Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 89,425,660 | 139,531,063 | 147,489,092 | 152,037,713 | 74,363,774 | 602,847,302 |
| 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 | 89,425,660 | 139,531,063 | 147,489,092 | 152,037,713 | 74,363,774 | 602,847,302 |
| 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).. | 226,757,168 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 376,090,134 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 89,425,660 | 139,531,063 | 147,489,092 | 152,037,713 | 74,363,774 | 602,847,302 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 2,090,422 | 877,930 | 310,792 | 533,741 | 590,922 | 4,403,807 |
| 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 | 607,251,109 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 | ||||
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART II: SUPPORT SCHEDULE | LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH CHANGED ITS FISCAL YEAR END FROM DECEMBER 31 TO AUGUST 31 DURING 2016. AS A RESULT, A SHORT PERIOD TAX RETURN WAS FILED TO CAPTURE EIGHT MONTHS OF ACTIVITY FROM JANUARY 1, 2016 - AUGUST 31, 2016. THE IRS REQUIRES THAT THE YEARS DISPLAYED IN PART II, COLUMNS (A) - (E) REFLECT SHORT YEAR RETURNS THAT WERE FILED. THE CORRECT YEARS ARE AS FOLLOWS: COLUMN (A) 2013 - CALENDAR YEAR 2014 COLUMN (B) 2014 - CALENDAR YEAR 2015 COLUMN (C) 2015 - SHORT YEAR JANUARY 1, 2016 - AUGUST 31, 2016 COLUMN (D) 2016 - FISCAL YEAR SEPTEMBER 1, 2016 - AUGUST 31, 2017 COLUMN (E) 2017 - FISCAL YEAR SEPTEMBER 1, 2017 - AUGUST 31, 2018 |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| 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 1 | 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 CHAIRMAN OF THE BOARD, THE PRESIDENT/CEO OF THE FOUNDATION, AND THE CHAIRS OF ALL OTHER STANDING COMMITTEES. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 2 | CHRISTOPHER DAWES AND DENNY LUND HAVE A BUSINESS RELATIONSHIP WITH ELAINE CHAMBERS, JEFF CHAMBERS, MARY LEONARD, LLOYD MINOR, SUSAN ORR, BRIAN PERRONNE, MINDY ROGERS AND DAVID ALEXANDER. DAVID STEVENSON, MARY LEONARD, MICHAEL LONGAKER, AND LLOYD MINOR HAVE A BUSINESS RELATIONSHIP WITH MINDY ROGERS. DAVID ORR, KATHERINE ORR, AND SUSAN ORR HAVE A FAMILY RELATIONSHIP. ELIZABETH DUNLEVIE AND JANE DUNLEVIE HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOUNDATION'S BOARD APPROVED THE FOLLOWING SUBSTANTIVE CHANGES TO THE BYLAWS DURING THE FISCAL YEAR: 1) CHANGED THREE STANDING COMMITTEES (AUDIT, INVESTMENT AND FINANCE, AND NOMINATING AND GOVERNANCE) FROM BOARD COMMITTEES TO ADVISORY COMMITTEES. AS SUCH, THEY DO NOT HAVE THE POWER OF THE BOARD, BUT THEY MAY HAVE VOTING NON-DIRECTOR MEMBERS. 2) ADDED A PROVISION THAT THE CHAIRS OF THE 3 ADVISORY COMMITTEES MUST BE DIRECTORS. 3) REPLACED 'TREASURER' WITH 'CHIEF FINANCIAL OFFICER AND UPDATED THE RELATED DESCRIPTION. |
| 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 COMPLETED FORM 990 AVAILABLE TO THE FULL BOARD AND ANY NON-DIRECTOR MEMBERS OF THE AUDIT COMMITTEE NO LESS THAN TWO WEEKS 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 AND CFO 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 NOVEMBER 20, 2017. IN DETERMINING COMPENSATION LEVELS, THE COMMITTEE USES TWO INDEPENDENT THIRD PARTY SALARY SURVEYS, ONE PUBLISHED BY WOODMARK AND ONE PUBLISHED BY LASNIK BROIDA. 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 NOVEMBER 20, 2017. |
| 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: | GIFTS IN KIND -500,228. CHANGE IN VALUE OF INVESTMENTS HELD IN TRUST 52,347. |
| FORM 990, PART XII, LINE 2C: | THE AUDIT COMMITTEE WAS CHANGED FROM A BOARD COMMITTEE TO AN ADVISORY COMMITTEE, IN THE FOUNDATION'S BYLAWS. AS SUCH, THE AUDIT COMMITTEE DOES NOT HAVE THE AUTHORITY OF THE BOARD. AS A RESULT, THE FOUNDATION'S ANNUAL AUDIT IS REVIEWED BY THE AUDIT COMMITTEE AND RECOMMENDED TO THE BOARD FOR FINAL ACCEPTANCE. PRIOR TO THIS CHANGE, THE ANNUAL AUDIT WAS REVIEWED AND ACCEPTED BY THE AUDIT COMMITTEE AND WAS NOT REQUIRED TO GO TO THE BOARD. |
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