2021-04-22T14:06:23-05:00 2020-06-30 951777440 GREEN HASSON & JANKS LLP 700 SOUTH FLOWER STREET SUITE 3300 LOS ANGELES CA 90017 990 2019-07-01 952769432 VENICE FAMILY CLINIC VENI 3103928630 604 ROSE AVENUE VENICE CA 90291 ELIZABETH B FORER CEO 3103928630 2021-04-22 1 LIZBETH G NEVAREZ P01399868 3108731600 2019 2022-09-23 18:48:47Z ELIZABETH B FORER 604 ROSE AVENUE VENICE CA 90291 61221484 0 X HTTP://WWW.VENICEFAMILYCLINIC.ORG/ X 1970 CA TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 21 21 427 662 0 0 17845497 29438260 31521106 29017288 310151 152080 0 0 49676754 58607628 0 0 0 0 36790161 44128618 0 0 2813597 12552076 12828003 49342237 56956621 334517 1651007 38471906 47529034 887290 8125950 37584616 39403084 TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 0 0 45879073 29017288 VFC SERVES AS A MEDICAL HOME, PROVIDING COORDINATED AND COMPREHENSIVE PRIMARY CARE, SPECIALTY CARE, AND ENABLING SERVICES FOR LOW-INCOME, UNINSURED, AND HOMELESS FAMILIES AND INDIVIDUALS. IT SERVES EVERYONE FROM INFANTS, CHILDREN, AND TEENS TO ADULTS AND SENIORS. VFC OFFERS A VARIETY OF SERVICES INCLUDING: MEDICAL PRIMARY AND SPECIALTY CARE, DENTAL, INTEGRATIVE MEDICINE, VISION SERVICES, PHARMACY, SUBSTANCE USE SERVICES, BEHAVIORAL HEALTH AND FOOD PROGRAMMING. VFC ALSO PROVIDES TREATMENT AND COUNSELING SERVICES TO HIV PATIENTS THROUGH ITS COMMON GROUND PROGRAM. VFC PROVIDES HEALTH CARE ON SIX DAYS AND FOUR EVENINGS PER WEEK. VFC'S PRIMARY SERVICE AREA INCLUDES VENICE, SANTA MONICA, PALMS, MAR VISTA, INGLEWOOD, CULVER CITY AND WEST LOS ANGELES, ALL IN LOS ANGELES COUNTY. 45879073 1 1 0 1 0 0 0 1 0 1 1 1 0 0 0 1 0 1 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 1 0 0 0 1 89 0 1 427 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X ANDREA BLACKBIRD 3106647941 604 ROSE AVENUE VENICE CA 90291 ELIZABETH B FORER CHIEF EXECUTIVE OFFICER 40.00 1.00 X 297010 0 84231 DESPINA G KAYICHIAN CHIEF MEDICAL OFFICER 40.00 0.00 X 295800 0 91027 MARGARITA LOEZA CHIEF MEDICAL INFORMATION 40.00 0.00 X 262983 0 81034 KAREN C LAMP ASSOCIATE MEDICAL DIRECTOR 36.00 0.00 X 257319 0 78926 BLANCA ANDRES ASSOCIATE MEDICAL DIRECTOR 36.00 0.00 X 242933 0 74066 COLEY MARVIN KING PHYSICIAN 40.00 0.00 X 239361 0 42170 ANITA MARIA ZAMORA CHIEF OPERATIONS OFFICER 40.00 0.00 X 238893 0 71860 CHARLES Q HUYNH PHYSICIAN 40.00 0.00 X 236497 0 45326 NAVEENA PONNUSAMY CHIEF DEVELOPMENT OFFICER 40.00 0.00 X 236378 0 75389 GILMORE SEISOON CHUNG PHYSICIAN 40.00 0.00 X 226269 0 37615 RIAN WELLINGTON RUTHERFORD PHYSICIAN 40.00 0.00 X 225328 0 41821 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 40.00 1.00 X 200895 0 64616 MICHELLE I AGUILAR PHYSICIAN 40.00 0.00 X 195899 0 36308 SHARON NG DIRECTOR OF PHARMACY 40.00 0.00 X 190976 0 57453 JASON VU HUA CHIEF INFORMATION OFFICER 40.00 0.00 X 174644 0 51010 STACEY ANN SCARBOROUGH DIR. OF HUMAN RESOURCES & HEAD START 40.00 0.00 X 169618 0 55860 JOHN GERESI BOARD CHAIR 2.00 2.00 X X 0 0 0 JOAN HERMAN CHAIR ELECT 2.00 2.00 X X 0 0 0 JEFFREY E SINAIKO TREASURER 2.00 2.00 X X 0 0 0 MICHAEL ST PIERRE SECRETARY 2.00 0.00 X X 0 0 0 JENIFER ANISMAN BOARD MEMBER 2.00 0.00 X 0 0 0 KEN BASCOM BOARD MEMBER 2.00 0.00 X 0 0 0 OLGA CARRASCO BOARD MEMBER 2.00 0.00 X 0 0 0 DIANA CARSOLA BOARD MEMBER 2.00 0.00 X 0 0 0 MAYER B DAVIDSON MD BOARD MEMBER 2.00 2.00 X 0 0 0 WILLIAM FLUMENBAUM BOARD MEMBER 2.00 2.00 X 0 0 0 ALLAN GORDON BOARD MEMBER 2.00 0.00 X 0 0 0 TARYN KEANE BOARD MEMBER 2.00 0.00 X 0 0 0 LOETTE LOSHAK BOARD MEMBER 2.00 0.00 X 0 0 0 EDITH J MADRID BOARD MEMBER 2.00 0.00 X 0 0 0 CAROLINA MONGE BOARD MEMBER 2.00 0.00 X 0 0 0 NEIL H PARKER MD BOARD MEMBER 2.00 2.00 X 0 0 0 PATRICIA RAMIREZ BOARD MEMBER 2.00 0.00 X 0 0 0 NADIA SHAHEEN BOARD MEMBER 2.00 0.00 X 0 0 0 CARMEN THOMAS-PARIS BOARD MEMBER 2.00 0.00 X 0 0 0 LEISA WU BOARD MEMBER 2.00 0.00 X 0 0 0 PAUL SABEN BOARD MEMBER 2.00 0.00 X 0 0 0 3690803 0 988712 25 0 1 0 BROTHERS MAINTENANCE SERVICES PO BOX 3283 WHITTIER CA 90605 CLEANING SERVICE 438786 RANDSTAD US LP PO BOX 894217 LOS ANGELES CA 90189 STAFFING SERVICES 430330 PEOPLE 20 GLOBAL INC PO BOX 31001-1288 PASADENA CA 91110 STAFFING SERVICES 144227 GIANT TECHNOLOGY 10366 CIRCULO DE JUAREZ FOUNTAIN VALLEY CA 92708 SQL PROGRAMMER 128400 4 2800000 15713937 10924323 29438260 THIRD PARTY REIMBURSEMENT 621400 20895720 20895720 MEDI-CAL PHARMACY 900099 8121568 8121568 29017288 222133 222133 2543803 2613856 -70053 -70053 -70053 58607628 29017288 0 152080 3431817 2835941 422747 173129 28187981 23341077 3414729 1432175 5014794 4117161 650393 247240 5208749 4276398 675548 256803 2285277 1876219 296389 112669 72198 72198 107202 107202 87672 87672 1560800 1078777 288090 193933 19909 5708 5598 8603 802105 621240 136909 43956 1065866 777190 214248 74428 1991584 1687777 284876 18931 173704 143632 24816 5256 38646 31921 5515 1210 11306 11306 887388 241632 641452 4304 468398 379264 54647 34487 PHARMACEUTICAL SUPPLIES 2728083 2728083 LICENSES & FEES 646654 183849 380899 81906 EQUIPMENT 601763 270465 323000 8298 MED SUP & WASTE REMOVAL 544505 534589 1371 8545 1020220 748150 164346 107724 56956621 45879073 8263951 2813597 802 1402 4627624 11706071 8003069 7269540 4242588 2377654 286904 270027 171418 260870 20966936 13460827 7654921 7506109 182 7984274 13153830 8011787 330568 2141300 38471906 47529034 887290 1453850 0 6672100 887290 8125950 X 24922381 25003037 12662235 14400047 37584616 39403084 38471906 47529034 X 1651007 163465 3996 X 0 1 X 1 1 1 X 21188376 18705895 15571302 17845497 29438260 102749330 21188376 18705895 15571302 17845497 29438260 102749330 3738164 99011166 53304 104279 125905 409836 222133 915457 103664787 141234409 0.95510 0.94720 X SCHEDULE A, PART II VENICE FAMILY CLINIC IS EXEMPT UNDER 509(A)(1) AND 170(B)(1)(A)(III). THE ORGANIZATION HAS MADE AN ELECTION TO COMPLETE SCHEDULE A, PART II, SECTION A. PUBLIC SUPPORT. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 33762 0 0 33762 0 PART II-B, LINE 1: DURING THE 2019-2020 FISCAL YEAR, VENICE FAMILY CLINIC'S IN-HOUSE ADVOCACY TEAM AND ITS PUBLIC POLICY COMMITTEE, BOTH COMPRISED OF STAFF AND BOARD MEMBERS, ADDRESSED HEALTH CARE POLICY ISSUES AT THE LOCAL, STATE AND FEDERAL LEVELS. ON THE FEDERAL LEVEL, WE WORKED TO EDUCATE OUR ELECTED OFFICIALS ABOUT TITLE X AND PUBLIC CHARGE CHANGES THAT HAVE HAD SERIOUS NEGATIVE CONSEQUENCES FOR THE MOST ECONOMICALLY DISADVANTAGED MEMBERS OF OUR COMMUNITY AND THE PROVIDERS TREATING THEM. WE ALSO LOBBIED FOR CONTINUED COMMUNITY HEALTH CENTER FUNDING AND RAISING AWARENESS OF HOMELESS ISSUE ON A FEDERAL LEVEL. A SMALL GROUP OF VENICE FAMILY CLINIC STAFF AND BOARD MEMBERS ATTENDED THE FAMILIES USA ANNUAL CONFERENCE IN WASHINGTON, DC IN JANUARY 2020 AND MET WITH LEGISLATORS TO DISCUSS THESE AND OTHER ISSUES IN PERSON. WITH THE START OF THE COVID-19 PANDEMIC IN MARCH, WE ADVOCATED FOR ADEQUATE PPE AND EQUITABLE COVID-19 TESTING SUPPLIES. ON THE STATE LEVEL, VENICE FAMILY CLINIC PARTICIPATED IN MEETINGS IN SACRAMENTO WITH LEADERS FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION AND THE DEPARTMENT OF HEALTH CARE SERVICES TO DISCUSS HOW THE PROPOSED PHARMACY TRANSITION WOULD NEGATIVELY IMPACT COMMUNITY HEALTH CENTERS AND THE PATIENTS THEY SERVE. LOCALLY, OVER THE PAST YEAR, VENICE FAMILY CLINIC WORKED CLOSELY WITH THE MAYOR'S OFFICE, OUR LOCAL COUNCILMEMBER'S OFFICE, SEVERAL OF OUR LONGTIME COMMUNITY PARTNERS AND MEMBERS OF OUR COMMUNITY EXPERIENCING HOMELESSNESS TO ADDRESS ISSUES RELATED TO INCREASING RESOURCES FOR THE LARGE AND GROWING UNHOUSED POPULATION IN VENICE AND SURROUNDING COMMUNITIES. THE GOAL OF ALL OF VENICE FAMILY CLINIC'S ADVOCACY EFFORTS IS TO INCREASE ACCESS TO AND QUALITY OF CARE FOR THE MEDICALLY UNDERSERVED, THEREBY FURTHERING THE CLINIC'S MISSION TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 21000 0 5918387 50000 -7100 -293801 5667486 6184965 50000 180189 -496765 5918387 5816199 50000 560879 -242113 6184965 5240862 50000 775581 -250244 5816199 5731858 50000 -262704 -278292 5240862 0.00000 0.89490 0.10510 0 0 1116512 1116512 7885906 5663560 2222346 8979538 5541770 3437768 2984980 2255497 729483 7506109 UCLA EIP FUND 5667486 F UCLA STIP FUND 2344301 F 8011787 X PART V, LINE 4: INTEREST/DIVIDEND INCOME FROM THE CLINIC'S ENDOWMENT FUNDS ARE USED TO PAY FOR THE SALARIES & BENEFITS OF PHYSICIANS AND OTHER PROVIDERS. PART X, LINE 2: THE VENICE FAMILY CLINIC RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEAR ENDED JUNE 30, 2020, THE VENICE FAMILY CLINIC PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AND DID NOT NOTE ANY MATTERS THAT WOULD REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OR WHICH MIGHT HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. X X 0 0 0 0 0 0 0 0 0 ELIZABETH B FORER CHIEF EXECUTIVE OFFICER 297010 0 0 0 0 0 45210 0 39021 0 381241 0 0 0 DESPINA G KAYICHIAN CHIEF MEDICAL OFFICER 295800 0 0 0 0 0 48858 0 42169 0 386827 0 0 0 MARGARITA LOEZA CHIEF MEDICAL INFORMATION 262983 0 0 0 0 0 43494 0 37540 0 344017 0 0 0 KAREN C LAMP ASSOCIATE MEDICAL DIRECTOR 257319 0 0 0 0 0 42363 0 36563 0 336245 0 0 0 BLANCA ANDRES ASSOCIATE MEDICAL DIRECTOR 242933 0 0 0 0 0 39754 0 34312 0 316999 0 0 0 COLEY MARVIN KING PHYSICIAN 239361 0 0 0 0 0 22634 0 19536 0 281531 0 0 0 ANITA MARIA ZAMORA CHIEF OPERATIONS OFFICER 238893 0 0 0 0 0 38570 0 33290 0 310753 0 0 0 CHARLES Q HUYNH PHYSICIAN 236497 0 0 0 0 0 24328 0 20998 0 281823 0 0 0 NAVEENA PONNUSAMY CHIEF DEVELOPMENT OFFICER 236378 0 0 0 0 0 40464 0 34925 0 311767 0 0 0 GILMORE SEISOON CHUNG PHYSICIAN 226269 0 0 0 0 0 20189 0 17426 0 263884 0 0 0 RIAN WELLINGTON RUTHERFORD PHYSICIAN 225328 0 0 0 0 0 22447 0 19374 0 267149 0 0 0 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 200895 0 0 0 0 0 34682 0 29934 0 265511 0 0 0 MICHELLE I AGUILAR PHYSICIAN 195899 0 0 0 0 0 19488 0 16820 0 232207 0 0 0 SHARON NG DIRECTOR OF PHARMACY 190976 0 0 0 0 0 30837 0 26616 0 248429 0 0 0 JASON VU HUA CHIEF INFORMATION OFFICER 174644 0 0 0 0 0 27379 0 23631 0 225654 0 0 0 STACEY ANN SCARBOROUGH DIR. OF HUMAN RESOURCES & HEAD START 169618 0 0 0 0 0 29982 0 25878 0 225478 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THIS QUESTION IS NOT APPLICABLE AS THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE AUDIT COMMITTEE. ONCE APPROVED BY THE AUDIT COMMITTEE, THE RETURN IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ELECTRONIC FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONNAIRES ARE GIVEN TO BOARD MEMBERS TO DISCLOSE ANY CONFLICTS. IF A CONFLICT IS DISCLOSED IN THE ANNUAL QUESTIONNAIRE, THE INDIVIDUAL WILL BE ASKED TO RECUSE THEMSELVES FROM ANY CONVERSATIONS PERTAINING TO THIS CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY, WITH THE CEO'S PARTICIPATION. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE IN BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS 3,998. BAD DEBT EXPENSE -2. VENICE FAMILY CLINIC FOUNDATION 604 ROSE AVENUE VENICE CA 90291 273484548 TO SUPPORT VENICE FAMILY CLINIC CA 501(C)(3) LINE 7 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0