2020-11-12T09:47:26-06:00 2019-12-31 721396621 CARR RIGGS & INGRAM LLC 4210 SPICEWOOD SPRINGS RD SUITE 108 AUSTIN TX 78759 990 2019-01-01 311624871 INTEGRATED CARE COLLABORATION INTE 5128042090 8627 N MOPAC NO 300 AUSTIN TX 78759 JOHN CLARK BOARD CHAIR & DIRECTOR 5128042090 2020-11-10 1 LISA A MATTHEWS P00297192 5123461880 104.55.109.194 2020-11-10 17:29:31 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2D08D3CE241FC16462865599220D91FF7462A57C 2019 2021-01-29 14:40:06Z JOHN CLARK 8627 N MOPAC NO 300 AUSTIN TX 78759 1655037 0 X WWW.ICC-CENTEX.ORG X 1998 TX THE ICC IS AN ALLIANCE OF HEALTH CARE SAFETY NET PROVIDERS THAT WORK TOGETHER TO IMPROVE THE EFFICIENCY AND QUALITY OF HEALTH CARE SERVICES AVAILABLE FOR UNINSURED INDIVIDUALS IN CENTRAL TEXAS (WILLIAMSON, TRAVIS, AND HAYS COUNTIES). ICC ACTS AS A CONVENER AND INCUBATOR AND IS NOT A HEALTH PROVIDER. 5 5 0 0 0 0 0 0 1659516 1654753 329 284 0 0 1659845 1655037 0 0 0 0 1078880 835359 0 0 20580 665179 1114642 1744059 1950001 -84214 -294964 665548 513128 424075 566619 241473 -53491 X THE ICC IS AN ALLIANCE OF HEALTH CARE SAFETY NET PROVIDERS THAT WORK TOGETHER TO IMPROVE THE EFFICIENCY AND QUALITY OF HEALTH CARE SERVICES AVAILABLE FOR UNINSURED INDIVIDUALS IN CENTRAL TEXAS (WILLIAMSON, TRAVIS, AND HAYS COUNTIES). ICC ACTS AS A CONVENER AND INCUBATOR AND IS NOT A HEALTH PROVIDER. 0 0 1012922 1034909 ICARE SYSTEM/HEALTH INFORMATION TECHNOLOGY: ICC OWNS, MAINTAINS, AND OPERATES A REGIONAL HIE CALLED THE ICARE SYSTEM. THE SYSTEM ALLOWS ICC AND ITS MEMBERS TO:-ACHIEVE MEANINGFUL USE STANDARDS BY MAXIMIZING MEMBER OPPORTUNITIES TO DEMONSTRATE MEANINGFUL USE OF INFORMATION EXCHANGE, CARE COORDINATION AND PUBLIC HEALTH PARTICIPATION THROUGH HIE.-EXPAND AND ENHANCE CARE COORDINATION PROGRAMS.-IMPROVE HEALTH OUTCOMES AND COMMUNITY HEALTH.-EXPAND AND ENHANCE RESEARCH AND EVALUATION CAPABILITIES. 226992 231920 MEMBER ANALYTICS TO SUPPORT COMMUNITY COLLABORATION: ICARE INCLUDES A ROBUST DATA WAREHOUSE AND ANALYTICS SOLUTION THAT FACILITATES PERFORMANCE-BASED OUTCOMES AND VALIDATED PATIENT INFORMATION WHICH DRIVES EVIDENCE-BASED PROGRAMS. THE SOLUTION ALSO SUPPORTS COMMUNITY HEALTH RESEARCH BY TRACKING POPULATION CARE PATTERNS, MEASURING EFFECTS OF PUBLIC POLICY CHANGES AND IDENTIFYING HEALTHCARE UTILIZATION PATTERNS. ICC ANALYTICS PROVIDE VALUABLE DATA THAT HELPS TO INCREASE ACCESS TO CARE, IMPROVE CARE COORDINATION AND PROVIDE MORE EFFICIENT AND APPROPRIATE CARE. 379683 387924 ACCESS AND COMMUNITY COLLABORATION: ICC FACILITATES COMMUNITY BASED ENROLLMENT FOR INCREASED ACCESS AND COMMUNITY INTEGRATION. ICC MEMBERS HAVE ACCESS TO A COMMON ELIGIBILITY PROGRAM, MEDICAIDER, THROUGH WHICH PATIENTS ARE SCREENED FOR ELIGIBILITY FOR THIRD PARTY FUNDING AND FEDERAL, STATE AND LOCAL HEALTH COVERAGE PROGRAMS. THE PATIENT PRESCRIPTION ASSISTANCE PROGRAM (PPAP) IS ALSO AVAILABLE TO MEMBERS. THIS PROGRAM ACTIVITY STOPPED THE END OF 2014. 1619597 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X JOHN CLARK 5128042090 8627 N MOPAC SUITE 300 AUSTIN TX 78759 X JEFF STRICKLAND SENIOR LINUX & NETWORK ENGINEER 40.00 X 0 0 0 DAVID EVANS BOARD VICE CHAIR & DIRECTO 0.00 X X 0 0 0 EARL MAXWELL BOARD TREASURER & DIRECTOR 0.00 X X 0 0 0 RYAN LESLIE DIRECTOR 0.00 X 0 0 0 JOHN CLARK BOARD CHAIR & DIRECTOR 0.00 X X 0 0 0 ANJUM KHURSHID DIRECTOR 0.00 X 0 0 0 PATRICIA DAVIS INTERFACE & PRODUCTION ANALYST 40.00 X 0 0 0 CAROLE TAMAYO DIRECTOR, TECHNOLOGY PROJE 40.00 X 0 135481 0 JARROD KNOX SENIOR DEVELOPER ARCHITECT 40.00 X 0 122691 0 STEPHANIE DOZIER SENIOR BUSINESS DATA ANALY 40.00 X 0 113644 0 EDIE MORRIS FORMER EXECUTIVE DIRECTOR & CFO 40.00 X 0 87893 0 0 459709 0 0 1 0 0 INSPERITY 19001 CRESCENT SPRINGS DR KINGWOOD TX 77339 PAYROLL 616339 UNIVERSITY OF TEXAS 3725 W BRAKER LANE SUITE 3340 STO AUSTIN TX 78759 OFFICE OF SPONSORED PROJECTS 370000 CHANCELLOR MOPAC INVESTMENT 7200 NORTH MOPAC EXPY STE 450 AUSTIN TX 78731 RENT 362264 INTEGRAL CARE PO BOX 3548 AUSTIN TX 78764 REIMBURSEMENT FOR PAYROLL AND BENEFITS 261071 ONRAMP ACCESS LLC 909 LOCUST STREET SUITE 301 DES MOINES IA 50309 DATA CENTER 184959 6 MEMBERSHIP FEES 519100 1510095 1510095 MISCELLANEOUS REVENUE 519100 144658 144658 1654753 284 284 1655037 1654753 0 284 X 760858 586700 162067 12091 74501 50605 22058 1838 23297 23297 17500 17500 647175 647175 77128 70477 6651 203766 200272 3494 89428 89428 215 215 1299 1299 54834 45202 9632 1950001 1619597 309824 20580 6717 57960 476982 172266 55648 57044 97409 198365 3133448 3132169 2578 1279 26214 26214 665548 513128 124075 266619 300000 300000 424075 566619 X 241473 -53491 241473 -53491 665548 513128 -294964 0 X X 0 0 1 0 X 0 0 531 456 421 329 284 2021 66995 81199 50490 149421 144658 492763 494784 8145473 0.00000 0.54250 X 3133448 3132169 1279 1279 SECURITY DEPOSIT 26214 26214 X PART X, LINE 2: FOOTNOTE TO FINANCIAL STATEMENTS REGARDING INCOME TAX STATUS: ICC QUALIFIES AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CONSEQUENTLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT ANY PROVISIONS FOR INCOME TAXES. HOWEVER, ICC IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. ICC HAS TAKEN NO UNCERTAIN TAX POSITIONS DURING OR FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018. ICC CONTINUALLY EVALUATES THE TAX EFFECTS OF EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. IN ADDITION, ICC'S TAX RETURNS FOR THE LAST FOUR YEARS REMAIN SUBJECT TO EXAMINATION BY THE IRS FOR WHICH ICC COULD BE LIABLE. X 0 0 0 0 0 0 0 0 0 EDIE MORRIS FORMER EXECUTIVE DIRECTOR & CFO 0 87893 0 0 0 0 0 0 0 0 0 87893 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS, WHO ARE THE SAFETY NET PROVIDERS BELONGING TO THE ALLIANCE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE BOARD TREASURER AND IS LATER PRESENTED AT THE NEXT BOARD MEETING FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS, DIRECTOR AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO SUBMIT A SIGNED STATEMENT AFFIRMING THAT THE POLICY HAS BEEN REVIEWED AND COMPLIED WITH. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD EVALUATES AND APPROVES ALL NEW EMPLOYEES' SALARIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE ON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 379,683. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 379,683. MIRTH FEES: PROGRAM SERVICE EXPENSES 230,894. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 230,894. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 38,918. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,918. RECONCILIATION DIFFERENCE: PROGRAM SERVICE EXPENSES -2,320. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -2,320. FORM 990, PART VII, PAGE 7 ICC PERSONNEL ARE PAID THROUGH LONESTAR CIRCLE OF CARE (THROUGH 2/28/15), EMPLOYER FLEXIBLE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE VIA A CONTRACTUAL ARRANGEMENT BETWEEN THE ENTITIES. ALL SALARIES AND BENEFITS ARE PAID BY LONESTAR CIRCLE OF CARE, EMPLOYER FLEXIBLE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE AND ARE THEN INVOICED TO ICC. WHEN ICC PAYS THESE INVOICES, THE EXPENSES ARE CODED TO THE APPROPRIATE ACCOUNTS SUCH AS SALARY EXPENSE AND BENEFIT EXPENSE. ICC DOES NOT ISSUE W-2'S OR A W-3; ALL ARE ISSUED THROUGH LONESTAR CIRCLE OF CARE, EMPLOYER FLEXIBLE AND AUSTIN TRAVIS COUNTY INTEGRAL CARE. HOWEVER, COMPENSATION FOR THE EXECUTIVE DIRECTOR AND EMPLOYEES PAID OVER $100,000 ARE BEING REFLECTED IN COLUMN (E).