2022-11-15T20:25:20-06:00 2021-12-31 390859910 BAKER TILLY US LLP 18500 VON KARMAN AVE 10TH FLOOR IRVINE CA 92612 990 2021-01-01 942944137 PATIENT ASSISTANCE FOUNDATION PATI 4159233155 2100 WEBSTER STREET SUITE 100 SAN FRANCISCO CA 94115 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 4159233155 2022-11-08 1 SCOTT PLYMALE LCSW XXX-XX-XXXX BRIAN YACKER P00401346 9492222999 2022-11-08 X 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z COMMUNITY HEALTH RESOURCE CENTER SCOTT PLYMALE 2100 WEBSTER STREET SUITE 100 SAN FRANCISCO CA 94115 1232528 0 X CHRCSF.ORG X 1984 CA TO PROVIDE AND PROMOTE INNOVATIVE HEALTH CARE AND HEALTH MAINTENANCE PROGRAMS TO THE GREATER BAY AREA AS WELL AS PATIENTS SERVED BY CPMC. CHRC PROVIDES COUNSELING, EDUCATION AND COORDINATION OF MULTIPLE PATIENT SERVICES TO SUPPLEMENT THE CARE AND SUPPORT PROVIDED BY PHYSICIANS. 15 15 16 15 0 0 286291 445473 456357 569812 66089 91015 19064 93 827801 1106393 0 0 0 0 946291 1033474 0 0 54159 270109 373844 1216400 1407318 -388599 -300925 3141067 2827445 229548 125235 2911519 2702210 X TO PROVIDE AND PROMOTE INNOVATIVE HEALTH CARE AND HEALTH MAINTENANCE PROGRAMS TO THE GREATER BAY AREA AS WELL AS PATIENTS SERVED BY CPMC. CHRC PROVIDES COUNSELING, EDUCATION AND COORDINATION OF MULTIPLE PATIENT SERVICES TO SUPPLEMENT THE CARE AND SUPPORT PROVIDED BY PHYSICIANS. 0 0 481284 3910 HEALTH EDUCATION -- THE ORGANIZATION OFFERS MONTHLY WELLNESS EVENTS THAT INCLUDE HEALTH SCREENINGS, COMMUNITY EDUCATION LECTURES AND EMPLOYEE WELLNESS PRESENTATIONS. 401297 565902 BEHAVIORAL/MENTAL HEALTH SERVICES AND NUTRITION COUNSELING -- THE ORGANIZATION HAS A TEAM OF LICENSED PROFESSIONALS OFFERING SUPPORT FOR INDIVIDUALS, GROUPS AND FAMILIES LOOKING FOR EMOTIONAL OR PRACTICAL GUIDANCE AND SUPPORT. LIKEWISE, THE ORGANIZATION HAS A TEAM OF REGISTERED DIETITIANS THAT PROVIDES NUTRITION COUNSELING SERVICES. THE ORGANIZATION'S NUTRITION SERVICES PROVIDE EDUCATION AND INSTRUCTION TO HELP SUPPORT ONE'S INDIVIDUAL VARIETY OF CONDITIONS, CONCERNS, GOALS AND LIFE STAGES. 248710 COVID RELIEF AND OTHER SUPPORT. 92021 HEALTH SCREENINGS -- THE ORGANIZATION PROVIDES BOTH GRANT-FUNDED AND CONTRACTED HEALTH SCREENING SERVICES AT EMPLOYEE HEALTH AFFAIRS, WELLNESS EVENTS, SCHOOLS AND COMMUNITY CENTERS. THE HEALTH SCREENING SERVICES, WHICH INCLUDE CHOLESTEROL, BLOOD GLUCOSE, BLOOD PRESSURE, BODY MASS INDEX, BONE DENSITY AND MEMORY SCREENS, ARE CONDUCTED BY REGISTERED NURSES. 92021 1223312 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 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 7 0 1 16 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X HALL TAI & ASSOCIATES 4155645183 1156 CLEMENT STREET SAN FRANCISCO CA 94118 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 40.00 X 153138 0 0 MARILYN KUTZSCHER MD PRESIDENT 2.00 X X 0 0 0 FRANK HUANG TREASURER - SECRETARY 2.00 X X 0 0 0 ARI BARON MD DIRECTOR 2.00 X 0 0 0 PETER CALLANDER DIRECTOR 2.00 X 0 0 0 SHELLY GORDON MD DIRECTOR 2.00 X 0 0 0 BARRY BARON MD DIRECTOR 2.00 X 0 0 0 HOLLY HOLTER MD DIRECTOR 2.00 X 0 0 0 NAVEEN SRIVATSA DIRECTOR 2.00 X 0 0 0 DAVID TONG MD DIRECTOR 2.00 X 0 0 0 RUSSELL WOO MD DIRECTOR 2.00 X 0 0 0 BROCK BERNSTEN MD DIRECTOR 2.00 X 0 0 0 CHARLES SELLMAN DIRECTOR 2.00 X 0 0 0 MARCY NATHAN DIRECTOR 2.00 X 0 0 0 BAGNA BRAESTRUP DIRECTOR 2.00 X 0 0 0 JEAN-LUC LAMIRANDE DIRECTOR 2.00 X 0 0 0 153138 0 0 1 0 1 0 0 139283 306190 445473 BEHAVIORAL/MENTAL HEAL 621400 565902 565902 HEALTH EDUCATION 611600 3910 3910 569812 42698 42698 12000 11907 93 93 93 162545 114228 48317 48317 48317 1106393 569812 0 91108 153138 91882 30628 30628 706608 693847 6337 6424 13679 12535 575 569 97356 89027 4176 4153 62693 57299 2694 2700 44680 44680 109745 94472 15106 167 1622 1553 34 35 13994 6977 1190 5827 10230 9810 209 211 154807 148417 3196 3194 964 784 180 19064 19064 6680 6404 138 138 6966 5213 1640 113 PROGRAM SUPPLIES 4853 4853 MEMBERSHIP DUES 239 239 1407318 1223312 129847 54159 210624 97057 31342 37390 1301632 888767 44300 88332 11045 8450 83202 75571 13223 7631 1522687 1693604 6214 6214 3141067 2827445 105265 125235 124283 0 229548 125235 X 1609887 1813443 1301632 888767 2911519 2702210 3141067 2827445 -300925 91616 0 X 0 0 0 X 389771 365307 323723 286291 445473 1810565 389771 365307 323723 286291 445473 1810565 218642 1591923 23659 41094 46724 40674 54698 206849 16989 1242 210 7064 25505 2042919 2085683 0.77920 0.77250 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 16,989. 2018 AMOUNT: $ 1,242. 2019 AMOUNT: $ 210. 2020 AMOUNT: $ 7,064. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1301632 412865 888767 1638933 337301 1301632 1912779 257939 531785 1638933 2207609 284670 579500 1912779 2440683 328926 562000 2207609 0.00000 0.00000 1.00000 0 0 60016 53122 6894 23186 22449 737 7631 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSET IS USED TO ACCOUNT FOR RESOURCES THAT ARE RESTRICTED BY THE DONOR FOR USE FOR PARTICULAR PURPOSE OR IN A PARTICULAR FUTURE PERIOD. WHEN A RESTRICTION EXPIRES, TEMPORARILY RESTRICED NET ASSETS ARE RECLASSIFIED TO UNRESTRICTED NET ASSETS AND REPORTED IN THE STATEMENT OF ACTIVITIES AS "NET ASSETS RELEASED FROM RESTRICTIONS. X X 0 0 0 0 0 0 0 0 0 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 143138 0 10000 0 0 0 0 0 0 0 153138 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B ELECTRONIC COPY OF 990 IS DISTRIBUTED TO EACH BOARD MEMBER FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST IS REVIEWED BY EACH OFFICER, DIRECTOR, OR KEY EMPLOYEE AT THE BEGINNING OF EACH MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST.