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 Southern Trinity Health Services, Inc. Non-profit, non-foundation 10/01/09 2009 Community Clinic Initiative $35,000.00 Southside Coaltion of Community Health Centers Southwest Community Health Center St. Anthony Foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 12/02/09 09/18/09 09/18/09 2009 Clinic Fiscal Health Initiative 2009 Community Clinic Initiative 2009 Community Clinic Initiative $57,000.00 $40,000.00 $50,000.00 St. James Infirmary St. John's Well Child and Family Center, Inc. St. Vincent De Paul Society, Particular Council of San Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 09/18/09 09/18/09 07/31/09 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative $50,000.00 $40,000.00 $5,000.00 St. Vincent de Paul Village, Inc. Su Casa ~ Ending Domestic Support Network for Battered Women Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 10/01/09 08/13/09 07/31/09 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative 2008 - 2010 Shelter Initiative $25,000.00 $10,000.00 $15,000.00 Sutter Delta Medical Center Non-profit, non-foundation 10/01/09 CHAIPI Phase II $22,500.00 Sutter Delta Medical Center Non-profit, non-foundation 10/14/09 CHAIPI Phase II $32,500.00 Sutter Health Sacramento Sierra Region Sutter Health Sacramento Sierra Region Non-profit, non-foundation Non-profit, non-foundation 12/30/09 10/01/09 CHAIPI Phase II: Sutter Roseville Medical Center CHAIPI Phase II: Sutter Auburn Faith Hospital $10,000.00 $10,000.00 Sutter Health Sacramento Sierra Region Sutter Health Sacramento Sierra Region Sutter Solano Medical C t Swords to Plowshares Veterans Rights Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 12/30/09 10/01/09 12/30/09 12/30/09 CHAIPI Phase II: Sutter Davis Hospital CHAIPI Phase II: Sutter Medical Center, CHAIPI Phase II Veteran Family Violence: Increasing Awareness and Access to Service $10,000.00 $10,000.00 $10,000.00 $124,927.00 T.H.E. Clinic, Inc. Non-profit, non-foundation 09/18/09 2009 Community Clinic Initiative $25,000.00 Tahoe Women's Services Taiwan Buddhist Tzu Chi Medical Foundation USA Taproot Foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 09/04/09 09/18/09 09/18/09 2008 - 2010 Shelter Initiative 2009 Community Clinic Initiative Service Grant Sponsorships for Blue Shield of California Foundation¿s Grantees in Los Angeles and the San $5,000.00 $60,000.00 $60,000.00 Taproot Foundation Non-profit, non-foundation 12/18/09 Building the Capacity of Blue Shield of California Foundation¿s Grantees: $50,000.00 Tehachapi Valley Healthcare Government/tribal/public entity 08/13/09 Health Information Exchange $62,500.00 Page 22 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 Tehachapi Valley Healthcare The Center For Violencefree Relationships (formerly the The Center to Promote HealthCare Access, Inc. The Children's Clinic, Serving The Coalition to End Family Violence The Regents of the University of California The Regents of the University of California The Regents of the University of California The Regents of the University of California The Regents of the University of California The Regents of the University of California The Regents of the University of California The Regents of the University of California on behalf of its Davis campus The Regents of the University of California on behalf of its Davis campus The Saban Free Clinic The Trustees of Columbia University in the City of New The Trustees of Columbia University in the City of New The University Corporation San Francisco State The University Corporation San Francisco State Tiburcio Vasquez Health Center, Inc. Tides Center Tides Center Government/tribal/public entity Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation 10/01/09 07/31/09 09/04/09 09/18/09 07/31/09 01/30/09 10/14/09 01/13/09 03/26/09 03/12/09 09/04/09 03/12/09 02/18/09 08/13/09 10/01/09 10/01/09 03/26/09 08/13/09 02/18/09 10/01/09 01/13/09 09/18/09 Page 23 of 26 January 26, 2010 CHAIPI Phase II 2008 - 2010 Shelter Initiative Promoting Enrollment Modernization and Reform 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative Clinic Leadership Institute Cohort 2 Clinic Leadership Institute ¿ Cohort 3 Pilot Telehealth Project to Increase Access to Health Services for African American Translating Personalized Medicine to Clinical Practice Clinic Leadership Institute Cohort 2 Clinic Leadership Institute Cohort 2 Clinic Leadership Institute- Cohort 1 Implementing Telemedicine for Improved Cancer Patient Management by Implementing Telemedicine for Improved Cancer Patient Management by 2009 Community Clinic Initiative Understanding the Changing Role of the Infection Understanding the Changing Role of the Infection An Investigation of Business Models for Health An Investigation of Business Models for Health 2009 Community Clinic Initiative Tools for Community Clinics- Advancing Technology- Enabled Quality 2009 Community Clinic Initiative Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status of 'Paid'. $10,000.00 $10,000.00 $125,000.00 $30,000.00 $10,000.00 $463,933.00 $491,204.00 $62,500.00 $112,500.00 $463,933.00 $463,933.00 $347,278.00 $162,500.00 $162,500.00 $40,000.00 $90,583.00 $90,582.25 $59,829.00 $59,829.00 $40,000.00 $233,975.00 $25,000.00
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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 990-PF (2009) Part XVI-A Enter
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Schedule B (Form 990, 990-EZ, or 99
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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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