TY 2015 Form 990

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) JAMES BLUHM MD......................................................................
PRESIDENT

1.00
.................
2.50

8,320

(2) DEAN MOSHOFSKY MD......................................................................
VICE PRESIDENT

0.50
.................
0.50

3,269

(3) CHRISTINA GRUCELLA MD......................................................................
TREASURER

0.50
.................
0.50

5,351

(4) ROBERT MENDELSON MD......................................................................
SECRETARY

0.50
.................
0.50

2,102

(5) MICHAEL ERICKSEN MD......................................................................
BOARD MEMBER

0.30
.................
0.30

2,000

(6) DAVID SKAU MD......................................................................
BOARD MEMBER

0.30
.................
0.30

1,705

(7) BRIAN KITTAMS MD......................................................................
BOARD MEMBER

0.30
.................
0.30

(8) CLOTILDE JOHNSON-BEALE MD......................................................................
BOARD MEMBER

0.30
.................
0.30

2,000

(9) MARK HELM MD......................................................................
BOARD MEMBER

0.30
.................
0.30

(10) RUPA SHAH MD......................................................................
BOARD MEMBER

0.30
.................
0.30

4,600

(11) DEBORAH RUMSEY......................................................................
EXECUTIVE DIRECTOR

10.00
.................
30.00

127,336

4,083

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(A)
Name and business address

(B)
Description of services

CHILDREN'S HEALTH ALLIANCE

5901 SW MACADAM AVE SUITE 220
PORTLAND,OR97239

PROFESSIONAL SERVICES/EMPLOYEES

283,980

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

CHILDREN'S HEALTH FOUNDATION INC

Employer identification number

26-0498033

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....	100,477	151,595	141,000	185,767	123,140	701,979
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3	100,477	151,595	141,000	185,767	123,140	701,979
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..						596,096
6	Public support. Subtract line 5 from line 4.						105,883

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..	100,477	151,595	141,000	185,767	123,140	701,979
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	1,075	1,339	1,528	1,371	826	6,139
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.						708,118

Gross receipts from related activities, etc. (see instructions) ..................

826,314

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

14.950 %

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

14.890 %

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test
THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT CHILDREN'S HEALTH FOUNDATION, INC. (THE TAXPAYER) IS NOT A PRIVATE FOUNDATION PURSUANT TO IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI). IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI) PROVIDE THAT AN EXEMPT ORGANIZATION WILL BE CONSIDERED A PUBLICLY SUPPORTED CHARITY (I.E. NOT A PRIVATE FOUNDATION) AS LONG AS THE ORGANIZATION RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM DIRECT OR INDIRECT CONTRIBUTIONS FROM THE GENERAL PUBLIC. THE FOUNDATION MUST SUBMIT INFORMATION TO THE IRS ON AN ANNUAL BASIS (ON FORM 990) THAT ESTABLISHES THAT THE ORGANIZATION MEETS THE PUBLIC SUPPORT TEST UNDER IRC SECTION 170(B)(1)(A)(VI). TO THE EXTENT THAT THE TAXPAYER DOES NOT MEET THIS SUPPORT TEST, THE IRS MAY RECLASSIFY THE TAXPAYER AS A PRIVATE FOUNDATION AND ASSESS CERTAIN EXCISE TAXES FOR ALL YEARS SINCE INCEPTION.TO QUALIFY AS A NON PRIVATE FOUNDATION UNDER IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI), THE TAXPAYER MUST RECEIVE A SUBSTANTIAL PART OF ITS SUPPORT IN GIFTS, GRANTS AND CONTRIBUTIONS FROM THE GENERAL PUBLIC AND/OR A GOVERNMENTAL UNIT. A "SUBSTANTIAL PART OF ITS SUPPORT" IS MET IF AT LEAST 33 1/3% OF THE TOTAL SUPPORT NORMALLY RECEIVED BY THE ORGANIZATION COMES FROM GIFTS, GRANTS AND CONTRIBUTIONS. "NORMALLY" GENERALLY MEANS MEETING THIS REQUIREMENT FOR THE PRECEDING FIVE TAXABLE YEARS. CONTRIBUTIONS BY ANY PERSON (OTHER THAN A GOVERNMENTAL UNIT OR 170(B)(1)(A)(VI) ORGANIZATION) ARE TREATED AS "ALLOWABLE SUPPORT" FROM THE GENERAL PUBLIC ONLY TO THE EXTENT THAT THE CONTRIBUTIONS BY SUCH PERSONS DURING THE FIVE YEAR PERIOD DO NOT EXCEED TWO PERCENT OF THE ORGANIZATION'S TOTAL SUPPORT FOR SUCH FIVE YEAR PERIOD.GIFTS IN KIND ARE TREATED THE SAME AS CASH CONTRIBUTIONS FOR PURPOSES OF THE PUBLIC SUPPORT TEST. AN ORGANIZATION MAY EXCLUDE FROM ITS CALCULATION OF PUBLIC SUPPORT AMOUNTS THAT QUALIFY AS "UNUSUAL GRANTS". UNUSUAL GRANTS ARE DEFINED AS SUBSTANTIAL CONTRIBUTIONS OR BEQUESTS FROM DISINTERESTED PARTIES WHICH:* ARE ATTRACTED BY REASON OF THE PUBLICLY SUPPORTED NATURE OF THE ORGANIZATION;* ARE UNUSUAL OR UNEXPECTED WITH RESPECT TO THE AMOUNT THEREOF; AND * WOULD, BY REASON OF THEIR SIZE, ADVERSELY AFFECT THE STATUS OF THE ORGANIZATION AS NORMALLY BEING PUBLICLY SUPPORTED FOR THE APPLICABLE PERIOD.IF THE TAXPAYER DOES NOT MEET THE 33 1/3% PUBLIC SUPPORT TEST, IT MAY QUALIFY UNDER THE 10% PERCENT FACTS AND CIRCUMSTANCES TEST TO PREVENT IT FROM LOSING ITS PUBLIC CHARITY STATUS.AN ORGANIZATION WILL MEET THE 10% FACTS AND CIRCUMSTANCES TEST IF IT NORMALLY RECEIVES 10% OF ITS SUPPORT FROM GOVERNMENTAL UNITS AND THE GENERAL PUBLIC. FOR PURPOSES OF THIS TEST, THE TERMS "NORMALLY AND "SUPPORT" HAVE BASICALLY THE SAME MEANING AS THEY HAVE IN THE 33 1/3% SUPPORT TEST. IN ADDITION, THE ORGANIZATION MUST SHOW THAT IT IS ORGANIZED AND OPERATED SO AS TO ATTRACT NEW AND ADDITIONAL PUBLIC AND GOVERNMENTAL SUPPORT. FINALLY, ALL PERTINENT FACTS AND CIRCUMSTANCES WILL BE TAKEN INTO CONSIDERATION IN DETERMINING IF THE ORGANIZATION IS PUBLICLY SUPPORTED. SUCH FACTORS INCLUDE THE DEGREE OF SUPPORT RECEIVED FROM PUBLIC OR GOVERNMENTAL UNITS, SOURCES OF SUPPORT, THE ORGANIZATION'S REPRESENTATIVE GOVERNING BODY AND THE AVAILABILITY OF PUBLIC SERVICES, FACILITIES OR PARTICIPATION IN PUBLIC PROGRAMS OR POLICIES.BASED ON OUR COMPUTATION OF THE PUBLIC CHARITY SUPPORT TEST (SEE SCHEDULE A, PART II, SECTION C, LINE 14) FOR THE FIVE YEARS ENDING JUNE 30, 2012 THROUGH JUNE 30, 2016, THE TAXPAYER FAILS THE MECHANICAL 33 1/3% PUBLIC SUPPORT TEST SINCE 14.95% OF ITS TOTAL SUPPORT COMES FROM GIFTS, GRANTS AND CONTRIBUTIONS.IT IS IMPORTANT TO NOTE, THE ORGANIZATION DOES QUALIFY AS A PUBLIC CHARITY UNDER THE 10% FACTS AND CIRCUMSTANCES TEST. THE TAXPAYER NORMALLY RECEIVES MORE THAN 10% OF ITS SUPPORT FROM THE GENERAL PUBLIC. IN ADDITION, THE FOLLOWING "FACTS AND CIRCUMSTANCE" REQUIREMENTS ESTABLISHING THAT IT SERVES BROAD-BASED PUBLIC INTERESTS HAVE BEEN SATISFIED [TREAS. REG. 1.170A-9(E)(3)].THE CHILDREN'S HEALTH FOUNDATION (CHF) CONTINUES TO DEVELOP PROGRAMS THAT SUPPORT THE OVERALL HEALTH OF CHILDREN IN THE COMMUNITY THROUGH WORKING DIRECTLY WITH PEDIATRIC PRACTICES IN THE PORTLAND METRO AREA AND BEYOND. ALL PEDIATRICIANS ARE ENCOURAGED TO PARTICIPATE IN THE QUALITY PROGRAMS, AND THE PARTICIPATING PEDIATRICIANS OPENLY SHARE IDEAS OF HOW TO IMPROVE CHILDREN'S HEALTH THROUGH NOT ONLY THEIR WORK IN PEDIATRIC PRACTICE, BUT THROUGH ALIGNMENT OF PROGRAMS IN THE COMMUNITY. THE CHF ACTIVITIES ARE OFTEN CONSIDERED LEADING EDGE, AND CHF RECEIVED SEVERAL NON-FINANCIAL COMMUNITY AWARDS FOR ITS ACCOMPLISHMENTS IN 2015 FOR ITS WORK IN THE COMMUNITY. IN ADDITION, CHF IS ASKED TO PARTICIPATE IN COMMUNITY-WIDE COMMITTEES, SUCH AS THE OREGON PEDIATRIC IMPROVEMENT PARTNERSHIP (OPIP), WHICH IS A PUBLIC-PRIVATE PARTNERSHIP TO COLLABORATE WITH OTHER LOCAL ORGANIZATIONS ALSO SEEKING TO IMPROVE CHILDREN'S HEALTH IN THE COMMUNITY, AND CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS ADVISORY GROUP (CAG). CHILDREN'S HEALTH FOUNDATION REGULARLY APPLIES FOR GRANTS FROM EXTERNAL ORGANIZATIONS TO SUPPORT ITS ACTIVITIES. IN THE PERIOD JULY 1, 2015 THROUGH JUNE 30, 2016, CHF UNSUCCESSFULLY APPLIED FOR SIX GRANTS TO SUPPORT ITS PROGRAMS. CHF IS CONSISTENTLY MONITORING THE LOCAL GRANT OPPORTUNITIES AND COMPLETES APPLICATIONS FOR GRANTS THAT ALIGN WITH THE PRIORITIES AND DIRECTION OF THE BOARD OF DIRECTORS. CHF WILL CONTINUE TO LOOK FOR ALIGNED GRANT OR FUNDING OPPORTUNITIES, AND APPLY, AS APPROPRIATE.THE MEMBERS OF THE BOARD OF DIRECTORS REPRESENT A DIVERSE GROUP OF PEDIATRIC PRACTICES RANGING FROM SOLO PRACTICES TO LARGE MULTI-SITE PRACTICES. THE BOARD IS CONSTANTLY LOOKING FOR NEW PARTICIPANTS IN THE COMMUNITY TO FURTHER EXPAND THE COLLABORATION AND EXPAND THE REACH OF ITS PROGRAMS. OUTREACH THROUGH COMMUNITY EVENTS, ONE-ON-ONE DISCUSSIONS, AND PARTICIPATION ON MUTUAL COMMUNITY ORGANIZATIONS PROVIDES THE VENUES TO ENCOURAGE NEW PARTICIPATION. PARTICIPATION IN THE CHILDREN'S HEALTH FOUNDATION QUALITY PROGRAMS IS OPEN TO ALL CLINICAL PROVIDERS WHO SERVE CHILDREN AND SEEK TO BE A PART OF THE ORGANIZATION. NEW PROVIDERS WHO SEEK TO PARTICIPATE IN THE CHILDREN'S HEALTH FOUNDATION ARE GENERALLY LOOKING FOR PEER COLLABORATION WITH OTHERS AND ARE ALSO INTERESTED IN IMPROVING HEALTH OF CHILDREN IN THE COMMUNITY. RATES FOR PARTICIPATION ARE SET AT A REASONABLE FEE, AND ARE NOT INTENDED TO EXCLUDE ANY PARTICIPANT INTERESTED IN PARTICIPATION WITH CHF. THE CHF BOARD WOULD BE MORE THAN HAPPY TO CONSIDER DISCOUNTED RATES SHOULD IT BE CONSIDERED A BARRIER TO PARTICIPATION.THE CHILDREN'S HEALTH FOUNDATION PROVIDES EDUCATIONAL OPPORTUNITIES THAT BRING TOGETHER PROVIDERS, COMMUNITY ORGANIZATIONS, AND OTHERS TO LEARN FROM EACH OTHER ON TOPICS THAT PROMOTE CHILDREN'S HEALTH. EACH YEAR, CHF HOSTS AT LEAST ONE MAJOR EVENT THAT BRINGS TOGETHER MEMBERS OF THE COMMUNITY TO LEARN ABOUT A RELEVANT HEALTH TOPIC, NETWORK AND EXPAND RELATIONSHIPS. IN OCTOBER 2015, THE CHILDREN'S HEALTH FOUNDATION HOSTED A COMMUNITY-WIDE EVENT TO PROMOTE UNDERSTANDING OF HOW TO OPTIMIZE RESILIENCY AS A METHOD TO REDUCE THE IMPACT OF ADVERSE CHILDHOOD EXPERIENCES. IN MAY 2016, THE CHILDREN'S HEALTH FOUNDATION DEVELOPED CURRICULUM AND TRAINED PROVIDER PRACTICES ON HOW TO BE TRAUMA-INFORMED AND PROVIDE A SAFE PLACE FOR CHILDREN AND FAMILIES WHO HAVE EXPERIENCED TRAUMA TO BE SERVED. THE WORK TO UNDERSTAND, EDUCATE AND TRAIN PROVIDERS AND THE COMMUNITY ON THE IMPACT OF ADVERSE CHILDHOOD EXPERIENCES OF METHODS TO COMBAT IT CONTINUES AS A CORE PROGRAM OF CHF. IN ADDITION, THE CHILDREN'S HEALTH FOUNDATION DEVELOPS A QUARTERLY NEWSLETTER, TAKE CARE, THAT IS DISTRIBUTED TO PEDIATRIC PRACTICES AND OTHER ORGANIZATIONS TO PROVIDE EDUCATIONAL MATERIAL ON CHILDREN'S HEALTH TO PARENTS. THIS NEWSLETTER FOCUSES ON TIMELY AND RELEVANT HEALTH ARTICLES TARGETED TOWARDS CHILDREN, ADOLESCENTS, AND HEALTH ISSUES THEY MIGHT FACE. IT ALSO COVERS KEY DEVELOPMENTAL MILESTONES AND SHARES RESOURCES TO COMMUNITY ORGANIZATIONS. ANOTHER PROGRAM OF CHF IS THE PEDIATRIC CARE MANAGEMENT IMPROVEMENT COLLABORATIVE. THIS GROUP MEETS QUARTERLY TO DISCUSS METHODS TO FURTHER IMPROVE THE HEALTH OF CHILDREN WITH COMPLEX MEDICAL AND SOCIAL NEEDS. ONE OF THE MAIN PURPOSES OF THIS GROUP IS TO HIGHLIGHT EXTERNAL ORGANIZATIONS WORKING TO SERVE A CRITICAL NEED FOR CHILDREN'S HEALTH TO INCREASE AWARENESS, DEVELOP RELATIONSHIPS, AND MOST IMPORTANTLY, HELP THE CHILDREN THEY SERVE.IN SUMMARY, CHF IS CONSIDERED A LEADING PARTNER IN THE COMMUNITY TO PROMOTE CHILDREN'S HEALTH THAT EXTENDS BEYOND ITS PARTICIPATING MEMBERS TO THE OVERALL COMMUNITY.

Facts And Circumstances Test

THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT CHILDREN'S HEALTH FOUNDATION, INC. (THE TAXPAYER) IS NOT A PRIVATE FOUNDATION PURSUANT TO IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI). IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI) PROVIDE THAT AN EXEMPT ORGANIZATION WILL BE CONSIDERED A PUBLICLY SUPPORTED CHARITY (I.E. NOT A PRIVATE FOUNDATION) AS LONG AS THE ORGANIZATION RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM DIRECT OR INDIRECT CONTRIBUTIONS FROM THE GENERAL PUBLIC. THE FOUNDATION MUST SUBMIT INFORMATION TO THE IRS ON AN ANNUAL BASIS (ON FORM 990) THAT ESTABLISHES THAT THE ORGANIZATION MEETS THE PUBLIC SUPPORT TEST UNDER IRC SECTION 170(B)(1)(A)(VI). TO THE EXTENT THAT THE TAXPAYER DOES NOT MEET THIS SUPPORT TEST, THE IRS MAY RECLASSIFY THE TAXPAYER AS A PRIVATE FOUNDATION AND ASSESS CERTAIN EXCISE TAXES FOR ALL YEARS SINCE INCEPTION.TO QUALIFY AS A NON PRIVATE FOUNDATION UNDER IRC SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI), THE TAXPAYER MUST RECEIVE A SUBSTANTIAL PART OF ITS SUPPORT IN GIFTS, GRANTS AND CONTRIBUTIONS FROM THE GENERAL PUBLIC AND/OR A GOVERNMENTAL UNIT. A "SUBSTANTIAL PART OF ITS SUPPORT" IS MET IF AT LEAST 33 1/3% OF THE TOTAL SUPPORT NORMALLY RECEIVED BY THE ORGANIZATION COMES FROM GIFTS, GRANTS AND CONTRIBUTIONS. "NORMALLY" GENERALLY MEANS MEETING THIS REQUIREMENT FOR THE PRECEDING FIVE TAXABLE YEARS. CONTRIBUTIONS BY ANY PERSON (OTHER THAN A GOVERNMENTAL UNIT OR 170(B)(1)(A)(VI) ORGANIZATION) ARE TREATED AS "ALLOWABLE SUPPORT" FROM THE GENERAL PUBLIC ONLY TO THE EXTENT THAT THE CONTRIBUTIONS BY SUCH PERSONS DURING THE FIVE YEAR PERIOD DO NOT EXCEED TWO PERCENT OF THE ORGANIZATION'S TOTAL SUPPORT FOR SUCH FIVE YEAR PERIOD.GIFTS IN KIND ARE TREATED THE SAME AS CASH CONTRIBUTIONS FOR PURPOSES OF THE PUBLIC SUPPORT TEST. AN ORGANIZATION MAY EXCLUDE FROM ITS CALCULATION OF PUBLIC SUPPORT AMOUNTS THAT QUALIFY AS "UNUSUAL GRANTS". UNUSUAL GRANTS ARE DEFINED AS SUBSTANTIAL CONTRIBUTIONS OR BEQUESTS FROM DISINTERESTED PARTIES WHICH:* ARE ATTRACTED BY REASON OF THE PUBLICLY SUPPORTED NATURE OF THE ORGANIZATION;* ARE UNUSUAL OR UNEXPECTED WITH RESPECT TO THE AMOUNT THEREOF; AND * WOULD, BY REASON OF THEIR SIZE, ADVERSELY AFFECT THE STATUS OF THE ORGANIZATION AS NORMALLY BEING PUBLICLY SUPPORTED FOR THE APPLICABLE PERIOD.IF THE TAXPAYER DOES NOT MEET THE 33 1/3% PUBLIC SUPPORT TEST, IT MAY QUALIFY UNDER THE 10% PERCENT FACTS AND CIRCUMSTANCES TEST TO PREVENT IT FROM LOSING ITS PUBLIC CHARITY STATUS.AN ORGANIZATION WILL MEET THE 10% FACTS AND CIRCUMSTANCES TEST IF IT NORMALLY RECEIVES 10% OF ITS SUPPORT FROM GOVERNMENTAL UNITS AND THE GENERAL PUBLIC. FOR PURPOSES OF THIS TEST, THE TERMS "NORMALLY AND "SUPPORT" HAVE BASICALLY THE SAME MEANING AS THEY HAVE IN THE 33 1/3% SUPPORT TEST. IN ADDITION, THE ORGANIZATION MUST SHOW THAT IT IS ORGANIZED AND OPERATED SO AS TO ATTRACT NEW AND ADDITIONAL PUBLIC AND GOVERNMENTAL SUPPORT. FINALLY, ALL PERTINENT FACTS AND CIRCUMSTANCES WILL BE TAKEN INTO CONSIDERATION IN DETERMINING IF THE ORGANIZATION IS PUBLICLY SUPPORTED. SUCH FACTORS INCLUDE THE DEGREE OF SUPPORT RECEIVED FROM PUBLIC OR GOVERNMENTAL UNITS, SOURCES OF SUPPORT, THE ORGANIZATION'S REPRESENTATIVE GOVERNING BODY AND THE AVAILABILITY OF PUBLIC SERVICES, FACILITIES OR PARTICIPATION IN PUBLIC PROGRAMS OR POLICIES.BASED ON OUR COMPUTATION OF THE PUBLIC CHARITY SUPPORT TEST (SEE SCHEDULE A, PART II, SECTION C, LINE 14) FOR THE FIVE YEARS ENDING JUNE 30, 2012 THROUGH JUNE 30, 2016, THE TAXPAYER FAILS THE MECHANICAL 33 1/3% PUBLIC SUPPORT TEST SINCE 14.95% OF ITS TOTAL SUPPORT COMES FROM GIFTS, GRANTS AND CONTRIBUTIONS.IT IS IMPORTANT TO NOTE, THE ORGANIZATION DOES QUALIFY AS A PUBLIC CHARITY UNDER THE 10% FACTS AND CIRCUMSTANCES TEST. THE TAXPAYER NORMALLY RECEIVES MORE THAN 10% OF ITS SUPPORT FROM THE GENERAL PUBLIC. IN ADDITION, THE FOLLOWING "FACTS AND CIRCUMSTANCE" REQUIREMENTS ESTABLISHING THAT IT SERVES BROAD-BASED PUBLIC INTERESTS HAVE BEEN SATISFIED [TREAS. REG. 1.170A-9(E)(3)].THE CHILDREN'S HEALTH FOUNDATION (CHF) CONTINUES TO DEVELOP PROGRAMS THAT SUPPORT THE OVERALL HEALTH OF CHILDREN IN THE COMMUNITY THROUGH WORKING DIRECTLY WITH PEDIATRIC PRACTICES IN THE PORTLAND METRO AREA AND BEYOND. ALL PEDIATRICIANS ARE ENCOURAGED TO PARTICIPATE IN THE QUALITY PROGRAMS, AND THE PARTICIPATING PEDIATRICIANS OPENLY SHARE IDEAS OF HOW TO IMPROVE CHILDREN'S HEALTH THROUGH NOT ONLY THEIR WORK IN PEDIATRIC PRACTICE, BUT THROUGH ALIGNMENT OF PROGRAMS IN THE COMMUNITY. THE CHF ACTIVITIES ARE OFTEN CONSIDERED LEADING EDGE, AND CHF RECEIVED SEVERAL NON-FINANCIAL COMMUNITY AWARDS FOR ITS ACCOMPLISHMENTS IN 2015 FOR ITS WORK IN THE COMMUNITY. IN ADDITION, CHF IS ASKED TO PARTICIPATE IN COMMUNITY-WIDE COMMITTEES, SUCH AS THE OREGON PEDIATRIC IMPROVEMENT PARTNERSHIP (OPIP), WHICH IS A PUBLIC-PRIVATE PARTNERSHIP TO COLLABORATE WITH OTHER LOCAL ORGANIZATIONS ALSO SEEKING TO IMPROVE CHILDREN'S HEALTH IN THE COMMUNITY, AND CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS ADVISORY GROUP (CAG). CHILDREN'S HEALTH FOUNDATION REGULARLY APPLIES FOR GRANTS FROM EXTERNAL ORGANIZATIONS TO SUPPORT ITS ACTIVITIES. IN THE PERIOD JULY 1, 2015 THROUGH JUNE 30, 2016, CHF UNSUCCESSFULLY APPLIED FOR SIX GRANTS TO SUPPORT ITS PROGRAMS. CHF IS CONSISTENTLY MONITORING THE LOCAL GRANT OPPORTUNITIES AND COMPLETES APPLICATIONS FOR GRANTS THAT ALIGN WITH THE PRIORITIES AND DIRECTION OF THE BOARD OF DIRECTORS. CHF WILL CONTINUE TO LOOK FOR ALIGNED GRANT OR FUNDING OPPORTUNITIES, AND APPLY, AS APPROPRIATE.THE MEMBERS OF THE BOARD OF DIRECTORS REPRESENT A DIVERSE GROUP OF PEDIATRIC PRACTICES RANGING FROM SOLO PRACTICES TO LARGE MULTI-SITE PRACTICES. THE BOARD IS CONSTANTLY LOOKING FOR NEW PARTICIPANTS IN THE COMMUNITY TO FURTHER EXPAND THE COLLABORATION AND EXPAND THE REACH OF ITS PROGRAMS. OUTREACH THROUGH COMMUNITY EVENTS, ONE-ON-ONE DISCUSSIONS, AND PARTICIPATION ON MUTUAL COMMUNITY ORGANIZATIONS PROVIDES THE VENUES TO ENCOURAGE NEW PARTICIPATION. PARTICIPATION IN THE CHILDREN'S HEALTH FOUNDATION QUALITY PROGRAMS IS OPEN TO ALL CLINICAL PROVIDERS WHO SERVE CHILDREN AND SEEK TO BE A PART OF THE ORGANIZATION. NEW PROVIDERS WHO SEEK TO PARTICIPATE IN THE CHILDREN'S HEALTH FOUNDATION ARE GENERALLY LOOKING FOR PEER COLLABORATION WITH OTHERS AND ARE ALSO INTERESTED IN IMPROVING HEALTH OF CHILDREN IN THE COMMUNITY. RATES FOR PARTICIPATION ARE SET AT A REASONABLE FEE, AND ARE NOT INTENDED TO EXCLUDE ANY PARTICIPANT INTERESTED IN PARTICIPATION WITH CHF. THE CHF BOARD WOULD BE MORE THAN HAPPY TO CONSIDER DISCOUNTED RATES SHOULD IT BE CONSIDERED A BARRIER TO PARTICIPATION.THE CHILDREN'S HEALTH FOUNDATION PROVIDES EDUCATIONAL OPPORTUNITIES THAT BRING TOGETHER PROVIDERS, COMMUNITY ORGANIZATIONS, AND OTHERS TO LEARN FROM EACH OTHER ON TOPICS THAT PROMOTE CHILDREN'S HEALTH. EACH YEAR, CHF HOSTS AT LEAST ONE MAJOR EVENT THAT BRINGS TOGETHER MEMBERS OF THE COMMUNITY TO LEARN ABOUT A RELEVANT HEALTH TOPIC, NETWORK AND EXPAND RELATIONSHIPS. IN OCTOBER 2015, THE CHILDREN'S HEALTH FOUNDATION HOSTED A COMMUNITY-WIDE EVENT TO PROMOTE UNDERSTANDING OF HOW TO OPTIMIZE RESILIENCY AS A METHOD TO REDUCE THE IMPACT OF ADVERSE CHILDHOOD EXPERIENCES. IN MAY 2016, THE CHILDREN'S HEALTH FOUNDATION DEVELOPED CURRICULUM AND TRAINED PROVIDER PRACTICES ON HOW TO BE TRAUMA-INFORMED AND PROVIDE A SAFE PLACE FOR CHILDREN AND FAMILIES WHO HAVE EXPERIENCED TRAUMA TO BE SERVED. THE WORK TO UNDERSTAND, EDUCATE AND TRAIN PROVIDERS AND THE COMMUNITY ON THE IMPACT OF ADVERSE CHILDHOOD EXPERIENCES OF METHODS TO COMBAT IT CONTINUES AS A CORE PROGRAM OF CHF. IN ADDITION, THE CHILDREN'S HEALTH FOUNDATION DEVELOPS A QUARTERLY NEWSLETTER, TAKE CARE, THAT IS DISTRIBUTED TO PEDIATRIC PRACTICES AND OTHER ORGANIZATIONS TO PROVIDE EDUCATIONAL MATERIAL ON CHILDREN'S HEALTH TO PARENTS. THIS NEWSLETTER FOCUSES ON TIMELY AND RELEVANT HEALTH ARTICLES TARGETED TOWARDS CHILDREN, ADOLESCENTS, AND HEALTH ISSUES THEY MIGHT FACE. IT ALSO COVERS KEY DEVELOPMENTAL MILESTONES AND SHARES RESOURCES TO COMMUNITY ORGANIZATIONS. ANOTHER PROGRAM OF CHF IS THE PEDIATRIC CARE MANAGEMENT IMPROVEMENT COLLABORATIVE. THIS GROUP MEETS QUARTERLY TO DISCUSS METHODS TO FURTHER IMPROVE THE HEALTH OF CHILDREN WITH COMPLEX MEDICAL AND SOCIAL NEEDS. ONE OF THE MAIN PURPOSES OF THIS GROUP IS TO HIGHLIGHT EXTERNAL ORGANIZATIONS WORKING TO SERVE A CRITICAL NEED FOR CHILDREN'S HEALTH TO INCREASE AWARENESS, DEVELOP RELATIONSHIPS, AND MOST IMPORTANTLY, HELP THE CHILDREN THEY SERVE.IN SUMMARY, CHF IS CONSIDERED A LEADING PARTNER IN THE COMMUNITY TO PROMOTE CHILDREN'S HEALTH THAT EXTENDS BEYOND ITS PARTICIPATING MEMBERS TO THE OVERALL COMMUNITY.

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:


Name of organization CHILDREN'S HEALTH FOUNDATION INC	Employer identification number 26-0498033
Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)


Name of organization CHILDREN'S HEALTH FOUNDATION INC	Employer identification number 26-0498033
Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND PRESIDENT OF THE BOARD IN DETAIL.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION ASKS THE BOARD MEMBERS, INCLUDING ALL COMMITTEE LEADERS, TO REVEAL ANY CONFLICTS OF INTEREST. IF A CONFLICT EXISTS, THE REMAINING BOARD MEMBERS MUST CONSENT TO THE CONFLICT, AND THE FOLLOWING CRITERIA MUST BE MET: THE INTEREST OF THE DIRECTOR IS DISCLOSED TO THE BOARD, THE INTERESTED DIRECTOR MAY NOT VOTE ON ANY RESOLUTION REGARDING THE TRANSACTION AND HIS/HER PRESENCE MAY NOT BE COUNTED TOWARD A QUORUM, AND THE BOARD APPROVES THE TRANSACTION AT A REGULAR OR SPECIAL MEETING.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Return Reference

Explanation

FORM 990, PART VI, SECTION B, LINE 11

FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND PRESIDENT OF THE BOARD IN DETAIL.

FORM 990, PART VI, SECTION B, LINE 12C

THE ORGANIZATION ASKS THE BOARD MEMBERS, INCLUDING ALL COMMITTEE LEADERS, TO REVEAL ANY CONFLICTS OF INTEREST. IF A CONFLICT EXISTS, THE REMAINING BOARD MEMBERS MUST CONSENT TO THE CONFLICT, AND THE FOLLOWING CRITERIA MUST BE MET: THE INTEREST OF THE DIRECTOR IS DISCLOSED TO THE BOARD, THE INTERESTED DIRECTOR MAY NOT VOTE ON ANY RESOLUTION REGARDING THE TRANSACTION AND HIS/HER PRESENCE MAY NOT BE COUNTED TOWARD A QUORUM, AND THE BOARD APPROVES THE TRANSACTION AT A REGULAR OR SPECIAL MEETING.

FORM 990, PART VI, SECTION C, LINE 19

THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CHILDREN'S HEALTH FOUNDATION INC

Employer identification number

26-0498033

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CHILDREN'S HEALTH ALLIANCE 5901 SW MACADAM AVE SUITE 220 PORTLAND,OR97239 93-1256381	PRACTICE ASSOCIATION	OR	N/A	C				No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	185,767	123,140
9	Program service revenue (Part VIII, line 2g) .........	177,791	177,644
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,371	826
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	364,929	301,610
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	27,040	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	310,924	251,392
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	337,964	251,392
19	Revenue less expenses. Subtract line 18 from line 12.......	26,965	50,218
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	341,729	448,448
21	Total liabilities (Part X, line 26).............	101,770	158,271
22	Net assets or fund balances. Subtract line 21 from line 20.....	239,959	290,177

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 87,493 including grants of $ ) (Revenue $ 70,979 )
	CARE MANAGEMENT IMPROVEMENT INITIATIVE: CHF SUPPORTS PEDIATRICIANS IN ENHANCING OR FORMALIZING THEIR CARE DELIVERY MODELS TO SUPPORT EFFECTIVE OPERATION AS A PEDIATRIC PRIMARY CARE MEDICAL HOME. THE ABILITY TO TARGET SPECIFIC POPULATIONS OF CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS (CYSHCN) IS KEY IN FOCUSING PRACTICE RESOURCES ON CHILDREN AND FAMILIES WITH THE MOST NEED AND ACHIEVING GREATEST IMPACT. CHF HAS DEVELOPED A PEDIATRIC POPULATION MODEL TO IDENTIFY POPULATIONS BASED ON MEDICAL AND PSYCHO-SOCIAL CONDITIONS WHICH CAN CORRELATE WITH THE LEVEL OF NEED FOR CARE COORDINATION/MANAGEMENT. THE SCOPE OF OPPORTUNITY FOR PEDIATRIC CARE COORDINATION SPANS ACROSS MANY SETTINGS INCLUDING MEDICAL CARE, MENTAL HEALTH SERVICES, COMMUNITY PROGRAMS, SCHOOL SYSTEMS AND FAMILY/CARE TAKER SETTINGS. CHF CONTINUES TO FACILITATE A FORMAL PEDIATRIC CARE MANAGEMENT IMPROVEMENT COLLABORATIVE TO ENGAGE INNOVATORS FROM OVER TWENTY LEADING PEDIATRIC PRACTICES TO FURTHER DEVELOP AND DEPLOY EDUCATION, METHODS, INTERVENTIONS, COMPETENCIES, TOOLS, HEALTH INFORMATION SYSTEMS, AND RESOURCES TO ADVANCE POPULATION MANAGEMENT IN PEDIATRICS. THESE EFFORTS ALIGN WITH STATE AND FEDERAL MEDICAL HOME EFFORTS. ANNUALLY, CHF HOSTS A COMMUNITY-WIDE TRAINING TO BRING TOGETHER CHF CARE MANAGERS AND OTHER CARE MANAGERS SERVING CHILDREN IN THE COMMUNITY, PROVIDING VISIBILITY INTO COMMUNITY ORGANIZATIONS SERVING THE NEEDS OF CHILDREN.

4b	(Code: ) (Expenses $ 55,324 including grants of $ ) (Revenue $ 0 )
	TARGETING ADVERSE CHILDHOOD EXPERIENCES (ACES): CHF SUPPORTS PEDIATRIC PRACTICES IN EXPLORING APPROACHES TO ADDRESS ACES IN A PEDIATRIC SETTING THROUGH EDUCATION AND AWARENESS OF ACES, TRAINING FOR PROVIDERS ON INTERVENTIONS TO HELP MITIGATE THE LONG-TERM IMPACTS OF ACES THROUGH BUILDING RESILIENCE IN EVERY CHILD, AND IDENTIFICATION OF HIGH RISK CHILDREN TO CONNECT TO APPROPRIATE RESOURCES. CHF IS PROVIDING TRAUMA-INFORMED CARE TRAINING TO PEDIATRIC PRACTICES TO PROVIDE A SAFE ENVIRONMENT FOR ALL PATIENTS AND FAMILIES, AND IS DEVELOPING CURRICULUM FOR PEDIATRICIANS AND CARE MANAGERS TO BUILD RESILIENCE AT EVERY WELL-CHILD VISIT AND INTERACTION WITH THE FAMILY. THE TRAINING IS AND WILL BE SHARED WITH COMMUNITY PROVIDERS AND ORGANIZATIONS WHO WORK WITH CHILDREN IN SIMILAR CAPACITIES. CHF CONTINUES TO DEVELOP RESOURCES TO SUPPORT THE PRACTICES IN TRAUMA-INFORMED APPROACHES AND RESILIENCE INTERVENTIONS.

4c	(Code: ) (Expenses $ 19,860 including grants of $ ) (Revenue $ 17,745 )
	ASTHMA CARE MANAGEMENT IMPROVEMENT INITIATIVE: THE GOALS OF THE ASTHMA CARE MANAGEMENT IMPROVEMENT INITIATIVE ARE TO 1) IMPROVE THE OVERALL HEALTH OF THE ASTHMATIC POPULATION WITHIN PEDIATRIC PRACTICES; 2) PROVIDE BETTER PREVENTATIVE SERVICES TO CHILDREN WITH ASTHMA; AND 3) REDUCE ASTHMA-RELATED EMERGENCY DEPARTMENT (ED) UTILIZATION AND HOSPITALIZATION ASSOCIATED WITH EXACERBATION OF INADEQUATELY MANAGED CHRONIC ASTHMA. IN 2015 AND 2016, PRACTICES CONTINUED TO ENTER PATIENTS WITH AN ASTHMATIC ENCOUNTER INTO THE ASTHMA PATIENT REGISTRY, WITH OVER 9,000 ENTERED AT JUNE 2016. INFORMATION TRACKED INCLUDES KEY AREAS OF ASTHMA CARE MANAGEMENT ACTIONS ACROSS THE PEDIATRIC ASTHMA POPULATION FROM WHICH PRACTICES CAN TAKE ACTIONABLE MEASURES TO CONTINUE TO IMPROVE ASTHMA CARE MANAGEMENT. TO SUPPORT IMPROVEMENT EFFORTS, CLINICAL SUPPORT TOOLS AND TRAINING TO SUPPORT THE DELIVERY OF "PERFECT ASTHMA CARE" ARE BEING DELIVERED AND ADOPTED BY PARTICIPATING PEDIATRIC PRACTICES.

	(Code: ) (Expenses $ 49,462 including grants of $ ) (Revenue $ 88,920 )
	THE REMAINING PROGRAMS INCLUDE IMMUNIZATION RATE IMPROVEMENT PROGRAMS (CHILD AND ADOLESCENT) TO HELP PEDIATRIC PRACTICES TARGET IMPROVEMENT IN WORKFLOWS BASED UPON ACTIONABLE DATA AND GENERAL CHF ACTIVITIES WHICH PROVIDE CLINICAL SUPPORT IN QUALITY IMPROVEMENT, INCLUDING ANALYSIS AND ADVICE REGARDING CHILD HEALTH MEASURES AND REPORTING AND DEVELOPMENT OF OVERALL PROGRAM MATERIALS, EDUCATION AND TRAINING FOR PRACTICES AND THE COMMUNITY, OUTREACH TO THE COMMUNITY, AND PARTICIPATION IN COMMUNITY AND STATE-WIDE COMMITTEES TO IMPROVE HEALTHCARE FOR CHILDREN. IN ADDITION, IT INCLUDES EDUCATIONAL PROGRAMS PROVIDED TO THE COMMUNITY TO IMPROVE CHILDREN'S HEALTH.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 49,462 including grants of $ ) (Revenue $ 88,920 )
4e	Total program service expenses212,139

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	156,683	4,083

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	9,500
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	113,640

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		123,140

1	Briefly describe the organization’s mission or most significant activities: IMPROVE HEALTH OUTCOMES FOR CHILDREN BY FOSTERING A STRONG CULTURE OF QUALITY IMPROVEMENT WITHIN PEDIATRIC CARE THROUGH MEANINGFUL CHANGE AND ACTIONABLE MEASURES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	30
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

			Business Code
2a	QUALITY SERVICE FEES	624100	177,644	177,644
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			177,644

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			826			826
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			301,610	177,644	0	826

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	182,328	173,744	8,584
b	Legal .........
c	Accounting ...........	6,750		6,750
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	24,978	24,978
12	Advertising and promotion ....
13	Office expenses .......	9,163	960	8,203
14	Information technology ......	3,600		3,600
15	Royalties ..
16	Occupancy ...........	10,800		10,800
17	Travel ............	1,225	1,225
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	10,482	10,482
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	1,142		1,142
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	EDUCATION COSTS	750	750
b	BUSINESS FEES	174		174
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	251,392	212,139	39,253	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		87,289	1	132,500
2	Savings and temporary cash investments .........		253,293	2	314,720
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............			4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				6
7	Notes and loans receivable, net ....			7
8	Inventories for sale or use ........			8
9	Prepaid expenses and deferred charges ......		1,147	9	1,228
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .			11
12	Investments—other securities. See Part IV, line 11 .....			12
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........			15
16	Total assets. Add lines 1 through 15 (must equal line 34)...		341,729	16	448,448

17	Accounts payable and accrued expenses .....	31,770	17	25,771
18	Grants payable ...		18
19	Deferred revenue .........	70,000	19	132,500
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	101,770	26	158,271

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	239,959	32	290,177
33	Total net assets or fund balances ...........	239,959	33	290,177
34	Total liabilities and net assets/fund balances ........	341,729	34	448,448


Name of organization CHILDREN'S HEALTH FOUNDATION INC			Employer identification number 26-0498033
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.