2016-02-15T00:00:00-06:00 2015-06-30 560747981 DIXON HUGHES GOODMAN LLP 701 TOWN CENTER DRIVE SUITE 700 NEWPORT NEWS VA 236064295 990 2014-07-01 541806317 PATIENT ADVOCATE FOUNDATION PATI 8005325274 421 BUTLER FARM ROAD HAMPTON VA 23666 ALAN BALCH CHIEF EXECUTIVE OFFICER 7578736668 2016-02-11 1 JAMES M HAGGARD P00100566 7578731033 2014 2016-08-17 19:52:53Z ALAN BALCH 421 BUTLER FARM ROAD HAMPTON VA 23666 76343566 0 X WWW.PATIENTADVOCATE.ORG X 1996 VA PATIENT ADVOCATE FOUNDATION (PAF) IS A NATIONAL 501 (C)(3) NON-PROFIT ORGANIZATION THAT PROVIDES PROFESSIONAL CASE MANAGEMENT AND FINANCIAL AID SERVICES TO AMERICANS WITH CHRONIC, LIFE THREATENING AND DEBILITATING ILLNESSES. PAF CASE MANAGERS SERVE AS ACTIVE LIAISONS BETWEEN THE PATIENT AND THEIR INSURER, EMPLOYER AND/OR CREDITORS TO RESOLVE INSURANCE, JOB RETENTION AND/OR DEBT CRISIS MATTERS AS THEY RELATE TO THEIR DIAGNOSIS. PATIENT ADVOCATE FOUNDATION SEEKS TO SAFEGUARD PATIENTS THROUGH EFFECTIVE MEDIATION ASSURING ACCESS TO CARE, MAINTENANCE OF EMPLOYMENT AND PRESERVATION OF THEIR FINANCIAL STABILITY. 21 18 227 32 0 0 55140961 70512193 4582380 5070725 255764 402974 39591 35020 60018696 76020912 33369170 28381018 0 0 10050649 10360662 0 0 1251045 4645953 4969839 48065772 43711519 11952924 32309393 51356753 84425651 5222074 5986911 46134679 78438740 X PATIENT ADVOCATE FOUNDATION (PAF) IS A NATIONAL 501 (C)(3) NON-PROFIT ORGANIZATION THAT PROVIDES PROFESSIONAL CASE MANAGEMENT AND FINANCIAL AID SERVICES TO AMERICANS WITH CHRONIC, LIFE THREATENING AND DEBILITATING ILLNESSES. PAF CASE MANAGERS SERVE AS ACTIVE LIAISONS BETWEEN THE PATIENT AND THEIR INSURER, EMPLOYER AND/OR CREDITORS TO RESOLVE INSURANCE, JOB RETENTION AND/OR DEBT CRISIS MATTERS AS THEY RELATE TO THEIR DIAGNOSIS. PATIENT ADVOCATE FOUNDATION SEEKS TO SAFEGUARD PATIENTS THROUGH EFFECTIVE MEDIATION ASSURING ACCESS TO CARE, MAINTENANCE OF EMPLOYMENT AND PRESERVATION OF THEIR FINANCIAL STABILITY. 0 0 5902234 33000 20182 THE FOUNDATION PROVIDES SUSTAINED, ONE ON ONE, CASE MANAGEMENT SERVICES TO PATIENTS THROUGHOUT THE COUNTRY WHO ARE EXPERIENCING ACCESS TO CARE ISSUES. THE PROFESSIONAL CASE MANAGEMENT STAFF WORKS WITH PATIENT'S INSURERS, EMPLOYERS AND/OR CREDITORS IN AN EFFORT TO RESOLVE ACCESS TO CARE, DEBT CRISIS AND JOB RETENTION ISSUES THAT ARE A RESULT OF A LIFE THREATENING AND/OR DEBILITATING ILLNESS. THE FOUNDATION'S PROFESSIONAL CASE MANAGEMENT STAFF DIRECTLY ASSISTED 22,468 INDIVIDUALS IN FY2014/2015. ON AVERAGE, CASE MANAGERS MADE 20.57 CONTACTS ON BEHALF OF EACH PATIENT TO RELEVANT STAKEHOLDERS IN ORDER TO BRING RESOLUTION TO THE PATIENT'S ACCESS ISSUE. IN ADDITION TO NAVIGATING PATIENTS TO REQUIRED CARE, FACILITATING THEIR ENROLLMENT INTO AVAILABLE INSURANCE PLANS, WHEN APPROPRIATE, AND MANAGING COST OF LIVING ISSUES FACED BY OUR CHRONICALLY AND CRITICALLY ILL PATIENTS, OUR CASE MANAGERS WERE SUCCESSFUL IN RESOLVING OVER $40 MILLION DOLLARS IN MEDICAL DEBT FOR PATIENTS SERVED BY PAF IN THE FY2014/2015. THE DEBT RELIEF OBTAINED FOR OUR PATIENTS IS CAPTURED AND REPORTED IN THE FOLLOWING CATEGORIES:" AMOUNT RECOVERED: THE AMOUNT PAF RECOVERED FROM THIRD PARTY PAYERS SUCH AS COMMERCIAL INSURANCE PLANS AND MEDICAID OR MEDICARE PROGRAMS." CHARITABLE CONTRIBUTIONS: THE AMOUNT PAF SECURED ON BEHALF OF PATIENTS THROUGH UTILIZATION OF NATIONAL AND/OR LOCAL CHARITABLE RESOURCES SUCH AS HOSPITAL CHARITY CARE PROGRAMS, NON-PROFIT FINANCIAL AID PROGRAMS AND/OR LOCAL FAITH OR DISEASE BASED PROGRAMS." COST OF LIVING: THE AMOUNT RECOVERED BY PAF CASE MANAGERS TO DIRECTLY OFFSET LIVING EXPENSES SUCH AS: RENT/MORTGAGE ASSISTANCE, EVICTION/FORECLOSURE ASSISTANCE, UTILITY ASSISTANCE, FOOD/NUTRITIONAL ASSISTANCE, OR CAR PAYMENT/REPAIR EXPENSES AMONG OTHERS." PATIENT AMOUNT: THE AMOUNT DIRECTLY RETURNED TO PATIENTS AS A RESULT OF PAF NEGOTIATING REIMBURSEMENT FOR OUT OF POCKET MEDICAL EXPENSES." PROVIDER AMOUNT: THE AMOUNT DIRECTLY RETURNED TO PROVIDERS AS A RESULT OF PAF NEGOTIATING REIMBURSEMENT FOR MEDICAL DEBT THAT HAD PREVIOUSLY BEEN WRITTEN OFF OR LOGGED BY THE FACILITY AS "UNCOLLECTED"." WRITE OFF AMOUNT: THE AMOUNT OF PATIENT DEBT RELIEF OBTAINED BY PAF THROUGH NEGOTIATIONS WITH FACILITIES AND/OR MEDICAL PROVIDERS.IN 2013, PAF LAUNCHED THE FINANCIAL AID FUND DIVISION THROUGH WHICH WE PROVIDE FINANCIAL ASSISTANCE TO QUALIFIED PATIENTS FOR NON-MEDICATION RELATED EXPENSES FACED DURING TREATMENT. THROUGH THE ADMINISTRATION OF THREE DISTINCT FINANCIAL AID FUNDS INCLUDING THE LIVESTRONG/MOVEMBER RADIATION SMALL GRANT PROGRAM FOR PROSTATE CANCER PATIENTS, AND THE HEART VALVE FINANCIAL AID FUND FOR PATIENTS WHO ARE BEING TREATED FOR HEART VALVE CONDITIONS AND THE NEWLY LAUNCHED TRANSPORTATION FINANCIAL AID FUND FOR METASTATIC MELANOMA & METASTATIC LUNG CANCER PATIENTS, PAF SUCCESSFULLY PROVIDED ONE-TIME SMALL GRANTS TO 597 PATIENTS, PROVIDING OVER $562,400 IN FINANCIAL RELIEF IN FY2014/2015. THE SMALL GRANTS RANGE IN VALUE FROM $300-$1000 PER PATIENT AND ARE DESIGNED TO DEFRAY THE COSTS OF TRANSPORTATION COSTS AND OUT-OF-POCKET EXPENSES ASSOCIATED WITH TREATMENTS.ADDITIONALLY, THE FOUNDATION HAS AN ESTABLISHED PUBLICATIONS COMMITTEE THAT IS RESPONSIBLE FOR PROVIDING A WIDE ARRAY OF PATIENT EDUCATION MATERIALS DESIGNED WITH THE MISSION OF PROVIDING ADDITIONAL GUIDANCE FOR PATIENTS CONTACTING OUR FOUNDATION. THESE PUBLICATIONS ARE FREQUENTLY REQUESTED BY OTHER ORGANIZATIONS AND FACILITIES FOR USE WITH THEIR PATIENTS AS WELL. THE FOUNDATION CURRENTLY HAS AUTHORED 34 PATIENT EDUCATIONAL PUBLICATIONS, ALL OF WHICH ARE AVAILABLE FREE OF CHARGE TO PATIENTS. IN FY2014/2015, THE CHARGE OF THE COMMITTEE WAS TO CREATE THE FOUNDER'S LIBRARY FOR STAFF USE IN HONOR OF NANCY DAVENPORT-ENNIS. WITH A STARTING INVENTORY OF 42 PUBLICATIONS AND EDUCATIONAL DVDS, THIS LIBRARY SEEKS TO ENCOURAGE A LIFELONG HABIT OF READING AND THE PURSUIT OF KNOWLEDGE HONORING THE LEGACY OF OUR FOUNDER. LIBRARY MATERIALS ARE FREE FOR STAFF TO CHECK OUT AND UTILIZE.THE COMMITTEE ALSO REVISED AND UPDATED CONTENT, A CLEAR VIEW TO MEDICARE - MAKING THE MOST OF YOUR BENEFITS, NOW AVAILABLE IN PRINT AND ONLINE AND RELEASED TWO NEW PUBLICATIONS. THE COVERAGE ACCESS GUIDE, THAT SEEKS TO SUPPORT A PATIENT THROUGH ALL STAGES OF INSURANCE FROM BEGINNING TO END. BEGINNING WITH TIPS FOR ENROLLMENT AND PLAN SELECTION, THIS GUIDE COVERS TOPICS RELEVANT TO EVERY INSURED PATIENT. THE GUIDE CONCLUDES WITH ARTICLES THAT HELP UNDERSTAND FEDERAL DISABILITY ENROLLMENT AND VARIOUS PATHWAYS TO MEDICARE AND MEDICAID INSURANCE FOR THOSE WITH AGE OR DISABILITY ELIGIBILITY. A COMPANION NEW MOBILE PHONE APP FOR APPLE PHONES AND TABLETS, COVERAGE ACCESS GUIDE: A CONSUMER'S GUIDE TO INSURANCE WAS LAUNCHED, WHICH PROVIDES MOBILE ARTICLES THAT SUPPORT A PATIENT THROUGH ALL STAGES OF INSURANCE FROM BEGINNING TO END. THIS APP IS POPULATED WITH CONTENT SIMILAR TO THE PRINTED COVERAGE ACCESS GUIDE, BUT IS ENHANCED WITH ADDITIONAL MOBILE-ONLY CONTENT. THE MOBILE APP INCLUDES IN-DEPTH ARTICLES ON VOCABULARY, EMBEDDED VIDEOS AND ANIMATED SEGMENTS, ACTIONABLE LINKS TO OUTSIDE RESOURCES, AND HAS THE ABILITY TO BE UPDATED TO COVER BREAKING-NEWS HEALTHCARE TOPICS IF NEEDED. THE SECOND NEW PUBLICATION, THE METASTATIC BREAST CANCER GUIDE, A CONNECTED DISEASE-SPECIFIC INSERT THAT IS DISTRIBUTED ALONGSIDE THE COVERAGE ACCESS GUIDE TO PROVIDE PATIENTS MORE IN-DEPTH AND CUSTOM GUIDANCE BASED ON THE SPECIFICS OF THEIR CONDITION. TOPICS INCLUDE GENOMIC AND GENETIC TESTING, DISEASE-SPECIFIC VOCABULARY AND TREATMENT TERMINOLOGY, PERSONALIZED MEDICINE, COMPASSIONATE ALLOWANCE FOR DISABILITY ELIGIBILITY; WORKPLACE CHALLENGES WHILE SICK, LIVING WILLS, PALLIATIVE CARE AND OTHERS. THIS GUIDE IS ALSO AVAILABLE IN PRINT AND ELECTRONIC VERSIONS IN SPANISH.IN ADDITION TO THE PAF REGULARLY CONDUCTED SPECIALIZED WEBINARS, PAF LAUNCHED A NEW BRANDED INTERACTIVE WEBINAR SERIES CALLED PATIENT EMPOWERMENT SERIES. PRESENTED LIVE AS WELL AS AVAILABLE ON-DEMAND, THESE MONTHLY SESSIONS COVER TOPICS THAT HELP PATIENTS PREVENT AND RESOLVE CHALLENGES THAT OFTEN PRESENT DURING ONE'S HEALTHCARE JOURNEY. GEARED TOWARDS THE PATIENT AND CAREGIVER, THESE SESSIONS ARE ALSO APPROPRIATE FOR PROFESSIONAL ADVOCATES, CASE WORKERS, COMMUNITY SOCIAL WORKERS, NONPROFIT STAFF AND OTHER PATIENT SERVICE GROUPS.THE FOUNDATION'S CASE MANAGEMENT STAFF PROVIDED FOLLOW UP EDUCATIONAL MATERIALS TO ALL PATIENTS SERVED BY THE FOUNDATION BY SELECTING APPROPRIATE EDUCATIONAL MATERIALS FROM OVER 400 PUBLICATIONS AVAILABLE IN THE FOUNDATION'S RESOURCE CENTER. THESE PUBLICATIONS INCLUDE THOSE AUTHORED BY THE FOUNDATION AS WELL AS MATERIALS PUBLISHED BY GOVERNMENT AGENCIES, VARIOUS NONPROFIT HEALTHCARE ORGANIZATIONS, ACADEMIC INSTITUTIONS, HEALTHCARE PROVIDERS AND FACILITIES AS WELL AS FOR PROFIT HEALTHCARE COMPANIES. THE FOUNDATION DISTRIBUTED 31,261 PIECES OF EDUCATIONAL MATERIAL IN CUSTOMIZED PATIENT EDUCATION PACKETS TO THOSE PATIENTS SERVED IN FY2014/2015.DURING FY2014/2015, THE FOUNDATION'S CASE MANAGEMENT AND CO-PAY RELIEF TEAMS ALSO CONDUCTED EDUCATIONAL OUTREACH AT THE LOCAL, REGIONAL AND NATIONAL LEVELS WITH THE GOAL OF EDUCATING HEALTHCARE PROFESSIONALS, NONPROFIT ORGANIZATIONS AND THE GENERAL PUBLIC ABOUT THE SERVICES OFFERED BY THE FOUNDATION. THIS OUTREACH WAS, IN SOME CASES, TARGETED TO A SPECIFIC POPULATION THAT IS KNOWN TO BE CONSIDERED DISPARATE IN HEALTHCARE ACCESS AND DISEASE OUTCOMES DATA AND INCLUDED THE AFRICAN AMERICAN POPULATION AND HISPANIC/LATINO POPULATIONS. IN FY2014/2015, THE FOUNDATION DISTRIBUTED OVER 8,300 EDUCATIONAL PUBLICATIONS THROUGH OUTREACH EVENTS.THE SCHOLARSHIP FOR SURVIVORS PROGRAM WAS ESTABLISHED TO HONOR INDIVIDUALS THAT HAVE EXPERIENCED THE IMPACT OF A CHRONIC ILLNESS OR LIFE THREATENING DISEASE ON ONE'S SECONDARY EDUCATION. THESE STUDENTS HAVE, DESPITE THEIR DISEASE/CONDITION, EXCELLED ACADEMICALLY, SERVED THE COMMUNITY, AND DESIRE TO PURSUE A SECONDARY EDUCATION. SINCE THE PROGRAM'S INCEPTION, PAF HAS AWARDED 59 SCHOLARSHIPS TOTALING OVER $435,000; OF THE 59 STUDENTS, 41 HAVE ACHIEVED FULLY DEGREED GRADUATION AND 12 ARE STILL PURSUING THEIR COURSE OF STUDY. IN FY2014/2015, PAF AWARDED 12 SCHOLARSHIPS TO STUDENTS THROUGH THIS PROGRAM. 32204574 28348018 0 LAUNCHED IN 2004, PATIENT ADVOCATE FOUNDATION'S CO-PAY RELIEF PROGRAM (CPR) PROVIDES FINANCIAL ASSISTANCE WITH CO-PAYMENTS, CO-INSURANCE AND DEDUCTIBLES REQUIRED BY A PATIENT'S INSURER FOR PHARMACEUTICAL TREATMENTS AND/OR PRESCRIPTION MEDICATIONS PRESCRIBED TO TREAT AND/OR MANAGE THE PATIENT'S DISEASE. THE PROGRAM OFFERS PERSONAL SERVICE TO ALL PATIENTS THROUGH THE USE OF CALL COUNSELORS; PERSONALLY GUIDING PATIENTS THROUGH THE ENROLLMENT AND BENEFIT PROCESS.IN FY2014/2015, PAF'S CO-PAY RELIEF PROGRAM ASSISTED PATIENTS WHO WERE BEING TREATED FOR BREAST CANCER, CERVICAL CANCER, CHRONIC PAIN, CUTANEOUS T-CELL LYMPHOMA, ELECTROLYTE IMBALANCE, HEPATITIS C, HEPATITS B, INHERITED OR ACQUIRED LIPODYSTROPHY, METASTATIC COLORECTAL CANCER, METASTATIC GASTRIC CANCER, METASTATIC PROSTATE CANCER, MULTIPLE MYELOMA, MYELODYSPLASTIC SYNDROME, NON-MUSCLE INVASIVE BLADDER CANCER, NON-SMALL CELL LUNG CANCERS (NSCLC), NON-SMALL CELL LUNG CANCERS, BIOMARKER SPECIFIC, OSTEOPOROSIS, OVARIAN CANCER AND RENAL CELL CARCINOMA.CURRENTLY, THE FOUNDATION'S CO-PAY RELIEF PROGRAM OFFERS TWO DEDICATED, SECURED WEBSITES FOR MEDICAL PROVIDERS AND PHARMACY REPRESENTATIVES TO ENROLL ELECTRONICALLY FOR THE CO-PAY RELIEF PROGRAM ON BEHALF OF THE PATIENTS THEY ARE WORKING WITH. AS WELL, CPR OFFERS A DEDICATED, SECURE WEB BASED APPLICATION FOR PATIENTS AND/OR THEIR FAMILY MEMBERS TO ENROLL ELECTRONICALLY FOR THE CO-PAY RELIEF PROGRAM DIRECTLY FROM THE CO-PAY RELIEF PROGRAM WEBSITE.IN FY2014/2015, THE FOUNDATION ADMINISTERED CO-PAYMENT ASSISTANCE TO 19,601 QUALIFIED PATIENTS THROUGH THE 19 ASSISTANCE FUNDS AVAILABLE THROUGH THE CO-PAY RELIEF PROGRAM. OF THE QUALIFIED PATIENTS, 16,595 PATIENTS WERE SEEKING ASSISTANCE FOR THE FIRST TIME AND 3,006 PATIENTS HAD RECEIVED ASSISTANCE FROM CPR IN PRIOR YEARS. THE PROGRAM STAFF FIELDED 115,083 TELEPHONE CALLS AND PROCESSED 52,968 CLAIMS IN SUPPORT OF QUALIFIED PATIENTS OUT OF POCKET EXPENSES FOR REQUIRED CO-PAYMENTS, CO-INSURANCE AND DEDUCTIBLES. SINCE ITS INCEPTION IN 2004, THE FOUNDATION HAS PROVIDED CO-PAYMENT ASSISTANCE TO OVER 145,000 INDIVIDUALS ALLOCATING MORE THAN $227 MILLION DOLLARS IN CO-PAYMENT AWARDS. 2857891 0 5070725 IN FY2008/2009, THE FOUNDATION ENTERED INTO A TRANSPARENT SERVICE ADMINISTRATION CONTRACT WITH A NATIONAL NONPROFIT ORGANIZATION. THE FOUNDATION HAS BEEN CONTRACTED TO PROVIDE FULL SERVICE, TRANSPARENT ADMINISTRATION SERVICES TO QUALIFIED PATIENTS THAT ENTER THEIR CO-PAY ASSISTANCE PROGRAM. THE FOUNDATION CONTINUED TO PROVIDE THIS CONTRACTUAL SERVICE DURING FY2014/2015 AND WAS PAID ADMINISTRATION FEES ON A MONTHLY BASIS THROUGH THIS SERVICE CONTRACT. THE FOUNDATION ADMINISTERED SERVICES TO 21,502 PATIENTS IN FY2014/2015 THROUGH THIS CONTRACT. 40964699 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 0 1 0 1 229 0 1 227 1 0 0 0 0 1 1 1 1 0 0 X 21 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA CA X X X CORPORATE OFFICE 7578736668 421 BUTLER FARM ROAD HAMPTON VA 23666 NANCY DAVENPORT-ENNIS SEE SCH O FOUNDER AND CHAIR EMERITI 5.00 5.00 X 113005 223216 0 JOHN H ENNIS CHEIF DEVELOPMENT OFFICER 5.00 X 125319 0 5778 DENNIS A GASTINEAU IMMEDIATE PAST PRESIDENT 5.00 X 0 0 0 F MARC STEWART BOARD PRESIDENT 5.00 X X 0 0 0 ALAN J BALCH CHIEF EXECUTIVE OFFICER 40.00 X X 170674 125000 24023 PEARL MOORE BOARD MEMBER 5.00 X 0 0 0 JOHN L MURPHY BOARD MEMBER 5.00 X 0 0 0 AL BENSON III BOARD MEMBER 5.00 X 0 0 0 CHRISTIAN G DOWNS BOARD MEMBER 5.00 X 0 0 0 DEBORAH PARHAM HOPSON EXECUTIVE VICE PRESIDENT 5.00 X X 0 0 0 LOVELL JONES BOARD MEMBER 5.00 X 0 0 0 ROBERT M RIFKIN BOARD MEMBER 5.00 X 0 0 0 LORI WILLIAMS BOARD MEMBER 5.00 X 0 0 0 CHRISTOPHER BOONE BOARD MEMBER 5.00 X 0 0 0 JOHN HARRINGTON BOARD MEMBER 5.00 X 0 0 0 DIANE MAUK BOARD SECRETARY 5.00 X X 0 0 0 OTIS MAYNARD BOARD MEMBER 5.00 X 0 0 0 BRIAN GAROFALO BOARD MEMBER 5.00 X 0 0 0 ANDY MILLER BOARD MEMBER 5.00 X 0 0 0 W JACKSON WISDOM BOARD MEMBER 5.00 X 0 0 0 LOUIS JACQUES BOARD MEMBER 5.00 X 0 0 0 FRAN CASTELLOW PRESIDENT OF OPERATIONS 40.00 X 162231 0 7212 WILLIAM NASON CHIEF FINANCIAL OFFICER 40.00 X 180353 0 19834 BETH MOORE EVP OF PROGRAM STRATEGY 40.00 X 125663 0 11400 ERIN SINGLETON CHIEF OF MISSION DELIVERY 40.00 X 131018 0 13767 ANGELA M WALKER CHIEF OF TALENT MANAGEMENT 40.00 X 148374 0 3717 KEVIN J COX CHIEF INFORMATION OFFICER 40.00 X 132643 0 17330 ALAN RICHARDSON CHIEF DEVELOPMENT OPERATIONS OFFICER 40.00 X 118202 0 13466 1407482 348216 116527 10 0 1 0 RULESWARE LLC 10 N MARTINGALE RD SUITE 400 SCHAUMBURG IL 06173 SOFTWARE CONSULTING 2209125 PEGASYSTEMS INC 1 ROGERS ST CAMBRIDGE MA 02142 SOFTWARE CONSULTING 482027 MARATHON CONSULTING LLC 4876-118 PRINCESS ANNE RD PMB 310 VIRGINIA BEACH VA 23462 SOFTWARE CONSULTING 290135 3 125000 224289 431824 69731080 40281 70512193 SERVICE CONTRACTS 541900 5070725 5070725 5070725 402970 402970 270000 269996 4 4 4 67496 224289 52658 14838 14838 20182 0 20182 20182 76020912 5090907 0 417812 28381018 28381018 1535436 614316 444743 476377 7078305 6452502 284941 340862 178696 170082 7532 1082 893323 766747 61991 64585 674902 557346 55825 61731 124166 5513 116339 2314 133033 9594 123439 880000 818928 42328 18744 207172 181252 7769 18151 60114 49173 6775 4166 1844858 1675718 131820 37320 748414 685697 35250 27467 160248 106073 22620 31555 280240 70060 75076 135104 119952 112299 5713 1940 354675 296481 29185 29009 56967 11900 44429 638 43711519 40964699 1495775 1251045 4121397 3425252 41733713 72022026 183529 1603086 426999 453172 47958 57869 476623 355231 6443096 1920783 2403781 4522313 1909422 1933371 53331 53331 51356753 84425651 1276956 907630 3304936 3246672 0 1280000 640182 552609 5222074 5986911 X 2582399 3680105 41642858 72825264 1909422 1933371 46134679 78438740 51356753 84425651 X 32309393 -5328 -4 X X 0 1 X 1 1 1 X 22345618 37041936 39039469 35867506 59477193 193771722 22345618 37041936 39039469 35867506 59477193 193771722 118571837 75199885 271544 288925 196564 258390 402970 1418393 195190115 23529929 0.38530 0.44580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 880000 880000 42831519 43711519 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 662500 485000 790000 880000 2817500 250000 250000 250000 250000 1000000 1500000 1909422 23949 1933371 1846290 63132 1909422 1920715 -74425 1846290 1943750 -23035 1920715 1974377 -30627 1943750 0 0 78896 10342 68554 5187584 1910441 3277143 1176616 1176616 4522313 ACCRUED VACATION 225230 LEASE OBLIGATION 68770 LONG-TERM LEASE LIABILITY 72654 IBNR RESERVE 101764 DUE TO RELATED PARTY 84191 552609 X 76099684 -5332 31446 26114 76073570 -52658 -52658 76020912 43795623 31446 52658 84104 43711519 0 43711519 PART V, LINE 4: THE ENDOWMENT FUND OF PATIENT ADVOCATE FOUNDATION WAS ESTABLISHED IN 2001 TO FURTHER ITS EXEMPT PURPOSE BY SUPPORTING DIRECT PATIENT SERVICES. THE ENDOWMENT FUND BUILDS LONG-TERM STABILITY FOR THE FUTURE OF THE FOUNDATION BY PROVIDING AN ADDITIONAL SOURCE OF INCOME TO MEET AN INCREASING DEMAND FOR NATIONAL PROGRAMS AND SERVICES. IT PROVIDES FOR INTEREST INCOME TO BE USED BY PAF AND RESTRICTS ACCESS TO PRINCIPAL BASED UPON BOARD APPROVAL. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF SECTION 501C3 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT EXPENSES FOR FUNDRAISING EVENT -52,658. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT EXPENSES FOR FUNDRAISING EVENT 52,658. PROMISE OF HOPE 291785 224289 67496 20086 26085 4740 1747 291785 224289 67496 20086 26085 4740 1747 52658 14838 1 SCHOLARSHIPS 12 33000 CO PAY RELIEF ASSISTANCE 19601 28348018 PART I, LINE 2: THROUGH PATIENT ADVOCATE FOUNDATIONS SCHOLARSHIP FOR SURVIVORS, 12 SCHOLARSHIPS WERE AWARDED TO STUDENTS WHOSE STUDIES WERE INTERRUPTED OR DELAYED BY A DIAGNOSIS OF A LIFE THREATENING, CHRONIC OR DEBILITATING DISEASE. THE STUDENTS MUST BE ENROLLED FULL-TIME, MAINTAINING GPA OF 3.0 OR BETTER AND COMPLETE 20 HOURS OF COMMUNITY SERVICE DURING THE ACADEMIC YEAR. PATIENT ADVOCATE FOUNDATION (PAF) CO-PAY RELIEF PROGRAM (CPR) CURRENTLY PROVIDES DIRECT FINANCIAL SUPPORT TO INSURED PATIENTS WHO MUST FINANCIALLY AND MEDICALLY QUALIFY TO ACCESS PHARMACEUTICAL CO-PAYMENT ASSISTANCE. THE PROGRAM OFFERS PERSONAL SERVICE TO ALL PATIENTS THROUGH THE USE OF CALL COUNSELORS; PERSONALLY GUIDING PATIENTS THROUGH THE ENROLLMENT PROCESS. X X X X X X 0 0 0 0 0 0 0 0 0 NANCY DAVENPORT-ENNIS SEE SCH O FOUNDER AND CHAIR EMERITI 113005 223216 0 0 0 0 0 0 0 0 113005 223216 0 0 ALAN J BALCH CHIEF EXECUTIVE OFFICER 156346 125000 14328 0 0 0 8250 0 15773 0 194697 125000 0 0 FRAN CASTELLOW PRESIDENT OF OPERATIONS 157388 0 4843 0 0 0 6210 0 1002 0 169443 0 0 0 WILLIAM NASON CHIEF FINANCIAL OFFICER 175100 0 5253 0 0 0 6974 0 12860 0 200187 0 0 0 ALAN BALCH CHIEF EXECUTIVE OFFICER 1168480 ALAN BALCH IS THE CHIEF EXECUTIVE OFFICER OF PATIENT ADVOCATE FOUNDATION. HE IS ALSO THE CHIEF EXECUTIVE OFFICER OF NATIONAL PATIENT ADVOCATE FOUNDATION. NATIONAL PATIENT ADVOCATE FOUNDATION HAS A CONSULTING AGREEMENT IN WHICH PATIENT ADVOCATE FOUNDATION PAYS NATIONAL PATIENT ADVOCATE FOUNDATION FEES TO REPRESENT THE POLICY INTERESTS OF PATIENT ADVOCATE FOUNDATION. THE CONSULTING FEES FOR FY 2014/2015 WERE $880,000. NATIONAL PATIENT ADVOCATE FOUNDATION ALSO REIMBURSES PATIENT ADVOCATE FOUNDATION FOR SERVICES PROVIDED BY ALAN BALCH. SALARY REIMBURSEMENT IS $125,000 PER YEAR. NATIONAL PATIENT ADVOCATE FOUNDATION ALSO REIMBURSED PATIENT ADVOCATE FOR $163,480 OF OTHER EXPENSES IN FY 2014/2015. 0 JACK ENNIS CHIEF DEVELOPMENT OFFICER AND CO-FOUNDER PAF 134599 HE IS THE HUSBAND OF NANCY DAVENPORT-ENNIS, FOUNDER AND CHAIR EMERITI OF PAF. 0 FRANCES CASTELLOW PRESIDENT, OPERATIONS PAF 185047 SHE IS THE DAUGHTER OF NANCY DAVENPORT-ENNIS, FOUNDER AND CHAIR EMERITI OF PAF. 0 BETH MOORE EXECUTIVE VICE PRESIDENT, PROGRAM STRATEGY OF PAF 139279 SHE IS THE DAUGHTER OF NANCY DAVENPORT-ENNIS, FOUNDER AND CHAIR EMERITI OF PAF. 0 SHAWN NASON SPECIAL EVENTS DIRECTOR 65921 SHE IS THE WIFE OF WILLIAM NASON, CHIEF FINANCIAL OFFICER OF PAF. 0 X 4 2994 RETAIL VALUE X 4536 RETAIL VALUE X 4 2800 RETAIL VALUE X GIFT BASKETS 117 15872 RETAIL VALUE X ADDITIONAL MISCELLANEOUS CONTRIBUTIONS 1 9714 RETAIL VALUE X JEWELRY/ACCESSORIES 14 4365 RETAIL VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 JOHN L. MURPHY, BOARD MEMBER OF PATIENT ADVOCATE FOUNDATION, IS THE BROTHER-IN-LAW OF NANCY DAVENPORT-ENNIS, FOUNDER AND CHAIR EMERITI OF PATIENT ADVOCATE FOUNDATION. FRANCES CASTELLOW, PRESIDENT, OPERATIONS OF PATIENT ADVOCATE FOUNDATION, IS THE DAUGHTER OF NANCY DAVENPORT-ENNIS, FOUNDER AND CHAIR EMERITI OF PATIENT ADVOCATE FOUNDATION. JACK ENNIS, CHIEF DEVELOPMENT OFFICER AND CO-FOUNDER OF PATIENT ADVOCATE FOUNDATION, IS THE HUSBAND OF NANCY DAVENPORT-ENNIS,FOUNDER AND CHAIR EMERITI OF PATIENT ADVOCATE FOUNDATION. BETH MOORE, EXECUTIVE VICE PRESIDENT, PROGRAM STRATEGY OF PATIENT ADVOCATE FOUNDATION, IS THE DAUGHTER OF NANCY DAVENPORT-ENNIS, FOUNDER AND CHAIR EMERITI OF PATIENT ADVOCATE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS RECEIVES A DRAFT COPY OF THE FORM 990 THEN SUBSEQUENTLY REVIEWS IT FOR ACCURACY AND COMPLIANCE. ONCE IT IS APPROVED BY THE FINANCE COMMITTEE, ALL MEMBERS OF THE EXECUTIVE BOARD OF DIRECTORS RECEIVE THE FINAL COPY OF THE FORM 990 FOR REVIEW AND APPROVAL PRIOR TO FILING AND IS SO NOTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE PAF BOARD OF DIRECTORS ARE REQUIRED TO REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY UPON ESTABLISHING MEMBERSHIP AND ANNUALLY COMPLETE AN UPDATED CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. EACH MEMBER MUST DISCLOSE ANY/ALL KNOWN CONFLICTS OF INTEREST AT THAT TIME. IF ANY CONFLICTS OF INTEREST ARE NOTED MORE INFORMATION WILL BE GATHERED BY THE EXECUTIVE COMMITTEE AND A DETERMINATION ON THE EXISTENCE OF A MATERIAL CONFLICT WILL BE ISSUED. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS CHARGED WITH ENFORCEMENT OF THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 PATIENT ADVOCATE FOUNDATION COMPLETES COMPENSATION STUDIES THAT UTILIZE NATIONAL COMPARABILITY DATA OF ORGANIZATIONS SIMILAR IN MISSION, SIZE AND REVENUES. PAF HAS A COMPENSATION COMMITTEE WITHIN THE BOARD OF DIRECTORS THAT CONSISTS OF AT LEAST 4 INDEPENDENT EXECUTIVE BOARD MEMBERS AND IS CHAIRED BY THE BOARD PRESIDENT. THIS COMMITTEE IS PROVIDED WITH THE COMPENSATION REPORT AND UTILIZES IT TO ESTABLISH THE CEO'S ANNUAL COMPENSATION. THIS COMMITTEE ALSO REVIEWS THE COMPENSATION OF KEY EMPLOYEES UTILIZING THE COMPENSATION REPORT. THIS PROCESS IS DOCUMENTED THROUGH MINUTES OF THE COMPENSATION COMMITTEE MEETING. FORM 990, PART VI, SECTION C, LINE 19 PATIENT ADVOCATE FOUNDATION MAKES AVAILABLE THE LAST 10 YEARS OF FORM 990S, AUDITED FINANCIAL STATEMENTS, ANNUAL REPORTS AND CURRENT LIST OF BOARD MEMBERS ON THE ORGANIZATION'S WEBSITE, WWW.PATIENTADVOCATE.ORG UNDER THE "MEET PAF" SECTION. ADDITIONALLY, PAF MAKES AVAILABLE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, ARCHIVED FORM 990S (OLDER THAN 10 YEARS) AND AUDITED FINANCIAL STATEMENTS (OLDER THAN 10 YEARS) UPON REQUEST. FORM 990, PART XI, LINE 9: GAIN ON 990 - RECORDED AS UNREALIZED GAIN ON FINANCIALS -4. PART XII, LINE 2C NO CHANGES WERE MADE TO THE ORGANIZATION OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. NATIONAL PATIENT ADVOCATE FOUNDATION (NPAF) 725 15TH STREET WASHINGTON DC 20005 541839226 SEEKS TO REMOVE OBSTACLES TO HEALTHCARE ACCESS FOR PATIENTS VA 501(C)(4) NPAF IS THE SISTER ORGANIZATION TO PAFMRBALCH IS CEO OF AND PAID BY BOTH 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 NATIONAL PATIENT ADVOCATE FOUNDATION M 880000 NATIONAL PATIENT ADVOCATE FOUNDATION O 125000 NATIONAL PATIENT ADVOCATE FOUNDATION Q 163480