Kansas Hospital Association Political Actlon...
Transcript of Kansas Hospital Association Political Actlon...
KANSAS GOVERNMENTAL ETHICS COMMISSION
RECEIPTS AND EXPENDITURES REPORT OF A POLITICAL OR PAR TY COMMITTEE
October 31, 2016
RECEIVED
OCT 3 1 2016
FILE WITH SECRETARY OF ST AT~5 Govemmentat Ethics Commissio
SEE REVERSE SIDE FOR INSTRUCTIONS
A. Name of Committee: Kansas Hospital Association Political Actlon Committee
215 SE 8th Street
This is a (check one): __ Party Committee " Political Committee
B. Check only if appropriate: __ Amended Filing __ Termination Report
C. Summary (covering the period from July 22, 2016 through October 27, 2016)
1. Cash on hand at beginning of period ......................................................................... . 82,094.93
2. Total Contributions and Other Receipts (Use Schedule A) ...................................... . . 29,041.24
3. Cash available this period (Add Lines 1 and 2) ............... ......................... ...... ......... .. . 111 ,136.17
4. Total Expenditures and Other Disbursements (Use Schedule C) ...... .. ........... ... ........ . 73,692.78
5. Cash on hand at close of period (Subtract Line 4 from 3) ............. ..... ...................... . .. 37,443.39
6. In-Kind Contributions (Use Schedule B) ........ . 1,747.00
7. Other Transactions (Use Schedule D) ............ .. 0.00
D. "I declare that this report, including any accompanying schedules and statements, has been examined by me and to the best of my knowledge and belief is true, correct and complete. I understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor."
1ot si )i10 Date
GEC Form Rev, 2016
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Polltlcal Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,
Date of Contributor Than $150 Loan or Other Cash Check Loan E funds
Receipt Other
Mr. Kevin Myers Director Information Technology 100.00
PO Box 360 Wilson Medical Center 7/26/2016 Neodesha. KS 66757-0360
Mrs. Carrie L Sala BSN, MSM Chief Executive Officer 250.00
8553 11 OTh Rd Holton Community Hospital
./ 7/26/2016 Della. KS 66418-9536
Ms. Reagan Cussimanio JD Government Relations Liaison 250.00
7/28/2016 3901 Rainbow Boulevard University of Kansas Hospital, The ./ Kansas City, KS 66160-8500
Brenda Dykstra 100.00
7/28/2016 14157 W. 141st Street University of Kansas Hospital, The ./ Olathe, KS 56062-5376
Barbara MacArthur 100.00
7/29/2016 700 W. 31st Street #703 University of Kansas Hospital, The Kansas City, MO 64108-3628
Kathy Cummings 100.00
8/3/2016 1014 E. Lamplighter Ln. St. Catherine Hospital Garden City, KS 67846-3240
Mr. Chad R. Austin Sr. Vice President, Government 76.92
8/4/2016 6518 SW 26th Court Relations Topeka, KS 56614-4305 Kansas Hospital Association
Ms. Reta K Baker President 500.00
8/4/2016 985 225th St. Mercy Hospital Fort Scott Fort Scott, KS 66701-8797
Ms. Cindi Beadman Director Medical Records 100.00
8/4/2016 401 W. Main St. Harper Hospital District Five Harper, KS 67058-1438
Ms. Debra Cartwright CPA, FHFMA Chief Financial Officer 100.00
8/4/2016 14505 W. 49th Street Providence Medical Center ./ Shawnee, KS 66216-5159
Trustee 75.00
8/4/2016 Memorial Health System ./ 1,751 ,92
Page 1 of 10 -- --
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,
Date of Contributor Than $150 Loan or Other Cnsh Ch eel< Loan E funds
Receipt Other
Mr. Elgin Glanzer Chief Fina nclal Officer 100.00
1602 Park Place Ct. Memorial Health System
./ 8/4/2016 Abilene, KS 67410-2153
Mrs. Vallerle L. Gleason VP 350.00
3123 N. Lakerldge Ct. Newton Medical Center
./ 8/4/2016 Wichita, KS 67205-1928
Mr. Jack L Kennedy RN , BSN, MS Vice President end Chief Nursing 100.00
B/4/2016 255 SW 60th Ave. Officer ./ Pratt, KS 67124-2903 Pratt Regional Medical Center
Ms. Kelly McDermelt Director Outreach and Support 100.00
8/4/2016 10390 SW Lakeview Drive Services Pratt, KS 67124-8209 Pratt Regional Medical Center
Ms. Deanna Mustin RN Administrator 300.00
8/4/2016 415 North Main Street Bob Wilson Memorial Grant Ulysses, KS 67880-2133 County Hospital
Ms. Susan M Page President and Chief Execu11ve 350.00
8/4/2016 1410 Maple Street Officer Pratt, KS 67124-2903 Pratt Regional Medical Center
Vincent Wiiczak 100.00
8/4/2016 PO Box 8603 Pratt Regional Medlcal Center Pratt, KS 67124-8603
Mr. Ron Marshall 100.00
8/5/2016 5909 SW Cherokee Ct. Kansas Hospital Association ./ Topeka, KS 66614-4563
Ms. Deborah Bruner Chief Executive Officer and 150.00
8/8/2016 P 0Box127 Administrator ./ Minneola, KS 67865-0127 Minneola District Hospital
Mr. Dennis R Shelby Chief Executive Officer 90.00
8/10/2016 P 0 Box 360 Wilson Medical Center ./ Neodesha, KS 66757-0360
r. Dennis R Shelby Chief Executive Officer 20.00
8/10/2016 0 Box 360 Wilson Medical Center ./ eodesha, KS 66757-0360
1,760.00
Page _2 __ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,
Date of Contributor Than $150 Loan or Other Co sh Check Loan E fund•
Receipt Other
Jody Gragg 100.00
11414 West Central Park SL Via Christi Health 8/12/2016 Wichita, KS 67205-2028
Mr. Harold Courtois Chief Executive Officer 230.00
200 South Main Street Russell Regional Hospital
./ 8/16/2016 Russell, KS 67665-2920
OrganizaUon of Nurse Leaders Kansas Nursing Professional Association 500.00
8/16/2016 215 SE Eighth KONL ./ Topeka, KS 66603-3906
Michael Mullins 100.00
8/16/2016 479 Chimney Rock Dr. Via Christi Health Carmel, IN 46032-1500
Dr. Craig Concannon Board Member 1,000.00
8/17/2016 921 N. Mill Kansas Hospital Association Beloit, KS 67420-1751
Mr. John L Jacobson Chief Executive Officer 350.00
8/17/2016 3955 Highway 73 Atchison Hospital Atchison, KS 66002-9204
Mr. Leonard Hernandez Chief Executive Officer 250.00
8/18/2016 116 W. Apache St. New Strawn, KS 66839-8801
Coffey County Hospital
Mrs. Letitia A. Hollingsworth Director of Reimbursement 150.00
8/18/2016 2635 SW Santa Fe Dr. Kansas Hospital Association ./ Topeka, KS 66614-4956
Ms. Laurie Labarca 100.00
8/18/2016 1149 N. Glenmoor Dr. Via Christi Hospital on St. Francis ./ Wichita, KS 67206-4131
Mr. David M. Robinson Trustee 300.00
8/18/2016 810 S. Denman Neosho Memorial Regional ./ Chanute, KS 66720-2536 Medical Center
r. Curt Colson 225.00
8/19/2016 05 N. Main St. Great Plains Health Alliance, Inc. ./ oislngton, KS 67544-2150
3,305.00
Page _3 _ _ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospltal Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of
Name and Address Individual Giving More Appropriate Box Cash, Check,
Date of Contributor Than $150 Loan or Other Cash Chtck Loan E l'nnds
Receipt ~
Dawn M Engel 100.00
2909 J Ave Geary Community Hospital
~ 8/1912016 Herington, KS 67449-4024
Ms. Kiley Floyd Chief Executive Officer 350.00
224 N. Fourth Nemaha Valley Community
~ 8/19/2016 Osborne, KS 67473-1912 Hospital
Ms. Deborah Bruner Chief Executive Officer and 150.00
8/22/2016 PO Box 127 Administrator
~ Minneola, KS 67865-0127 Minneola District Hospital
Ms. Sarah Cosgrove Trustee 200.00
8/29/2016 1136 Highway 177 Morris County Hospital
~ Council Grove, KS 66846-8505
Mr. Chad R. Austin Sr. Vice President, Government 76.92
8/31/2016 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association
Ms. Audrey Dunkel Director of Financial Advocacy 38.46
8/31/2016 215 SE 8th Street Kansas Hospital Association Topeka, KS 66603-3906
Ms. Laraine Gengler Chief Financial Officer 100.00
8/31/2016 401 Cedar Circle Lindsborg, KS 67456-2328
Lindsborg Community Hospital
Ms. Beth Hedberg Nursing Administration 100.00
8/31/2016 2570 First Avenue Lindsborg Community Hospital
~ Marquette, KS 67464-9801
Mr. Tom M. Jernigan DVM Veterinarian 200.00
8/31/2016 925 T Avenue Jernigan Veterinary Clinic ~ Council Grove, KS 66846-Bn7
Diane Miller 200.00
8/31/2016 436 S. 1200 Rd . Morris County Hospital ~ Dwight, KS 66849-9531
r. William J Miller Board member 200.00
8/31/2016 193 Four Mile Rd. Morris County Hospital ~ ouncll Grove, KS 66846-8719
1,715.38
Page _4 __ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Name and Address Individual Giving More Appropriate Box
Date of Contributor Than $150 c .. h Check Loan
Mr. Steven B. Poage Vice PresidenUCFO 3401 SW Alameda Kansas Hospital Association
8/31/2016 Topeka, KS 66614-5109
Dr. James H Reagan Jr PhD Chief Executive Officer
8/31/2016 265 Fairway Dr. Morris County Hospital
../ Council Grove, KS 66846-1422
Mr. Scott J Taylor President and Chief Executive
8/31/2016 401 East Spruce Street Officer ../ Garden City, KS 67846-5679 St. Catherine Hospital
\ Mr. Larry VanDerWege Administrator
8/31/2016 743 Diamond Dr. Lindsborg Community Hospital Lindsborg, KS 67456-2328
Sheri Brenner
9/1/2016 607 E. 7th St. Edwards County Hospital and Kinsley, KS 67547-1313 Healthcare Center
Dean Miller Trustee
9/1/2016 1925 S 2500 Rd Morris County Hospital ../ Herington , KS 67449
Tom Moxley Board Member
9/1/2016 1852 S 200 Rd Council Grove, KS 66846-8310
Morris County Hospital
Mr. Kevin J Hicks President and CEO 9/2/2016 PO Box 15959 Overland Park Regional Medical ../ Overland Park, KS 66215-5959 Center
Mr. Charles Laird Chief Executive Officer 9/2/2016 5721 West 11 Sth Street Menorah Medical Center ../ Overland Park, KS 66209-3722
Ms. Deborah Frey Stern RN, JD Clinical Services/Legal Counsel 9/2/2016 3338 SW Alameda Dr. Kansas Hospital Association ../ Topeka, KS 66604-2660
r. Marion A Thompson FACHE, MSHCA Chief Executive Officer 9/2/2016 23 S. Colborn Allen County Regional Hospital ../ ola, KS 66749-3405
Amount of Cash, Check,
Loan or Other E funds
Receipt Other
500.00
350.00
500.00
100.00
100.00
200.00
200.00
1,000.00
1,000.00
100.00
500.00
4,550.00
Page _5 __ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Name and Address Individual Giving More Appropriate Box
Date of Contributor Than $150 Cash Check Lona
Mr. Bill Voloch President and Chief Executive 550 North Hillside Officer
9/2/2016 Wichita, KS 67214-4910 Wesley Medical Center
Mr. Bill Voloch President and Chief Executive 550 North Hillside Officer
9/2/2016 Wichita, KS 67214-4910 Wesley Medical Center
Mr. Claudio J. Ferraro VP Planning
9/8/2016 541 N. Tallyrand St. Via Christi Regional Medical Wichita, KS 67206-1112 Center-St. Joseph Cam
Ms. Kiley Floyd Chief Executive Officer
9/8/2016 224 N. Fourth Nemaha Valley Community Osborne, KS 67473-1912 Hospital
Mr. Steven L Granzow Chief Executive Officer
9/8/2016 422 S. Fourth St. Lincoln County Hospital Lincoln, KS 67455-0406
Ms. Nancy J. McKenzie Chief Executive Officer
9/8/2016 1005 Country Club Drive Greenwood County Hospital Eureka, KS 67045-0471
Mr. Scott J Taylor President and Chief Executive
9/8/2016 401 East Spruce Street Officer Garden City, KS 67846-5679 St. Catherine Hospital
Mr. Allen Van Driel FACHE Administrator 9/8/2016 614 South Main Street Smith County Memorial Hospital
Smith Center, KS 66967-3001
Sherri Vaughn MD 9/8/2016 1216 Waverly Dr. Lawrence Memorial Hospital
Lawrence, KS 66049-5016
Mr Kenny Wilk Board Member 9/8/2016 3901 Rainbow Boulevard University of Kansas Medical
Kansas City, KS 66160-8500 Center
Director, Government Relations 9/8/2016 Via Christi Health
Amount of Cash, Check,
Loan or Other E funds
Receipt Other
500.00
2,000.00
250.00
40.00
250.00
500.00
70.00
100.00
~ 150.00
~ 250.00
~ 100.00
~
4,210.00
Page _6 __ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Name and Address Individual Giving More Appropriate Box
Date of Contributor Than $150 Cash Check Loan
Ms. Shelley Boden Consultant 4612 188th St Boden Health care
9/9/2016 Russell, KS 67665-8893
Dr. Rob Kenagy MD Senior Vice President and Chief 1500 SW 10th Avenue Medical Officer
9/9/2016 Topeka , KS 66604-1301 Stormont Vail Health
John Manning
9/9/2016 11111 W. 951h Suite 217 Advanced Net Providers Overland Park, KS 66214-1846
Ms. Linda Murphy Chief Financial Officer
9/9/2016 P 0 Box 70 Osborne County Memorial Osborne, KS 67473-0070 Hospital
Mrs. Cindy Leah Samuelson Vice President
9/9/2016 1107 NE 54th St Kansas Hospital Association Topeka, KS 66617-4505
KimWilllams
9/9/2016 619 S. Clark Hospital District No 1 of Rice Lyons, KS 67554-3003 County
Eric Otting
9/13/2016 534 S. Kansas Ave, Suite 1500 Topeka, KS 66603-3437
Wendling, Noe, Nelson & Johnson
Sara Beikman 9/14/2016 825 Heritage Road Clay County Medical Center ./ Linn, KS 66953-9243
Mr. Dave Engel CEO 9/14/2016 256 West H Street Phillips County Hospital ./ Phillipsburg, KS 67661-1743
Robert Gibbs MD 9/14/2016 611 Quall Creek Rd. Labette Health ./ Parsons, KS 67357-2257
r. Jimmie W Hansel PhD Chief Executive Officer 9/14/2016 15 E. 5th St. Edwards County Hospital and ./ insley, KS 67547-1231 Healthcare Center
Amount of Cash, Check,
Loan or Other E funds
Receipt Other
150.00
250.00
./ 150.00
./ 325.00
90.00
./ 125.00
375.00
300.00
300.00
400.00
125.00
2,590.00
Page _7 __ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Name and Address Individual Giving More Appropriate Box
Date of Contributor Than $150 Cash Check Loan
Ms. Beth Hedberg Nursing Administration 2570 First Avenue Lindsborg Community Hospital
9/14/2016 Marquette, KS 67464-9801
Mrs. Judith Ann Hodgson Chief Nursing Officer 1240 28th Rd Hospital District No 1 of Rice
./ 9/14/2016 Little River, KS 67457-9004 County
Mr. Doyle L Mcl<immy FACHE Chief Executive Officer
9/14/2016 100 Crestvue Jewell County Hospital ./ Mankato, KS 66956-2407
Mr. Terry Pound Chief Financial Officer
9/14/2016 420 S Pioneer Hospital District No 1 of Rice Lyons, KS 67554-2613 County
Ms. Jodi A Schmidt Executive Director, Heart and
9/14/2016 26330 W. Cedar Niles Ct. Stroke Collaborative Olathe, KS 66061 -7477 University of Kansas Hospital, The
Mr. George M Stover Chief Executive Officer
9/14/2016 P 0 Box 828 Hospital District No 1 of Rice ./ Lyons, KS 67554-0828 County
Mr. Joseph Stratton FACHE Chief Executive Officer
9/14/2016 4174 Otter Creek Rd. Junction City, KS 66441 -0490
Geary Community Hospital
Ms. Mary Sweet Administrator 9/14/2016 721 West Kansas Avenue Kiowa County Memorial Hospital ./ Greensburg, KS 67054-1633
Mr. Jeremy Armstrong FACHE Chief Executive Officer 9/15/2016 Po Box 399 Mitchell County Hospital Health ./ Beloit, KS 67420-0399 Systems
Don Harmison Trustee 9/15/2016 1081Hwy149 Morris County Hospital ./ White City, KS 66872-9413
r. Kevin A White Administrator 9/15/2016 10 North Walnut Street Medicine Lodge Memorial Hospital ./ edlcine Lodge, KS 67104-1019
Amount of Cash, Check,
Loan or Other E fuods
Receipt Other
20.00
100.00
250.00
100.00
100.00
150.00
300.00
525.00
189.00
200.00
80.00
2,014.00
Page _8 _ _ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,
Date of Contributor Than $150 Loan or Other Cash Check Loan E funds
Receipt Other
Mr. Michael Mages Chief E>eecutive Officer 100.00 PO Box 188 Ashland Health Center
9/16/2016 Ashland, KS 67831-0188
Mrs. Cindy Leah Samuelson Vice President 20.00
1107 NE 54th St Kansas Hospital Association
./ 9/16/2016 Topeka, KS 66617-4505
KS Healthcare Environmental Services Professional Association 250.00
9/16/2016 Association ./ PO BOX 3208 Topeka, KS 66601
Mr. Marion A Thompson FACHE, MSHCA Chief Executive Officer 100.00
9/16/2016 223 S. Colborn Allen County Regional Hospital ./ Iola, KS 66749-3405
Mr. Dallas A. Polen Director of Government Relations 350.00
9/21/2016 5401 West 101 th Terrace Children's Mercy Hospitals and Overland Park, KS 66207-3127 Clinics
Doug Spear Director of Marketing 100.00
10/10/2016 12815 S Rene St Shawnee Mission Medica l Center Olathe, KS 66062-6223
Mr. Chad R. Austin Sr. Vice President, Government 116.38
10/12/2016 6518 SW 26th Court Relations Topeka, KS 66614-4305 Kansas Hospital Association
Ms. Audrey Dunkel Director of Financial Advocacy 57.69
10/12/2016 215 SE 8th Street Kansas Hospital Association ./ Topeka, KS 66603-3906
Mr. Dave Engel CEO 78.00
10/12/2016 256 West H Street Phillips County Hospital ./ Phillipsburg, KS 67661 -1743
Mrs. Jennifer A. Findley VP Education/Special Projects 24.00
10/12/2016 3517 SW Ashworth Ct. Kansas Hospital Association ./ Topeka, KS 66614-4590
s. Melissa Levy Hungerford Sr. Vice President 28.86
448 SW Bayshore Dr Kansas Hospital Association ./ uburn, KS 66402-9324
1,223.93
Page _9 __ of~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Occupation & Industry of Check Name and Address Individual Giving More Appropriate Box
Date of Contributor Than $150 Cash Check Loan
Mrs. Cindy Leah Samuelson Vice President 1107 NE 54th St Kansas Hospital Association ,/ 10112/2016 Topeka, KS 66617-4505
Ms. Adele Ducharme MBA, RN , MSN Chief Executive Officer
10/1312016 711 Marshall Street Saint Luke's Cushing Hospital ,/ Leavenworth, KS 66048-3235
Kansas Hospital Attorneys KAHA Professional Organization
10/13/2016 215 SE Eighth Ave. Kansas Hospital Attorneys KAHA ,/ Topeka, KS 66603-3906
Mr. Richard McKaln Chief Executive Officer
10113/2016 4005 W 137th Terrace Anderson County Hospital Leawood, KS 66224-9609
Mr. Bobby Olm-Shipman Chief Executive Officer
10/1312016 10920 Elm Avenue Saint Luke's South Hospital Kansas City, MO 64134-4108
Mr. Bruce Witt Director, Government Relations
10/13/2016 820 Carriage Rd. Via Christi Health Maize, KS 67101 -9697
Mr. Richard Q Bergllng Chief Executive Officer
10/1412016 PO Box 937 Morton County Health System Elkhart, KS 67950-0937
KHHRA Hospital HR Professional 10/26/2016 215 SE Eighth Association
Topeka, KS 66603-3906 KHHRA
Complete if last page of Schedule A
Total Itemized Receipts for Period
Total Unitemized Contributions ($50 or less)
Sale of Political Materials (Unitemized)
Total Contributions When Contributor Not Known
Amount of Cash, Check,
Loan or Other E funds
Receipt Otber
28.86
300.00
1,000.00
250.00
600.00
750.00
100.00
1,000.00
4,028.86
27, 149.09
1,892.15
0.00
0.00
29,041 .24
Page _1_0_ of _!Q__
SCHEDULEB IN-KIND CONTRIBUTIONS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
List Occupation &
Date Name and Address Industry for Those Giving of Contributor an In-Kind of More Than
$150
Kansas Hospital Association 8/3/2016 215 SE Eighth
Topeka, KS 66603
Kansas Hospital Association
8/4/2016 215 SE Eighth Topeka, KS 66603
Kansas Hospital Association
9/1/2016 215 SE Eighth Topeka, KS 66603
Kansas Hospital. Association
9/1/2016 215 SE Eighth ; Topeka, KS 66603
Kansas Hospital Association 215 SE Eighth
10/6/2016 Topeka, KS 66603
Kansas Hospital Association 215 SE Eighth
10/6/2016 Topeka, KS 66603
Description of In-Kind Contribution
Lunch - Steering Committee
Postage AHA PAC
EAS - Flash Drives
Postage AHA PAC
Postage AHA PAC
Postage AHA PAC
Complete if last page of Schedule B
Total Itemized (over $100) In-Kind Contributions
Total Unitemized($! 00 or less) In-Kind Contributions
Value of In-Kind
Contribution
135.07
34.26
1,478.98
34.43
34.26
30.00
1,747.00
1,747.00
0.00
1,747.00
Page _1 __ of_ 1 __
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
PurEose of ExEenditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
CoreFlrst Bank & Trust Bank Fee for Credit Card Services - July 3035 SW Topeka Blvd
104.50 8/2/2016 Topeka, KS 66611
Steven Becker for Kansas House Steven Becker, STATE HOUSE 104th KS PO Box 384
8/15/2016 Buhler, KS 67522 500.00
Ed Berger for Kansas Senate Ed Berger, STATE SENATE 34th KS
8/15/2016 2603 Heather Parkway, Suite B
1,000.00 Hutchinson, KS 67502
Barbara Bollier for Kansas Senate Barbara Bollier, STATE SENATE 7th KS
8/18/2016 691 O Overhill Rd. 1,000.00 Mission Hills, KS 66208
Marci Francisco for Kansas Senate Marci Francisco, STATE SENATE 2nd KS
8/18/2016 1101 Ohio Lawrence, KS 66044 500.00
Bruce Givens for Kansas Senate Bruce Givens, STATE SENATE 14th KS
8/18/2016 1525 Country Club Rd 1,000.00 El Dorado, KS 67042
Jerry Henry for Senate Jerry Henry, STATE SENATE 1st KS
8/18/2016 3515 Neosho Rd . 1,000.00 Cummings, KS 66016
Tom Holland for Kansas Senate Tom Holland, STATE SENATE 3rd KS 8/18/2016 961 E 1600 Rd 1,000.00
Baldwin City, KS 66006
Biii Hutton for Kansas Senate Bill Hulton, STATE SENATE 5th KS 8/18/2016 13939 Parallel
1,000.00 Basehor, KS 66007
John Skubal for State Senate John Skubal, STATE SENATE 11th KS 8/18/2016 6503 W. 134th Terrace
Overland Park, KS 66209 1,000.00
8,104.50
Page_1_of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Name and Address Date To Whom Expenditure is Made
AHAPAC-American Hospital Association FEDERAL
8/2212016 800 101h Street, NW Two City Center, Suite 400
Dave Baker for Kansas House 278 Lakeroad
8/23/2016 Council Grove, KS 66846
John Barker for Kansas House
8/23/2016 103 Wassinger AvfJ Abilene, KS 67410
Shelee Brim for Kansas House
8/23/2016 6756 Longview Shawnee, KS 66218
Tom Burroughs for Kansas House
8/23/2016 3131 So. 73rd Terr Kansas City, KS 66106
Stephanie Claytqn for Kansas House
B/23/2016 9825 Woodson Dr. Overland Park, KS 66207
Susan L. Concannon for Kansas House
8/23/2016 921 North Miii Beloit, KS 67420
Tom Cox for Kansas House 8/23/2016 14814 W. 71st Terrace
Shawnee, KS 66217
Debbie Deere for Kansas House 8/23/2016 101 E. Kansas, Suite 101
Lansing, KS 66043
Diana Dierks for Kansas House 8/23/2016 1221 Sunrise Dr.
Salina, KS 67401
Purpose of Expenditure
If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Dave Baker, STATE HOUSE 68th KS
John Barker, STATE HOUSE 70th KS
Shelee Brim, STATE HOUSE 39th KS
Tom Burroughs, STATE HOUSE 33rd KS
Stephanie Clayton, STATE HOUSE 19th KS
Susan Concannon, STATE HOUSE 107th KS
Tom Cox, STATE HOUSE 17th KS
Debbie Deere, STATE HOUSE 4oth KS
Diana Dierks, STATE HOUSE 71st KS
Amount
2,811 .30
500.00
500.00
500.00
250.00
500.00
500.00
500.00
500.00
500.00
7,061 .30
Page_2_ of~
SCHEDULE C EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Pur[!OSe of Ex[!end,iture Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
John Doll for Kansas Senate John Doll , STATE SENATE 39th KS 2927 Cliff Place
8/23/2016 Garden City, KS 67846 1,000.00
Roger Elliot for Kansas House Roger Elliott, STATE HOUSE 87th KS 12015 E. Tamarac
6/23/2016 Wichita, KS 67206 500 .00
John Eplee for Kansas House John Eplee, STATE HOUSE 63rd KS 163 Deer Run
500 00 8/23/2016 Atchison, KS 66002
Blaine Finch for Kansas House Blaine Finch, STATE HOUSE 59th KS
8/23/2016 5 SW Fairview Dr. 250.00 Ottawa, KS 66067
Mary Martha Good for Kansas House Mary Good, STATE HOUSE 75th KS PO Box 1265
250.00 6/23/2016 El Dorado, KS 67042
Henry Helgerson for Kansas House Henry Helgerson, STATE HOUSE 83rd KS
8/23/2016 12 E. Peach Tree Lane 500.00 Wichita, KS 67207
Anthony Hensley for Kansas Senate Anthony Hensley, STATE SENATE 19th KS
8/23/2016 2226 SE Virginia 1,000.00 Topeka, KS 66605
Dorothy Hughes for Kansas House Dorothy Hughes, STATE HOUSE 21st KS 6/23/2016 6900 W. 76th Terrace 500.00
Prairie Village, KS 66208
Steven Johnson for Kansas House Steven Johnson, STATE HOUSE 108th KS 8/23/2016 10197 South Hopkins Road
500.00 Assaria , KS 67416
Anita Judd-Jenkins for Kansas House Anita Judd-Jenkins, STATE HOUSE 80th KS 8/23/2016 225 N "C" Street
500.00 Arkansas City, KS 67005
5,500.00
Page _3_ of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Puri:!ose of Ex[!enditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Jim Kelly for Kansas House Jim Kelly, STATE HOUSE 12th KS 309 S. 5th
8/23/2016 Independence, KS 67301 250.00
Laura Kelly for Kansas Senate Laura Kelly, STATE SENATE 18th KS 234 SW Greenwood
8/23/2016 Topeka, KS 66606 1,000.00
Dan Kerschen for Kansas Senate Dan Kerschen, STATE SENATE 26th KS 645 South 263 West
1,000.00 8/23/2016 Garden Plain, KS 67050
Jan Kessinger for Kansas House Jan Kessinger, STATE HOUSE 2Dth KS
8/23/2016 12605 Walmer St. 500.00 Overland Park, KS 66209
Jeff Longbine for Kansas Senate Jeff Longbine, STATE SENATE 17th KS PO Box 1903
1,000.00 8/23/2016 Emporia, KS 66801
Patty Markley for Kansas House Patty Markley, STATE HOUSE 8th KS
8/23/2016 12312 Nieman Road 500.00
Overland Park, KS 66213
Carolyn McGinn for Kansas Senate Carolyn McGinn, STATE SENATE 31st KS
8/23/2016 11047 N 87W 1,000.00 SEDGWICK, KS 67135
Vic ~iller for Kansas House Vic Miller, STATE HOUSE 58th KS 8/23/2016 510SW10th 250.00
Topeka, KS 66612
Kathy Wolfe Moore for Kansas House Kathy Moore, STATE HOUSE 36th KS 8/23/2016 3209 N 131 st Street
500.00 Kansas City, KS 66109
Fred Patton for Kansas House Fred Patton, STATE HOUSE 50th KS 8/23/2016 339 NE 46th
Topeka, KS 66048 500.00
6,500.00
Page_4_ of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Polltlcal Action Committee
(Name of Party Committee or Political Committee)
PurEose of ExEenditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Lynn Rogers for Kansas Senate Lynn Rogers, STATE SENATE 25th KS 912 Spaulding
1,000.00 8/23/2016 Wichita, KS 67203
Melissa Rooker for State Representative Melissa Rooker, STATE HOUSE 25th KS 4124 Brookridge Drive
500.00 8/23/2016 Fairway, KS 66205
Ron Ryckman for Kansas Ho\jse Ron Ryckman, STATE HOUSE ?8th KS 14234 W 158th St.
500.00 8/23/2016 Olathe, KS 66062
Vicki Schmidt for Kansas Senate Vicki Schmidt, STATE SENATE 20th KS
8/23/2016 5906 SW 43rd Court 1,000.00 Topeka, KS 66610-1632
Mark Schreiber for Kansas House Mark Schreiber, STATE HOUSE 60th KS
8/23/2016 1722 Yucca Lane Emporia, KS 66801
500.00
Gene Suellentrop for Kansas Senate Gene Suellentrop, STATE SENATE 27th KS
8/23/2016 6813 W. Northwind Circle 1,000.00 Wichita, KS 67205
Mary Jo Taylor for Kansas Senate Mary Taylor, STATE SENATE 33rd KS
8/23/2016 114 N. Union 1,000.00 Stafford, KS 67578
Susan Wagle for Kansas Senate Susan Wagle, STATE SENATE 30th KS 8/23/2016 4 N. Sagebursh 1,000.00
Wichita, KS 67230
Jim Ward for Kansas State House Jlm Ward, STATE HOUSE 86th KS 8/23/201 6 3100 E Clark
500.00 Wichita, KS 67211
Valdenla Winn for Kansas House Valdenla Winn, STATE HOUSE 34th KS 8/23/2016 1044 Washington Blvd
Kansas City, KS 66102 250.00
7,250.00
Page_5_ of~
.I'
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Pur[!ose of Ex(!enditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
John Alacala for Kansas House John Alcala, STATE HOUSE 57th KS 520 NE Lake SI.
250.00 8/30/2016 Topeka , KS 66616
Tory Amberger for Kansas House Tory Arnberger, STATE HOUSE 112th KS 1221 McKinley St.
250.00 8/30/2016 Great Bend, KS 67530
Barbara W. Ballard for Kansas House Barbara W. Ballard, STATE HOUSE 44th KS 1532 Alvamar Drive
250.00 8/30/2016 Lawrence, KS 66047
Rick Billinger for Kansas Senate Rick Biiiinger, STATE SENATE 4oth KS
8/30/2016 PO Box 594 1,000,00 Goodland, KS 67735
Elizabeth Bishop for Kansas House Elizabeth Bishop, STATE HOUSE 88th KS
8/30/2016 8518 E. Longlake St.
500.00 Wlchlta, KS 67207
Elaine S. Bowers for Kansas Senate Elaine Bowers, STATE SENATE 36th KS
8/30/2016 1326 N 150th Rd 1,000.00 Concordia, KS 66901
Teresa Briggs for Kansas House Teresa Briggs, STATE HOUSE 76th KS
8/30/2016 10933 W. 333rd SI. 500.00 Reading, KS 66868
Larry Campbell for Kansas House Larry Campbell, STATE HOUSE 26th KS 8/30/2016 15803 S. Avalon 500.00
Olathe, KS 66062
Sydney Carlin for Kansas House Sydney Carlin, STATE HOUSE 66th KS 8/30/2016 1650 sunnyslope
500.00 Manhattan, KS 66502
Carmichael for Kansas John Carmichael, STATE HOUSE 92nd KS 8/30/2016 1475 North Lieunett
Wichita, KS 67203 250.00
5,000.00
Page_6_ of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Pollllcal Action Committee
(Name of Party Committee or Political Committee)
Puri:!ose of Ex~enditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Lonnie Clark for State Representative Lonnie Clark, STATE HOUSE 65th KS 824 BS. Madison
8/30/2016 Junction City, KS 66441
Erin Davis for State House Erin Davis, STATE HOUSE 15th KS 12018 S. Clinton
8/30/2016 Olathe, KS 66061
Jim Denning for Kansas Senate Jim Denning, STATE SENATE 8th KS 8416 West 115thSlreel
8/30/2016 Overland Park, KS 66210
Brenda Dietrich for Kansas House Brenda Dietrich, STATE HOUSE 52nd KS
8/30/2016 611 O SW 38th Terrace Topeka, KS 66610
Ronald Ellis for Kansas House Ronald Ellis, STATE HOUSE 47th KS
8/30/2016 9199 K-4 Highway Meriden, KS 66512
Bud Estes for Kansas Senate Bud Estes, STATE SENATE 3Bth KS
8/30/2016 1405 Elbow Bend Dodge City, KS 67801
Oletha Faust-Goudeau for Kansas Senate Oletha Faust-Goudeau, STATE SENATE 29th KS 8/30/2016 4158 Regents Lane
Wichita, KS 67208
Gall Finney for Kansas House B/30/2016 1754 N. Madison St
Wichita, KS 67214
Linda Gallagher for Kansas House 8/30/2016 7804 Monrovia SL
Lenexa, KS 6621 5
Jim Gartner for Kansas House 8/30/2016 928 SW Woodbridge Court
Topeka, KS 66606
Gail Finney, STATE HOUSE B4th KS
Linda Gallagher, STATE HOUSE 23rd KS
Jim Gartner, STATE HOUSE 53rd KS
250.00
500.00
1,000 .00
250.00
500.00
1,000.00
250.00
250.00
500.00
500.00
5,000.00
Page _7_of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Date
B/30/2016
8/30/2016
B/30/2016
8/30/2016
8/30/2016
8/30/2016
8/30/2016
8/30/2016
8/30/2016
8/30/2016
Name and Address To Whom Expenditure is Made
Dan Goddard for Kansas Senate 3420 Mosher Rd. Parsons, KS 67357
David Haley for Kansas Senate
Tom Hawk for Kansas Senate 2600 Woodhaven Ct. Manhattan, KS 66502
Vicki Hiatt for Kansas Senate 21522 W. 72nd St. Shawnee, KS 66218
Larry Hibbard for Kansas House 858 EE 75 Rd. Toronto, KS 66777
Boog Highberger for State Representative 918 Massachusetts, Suite B Lawrence, KS 66044
Tlm Hodge for Kansas House 2727 N. Main North Newton, KS 67117
Cindy Holscher for Kansas House 12345 Westgate St. Overland Park, KS 66213
Trevor Jacobs for Kansas House 1927 Locust Rd. Fort Scott, KS 66701
Jim Karleskint for Kansas House 24542 Cantrell Road Tonganoxie, KS 66086
Pu~ose of Ex~enditure Amount
If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Dan Goddard, STATE SENATE 15th KS
1,000.00
David Haley, STATE SENATE 4th KS
250.00
Tom Hawk, STATE SENATE 22nd KS
250.00
lckl Hiatt, STATE SENATE 10th KS
1,000.00
Larry Hibbard, STATE HOUSE 13th KS
250.00
Dennis Highberger, STATE HOUSE 46th KS
250.00
Tim Hodge, STATE HOUSE 72nd KS
500.00
Cindy Holscher, STATE HOUSE 16th KS
500.00
Trevor Jacobs, STATE HOUSE 4th KS
250.00
Jim Karlesklnt, STATE HOUSE 42nd KS
500.00
4,750.00
Page_B_of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Puq~ose of Ex(!enditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Marvin Kleeb for Kansas House Marvin Kleeb, STATE HOUSE 48th KS 14206 Eby
500.00 8/30/2016 Overland Park, KS 66221
Annie Kuether for Kansas State House Annie Kuether, STATE HOUSE 55th KS
8/30/2016 250.00
Greg Lakin for State Representative Greg Lakin, STATE HOUSE 91st KS 2824 W. Timbercreek Circle
250.00 8/30/2016 Wichita, KS 67204
Greg Lewis for Kansas House Greg Lewis, STATE HOUSE 113th KS
8/30/2016 910 NE 30th Ave. 250.00 St. John, KS 67576
Nancy Lusk for Kansas House Nancy Lusk, STATE HOUSE 22nd KS
8/30/2016 PO Box 35
250.00 Overland Park,
Adam Lusker for Kansas House Adam Lusker, STATE HOUSE 2nd KS
8/30/2016 452 S. 210th St. 250.00 Frontenac, KS 66763
KC Ohaeboslm for Kansas House KC Ohaebosin, STATE HOUSE 89th KS
8/30/2016 2330 N. Oliver#511 250.00 Wichita, KS 67220
Boyd Orr for Kansas House Boyd Orr, STATE HOUSE 115th KS 8/30/2016 30111 H. Rd. 250.00
Fowler, KS 67844
Jerrod Ousley for State House Jerrod Ousley, STATE HOUSE 24th KS 8/30/2016 6800 Farley
500 .00 Merriam, KS 66203
Janice L. Pauls for Kansas House Janice L. Pauls, STATE HOUSE 102nd KS 8/30/2016 1634 North Baker
Hutchinson, KS 67501 250.00
3,000.00
Page_9_ of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Puq~ose of ExEenditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Tom Phillips for Kansas House Tom Phillips, STATE HOUSE 67th KS PO Box 1731
250.00 8/30/2016 Manhattan, KS 66505-1732
Jeff Pittman for Kansas House Jeff Pittman, STATE HOUSE 41st KS 1108 S. Broadway St.
500.00 8/30/2016 Leavenworth, KS 66048
Richard Proehl for Kansas House Richard Proehl, STATE HOUSE 7th KS
8/30/2016 510 Pine Ridge Rd
250.00 Parsons, KS 67357
Ken Rahjes for Kansas House Ken Rahjes, STATE HOUSE 110th KS
8/30/2016 1798 E. 900 Rd . 250.00 Agra, KS 67621
Stan Reeser for Kansas House Stan Reeser, STATE HOUSE 97th KS
8/30/2016 2551 S. Hiram Ave. Wichita, KS 67217
250.00
Tom Sawyer for Kansas House Tom Sawyer, STATE HOUSE 95th KS
8/30/2016 1041 S. Elizabeth St
250 .00 Wichita , 6721 3
Chuck Schmidt for Kansas Senate Chuck Schmidt, STATE SENATE 15th KS
8/30/2016 1001 N. 2nd Street 1,000.00 Independence, KS 67301
Don Schroeder for Kansas House Don Schroeder, STATE HOUSE 74th KS 8/30/2016 131 14th Ave. 250 .00
Inman, KS 67546
Tom Sloan for Kansas House Tom Sloan, STATE HOUSE 451h KS 8/30/2016 772 Highway 40
250.00 Lawrence, KS 66049
Susie SWanson for Kansas House Susie Swanson, STATE HOUSE 64th KS 8/30/2016 1422 5th
Clay Center, KS 67432 250.00
3,500.00
Page~of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Pur~ose of ExEenditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Dinah Sykes for Kansas Senate Dinah Sykes, STATE SENATE 21st KS 10227 Theden Circle
1,000.00 8/30/2016 Lenexa, KS 66212
Patsy Terrell for Kansas House Patsy Terrell, STATE HOUSE 102nd KS 906 E. Avenue A
8/30/2016 Hutchinson, KS 67501 250.00
Jack Thimesch for Kansas House Jack Thimesch, STATE HOUSE 114th KS 234 N Henderson
250.00 8/30/2016 Cunningham, KS 67035
Kent Thompson for Kansas House Kent Thompson, STATE HOUSE 9th KS
8/30/2016 PO Box 626 250.00 Iola, KS 66749
Ed Trimmer for Kansas House Ed Trimmer, STATE HOUSE 78th KS
8/30/2016 1402 East 9th
250 .00 Winfield, KS 67156
Jene Vickrey for Stale House Jene Vickrey, STATE HOUSE 6th KS
8/30/2016 502 S. Countryside
500.00 Louisburg, KS 66053
Ponka-We Victors for Kansas House Ponka-We Victors, STATE HOUSE 103rd KS
8/30/2016 PO Box 48081 250.00 Wichita, KS 67201
Troy L. Waymaster for Kansas House Troy Waymaster, STATE HOUSE 109th KS 8/30/2016 112 N Fairview Ave 250.00
Luray, KS 67649
Brandon Whipple for Kansas House Brandon Whipple, STATE HOUSE 96th KS 8/30/2016 4455 S. Washington Ct.
250.00 Wichita, KS 67216
Wilborn for Senate Richard Wilborn, STATE SENATE 351h KS B/30/2016 1504 Heritage Place
McPherson, KS 67460 1,000.00
4,250.00
Page _ 1_1_ of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Pur~ose ofEx~enditure Name and Address Amount
Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Kristey Williams for State Representative Kristey Williams, STATE HOUSE 77th KS 21 Taylor Ave.
250.00 8/30/2016 Augusta, KS 67010
John Wilson for Kansas House John Wilson , STATE HOUSE 10th KS 1923 Ohio St.
8/30/2016 Lawrence, KS 66046 250.00
Steve Alford for Kansas House J. Stephen Alford, STATE HOUSE 124th KS 4179 East Road 19
250.00 8/31/2016 Ulysses, KS 67880
Shannon Francis for Kansas House Shannon Francis, STATE HOUSE 1251h KS
8/31/2016 1501 Tucker Court Liberal, KS 67901
250.00
Don Hineman for Kansas House Don Hineman, STATE HOUSE 118th KS
8/31/2016 116 S Longhorn Rd 250.00 Dighton, KS 67839
J. Russell Jennings for Kansas House J Russell Jennings , STATE HOUSE 122nd KS
8/31/2016 515 Pleasntview 250.00 Lakin, KS 67830
Leonard Mastroni for Kansas House Leonard Mastronl, STATE HOUSE 117th KS
8/31/2016 102 Fairway Drive 250.00 Lacrosse, KS 67548
Bradley Ralph for Kansas House Bradley Ralph, STATE HOUSE 119th KS 8/31/2016 2009 Frederick Dr. 250.00
Dodge City, KS 67801
Adam Smith for Kansas House Adam Smith, STATE HOUSE 120th KS 8/31/2016 1970 RD 3
250.00 Weskan, KS 67762
John Wheeler for Kansas House John Wheeler, STATE HOUSE 123rd KS 8/31/2016 902 Anderson Street
Garden City, KS 67846 250.00
2,500.00
Page_1_2_of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Politjcal Committee)
Name and Address Date To Whom Expenditure is Made
AHAPAC-Arnerican Hospital Association FEDERAL
9/2/2016 800 10th Street, NW , Two City Center, Suite 400
Square Up
9/9/2016
Square Up
9/9/2016
Square Up
9/9/2016
Square Up
9/9/2016
Square Up
9/9/2016
Square Up
9/9/2016
Square Up 9/9/2016
Square Up 9/9/2016
9/15/2016 Square Up
Purpose of Expenditure
U independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Kim Williams
Linda Murphy
Robert Kenagy
Ann Jeter
Pat Cook
Lois Klug
John Manning
Cindy Samuelson
Eric Otting
Amount
1,526.28
3.44
8.94
6.68
0.55
0.28
1.10
4.13
2.48
10.31
1,564.39
Page _ 1_3_ of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
(Name of Party Committee or Political Committee)
Date
9/15/2016
9/16/2016
9/16/2016
9/20/2016
9/26/2016
9/26/2016
9/26/2016
Name and Address To Whom Expenditure is Made
Square Up
Square Up
Square Up
AHAPAC-American Hospital Association FEDERAL 800 10th Street, NW Two City Center, Suite 400
Lynn Grant for Kansas Senate 202 S. Appleton Frontenac, KS 66763
Randall Hardy for Kansas Senate 816 Highland Ave. Salina, KS 67401
Donald Merriman for Kansas Senate 325 Pine Ridge Dr. Salina, KS 67401
Purpose of Expenditure
If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Kenny Wilk
Frank Rajewski
Kendall Johnson
Lynn Grant, STATE SENATE 13th KS
Randall Hardy, STATE SENATE 24th KS
Donald Merriman, STATE SENATE 24th KS
Amount
6.88
0.55
0.55
2,894.50
1,000.00
500.00
500.00
4,902.48
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Hospital Association Political Action Committee
( Name of Party Committee or Political Committee)
Date Name and Address
To Whom Expenditure is Made
Monica Murnan for Kansas House 1313 Mallory Ct.
9/2612016 Pittsburg, KS 66762
Pat Pettey for Kansas Senate 5316 Lakewood St.
9/26/2016 Kansas City, KS 66106
Jolene Roitman for Kansas House 57 Westborough Rd.
9/2612016 Wellington, KS 67152
Sean Tarwater for Kansas House 16006 Meadow Lane
9/26/2016 Stillwell, KS 66085
Don Shimkus for Kansas Senate 301 N. Pacific
10/4/2016 Oxford, KS 67119
Chris Morrow for Kansas Senate 420 N. Cherry St.
10/12/2016 Gardner, KS 66030
CoreFlrst Bank & Trust 3035 SW Topeka Blvd
10/27/2016 Topeka, KS 66611
Coreflrst Bank & Trust 3035 SW Topeka Blvd
10/27/2016 Topeka, KS 66611
Purpose of Expenditure
If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
Monica Murnan, STATE HOUSE 3rd KS
Pat Pettey, STATE SENATE 6th KS
Jolene Roitman, STATE HOUSE 116th KS
Sean Tarwater, STATE HOUSE 27th KS
Don Shimkus, STATE SENATE 32nd KS
Chris Morrow, STATE SENATE 9th KS
Bank Fee for Credit Card Services - August
Bank Fee for Credit Card Services - September
Complete if last page of Schedule c
Total Itemized Expenditures This Period
Total Unitemized Expenditures of$50 or Jess
Amount
500.00
1,000.00
500.00
500 .00
1,000.00
1,000.00
215.32
46.08
4,761.40
73,644.07
48.71
73,692.78
Page _15_ of~