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      <Desc>Blue Mountain Clinic is a mission-driven 501(c)3 non-profit corporation organized in the state of Montana and is governed by a volunteer board of directors. Located at 610 N California Street in Missoula, MT, we are the only independent, non-government funded primary and family medicine clinic in the United States that has fully integrated family medicine, mental health counseling, abortion care, and comprehensive trans* care into our daily practice. We are not subsidized by any government money, are not a title X organization and do not offer a sliding fee scale for services. Because of this we are not eligible for many programs that offer amenities such as discounted birth control, sliding scales and large government grants. While such programs can be beneficial, we have always held the belief that we do not want federal regulations to influence how we care for our patients. This status does allow us to have complete autonomy in how we provide care while staying committed to our mission. BMC directly impacts the lives of over 10,000 patients per year who access a wide range of health services within our choice-based, primary medicine model. This is evidenced by the fact that 25% of our clients are traveling 100 miles or more to receive care at BMC. Since 2013 the demand for our care has increased by almost 30%. Blue Mountain Clinic is called upon daily by those who need care for their families, at an ever-increasing rate. This is a direct reflection of changes in our current healthcare environment; expanded services at BMC, lack of access due to clinic closures both in our region, and across the state, the retirement of several local family medicine doctors, anti-choice legislation, and most recently the expansion of Medicaid programs in Montana.In addition to our primary and reproductive care clients, we have been providing care to transgender patients throughout the Northern Rockies for over 16 years. In 2012, after receiving a grant from the Pride Foundation, we further strengthened our Trans* care through training, advocacy and marketing. Because of these trainings we have more than quadrupled the number of trans* identified patients we care for ranging in age from 9 to 72 years old. Per the US Census Bureau, Montana and the Northern Rockies are home to some of the least populated regions, resulting in a large concentration of rural areas. These sparsely populated areas often result in very limited access to many of lifes necessities, including health care. Reports released by the American Medical Association and the American Academy of Family Physicians indicate that we will continue to experience a critical shortage of family medicine clinicians and clinics. The shortage is due in part to retiring physicians as well as a recent trend emerging where providers are choosing specialty areas of medicine over family medicine because they offer much higher salaries. In a report released by the Montana Office of Rural Health (MORH) a serious shortage of primary care physician services is cited in Montana. The distribution of physicians in Montana is extremely uneven, with 37% of all primary care physicians practicing in only three cities and 40 of Montana's 56 counties are designated health professional shortage areas. As we witness these changes and prepare for great uncertainty in the landscape of our healthcare both regionally and nationally, it is of the utmost importance that we remain a sound presence to ensure access to independent, choice-based health care that respects the power of personal connection.We are starting our 9th year providing critical gynecological training to residents in the Western Montana Family Medicine Residency Program. We train 10 residents a year preparing them to provide comprehensive reproductive and family medicine through our choice-based lens. We are striving to ensure these residents will continue to practice and provide care filling the need for healthcare in our rural areas, many of which Blue Mountain Clinic currently serves.</Desc>
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      <GrantsToDomesticIndividualsGrp>
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      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
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      <BenefitsToMembersGrp>
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      <CompCurrentOfcrDirectorsGrp>
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        <ManagementAndGeneralAmt>32590</ManagementAndGeneralAmt>
        <FundraisingAmt>10863</FundraisingAmt>
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      <CompDisqualPersonsGrp>
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        <ProgramServicesAmt>834279</ProgramServicesAmt>
        <ManagementAndGeneralAmt>98151</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>22559</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7520</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>31626</ProgramServicesAmt>
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        <ProgramServicesAmt>49567</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10854</ManagementAndGeneralAmt>
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        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>327616</TotalAmt>
        <ProgramServicesAmt>327616</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>ELECTRONIC HEALTH RECORDS</Desc>
        <TotalAmt>97967</TotalAmt>
        <ProgramServicesAmt>97967</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>CONTRACTED SERVICES</Desc>
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        <ProgramServicesAmt>47042</ProgramServicesAmt>
        <ManagementAndGeneralAmt>698</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>DUES &amp; SUBSCRIPTIONS</Desc>
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        <ProgramServicesAmt>15895</ProgramServicesAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>614482</BOYAmt>
        <EOYAmt>547548</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>1211643</BOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
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      <ReconcilationRevenueExpnssAmt>119257</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>false</FSAuditedInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
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      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
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        <CurrentTaxYearMinus3YearsAmt>191239</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>320280</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>996312</CurrentTaxYearMinus1YearAmt>
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        <CurrentTaxYearMinus1YearAmt>1536723</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1559518</CurrentTaxYearAmt>
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      <GrossReceiptsNonUnrltBusGrp>
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        <CurrentTaxYearMinus2YearsAmt>610</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1599</CurrentTaxYearMinus1YearAmt>
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      <NetIncomeFromOtherUBIGrp>
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      <OtherIncome509Grp>
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      <TotalSupportCalendarYearGrp>
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        <CurrentTaxYearMinus3YearsAmt>1836290</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1915267</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2534634</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>2106841</CurrentTaxYearAmt>
        <TotalAmt>10210186</TotalAmt>
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      <PublicSupportCY509Pct>0.86350</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.85120</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00020</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00020</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB" softwareId="19009920" softwareVersionNum="2019v5.0">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
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        <ContributorUSAddress>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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        <BookValueAmt>79989</BookValueAmt>
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      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1905377</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>544969</DepreciationAmt>
        <BookValueAmt>1360408</BookValueAmt>
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      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>232871</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>218361</DepreciationAmt>
        <BookValueAmt>14510</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>24633</OtherCostOrOtherBasisAmt>
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        <BookValueAmt>6256</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>1461163</TotalBookValueLandBuildingsAmt>
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      <TotalLiabilityAmt>26165</TotalLiabilityAmt>
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    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="19009920" softwareVersionNum="2019v5.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CURRENT BOARD TREASURER REVIEWS THE 990 IN DETAIL WITH THE EXECUTIVE DIRECTOR. A DRAFT OF THE 990 IS THEN PRESENTED TO THE EXECUTIVE COMMITTEE. ANY CHANGES AND/OR SIGNIFICANT INFORMATION THAT IS RELEVANT TO BOARD MEMBERS IS PASSED ON TO THE BOARD FOR DISCUSSION PURPOSES VIA THE TREASURER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS AND KEY STAFF MEMBERS ARE ASKED TO DIVULGE ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO JOINING THE BOARD OR COMMENCING EMPLOYMENT AT THE CLINIC. BOTH BOARD AND STAFF MEMBERS UNDERGO A THOROUGH APPLICATION PROCESS DESIGNED TO PREVENT AND AVOID ANY POTENTIAL CONFLICTS OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION OF THE EXECUTIVE DIRECTOR AND THE MEDICAL DIRECTOR IS SUBJECT TO ANNUAL REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS. CHANGES TO COMPENSATION BASED ON PERFORMANCE EVALUATIONS, COST OF LIVING INCREASE, OR ANNUAL BUDGET CONSTRAINTS ARE REVIEWED AND VOTED ON BY THE BOARD AS A WHOLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>ANY OF THESE DOCUMENTS ARE READILY AVAILIBLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>