2013-02-11T18:17:13-06:00 2012-06-30 942847272 DELUCCHI HAWN LLP 333 W SANTA CLARA ST STE 750 SAN JOSE CA 951131716 990 2011-07-01 770545774 SANTA CLARA FAMILY HEALTH FOUNDATION SANT 4088741999 210 E HACIENDA AVENUE CAMPBELL CA 950086617 KATHLEEN M KING 4088741999 2013-02-05 1 PETER J MALUTTA P00445699 4082862200 2013-01-23 2011 2016-02-25 16:41:14Z KATHLEEN M KING 210 E HACIENDA AVENUE CAMPBELL CA 95008 2101407 0 X WWW.HEALTHYFAMILYFUND.ORG X 2000 CA PROMOTES ACCESS TO AFFORDABLE, HIGH QUALITY HEALTHCARE THROUGH RESOURCE DEVELOPMENT AND OUTREACH. 17 16 0 15 0 0 1283336 2025695 0 0 7993 4006 -25 0 1291304 2029701 125000 16000 0 0 419380 476074 0 0 159863 1339214 1677920 1883594 2169994 -592290 -140293 2047510 1940910 132756 166449 1914754 1774461 X PROMOTES ACCESS TO AFFORDABLE, HIGH QUALITY HEALTHCARE THROUGH RESOURCE DEVELOPMENT AND OUTREACH. 0 0 1433997 4006 HEALTHY KIDS PROGRAM: COMPREHENSIVE MEDICAL, DENTAL, VISION AND MENTAL HEALTH COVERAGE FOR LOW INCOME CHILDREN RESIDING IN SANTA CLARA COUNTY. PROGRAM PROVIDES HEALTH COVERAGE TO APPROXIMATELY 6,500 CHILDREN EACH MONTH. 36294 COMMUNITY OUTREACH & RETENTION: OUTREACH, ENROLLMENT AND RETENTION ACTIVITIES THROUGH THE CHILDREN'S HEALTH INITIATIVE TO IDENTIFY AND ASSIST PARENTS OF UNINSURED CHILDREN IN APPLYING FOR SUBSIDIZED HEALTH COVERAGE FOR THEIR CHILDREN OR ASSIST CURRENTLY INSURED CHILDREN RETAIN THEIR SUBSIDIZED HEALTH COVERAGE. 224800 SENIORS AND PEOPLE WITH DISABILITIES PROJECT: THE DEVELOPMENT AND IMPLEMENTATION OF AN ONLINE PORTAL TO COLLECT MEDICAL HISTORY DATA ON SPECIAL PERSONS WITH DISABILITIES (SPDS) SO THAT PATIENTS, PROVIDERS AND SANTA CLARA FAMILY HEALTH PLAN ARE ABLE TO BETTER MANAGE THEIR CARE. 19418 SCHOOL OUTREACH PROGRAM:OUTREACH AND ENROLLMENT ASSISTANCE FOR UNINSURED, SCHOOL-AGED CHILDREN. 68078 TECHNOLOGY PROJECTS: VARIOUS TECHNOLOGY PROJECTS TO ENSURE THAT SANTA CLARA FAMILY HEALTH PLAN HAS THE TECHNOLOGICAL EQUIPMENT NEEDED TO SERVE ITS MEMBERS IN THE MOST EFFECTIVE AND EFFICIENT MANNER. 3138 GARDNER FAMILY PROJECT: RESEARCH PROJECT TO DETERMINE THE FEASIBILITY OF DEVELOPING AND IMPLEMENTING A NEW HEALTH COVERAGE PROGRAM FOR UNINSURED CHILDREN AGES 0-5 AND THEIR UNINSURED PARENTS AND SIBILINGS. 90634 1785725 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 10 0 1 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X X EMILY M HENNESSY 4088741912 210 E HACIENDA AVENUE CAMPBELL CA 95008 RON COHN 2.00 X X 0 0 0 SUNSHINE BORELLI 1.00 X 0 0 0 CINDY CHAVEZ 1.00 X X 0 0 0 ELIZABETH DARROW 1.00 X 0 277054 50442 DANA DITMORE 1.00 X X 0 0 0 REYMUNDO ESPINOZA 1.00 X 0 0 0 CHRISTOPHER B GIORDANO 1.00 X 0 0 0 HON KATHLEEN M KING 40.00 X X 159809 0 22120 EMILY LAM 1.00 X 0 0 0 NGAI X NGUYEN MD 1.00 X 0 0 0 QUYEN VUONG 1.00 X 0 0 0 SANDRA WHEATLEY 1.00 X 0 0 0 E CHRISTOPHER WILDER 1.00 X 0 0 0 SUSIE WILSON 1.00 X 0 0 0 JUDY CHIRCO 1.00 X 0 0 0 NORA CAMPOS 1.00 X 0 0 0 BRAD LAMBERT 1.00 X 0 0 0 EMILY HENNESSY 40.00 X 98723 0 35165 258532 277054 107727 1 0 1 0 0 398345 338819 297162 991369 183463 2025695 4006 4006 71706 398345 71706 0 2029701 4006 0 0 16000 16000 258532 53345 100728 104459 114535 114535 103007 46353 27812 28842 2948 2948 28600 28600 30432 2775 27657 18475 18475 19042 503 10691 7848 12000 12000 5167 1519 3409 239 HEALTHY KIDS PREMIUMS 1012134 1012134 OTHER PROGRAMS 501658 501658 HEALTHY KIDS HARDSHIP F 33403 33403 MEMBERSHIP FEES 7690 3500 4190 6371 6371 2169994 1785725 224406 159863 -82585 29091 1644289 1321785 63000 402500 422806 177386 10148 2047510 1940910 69986 152949 62770 13500 132756 166449 X 1810458 1320871 104296 453590 1914754 1774461 2047510 1940910 -140293 0 X 0 1 1 X 0 X 3420660 4298124 2450920 920656 2025695 13116055 3420660 4298124 2450920 920656 2025695 13116055 13116055 212195 -37362 11036 7993 4006 197868 3322597 139967 139932 411634 71706 4085836 17399759 0.75380 0.78170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 244180 244180 366270 199000 199000 61045 61045 91568 0 2029701 2169994 -140293 -140293 2029701 0 2029701 0 2029701 2169994 0 2169994 0 2169994 WINE TASTING BENEFIT 161995 136355 25640 4726 14030 6884 TURKEY TROT 204000 204000 3 104056 57990 46066 46066 470051 398345 71706 4726 14030 52950 71706 0 1 WORKING PARTNERSHIP USA 2102 ALMADEN ROAD STE 107 SAN JOSE CA 95125 770387535 16000 TO SUPPORT 2012 LIVE REPORT PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ON RARE OCCASIONS, SANTA CLARA FAMILY HEALTH FOUNDATION MAKES GRANTS TO DOMESTIC ENTITIES. IT DOES NOT SOLICIT GRANT REQUESTS, BUT RATHER MAKES GRANTS TO ORGANIZATIONS THAT SERVE THE SAME POPULATION AS THE FOUNDATION. THE ELIGIBILITY CRITERIA IS DETERMINED BY THE EXECUTIVE DIRECTOR AND THE SELECTION PROCESS IS DETERMINED BY THE BOARD OF DIRECTORS. THE FOUNDATION MAINTAINS RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANTS, WHICH IS DETERMINED BY NEED AND AVAILABLE RESOURCES. X X X X X 0 0 0 0 0 0 0 0 0 ELIZABETH DARROW 0 277054 0 0 0 0 0 41255 0 9187 0 327496 0 0 HON KATHLEEN M KING 159809 0 0 0 0 0 22105 0 15 0 181929 0 0 0 X PHONE SYSTEM 1 183463 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S EXECUTIVE DIRECTOR, WHO ALSO IS A VOTING MEMBER OF THE BOARD OF DIRECTORS, REVIEWS AND APPROVES THE IRS FORM 990. THE BOARD-APPOINTED AUDIT COMMITTEE, ALL OF WHOM ARE VOTING MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE FORM 990 AND PROVIDES APPROVAL PRIOR TO FILING THE DOCUMENT. FORM 990, PART VI, SECTION B, LINE 12C STAFF DISTRIBUTE A CONFLICT OF INTEREST STATEMENT TO EACH BOARD MEMBER ON AN ANNUAL BASIS AND ONCE NEW MEMBERS ARE APPOINTED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION POSTS ITS IRS FORM 990 AND AUDITED FINANCIAL STATEMENTS ON GUIDESTAR.ORG. THE ORGANIZATION DISTRIBUTES ITS IRS FORM 990 TO FUNDERS AND ANY OTHER ENTITIES OR INDIVIDUALS WHO REQUEST IT. IT ALSO DISTRIBUTES ITS AUDITED FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS TO ITS BOARD OF DIRECTORS AND FUNDERS. WHEN REQUESTED, THE ORGANIZATION DISTRIBUTES ITS CONFLICT OF INTEREST STATEMENTS TO ENTITIES AND/OR INDIVIDUALS. SANTA CLARA COUNTY HEALTH AUTHORITY 210 EAST HACIENDA AVENUE CAMPBELL CA 95008 770423586 ENTITY FOR WHICH THE ORGANIZATION CONDUCTS RESOURCE DEVELOPMENT AND OUTREACH CA 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 SANTA CLARA COUNTY HEALTH AUTHORITY N 335681 TOTAL WAGES PAID SANTA CLARA COUNTY HEALTH AUTHORITY O 1012134 HEALTHY KID PREMIUMS