2012-11-13T11:27:58-06:00 2011-12-31 PRICEWATERHOUSECOOPERS LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2011-01-01 581592076 KAISER FDN HEALTH PLAN OF GEORGIAINC % VP - NATIONAL TAX COMPLIANCE KAIS 5102716611 ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 DEBORAH STOKES 5102716385 2012-11-02 2673303000 2011 2016-02-24 21:20:13Z PETER ANDRUSZKIEWICZ ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 1165210262 false X N/A X 1985 GA TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE 5 2 2161 754 0 0 2350668 8056693 945171878 1087593114 5931849 4236372 7140775 0 960595170 1099886179 9046312 12022634 0 0 166674729 182121879 0 0 0 938805370 935402301 1114526411 1129546814 -153931241 -29660635 372483994 375804045 420376284 468048759 -47892290 -92244714 X TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE false false 1011943067 0 1087051961 Member health care services and medical training for care improvement Kaiser Foundation Health Plan of Georgia, Inc. (KFHP of Georgia) provides medical and surgical care, including urgent care services, extended care and home health care, for its members without regards to age, sex, race, religion or national origin or the ability to pay. KFHP of Georgia educates and trains medical students and other health care professionals and promotes scientific and nursing education in order to improve care. Additional information about Georgia Health Plan's charitable activities can be found in Schedule O, Community Benefit Report. 11589112 0 541153 Charitable Care (Medical Financial Assistance and Charitable Coverage) Health Plan provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. MFA - Health Plan offers financial assistance to help families and individuals that are unable to pay for all or part of the cost of urgent or emergent care provided in Kaiser Permanente facilities. In 2011 this program assisted 2,175 applicants. CHC - The Kaiser Permanente Bridge Program is uniquely designed to help uninsured; income eligible individuals obtain subsidized health care coverage for up to 24 months. As a community benefit, Kaiser Permanente subsidizes 95% of the premium. Community agencies partner to identify clients/students whose income falls at or below 300% of the federal poverty level and meet all other eligibility criteria. Throughout 2011, 2,617 individuals were enrolled in the Bridge Program and we ended the year with 1,027 members. Additional information about Georgia Health Plan's charitable activities can be found in Schedule O, Community Benefit Report. 12022634 12022634 0 Grants and Donations The Georgia Region Health Plan offered a variety of health education classes, events and programs to both members and the general public. Classes included heart health, healthy cooking, and benefits of physical activity, smoking cessation, weight loss, parenting, diabetes, stress management, and managing chronic illness. In 2011 KPGA offered a variety of healthy living classes and customized programs to over 1,050 clients of 3 Metro Atlanta "Y" branches who serve vulnerable communities- (Villages of Carver Family, Eastlake and Andrew Young). The Georgia region also sponsored the Green Market, a weekly farmers' market (May-December) offering a variety of organic fruits, vegetables, fresh cut flowers, baked goods as well as healthy cooking demonstrations and Tai Chi Classes. In 2011, 77,500 people attended the Green Market. Additional information about Georgia Health Plan's charitable activities can be found in Schedule O, Community Benefit Report. 4463762 0 0 SCH. O, COMMUNITY BENEFIT REPORT 4463762 0 0 1040018575 true true false true false false false false false false true false false false true false true true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true 1241 0 true 2161 true false false false false false false false false false false X 5 2 false false true false true true true true true false false true true true true true true true true false GA X VP - NATIONAL TAX COMPLIANCE 5102716385 ONE KAISER PLAZA STE 15L OAKLAND CA 94612 X Peter Andruszkiewicz 30.0 X X 0 634729 138008 Kerry Kohnen 40.0 X X 0 695379 141557 Jeffrey Koplan 1.0 X 12000 0 0 Donna Lynne 4.0 X X 0 1314917 222947 J Neal Purcell 1.0 X 13000 221858 0 Bernard Tyson 5.0 X X 0 2800296 482152 George Halvorson 5.0 X 0 7861915 74595 Kathryn Lancaster 4.0 X 0 2109102 289626 Kirkland McGhee 50.0 X 0 218783 38441 Thomas Meier 3.0 X 0 802247 110802 Donald Orndoff 5.0 X 0 634274 137999 Arthur Southam 5.0 X 0 2649224 348687 Deborah Stokes 4.0 X 0 720302 118018 Victoria Zatkin 4.0 X 0 314768 84531 Mark Zemelman 3.0 X 0 778576 191923 James Cullinan 30.0 X 0 278833 65822 Carrie J Jennison 30.0 X 0 617276 83687 Michael Bernard Wathen 30.0 X 0 143984 41765 Dawn Bading 30.0 X 0 255070 69883 Lori k Ehrlich 30.0 X 0 323634 27565 Jonna Kirkwood 30.0 X 0 257853 86309 Carolyn J Mustille 30.0 X 0 267369 89467 Beverly Thomas 30.0 X 0 300208 78600 Frank Boone 0.0 X 0 185876 46778 Steven Zatkin 0.0 X 0 574121 76925 25000 24960594 3046087 165 true true false PIEDMONT HOSPITAL PO BOX 102526 ATLANTA GA 30368 MEDICAL SERVICES 59057983 NORTHSIDE HOSPITAL PO BOX 101818 ATLANTA GA 30392 MEDICAL SERVICES 73777759 SOUTHEASTERN PERMANENTE MEDICAL GRO 3495 PIEDMONT ROAD NE ATLANTA GA 30305 MEDICAL SERVICES 365807869 CHILDREN'S HEALTHCARE OF ATLANTA PO BOX 116101 ATLANTA GA 30368 MEDICAL SERVICES 14224131 BRASFIELD GORRIE LLC 1990 VAUGHN ROAD 100 KENNESAW GA 30144 GENERAL CONTRACTING 12597815 358 7784437 8919 263337 8056693 MEMBERS HEALTH CARE 621400 831545002 831545002 SUPPLEMENTAL CHARGE 621400 49055815 49055815 NON-PLAN & INDUSTRIAL 621400 2911296 2911296 OTHER PROGRAM SERVICES 621400 36338064 36338064 MEDICARE/MEDICAID PAYMENTS 621400 167742937 167742937 1087593114 3549083 3549083 0 0 66000908 10464 65320963 3120 679945 7344 687289 687289 0 0 0 0 1099886179 1087593114 4236372 12022634 12022634 0 0 0 25000 25000 0 137262384 117939558 19322826 0 12696811 12696811 22111762 16621965 5489797 10025922 10025922 0 2540 2540 952768 952768 165687 165687 0 0 83805409 66974139 16831270 20912348 13251580 7660768 2325918 2066973 258945 68526935 57935135 10591800 0 11298814 11298814 1546156 1161992 384164 0 519278 519278 10958793 10958793 0 15022540 15022540 1772669 1772669 PURCHASED MEDICAL SVC - BCP 543339983 543339983 SUPPLIES 117070088 106373263 10696825 INTER-REGIONAL CHARGES 30690865 25959923 4730942 REPAIRS & MAINTENANCE 8876033 8804913 71120 17615477 5790968 11824509 1129546814 1040018575 89528239 0 406177 695806 0 0 0 0 26718979 32310378 0 0 0 0 0 0 9806294 10527838 867207 1280557 331584283 145360539 140809725 186223744 193511986 144304913 0 0 0 0 0 0 363626 460809 372483994 375804045 84150555 97667730 0 0 9470758 16107012 0 0 0 0 0 0 0 0 0 0 326754971 354274017 420376284 468048759 X 5665218 5665218 0 0 -53557508 -97909932 -47892290 -92244714 372483994 375804045 X -29660635 -14691789 X false true true X true true X 1562162 1882337 2057241 2350668 8056693 15909101 1041404677 1083297320 1060150602 945171878 1087593114 5217617591 1042966839 1085179657 1062207843 947522546 1095649807 5233526692 5233526692 7749684 6513719 5254905 4327774 3549083 27395165 7749684 6513719 5254905 4327774 3549083 27395165 1050716523 1091693376 1067462748 951850320 1099198890 5260921857 0.99479 0.99396 0.00521 0.00604 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X false false true false true true true true 156312 false true 9375 165687 false false SCHEDULE C, PART II-B, LINE 1A THROUGH 1I LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES The Organization is a member of the Kaiser Permanente Medical Care Program and participated and benefited from lobbying activities conducted at the regional and national level for the benefit of its enrolled members and for the health care industry as a whole. As an organization generally exempt from income tax under Internal Revenue Code Section 501(c)(3), Health Plan has a policy prohibiting internal involvement in any political campaigns. This policy is closely monitored for compliance. During the year this Organization may have made comments or statements concerning legislation which may affect the health care industry. Health Plan may have engaged in telephone conversations and/or written letters to various federal, state, and local officials regarding matters which affected the healthcare industry as a whole. The amount of time and money involved in the activities is detailed on lines a through i. Health Plan has several employees and/or may retain a professional consultant to represent Health Plan's interests in various legislative and regulatory bodies and from time-to-time to keep informed of Federal and State legislation having an impact on Health Plan's charitable activities as an exempt Health Maintenance Organization. These individuals attempt to ensure that proposed legislation and enacted laws are compatible with the Interest of Health Plan and its members by performing the following activities: - Collecting, analyzing and distributing within the Organization, public and private policy recommendations regarding proposed legislation that affect the operation of Health Plan and its ability to provide quality health and medical care services to its members in a cost effective environment. - Providing appropriate informational materials to legislators and to their staffs that pertain to matters of common interest in the health care community and in the not-for-profit community. - Also by preparing written and oral testimony, these individuals appear at legislative hearings, monitor legislative proceedings and meet with legislators and/or their staffs regarding issues pertinent to the mission of Health Plan. Those individuals appearing at such hearings and meetings for and on behalf of Health Plan often are representing the interests of common interest groups as well as the interests of the members of Health Plan. - Other employees and officers perform services by delivering speeches at various public and private functions and in serving as faculty in healthcare related educational programs throughout the community. 24371491 24371491 125305855 59390835 65915020 34127275 18101660 16025615 94025417 62897389 31128028 53754245 4970655 48783590 186223744 0 PENSION PLAN PAYABLE 63786210 SELF INS RISK-PROF PUBLIC LIAB 34125900 OTHER CURRENT LIABILITIES 6655981 OTHER LONG-TERM LIABILITIES 7979590 DUE TO AFFILIATED ORGANIZATION 56957689 PREMIUM DEFICIENCY RESERVE 18998480 NOTE PAYABLE TO AFFILIATES 164330167 SELF INS RISK - WORKERS COMP 1440000 354274017 1099886179 1129546814 -29660635 -542029 -14149760 -14691789 -44352424 1082662332 -542029 5943538 5401509 1077260823 22625356 22625356 1099886179 1127014756 -2532058 -2532058 1129546814 1129546814 SCHEDULE D, PART X, LINE 2 FIN 48 FOOTNOTE NOT REQUIRED SCHEDULE D, PART XI, LINE 8 RECONCILIATION OF CHANGE IN NET ASSETS DECREASE IN PENSION & OTHER COMPREHENSIVE INCOME <$13,935,473> GAIN/LOSS ON INVESTMENTS - TAX < 679,945> GAIN/LOSS ON INVESTMENTS - BOOK 959,929 SEE "NOTE 1" < 494,271> ____________ TOTAL <$14,149,760> NOTE 1: OTHER THAN TEMPORARY IMPAIRMENT (OTTI) OF INVESTMENT RECOGNIZED FOR FINANCIAL STATEMENT PURPOSES, WHICH WILL BE TAX REPORTED WHEN REALIZED SCHEDULE D, PART XII RECONCILIATION OF REVENUE LINE 2D: INTER-ENTITY REVENUE - RECLASS 5,477,880 GAIN/LOSS ON INVESTMENTS - BOOK 959,929 OTTI < 494,271> _____________ TOTAL $5,943,538 LINE 4B: FIXED ASSET LOSS - RECLASS <$ 980> PREMIUM DEFICIENCY RESERVES - RECLASS 21,946,391 GAIN/LOSS ON INVESTMENTS - TAX 679,945 ___________ TOTAL $22,625,356 SCHEDULE D, PART XIII RECONCILIATION OF EXPENSES LINE 2D: FIXED ASSET LOSS - RECLASS $ 980 INTER-ENTITY REVENUE - RECLASS 5,477,880 DECREASE IN PENSION & OTHER COMPREHENSIVE INCOME 13,935,473 PREMIUM DEFICIENCY RESERVES - RECLASS <21,946,391> _____________ TOTAL <$ 2,532,058> true AID Gwinnett Inc 3075 Breckinridge Blvd415 Duluth GA 30096 581973324 501(c)(3) 75000 High-Risk Youth HIV American Heart Association Inc 1101 Northchase Pkwy 1 Marietta GA 30067 135613797 501(c)(3) 92880 Children's Nutrition Angel Flight of Georgia Inc 2000 Airport Rd 227 Atlanta GA 30341 581702239 501(c)(3) 37344 Fly A Metro Atlantan Armstrong Atlantic State Univ Fdn Inc 11935 Abercorn St Savannah GA 31419 581577237 501(c)(3) 25000 Nursing Recruitment Arthritis Foundation SE Region Inc 2970 Peachtree Rd NW 200 Atlanta GA 30305 383806275 501(c)(3) 30000 Life Improvement Assoc of State &Territorial Chronic Disease 2872 Woodstock Blvd 220 Atlanta GA 30341 731328414 501(c)(3) 99864 School Network Proj Athens Area Community Fdn Inc 1240 S Lumpkin St Athens GA 30602 261838979 501(c)(3) 25000 Athens Health Netwrk Atlanta Bicycle Coalition 213 Mitchell St Atlanta GA 30303 581996013 501(c)(3) 10000 Bicycle Educ Prog Atlanta Community Food Bank Inc 732 Joseph E Lowery Blvd NW Atlanta GA 30318 581376648 501(c)(3) 75000 Nutrition Education Atlanta Leadership Development Fdn Inc Ten Peachtree Place 620 Atlanta GA 30309 237015688 501(c)(3) 6000 Health Day 2011 Atlanta Regional Commission 40 Courtland St NE Atlanta GA 30303 586002324 501(c)(3) 68000 Sr Community Garden Atlanta Women's Fdn Inc 50 Hurt Plaza 401 Atlanta GA 30303 582389721 501(c)(3) 125000 Women's Foundation Atlanta BeltLine Partnership Inc 50 Hurt Plaza 910 Atlanta GA 30303 562464486 501(c)(3) 1250000 Beltline Project Boys and Girls Clubs of Metro Atlanta Inc 100 Edgewood Ave NE 700 Atlanta GA 30303 580566123 501(c)(3) 75000 Teen Ambassadors Brain Tumor Fdn for Children Inc 6065 Roswell Rd NE 505 Atlanta GA 30328 581524616 501(c)(3) 30000 Butterfly Fund Hosp Camp Kudzu Inc 5885 Glenridge Dr 160 Atlanta GA 30328 582449646 501(c)(3) 25000 Diabetes Management Camp Twin Lakes Inc 600 Means St 110 Atlanta GA 30318 581826782 501(c)(3) 22100 Sustainable EducFarm Center for Pan Asian Community Svcs Inc 3510 Shallowford Rd NE Atlanta GA 30341 581437980 501(c)(3) 72810 Dowa Clinic Chattahoochee Nature Center Inc 9135 Willeo Rd Roswell GA 30075 581275604 501(c)(3) 32553 Community Garden Children's Healthcare of Atlanta Inc 1584 Tullie Circle NE Atlanta GA 30329 581710601 501(c)(3) 1000000 Children Healthcare CHRIS Kids Inc 3109 Clairmont Rd B Atlanta GA 30329 581430183 501(c)(3) 50000 Trauma Treatment Clarkston Community Center Fdn Inc 3701 College Ave Clarkston GA 30021 582127610 501(c)(3) 20000 Food Security/Active Clayton County Board of Health 1117 Battlecreek Rd Jonesboro GA 30236 581108112 Government 75000 Hyperten & Diabetes Clayton State University Fdn Inc 2000 Clayton State Blvd Morrow GA 30260 237419285 501(c)(3) 85000 Nursing Recruitment Cobb County Board of Health 1650 County Srvcs Pkwy Marietta GA 30008 581517015 Government 75000 Babies Born Healthy Cobb County Community Services Board 3830 S Cobb Dr 300 Suite 200 Smyrna GA 30080 582107033 Government 75000 Project Gateway Community Advanced Practice Nurses Inc 173 Boulevard NE Atlanta GA 30312 582435328 501(c)(3) 74847 Healthcare/Med Home DeKalb Community Service Board 445 Winn Way 4th Fl Decatur GA 30031 582104166 Government 74029 Telehealth DeKalb County Board of Health 445 Winn Way Decatur GA 30031 581417092 Government 75000 Expansion HIV Prg DeKalb Habitat for Humanity 2915 Midway Rd Decatur GA 30030 581792761 501(c)(3) 90000 A Brush w/ Kindness Diabetes Association of Atlanta Inc 100 Edgewood Ave NE 1004 Atlanta GA 30303 580973055 501(c)(3) 65000 Diabetes Prevention Families First Inc 1105 W Peachtree St NE Atlanta GA 30357 581054331 501(c)(3) 84250 Healthy Babies/Moms Fayette Care Clinic Inc 1260 Highway 54W101 Fayetteville GA 30214 200314897 501(c)(3) 85000 FCC Community Wellns Fernbank Inc 767 Clifton Rd Atlanta GA 30307 586028607 501(c)(3) 50000 Fernbank Youth Educ First Step Staffing 236 Auburn Ave NE 203 Atlanta GA 30303 208038859 501(c)(3) 65000 First Step Staffing Four Corners Primary Care Centers Inc 5030 Georgia Belle Court Norcross GA 30093 205870972 501(c)(3) 74963 Keep in Touch Prog Georgia Campaign AdolescPregn Prevent Inc 1450 W Peachtree St NW 200 Atlanta GA 30309 311520709 501(c)(3) 46719 Be Proud/Respons Georgia Conservancy Inc 817 W Peachtree St 200 Atlanta GA 30308 581027246 501(c)(3) 52350 Dev & Training Georgia Family Connection Partnership Inc 235 Peachtree St 1600 Atlanta GA 30303 581888262 501(c)(3) 75000 Reducing Low Birthwt Georgia Free Clinic Network Inc 1015 Donald Lee Hollowell Pkwy 20 Atlanta GA 30318 800100336 501(c)(3) 49425 GFCN Operating Suprt Georgia Health News Inc 2635 Rangewood Court Atlanta GA 30345 273543332 501(c)(3) 8500 HealthCare SafetyNet Georgia Lions Lighthouse Fdn Inc 5582 Peachtree Rd Suite 290 Chamblee GA 30341 580548732 501(c)(3) 50000 Access Vision Care Georgia Organics Inc 200 A Ottley Dr Atlanta GA 30324 582345310 501(c)(3) 75000 GA Organics Iniative Georgia Perimeter College Fdn Inc 3251 Panthersville Rd Decatur GA 30034 581492364 501(c)(3) 85000 Nursing Recruitment Georgia Southern University Fdn Inc 2472 Akins Blvd Statesboro GA 30460 586034031 501(c)(3) 25000 Nursing Recruitment Georgia State University Fdn Inc One Park Place 533 Atlanta GA 30303 586033185 501(c)(3) 92500 Nursing Recruitment Girl Scout Council of Northwest GA Inc 5601 N Allen Rd Mableton GA 30126 580566190 501(c)(3) 25000 Summer Ed & Wellness Good News Clinics Inc 810 Pine St Gainesville GA 30501 582058853 501(c)(3) 75000 Promoting Wellness Good Samaritan Health & Wellness Ctr Inc 175 Samaritan Way Jasper GA 30143 582576315 501(c)(3) 63750 Community Needs Proj Good Samaritan Health Center of Cobb Inc 1605 Roberta Dr SW Marietta GA 30008 320045238 501(c)(3) 75000 Primary Medical Good Samaritan Health Center Inc 1015 Donald Lee Hollowell Pkwy Atlanta GA 30318 582373395 501(c)(3) 75000 Patient Navigation Grant Park Family Health Center Inc 1340 Boulevard SE Atlanta GA 30315 581577640 501(c)(3) 69474 Hispanic Diabetes Gwinnett Community Clinic Inc 2160 Fountain Dr Snellville GA 30078 581868227 501(c)(3) 22500 Primary Care HABESHA Inc 477 Windsor St Atlanta GA 30312 020536428 501(c)(3) 10750 Urban Agriculture Hands of Hope Clinic Inc 1010 Hospital Dr B Stockbridge GA 30281 421591970 501(c)(3) 37750 Diabetic Self-Care Health Educ Assessment & Leadership Inc 1300 Joseph E Boone Blvd NW Atlanta GA 30314 263990559 501(c)(3) 33357 HEALing Community Heritage Fund of Atlanta Medical Assoc Inc 100 Edgewood Ave NE 975 Atlanta GA 30303 582372394 501(c)(3) 9100 Heritage Fund Hispanic Health Coalition of Georgia Inc 424 Decatur St Atlanta GA 30312 752995466 501(c)(3) 37060 Prenatal Care Hope Health Clinic Inc 125 N 10th St Griffin GA 30223 200719396 501(c)(3) 75000 Dietary Effect Jerusalem House Inc 17 Executive Pk Dr NE290 Atlanta GA 30329 581829807 501(c)(3) 50000 Housing Programs Junior Achievement of Georgia Inc 460 Abernathy Rd Atlanta GA 30328 580598050 501(c)(3) 35000 Program Support Keep Cobb Beautiful Inc 1940 County Srvcs Pkwy Marietta GA 30008 581659192 501(c)(3) 9800 Medication Disposal Kennesaw State University Fdn Inc 1000 Chastain Rd Kennesaw GA 30066 237034345 501(c)(3) 99915 Nursing Recruitment Macon College Fdn Inc 100 College Station DrA217 Macon GA 31210 237066010 501(c)(3) 25000 Nursing Endowment Martin Luther King Jr Ctr Nonviolent Social 449 Auburn Ave NE Atlanta GA 30312 581030989 501(c)(3) 13500 Awards Dinner Martin Luther King Jr Poor Peoples Church 1035 Donnelly Ave SW Atlanta GA 30310 581340903 501(c)(3) 50000 Community Outrch Prg McIntosh Trail Community Service Board 1501-A Kalamazoo Dr Suite 100 Griffin GA 30224 582098758 Government 74859 Spalding Health Ministries United for Service & Training 1407 Cobb Pkwy N Marietta GA 30061 582034725 501(c)(3) 58140 Summer Lunch Morehouse College 830 Westview Dr NW Atlanta GA 30314 580566205 501(c)(3) 25000 Scholarship Fund National Mental Health Assoc of GA Inc 100 Edgewood Ave 502 Atlanta GA 30303 580611310 501(c)(3) 56000 Access and Treatment New Hope Initiatives Inc 970 Jefferson St Atlanta GA 30318 270230104 501(c)(3) 40000 Job Readiness North Fulton Community Charities Inc 11270 Elkins Rd Roswell GA 30076 581521088 501(c)(3) 25000 Emergency Financial Oakhurst Community Garden Project Inc 435 Oakview Rd Decatur GA 30030 582339007 501(c)(3) 20000 Youth Outreach Our House Inc 711 Columbia Dr Suite 300 Decatur GA 30030 581743333 501(c)(3) 15000 Family Advocacy Palmetto Health Council Inc 547 Ponce de Leon Ave200 Atlanta GA 30308 581307597 501(c)(3) 75000 Case Mgmt Project Park Pride Atlanta Inc 233 Peachtree St NE 1600 Atlanta GA 30303 581883895 501(c)(3) 33550 Community Gardens Partnership Against Domestic Violence 114 New St L Decatur GA 30030 581314556 501(c)(3) 50000 Violence Prevention Pedestrians Educating Drivers Safety 1389 Peachtree St NE 202 Atlanta GA 30309 582267503 501(c)(3) 25000 Safe Routes Transit Piedmont Park Conservancy Inc 400 Park Dr NE Atlanta GA 30306 581551369 501(c)(3) 345000 Healthy Living Project Open Hand-Atlanta Inc 176 Ottley Dr Atlatnta GA 30324 581816778 501(c)(3) 65000 Market Basket Pantry Rally Fdn Inc 5775 Glenridge Dr Bldg B 370 Atlanta GA 30328 201950849 501(c)(3) 7500 Public Policy Robert W Woodruff Arts Center Inc 1280 Peachtree St NE Atlanta GA 30309 580633971 501(c)(3) 99000 Corporate Campaign Rockdale Coalition Chidlren & Families 2796 Georgia Highway 20 S Conyers GA 30013 582336561 501(c)(3) 10000 Mercy Heart Clinic Senior Citizen Svcs Metropolitan Atlanta 1705 Commerce Dr NW Atlanta GA 30318 580960309 501(c)(3) 49125 Extra Helping Senior Connections Inc 5328 Peachtree Rd Chamblee GA 30341 581187876 501(c)(3) 50000 Meals On Wheels Svcs Senior Services North Fulton Inc 490 Sun Valley Dr 202 Roswell GA 30076 581948370 501(c)(3) 25000 Seniors (TOPS) Special Olympics Georgia Inc 4000 DeKalb Technology Pkwy 400 B Atlanta GA 30340 237201676 501(c)(3) 7500 Health and Wellness Susan G Komen Breast Cancer Fdn 4840 Roswell Rd Bldg D 100 Atlanta GA 30342 581959763 501(c)(3) 25000 Komen Race for Cure The Center Black Women's Wellness CBWW 477 Windsor St SW 309 Atlanta GA 30312 582212203 501(c)(3) 70433 Safety Net Clinic The Center for Family Resources Inc 995 Roswell St 100 Marietta GA 30060 580876634 501(c)(3) 50000 Building Strong Comm The Community Fdn Greater Atlanta Inc 50 Hurt Plaza 449 Atlatnta GA 30303 581344646 501(c)(3) 1175000 The Centers of Hope The Corporation of Mercer University 3001 Mercer University Dr Atlanta GA 30341 580566167 501(c)(3) 30000 KP Pharm Endowment The Environmental Fund for Georgia Inc 1447 Peachtree St 214 Atlanta GA 30309 582022001 501(c)(3) 97910 2011 KP CorpContrib The Henry W Grady Health System Fdn 50 Hurt Plaza 803 Atlanta GA 30303 582130437 501(c)(3) 2023500 Ambulatory Care Ctr The Leukemia & Lymphoma Society Inc 3715 Northside Pkwy Bldg 400 300 Atlanta GA 30327 135644916 501(c)(3) 25500 Pt Financial Aid Prg The Morehouse School Of Medicine Inc 720 WestviewDr SW 238 Atlanta GA 30310 581438873 501(c)(3) 160000 Strategic Partnershp The Sheltering Arms 385 Centennial Olympic Park Dr Atlanta GA 30313 580566236 501(c)(3) 20000 Operation StoryBook Trees Atlanta Inc 225 Chester Ave Atlanta GA 30316 581584758 501(c)(3) 90000 Docent Education United Way of Metropolitan Atlanta Inc 100 Edgewood Ave NE Atlanta GA 30303 580566194 501(c)(3) 800000 Healthy Communities University of Georgia Fdn 394 S Milledge Ave 100 Athens GA 30602 586033837 501(c)(3) 25000 KP Pharm Endowment University of West Georgia Fdn Inc 1601 Maple St Carrollton GA 30118 586056464 501(c)(3) 20000 KP Nurse Scholarship Voices for Georgia's Children 100 Edgewood Ave NE 1580 Atlanta GA 30303 020678823 501(c)(3) 64987 Advocacy & Consumer Year Up Inc 730 Peachtree St Atlanta GA 30308 043534407 501(c)(3) 28540 Literacy & Preventn YMCA of Metropolitan Atlanta Inc 100 Edgewood Ave 1100 Atlanta GA 30303 580566253 501(c)(3) 300000 HEAL Fund YWCA Greater Atlanta 957 N Highland Ave NE Atlanta GA 30306 580593442 501(c)(3) 50000 ENCOREplus Program YWCA NW Georgia 48 Henderson St SW Marietta GA 30064 580617782 501(c)(3) 37500 Operating Support 106 0 PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 At the end of their funding cycle, grantees are required to submit a final report which delineates accomplishments related to stated objectives. Large grants (typically over $100K) may require quarterly progress reports. true true false false false false false true false Peter Andruszkiewicz 0 162469 0 241999 0 230261 0 130331 0 7677 0 772737 0 220256 Dawn Bading 0 185982 0 37951 0 31137 0 53177 0 16706 0 324953 0 0 Frank Boone 0 0 0 0 0 185876 0 32479 0 14299 0 232654 0 0 James Cullinan 0 198066 0 64804 0 15963 0 49558 0 16264 0 344655 0 0 Lori k Ehrlich 0 85650 0 235066 0 2918 0 11109 0 16456 0 351199 0 0 George Halvorson 0 1215613 0 5039506 0 1606796 0 61308 0 13287 0 7936510 0 0 Carrie J Jennison 0 363589 0 171682 0 82005 0 70693 0 12994 0 700963 0 0 Jonna Kirkwood 0 213059 0 27368 0 17426 0 68584 0 17725 0 344162 0 0 Kerry Kohnen 0 356960 0 188914 0 149505 0 126718 0 14839 0 836936 0 81203 Kathryn Lancaster 0 630520 0 907953 0 570629 0 276632 0 12994 0 2398728 0 529003 Donna Lynne 0 476108 0 475000 0 363809 0 208108 0 14839 0 1537864 0 323554 Kirkland McGhee 0 192809 0 22776 0 3198 0 21176 0 17265 0 257224 0 0 Thomas Meier 0 314471 0 339188 0 148588 0 97808 0 12994 0 913049 0 113944 Carolyn J Mustille 0 197238 0 15400 0 54731 0 76393 0 13074 0 356836 0 0 Donald Orndoff 0 376297 0 235328 0 22649 0 124482 0 13517 0 772273 0 0 J Neal Purcell 13000 221858 0 0 0 0 0 0 0 0 13000 221858 0 0 Arthur Southam 0 741374 0 1175000 0 732850 0 336623 0 12064 0 2997911 0 688121 Deborah Stokes 0 315132 0 337575 0 67595 0 105024 0 12994 0 838320 0 48521 Beverly Thomas 0 179569 0 45214 0 75425 0 61335 0 17265 0 378808 0 56607 Bernard Tyson 0 892605 0 1290000 0 617691 0 469158 0 12994 0 3282448 0 587707 Michael Bernard Wathen 0 132539 0 0 0 11445 0 24500 0 17265 0 185749 0 0 Steven Zatkin 0 4500 0 542685 0 26936 0 66393 0 10532 0 651046 0 0 Victoria Zatkin 0 192675 0 85692 0 36401 0 82570 0 1961 0 399299 0 0 Mark Zemelman 0 398502 0 259500 0 120574 0 179338 0 12585 0 970499 0 80051 SCHEDULE J, PART II Peter Andruszkiewicz- Regional President of Georgia until 4/26/11. Kerry Kohnen- Regional President of Georgia beginning 5/30/11. Steve Zatkin- General Council to 6/30/10; consultant 3/4/11 to present. SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT OFFICIALS' COMPENSATION Kaiser Foundation Health Plan of Georgia relied on Kaiser Foundation Health Plan, Inc that used one or more of the methods described below to establish the top management officials' compensation: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study, and - Approval by the board or compensation committee SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENT FRANK BOONE $185,608 Listed persons participated in arrangements entitling them to severance benefits in the event of termination by the organization without cause or due to job elimination. Depending on position level, tenure, and termination reason, severance benefits payable under these arrangements provide for pay and health benefits continuation plus payment of accrued obligations. In addition, for some of the listed persons, severance benefits payable include prorated incentive awards for performance periods not yet ended. None of the listed persons participated in arrangements entitling them to change-of-control payments. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENT GEORGE HALVORSON $1,500,000 FRANK BOONE 62 KATHRYN LANCASTER 529,350 THOMAS MEIER 114,428 DEBORAH STOKES 48,521 STEVEN ZATKIN 4,891 MARK ZEMELMAN 81,133 ARTHUR SOUTHAM 688,121 PETER ANDRUSZKIEWICZ 220,256 KERRY KOHNEN 81,203 BERNARD TYSON 587,707 CAROLYN MUSTILLE 238 BEVERLY THOMAS 56,607 DONNA LYNNE 323,554 Some of the listed persons participated in nonqualified supplemental retirement plans. Under these plans, the organization makes annual contributions to accounts held in the name of individual participants. Contributions vary by position level and pay, and vest over time based on age and/or service. Participant accounts are credited with actual investment returns from up to four mutual funds and/or with a fixed rate of interest or a combination thereof. Unvested amounts are subject to risk of forfeiture. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS The organization provided non-fixed payments to some of the persons listed. Payments were made under incentive plans, based on attainment of organizational performance goals and individual performance, designed to support the organization's mission to provide high-quality, affordable care and improve the health of its members and the communities it serves. FORM 990, PART VI, LINE 4 CHANGES TO GOVERNING DOCUMENTS On June 24, 2010 the member of the Corporation approved an amendment to Article FIVE of the Restated Articles of Incorporation to add a Chief Executive Officer as one of the officers of the Corporation whose removal shall require the approval of the member, which amendment was approved by the Board of Directors of the Corporation on November 17, 2010, and filed with the Secretary of State of Georgia on January 25, 2011; On December 1, 2011 the member of the Corporation approved amendments to Articles Four, Five and Seven of the Restated Articles of Incorporation of the Corporation to (a) revise the purpose section for consistency with the Articles of Incorporation of Kaiser Foundation Health Plan, Inc. (the member of the Corporation) and its other Health Plan subsidiaries, including making a reference to the Internal Revenue Code (Section 501(c)(3)) consistent with other references in the Articles; (b) add the provision that removal of "any" President shall require the approval of the member; (c) add the provision that compensation of "any" President shall require the approval of the member; and (d) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office; which amendment was approved by the Board of Directors of the Corporation on December 7, 2011, filed with the Commissioner of Insurance on January 20, 2012, published, and resubmitted to the Commissioner of Insurance on April 3, 2012. Receipt of the Secretary of State's Certificate of Amendment is pending; and On March 3, 2011, Article E., Officers, of the Bylaws of the Corporation was amended by the member to (a) provide that the officers of the Corporation may include one or more Group Presidents (Section E-1, Officers); (b) add a new Section E-8, Group President and/or Regional President, to describe the duties and responsibilities of those positions; (c) provide that the President shall be the Chief Operating Officer of the Corporation (Section E-7, President); and (d)) provide clarification regarding leadership in the event of the absence or disability of the President (Section D-9, Executive Vice President or National Senior Vice President); and (e) to change the reference to "the President" in Sections E-3, E-4 and E-11 to "any President"; which amendments were approved by the Board of Directors of the Corporation on April 6, 2011; and On June 23, 2011, minor technical amendments to the Bylaws of the Corporation were approved by the member to make them more consistent with the Bylaws of the member and its Health Plan subsidiaries and with organizational policies and current law, which amendments were approved by the Board of Directors of the Corporation on June 29, 2011. None of the changes were significant; and On December 1, 2011, amendments to Article A, Purpose, of the Bylaws of the Corporation were approved by the member to (a) more clearly state the purposes in one Purpose section (A-1, former section A-2 was deleted); (b) expressly state that the corporation is prohibited from engaging in activities not permitted by Section 501(c)(3) of the Internal Revenue Code and to specifically state that the corporation shall not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office (Section A-3 Nonprofit Character - now A-2); (c) make a reference to the Internal Revenue Code consistent with other references in the Bylaws (Section A-4 Disposition of Assets on Liquidation or Dissolution - now A-3); and (d) be consistent with current legal standards (Section A-5 Non-discrimination - now A-4); which amendments were approved by the Board of Directors of the Corporation on December 7, 2011. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS KAISER FOUNDATION HEALTH PLAN, INC IS SOLE MEMBER Upon dissolution, remaining assets shall be distributed to a 501(c)(3) organization FORM 990, PART VI, LINE 7A ELECT MEMBERS OF THE GOVERNING BODY Kaiser Foundation Health Plan, Inc appoints the Board of Directors (and fills vacancies and has authority to remove Directors) FORM 990, PART VI, LINE 7B MEMBERS' APPROVAL The following actions of the corporation require the approval of the member. Typically the member (KFHP) would approve actions requiring member approval and the Board of Directors of KFHP-GA also would approve or ratify the action: 1. Removal of the Chairman of the Board, CEO, or Regional President. The compensation of the Regional President and other executive officers of the corporation shall be approved by the member's Compensation Committee; 2. The sale, lease, exchange, or other disposition of, the mortgage, pledge or dedication to the repayment of indebtedness (whether with or without recourse), or any other encumbrance of property of the corporation, or the acquisition of assets, whether or not in the usual or regular course of the corporation's activities, where the fair market value of such corporate property or assets being disposed of, acquired or encumbered exceeds 10% of the value of the assets of the corporation as reflected in the most recent annual or quarterly financial statements that are available on the date immediately preceding the date of the relevant transaction shall require the approval of the member 3. Capital expenditures that exceed $25 million shall require the approval of the member 4. The issuance of tax-exempt bonds 5. Amendments to Article C (Members), D (Directors) and H (Amendment and Effect of Bylaws) of the Bylaws and amendments to the Articles of Incorporation. Article A (Purposes), B (Offices), E (Officers), F (Committees) and G (Miscellaneous) of the Bylaws may be amended by the Board of KFHP-GA acting alone and do not require ratification by the member. FORM 990, PART VI, LINE 11B FORM 990 REVIEW PROCESS 1. Community benefit details are presented to the community benefit committee of the board for review 2. The tax return is reviewed and signed by a Pricewaterhousecoopers tax advisor 3. The complete tax return is reviewed and signed by an officer or a member of management designated by an officer 4. A compact disk containing the signed return is provided to each board member prior to filing FORM 990, PART VI, LINE 12C COMPLIANCE ENFORCEMENT Regularly and Consistently Monitors Compliance with the Conflicts of Interest Policy Kaiser Permanente regularly monitors compliance with the Conflicts of Interest Policy in 3 key ways: 1. The Kaiser Permanente Compliance Hotline is available to all employees and vendors to report actual or potential conflicts of interest. All calls are answered by a third party and provided to Kaiser Permanente's National Compliance Office for review and appropriate action. Employees can report anonymously. Retaliation is prohibited. Reports of actual or potential Conflicts of Interest are generated and investigations are conducted as required and information is tracked and trended to determine if additional guidance is required to avoid or manage conflicts of interest. Compliance Hotline Reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually. 2. The Chief Compliance Officer and the SVP of Internal Audit Services annually review the directors', officers', key employees', and executives' Annual Conflicts of Interest Questionnaire disclosures and provide direction on any investigations required. Investigations are documented, tracked and trended to determine if additional controls or education is required; In addition, Conflicts of Interest Questionnaire reports are provided for review and action to the Kaiser Foundation Health Plan/ Hospitals Boards of Directors annually; and 3. Annually, as a component of the external audit, KPMG reviews the Annual Conflicts of Interest Questionnaires process completed by Directors, Officers, Key Employees, and Executives, and actions taken as a result of the disclosures. The results of the annual audit, including any findings in this area are presented to the Kaiser Foundation Health Plan/ Hospitals Audit and Compliance Committee. Regularly and Consistently Enforces Compliance with the Conflicts of Interest Policy To ensure consistency in the enforcement of the policy Kaiser Permanente uses the following steps as a general guideline: A. Represented employees are subject to any corrective/disciplinary action provisions described in specific regional/national collective bargaining agreements and/or organizational policies and practices. B. Kaiser Permanente informs employees of the National Human Resources Policy No. 14. Corrective/Disciplinary Action Policy during new employee orientation and in annual compliance training. C. In the event that it is necessary to discipline any employee because of, but not limited to, failure to comply with applicable legal/regulatory requirements, Kaiser Permanente policies and procedures, or the Principles of Responsibility, or for unsatisfactory performance or misconduct, coaching/counseling and/or corrective/disciplinary action may include, but is not limited to: - Oral discussion and/or warning by the employee's immediate supervisor or higher level manager to correct the problem - Written notice, with or without final warning - Paid or unpaid suspension, with or without final warning - Termination of employment FORM 990, PART VI, LINE 15A/B COMPENSATION DETERMINATION The executive compensation program is designed to recruit, retain and motivate qualified senior management personnel. Senior management personnel have a significant impact on the strategic and policy direction and results of the organization. Therefore, the executive compensation program is, to a significant degree, performance-based. The compensation program is reviewed annually by the Compensation Committee of the Board of Directors which evaluates and approves, prior to payment, all programs and payments to CEO, Executive Director and top management officials (executives). Base pay for executive positions is established at a level comparable to the relevant market. In addition, other components of the compensation program bear 'at-risk' features designed to focus on strategically important performance goals and to assist in attracting and retaining top performers. The executive compensation program is targeted at the median of the comparable external market in which the organization competes for executive leadership. Evaluation of comparable pay data is performed by an Independent Compensation, Benefit & Human Resource Consulting firm. The compensation program focuses on objectives in the areas of quality of member care and service, financial soundness, and the community and social mission of the organization. FORM 990, PART VI, LINE 19 PUBLIC INSPECTION Governing documents are available as provided to state Dept. of Insurance and maintained on state agency website or upon request. Conflict of Interest is available on KP website under vendor Principles of Responsibility or upon request. Financial Statements are on file with state insurance agency on a statutory basis (stand alone entity). Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with audit opinion by KPMG upon request. To request copies contact: VP - National Tax Compliance Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, Ste 15L Oakland, CA 94612 FORM 990, PART VII, SECTION A, COLUMN B HOURS FOR RELATED ORGANIZATIONS Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated. FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN UNREALIZED GAIN/LOSS ON INVESTMENTS <$ 542,029> CHANGE IN OTHER COMPREHENSIVE INCOME < 13,935,473> GAIN/LOSS ON INVESTMENTS - TAX < 679,945> GAIN/LOSS ON INVESTMENTS - BOOK 959,929 OTTI LOSSES < 494,271> ____________ TOTAL <$14,691,789> FORM 990, PART III, LINE 4A-D 2011 COMMUNITY BENEFIT REPORT KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. Kaiser Foundation Health Plan of Georgia, Inc. or "Georgia Health Plan" is a tax-exempt subsidiary health plan of Kaiser Foundation Health Plan, Inc. (KFHP). Kaiser Foundation Health Plan of Georgia, as well as Kaiser Foundation Hospitals (KFH) are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." In 2011, Georgia Health Plan served 238,078 members and has 2,288 full-time administrative, clerical and technical employees. Georgia Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis. Health Plan fulfills its contractual obligations to group and individual members by contracting with KFH and a Permanente Medical Group to provide the required health care services. Membership in KFHP and its health plan subsidiaries is available without regard to sex, race, religion, ethnic background, sexual orientation, and occupational status or income level. Health Plan members are broadly representative of the various ages, social and income groups within the areas it serves. Once enrolled, a member is free to maintain membership regardless of age, health status or employment. KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY Kaiser Permanente believes its Direct Community Benefit Investment (DCBI), is fundamental to being a nonprofit organization. It embodies the organization's commitment to improve the health of communities beyond services to Health Plan members. It is more than traditional corporate citizenship or corporate philanthropy. It is an intentional, planned, budgeted, measurable, accountable creation for better health in our communities. It is done in collaboration with, not in isolation from, the community. DCBI serves to fulfill Kaiser Permanente's social purpose, justify its tax-exempt status, and differentiate it from other health care organizations. This tradition of community benefit dates from the earliest days of the Program, when charitable care to non-employees, and later, nonmembers, was initiated. That heritage has continued through the years in Kaiser Permanente's early participation in publicly financed programs such as Medicaid and Medicare, establishment of residency training and medical research programs, and later, in the development of the Educational Theatre Programs, Safety Net Partnerships, Community Health Initiatives and Charitable Health Coverage Programs. In 2007, the KFHP/H Board of Directors refined the focus of the organization's Community Benefit Program and established the following four priority areas which have come to be known as "streams of work": - Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for the under- and uninsured. - Community Health Initiatives - Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. - Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. - Developing and Disseminating Knowledge - Improves health care by sharing our knowledge- educating practitioners, advancing research, empowering consumers and informing policymakers about the evidence base for care and health. The Board elaborated that at least 75% of total community benefit funding will be directed to program priorities within the four streams of work and the remaining 25% of funding will be directed by local regions to respond to local community benefit needs and opportunities that may or may not be within the four key focus areas. THE COMMUNITY BENEFIT PROGRAM IN THE GEORGIA REGION In 2011, Georgia Health Plan expended $32.8 million to support community benefit activities. A breakdown of the 2011 Community Benefit dollars attributable to the Georgia Health Plan is included in Attachment A. The following identifies many of the signature community benefit programs and services grouped according to the national streams of work funded by Georgia Health Plan. CARE AND COVERAGE FOR LOW-INCOME PEOPLE There are roughly 49 million people in America without access to health care or coverage. Uninsured, low-income individuals and families who are not eligible for public programs often have to rely on traditional charity care. Frequently, individuals in this situation may wait to seek medical care until their conditions become critical, and end up in hospital emergency rooms for treatment of conditions that are preventable or easily treated in earlier stages. In 2011, the Georgia Health Plan expended $13.3 million to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age, or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a Kaiser Permanente facility or a by Permanente provider. Charitable Care (Medical Financial Assistance and Charitable Health Coverage Programs) In the Georgia Region, Health Plan provides charity care to low-income vulnerable populations through the Medical Financial Assistance and Charitable Coverage Program. In 2011, the Georgia Health Plan spent approximately $11 million on under- and uninsured residents. - Medical Financial Assistance Program The Georgia Health Plan's Medical Financial Assistance Program provides temporary financial assistance and/or medically necessary services, medications or supplies to patients with a demonstrated financial need. Patients must receive health care services at a Kaiser Permanente facility and/or from a Kaiser Permanente provider. Kaiser Permanente's charity care program also includes discounted charges for uninsured patients below 400% federal poverty guidelines and aligned contracted collection agency practices with Kaiser Permanente social values. In 2011, this program assisted 2,175 patients. - Charitable Health Coverage Program Charitable Health Coverage (CHC) is our unique approach to caring for low-income uninsured persons in our communities. Participants receive a regular Kaiser Permanente membership card and access to the full range of our service and providers-a much better alternative to a brief and costly emergency room visit or hospitalization. This allows us to invest in the longer term health of patients and the community. Since inception in the early 1980s, CHC programs have made a real difference in the lives of persons who might otherwise have no other source of care. The Kaiser Permanente Bridge Program enrolls and subsidizes for up to two years, 95% of the premium for income-eligible individuals who do not have access to any other form of health insurance. This program partners with community agencies to identify eligible clients whose income falls at or below 300% of the federal poverty guidelines. By year-end 2011, the Georgia Health Plan had 1,027 individuals in the Kaiser Permanente Bridge Program. COMMUNITY HEALTH INITIATIVES As an innovator in health, Kaiser Permanente designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods, workplaces, and schools to support good health, particularly Healthy Eating, Active Living (HEAL). The Georgia Health Plan spent approximately $5.6 million on community health initiatives during 2011. Community Health Education and Prevention Programs The Georgia Health Plan offered a variety of health education classes, events, and programs for the general public. During 2011, the Health Education Department organized numerous health fairs and screenings at Health Plan medical offices which were open to the general public. Expenditures in this category exclude program cost for health education programs targeting or restricted to Health Plan members. The following is an example of a community partnership aimed at promoting health and well being. - The Georgia Health Plan is the sponsor of the Green Market, weekly farmers' market (May-December) offering a variety of organic fruits, vegetables, fresh cut flowers, baked goods as well as healthy cooking demonstrations and fitness classes. In 2011, 77,500 people attended the Green Market. - In 2011 KPGA offered a variety of healthy living classes and customized programs to over 1,050 clients of 3 Metro Atlanta "Y" branches who serve vulnerable communities. Grants and Donations for Community Health Initiatives The Georgia Health Plan (KPGA) contributed $5.6 million to 76 nonprofit organizations to support a variety of community health initiatives. Following are examples of two programs funded in 2011. - Supported by a Kaiser Permanente grant, the Chattahoochee Nature Center (CNC) provided fresh produce for a local food pantry. With a $32,553 Kaiser Permanente grant, CNC continued its soccer-field-turned-community garden project. The garden produced over 5,000 pounds and 30,000 servings of fresh, seasonal produce in 2011. The produce benefited clients of another KPGA grantee, the nearby North Fulton Community Charities, a nonprofit that provides food, clothing and short-term emergency assistance to low-income families. Over 5,000 clients received produce in 2011, and participated in educational workshops on healthy eating and active living provided by CNC. - KPGA is addressing the region's childhood obesity challenge (almost 38% of children younger than 17 are obese) through a project implemented by the YMCA of Metropolitan Atlanta. The initiative tested and put into practice techniques that minimize health risks related to overweight/obesity. The goal is to improve health outcomes for youth (ages 2 to 16) through programs that promote healthy eating, physical activity and behavior change that establish lifelong habits of health and wellness. The contribution supported the study's first phase, which focuses on 3 to 5 year olds, and funded curriculum development and strategy implementation to prevent and address obesity in YMCA pre-school Head Start students. 526 children participated in the project's control and intervention groups at nine YMCA sites in 2011. SAFETY NET PARTNERSHIPS Through funding, technical assistance, public policy advocacy, training and volunteering, dissemination of care-management and quality improvement technologies, Kaiser Permanente helps these vital health care providers improve care and expand treatment capacity for the communities and vulnerable people they serve. Grants and Donations for Safety Net Partnerships The Georgia Health Plan contributed $4.9 million to 33 organizations that deliver medical or dental care services to uninsured people in community settings, primarily safety net clinics in Georgia. Following are two community organizations supported by these grants in 2011 - Nationally, Georgia is ranked 36th in the percent of its population that has access to primary care. A Kaiser Permanente Georgia grant to the United Way of Metropolitan Atlanta created the Primary Care Access program, and served over 2,700 people in 2011. The initiative expands access to care in five metro Atlanta counties. The program helped people access primary care and addresses the dramatic increase in patients seeking care that community clinics have recently experienced. Counties were selected based on residents' health status, income levels, and the capacity of community-based health care organizations. Because of the project, patients who have no other options for care received services through new access points for primary care. - Community clinics are a vital part of the safety net providing healthcare to thousands of under- and uninsured patients each year. Hands of Hope Clinic is such a facility. With a $37,750 Kaiser Permanente Georgia grant, the clinic launched their "Diabetic Self-Care Program, which provided American Diabetes Association-approved diabetes education to patients. Diabetes is a leading cause of death among Georgians, and is linked to health disparities in the Kaiser Permanente service area. The grant made possible health care for 120 diabetic patients who might not otherwise receive appropriate care. By providing patient education, screening, monitoring, and medication Hands of Hope is improving its patients' health, but is also freeing the local hospital emergency room to treat patients with urgent health crises. DEVELOPING AND DISSEMINATING KNOWLEDGE Kaiser Permanente aims to improve health by sharing its knowledge, educating practitioners, advancing research, empowering consumers, and informing policymakers about the evidence base for care and health. The Georgia Health Plan spent $7.6 million to support programs and services for the development and dissemination of knowledge and provided grants and donations to nonprofit organizations. Clinical and Health Services Research The Georgia Health Plan's Center for Health Research department partners with research programs at Emory University, Morehouse School of Medicine, Centers for Disease Control and Prevention (CDC) and the Georgia Department of Human Resources, Division of Public Health. During 2011, the Center for Health Research participated in 97 studies and published results in 23 peer-reviewed publications. Following are examples of studies conducted in 2011 - Three Community Benefit-funded studies focused on conditions affecting vulnerable populations in Georgia. The studies involved vulnerable populations and 1) Hypertension, 2) Chronic Kidney Disease - especially among Diabetics and 3) Maternal Influenza Vaccinations on Fetal and Infant Outcomes. Educational Theatre Programs (ETP) The Georgia Health Plan offered free, award-winning health education plays for youth and adults. Kaiser Permanente's Educational Theatre Programs offers a unique series of dynamic theatre programs with compelling health messages to reach children, teens and adults. These national award-winning plays promote individual responsibility for one's health, instill positive attitudes about healthy lifestyle choices and demonstrate the benefits of positive action. Topics addressed in the performances range from AIDS awareness and stress management to grief counseling and health and wellness messages, related to nutrition and asthma education. All programs are offered free of charge as a community benefit of Kaiser Permanente. In 2011, the program reached approximately 59,856 children and adults through 585 programs. Training and Education of Health Care Professionals In 2011, the Georgia Health Plan spent $282,214 to support the education and training of health care professionals. The following provides a description of two efforts undertaken to alleviate health care workforce shortages in the community. Pharmacy Residency Program The Pharmacy Residency Program helps students gain post graduate training experience in a managed care setting. Training components of the Georgia Health Plan program include: management and improvement of medication use through evidence-based patient-centered therapy with interdisciplinary teams; medication and practice-related education, population-based care and formulary management. In 2011, four interns participated in the program. Grants and Donations for Knowledge Dissemination The Georgia Health Plan donated $874,487 in charitable contributions to 15 nonprofit organizations for the dissemination of evidence-based studies which informed the community about health care public policy and educational opportunities for individuals seeking a career as a health care professional. Following is an example of one of the programs supported in 2011 - Voices for Georgia's Children provides research-based information that helps policymakers and Georgia's citizens make informed decisions about policies affecting children. Kaiser Permanente Georgia granted the organization $64,987 to use education and advocacy to decrease the number of uninsured children in Georgia. The organization provided culturally and linguistically-appropriate child health insurance eligibility and enrollment materials and partnered with community-based organizations to ensure that eligible children were enrolled in health insurance programs. - In addition, the Georgia Health Plan awarded $692,500 in grants to local colleges and universities to address health care worker shortages. We supported scholarship programs at 8 nursing programs, the Morehouse School of Medicine and two pharmacy programs, which awarded a total of 32 nursing, pharmacy, and medical student scholarships. Finally, we contributed $100,000 to the Satcher Health Leadership Institute at the Morehouse School of Medicine to address mental health disparities, and facilitate the integration of primary and behavioral health care. Other Community Benefit The Georgia Health Plan spent $1.2 million on other community benefit activities and programs beyond the national streams of work. Self-Sufficiency Programs The Georgia Health Plan spent $100,492 to support seven INROADS interns in 2011. The INROADS program is aimed at improving education and job skills or providing employment opportunities for targeted populations. INROADS is an organization focused on developing minority college students for leadership roles in corporations and in the community. Student interns typically work two to five summers with the organization with the goal of permanent placement upon graduation from college. Community Giving Campaign The Georgia Region's Community Giving Campaign is the employee's charitable giving program. Employees contribute to United Way and Earthshare through payroll deductions, direct gifts and special event fundraising. The amount reported is to cover administrative expenses for operating the campaign. Other Community Grants and Donations The Georgia Health Plan contributed $114,000 to two nonprofit community organizations in support of a variety of other programs and services for vulnerable populations. Following are highlights of one of the programs funded: - The Martin Luther King, Jr. Center for Nonviolent Social Change provides education about Dr. King's philosophy and continues his work to promote research, education and training. Each year, the Center hosts the Salute to Greatness Awards Dinner to honors recipients of the Salute to Greatness Award, the Center's highest recognition afforded individuals and institutions that embody the principles espoused by Dr. King. Kaiser Permanente Georgia joined with other local and national companies to support the King Center, and award recipients who help improve quality of life through their efforts. Regional Community Benefit Operations The Georgia Health Plan has a Community Benefit Department with nine employees to support regional community benefit programs and coordinate CB initiatives including the Educational Theatre Programs. In addition, there are many other Health Plan personnel who collaborate to help manage community benefit programs like Charity Care, Charitable Health Coverage. ATTACHMENT A 2011 COMMUNITY BENEFIT INVESTMENT - GEORGIA REGION The following chart summarizes 2011 Community Benefit investments by the Georgia Health Plan. The investments in the community reflected in the chart are unaudited. CARE AND COVERAGE Charitable Care & Coverage Programs $11,047,959 Government Sponsored Program 1,719,080 Grants/Donations for Care and Coverage 500,000 Subtotal: $13,267,039 COMMUNITY HEALTH INITIATIVES Community Health Education $12,262 Grants/Donations for Community Health Initiatives 5,635,675 Subtotal: $5,647,937 SAFETY NET PARTNERSHIPS Grants/Donations for Safety Net Partnerships $4,908,112 Safety Net CB Operations 211,653 Subtotal: $5,119,765 KNOWLEDGE DISSEMINATION Medical Research $5,506,146 Educational Theatre Program 890,350 Health Care Training & Education Programs 282,214 Grants/Donations for Knowledge Dissemination 874,487 Subtotal: $7,553,197 OTHER COMMUNITY BENEFITS Self Sufficiency Programs $100,492 Grants/Donations for Other Community Benefits 114,000 Other CB Operations 970,783 Subtotal: $1,185,275 TOTAL $32,773,213 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Peter Andruszkiewicz TITLE:Region President - Georgia HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kerry Kohnen TITLE:Region President - Georgia HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jeffrey Koplan TITLE:Director HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donna Lynne TITLE:Director HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Neal Purcell TITLE:Director HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Bernard Tyson TITLE:Director & Chair HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:George Halvorson TITLE:Chairman and CEO HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kathryn Lancaster TITLE:EVP & CFO HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kirkland McGhee TITLE:VP, Regional Counsel - GA HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Thomas Meier TITLE:SVP, Corporate Treasurer HOURS:47 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donald Orndoff TITLE:SVP, NFS HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur Southam TITLE:EVP, Health Plan Operations HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Deborah Stokes TITLE:SVP, CC & CAO HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Victoria Zatkin TITLE:Assistant Secretary HOURS:46 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark Zemelman TITLE:SVP, Gen Counsel & Secretary HOURS:47 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James Cullinan TITLE:VP, Mktg Sales & Bus Dev't HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carrie J Jennison TITLE:VP, CFO - Georgia HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Bernard Wathen TITLE:VP, HP Svcs Admin - GA HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dawn Bading TITLE:VP, Human Resources - GA HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lori k Ehrlich TITLE:Sr Sales Exec. - Large Group HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jonna Kirkwood TITLE:VP, Operations - GA HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carolyn J. Mustille TITLE:VP, Quality, Service & Nursing HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Beverly Thomas TITLE:VP, Community & Public Affairs HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Frank Boone TITLE:VP, Finance HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Steven Zatkin TITLE:Consultant HOURS: KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 941340523 HEALTH CARE CA 501(c)(3) 9 NA false KAISER FOUNDATION HOSPITALS ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 941105628 HEALTH CARE CA 501(c)(3) 3 KFHP INC true KAISER FDN HEALTH PLAN OF COLORADO ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 840591617 HEALTH CARE CO 501(c)(3) 9 KFHP INC true KFHP OF THE MID-ATLANTIC STATES ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 520954463 HEALTH CARE MD 501(c)(3) 9 KFHP INC true KAISER FDN HEALTH PLAN OF THE NORTHWEST ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 930798039 HEALTH CARE OR 501(c)(3) 9 KFHP INC true KAISER FDN HEALTH PLAN OF OHIO ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 340922268 HEALTH CARE OH 501(c)(3) 9 KFHP INC true KAISER HEALTH PLAN ASSET MANAGEMENT INC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943299124 ASSET MGMT CA 501(c)(3) 11 - I KFHP INC true LOKAHI ASSURANCE LTD ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 912171891 RISK MGMT HI 501(c)(3) 11 - I KFHP INC true KAISER HOSPITAL ASSET MANAGEMENT INC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943299125 ASSET MGMT CA 501(c)(3) 11 - I KF HOSPITALS true CAMP BOWIE SERVICE CENTER ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943299123 ADMIN CA 501(c)(3) 11 - I KFHP INC true OHP ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 930480268 LEASING WA 501(c)(3) 11 - I KFHP INC true KAISER HEALTH ALTERNATIVES ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 930954562 HEALTH CARE OR 501(c)(3) 9 KFHP INC true 1800 HARRISON ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943317484 FINANCING CA 501(c)(3) 11 - II KFHP INC true KAISER HOSPITAL ASSISTANCE CORPORATION ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 311779500 FINANCING CA 501(c)(3) 11 - III-O KF HOSPITALS true HCMS LLC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 203924985 CASE MANAGEMENT CA NA NONE 0 0 0 0.00000 KAISER PERMANENTE VENTURES LLC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 272252521 INVESTMENTS SVC CA NA NONE OAK TREE ASSURANCE LTD ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 030329760 INUSRANCE VT NA C CORP 0 0 0.00000 KAISER PERMANENTE INSURANCE COMPANY ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943203402 INUSRANCE CA NA C CORP KAISER PROPERTY SERVICES INC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943259432 REAL ESTATE CA NA C CORP ARCHIMEDES INC ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 203774729 CONSULTING CA NA C CORP KAISER PERMANENTE INTERNATIONAL ONE KAISER PLAZA SUITE 15L OAKLAND CA 94612 943245176 CONSULTING CA NA C CORP false true false false true false false false true false true true false true true true true true kaiser foundation hospitals b 54155 per agreement kaiser foundation hospitals e 11290667 per agreement kaiser foundation hospitals i 177170027 per agreement Kaiser foundation health plan inc k 6802359 per agreement KFHP of colorado k 228566 per agreement kfhp of the mid- atlantic states k 1149007 per agreement kfhp of the northwest k 163772 per agreement kfhp of ohio k 347471 per agreement kaiser permanente insurance company k 4154185 per agreement kaiser foundation health plan inc l 25285720 per agreement kaiser foundation hospitals l 71035877 per agreement kfhp of colorado l 194970 per agreement kfhp of the mid-atlantic states l 609177 per agreement kfhp of the northwest l 15328 per agreement kfhp of Ohio l 149026 per agreement camp bowie service center l 3502819 per agreement kaiser permanente insurance company l 24350616 per agreement lokahi assurance ltd l 20679149 per agreement oak tree assurance ltd l 967500 per agreement ordway indemnity l 498900 per agreement kfhp of colorado n 422638 per agreement kaiser foundation health plan inc o 19556476 per agreement kaiser foundation hospitals o 51599405 per agreement kfhp of colorado o 123330 per agreement kfhp of the mid-atlantic states o 65309 per agreement kfhp of the northwest o 2654 per agreement kfhp of ohio o 18601 per agreement camp bowie service center o 314348 per agreement kaiser foundation health plan inc p 11149619 per agreement kaiser foundation hospitals p 29663609 per agreement kfhp of colorado p 12846 per agreement kfhp of the mid-atlantic states p 144216 per agreement kfhp of the northwest p 42020 per agreement kfhp of ohio p 37125 per agreement kaiser permanente insurance company p 18115403 per agreement lokahi assurance ltd p 2863985 per agreement oak tree assurance ltd p 475218 per agreement kaiser foundation health plan inc q 3051 per agreement kaiser foundation hospitals q 183463568 per agreement lokahi assurance ltd q 4833000 per agreement kaiser foundation health plan inc r 4946 per agreement