2016-11-15T10:20:43-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2015-01-01 320087353 CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION CHIL 3139646994 3901 BEAUBIEN MAIL SLOT 257 DETROIT MI 48201 JODI WONG INTERIM PRESIDENT 3139646994 2016-11-11 1 LYNNE HUISMANN P00053811 2483522500 2015 2017-02-10 21:41:12Z MATTHEW FRIEDMAN 3901 BEAUBIEN MAIL SLOT 257 DETROIT MI 48201 41916284 0 X WWW.CHMFOUNDATION.ORG X 2003 MI THE MISSION OF CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION IS TO SUPPORT PEDIATRIC RESEARCH, EDUCATION, COMMUNITY BENEFIT PROGRAMS, AND OTHER INITIATIVES TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 23 23 23 66 13577 6377 6020612 4160038 0 0 4395978 2422876 -221285 -189217 10195305 6393697 5732007 6694159 0 0 1616412 1909210 0 5900 1331135 1228053 1460959 8576472 10070228 1618833 -3676531 111764598 104698981 342069 1739851 111422529 102959130 X CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION SUPPORTS PEDIATRIC RESEARCH, EDUCATION, COMMUNITY BENEFIT PROGRAMS, AND OTHER INITIATIVES TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 0 0 3844018 3573312 TO SUPPORT RESEARCH PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 2015 AWARDS INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: FUNDING FOR THE CHILDREN'S RESEARCH CENTER OF MICHIGANFUNDING FOR WAYNE STATE UNIVERSITY ("WSU") ENDOWED CHAIR AND PROFESSORSHIPSFUNDING VARIOUS STUDIES ON THE TREATMENT OF PEDIATRIC ACUTE MYELOID LEUKEMIAFUNDING TO EXPLORE BRAIN NETWORK DYSFUNCTION IN PEDIATRIC BIPOLAR DISORDER USING ADVANCED NEUROIMAGING AND ANALYTIC TECHNIQUESFUNDING TO STUDY THE COAGULOPATHY ASSOCIATED WITH ACUTE PROMYELOCYTIC LEUKEMIA TO IDENTIFY MARKERS ASSOCIATED WITH ADVERSE EVENTSFUNDING TO ESTABLISH A NATIONAL/INTERNATIONAL AND STATEWIDE COLLABORATIVE AT INSTITUTIONS PERFORMING CARDIAC CATHETERIZATION PROCEDURESFUNDING TO EVALUATE CHANGES IN CARDIAC FUNCTION ON ECHOCARDIOGRAMS IN INFANTS WITH HYPOXIC-ISCHEMIC ENCEPHALOPATHYFUNDING TO SUPPORT INNOVATIVE NEUROIMAGING STUDIES IN CHILDHOOD ONSET NEUROPSYCHIATRIC DISORDERS AND CHILDREN AT INCREASED RISK FOR PSYCHIATRIC ILLNESSFUNDING FOR CONTINUING RESEARCH TO UNDERSTAND BIOLOGICAL MECHANISMS BEHIND TOURETTE SYNDROMEFUNDING FOR A NOVEL AND PROMISING NEW APPROACH TO EXAMINE THE IMPACT OF POTENTIAL TOXICANTS ON THE DEVELOPMENT OF CHILDHOOD LEUKEMIA 915973 851468 TO SUPPORT EDUCATION PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 2015 AWARDS INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:FUNDING FOR WAYNE STATE UNIVERSITY ("WSU") ENDOWED CHAIR AND PROFESSORSHIPSFUNDING TO PROMOTE EXCELLENCE IN NURSING BY PROVIDING ACCESS TO INFORMATION AND NETWORKING OPPORTUNITIESFUNDING TO IMPLEMENT TWO CHILD LIFE FELLOWSHIPS, ONE AT CHM, WSU, AND KARMANOS CANCER INSTITUTE AND ONE FOR CHM PATIENTS RECEIVING BONE MARROW TRANSPLANTSFUNDING TO TRAIN BOARD CERTIFIED ANALYSTS IN MOTIVATIONAL INTERVIEWING TO MORE SUCCESSFULLY ENGAGE PARENTS IN THE TREATMENT FOR CHILDREN WITH AUTISM SPECTRUM DISORDERFUNDING FOR PEDIATRIC EDUCATIONAL SESSION FOR PHYSICIANS AND ALLIED HEALTH PROFESSIONALSEDUCATIONAL FUNDING FOR MEDICAL LECTURES FOR COMMUNITY PEDIATRICIANS AND OTHER PHYSICIANS, NURSES, MEDICAL STUDENTS, AND OTHERSFUNDING FOR CONFERENCES FOR CAREGIVERS AND PATIENT FAMILIES 2486266 2269379 TO SUPPORT COMMUNITY BENEFIT PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 2015 AWARDS INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: FUNDING TO TEACH CHILDREN'S HOSPITAL OF MICHIGAN ("CHM") PATIENTS AND FAMILIES ABOUT SAFETY TO REDUCE THE NUMBER OF UNINTENTIONAL INJURIES TO CHILDREN FUNDING FOR PSYCHOSOCIAL AND SUPPORTIVE SERVICES FOR CHILDREN AND FAMILIES FACING CHRONIC AND ACUTE LIFE-THREATENING ILLNESSESEMERGENCY ASSISTANCE FOR NON-MEDICAL NEEDS FOR FAMILIES OF CHILDREN WITH ACUTE MEDICAL NEEDSFUNDING TO SUPPORT A COMPREHENSIVE CONTINUUM OF CARE PROGRAM FOR AT-RISK YOUTH AND YOUTH LIVING WITH HIVFUNDING TO SUPPORT VACCINATION PROGRAMSFUNDING TO SUPPORT IMPLEMENTATION OF FITKIDS 360, AN OBESITY INTERVENTION PROGRAM FOR CHILDREN AGES 6-17 AND THEIR FAMILIESFUNDING TO INTEGRATE MENTAL HEALTH SERVICES FOR CHM GENERAL PEDIATRIC AND ADOLESCENT MEDICINE CLINIC PATIENTSFUNDING FOR A "CELEBRATION OF LIFE" TO RECOGNIZE AND SUPPORT CANCER SURVIVORS 7246257 1 1 0 0 0 1 0 0 0 1 1 1 0 0 0 1 0 1 0 0 1 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 25 0 1 23 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 X 23 23 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MI FL NJ NY X KURT MILLER RDM ASSOCIATES 2486207100 7457 M E CAD BLVD SUITE 200 CLARKSTON MI 48348 MATTHEW A FRIEDMAN CHAIR 1.00 0.00 X X 0 0 0 CYNTHIA FORD VICE-CHAIR 1.00 0.00 X X 0 0 0 FRED MINTURN VICE-CHAIR AND TREASURER 1.00 0.00 X X 0 0 0 RITA MARGHERIO SECRETARY 1.00 0.00 X X 0 0 0 LARRY E FLEISCHMANN MD TRUSTEE 1.00 1.00 X 0 0 0 JOHN D BAKER MD TRUSTEE 1.00 0.00 X 0 0 0 JAMES F CARR JR TRUSTEE 1.00 0.00 X 0 0 0 DOUGLAS M ETKIN TRUSTEE 1.00 0.00 X 0 0 0 PETER GINOPOLIS TRUSTEE 1.00 0.00 X 0 0 0 JOHNNY GINOPOLIS TRUSTEE 1.00 0.00 X 0 0 0 BRIAN HERMELIN TRUSTEE 1.00 0.00 X 0 0 0 JACK KRASULA TRUSTEE 1.00 0.00 X 0 0 0 STEVEN R LEFKOFSKY TRUSTEE 1.00 0.00 X 0 0 0 EDWARD C LEVY JR TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL J MADISON CFA TRUSTEE 1.00 0.00 X 0 0 0 LEWIS J NEDELCOFF TRUSTEE (PART YEAR) 1.00 0.00 X 0 0 0 ANITA MASTERS PENTA TRUSTEE 1.00 0.00 X 0 0 0 DICK PURTAN TRUSTEE 1.00 0.00 X 0 0 0 DEREK J SARAFA TRUSTEE (PART YEAR) 1.00 1.00 X 0 0 0 LYLE M WOLBERG CFP TRUSTEE 1.00 0.00 X 0 0 0 MABLE V JONES PHD TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL BEN TRUSTEE 1.00 1.00 X 0 0 0 TOM CONSTAND TRUSTEE 1.00 0.00 X 0 0 0 GLEN DONOVAN TRUSTEE 1.00 0.00 X 0 0 0 ANDREW ZALESKI TRUSTEE (PART YEAR) 1.00 0.00 X 0 0 0 ANTHONY A WERNER PRESIDENT AND CEO 40.00 1.00 X 239379 0 25190 JODI L WONG VICE PRESIDENT OF OPERATIO 40.00 0.00 X 122643 0 10267 362022 0 35457 2 0 1 0 PHOENIX INNOVATE 1775 BELLINGHAM TROY MI 48083 ADVERTISING/MARKETING 225630 RDM ASSOCIATES INC 7457 M E CAD BLVD SUITE 200 CLARKSTON MI 48348 ACCOUNTING SERVICES 158584 2 436436 443310 3280292 383544 4160038 1209750 13577 1196173 36334918 35121792 1213126 1213126 1213126 175654 436436 383710 -208056 -208056 35924 17085 18839 18839 6393697 0 13577 2220082 6447393 6447393 246766 246766 264569 66143 132284 66142 1308714 235438 410151 663125 33584 6042 10525 17017 183979 33666 58649 91664 118364 21294 37095 59975 18501 18501 187459 187459 5900 5900 451378 451378 134915 73978 51018 9919 241721 20429 41207 180085 226332 18067 40138 168127 7600 1290 2550 3760 4407 4407 28102 25886 2216 DONOR RELATIONS 75104 10048 19873 45183 PLEDGE WRITE OFF 62700 58200 4500 DUES & MEMBERSHIP 16768 2243 4435 10090 OTHER NONOPERATING EXPE 5972 853 1687 3432 10070228 7246257 1492836 1331135 11486414 5301050 615862 551781 374610 121766 85582 71076 104622 15423 43880 89199 40494390 62136020 58004479 35754667 659381 673422 111764598 104698981 215183 217888 76596 1521963 50290 0 342069 1739851 X 24762104 22251000 38657881 32582848 48002544 48125282 111422529 102959130 111764598 104698981 X -3676531 -5160219 373351 X X 0 1 X 1 0 X 95712063 5928408 4652844 6020612 4160038 116473965 95712063 5928408 4652844 6020612 4160038 116473965 116473965 765663 1356300 1221597 1376446 1209750 5929756 87219 127555 538656 121313 211578 1086321 123490042 0.94320 0.95270 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2 220000 789826 1 1 71311920 147413 -1551542 2178388 499538 67229865 72226954 158609 1571803 1863605 781841 71311920 67789770 387437 6283076 1860503 372826 72226954 63347448 92660 6095870 1692041 54167 67789770 1203856 61971656 -116726 63058786 0.00300 0.71580 0.28120 0 0 104622 15423 89199 89199 GLOBAL ASSET ALLOCATION FUNDS 21826604 F HEDGE FUNDS 10925015 F PRIVATE EQUITY FUND 2319844 F MONEY MARKET FUNDS 683204 F 35754667 X 1005657 -5160219 230193 436674 -4493352 5499009 451378 443310 894688 6393697 9474300 230193 461224 691417 8782883 451378 835967 1287345 10070228 PART V, LINE 4: TO SUPPORT CHILDREN'S PROGRAMS PER THE STIPULATIONS OF THE DONOR. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAX UNDER PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: LEGACY CHM REVENUE REPORTED ON LEGACY CHM 990 455,980. DECREASE IN CASH VALUE OF LIFE INSURANCE -6,422. SPECIAL EVENT DONATED SERVICES -12,884. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FROM LEGACY CHM ELIMINATED ON CONSOLIDATED FINANCIALS 443,310. PART XII, LINE 2D - OTHER ADJUSTMENTS: LEGACY CHM EXPENSES REPORTED ON LEGACY CHM 990 461,224. PART XII, LINE 4B - OTHER ADJUSTMENTS: REFUNDED GRANT PAYMENTS 379,773. LEGACY CHM EXPENSES ELIMINATED ON CONSOLIDATED FINANCIALS 443,310. SPECIAL EVENT DONATED SERVICES 12,884. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 29792800 0 0 0 0 0 0 29792800 0 29792800 1 0 1 1 0 0 CHEERS FOR CHILDREN 2015 92076 67026 25050 21605 8200 10347 11128 WINE, WOMEN & SHOES 170953 93943 77010 44500 48222 7610 34224 12 349061 275467 73594 101035 5678 3084 88077 612090 436436 175654 44500 170862 13878 21041 133429 383710 -208056 35924 16929 156 0 35924 16929 156 17085 18839 MI 1 0 0 0 1.00000 CHILDREN'S HOSPITAL OF MICHIGAN FDN 3901 BEAUBIEN CARLS BLDG 1ST FLOOR DETROIT MI 48201 0 ANTHONY WERNER 1197 SUPERVISES EMPLOYEES WHO KEEP RECORDS, COUNT MONEY, OVERSEE GAMING ACTIVITIES DURING EVENTS, AND PREPARE STATE MANDATED FINANCIAL REPORTS. X 0 FORM 990, SCHEDULE G, PART II THE NET ECONOMIC PROFIT EARNED FROM SPECIAL EVENTS IS $228,380, AS FOLLOWS: SCH. G, PART II, LINE 1 TOTAL GROSS RECEIPTS: $612,090 SCH. G, PART II, LINE 10 - LESS DIRECT EXPENSES ($383,710) NET ECONOMIC PROFIT EARNED FROM SPECIAL EVENTS $228,380 SCH. G, PART II LINE 11 RESULTS IN A NET LOSS DUE TO THE REQUIREMENT TO SEPARATELY STATE THE AMOUNT OF CONTRIBUTIONS, $436,436, REQUIRED BY THE IRS TO BE ACKNOWLEDGED TO DONORS AS CHARITABLE CONTRIBUTIONS. 1 VHS CHILDREN'S HOSPITAL OF MICHIGAN INC 3901 BEAUBIEN DETROIT MI 48201 272845064 1197695 TO SUPPORT PEDIATRIC MEDICAL EDUCATION, RESEARCH, AND OTHER COMMUNITY BENEFIT PROGRAMS WAYNE STATE UNIVERSITY 5401 CASS AVE DETROIT MI 48202 386028429 115 3611411 TO SUPPORT THE CHILDREN'S RESEARCH CENTER OF MICHIGAN AS WELL AS VARIOUS ASPECTS OF PEDIATRIC HEALTH RESEARCH FOR AREAS SUCH AS BRAIN NETWORK DYSFUNCTION, HIV, DIABETES, CANCER, AND OPHTHALMOLOGY UNIVERSITY PEDIATRICIANS 3901 BEAUBIEN ROOM 1K40 DETROIT MI 48201 383336414 501(C)(3) 390778 TO SUPPORT PEDIATRIC MEDICAL EDUCATION AND RESEARCH DETROIT INSTITUTE OF ARTS 5200 WOODWARD AVE DETROIT MI 48202 381359510 501(C)(3) 19000 TO USE THE NATURAL CREATIVITY OF YOUNG PATIENTS AND THEIR FAMILIES TO CREATE DISTRACTION AND RELIEF FROM DISEASE AND TREATMENT BY PROVIDING ENGAGING AND DIVERSE OPPORTUNITIES TO MAKE ART HAMTRAMCK PUBLIC SCHOOLS 11410 CHAREST HAMTRAMCK MI 48221 386004194 115 231650 TO SUPPORT THE "NEWCOMER" VACCINATION PROGRAM AT THE HAMTRAMCK SCHOOL BASED HEALTH CENTER KIDS KICKING CANCER 645 GRISWOLD SUITE 444 DETROIT MI 48226 383500655 501(C)(3) 340000 TO PROVIDE PAIN MANAGEMENT, PSYCHOTHERAPEUTIC AND END-OF-LIFE CARE TO CHILDREN AND FAMILIES FACING CHRONIC AND ACUTE LIFE-THREATENING ILLNESS CATCH 223 FISHER BUILDING 3011 WGRAND BLVD DETROIT MI 48202 382746810 501(C)(3) 9500 OUTSTANDING HIGH SCHOOL GRADS EVENT SPONSORSHIP FESTIVAL OF TREES 2734 WEST ELEVEN MILE RD BERKLEY MI 48072 382785495 501(C)(3) 11000 HOLIDAY FESTIVAL OF TREES EVENT SPONSORSHIP SPHINX ORGANIZATION 400 RENAISSANCE CTR STE 2550 DETROIT MI 48243 383283759 501(C)(3) 8500 TO PROVIDE ENTERTAINMENT FOR SICK CHILDREN WAYNE CHILDREN'S HEALTHCARE ACCESS PROGRAM INC 37567 HUBBELL DETROIT MI 48235 454949783 501(C)(3) 139000 TO SUPPORT A OBESITY INTERVENTION PROGRAM FOR CHILDREN AND THEIR FAMILIES CONKERR CANCER 295 SWEDESFORD ROAD 396 WAYNE MI 19087 861173750 501(C)(3) 10000 TO SUPPORT COMFORTABLE BEDDING AND CRAFTS FOR SICK CHILDREN DETROIT SYMPHONY ORCHESTRA 3711 WOODWARD AVE DETROIT MI 48201 381385132 501(C)(3) 30000 TO PROVIDE SUPPORT FOR MUSIC THERAPY FOR SICK CHILDREN RONALD MCDONALD HOUSE OF DETROIT 3911 BEAUBIEN ST DETROIT MI 48201 382182406 501(C)(3) 50000 TO PROVIDE TRANSPORTATION TO AND FROM CHM FOR THE FAMILIES OF SICK CHILDREN SEASONS HOSPICE FOUNDATION 6400 SHAFER COURT SUITE 700 DES PLAINES IL 60018 271825679 501(C)(3) 15000 TO SUPPORT A BEREAVEMENT CAMP FOR CHILDREN THE BOTTOMLESS TOY CHEST PO BOX 623 BLOOMFIELD HILLS MI 483030623 263315140 501(C)(3) 7385 TO PROVIDE ENGAGING, EMPOWERING AND INTERACTIVE TOYS TO PEDIATRIC CANCER PATIENTS THE JUDSON CENTER 4410 WEST THIRTEEN MILE RD ROYAL OAK MI 48073 381359084 501(C)(3) 15000 TO SUPPORT SERVICES TO FAMILIES OF CHILDREN WITH AUTISM OR SEVERE DEVELOPMENTAL DISABILITIES NORTH STAR REACH 1050 HIGHLAND DR SUITE F ANN ARBOR MI 48108 260347065 501(C)(3) 15000 TO SUPPORT THE COST OF CHM PATIENTS TO ATTEND CAMP THE CHILDREN'S CENTER 79 W ALEXANDRINE DETROIT MI 48201 381359505 501(C)(3) 10000 TO PROVIDE BEDS TO CHILDREN RECEIVING TCC TREATMENT THE GUILD OF ARTISTS & ARTISANS 118 N FOURTH AVENUE ANN ARBOR MI 481041402 382300196 501(C)(3) 5200 ART FAIR SPONSORSHIP 18 1 GIFTS TO PEDIATRIC PATIENTS 365418 246766 DONOR VALUES BOOKS, GAMES, TOYS, ETC. PART I, LINE 2: AT THE END OF THE GRANT PERIOD, THE ORGANIZATION REQUIRES A FINAL REPORT OF GRANT ACTIVITIES AND A FINAL FINANCIAL ACCOUNTING REPORT. ADDITIONALLY, ANY GRANTS THAT ARE ON A REIMBURSEMENT BASIS MUST BE ACCOMPANIED BY A DETAILED INVOICE FOR REIMBURSEMENT. SCHEDULE I, PART III, COLUMN B: THE NUMBER OF RECIPIENTS IS AN ESTIMATE, WHICH IS BASED ON THE NUMBER OF PEDIATRIC PATIENTS SEEN DURING THE YEAR FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM SERVICES. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 ANTHONY A WERNER PRESIDENT AND CEO 206751 0 25000 0 7628 0 6081 0 19109 0 264569 0 0 0 PART I, LINE 1A DURING THE YEAR, HEALTH AND SOCIAL CLUB DUES WERE PROVIDED TO ANTHONY WERNER. THE DUES WERE TREATED AS TAXABLE COMPENSATION. X 2 9090 COMPARABLE SALES X 18292 COST X 49078 THRIFT SHOP VALUE X 5 19102 FAIR MARKET VALUE X TOYS & CRAFTS 288 138588 COST X ENTERTAINMENT 20 27451 MARKET RATE X MISCELLANEOUS 12 6290 COST X GIFT CARDS 23 5612 COST X ELECTRONICS 3 1455 COST 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART II, EXPLANATION REGARDING RETURN SIGNER: THE PRESIDENT, TONY WERNER, RESIGNED SUBSEQUENT TO THE 2015 YEAR-END AND THE RETURN IS BEING SIGNED BY THE INTERIM PRESIDENT, JODI WONG. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES JOHNNY GINOPOLIS AND PETER GINOPOLIS HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 AFTER CHMF'S MANAGEMENT HAS REVIEWED THE FORM 990, THE RETURN IS PROVIDED TO THE BOARD CHAIR, TREASURER, AND PRESIDENT AND CEO. THESE INDIVIDUALS REVIEW THE FORM 990 WITH THE AUDIT COMMITTEE. ANY NECESSARY CHANGES WILL THEN BE UPDATED ON THE FORM. ONCE ALL NECESSARY CHANGES ARE MADE AND THE CHMF BOARD CHAIR IS IN AGREEMENT WITH THE AUDIT COMMITTEE ABOUT THE FINISHED FORM 990, IT WILL BE SIGNED BY THE CHMF PRESIDENT AND CEO, DATED AND SUBMITTED BY THE FILING DEADLINE. PRIOR TO FILING, A COPY OF THE APPROVED FORM 990 WILL BE MADE AVAILABLE TO ALL OF THE CHMF BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO THE ORGANIZATION'S BOARD TRUSTEES, OFFICERS, KEY EMPLOYEES AND STAFF MEMBERS. THE COVERED PARTIES DISCLOSE INTERESTS THROUGH A QUESTIONNAIRE. EACH COVERED PERSON IS REQUIRED TO ACKNOWLEDGE, NOT LESS THAN ANNUALLY, THAT HE OR SHE HAS READ AND IS IN COMPLIANCE WITH THE POLICY AND MUST RE-ATTEST IN WRITING THAT THERE ARE NO CONFLICTS OR DISCLOSE ANY CONFLICTS THAT DO EXIST. AN ANNUAL REVIEW IS DONE BY THE EXECUTIVE COMMITTEE. IF A CONFLICT ARISES, THE INVOLVED PERSON(S) RECUSE THEMSELVES FROM VOTING ON THE MATTER. COVERED MEMBERS ALSO MUST DECLARE ANY CONFLICT(S) OF INTEREST THAT ARISE BETWEEN ANNUAL DECLARATIONS AS THEY EMERGE. FAILURE TO DISCLOSE, DEPENDING ON GRAVITY, CAN LEAD TO BEING REMOVED FROM THEIR POSITION. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION HAS A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS CURRENTLY SERVING ON THE BOARD OF TRUSTEES. PERSONS WITH A CONFLICT OF INTEREST REGARDING THE PRESIDENT AND CEO'S COMPENSATION ARRANGEMENT ARE NOT INVOLVED IN THIS PROCESS. COMPARABILITY DATA SHOWING COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS IS REVIEWED WHEN DETERMINING THE PRESIDENT AND CEO'S COMPENSATION. CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION WAS MAINTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: REFUND OF GRANT PAYMENTS 379,773. CHANGE IN CASH VALUE OF LIFE INSURANCE -6,422. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTION AND OVERSIGHT HAS NOT CHANGED FROM THE PROCESS USED IN PRIOR YEARS. LEGACY CHM 3901 BEAUBIEN CARLS BLDG 1ST FLOOR DETROIT MI 48201 381357994 PEDIATRIC HEALTH CARE - IMPROVING HEALTH WELL/BEING OF CHILDREN MI 501(C)(3) LINE 11A, I CHILDREN'S HOSPITAL OF MI FOUNDATION 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LEGACY CHM C 443310 CASH