2023-07-07T16:22:24-05:00 2022-08-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1400 BELLEVUE WA 98004 990 2021-09-01 770440090 LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH LUCI 6504978365 400 HAMILTON AVENUE 340 PALO ALTO CA 94301 KATHRYN COULBOURN CFO 6504978365 2023-07-07 1 KATHRYN COULBOURN XXX-XX-XXXX MEGAN R RYAN P00737884 4254544919 2023-07-05 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z CYNTHIA BRANDT 400 HAMILTON AVENUE 340 PALO ALTO CA 94301 259308029 0 X WWW.LPFCH.ORG X 1996 CA THE LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH WORKS IN ALIGNMENT WITH LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD AND THE CHILD HEALTH PROGRAMS OF STANFORD UNIVERSITY SCHOOL OF MEDICINE. OUR MISSION IS TO ELEVATE THE PRIORITY OF CHILDREN'S HEALTH AND INCREASE THE QUALITY AND ACCESSIBILITY OF CHILDREN'S HEALTH CARE THROUGH LEADERSHIP AND DIRECT INVESTMENT. 27 25 126 437 0 259672 151133651 201991701 22342066 28359562 2194830 -183849 0 -134836 175670547 230032578 138462928 111820786 0 0 16803792 21110509 595770 156550 23942570 8295180 9378067 164157670 142465912 11512877 87566666 374660556 458952440 40980864 51281050 333679692 407671390 X THE LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH WORKS IN ALIGNMENT WITH LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD AND THE CHILD HEALTH PROGRAMS OF STANFORD UNIVERSITY SCHOOL OF MEDICINE.OUR MISSION IS TO ELEVATE THE PRIORITY OF CHILDREN'S HEALTH AND INCREASE THE QUALITY AND ACCESSIBILITY OF CHILDREN'S HEALTH CARE THROUGH LEADERSHIP AND DIRECT INVESTMENT. 0 0 109789114 109789114 28359562 DEVELOPMENT: THE FOUNDATION RAISES FUNDS TO SUPPORT THE LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD AND THE CHILD HEALTH PROGRAMS AT THE STANFORD SCHOOL OF MEDICINE. ONE HUNDRED PERCENT OF FUNDS RAISED ARE TRANSFERRED TO THE HOSPITAL AND SCHOOL OF MEDICINE ON A MONTHLY BASIS. THE FOUNDATION COMPLETED ITS LAST CAMPAIGN AT THE END OF 2012, RAISING A TOTAL OF $548M AGAINST A CAMPAIGN GOAL OF $500M. THE FOUNDATION HAS ENTERED A NEW CAMPAIGN AND IS SOLICITING LEAD GIFTS. 3999713 2031672 FOUNDATION PROGRAMS: THROUGH ITS PROGRAMS AND PARTNERSHIPS WORK, THE FOUNDATION SEEKS TO BUILD AWARENESS ABOUT ISSUES AFFECTING CHILDREN'S HEALTH BY INVESTING IN PROGRAMS TO ENHANCE THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES. DURING THE FISCAL YEAR ENDED AUGUST 31, 2022, THE FOUNDATION INVESTED APPROXIMATELY $4.0 MILLION IN THIS AREA. 113788827 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 1 1 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 1 84 0 126 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 27 25 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AR CA FL GA HI IL KS KY MD MA MI MN MS NH NJ NM NY NC OR PA RI SC TN UT VA WV WI X KATHRYN COULBOURN 6504978365 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 PAUL KING DIRECTOR 0.30 50.00 X 0 2396216 65315 CYNTHIA BRANDT PRESIDENT & CEO 40.00 0.00 X X 837944 0 157154 ELIZABETH DUNLEVIE CHAIR 0.30 2.00 X X 0 0 0 MINDY ROGERS VICE CHAIR 0.30 3.00 X X 0 0 0 DAN BOMZE DIRECTOR 0.30 0.00 X 0 0 0 JONATHAN COSLET DIRECTOR 0.30 2.00 X 0 0 0 C BRYAN CAMERON DIRECTOR 0.30 0.00 X 0 0 0 YVONNE MALDONADO DIRECTOR 0.30 0.00 X 0 0 0 LISA COLE DIRECTOR 0.30 0.00 X 0 0 0 KATE DACHS DIRECTOR 0.30 0.00 X 0 0 0 SUSAN FORD DORSEY DIRECTOR 0.30 0.00 X 0 0 0 JANE DUNLEVIE DIRECTOR 0.30 0.00 X 0 0 0 PAUL FISHER MD DIRECTOR 0.30 0.00 X 0 0 0 CHRIS GALLO DIRECTOR 0.30 0.00 X 0 0 0 PAUL KWAN DIRECTOR 0.30 0.00 X 0 0 0 MARY B LEONARD MD DIRECTOR 0.30 3.00 X 0 0 0 JOHN LILLIE DIRECTOR 0.30 0.00 X 0 0 0 LLOYD MINOR MD DIRECTOR 0.30 3.00 X 0 0 0 PETER MUNZIG DIRECTOR 0.30 0.00 X 0 0 0 KATHERINE ORR DIRECTOR 0.30 0.00 X 0 0 0 SUSAN P ORR DIRECTOR 0.30 0.00 X 0 0 0 MICHELLE SANDBERG MD DIRECTOR 0.30 0.00 X 0 0 0 DAVID K STEVENSON MD DIRECTOR 0.30 0.00 X 0 0 0 GEORGE TIDMARSH MD PHD DIRECTOR 0.30 0.00 X 0 0 0 HILARY VALENTINE DIRECTOR 0.30 0.00 X 0 0 0 CHARLOTTE WAXMAN DIRECTOR 0.30 0.00 X 0 0 0 ELIZABETH WEIL DIRECTOR 0.30 0.00 X 0 0 0 KIRK BOSTROM DIRECTOR 0.30 0.00 X 0 0 0 JEFF CHAMBERS DIRECTOR 0.30 10.00 X 0 0 0 CHRIS SCHAEPE DIRECTOR 0.30 0.00 X 0 0 0 KATHRYN COULBOURN CFO 40.00 0.00 X 446333 0 54587 ANDREW KAUFTEIL SVP STRATEGIC COMMUNICATIONS 40.00 0.00 X 291682 0 72641 RACHEL OLINGER EXECUTIVE DIRECTOR, CSHCN 40.00 0.00 X 282660 0 54476 SARAH COLLINS VP PRINCIPAL GIFTS 40.00 0.00 X 377306 0 32265 JAMES DEASY VP STRATEGY & INSTITUTIONAL RELATIONS 40.00 0.00 X 315992 0 75441 CINDI TROST ASSOCIATE VP CAMPAIGNS 40.00 0.00 X 292685 0 43284 SARAH HERNANDEZ CHIEF OF STAFF & AVP PEOPLE 40.00 0.00 X 256544 0 40348 JEAN GORMAN ASSOCIATE VP GIFT PLANNING 40.00 0.00 X 250264 0 44256 BRIAN PERRONNE FORMER OFFICER 40.00 0.00 X 201791 0 19726 3553201 2396216 659493 56 1 1 0 MATTHEW I REAMY POBOX 46216 DENVER CO 80202 CONSULTING/RECRUITMENT 608888 COMMUNITY COUNSELLING SERVICE 527 MADISON AVENUE 5TH FLOOR NEW YORK NY 10022 CONSULTING/FUNDRAISING 528364 ONE WORKPLACE L FERRARI LLC 2500 DE LA CRUZ BLVD SANTA CLARA CA 95050 CONSTRUCTION/CONSULTING 283186 DAVINCI DIRECT INC 3 VILLAGE GREEN N 311 PMBB6 PLYMOUTH MA 02360 CONSULTING/PRODUCTION/PRINTING 267989 CAMBRIDGE ASSOCIATES LLC 125 HIGH STREET BOSTON MA 02110 CONSULTING/INVESTMENTS 263232 19 648860 98000 201244841 5222060 201991701 DEVELOPMENT FEES REIMB 900099 28359562 28359562 28359562 383110 383110 28391343 28958302 -566959 -566959 -566959 182313 648860 317149 -134836 -134836 230032578 28359562 0 -318685 111820786 111820786 2788507 479212 245701 2063594 12670 3801 8869 14684721 462045 1498681 12723995 1104641 30997 156613 917031 1483753 60909 287246 1135598 1036217 58132 99569 878516 285893 285893 156550 156550 306322 306322 4360841 634570 1232527 2493744 233428 9000 224428 579190 13057 88214 477919 51661 18116 12531 21014 2373597 94954 394343 1884300 92555 2466 4032 86057 87705 3539 31125 53041 232746 10978 30908 190860 145239 2923 74671 67645 SUPPLIES 303072 355 749 301968 OUTSIDE SERVICES/FEES 216281 27285 16162 172834 TRAVEL/ENTERTAINMENT 60826 432 1301 59093 BUS. TAXES & INSURANCE 53355 88958 -35874 271 -4644 -29887 25243 142465912 113788827 4734515 23942570 277142 126383 30692067 39824139 152686866 245620160 1106783 1073682 585868 746366 4518172 1356664 440860 3161508 28257598 26379157 146140568 128913802 14472804 13107243 374660556 458952440 3486024 4480689 2140323 1925615 10019759 9409883 25334758 35464863 40980864 51281050 X 151776707 135053368 181902985 272618022 333679692 407671390 374660556 458952440 X 87566666 -12398319 -1176649 X 0 1 X 1 0 X 74363774 140831261 85001090 151133651 201991701 653321477 74363774 140831261 85001090 151133651 201991701 653321477 177039825 476281652 590922 592472 497152 286450 383110 2350106 655671583 111588886 0.72640 0.79450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 153162075 -12435534 2100601 3406205 239686 134980049 118883388 39885897 2233924 2985942 387344 153162075 116637637 9154414 1681052 7099088 -1871477 118883388 118241165 489705 2094558 2814728 -2816053 116637637 113411531 8999933 3590488 2810823 -2231012 118241165 1.00000 0.00000 0.00000 0 0 1163760 950995 212765 3354412 405669 2948743 3161508 HEDGE FUNDS 23164340 F INTERNATIONAL EQUITY TRUSTS 38861709 F REAL ASSET FUNDS 13480910 F VENTURE CAPITAL/PRIVATE EQUITY 41768404 F DEBT SECURITIES 5372622 F FIXED INCOME 6265817 F 128913802 FUNDS TO BE TRANSFERRED TO LPCH AND SOM 14098861 FUNDS TO BE TRANSFERRED TO OTHERS 442250 PAYMENTS FOR TRUST BENEFICIARY 7456420 LEASE LIABILITY - REAL ESTATE 13467332 35464863 X 216443192 -12398319 -1176649 -13574968 230018160 306322 -291904 14418 230032578 142451494 317149 317149 142134345 306322 25245 331567 142465912 PART V, LINE 4: THE FOUNDATION USES ITS ENDOWMENT TO FUND ACTIVITIES TO SUPPORT ITS PROGRAMMATIC OBJECTIVES IN CHILDREN'S HEALTH AND RELATED ADMINISTRATIVE COSTS. PROGRAMMATIC OBJECTIVES INCLUDE BUILDING AWARENESS AT THE COMMUNITY AND STATE LEVEL ABOUT ISSUES AFFECTING CHILDREN'S HEALTH AND ENHANCING THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES. PART X, LINE 2: THE FOUNDATION FOLLOWS THE PROVISION OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX PROVISION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN AND PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. MANAGEMENT BELIEVES THAT NO SUCH UNCERTAIN TAX POSITIONS EXIST REQUIRING ACCRUAL OR DISCLOSURE AS OF AUGUST 31, 2022 OR 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST -1,176,649. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONATED GIFTS IN KIND 25,245. FUNDRAISING EXPENSES -317,149. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 317,149. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATED GIFTS IN KIND 25,245. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 32159977 NORTH AMERICA 0 0 FUNDRAISING REVENUES RECEIVED FROM DONORS IN THE REGION SOUTH AMERICA 0 0 FUNDRAISING REVENUES RECEIVED FROM DONORS IN THE REGION EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 FUNDRAISING REVENUES RECEIVED FROM DONORS IN THE REGION MIDDLE EAST AND NORTH AFRICA 0 0 FUNDRAISING REVENUES RECEIVED FROM DONORS IN THE REGION EAST ASIA AND THE PACIFIC 0 0 MANAGEMENT & GENERAL 3540 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 MANAGEMENT & GENERAL 25944 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 FUNDRAISING 916 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 643799 0 0 0 0 0 0 32190377 643799 32834176 1 0 0 0 1 1 PART I, LINE 3: THE ACCRUAL BASIS WAS USED TO ACCOUNT FOR EXPENDITURES. PART III ACCOUNTING METHOD: SCHEDULE F, PART I THE FOUNDATION'S DISCLOSURE IN PART 1, LINE 3 REFLECTS THE DOMICILE OF CERTAIN INVESTMENT ENTITIES WHICH SERVE MERELY AS THE VEHICLE FOR SUBSEQUENT INVESTING OF FUNDS AND IS NOT REPRESENTATIVE OF THE UNDERLYING GEOGRAPHICAL STRATEGY OF THOSE INVESTMENTS. THE FOUNDATION'S INVESTMENTS ARE FULLY DIVERSIFIED ACROSS ASSET CLASSES, STRATEGIES AND GEOGRAPHICAL REGIONS. IT ADHERES TO AN APPROVED STATEMENT OF INVESTMENT OBJECTIVES AND POLICIES AND HAS IN PLACE A STRATEGIC ASSET ALLOCATION POLICY WHICH ALLOWS IT TO ACHIEVE ITS SHORT TERM FINANCIAL AND LONG TERM INVESTMENT OBJECTIVES. X X X X X X 1 COMMUNITY COUNSELLING SERVICE CO LLC 527 MADISON AVENUE 5TH FLOOR NEW YORK NY 10022 GUIDANCE AND CONSULTING ON STRATEGIC FUNDRAISING PLAN 0 0 24000 -24000 GRENZEBACH GLIER & ASSOCIATES 200 S MICHIGAN AVENUE SUITE 2100 CHICAGO IL 60604 WRITING GIFT PROPOSALS AND DONOR IMPACT REPORTS. 0 0 16000 -16000 RUTH RICHERSON CONSULTING 720 EVELYN AVENUE ALBANY CA 94706 FUNDRAISING CONSULTING & IMPLEMENTING FUNDRAISING STRATEGIES 0 0 67500 -67500 DAVINCI DIRECT 3 VILLAGE GREEN N 311 PMBB6 PLYMOUTH MA 02360 CREATIVE DIRECTION IN PLANNING DIRECT MAIL PROGRAM 0 0 49050 -49050 156550 -156550 AL AK AR CA CO CT FL GA HI IL KS KY LA ME MD MA MI MN MS MO NV NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI LUNCH AND LEARN 250410 177160 73250 37942 30157 32494 SUMMER SCAMPER 580763 471700 109063 2633 40337 6892 1400 165294 831173 648860 182313 2633 78279 6892 31557 197788 317149 -134836 1 CHILDREN'S SPECIALTY CARE COALITION 1017 L STREET SUITE 338 SACRAMENTO CA 95814 680484332 501C(3) 15000 0 SURVEYING CA-BASED PEDIATRIC SUBSPECIALTY PHYSICIANS ON PRACTICES AND ATTITUDES TOWARD FAMILY-TO-FAMILY /PEER SUPPORT FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS BOARD OF TRUSTEES OF LELAND STANFORD UNIVERSITY 485 BROADWAY ST REDWOOD CITY CA 94063 941156365 501C(3) 17250 0 EXPLORING CAREGIVER AND PROVIDER PERSPECTIVES CENTER FOR HEALTH POLICY DEVELOPMENT (NASHP) TWO MONUMENT SQ PORTLAND ME 04101 521576801 501C(3) 190259 0 SUPPORTING STATES TO IMPROVE EQUITABLE SYSTEMS OF CARE CHILDREN NOW 1404 FRANKLIN ST SUITE 700 OAKLAND CA 94708 943059243 501C(3) 98960 0 DESIGNING THE NEW ENHANCED CARE MANAGEMENT BENEFIT TO WORK FOR KIDS IN MEDI-CAL CHOC FOUNDATION 1201 W LA VETA AVE ORANGE CA 92868 956097416 501C(3) 17204 0 OCC3 FOR KIDS: ACCESS TO CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS - SUPPLEMENT FAMILY VOICES 1663 MISSION STREET 7TH FLOOR SAN FRANCISCO CA 94103 942819062 501C(3) 250000 0 FAMILY ENGAGEMENT IN SYSTEMS ASSESSMENT TOOLS: NEW STRATEGIES TO FACILITATE EASE AND STANDARDIZATION OF USE INSTITUTE FOR PATIENT AND FAMILY CENTERED CARE PO BOX 6397 MCLEAN VA 22106 521777133 501C(3) 25000 0 INSTITUTE FOR PATIENT & FAM CENTERED CARE INSTITUTE FOR PATIENT AND FAMILY CENTERED CARE PO BOX 6397 MCLEAN VA 22106 521777133 501C(3) 220452 0 BUILDING CAPACITY FOR DIVERSITY, EQUITY AND INCLUSION IN CHILDREN'S HOSPITAL PFACS LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501C(3) 225000 0 CREATION OF A PARENT MENTOR PROGRAM TO MEET THE HEALTH EQUITY NEEDS OF CHILDREN AND FAMILIES FROM DIVERSE BACKGROUNDS NATIONAL HEALTH LAW PROGRAM INC 3701 WILSHIRE BLVD SUITE 750 LOS ANGELES CA 90010 953080947 501C(3) 155000 0 OVERSIGHT AND MONITORING OF THE CALIFORNIA'S CHILDREN'S SERVICES (CCS) PROGRAM PUBLIC COUNSEL 610 SOUTH ARDMORE AVE LOS ANGELES CA 90005 237105149 501C(3) 115140 0 ENSURING EFFECTIVE IMPLEMENTATION OF THE STATES EFFORTS TO REDUCE REGIONAL CENTER DISPARITIES THE NATIONAL ALLIANCE TO ADVANCE ADOLESCENT HEALTH 1615 M ST NW SUITE 290 WASHINGTON DC 20036 204145524 501C(3) 233314 0 BARRIERS, INEQUITIES AND POLICY OPTIONS FOR YSHCN UNIVERSITY OF PITTSBURGH 371220 500 ROSS ST 154-0455 PITTSBURGH PA 15262 250965591 501C(3) 353202 0 DIVERSE COLLECTIVE LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501C(3) 51335 0 CHILDREN'S HEALTH INITIATIVE LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501C(3) 49309101 0 CHILDREN'S HEALTH LUCILE PACKARD CHILDREN'S HOSPITAL 725 WELCH ROAD PALO ALTO CA 94304 770003859 501C(3) 61756 0 CHILDREN'S HEALTH BOARD OF TRUSTEES OF LELAND STANFORD UNIVERSITY 485 BROADWAY ST REDWOOD CITY CA 94063 941156365 501C(3) 60480013 0 CHILDREN'S HEALTH 13 0 PART I, LINE 2: GRANTS ARE AWARDED TO ORGANIZATIONS BASED ON THEIR ABILITY TO SUPPORT THE FOUNDATION'S CHARITABLE PROGRAM OBJECTIVES, SPECIFICALLY IN RESPECT OF THE FOUNDATION'S WORK TO ENHANCE THE SYSTEM OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND THEIR FAMILIES. APPLICANT ORGANIZATIONS SUBMIT PROPOSALS BASED ON MUTUALLY AGREED UPON OBJECTIVES, MILESTONES AND DELIVERABLES. FOUNDATION PROGRAM STAFF ANALYZE THE APPLICANT'S EXPERTISE, PROJECT GOALS, AND COSTS BEFORE AWARDING A GRANT. GRANTS OVER $50,000 AND UP TO $250,000 MAY BE APPROVED BY THE CEO UPON REVIEW AND FORMAL RECOMMENDATION OF A MAJORITY OF THE MEMBERS OF THE PROGRAMS AND PARTNERSHIPS COMMITTEE. GRANTS OVER $250,000 MUST BE APPROVED BY THE BOARD. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 PAUL KING DIRECTOR 0 1086047 0 726359 0 583810 0 65315 0 0 0 2461531 0 338450 CYNTHIA BRANDT PRESIDENT & CEO 577044 0 170340 0 90560 0 147083 0 10071 0 995098 0 0 0 KATHRYN COULBOURN CFO 353088 0 54088 0 39157 0 29000 0 25587 0 500920 0 36835 0 SARAH COLLINS VP PRINCIPAL GIFTS 288802 0 82847 0 5657 0 29000 0 3265 0 409571 0 0 0 JAMES DEASY VP STRATEGY & INSTITUTIONAL RELATION 270010 0 35180 0 10802 0 50422 0 25019 0 391433 0 0 0 ANDREW KAUFTEIL SVP STRATEGIC COMMUNICATIONS 221630 0 69647 0 405 0 62217 0 10424 0 364323 0 0 0 RACHEL OLINGER EXECUTIVE DIRECTOR, CSHCN 261141 0 20979 0 540 0 28627 0 25849 0 337136 0 0 0 CINDI TROST ASSOCIATE VP CAMPAIGNS 246526 0 45349 0 810 0 27503 0 15781 0 335969 0 0 0 SARAH HERNANDEZ CHIEF OF STAFF & AVP PEOPLE 227454 0 28703 0 387 0 26257 0 14091 0 296892 0 0 0 JEAN GORMAN ASSOCIATE VP GIFT PLANNING 228205 0 18222 0 3837 0 25026 0 19230 0 294520 0 0 0 BRIAN PERRONNE FORMER OFFICER 108025 0 0 0 93766 0 19423 0 303 0 221517 0 12350 0 PART I, LINE 1A CYNTHIA BRANDT RECEIVES A HOUSING ALLOWANCE THAT IS TREATED AS TAXABLE COMPENSATION. PART I, LINE 4B THE FOUNDATION OFFERS A 457(F) PLAN FOR SELECT MEMBERS OF EXECUTIVE MANAGEMENT. DURING THE CALENDAR YEAR 2021, THE CEO, CFO, COO, SVP STRATEGIC COMMUNICATIONS AND VP STRATEGY & INSTITUTIONAL RELATIONS WERE ELIGIBLE FOR EMPLOYER CONTRIBUTIONS TO THE PLAN. THE AMOUNTS CONTRIBUTED TO THE PLAN, BUT NOT PAID WERE: CYNTHIA BRANDT: $98,583, ANDREW KAUFTEIL: $18,352 AND JAMES DEASY: $22,077. THE AMOUNTS DISTRIBUTED FROM THE PLAN WERE AS FOLLOWS: BRIAN PERRONNE (FORMER OFFICER) $12,350 AND KATHRYN COULBOURN (CFO) $36,835. PART I, LINE 7 THE CEO AND CFO RECEIVE AN INCENTIVE COMPENSATION PAYMENT EQUAL TO A PERCENTAGE OF TOTAL BASE COMPENSATION. THE PERCENTAGE IS DETERMINED BASED ON THE ACHIEVEMENT OF SPECIFIC GOALS BUT IS LIMITED TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN THE FOUNDATION'S POLICY RANGE OF THE 75TH TO 90TH PERCENTILE OF COMPENSATION AS PER SPECIFIC COMPENSATION SURVEYS. THE PERCENTAGE MAY VARY YEAR TO YEAR AS A RESULT OF THIS PROCESS. INCENTIVE COMPENSATION FOR THE CEO IS DETERMINED AND APPROVED BY THE COMPENSATION COMMITTEE. THE INCENTIVE COMPENSATION FOR THE CFO IS PROPOSED BY THE CEO AND APPROVED BY THE COMPENSATION COMMITTEE. X 1 0 APPRAISAL X 189 5196815 AVERAGE MARKET VALUE X EQUIPMENT 11 25245 RETAIL VALUE 0 0 1 1 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BASED ON THE NUMBER OF ITEMS (EQUIPMENT) OR CONTRIBUTIONS RECEIVED (PUBLICLY TRADED STOCK). PART I, LINE 32B: THE FOUNDATION ENGAGES A BROKER TO RECEIVE AND LIQUIDATE GIFTS OF MARKETABLE SECURITIES. FORM 990, PART I, LINE 6: VOLUNTEERS INCLUDE THE FOUNDATION'S BOARD OF DIRECTORS AS WELL AS VOLUNTEERS WHO SUPPORT VARIOUS FOUNDATION FUNDRAISING EVENTS. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE BOARD BETWEEN BOARD MEETINGS WITH THE EXCEPTION OF CERTAIN SPECIFIC POWERS, AS SPECIFIED IN THE BYLAWS. THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIR OF THE BOARD, THE VICE CHAIR OF THE BOARD, THE PRESIDENT/CEO OF THE FOUNDATION, THE CHAIRS OF ALL OTHER STANDING COMMITTEES, THE DEAN OF THE STANFORD UNIVERSITY SCHOOL OF MEDICINE, AND THE PRESIDENT OF THE CHILDREN'S HOSPITAL AT STANFORD. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 JEFF CHAMBERS, JONATHAN COSLET, ELIZABETH DUNLEVIE, PAUL KING, MARY LEONARD, LLOYD MINOR, SUSAN ORR AND MINDY ROGERS HAVE A BUSINESS RELATIONSHIP. KATHERINE ORR AND SUSAN ORR HAVE A FAMILY RELATIONSHIP. ELIZABETH DUNLEVIE AND JANE DUNLEVIE HAVE A FAMILY RELATIONSHIP. KATE DACHS AND PETER MUNZIG HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD IS THE SOLE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE FOUNDATION, THE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE FOUNDATION, THE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS OF THE FOUNDATION. REVISIONS TO THE FOUNDATION'S BYLAWS MUST BE APPROVED BY THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT MAKES THE FORM 990 AVAILABLE TO THE FULL BOARD AND ANY NON-DIRECTOR MEMBERS OF THE AUDIT COMMITTEE PRIOR TO THE AUDIT COMMITTEE MEETING AT WHICH THE FORM WILL BE REVIEWED. THE BOARD AND AUDIT COMMITTEE ARE ASKED TO PROVIDE FEEDBACK AND/OR QUESTIONS FOR DISCUSSION AT THE AUDIT COMMITTEE MEETING. UPON REVIEW OF THE FORM 990 AND AFTER ALL FEEDBACK AND QUESTIONS HAVE BEEN ADDRESSED, THE AUDIT COMMITTEE WILL VOTE WHETHER TO APPROVE A RECOMMENDATION TO THE FULL BOARD TO APPROVE THE FORM 990. THE FORM 990 IS THEN PRESENTED TO THE FULL BOARD FOR FINAL APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS, AND KEY EMPLOYEES ("KEY PERSONS") ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS AND TO DISCLOSE ALL REAL AND POTENTIAL CONFLICTS OF INTEREST. KEY PERSONS ARE REQUIRED TO CONFIRM THAT THEY HAVE REVIEWED THE POLICY BY SIGNING THAT THEY HAVE DONE SO, EVEN IF NO CONFLICTS ARE DISCLOSED. IN ADDITION, KEY PERSONS ARE REQUIRED TO DISCLOSE REAL OR APPARENT CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE DURING DISCUSSIONS OF THE BOARD, BOARD COMMITTEES, OR STAFF. KEY PERSONS WITH CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM RELATED DISCUSSIONS AND DECISIONS. THE FOUNDATION'S CEO IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION HAS A COMPENSATION COMMITTEE COMPRISED ENTIRELY OF INDEPENDENT DIRECTORS, NONE OF WHOM HAVE A CONFLICT OF INTEREST WITH THE CEO, CFO, OR ANY OF THE KEY EMPLOYEES. THE COMPENSATION COMMITTEE ESTABLISHES THE COMPENSATION PHILOSOPHY FOR THE ORGANIZATION AND MEETS ANNUALLY TO SET THE SALARY FOR THE CEO, CFO, AND SVPS AND REVIEW AND DISCUSS SALARIES FOR KEY EMPLOYEES. THE COMMITTEE HAS ENGAGED A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT TO ATTEND ITS ANNUAL MEETING THE LAST OF WHICH WAS HELD ON SEPTEMBER 28, 2022. IN DETERMINING COMPENSATION LEVELS, OUR CONSULTANTS FREDERICK W. COOK & CO., INC. USE WOODMARK SURVEY DATA AND THEIR OWN DETAILED MARKET ANALYSIS. KEY DELIBERATIONS OF THE COMPENSATION COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING. THE LAST COMPENSATION REVIEW WAS DONE ON SEPTEMBER 28, 2022. FORM 990, PART VI, SECTION C, LINE 19 WHILE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST -1,176,649. LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD 725 WELCH ROAD PALO ALTO CA 94304 770003859 HEALTHCARE/HOSPITAL CA 501(C)(3) LINE 3 N/A 0 CHARITABLE REMAINDER TRUST (13) INVESTMENT CA N/A T 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1