2015-11-16T11:41:14-06:00 2014-12-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2014-01-01 911893957 THE MAX FOUNDATION MAXF 4257788660 200 NE PACIFIC STREET SUITE 103 SEATTLE WA 98105 PATRICIA GARCIA-GONZALEZ CEO 4257788660 2015-11-01 1 JANE M SEARING P00000565 4254544919 2015-11-13 2014 2016-04-25 22:37:26Z PATRICIA GARCIA-GONZALEZ 200 NE PACIFIC STREET SUITE 103 SEATTLE WA 98105 2921911 0 X WWW.THEMAXFOUNDATION.ORG X 1997 WA INCREASE GLOBAL ACCESS TO TREATMENT, CARE, AND SUPPORT FOR PEOPLE LIVING WITH CANCER. 8 7 10 1052 0 0 623457 1068789 2169705 1831127 3467 3912 4351 18083 2800980 2921911 114110 208073 0 0 896456 938120 0 0 65399 1444251 1279713 2454817 2425906 346163 496005 1851526 2240467 0 53619 1851526 2186848 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 2166735 208073 1831127 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 2014 THE ORGANIZATION ADMINISTERED SIX UNIQUE PATIENT-ORIENTED PROGRAMS OF DIVERSE SCOPE AND FOCUS, IN PARTNERSHIP WITH INDUSTRY, GOVERNMENT AND PHYSICIANS IN 82 COUNTRIES, HELPING MORE THEN 37,000 PATIENTS. 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. 2166735 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 4 0 1 10 1 0 1 IN MY AR 0 0 0 0 0 0 0 0 X 8 7 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 60.00 5.00 X X 176256 0 21004 TRACEY HIGGINS VICE PRESIDENT 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 4.00 0.00 X X 0 0 0 GRANT RUBENSTEIN DIRECTOR 2.00 0.00 X 0 0 0 KEN WEYANT DIRECTOR 2.00 0.00 X 0 0 0 JIM LUMSDEN DIRECTOR 2.00 0.00 X 0 0 0 176256 0 21004 1 0 1 0 0 1068789 129773 1068789 PATIENT CARE 624100 1752110 1752110 MEDICAL TEST KITS 624100 79017 79017 1831127 3912 3912 159 159 REIMBURSEMENTS 900099 17334 17334 590 590 17924 2921911 1831127 0 21995 X 208073 208073 197260 177534 9863 9863 44000 44000 575986 513988 30999 30999 60207 54187 3010 3010 60667 54601 3033 3033 200 200 22198 22198 16300 16300 4758 2379 476 1903 61100 39561 21498 41 28485 26206 2279 67208 61831 5377 129751 116776 12975 7284 7284 18574 17088 1486 4989 4989 MAXSTATION CONTRACTORS 521602 447128 57924 16550 EDUCATIONAL PROJECTS 319953 319953 MEDICAL EQUIPMENT 76915 76146 769 STATE B & O TAXES 396 396 2425906 2166735 193772 65399 1798312 1570900 7824 16083 969 489448 17970 17176 0 8460 256836 122120 22420 134716 4031 3684 1851526 2240467 0 53619 0 53619 X 1851526 1957354 0 229494 1851526 2186848 1851526 2240467 X 496005 -160683 X X 1 X 0 1 0 X 190352 84917 502731 623457 1068789 2470246 190352 84917 502731 623457 1068789 2470246 1533655 936591 3 3535 4071 7609 590 590 2478445 9814486 0.37790 0.40920 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 256836 122120 134716 134716 1 CENTRAL AMERICA AND THE CARIBBEAN 2 2 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 80000 EAST ASIA AND THE PACIFIC 3 9 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 400000 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 GRANTS PATIENT GROUP GRANTS 2400 NORTH AMERICA 2 4 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 83000 SUB-SAHARAN AFRICA 1 1 PROGRAM SRVCS, GRANTS PATIENT COUNSELING AND ADVOCACY 95000 SOUTH AMERICA 2 4 PROGRAM SRVCS, GRANTS PATIENT COUNSELING AND ADVOCACY 153000 MIDDLE EAST AND NORTH AFRICA 0 0 GRANTS PATIENT GROUP GRANTS 14000 RUSSIA & THE NEWLY INDEPENDENT STATES 1 1 PROGRAM SRVCS, GRANTS EDUCATIONAL WORKSHOPS, PATIENT COUNSELING AND ADVOCACY 18000 SOUTH ASIA 2 17 PROGRAM SRVCS, GRANTS PATIENT COUNSELING AND ADVOCACY 278000 11 21 2 17 13 38 845400 278000 1123400 CENTRAL AMERICA AND THE CARIBBEAN MEDICAL EQUIPMENT FOR CANCER DIAGNOSTIC PURPOSES N/A 38490 EQUIPMENT FAIR MARKET VALUE EAST ASIA AND THE PACIFIC MEDICAL EQUIPMENT AND SUPPORT FOR CANCER DIAGNOSTIC PURPOSES 2900 WIRE TRANSFER 11441 EQUIPMENT, CHILDREN'S BOOKS FAIR MARKET VALUE 2 0 EVENTS FOR PATIENT ASSISTANCE AND AWARENESS CENTRAL AMERICA AND THE CARIBBEAN 50 6059 WIRE TRANSFER 1347 EDUCATIONAL MATERIALS FMV WORKSHOPS, TRAINING PATIENT ADVOCATES EAST ASIA AND THE PACIFIC 20 5680 WIRE TRANSFER 22197 TRAVEL EXPENSES, REGISTRATION FMV EVENTS FOR PATIENT ASSISTANCE AND AWARENESS EUROPE (INCLUDING ICELAND & GREENLAND) 5 2400 WIRE TRANSFER N/A N/A EVENTS FOR PATIENT ASSISTANCE AND AWARENESS, TRAINING MIDDLE EAST AND NORTH AFRICA 50 6758 WIRE TRANSFER 6916 TRAVEL EXPENSES, EDUCATIONAL MATERIALS FMV EVENTS FOR PATIENT ASSISTANCE AND AWARENESS, WORKSHOP PARTICIPATION NORTH AMERICA 40 18593 WIRE TRANSFER 4341 TRAVEL EXPENSES, EDUCATIONAL MATERIALS FMV EVENT FOR PATIENT ASSISTANCE AND AWARENESS RUSSIA AND NEIGHBORING STATES 15 1500 WIRE TRANSFER 1081 EDUCATIONAL MATERIALS FMV PATIENT ASSISTANCE, EVENTS FOR PATIENT ASSISTANCE AND AWARENESS SOUTH AMERICA 300 24537 WIRE TRANSFER 6404 TRAVEL EXPENSES, EDUCATIONAL MATERIALS FMV WORKSHOPS, TRAINING PATIENT ADVOCATES, EVENTS SOUTH ASIA 50 4150 WIRE TRANSFER 4294 TRAVEL EXPENSES, EDUCATIONAL MATERIALS FMV EVENTS FOR PATIENT ASSISTANCE AND AWARENESS, WORKSHOP PARTICIPATION SUB-SAHARAN AFRICA 100 16470 WIRE TRANSFER 28626 TRAVEL EXPENSES, EDUCATIONAL MATERIALS FMV 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. SCHEDULE F, PART IV, LINE 1: THE ORGANIZATION DOES NOT MEET THE FILING REQUIREMENTS FOR FILING THE FORM 926. X 1 1 X X X 0 0 0 0 0 0 0 0 0 PATRICIA GARCIA-GONZALEZ PRESIDENT, CEO 166256 0 10000 0 0 0 0 0 21004 0 197260 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 44000 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 14 115373 PERCENTAGE OF FMV X SOFTWARE 2 14400 FMV 0 0 0 0 PART I, COLUMN (B): THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 6, VOLUNTEERS: IN COLLABORATION WITH OUR PARTNER ORGANIZATIONS WE HOSTED 41 CANCER AWARENESS AND EDUCATION EVENTS IN 30 COUNTRIES AS PART OF THE MAXIMIZE LIFE CAMPAIGN, AND TRACKED SPECIFICALLY THE NUMBER OF VOLUNTEERS AT THESE EVENTS. VOLUNTEERS HELPED TO ORGANIZE THE EVENTS, AS WELL AS PROVIDING 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 24A, OTHER EXPENSES: MAXSTATIONS ARE LOCAL CANCER ADVOCATES WHO RECEIVE FUNDS FROM THE MAX FOUNDATION TO MANAGE SPECIFIC PROGRAMS OF THE ORGANIZATION IN THEIR COUNTRIES. MAXSTATIONS ACT AS A LIAISON BETWEEN THE ORGANIZATION AND LOCAL PARTNERS, PROVIDE EMOTIONAL SUPPORT TO PATIENTS AND BUILD LOCAL RESOURCES AROUND CANCER PATIENTS. FORM 990, PART XI, LINE 9: CHANGE IN ACCOUNTING METHOD -17,779. DECONSOLIDATION RELATING TO FOREIGN SUBSIDIARY -142,904. FORM 990, PART XII, LINE 1: TO MORE ACCURATELY REFLECT ORGANIZATION'S ACTIVITIES, THE MAX FOUNDATION CHANGED FROM THE MODIFIED CASH-BASIS OF ACCOUNTING TO THE ACCRUAL-BASIS OF ACCOUNTING IN THE YEAR ENDED DECEMBER 31, 2014. MAXSTATION MALAYSIA SDN BHD UNIT 1302 LOBBY 1 BLOCK A DAMAN SELANGOR MY PATIENT ORIENTED PROGRAMS MY THE MAX FOUNDATION C 99364 145911 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 653222 CASH