2024-09-25T12:16:23-05:00 2023-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-01-01 550809159 THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ILLI 8158752999 1945 VANS WAY PRINCETON IL 61356 PATRICIA SCHOU EXECUITVE DIRECTOR 8158752999 2024-09-05 1 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-08-26 2023 2024-08-08 14:25:15Z PATRICIA SCHOU 1945 VANS WAY PRINCETON IL 61356 4617634 0 X WWW.ICAHN.ORG X 2003 IL THE MISSION OF ICAHN IS TO STRENGTHEN CRITICAL ACCESS AND SMALL, RURAL HOSPITALS THROUGH COLLABORATION. BETTER TOGETHER, ICAHN AND ITS 58 MEMBER HOSPITALS MAKE IT THEIR OVERARCHING GOAL TO PRESERVE ACCESS TO RURAL HEALTHCARE WHILE IMPROVING THE VIBRANCY AND VIABILITY OF THE COMMUNITIES SERVED. 9 9 26 120 0 0 2447784 2072998 3076486 2365876 41362 156499 0 0 5565632 4595373 1719771 1248810 0 0 1815706 1822751 0 0 0 1832431 1202634 5367908 4274195 197724 321178 6228606 4799848 2212846 1608540 4015760 3191308 X ICAHN IS A NOT-FOR-PROFIT 501(C)(3) CORPORATION ESTABLISHED IN 2003 FOR THE PURPOSES OF SHARING RESOURCES, EDUCATION, PROMOTING EFFICIENCY AND BEST PRACTICE AND IMPROVING HEALTH CARE SERVICES FOR MEMBER CRITICAL ACCESS HOSPITALS AND THEIR RURAL COMMUNITIES. ICAHN, WITH 58 MEMBER HOSPITALS, IS AN INDEPENDENT NETWORK GOVERNED BY A NINE-MEMBER BOARD OF DIRECTORS. 0 0 2559148 1248810 1598587 ICAHN PROVIDES TECHNICAL ASSISTANCE TO SMALL RURAL HOSPITALS:1) TO HELP THEM WITH ADMINISTRATIVE PROCESSES FOR CRITICAL ACCESS HOSPITALS2) TO SHARE RESOURCES WITH MEMBERS3) TO IMPLEMENT PROGRAMS TO IMPROVE QUALITY AND EFFICIENCIES OF MEDICAL SERVICES PROVIDED BY RURAL HEALTH CARE FACILITIES.4) TO PROVIDE CODING SUPPORT WHEN HOSPITALS NEED COVERAGE FOR UNANTICIPATED CERTIFIED CODE ABSENCES, VACANCIES, OR BACKLOG SERVES APPROXIMATELY 58 HOSPITALS. 366710 0 514233 ICAHN PROVIDES INFORMATION TECHNOLOGY ASSISTANCE TO SMALL RURAL HOSPITALS ACROSS THE STATE, SERVING APPROXIMATELY 58 HOSPITALS. SERVICES ARE AVAILABLE TO ALL 58 HOSPITALS IF THEY CHOOSE TO UTILIZE THEM. 232485 0 101500 IN SURVEY SOLUTIONS, ICAHN OFFERS A COMPREHENSIVE SURVEY APPROACH FOR SMALL AND RURAL HOSPITALS AND PRACTICES AT A COST-EFFECTIVE RATE, WHILE PROVIDING A STREAMLINED DATA REPORTING STRUCTURE FOR CMS AND OTHER AGENCIES FOR FURTHER NATIONAL BENCHMARKING STATISTICS. 184261 0 151556 ICAHN PROVIDES QUALITY EDUCATIONAL OPPORTUNITIES TO MEMBER HOSPITALS FOCUSING ON RURAL HEALTH ISSUES AND STRATEGIES FOR SUCCESS THROUGH ONSITE MEETINGS, VIDEOCONFERENCING, AND WEB-BASED TRAINING.BOARD EDUCATION FOR HOSPITALS INCLUDING BOARD BASICS, CRITICAL ACCESS HOSPITAL 101, 340B, CAH FINANCE, AND OTHER TOPICS. 184261 0 151556 3342604 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 35 0 26 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X PATRICIA SCHOU 8158752999 1945 VANS WAY PRINCETON IL 61356 PAUL SKOWRON PAST PRESIDENT 1.00 X X 0 0 0 TED ROGALSKI PRESIDENT 1.00 X X 0 0 0 KARISSA TURNER PRESIDENT ELECT 1.00 X X 0 0 0 ALISA COLEMAN PAST PRESIDENT (THRU 02/2023) 1.00 X X 0 0 0 PAM PFISTER SECRETARY/TREASURER 1.00 X X 0 0 0 KIM BOURNE DIRECTOR 1.00 X 0 0 0 JIM JOHNSON DIRECTOR 1.00 X 0 0 0 DON ROBBINS DIRECTOR 1.00 X 0 0 0 BOB SELLERS DIRECTOR 1.00 X 0 0 0 VICTORIA WOODROW DIRECTOR 1.00 X 0 0 0 PATRICIA SCHOU EXECUTIVE DIRECTOR 40.00 X 280855 0 25522 WENDY HODGE DIR OF FINANCE (THRU 03/2023) 40.00 X 24114 0 5327 CRAIG HENKAUS DIRECTOR OF FINANCE 40.00 X 99785 0 15207 CURT ZIMMERMAN SR DIRECTOR OF BUSINESS SVCS & DEV 40.00 X 145378 0 28556 RYAN MORGAN CHIEF INFO SECURITY OFFICER 40.00 X 130897 0 16971 RYAN SIERMAN IT CONSULTANT/CIO 40.00 X 122857 0 8153 803886 0 99736 4 0 1 0 0 522000 1550998 2072998 IT SERVICES 541519 514233 514233 SPONSOR/PARTNER REVENUE 900099 367843 367843 MANAGED CARE 541610 278311 278311 IL RURAL COMMUNITY CARE 900099 264532 264532 PROFESSIONAL EDUCATION 611710 151556 151556 789401 789401 2365876 108760 108760 70000 22261 0 -22261 70000 47739 47739 4595373 2365876 0 156499 X 1248810 1248810 450810 315567 135243 1118996 783298 335698 32369 22658 9711 113034 79124 33910 107542 75279 32263 27234 27234 32000 32000 565337 452433 112904 299617 179516 120101 8985 6290 2695 33676 33676 152105 91264 60841 17820 12475 5345 59114 35468 23646 BAD DEBT EXPENSE 6746 6746 4274195 3342604 931591 0 2118899 127918 1753496 2471608 28526 28526 478139 631426 85765 91037 1467385 402431 1104537 1064954 644019 374480 15225 9899 6228606 4799848 216687 190201 1459563 913913 521371 494527 15225 9899 2212846 1608540 X 3986131 3161129 29629 30179 4015760 3191308 6228606 4799848 X 321178 68444 -1214074 X 0 1 X 1 1 1 X 2471371 8498500 17447257 2447784 2072998 32937910 2582631 4475555 3816059 3076486 2365876 16316607 5054002 12974055 21263316 5524270 4438874 49254517 0 0 0 49254517 34279 56142 57514 11529 108760 268224 34279 56142 57514 11529 108760 268224 4490 4490 5092771 13030197 21320830 5535799 4547634 49527231 0.99450 0.99610 0.00540 0.00380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25501 25501 1099024 198436 900588 342860 203995 138865 1064954 OPERATING LEASE OBLIGATION 9899 9899 4657071 68444 -6746 61698 4595373 0 4595373 4267449 0 4267449 6746 6746 4274195 PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -6,746. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 6,746. 1 CARLE EUREKA HOSPITAL 101 S MAJOR ST EUREKA IL 61530 362169147 501(C)(3) 19938 0 23 SHIP, 23 FLEX GRANTS CARLE HOOPESTON REGIONAL HEALTH CENTER 701 E ORANGE ST HOOPESTON IL 60942 261503640 501(C)(3) 11938 0 22 SHIP CLAY COUNTY HOSPITAL 911 STACY BURKE DRIVE FLORA IL 62839 010686913 501(C)(3) 15500 0 23 FLEX COMMUNITY HOSPITAL OF STAUNTON 400 NORTH CALDWELL STREET STAUNTON IL 62088 370624255 501(C)(3) 8650 0 23 FLEX GRANTS, EMS, FELLOWSHIP FAIRFIELD MEMORIAL HOSPITAL 303 NW 11TH ST FAIRFIELD IL 62837 370661202 501(C)(3) 23088 0 23 SHIP, 23 FLEX GRANTS, EMS, SCHOLARSHIP FAYETTE COUNTY HOSPITAL AND LONG TERM CARE 650 WEST TAYLOR ST VANDALIA IL 62471 371255150 501(C)(3) 11938 0 22 SHIP FERRELL HOSPITAL 1201 PINE ST ELDORADO IL 62930 201244058 501(C)(3) 24828 0 22 FLEX GRANTS, 22 SHIP, EMS, SCHOLARSHIP FRANKLIN HOSPITAL 201 BAILEY LANE BENTON IL 62812 376058530 501(C)(3) 12588 0 22 SHIP, SCHOLARSHIP GENESIS MEDICAL CENTER 409 NW 9TH AVENUE ALEDO IL 61231 454475683 501(C)(3) 23000 0 22 FLEX GRANTS GIBSON AREA HOSPITAL & HEALTH SERVICES 1120 N MELVIN ST GIBSON CITY IL 60936 364311943 501(C)(3) 9500 0 22 FLEX GRANTS, HYPERTNSN GRAHAM HOSPITAL 210 WEST WALNUT STREET CANTON IL 61520 370673506 501(C)(3) 12438 0 22 SHIP, HYPERTNSN HAMMOND HENRY HOSPITAL 600 NORTH COLLEGE AVENUE GENESEO IL 61254 366008003 GOV 15350 0 22 FLEX GRANTS, SCHOLARSHIP HILLSBORO AREA HOSPITAL 1200 EAST TREMONT ST HILLSBORO IL 62049 370661208 501(C)(3) 19800 0 22 FLEX GRANTS, ASTHMA GRANT, CAH FELLOWSHIP HOPEDALE MEDICAL CENTER 107 TREMONT ST HOPEDALE IL 61747 370808925 501(C)(3) 11938 0 22 SHIP HORIZON HEALTH 721 EAST COURT ST PARIS IL 61944 370860281 501(C)(3) 21800 0 22 FLEX GRANTS, SCHOLARSHIP HSHS GOOD SHEPHERD HOSPITAL 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 501(C)(3) 11938 0 22 SHIP HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DR GREENVILLE IL 62246 370792770 501(C)(3) 11938 0 22 SHIP IROQUOIS MEMORIAL HOSPITAL 200 FAIRMAN WATSEKA IL 60970 370673512 501(C)(3) 11938 0 22 SHIP KIRBY MEDICAL CENTER 1000 MEDICAL CENTER DRIVE MONTICELLO IL 61856 370661215 501(C)(3) 9450 0 22 FLEX GRANTS, SCHOLARSHIP LAWRENCE COUNTY MEMORIAL HOSPITAL 2200 WEST STATE ST LAWRENCEVILLE IL 62439 800618988 501(C)(3) 34738 0 22 FLEX GRANTS MARSHALL BROWNING HOSPITAL 900 N WASHINGTON ST DUQUOIN IL 62832 370661218 501(C)(3) 15838 0 23 SHIP, 23 FLEX GRANTS, SCHOLARSHIP MASSAC MEMORIAL HOSPITAL 28 CHICK ST METROPOLIS IL 62960 370857853 GOV 19438 0 23 FLEX GRANTS MCDONOUGH DISTRICT HOSPITAL 525 E GRANT ST MACOMB IL 61455 465143822 GOV 11938 0 22 SHIP MEMORIAL HOSPITAL - CARTHAGE 1454 N COUNTY ROAD 2050 CARTHAGE IL 62321 370662570 501(C)(3) 34938 0 22 FLEX GRANTS MEMORIAL HOSPITAL - CHESTER 1900 STATE STREET CHESTER IL 62233 376020801 501(C)(3) 18896 0 22 SHIP, 23 FLEX GRANTS MERCY HARVARD HOSPITAL 901 GRANT STREET HARVARD IL 60033 311551871 501(C)(3) 14938 0 22 SHIP, 23 FLEX GRANTS MIDWEST MEDICAL CENTER 1 MEDICAL CENTER DRIVE GALENA IL 61036 204560540 501(C)(3) 18500 0 22 FLEX GRANTS, ASTHMA OSF HOLY FAMILY MEDICAL CENTER 1000 W HARLEM AVE MONMOUTH IL 61462 370813229 501(C)(3) 11938 0 22 SHIP OSF ST CLARE MEDICAL CENTER 530 PARK AVENUE EAST PRINCETON IL 61356 366006057 501(C)(3) 19938 0 22 SHIP, 23 FLEX GRANTS OSF ST LUKE MEDICAL CENTER 1051 WEST SOUTH ST KEWANEE IL 61443 362167767 501(C)(3) 11938 0 22 SHIP OSF ST PAUL MEDICAL CENTER 1401 EAST 12TH STREET MENDOTA IL 61342 362167785 501(C)(3) 11938 0 22 SHIP PANA COMMUNITY HOSPITAL 101 EAST NINTH ST PANA IL 62557 376062326 501(C)(3) 22435 0 22 SHIP, 23 FLEX GRANTS PINCKNEYVILLE COMMUNITY HOSPITAL 101 NORTH WALNUT STREET PINCKNEYVILLE IL 62274 376006955 GOV 15500 0 22 FLEX GRANTS RICHLAND MEMORIAL HOSPITAL 800 EAST LOCUST OLNEY IL 62450 371363001 501(C)(3) 11938 0 22 SHIP ROCHELLE COMMUNITY HOSPITAL 900 NORTH SECOND ST ROCHELLE IL 61068 362548549 501(C)(3) 25938 0 22 SHIP, 23 FLEX GRANTS SALEM TOWNSHIP HOSPITAL 1201 RICKER DRIVE SALEM IL 62881 370925318 GOV 7300 0 22 FLEX GRANTS SARAH D CULBERTSON MEMORIAL HOSPITAL 238 SOUTH CONGRESS AVE RUSHVILLE IL 62681 376006672 GOV 24000 0 22 FLEX GRANTS, EMS, HYPRTNSN SPARTA COMMUNITY HOSPITAL DISTRICT 818 EAST BROADWAY SPARTA IL 62286 376014817 GOV 20805 0 22 FLEX GRANTS ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 501(C)(3) 16930 0 22 SHIP, 23 FLEX GRANTS ST JOSEPH MEMORIAL HOSPITAL 2 SOUTH HOSPITAL DRIVE MURPHYSBORO IL 62966 370618939 501(C)(3) 11938 0 22 SHIP ST JOSEPH'S HOSPITAL 12866 TROXLER AVE HIGHLAND IL 62249 370663568 501(C)(3) 11938 0 22 SHIP ST MARGARET'S HEALTH - PERU 925 WEST STREET PERU IL 61354 362852553 501(C)(3) 11938 0 22 SHIP THOMAS H BOYD MEMORIAL HOSPITAL 800 SCHOOL ST CARROLTON IL 62016 370673461 501(C)(3) 20938 0 22 SHIP, 23 FLEX GRANTS UNION COUNTY HOSPITAL DISTRICT 517 NORTH MAIN ST ANNA IL 62906 586025393 501(C)(3) 11938 0 22 SHIP WABASH GENERAL HOSPITAL 1418 COLLEGE DR MT CARMEL IL 62863 376013625 GOV 15338 0 22 SHIP, 23 FLEX GRANTS WARNER HOSPITAL & HEALTH SERVICES 422 WEST WHITE ST CLINTON IL 61727 371380376 501(C)(3) 26940 0 22 SHIP, 23 FLEX GRANTS, DISEASE, CARTIOVASCULR WASHINGTON COUNTY HOSPITAL 705 S GRAND NASHVILLE IL 62263 376020408 GOV 14300 0 23 FLEX GRANTS 47 0 PART I, LINE 2: ONCE IT IS DETERMINED THAT AN INDIVIDUAL OR ORGANIZATION WILL BE RECEIVING A GRANT AWARD, THEY ARE ISSUED A TRACKING NUMBER AND ENTERED INTO THE GRANT MONITORING DATABASE. THE DATABASE INCLUDES CONTACT INFORMATION FOR THE RECIPIENT, AS WELL AS PAYMENT TERMS, DATE, CHECK NUMBER, AND PAYMENT AMOUNT. AT THE END OF THE GRANT TERM OUTLINED IN THE GRANT AGREEMENT PROVIDED TO THE RECIPIENT A FINAL REPORT IS COMPLETED BY THE RECIPIENT AND SENT BACK TO ICAHN THROUGH THE MAIL OR ELECTRONICALLY WITH A SIGNATURE. ICAHN THEN REVIEWS THE REPORT AND COMPARES IT TO THE AGREEMENT TO ENSURE GRANT FUNDS WERE SPENT AS OUTLINED ON OCCASION. IF A RECIPIENT'S PROJECT IS NEEDED TO CHANGE DUE TO UNFORESEEN CIRCUMSTANCES, THE GRANTEE IS INSTRUCTED TO REQUEST WRITTEN PERMISSION FROM ICAHN AUTHORIZING THE CHANGE. A COPY OF THIS CORRESPONDENCE IS PLACED IN THE RECIPIENT'S GRANT FILE DOCUMENTING THE CHANGE TO THE GRANT PROJECT WHEN THE GRANT REPORT IS RECEIVED BY ICAHN. IT CAN THEN BE NOTED THAT THERE WAS AN AUTHORIZED CHANGE TO THE GRANT PROJECT. IN ADDITION TO THESE TRACKING PROCESSES, THE OPERATIONS COORDINATOR PERFORMS ONSITE VISITS TO GRANT RECIPIENTS OVER THE COURSE OF THE YEAR. DURING THESE VISITS, DOCUMENTATION SUCH AS INVOICES, RECEIPTS, AND FINANCIAL STATEMENTS ARE REVIEWED WITH COPIES OBTAINED, TO ENSURE GRANT FUNDS HAVE BEEN SPENT ON OUTLINED PROJECTS. THE OPERATIONS COORDINATOR PERFORMS ABOUT 12 ONSITE GRANT REVIEW VISITS PER YEAR. X X X X 0 0 0 1 0 0 0 0 0 PATRICIA SCHOU EXECUTIVE DIRECTOR 258049 0 21574 0 1232 0 8384 0 17138 0 306377 0 0 0 CURT ZIMMERMAN SR DIRECTOR OF BUSINESS SVCS & DEV 132883 0 11342 0 1153 0 4600 0 23956 0 173934 0 0 0 PART I, LINE 5 THE SENIOR DIRECTOR OF BUSINESS SERVICES IS PAID AN INCENTIVE ON A PERCENTAGE OF THE INSURANCE REVENUES PAID TO ICAHN DURING THE YEAR. ADDITIONAL INCENTIVES ARE PAID ON NEW BUSINESS PARTNER SPONSORSHIPS ADDED DURING THE YEAR, AND ON NEW ACCOUNTS ADDED UNDER CERTAIN BUSINESS SERVICE LINES, INCLUDING CVO SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ARE CRITICAL ACCESS HOSPITALS AND NECESSARY PROVIDER HOSPITALS RESIDING IN THE STATE OF ILLINOIS WHO HAVE PAID AN INITIAL MEMBERSHIP FEE OF FIVE THOUSAND DOLLARS ($5,000). EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. AS OF 2023 THE MEMBERSHIP DUES FOR THE YEAR ARE $9,000. FORM 990, PART VI, SECTION A, LINE 7A EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS MAY BE AMENDED AT ANY MEETING OF THE MEMBERSHIP PROVIDED A NOTICE SETTING FORTH THE AMENDMENT OR A SUMMARY OF THE CHANGES TO BE AFFECTED THEREBY IS GIVEN TO EACH MEMBER ENTITLED TO VOTE THEREON IN THE MANNER AND WITHIN THE TIME PROVIDED IN THE BYLAWS FOR THE NOTICE OF THE MEETING. NO AMENDMENT INCONSISTENT WITH THE ARTICLES OF INCORPORATION SHALL BE EFFECTIVE PRIOR TO AMENDMENT OF THE ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS PROVIDED TO BOTH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. THE GOAL IS TO PROVIDE THE REPORT TO BOTH PRIOR TO THE FILING, SO IF DISCREPANCIES ARE DISCOVERED, THERE IS TIME FOR CORRECTIONS IF DEEMED NECESSARY AFTER REVIEW, A MEETING WILL BE SCHEDULED FOR DISCUSSION AND FURTHER REVIEW OF THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK REQUIRES THEIR BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST ACTIVITY QUESTIONNAIRE ANNUALLY. ANY QUESTION OF WHETHER A CONFLICT EXISTS SHALL BE DECIDED UPON BY A MAJORITY VOTE OF THE DIRECTORS OR COMMITTEE MEMBERS, EXCLUDING THE DIRECTOR OR COMMITTEE MEMBER WITH A POSSIBLE CONFLICT IN THE CASE AN ACTUAL CONFLICT EXISTS, THE DIRECTOR OR MEMBER WITH THE CONFLICT MUST ABSTAIN FROM VOTING ON SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE FINANCE COMMITTEE OF THE ORGANIZATION RECOMMENDS TO THE BOARD THE APPROVAL OF THE FISCAL YEAR BUDGET WHICH INCLUDES SALARY INCREASES. INCREASES ARE THEN MADE BY THE EXECUTIVE DIRECTOR PRIOR TO THE START OF THE NEXT FISCAL YEAR. THE EXECUTIVE DIRECTOR'S CONTRACT ALLOWS FOR A YEARLY INCREASE PER BUDGET. THE EXECUTIVE DIRECTOR'S CONTRACT IS NEGOTIATED EVERY TWO TO THREE YEARS AND SALARY IS SET AT THAT TIME. THIS COMPENSATION IS SET BASED ON A COMPARISON REVIEW OF OTHER NETWORK DIRECTOR'S SALARIES AND COMPENSATION. OTHER ICAHN POSITIONS ARE BASED ON SIMILAR POSITIONS IN OTHER ORGANIZATIONS INCLUDED IN THE BUDGET PRESENTATION ARE BUDGET ASSUMPTIONS WHICH IDENTIFIES THE SALARY INCREASES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MANAGED CARE: PROGRAM SERVICE EXPENSES 191,009. MANAGEMENT AND GENERAL EXPENSES 44,805. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 235,814. OTHER FEES: PROGRAM SERVICE EXPENSES 257,371. MANAGEMENT AND GENERAL EXPENSES 67,148. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 324,519. EDUCATION: PROGRAM SERVICE EXPENSES 4,053. MANAGEMENT AND GENERAL EXPENSES 951. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,004. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS FOR DECONSOLIDATION OF AFFILIATE -1,214,074.