2019-11-12T00:30:25-06:00 2018-12-31 330835986 SQUAR MILNER LLP 135 MAIN STREET 9TH FLOOR SAN FRANCISCO CA 941051815 990 2018-01-01 942944137 PATIENT ASSISTANCE FOUNDATION PATI 4159233155 2100 WEBSTER STREET SUITE 100 SAN FRANCISCO CA 94115 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 4159233155 2019-11-15 1 JOUA LO P01225144 4157812500 71.6.48.101 2019-11-07 11:34:41 PS P E2EA9FACFDC92D91A7B2E1D38CDE8E962D13A943 04688926A99AB1187F8A3E5828E2B676A02AA1A4 2018 2020-03-31 21:24:44Z COMMUNITY HEALTH RESOURCE CENTER SCOTT PLYMALE 2100 WEBSTER STREET SUITE 100 SAN FRANCISCO CA 94115 1047369 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 10 16 0 0 389771 365307 314437 322718 23659 40839 16989 13242 744856 742106 0 0 0 0 658234 674815 0 0 60027 393168 418045 1051402 1092860 -306546 -350754 3847625 3392119 45246 53291 3802379 3338828 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 444813 310313 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. 346897 1790 HEALTH EDUCATION -- THE ORGANIZATION OFFERS MONTHLY WELLNESS EVENTS THAT INCLUDE HEALTH SCREENINGS, COMMUNITY EDUCATION LECTURES AND EMPLOYEE WELLNESS PRESENTATIONS. 124305 10615 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. 916015 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 21 0 1 10 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 CHARLES SELLMAN 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 ANDREW KLOMPUS MD DIRECTOR (PART YEAR) 2.00 X 0 0 0 JEAN-LUC LAMIRANDE DIRECTOR 2.00 X 0 0 0 ELIZA MCCAW MD 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 (PART YEAR) 2.00 X 0 0 0 NENA MONTGOMERY DIRECTOR - ADVISORY BOARD 2.00 X 0 0 0 FRANK HUANG DIRECTOR 2.00 X 0 0 0 SCOTT PLYMALE LCSW EXECUTIVE DIRECTOR 40.00 X 151692 0 13148 151692 0 13148 1 0 0 0 0 365307 365307 PROGRAM 900099 322718 322718 322718 29094 29094 12000 0 12000 12000 12000 317008 305263 11745 11745 11745 OTHER INCOME 900099 1242 1242 1242 742106 322718 0 54081 X 164840 164840 393288 327805 31732 33751 116687 101606 7309 7772 57737 57737 146360 137225 8987 148 27849 24381 2684 784 146776 138386 4109 4281 9049 8530 254 265 14632 10596 3708 328 MISCELLANEOUS 15642 2646 298 12698 1092860 916015 116818 60027 153245 157156 2294225 1941622 36160 17374 5583 7922 82114 52023 39141 30091 1313057 1231740 6214 6214 3847625 3392119 45246 53291 45246 53291 X 1594770 1426049 2207609 1912779 3802379 3338828 3847625 3392119 -350754 -112797 0 X 1 X 0 1 0 X 366958 787383 393141 389771 365307 2302560 366958 787383 393141 389771 365307 2302560 128685 2173875 26882 27249 28829 23659 41094 147713 44188 14515 13543 16989 1242 90477 2540750 1372126 0.85560 0.93600 X 0.93600 0.03270 SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 44,188. 2015 AMOUNT: $ 14,515. 2016 AMOUNT: $ 13,543. 2017 AMOUNT: $ 16,989. 2018 AMOUNT: $ 1,242. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2207609 284670 579500 1912779 2440683 328926 562000 2207609 2656802 357781 573900 2440683 2656802 2656802 0.00000 0.00000 1.00000 0 0 60016 34100 25916 22098 17923 4175 30091 INVESTMENTS - MARKETABLE SECURITIES 1231740 F 1231740 629309 -112797 -112797 742106 0 742106 1092860 0 1092860 0 1092860 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 142692 0 9000 0 0 0 2900 0 10248 0 164840 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. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 137,225. MANAGEMENT AND GENERAL EXPENSES 8,987. FUNDRAISING EXPENSES 148. TOTAL EXPENSES 146,360.