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Community Clinic Consortium: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
Community Clinic Consortium (EIN 20-0782029)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-15
IRS object ID
202101359349301410
Schema version
2019v5.0
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)
Return2021-05-15T07:49:21-07:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

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 Begin2019-07-01TaxPeriodBeginDt

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
Signature2021-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSanwar Harshwal CPAPreparerPersonNm
PTINP01249746PTIN
Phone5104525051PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerAlvaro FuentesPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13720 Barrett AvenueAddressLine1Txt
CityRichmondCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94805ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,521,321GrossReceiptsAmt
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 Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$492,558PYContributionsGrantsAmt
CY Contributions Grants$1,428,290CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$6,155PYInvestmentIncomeAmt
CY Investment Income$5,698CYInvestmentIncomeAmt
PY Other Revenue$7,019PYOtherRevenueAmt
CY Other Revenue$87,333CYOtherRevenueAmt
PY Total Revenue$505,732PYTotalRevenueAmt
CY Total Revenue$1,521,321CYTotalRevenueAmt
PY Grants And Similar Paid$39,509PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$175,739CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$433,940PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$463,945CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$60,479CYTotalFundraisingExpenseAmt
PY Other Expenses$127,432PYOtherExpensesAmt
CY Other Expenses$158,478CYOtherExpensesAmt
PY Total Expenses$600,881PYTotalExpensesAmt
CY Total Expenses$798,162CYTotalExpensesAmt
PY Revenues Less Expenses-$95,149PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$723,159CYRevenuesLessExpensesAmt
Total Assets BOY$993,306TotalAssetsBOYAmt
Total Assets EOY$1,931,874TotalAssetsEOYAmt
Total Liabilities BOY$90,381TotalLiabilitiesBOYAmt
Total Liabilities EOY$305,790TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$902,925NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,626,084NetAssetsOrFundBalancesEOYAmt
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$612,593ExpenseAmt
Grant$175,739GrantAmt
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$612,593TotalProgramServiceExpensesAmt
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 Document5IRPDocumentCnt
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 Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
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)
PersonBrandie N NewtonPersonNm
Phone5102336230PhoneNum

US Address USAddress

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

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)$138,578$0$4,263
Christine Noguera
Board Chair4.000.00$0$0$0Yes (X)
Marty Lynch
Treasurer4.000.00$0$0$0Yes (X)
Jane Garcia
Secretary4.000.00$0$0$0Yes (X)
Gilda Gonzalez
Director4.000.00$0$0$0Yes (X)
Alicia Hardy
Director4.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$138,578TotalReportableCompFromOrgAmt
Total Other Compensation$4,263TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Membership Dues$2,040MembershipDuesAmt
Government Grants$25,000GovernmentGrantsAmt
All Other Contributions$1,401,250AllOtherContributionsAmt
Total Contributions$1,428,290TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,698TotalRevenueColumnAmt
Related Or Exempt Func Income$5,698RelatedOrExemptFuncIncomeAmt

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$87,333TotalRevenueColumnAmt
Related Or Exempt Func Income$87,333RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$87,333OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,521,321TotalRevenueColumnAmt
Related Or Exempt Func Income$93,031RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$175,739TotalAmt
Program Services$175,739ProgramServicesAmt

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$144,265TotalAmt
Program Services$106,756ProgramServicesAmt
Management And General$21,640ManagementAndGeneralAmt
Fundraising$15,869FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$241,945TotalAmt
Program Services$179,039ProgramServicesAmt
Management And General$36,292ManagementAndGeneralAmt
Fundraising$26,614FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$48,784TotalAmt
Program Services$36,100ProgramServicesAmt
Management And General$7,318ManagementAndGeneralAmt
Fundraising$5,366FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$28,951TotalAmt
Program Services$21,423ProgramServicesAmt
Management And General$4,343ManagementAndGeneralAmt
Fundraising$3,185FundraisingAmt

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$66,979TotalAmt
Program Services$30,000ProgramServicesAmt
Management And General$36,979ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$31,446TotalAmt
Program Services$23,269ProgramServicesAmt
Management And General$4,717ManagementAndGeneralAmt
Fundraising$3,460FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$32,529TotalAmt
Program Services$24,072ProgramServicesAmt
Management And General$4,879ManagementAndGeneralAmt
Fundraising$3,578FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,711TotalAmt
Program Services$7,926ProgramServicesAmt
Management And General$1,607ManagementAndGeneralAmt
Fundraising$1,178FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,004TotalAmt
Program Services$2,963ProgramServicesAmt
Management And General$601ManagementAndGeneralAmt
Fundraising$440FundraisingAmt

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$1,342TotalAmt
Program Services$993ProgramServicesAmt
Management And General$201ManagementAndGeneralAmt
Fundraising$148FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,755TotalAmt
Program Services$3,519ProgramServicesAmt
Management And General$713ManagementAndGeneralAmt
Fundraising$523FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
Cost of goods Sold$5,640$5,640
Contribution$862$129$638$95
Postage and Shipping$210$31$156$23

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$798,162TotalAmt
Program Services$612,593ProgramServicesAmt
Management And General$125,090ManagementAndGeneralAmt
Fundraising$60,479FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$709,378BOYAmt
EOY$1,274,569EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$270,000BOYAmt
EOY$629,500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$14,888EOYAmt

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$10,917BOYAmt
EOY$11,248EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$113,641LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$111,972LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,011BOYAmt
EOY$1,669EOYAmt

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$993,306BOYAmt
EOY$1,931,874EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$90,381BOYAmt
EOY$55,790EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$250,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$90,381BOYAmt
EOY$305,790EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$385,336BOYAmt
EOY$427,380EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$517,589BOYAmt
EOY$1,198,704EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$902,925BOYAmt
EOY$1,626,084EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$993,306BOYAmt
EOY$1,931,874EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$723,159ReconcilationRevenueExpnssAmt
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$1,150,989CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$404,852CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$736,550CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$492,558CurrentTaxYearMinus1YearAmt
Current Tax Year$1,428,290CurrentTaxYearAmt
Total$4,213,239TotalAmt

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$1,150,989CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$404,852CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$736,550CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$492,558CurrentTaxYearMinus1YearAmt
Current Tax Year$1,428,290CurrentTaxYearAmt
Total$4,213,239TotalAmt

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$4,213,239PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,657CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,174CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,458CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,155CurrentTaxYearMinus1YearAmt
Current Tax Year$5,698CurrentTaxYearAmt
Total$20,142TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,657CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,174CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,458CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,155CurrentTaxYearMinus1YearAmt
Current Tax Year$5,698CurrentTaxYearAmt
Total$20,142TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-$500CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years-$254CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus1 Year$7,019CurrentTaxYearMinus1YearAmt
Current Tax Year$87,333CurrentTaxYearAmt
Total$93,598TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,152,146CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$407,772CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$740,008CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$505,732CurrentTaxYearMinus1YearAmt
Current Tax Year$1,521,321CurrentTaxYearAmt
Total$4,326,979TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97370PublicSupportCY509Pct
Public Support PY5090.99050PublicSupportPY509Pct
Investment Income CY0.00470InvestmentIncomeCYPct
Investment Income PY0.00500InvestmentIncomePYPct
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$113,641OtherCostOrOtherBasisAmt
Depreciation$111,972DepreciationAmt
Book Value$1,669BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,669TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,521,321TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$1,521,321RevenueSubtotalAmt
Total Revenue Per Form990$1,521,321TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$798,162TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$798,162ExpensesSubtotalAmt
Total Expenses Per Form990$798,162TotalExpensesPerForm990Amt

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 (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
Benicia Community Action Coun
480 Military EBeniciaCA94510680294153$74,489$0BookHealthcare Services
Community Medical Centers
PO Box 779StocktonCA95201942437106$33,750$0BookHealthcare Services
La Clinica de la Raza
1450 Frutivale AvenueOaklandCA94601941744108$33,750$0BookHealthcare Services
Ole Health
1141 Pear Tree LaneNapaCA94558237221695$33,750$0BookHealthcare Services
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

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, 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 (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Jane Garcia
Board Member$33,750Grantfalse
Christine Noguera
Board Member$33,750Grantfalse
Alicia Hardy
Board Member$33,750Grantfalse

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.