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 East Valley Community Clinic, East Valley Community Health Center, Inc Effort Medical Clinic Eisner Pediatric and Family Medical Center El Dorado County Community Health Center El Dorado County Health Services Department, Public El Dorado County Health Services Department, Public El Proyecto del Barrio, Inc. Emergency Shelter Program, Emmaus House Endowment for California Leadership Enloe Medical Center Family Health Care Centers of Greater Los Angeles, Family Health Centers of San Family HealthCare Network Family Services of Tulare County Feather River Tribal Health Inc Foundation Center Foundation for Students Rising Above Free Clinic of Simi Valley Fresno Regional F d ti Gardner Family Health Network, Inc. Glide Memorial United Methodist Church Glide Memorial United Methodist Church Golden Valley Health C t Good Samaritan Hospital Good Samaritan Hospital Grantmakers In Health Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Non-profit, non-foundation Government/tribal/public entity 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 11/19/09 09/18/09 09/18/09 11/19/09 10/01/09 02/18/09 08/13/09 09/18/09 07/31/09 07/31/09 07/31/09 10/29/09 09/04/09 09/18/09 09/18/09 07/31/09 09/18/09 12/18/09 10/14/09 09/04/09 04/30/09 09/18/09 09/04/09 09/04/09 09/04/09 10/01/09 10/14/09 12/02/09 Page 9 of 26 January 26, 2010 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2009 Community Clinic Initiative Health Information Exchange Health Information Exchange 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative 2008 - 2010 Shelter Initiative Youth Constitutional Convention 2010 CHAIPI Phase II 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2009 Community Clinic Initiative 2008 - 2010 Shelter Initiative 2009 Community Clinic Initiative 2009-2010 General Support Student Health Care Fund 2009 Community Clinic Initiative 2009 Healthy Kids Premium 2009 Community Clinic Initiative General Operating Support 2009 Community Clinic Initiative 2009 Community Clinic Initiative CHAIPI Phase II CHAIPI Phase II 2009-2010 General Support Data contained in this report was filtered on Payment Date between 01/01/09 and 12/31/09, Payment Status of 'Paid'. $25,000.00 $30,000.00 $25,000.00 $25,000.00 $25,000.00 $62,500.00 $62,500.00 $30,000.00 $5,000.00 $5,000.00 $20,000.00 $12,500.00 $30,000.00 $30,000.00 $40,000.00 $5,000.00 $40,000.00 $5,000.00 $2,500.00 $50,000.00 $276,391.00 $40,000.00 $25,000.00 $50,000.00 $40,000.00 $22,500.00 $32,500.00 $35,000.00
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'.
Page 1 and 2: November 9, 2010 California Physici
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IRS Form 990-PF for 2009 - Blue Shield of California Foundation

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