Civic Intelligence

National Patient Advocate Foundation

EIN 54-1839226 • 501(c)4 • Hampton, VA

Profile

Npaf is a nonprofit organization which seeks to create avenues of access to and reimbursement for evolving therapies, therapeutic devices and agents through legislative and policy reform.

421 Butler Farm RoadHampton, VA 23666

www.npaf.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

64th percentile

0.17x

Higher debt load relative to assets than 64% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Liabilities / Revenue

70th percentile

0.24x

Higher debt load relative to revenue than 70% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Net Margin

43rd percentile

1.6%

Higher net margin than 43% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Top Officer Pay

98th percentile

$614,315

Higher top officer pay than 98% of similar nonprofits.

Top officer pay equals 62.5% of source-year revenue.

501(c)3 • $1M-$5M nonprofits • Source year 2025

Asset Growth

15th percentile

-12%

Faster asset growth than 15% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2024 to 2025

Revenue Growth

10th percentile

-33%

Faster revenue growth than 10% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2024 to 2025

Assets

Down

$1,418,412

Down $184,686 (-12%) from 2024

Liabilities

Down

$239,173

Down $199,967 (-46%) from 2024

Net Assets

Up

$1,179,239

Up $15,281 (+1.3%) from 2024

Revenue

Down

$982,347

Down $488,197 (-33%) from 2024

Expenses

Down

$967,066

Down $457,916 (-32%) from 2024

Net Income

Down

$15,281

Down $30,281 (-66%) from 2024

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$2.0M$1.5M$1.0M$500K$0Assets 2011: $774,684Liabilities 2011: $263,150Net Assets 2011: $511,5342011Assets 2012: $1,224,600Liabilities 2012: $684,502Net Assets 2012: $540,0982012Assets 2013: $1,749,914Liabilities 2013: $1,195,182Net Assets 2013: $554,7322013Assets 2014: $1,226,495Liabilities 2014: $660,830Net Assets 2014: $565,6652014Assets 2015: $655,990Liabilities 2015: $291,221Net Assets 2015: $364,7692015Assets 2016: $889,423Liabilities 2016: $351,624Net Assets 2016: $537,7992016Assets 2017: $998,178Liabilities 2017: $389,809Net Assets 2017: $608,3692017Assets 2018: $1,045,899Liabilities 2018: $258,495Net Assets 2018: $787,4042018Assets 2019: $1,284,652Liabilities 2019: $498,822Net Assets 2019: $785,8302019Assets 2020: $1,733,017Liabilities 2020: $815,900Net Assets 2020: $917,1172020Assets 2021: $1,690,384Liabilities 2021: $624,868Net Assets 2021: $1,065,5162021Assets 2022: $1,546,103Liabilities 2022: $427,829Net Assets 2022: $1,118,2742022Assets 2023: $1,606,464Liabilities 2023: $488,068Net Assets 2023: $1,118,3962023Assets 2024: $1,603,098Liabilities 2024: $439,140Net Assets 2024: $1,163,9582024Assets 2025: $1,418,412Liabilities 2025: $239,173Net Assets 2025: $1,179,2392025

Highlighted filing

2025

Assets$1,418,412
Liabilities$239,173
Net Assets$1,179,239

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MExpenses 2011: $1,727,1282011Expenses 2012: $2,698,5882012Revenue 2013: $2,650,953Expenses 2013: $2,636,319Net Income 2013: $14,6342013Revenue 2014: $2,832,943Expenses 2014: $2,822,010Net Income 2014: $10,9332014Revenue 2015: $1,012,929Expenses 2015: $1,213,825Net Income 2015: -$200,8962015Revenue 2016: $1,914,847Expenses 2016: $1,741,817Net Income 2016: $173,0302016Revenue 2017: $1,659,415Expenses 2017: $1,588,845Net Income 2017: $70,5702017Revenue 2018: $1,651,241Expenses 2018: $1,472,206Net Income 2018: $179,0352018Revenue 2019: $1,508,063Expenses 2019: $1,509,637Net Income 2019: -$1,5742019Revenue 2020: $1,762,015Expenses 2020: $1,630,728Net Income 2020: $131,2872020Revenue 2021: $1,926,502Expenses 2021: $1,778,103Net Income 2021: $148,3992021Revenue 2022: $1,621,847Expenses 2022: $1,569,089Net Income 2022: $52,7582022Revenue 2023: $1,504,035Expenses 2023: $1,503,913Net Income 2023: $1222023Revenue 2024: $1,470,544Expenses 2024: $1,424,982Net Income 2024: $45,5622024Revenue 2025: $982,347Expenses 2025: $967,066Net Income 2025: $15,2812025

Highlighted filing

2025

Revenue$982,347
Expenses$967,066
Net Income$15,281

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2025Detailed filing. Detailed filing data is available for this year.$1.42$0.24$1.18$0.98$0.97$0.02
2024XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.60$0.44$1.16$1.47$1.42$0.05
2023Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.61$0.49$1.12$1.50$1.50$0.00
2022XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.55$0.43$1.12$1.62$1.57$0.05
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.69$0.62$1.07$1.93$1.78$0.15
2020Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.73$0.82$0.92$1.76$1.63$0.13
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.28$0.50$0.79$1.51$1.51$0.00
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.05$0.26$0.79$1.65$1.47$0.18
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.00$0.39$0.61$1.66$1.59$0.07
2016Detailed filing. Detailed filing data is available for this year.$0.89$0.35$0.54$1.91$1.74$0.17
2015Summary only. Only limited summary data is available for this year.$0.66$0.29$0.36$1.01$1.21$0.20
2014Detailed filing. Detailed filing data is available for this year.$1.23$0.66$0.57$2.83$2.82$0.01
2013Detailed filing. Detailed filing data is available for this year.$1.75$1.20$0.55$2.65$2.64$0.01
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.22$0.68$0.54$2.70
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.77$0.26$0.51$1.73
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2024 to Jun 30, 2025
Signed
Jan 13, 2026
Return Version
2024v5.5
Gross Receipts
$982,347
Mission and Program Overview

Mission

The national patient advocate foundation, the advocacy affiliate of the patient advocate foundation, represents the patient voice, both the powerful stories of individuals and the collective needs of the community. Our programs are developed to reflect the experiences and overcome the barriers that paf patients who are living with chronic, debilitating or life-threatening illness and their caregivers encounter in accessing affordable, quality health care. Npaf is a thought leader in developing policies that protect patients and caregivers from lack of transparency, medical debt and equitable access to care and services at key points during their illness.

National patient advocate foundation (npaf), established in 1996, brings perspectives, engagement and lived experiences of patients and caregivers to the forefront of healthcare reform activities. Npaf's mission is to make the healthcare system work for all of us. As the advocacy affiliate of patient advocate foundation, npaf is a national nonprofit organization working with partners at the system level to influence public policy and drive changes in healthcare access, affordability and outcomes.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$1,377,622$1,324,945▼ $52,677
Accounts Receivable$40,475$39,200▼ $1,275
Prepaid Expenses and Deferred Charges$33,176$8,492▼ $24,684
Land, Buildings, and Equipment, Net$16,872$3,374▼ $13,498
Cash and Non-Interest-Bearing Accounts$200$200→ $0
Total Assets$1,603,098$1,418,412▼ $184,686
Other Assets Total$134,753$42,201▼ $92,552
Liabilities
Deferred Revenue$198,400$134,384▼ $64,016
Accounts Payable and Accrued Expenses$81,211$61,872▼ $19,339
Other Liabilities$159,529$42,917▼ $116,612
Total Liabilities$439,140$239,173▼ $199,967
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$1,163,958$1,179,239▲ $15,281
Total Net Assets Fund Balance$1,163,958$1,179,239▲ $15,281
Total Liabilities and Net Assets / Fund Balance$1,603,098$1,418,412▼ $184,686

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$3,374$124,383$127,757
Leasehold Improvements$0$3,067$3,067
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Rebecca KirchEvp, Policy & ProgramsFT$223,412$22,583$245,995
Gwen DarienEvp, Patient AdvocacyFT$192,268$22,216$214,484
Dr Alan J Balch PhdChief Executive OfficerPT$125,000$489,315$125,000
Melissa WilliamsAssoc. Dir., Policy and FiFT$104,864$18,861$123,725
Caitlin DonovanSenior Director PrFT$103,627$5,409$109,036

Board Members and Trustees

NameTitle
John L MurphyFinance Committee Chair
Otis Maynard EsqBoard President
Al Benson Iii Md FacpPast Board President
Reginald Tucker-seeley Ma Scm ScdBoard Vice President
Bryan Loy Md MbaBoard Member
Daniel Press PhdBoard Member
David WhiteBoard Member
Larri ShortBoard Member
Loretta Williams Phdaprnmsn BsnbaBoard Member
Maria TolerBoard Member
Norman Hubbard MbaBoard Member
Robert Winn MdBoard Member
Maureen CulbertsonBoard Secretary
Revenue and Support

Revenue Composition

Contributions and Grants
$619,790
Program Service Revenue
$292,500
Investment Income
$37,729
Other Revenue
$32,328
All Other Contributions
$93,915
Change in Net Assets
$15,281

Audited Revenue Reconciliation

Revenue per Audited Statements
$982,347
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$203,822
Total Revenue per Audited Statements
$1,186,169
Total Revenue per Form 990
$982,347
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$692,520
Other Expenses$274,546
Total Fundraising Expense$71,672
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$442,867$3,144$15,760$461,771
Current Officers, Directors, Trustees, and Key Employees$87,500-$37,500$125,000
Occupancy$59,480$19,543$5,948$84,971
Fees for Services Other$62,709--$62,709
Payroll Taxes$39,363$1,269$3,936$44,568
Other Employee Benefits$39,765-$3,976$43,741
Office Expenses$16,603$23,145$1,662$41,410
Fees for Services Accounting-$30,677-$30,677
Pension Plan Contributions$15,717$151$1,572$17,440
Conferences and Meetings$17,056--$17,056
Depreciation Depletion$9,448$3,104$945$13,497
Advertising$6,218$5,000-$11,218
Travel-$7,485-$7,485
Insurance$3,500$1,150$350$5,000
Other Expenses$233$267$23$523
Total Functional Expenses$800,459$94,935$71,672$967,066

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Audited Statements$1,170,888
Expenses per Audited Statements$967,066
Total Expenses per Form 990$967,066
Expenses Not Reported on Form 990$203,822
Expenses Not Reported on Financial Statements$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
Dr Alan J BalchChief Executive OfficerINTERCOMPANY ACTIVITY OCCURS BETWEEN PATIENT ADVOCATE FOUNDATION (PAF) AND NATIONAL PATIENT ADVOCATE FOUNDATION (NPAF). ALSO, PAF AND NPAF SHARE THE SAME CHIEF EXECUTIVE OFFICER. NPAF HAS A CONSULTING AGREEMENT IN WHICH PAF PAYS NPAF FEES TO REPRESENT THE POLICY INTERESTS OF PAF. THE CONSULTING FEES FOR FY 2024/2025 WERE $516,000. NPAF REIMBURSED PAF FOR SALARIES AND BENEFITS OF $249,877 FOR SHARED SERVICES, OF WHICH $125,000 WAS FOR ALAN BALCH'S SALARY. PAF REIMBURSED TO NPAF $214,645 IN SALARIES AND BENEFITS FOR SHARED SERVICES. NPAF ALSO REIMBURSED PAF FOR $8,700 OF OTHER EXPENSES, AND PAF REIMBURSED NPAF FOR $13,140 OF OTHER EXPENSES IN FY 2024/2025.No$1,002,362
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Lease Liability$42,851
Due to Paf$66
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

The finance committee of the board of directors receives a draft copy of the form 990 then subsequently reviews it for accuracy and compliance. Once it is approved by the finance committee, all members of the executive board of directors receive the final copy of the form 990 for review and approval and is so noted in the board meeting minutes.

Form 990, Part VI, Section B, Line 12C

Under the direction of the governance committee, members of the npaf board of directors are required to review and sign the conflict of interest policy upon establishing membership on the board and again annually. This includes completing an updated conflict of interest disclosure questionnaire in which each member must disclose any/all known conflicts of interest at that time. If any conflicts of interest are noted more information will be gathered by the governance committee and a determination on the existence of a material conflict will be issued. The governance committee of the board of directors is charged with enforcement of this policy.

Form 990, Part VI, Section B, Line 15

The compensation and benefits committee shall consist of at least three directors appointed by the committee chair and subject to an affirmative majority vote with the necessary quorum of duly elected directors present. Members of the compensation and benefit committee must be independent and complete a signed attestation to that effect. The committee will be chaired by the president. Experts in compensation and benefits not currently directors may serve as voting committee members. The compensation and benefits committee is responsible for the annual performance review of the chief executive officer. The compensation committee is also responsible for evaluating and determining the total compensation of the chief executive officer in addition to reviewing the compensation levels for all officers and key employees. This review shall be conducted annually. The compensation committee shall base its evaluation and recommendations in part on a bi-annual benchmarking study conducted by a reliable third party that utilizes national comparability data on salary and benefits of organizations similar in mission, size, and revenue. The compensation and benefits committee is also responsible for ensuring contemporaneous documentation and recordkeeping of its actions and decisions and must submit a written memorandum to the foundation's talent management department affirming the committee's determination of reasonableness of compensation for all the officers and key employees. Finally, the compensation and benefits committee is responsible for reviewing the benefits offered all employees of the corporation and making recommendations about their suitability to the board of directors.

Form 990, Part VI, Section C, Line 19

National patient advocate foundation makes their governing documents, conflict of interest policy, and financial statements available upon request.

Filing and Contact Details

Filer

Filer Name
National Patient Advocate Foundation
EIN
54-1839226
Phone
7579521369
Address
421 BUTLER FARM ROAD, HAMPTON, VA 23666

Signing Officer

Name
Dr Alan Balch
Title
Chief Executive Officer
Phone
7578736668
Signed
2026-01-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Dr Alan Balch
Formed
1996
Legal Domicile
Va
Voting Board Members
13
Independent Board Members
13
Employees
9
Volunteers
23

Preparer

Firm
Brown Edwards & Company Llp
Address
701 TOWN CENTER DRIVE SUITE 700, NEWPORT NEWS, VA 23606
Preparer
Jacob Reeves
Phone
7578731033
Supplemental Narrative

Additional Explanations

Form 990 - Page 1 - Box I

Effective 7/1/22, national patient advocate foundation is a 501(c)(3) organization. An irs determination letter dated 4/18/23, noted the organization was to be exempt from federal income tax under internal revenue code 501(c)(3). Further, the organization was determined to be a public charity under irc section 509(a)(3). Previously, the organization was exempt from federal income tax under internal revenue code 501(c)(4).

Form 990 - Part XII - Line 2C

The finance committee reviews and approves the draft of the audited financial statements for accuracy and compliance. The board of directors receives the final copy of the audited financial statements when it is complete and approved by the finance committee, so noted in the minutes and approved by the board. When selecting a new audit firm, national patient advocate foundation identifies three recommended regional firms and requests proposals from them. The information is reviewed and the final selection is approved by the finance committee.

Financial Statement Notes

PART X, LINE 2:

The foundation is exempt from income taxes under section 501(c)(3) of the internal revenue code; accordingly, the accompanying financial statements do not reflect a provision or liability for federal and state income taxes.

Raw XML AppendixShowing 400 of 633 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Desc0NPAF LEADS A VOLUNTEER GRASSROOTS NETWORK IN ACTIVITIES TO ADVANCE THE ORGANIZATION'S POLICY PRIORITIES AS GUIDED BY BOARD-APPROVED PRINCIPLES THAT ARE UPDATED ANNUALLY. THE COMPLEMENT OF PRINCIPLES TRANSLATES TO VARIOUS ADVOCACY OPPORTUNITIES FOR MINIMIZING BURDENS EXPERIENCED BY PATIENTS AND CAREGIVERS SO THEY CAN MAINTAIN MEDICAL, MENTAL/BEHAVIORAL AND FINANCIAL HEALTH. OUR AGENDA TARGETS HARDSHIPS EXPERIENCED BY ALL PAITENTS REGARDLESS OF WHERE THEY LIVE, THEIR DIAGNOSIS, RACE, GENDER, EDUCATION OR INCOME LEVEL. AMONG OTHER PRIORITIES, NPAF FOCUSES ON OPPORTUNITIES TO ADVANCE INNOVATIVE POLICIES ESTABLISHING "NEEDS NAVIGATION" AS A STANDARD PART OF CARE. THESE SERVICES MUST BE RELIABLY AVAILABLE IN ALL SETTINGS TO EASE PATIENTS' HEALTHCARE COSTS CONCERNS THAT ARE CONSEQUENCES OF COMPLEX AND CHRONIC ILLNESSES. NPAF ALSO PARTNERS WITH PAF'S PATIENT INSIGHT INSTITUTE ON PRODUCING PATIENT INSIGHT CONGRESS. THE CONFERENCE AGENDA OFFERS A UNIQUE APPROACH FOR GENERATING ACTIONABLE RESEARCH IDEAS AND ACADEMIC-PARTNERED PROJECTS, INCLUDING EVIDENCE SUPPORTING NPAF'S HEALTHCARE POLICY AGENDA. THE PROGRAM BRINGS REPRESENTATIVE COHORTS OF PATIENTS, CAREGIVERS AND GRASSROOTS VOLUNTEERS TO THE CONFERENCE ALONGSIDE RESEARCHERS. NPAF STAFF SERVE AS FACULTY AND ADMINISTRATIVE SUPPORT PARTNERING WITH PATIENT INSIGHT INSTITUTE IN PLANNING, EXECUTING AND EVALUATING OUTCOMES OF THESE EVENTS.
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IRS990/Form990PartVIISectionAGrp/TitleTxt0PAST BOARD PRESIDENT
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IRS990/Form990PartVIISectionAGrp/TitleTxt5BOARD MEMBER
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IRS990/Form990PartVIISectionAGrp/TitleTxt7BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt8BOARD MEMBER
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IRS990/Form990PartVIISectionAGrp/TitleTxt10BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt11BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt12BOARD MEMBER
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IRS990/Form990PartVIISectionAGrp/TitleTxt14EVP, PATIENT ADVOCACY
IRS990/Form990PartVIISectionAGrp/TitleTxt15EVP, POLICY & PROGRAMS
IRS990/Form990PartVIISectionAGrp/TitleTxt16ASSOC. DIR., POLICY AND FI
IRS990/Form990PartVIISectionAGrp/TitleTxt17SENIOR DIRECTOR PR
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IRS990/MissionDesc0THE NATIONAL PATIENT ADVOCATE FOUNDATION, THE ADVOCACY AFFILIATE OF THE PATIENT ADVOCATE FOUNDATION, REPRESENTS THE PATIENT VOICE, BOTH THE POWERFUL STORIES OF INDIVIDUALS AND THE COLLECTIVE NEEDS OF THE COMMUNITY. OUR PROGRAMS ARE DEVELOPED TO REFLECT THE EXPERIENCES AND OVERCOME THE BARRIERS THAT PAF PATIENTS WHO ARE LIVING WITH CHRONIC, DEBILITATING OR LIFE-THREATENING ILLNESS AND THEIR CAREGIVERS ENCOUNTER IN ACCESSING AFFORDABLE, QUALITY HEALTH CARE. NPAF IS A THOUGHT LEADER IN DEVELOPING POLICIES THAT PROTECT PATIENTS AND CAREGIVERS FROM LACK OF TRANSPARENCY, MEDICAL DEBT AND EQUITABLE ACCESS TO CARE AND SERVICES AT KEY POINTS DURING THEIR ILLNESS.
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IRS990/ProgSrvcAccomActy2Grp/Desc0NPAF POLICY CONSORTIUM FEATURES A FORUM FOR DYNAMIC DIALOGUE THAT INVITES MEMBERS, ALONG WITH PATIENTS, CAREGIVERS AND COMMUNITY PARTNERS TO EXPLORE TOGETHER THE IMPACT AND IMPLICATIONS OF SERIOUS ILLNESSES ON PEOPLES' LIVES. THROUGH GUARTERLY VIRTUAL PATIENT-DRIVEN LISTENING SESSIONS, MEMBER SUPPORTERS GET A SEAT AT THE TABLE TO LEARN FROM THE REAL-WORLD LIVED EXPERIENCES OF PATIENTS, CAREGIVERS, SERVICE PROVIDERS AND COMMUNITY PARTNERS. POLICY CONSORTIUM PROVIDES AN INTERACTIVE LEARNING COMMUNITY FOR GENERATING ACTIONALBLE RESEARCH IDEAS, PRAGMATIC POLICY SOLUTIONS, AND ADVOCACY INITIATIVES TO IMPROVE HEALTHCARE ACCESS, AFFORDABILITY AND QUALITY. MEMBERS FROM ACROSS THERAPEUTIC AREAS ARE WELCOME TO THIS FORUM.
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