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					    1.

                                       Private Foundation Trust
         "Form 990,,-,,F Return of 4947(a)(1) Nonexempt CharitableOMBNO 15-15-0052
    E­   , * Treated as a Private Foundation
                            or Section
         ry Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements
         For calendar year 2009, or tax year beginning , and ending
         G Check aiitnat apply LJ Initial return I-,I Initial return ofaformer public charity ll Final return
                                           III Amended return EL-I Address change lj Name change
          useme ,Rs Name of foundation A Employer identiiication number
            I b I.
          ginzrrzisg, EW YORK STATE HEALTH FOUNDATION                                                                         30-0127892
             print Number and street (or P O box number If mail is not delivered to etreet address) Room/suite          B Telephone number
           vrtvne- 1 3 85 BROADWAY , 2 3RD FLOOR                                                                              2 12-664-7656
         lsneirspxtlnc City or town, state, and ZIP code                                                                C If exemption application is pending, check here , LJ
          *"""* ew yonx, NY 10018-6013                                                                                  U 1- Foreign organizations. check here P lj
                                                                                                                         2. Foreign organizations meeting the 85% test,
         H Check type of organization l.X.l Section 501(c)(3) exempt private foundation                                      check here and attach computation , E
         1:1 Section 4947(a)(1) nonexempt chantabie trust E Othertaxable pnvate foundation                              E It private foundation status was terminated
         I Fair market value ofall assets atend of year .I Accounting method I-I Cash Ill Accrual                           under section s07(o)(i)iA), cheek here P III
           (from Parr ii, ed/. ie), /ine 16) II other (specify)                                                         F If the foundation is in a 60-month termination
I

I          P S 2 6 7 , 5 3 8 , 5 5 4 (Part I, column (d) must be on cash basis.) "                                          under section 507(b)(1)iB), check here
         In I AIWWSIS 01 3"9""9 3"" E*P9"595 (a) Revenue and (b) Net investment                                               (c) Adiusted net bif2g:Sb"Sems"B
                                                                                                                                                        table purposes
                      i.Tl"e1$i2r$f&,"JZ?Frf2 TSJZETZ (.?ll.ff3lrFr".f,"" "W "ot expenses per books income                  ..-H.T9"Ti. ....... 1 ..@sP"ee9vM.,
i



i              1 Contnbutions, gifts, grants, etc , received ,                                                                    NWA gggg
               2 cheek P IE iirirerecndaircnsneireqrrrredieauach sch e 2
               3 ll$Zr2ei?vZ2i*r5"ZLT.9s "G """p""""/ 3 1 0 - 3 1 0
               4 Dividends and interestfrom securities 7 r 1 7 0 r 3 1 1 - 9 r 1 1 6 r 5 35                                                                  y Tawemssfr 1
                                                                                                                                                             ET"11T"i:1@1srf:"c2
               5a Gross rents
                                                I )- .
                ll Netrentnlinoomeorhoss) V -I H ..I. H , ..
               53 Net gain or (loss) from sale of assets not on line 10 8 I 0 4 2 I 4 4 4 * 1
                hi"23ri?.iiT.2%?""""" l46r695r008- , . .. ..
               7 Capital gain net income (from Part N, line 2) V V 6 I 8 2 7 , 6 3 7
               8 Net short-term capltalgam . .- i--i-r-r.                                                                  . . . . . . . . . . . ...
               9 IncomeI modifi . rr , H g I
              13@aea@ew.i1f
               3 oss profit or io s) ­ "m""11*923Q STATgm3sTM3
                     L.- "e . 5-we-r
                                                                                                                        fr-i-i."...1-i... 1-I-I ..."r" i-r+o-+-i-o-9-r-rf" I-ro-i . .. ... .. ..



              11 231 erlnuiiute  299 756.
                                 372,770. 0. 266,523.
                              15,512fe21. 15,956f405
              12 tai. Add lines 1 throuqh 11 ­

                               1,932,667. 372,155. 1,637,145.                 433,726. 64,896. 369,159.
                                                                              114,418. 47,825. 78,698.
                                                                              53,094. 0. 51,799.
                                                                                                                      I OI
              15 Pension plans, employee benefits
              16a Legal fees STMT 4
                b Accounting fees STMT 5
                                                                              608,446. 321,475. 417,726.
               140,000. 752
          "" Occupancy 2441969.ol 232,724.
                           I 12,248.
                c Otherprofessionalfees STMT 6
              17 Interest
              18 Taxes STMT 7
          -- 19 Depreciation and depletion 5 6 6 7 4
          " 2021 Travel, conferences, and meetings                            110,921. 3,308. 110,614.
                                                                               18,672. 0. 18,672.
              22 Pnntrng and publications
              23 Other expenses STMT 8                                        234,591. 11,808. 218,886.
              24 Total operating and administrative
                  expenses. Add lines 13 through 23
              25 Contributions, gifts, grants paid
                                                                            4,320,948. 834,467. 3,401,946.
                                                                           13,915,583. is iifjjr iiiiiiiiiiiiii " 13,017,652.



                                                                                                1 1/1
              26 Total expenses and disbursements
                     Add lines 24 and 25                               ,l3r235r531e,m. 3341457-.NWN ,, ,,16r419r598­
              27 Subtract line 26 from line 12 3
                I Excessofrevenueoverexpenses and disbursements                    , , , , , , , , , A , , , , , , , , , , , , , , , , , , , , , I IH ,HHAHHI I                 ,H H H
                b Net InvestmentIncome6rnegairve,en1er-oi g g 1 5 , 1 2 1 , 9 3 8
                c Adjusted net income ainegairveenrer-e) . I g I                                                                   N/A "
         223052110 LHA For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Form 990-PF ( 09)
     10130602 756359 620245 2o09.o306o New vonx STATE HEALTH Founp 62024
U
1.
     Form 990-Pr (2009) NEW YORK STATE HEALTH FOUNDATION 3 0 -0 1 2 7 8 9 2 Paoe 2
                          C"*""*"S"""*""**"*""*"*l"f"""""*""*Y Beginning 011/937 value la) Fall
l Balance Sheets Anachedscnedulcsanoamounlslnlrledescnptlonla) Book value ln) BookEnd 011/937 lvlarkal value
L

           1 Cash - non-interest-bearlng
                             8,981,563.
           3 Accounts receivable* I 7,815,635. 7,815,635.
           2 Savlngs and temporary cash investments

                Less allowance for doubtful accounts P
           4 Pledges receivable*
              Less allowance for doubtful accounts P
           5 Grants receivable
           6 Receivables due from offlcers, directors, trustees, and other
                disquallfled persons
           7 Othernolesandloansreoelvablc b
               Less allowance for doubtful accounts P
           8 lnventones for sale or use
           9 Prepald expenses and deferred charges
         10a Investments - U S and state government obllgatlons
                                                                                                      38,913. 215,103. 215,103.
           b Investments - corporate stock
              F Investments " Corporate bonds ............................................................................................ ..


         13 Investments-gther
         11 Investments - land. buildings, and equlpment basls F
                Less accumulated ltpreuatlon *
         12 Investments - mortgage loans

         14 Land,bulldlngs,and equlpment basis* 567,558. """"""""""""""""""" H I I I in
                Lessamunulalaaueplwauua P 154,235. 174,031. 413,323. 413,323.
         15 01neragset5(ue5cnbeP STATEMENT 11) 2,332,510. 1,884,846. 1,884,846.
         16 Total assets (to be completed by all fliers) 304,466,473. 267,538,554. 267,538,554.
         17 Accounts payable and accrued expenses            206,208. 356,963.
         18 Grants payable                                13,429,976. 14,093,640.
         19 Deferred revenue ,
     Q 20 Loans from oflicers, dlrectors, trustees, and other disqualified persons
     - 21 Mortgages and other notes payable
         22 Other llaollitles (describe P STATEMENT 12) 39 1 r 2 0 3 - 34 7 30 3
         23 Total Ilabllities (add llnes 17 throuqh 22)                                        14,027,387. 14,484,906
                Foundations that follow SFAS 117, :heck here P lll
                and complete Ilnes 24 through 26 and llnes 30 and 31 .
         24 Unrestricted                                                                   290,439,086. 253,053,648
         25 Temporanlyrestrlcted
         26 Permanently restricted
                Founuallons lnal an not lulluw srns 117, :neun nere P LI
             and complete lines 27 through 31.
         27 Capital stock, tnlst pnnclpal, or current funds
         28 Pald-ln or capltal surplus, or land, bldg ,and equlpment fund
         29 Retained eamlngs, accumulated Income, endowment, or other funds
         30 Total net assets or fund balances                                              290,439,086. 253,053,648
         31 Total Ilahllltles and net assets/fund balances                                 304,466,473. 267,538,554
     Analysis of Changes in Net Assets or Fund Balances
     1 Total net assets or fund balances at beglnnlng of year - Part ll, column (a), llne 30
        (must agree with end-of-year flgure reported on prior year*s return)                                                                    290,439,086.
       Enter amount from 2 (ltemlze) P SEE STATEMENT
     2Other increases not included ln IlnePart I, Ilne 27a , , 9
     3
                                                                                                                                             -2,723,710.
                                                                                                                                                 350,916.
     4 Add llnes1,2,and3                                                                                                                    288,066,292.
     5 Decreasesnotlncludedlnllne2(ltemlze) P UNREALIZED LOSS ON INVESTMENTS                                                                 35,012,644.
     6 Total net assets orfund balances at end of year (llne 4 mlnus Ilne 5)- Part ll, column Q), llne 30                                   253,053,648.
     923511
                                                                                                                                                 Form 990-PF (2009)
     02-02-10


10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245 1
:E " rpqleeoipr zone) NEw YORK STATE HEALTH FOUNDATION 30-0127892 Pages
    I Part N ij Capital Gains and Losses for Tax on Investment Income
     " (a) List and warehouse, or common stock, 200 real estate, Co ) D . Dommon m0 1 Date I/Y) (m0 . day. VI)
*" .2-story bnckdescribe the kind(s) of property sold (e g , shs MLC (b(,l"f0,,*Lf(fI$a*Js*g9d (ce day- acquired (rl) Date sold
             SEE ATTACHED STATEMENT


                                                                                                                                                                l


                                                                                                                                               (h) Gain or (loss)
                                        (or allowable) plus other basis
            (e) Gross sms price (I) Depreciation allowed (g) Cost orexpense ot sale                                                          (e) plus (1) minus (g)




              137,785,008. 130,278,509.
        Complete only tor assets showing gain in column (h) and owned by the foundation on 12/31/69
                                                                                                                                                                6,827,637.
                                                                                                                                        (I) Gains (Col (h) gain minus
                                                     (i) Adiusted basis (k) Excess ot col (i)                                          col (k), but not less than -0-) or
          (I) F MV as 0112/31/59 as ot 12/31/69 over col (1), rf any                                                                        Losses (from col (h))




                                                                                                                                                                6,827,637.
                                                                If gain, also enter in Part I, line 7
    2 Capital gain net income or (net capital loss) It (loss), enter -0- in Part I, line 7 2                                                                    6,827,637.
    3 Net short-term capital gain or (loss) as detined in sections 1222(5) and (6)
       It gain, also enter in Part I, line 8, column (c)
       If (loss enter-0- in Part I, line 8                          1.
    V11 Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
                                                                                                                                                         N/A

    (For optional use by domestic pnvate foundations subiect to the section 4940(a) tax o n net investment income )

    It section 4940(d)(2) applies, leave this part blank




                        2008 - - ­
    Was the foundation liable tor the section 4942 tax on the distnbutable amount of any year in the base penod7                                                    iii vas no

                                                                          lb) lvl
    It "Yes,* the toundation does not quality under section 4940(-e) Do not complete this part
    1 Enter the appropriate amount in each column lor each year, see instmctions before making any entnes
                          (3)
                   Base period years
       Calendar yea, (0, tax yea, begmmng m) Adjusted qualifying distnbutions Net value of nonchantable-use assets (C0) (D) dlvlded by cgi (0))
                                                                       13,858,855                                 287, 159,627
                                                                                                                                                                    (ll)
                                                                                                                                                          Distnbution ratio

                                                                                                                                                                             048262
                         2007 10,753,787.
                         zoos 2,496,540.                                                                          291,746,752
                                                                                                                  236,585,647
                                                                                                                                                                            .036860
                                                                                                                                                                            .010552
                        2005                                                                  OO                    68,219,805                                              .000O00
                        2004


    2 Total ot line 1, column (d)                                                                                                                                           .095674
    3 Average distnbution ratio tor the 5-year base period - divide the total on line 2 by 5 , or by the number of years
       the foundation has been in existence it less than 5 years                                                                                                            .023919
    4 Enterthe net value of nonchantable-use assets for 2009 trom Part X, line 5                                                                           265,726,299.
    5 Multiply line 4 by line 3                                                                                                                                 6,355,907.
    6 Enter 1% of net investment income (1% ot Part I, line 27b)                                                                                                           151,219.
     7 Add lines 5 and 6                                                                                                                                       6,507,126.
    8 Enter qualitying distnbutions from Part XII, line 4                                                                                                     16,728,769.

    923521 02.02.10 FDHTI (2009)
        It line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and com plete that part using a 1% tax rate
        See the Part Vl instructions

                                                                                                        3
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
2- retiring-igiofrfr (zoos) NEW YORK STATE HEALTH FOUNDATION 3 0-0 1 2 7 8 9 2 Page 4
   I Part VI 1 Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948 - see instructions)
  , 1a Exempt operating toundations descnbed in section 4940(d)(2), check here P M and enter "N/A" on line 1 Y 2

        of Part I, line 27b 3 5
I Date of ruling or determination letter (attach copy ot letter it necessary-see Instructions) E
      h Domestic foundations that meet the section 4940(e) requirements in Part V, check here P iii and enter 1% 1 1 5 1 , 2 1 9 .



        Aridiinesianaz 151,219.
      i: All otherdomestic foundations enter 2% of line 27b Exempt foreign organizations enter 4% ot Part I, line 12, col (b) L 5
        Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only Others enter -0-)




        Credits/Payments 5
        Subtitle A (income) tax (domestic section 4947(a)( 1) trusts and taxable foundations only Others enter -0-)
            ax based on Investment Income. Subtract line 4 from line 3 lf zero or less, enter -0- 1 5 1 , 2 1 9 .
      a 2009 estimated tax payments and 2008 overpayment credited to 2009 1 7 1 , 5 2 3 . 5 I
      b Exempt foreign organizations - tax withheld at source
      c Tax paid with application for extension oftime to hte (Fomi 8868)
      d Backup withholding erroneously withheld
     7 Total credits and payments Add lines 6a through 6d , 1 7 1 , 5 2 3 .
     8 Enter any penalty for underpayment ot estimated tax Check here 1:1 if Form 2220 is attached
     9 Tax due. It the total of lines 5 and 8 is more than line 7, enter amount owed
    10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid 2 0 , 3 0 4 .
    11 Enter the amount of line 10 to be Credited to 2010 estimated tax P 2 0 , 30 4 . Retuniieii P 0 .
   I Statements Regarding Activities
        any political campaign? 1ainX
     1a During the tax year, did the toundation attempt to influence any national, state, or local legislation or did it participate or inteniene in YES NO

                                    Ax
      b Did it spend more than $100 dunng the year (either directly or indirectly) for political purposes (see instructions for definition)?
        If the answer is "Yes" to 1 a or 1 b, attach a detailed descnption of the activities and copies of any matenals published or 5
        distributed by the foundation in connection with the activities. 1 :
      c Did the toundation file Form 1120-POL for this year?
      it Enter the amount (rf any) of tax on political expenditures (section 4955) imposed during the year: *
                                                                                                                                                   1c .X
        managers P $ 0 - I E
        (1) On the foundation P S 0 - (2) On foundation managers P $ 0 ­
      e Enter the reimbursement (rt any) paid by the foundation during the year for political expenditure tax imposed on foundation

     2 Has the foundation engaged in any activities that have not previously been reported to the IRS?
        If "Yes, " attach a detailed descnption of the activities. 5
     3 Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or 1 5
        bylaws, or other similar instniments? If "Yes, " attach a conformed copy of the changes 3 X
     4a Did the foundation have unrelated business gross income of$1,000 or more dunng the year? 4a X
      h It "Yes," has it hled a tax retum on Form 990-T for this year? N /A 4b
     5 Was there a liquidation, temiination, dissolution, or substantial contraction dunng the year?
        lf "Yes, " attach the statement required by General Instruction T. E 2
     6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either 2 1
        0 By language in the governing instrument, or

              remain in the governing instniment? 6 X
        0 By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law 5 j

     7 Did the toundation have at least $5,000 in assets at any time dunng the year?
        If "Yes, " complete Part ll, col. (c), and Part XV. 2 5
     8a Enter the states to which the toundation reports or with which it is registered (see instructions) P I
          NY
      ii If the answer is "Yes" to line 7, has the foundation furnished a copy of Fomi 990-PF to the Attorney General (or designate) e
         of each state as required by General Instruction G? lf "No, " attach explanation                                  ,..@.Il.,.l(.........
     9 ls the foundation claiming status as a pnvate operating foundation within the meaning of section 4942())(3) or 4942(i)(5) for calendar 5 g
        year 2009 or the taxable year beginning in 2009 (see instructions tor Part XlV)? lf "Yes, " complete Part X/V 9 X
    10 Did any-persons become substantial contributors during the tax year? ir -Yes: amen e schedule iiering their names ana eearessee 10 X
                                                                                                                                               Form 990-PF (2009)




   923531
   02-02-io
                                                                                               4
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
    1 DFW" 990"PF (2009) NEW YORK STATE HEALTH FOUNDATION 3 0 -0 1 2 7 8 9 2 P399 5
          I"Part"Vtl"-A Statements Regarding Activities (continued)
           11 At -any time dunng the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of
               section 5f2(b)(13)? If "Yes," attach schedule (see instructions)                                                                                  11 X
           12 Did the foundation acquire a direct or indirect interest in any applicable insurance contract before
               August 17, 2008?
           13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
                                                                                                                                                                HI X
                Website address P WWW . NYSHEALTH . ORG
           14 Thebooksareincareof P THE FOUNDATION Telephone no P212-664-7656
                Located at P 1 385 BROADWAY , 2 3RD FLOOR, NEW YORK , NY ZlP+4 P100 1 8-60 1 3
           15 Section 4947(a)( 1) nonexempt charitable trusts hling Form 990-PF in lieu of Form 1041 - Check here P D
                and enter the amount of tax-exempt interest received or accrued dunng the year P I 15 I N/A
          I Part VII"-B 1 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 N0
            1a Dunng the year did the foundation (either directly or indirectly)
               (1) Engage in the sale or exchange, or leasing of property with a disqualified person?                                       (:1Yes Elm
               (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
                   a disqualified person?                                                                                                   mYes )1(:)Nn
                (3) Fumish goods, services, orfacilities to (or accept them from) a disqualified person?                                    @Yes ):)No
                (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?                                        Yes (:)No
                (5) Transfer any income or assets to a disqualified person (or make any of either available
                     for the benefit or use of a disqualihed person)? ,                                                                     (Il Yes IX) No
                (6) Agree to pay money or property to a govemment official? (Exception. Check "No"
                     if the foundation agreed to make a grant to or to employ the ofhcial for a penod after
                     termination of govemment service, rfterminating within 90 days)                                                        (I) Yes EZ( No
             b lf any answer is "Yes" to 1a(1)-(6), did any of the acts fail to qualify under the exceptions descnbed in Regulations
                section 53 4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instmctions)?                                      in "X
                Organizations relying on a current notice regarding disaster assistance check here P C) I
             i: Did the foundation engage in a prior year in any of the acts descnbed in fa, otherthan excepted acts, that were not corrected
                before the first day of the tax year beginning in 2009?                                                                                          11: X
            2 Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation



                before 2009? E Yes Q) No
                defined in section 4942(r)(3) or 4942(r)(5))
             a At the end of tax year 2009, did the foundation have any undistributed income (lines 6d and 6e, Part Xlll) for tax year(s) beginning




1P...
                lf "Yes," list the years P
              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

                statement- see instructions ) N / A
                valuation of assets) to the year*s undistnbuted income? (lf applying section 4942(a)(2) to all years listed, answer "No" and attach


) i: lf the provisions of section 4942(a)(2) are being applied to any ofthe years listed in 2a, list the years here
                                                                                                                                                                 20




                during the year? lj Yes N0
            3a Did the foundation hold more than a 2% direct or indirect interest in any business enterpnse at any time


              b lf "Yes," did it have excess business holdings in 2009 as a result of (1) any purchase by the foundation or disqualified persons after
                May 26,1969, (2) the lapse ofthe 5-year period (or longer penod approved by the Commissioner under section 4943(c)(7)) to dispose
                of holdings acquired by gift or bequest, or (3) the lapse ofthe 10-, 15-, or 20-year first phase holding penod? (Use Schedule C,
                Form 4720, to determine lf the foundat/on had excess bus/ness holdings in 2009.) N/ A                                                            30
            4a Did the foundation invest dunng the year any amount in a manner that would reopardize its charitable purposes?
             b Did the foundation make any investment in a pnor year (but after December 31, 1969) that could jeopardize its chantable purpose that
                had not been removed from geopardy before the first day of the tax year beginning in 2009?                                                       ae) x
                                                                                                                                                             Form 990-PF (2009)




          923541
          02-02-10
                                                                                                       5
     10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
1 ,. .... ..
 ,rmmpmmgpwm NEW YORK STATE HEALTH FOUNDATION 30-0127892 wwe
 I Part Vll-B 1 Statements Regarding Activities for Which Form 4720 May Be Required (continued)
   5a Dunng the year did the foundation pay or incur any amount to 5
       (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? E Yes lE No

             any voter registration dnve? E Yes No
       (2) Influence the outcome of any specific public election (see section 4955), or to carry on, directly or indirectly,

       (3) Provide a grant to an individual fortravel, study, or othersimilar purposes? E Yes i-Zi No
       (4) Provide a grant to an organization other than a chantable, etc , organization descnbed in section
             so9(a)(1), (2), aria), orseciien 4e40(ii)(2y1 il Yes I3 Ne
       (5) Provide for any purpose otherthan religious, chantable, scientific, literary, or educational purposes, or for
             the prevention of cruelty to children or animals? E Yes iii No
     b lf any answer is "Yes" to 5a(1)-(5), did any of the transactions fail to qualify under the exceptions described in Regulations 1 2
       section 53 4945 or in a current notice regarding disaster assistance (see instructions)? 5b X
        Organizations relying on a current notice regarding disaster assistance check here
     c If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the tax because it maintained
       expenditure responsibility tor the grant? SEE, A"1jTACHMEN"1j G IE Yes D No
                                                                                                                                         *U
       lf "Yes, " attach the statement required by Regulations section 53.4945-5(d).

       a personal benefit contract? E Yes lil No .
    6a Did the foundation, dunng the year, recenie any funds, directly or indirectly, to pay premiums on



       If "Yes" to 6b, file Form 88 70.
     b Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 6b X

    7a At any time during the tax year, was the foundation a party to a prohibited tax sheltertransaction? Fi Yes V7(-I No , 5
     b lf yes, did the foundation receive anlproceeds or have any net income attributable to the transaction? N/ A 1b
  lnfpnnation About Officers, Directors, Trustees, Foundation Managers, Highly
            Paid Employees, and Contractors
  1 List all officers, directors, trustees, foundation managers and their compensation.
                                                                                                                           c Com ensation 7( cenmnuuensre n
                                                                               ( position *"t32Z,%*&FQ",,2H*""S a060En(P,eot?i%r
                                 (a) Name and address h0?i)rsT?gr" 02260223330 0)(lt no?paid,enter -0-) cempensanen allowances


  SEE STATEMENT 13 372,770. 40,375. 0.


  2 Compensation of tive highest-paid employees (other than those included on line 1). If none, enter "NONE."
                                                                                             (b) Title, and average Cefmibvvefeiv (e) Ex ense
             (a) Name and address 01 each employee paid more than $50,000
                                                                                               hours per o position compensaien allowances
                                                                                              devotedweek (c) Compensation *q2$&?,*f,2f""s accounp, other
  NICHOLAS SMIRENSKY - 1385 BROADWAY, CHIEF INVESTMENT OFFICER
  23RD FLOOR, NEW YORK, NY 10018 40.00 337,962. 51,375. 0.
  DAVID SANDMAN - 1385 BROADWAY, 23RD SENIOR VICE PRESIDENT
  FLOOR, NEW YORK, NY 10018 40.00 196,021. 30,490. 0.
  BENJAMIN PRAYZ - 1385 BROADWAY, 23RD pIRECTOR OF FINANCE e OPERATIONS
  FLOOR, NEW YORK, NY 10018 40.00 174,753. 27,360. 0.
  JACQUELINE MARTINEZ - 1385 BROADWAY, SENIOR PROGRAM DIRECTOR
  23RD FLOOR, NEW YORK, NY 10018 40.00 140,351. 21,701. 0.
  DEBORAH zAHN - 1385 BROADWAY, 23RD POLICY DIRECTOR
  FLOOR, NEW YORK, NY 10018 40.00 132,208. 21,590. 0.
  Total number of other employees paid over $50,000                                                                                           rl 9
                                                                                                                                              Form 990-PF (2009)




  923551
  02-O2-10
                                                                                              6
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
* Wm9W*F@WW NEW YORK STATE HEALTH FOUNDATION 30-0127892 WW7
1



      " Information About Officers, Directors, Trustees, Foundation Managers, Highly
                 Paid Employees, and Contractors (coniinued)
* 1 3 Five highest-paid independent contractors for professional services. lf none, enter "NONE."
                             (a) Name and address of each person paid more than $50,000 (b) Type of service                                            (c) Compensation
      1412 OWNER LLC
      P.O. BOX 6153, HICKSVILLE, NY 10087-9153                                                                      RENT                               221,853.
      PROSKAUER ROSE, LLP
      1585 BROADWAY, NEW YORK, NY 10036                                                                             LEGAL FEES                         132,031.
      CAMBRIDGE ASSOCIATES LLC                                                                                      INVESTMENT
      P.O. BOX 10317, UNIONDALE, NY 11555-0317                                                                      MANAGEMENT                          122,052.
      TULLER MCNEALUS FELD, LLC
      54 WEST 39TH STREET, NEW YORK, NY 10018                                                                       ARCHITECT                            95,740.

      Total number ot others receiving over $50,000 for professional services P                                                                                      0
      f,P,art3Xf,@i,1 Summary of Direct Charitable Activities
       List the foundation"s tour largest direct charitable activities during the tax year Include relevant statistical information such as the
                                                                                                                                                      Expenses
       number of organizations and other beneticianes served, conferences convened, research papers produced, etc
      1THE NEW YORK STATE DIABETES CAMPAIGN - SEE ATTACHMENT D
                                                                                                                                                       278,050.
      2HAVING IT ALL - SEE ATTACHMENT D
                                                                                                                                                         77,500.
      3EVALUATION INITIATIVE - SEE ATTACHMENT D
                                                                                                                                                         62,829.
      4CONVERSATION WITH... - SEE ATTACHMENT D
                                                                                                                                                         16,015.
      i"Par*t" D(-#B1 Summary of Program-Related Investments
                                                                                                                                                      Amount
      1 N/A
          Describe the two largest program-related investments made by the foundation dunng the tax year on lines 1 and 2




      2



       All other program-related investments See instructions




                                                                                                                                                  P 0.
      3




i7
      Total. Add lines 1 through 3
                                                                                                                                                   Form 990-PF (2009)




      923561
      02-02-10


    10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245 1
-- Form 990-PF (2009) NEW YORK STATE HEALTH FOUNDATION 3 0 -0 1 2 7 89 2 Page ii
i




     Minimum lnVBStm9nt 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 chantabie, etc , purposes I
       a Average monthly fair market value of securities , 1a 2 6 0 , 6 32 , 5 4 9 .
       c Fair market value cash other assets 1
       b Average ot monthlyof all balances 1b 9 .11: 4 0 , 3 4 3 .
         TotaI(addlines1a,b,and c) on 2691 1
       dReduction claimed for blockage or othertactors reported10lines 1a and 1772: 892 ­
       e
          tc (attach detailed explanation) I to - I
          Acquisition line2from linetd 1e I 0linej1 assets 0 ­
          Subtract indebtedness applicable 772 , 892 .
                                            269,
          Cash deemed held for chantable activities Entert 1/2% of line 3 (tor greater amount, see instructions) 4 , 0 4 6 , 5 9 3 ­
          Net value oi noncharltalile-use assets. Subtract line 4 from line 3 Enter here and on Part V, line 4 2 6 5 , 7 2 6 , 2 9 9 .
          Mlnlmum Investment return. Enter 5% of line 5 6 1 3 , 2 86 , 3 1 5 .
                  foreign organizations check here P III and do not complete ())(5) private operating foundations and certain
      Distributable Amount (see instructions) (Section 4942())(3) and this part)
      1 Minimum investment return from Part X, line 6 1 3 , 2 86 , 3 1 5 .
      2a Tax on investment income for 2009 from Part VI, line 5 1 5 1 , 2 1 9 . ,
       i: Addlines2aand2b 151,219.
       b Income tax for 2009 (This does not include the tax from Part Vi ) 1 .
          Distnbutable amount before adlustments Subtract line 2c from line 1 1 3 , 1 3 5 , 0 9 6 .
        Addlines3and4 13,188,662..
        Recoveries of amounts treated as qualifying distnbutions 5 3 , 5 6 6
          Deduction from distnbutable amount (see instmctions)                                                                 0.
          Distrlhutalile amount as adiusted Subtract line 6 from line 5 Enter here and on Part Xlll, line1 . 1 3 , 1 8 8 , 6 6 2 .
      Qualifying Distributions (see instructions)
      1 Amounts paid (including administrative expenses) to accomplish chantabie, etc , purposes 1 z
       a Expenses, contnbutions, gifts, etc -total from Part I, column (d), line 26 ta 1 6 , 4 1 9 , 5 9 8 .
       li Program-related investments - total from Part IX-B 1b 0 ­
      2 Amounts paid to acquire assets used (or held tor use) directly in carrying out chantabie, etc , purposes 21,7 3 O 9 , 1 7 1 .
      3 Amounts set aside lor specific charitable pro)ects that satisfy the s
       a Suitability test (pnor IRS approval required) 3a
       ti Cash distribution test (attach the required schedule) 3h
      4 Qualifying dlstrlliutlons. Add lines 1a through 3b Enter here and on Part V, line 8, and Part Xlll, line 4 4 1 6 , 7 2 8 , 7 6 9 .
      5 Foundations that quality under section 4940(e) for the reduced rate of tax on net investment
          income Enter 1% of Part l, line 27b , 5 1 5 1 , 2 1 9 ­
      6 Adlusted qualllylng dlstrlliutlons. Subtract line 5 from line 4 6 1 6 , 5 7 7 , 5 5 0 .
          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
                                                                                                                                                        Fomi 990-PF (2009)




      923571
      02-02-10
                                                                                               8
    10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245*1
" " Form 990-PF (2009) NEW YORK STATE HEALTH FOUNDATION 30-0 1 2 7 8 9 2 Page 9
  -Undisiribuied lI1COI118 (see instructlons)
                                                         (2) (bl (Cl (dl
       IIne7 5 5 I 13,188,662.                          Corpus Years pnorto 2008 2008 2009


       , , 3 0.? 3
   1 DIstrIbutabIe amount for 2009 trom Part Xl, I I H H I ll* I I I I I I I H IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII

   2 Undlstnbuted Income, If any, as ot the end of2009 1
     n Total for pnoryears A 5
     @E"tefam0U"1f0f2008 only ,.......l.3..e.,l,5.5..r..?,?5.:....,....,,.............,,..,. .1

     3 Fr0m 2004 T "
    3 Excess dIstnbutIons carryover, If any, to 2009 f
     b From 2005



     e from zoos L
     I: From 2006
     d From 2007


     I Total of Ilnes 3a through e (((((((((((((((((((((((((((((( H
       PartXll,lIne4P$ 16L728z769.I I A
    4 Qualrtymg dIstrIbutIons for 2009 from 2 A
     aApplIed to 2008, but not more than lIne 2a H H ,, lllll H-H ......... HH, H M
     b ApplIed to undlstnbuted Income of pnor 5 5 1
      years(ElectIonrequIred-seelnstructlons)
     c Treated as dlstnbutlons out of corpus H. A , ,I I *
                                             H
                                               @
      (Electlonrequlred-seelnstructlons) T T 3, 5710, 893 ­
     uAppIIeu to 2009 oIstrIburanIe amount A
     e
        Excess Inamountdlstnbuted"outYof" "corpus" 0" -" YI" YH" "H "2009
    5(ltRemammgdlstnbutlons carryover Yapphed""to" H, I 0 Q O s
        an amount a ears column (d), the same amount " " " " Y""" " " . "
       must be shown In column (al) - 3
                    PP



      Indicated below: I
    6 Enter the nel total ol each column as

     3 Corpus Add lmes 31, dc. and 4e Subtract Ime 5 VVVVVVVVVVVVVVVVVV

      lIne 4b from lIne 2b 0 - I
     h Prloryears" undlstnbuted Income Subtract 5
     c Enter the amount ot pnor years"



       assessed A 0 -0I
       undlstnbuted Income for whIch a notlce of
       det"IcIency has been Issued, or on whlch
       the sectlon 4942(a) tax has been prevlously 1


       amount- see Instructions .
     d Subtract llne 6c from lIne 6b Taxable OOOO A y
     eUndIstrIbuted Income for2008 Subtract lIne 5
       4a from line 2a Taxable amount-see Instr. 2 0 . yyyy H
     l Undlstnbuted Income for 2009 Subtract 2
       IInes 4d and 5 from In 1 Thls 5 1 I must 5
       be alsmouxen lIne 2010 amount I 9 6I 1 .6 7
    7 Amounts treated. .as. .dlstnbutlons , out. .ot. .2 . "... ...WH6 - 9 .
                   I.. .. ................. .... .. . .              .. I f
       corpus to satlsfy requlrements Imposed by / f 5
       secuon17o(oI(1)(F)or4e42(g)(3) 0 .
    8 Excess dlstnbutions carryover from 2004
       not applred online 5 or Ime 7 0 . y
    9 Excess dlstrlbutlons carryover to 2010.
   Subtract lines 7 and 8 from IIne
  10 Analysls of lIne 6a 05
     a Excess from 2005
                                    9 .
     o Excess trom 2006
     c Excess from 2007
     d Excess from 2008
     e Excess from 2009

   923581
                                                                                                                        form eeo-PF (zoos)
   oz-oz-to
                                                                           9
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
  Fqrrri ooo-Pr. 2009) NEW YORK STATE HEALTH FOUNDATION 30 -0 1 2 7 89 2 Page 10
 ( PKR XIV() Private Operating FOUr1dafi0ns (see Instructions and Part VII-A, question 9) N/ A
  1 a If the foundation has received a ruling or determination Ietterthat it is a private operating
       foundation, and the ruling is effective for 2009, enter the date of the ruling p
     b Check box to indicate whether the foundation is a pnvate operating foundation descnbed in section 1....) 4942(l)(3) or 1-I 4942(l)(5)
  2 a Enterthe lesser ofthe adiusted net                 Tax year Prior 3 years
                                                         (3) 2009 (D) 2008 (I2) 2007 (lf) 2006 (B) Total
       income from Part I orthe minimum
       investment return from Part X for
        each year listed
     ti 85% of line 2a
     c Qualifying distnbutions 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 distnbutions made directly
       for active conduct of exempt activities
       Subtract line 2d from line 2c
  3 Complete 3a, b, or c for the
       altemative test relied upon
     a *Assets* altemative test - enter
       (1) Value ofall assets
       (2) Value of assets qualifying
            under section 4942(i)(3)(B)(i)
     b *Endowment* altemative test - enter
       2/3 of minimum investment return
       shown In Part X, line 6 for each year
       listed
     c *Support* altemative test - enter
       (1) Total support other than gross
            investment income (interest.
            dividends, rents, payments on
            secunties loans (section
            512(a)(5)), or royalties)
       (2) Support from general public
            and 5 or more exempt
            organizations as provided In
            section 4942())(3)(B)(iii)
       (3) Largest amount of support from
            an exempt organization
            Gross investment income
  I Part XV I Supplementary Information (Complete this part only if the foundation had $5,000 or more in assets
             at any time during the year-see the instructions.)
   1 Information Regarding Foundation Managers:
     a List any managers of the foundation who have contributed more than 2% of the total contnbutions received by the foundation before the close of any tax
       year (but only rltney have contributed more than $5,000) (See section 507(d)(2) )
  NONE
     b List any managers ofthe foundation who own 10% or more of the stock of a corporation (oi an equally large portion ofthe ownership of a partnership or
       other entity) of which the foundation has a 10% or greater interest
  NONE
   2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
       Check here P I-J if the foundation only makes contnbutions to preselected chantable organizations and does not accept unsolicited requests for funds if
       the foundation makes gifts, grants, etc (see Instructions) to individuals or organizations under other conditions, complete Items 2a, b, c, and d
     a The name, address, and telephone number of the person to whom applications should be addressed
  JAMES KNICKMAN
  1385 BROADWAY, 23RD FLOOR, NEW YORK, NY 10018
     b The form in which applications should be submitted and information and matenals they should Include
  SEE WWW . NYSHEALTH . ORG
     I.: Any submission deadlines
  SEE WWW . NYSHEALTH . ORG
     d Any restnctions or limitations on awards, such as by geographical areas, chantable fields, kinds of institutions, or other factors
  SEE WWW . NYSHEALTH . ORG

  923601 02-02-10                                                                                                                                Fomt 990-PF (2009)
                                                                                               10
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
"".@@R@ffQw% NEW YORK STATE HEALTH FOUNDATION 30-0127892 NWN
  I Part XVl Supplementary Information (continued)
  3 Grents and Contributions Paid During the Year or Agproved for Future Payment
" Rgclprgm It recipient is an individual,
                               any foundation manager S H US 0 PUFDOS? tg
                               show any relationship to FotindatirinCON fl U I0" gram Of Amount
         mmemdmdmw(mmembwm%Q msmwmmmcmummm mmmmt
  SEE ATTACHMENT B 13017652.
    a Paid during the year




   Total P 3a 13017652.
  SEE ATTACHMENT C 14093640.
    IJ Approved for future payment




       Total P 3h 14093640.
  923611 o2"02"1o FOITI1 990-PF (2009)                                  11
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
    "- . Form 990-PF (2009) NEW YORK STATE HEALTH FOUNDATION 3 0-0 1 2 7 8 9 2 page 12
        Analysis of Income-Producing Activities
    " Enter gross amounts unless otherwise indicated

          1 Program service revenue
                                                                               la) (b)
                                                                           I Unrelated business income Excluded by section 512, sis, @1514 I (E)
                                                                                              Exe U. (d) Related or exempt
                                                                                              ic)
                                                                             Bufgggss Amount 22,21 Amount function income
            a




            l
            g Fees and contracts from govemment agencies
         2 Membership dues and assessments
         3 Interest on savings and temporary cash
            investments                                                                                       14                      310.
         4 Dividends and interest from secunties                                                              14         7,170,311.
         5 Net rental income or (loss) from real estate
           a Debt-financed property
           h Not debt-financed property
         6 Net rental income or (loss) from personal


l
            DYODBITV

          7 Other investment income                                                                           14 11,923.
l


         8 Gain or (loss) from sales ol assets other
           than inventory                                                                                     18 8,042,444.
         9 Net income or (loss) from special events
        10 Gross protit or (loss) from sales of inventory
        11 Other revenue
            a GRANT REFUND
            I1 GRANT REDUCTIONS
                                                                                                                 53,566.
                                                                                                              01 234,267.
                                                                                                              01

        12 Subtotal Add columns (b), (d), and (e)                            """"""""""""" " o. "" 15,512,821. o.
                                                                                                     13 15,512,821.
        13 Total. Add line 12, columns (b), (d). and (e)
         1 See worksheet in line 13 instnictions to venfv calculations )
          Part XVI-B Relationship of Activities to the Accomplishment of Exempt Purposes
          Llne No. Explain below how each activity for which income is reported in column (e) ol Part Xvl-A contnbuted importantly to the accomplishment ol
                1 the foundation"s exempt purposes (other than by providing tunds lor such purposes)




         923s21
         02-02-10                                                                                                                                  Form 990-PF (zoos)
                                                                                              12
    10130602 756359 620245                                                 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
   t Form 990 PF 2009) NEW YORK STATE HEALTH FOUNDATION 3 0 -0 1 2 7 8 9 2 Page 13
      Puiuaiftuxvll * lnfonnation Regarding Transfers To and Transactions and Relationships With Noncharitable
               - Exempt Organizations


        (2) Cash 1a(1)3 3
        (1)Other assets 1a(2)X                                                                                                             H I I H Yes No
" I 1 Did the organization directly or indirectly engage in any ofthe following with any other organization described in section 501(c) of---v----.-.---.-......-.­
          the Code (otherthan section 501(c)(3) organizations) or in section 527, relating to political organizations? 2


        h Other transactions X
        a Transfers from the reporting foundation to a noncharitable exempt organization of ,


           (1) Sales of assets to a noncharitable exempt organization 1b(1)
           (2) Purchases of assets from a noncharitable exempt organization 1h(2)
           (3) Rental of facilities, equipment, or other assets 1b(3)
           (4) Reimbursementarrangements 1li(5)
           (5) Loans or loan guarantees 1h(-1)
           (5) Performance of services or membership or fundraising solicitations 1b(6)
        i: Sharing of facilities, equipment, mailing lists, other assets, or paid employees 1i:
        d lf 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 sen/ices received.
      (3) Une no (D) AITIOUM IFIVDIVCU (C) NBITIO Of l"l0llCh8l"It3bl6 8X9fTlDt OTQBHIZBIIOH (ll) Descnption of transfers, transactions, and shanng arrangements
                                                                                 N/ A




       2a ls the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations descnbed
           iii section soirc) mine ciiee (iiiiieiiniiii section 5o1ic)ia)) eiiii seciiiiii 5277 . Ci vas @ Ne
        h If *Yes," complete the following schedule
                                  (a) Name of organization (b) Type of organization (i:) Descnption of relationship
                                      N/A



          Under pena es of penury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct,
          and complet eclaretion of preparer (other than taxp or fiducia ls based on all infomation of which preparer has any knowledge


                 officer ortrustee 13110 Pfesisfiefe Lcfo
          , Sign -we L2 X l "1 A Date *Title
            Pmpareris 6-,ff Date I Q em ioyeu P I*I P00234022
      - - signature ( 9, g 4 AZ- "7 1If Pieparefs identifying number
          "" fm-s,,,m,(,,,y,,,,s O *CONNOR DAVI S & DOBBINS, LL EIN P 13-3385019
                   lsell-employed). EAST 42ND STREET
                   *dm*-i"dZlPC0*,NEW YORK, NY 10165 Phoneno 212-286-2600
                                                                                                                                                                                Form 990-PF (2009)




      923522
      oz-oz-io
                                                                                                              13
 10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
                                                                                        CONTINUATION FOR 990-PF, PART IV
  NEW YORK STATE HEALTH FOUNDATION 30-0127892 PAGE 1                                                                          OF 1
  Capital Gains and Losses lor Tax on Investment Income
                  * (ULmamdnmmememm6)MpmnnywwJg.mmwmw, Wywxgfdu mmamwmd                                                        (it) Date sold



           -10 ATTACHMENT A
           EEYEAR TREASURY FUNDPBARIOUS
           - 2-story brick warehouse, or common stock, 200 shs MLC Co D . Donanon F110 . day- Yf)
                                 P ARIOUS
                                                                                                                              (m0 , day, yr)
                                                                                                                              ARIOUS
                                                                                                                              ARIOUS

           EX-US SUPERFUND B ARIOUS
     -10 YEAR TREASURY FUNDB ARIOUS
   dACWI EX-US SUPERFUND B ARIOUS                                                                                             ARIOUS
                                                                                                                              ARIOUS
   eACWI
   tMSCI EMERGING MARKETS FREE FUND B ARIOUS
                                                                                                                              ARIOUS
                                                                                                                              ARIOUS

  nRUSSELL 1000 INDEX FUND B B ARIOUS
  Aj MSCI EMERGING MARKETS FREE FUNDARIOUS                                                                                    ARIOUS
                                                                                                                              ARIOUS
   iRUSSELL 1000 INDEX FUND B ARIOUS                                                                                          ARIOUS
  J


                                            (t) Depreciation allowed (g) Cost or other basis (h) Gain or (loss)
             137,785,008. 130,278,509. 7, 506,499.
           (e)Gf0sSsamsp"ce (oranowabw) pmsexpenseofsme (e)pms(f)nunus(g)

                                                                                                                              196,548.
                                                                                                                                 5,9650
                                                                                                                              -44,604.
                                                                                                                                      679.
                                                                                                                                      677.
                                                                                                                              216,821.
                                                                                                                       -ll 006,701.



      Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (1) Lgsses (from col (ni)
                                               (I) Adlusted bags (K) Excess 01 col (0 Gains (excess of col. (h) gain over col (k),
           (1) F M V 85 0112/31/69 as M12/31/69 Ove, col (I). If any DUI HDI 198511180 50".)
                                                                                          7, 506,499.
                                                                                                                              -48,247.
                                                                                                                              196,548.
                                                                                                                                5,965.
                                                                                                                              -44,604.
                                                                                                                                      679.
                                                                                                                                      677.
                                                                                                                              216,821.
                                                                                                                       -ll 006,701.



                                   If ", I t P rtl,I 7                             )2II
  2 Capital gain net income or (net capital loss) ( If 32215)? ggtg?-55..-n,,-, ivan Ilnfgwy 6 827 637.
  3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6)

      lHmwLmwHOHn%nLme8 , , 1 3 N/A
     It gain, also enter in Part I, line 8, column (c)


  923591
  o4-24-os
                                                                                   14
10 130602       756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245 1
Ai
w




 1   .NEW YORK STATE HEALTH FOUNDATION 30-0127892
             I




    SOURCE AMOUNT
    FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 1



    INTEREST FROM CHECKING 310.
    TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A 310.

    FORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 2

    SOURCE GROSS AMOUNT DIVIDENDSGAINS COLUMN (A)
    DIVIDENDS 6,905,286
    INTEREST 265,025
                             CAPITAL
                                     AMOUNT

    TOTAL TO FM 990-PF, PART I, LN 4 7,170,311. 0. 7,170,311.
                                                                A­
                                                                .--.
                                                                    6,905,286.
                                                                      265,025.



    FORM 990-PF OTHER INCOME STATEMENT 3
                             (A) (B) (C)   REVENUE NET INVEST- ADJUSTED
    DESCRIPTION PER BOOKS MENT INCOME NET INCOME
    GRANT REFUND 53,566. 0.
    PROGRAM RELATED INVESTMENT INTEREST 11,923. 11,923.
    GRANT REDUCTIONS 234,267. 0.
    TOTAL TO FORM 990-PF, PART I, LINE 11 299,756. 11,923.

    FORM 990-PF LEGAL FEES STATEMENT 4
                                   (A) (B) (C) (D)
                                ExPENSES NET INVEST- ADJUSTED CHARITAELE
    DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
    LEGAL FEES 114,418. 47,825. 78,698.
    TO FM 990-PF, PG 1, LN 16A 114,418. 47,825. 78,698.



                                            15 STATEMENT(S) 1, 2, 3, 4
    10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245 1
.
    NEW YORK STATE HEALTH FOUNDATION 30-0127892
        I

FORM 990-PF ACCOUNTING FEES STATEMENT 5
                              (A) (B) (C) (D)
                           EXPENSES NET INVEST- ADJUSTED CHARITABLE
DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
ACCOUNTING FEES 53,094. 0. 51,799.
TO FORM 990-PF, PG 1, LN 16B 53,094. 0. 51,799.
FORM 990-PF OTHER PROFESSIONAL FEES STATEMENT 6
                              (A) (B) (C) (D)
                           EXPENSES NET INVEST- ADJUSTED CHARITABLE
DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES

INVESTMENT MANAGEMENT 111,052. 417,726.
CONSULTING FEES 487,247. 121,199. 210,423. 0.
TO FORM 990-PF, PG 1, LN 16C 608,446. 321,475. 417,726.

FORM 990-PF TAXES STATEMENT 7
                              (A) (B) (C) (D)
                           EXPENSES NET INVEST- ADJUSTED CHARITABLE
DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
FEDERAL EXCISE TAX 140,000
FOREIGN TAXES PAID 0. 752
TO FORM 990-PF, PG 1, LN 18 140,000. 752. 0.
FORM 990-PF OTHER EXPENSES STATEMENT 8
                              (A) (B) (C) (D)
                           EXPENSES NET INVEST- ADJUSTED CHARITABLE
DESCRIPTION PER BOOKS MENT INCOME NET INCOME PURPOSES
OFFICE EXPENSE 39,706. 11,300. 28,406.
TELECOMMUNICATIONS 52,460. 0. 53,570.
INSURANCE 39,903. 0. 3,974.
POSTAGE 4,212. 213. 39,903.
OUTREACH AND PUBLIC EVENTS 53,970. 295. 48,607.


                                      16 sTATEMENT(S) 5, 6, 7, 8
10130602 756359 620245 20o9.03060 NEW YORK STATE HEALTH FOUND 620245 1
 NEW YORK STATE HEALTH FOUNDATION 30-0127892
                                      A--A
REPAIRS AND MAINTENANCE 37,583. 0.                               37,583.
MISCELLANEOUS 6,757. 0.                                           6,843.
TO FORM 990-PF, PG 1, LN 23 234,591. 11,808. 218,886.
FORM 990-PF OTHER INCREASES IN NET ASSETS OR FUND BALANCES STATEMENT 9

DESCRIPTION AMOUNT
BENEFIT FOR DEFERRED FEDERAL EXCISE TAX 350,916.
TOTAL TO FORM 990-PF, PART III, LINE 3 350,916.
FORM 990-PF OTHER INVESTMENTS STATEMENT 10
DESCRIPTION METHOD VALUATION VALUE FAIR MARKET
                    BOOK                VALUE

SEE ATTACHMENT E COST 257,209,647. 257,209,647.
TOTAL TO FORM 990-PF, PART II, LINE 13 257,209,647. 257,209,647.

FORM 990-PF OTHER ASSETS STATEMENT 11
                                BEGINNING OF END OF YEAR FAIR MARKET
DESCRIPTION YR BOOK VALUE BOOK VALUE VALUE
DEPOSITS 54,842. 54,842. 54,842.
ACCRUED INVESTMENT INCOME 1,064,076. 470,185. 470,185.
PREPAID FEDERAL EXCISE TAX 25,000. 25,000. 25,000.
OTHER ASSETS 0. 146,227. 146,227.
PROGRAM RELATED INVESTMENTS 1,188,592. 1,188,592. 1,188,592.
TO FORM 990-PF, PART II, LINE 15 2,332,510. 1,884,846. 1,884,846.




                                      17 sTATEMENT(s) 8, 9, 10, 11
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
*.
      .NEW YORK STATE HEALTH FOUNDATION 30-0127892
 FORM 990-PF OTHER LIABILITIES STATEMENT 12
 DESCRIPTION                                            BOY AMOUNT EOY AMOUNT
 DEFERRED FEDERAL EXCISE TAX 352,050. 1,134.
 DEFERRED RENT               39,153. 33,169.
 TOTAL TO FORM 990-PF, PART II, LINE 22 391,203. 34,303.

 FORM 990-PF PART VIII - LIST OF OFFICERS, DIRECTORS STATEMENT 13
                        TRUSTEES AND FOUNDATION MANAGERS


                                                                EMPLOYEE
                                        TITLE AND COMPEN- BEN PLAN EXPENSE
 NAME AND ADDRESS                      AVRG HRS/WK SATION CONTRIB ACCOUNT
 JAMES R. KNICKMAN                    PRESIDENT & CEO
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                         40.00 372,770. 40,375. 0.
 PAUL BADER
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER



 JO-ANN COSTANTINO
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER



 ROBERT G. SMITH
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER



 CARL WEISBROD
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER



 CHARLES STRAIN
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER



 MELVYN B. RUSKIN
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER



 ANGELA DIAZ
 1385 BROADWAY, 23RD FLOOR
 NEW YORK, NY 10018
                                          3.00 0. 0. 0.
                                      BOARD MEMBER




                                             18 STATEMENT(S) 12, 13
     10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245 1
  NEW YORK STATE HEALTH FOUNDATION 30-0127892
LUCY N. FRIEDMAN BOARD MEMBER
1385 BROADWAY, 23RD FLOOR 3.00 0. 0. 0.
NEW YORK, NY 10018
JOHN L PALMER BOARD MEMBER
                                                              ll
1385 BROADWAY, 23RD FLOOR 3.00 0. 0. 0.
NEW YORK, NY 10018

TOTALS INCLUDED ON 990-PF, PAGE 6, PART VIII 372,770. 40,375. 0.




, 19 sTATEMENT(s) 13
10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1
                                        New York State Health Foundation
                                              December 31, 2009
                                         Form 990-PF:Part XV - Line 3a
                                          Grants Paid During the Year


                                        Complete
                                      Organization Organization Payment
                                       Address                     Amount
     Organization Legal Name                               Txpe             Project Title
                                  PO BOX 471
                                  SARANAC LAKE NY                      The Tri-Lakes Uninsured
Adirondack Medical Center         12983-0471             Non-Profit           Task Force             12,386
                                  206 S ELMWOOD                       Four Agency Financial and
AIDS Community Services of        AVE BUFFALO NY                          Data Management
Western New York, Inc.            14201-2313             Non-Profit     Systems Consolidation       128,948
                                  43 New Scotland                       Pediatric Mental Health
                                  Avenue, MC 119                        Services in the Capital
Albany Medical College            ALBANY NY 12208        Non-Profit              Region             194,096
                                                                         Expanded Access to
                                                                          Colorectal Cancer
                                                                       Screening among Rural
                                   31 Adams Avenue                      Populations in Upstate
American Cancer Society, lnc.      Endicott NY 13760     Non-Proit            New York                4,726
                                   39 Farrell Road
Associated Community Action of the Willsboro NY 12996­                  Creating Primary Care
Northeast Adirondack Region, Inc. 3904                   Non-Profit     Access in Dannemora          40,000
                                   731 Market Street                   New York State Diabetes
                                   Suite 220 San                           Social Marketing
Better World Advertising, Inc.     Francisco CA 94103      Profit             Campaign              174,994
                                   731 Market Street                   New York State Diabetes
                                   Suite 220 San                           Social Marketing
Better World Advertising, Inc.     Francisco CA 94103      Profit             Campaign              174,994
                                                                      From Potentially Avoidable
                                                                           Complications to
                                                                        Potentially Achievable
                                  13 Sugar Street                        Savings: A Payment
                                  Newtown CT 06470­                    Reform initiative For New
Bridges To Excellence, Inc.       2046                   Non-Protit           York State            123,899
                                                                       Developing a Statewide
                                  13 Sugar Street                      Diabetes Care Physician
                                  Newtown CT 06470­                   Incentive Program Among
Bridges To Excellence, Inc.       2046                   Non-Profit             Payers               64,429
                                                                       Developing a Statewide
                                  13 Sugar Street                      Diabetes Care Physician
                                  Newtown CT 06470­                   incentive Program Among
Bndges To Excellence, inc         2046                   Non-Protit             Payers               64,429
                                  25 Elm Place, Suite
                                  200 Brooklyn NY
Brooklyn Alliance, Inc            11201                  Non-Profit    Brooklyn HealthWorks          10,474
                                  25 Elm Place, Suite
                                  200 Brooklyn NY
Brooklyn Alliance, Inc.           11201                  Non-Profit     Brooklyn Healthworks         10,474
                                  592 ROCKAWAY                        Preserving and Expanding
Brownsville Community             AVE BROOKLYN NY                      Primary Care Access in
Development Corporation           11212-5539             Non-Profit           Brooklyn              199,840


                                                                                              ATTACHMENT B
                                                                                                     1 of11
                                            Complete
                                         Organization Organization Payment
       Organization Legal Name Address Type Project Title Amount
                                     1654 W ONONDAGA
Catholic Charities of Onondaga       ST SYRACUSE NY
County                               13204-3310
                                     200 American Metro
                                                            Non-Profit   Restructuring for Results
                                                                           Evaluation Technical
                                                                                                       $ 88,800
                                     Blvd., Suite 119                    Assistance for NYSHealth
Center for Health Care Strategies    Hamilton NJ 08619­                  Grantees and Applicants"
Inc                                  2311                   Non-Proht             Phase 2              $ 173,635
                                                                         Increasing Enrollment and
                                     15 Maiden Lane,                      Retention in New Yorkgs
                                     Suite 1200 New York                  Public Health Insurance
Children"s Defense Fund              NY 10038               Non-Protit            Programs             $ 20,538
                                                                          Designing an Arbitration­
                                                                            Based Medical Injury
                                  620 Eighth Avenue,                     Dispute Resolution System
                                  Floor 38, Suite D New                     for New York Health
Common Good Institute, Inc., The York NY 10018              Non-Profit            Systems              $ 50,660
                                  535 Eighth Avenue,                     Community Health Center
Community Health Care Association 8th Floor NEW YORK                        Immigrant Outreach
of New York State                 NY 10018                  Non-Profit             Project             $ 20,318
                                  99 Troy Rd Suite 200
Community Health Care Services    East Greenbush NY                      Improving Retention of the
Foundation, Inc.                  12061                     Non-Profit     Home Care Workforce         $ 199,984
                                  462 GRIDER ST                            Increasing Access to
Community Health Center of        BUFFALO NY 14215­                       Pnmary Care in Niagara
Buffalo, Inc.                        3021                   Non-Proit              Falls               $ 163,699
                                     356 West 18th Street                  Establishing On-Site
                                 New York NY 10011­                       Pharmacy Access at a
Community Health Project, Inc.   4401                       Non-Profit   Community Health Center $          150,000
                                 105 E 22ND ST NEW                       Family Health Plus Buy-ln"
Community Service Society of New YORK NY 10010­                           A Practical Solution for
York                             5413                       Non-Profit       Small Businesses          5 160,000
                                                                              Reducing Racial
                                                                            Disparities in Health
                                                                           Outcomes Through a
Community Service Society of New 105 E. 22nd Street                          Publicly Financed
York                             New York NY 10010          Non-Profit     Insurance Expansion         $ 34,827
                                                                         Depression in Older Home
                                                                         Health Patients* Increasing
                                     1300 York Ave New                   Access to Evidence-Based
Cornell University                   York NY 10021
                                     5001 Brittonfield
                                                            Non-Profit              Care               $ 37,446
                                                                             Increasing Health
                                     Parkway East                         Insurance for New York"s
Dairylea Cooperative, Inc.           Syracuse NY 13057        Prolit         Agricultural Sector       $ 127,500
                                                                          The Intensive Wellness
                                                                          Program. A Health and
Dr. Martin Luther King, Jr. Health   1265 Franklin Avenue                Mental Health Intervention
Center, Inc.                         Bronx NY 10456-3402    Non-Profit    for High Cost Patients       $ 85,158
                                     1265 Franklin Avenue                The Dr. Martin Luther King,
Dr. Martin Luther King, Jr. Health   BRONX NY 10456­                     Jr. Health Center Diabetes
Center, Inc.                         3402                   Non-Profit      Management Initiative      $ 53,552
                                                                                                     ATTACHMENT B
                                                                                                            2 of 11
                                          Complete
                                         Organization        Organization                                    Payment
    Organization Legal Name                Address              Type               Project Title             Amount
                                     1 WEST MAIN
                                     STREET 2ND
                                     FLOOR
                                     ROCHESTER NY                             Community Health Law
Empire Justice Center, lnc.          14614-1418
                                     1000 Main Street
                                                              Non-Profit         Collaborative             $ 20.639
EPIC - Every Person Influences       Buffalo NY 14202­                         Ready, Set, Parent*
Children Inc                         1102                     Non-Profit      Statewide Expansion          $ 285,155
                                                                               Evaluating Patient­
                                     165 Court Street                        Centered Medical Home
Excellus Health Plan, lnc.           Rochester NY 14647       Non-Proit            Pilot Project           $ 75,000
                                     Grand Central Station
                                     PO Box 3391 New                         Expanding Primary Care
Floating Hospital Foundation, lnc.   York NY 10163-3391       Non-Profit    Access in Long Island City     $ 171,160
                                     150 STATE ST STE
                                     301 ALBANY NY                          Efficient and Cost-Effective
Foundation for Long Term Care, lnc. 12207-1626                Non-Profit           Care Planning           $ 88,740
                                     2975                                   Recognition and Treatment
                                   INDEPENDENCE                               of Pain in Cognitively
Frances Schervier Home and         AVE BRONX NY                              Impaired Older Adults: A
Hospital                           10463-4620
                                   291 BROADWAY FL
                                                              Non-Profit          Video Library            $ 3,486
                                                                               A Falling Tide of Salt
                                   17 NEW YORK NY                                Lowers All Blood
Fund for Public Health in New York 10007-1855                 Non-Profit            Pressures              $ 159,908
                                   1413 K Street, NW,
                                   2nd Floor
Grantmakers for Effective          Washington, DC DC
Organizations                        20005
                                     1100 Connecticut
                                                              Non-Protit        Membership Grant           $ 5,000
                                     Avenue, NW
                                     Washington, DC DC
Grantmakers in Health                20036                    Non-Profit        Membership Grant           $ 10,000
                                     555 West 57th Street,                     Promoting a Medical
Greater New York Hospital            15th floor New York                        Malpractice Early
Foundation, Inc                      NY 10019-2925            Non-Proht         Settlement Model           $ 19,360
                                   1 Helen Keller Way
Health and Welfare Council of Long 4th Floor Hempstead                       The Long Island Health
Island, Inc                        NY 11550                   Non-Protit         Care Coalition            $ 13,475
                                                                              Merging Agencies to
                                     1302 MAIN ST                               Advance Disease
Health Association of Niagara        NIAGARA FALLS NY                         Prevention in Niagara
County, Inc                          14301-1116
                                     300 Nasser Civic
                                                              Non-Profit             County                $ 63,836
                                     Center Plaza, Suite                      Expanded Medical and
Health Ministry of the Southem Tier, 230 Corning NY                            Dental Sen/ices for
Inc.                                 14830                    Non-Profit           Uninsured               $ 18,787
                                     Riverview Center, 150                   Assessment of Certified
                                     Broadway, Suite 560                    Diabetes Educators in New
Health Research, lnc                 Menands NY 12204         Non-Profit            York State             $ 99,669
                                                                                                        ATTACHMENT B
                                                                                                               3 Of 11
                                               Complete
                                             Organization Organization Payment
         Organization Legal Name Address Type Project Title Amount
                                                                             Improving Diabetes
                                                                           Outcomes in New York
    Hospital Educational and Research One Empire Dnve                     State Hospital Outpatient
    Fund, Inc.                           Rensselaer NY 12144 Non-Profit             Clinics                  159,775
                                                                               Electronic Fetal
                                         1 EMPIRE DR                      Monitoring: Improving Birth
    Hospital Educational and Research RENSSELAER NY                        Outcomes in New York
    Fund, lnc.                        12144-5729 Non-Protit                         State                    119,428
                                                                              Expanding Health
                                                                           Insurance Coverage in
                                                                              New York State 4
                                                                           Streamlining Facilitated
                                                                               Enrollment and
i




i




                                         303 South Broadway,                Development of Web
    Hudson Center for Health Equity &    Suite 321 Tarrytown                   Based Eligibility
    Quality (Hcheq)                      NY 10591 Non-Profit                     Assessment                   22,914
                                         One Broad Street                    Transitioning Elderly
                                         Plaza Glens Falls NY              Patients from Hospital to
    Hudson Headwaters Health Network     12801 Non-Profit                            Home                    123,737
                                         1037 Main Street
                                         Peekskill NY 10566­               Yonkers Health Access
    Hudson River HealthCare, Inc.        2913 Non-Protit
                                         911 E MAIN ST
                                                                                  Project                    200,000

                                         ROCHESTER NY
    lbero-American Action League, Inc.   14605-2724 Non-Profit               Promotores de Salud              37,500
                                                                           improving Diabetes Care
                                                                             Among New Yorkgs
    IM Research and Service              744 Broadway Albany                   lntemal Medicine
    Corporation                          NY 12207 Non-Profit                       Physicians                 64,776

                                                                              Integrated Wellness.
                                                                          Improving the Assessment
                                         40 Rector Street, 8th            and Management of Type
                                         Floor New York NY                 ll Diabetes in Adults with
    Institute for Community Living       10006 Non-Proit                     Serious Mental Illness          143,105
                                         16 East 16th Street               New York State Diabetes
    institute for Family Health, The     New York NY 10003 Non-Profit        Campaign Leadership             217,207
                                         16 East 16th Street               New York State Diabetes
    Institute for Family Health, The     New York NY 10003 Non-Profit        Campaign Leadership             434,412

                                                                              Development and
                                         16 East 16th Street              Leadership of a New York
    Institute for Family Health, The     New York NY 10003 Non-Profit     State Diabetes Campaign            148,343
                                         2576 Broadway, Suite
                                         272 New York NY                   New York State Faith­
    Institute for Leadership lnc         10025 Non-Profit                 Based Diabetes Initiative          110,000
                                         2576 Broadway, Suite
                                         272 New York NY                   New York State Faith­
    institute for Leadership Inc         10025 Non-Profit                 Based Diabetes Initiative           89,081

                                         8900 Van Wyck                      initiating a Diabetes
                                         Expressway Jamaica               Management Program for
    Jamaica Hospital                     NY 11418-2897 Non-Profit         Underserved Populations            46,177

                                                                                                       ATTACHMENT B
                                                                                                              4of11
           a                             Complete
                                        Organization        Organization                                  Payment
    Organization Legal Name               Address              Ty-pe            Project Title             Amount
                                    184 Barton Street                         Diabetes Center of
Jericho Road Ministries             Buffalo NY 14213         Non-Proht       Community Excellence       $ 115,000
                                                                            Home Again: Veterans &
Jewish Board of Family and          120 West 57th Street                     Families Readjustment
Children"s Services, Inc.           New York NY 10019        Non-Proht         and Reintegration        $ 37,244
                                    6200 Beach Channel                     Preserving and Enhancing
Joseph P. Addabbo Family Health     Drive Arverne NY                        Primary Care Access in
Center, Inc.                        11692                    Non-Profit         Central Queens          $ 200,000
                                    149 West 24th Street
Korean Community Services of        6th Floor New York
Metropolitan New York, Inc.         NY 10011                 Non-Prolit           Stop Hep Bl           $ 13,244
                                    1726 M Street, Suite
                                    500 Nortwest                           Insight into How to Reduce
                                    Washington DC                            Churning in New York"s
Lake Research Partners lnc.         20036                      Profit           Medicaid Program        $ 11,633
                                                                              increasing immigrant
                                                                               Enrollment in Public
                                                                               Insurance Programs
                                                                                Through Targeted
                                                                            Education, Outreach, and
                                    301 Grove Street Direct Assistance in 10
Make the Road New York              Brooklyn NY 11237 Non-Profit Languages                              5 20,919
                                    7 Times Square New Streamlining Medicaid
Manatt Health Solutions             York NY 10036 Profit Spend Down                                     $ 4,820
                                    52 Vanderbilt Avenue Reforming New Yorkcs
Manhattan Institute for Policy      New York NY 10017- individual Insurance
Research, Inc.                      3808 Non-Profit Market, Phase 2                                     $ 36,059
                                                                           An Evaluation of Expande d
                                    1 ATWELL RD Access to Specialty Care
                                    COOPERSTOWN NY in Rural Hospitals through
Mary Imogene Bassett Hospi     tal, The 13326 Non-Prolit Telemedicine                                   $ 97,759
                                     600 Maryland
                                     Avenue, SW, Suite Reducing Hospital
Mathematica Policy Research, Inc.
                                    550 Washington DC
                                    20024-2512 Readmissions in New York $ 80,455
                                                      Profit State
                                                                               Increasing Health
                                                                            insurance Coverage for
                                  180 Water Street,                          Low Wage Workers at
Mayor"s Fund to Advance Ne w York 19th Floor New York Public/Govern          New York Citygs Small
City, The                         NY 10038                 ment                  Businesses             S 22,996
                                                                            Saving State Dollars by
                                    520 8th Avenue,                         Expanding Enrollment in
                                    North Wing, 3rd Floor                      Medicare Savings
Medicare Rights Center, Inc.        New York NY 10018        Non-Profit       Programs" Phase 2         $ 67,873
                                                                               Community MAP.
                                    520 8th Avenue, Medicare/Medicaid
                                    North Wing, 3rd Floor Assistance Project for the
Medicare Rights Center, Inc New York NY 10018 Non-Proht Southeast Bronx                                 $ 22,004
                                                                            Saving State Dollars by
                                    520 8th Avenue, Expanding Enrollment in
                                    North Wing, 3rd Floor Medicare Savings
Medicare Rights Center, Inc New York NY 10018 Non-Profit Programs                                       5 48,000
                                                                                                      ATTACHMENT B
                                                                                                              5 of 11
                                              Complete
                                            Organization Organization Payment
                                                     Title
r Organization Legal Name Address Type Project Dollars by Amount
                                        Saving State
                                        520 8th Avenue,                          Expanding Enrollment in
                                        North Wing, 3rd Floor                       Medicare Savings
   Medicare Rights Center, Inc.         New York NY 10018        Non-Profit              Programs              $ 12,000
                                                                                   Establishing a Bronx
                                        200 Corporate                            Collaborative for Health
                                        Boulevard South                           Improvement: Planning
   Monteliore Medical Center            Yonkers NY 10701         Non-Prolit                Grant               $ 37,500
                                                                                   Establishing a Bronx
                                        200 Corporate                            Collaborative for Health
                                        Boulevard South                           Improvement: Planning
   Montefiore Medical Center            Yonkers NY 10701
                                        3450 DEKALB AVE
                                                                 Non-Profit                Grant               $ 18,750
                                                                                 The Bronx Nutrition and
   Mosholu-Montefiore Community         BRONX NY 10467­                         Fitness Initiative for Teens
   Center, Inc.                         2302                     Non-Profit               (B"N Fit)            $ 7,500
                                                                                    Providing Technical
                                        1255 Fifth Avenue,                       Assistance to Expand
   Mount Sinai School of Medicine o f   Suite C-2 New York                       Palliative Care in New
   New York University                  NY 10029                 Non-Profit       York State Hospitals         $ 250,000
                                        2201 Hempstead                          NuCare. Coordinated Care
   Nassau Health Care Corporation,      Turnpike East           Public/Gove m   for the Medically
   The                                  Meadow NY 11554             ment               Underserved             $ 59,988
                                                                                  Developing Sustainable
                                                                                    Screening and Brief
                                                                                 Intervention Programs for
   National Center on Addiction and     633 3RD Avenue,                          Substance Use Disorders
   Substance Abuse at Columbia          19th Floor New York                     in Emergency Departments
   University                           NY 10017-8155            Non-Profit          in New York State         $ 214,953
                                                                                  Merger of the New York
                                                                                 City (NYC) and Southem
                                        733 Third Avenue, 3rd                    New York Chapters of the
   National Multiple Sclerosis Society, Floor New York NY                        National Multiple Sclerosis
   New York City Chapter                10017-3288
                                        4350 East West
                                                                 Non-Proit                Society              $ 78,200
                                        Highway Bethesda                        Survey of Employer Health
   National Opinion Research Cente F MD 20814                    Non-Profit     Benefits in New York, 2009 $       160,000
                                        102 West 38th Street,                   lntemships of the National
                                        7th Floor New York                       Urban Fellows, Class of
   National Urban Fellows, Inc.         NY 10018                 Non-Profit                 2010               $ 100,800
                                                                                   Expanding Technical
                                                                                 Assistance Support and
                                        71 West 23rd Street,                       Reach of NYSHealth
                                        8th Floor New York                       Center for Excellence in
   NDRI State, Inc                      NY 10010-3509            Non-Profit          Integrated Care           $ 110,644
                                                                                  Evaluation of The New
                                                                                   York Immigration
                                        1216 Fifth Ave New                      Coalition*s Strengthening
   New York Academy of Medicine         York NY 10029
                                        310 East 67th Street
                                                                 Non-Profit         Capacity Project           $ 14,472
                                                                                   Diversity Outreach
   New York Blood Center Inc            New York NY 10065        Non-Profit              Initiative            $ 111,972

                                                                                                            ATTACHMENT B
                                                                                                                    6 of 11
n


                                            Complete
                                           Organization         Organization                                    Payment
* Organization Legal Name                    Address               Type               Project Title             Amount
                                                                              New York City Health and
                                       CPHIVS, 125 Worth                        Hospitals Corporation
    New York City Health & Hospitals   Street, Rm 405 New       Public/Govem Evaluation of Expansion of
    Corporation                        York NY 10013                ment             HIV Testing             $ 1,475
                                                                                 improving Care and
                                                                                  Reducing Hospital
                                                                              Admissions and Costs for
                                                                               Patients at High Risk of
    New York City Health and Hospitals 462 First Avenue New Public/Govern Frequent Hospital
    Corporation                        York NY 10016           ment           Admissions                     $ 125,000
                                       c/o Public Health                         Public Education and
                                       Solutions, 220 Church                   Consumer Engagement in
    New York eHealth Collaborative,    Street, 5th Floor New                    NYS Health information
    inc.                               York NY 10013             Non-Profit      Technology Strategy         , S 99,935 1
    New York Health Plan Association   90 State Street, #825
    Council, Inc.                      Albany NY 12207           Non-Profit      NYQA Physician Portal       $ 88,510
                                       90 State Street, Suite                  Primary Care Practice and
    New York Health Plan Association   825 Albany NY 12207-1                     Regional Stakeholders
    Council, Inc                       1708                      Non-Profit      Assessment Proposal         $ 51,472
                                       90 State Street, Suite                  Primary Care Practice and
    New York Health Plan Association   825 Albany NY 12207                       Regional Stakeholders
    Council, Inc.                      1708                      Non-Prolit      Assessment Proposal         $ 10,942
                                       61 Broadway, Suite
    New York Health Purchasing         2705 New York NY                         HealthPass-Healthy NY
    Alliance, lnc.                     10006                     Non-Profit           Integration            $ 25,798
                                       61 Broadway, Suite
    New York Health Purchasing         2705 New York NY                         HealthPass-Healthy NY
    Alliance, lnc.                     10006                     Non-Prolit           Integration            $ 25,798
                                       61 Broadway, Suite
    New York Health Purchasing         2705 New York NY                         HealthPass-Healthy NY
    Alliance, Inc.                     10006                     Non-Profit           Integration            ZS 25,798
                                                                               Strengthening the Capacity
                                         137-139 W 25TH                        of Immigrant Organization S
                                         STREET 12TH F LR                           to Link Uninsured
                                         NEW YORK NY                           Immigrants to Health Care
    New York Immigration Coalition, Inc. 10001                   Non-Prolit          and ITISUTSDCE          $ 30,230
                                                                                 Leveraging Coverage
                                       95-25 Queens                               Through "Employer
    New York State Catholic Health     Boulevard Rego Park                      Partnerships For Family
    Plan. inc.                         NY 1 1374                 Non-Profit           Health Plus"           $ 79,856
                                       20 Corporate Woods
                                       Boulevard, Suite 602
    New York State Dental Foundation   Albany NY 12211           Non-Profit     Donated Dental Services      $ 180,000
                                       25 Beaver Street, 8th                     Process Evaluation of
    New York State Unified Court Floor New York NY Public/Govern Buffalo Veterans
    System 10004 ment Treatment Court                                                                        $ 15,480

                                                                                                          ATTACHMENT B
                                                                                                                    7 of 11
                                       Complete
     1
                                     Organization Organization Payment
                                      Address                     Amount
     Organization Legal Name                               Ty-pe             Project Title
                                 295 Lafayette Street,
                                 2nd Floor" New York                   Reimbursement Reform
New York University              NY 10012-7455           Non-Profit    and Cost Management             19,870
                                 345 East 24th Street,                  Columbia County Oral
                                 1037W New York NY                       Health Intervention
New York University              10010                   Non-Protit            Program                158,146
                                                                         Merger of Northeast
                                                                      Health, St. Petergs Health
                                 2212 Burdett Avenue                  Care Services, and Seton
Northeast Health, Inc.           Troy NY 12180-2401      Non-Profit             Health                160,000

                                 800 Starbuck Avenue,                 You"re Never Too Small to
Northem New York Rural Health    Suite A-5 Watertown                   Save a Life: Quality in
Care Alliance, Inc.              NY 13601                Non-Profit        CAH Hospitals               13,919
                                 61 DELANO ST
Northern Oswego County Health    PULASKI NY 13142­                    Consolidating the Oswego
Services, lnc.                   1400                    Non-Profit    Primary Care Safety Net        200,000
                                 169 RIVERSIDE DR
Our Lady of Lourdes Memorial     BINGHAMTON NY                        The Hope Dispensary of
Hospital, Inc.                   13905-4246              Non-Profit       the Southem Tier            198,326
                                                                        Quality Care through
                                                                      Quality Jobs: Expanding
                                 349 E 149TH ST FL                     Affordable Coverage to
Paraprofessional Healthcare      10 BRONX NY 10451­                   New York Stategs Direct­
Institute, Inc                   5603                    Non-Profit         Care Workers               21,762

                                                                      Resilience Project: A Rural
                                                                        Expansion of a Mental
                                 144 GENESEE ST                        Health Early Intervention
                                 STE 410 AUBURN                        Program for Elementary
Partnership for Results, Inc.    NY 13021-3511           Non-Profit         School Children            36,886
                                 79 Fifth Avenue, 4th
                                 Floor New York NY
Philanthropy New York            10003-3076              Non-Profit       Membership Grant             15,100
                                 26 BLEECKER ST                         Merging Resources to
Planned Parenthood of New York   NEW YORK NY                            Improve Reproductive
City, lnc.                       10012-2413              Non-Profit       -Health Services            175,243 ,
                                                                        Overcoming Tri-Lakes
                                 7061 State Rte. 9, PO                Small Business Barriers to
Plattsburgh & Clinton County     Box 310 Plattsburgh                  Offering Employee Health
Chamber of Commerce              NY 12901                Non-Profit           Insurance                13,287
                                                                       Developing a Telephone
                                                                       Renewal System for New
                                 18 Carriage Hill Road                 York State Public Health
PMB Healthcare Consulting        Brewster NY 10509         Proit         Insurance Programs            12,678
                                                                       Developing a Telephone
                                                                       Renewal System for New
                                 18 Carriage Hill Road                 York State Public Health
PMB Healthcare Consulting Brewster NY 10509 Profit                       Insurance Programs            12,678
                                 220 Church Street,                    Applying Technology to
                                 5th Floor New York                   Increase Health Insurance
Public Health Solutions NY 10013 Non-Proit                                    Enrollment              60,000

                                                                                                ATTACHMENT B
                                                                                                       8of11
                                        Complete
                                      Organization Organization Payment
                                       Address                     Amount
    Organization Legal Name                                Type             Project Title
                                  220 Church Street,
                                  5th Floor New York                  Open This Envelope, Stay
Public Health Solutions           NY 10013               Non-Profit            Covered             $ 20,000
                                                                       A Needs Assessment of
                                  P.O. Box 2138 Santa                  Retuming Veterans and
                                  Monica CA 90407­                    Their Families in New York
RAND Corporation                  2138                   Non-Profit State                          5 209,950
Research Foundation of City       425 E. 25th St New                  CUNY Campaign Against
University of New York (CUNY)     York NY 10010          Non-Profit             Diabetes           $ 150.000
                                                                         Addressing Cultural &
Research Foundation of State      402 Crofts Hall                         Linguistic Barners to
University of New York (SUNY)     Amherst NY 14260       Non-Profit      Facilitated Enrollment    $ 5.096
                                                                        Increasing Health Care
                                  411 State Street                       Policy Research and
Research Foundation of State      Albany NY 12203­                    Analysis Capability in New
University of New York (SUNY)     1003                   Non-Proht             York State          $ 32,289
                                                                          Reforming the Small
                                  411 State Street                     Group Insurance Market:
Research Foundation of State      Albany NY 12203­                     An Assessment of State
University of New York (SUNY)     1003                   Non-Profit Policies                       $ 46,921
                                  SUNY Plaza, 22
Research Foundation of State      Corporate Woods                       Reducing Variation in
University of New York, The       Blvd., 3rd Floor                     Medicaid Asset Transfer
(SUNY)                            Albany NY 12246        Non-Profit        Rates: Phase 2          S 79,741
                                  SUNY Plaza, 22
Research Foundation of State      Corporate Woods                       Reforming the Small
University of New York, The       Blvd., 3rd Floor                    Group Insurance Market,
(SUNY)                            Albany NY 12246
                                  250 Bedford Park
                                                         Non-Profit Phase 2                        $ 39,052
                                                                          CUNY-Community
Research Foundation of the City   Blvd. West Bronx N Y                  Partnership for Public
University of New York (CUNY)     10468                  Non-Proit        Health (CCPPH)           $ 127,520
                                  1425 PORTLAND
                                  AVE ROCHESTER                          Refugee Healthcare
Rochester General Hospital        NY 14621-3001          Non-Proit Project                         $ 134,102
                                  clo A. Holly
                                  Patterson, 875
                                  Jerusalem Ave                         The Medical Altruism
RotaCare, Inc.                    Uniondale NY 1155 3    Non-Profit Project                        S 25,000
                                  clo A. Holly
                                  Patterson, 875
                                  Jerusalem Ave                         The Medical Altruism
RotaCare, inc.                    Uniondale NY 1155 3    Non-Profit Project                        $ 25,000
                                  987 R.C. Hoag Driv 6 Public/Govem Revisioning SNHD
Seneca Nation Health Department   Salamanca NY 14779      ment Diabetes Management                 $ 6,315
                                  1300 Massachusett S
                                 Avenue Troy NY
Seton Health System, lnc.        12180                   Non-Proirit DEFY DIABETES*                $ 141,202
                                 1 Bluebird Square                     Establishing a Southern
Southem Tier Health Care System, Olean NY 14760­                        Tier Child Advocacy
Inc                              2500                    Non-Profit Center                         $ 29,112
                                                                                                 ATTACHMENT B
                                                                                                        9 of 11
                                          Complete
                                         Organization Organization Payment
     Organization Legal Name Address Type Project Title Amount
                                     1800 M Street, NW, Strategic Development and
                                     Suite 300 North Implementation Support for
                                     Washington, DC DC Children"s Coverage
Spitfire Strategies                  20036 Profit Enrollment Drives $                                           20.299
St. Lawrence County Health
Initiative and St. Lawrence County   80 State Highway 310 Public/Govern
Public Health Department             Canton NY 13617 ment Toward Total Coverage $                                9,415
                                     150 55th Street,
                                     Station 20 Brooklyn Dental Clinic Preservation
Sunset Park Health Council, Inc.     NY 11220 Non-Protit and Expansion $                                       160,000

                                     Ofhce of Sponsored Spreading Best Practices
                                     Programs, 113 Bowne to Reduce Geographic
                                     Hall SYRACUSE NY Variation and Health Care
Syracuse University                  13244-1200 Non-Profit Costs in New York State $                           223,105

                                     3130 Fairview Park
                                     Drive, Suite 800 Falls Bending the Cost Curve in
The Lewin Group, Inc.                Church VA 22042 Profit New York $                                          99,996

                                     3130 Fairview Park
                                     Drive, Suite 800 Falls Bending the Cost Curve in
The Lewin Group, Inc.                Church VA 22042 Profit New York $                                          99,995
The President and Directors of       37th and O Streets,
Georgetown College for              NW Washington DC                        Eligibility Simplification
Georgetown University               20057-0001
                                    Richardson 383,
                                                            Non-Proht                Project $ 5,000
                                                                           Cost Effective Delivery of
The Research Foundation of State University at Albany                      an Active Choices Health
University of New York (SUNY), Th 6 Albany NY 12222         Non-Profit        Promotion Program S 14,075
                                                                                A Healthcare
                                                                          Collaborative: Grass Roots
                                     333 W 57TH ST APT                       Caring Communities
                                     8C NEW YORK NY                        Connecting with Health
Transition Network, Inc.             10019-3120            Non-Profit              Providers $ 36,081
                                                                              Development and
                                                                             Implementation of an
                                                                           Innovative Primary Care
                                                                            Model for Low Income
                                     275 Seventh Avenue                      Retired Patients with
Unite Health Center, Inc.            New York NY 10001     Non-Profit              Diabetes $ 184,017
                                                                              Development and
                                                                             Implementation of an
                                                                           Innovative Primary Care
                                                                            Model for Low Income
                                     275 Seventh Avenue                      Retired Patients with
Unite Health Center, Inc             New York NY 10001     Non-Proit               Diabetes $ 46,004
                                     Empire State
                                     Building, 350 Fifth
                                     Avenue, 23rd Floor                    Promoting the Expansion
                                     New York NY 10118­                   of Health Insurance in New
United Hospital Fund of New York     2300                  Non-Profit             York State $ 388,362
                                     33 Second Street
Unity House of Troy Inc.             Troy NY 12180         Non-Profit     Hudson River Consortium $ 200,441
                                                                                                         ATTACHMENT B
                                                                                                               10 of 11
                                         Complete
                                       Organization Organization Payment
    Organization Legal Name Address Ty-pe Project Title Amount
                                   601 Elmwood Avenue
                                   Box 777 Pediatrics
University of Rochester            Rochester NY 14642
                                   601 Elmwood
                                                          Non-Prolit     Fostering Connections        $ 75,036
                                                                       Building Local Coalitions to
                                   Avenue, Box EHSC                     Prevent Childhood Lead
University of Rochester            Rochester NY 14620
                                   459 South Avenue
                                                          Non-Profit            Poisoning             $ 27,954
                                   Rochester NY 14620­                 Operation Welcome Home
Veterans Outreach Center, Inc.     1020                   Non-Profit         and Recovery             $ 93,084
                                   154 Christopher
                                   Street New York NY                   A Short-Stay Adult Day
Village Center for Care            10014-2840             Non-Protit      Rehabilitation Pilot        $ 82,895
                                                                       Establishing an Advanced
                                                                       lllness Management (AIM)
                                                                         Model in a Community­
                                                                       based Setting :Innovation
                                   107 East 70th Street                    at the Visiting Nurse
Visiting Nurse Service of New York New York NY 10021      Non-Profit       Service of New York        $ 389,177
                                                                       Establishing an Advanced
                                                                       Illness Management (AIM)
                                                                         Model in a Community­
                                                                       based Setting :Innovation
                                   107 East 70th Street                    at the Visiting Nurse
Visiting Nurse Service of New York New York NY 10021      Non-Profit       Service of New York        S 172,967
                                   110 W 97TH ST NEW                   Thelma C. Davidson Adair
William F. Ryan Community He alth YORK NY 10025­                       Community Health Center
Center Inc.                        6450                   Non-Profit            Acquisition           $ 160,001
                                   20 Jay Street, Suite                   Independent Workers
                                   700 Brooklyn NY                        Employment Benelits
Working Today, Inc                 11201                  Non-Profit              System              $ 125,000
                                                                                                      $ 13,017,652




                                                                                                 ATTACHMENT B
                                                                                                            11 Of11
                                                      New York State Health Foundation
                                                             December 31, 2009
                                                         Form 990-PF:Part XV - Line 3
                                                      Grant Approved for Future Payment




Actors Fund of America
                                 729 7th A 10th Flo " * "
 Organization Legal Name Complete Organization Address Organization Type Project Title Payment Amt
                                   venue, or
                                 New York NY 10019-6895                   Non-Prolit
                                                                                       Expanding Services for Artists at a
                                                                                             Free Health Care Clinic               43,798
                                                                                        Four Agency Financial and Data
AIDS Community Services of 206 S ELMWOOD AVE                                                  Management Systems
Westem New York, lnc.       BUFFALO NY 14201-2313                         Non-Prolit              Consolidation                    32,236
                            43 New Scotland Avenue, MC 119                             Pediatric Mental Health Services in I
Albaey Medical College      ALBANY NY 12208                               Non-Profit            the Capital Region                 48.524
                            PO BOX 471                                                    Northam Adirondack Health
Adirondack Medical Center   SARANAC LAKE NY 12983-0471                    Non-Profit                Exchange                       27,740
American Cancer Society,    260 Osbome Road
Eastem Division Inc.        Loudonville NY 12211                          Non-Profit      Consumer Voices for Coverage            150.026
Associated Community Action
of the Northeast Adirondack 39 Farrell Road                                               Creating Primary Care Access in
Region, lnc.                Willsboro NY 12996-3904                    , Non-Pront                  Dannemora                       1 0.000

                                 First Avenue & 16th Street New                             ADEPT: Action for Diabetes
Beth Israel Medical Center       York NY 10003                            Non-Profit   Education Programs and Treatment            51.099
                                 731 Market Street Suite 220 San ,                       New York State Diabetes Social
Better World Advertising, Inc.   Francisco CA 94103                         Pront             Marketing Campaign                 1 ,049,953
                                                                                        Developing a Statewide Diabetes
                                 13 Sugar Street                                        Care Physician Incentive Program
Bridges To Excellence, Inc.      Newtown CT 06470-2046                    Non-Profit            Among Payers                       64.429
                                                                                           From Potentially Avoidable
                                                                                           Complications to Potentially
                                                                                         Achievable Savings: A Payment
                                 13 Sugar Street           Newtown                         Reform Initiative For New York
Bridges To Excellence, lnc.      CT 06470-2046                            Non-Profit                   State                      371.695
Brownsville Community            592 ROCKAWAY AVE                                      Preserving and Expanding Primary
Development Corporation          BROOKLYN NY 11212-5539                   Non-Prolit        Care Access in Brooklyn                 49,960
Catholic Charities of            1654 W ONONDAGA ST SYRACUSE
Onondaga County                  NY 1 3204-331 0                          Non-Profit        Restructuring for Results               22,200
                                                                                       Evaluation Technical Assistance for
Center for Health Care           200 American Metro Blvd. Suite 119                         NYSHeelth Grantees and
Strategies Inc.                  Hamilton NJ 08619-2311                   Non-Profit           Applicants: Phase 2                 43,408
Center for Health Care           200 American Metro Blvd., Suite 119                      lntemal Evaluation Technical
Strategies lnc.                  Hamilton NJ 08619-2311                   Non-Proht     Assistance for NYSHF Grantees               50,778
Center for Health Care           200 American Metro Blvd. , Suite 119 "                  Reminkrng Care for New York-s
Strategies Inc.                  HBmiIt0n NJ 06619-2311                   Non-Front         High-Opportunity Patients             161,281
                                                                                        Policies to Maximize Immigrants:
Center for Independence of B41 Broadway, Suite 301                                          Enrollment in Existing and
the Disabled in New York, Inc. NEW YORK NY 10003-4704                     Non-Profit    Prospective Insurance Programs              21,495
                                                                                          Chinatown Diabetes ACTION
Charles B. Wang Community 268 Canal St.                                                  (Accelerating Collaboration To
Health Center, Inc.       New York NY 10013                               Non-Prolit    Improve Health Outcomes Now)                46,000
                                                                                         Designing an Arbitration-Based
                                                                                        Medical Injury Dispute Resolution
Common Good institute, Inc., 620 Eighth Avenue, Floor 38, Suite D                          System for New York Health
The                          New York NY 10018                            Non-Proht                  Systems                       101,320

Community Health Care            535 Eighth Avenue. 8th Floor
Association of New York State    NEW YORK NY 10018                        Non-Profit     Diabetes Leadership Campaign               50,515
Community Health Care            99 Troy Rd Suite 200 East Greenbush*                   Improving Retention ofthe Home
Services Foundation, Inc.        NY 12061                                 Non-Prolit            Care Workforce                      49.996
Community Health Center of       462 GRIDER ST                                         Increasing Access to Primary Ca re
Buffalo, Inc.                    BUFFALO NY 142153021                     Non-Profit              in Niagara Falls ,                40,925


                                                                                                                 ATTACHMENT C
                                                                                                                               1of6
1 Organization-Legal Name " Complete Organization Address Organization Type Project Title Payment Amt
                                                                                   Establishing On-Site Pharmacy
Community Health Project,      356 West 18th Street                                Access at a Community Health
Inc.                           New York NY 10011-4401               Non-Proit                   Center                    150,000
                                                                                    Family Health Plus Buy-ln: A
Community Service Society of 105 E 22ND ST                                           Practical Solution for Small
New York                     NEW YORK NY 10010-5413                 Non-Prolit              Businesses                        40,000
                             5001 Brittontield Parkway East                        Increasing Health Insurance for
Dairylea Cooperative, Inc.   Syracuse NY 13057                        Proht        New York"s Agricultural Sector         255.000
                                                                                    Coverage Reform Options:
Demos: A Network for Ideas     1 15 West 30th Street, Suite 1213                   Assessing the Impact on New
and Action                     New York NY 10001                    Non-Protit       York*s Small Businesses                  30,442
                                                                                   The Dr. Martin Luther King, Jr.
Dr. Martin Luther King, Jr.    1265 Franklin Avenue                                    Health Center Diabetes
Health Center, Inc.            BRONX NY 10456-3402                  Non-Profit          Management Initiative                 53.552
                                                                                 The Intensive Wellness Program: A
Dr. Martin Luther King, Jr.   1265 Franklin Avenue                                    Health and Mental Health
Health Center, Inc.           Bronx NY 10456-3402                   Non-Profit   Intervention for High Cost Patients      170,315
EPIC - Every Person           1000 Main Street                                     Ready, Set, Parentl Statewide
Influences Children Inc.      Buffalo NY 14202-1102                 Non-Profit               Expansion                    285,155
                              165 Court Street                                      Evaluating Patient-Centered
Excellus Health Plan, Inc.    Rochester NY 14647                    Non-Proit        Medical Home Pilot Project           225.000
Family Health Network of      17 MAIN ST Suite 302                                 Taking Charge of Diabetes, A
Central New York, Inc.        CORTLAND NY 13045-6615                Non-Profit         Collaborative Approach                 50.230
Floating Hospital Foundation, Grand Central Station - PO Box 3391                Expanding Primary Care Access in
Inc.                          New York NY 10163-3391                Non-Profit                                                42.790
                                                                                           Long Island City
Foundation for Long Term      150 STATE ST STE 301                                Efiicient and Cost-Effective Care
Care, Inc.                    ALBANY NY 12207-1626                  Non-Profit                 Planning                       88,739

Foundation for Long Term      150 STATE ST STE 301                                Research to Practice: Long Term
Care, Inc.                    ALBANY NY 12207-1626                  Non-Profit   Care Charge Nurse Peer Mentoring             36.636
Fund for Public Health in New 291 BROADWAY FL 17                                  A Falling Tide of Salt Lowers All
York                          NEW YORK NY 10007-1855                Non-Profit            Blood Pressures                     39,977
                              100 PARK ST                                        Sustainable Strategies for Diabetes
Glens Falls Hospital, Inc.    GLENS FALLS NY 12801-4413             Non-Profit           Self Management                      34,554
Greater New York Hospital     555 West 57th Street, 15th Floor                    Promoting a Medical Malpractice
Foundation, Inc.              New York NY 10019-2925                Non-Prolit         Early Settlement Model                  4,840
                               1 HARTWICK DR                                      Strengthening the Rural Nursing
Hartwick College               ONEONTA NY 13820-4000                Non-Profit              Workforce                         16.606
                                                                                   Merging Agencies to Advance
Health Association of Niagara 1302 MAIN ST                                         Disease Prevention in Niagara
County, Inc.                  NIAGARA FALLS NY 14301-1118           Non-Prolit                County                          15,959
                              Riverview Center,
                              150 Broadway, Suite 560                            Assessment of Certified Diabetes
Health Research, Inc.         Menands NY 12204                      Non-Profit     Educators in New York State                24,917
                                                                                     Electronic Fetal Monitoring:
Hospital Educational and       1 EMPIRE DR                                        Improving Birth Outcomes in New
Research Fund, Inc.            RENSSELAER NY 12144-5729             Non-Profit               York State                   238,854
                                                                                   Improving Diabetes Outcomes in
Hospital Educational and       One Empire Drive                                  New York State Hospital Outpatient
Research Fund, Inc.            Rensselaer NY 12144                  Non-Profit                  Clinics                   159,775
Hudson Headwaters Health       One Broad Street Plaza                            Transitioning Elderly Patients from
Network                       Glens Falls NY 12801                  Non-Profit            Hospital to Home                123,737
                              1037 Main Street
Hudson River HealthCare, Inc. Peekskill NY 10566-2913               Non-Proit      Yonkers Health Access Project              50,000
                                                                                  Improving Diabetes Care Among
IM Research and Service        744 Broadway                                         New York"s lntemal Medicine
Corporation                    Albany NY 12207                        Profit                Physicians                    129,552

                                                                                 Integrated Wellness: Improving the
                                                                                  Assessment and Management of
                               40 Rector Street, Bth Floor                          Type ll Diabetes in Adults with
Institute for Community Living New York NY 10006                    Non-Profit          Serious Mental Illness            143,104

                                                                                                          ATTACHMENT C
                                                                                                                       2of6
- g Organization Legal Name Complete Organization Address Organization Type Project Title                                    Payment Amt
                                    16 East 16th Street                                 Development and Leadership ofa
  ,institute for Family Health. The New York NY 10003                     Non-Proht    New York State Diabetes Campaign           148,343
                                  18 East 16th Street                                  New York State Diabetes Campaign
  institute for Family Health, The New York NY 10003                      Non-Profit              Leadership                      217,206
                                   2576 Broadway. Suite 272                               New York State Faith-Based
   institute for Leadership inc.   New York NY 10025                      Non-Prclit           Diabetes initiative                267,243
   iraq and Afghanistan Veterans 292 Madison Ave, 10th Floor New
   of America inc.                 York NY 10017                          Non-Profit     IAVA Veteransg Health initiative          14.997
                                                                                        initiating a Diabetes Management
                                  8900 Van Wyck Expressway Jamaica                           Program for Underserved
  Jamaica Hospital                NY 11418-2897                           Non-Profit                 Populations                   46,177
                                  184 Barton Street                                       Diabetes Center of Community
  Jericho Road Ministries         Buffalo NY 14213                        Non-Profit                 Excellence                   115,000
  Jewish Board of Family and      120 West 57th Street New                              Home Again: Veterans 8. Families 1
  Chiidren"s Services, inc.       York NY 10019                           Non-Profit     Readjustment and Reintegration            55,867

  Joseph P. Addabbo Family        6200 Beach Channel Drive                             Preserving and Enhancing Primary
  Health Center. inc.             Arveme NY 11692                         Non-Profit    Care Access in Central Queens              50.000
  Manufacturers Association of    512 Falconer Street                                    Small Business Access Health
  the Southem Tier, Inc.          Jamestown NY 14701                      Non-Proit            Insurance initiative                19.844
  Mathematica Policy Research,    600 Maryland Avenue, SW, Suite 550                   Reducing Hospital Readmissions in
  inc.                            Washington DC 20024-2512                  Proit                New York State                   241 ,365
                                  16 East 34 Street New York NY
  MDRC                            10016                                   Non-Profit           Evaluation of CIDP                 1 50,000

                                                                                       Saving State Dollars by Expanding
                                  520 8th Avenue, North Wing, 3rd Fi                     Enrollment in Medicare Savings
  Medicare Rights Center, inc.    New York NY 10018                       Non-Profit           Proglamsz Phase 2                   16.968
                                                                                       Establishing a Bronx Collaborative
                                  200 Corporate Boulevard                               for Health improvement: Planning
  Montehore Medii Center          South Yonkers NY 10701                  Non-Profit                   Grant                        18,750
  Mount Sinai School of                                                                 Providing Technical Assistance to
  Medicine cf New York            1255 Fifth Avenue, Suite C-2                         Expand Palliative Care in New York
  University                      New York NY 10029                       Non-Profit              State Hospitals                 250,000
  Nassau Health Care              2201 Hempstead Turnpike                               NuCare: Coordinated Care for the
  Corporation, The                East Meadow NY 11554                 Public/Govemment Medically Underserved                     119,974
                                                                                       Developing Sustainable Screening
                                                                                       and Brief intervention Programs for
  National Center on Addiction                                                             Substance Use Disorders in
  and Substance Abuse at          633 3RD Avenue, 19th Floor New                         Emergency Departments in New
  Columbia University             York NY 10017-8155                      Non-Profit                York State                    214.953
                                                                                       Merger ofthe New York City (NYC)
  National Multiple Sclerosis                                                           and Southem New York Chapters
  Society, New York City          733 Third Avenue, 3rd Floor                           of the National Multiple Sclerosis
  Chapter                         New York NY 10017-3288                  Non-Profit                  Society                       19.550
  National Opinion Research       4350 East West Highway                               Survey of Employer Health Benefits
  Center                          Bethesda MD 20814                       Non-Proiit            in New York, 2009                  40.000
                                  102 West 38th Street. 7th Floor                       lntemships of the National Urban
  National Urban Fellows, inc.    New York NY 10018                       Non-Proit           Fellows, Class of 2010               25,200
                                  120 Wall Street, 8th Floor New                        Community Healthcare Navigator
  National Urban League           York NY 10005                           Non-Proit                   Project                      41.065
                                                                                       People First Center of Excellence
                                                                                          for the integration of Care for
                                                                                          Individuals with Co-Occurring
                                  71 West 23rd Street, 8th Floor                         Mental Health & Substance Use
  NDRI State, inc.                New York NY 10010-3509                  Non-Profit                 Disorders                  2,401,149
                                                                                        Expanding Technical Assistance
                                                                                       Support and Reach of NYSHeaith
                                  71 West 23rd Street, 8th Floor                       Center for Excellence in integrated
  ,NDRl State. inc.               New York NY 10010-3509                  Non-Profit                   Care                       331,927
                                  310 East 67th Street
  New York Blood Center Inc.      New York NY 10065                       Non-Profit       Diversity Outreach Initiative            55,986
                                                                                                                 KTTKCHMENTC"-1
                                                                                                                             3of6
 Organlzatlon,Legal Name Complete Organization Address .Organization Type Project Title Payment Ami
New York City Alliance                 27 Christopher Street                                         SAFE NYC: Quality Care for
Against Sexual Assault                 New York NY 10014                           Non-Protit             Assault Victims                   35.411
New York City Health &                 506 Lenox Avenue New York NY
Hospitals Corporation                  10037                                   PubliclGovemment          Muslim Health Clinic              154 ,631
New York City Health &                 79-01 Broadway                                            New Mothers Breastfeeding
Hospitals Corporation                  Elmhurst NY 11373                      PubliclGovemment      Education and Sugport                   31.205
                                                                                                Improving Care and Reducing
                                                                                               Hospital Admissions and Costs for
New York City Health and               462 First Avenue                   New                  Patients at High Risk of Frequent
Hospitals Corporation                  York NY 10016                          PubliclGovemment       Hospital Admissions                   375.00(
New York Health Plan                   90 State Street, #825
Association Council, Inc.              Albany NY 12207                             Non-Proht            NYQA Physician Portal               88,51(
New York Health Purchasing             61 Broadway, Suite 2705
Alliance, Inc.                         New York NY 10006                           Non-Proit      HealthPass-Healthy NY Integration         25.795
New York Legal Assistan ce             450 West 33rd Street, 11th Floor                           LegelHealth Technical Assistance
Group, inc.                            New York NY 10001-2603                      Non-Protit                  Project                      23,00(
                                                                                                    Leveraging Coverage Through
New York State Catholic                95-25 Queens Boulevard                                     "Employer Partnerships For Family
Health Plan, Inc.                      Rego Park NY 11374                          Non-Proht                 Health Plus"                   19.964
New York State Dental                  20 Corporate Woods Boulevard, Suite
Foundation                             602 Albany NY 12211                         Non-Protit         Donated Dental Services               45.000
New York State Unihed Court            25 Beaver Street, 8th Floor                                  Process Evaluation of Buffalo
System                                 New York NY 10004                       Public/Govemment      Veterans Treatment Court                  3,870
                                       345 EeS124th Street, N BW                                    Columbia County Oral Health
New York University                    York NY 10010                               Non-Protit           lnteniention Program                39.536
                                                                                                    Merger of Northeast Health. St.
                                       2212 Burdett Avenue                                        Peters Health Care Services, and
Northeast Health, Inc.                 Troy NY 12180-2401                          Non-Protit              Seton Health                     40.000

Northem New York Rural                 P.O. Box 891                                               HeaIthNet Mental Health Services
Behavioral Health Institute   Ill C.   Saranac Lake NY 12983-0891                  Non-Protit         for North Country Elders              52.785
Northem Oswego County                  61 DELANO ST                                               Consolidating the Oswego Primary
Health Services, inc.                  PULASKI NY 13142-1400                       Non-Protit             Care Safety Net                  200.000

Northwest Buffalo Commu nity 155 Lawn Ave                                                          integrating Mental Health Services
Health Care Center Inc       Buffalo NY 14207                                      Non-Profit          into a Primary Care Setting          47, 943
Our Lady of Lourdes Memori 169 RIVERSIDE DR                                                           The Hope Dispensary ofthe
Hospital, Inc                BINGHAMTON NY 13905-4246                              Non-Proit                  Southem Tier                  49.581
Planned Parenthood of NeW 126 BLEECKER ST                                                             Expanding Access to Care on
York City, Inc.              NEW YORK NY 10012-2413                                Non-Profit        Staten Island for Young Adults         10,707
Planned Parenthood of N eW             26 BLEECKER ST N
                                                      EW                                             Merging Resources to Improve
York City, lnc.              YORK NY 10012-2413                                    Non-Profit         Reproductive Health Services         175,242
Primary Care Developme nt    22 CORTLANDT ST 12TH FLR                                                 Assessment of the Financial
Corporation                  NEW YORK NY 10007-3107                                Non-Protit        Viability of NYS Health Centers        59.000
                                                                                                   Use of the Scanvan for Screening
                                                                                                  for Tuberculosis and Breast Cancer
                                       200 VARICK STREET                                            among Poor and Homeless New
Project Renewal. Inc.                  NEW YORK NY 10014-4610                      Non-Protit                     Yorkers                   46.000
                                       220 Church Street, 5th Floor                                 Applying Technology to Increase
Public Health Solutions                New York NY 10013                           Non-Protit         Health insurance Enrollment              15.000

Queens Library Foundatio ni            89-11 MERRICK BOULEVARD                                    "Know Better-Feel Better": Queens
Inc.                                   JAMAICA NY 11432-5242                       Non-Protit      Library"s Health Literacy Program        40.000
                                                                                                  A Needs Assessment of Retuming
                                       P.O. Box 2138 Sa nta                                       Veterans and Their Families in New
RAND Corporation                       Monica CA 90407-2138                        Non-Protit                 York State                   264.950
Research 8. Education
Foundation of the New Yo rk
State Academy of Family                260 Osbome Road                                             improving Diabetes Care Among
Physicians                             Loudonvrlle NY 12211-1822                   Non-Protit       New York"s Family Physicians               31,395



                                                                                                                           ATTACHMENT C
                                                                                                                                        4of6
    , , Organization Legal Name Complete Organization Address Organization Type Project Title Payment Amt
                                                                                                 Critical Time intervention for
                                                                                                   Frequent Users of the
      Research Foundation for             1051 Riverside Drive                                   Comprehensive Psychiatric
      Mental l-lygiene, Inc.              New York NY 10032                      Non-Proit          Emergency Programs 222,460
      Research Foundation of City
      University of New York              425 E. 25th St
     -(CU NYl                             New York NY 10010                      Non-Proiit   CUNY Campaign Against Diabetes 45,000
      Research Foundation of State
      University of New York, The         SUNY Plaza, 22 Corporate Woods                       Reducing Variation in Medicaid
     jSUNYl                               Blvd., 3rd Floor Albany NY 12246       Non-Proit     Asset Transfer Rates: Phase 2 19,935
      Research Foundation of the
      City University of New York         250 Bedford Park Blvd. West                         CUNY-Community Partnership for
     *(cui-ivy                            Bronx NY 10468                         Non-Proht        Public Health (CCPPH) 127.499
                                          1425 PORTLAND AVE
      Rochester General Hospital          ROCHESTER NY 14621-3001                Non-Profit      Refugee Healthcare Project 33,526
                                          do A. Holly Patterson, 875 Jerusalem
      RotaCare, lnc.                      Ave Uniondale NY 11553                 Non-Prolit     The Medical Altruism Project 25,000
                                                                                               Making it Easy: Planning a Rural
      S2AY Rural Health Network           PO BOX 97                                           Strategy to Increase Enrollment in
      lnc.
      Schenectady Inner City
                                          CORNING NY 14830-0097
                                          930 ALBANY ST SCHENECTADY NY
                                                                                 Non-Profit               Healthy NY , 19,527
      Ministry*                           12307-1 514                            Non-Proit     spiritually sauna - Physically Fii 23,000
                                          1300 Massachusetts Avenue Troy
      Seton Health System, Inc.           NY 12180                               Non-Prolit           DEFY DIABETESI 141.202
      Southern Tier Health C BFE          1 Bluebird Square                                   Establishing a Southem Tier Child
      System, Inc.
      Sunset Park Health Council,
                                          Olean NY 14760-2500                    Non-Prolit           Advocacy Center , 58.222
                                                                                                Dental Clinic Preservation and
                                          150 55th Street, Station 20 Brooklyn
      lnc                                 NY 11220                               Non-Prolit               Expansion 40.000
                                                                                                Spreading Best Practices to
                                          Oflice of Sponsored Programs,                       Reduce Geographic Variation and

      ,Syracuse University
                                          113 Bowne Hall SYRACUSE NY
                                          1 3244-1 200
                                          3130 Fairview Park Drive, Suite 800
                                                                                 Non-Prolit                  State 55,776
                                                                                               Health Care Costs in New York


      The Lewin Group, inc.               Falls Church VA 22042                    Profit                    York , 199,990
                                                                                               Bending the Cost Curve in New

                                                                                              A Healthcare Collaborative: Grass
                                          333 W 57TH ST APT 8C NEW                               Roots Caring Communities
      Transition Network, inc.            YORK NY 10019-3120                     Non-Profit   Connecting with Health Providers 36,081
                                                                                                 First Steps to Healthy Living:
            . . . . of
      Trustees of Columbia
      University in the City        New   722 West 168th Street
                                                                                              Evaluation of New York State Early
                                                                                                Childhood Obesity Prevention
      York                                New York NY 10032
                                          462 Grider Street Buffalo
                                                                                 Non-Proht                 Programs 39,341
                                                                                               improving Diabetes Outcomes in
      UB Famly Medicine, Inc.             NY 14215-3021                          Non-Prolit   Behavioral Health Care Recipients 88.013
                                          EMPIRESTATE BLDG
      United Hospital Fund of New         350 ST H AVE, 23rd floor                            Promoting the Expansion of Health
      York                                NEW YORK NY 10118-0000                 Non-Prolit      Insurance in New York State 116.509
                                          EMPIRESTATE BLDG                                       Expanding Health Insurance
      United Hospital Fund of New         350 5TH AVE, 23rd floor
      York
      United Way of Long Island,
                                          NEW YORK NY 10118-0000
                                          819 Grand Blvd. Deer
                                                                                 Non-Profit                Phase ll 273.676
                                                                                                Expansion in New York State,
                                                                                              Mobile Dental Services for At-Risk
      Inc.                                Park NY 11729
                                          aa second street
                                                                                 Non-Prolit              Populations 189.927
i




      Unity House of Troy Inc.            Troy NY 12180                          Non-Profit       Hudson River Consortium 50.110
                                          601 Elmwood Avenue
                                          Box 777 Pediatrics
      Universiy of Rocheste    I"         Rochester NY 14642
                                          601 Elmwood Avenue
                                                                                 Non-Prolit         Fostering Connections 225.105
                                                                                                 Health-e-Access: Optimizing
                                          Box 777 Pediatrics                                     Access to Avoid Emergency
      University of Rocheste F
      Veterans Outreach Ce rlter,
                                          Rochester NY 14642
                                          459 South Avenue
                                                                                 Non-Prolit            Department Use 159.071
                                                                                               Operation Welcome Home and
      Inc.
      Visiting Nurse Service of New
                                          Rochester NY 14620-1020
                                          107 East 70th Street New
                                                                                 Non-Proit                 Recovery 93,063
                                                                                                 CHAMP Geriatric Medication
      York                                York NY 10021                          Non-Profit         Management Program 46. 543
                                                                                                                                   5 of 6
      i
Q.

      Organization Legal Name Complete Organization Address Org anlzation TDE              Project Tltle            Payment Amt
4 Westfield ,Memonal Hospital, 189 East Main Street
- lnc.                           Westfield NY 14787                  Non-Profit     Amish Midwifery Care Program         22.800
                                                                                     Baby Basics Prenatal Health
                                 211 West 80th Street, Lower Level                Literacy Program at MIC Women"s
     What to Expect Foundation   New York NY 10024                   Non-Proit              Health Centers               59.984
                                                                                      Thelma C. Davidson Adair
     William F. Ryan Community   110 W 97TH ST                                        Community Health Center
     Health Center Inc. "        NEW YORK NY 10025-6450              Non-Proit                Acquisition                40.000
                                 20 Jay Street, Suite 700                         Independent Workers Employment
     Working Today, Inc.         Brooklyn NY 11201                   Non-Profit            Benehts System                125.000

                                                                                          Grants Payable S 14,229,790
                                                                                          Grant Discount (136,150)
                                                                                                                    Lm-g
                                                                                        Net Grants Payable S 14,093 640




                                                                                                           ATTACHMENT C
                                                                                                                    60f6
                   NEW YORK STATE HEALTH FOUNDATION
                             EIN # 30-0127892
                                   December 31, 2009
                                     Form 990-PF



Part IX-A Summary of Direct Charitable Activities

The New York State Diabetes Campaign - Reversing the Epidemic: An initiative to
reverse the growing diabetes epidemic in New York State by working to improve clinical
care, mobilize communities, and promote policy to create better outcomes for patients
with diabetes.
$ 278,050

Having it A11: Conference hosted by NYSHealth and attended by more than 300
participants that examined health care cost containment strategies.
$ 77,500

Evaluation Initiative: A project in which the foundation evaluates its grant making
initiatives and develops reports that communicate the findings from the initiatives that
NYSHealth has funded. The purpose of these reports is to make it possible for
individuals in the health sector to learn from the Foundation*s work and to be able to
apply these findings to improve the New York State health system.
S 62,829

Conversations With... A regular series of educational seminars with leaders in health care
policy and practice conducted for grantees and other stakeholders in healthcare policy
attended by a total of approximately 240 participants.
$ 16,015




                                                                      ATTACHIVIENT D
                                         New York State Health Foundation
                                                   EIN # 30-0127892
                                       Fonn 990-PF: Part II - Balance Sheet
                                         Schedule of Portfolio Holdings
                                               December 31, 2009



                                                                      BALANCE AT DECEMBER 31, 2009
              TYPE AND NAME OF                             N0. OF                                    MARKET
                  SECURITY                                 SHARES                 COST               VALUE


ISHARES Tmst Russell 1000 Index Fund                             732,000            49,851,126         44,878,919
ACWI Ex-US Superfund B                                        407,108 74             8,020,000          8,143,320
MSCI Emerging Mkts Free B                                      30,661.76               890,000            910,182
Russell 1000 Index B                                        1,457,081 24            15,455,088         17,928,930

                        Equlty Index Funds Sub-total        z,s2e,es1.14            74,216,214         71 ,861,351

ISHARES TRUST COMEX GOLD ETF                                        31.050           4,133,580          3.978.059

                                  Gold ETF Sub-total 37,050.00                       4,133,580          3,976,059

BGI 7-1 Oyr Treas Bond                                      6,070,024.61            84,493,601         83,116,610
ISHARES 20+ Yr Treasury Index                                    429.800            36,774,685         38,634,722
ISHARES TRUST US TREAS INFLATION PROJECT                         411,480            40,909,118         42,752,772
                        Flxed Income Funds Sub-total        6,91 1 ,304.61         1 62,1 77,404      1 64,504,104


              TYPE AND NAME OF                              PAR                                      MARKET
                    BOND                                   VALUE                  COST               VALUE


CVS Caremark 5 75%                                            750,000.00               761,970            791,558
Dow Chem Co SR 5.7%                                         1,000,000 00               912,480          1,015,860
Home Depot 5.25%                                            1,000,000.00             1,037,780          1,070,560
Kroger Co 6.15%                                             1,000,000.00             1,049,430          1,070,250
Oracle Corp 5%                                              1,000,000.00               998,050          1,031,300
Time Wamer 5 4%                                             1,000,000 00             1,044,990          1,068,430
Venzon 6.4%                                                 1,000,000.00               997,960          1,045,410
Viacom Inc 4.375%                                           1,000,000.00               996,485          1,031,260
News Amenca 5.65%                                           1,000,000.00             1,011,160          1,041,250
Newmont Mimng 5 125%                                          500,000.00               497,510            500,235
Goldman Sachs 5 5%                                          1,000,000 00             1,164,140          1,165,800
JPMorgan Chase 6.3%                                         1,000,000.00             1,092,690          1,100,080
Computer Assoc 5 375%                                       1,000,000.00               991,620          1,005,610
Republic Svcs 5 250%                                        1,000,000.00             1,001,788            983,230
TD Amentrade 4 150%                                         1,000,000.00             1,005,901            985,930
Blackrock, Inc 3.500%                                       1,000,000.00             1,005,118            987,440

                          Corporate Bonds Sub-total        1 5,250,000.00           1 5,569,072        1s,a94,zoa
NY NY Ser D-1 4 749% *                                      1,000,000.00             1.000.000            971.930

                Taxable Munlclpal Bonds Sub-total           1 ,000,000.00            1 ,000,000           911,930

                                      Total Holdlngs                               257,096,270        251,209,541




                                                                                                       ATTACHMENT E
F"
      New York State Health Foundation
* EIN# 30-0127892
      Form 990-PF
      Part Il - Balance Sheet
      Detail of Line 14



                                                          (A) (B)
                                                    Beginning of year End of year
                          Property Description Book Vaule Book Vaule FMV
      Leasehold Improvements $ 39,890 S 129,420 $ 129,420
      Leasehold Improvements - Accumulated Depreciation (13,222) (21,200) (21,200)
      Furniture Fixtures and Equipment 239,074 438,138 438,138
      Fumiture Fixtures and Equipment - Accumulated Depreciation (91 ,71 11 (1 33,0351 (133,035)
            Total of Line 14 Column (A) and (B) S 1 74,031 $ 413,323 $ 413,323




                                                                                   ATTACHMENT F
" . Form 8868 Application for Extension of Time To File an
                               2009) Exempt Organization Return
4 o (Rev-AP"* service P File a separate application for each return. OMB N0-1545-1109
    Department of the Treasury
    iniemai Revenue
   0 lf you are filing for an Automatic 3-Month Extension, complete only Part I and check this box P
   0 lf you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part ll (on page 2 of this form)




   Part I only P lj
   Do not complete Part ll unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.

   Alliomatic 3-MOrlth EXIel1Si0l1 Of TilT16. Only submit onginal (no copies needed).
   A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete

   A/I other corporations 0nc/uding 1120-C fi/ers). partnerships, REMICS, and trusts must use Form 7004 to request an extension of time
   to file income tax retums.
   Electronic Filing (e-file). Generally, you can electronically t"iIe Form 8868 if you want a 3-month automatic extension of time to file one of the returns
   noted below (6 months for a corporation required to file Form 990-T). However. you cannot file Form 8868 electronically if (1) you want the additional
   (not automatic) 3-month extension or (2) you tile Fomis 990-BL, 6069, or 8870, group retums, or a composite or consolidated Form 990-T. Instead.
   you must submit the fully completed and signed page 2 (Part ll) of Form 8868. For more details on the electronic filing of this form, visit
   www.irs , ov/eHIe and click on e-fi/e for Chanties & Nonprofits.
   Type or Name of Exempt Organization Employer identification number
   print
   Flle by the
                  NEW YORK STATE HEALTH FOUNDATION 30-0 1 2 7 89 2
   du., dat., fo, Number, street, and room or suite no. lf a P.O. box, see instnictions.
   """9See
   retum YW* 1 3 85 BROADWAY , 2 3RD FLOOR
   lfislwciiviis City, town or post office, state, and ZIP code. For a foreign address, see instructions.
                  NEW YORK, NY 10018-6013
   Check type of retum to be filed(file a separate application for each return):
    1:1 Form 990 1:1 Form 990-T (corporation) 1:1 Form 4720
    II) Form 990-BL Il Form 990-T (sec. 4o1(a) or 4oa(a) trust) Il Form 5227
    Q Form 990-EZ 1:1 Form 990-T (trust other than above) E Form 6069
    KI Form 990-PF lj Form 1041-A Cl Form aavo
                               THE FOUNDATION
   o The books are in the care of P 1 385 BROADWAY , 2 3RD FLOOR - NEW YORK , NY 100 1 8-60 1 3
       TelephoneNo.P 212-664-7656 FAXNo.P
   0 If the organization does not have an office or place of business in the United States, check this box P 1:1
   0 If this is for a Group Fletum, enter the organization"s four digit Group Exemption Number (GEN) . lf this is for the whole group, check this
   box P 1:1 . If it is for part of the group, check this box P Cl and attach a list with the names and ElNs of all members the extension will cover

    1 I request an automatic 3-month (6-months for a corporation required to file Form 990-T) extension of time until
                 AUGUST 1 6 , 2 0 1 0 ,to tile the exempt organization retum for the organization named above. The extension
            is for the organization"s retum for:

            P lj tax year beginning , and ending .
            P ,X1 calendar year 2 0 0 9 or


    2 If this tax year is for less than 12 months, check reason: lj Initial retum 1:1 Hnal retum 1:1 Change in accounting penod

    3a lf this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentatwe tax, less any
            nonrefundable credits. See instructions. 3a $ 1 7 1 r 5 2 3 ­
     b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated
            tax payments made. Include any-pnor year overpayment allowed as a credit. $ 1 7 1 r 5 2 3 ­

            See instructions. 3c 0 ­
     c Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, " 1
            deposit with l-TD coupon or, if required, by using EFI" PS (Electronic Federal Tax Payment System). f

   Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions.
   LHA For Privacy Act and Paperwork Reduction Act Notice, see Instructions. Form 8868 (Rev 4-2009)


   923531
   05-26-09
                                                                                       20
 10130602 756359 620245 2009.03060 NEW YORK STATE HEALTH FOUND 620245-1

				
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