LOUISIANA PRIMARY CARE ASSOCIATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- LOUISIANA PRIMARY CARE ASSOCIATION INC (EIN 72-1040949)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2023-02-14
- IRS object ID
- 202310459349301981
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-02-14T16:39:01-05:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 854373220 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Steven M DeRouen & Associates LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 4265 | AddressLine1Txt |
| City | Lake Charles | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721040949 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Louisiana Primary Care Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LOUI | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 966 | AddressLine1Txt |
| City | Baton Rouge | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70821 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Gerrelda Davis | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Phone | 2259277662 | PhoneNum |
| Signature | 2022-12-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Gerrelda | PersonFirstNm |
| Person Last | Davis | PersonLastNm |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Steven M DeRouen | PreparerPersonNm |
| PTIN | P01050140 | PTIN |
| Phone | 3375134915 | PhoneNum |
| Preparation | 2023-02-14 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-03-07 01:45:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Gerrelda Davis | PrincipalOfficerNm |
| Gross Receipts | $4,589,222 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lpca.net | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | The Louisiana Primary Care Association, Inc. works to promote community based health services through advocacy, education, public awareness and leveraging resources. | ActivityOrMissionDesc |
| Voting Members Governing Body | 41 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 41 | VotingMembersIndependentCnt |
| Total Employee | 24 | TotalEmployeeCnt |
| Total Volunteers | 41 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,982,888 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,735,545 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $682,908 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $816,739 | CYProgramServiceRevenueAmt |
| PY Investment Income | $28,624 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,917 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,067 | PYOtherRevenueAmt |
| CY Other Revenue | $26,021 | CYOtherRevenueAmt |
| PY Total Revenue | $3,701,487 | PYTotalRevenueAmt |
| CY Total Revenue | $4,589,222 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,935,991 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,307,298 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,284,794 | PYOtherExpensesAmt |
| CY Other Expenses | $1,256,362 | CYOtherExpensesAmt |
| PY Total Expenses | $3,220,785 | PYTotalExpensesAmt |
| CY Total Expenses | $3,563,660 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $480,702 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,025,562 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,031,321 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,206,016 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $534,110 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $646,281 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,497,211 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,559,735 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The Louisiana Primary Care Association, Inc. works to promote community based health services through advocacy, education, public awareness and leveraging resources. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,135,081 | ExpenseAmt |
| Revenue | $990,564 | RevenueAmt |
| Desc | Services include providing CME workshops for doctors, coordinating shared services, member newsletters and journals, health disparities, collaborative mentoring programs, and conferences and training. | Desc |
| Total Program Service Expenses | $3,135,081 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 24 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 41 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 41 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Christine Foerstner | PersonNm |
| Phone | 2259277662 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 503 Colonial Drive | AddressLine1Txt |
| City | Baton Rouge | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70806 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (48 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| Gerrelda Davis | |||||||||
| Executive Director | 40.00 | 0.00 | Yes (X) | $220,395 | $0 | $16,213 | |||
| Christopher Obafunwa | |||||||||
| HIT Director | 40.00 | 0.00 | $152,256 | $0 | $13,907 | Yes (X) | |||
| Christine Foerstner | |||||||||
| Finance Director | 40.00 | 0.00 | Yes (X) | $135,665 | $0 | $13,456 | |||
| Shannon Robertson | |||||||||
| Clinical Quality Director | 40.00 | 0.00 | $114,314 | $0 | $27,533 | Yes (X) | |||
| Susie Hutchinson | |||||||||
| Practice MgmtClinic | 40.00 | 0.00 | $123,592 | $0 | $7,767 | Yes (X) | |||
| Raegan Carter | |||||||||
| Government Affairs Director | 40.00 | 0.00 | $118,612 | $0 | $8,093 | Yes (X) | |||
| Nakeisha Cleveland | |||||||||
| Deputy Director | 40.00 | 0.00 | $115,403 | $0 | $4,434 | Yes (X) | |||
| Jennifer Harris | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Mark Windham | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Claude Martin | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Deano Thornton | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Dodie LaMott | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Roderick Campbell | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Rosanna Dichiro | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Barbara Hutchinson | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Patricia Lewis | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Dr Mark Guidry | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Carleetha Smith | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Debra Meisch | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Kim Brunson | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Matthew Valliere | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Jeremy Simmons | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Cindy Peavy | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Ragan Collins | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Katie Parnell | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Tim Young | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Diem Nguyen | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Mark Keiser | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Jackie Schauf | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Beth Chumley | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Willie White III | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Noel Twilbeck Jr | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Christi Hunt | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Casey Guidry | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Catherine Tonore | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Dr Donald Erwin | |||||||||
| Trustee | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Dr Stacie Bland | |||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Dr Alecia Cyprian | |||||||||
| President | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| William Brent III | |||||||||
| Treasurer | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Leroy Willis | |||||||||
| Advocacy Branch Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Keith Winfrey MD | |||||||||
| Clinical Branch Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Shirley Wade | |||||||||
| Clinical Branch Vice Chair | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Tamara Boutte | |||||||||
| Parlimentarian | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Ed Carlson | |||||||||
| LPCA Legislative Committee Ch | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Dr Gary Wiltz | |||||||||
| Clinical Branch Secretary | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Dr Michael Griffin | |||||||||
| President Elect | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Dr Shondra Williams | |||||||||
| Immediate Past President | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Michael Andry | |||||||||
| Parliamentarian | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $980,237 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $91,403 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Certintell Inc | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 317 6th Avenue Suite 901 | AddressLine1Txt |
| City | Des Moines | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Patient Monitoring | ServicesDesc |
| Compensation | $150,000 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $173,825 | MembershipDuesAmt |
| Government Grants | $3,554,620 | GovernmentGrantsAmt |
| All Other Contributions | $7,100 | AllOtherContributionsAmt |
| Total Contributions | $3,735,545 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Contract Fees | 900099 | $76,951 | $76,951 |
| Conferences | 900099 | $188,146 | $188,146 |
| Management Fees | 900099 | $551,642 | $551,642 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $816,739 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,917 | TotalRevenueColumnAmt |
| Exclusion | $10,917 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $26,021 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,021 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $26,021 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,589,222 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $842,760 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,917 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $551,892 | TotalAmt |
| Program Services | $507,741 | ProgramServicesAmt |
| Management And General | $44,151 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,369,966 | TotalAmt |
| Program Services | $1,256,774 | ProgramServicesAmt |
| Management And General | $113,192 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,044 | TotalAmt |
| Program Services | $48,921 | ProgramServicesAmt |
| Management And General | $3,123 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,224 | TotalAmt |
| Program Services | $186,239 | ProgramServicesAmt |
| Management And General | $11,985 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,172 | TotalAmt |
| Program Services | $124,957 | ProgramServicesAmt |
| Management And General | $10,215 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,807 | TotalAmt |
| Program Services | $22,626 | ProgramServicesAmt |
| Management And General | $14,181 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,555 | TotalAmt |
| Program Services | $61,346 | ProgramServicesAmt |
| Management And General | $16,209 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $868,912 | TotalAmt |
| Program Services | $777,785 | ProgramServicesAmt |
| Management And General | $91,127 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,260 | TotalAmt |
| Program Services | $14,513 | ProgramServicesAmt |
| Management And General | $30,747 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,090 | TotalAmt |
| Program Services | $8,079 | ProgramServicesAmt |
| Management And General | $14,011 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,115 | TotalAmt |
| Program Services | $16,588 | ProgramServicesAmt |
| Management And General | $527 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,311 | TotalAmt |
| Program Services | $29,887 | ProgramServicesAmt |
| Management And General | $424 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,198 | TotalAmt |
| Program Services | $551 | ProgramServicesAmt |
| Management And General | $16,647 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,261 | TotalAmt |
| Management And General | $41,261 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,185 | TotalAmt |
| Program Services | $8,437 | ProgramServicesAmt |
| Management And General | $7,748 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Dues and Subscriptions | $37,836 | $33,093 | $4,743 |
| Supplies | $37,101 | $37,101 | |
| Repairs and Maintenance | $6,663 | $6,663 | |
| Meals and Entertainment | $1,068 | $443 | $625 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,563,660 | TotalAmt |
| Program Services | $3,135,081 | ProgramServicesAmt |
| Management And General | $428,579 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,034,134 | BOYAmt |
| EOY | $3,227,088 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,536,066 | BOYAmt |
| EOY | $2,547,010 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $312,724 | BOYAmt |
| EOY | $357,790 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,620 | BOYAmt |
| EOY | $187,725 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,845 | BOYAmt |
| EOY | $8,493 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,305,596 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $458,949 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $887,908 | BOYAmt |
| EOY | $846,647 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,024 | BOYAmt |
| EOY | $31,263 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,031,321 | BOYAmt |
| EOY | $7,206,016 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,109 | BOYAmt |
| EOY | $232,542 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $60,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $394,001 | BOYAmt |
| EOY | $353,739 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $534,110 | BOYAmt |
| EOY | $646,281 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,502,405 | BOYAmt |
| EOY | $4,295,723 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,994,806 | BOYAmt |
| EOY | $2,264,012 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,497,211 | BOYAmt |
| EOY | $6,559,735 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,031,321 | BOYAmt |
| EOY | $7,206,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,025,562 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $36,962 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,286,654 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,733,055 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,313,709 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,982,888 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,735,545 | CurrentTaxYearAmt |
| Total | $15,051,851 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,286,654 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,733,055 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,313,709 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,982,888 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,735,545 | CurrentTaxYearAmt |
| Total | $15,051,851 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $15,051,851 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,821 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,252 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,398 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,624 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,917 | CurrentTaxYearAmt |
| Total | $126,012 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $213 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,267 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,820 | CurrentTaxYearMinus1YearAmt |
| Total | $5,300 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,744 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $201,576 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $26,021 | CurrentTaxYearAmt |
| Total | $233,620 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,416,783 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,685,649 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97630 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97090 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other income Part II line 10 or Part III line 12 | FormAndLineReferenceDesc |
| Explanation | Other Income:Miscellaneous $2,785Settlements $23,236 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $150,000 | OtherCostOrOtherBasisAmt |
| Book Value | $150,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $992,554 | OtherCostOrOtherBasisAmt |
| Depreciation | $296,073 | DepreciationAmt |
| Book Value | $696,481 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $163,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $162,876 | DepreciationAmt |
| Book Value | $166 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $846,647 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $31,263 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $31,263 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $4,626,184 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $36,962 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $36,962 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,589,222 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $4,589,222 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,563,660 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $3,563,660 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $3,563,660 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| Gerrelda Davis | ||||||
| Executive Director | $178,126 | $28,809 | $13,460 | $7,622 | $8,591 | $236,608 |
| Christopher Obafunwa | ||||||
| HIT Director | $149,171 | $3,085 | $5,814 | $8,093 | $166,163 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other non-fixed payments (Part I, line 7) | FormAndLineReferenceDesc |
| Explanation | Non-fixed bonus payments were based on the achievement of various performance objectives. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Members or stockholder classes and rights Part VI line 6 | Members consist of participating healthcare clinics. |
| Member election for additional members Part VI line 7a | Each health clinic member votes on the hiring of the CEO position when a vacancy arises. |
| Form 990 governing body review Part VI line 11 | The Form 990 return is distributed to the board members for review and approval prior to its filing. |
| Conflict of interest policy compliance Part VI line 12c | Conflict of interest updates are documented on an annual basis. Interim updates pertaining to changes are required of each board member. |
| CEO executive director top management comp Part VI line 15a | The Executive Directors salary is determined by the Board of the Directors Executive Committee (Board President, President-Elect, Immediate Past President, Treasurer, Secretary and Parliamentarian) and is based on industry comparable position data along with substantiation of the deliberation and decision by the Board of Directors. |
| Other officer or key employee compensation Part VI line 15b | Other key management salaries are detemined by the Executive Director based on industry comparable position data, duties and responsibilities as per the determined job description of each management position, and level of experience and/or education the position requires. |
| Governing documents etc available to public Part VI line 19 | Organizational documents are made available to the public upon request. |
| List of other fees for services expenses Part IX line 11g | Contract Labor $718,912Remote Patient Monitoring and Expanded Telehealth Solutions $150,000 |