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Community Clinic Consortium: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
Community Clinic Consortium (EIN 20-0782029)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-12
IRS object ID
202221329349306382
Schema version
2020v4.0
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

FieldValueIRS element (for citing)
Return2022-05-12T13:24:03-07:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN270741376PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HARSHWAL & COMPANY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17677 OAKPORT ST STE 460AddressLine1Txt
CityOAKLANDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94621ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200782029EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Community Clinic ConsortiumBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone5102336230PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13720 Barrett AvenueAddressLine1Txt
CityRichmondCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94805ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAlvaro FuentesPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Signature2022-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstAlvaroPersonFirstNm
Person LastFuentesPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSanwar Harshwal CPAPreparerPersonNm
PTINP01249746PTIN
Phone5104525051PhoneNum
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Alvaro FuentesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13720 Barrett AvenueAddressLine1Txt
CityRichmondCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94805ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,087,284GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.clinicconsortium.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionThe mission of the Community Clinic Consortium is to promote and improve the health and quality of life for all Contra Costa and Solano County residents. The Consortium is dedicated to supporting the involvement of communities in developing a responsive health care system.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,428,290PYContributionsGrantsAmt
CY Contributions Grants$1,023,149CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$5,698PYInvestmentIncomeAmt
CY Investment Income$1,635CYInvestmentIncomeAmt
PY Other Revenue$87,333PYOtherRevenueAmt
CY Other Revenue$62,500CYOtherRevenueAmt
PY Total Revenue$1,521,321PYTotalRevenueAmt
CY Total Revenue$1,087,284CYTotalRevenueAmt
PY Grants And Similar Paid$175,739PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$516,834CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$463,945PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$496,779CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$61,840CYTotalFundraisingExpenseAmt
PY Other Expenses$158,478PYOtherExpensesAmt
CY Other Expenses$110,970CYOtherExpensesAmt
PY Total Expenses$798,162PYTotalExpensesAmt
CY Total Expenses$1,124,583CYTotalExpensesAmt
PY Revenues Less Expenses$723,159PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$37,299CYRevenuesLessExpensesAmt
Total Assets BOY$1,931,874TotalAssetsBOYAmt
Total Assets EOY$1,635,848TotalAssetsEOYAmt
Total Liabilities BOY$305,790TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,063TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,626,084NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,588,785NetAssetsOrFundBalancesEOYAmt
MissionThe mission of the Community Clinic Consortium is to promote and improve the health and quality of life for all Contra Costa and Solano County residents. The Consortium is dedicated to supporting the involvement of communities in developing a responsive health care system.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$936,306ExpenseAmt
Grant$516,834GrantAmt
DescThe Organization is dedicated to supporting the involvement of communities in developing a responsive health care system and articulating and advancing the role of community health centers. The Organization does this through their four main programs:Community Partnership and Outreach The Consortium and its community partners collaborate to improve service delivery. The Organization works to understand community needs and to provide information about health care resources.Policy Advocacy The Consortium advocates for expanded health care access to underserved populations and other pressing health care needs in Contra Costa and Solano Counties. The Organization distributes health policy updates, engages in media advocacy, educates local and state policymakers, and builds coalitions.Resource Growth and Technical Assistance The Consortium assist member clinics in maximizing resources through collaboration and shares expertise. It has helped clinics secure funding for after-school programs, medical supplies, emergency preparedness equipment, chronic disease management, clinic redesign, Health Information Technology and other services that improve the health of our community.Skills Training The Consortium arranges trainings for clinic staff on topics that improve their ability to serve clients and the community. Training topics have included customer service, cultural competence, Medi-Cal enrollment, specialty referral access, and CBRNE Trainings for emergency preparedness purposes.Desc
Total Program Service Expenses$936,306TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMichelle Lounibos RussellPersonNm
Phone7072852967PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11310 RedwoodWay Suite 135AddressLine1Txt
CityPetalumaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94954ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Alvaro Fuentes
Executive Dir.40.000.00Yes (X)$143,533$0$4,660
Jane Garcia
Chair Person4.000.00$0$0$0Yes (X)
David Villet
Secretary4.000.00$0$0$0Yes (X)
Alicia Hardy
Treasurer4.000.00$0$0$0Yes (X)
Gilda Gonzalez
Director4.000.00$0$0$0Yes (X)
Christine Noguera
Director4.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$143,533TotalReportableCompFromOrgAmt
Total Other Compensation$4,660TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Benicia Community Action CouncilBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 Military EAddressLine1Txt
CityBeniciaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94510ZIPCd
FieldValueIRS element (for citing)
ServicesTransitional Care ProgramServicesDesc
Compensation$134,867CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Membership Dues$3,750MembershipDuesAmt
All Other Contributions$1,019,399AllOtherContributionsAmt
Total Contributions$1,023,149TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,635TotalRevenueColumnAmt
Related Or Exempt Func Income$1,635RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOther IncomeDesc
Business900099BusinessCd
Total Revenue Column$62,500TotalRevenueColumnAmt
Related Or Exempt Func Income$62,500RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$62,500OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,087,284TotalRevenueColumnAmt
Related Or Exempt Func Income$64,135RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$516,834TotalAmt
Program Services$516,834ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$152,475TotalAmt
Program Services$112,831ProgramServicesAmt
Management And General$22,872ManagementAndGeneralAmt
Fundraising$16,772FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$265,504TotalAmt
Program Services$196,473ProgramServicesAmt
Management And General$39,825ManagementAndGeneralAmt
Fundraising$29,206FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$47,328TotalAmt
Program Services$35,023ProgramServicesAmt
Management And General$7,099ManagementAndGeneralAmt
Fundraising$5,206FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$31,472TotalAmt
Program Services$23,289ProgramServicesAmt
Management And General$4,721ManagementAndGeneralAmt
Fundraising$3,462FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$39,938TotalAmt
Program Services$3,467ProgramServicesAmt
Management And General$36,471ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$26,340TotalAmt
Program Services$19,492ProgramServicesAmt
Management And General$3,950ManagementAndGeneralAmt
Fundraising$2,898FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$33,183TotalAmt
Program Services$24,555ProgramServicesAmt
Management And General$4,978ManagementAndGeneralAmt
Fundraising$3,650FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$310TotalAmt
Program Services$229ProgramServicesAmt
Management And General$47ManagementAndGeneralAmt
Fundraising$34FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$846TotalAmt
Program Services$626ProgramServicesAmt
Management And General$127ManagementAndGeneralAmt
Fundraising$93FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$652TotalAmt
Program Services$482ProgramServicesAmt
Management And General$98ManagementAndGeneralAmt
Fundraising$72FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,891TotalAmt
Program Services$2,879ProgramServicesAmt
Management And General$584ManagementAndGeneralAmt
Fundraising$428FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
Cost of goods Sold$5,640$5,640
Postage and Shipping$100$15$74$11
Contribution$70$10$52$8

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,124,583TotalAmt
Program Services$936,306ProgramServicesAmt
Management And General$126,437ManagementAndGeneralAmt
Fundraising$61,840FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,274,569BOYAmt
EOY$1,321,463EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$629,500BOYAmt
EOY$279,623EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,888BOYAmt
EOY$22,500EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$11,248BOYAmt
EOY$11,246EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$113,640LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$112,624LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,669BOYAmt
EOY$1,016EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,931,874BOYAmt
EOY$1,635,848EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$55,790BOYAmt
EOY$47,063EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$250,000BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$305,790BOYAmt
EOY$47,063EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$427,380BOYAmt
EOY$484,623EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,198,704BOYAmt
EOY$1,104,162EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,626,084BOYAmt
EOY$1,588,785EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,931,874BOYAmt
EOY$1,635,848EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$37,299ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$404,852CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$736,550CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$492,558CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,428,290CurrentTaxYearMinus1YearAmt
Current Tax Year$1,023,149CurrentTaxYearAmt
Total$4,085,399TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$404,852CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$736,550CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$492,558CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,428,290CurrentTaxYearMinus1YearAmt
Current Tax Year$1,023,149CurrentTaxYearAmt
Total$4,085,399TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$4,085,399PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,174CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,458CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,155CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,698CurrentTaxYearMinus1YearAmt
Current Tax Year$1,635CurrentTaxYearAmt
Total$20,120TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,174CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,458CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,155CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,698CurrentTaxYearMinus1YearAmt
Current Tax Year$1,635CurrentTaxYearAmt
Total$20,120TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$254CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus2 Years$7,019CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$87,333CurrentTaxYearMinus1YearAmt
Current Tax Year$62,500CurrentTaxYearAmt
Total$156,598TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$407,772CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$740,008CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$505,732CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,521,321CurrentTaxYearMinus1YearAmt
Current Tax Year$1,087,284CurrentTaxYearAmt
Total$4,262,117TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.95850PublicSupportCY509Pct
Public Support PY5090.97370PublicSupportPY509Pct
Investment Income CY0.00470InvestmentIncomeCYPct
Investment Income PY0.00470InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$113,640OtherCostOrOtherBasisAmt
Depreciation$112,624DepreciationAmt
Book Value$1,016BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,016TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,087,284TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$1,087,284RevenueSubtotalAmt
Total Revenue Per Form990$1,087,284TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,124,583TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$1,124,583ExpensesSubtotalAmt
Total Expenses Per Form990$1,124,583TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X : FIN48 FootnoteFormAndLineReferenceDesc
ExplanationThe Organization is not classified as a private foundation and is exempt from federal and state income taxes under the provisions of Internal Revenue Code Section 501(c) (3) and California Revenue and Taxation Code Section 23701d respectively. The Organization is considered a publicly supported organization. The Financial Accounting Standards Board (FASB) interpretation No. 48, Accounting for Uncertainty in Income Taxes, subsequently included in the FASB codification as ASC 740 prescribes a recognition threshold and a measurement attribute for financial statement recognition of tax positions taken or expected to be taken on a tax return. Management has considered its tax position and believes that all of the positions taken by the Organization in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organizations returns are subject to examination by federal and state taxing authorities, generally for three and four years respectively after they are filed.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
Benicia Community Action Coun
480 Military EBeniciaCA94510680294153$106,538$0BookHealthcare Services
Community Medical Centers
PO Box 779StocktonCA95201942437106$92,796$0BookHealthcare Services
La Clinica de la Raza
1450 Frutivale AvenueOaklandCA94601941744108$115,000$0BookHealthcare Services
LifeLong Brookside
PO Box 11247BerkeleyCA94712942502308$77,500$0BookHealthcare Services
Ole Health
1141 Pear Tree LaneNapaCA94558237221695$125,000$0BookHealthcare Services
FieldValueIRS element (for citing)
Total501c3 Org5Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceGrantmaker's Description of How Grants are UsedFormAndLineReferenceDesc
ExplanationMOU's were signed with La Clinica, OLE Health, Lifelong Brookside and Community Medical Centers to enable community health centers and Solano County to work towards addressing the myriad of social and economic conditions that contribute to poor health outcomes for residents in Solano County. Payments were made after the data reports were provided.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Jane Garcia
Chair Person$115,000Grantfalse
Christine Noguera
Board Member$92,796Grantfalse
Alicia Hardy
Treasurer$125,000Grantfalse
David Villet
Secretary$77,500Grantfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part V Supplemental InformationFormAndLineReferenceDesc
ExplanationThe organization receives grants from funders that sometimes include participation of its membership, and as such, the organization will provide grants to the member organizations.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtThe members of the board of directors are comprised of the organization's member clinic's Chief Executive Officers. Those member clinics have received grants from the organization.
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe Form 990 is reviewed and approved by the Board of Directors. The approval is documented in the board minutes.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAll Officers/Directors are required to disclose potential conflicts prior to becoming a board member and are required to disclose any potential conflicts as they arise while serving on the board.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementThe compensation of the Executive Director is determined and approved by the Board of Directors. The compensation package was developed by reviewing market surveys which provided compensation ranges based on comparable non-profit organizations, location, organization size, and the responsibility level of the ED. The Board also considers the following: relationship of the ED's compensation to the compensation of other employees, the complexity of the organization and its size relative to assets, income, number of employees, job duties of the ED, the ED's salary history, and the organization's need for the services of the ED.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe organization governing documents, policies and financial statements are made available upon request.