2016-11-11T15:16:51-06:00 2015-12-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2015-01-01 911893957 THE MAX FOUNDATION MAXF 4257788660 200 NE PACIFIC STREET SUITE 103 SEATTLE WA 98105 PATRICIA GARCIA-GONZALEZ CEO 4257788660 2016-11-11 1 JANE M SEARING P00000565 4254544919 2016-11-10 2015 2017-02-10 21:41:12Z PATRICIA GARCIA-GONZALEZ 200 NE PACIFIC STREET SUITE 103 SEATTLE WA 98105 4722293 0 X WWW.THEMAXFOUNDATION.ORG X 1997 WA INCREASE GLOBAL ACCESS TO TREATMENT, CARE, AND SUPPORT FOR PEOPLE LIVING WITH CANCER. 7 6 12 1000 0 0 1068789 2765925 1831127 1934951 3912 4598 18083 16819 2921911 4722293 208073 671794 0 0 938120 1134493 0 0 35736 1279713 1171717 2425906 2978004 496005 1744289 2240467 4036871 53619 101612 2186848 3935259 X THE MAX FOUNDATION IS A GLOBAL HEALTH ORGANIZATION THAT BELIEVES THAT ALL PEOPLE LIVING WITH CANCER HAVE THE RIGHT TO ACCESS THE BEST TREATMENT AND SUPPORT. THROUGH PERSONALIZED ACCESS SERVICES, QUALITY TRAINING AND EDUCATION, AND GLOBAL ADVOCACY EFFORTS, WE AIM TO HELP PEOPLE FACE CANCER WITH DIGNITY AND HOPE. OUR SERVICES ARE GLOBAL AND MULTIFACETED. WE PROVIDE EDUCATION AND TRAINING AT ALL LEVELS OF THE COMMUNITIES IN WHICH WE WORK. BY PARTNERING WITH INDUSTRY, NON-GOVERNMENTAL AGENCIES, HEALTH CARE PROVIDERS, AND NATIONAL CANCER PATIENT ORGANIZATIONS, WE ARE ABLE TO SUPPORT PEOPLE AND PROVIDE EFFECTIVE SOLUTIONS FOR ACCESS TO TREATMENT. THROUGH OUR GLOBAL ADVOCACY EFFORTS, WE WORK TO RAISE AWARENESS OF THE DISEASE AND DRAW ATTENTION TO THE NEEDS OF PEOPLE LIVING WITH CANCER. EVERY YEAR, OUR DEDICATED TEAM HELPS PEOPLE IN MORE THAN 100 COUNTRIES. 0 0 2700740 671794 1934951 A KEY FOCUS OF THE ORGANIZATION IS EXPANDING ACCESS TO INNOVATIVE TREATMENTS FOR CANCER IN LOW AND MIDDLE INCOME COUNTRIES. OUR PRIMARY CLIENT IS A PATIENT AND HIS/HER FAMILY WHO IS ENROLLED IN ONE OF THE ACCESS SOLUTIONS WE DEVELOP OR MANAGE. WE ACT AS HEALTHCARE NAVIGATORS FOR THESE PATIENTS, HELPING THEM WALK THROUGH THE ACCESS PROGRAM ENVIRONMENT. IN ORDER TO OPTIMIZE TREATMENT, WE ALSO PROVIDE EMOTIONAL AND LOGISTICAL SUPPORT AND EDUCATION ONE ON ONE OR IN GROUPS, AND ADVOCATE ON THEIR BEHALF WHEN NEEDED. WE CREATE COMMUNITIES AROUND PATIENTS BY ESTABLISHING AND SUPPORTING PATIENT ORGANIZATIONS, AND SET UP AWARENESS INITIATIVES IN THE PATIENT'S COMMUNITY. WE USE A SOPHISTICATED PROGRAM WEB-ENGINE DEVELOPED IN-HOUSE TO ALLOW US TO CREATE INDIVIDUALIZED PROGRAM LIFE CYCLES TO MEET EACH PATIENT'S NEEDS. IN 2015 THE ORGANIZATION ADMINISTERED SIX UNIQUE PATIENT-ORIENTED PROGRAMS OF DIVERSE SCOPE AND FOCUS, IN PARTNERSHIP WITH INDUSTRY, GOVERNMENT AND PHYSICIANS IN 74 COUNTRIES, HELPING MORE THAN 38,140 PATIENTS WITH PATIENT NAVIGATION SERVICES, ONE ON ONE EMOTIONAL SUPPORT IN 75 COUNTRIES, PROVIDING ADVOCACY SERVICES TO 11,852 PATIENTS IN 65 COUNTRIES AND INFORMATIONAL REFERRALS TO 6,248 PATIENTS IN 21 COUNTRIES. THROUGH A PATIENT HELPLINE, WE SERVED 25,536 PATIENTS WITH COUNSELING AND EMOTIONAL SUPPORT, PROVIDED ADVOCACY SERVICES TO 5,661 PATIENTS AND INFORMATIONAL REFERRALS TO 4,027 PATIENTS. 2700740 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 9 0 1 12 1 0 1 IN MY AR 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X PATRICIA GARCIA-GONZALEZ 4257788660 200 NE PACIFIC STREET SUITE 103 SEATTLE WA 98105 PATRICIA GARCIA-GONZALEZ PRESIDENT, CEO 50.00 5.00 X X 184145 0 10647 TRACEY HIGGINS DIRECTOR 2.00 0.00 X X 0 0 0 DAVID TINGSTAD DIRECTOR 2.00 0.00 X 0 0 0 ROBERT FARMER SECRETARY 2.00 0.00 X X 0 0 0 JERRY SCOTT TREASURER 2.00 0.00 X X 0 0 0 GRANT RUBENSTEIN DIRECTOR 2.00 0.00 X 0 0 0 PAULA BOULTBEE DIRECTOR 4.00 0.00 X 0 0 0 184145 0 10647 1 0 1 0 0 2765925 1753851 2765925 PATIENT CARE 624100 1880409 1880409 MEDICAL TEST KITS 624100 54542 54542 1934951 4598 4598 7 7 REIMBURSEMENTS 900099 15692 15692 OTHER INCOME 900099 697 697 HONORARIUM 900099 423 423 16812 4722293 1934951 0 21417 X 671794 671794 172396 159229 9405 3762 48363 48363 761212 699382 44164 17666 91085 84046 5028 2011 61437 56281 3683 1473 65953 65953 380246 380246 6103 2710 679 2714 90200 38579 51621 14930 14930 107386 97903 9483 157053 140833 8110 8110 30023 20152 9871 6314 6314 EDUCATION WORKSHOPS 282028 282028 FOREIGN CURRENCY LOSS 19194 19194 BUS. LICENSE & TAXES 11252 11252 MISCELLANEOUS 1035 1035 2978004 2700740 241528 35736 1570900 2044267 16083 4715 489448 387809 0 234853 17176 1195977 8460 17568 305149 160428 134716 144721 3684 6961 2240467 4036871 53619 98646 0 2966 53619 101612 X 1957354 2477415 229494 1457844 2186848 3935259 2240467 4036871 X 1744289 4122 X 1 X 0 1 0 X 84917 502731 623457 1068789 2765925 5045819 84917 502731 623457 1068789 2765925 5045819 3502407 1543412 3 3535 4071 4605 12214 590 1120 1710 5059743 9900082 0.30500 0.37790 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2014 AMOUNT: $ 590. 2015 AMOUNT: $ 1,120. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 305149 160428 144721 144721 1 CENTRAL AMERICA AND THE CARIBBEAN 1 3 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 60000 EAST ASIA AND THE PACIFIC 3 9 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY, DIRECT DRUG DONATION 330000 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 GRANTS PATIENT GROUP GRANTS 5000 NORTH AMERICA 2 3 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 64000 SUB-SAHARAN AFRICA 2 2 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY, DIRECT DRUG DONATION, DIAGNOSTIC EQUIPMENT 415000 SOUTH AMERICA 2 5 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 175000 MIDDLE EAST AND NORTH AFRICA 0 0 PRGRM SRVCS, GRANTS DIRECT DRUG DONATION 70000 RUSSIA & THE NEWLY INDEPENDENT STATES 1 1 PROGRAM SRVCS, GRANTS PATIENT COUNSELING AND ADVOCACY 22000 SOUTH ASIA 2 18 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 281000 11 23 2 18 13 41 1141000 281000 1422000 EAST ASIA & THE PACIFIC MEDICAL EQUIPMENT FOR CANCER DIAGNOSTIC PURPOSES 0 N/A 18545 DIAGNOSTIC EQUIPMENT FAIR MARKET VALUE EAST ASIA & THE PACIFIC MEDICAL EQUIPMENT FOR CANCER DIAGNOSTIC PURPOSES N/A 18545 DIAGNOSTIC EQUIPMENT FAIR MARKET VALUE CENTRAL AMERICA & THE CARIBEEAN MEDICAL EQUIPMENT FOR CANCER DIAGNOSTIC PURPOSES N/A 5000 DIAGNOSTIC EQUIPMENT FAIR MARKET VALUE MIDDLE EAST AND NORTH AFRICA PATIENT GROUP CAPACITY BUILDING 4228 WIRE TRANSFER 2640 TRAVEL EXPENSES FAIR MARKET VALUE 4 0 DRUG EAST ASIA & THE PACIFIC 1 84818 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUG MIDDLE EAST AND NORTH AFRICA 1 56545 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUG SOUTH AMERICA 1 32482 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUG SUB-SAHARAN AFRICA 1 84818 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUG SUB-SAHARAN AFRICA 1 56545 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUG SUB-SAHARAN AFRICA 1 48722 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUG SUB-SAHARAN AFRICA 1 56545 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST DRUB SUB-SAHARAN AFRICA 1 56545 CANCER TREATMENT DRUG WHOLESALE ACQUISITION COST 1 0 1 0 0 0 PART I, LINE 2: PROTOCOL FOR GRANTMAKING 1.THE PROGRAM OFFICER MAKING GRANT REQUESTS WILL NEED TO DETERMINE WHO IS DIRECTLY INVOLVED IN THE EXCHANGE OF FUNDS. A) IF FUNDS GO DIRECTLY TO THE PATIENT OR THE PATIENT'S FAMILY, THE PATIENT NAME IS CHECKED AGAINST THE SPECIALLY DESIGNATED NATIONALS LIST (SDN). B) IF FUNDS GO DIRECTLY TO A LABORATORY, THE NAME OF THE LABORATORY AND THE INDIVIDUAL RECEIVING THE FUNDS ARE CHECKED. LIKEWISE, IF IT IS A BANK, THE NAME OF THE BANK AND THE INDIVIDUAL NAME ON THE ACCOUNT ARE CHECKED. C) OUR REGIONAL STAFF MEMBERS UNDERGO A RIGOROUS HIRING PROCESS. IN ADDITION, MS STAFF ARE PERIODICALLY CHECKED AGAINST THE SDN LIST. HOWEVER, IF FUNDS MOVE THROUGH THE HANDS OF MS STAFF TO OTHER INDIVIDUALS OR ENTITIES, THE TRANSACTION IS SUBJECT TO THE SAME PROTOCOL. MS STAFF INDICATE THE INDIVIDUAL OR ENTITY THAT IS DIRECTLY INVOLVED IN THE EXCHANGE OF FUNDS. 2. THE ADMINISTRATIVE ASSISTANT REVIEWS THE SDN LIST AND OFAC COUNTRY SANCTIONS TO DETERMINE IF: A) THE PATIENT OR INDIVIDUAL APPEARS ON THE SDN LIST. B) THE PATIENT OR INDIVIDUAL RESIDES IN A SANCTIONED OFAC COUNTRY THAT LIMITS THIS GRANT. 3. THE INDIVIDUAL PATIENT GRANTS FORM INDICATES WHICH NAME(S) WERE CROSS-REFERENCED WITH THE SDN LIST. 4. IF THE PATIENT OR COUNTRY SHOWS UP ON EITHER LIST, IT WILL BE BROUGHT TO THE CEO AND THE CEO ASSISTANT'S ATTENTION AND THE PROGRAM OFFICER WILL BE GIVEN INSTRUCTIONS ON HOW TO INFORM THE MAX STATION AND THE PROPOSED RECIPIENT THAT THE GRANT IS DENIED. PART I, LINE 3: THE EXPENDITURES REPORTED ON SCHEDULE F, PART I, LINE 3 ARE ON THE ACCRUAL BASIS OF ACCOUNTING. X 1 1 X X X 0 0 0 0 0 0 0 0 0 PATRICIA GARCIA-GONZALEZ PRESIDENT, CEO 167744 0 10000 0 6401 0 0 0 10647 0 194792 0 0 0 PART I, LINE 1A THE MAX FOUNDATION PAYS FOR A COMPANY WIDE FITNESS CLUB MEMBERSHIP THAT ALL STAFF AND BOARD MEMBERS MAY MAKE USE OF. IT IS NOT TREATED AS TAXABLE INCOME. INES GARCIA-GONZALEZ SEE PART V 48363 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: INES GARCIA GONZALEZ(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF PATRICIA GARCIA-GONZALEZ, CEO.(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT X 128 1753851 WHOLESALE ACQ. COST 0 0 1 0 PART I, COLUMN (B): THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 6, VOLUNTEERS: IN 2015, THE ORGANIZATION HELD THREE CAPACITY BUILDING CONFERENCES FOR REPRESENTATIVES OF PATIENT ASSOCIATIONS FROM AFRICA AND THE MIDDLE EAST, LATIN AMERICA AND ASIA. THROUGH TRAVEL GRANTS, 84 REPRESENTATIVES OF PATIENT ASSOCIATIONS WERE ABLE TO ATTEND THESE EDUCATIONAL EVENTS. THE ORGANIZATION ALSO RAN TWO GLOBAL AWARENESS CAMPAIGNS; BY PROVIDING GRANTS TO LOCAL PATIENT ASSOCIATIONS, THESE ASSOCIATIONS HELD 87 EVENTS AIMED AT INCREASING AWARENESS OF CANCER. VOLUNTEERS HELPED TO ORGANIZE THE EVENTS, AS WELL AS PROVIDED SUPPORT DURING THE EVENTS. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN IS PREPARED BY AN OUTSIDE ACCOUNTANT. AFTER PREPARATION, THE CEO PERFORMS A REVIEW OF THE RETURN. THE RETURN IS THEN FILED WITH THE IRS. A COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD HAS ADOPTED A CONFLICT OF INTEREST POLICY AND THE POLICY IS REVIEWED ON AN ANNUAL BASIS. EACH YEAR, BOARD MEMBERS MUST REVIEW THE POLICY AND DETERMINE IF ANY CONFLICT OF INTERESTS EXIST. NO BOARD MEMBER MAY VOTE ON ANY MATTER UNDER CONSIDERATION AT A BOARD MEETING IN WHICH SUCH BOARD MEMBER HAS A CONFLICT OF INTEREST. FURTHER, ANY BOARD MEMBER WITH A MATERIAL CONFLICT OF INTEREST IN ANY DECISION SHOULD BE ABSENT FROM THE ROOM DURING THE BOARD'S REVIEW, INCLUDING ITS VOTE, ON THE DECISION IN QUESTION. FORM 990, PART VI, SECTION B, LINE 15A THE CEO HAS A CONTRACT WITH THE BOARD, LAST DATED AND APPROVED ON MAY 28, 2013. IN THIS CONTRACT, A BASE SALARY AND A YEARLY PERCENTAGE INCREASE HAS BEEN ESTABLISHED, AS WELL AS A YEARLY BONUS. IN JANUARY OF 2015, ORGANIZATION WIDE GUIDELINES FOR SALARY/COMPENSATION FOR CONTRACTORS WERE VOTED ON AND APPROVED BY THE BOARD. EMPLOYEE COMPENSATION REVIEWS OCCUR IN JANUARY OF EACH YEAR. MAX STATIONS, WHO WORK BY CONTRACT, ARE REVIEWED ON A SCHEDULE RELATED TO THEIR HIRING OR THE ACHIEVEMENT OF KNOWLEDGE OF EXPERIENCE GOALS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST. FORM 990, PART IX, LINE 11G MAX COUNTRY REPS: PROGRAM SERVICE EXPENSES 380,246. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 380,246. FORM 990, PART XI, LINE 9: PRIOR PERIOD ADJUSTMENTS FOR PRIOR YEAR ACCRUALS 4,122. MAXSTATION MALAYSIA SDN BHD UNIT 1302 LOBBY 1 BLOCK A DAMAN SELANGOR MY 320492996 PATIENT ORIENTED PROGRAMS MY THE MAX FOUNDATION C 128207 158164 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MAXSTATION MALAYSIA SDN BHD D 234854 CASH