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 -- --


Kansas Hospital Association Political Action Committee



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~





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~


Kansas Hospltal Association Political Action 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



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~




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~





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



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~





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



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~






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


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~





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



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~






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



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



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



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~




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



Pur[!OSe of Ex[!end,iture Name and Address Amount


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~




Puri:!ose of Ex[!enditure Name and Address Amount


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~


Kansas Hospital Association Polltlcal Action Committee


PurEose of ExEenditure Name and Address Amount


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'




Pur[!ose of Ex(!enditure Name and Address Amount


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~


Kansas Hospital Association Pollllcal Action Committee


Puri:!ose of Ex~enditure Name and Address Amount


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~




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


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~




Puq~ose of Ex(!enditure Name and Address Amount


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~




Puq~ose of ExEenditure Name and Address Amount


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~




Pur~ose of ExEenditure Name and Address Amount


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~




Pur~ose ofEx~enditure Name and Address Amount


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~



(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


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~




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



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



( 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



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~

kansas hospital association political actlon...

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