2020-11-16T15:45:23-06:00 2019-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2019-01-01 861174825 HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA HEAL 9165527629 1215 K STREET NO 730 SACRAMENTO CA 95814 JENNIFER NEWMAN CFO 9165527629 2020-11-09 1 TRACY S PAGLIA P00366884 2099556100 2020-11-09 172.9.161.112 2020-11-09 19:17:02 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 2019 2021-01-29 14:40:06Z BRYAN BUCKLEW 1215 K STREET NO 730 SACRAMENTO CA 95814 273156 0 X N/A X 2006 CA TO SUPPORT A WIDE RANGE OF HEALTH CARE ISSUES IN CALIFORNIA. 26 25 0 0 0 0 0 268500 0 0 4438 4656 0 0 4438 273156 86535 0 0 0 0 0 0 0 0 279156 395911 365691 395911 -361253 -122755 1719115 1982972 1384811 1787980 334304 194992 TO SPONSOR AND SUPPORT A WIDE RANGE OF HEALTH CARE ISSUES AND RESEARCH IN THE AREA OF HEALTH CARE IN CALIFORNIA. 0 0 270281 0 0 STANFORD HOSPITAL & CLINICS COMMUNITY PARTNERSHIP PROGRAM:SUPPORT OF THE MEDICAL RESPITE PROGRAM TO IMPROVE THE ACCESS TO HEALTHCARE, QUALITY OF LIFE AND FUNCTIONAL STATUS OF HOMELESS PATIENTS DISCHARGED FROM HOSPITALS IN SANTA CLARA COUNTY. 94178 0 0 EL CAMINO HOSPITAL AND HEALTHCARE DISTRICT:SUPPORT OF THE MEDICAL RESPITE PROGRAM TO IMPROVE THE ACCESS TO HEALTHCARE, QUALITY OF LIFE AND FUNCTIONAL STATUS OF HOMELESS PATIENTS DISCHARGED FROM HOSPITALS IN SANTA CLARA COUNTY. 8787 0 0 ABBOTT LABORATORIES HEALTHCARE WORKFORCE INITIATIVE (HLWI): TRAINING GRANTS PROGRAM FOR CLINICAL LABORATORY SCIENTIST (CLS) AND MEDICAL LABORATORY TECHNICIAN (MLT). 373246 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 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 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 26 25 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JENNIFER NEWMAN 9165527629 1215 K STREET SUITE 800 SACRAMENTO CA 95814 BRYAN J BUCKLEW PRESIDENT/CEO 0.50 40.00 X X 0 519738 46159 TODD A SUNTRAPAK CHAIR 0.50 1.00 X X 0 0 0 GRANT DAVIES CHAIR-ELECT (THRU 10/19) 0.50 1.00 X X 0 0 0 JUDY COFFEY PAST-CHAIR (THRU 3/19) 0.50 1.00 X X 0 0 0 EDMUNDO CASTANEDA SECRETARY/TREASURER 0.50 1.00 X X 0 0 0 JONATHON ANDRUS DIRECTOR 0.50 1.00 X 0 0 0 ERICK BERRY DIRECTOR (THRU 3/19) 0.50 1.00 X 0 0 0 WARREN S BROWNER MD MPH DIRECTOR 0.50 1.00 X 0 0 0 IRENE CHAVEZ DIRECTOR 0.50 1.00 X 0 0 0 CARMELA COYLE DIRECTOR 0.50 1.00 X 0 0 0 PETE DELGADO DIRECTOR 0.50 1.00 X 0 0 0 JEFF ELLER DIRECTOR 0.50 1.00 X 0 0 0 LUIS FONSECA DIRECTOR 0.50 1.00 X 0 0 0 ASH GOKLI MD MMM FACHE DIRECTOR 0.50 1.00 X 0 0 0 BILL GRAHAM DIRECTOR 0.50 1.00 X 0 0 0 CORWIN N HARPER MHA FACHE DIRECTOR 0.50 1.00 X 0 0 0 LAURIE HARTING DIRECTOR 0.50 1.00 X 0 0 0 MARY JO JACOBSON DIRECTOR 0.50 1.00 X 0 0 0 B KONARD JONES DIRECTOR 0.50 1.00 X 0 0 0 MARK LISA DIRECTOR 0.50 1.00 X 0 0 0 KELLY MATHER DIRECTOR 0.50 1.00 X 0 0 0 JOHN MCCORMICK DIRECTOR 0.50 1.00 X 0 0 0 CLINT PURVANCE MD DIRECTOR 0.50 1.00 X 0 0 0 PAUL RAINS RN MSN DIRECTOR 0.50 1.00 X 0 0 0 MATT REES DIRECTOR 0.50 1.00 X 0 0 0 TOMI RYBA DIRECTOR 0.50 1.00 X 0 0 0 MARTHA SAMORA RN CPHQ FACHE BSN DIRECTOR 0.50 1.00 X 0 0 0 BALJEET SANGHA DIRECTOR 0.50 1.00 X 0 0 0 STEVE STARK DIRECTOR 0.50 1.00 X 0 0 0 JENNIFER M NEWMAN SVP & CFO 0.50 1.00 X 0 0 0 0 519738 46159 0 0 1 1 HOMEFIRST SERVICES OF SANTA CLARA COUNTY 507 VALLEY WAY MILPITAS CA 95035 RESPITE SERVICES 340671 COMMUNITY HOMELESS SOLUTIONS PO BOX 1340 MARINA CA 93933 RESPITE SERVICES 286790 2 268500 268500 4656 4656 273156 0 0 4656 X 22655 22655 82581 82581 450 440 10 CASE MANAGEMENT 211047 211047 PATIENT/CLIENT SUPPORT 79178 79178 395911 373246 22665 0 1718610 1982432 0 540 505 0 1719115 1982972 41861 218893 93915 150155 1249035 1418932 1384811 1787980 X 213679 194992 120625 0 334304 194992 1719115 1982972 X -122755 -16557 X 0 1 X 1 0 X X X 1 HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA 941533644 10 1 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 3B: AS PART OF THE REQUIREMENTS OF SUPPORTING A 501(C)(6) ORGANIZATION, HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA (HFNCC) CONFIRMS EACH YEAR THAT ITS SUPPORTED ORGANIZATION, HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA (HCNCC), QUALIFIES AS A 501(C)(3) PUBLIC CHARITY UNDER 509(A)(2) THROUGH REGULAR CONSULTATIONS, AN ANNUAL REVIEW OF FORM 990, AND COMPLETION OF THE SCHEDULE A, PART III PUBLIC SUPPORT TEST. THIS PROCESS WAS UNDERTAKEN IN 2020 TO VERIFY THAT HCNCC CONTINUED TO QUALIFY TO BE A SUPPORTED ORGANIZATION OF HFNCC. PART IV, SECTION A, LINE 3C: TO THE KNOWLEDGE OF HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA ALL SUPPORT PROVIDED TO HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA WAS USED EXCLUSIVELY FOR 170(C)(2) PURPOSES AS CONFIRMED THROUGH REGULAR REPORTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 FUNDS HELD FOR PROJECTS 1418932 1418932 X 256599 0 256599 16557 16557 273156 395911 0 395911 0 395911 PART X, LINE 2: THE FOUNDATION IS A NONPROFIT PUBLIC BENEFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAX CODE SECTION 23701E. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN THE EVENT THE FOUNDATION HAD A TAX PROVISION THAT WAS UNCERTAIN OF BEING SUSTAINED, THE FOUNDATION WOULD APPLY THE MINIMUM PROBABILITY THRESHOLD TO DETERMINE WHETHER A FINANCIAL STATEMENT LIABILITY OR BENEFIT SHOULD BE RECOGNIZED. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2019 OR 2018. PART XI, LINE 4B - OTHER ADJUSTMENTS: PLEDGE REFUNDED 16,557. 0 0 0 0 0 0 0 0 0 BRYAN J BUCKLEW PRESIDENT/CEO 0 486470 0 0 0 33268 0 19600 0 26559 0 565897 0 0 PART II: THE FOUNDATION'S OFFICERS AND KEY EMPLOYEES WERE PAID WAGE COMPENSATION BY CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) FOR SERVICES PROVIDED TO HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA (HCNCC). SEE COMPENSATION AMOUNTS ON SCHEDULE J, PART II. THE COMPENSATION PAID BY CAHHS WAS REIMBURSED BY HCNCC UNDER A LEASED EMPLOYEE ARRANGEMENT. THE FOUNDATION DID NOT REIMBURSE CAHHS FOR ANY COMPENSATION REPORTED. FORM 990, PART VI, SECTION A, LINE 6 THE FOUNDATION'S SOLE MEMBER IS HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA, A CALIFORNIA NONPROFIT MUTUAL BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA ELECTS THE FOUNDATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS CERTAIN RESERVED POWERS: A. MATERIALLY CHANGING THE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE FOUNDATION; B. ENGAGING IN ANY MERGER, CONSOLIDATION, AFFILIATION, OR DISSOLUTION OF THE FOUNDATION; C. ENGAGING IN ANY SALE, LEASE, DISPOSITION OR HYPOTHECATION OF ANY ASSET OWNED BY THE FOUNDATION, WHERE THE MARKET VALUE OF SUCH ASSET EQUALS OR EXCEEDS $100,000.00; D. ENTERING INTO ANY CONTRACT, LEASE, OR OTHER OBLIGATION NOT OTHERWISE APPROVED IN THE ANNUAL BUDGET THAT CREATES AN AGGREGATE OBLIGATION FOR THE FOUNDATION IN EXCESS OF $100,000.00 IN ANY CONSECUTIVE TWELVE (12) MONTHS; E. ENTERING INTO ANY CONTRACT, LEASE OR OTHER OBLIGATION NOT OTHERWISE APPROVED IN THE ANNUAL BUDGET WHERE THE DURATION OF THE FOUNDATION'S OBLIGATION IS IN EXCESS OF 24 MONTHS; F. ADMISSION OF ANY OTHER MEMBERS; G. RELINQUISHING OR ALTERING THE TAX-EXEMPT STATUS OF THE FOUNDATION; H. MATERIALLY CHANGING THE CORPORATE STRUCTURE OF THE FOUNDATION OR ANY OF ITS COMPONENT PARTS; AND I. AMENDING, RESTATING, OR RESCINDING THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWS AND APPROVES THE FORM 990 WITH MANAGEMENT PRIOR TO FILING. THE FOUNDATION'S GOVERNING BODY IS PROVIDED WITH A COPY OF FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS EACH MEMBER OF THE BOARD OF DIRECTORS; THE PRESIDENT/CHIEF EXECUTIVE OFFICER; CHIEF FINANCIAL OFFICER; KEY EMPLOYEES; ANY PERSON WHO HAS HELD ONE OF THOSE POSITIONS DURING THE PRECEDING FIVE YEARS; FAMILY MEMBERS; AND CERTAIN CONTROLLED ORGANIZATIONS (INTERESTED PERSONS). ALL INTERESTED PERSONS ANNUALLY SIGN A STATEMENT THAT AFFIRMS RECEIPT AND AGREEMENT TO COMPLY WITH THE POLICY AND TO DISCLOSE ANY FINANCIAL INTERESTS OR FAMILY RELATIONSHIPS THAT COULD GIVE RISE TO A CONFLICT OF INTEREST. EACH INTERESTED PERSON IS REQUIRED TO DISCLOSE TO THE BOARD (OR COMMITTEE THEREOF), ALL MATERIAL FACTS REGARDING THE FINANCIAL INTEREST OR RELATIONSHIP IN THE TRANSACTION. WITH REGARD TO AN INTERESTED PERSON, THE BOARD OR COMMITTEE DETERMINES IF A CONFLICT OF INTEREST EXISTS. THE INSIDER(S) INVOLVED WITH THE TRANSACTION WILL NOT BE PRESENT DURING THE BOARD OR COMMITTEE'S DISCUSSION OR DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, AND MAY NOT VOTE ON THE TRANSACTION OR COUNTED IN DETERMINATION OF A QUORUM. ALL PROCEEDINGS ARE DOCUMENTED IN MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 82,581. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 82,581. FORM 990, PART XI, LINE 9: PLEDGE REFUNDED -16,557. HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA 1215 K STREET SUITE 730 SACRAMENTO CA 95814 941533644 MEMBERSHIP SERVICES TO NORTHERN AND CENTRAL CALIFORNIA HOSPITALS CA 501(C)(6) N/A 0 HEALTHPLUS SHARED SERVICES INC 1215 K STREET SUITE 800 SACRAMENTO CA 95814 942685988 PROVIDING BUSINESS SERVICES FOR HOSPITALS CA N/A C 0 BEACON PATIENT SAFETY COLLABORATIVE 1215 K STREET SUITE 730 SACRAMENTO CA 95814 INACTIVE CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0