Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
HMSA FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)POBOX 860
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HONOLULU, HI96808
A Employer identification number

99-0250429
B Telephone number (see instructions)

(808) 948-5145
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$26,810,771J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 321 321  
4 Dividends and interest from securities... 523,637 523,637  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 -187,185
b Gross sales price for all assets on line 6a 1,300,000
7 Capital gain net income (from Part IV, line 2)... 0
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 492 492 0
12 Total. Add lines 1 through 11........ 337,265 524,450 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 0
14 Other employee salaries and wages...... 256,246 0 0 0
15 Pension plans, employee benefits....... 393,157 0 0 0
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 38,317 0 0 0
c Other professional fees (attach schedule).... Click to see attachment 58,632 0 0 0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 21,595 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 180 0 0 0
21 Travel, conferences, and meetings....... 9,165 0 0 0
22 Printing and publications.......... 402 0 0 0
23 Other expenses (attach schedule)....... Click to see attachment 96,414 0 0 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 874,108 0 0 0
25 Contributions, gifts, grants paid....... 7,024,561 1,179,071
26 Total expenses and disbursements. Add lines 24 and 25 7,898,669 0 0 1,179,071
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -7,561,404
b Net investment income (if negative, enter -0-) 524,450
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 451,938 126,944 126,944
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet15,595
Less: allowance for doubtful accounts bullet   23,826 15,595 15,595
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 625,416 169,965 169,965
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 18,139,408 Click to see attachment18,175,821 26,498,267
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 19,240,588 18,488,325 26,810,771
Liabilities 17 Accounts payable and accrued expenses.......... 77,573 68,628
18 Grants payable................. 2,887,169 8,736,417
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment138,536 Click to see attachment107,373
23 Total liabilities (add lines 17 through 22)......... 3,103,278 8,912,418
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 16,137,310 9,575,907
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 16,137,310 9,575,907
30 Total liabilities and net assets/fund balances (see instructions). 19,240,588 18,488,325
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
16,137,310
2
Enter amount from Part I, line 27a .....................
2
-7,561,404
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
1,000,001
4
Add lines 1, 2, and 3 ..........................
4
9,575,907
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
9,575,907
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a PIMCO 28,089.89 SHARES P 2011-03-31 2020-05-20
b VANGUARD MID CAP 2,592.29 P 2007-12-31 2020-08-04
c VANGUARD SMALL CAP 1,344 P 2007-12-31 2020-08-04
d VANGUARD INSTL INDEX 931 P 1997-05-29 2020-08-04
e VANGUARD MID CAP 2,744.7 P 2007-12-31 2020-11-30
VANGUARD SMALL CAP 1,146 P 2007-12-31 2020-11-30
VANGUARD INSTL INDEX 771 P 2007-12-31 2020-11-30
LONG TERM CAPITAL GAIN DISTRIBUTION P    
SHORT TERM CAPITAL GAIN DISTRIBUTION P    
TGI HOLDINGS, INC. DISSOLUTION P 2011-12-30 2020-12-15
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 300,000   300,597 -597
b 125,000   57,858 67,142
c 100,000   47,671 52,329
d 275,000   99,023 175,977
e 150,000   61,518 88,482
100,000   40,813 59,187
250,000   82,688 167,312
      118,951
      84,032
    1,000,000 -1,000,000
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       -597
b       67,142
c       52,329
d       175,977
e       88,482
      59,187
      167,312
      118,951
      84,032
      -1,000,000
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 -187,185
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3 84,032
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 7,290
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 7,290
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 7,290
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 13,000
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 6,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 19,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 11,710
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet11,710 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletHI
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.HMSAFOUNDATION.ORG
    14
    The books are in care ofbulletMARCUS CHUN Telephone no.bullet (808) 948-5145

    Located atbullet818 KEEAUMOKU STREETHONOLULUHI ZIP+4bullet96814
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
    0
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
     
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2020.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    MARK MUGIISHI PRESIDENT
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    KATHRYN MATAYOSHI VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    GINA L MARTING TREASURER
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    MICHAEL BRODERICK DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    HELEN COX DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    KASHA HO DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    KEAWE AIMOKU KAHOLOKULA DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    KENNETH NAKAMURA DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    RICHARD TAAFEE DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    GAVIN THORNTON DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    LINDA EZUKA DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    BRANDEE MENINO DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    LESILE WIKLINS DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    AMY ASSELBAYE EXECUTIVE DIRECTOR
    40.00     		98,034 3,758 0
    PO BOX 860
    HONOLULU,HI96808
    KAIPO KAUKAHIKO PROGRAM OFFICE
    40.00     		93,852 3,764 0
    PO BOX 860
    HONOLULU,HI96808
    MERYAM LEONG ADMINISTRATOR
    40.00     		71,303 4,276 0
    PO BOX 860
    HONOLULU,HI96808
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    23,580,571
    b
    Average of monthly cash balances.......................
    1b
    227,301
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    23,807,872
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    23,807,872
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    357,118
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    23,450,754
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    1,172,538
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    1,172,538
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    7,290
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    7,290
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,165,248
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    3,758
    5
    Add lines 3 and 4............................
    5
    1,169,006
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    1,169,006
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    1,179,071
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    1,179,071
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    1,179,071
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2019     		(c)
    2019     		(d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7 1,169,006
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only....... 1,097,133
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2020:
    a From 2015......  
    b From 2016......  
    c From 2017......  
    d From 2018......  
    e From 2019......  
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 1,179,071
    a Applied to 2019, but not more than line 2a 1,097,133
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2020 distributable amount..... 81,938
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2020. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		1,087,068
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2016....  
    b Excess from 2017....  
    c Excess from 2018....  
    d Excess from 2019....  
    e Excess from 2020....  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    HMSA FOUNDATION
    PO BOX 860
    HONOLULU,HI96808
    (808) 948-5145
    bThe form in which applications should be submitted and information and materials they should include:
    SEE STATEMENT 12
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    SEE STATEMENT 13
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    HANA RETREAT
    4224 HANA HIGHWAY
    HANA,HI96713     		  PC THE 'WAHINE LEADER HUI" IS A PEER SUPPORT NETWORK ANDLEARNING COMMUNITY FOR WOMEN WHO ARE FIRST-TIME NONPROFITLEADERS EARLY IN THEIR TENURE. INVITED PARTICIPANTS ARE LEADINGNONPROFITS WHO LIFT UP THE HEALTH OF OUR LAND. FAMILIES ANDISLAND COMMUNITIES. RETREATS WILL BLEND CONNECTION TOLAND AND COMMUNITY WHERE WE GATHER, PEER SUPPORTFOR EACH OTHER'S WORK, MENTORING LEARNINGOPPORTUNITIES AROUND NONPROFIT MANAGEMENT ANDLEADERSHIP, DEDICATED WORK TIME, REST AND FUN. 5,000
    HAWAII INSTITUTE OF PACIFIC AGRICULTURE
    PO BOX 497
    KAPAAU,HI96755     		  PC ON JANUARY 15. 2020, HAWAII INSTITUTE OF PACIFIC AGRICULTURETOOK SIX HIGH SCHOOL STUDENTS AND THREE TEACHERS TOPARTICIPATE IN THE STATE CAPITAL OPENING DAY OF THELEGISLATIVE SESSION. THE STUDENTS SPENT TIMECONNECTING WITH THEIR DISTRICT SENATORS AND REPRESENTATIVESAND LEARNING ABOUT CIVICS. 2,630
    FIVE MOUNTAINS HAWAII
    64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC PROVIDE BIO-PSYCHO-SOCIAL SERVICES TO ADDRESS THE DISPARITIESTHAT EXIST AMONG NORTH HAWAII NATIVE HAWAIIANS AND THEIRFAMILY. 100,000
    HAWAIIAN COMMUNITY ASSETS INC
    2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC BUILD THE CAPACITY OF LOW- AND MODERATE-INCOMECOMMUNITIES TO ACHIEVE AND SUSTAIN ECONOMIC SELF-SUFFICIENCYWITH A PARTICULAR FOCUS ON NATIVE HAWAIIANS THROUGHMORTGAGE LENDING PROGRAMS; MICRO-LOANS, HOMEOWNERSHIPASSET BUILDING, AND FINANCIAL EDUCATION; AND TRAINING FORTRANSITIONAL HOUSING AND COMMUNITY BASED ORGANIZATIONSEDUCATION AND FINANCIAL INSTITUTIONS AND GOVERNMENT ENTITIES. 65,000
    FAMILY VIOLENCE AND SEXUAL ASSAULT INSTITUTE
    10065 OLD GROVE RD STE 101
    SAN DIEGO,CA92131     		  PC KAHAUIKI VILLAGE (KV) IS A UNIQUE PERMANENT HOUSING PROJECT THAT ADDRESSES GENERATIONAL HOMELESSNESS, WITH A GOAL TO MITIGATE ADVERSE CHILDHOOD EXPERIENCES AND TRAUMA THAT MANY HOMELESS CHILDREN AND FAMILIES FACE. THEY SEEK TO BUILD RESILIENCE BY FOSTERING A NEIGHBORHOOD CULTURE THAT AFFORDS OPPORTUNITIES FOR PRO-SOCIAL EXPERIENCES. THEY HOPE THAT THEIR EFFORTS SUPPORT THE GOAL THAT THEIR FAMILIES CAN LEAD PRODUCTIVE AND FULFILLING LIVES TO BREAK THE CYCLE OF INTERGENERATIONAL TRAUMA. DESIGN AND IMPLEMENT PROGRAM EVALUATION TO TRACK OUTCOMES FOR KV FAMILIES AND CHILDREN SERVED THROUGH THEPROJECT AND ESTABLISH FEEDBACK LOOPS TO CONTINUOUSLY IMPROVE CLIENT SERVICES, CONTENT, AND DELIVERY. EVALUATION WILL UTILIZE A MIXED METHODS APPROACH, COLLECTING BOTH QUANTITATIVE AND QUALITATIVE DATA TO CAPTURE THE DIVERSE PERSPECTIVES OF CLIENT FAMILIES, PROGRAM STAFF, AND ALLIED PROVIDERS. 15,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
    2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC SERVE COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGHSTRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH ANDHARMONY THROUGH TWO PROGRAMS, HO'OULU 'AINA ANDROOT'S. THE PROGRAMS PROVIDED WRAPAROUND SUPPORT,SUPPLIES, FRESH PRODUCE, MEALS AND MEDICINE TO PATIENTSDURING THE 2020 COVID PANDEMIC. 100,000
    IMUA FAMILY SERVICES
    161 SOUTH WAKEA AVE
    KAHULUI,HI96732     		  PC GROUP LEARNING OPPORTUNITIES FOR KEIKI AND FAMILIES ENROLLED INAUTISM SERVICES AT LMUA FAMILY SERVICES. SOCIAL, PEERINTEGRATION GROUPS SUCH AS TODDLERS WITH AUTISM SPECTRUMDISORDER (ASD) ENTERING PRESCHOOL AND KINDERGARTEN ARE MUCHNEEDED GROUPS THAT FALL OUTSIDE THE TYPICAL SCOPE OF SERVICEDELIVERY YET HAVE A HUGE IMPACT ON CHILDREN'S ABILITIES TOSUCCEED AS THEY MOVE INTO EDUCATION AND EARLY CHILDHOODSETTINGS. ALSO, FAMILY SUPPORT AND TRAINING. COACHING ANDMENTORING ARE CRITICAL TO THE FAMILY SUPPORT OF CHILDREN WITHASD. CURRENTLY, THESE GROUP LED ACTIVITIES FALL OUTSIDE OFBILLING INSURANCE SUPPORT FOR CHILDREN AND FAMILIES WITH ASDBUT ARE CRITICAL TO THEIR ABILITY TO THRIVE IN COMMUNITY ANDEDUCATION. 10,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT
    47-200 WAIHEE RD
    KANEOHE,HI96744     		  PC "KEY PROJECT". NURTURE AND PROMOTE THE CULTURAL,ENVIRONMENTAL, SOCIAL, ECONOMIC AND RECREATIONAL WELL-BEINGOF THE KUALOA-HEEIA AREA BY PROVIDING VITAL GRASSROOTS CIVICPROGRAMS AND RESOURCES THAT EFFECTIVELY SERVE THE NEEDS OFTHE DIVERSE MULTI-CULTURAL COMMUNITY. 75,000
    KUMANO I KE ALA
    P0 BOX 181
    WAIMEA,HI97696     		  PC KUMANO I KE ALA (KIKA) WILL BUILD A FOUNDATION OFSTEWARDSHIP OF THE LAND AND PLACE THROUGH NATIVEHAWAIIAN CULTURAL EDUCATION PROGRAMS TO GROWSELF-DIRECTED, CRITICAL THINKERS FOR A SUSTAINABLE WEST KAUAI.KIKA'S PROGRAM FOCUS IS LAND RESTORATION, TARO FARMING,FOOD SECURITY, AND YOUTH EMPOWERMENT 80,000
    MA KA HANA KA IKE
    P0 BOX 968
    HANA,HI96713     		  PC MA KA HANA KA IKE (MKH) WILL PROVIDE HANA YOUTH WITHA WAY TO LEARN THAT MAKES SENSE TO THEM, THAT BUILDSTHEIR SELF-ESTEEM AND SHOWS THEM THEY HAVE THE POWERTO CHANGE THEIR FUTURE 95,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS
    30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC KEEP CHILDREN SAFE AND SUPPORTS FAMILY WELL-BEING THROUGHPRIMARY PREVENTION EDUCATION. WORK IN MOLOKAI SCHOOLSON THREE AREAS: PRIMARY PREVENTION EDUCATION, ADVOCACYAND EVALUATION, AND IMPACT. 50,000
    PARTNERS IN DEVELOPMENT FOUNDATION
    2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THEOVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII.PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATIONTRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS,PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIALSERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 50,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC SUPPORT DISTRIBUTION OF THE SAFEST AND HIGHEST FOODFOR HAWAII COUNTY THROUGH THEIR FOOD BANK SITES AS WELL ASTHROUGH OUTREACH PROGRAMS AND PANTRY FOR SENIOR CITIZENS,FOOD BACK PACKS FOR CHILDREN, COMMUNITY SUPPORTEDAGRICULTURE BOXES, BUS MOBILE MARKET. AND FARMERS MARKET 75,000
    YWCA OF OAHU
    1040 RICHARDS ST
    HONOLULU,HI96813     		  PC SUPPORT THE FERNHURST STRATEGIC PLANNING PROGRAM.THE CURRENT COMMUNITY-BASED FURLOUGH PROGRAM IS THE ONLYFEMALE RE-ENTRY PROGRAM IN THE STATE AND SO THERE IS ACHALLENGE TO REMAIN VIGILANT TO THE MISSION AND POPULATION WESERVE WHILE STILL ENSURING THE PROGRAM REMAINS FINANCIALLYSUSTAINABLE. YWCA O'AHU SEEKS ADDITIONAL SUPPORT FROMEXTERNAL PARTNERS AND CONSULTANTS TO HELP STRATEGIZE WAYS TOCONTINUE TO SERVE THE JUSTICE-INVOLVED POPULATION ANDECONOMICALLY DISADVANTAGED WOMEN. 12,000
    HELPING HANDS HAWAII
    2100 N NIMITZ HWY
    HONOLULU,HI96819     		  PC STAFF DEVELOPMENT FOR LEADERSHIP TEAM TO IMPROVEAND INSPIRE EFFICIENT AND EFFECTIVE OPERATIONS THAT WILLTRANSLATE INTO IMPROVING ABILITY TO SERVICE THE COMMUNITY. 3,500
    WAIMANALO HEALTH CENTER
    41-1347 KALANIANAOLE HWY
    WAIMANALO,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY ANDPREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TOTHE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLYUNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE ANDPROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALINGGARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERSWITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINALGARDENS AND ALSO PROVIDES REMEDIES THROUGHTHE PROVISION OF HEALING SERVICES AND CLASSES 100,000
    LANAI COMMUNITY HEALTH CENTER
    P0 BOX 630142
    LANAI CITY,HI96763     		  PC LANAI HIGH AND ELEMENTARY SCHOOL EDUCATION ANDPHYSICAL EDUCATION SCHOOL PROGRAM. DEVELOP A TRUSTINGRELATIONSHIP WITH THE YOUTH; PROVIDING EDUCATION ON HEALTHAND WELLNESS; AND DEVELOPMENT OF FUTURE WORKFORCE. ACTIVITIESINCLUDE HEALTH EDUCATION, SCREENING PROGRAMS, PARTICIPATIONIN COLLEGE AND CAREER FAIRS AND OUTREACH AT SCHOOLEVENTS/CARNIVALS. 15,000
    THE WAIPA FOUNDATION
    P0 BOX 1189
    HANALEI,HI96714     		  PC SUPPORT COMMUNITY POI DAY WHICH PRODUCES AND DELIVERS POITO CRITICALLY ILL AND OTHER AT RISK COMMUNITY MEMBERS. RENOVATEWEBSITE. STRATEGIC PLAN UPDATE. 15,000
    YMCA OF HONOLULU
    1441 PALI HWY
    HONOLULU,HI96813     		  PC PROVIDE 5,100 USDA REIMBURSABLE MEALS PER WEEK FROMJULY 29 - 31, 2020 TO CHILDREN AND TEENS FROM LOW INCOMEHOUSEHOLDS WHO ARE ELIGIBLE FOR FREE SCHOOL LUNCHES. 10,441
    WAIANAE COMMUNITY RE-DEVELOPMENT CORPORATION
    P0 BOX 441
    WAIANAE,HI96792     		  PC DEVELOP COMMUNITY HEALTH HUBS (CHHS) TO EMPOWERCOMMUNITY-BASED ORGANIZATIONS (CBOS) WITH RIGOROUS,SCIENTIFICALLY-INFORMED METHODOLOGIES AND DATA TYPICALLYRESERVED FOR ACADEMIC RESEARCH. CHHS WILL SERVE AS A NOVELPLATFORM THAT OFFERS CBOS THE CAPACITY TO COLLECT ANDUNDERSTAND HEALTH-RELEVANT DATA FROM PARTICIPANTS OF THEIRCOMMUNITY-INITIATED PROGRAMS ALONG WITH THAT OF THEIR SOCIALNETWORK. DATA WILL BE EVALUATED IN THE CONTEXT OF THE BUILTENVIRONMENT FOR HEALTH/SOCIAL/ECONOMICS/POLICY IMPACTS BYACADEMIC CONSULTANTS, WHICH WILL BE ROUTED BACK TO THECOMMUNITY AND STAKEHOLDERS. THE INFORMATION CAN ENABLECOMMUNITY ORGANIZATIONS TO ENGAGE STAKEHOLDERS INHEALTH/WELLBEING AND POTENTIALLY PLAY A PREVIOUSLY UNRECOGNIZEDROLE IN PREVENTION 150,000
    PACIFIC SURVIVOR CENTER
    P0 BOX 3535
    HONOLULU,HI96811     		  PC DEVELOP SHORT ANIMATIONS THAT PROVIDE SIMPLE AND ENTERTAINING EDUCATION ABOUT TRAUMA-INFORMED CARE AS WELL AS THE NEUROBIOLOGY OF TRAUMA, RESILIENCE, MENTAL ILLNESS, AND ADDICTION. THE GOAL IS TO IMPROVE UNDERSTANDINGABOUT TRAUMA, ADDICTION, AND MENTAL HEALTH DISORDERS;INCREASE COMPASSION FOR THOSE IMPACTED BY TRAUMA; ANDTO PROVIDE PROFESSIONALS WITH TECHNIQUES FOR INTERACTING WITHPATIENTS, CLIENTS AND STUDENTS IN A TRAUMA-INFORMED WAY. 7,500
    ALOHA HARVEST
    3599 WAIALAE AVE 23
    HONOLULU,HI96816     		  PC A VOLUNTEER-BASED, COMMUNITY-WIDE GLEANING PROJECTBASED ON THE ANCIENT TRADITION OF COLLECTING EXCESS FRESHFOOD FROM FARMS, GARDENS, RESTAURANTS, EVEN BACKYARDAND OTHER SOURCES AND DONATING IT TO THOSE IN NEED.IT CAN REDUCE THE WASTE OF VALUABLE PRODUCE AND IT GIVESLOW-INCOME INDIVIDUALS ACCESS TO FRESH, NUTRITIOUS ANDLOCALLY GROWN FOODS NOT OFTEN AVAILABLE IN FOOD PANTRIES. 15,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC "DA BUX SNAP" PROJECT TO ENLIST NEW SNAP(SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) OUTLETS TO PROVIDE SNAP RECIPIENTS ACCESS TO AFFORDABLE HAWAIIGROWN PRODUCE. 15,000
    AHA KANE - FOUNDATION FOR THE ADVANCEMENT OF NATIVE HAWAIIAN MALES
    677 ALA MOANA BLVD STE 105
    HONOLULU,HI96813     		  PC "HE HUEWAI OLA" PROGRAM WHICH OFFERS MENTORING,INSTRUCTION AND INSPIRATION TO FAMILIES ON NATIVE HAWAIIANCULTURAL PRACTICES AND SKILLS (E.G. COOKING, CARVING, LOMI(NATIVE HAWAIIAN HEALING MASSAGE), MELE (NATIVEHAWAIIAN SONG), BUILDING PROJECTS AND OTHERS).WEEKLY WORKSHOPS PROVIDE INSTRUCTION TO IMPLEMENT THEPRACTICE WITHIN THE HOME AND FOLLOW-UP WITHPARTICIPANTS TO MONITOR PROGRESS AND PROVIDE SUPPORT ANDEVALUATE THE PROGRAM 10,000
    THE KOHALA CENTER INC
    PO BOX 437462
    KAMUELA,HI96743     		  PC "THE FULL CALABASH FUND" PROVIDES GRANTS TO HAWAII COMMUNITY-BASED ORGANIZATIONS THAT ARE PURCHASING FOOD FROM LOCAL FARMERS, RANCHERS AND FOOD PRODUCERS AND PROVIDING FOOD TO COMMUNITY MEMBERS IN NEED. 25,000
    FIVE MOUNTAINS HAWAII
    64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC GAP FUNDING FOR PROGRAMS, EQUIPMENT, MEDICAL SUPPLIES SUPPORT FOR COVID-19 PANDEMIC RELATED EXPENSES. 20,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
    2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC PURCHASE FOOD FOR THE FOOD HUB, SUPPORT LOCAL FARMERS, HIRE FARM AND AGROFORESTRY STAFF, PURCHASE FOOD AND OUTDOORKITCHEN EQUIPMENT, AND ADVOCATE FOR LONG-TERM FOODSECURITY IN THE COMMUNITY. 20,000
    EFFECTIVE PLANNING INNOVATIVE COMMUNICATION INC
    1130 N NIMITZ HWY STE C-210
    HONOLULU,HI96817     		  PC "SHARED PARENTING IN FOSTER CARE" VIDEO TO LESSEN THETRAUMA FOR PARENTS AND CHILDREN WHEN CHILDREN ARE REMOVEDAND PLACED IN FOSTER CARE. THE VIDEO AIMS TO CHANGE HEARTSAND MINDS AND SHIFT PRACTICE SO THAT FOSTER PARENTS SUPPORTBIRTH PARENT CONNECTIONS TO CHILDREN WHILE THEY ARE IN FOSTERCARE AND FAMILY RELATIONSHIPS AFTER REUNIFICATION,ADOPTION OR GUARDIANSHIP. 8,000
    HANA RETREAT
    4224 HANA HIGHWAY
    HANA,HI96713     		  PC "HANA KU/NOENOE NIGHTS" PROGRAM TO FOCUS ON MULTI-GENERATIONAL MEMBERS ON THE 'OHANA UNIT AND HOWFAMILIAL RELATIONSHIPS ARE NURTURED. 15,000
    KE KULA NUI 0 WAIMANALO
    P0 BOX 723
    WAIMANALO,HI96795     		  PC "KUKULU KAIAULU" PROGRAM TO PROVIDE AND SUPPORTCULTURALLY GROUNDED, COMMUNITY DRIVEN AND HANDS-ON PROGRAMMING AND RESEARCH THAT PROMOTE WHOLISTIC WELLNESS, MULTI-GENERATIONAL KNOWLEDGE, AND COMMUNITY CONNECTEDNESS. 15,000
    Total .................................bullet 3a 1,179,071
    bApproved for future payment
    FIVE MOUNTAINS HAWAII
    64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC PROVIDE BIO-PSYCHO-SOCIAL SERVICES TO ADDRESS THE DISPARITIES THAT EXIST AMONG NORTH HAWAII NATIVE HAWAIIANS AND THEIR FAMILY. 300,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT
    47-200 WAIHEE RD
    KANEOHE,HI96744     		  PC "KEY PROJECT". NURTURE AND PROMOTE THE CULTURAL, ENVIRONMENTAL, SOCIAL, ECONOMIC AND RECREATIONAL WELL-BEING OF THE KUALOA-HEEIA AREA BY PROVIDING VITAL GRASSROOTS CIVIC PROGRAMS AND RESOURCES THAT EFFECTIVELY SERVE THE NEEDS OF THE DIVERSE MULTI-CULTURAL COMMUNITY. 225,000
    KUMANO I KE ALA
    P O BOX 181
    WAIMEA,HI96796     		  PC KUMANO I KE ALA (KIKA) WILL BUILD A FOUNDATION OFSTEWARDSHIP OF THE LAND AND PLACE THROUGH NATIVEHAWAIIAN CULTURAL EDUCATION PROGRAMS TO GROWSELF-DIRECTED, CRITICAL THINKERS FOR A SUSTAINABLE WEST KAUAI.KIKA'S PROGRAM FOCUS IS LAND RESTORATION, TARO FARMING,FOOD SECURITY, AND YOUTH EMPOWERMENT 180,000
    MA KA HANA KA IKE
    P O BOX 968
    HANA,HI96713     		  PC MA KA HANA KA IKE (MKH) WILL PROVIDE HANA YOUTH WITHA WAY TO LEARN THAT MAKES SENSE TO THEM, THAT BUILDSTHEIR SELF-ESTEEM AND SHOWS THEM THEY HAVE THE POWERTO CHANGE THEIR FUTURE 225,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC SUPPORT DISTRIBUTION OF THE SAFEST AND HIGHEST FOODFOR HAWAII COUNTY THROUGH THEIR FOOD BANK SITES AS WELL ASTHROUGH OUTREACH PROGRAMS AND PANTRY FOR SENIOR CITIZENS,FOOD BACK PACKS FOR CHILDREN, COMMUNITY SUPPORTEDAGRICULTURE BOXES, BUS MOBILE MARKET. AND FARMERS MARKET 225,000
    WAIMANALO HEALTH CENTER
    41-1347 KALANIANAOLE HWY
    WAIMANALO,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY ANDPREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TOTHE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLYUNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE ANDPROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALINGGARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERSWITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINALGARDENS AND ALSO PROVIDES REMEDIES THROUGHTHE PROVISION OF HEALING SERVICES AND CLASSES 300,000
    HAWAIIAN COMMUNITY ASSETS INC
    2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC BUILD THE CAPACITY OF LOW- AND MODERATE-INCOMECOMMUNITIES TO ACHIEVE AND SUSTAIN ECONOMIC SELF-SUFFICIENCYWITH A PARTICULAR FOCUS ON NATIVE HAWAIIANS THROUGHMORTGAGE LENDING PROGRAMS; MICRO-LOANS, HOMEOWNERSHIPASSET BUILDING, AND FINANCIAL EDUCATION; AND TRAINING FORTRANSITIONAL HOUSING AND COMMUNITY BASED ORGANIZATIONSEDUCATION AND FINANCIAL INSTITUTIONS AND GOVERNMENT ENTITIES. 195,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
    2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC SERVE COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGHSTRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH ANDHARMONY THROUGH TWO PROGRAMS, HO'OULU 'AINA ANDROOT'S CAF. 300,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS
    30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC KEEP CHILDREN SAFE AND SUPPORTS FAMILY WELL-BEING THROUGHPRIMARY PREVENTION EDUCATION. WORK IN MOLOKAI SCHOOLSON THREE AREAS: PRIMARY PREVENTION EDUCATION, ADVOCACYAND EVALUATION, AND IMPACT. 150,000
    PARTNERS IN DEVELOPMENT FOUNDATION
    2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THEOVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII.PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATIONTRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS,PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIALSERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 150,000
    WAIANAE COMMUNITY RE-DEVELOPMENT CORPORATION
    P O BOX 441
    WAIANAE,HI96792     		  PC DEVELOP COMMUNITY HEALTH HUBS (CHHS) TO EMPOWERCOMMUNITY-BASED ORGANIZATIONS (CBOS) WITH RIGOROUS,SCIENTIFICALLY-INFORMED METHODOLOGIES AND DATA TYPICALLYRESERVED FOR ACADEMIC RESEARCH. CHHS WILL SERVE AS A NOVELPLATFORM THAT OFFERS CBOS THE CAPACITY TO COLLECT ANDUNDERSTAND HEALTH-RELEVANT DATA FROM PARTICIPANTS OF THEIRCOMMUNITY-INITIATED PROGRAMS ALONG WITH THAT OF THEIR SOCIALNETWORK. DATA WILL BE EVALUATED IN THE CONTEXT OF THE BUILTENVIRONMENT FOR HEALTH/SOCIAL/ECONOMICS/POLICY IMPACTS BYACADEMIC CONSULTANTS, WHICH WILL BE ROUTED BACK TO THECOMMUNITY AND STAKEHOLDERS. THE INFORMATION CAN ENABLECOMMUNITY ORGANIZATIONS TO ENGAGE STAKEHOLDERS INHEALTH/WELLBEING AND POTENTIALLY PLAY A PREVIOUSLY UNRECOGNIZEDROLE IN PREVENTION 600,000
    Total .................................bullet 3b 2,850,000
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 321  
    4 Dividends and interest from securities....     14 523,637  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....     14 492  
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 -187,185  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 337,265 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    337,265
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    HAWAII MEDICAL SERVICE ASSOCIATION (HMSA) 501(C)(4) THE FOUNDATION IS ORGANIZED AND OPERATED FOR THE PRIMARY PURPOSE OF ENGAGING IN HEALTH PROMOTION, EDUCATION AND RESEARCH ACTIVITIES WITHIN THE MEANING OF IRC SECTION 170(C)(2).
    HAWAII MEDICAL SERVICE ASSOCIATION RETIREE HEALTH BENEFITS TRUST 501(C)(9) THE TRUST WAS ESTABLISHED BY HMSA ("EMPLOYER") TO FUND THE COST OF POST-RETIREMENT MEDICAL BENEFITS FOR ELIGIBLE EMPLOYEES AND DEPENDENTS.
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2020)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    Form 990PF Part XV Line 3 - Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    HANA RETREAT4224 HANA HIGHWAY
    HANA,HI96713     		  PC THE 'WAHINE LEADER HUI" IS A PEER SUPPORT NETWORK ANDLEARNING COMMUNITY FOR WOMEN WHO ARE FIRST-TIME NONPROFITLEADERS EARLY IN THEIR TENURE. INVITED PARTICIPANTS ARE LEADINGNONPROFITS WHO LIFT UP THE HEALTH OF OUR LAND. FAMILIES ANDISLAND COMMUNITIES. RETREATS WILL BLEND CONNECTION TOLAND AND COMMUNITY WHERE WE GATHER, PEER SUPPORTFOR EACH OTHER'S WORK, MENTORING LEARNINGOPPORTUNITIES AROUND NONPROFIT MANAGEMENT ANDLEADERSHIP, DEDICATED WORK TIME, REST AND FUN. 5,000
    HAWAII INSTITUTE OF PACIFIC AGRICULTUREPO BOX 497
    KAPAAU,HI96755     		  PC ON JANUARY 15. 2020, HAWAII INSTITUTE OF PACIFIC AGRICULTURETOOK SIX HIGH SCHOOL STUDENTS AND THREE TEACHERS TOPARTICIPATE IN THE STATE CAPITAL OPENING DAY OF THELEGISLATIVE SESSION. THE STUDENTS SPENT TIMECONNECTING WITH THEIR DISTRICT SENATORS AND REPRESENTATIVESAND LEARNING ABOUT CIVICS. 2,630
    FIVE MOUNTAINS HAWAII64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC PROVIDE BIO-PSYCHO-SOCIAL SERVICES TO ADDRESS THE DISPARITIESTHAT EXIST AMONG NORTH HAWAII NATIVE HAWAIIANS AND THEIRFAMILY. 100,000
    HAWAIIAN COMMUNITY ASSETS INC2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC BUILD THE CAPACITY OF LOW- AND MODERATE-INCOMECOMMUNITIES TO ACHIEVE AND SUSTAIN ECONOMIC SELF-SUFFICIENCYWITH A PARTICULAR FOCUS ON NATIVE HAWAIIANS THROUGHMORTGAGE LENDING PROGRAMS; MICRO-LOANS, HOMEOWNERSHIPASSET BUILDING, AND FINANCIAL EDUCATION; AND TRAINING FORTRANSITIONAL HOUSING AND COMMUNITY BASED ORGANIZATIONSEDUCATION AND FINANCIAL INSTITUTIONS AND GOVERNMENT ENTITIES. 65,000
    FAMILY VIOLENCE AND SEXUAL ASSAULT INSTITUTE10065 OLD GROVE RD STE 101
    SAN DIEGO,CA92131     		  PC KAHAUIKI VILLAGE (KV) IS A UNIQUE PERMANENT HOUSING PROJECT THAT ADDRESSES GENERATIONAL HOMELESSNESS, WITH A GOAL TO MITIGATE ADVERSE CHILDHOOD EXPERIENCES AND TRAUMA THAT MANY HOMELESS CHILDREN AND FAMILIES FACE. THEY SEEK TO BUILD RESILIENCE BY FOSTERING A NEIGHBORHOOD CULTURE THAT AFFORDS OPPORTUNITIES FOR PRO-SOCIAL EXPERIENCES. THEY HOPE THAT THEIR EFFORTS SUPPORT THE GOAL THAT THEIR FAMILIES CAN LEAD PRODUCTIVE AND FULFILLING LIVES TO BREAK THE CYCLE OF INTERGENERATIONAL TRAUMA. DESIGN AND IMPLEMENT PROGRAM EVALUATION TO TRACK OUTCOMES FOR KV FAMILIES AND CHILDREN SERVED THROUGH THEPROJECT AND ESTABLISH FEEDBACK LOOPS TO CONTINUOUSLY IMPROVE CLIENT SERVICES, CONTENT, AND DELIVERY. EVALUATION WILL UTILIZE A MIXED METHODS APPROACH, COLLECTING BOTH QUANTITATIVE AND QUALITATIVE DATA TO CAPTURE THE DIVERSE PERSPECTIVES OF CLIENT FAMILIES, PROGRAM STAFF, AND ALLIED PROVIDERS. 15,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC SERVE COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGHSTRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH ANDHARMONY THROUGH TWO PROGRAMS, HO'OULU 'AINA ANDROOT'S. THE PROGRAMS PROVIDED WRAPAROUND SUPPORT,SUPPLIES, FRESH PRODUCE, MEALS AND MEDICINE TO PATIENTSDURING THE 2020 COVID PANDEMIC. 100,000
    IMUA FAMILY SERVICES161 SOUTH WAKEA AVE
    KAHULUI,HI96732     		  PC GROUP LEARNING OPPORTUNITIES FOR KEIKI AND FAMILIES ENROLLED INAUTISM SERVICES AT LMUA FAMILY SERVICES. SOCIAL, PEERINTEGRATION GROUPS SUCH AS TODDLERS WITH AUTISM SPECTRUMDISORDER (ASD) ENTERING PRESCHOOL AND KINDERGARTEN ARE MUCHNEEDED GROUPS THAT FALL OUTSIDE THE TYPICAL SCOPE OF SERVICEDELIVERY YET HAVE A HUGE IMPACT ON CHILDREN'S ABILITIES TOSUCCEED AS THEY MOVE INTO EDUCATION AND EARLY CHILDHOODSETTINGS. ALSO, FAMILY SUPPORT AND TRAINING. COACHING ANDMENTORING ARE CRITICAL TO THE FAMILY SUPPORT OF CHILDREN WITHASD. CURRENTLY, THESE GROUP LED ACTIVITIES FALL OUTSIDE OFBILLING INSURANCE SUPPORT FOR CHILDREN AND FAMILIES WITH ASDBUT ARE CRITICAL TO THEIR ABILITY TO THRIVE IN COMMUNITY ANDEDUCATION. 10,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT47-200 WAIHEE RD
    KANEOHE,HI96744     		  PC "KEY PROJECT". NURTURE AND PROMOTE THE CULTURAL,ENVIRONMENTAL, SOCIAL, ECONOMIC AND RECREATIONAL WELL-BEINGOF THE KUALOA-HEEIA AREA BY PROVIDING VITAL GRASSROOTS CIVICPROGRAMS AND RESOURCES THAT EFFECTIVELY SERVE THE NEEDS OFTHE DIVERSE MULTI-CULTURAL COMMUNITY. 75,000
    KUMANO I KE ALAP0 BOX 181
    WAIMEA,HI97696     		  PC KUMANO I KE ALA (KIKA) WILL BUILD A FOUNDATION OFSTEWARDSHIP OF THE LAND AND PLACE THROUGH NATIVEHAWAIIAN CULTURAL EDUCATION PROGRAMS TO GROWSELF-DIRECTED, CRITICAL THINKERS FOR A SUSTAINABLE WEST KAUAI.KIKA'S PROGRAM FOCUS IS LAND RESTORATION, TARO FARMING,FOOD SECURITY, AND YOUTH EMPOWERMENT 80,000
    MA KA HANA KA IKEP0 BOX 968
    HANA,HI96713     		  PC MA KA HANA KA IKE (MKH) WILL PROVIDE HANA YOUTH WITHA WAY TO LEARN THAT MAKES SENSE TO THEM, THAT BUILDSTHEIR SELF-ESTEEM AND SHOWS THEM THEY HAVE THE POWERTO CHANGE THEIR FUTURE 95,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC KEEP CHILDREN SAFE AND SUPPORTS FAMILY WELL-BEING THROUGHPRIMARY PREVENTION EDUCATION. WORK IN MOLOKAI SCHOOLSON THREE AREAS: PRIMARY PREVENTION EDUCATION, ADVOCACYAND EVALUATION, AND IMPACT. 50,000
    PARTNERS IN DEVELOPMENT FOUNDATION2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THEOVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII.PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATIONTRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS,PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIALSERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 50,000
    THE FOOD BASKET INC80 HOLOMUA ST
    HILO,HI96720     		  PC SUPPORT DISTRIBUTION OF THE SAFEST AND HIGHEST FOODFOR HAWAII COUNTY THROUGH THEIR FOOD BANK SITES AS WELL ASTHROUGH OUTREACH PROGRAMS AND PANTRY FOR SENIOR CITIZENS,FOOD BACK PACKS FOR CHILDREN, COMMUNITY SUPPORTEDAGRICULTURE BOXES, BUS MOBILE MARKET. AND FARMERS MARKET 75,000
    YWCA OF OAHU1040 RICHARDS ST
    HONOLULU,HI96813     		  PC SUPPORT THE FERNHURST STRATEGIC PLANNING PROGRAM.THE CURRENT COMMUNITY-BASED FURLOUGH PROGRAM IS THE ONLYFEMALE RE-ENTRY PROGRAM IN THE STATE AND SO THERE IS ACHALLENGE TO REMAIN VIGILANT TO THE MISSION AND POPULATION WESERVE WHILE STILL ENSURING THE PROGRAM REMAINS FINANCIALLYSUSTAINABLE. YWCA O'AHU SEEKS ADDITIONAL SUPPORT FROMEXTERNAL PARTNERS AND CONSULTANTS TO HELP STRATEGIZE WAYS TOCONTINUE TO SERVE THE JUSTICE-INVOLVED POPULATION ANDECONOMICALLY DISADVANTAGED WOMEN. 12,000
    HELPING HANDS HAWAII2100 N NIMITZ HWY
    HONOLULU,HI96819     		  PC STAFF DEVELOPMENT FOR LEADERSHIP TEAM TO IMPROVEAND INSPIRE EFFICIENT AND EFFECTIVE OPERATIONS THAT WILLTRANSLATE INTO IMPROVING ABILITY TO SERVICE THE COMMUNITY. 3,500
    WAIMANALO HEALTH CENTER41-1347 KALANIANAOLE HWY
    WAIMANALO,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY ANDPREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TOTHE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLYUNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE ANDPROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALINGGARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERSWITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINALGARDENS AND ALSO PROVIDES REMEDIES THROUGHTHE PROVISION OF HEALING SERVICES AND CLASSES 100,000
    LANAI COMMUNITY HEALTH CENTERP0 BOX 630142
    LANAI CITY,HI96763     		  PC LANAI HIGH AND ELEMENTARY SCHOOL EDUCATION ANDPHYSICAL EDUCATION SCHOOL PROGRAM. DEVELOP A TRUSTINGRELATIONSHIP WITH THE YOUTH; PROVIDING EDUCATION ON HEALTHAND WELLNESS; AND DEVELOPMENT OF FUTURE WORKFORCE. ACTIVITIESINCLUDE HEALTH EDUCATION, SCREENING PROGRAMS, PARTICIPATIONIN COLLEGE AND CAREER FAIRS AND OUTREACH AT SCHOOLEVENTS/CARNIVALS. 15,000
    THE WAIPA FOUNDATIONP0 BOX 1189
    HANALEI,HI96714     		  PC SUPPORT COMMUNITY POI DAY WHICH PRODUCES AND DELIVERS POITO CRITICALLY ILL AND OTHER AT RISK COMMUNITY MEMBERS. RENOVATEWEBSITE. STRATEGIC PLAN UPDATE. 15,000
    YMCA OF HONOLULU1441 PALI HWY
    HONOLULU,HI96813     		  PC PROVIDE 5,100 USDA REIMBURSABLE MEALS PER WEEK FROMJULY 29 - 31, 2020 TO CHILDREN AND TEENS FROM LOW INCOMEHOUSEHOLDS WHO ARE ELIGIBLE FOR FREE SCHOOL LUNCHES. 10,441
    WAIANAE COMMUNITY RE-DEVELOPMENT CORPORATIONP0 BOX 441
    WAIANAE,HI96792     		  PC DEVELOP COMMUNITY HEALTH HUBS (CHHS) TO EMPOWERCOMMUNITY-BASED ORGANIZATIONS (CBOS) WITH RIGOROUS,SCIENTIFICALLY-INFORMED METHODOLOGIES AND DATA TYPICALLYRESERVED FOR ACADEMIC RESEARCH. CHHS WILL SERVE AS A NOVELPLATFORM THAT OFFERS CBOS THE CAPACITY TO COLLECT ANDUNDERSTAND HEALTH-RELEVANT DATA FROM PARTICIPANTS OF THEIRCOMMUNITY-INITIATED PROGRAMS ALONG WITH THAT OF THEIR SOCIALNETWORK. DATA WILL BE EVALUATED IN THE CONTEXT OF THE BUILTENVIRONMENT FOR HEALTH/SOCIAL/ECONOMICS/POLICY IMPACTS BYACADEMIC CONSULTANTS, WHICH WILL BE ROUTED BACK TO THECOMMUNITY AND STAKEHOLDERS. THE INFORMATION CAN ENABLECOMMUNITY ORGANIZATIONS TO ENGAGE STAKEHOLDERS INHEALTH/WELLBEING AND POTENTIALLY PLAY A PREVIOUSLY UNRECOGNIZEDROLE IN PREVENTION 150,000
    PACIFIC SURVIVOR CENTERP0 BOX 3535
    HONOLULU,HI96811     		  PC DEVELOP SHORT ANIMATIONS THAT PROVIDE SIMPLE AND ENTERTAINING EDUCATION ABOUT TRAUMA-INFORMED CARE AS WELL AS THE NEUROBIOLOGY OF TRAUMA, RESILIENCE, MENTAL ILLNESS, AND ADDICTION. THE GOAL IS TO IMPROVE UNDERSTANDINGABOUT TRAUMA, ADDICTION, AND MENTAL HEALTH DISORDERS;INCREASE COMPASSION FOR THOSE IMPACTED BY TRAUMA; ANDTO PROVIDE PROFESSIONALS WITH TECHNIQUES FOR INTERACTING WITHPATIENTS, CLIENTS AND STUDENTS IN A TRAUMA-INFORMED WAY. 7,500
    ALOHA HARVEST3599 WAIALAE AVE 23
    HONOLULU,HI96816     		  PC A VOLUNTEER-BASED, COMMUNITY-WIDE GLEANING PROJECTBASED ON THE ANCIENT TRADITION OF COLLECTING EXCESS FRESHFOOD FROM FARMS, GARDENS, RESTAURANTS, EVEN BACKYARDAND OTHER SOURCES AND DONATING IT TO THOSE IN NEED.IT CAN REDUCE THE WASTE OF VALUABLE PRODUCE AND IT GIVESLOW-INCOME INDIVIDUALS ACCESS TO FRESH, NUTRITIOUS ANDLOCALLY GROWN FOODS NOT OFTEN AVAILABLE IN FOOD PANTRIES. 15,000
    THE FOOD BASKET INC80 HOLOMUA ST
    HILO,HI96720     		  PC "DA BUX SNAP" PROJECT TO ENLIST NEW SNAP(SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) OUTLETS TO PROVIDE SNAP RECIPIENTS ACCESS TO AFFORDABLE HAWAIIGROWN PRODUCE. 15,000
    AHA KANE - FOUNDATION FOR THE ADVANCEMENT OF NATIVE HAWAIIAN MALES677 ALA MOANA BLVD STE 105
    HONOLULU,HI96813     		  PC "HE HUEWAI OLA" PROGRAM WHICH OFFERS MENTORING,INSTRUCTION AND INSPIRATION TO FAMILIES ON NATIVE HAWAIIANCULTURAL PRACTICES AND SKILLS (E.G. COOKING, CARVING, LOMI(NATIVE HAWAIIAN HEALING MASSAGE), MELE (NATIVEHAWAIIAN SONG), BUILDING PROJECTS AND OTHERS).WEEKLY WORKSHOPS PROVIDE INSTRUCTION TO IMPLEMENT THEPRACTICE WITHIN THE HOME AND FOLLOW-UP WITHPARTICIPANTS TO MONITOR PROGRESS AND PROVIDE SUPPORT ANDEVALUATE THE PROGRAM 10,000
    THE KOHALA CENTER INCPO BOX 437462
    KAMUELA,HI96743     		  PC "THE FULL CALABASH FUND" PROVIDES GRANTS TO HAWAII COMMUNITY-BASED ORGANIZATIONS THAT ARE PURCHASING FOOD FROM LOCAL FARMERS, RANCHERS AND FOOD PRODUCERS AND PROVIDING FOOD TO COMMUNITY MEMBERS IN NEED. 25,000
    FIVE MOUNTAINS HAWAII64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC GAP FUNDING FOR PROGRAMS, EQUIPMENT, MEDICAL SUPPLIES SUPPORT FOR COVID-19 PANDEMIC RELATED EXPENSES. 20,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC PURCHASE FOOD FOR THE FOOD HUB, SUPPORT LOCAL FARMERS, HIRE FARM AND AGROFORESTRY STAFF, PURCHASE FOOD AND OUTDOORKITCHEN EQUIPMENT, AND ADVOCATE FOR LONG-TERM FOODSECURITY IN THE COMMUNITY. 20,000
    EFFECTIVE PLANNING INNOVATIVE COMMUNICATION INC1130 N NIMITZ HWY STE C-210
    HONOLULU,HI96817     		  PC "SHARED PARENTING IN FOSTER CARE" VIDEO TO LESSEN THETRAUMA FOR PARENTS AND CHILDREN WHEN CHILDREN ARE REMOVEDAND PLACED IN FOSTER CARE. THE VIDEO AIMS TO CHANGE HEARTSAND MINDS AND SHIFT PRACTICE SO THAT FOSTER PARENTS SUPPORTBIRTH PARENT CONNECTIONS TO CHILDREN WHILE THEY ARE IN FOSTERCARE AND FAMILY RELATIONSHIPS AFTER REUNIFICATION,ADOPTION OR GUARDIANSHIP. 8,000
    HANA RETREAT4224 HANA HIGHWAY
    HANA,HI96713     		  PC "HANA KU/NOENOE NIGHTS" PROGRAM TO FOCUS ON MULTI-GENERATIONAL MEMBERS ON THE 'OHANA UNIT AND HOWFAMILIAL RELATIONSHIPS ARE NURTURED. 15,000
    KE KULA NUI 0 WAIMANALOP0 BOX 723
    WAIMANALO,HI96795     		  PC "KUKULU KAIAULU" PROGRAM TO PROVIDE AND SUPPORTCULTURALLY GROUNDED, COMMUNITY DRIVEN AND HANDS-ON PROGRAMMING AND RESEARCH THAT PROMOTE WHOLISTIC WELLNESS, MULTI-GENERATIONAL KNOWLEDGE, AND COMMUNITY CONNECTEDNESS. 15,000
    Total ...............................bullet 3a 1,179,071
    bApproved for future payment
    FIVE MOUNTAINS HAWAII64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC PROVIDE BIO-PSYCHO-SOCIAL SERVICES TO ADDRESS THE DISPARITIES THAT EXIST AMONG NORTH HAWAII NATIVE HAWAIIANS AND THEIR FAMILY. 300,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT47-200 WAIHEE RD
    KANEOHE,HI96744     		  PC "KEY PROJECT". NURTURE AND PROMOTE THE CULTURAL, ENVIRONMENTAL, SOCIAL, ECONOMIC AND RECREATIONAL WELL-BEING OF THE KUALOA-HEEIA AREA BY PROVIDING VITAL GRASSROOTS CIVIC PROGRAMS AND RESOURCES THAT EFFECTIVELY SERVE THE NEEDS OF THE DIVERSE MULTI-CULTURAL COMMUNITY. 225,000
    KUMANO I KE ALAP O BOX 181
    WAIMEA,HI96796     		  PC KUMANO I KE ALA (KIKA) WILL BUILD A FOUNDATION OFSTEWARDSHIP OF THE LAND AND PLACE THROUGH NATIVEHAWAIIAN CULTURAL EDUCATION PROGRAMS TO GROWSELF-DIRECTED, CRITICAL THINKERS FOR A SUSTAINABLE WEST KAUAI.KIKA'S PROGRAM FOCUS IS LAND RESTORATION, TARO FARMING,FOOD SECURITY, AND YOUTH EMPOWERMENT 180,000
    MA KA HANA KA IKEP O BOX 968
    HANA,HI96713     		  PC MA KA HANA KA IKE (MKH) WILL PROVIDE HANA YOUTH WITHA WAY TO LEARN THAT MAKES SENSE TO THEM, THAT BUILDSTHEIR SELF-ESTEEM AND SHOWS THEM THEY HAVE THE POWERTO CHANGE THEIR FUTURE 225,000
    THE FOOD BASKET INC80 HOLOMUA ST
    HILO,HI96720     		  PC SUPPORT DISTRIBUTION OF THE SAFEST AND HIGHEST FOODFOR HAWAII COUNTY THROUGH THEIR FOOD BANK SITES AS WELL ASTHROUGH OUTREACH PROGRAMS AND PANTRY FOR SENIOR CITIZENS,FOOD BACK PACKS FOR CHILDREN, COMMUNITY SUPPORTEDAGRICULTURE BOXES, BUS MOBILE MARKET. AND FARMERS MARKET 225,000
    WAIMANALO HEALTH CENTER41-1347 KALANIANAOLE HWY
    WAIMANALO,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY ANDPREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TOTHE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLYUNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE ANDPROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALINGGARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERSWITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINALGARDENS AND ALSO PROVIDES REMEDIES THROUGHTHE PROVISION OF HEALING SERVICES AND CLASSES 300,000
    HAWAIIAN COMMUNITY ASSETS INC2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC BUILD THE CAPACITY OF LOW- AND MODERATE-INCOMECOMMUNITIES TO ACHIEVE AND SUSTAIN ECONOMIC SELF-SUFFICIENCYWITH A PARTICULAR FOCUS ON NATIVE HAWAIIANS THROUGHMORTGAGE LENDING PROGRAMS; MICRO-LOANS, HOMEOWNERSHIPASSET BUILDING, AND FINANCIAL EDUCATION; AND TRAINING FORTRANSITIONAL HOUSING AND COMMUNITY BASED ORGANIZATIONSEDUCATION AND FINANCIAL INSTITUTIONS AND GOVERNMENT ENTITIES. 195,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC SERVE COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGHSTRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH ANDHARMONY THROUGH TWO PROGRAMS, HO'OULU 'AINA ANDROOT'S CAF. 300,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC KEEP CHILDREN SAFE AND SUPPORTS FAMILY WELL-BEING THROUGHPRIMARY PREVENTION EDUCATION. WORK IN MOLOKAI SCHOOLSON THREE AREAS: PRIMARY PREVENTION EDUCATION, ADVOCACYAND EVALUATION, AND IMPACT. 150,000
    PARTNERS IN DEVELOPMENT FOUNDATION2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THEOVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII.PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATIONTRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS,PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIALSERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 150,000
    WAIANAE COMMUNITY RE-DEVELOPMENT CORPORATIONP O BOX 441
    WAIANAE,HI96792     		  PC DEVELOP COMMUNITY HEALTH HUBS (CHHS) TO EMPOWERCOMMUNITY-BASED ORGANIZATIONS (CBOS) WITH RIGOROUS,SCIENTIFICALLY-INFORMED METHODOLOGIES AND DATA TYPICALLYRESERVED FOR ACADEMIC RESEARCH. CHHS WILL SERVE AS A NOVELPLATFORM THAT OFFERS CBOS THE CAPACITY TO COLLECT ANDUNDERSTAND HEALTH-RELEVANT DATA FROM PARTICIPANTS OF THEIRCOMMUNITY-INITIATED PROGRAMS ALONG WITH THAT OF THEIR SOCIALNETWORK. DATA WILL BE EVALUATED IN THE CONTEXT OF THE BUILTENVIRONMENT FOR HEALTH/SOCIAL/ECONOMICS/POLICY IMPACTS BYACADEMIC CONSULTANTS, WHICH WILL BE ROUTED BACK TO THECOMMUNITY AND STAKEHOLDERS. THE INFORMATION CAN ENABLECOMMUNITY ORGANIZATIONS TO ENGAGE STAKEHOLDERS INHEALTH/WELLBEING AND POTENTIALLY PLAY A PREVIOUSLY UNRECOGNIZEDROLE IN PREVENTION 600,000
    Total ................................bullet 3b 2,850,000

    TY 2020 AccountingFeesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 38,317 0 0 0

    TY 2020 GeneralExplanationAttachment
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Identifier Return Reference Explanation
      PART XV, LINE 2B THE FORM IN WHICH APPLICATIONS SHOULD BE SUBMITTED AND INFORMATION AND MATERIALS THEY SHOULD INCLUDE: 1. REGISTRATION INFORMATION * ORGANIZATION INFORMATION * CONTACT INFORMATION 2. PROPOSAL ON ORGANIZATION'S LETTERHEAD (NO MORE THAN EIGHT PAGES). INCLUDE THE FOLLOWING: * STATEMENT OF NEED. WHAT IS THE DESIRED LONG-TERM EFFECT OF THE PROJECT AND WHY IS IT SO IMPORTANT THAT IT HAVE THIS EFFECT? * ACTIVITIES. WHAT WOULD BE THE KEY ACTIONS OR EVENTS DURING THE GRANT PERIOD? * OUTPUTS. WHAT ARE THE PRODUCTS OF THOSE ACTIONS OR EVENTS? * OUTCOMES. WHAT KEY CHANGES IN SKILLS, KNOWLEDGE, VALUES, ATTITUDES, BEHAVIORS, CONDITIONS, ETC. WILL RESULT FROM THE ACTIVITIES? * INDICATORS. INDICATORS, SOMETIMES CALLED EVALUATION, ARE OBSERVABLE AND MEASURABLE DATA THAT CAN BE COLLECTED TO TRACK THE SUCCESS IN ACHIEVING THE OUTCOMES. * DESCRIPTION OF THE ORGANIZATION AND ITS QUALIFICATIONS. * BUDGET. INDICATE THE AMOUNT REQUESTED, THE PROPOSED USE OF FUNDS AND OTHER SOURCES OF FUNDING CURRENTLY BEING SOUGHT. 3. COPY OF THE ORGANIZATION'S CURRENT IRS DETERMINATION LETTER INDICATING 501(C)(3) TAX-EXEMPT STATUS OR LETTER STATING STATUS AS A UNIT OF GOVERNMENT. 4. LIST OF THE ORGANIZATION'S OFFICERS AND DIRECTORS AND THEIR AFFILIATIONS. 5. MOST RECENT IRS FORM 990 AND ANNUAL FINANCIAL STATEMENTS OF THE ORGANIZATION. 6. RELEVANT LETTERS OF SUPPORT. 7. OTHER RELEVANT APPENDICES (QUALIFICATIONS OF KEY STAFF, SAMPLE PROGRAM MATERIALS, ETC.)
      PART XV, LINE 2D ANY RESTRICTIONS OR LIMITATIONS ON AWARDS, SUCH AS BY GEOGRAPHICAL AREAS, CHARITABLE FIELDS, KINDS OF INSTITUTIONS, OR OTHER FACTORS: IN GENERAL, THE FOUNDATION MAKES GRANTS TO ORGANIZATIONS THAT ARE TAX-EXEMPT BECAUSE 1) THEY ARE A UNIT OF GOVERNMENT OR 2) THEY ARE A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THE FOUNDATION DOES NOT MAKE GRANTS TO INDIVIDUALS. ALL APPLICANT ORGANIZATIONS ARE REQUIRED TO SUBMIT PROOF OF THEIR TAX-EXEMPT STATUS BEFORE THEIR PROPOSAL WILL BE CONSIDERED. THE FOUNDATION DOES NOT GENERALLY SUPPORT REQUESTS FOR ENDOWMENTS, CAPITAL CAMPAIGNS, SCHOLARSHIP FUNDS LOBBYING, OR VOTER REGISTRATION FUNDS. A MAXIMUM FLAT RATE OF 5 PERCENT OF TOTAL BUDGET WILL BE ALLOWED FOR INDIRECT COSTS. ALL PROJECTS MUST PRIMARILY BENEFIT PEOPLE WITHIN THE STATE OF HAWAII. FUNDING AMOUNTS AND GRANT PERIODS SHOULD BE COMMENSURATE WITH THE SIZE AND SCOPE OF THE ACTIVITY.

    TY 2020 InvestmentsOtherSchedule2
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    VANGUARD INSTITUTIONAL INDEX FMV 2,085,472 6,265,244
    VANGUARD DEVELPED MARKETS FMV 4,367,321 4,600,018
    VANGUARD EMERGING MARKETS FMV 2,657,507 2,907,616
    VANGUARD INDEX MID CAP FUND FMV 1,237,406 3,105,674
    VANGUARD SMALL CAP FUND FMV 1,180,412 3,069,015
    PIMCO TOTAL RETURN FUND FMV 3,229,458 3,199,707
    DOUBLELINE TOTAL RETURN FUND FMV 3,418,245 3,350,993

    TY 2020 OtherExpensesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    NON DEDUCTIBLE PROMOTION 8,167 0 0 0
    PROFESSIONAL ASSOCIATIONS 4,256 0 0 0
    MEALS 371 0 0 0
    PARKING 492 0 0 0
    POSTAGE AND FREIGHT 45 0 0 0
    DUES AND SUBSCRIPTIONS 316 0 0 0
    MISCELLANEOUS 34 0 0 0
    FAS 158 ADJUSTMENT 82,733 0 0 0


    TY 2020 OtherIncomeSchedule2
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    REFUND OF INVESTMENT FEES 492 492 0


    TY 2020 OtherIncreasesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Amount
    ROUNDING 1
    TGI HOLDINGS, INC. DISSOLUTION 1,000,000


    TY 2020 OtherLiabilitiesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Beginning of Year - Book Value End of Year - Book Value
    DUE TO AFFILIATES 29,885 11,691
    DEFERRED TAX LIABILITY 108,651 95,682


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BLACKBAUD 12,340 0 0 0
    ISLANDER INSTITUTE 42,932 0 0 0
    KOKUA KALIHI VALLEY 3,360 0 0 0


    TY 2020 TaxesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PAYROLL AND OTHER TAXES 10,238 0 0 0
    TAX ON INVESTMENT INCOME 11,357 0 0 0