IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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Blue Shield of California Foundation 990PF- Part XV 3a-Paid during the year California Physicians' Service Fdn (dba Blue Shield of California Fdn) FEIN: 94-2822302 Attachment A Organization Legal Name Foundation Status of Organization Payment Date Project Title Payment Amount Grantmakers In Health Non-profit, non-foundation 01/30/09 Supporting Dialogues on Health Reform $10,000.00 Grantmakers for Children Youth and Families Inc. Non-profit, non-foundation 12/02/09 2009-2010 General Support $2,500.00 Grantmakers for Effective Organizations Non-profit, non-foundation 11/19/09 2009-2010 General Support $20,000.00 Grants Managers Network Non-profit, non-foundation 11/19/09 2009-2010 General Support $1,500.00 Greater Bakersfield Legal Assistance, Inc. Non-profit, non-foundation 01/13/09 Immigrant Rights for Domestic Violence Victims $30,000.00 Greenville Rancheria Government/tribal/public entity 09/18/09 2009 Community Clinic Initiative $30,000.00 Haight Ashbury Free Cli i Non-profit, non-foundation 10/01/09 2009 Community Clinic Initiative $60,000.00 Hanford Community Medical Non-profit, non-foundation 10/01/09 CHAIPI Phase II $10,000.00 Hannah Yterdal Scholarship recipient 08/13/09 Scholarship to Southwestern $2,000.00 Hannah Yterdal Scholarship recipient 12/02/09 Scholarship to Southwestern $2,000.00 Harbor Community Clinic Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $30,000.00 Harvard Pilgrim Health Care, Non-profit, non-foundation 08/13/09 Consolidating for Implementation: A Portfolio of Comparative Effectiveness Assessments for Treatment of Localized Prostate Cancer $137,500.00 Harvard Pilgrim Health Care, Non-profit, non-foundation 01/13/09 Consolidating for Implementation: A Portfolio of Comparative Effectiveness Assessments for Treatment of Localized Prostate Cancer $137,500.00 Haven Hills, Inc. Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $15,000.00 Haven House Non-profit, non-foundation 08/13/09 2008 - 2010 Shelter Initiative $10,000.00 Haven Women's Center of Stanislaus Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $10,000.00 Health Career Connection, Inc. Non-profit, non-foundation 04/15/09 Intern Placement - 2009 $13,000.00 Health Plan of San Joaquin Government/tribal/public entity 11/19/09 2009 Healthy Kids Premium $79,135.00 Health Research Association, Non-profit, non-foundation 12/30/09 CHAIPI Phase II $10,000.00 Health Technology Center Non-profit, non-foundation 05/29/09 2009 General Support $30,000.00 Health and Life Organization, Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $30,000.00 Healthy Kids, Healthy F t Non-profit, non-foundation 05/14/09 2009 Healthy Kids Premium $151,732.00 High Desert Domestic Violence Program, Inc. Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $15,000.00 Page 10 of 26 January 26, 2010 Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status of 'Paid'.
Blue Shield of California Foundation 990PF- Part XV 3a-Paid during the year California Physicians' Service Fdn (dba Blue Shield of California Fdn) FEIN: 94-2822302 Attachment A Organization Legal Name Foundation Status of Organization Payment Date Project Title Payment Amount Hill Country Community Clinic Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $35,000.00 Hispanic Foundation of Silicon Valley Non-profit, non-foundation 12/30/09 General Operating Support $15,000.00 Hispanics in Philanthropy Non-profit, non-foundation 11/19/09 2009-2010 General Support $8,000.00 Hollywood Sunset Free Cli i Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $50,000.00 Homeless Prenatal P Non-profit, non-foundation 10/14/09 Homeless Prenatal Program $20,000.00 House of Ruth, Inc. Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $15,000.00 Human Options, Inc. Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $10,000.00 Human Response Network Inc. Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $5,000.00 Humboldt Domestic Violence Non-profit, non-foundation 07/31/09 2008 - 2010 Shelter Initiative $15,000.00 I'SOT Inc. DBA Canby Family Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $25,000.00 Immigrant Legal Resource Center Non-profit, non-foundation 12/18/09 Ensuring Immigrant Violence Victims' Safety Using New $97,500.00 Immigrant Legal Resource Center Non-profit, non-foundation 01/13/09 Improving the Lives of Immigrant Survivors $45,000.00 Imperial Beach Community Clinic Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $35,000.00 Independent Sector Non-profit, non-foundation 03/26/09 2008-2009 General Support $12,500.00 Independent Sector Non-profit, non-foundation 12/02/09 2009-2010 General Support $15,000.00 Indian Health Center of Santa Clara Valley Non-profit, non-foundation 09/04/09 2009 Community Clinic Initiative $35,000.00 Indian Health Council Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $35,000.00 Inland Behavioral & Health Services Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $40,000.00 Inland Empire Health Plan Health Access Government/tribal/public entity 04/30/09 2009 Healthy Kids Premium $420,138.00 Inland Empire Health Plan Health Access Government/tribal/public entity 09/18/09 Healthy Kids Program Premium Subsidy in Riverside $435,300.00 Inland Empire Health Plan Health Access Government/tribal/public entity 04/30/09 2009 Healthy Kids Premium $304,542.00 Institute for Healthcare Advancement Private Operating F d ti 09/18/09 2009 Community Clinic Initiative $35,000.00 Institute for Healthcare Improvement Non-profit, non-foundation 03/26/09 A Collaborative to Reduce Hospital-Acquired Infections in a Group of California $62,500.00 Institute for Healthcare Improvement Non-profit, non-foundation 10/01/09 A Collaborative to Reduce Hospital-Acquired Infections in a Group of California $62,500.00 Page 11 of 26 January 26, 2010 Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status of 'Paid'.
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November 9, 2010 California Physici
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TAX RETURN FILING INSTRUCTIONS FORM
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Form 990-PF (2009) Assets Liabiliti
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Form 990-PF (2009) Part VI CALIFORN
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Form 990-PF (2009) Part VII-B CALIF
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Form 990-PF (2009) Part X CALIFORNI
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CALIFORNIA PHYSICIANS' SERVICE FDN
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Form 8868 (Rev. 4-2009) ¥ If you a
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Blue Shield of California Foundatio
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IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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