PEDIATRIC PRIMARY CARE FOUNDATION INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: PEDIATRIC PRIMARY CARE FOUNDATION INC (EIN 59-3113135)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-03-15
IRS object ID: 201240759349300304
Schema version: 2010v3.7
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-03-15T07:38:47-05:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PURVIS GRAY & COMPANY	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2347 SE 17TH STREET	AddressLine1
City	OCALA	City
State	FL	State
ZIP Code	34471	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	593113135	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	PEDIATRIC PRIMARY CARE	BusinessNameLine1
Business Name Line2	FOUNDATION INC	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	PEDI	NameControl
Phone	3523692100	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3200 E SILVER SPRINGS BLVD	AddressLine1
Address Line2	ROOM/SUITE 202	AddressLine2
City	OCALA	City
State	FL	State
ZIP Code	34470	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JEFF BAXLA	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	3523692100	Phone
Date Signed	2012-03-14	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MARK A WHITE CPA	Name
Phone	3527323872	Phone
Date Prepared	2012-03-15	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	JEFF BAXLA	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	3200 E SILVER SPRINGS BLVD STE 202	AddressLine1
City	OCALA	City
State	FL	State
ZIP Code	34470	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	2362374	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1992	YearFormation
State Legal Domicile	FL	StateLegalDomicile
Activity Or Mission Description	TO CHAMPION EXCELLENCE IN THE DELIVERY OF HEALTH CARE TO CHILDREN WITH SPECIAL NEEDS THROUGH A COMPREHENSIVE SYSTEM OF CARE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	52	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	1036524	ContributionsGrantsPriorYear
Contributions Grants Current Year	1051824	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	1534097	ProgramServiceRevenuePriorYear
Program Service Revenue CY	1296955	ProgramServiceRevenueCY
Investment Income Prior Year	12076	InvestmentIncomePriorYear
Investment Income Current Year	13588	InvestmentIncomeCurrentYear
Other Revenue Prior Year	51	OtherRevenuePriorYear
Other Revenue Current Year	7	OtherRevenueCurrentYear
Total Revenue Prior Year	2582748	TotalRevenuePriorYear
Total Revenue Current Year	2362374	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1902484	SalariesEtcPriorYear
Salaries Etc Current Year	1860046	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	467510	OtherExpensePriorYear
Other Expenses Current Year	324296	OtherExpensesCurrentYear
Total Expenses Prior Year	2369994	TotalExpensesPriorYear
Total Expenses Current Year	2184342	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	212754	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	178032	RevenuesLessExpensesCY
Total Assets BOY	1468275	TotalAssetsBOY
Total Assets EOY	1542689	TotalAssetsEOY
Total Liabilities BOY	260969	TotalLiabilitiesBOY
Total Liabilities EOY	157351	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1207306	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1385338	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	TO CHAMPION EXCELLENCE IN THE DELIVERY OF HEALTH CARE TO CHILDREN WITH SPECIAL NEEDS THROUGH A COMPREHENSIVE SYSTEM OF CARE.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	1453716	Expense
Revenue	1862164	Revenue
Description	THE PRIMARY CARE PROGRAM PROVIDES PATIENT AND CASE MANAGEMENT SERVICES TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS. ELIGIBLE CHILDREN WITHIN OR NEAR FEDERAL POVERTY GUIDELINES ARE ENROLLED WITH CHILDREN'S MEDICAL SERVICES. PATIENT SERVICES ARE PROVIDED TO ENROLLED CHILDREN THRU A LOCAL MEDICAL HOME WITH APPROPRIATE LINKAGES TO NECESSARY SECONDARY AND TERTIARY SERVICES BY ACCESS. 24 HOUR ACCESS TO MEDICAL CARE IS AVAILABLE TO ALL ENROLLEES. CASE MANAGEMENT THROUGH AN ASSIGNED CARE COORDINATOR ASSISTS WITH THOSE AND OTHER LINKAGES. PARENT TEACHING AND GENERAL ASSISTANCE IS AVAILABLE TO PROVIDE THE CHILD WITH A CONTINUUM OF CARE AND SOMETIMES HELPING FULFILL OTHER NEEDS OF THE CHILD OR OTHERS THE FAMILY MIGHT HAVE.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	386157	Expense
Revenue	99707	Revenue
Description	THE MEDICAL FOSTER CARE PROGRAM IS A MEDICAL OVERLAY INTO THE COMMUNITY FOSTER PROGRAM THAT ASSISTS IN ENABLING FOSTER CHILDREN WITH SPECIAL HEALTH CARE NEEDS TO BE SAFELY CARED FOR IN A PRIVATE HOME RATHER THAN A HOSPITAL, NURSING HOME OR DEPENDENCE OR RELIANCE UPON 24 HOUR NURSING CARE. THE PROGRAM HELPS TO ENHANCE THE QUALITY OF LIFE FOR THE MEDICALLY COMPLEX AND MEDICALLY FRAGILE FOSTER CHILDREN, ALLOWING THEM TO DEVELOP TO THEIR FULLEST POTENTIAL. SELECT FOSTER PARENTS ARE SPECIFICALLY TRAINED TO CARE FOR A SPECIFIC FOSTER CHILD WITH SPECIAL HEALTH CARE NEEDS. THESE SPECIAL FOSTER PARENTS ARE SUPPORTED BY A MEDICAL DOCTOR, A SOCIAL WORKER AND A NURSE. MFC SERVICES ARE ORDERED AND PRESCRIBED THROUGH THE PROGRAM MEDICAL DOCTOR AND THERE IS A NURSE ON CALL 24 HOURS TO ASSIST WITH CARE COORDINATION OF THESE ENROLLED FOSTER CHILDREN. ONLY FOSTER CHILDREN ARE SERVED IN THE MEDICAL FOSTER CARE PROGRAM. ALL SERVICES WERE PROVIDED AT NO COST TO THE ENROLLED CHILD OR FAMILY.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	1839873	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	4	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	52	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	JEFF BAXLA	NamePerson
Telephone Number	3523692100	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3200 E SILVER SPRINGS BLVD STE 202	AddressLine1
City	OCALA	City
State	FL	State
ZIP Code	34470	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
TED N SAHA MD
MEDICAL DIR.	1.00	X	0	0	0
JOSELYN LEE
PRESIDENT	2.00	X	0	0	0	X
LINDA WILSON
VICE PRESIDE	0.25	X	0	0	0	X
CRAIG TURNER
SECRETARY	0.25	X	0	0	0	X
MATHEW ZAYNE
TREASURER	1.00	X	0	0	0	X
JASON WELBORN
DIRECTOR	1.00	X	0	0	0
JAMES CASEY MD
MEDICAL DIR.	1.00	X	0	0	0
NANCY GUINTA
DIRECTOR	1.00	X	0	0	0
BETSY POORE
DIRECTOR	0.25	X	0	0	0
JEFF BAXLA
PROGRAM ADM.	60.00		73805	0	22482	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	73805	TotalReportableCompFromOrg
Total Other Compensation	22482	TotalOtherCompensation
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	BLUE CROSS BLUE SHIELD OF FLORIDA	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 105358	AddressLine1
City	ATLANTA	City
State	GA	State
ZIP Code	30348	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	MEDICAL INSURAN	DescriptionOfServices
Compensation	143568	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
Government Grants	1031824	GovernmentGrants
All Other Contributions	20000	AllOtherContributions
Total Contributions	1051824	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER STATE OF FL DOH REVENUE	1014887	1014887
MEDICAID- PHYSICIAN SERVICES	143573	143573
MEDICAID- CASE MANAGEMENT	138495	138495

Field	Value	IRS element (for citing)
Total Program Service Revenue	1296955	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	13588	TotalRevenueColumn
Exclusion	$13,588	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	MISCELLANEOUS	Description
Total Revenue Column	7	TotalRevenueColumn
Exclusion	$7	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	7	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2362374	TotalRevenueColumn
Related Or Exempt Function Income	1296955	RelatedOrExemptFunctionIncome
Exclusion	$13,595	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1418889	Total
Program Services	1242742	ProgramServices
Management And General	176147	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	189238	Total
Program Services	164438	ProgramServices
Management And General	24800	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	141663	Total
Program Services	120246	ProgramServices
Management And General	21417	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	110256	Total
Program Services	97312	ProgramServices
Management And General	12944	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	31810	Total
Management And General	31810	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	86625	Total
Program Services	86625	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	4100	Total
Program Services	4100	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	61922	Total
Program Services	43278	ProgramServices
Management And General	18644	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	56482	Total
Program Services	28791	ProgramServices
Management And General	27691	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	26817	Total
Program Services	26332	ProgramServices
Management And General	485	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	60	Total
Management And General	60	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	14679	Total
Management And General	14679	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	25230	Total
Program Services	24113	ProgramServices
Management And General	1117	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
WHEELCHAIR RAMPS	9200	9200
OTHER/MISC.	5761	4268	1493
REPAIRS AND MAINTENANCE	1610	1207	403

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	2184342	Total
Program Services	1839873	ProgramServices
Management And General	344469	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	69	BOY
EOY	14321	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1026120	BOY
EOY	1176771	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	333796	BOY
EOY	241117	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	28873	BOY
EOY	8992	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	207215	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	105727	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	79417	BOY
EOY	101488	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1468275	BOY
EOY	1542689	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	260969	BOY
EOY	157351	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	260969	BOY
EOY	157351	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1164938	BOY
EOY	1374538	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	42368	BOY
EOY	10800	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1207306	BOY
EOY	1385338	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1468275	BOY
EOY	1542689	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	178032	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	807083	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	946498	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	952324	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1036524	CurrentTaxYearMinus1Year
Current Tax Year	1031824	CurrentTaxYear
Total	4774253	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	807083	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	946498	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	952324	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1036524	CurrentTaxYearMinus1Year
Current Tax Year	1031824	CurrentTaxYear
Total	4774253	Total

Field	Value	IRS element (for citing)
Public Support Total170	4774253	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	27742	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	28117	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	17864	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	12076	CurrentTaxYearMinus1Year
Current Tax Year	13588	CurrentTaxYear
Total	99387	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	51	CurrentTaxYearMinus1Year
Current Tax Year	7	CurrentTaxYear
Total	58	Total

Field	Value	IRS element (for citing)
Total Support	4873698	TotalSupport
Gross Receipts From Admissions Etc	1296955	GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage170	0.97960	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.97990	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	207215	OtherCostOrOtherBasis
Depreciation	105727	Depreciation
Book Value	101488	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	101488	TotalOfBookValueLandBuildings
Total Revenue	2362374	TotalRevenue
Total Expenses	2184342	TotalExpenses
Excess Or Deficit For Year	178032	ExcessOrDeficitForYear
Excess Or Deficit Per FS	178032	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	2362374	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	2362374	RevenueSubtotal
Total Revenue Per Form990	2362374	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	2184342	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	2184342	ExpensesSubtotal
Total Expenses Per Form990	2184342	TotalExpensesPerForm990

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
KIDS HEALTH ALLIANCE
PHYSICIAN	24247	PATIENT SERVICES	false
FIRST NATIONAL BANK
EXEC. VP		BOARD MEMBER	false
TED SAHA MD
MEDICAL DIRECTO	12964	MEDICAL DIRECTOR FEE	false

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
FIRST ACHIEVEMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4A	AVAILABLE TO PROVIDE THE CHILD WITH A CONTINUUM OF CARE AND SOMETIMES HELPING FULFILL OTHER NEEDS OF THE CHILD OR OTHERS THE FAMILY MIGHT HAVE.
SECOND ACHIEVEMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4B	PARENTS ARE SUPPORTED BY A MEDICAL DOCTOR, A SOCIAL WORKER AND A NURSE. MFC SERVICES ARE ORDERED AND PRESCRIBED THROUGH THE PROGRAM MEDICAL DOCTOR AND THERE IS A NURSE ON CALL 24 HOURS TO ASSIST WITH CARE COORDINATION OF THESE ENROLLED FOSTER CHILDREN. ONLY FOSTER CHILDREN ARE SERVED IN THE MEDICAL FOSTER CARE PROGRAM. ALL SERVICES WERE PROVIDED AT NO COST TO THE ENROLLED CHILD OR FAMILY.
RELATED PARTY INFORMATION AMONG OFFICERS	FORM 990, PAGE 6, PART VI, LINE 2	TED N. SAHA, M.D. KIDS HEALTH ALLIANCE MEDICAL DIR. PHYSICIAN BUSINESS RELATIONSHIP JASON WELBORN FIRST NATIONAL BANK BOARD MEMBER EXEC. VP BUSINESS RELATIONSHIP JAMES CASEY, M.D. CHILDREN'S MEDICAL SERVICE MEDICAL DIR. PHYSICIAN BUSINESS RELATIONSHIP
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	A COPY OF IRS FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS AND REVIEWED AT A BOARD OF DIRECTORS MEETING.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	CONFLICT OF INTEREST POLICY IS PROVIDED WHEN AN EMPLOYEE IS HIRED BY THE ORGANIZATION OR WHEN A NEW BOARD MEMBER SELECTED. THE ORGANIZATION OBTAINS A SIGNED STATEMENT THAT THE EMPLOYEE OR BOARD MEMBER WAS PROVIDED AND READ THE POLICY. THE POLICY IS THEN PROVIDED TO BOARD MEMBERS AND STAFF ANNUALLY AND A NEW SIGNED STATEMENT IS OBTAINED.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	CEO COMPENSATION DETERMINATION AND ADJUSTMENT IS ONLY PERMISSIBLE THROUGH BOARD ACTION THAT IS CLEARLY DOCUMENTED IN MEETING MINUTES.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	KEY EMPLOYEES SALARIES ARE COMPARABLE TO STATE CAREER SERVICE OR OTHER PRIMARY CARE STAFF AND INCREASES ARE GRANTED IN ACCORDANCE WITH AVAILABLE FUNDING AT APPROPRIATE INTERVALS AT THE DESCRETION OF THE PEDIATRIC PRIMARY CARE FOUNDATION BOARD OF DIRECTORS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.