2021-10-10T20:23:23-05:00 2020-12-31 390859910 BAKER TILLY US LLP 135 MAIN STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2020-01-01 942944137 PATIENT ASSISTANCE FOUNDATION PATI 4159233155 2100 WEBSTER STREET SUITE 100 SAN FRANCISCO CA 94115 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 4159233155 2021-09-29 1 SCOTT PLYMALE LCSW XXX-XX-XXXX JOUA LO P01225144 4157812500 2021-09-29 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z COMMUNITY HEALTH RESOURCE CENTER SCOTT PLYMALE 2100 WEBSTER STREET SUITE 100 SAN FRANCISCO CA 94115 1059444 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. 14 14 14 14 0 0 323723 286291 422359 456357 33315 66089 16410 19064 795807 827801 0 0 0 0 802257 946291 0 0 51142 361810 270109 1164067 1216400 -368260 -388599 3237934 3141067 73583 229548 3164351 2911519 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 528520 453494 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. 447884 2310 HEALTH EDUCATION -- THE ORGANIZATION OFFERS MONTHLY WELLNESS EVENTS THAT INCLUDE HEALTH SCREENINGS, COMMUNITY EDUCATION LECTURES AND EMPLOYEE WELLNESS PRESENTATIONS. 84794 553 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. 1061198 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 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 10 0 1 14 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 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 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 - ADVISORY BOARD 2.00 X 0 0 0 BARRY BARON MD DIRECTOR 2.00 X 0 0 0 JOAN DEHOVITZ BRAUN 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 - ADVISORY BOARD 2.00 X 0 0 0 CHARLES SELLMAN DIRECTOR 2.00 X 0 0 0 MARCY NATHAN DIRECTOR 2.00 X 0 0 0 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 40.00 X 144355 0 7800 144355 0 7800 1 0 1 0 0 286291 286291 PROGRAM 900099 456357 456357 456357 28674 28674 12000 0 12000 12000 12000 269058 231643 37415 37415 37415 OTHER INCOME 900099 7064 7064 7064 827801 456357 0 85153 152155 152155 602949 531829 35409 35711 19788 17923 929 936 104205 94358 4896 4951 67194 60855 3155 3184 47195 47195 23413 20888 2525 495 473 11 11 19388 10203 4280 4905 6925 6608 158 159 148393 141593 3389 3411 7939 7573 182 184 6612 4879 1615 118 EQUIPMENT RENTAL, MAINT 11250 10729 258 263 STAFF DEVELOPMENT 1249 1132 58 59 MISCELLANEOUS -2750 -2750 1216400 1061198 104060 51142 210624 49801 31342 1638933 1301632 28877 44300 14006 11045 82115 68892 21162 13223 1478941 1522687 6214 6214 3237934 3141067 73583 105265 0 124283 73583 229548 X 1525418 1609887 1638933 1301632 3164351 2911519 3237934 3141067 -388599 135767 0 X 0 0 0 X 393141 389771 365307 323723 286291 1758233 393141 389771 365307 323723 286291 1758233 229935 1528298 28829 23659 41094 46724 40674 180980 13543 16989 1242 210 7064 39048 1978261 1849299 0.77250 0.84070 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 13,543. 2017 AMOUNT: $ 16,989. 2018 AMOUNT: $ 1,242. 2019 AMOUNT: $ 210. 2020 AMOUNT: $ 7,064. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1638933 337301 1301632 1912779 257939 531785 1638933 2207609 284670 579500 1912779 2440683 328926 562000 2207609 2656802 357781 573900 2440683 0.00000 0.00000 1.00000 0 0 60016 46793 13223 22099 22099 0 13223 INVESTMENTS - MARKETABLE SECURITIES 1522687 F 1522687 PPP LOAN PAYABLE 124283 124283 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 144355 0 0 0 0 0 7800 0 0 0 152155 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.