 X 197280 0 44286 ANN ROSE SENIOR DIRECTOR FOUNDATIONS 40.00 0.00 X 189401 0 40233 EILEEN WALSH DIRECTOR, PROGRAMS & PARTNERSHIPS 40.00 0.00 X 120530 0 21419 3600446 1367557 880845 36 1 1 0 PATSONS PRESS INC 970 STEWART DRIVE SUNNYVALE CA 94085 PRINTING/CONSULTING 349638 SCHULTZ & WILLIAMS INC 1 PENN CTR 1617 JFK BLVD 1700 PHILADELPHIA PA 19103 PRINTING/CONSULTING 334718 POPULATION REF BUREAU 1875 CONNECTICUT AVE NW 520 WASHINGTON DC 200095728 DATA COLLECTION FOR WEBSITE 226748 INTL CREATIVE MGMT PARTNERS LLC 10250 CONSTELLATION BLVD LOS ANGELES CA 90067 TALENT AND LITERARY AGENCY 210000 KPMG LLP PO BOX 120922 DEPT 0922 DALLAS TX 753120922 AUDIT/CONSULTING 205820 11 2306 3248768 148786640 1092987 152037714 DEVELOPMENT FEES REIMB 900099 17368869 17368869 17368869 533741 533741 28411504 28214970 196534 196534 196534 196457 3248768 1199469 -1003012 -1003012 18305 5185 13120 13120 169146966 17368869 0 -259617 125292421 125292421 2840981 658209 439025 1743747 8786104 768847 780969 7236288 673168 49838 76961 546369 986572 6217 258256 722099 675411 77494 68490 529427 37429 2844 34585 151257 151257 96709 96709 222011 222011 1178274 113437 129044 935793 254777 22339 232438 574972 20921 70598 483453 572668 174687 111128 286853 1293563 134844 129233 1029486 148385 28883 7872 111630 104533 13444 40151 50938 220326 78525 13827 127974 82354 7375 37102 37877 PROGRAM CONTRACTS 773198 773198 PRINTING 479447 4484 182 474781 MEMBERSHIPS 67220 6708 3169 57343 MEALS 33945 1553 952 31440 78456 1555 32577 44324 145624181 128234979 2575648 14813554 141633 197490 13148808 11569493 123187959 162325393 100288 577473 600000 600000 727027 550582 2147835 1644649 657329 503186 35255856 31150154 104037493 104379341 59913 128064 277916306 311981176 2708217 2756356 908024 1131087 8059786 6632110 146716773 7970437 158392800 18489990 X 109793722 116872470 9729784 176618716 119523506 293491186 277916306 311981176 X 23522785 11429709 139015187 X 0 1 X 1 0 X 66087824 89425660 139531063 147489092 152037713 594571352 66087824 89425660 139531063 147489092 152037713 594571352 252317164 342254188 1473915 2090422 877930 310792 533741 5286800 1400 1400 599859552 68578235 0.57060 0.55710 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) 2012 - CALENDAR YEAR 2013 COLUMN (B) 2013 - CALENDAR YEAR 2014 COLUMN (C) 2014 - CALENDAR YEAR 2015 COLUMN (D) 2015 - SHORT YEAR JANUARY 1, 2016 - AUGUST 31, 2016 COLUMN (E) 2016 - FISCAL YEAR SEPTEMBER 1, 2016 - AUGUST 31, 2017 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 146732126 146732126 0 1000000 0 250000 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 250000 250000 250000 250000 1000000 1500000 112452618 11767062 1207106 8701992 899051 113411531 111085968 5037607 807259 2097675 766023 112452618 116338431 138310 1291038 2615555 1484180 111085968 112625884 5102796 1366057 2783257 -2759065 116338431 101862227 15252723 1769465 2797352 -77751 112625884 1.00000 0 0 313792 176164 137628 910699 586265 324434 923344 882220 41124 503186 HEDGE FUNDS 21341008 F INTERNATIONAL EQUITY TRUSTS 42086474 F REAL ASSET FUNDS 17547673 F VENTURE CAPITAL/PRIVATE EQUITY 18983798 F DEBT SECURITIES 4420388 F 104379341 DEFERRED RENT 519216 FUNDS TO BE TRANSFERRED TO LPCH AND SOM 2785033 FUNDS TO BE TRANSFERRED TO OTHERS 4666188 7970437 X 320560802 11429709 138846314 150276023 170284779 -1137814 -1137814 169146965 146593122 1204654 1204654 145388468 222011 13702 235713 145624181 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 AT AUGUST 31, 2017. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSES -222,011. RECLASSIFICATION OF CONTRIBUTION INCOME UNDER ASC 958-20 139,068,325. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT, NET -1,204,654. GIFTS IN KIND 66,840. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT, NET 1,204,654. PART XII, LINE 4B - OTHER ADJUSTMENTS: REFUND OF PRIOR YEAR GRANT 13,702. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 17842312 0 0 0 0 0 0 17842312 0 17842312 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 237557 59390 178167 RUFFALO NOEL LEVITZ 1025 KIRKWOOD PARKWAY SW CEDAR RAPIDS IA 52404 TELEPHONE FUNDRAISING 0 8747 37319 -28572 246304 96709 149595 AL AK AR CA CO CT FL GA HI IL KS KY LA ME MD MA MI MN MS NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI THE DINNER 3232098 3065108 166990 27021 199132 515085 372932 LUNCH AND LEARN 198972 170492 28480 4272 3270 25072 17245 6856 1 14155 13168 987 2116 21510 4958 3445225 3248768 196457 33409 24780 224204 532330 384746 1199469 -1003012 18305 5080 105 0 18305 5080 105 5185 13120 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 FAMILY VOICES - SUPPORT FOR FAMILIES OF CHILDREN WITH DISABILITIES 1663 MISSION ST SAN FRANCISCO CA 94103 942819062 501(C)(3) 217640 FAMILY VOICES OF CALIFORNIA: PROJECT LEADERSHIP TRAINING FAMILIES TO ADVOCATE FOR SYSTEMS CHANGE: PHASE IV REGENTS OF THE UNIVERSITY OF COLORADO 13001 E 17TH PLACE AURORA CA 80045 846000555 501(C)(3) 49584 RIGHT CHILD, RIGHT SERVICES: CHARACTERIZING THE PYRAMID OF RESOURCE NEEDS OF CHILDREN WITH CHRONIC AND COMPLEX NEEDS FAMILY VOICES PO BOX 37188 ALBUQUERQUE NM 87176 850430800 501(C)(3) 50000 FRAMEWORK FOR ASSESSING FAMILY ENGAGEMENT NASHP (CENTER FOR HEALTH POLICY DEVELOPMENT) 10 FREE ST PORTLAND ME 04101 521576801 501(C)(3) 50000 IMPROVING SYSTEMS OF CARE FOR CHILDREN WITH MEDICAL COMPLEXITY THROUGH MEDICAID QUALITY MEASUREMENT INITIATIVES RESEARCH FOUNDATION OF STATE UNIVERSITY OF NEW YORK 520 LEE ENTRANCE AMHERST NY 14228 141368361 501(C)(3) 68903 BUILDING HEALTH THROUGH CARE COORDINATION FOR CHILDREN WITH MEDICAL COMPLEXITY INSTITUTE FOR PATIENT AND FAMILY CENTERED CARE 6917 ARLINGTON ROAD BETHESDA MD 20814 521777133 501(C)(3) 10000 GENERAL SUPPORT OF IPFCC'S WORK BOARD OF TRUSTEES OF LELAND STANFORD JUNIOR UNIVERSITY 117 ENCINA COMMONS STANFORD CA 94305 941156365 501(C)(3) 13800 CHILD HEALTH AND IMMIGRATION CONFERENCE NASHP (CENTER FOR HEALTH POLICY DEVELOPMENT) 10 FREE ST PORTLAND ME 04101 521576801 501(C)(3) 235226 NATIONAL STANDARDS FOR SYSTEMS OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS: PHASE 4 THE NATIONAL ALLIANCE TO ADVANCE ADOLESCENT HEALTH 1615 M ST NW WASHINGTON DC 20036 204145524 501(C)(3) 92278 EXPERT PANEL ON PAYING FOR THE TRANSITION FROM PEDIATRIC TO ADULT HEALTH CARE BOARD OF TRUSTEES OF THE LELAND STANFORD JUNIOR UNIVERSITY SCHOOL OF MEDICINE PO BOX 44253 SAN FRANCISCO CA 94144 941156365 501(C)(3) 90653 EVALUATION OF NOVEL INTERVENTIONS IN CHILDREN'S HEALTH OREGON HEALTH AND SCIENCE UNIVERSITY FOUNDATION 1121 SW SALMON STREET PORTLAND OR 97205 237083114 501(C)(3) 138244 SYSTEM-LEVEL APPROACHES TO IDENTIFY CHILDREN WITH HEALTH COMPLEXITY AND DEVELOP MODELS FOR COMPLEX CARE MANAGEMENT UNIVERSITY OF VIRGINIA SCHOOL OF NURSING 1001 NORTH EMMET STREET CHARLOTTESVILLE VA 22903 546001796 501(C)(3) 119177 ANALYSIS OF HOME AND COMMUNITY-BASED CARE MEDICAID WAIVER SERVICES AMONG CHILDREN WITH MEDICAL COMPLEXITY COTTAGE CHILDREN'S MEDICAL CENTER AT SANTA BARBARA COTTAGE HOSPITAL 400 W PUEBLO ST SANTA BARBARA CA 93105 951644629 501(C)(3) 23100 MEDICAL HOME CARE COORDINATION IN A COMMUNITY HOSPITAL SETTING HELP ME GROW ORANGE COUNTY 2500 RED HILL AVE SANTA ANA CA 92705 956097416 501(C)(3) 12000 ORANGE COUNTY CARE COORDINATION COLLABORATIVE FOR KIDS FAMILY RESOURCE NETWORK 5250 CLAREMONT AVE STOCKTON CA 95207 946000531 501(C)(3) 12000 INCREASE ACCESS TO SPECIALTY MEDICAL CARE FOR SAN JOAQUIN 5CS STANFORD SOM & LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTOS CA 94304 941156365 501(C)(3) 2353909 CHILDREN'S HEALTH INITIATIVE STANFORD SOM & LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTOS CA 94304 941156365 501(C)(3) 121717704 CHILDREN'S HEALTH LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTOS CA 94304 770003859 501(C)(3) 25862 CHILDREN'S HEALTH 17 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 UP TO $25,000 MAY BE APPROVED BY THE CEO OF THE FOUNDATION; GRANTS OVER $50,000 REQUIRE APPROVAL AND RECOMMENDATION BY THE PROGRAM & 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 CHRISTOPHER DAWES DIRECTOR 0 946410 0 226486 0 194661 0 332756 0 41015 0 1741328 0 0 DAVID ALEXANDER MD PRESIDENT & CEO 538510 0 236936 0 179853 0 26500 0 27004 0 1008803 0 45685 0 KATHRYN COULBOURN CFO 205794 0 30000 0 1039 0 38720 0 16668 0 292221 0 0 0 BRIAN PERRONNE SR. VP DEVELOPEMENT & ADMIN 340063 0 105508 0 22395 0 53208 0 24064 0 545238 0 13759 0 DONNA RICHARDSON SR. VP MAJOR & PRINCIPAL GIFTS 336985 0 73389 0 44244 0 26500 0 9930 0 491048 0 0 0 EDWARD SCHOR SR. VP/DIRECTOR PROGRAMS & PRTNSHIP 296048 0 15025 0 30025 0 26500 0 27004 0 394602 0 0 0 GREG MUNIZ DIRECTOR, PRINCIPAL GIFTS 196611 0 26183 0 373 0 22731 0 24064 0 269962 0 0 0 JEAN GORMAN DIRECTOR, GIFT PLANNING 198059 0 15717 0 3170 0 21183 0 9930 0 248059 0 0 0 JAMES DEASY DIRECTOR, MAJOR GIFTS 179721 0 14454 0 3133 0 20126 0 27004 0 244438 0 0 0 ANDREW COPE DIRECTOR OF MAJOR GIFTS 181994 0 14708 0 578 0 20222 0 24064 0 241566 0 0 0 ANN ROSE SENIOR DIRECTOR FOUNDATIONS 173760 0 14120 0 1521 0 19031 0 21202 0 229634 0 0 0 EILEEN WALSH DIRECTOR, PROGRAMS & PARTNERSHIPS 114698 0 3053 0 2779 0 11791 0 9628 0 141949 0 0 0 PART I, LINE 4B THE FOUNDATION OFFERS A 457(F) PLAN FOR SELECT MEMBERS OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. DURING 2016, THE CEO, CFO AND THREE SENIOR VPS WERE ELIGIBLE TO RECEIVE CONTRIBUTIONS FROM THE PLAN. THE TOTAL AMOUNT CONTRIBUTED TO THE PLAN BUT NOT PAID OUT WAS $81,964. THE TOTAL AMOUNTS DISTRIBUTED OUT UNDER THE PLAN WERE $155,521 TO DAVID ALEXANDER (CEO), $13,759 TO BRIAN PERRONNE (SR. VP DEVELOPMENT AND ADMINISTRATION), $39,338 TO DONNA RICHARDSON (SR. VP MAJOR AND PRINCIPAL GIFTS), AND $24,463 TO EDWARD SCHOR (SR. VP PROGRAMS AND PARTNERSHIPS). PART I, LINE 7 THE CEO, CFO, AND THREE 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 THREE SENIOR VPS IS PROPOSED BY THE CEO AND APPROVED BY THE COMPENSATION COMMITTEE. DAVID ALEXANDER CEO HOUSING X 600000 600000 0 1 1 600000 X 91 1026147 AVERAGE MARKET VALUE X SUPPLIES 38 66840 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, DAVID ALEXANDER, LLOYD MINOR, J TAYLOR CRANDAL, MINDY ROGERS, JEFF CHAMBERS, MARY LEONARD, MICHAEL LONGAKER, AND DAVID STEVENSON HAVE A BUSINESS RELATIONSHIP. DAVID ORR AND SUSAN ORR 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. FORM 990, PART VI, SECTION B, LINE 11B THE FOUNDATION'S AUDIT COMMITTEE IS PRIMARILY RESPONSIBLE FOR REVIEWING AND APPROVING THE FOUNDATION'S FORM 990 BEFORE IT IS FILED WITH THE IRS. THE FINAL DRAFT OF THE FORM 990 IS DISTRIBUTED TO THE FULL BOARD IN ADVANCE OF THE AUDIT COMMITTEE MEETING AT WHICH THE FORM WILL BE REVIEWED AND APPROVED. ALL MEMBERS OF THE BOARD ARE INVITED TO ATTEND THE AUDIT COMMITTEE MEETING. 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 APPROVE 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 AS 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 -66,840. RECLASSIFICATION OF CONTRIBUTION INCOME UNDER ASC 958-20 139,068,325. REFUND OF PRIOR YEAR GRANT 13,702. 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