2012-05-11T15:31:51-05:00 2011-06-30 BLACKMAN KALLICK LLP 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2010-07-01 363088628 ERIE FAMILY HEALTH CENTER INC ERIE 3126663494 1701 W SUPERIOR STREET CHICAGO IL 60622 LEE FRANCIS 3126663494 2012-05-10 1 KIMBERLY HAUMANN 3122071040 2012-05-09 2010 2016-02-24 21:20:13Z LEE FRANCIS 1701 W SUPERIOR STREET CHICAGO IL 60622 30307585 0 X WWW.ERIEFAMILYHEALTH.ORG X 1970 IL OPERATE A HEALTHCARE CENTER TO SERVE A LARGELY MEDICALLY UNDERSERVED POPULATION IN CHICAGO. 24 24 421 50 0 0 11249810 13455508 15704428 16779866 20124 18134 -6942 10683 26967420 30264191 0 0 0 0 18489377 19614327 0 0 418276 6918035 6235513 25407412 25849840 1560008 4414351 16999850 21802587 4708279 5096665 12291571 16705922 X ERIE FAMILY HEALTH CENTER, INC OPERATES A HEALTHCARE CENTER LOCATED IN CHICAGO, ILLINOIS. THE CENTER PROVIDES A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 0 0 19485189 14923579 ERIE FAMILY HEALTH CENTER (ERIE) SERVES PATIENTS REGARDLESS OF THE ABILITY TO PAY. APPROXIMATELY 59% OF ADULTS SERVED BY ERIE ARE UNINSURED. ERIE PROVIDED COMPREHENSIVE HEALTH SERVICES TO APPROXIMATELY 36,000 PATIENTS ANNUALLY AT NINE HEALTH CENTERS: THREE LARGE PRIMARY HEALTH CARE CENTERS, ONE ADOLESCENT-ONLY HEALTH CENTER,THREE SCHOOL-BASED HEALTH CENTERS, AND 2 DENTAL HEALTH CENTERS AS DESCRIBED IN 4B. ERIE PROVIDES PRIMARY CARE MEDICAL SERVICES INCLUDING PEDIATRICS, INTERNAL MEDICINE, FAMILY MEDICINE, WOMEN'S HEALTH AND PODIATRY. IN ADDITION, ERIE PROVIDES HIV/AIDS CARE, BEHAVIORAL HEALTH COUNSELING, CASE MANAGEMENT SERVICES, AND HEALTH EDUCATION (ASTHMA, DIABETES, NUTRITION, PARENTING AND PRENATAL). ERIE PROVIDES THESE SERVICES TO LOW-INCOME, MINORITY INDIVIDUALS WHO PREDOMINANTLY RESIDE IN THE CHICAGO COMMUNITY AREAS OF ALBANY PARK, AVONDALE, BELMONT CRAGIN, HERMOSA, HUMBOLDT PARK, IRVING PARK, LINCOLN SQUARE, LOGAN SQUARE, NORTH LAWNDALE AND WEST TOWN. (ERIE'S PATIENT POPULATION IS 84% HISPANIC AND 95% LIVE BELOW 200% OF THE FEDERAL POVERTY LEVEL. APPROXIMATELY 60% OF ERIE'S PATIENTS IDENTIFY THEMSELVES AS BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. THIRTY-FOUR PERCENT OF PATIENTS ARE UNINSURED, 60% ARE LOW INCOME AND QUALIFY FOR MEDICAID COVERAGE ONLY 4% CARRY PRIVATE INSURANCE AND 2% HAVE MEDICARE COVERAGE. UNINSURED PATIENTS PAY A MINIMAL FEE BASED ON THEIR INCOME TO RECEIVE COMPREHENSIVE SERVICES.)ERIE'S MISSION IS TO PROVIDE COMPREHENSIVE AFFORDABLE HEALTH CARE FOR THOSE IN NEED. ERIE THEREFORE FOCUSES ON PRIMARY CARE THROUGHOUT THE FULL RANGE AGES. OVER 1,500 HEALTHY BABIES WERE DELIVERED BY ERIE PRACTITIONERS IN 2010 MEETING THE NEED OF LACK OF PRENATAL CARE IN THE SERVICE AREA AND FOCUSING ON HIGH RISK EXPECTANT MOMS. CHILDREN RECEIVE UP TO DATE IMMUNIZATIONS VIA OUR PEDIATRIC PROGRAM AND COMPREHENSIVE WELL CHILD CARE SUCH THAT ERIE'S IMMUNIZATION RATES ARE BETTER THAN LOCAL, STATE AND NATIONAL AVERAGES. ALTHOUGH ERIE PROVIDES HEALTH CARE TO APPROXIMATELY 30,000 INDIVIDUALS, THIS GENERATED APPROXIMATELY 150,000 PATIENT VISITS IN 2010 INDICATING THAT MANY PATIENTS VISIT THE HEALTH CENTER SEVERAL TIMES PER YEAR, A REFLECTION OF THE LEVEL OF CHRONIC DISEASE AMONGST ADULTS IN THE SERVICE COMMUNITY. CHRONIC ILLNESS SUCH AS DIABETES, OBESITY, ASTHMA, HYPERTENSION AND CARDIOVASCULAR DISEASE ALL RECEIVE SPECIAL ATTENTION AT ERIE. IN ADDITION, THERE IS A SPECIAL FOCUS ON CANCER SCREENING IN ADULTS. ONE OF ERIE'S MAJOR RECENT ACCOMPLISHMENTS HAS BEEN THE LAUNCH OF AN ELECTRONIC HEALTH RECORD SYSTEM (EHRS) WHICH INCREASES EFFICIENCIES IN CARE AND HAS PROVEN TO REDUCE MEDICAL ERRORS, AS WELL AS PROVIDING PROMPTS FOR IMPROVING ERIE'S QUALITY OF PATIENT CARE OVERALL. ERIE ALSO HAS IMPROVED ITS PATIENT CARE BY INCREASING ACCESS TO LOW COST MEDICATIONS. ERIE SCHEDULES PATIENTS EFFICIENTLY USING A CENTRALIZED CALL CENTER WHICH IMPROVES ACCESS TO CARE.ERIE PROVIDES INNOVATIVE SERVICES SUCH AS SCHOOL-BASED HEALTH WITH CLINIC SITES LOCATED IN 3 HIGH IMPACT CHICAGO PUBLIC SCHOOL SITES. THIS ALLOWS ERIE TO ADDRESS HEALTH ISSUES WHICH IMPROVES A CHILD'S ABILITY TO STAY IN SCHOOL. SIMILARLY, OUR ADOLESCENT HEALTH CENTER WORKS WITH CHALLENGING TEENAGERS WITH A FOCUS ON PREVENTION IN A UNIQUE SETTING.AS A RESPONSE TO COMMUNITY NEED ERIE HAS ALMOST DOUBLED THE VOLUME OF SERVICES PROVIDED BETWEEN CALENDAR YEAR 2000 AND CALENDAR YEAR 2010. THE 53 YEARS OF ERIE'S EXISTENCE HAVE SHOWN PROGRESSIVE ACCOMPLISHMENTS, COMMITMENT TO THE COMMUNITY AND TO MAKING A DIFFERENCE AMONGST THOSE MOST IN NEED OF HEALTH SERVICES. 2615737 1856287 ERIE'S ORAL HEALTH PROGRAM ADDRESSES THE NEED FOR HIGH QUALITY ORAL HEALTH SERVICES IN THE COMMUNITY BY LINKING DENTAL AND MEDICAL HOMES FOR ITS PATIENTS. ERIE EMPLOYS A TRI-FOLD STRATEGY TO ACHIEVE PROGRAM GOALS, WHICH INCLUDES: 1) DIRECT PATIENT CARE; 2) ANTICIPATORY GUIDANCE AT MEDICAL VISITS; AND 3) ORAL HEALTH EDUCATION IN THE MEDICAL AND COMMUNITY SETTINGS. IN THE SECOND HALF OF 2010, THE ORAL HEALTH PROGRAM SERVED APPROXIMATELY 6,500 PATIENTS AND 22,000 VISITS. DIRECT PATIENT CARE: ERIE HAS EXPANDED THE FOLLOWING DIRECT PATIENT CARE ORAL HEALTH SERVICES TO THE TARGET POPULATION: BASIC COMMUNITY-BASED DENTISTRY SERVICES SUCH AS COMPREHENSIVE PREVENTIVE SERVICES (INCLUDING X-RAY), RESTORATIVE SERVICES (FILLINGS, CROWNS AND BRIDGES), PROSTHONTIC SERVICES (RESTORE MISSING TEETH AS WELL AS PARTIALS, DENTURES, SPACERS, AND CROWNS), ENDODONTIC SERVICES (ROOT CANALS) AND EMERGENCY, PERIODONTAL (GUMS) SERVICES AND ORAL CANCER SCREENING SERVICES. THESE SERVICES ARE PROVIDED TO PREGNANT WOMEN, CHILDREN AND THEIR PARENTS AND HIV/AIDS PATIENTS. ADDITIONAL PREVENTIVE CARE ARE PROVIDED BY THE DENTAL HYGIENISTS AND RESTORATIVE CARE AND OTHER COMPLEX SERVICES (PROSTHONTIC AND ENDODONTIC CARE) PROVIDED. IN ORDER TO REDUCE BARRIERS TO CARE FOR WORKING FAMILIES, ERIE HAS EXPANDED DENTAL CENTER'S HOURS. ADDITIONALLY, ORAL CANCER SCREENINGS ARE PROVIDED FOR PATIENTS THAT USE TOBACCO. AN ORAL HEALTH PATIENT OF ANY AGE THAT SMOKES IS SCREENED FOR ORAL CANCER AND REFERRED TO COMMUNITY PARTNER, DIVISION ORAL SURGERY, IF SCREENING RESULTS ARE ABNORMAL.ANTICIPATORY GUIDANCE AT MEDICAL VISITS: ONE OF THE MOST INNOVATIVE COMPONENTS OF ERIE'S ORAL HEALTH PROGRAM IS ANTICIPATORY GUIDANCE. ANTICIPATORY GUIDANCE (ORAL HEALTH PREVENTIVE EDUCATION IN THE MEDICAL SETTING) LINKS THE MEDICAL HOME WITH THE ORAL HEALTH HOME. THIS IS PARTICULARLY IMPORTANT AS MORE RESEARCH IS REVEALING A LINK BETWEEN DENTAL HEALTH AND OVERALL HEALTH. ERIE'S PROVIDERS WILL EDUCATE THEIR PATIENTS ON THE IMPORTANCE OF ORAL HEALTH FOR THEIR OVERALL WELLNESS AS PART OF THE MEDICAL VISIT. THROUGH CONVERSATIONS WITH PROVIDERS AND INFORMATIONAL BROCHURES, PATIENTS WILL BEGIN TO UNDERSTAND THE LINK BETWEEN ORAL HEALTH AND OVERALL HEALTH. THIS APPROACH HAS PROVEN TO IMPROVE THE ORAL HEALTH STATUS OF CHILDREN. ORAL HEALTH PREVENTION EDUCATION: ERIE CANNOT POSSIBLY SERVE ALL COMMUNITY MEMBERS IN NEED OF ORAL HEALTH CARE; THEREFORE, ERIE PROVIDES EDUCATION TO COMMUNITY MEMBERS ON HOW TO TAKE CARE OF THEIR ORAL HEALTH AT HOME AND HOW TO RECEIVE CARE AT ERIE DENTAL HEALTH CENTER OR OTHER COMMUNITY RESOURCES. THIS PREVENTIVE HEALTH EDUCATION AND OUTREACH IS PROVIDED BY ERIE'S ORAL HEALTH EDUCATOR AT A VARIETY OF COMMUNITY VENUES, SUCH AS ELEMENTARY SCHOOLS AND COMMUNITY AGENCIES. THE ORAL HEALTH EDUCATOR ESTABLISHES NEW RELATIONSHIPS WITH COMMUNITY ORGANIZATIONS, AS WELL AS MAINTAIN CONTACT WITH EXISTING COMMUNITY PARTNERS. AT PRESENTATIONS, THE ORAL HEALTH EDUCATOR PRESENTS ON VARIOUS TOPICS SUCH AS WHY OUR TEETH ARE IMPORTANT, HOW WE TAKE CARE OF THEM, BRUSHING AND FLOSSING, GOOD FOODS VERSUS BAD FOODS AND VISITING THE DENTIST. THIS UNIQUE AND COST-EFFECTIVE COMPONENT OF ERIE'S ORAL HEALTH PROGRAM HELPS ERIE IMPROVE THE ORAL HEALTH OF THE COMMUNITY BEYOND THE WALLS OF ERIE DENTAL HEALTH CENTER-HUMBOLDT PARK, REACHING OUT TO THE GREATER LOW-INCOME COMMUNITY THROUGH A CULTURALLY COMPETENT APPROACH. 22100926 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 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 0 0 0 0 0 1 38 0 1 421 1 0 0 0 0 0 1 1 0 0 0 0 X 24 24 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X KEVIN GREENBERG 3124322725 1701 WEST SUPERIOR STREET CHICAGO IL 60622 BRIAN P MARSELLA 2.00 X X 0 0 0 ANA MARIA SOTO 1.50 X X 0 0 0 ERIC MAYEDA 2.00 X X 0 0 0 DEBORAH B WRIGHT-POWELL 1.50 X X 0 0 0 WILLIAM KISTNER 2.00 X 0 0 0 DANIEL J TOUNSEL III 1.00 X 0 0 0 ROSALIE ALICEA 1.50 X 0 0 0 CELESTE CASTILLO 1.50 X 0 0 0 MICHAEL COLE 1.00 X 0 0 0 LINDA CUSHMAN 0.50 X 0 0 0 PILAR GONZALEZ 0.50 X 0 0 0 MARIA HERNANDEZ 0.50 X 0 0 0 REVERAND ED SARDEN 1.00 X 0 0 0 DARYL TOM 1.00 X 0 0 0 HUMBERTO URIBE 1.00 X 0 0 0 KATHERINE WILSON 1.00 X 0 0 0 JULIE ZERWIC 1.00 X 0 0 0 MATT AARONSON 1.00 X 0 0 0 JILL SIMON SVOBODA 1.50 X 0 0 0 JACQUELINE CERVANTES 1.00 X 0 0 0 AMELIA MADRIGAL 1.00 X 0 0 0 JUAN FERNANDO JAUREGI 1.00 X 0 0 0 ANA LILIA VIVAR 1.00 X 0 0 0 LEE FRANCIS 40.00 X 184366 0 6034 DAVID R BUCHANAN 40.00 X 180197 0 12401 ZAKEYA ATIA 40.00 X 133221 0 1857 RAMON BARAJAS 40.00 X 246324 0 7257 DEBORAH L EDBERG 40.00 X 198125 0 9726 KATHERINE A THURER 40.00 X 184434 0 7460 FRED RACHMAN 40.00 X 182906 0 5374 FRANK CASTILLO 40.00 X 176937 0 9020 1486510 0 59129 32 0 1 0 LAB CORP PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 627168 KRAUSE CONSTRUCTION LLC 3330 EDISON AVENUE BLUE ISLAND IL 60406 CONSTRUCTION CONTRACTOR 290246 MCKESSON MEDICAL SURGICAL PO BOX 93302 ATLANTA GA 31193 MEDICAL SUPPLIES 272409 STATEWIDE INVESTIGATIVE SERVICES 2041 W CARROL AVENUE SUITE 221 CHICAGO IL 60612 SECURITY SERVICES 154125 GHAFARI ASSOCIATES LLC 17101 MICHIGAN AVENUE DEARBORN MI 48126 CONSTRUCTION CONTRACTOR 118650 7 117871 9778160 3559477 18978 13455508 MEDICARE/MEDICAID PAYM 624100 14184550 14184550 SELF-PAY 624100 1730691 1730691 KID CARE/HEALTHY MOM 624100 703910 703910 ALLIANCE EQUITY INCOME 624100 147235 147235 MEDICAL RECORD FEES 624100 13480 13480 16779866 18134 18134 27555 117871 43394 -15839 -15839 OTHER 624100 26522 26522 26522 30264191 16779866 0 28817 1119931 963140 134392 22399 15873151 13650910 1904778 317463 186598 160474 22392 3732 1264813 1087739 151778 25296 1169834 1006057 140380 23397 46722 46722 73200 73200 206388 124589 67307 14492 36730 28452 8278 349044 279000 62830 7214 1025202 926682 98520 35091 27275 7703 113 64796 50364 14315 117 99118 99118 1135078 946715 187926 437 153837 136937 16900 CONTRACTED DIAGNOSTIC S 566286 566286 BAD DEBT 482436 482436 EQUIPMENT RENTAL & MAIN 468713 386941 81772 MEDICAL AND LAB SUPPLIE 459342 459342 PHARMACEUTICALS 282548 282548 750982 535039 212327 3616 25849840 22100926 3330638 418276 1613798 2368921 4404989 4420917 1832327 1993216 1863269 1708683 139476 148928 17784871 7319290 6695680 10465581 294980 462216 155331 234125 16999850 21802587 1981621 2533485 75950 10717 1818598 1720353 832110 832110 4708279 5096665 X 11886243 16072557 405328 633365 12291571 16705922 16999850 21802587 4414351 0 X 0 1 1 X 1 1 X 9827952 9769035 10716883 11249810 13455508 55019188 31160 37597 40830 42883 40002 192472 9859112 9806632 10757713 11292693 13495510 55211660 55211660 25246 83204 74238 17624 18134 218446 37597 40830 42883 40002 161312 55591418 69011920 0.99320 0.99340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7500 7500 21218256 21225756 1000000 250000 0 0 1000000 1000000 1500000 7500 7500 250000 250000 375000 77800 77800 5016799 2041835 2974964 7292235 2291143 5001092 2772487 1495148 1277339 2625550 1491164 1134386 10465581 THIRD-PARTY PAYOR LIABILITY 832110 832110 30264191 25849840 4414351 0 4414351 30301872 37681 37681 30264191 0 30264191 25887521 37681 37681 25849840 0 25849840 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER'S APPLICATION OF GAAPUSA REGARDING UNCERTAIN TAX POSITIONS HAD NO EFFECT ON ITS FINANCIAL POSITION AS MANAGEMENT BELIEVES THE CENTER HAS NO MATERIAL UNRECOGNIZED INCOME TAX BENEFITS, INCLUDING ANY POTENTIAL RISK OF LOSS OF ITS NOT-FOR-PROFIT TAX STATUS. THE CENTER WOULD ACCOUNT FOR ANY POTENTIAL INTEREST OR PENALTIES RELATED TO POSSIBLE FUTURE LIABILITIES FOR UNRECOGNIZED INCOME TAX BENEFITS AS INCOME TAX EXPENSE. THE CENTER IS NO LONGER SUBJECT TO EXAMINATION BY FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR PERIODS BEFORE 2008. GOLDEN TOOTHBRUSH 103670 92570 11100 25455 SALUD AND THE CITY 41756 25301 16455 9907 8032 145426 117871 27555 9907 33487 43394 -15839 X X X X 0 0 0 0 0 0 0 0 0 LEE FRANCIS 168223 0 16143 0 0 0 3800 0 2234 0 190400 0 0 0 DAVID R BUCHANAN 163797 0 16400 0 0 0 4262 0 8139 0 192598 0 0 0 RAMON BARAJAS 234053 0 12271 0 0 0 4102 0 3155 0 253581 0 0 0 DEBORAH L EDBERG 195157 0 2968 0 0 0 4575 0 5151 0 207851 0 0 0 KATHERINE A THURER 171881 0 12553 0 0 0 4329 0 3131 0 191894 0 0 0 FRED RACHMAN 175206 0 7700 0 0 0 0 0 5374 0 188280 0 0 0 FRANK CASTILLO 163056 0 13881 0 0 0 4139 0 4881 0 185957 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 ERIE FAMILY HEALTH CENTER (EFHC) USES A THIRD PARTY (INDEPENDENT CPA FIRM) TO PREPARE ITS 990 TAX FORM. UPON THE FORM'S COMPLETION, A COPY IS PROVIDED TO EFHC'S MANAGEMENT FOR REVIEW AND THEN SUBSEQUENTLY REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE COMMUNICATED TO THE CPA FIRM AND INCORPORATED AS APPROPRIATE. ONCE THE 990 DRAFT IS FINALIZED A COPY IS MADE AVAILABLE TO THE BOARD OF DIRECTORS. THE THIRD PARTY WILL THEN FILE THE 990 ON EFHC'S BEHALF. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, KEY EMPLOYEES, AND MEMBERS OF THE BOARD ARE ANNUALLY REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM AS A PRECURSOR TO THEIR SERVICE TO THE ORGANIZATION. POTENTIAL CONFLICTS ARE LOGGED WITH AND MONITORED BY EFHC MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 EFHC PERIODICALLY USES AN INDEPENDENT THIRD PARTY TO REVIEW THE CURRENT COMPENSATION FOR MEMBERS OF THE LEADERSHIP TEAM. BASED ON THIS REVIEW, COMPENSATION LEVELS ARE SET FOR EACH LEVEL OF EMPLOYMENT. COMPENSATION REVIEWS BY THIRD PARTIES ARE CONDUCTED EVERY 3 YEARS. THE LAST REVIEW WAS IN 2011. FORM 990, PART VI, SECTION C, LINE 19 EFHC GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FOR PUBLIC REVIEW UPON REQUEST. REQUESTS ARE REQUIRED TO BE IN WRITING AND AT THE ATTENTION OF KEVIN GREENBERG, VP OF FINANCE.