CAROLINA COLLABORATIVE COMMUNITY CARE INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CAROLINA COLLABORATIVE COMMUNITY CARE INC (EIN 20-1822815)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-02-01
- IRS object ID
- 201600329349300210
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-02-01T08:20:38-06:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560587513 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAIGH BYRD & LAMBERT LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 53349 | AddressLine1Txt |
| City | FAYETTEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 283053349 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201822815 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROLINA COLLABORATIVE COMMUNITY CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARO | BusinessNameControlTxt |
| Phone | 9104851250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 GREEN STREET | AddressLine1Txt |
| City | FAYETTEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KARIN SUESS | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9104851250 | PhoneNum |
| Signature | 2016-01-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TONYA R STRICKLAND | PreparerPersonNm |
| PTIN | P00095788 | PTIN |
| Phone | 9104831437 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KARIN SUESS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 GREEN STREET | AddressLine1Txt |
| City | FAYETTEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,109,494 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CAROLINACCC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE HEALTH OUTCOMES AND REDUCE MEDICAID COSTS | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 93 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $386,006 | PYContributionsGrantsAmt |
| CY Contributions Grants | $435,507 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,496,006 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,671,539 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,342 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,448 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,884,354 | PYTotalRevenueAmt |
| CY Total Revenue | $6,109,494 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,271,035 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,947,187 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,726,947 | PYOtherExpensesAmt |
| CY Other Expenses | $2,709,522 | CYOtherExpensesAmt |
| PY Total Expenses | $5,997,982 | PYTotalExpensesAmt |
| CY Total Expenses | $6,656,709 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$113,628 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$547,215 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,671,363 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,062,375 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $285,035 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $223,262 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,386,328 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,839,113 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ORGANIZATION PROVIDES CARE MANAGEMENT, CASE MANAGEMENT, DISEASE MANAGEMENT AND POPULATION MANAGEMENT SERVICES TO THE CAROLINA ACCESS MEDICAID POPULATION. ORGANIZATION ALSO WORKS COOPERATIVELY WITH COMMUNITY PHYSICIANS, HOSPITALS, HEALTH DEPARTMENT, DEPARTMENT OF SOCIAL SERVICES, AND MENTAL HEALTH CENTERS TO DEVELOP AND IMPLEMENT PROGRAMS THAT MEET THE HEALTH CARE NEEDS FOR THIS POPULATION WHILE REDUCING HEALTH CARE COSTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,774,929 | ExpenseAmt |
| Revenue | $5,671,539 | RevenueAmt |
| Desc | PRO-ACTIVELY MANAGES THE HEALTH CARE OF MEDICAID ENROLLEES BY EMPLOYING SUCH TOOLS AS RISK STRATIFICATION, DISEASE MANAGEMENT, CASE MANAGEMENT, AND ACCESS MANAGEMENT TO ESTABLISH THE CARE MANAGEMENT PROCESSES AND SUPPORT MECHANISMS NEEDED TO IMPROVE MEDICAID ENROLLEE CARE.CLINICAL IMPROVEMENT INITIATIVES INCLUDE: CASE MANAGEMENT OF HIGH RISK / HIGH COST PATIENTS, AGED / BLIND / DISABLED CHRONIC CARE MANAGEMENT, PREGNANCY HOME INITIATIVES, CHRONIC PAIN INITIATIVES, PALLIATIVE CARE INITIATIVES, ASTHMA DISEASE MANAGEMENT, HYPERTENSION / STROKE PREVENETION, DIABETES DISEASE MANAGEMENT, EMERGENCY DEPARTMENT INITIATIVES, PHARMACY MANAGEMENT INITIATIVES, AND MENTAL HEALTH INITIATIVES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $224,862 | ExpenseAmt |
| Desc | HEALTHNET GRANT (TDE) - COORDINATES THE RECEIPT OF HEALTH SERVICES TO LOW INCOME, UNINSURED RESIDENTS OF CUMBERLAND COUNTY THROUGH A NETWORK OF COLLABORATING HEALTHCARE PARTNERS. THESE INCLUDE THE LOCAL HOSPITAL, HEALTH DEPARTMENT, LOCALLY BASED COMMUNITY ORGANIZATIONS, AND INDIGENT CARE PROGRAMS. ENROLLEES ARE PROVIDED A MEDICAL HOME, ASSISTANCE IN GAINING ACCESS TO SPECIALTY CARE, MEDICATION ASSISTANCE PROGRAMS, AND CASE MANAGEMENT / DISEASE MANAGEMENT FOR HIGH RISK AND HIGH COST CONDITIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $176,000 | ExpenseAmt |
| Desc | PROVIDE COMPREHENSIVE MEDICAL AND EDUCATIONAL SERVICES TO UNINSURED DIABETIC RESIDENTS OF CUMBERLAND COUNTY. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $169,846 | ExpenseAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $169,846 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $6,345,637 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 12 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 93 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DR KARIN SUESS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9104851250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 GREEN STREET STE 1006 | AddressLine1Txt |
| City | FAYETTEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| KARIN SUESS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $129,938 | $0 | $2,832 | ||
| DEBORAH TEASLEY | |||||||
| CHAIRMAN | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| ROXIE WELLS | |||||||
| VICE CHAIRMAN | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| CANDICE YORK | |||||||
| TREASURER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| ANGELA WALL | |||||||
| SECRETARY | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| CYNDY KERN | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| BUCK WILSON | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| GAURI DAIVI | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| HANK DEBNAM | |||||||
| BOARD MEMBER | 10.00 | $0 | $0 | $0 | Yes (X) | ||
| REUBEN RIVERS | |||||||
| MEDICAL DIRECTOR | 5.00 | $9,350 | $0 | $0 | Yes (X) | ||
| BRENDA SPARKS | |||||||
| FORMER EXECUTIVE DIRECTOR | 10.00 | $116,230 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $255,518 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,832 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HEIDI MIDDENDORF | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 PROVIDENCE RD STE 5 | AddressLine1Txt |
| City | CHAPEL HILL | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27514 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CARE MANAGEMENT | ServicesDesc |
| Compensation | $116,314 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $100,723 | GovernmentGrantsAmt |
| All Other Contributions | $334,784 | AllOtherContributionsAmt |
| Total Contributions | $435,507 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID PAYMENTS | 624100 | $5,366,965 | $5,366,965 |
| HEALTH CHECK | 624100 | $127,043 | $127,043 |
| HEALTH CHOICE | 624100 | $99,259 | $99,259 |
| CASE MANAGEMENT SERVIC | 624100 | $78,272 | $78,272 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,671,539 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,448 | TotalRevenueColumnAmt |
| Exclusion | $2,448 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,109,494 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,671,539 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,448 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,938 | TotalAmt |
| Program Services | $103,950 | ProgramServicesAmt |
| Management And General | $25,988 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,164,889 | TotalAmt |
| Program Services | $3,008,440 | ProgramServicesAmt |
| Management And General | $156,449 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,174 | TotalAmt |
| Program Services | $19,165 | ProgramServicesAmt |
| Management And General | $1,009 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,571 | TotalAmt |
| Program Services | $343,786 | ProgramServicesAmt |
| Management And General | $16,785 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,615 | TotalAmt |
| Program Services | $259,143 | ProgramServicesAmt |
| Management And General | $12,472 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,336 | TotalAmt |
| Management And General | $4,336 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,500 | TotalAmt |
| Program Services | $500 | ProgramServicesAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $497,605 | TotalAmt |
| Program Services | $475,016 | ProgramServicesAmt |
| Management And General | $22,589 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $627 | TotalAmt |
| Program Services | $609 | ProgramServicesAmt |
| Management And General | $18 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,634 | TotalAmt |
| Program Services | $25,649 | ProgramServicesAmt |
| Management And General | $5,985 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,998 | TotalAmt |
| Program Services | $160,351 | ProgramServicesAmt |
| Management And General | $14,647 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,124 | TotalAmt |
| Program Services | $34,124 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,678 | TotalAmt |
| Program Services | $18,678 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,185 | TotalAmt |
| Program Services | $18,288 | ProgramServicesAmt |
| Management And General | $897 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,164 | TotalAmt |
| Program Services | $11,887 | ProgramServicesAmt |
| Management And General | $1,277 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OBCM TO CCHD | $1,615,696 | $1,615,696 | |
| CLINICAL SUPPORT / LABS | $151,764 | $151,764 | |
| SUPPLIES & PROGRAM EXPE | $35,194 | $23,783 | $11,411 |
| TELEPHONE | $25,893 | $23,727 | $2,166 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,124 | TotalAmt |
| Program Services | $51,081 | ProgramServicesAmt |
| Management And General | $20,043 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,656,709 | TotalAmt |
| Program Services | $6,345,637 | ProgramServicesAmt |
| Management And General | $311,072 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $963,395 | BOYAmt |
| EOY | $1,798,125 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,381,383 | BOYAmt |
| EOY | $111,750 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,000 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,585 | BOYAmt |
| EOY | $69,922 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,542 | BOYAmt |
| EOY | $20,951 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $215,788 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $157,345 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,682 | BOYAmt |
| EOY | $58,443 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,776 | BOYAmt |
| EOY | $3,184 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,671,363 | BOYAmt |
| EOY | $2,062,375 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $285,035 | BOYAmt |
| EOY | $223,262 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $285,035 | BOYAmt |
| EOY | $223,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,248,388 | BOYAmt |
| EOY | $1,839,113 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,940 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,386,328 | BOYAmt |
| EOY | $1,839,113 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,671,363 | BOYAmt |
| EOY | $2,062,375 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$547,215 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,499 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $129,669 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $270,099 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $386,006 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $435,507 | CurrentTaxYearAmt |
| Total | $1,276,780 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,499 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $129,669 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $270,099 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $386,006 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $435,507 | CurrentTaxYearAmt |
| Total | $1,276,780 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,276,780 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,867 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,887 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,342 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,448 | CurrentTaxYearAmt |
| Total | $29,069 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,305,849 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $26,128,846 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97770 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97400 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $215,788 | OtherCostOrOtherBasisAmt |
| Depreciation | $157,345 | DepreciationAmt |
| Book Value | $58,443 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $58,443 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $6,109,494 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,109,494 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,109,494 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,656,709 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,656,709 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,656,709 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FINANCE / AUDIT COMMITTEE WAS PROVIDED A DRAFT OF THE FORM 990 FOR THEIR REVIEW PRIOR TO THE SUBMISSION OF THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST STATEMENT AND POLICY ARE REVIEWD AND SIGNED BY THE BOARD MEMBERS ANNUALLY AT THE BOARD RETREAT. ALL NEW EMPLOYEES RECEIVE AND SIGN A CONFLICT OF INTERST STATEMENT DURING ORIENTATION. ALL EMPLOYEES REVIEW AND SIGN THE CONFLICT OF INTEREST STATEMENT ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR PERFORMS A SELF EVALUATION AND PRESENTS IT TO THE BOARD OF DIRECTORS. THE BOARD PERFORMS A REVIEW IN THE ABSENCE OF THE EXECUTIVE DIRECTOR. THE BOARD REVIEWS A MARKET ANALYSIS OF COMPARABLE SALARIES IN THE NONPROFIT INDUSTRY. THE BOARD PREPARES THE FINAL EVALUATION WHICH IS SIGNED BY THE EXECUTIVE DIRECTOR AND KEPT IN THE EXECUTIVE DIRECTOR'S PERSONNEL FILE. KEY EMPLOYEES ARE ALSO GIVEN A SELF EVALUATION THAT IS COMPLETED AND RETURNED TO THE EMPLOYEE'S SUPERVISOR. THE SUPERVISOR THEN EVALUATES THE EMPLOYEE AND DISCUSSES THE EVALUATION WITH THE EMPLOYEE. THE EMPLOYEE SIGNS THE EVALUATION AND IT IS KEPT IN THE EMPLOYEE'S PERSONNEL FILE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES INFORMATION AVAILABLE TO THE PUBLIC AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES UPON REQUEST |