Form990-PF


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. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
Cambia Health Foundation
 
% CAMBIA HEALTH SOLUTIONS INC
Number and street (or P.O. box number if mail is not delivered to street address)100 SW Market Street WW2-25
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Portland, OR97201
A Employer identification number

32-0200578
B Telephone number (see instructions)

(503) 721-4004
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$95,632,719J 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) 18,745,641
2 Check bullet.............
3 Interest on savings and temporary cash investments 27 27  
4 Dividends and interest from securities... 1,752,442 1,787,662  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,611,964
b Gross sales price for all assets on line 6a 21,465,412
7 Capital gain net income (from Part IV, line 2)... 13,402,677
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).......      
12 Total. Add lines 1 through 11........ 22,110,074 15,190,366  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0      
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 96,074     90,108
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 62,177      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 118,871     1,620
22 Printing and publications.......... 9,062     1,488
23 Other expenses (attach schedule)....... Click to see attachment 413,551 60,827   479,058
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 699,735 60,827   572,274
25 Contributions, gifts, grants paid....... 7,712,612 9,235,406
26 Total expenses and disbursements. Add lines 24 and 25 8,412,347 60,827   9,807,680
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 13,697,727
b Net investment income (if negative, enter -0-) 15,129,539
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
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............. 2,173,312 1,897,663 1,897,663
2 Savings and temporary cash investments......... 256,759 73,413 73,413
3 Accounts receivable bullet19,734,648
Less: allowance for doubtful accounts bullet   15,388,553 19,734,648 19,734,648
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..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 22,388,723 Click to see attachment23,895,947 23,895,947
c Investments—corporate bonds (attach schedule)....... 43,218,183 Click to see attachment50,031,048 50,031,048
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........      
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) 83,425,530 95,632,719 95,632,719
Liabilities 17 Accounts payable and accrued expenses.......... 29,508 38,889
18 Grants payable................. 4,440,998 2,962,500
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 attachment130,048 Click to see attachment108,627
23 Total liabilities (add lines 17 through 22)......... 4,600,554 3,110,016
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........... 78,824,976 92,522,703
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)..... 78,824,976 92,522,703
30 Total liabilities and net assets/fund balances (see instructions). 83,425,530 95,632,719
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
78,824,976
2
Enter amount from Part I, line 27a .....................
2
13,697,727
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
92,522,703
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
92,522,703
Form 990-PF (2021)
Form 990-PF (2021)
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 VARIOUS INVESTMENT FUNDS D    
b
c
d
e
(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 21,465,412   8,062,735 13,402,677
b
c
d
e
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       13,402,677
b
c
d
e
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 13,402,677
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  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
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 All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) 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  
3 Add lines 1 and 2........................... 3 210,301
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 210,301
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 72,000
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 21,000
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 93,000
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 117,301
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet   RefundedBullet 11  
Part VI-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? Click to see attachment....................
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$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
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 changesClick to see attachment....
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.Click to see attachment
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 XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletOR
    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 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    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 (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-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.CAMBIAHEALTHFOUNDATION.ORG
    14
    The books are in care ofbulletCAMBIA HEALTH SOLUTIONS INC Telephone no.bullet (503) 721-4004

    Located atbullet100 SW MARKET ST MS WW2-25PORTLANDOR ZIP+4bullet97201
    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
     
    16 At any time during calendar year 2021, 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 VI-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? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (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)? ......................
    1a(5)
     
    No
    (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.) ...............
    1a(6)
     
    No
    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
     
     
    c
    ........bullet
    d
    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 2021? .............
    1d
     
    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 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    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
     
    No
    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? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 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 2021.) .....................
    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 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-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))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    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
     
     
    c
    .........bullet
    d
    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? .................
    5d
     
     
    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? .............................
    6a
     
    No
    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?
    7a
     
    No
    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? .........................
    8
     
    No
    Part VII
    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
    Margaret M Maguire Chair & Pres. Board Member
    32.0     		0 0 0
    100 SW Market Street
    WW2-25
    Portland,OR97201
    Andreas B Ellis Treasurer
    0.25     		0 0 0
    1800 9th Ave
    Seattle,WA98101
    Lisa J Oman Secretary, Board Member
    0.25     		0 0 0
    1800 9th Ave
    Seattle,WA98101
    Anjie L Vannoy Controller, Board Member
    0.25     		0 0 0
    100 SW Market St
    WW2-25
    Portland,OR97201
    Maddie E Andrews Board Member
    0.25     		0 0 0
    100 SW Market Street WW2-25
    Portland,OR97201
    Robert M Coppedge Board Member
    0.25     		0 0 0
    1800 9th Ave
    Seattle,WA98101
    Stephen R Styles Board Member
    0.25     		0 0 0
    2890 East Cottonwood Parkway
    Salt Lake City,UT84121
    Kathleen Pitcher-Tobey Foundation Operations Director
    40.0     		0 0 0
    2890 East Cottonwood Parkway
    Salt Lake City,UT84121
    Gary H Lau Assistant Secretary
    0.25     		0 0 0
    100 SW Market Street WW2-25
    Portland,OR97201
    Tonya Adams Board Member
    0.25     		0 0 0
    100 SW Market Street WW2-25
    Portland,OR97201
    Lisa T Murphy Board Member
    0.25     		0 0 0
    100 SW Market Street WW2-25
    Portland,OR97201
    Sam Yamoah Board Member
    0.25     		0 0 0
    100 SW Market Street WW2-25
    Portland,OR97201
    Lindsay A Harris Board Member
    0.25     		0 0 0
    1800 9th Ave
    Seattle,WA98101
    Andrew J Over Board Member
    0.25     		0 0 0
    100 SW Market St MS WW2-25
    Portland,OR97201
    Mark H Ruszczyk Board Member
    0.25     		0 0 0
    1100 W Idaho Street Suite 400
    Boise,ID83702
    Leslie Foren Director Program Strategy
    40.0     		0 0 0
    100 SW Market St MS WW2-25
    Portland,OR97201
    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
     
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    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
    Future Work Design 0 59,480
    8115 SW 4th Ave
    PORTLAND,OR97219
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part VIII-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 VIII-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 NONE  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    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
    74,295,273
    b
    Average of monthly cash balances.......................
    1b
    959,987
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    75,255,260
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    75,255,260
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    1,128,829
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    74,126,431
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    3,706,322
    Part X
    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 IX, line 6..................
    1
    3,706,322
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    210,301
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    210,301
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    3,496,021
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    3,496,021
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    3,496,021
    Part XI
    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
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    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 XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 3,496,021
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:2019, 2018, 2017 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 8,717,122
    b From 2017...... 11,399,198
    c From 2018...... 9,360,302
    d From 2019...... 7,645,563
    e From 2020...... 7,208,411
    f Total of lines 3a through e ........ 44,330,596
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 9,807,680
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		 
    d Applied to 2021 distributable amount..... 3,496,021
    e Remaining amount distributed out of corpus 6,311,659
    5 Excess distributions carryover applied to 2021.    
    (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 50,642,255
    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......     		 
    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 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    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) .......     		 
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		8,717,122
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		41,925,133
    10 Analysis of line 9:
    a Excess from 2017.... 11,399,198
    b Excess from 2018.... 9,360,302
    c Excess from 2019.... 7,645,563
    d Excess from 2020.... 7,208,411
    e Excess from 2021.... 6,311,659
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-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 2021, 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) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    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 IX, 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 XIV
    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).)
    NA
    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.
    NA
    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:
    The Cambia Health Foundation
    100 SW Market St MS E15B
    Portland,OR97201
    (503) 225-5221
    bThe form in which applications should be submitted and information and materials they should include:
    See application guidelines at www.cambiahealthfoundation.org. Complete an online questionnaire for eligibility determination.
    cAny submission deadlines:
    Determined on an annual basis
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Grants are limited to non-profit organizations serving communities throughout Idaho, Oregon, Utah, and Washington.
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    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
    Beth Israel Deaconess Medical Center
    133 Brookline Avenue HVMA Annex S
    Boston,MA02115     		  PC Healthy People, Healthy Communities 100,000
    Cascadia Behavioral Healthcare
    847 NE 19th Ave Suite 100
    Portland,OR97232     		  PC Healthy People, Healthy Communities 10,000
    City of Hope
    1500 E Duarte Road
    Duarte,CA91010     		  PC Sojourns 140,000
    Clemson University
    105 Sikes Hall
    Clemson,SC29634     		  PC Sojourns 90,000
    Coalition to Transform Advanced Care
    900 16th St NW Suite 400
    Washington,DC20006     		  PC Sojourns 25,000
    Downtown Emergency Service Center
    515 Third Ave
    Seattle,WA98104     		  PC Healthy People, Healthy Communities 10,000
    Eastern Washington University Foundation
    616 Study Lane
    Cheney,WA99004     		  PC Healthy People, Healthy Communities 25,000
    Emory University School of Medicine
    1599 Clifton Road 3rd Floor 3101
    Atlanta,GA30322     		  PC Sojourns 90,000
    End Well Foundation
    41 Castle Street
    San Francisco,CA94133     		  PC Sojourns 50,000
    Idaho Immunization Coalition
    PO Box 234
    Shoshone,ID83352     		  PC Healthy People, Healthy Communities 50,000
    Idaho Immunization Coalition
    PO Box 234
    Shoshone,ID83352     		  PC Healthy People, Healthy Communities 20,000
    Maine Medical Center
    22 Bramhall St
    Portland,ME04102     		  PC Sojourns 90,000
    Medstar Georgetown University Hospital
    10980 Grantchester Way
    Columbia,MD21044     		  PC Sojourns 90,000
    Memorial Sloan Kettering Cancer Center
    1275 York Ave
    New York,NY10065     		  PC Sojourns 90,000
    National Academy of Sciences
    500 5th Street NW
    Washington,DC20001     		  PC Sojourns 25,000
    OHSU Foundation
    PO Box 29017
    Portland,OR97205     		  PC Healthy People, Healthy Communities 50,000
    OHSU Foundation
    PO Box 29017
    Portland,OR97205     		  PC Healthy People, Healthy Communities 32,500
    People's Health Clinic
    650 Round Valley Drive
    Park City,UT84068     		  PC Healthy People, Healthy Communities 15,000
    Primary Care Progress
    24 School Street 2nd Floor
    Boston,MA02108     		  PC Healthy People, Healthy Communities 110,000
    Ronald McDonald House Charities of the Intermounta
    935 E South Temple
    Salt Lake City,UT84102     		  PC Sojourns 500,000
    Rosalynn Carter Institute for Caregivers
    PO Box 647
    Americus,GA31709     		  PC Sojourns 250,250
    Scripps Health Inpatient Providers Medical Group
    10010 Campus Point Drive Mailbox C
    San Diego,CA92121     		  PC Sojourns 90,000
    Seattle Children's Hospital Foundation
    6901 Sand Point Way NE Suite 200
    Seattle,WA98115     		  PC Sojourns 438,892
    Jefferson University Physicians
    1101 Market Street Suite 2004
    Philadelphia,PA19107     		  PC Sojourns 90,000
    Southern Oregon University Foundation
    1250 Siskiyou Blvd
    Ashland,OR97520     		  PC Healthy People, Healthy Communities 25,000
    St Charles Health System
    2500 NE Neff Road
    Bend,OR97701     		  PC Healthy People, Healthy Communities 5,000
    Trust for America's Health
    1730 M Street NW Suite 900
    Washington,DC20036     		  PC Sojourns 75,000
    UCSF Division of Hospital Medicine
    521 Parnassus Avenue 5th Floor Bo
    San Francisco,CA94143     		  PC Sojourns 90,000
    UCSF Division of Palliative Medicine
    PO Box 45339
    San Francisco,CA94145     		  PC Sojourns 500,000
    University of Idaho Foundation
    875 Perimeter Drive MS 3143
    Moscow,ID83844     		  PC Healthy People, Healthy Communities 25,000
    University of Texas at Austin
    PO Box 7159
    Austin,TX78713     		  PC Sojourns 90,000
    University of Utah
    201 S Presidents Circle Room 406
    Salt Lake City,UT84112     		  PC Sojourns 90,000
    University of Utah
    332 South 1400 East Suite 160
    Salt Lake City,UT84112     		  PC Healthy People, Healthy Communities 50,000
    University of Utah
    332 South 1400 East Suite 160
    Salt Lake City,UT84112     		  PC Healthy People, Healthy Communities 40,000
    University of Washington
    433 NE Brooklyn Ave Box 359472
    Seattle,WA98195     		  PC Healthy People, Healthy Communities 50,000
    University of Washington
    433 NE Brooklyn Ave Box 359472
    Seattle,WA98195     		  PC Sojourns 76,720
    University of Washington
    433 NE Brooklyn Ave Box 359472
    Seattle,WA98195     		  PC Healthy People, Healthy Communities 50,000
    University of Washington
    433 NE Brooklyn Ave Box 359472
    Seattle,WA98195     		  PC Healthy People, Healthy Communities 20,000
    University of Wisconsin
    PO Box 340
    Milwaukee,WI53201     		  GOV Sojourns 90,000
    Utah Valley University
    800 West University Parkway 111
    Orem,UT84058     		  PC Healthy People, Healthy Communities 20,000
    Cambia Health Solutions - Employee Giving
    PO Box 1271
    Portland,OR97207     		  PC Employee Giving Campaign 991,750
    Total .................................bullet 3a 4,770,112
    bApproved for future payment
    Association for Utah Community Health
    860 East 4500 South Suite 206
    Salt Lake City,UT84107     		  PC Healthy People, Healthy Communities 100,000
    Beth Israel Deaconess Medical Center
    133 Brookline Avenue HVMA Annex S
    Boston,MA02115     		  PC Healthy People, Healthy Communities 100,000
    City of Hope
    1500 E Duarte Road
    Duarte,CA91010     		  PC Sojourns 280,000
    Clemson University
    105 Sikes Hall
    Clemson,SC29634     		  PC Sojourns 90,000
    Emory University School of Medicine
    1599 Clifton Road 3rd Floor 3101
    Atlanta,GA30322     		  PC Sojourns 90,000
    Idaho Immunization Coalition
    PO Box 234
    Shoshone,ID83352     		  PC Healthy People, Healthy Communities 20,000
    Idaho Primary Care Association
    1087 W River Street Suite 160
    Boise,ID83702     		  PC Healthy People, Healthy Communities 100,000
    Maine Medical Center
    22 Bramhall St
    Portland,ME04102     		  PC Sojourns 90,000
    March of Dimes Inc
    1550 Crystal Dr Suite 130
    Arlington,VA22202     		  PC Healthy People, Healthy Communities 35,000
    Medstar Georgetown University Hospital
    10980 Grantchester Way
    Columbia,MD21044     		  PC Sojourns 90,000
    Memorial Sloan Kettering Cancer Center
    1275 York Ave
    New York,NY10065     		  PC Sojourns 90,000
    OHSU Foundation
    PO Box 29017
    Portland,OR97205     		  PC Sojourns 10,000
    OHSU Foundation
    PO Box 29017
    Portland,OR97205     		  PC Healthy People, Healthy Communities 25,000
    OHSU Foundation
    PO Box 29017
    Portland,OR97205     		  PC Healthy People, Healthy Communities 30,000
    OHSU Foundation
    PO Box 29017
    Portland,OR97205     		  PC Healthy People, Healthy Communities 32,500
    Oregon Primary Care Association
    333 SW 5th Ave
    Portland,OR97204     		  PC Healthy People, Healthy Communities 150,000
    Primary Care Progress
    24 School Street 2nd Floor
    Boston,MA02108     		  PC Healthy People, Healthy Communities 110,000
    Ronald McDonald House Charities of the Intermounta
    935 E South Temple
    Salt Lake City,UT84102     		  PC Sojourns 750,000
    Scripps Health Inpatient Providers Medical Group
    10010 Campus Point Drive Mailbox C
    San Diego,CA92121     		  PC Sojourns 90,000
    Jefferson University Physicians
    1101 Market Street Suite 2004
    Philadelphia,PA19107     		  PC Sojourns 90,000
    Southern Oregon University Foundation
    1250 Siskiyou Blvd
    Ashland,OR97520     		  PC Healthy People, Healthy Communities 25,000
    UCSF Division of Hospital Medicine
    521 Parnassus Avenue 5th Floor Bo
    San Francisco,CA94143     		  PC Sojourns 90,000
    University of Idaho Foundation
    875 Perimeter Drive MS 3143
    Moscow,ID83844     		  PC Healthy People, Healthy Communities 25,000
    University of Texas at Austin
    PO Box 7159
    Austin,TX78713     		  PC Sojourns 90,000
    University of Utah
    332 South 1400 East Suite 160
    Salt Lake City,UT84112     		  PC Healthy People, Healthy Communities 20,000
    University of Washington
    433 NE Brooklyn Ave Box 359472
    Seattle,WA98195     		  PC Healthy People, Healthy Communities 40,000
    University of Washington
    433 NE Brooklyn Ave Box 359472
    Seattle,WA98195     		  PC Healthy People, Healthy Communities 40,000
    University of Wisconsin
    PO Box 340
    Milwaukee,WI53201     		  GOV Sojourns 90,000
    Washington Association for Community Health
    101 Capitol Way N Suite 201
    Olympia,WA98501     		  PC Healthy People, Healthy Communities 150,000
    Total .................................bullet 3b 2,942,500
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-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 27  
    4 Dividends and interest from securities ....          
    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 .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 1,611,964  
    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) ..   3,364,433  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    3,364,433
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-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 XV-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 (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    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
    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 (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    Cambia Health Foundation
     
    Employer identification number

    32-0200578
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    Cambia Health Foundation
          		Employer identification number
    32-0200578
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    Regence BlueShield
    1800 Ninth Avenue
     
    Seattle, WA98101

    		$ 8,148,083


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    2
    Regence BlueCross BlueShield of Ore
    100 SW Market Street
     
    Portland, OR97201

    		$ 5,853,370


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    3
    Regence BlueCross BlueShield of Uta
    2890 East Cottonwood Parkway
     
    Salt Lake City, UT841210703

    		$ 3,123,538


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    4
    Regence BlueShield of Idaho
    1602 21st Avenue
     
    Lewiston, ID835011930

    		$ 1,620,650


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    Cambia Health Foundation
          		Employer identification number

    32-0200578
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    1
    		 Various Investment Funds $ 8,148,083 2022-02-25
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    2
    		 Various Investment Funds $ 5,853,370 2022-02-25
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    3
    		 Various Investment Funds $ 3,123,538 2022-02-25
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
    4
    		 Various Investment Funds $ 1,620,650 2022-02-25
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    Cambia Health Foundation
          		Employer identification number

    32-0200578
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AllOthProgRltdInvestmentsSch
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Category Amount
    NONE  

    TY 2021 ContractorCompensationExpln
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Contractor Explanation
    Future Work Design Consulting

    Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

    TY 2021 DepreciationSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Description of Property Date Acquired Cost or Other Basis Prior Years' Depreciation Computation Method Rate /
    Life (# of years)    		 Current Year's Depreciation Expense Net Investment Income Adjusted Net Income Cost of Goods Sold Not Included

    TY 2021 InvestmentsCorpBondsSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Name of Bond End of Year Book Value End of Year Fair Market Value
    VANGUARD TIP FUND 6,332,400 6,332,400
    MFB NTGI 999F11791 43,698,648 43,698,648

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Name of Stock End of Year Book Value End of Year Fair Market Value
    MFB NTGI 999F11809 11,971,947 11,971,947
    MFB NTGI 999F11817 11,924,000 11,924,000

    TY 2021 OtherExpensesSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADVERTISING 521     521
    INVESTMENT EXPENSES 60,827 60,827    
    MISCELLANEOUS EXPENSES 201,195     326,893
    SOFTWARE EXPENSE 33,445     34,081
    SPONSORSHIPS 105,000     105,000
    OR COALITION 12,563     12,563


    TY 2021 OtherLiabilitiesSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Description Beginning of Year - Book Value End of Year - Book Value
    DEFERRED TAXES 130,048 108,627


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    CASCADE WEB DEVELOPMENT 10,388     10,388
    BUSATH 199     199
    SPOT COLOR MARKETING 3,158     3,158
    EDIS JURCYS PHOTOGRAPHY 250     250
    CENTER FOR EQUITY AND INCLUSIO 2,824     16,108
    US PATENT AND TRADEMARK OFFICE 525     525
    FUTURE WORK DESIGN 78,730     59,480


    TY 2021 TaxesSchedule
    Name:
    Cambia Health Foundation
    EIN:
    32-0200578
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAX ON INVESTMENT INC 62,177