Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIAINC
 
Employer identification number
58-1592076
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) AMERICAN CANCER SOCIETY INC
250 Williams NW
Atlanta,GA30303
13-1788491 501(c)(3) 50,000       Resource Navigation for Cancer Patients
(2) AMERICAN HEART ASSOCIATION
1101 Northchase Pky
Marietta,GA30067
13-5613797 501(c)(3) 48,210       Funding for Atlanta Go Red-Women Lunch and 2016 He
(3) ATLANTA BELTLINE PARTNERSHIP INC
250 Williams St 2115
Atlanta,GA30303
56-2464486 501(c)(3) 1,250,000       Segment of the Westside Trail
(4) ATLANTA COMMUNITY FOOD BANK
732 Joseph E Lowery
Atlanta,GA30318
58-1376648 501(c)(3) 85,000       Incr access-health food client thru
(5) ATLANTA LEADERSHIP DEVELOPMENT
10 Peachtree Pl 620
Atlanta,GA30309
23-7015688 501(c)(3) 6,000       Leadership Atlanta Health Day Program
(6) BACK ON MY FEET
100 S Broad 1400
Philadelphia,PA19110
26-2109809 501(c)(3) 50,000       Reduce Homelessness individuals' disease
(7) BIG BROTHERS BIG SISTERS OF METRO
1382 Peachtree NE
Atlanta,GA30309
58-0861895 501(c)(3) 25,000       Address childhd obesity-incr participa
(8) BOAT PEOPLE SOS-ATLANTA INC
6107 Oakbrook Pkwy
Norcross,GA30093
30-0737900 501(c)(3) 50,000       Impact care access thru health life
(9) BOYS & GIRLS CLUBS OF METRO ATLANTA INC
1275 Peachtree NE500
Atlanta,GA30309
58-0566123 501(c)(3) 50,000       Impact Childhood Obesity-Incr Part. Exer
(10) CAMP KUDZU INC
5885 Glenridge 160
Atlanta,GA30328
58-2449646 501(c)(3) 50,000       Funding for The Diabetes Summer Camp
(11) CAPTAIN PLANET FOUNDATION
133 Luckie St 2nd Fl
Atlanta,GA30303
58-1959421 501(c)(3) 52,500       Garden-Cafeteria & Learning Garden Prog
(12) CATHOLIC CHARITIES OF THE ARCHDIOCESE
2401 Lake Park SE
Smyrna,GA30080
58-1097003 501(c)(3) 10,000       Mental Health Counseling in Dekalb
(13) CENTER FOR PUPPETRY ARTS INC
1404 Spring St NW
Atlanta,GA30309
58-1275610 501(c)(3) 15,000       Distance Learning Health Initiative
(14) CENTER FOR THE VISUALLY IMPAIRED INC
739 W Peachtree SW
Atlanta,GA30308
58-1168874 501(c)(3) 10,000       Diabetes Mgmt Program for Low-Vision
(15) CHATTAHOOCHEE NATURE CENTER INC
9135 Willeo Rd
Roswell,GA30075
58-1275604 501(c)(3) 30,000       Increase healthy food availability
(16) CHILDREN'S MUSEUM OF ATLANTA
275 Centennial Oly
Atlanta,GA30313
58-1785484 501(c)(3) 85,000       Deliver Nutrition Ditness & Safety
(17) CHRIS KIDS INC
1017 Fayetteville B
Atlanta,GA30316
58-1430183 501(c)(3) 75,000       Provide the comm w high quality behavio
(18) CLAYTON COUNTY BOARD OF HEALTH
1117 Battlecreek Rd
Jonesboro,GA30236
58-1108112 GOVERNMENT 75,000       Health Care-Uninsured & Hypertensive
(19) CLAYTON STATE UNIVERSITY FOUNDATION
2000 Clayton State
Morrow,GA30260
23-7419285 501(c)(3) 90,000       Nurse Scholarship&Nurse Faculty Rention
(20) CLEAN AIR CAMPAIGN INC
55 Park Place NE 250
Atlanta,GA30303
58-2600070 501(c)(3) 30,000       2016 measurement tool for pollute
(21) COBB COUNTY BOARD OF HEALTH
1650 County Serv Pkwy
Marietta,GA30008
58-1517015 GOVERNMENT 75,000       Prenatal Screen & HC for Pregnant Women
(22) COBB COUNTY COMMUNITY SERVICES BOARD
3830 South Cobb 300
Smyrna,GA30080
58-2107033 GOVERNMENT 57,500       Project Support
(23) COMMUNITY ADVANCED PRACTICE NURSES INC
173 Boulevard NE
Atlanta,GA30312
58-2435328 501(c)(3) 64,906       Free Primary & Mental Health Care
(24) EAST ATLANTA KIDS CLUB INC
659A Gresham Ave SE
Atlanta,GA30316
91-2130691 501(c)(3) 15,000       Combat youth obesity via fitness, nutrit
(25) EAST LAKE FOUNDATION INC
2606 Alston Dr SE
Atlanta,GA30317
58-2204306 501(c)(3) 25,000       Health Care-Underserved Males
(26) FAMILIES FIRST
1105 W Peachtree NE
Atlanta,GA30309
58-1054331 501(c)(3) 95,000       Financial literacy training and finance park ticke
(27) FAYETTE CARE CLINIC INC
1260 Highway 54W 101
Fayette,GA30214
20-0314897 501(c)(3) 75,000       Attain patient centered medical home
(28) FERNBANK INC
767 Clifton Rd
Atlanta,GA30307
58-6028607 501(c)(3) 50,000       Incr unserved youth's school engagement
(29) FIRST STEP STAFFING
302 Decatur St SE
Atlanta,GA30312
20-8038859 501(c)(3) 95,000       Assists indvls with disab obtain SS
(30) FOUNDATION OF WESLEY WOODS INC
1817 Clifton Rd NE
Atlanta,GA30329
58-1543164 501(c)(3) 50,000       Physical activities and Nutrition Education for Lo
(31) GEORGIA BUDGET AND POLICY INSTITUTE INC
100 Edgewood 950
Atlanta,GA30303
55-0860376 501(c)(3) 60,000       Analyze Georgia's health care workforce
(32) GEORGIA CAMPAIGN FOR ADOLESCENT POWER
1718 Peachtree 465
Atlanta,GA30309
31-1520709 501(c)(3) 77,500       support the Compreh Sex Education prog
(33) GEORGIA CHARITABLE CARE NETWORK INC
5582 Peachtree 3rdFl
Atlanta,GA30341
80-0100336 501(c)(3) 65,000       Provide org support operation and achievement
(34) GEORGIA CONSERVANCY
817 W Peachtree 200
Atlanta,GA30308
58-1027246 501(c)(3) 85,000       Educate public of comm-ctr, walkable sch
(35) GEORGIA FAMILY CONNECTION PARTNERSHIP
253 Peachtree 1600
Atlanta,GA30303
58-1888262 501(c)(3) 85,000       Help reduce low birthweight rate in coun
(36) GEORGIA HEALTH NEWS
2635 Rangewood CT
Atlanta,GA30345
27-3543332 501(c)(3) 19,000       Increase citizen & policy maker awarene
(37) GEORGIA LIONS LIGHTHOUSE FOUNDATION INC
5582 Peachtree Rd
Chamblee,GA30341
58-0548732 501(c)(3) 85,000       Vision Care for Students
(38) GEORGIA ORGANICS INC
200 Ottley Dr NE A
Atlanta,GA30324
58-2345310 501(c)(3) 90,000       institut. Farms-adopt health eat habit
(39) GEORGIA PERIMETER COLLEGE FOUNDATION INC
6251 Panthersville
Decatur,GA30034
58-1492364 501(c)(3) 90,000       Nurse Scholarship and Nurse Faculty Rention
(40) GEORGIA STATE UNIVERSITY FOUNDATION INC
1 Park Pl NE 533
Atlanta,GA30303
58-6033185 501(c)(3) 90,000       Nurse Scholarship and Nurse Faculty Rention
(41) GEORGIANS FOR A HEALTHY FUTURE INC
100 Edgewood NE 1015
Atlanta,GA30303
26-3695851 501(c)(3) 30,000       Sponsorship of Post-Enrollment Consumer
(42) GLOBAL GROWERS NETWORK INC
PO BOX 267
Global Estates,GA30002
46-2247454 501(c)(3) 40,000       Improve Local Food Access-Underserve Ppl
(43) GOOD NEWS CLINIC
810 Pine St
Gainesville,GA30501
58-2058853 501(c)(3) 75,000       Diabetes Mgmt Prog-High Risk Diabetics
(44) GOOD SAMARITAN HEALTH & WELLNESS CENTER
175 Samaritan Dr
Jasper,GA30143
58-2576315 501(c)(3) 75,000       Improve Diabetic patients' health thru
(45) GOOD SAMARITAN HEALTH CENTER INC
1015 Donald Lee Holl
Atlanta,GA30318
58-2373395 501(c)(3) 75,000       Staff Train-Mental Health and Primary Care
(46) GOOD SHEPHERD CLINIC INC
6392 Murphy Dr
Morrow,GA30260
58-2578581 501(c)(3) 63,000       Provide Health Care-Chronically Patients
(47) GOODWILL OF NORTH GEORGIA INC
235 Peachtree 2300
Atlanta,GA30303
20-8351046 501(c)(3) 50,000       Capital Campaign-Support Job Skill Devlt
(48) HABESHA INC
5350 Fox Valley Tr
Stone Mountain,GA30088
02-0536428 501(c)(3) 20,000       Community Revival through Workforce
(49) HANDS OF HOPE CLINIC INC
1010 Hospital Bldg B
Stockbridge,GA30281
42-1591970 501(c)(3) 36,325       Diabetes Self Care Prog-Underse Diabetic
(50) HEALTH EDUCATION ASSESSMENT & Leader
2600 MLK Jr Blvd
Atlanta,GA30311
26-3990559 501(c)(3) 63,000       Improve patient health mgmt and behavior care acce
(51) HERITAGE FUND OF ATLANTA MEDICAL ASSOC
100 Edgewood NE 820
Atlanta,GA30303
58-2372394 501(c)(3) 10,000       2016 Heritage Scholarship Fund
(52) ITS THE JOURNEY INC
270 Carpenter 515
Atlanta,GA30328
47-0897591 501(c)(3) 27,500       Sponsorship at the Atlanta 2-day Walk
(53) JERUSALEM HOUSE
17 Executive Park 290
Atlanta,GA30309
58-1829807 501(c)(3) 95,000       Program for People Living with HIV, Aids
(54) JEWISH FAMILY & CAREER SCVS INC
4549 ChambleeDunwood
Atlanta,GA30338
58-1479212 501(c)(3) 60,000       Capital Campaign to Complete the Jewish
(55) JUNIOR ACHIEVEMENT OF GEORGIA
460 Abernathy Rd NE
Atlanta,GA30328
58-0598050 501(c)(3) 35,000       Financial literacy training
(56) KATES CLUB INC
1330 W Peachtree 520
Atlanta,GA30309
16-1646487 501(c)(3) 50,000       Mental Health Counseling-grieving youth
(57) KENNESAW STATE UNIVERSITY FOUNDATION INC
3391 Town Point4430
Kennesaw,GA30144
23-7034345 501(c)(3) 90,000       Nurse Scholarship and Nurse Faculty Rention
(58) LEADERSHIP DEKALB INC
315 Ponce DeLeon 1069
Atlanta,GA30030
58-2131661 501(c)(3) 11,500       Leadership DeKalb Health Day Program
(59) MARTIN LUTHER KING JR CENTER
449 Auburn Ave NE
Atlanta,GA30312
58-1030989 501(c)(3) 48,500       2016 Salute to Greatness Dinner
(60) MCINTOSH TRAIL COMMUNITY SERVICE BOARD
1435 Expressway301
Griffin,GA30223
58-2098758 501(c)(3) 75,000       Provide Behavior and Prime care wtih clinic
(61) MEDICAL ASSOCIATION OF GEORGIA
1849 The Exchange
Atlanta,GA30339
58-0605267 501(c)(6) 30,000       Prescription Take Back Initiative
(62) MLK JR POOR PEOPLES CHURCH OF LOVE
1035 Donnelly Ave SW
Atlanta,GA30310
58-1340903 501(c)(3) 50,000       Food & health educa - hungry & homeless
(63) MOVING IN THE SPIRIT
750 Glenwood Ave SE
Atlanta,GA30316
58-2207431 501(c)(3) 50,000       student-Physical act. educa.therapy tech
(64) MUSEUM OF DESIGN ATLANTA INC
1315 Peachtree NE
Atlanta,GA30309
58-1829492 501(c)(3) 10,000       support the Designing Healthy Comm Exh
(65) MUST MINISTRIES
PO BOX 1717
Marietta,GA30061
58-2034725 501(c)(3) 50,000       Med&Psychiatric Care&Medication-Homeless
(66) NTL AIDS Educa & Services for Minorities
2140 MLK Jr Dr SW
Atlanta,GA30310
58-1986941 501(c)(3) 35,000       Prev.Diagnose HIV Pos. Ind. And Link-Servs
(67) NATIONAL KIDNEY FOUNDATION
30 East 33rd Street
New York,NY10016
13-1673104 501(c)(3) 30,000       Promote Kidney Health-Avoid Diabete
(68) NATIONAL TRUST FOR HISTORIC
1785 Massachusetts
Washington,DC20036
53-0210807 501(c)(3) 10,000       Funding for the 2015 Nat'l Main St Conf
(69) PALMETTO HEALTH COUNCIL INC
643 Main Street
Palmetto,GA30268
58-1307597 501(c)(3) 75,000       Integrated Prim&Behavioral health care
(70) PARTNERSHIP AGAINST DOMESTIC VIOLENCE
315 Ponce De Leon 735
Atlanta,GA30030
58-1314556 501(c)(3) 69,440       Reduce teen relation. and sexual violent
(71) PEDESTRIANS EDUCATING DRIVERS ON SAFETY
235 Peachtree 1600
Atlanta,GA30303
58-2267503 501(c)(3) 40,000       Remove physical barriers to walking
(72) PHYSICIANS CARE CLINIC INC
4850 Golden Py B-418
Buford,GA30518
58-2107579 501(c)(3) 25,000       Incr care access-Vulnerable DeKalb City
(73) PIEDMONT PARK CONSERVANCY INC
PO BOX 7795
Atlanta,GA30357
58-1551369 501(c)(3) 83,950       Sponsorship the Green Market 2015 Lunch
(74) PROJECT OPEN HAND ATLANTA INC
181 Armour Drive NE
Atlanta,GA30324
58-1816778 501(c)(3) 95,000       Improve Nutrition education for Seniors
(75) ROBERT W WOODRUFF ART CENTER INC
1280 Peachtree St NE
Atlanta,GA30309
58-0633971 501(c)(3) 99,000       Funding for WAC's annual campaign
(76) SENIOR CITIZEN SERVICES
1705 Commerce Dr NW
Atlanta,GA30318
58-0960309 501(c)(3) 50,000       Support Extra Help Care Mgmt for seniors
(77) SENIOR CONNECTIONS INC
5238 Peachtree Rd
Chamblee,GA31341
58-1187876 501(c)(3) 50,000       Nutrional & Educa Support Prog-Diabetics
(78) SPECIAL OLYMPICS GEORGIA INC
4000 Dekalb T P 400
Atlanta,GA30340
23-7201676 501(c)(3) 10,000       Healthy Athlete Screen-Spcl Needs Youth
(79) SUSAN G KOMEN BREAST CANCER FOUNDATION
3525 Piedmont Bldg 5
Atlanta,GA30305
58-1959763 501(c)(3) 25,000       breast cancer awareness and health serv
(80) TANNER MEDICAL CENTER INC
705 Dixie Street
Carrolton,GA30117
58-1790149 501(c)(3) 50,000       Diabetes Care Management
(81) The CENTER FOR BLACK WOMENS WELLNESS CBWW
477 Windsor 309
Atlanta,GA30312
58-2212203 501(c)(3) 75,000       Health Care & Chronic Disease Mgmt
(82) The COMMUNITY FDN FOR GREATER ATLANTA
50 Hurt Plz STE 449
Atlanta,GA30303
58-1344646 501(c)(3) 1,400,000       Increase access to healthcare
(83) The ENVIRONMENTAL FUND FOR GEORGIA
100 Peachtree 1960
Atlanta,GA30303
58-2022001 501(c)(3) 97,000       Sponsorship for the Annual Earth Day
(84) The HEALTH INITIATIVE INC
1530 Dekalb NE A
Atlanta,GA30307
58-2271500 501(c)(3) 50,000       Reduce health disparities by engaging
(85) The Henry W Grady Health System Fdn
191 Peachtree St
Atlanta,GA30303
58-2130437 501(c)(3) 63,500       KP Sponsorship at the White Coat Grady
(86) The SHELTERING ARMS
385 Centennial Oly
Atlanta,GA30313
58-0566236 501(c)(3) 50,000       Need-based tuition scholarships
(87) TREES ATLANTA INC
225 Chester Ave
Atlanta,GA30316
58-1584758 501(c)(3) 84,650       Help Trees Atlanta and support for Root Ball Progr
(88) TURNINGPOINT BREAST CANCER
8010 Roswell 120
Atlanta,GA30350
56-2318721 501(c)(3) 18,000       Rehab Service-Undr Breast Cancer Patient
(89) UNITED WAY OF GREATER ATLANTA INC
100 Edgewood NE
Atlanta,GA30303
58-0566194 501(c)(3) 500,000       Provide Exercise, Healthy Eating,
(90) VETERANS EMPOWERMENT ORGANIZATION OF
373 W Lake Ave NW
Atlanta,GA30318
80-0219022 501(c)(3) 25,000       Mental Health Assessment and treatment for Veteran
(91) VOICES FOR GEORGIAS CHILDREN INC
100 Edgewood 1580
Atlanta,GA30303
02-0678823 501(c)(3) 85,000       Help Trees Atlanta protect&improve
(92) WELLSPRING LIVING INC
860 Johnson Ferry
Atlanta,GA30342
58-2614182 501(c)(3) 50,000       Funding for the Healing to Hope Program
(93) WHOLESOME WAVE GEORGIA INCORPORATED
1070 Colquitt Ave
Atlanta,GA30307
45-4816906 501(c)(3) 35,000       Double Value Program for SNAP Recipients
(94) WYLDE CENTER INC
435 Oakview Rd
Decatur,GA30030
58-2339007 501(c)(3) 20,000       Decatur Housing Auth. prog participants
(95) YEAR UP INC
93 Summer Street
Boston,MA02110
04-3534407 501(c)(3) 75,000       Young adult health and wellness
(96) YMCA of Metropolitan Atlanta Inc
100 Edgewood 1100
Atlanta,GA30303
58-0566253 501(c)(3) 400,000       Provide Exercise, Healthy Eating,
(97) YOUNG WOMENS CHRISTIAN ASSN
957 North Highland
Atlanta,GA30306
93-0386985 501(c)(3) 50,000       Early Breast Cancer Detection&Awareness
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
96
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015
Page 2

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of non-cash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANTS At the end of their funding cycle, grantees are required to submit a final report which delineates accomplishments related to stated objectives. Large grants (typically over $100K) may require quarterly progress reports.
Schedule I (Form 990) 2015



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