2016-02-12T10:35:08-06:00 2015-06-30 371335003 Eck Schafer & Punke LLP 227 South Seventh Street Springfield IL 62701 990 2014-07-01 364345660 CQuest America Inc CQUE 2175417460 500 South 9th Street Springfield IL 62701 H Kevin Davis President & CEO 2175417460 2016-02-11 1 Brent Leach P00331592 2175251111 2014 2016-08-17 19:52:53Z H Kevin Davis 500 South 9th Street Springfield IL 62701 8680412 0 X www.cquest.us X 1999 IL CQuest is a unique not-for-profit organization, dedicated to delivering information technology and services for health care, human services, and education customers. Through its Foundation, CQuest supports the delivery of quality health care to the medically underserved. 9 8 54 9 0 0 0 0 10848205 8427135 3474 551 344565 252726 11196244 8680412 281675 456000 0 0 3383846 3830871 0 0 0 6772982 4056268 10438503 8343139 757741 337273 2147919 1944439 1207824 667071 940095 1277368 X CQuest is a unique not-for-profit organization, dedicated to delivering information technology and services for health care, human services, and education customers. Through its Foundation, CQuest supports the delivery of quality health care to the medically underserved. 0 1 2087560 2918521 WIC System Development and Support. CQuest provides system operations and maintenance services for the WIC programs in the states of Kansas and New Hampshire as well as in the Inter Tribal Council of Arizona. In addition, CQuest develops WIC system features/upgrades that improve the functionality of the system for these clients. Finally, CQuest hosts the WIC systems for the State of Kansas and the State of New Hampshire. The clients utilize this system to provide services to patients enrolled in the WIC programs in their respective states. 2384183 3501582 Early Intervention/Centralized Billing Services Unit generates vouchers and payment records for claims on Illinois Early Intervention services. Illinois Early Intervention program is a statewide program administered by the Illinois Department of Human Services that provides early intervention services to children under 3 years of age who have developmental delays or disabilities. The Centralized Billing Services Unit also generates and processes recoupment payments to Medicaid, manages Family Participation Fees, and prints and distributes invoices, statements and reports to all the Early Intervention program stakeholders. From July 1, 2014 thru June 30, 2015, the Centralized Billing Services Unit processed approximately 1.4 million claims totaling over $100 million. There are over 5,000 service providers delivering early intervention services to more than 20,000 children across the state of Illinois at any given time. 1900905 1929500 CQuest provided training, maintenance, and software support services for the Illinois Primary Health Care Association's integrated Practice Management/Electronic Health Record/Electronic Dental Record system that 13 Federally Qualified Health Centers with delivery sites in medically underserved areas utilized during the year. CQuest ceased these program operations effective June 30, 2015.The goal of the network was to allow participating health centers to continue the services they provided to their community while realizing significant cost savings and benefits as a result of being part of a collaboration. The network facilitated further integration and use of new technologies to enhance communication, trust, and renewed working relationships between diverse health center partners. The network helped foster a working environment among health center partners, allowing for the free exchange of ideas and information between entities hundreds of miles away. Finally, it created additional commonality among partners and eliminated old excuses for not working together on common ground issues. 484677 456000 77532 The first program included in this secton is Catalyst. Catalyst is a grants management system that CQuest supports for various programs within Kentucky's Department of Public Health. The other relates to an annual contribution / grant to the Illinois Community Health Foundation, Inc. (ICHF) to help fulfill its ission, which is in alignment with Cquest's mission. ICHF's mission is listed in Schedule I, Part IV. 484677 456000 77532 6857325 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 8 0 54 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X Adam A Bruns CFO 2175417405 500 South 9th Street Springfield IL 62701 Bruce Johnson Board Chair 10.00 X X 0 0 0 Robert Klutts Vice-Chair 2.00 X X 0 0 0 Berneice Mills-Thomas Secretary 2.00 X X 0 0 0 Kim Mitroka Treasurer 2.00 X X 0 0 0 Melinda Whiteman Director 2.00 X 0 0 0 Dan Vicencio Director 2.00 X 0 0 0 Henry Taylor Director 2.00 X 0 0 0 Virgil Tolbert Director 2.00 X 0 0 0 James Nelson Director 2.00 X 0 0 0 Denise Rice Director 2.00 X 0 0 0 Kevin Davis President & CEO 40.00 X 229476 0 13484 Adam Bruns CFO 40.00 X 125201 0 19910 Brian Rogers VP of Product Development 40.00 X 106292 0 10184 460969 0 43578 3 0 1 0 PTSO of Washington 2101 Fourth Avenue Suite 850 Seattle WA 98121 IT Consulting Services 1471985 Itentive Healthcare Solutions 500 Park Boulevard Suite 40 Itasca IL 60143 IT Consulting Services 311600 Levi Ray & Shoup Inc 2401 West Monroe Springfield IL 62704 IT Consulting Services 115851 Ken Stanton Consulting 5010 Brassfield Drive SE Olympia WA 98501 IT Consulting Services 114550 4 Early Intervention/CBO 518210 3501582 3501582 WIC System Dev. and Su 541519 2918521 2918521 Practice Management/EM 541519 1929500 1929500 Catalyst Grants Mgmt S 541519 77532 77532 8427135 551 551 Leased Employees 561000 252726 252726 252726 8680412 8427135 0 253277 456000 456000 421843 274965 146878 2743852 2123738 620114 392220 324630 67590 272956 213793 59163 236609 78320 158289 22666 16187 6479 282787 280210 2577 78834 64240 14594 877629 678997 198632 124649 56117 68532 16909 14234 2675 8868 6787 2081 70109 56376 13733 35287 26977 8310 Other Professional Serv 992834 948408 44426 Equipment Maintenance 862686 842951 19735 Printing & Postage 264616 262194 2422 Licenses & Fees 159250 130568 28682 22535 1633 20902 8343139 6857325 1485814 0 542221 316876 1273120 936340 59966 171787 686915 304990 135101 381925 137511 137511 2147919 1944439 938879 501854 69231 174981 0 93964 95986 1207824 667071 X 940095 1277368 940095 1277368 2147919 1944439 337273 0 X 0 1 X 1 0 14959 14959 14959 1 Community Health PAC Inc 3109 Markwood Lane Springfield IL 62712 463222053 14959 Part I-A, Line 1: Contribution to Community Health PAC 27411 27411 0 637333 255408 381925 22171 22171 0 381925 Unamortized Goodwill from the November 2007 purchase of Starling Systems 137511 137511 Deferred Rent Obligation 19774 Capital Lease Obligation 76212 95986 X Part X, Line 2: CQuest follows accounting principles generally accepted in the United States of America which sets a minimum threshold for financial statement recognition of the benefit of a tax position taken or expected to be taken in a tax return. Tax positions for the open tax years as of June 30, 2015 were reviewed, and it was determined that no provision for uncertain tax positions is required. 1 Illinois Community Health Foundation Inc 500 South 9th Street Springfield IL 62701 463211226 501(c)(3) 456000 FMV N/A Support delivery of quality health care to the medically underserved. 1 0 Part I, Line 2: As part of CQuest's mission to suport the delivery of quality heatlh care to the medically underserved, a contribution to the Illinois Community Health Foundation, Inc. (Foundation) is approved by CQuest's Board of Directors during the annual budget process. The Foundation's purpose is to promote the health care welfare of medically underserved communities throughout the State of Illinois by providing funding opportunities to Illinois based state-wide Associations whose members are comprised of at least 90% federally qualified health centers or by providing funding opportunities directly to members of such Illinois based state-wide Associations. X X X X X 0 0 0 0 0 0 0 0 0 Kevin Davis President & CEO 199926 0 0 0 29550 0 0 0 13484 0 242960 0 0 0 Form 990, Part III, line 3 Through June 30, 2015, CQuest provided maintenance and support services for the Illinois Primary Health Care Association's integrated Practice Management/Electronic Health Record/Electronic Dental Record system that a network of Federally Qualified Health Centers with delivery sites in medically underserved areas utilized. These services also included data conversion, installation, training, and hosting. In July 2015, all data was deleted and securely disposed of in accordance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines and CQuest's security and privacy policies and procedures promulgated pursuant to HIPAA. Form 990, Part VI, Section B, line 11 CQuest's tax returns are prepared by independent accountants. After completion, review is done by the President & CEO and the CFO. Following review by the President & CEO and the CFO, the returns are distributed to the organization's Board of Directors who are given time to review and comment on the returns. The final step is submission to the Internal Revenue Service. Form 990, Part VI, Section B, line 12c CQuest has a written conflict of interest policy for all of its employees, including the President and CEO. Employees are asked to confirm annually, at the time of their performance review, that they have read the organization's conflict of interest policy. CQuest's Board of Directors also annually disclose if they have interests that could give rise to conflicts. Form 990, Part VI, Section B, line 15 CQuest utilizes an outside independent consultant to assist in establishing its compensation for the President & CEO and CFO. The consultant uses industry data including compensation studies, 990 tax returns of other organizations, and all other applicable sources to determine appropriate compensation levels. Form 990, Part VI, Section C, line 19 CQuest files annual audited financial statements with Dun and Bradstreet, which are available to the public. Form 990's and all applicable schedules are made available to the public upon request. Organizational policies are not made available to the general public. Community Health PAC Inc 3109 Markwood Lane Springfield IL 62712 463222053 PAC-Healthcare IL 527 CQuest America 0 Illinois Community Health Foundation Inc 500 South 9th Street Springfield IL 62701 463211226 To help disadvantaged Illinois communities meet their healthcare needs. IL 501(c)(3) N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 Illinois Community Health Foundation Inc B 456000 Fair Market Value